| 1. |
- Andersson, Claes, et al.
(författare)
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Effects of COVID-19 contagion in cohabitants and family members on mental health and academic self-efficacy among university students in Sweden : a prospective longitudinal study
- 2024
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 14:3
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Tidskriftsartikel (refereegranskat)abstract
- Objective This study used causal inference to estimate the longitudinal effects of contagion in cohabitants and family members on university students’ mental health and academic self-efficacy during the COVID-19 pandemic. Design A prospective longitudinal study including a baseline online measurement in May 2020, and online follow-ups after 5 months and 10 months. Participants were recruited through open-access online advertising. Setting Public universities and university colleges in Sweden. Participants The analytical sample included 2796 students. Outcome measures Contagion in cohabitants and in family members was assessed at baseline and at the 5-month follow-up. Mental health and academic self-efficacy were assessed at the 5-month and 10-month follow-ups. Results Mild symptoms reported in cohabitants at baseline resulted in negative mental health effects at follow-up 5 months later, and mild baseline symptoms in family members resulted in negative effects on academic self-efficacy at follow-ups both 5 and 10 months later. Conclusions Notwithstanding the lack of precision in estimated effects, the findings emphasise the importance of social relationships and the challenges of providing students with sufficient support in times of crisis.
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| 2. |
- Attauabi, Mohamed, et al.
(författare)
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Influence of Genetics, Immunity and the Microbiome on the Prognosis of Inflammatory Bowel Disease (IBD Prognosis Study) : the protocol for a Copenhagen IBD Inception Cohort Study
- 2022
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:6, s. e055779-e055779
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Inflammatory bowel diseases (IBD), encompassing Crohn's disease and ulcerative colitis, are chronic, inflammatory diseases of the gastrointestinal tract. We have initiated a Danish population-based inception cohort study aiming to investigate the underlying mechanisms for the heterogeneous course of IBD, including need for, and response to, treatment.Methods and analysis: IBD Prognosis Study is a prospective, population-based inception cohort study of unselected, newly diagnosed adult, adolescent and paediatric patients with IBD within the uptake area of Hvidovre University Hospital and Herlev University Hospital, Denmark, which covers approximately 1 050 000 inhabitants (~20% of the Danish population). The diagnosis of IBD will be according to the Porto diagnostic criteria in paediatric and adolescent patients or the Copenhagen diagnostic criteria in adult patients. All patients will be followed prospectively with regular clinical examinations including ileocolonoscopies, MRI of the small intestine, validated patient-reported measures and objective examinations with intestinal ultrasound. In addition, intestinal biopsies from ileocolonoscopies, stool, rectal swabs, saliva samples, swabs of the oral cavity and blood samples will be collected systematically for the analysis of biomarkers, microbiome and genetic profiles. Environmental factors and quality of life will be assessed using questionnaires and, when available, automatic registration of purchase data. The occurrence and course of extraintestinal manifestations will be evaluated by rheumatologists, dermatologists and dentists, and assessed by MR cholangiopancreatography, MR of the spine and sacroiliac joints, ultrasonography of peripheral joints and entheses, clinical oral examination, as well as panoramic radiograph of the jaws. Fibroscans and dual-energy X-ray absorptiometry scans will be performed to monitor occurrence and course of chronic liver diseases, osteopenia and osteoporosis.Ethics and dissemination: This study has been approved by Ethics Committee of the Capital Region of Denmark (approval number: H-20065831). Study results will be disseminated through publication in international scientific journals and presentation at (inter)national conferences.
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| 3. |
- Deprez, Julie, 1996-, et al.
(författare)
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What are the prognostic factors for the development of incontinence-associated dermatitis (IAD) : a protocol for a systematic review and meta-analysis
- 2023
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:7
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Incontinence-associated dermatitis (IAD) is irritant contact dermatitis and skin damage associated with prolonged skin contact with urine and/or faeces. Identifying prognostic factors for the development of IAD may improve management, facilitate prevention and inform future research. Methods and analysis This protocol follows the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Prospective and retrospective observational studies or clinical trials in which prognostic factors associated with the development of IAD are described are eligible. There are no restrictions on study setting, time, language, participant characteristics or geographical regions. Reviews, editorials, commentaries, methodological articles, letters to the editor, cross-sectional and case-control studies, and case reports are excluded. MEDLINE, CINAHL, EMBASE and The Cochrane Library will be searched from inception until May 2023. Two independent reviewers will independently evaluate studies. The Quality in Prognostic Studies tool will be used to assess the risk of bias, and the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies-Prognostic Factors checklist will be used for data extraction of the included studies. Separate analyses will be conducted for each identified prognostic factor, with adjusted and unadjusted estimated measures analysed separately. Evidence will be summarised with a meta-analysis when possible, and narratively otherwise. The Q and I 2 statistics will be calculated in order to quantify heterogeneity. The quality of the evidence obtained will be evaluated according to the Grades of Recommendation Assessment, Development and Evaluation guidance. Ethics and dissemination No ethical approval is needed since all data is already publicly accessible. The results of this work will be published in a peer-reviewed scientific journal.
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| 4. |
- Feldman, Inna, Docent, 1951-, et al.
(författare)
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Cost-effectiveness of a high-intensity versus a low-intensity smoking cessation intervention in a dental setting : long-term follow-up
- 2019
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Ingår i: BMJ Open. - : BMJ PUBLISHING GROUP. - 2044-6055. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to conduct a cost-effectiveness analysis (CEA) of a high-intensity and a low-intensity smoking cessation treatment programme (HIT and LIT) using long-term follow-up effectiveness data and to validate the cost-effectiveness results based on short-term follow-up.Design and outcome measures: Intervention effectiveness was estimated in a randomised controlled trial as numbers of abstinent participants after 1 and 5-8 years of follow-up. The economic evaluation was performed from a societal perspective using a Markov model by estimating future disease-related costs (in Euro (Euro) 2018) and health effects (in quality-adjusted life-years (QALYs)). Programmes were explicitly compared in an incremental analysis, and the results were presented as an incremental cost-effectiveness ratio.Setting: The study was conducted in dental clinics in Sweden.Participants: 294 smokers aged 19-71 years were included in the study.Interventions: Behaviour therapy, coaching and pharmacological advice (HIT) was compared with one counselling session introducing a conventional self-help programme (LIT).Results: The more costly HIT led to higher number of 6-month continuous abstinent participants after 1 year and higher number of sustained abstinent participants after 5-8 years, which translates into larger societal costs avoided and health gains than LIT. The incremental cost/QALY of HIT compared with LIT amounted to Euro918 and Euro3786 using short-term and long-term effectiveness, respectively, which is considered very cost-effective in Sweden.Conclusion: CEA favours the more costly HIT if decision makers are willing to spend at least Euro4000/QALY for tobacco cessation treatment.
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| 5. |
- Gustavsson, Kristoffer, et al.
(författare)
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Healthcare professionals' experiences of job satisfaction when providing person-centred care: a systematic review of qualitative studies
- 2023
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Ingår i: Bmj Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:6
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThis qualitative systematic review aimed to explore and synthesise healthcare professionals' (HCPs) experiences of job satisfaction when providing person-centred care (PCC) in healthcare settings in Europe.MethodThis systematic review of qualitative studies was followed by a thematic synthesis applying an inductive approach. Studies concerning HCPs and different levels of healthcare in Europe were eligible for inclusion. The CINAHL, PubMed and Scopus databases were searched. Study titles, abstracts and full texts were screened for relevance. Included studies were assessed for methodological quality using a quality appraisal checklist. Data were extracted and synthesised via thematic synthesis, generating analytical themes.ResultsSeventeen studies were included in the final thematic synthesis, and eight analytical themes were derived. Most studies were conducted in Sweden and the UK and were performed in hospitals, nursing homes, elderly care and primary care. Thirteen of these studies were qualitative and four used a mixed-method design in which the qualitative part was used for analysis. HCPs experienced challenges adapting to a new remoulded professional role and felt torn and inadequate due to ambiguities between organisational structures, task-oriented care and PCC. Improved job satisfaction was experienced when providing PCC in line with ethical expectations, patients and colleagues expressed appreciation and team collaboration improved, while learning new skills generated motivation.ConclusionThis systematic review found varied experiences among HCPs. Notably, the new professional role was experienced to entail disorientation and uncertainty; importantly, it also entailed experiences of job satisfaction such as meaningfulness, an improved relationship between HCPs and patients, appreciation and collaboration. To facilitate PCC implementation, healthcare organisations should focus on supporting HCPs through collaborational structures, and resources such as time, space and staffing.PROSPERO registration numberCRD42022304732.
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| 6. |
- Hofman, Hannelore, et al.
(författare)
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Patients’ experiences with the application of medical adhesives to the skin : a qualitative systematic review protocol
- 2023
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:6
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Forskningsöversikt (refereegranskat)abstract
- Introduction: Medical adhesives are adhesives used in medical devices to establish and maintain contact with the body over a period of time (usually by application to the skin) and are widely used in most care settings. Application of medical adhesives to the skin can lead to skin stripping, mild or severe allergic reactions and skin irritation that may manifest as redness, itching or rash. Adhesive-related skin injury can lead to infection, delayed wound healing and an increased risk of scarring. These injuries can cause severe discomfort and pain, and can affect the patient’s quality of life. A systematic review summarising patient’s experiences on this topic will contribute to informing adhesive producers and policy makers, and guiding further development and improvement of available technologies.Methods and analysis: This systematic review protocol is based on the principles of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guideline. A systematic search will be conducted in CINAHL, EMBASE, MEDLINE and PsycINFO. In addition, manual searches will be performed, reviewing the reference lists of relevant reviews and articles included for quality assessment. Qualitative studies using various methods will be considered for inclusion. Screening of title, abstract and full text will be done by two reviewers. The methodological quality of studies under consideration will be critically assessed by two reviewers using the Joanna Briggs Institute Critical Appraisal Tool for Qualitative Research. Data extraction will be performed independently by two reviewers using a predefined data extraction form. Meta-aggregation will be used to summarise the evidence.Ethics and dissemination No ethical approval or consentis required because no participants will be recruited.This systematic review protocol is published in an openaccess journal to increase transparency of the researchmethods used. Results will be disseminated at nationaland international conferences.
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| 7. |
- Ljungbeck, Birgitta, 1971-, et al.
(författare)
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Curricula and learning objectives in nurse practitioner programmes : a scoping review protocol
- 2019
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 9:7
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Globally, nurse practitioner (NP) has become an important nursing role in the pursuit of a more efficient healthcare, possessing the necessary expert skills to work as autonomous practitioners. Nevertheless, there are barriers in the implementation of this role. One barrier concerns the different levels of education required for NPs. Previous studies demonstrate the importance of acting for a uniform international education. The aim of the scoping review was to compile research about education to become an NP, focusing on the content of curricula and learning objectives.Methods and analysis: The six-stage methodological framework by Arksey and O'Malley will guide the scoping review through the following stages: identifying the research questions; identifying relevant studies; study selection; charting the data; collating, summarising and reporting the results; and consultation. The research questions are as follows: What is the content of curricula in NP programmes? What are the learning objectives in NP programmes? The literature searches will be conducted between March and June 2019 in the following databases: PubMed, CINAHL and ERIC, followed by hand searching reference lists of key studies. Grey literature will be searched in Google Scholar, Libsearch, existing networks and relevant organisations. Two researchers will screen titles and abstracts. Included full-text articles will be screened by three researchers and assessed for their methodological quality by the use of the Critical Appraisal Skills Programme. The PreferredReporting Items for Systematic Reviews and Meta-Analyses flow diagram will be used to demonstrate included and excluded articles. The findings will be presented through a numerical summary of the included articles, followed by a thematic analysis.Ethics and dissemination: Research ethics approval is not required for a scoping review. The scoping review will be submitted to a peer-reviewed journal. Additionally, the findings will be disseminated to stakeholders representing political, educational, professional and union organisations through a Delphi study as part of the consultation stage of the Arksey and O'Malleys framework.
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| 8. |
- Magnéli, Martin, et al.
(författare)
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Validation of adverse events after hip arthroplasty : a Swedish multi-centre cohort study.
- 2019
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Preventing adverse events (AEs) after orthopaedic surgery is a field with great room for improvement. A Swedish instrument for measuring AEs after hip arthroplasty based on administrative data from the national patient register is used by both the Swedish Hip Arthroplasty Register and the Swedish Association of Local Authorities and Regions. It has never been validated and its accuracy is unknown. The aim of this study was to validate the instrument's ability to detect AEs, and to calculate the incidence of AEs following primary hip arthroplasties.DESIGN: Retrospective cohort study using retrospective record review with Global Trigger Tool methodology in combination with register data.SETTING: 24 different hospitals in four major regions of Sweden.PARTICIPANTS: 2000 patients with either total or hemi-hip arthroplasty were recruited from the SHAR. We included both acute and elective patients.PRIMARY AND SECONDARY OUTCOME MEASURES: The sensitivity and specificity of the instrument. Adjusted cumulative incidence and incidence rate.RESULTS: The sensitivity for all identified AEs was 5.7% (95% CI: 4.9% to 6.7%) for 30 days and 14.8% (95% CI: 8.2 to 24.3) for 90 days, and the specificity was 95.2% (95% CI: 93.5% to 96.6%) for 30 days and 92.1% (95% CI: 89.9% to 93.8%) for 90 days. The adjusted cumulative incidence for all AEs was 28.4% (95% CI: 25.0% to 32.3%) for 30 days and 29.5% (95% CI: 26.0% to 33.8%) for 90 days. The incidence rate was 0.43 AEs per person-month (95% CI: 0.39 to 0.47).CONCLUSIONS: The AE incidence was high, and most AEs occurred within the first 30 days. The instrument sensitivity for AEs was very low for both 30 and 90 days, but the specificity was high for both 30 and 90 days. The studied instrument is insufficient for valid measurements of AEs after hip arthroplasty.
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| 9. |
- Neziraj, Merita, et al.
(författare)
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The STAIR OF KNOWLEDGE-a codesigned intervention to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes in Sweden : development of a complex intervention
- 2023
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To describe the development of a codesigned complex intervention intended to prevent the risks of pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes.DESIGN: : Nursing homes in the municipality in southern Sweden.PARTICIPANTS: End users (n=16) in nursing homes (n=4) codesigned the intervention together with the research group in workshops (n=4) in March-April 2022. Additionally, stakeholders (n=17) who were considered to play an important role in developing the intervention participated throughout this process. Data were analysed using reflexive thematic analysis.RESULTS: Four workshops were conducted with end users (n=16) and 13 meetings with stakeholders (n=12) were held during the development process. The intervention aims to bridge the evidence-practice gap regarding the preventive care process of the risks of pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. The intervention is aimed at end users, lasts for 3 weeks and is divided into two parts. First, end users obtain knowledge on their own by following written instructions. Second, they meet, interact and discuss the knowledge acquired during part 1.CONCLUSION: The intervention is robustly developed and thoroughly described. The study highlights the extensive process that is necessary for developing tailored complex interventions. The description of the entire development process may enhance the replicability of this intervention. The intervention needs to be tested and evaluated in an upcoming feasibility study.TRIAL REGISTRATION NUMBER: NCT05308862.
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| 10. |
- Nwaru, Bright I, 1978, et al.
(författare)
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Cohort profile: the West Sweden Asthma Study (WSAS): a multidisciplinary population-based longitudinal study of asthma, allergy and respiratory conditions in adults
- 2019
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 9:6
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Tidskriftsartikel (refereegranskat)abstract
- The West Sweden Asthma Study (WSAS) is a population-representative longitudinal study established to: (1) generate data on prevalence trends, incidence and remission of asthma, allergy and respiratory conditions, (2) elucidate on the risk and prognostic factors associated with these diseases, (3) characterise clinically relevant phenotypes of these diseases and (4) catalyse relevant mechanistic, genomic, genetic and translational investigations.WSAS comprised of randomly selected individuals aged 16 to 75 years who are followed up longitudinally. The first stage involved a questionnaire survey (>42000 participants) and was undertaken in 2008 and 2016. A random sample (about 8000) of participants in the initial survey undergoes extensive clinical investigations every 8 to 10 years (first investigations in 2009 to 2012, second wave currently ongoing). Measurements undertaken at the clinical investigations involve structured interviews, self-completed questionnaire on personality traits, physical measurements and extensive biological samples.Some of our key findings have shown a 54% increase in the use of asthma medications between the 1990s and 2000s, primarily driven by a five-fold increase in the use of inhaled corticosteroids. About 36% of asthmatics expressed at least one sign of severe asthma indicator, with differential lung performance, inflammation and allergic sensitisation among asthmatics with different signs of severe asthma. Multi-symptom asthmatics were at greater risk of having indicators of severe asthma. In all adults, being raised on a farm was associated with a decreased risk of allergic sensitisation, rhinitis and eczema, but not asthma. However, among adolescents (ie, those 16 to 20 years of age), being raised on a farm decreased the risk of asthma. Personality traits were associated with both beliefs of asthma medication and adherence to treatment.Follow-up of the cohort is being undertaken every 8 to 10 years. The repeated clinical examinations will take place in 2019 to 2022. The cohort data are currently being linked to routine Swedish healthcare registers for a continuous follow-up. Mechanistic, genomic, genetic and translational investigations are ongoing.
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