Impact of health education on promoting influenza vaccination health literacy in primary school students: a cluster randomised controlled trial protocol
This study aims to evaluate the effect of health education interventions on influenza vaccination rates and health literacy. Methods and analysis This cluster randomised controlled trial will enrol 3036 students in grades 4–5 from 20 primary schools in Dongguan City, China. Schools will be randomised to an intervention group receiving influenza vaccination health education or a control group receiving routine health education. The primary outcome is the influenza vaccination rate. Secondary outcomes include health literacy levels, influenza diagnosis rate, influenza-like illness incidence and vaccine protection rate...
Source: BMJ Open - April 12, 2024 Category: General Medicine Authors: Xie, W., Xiao, J., Chen, J., Huang, H., Huang, X., He, S., Xu, L. Tags: Open access, Epidemiology Source Type: research

Development of an enhanced scoring system to predict ICU readmission or in-hospital death within 24 hours using routine patient data from two NHS Foundation Trusts
Conclusions We showed that a scoring system incorporating data from a patient’s stay in the ICU has better performance than commonly used EWS systems based on vital signs alone. Trial registration number ISRCTN32008295. (Source: BMJ Open)
Source: BMJ Open - April 12, 2024 Category: General Medicine Authors: Pimentel, M. A. F., Johnson, A., Darbyshire, J. L., Tarassenko, L., Clifton, D. A., Walden, A., Rechner, I., Watkinson, P. J., Young, J. D. Tags: Open access, Intensive care Source Type: research

A cross-sectional study on the proper administration of eye medications and its determinants among outpatients attending Brhan Aini Ophthalmic National Referral Hospital in Asmara, Eritrea
Conclusion This research revealed that there was an inappropriate administration technique and disposal practices of eye medications among ophthalmic outpatients. This requires immediate attention from policy-makers, programme managers and healthcare professionals to ensure the appropriate use of eye medications by the patients. (Source: BMJ Open)
Source: BMJ Open - April 11, 2024 Category: General Medicine Authors: Abdu, N., Weldemariam, D. G., Goitom Tesfagaber, A., Tewelde, T., Tesfamariam, E. H. Tags: Open access, Ophthalmology Source Type: research

Assessment of the prevalence and associated factors of lower back pain (LBP) among three different professionals in Bangladesh: Findings from a face-to-face survey
Conclusion The study underscores occupational differences in LBP prevalence, emphasising the necessity for tailored interventions and occupational health policies. Identifying specific risk factors and management practices in these professions can aid in developing effective prevention strategies and enhancing healthcare services. (Source: BMJ Open)
Source: BMJ Open - April 11, 2024 Category: General Medicine Authors: Nasim, A. S. M., Siddique, A. B., Devnath, N., Zeba, Z. Tags: Open access, Public health Source Type: research

Point-of-choice kilocalorie labelling practices in large, out-of-home food businesses: a preobservational versus post observational study of labelling practices following implementation of The Calorie Labelling (Out of Home Sector) (England) Regulations 2021
Conclusion The number of large businesses in the OHFS providing kcal labelling increased following the implementation of mandatory labelling regulations. However, around one-fifth of eligible outlets sampled were not providing kcal labelling 4–8 months after the regulations came into force, and the majority of businesses only partially complied with government guidance. More effective enforcement may be required to further improve kcal labelling practices in the OHFS in England. Preregistration Study protocol and analysis strategy preregistered on Open Science Framework (https://osf.io/pfnm6/). (Source: BMJ Open)
Source: BMJ Open - April 11, 2024 Category: General Medicine Authors: Polden, M., Jones, A., Essman, M., Adams, J., Bishop, T., Burgoine, T., Donohue, A., Sharp, S., White, M., Smith, R., Robinson, E. Tags: Open access, Public health Source Type: research

Multicomponent processes to identify and prioritise low-value care in hospital settings: a scoping review
Conclusions Gaps identified included applying systematic efforts to contextualise the identification of low-value care, involving people with lived experience of hospital care and initiatives in resource poor contexts. Insights were obtained regarding the theories, models and frameworks used to guide initiatives and ways in which the concept ‘low-value care’ had been used and reported. A priority for further research is evaluating the effect of initiatives that identify low-value care using contextualisation as part of multicomponent processes. (Source: BMJ Open)
Source: BMJ Open - April 11, 2024 Category: General Medicine Authors: Tyack, Z., Carter, H., Allen, M., Senanayake, S., Warhurst, K., Naicker, S., Abell, B., McPhail, S. M. Tags: Open access, Health services research Source Type: research

Community perceptions, beliefs and factors determining family planning uptake among men and women in Ekiti State, Nigeria: finding from a descriptive exploratory study
Conclusion The study concluded that there are varied reactions to family planning uptake due to varied perception, cultural and religious beliefs and determining factors. It was recommended that more targeted male partner engagement in campaign would boost family planning uptake. (Source: BMJ Open)
Source: BMJ Open - April 11, 2024 Category: General Medicine Authors: Ibikunle, O. O., Ipinnimo, T. M., Bakare, C. A., Ibirongbe, D. O., Akinwumi, A. F., Ibikunle, A. I., Ajidagba, E. B., Olowoselu, O. O., Abioye, O. O., Alabi, A. K., Seluwa, G. A., Alabi, O. O., Filani, O., Adelekan, B. Tags: Open access, Public health Source Type: research

Do patients with type 2 diabetes mellitus included in randomised clinical trials differ from general-practice patients? A cross-sectional comparative study
Conclusions Patients with type 2 diabetes mellitus cared for in general practice differ in a number of important aspects from patients included in randomised controlled trials on which clinical practice guidelines are based. This situation hampers the applicability of these guidelines. Future randomised trials should include patients who better fit the ‘average’ general-practice patient with type 2 diabetes mellitus to help improve the translation of study findings in daily practice. (Source: BMJ Open)
Source: BMJ Open - April 11, 2024 Category: General Medicine Authors: Dugard, A., Giraudeau, B., Dibao-Dina, C. Tags: Open access, Diabetes and Endocrinology Source Type: research

Association of antibiotic duration and all-cause mortality in a prospective study of patients with ventilator-associated pneumonia in a tertiary-level critical care unit in Southern India
Conclusion In this hospital-based cohort study, there is insufficient evidence to suggest that prolonging antibiotic duration beyond 8 days in patients with VAP improves survival. (Source: BMJ Open)
Source: BMJ Open - April 11, 2024 Category: General Medicine Authors: Stanley, N. D., Jeevan, J. A., Yadav, B., Gunasekaran, K., Pichamuthu, K., Chandiraseharan, V. K., Sathyendra, S., Hansdak, S. G., Iyyadurai, R. Tags: Open access, Intensive care Source Type: research

SARS-CoV-2 infection by trimester of pregnancy and adverse perinatal outcomes: a Mexican retrospective cohort study
Conclusions In the overall sample, there was no evidence of an association between COVID-19 and adverse perinatal outcomes. However, the findings suggest that severe COVID-19 may increase the risk of some perinatal outcomes, with the first trimester potentially being a high-risk period. (Source: BMJ Open)
Source: BMJ Open - April 11, 2024 Category: General Medicine Authors: Ghosh, R., Gutierrez, J. P., de Jesus Ascencio-Montiel, I., Juarez-Flores, A., Bertozzi, S. M. Tags: Open access, Epidemiology Source Type: research

Effect of transcranial direct current stimulation combined with transcutaneous auricular vagus nerve stimulation on poststroke cognitive impairment: a study protocol for a randomised controlled trial
This study protocol aims to investigate the effect and neural mechanism of the combination of tDCS and taVNS on cognitive function in patients who had a stroke. Methods and analysis In this single-centre, prospective, parallel, randomised controlled trial, a total of 66 patients with poststroke cognitive impairment will be recruited and randomly assigned (1:1:1) to the tDCS group, the taVNS group and the combination of tDCS and taVNS group. Each group will receive 30 min of treatment daily, five times weekly for 3 weeks. Primary clinical outcome is the Montreal Cognitive Assessment. Secondary clinical outcomes include the...
Source: BMJ Open - April 10, 2024 Category: General Medicine Authors: Liu, W., Cheng, X., Zhang, Y., Liao, W. Tags: Open access, Rehabilitation medicine Source Type: research

Understanding lived experiences and perceptions of resilience in black and South Asian Muslim children living in East London: a qualitative study protocol
Introduction It is important to promote resilience in preadolescence; however, there is limited research on children’s understandings and experiences of resilience. Quantitative approaches may not capture dynamic and context-specific aspects of resilience. Resilience research has historically focused on white, middle-class Western adults and adolescents, creating an evidence gap regarding diverse experiences of resilience in middle childhood which could inform interventions. East London’s Muslim community represents a diverse, growing population. Despite being disproportionately affected by deprivation and raci...
Source: BMJ Open - April 10, 2024 Category: General Medicine Authors: Murray, A., Durrani, F., Winstanley, A., Keiller, E., Taleb, P. A., Islam, S., Foka, S., Turri, M. G., Lau, J. Y. F. Tags: Open access, Qualitative research Source Type: research

Predictors of late initiation of breastfeeding practice in Ethiopia: a multilevel mixed-effects analysis of recent evidence from EDHS 2019
Conclusion More than one-fourth of newborn children do not start breast feeding within the WHO-recommended time (first hour). Programmes should focus on promoting the health facility birth and increasing the ANC visits. Further emphasis should be placed on young mothers and those who deliver via caesarean section to improve the timely initiation of breast feeding. (Source: BMJ Open)
Source: BMJ Open - April 10, 2024 Category: General Medicine Authors: Haile, R. N., Abate, B. B., Kitaw, T. A. Tags: Open access, Nutrition and metabolism Source Type: research

Understanding responsibility for health inequalities in childrens hospitals in England: a qualitative study with hospital staff
Conclusions Broadly speaking, senior leaders were clear about their organisational role in reducing health inequalities where they impacted on access and quality of care, but there was some uncertainty about the perceived boundaries of responsibility. This led to fragility in the sustainability of activity, and a lack of joined-up intervention. Most hospitals were forging ahead with activity, considering that it was more important to work to overcome health inequalities rather than debate whose job it was. (Source: BMJ Open)
Source: BMJ Open - April 10, 2024 Category: General Medicine Authors: Brewster, L., Brennan, L., Hindocha, A., Lunn, J., Isba, R. Tags: Open access, Paediatrics Source Type: research

Conceptual framework for establishing twins prevention and continuous health promotion programme: a qualitative study
Conclusion This study presented the initial endeavour to establish a comprehensive and practical solution in the form of a continuous HPPP designed to tackle the obstacles of twins’ cohorts. (Source: BMJ Open)
Source: BMJ Open - April 10, 2024 Category: General Medicine Authors: Abtahi, H., Khoshnam-Rad, N., Gholamzadeh, M., Daraie, M., Sabouri, F. Tags: Open access, Health services research Source Type: research