Objectives To explore healthcare practitioner perspectives and experiences of using strength assessment and strength training within pulmonary rehabilitation, focusing on perceived utility, barriers and impact on service delivery and patient care. Design Qualitative study using semi-structured one-to-one interviews analysed through reflexive thematic analysis. Setting A pulmonary rehabilitation service in the South East of England, operating across three community sites. Participants 11 female healthcare practitioners (including physiotherapists, nurses, and associate practitioners) involved…
Objectives This study aimed to examine the relationship between maternal conflict and psychological symptoms (depression and anxiety) as well as maternal role satisfaction among pregnant women. It also explored the associations between demographic characteristics and maternal conflict and role satisfaction. Design A cross-sectional design was employed. The study was conducted among pregnant women attending healthcare centres affiliated with Babol University of Medical Sciences, Iran, during 2022–2023. Setting Babol, Iran, between March 2022 and February 2023. Participants Data were collected…
Background Intermediate-risk prostate cancer (PCa) is currently managed with radical whole-gland therapies, such as radical prostatectomy (RP) or radiotherapy (RT). While effective, these treatments can significantly impact quality of life (QoL), particularly in relation to urinary incontinence and erectile dysfunction. Focal therapy poses a promising alternative for whole-gland treatment in this specific patient population; however, current evidence has primarily been limited to phase I and II studies. Robust prospective evidence is needed to determine whether focal therapy can be considered…
Introduction Rigid thoracoscopy is an established diagnostic instrument for pleural diseases; however, it is limited by challenges related to manoeuvrability, patient comfort and operator learning curve. A novel dual-function semi-rigid thoracoscope with associated semi-rigid forceps has been engineered to integrate the diagnostic efficacy of rigid biopsy forceps with the ergonomic advantages of a semi-rigid system. The Dual-functIon Semi-rigid thoraCoscOpy Versus rigid thoracoscopy for the diagnosis of plEuRal disease trial was designed to evaluate whether this device achieves a diagnostic…
Introduction Congenital melanocytic nevi (CMN) are congenital malformations that cannot be detected by prenatal ultrasounds and may have a significant physical and psychological impact on affected individuals, particularly when they are large. Congenital anomalies are known to impair parental quality of life, which may in turn affect the child’s well-being and development. However, little is known about the feelings and lived experience of parents on the birth of a CMN-affected child. The aim of this study is to describe the lived experience of parents of a child with a large or giant CMN, and…
Objectives To quantify Scope 1 and Scope 2 greenhouse gas (GHG) emissions associated with surgical care and identify key modifiable drivers at the institutional level, including operative duration and operating room (OR) type. Design Retrospective cohort study. Setting A tertiary university hospital with 17 ORs in Japan. Participants All 6996 elective surgeries were performed under general anaesthesia between 1 January and 31 December 2022. Primary and secondary outcome measures The primary outcome was per-case total Scope 1 and Scope 2 carbon dioxide equivalent emissions (CO 2 e) emissions…
Objectives The objectives were to evaluate if a novel self-triaging and self-scheduling emergency department (ED) service, the Minor Ailment Patient Pathway (MAPP), can safely reduce ED wait times for low-acuity patients presenting with either cold and influenza or musculoskeletal ailments. Design Prospective cohort study including all consecutive ED patients from 1 June 2023 to 31 March 2024. Outcomes for MAPP patients were compared with contemporaneous, matched ED patients who followed the usual care (UC) ED intake and evaluation process. Setting Single acute care hospital, Royal Victoria…
Objectives To characterise current practices in adolescent sexual and reproductive health (SRH) assessment during routine clinical encounters in a tertiary care setting and to triangulate these findings with young adults’ experiences of adolescent healthcare, identifying gaps between recommended assessment approaches and real-world clinical practice. Design Qualitative study using semistructured in-depth interviews (IDIs) and group discussions with clinicians, followed by a sequential triangulation phase involving IDIs with young adults. Data were analysed using Braun and Clarke’s reflexive…
Introduction Stimulant use disorder is a growing contributor to drug poisoning and mortality in the USA, with disproportionate impact on black communities driven by stimulant-opioid polysubstance use and other structural barriers to treatment. Contingency management (CM) is the most effective evidence-based treatment for stimulant use disorder but remains poorly implemented especially in minoritised communities. Cultural adaptation represents a promising implementation strategy to improve acceptability, engagement and equity of CM while maintaining fidelity to core evidence-based programming…
Background The Tesamorelin as an Adjunct to Exercise for Improving Physical Function in HIV (TRIUMPH) study is a randomised controlled trial with the overall goal of examining the combined effect of exercise and the growth hormone-releasing hormone analogue tesamorelin on physical function. Methods TRIUMPH is a two-site, double-blind, randomised trial of 100 sedentary older adults (aged 50–80 years) living with HIV who are frail or at risk for frailty and have excess abdominal adiposity. Enrolled participants will be randomised to receive tesamorelin or placebo as an adjunct to a home-based…
Objectives To assess factors associated with chronic kidney disease (CKD) awareness and preventive self-care among people living with diabetes at a national tertiary hospital in Tanzania. Design Hospital-based cross-sectional analytical study. Setting The study was conducted at the diabetic clinic of Muhimbili National Hospital in Tanzania. Participants A total of 271 patients attending the diabetic clinic were enrolled. Primary outcome measures Primary outcomes were awareness and preventive self-care regarding CKD among patients. Median scores were used to categorise awareness as either…
Background Traditional approaches to designing decision aids have focused on providing completeness of information and quantitative detail. An alternative approach based on psychological research emphasises understanding the essence or ‘gist’ of the decision. Few gist-based decision aids exist. The objective of this study was to develop novel gist-based decision aids for prostate and breast cancer screening and evaluate their acceptability. Methods Men aged 40–60 years and women aged 40–49 years eligible for prostate or breast cancer screening were recruited from ResearchMatch (National…
Introduction Advances in ultrasensitive assay techniques have enabled precise quantification of serum neurofilament light chain (sNfL) and serum glial fibrillary acidic protein (sGFAP), highlighting their potential as dynamic biomarkers for detecting neuroaxonal injury, disease activity and progression in multiple sclerosis (MS). In the NeuroFilMS study, sNfL is being investigated prospectively as a prognostic biomarker for clinical and radiological disease activity in relapsing MS, while sGFAP is retrospectively explored as a marker of disease progression. The aim is to assess whether…
Objective This scoping review aims to identify and map the characteristics of participatory research approaches in mental healthcare services conducted in low-income and middle-income countries (LMICs). Design This review followed a scoping review methodology developed by Joanna Briggs Institute (JBI). This review searched various databases and screened studies that met inclusion criteria. Data sources Published and unpublished studies were searched for in MEDLINE (PubMed), Embase (Ovid), PsycINFO (EBSCOhost), CINAHL (EBSCOhost) and Google Scholar (first 10 pages), as well as grey literature…
Introduction Spinal cord injury (SCI) frequently results in severe neurological impairment due to neural tissue destruction and scarring, representing a substantial and increasing global health burden. Current standard treatments primarily focus on preventing secondary complications but offer limited efficacy in repairing neural circuits or reversing neurological deficits. Stem cell transplantation, particularly using induced pluripotent stem cell (iPSC)-derived therapies, presents a regenerative strategy that avoids the ethical constraints associated with embryonic stem cells while providing…
Objectives To explore perspectives, preferences and decision-making regarding mode of delivery after a previous caesarean section among women in urban Tanzania. Design A descriptive qualitative study using semi-structured in-depth interviews. Data were analysed using thematic analysis. Setting A private tertiary hospital in Dar es Salaam, Tanzania. Participants 11 women with one previous caesarean section who delivered at the study site were interviewed on the third day after delivery. Participants were purposively sampled to include both modes of delivery: five women underwent repeat…
Objectives To assess the perceived burden and quality of life (QoL) of family caregivers (FCs) of chronically ill older adults in Abha, Saudi Arabia; explore the relationship between burden and QoL; and identify key sociodemographic, clinical and caregiving-related predictors of both outcomes. Design A cross-sectional study. Setting Primary healthcare centres in Abha city, the capital of the Asir region in southwestern Saudi Arabia. Participants A total of 400 FCs of community-dwelling older adults with chronic diseases, selected using a multistage probability sampling technique. Data were…
This randomized clinical trial assesses whether 10 sessions of once-daily intermittent theta-burst stimulation improve depressive symptoms more than sham among adults with major depressive disorder.
This cohort study evaluates the outcomes of germline pathogenic variants associated with increased breast cancer risk in the prognosis of women with primary invasive lobular carcinoma.
This randomized clinical trial assesses whether targeted intraoperative hygiene measures could reduce surgical site contamination with Cutibacterium acnes in male patients undergoing cardiac surgery.
This economic evaluation evaluates 4 low-dose computed tomographic (LDCT) screening strategies to identify the minimum risk model performance required for targeted lung cancer screening for individuals in Singapore who have never smoked.
This cross-sectional study uses data from the 2023-2024 Behavioral Risk Factor Surveillance System to examine the association between prior childhood sexual abuse and adult loneliness in the US population and whether this association varies by sex, race and ethnicity, and age group.