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Devoldere J, Droogmans S, Heggermont WA, Van Craenenbroeck E. Implementation of guideline-directed medical therapy for heart failure patients with reduced ejection fraction in Belgium: a Delphi panel approach. Acta Cardiol 2024:1-12. [PMID: 39254605 DOI: 10.1080/00015385.2024.2396767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/17/2024] [Accepted: 08/21/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND The 2021 European Society of Cardiology (ESC) guidelines recommended a shift from a traditional hierarchical treatment for heart failure with reduced ejection fraction (HFrEF) to a four-pillar medical therapy strategy intended for near-simultaneous initiation. However, practical guidance for implementation in clinical practice is lacking. To address this, a Delphi Panel of 12 Belgian heart failure experts aimed to obtain consensus on integrating guideline-directed medical therapy (GDMT) in HFrEF patients in Belgian clinical practice, considering local specificities, including reimbursement criteria. METHODS A geographically representative sample of 12 Belgian cardiologists engaged in a three-round Delphi process, evolving from 20 open-ended questions to 39 statements. A qualitative analysis after the first round resulted in expert statements for the subsequent questionnaire, categorised into treatment for newly diagnosed and chronic HFrEF patients. RESULTS The Delphi consensus revealed four key findings: (i) Agreement on initiating the four medical cornerstones within 7-14 days of HFrEF diagnosis, prioritising initiation over individual class up-titration; (ii) Lack of consensus on a fixed sequence for initiation due to patient variability and national reimbursement criteria; (iii) Emphasis on treatment adjustment based on the patient's clinical presentation and comorbidities; (iv) Recognition of the crucial role of regular follow-up visits, allowing optimisation of medical therapy where appropriate. CONCLUSION This national Delphi consensus addresses clinical implementation of GDMT in HFrEF patients for Belgian cardiologists. The consensus highlights the importance of swift implementation of the four cornerstone medical therapies in newly diagnosed HFrEF patients, individualising treatment sequencing, and ensuring regular follow-up to optimise therapy.
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Affiliation(s)
- Joke Devoldere
- Medical Affairs, BioPharmaceuticals, AstraZeneca, Groot-Bijgaarden, Belgium
| | - Steven Droogmans
- Department of Cardiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZB), Centrum voor Hart- en Vaatziekten (CHVZ), Brussels, Belgium
| | - Ward A Heggermont
- Cardiovascular Research Center, Hartcentrum OLV Aalst, Aalst, Belgium
| | - Emeline Van Craenenbroeck
- Research Group Cardiovascular Diseases, University of Antwerp, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium
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McInerney BE, Cross AJ, Alderman CP, Bhat R, Boyd CM, Brandt N, Cossette B, Desforges K, Dowd LA, Frank C, Hartikainen S, Herrmann N, Hilmer SN, Jack L, Jordan S, Kitamura CR, Koujiya E, Lampela P, Macfarlane S, Manias E, Martin C, Martínez-Velilla N, Moriarty F, Onder G, Quirke T, Silvius JL, Soulsby N, Stafford AC, Steinman MA, Sun W, Taguchi R, Todd A, Trenaman SC, Yap KZ, Zhao M, Bell JS, Turner JP. Top 10 Signs and Symptoms of Psychotropic Adverse Drug Events to Monitor in Residents of Long-Term Care Facilities. J Am Med Dir Assoc 2024; 25:105118. [PMID: 38950588 DOI: 10.1016/j.jamda.2024.105118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVES To produce a consensus list of the top 10 signs and symptoms suggestive of adverse drug events (ADEs) for monitoring in residents of long-term care facilities (LTCFs) who use antipsychotics, benzodiazepines, or antidepressants. DESIGN A 3-round Delphi study. SETTING AND PARTICIPANTS Geriatricians, psychiatrists, pharmacologists, general practitioners, pharmacists, nurses, and caregivers from 13 Asia Pacific, European, and North American countries. METHODS Three survey rounds were completed between April and June 2023. In Round 1, participants indicated their level of agreement on a 9-point Likert scale on whether 41 signs or symptoms identified in a systematic review should be routinely monitored. Participants considered signs and symptoms that reduce quality of life or cause significant harm, are observable or measurable by nurses or care workers, and can be assessed at a single time point. Round 1 statements were included in a list for prioritization in Round 3 if ≥ 70% of participants responded ≥7 on the Likert scale. Statements were excluded if ≤ 30% of participants responded ≥7. In Round 2, participants indicated their level of agreement with statements that did not reach initial consensus, plus amended statements based on Round 1 participant feedback. Round 2 statements were included in Round 3 if ≥ 50% of the participants responded ≥7 on the Likert scale. In Round 3, participants prioritized the signs and symptoms. RESULTS Forty-four participants (93.6%) completed all 3 rounds. Four of 41 signs and symptoms reached consensus for inclusion after Round 1, and 9 after Round 2. The top 10 signs and symptoms prioritized in Round 3 were recent falls, daytime drowsiness or sleepiness, abnormal movements (eg, shaking or stiffness), confusion or disorientation, balance problems, dizziness, postural hypotension, reduced self-care, restlessness, and dry mouth. CONCLUSIONS AND IMPLICATIONS The top 10 signs and symptoms provide a basis for proactive monitoring for psychotropic ADEs.
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Affiliation(s)
- Brigid E McInerney
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia.
| | - Amanda J Cross
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia
| | | | - Ravi Bhat
- Department of Rural Health, The University of Melbourne, Melbourne, Australia
| | - Cynthia M Boyd
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, MD, USA
| | - Nicole Brandt
- Lamy Center, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Benoit Cossette
- Faculte de medecine et des sciences de la sante, Universite de Sherbrooke, Canada
| | | | - Laura A Dowd
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia
| | - Chris Frank
- Department of Medicine, Queen's University, Kingston, Canada
| | - Sirpa Hartikainen
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | | | - Sarah N Hilmer
- Kolling Institute, Northern Sydney Local Health District and The University of Sydney, Sydney, Australia
| | - Leanne Jack
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Brisbane, Australia
| | - Sue Jordan
- Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales, United Kingdom
| | | | - Eriko Koujiya
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Pasi Lampela
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Stephen Macfarlane
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Elizabeth Manias
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Christine Martin
- Advocate and Caregiver for Relative in Residential Care, North Vancouver, British Columbia, Canada
| | - Nicolás Martínez-Velilla
- Navarre Health Service (SNS-O), Navarre University Hospital (HUN), Department of Geriatrics, Navarrabiomed, Navarre Public University (UPNA), Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Graziano Onder
- Department of Geriatrics, Università Cattolica del Sacro Cuore and Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - Tara Quirke
- Dementia Training Study Centre, University of Wollongong, Queensland, Australia
| | - James L Silvius
- Division of Geriatric Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Andrew C Stafford
- Curtin Medical School & enAble Institute, Curtin University, Perth, Australia
| | - Michael A Steinman
- Division of Geriatrics, University of California, San Francisco, CA, USA
| | - Winnie Sun
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Reina Taguchi
- Research Department, Institute for Health Economics and Policy, Tokyo, Japan
| | - Adam Todd
- School of Pharmacy, Newcastle University, Newcastle, United Kingdom
| | - Shanna C Trenaman
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Kai Zhen Yap
- Faculty of Science, Department of Pharmacy and Pharmaceutical Sciences, National University of Singapore, Singapore
| | - Meng Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - J Simon Bell
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia
| | - Justin P Turner
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia
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Ogundipe A, Sim TF, Emmerton L. Prescription for Digital Evolution: Transformative Recommendations for Pharmacy Practice in the Digital Age. J Pharm Pract 2024:8971900241277049. [PMID: 39209799 DOI: 10.1177/08971900241277049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Increased administrative tasks, evolving expectations of care and advancement in practice scope have rapidly advanced digital health. Health policy has acknowledged the need for evaluation to determine the technological needs of clinicians, including pharmacists, to practice to full and top of scope. There is an emergent need for recommendations to address the technological transformation to enable community pharmacists' practice. This study aimed to develop digital health recommendations, through expert consensus, for the government, pharmacy professional associations, pharmacy enterprises and software vendors, to facilitate community pharmacists' practice. A modified Delphi survey was conducted online in February-March 2024. Pharmacists with digital health expertise were purposively recruited. Participants were asked to rate their level of agreement with the initial 24 research-derived statements in round 1. Consensus was defined a priori as ≥80% of participants strongly agreeing or agreeing with a statement and a standard deviation of ≤1.00. Review of participants' free-text comments progressively reduced and refined the statements. All 22 participants completed the modified Delphi study in 3 survey rounds. Participants represented every Australian jurisdiction. Eighteen participants had more than 10 years of professional experience. Sixteen recommendations emerged: 6 for government, 2 for pharmacy professional associations, 4 for pharmacy enterprises and 4 for software vendors. The majority of recommendations require financial investment and harmonization of legislation across jurisdictions. Adoption of these recommendations, with significant investment across partners in the healthcare system and technology providers, will enable pharmacists to more effectively and safely practice utilizing technology solutions.
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Affiliation(s)
| | - Tin Fei Sim
- Curtin Medical School, Curtin University, Perth, Australia
| | - Lynne Emmerton
- Curtin Medical School, Curtin University, Perth, Australia
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Carl J, Mazzoli E, Mouton A, Sum RKW, Singh A, Niederberger M, Martins J, Kriellaars D, Green N, Elsborg P, Dudley DA, Cairney J, Barratt J, Barnett LM. Development of a Global Physical Literacy (GloPL) Action Framework: Study protocol for a consensus process. PLoS One 2024; 19:e0307000. [PMID: 39133681 PMCID: PMC11318864 DOI: 10.1371/journal.pone.0307000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/26/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND The holistic concept of physical literacy (PL) has gained growing attention in recent research, policy, and practice. Many important policy documents of the physical activity and educational fields (e.g., Global Action Plan on Physical Activity 2018-2030 by the World Health Organization, UNESCO's Quality Physical Education guidelines for policymakers) have specified PL. However, a clear framework for action is needed, as most initiatives across the world are fragmented, lack a prospective orientation, can benefit from conceptual clarification, and are not linked to effective translation into practice. Therefore, we aim to consensually develop a Global Physical Literacy (GloPL) Action Framework to define goals and principles (asking what is needed) as well as actions and ways (asking how these can be achieved) to move PL forward. MATERIALS AND METHODS We apply a three-stage group Delphi technique involving three representation groups: (a) geographical representatives to achieve global coverage of perspectives; (b) representatives of special thematic interest reflecting prominent gaps of current PL activities; and (c) representatives of societies from the broad field of physical activity and health to facilitate dissemination. The process will begin with an individual pre-Delphi exercise, in which experts generate initial ideas for the framework, followed by a four-eye document analysis to derive themes for the discussion. Subsequently, the experts will meet face-to-face in three online rounds to discuss and prioritize the themes. Interspersed formal voting with pre-defined agreement thresholds (via descriptive statistics) will inform the inclusion of themes within the final framework. CONCLUSIONS A global consensus on goals, principles, actions, and ways for the development of PL has the potential to provide a largely accepted roadmap for future activities in research, policy, and practice. The co-production approach will help disseminate the GloPL Action Framework and benefit work in relevant application fields of physical activity and health worldwide.
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Affiliation(s)
- Johannes Carl
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Emiliano Mazzoli
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Alexandre Mouton
- Department of Physical Activity and Rehabilitation Sciences, University of Liège, Liège, Belgium
| | - Raymond Kim-Wai Sum
- Department of Sports Science and Physical Education, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Amika Singh
- Mulier Instituut, Utrecht, The Netherlands
- Department of Movement, School & Sports, Windesheim University of Applied Sciences, Zwolle, The Netherlands
| | - Marlen Niederberger
- Department of Sports Science and Physical Education, University of Education, Schwäbisch Gmünd, Germany
| | - João Martins
- Centro de Estudos em Educação, Faculdade de Motricidade Humana e UIDEF, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Dean Kriellaars
- Department of Physical Therapy, University of Manitoba, Winnipeg, Canada
| | - Nigel Green
- International Physical Literacy Association, Wigan, England, United Kingdom
| | - Peter Elsborg
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Frederiksberg, Denmark
| | - Dean A. Dudley
- Macquarie School of Education, Macquarie University, North Ryde, New South Wales, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - John Cairney
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - Jaime Barratt
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
- Department of Educational Studies, Brock University, St. Catharines, Ontario, Canada
| | - Lisa M. Barnett
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
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Araújo-Neto FDC, Prado FO, Dosea AS, Fonseca FLD, Araújo DCSAD, Brito GDC, Mesquita AR, Lyra-Jr DPD. Assessment of Professionalism in Pharmacists and Pharmacy Students: Scoping Review of Instruments and Validity Evidence. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100733. [PMID: 38866371 DOI: 10.1016/j.ajpe.2024.100733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/31/2024] [Accepted: 06/02/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE To characterize which instruments have been developed to assess professionalism in the field of pharmacy. FINDINGS A scoping review was conducted to answer which instruments have been developed to assess professionalism in the field of Pharmacy. The databases consulted were EMBASE, ERIC, PUBMED/Medline, Scopus, and Web of Science. No restrictions on language or year of publication were made. Only studies about development or translation of instruments for professionalism assessment were included. The methodological quality of studies was verified by the Questionnaire Cross-Cultural Adaptation Guideline and the COnsensus-based Standards for the selection of health Measurement INstruments. Seven studies met the eligibility criteria and were included in this scoping review. In general, the instruments were developed from ideological elements assigned to professionalism by pharmaceutical and medical entities, in addition to theoretical references that came from social sciences. Regarding the evaluation of validation and psychometric property evidence, the studies generally adopted distinct procedures which highlights some destandardization, although the methodological quality was accepted. SUMMARY More studies on the professionalism field should be conducted to characterize professionalism and develop pharmaceutical practices in line with societal demands and expectations.
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Affiliation(s)
- Fernando de Castro Araújo-Neto
- Federal University of Sergipe, Graduate Program in Pharmaceutical Sciences, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), São Cristóvão, Sergipe, Brazil.
| | - Fernanda Oliveira Prado
- Federal University of Sergipe, Health Sciences Graduate Program, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), São Cristóvão, Sergipe, Brazil.
| | - Aline Santana Dosea
- Federal University of Sergipe, Health Sciences Graduate Program, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), São Cristóvão, Sergipe, Brazil.
| | - Francielly Lima da Fonseca
- Federal University of Sergipe, Graduate Program in Pharmaceutical Sciences, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), São Cristóvão, Sergipe, Brazil
| | - Dyego Carlos Souza Anacleto de Araújo
- Federal University of Espírito Santo, Department of Pharmaceutical Sciences, Laboratory for Innovation in Health Care, Vitória, Espírito Santo, Brazil.
| | - Giselle de Carvalho Brito
- Federal University of Sergipe, Laboratory of Studies in Pharmaceutical Care, Department of Pharmacy, Lagarto, Sergipe, Brazil.
| | - Alessandra Rezende Mesquita
- Federal University of Sergipe, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), São Cristóvão, Sergipe, Brazil.
| | - Divaldo Pereira de Lyra-Jr
- Federal University of Sergipe, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), São Cristóvão, Sergipe, Brazil.
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Carroll P, Smith É, Dervan A, McCarthy C, Woods I, Beirne C, Harte G, O'Flynn D, Quinlan J, O'Brien FJ, Flood M, Moriarty F. The Development of Principles for Patient and Public Involvement (PPI) in Preclinical Spinal Cord Research: A Modified Delphi Study. Health Expect 2024; 27:e14130. [PMID: 38962988 PMCID: PMC11222973 DOI: 10.1111/hex.14130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 06/07/2024] [Accepted: 06/19/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION There is currently limited guidance for researchers on Patient and Public Involvement (PPI) for preclinical spinal cord research, leading to uncertainty about design and implementation. This study aimed to develop evidence-informed principles to support preclinical spinal cord researchers to incorporate PPI into their research. METHODS This study used a modified Delphi method with the aim of establishing consensus on a set of principles for PPI in spinal cord research. Thirty-eight stakeholders including researchers, clinicians and people living with spinal cord injury took part in the expert panel. Participants were asked to rate their agreement with a series of statements relating to PPI in preclinical spinal cord research over two rounds. As part of Round 2, they were also asked to rate statements as essential or desirable. RESULTS Thirty-eight statements were included in Round 1, after which five statements were amended and two additional statements were added. After Round 2, consensus (> 75% agreement) was reached for a total of 27 principles, with 13 rated as essential and 14 rated as desirable. The principles with highest agreement related to diversity in representation among PPI contributors, clarity of the purpose of PPI and effective communication. CONCLUSION This research developed a previously unavailable set of evidence-informed principles to inform PPI in preclinical spinal cord research. These principles provide guidance for researchers seeking to conduct PPI in preclinical spinal cord research and may also inform PPI in other preclinical disciplines. PATIENT AND PUBLIC INVOLVEMENT STATEMENT This study was conducted as part of a project aiming to develop PPI in preclinical spinal cord injury research associated with an ongoing research collaboration funded by the Irish Rugby Football Union Charitable Trust (IRFU CT) and the Science Foundation Ireland Centre for Advanced Materials and BioEngineering Research (SFI AMBER), with research conducted by the Tissue Engineering Research Group (TERG) at the RCSI University of Medicine and Health Sciences. The project aims to develop an advanced biomaterials platform for spinal cord repair and includes a PPI Advisory Panel comprising researchers, clinicians and seriously injured rugby players to oversee the work of the project. PPI is included in this study through the involvement of members of the PPI Advisory Panel in the conceptualisation of this research, review of findings, identification of key points for discussion and preparation of the study manuscript as co-authors.
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Affiliation(s)
- Pádraig Carroll
- School of Pharmacy and Biomolecular ScienceRCSI University of Medicine and Health SciencesDublinIreland
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative MedicineRCSI University of Medicine and Health SciencesDublinIreland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD)RCSI University of Medicine and Health SciencesDublinIreland
| | | | - Adrian Dervan
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative MedicineRCSI University of Medicine and Health SciencesDublinIreland
| | - Ciarán McCarthy
- c/o Irish Rugby Football Union Charitable TrustDublinIreland
| | - Ian Woods
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative MedicineRCSI University of Medicine and Health SciencesDublinIreland
| | | | - Geoff Harte
- c/o Irish Rugby Football Union Charitable TrustDublinIreland
| | - Dónal O'Flynn
- c/o Irish Rugby Football Union Charitable TrustDublinIreland
| | - John Quinlan
- Tallaght University Hospital, TallaghtDublinIreland
| | - Fergal J. O'Brien
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative MedicineRCSI University of Medicine and Health SciencesDublinIreland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD)RCSI University of Medicine and Health SciencesDublinIreland
| | - Michelle Flood
- School of Pharmacy and Biomolecular ScienceRCSI University of Medicine and Health SciencesDublinIreland
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative MedicineRCSI University of Medicine and Health SciencesDublinIreland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD)RCSI University of Medicine and Health SciencesDublinIreland
- RCSI PPI Ignite Network Officepart of the National PPI Ignite Network based at the University of GalwayGalwayIreland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular ScienceRCSI University of Medicine and Health SciencesDublinIreland
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Araújo-Neto FDC, Dosea AS, Tavares TMA, Santos DDM, Mesquita AR, de Araújo DCSA, de Lyra-Jr DP. "Opportunities and responsibilities": how do pharmacists assess their professionalism? BMC MEDICAL EDUCATION 2024; 24:831. [PMID: 39090712 PMCID: PMC11295506 DOI: 10.1186/s12909-024-05767-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 07/11/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION Professionalism is fundamental to the existence of professions. In pharmacy, interest in this theme improved with events that examined the resocialization of pharmacists in care. With this, evaluating professionalism can help the operationalization of the theme and, consequently, the development of strategies for pharmacy consolidation before its challenges. Therefore, this study aimed to evaluate the professionalism of Brazilian pharmacists. METHODS To meet the objective, a cross-sectional study was conducted between March 2022 and August 2023. Data were collected using the Brazilian version of the "Modification of Hall's Professionalism Scale for Use with Pharmacists". The scale has 39 items grouped into the domains: autonomy, vocation, professional council, self-regulation, continuing education, and altruism. Data were analyzed using descriptive statistics and an ANOVA analysis of variance with post-hoc Hochberg or Games-Howell tests with Bootstrapping was conducted to verify differences between groups. RESULTS 600 pharmacists participated in this study. The majority (69%) was female and carried out their professional activities in community pharmacies (50%). Professionalism scores ranged between 14 and 29 points, with an average of 22.8 points. Pharmacists working in outpatient clinics had higher scores in most factors, namely, altruism, continuing education, professional council, vocation, and autonomy. This indicates that the inclination of pharmacists to occupy areas focused on care can be significant to assess professionalism. CONCLUSIONS The data obtained indicate that pharmacists working in outpatient clinics had higher professionalism scores compared to others. This corroborates the worldwide trend experienced by pharmacy in recent decades, which is the execution of increasingly patient-centered practice models.
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Affiliation(s)
- Fernando de Castro Araújo-Neto
- Health Sciences Graduate Program, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil.
| | - Aline Santana Dosea
- Health Sciences Graduate Program, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Thaís Maria Araújo Tavares
- Graduate Program in Pharmaceutical Sciences, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Douglas de Menezes Santos
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Alessandra Rezende Mesquita
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Dyego Carlos Souza Anacleto de Araújo
- Department of Pharmaceutical Sciences, Laboratory of Innovation in Pharmaceutical Care, Federal University of Espírito Santo - Maruípe Campus, Vitória, Espírito Santo, Brazil
| | - Divaldo Pereira de Lyra-Jr
- Health Sciences Graduate Program, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil.
- Department of Pharmacy, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Sergipe, CEP: 49100-000, Brazil.
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Slade K, Jowett S, Rhind D. Developing guidelines for selection-deselection in high performance sport for athletes, coaches, and organisations: A delphi study. J Sports Sci 2024; 42:1209-1223. [PMID: 39120476 DOI: 10.1080/02640414.2024.2387968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/27/2024] [Indexed: 08/10/2024]
Abstract
The process of athlete selection and deselection in sport involves not only athletes but also coaches, managers, performance directors, talent pathway coordinators and the wider organisation. Athlete selection and deselection can be viewed as the opposite sides of the same coin in that the process may be the same for all athletes but the outcome is very different. The outcome of this process can evoke extremely powerful emotions ranging from elevation to devastation. While selection and deselection are part of competitive sport regardless of type, level, gender or age, research is scarce. Employing the Delphi method, a total of 20 participants comprised the expert panel (coaches, athletes and other key personnel in high performance) from various sports, and ages ranged from 21 to 59 years old. Following three rounds, 60 items reached the pre-determined consensus level of 75%. The 60 items were then further content analysed and grouped with respect to the three key stakeholders: athlete (14), coach (21) and organisation (25). Within each of these categories, subcategories emerged: personal, interpersonal, procedural, educational, supportive, communicative and reviewing behaviours and actions that athletes, coaches and organisations can take to ease the navigation, apply consistency and establish a common ground during this challenging situation.
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Affiliation(s)
- Katelynn Slade
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Sophia Jowett
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Daniel Rhind
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Ruscitti P, Allanore Y, Baldini C, Barilaro G, Bartoloni Bocci E, Bearzi P, Bellis E, Berardicurti O, Biaggi A, Bombardieri M, Cantarini L, Cantatore FP, Caporali R, Caso F, Cervera R, Ciccia F, Cipriani P, Chatzis L, Colafrancesco S, Conti F, Corberi E, Costa L, Currado D, Cutolo M, D'Angelo S, Del Galdo F, Di Cola I, Di Donato S, Distler O, D'Onofrio B, Doria A, Fautrel B, Fasano S, Feist E, Fisher BA, Gabini M, Gandolfo S, Gatto M, Genovali I, Gerli R, Grembiale RD, Guggino G, Hoffmann-Vold AM, Iagnocco A, Iaquinta FS, Liakouli V, Manoussakis MN, Marino A, Mauro D, Montecucco C, Mosca M, Naty S, Navarini L, Occhialini D, Orefice V, Perosa F, Perricone C, Pilato A, Pitzalis C, Pontarini E, Prete M, Priori R, Rivellese F, Sarzi-Puttini P, Scarpa R, Sebastiani G, Selmi C, Shoenfeld Y, Triolo G, Trunfio F, Yan Q, Tzioufas AG, Giacomelli R. Tailoring the treatment of inflammatory rheumatic diseases by a better stratification and characterization of the clinical patient heterogeneity. Findings from a systematic literature review and experts' consensus. Autoimmun Rev 2024; 23:103581. [PMID: 39069240 DOI: 10.1016/j.autrev.2024.103581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 07/23/2024] [Indexed: 07/30/2024]
Abstract
Inflammatory rheumatic diseases are different pathologic conditions associated with a deregulated immune response, codified along a spectrum of disorders, with autoinflammatory and autoimmune diseases as two-end phenotypes of this continuum. Despite pathogenic differences, inflammatory rheumatic diseases are commonly managed with a limited number of immunosuppressive drugs, sometimes with partial evidence or transferring physicians' knowledge in different patients. In addition, several randomized clinical trials, enrolling these patients, did not meet the primary pre-established outcomes and these findings could be linked to the underlying molecular diversities along the spectrum of inflammatory rheumatic disorders. In fact, the resulting patient heterogeneity may be driven by differences in underlying molecular pathology also resulting in variable responses to immunosuppressive drugs. Thus, the identification of different clinical subsets may possibly overcome the major obstacles that limit the development more effective therapeutic strategies for these patients with inflammatory rheumatic diseases. This clinical heterogeneity could require a diverse therapeutic management to improve patient outcomes and increase the frequency of clinical remission. Therefore, the importance of better patient stratification and characterization is increasingly pointed out according to the precision medicine principles, also suggesting a new approach for disease treatment. In fact, based on a better proposed patient profiling, clinicians could more appropriately balance the therapeutic management. On these bases, we synthetized and discussed the available literature about the patient profiling in regard to therapy in the context of inflammatory rheumatic diseases, mainly focusing on randomized clinical trials. We provided an overview of the importance of a better stratification and characterization of the clinical heterogeneity of patients with inflammatory rheumatic diseases identifying this point as crucial in improving the management of these patients.
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Affiliation(s)
- Piero Ruscitti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Yannick Allanore
- Rheumatology Department, Cochin Hospital, APHP, INSERM U1016, Université Paris Cité, Paris, France
| | - Chiara Baldini
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Barilaro
- Department of Autoimmune Diseases, Reference Centre for Systemic Autoimmune Diseases, Vasculitis and Autoinflammatory Diseases of the Catalan and Spanish Health Systems, Member of ERN-ReCONNET/RITA, Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain
| | - Elena Bartoloni Bocci
- Section of Rheumatology, Department of Medicine and Surgery, University of Perugia, Italy
| | - Pietro Bearzi
- Rheumatology and Clinical Immunology, Department of Medicine, School of Medicine, University of Rome "Campus Bio-Medico", 00128 Rome, Italy; Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Elisa Bellis
- Academic Rheumatology Centre, Dipartimento di Scienze Cliniche e Biologiche Università di Torino - AO Mauriziano di Torino, Turin, Italy
| | - Onorina Berardicurti
- Rheumatology and Clinical Immunology, Department of Medicine, School of Medicine, University of Rome "Campus Bio-Medico", 00128 Rome, Italy; Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Alice Biaggi
- Rheumatology and Clinical Immunology, Department of Medicine, School of Medicine, University of Rome "Campus Bio-Medico", 00128 Rome, Italy; Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Michele Bombardieri
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC & NHS Trust & National Institute for Health and Care Research (NIHR) Barts Biomedical Research Centre (BRC), London, UK
| | - Luca Cantarini
- Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, University of Siena, Siena, Italy; Azienda Ospedaliero-Universitaria Senese [European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA) Center] Siena, Italy
| | - Francesco Paolo Cantatore
- Rheumatology Clinic, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Roberto Caporali
- Department of Clinical Sciences and Community Health, University of Milan, Paediatric Rheumatology Unit, and Clinical Rheumatology Unit, ASST Pini-CTO, Milan, Italy
| | - Francesco Caso
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Ricard Cervera
- Department of Autoimmune Diseases, Reference Centre for Systemic Autoimmune Diseases, Vasculitis and Autoinflammatory Diseases of the Catalan and Spanish Health Systems, Member of ERN-ReCONNET/RITA, Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain
| | - Francesco Ciccia
- Rheumatology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paola Cipriani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Loukas Chatzis
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Serena Colafrancesco
- Department of Internal Medicine and Medical Specialties, Rheumatology Unit, Sapienza University of Rome, Viale del Policlinico 155, 00185 Rome, Italy
| | - Fabrizio Conti
- Department of Internal Medicine and Medical Specialties, Rheumatology Unit, Sapienza University of Rome, Viale del Policlinico 155, 00185 Rome, Italy
| | - Erika Corberi
- Rheumatology and Clinical Immunology, Department of Medicine, School of Medicine, University of Rome "Campus Bio-Medico", 00128 Rome, Italy; Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Luisa Costa
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Damiano Currado
- Rheumatology and Clinical Immunology, Department of Medicine, School of Medicine, University of Rome "Campus Bio-Medico", 00128 Rome, Italy; Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Maurizio Cutolo
- Laboratory of Experimental Rheumatology and Academic Division of Rheumatology, Department of Internal Medicine and Specialties, University of Genova Italy, IRCCS Polyclinic Hospital, Genova, Italy
| | - Salvatore D'Angelo
- Rheumatology Depatment of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Italy
| | - Francesco Del Galdo
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Ilenia Di Cola
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Stefano Di Donato
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bernardo D'Onofrio
- Department of Internal Medicine and Therapeutics, Università di Pavia, Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Doria
- Rheumatology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Bruno Fautrel
- Sorbonne Université - Assistance Publique Hôpitaux de Paris, INSERM UMRS 1136, Hôpital de La Pitié Salpêtrière, Paris, France
| | - Serena Fasano
- Rheumatology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Eugen Feist
- Department of Rheumatology, Helios Fachklinik, Sophie-von-Boetticher-Straße 1, 39245, Vogelsang-Gommern, Germany; Charité - Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Berlin, Germany
| | - Benjamin A Fisher
- Institute of Inflammation and Ageing, University Hospitals Birmingham, Birmingham, UK; Department of Rheumatology, National Institute for Health Research (NIHR), Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Marco Gabini
- Rheumatology Unit, Santo Spirito Hospital, Pescara, Italy
| | - Saviana Gandolfo
- Unit of Rheumatology, San Giovanni Bosco Hospital, Naples, Italy
| | - Mariele Gatto
- Academic Rheumatology Centre, Dipartimento di Scienze Cliniche e Biologiche Università di Torino - AO Mauriziano di Torino, Turin, Italy
| | - Irene Genovali
- Rheumatology and Clinical Immunology, Department of Medicine, School of Medicine, University of Rome "Campus Bio-Medico", 00128 Rome, Italy; Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Roberto Gerli
- Section of Rheumatology, Department of Medicine and Surgery, University of Perugia, Italy
| | - Rosa Daniela Grembiale
- Rheumatology Research Unit, Dipartimento di Scienze della Salute, Università degli studi "Magna Graecia" di Catanzaro, Catanzaro, Italy
| | - Giuliana Guggino
- Rheumatology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy
| | - Anna Maria Hoffmann-Vold
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Rheumatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Annamaria Iagnocco
- Academic Rheumatology Centre, Dipartimento di Scienze Cliniche e Biologiche Università di Torino - AO Mauriziano di Torino, Turin, Italy
| | - Francesco Salvatore Iaquinta
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC & NHS Trust & National Institute for Health and Care Research (NIHR) Barts Biomedical Research Centre (BRC), London, UK
| | - Vasiliki Liakouli
- Rheumatology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Menelaos N Manoussakis
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Annalisa Marino
- Rheumatology and Clinical Immunology, Department of Medicine, School of Medicine, University of Rome "Campus Bio-Medico", 00128 Rome, Italy; Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Daniele Mauro
- Rheumatology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Carlomaurizio Montecucco
- Department of Internal Medicine and Therapeutics, Università di Pavia, Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marta Mosca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Saverio Naty
- Department of Health Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Luca Navarini
- Rheumatology and Clinical Immunology, Department of Medicine, School of Medicine, University of Rome "Campus Bio-Medico", 00128 Rome, Italy; Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Daniele Occhialini
- Rheumatic and Systemic Autoimmune Diseases Unit, Department of Interdisciplinary Medicine (DIM), University of Bari Medical School, Italy
| | - Valeria Orefice
- Rheumatology Unit, San Camillo-Forlanini Hospital, Rome, Italy
| | - Federico Perosa
- Rheumatic and Systemic Autoimmune Diseases Unit, Department of Interdisciplinary Medicine (DIM), University of Bari Medical School, Italy
| | - Carlo Perricone
- Section of Rheumatology, Department of Medicine and Surgery, University of Perugia, Italy
| | - Andrea Pilato
- Rheumatology and Clinical Immunology, Department of Medicine, School of Medicine, University of Rome "Campus Bio-Medico", 00128 Rome, Italy; Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Costantino Pitzalis
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC & NHS Trust & National Institute for Health and Care Research (NIHR) Barts Biomedical Research Centre (BRC), London, UK; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Elena Pontarini
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC & NHS Trust & National Institute for Health and Care Research (NIHR) Barts Biomedical Research Centre (BRC), London, UK
| | - Marcella Prete
- Rheumatic and Systemic Autoimmune Diseases Unit, Department of Interdisciplinary Medicine (DIM), University of Bari Medical School, Italy
| | - Roberta Priori
- Department of Internal Medicine and Medical Specialties, Rheumatology Unit, Sapienza University of Rome, Viale del Policlinico 155, 00185 Rome, Italy
| | - Felice Rivellese
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC & NHS Trust & National Institute for Health and Care Research (NIHR) Barts Biomedical Research Centre (BRC), London, UK
| | - Piercarlo Sarzi-Puttini
- Rheumatology Department, ASST Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Raffaele Scarpa
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | | | - Carlo Selmi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Yehuda Shoenfeld
- Zabludovwicz autoimmunity center, Sheba medical center, Tel Hashomer Israel, Reichman University, Herzeliya, Israel
| | - Giovanni Triolo
- Rheumatology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy
| | - Francesca Trunfio
- Rheumatology and Clinical Immunology, Department of Medicine, School of Medicine, University of Rome "Campus Bio-Medico", 00128 Rome, Italy; Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Qingran Yan
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Athanasios G Tzioufas
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Roberto Giacomelli
- Rheumatology and Clinical Immunology, Department of Medicine, School of Medicine, University of Rome "Campus Bio-Medico", 00128 Rome, Italy; Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
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Aly M, Schneider CR, Sukkar MB, Lucas C. Development of an adaptation framework to implement a new professional pharmacy service (PPS) to a new environment. Res Social Adm Pharm 2024; 20:165-169. [PMID: 38438294 DOI: 10.1016/j.sapharm.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 03/06/2024]
Abstract
The effective provision of professional pharmacy services is critical to support the delivery of primary health care. Structured frameworks and theoretical strategies are required to facilitate successful service implementation processes, outcomes and sustainability. This commentary discusses the considerations of what framework (adoption versus adaptation) would be suitable when implementing a new professional pharmacy service to a new environment. Utilizing Minor Ailments Services (MASs) as an exemplar as a professional pharmacy service case study, the research that underpinned these considerations enabled the development of a sequential, phased framework. There is the potential to utilize this framework for future evolving professional pharmacy services in the new setting.
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Affiliation(s)
- Mariyam Aly
- Pharmaceutical Society of Australia, 32 Ridge St, North Sydney, New South Wales, Australia, 2060.
| | - Carl R Schneider
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Sydney New South Wales, Australia.
| | - Maria B Sukkar
- The University of Technology Sydney, School of Life Sciences, Faculty of Science, 15 Broadway, Ultimo, NSW, 2007, Australia.
| | - Cherie Lucas
- The University of Technology Sydney, Faculty of Health, 15 Broadway, Ultimo, NSW, 2007, Australia; University of NSW (UNSW) Sydney, School of Population Health, Faculty of Medicine and Health, Sydney, NSW, Australia.
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Muirhead R, Kynoch K, Peacock A, Birch P, Lewis PA. Developing a model of neonatal nurse-controlled analgesia: A Delphi study. J Adv Nurs 2024; 80:2429-2438. [PMID: 37983737 DOI: 10.1111/jan.15972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 10/28/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Abstract
AIM To develop a nurse-led model of analgesia to manage post-operative pain in the surgical neonate. DESIGN A four-round e-Delphi study was conducted from March to December 2022. METHODS An e-Delphi method was used seeking a consensus of 70% or greater. Fifty-one experts were invited to join the panel. Members consisted of multi-disciplinary healthcare professionals who work in areas associated with neonatal care. In round 1, 49 statements relative to neonatal pain assessment and management were distributed to the panel. Panel members were asked to rate their level of agreeance on a Likert scale from 1 to 5 (1 = strongly disagree to 5 = strongly agree). Ratings equal to or greater than 4 represented agreement, 3 indicated uncertainty and 2 or less disagreement with the proposed statement. An opportunity for free-text responses after each statement was provided. This iterative process continued for three rounds. In the fourth and final round, the completed model of neonatal nurse-controlled analgesia was presented along with a further opportunity to provide feedback on the final version. RESULTS Four rounds of statements and voting were required to reach consensus on a model of neonatal nurse-controlled analgesia. The model consists of criteria for use, over-arching guidelines and three separate pathways based on an individual baby's pain assessment scores, need for pain relieving interventions and time-lapsed post-surgical procedure. CONCLUSION A comprehensive model of neonatal nurse-controlled analgesia, applicable to the Australasian context, was developed in collaboration with a group of neonatal experts. IMPACT This study provides a multi-modal family-integrated model to manage neonatal post-operative pain. By providing nurses with increased autonomy to assess and manage acute pain, this model has the potential to not only provide a more responsive and individualized approach to alleviate discomfort, but highlights the integral role of parent partnerships in the neonatal intensive care. REPORTING METHOD This study was reported in line with the Conducting and REporting of DElphi studies (CREDE) guidance on Delphi studies. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was utilized for this study.
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Affiliation(s)
- Renee Muirhead
- Neonatal Critical Care Unit, Mater Health, South Brisbane, Queensland, Australia
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
| | - Kathryn Kynoch
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
- Mater Health and Queensland Centre for Evidence Based Nursing and Midwifery: A JBI Centre of Excellence, Newstead, Queensland, Australia
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Ann Peacock
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
| | - Pita Birch
- Neonatal Critical Care Unit, Mater Health, South Brisbane, Queensland, Australia
| | - Peter A Lewis
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
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Brady K, Cleary R, O'Gorman E, McDonough S, Kerr C, Kiernan D, McConkey E, Ryan J, Malone A. Identifying the top 10 priorities of adolescents with a physical disability regarding participation in physical activity: A Delphi study. Dev Med Child Neurol 2024. [PMID: 38815177 DOI: 10.1111/dmcn.15986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/03/2024] [Accepted: 05/10/2024] [Indexed: 06/01/2024]
Abstract
AIM To establish consensus among adolescents with a physical disability regarding their priorities for enhancing participation in physical activity and help inform the design of future interventions for participation in physical activity. METHOD We conducted a national multi-round Delphi study involving adolescents with a physical disability aged 13 to 17 years. Round 1 of the initial survey consisted of open-ended questions. Free-text responses were then analysed thematically, creating items categorized according to the family of participation-related constructs (fPRC). In round 2, participants rated the perceived importance of these items using a 5-point Likert scale. The top 10 priorities were constructed from the highest-ranked items. RESULTS One hundred and sixteen participants (mean age = 14 years 7 months, range = 13-17 years; 66 males; 58 with cerebral palsy; 43 wheelchair users) completed round 1; 108 items were included in round 2. Fifty-eight items were rated as either 'important' or 'really important' by 70% of participants. The top 10 priorities were rated as important or really important by 82% to 94% of participants with a mean Likert score of 4.40 (range = 4.25-4.63). Seven of the top 10 priorities were related to the environmental context of the fPRC. The other three were related to involvement and the related concept of preference. INTERPRETATION The priorities identified will help inform future physical activity interventions for adolescents with a physical disability.
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Affiliation(s)
- Karen Brady
- Central Remedial Clinic, Dublin, Ireland
- CP-Life Research Centre, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Ronan Cleary
- School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Suzanne McDonough
- School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Kerr
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | | | - Jennifer Ryan
- CP-Life Research Centre, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Ailish Malone
- CP-Life Research Centre, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
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Petsani D, Santonen T, Merino-Barbancho B, Epelde G, Bamidis P, Konstantinidis E. Categorizing digital data collection and intervention tools in health and wellbeing living lab settings: A modified Delphi study. Int J Med Inform 2024; 185:105408. [PMID: 38492408 DOI: 10.1016/j.ijmedinf.2024.105408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Health and Wellbeing Living Labs are a valuable research infrastructure for exploring innovative solutions to tackle complex healthcare challenges and promote overall wellbeing. A knowledge gap exists in categorizing and understanding the types of ICT tools and technical devices employed by Living Labs. AIM Define a comprehensive taxonomy that effectively categorizes and organizes the digital data collection and intervention tools employed in Health and Wellbeing Living Lab research studies. METHODS A modified consensus-seeking Delphi study was conducted, starting with a pre-study involving a survey and semistructured interviews (N=30) to gather information on existing equipment. The follow-up three Delphi rounds with a panel of living lab experts (R1 N=18, R2 - 3 N=15) from 10 different countries focused on achieving consensus on the category definitions, ease of reading, and included subitems for each category. Due to the controversial results in the 2nd round of qualitative feedback, an online workshop was organized to clarify the contradictory issues. RESULTS The resulting taxonomy included 52 subitems, which were divided into three levels as follows: The first level consists of 'devices for data monitoring and collection' and 'technologies for intervention.' At the second level, the 'data monitoring and collection' category is further divided into 'environmental' and 'human' monitoring. The latter includes the following third-level categories: 'biometrics,' 'activity and behavioral monitoring,' 'cognitive ability and mental processes,' 'electrical biosignals and physiological monitoring measures,' '(primary) vital signs,' and 'body size and composition.' At the second level, 'technologies for intervention' consists of 'assistive technology,' 'extended reality - XR (VR & AR),' and 'serious games' categories. CONCLUSION A common language and standardized terminology are established to enable effective communication with living labs and their customers. The taxonomy opens a roadmap for further studies to map related devices based on their functionality, features, target populations, and intended outcomes, fostering collaboration and enhancing data capture and exploitation.
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Affiliation(s)
- Despoina Petsani
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | | | | | - Gorka Epelde
- Digital Health and Biomedical Technologies, Vicomtech Foundation, Basque Research and Technology Alliance (BRTA), Donostia-San Sebastián, Spain; eHealth Group, Biogipuzkoa Health Research Institute, Donostia-San Sebastian, Spain
| | - Panagiotis Bamidis
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evdokimos Konstantinidis
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; European Network of Living Labs, Brussels, Belgium
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Ramaswamy V, Danciu T, Kennedy EN, Romito L, Stewart D, Gul G, Marucha P, Quinonez RB. American Dental Education Association Compendium Entrustable Professional Activities Workgroup report. J Dent Educ 2024; 88:639-653. [PMID: 38693898 DOI: 10.1002/jdd.13542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE Entrustable professional activities (EPAs) are discrete clinical tasks that can be evaluated to help define readiness for independent practice in the health professions and are intended to increase trust in the dental graduate. EPAs provide a framework that bridges competencies to clinical practice. This report describes the work of the American Dental Education Association (ADEA) Compendium EPA Workgroup to develop a list of EPAs for dental education and supportive resources, including specifications and a glossary. METHODS Preliminary work including literature and resource review, mapping of existing competencies, and review of other health professions' EPAs informed the development of our EPAs list. Workgroup members achieved consensus using a modified Delphi process. A Qualtrics survey using a validated rubric for the assessment of EPAs as described in peer-reviewed literature was used. Dental educators, including academic deans, were surveyed for feedback on the content and format of the EPAs. RESULTS Based on findings in the literature analysis of existing EPAs and competencies in health professions, a list of EPAs was developed along with a description of specifications. The EPA workgroup (nine members from multiple institutions) used the Delphi process in receiving feedback from various experts. A list of 11 core EPAs was vetted by dental educators including academic deans (n = ∼23), and the process of development was reviewed by EPAs experts outside dental education. A glossary was developed to align language. CONCLUSION These EPAs define the scope of dental practice. This report represents Phase 1 of the EPA framework development and vetting process. Future directions will include a broader vetting of the EPA list, faculty development, and national standardized technology that support this work to optimize implementation.
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Affiliation(s)
- Vidya Ramaswamy
- Director for Curriculum Evaluation and Promotion of Teaching and Learning at the University of Michigan, School of Dentistry, Ann Arbor, Michigan, USA
| | - Theodora Danciu
- Clinical Professor and Director of Engaged Learning and Assessment at the University of Michigan, School of Dentistry, Ann Arbor, Michigan, USA
| | - Erinne N Kennedy
- Assistant Professor and Assistant Dean for Curriculum and Integrated Learning at Kansas City University College of Dental Medicine, Joplin, Missouri, USA
| | - Laura Romito
- Professor and Associate Dean of Education and Academic Affairs at the Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Denice Stewart
- Adjunct Professor at the University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, North Carolina, USA
| | - Gulsun Gul
- Chief of Innovation, Clinical Education & Public Health at the American Dental Education Association, Washington, District of Columbia, USA
| | - Phillip Marucha
- Co-Chair, ADEA EPA group; Professor, Oregon Health & Science University School of Dentistry, Portland, Oregon, USA
| | - Rocio B Quinonez
- Co-Chair, ADEA EPA group; Professor and Associate Dean for Curriculum, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, North Carolina, USA
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Ling Ting T, Chou MC, Chen SC. Infectious Disease Specialists Affecting the Delphi Consensus Document on Infective Native Aortic Aneurysms. Eur J Vasc Endovasc Surg 2024; 67:860. [PMID: 38182105 DOI: 10.1016/j.ejvs.2024.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 12/20/2023] [Accepted: 01/02/2024] [Indexed: 01/07/2024]
Affiliation(s)
- Tsai Ling Ting
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan; Institute of Nursing, Chung Shan Medical University, Taichung, Taiwan
| | - Ming-Chih Chou
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shiuan-Chih Chen
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
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16
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Montesanti S, Sehgal A, Zaeem L, McManus C, Squires S, Silverstone P. Assessing primary health care provider and organization readiness to address family violence in Alberta, Canada: development of a Delphi consensus readiness tool. BMC PRIMARY CARE 2024; 25:146. [PMID: 38684969 PMCID: PMC11059610 DOI: 10.1186/s12875-024-02396-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Family violence, which includes intimate partner abuse, child abuse, and elder abuse, is a serious public health concern. Primary healthcare (PHC) offers a vital opportunity to identify and address family violence, yet barriers prevent the effective implementation of family violence interventions in PHC settings. The purpose of this study is to improve family violence identification and response in Alberta's PHC settings by exploring readiness factors. METHODS An integrated knowledge translation approach, combining implementation science and participatory action research, was employed to develop a readiness assessment tool for addressing family violence within PHC settings in Alberta. The research involved three phases: phase 1 involved a rapid evidence assessment, phase 2 engaged a panel of healthcare and family violence experts to explore readiness components in the Alberta context, and phase 3 utilized a 3-round Delphi consensus-building process to refine readiness indicators. RESULTS Phase 1 findings from a rapid evidence assessment highlighted five main models/tools for assessing readiness to implement family violence interventions in PHC settings. In phase 2, additional concepts were identified through exploration with healthcare and family violence expert panel members, resulting in a total of 16 concepts for assessing family violence readiness within the Alberta PHC context. The 3-round Delphi consensus-building process in Phase 3 involved nine panelists, who collectively agreed on the inclusion of all concepts and indicators, yielding a total of 60 items for the proposed readiness assessment tool for addressing family violence in PHC within Alberta. CONCLUSION The current study lays the groundwork for future family violence intervention programs, offering insights into key components that promote readiness for implementing comprehensive programs and supporting PHC organizations in effectively addressing family violence.
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Affiliation(s)
- Stephanie Montesanti
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
- Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada.
| | - Anika Sehgal
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lubna Zaeem
- Islamic Family and Social Services Association, Edmonton, AB, Canada
| | - Carrie McManus
- Sagesse Domestic Violence Prevention Society, Calgary, AB, Canada
| | - Suzanne Squires
- Westgrove Clinic, Westview Primary Care Network, Spruce Grove, AB, Canada
| | - Peter Silverstone
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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17
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Le Roux E, Meunier-Beillard N, Simonel C, Omorou A, Lejeune C. Spouses of patients treated for colon cancer: identification of key caregiver skills using the Delphi method. Support Care Cancer 2024; 32:263. [PMID: 38564042 DOI: 10.1007/s00520-024-08456-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE Spouses are often the front-line caregivers for colon cancer patients. Providing this support requires a particular set of coping skills. Our objective was to identify key skills that healthcare and medico-social sector professionals could assess in routine practice that would allow them to propose appropriate support to spouses who are accompanying colon cancer patients in their care pathway. METHODS An online two-round Delphi study was conducted among French colon cancer patients, spouses and professionals. The content of the Delphi study was developed from a previously published qualitative study. RESULTS In the first round of the study, 63% of the participants were professionals (n = 40), 19% spouses (n = 12) and 17% patients (n = 11). In the second round, they were respectively 55% (n = 22), 22% (n = 9) and 22% (n = 9). Twenty-seven of the 75 proposed skills were consensually identified as key skills. Nine were related to emotional and psychological well-being, six to social relations, four to organisation, five to health and three to domestic domains. The three most consensual skills (≥ 90% agreement) for spouses were (1) helping the tired patient in everyday life, (2) stimulating the patient to prevent him/her from giving up and (3) limiting one's amount of personal time to care for the patient. CONCLUSION The study identified the key skills needed by spouses of patients being treated for colon cancer. Better awareness of these skills among professionals would enable them to offer tailored support to help patients and spouses maintain their physical and emotional well-being.
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Affiliation(s)
- Enora Le Roux
- Université Paris Cité, Inserm, ECEVE, F-75010, Paris, France
- AP-HP Nord-Université de Paris, Hôpital Universitaire Robert Debré, Unité d'épidémiologie clinique, Inserm, CIC 1426, Paris, France
| | - Nicolas Meunier-Beillard
- CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France
- CHU Dijon Bourgogne, Délégation à la Recherche Clinique et à l'Innovation, USMR, Dijon, France
| | - Caroline Simonel
- CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France
| | - Abdou Omorou
- Université de Lorraine, CHRU Nancy, Inserm CIC 1433 Clinical Epidemiology, Nancy, France
- 1319 UMR INSPIIRE, Inserm, Université de Lorraine, Nancy, France
- The French National Platform Quality of Life and Cancer, Nancy, France
| | - Catherine Lejeune
- CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France.
- Inserm, Université Bourgogne-Franche-Comté, UMR 1231, EPICAD, Dijon, France.
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18
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Desselle SP. Pharmacy practice and social pharmacy forging ahead. Res Social Adm Pharm 2024; 20:377-378. [PMID: 38242764 DOI: 10.1016/j.sapharm.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 01/21/2024]
Affiliation(s)
- Shane P Desselle
- Department of Clinical and Administrative Pharmaceutical Sciences, College of Pharmacy, Touro University, CA, 94592, USA.
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19
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Garcia-Ros R, Ruescas-Nicolau MA, Cezón-Serrano N, Flor-Rufino C, Martin-Valenzuela CS, Sánchez-Sánchez ML. Improving assessment of procedural skills in health sciences education: a validation study of a rubrics system in neurophysiotherapy. BMC Psychol 2024; 12:147. [PMID: 38486300 PMCID: PMC10941460 DOI: 10.1186/s40359-024-01643-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 03/05/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND The development of procedural skills is essential in health sciences education. Rubrics can be useful for learning and assessing these skills. To this end, a set of rubrics were developed in case of neurophysiotherapy maneuvers for undergraduates. Although students found the rubrics to be valid and useful in previous courses, the analysis of the practical exam results showed the need to change them in order to improve their validity and reliability, especially when used for summative purposes. After reviewing the rubrics, this paper analyzes their validity and reliability for promoting the learning of neurophysiotherapy maneuvers and assessing the acquisition of the procedural skills they involve. METHODS In this cross-sectional and psychometric study, six experts and 142 undergraduate students of a neurophysiotherapy subject from a Spanish university participated. The rubrics' validity (content and structural) and reliability (inter-rater and internal consistency) were analyzed. The students' scores in the subject practical exam derived from the application of the rubrics, as well as the rubrics' criteria difficulty and discrimination indices were also determined. RESULTS The rubrics´ content validity was found to be adequate (Content Validity Index > 0.90). These showed a unidimensional structure, and an acceptable internal consistency (α = 0.71) and inter-rater reliability (Fleiss' ƙ=0.44, ICC = 0.94). The scores of the subject practical exam practically covered the entire range of possible theoretical scores, showing all the criterion medium-low to medium difficulty indices - except for the one related to the physical therapist position-. All the criterion exhibited adequate discrimination indices (rpbis > 0.39), as did the rubric as a whole (Ferguson's δ = 0.86). Students highlighted the rubrics´ usefulness for learning the maneuvers, as well as their validity and reliability for formative and summative assessment. CONCLUSIONS The changed rubrics constitute a valid and reliable instrument for evaluating the execution quality of neurophysiotherapy maneuvers from a summative evaluation viewpoint. This study facilitates the development of rubrics aimed at promoting different practical skills in health-science education.
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Affiliation(s)
- Rafael Garcia-Ros
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Blasco Ibáñez Av. no. 21, Valencia, 46010, Spain
- Neurophysiotherapy Teaching Innovation Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street no. 5, Valencia, 46010, Spain
| | - Maria-Arantzazu Ruescas-Nicolau
- Neurophysiotherapy Teaching Innovation Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street no. 5, Valencia, 46010, Spain.
- Physiotherapy in Motion. Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street no. 5, Valencia, 46010, Spain.
| | - Natalia Cezón-Serrano
- Neurophysiotherapy Teaching Innovation Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street no. 5, Valencia, 46010, Spain
- Physiotherapy in Motion. Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street no. 5, Valencia, 46010, Spain
| | - Cristina Flor-Rufino
- Neurophysiotherapy Teaching Innovation Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street no. 5, Valencia, 46010, Spain
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street no. 5, Valencia, 46010, Spain
| | - Constanza San Martin-Valenzuela
- Neurophysiotherapy Teaching Innovation Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street no. 5, Valencia, 46010, Spain
- Research unit in Clinical biomechanics - UBIC, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street no. 5, Valencia, 46010, Spain
| | - M Luz Sánchez-Sánchez
- Neurophysiotherapy Teaching Innovation Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street no. 5, Valencia, 46010, Spain
- Physiotherapy in Motion. Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street no. 5, Valencia, 46010, Spain
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20
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Cheung CK, Miller KA, Goings TC, Thomas BN, Lee H, Brandon RE, Katerere-Virima T, Helbling LE, Causadias JM, Roth ME, Berthaud FM, Jones LP, Ross VA, Betz GD, Simmons CD, Carter J, Davies SJ, Gilman ML, Lewis MA, Lopes G, Tucker-Seeley RD. BIPOC experiences of (anti-)racist patient engagement in adolescent and young adult oncology research: an electronic Delphi study. Future Oncol 2024; 20:547-561. [PMID: 38197386 PMCID: PMC10988539 DOI: 10.2217/fon-2023-0771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/06/2023] [Indexed: 01/11/2024] Open
Abstract
Aims: To characterize Black, Indigenous and People of Color (BIPOC) adolescent and young adult (AYA) cancer patients' experiences of patient engagement in AYA oncology and derive best practices that are co-developed by BIPOC AYAs and oncology professionals. Materials & methods: Following a previous call to action from AYA oncology professionals, a panel of experts composed exclusively of BIPOC AYA cancer patients (n = 32) participated in an electronic Delphi study. Results: Emergent themes described BIPOC AYA cancer patients' direct experiences and consensus opinion on recommendations to advance antiracist patient engagement from BIPOC AYA cancer patients and oncology professionals. Conclusion: The findings reveal high-priority practices across all phases of research and are instructional for advancing health equity.
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Affiliation(s)
| | - Kimberly A Miller
- Department of Preventive Medicine and Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | | | - Bria N Thomas
- Temple University School of Podiatric Medicine, Philadelphia, PA 19107, USA
| | - Haelim Lee
- University of Maryland School of Social Work, Baltimore, MD 21201, USA
| | - Rachel E Brandon
- University of Michigan School of Social Work, Ann Arbor, MI 48109, USA
| | | | - Laura E Helbling
- University of Maryland School of Social Work, Baltimore, MD 21201, USA
| | - José M Causadias
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ 85287, USA
| | - Michael E Roth
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | | | - Valentina A Ross
- University of Maryland School of Social Work, Baltimore, MD 21201, USA
| | - Gail D Betz
- University of Maryland Baltimore Health Sciences & Human Services Library, Baltimore, MD 21201, USA
| | - Cole D Simmons
- Bryn Mawr Graduate School of Social Work and Social Research, Bryn Mawr, PA 19010, USA
| | - Jay Carter
- University of Maryland School of Social Work, Baltimore, MD 21201, USA
| | | | - Megan L Gilman
- AYA Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Mark A Lewis
- Department of Gastrointestinal Oncology, Intermountain Healthcare, Salt Lake City, UT, 84107 USA
| | - Gilberto Lopes
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
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21
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Collado P, Naredo E, D'Agostino MA. Reply. Arthritis Care Res (Hoboken) 2023; 75:2545. [PMID: 37458137 DOI: 10.1002/acr.25198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Paz Collado
- Hospital Universitario Severo Ochoa and Universidad Internacional Alfonso X El Sabio, Madrid, Spain
| | - Esperanza Naredo
- Hospital General Universitario Gregorio Marañón and Universidad Autónoma de Madrid, Madrid, Spain
| | - Maria Antonietta D'Agostino
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
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22
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Chen CC, Tsai CF, Chen SC. Consensus and agreements on the sonographic definitions of pediatric tenosynovitis: comment on the article by Collado et al. Arthritis Care Res (Hoboken) 2023; 75:2544-2545. [PMID: 37382037 DOI: 10.1002/acr.25185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Affiliation(s)
- Chun-Chieh Chen
- Chung Shan Medical University School of Medicine and Chung Shan Medical University Hospital Health Management Center, Taichung, Taiwan
| | - Chin-Feng Tsai
- Chung Shan Medical University School of Medicine and Chung Shan Medical University Hospital Health Management Center, Taichung, Taiwan
| | - Shiuan-Chih Chen
- Chung Shan Medical University School of Medicine and Chung Shan Medical University Hospital Health Management Center, Taichung, Taiwan
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23
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Reina-Varona Á, Madroñero-Miguel B, Gaul C, Hall T, Oliveira AB, Bond DS, Fernández-de Las Peñas C, Florencio LL, Carvalho GF, Luedtke K, Varkey E, Krøll LS, Bevilaqua-Grossi D, Kisan R, La Touche R, Paris-Alemany A. Therapeutic Exercise Parameters, Considerations, and Recommendations for Migraine Treatment: An International Delphi Study. Phys Ther 2023; 103:pzad080. [PMID: 37410390 DOI: 10.1093/ptj/pzad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/27/2023] [Accepted: 06/30/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE The goal of this study was to reach consensus about the best exercise prescription parameters, the most relevant considerations, and other recommendations that could be useful for prescribing exercise to patients with migraine. METHODS This was an international study conducted between April 9, 2022 and June 30, 2022. An expert panel of health care and exercise professionals was assembled, and a 3-round Delphi survey was performed. Consensus was reached for each item if an Aiken V Validity Index ≥ 0.7 was obtained. RESULTS The study included 14 experts who reached consensus on 42 items by the third round. The most approved prescription parameters were 30 to 60 minutes of exercise per session, 3 days per week of moderate-intensity continuous aerobic exercise, and relaxation and breathing exercises for 5 to 20 minutes every day. When considering an exercise prescription, initial exercise supervision should progress to patient self-regulation; catastrophizing, fear-avoidance beliefs, headache-related disability, anxiety, depression, physical activity baseline level, and self-efficacy could influence the patients' exercise participation and efficacy; and gradual exposure to exercise could help improve these psychological variables and increase exercise efficacy. Yoga and concurrent exercise were also included as recommended interventions. CONCLUSION From the experts in the study, exercise prescriptions should be adapted to patients with migraine considering different exercise modalities, such as moderate-intensity aerobic exercise, relaxation, yoga, and concurrent exercise, based on the patients' preferences and psychological considerations, level of physical activity, and possible adverse effects. IMPACT The consensus reached by the experts can help prescribe exercise accurately to patients with migraine. Offering various exercise modalities can improve exercise participation in this population. The evaluation of the patients' psychological and physical status can also facilitate the adaptation of the exercise prescription to their abilities and diminish the risk of adverse events.
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Affiliation(s)
- Álvaro Reina-Varona
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- PhD Program in Medicine and Surgery, Doctoral School, Universidad Autónoma de Madrid, Madrid, Spain
| | - Beatriz Madroñero-Miguel
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
| | - Charly Gaul
- Headache Center Frankfurt, Frankfurt, Hesse, Germany
| | - Toby Hall
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Arão B Oliveira
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Dale S Bond
- Departments of Research and Surgery, Hartford Hospital/HealthCare, Hartford, Connecticut, USA
| | - César Fernández-de Las Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine. Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcon, Madrid, Spain
| | - Lidiane L Florencio
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine. Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcon, Madrid, Spain
| | - Gabriela F Carvalho
- Institut für Gesundheitswissenschaften, Studiengang Physiotherapie, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Lübeck, Schleswig-Holstein, Deutschland
| | - Kerstin Luedtke
- Institut für Gesundheitswissenschaften, Studiengang Physiotherapie, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Lübeck, Schleswig-Holstein, Deutschland
| | - Emma Varkey
- Department of Occupational Therapy and Physiotherapy, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, Västra Götaland County, Sweden
| | - Lotte S Krøll
- Department of Neurology, Rigshospitalet-Glostrup, Danish Headache Centre, University of Copenhagen, Copenhagen, Zealand, Denmark
| | - Debora Bevilaqua-Grossi
- Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ravikiran Kisan
- Department of Physiology, Kodagu Institute of Medical Sciences, Karnataka, Madikeri, India
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, Madrid, Spain
| | - Alba Paris-Alemany
- Motion in Brains Research Group, Departamento de Fisioterapia, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, Madrid, Spain
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Anawati A, Cameron E, Harvey J. Exploring the development of a framework of social accountability standards for healthcare service delivery: a qualitative multipart, multimethods process. BMJ Open 2023; 13:e073064. [PMID: 37709334 PMCID: PMC10503373 DOI: 10.1136/bmjopen-2023-073064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/23/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Social accountability is an equity-oriented health policy strategy that requires institutions to focus on local population needs. This strategy is well established in health professional education, but there is limited understanding of its application in healthcare service delivery. Building on what is known in the education setting, this study aimed to explore the development of a framework of comprehensive, evidence-based social accountability standards for healthcare service delivery institutions. DESIGN This qualitative, multipart, multimethods study consisted of a modified Delphi process guided by an evidence-based social accountability tool for health professional education and complementary methods including developmental evaluation and a review of select literature to capture emerging evidence and contextual relevance. SETTING The study took place in Northern Ontario, Canada at a medical school and a tertiary, regional academic health sciences centre that are both grounded in social accountability. PARTICIPANTS Eight expert participants from diverse, multidisciplinary backgrounds, including a patient advocate, were purposefully recruited from both institutions, enrolled and seven completed the study. MAIN OUTCOME The resulting framework of social accountability standards is organised into 4 major sections that capture broad and critical concepts; 17 key component reflective questions that address key themes; 39 aspirations that describe objective standards and 197 indicators linked to specific expectations. RESULTS Three modified Delphi rounds were completed producing a framework of consensus derived standards. Developmental evaluation helped identify facilitators, barriers and provided real-time feedback to the study's processes and content. The literature reviewed identified 10 new concepts and 43 amendments. CONCLUSION This study highlights the development of a comprehensive, evidence-based framework of social accountability standards for healthcare service delivery institutions. Future studies will aim to evaluate the application of these standards to guide equity-oriented social accountability health policy strategies in healthcare service delivery.
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Affiliation(s)
- Alex Anawati
- Clinical Sciences, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
- Emergency Department, Health Sciences North, Sudbury, Ontario, Canada
| | - Erin Cameron
- Human Sciences, Northern Ontario School of Medicine University, Thunder Bay, Ontario, Canada
| | - Jacqueline Harvey
- Northern Ontario School of Medicine University, Sudbury, Ontario, Canada
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25
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Guo Z, Zhong F, Shu H. Construction of a risk index system for the prediction of chronic post-surgical pain after video-assisted thoracic surgery for lung resection: A modified Delphi study. Glob Health Med 2023; 5:229-237. [PMID: 37655184 PMCID: PMC10461330 DOI: 10.35772/ghm.2023.01061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/24/2023] [Accepted: 06/11/2023] [Indexed: 09/02/2023]
Abstract
In the present study, several research methods were adopted, including literature retrieval, theoretical analysis, and qualitative research, and then the draft of the prognostic factors for the chronic post-surgical pain (CPSP) index system after video-assisted thoracoscopic surgery (VATS) for lung resection was constructed. A Delphi survey was used for the study of 24 experts in the field of pain from three different grade-A tertiary hospitals in Guangzhou, China. In the two rounds of survey, the experts rated these indicators for the importance and feasibility of measurement (round 1, n = 21 participants; round 2, n = 20). Finally, we calculated Kendall's W index as a measure of consensus. A general consensus was reached on predicting CPSP after VATS, consisting of 10 first-level domains and 64 second-level indicators, involving biological, psychological and social perspectives. This study provides a comprehensive draft of risk factors developed and identified by experts to inform research-based evidence on chronic pain. Increased clinical awareness and a full understanding of how to screen and identify people with CPSP problems may lead to earlier recognition of chronic pain and greater facilitation of professional prevention.
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Affiliation(s)
- Zhimin Guo
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Fei Zhong
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Haihua Shu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Serna CDDLRDL, Drury A, Oldenmenger WH, Kelly D, Kotronoulas G. A Delphi Study of Core Patient-Reported Outcomes for Advanced Renal Cell Carcinoma and Advanced Hepatocellular Carcinoma. Semin Oncol Nurs 2023; 39:151409. [PMID: 37012164 DOI: 10.1016/j.soncn.2023.151409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/02/2023] [Indexed: 04/04/2023]
Abstract
OBJECTIVES There is little research to help health care professionals understand what patient outcomes are considered a priority in advanced liver or kidney cancer. Knowing what is important to patients can help promote person-centered approaches to treatment and disease management. The aim of this study was to identify those patient-reported outcomes (PROs) that patients, carers, and health care professionals consider as "core" when providing care to those with advanced liver or kidney cancer. DATA SOURCES A three-round Delphi study was undertaken to ask experts by profession or experience to rank PROs identified from a previous literature review. Fifty-four experts, including people living with advanced liver or kidney cancer (44.4%), family members and caregivers (9.3%), and health care professionals (46.8%), reached consensus on 49 PROs including 12 new items (eg, palpitations, hopefulness, or social isolation). Items with the highest rate of consensus included quality of life, pain, mental health, and capacity to do daily activities. CONCLUSION People living with advanced liver or kidney cancer experience complex health care needs. Some important outcomes were not actually captured in practice in this population and were suggested as part of this study. There are discrepancies between the views of health care professionals, patients, and family in what is important, highlighting the need of using measures to facilitate communication. IMPLICATIONS FOR NURSING PRACTICE Identification of priority PROs reported here will be key to facilitate more focused patient assessments. The actual use of measures in cancer nursing practice to allow monitoring of PROs must be tested for feasibility and usability.
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Affiliation(s)
| | - Amanda Drury
- Associate Professor, School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Wendy H Oldenmenger
- Assistant Professor, Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, Netherlands
| | - Daniel Kelly
- Professor, Cardiff University, School of Healthcare Sciences, Cardiff, United Kingdom
| | - Grigorios Kotronoulas
- Reader, School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom.
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Schwartz KL, Xu AXT, Alderson S, Bjerrum L, Brehaut J, Brown BC, Bucher HC, De Sutter A, Francis N, Grimshaw J, Gunnarsson R, Hoye S, Ivers N, Lecky DM, Lindbæk M, Linder JA, Little P, Michalsen BO, O'Connor D, Pulcini C, Sundvall PD, Lundgren PT, Verbakel JY, Verheij TJ. Best practice guidance for antibiotic audit and feedback interventions in primary care: a modified Delphi study from the Joint Programming Initiative on Antimicrobial resistance: Primary Care Antibiotic Audit and Feedback Network (JPIAMR-PAAN). Antimicrob Resist Infect Control 2023; 12:72. [PMID: 37516892 PMCID: PMC10387210 DOI: 10.1186/s13756-023-01279-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/21/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Primary care is a critical partner for antimicrobial stewardship efforts given its high human antibiotic usage. Peer comparison audit and feedback (A&F) is often used to reduce inappropriate antibiotic prescribing. The design and implementation of A&F may impact its effectiveness. There are no best practice guidelines for peer comparison A&F in antibiotic prescribing in primary care. OBJECTIVE To develop best practice guidelines for peer comparison A&F for antibiotic prescribing in primary care in high income countries by leveraging international expertise via the Joint Programming Initiative on Antimicrobial Resistance-Primary Care Antibiotic Audit and Feedback Network. METHODS We used a modified Delphi process to achieve convergence of expert opinions on best practice statements for peer comparison A&F based on existing evidence and theory. Three rounds were performed, each with online surveys and virtual meetings to enable discussion and rating of each best practice statement. A five-point Likert scale was used to rate consensus with a median threshold score of 4 to indicate a consensus statement. RESULTS The final set of guidelines include 13 best practice statements in four categories: general considerations (n = 3), selecting feedback recipients (n = 1), data and indicator selection (n = 4), and feedback delivery (n = 5). CONCLUSION We report an expert-derived best practice recommendations for designing and evaluating peer comparison A&F for antibiotic prescribing in primary care. These 13 statements can be used by A&F designers to optimize the impact of their quality improvement interventions, and improve antibiotic prescribing in primary care.
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Affiliation(s)
- Kevin L Schwartz
- Public Health Ontario, 480 University Ave, Ste 300, Toronto, ON, M5G 1V2, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
- Unity Health Toronto, Toronto, Canada.
| | - Alice X T Xu
- Public Health Ontario, 480 University Ave, Ste 300, Toronto, ON, M5G 1V2, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sarah Alderson
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Oaklands Health Centre, Holmfirth, UK
| | - Lars Bjerrum
- Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jamie Brehaut
- Centre for Practice-Changing Research (CPCR), Ottawa Hospital Research Institute, Ottawa, Canada
| | - Benjamin C Brown
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Heiner C Bucher
- Division of Clinical Epidemiology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - An De Sutter
- Department of Public Health and Primary Care, Center for Family Medicine UGent, Ghent University, Ghent, Belgium
| | - Nick Francis
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Jeremy Grimshaw
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Ronny Gunnarsson
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development & Innovation, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
- Centre for Antibiotic Resistance Research (CARe) at University of Gothenburg, Gothenburg, Sweden
| | - Sigurd Hoye
- Department of General Practice, Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Noah Ivers
- Women's College Hospital, Toronto, Canada
| | - Donna M Lecky
- Primary Care and Interventions Unit, UK Health Security Agency, Gloucester, England
| | - Morten Lindbæk
- Department of General Practice, Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Jeffrey A Linder
- Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Paul Little
- Primary Care Research Centre, University of Southampton, Southampton, England
| | - Benedikte Olsen Michalsen
- Department of General Practice, Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Denise O'Connor
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Celine Pulcini
- APEMAC, Université de Lorraine, Nancy, France
- CHRU-Nancy, Centre regional en antibiotherapie de la region Grand Est AntibioEst, Université de Lorraine, Nancy, France
| | - Pär-Daniel Sundvall
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development & Innovation, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
- Centre for Antibiotic Resistance Research (CARe) at University of Gothenburg, Gothenburg, Sweden
| | | | - Jan Y Verbakel
- Department of Public Health and Primary Care, KU Leuven, Louvain, Belgium
- NIHR Community Healthcare Medtech and IVD Cooperative, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Theo J Verheij
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Basantes-Andrade A, López-Gutiérrez JC, Mora Grijalva M, Ricardo Y. Validity and reliability of the questionnaire of academic knowledge of teachers of basic general education. F1000Res 2023; 12:642. [PMID: 38784642 PMCID: PMC11112302 DOI: 10.12688/f1000research.134261.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 05/25/2024] Open
Abstract
Background: The concern and analysis about the knowledge possessed by teachers of basic general education persists in academic debate and professional practice. It is noteworthy that in the studies consulted, there is no precise evidence that determines with accuracy the configurations of these knowledge factors that function as the basis of the teaching profession. Therefore, the objective of this study is to establish the construct validity and reliability of the questionnaire on the nature or origin of the academic knowledge of teachers of basic general education, adapted from the Pedagogical Content Knowledge (PCK) Competence Model. Methods: A methodological study was established that applies a test to the processes of reliability and internal consistency. The construct validity was performed through (n = 8) expert judges, using Cohen's Kappa. An exploratory factor analysis was performed following the criteria of the Kaiser-Meyer-Olkin Coefficient (KMO), the Bartlett sphericity test and the principal components extraction method in the factor analysis with varimax rotation. The sample consisted of (n = 27) teachers of basic general education of the Ibarra Canton. Results: The results show a reliability analysis for the instrument obtained a Cronbach's alpha (α = 0.901), estimated to be an excellent level. Conclusions: The questionnaire is relevant, valid and reliable, adapting to the needs of teachers of basic general education to determine the nature or origin of the academic knowledge in a fast and reliable manner.
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Affiliation(s)
- Andrea Basantes-Andrade
- Grupo de Investigación de Educación, Ciencia y Tecnología GIECYT, Universidad Técnica del Norte, Ibarra, Imbabura, 100105, Ecuador
| | - Juan Carlos López-Gutiérrez
- Grupo de Investigación de Educación, Ciencia y Tecnología GIECYT, Universidad Técnica del Norte, Ibarra, Imbabura, 100105, Ecuador
| | - Milton Mora Grijalva
- Grupo de Investigación de Educación, Ciencia y Tecnología GIECYT, Universidad Técnica del Norte, Ibarra, Imbabura, 100105, Ecuador
| | - Yenney Ricardo
- Grupo de Investigación Cultura, Sociedad e Imagen, Universidad Técnica del Norte, Ibarra, Imbabura, 100105, Ecuador
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Nabovati E, Rangraz Jeddi F, Tabatabaeizadeh SM, Hamidi R, Sharif R. Design, development, and usability evaluation of a smartphone-based application for nutrition management in patients with type II diabetes. J Diabetes Metab Disord 2023; 22:315-323. [PMID: 37255839 PMCID: PMC10225392 DOI: 10.1007/s40200-022-01140-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/16/2022] [Accepted: 10/03/2022] [Indexed: 06/01/2023]
Abstract
Purpose Information technology (IT)-based interventions, especially mobile health (mHealth), possess a great potential for promoting self-management in patients with chronic diseases, including diabetes type II. The present study was aimed to design and develop a smartphone-based application (app) for nutrition management in patients with type II diabetes and evaluation of its usability. Methods In this study, a three-phase research approach was followed; (1) To determine the information content and functionalities of the app, a five-point Likert scale checklist including six parts was developed based on reviews of clinical practice guidelines and specialized databases. The checklist was then given to ten experts in endocrinology and metabolism, internal medicine, and nutrition, and those items with a mean score higher than 3.75 were approved. (2) In Android Studio, the app was designed and developed using Java language. (3) The Questionnaire for User Interaction Satisfaction (QUIS) was used to assess the app's usability by 21 patients with type II diabetes, ten IT experts, and seven endocrinologists, internal medicine practitioners, and nutritionists over one month. Mean scores were divided into three levels: weak (0-3), average (3-6), and good (6-9). Results According to experts' view, 17 out of 22 educational content and 17 out of 27 functionalities were approved. The app's most important educational content was the timing of meals for insulin patients and the definition of diabetes and its complications. The designed app had the following functionalities: providing educational information, recording information, performing calculations, representing data graphically, setting reminders, and communicating with physicians. The most important features of the app were the insulin dose calculation, reminders for doctors' appointments, setting times for tests and blood glucose measurements, and also tracking weight, blood glucose levels, and blood pressure. In terms of usability evaluation, the app was rated "good" level by diabetic patients (7.83 ± 0.74), IT experts (8.1 ± 0.66), and physicians (8.03 ± 0.95). Conclusion Given the desirable evaluation of the app by patients, physicians, and IT experts, it can be concluded that the developed app has the required functionalities for nutrition management of patients with type II diabetes. Smartphone-based apps appear to be able to improve self-management, the quality of care and health in patients with diabetes, and reduce many of their unnecessary visits to healthcare centers, and costs. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-01140-x.
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Affiliation(s)
- Ehsan Nabovati
- Health Information Management Research Center, Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Pezeshk Blvd, 5th of Qotbe Ravandi Blvd – Pardis Daneshgah, Kashan, IR Iran
| | - Fatemeh Rangraz Jeddi
- Health Information Management Research Center, Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Pezeshk Blvd, 5th of Qotbe Ravandi Blvd – Pardis Daneshgah, Kashan, IR Iran
| | | | - Rahele Hamidi
- Health Information Management Research Center, Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Pezeshk Blvd, 5th of Qotbe Ravandi Blvd – Pardis Daneshgah, Kashan, IR Iran
| | - Reihane Sharif
- Health Information Management Research Center, Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Pezeshk Blvd, 5th of Qotbe Ravandi Blvd – Pardis Daneshgah, Kashan, IR Iran
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30
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Albertella L, Kirkham R, Adler AB, Crampton J, Drummond SPA, Fogarty GJ, Gross JJ, Zaichkowsky L, Andersen JP, Bartone PT, Boga D, Bond JW, Brunyé TT, Campbell MJ, Ciobanu LG, Clark SR, Crane MF, Dietrich A, Doty TJ, Driskell JE, Fahsing I, Fiore SM, Flin R, Funke J, Gatt JM, Hancock PA, Harper C, Heathcote A, Heatown KJ, Helsen WF, Hussey EK, Jackson RC, Khemlani S, Killgore WDS, Kleitman S, Lane AM, Loft S, MacMahon C, Marcora SM, McKenna FP, Meijen C, Moulton V, Moyle GM, Nalivaiko E, O'Connor D, O’Conor D, Patton D, Piccolo MD, Ruiz C, Schücker L, Smith RA, Smith SJR, Sobrino C, Stetz M, Stewart D, Taylor P, Tucker AJ, van Stralen H, Vickers JN, Visser TAW, Walker R, Wiggins MW, Williams AM, Wong L, Aidman E, Yücel M. Building a transdisciplinary expert consensus on the cognitive drivers of performance under pressure: An international multi-panel Delphi study. Front Psychol 2023; 13:1017675. [PMID: 36755983 PMCID: PMC9901503 DOI: 10.3389/fpsyg.2022.1017675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/02/2022] [Indexed: 01/19/2023] Open
Abstract
Introduction The ability to perform optimally under pressure is critical across many occupations, including the military, first responders, and competitive sport. Despite recognition that such performance depends on a range of cognitive factors, how common these factors are across performance domains remains unclear. The current study sought to integrate existing knowledge in the performance field in the form of a transdisciplinary expert consensus on the cognitive mechanisms that underlie performance under pressure. Methods International experts were recruited from four performance domains [(i) Defense; (ii) Competitive Sport; (iii) Civilian High-stakes; and (iv) Performance Neuroscience]. Experts rated constructs from the Research Domain Criteria (RDoC) framework (and several expert-suggested constructs) across successive rounds, until all constructs reached consensus for inclusion or were eliminated. Finally, included constructs were ranked for their relative importance. Results Sixty-eight experts completed the first Delphi round, with 94% of experts retained by the end of the Delphi process. The following 10 constructs reached consensus across all four panels (in order of overall ranking): (1) Attention; (2) Cognitive Control-Performance Monitoring; (3) Arousal and Regulatory Systems-Arousal; (4) Cognitive Control-Goal Selection, Updating, Representation, and Maintenance; (5) Cognitive Control-Response Selection and Inhibition/Suppression; (6) Working memory-Flexible Updating; (7) Working memory-Active Maintenance; (8) Perception and Understanding of Self-Self-knowledge; (9) Working memory-Interference Control, and (10) Expert-suggested-Shifting. Discussion Our results identify a set of transdisciplinary neuroscience-informed constructs, validated through expert consensus. This expert consensus is critical to standardizing cognitive assessment and informing mechanism-targeted interventions in the broader field of human performance optimization.
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Affiliation(s)
- Lucy Albertella
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia,*Correspondence: Lucy Albertella,
| | - Rebecca Kirkham
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Amy B. Adler
- Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - John Crampton
- APS College of Sport and Exercise Psychologists, Melbourne, VIC, Australia
| | - Sean P. A. Drummond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Gerard J. Fogarty
- School of Psychology and Wellbeing, University of Southern Queensland, Toowoomba, QLD, Australia
| | | | - Leonard Zaichkowsky
- Wheelock College of Education and Human Development, Boston University, Boston, MA, United States
| | | | | | - Danny Boga
- Australian Army Psychology Corps, Canberra, ACT, Australia
| | - Jeffrey W. Bond
- APS College of Sport and Exercise Psychologists, Melbourne, VIC, Australia
| | - Tad T. Brunyé
- U.S. Army DEVCOM Analysis Center, Natick, MA, United States
| | - Mark J. Campbell
- Physical Education & Sport Sciences Department, University of Limerick, Limerick, Ireland
| | - Liliana G. Ciobanu
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Scott R. Clark
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Monique F. Crane
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Arne Dietrich
- Department of Psychology, American University of Beirut, Beirut, Lebanon
| | - Tracy J. Doty
- Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | | | - Ivar Fahsing
- Norwegian Police University College, Oslo, Norway
| | - Stephen M. Fiore
- Department of Psychology, and Institute of Simulation and Training, University of Central Florida, Orlando, FL, United States
| | - Rhona Flin
- Aberdeen Business School, Robert Gordon University, Aberdeen, United Kingdom
| | - Joachim Funke
- Department of Psychology, Heidelberg University, Heidelberg, Germany
| | - Justine M. Gatt
- School of Psychology, University of New South Wales, Kensington, NSW, Australia,Neuroscience Research Australia, Sydney, NSW, Australia
| | - P. A. Hancock
- Department of Psychology, and Institute of Simulation and Training, University of Central Florida, Orlando, FL, United States
| | - Craig Harper
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Andrew Heathcote
- The University of Newcastle, Callaghan, NSW, Australia,School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
| | - Kristin J. Heatown
- US Army Research Institute of Environmental Medicine (USARIEM), Natick, MA, United States
| | | | | | - Robin C. Jackson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Sangeet Khemlani
- United States Naval Research Laboratory, Washington, DC, United States
| | | | - Sabina Kleitman
- School of Psychology, The University of Sydney, Darlington, NSW, Australia
| | - Andrew M. Lane
- Sport, Physical Activity Research Centre (SPARC), School of Sport, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Shayne Loft
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Clare MacMahon
- School of Allied Health, Human Services, and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Samuele M. Marcora
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Frank P. McKenna
- Department of Psychology, University of Reading, Reading, United Kingdom
| | - Carla Meijen
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, United Kingdom
| | | | - Gene M. Moyle
- Faculty of Creative Industries, Education and Social Justice, Queensland University of Technology, Brisbane, QLD, Australia
| | - Eugene Nalivaiko
- The University of Newcastle, Callaghan, NSW, Australia,School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
| | - Donna O'Connor
- Sydney School of Education and Social Work, The University of Sydney, Darlington, NSW, Australia
| | | | - Debra Patton
- United States Department of Defense, Washington DC, United States
| | | | - Coleman Ruiz
- Mission Critical Team Institute, Annapolis, MD, United States
| | - Linda Schücker
- Department of Sport Psychology, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | | | - Sarah J. R. Smith
- Defense Science and Technology Laboratory, Salisbury, United Kingdom
| | - Chava Sobrino
- NSW Institute of Sport and Diving, Sydney, NSW, Australia
| | - Melba Stetz
- Independent Practitioner, Grand Ledge, MI, United States
| | | | - Paul Taylor
- The University of Newcastle, Callaghan, NSW, Australia,School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
| | - Andrew J. Tucker
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | | | - Joan N. Vickers
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Troy A. W Visser
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Rohan Walker
- The University of Newcastle, Callaghan, NSW, Australia,School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
| | - Mark W. Wiggins
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | | | - Leonard Wong
- United States Army War College, Carlisle, PA, United States
| | - Eugene Aidman
- The University of Newcastle, Callaghan, NSW, Australia,Decision Sciences Division, Defense Science and Technology Group, Adelaide, SA, Australia
| | - Murat Yücel
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
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Cook C, Reid L, Smith S, Crockford D, El Sharkawy AM, McPherson S, Wright M, Radley A, Malik H, Keall S, Catt J, Shah S, Hampton H, Powell J, Morris D, Boothman H, Khakoo SI, Parkes J, Buchanan RM. I-COPTIC: Implementation of community pharmacy-based testing for hepatitis C: Delphi consensus protocol. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2022; 30:541-547. [PMID: 35997159 DOI: 10.1093/ijpp/riac064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 07/22/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The World Health Organisation aims to eliminate Hepatitis C (HCV) by 2030. To achieve this, targeted testing needs to be widely available. Studies have demonstrated that community pharmacies can deliver effective targeted testing for HCV and the National Health Service in England has commissioned a national service. However, a recent survey of HCV operational delivery networks has shown limited uptake of this service. The objective of this protocol is to guide the formation of a consensus statement to facilitate the widespread implementation of community pharmacy-based targeted testing for HCV. METHOD We will use a modified Delphi method. A purposive selection of panel participants will be identified and recruited from a national survey and via chain-referral sampling. The main inclusion criteria for selection is direct involvement in the implementation of an HCV testing service in pharmacies. We aim for a heterogenous group, encompassing all aspects of the testing service. We will conduct a three round Delphi. The first round will consist of open questions which will be qualitatively analysed using thematic analysis with a framework method based on the WHO Health Systems Framework. This analysis will generate statements, that will be sent to the participants in the second round. A third round will be used where consensus is not reached. CONCLUSIONS The findings from this Delphi consensus study will facilitate the widespread implementation of targeted testing for HCV in community pharmacies.
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Affiliation(s)
| | | | | | | | - Deborah Crockford
- Hampshire & Isle of Wight LPC (operating as Community Pharmacy South Central) , Hampshire , UK
| | - Ahmed M El Sharkawy
- Liver Unit, Queen Elizabeth Hospital Birmingham , Birmingham , UK
- National Institute for Health Research, Birmingham Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust , Birmingham , UK
| | - Stuart McPherson
- Liver Unit, The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne , UK
- The Translational and Clinical Research Institute, Newcastle University , Newcastle upon Tyne , UK
| | - Mark Wright
- University Hospital Southampton NHS Foundation Trust , Southampton , UK
| | - Andrew Radley
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee , Dundee , UK
- Ninewells Hospital, NHS Tayside , Dundee , UK
| | | | | | - Janet Catt
- Kings College NHS Foundation Trust , London , UK
| | - Sital Shah
- Kings College NHS Foundation Trust , London , UK
| | | | - Julia Powell
- Community Pharmacy Surrey and Sussex , Surrey , UK
| | | | | | - Salim I Khakoo
- Faculty of Medicine, University of Southampton , Southampton , UK
| | - Julie Parkes
- Faculty of Medicine, University of Southampton , Southampton , UK
| | - Ryan M Buchanan
- Faculty of Medicine, University of Southampton , Southampton , UK
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Sturgiss EA, Prathivadi P, Phillips WR, Moriarty F, Lucassen PLBJ, van der Wouden JC, Glasziou P, Olde Hartman TC, Orkin A, Reeve J, Russell G, van Weel C. Key items for reports of primary care research: an international Delphi study. BMJ Open 2022; 12:e066564. [PMID: 36535712 PMCID: PMC9764621 DOI: 10.1136/bmjopen-2022-066564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Reporting guidelines can improve dissemination and application of findings and help avoid research waste. Recent studies reveal opportunities to improve primary care (PC) reporting. Despite increasing numbers of guidelines, none exists for PC research. This study aims to prioritise candidate reporting items to inform a reporting guideline for PC research. DESIGN Delphi study conducted by the Consensus Reporting Items for Studies in Primary Care (CRISP) Working Group. SETTING International online survey. PARTICIPANTS Interdisciplinary PC researchers and research users. MAIN OUTCOME MEASURES We drew potential reporting items from literature review and a series of international, interdisciplinary surveys. Using an anonymous, online survey, we asked participants to vote on and whether each candidate item should be included, required or recommended in a PC research reporting guideline. Items advanced to the next Delphi round if they received>50% votes to include. Analysis used descriptive statistics plus synthesis of free-text responses. RESULTS 98/116 respondents completed round 1 (84% response rate) and 89/98 completed round 2 (91%). Respondents included a variety of healthcare professions, research roles, levels of experience and all five world regions. Round 1 presented 29 potential items, and 25 moved into round 2 after rewording and combining items and adding 2 new items. A majority of round 2 respondents voted to include 23 items (90%-100% for 11 items, 80%-89% for 3 items, 70%-79% for 3 items, 60%-69% for 3 items and 50%-59% for 3 items). CONCLUSION Our Delphi study identified items to guide the reporting of PC research that has broad endorsement from the community of producers and users of PC research. We will now use these results to inform the final development of the CRISP guidance for reporting PC research.
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Affiliation(s)
- Elizabeth Ann Sturgiss
- School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
- National Centre for Epidemiology and Population Health, The Australian National University, Acton, Australian Capital Territory, Australia
| | - Pallavi Prathivadi
- Department of General Practice, Monash University, Clayton, Victoria, Australia
| | | | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Peter L B J Lucassen
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University, Nijmegen, The Netherlands
| | | | | | - Tim C Olde Hartman
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University, Nijmegen, The Netherlands
| | - Aaron Orkin
- University of Toronto, Toronto, Ontario, Canada
- Schwartz/Reisman Emergency Medicine Institute, Toronto, Ontario, Canada
| | - Joanne Reeve
- Hull York Medical School, Hull University, Hull, UK
| | - Grant Russell
- Department of General Practice, Monash University, Clayton, Victoria, Australia
| | - Chris van Weel
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University, Nijmegen, The Netherlands
- Department of Health Services Research and Policy, Australian National University, Acton, Australian Capital Territory, Australia
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Zare Jeddi M, Hopf NB, Louro H, Viegas S, Galea KS, Pasanen-Kase R, Santonen T, Mustieles V, Fernandez MF, Verhagen H, Bopp SK, Antignac JP, David A, Mol H, Barouki R, Audouze K, Duca RC, Fantke P, Scheepers P, Ghosh M, Van Nieuwenhuyse A, Lobo Vicente J, Trier X, Rambaud L, Fillol C, Denys S, Conrad A, Kolossa-Gehring M, Paini A, Arnot J, Schulze F, Jones K, Sepai O, Ali I, Brennan L, Benfenati E, Cubadda F, Mantovani A, Bartonova A, Connolly A, Slobodnik J, Bruinen de Bruin Y, van Klaveren J, Palmen N, Dirven H, Husøy T, Thomsen C, Virgolino A, Röösli M, Gant T, von Goetz N, Bessems J. Developing human biomonitoring as a 21st century toolbox within the European exposure science strategy 2020-2030. ENVIRONMENT INTERNATIONAL 2022; 168:107476. [PMID: 36067553 DOI: 10.1016/j.envint.2022.107476] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/28/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
Human biomonitoring (HBM) is a crucial approach for exposure assessment, as emphasised in the European Commission's Chemicals Strategy for Sustainability (CSS). HBM can help to improve chemical policies in five major key areas: (1) assessing internal and aggregate exposure in different target populations; 2) assessing exposure to chemicals across life stages; (3) assessing combined exposure to multiple chemicals (mixtures); (4) bridging regulatory silos on aggregate exposure; and (5) enhancing the effectiveness of risk management measures. In this strategy paper we propose a vision and a strategy for the use of HBM in chemical regulations and public health policy in Europe and beyond. We outline six strategic objectives and a roadmap to further strengthen HBM approaches and increase their implementation in the regulatory risk assessment of chemicals to enhance our understanding of exposure and health impacts, enabling timely and targeted policy interventions and risk management. These strategic objectives are: 1) further development of sampling strategies and sample preparation; 2) further development of chemical-analytical HBM methods; 3) improving harmonisation throughout the HBM research life cycle; 4) further development of quality control / quality assurance throughout the HBM research life cycle; 5) obtain sustained funding and reinforcement by legislation; and 6) extend target-specific communication with scientists, policymakers, citizens and other stakeholders. HBM approaches are essential in risk assessment to address scientific, regulatory and societal challenges. HBM requires full and strong support from the scientific and regulatory domain to reach its full potential in public and occupational health assessment and in regulatory decision-making.
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Affiliation(s)
- Maryam Zare Jeddi
- National Institute for Public Health and the Environment (RIVM), the Netherlands.
| | - Nancy B Hopf
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
| | - Henriqueta Louro
- National Institute of Health Dr. Ricardo Jorge, Department of Human Genetics, Lisbon and ToxOmics - Centre for Toxicogenomics and Human Health, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Susana Viegas
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; Comprehensive Health Research Center (CHRC), 1169-056 Lisbon, Portugal
| | - Karen S Galea
- Institute of Occupational Medicine (IOM), Research Avenue North, Riccarton, Edinburgh EH14 4AP, UK
| | - Robert Pasanen-Kase
- State Secretariat for Economic Affairs (SECO), Labour Directorate Section Chemicals and Work (ABCH), Switzerland
| | - Tiina Santonen
- Finnish Institute of Occupational Health (FIOH), P.O. Box 40, FI-00032 Työterveyslaitos, Finland
| | - Vicente Mustieles
- University of Granada, Center for Biomedical Research (CIBM), School of Medicine, Department of Radiology and Physical Medicine, Granada, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid, Spain
| | - Mariana F Fernandez
- University of Granada, Center for Biomedical Research (CIBM), School of Medicine, Department of Radiology and Physical Medicine, Granada, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid, Spain
| | - Hans Verhagen
- University of Ulster, Coleraine, Northern Ireland, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | | | | | - Arthur David
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, F-35000 Rennes, France
| | - Hans Mol
- Wageningen Food Safety Research - part of Wageningen University & Research, Wageningen, the Netherlands
| | - Robert Barouki
- Université Paris Cité, T3S, Inserm Unit 1124, 45 rue des Saints Pères, 75006 Paris, France
| | - Karine Audouze
- Université Paris Cité, T3S, Inserm Unit 1124, 45 rue des Saints Pères, 75006 Paris, France
| | - Radu-Corneliu Duca
- Department of Health Protection, Laboratoire national de santé (LNS), 1, Rue Louis Rech, 3555 Dudelange, Luxembourg; Environment and Health, Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Peter Fantke
- Quantitative Sustainability Assessment, Department of Environmental and Resource Engineering, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Paul Scheepers
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, the Netherlands
| | - Manosij Ghosh
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - An Van Nieuwenhuyse
- Department of Health Protection, Laboratoire national de santé (LNS), 1, Rue Louis Rech, 3555 Dudelange, Luxembourg; Environment and Health, Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Joana Lobo Vicente
- EEA - European Environment Agency, Kongens Nytorv 6, 1050 Copenhagen K, Denmark
| | - Xenia Trier
- SPF - Santé Publique France, Environmental and Occupational Health Division, France
| | - Loïc Rambaud
- SPF - Santé Publique France, Environmental and Occupational Health Division, France
| | - Clémence Fillol
- SPF - Santé Publique France, Environmental and Occupational Health Division, France
| | - Sebastien Denys
- SPF - Santé Publique France, Environmental and Occupational Health Division, France
| | - André Conrad
- German Environment Agency (Umweltbundesamt), Dessau-Roßlau/Berlin, Germany
| | | | - Alicia Paini
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Jon Arnot
- ARC Arnot Research and Consulting, Inc., Toronto ONM4M 1W4, Canada
| | - Florian Schulze
- European Center for Environmental Medicine, Weserstr. 165, 12045 Berlin, Germany
| | - Kate Jones
- HSE - Health and Safety Executive, Harpur Hill, Buxton SK17 9JN, UK
| | | | | | - Lorraine Brennan
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Emilio Benfenati
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156 Milano, Italy
| | - Francesco Cubadda
- Istituto Superiore di Sanità - National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy
| | - Alberto Mantovani
- Istituto Superiore di Sanità - National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy
| | - Alena Bartonova
- NILU Norwegian Institute for Air Research, 2027 Kjeller, Norway
| | - Alison Connolly
- Centre for Climate and Air Pollution Studies, Physics, School of Natural Science and the Ryan Institute, University of Galway, University Road, Galway H91 CF50, Ireland
| | - Jaroslav Slobodnik
- NORMAN Association, Rue Jacques Taffanel - Parc Technologique ALATA, 60550 Verneuil-en-Halatte, France
| | - Yuri Bruinen de Bruin
- Commission, Joint Research Centre, Directorate for Space, Security and Migration, Geel, Belgium
| | - Jacob van Klaveren
- National Institute for Public Health and the Environment (RIVM), the Netherlands
| | - Nicole Palmen
- National Institute for Public Health and the Environment (RIVM), the Netherlands
| | - Hubert Dirven
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Trine Husøy
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Cathrine Thomsen
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ana Virgolino
- Environmental Health Behaviour Lab, Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal; Laboratório Associado TERRA, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Martin Röösli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), CH-4123 Allschwil, Switzerland
| | - Tim Gant
- Center for Radiation, Chemical and Environmental Hazards, Public Health England, UK
| | | | - Jos Bessems
- VITO HEALTH, Flemish Institute for Technological Research, 2400 Mol, Belgium
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van Zuuren EJ, Logullo P, Price A, Fedorowicz Z, Hughes EL, Gattrell WT. Existing guidance on reporting of consensus methodology: a systematic review to inform ACCORD guideline development. BMJ Open 2022; 12:e065154. [PMID: 36201247 PMCID: PMC9462098 DOI: 10.1136/bmjopen-2022-065154] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To identify evidence on the reporting quality of consensus methodology and to select potential checklist items for the ACcurate COnsensus Reporting Document (ACCORD) project to develop a consensus reporting guideline. DESIGN Systematic review. DATA SOURCES Embase, MEDLINE, Web of Science, PubMed, Cochrane Library, Emcare, Academic Search Premier and PsycINFO from inception until 7 January 2022. ELIGIBILITY CRITERIA Studies, reviews and published guidance addressing the reporting quality of consensus methodology for improvement of health outcomes in biomedicine or clinical practice. Reports of studies using or describing consensus methods but not commenting on their reporting quality were excluded. No language restrictions were applied. DATA EXTRACTION AND SYNTHESIS Screening and data extraction of eligible studies were carried out independently by two authors. Reporting quality items addressed by the studies were synthesised narratively. RESULTS Eighteen studies were included: five systematic reviews, four narrative reviews, three research papers, three conference abstracts, two research guidance papers and one protocol. The majority of studies indicated that the quality of reporting of consensus methodology could be improved. Commonly addressed items were: consensus panel composition; definition of consensus and the threshold for achieving consensus. Items least addressed were: public patient involvement (PPI); the role of the steering committee, chair, cochair; conflict of interest of panellists and funding. Data extracted from included studies revealed additional items that were not captured in the data extraction form such as justification of deviation from the protocol or incentives to encourage panellist response. CONCLUSION The results of this systematic review confirmed the need for a reporting checklist for consensus methodology and provided a range of potential checklist items to report. The next step in the ACCORD project builds on this systematic review and focuses on reaching consensus on these items to develop the reporting guideline. PROTOCOL REGISTRATION https://osf.io/2rzm9.
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Affiliation(s)
- Esther J van Zuuren
- Department of Dermatology, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands
| | - Patricia Logullo
- Nuffield Department of Orthopaedics, Rheumatology and Muskuloskeletal Sciences, Centre for Statistics in Medicine, University of Oxford and EQUATOR Network UK Centre, Oxford, Oxfordshire, UK
| | - Amy Price
- Stanford Anesthesia, Informatics and Media Lab, Stanford University School of Medicine, Stanford, California, USA
- The BMJ, London, UK
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Educational Programme for Cancer Nurses in Genetics, Health Behaviors and Cancer Prevention: A Multidisciplinary Consensus Study. J Pers Med 2022; 12:jpm12071104. [PMID: 35887601 PMCID: PMC9318790 DOI: 10.3390/jpm12071104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 06/26/2022] [Accepted: 07/01/2022] [Indexed: 11/21/2022] Open
Abstract
(1) Background: Most common hereditary cancers in Europe have been associated with lifestyle behaviors, and people affected are lacking follow up care. However, access to education programmes to increase knowledge on cancer and genetics and promote healthy lifestyle behaviors in people at high risk of cancer is scarce. This affects the quality of care of people with a hereditary risk of cancer. This study aimed to reach a multidisciplinary consensus on topics and competencies and competencies that cancer nurses need in relation to cancer, genetics, and health promotion. (2) Methods: A two-round online Delphi study was undertaken. Experts in cancer and genetics were asked to assess the relevance of eighteen items and to suggest additional terms. Consensus was defined as an overall agreement of at least 75%. (3) Results: A total of 74 multiprofessional experts from all around the world participated in this study including healthcare professionals working in genetics (39%), researchers in cancer and genetics (31%) and healthcare professionals with cancer patients (30%). Thirteen additional items were proposed. A total of thirty-one items reached consensus. (4) Conclusions: This multidisciplinary consensus study provide the essential elements to build an educational programme to increase cancer nurses’ skills to support the complex care of people living with a higher risk of cancer including addressing lifestyle behaviors. All professionals highlighted the importance of cancer nurses increasing their skills in cancer and genetics.
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Song H, Bai M, Wang J, Xia J, Wang Q, Ni C. Revision and validation of the “Constitution in Chinese Medicine Questionnaire (Elderly Edition)” based on the Delphi process. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2022. [DOI: 10.1016/j.jtcms.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Khalaf KA, Moore C, Mckenna G, Da Mata C, Lynch C. Undergraduate Teaching and Assessment Methods in Prosthodontics Curriculum: An International Delphi Survey. J Dent 2022; 123:104207. [PMID: 35760208 DOI: 10.1016/j.jdent.2022.104207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/16/2022] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To achieve consensus amongst an expert panel of prosthodontics/restorative dentistry academics on the best undergraduate teaching and assessments, and to develop recommendations regarding teaching and assessment of undergraduate prosthodontics. METHODS Semi-structured electronic questionnaires were used to collect data from senior clinical academics involved in the teaching of prosthodontics on three consecutive occasions (Delphi method). The questionnaires asked the experts' opinion on best teaching and assessment methods in the undergraduate prosthodontics curriculum. Invitation emails, with a hyperlink to the Round 1 questionnaire, were sent to 36 international dental academic experts. In later rounds, panellists were invited to consider their previous responses in light of the overall group response in attempt to bring the panel to a consensus. The group response was summarized using simple descriptive statistics, and the target level of consensus for each question was set at ≥ 70%. A response rate of at least 70% between rounds was deemed appropriate to maintain rigour. RESULTS Twenty-three senior academic experts from eleven countries agreed to participate. Eighteen (representing nine different countries) completed the questionnaires in its entirety (response rate 78.3%). The number of statements that attained consensus agreement was much higher than the number of non-consensus statements-92.6%, 175 statements out of 189 over three iterative rounds. Only 14 statements did not obtain a consensus during this Delphi study. CONCLUSIONS A total of 175 consensus statements represent the agreement expert views of participated senior academics in prosthodontics from nine different countries and across four continents. These consensus statements could be considered detailed guidelines and recommendations to improve future undergraduates' curriculum in prosthodontics. CLINICAL SIGNIFICANCE This Delphi study achieved a high consensus among a panel of senior academics in the teaching and assessment of undergraduate prosthodontics. This consensus could help minimise the current international and national divergence in dental schools' prosthodontics curricula, which could benefit future dentists and, subsequently, the patients.
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Affiliation(s)
- Khaleel Al Khalaf
- Restorative Dentistry Department, University Dental School & Hospital, University College Cork, Wilton, Cork, Ireland; Prosthodontics Department, Dammam Specialist Dental Centre, Dammam Medical Complex, Dammam, Saudi Arabia.
| | - Ciaran Moore
- Centre for Public Health, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Gerry Mckenna
- Centre for Public Health, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Cristiane Da Mata
- Restorative Dentistry Department, University Dental School & Hospital, University College Cork, Wilton, Cork, Ireland
| | - Christopher Lynch
- Restorative Dentistry Department, University Dental School & Hospital, University College Cork, Wilton, Cork, Ireland
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Gattrell WT, Hungin AP, Price A, Winchester CC, Tovey D, Hughes EL, van Zuuren EJ, Goldman K, Logullo P, Matheis R, Harrison N. ACCORD guideline for reporting consensus-based methods in biomedical research and clinical practice: a study protocol. Res Integr Peer Rev 2022; 7:3. [PMID: 35672782 PMCID: PMC9171734 DOI: 10.1186/s41073-022-00122-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/09/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Structured, systematic methods to formulate consensus recommendations, such as the Delphi process or nominal group technique, among others, provide the opportunity to harness the knowledge of experts to support clinical decision making in areas of uncertainty. They are widely used in biomedical research, in particular where disease characteristics or resource limitations mean that high-quality evidence generation is difficult. However, poor reporting of methods used to reach a consensus - for example, not clearly explaining the definition of consensus, or not stating how consensus group panellists were selected - can potentially undermine confidence in this type of research and hinder reproducibility. Our objective is therefore to systematically develop a reporting guideline to help the biomedical research and clinical practice community describe the methods or techniques used to reach consensus in a complete, transparent, and consistent manner. METHODS The ACCORD (ACcurate COnsensus Reporting Document) project will take place in five stages and follow the EQUATOR Network guidance for the development of reporting guidelines. In Stage 1, a multidisciplinary Steering Committee has been established to lead and coordinate the guideline development process. In Stage 2, a systematic literature review will identify evidence on the quality of the reporting of consensus methodology, to obtain potential items for a reporting checklist. In Stage 3, Delphi methodology will be used to reach consensus regarding the checklist items, first among the Steering Committee, and then among a broader Delphi panel comprising participants with a range of expertise, including patient representatives. In Stage 4, the reporting guideline will be finalised in a consensus meeting, along with the production of an Explanation and Elaboration (E&E) document. In Stage 5, we plan to publish the reporting guideline and E&E document in open-access journals, supported by presentations at appropriate events. Dissemination of the reporting guideline, including a website linked to social media channels, is crucial for the document to be implemented in practice. DISCUSSION The ACCORD reporting guideline will provide a set of minimum items that should be reported about methods used to achieve consensus, including approaches ranging from simple unstructured opinion gatherings to highly structured processes.
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Affiliation(s)
| | | | - Amy Price
- Stanford Anesthesia, Informatics and Media Lab, Stanford University School of Medicine, Stanford, CA, USA
| | | | - David Tovey
- Journal of Clinical Epidemiology, Sussex, UK
| | | | | | - Keith Goldman
- Global Medical Affairs, AbbVie, North Chicago, IL, USA
| | - Patricia Logullo
- Centre for Statistics in Medicine (CSM), University of Oxford, and EQUATOR Network UK Centre, Oxford, UK
| | - Robert Matheis
- International Society for Medical Publication Professionals, New York, NY, USA
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Abstract
Lithium-ion batteries have become a crucial part of the energy supply chain for transportation (in electric vehicles) and renewable energy storage systems. Recycling is considered one of the most effective ways for recovering the materials for spent LIB streams and circulating the material in the critical supply chain. However, few review articles have been published in the research domain of recycling and the circular economy, with most mainly focusing on either recycling methods or the challenges and opportunities in the circular economy for spent LIBs. This paper reviewed 93 articles (66 original research articles and 27 review articles) identified in the Web of Science core collection database. The study showed that publications in the area are increasing exponentially, with many focusing on recycling and recovery-related issues; policy and regulatory affairs received less attention than recycling. Most of the studies were experiments followed by evaluation and planning (as per the categorization made). Pre-treatment processes were widely discussed, which is a critical part of hydrometallurgy and direct physical recycling (DPR). DPR is a promising recycling technique that requires further attention. Some of the issues that require further consideration include a techno-economic assessment of the recycling process, safe reverse logistics, a global EV assessment revealing material recovery potential, and a lifecycle assessment of experiments processes (both in the hydrometallurgical and pyrometallurgical processes). Furthermore, the application of the circular business model and associated stakeholders’ engagement, clear and definitive policy guidelines, extended producer responsibility implications, and material tracking, and identification deserve further focus. This study presents several future research directions that would be useful for academics and policymakers taking necessary steps such as product design, integrated recycling techniques, intra-industry stakeholder cooperation, business model development, techno-economic analysis, and others towards achieving a circular economy in the LIB value chain.
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