BMJ Open最新文献

{"title":"Time to first optimal glycaemic control and associated factors among adult patients with diabetes at the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia: a retrospective cohort study.","authors":"Adane Desta Getahun, Emneteab Mesfin Ayele, Tilahun Degu Tsega, Sisay Sitotaw Anberbr, Gebremariam Wulie Geremew, Alemneh Ayu Biyazin, Basazinew Mekuria Taye, Gizework Alemnew Mekonnen","doi":"10.1136/bmjopen-2024-096615","DOIUrl":"10.1136/bmjopen-2024-096615","url":null,"abstract":"<p><strong>Objective: </strong>To assess the time to first optimal glycaemic control and its predictors among adult patients with type 1 and type 2 diabetes at the University of Gondar Comprehensive Specialized Hospital in Ethiopia.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>University of Gondar Comprehensive Specialized Hospital, northwest, Ethiopia.</p><p><strong>Participants: </strong>We recruited 423 adult diabetic patients who were diagnosed between 1 January 2018 and 30 December 2022 at the University of Gondar Comprehensive Specialized Hospital.</p><p><strong>Outcome measures: </strong>The primary outcome was the time from diagnosis to the achievement of the first optimal glycaemic control, measured in months. A Cox proportional hazards regression model was fitted to identify predictors of time to first optimal glycaemic control. Data were collected with KoboToolbox from patient medical charts and exported to Stata V.17. The log-rank test was used to determine the survival difference between subgroups of participants.</p><p><strong>Results: </strong>Median time to first optimal glycaemic control was 10.6 months. Among 423 adult diabetic patients, 301 (71.16%) achieved the first optimal glycaemic control during the study period. Age category (middle age (adjusted HR (AHR)=0.56, 95% CI 0.41 to 0.76), older age (AHR=0.52, 95% CI 0.33 to 0.82)), comorbidity (AHR=0.52, 95% CI 0.35 to 0.76), therapeutic inertia (AHR=0.20, 95% CI 0.13 to 0.30) and medication non-compliance (AHR=0.49, 95% CI 0.27 to 0.89) were significant predictors of time to optimal glycaemic control.</p><p><strong>Conclusion: </strong>The median time to first optimal glycaemic control was prolonged. Diabetic care should focus on controlling the identified predictors to achieve optimal glycaemic control early after diagnosis.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e096615"},"PeriodicalIF":2.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study protocol for a prospective diagnostic accuracy study to assess the feasibility and diagnostic accuracy of serial ankle handheld Doppler waveform assessment (Ankle HHD) for surveillance after lower-limb revascularisation: WAVE study.","authors":"Hamidah Mabruk Alodayni, Sasha Smith, Sepideh Poushpas, Kelly Swagell, Danilo Mandic, Nicholas Andrew Johnson, Usman Jaffer, Alun Davies, Pasha Normahani","doi":"10.1136/bmjopen-2025-107609","DOIUrl":"10.1136/bmjopen-2025-107609","url":null,"abstract":"<p><strong>Introduction: </strong>Peripheral arterial disease (PAD) affects approximately one in five people over 60 in the UK. In severe cases, revascularisation, such as surgical bypass or endovascular methods, is often required to restore limb perfusion. Between 2000 and 2019, 527 131 revascularisation procedures were carried out in the UK. Postprocedural surveillance is essential to detect restenosis and maintain vessel patency. However, standard surveillance using duplex ultrasound (DUS) is resource intensive. Ankle Doppler waveform assessment is quick, inexpensive and accurate for PAD diagnosis, yet its role in postrevascularisation surveillance remains unexplored. This study aims to evaluate the diagnostic accuracy of ankle handheld Doppler waveform assessment (ankle HHD) for detecting restenosis after lower limb revascularisation, as compared with formal DUS.</p><p><strong>Methods and analysis: </strong>This is a prospective diagnostic accuracy study (ClinicalTrials.gov Identifier NCT06619223). We aim to recruit 121 people with PAD undergoing planned lower limb revascularisation at Imperial College Healthcare NHS Trust. Follow-up assessments will take place at 3 months, 6 months and 12 months post revascularisation. At each visit, a vascular scientist will perform the index test (Ankle HHD) followed by DUS as the reference standard. A subset of participants will undergo repeat testing to assess interobserver and intraobserver reliability. Restenosis will be defined as one or more arterial lesions of ≥50% stenosis or tandem lesions with a combined value of ≥50%. The primary outcome is the sensitivity of ankle Doppler waveform assessment for detecting restenosis, compared with DUS.</p><p><strong>Ethics and dissemination: </strong>The study has received approval from Health Research Authority (HRA) and Health and Care Research Wales (REC reference 24/LO/0462). Results will be disseminated through research presentations and papers.</p><p><strong>Trial registration number: </strong>ClinicalTrials.gov, NCT06619223.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e107609"},"PeriodicalIF":2.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and enablers to healthcare access for older adults in Cambodia: perspectives of healthcare professionals - a qualitative study.","authors":"Khin Thiri Maung, Socheata Phou, Monica Hunsberger, Ailiana Santosa, Nawi Ng, Heng Sopheab, Chhorvann Chhea, Malin Eriksson","doi":"10.1136/bmjopen-2025-101776","DOIUrl":"10.1136/bmjopen-2025-101776","url":null,"abstract":"<p><strong>Objective: </strong>To explore health professionals' perspectives on the barriers and enablers of healthcare access for older adults in Cambodia.</p><p><strong>Design: </strong>A qualitative study based on semi-structured interviews conducted in Khmer, recorded, transcribed, translated into English and analysed using an abductive thematic analysis approach.</p><p><strong>Setting: </strong>Phnom Penh, Cambodia.</p><p><strong>Participants: </strong>A purposive sample of 11 health professionals serving in diverse roles and sectors participated in the study.</p><p><strong>Results: </strong>Three key barriers emerged: (1) institutional barriers, (2) patient-specific access barriers and (3) communication barriers. However, four key enablers were also identified: (1) supportive healthcare environment, (2) reaching out to improve access to health services, (3) peer and community engagement and (4) government direct support to access healthcare. Despite previous policy efforts, gaps in the implementation of healthcare services for older adults persist across all health facilities. Health professionals identified that improving healthcare access for older adults in Cambodia requires a multifaceted strategy involving proactive outreach, health promotion, financial assistance and stronger community and family support.</p><p><strong>Conclusion: </strong>Effective policy implementation requires collaboration among stakeholders and the active involvement of older adults in programme design to enhance dignity and well-being in Cambodia's ageing population.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e101776"},"PeriodicalIF":2.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional status and its influencing factors among elderly patients with malignant tumours: a retrospective study from a tertiary hospital in Chengdu, China.","authors":"Ran Duan, Feng Wang, Ting Zhang, Tong Feng, Tao Ren","doi":"10.1136/bmjopen-2024-089479","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-089479","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the nutritional status and its influencing factors in elderly patients aged 60 years and above with malignant tumours.</p><p><strong>Design: </strong>A retrospective observational study.</p><p><strong>Setting: </strong>The First Affiliated Hospital of Chengdu Medical College, a tertiary care hospital in Chengdu, China.</p><p><strong>Participants: </strong>A total of 450 elderly patients with cancer (aged ≥60 years) admitted between January 1, 2022, and January 1, 2023. Patients were selected based on their clinical records, excluding those with communication disorders, mental illness or incomplete data.</p><p><strong>Primary outcome measures: </strong>Nutritional status was assessed using the Patient-Generated Subjective Global Assessment (PG-SGA). Participants were categorised based on the presence or absence of malnutrition. Multivariate logistic regression was used to identify independent risk factors for malnutrition.</p><p><strong>Results: </strong>Of the 450 patients included, 63.7% were male and 36.3% female, with a median age of 69 years. The prevalence of severe malnutrition was 46.4%. Univariate analysis showed significant associations between malnutrition and factors such as older age (p<0.001), alcohol consumption (p=0.003), high pain score (p<0.001), diabetes (p<0.001), low body mass index (BMI) (p<0.001), low haemoglobin (p<0.001), elevated C-reactive protein (p<0.001), low albumin (p<0.001), and reduced self-care ability (p<0.001). Multivariate logistic regression identified advanced age (OR=1.08, 95% CI: 1.04 to 1.13), low BMI (OR=0.82, 95% CI (CI): 0.74 to 0.90), low serum albumin (OR=0.90, 95% CI: 0.85 to 0.96) and low activities of daily living score (OR=0.97, 95% CI: 0.96 to 0.98) as independent risk factors for malnutrition. Receiver operating characteristic curve analysis confirmed the predictive value of these factors.</p><p><strong>Conclusions: </strong>Malnutrition is highly prevalent in elderly patients with cancer and is significantly associated with age, BMI, albumin levels and self-care ability. Early identification and targeted nutritional interventions may improve outcomes and quality of life in this population.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e089479"},"PeriodicalIF":2.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198250","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":"Adherence to the recommended diabetic retinopathy screening guidelines in pregnant women with pregestational diabetes: a cross-sectional survey study.","authors":"Felicia Widyaputri, Sophie L Rogers, Alison J Nankervis, Jennifer J Conn, Alexis Shub, Sandra E Staffieri, Muhammad B Sasongko, Xavier J Fagan, Robert C A Symons, Lyndell L Lim","doi":"10.1136/bmjopen-2025-099917","DOIUrl":"https://doi.org/10.1136/bmjopen-2025-099917","url":null,"abstract":"<p><strong>Objective: </strong>Diabetic retinopathy (DR) in pregnancy can cause blindness. National guidelines recommend at least one eye examination in early pregnancy, then ideally 3-monthly, through to the postpartum for pregnant women with pregestational diabetes. Here we examined adherence rates, barriers and enablers to recommended DR screening guidelines.</p><p><strong>Design: </strong>Cross-sectional survey study, as part of a larger prospective cohort study.</p><p><strong>Setting: </strong>Participants were recruited from two tertiary maternity hospitals in Melbourne, Australia.</p><p><strong>Participants: </strong>Of the 173 pregnant women with type 1 (T1D) or type 2 diabetes (T2D) in the main cohort study, with an additional four who participated solely in this survey study, 130 (74.3%) completed the survey.</p><p><strong>Primary and secondary outcome measures: </strong>This study calculated rates of adherence to guideline-recommended DR screening schedules and collected data on the enablers and barriers to attendance using a modified Compliance with Annual Diabetic Eye Exams Survey. Each of the 5-point Likert-scale survey items was compared between adherent and non-adherent participants using the Wilcoxon rank-sum test and logistic regression models were constructed to quantify associations as ORs.</p><p><strong>Results: </strong>A retinal assessment was undertaken at least once during pregnancy in 86.3% of participants, but only 40.9% attended during their first trimester and only 21.2% attended the recommended number of examinations. Competing priorities were the main barriers to adherence, with eye examinations ranked as the fourth priority (IQR 4th-5th) among other health appointments during pregnancy. Meanwhile, knowledge of the benefits of eye screening examinations, eye-check reminders and support from relatives was identified as enablers.</p><p><strong>Conclusions: </strong>Despite the risk of worsening DR during pregnancy, less than half of the participants adhered to recommended screening guidelines, suggesting that eye health is not a priority. Proactive measures to integrate care are needed to prevent visual loss in this growing population.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e099917"},"PeriodicalIF":2.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197660","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":"What is the impact of an allied health service-learning programme for rural communities: a study protocol using the RE-AIM/PRISM framework.","authors":"Robyn McNeil, Ryan L McGrath, Kim Ackland, Rebecca-Kate Oates, Lauren Woodhart, Keryn Wright","doi":"10.1136/bmjopen-2025-105353","DOIUrl":"10.1136/bmjopen-2025-105353","url":null,"abstract":"<p><strong>Introduction: </strong>People in rural areas of Australia experience poorer health in almost every indicator compared with urban populations; however, rural communities have lower access to primary health, allied health and specialist healthcare. Timely access to care is compounded by persistent and widespread health workforce issues, including attracting and retaining staff.Australian University Departments of Rural Health (UDRH) have been established to address the needs of rural populations with the goal of improving recruitment and retention of health professionals across rural and remote Australia. The work-integrated learning team within The University of Melbourne works with nursing and allied health university students on clinical placement to provide exposure to working in rural health, with a remit to build the capacity of the existing and future workforce. The service-learning model aims to provide reciprocal benefits to stakeholders through purposefully co-designed placements that respond to rural health needs by providing services to underserved communities and ensuring university students are exposed to real world, diverse practice settings.The overarching aim of this project is to determine the impact of the SL programme for key stakeholders, predominately end users and those stakeholders involved in the delivery of the SL model. The key stakeholders are host site staff, allied health university students, allied health supervisors and the end users of the programme. End users are those individuals that have received allied health services through the programme, such as clients, residents and children.</p><p><strong>Methods and analysis: </strong>This study will adopt a convergent mixed methods methodology underpinned by a RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance)/PRISM (Practical, Robust Implementation Sustainability Model) approach. Data collection will include document review, existing programme data review and primary data collection. This will involve conducting surveys and interviews with allied health university students, host organisations and allied health supervisors, and interviews with adult recipients of the service-learning programme. Art-based consultation will be conducted with school-aged children recipients of the service-learning programme. Analysis will be underpinned by the RE-AIM/PRISM framework to inform programme learnings and impact for key stakeholders.</p><p><strong>Ethics and dissemination: </strong>This study has been approved by the University of Melbourne Human Research Ethics Committee (Project ID: 30409).Findings will be published in a stakeholder project report and peer-review journals in the fields of rural health, implementation science and work integrated learning.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e105353"},"PeriodicalIF":2.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FAST MRI: DYAMOND trial protocol (can an abbreviated MRI scan detect breast cancers missed by mammography for screening clients with average mammographic density attending their first screening mammogram?)-a diagnostic yield study within the NHS population-risk breast screening programme.","authors":"Lyn Isobel Jones, Rebecca Geach, Abi Loose, Sadie McKeown-Keegan, Andrea Marshall, Mark Halling-Brown, Siân Curtis, Sam Harding, Jan Rose, Helen Matthews, Sarah Vinnicombe, Abeer M Shaaban, Sian Taylor-Phillips, Janet Dunn","doi":"10.1136/bmjopen-2025-106545","DOIUrl":"10.1136/bmjopen-2025-106545","url":null,"abstract":"<p><strong>Introduction: </strong>First post-contrAst SubtracTed (FAST) MRI, an abbreviated breast MRI scan, has high sensitivity for sub-centimetre aggressive breast cancer and short acquisition and interpretation times. These attributes promise effective supplemental screening. Until now, FAST MRI research has focused on women above population-risk of breast cancer (high mammographic density or personal history). DYAMOND aims to define the population within the population-risk NHS Breast Screening Programme (NHSBSP) likely to benefit from FAST MRI. The study population is the 40% of screening clients aged 50-52 who have average mammographic density (BI-RADS (Breast Imaging Reporting and Data System) B) on their first screening mammogram. DYAMOND will answer whether sufficient numbers of breast cancers, missed by mammography, can be detected by FAST MRI to justify the inclusion of this group in a future randomised controlled trial.</p><p><strong>Methods and analysis: </strong>Prospective, multicentre, diagnostic yield, single-arm study with an embedded qualitative sub-study: all recruited participants undergo a FAST MRI. An internal pilot will assess the willingness of sites and screening clients to participate in the study. Screening clients aged 50-52, with a clear first NHSBSP mammogram and BI-RADS B mammographic density (by automated measurement) will be invited to participate (recruitment target: 1000). The primary outcome is the number of additional cancers detected by FAST MRI (missed by screening mammography). A Fleming's two-stage design will be used as this allows for early stopping after stage 1, to save participants, funding costs and time continuing to the end of the study if the question can be answered earlier.</p><p><strong>Ethics and dissemination: </strong>The NHSBSP Research and Innovation Development Advisory Committee and the Yorkshire and Humber-Sheffield Research Ethics Committee (23/YH/0268, study ID (IRAS): 330059) approved this research protocol. Participation involves a two-stage informed consent process, enabling screening for eligibility through automated mammographic density measurement. Patients with breast cancer helped shape the study design and co-produced participant-facing documents. They will disseminate the results to the public in a clear and meaningful way. Results will be published with open access in international peer-reviewed scientific journals.</p><p><strong>Trial registration number: </strong>ISRCTN74193022.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e106545"},"PeriodicalIF":2.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RIMA-SVG versus Ao-SVG in coronary artery bypass grafting: protocol for a prospective, randomised, double-blind, non-inferiority and single-centre trial.","authors":"Ran Wei, Maoxun Huang, Nan Jiang, Rong Zhang, Tianqi He, Cuilin Zhu, Weitie Wang, Hulin Piao, Shi Yu, Zhicheng Zhu, Tiance Wang, Kexiang Liu","doi":"10.1136/bmjopen-2025-104578","DOIUrl":"10.1136/bmjopen-2025-104578","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary artery bypass grafting (CABG) is a standard treatment for coronary artery disease, particularly in patients with multivessel disease. Connecting the saphenous vein graft (SVG) to the right internal mammary artery (RIMA) instead of the aorta has been proposed as an alternative approach to minimise aortic manipulation and potentially improve graft patency. This study aims to determine whether the RIMA-SVG technique is non-inferior to the conventional Aorta (Ao)-SVG approach in terms of 1-year graft patency, while also comparing perioperative complications and short-term clinical outcomes.</p><p><strong>Methods and analysis: </strong>This non-inferiority, single-centre, prospective, double-blind, randomised clinical trial will enrol 300 patients undergoing CABG. Participants will be randomised into two surgical groups (RIMA-SVG vs Ao-SVG). The primary outcome is the 1-year SVG patency rate, assessed using coronary CT angiography. Secondary outcomes include perioperative complications, all-cause mortality, major adverse cardiovascular and cerebrovascular events (MACCE), and surgical site infections occurring during hospitalisation and up to 1 year postoperatively. Randomisation will be computer-generated, and all procedures will be performed by experienced surgeons. Patients will be followed up 12 months post-surgery. Non-inferiority will be established if the upper bound of the one-sided 97.5% CI for the difference in graft occlusion rates is less than the prespecified non-inferiority margin of 10%.</p><p><strong>Ethics and dissemination: </strong>This study has been approved by the Ethics Committee of the Second Hospital of Jilin University (No. 460) and registered at ClinicalTrials.gov (NCT06787651). All participants will provide written informed consent before enrolment. To ensure data integrity and minimise bias, randomisation details will be concealed from researchers until surgery, and data analysts will remain blinded to group assignments. The findings will be disseminated through academic journals and conference presentations to promote knowledge sharing and clinical application in the field of cardiovascular surgery.</p><p><strong>Trial registration number: </strong>NCT06787651.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e104578"},"PeriodicalIF":2.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health literacy and perinatal mental health experiences among healthcare professionals in the United Arab Emirates: a qualitative study.","authors":"Rouwida ElKhalil, Rasha Bayoumi, Preetha Karuveetil, Mohamad AlMekkawi, Luai A Ahmed, Rami H Al-Rifai, Emad Masuadi, Iffat Elbarazi","doi":"10.1136/bmjopen-2025-107176","DOIUrl":"10.1136/bmjopen-2025-107176","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined the mental health literacy of perinatal healthcare professionals in the United Arab Emirates (UAE) and analysed how their knowledge, attitudes and confidence impact their clinical practices in addressing perinatal mental health disorders.</p><p><strong>Design: </strong>A qualitative study with a descriptive phenomenological design. Data were collected via semi-structured individual interviews and focus group discussions. The data were analysed inductively using Braun and Clarke's six-step thematic analysis.</p><p><strong>Setting: </strong>The study was conducted in Abu Dhabi, Dubai and Al Ain in the UAE. Participants were recruited from various healthcare facilities and professional educational events.</p><p><strong>Participants: </strong>The participants consisted of perinatal healthcare professionals from seven disciplines, including lactation consultants, midwives, nurses, obstetricians, paediatricians, family medicine practitioners and psychiatrists/psychologists. All participants were required to be actively involved in providing care to perinatal patients and to have a minimum of one year of clinical experience. The study included three focus group discussions and 28 semistructured individual interviews, culminating in a sample of 43 participants for analysis.</p><p><strong>Results: </strong>Three key themes emerged: (1) Knowledge and awareness, highlighting variable understanding of perinatal mental health and reliance on instinct over formal screening; (2) Navigating professional roles and realities, showing empathy and willingness to support patients, yet role ambiguity, low confidence and societal stigma influence perinatal healthcare professionals' responses and care practices and (3) Strengthening support systems and resources, where participants called for improved training, clear policies and psychosocial resources to overcome institutional and educational gaps and to enhance perinatal mental healthcare and patient outcomes.</p><p><strong>Conclusions: </strong>The study reveals gaps in mental health literacy and institutional support that hinder the delivery of effective perinatal mental healthcare. Strengthening provider training, implementing standardised screening and referral pathways, and promoting culturally sensitive, multidisciplinary approaches are essential. Such interventions can enhance early detection and improve outcomes for mothers and infants. Further research should focus on developing and evaluating the efficacy of such interventions to enhance early detection and improve outcomes for mothers and infants.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e107176"},"PeriodicalIF":2.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of thyroid hormone abnormalities among men with primary and secondary infertility: a cross-sectional study in Benin City, Nigeria.","authors":"Irabonosa Asiriuwa, Mathias Abiodun Emokpae, Agbonmwanre James Osaikhuwuomwan","doi":"10.1136/bmjopen-2025-101778","DOIUrl":"10.1136/bmjopen-2025-101778","url":null,"abstract":"<p><strong>Objective: </strong>Male infertility can be primary or secondary, depending on whether pregnancy has been achieved before or not, but thyroid gland involvement is rarely investigated in the laboratory work-up. This study aimed to assess thyroid hormone abnormalities among primary and secondary infertile men.</p><p><strong>Design: </strong>This is a cross-sectional study involving male partners of infertile couples presenting at the fertility clinic with an established diagnosis of infertility after review by the clinician. Males with proven fertility served as controls.</p><p><strong>Setting: </strong>The study was conducted at the Human Reproduction and Research Programme unit and the Chemical Pathology Laboratory of the University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.</p><p><strong>Participants: </strong>This study involved 200 participants who consisted of 50 controls (fertile men) and 150 infertile men (80 primary infertile men and 70 secondary infertile men). The participants were reviewed by a clinician, and a semen analysis was done to ascertain their fertility status.</p><p><strong>Results: </strong>The results show that sperm indices, such as sperm count, total motility, progressive motility, viable sperm cells, normal forms and volume were significantly lower (p<0.001) while non-viable sperm cells and abnormal forms were significantly higher (p<0.001) in both primary and secondary infertile males than controls. The mean triiodothyronine and thyroxine values were significantly higher (p<0.001), while thyroid-stimulating hormone was lower (p<0.001) among primary infertile males than secondary infertile men. Some 33/80 (41.3%) primary infertile men had thyroid abnormalities (5 subclinical hypothyroidism and 28 overt hypothyroidism), while 55/70 (78.6%) secondary infertile men had thyroid abnormalities (6 subclinical hypothyroidism and 49 overt hypothyroidism).</p><p><strong>Conclusion: </strong>Thyroid abnormalities were more predominant among secondary infertile men than primary infertile men in this study.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e101778"},"PeriodicalIF":2.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}