9,800 results match your criteria BMJ Quality & Safety [Journal]


Implementation of the WHO manual for Robson classification: an example from Sri Lanka using a local database for developing quality improvement recommendations.

BMJ Open 2019 Feb 19;9(2):e027317. Epub 2019 Feb 19.

WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.

Objectives: This study aimed at describing the use of a prospective database on hospital deliveries for analysing caesarean section (CS) practices according to the WHO manual for Robson classification, and for developing recommendations for improving the quality of care (QoC).

Design: Observational study.

Setting: University Obstetric Unit at De Soysa Hospital for Women, the largest maternity unit in Sri Lanka. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-027317DOI Listing
February 2019

Maternity Log study: a longitudinal lifelog monitoring and multiomics analysis for the early prediction of complicated pregnancy.

BMJ Open 2019 Feb 19;9(2):e025939. Epub 2019 Feb 19.

Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.

Purpose: A prospective cohort study for pregnant women, the Maternity Log study, was designed to construct a time-course high-resolution reference catalogue of bioinformatic data in pregnancy and explore the associations between genomic and environmental factors and the onset of pregnancy complications, such as hypertensive disorders of pregnancy, gestational diabetes mellitus and preterm labour, using continuous lifestyle monitoring combined with multiomics data on the genome, transcriptome, proteome, metabolome and microbiome.

Participants: Pregnant women were recruited at the timing of first routine antenatal visits at Tohoku University Hospital, Sendai, Japan, between September 2015 and November 2016. Of the eligible women who were invited, 65. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025939DOI Listing
February 2019

Chronic heart failure patients' experiences of German healthcare services: a protocol for a scoping review.

BMJ Open 2019 Feb 19;9(2):e025685. Epub 2019 Feb 19.

Institute of General Practice, Goethe University Frankfurt, Frankfurt, Germany.

Introduction: Chronic heart failure (CHF) is a heterogeneous condition requiring complex treatment from diverse healthcare services. An increasingly holistic understanding of healthcare has resulted in contextual factors such as perceived quality of care, as well as patients' acceptance, preferences and subjective expectations of health services, all gaining in importance. How patients with CHF experience the use of healthcare services has not been studied within the scope of a systematic review in a German healthcare context. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025685DOI Listing
February 2019

Association between child maltreatment and central sensitivity syndromes: a systematic review protocol.

BMJ Open 2019 Feb 19;9(2):e025436. Epub 2019 Feb 19.

School of Nursing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.

Introduction: A growing body of evidence is identifying the link between a history of child maltreatment and a variety of adverse health outcomes ultimately leading to significant social and healthcare burden. Initial work has identified a potential association between child maltreatment and the development of a selection of somatic and visceral central sensitivity syndromes: fibromyalgia, chronic fatigue syndrome, temporomandibular joint disorder, chronic lower back pain, chronic neck pain, chronic pelvic pain, interstitial cystitis, vulvodynia, chronic prostatitis, tension-type headache, migraine, myofascial pain syndrome, irritable bowel syndrome and restless legs syndrome.

Methods And Analysis: Primary electronic searches will be performed in the Embase, MEDLINE, PubMed, Scopus, PyscINFO, CINAHL and Cochrane Library databases and a number of Grey Literature sources including child protection and paediatric conference proceedings. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025436DOI Listing
February 2019

Protocol for a prospective, longitudinal cohort study on the effect of arterial disease level on the outcomes of supervised exercise in intermittent claudication: the ELECT Registry.

BMJ Open 2019 Feb 19;9(2):e025419. Epub 2019 Feb 19.

Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands.

Introduction: Despite guideline recommendations advocating conservative management before invasive treatment in intermittent claudication, early revascularisation remains widespread in patients with favourable anatomy. The aim of the Effect of Disease Level on Outcomes of Supervised Exercise in Intermittent Claudication Registry is to determine the effect of the location of stenosis on the outcomes of supervised exercise in patients with intermittent claudication due to peripheral arterial disease.

Methods And Analysis: This multicentre prospective cohort study aims to enrol 320 patients in 10 vascular centres across the Netherlands. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025419DOI Listing
February 2019

Quality assessment of clinical trial registration with traditional Chinese medicine in WHO registries.

BMJ Open 2019 Feb 19;9(2):e025218. Epub 2019 Feb 19.

Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China.

Objective: This study aimed to assess the registration quality of clinical trials (CTs) with traditional Chinese medicine (TCM) in the WHO International Clinical Trials Registry Platform (ICTRP) and identify the common problems if any.

Methods: The ICTRP database was searched for all TCM CTs that were registered up to 31 December 2017. Registered information of each trial was collected from specific registry involved in ICTRP through hyperlink. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025218DOI Listing
February 2019

The China Patient-centred Evaluative Assessment of Cardiac Events (PEACE) prospective heart failure study design.

BMJ Open 2019 Feb 19;9(2):e025144. Epub 2019 Feb 19.

National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Introduction: China faces the prospect of a large growth in the prevalence of heart failure (HF). However, there is limited knowledge about outcomes in patients after HF hospitalisations, including patient-reported outcomes (PROs). This paper is to present the study goal, methodology and data collection of the China Patient-centred Evaluative Assessment of Cardiac Events Prospective Heart Failure Study (China PEACE 5p-HF Study). Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025144DOI Listing
February 2019

Improving the management of musculoskeletal conditions: can an alternative approach to referral management underpinned by quality improvement and behavioural change theories offer a solution and a better patient experience? A mixed-methods study.

BMJ Open 2019 Feb 19;9(2):e024710. Epub 2019 Feb 19.

Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Objectives: To assess whether a quality improvement-based approach to referral management can result in better musculoskeletal care within general practice.

Design: Prospective cohort study using mixed methodology including random-effects meta-analysis and interrupted time series.

Setting And Participants: 36 general practices in East London. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024710DOI Listing
February 2019

Temporal trends in relative survival following percutaneous coronary intervention.

BMJ Open 2019 Feb 19;9(2):e024627. Epub 2019 Feb 19.

Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele, Keele, UK.

Objective: Percutaneous coronary intervention (PCI) has seen substantial shifts in patient selection in recent years that have increased baseline patient mortality risk. It is unclear to what extent observed changes in mortality are attributable to background mortality risk or the indication and selection for PCI itself. PCI-attributable mortality can be estimated using relative survival, which adjusts observed mortality by that seen in a matched control population. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024627DOI Listing
February 2019

Pharmacological interventions for prevention and management of delirium in intensive care patients: a systematic overview of reviews and meta-analyses.

BMJ Open 2019 Feb 19;9(2):e024562. Epub 2019 Feb 19.

Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Objectives: We assessed the evidence from reviews and meta-analyses of randomised clinical trials on the effects of pharmacological prevention and management of delirium in intensive care unit (ICU) patients.

Methods: We searched for reviews in July 2017 in: Cochrane Library, MEDLINE, Embase, Science Citation Index, BIOSIS Previews, CINAHL and LILACS. We assessed whether reviews were systematic according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and assessed the methodological quality using ROBIS. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024562DOI Listing
February 2019

Frailty in patients undergoing transcatheter aortic valve implantation: a protocol for a systematic review.

BMJ Open 2019 Feb 19;9(2):e024163. Epub 2019 Feb 19.

Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.

Introduction: Aortic stenosis is a significant cause of morbidity and mortality in older patients. The advent of transcatheter aortic valve implantation (TAVI) offers an alternative to surgical aortic valve replacement for patients with severe symptomatic aortic stenosis who are at high or intermediate risk of adverse events. Existing evidence highlights the importance of frailty as a predictor of poor outcomes post-TAVI. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024163DOI Listing
February 2019

Effectiveness and cost-effectiveness of basic versus biofeedback-mediated intensive pelvic floor muscle training for female stress or mixed urinary incontinence: protocol for the OPAL randomised trial.

BMJ Open 2019 Feb 19;9(2):e024153. Epub 2019 Feb 19.

Consumer Representative, Ayrshire, UK.

Introduction: Accidental urine leakage is a distressing problem that affects around one in three women. The main types of urinary incontinence (UI) are stress, urgency and mixed, with stress being most common. Current UK guidelines recommend that women with UI are offered at least 3 months of pelvic floor muscle training (PFMT). Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024153DOI Listing
February 2019

HORYZONS trial: protocol for a randomised controlled trial of a moderated online social therapy to maintain treatment effects from first-episode psychosis services.

BMJ Open 2019 Feb 19;9(2):e024104. Epub 2019 Feb 19.

School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.

Introduction: Specialised early intervention services have demonstrated improved outcomes in first-episode psychosis (FEP); however, clinical gains may not be sustained after patients are transferred to regular care. Moreover, many patients with FEP remain socially isolated with poor functional outcomes. To address this, our multidisciplinary team has developed a moderated online social media therapy (HORYZONS) designed to enhance social functioning and maintain clinical gains from specialist FEP services. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024104DOI Listing
February 2019

Health assets in a global context: a systematic review of the literature.

BMJ Open 2019 Feb 3;9(2):e023810. Epub 2019 Feb 3.

Institute for Health and Human Development, University of East London, London, UK.

Objective: To provide an up-to-date overview of health assets in a global context both from a theoretical perspective and its practical applications to address health inequalities and achieve sustainable health.

Design: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data Sources: A comprehensive search, including 10 electronic bibliographic databases and hand searches, was undertaken to capture the wide range of terms associated with 'health assets' and 'asset-based approaches to health'. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023810DOI Listing
February 2019

Cognitive effects of non-surgical brain stimulation for major depressive disorder: protocol for a systematic review and meta-analysis.

BMJ Open 2019 Feb 19;9(2):e023796. Epub 2019 Feb 19.

Faculty of Medicine, School of Public Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK.

Introduction: Non-surgical brain stimulation techniques may be considered as alternative or add-on treatments for patients with major depressive disorder who failed to respond to pharmacological interventions. Electroconvulsive therapy has been shown to be highly effective in reducing depressive symptoms but stakeholders remain concerned about adverse cognitive effects. Repetitive transcranial magnetic stimulation and transcranial direct current stimulation may be associated with more benign adverse effect profiles and may indeed improve certain cognitive functions such as memory and attention. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023796DOI Listing
February 2019

Implementation of an individual patient prospective database of hospital births in Sri Lanka and its use for improving quality of care.

BMJ Open 2019 Feb 19;9(2):e023706. Epub 2019 Feb 19.

WHO Collaborating Centre, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.

Objectives: This study was aimed at piloting a prospective individual patient database on hospital deliveries in Colombo, Sri Lanka, and at exploring its use for developing recommendations for improving quality of care (QoC).

Design: Observational study.

Setting: De Soysa Maternity Hospital, the largest referral hospital for maternity care in Sri Lanka. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023706DOI Listing
February 2019

Gaps, traps, bridges and props: a mixed-methods study of resilience in the medicines management system for patients with heart failure at hospital discharge.

BMJ Open 2019 Feb 19;9(2):e023440. Epub 2019 Feb 19.

School of Pharmacy and Medical Sciences, University of Bradford, Bradford, UK.

Introduction: Poor medicines management places patients at risk, particularly during care transitions. For patients with heart failure (HF), optimal medicines management is crucial to control symptoms and prevent hospital readmission. This study explored the concept of resilience using HF as an example condition to understand how the system compensates for known and unknown weaknesses. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023440DOI Listing
February 2019

Effects of traditional Chinese exercise on cardiac rehabilitation after percutaneous coronary intervention: study protocol for network meta-analysis of randomised controlled trials.

BMJ Open 2019 Feb 19;9(2):e023096. Epub 2019 Feb 19.

Department of Cardiovascular Disease, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.

Introduction: Coronary heart disease (CHD) is the most common cause of death worldwide. Percutaneous coronary intervention (PCI) has been shown to reduce mortality in patients with CHD. However, there are still recurrences of cardiovascular events after PCI. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023096DOI Listing
February 2019

Cost-effectiveness of cell salvage and donor blood transfusion during caesarean section: results from a randomised controlled trial.

BMJ Open 2019 Feb 19;9(2):e022352. Epub 2019 Feb 19.

Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Objectives: To evaluate the cost-effectiveness of routine use of cell salvage during caesarean section in mothers at risk of haemorrhage compared with current standard of care.

Design: Model-based cost-effectiveness evaluation alongside a multicentre randomised controlled trial. Three main analyses were carried out on the trial data: (1) based on the intention-to-treat principle; (2) based on the per-protocol principle; (3) only participants who underwent an emergency caesarean section. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-022352DOI Listing
February 2019

Mat Pilates and aquatic aerobic exercises for women with fibromyalgia: a protocol for a randomised controlled blind study.

BMJ Open 2019 Feb 19;9(2):e022306. Epub 2019 Feb 19.

Faculty of Health Sciences of Trairi - UFRN/FACISA, Federal University of Rio Grande do Norte, Santa Cruz, Brazil.

Introduction: Physical exercises have been recommended to improve the overall well-being of patients with fibromyalgia, with the main objective of repairing the effects of lack of physical conditioning and of improving the symptoms, especially pain and fatigue. Although widely recommended and widely known, few studies support the use of Pilates as an effective method in improving the symptoms of the disease, comparing it with other well-founded exercise modalities. This protocol was developed to describe the design of a randomised controlled study with a blind evaluator that evaluates the effectiveness of mat Pilates, comparing it with aquatic aerobic exercises, in improving pain in women with fibromyalgia. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-022306DOI Listing
February 2019

Health facility service availability and readiness to provide basic emergency obstetric and newborn care in a low-resource setting: evidence from a Tanzania National Survey.

BMJ Open 2019 Feb 19;9(2):e020608. Epub 2019 Feb 19.

Department of Internal Medicine, College of Health Sciences, The University of Dodoma, Dodoma, United Republic of Tanzania.

Objective: This study used a nationally representative sample from Tanzania as an example of low-resource setting with a high burden of maternal and newborn deaths, to assess the availability and readiness of health facilities to provide basic emergency obstetric and newborn care (BEmONC) and its associated factors.

Design: Health facility-based cross-sectional survey.

Setting: We analysed data for obstetric and newborn care services obtained from the 2014-2015 Tanzania Service Provision Assessment survey, using WHO-Service Availability and Readiness Assessment tool. Read More

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http://dx.doi.org/10.1136/bmjopen-2017-020608DOI Listing
February 2019

Quality & safety in the literature: March 2019.

BMJ Qual Saf 2019 Mar;28(3):249-252

Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.

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http://dx.doi.org/10.1136/bmjqs-2018-009271DOI Listing

Evaluating the impact of a community-based social prescribing intervention on people with type 2 diabetes in North East England: mixed-methods study protocol.

BMJ Open 2019 Jan 15;9(1):e026826. Epub 2019 Jan 15.

Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.

Introduction: Social prescribing enables healthcare professionals to use voluntary and community sector resources to improve support for people with long-term conditions. It is widely promoted in the UK as a way to address complex health, psychological and social issues presented in primary care, yet there is insufficient evidence of effectiveness or value for money. This study aims to evaluate the impact and costs of a link-worker social prescribing intervention on the health and healthcare use of adults aged 40-74 with type 2 diabetes, living in a multi-ethnic area of high socioeconomic deprivation. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-026826DOI Listing
January 2019

Study protocol for a quasi-experimental claims-based study evaluating 10-year results of the population-based integrated healthcare model 'Gesundes Kinzigtal' (Healthy Kinzigtal): the INTEGRAL study.

BMJ Open 2019 Jan 15;9(1):e025945. Epub 2019 Jan 15.

Institute for Health Services Research and Clinical Epidemiology, University of Marburg, Marburg, Germany.

Introduction: Patients often experience interface problems when treated by different specialists and in different healthcare sectors. Integrated care concepts aim to reduce these problems. While most integrated healthcare models focus on individual diseases, the integrated care model 'Gesundes Kinzigtal' applies a population-based approach and addresses the full spectrum of morbidities for a population defined by area of residence-the Kinzigtal. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025945DOI Listing
January 2019

Towards sustainable healthcare system performance in the 21st century in high-income countries: a protocol for a systematic review of the grey literature.

BMJ Open 2019 Jan 17;9(1):e025892. Epub 2019 Jan 17.

Centre for Health Economics Research and Evaluation, University of Technology, Sydney, New South Wales, Australia.

Introduction: There is wide recognition that, if healthcare systems continue along current trajectories, they will become harder to sustain. Ageing populations, accelerating rates of chronic disease, increasing costs, inefficiencies, wasteful spending and low-value care pose significant challenges to healthcare system durability. Sustainable healthcare systems are important to patients, society, policy-makers, public and private funders, the healthcare workforce and researchers. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025892DOI Listing
January 2019

Impact of point-of-care C reactive protein in ambulatory care: a systematic review and meta-analysis.

BMJ Open 2019 Feb 1;9(1):e025036. Epub 2019 Feb 1.

Nuffield Department of Primary Care Health Sciences, NIHR Community Healthcare MIC, University of Oxford, Oxford, UK.

Objective: The aim of this review was to collate all available evidence on the impact of point-of-care C reactive protein (CRP) testing on patient-relevant outcomes in children and adults in ambulatory care.

Design: This was a systematic review to identify controlled studies assessing the impact of point-of-care CRP in patients presenting to ambulatory care services. Ovid Medline, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, DARE, Science Citation Index were searched from inception to March 2017. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025036DOI Listing
February 2019

Evaluation of the intensive outpatient clinic: study protocol for a prospective study of high-cost, high-need patients in the University of Utah Health system.

BMJ Open 2019 Feb 1;9(1):e024724. Epub 2019 Feb 1.

Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, Utah, USA.

Introduction: The University of Utah (UofU) Health intensive outpatient clinic (IOC) is a primary care clinic for medically complex (high-cost, high-need) patients with Medicaid. The clinic consists of a multidisciplinary care team aimed at providing coordinated, comprehensive and patient-centred care. The protocol outlines the quantitative design of an evaluation study to determine the IOC's effects on reducing healthcare utilisation and costs, as well as improving patient-reported health outcomes and quality of care. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024724DOI Listing
February 2019

Depressive symptoms and quality of life after screening for cognitive impairment in patients with type 2 diabetes: observations from the Cog-ID cohort study.

BMJ Open 2019 Jan 17;9(1):e024696. Epub 2019 Jan 17.

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.

Objectives: To assess changes in depressive symptoms and health-related quality of life (HRQOL) after screening for cognitive impairment in people with type 2 diabetes.

Design: A prospective cohort study, part of the Cognitive Impairment in Diabetes (Cog-ID) study.

Setting: Participants were screened for cognitive impairment in primary care. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024696DOI Listing
January 2019

Protocol for a prospective observational study to develop a frailty index for use in perioperative and critical care.

BMJ Open 2019 Jan 9;9(1):e024682. Epub 2019 Jan 9.

Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.

Introduction: Frailty is of increasing importance to perioperative and critical care medicine, as the proportion of older patients increases globally. Evidence continues to emerge of the considerable impact frailty has on adverse outcomes from both surgery and critical care, which has led to a proliferation of different frailty measurement tools in recent years. Despite this, there remains a lack of easily implemented, comprehensive frailty assessment tools specific to these complex populations. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024682DOI Listing
January 2019

Electronic patient reported outcomes to support care of patients with traumatic brain injury: PRiORiTy study qualitative protocol.

BMJ Open 2019 Jan 25;9(1):e024617. Epub 2019 Jan 25.

Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

Introduction: Traumatic brain injury (TBI) represents a major health and socioeconomic problem internationally. The expansive nature of injuries results in a heterogeneous population. The degree and type of long-term impacts following TBI and improvement following injury are highly variable. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024617DOI Listing
January 2019

Finnish National Esophago-Gastric Cancer Cohort (FINEGO) for studying outcomes after oesophageal and gastric cancer surgery: a protocol for a retrospective, population-based, nationwide cohort study in Finland.

BMJ Open 2019 Jan 15;9(1):e024094. Epub 2019 Jan 15.

Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.

Introduction: Surgery for oesophageal and gastric cancers is associated with high morbidity, mortality and poor quality of life postoperatively. The Finnish National Esophago-Gastric Cancer Cohort has been established with the aim of identifying factors that could contribute to improved outcomes in oesophago-gastric cancer.

Methods And Analysis: All patients with oesophageal and gastric cancer diagnosed in Finland between 1987 and 2015 will be identified from the Finnish national registries. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024094DOI Listing
January 2019

Disparity of the Chinese elderly's health-related quality of life between urban and rural areas: a mediation analysis.

BMJ Open 2019 Jan 25;9(1):e024080. Epub 2019 Jan 25.

Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China.

Objectives: This study aimed to examine the urban-rural disparity in health-related quality of life (HRQoL) of the Chinese elderly and to explore the mediating roles of socioeconomic status (SES) and frequency of contact with children in the relationship between urban/rural areas and HRQoL.

Methods: This cross-sectional study used data from China Health and Retirement Longitudinal Study for 2015-2016, involving 12 369 Chinese aged 45 years and over. HRQoL of respondents was measured by three-level EuroQol five dimensions (EQ-5D-3L). Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024080DOI Listing
January 2019

WHO guidance on mental health training: a systematic review of the progress for non-specialist health workers.

BMJ Open 2019 Feb 1;9(1):e024059. Epub 2019 Feb 1.

Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK.

Objective: To assess existing literature on the effectiveness of mental health training courses for non-specialist health workers, based on the WHO guidelines (2008).

Design: A systematic review was carried out, complying with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.

Data Sources: After examination of key studies in the literature, a comprehensive search was performed within the following electronic databases on 31 May 2017: PubMed, PsycINFO, CINAHL (using EBSCOHost interface), Cochrane, Web of Science. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024059DOI Listing
February 2019

Use of patient-reported outcome measures (PROMs) in clinical diabetes consultations: study protocol for the DiaPROM randomised controlled trial pilot study.

BMJ Open 2019 Jan 17;9(1):e024008. Epub 2019 Jan 17.

Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway.

Introduction: Although diabetes distress is found to be associated with decreased glycaemic control among adults with type 1 diabetes, the psychological and emotional impact of living with the condition is often not recognised and often under-reported in diabetes care. Therefore, regular assessment of diabetes distress is recommended. Assessment of diabetes distress using patient-reported outcome measures (PROMs) in clinical practice has the potential to enhance care for people with diabetes by identifying problems and improving patient-clinician communication. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024008DOI Listing
January 2019

Supporting children and young people when making decisions about joining clinical trials: qualitative study to inform multimedia website development.

BMJ Open 2019 Jan 9;9(1):e023984. Epub 2019 Jan 9.

Department of Psychological Sciences, University of Liverpool, Liverpool, UK.

Objectives: To understand stakeholders' views regarding the content and design of paediatric clinical trial multimedia websites. To describe how this knowledge informed the development of the multimedia websites.

Design: Qualitative study comprising two rounds of interviews or focus groups, with thematic analysis of interview transcripts. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023984DOI Listing
January 2019

Relaxation for Critically ill Patient Outcomes and tress-coping Enhancement (REPOSE): a protocol for a pilot randomised trial of an integrative intervention to improve critically ill patients' delirium and related outcomes.

BMJ Open 2019 Jan 15;9(1):e023961. Epub 2019 Jan 15.

Critical Care Research Group, Royal Alexandra Hospital, Edmonton, AB, Canada.

Introduction: Delirium is a common complication of critical illness, associated with negative patient outcomes. Preventive or therapeutic interventions are mostly ineffective. Although relaxation-inducing approaches may benefit critically ill patients, no well-designed studies target delirium prevention as a primary outcome. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023961DOI Listing
January 2019

Pros and cons of gastric bypass surgery in individuals with obesity and type 2 diabetes: nationwide, matched, observational cohort study.

BMJ Open 2019 Jan 15;9(1):e023882. Epub 2019 Jan 15.

Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.

Objectives: Long-term effects of gastric bypass (GBP) surgery have been presented in observational and randomised studies, but there are only limited data for persons with obesity and type 2 diabetes mellitus (T2DM) regarding postoperative complications.

Design: This is a nationwide observational study based on two quality registers in Sweden (National Diabetes Register, NDR and Scandinavian Obesity Surgery Register, SOReg) and other national databases.

Setting: After merging the data, we matched individuals with T2DM who had undergone GBP with those not surgically treated for obesity on propensity score, based on sex, age, body mass index (BMI) and calendar time. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023882DOI Listing
January 2019

Impact of a specific training programme on the neuromodulation of pain in female patient with fibromyalgia (DouFiSport): a 24-month, controlled, randomised, double-blind protocol.

BMJ Open 2019 Jan 25;9(1):e023742. Epub 2019 Jan 25.

LIEN, EA4685, University of Western Brittany (UBO), Brest, France.

Introduction: The main symptom of fibromyalgia (FM) is diffuse pain. There is currently no aetiological treatment for FM. However, all pain associations and best practice guidelines strongly advocate the practice of aerobic physical activity to improve the symptoms of FM subjects. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023742DOI Listing
January 2019

Development of a binational thyroid cancer clinical quality registry: a protocol paper.

BMJ Open 2019 Jan 28;9(1):e023723. Epub 2019 Jan 28.

Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Introduction: The occurrence of thyroid cancer is increasing throughout the developed world and since the 1990s has become the fastest increasing malignancy. In 2014, a total of 2693 Australians and 302 New Zealanders were diagnosed with thyroid cancer, with this number projected to rise to 3650 in 2018. The purpose of this protocol is to establish a binational population-based clinical quality registry with the aim of monitoring and improving the quality of care provided to patients diagnosed with thyroid cancer in Australia and New Zealand. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023723DOI Listing
January 2019

Dairy product consumption and development of cancer: an overview of reviews.

BMJ Open 2019 Jan 25;9(1):e023625. Epub 2019 Jan 25.

The George & Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada.

Objectives: To provide a comprehensive systematic overview of current evidence from pooled analyses/meta-analyses and systematic reviews (PMASRs) pertaining to dairy consumption and incident cancer and/or all-cause or cancer-specific mortality.

Design: Overview of reviews.

Setting: Community setting. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023625DOI Listing
January 2019

Development and validation protocol for an instrument to measure household water insecurity across cultures and ecologies: the Household Water InSecurity Experiences (HWISE) Scale.

BMJ Open 2019 Jan 17;9(1):e023558. Epub 2019 Jan 17.

School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA.

Introduction: A wide range of water-related problems contribute to the global burden of disease. Despite the many plausible consequences for health and well-being, there is no validated tool to measure individual- or household-level water insecurity equivalently across varying cultural and ecological settings. Accordingly, we are developing the Household Water Insecurity Experiences (HWISE) Scale to measure household-level water insecurity in multiple contexts. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023558DOI Listing
January 2019

Long-term follow-up for Psychological stRess in Intensive CarE (PRICE) survivors: study protocol for a multicentre, prospective observational cohort study in Australian intensive care units.

BMJ Open 2019 Jan 25;9(1):e023310. Epub 2019 Jan 25.

Intensive Care Unit, Canberra Hospital, Canberra, Australian Capital Territory, Australia.

Introduction: There are little published data on the long-term psychological outcomes in intensive care unit (ICU) survivors and their family members in Australian ICUs. In addition, there is scant literature evaluating the effects of psychological morbidity in intensive care survivors on their family members. The aims of this study are to describe and compare the long-term psychological outcomes of intubated and non-intubated ICU survivors and their family members in an Australian ICU setting. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023310DOI Listing
January 2019

Children with Hemiparesis Arm and Movement Project (CHAMP): protocol for a multisite comparative efficacy trial of paediatric constraint-induced movement therapy (CIMT) testing effects of dosage and type of constraint for children with hemiparetic cerebral palsy.

BMJ Open 2019 Jan 15;9(1):e023285. Epub 2019 Jan 15.

University of Virginia, Charlottesville, Virginia, USA.

Introduction: The Children with Hemiparesis Arm and Movement Project (CHAMP) addresses two pressing issues concerning paediatric constraint-induced movement therapy (CIMT): effects of two dosages and two types of constraint on functional outcomes. Systematic reviews conclude that CIMT is one of the most efficacious treatments, but wide variations in treatment protocols, outcome measures and patient characteristics have prevented conclusions about potential effects of dosage levels and constraint methods.

Methods And Analysis: CHAMP is a multisite comparative efficacy randomised controlled trial of 135 children (2-8 years) with hemiparetic cerebral palsy. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023285DOI Listing
January 2019

Hearing Norton Sound: a community randomised trial protocol to address childhood hearing loss in rural Alaska.

BMJ Open 2019 Jan 15;9(1):e023078. Epub 2019 Jan 15.

Norton Sound Health Corporation, Nome, Alaska, USA.

Introduction: The population in rural Alaska experiences a disproprionately high burden of infection-mediated hearing loss. While the state mandates school hearing screening, many children with hearing loss are not identified or are lost to follow-up before ever receiving treatment. A robust, tribally owned healthcare system exists in Alaska, but children with hearing loss must first be identified and referred for existing infrastructure to be used. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023078DOI Listing
January 2019

Cross-sectional study on medicinal products without commercial interest (MPWCI) in the Spanish market.

BMJ Open 2019 Jan 17;9(1):e023054. Epub 2019 Jan 17.

Pharmacy and Pharmaceutical Technology, and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain.

Objective: To confirm that there is a defined group of products to be protected in the Spanish therapeutic arsenal known as 'medicinal products without commercial interest' (MPWCI) and propose the adoption of legal measures aimed at avoiding, or reducing, the lack of supply of said products.

Design: A cross-sectional study of proposed MPWCI based on a survey. The Spanish Agency of Medicines and Medical Devices (AEMPS) was asked for a list of presentations of medicines in order to identify those whose lack could have an impact on welfare. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023054DOI Listing
January 2019

Examining reliability of WHOBARS: a tool to measure the quality of administration of WHO surgical safety checklist using generalisability theory with surgical teams from three New Zealand hospitals.

BMJ Open 2019 Jan 9;9(1):e022625. Epub 2019 Jan 9.

Center for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand.

Objectives: To extend reliability of WHO Behaviourally Anchored Rating Scale (WHOBARS) to measure the quality of WHO Surgical Safety Checklist administration using generalisability theory. In this context, extending reliability refers to establishing generalisability of the tool scores across populations of teams and raters by accounting for the relevant sources of measurement errors.

Design: Cross-sectional random effect measurement design assessing surgical teams by the five items on the three Checklist phases, and at three sites by two trained raters simultaneously. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-022625DOI Listing
January 2019

Acceptability and feasibility pilot randomised controlled trial of medical skin camouflage for recovery of women prisoners with self-harm scarring (COVER): the study protocol.

BMJ Open 2019 Jan 17;9(1):e021891. Epub 2019 Jan 17.

Centre for Women's Mental Health, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.

Introduction: Self-harm in prison is a major public health concern. Less than 5% of UK prisoners are women, but they carry out more than a fifth of prison self-harm. Scars resulting from self-harm can be traumatising and stigmatising, yet there has been little focus on recovery of women prisoners with self-harm scarring. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-021891DOI Listing
January 2019

A pilot randomised controlled trial of metacognitive therapy for prolonged grief.

BMJ Open 2019 Jan 9;9(1):e021409. Epub 2019 Jan 9.

School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.

Objectives: Prolonged grief disorder is associated with significant distress and impairment and thus efforts to improve treatments are essential. The present pilot study tested the efficacy and feasibility of group Metacognitive Grief Therapy (MCGT) designed specifically for prolonged grief symptomatology to reduce the psychological distress and impaired function resulting from bereavement.

Design/participants: Twenty-two bereaved adult participants with prolonged grief symptomatology were randomised to a wait-list control (n=10) or an intervention condition (n=12) with a 3-month and 6-month follow-up. Read More

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http://dx.doi.org/10.1136/bmjopen-2017-021409DOI Listing
January 2019

Does endometriosis affect professional life? A matched case-control study in Switzerland, Germany and Austria.

BMJ Open 2019 Jan 9;9(1):e019570. Epub 2019 Jan 9.

Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland.

Objectives: Endometriosis is a gynaecological disease most commonly causing severe and chronic pelvic pain as well as an impaired quality of life. The aim of this study was to investigate if and how endometriosis affects choices regarding professional life as well as the quality of daily working life.

Design, Setting And Participants: In the context of a multicentre case-control study, we collected data from 505 women with surgically/histologically confirmed diagnosis of endometriosis and 505 matched controls. Read More

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http://dx.doi.org/10.1136/bmjopen-2017-019570DOI Listing
January 2019

Evidence maps: a tool to guide research agenda setting.

BMJ Evid Based Med 2019 Feb 18. Epub 2019 Feb 18.

Department of Preventive Medicine, Mayo Clinic, Rochester, Minnesota, USA.

A surprisingly huge proportion of medical research still shows poor quality in design, conduct and analysis, leading to far from optimal robustness of findings and validity of conclusions. Research waste remains a problem caused by a number of reasons. Asking the wrong research questions and ignoring the existing evidence are possible preventable ones. Read More

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http://dx.doi.org/10.1136/bmjebm-2018-111137DOI Listing
February 2019