Investigating mortality and morbidity associated with UrINary incontinence during Older Womens Secondary Care Admissions and exploring nurses experiences of delivering related care (U-INconti): a mixed methods research protocol.

INTRODUCTION: Urinary incontinence (UI) is associated with increasing age and is more frequently experienced by women. Despite 40% prevalence in the community, little is known about the prevalence/incidence of UI in older women during hospital admission. UI during hospital admissions, within this group, has also been under-researched in terms of its relationship to specific clinical conditions and mortality rates. Given that UI has serious implications for both patient care and women's general health and well-being on discharge, this protocol describes a planned research project which aims to determine mortality, morbidity, prevalence and incidence of UI in older women (≥55 years) during hospital admission to inform nursing practice. Additionally, it aims to explore the experience of nurses who deliver women's care. METHODS AND ANALYSIS: This is an explanatory mixed-methods study consisting of two phases: (1) retrospecitive analysis of electronic patient care records (EPCR) to determine prevalence/incidence of UI, clinical conditions most likely associated with UI and any associations between UI and death, (2) nurse interviews to explore views, knowledge and perceptions of performing the nursing assessment and providing care for older women (≥55 years) with UI during admission. EPCR will be gained from a National Health Service (NHS) teaching hospital. Nurse interviews will be conducted with nurses from an alternative but similar-sized NHS hospital. ETHICS AND DISSEMINATION: Ethical approval is provided by the University of Salford Ethics Committee and regulatory approval by the NHS Health Research Authority (Integrated Research Application System project ID: 303118). Local NHS trust approval to access electronic care records for the purposes of analysis of anonymised data has been provided by one of the two collaborating NHS hospitals. Findings will be disseminated through open-access geriatric or urogynaecology journals and presented to relevant stakeholders at local, national and international meetings including scientific meetings such as the UK Continence Society and International Continence Society.

Early deaths from ischaemic heart disease in childhood-onset type 1 diabetes.

AIMS: The risk of ischaemic heart disease (IHD) death in early type 1 diabetes onset was assessed using death certification data. METHODS: The Yorkshire Register of type 1 Diabetes in Children and Young People was linked to clinically validated death certification data for those diagnosed under 15 years. Standardised mortality ratios (SMRs) were calculated using the England and Wales population and IHD death rates between 1978 and 2014 by 5-year age group and sex. RESULTS: The cohort included 4382 individuals (83 097 person years). Of 156 deaths, nine were classed as IHD deaths before clinical validation. After clinical validation, 14 IHD deaths were classified, with an SMR of 13.8 (95% CI 8.2 to 23.3) and median age at death of 35.1 years (range 21.9â€"47.9 years). CONCLUSIONS: There is an early emergence of death from IHD in early onset type 1 diabetes. Underascertainment of IHD deaths was present without clinical validation of death certification.