BMJ Open最新文献

{"title":"Immunisation status of children under 2 years of age visiting Khyber Teaching Hospital, Peshawar, Pakistan: a cross-sectional analysis.","authors":"Jehan Hussan, Laiba Gul, Mehran Ali, Afroz Ali, Nimra Khattak, Laiba Ali, Abida Ambreen, Muhammad Khan, Muhammad Baryal Khan, Cyrus Wasim, Rafi Ullah","doi":"10.1136/bmjopen-2024-094667","DOIUrl":"10.1136/bmjopen-2024-094667","url":null,"abstract":"<p><strong>Objective: </strong>The study was conducted to determine the immunisation status of children under 2 years of age, assess the determinants of non-immunisation and evaluate the association between immunisation status and various sociodemographic factors.</p><p><strong>Methods: </strong>A cross-sectional questionnaire-based study was conducted at the outpatient department of Khyber Teaching Hospital, Peshawar, over a period of 4 months. A convenience sampling technique was used and the sample size was calculated using the WHO sample size formula, resulting in n=363. A semistructured questionnaire was used to measure the primary outcome, which was the immunisation status of children under 2 years of age. Immunisation data were verified through vaccination cards to ensure accuracy and minimise recall bias. The questionnaire also collected information on sociodemographic factors, including maternal education, place of residence and household income. Statistical analysis was done at the end of the study using SPSS (V.25).</p><p><strong>Results: </strong>According to the vaccination card, it was found that 43.3% of the children were fully immunised, 32.5% of the children were partially immunised and the percentage of unimmunised children was 24.2.</p><p><strong>Conclusion: </strong>We found that the immunisation status of children was not satisfactory. Sustained efforts are required to achieve universal coverage of immunisation. Significant interventions are required, especially in areas that are more rural and less educated.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e094667"},"PeriodicalIF":2.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802445","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":"Assessing statistical literacy in medical students and doctors: a single-centre, cross-sectional survey in South Korea.","authors":"Sun Young Lee, Soela Kim, Soyun Kim, Yukyung Shin, Jae-Joon Yim, Hyeontaek Hwang, Youngsuk Kwon, Un-Na Kim, Young Kyung Do","doi":"10.1136/bmjopen-2024-095173","DOIUrl":"10.1136/bmjopen-2024-095173","url":null,"abstract":"<p><strong>Objective: </strong>Healthcare professionals must possess statistical literacy to provide evidence-based care and engage patients in decision-making. However, there have been concerns about healthcare professionals' inadequate understanding of health statistics. As an initial step in addressing the issue, we assessed the statistical literacy of medical students and doctors in South Korea by evaluating their comprehension of four statistical concepts: (a) single-event probability, (b) relative risk reduction, (c) positive predictive value and (d) 5-year survival rate.</p><p><strong>Design: </strong>Cross-sectional survey study.</p><p><strong>Setting: </strong>The survey was conducted from October 2018 to January 2019 in one medical school and its affiliated teaching hospital in Seoul, South Korea.</p><p><strong>Participants: </strong>303 medical students from all six grades and 291 doctors from various specialties.</p><p><strong>Primary and secondary outcome measures: </strong>The primary outcome measure was the correct answer rate for each question. The secondary outcome measure was the mean number of correct answers across the four statistical literacy questions, calculated for each individual.</p><p><strong>Results: </strong>The correct answer rates for basic numeracy questions were close to 100%. Regarding statistical literacy, 95.5% and 83.2% of the participants accurately understood single-event probability and relative risk reduction, respectively. However, only 49.3% and 49.2% of the participants accurately understood the positive predictive value and 5-year survival rate, respectively. The correct answer rates for the question about the 5-year survival rate differed significantly between students (40.9%) and doctors (57.7%) (p<0.001). There were no statistically significant differences in the correct answer rates for other questions, regardless of the student's grade level or the doctor's specialty.</p><p><strong>Conclusions: </strong>Medical students and doctors have weaker statistical literacy than their basic numeracy. Therefore, it is essential to implement medical education and professional development programmes that focus on improving their statistical literacy. These programmes should specifically address measures of medical test accuracy and the distinction between a 5-year survival rate and mortality.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e095173"},"PeriodicalIF":2.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802452","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 of congenital anomalies in the Gulf Cooperation Council countries: a scoping review.","authors":"Hiba Adam, Nadirah Ghenimi, Rouwida ElKhalil, Hassib Narchi, Iffat Elbarazi, Rami H Al-Rifai, Luai A Ahmed","doi":"10.1136/bmjopen-2024-093825","DOIUrl":"10.1136/bmjopen-2024-093825","url":null,"abstract":"<p><strong>Objectives: </strong>Congenital anomalies (CAs) are significant contributors to perinatal mortality and morbidity. The epidemiology of CAs in the Gulf Cooperation Council (GCC) countries remains insufficiently explored. This scoping review aims to provide a comprehensive overview of the existing literature on the epidemiology of perinatally diagnosed CAs in the GCC countries.</p><p><strong>Design: </strong>Scoping review.</p><p><strong>Data sources: </strong>We searched MEDLINE, Embase, Scopus and Web of Science for articles published between 1 January 2000 and 1 February 2024.</p><p><strong>Eligibility criteria: </strong>This review included (a) original observational studies such as cross-sectional, cohort or nested case-control studies, which were sourced from general populations, hospital records or registries; (b) published in English between 2000 and 2024; (c) conducted in any of the six GCC countries; and (d) reporting the prevalence or incidence of CAs.</p><p><strong>Data extraction and synthesis: </strong>Two reviewers independently screened titles, abstracts and full texts for inclusion and extracted data using Covidence software.</p><p><strong>Results: </strong>In total, 51 studies reporting the epidemiology of CAs in the GCC countries were eligible and thus summarised. Saudi Arabia dominated with nearly two-thirds of the studies, while Bahrain contributed the least. All studies were hospital based and primarily retrospective. The most researched CAs were cleft lip and cleft palate as well as nervous and circulatory system anomalies, whereas the least researched CAs were chromosomal abnormalities, digestive anomalies and urinary system anomalies. The review reported discrepancies in CA rates across the region, ranging from 2.5 to 68.7 per 1000 live births for multiple anomalies. Few studies explored the association between CAs and risk factors; the main factors reported were advanced maternal age, maternal diabetes and consanguinity.</p><p><strong>Conclusions: </strong>This review summarises the heightened prevalence of CAs in the GCC countries, discrepancies in estimates and gaps in research on specific anomalies. Future research is warranted to explore the association between CAs and various risk factors, thereby enabling the development of targeted preventive strategies.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e093825"},"PeriodicalIF":2.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802487","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":"Cost-effectiveness of support for health professionals to implement physical activity promotion: a protocol for within-trial and modelled economic evaluations of the PROMOTE-PA effectiveness-implementation hybrid trial.","authors":"Belinda Wang, Catherine Sherrington, Jennifer N Baldwin, Leanne Hassett, Kate Purcell, Roslyn Savage, Anne Tiedemann, Sakina Chagpar, Daniel Cheung, Michael Noetel, Georgina Clutterbuck, Kirsten Howard, Marina Pinheiro","doi":"10.1136/bmjopen-2024-098452","DOIUrl":"10.1136/bmjopen-2024-098452","url":null,"abstract":"<p><strong>Introduction: </strong>Physical activity has important benefits for the prevention and management of chronic diseases and healthy ageing. Health professionals have valuable opportunities to promote physical activity to a large group of people across the lifespan. Promotion of Physical Activity by Health Professionals is a hybrid type 1 effectiveness-implementation cluster randomised trial designed to evaluate the impact of physical activity promotion by health professionals (n=30 clusters) on physical activity participation in their patients (n=720). To inform the future implementation of this programme, we will be conducting a within-trial and modelled economic evaluation.</p><p><strong>Methods and analysis: </strong>We will conduct a cost-effectiveness and cost-utility analysis from the perspective of the healthcare, aged care and disability funder. The time horizon will be 6 months for the within-trial analysis and 2 years for the modelled analysis. Data on intervention costs will be collected using trial records. Data on healthcare utilisation will be collected using data linkage. Incremental cost-effectiveness ratios (ICERs) will be reported for physical activity and quality-adjusted life years outcomes. Bootstrapping will be used to explore uncertainty around the ICERs and estimate 95% CIs. Results will be presented on a cost-effectiveness plane. The probability that the intervention would be cost-effective at varying willingness-to-pay thresholds will be presented using a cost-effectiveness acceptability curve.</p><p><strong>Ethics and dissemination: </strong>Ethics approval was obtained through Sydney Local Health District (RPAH zone) Ethics Review Committee (X23-0197). The findings of this study will be disseminated through peer-reviewed journal articles and conference presentations.</p><p><strong>Trial registration number: </strong>Australian New Zealand Clinical Trials Registry: ACTRN12623000920695.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e098452"},"PeriodicalIF":2.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787774","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":"Paediatric oncology short learning programmes for nurses: a scoping review.","authors":"Maureen Daisy Majamanda, Felix Chisoni, Apatsa Selemani, Irene Kearns, Johanna Maree","doi":"10.1136/bmjopen-2024-085439","DOIUrl":"10.1136/bmjopen-2024-085439","url":null,"abstract":"<p><strong>Objective: </strong>This scoping review aimed to map the content, duration, delivery methods and modes of assessment for paediatric oncology nursing education and training programmes.</p><p><strong>Design: </strong>Scoping review.</p><p><strong>Data sources: </strong>Published articles were retrieved from Cumulative Index to Nursing and Allied Health Literature, Dimensions, Embase, PubMed and Scopus. Additional articles were identified from the reference list of the included studies.</p><p><strong>Eligibility criteria: </strong>Articles that described or reported on a paediatric oncology nursing education and training programme, from any setting, published in English from 2012 to 2022.</p><p><strong>Data extraction and synthesis: </strong>Two reviewers independently screened the titles, abstracts and full texts. Data were extracted using a standardised data extraction tool. Content analysis using basic coding of data was performed. The findings are presented in figures and tables, and the results are described narratively.</p><p><strong>Results: </strong>This review included 15 articles. Content identified for paediatric oncology education and training programmes included supportive care, chemotherapy, overview of paediatric oncology, management of venous access devices, oncological emergencies, nursing considerations, infection prevention and control, paediatric cancers, patient and family education, communication, ethical legal considerations, grief and bereavement, and overview of haematological cancers. Didactic methods used included traditional face-to-face and virtual approaches to deliver theoretical and practical content. The duration of the programmes ranged from 2 hours to 6 months. Both qualitative and quantitative methods of assessment were used before, during and after the training.</p><p><strong>Conclusion: </strong>This review offers valuable insights for the development of paediatric oncology education and training programmes for nurses. It provides comprehensive guidance on key content, duration, delivery methods and modes of assessment. However, there is a need to consider context-specific issues and availability of resources when developing the programmes to ensure relevance and sustainability.</p><p><strong>Study registration: </strong>Open Science Framework (https://doi.org/10.17605/OSF.IO/X3Q4H).</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e085439"},"PeriodicalIF":2.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787822","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":"Personalised selection of medication for newly diagnosed adult epilepsy: study protocol of a first-in-class, double-blind, randomised controlled trial.","authors":"Daniel Thom, Richard Shek-Kwan Chang, Natasha A Lannin, Zanfina Ademi, Zongyuan Ge, David Reutens, Terence O'Brien, Wendyl D'Souza, Piero Perucca, Sandra Reeder, Armin Nikpour, Chong Wong, Michelle Kiley, Jacqui-Lyn Saw, John-Paul Nicolo, Udaya Seneviratne, Patrick Carney, Dean Jones, Ernest Somerville, Clare Stapleton, Emma Foster, Lata Vadlamudi, David N Vaughan, James Lee, Tania Farrar, Mark Howard, Robert Sparrow, Zhibin Chen, Patrick Kwan","doi":"10.1136/bmjopen-2024-086607","DOIUrl":"10.1136/bmjopen-2024-086607","url":null,"abstract":"<p><strong>Introduction: </strong>Selection of antiseizure medications (ASMs) for newly diagnosed epilepsy remains largely a trial-and-error process. We have developed a machine learning (ML) model using retrospective data collected from five international cohorts that predicts response to different ASMs as the initial treatment for individual adults with new-onset epilepsy. This study aims to prospectively evaluate this model in Australia using a randomised controlled trial design.</p><p><strong>Methods and analysis: </strong>At least 234 adult patients with newly diagnosed epilepsy will be recruited from 14 centres in Australia. Patients will be randomised 1:1 to the ML group or usual care group. The ML group will receive the ASM recommended by the model unless it is considered contraindicated by the neurologist. The usual care group will receive the ASM selected by the neurologist alone. Both the patient and neurologists conducting the follow-up will be blinded to the group assignment. Both groups will be followed up for 52 weeks to assess treatment outcomes. Additional information on adverse events, quality of life, mood and use of healthcare services and productivity will be collected using validated questionnaires. Acceptability of the model will also be assessed.The primary outcome will be the proportion of participants who achieve seizure-freedom (defined as no seizures during the 12-month follow-up period) while taking the initially prescribed ASM. Secondary outcomes include time to treatment failure, time to first seizure after randomisation, changes in mood assessment score and quality of life score, direct healthcare costs, and loss of productivity during the treatment period.This trial will provide class I evidence for the effectiveness of a ML model as a decision support tool for neurologists to select the first ASM for adults with newly diagnosed epilepsy.</p><p><strong>Ethics and dissemination: </strong>This study is approved by the Alfred Health Human Research Ethics Committee (Project 130/23). Findings will be presented in academic conferences and submitted to peer-reviewed journals for publication.</p><p><strong>Trial registration number: </strong>ACTRN12623000209695.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e086607"},"PeriodicalIF":2.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787824","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":"Protocol for a multisite, observational clinical study of the association between skin colour and pulse oximeter accuracy in children undergoing cardiac catheterisation (PACH study).","authors":"Halley Ruppel, Liming Huang, Christopher J Petit, Athar M Qureshi, Christopher P Bonafide, Elizabeth E Foglia, Jeffery Feldman, Meghan B Lane-Fall, Jennifer M Lynch, Anna Chien, Michelle Dunn, Michael L O'Byrne","doi":"10.1136/bmjopen-2025-100391","DOIUrl":"10.1136/bmjopen-2025-100391","url":null,"abstract":"<p><strong>Introduction: </strong>Prospective, real-world clinical studies of the association between skin color and pulse oximeter (SpO2) accuracy in children are needed to address the limitations of previous research. Such studies are essential for generating evidence for clinicians, regulators and industry. This is the protocol for a multisite study funded by the National Heart, Lung, and Blood Institute (R01HL171313; 1 January 2024-31 December 2028).</p><p><strong>Methods and analysis: </strong>In this pragmatic, observational study conducted in three large paediatric cardiac catheterisation centres in the USA, children undergoing cardiac catheterisation with directly measured arterial oxygen saturation will be prospectively enrolled. The outcome variable (SpO₂ bias) is the difference between contemporaneous paired measurements of pulse oximetry (SpO₂) and the standard reference comparator, arterial blood sample oxygen saturation (SaO₂), obtained during the catheterisation procedure. The independent variable is an objective measure of skin colour obtained via spectrophotometry. Our primary analysis is a multivariable regression model testing the relationship between skin colour and SpO₂ bias, after adjusting for covariates. We will also conduct a moderator analysis to identify factors that may affect the magnitude of the association. The target sample size is 584 participants.</p><p><strong>Ethics and dissemination: </strong>This study was approved by the University of Pennsylvania Institutional Review Board (#854895) under expedited review. Study risks are minimal. Parental permission, and child assent when applicable, are obtained prior to enrolment. In accordance with the NIH Public Access Policy, publications associated with the study will be made publicly available through PubMed Central. The analytic dataset will be contributed to a repository for future use. In collaboration with a children's hospital-based research family advisory council, interpretation and dissemination of the results for lay, clinical and scientific audiences will be considered.</p><p><strong>Trial registration number: </strong>Although not a clinical trial, this observational study is registered on ClinicalTrials.gov (identifier: NCT06529575) for public awareness.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e100391"},"PeriodicalIF":2.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787839","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":"Association between emergency department to intensive care units time and in-hospital mortality: an analysis of the MIMIC-IV database.","authors":"Junwei Qian, Yinuo Yuan, Zhaoming Shang, Kangshuai Zhou, Qiuxin Lu, Lingyu Zhou, Wenzhen Zhou, Xiaofei Jiang, Mingquan Chen","doi":"10.1136/bmjopen-2024-090011","DOIUrl":"10.1136/bmjopen-2024-090011","url":null,"abstract":"<p><strong>Objectives: </strong>The association between the duration from the emergency department (ED) to the intensive care units (ICUs) and in-hospital mortality among patients admitted directly to the ICUs from the ED remains controversial. This study aimed to use data from the Medical Information Mart for Intensive Care-IV database to explore the relationship between the ED to ICUs time and patient outcomes.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Admissions to the Beth Israel Deaconess Medical Center intensive care from 2008 to 2019.</p><p><strong>Participants: </strong>A total of 15 246 adult patients were identified as admitted directly from the ED to the ICUs during their first hospitalisation. After excluding those without recorded ED registration times and those with a hospital-to-ICU admission interval exceeding 6 hours (n=2432), the final analysis cohort comprised 12 703 patients.</p><p><strong>Primary and secondary outcome measures: </strong>The primary outcome was in-hospital all-cause mortality. Secondary outcomes included 28-day all-cause mortality and length of stay in ICU and hospital.</p><p><strong>Results: </strong>The median ED to ICUs time was 3.98 hours. Longer ED to ICUs times were associated with lower in-hospital mortality, decreasing from 17.6% in the shortest to 12.2% in the longest interval group, and shorter ICU stays. After propensity score weighting, adjusted logistic regression models confirmed the inverse association between longer ED to ICUs time and in-hospital mortality (OR: 0.75, 95% CI: 0.69 to 0.82, p<0.01). Restricted cubic spline analysis showed a non-linear decline in mortality risk with increasing ED to ICUs time, with a sharper reduction after 5.65 hours. Kaplan-Meier curves indicated consistently better survival in the longest interval group (p<0.01). Sensitivity analysis, reintroducing patients with hospital to ICUs times over 6 hours, confirmed the robustness of these results.</p><p><strong>Conclusions: </strong>Longer ED to ICUs time is linked to lower mortality and shorter ICU length of stay, suggesting that appropriately extending ED stays may benefit critically ill patients.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e090011"},"PeriodicalIF":2.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787645","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":"Development of an evaluation programme for the intelligent management of mobile infectious disease hospitals in response to public health emergencies: a Delphi study.","authors":"Juanling He, Sifeng Wu, Rongrong Ni, Xu Luo","doi":"10.1136/bmjopen-2024-094769","DOIUrl":"10.1136/bmjopen-2024-094769","url":null,"abstract":"<p><strong>Objectives: </strong>To construct a scientific and practical intelligent management assessment programme for mobile infectious disease hospitals and explore pathways to enhance their management effectiveness.</p><p><strong>Design: </strong>A preliminary pool of indicators was developed based on policy documents issued by the Chinese government. Two rounds of Delphi expert consultations were conducted via email between February and August 2024. These indicators were then refined using the margin method. Finally, a hierarchical analysis was employed to assign weights to each indicator.</p><p><strong>Setting and participants: </strong>In line with the policy guidance of the Chinese government, an initial set of assessment indicators for smart management of mobile infectious disease hospitals was established. 32 experts with extensive knowledge in the construction of smart management systems for such hospitals were chosen to participate in the Delphi study, offering a comprehensive professional perspective.</p><p><strong>Results: </strong>The Cr values were 0.860 (Round 1) and 0.894 (Round 2), demonstrating the accuracy and reliability of the expert consultations. The coordination coefficient among the experts was statistically significant at the p<0.01 level, reflecting a high degree of consensus. In total, 29 assessment items for the smart management of mobile infectious disease hospitals were finalised.</p><p><strong>Conclusions: </strong>A comprehensive set of indicators for assessing smart management in mobile infectious disease hospitals has been developed. This system is scientific, logical and dependable, providing effective guidance for the smart development of such hospitals. It not only improves the quality and efficiency of medical services but also safeguards patients' health rights.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e094769"},"PeriodicalIF":2.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787786","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":"What are the experiences of people with heart failure regarding participation in physical activity? A systematic review, meta-aggregation and development of a logic model.","authors":"Lorna Duncan, Rosie Essery, Shoba Dawson, Yasmin Ismail, Justine Baird, Karen Butcher, Emily Whight, Rachel Johnson, Alyson L Huntley","doi":"10.1136/bmjopen-2024-092457","DOIUrl":"10.1136/bmjopen-2024-092457","url":null,"abstract":"<p><strong>Objectives: </strong>To (1) synthesise the experiences of people with heart failure and those who care for them concerning participation in physical activity (2) develop a logic model for a future intervention which will support people with heart failure to feel confident and safe in being physically active.</p><p><strong>Design: </strong>A systematic review and meta-aggregation using Joanna Briggs Institute (JBI) methodology.</p><p><strong>Data sources: </strong>MEDLINE, Emcare and PsycINFO databases were searched through until June 2024 inclusively.</p><p><strong>Eligibility criteria: </strong>Studies with a qualitative design, including qualitative components of mixed-methods studies, which describe experiences of participation in physical activity by adults with chronic heart failure.</p><p><strong>Data extraction and synthesis: </strong>Two independent reviewers used standardised methods to search and screen studies. Data extraction included the PROGRESS-Plus items. The JBI checklist for qualitative studies was applied. Meta-aggregation guided by JBI methods was used to synthesise the data. This evidence, along with input from a patient and public involvement group, healthcare professionals and charity organisations, was used to develop a logic model.</p><p><strong>Results: </strong>We included 28 papers (25 studies) comprising 14 qualitative studies and 11 mixed-method studies describing the perspectives of 483 people with heart failure, 64 carers and 12 healthcare professionals.The meta-aggregation produced seven synthesised findings describing the impact of physical symptoms, emotional factors, extrinsic factors, access to knowledge, self-motivation and peer/professional motivation and the positive impact of physical activity. The PROGRESS-PLUS tool identified significant inclusivity issues within the studies. The meta-aggregation with relevant contributor input informed behavioural determinants and potential intervention components of a logic model.</p><p><strong>Conclusions: </strong>This study identifies behavioural determinants that underlie the actions of people with heart failure in their relationship with physical activity and potential intervention components for a novel intervention design to support this population. There is a lack of studies exploring health professionals' and carers' perspectives on this topic.</p><p><strong>Prospero registration number: </strong>CRD42022342883.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e092457"},"PeriodicalIF":2.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787864","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}