227,040 results match your criteria BMJ USA[Journal]


A theory-based, task-oriented, outdoor walking programme for older adults with difficulty walking outdoors: protocol for the Getting Older Adults Outdoors (GO-OUT) randomised controlled trial.

BMJ Open 2019 Apr 20;9(4):e029393. Epub 2019 Apr 20.

College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

Introduction: A theory-based, task-oriented, community walking programme can increase outdoor walking activity among older adults to optimise functional independence, social participation and well-being. The study objective is to determine if there is a difference in the change in outdoor walking activity from baseline to 10 weeks, 5.5 months and 12 months after receiving a 1-day interactive workshop and outdoor walking programme (Getting Older Adults Outdoors (GO-OUT)) compared with the workshop and weekly reminders (WR) in older adults with difficulty walking outdoors. Read More

View Article

Download full-text PDF

Source
http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2019-02939
Publisher Site
http://dx.doi.org/10.1136/bmjopen-2019-029393DOI Listing
April 2019
1 Read

Effect of metformin on the size of the HIV reservoir in non-diabetic ART-treated individuals: single-arm non-randomised Lilac pilot study protocol.

BMJ Open 2019 Apr 20;9(4):e028444. Epub 2019 Apr 20.

The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.

Introduction: People living with HIV (PLWH) on antiretroviral therapy (ART) do not progress to AIDS. However, they still suffer from an increased risk of inflammation-associated complications. HIV persists in long-lived CD4+ T cells, which form the major viral reservoir. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-028444DOI Listing

Could implementation of mifepristone address Canada's urban-rural abortion access disparity: a mixed-methods implementation study protocol.

BMJ Open 2019 Apr 20;9(4):e028443. Epub 2019 Apr 20.

Department of Family & Community Medicine, University of Toronto, Toronto, Ontario, Canada.

Introduction: In January 2017, mifepristone-induced medical abortion was made available in Canada. In this study, we will seek to (1) understand facilitators and barriers to the implementation of mifepristone across Canada, (2) assess the impact of a 'community of practice' clinical and health service support platform and (3) engage in and assess the impact of integrated knowledge translation (iKT) activities aimed to improve health policy, systems and service delivery issues to enhance patient access to mifepristone.

Methods And Analysis: This prospective mixed-methods implementation study will involve a national sample of physicians and pharmacists recruited via an online training programme, professional networks and a purpose-built community of practice website. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-028443DOI Listing

Screening and treatment to reduce severe hyperbilirubinaemia in infants in primary care (STARSHIP): a factorial stepped-wedge cluster randomised controlled trial protocol.

BMJ Open 2019 Apr 20;9(4):e028270. Epub 2019 Apr 20.

Division of Neonatology, Department of Paediatrics, Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands.

Introduction: Jaundice caused by hyperbilirubinaemia is a physiological phenomenon in the neonatal period. However, severe hyperbilirubinaemia, when left untreated, may cause kernicterus, a severe condition resulting in lifelong neurological disabilities. Although commonly applied, visual inspection is ineffective in identifying severe hyperbilirubinaemia. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-028270DOI Listing

Description of the BRIGHTLIGHT cohort: the evaluation of teenage and young adult cancer services in England.

BMJ Open 2019 Apr 20;9(4):e027797. Epub 2019 Apr 20.

Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK.

Objective: International recognition of the unique needs of young people with cancer is growing. Many countries have developed specialist age-appropriate cancer services believing them to be of value. In England, 13 specialist principal treatment centres (PTCs) deliver cancer care to young people. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-027797DOI Listing

Fit for purpose? OrganisationaL prOdUctivity and woRkforce wellbeIng in workSpaces in Hospital (FLOURISH): a multimethod qualitative study protocol.

BMJ Open 2019 Apr 20;9(4):e027636. Epub 2019 Apr 20.

Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.

Introduction: Workspaces are socially constructed environments where social relationships are produced, reproduced, challenged and transformed. Their primary function is to support high-quality service delivery to the benefit of 'patients'. They are also settings where employees can work effectively, in a safe and healthy environment, delivering a high-quality service according to a 'Work-As-Done' rather than a 'Work-As-Imagined' model. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-027636DOI Listing

Impact of psoriasis severity on patient-reported clinical symptoms, health-related quality of life and work productivity among US patients: real-world data from the Corrona Psoriasis Registry.

BMJ Open 2019 Apr 20;9(4):e027535. Epub 2019 Apr 20.

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.

Objectives: This analysis examined the association between psoriasis severity, assessed by body surface area (BSA) and the Investigator's Global Assessment (IGA; previously used only in clinical trials), and patient-reported outcomes (PROs) in a real-world setting.

Design: Cross-sectional analysis within the Corrona Psoriasis Registry, an independent, prospective registry.

Setting: 70 dermatology practices in the USA. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-027535DOI Listing

Longitudinal access and exposure to green-blue spaces and individual-level mental health and well-being: protocol for a longitudinal, population-wide record-linked natural experiment.

BMJ Open 2019 Apr 20;9(4):e027289. Epub 2019 Apr 20.

Swansea University Medical School, Swansea University, Swansea, UK.

Introduction: Studies suggest that access and exposure to green-blue spaces (GBS) have beneficial impacts on mental health. However, the evidence base is limited with respect to longitudinal studies. The main aim of this longitudinal, population-wide, record-linked natural experiment, is to model the daily lived experience by linking GBS accessibility indices, residential GBS exposure and health data; to enable quantification of the impact of GBS on well-being and common mental health disorders, for a national population. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-027289DOI Listing

Omega-3 polyunsaturated fatty acid intake norms and preterm birth rate: a cross-sectional analysis of 184 countries.

BMJ Open 2019 Apr 20;9(4):e027249. Epub 2019 Apr 20.

Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA.

Background: The preponderance of evidence now indicates that elevated long-chain omega-3 polyunsaturated fatty acid (LC omega-3 PUFA) intake is often associated with reduced risk of preterm birth (PTB). This conclusion is based on recent meta-analyses that include several studies that reported null findings. We probed the reasons for this heterogeneity across studies and its implications for PTB prevention using country-level data. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-027249DOI Listing
April 2019
1 Read

Participatory governance over research in an academic research network: the case of Diabetes Action Canada.

BMJ Open 2019 Apr 20;9(4):e026828. Epub 2019 Apr 20.

Family and Community Medicine, North York General Hospital, Toronto, Ontario, Canada.

Digital data generated in the course of clinical care are increasingly being leveraged for a wide range of secondary purposes. Researchers need to develop governance policies that can assure the public that their information is being used responsibly. Our aim was to develop a generalisable model for governance of research emanating from health data repositories that will invoke the trust of the patients and the healthcare professionals whose data are being accessed for health research. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-026828DOI Listing

Trends in occurrence and 30-day mortality of infective endocarditis in adults: population-based registry study in Finland.

BMJ Open 2019 Apr 20;9(4):e026811. Epub 2019 Apr 20.

Heart Center, Turku University Hospital, Turku, Finland.

Objectives: Infective endocarditis (IE) is a life-threatening disease associated with significant mortality. We studied recent temporal trends and age and sex differences in the occurrence and short-term mortality of IE.

Design: Population based retrospective cohort study. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-026811DOI Listing

Oral anticoagulation therapy use in patients with atrial fibrillation after the introduction of non-vitamin K antagonist oral anticoagulants: findings from the French healthcare databases, 2011-2016.

BMJ Open 2019 Apr 20;9(4):e026645. Epub 2019 Apr 20.

University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology - UMR 1219, Bordeaux, France.

Objectives: To describe (i) the trend in oral anticoagulant (OAC) use following the introduction of non-vitamin K antagonist oral anticoagulant (NOAC) therapy for stroke prevention in atrial fibrillation (AF) patients and (ii) the current patterns of use of NOAC therapy in new users with AF in France.

Design: (i) Repeated cross-sectional study and (ii) population-based cohort study.

Setting: French national healthcare databases (50 million beneficiaries). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-026645DOI Listing

Accuracy of mortality statistics in Palestine: a retrospective cohort study.

BMJ Open 2019 Apr 20;9(4):e026640. Epub 2019 Apr 20.

Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.

Objective: To examine the accuracy of mortality statistics in Palestine, to identify gaps and to provide evidence-based recommendations to improve mortality statistics in Palestine.

Study Design And Setting: A retrospective death registry-based study that examined a stratified random sample of death notification forms (DNFs) of patients who died in hospitals in Palestine was reported in 2012. We randomly selected 600 deceased from the Cause of Death Registry: 400 from the West Bank and 200 from the Gaza Strip. Read More

View Article

Download full-text PDF

Source
http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02664
Publisher Site
http://dx.doi.org/10.1136/bmjopen-2018-026640DOI Listing
April 2019
1 Read

International prospective observational study on intracranial pressure in intensive care (ICU): the SYNAPSE-ICU study protocol.

BMJ Open 2019 Apr 20;9(4):e026552. Epub 2019 Apr 20.

Department of Public Health, Erasmus MC, Rotterdam, Netherlands.

Introduction: Intracranial pressure (ICP) monitoring is commonly used in neurocritical care patients with acute brain injury (ABI). Practice about indications and use of ICP monitoring in patients with ABI remains, however, highly variable in high-income countries, while data on ICP monitoring in low and middle-income countries are scarce or inconsistent. The aim of the SYNAPSE-ICU study is to describe current practices of ICP monitoring using a worldwide sample and to quantify practice variations in ICP monitoring and management in neurocritical care ABI patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-026552DOI Listing
April 2019
1 Read

The effect of lowering the legal blood alcohol concentration limit on driving under the influence (DUI) in southern Taiwan: a cross-sectional retrospective analysis.

BMJ Open 2019 Apr 20;9(4):e026481. Epub 2019 Apr 20.

Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Objectives: We aimed to profile the epidemiological changes of driving under the influence (DUI) in southern Taiwan after the legal blood alcohol concentration (BAC) limit was lowered from 50 to 30 mg/dL in 2013.

Setting: Level 1 trauma medical centre in southern Taiwan.

Participants: Data from 7447 patients (4375 males and 3072 females) were retrieved from the trauma registry system of a single trauma centre to examine patient characteristics (gender, age and BAC), clinical outcome variables (Abbreviated Injury Score, Injury Severity Score and mortality) and vehicular crash-related factors (vehicle type, airbag use in car crashes, helmet use in motorcycle crashes and time of crash) before and after the BAC limit change. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-026481DOI Listing

Perception of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement of authors publishing reviews in nursing journals: a cross-sectional online survey.

BMJ Open 2019 Apr 20;9(4):e026271. Epub 2019 Apr 20.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore.

Objective: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement has been developed as a guideline for reporting systematic reviews and meta-analyses. Despite the prevalent use of the PRISMA statement in medicine and nursing, no studies have examined authors' perception of it. The purpose of this study is to explore the perception of the PRISMA statement of authors who published reviews, meta-analyses, or both in nursing journals. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-026271DOI Listing

Protocol for the Gut Bugs Trial: a randomised double-blind placebo-controlled trial of gut microbiome transfer for the treatment of obesity in adolescents.

BMJ Open 2019 Apr 20;9(4):e026174. Epub 2019 Apr 20.

Liggins Institute, University of Auckland, Auckland, New Zealand.

Introduction: Animal studies showed that germ-free mice inoculated with normal mouse gut bacteria developed obesity, insulin resistance and higher triglyceride levels, despite similar food intake. In humans, an association has been found between obesity and gut microbiome dysbiosis. However, gut microbiome transfer has not been evaluated for the treatment of human obesity. Read More

View Article

Download full-text PDF

Source
http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02617
Publisher Site
http://dx.doi.org/10.1136/bmjopen-2018-026174DOI Listing
April 2019
1 Read

Plasma NT-proBNP levels associated with cardiac structural abnormalities in asymptomatic health examinees with preserved ejection fraction: a retrospective cross-sectional study.

BMJ Open 2019 Apr 20;9(4):e026030. Epub 2019 Apr 20.

MEDIcheck LAB, Korea Association of Health Promotion, Cheongju, South Korea.

Objectives: Stage B heart failure (HF) is defined as an asymptomatic abnormality of the heart structure or function. The circulating level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) is elevated in symptomatic patients with left ventricular (LV) dysfunction caused by a structural or functional abnormality. This study investigated the association of the NT-proBNP level with echocardiography-detected cardiac structural or diastolic abnormalities in asymptomatic subjects with preserved LV systolic function (ejection fraction >50%). Read More

View Article

Download full-text PDF

Source
http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02603
Publisher Site
http://dx.doi.org/10.1136/bmjopen-2018-026030DOI Listing
April 2019
1 Read

Comparative evaluation of novel screening strategies for colorectal cancer screening in China (TARGET-C): a study protocol for a multicentre randomised controlled trial.

BMJ Open 2019 Apr 20;9(4):e025935. Epub 2019 Apr 20.

Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Introduction: Screening for colorectal cancer (CRC) is effective in reducing the disease burden. However, high-level evidence from randomised controlled trials on the effectiveness of CRC screening modalities is still lacking. We will conduct a large-scale multicentre randomised controlled trial in China to evaluate the effectiveness and cost-effectiveness of different CRC screening strategies. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-025935DOI Listing

One-shot dilation versus serial dilation technique for access in percutaneous nephrolithotomy: a systematic review and meta-analysis.

BMJ Open 2019 Apr 20;9(4):e025871. Epub 2019 Apr 20.

Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China.

Objective: The purpose of this study was to systematically review the outcomes of the use of one-shot dilation (OSD) and serial tract dilation for percutaneous nephrolithotomy (PCNL).

Methods: A systematic review and meta-analysis was conducted. The randomised controlled trials (RCTs) included in the study were identified from EMBASE, MEDLINE and the Cochrane Central Register of Controlled Trials. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-025871DOI Listing

The utility of diagnostic selective nerve root blocks in the management of patients with lumbar radiculopathy: a systematic review.

BMJ Open 2019 Apr 20;9(4):e025790. Epub 2019 Apr 20.

Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Objective: Lumbar radiculopathy (LR) often manifests as pain in the lower back radiating into one leg (sciatica). Unsuccessful back surgery is associated with significant healthcare costs and risks to patients. This review aims to examine the diagnostic accuracy of selective nerve root blocks (SNRBs) to identify patients most likely to benefit from lumbar decompression surgery. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-025790DOI Listing

Does the 'Chinese New Year effect' exist? Hospital mortality in patients admitted to internal medicine departments during official consecutive holidays: a nationwide population-based cohort study.

BMJ Open 2019 Apr 20;9(4):e025762. Epub 2019 Apr 20.

Department of Family Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.

Objective: Our study aimed to compare the mortality risk among patients admitted to internal medicine departments during official consecutive holidays (using Chinese New Year holidays as an indicator) with that of weekend and weekday admissions.

Design: Nationwide population-based cohort study.

Setting: Taiwan's National Health Insurance Research Database. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-025762DOI Listing

Protocol for a pilot randomised controlled trial of mindfulness-based cognitive therapy in youth with inflammatory bowel disease and depression.

BMJ Open 2019 Apr 20;9(4):e025568. Epub 2019 Apr 20.

Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.

Introduction: Inflammatory bowel disease (IBD) is a chronic autoinflammatory disease of the gastrointestinal tract with peak age of onset during adolescence and young adulthood. Adolescents and young adults (AYAs) with IBD experience higher depression rates compared with peers who are well or have other chronic conditions. Mindfulness-based interventions are of particular interest because of their potential to improve both the course of IBD and depression. Read More

View Article

Download full-text PDF

Source
http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02556
Publisher Site
http://dx.doi.org/10.1136/bmjopen-2018-025568DOI Listing
April 2019
1 Read

Genetic components of human pain sensitivity: a protocol for a genome-wide association study of experimental pain in healthy volunteers.

BMJ Open 2019 Apr 20;9(4):e025530. Epub 2019 Apr 20.

Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK.

Introduction: Pain constitutes a major component of the global burden of diseases. Recent studies suggest a strong genetic contribution to pain susceptibility and severity. Whereas most of the available evidence relies on candidate gene association or linkage studies, research on the genetic basis of pain sensitivity using genome-wide association studies (GWAS) is still in its infancy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-025530DOI Listing

Multidimensional analysis of factors responsible for the low prevalence of ambulatory peritoneal dialysis in Germany (MAU-PD): a cross-sectional Mixed-Methods Study Protocol.

BMJ Open 2019 Apr 20;9(4):e025451. Epub 2019 Apr 20.

Dr Klaus-Ketzler-Zentrum, KfH-Nierenzentrum, Wiesbaden, Germany.

Introduction: Patients with end-stage kidney failure can be treated either by transplant or by dialysis, which can be administered as haemodialysis (HD) or peritoneal dialysis (PD). Although they are equivalent therapeutic options in terms of mortality, the percentage of patients in Germany treated with PD is currently very low (∼6%) compared with other countries. The aim of our study is to analyse the factors behind this percentage and their relevance to the choice of dialysis treatment in Germany. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-025451DOI Listing

Communication skills training for the radiotherapy team to manage cancer patients' emotional concerns: a systematic review.

BMJ Open 2019 Apr 20;9(4):e025420. Epub 2019 Apr 20.

School of Medicine, University of St Andrews, St Andrews, UK.

Objectives: Many cancer patients experience high levels of anxiety and concern during radiotherapy, often with long-lasting effects on their well-being. This systematic review aims to describe and determine the effectiveness of communication skills training (CST) for the radiotherapy team (RT) to improve conversations in this setting and to support patients with emotional concerns.

Design: Systematic review. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-025420DOI Listing

Patient expectations of a new treatment for eating disorders combining guided physical exercise and dietary therapy: an interview study of women participating in a randomised controlled trial at the Norwegian School of Sport Sciences.

BMJ Open 2019 Apr 20;9(4):e025344. Epub 2019 Apr 20.

Department of Sports Medicine, Norwegian School of Sport Sciences, Norway, Europe.

Objectives: To study the expectations women with bulimia nervosa (BN) or binge eating disorder (BED) had to a new treatment programme based on guided physical exercise and dietary therapy.

Design And Participants: Semistructured interviews were conducted with six women with BN and four women with BED following a group-based therapy programme. Transcribed interviews were analysed using a text-condensing analytic approach. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-025344DOI Listing

Number of blood pressure measurements needed to estimate long-term visit-to-visit systolic blood pressure variability for predicting cardiovascular risk: a 10-year retrospective cohort study in a primary care clinic in Malaysia.

BMJ Open 2019 Apr 20;9(4):e025322. Epub 2019 Apr 20.

School of Medicine, Faculty of Health and Medical Science, Taylor's University, Subang Jaya, Selangor, Malaysia.

Objective: To determine the reproducibility of visit-to-visit blood pressure variability (BPV) in clinical practice. We also determined the minimum number of blood pressure (BP) measurements needed to estimate long-term visit-to-visit BPV for predicting 10-year cardiovascular (CV) risk.

Design: Retrospective study SETTING: A primary care clinic in a university hospital in Malaysia. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-025322DOI Listing

The FOOTPATH study: protocol for a multicentre, participant- and assessor-blind, parallel group randomised clinical trial of foot orthoses for patellofemoral osteoarthritis.

BMJ Open 2019 Apr 20;9(4):e025315. Epub 2019 Apr 20.

La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia.

Introduction: Patellofemoral (PF) osteoarthritis (OA) is a common and burdensome subgroup of knee OA, with very little evidence for effective treatments. Prefabricated foot orthoses are an affordable and accessible intervention that have been shown to reduce PF pain in younger adults. Similarities between PF pain and PFOA, as well as our pilot work, suggest that foot orthoses may also be an effective intervention for PFOA. Read More

View Article

Download full-text PDF

Source
http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02531
Publisher Site
http://dx.doi.org/10.1136/bmjopen-2018-025315DOI Listing
April 2019
1 Read

Socioeconomic trajectories of body mass index and waist circumference: results from the English Longitudinal Study of Ageing.

BMJ Open 2019 Apr 20;9(4):e025309. Epub 2019 Apr 20.

Epidemiology and Public Health, University College London, London, UK.

Objectives: To explore age trajectories of body mass index (BMI) and waist circumference (WC) and to examine whether these trajectories varied by wealth.

Design: Nationally representative prospective cohort study.

Setting: Observational study of people living in England. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-025309DOI Listing

Simulation-based training for increasing health service board members' effectiveness: protocol for a cluster-randomised controlled trial.

BMJ Open 2019 Apr 20;9(4):e025170. Epub 2019 Apr 20.

Bass Coast Health, Wonthaggi, Victoria, Australia.

Introduction: Research indicates that health service boards can influence quality of care. However, government reviews have indicated that board members may not be as effective as possible in attaining this goal. Simulation-based training may help to increase board members' ability to effectively communicate and hold hospital staff to account during board meetings. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-025170DOI Listing

Pathways and associated costs of care in patients with confirmed and presumptive tuberculosis in Tanzania: A cross-sectional study.

BMJ Open 2019 Apr 20;9(4):e025079. Epub 2019 Apr 20.

Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.

Objective: To assess pathways and associated costs of seeking care from the onset of symptoms to diagnosis in patients with confirmed and presumptive tuberculosis (TB).

Design: Cross-sectional study.

Setting: District hospital in Dar es Salaam, Tanzania. Read More

View Article

Download full-text PDF

Source
http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02507
Publisher Site
http://dx.doi.org/10.1136/bmjopen-2018-025079DOI Listing
April 2019
1 Read

Effectiveness of an antenatal maternal supplementation with prebiotics for preventing atopic dermatitis in high-risk children (the PREGRALL study): protocol for a randomised controlled trial.

BMJ Open 2019 Apr 20;9(4):e024974. Epub 2019 Apr 20.

Department of Dermatology, Centre Hospitalier Universitaire de Nantes, Nantes, Pays de la Loire, France.

Introduction: Atopic dermatitis (AD) is a chronic inflammatory disease affecting 10%-15% of children in Europe. There is a need for new primary preventive therapeutic strategies in at-risk populations. Recent research has indicated that atopic diseases are associated with a disrupted gut microbial 'balance' in early life raising the possibility that interventions which yield optimal patterns of microflora could improve host's health. Read More

View Article

Download full-text PDF

Source
http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02497
Publisher Site
http://dx.doi.org/10.1136/bmjopen-2018-024974DOI Listing
April 2019
1 Read

Diet quality in relation to healthy ageing: the Israeli Longitudinal Study on Aging (ILSA)-a study protocol.

BMJ Open 2019 Apr 20;9(4):e024673. Epub 2019 Apr 20.

Department of Epidemiology and Preventive Medicine, Tel Aviv University, Tel Aviv, Israel.

Introduction: Population ageing is accelerating rapidly in Israel as well as worldwide, necessitating adaptation of the healthcare system and consideration of new approaches that serve the specific needs of older adults. In addition to cognitive function, frailty is one of the most challenging expressions of physical and mental ageing, a multidimensional syndrome of increased vulnerability. Several studies have shown that low intake of certain micronutrients and protein is associated with higher risk of frailty and cognitive impairment. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-024673DOI Listing

Comparison between different instruments for measuring health-related quality of life in a population sample, the WHO MONICA Project, Gothenburg, Sweden: an observational, cross-sectional study.

BMJ Open 2019 Apr 20;9(4):e024454. Epub 2019 Apr 20.

Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Objective: The general aim was to meet the need for empirical comparative studies of health-related quality of life (HRQoL) assessment instruments, by evaluating and comparing the psychometric properties and results of three different, widely used, generic HRQoL instruments in a population sample. The specific aims were to evaluate the subscales of the different instruments that measure the same domain and to assess the association between the HRQoL measures and a single-item self-rated health scale.

Design: An observational cross-sectional study. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-024454DOI Listing

Serogroup-specific meningococcal carriage by age group: a systematic review and meta-analysis.

BMJ Open 2019 Apr 20;9(4):e024343. Epub 2019 Apr 20.

Sanofi Pasteur, Inc., Swiftwater, Pennsylvania, USA.

Objective: carriage prevalence has known variation across the lifespan, but it is unclear whether carriage varies among meningococcal capsular groups. Therefore, we aimed to characterise group-specific meningococcal carriage by age group and world region from 2007 to 2016.

Design: Systematic review and meta-analysis. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-024343DOI Listing

Long-term outcomes of urinary tract infection (UTI) in Childhood (LUCI): protocol for an electronic record-linked cohort study.

BMJ Open 2019 Apr 20;9(4):e024210. Epub 2019 Apr 20.

Division of Population Medicine, School of Medicine, Wales Centre for Primary and Emergency Care Research (PRIME Centre Wales), Cardiff University, Cardiff, UK.

Introduction: Current guidelines advise the prompt diagnosis and treatment of urinary tract infection (UTI) in children to improve both short and longer term outcomes. However, the risk of long-term complications following childhood UTI is unclear.UTI is relatively common but difficult to diagnose in children as symptoms are non-specific. Read More

View Article

Download full-text PDF

Source
http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02421
Publisher Site
http://dx.doi.org/10.1136/bmjopen-2018-024210DOI Listing
April 2019
1 Read

Exploring the clinical context of adopting an instrumented insole: a qualitative study of clinicians' preferences in England.

BMJ Open 2019 Apr 20;9(4):e023656. Epub 2019 Apr 20.

Department of Surgery and Cancer, Imperial College London, London, UK.

Objectives: This study explores clinicians' views of the clinical uptake of a smart pressure-sensing insole, named Flexifoot, to enhance the care and management of patients with osteoarthritis (OA). Clinicians are key users of wearable technologies, and can provide appropriate feedback for a specific device for successful clinical implementation.

Design: Qualitative study with in-depth, semi-structured interviews, analysed using inductive analysis to generate key themes. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-023656DOI Listing

Locked-in syndrome in Sweden, an explorative study of persons who underwent rehabilitation: a cohort study.

BMJ Open 2019 Apr 20;9(4):e023185. Epub 2019 Apr 20.

Institution of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.

Objective: Locked-in syndrome (LiS) is a rare condition, characterised by a complete paresis except for vertical eye movements and blinking with cognitive functions intact, commonly caused by ischaemia in the ventral pons. Previous studies have indicated that persons with LiS can live on for many years and have a good quality of life (QoL). To our knowledge, LiS has never been studied in Sweden. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-023185DOI Listing

Identification of earlier predictors of pregnancy complications through wearable technologies in a Brazilian multicentre cohort: Maternal Actigraphy Exploratory Study I (MAES-I) study protocol.

BMJ Open 2019 Apr 20;9(4):e023101. Epub 2019 Apr 20.

Social Medicine, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, Ribeirao Preto, Brazil.

Introduction: Non-invasive tools capable of identifying predictors of maternal complications would be a step forward for improving maternal and perinatal health. There is an association between modification in physical activity (PA) and sleep-wake patterns and the occurrence of inflammatory, metabolic, pathological conditions related to chronic diseases. The actigraphy device is validated to estimate PA and sleep-wake patterns among pregnant women. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-023101DOI Listing

Positive and negative social support and depressive symptoms according to economic status among adults in Korea: cross-sectional results from the Health Examinees-Gem Study.

BMJ Open 2019 Apr 20;9(4):e023036. Epub 2019 Apr 20.

Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

Objectives: The interaction between positive and negative social support as well as each domain of social support and income on depressive symptom has not been much explored. We aimed to examine the associations of positive and negative social support with the risk of depressive symptoms among urban-dwelling adults in Korea, focusing on those interaction effects.

Design: We used the first wave of a large-scale cohort study called The Health Examinees-Gem Study. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-023036DOI Listing

Efficacy and safety of electroacupuncture on treating depression-related insomnia: a study protocol for a multicentre randomised controlled trial.

BMJ Open 2019 Apr 20;9(4):e021484. Epub 2019 Apr 20.

Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Introduction: Sleep disorders including insomnia occur frequently in depressive patients. Acupuncture is a widely recognised therapy to treat depression and sleep disorders in clinical practice. This multicentre randomised controlled trial (RCT) is aimed to investigate the efficacy and safety of electroacupuncture (EA) in the treatment of depression patients with insomnia. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-021484DOI Listing
April 2019
1 Read

Deep continuous patient-requested sedation until death: a multicentric study.

BMJ Support Palliat Care 2019 Apr 20. Epub 2019 Apr 20.

Department of Palliative Care, Hospices Civils de Lyon, Lyon, France

Objectives: In 2016, a new law was adopted in France granting patients the right, under specific conditions, to continuous deep sedation until death (CDSUD). The goal of this study was to measure the frequency of requests for CDSUD from patients in palliative care.

Methods: The data collected from the medical records of patients in palliative care units (PCU) or followed by palliative care support teams (PCST) in the Rhône-Alpes area, who died after CDSUD, focused on the patient's characteristics, the drugs used (and compliance with regulatory processes). Read More

View Article

Download full-text PDF

Source
http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0017
Publisher Site
http://dx.doi.org/10.1136/bmjspcare-2018-001712DOI Listing
April 2019
1 Read

Hemiazygos continuation of isolated left-sided inferior vena cava into persistent left superior vena cava: rare association of left isomerism.

BMJ Case Rep 2019 Apr 20;12(4). Epub 2019 Apr 20.

Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, Delhi, India.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2019-230350DOI Listing

Septal bounce illustrated on coronary angiogram.

BMJ Case Rep 2019 Apr 20;12(4). Epub 2019 Apr 20.

Cardiology, All India Institute of Medical Sciences, New Delhi, India.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2019-230179DOI Listing

Head of the pancreas mass that turned out to be not a pancreatic cancer.

BMJ Case Rep 2019 Apr 20;12(4). Epub 2019 Apr 20.

Department of Internal Medicine, Tripler Army Medical Center, Honolulu, Hawaii, USA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2019-230110DOI Listing

Perineal ulcer: a rare cause of extensive subcutaneous emphysema.

BMJ Case Rep 2019 Apr 20;12(4). Epub 2019 Apr 20.

Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, USA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2019-229918DOI Listing
April 2019
1 Read

Crohn's disease initiated with extraintestinal features.

BMJ Case Rep 2019 Apr 20;12(4). Epub 2019 Apr 20.

Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.

Crohn's disease (CD) is a multifactorial, chronic immune-mediated disorder. The oral cavity is involved in 0.5% to 20% of the patients with CD. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2019-229916DOI Listing
April 2019
1 Read

Prolapsing mass in the caecum: learning point for the colonoscopist.

BMJ Case Rep 2019 Apr 20;12(4). Epub 2019 Apr 20.

Colorectal Surgery, Royal Gwent Hospital, Newport, UK.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2019-229811DOI Listing

Simple and novel technique for fabrication of prosthetic vaginal dilators.

BMJ Case Rep 2019 Apr 20;12(4). Epub 2019 Apr 20.

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, India.

Vaginal agenesis is one of the major congenital anomalies affecting women. Postoperative prosthetic vaginal dilators are indicated in patients treated surgically for vaginal agenesis. Although different dental materials such as acrylics and silicone-coated materials are used, addition silicones alone have never been used for the fabrication of prosthetic vaginal dilators. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2019-229524DOI Listing