Despite implementation of the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD), screening coverage for oral, breast and cervical cancers remains below 2%. Screening quality is inadequately addressed and delays in diagnosis and treatment initiation continue to persist. This multisite implementation research aims to improve district-level coverage and quality of screening, early diagnosis and timeliness of treatment initiation through a model co-developed within the NP-NCD context.

The study will be conducted in three phases across seven districts in diverse regions of India. In phase I (formative), the current status, barriers and facilitators of cancer screening, diagnosis and treatment initiation under NP-NCD will be assessed. In phase II (optimisation), a model (package of implementation strategies) will be co-developed and iteratively optimised with multistakeholder engagement at the subdistrict level to improve screening coverage and quality and strengthen the referral system for early diagnosis and treatment initiation. In phase III (scale-up and evaluation), the model will be implemented at the district level and evaluated for improvements in screening, early diagnosis and treatment initiation. A convergent mixed-methods design will be used, incorporating household surveys, facility assessments and stakeholder interviews. Implementation Research Logic Model will guide planning, execution and evaluation in the present study. Determinants of screening coverage and quality, early diagnosis and treatment initiation will be assessed using the Consolidated Framework for Implementation Research. Implementation strategies for the model will be finalised using the Expert Recommendations for Implementing Change framework. Implementation and service outcomes will be evaluated using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework.

Ethical approval has been obtained from all study sites. The study findings will be disseminated at the state, national and global levels through meetings and conferences and submitted to a peer-reviewed journal for publication.

CTRI/2025/08/092672.

The first year after childbirth is a critical yet insufficiently monitored period for parental health. Postpartum mental and physical morbidity can affect both mothers and co-parents, but national longitudinal data remain scarce. The Stress Of Co-parents Related to A Traumatic Experience of birth across Switzerland (SOCRATES) cohort study aims to describe maternal and co-parental health and well-being trajectories during the first year after childbirth.

SOCRATES is a prospective, population-based cohort study conducted in all linguistic regions of Switzerland. Eligible participants include women aged 14 and above who gave birth to a live or stillborn infant (≥22⁺⁰ weeks’ gestation and ≥500 g) and their cohabiting co-parents, provided they speak German, French, Italian or English. Recruitment was conducted in 81 of the 112 Swiss maternity units, birth centres and organisations of midwives over 6 weeks in spring 2025. Clinical data on pregnancy, childbirth and the early postpartum period are extracted from medical records. Postpartum hospitalisation data are obtained through linkage with national medico-administrative databases. Participants complete online questionnaires shortly after birth and at 2, 6 and 12 months post partum, including sociodemographic characteristics and patient-reported outcomes. The primary outcome is the prevalence of childbirth-related post-traumatic stress disorder at 2 months, assessed using the City Birth Trauma Scale. Secondary outcomes include depression, physical recovery, sexual health, quality of life, healthcare use, perceived care quality and overall well-being. A weighting procedure will be used to ensure representativeness and to account for attrition.

Ethical approval was granted by all seven Swiss ethics committees (number 2024-02262). All participants provided informed consent. Findings will be disseminated through national and international conferences, peer-reviewed publications, policy briefs, social media and stakeholder engagement activities.

NCT06886841.

The survival rate of patients with life-threatening diseases primarily depends on the speed of diagnosis. Too often, diseases are detected only after symptoms appear, which usually occurs at later stages of a disease when available treatments may be less effective. Current detection techniques primarily depend on identifying metabolites in biofluids such as blood and urine. The analysis of these fluids is typically performed in laboratories, resulting in lengthy waiting times for patients to receive their results. In severe cases, invasive biopsies and radiative methods are used to diagnose conditions such as cancer. These biopsies can cause distress for patients who are already experiencing significant emotional or physical stress, while imaging techniques involving ionising radiation may pose additional health risks. Additionally, these methods can be costly. In recent years, exhaled breath has become a biofluid matrix of interest for disease detection, allowing for the identification of volatile organic compounds (VOCs) or VOC profiles associated with specific conditions. To improve early disease detection through breath analysis, the VOCORDER project aims to develop a device that provides a fast, simple, user-friendly and cost-effective method for continuous health monitoring to identify diseases in their early stages before symptoms appear.

A literature review was initially conducted to identify five reference diseases of interest (lung cancer, stomach/colon cancer, breast cancer and kidney insufficiency) and previously reported VOC profiles associated with these diseases. In this trial, the project team from the MITERA Hospital will select patients, and the hospital staff will conduct personal interviews with these subjects. Each participant will also complete a questionnaire for the acquisition of demographic and medical history data, after being informed in detail about the purposes of the questionnaire and signing a consent form. The study protocol consists of two phases. Phase 1 is a baseline study designed to detect and identify breath biomarkers for the early diagnosis of the diseases mentioned above using gas chromatography-mass spectrometry (GC-MS) and secondary electrospray ionisation high-resolution mass spectrometry (SESI-HR-MS). Prescreening will select 120 healthy controls and 175 patients for the baseline phase of the clinical trial, for which breath samples will be collected in 1 L Supel-Inert Multi-Layer Foil gas sampling bags. New biomarkers and VOC profiles will be extracted from these data, and further statistical analysis will allow for artificial intelligence (AI) models to be produced and tested. For phase 2 (validation phase), 120 healthy controls and 100 patients will be selected. Breath samples will again be collected in 1 L gas sampling bags for analyses with GC-MS and SESI-HR-MS. The VOCORDER device will also be used, and its functioning with the newly developed AI models will be evaluated.

This clinical study has been approved by the scientific council at the MITERA hospital in Athens, Greece (#513/2024). The outcomes will be disseminated through peer-reviewed journal publications and presentations at scientific conferences.

NCT06711939.

Pain experienced during functional activities, referred to as movement-evoked pain (MEP), is a common and disabling symptom in individuals with knee osteoarthritis (KOA). Unlike pain at rest, MEP may better reflect the real-life burden of KOA and is increasingly recognised as a core outcome in musculoskeletal pain trials. However, its clinical utility remains limited by a lack of evidence on its measurement properties. This study aims to evaluate the test-retest reliability and validity of MEP assessments during functional tasks in individuals with KOA.

This study includes two components: (1) a test-retest reliability assessment conducted over two sessions separated by approximately 7 days and (2) a cross-sectional analysis of convergent validity. We will recruit 62 participants with symptomatic KOA from the local communities. MEP will be assessed using an 11-point Numeric Rating Scale during five standardised functional tasks: 30-Second Chair Stand Test, One-Step Stair Climb Test, 40m Fast-Paced Walk Test, Timed Up and Go Test and Six-Minute Walk Test. Test-retest reliability will be evaluated using intraclass correlation coefficients (ICC_3,1). Convergent validity will be assessed separately for each functional task by calculating correlation coefficients between MEP ratings and the pain subscale of the Knee injury and Osteoarthritis Outcome Score.

This study was approved by the Ethics Committee from Shanghai University of Sport (Ref: 102772025RT193). The study protocol was registered on the Open Science Framework (10.17605/OSF.IO/B9N7G). The findings will be disseminated through presentations at national and international scientific conferences and submitted for publication in a peer-reviewed journal.

The overall aim of the present project is to increase healthcare professionals’ ability to ask about exposure and to identify individuals exposed to intimate partner violence (IPV). The project will evaluate the effects of three different interventions that can be assumed to increase healthcare professionals’ ability to ask and identify individuals who have been or are exposed to IPV.

This project has a quasi-experimental design. After a 2-month baseline period, participating care units (primary health centres, maternal health clinics and youth guidance clinics) will be assigned to one of three interventions to potentially increase the ability to enquire and identify patient exposure to IPV: (1) healthcare professionals’ use of a standardised questionnaire about exposure to IPV in patient meetings, (2) training through the use of a virtual patient case tailored to health professionals and (3) a combination of (1) and (2) earlier. Preintervention (baseline) and postintervention measurements of the health professionals’ enquiry and identification of patients exposed to IPV will be used to explore the effect of the interventions. Focus group interviews with the participating health professionals will be used as a qualitative method, applying thematic analysis, to explore which intervention they perceive as most effective in increasing their ability to identify victims of IPV.

Data analysis will focus on a comparison of pre- and post-measurements regarding the number of patients asked about and identified patients in each intervention arm that have been or are exposed to IPV. Measurements will be carried out per care unit at the group level. Qualitative data from focus group interviews will be analysed using thematic analysis.

All participants will sign a written consent form and the study has been approved by the Swedish Ethical Review Authority (Dnr 2023-03399-01). The study will be conducted according to good clinical practice and the Declaration of Helsinki. The results of this study will increase knowledge about how identification of violence in close relationships can be improved in the clinical setting through publications in peer-reviewed journals and presentations at national and international scientific conferences.

Recruiting since May 2024. Expected trial termination December 2026.

NCT06322251.

Gender, sex and ethnicity-sensitive approaches to psychosocial interventions for behavioural and psychological symptoms of dementia have been under-represented in the literature. Although the initial findings have revealed relevant differences with regard to sex, gender and ethnicity-sensitive approaches to those interventions. The GenderDem study aims to identify the top-10 research priorities in this context for future dementia care research.

The methodological approach in GenderDem is based on the James Lind Alliance Guidebook and the concept of priority setting partnerships. In this participatory research approach, people living with dementia, their caregivers (and/or their loved ones) and healthcare professionals will be actively involved in the study. As members of a steering group, they act as coresearchers in the GenderDem study. We aim to recruit a diverse group of people for the steering group by considering different factors, eg, gender identity, sex, ethnicity and age. Future research priorities will be identified through two rounds of online surveys to collect and rank research topics from additional participants (eg, people with dementia, caregivers and/or loved ones and healthcare professionals). Additionally, a literature review and a workshop will be carried out in parallel to consider the current state of the research and to finalise the top-10 research priorities.

An ethics application for conducting the two surveys and the workshop for this study has been approved by the German Society of Nursing Science (No. 25-029). Study participants will be informed in detail about the voluntary nature of their participation. Together with the coresearchers from the steering group, we will develop a dissemination plan that considers the different media consumption forms of the various groups. Additionally, we will disseminate our project results on an ongoing basis.

This study aimed to develop prediction models for symptoms of poor mental health among Lebanese adults and adult Syrian refugees or migrants residing in a suburb of Beirut, Lebanon, separately.

Nested cross-sectional study.

Sin-El-Fil, a suburb east of Beirut, Lebanon.

Lebanese and Syrian adults residing in low socio-economic status areas of Sin-El-Fil.

Primary outcome was having depressive symptoms, ascertained through the Patient Health Questionnaire-9 where a total summative score of 10 or more indicated having depressive symptoms. Secondary outcome was having anxiety symptoms, ascertained through the Generalised Anxiety Disorder-7 where a total summative score of 10 or more indicated having anxiety symptoms.

Of 1986 participants, 1322 (66.5%) were Lebanese adults, 664 (33.5%) were Syrian refugees or migrants. Among Lebanese adults and adult Syrian refugees or migrants, 324 (25.3%) and 289 (43.9%) had depressive symptoms, respectively. Having pain that impacts usual activity, having debt, not feeling safe at home and having none or one person to count on in difficult times were common predictors of depressive and anxiety symptoms among Lebanese adults and Syrian refugees or migrants. Not having a legal residency permit was also a predictor of depressive symptoms for Syrian refugees or migrants. Prediction models developed for depressive and anxiety symptoms among both nationalities had good performance measures.

The predictors of poor mental health included financial, health and social indicators for both Lebanese adults and Syrian refugees or migrants during the concurrent crisis in Lebanon. These models are most applicable in similar urban, crisis-affected and low-resource settings. Findings emphasise the need for social protection and financial support among populations with vulnerabilities.

Chronic and life-limiting illnesses require coordinated care beyond hospital settings, with increasing emphasis on continuity of care in community and out-of-hospital environments. Respite care plays an important role in supporting both patients and caregivers; however, its delivery is often variable and lacks structured clinical guidance. While several frameworks exist to support chronic and palliative care, these have been primarily studied in broader care settings and have not been systematically examined within out-of-hospital respite care. This scoping review aims to map clinical guidance frameworks used in respite care, describe their components and implementation and identify reported patient-level, caregiver-level and system-level outcomes.

This scoping review will be conducted in accordance with Joanna Briggs Institute methodology and reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search will be undertaken across the electronic databases PubMed, Scopus, Embase, CINAHL, Web of Science, PsycINFO and Global Health, along with grey literature sources (ProQuest). Studies of any design including quantitative, qualitative, mixed-methods, implementation studies and service evaluations, published in English from database inception to 31 December 2025 will be included. Two reviewers will independently screen studies, extract data using a structured data-charting form and resolve discrepancies through discussion. Extracted data will be synthesised using descriptive mapping and thematic analysis. Findings will be integrated to identify gaps and implications for low and middle-income country settings.

Ethical approval is not required for this review, as it will use publicly available data. Findings will be disseminated through peer-reviewed publication, conference presentations and integration into the ongoing mixed-methods doctoral project.

Open Science Framework, osf.io/avyzp.

Behavioural and psychological symptoms of dementia (BPSD) affect up to 80% of people with dementia and pose significant challenges in the context of care. Psychosocial interventions have been recommended as first-line strategies, but the roles of aspects of sex, gender and ethnicity in this context remain underexplored. This umbrella review, which will be conducted as part of the GenderDem project, aims to synthesise existing reviews on psychosocial interventions for BPSD and to investigate the potential sex-, gender- and ethnicity-sensitive differences among them.

Our GenderDem project follows the methodology of the James Lind Alliance for Priority Setting Partnerships. As part of this approach, this participatory umbrella review actively involves people living with dementia, their caregivers and/or loved ones and healthcare professionals in examining the existing review literature.

Different types of reviews on this topic will be identified by reference to the databases MEDLINE (via PubMed), CINAHL (via EBSCO) and PsycInfo (via Ovid) databases. Two reviewers will independently screen titles, abstracts and full texts using Rayyan. Data will be extracted in line with the Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare: revised reporting guidelines, supplemented with items pertaining to gender, sex and ethnicity. The results will be summarised descriptively, and relevant intervention types (including whether sex/gender/ethnicity has been taken into consideration), the characteristics of the study populations, outcomes and research gaps will be highlighted.

Ethical approval is not required, as this umbrella review will include only data from published studies. The findings of this review will be disseminated through a publication in a peer-reviewed journal and conference presentations.

To document the first application of the WHO New Vaccine Introduction Prioritization and Sequencing Toolkit (NVI-PST) in the WHO Eastern Mediterranean Region and to describe how Iran’s National Immunization Technical Advisory Group (NITAG) adapted and implemented the framework to develop a prioritised roadmap for vaccine introduction during 2025–2030.

Policy implementation case study applying a structured multicriteria decision analysis-informed prioritisation framework through a three-phase process including framework adaptation, evidence synthesis, ordinal ranking of candidate vaccines, weighted aggregation and development of sequencing scenarios.

National immunisation governance process in Iran, coordinated by the Ministry of Health and Medical Education and Iran’s NITAG, with technical support from the WHO Country Office.

Core and non-core members of Iran’s NITAG and key immunisation stakeholders involved in the deliberative prioritisation process.

Human papillomavirus (HPV) vaccine ranked highest in both importance and feasibility, followed by pneumococcal conjugate vaccine (PCV) for high-risk adults and seasonal influenza vaccine for high-risk groups. Two sequencing scenarios were proposed: both placed HPV first, with either PCV or influenza third after the already-approved hexavalent vaccine. Respiratory syncytial virus (RSV) and varicella vaccines were classified as low priority for the 5-year horizon. The toolkit enabled structured multistakeholder deliberation, improved the transparency and reproducibility of prioritisation, and supported systematic integration of epidemiological, economic and programme evidence. The main implementation challenges arose from national evidence constraints, particularly gaps in adult RSV and pneumococcal disease burden, limited locally generated cost-effectiveness analyses and uncertainty in long-term budget impact estimation under macroeconomic instability, rather than from limitations of the toolkit itself.

The NVI-PST proved feasible under national leadership and generated credible, consensus-based recommendations aligned with Iran’s public health priorities and programme constraints. Minor refinements (streamlined evidence compendium, simpler weighting, stronger secretariat support) would make the toolkit lighter and more sustainable, especially for resource-constrained settings. This Iranian experience provides a replicable model for structured multi-vaccine prioritisation in the Eastern Mediterranean Region and beyond.

Colorectal cancer (CRC) is one of the most common cancers worldwide. Stage II/III patients undergo curative-intent surgery yet still face the recurrence risk. Detecting recurrences early provides the best opportunity for optimal treatment. We aimed to develop a microsimulation model to evaluate CRC management-associated outcomes based on current guidelines, including the performance of guideline-recommended surveillance in detecting recurrences.

Two separate individual-level state transition (microsimulation) models for colon and rectal cancer were built with a lifetime horizon using monthly cycles. The models integrated treatment and surveillance strategies per current guidelines.

The currently recommended surveillance modalities by National Comprehensive Cancer Network guidelines for surveilling patients with CRC after curative-intent surgery.

65-year-old patients with stage II and stage III CRC who underwent curative-intent surgery in the USA.

Cumulative recurrences, detected recurrences, detection rate, overall survival and recurrence-free survival in a 5-year horizon, as well as average life expectancy, were the outcome measures used.

Over 5 years, disease recurrence was observed in 9.5% of patients with stage II–III colon cancer and in 38.0% of patients with stage II–III rectal cancer. Of these, 82.5% and 85.5% were detected via surveillance, respectively, within 5 years. The predicted 5-year overall survival was 86.0% for colon cancer and 69.3% for rectal cancer, with corresponding recurrence-free survival rates of 78.9% and 53.8%. Based on current guidelines-recommended surveillance, detecting one colon cancer recurrence requires 148 carcinoembryonic antigen (CEA) tests, 37 CT scans and 21 colonoscopies. In contrast, detecting one rectal cancer recurrence requires 31 CEA tests, 8 CT scans and 4 colonoscopies.

Our validated model suggests that relative to an optimal benchmark in which all recurrences are detected, recurrence detection under current guidelines may be suboptimal, indicating room for improvement. As new tests emerge, this model could be a valuable tool for evaluating existing clinical practices and the potential of new tests to enhance patient outcomes.

Age acceleration in survivors of breast cancer is a critical issue because cancer and its treatment can increase structural and numerical chromosomal aberrations, while simultaneously shortening telomere length and changing ageing phenotype. Therefore, the current study will be using machine learning architectures to accurately predict the factors that contribute to age acceleration among survivors of breast cancer.

The Cancer Survivors’ Trajectories of Ageing Research (C*STAR) is a hospital-based cross-sectional study involving multi-ethnic Malaysian survivors of breast cancer and a non-breast cancer control group, frequency-matched by age group (±5 years), sex and ethnicity. The three main stages of this study will be conducted in the predictive model development. First, a set of validated questionnaires will be used to collect the data on modifiable factors of ageing phenotypes and behavioural determinants of health. Second, 3 mL non-fasting blood samples will be collected, and lymphocytes will be isolated to determine telomere length using real-time PCR as a biomarker of age acceleration. Lastly, a machine learning architecture will be deployed to identify modifiable factors that may contribute to age acceleration in survivors of breast cancer and controls, with these factors used as input and ageing biomarkers of telomere length as output. The study outcomes may serve as guidance to enhance the quality of life of survivors of breast cancer and hinder the recurrence of cancer while ageing successfully.

Ethical approval was obtained from the Research Ethics Committee, Universiti Kebangsaan Malaysia (JEP-2022-700) to carry out this study. Written informed consent will be obtained from each survivor of breast cancer and each cancer-free woman prior to participation. The results of this study will be published for future research and clinical applications.