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Total 1631 results found since Jan 2013.

Impact of primary health care reforms in Quebec Health Care System: a systematic literature review protocol
Introduction During the last decade the Quebec Public Health Care System (QPHCS) had an important transformation in primary care planning activity. The increase of the service demand together with a significant reduction of supply in primary care may be at risk of reducing access to health care services, with a negative impact on costs and health outcomes. The aims of this systematic literature review are to map and aggregate existing literature and evidence on the primary care provided in Quebec, showing the benefits and limitations associated with the health policies developed in the last two decades, and highlighting ar...
Source: BMJ Open - July 31, 2023 Category: General Medicine Authors: Landa, P., Lalonde, J.-D., Bergeron, F., Kassim, S. A., Cote, A., Gartner, J.-B., Tanfani, E., Resta, M. Tags: Open access, Public health Source Type: research

Acceptability of surgical care in Uganda: a qualitative study on users and providers
Conclusion While affordability and accessibility are well defined and therefore easier to assess, acceptability is a much less quantifiable concept. This study breaks it down into tangible concepts in the form of five categories, which provide guidance for future interventions targeting acceptability of surgical care. We also demonstrated that multiple perspectives are beneficial to understanding the multifactorial nature of healthcare seeking and provision.
Source: BMJ Open - July 31, 2023 Category: General Medicine Authors: Rauschendorf, P., Nume, R., Bruchhausen, W. Tags: Open access, Global health Source Type: research

Effects of internalised racism and internalised homophobia on sexual behaviours among black gay and bisexual men in the USA: a systematic review protocol
Introduction Black gay and bisexual men are overburdened by HIV in the USA. While the socioecological model has been applied to understand potential mechanisms of HIV acquisition among black gay and bisexual men, there is mixed evidence on the impact of internalised stigma on HIV risk among this population. This systematic review protocol paper outlines the systematic review being conducted to determine the relationship between internalised racism, internalised homophobia and engagement in sexual behaviour, which puts individuals at risk for HIV infection. Methods and analysis For the review, we will conduct a systematic ...
Source: BMJ Open - July 31, 2023 Category: General Medicine Authors: Whitfield, D. L., Miller, R. S., Escobar-Viera, C. G., Mammadli, T., Brown, A. L., Gordon, J. D., Chandler, C. Tags: Open access HIV/AIDS Source Type: research

Applying an equity lens to hospital safety monitoring: a critical interpretive synthesis protocol
Introduction Hospital safety monitoring systems are foundational to how adverse events are identified and addressed. They are well positioned to bring equity-related safety issues to the forefront for action. However, there is uncertainty about how they have been, and can be, used to achieve this goal. We will undertake a critical interpretive synthesis (CIS) to examine how equity is integrated into hospital safety monitoring systems. Methods and analysis This review will follow CIS principles. Our initial compass question is: How is equity integrated into safety monitoring systems? We will begin with a structured search ...
Source: BMJ Open - July 31, 2023 Category: General Medicine Authors: Goldman, J., Lo, L., Rotteau, L., Wong, B. M., Kuper, A., Coffey, M., Rawal, S., Alfred, M., Razack, S., Pinard, M., Palomo, M., Trbovich, P. Tags: Open access, Health services research Source Type: research

Therapeutic outcomes with surgical and medical management for primary aldosteronism: protocol for a systematic review and meta-analysis
Introduction Treatment strategies for primary aldosteronism (PA) include unilateral adrenalectomy and medical treatment with mineralocorticoid receptor (MR) antagonists. Whether these two different treatment strategies are comparable in mitigating the detrimental effect of PA on outcomes is still debated. Objectives The primary aim of this systematic review is to identify, appraise and synthesise existing literature comparing clinical outcomes after treatment in patients with PA. Methods and analysis A systematic and comprehensive search will be performed using PubMed, Web of Science and EMBASE, for studies published unt...
Source: BMJ Open - July 30, 2023 Category: General Medicine Authors: Rocca, A., Gkaniatsa, E., Brunese, M. C., Hessman, E., Muth, A., Nwaru, B. I., Ragnarsson, O., Bobbio, E., Esposito, D. Tags: Open access, Diabetes and Endocrinology Source Type: research

Teen pregnancy involvement among African, Caribbean and Black adolescent boys and girls: a scoping review protocol
Introduction African, Caribbean and Black (ACB) adolescents are disproportionately affected by teen pregnancy in North America. Teen pregnancy poses risks to the quality of life of adolescent boys and girls, including physical, psychosocial and socioeconomic risks. Our review aims to explore this public health concern for ACB adolescents within North America. We aim to identify and analyse available evidence on the incidence and prevalence of, associated factors of and interventions to curtail teen pregnancy involvement (TPI) among ACB adolescent boys and girls in North America. This review will explore TPI, rather than te...
Source: BMJ Open - July 26, 2023 Category: General Medicine Authors: Ojukwu, E., Bawafaa, E., Afsah, S., Singh, S., Grewal, H., Raja, Z., McKay, E. Tags: Open access, Sexual health Source Type: research

How and why educational interventions work to increase knowledge of delirium among healthcare professionals in nursing homes: a protocol for a realist review
Background Delirium is a neuropathological condition that impairs cognitive performance, attention and consciousness and can be potentially life-threatening. Nursing home residents are particularly vulnerable to developing delirium, but research thus far tends to focus on the acute hospital setting. Healthcare professionals (HCPs) working in nursing homes seem to be little aware of delirium. To improve healthcare for affected or at-risk individuals, increasing knowledge among HCPs is highly relevant. Using the realist review method helps to understand how and why an educational intervention for HCPs on delirium in nursing ...
Source: BMJ Open - July 26, 2023 Category: General Medicine Authors: Molitor, V., Busse, T. S., Giehl, C., Lauer, R., Otte, I. C., Vollmar, H. C., Thürmann, P., Holle, B., Palm, R. Tags: Open access, Medical education and training Source Type: research

'You feel like youve been duped: is the current system for health professionals declaring potential conflicts of interest in the UK fit for purpose? A mixed methods study
Conclusion Declarations of interest are important and conflicts of interest concern patients and professionals, particularly in regard to trust in decision-making. If declarations, as currently made, are intended to improve transparency, they do not achieve this, due to difficulties in locating and interpreting them. Unintended consequences may arise if transparency alone is assumed to provide management of conflicts. Increased trust resulting from transparency may be misplaced, given the evidence on the hazards associated with conflicts of interest. Clarity about the purposes of transparency is required. Future policies m...
Source: BMJ Open - July 26, 2023 Category: General Medicine Authors: McCartney, M., Metsis, K., MacDonald, R., Sullivan, F., Ozakinci, G., Boylan, A.-M. Tags: Open access, Health services research Source Type: research

Does adherence to antiretroviral therapy differ by place of residence in Nigeria? A systematic review and meta-analysis protocol
Introduction Retention in care is still a significant challenge in the HIV treatment cascade and varies extensively across regions, leading to poor adherence to antiretroviral therapy (ART). Several factors across different socioecological levels, such as health and community-level factors, inhibit ART adherence among people living with HIV (PLWH) in Nigeria. This review seeks to ask whether adherence to ART differs by place of residence in Nigeria. Method and analysis This systematic review and meta-analysis will follow the updated Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. We...
Source: BMJ Open - July 25, 2023 Category: General Medicine Authors: Badru, O. A., Bain, L. E., Adeagbo, O. A. Tags: Open access HIV/AIDS Source Type: research

Effects of virtual reality for psychological health of ICU patients: a study protocol for systematic review and meta-analysis
This study follows the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols guidelines. Electronic data search is carried out on PubMed, Web of Science, CINAHL, EBSCO, EMBASE, Cochrane Library, PsycINFO, China National Knowledge Infrastructure, Wan Fang, VIP and Chinese Biology Medicine Database. The inclusion criteria follow the PICO principle, wherein ICU patients who have been hospitalised for 24 hours or more are included. Studies using VR-based interventions to improve the psychological health of ICU patients, compared with waitlist controls or traditional therapy groups; outcome assessments con...
Source: BMJ Open - July 21, 2023 Category: General Medicine Authors: Zou, J., Chen, Q., Wang, J., Gu, M., Jiang, X., Mao, M. Tags: Open access, Mental health Source Type: research

Exploring physical and biological manifestations of burnout and post-traumatic stress disorder symptoms in healthcare workers: a scoping review protocol
Introduction The COVID-19 pandemic has strained the mental and physical well-being of healthcare workers (HCW). Increased work-related stress and limited resources have increased symptoms of anxiety, depression, insomnia and post-traumatic stress disorder (PTSD) in this population. Stress-related disorders have been strongly associated with long-term consequences, including cardiometabolic disorders, endocrine disorders and premature mortality. This scoping review aims to explore available literature on burnout, PTSD, and other mental health-associated symptoms in HCW to synthesise relationships with physiological and biol...
Source: BMJ Open - July 21, 2023 Category: General Medicine Authors: Kottler, J., Gingell, M. J., Khosla, S., Kordzikowski, M., Raszewski, R., Chestek, D., Maki, K. Tags: Open access, Mental health Source Type: research

Family role in paediatric safety incidents: a retrospective study protocol
This study was approved by Cardiff University Research Ethics Committee (SMREC 22/32). Findings will be submitted to a peer-reviewed journal, presented at international conferences and presented at stakeholder workshops.
Source: BMJ Open - July 21, 2023 Category: General Medicine Authors: Rees, P., Purchase, T., Ball, E., Beggs, J., Gabriel, F., Gwyn, S., Hellard, S., Jones, E., McFadzean, I. J., Paccagnella, D., Robb, P., Walsh, K., Carson-Stevens, A. Tags: Open access, Paediatrics Source Type: research

Assessment of redundancy, methodological and reporting quality, and potential discrepancies of results of systematic reviews of early mobilisation of critically ill adults: a meta-research protocol
Introduction Several systematic reviews (SRs) have been conducted to determine the effectiveness of early mobilisation in critically ill adults with heterogeneous methodology and results. Redundancy in conducting SRs, unclear justification when leading new SRs or updating, and discordant results of SRs on the same research question may generate research waste that makes it difficult for clinicians to keep up to date with the best available evidence. This meta-research aims to assess the redundancy, methodological and reporting quality, and potential reasons for discordance in the results reported by SRs conducted to determ...
Source: BMJ Open - July 20, 2023 Category: General Medicine Authors: Gutierrez-Arias, R., Pieper, D., Nydahl, P., Gonzalez-Seguel, F., Jalil, Y., Oliveros, M.-J., Torres-Castro, R., Seron, P. Tags: Open access, Rehabilitation medicine Source Type: research

Impact of armed conflict on health professionals education and training in Syria: a systematic review
Conclusion Conflict in Syria has politicised all aspects of MEHPT. Influenced by political control, the MEHPT system has been divided into two distinguished geopolitical contexts; government-controlled areas (GCAs) and non-GCAs (NGCAs), each having its characteristics and level of war impact. International and regional academic institutes collaboration and coordination efforts are needed to formulate educational platforms using innovative approaches (such as online/blended/store-and-forward/peer-training/online tutoring) to strengthen and build the capacity of the health workforce in conflict-affected areas.
Source: BMJ Open - July 20, 2023 Category: General Medicine Authors: Bdaiwi, Y., Sabouni, A., Patel, P., Ekzayez, A., Alchalati, S., Abdrabbuh, O., Abbara, A., Glogowska, M. Tags: Open access, Medical education and training Source Type: research

Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare
Conclusion The identified barriers and facilitators point to a complex interplay of many factors, highlighting the need for an international effort to increase awareness of PMH problems, reduce mental health stigma, and provide woman-centred, flexible care, delivered by well trained and culturally sensitive primary care, maternity, and psychiatric health professionals. PROSPERO registration number CRD42019142854.
Source: BMJ Open - July 20, 2023 Category: General Medicine Authors: Webb, R., Uddin, N., Constantinou, G., Ford, E., Easter, A., Shakespeare, J., Hann, A., Roberts, N., Alderdice, F., Sinesi, A., Coates, R., Hogg, S., Ayers, S., The MATRIx Study Team, Clark, Frame, Gilbody, McMullen, Rosan, Salmon, Thompson, Williams Tags: Open access, Mental health Source Type: research