BMJ Open最新文献

{"title":"Technology-facilitated gender-based violence against women with disabilities in low- and middle-income countries: a scoping review protocol.","authors":"Shaffa Hameed, Babalwa Tyabashe-Phume, Eunice Tunggal, Xanthe Hunt, Lieketseng Ned, Karen Soldatić","doi":"10.1136/bmjopen-2024-093988","DOIUrl":"10.1136/bmjopen-2024-093988","url":null,"abstract":"<p><strong>Introduction: </strong>Women with disabilities in low- and middle-income countries (LMICs) face heightened risks of experiencing gender-based violence (GBV). The rapid growth of digital technologies has introduced new forms of violence, such as technology-facilitated gender-based violence (TFGBV), which disproportionately affects marginalised groups. Despite growing awareness, the intersection of disability, gender and TFGBV is under-researched. This scoping review aims to map and synthesise the evidence on TFGBV against women with disabilities in LMICs, exploring the manifestations of violence, its key vulnerabilities and protective factors within these settings.</p><p><strong>Methods and analysis: </strong>This scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines. A systematic search of peer-reviewed and grey literature will be performed in six databases, including CINAHL, Scopus, Web of Science, Social Sciences Citation Index, PubMed and PsycINFO. Studies published from 2010 onwards, focusing on women with disabilities in LMICs and involving any form of TFGBV, will be included. The search strategy includes broad query terms to capture diverse experiences of TFGBV. The identified literature will be screened and double-checked for relevance by independent reviewers. Data extraction will focus on key themes such as study design, forms of TFGBV and the risks and protective factors reported. We will conduct basic content analysis, and results will be presented in tables and narratives, providing a descriptive map of the evidence.</p><p><strong>Ethics and dissemination: </strong>This review will synthesise previously published studies and publicly available grey literature; therefore, ethical approval is not required. The findings will be disseminated through a peer-reviewed publication, presentations at relevant conferences and knowledge-sharing sessions with stakeholders working in the field of disability and GBV prevention. The review will inform future research and interventions aimed at addressing TFGBV in LMICs.</p><p><strong>Trial registration details: </strong>Open Science Framework (https://doi.org/10.17605/OSF.IO/GZ2UR).</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e093988"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708610","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 a rapid screener through network analysis to identify central cognitive complaints in haemodialysis patients: a cross-sectional study.","authors":"Frederick H F Chan, Pearl Sim, Phoebe X H Lim, Behram A Khan, Jason C J Choo, Konstadina Griva","doi":"10.1136/bmjopen-2024-088502","DOIUrl":"10.1136/bmjopen-2024-088502","url":null,"abstract":"<p><strong>Objectives: </strong>Cognitive impairments and cognitive complaints are commonly present in dialysis patients and can affect clinical, functional, occupational, and psychosocial well-being. It is important to screen for patients' cognitive status as it offers a gateway to specialty referral, prevention or rehabilitation programmes, and personalisation of clinical care. The Patient's Assessment of Own Functioning Inventory (PAOFI) is a comprehensive questionnaire that assesses patient-reported difficulties in memory, language, motor/sensory-perceptual skills and higher-level cognitive function. In the current study, we adopted network analysis to identify central cognitive complaints in dialysis patients and derived a PAOFI short form (PAOFI-SF) based on these core symptoms to improve screening efficiency in real-world renal settings.</p><p><strong>Design: </strong>Multicentre, cross-sectional study.</p><p><strong>Setting: </strong>Participants were recruited from 10 community-based dialysis centres in Singapore, from May to November 2022.</p><p><strong>Participants: </strong>A total of 369 eligible haemodialysis patients were invited to join the study, and 268 completed the measures (response rate 72.6%).</p><p><strong>Outcome measures: </strong>Cognitive assessment tools including the PAOFI and the Montreal Cognitive Assessment were administered.</p><p><strong>Results: </strong>Based on the PAOFI measure, 98 participants (36.6%) endorsed the presence of three or more complaints, indicating clinically significant cognitive complaints. Network analysis identified five central cognitive complaints among dialysis patients: problem-solving difficulty, difficulty following instructions, forgetting how to do tasks, difficulty being understood, and forgetting people known years ago. These core items were combined into a five-item short form of PAOFI, which showed good reliability and validity, and an area under the curve of 83.4% in identifying clinically significant cognitive complaints. The optimal cut-off point of the short form was 11.5 (out of 30), with a specificity of 89.5%, sensitivity of 63.9%, positive predictive value of 77.5% and negative predictive value of 81.4%. This cut-off point also predicted objective cognitive performance even after controlling for sociodemographic and clinical confounders.</p><p><strong>Conclusions: </strong>Pending future replication and external validation, the PAOFI-SF may be suitable for use in renal care settings as an initial screening tool to identify patients with cognitive complaints and increased risk of objective cognitive impairments.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e088502"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708525","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 to redefine muscle attenuation cut-offs for better prediction of mortality in patients with cirrhosis: a comprehensive post hoc validation study - a study protocol.","authors":"Simone Di Cola, Gennaro D'Amico, Maryam Motamedrad, Aldo Montano-Loza, Manuela Merli","doi":"10.1136/bmjopen-2024-094252","DOIUrl":"10.1136/bmjopen-2024-094252","url":null,"abstract":"<p><strong>Introduction: </strong>Myosteatosis, characterised by altered muscle composition detectable by muscle radiodensity attenuation on CT scans, has been associated with increased mortality in patients with cirrhosis. However, standard attenuation cut-offs, derived primarily from oncology populations, may not be appropriate for patients with cirrhosis. This study protocol aims to address this diagnostic gap by validating the Ebadi cut-offs, which are based on a retrospective cohort and have not been extensively validated in a cirrhotic population. The aim of the study is to refine these cut-offs for more accurate prediction of mortality in patients with cirrhosis using two independent patient cohorts (retrospective and prospective).</p><p><strong>Methods and analysis: </strong>This post hoc validation study analyses muscle weakness cut-offs in patients with cirrhosis using data from two independent cohorts. A total of 1537 patients will be analysed. The study will assess interobserver variability to ensure robust results by analysing random samples of 60 patients from the two cohorts. Statistical methods will be used to determine the accuracy and relevance of current cut-offs in predicting patient mortality. The analysis will also examine the relationship between muscle wasting and clinical outcomes in cirrhosis and the relationship with muscle mass loss.</p><p><strong>Ethics and dissemination: </strong>Ethical approval for this study has been obtained from the relevant institutional review boards. The results will be disseminated through presentations at scientific conferences and publication in peer-reviewed journals. The results of the study are expected to contribute to improved diagnostic criteria for myosteatosis in cirrhosis, providing clinicians with more tailored and accurate tools for cirrhosis prognosis.</p><p><strong>Trial registration number: </strong>NCT06593015.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e094252"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708601","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":"Effects of azithromycin in young adults with cystic fibrosis: a protocol for emulating a published randomised controlled trial using registry data.","authors":"Emily Granger, Jonathan Todd, Susan Christine Charman, Elizabeth Cromwell, Gwyneth Davies, Freddy Frost, Alex Gifford, Bin Huang, Nicole Mayer Hamblett, Lutz Naehrlich, Josh Ostrenga, Sanja Stanojevic, Rhonda Szczesniak, Ruth Keogh","doi":"10.1136/bmjopen-2024-091357","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-091357","url":null,"abstract":"<p><strong>Introduction: </strong>Target trial emulation is a framework for evaluating the effects of treatments using observational data. The trial emulation approach involves specifying key elements of a protocol for a target trial (a randomised controlled trial designed to address the question of interest) and then describing how best to emulate the trial using observational data. Recent years have seen an uptake of target trial emulation in several disease areas, although there are limited examples in cystic fibrosis (CF). This protocol describes a study which aims to assess the applicability of target trial emulation in CF. We aim to emulate an existing trial in CF and assess to what extent the results from the trial can be replicated using registry data.</p><p><strong>Methods and analysis: </strong>The target trial is a published randomised controlled trial which found evidence for beneficial effects of azithromycin use on lung function in young adults with CF. Two emulated trials are planned: one using data from the UK CF Registry and one using data from the US CF Registry. The inclusion and exclusion criteria, treatment and outcome definitions, follow-up period, and estimand of interest are all designed to match the published trial as closely as possible. The analysis step of the trial emulations will use causal inference methods to control for confounding. Results obtained in the emulated trials using registry data will be compared with those from the target trial.</p><p><strong>Ethics and dissemination: </strong>Ethical approval has been granted by the London School of Hygiene and Tropical Medicine Ethics Committee (Ref: 29609). This study has also been approved by the UK CF Registry Research Committee and the North Star Review Board. The results of this study will be published in a peer-reviewed journal and presented at relevant scientific conferences.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e091357"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708531","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":"Awareness, perceptions and willingness to accept malaria vaccine for children under age 5 among mothers in Northcentral Nigeria: a cross-sectional study.","authors":"Oludare Oladayo Alagbe, Rahamatu Shamsiyyah Iliya, Bosede Rotimi, Amos Solomon","doi":"10.1136/bmjopen-2024-091739","DOIUrl":"10.1136/bmjopen-2024-091739","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess mothers' awareness, perceptions and willingness to accept malaria vaccines for their children under 5 years old in a city in Northcentral Nigeria.</p><p><strong>Design: </strong>The research employed a hospital-based cross-sectional observational study design to gather and analyse relevant data.</p><p><strong>Setting: </strong>The study was conducted at the immunisation clinic of a tertiary health centre in Northcentral Nigeria.</p><p><strong>Participants: </strong>A total of 376 women of reproductive age (15-49 years) participated in the study. All participants resided in the study area and had children aged 0-5 years.</p><p><strong>Main outcome measures: </strong>The study evaluated mothers' awareness of the malaria vaccine, their perceptions about its use and their willingness to vaccinate their children under 5 years of age.</p><p><strong>Results: </strong>Awareness of the malaria vaccine was low, with only 89 mothers (23.7%) reporting prior knowledge of it. Despite this, an overwhelming 366 participants (97.3%) expressed willingness to vaccinate their children and 352 (93.6%) were willing to pay for the vaccine. Concerns about injection site reactions, fever and pain were common, with 126 mothers (33.6%) preferring an oral vaccine. Positive perception significantly influenced willingness to vaccinate (χ²=5.987, p=0.014). Additionally, age, marital status, educational level and income were significantly associated with willingness to vaccinate (p=0.002, 0.025, 0.015, 0.026, respectively). At the multivariate level, younger maternal age (OR=1.179, p=0.011) and higher income (OR=1.040, p=0.049) emerged as direct predictors of vaccine acceptance.</p><p><strong>Conclusions: </strong>While awareness of malaria vaccines among mothers was limited, there was a strong willingness to vaccinate, influenced by positive perceptions, younger maternal age and higher income. The findings highlight the importance of targeted educational campaigns to improve awareness and acceptance of malaria vaccines. Future studies should explore interventions to enhance vaccine acceptance and address potential barriers to vaccine awareness.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e091739"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708488","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":"Factors influencing health-promoting lifestyle among medical personnel: a systematic review protocol.","authors":"Peng Huang, Dayang Shobihah Binti Abang Abai, Huajing Xiao, Qi Zhang, Zongji Xian, Karmilah Binti Abdullah","doi":"10.1136/bmjopen-2024-097470","DOIUrl":"10.1136/bmjopen-2024-097470","url":null,"abstract":"<p><strong>Introduction: </strong>A health-promoting lifestyle is essential for improving quality of life and reducing the risk of chronic diseases. However, despite their high health literacy, medical personnel often show low adherence to such lifestyles. Identifying the factors influencing these behaviours in medical professionals is critical for developing effective interventions. This review aims to identify the factors that influence the health-promoting lifestyle among medical personnel.</p><p><strong>Methods and analysis: </strong>We will conduct a systematic search across three electronic databases: Web of Science, Scopus and PubMed. To ensure comprehensive literature coverage, we will also examine the reference lists of included studies and relevant reviews identified during the search. Eligible studies will include quantitative, qualitative and mixed-methods research articles that investigate factors influencing health-promoting lifestyles among medical personnel. No restrictions will be applied regarding geographical location or publication year. Only original, peer-reviewed journal articles published in English will be considered. The search strategy will incorporate key terms and their synonyms, including Medical Subject Headings terms such as 'factor', 'barrier', 'enabler', 'health-promoting lifestyle', 'medical personnel', 'doctor', 'nurse', 'medical technician', 'pharmacist' and 'hospital administrative staff.' All retrieved studies will be imported into Rayyan software for duplicate removal. Two independent reviewers will conduct the screening process based on predefined inclusion and exclusion criteria. The risk of bias in individual studies will be assessed using the Mixed Methods Appraisal Tool. A narrative synthesis approach will be employed to synthesise findings, categorising identified influencing factors into five levels of the Ecological Model of Health Behavior: intrapersonal, interpersonal, organisational, community and public policy levels.</p><p><strong>Ethics and dissemination: </strong>Ethical approval is not required as no original data collection is involved. Findings will be disseminated via peer-reviewed journals, conferences and the primary author's PhD thesis.</p><p><strong>Prospero registration number: </strong>CRD42024579746.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e097470"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708534","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":"Digital solution for salutogenic brain health: a pilot sequential multiple assignment randomised trial (SMART) protocol for clinical implementation.","authors":"Claire See Ying Chang, Vanessa Phua, Xiang Cong Tham, Yuanxi Jia, Nicole Yun Ching Chen, Wentao Zhou, Wei Fong Liau, Jing Xu, Bibhas Chakraborty, Nicholas Graves, Nick Sevdalis, Yanhong Dong","doi":"10.1136/bmjopen-2024-096568","DOIUrl":"10.1136/bmjopen-2024-096568","url":null,"abstract":"<p><strong>Introduction: </strong>Middle-aged adults with chronic conditions including diabetes, hyperlipidaemia and hypertension are at higher risk for cognitive decline. However, there is a lack of a targeted solution for this population. This study aims to develop a digital solution for salutogenic brain health targeting this population, assess its clinical effectiveness and evaluate the implementation in primary care settings by local champions, that is, nurses.</p><p><strong>Methods and analysis: </strong>A type-I hybrid effectiveness-implementation design with a sequential multiple-assignment randomised trial will be adopted. 160 adults aged 40-64 years old with chronic conditions hypertension, hyperlipidaemia and type-II diabetes will be recruited from three National University Polyclinics in Singapore. They will be randomised using block randomisation to either the intervention group ('Digital solution for Salutogenic Brain health' programme) or the waitlist control group. Cognitive tests, clinical measures, questionnaires and interviews will be used to evaluate outcome measures. The Reach, Effectiveness, Adoption, Implementation, Maintenance framework and the Capability, Opportunity, Motivation and Behaviour model will be employed to evaluate clinical effectiveness and implementation strategies.</p><p><strong>Ethics and dissemination: </strong>This study has been reviewed and approved by the National Healthcare Group Domain Specific Review Board (NHG DSRB) in Singapore (NHG DSRB Reference Number: 2023/00620 (25 June 2024)). Data will be analysed by study team members and findings will be published in peer-reviewed journals.</p><p><strong>Trial registration number: </strong>NCT06582316.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e096568"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708526","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":"Machine learning models for prediction of lymph node metastasis in patients with gastric cancer: a Chinese single-centre study with external validation in an Asian American population.","authors":"Qian Li, Shangcheng Yan, Weiran Yang, Zhuan Du, Ming Cheng, Renwei Chen, Qiankun Shao, Yuan Tian, Mengchao Sheng, Wei Peng, Yongyou Wu","doi":"10.1136/bmjopen-2024-098476","DOIUrl":"10.1136/bmjopen-2024-098476","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate machine learning (ML)-based models to predict lymph node metastasis (LNM) in patients with gastric cancer (GC).</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Second Affiliated Hospital of Soochow University.</p><p><strong>Participants: </strong>A total of 500 inpatients from the Second Affiliated Hospital of Soochow University, collected retrospectively between 1 April 2018 and 31 March 2023, were used as the training set, while 824 Asian patients from the Surveillance, Epidemiology and End Results database comprised the external validation set.</p><p><strong>Main outcome measures: </strong>Prediction models were developed using multiple ML algorithms, including logistic regression, support vector machine, k-nearest neighbours, naive Bayes, decision tree (DT), gradient boosting DT, random forest and artificial neural network (ANN). The predictive value of these models was validated and evaluated through receiver operating characteristic curves, precision-recall (PR) curves, calibration curves, decision curve analysis and accuracy metrics.</p><p><strong>Results: </strong>Among the ML algorithms, the ANN outperformed others, achieving the highest accuracy (0.722; 95% CI: 0.692 to 0.751), precision (0.732; 95% CI: 0.694 to 0.776), F1 score (0.733; 95% CI: 0.695 to 0.773), specificity (0.728; 95% CI: 0.684 to 0.770) and area under the PR curve (0.781; 95% CI: 0.740 to 0.821) in the external validation results. Moreover, it demonstrated superior calibration and clinical utility. Shapley Additive Explanations analysis identified the depth of invasion, tumour size and Lauren classification as the most influential predictors of LNM in patients with GC. Furthermore, a user-friendly web application was developed to provide individual prediction results.</p><p><strong>Conclusions: </strong>This study introduces an accurate, reliable and clinically applicable approach for predicting the risk of LNM in patients with GC. The model demonstrates its potential to enhance the personalised management of GC in diverse populations, supported by external validation and an accessible web application for practical use.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e098476"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708407","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":"Healthcare professionals' experiences of the Four Habits Model communication course: a qualitative and survey approach to evaluate impact in an intermediate care setting.","authors":"Linda Aimée Hartford Kvæl, Asta Bye, Astrid Bergland, Cecilie Fromholt Olsen","doi":"10.1136/bmjopen-2024-091143","DOIUrl":"10.1136/bmjopen-2024-091143","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate healthcare professionals' (HCPs') experiences with the simulation-based Four Habits Model (4HM) course programme and evaluate how they perceived the 4HM's immediate and persistent significance for practice within the intermediate care (IC) context.</p><p><strong>Design: </strong>A qualitative approach was combined with a survey design, structured within an exploratory sequential framework consisting of two phases: (1) focus group interviews with HCPs who had completed the course 2-4 weeks postcourse (n=11), and (2) a detailed questionnaire completed 4 months postcourse (n=14).</p><p><strong>Setting and intervention: </strong>IC serves as a bridge in the patient pathway from hospital to home providing community-based rehabilitation. The 4HM is a well-established framework for improving clinical communication in healthcare. However, it has never been tested in IC. We conducted two 4HM courses in April 2023 at an IC institution in Norway's capital.</p><p><strong>Participants: </strong>The study involved clinical HCPs (n=15) working in IC, participating in the 4HM courses, and consisted of seven nursing assistants, five nurses and three therapists.</p><p><strong>Results: </strong>The HCPs experienced the 4HM course to be important and useful for practice in the IC context. They perceived that the easy-to-use framework could be applied in many patient-HCP interactions, had the potential to frame the 'what matters to you' question and increase satisfaction among patients and relatives. The survey conducted after 4 months disclosed that participants believed they had acquired and applied new communication skills.</p><p><strong>Conclusion: </strong>The 4HM provided a structured framework for interactions in the IC context, enhancing professionalism and streamlining daily tasks. Overall, the model fostered patient participation through improved communication skills. The findings could assist stakeholders, HCPs and IC service managers in developing educational programmes for HCPs to enhance communication skills and improve the quality of care for older patients in transitional care.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e091143"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708107","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":"Adolescent health research and initiatives in the occupied Palestinian territory: a scoping review.","authors":"Mariam Sawalma, Aisha Shalash, Beesan Maraqa, Majd Quran, Khalifa Elmusharaf, Niveen M E Abu-Rmeileh","doi":"10.1136/bmjopen-2023-082563","DOIUrl":"https://doi.org/10.1136/bmjopen-2023-082563","url":null,"abstract":"<p><strong>Objective: </strong>Adolescence is a period characterised by profound changes that warrant special attention, particularly for adolescents living in conflict-stricken regions. The dearth of available information regarding observational health research and interventions in the occupied Palestinian territory emphasises the need for a comprehensive examination of all accessible data. The aim of this review is to conduct a thorough analysis of the existing literature and initiatives focusing on adolescent health in the occupied Palestinian territory.</p><p><strong>Design: </strong>Scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) framework.</p><p><strong>Data sources: </strong>PubMed, Embase, Web of Science, Scopus, CINAHL and PsycINFO, along with grey literature, were searched for the period between 2012 and 2023.</p><p><strong>Eligibility criteria for selecting studies: </strong>Research studies, programmes or interventions targeting adolescents aged 10-19 years, conducted in the occupied Palestinian territory, and published between 2012 and 2023 were considered. Both peer-reviewed articles and grey literature were included.</p><p><strong>Data extraction and synthesis: </strong>Two independent reviewers conducted abstract and full-text screening of the selected articles. Discrepancies were resolved through discussion, with a third reviewer consulted when necessary. Data extraction was performed using Excel software by two independent reviewers. Extracted data were categorised as either intervention or observational research. For analysis, the extracted data underwent an explanatory frequency analysis using SPSS software.</p><p><strong>Results: </strong>Our search yielded 114 research projects and 19 interventions from peer-reviewed and grey literature searches. The most frequently addressed topic was non-communicable diseases, with health awareness being the most common method employed in interventions. The studies targeted both male and female participants, with a particular focus on adolescents aged 10-19 years. The majority of the included studies received funding from international sources and were conducted by foreign and local researchers.</p><p><strong>Conclusion: </strong>This review sheds light on the current framework of adolescent health interventions, identifies areas where research is lacking and advocates for evidence-based practices to enhance the well-being of Palestinian adolescents. Future interventions should encompass the younger age group, and research should strive to provide precise information for each age group independently.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e082563"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708429","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}