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  • 1
    Online Resource
    Online Resource
    Parental detection of neonatal jaundice using a low-cost colour card: a multicentre prospective study
    BMJ ; 2023
    In:  BMJ Paediatrics Open Vol. 7, No. 1 ( 2023-06), p. e001924-
    Details
    In: BMJ Paediatrics Open, BMJ, Vol. 7, No. 1 ( 2023-06), p. e001924-
    Abstract: Since most infants are usually discharged before age 48–72 hours, peak bilirubin levels will almost always occur after discharge. Parents may be the first to observe the onset of jaundice after discharge, but visual assessment is unreliable. The jaundice colour card (JCard) is a low-cost icterometer designed for the assessment of neonatal jaundice. The objective of this study was to evaluate parental use of JCard to detect jaundice in neonates. Methods We conducted a multicentre, prospective, observational cohort study in nine sites across China. A total of 1161 newborns ≥35 weeks of gestation were enrolled in the study. Measurements of total serum bilirubin (TSB) levels were based on clinical indications. The JCard measurements by parents and paediatricians were compared with the TSB. Results JCard values of parents and paediatricians were correlated with TSB (r=0.754 and 0.788, respectively). The parents’ and paediatricians’ JCard values 9 had sensitivities of 95.2% vs 97.6% and specificities of 84.5% vs 71.7% for identifying neonates with TSB ≥153.9 µmol/L. The parents’ and paediatricians’ JCard values 15 had sensitivities of 79.9% vs 89.0% and specificities of 66.7% vs 64.9% for identifying neonates with TSB ≥256.5 µmol/L. Areas under the receiver operating characteristic curves of parents for identifying TSB ≥119.7, ≥153.9, ≥205.2, and ≥256.5 µmol/L were 0.967, 0.960, 0.915, and 0.813, respectively, and those of paediatricians were 0.966, 0.961, 0.926 and 0.840, respectively. The intraclass correlation coefficient was 0.933 between parents and paediatricians. Conclusion The JCard can be used to classify different levels of bilirubin, but it is less accurate with high bilirubin levels. The JCard diagnostic performance of parents was slightly lower than that of paediatricians.
    Type of Medium: Online Resource
    ISSN: 2399-9772
    URL: Article
    DOI: 10.1136/bmjpo-2023-001924
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2895377-0
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  • 2
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    Online Resource
    Indwelling experience and coping strategies of upper arm infusion ports in patients with cancer: a qualitative study
    BMJ ; 2023
    In:  BMJ Open Vol. 13, No. 3 ( 2023-03), p. e069772-
    Details
    In: BMJ Open, BMJ, Vol. 13, No. 3 ( 2023-03), p. e069772-
    Abstract: The upper arm infusion ports have been proven to be advanced and safe, but the experience from the perspective of patients is lacking. This study explored the indwelling experience and coping strategies of upper arm infusion ports in patients with cancer. Design Qualitative exploratory study. Setting This study was conducted between May 2021 and August 2021 at a level III-A general hospital in Shanghai, China. Participants The participants, who are patients with cancer implanted with the upper arm infusion ports, included 10 women and 6 men, and the average age was 54.4±8.3 years old. Methods Data were selected from semistructured in-depth interviews and analysed by thematic analysis. Results There were 10 descriptive topics and 4 analytical topics in 2 parts. The indwelling experience includes positive experience (treatment benefit, life convenience) and negative experience (physical discomfort, social anxiety, psychological distress). Coping strategies include emotional-focused strategies (self-acceptance, avoidance and self-protection) and problem-focused strategies (information seeking, functional exercise and remove as soon as possible). Conclusion The infusion port in the upper arm is beneficial to the safety and quality of life of patients with cancer. At the same time, there are challenges in physical, psychological and social adaptation. Patients respond with some measures, but obstacles may arise during implementation.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2022-069772
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2599832-8
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  • 3
    Online Resource
    Online Resource
    Resilience of human gut microbial communities for the long stay with multiple dietary shifts
    BMJ ; 2019
    In:  Gut Vol. 68, No. 12 ( 2019-12), p. 2254-2255
    Details
    In: Gut, BMJ, Vol. 68, No. 12 ( 2019-12), p. 2254-2255
    Type of Medium: Online Resource
    ISSN: 0017-5749 , 1468-3288
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.1136/gutjnl-2018-317298
    DOI: 10.1136/gutjnl-2018-317298.supp1
    DOI: 10.1136/gutjnl-2018-317298.supp2
    DOI: 10.1136/gutjnl-2018-317298.supp3
    DOI: 10.1136/gutjnl-2018-317298.supp4
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 1492637-4
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  • 4
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    Online Resource
    Time to recurrence after first-ever ischaemic stroke within 3 years and its risk factors in Chinese population: a prospective cohort study
    BMJ ; 2019
    In:  BMJ Open Vol. 9, No. 12 ( 2019-12), p. e032087-
    Details
    In: BMJ Open, BMJ, Vol. 9, No. 12 ( 2019-12), p. e032087-
    Abstract: This study aimed to estimate the time of recurrent ischaemic stroke events among the first 3 years of follow-up after hospitalisation discharge. Study design A prospective cohort study. Setting The research was conducted in the Department of Neurology at a tertiary hospital, Chengdu of China, from January 2010 to June 2016. Outcome measures We estimated the restricted mean survival time (RMST) of ischaemic stroke recurrence for the first 3 years after discharge. Basic sociodemographic characteristics and major potential risk factors for recurrence were collected using a semistructured questionnaire. Regression analysis of RMST was used to identify risk factors of recurrent stroke. Participants Patients hospitalised with first-ever ischaemic stroke were eligible for this study. Patients with severe cognitive impairment were excluded. Results We included 641 surviving patients who were followed up for 3 years. Stroke recurrence occurred in 115 patients, including 16 patients who died of stroke recurrence. The cumulative risk of stroke recurrence rate was 11.51% (9.20%–14.35%) at 1 year, 16.76% (13.96%–20.05%) at 2 years and 20.07% (17.00%–23.61%) at 3 years. Modified Rankin Scale (mRS) score ≥3 thus resulted in the recurrence time loss, which was 0.22 months (p=0.008) at 6 months, 0.61 months (p=0.004) at 1 year, 1.49 months (p=0.007) at 2 years and 2.46 months (p=0.008) at 3 years. It is similar with the effects of drug adherence after stroke. The recurrence time of patients ≥75 years at 3 years was 2.02 months (p=0.220) less than that of those aged 〈 55 years. Conclusion In China, the time of first recurrence varies among different patients with ischaemic stroke. The mRS and the level of drug adherence after stroke are important risk factors of stroke recurrence.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2019-032087
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2599832-8
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  • 5
    Online Resource
    Online Resource
    Clustering of malignant pleural mesothelioma in asbestos factories: a subgroup analysis in a 29-year follow-up study to identify high-risk industries in Taiwan
    BMJ ; 2018
    In:  BMJ Open Vol. 8, No. 12 ( 2018-12), p. e021063-
    Details
    In: BMJ Open, BMJ, Vol. 8, No. 12 ( 2018-12), p. e021063-
    Abstract: Exposure to asbestos is the major cause for malignant pleural mesothelioma (MPM), but the causal link of individual cases is difficult to establish for lack of exposure information and long disease latency. Methods We established a retrospective cohort of workers employed in asbestos industries during the period of 1950–1989 and the occurrence of MPM during the period of 1980–2009 was examined with the Taiwan Cancer Registry. Estimated rate ratios (eRRs) were computed for each factory where any case of MPM was diagnosed by assuming Poisson distribution with a minimal latency of 20 years. Results A total of 18 MPM (17 males, 1 female) in eight factories were found. The incidence rate of MPM for the eight factories was 18.0 per million, ranging from 6.2 per million (military factory) to 268.2 per million (asbestos cement). We observed significantly increased risks for MPM in asbestos cement, thermal insulation and shipbuilding industries, with eRR (genders combined) of 113.6, 87.5 and 15.8, respectively. The sensitivity analyses considering latency showed similar findings in latency ≥ 30 years, and the shipbuilding industry presented a significant eRR given a latency ≥ 40 years. The gender-specific eRR showed similar results in men, but high eRR of 729.6 was observed in an asbestos cement factory where a female MPM was diagnosed. Conclusions This nationwide study in Taiwan comprehensively shows that different asbestos manufacturing processes, including asbestos cement, thermal insulation and shipbuilding industries, were at significantly increased risks for MPM. We recommend to establish a medical screening programme for workers previously exposed to asbestos to identify MPM and other asbestos-related diseases at an earlier stage.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2017-021063
    DOI: 10.1136/bmjopen-2017-021063.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2018
    detail.hit.zdb_id: 2599832-8
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  • 6
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    Online Resource
    Efficacy of TTFields in high-grade gliomas: a protocol for systematic review and meta-analysis
    BMJ ; 2023
    In:  BMJ Open Vol. 13, No. 9 ( 2023-09), p. e073753-
    Details
    In: BMJ Open, BMJ, Vol. 13, No. 9 ( 2023-09), p. e073753-
    Abstract: Despite their recent FDA(Food and Drug Administration) approval, tumour treatment fields (TTFields) have not seen acceptance as part of standard of care (SOC) for the treatment of high-grade gliomas (HGGs). Few studies have reported the clinical effect of simultaneous or sequential use of TTFields with the current SOC. However, whether TTFields are beneficial over the standard treatment remains to be established with a meta-analysis. Therefore, we here performed a systematic review and meta-analysis to understand the benefit of TTFields for patients with HGGs. Methods and analysis We registered this systematic review with the PROSPERO network (registration number: CRD42023398972) and aimed to follow the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines in the study. All articles related to TTFields in glioma will be systematically searched for in the following databases since their inception until November 2023: the China National Knowledge Infrastructure, Embase, Cochrane Library, Wanfang Database, China Science Journal Database, China Biomedical Documentation Database, VIP database, Web of Science and PubMed. Article screening and data extraction will be done independently by the authors and cross-checked by two of the authors on completion. The Cochrane risk of bias assessment tool will be used for quality assessment of the included studies. Review Manager V.5.3 (Cochrane Collaboration) will be used to perform the meta-analysis. Ethics and dissemination Ethical approval is not required because the data used will be obtained from published studies, and there will be no concerns about privacy. The results of this study will be published in a peer-reviewed journal. PROSPERO registration number CRD42023398972.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2023-073753
    DOI: 10.1136/bmjopen-2023-073753.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2599832-8
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  • 7
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    Online Resource
    Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis
    BMJ ; 2019
    In:  Occupational and Environmental Medicine Vol. 76, No. 12 ( 2019-12), p. 927-937
    Details
    In: Occupational and Environmental Medicine, BMJ, Vol. 76, No. 12 ( 2019-12), p. 927-937
    Abstract: We aim to quantitatively synthesise available epidemiological evidence on the prevalence rates of workplace violence (WPV) by patients and visitors against healthcare workers. We systematically searched PubMed, Embase and Web of Science from their inception to October 2018, as well as the reference lists of all included studies. Two authors independently assessed studies for inclusion. Data were double-extracted and discrepancies were resolved by discussion. The overall percentage of healthcare worker encounters resulting in the experience of WPV was estimated using random-effects meta-analysis. The heterogeneity was assessed using the I 2 statistic. Differences by study-level characteristics were estimated using subgroup analysis and meta-regression. We included 253 eligible studies (with a total of 331 544 participants). Of these participants, 61.9% (95% CI 56.1% to 67.6%) reported exposure to any form of WPV, 42.5% (95% CI 38.9% to 46.0%) reported exposure to non-physical violence, and 24.4% (95% CI 22.4% to 26.4%) reported experiencing physical violence in the past year. Verbal abuse (57.6%; 95% CI 51.8% to 63.4%) was the most common form of non-physical violence, followed by threats (33.2%; 95% CI 27.5% to 38.9%) and sexual harassment (12.4%; 95% CI 10.6% to 14.2%). The proportion of WPV exposure differed greatly across countries, study location, practice settings, work schedules and occupation. In this systematic review, the prevalence of WPV against healthcare workers is high, especially in Asian and North American countries, psychiatric and emergency department settings, and among nurses and physicians. There is a need for governments, policymakers and health institutions to take actions to address WPV towards healthcare professionals globally.
    Type of Medium: Online Resource
    ISSN: 1351-0711 , 1470-7926
    URL: Article
    DOI: 10.1136/oemed-2019-105849
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2020276-3
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  • 8
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    Online Resource
    Incorporating future unrelated medical costs in cost-effectiveness analysis in China
    BMJ ; 2021
    In:  BMJ Global Health Vol. 6, No. 10 ( 2021-10), p. e006655-
    Details
    In: BMJ Global Health, BMJ, Vol. 6, No. 10 ( 2021-10), p. e006655-
    Abstract: The occurrence of future unrelated medical costs is a direct consequence of life-prolonging interventions, but most pharmacoeconomic guidelines recommend the exclusion of these costs. The Chinese guidelines were updated in 2020, taking an exclusion approach for the future unrelated medical cost. We notice the research surrounding this issue continues in other countries and leads to an inclusion recommendation in some guidelines. Meanwhile, this issue has not been discussed in China, reflecting an urgent need for extensive research on its impact. We reviewed the theoretical and practical studies surrounding the inclusion of future unrelated medical costs, summarised the landscape of guidelines in other jurisdictions. We found that the inclusion would increase the internal and external consistency of economic evaluation and the comparability of results between different jurisdictions. However, more research is needed surrounding this issue. We proposed a future research agenda to inform the update of Chinese guidelines. We recommend research on individual-level healthcare reimbursement data and end-of-life costs from hospital administrative data to generate the age-specific, sex-specific and condition-specific costs. We also recommend establishing a formal process to evaluate the ethical and economic impact of including future unrelated medical costs and adjust the threshold accordingly in the guidelines.
    Type of Medium: Online Resource
    ISSN: 2059-7908
    URL: Article
    DOI: 10.1136/bmjgh-2021-006655
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2851843-3
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  • 9
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    Online Resource
    Incorporating productivity loss in health economic evaluations: a review of guidelines and practices worldwide for research agenda in China
    BMJ ; 2022
    In:  BMJ Global Health Vol. 7, No. 8 ( 2022-08), p. e009777-
    Details
    In: BMJ Global Health, BMJ, Vol. 7, No. 8 ( 2022-08), p. e009777-
    Abstract: Productivity loss may contribute to a large proportion of costs of health conditions in an economic evaluation from a societal perspective, but there is currently a lack of methodological consensus on how productivity loss should be measured and valued. Despite the research progress surrounding this issue in other countries, it has been rarely discussed in China. Methods We reviewed the official guidelines on economic evaluations in different countries and regions and screened the literature to summarise the extent to which productivity loss was incorporated in economic evaluations and the underlying methodological challenges. Results A total of 48 guidelines from 46 countries/regions were included. Although 32 (67%) guidelines recommend excluding productivity loss in the base case analysis, 23 (48%) guidelines recommend including productivity loss in the base case or additional analyses. Through a review of systematic reviews and the economic evaluation studies included in these reviews, we found that the average probability of incorporating productivity loss in an economic evaluation was 10.2%. Among the economic evaluations (n=478) that explicitly considered productivity loss, most (n=455) considered losses from paid work, while only a few studies (n=23) considered unpaid work losses. Recognising the existing methodological challenges and the specific context of China, we proposed a practical research agenda and a disease list for progress on this topic, including the development of the disease list comprehensively consisting of health conditions where the productivity loss should be incorporated into economic evaluations. Conclusion An increasing number of guidelines recommend the inclusion of productivity loss in the base case or additional analyses of economic evaluation. We optimistically expect that more Chinese researchers notice the importance of incorporating productivity loss in economic evaluations and anticipate guidelines that may be suitable for Chinese practitioners and decision-makers that facilitate the advancement of research on productivity loss measurement and valuation.
    Type of Medium: Online Resource
    ISSN: 2059-7908
    URL: Article
    DOI: 10.1136/bmjgh-2022-009777
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2851843-3
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  • 10
    Online Resource
    Online Resource
    P.2.12 Clustering of malignant pleural mesothelioma in asbestos factories in a 29-years follow-up study to identify high-risk industries in taiwan
    BMJ ; 2019
    In:  Occupational and Environmental Medicine Vol. 76, No. Suppl 1 ( 2019-04), p. A90.2-A90
    Details
    In: Occupational and Environmental Medicine, BMJ, Vol. 76, No. Suppl 1 ( 2019-04), p. A90.2-A90
    Abstract: Exposure to asbestos is the major cause for malignant pleural mesothelioma (MPM) but the causal link of individual cases is difficult to establish for lack of exposure information and long disease latency. Methods We established a retrospective cohort of workers employed in asbestos industries during the period of 1950–1989 and the occurrence of MPM during the period of 1980–2009 was examined with the Taiwan Cancer Registry. Estimated rate ratios (eRR) were computed for each factory where any case of MPM was diagnosed by assuming Poisson distribution with a minimal latency of 20 years. Results A total of 18 MPM (17 males, 1 female) in 8 factories were found. The incidence rate of MPM for the 8 factories was 18.0 per million, ranging from 6.2 per million (military factory) to 268.2 per million (asbestos cement). We observed significantly increased risks for MPM in asbestos cement, thermal insulation and shipbuilding industries, with eRR (genders combined) of 113.6, 87.5, and 15.8 respectively. The sensitivity analyses considering latency showed similar findings in latency ≥30 years, and the shipbuilding industry presented a significant eRR given a latency ≥40 years. The gender-specific eRR showed similar results in men, but high eRR of 729.6 was observed in an asbestos cement factory where a female MPM was diagnosed. Conclusions This nationwide study in Taiwan comprehensively showed different asbestos manufacturing processes, including asbestos cement, thermal insulation, and shipbuilding industries, at significantly increased risks for MPM. We recommend to establish a medical screening program for workers previously exposed to asbestos to identify MPM and other asbestos-related diseases at an earlier stage.
    Type of Medium: Online Resource
    ISSN: 1351-0711 , 1470-7926
    URL: Article
    DOI: 10.1136/OEM-2019-EPI.246
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2020276-3
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