BMJ Open最新文献

{"title":"Development and testing of a scale for nurses' knowledge, attitudes and practices regarding insulin injection-induced lipohypertrophy: A Delphi research and cross-sectional survey.","authors":"Qin Zhang, Xinyu Li, Min Chen, Ping Jia, Yan Zhu, Li Wang, Li Xiao","doi":"10.1136/bmjopen-2025-101485","DOIUrl":"https://doi.org/10.1136/bmjopen-2025-101485","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a scale for nurses' knowledge, attitudes and practices regarding the prevention and treatment of subcutaneous lipohypertrophy associated with insulin injections and evaluate its reliability and validity.</p><p><strong>Design: </strong>A Delphi research and cross-sectional survey.</p><p><strong>Setting: </strong>Medical, education and nursing experts from seven different regions conducted Delphi consultation by E-mail or Wechat, whereas clinical nurses from primary, secondary and tertiary general hospitals in different regions of Sichuan Province were conveniently selected for the questionnaire survey.</p><p><strong>Participants: </strong>A total of 16 female experts aged 35-58 years participated in the Delphi expert consultation process; 812 clinical nurses participated in the questionnaire survey.</p><p><strong>Outcome measure: </strong>Content validity, internal consistency reliability and construct validity of the scale.</p><p><strong>Results: </strong>The scale comprises 3 dimensions and 36 items, with a content validity index of 0.99, a Cronbach's α coefficient of 0.93, a split-half reliability of 0.87 and a test-retest reliability of 0.93. Exploratory factor analysis revealed a cumulative variance contribution rate of 53.38%, whereas confirmatory factor analysis indicated a χ2 degree of freedom 2 ratios of 2.65, a goodness-of-fit index of 0.86, a root mean square error of approximation of 0.06, a root mean square error of 0.04 and a comparative fit index of 0.90.</p><p><strong>Conclusion: </strong>The developed scale demonstrated strong reliability and validity, enabling the assessment of nurses' knowledge, attitudes and practices regarding the prevention and treatment of lipohypertrophy associated with insulin injections.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e101485"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-sectional quantitative analysis of production and requirements of medical oxygen during the COVID-19 pandemic in Nepal.","authors":"Samir Kumar Adhikari, Yeshoda Aryal, Anant Nepal, Melissa Beth Bingham, Subash Neupane, Ashok Basnet, Amit Kumar Singh, Bigyan Prajapati, Deepesh Sthapit, Gaurav Devkota, Samriddha Rana","doi":"10.1136/bmjopen-2024-091189","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-091189","url":null,"abstract":"<p><strong>Objectives: </strong>Medical oxygen supplementation is essential for treating severe illnesses and plays a critical role in managing life-threatening conditions, especially during the period of increased demand, such as the delta wave of COVID-19. The study aims to evaluate oxygen requirements and production to support effective capacity planning for future health crises.</p><p><strong>Design and setting: </strong>Cross-sectional quantitative study. Data collection was carried out between 15 March and 19 December 2021.</p><p><strong>Main outcome measures: </strong>The study used secondary data from Nepal's Health Emergency Operation Centre. Regarding medical oxygen production, calculations included oxygen generated from both hospital-based oxygen plants and private companies, using their highest capacities for comparison. These production capacities were then assessed using three levels of efficiency (100%, 80% and 50%), revealing significant gaps when compared against the oxygen requirements of hospitalised COVID-19 patients, as guided by WHO recommendations. The results were communicated in terms of J-size cylinders, alongside average daily COVID-19 hospitalizations. Data was inputted and analysed using Microsoft Excel and presented in numbers and percentage.</p><p><strong>Results: </strong>The country's oxygen demand relies largely on the production from private enterprises, with meeting approximately 85.2% of the total requirement. Optimal production ensures that national oxygen needs will be met. The analysis highlighted that at 80% operational efficiency, 90.8% of the hospital's requirements could be fulfilled. However, if operational efficiency drops to 50%, the fulfilment rate diminishes to 56.7%. The differences in requirement and production of oxygen are consistent across the provinces; however, a huge disparity was notable in Karnali and Sudurpaschim.</p><p><strong>Conclusion: </strong>Continuous assessment of production capacities in both hospital and private enterprises producing oxygen is necessary to plan and address the gaps.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e091189"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of aromatherapy in pain relief postcardiac surgery: a systematic review and meta-analysis protocol.","authors":"Roberta Paolli de Paiva Oliveira Arruda Camara, Maria Carolina Batista Silva, Fernanda de Castro Teixeira, Vinicius Dos Santos Lemos Pereira, Bruna Carmelita Rocha Pontes, Ayane Cristine Alves Sarmento, Kleyton Santos Medeiros, Rodrigo Assis Neves Dantas, Daniele Vieira Dantas","doi":"10.1136/bmjopen-2025-099639","DOIUrl":"https://doi.org/10.1136/bmjopen-2025-099639","url":null,"abstract":"<p><strong>Introduction: </strong>Acute pain in the postoperative period of cardiac surgery is mostly treated with opioid analgesics. However, with the risk of adverse reactions and complications, strategies which do not involve opioid analgesics can be considered, such as aromatherapy. This systematic review aims to analyse the effectiveness of aromatherapy in relieving pain in post-cardiac surgery patients.</p><p><strong>Methods and analysis: </strong>Two researchers will independently and simultaneously conduct searches and select studies from the following databases: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Literature on Health Sciences, Scopus, Web of Science, Cochrane (Library) and clinical trial registries (clinicaltrials.com), with no language or publication date restrictions. Randomised and quasi-randomised clinical trials on the use of aromatherapy for pain relief in postcardiac surgery patients will be included. Then, two researchers will independently examine the studies based on inclusion criteria, extract data from the included studies and assess the risk of bias using the Risk of Bias 2 tool and the Risk of Bias in Non-randomized Studies of Interventions tool from Cochrane. Data will be synthesised using Review Manager software. The strength of the evidence will be evaluated using the Grading of Recommendation Assessment, Development and Evaluation approach. The literature search, study selection, review and meta-analysis stages will be conducted from early October 2025 to April 2026.</p><p><strong>Ethics and dissemination: </strong>This study is based on secondary data, and therefore ethical approval from a research ethics committee was not required. The results will be disseminated through publication in a peer-reviewed scientific journal.</p><p><strong>Prospero registration number: </strong>CRD42024568532.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e099639"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two years and counting: a prospective cohort study on the scope and severity of post-COVID symptoms across diverse patient groups in the Netherlands-insights from the CORFU study.","authors":"Dorthe O Klein, Sophie F Waardenburg, Emma B N J Janssen, Marieke S J N Wintjens, Maike Imkamp, Stella C M Heemskerk, Erwin Birnie, Gouke J Bonsel, Michiel C Warlé, Lotte M C Jacobs, Bea Hemmen, Jeanine Verbunt, Bas C T van Bussel, Susanne van Santen, Bas L J H Kietelaer, Gwyneth Jansen, Frederikus A Klok, Martijn D de Kruif, Kevin Vernooy, Juanita A Haagsma, Folkert W Asselbergs, Marijke Linschoten, Jochen W L Cals, Hugo Ten Cate, Iwan C C van der Horst, Nick Wilmes, Chahinda Ghossein-Doha, Sander M J van Kuijk","doi":"10.1136/bmjopen-2024-093639","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-093639","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Little research has been done on post-COVID symptoms at 24 months postinfection and on the association these may have on health-related quality of life (HRQOL).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We assessed the prevalence and severity of post-COVID symptoms and quantified EuroQol 5 Dimension 5 Level (EQ-5D-5L), self-perceived health question (EuroQol Visual Analogue Scale (EQ-VAS)) and health utility scores (HUS) up to 24 months follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;The longitudinal multiple cohort CORona Follow-Up (CORFU) study combines seven COVID-19 patient cohorts and a survey among the general public. The participants received questionnaires on several time points. Participants were stratified by: without a known SARS-CoV-2 infection (control group), proven SARS-CoV-2 infection but non-hospitalised, proven SARS-CoV-2 infection hospitalised to the ward, and proven SARS-CoV-2 infection hospitalised to the intensive care unit (ICU).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;In this study, data of seven COVID-19 patient cohorts and a survey among the general public are included.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Former COVID-19 patients and controls participated in this cohort study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Former COVID-19 patients and non-COVID-19 controls were sent questionnaires on symptoms associated with post-COVID condition. The CORFU questionnaire included 14 symptom questions on post-COVID condition using a five-level Likert-scale format. Furthermore, HRQOL was quantified using the EuroQol EQ-5D-5L questionnaire: EQ-VAS and the EQ-5D-5L utility score. The EQ-5D-5L questionnaire includes five domains that are scored on a five-point Likert scale: mobility, self-care, usual activities, pain/discomfort and anxiety/depression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 901 participants (and 434 controls) responded at 24 months follow-up. In all former COVID-19 patients, the presence of post-COVID condition at 24 months was observed in 62 (42.5%, 95% CI 34.3% to 50.9%) of the non-hospitalised patients, 333 (65.0%, 95% CI 60.7% to 69.2%) of the hospitalised ward patients and 156 (63.2%, 95% CI 56.8% to 69.2%) of the ICU patients, respectively (p&lt;0.001). The most common symptoms included fatigue, sleep problems, muscle weakness/pain and breathing issues, with hospitalised participants reporting most often having symptoms. Multiple post-COVID symptoms were significantly associated with EQ-5D-5L measures. The mean and SD of the EQ-VAS were 71.6 (17.9), 70.0 (17.3) and 71.4 (17.5) for non-hospitalised, ward and ICU participants, respectively, and 75.6 (17.7) for the controls (p&lt;0.001). The HUS resulted in 0.81 (0.20), 0.77 (0.19) and 0.79 (0.22) for non-hospitalised, hospitalised ward and ICU participants, respectively, and 0.84 (0.19) for the control group (CG) (p&lt;0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Many former COVID-19 patients experience post-COVID symptoms at 24 months follow-up, w","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e093639"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps between patients' healthcare-seeking behaviour, physicians' clinical judgement and tiered rehabilitation service outcomes: a cross-sectional study in China.","authors":"Ruixue Ye, Xuehui Fan, Jing Xu, Yan Gao, Yingzi Hao, Yuqi Wang, Xiaoxuan Li, Xinyue Zhou, Longyao Cao, Jianjun Long, Yongjun Jiang, Zejun Wang, Yulong Wang","doi":"10.1136/bmjopen-2024-091076","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-091076","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Faced with the challenge of ageing populations and growing rehabilitation demands, misallocating healthcare resources may impede tiered service. This study aimed to (1) evaluate gaps between patients' healthcare-seeking behaviour, doctors' clinical judgement and rehabilitation tiered service (RTS) tool results using the first-hand data from the field survey in China and (2) identify factors associated with these gaps across institution, doctor and patient levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Population-based, multicentre cross-sectional study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;41 medical institutions across 21 cities in China.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;5856 participants were included in our study. The inclusion criteria of participants were (1) he/she had dysfunctional problems, (2) he/she had visited rehabilitation doctors, (3) he/she was outpatients, (4) he/she would complete all evaluation procedures and (5) he/she agreed to participate in our study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Gaps between patients' healthcare-seeking behaviour, doctors' clinical judgement and RTS tool results. The results included outpatient rehabilitation treatment, visiting other clinical departments, admission to primary healthcare, secondary hospitals, tertiary hospitals, nursing homes and other clinical departments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age of participants was 47.5 years (SD: 24.4), and half (53.6%) were male. Most were diagnosed with orthopaedic disorders (55.2%) and neurological disease (29.0%). The majority had mobility difficulty (81.8%), self-care ability (69.8%), controlled disease (89.5%) and stable vital signs (98.9%). The minority participants had an onset of over 1 year (8.5%). The first gap (the rate of misalignment between patients' healthcare-seeking behaviour and doctors' clinical judgement) was 21.0%; doctors with higher educational level (OR=4.89, 95% CI 1.35 to 17.73), those who majored in western medicine (OR=2.97, 95% CI 1.15 to 7.67), elder patients (OR=1.01, 95% CI 1.01 to 1.02) and patients with neurological disease (OR=2.11, 95% CI 1.34 to 3.30), geriatric diseases (OR=1.60, 95% CI 1.17 to 2.19) and childhood diseases (OR=2.72, 95% CI 1.04 to 7.13) were associated with the increased first gap, whereas doctors from public institution (OR=0.10, 95% CI 0.02 to 0.44), receiving more medical training (OR=0.94, 95% CI 0.88 to 1.00) and patients with cardiopulmonary disease (OR=0.44, 95% CI 0.29 to 0.67) were associated with reduced first gap. The second gap (the rate of misalignment between doctors' clinical judgement and RTS tool results) was 49.3%; doctors from primary healthcare (OR=24.60, 95% CI 7.82 to 77.42), male doctors (OR=2.66, 95% CI 1.45 to 4.86), those who majored in western medicine (OR=1.91, 95% CI 1.04 to 3.51) or Chinese and western medicine (OR=4.19, 95% CI 1.47 to 11.91) and elder patients (OR=1.01, 95% CI 1.00 to 1.01) were associated with increased secon","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e091076"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerating clinical development outside the usual regions for future pandemics: a comparative analysis of COVID-19 therapeutic development between the USA and Japan.","authors":"Miyuki Katayama, Mayumi Shikano","doi":"10.1136/bmjopen-2024-096074","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-096074","url":null,"abstract":"<p><strong>Objectives: </strong>During the COVID-19 pandemic, the clinical development of therapeutics progressed rapidly. However, regions outside the areas where most clinical development occurred experienced delayed access and had fewer options for new therapeutics. To adequately respond to future pandemics, these regions must be prepared to expedite the development of necessary therapeutics. In this study, we compared the clinical development of COVID-19 therapeutics between the USA and Japan and proposed strategies for enhancing global therapeutic deployment in future pandemics.</p><p><strong>Design: </strong>Cross-sectional analysis.</p><p><strong>Setting: </strong>The regulatory documentation for COVID-19 therapeutics granted Emergency Use Authorization (EUA) in the USA or approved in Japan during the WHO-declared pandemic period (30 January 2020 to 5 May 2023) was analysed.</p><p><strong>Primary and secondary outcome measures: </strong>The development timelines and submitted data in both regions were analysed.</p><p><strong>Results: </strong>14 therapeutics were authorised in the USA compared with 9 in Japan, of which 8 were authorised in both countries. For all eight therapeutics, authorisation was obtained earlier in the USA, with an average difference of 4 months. The number of clinical studies submitted for authorisation was 1.0 in Japan and 4.0 in the USA. The data packages submitted for approval in the USA generally followed the standard structure for a typical application, including phase 1, 2 and 3 studies, whereas in Japan, phase 3 study data were often the primary focus.</p><p><strong>Conclusion: </strong>Compared with the USA, fewer therapeutics were approved in Japan, and the approvals occurred later. Most therapeutics approved in Japan had previously received EUA in the USA, with Japanese approvals largely dependent on participation in large-scale global studies and the US review schedule. Application data in Japan were primarily based on data from large-scale global studies that had been submitted for the US application; the observed delay in approval was considered attributable to the time required for application preparation. In preparation for future pandemics, it will be necessary to establish systems that take these characteristics into account.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e096074"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study protocol for healthy hearts: a prospective observational cohort study on dyadic management of HIV and cardiometabolic comorbidities in couples from Malawi.","authors":"Amy A Conroy, Julie T Bidwell, Allison Ruark, Torsten B Neilands, Sheri D Weiser, Rita M Butterfield, Nancy Mulauzi, James Mkandawire","doi":"10.1136/bmjopen-2025-102236","DOIUrl":"https://doi.org/10.1136/bmjopen-2025-102236","url":null,"abstract":"<p><strong>Introduction: </strong>As the HIV epidemic stabilises in Sub-Saharan Africa with effective antiretroviral therapy, cardiometabolic disorders (CMDs) remain the next major challenge for people living with HIV. Relationship dynamics and spousal support are important for the medical management of single diseases such as HIV, yet little is known about how couples manage the complexity of multiple competing health conditions and their synergistic effects on health. The <i>Healthy Hearts</i> study aimed to develop a conceptual model of dyadic management of HIV and CMDs, inform interventions for couples in Sub-Saharan Africa, and ultimately improve clinical practice and disease management for HIV and CMD comorbidities.</p><p><strong>Methods and analysis: </strong>This study will enrol 250 couples who have at least one partner living with HIV and CMD (either hypertension or diabetes) for a prospective observational cohort study. Patients will be recruited from HIV and CMD clinics in Zomba and Blantyre, Malawi. Couples will attend four study visits at quarterly intervals over 12 months. Both partners are given interviewer-administered surveys and complete a clinical assessment. Regression techniques will be used to test associations between key constructs in our conceptual model, including communal coping, multimorbidity illness perceptions, relationship quality, psychosocial health, disease management (eg, adherence to lifestyle advice and medications) and disease outcomes (eg, viral suppression and CMD control). Findings will be used to identify elements to target in a couple-based intervention for CMD and HIV.</p><p><strong>Ethics and dissemination: </strong>This study was approved by the University of California, San Francisco (HRPP (Human Research Protection Program); Protocol number 20-32126), and the National Health Sciences Research Committee of Malawi (Protocol number 21/04/2677). The results will be disseminated at local community meetings and conferences focused on relationships, CMDs and HIV and published in scientific journals.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e102236"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hidden barriers to leadership: a cross-sectional survey of prevalence and predictors of Imposter Phenomenon in Trauma and Orthopaedic surgery in the UK.","authors":"Zaha Kamran Siddiqui, James Tomlinson, Arabella Scantlebury, Raveen Jayasuriya, Helen Church, Amy Grove","doi":"10.1136/bmjopen-2025-100557","DOIUrl":"https://doi.org/10.1136/bmjopen-2025-100557","url":null,"abstract":"<p><strong>Objectives: </strong>Imposter Phenomenon is characterised by persistent self-doubt despite objective success. It has been associated with anxiety, burnout and reduced job satisfaction. Little is known about imposter phenomenon's presence and impact in Trauma and Orthopaedic surgery. This study aims to determine the prevalence and predictors of Imposter Phenomenon among UK orthopaedic surgeons, further mapping domains that affect leadership and professional development.</p><p><strong>Design: </strong>Cross-sectional survey using the validated Clance Imposter Phenomenon Scale (CIPS).</p><p><strong>Setting: </strong>The survey was distributed to UK orthopaedic surgeons between 20 October 2023 and 28 February 2024 via Training Programme Directors and the British Orthopaedic Association.</p><p><strong>Participants: </strong>Orthopaedic trainees and consultant surgeons (n=441) PRIMARY AND SECONDARY OUTCOME MEASURES: Imposter Phenomenon severity measured using CIPS (mild: 41-60, moderate: 61-80 and severe: 81-100). Univariate and multivariate analyses identified predictors of this severity. Self-reported impact of Imposter Phenomenon assessed across personal and leadership domains.</p><p><strong>Results: </strong>92% of respondents reported moderate to intense Imposter Phenomenon symptoms (mean CIPS=65.17). Trainees had significantly higher mean scores (70.64±13.85) compared with consultants (59.82±15.71). Female surgeons reported significantly higher mean scores (72.57±13.35) than male surgeons (61.19±15.74). Female gender, non-consultant training grade and time out of training were predictors of severity (p<0.01). 90% reported negative impacts, with 49% discouraged from applying for leadership roles and 45% experiencing hindered career progression.</p><p><strong>Conclusion: </strong>The Imposter Phenomenon is highly prevalent among UK orthopaedic surgeons; disproportionately affecting women, trainees and those taking career breaks. Imposter Phenomenon significantly impacts leadership aspirations and career development, potentially contributing to reduced diversity in surgical leadership. Targeted interventions addressing Imposter Phenomenon are needed to support equitable leadership development in Trauma and Orthopaedic surgery.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e100557"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the core characteristics of competence in healthcare assistants: a scoping review protocol.","authors":"Nana Cui, Ran Liang, Xiangru Yan, Yanan Song, Ling Meng, Hui Zhang, Yuan Chu","doi":"10.1136/bmjopen-2025-107248","DOIUrl":"https://doi.org/10.1136/bmjopen-2025-107248","url":null,"abstract":"<p><strong>Introduction: </strong>The global healthcare landscape is undergoing a significant shift in demographics, evolving disease epidemiology and an ageing population, prompting the expansion of healthcare roles, including the healthcare assistant (HCA). However, there remains limited clarity regarding the scope and standards of their competence.</p><p><strong>Methods and analysis: </strong>A scoping review will be conducted following the updated Joanna Briggs Institute methodological framework. Five databases encompassing PubMed, Cumulative Index to Nursing and Allied Health Literature Complete (EBSCOhost), EMBASE, Web of Science and PsycINFO (EBSCOhost) will be searched. Selected studies will include all types of studies on the competence of HCAs. Two reviewers will independently perform the screening and data extraction process. The quality of evidence in this review will be assessed by the Crowe Critical Appraisal Tool. Data synthesis will be presented using the narrative descriptions and tabular illustrations. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews will be employed for transparent reporting.</p><p><strong>Ethics and dissemination: </strong>No ethical clearance is required for this review. The final review will be submitted for publication to a peer-reviewed journal. Additionally, the results of the final review will be disseminated both locally and nationally to inform clinical practice.</p><p><strong>Registration: </strong>This protocol has been registered with the Open Science Framework. Registration number is OSF.IO/5RGUC.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e107248"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and attitudes regarding cardiopulmonary resuscitation among Jordanian physical education students: a cross-sectional online survey.","authors":"Thaer S Manaseer, Saad M Al-Nassan, Alaa O Oteir","doi":"10.1136/bmjopen-2024-094608","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-094608","url":null,"abstract":"<p><strong>Objective: </strong>To examine the knowledge and attitudes regarding cardiopulmonary resuscitation (CPR) among Jordanian physical education (PE) students with and without CPR training, and the association between knowledge and attitudes.</p><p><strong>Design: </strong>Cross-sectional survey-based study.</p><p><strong>Settings: </strong>Private and public universities in Jordan.</p><p><strong>Participants: </strong>A convenience sample of 372 full-time second, third and fourth-year PE students.</p><p><strong>Outcome measures: </strong>Primary outcomes were levels of knowledge and attitudes towards CPR, measured using a validated questionnaire. Secondary outcomes included group comparisons (trained vs untrained) and the correlation between knowledge and attitude scores.</p><p><strong>Result: </strong>Of the 372 participants (mean age: 22.0±1.6 years; 51% female), 189 (51%) reported prior CPR training. Only 3% of students demonstrated high knowledge (>80% of correct answers), while 56% had low knowledge (<50% of correct answers). Trained students had significantly higher median knowledge scores (4) compared with their untrained peers (3), p<0.01. Item-level analysis of attitudes revealed that trained students were significantly more likely to perform mouth-to-mouth ventilation on individuals of the opposite sex (p=0.01), perform CPR despite fear of infection (p=0.01) and provide chest compressions to strangers (p<0.01). Weak but statistically significant positive correlations between CPR knowledge and several attitude items were observed (ρ=0.12-0.26, p<0.05).</p><p><strong>Conclusion: </strong>CPR knowledge among Jordanian PE students was low regardless of training. Attitudes were positive, mainly among trained students. There is a need for a structured CPR education in PE that addresses cultural and psychological barriers to improve preparedness for emergency response in athletic settings.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e094608"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}