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Mechanisms to support primary care to be research active (evidence summary)
No full textThis is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service
Disclaimer: We will endeavour to use the best, most appropriate and most recent sources available to ensure that the information supplied is accurate, up-to-date and evidence-based. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the search results. No responsibility can be taken by the library for any action taken on the basis of this information. New evidence may have been published since the date this evidence summary was created
OT for neuropathy following chemotherapy (evidence summary)
No full textThis is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service
Disclaimer: We will endeavour to use the best, most appropriate and most recent sources available to ensure that the information supplied is accurate, up-to-date and evidence-based. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the search results. No responsibility can be taken by the library for any action taken on the basis of this information. New evidence may have been published since the date this evidence summary was created
Patient Safety bulletin April 2025 (current awareness bulletin)
No full textThis is your monthly Current Awareness Bulletin produced by Somerset Foundation Trust Knowledge & Library Services. It is intended to provide you with a range of the most up-to-date resources, including recently published guidelines and research articles, news and policy items
Mobile Health Biometrics to Enhance Exercise and Physical Activity Adherence in Type 2 Diabetes (MOTIVATE-T2D): a decentralised feasibility randomised controlled trial delivered across the UK and Canada.
Full text link© Author(s) (or their
employer(s)) 2025. Re-use
permitted under CC BY.
Published by BMJ GroupObjectives Assess the feasibility of a mobile health (mHealth)-supported home-delivered physical activity (PA) intervention (MOTIVATE-T2D) in people with recently diagnosed type 2 diabetes (T2D).
Design Feasibility multicentre, parallel group, randomised controlled trial (RCT).
Setting Participants were recruited from England and Canada using a decentralised design.
Participants Adults (40–75 years) recently diagnosed with T2D (5–24 months).
Interventions Participants were randomised 1:1 to intervention (MOTIVATE-T2D) or active control groups. Participants codesigned 6month- home-delivered, personalised, progressive PA programmes supported by virtual behavioural counselling. MOTIVATE-T2D used biofeedback from wearable technologies to support the programme. The active control group received the same intervention without wearables.
Outcomes The primary outcomes were recruitment rate, retention and adherence to purposeful exercise. Clinical data on effectiveness were collected as exploratory outcomes at baseline, 6 and 12 months, with HbA1c and systolic blood pressure (BP) proposed as primary outcomes for a future full RCT.
Results n=135 eligible participants expressed an interest in the trial, resulting in 125 participants randomised (age 55±9 years, 48% female, 81% white), a recruitment rate of 93%. Retention at 12 months was 82%. MOTIVATE-T2D participants were more likely to start (OR 10.4, CI 3.4 to 32.1) and maintain purposeful exercise at 6 (OR 7.1, CI 3.2 to 15.7) and 12 months (OR 2.9, CI 1.2 to 7.4). Exploratory clinical outcomes showed a potential effect in favour of MOTIVATE-T2D, including proposed primary outcomes HbA1c and systolic BP (between-group mean differences: HbA1c: 6 months: −5% change from baseline, CI −10 to 2: 12 months: −2% change from baseline, CI −8 to −4; systolic BP: 6 months: −1 mm Hg, CI −5 to 3: 12 months: −4 mm Hg, CI −8 to 1).
Conclusions Our findings support the feasibility of delivering the MOTIVATE-T2D mHealth-supported PA intervention for people with recently diagnosed T2D and progression to a full RCT to examine its clinical and cost-effectiveness.
Trial registration number ISRCTN: 14335124; ClinicalTrials.gov: NCT0465353
Recommendation on the use of protective eyewear in endourological laser procedures.
Full text linkThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use,distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.BJU Int 2025 doi:10.1111/bju.16664ReviewObjectives: This work examines the current evidence available regarding the risks of eye injury in endourology laser environments with the aim of providing a consensus recommendation on the appropriate use of protective eyewear.
Methods: A working group was set up consisting of urological surgeons and laser protection advisors. A literature review was conducted to identify articles relevant to endourology practice and the commonly used lasers, and these were reviewed by the working group. Searches of the medical device fault/reporting databases were also undertaken. A consensus was developed and shared with stakeholders.
Results: No reports of eye injuries from Ho:YAG, Tm:YAG, or Thulium Fibre Lasers (TFLs) were identified, although reports of skin burns and equipment-related fires were found. Available evidence suggests that ocular risks in endourology from these lasers are minimal and limited to rare cases of reversible corneal damage. Protective eyewear can further reduce this risk. However, Lasers with wavelengths below 1400 nm pose significant ocular risks, including blindness.
Conclusion: Personnel working in an endourology environment using Ho:YAG, Tm:YAG, or TFLs face minimal ocular risks when adhering to established safety procedures, and laser-specific eyewear may not always be essential. This requires an understanding of the hazards and risks and is in accordance with the recommendations herein, which should form the basis for relevant local rules. Protective eyewear remains critical when using visible and near-infrared lasers due to the heightened associated ocular risks
Pathways for dual diagnosis of ME/CFs & Fibromyalgia (evidence summary)
No full textThis is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service. Disclaimer: We will endeavour to use the best, most appropriate and most recent sources available to ensure that the information supplied is accurate, up-to-date and evidence-based. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the search results. No responsibility can be taken by the library for any action taken on the basis of this information. New evidence may have been published since the date this evidence summary was created
Sympathetic reactivity to physiological stress is associated with expanded cardiac extracellular volume in humans.
No full text© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which
permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the
original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or
other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line
to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory
regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this
licence, visit http://creativecommons.org/licenses/by/4.0/Background: Expanded extracellular volume (ECV) is an early marker of myocardial interstitial fibrosis in patients with hypertension. Animal studies suggest that surges in sympathetic nerve activity (SNA) might contribute more to the development of interstitial fibrosis than the resting level of SNA. The aim of this study was to investigate whether resting SNA or greater SNA reactivity to a stressor may be associated with expanded ECV in humans across a range of blood pressures.
Methods: This was a cross-sectional study in 19 individuals with varying levels of ambulatory systolic blood pressure (111-153 mmHg, 48 ± 13 years, 26.5 ± 2.6 kg/m2, n = 10 diagnosed with hypertension and n = 9 normotensive controls). Beat-to-beat non-invasive blood pressure (Finometer), heart rate (3-lead ECG) and muscle SNA (MSNA; peroneal microneurography) were recorded simultaneously during baseline, and throughout a cold pressor test (physiological stress), with hand immersion in 3-4 °C water. LV chamber size, wall thickness and ECV were assessed using cardiac magnetic resonance imaging.
Results: Resting MSNA was not associated with cardiac ECV (B coefficient = - 0.07, 95% CI (- 0.24-0.10), P = 0.549), but SNA reactivity to the cold pressor test was a predictor of ECV independent of daytime systolic blood pressure (B coefficient = 0.12, 95% CI (0.05-0.20), P = 0.007). We determined associations between ECV and MSNA variables using liner regressions, with ECV as the dependent variable.
Conclusions: Our findings show that SNA responses to physiological stress were predictive of ECV, whereas resting SNA was not, independent of the level of blood pressure. Thus, surges in SNA during stress might be more important in cardiac remodelling than overall resting levels of SNA. Further studies should test this hypothesis in larger cohorts
National prevalence of peripheral venous catheter infections in the UK (evidence summary)
No full textThis is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service
Disclaimer: We will endeavour to use the best, most appropriate and most recent sources available to ensure that the information supplied is accurate, up-to-date and evidence-based. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the search results. No responsibility can be taken by the library for any action taken on the basis of this information. New evidence may have been published since the date this evidence summary was created
Balloon Pulmonary Angioplasty Versus Riociguat in Inoperable Chronic Thromboembolic Pulmonary Hypertension: Systematic Review and Meta-Analysis of Randomized Controlled Trials.
No full textChronic thromboembolic pulmonary hypertension (CTEPH) results from unresolved pulmonary emboli that lead to persistent obstruction of the pulmonary vasculature, elevated pulmonary arterial pressure, and subsequent right-heart strain. About half of CTEPH patients cannot have surgery to remove blockages and need other treatments-either balloon pulmonary angioplasty (BPA), a procedure that widens vessels, or riociguat, a medication that relaxes them. We followed PRISMA guidelines and searched PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov for randomized trials from January 2018 to April 2025 that directly compared BPA and riociguat in adults with inoperable CTEPH. We pooled data from 3 trials (262 patients total: 134 BPA, 128 riociguat) using random-effects models and checked consistency with I² and leave-one-out tests. Compared to riociguat, BPA reduced mean pulmonary arterial pressure by 12.23 mm Hg (95% CI, 15.32-9.15; I² = 82%), pulmonary vascular resistance by 208.58 dyn·s/cm⁵ (95% CI, 299.85-117.32; I² = 87%), right atrial pressure by 2.18 mm Hg (95% CI, 3.13-1.23; I² = 66%), and NT-proBNP by 989.61 pg/mL (95% CI, 1456.66-522.55; I² = 0%) (all P < 0.0001). Riociguat led to a larger increase in cardiac output (0.47 L/min; 95% CI, 0.37-0.58; I² = 0%; P < 0.00001). Removing the Kawakami trial eliminated heterogeneity (I² = 0%). Both treatments were similarly safe. In summary, BPA delivers stronger pressure and biomarker improvements, while riociguat better boosts heart output. Combining or sequencing these treatments deserves further study in larger trials
Small cell carcinoma of the ovary, hypercalcaemic type causing an acute kidney injury.
No full textSummaryWe report a case of small cell carcinoma of the ovary, hypercalcaemic type, a rare and aggressive form of ovarian cancer, causing an acute kidney injury. A woman in her mid-30s presented with a large pelvic mass and abdominal distention, this was associated with rapidly deteriorating renal function, which did not improve with standardised kidney injury treatment. There was a high suspicion of ovarian cancer. She deteriorated and underwent emergency cytoreductive surgery, followed by systemic chemotherapy. Her presentation, acute kidney injury and electrolyte disturbance preoperatively and postoperatively suggest this was caused by her cancer. Renal dysfunction, due to paraneoplastic syndromes, is a rare oncological emergency seen with solid tumours. Awareness of the condition can lead to early recognition and timely management