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☐ ☆ ✇ BMJ Open

Cohort profile: Infant Gut Bacterial Study in Nigeria (INBUGS-NG)

Por: Akpulu · C. P. · Maikudi Sada · H. · Ahmed · H. · Idris · H. B. · Yakubu · R. · Aminu · A. · Iregbu · K. · Oduwo · J. · Owinoh · E. · Lankapalli · A. K. · De Nies · L. · Achi · C. R. · Thomson · K. · Stracy · M. · Walsh · T. R. · Sands · K. — Febrero 12th 2026 at 19:06
Purpose

The Infant Gut Bacterial Study in Nigeria (INBUGS-NG) investigates how delivery mode, antibiotic exposure, feeding practices and environmental factors shape gut microbiome development and acquisition of antibiotic resistance genes (ARGs) during the first year of life in northern Nigeria.

Participants

Between February and July 2024, 90 mother–infant dyads were enrolled at a tertiary hospital in Kano city, Nigeria. This was a prospective longitudinal cohort with follow-ups at 10 scheduled time points: days 0, 1, 3, 5, 7, 14, 28, 90, 180 and 365. We also intensified stool sampling after infant antibiotic administration, enabling dense early-life sampling. To date, the cohort has contributed 480 infant stool samples, 232 maternal rectal swabs, 254 breast milk samples and 806 environmental samples (total 1772). In parallel, socio-demographic, clinical and cultural data were collected using Research Electronic Data Capture (REDCap) and household visit diaries.

Findings to date

Baseline data show that 84/90 mothers (93.3%) received postpartum antibiotics, and 26/90 infants (28.9%) received antibiotics within the first 3 months of life. Only 8% of infants were exclusively breastfed, with early water supplementation common. Caesarean deliveries accounted for 25% of births, and the mean gestational age was 38.5 weeks. Across the cohort, high retention was achieved, and the study has generated a unique long-read metagenomic resource from an African infant population, with analyses ongoing.

Future plans

Shotgun long-read metagenomic sequencing (Oxford Nanopore) will enable strain-level and plasmid-level profiling of microbial communities and ARGs. Planned analyses include associations between early-life exposures and resistome dynamics, as well as cross-cohort comparisons with a parallel study in Pakistan. Follow-up will continue through 12 months.

☐ ☆ ✇ BMJ Open

Prevalence of sexually transmitted infections among military personnel: a systematic review protocol

Por: Shoemaker · E. S. · Sandstrom · E. · Dangerfield · C. D. · Linton · J. · Cholette · F. · McClarty · L. M. · Lazarus · L. · Herpai · N. · Pavlova · D. · Pickles · M. · Becker · M. — Noviembre 28th 2025 at 03:17
Introduction

Military personnel are a unique population with heightened vulnerability to sexually transmitted infections (STIs), often exhibiting higher prevalence rates than civilians due to demographic, environmental and occupational factors. These vulnerabilities underscore the need for global prevalence estimates to guide effective, evidence-based interventions. This study aims to quantify the global burden of STIs among military personnel, providing a comprehensive and up-to-date assessment.

Methods and analysis

This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Guidelines (2020). Using the CoCoPop (Condition, Context, and Population) framework, a comprehensive search strategy will be conducted in MEDLINE, Embase, Global Health and Scopus to retrieve peer-reviewed records published between January 2010 and June 2025. Eligible studies will report numerical STI prevalence data among military personnel. Studies with insufficient information to calculate prevalence or those relying on self-reported STI data will be excluded. Data extraction will include study details, military descriptors, STI prevalence and diagnostic methods. Risk of bias will be assessed using the Joanna Briggs Institute critical assessment tool for prevalence and incidence studies. Prevalence estimates with 95% CIs will be reported for each STI and, where appropriate, pooled for curable STIs. Subgroup analyses will stratify prevalence by geographic region, service status, deployment status and socioeconomic factors. Heterogeneity will be evaluated within predefined subgroups using the I² statistic. Data will be presented in comprehensive tables and visualised with graphical tools, including forest plots for subgroup analyses and pooled estimates.

Ethics and dissemination

Ethical approval is not required for this review. The results will be disseminated through a peer-reviewed publication and conference presentations.

PROSPERO registration number

CRD42023472113.

☐ ☆ ✇ BMJ Open

Surgical patients experiences with the Patients Safety Checklist (PASC): a qualitative interview study

Por: Harris · K. · Waehle · H. V. · Storesund · A. · Harthug · S. · Tangvik · R. J. · Monsen Lukcova · D. · Havik · W. · Humberset · A. · Stavang · E. · Hagerup · K. · Teigland Tepstad · A. · Sandsbakk Austarheim · A. K. · Healey · A. · Sevdalis · N. · Haugen · A. S. — Octubre 6th 2025 at 02:14
Background

Engaging patients in surgical safety is challenging and has not been thoroughly investigated. Although surgical checklists and other safety protocols have been introduced across various surgical fields, preventable adverse events still occur, highlighting the need for additional research. A Patient’s Safety Checklist (PASC) has been developed and validated for use by surgical patients. Its effect on patient safety and patient outcomes is currently being investigated in a Stepped Wedge Cluster Randomised Controlled Trial (NCT03105713). In connection with this trial, we have examined elective patients’ experiences with using the PASC.

Methods

An exploratory qualitative study was conducted based on individual in-depth telephone interviews with 31 elective surgical patients. The interviews were carried out across three Norwegian hospitals including seven surgical specialties. The patients interviewed were part of the trial’s intervention arm and had used PASC. The interviews were transcribed verbatim, and reflective thematic analysis was applied.

Result

Three themes were identified in the data: patient awareness, patient actions and utility value. Patients perceived PASC to increase awareness around surgical information, preparations, what to speak up about and which information to seek and repeat. This awareness led to a series of actions, such as ensuring medication control, optimising their own health, contacting healthcare professionals, asking questions, and for some no actions were needed. Patients perceived PASC to have high utility value for their surgical preparation.

Conclusions

The PASC enhanced patients’ involvement in surgical care and safety by ensuring they received systematic, accurate, clear, and understandable information and instructions throughout the surgical pathway. It is one of the few existing interventions that specifically focuses on assisting patients in preparing for surgery and managing their recovery. Further research is needed on the implementation of PASC and its adaptation to other clinical settings.

Trial registration number

NCT03105713.

☐ ☆ ✇ Journal of Advanced Nursing

Advanced Practice Nurses' Roles and Responsibilities in Advance Care Planning for Older Persons—A Mixed Methods Systematic Review

Por: Jan Eilert Pedersen · Hilde Eide · Marit Gjone Sandsleth · Ingrid Taylor · Linn Hege Førsund — Septiembre 25th 2025 at 07:02

ABSTRACT

Aim

To systematically identify, evaluate and synthesise the research literature about (a) the roles and responsibilities of advanced practice nurses (APNs) in the context of advance care planning (ACP) for older persons, (b) the characteristics of APNs' ACP practices and (c) the facilitators and barriers influencing APNs' involvement in ACP.

Design

Mixed-methods systematic review.

Methods

Followed the mixed methods systematic review guidelines outlined by the Joanna Briggs Institute. Three researchers independently screened studies for eligibility using the Covidence Screening Application. The screening involved two stages: titles and abstracts, followed by full-text evaluation. The Mixed Methods Appraisal Tool was used for quality assessment. A convergent integrated synthesis combined quantitative and qualitative data by ‘qualitising’ quantitative findings into text, enabling integration and thematic analysis to synthesise the results.

Data Sources

Medline, CINAHL and Embase were searched from 2012 to 2024 for original research in English, focusing on APNs involved in ACP for individuals aged 65 or older, using qualitative, quantitative or mixed method designs.

Results

The review included 19 studies: seven qualitative, nine quantitative and three mixed method designs. Thematic analysis revealed that APNs play a key role in ACP, aligning care with patient preferences through discussions and documentation. Studies from the United States (12), United Kingdom (4), Canada (2) and Australia (1) show varying APN roles and responsibilities.

Conclusion

APNs are crucial to ACP, but barriers limit their impact. Overcoming these is key to improving outcomes.

Implications for the Profession and Patient Care

APNs clinical expertise and close patient relationships are crucial for aligning care with patient preferences and needs in ACP. However, to fully maximise their contribution, it is essential to overcome barriers such as time constraints, lack of role recognition and insufficient training. Addressing these challenges will enhance the effectiveness of APNs in providing person-centred care.

Reporting Method

This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Patient or Public Contribution

No patient or public contribution.

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