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ATME—Needs, requirements and cross-sectoral patient journeys of patients with out-of-hospital mechanical ventilation and intensive care in outpatient settings: study protocol for an observational study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Nahne-Alina Knizia, Josefine Hirschler, Constance Stegbauer, Antje Schwinger, Andreas Büscher, Nathalie Englert, Lara Peters, Hakim A. Bayarassou, Leonie Mallmann, Gerald Willms
Introduction An increasing number of tracheotomised and/or ventilated patients with high-cost out-of-hospital intensive care needs and, at the same time, a decreasing number of healthcare professionals inevitably lead to challenges in the care of this patient population. In addition, little is known about this population, their health restrictions, needs, patient journeys, care structures and processes
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Prevalence and determinants of antibiotics self-medication among indigenous people of Bangladesh: a cross-sectional study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Adnan Mannan, Kallyan Chakma, Gourab Dewan, Ayan Saha, Naim Uddin Hasan A Chy, H M Hamidullah Mehedi, Amzad Hossain, Jannatun Wnaiza, Md Tanveer Ahsan, Md Mashud Rana, Nazmul Alam
Objectives Self-medication with antibiotics (SMA) contributes significantly to the emergence of antimicrobial resistance (AMR), especially in low-income countries including Bangladesh. This study aimed to generate evidence on the self-reported prevalence of antibiotic self-medication and its determinants among indigenous people residing in Bangladesh’s Chittagong Hill Tracts (CHT) districts. Design
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Interventions in adult patients with multimorbidity in low-income and middle-income countries: protocol for a mixed-methods systematic review BMJ Open (IF 2.9) Pub Date : 2024-03-01 Tina George, Jo-Anne Manski-Nankervis, Marlena Klaic, Gagandeep Kang, Thambu David Sudarsanam
Introduction Multimorbidity, the coexistence of two or more chronic conditions in the same individual, is a major public health problem in low-income and middle-income countries (LMICs). The use of single-disease guidelines contributes to polypharmacy, fragmented care and increased treatment burden. Health systems in LMICs are very different from those in high-income countries, and adapting interventions
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Universal screening for early detection of chronic autoimmune, metabolic and cardiovascular diseases in the general population using capillary blood (UNISCREEN): low-risk interventional, single-centre, pilot study protocol BMJ Open (IF 2.9) Pub Date : 2024-03-01 Aurora Merolla, Rebecca De Lorenzo, Giulia Ferrannini, Cristina Renzi, Francesca Ulivi, Elena Bazzigaluppi, Vito Lampasona, Emanuele Bosi
Introduction Chronic autoimmune (type 1 diabetes and coeliac disease) and metabolic/cardiovascular (type 2 diabetes, dyslipidaemia, hypertension) diseases are highly prevalent across all age ranges representing a major public health burden. Universal screening for prediction/early identification of these conditions is a potential tool for reducing their impact on the general population. The aim of
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Knowledge, attitude and practices of insulin therapy among patients with type 2 diabetes: a cross-sectional study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Ayesha Almheiri, Eman Ali Binjab, Maha Murad Albloushi, Mohamed Taryam Alshamsi, Hamda Hassan Khansaheb, Marwan Zidan, Ahmed Abdul Karim Hassoun
Objectives This study aimed to assess the knowledge, attitude and practices of patients with type 2 diabetes on insulin regarding insulin therapy. Design A cross-sectional study. Setting This study was conducted at the Dubai Diabetes Center from 1 December 2018 to 1 March 2020. Participants Face-to-face interviews were conducted for 350 participants with type 2 diabetes at the Dubai Diabetes Center
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Sociological determinants of adherence to continuous positive airway pressure in the management of sleep apnoea syndrome: protocol for a transdisciplinary, prospective observational study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Sebastien Bailly, Alison Foote, Monique Mendelson, Andry Rakotovao, Jean Christian Borel, Jean Louis Pepin, Renaud Tamisier, Helena Revil
Introduction Obstructive sleep apnoea syndrome (OSAS) is a chronic multiorgan pathology that has a negative impact on quality of life. Continuous positive airway pressure (CPAP) is the first-line treatment for OSAS. However, CPAP termination rates remain very high, and adherence to therapy is a major issue. To date, studies targeting predictive factors of CPAP adherence by OSAS patients mainly include
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Tracking deaths of people who have experienced homelessness: a dynamic cohort study in an Australian city BMJ Open (IF 2.9) Pub Date : 2024-03-01 Matthew Tuson, Shannen Vallesi, Lisa Wood
Objective Life expectancy and rates of premature death are fundamental markers of health and social equity globally, and measures on which people experiencing homelessness face enormous disparities. However, unlike for other population groups with similar disparities, concerted government action to reduce homeless mortality is rare, partly due to a lack of reliable, timely data. Contemporaneous tracking
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Perinatal healthcare for women at risk of children’s social care involvement: a qualitative survey of professionals in England BMJ Open (IF 2.9) Pub Date : 2024-03-01 Claire Grant, Tamsin Bicknell-Morel, Billie Lever Taylor, Claire Powell, Ruth Marion Blackburn, Rebecca Lacey, Jenny Woodman
Background Women with complex health needs are more at risk of having children’s social care involvement with their newborns than other mothers. Around the time of pregnancy, there are opportunities for health services to support women with these needs and mitigate the risk of mother–baby separation. Yet little is known about healthcare professionals’ experiences of providing this support. Methods
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Sarcopenia in systemic sclerosis: prevalence and impact—a systematic review and meta-analysis BMJ Open (IF 2.9) Pub Date : 2024-03-01 Xiangping Tu, Taiping Lin, Yuan Ju, Xiaoyu Shu, Tingting Jiang, Ning Ge, Jirong Yue
Objective This review aims to provide an estimate of sarcopenia prevalence and its impact on clinical characteristics in patients with systemic sclerosis (SSc). Design Systematic review and meta-analysis. Data sources Embase, Medline, Web of Science and the Cochrane Central Register of Controlled Trials were systemically searched from inception to 24 May 2023. Eligibility criteria for selecting studies
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Development and feasibility of a conceptual model for planning individualised physical exercise training (IPET) for older adults: a cross-sectional study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Sanel Teljigovic, Tina Dalager, Nina Odgaard Nielsen, Lars Holm, Mette Bahn Ejvang, Gisela Sjøgaard, Karen Søgaard, Louise Fleng Sandal
Objective Older adults constitute a heterogeneous group, and the focus of the individual physical exercise is often subject to the reasoning and experience of health professionals or exercise physiologists who prescribe them. Thus, this is the first effort to explicitly conceptualise the planning of individualised physical exercise training (IPET) for older adults in an outpatient setting and investigate
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Impact of the economic crisis, COVID-19 and the Beirut explosion on ophthalmology training in Lebanon: an observational cohort survey-based study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Alaa Bou Ghannam, Hanadi Ahmad Ibrahim, Bassel Hammoud, Rola Hamam
Objectives The objective of the study is to investigate the effects of the COVID-19 pandemic, the economic crisis and the Beirut explosion on the training and work of ophthalmology residents and faculty in Lebanon. Design This is an observational cohort survey-based research conducted between January and December 2022. Setting The study targeted all ophthalmology residents and core faculty in Lebanon
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Epicardial left atrial appendage clipping versus direct oral anticoagulant to reduce stroke risk in non-paroxysmal atrial fibrillation (LAA-CLIP): rationale, design and study protocol for a multicentre randomised controlled trial BMJ Open (IF 2.9) Pub Date : 2024-03-01 Chunyu Yu, Haojie Li, Chuxiang Lei, Yang Wang, Sipeng Chen, Yan Zhao, Zhe Zheng
Introduction The prevalence of atrial fibrillation (AF) is increasing globally, and stroke prevention is the key to reduce the morbidity and mortality related to AF. Currently, direct oral anticoagulants (DOACs) are the primary options for stroke prevention, while it increases risk of bleeding. Left atrial appendage (LAA) is suspected as a vital source of cerebral emboli and may lead to ischaemic stroke
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Analysis of problems and potentials for increasing pandemic resilience in public health administrations in Saxony-Anhalt, Germany—a mixed-methods approach BMJ Open (IF 2.9) Pub Date : 2024-03-01 Pascal Samtlebe, Jana Niemann, Jenny Markert, Anja Knöchelmann, Marie Bernard
Introduction The COVID-19 pandemic has shown the importance of resilient, modern, and well-equipped public health administrations from national to communal levels. In Germany, the surveillance, contact tracing, and local adaptions went through local health offices, revealing both their important role and also their lack of equipment and general preparation for health crises. Research on the mode of
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Immunosuppressant medication behaviours in solid organ transplant recipients: a cross-sectional study from south-central China during COVID-19 reopening period BMJ Open (IF 2.9) Pub Date : 2024-03-01 Qin Zhao, Lei Dong, Liang Wang, Hongyu Zhao, Xiao Zhu, Zhihao Zhang, Jia Liu
Objective Medication non-adherence to immunosuppressants threatens allograft survival and function maintenance among solid organ transplant (SOT) recipients. This study aimed to investigate the prevalence of immunosuppressant medication non-adherence and associated factors during the COVID-19 reopening period among Chinese SOT recipients. Design Cross-sectional study. Setting South-central China. Population
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Barriers and facilitators to use of digital health tools by healthcare practitioners and their patients, before and during the COVID-19 pandemic: a multimethods study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Sophie Louise Turnbull, Charlotte Dack, Jiedi Lei, Irem Aksu, Sabrina Grant, Gemma Lasseter, Barbora Silarova, Ben Ainsworth
Objectives To explore how healthcare practitioners (HCPs) made decisions about the implementation of digital health technologies (DHTs) in their clinical practice before and during the COVID-19 pandemic. Design A multimethods study, comprising semistructured interviews conducted prior to the COVID-19 pandemic, supplemented with an online survey that was conducted during the pandemic with a different
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Scoping review protocol of post-traumatic growth (PTG) in Korean cancer survivors BMJ Open (IF 2.9) Pub Date : 2024-03-01 Yu-Jin Park, Kyoung Suk Lee
Introduction Cancer, a life-threatening chronic disease, is the leading cause of death in Korea, accounting for 27% of all deaths in 2020. Due to advancements in medical technology and early detection of cancer in Korea, the 5-year relative survival rate reached 70.7% (2015–2019), highlighting remarkable progress over the past decades. Although cancer has been seen as a traumatic event, cancer survivors
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Protocol for venoarterial ExtraCorporeal Membrane Oxygenation to reduce morbidity and mortality following bilateral lung TransPlantation: the ECMOToP randomised controlled trial BMJ Open (IF 2.9) Pub Date : 2024-03-01 Jonathan Messika, Philippine Eloy, David Boulate, Aude Charvet, Julien Fessler, Jacques Jougon, Philippe Lacoste, Olaf Mercier, Philippe Portran, Hadrien Roze, Edouard Sage, Jacques Thes, Francois Tronc, Mickael Vourc'h, Philippe Montravers, Yves Castier, Herve Mal, Pierre Mordant
Introduction Lung transplantation (LTx) aims at improving survival and quality of life for patients with end-stage lung diseases. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used as intraoperative support for LTx, despite no precise guidelines for its initiation. We aim to evaluate two strategies of VA-ECMO initiation in the perioperative period in patients with obstructive or restrictive
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Knowledge, attitude and practice of contraceptive methods among women with an unplanned pregnancy BMJ Open (IF 2.9) Pub Date : 2024-03-01 Binyue Sheng, Dongmei Yao, Haihua Zhang, Jing Tang, Xin Du
Objectives The study aimed to investigate the knowledge, attitude and practice (KAP) of contraceptive methods among women with an unplanned pregnancy, aiming to improve their reproductive health and increase their understanding of contraceptive methods. Design This is a cross-sectional study. Setting The study was conducted at the Maternity and Child Healthcare Hospital of Hubei between 20 November
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Effectiveness of an online intervention for parents/guardians of children aged 4–7 years who are concerned about their child’s emotional and behavioural development: protocol for an online randomised controlled trial (EMERGENT study) BMJ Open (IF 2.9) Pub Date : 2024-03-01 Daniel Frings, Paula Reavey, Jowinn Chew, Michael Leahy, Clare Allabyrne, Claudiu Herteliu
Introduction The demand for resources to support emotional and behavioural development in early childhood is ever increasing. However, conventional interventions are lacking in resources and have significant barriers. The Embers the Dragon programme helps address the growing unmet need of children requiring support. The delivery of the current project seeks to help support parents, reduce the burden
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Self-management needs, strategies and support for sickle cell disease in developing countries: a scoping review protocol BMJ Open (IF 2.9) Pub Date : 2024-03-01 Andrews Adjei Druye, Christian Makafui Boso, Mustapha Amoadu, Paul Obeng, Bernard Nabe, Justice Enock Kagbo, Patience Fakornam Doe, Christiana Okantey, Godson Obeng Ofori, Rita Opoku-Danso, Dorcas Frempomaa Agyare, Gifty Osei Berchie, Gifty Owusu, Frederick Nsatimba, Susanna Aba Abraham
Introduction Sickle cell disease (SCD) poses a significant global health burden, particularly affecting individuals in developing countries with constrained healthcare resources. While research on self-management in the context of SCD is emerging, it has predominantly focused on primary studies, and there is a notable dearth of evidence synthesis on SCD self-management in developing countries. This
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Exploring associations between pregnancy cravings and sociodemographic, lifestyle and health factors: insights from a cross-sectional population study in Jordan BMJ Open (IF 2.9) Pub Date : 2024-03-01 Suad M Kloub, Saleem A Banihani
Objective To explore the potential associations between pregnancy cravings and various sociodemographic, lifestyle and health factors. Design Cross-sectional study. Setting Population-based study in Jordan. Participants A total of 500 women who had children and experienced pregnancy cravings were included. Primary and secondary outcome measures Pregnancy cravings are prevalent among Jordanian women
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University staff perspectives on determinants of high-quality health professions student placements in regional, rural and remote Australia: protocol for a mixed-method study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Claire Quilliam, Elyce Green, Rohan L Rasiah, Lyndal Sheepway, Catherine Seaton, Leigh Moore, Jodie Bailie, Kylie Maree Matthews, Jane Ferns, James Debenham, Carolyn Taylor, Kathryn Fitzgerald, Melissa Ridd
Introduction In rural areas, work-integrated learning in the form of health student placements has several potential benefits, including contributing to student learning, enhancing rural health service capacity and attracting future rural health workforce. Understanding what constitutes a high-quality rural placement experience is important for enhancing these outcomes. There is no current standardised
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Cyberbullying and cyber-victimisation among higher secondary school adolescents in an urban city of Nepal: a cross-sectional study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Surakshya Kunwar, Sudim Sharma, Sabina Marasini, Anjali Joshi, Ashish Adhikari, Anushka Ranjit, Ishwori Byanju Shrestha, Archana Shrestha, Akina Koju Shrestha, Biraj Man Karmacharya
Objective To assess the prevalence and factors associated with cyberbullying and cyber-victimisation among high school adolescents of Pokhara Metropolitan City, Nepal. Design A cross-sectional study. Setting Pokhara Metropolitan City, Nepal. Participants We used convenient sampling to enrol 450 adolescents aged 16–19 years from four distinct higher secondary schools in Pokhara Metropolitan City. Outcome
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Impact of the design of adult mental health inpatient facilities on healthcare staff: a mixed methods systematic review BMJ Open (IF 2.9) Pub Date : 2024-03-01 Laura Rodríguez-Labajos, Joanne Kinloch, Louise Nicol, Susan Grant, Geraldine O'Brien
Objectives Mental health inpatient facilities are increasingly focusing on creating therapeutic, person-centred care environments. However, research shows that this focus may have unintended consequences for healthcare staff. Designs that do not pay attention to staff needs may risk contributing to stress, burnout, job dissatisfaction and mental exhaustion in the work environment. This systematic review
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Toxoplasma gondii seropositivity and cognitive functioning in older adults: an analysis of cross-sectional data of the National Health and Nutrition Examination Survey 2011–2014 BMJ Open (IF 2.9) Pub Date : 2024-03-01 Ge Song, Qingxia Zhao, Hongyu Chen, Meng Li, Zeyu Zhang, Zhe Qu, Chao Yang, Xuechun Lin, Weixia Ma, Courtney Rose Standlee
Objectives This study sought to examine the relationship between Toxoplasma gondii seropositivity and cognitive function in older adults. Design An observational cross-sectional study. Setting The National Health and Nutrition Examination Survey (NHANES) study took place at participants’ homes and mobile examination centres. Participants A total of 2956 older adults aged 60 and above from the NHANES
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Impact of inconsistent ethnicity recordings on estimates of inequality in child health and education data: a data linkage study of Child and Adolescent Mental Health Services in South London BMJ Open (IF 2.9) Pub Date : 2024-03-01 Alice Wickersham, Jayati Das-Munshi, Tamsin Ford, Amelia Jewell, Robert Stewart, Johnny Downs
Objectives Ethnicity data are critical for identifying inequalities, but previous studies suggest that ethnicity is not consistently recorded between different administrative datasets. With researchers increasingly leveraging cross-domain data linkages, we investigated the completeness and consistency of ethnicity data in two linked health and education datasets. Design Cohort study. Setting South
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Factors associated with changes in walking performance in individuals 3 months after stroke or TIA: secondary analyses from a randomised controlled trial of SMS-delivered training instructions in Sweden BMJ Open (IF 2.9) Pub Date : 2024-03-01 Birgit Maria Vahlberg, Staffan Eriksson, Ulf Holmbäck, Erik Lundström
Objectives This study aimed to identify factors related to changes in walking performance in individuals 3 months after a stroke or TIA. Design Cross-sectional study with post hoc analysis of a randomised controlled study. Setting University Hospital, Sweden. Participants 79 individuals, 64 (10) years, 37% women, who were acutely hospitalised because of stroke or TIA between November 2016 and December
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Defining and assessing psychological frailty in older adults: a scoping review protocol BMJ Open (IF 2.9) Pub Date : 2024-03-01 Joanes Lameirinhas, Arantxa Gorostiaga, Igone Etxeberria
Introduction Frailty is widely acknowledged as a multidimensional construct encompassing physical, psychological and social aspects. However, the lack of consensus in defining and operationalising psychological frailty challenges the holistic approach to frailty advocated by health professionals. Consequently, there is a need to develop a comprehensive definition of psychological frailty based on contributions
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Study protocol for a cross-sectional online survey investigating patient preferences and experiences of waiting for elective cardiac surgery BMJ Open (IF 2.9) Pub Date : 2024-03-01 Manuela Russo, Kathryn Watson, Katie Richards, Rachel Rowan Olive, Barbora Krausova, Rashmi Kumar, Joanna Burridge, Lucy Goulding, Kia-Chong Chua, David Hardy, Avlonitis Vassilios, Baig Kamran, Sunil Bhudia, Noorani Alia, Khan Habib, Nick Sevdalis, Mario Petrou
Introduction Being on a waiting list for elective (planned) cardiac surgery can be physically and psychologically challenging for patients. Research suggests that stress associated with waiting for surgery is dependent on different individual and contextual factors. However, most data on patients’ experiences of waiting for surgery and preferences for waiting list management derives from non-cardiac
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Comparative efficacy and safety of different anti-VEGF agents combined with different delivery methods for neovascular glaucoma: a systematic review and Bayesian network meta-analysis BMJ Open (IF 2.9) Pub Date : 2024-03-01 Jiaqi Wang, Yi-Ming Guo, Junhan Wei, Jie Min, Lu Ye
Objective To compare the efficacy and safety of different anti-vascular endothelial growth factor (VEGF) agents combined with different delivery methods for neovascular glaucoma (NVG). Design Systematic review and Bayesian network meta-analysis (NMA). Data sources PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, ISRCTN and Chinese databases including the China National Knowledge
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Availability of essential, generic medicines before and during COVID-19 at selected public pharmaceutical supply agencies in Ethiopia: a comparative cross-sectional study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Tsegaye Melaku, Zeleke Mekonnen, Gudina Terefe Tucho, Mohammed Mecha, Christine Årdal, Marianne Jahre
Objectives Lockdowns and border closures impacted medicine availability during the COVID-19 pandemic. This study aimed to assess the availability of essential, generic medicines for chronic diseases at public pharmaceutical supply agencies in Ethiopia. Design Comparative cross-sectional study. Setting The availability of essential, generic medicines for chronic diseases was assessed at two public pharmaceutical
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Risk factors for medical adhesive-related skin injury at the site of peripherally inserted central venous catheter placement in patients with cancer: a single-centre prospective study from China BMJ Open (IF 2.9) Pub Date : 2024-03-01 Mengying Qi, Yuju Qin, Siya Meng, Nan Feng, Yan Meng
Objectives This study aims to explore the incidence of, and risk factors for medical adhesive-related skin injury (MARSI) at peripherally inserted central venous catheter (PICC) sites in patients with cancer. Design A prospective observational cohort study was conducted at a tertiary hospital in Shenzhen, China. Setting This was a single-centre study conducted in a tertiary hospital in Shenzhen, China
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Effectiveness of mHealth interventions to promote physical activity and reduce sedentary behaviours on work-related productivity and performance: a systematic review protocol BMJ Open (IF 2.9) Pub Date : 2024-03-01 Takako Miki, Michiko Nohara, Kyoko Nomura
Introduction Technologies such as health and fitness applications (apps) and wearable activity trackers have recently gained popularity and may play a key role in promoting physical activity and reducing sedentary behaviours. Although several systematic reviews have investigated their efficacy in physical activity and sedentary behaviours, few studies have focused on their impact on work-related outcomes
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Selecting an e-cigarette for use in smoking cessation interventions and healthcare services: findings from patient and public consultation for the COSTED trial BMJ Open (IF 2.9) Pub Date : 2024-03-01 Pippa Belderson, Emma Ward, Ian Pope, Caitlin Notley
Objectives The Cessation of Smoking Trial in the Emergency Department (COSTED) trial aims to ascertain whether brief advice, the provision of an e-cigarette starter kit and referral to stop smoking services (SSS), increases smoking cessation in people attending the emergency department. Patient and public involvement (PPI) and scoping work were undertaken to select an appropriate e-cigarette for the
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A scoping review to map the research on the mental health of students and graduates during their university-to-work transitions BMJ Open (IF 2.9) Pub Date : 2024-03-01 David Matthew Edmonds, Olga Zayts-Spence, Zoë Fortune, Angus Chan, Jason Shang Guan Chou
Objectives This scoping review maps the extant literature on students’ and graduates’ mental health experiences throughout their university-to-work transitions. The current review investigates the methodological features of the studies, the main findings, and the theories that the studies draw on to conceptualise mental health and transitions. Design This project used a scoping review methodology created
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Importance of kidney function, number of chronic conditions and medications for hospitalisation in elderly in Blekinge County, Sweden: a case–control study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Isabell Norstedt, Kristine Thorell, Anders Halling
Objectives To study the association between risk for hospitalisation in an elderly population related to renal function, number of chronic diseases and number of prescribed drugs. Design A case–control study. Persons hospitalised were included and their controls were obtained from electronic hospital medical records. If data were lacking on creatinine levels, multiple imputation was used. Setting Blekinge
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DEcreased Cognitive functiON, NEurovascular CorrelaTes and myocardial changes in women with a history of pre-eclampsia (DECONNECT): research protocol for a cross-sectional pilot study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Yentl Brandt, Robert-Jan Alers, Lisanne P W Canjels, Laura M Jorissen, Gwyneth Jansen, Emma B N J Janssen, Sander van Kuijk, Tamara Michelle Went, Dennis Koehn, Suzanne C Gerretsen, Jacobus Jansen, Walter Backes, Petra P M Hurks, Vincent van de Ven, M Eline Kooi, Marc E A Spaanderman, Chahinda Ghossein-Doha
Introduction Pre-eclampsia is a hypertensive disorder affecting up to 8% of pregnancies. After pre-eclampsia, women are at increased risk of cognitive problems, and cerebrovascular and cardiovascular disorders. These sequelae could result from microvascular dysfunction persisting after pre-eclampsia. This study will explore differences in cerebral and myocardial microvascular function between women
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Efficacy of migraine prophylaxis treatments for treatment-naïve patients and those with prior treatment failure: a protocol for systematic review and network meta-analysis of randomised controlled trials BMJ Open (IF 2.9) Pub Date : 2024-03-01 Pawin Numthavaj, Thunyarat Anothaisintawee, John Attia, Gareth McKay, Ammarin Thakkinstian
Introduction Migraine headache is a significant health problem affecting patients’ psychological well-being and quality of life. Several network meta-analyses (NMAs) have compared the efficacy of migraine prophylaxis medications. However, some have focused exclusively on oral medications, while others were limited to injectable medications. Moreover, none of these NMAs conducted a stratified analysis
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Implementation of an intervention to reduce urine dipstick testing in aged care homes: a qualitative study of enablers and barriers, and strategies to enhance delivery BMJ Open (IF 2.9) Pub Date : 2024-03-01 Lyn-li Lim, Kate Williams, Jill J Francis, Melanie Wroth, Juanita Breen
Objective The ‘To Dip or Not to Dip’ (TDONTD) intervention aims to reduce antibiotic prescribing for urinary tract infection (UTI) by reducing low-value dipstick testing. The aims of this study were to use a qualitative approach to (1) evaluate potential influences on the delivery of the TDONTD intervention in Australian residential aged care homes (RACHs) by identifying perceived barriers and enablers
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Biomechanical and neuromuscular characteristics in patients with traumatic anterior shoulder instability undergoing arthroscopic Bankart repair: a clinical prospective cohort study protocol BMJ Open (IF 2.9) Pub Date : 2024-03-01 Catarina Malmberg, Kristine Rask Andreasen, Jesper Bencke, Birgitte Hougs Kjær, Per Hølmich, K W Barfod
Introduction Traumatic shoulder dislocation is a common shoulder injury, especially among the young and active population. More than 95% of dislocations are anterior, in which the humeral head is forced beyond the anterior glenoid rim. The injury leads to increased joint laxity and recurrence rates are high. There is evidence that the shoulder biomechanics and neuromuscular control change following
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NeuroMotion smartphone application for remote General Movements Assessment: a feasibility study in Nepal BMJ Open (IF 2.9) Pub Date : 2024-03-01 Antti Juhani Kukka, Heléne E K Sundelin, Omkar Basnet, Prajwal Paudel, Kalpana Upadhyay Subedi, Katarina Svensson, Nick Brown, Helena Litorp, Rejina Gurung, Pratiksha Bhattarai, Johan Wrammert, Ashish KC
Objectives To evaluate the feasibility of using the NeuroMotion smartphone application for remote General Movements Assessment for screening infants for cerebral palsy in Kathmandu, Nepal. Method Thirty-one term-born infants at risk of cerebral palsy due to birth asphyxia or neonatal seizures were recruited for the follow-up at Paropakar Maternity and Women’s Hospital, 1 October 2021 to 7 January 2022
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Kentucky Outreach Service Kiosk (KyOSK) Study protocol: a community-level, controlled quasi-experimental, type 1 hybrid effectiveness study to assess implementation, effectiveness and cost-effectiveness of a community-tailored harm reduction kiosk on HIV, HCV and overdose risk in rural Appalachia BMJ Open (IF 2.9) Pub Date : 2024-03-01 April M Young, Jennifer R Havens, Hannah L F Cooper, Amanda Fallin-Bennett, Laura Fanucchi, Patricia R Freeman, Hannah Knudsen, Melvin D Livingston, Kathryn E McCollister, Jack Stone, Peter Vickerman, Edward Freeman, Tasfia Jahangir, Elizabeth Larimore, Carol R White, Chelsi Cheatom, KyOSK Community Staff, KyOSK Design Team
Introduction Many rural communities bear a disproportionate share of drug-related harms. Innovative harm reduction service models, such as vending machines or kiosks, can expand access to services that reduce drug-related harms. However, few kiosks operate in the USA, and their implementation, impact and cost-effectiveness have not been adequately evaluated in rural settings. This paper describes the
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Patient-planetary health co-benefit prescribing in a circumpolar health region: a qualitative study of physician voices from the Northwest Territories, Canada BMJ Open (IF 2.9) Pub Date : 2024-03-01 Nicole Redvers, Jamie Hartmann-Boyce, Sarah Tonkin-Crine
Background Despite climate change being described as a code red for humanity, health systems have been particularly slow in both climate mitigation and adaptation responses. The effects of climate change on health and health systems will not be felt equally, with underserved and marginalised communities disproportionately impacted. The circumpolar region is warming at 3–4 times the global rate, amplifying
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Modifiable prognostic factors of high societal costs among people on sick leave due to musculoskeletal disorders: findings from an occupational cohort study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Rikke Munk Killingmo, Anne Therese Tveter, Are Hugo Pripp, Alexander Tingulstad, Esther Maas, Tarjei Rysstad, Margreth Grotle
Objectives The objective was to identify modifiable prognostic factors of high societal costs among people on sick leave due to musculoskeletal disorders, and to identify modifiable prognostic factors of high costs related to separately healthcare utilisation and productivity loss. Design A prospective cohort study with a 1-year follow-up. Participants and setting A total of 549 participants (aged
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Effects of opioid-free anaesthesia compared with balanced general anaesthesia on nausea and vomiting after video-assisted thoracoscopic surgery: a single-centre randomised controlled trial BMJ Open (IF 2.9) Pub Date : 2024-03-01 Rui Bao, Wei-shi Zhang, Yi-feng Zha, Zhen-zhen Zhao, Jie Huang, Jia-lin Li, Tong Wang, Yu Guo, Jin-jun Bian, Jia-feng Wang
Objectives Opioid-free anaesthesia (OFA) has emerged as a promising approach for mitigating the adverse effects associated with opioids. The objective of this study was to evaluate the impact of OFA on postoperative nausea and vomiting (PONV) following video-assisted thoracic surgery. Design Single-centre randomised controlled trial. Setting Tertiary hospital in Shanghai, China. Participants Patients
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Estimating quality-adjusted life expectancy (QALE) for local authorities in Great Britain and its association with indicators of the inclusive economy: a cross-sectional study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Andreas Höhn, Nik Lomax, Hugh Rice, Colin Angus, Alan Brennan, Denise Brown, Anne Cunningham, Corinna Elsenbroich, Ceri Hughes, Srinivasa Vittal Katikireddi, Gerry McCartney, Rosie Seaman, Aki Tsuchia, Petra Meier
Objectives Quantifying area-level inequalities in population health can help to inform policy responses. We describe an approach for estimating quality-adjusted life expectancy (QALE), a comprehensive health expectancy measure, for local authorities (LAs) in Great Britain (GB). To identify potential factors accounting for LA-level QALE inequalities, we examined the association between inclusive economy
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Evaluating the accuracy of the Ophthalmologist Robot for multiple blindness-causing eye diseases: a multicentre, prospective study protocol BMJ Open (IF 2.9) Pub Date : 2024-03-01 Qixin Li, Jie Tan, He Xie, Xiaoyu Zhang, Qi Dai, Zhongwen Li, Lijing L Yan, Wei Chen
Introduction Early eye screening and treatment can reduce the incidence of blindness by detecting and addressing eye diseases at an early stage. The Ophthalmologist Robot is an automated device that can simultaneously capture ocular surface and fundus images without the need for ophthalmologists, making it highly suitable for primary application. However, the accuracy of the device’s screening capabilities
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Combined MRI-TRUS fusion targeted and systematic biopsy versus systematic biopsy alone for the detection of prostate cancer: protocol for a prospective single-centre trial BMJ Open (IF 2.9) Pub Date : 2024-03-01 Wujianhong Liu, Aimaitiaji Kadier, Danjing Shen, Yanyan He, Shengrong Dong, Kun Zhu, Guang Xu, Binghui Zhao, Shiyu Mao, Changcheng Guo, Xudong Yao, Qin Wei, Dongyan Han, Bin Yang
Introduction The classic way of diagnosing prostate cancer (PCa) is by conducting the 12-core systematic biopsy (SB). However, it has a low detection rate for clinically significant PCa (csPCa) and can lead to the detection of clinically insignificant PCa (cisPCa). Although MRI-transrectal ultrasound (MRI-TRUS) fusion targeted biopsy (TB) can effectively improve the detection rate of csPCa, it may
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Voluntariness of consent in paediatric HIV clinical trials: a mixed-methods, cross-sectional study of participants in the CHAPAS-4 and ODYSSEY trials in Uganda BMJ Open (IF 2.9) Pub Date : 2024-03-01 Shafic Makumbi, Francis Bajunirwe, Deborah Ford, Anna Turkova, Annabelle South, Abbas Lugemwa, Victor Musiime, Diana Gibb, Imelda K Tamwesigire
Objectives To examine the voluntariness of consent in paediatric HIV clinical trials and the associated factors. Design Mixed-methods, cross-sectional study combining a quantitative survey conducted concurrently with indepth interviews. Setting and participants From January 2021 to April 2021, we interviewed parents of children on first-line or second-line Anti-retroviral therapy (ART) in two ongoing
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Knowledge, attitude and practice on ovarian reserve function among women of childbearing age: a prospective cross-sectional study in Chongqing and surrounding regions BMJ Open (IF 2.9) Pub Date : 2024-03-01 Youfang Yuan, Li Yang, Jun Hu, Yu Deng, Hongying Zhang
Objectives To evaluate the knowledge, attitudes and practice (KAP) on ovarian reserve function among women of childbearing age in Chongqing and surrounding regions, China. Design Cross-sectional study. Setting Chongqing and surrounding regions, China. Participants Women of childbearing age (18–48 years) by convenience sampling. Primary and secondary outcome measures The demographic characteristics
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Determining the distance patterns in the movements of future doctors in UK between 2002 and 2015: a retrospective cohort study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Lucy Hitchings, Ben Fleet, Daniel Thomas Smith, Jonathan M Read, Colin Melville, Luigi Sedda
Objective To determine and identify distance patterns in the movements of medical students and junior doctors between their training locations. Design A retrospective cohort study of UK medical students from 2002 to 2015 (UKMED data). Setting All UK medical schools, foundations and specialty training organisation. Participants All UK medical students from 2002 to 2015, for a total of 97 932 participants
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Identifying the top 10 research priorities for the school food system in the UK: a priority setting exercise BMJ Open (IF 2.9) Pub Date : 2024-03-01 Désirée Schliemann, Suzanne Spence, Niamh O’Kane, Cheng Choo Chiang, Dilara Olgacher, Michelle C McKinley, Jayne V Woodside
Introduction The school food system varies widely between schools and across the UK. There is a need to understand evidence gaps in school food research to allow the development, implementation and evaluation of policies and interventions to support children’s healthy eating at school. This study aimed to conduct a priority setting exercise to co-produce research priorities in relation to the UK school
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Tax revenue lost due to illicit cigarettes in South Africa: 2002−2022 BMJ Open (IF 2.9) Pub Date : 2024-03-01 Nicole Vellios, Corné van Walbeek
Objective To estimate lost excise and value-added tax (VAT) revenue as a result of illicit cigarette trade from 2002 to 2022. Design Using gap analysis, we estimated the number of illicit cigarettes by calculating the difference between the number of self-reported cigarettes (derived from nationally representative surveys) and the number of legal (tax-paid) cigarettes (derived from government sources)
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Application of generative language models to orthopaedic practice BMJ Open (IF 2.9) Pub Date : 2024-03-01 Jessica Caterson, Olivia Ambler, Nicholas Cereceda-Monteoliva, Matthew Horner, Andrew Jones, Arwel Tomos Poacher
Objective To explore whether large language models (LLMs) Generated Pre-trained Transformer (GPT)-3 and ChatGPT can write clinical letters and predict management plans for common orthopaedic scenarios. Design Fifteen scenarios were generated and ChatGPT and GPT-3 prompted to write clinical letters and separately generate management plans for identical scenarios with plans removed. Main outcome measures
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Cross-sectional analysis of use of real-world data in single technology appraisals of oncological medicine by the National Institute for Health and Care Excellence in 2011–2021 BMJ Open (IF 2.9) Pub Date : 2024-03-01 Jiyeon Kang, John Cairns
Objectives This study aims to identify how real-world data (RWD) have been used in single technology appraisals (STAs) of cancer drugs by the National Institute for Health and Care Excellence (NICE). Design Cross-sectional study of NICE technology appraisals of cancer drugs for which guidance was issued between January 2011 and December 2021 (n=229). The appraisals were reviewed following a published
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Inhaled Nitric Oxide ReDuce postoperatIve pulmoNAry complicaTions in patiEnts with recent COVID-19 infection (INORDINATE): protocol for a randomised controlled trial BMJ Open (IF 2.9) Pub Date : 2024-03-01 Ziyu Zheng, Lini Wang, Shuxiu Wang, Qianqian Fan, Hui Zhang, Gang Luo, Baobao Gao, Xue Yang, Bingqing Zhao, Xiaomei Wang, Hailong Dong, Huang Nie, Chong Lei
Background A history of SARS-CoV-2 infection has been reported to be associated with an increased risk of postoperative pulmonary complications (PPCs). Even mild PPCs can elevate the rates of early postoperative mortality, intensive care unit (ICU) admission and prolong the length of ICU and/or hospital stays. Consequently, it is crucial to develop perioperative management strategies that can mitigate
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Evaluating a rehabilitative intervention for substance-dependent patients with and without their accompanying children in Germany (KontextSucht): study protocol for a non-randomised trial BMJ Open (IF 2.9) Pub Date : 2024-03-01 Ananda Stullich, Laura Hoffmann, Johannes Stephan, Jan Gehrmann, Matthias Richter
Introduction People suffering from substance use disorders often live in social contexts with children or are parents themselves. Addicted parents show specific substance-related problems while raising their children, which often leads to various lifelong consequences for the children. The German rehabilitative treatment system allows bringing children to inpatient treatment centres. This mixed-methods
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Physician characteristics associated with antiviral prescriptions for older adults with COVID-19 in Japan: an observational study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Atsushi Miyawaki, Kei Kitajima, Akihiro Iwata, Daichi Sato, Yusuke Tsugawa
Objectives Although guidelines recommend antiviral therapy for outpatients with COVID-19 who are at high risk of progressing to severe conditions, such as older adults, many patients do not receive appropriate treatment. Little is known, however, about the physician factors associated with the prescription of guideline-recommended antiviral therapy for patients with COVID-19. Design A cross-sectional
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Exploring Norwegian homecare healthcare professionals’ perceptions of risk and the link to high-quality care: a qualitative multiple case study BMJ Open (IF 2.9) Pub Date : 2024-03-01 Ingvild Idsøe-Jakobsen, Heidi Dombestein, Kolbjørn Kallesten Brønnick, Siri Wiig
Objectives Homecare is a critical component of the ongoing restructuring of healthcare worldwide, given the shift from institution- to home-based care. The homecare evidence base still contains significant gaps: There is a lack of knowledge regarding quality and safety work and interventions. This study explores how home healthcare professionals perceive and use the concept of risk to guide them in
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IMPROVE study protocol, investigating post-stroke local muscle vibrations to promote cerebral plasticity and functional recovery: a single-blind randomised controlled trial BMJ Open (IF 2.9) Pub Date : 2024-03-01 Sophie Julliand, Charalambos Papaxanthis, Corentin Delphin, Anne Mock, Marc-Antoine Raumel, Mathieu Gueugnon, Paul Ornetti, Davy Laroche
Introduction Spasticity is a frequent disabling consequence following a stroke. Local muscle vibrations (LMVs) have been proposed as a treatment to address this problem. However, little is known about their clinical and neurophysiological impacts when used repeatedly during the subacute phase post-stroke. This project aims to evaluate the effects of a 6-week LMV protocol on the paretic limb on spasticity