Midlands Evidence Repository

Welcome to the Midlands Evidence Repository (MIDER).

MIDER serves as the institutional research repository for 21 NHS Trusts across the Midlands and is managed by a consortium of Midlands NHS Knowledge and Library Services. Its purpose is to enhance the visibility and discoverability of NHS research by capturing, storing, and providing access to research outputs and other non‑traditional publications produced by NHS organisations in the region. Wherever possible, full‑text publications are made available through open‑access, and the repository continues to expand as new collections are added.

Please note that the deposit of items within MIDER does not imply endorsement of the research or the views expressed within it by the consortium organisations. A full list of MIDER partner organisations can be found below.

If you would like to collaborate with us as the repository continues to develop, please contact us at midlandsevidencerepository@gmail.com

Communities in MIDER

Select a community to browse its collections.

Recent Submissions

  • ItemMetadata only
    Antihypertensive therapy in diabetes mellitus: efficacy, safety, and metabolic impacts in type 1 and type 2 diabetes.
    (BioMed Central, 2026-02-18) Joshi, Pooja; Rick, Griffin; Mesineni, Srihitha; Bohara, Sujan; Atif, Sehrish; Poonthottam, Nandakumar; Azam, Aiesha; Mehmood, Yasir; Ali, Ramsha; Raquib, Naama; Sasikumar, Abhijith; Khalid, Areeba; Anyagwa, Onyekachi Emmanuel
    Treating hypertension in diabetic patients with antihypertensive medications should be done with careful consideration because these medications may interfere with macro- and microvascular complications of diabetes, such as myocardial infarction, stroke, and diabetic nephropathy. Some medications also come with cardio- and reno-protective effects along with lowering blood pressure. This narrative review focuses on major antihypertensive drug classes and their efficacy, safety, and metabolic impacts in type 1 and type 2 diabetes mellitus. We found that most classes of drugs, such as ACEIs (Angiotensin-Converting Enzyme Inhibitors), ARBs (Angiotensin II-Receptor Blockers), and thiazide diuretics, exert cardio- and renoprotective effects but also come with their own set of side effects, including dry cough, hyperkalemia, and hypokalemia, respectively. Beta blockers are used when patients have underlying conditions such as a previous heart attack or angina, but with caution, as they can cause masking of hypoglycemia. This review also discusses emerging therapies such as SGLT2 (Sodium-Glucose CoTransporter-2) inhibitors. Hence, all these drugs can offer additional benefits in addition to lowering blood pressure if chosen properly and tailored to suit the patient’s overall health needs. GRAPHICAL ABSTRACT: [Image: see text]
  • ItemOpen Access
    Improving the Completeness of Surgical Consent Documentation Through a Closed-Loop Quality Improvement Audit at a Secondary Care Teaching Hospital
    (Springer Nature, 2026-02-11) Homaida, Hashim; Ahmed, Zubaida; Awad, Shahd; Mohammed, Gesaim; Suliman, Hisham; Edris, Elshayma; Abdalla, Matab; Elnour, Mohey; Ibrahim, Inas; Yousif, Tasneem; Muhammed, Abubakr; Hamad Medical Corporation; Almanagil Teaching Hospital; Farwaniya Hospital; University Hospitals of Derby and Burton NHS Foundation Trust; et al; Trauma and Orthopaedics; Medical and Dental; Elnour, Mohey
    Background Incomplete surgical consent documentation undermines informed decision-making, patient safety, and medico-legal protection. Despite clear ethical and professional standards, deficiencies in consent documentation remain common, particularly in resource-limited settings. Objective To assess the completeness of surgical consent documentation, implement targeted quality improvement interventions, and evaluate their impact through a closed-loop clinical audit. Methods A closed-loop quality improvement audit was conducted at Almanagil Teaching Hospital, Sudan. Two audit cycles were performed, each reviewing 44 consecutive surgical consent forms. The first cycle (July-August 2025) established baseline compliance with predefined consent documentation standards. A structured intervention, including staff education, feedback, and introduction of a revised consent form, was implemented over two months. The second cycle (October-December 2025) reassessed documentation completeness using the same criteria. Data were analysed descriptively and reported as frequencies and percentages. Results At baseline, documentation completeness was low in several key domains, including hospital/file number (1.8%), surgical indication (5.4%), explanation of procedure (16.1%), and anaesthetic and surgical risk explanation (1.8% each). Following the intervention, substantial improvements were observed across nearly all components. Documentation of consent, anaesthesia type, physician and witness details, and patient satisfaction confirmation reached 100% compliance. Explanation of anaesthetic and surgical risks increased to 97.7% and 93.2%, respectively. Documentation of possible additional procedures and patient incapacity details improved to 47.7% and 50.0%, although these remained below full compliance. Conclusion This audit demonstrates that structured, audit-driven quality improvement interventions can markedly enhance the completeness of surgical consent documentation. Regular auditing and sustained reinforcement are recommended to maintain improvements and address remaining gaps.
  • ItemOpen Access
    Study protocol for a feasibility randomised controlled trial of MOVE SMART—An intervention to increase physical activity, reduce sedentary behaviour and improve health outcomes in patients with psoriasis
    (Public Library of Science (PLOS), 2026-03-16) Onambele-Pearson, Gladys; Ives, Ben; Khosla, Ishani; Witkam, Rozemarijn; Roberts, Matthew; Moorhead, Lucy; Cowper, Russ; Burnside, Girvan; Young, Helen; Manchester Metropolitan University; University Hospitals of Derby and Burton NHS Foundation Trust; University of Manchester; Salford Royal Hospital; University of Liverpool; Kings College London; Specialist Medicine; Medical and Dental; Khosla, Ishani
    Patients with psoriasis are less physically active than age-matched controls, due to psoriasis-specific barriers; significantly limiting their ability to benefit from health-promoting levels of physical activity. We co-designed an exercise intervention, with patients, which in proof-of-concept studies, led to significantly improved psoriasis; reduced cardiovascular disease/metabolic syndrome risk and enhanced wellbeing/psychosocial functioning. This suggested increased physical activity may improve health outcomes for those with psoriasis. However, individuals remained sedentary for prolonged periods, which also has a detrimental effect on health. We therefore developed a new intervention - MOVE SMART - to increase light-intensity physical activity and interrupt sedentary behaviour. This randomised controlled clinical trial (RCT) will assess the feasibility and acceptability of MOVE SMART. Utilising a decentralised, two-arm, trial design, people with Type 1 psoriasis with/without stable psoriatic arthritis, (n = 60) will be recruited from across the UK, and randomised to intervention (MOVE SMART with "Standard Care", n = 30) or control ("Standard Care", n = 30). The intervention group will follow MOVE SMART for 12-weeks, followed by activities of their own choice during weeks 13-24. MOVE SMART will prompt 2-minutes of light-intensity physical activity, following 30-minutes of continuous sedentary behaviour, during daytime waking hours. The study comprises of three Workstreams. In Workstream-1 participants will use wearable devices to allow monitoring of physical behaviour and adherence to MOVE SMART. A blood pressure monitor and body weight scales will be posted to participants for use throughout the study and functional capacity will be measured by video-link. At baseline, week-12 and -24 all participants will complete self-assessment of the extent/impact of psoriasis and wellbeing. Capillary blood will be collected using home-sampling kits. In Workstream-2 acceptability of the intervention will be evaluated and the trial design will be finalised in Workstream-3. The study is registered at www.isrctn.com (ISRCTN 17400289).
  • PublicationMetadata only
    Arrested hydrocephalus and beyond: advances in the pathophysiology, diagnosis, and management of various forms of chronic hydrocephalus: a comprehensive narrative review.
    (Springer, 2026-04-15) Sanker, Vivek; Wahi, Riddhpreet; Jamal, Syeda Maham; Elnour, Mohey Aldien Ahmed Elamin; Venkatesan, Aparna; Liverani, Linda; Lear, Bo Peng; Cavagnaro, Maria Jose; Desai, Atman; Prolo, Laura; Department of Neurosurgery, Stanford University, Stanford, CA, USA; Department of Neurosurgery, Grant Government Medical College and Sir J.J Group of Hospitals, Mumbai, India; Department of Neurosurgery, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania; Department of Neurosurgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK; Department of Neurosurgery, Teaching University Geomedi, University of Tbilisi, Tbilisi, Georgia; Department of Neurosurgery, Stanford University, Stanford, CA, USA; Neurosurgery; Medical and Dental; Elnour, Mohey Aldien Ahmed Elamin
    Hydrocephalus results from an imbalance between cerebrospinal fluid (CSF) secretion and absorption. Absence or lack of physiological compensatory mechanisms leads to ventricular dilation and associated clinical symptoms. However, when it is compensated, it is termed as arrested hydrocephalus, which ensures a stable balance between the production and clearance of CSF, that results in normalized intraventricular pressure and minimal ventricular dilatation. Although hydrocephalus can be understood using the traditional bulk flow theory of CSF circulation, arrested hydrocephalus poses unique diagnostic difficulties because of its subtle manifestations and lack of radiographic changes. In this thorough review, the pathogenesis, clinical manifestation, diagnostic standards, and available treatments for various types chronic hydrocephalus, including normal pressure hydrocephalus (NPH) and congenital hydrocephalus, are discussed with emphasis on arrested hydrocephalus.
  • ItemMetadata only
    Infographic: five-year outcomes after initial aflibercept, bevacizumab, or ranibizumab treatment for diabetic macular edema (DRCR Protocol T Extension Study)
    (Nature, 2026-02-16) Riotto, Eleonora; Lamanna, Fransesca; Manikavasagar, Venughanan; Faes, Livia; Fu, Dun Jack; Moorfields Eye Hospital; University Hospitals of Derby and Burton NHS Foundation Trust; Cantonal Hospital; University of Zurich; Ophthalmology Department; Medical and Dental; Manikavasagar, Venughanan
    No abstract available.
Show more