Conectar
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.
To determine the predictors of pressure injuries among residents living in Sri Lankan nursing homes.
A prospective multi-site longitudinal cohort study design.
Semi-structured observations and chart audits were used to gather data on 17 predictors of pressure injury from a consecutive sample of 210 residents (aged ≥ 60 years old) from nine nursing homes in Sri Lanka. Data were collected at baseline and followed up every week until the study endpoint: a new pressure injury or reaching the maximum 12 weeks of data collection, from July to October 2023. Validated semi-structured data collection forms and chart audits were utilised. Binary logistic regression was used to identify the predictors of pressure injuries. Generalised linear mixed models were used to assess the association between predictors and the development of new pressure injuries.
The cumulative incidence of pressure injuries was 17.1% (36/210) during the 12 weeks. The number of medical devices and baseline pressure injuries predicted the development of new pressure injuries. Each additional medical device increased the likelihood of developing a pressure injury by 2.3-fold, and individuals with a baseline pressure injury were 2.1 times more likely to develop a new pressure injury.
Multiple medical devices and baseline pressure injuries are predictors of pressure injury in older residents living in nursing homes.
This study provides evidence of pressure injury predictors among older residents living in nursing homes. Early identification of high-risk residents with an existing pressure injury and those with multiple medical devices is important for nurses and managers at nursing homes. Accurately assessing residents' risk of a pressure injury may result in implementing various preventive strategies that may ultimately help prevent future pressure injuries.
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for cohort studies guidelines.
No patient or public contribution.
Preventing pressure injuries among nursing home residents is a significant challenge that necessitates understanding the barriers and facilitators from the perspective of staff. This qualitative study aimed to describe these factors within Sri Lankan nursing homes. Semi-structured interviews were conducted with 15 nursing home staff members from nine nursing homes in and near the Colombo district, Sri Lanka. The study was informed by the capability, opportunity, motivation, and behaviour model that guided both data collection and analysis. Data were analysed using content analysis. Using deductive coding based on capability, opportunity, and motivation, followed by inductive analysis, four primary categories emerged: focusing on skincare is foundational for pressure injury prevention, pressure injury knowledge is critical for prevention, pressure injury prevention is a low organisational priority, and overcoming challenges to enact pressure injury prevention. Key facilitators included access to skincare products, maintaining clean and dry skin, recognising risk factors, proactively managing risks, and understanding the broader implications of pressure injuries on residents and their families. Conversely, barriers encompassed limited training, varying staff support, inadequate resources, and the complexities of managing multiple tasks. This research highlights that enhancing knowledge and allocating resources effectively can improve the implementation of pressure injury prevention strategies in Sri Lankan nursing homes.
Imposter Phenomenon is characterised by persistent self-doubt despite objective success. It has been associated with anxiety, burnout and reduced job satisfaction. Little is known about imposter phenomenon’s presence and impact in Trauma and Orthopaedic surgery. This study aims to determine the prevalence and predictors of Imposter Phenomenon among UK orthopaedic surgeons, further mapping domains that affect leadership and professional development.
Cross-sectional survey using the validated Clance Imposter Phenomenon Scale (CIPS).
The survey was distributed to UK orthopaedic surgeons between 20 October 2023 and 28 February 2024 via Training Programme Directors and the British Orthopaedic Association.
Orthopaedic trainees and consultant surgeons (n=441)
Imposter Phenomenon severity measured using CIPS (mild: 41–60, moderate: 61–80 and severe: 81–100). Univariate and multivariate analyses identified predictors of this severity. Self-reported impact of Imposter Phenomenon assessed across personal and leadership domains.
92% of respondents reported moderate to intense Imposter Phenomenon symptoms (mean CIPS=65.17). Trainees had significantly higher mean scores (70.64±13.85) compared with consultants (59.82±15.71). Female surgeons reported significantly higher mean scores (72.57±13.35) than male surgeons (61.19±15.74). Female gender, non-consultant training grade and time out of training were predictors of severity (p
The Imposter Phenomenon is highly prevalent among UK orthopaedic surgeons; disproportionately affecting women, trainees and those taking career breaks. Imposter Phenomenon significantly impacts leadership aspirations and career development, potentially contributing to reduced diversity in surgical leadership. Targeted interventions addressing Imposter Phenomenon are needed to support equitable leadership development in Trauma and Orthopaedic surgery.
FreshRSS 