AIMS: To identify the effect on the family and/or caregivers when infants undergo brace treatment for developmental dysplasia of the hip (DDH) by integrating findings from a literature review and stakeholder survey. METHODS: Thematic analysis combining a comprehensive literature review and data from a UK-based online survey with international involvement. Identification of key themes related to the effect of brace treatment for DDH on the family/ caregivers. RESULTS: The literature review identified eight relevant articles for inclusion. The online survey had 131 participants. During the thematic analysis, ten key themes emerged, highlighting substantial emotional distress among parents, issues with information provision and consistency, and practical challenges related to clothing, feeding, and sleep. Additional concerns included cleanliness, equipment, child development concerns, infant discomfort, bonding, financial impact, and disruption to daily life. CONCLUSION: Brace treatment for DDH has a significant impact on various aspects of family life. Identifying the specific areas of family life affected by brace treatment enables recognition of key challenges, informing the development of robust support systems, clear communication strategies, and customized informational resources. While bracing remains the cornerstone of DDH management in infants, with proven effectiveness in achieving positive clinical outcomes, substantial uncertainties persist regarding critical aspects of treatment, including determining the severity of dysplasia that warrants brace treatment, the optimal duration of treatment, and the most effective approach to brace removal. Resolving these uncertainties requires well-designed randomized controlled trials to establish clear, evidence-based guidelines. Furthermore, evaluations of brace treatments should explicitly incorporate family-centred outcomes. Developing a core outcome set focused on family-relevant measures would significantly enhance the design, comparability, and quality of future DDH research.
\n \n\n \n \nWearable cuffless blood pressure (BP) technology is emerging as a critical tool for monitoring hypertension, the leading risk factor of most cardiovascular diseases. However, current cuffless BP methods are not accurate enough for clinical use, because they mainly use single or dual modalities/features as inputs for estimation. To address this challenge, we propose multimodal McBP-Net, built with hybrid CNN-LSTM architecture combing two-layer convolution operations with four-layer LSTMs to capture both local signal features and temporal dependencies for continuous dynamic beat-to-beat BP estimation. The McBP-Net includes photoplethysmographic, electrocardiographic, impedanceplethysmographic (IPG), and skin temperature (ST) signals as inputs. Validated on 23 subjects undergoing cold pressor test to induce large BP variability, the McBP-Net achieves the mean absolute errors of 4.19 and 2.98 mmHg for systolic BP (SBP) and diastolic BP (DBP), respectively, which fall within the accuracy range required by the Grade A of IEEE standard. The integration of four multimodal signals improves performance by 16.20%, 37.37%, and 49.52% over three-, dual-, and single-modality approaches, respectively, with significant contributions from IPG and ST signals. Notably, ST shows a strong nonlinear relationship with BP with high mutual information of 0.9056 for SBP. Furthermore, McBP-Net achieves a reasonable balance between accuracy and computational efficiency, offering inference speed of 36.7% faster and reducing computational demands by 78% compared to transformer-based models tested. Importantly, it maintains robust performance, with only a 0.21 mmHg degradation in dynamic SBP estimation when trained on rest-stage data. McBP-Net demonstrates promising potential in medical-grade wearable cuffless dynamic BP measurements.
\n \n\n \n \nHip fractures present some of the biggest challenges facing patients and healthcare systems. Worldwide, there are currently 1.3 million hip fractures per year, projected to rise to more than six million by 2050. The World Hip Trauma Evaluation (WHiTE) platform trial will provide randomized evidence dealing with the clinical and cost-effectiveness of interventions to improve outcomes for patients with a fragility fracture of the hip. The previous WHiTE cohort multiple-embedded trials' model was highly successful in delivering evidence to inform national and international policy and practice guidelines. This annotation addresses two questions: why change to a platform trial design? And what are the potential advantages and disadvantages of trials which use newer methodologies?
\n \n\n \n \nBACKGROUND: Evaluate functional and participation predictors of outcome following knee arthroplasty (KA) focusing on theInternational Classification of Functioning, Disability, and Health framework. METHODS: Secondary analysis of the CORKA randomised controlled trial, which included patients undergoing KA. The primary outcome was the Late-Life Function and Disability Instrument (LLFDI) was assessed using a linear mixed-effects model. Secondary outcomes with baseline assessments of the Physical Activity Scale for the Elderly (PASE), Figure of 8 Walk Test (F8WT), 30-Second Chair Stand Test (30CST), and single-leg stance on the operated leg (SLS) were used to predict functional and participation outcomes at 6, 12, and 24-months using multiple linear regression models. RESULTS: 621 participants were recruited (males 250, females 371), with a mean age of 70\u00a0\u00b1\u00a08 years. SLS significantly predicted LLFDI function across all time points (6-months 0.14, 0.06-0.22, p\u00a0=\u00a00.001, 12-months 0.18, 0.09-0.27, p\u00a0
\n \n\n \n \nUNLABELLED: Vertebral fragility fracture (VFF) incidence is rising with significant associated patient and health service burden. Patient education is core to effective VFF management and thus the focus of this robust literature review. Eight studies met review inclusion criteria with the limited evidence and inconsistent approach to education post VFF illustrated. PURPOSE: The incidence of vertebral fragility fracture is rising, associated with osteoporosis among an ageing global population. Most VFFs are managed conservatively with patient education, a core element of conservative management. This review aims to identify and synthesise the available literature regarding healthcare professional (HCP)-led patient education post VFF. METHODS: This review was registered on OSF [25] and conducted in accordance with the Joanna Briggs Institute methodology [21] for scoping reviews and guided by the Arksey and O'Malley Framework [22], using five key stages: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data and (5) charting, collecting and summarising the data. Six databases (Pubmed, ERIC, Embase, Cinahl, APA PsychINFO and Cochrane) were searched for papers published (in English) from January 2008 to November 2023, using a clearly defined search strategy. Predefined inclusion/exclusion criteria were used for screening papers using Covidence software [26] and a minimum of two independent reviewers. Data were extracted from full-text articles which met the inclusion criteria, with narrative synthesis of findings. Reporting of results adhered to the PRISMA-Scoping review checklist. RESULTS: Title and abstract screening was conducted for the 7177 retrieved studies. Of the 34 papers identified for full text review, 8 studies (from Canada, Norway, Sweden, China and the UK) met the scoping review inclusion criteria. These included four randomised controlled trials, one pilot RCT, one non RCT one retrospective analysis of data from patients with fragility fractures and one pre-post interventional study. Where specified in the papers, education providers were a mix of healthcare professionals (Physiotherapists, Nurses, Doctors, Dietitians, Occupational Therapists). Education was delivered in a variety of settings using verbal, written and visual communication media. The most common education topics were exercise, osteoporosis, nutrition and falls management. A diversity of outcome measures captured patient knowledge, quality of life, falls efficacy, physical function, balance and pain. CONCLUSION: Findings of this review demonstrate the limited evidence and an inconsistent approach to education post VFF in terms of education topics, mode of delivery and outcome measures. A range of HCP disciplines deliver education. Research is critically needed to inform the development and delivery of effective, evidence-based education interventions for VFF management.
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