BMJ Open最新文献

{"title":"Beyond BRCA: A scoping review of person-centred care for women diagnosed with a BRCA gene mutation.","authors":"Leonie Emilia Witte, Cornelia van Diepen, Jane Murray Cramm","doi":"10.1136/bmjopen-2024-094416","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-094416","url":null,"abstract":"<p><strong>Objectives: </strong>Women diagnosed with BRCA1/2 mutations face significantly elevated lifetime risks of breast and ovarian cancer. Due to the distinctive biopsychosocial implications of a BRCA diagnosis, the care trajectory for these women is highly personalised, yet their care needs frequently remain unmet. The aim was to provide a first overview of the evidence of women's experiences with person-centred care (PCC) within BRCA care and their needs for further PCC implementation.</p><p><strong>Design: </strong>A scoping review, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, was conducted.</p><p><strong>Data sources: </strong>Medline, Embase, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, CINAHL Plus and Google Scholar were searched for literature published between January 2004 and February 2024.</p><p><strong>Eligibility criteria: </strong>Peer-reviewed, primary studies on BRCA and PCC using quantitative, qualitative and mixed-methods designs were eligible. The criteria were iteratively refined to include publications based on samples that were >80% female and >80% BRCA positive.</p><p><strong>Data extraction and synthesis: </strong>Titles and abstracts were screened with ASReview, a validated AI-driven tool. Data on PCC evidence and needs were extracted based on the eight Picker Principles of PCC and synthesised by describing themes within each principle.</p><p><strong>Results: </strong>Of the 3801 articles identified as potentially relevant, 18 were included in the review. PCC needs were more prevalent than evidence of their implementation. Most of women's positive experiences with PCC focused on 'clear information, communication and support for self-care', while limited to no evidence existed for other principles. The highest needs were found for increased 'emotional support, empathy and respect', 'attention to physical and environmental needs', and 'clear information, communication and support for self-care'. All articles reported demands for more holistic, yet personalised care, though PCC was not mentioned explicitly.</p><p><strong>Conclusions: </strong>This review suggests a person-centred approach is relevant to improving the standard of BRCA care for women. The first evidence of women's experiences with PCC demonstrates how care delivered with sensitivity and respect for individual backgrounds can support women throughout their BRCA trajectory. Yet, substantial unmet needs remain among female BRCA carriers, highlighting the importance of further research and PCC implementation to enhance the quality of postdiagnostic care.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e094416"},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572066","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":"Evaluating the impact of a full-service mobile food market on food security, diet quality and food purchases: a cluster randomised trial protocol and design paper.","authors":"Melissa L Horning, Kristen S Gorman, Stephanie Wagner, Jayne A Fulkerson, Julian Wolfson, Melissa N Laska, Lisa Harnack","doi":"10.1136/bmjopen-2025-099414","DOIUrl":"https://doi.org/10.1136/bmjopen-2025-099414","url":null,"abstract":"<p><strong>Introduction: </strong>Mobile food markets may help to mitigate diet-related and weight-related inequities by bringing low-cost, nutritious food directly to underserved populations. By stocking foods to meet a range of dietary needs, full-service mobile markets may improve multiple aspects of diet, food security and fruit and vegetable procurement with a convenient one-stop shop.</p><p><strong>Methods and analysis: </strong>This cluster randomised trial is evaluating the impact of a full-service mobile market, the Twin Cities Mobile Market (TCMM). The TCMM sells staple foods at affordable prices from a retrofitted bus that regularly visits communities experiencing low incomes. The trial's primary outcome is participant diet quality. Secondary outcomes include intake of specific foods and nutrients, food security and servings of fruits and vegetables procured for the home.Together with our partners, we enrolled four subsidised community housing sites in three waves (12 total sites), aimed to recruit 22 participants per site (N=264) and collected baseline data. Sites were then randomised to either receive the full-service TCMM intervention or serve as a waitlist control, and the full-service TCMM began implementing at intervention sites. Follow-up data collection is occurring at 6 months post-implementation. After follow-up data collection for each wave, the full-service TCMM intervention is being implemented at the waitlist control sites. Waves 1 and 2 are complete and Wave 3 is in progress.At baseline and follow-up data collection, dietary quality and intake are being assessed through three, interviewer-administered, 24-hour dietary recalls, food insecurity is being assessed by the 18-item Food Security Screening Module and fruit and vegetable procurement is being measured by collecting one month of food procurement tracking forms.We will use intent-to-treat analyses to determine if participant diet quality, food security and procurement of fruits and vegetables improve in the sites that received the full-service TCMM intervention relative to the participants in the waitlist control condition.</p><p><strong>Ethics and dissemination: </strong>Trial procedures have been approved by the University of Minnesota Institutional Review Board. We plan to disseminate main outcomes in Grant Year 5 in both scientific and community spaces.</p><p><strong>Trial registration number: </strong>ClinicalTrials.gov: NCT05672186.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e099414"},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572075","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":"Epidemiology and burden of adult chronic pancreatitis in South Australia: a 20-year data linkage study.","authors":"Tristan J Bampton, John W Chen, Alex Brown, Meghan I Barnett, P Toby Coates, Lyle John Palmer","doi":"10.1136/bmjopen-2024-089297","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-089297","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the epidemiology and burden of adult-onset chronic pancreatitis (CP) in South Australia.</p><p><strong>Design: </strong>Retrospective case-control study; data linkage.</p><p><strong>Setting: </strong>All public adult hospitals in SA.</p><p><strong>Participants: </strong>Administrative data linkage from South Australia-Northern Territory DataLink was used to ascertain an index cohort of all adults with an initial diagnosis of CP aged >19 years between June 2000 and June 2019. Age- and sex-matched controls were drawn from the general population of SA, adults with type 1 diabetes mellitus and adults with type 2 diabetes mellitus (defined by International Classification of Diseases 10th Revision coding).</p><p><strong>Main outcome measures: </strong>Hospital visits, days in hospital, emergency department visits, intensive care unit admissions, incidence, prevalence.</p><p><strong>Results: </strong>A total of 2503 incident index cases with CP were identified. The crude prevalence and incidence were estimated as 195.1 per 100 000 and 10.4 per 100 000 per annum, respectively. Cases of CP averaged more hospital visits for any reason (median 11, IQR 5 to 21.75) than the general population (median 1, IQR 0 to 4) and had a higher healthcare burden than controls with type 1 diabetes or type 2 diabetes (all p<0.001). Indigenous individuals were over-represented in the cohort (n=358; 14.8% vs 1.5% of the general population) and had higher healthcare utilisation than other patients with CP (p<0.001).</p><p><strong>Conclusions: </strong>CP is a significant burden on the SA healthcare system and was more prevalent and more burdensome in Indigenous adults. CP consumes a disproportionate level of public health services. Our findings support further research and preventive efforts, particularly in the Indigenous population.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e089297"},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572088","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":"Air pollution-associated chronic kidney disease (APA-CKD): evidence from a cross-sectional study of Niger Delta communities.","authors":"Ogochukwu Chinedum Okoye, Elaine Carnegie, Luca Mora","doi":"10.1136/bmjopen-2024-096336","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-096336","url":null,"abstract":"<p><strong>Objective: </strong>Air pollution is an emerging risk factor for chronic kidney disease (CKD) that is typically ignored in preventive interventions. This study investigated whether long-term exposure to ambient air pollution in communities near petrochemical industries in the Niger Delta was associated with CKD.</p><p><strong>Design: </strong>A cross-sectional study with an embedded citizen science inquiry.</p><p><strong>Settings: </strong>Four communities situated at varying distances from a petrochemical refinery in Niger Delta, Nigeria.</p><p><strong>Participants: </strong>We obtained sociodemographic, behavioural, exposure history and clinical data from 1460 participants who have resided for at least 5 years in the four communities. A citizen science approach was used to monitor air pollutant concentrations with eight community volunteers.</p><p><strong>Results: </strong>The mean PM_2.5, PM₁₀ and volatile organic compounds (VOC) concentrations exceeded the WHO-acceptable limits in all four communities. CO₂ was acceptable in the farthest communities from the refinery, while O₃ was within acceptable limits in all communities. The total hazard quotient was relatively higher in the two communities near the refinery (11.27, 11.63) than those farther (9.63, 10.68), F=0.038, p=0.989. The overall prevalence of CKD was 12.3%; it was 17.9% in the community closest to the refinery and 8.0% in the farthest (χ²=18.292, p=0.004). Increasing age was the only independent risk factor for CKD after adjusting for confounding factors and intrahousehold design effect (adjusted OR 1.26; 95% CI 1.09 to 1.45, p=0.002).</p><p><strong>Conclusion: </strong>Long-term exposure to ambient air pollution may increase CKD risk in susceptible populations. Social factors and environmental exposures associated with CKD are prevalent in the communities, necessitating multifaceted and inclusive approaches to mitigate air pollution and the associated kidney disease risks. More studies are required to explore the mechanism of air pollution-associated kidney disease and interventions to reverse or limit it.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e096336"},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572049","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":"Factors contributing to paracetamol overdoses (intentional and accidental) amongst adult and paediatric populations in the United Kingdom: protocol for a systematic review and meta-analysis.","authors":"Nasloon Ali, Andrew Radley, Heather Cassie, Giorgia De Paoli","doi":"10.1136/bmjopen-2024-090135","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-090135","url":null,"abstract":"<p><strong>Introduction: </strong>Paracetamol, the most used analgesic medicine in the world, is considered a safe treatment, but when overdosed, it can be fatal. Evidence suggests that despite sales legislations, paracetamol overdose still accounts for around 100 000 accident and emergency visits and 50 000 hospital admissions per year in the UK. This systematic review aims to describe the possible factors linked to paracetamol overdoses (intentional and/or accidental) in the adult and child populations in the UK and the subgroups of the population that are at higher risk and identify any preventative interventions.</p><p><strong>Methods and analysis: </strong>This review will be carried out in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidance. Literature searches will be performed using six bibliographic databases: MEDLINE via PubMed, EMBASE, SCOPUS, PsycINFO, the Cochrane Library and PROSPERO register. Grey literature and social media will also be searched, and article reference lists are reviewed. Studies included will be in English with populations in the UK from 1998 onwards, experiencing paracetamol overdose (intentional or accidental), with no age restriction. Title and abstract screening and full-text review of included articles will be performed by two independent reviewers (with a third member to resolve disagreement). The risk of bias will be assessed using the JBI critical appraisal checklist. The quality of any systematic reviews included will be assessed using the AMSTAR 2 tool or the Mixed Methods Appraisal Tool (MMAT), as appropriate. It is anticipated to adopt a narrative synthesis of the findings via a thematic analysis. Meta-analysis and subgroup analysis will be considered if data are available.</p><p><strong>Ethics and dissemination: </strong>Ethics approval is not required for this work since no data will be collected. Results will be disseminated through a peer-reviewed publication and local as well as national conference presentations; and a range of creative and inclusive methods and formats to inform and educate patients and the community.</p><p><strong>Prospero registration number: </strong>CRD42024555406.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e090135"},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572076","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":"Multicentre, multi-arm, double-blind randomised placebo-controlled dose-finding trial investigating the safety and Efficacy of MirococePt (APT070) In Reducing delayed graft function In the Kidney ALlograft (EMPIRIKAL-2): study protocol for a randomised controlled trial.","authors":"Theodoros Kassimatis, Alima Rahman, Fayyad Jaradat, Abdel Douiri, Marc Delord, Roseanna Greenlaw, Joanne Palmer Joyce, Jonathon Olsburgh, Muhammad Khurram, Abbas Ghazanfar, Simon Knight, Peter Friend, Sapna Shah, Hannah Killbride, Richard Smith, Steven Sacks","doi":"10.1136/bmjopen-2024-097029","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-097029","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Up to 50% of kidney transplant patients are diagnosed with delayed graft function (DGF) following transplantation-the majority being linked to ischaemia reperfusion injury (IRI). DGF is traditionally defined as the requirement for dialysis during the first week after transplantation and is associated with inferior graft and patient outcomes. Local synthesis of complement components, largely by the renal tubule, plays a critical role in IRI. We have developed Mirococept, a membrane-targeted complement inhibitor, that can be administered to the donor kidney ex vivo prior to transplantation. After administration, Mirococept is retained in the donor organ, thereby minimising the risk of systemic side effects. We previously launched the EMPIRIKAL study aiming to evaluate the efficacy of Mirococept in reducing DGF in deceased-donor kidney transplantation (KT). The funding body recommended termination of the study to allow a dose-saturating study before the next stage of clinical evaluation. This was carried out in a porcine kidney model and led to a revised dosing regimen for EMPIRIKAL-2 (60-180 mg compared with 5-25 mg in the initial trial). The EMPIRIKAL-2 trial (REC 24/NE/0071) aims to identify the most safe and efficacious dose of Mirococept to reduce DGF rate in deceased-donor KT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and analysis: &lt;/strong&gt;EMPIRIKAL-2 is a Phase IIa multicentre double-blind randomised controlled trial (RCT) with an initial safety run. Participants will be recruited from renal departments at National Health Service tertiary hospital sites in the UK. The purpose of the safety run is to assess the tolerance of each of the three proposed Mirococept doses (60, 120 or 180 mg), before the RCT begins. Three patients will be assigned to each treatment dose, starting from the lower dose. The safety run will be considered successful if at least one dose can be taken forward to the RCT for comparison to placebo.If safety is met, 144 participants (36 per arm excluding drop-outs) will be randomised to all doses meeting the safety criteria or placebo on a 1:1:1:1 basis. The primary endpoint is DGF, defined as the requirement for dialysis during the first week after transplantation. Safety evaluation will include the monitoring of laboratory data and the recording of all adverse events. Immunosuppression therapy, antibiotic and antiviral prophylaxis will be administered as per local centre protocols. Enrolment in the RCT is anticipated to take approximately 12 months, and patients will be followed-up for 12 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Ethics and dissemination: &lt;/strong&gt;The study has been approved by the Northeast - Newcastle and North Tyneside 2 Research Ethics Service Committee, REC reference 24/NE/0071. The results of the study will be reported and disseminated at international conferences and in peer-reviewed scientific journals. Once published, a lay summary of the results will be made available to participants who request this inf","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e097029"},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572128","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":"The Canadian Lung Outcomes in Users of Vaping Devices (CLOUD) Study: protocol for a prospective, observational cohort study.","authors":"Paloma Burns, Rachel L Eddy, Xuan Li, Julia Yang, Satvir S Dhillon, Simon Couillard, Michael K Stickland, Jordan Guenette, Sarah Svenningsen, Trisha Tulloch, Hasina Samji, Rafael Meza, Laura L Struik, Shawn Aaron, Terence Ho, Stephen Lam, Jonathon Leipsic, Joanna Maclean, Tina Afshar, Theo J Moraes, Brandon Zanette, Giles Santyr, François-Pierre Counil, Ana I Hernandez Cordero, Sheila Matano, Giulia de Arruda Maluf, Clarus Leung, Carmen Feng, Lydia Bal, Harnoor Dhaliwal, Adeola Mumuni, Caitlyn Lui, Heather Drew, Don D Sin, Jonathan H Rayment, Janice M Leung","doi":"10.1136/bmjopen-2025-100568","DOIUrl":"https://doi.org/10.1136/bmjopen-2025-100568","url":null,"abstract":"<p><strong>Introduction: </strong>The rapid growth in popularity of e-cigarettes over the past decade has prompted concerns about their impact on long-term respiratory health. Small airway injury is suspected to be a direct consequence of e-cigarette use and may be quantifiable by novel structural and functional diagnostic modalities.</p><p><strong>Methods and analysis: </strong>In a multicentre observational longitudinal study, participants will be enrolled in either an adolescent (ages ≥12 and <19 years) or an adult arm (≥19 years old) and followed over 3 years across three time points (baseline, 18 months and 36 months). In the adolescent arm, a total of 50 e-cigarette and 50 non-e-cigarette users will be enrolled across 4 sites. In the adult arm, a total of 100 e-cigarette users, 100 non-e-cigarette users, and an additional 100 combustible cigarette-only users and 100 dual combustible cigarette-e-cigarette users will be enrolled across 5 sites. Participants will undergo respiratory questionnaires, pulmonary function tests, oscillometry, cardiopulmonary exercise testing, hyperpolarised 129-xenon gas MRI and blood collection. In adolescent participants only, multiple breath washout and induced sputum collection will be performed. Adult participants will also undergo inspiratory/expiratory chest CT and bronchoscopy. The primary endpoint will be a composite of small airway dysfunction according to oscillometry, cardiopulmonary testing and/or chest imaging parameters.</p><p><strong>Ethics and dissemination: </strong>This protocol has been approved by The University of British Columbia-Providence Health Care Research Ethics Board (Certificate H24-00374). The use of hyperpolarised 129-xenon gas in this study has been approved by Health Canada (Certificate HC6-024-c291776). Written documentation of informed consent will be required prior to study initiation. We will seek to enrol adolescent participants who are capable of providing informed consent with an optional support statement from a parent encouraged but not required. Study findings will be disseminated to medical/scientific audiences through scientific conferences and published manuscripts respecting the Strengthening the Reporting of Observational Studies in Epidemiology statement, to youths through outreach events at high schools and community programmes and through social media, and to adults through lung health community events.</p><p><strong>Trial registration number: </strong>NCT06819969.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e100568"},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572132","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":"Theory development of under what circumstances and what works for promoting disaster preparedness among long-term care facility (LTCF) stakeholders: protocol for realist review.","authors":"Shinya Mitani, Hirofumi Ogawara, Shoko Miyagawa, Ardith Z Doorenbos, Hiroki Fukahori","doi":"10.1136/bmjopen-2024-087837","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-087837","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of severe natural disasters has been increasing worldwide. The residents of long-term care facilities (LTCFs) are particularly vulnerable to such events. Therefore, promoting disaster preparedness among LTCF stakeholders is urgent. However, the optimal preparedness process remains unclear. To close this gap, we use a realist review (RR) to promote an understanding of under what circumstances and what works for promoting the disaster preparedness among LTCF stakeholders and develop theories for the process.</p><p><strong>Methods and analysis: </strong>RR will be guided by the Realist and Meta-Narrative Evidence Synthesis: Evolving Standard. The following five steps will be employed: (1) literature review and search for evidence, (2) study selection, (3) data extraction, (4) data synthesis and (5) development of the initial programme theory (IPT). Evidence will be searched using MEDLINE, CINAHL, PsycINFO, Web of Science, Cochrane Library, Scopus and ICHUSHI (a Japanese database). Grey literature and citation tracking will also be used. Documents of any design or publication type will be included. The study selection, coding and synthesis will be conducted independently by two authors. An IPT will be developed in the Context-Mechanism-Outcome configuration to understand how to promote disaster preparedness among LTCF stakeholders. The developed IPT will be verified by experts or stakeholders to enhance its validity.</p><p><strong>Ethics and dissemination: </strong>Ethical approval will not be required because this is a review of published literature. The results will be disseminated at scientific conferences and peer-reviewed journals. The developed IPT will be used in subsequent research and iteratively tested or refined to better explain under what circumstances and what works for promoting disaster preparedness among LTCF stakeholders.</p><p><strong>Registration details: </strong>This protocol has been registered at the Open Science Framework https://doi.org/10.17605/OSF.IO/J4TU6.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e087837"},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572143","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":"Dietary habits and breast cancer in South Asian women: a systematic review protocol.","authors":"Maheeka Seneviwickrama, Sachintha Dilhani, Surangi Jayakody, Sashini Shehana Denagamagei, Sashiprabha Nawaratne","doi":"10.1136/bmjopen-2024-087661","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-087661","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer is the fifth-leading cause of cancer-related mortality in women globally. Asia has a lower overall incidence of breast cancer compared with global incidence rates. Unique dietary habits observed in South Asians contribute significantly to low incidence rates. This review aims to explore the literature on the association between dietary habits and breast cancer among South Asian women.</p><p><strong>Methods and analysis: </strong>A systematic search will be conducted using electronic databases MEDLINE, EMBASE, CINAHL, Web of Science and Scopus. Additional articles will be searched in Google Scholar and a reference list of the selected articles. Review questions will be framed into different components according to the PICOS (population, intervention, comparator, outcomes, studies) framework. Women above 18 years of age who are diagnosed with breast cancer in the South Asian region will be the population of interest. Only the studies reported in the English language will be included. Both title and abstract screening and full-text screening will be done by two independent reviewers. The quality of included studies will be assessed using the Joanna Briggs Institute critical appraisal tools. Based on the findings, a random-effects meta-analysis will be performed if outcomes are homogeneous, or a narrative synthesis will be conducted if outcomes are heterogeneous.</p><p><strong>Ethics and dissemination: </strong>This study does not require ethics approval, as it is based on published documents. The findings of this study will be shared with a broader audience through scientific channels including publication in open-access journals and presentations at both national and international forums.</p><p><strong>Prospero registration number: </strong>CRD42023464682.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e087661"},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572085","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":"Effect of driving pressure-guided individualised positive end-expiratory pressure on postoperative atelectasis in patients with morbid obesity: study protocol of a randomised controlled trial.","authors":"Yawen Ren, Yong T Sun, Peipei Zhang, Lina Chen, Peng Liu, Zheng Zhou, Yuelan Wang","doi":"10.1136/bmjopen-2024-091217","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-091217","url":null,"abstract":"<p><strong>Introduction: </strong>Atelectasis is a common postoperative complication in patients with obesity, contributing to respiratory insufficiency, pneumonia and poor clinical outcomes. Studies have shown that driving pressure (DP)-guided individualised positive end-expiratory pressure can improve respiratory mechanics and oxygenation, while also reducing the incidence of atelectasis and other postoperative pulmonary complications (PPCs). However, the effect of this ventilation strategy on patients with morbid obesity remains unclear. The trial presented here aims to use lung ultrasound to evaluate the effect of DP-guided individualised positive end-expiratory pressure (PEEP) on postoperative atelectasis in patients with obesity undergoing bariatric surgery.</p><p><strong>Methods and analysis: </strong>This single-centre, randomised, controlled, single-blind study will enrol 52 participants with morbid obesity scheduled for laparoscopic bariatric surgery from 1 March 2024, to 30 April 2025. They will be randomly assigned in a 1:1 ratio to one of two groups: (1) the DP group, where participants will receive dynamic individualised PEEP guided by DP and (2) the fixed PEEP group, where participants will receive a PEEP of 8 cmH₂O. The primary outcome is the lung ultrasound score 30 minutes after extubation. Secondary outcomes include the lung ultrasound score on postoperative day 1, the incidence and severity of PPCs within 3 days after surgery, the intraoperative partial pressure of arterial oxygen, DP, static lung compliance, mechanical power, the incidence of hypotension during titration and the dosage of vasoactive drugs.</p><p><strong>Ethics and dissemination: </strong>This study has been approved by the Ethics Committee of The First Affiliated Hospital of Shandong First Medical University (YXLL-KY-2023(144)). The trial results will be published in peer-reviewed journals and at conferences.</p><p><strong>Trial registration number: </strong>https://clinicaltrials.gov/; NCT06181279.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e091217"},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572087","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}