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

BMJ Open · Aug 4, 2026

Changes in knowledge of the major harms of tobacco smoking and secondhand smoke exposure among adults who smoke: findings from 26 countries of the International Tobacco Control (ITC) Project (2002-2022) and 32 countries of the Global Adult Tobacco Survey (GATS) (2008-2020)

Objectives To assess levels of and trends in knowledge that smoking and secondhand smoke (SHS) cause lung cancer and cardiovascular disease (CVD) in 46 countries over two decades. Design Longitudinal cohort and repeat cross-sectional surveys. Setting Nationally representative surveys in 26 International Tobacco Control (ITC) Project countries (2002–2022) and 32 Global Adult Tobacco Survey (GATS) countries (2008–2020). Participants Adults (aged 18+ years) who smoke tobacco (26 ITC countries: n=133 410; 32 GATS countries: n=110 537). Analysis outcomes Current use of cigarettes at least monthly…

BMJ Open · Aug 4, 2026

Multicentre randomised comparative effectiveness trial of cleavage-stage versus blastocyst-stage embryo transfer in patients with few embryos (PRECISE): implementation of a study protocol in reproductive medicine

Background With improvements in in vitro culture techniques, there has been a steady shift in practice to transfer in vitro fertilisation (IVF) embryos at the blastocyst-stage to increase pregnancy rates per embryo transfer (ET) and reduce the risk of multiple pregnancy. In patients with fewer embryos (≤5 zygotes), fresh cleavage-stage ET is still commonly performed to reduce the risk of cycle cancellation if no embryo survives to the blastocyst-stage in vitro. However, evidence for improved outcomes with cleavage-stage embryo transfer in this subgroup of patients is lacking. We will…

BMJ Open · Aug 4, 2026

Non-pharmacological interventions for managing fatigue across the lifespan of people living with chronic musculoskeletal conditions: a scoping review

Objectives Fatigue is an important and distressing symptom for many people living with chronic musculoskeletal (MSK) conditions. Non-pharmacological interventions designed to reduce fatigue have been investigated but the evidence is disparate across MSK conditions and across the lifespan. This scoping review aimed to create an overview of the current knowledge of non-pharmacological interventions for fatigue in MSK conditions across the lifespan, including their theoretical bases, the characteristics of participants and the clinical competencies of those delivering interventions. It aimed to…

BMJ Open · Aug 4, 2026

Effects of an increase in schooling on HIV infection and behavioural risk: a multicountry instrumental variable analysis of 23 sub-Saharan African countries

Objectives To estimate the causal effect of increased schooling arising from national policy reforms on HIV/AIDS infection and testing, along with associated indicators of risk across a wide range of settings in sub-Saharan Africa. Design Multicountry quasi-experimental analysis using two-stage least squares (instrumental variable) analysis with national schooling reforms as the instrument for years of schooling. Setting A pooled sample from 23 sub-Saharan African countries with historical peak HIV-prevalence rates ranging from under 1% to over 20%, surveyed from 2003 to 2019. Participants A…

BMJ Open · Aug 4, 2026

Rapid consensus building to strengthen AMR surveillance in LMICs using One Health approach: a modified table-top exercise coupled with a Delphi study protocol

Introduction Implementing integrated One Health surveillance of antimicrobial resistance (OH-AMR) remains a challenge globally, particularly in developing countries. Resource limitations, infrastructural gaps and inadequate technical capacity often hinder adherence to standardised antimicrobial resistance (AMR) surveillance guidelines, resulting in suboptimal data coverage and quality in resource-constrained settings. Moreover, considerable disparities exist in the design and execution of OH-AMR surveillance systems across regions, further complicating global data harmonisation and comparative…

BMJ Open · Aug 4, 2026

Exploring the reasons behind induced abortion among Iranian couples: a qualitative study

Background Induced abortion remains a significant reproductive health issue in Iran, shaped by complex socio-economic, cultural and legal factors. Despite its importance, limited evidence exists on the underlying motivations for seeking abortion in a context of restrictive laws and pronatalist policies. Objectives This study aimed to explore the reasons underlying couples’ decisions to seek induced abortion within the constraints of the current legal framework. Design Qualitative interview study, co-designed with couples with a history of induced abortion. Methods We conducted semi-structured…

BMJ Open · Aug 4, 2026

Socioeconomic and environmental disparities in childhood unintentional injury risk in urban households in Chongqing, China: a latent profile analysis of cross-sectional survey data

Objectives While the social determinants of the home environment and childhood unintentional injuries (UIs) are well established, their association within the context of rapid urbanisation in China remains understudied. Given its rapid urban growth and unique housing landscape, Chongqing provides a valuable context for this investigation. This study aimed to investigate how socioeconomic and home environmental factors collectively shape the risk of childhood UIs in urban households in Chongqing. Design Cross-sectional study. Setting Data were collected in April 2023, in Jiangbei District…

BMJ Open · Aug 4, 2026

Acceptability and impact of weight management interventions for adults with intellectual disability: protocol for a systematic review and meta-analysis

Introduction Obesity disproportionately impacts people with intellectual disabilities (PwID). Given the challenges that PwID face, such as cognitive deficits, differences in motivation and communication difficulties, the need for tailored interventions for weight management in PwID is recognised. Yet, this population is underserved, with limited weight management interventions for them compared with the general population. Existing reviews suggest that ‘multi-component’ interventions (including physical activity and dietary advice) are impactful at reducing weight in PwID; however, less is…

BMJ Open · Aug 4, 2026

Association between inpatient AUDIT-C alcohol screening scores and postoperative outcomes: a retrospective cohort study

Objectives To evaluate whether alcohol use severity, as measured by the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), is associated with postoperative complications, hospital utilisation and opioid prescribing among adult surgical inpatients. Design Retrospective cohort study. Setting Single tertiary academic hospital in the USA, using data from inpatient surgical admissions between April 2021 and September 2023. Participants Adult patients (≥18 years) admitted for inpatient surgery with a completed AUDIT-C screening during their admission. Measures AUDIT-C scores were…

BMJ Open · Aug 4, 2026

Use of cost analysis in examinations of health coaching interventions: a scoping review

Background Health coaching is the process of using conversation, clinical strategies and interventions to engage clients in setting goals and identifying strategies to facilitate behaviour changes that allow clients to better self-manage their health. Health coaching is a new and growing industry in the USA. With increasing budgetary strain and limited resources, understanding the financial outcomes of adding health coaching is critical. Objectives The objective of this review was to examine what is known in the literature about health coaching and cost analyses since 2017, building and…

BMJ Open · Aug 4, 2026

F-words as core components in global early childhood development interventions: a scoping review protocol

Introduction Early childhood development (ECD) interventions within global health systems support children aged 0–5 years across a range of developmental needs, including those who are typically developing (healthy), at risk of developmental delay or living with developmental disorders. These interventions address multiple domains of development, yet their conceptual integration remains variable across contexts. The F-words framework—encompassing Functionig, Family, Fitness, Fun, Friends and Future—provides a holistic, strengths-based lens for understanding child development, yet its…

BMJ Open · Aug 4, 2026

Differences and trends in pathogens between ventilator-associated pneumonia and non-ventilator-associated pneumonia: data from 61 hospitals in Suzhou, China, 2020-2024

Objective To investigate the differences in pathogenic bacterial profiles between ventilator-associated pneumonia (VAP) and non-ventilator-associated hospital-acquired pneumonia (NV-HAP) and to provide data to support clinical infection prevention and control. Design A retrospective observational study using surveillance data, accompanied by a statistical analysis of pathogen-related variables between the two study cohorts. Setting Sixty-one secondary and tertiary healthcare institutions in a single city. Data were extracted from the city’s regional healthcare-associated infection surveillance…

BMJ Open · Aug 4, 2026

Association between changes in working status and frailty across different types of employment: a longitudinal study in Korea, the worlds most rapidly ageing nation

Objective Frailty, a critical health indicator of ageing, poses significant public health challenges for individuals and society. This study analysed the longitudinal association between changes in employment status and frailty among middle-aged and older adults in Korea across different employment types. It also examined how employment transitions impact frailty components, particularly weakness, isolation and exhaustion. Design A longitudinal study. Setting A nationwide community-based longitudinal study using data from the Korean Longitudinal Study of Aging from 2006 to 2022. Participants…

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…

KFF Health News · Aug 4, 2026

AI Is Being Used to Boost Medicaid Enrollment, but Not Without Concerns

Ahead of Medicaid work requirements, a health plan in California hopes to stanch the number of people losing coverage by using an AI program to schedule appointments and remind enrollees to fill out paperwork. The plan says it can do the work of 40 employees at a fraction of the cost.

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