BMJ Open最新文献

{"title":"Effects of Baduanjin exercise on cancer-related fatigue in patients with prostate cancer treated with androgen deprivation therapy in Shanghai, China: a study protocol for a randomised controlled trial.","authors":"Yihang Wang, Yuan Qin, Xiruo Xu, Yali Li, Xuanying Zhu, Guangpu Yang, Yifei Xu, Fei Yao, Guangxin Guo","doi":"10.1136/bmjopen-2024-092363","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-092363","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer-related fatigue (CRF) is one of the most common and painful symptoms in patients with prostate cancer (PCa). Moreover, PCa patients who receive the androgen deprivation therapy (ADT) are more likely to develop CRF. Baduanjin exercise has been shown to improve CRF in some cancers. However, such effects have not been verified in patients with PCa treated with the ADT. So, this study was designed as a randomised controlled trial (RCT) to explore the effects of Baduanjin exercise on CRF in PCa patients treated with the ADT.</p><p><strong>Methods and analysis: </strong>This study will be a single-centre, assessor and statistician blinded, RCT consisting of a 12 week intervention and 12 week follow-up. Patients with PCa who meet the inclusion criteria will be recruited from Shanghai Hudong Hospital. Participants will be randomly assigned to Baduanjin exercise group (n=42) and the control group (n=42), performing 12 weeks of Baduanjin exercise or reeiving the standard care. The primary outcome will be the clinical effect of Baduanjin exercise on CRF in PCa patients, which will be measured using the Piper Fatigue Self-Assessment (PFS) scale, a multidimensional measure of CRF using three different dimensions: somatic, emotional and cognitive. The secondary outcome will be the clinical effect of the Baduanjin exercise on the patient's level of fatigue, sleep, depression and life quality at the time, which will be assessed by the Brief Fatigue Inventory (BFI), the Pittsburgh Sleep Quality Index (PSQI), the Beck Depression Inventory (BDI) and the Functional Assessment of Cancer Therapy-Prostate (FACT-P).</p><p><strong>Ethics and dissemination: </strong>This study has been approved by Shanghai Hudong Hospital Ethics Committee, Shanghai province (2022 SHHDKY08). The trial results will be submitted to conferences and peer-reviewed journals.</p><p><strong>Trail registration number: </strong>ChiCTR2300074293.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614906","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":"'Blue-lighting' seizure-related needs in care homes: a retrospective analysis of ambulance call-outs for seizures in North West England (2014-2021), their management and costs, with community comparisons.","authors":"Adam J Noble, Steven Lane, Peter Lloyd, Beth Morris, Steve Bell, Tom Shillito, Pete Dixon, Anthony Guy Marson","doi":"10.1136/bmjopen-2024-089126","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-089126","url":null,"abstract":"<p><strong>Objectives: </strong>With a projected rise in care home residency and the disproportionate impact of epilepsy and seizures on older adults, understanding seizure-related needs in this population is crucial. Data silos and inconsistent recording of residence status make this challenging. We thus leveraged ambulance data to investigate seizure call-out incidence, characteristics, management and costs in care homes compared with the wider community.</p><p><strong>Design: </strong>Retrospective analysis of dispatch data from a regional English ambulance service over four 9-month periods between 2014/2015 and 2021/2022. Suspected seizures in adults (≥16 years) were identified, with data on location, patient age, severity and management extracted. Incidence rates, trends over time and case characteristics were compared. Costs of ambulance response were estimated, and factors influencing emergency department (ED) conveyance were analysed using logistic regression.</p><p><strong>Setting: </strong>North West Ambulance Service National Health Service Trust, serving an adult population of ~5.5 million.</p><p><strong>Participants: </strong>Dispatch data for 98 752 suspected seizure cases.</p><p><strong>Results: </strong>Care homes, accommodating ~0.8% of the regional population, accounted for 7.2% of seizure call-outs. Incidence was higher in care homes than the wider community (55.71 vs 5.97 per 1000 person/year in 2021/2022) and increased over time. Care home cases peaked around 8:00-9:00. Despite similar or lower severity, they had a higher ED conveyance rate (78.3% vs 70.6%). Conveyance likelihood was influenced by factors beyond severity: reduced in homes specialising in learning disabilities (adjusted OR=0.649) and increased in homes with nursing provision (adjusted OR=1.226). Care homes accounted for 7.26% of the £24 million cost.</p><p><strong>Conclusions: </strong>This study highlights the growing seizure-related needs in care homes. Despite similar severity, most cases result in ED conveyance. Future research should examine the appropriateness and implications of these transfers, ensuring specialist services support the care home population effectively.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614678","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":"Trajectories of functional limitations, health-related quality of life and societal costs in individuals with long COVID: a population-based longitudinal cohort study.","authors":"Jiunn Wang, Henry Goodfellow, Sarah Walker, Ann Blandford, Paul Pfeffer, John R Hurst, David Sunkersing, Katherine Bradbury, Chris Robson, William Henley, Manuel Gomes","doi":"10.1136/bmjopen-2024-088538","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-088538","url":null,"abstract":"<p><strong>Objectives: </strong>To examine trajectories of functional limitations, fatigue, health-related quality of life (HRQL) and societal costs of patients referred to long COVID clinics.</p><p><strong>Design: </strong>A population-based longitudinal cohort study using real-time user data.</p><p><strong>Setting: </strong>35 specialised long COVID clinics in the UK.</p><p><strong>Participants: </strong>4087 adults diagnosed with long COVID in primary or secondary care deemed suitable for rehabilitation and registered in the Living With Covid Recovery (LWCR) programme between 4 August 2020 and 5 August 2022.</p><p><strong>Main outcome measures: </strong>Generalised linear mixed models were fitted to estimate trajectories of functional limitations, using the Work and Social Adjustment Scale (WSAS); scores of ≥20 indicate moderately severe limitations. Other outcomes included fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) reversed score (scores of ≥22 indicate impairment), HRQL using the EQ-5D-5L, and long COVID-related societal costs, encompassing healthcare costs and productivity losses.</p><p><strong>Results: </strong>The mean WSAS score at 6 months after registration in the LWCR was 19.1 (95% CI 18.6, 19.6), with 46% of the participants (95% CI 40.3%, 52.4%) reporting a WSAS score above 20 (moderately severe or worse impairment). The mean change in the WSAS score over the 6-month period was -0.86 (95% CI -1.32, -0.41). The mean reversed FACIT-F score at 6 months was 29.1 (95% CI 22.7, 35.5) compared with 32.0 (95% CI 31.7, 32.3) at baseline. The mean EQ-5D-5L score remained relatively constant between baseline (0.63, 95% CI 0.62, 0.64) and 6 months (0.64, 95% CI 0.59, 0.69). The monthly societal cost per patient related to long COVID at 6 months was £931, mostly driven by the costs associated with working days lost.</p><p><strong>Conclusions: </strong>Individuals referred to long COVID clinics in the UK reported small improvements in functional limitations, fatigue, HRQL and ability to work within 6 months of registering in the LWCR programme.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615005","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 are the risk factors for ascending aorta dilatation in the non-diabetic normotensive population? A cross-sectional study in China.","authors":"Xiangyu Yang, Xinran Li, Naeem Ul Hassan, Runyu Ye, Xin Zhang, Jun Ma, Hang Liao, Xin Zhang, Si Wang, Xiaoping Chen","doi":"10.1136/bmjopen-2023-080194","DOIUrl":"https://doi.org/10.1136/bmjopen-2023-080194","url":null,"abstract":"<p><strong>Objectives: </strong>Ascending aorta dilatation (AAD) has been suggested as a surrogate marker for vascular organ damage in the hypertensive population. However, limited data are available on AAD in normotensive individuals. This study aims to preliminarily explore the correlation between ascending aorta (AAO) and other established clinically significant target organ damage parameters and to investigate the possible risk factors of AAD in the non-diabetic normotensive individuals.</p><p><strong>Design: </strong>Our study has a cross-sectional design.</p><p><strong>Setting: </strong>All participants were recruited from the inpatient and outpatient departments of our hospital.</p><p><strong>Participants: </strong>We recruited 634 normotensive participants (52.26±16.22 years, 39.43% male) who underwent both ambulatory blood pressure monitoring (ABPM) and echocardiography. The whole study population was divided into AAD and non-AAD groups according to age-gender-specific criteria. The baseline mean blood pressure (BP) of the two groups was 126.92/77.72 and 124.16/77.61 mm Hg, respectively.</p><p><strong>Primary and secondary outcome measures: </strong>The relationship between AAO and other acknowledged cardiac damage indicators, as well as the associations of AAD with ABPM indexes in the non-diabetic normotensive individuals.</p><p><strong>Results: </strong>We observed that AAO exhibited a significant correlation with left ventricular mass index (β=1.905, p<0.001), e' (β=-0.324, p<0.001) and E/e' (β=0.221, p<0.001). Among all the ABPM indexes, only those related to diastolic BP (DBP), specifically 24-hour DBP (OR=1.056, 95% CI 1.004 to 1.110, p<0.05) and night-time DBP (OR=1.071, 95% CI 1.011 to 1.134, p<0.05), were associated with AAD after adjustment for age, gender and other confounders. Furthermore, in the multivariate forward logistic regression analysis, night-time DBP was most strongly associated with AAD (OR=1.064, 95% CI 1.008 to 1.124, p<0.05).</p><p><strong>Conclusions: </strong>We found that AAO was correlated with alterations in other acknowledged cardiac parameters, both structural and functional, in non-diabetic normotensive individuals, indicating AAD may be significant in these individuals. Notably, DBP, especially night-time DBP, showed a more significant correlation with AAD.</p><p><strong>Trial registration number: </strong>ChiCTR2000030677.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614477","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":"Management of Post-transplant Infections in Collaborating Hospitals (MATCH) Programme: a prospective cohort of all transplant recipients at Copenhagen University Hospital-Rigshospitalet, Denmark.","authors":"Frederik Viggo Lautrup Esmann, Sadaf Zahid, Kasper Sommerlund Moestrup, Nick Normand, Charlotte Matthews, Finn Gustafsson, Henrik Sengeløv, Michael Perch, Nicolai Aagaard Schultz, Søren Schwartz Sørensen, Jesper Melchior Hansen, Vibeke Brix Christensen, Daniel D Murray, J Lundgren, Cornelia Geisler Crone, Marie Helleberg","doi":"10.1136/bmjopen-2024-089966","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-089966","url":null,"abstract":"<p><strong>Purpose: </strong>The Management of Post-transplant Infections in Collaborating Hospitals (MATCH) programme, initiated in 2011 and still ongoing, was created to 1) optimise the implementation of existing preventive strategies against viral infections in solid organ transplant (SOT) recipients and allogenic haematopoietic stem-cell transplant (HSCT) recipients and 2) advance research in the field of transplantation by collecting data from a multitude of sources.</p><p><strong>Participants: </strong>All SOT and HSCT recipients at Copenhagen University Hospital, Rigshospitalet, are followed in MATCH. By February 2021, a total of 1192 HSCT recipients and 2039 SOT recipients have been included. Participants are followed life long. An automated electronic data capture system retrieves prospective data from nationwide registries. Data from the years prior to transplantation are also collected.</p><p><strong>Findings to date: </strong>Data entries before and after transplantation include the following: biochemistry: 13 995 222 and 26 127 817; microbiology, cultures: 242 023 and 410 558; other microbiological analyses: 265 007 and 566 402; and pathology: 170 884 and 200 394. There are genomic data on 2431 transplant recipients, whole blood biobank samples from 1003 transplant recipients and faeces biobank samples from 207 HSCT recipients. Clinical data collected in MATCH have contributed to 50 scientific papers published in peer-reviewed journals and have demonstrated success in reducing cytomegalovirus disease in SOT recipients. The programme has established international collaborations with the Swiss Transplant Cohort Study and the lung transplant cohort at Toronto General Hospital.</p><p><strong>Future plans: </strong>Enrolment into MATCH is ongoing with no planned end date for enrolment or follow-up. MATCH will continue to provide high-quality data on transplant recipients and expand and strengthen international collaborations.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614780","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":"Comparison of the aetiology, microbiological isolates and antibiotic susceptibilities of endophthalmitis between children and adults in southern China: a retrospective, cohort study.","authors":"Yao Yang, Jiaqi Lin, Yujie Li, Xiaohu Ding, Manli Liu, Jieting Zeng, Xiaofeng Lin, Fang Duan","doi":"10.1136/bmjopen-2024-085021","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-085021","url":null,"abstract":"<p><strong>Objectives: </strong>To compare aetiology, microbiological isolates and antibiotic susceptibilities of endophthalmitis between children and adults.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Participants: </strong>Patients admitted to Zhongshan Ophthalmic Center between January 2013 and December 2019 with clinically diagnosed endophthalmitis were included.</p><p><strong>Outcome measures: </strong>The aetiology, microbiological isolates and antibiotic susceptibilities of endophthalmitis were analysed.</p><p><strong>Results: </strong>Of 1803 patients, 430 (23.8%) were aged ≤16 years. In both children and adults, the main aetiology was trauma (85.6% vs 64.7%, p<0.05). <i>Streptococcus</i> species (spp.) (28.8%) were most prevalent in paediatric post-traumatic endophthalmitis; whereas, coagulase-negative staphylococci (36.9%) were dominant in adults. In postoperative endophthalmitis, all children had bacterial infections, while fungal infections accounted for 12.5% in adults. In endogenous endophthalmitis caused by fungi, <i>Candida</i> was most prevalent in adults (26.9%); whereas, all causative fungi involved filamentous fungi in children. Isolated bacteria in children presented a higher susceptibility in 7 of 11 antibiotics compared with those in adults. Levofloxacin had the highest susceptibility rate in children (97.9%), and ofloxacin had the highest susceptibility rate in adults (90.6%).</p><p><strong>Conclusion: </strong>The main aetiology was trauma, with a higher proportion in children than in adults. The microbial profile of paediatric endophthalmitis was different from those of adults. Susceptibilities of causative bacteria to most antibiotics were higher in children than in adults.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614704","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":"Trends and patterns of antimicrobial consumption at Benjamin Mkapa Zonal Referral Hospital, Dodoma, Tanzania: a cross-sectional retrospective analysis.","authors":"Kauke Bakari Zimbwe, Yusto Julius Yona, Charity Alphonce Chiwambo, Alphonce Bilola Chandika, Humphrey Sawira Kiwelu, Moshi Moshi Shabani","doi":"10.1136/bmjopen-2023-083842","DOIUrl":"https://doi.org/10.1136/bmjopen-2023-083842","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed the trends and patterns of antimicrobial consumption (AMC) from 2020 to 2021, 2021-2022 and 2022-2023 at the Benjamin Mkapa Zonal Referral Hospital (BMH) in Dodoma, Tanzania.</p><p><strong>Design: </strong>A retrospective cross-sectional study was conducted to collect AMC data for three financial years with respective denominators. The data were computed using the AMC Tool 2019 v1.9.0 and defined daily dose per 1000 inhabitants per day (DID).</p><p><strong>Setting: </strong>The BMH, Dodoma, Tanzania.</p><p><strong>Participants: </strong>This study surveyed quantities of antimicrobials procured at the BMH. It did not have any human participants.</p><p><strong>Outcome measures: </strong>AMC was quantified in DID. The comparisons were made based on the DID of all surveyed antimicrobials, taking into account oral and parenteral administration and based on pharmacological classes. Further, DIDs were presented based on the 2023 WHO Access (A), Watch (W) and Reserve (R) (AWaRe) classification.</p><p><strong>Results: </strong>In 29 assessed antimicrobials, the DIDs for 2020-2021, 2021-2022 and 2022-2023 were 3.0852, 3.5892 and 3.9213, respectively. The average DID per year was 3.5319, with a mean of 2.4207±1.9765 DID per year. The topmost consumed antimicrobials over the 3 years (doxycycline, azithromycin, amoxicillin/beta-lactamase inhibitors, ampicillin/cloxacillin, amoxicillin/flucloxacillin, ceftriaxone, nitrofurantoin and clarithromycin) account over 90% of consumption. The most highly consumed therapeutic classes were beta-lactam antibacterial penicillins (34.71%), macrolides, lincosamides, streptogramins and others (25.75%), followed by tetracycline (23.88%). The AWaRe categorisation and antimicrobials not recommended (ANR) distribution were as follows: Access-51.61%, Watch-31.96%, Reserve-0.00%, and ANR-16.43%, respectively.</p><p><strong>Conclusion: </strong>For every 1000 patients attending the BMH per day, our study found 2.4207±1.9765 DIDs of an antimicrobial were consumed. The most consumed antimicrobials include doxycycline, azithromycin, amoxicillin/beta-lactamase inhibitor, ceftriaxone and metronidazole. To combat antimicrobial resistance effectively, it is imperative to institute a hospital policy for antimicrobial stewardship that prioritises the utilisation of a hospital formulary and antibiograms for the procurement of antimicrobials at the BMH.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615022","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":"Global trends in the burden of rheumatoid arthritis by sociodemographic index: a joinpoint and age-period-cohort analysis based on the Global Burden of Disease Study 2019.","authors":"Cheng Chen, QiLin Shi, WenBao He, HaoJun Tian, TianBao Ye, YunFeng Yang","doi":"10.1136/bmjopen-2023-082966","DOIUrl":"https://doi.org/10.1136/bmjopen-2023-082966","url":null,"abstract":"<p><strong>Objective: </strong>To describe temporal trends in the incidence and disability-adjusted life years (DALYs) of rheumatoid arthritis (RA) across sociodemographic index (SDI) quintiles and sexes from 1990 to 2019.</p><p><strong>Methods: </strong>Data on RA incidence and DALYs with a 95% uncertainty interval from 1990 to 2019 were extracted from the Global Burden of Disease 2019. Subsequently, trends across SDI quintiles and sexes from 1990 to 2019 were determined using joinpoint regression and age-period-cohort analyses.</p><p><strong>Results: </strong>A significant upward trend in the global age-standardised incidence rate (ASIR) of RA was observed for both sexes from 1990 to 2019 (average annual per cent change (AAPC): 0.214, 95% CI 0.179 to 0.249, p<0.001). Specifically, the ASIR of RA for both sexes demonstrated a significant increasing trend at all SDI levels, with the highest AAPC observed in the low SDI regions. A non-significant increasing trend in the global age-standardised DALYs rate (ASDR) of RA was observed for both sexes from 1990 to 2019 (AAPC: 0.017, 95% CI -0.051 to 0.085, p=0.621). Varying trends in ASDR were observed for both sexes and across SDI quintiles. Additionally, diverse age-period-cohort patterns in incidence and DALYs were observed across SDI quintiles and sexes.</p><p><strong>Conclusion: </strong>The significant heterogeneity observed in the temporal trends of the incidence and DALYs of RA across SDI quintiles and sexes suggests potential disparities in the prevention, management and treatment of RA. Therefore, establishment of practical and customised healthcare initiatives for specific populations across SDI quintiles and sexes and allocation of supplementary health resources to high-risk populations are crucial for effective management of RA.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614378","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":"Association of relationship satisfaction with blood pressure: a cross-sectional study of older adults in rural Burkina Faso.","authors":"Felicitas Maria Jaspert, Guy Harling, Ali Sie, Mamadou Bountogo, Till Bärnighausen, Beate Ditzen, Melanie Sandy Fischer","doi":"10.1136/bmjopen-2024-089374","DOIUrl":"https://doi.org/10.1136/bmjopen-2024-089374","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study is to examine the association between relationship satisfaction and blood pressure (BP) in a low-income setting and to screen for gender moderation in this context. Research conducted in high-income settings suggests that relationship satisfaction is associated with better physical and mental health outcomes.</p><p><strong>Design: </strong>A cross-sectional study design was employed, using both questionnaire and physical measurement data. Multiple linear regression models were calculated for systolic and diastolic BP and adjusted for age, gender, demographics/socioeconomics and other health-related variables. Gender moderation was tested using interaction terms in multivariable analyses.</p><p><strong>Setting: </strong>A household survey was conducted in 2018 in rural northwestern Burkina Faso.</p><p><strong>Participants: </strong>Final analysis included 2114 participants aged over 40 who were not pregnant, reported being in a partnership and had valid BP readings.</p><p><strong>Main outcome measures: </strong>Systolic and diastolic BP levels.</p><p><strong>Results: </strong>A significant positive association existed between relationship satisfaction (Couples Satisfaction Index-4 score) and systolic BP (B=0.23, 95% CI (0.02 to 0.45), p=0.03) when controlling for demographics/socioeconomics. Nevertheless, this relationship lost statistical significance when additional adjustments were made for health-related variables (B=0.21, 95% CI (-0.01 to 0.42), p=0.06). There was no significant association of relationship satisfaction and diastolic BP and no evidence of gender moderation.</p><p><strong>Conclusion: </strong>In contrast to many higher-income settings, we found a positive association between relationship satisfaction and systolic BP in very low-income rural Burkina Faso. Our results add to the evidence regarding the contextual nature of the association between relationship satisfaction and health, as high relationship satisfaction may not act as a health promotor in this socioeconomic context.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of a brief online and group focusing intervention: a protocol for a randomised clinical trial.","authors":"Clara Aguiar, Cláudia Oliveira, Marina Monteiro, Alexandra Paiva, João Salgado","doi":"10.1136/bmjopen-2023-080094","DOIUrl":"https://doi.org/10.1136/bmjopen-2023-080094","url":null,"abstract":"<p><strong>Introduction: </strong>Emotion dysregulation is a transdiagnostic characteristic that affects many people with many psychopathological problems. Two mechanisms that have been frequently associated with emotional regulation are immersion and distancing. Focusing is a task that combines these two mechanisms of emotion regulation through the phase of creating a working distance and subsequently the phase of reassigning meaning. However, the benefit of its use in Portuguese population without a moderate to severe symptomatology for promoting mental health remains unclear.</p><p><strong>Methods and analysis: </strong>Participants aged between 18 and 65 years who wish to improve their awareness and understanding of their emotions will be recruited and then, randomised into two groups: the intervention group (IG) and the control group (CG; delayed intervention). The IG will have access to two focusing sessions and the CG will only have access to the intervention 4 weeks later. Both groups will be evaluated at five different times. Primary outcomes include positive and negative affect, attitudes towards focusing (emotions and bodily sensations), the ability to perform focusing and emotion regulation. Secondary outcomes include mental health and psychological well-being, depression and anxiety symptoms and self-esteem.</p><p><strong>Ethics and dissemination: </strong>Our study has been approved by the Council of Ethics and Deontology of the University of Maia. Findings will be disseminated via manuscripts, presentations and the lead author's thesis.</p><p><strong>Trial registration number: </strong>ISRCTN16974329.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614896","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}