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The latest headlines across every section, pulled from official and open-access sources.

BMJ Open · Jul 24, 2026

Mapping occupational therapy interventions in caregiver skill training for children with neurodiversity: a scoping review protocol

Introduction Caregivers of children with neurodiversity, particularly autism spectrum disorder and attention deficit hyperactivity disorder, experience sustained occupational, emotional and participation-related challenges. Occupational therapy (OT) plays a crucial role in supporting caregivers through skill training that enhances daily routines, participation and family functioning. Although caregiver training programmes are described across multiple disciplines, the scope, nature and specific contribution of OT-related caregiver skill training interventions remain insufficiently synthesised…

BMJ Open · Jul 24, 2026

Survival and predictors of major adverse cardiovascular events among patients with acute coronary syndrome in Ethiopia: a retrospective cohort study

Objectives To determine the time to major adverse cardiovascular events (MACE) and identify its predictors among patients with acute coronary syndrome (ACS) discharged on secondary prevention medications in Ethiopia. Design Institution-based retrospective cohort study. Setting University of Gondar Comprehensive Specialized Hospital, Northwest, Ethiopia. Participants A total of 400 adult patients diagnosed with ACS and discharged with secondary prevention medications between January 2020 and December 2024. Outcome measures The primary outcome was time to first MACE, defined as reinfarction…

BMJ Open · Jul 24, 2026

Development of a population-level frfailty index using Quebec administrative data: a Canadian retrospective study

Objectives The objectives of this study were to develop and validate a frailty index in the Quebec health administrative dataset designed to identify frail ICU patients and investigate the effects of frailty on ICU patients’ outcomes. Design We conducted a retrospective observational study. Settings We used the administrative data of the Centre intégré universitaire de santé et de services sociaux de l'Est-de-l’Île-de-Montréal (CIUSSS-EMTL), which regroups a supra-regional academic hospital and a community centre in Montreal, Quebec. We created a cohort through data linkage of hospital…

BMJ Open · Jul 24, 2026

Blood-based cell-free DNA for addressing colorectal cancer screening disparities: a study protocol for a randomised trial

Introduction Colorectal cancer (CRC) screening reduces cancer incidence and mortality, but participation rates are suboptimal in the USA and associated with inequities in CRC outcomes for lower income and many racial/ethnic minoritised groups. A novel, US Food and Drug Administration-approved cell-free tumour DNA (cfDNA) blood test has the potential to improve screening rates, but the impact of offering this test on participation, including among populations at disproportionately increased risk for inequities in CRC outcomes, has not been studied. We designed a small effectiveness randomised…

BMJ Open · Jul 24, 2026

Self-management digital intervention to promote physical activity in people living with chronic obstructive pulmonary disease: a pilot randomised controlled trial study protocol

Introduction Self-management is a key component of effective chronic obstructive pulmonary disease (COPD) management and is mainly promoted through pulmonary rehabilitation (PR) programmes. However, less than 2% of patients participate in PR programmes. Among those who do, approximately 40% fail to complete the programme. The reasons for this are multifactorial and include dyspnoea, reduced exercise tolerance, lack of motivation and inadequate transportation and infrastructure to access PR centres. In this context, self-management digital health interventions emerge as a promising approach to…

BMJ Open · Jul 24, 2026

Cost-effectiveness of home-based fall detection and monitoring technologies for community-dwelling older adults: a systematic review protocol

Background Falls affect approximately one-third of community-dwelling adults aged 65 years and older annually, with healthcare costs exceeding US$80 billion in the USA alone. Home-based fall detection technologies have proliferated, yet cost-effectiveness evidence remains fragmented. Objectives To systematically identify, appraise and synthesise evidence on the cost-effectiveness of home-based fall detection and monitoring technologies for community-dwelling older adults. Methods This protocol is reported following Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols…

BMJ Open · Jul 24, 2026

Relative strength of major determinants of quality of life in rheumatoid arthritis: an observational, cross-sectional study in tertiary rheumatology centres

Objectives To evaluate the relative strength of clinical and sociodemographic predictors of health-related quality of life (HRQoL) in patients with rheumatoid arthritis (RA) under real-life conditions. Methods This cross-sectional, observational study included adult patients fulfilling the 2010 American College of Rheumatology-European Alliance of Associations for Rheumatology classification criteria for RA, recruited from 11 public tertiary rheumatology centres in Brazil. To reflect real-life clinical practice, no restrictions were applied regarding disease stage or treatment status. HRQoL…

BMJ Open · Jul 24, 2026

Incidence and predictors of loss to follow-up after ART initiation at public health facilities in Sierra Leone (2020-2024): a retrospective cohort study

Objective This study aimed to estimate the incidence and predictors of loss to follow-up (LTFU) among adults after antiretroviral therapy (ART) initiation at five provincial referral hospitals in Sierra Leone. Design A facility-based retrospective cohort study. Setting This study was conducted at five provincial government referral hospitals in Sierra Leone from January 2020 to December 2024. Participant HIV patients aged 15 and above who initiated ART between 1 January 2020, and 31 December 2020, and attended at least one follow-up visit at the five national referral hospitals. Primary…

BMJ Open · Jul 24, 2026

Using narrative practices in nursing to enhance compassionate care for older adults: protocol for a qualitative study

Introduction Compassionate care is a core ethical and professional value in nursing, especially in the context of elderly care, where vulnerability, chronic illness and relational dependency are at the forefront. Despite the growing international interest in compassion and narrative medicine, there is limited empirical research examining how nurses experience, construct and sustain compassionate care for older people in everyday practice, especially in Eastern European contexts. Narrative practices offer a valuable methodological lens for capturing the experiences, moral meanings and emotional…

BMJ Open · Jul 24, 2026

Realist evaluation of the community paramedicine at clinic (CP@clinic) programme in rural Australian community health: protocol

Introduction The healthcare challenges associated with multimorbidity, population ageing and socioeconomic disadvantage are well known. This requires primary care services to adapt to greater population complexity and embrace new models of care. One example is the community paramedic (CP) role, which can provide screening, education and care coordination for complex and underserved populations. While relatively new in Australia, CPs have the potential to bridge primary care gaps especially in rural settings with workforce shortages. In this study, we are implementing an established and…

BMJ Open · Jul 24, 2026

ADDRESS-LC: study protocol for a phase 2, triple-blind, randomised, placebo-controlled trial to evaluate the efficacy and safety of bezisterim (NE3107) in adults with long COVID

Introduction Long COVID is a debilitating condition consisting of prolonged neurological symptoms such as cognitive impairment (‘brain fog’) and sleep disturbance. Symptoms may be associated with ongoing neuroinflammation from the persistence of a viral reservoir, activation of other viruses, protracted macrophagic inflammatory memory or enduring viral Spike protein that stimulates proinflammatory cytokines via toll-like receptor (TLR) signalling. Bezisterim (NE3107) is an oral, blood–brain barrier-permeable, anti-inflammatory, insulin-sensitising dehydroepiandrosterone derivative that…

BMJ Open · Jul 24, 2026

Availability, treatment costs and affordability of SGLT-2 inhibitors and GLP-1 RAs for diabetes in 10 countries: a cross-sectional study

Background Diabetes complicated by cardiovascular diseases and chronic kidney diseases poses a growing global burden. Sodium-glucose co-transporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly recommended, yet their availability, treatment costs and affordability across countries of different income levels remain poorly understood. Objectives To evaluate the regulatory availability, treatment costs and affordability of all marketed SGLT-2 inhibitors and GLP-1 RAs across 10 countries, including Nepal, Pakistan, Bangladesh, Sri Lanka, South…

BMJ Open · Jul 24, 2026

Level and predictors of micronutrient intake inadequacy among pregnant women attending public health facilities in Bahir Dar City, Northwest Ethiopia: a multicentre, cross-sectional study

Objective To determine the level and predictors of micronutrient intake inadequacy among pregnant women attending antenatal public health facilities in Bahir Dar City, Northwest Ethiopia. Design A multicentre, cross-sectional study. Setting The study was conducted in public health facilities in Bahir Dar City, Northwest Ethiopia from January to March 2024. Participants About 420 pregnant women aged 18 years and older attending antenatal care at public health facilities in Bahir Dar. Pregnant women diagnosed with chronic diseases, sick and unable to communicate, and who had attended weddings…

BMJ Open · Jul 24, 2026

Impact evaluation of a Prescription Search Support (PSS) for antimicrobials: protocol for a stepped-wedge cluster randomised trial in Belgian primary care

Introduction Inappropriate antibiotic prescribing in primary care remains a major driver of antimicrobial resistance, despite national guidelines and audit-and-feedback systems. Digital antimicrobial stewardship tools may support clinicians in making evidence-based prescribing decisions. The Prescription Search Support (PSS) tool translates guideline recommendations into an interactive decision tree integrated into electronic health records (EHR). This project aims to evaluate the impact of implementing the tool on antibiotic prescribing behaviour in Belgian general practice and to understand…

BMJ Open · Jul 24, 2026

Cost-effectiveness of glaucoma screening: a systematic review protocol

Introduction Glaucoma is an increasing global health problem and the leading cause of irreversible blindness which affects millions of people worldwide. Multiple studies on the cost-effectiveness of glaucoma screening conducted at community, clinic or hospital in developed and developing countries have been conducted, but evidence from systematic reviews is lacking. Therefore, this systematic review aims to assess the cost-effectiveness of glaucoma screening among adult populations across various countries and healthcare settings. Methods and analysis A systematic search will be conducted in…

BMJ Open · Jul 24, 2026

From diagnosis to daily life: a qualitative investigation into patients lived experiences of pre-diabetes diagnosis and care in a primary care setting in Singapore

Introduction The prevalence of pre-diabetes mellitus (pre-diabetes, pre-DM) is increasing globally, with 5%–10% of adults with pre-DM progressing to type 2 DM (T2DM) annually. Despite the availability of national screening programmes and lifestyle interventions, uptake remains suboptimal and the lived experiences of individuals navigating pre-DM diagnosis and care in Singapore remain poorly understood. Understanding these experiences is critical, as patient perspectives can reveal gaps in care delivery, particularly in a multiethnic population where cultural, social and systemic factors…

BMJ Open · Jul 24, 2026

Efficacy of cycled environmental light and noise during initial hospitalisation for improved cognitive outcomes at 2 years in infants born extremely or very preterm: study protocol for the prospective, randomised, open, blinded endpoint controlled multicentre CIRCA DIEM trial

Introduction Very preterm infants (<32 weeks gestation) have an undeveloped primary endogenous circadian rhythm and are deprived abruptly of vital maternal circadian inputs after delivery. Postnatal care in neonatal intensive care units is characterised by constant levels of lighting and noise. Stress arising from disrupted cues for circadian rhythmicity likely disrupts development of coordinated circadian rhythms critical for neurogenesis, organ growth and development. We hypothesise that cycled environmental light and noise commenced soon after birth and continued until discharge home will…

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