BMJ Open最新文献

{"title":"Association between smoking status and changes in health behaviours during the COVID-19 lockdown: a cross-sectional study in Israel.","authors":"Michael Cleiman, Yael Bar-Zeev","doi":"10.1136/bmjopen-2024-084651","DOIUrl":"10.1136/bmjopen-2024-084651","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the association between smoking status (current vs former), changes in smoking habits (among current smokers only) and negative changes in dietary and physical activity habits during the initial COVID-19 lockdown in Israel.</p><p><strong>Design: </strong>A secondary analysis of an online cross-sectional study (6 April 2020 to 28 April 2020). Dependent variables included deteriorations in dietary habits score and odds of reporting worsening of physical activity habits during the first COVID-19 lockdown. The study analysed the association between these variables and 'smoking status' (current vs former) and, within smokers, changes in smoking habits, using multivariate logistic and linear regression models. For changes in physical activity habits, there was a significant interaction with baseline physical activity levels (p=0.04), therefore, analysis was stratified accordingly.</p><p><strong>Setting: </strong>Online data collection.</p><p><strong>Participants: </strong>660 participants, current or former smokers in Israel, Hebrew speakers and ≥18 years old.</p><p><strong>Primary outcomes: </strong>Self-reported negative changes in dietary habits and physical activity during the first COVID-19 lockdown.</p><p><strong>Results: </strong>The sample (n=660) included 66.2% (n=437) current smokers and 33.8% (n=223) former smokers. Among current smokers, 43.5% (n=190) indicated an increase in their smoking habits. Of all respondents, 25% (n=170) reported a negative dietary change and 48% (n=192) spent less time engaging in physical activity, with 66% (n=437) reporting increased levels of stress. No significant association was found between smoking status and the dietary habits score in the multivariate linear regression (B=-0.046, CI -0.493 to 0.401, reference group: former smokers). This indicates that being a current smoker was associated with a non-significant 0.046 point decrease in the dietary habits score compared with former smokers. Similarly, no significant association was found between smoking status and odds of reporting worsening of physical activity, even after stratifying by baseline physical activity levels. Among participants who currently smoke, no significant association was found between changes in smoking habits and the dietary habits score (B=0.391, 95% CI -0.061 to 0.843, p=0.090, reference group: those who smoke the same or less) or with odds of reporting worsening of physical activity (OR=1.16, 95% CI 0.688 to 1.956, p=0.577, reference group: those who smoke the same or less).</p><p><strong>Conclusion: </strong>Among current and former smokers, high rates of negative health habit changes were found, emphasising the need for interventions during future crises. Smoking status and/or changes in smoking habits among current smokers were not associated with negative changes in dietary and physical activity habits.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e084651"},"PeriodicalIF":2.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779184","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":"'My first thoughts are…': a Framework Method analysis of UK general practice healthcare professionals' internal dialogue and clinical reasoning processes when seeing patients living with obesity in primary care.","authors":"Sarah Serjeant, Sally Abbott, Helen Parretti, Sheila Greenfield","doi":"10.1136/bmjopen-2024-086722","DOIUrl":"10.1136/bmjopen-2024-086722","url":null,"abstract":"<p><strong>Objectives: </strong>To use vignettes to facilitate exploration of the internal dialogue and clinical reasoning processes of general practice healthcare professionals (GPHCPs) during interactions with patients living with obesity.</p><p><strong>Design: </strong>This study used an exploratory qualitative research design. Data were collected using semistructured interviews. Interviews were transcribed verbatim, and data analysed using Framework Method analysis. Five vignettes were presented to participants, showing a patient's photograph, name, age and body mass index. Participants were asked to describe their first impressions of each fictionalised patient.</p><p><strong>Setting: </strong>Interviews were conducted remotely via Skype between August and September 2019.</p><p><strong>Participants: </strong>A convenience sample of UK GPHCPs was recruited via a targeted social media strategy, using virtual snowball sampling. 20 participants were interviewed (11 general practice nurses and 9 general practitioners).</p><p><strong>Results: </strong>Five themes were generated: visual assessment, assumed internal contributing factors, assumed external contributing factors, potential clinical contributing factors and potential clinical consequences. A pattern-recognition approach was identified, as GPHCPs' assumptions around patients' lifestyles, occupations and eating habits emerged as explanations for their weight, with a mixture of both objective and subjective comments.</p><p><strong>Conclusions: </strong>While it is part of the diagnostic skill of a clinician to be able to form a clinical picture based on the information available, it is important to be aware of the potential for assumptions made within this process to contribute to unconscious bias/stereotyping. Healthcare professionals need to work to counteract the potential impact of internal bias on their consultations to provide fair and equitable care for people living with obesity, by exercising reflexivity within their clinical practice.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e086722"},"PeriodicalIF":2.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779193","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":"Understanding symptom clusters, diagnosis and healthcare experiences in myalgic encephalomyelitis/chronic fatigue syndrome and long COVID: a cross-sectional survey in the UK.","authors":"Maedeh Mansoubi, Thomas Richards, Martine Ainsworth-Wells, Russell Fleming, Phaedra Leveridge, Charles Shepherd, Helen Dawes","doi":"10.1136/bmjopen-2024-094658","DOIUrl":"10.1136/bmjopen-2024-094658","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to provide an in-depth analysis of the symptoms, coexisting conditions and service utilisation among people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID. The major research questions include the clustering of symptoms, the relationship between key factors and diagnosis time, and the perceived impact of National Institute for Health and Care Excellence (NICE) guidelines on patient care.</p><p><strong>Design: </strong>Cross-sectional survey using secondary data analysis.</p><p><strong>Setting: </strong>Community-based primary care level across the UK, incorporating online survey participation.</p><p><strong>Participants: </strong>A total of 10 458 individuals responded to the survey, of which 8804 confirmed that they or a close friend/family member had ME/CFS or long COVID. The majority of respondents were female (83.4%), with participants from diverse regions of the UK.</p><p><strong>Primary and secondary outcome measures: </strong>Primary outcomes included prevalence and clustering of symptoms, time to diagnosis, and participant satisfaction with National Health Service (NHS) care, while secondary outcomes focused on symptom management strategies and the perceived effect of NICE guidelines.</p><p><strong>Results: </strong>Fatigue (88.2%), postexertional malaise (78.2%), cognitive dysfunction (88.4%), pain (87.6%) and sleep disturbances (88.2%) were the most commonly reported symptoms among participants with ME/CFS, with similar patterns observed in long COVID. Time to diagnosis for ME/CFS ranged widely, with 22.1% diagnosed within 1-2 years of symptom onset and 12.9% taking more than 10 years. Despite updated NICE guidelines, only 10.1% of participants reported a positive impact on care, and satisfaction with NHS services remained low (6.9% for ME/CFS and 14.4% for long COVID).</p><p><strong>Conclusions: </strong>ME/CFS and long COVID share overlapping but distinct symptom clusters, indicating common challenges in management. The findings highlight significant delays in diagnosis and low satisfaction with specialist services, suggesting a need for improved self-management resources and better-coordinated care across the NHS.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e094658"},"PeriodicalIF":2.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778955","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":"Risk, rate or rhythm control for new onset supraventricular arrhythmia during septic shock: protocol for the CAFS multicentre, parallel-group, open-label trial.","authors":"Vincent Labbé, Cyrielle Desnos, Sebastien Preau, Denis Doyen, Damien Contou, François Bagate, Bertrand Souweine, Vincent Pey, Pierre-Marie Bertrand, Grégoire Müller, Florence Boissier, Pierre Asfar, Nicolas Bonnet, Jérémie Joffre, Oumar Sy, Martin Dres, Filippo Annoni, Xavier Monnet, Serge Carreira, Emmanuel Vivier, Nicolas Serck, Adil Wiart, Sebastian Voicu, Nicholas Heming, Camille Le Breton, Guillaume Chevrel, Frank Chemouni, Michael Piagnerelli, Lionel Haentjens, Muriel Fartoukh, Fabio Taccone, Dominique Durand, Gladys Monthieux, Laurence Berard, Alexandra Rousseau, Armand Mekontso Dessap","doi":"10.1136/bmjopen-2024-090404","DOIUrl":"10.1136/bmjopen-2024-090404","url":null,"abstract":"<p><strong>Introduction: </strong>New-onset supraventricular arrhythmia (NOSVA) is the most common arrhythmia in patients with septic shock and is associated with haemodynamic alterations and increased mortality rates. With no data available from randomised trials, clinical practice for patient management varies widely. In this setting, rate control or rhythm control could be beneficial in limiting the duration of shock and preventing evolution to multiorgan dysfunction.</p><p><strong>Methods and analysis: </strong>The Control Atrial Fibrillation in Septic shock (CAFS) study is a binational (French and Belgium), multicentre, parallel-group, open-label, randomised controlled superiority trial to compare the efficacy and safety of three management strategies in patients with NOSVA during septic shock. The expected duration of patient enrolment is 42 months, starting from November 2021. Patients will be randomised to receive either risk control (magnesium and control of risk factors for NOSVA), rate control (risk control and low dose of amiodarone) or rhythm control (risk control and cardioversion using high dose of amiodarone with external electrical shock if NOSVA persists) for 7 days. Patients with a history of SVA, NOSVA lasting more than 48 hours, recent cardiac surgery or a contraindication to amiodarone will not be included. We plan to recruit 240 patients. Patients will be randomised on a 1:1:1 basis and stratified by centre. The primary endpoint is a hierarchical criterion at day 28 including all-cause mortality and the duration of septic shock defined as time from randomisation to successful weaning of vasopressors. Secondary outcomes include: individual components of the primary endpoint; arterial lactate clearance at day 3; efficacy at controlling cardiac rhythm at day 7; proportion of patients free from organ dysfunction at day 7; ventricular arrhythmia, conduction disorders, thrombotic events, major bleeding events and acute hepatitis related to amiodarone at day 28; intensive care unit and hospital lengths of stay at day 28.</p><p><strong>Ethics and dissemination: </strong>The study has been approved by the French (Comité Sud-Ouest et Outre-Mer II, France, registration number 2019-A02624-53) and Belgian (Comité éthique de l'hôpital Erasme, Belgium, registration number CCB B4062023000179) ethics committees. Patients will be included after obtaining signed informed consent. The results will be submitted for publication in peer-reviewed journals.</p><p><strong>Trial registration number: </strong>NCT04844801.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 4","pages":"e090404"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762874","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":"Omission of axillary lymph node dissection in patients with breast cancer with axillary pathological complete response confirmed by stained region lymph node biopsy after neoadjuvant systemic therapy (SrLNB study): study protocol for a single-arm, single-centre, phase-II trial.","authors":"Lingjun Ma, Rui Chen, Mingyu Wang, Xuan Li, Ran Zheng, Lexin Wang, Jingjing Ding, Hao Yao, Yichun Gong, Yuanyuan Wang, Xingye Sheng, Jue Wang, Xiaoming Zha","doi":"10.1136/bmjopen-2024-092563","DOIUrl":"10.1136/bmjopen-2024-092563","url":null,"abstract":"<p><strong>Introduction: </strong>Given that axillary lymph node dissection (ALND) may not contribute to local control or survival and could lead to increased arm morbidity, axillary de-escalation procedures have replaced ALND in patients achieving axillary pathologic complete response (apCR) after neoadjuvant systemic therapy (NST). However, the application of targeted lymph node biopsy, one of the de-escalation procedures, remains limited due to a lack of long-term follow-up studies.</p><p><strong>Methods and analysis: </strong>This prospective, single-arm, open-label, non-inferiority, single-centre phase II trial targets breast cancer patients initially diagnosed with axillary metastasis who achieved apCR after NST. The study aims to validate the oncological safety of stained region lymph node biopsy (SrLNB) procedure. SrLNB is a novel de-escalation axillary surgery, which was developed and tested in our preliminary study. The primary endpoint of this trial is the 3-year invasive disease-free survival (iDFS). Secondary endpoints include local-regional recurrence, incidence of breast cancer-related lymphoedema and patient-reported outcomes. The 3-year iDFS in patients undergoing ALND is expected to be approximately 90%, with a non-inferiority margin of 10%, a significance level of 0.05, power of 0.8 and a loss-to-follow-up rate of 10%. The planned enrolment is 92 patients. The trial was initiated on 11 September 2023, with the first patient enrolled on 25 September 2023, and is scheduled to end in 2026.</p><p><strong>Ethics and dissemination: </strong>The trial protocol received approval from the Human Research Ethics Committee of The First Affiliated Hospital with Nanjing Medical University in May 2023 (No. 2023-SR-169). All participants will provide informed consent. The study results will be disseminated through international peer-reviewed scientific journals, presentations at international scientific conferences and public lectures.</p><p><strong>Trial registration number: </strong>NCT05939830.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e092563"},"PeriodicalIF":2.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751125","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":"Drug prescription for the management of gastrointestinal and skin symptoms in cancer patients by advanced practice nurses in China: a Delphi method.","authors":"Zhiying Yue, Dan Zhou, Mingli Zeng, Junying Li, Rujun Zheng","doi":"10.1136/bmjopen-2024-089803","DOIUrl":"10.1136/bmjopen-2024-089803","url":null,"abstract":"<p><strong>Background: </strong>The authority to prescribe drugs has been reserved only for the medical community, mainly clinicians. Recently, more and more countries worldwide have begun implementing reforms to grant advanced practice nurses (APNs) the authority to prescribe from the legislative level. This study aimed to explore the prescription drugs and forms for gastrointestinal and dermatological symptom management of cancer patients that APNs can prescribe in China.</p><p><strong>Design: </strong>A qualitative study reported in accordance with Conducting and REporting of DElphi Studies guidelines. The modified Delphi technique with two-round email consultations among 36 experts was applied.</p><p><strong>Methods: </strong>We conducted a study from January 2022 to March 2022 to reach a consensus among medical, nursing and pharmacy experts about drugs that nurses may prescribe for gastrointestinal and dermatological symptom management in cancer patients.</p><p><strong>Results: </strong>The expert authority coefficients are 0.95 and 0.96, respectively. A total of 35 drugs in 16 categories could be prescribed by APNs for gastrointestinal and dermatological symptoms management in China. Among them, three drugs were determined to be prescribed collaboratively, and 32 drugs were determined to be prescribed independently.</p><p><strong>Conclusions: </strong>The drug prescription formulated in this study is the basis for APNs to prescribe drugs for controlling gastrointestinal and skin symptoms for cancer patients in mainland China. The results are important as a guide for formulating and implementing policies related to nurse prescribing and will provide some reference for future nurse prescribing in China.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e089803"},"PeriodicalIF":2.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751124","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":"Social, personal and medical factors influencing treatment delay for patients with primary glaucoma during the COVID-19 pandemic: a qualitative interview study.","authors":"Hua Liu, Lina Sun, Yan Li, Wei Liu, Shaochong Bu, Shaohui Huang, Dan Hu, Jing Yan, Tong Bian, Shuang Li, Qian Li, Jingyi Shi, Ping Zhou, Yan Xing","doi":"10.1136/bmjopen-2024-096469","DOIUrl":"10.1136/bmjopen-2024-096469","url":null,"abstract":"<p><strong>Background: </strong>Primary glaucoma patients faced many difficulties that affected their treatment during the COVID-19 pandemic. Glaucoma treatment often starts with prescription eye-drops. However, delays in ophthalmic therapy often occur due to poor awareness of the dangers of glaucoma, which subsequently leads to irreversible visual field defects and eventual blindness.</p><p><strong>Objective: </strong>This study aimed to explore the social, personal and medical factors that contributed to barriers in the treatment of primary glaucoma during the COVID-19 pandemic, with the overarching goal of providing insights to develop measures that can identify the barriers of the treatment process and prevent consequent adverse outcomes.</p><p><strong>Methods: </strong>We adopted a phenomenological approach and used purposive sampling to recruit 122 patients into our study. Face-to-face, semistructured, one-on-one interviews were conducted in a private office. The data were analysed using Colaizzi's seven-step method. In cases where classification was difficult, consensus was reached among the three researchers who formed the core assessment team.</p><p><strong>Results: </strong>A total of 122 glaucoma patients experienced delayed pharmaceutical treatment during the outbreak. Delays were longer among females and patients over 75 years old, highlighting that treatment delays were a significant issue for glaucoma patients during the COVID-19 pandemic, particularly for older females. Coding of the transcripts yielded three themes (eight subthemes): (1) the impact of social support on glaucoma pharmaceutical treatment: (a) the inability to seek pharmaceutical treatment alone and (b) online reservation and payment requirements; (2) the impact of personal reasons on glaucoma pharmaceutical treatment: (c) fear of being infected with COVID-19, (d) being infected with COVID-19 or coming into contact with COVID-19 patients, (e) being busy with work or life; (3) the impact of medical resources on glaucoma pharmaceutical treatment: (f) abnormal diagnosis and treatment processes, (g) insufficient medical manpower and (h) insufficient communication from medical staff.</p><p><strong>Conclusions: </strong>To prevent medication delays and potential irreversible damage to the visual field in primary glaucoma patients during health crises, it is essential to further explore personalised strategies for coping with the impact of pandemics. Special attention should be given to glaucoma patients facing significant life burdens, such as the elderly and females, and efforts should be made to increase their awareness of the risks of glaucoma. Future studies could explore the feasibility of providing more support to glaucoma patients, such as online payment and appointment scheduling options, to reduce delays and alleviate patient anxiety.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e096469"},"PeriodicalIF":2.4,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742328","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":"Quality indicators for substance use disorder care: a scoping review protocol.","authors":"Ti-Amo DeRuz Richards, Julia Kirkham, Diane Lorenzetti, Jennifer Anderson, Anees Bahji, Youssef Allami, David Crockford, Michele P Dyson, Sumantra Monty Ghosh, David Hodgins, Geoffrey Messier, Shelly Vik, Dallas P Seitz","doi":"10.1136/bmjopen-2024-085216","DOIUrl":"10.1136/bmjopen-2024-085216","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Substance use disorders (SUDs) are a major public health challenge, affecting millions of individuals globally and contributing to substantial morbidity and mortality. Individuals with SUDs face numerous barriers to accessing high-quality healthcare, leaving vulnerable populations susceptible to the undertreatment of SUDs. Despite the availability of clinical practice guidelines and effective interventions for SUD, there is a notable gap in the implementation and adherence to evidence-based care.Measuring the quality of care (QoC) is a critical initial step toward enhancing the treatment and services provided to individuals with SUDs. While quality indicators (QIs) for SUD care have been established in various regions, including the USA, Canada and the UK, the application of QIs for the routine measurement of QoC for SUDs is not common. Identifying and characterising the areas of low QoC in SUD management can highlight critical targets for quality improvement initiatives. However, QoC measurement in SUD care is complex, with potentially redundant indicators derived from different sources, each with its own definitions, criteria and data requirements. This scoping review aims to explore the range of QIs that are currently available to assess the QoC for individuals with SUDs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The review will follow the Arksey and O'Malley framework and incorporate methods proposed by the Joanna Briggs Institute (JBI) and Levac &lt;i&gt;et al&lt;/i&gt;. Reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review guidelines (PRISMA). Stage 1: the research question will be identified, clarifying the purpose of the scoping review. Stage 2: six academic databases (Cochrane Library, Embase, CINAHL, Medline, APA PsycINFO and Scopus) and grey literature sources will be searched for studies reporting QIs and published from 1990 until 2023. Stage 3: study screening and selection will be completed by two reviewers independently to review titles, abstracts and full texts based on study inclusion criteria. Stage 4: a pilot data charting form has been developed to capture information from each study, including study design, population details, setting, methodology for QI development and reported QIs. Stage 5: data synthesis and consultation will employ thematic analysis and frequency counts to categorise identified QIs within established domains for quality of healthcare. Any discrepancies in data extraction or thematic synthesis will be identified and resolved using a third reviewer when necessary. A consultation exercise using a modified Delphi process will engage experts to prioritise identified QIs, aligning with JBI recommendations for stakeholder involvement in scoping reviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and public involvement: &lt;/strong&gt;Patients and the public will not be directly involved in the design or conduct of this scoping review. However, stakeholder con","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e085216"},"PeriodicalIF":2.4,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742325","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":"Evaluation of infant and young child feeding practices in low-income areas of Dhaka, Bangladesh: insights from a cross-sectional study using the 2021 WHO/UNICEF guideline.","authors":"Tasmia Tasnim, Md Hafizul Islam, Ali Abbas Mohammad Kurshed, Saiful Islam, Sadia Sultana, Kazi Muhammad Rezaul Karim","doi":"10.1136/bmjopen-2024-093064","DOIUrl":"10.1136/bmjopen-2024-093064","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the status of infant and young child feeding (IYCF) practices and associated factors among children aged 0-23 months in the low-income regions of Dhaka City, Bangladesh.</p><p><strong>Design: </strong>A community-based cross-sectional study.</p><p><strong>Settings: </strong>Low-income regions of Dhaka City, Bangladesh.</p><p><strong>Participants: </strong>530 children aged 0-23 months and their mothers.</p><p><strong>Primary and secondary outcome measures: </strong>Prevailing IYCF practices were assessed against the 17 indicators of IYCF recommended by the WHO/UNICEF in 2021. Modified Poisson regression models were built to explore the relation between socio-demographic variables and each of the selected IYCF indicators (early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)).</p><p><strong>Results: </strong>More than two-thirds of the children were reported to follow appropriate breastfeeding practices (EIBF, 70.4% and EBF, 60.9%). Among the complementary feeding indicators, almost half of the children (48.8%) were reported to meet MMF; however, only about 26% of the children reportedly met the MDD with a consequent low prevalence (22.9%) of the composite indicator MAD. More than half (55%) of the children were reported to consume egg and/or flesh food consumption; still, inappropriate dietary practices were observed among 60% had unhealthy food consumption, and 56% had zero vegetable or fruit consumption). Child age was a significant determinant of IYCF practices. The children of mothers with no pregnancy complications exhibited a greater chance of having EIBF (estimate: 1.21, 95% CI: 1.04, 1.42, p=0.02), MDD (Estimate: 1.67, 95% CI: 1.09, 2.55, p=0.02), and MAD (estimate: 1.70, 95% CI: 1.04, 2.77, p=0.03) compared with the children of mothers with pregnancy complications. The children with a mother having secondary or higher education had a higher chance of having MDD (estimate: 1.93, 95% CI: 1.35, 2.76, p=0.003) and MMF (estimate: 1.27, 95% CI: 1.03, 1.56, p=0.02) than the children of mothers having primary or no education. Similarly, children from higher-income households had a higher chance of getting MDD (estimate: 1.57, 95% CI: 1.07, 2.03, p=0.02), and MAD (estimate: 1.73, 95% CI: 1.14, 2.64, p=0.01) compared with children from lower-income households.</p><p><strong>Conclusion: </strong>IYCF practices among a considerable proportion of children aged 0-23 months in the low-income regions of Dhaka City were found to be suboptimal and predicted by children's age, maternal education and pregnancy complications, and household income.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e093064"},"PeriodicalIF":2.4,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742318","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":"Connecting patients with clinical trials using patient navigation: a scoping review protocol.","authors":"Olla Hilal, Pratham Gupta, Nasong Anthony Luginaah, Leena Moshref, Nicole Askin, Carla Epp, Renee Nassar, Roaa Hirmiz, Milica Paunic, Mahmoud Hossami, Rhonda Abdel-Nabi, Kayla Touma, Depen Sharma, Rija Fatima, Emmanuel Akingbade, Caroline Hamm, Megan Delisle","doi":"10.1136/bmjopen-2024-088828","DOIUrl":"10.1136/bmjopen-2024-088828","url":null,"abstract":"<p><strong>Introduction: </strong>Interventions are needed to increase participation in clinical trials through optimised trial design and enrolment workflows. Patient navigation is a promising intervention for increasing participation in clinical trials by optimising enrolment workflows. Patient navigation is defined as a personalised intervention aimed at overcoming barriers and ensuring timely access to healthcare services, diagnosis, treatment and care. This scoping review aims to fill a gap in current literature by summarising what is known about patient navigation, aiming to increase clinical trial participation.</p><p><strong>Methods and analysis: </strong>A search was conducted for peer-reviewed literature published in English from inception through 21 December 2023, and the search was updated on 5 March 2025. Sources of literature included Cochrane CENTRAL (Ovid), MEDLINE (Ovid), EMBASE (Ovid), Cumulative Index of Nursing and Allied Health (CINAHL; on EBSCOhost; EBSCO Industries, Inc), Epistemonikos and PROSPERO databases. Searches were also conducted through the Turning Research into Practice and International Clinical Trials Registry Platform (WHO) databases, Google Scholar and the Agency for Health Research and Quality platform to ensure the retrieval of all relevant articles. Reference lists of eligible studies were also examined. The Google Scholar search was limited to the first 10 pages of results. The search strategy focused on the following key concepts: navigation (eg, navigator, care coordination, case management) and clinical trials. Searches were reviewed using the PRESS Peer Review of Electronic Search Strategies 2015. This review was guided based on the JBI methodology for scoping reviews using a five-step review process: identify the research questions; search and identify relevant studies; select studies based on a priori criterion; chart the data; and collate, summarise and report the results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews.</p><p><strong>Ethics and dissemination: </strong>This scoping review identifies and analyses existing research; therefore, ethics approval is not required. Findings will be disseminated through conference presentations and a publication in a scientific journal.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 3","pages":"e088828"},"PeriodicalIF":2.4,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742300","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}