Top 10 palliative care research priorities in France: a 3-step, mixed-methods protocol (AXEPRO study)
As one means to avoid waste in research investment, involving patients as full partners in research has become increasingly frequent. There is clearly a low level of investment in palliative care research. Following the guidance from the James Lind Alliance and the UK public consultation ('Palliative and End of Life Care Research Priorities Project'), we developed a 3-step protocol aimed at prioritising 10 unanswered questions in palliative care (PC) research in France, from the viewpoint of patients, volunteers, healthcare professionals and family caregivers.
Effect of intermittent theta burst stimulation combined with acoustic startle priming motor training on upper limb motor function and neural plasticity in stroke individuals: study protocol for a randomised controlled proof-of-concept trial
Stroke is a major cause of acquired disability globally, yet the neural mechanisms driving motor recovery post-stroke remain elusive. Recent research has underscored the growing significance of subcortical pathways in neural plasticity and motor control. Among these, the cortico-reticulospinal tract (CRST) has gained attention in rehabilitation due to its unique ascending and descending structural features as well as its cellular properties which position it as an excellent candidate to compensate for inadequate motor control post-stroke. However, the optimal strategies to harness the CRST for motor recovery remain unknown. Non-invasive modulation of the CRST presents a promising though challenging, therapeutic opportunity. Acoustic startle priming (ASP) training and intermittent theta burst stimulation (iTBS) are emerging as potential methods to regulate CRST function. This study aims to investigate the feasibility of segmentally modulating the cortico-reticular and reticulospinal tracts through ASP and iTBS while evaluating the resulting therapeutic effects.
Effectiveness of midwife/nurse-led non-invasive uterine massage in preventing postpartum haemorrhage: a quantitative systematic review protocol
Postpartum haemorrhage (PPH) negatively impacts women's health. Preventing and managing PPH is important, and nurse-led interventions are needed. However, no systematic review has evaluated the effectiveness of non-invasive uterine massage for PPH prevention. Therefore, this systematic review aims to assess the efficacy of midwife/nurse-led intervention in managing PPH, serving as the best available evidence to develop further guidelines and recommendations in practice and policy-making.
Exploring how PRIME-Parkinson care is implemented and whether, how and why it produces change, for who and under what conditions: a protocol for an embedded process evaluation within the PRIME-UK randomised controlled trial
The PRIME-UK randomised controlled trial (RCT) aims to establish whether a model of care that seeks to be proactive, integrated and empower participants, caregivers and healthcare professionals can improve outcomes in people with parkinsonism. Given that this intervention is novel and complex, understanding whether and how the intervention will be acceptable, implementable, cost-effective and scalable across contexts are key questions beyond that of whether 'it works'. We describe an embedded process evaluation to answer these questions, which aims to support interpretation of the trial results, refinement of the intervention and support future scaling of the PRIME-Parkinson model of care.
Comparison of glycosylated fibronectin versus soluble fms-like tyrosine kinase/placental growth factor ratio testing for the assessment of pre-eclampsia: protocol for a multicentre diagnostic test accuracy study
Pre-eclampsia is a condition associated with significant maternal and neonatal morbidity and mortality. The prediction of pre-eclampsia in high-risk populations using angiogenic markers, such as serum placental growth factor (PlGF) assessment, has been shown to improve maternal outcomes and is recommended by the National Institute for Health and Care Excellence (NICE). However, such tests are not yet available at the point of care (POC). Glycosylated fibronectin (GlyFn) level for the prediction of pre-eclampsia development is available as a POC test (Lumella) and has the potential to aid rapid clinical decision making. This study aimed to test the hypothesis that the sensitivity of the GlyFn test is not inferior to that of the current gold standard of soluble fms-like tyrosine kinase (sFlt)/PlGF-based laboratory testing for pre-eclampsia.
Knowledge, attitudes, motivations and expectations regarding antimicrobial use among community members seeking care at the primary healthcare level: a scoping review protocol
Inappropriate antibiotic use in (primary healthcare, PHC) settings fuels antimicrobial resistance (AMR), threatens patient safety and burdens healthcare systems. Patients' knowledge, attitudes, motivations and expectations play a crucial role in antibiotic use behaviour, especially in low-income and middle-income countries including South Africa. There is a need to ensure measures of antibiotic use, interventions and future guidance reflect cultural, community and demographic issues associated with patient views to reduce inappropriate use of antibiotics and associated AMR. The objective of this scoping review is to identify key themes surrounding knowledge, attitudes, motivations and expectations among patients and community members regarding antimicrobial use in PHC settings especially in low-income and middle-income countries.
Deployment and uptake of COVID-19 vaccines for refugees and migrants in regular and irregular situations: a mixed-method multicountry study
The COVID-19 pandemic has widened inequities, affecting migrant and refugee populations in vulnerable situations, who may face elevated risks of infection, constrained healthcare access and discrimination. Inclusive vaccination campaigns are recommended, but barriers persist. This study aimed to identify barriers and facilitators and estimate vaccination coverage among refugees and migrants in low- and middle-income countries, emphasising inclusive policies for effective rollout.
Legal interventions for perinatal depression in India: a qualitative study with clinical specialists having expertise in perinatal mental health
To provide insights into the perspectives of clinical specialists (CSs) regarding the efficacy of existing legal interventions (health laws, policies, guidelines, etc) in addressing and managing perinatal depression (PND) in women in India, in the background of the existing policy gap.
Rationale and design of a multicentre randomised controlled trial on circulating tumour DNA-guided neoadjuvant treatment strategy for locally advanced rectal cancer (CINTS-R)
The traditional neoadjuvant chemoradiotherapy (nCRT) combined with total mesorectal excision has been widely accepted as the standard treatment for patients with locally advanced rectal cancer (LARC). New strategies such as total neoadjuvant therapy (TNT) and neoadjuvant immunotherapy have shown great promise in certain patient populations. Currently, there is an urgent need to stratify patients before treatment to adopt the appropriate neoadjuvant strategies. Our previous study has shown that circulating tumour DNA (ctDNA) effectively reflects tumour burden and genetic characteristics and has significant predictive value for tumour recurrence, demonstrating great potential in guiding the choice of neoadjuvant strategies.
Virtual reality-based fine motor skills training in paediatric rehabilitation: a protocol for a scoping review
Fine motor skill (FMS) development during childhood is essential to many learning processes, especially in school. FMS impairment can have a major impact on children's quality of life. Developing effective and engaging rehabilitation solutions to train FMS that engage children in the abundant practice required for motor learning can be challenging. Virtual reality (VR) is a promising intervention option offering engaging FMS training tasks and environments that align with evidence-based motor learning principles. Other potential advantages of VR for rehabilitation include accessibility for home-based use and adaptability to individual needs. The objective of this scoping review is to map the extent, range and nature of VR applications focused on FMS training in paediatric rehabilitation, including hardware, software and interventional parameters.
Protocol for an adaptive platform trial of intended service user-derived interventions to equitably reduce non-attendance in eye screening programmes in Botswana, India, Kenya and Nepal
Only 30%-50% of people referred to clinics during community-based eye screening are able to access care in Botswana, India, Kenya and Nepal. The access rate is even lower for certain population groups. This platform trial aims to test multiple, iterative, low-risk public health interventions and simple service modifications with a series of individual randomised controlled trials (RCT) conducted in each country, with the aim of increasing the proportion of people attending.
Spatial and temporal changes of breast-conserving surgery rates and its influential factors among Chinese patients with breast cancer from 2013 to 2019: a registry-based study
Our study aims to evaluate the spatial and temporal changes of breast-conserving surgery (BCS) rates and influential factors of BCS in Guangdong Province, China.
Trends in clinical encounters and management for infertility among women attending Australian general practice: a national longitudinal study using MedicineInsight, 2011 to 2021
To examine longitudinal trends in infertility management in women attending general practice.
Rural-urban and age differences in association between depression and suicidal attempt: a large retrospective clinical sample study in China
To assess the association between depression and suicide attempt (SA) by age and region.
Policies, programmes and research on adolescent and youth sexual and reproductive health in South Sudan: a systematic scoping review
To provide an overview of research, policies and programmes related to the sexual and reproductive health (SRH) needs of adolescents and youth (AY) in South Sudan in order to identify the gaps and potential areas of focus for researchers, policymakers and local and global SRH actors.
Prevalence of sudden unexpected death of infants and its subcategories in low- or middle-income countries: a systematic review protocol
Infant mortality in low or middle-income countries (LoMICs) is still triple that of high-income countries (HICs), and the high mortality burden regions are also weighed down by a triple or quadruple burden of disease such as HIV and tuberculosis; chronic illness; mental health; injury and violence; and maternal, neonatal and child mortality. Emerging data suggest that the sudden unexpected death in infancy (SUDI) burden in LoMICs is at least 10-fold that in HICs. While ending preventable deaths in the neonatal period has received some global attention, the postnatal period where SUDIs occur is a poorly understood and data-poor area in LoMICs. We propose conducting a systematic review to evaluate the burden and trends of SUDIs in LoMICs since 2004.
Characterising melanoma diagnostic pathways for patients in routine practice using administrative health data in Ontario, Canada: a population-based study
To characterise diagnostic pathways for patients with melanoma in routine practice and compare patient, disease and diagnostic interval (DI) characteristics across pathways.
Clinical course of spinal pain in adolescents: a feasibility study in a chiropractic setting
Prospective feasibility study.
Occupational skin diseases among bricklayers and brick masons in a resource poor setting, Southwest Nigeria: prevalence and correlates - a case-control study
Cement and most other materials used by bricklayers and brick masons for construction purposes could heighten the risk for occupational skin diseases (OSDs) which mostly include occupational contact dermatitis (OCD) and others. The activities of the bricklayers or brick masons are essentially manual as they work as artisans involving mixing sands and gravels with cement and water for building and block moulding, respectively. This can lead to a significant decline in the quality of life and psychosocial function. We determined the prevalence of OSDs and their correlates among bricklayers and brick masons.
Barriers and enablers of access to diabetes eye care in Auckland, New Zealand: a qualitative study
To explore the barriers and enablers to accessing diabetes eye care services among adults in Auckland.
Understanding how older people with mild frailty engage with behaviour change to support their independence: a qualitative study
To explore barriers and facilitators to behaviour change in older people with mild frailty.