Cardiovascular evaluation, including resting and exercise electrocardiography, before participation in competitive sports

Four fifths of people barred for health reasons from sport in Italy, where pre-screening for heart disease is a legal requirement, were picked up by exercise electrocardiography in this five year national study. An accompanying editorial backs calls for adding electrocardiography to the screening programmes to help detect more athletes with silent cardiovascular disorders at risk of sudden death.

Association between muscular strength and mortality in men: prospective cohort study

Muscular strength, measured during bench presses and leg presses, seems to add to the protective effect of cardiorespiratory fitness in reducing mortality risk.
This study will appear in the BMJ theme issue on sports and exercise medicine on 12 July.

Neuromuscular training and the risk of leg injuries in female floorball players: cluster randomised controlled study

In more than 450 young Finnish female players of floorball (an indoor game like hockey) the risk of non-contact leg injury was 66% lower in the group randomised to six months of specialist training.
This study will appear in the BMJ theme issue on sports and exercise medicine on 12 July.

Multiple vaccinations, health, and recall bias within UK armed forces deployed to Iraq: cohort study

Scrutiny of vaccination records suggests that earlier associations between self reported multiple vaccination and subsequent illness arose from recall bias.

Positive and negative affect and risk of coronary heart disease

Negative affect was a weak independent predictor of coronary heart disease in men and women in the Whitehall II prospective cohort study, a long term follow-up of more than 10 000 middle aged civil servants. The mechanisms for this link are unclear, but strong independent reasons exist for treating conditions that are related to negative affect, says the accompanying editorial.

Mental capacity to make decisions on treatment in people admitted to psychiatric hospitals

Two fifths of patients admitted voluntarily and four fifths of those detained involuntarily lacked the capacity to decide on treatment, yet capacity is not assessed routinely, according to this cross sectional study in London. The accompanying editorial says that even though some patients will meet the legal criteria for treatment under the Mental Capacity and Mental Health acts at the time of admission to hospital, practitioners might prefer to rely on the authority of the Mental Health Act when a patient with a fluctuating mental state needs a sustained programme of care.

Alternative approaches to endoscopic ablation for benign enlargement of the prostate

Despite 45 trials with nearly 4000 patients there is still not enough reliable evidence to identify the safest and most effective method of ablation, according to this systematic review of randomised controlled trials. The accompanying editorial by Sean P Elliott (pictured) agrees that newer techniques are no better than transurethral resection but points out that the evidence base is poor.

Evidence for the impact of quality improvement

Collaboratives such as the Institute of Healthcare Improvements' Breakthrough series are being adopted widely, but evidence on their effectiveness is limited and their effects, while mostly positive, are unpredictable. An accompanying editorial asks whether the methods used in traditional biomedical research are sufficient to evaluate quality improvement collaboratives.

All Research