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Clinical & Research · page 4

New research and findings from open-access journals and the U.S. research agencies.

BMJ Open · Aug 4, 2026

AquOTic: protocol for a type 1 hybrid effectiveness-implementation trial of an occupational therapy-based water competency intervention for children on the autism spectrum

Introduction Drowning is a leading cause of unintentional death among children on the autism spectrum, emphasising the need for tailored water competency interventions. Autism-related factors such as wandering, sensory differences and limited danger awareness increase drowning risk. Evidence suggests structured aquatic programmes improve water safety, yet guidance on effective components and implementation fidelity in community settings remains limited. Methods and analysis This type 1 hybrid effectiveness-implementation randomised controlled trial will evaluate AquOTic, an occupational…

BMJ Open · Aug 4, 2026

Cultural adaptation of the 4Rs and 2Ss multiple family group therapy for adolescents living with HIV and their families in Ghana: a systematic community-based participatory study

Background Multiple family group therapy (MFGT) using the 4Rs and 2Ss (rules, responsibility, relationships, respectful communication, stress management and social support) framework has demonstrated effectiveness in addressing mental health and behavioural problems in high-income countries. However, the MFGT requires cultural adaptation for sub-Saharan African contexts where family structures, traditional healing practices and community support systems differ substantially from Western therapeutic models. Objective To systematically document the cultural adaptation process of the 4Rs and 2Ss…

BMJ Open · Aug 4, 2026

Photobiomodulation therapy combined with a static magnetic field for chronic non-specific knee pain: protocol for a multicentre, randomised, triple-blind, placebo-controlled trial

Introduction Chronic non-specific knee pain represents a prevalent and disabling musculoskeletal condition that often lacks a clearly identifiable structural cause and evidence-based management strategies. Photobiomodulation therapy combined with a static magnetic field (PBMT-sMF) has been proposed as a non-invasive approach capable of modulating inflammation, reducing oxidative stress and promoting tissue repair. However, high-quality clinical evidence regarding its effectiveness in this population remains scarce. This trial aims to investigate the effects of PBMT-sMF on pain intensity…

BMJ Open · Aug 4, 2026

READYCOM: protocol for a 2-year prospective natural history and cross-sectional muscle-fatigability study for improving trial readiness in congenital myopathies

Introduction Congenital myopathies (CMYO) are a group of rare hereditary muscle diseases defined by characteristic abnormalities on muscle biopsy. Several types, including the core myopathies central core disease and multi-minicore disease, nemaline myopathy and centronuclear myopathy, have been identified based on the characteristic histopathological changes and attributed to various genetic backgrounds. The most prominent clinical features are generalised muscle weakness often pronounced axially, variable cardiorespiratory and bulbar impairment, and skeletal and joint involvement. Currently…

BMJ Open · Aug 4, 2026

Does the I-CARE e-learning programme improve primary care physicians competence in LGBTI health? Protocol for a two-arm, parallel-group, superiority randomised controlled trial in French-speaking Switzerland (EFFICARE study)

Introduction Lesbian, gay, bisexual, transgender or non-binary and intersex (LGBTI) populations experience persistent health inequities, including poorer mental and physical health outcomes and higher unmet healthcare needs compared with non-LGBTI populations. These inequities are partly attributable to insufficient training of primary care physicians (PCPs) in LGBTI health. However, evidence on effective and scalable training interventions for PCPs remains limited, particularly outside North America. This study evaluates the effectiveness of a self-directed e-learning programme—Improving Care…

BMJ Open · Aug 4, 2026

Feasibility of a randomised controlled trial comparing opioid dose escalation with low-dose methadone addition for refractory cancer pain: JORTC-PAL23/NCCH2309 - protocol

Introduction Methadone exerts analgesic effects through μ-opioid receptor affinity and N-methyl-D-aspartate receptor antagonism, which may benefit refractory cancer pain with neuropathic components. Methadone can be introduced by the ‘stop-and-go’ (SAG) method or the ‘add-on’ (AO) method, in which low-dose methadone is added to existing opioids. Observational studies suggest AO may improve pain control but no double-blind randomised controlled trial (RCT) has evaluated this approach. Therefore, the primary aim of this study is to assess the feasibility of conducting a double-blind RCT…

BMJ Open · Aug 4, 2026

Biceps tenodesis with 360{degrees} suture anchor versus self-locking tenodesis in the absence of full-thickness rotator cuff tears: protocol for a non-inferiority randomised controlled trial (BLAST-2)

Introduction Pathology of the long head of the biceps tendon (LHBT) is commonly treated with either tenotomy or tenodesis, which provide comparable clinical outcomes but have distinct disadvantages. A novel self-locking biceps tenodesis aims to combine the benefits of both techniques. Comparative evidence in patients without full-thickness rotator cuff tears is limited. This study aims to compare the clinical outcomes and complications of self-locking biceps tenodesis and biceps tenodesis with 360° suture anchor in patients without full-thickness rotator cuff tears. Methods and analysis This…

JAMA Network Open · Aug 4, 2026

Epidemiology of Health-Related Social Needs Screening and Positivity

This cohort study evaluates patient characteristics associated with completion of screening for health-related social needs, identification of at least 1 need, total identified needs, and assistance requests across a multistate US health system.

MedCity News · Aug 3, 2026

Report: Telehealth Uptake Is Lagging in Rural Areas

An Elevance Health Public Policy Institute study found rural patients used telehealth less than non-rural patients across all chronic conditions and insurance types. The post Report: Telehealth Uptake Is Lagging in Rural Areas appeared first on MedCity News .

PLOS Medicine · Aug 3, 2026

Adherence to medications, lifestyle advice, and self-monitoring for type 2 diabetes and hypertension in sub-Saharan Africa: A systematic review, meta-analysis, and interactive network analysis

by Angeliki Apostolou, Reuben Simfukwe, Adrias Saint, Bridget Mushani, Hannah Chekhchar, Pearl Aovare, Kouamivi M. Agboyibor, Karlijn A. C. Meeks, George F. Mkoma, Charles Agyemang, Felix P. Chilunga Background Type 2 diabetes and hypertension are major public health challenges in sub-Saharan Africa, yet treatment control remains poor. Patient adherence to key treatment pillars (medication, lifestyle advice, and self-monitoring) is essential for treatment control, yet adherence across these pillars has not been comprehensively synthesized. We conducted a systematic review and meta-analysis to…

PLOS Medicine · Aug 3, 2026

Trajectories of physical function, depressive symptoms, and cognitive performance before and after falls in older adults: A matched multicohort study

by Junjie Lin, Mika Kivimäki, Zifan Zhang, Hui Wang, Yangyang Cheng, Xiaolin Xu Background Impairments in physical, psychological, and cognitive functioning are associated with an increased risk of falls. However, how these functional domains change longitudinally before and after fall events remains unclear. We examined individual and joint trajectories of these outcomes preceding and following falls. Methods and findings Using data collected between 2010 and 2021 from three national cohorts in China, the UK, and the USA, we included 28,773 adults aged ≥60 years and performed 1:1 matching…

BMJ Open · Aug 3, 2026

Integrated service delivery to improve adolescent health and human papillomavirus (HPV) vaccination in Lao PDR: a quasi-experimental mixed-methods study - study protocol

Introduction The Lao People’s Democratic Republic (PDR) faces the significant public health challenges of high cervical cancer incidence and suboptimal human papillomavirus (HPV) vaccine coverage alongside broader adolescent health concerns such as high adolescent pregnancy rates and inadequate sexual and reproductive health (SRH) literacy. This study protocol outlines an approach to address these interconnected issues comprehensively by evaluating an integrated service delivery model. Methods and analysis This study employed a quasi-experimental design with mixed methods to assess the impact…

BMJ Open · Aug 3, 2026

Mapping the literature on improving primary-to-secondary care referrals through the lens of the Quintuple Aim framework for healthcare improvement: a scoping review

Objectives To explore and map the literature on referral pathway gaps and improvement strategies in primary healthcare (PHC) to secondary healthcare (SHC) referrals, and to categorise both gaps and improvements using the Quintuple Aim framework for healthcare improvement—a model encompassing patient experience, population health, costs, provider well-being and health equity. Design Scoping review guided by Arksey and O’Malley’s framework, refined by the Joanna Briggs Institute and reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping…

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