JMIR Research Protocols

Mental health disorders (MHDs) remain a leading cause of the global burden of diseases. Early identification of neurobiological mechanisms mediating a risk for MHDs is key to reducing a lifetime burden. Recent findings emphasize the locus coeruleus-norepinephrine (LC-NE) system as a neuromodulator of arousal translating acute stress responses into neuronal excitability. We propose that individual differences in LC-NE functioning can explain a differential susceptibility to psychological adversity, which mediates the development of transdiagnostic psychopathology in early childhood.

Medication adherence and lifestyle modification remain key in the management of hypertension. Leveraging mobile technologies to improve patient adherence has been found to be effective in chronic disease management. Given the high mobile penetration and the opportunities it provides for encouraging lifestyle modification, an app such as WhatsApp, which is a free-to-use and real-time messaging platform, could facilitate patient-clinician interactions. We present a protocol for a WhatsApp-led mobile health (mHealth) intervention to improve adherence to medication and healthy lifestyles among adults aged 40 to 59 years in Kerala, India.

Research on dementia has primarily focused on adults, leaving a gap in understanding related to children’s attitudes toward dementia. This gap is relevant given the growing societal impact of dementia and the potential role of early education in shaping attitudes.

Despite high pre-exposure prophylaxis (PrEP) awareness and willingness among Chinese men who have sex with men (MSM), actual uptake remains critically low. The health action process approach (HAPA) is a 2-phase theory that addresses both the motivational and volitional phases of health behavior change, making it suitable for tackling the intention-behavior gap in PrEP use. In China, where PrEP is not covered by national health insurance, financial barriers further hinder uptake. Group-based conditional economic incentives (GCEIs) represent an innovative strategy to address cost-related disincentives by leveraging peer influence.

Technology-enabled tasks to conduct financial transactions are ubiquitous around the world. In a recent survey, about 75% of the respondents endorsed the use of technology to perform financial activities such as reviewing bank statements and keeping track of money spent. However, assessment of financial decision-making (FDM) is limited by tasks that use traditional paper-and-pencil methods or by relying on self or informant reports. Furthermore, such tools have weak psychometric properties, are prone to biases, and are at times limited in scope. Thus, there is an urgent need to develop modern, technology-based tools that have strong psychometric properties and that can assess FDM comprehensively and accurately.

Cancer inequities among vulnerable populations in rural areas remain a public health challenge in Canada. Rural populations are defined as vulnerable due to geographic isolation, limited access to specialized oncology care, and socioeconomic barriers such as transportation and financial toxicity. Professional navigation offers a potential solution to bridge these gaps, yet there is a lack of evidence on the barriers to and facilitators of its adoption in breast cancer survivorship.

Medical assistance in dying (MAiD) became a legal end-of-life option on December 10, 2015, in Québec, and on June 17, 2016, in the rest of Canada. Since its legalization, there has been a steady increase in the number of MAiD requests and provisions. Across permissive jurisdictions, Québec now has the highest rate of assisted death. Despite the growing use of MAiD, research examining the factors driving this increase remains limited and fragmented. Existing studies offer partial and sometimes contradictory explanations, with little integration of legal, institutional, societal, and individual dimensions. Further research is needed to better understand the determinants of MAiD requests and practices, particularly in the Canadian and Québec contexts.

Globally, successful strategies to engage high-risk heterosexual men in HIV prevention are scarce, resulting in limited access and uptake. Barbershops offer a potential venue for HIV prevention.

Developing surgical skills among residents requires time and resources, often in conflict with the goals of efficiency and hospital economics in surgical practice. Optimizing resident training may prevent a decline in quality. Skilled surgeons are vital to effective and safe surgical performance, yet the training trajectory for surgical residents is often inefficient, particularly in the era of minimally invasive surgery. A framework that efficiently disseminates surgical skills is essential to cultivate skilled future surgeons within an acceptable time frame. Surgical telementoring (ST) aligns well with minimally invasive surgery because the mentee operating in the field shares the telementor’s perspective. Despite growing experience with telemedicine, data on educational outcomes remain limited.

Conventional semen analysis does not fully capture male reproductive potential. The sperm DNA fragmentation index (DFI) may detect latent infertility, although the sperm chromatin structure assay (SCSA) is costly and technically demanding. Image-based analysis of semen microscopy, including artificial intelligence (AI), may enable lower-cost noninvasive assessment. However, progress is limited by a lack of standardized multimodal datasets linking sperm images with the DFI and relevant covariates.

Cognitive behavioral therapy (CBT) is the most effective treatment for binge eating disorder (BED) but is limited by modest efficacy and low reach of in-person delivery. Combining mindfulness training with CBT could enhance efficacy by targeting emotion dysregulation, a key factor in BED that CBT does not adequately target. Digital delivery can enhance the reach of treatment. Accordingly, we developed CBT-based Mindful Courage, a 16-session digital intervention combining CBT and mindfulness training for BED.

Vaginal itching is a frequent gynecological issue impacting women of various age groups. Although commonly linked to nonserious conditions, it may also signal infections, sexually transmitted diseases, prolonged use of certain medications, such as oral contraceptives, hormonal fluctuations, or suboptimal hygiene. Standard pharmaceutical treatments, despite being widely used, often produce undesirable effects, such as irritation of the vaginal lining, alterations in vaginal pH, and disruption of healthy microbial flora. These challenges highlight the need for safer, natural alternatives rooted in traditional systems of medicine, such as Ayurveda.