The Clinical Times
The Front Page of Medicine

Clinical & Research · page 51

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

BMJ Open · Jun 16, 2026

In-bedroom renewed air as anti-inflammatory adjuvant therapy in cancer survivors: protocol for the randomised, placebo-controlled BREATHS N-of-1 trial series

Introduction Inflammation is causally related to cancer progression and cardiovascular toxicities of anticancer treatments. Fine particulate matter (PM 2.5 ) air filtration lowers interleukin-6 and C reactive protein (CRP) levels in high-risk cardiopulmonary groups, though potential synergistic or confounding effects with routine medications—statins, cyclo-oxygenase-2 inhibitors, beta-blockers—remain poorly understood. Whether overnight in-bedroom PM 2.5 air filtration effectively reduces inflammation and prothrombotic biomarkers in survivors of adult-onset cancer at high cardiovascular…

BMJ Open · Jun 16, 2026

Effects of laughter yoga on reducing depression and anxiety in children with autism spectrum disorder and parenting stress in their parents: study protocol for a randomised-controlled feasibility trial

Introduction Both children with autism spectrum disorder (ASD) and their parents are at a high risk of experiencing anxiety and depression. Recent studies have indicated that laughter yoga can create happiness and reduce negative emotions in adults. However, there are limited studies about how laughter yoga benefits children with ASD and parents of children with ASD. This feasibility study aims to explore the recruitment, retention rate, protocol adherence and acceptability of a laughter yoga programme in children with ASD and their parents. Moreover, it investigates the safety issues and the…

BMJ Open · Jun 16, 2026

Spatial access to inpatient mental health services in Kerala, India: a Geospatial Information System-based travel-time isochrone analysis

Objectives This study aimed to estimate the spatial accessibility of inpatient mental health services in Kerala, India. We also aimed to calculate bed-to-population ratios for these services for each district in the state. Design We used a Geospatial Information System (GIS)-based travel time isochrone analysis to estimate potential spatial accessibility. Setting Kerala, India. Data sources and methods A list of all mental health facilities licensed to admit patients was obtained from data published by the Kerala State Mental Health Authority in 2025. The facilities were geocoded and mapped…

BMJ Open · Jun 16, 2026

Understanding contemporary challenges to safe abortion access in Africa through a health systems lens: a systematic review protocol

Background Unsafe abortion remains a major public health concern in Africa, contributing substantially to maternal morbidity and mortality across the continent. Although legal restrictions, stigma and socio-cultural factors are well-documented barriers to safe abortion access, health systems-related barriers are not adequately explored. This systematic review aims to examine how health systems-related barriers hinder access to safe abortion in clinic settings in Africa over the past decade. Methods and analysis A comprehensive search strategy will be employed to retrieve relevant studies from…

BMJ Open · Jun 16, 2026

What is the feasibility and acceptability of stool sampling and testing for childhood tuberculosis diagnosis? A qualitative study in The Gambia

Objective To explore the feasibility and acceptability of stool sampling and testing for childhood tuberculosis (TB) diagnosis among adolescents, child caregivers and healthcare workers (HCWs) who participated in a diagnostic accuracy study and among National Leprosy and TB Control Programme (NLTP) officials in The Gambia. Design This was a qualitative cross-sectional study that used semi-structured interviews. Braun and Clarke’s thematic analysis framework guided our analysis. Setting The study was conducted in The Gambia at the TB clinic of the Medical Research Council Unit The Gambia at the…

BMJ Open · Jun 16, 2026

Diagnostic stewardship in emergency departments using the UNTIE framework: a stepped-wedge cluster randomised study protocol

Introduction Pathology testing accounts for over half of non-labour costs in Australian Emergency Departments (EDs), yet up to one-fifth of tests are unnecessary. Despite national guidance from the Australasian College for Emergency Medicine (ACEM) and the Royal College of Pathologists of Australasia (RCPA), variation in test ordering persists across departments and across clinical presentations. The Unnecessary Tests in Emergency (UNTIE) study aims to evaluate whether audit and feedback using a novel indicator can reduce unnecessary pathology testing. Methods and analysis UNTIE is a…

BMJ Open · Jun 16, 2026

Adaptation and resilience in families of cancer survivors: a scoping review protocol on their dual impact on caregiver burden and post-traumatic growth

Introduction Cancer survivorship places substantial and enduring demands not only on survivors themselves but also on their families and informal caregivers. Family adaptation and family resilience are increasingly recognised as key family-level processes that may alleviate caregiver burden and foster post-traumatic growth (PTG). However, the existing evidence remains fragmented because of inconsistencies in conceptual definitions, theoretical frameworks, study designs and outcome measures. Objectives This scoping review aims to systematically map the existing literature on family adaptation…

BMJ Open · Jun 16, 2026

Effectiveness of interventions to promote social inclusion of people with disabilities in high-income countries: a systematic review of quantitative evaluation studies

Objectives Despite policy commitments to social inclusion for people with disabilities, the effectiveness of interventions remains unclear, particularly in high-income countries. This systematic review synthesises evidence and examines variation by population, setting and intervention. Design Systematic review. Setting All settings in which social inclusion interventions might be implemented in high-income countries. Participants Children and adults with disabilities (0–65 years) living in high-income countries. Interventions Promoting social inclusion for people with disabilities. Eligibility…

BMJ Open · Jun 16, 2026

Data from a UK-based multicentre randomised feasibility study investigating the management of post-traumatic benign paroxysmal positional vertigo: mixed-methods analyses

Objectives Traumatic brain injury commonly causes dizziness and balance problems. Benign paroxysmal positional vertigo (BPPV) is the most frequent cause of inner-ear related post-traumatic vestibular dysfunction. However, optimal assessment and treatment practices are poorly evidenced. Using a mixed methods approach, we aimed to explore the feasibility of managing post-traumatic BPPV. Design A mixed-methods randomised feasibility study. In this paper, quantitative and qualitative data relating to key feasibility targets around recruitment, randomisation and assessment and treatment were…

BMJ Open · Jun 16, 2026

Prevalence and risk factors of gastro-oesophageal reflux disease in Saudi Arabia: a systematic review and meta-analysis

Objective To estimate the pooled prevalence and associated factors of gastro-oesophageal reflux disease (GERD) in Saudi Arabia and other Gulf Cooperation Council (GCC) countries. Design Systematic review and meta-analysis Data sources Searches were carried out in Web of Science, Scopus, PubMed, Google Scholar and Dimensions AI with no date or language filters. Eligibility criteria for selection of studies Cross-sectional studies that reported estimates of GERD prevalence from Saudi Arabia and other GCC countries were included. Data extraction and synthesis Two reviewers independently extracted…

BMJ Open · Jun 16, 2026

Wellbeing-focused media literacy interventions in secondary schools: A systematic review and meta-analysis protocol

Introduction Media and digital technologies shape adolescent development across interconnected online and offline contexts, offering opportunities for learning and connection while also exposing young people to risks that can affect wellbeing. Wellbeing-focused media literacy interventions aim to support young people in understanding and managing how media and technology shape their experiences and wellbeing. Schools are well placed to deliver such interventions at scale through curricular integration. However, existing interventions vary widely in focus, design and evaluation quality making…

BMJ Open · Jun 16, 2026

Perspectives on the injured childs hospital discharge process and opportunities for improvement: a scoping review protocol

Introduction Unintentional injury is a leading cause of hospitalisation and disability in children globally. Families may experience a second crisis of injury after the child’s discharge from the hospital, with the traumatic nature of injuries affecting physical and psychosocial recovery. This scoping review aims to summarise the literature on the perspectives of injured children’s caregivers and service providers on the hospital discharge process, the challenges and opportunities to improve discharge planning evident from qualitative and interventional studies, and the investigation of…

JAMA Network Open · Jun 16, 2026

Policy and Payment Factors in Adoption of Low-Barrier Buprenorphine Treatment

This qualitative study explores the perspectives of opioid use disorder (OUD) treatment program clinicians and staff about how broader policy and payment structures affect adoption of buprenorphine treatment and low-barrier care practices that promote access and retention.

BMJ Open · Jun 15, 2026

Use of case-based, problem-based and team-based learning in public health education - a scoping review

Objectives Active learning strategies, including case-based learning (CBL), problem-based learning (PBL) and team-based learning (TBL), have been extensively studied in clinical and basic science education; however, their application in public health programmes remains under-explored. Public health professionals address population-level challenges that differ substantially from clinical practice, making it necessary to evaluate whether these pedagogies are effective in this field. This review examines how CBL, PBL and TBL have been used in public health education and what outcomes have been…

BMJ Open · Jun 15, 2026

Loneliness and social isolation at the emergency department: a scoping review protocol

Introduction Loneliness and social isolation are critical public health issues linked to significant adverse health outcomes and increased healthcare utilisation, including visits to the emergency department (ED). The ED often serves as a primary societal safety net, providing care for vulnerable populations who may be disproportionately affected by these conditions. In fact, loneliness and social isolation might be the underlying reasons they presented to the ED in the first place either consciously or not. For such individuals, the ED encounter may represent a rare point of human contact…

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