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Kenning C, Usher-Smith JA, Jamison J, Jones J, Boaz A, Little P, Mallen C, Bower P, Park S. Impact of research activity on performance of general practices: a qualitative study. BJGP Open 2024:BJGPO.2024.0073. [PMID: 38649161 DOI: 10.3399/bjgpo.2024.0073] [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: 03/21/2024] [Accepted: 03/26/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND There is evidence that engaging in research is directly associated with better performance. If this relationship is to be strengthened, it is necessary to understand the mechanisms that might underlie that relationship. AIM To explore the perspectives of staff and wider stakeholders about mechanisms by which research activity may impact on the performance of general practices. DESIGN & SETTING Qualitative study using semi-structured interviews with general practice professionals and wider stakeholders in England. METHOD Individual interviews with 41 purposively sampled staff in 'research-ready' or 'research-active' general practices, and 21 other stakeholders. Interviews were independently coded by three researchers using a framework approach. RESULTS Participants described potential 'direct' and 'indirect' impacts on their work. 'Direct' impacts included improved knowledge and skills that could change practice work (for example, additional records searches for particular conditions); bringing in additional resources (for example, access to investigations or staff); and improving relationships with patients. 'Indirect' impacts included job satisfaction (for example, perception of practice as a centre of excellence and innovation, and the variety afforded by research activity reducing burnout); and staff recruitment (increasing the attractiveness of the practice as a place to work). Responders identified few negative impacts. CONCLUSION Staff and stakeholders identified a range of potential impacts of research activity on practice performance, with impacts on their working lives most salient. Negative impacts were not generally raised. Nevertheless, responders generally discussed potential impacts rather than providing specific examples of those impacts. This may reflect the type of research activity conducted in general practice, often led by external collaborators.
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Affiliation(s)
- Cassandra Kenning
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK
| | - Juliet A Usher-Smith
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - James Jamison
- Division of Psychiatry, University College London, London, UK
| | - Jennifer Jones
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Annette Boaz
- NIHR Health and Social Care Workforce Research Unit, Policy Institute, King's College London, London, UK
| | - Paul Little
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | | | - Peter Bower
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK
| | - Sophie Park
- Research Department of Primary Care and Population Health, University College London, Hampstead, UK
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Peters MJ, Plant K. Consent in Pediatric Critical Care Trials: Duty or Burden? Pediatr Crit Care Med 2024; 25:873-875. [PMID: 39240669 DOI: 10.1097/pcc.0000000000003577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Affiliation(s)
- Mark J Peters
- The Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, United Kingdom
- Children's Acute Transport Service, Great Ormond Street Hospital, London, United Kingdom
| | - Kate Plant
- Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, United Kingdom
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Boaz A, Goodenough B, Hanney S, Soper B. If health organisations and staff engage in research, does healthcare improve? Strengthening the evidence base through systematic reviews. Health Res Policy Syst 2024; 22:113. [PMID: 39160553 PMCID: PMC11331621 DOI: 10.1186/s12961-024-01187-7] [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: 05/14/2024] [Accepted: 07/22/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND There is an often-held assumption that the engagement of clinicians and healthcare organizations in research improves healthcare performance at various levels. Previous reviews found up to 28 studies suggesting a positive association between the engagement of individuals and healthcare organizations in research and improvements in healthcare performance. The current study sought to provide an update. METHODS We updated our existing published systematic review by again addressing the question: Does research engagement (by clinicians and organizations) improve healthcare performance? The search covered the period 1 January 2012 to March 2024, in two phases. First, the formal updated search ran from 1 January 2012 to 31 May 2020, in any healthcare setting or country and focussed on English language publications. In this phase two searches identified 66 901 records. Later, a further check of key journals and citations to identified papers ran from May 2020 to March 2024. In total, 168 papers progressed to full-text appraisal; 62 were identified for inclusion in the update. Then we combined papers from our original and updated reviews. RESULTS In the combined review, the literature is dominated by papers from the United States (50/95) and mostly drawn from the Global North. Papers cover various clinical fields, with more on cancer than any other field; 86 of the 95 papers report positive results, of which 70 are purely positive and 16 positive/mixed, meaning there are some negative elements (i.e. aspects where there is a lack of healthcare improvement) in their findings. CONCLUSIONS The updated review collates a substantial pool of studies, especially when combined with our original review, which are largely positive in terms of the impact of research engagement on processes of care and patient outcomes. Of the potential engagement mechanisms, the review highlights the important role played by research networks. The review also identifies various papers which consider how far there is a "dose effect" from differing amounts of research engagement. Additional lessons come from analyses of equity issues and negative papers. This review provides further evidence of contributions played by systems level research investments such as research networks on processes of care and patient outcomes.
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Affiliation(s)
- Annette Boaz
- Health and Social Care Workforce Research Unit, King's Policy Institute, King's College London, Virginia Woolf Building, 20 Kingsway, London, United Kingdom.
| | | | | | - Bryony Soper
- Brunel University London, Uxbridge, United Kingdom
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Whitehouse CL, Webster J, Copping J, Morris P, Yazbek J, Shiju M, Hall H. Developing critical enquiry, capacity, capability and confidence in the health and care workforce. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:718-725. [PMID: 39141333 DOI: 10.12968/bjon.2024.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
BACKGROUND Health and care staff have limited opportunities to design, deliver and lead critical enquiry activities. AIMS To explore barriers and enablers of building capacity, capability and confidence of these practitioners who wish to undertake critical enquiry activity. METHODS A realist conceptual framework including the development of middle range theory allowed analysis of the scholarship process and outcomes. Data were collected through snap surveys, interviews (face to face and online) and project output (posters). RESULTS Nine scholars completed the programme and all participated in the study. They all experienced an increase in capacity, capability and confidence in critical enquiry activity. Six overarching themes arose from analysis of the interviews and snap survey data: value; expertise; attitudes; meaningful, responsive support; brain space; and skill and knowledge acquisition. DISCUSSION A combined focus on people and project while staff remained embedded in their work area was key for the growth of skills and knowledge and creating impact from projects. Guilt at having dedicated time to take part in the programme was a self-imposed barrier to building capacity and capability. Social capital (gained from bringing together individuals from different groups with shared values) facilitated bonding, which increased psychological safety and helped enable capability and confidence. CONCLUSION The combination of theory and practice embedded in a real-world context led to positive outcomes for staff, patients, carers and the facilitation team as real-life changes were made in clinical environments.
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Affiliation(s)
- Claire L Whitehouse
- Senior Nurse for Nursing, Midwifery and Allied Health Professions Research, and Clinical Director for Research, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth
- Honorary Fellow, University of East Anglia, Norwich; and Visiting Professor, Staffordshire University, Stoke-on-Trent
| | - Jonathan Webster
- Professor of Practice Development, Norfolk Initiative for Coastal and Rural Health Equalities, University of East Anglia, Norwich
| | - Jacky Copping
- Deputy Chief Nurse, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth
| | - Paul Morris
- Chief Nurse, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, England
| | - Jonathan Yazbek
- Head of Quality Improvement, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth
| | - Mehar Shiju
- Research and Evaluation Associate, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth
| | - Helen Hall
- Research Grants Adviser and Research Paramedic, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, and Honorary Fellow, University of East Anglia, Norwich
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Morris A. Unlocking the power of NHS research: a priority for the new UK Government. Lancet 2024; 404:317-320. [PMID: 39008995 DOI: 10.1016/s0140-6736(24)01451-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 07/17/2024]
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Angus DC, Huang AJ, Lewis RJ, Abernethy AP, Califf RM, Landray M, Kass N, Bibbins-Domingo K. The Integration of Clinical Trials With the Practice of Medicine: Repairing a House Divided. JAMA 2024; 332:153-162. [PMID: 38829654 DOI: 10.1001/jama.2024.4088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Importance Optimal health care delivery, both now and in the future, requires a continuous loop of knowledge generation, dissemination, and uptake on how best to provide care, not just determining what interventions work but also how best to ensure they are provided to those who need them. The randomized clinical trial (RCT) is the most rigorous instrument to determine what works in health care. However, major issues with both the clinical trials enterprise and the lack of integration of clinical trials with health care delivery compromise medicine's ability to best serve society. Observations In most resource-rich countries, the clinical trials and health care delivery enterprises function as separate entities, with siloed goals, infrastructure, and incentives. Consequently, RCTs are often poorly relevant and responsive to the needs of patients and those responsible for care delivery. At the same time, health care delivery systems are often disengaged from clinical trials and fail to rapidly incorporate knowledge generated from RCTs into practice. Though longstanding, these issues are more pressing given the lessons learned from the COVID-19 pandemic, heightened awareness of the disproportionate impact of poor access to optimal care on vulnerable populations, and the unprecedented opportunity for improvement offered by the digital revolution in health care. Four major areas must be improved. First, especially in the US, greater clarity is required to ensure appropriate regulation and oversight of implementation science, quality improvement, embedded clinical trials, and learning health systems. Second, greater adoption is required of study designs that improve statistical and logistical efficiency and lower the burden on participants and clinicians, allowing trials to be smarter, safer, and faster. Third, RCTs could be considerably more responsive and efficient if they were better integrated with electronic health records. However, this advance first requires greater adoption of standards and processes designed to ensure health data are adequately reliable and accurate and capable of being transferred responsibly and efficiently across platforms and organizations. Fourth, tackling the problems described above requires alignment of stakeholders in the clinical trials and health care delivery enterprises through financial and nonfinancial incentives, which could be enabled by new legislation. Solutions exist for each of these problems, and there are examples of success for each, but there is a failure to implement at adequate scale. Conclusions and Relevance The gulf between current care and that which could be delivered has arguably never been wider. A key contributor is that the 2 limbs of knowledge generation and implementation-the clinical trials and health care delivery enterprises-operate as a house divided. Better integration of these 2 worlds is key to accelerated improvement in health care delivery.
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Affiliation(s)
- Derek C Angus
- JAMA , Chicago, Illinois
- University of Pittsburgh Schools of the Health Sciences, Pittsburgh, Pennsylvania
| | | | - Roger J Lewis
- JAMA , Chicago, Illinois
- David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Amy P Abernethy
- Verily Life Sciences, San Francisco, California
- Now with Highlander Health, Dallas, Texas
| | | | - Martin Landray
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Protas, Manchester, United Kingdom
| | - Nancy Kass
- Johns Hopkins University, Baltimore, Maryland
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Shepherd M, Quinn H. Implementing a strategic plan for research. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:500-504. [PMID: 38850146 DOI: 10.12968/bjon.2024.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2024]
Abstract
Effective integration of research within healthcare organisations is recognised to improve outcomes. A research strategy within a hospital Trust in South West England was revised, following the launch of a national Chief Nursing Officer (CNO) strategy that promotes research engagement and activity. The aim was to develop, implement and evaluate this revised strategic plan for research. High-level engagement within the organisation was established and previous initiatives evaluated. A 6-year plan with 2-year targets was defined and evaluated at year end. The four pillars of the CNO strategy were central to the revised strategy, underpinned by digital innovation. Evaluation of the earlier strategy indicated excellent engagement with the Chief Nurse Research Fellow initiative and the Clinical Academic Network. The 'Embedding Research In Care' (ERIC) unit was reconfigured to an ERIC model, which aided question generation and project development. Year one objectives were achieved within the revised plan. Implementing a research strategy within an organisation requires a cultural shift and a long-term vision is required with measurable objectives. The team demonstrated significant progress through high-level leadership, mentoring and cross-professional collaboration.
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Affiliation(s)
- Maggie Shepherd
- Consultant Nurse and Associate Director for Nursing Research, Royal Devon University Healthcare NHS Foundation Trust/Professor and Senior Clinical Investigator, Biomedical Research Centre, University of Exeter
| | - Helen Quinn
- Research and Development Director, Royal Devon University Healthcare NHS Foundation Trust/Clinical Director, NIHR PRC Exeter/Honorary Clinical Professor, Faculty of Health and Life Sciences, University of Exeter/Visiting Professor of Clinical Nursing, School of Nursing and Midwifery, University of Plymouth
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Lond B, Dodd C, Davey Z, Darlison L, McPhelim J, Rawlinson J, Williamson I, Merriman C, Waddington F, Bagnallainslie D, Rajendran B, Usman J, Henshall C. A systematic review of the barriers and facilitators impacting patient enrolment in clinical trials for lung cancer. Eur J Oncol Nurs 2024; 70:102564. [PMID: 38554615 DOI: 10.1016/j.ejon.2024.102564] [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: 12/27/2023] [Revised: 03/06/2024] [Accepted: 03/11/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE Clinical research trials are needed to enhance the medical care and treatment for lung cancer, which remains the leading cause of cancer-related deaths worldwide. While clinical trials allow for the development of novel therapies to treat cancer, the recruitment of lung cancer patients to trials is low. This review aimed to identify and synthesise the available literature concerning barriers and facilitators affecting lung cancer patients' decisions to enrol in clinical trials to guide future cancer research efforts. METHODS Four databases were systematically searched: Academic Search Complete, CINHAL, PubMed, and PsycINFO in August 2023. A supplemental grey literature search was also conducted alongside this. Articles were quality appraised using CASP and JMI checklists, and results were narratively synthesised. RESULTS Eighteen articles of varied design met the inclusion criteria, and results were mapped onto the Capability, Opportunity, and Motivation Behaviour (COM-B) Model to help structure and conceptualise review findings. Evidence suggests that the decision to enrol in a trial is multifaceted and informed by: when and how study information is presented, travel and trial eligibility, and altruistic hopes and fears. CONCLUSIONS There is need to address the many different concerns that lung cancer patients have about participating in a clinical trial through the supply of accessible and timely trial information, and via the reduction of travel, expansion of study eligibility criteria, and recognition of a person's altruistic wishes, hopes, fears, and family-oriented concerns. Future research should aim to work alongside lung cancer patients, clinicians, and other stakeholders to increase research accessibility.
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Affiliation(s)
- Benjamin Lond
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom.
| | - Christopher Dodd
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Zoe Davey
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Liz Darlison
- University Hospitals of Leicester, The Glenfield Hospital, Leicester, United Kingdom
| | - John McPhelim
- University Hospital Hairmyres, NHS Lanarkshire, East Kilbride, United Kingdom
| | - Janette Rawlinson
- Lung Cancer Patient Advisory Group, European Lung Foundation, Sheffield, United Kingdom; British Thoracic Oncology Group Steering Committee, Leicester, United Kingdom
| | - Iain Williamson
- Division of Psychology, De Montfort University, Leicester, United Kingdom
| | - Clair Merriman
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom; Oxford University Hospital Foundation Trust, Oxford, United Kingdom
| | - Francesca Waddington
- Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford, United Kingdom
| | | | - Balaji Rajendran
- Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford, United Kingdom
| | - Jesse Usman
- Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford, United Kingdom
| | - Catherine Henshall
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom; Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford, United Kingdom
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Katzenschlager S, Elshaer A, Metelmann B, Metelmann C, Thilakasiri K, Karageorgos V, Barry T, Alm-Kruse K, Karim H, Maurer H, Kramer-Johansen J, Orlob S. Top 5 barriers in cardiac arrest research as perceived by international early career researchers - A consensus study. Resusc Plus 2024; 18:100608. [PMID: 38524147 PMCID: PMC10957401 DOI: 10.1016/j.resplu.2024.100608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
Aim of the study Cardiac arrest research has not received as much scientific attention as research on other topics. Here, we aimed to identify cardiac arrest research barriers from the perspective of an international group of early career researchers. Methods Attendees of the 2022 international masterclass on cardiac arrest registry research accompanied the Global Out-of-Hospital Cardiac Arrest Registry collaborative meeting in Utstein, Norway, and used an adapted hybrid nominal group technique to obtain a diverse and comprehensive perspective. Barriers were identified using a web-based questionnaire and discussed and ranked during an in-person follow-up meeting. After each response was discussed and clarified, barriers were categorized and ranked over two rounds. Each participant scored these from 1 (least significant) to 5 (most significant). Results Nine participants generated 36 responses, forming seven overall categories of cardiac arrest research barriers. "Allocated research time" was ranked first in both rounds. "Scientific environment", including appropriate mentorship and support systems, ranked second in the final ranking. "Resources", including funding and infrastructure, ranked third. "Access to and availability of cardiac arrest research data" was the fourth-ranked barrier. This included data from the cardiac arrest registries, medical devices, and clinical studies. Finally, "uniqueness" was the fifth-ranked barrier. This included ethical issues, patient recruitment challenges, and unique characteristics of cardiac arrest. Conclusion By identifying cardiac arrest research barriers and suggesting solutions, this study may act as a tool for stakeholders to focus on helping early career researchers overcome these barriers, thus paving the road for future research.
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Affiliation(s)
- Stephan Katzenschlager
- Heidelberg University, Medical Faculty Heidelberg, Department of Anesthesiology, Heidelberg, Germany
| | - Ahmed Elshaer
- The Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Bibiana Metelmann
- Department of Anaesthesiology, Greifswald University Medicine, Greifswald, Germany
| | - Camilla Metelmann
- Department of Anaesthesiology, Greifswald University Medicine, Greifswald, Germany
| | - Kaushila Thilakasiri
- Oxford University Hospitals NHS Trust Oxford UK, Postgraduate Institute of Medicine, UK
- University of Colombo, Ministry of Health, Sri Lanka
| | - Vlasios Karageorgos
- Cardiopulmonary Resuscitation Lab, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | | | - Kristin Alm-Kruse
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Hritul Karim
- Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
| | - Holger Maurer
- Department of Anesthesiology and Intensive Care Medicine, University of Luebeck, Luebeck, Germany
| | - Jo Kramer-Johansen
- Norwegian National Advisory Unit on Prehospital Emergency Medicine (NAKOS) , Norway
- Norwegian Cardiac Arrest Registry, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Simon Orlob
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
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Watson J, Robertson S, Ryan T, Wood E, Cooke J, Hampshaw S, Roddam H. Understanding the value of a doctorate for allied health professionals in practice in the UK: a survey. BMC Health Serv Res 2024; 24:566. [PMID: 38698416 PMCID: PMC11064402 DOI: 10.1186/s12913-024-11035-7] [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] [Accepted: 04/23/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND The need to transform the United Kingdom's (UK) delivery of health and care services to better meet population needs and expectations is well-established, as is the critical importance of research and innovation to drive those transformations. Allied health professionals (AHPs) represent a significant proportion of the healthcare workforce. Developing and expanding their skills and capabilities is fundamental to delivering new ways of working. However, career opportunities combining research and practice remain limited. This study explored the perceived utility and value of a doctorate to post-doctoral AHPs and how they experience bringing their research-related capabilities into practice environments. METHODS With a broadly interpretivist design, a qualitatively oriented cross-sectional survey, with closed and open questions, was developed to enable frequency reporting while focusing on the significance and meaning participants attributed to the topic. Participants were recruited via professional networks and communities of practice. Descriptive statistics were used to analyse closed question responses, while combined framework and thematic analysis was applied to open question responses. RESULTS Responses were received from 71 post-doctoral AHPs located across all four UK nations. Findings are discussed under four primary themes of utilisation of the doctorate; value of the doctorate; impact on career, and impact on self and support. Reference is also made at appropriate points to descriptive statistics summarising closed question responses. CONCLUSION The findings clearly articulate variability of experiences amongst post-doctoral AHPs. Some were able to influence team and organisational research cultures, support the development of others and drive service improvement. The challenges, barriers and obstacles encountered by others reflect those that have been acknowledged for many years. Acknowledging them is important, but the conversation must move forward and generate positive action to ensure greater consistency in harnessing the benefits and value-added these practitioners bring. If system-wide transformation is the aim, it is inefficient to leave navigating challenges to individual creativity and tenacity or forward-thinking leaders and organisations. There is an urgent need for system-wide responses to more effectively, consistently and equitably enable career pathways combining research and practice for what is a substantial proportion of the UK healthcare workforce.
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Affiliation(s)
- Jo Watson
- Dr Jo Watson Consulting Ltd., Hampshire, UK.
| | - Steven Robertson
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Tony Ryan
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Emily Wood
- School of Health and Related Research, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Jo Cooke
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Susan Hampshaw
- NIHR Health Determinants Research Collaboration, Doncaster, UK
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Aggarwal A, Han L, Lewis D, Costigan J, Hubbard A, Taylor J, Rigg A, Purushotham A, van der Meulen J. Association of travel time, patient characteristics, and hospital quality with patient mobility for breast cancer surgery: A national population-based study. Cancer 2024; 130:1221-1233. [PMID: 38186226 DOI: 10.1002/cncr.35153] [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: 08/08/2023] [Revised: 09/20/2023] [Accepted: 10/02/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND This national study investigated hospital quality and patient factors associated with treatment location for breast cancer surgery. METHODS By using linked administrative data sets from the English National Health Service, the authors identified all women diagnosed between January 2, 2016, and December 31, 2018, who underwent breast-conserving surgery (BCS) or a mastectomy with or without immediate breast reconstruction. The extent to which patients bypassed their nearest hospital was investigated using a geographic information system (ArcGIS). Conditional logistic regressions were used to estimate the impact of travel time, hospital quality, and patient characteristics. RESULTS 22,622 Of 69,153 patients undergoing BCS, 22,622 (32.7%) bypassed their nearest hospital; and, of 23,536 patients undergoing mastectomy, 7179 (30.5%) bypassed their nearest hospital. Women who were younger, without comorbidities, or from rural areas were more likely to travel to more distant hospitals (p < .05). Patients undergoing BCS (odds ratio [OR], 1.85; 95% confidence interval [CI], 1.36-2.50) or mastectomy (OR, 1.52; 95% CI, 1.14-2.02) were more likely to be treated at specialist breast reconstruction centers despite not undergoing the procedure. Patients receiving mastectomy and immediate breast reconstruction were more likely to travel to hospitals employing surgeons who had a media reputation (OR, 2.41; 95% CI, 1.28-4.52). Patients undergoing BCS were less likely to travel to hospitals with shorter surgical waiting times (OR, 0.65; 95% CI, 0.46-0.92). The authors did not observe a significant impact for research activity, hospital quality rating, breast re-excision rates, or the status as a multidisciplinary cancer center. CONCLUSIONS Patient choice policies may drive inequalities in the health care system without improving patient outcomes.
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Affiliation(s)
- Ajay Aggarwal
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Department of Oncology, Guy's and St Thomas' National Health Service Foundation Trust, London, UK
| | - Lu Han
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Daniel Lewis
- UK Department for Environment, Food, and Rural Affairs, Agriculture Ministry of the United Kingdom, London, UK
| | | | - Alison Hubbard
- Patient and Public Involvement Representative, Liverpool, UK
| | | | - Anne Rigg
- Department of Oncology, Guy's and St Thomas' National Health Service Foundation Trust, London, UK
| | - Arnie Purushotham
- Department of Breast Surgery, Guy's and St Thomas' National Health Service Foundation Trust, London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Jan van der Meulen
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Jonker L, Jayne Fisher S. Appraisal of National Institute for Health and Care Research activity in primary care in England: cross-sectional study. Fam Pract 2024; 41:99-104. [PMID: 38300768 DOI: 10.1093/fampra/cmae004] [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] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND The National Institute for Health and Care Research (NIHR) was set up to enhance clinical and health research activity in a variety of National Health Service (NHS) healthcare settings, including primary care. OBJECTIVE To appraise how overall General Practitioner (GP) practice performance, location, and staffing levels may interact with NIHR Portfolio activity in primary care in England. METHODS Cross-sectional summary of GP practice research activity and practice descriptors; complete data from 6,171 GP practices was collated from NIHR (using data for 2013-2023 for Portfolio studies), Public Health England, Care Quality Commission, and NHS Digital sources, respectively. RESULTS In primary care, 1 million patients have been recruited into NIHR Portfolio studies in the last decade. The top 10% of practices-measured by different studies recruited to-contributed over 50% of that accrual. When the top decile of GP practices is compared to the 20% least active GP practices, research activity is significantly and individually linked with larger GP practices. Furthermore, it is significantly yet modestly associated with GP practice performance (positive patient feedback, Care Quality Commission rating), lower locality deprivation levels, and lower patient to GP ratios. CONCLUSIONS Research activity in GP practices is-as seen previously with hospitals-significantly linked with better GP practice performance and patient feedback. Practice list size and staffing levels in particular interact with the aforementioned. This should be taken into account when determining strategies to increase patient and GP practice participation in NIHR Portfolio research studies.
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Affiliation(s)
- Leon Jonker
- Research & Development Department, North Cumbria Integrated Care NHS Foundation Trust, Penrith CA11 8HX, United Kingdom
| | - Stacey Jayne Fisher
- Research & Development Department, North Cumbria Integrated Care NHS Foundation Trust, Penrith CA11 8HX, United Kingdom
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Brandenburg C, Stehlik P, Noble C, Wenke R, Jones K, Hattingh L, Dungey K, Branjerdporn G, Spillane C, Kalantari S, George S, Keijzers G, Mickan S. How can healthcare organisations increase doctors' research engagement? A scoping review. J Health Organ Manag 2024; ahead-of-print. [PMID: 38578070 DOI: 10.1108/jhom-09-2023-0270] [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] [Indexed: 04/06/2024]
Abstract
PURPOSE Clinician engagement in research has positive impacts for healthcare, but is often difficult for healthcare organisations to support in light of limited resources. This scoping review aimed to describe the literature on health service-administered strategies for increasing research engagement by medical practitioners. DESIGN/METHODOLOGY/APPROACH Medline, EMBASE and Web of Science databases were searched from 2000 to 2021 and two independent reviewers screened each record for inclusion. Inclusion criteria were that studies sampled medically qualified clinicians; reported empirical data; investigated effectiveness of an intervention in improving research engagement and addressed interventions implemented by an individual health service/hospital. FINDINGS Of the 11,084 unique records, 257 studies were included. Most (78.2%) studies were conducted in the USA, and were targeted at residents (63.0%). Outcomes were measured in a variety of ways, most commonly publication-related outcomes (77.4%), though many studies used more than one outcome measure (70.4%). Pre-post (38.8%) and post-only (28.7%) study designs were the most common, while those using a contemporaneous control group were uncommon (11.5%). The most commonly reported interventions included Resident Research Programs (RRPs), protected time, mentorship and education programs. Many articles did not report key information needed for data extraction (e.g. sample size). ORIGINALITY/VALUE This scoping review demonstrated that, despite a large volume of research, issues like poor reporting, infrequent use of robust study designs and heterogeneous outcome measures limited application. The most compelling available evidence pointed to RRPs, protected time and mentorship as effective interventions. Further high-quality evidence is needed to guide healthcare organisations on increasing medical research engagement.
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Affiliation(s)
- Caitlin Brandenburg
- Allied Health Research, Gold Coast Health, Southport, Australia
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Paulina Stehlik
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Southport, Australia
| | - Christy Noble
- Allied Health Research, Gold Coast Health, Southport, Australia
- Academy for Medical Education, Medical School, The University of Queensland, Brisbane, Australia
| | - Rachel Wenke
- Allied Health Research, Gold Coast Health, Southport, Australia
- School of Health Sciences and Social Work, Griffith University, Southport, Australia
| | - Kristen Jones
- Allied Health Research, Gold Coast Health, Southport, Australia
- School of Health Sciences and Social Work, Griffith University, Southport, Australia
| | - Laetitia Hattingh
- Allied Health Research, Gold Coast Health, Southport, Australia
- School of Health Sciences and Social Work, Griffith University, Southport, Australia
| | - Kelly Dungey
- Neurosciences Rehabilitation Unit, Gold Coast Health, Southport, Australia
| | - Grace Branjerdporn
- Allied Health Research, Gold Coast Health, Southport, Australia
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Ciara Spillane
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sharmin Kalantari
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Shane George
- School of Medicine and Dentistry, Griffith University, Southport, Australia
- Department of Emergency Medicine, Gold Coast Health, Southport, Australia
- Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Gerben Keijzers
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
- School of Medicine and Dentistry, Griffith University, Southport, Australia
- Department of Emergency Medicine, Gold Coast Health, Southport, Australia
| | - Sharon Mickan
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
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Khatri C, Metcalfe A, Wall P, Underwood M, Haddad FS, Davis ET. Robotic trials in arthroplasty surgery. Bone Joint J 2024; 106-B:114-120. [PMID: 38295854 DOI: 10.1302/0301-620x.106b2.bjj-2023-0711.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Total hip and knee arthroplasty (THA, TKA) are largely successful procedures; however, both have variable outcomes, resulting in some patients being dissatisfied with the outcome. Surgeons are turning to technologies such as robotic-assisted surgery in an attempt to improve outcomes. Robust studies are needed to find out if these innovations are really benefitting patients. The Robotic Arthroplasty Clinical and Cost Effectiveness Randomised Controlled Trials (RACER) trials are multicentre, patient-blinded randomized controlled trials. The patients have primary osteoarthritis of the hip or knee. The operation is Mako-assisted THA or TKA and the control groups have operations using conventional instruments. The primary clinical outcome is the Forgotten Joint Score at 12 months, and there is a built-in analysis of cost-effectiveness. Secondary outcomes include early pain, the alignment of the components, and medium- to long-term outcomes. This annotation outlines the need to assess these technologies and discusses the design and challenges when conducting such trials, including surgical workflows, isolating the effect of the operation, blinding, and assessing the learning curve. Finally, the future of robotic surgery is discussed, including the need to contemporaneously introduce and evaluate such technologies.
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Affiliation(s)
- Chetan Khatri
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- Warwick Orthopaedics Specialist Training Programme, University Hospitals Coventry & Warwickshire, Coventry, UK
| | - Andrew Metcalfe
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- Warwick Orthopaedics Specialist Training Programme, University Hospitals Coventry & Warwickshire, Coventry, UK
| | - Peter Wall
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Martin Underwood
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- Warwick Orthopaedics Specialist Training Programme, University Hospitals Coventry & Warwickshire, Coventry, UK
| | - Fares S Haddad
- Department of Trauma and Orthopaedic Surgery, University College Hospitals, London, UK
- The Bone & Joint Journal , London, UK
| | - Edward T Davis
- The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
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Kumar A, Yassin N, Marley A, Bellato V, Foppa C, Pellino G, Myrelid P, Millan M, Gros B, Avellaneda N, Catalan-Serra I, El-Hussuna A, Cunha Neves JA, Roseira J, Cunha MF, Verstockt B, Bettenworth D, Mege D, Brookes MJ. Crossing barriers: the burden of inflammatory bowel disease across Western Europe. Therap Adv Gastroenterol 2023; 16:17562848231218615. [PMID: 38144422 PMCID: PMC10748558 DOI: 10.1177/17562848231218615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 11/16/2023] [Indexed: 12/26/2023] Open
Abstract
An estimated 2.5-3 million individuals (0.4%) in Europe are affected by inflammatory bowel disease (IBD). Whilst incidence rates for IBD are stabilising across Europe, the prevalence is rising and subsequently resulting in a significant cost to the healthcare system of an estimated 4.6-5.6 billion euros per year. Hospitalisation and surgical resection rates are generally on a downward trend, which is contrary to the rising cost of novel medication. This signifies a large part of healthcare cost and burden. Despite publicly funded healthcare systems in most European countries, there is still wide variation in how patients receive and/or pay for biologic medication. This review will provide an overview and discuss the different healthcare systems within Western Europe and the barriers that affect overall management of a changing IBD landscape, including differences to hospitalisation and surgical rates, access to medication and clinical trial participation and recruitment. This review will also discuss the importance of standardising IBD management to attain high-quality care for all patients with IBD.
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Affiliation(s)
- Aditi Kumar
- Department of Gastroenterology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, UK B15 2GW
| | - Nuha Yassin
- Department of Colorectal Surgery, University Hospitals Birmingham, Birmingham, UK
| | - Alexandra Marley
- Department of Gastroenterology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Vittoria Bellato
- Department of Minimally Invasive Surgery, University of Rome ‘Tor Vergata’, Rome, Italy
| | - Caterina Foppa
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Gianluca Pellino
- Colorectal Surgery, Vall D’Hebron University Hospital, Universitat Autonoma de Barcelona, Barcelona, Spain
- Department of Advanced Medical and Surgical Sciences, Universita degli Studi della Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Pär Myrelid
- Department of Surgery, Linköping University Hospital, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Monica Millan
- Department of Surgery, La Fe University and Polytechnic Hospital, University of Valencia, Valencia, Spain
| | - Beatriz Gros
- Department of Gastroenterology and Hepatology, Reina Sofia University Hospital, Cordoba, Spain
- Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - Nicolas Avellaneda
- General and Colorectal Surgery Department, CEMIC University Hospital, Buenos Aires, Argentina
| | - Ignacio Catalan-Serra
- Department of Gastroenterology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Department of Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - João A. Cunha Neves
- Department of Gastroenterology, Algarve University Hospital Centre, Portimão, Portugal
- Algarve Biomedical Centre, University of Algarve, Faro, Portugal
| | - Joana Roseira
- Department of Gastroenterology, Algarve University Hospital Centre, Portimão, Portugal
- Algarve Biomedical Centre, University of Algarve, Faro, Portugal
| | - Miguel F. Cunha
- Algarve Biomedical Centre, University of Algarve, Faro, Portugal
- Department of Colorectal Surgery, Algarve University Hospital Centre, Portimão, Portugal
| | - Bram Verstockt
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Belgium
- Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Dominik Bettenworth
- CED Schwerpunktpraxis, Münster, Germany
- Medical Faculty, University of Münster, Münster, Germany
| | - Diane Mege
- Department of Digestive and Oncology Surgery, Timone University Hospital, Marseille, France
| | - Matthew J. Brookes
- Department of Gastroenterology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
- School of Medicine and Clinical Practice, Faculty of Sciences and Engineering, University of Wolverhampton, Wolverhampton UK
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Moffat VE, Brennan PN, Gaya DR, Hayes PC, Din S. The evolution of ScotRIGHT: The first pan-Scotland physician trainee research network. J R Coll Physicians Edinb 2023; 53:302-306. [PMID: 37650310 DOI: 10.1177/14782715231197240] [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] [Indexed: 09/01/2023] Open
Abstract
Scotland has a distinguished track record in foundational clinical research. From the completion of the first clinical trial undertaken in scurvy to cloning the world's first whole mammal, Scottish basic and clinical research is world leading. More recently, challenges in access to research skills, funding and programmes by clinical trainees led to the development of alternatives to these typical avenues of accessing research opportunities. Trainee networks evolved to meet the needs of trainees looking to access projects and collaboratives beyond audit and quality improvement commonly performed during structured training. These networks have enjoyed enormous success and have succeeded in progressing projects which have impactful outputs for patients, and improving clinical services. Here, we describe the foundation of the first pan-Scotland physician trainee research network; Scottish Trainees Research In Gastroterology and Hepatology (ScotRIGHT). We outline the foundational efforts, requisites and foundations required to develop a research network.
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Affiliation(s)
| | - Paul N Brennan
- Graduate School, College of Medicine Dentistry and Nursing, University of Dundee, Dundee, UK
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Westphal GA, Robinson CC, Giordani NE, Teixeira C, Rohden AI, Dos Passos Gimenes B, Guterres CM, Madalena IC, Andrighetto LV, Souza da Silva S, Barbosa da Silva D, Sganzerla D, Cavalcanti AB, Franke CA, Bozza FA, Machado FR, de Andrade J, Pontes Azevedo LC, Schneider S, Orlando BR, Grion CMC, Bezerra FA, Roman FR, Leite FO, Ferraz Siqueira ÍL, Oliveira JFP, de Oliveira LC, de Melo MDFRB, Leal PBGP, Diniz PC, Moraes RB, Salomão Pontes DF, Araújo Queiroz JE, Hammes LS, Meade MO, Rosa RG, Falavigna M. Evidence-Based Checklist to Delay Cardiac Arrest in Brain-Dead Potential Organ Donors: The DONORS Cluster Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2346901. [PMID: 38095899 PMCID: PMC10722341 DOI: 10.1001/jamanetworkopen.2023.46901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/25/2023] [Indexed: 12/17/2023] Open
Abstract
Importance The effectiveness of goal-directed care to reduce loss of brain-dead potential donors to cardiac arrest is unclear. Objective To evaluate the effectiveness of an evidence-based, goal-directed checklist in the clinical management of brain-dead potential donors in the intensive care unit (ICU). Design, Setting, and Participants The Donation Network to Optimize Organ Recovery Study (DONORS) was an open-label, parallel-group cluster randomized clinical trial in Brazil. Enrollment and follow-up were conducted from June 20, 2017, to November 30, 2019. Hospital ICUs that reported 10 or more brain deaths in the previous 2 years were included. Consecutive brain-dead potential donors in the ICU aged 14 to 90 years with a condition consistent with brain death after the first clinical examination were enrolled. Participants were randomized to either the intervention group or the control group. The intention-to-treat data analysis was conducted from June 15 to August 30, 2020. Interventions Hospital staff in the intervention group were instructed to administer to brain-dead potential donors in the intervention group an evidence-based checklist with 13 clinical goals and 14 corresponding actions to guide care, every 6 hours, from study enrollment to organ retrieval. The control group provided or received usual care. Main Outcomes and Measures The primary outcome was loss of brain-dead potential donors to cardiac arrest at the individual level. A prespecified sensitivity analysis assessed the effect of adherence to the checklist in the intervention group. Results Among the 1771 brain-dead potential donors screened in 63 hospitals, 1535 were included. These patients included 673 males (59.2%) and had a median (IQR) age of 51 (36.3-62.0) years. The main cause of brain injury was stroke (877 [57.1%]), followed by trauma (485 [31.6%]). Of the 63 hospitals, 31 (49.2%) were assigned to the intervention group (743 [48.4%] brain-dead potential donors) and 32 (50.8%) to the control group (792 [51.6%] brain-dead potential donors). Seventy potential donors (9.4%) at intervention hospitals and 117 (14.8%) at control hospitals met the primary outcome (risk ratio [RR], 0.70; 95% CI, 0.46-1.08; P = .11). The primary outcome rate was lower in those with adherence higher than 79.0% than in the control group (5.3% vs 14.8%; RR, 0.41; 95% CI, 0.22-0.78; P = .006). Conclusions and Relevance This cluster randomized clinical trial was inconclusive in determining whether the overall use of an evidence-based, goal-directed checklist reduced brain-dead potential donor loss to cardiac arrest. The findings suggest that use of such a checklist has limited effectiveness without adherence to the actions recommended in this checklist. Trial Registration ClinicalTrials.gov Identifier: NCT03179020.
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Affiliation(s)
- Glauco A Westphal
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
- Central Estadual de Transplantes de Santa Catarina, Rua Esteves Júnior, Florianópolis, Santa Catarina, Brazil
- Centro Hospitalar Unimed Joinville and Hospital Municipal São José, Joinville, Santa Catarina, Brazil
| | - Caroline Cabral Robinson
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Natalia Elis Giordani
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
- Postgraduate Programme in Epidemiology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Cassiano Teixeira
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Adriane Isabel Rohden
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Bruna Dos Passos Gimenes
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Cátia Moreira Guterres
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Itiana Cardoso Madalena
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Luiza Vitelo Andrighetto
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Sabrina Souza da Silva
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Daiana Barbosa da Silva
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Daniel Sganzerla
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Cristiano Augusto Franke
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
- Hospital de Pronto de Socorro (HPS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernando Augusto Bozza
- National Institute of Infectious Disease Evandro Chagas, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávia Ribeiro Machado
- Disciplina de Anestesiologia, Dor e Medicina Intensiva, Universidade Federal de São Paulo (UNIFESP), São Paulo, São Paulo, Brazil
| | - Joel de Andrade
- Central Estadual de Transplantes de Santa Catarina, Rua Esteves Júnior, Florianópolis, Santa Catarina, Brazil
| | | | - Silvana Schneider
- Department of Statistics, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bianca Rodrigues Orlando
- Hospital Universitário São Francisco de Paula, Pelotas, Rio Grande do Sul, Brazil
- Hospital Escola, Universidade Federal de Pelotas (UFPEL), Pelotas, Rio Grande do Sul, Brazil
| | - Cintia Magalhães Carvalho Grion
- Hospital Universitário Regional do Norte do Paraná, Londrina, Paraná, Brazil
- Hospital Evangélico de Londrina, Londrina, Paraná, Brazil
| | | | | | - Francisco Olon Leite
- Hospital Regional Norte, Centro Universitário Inta (UNINTA), Sobral, Ceará, Brazil
| | | | | | | | | | | | - Pedro Carvalho Diniz
- Hospital Universitário, Universidade Federal do Vale do São Francisco (HU/UNIVASF), Petrolina, Pernambuco, Brazil
| | | | - Daniela Ferreira Salomão Pontes
- General Coordination Office, National Transplant System, Brazilian Ministry of Health, Esplanada dos Ministérios, Bloco G, Edifício Sede, Brasília, Distrito Federal, Brazil
| | - Josélio Emar Araújo Queiroz
- General Coordination Office, National Transplant System, Brazilian Ministry of Health, Esplanada dos Ministérios, Bloco G, Edifício Sede, Brasília, Distrito Federal, Brazil
| | - Luciano Serpa Hammes
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Maureen O Meade
- Department of Medicine, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Regis Goulart Rosa
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Maicon Falavigna
- Responsabilidade Social-Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
- National Institute for Health Technology Assessment, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada
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Hoverd E, Cooper J, Shortland S, Zeh P, Bowers B, Tomlinson L, Dyer S, Boyer P, Charlewood J, Finney A. Editorial: Developing research potential in the primary and community-nursing workforce: the impact of a community of practice. Prim Health Care Res Dev 2023; 24:e64. [PMID: 38014428 PMCID: PMC10689090 DOI: 10.1017/s1463423623000543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/04/2023] [Accepted: 09/05/2023] [Indexed: 11/29/2023] Open
Affiliation(s)
- Eleanor Hoverd
- Unit of Academic Primary Care, University of Warwick, Warwick Medical School, Coventry, UK
| | - Joanne Cooper
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | | | | | - Lee Tomlinson
- Kent Community Health NHS Foundation Trust, Ashford, UK
| | - Sandra Dyer
- Royal Free London NHS Foundation Trust, London, UK
| | - Paula Boyer
- Rotherham NHS Foundation Trust, Rotherham, UK
| | - Jen Charlewood
- NHS South of England: NHS England and NHS Improvement South West, Gloucestershire, UK
| | - Andrew Finney
- Keele University School of Nursing and Midwifery, Newcastle-under-Lyme, UK
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Menzies JC, Brand S, Bench S, Bramley L, Smith V, Henshall C. Increasing nursing and midwifery research leadership: impact evaluation of the National Institute for Health and Care Research Senior Nurse and Midwife Research Leader Programme at 1 year. J Res Nurs 2023; 28:516-528. [PMID: 38144950 PMCID: PMC10741258 DOI: 10.1177/17449871231201550] [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: 12/26/2023] Open
Abstract
Background Although nurses and midwives make up the largest sector of the National Health Service (NHS) workforce, studies have identified a lack of knowledge, skills and confidence to engage and lead research. In 2018, the National Institute for Health and Care Research (NIHR) invested in the development of a 3-year Senior Nurse Midwife Research Leader (SNMRL) Programme aimed at developing nursing and midwifery research capacity and capability. This review was conducted at the end of year one as part of an ongoing impact evaluation of the programme. Aim To evaluate the impact of activities undertaken by NIHR SNMRL at the end of year one of the programme. Method The content of anonymised end-of-year one activity, self-reported by SNMRL, was coded independently and deductively analysed by a project team using the modified Visible ImpaCT Of Research framework (VICTOR). Exemplar case studies were selected by the team to illustrate activity within domains. Working group members coded two reports independently then compared them in pairs to increase inter-rater reliability and the quality and consistency of coding. Results Reports from 63 of 66 SNMRL were submitted and included for analysis. Reporting reflected progress towards NIHR programme objectives. These included acting as a programme ambassador, creating a vibrant research culture, supporting staff recruitment and retention, enhancing organisational reputation and clinical academic outputs. Networking and collaboration locally, regionally and nationally were widely reported. Conclusions The SNMRL cohort reported initiating multiple initiatives aimed at influencing organisational research culture, service provision and supporting nursing/midwifery engagement with research. Evaluation indicated progress to address barriers to research engagement within NHS Trusts.
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Affiliation(s)
- Julie C Menzies
- Clinical Academic/Nurse Researcher, Bristol Royal Hospital for Children, United Hospitals Bristol and Weston NHS Foundation Trust, UK
- Honorary Senior Research Fellow, University of Birmingham, UK
| | - Sarah Brand
- Assistant Divisional Nurse, Cancer and Associated Specialities, Nottingham University Hospital NHS Trust, UK
| | - Suzanne Bench
- Director of Nursing for Nurse and Midwife Led Research, Guys and St Thomas NHS Trust, UK
- Professor of Critical Care Nursing, London South Bank University, UK
| | - Louise Bramley
- Assistant Director of Nursing, Nottingham University Hospitals NHS Trust, UK
- Honorary Associate Professor, University of Nottingham, UK
| | - Vikki Smith
- Clinical Academic Midwife, Northumbria University, Department of Nursing, Midwifery and Health, UK
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Catherine Henshall
- Reader in Nursing, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, UK
- Associate Director of Nursing and Midwifery, National Institute for Health and Care Research (NIHR), UK
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20
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Menzies J, Grieve S, Ainsworth L, Sharman V, Smith V, Henshall C. The visibility of research within mandatory National Health Service Trust Induction programmes in England: an exploratory survey study. J Res Nurs 2023; 28:545-557. [PMID: 38144963 PMCID: PMC10741262 DOI: 10.1177/17449871231205816] [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: 12/26/2023] Open
Abstract
Background Mandatory NHS Trust induction programmes are an integral part of staff orientation processes. Although research is recognised as fundamental to high-quality care, little data exist regarding whether research information is included within hospital induction. Methods Two online national surveys were developed, with the aim of identifying Trusts which included research within their mandatory induction programme. Survey 1 was distributed to Research and Development managers across England (n = 201). Survey 2 collated information on the research content and delivery methods of induction material. The work was classified as a service evaluation and reported in accordance with CHERRIES reporting standards. Results Survey 1 generated 124 unique responses (61% response rate). Thirty-nine percent of Trusts (n = 48) featured information about research delivery and 24% (n = 30) about training or support to develop clinical academic careers. There was wide variation in how materials were delivered, by whom and for how long. Conclusions Currently research has a limited profile within English NHS Trust mandatory induction programmes. This needs to be addressed if research is truly to be considered part of the core National Health Service business. Guidance or a modifiable template could help Trusts communicate about research delivery and clinical academic development and training to all new employees.
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Affiliation(s)
- Julie Menzies
- Clinical Academic/Nurse Researcher, Bristol Royal Hospital for Children, United Hospitals Bristol and Weston NHS Foundation Trust, UK
- Honorary Senior Research Fellow University of Birmingham, UK
| | - Sharon Grieve
- Research Engagement Lead, Royal United Hospitals Bath NHS Foundation Trust, UK
- Research Fellow – Pain & Wellbeing, University of the West of England, UK
| | - Lucy Ainsworth
- Programme Officer, NIHR Nursing & Midwifery, National Institute for Health and Care Research (NIHR), UK
| | - Victoria Sharman
- Clinical Matron, Hertfordshire Partnership University NHS Foundation Trust, UK
| | - Vikki Smith
- Clinical Academic Midwife, Department of Nursing, Midwifery and Health, Clinical Academic Midwife, Northumbria University, UK
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - Catherine Henshall
- Reader in Nursing, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, UK
- Associate Director of Nursing and Midwifery, National Institute for Health and Care Research (NIHR), UK
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21
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Hinze V, Henshall C, Smith T, Littlejohns J, Collett Z, Jones H, Maughan D, Ede R, Moll D, Marlowe K, Broughton N, Geddes J, Cipriani A. Count Me In: an inclusive approach towards patient recruitment for clinical research studies in the NHS. BMJ MENTAL HEALTH 2023; 26:e300774. [PMID: 37879674 PMCID: PMC10603415 DOI: 10.1136/bmjment-2023-300774] [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: 05/19/2023] [Accepted: 09/29/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Participation in clinical research is associated with better patient outcomes and higher staff retention and satisfaction rates. Nevertheless, patient recruitment to mental health studies is challenging due to a reliance on clinician or patient referrals (standard approach). To empower patients and make healthcare research more equitable, we explored a novel researcher-led approach, called 'Count Me In' (CMI). OBJECTIVE To evaluate a 12-month implementation of CMI in a routine clinical setting. METHODS CMI was launched in August 2021 in a mental health National Health Service (NHS) Trust in England. Patients (aged 18+) learnt about CMI at their initial clinical appointment. Unless they opted out, they became contactable for research (via research informatics searches). FINDINGS After 12 months, 368 patients opted out and 22 741 became contactable through CMI, including 2716 through the standard approach and 20 025 through electronic searches (637% increase). Of those identified via electronic searches, 738 were contacted about specific studies and 270 consented to participate. Five themes were identified based on patient and staff experiences of CMI: 'level of awareness and accessibility of CMI', 'perceptions of research and perceived engagement with CMI', 'inclusive research practice', 'engagement and incentives for research participation', and 'relationships between clinical and research settings'. CONCLUSIONS CMI (vs standard) led to a larger and diverse patient cohort and was favoured by patients and staff. Yet a shift in the NHS research culture is needed to ensure that this diversity translates to actual research participation. CLINICAL IMPLICATIONS Through collaboration with other NHS Trusts and services, key funders (National Institute for Health and Care Research) and new national initiatives (Office for Life Sciences Mental Health Mission), CMI has the potential to address recruitment challenges through rapid patient recruitment into time-sensitive country-wide studies.
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Affiliation(s)
- Verena Hinze
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Catherine Henshall
- Oxford Precision Psychiatry Lab, NIHR Oxford Biomedical Research Centre, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
- Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Oxford Brookes University Faculty of Health and Life Sciences, Oxford, UK
| | - Tanya Smith
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | | | - Zoe Collett
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Helen Jones
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Daniel Maughan
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Roger Ede
- Oxford Precision Psychiatry Lab, NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Deborah Moll
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Karl Marlowe
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Nick Broughton
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - John Geddes
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Biomedical Research Centre, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
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22
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Ginnerup-Nielsen E, Christensen R, Bliddal H, Henriksen M. Effect of research participation versus usual clinical care in patients with rheumatic and musculoskeletal disorders: a prospective cohort study. RMD Open 2023; 9:e003414. [PMID: 37797965 PMCID: PMC10551945 DOI: 10.1136/rmdopen-2023-003414] [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: 06/19/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE To compare illness perception (IP), pain, functional level and health-related quality of life (HR-QoL) between patients with musculoskeletal pain who participate versus those who do not participate in clinical research projects. METHODS Data were collected between 1 January 2019 and 31 December 2021 in patients visiting the Outpatient Osteoarthritis Clinic at Frederiksberg Hospital, Copenhagen, as part of either clinical research or regular treatment. Questionnaires were collected at baseline and after 10-18 months. Major outcome measure was the change from baseline to follow-up in the Brief Pain Inventory - Short Form (BPI-SF) item 'Average pain'. Secondary outcome measures included The Brief Illness Perception Questionnaire (B-IPQ), measured only at baseline, the EuroQol (EQ-5D-3L), the Health Assessment Questionnaire Disability Index and PainDETECT. RESULTS 1495 patients were included with 358 (24%) categorised as research participants (exposed) and 1137 (76%) being non-participants (unexposed). The baseline B-IPQ item scores were generally more favourable in the exposed group with statistically significant standardised differences (SD) of 0.2-0.3. Similarly, an SD of 0.3 on the EQ-5D-3L score indicated a better HR-QoL in the exposed group. At follow-up, 24% in the exposed group and 27% in the unexposed group, completed the questionnaires. The mean BPI-sf Average pain between-group difference was: -0.01 points (95% CI: -0.6 to 0.6). Similar clinically irrelevant differences were seen in the other outcomes. CONCLUSIONS Among musculoskeletal pain patients, research participants report more positive IP and better HR-QoL than non-participants. No additional effect of research participation was found in any outcome over time. TRIAL REGISTRATION NUMBER NCT03785561.
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Affiliation(s)
| | - Robin Christensen
- Bispebjerg and Frederiksberg Hospital, The Parker Institute, Frederiksberg, Copenhagen, Denmark
- Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Henning Bliddal
- Bispebjerg and Frederiksberg Hospital, The Parker Institute, Frederiksberg, Copenhagen, Denmark
| | - Marius Henriksen
- Bispebjerg and Frederiksberg Hospital, The Parker Institute, Frederiksberg, Copenhagen, Denmark
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23
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Shafiq N, Mehroze A, Sarwar W, Arshad U, Parveen S, Rashid M, Farooq A, Rafiq N, Wondmie GF, Bin Jardan YA, Brogi S, Bourhia M. Exploration of phenolic acid derivatives as inhibitors of SARS-CoV-2 main protease and receptor binding domain: potential candidates for anti-SARS-CoV-2 therapy. Front Chem 2023; 11:1251529. [PMID: 37822772 PMCID: PMC10562575 DOI: 10.3389/fchem.2023.1251529] [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: 07/01/2023] [Accepted: 09/06/2023] [Indexed: 10/13/2023] Open
Abstract
Severe acute respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) is the etiological virus of Coronavirus Disease 2019 (COVID-19) which has been a public health concern due to its high morbidity and high mortality. Hence, the search for drugs that incapacitate the virus via inhibition of vital proteins in its life cycle is ongoing due to the paucity of drugs in clinical use against the virus. Consequently, this study was aimed at evaluating the potentials of natural phenolics against the Main protease (Mpro) and the receptor binding domain (RBD) using molecular modeling techniques including molecular docking, molecular dynamics (MD) simulation, and density functional theory (DFT) calculations. To this end, thirty-five naturally occurring phenolics were identified and subjected to molecular docking simulation against the proteins. The results showed the compounds including rosmarinic acid, cynarine, and chlorogenic acid among many others possessed high binding affinities for both proteins as evident from their docking scores, with some possessing lower docking scores compared to the standard compound (Remdesivir). Further subjection of the hit compounds to drug-likeness, pharmacokinetics, and toxicity profiling revealed chlorogenic acid, rosmarinic acid, and chicoric acid as the compounds with desirable profiles and toxicity properties, while the study of their electronic properties via density functional theory calculations revealed rosmarinic acid as the most reactive and least stable among the sets of lead compounds that were identified in the study. Molecular dynamics simulation of the complexes formed after docking revealed the stability of the complexes. Ultimately, further experimental procedures are needed to validate the findings of this study.
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Affiliation(s)
- Nusrat Shafiq
- Synthetic and Natural Products Discovery (SNPD) Laboratory, Department of Chemistry, Government College Women University Faisalabad, Faisalabad, Pakistan
| | - Aiman Mehroze
- Synthetic and Natural Products Discovery (SNPD) Laboratory, Department of Chemistry, Government College Women University Faisalabad, Faisalabad, Pakistan
| | - Warda Sarwar
- Synthetic and Natural Products Discovery (SNPD) Laboratory, Department of Chemistry, Government College Women University Faisalabad, Faisalabad, Pakistan
| | - Uzma Arshad
- Synthetic and Natural Products Discovery (SNPD) Laboratory, Department of Chemistry, Government College Women University Faisalabad, Faisalabad, Pakistan
| | - Shagufta Parveen
- Synthetic and Natural Products Discovery (SNPD) Laboratory, Department of Chemistry, Government College Women University Faisalabad, Faisalabad, Pakistan
| | - Maryam Rashid
- Synthetic and Natural Products Discovery (SNPD) Laboratory, Department of Chemistry, Government College Women University Faisalabad, Faisalabad, Pakistan
| | - Ariba Farooq
- Department of Chemistry, University of Lahore, Lahore, Pakistan
| | - Naila Rafiq
- Department of Biochemistry, Government College Women University Faisalabad, Faisalabad, Pakistan
| | | | - Yousef A. Bin Jardan
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Simone Brogi
- Department of Pharmacy, Pisa University, Pisa, Italy
| | - Mohammed Bourhia
- Department of Chemistry and Biochemistry, Faculty of Medicine and Pharmacy, Ibn Zohr University, Laayoune, Morocco
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24
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Homer C, Neylon K, Kennedy K, Baird K, Gilkison A, Keogh S, Middleton S, Gray R, Whitehead L, Finn J, Rickard C, Sharplin G, Neville S, Eckert M. Midwife led randomised controlled trials in Australia and New Zealand: A scoping review. Women Birth 2023; 36:401-408. [PMID: 36894484 DOI: 10.1016/j.wombi.2023.03.003] [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: 09/29/2022] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND Midwives are the largest workforce involved in caring for pregnant women and their babies, and are well placed to translate research into practice and ensure midwifery priorities are appropriately targeted in researched. Currently, the number and focus of randomised controlled trials led by midwives in Australia and New Zealand is unknown. The Australasian Nursing and Midwifery Clinical Trials Network was established in 2020 to build nursing and midwifery research capacity. To aid this, scoping reviews of the quality and quantity of nurse and midwife led trials were undertaken. AIM To identify midwife led trials conducted between 2000 and 2021 in Australia and New Zealand. METHODS This review was informed by the JBI scoping review framework. Medline, Emcare, and Scopus were searched from 2000-August 2021. ANZCTR, NHMRC, MRFF, and HRC (NZ) registries were searched from inception to July 2021. FINDINGS Of 26,467 randomised controlled trials registered on the Australian and New Zealand Clinical Trials Registry, 50 midwife led trials, and 35 peer-reviewed publications were identified. Publications were of moderate to high quality with scores limited due to an inability to blind participants or clinicians. Blinding of assessors was included in 19 published trials. DISCUSSION Additional support for midwives to design and conduct trials and publish findings is required. Further support is needed to translate registration of trial protocols into peer reviewed publications. CONCLUSION These findings will inform the Australasian Nursing and Midwifery Clinical Trials Network plans to promote quality midwife led trials.
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Affiliation(s)
| | - Kim Neylon
- Rosemary Bryant AO Research Centre, UniSA Clinical & Health Sciences, University of South Australia, South Australia, Australia
| | - Kate Kennedy
- Rosemary Bryant AO Research Centre, UniSA Clinical & Health Sciences, University of South Australia, South Australia, Australia
| | - Kathleen Baird
- University Technology Sydney, School of Nursing and Midwifery, New South Wales, Australia
| | - Andrea Gilkison
- Auckland University of Technology, School of Clinical Sciences, Auckland, New Zealand
| | - Samantha Keogh
- Queensland University of Technology, Faculty of Health, School of Nursing, Queensland, Australia
| | - Sandy Middleton
- Australian Catholic University, Nursing Research Institute, New South Wales, Australia
| | | | | | - Judith Finn
- Curtin University, Faculty of Health Sciences, Curtin School of Nursing, Western Australia, Australia
| | - Claire Rickard
- University of Queensland, School of Nursing, Midwifery and Social Work, Queensland, Australia
| | - Greg Sharplin
- Rosemary Bryant AO Research Centre, UniSA Clinical & Health Sciences, University of South Australia, South Australia, Australia
| | - Stephen Neville
- Auckland University of Technology, School of Clinical Sciences, Auckland, New Zealand
| | - Marion Eckert
- Rosemary Bryant AO Research Centre, UniSA Clinical & Health Sciences, University of South Australia, South Australia, Australia.
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25
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Alston L, McFayden L, Gupta TS, Payne W, Smith J. Creating a sustainable and supportive health research environment across rural and remote Australia: a call to action. Med J Aust 2023; 219 Suppl 3:S27-S30. [PMID: 37544008 DOI: 10.5694/mja2.52027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 04/12/2023] [Accepted: 04/28/2023] [Indexed: 08/08/2023]
Affiliation(s)
- Laura Alston
- Deakin Rural Health, Deakin University, Geelong, VIC
| | - Lisa McFayden
- College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW
- Hunter Medical Research Institute, Newcastle, NSW
| | - Tarun Sen Gupta
- College of Medicine and Dentistry, James Cook University, Townsville, QLD
| | | | - James Smith
- Flinders Rural and Remote Health NT, Flinders University, Darwin, NT
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26
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Hanney SR. If Providing Best Care Means Being at the Cutting Edge of Research, Should It Be Implemented System-wide? Comment on "'We're Not Providing the Best Care If We Are Not on the Cutting Edge of Research': A Research Impact Evaluation at a Regional Australian Hospital and Health Service". Int J Health Policy Manag 2023; 12:7718. [PMID: 37579364 PMCID: PMC10461875 DOI: 10.34172/ijhpm.2023.7718] [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: 10/01/2022] [Accepted: 06/06/2023] [Indexed: 08/16/2023] Open
Abstract
The COVID-19 pandemic intensified debates about the desirability of integrating health research systems into healthcare systems. An excellent evaluation undertaken prior to the pandemic examined a purposeful strategy to improve healthcare through an expansion in research capacity in the Townsville Hospital and Health Service (THHS), a regional service in northern Queensland. This comment puts that evaluation into a rapidly developing wider context, drawing on other work showing an association between research engagement in healthcare organisations and their improved healthcare. In most previous studies this impact arose as a by-product of the research activity. The Townsville scheme went further. But while the evaluation identified some progress and impacts, they were patchy, not system-wide. Recent pre-pandemic studies showed that going even further and integrating a health research system across a national healthcare system markedly improved healthcare, despite continuing challenges. The UK's research experiences during COVID-19 are giving additional momentum to this approach globally.
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Affiliation(s)
- Stephen R. Hanney
- Health Economics Research Group, Department of Health Sciences, Brunel University London, London, UK
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27
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Palmer S, Coad J, Gamble J, Jones C, Lees-Deutsch L, McWilliams D, Murphy E, Kneafsey R. Nursing, midwifery, and allied health professions research capacities and cultures: a survey of staff within a university and acute healthcare organisation. BMC Health Serv Res 2023; 23:647. [PMID: 37328877 DOI: 10.1186/s12913-023-09612-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 05/28/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND There is an increasing focus on the development of research capacity and culture in Nursing, Midwifery and Allied Health Professions (NMAHP). However, better understanding of the existing research success and skills, motivators, barriers, and development needs of NMAHP professionals is required to inform this development. This study sought to identify such factors within a university and an acute healthcare organisation. METHODS An online survey, incorporating the Research Capacity and Culture tool, was administered to NMAHP professionals and students at a university and an acute healthcare organisation in the United Kingdom. Ratings of success/skill levels of teams and individuals were compared between professional groups using Mann-Whitney U tests. Motivators, barriers, and development needs were reported using descriptive statistics. Descriptive thematic analysis was used for open-ended text responses. RESULTS A total of 416 responses were received (N&M n = 223, AHP n = 133, Other n = 60). N&M respondents were more positive than their AHP counterparts about the success/skill levels of their teams. There were no significant differences between N&M and AHP in their ratings of individual successes/skills. Finding and critically reviewing relevant literature were identified as specific individual strengths; with weaknesses in securing research funding, submitting ethics applications, writing for publication, and advising less experienced researchers. The main motivators for research were to develop skills, increased job satisfaction, and career advancement; whilst barriers included lack of time for research and other work roles taking priority. Key support needs identified included mentorship (for teams and individuals) and in-service training. Open-ended questions generated main themes of 'Employment & staffing', 'Professional services support', 'Clinical & academic management', 'Training & development', 'Partnerships' and 'Operating principles'. Two cross-cutting themes described issues common to multiple main themes: 'Adequate working time for research' and 'Participating in research as an individual learning journey'. CONCLUSIONS Rich information was generated to inform the development of strategies to enhance research capacity and culture in NMAHP. Much of this can be generic but some nuances may be required to address some specific differences between professional groups, particularly related to perceived team success/skills and priorities identified for support and development.
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Affiliation(s)
- S Palmer
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
| | - J Coad
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
- School of Health Sciences, Nottingham University Queen's Medical Centre, Nottingham, UK
| | - J Gamble
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
| | - C Jones
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
| | - L Lees-Deutsch
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
| | - D McWilliams
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
| | - E Murphy
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
| | - R Kneafsey
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK.
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28
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Jimenez Forero SJ, Palmer R. The impact of participation in research for speech and language therapy departments and their patients: A case example of the Big CACTUS multicentre trial of self-managed computerized aphasia therapy. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:723-736. [PMID: 36478493 DOI: 10.1111/1460-6984.12814] [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: 07/25/2021] [Accepted: 10/06/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND In order to conduct research that is meaningful to speech and language therapy services and their patients, it is often desirable to conduct the research within routine clinical services. This can require considerable time and commitment from speech and language therapists (SLTs). It is therefore important to understand the impact that such participation in research can have. AIMS To explore the impact of research participation in the Big CACTUS study of self-managed computerized aphasia therapy conducted in 21 UK NHS speech and language therapy departments. METHODS & PROCEDURES An online survey was sent to SLTs who took the lead role for the study at their NHS Trust to evaluate the impact of study participation in three domains: capacity-building, research development and health services. The questionnaire, based on the VICTOR framework for evaluating research impact, included Likert scale statements and closed and open-ended questions. The results from open-ended questions were coded and analysed using framework analysis in NVivo 12 and the data from closed questions were analysed descriptively. OUTCOMES & RESULTS A total of 12 SLTs returned the survey. Nine codes were identified from open-ended questions and 20 predefined from the literature. Analysis of the responses demonstrated the perceived impact including improvements in practices and access to therapy, investments in infrastructure, increased SLT profile, and impact on research culture among SLTs. The usefulness of the intervention during the COVID-19 pandemic was also highlighted. CONCLUSIONS & IMPLICATIONS The results suggest participation in Big CACTUS has resulted in improvements in patient care and SLT research capacity and culture in speech and language therapy departments. WHAT THIS PAPER ADDS What is already known on the subject Practice-based research is encouraged to assist with the clinical relevance of the research findings. Participation in research can be seen as an activity that is additional to the core business of patient care and it can be difficult to secure time to participate or conduct research in clinical settings. Impact evaluation initiatives of individual trials facilitate early identification of benefits beyond the trial. What this paper adds to existing knowledge This study describes specific examples of the impact on services, staff and patients from SLT participation and leadership in the Big CACTUS speech and language therapy trial in clinical settings. What are the potential or actual clinical implications of this study? Clinical services participating in research may benefit from improved clinical care for patients both during and after the study, an improved professional reputation, and increased research capacity and culture within the clinical settings.
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Affiliation(s)
| | - Rebecca Palmer
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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29
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Kirk J, Reynolds F, Adey E, Boazman M, Brookes M, Brocklehurst P. Developing paediatric chief investigators within the NHS: the Clinical Trials Scholars programme. Arch Dis Child Educ Pract Ed 2023; 108:139-141. [PMID: 35193887 DOI: 10.1136/archdischild-2021-322186] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/06/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Jeremy Kirk
- Research and Development, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Fiona Reynolds
- Chief Medical Office, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Elizabeth Adey
- Research and Development, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Matthew Boazman
- Research and Development, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | | | - Peter Brocklehurst
- Institute of Applied Health Research, Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
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30
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Li W, Abbas N, Brennan PN, Mcdowell H, Navaratnam J, Phoolchund A, Scott R, Shearer J, White H, Tavabie OD. UK national trainee survey of hepatology training, research and the future workforce. Frontline Gastroenterol 2023; 14:326-333. [PMID: 37409329 PMCID: PMC11138168 DOI: 10.1136/flgastro-2022-102307] [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: 08/31/2022] [Accepted: 12/23/2022] [Indexed: 01/09/2023] Open
Abstract
Objective The increasing prevalence of liver disease in the UK means there is a pressing need to expand the hepatology workforce. This survey aims to evaluate current hepatology training provision, and trainee attitudes towards future careers in hepatology. Method An electronic survey was distributed to higher specialty gastroenterology and hepatology trainees in the UK between March and May 2022. Results 138 trainees completed the survey covering all training grades and regions of the UK. 73.7% reported receiving adequate hepatology training currently, with 55.6% intending to become future hepatologists. Trainee preference for future hepatology consultant posts in specialist liver centres were almost threefold higher compared with district general hospitals (60.9% vs 22.6%). All trainees, irrespective of training grade reported high confidence in managing decompensated cirrhosis in both inpatient and outpatient settings. Senior trainees (grade ST6 and higher), without advanced training programme (ATP) experience reported significantly lower confidence in managing viral hepatitis, hepatocellular carcinoma and post-transplant patients compared with equivalent trainees with ATP experience. For junior trainees (IMT3-ST5), remaining in their current deanery was the most important factor when considering future hepatology training application. Conclusions There is a significant need to deliver widely available training on the management of complex liver disease to improve non-ATP trainee confidence. Innovative job planning strategies are required to encourage trainees to pursue careers outside of specialist liver centres. Expansion of hepatology training networks with wider geographical coverage are needed to address the growing need for more hepatologists around the UK.
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Affiliation(s)
- Wenhao Li
- Barts Liver Centre, Barts and The London School of Medicine and Dentistry Blizard Institute, London, UK
| | - Nadir Abbas
- Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Paul N Brennan
- University of Dundee, School of Medicine, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, Dundee, UK
| | - Hannah Mcdowell
- NIMDTA - Northern Ireland Medical Dental Training Agency, Belfast, UK
| | | | - Anju Phoolchund
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Robert Scott
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | | | - Helen White
- Royal Bolton Hospital NHS Foundation Trust, Bolton, UK
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31
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Alston L, Versace VL. Place-based research in small rural hospitals: an overlooked opportunity for action to reduce health inequities in Australia? THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 30:100682. [PMID: 36624882 PMCID: PMC9823201 DOI: 10.1016/j.lanwpc.2022.100682] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 12/22/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Laura Alston
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Warrnambool, Victoria, 3280, Australia
- Research Unit, Colac Area Health, Colac, Victoria, 3250, Australia
- Corresponding author. Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Warrnambool, Victoria, 3280, Australia.
| | - Vincent L. Versace
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Warrnambool, Victoria, 3280, Australia
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Aggarwal A, Han L, Boyle J, Lewis D, Kuyruba A, Braun M, Walker K, Fearnhead N, Sullivan R, van der Meulen J. Association of Quality and Technology With Patient Mobility for Colorectal Cancer Surgery. JAMA Surg 2023; 158:e225461. [PMID: 36350616 PMCID: PMC9647575 DOI: 10.1001/jamasurg.2022.5461] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Importance Many health care systems publish hospital-level quality measures as a driver of hospital performance and to support patient choice, but it is not known if patients with cancer respond to them. Objective To investigate hospital quality and patient factors associated with treatment location. Design, Setting, and Participants This choice modeling study used national administrative hospital data. Patients with colon and rectal cancer treated in all 163 English National Health Service (NHS) hospitals delivering colorectal cancer surgery between April 2016 and March 2019 were included. The extent to which patients chose to bypass their nearest surgery center was investigated, and conditional logistic regression was used to estimate the association of additional travel time, hospital quality measures, and patient characteristics with treatment location. Exposures Additional travel time in minutes, hospital characteristics, and patient characteristics: age, sex, cancer T stage, socioeconomic status, comorbidity, and rural or urban residence. Main Outcomes and Measures Treatment location. Results Overall, 44 299 patients were included in the final cohort (mean [SD] age, 68.9 [11.6] years; 18 829 [42.5%] female). A total of 8550 of 31 258 patients with colon cancer (27.4%) and 3933 of 13 041 patients with rectal cancer (30.2%) bypassed their nearest surgical center. Travel time was strongly associated with treatment location. The association was less strong for younger, more affluent patients and those from rural areas. For rectal cancer, patients were more likely to travel to a hospital designated as a specialist colorectal cancer surgery center (odds ratio, 1.45; 95% CI, 1.13-1.87; P = .004) and to a hospital performing robotic surgery for rectal cancer (odds ratio, 1.43; 95% CI, 1.11-1.86; P = .007). Patients were less likely to travel to hospitals deemed to have inadequate care by the national quality regulator (odds ratio, 0.70; 95% CI, 0.50-0.97; P = .03). Patients were not more likely to travel to hospitals with better 2-year bowel cancer mortality outcomes. Conclusions and Relevance Patients appear responsive to hospital characteristics that reflect overall hospital quality and the availability of robotic surgery but not to specific disease-related outcome measures. Policies allowing patients to choose where they have colorectal cancer surgery may not result in better outcomes but could drive inequities in the health care system.
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Affiliation(s)
- Ajay Aggarwal
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom,Clinical Effectiveness Unit, Royal College of Surgeons of England, London, United Kingdom
| | - Lu Han
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jemma Boyle
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom,Clinical Effectiveness Unit, Royal College of Surgeons of England, London, United Kingdom
| | - Daniel Lewis
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Angela Kuyruba
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, United Kingdom
| | - Michael Braun
- Department of Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom,School of Medical Sciences, University of Manchester, United Kingdom
| | - Kate Walker
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom,Clinical Effectiveness Unit, Royal College of Surgeons of England, London, United Kingdom
| | - Nicola Fearnhead
- Department of Colorectal Surgery, Cambridge University Hospitals, Cambridge, United Kingdom
| | - Richard Sullivan
- Institute of Cancer Policy, King’s College London, London, United Kingdom,Department of Oncology, Guy’s & St Thomas’ NHS Trust, London, United Kingdom
| | - Jan van der Meulen
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Brown A, Edelman A, Pain T, Larkins S, Harvey G. "We're Not Providing the Best Care If We Are Not on the Cutting Edge of Research": A Research Impact Evaluation at a Regional Australian Hospital and Health Service. Int J Health Policy Manag 2022; 11:3000-3011. [PMID: 35643418 PMCID: PMC10105178 DOI: 10.34172/ijhpm.2022.6529] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 05/10/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Research is central to high functioning health services alongside clinical care and health professional training. The impact of embedded research includes delivery of high-quality care and improved patient outcomes. Evaluations of research impact help health service leadership ensure investments lead to the greatest healthcare benefits for patients. This study aimed to retrospectively evaluate the impact of research investment from 2008 to 2018 at Townsville Hospital and Health Service (THHS), a regional Hospital and Health Service (HHS) in Queensland, Australia. The evaluation also sought to identify contextual conditions that enable or hinder intended impacts. METHODS A mixed-methods realist-informed evaluation was conducted using documentation, interviews with 15 staff and available databases to identify and measure research investments, impacts and contextual conditions influencing impact outcomes. RESULTS Between 2008 and 2018, THHS increased resources for research by funding research projects, employing research personnel, building research-enabling facilities, hosting research events, and providing research education and training. Clinical practice, policy and workforce impacts were successful in isolated pockets, championed by individual researchers and facilitated by their policy and community-of-practice networks. However, there was little organisational-level support for continuity of research and implementation into practice and policy. Availability of research supports varied geographically across THHS, and across disciplines. CONCLUSION Definitive steps in the development of THHS as a credible and productive research centre and leading hospital research centre in Northern Australia are evident. Continuing investments should address support for the research continuum through to translation and establish ongoing, systematic processes for evaluating research investment and impact.
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Affiliation(s)
- Amy Brown
- Townsville Hospital and Health Service, Townsville, QLD, Australia
| | - Alexandra Edelman
- Townsville Hospital and Health Service, Townsville, QLD, Australia
- James Cook University, Townsville, QLD, Australia
| | - Tilley Pain
- Townsville Hospital and Health Service, Townsville, QLD, Australia
- James Cook University, Townsville, QLD, Australia
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Sugimoto D, Del Bel M, Butler L. Barriers and Facilitators of Research in Pediatric Sports Medicine Practitioners: A Survey of the PRiSM Society. Int J Sports Phys Ther 2022; 17:1417-1429. [PMID: 36518842 PMCID: PMC9718726 DOI: 10.26603/001c.39739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 08/16/2022] [Indexed: 10/08/2023] Open
Abstract
Background Barriers and facilitators to research in sports medicine (SM) by physicians and allied health (AH) professions such as physical therapists and athletic trainers are understudied. The purpose of this research was to examine and compare research barriers, facilitators, and other research related facets including interests, comfort, knowledge, and resources among SM physicians and AH practitioners. Study Design Cross-sectional survey. Methods The survey was sent to Pediatric Research in Sports Medicine (PRiSM) members. The survey was designed to ask respondents to identify their top barrier and facilitator to conducting research. Research interest (binary), self-rated comfort reading research articles (0-100 scale), self-rated knowledge conducting research independently (0-100 scale), and available research resources were evaluated. Descriptive statistics, chi-square, and t-tests were used to compare the responses between SM physicians and AH practitioners. The value of p<0.05 was set as a statistically significant criterion. Results The response rate was 35.7% (N=100). For both SM physicians and AH practitioners, the greatest research barrier was a lack of time. However, the leading research facilitators differed in the two professions. The top research facilitator for SM physicians was availability of research personnel, while availability of research mentoring was selected as a prime facilitator by AH practitioners. There were no differences in research interest between SM physicians (87.0%) and AH practitioners (95.5%, p=0.267). However, self-rated comfort reading research articles was higher in SM physicians (75.6±20.6) than AH practitioners (60.6±28.3, p=0.018). There were no differences in self-rated knowledge conducting research independently between SM physicians (70.2±18.6) and AH practitioners (63.4±24.6, p=0.163). Conclusion Lack of time was the top research barrier for both SM physicians and AH practitioners. Regarding research facilitators, having available time was the main facilitator for SM physicians while availability of mentoring was the leading facilitator in AH practitioners. Level of Evidence 3.
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Affiliation(s)
- Dai Sugimoto
- Faculty of Sport Sciences Waseda University
- The Micheli Center for Sports Injury Prevention
| | | | - Lauren Butler
- Department of Rehabilitation Nicklaus Children's Hospital
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Burke E, Misstear K, Hennessy M. An exploration of the professional identity of clinical academics using repertory grid technique. PLoS One 2022; 17:e0277361. [PMID: 36395251 PMCID: PMC9671447 DOI: 10.1371/journal.pone.0277361] [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: 06/12/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Clinicians who divide their time between clinical work and research have contributed to some of the most fundamental breakthroughs in medicine in recent history, yet their role is not always well-understood or valued. Understanding the factors which contribute to career success for clinical academics is critical for supporting this workforce. Social Cognitive Career Theory (SCCT) provides a conceptual framework for career success, incorporating personal and environmental factors. PURPOSE The aim of this study is to explore clinical academics' construal of successful clinical academic practice and to contribute to a holistic view of the professional identity of the clinical academic. METHODOLOGY Using a constructivist technique, repertory grid, the authors interviewed ten clinical academics at different career stages in one-to-one structured interviews conducted virtually between November 2020 and April 2021. Data from the interviews were analysed qualitatively and quantitatively. Common themes were identified, analysed, and ranked according to importance with respect to successful clinical academic practice. Using SCCT as a framework, constructs were categorised as personal factors, organisational factors, competencies and person-environment fit. A differential analysis between established/trainee and female/male participants was carried out. SUMMARY OF RESULTS One hundred and thirty-three constructs were elicited and categorised into 20 themes (constructs). There was consensus among participants that 6 were of high importance with respect to successful clinical academic practice, 8 of intermediate and 4 of low importance, with no consensus on 2 constructs. Personal factors of high importance include innovation and integrity. Competencies including research and teaching skills are highly important, and ability to collaborate is also considered central to successful clinical academic practice. Female participants expressed greater concerns about the impact of familial responsibilities on career progression. DISCUSSION AND CONCLUSIONS This study highlights the importance of interactions between the person and environment, and characterises the important attributes of successful clinical academics including personal factors such as integrity and innovation.
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Affiliation(s)
- Elaine Burke
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- * E-mail:
| | - Karen Misstear
- Wellcome/Health Research Board Irish Clinical Academic Training Programme, Dublin, Ireland
| | - Martina Hennessy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Wellcome/Health Research Board Irish Clinical Academic Training Programme, Dublin, Ireland
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Lawton T, Wilkinson K, Corp A, Javid R, MacNally L, McCooe M, Newton E. Reduced critical care demand with early CPAP and proning in COVID-19 at Bradford: A single-centre cohort. J Intensive Care Soc 2022; 23:398-406. [PMID: 36751359 PMCID: PMC9679910 DOI: 10.1177/17511437211018615] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background Guidance in COVID-19 respiratory failure has favoured early intubation, with concerns over the use of CPAP. We adopted early CPAP and self-proning, and evaluated the safety and efficacy of this approach. Methods This retrospective observational study included all patients with a positive COVID-19 PCR, and others with high clinical suspicion. Our protocol advised early CPAP and self-proning for severe cases, aiming to prevent rather than respond to deterioration. CPAP was provided outside critical care by ward staff supported by physiotherapists and an intensive critical care outreach program. Data were analysed descriptively and compared against a large UK cohort (ISARIC). Results 559 patients admitted before 1 May 2020 were included. 376 were discharged alive, and 183 died. 165 patients (29.5%) received CPAP, 40 (7.2%) were admitted to critical care and 28 (5.0%) were ventilated. Hospital mortality was 32.7%, and 50% for critical care. Following CPAP, 62% of patients with S:F or P:F ratios indicating moderate or severe ARDS, who were candidates for escalation, avoided intubation. Figures for critical care admission, intubation and hospital mortality are lower than ISARIC, whilst critical care mortality is similar. Following ISARIC proportions we would have admitted 92 patients to critical care and intubated 55. Using the described protocol, we intubated 28 patients from 40 admissions, and remained within our expanded critical care capacity. Conclusion Bradford's protocol produced good results despite our population having high levels of co-morbidity and ethnicities associated with poor outcomes. In particular we avoided overloading critical care capacity. We advocate this approach as both effective and safe.
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Affiliation(s)
- Tom Lawton
- Department of Anaesthesia & Critical Care,
Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary,
Bradford BD9 6RJ, UK
| | - Kate Wilkinson
- Department of Anaesthesia & Critical Care,
Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary,
Bradford BD9 6RJ, UK
| | - Aaron Corp
- Department of Anaesthesia & Critical Care,
Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary,
Bradford BD9 6RJ, UK
| | - Rabeia Javid
- Department of Anaesthesia & Critical Care,
Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary,
Bradford BD9 6RJ, UK
| | - Laura MacNally
- Department of Anaesthesia & Critical Care,
Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary,
Bradford BD9 6RJ, UK
| | - Michael McCooe
- Department of Anaesthesia & Critical Care,
Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary,
Bradford BD9 6RJ, UK
| | - Elizabeth Newton
- Department of Anaesthesia & Critical Care,
Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary,
Bradford BD9 6RJ, UK
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Graham Y. Commentary: Navigating data governance approvals to use routine health and social care data to evidence the hidden population with severe obesity: a case study from a clinical academic's perspective. J Res Nurs 2022; 27:637-638. [PMID: 36405807 PMCID: PMC9669931 DOI: 10.1177/17449871221123858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Affiliation(s)
- Yitka Graham
- Professor of Health Services Research and Head, Helen
McArdle Nursing and Care Research Institute, University of Sunderland, Sunderland,
UK
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Hanney SR, Straus SE, Holmes BJ. Saving millions of lives but some resources squandered: emerging lessons from health research system pandemic achievements and challenges. Health Res Policy Syst 2022; 20:99. [PMID: 36088365 PMCID: PMC9464102 DOI: 10.1186/s12961-022-00883-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/27/2022] [Indexed: 12/15/2022] Open
Abstract
During the SARS-CoV-2 pandemic, astonishingly rapid research averted millions of deaths worldwide through new vaccines and repurposed and new drugs. Evidence use informed life-saving national policies including non-pharmaceutical interventions. Simultaneously, there was unprecedented waste, with many underpowered trials on the same drugs. We identified lessons from COVID-19 research responses by applying WHO's framework for research systems. It has four functions-governance, securing finance, capacity-building, and production and use of research-and nine components. Two linked questions focused the analysis. First, to what extent have achievements in knowledge production and evidence use built on existing structures and capacity in national health research systems? Second, did the features of such systems mitigate waste? We collated evidence on seven countries, Australia, Brazil, Canada, Germany, New Zealand, the United Kingdom and the United States, to identify examples of achievements and challenges.We used the data to develop lessons for each framework component. Research coordination, prioritization and expedited ethics approval contributed to rapid identification of new therapies, including dexamethasone in the United Kingdom and Brazil. Accelerated vaccines depended on extensive funding, especially through the Operation Warp Speed initiative in the United States, and new platforms created through long-term biomedical research capacity in the United Kingdom and, for messenger ribonucleic acid (mRNA) vaccines, in Canada, Germany and the United States. Research capacity embedded in the United Kingdom's healthcare system resulted in trial acceleration and waste avoidance. Faster publication of research saved lives, but raised challenges. Public/private collaborations made major contributions to vastly accelerating new products, available worldwide, though unequally. Effective developments of living (i.e. regularly updated) reviews and guidelines, especially in Australia and Canada, extended existing expertise in meeting users' needs. Despite complexities, effective national policy responses (less evident in Brazil, the United Kingdom and the United States) also saved lives by drawing on health research system features, including collaboration among politicians, civil servants and researchers; good communications; and willingness to use evidence. Comprehensive health research strategies contributed to success in research production in the United Kingdom and in evidence use by political leadership in New Zealand. In addition to waste, challenges included equity issues, public involvement and non-COVID research. We developed recommendations, but advocate studies of further countries.
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Affiliation(s)
- Stephen R Hanney
- Health Economics Research Group, Department of Health Sciences, Brunel University London, London, United Kingdom.
| | - Sharon E Straus
- St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Bev J Holmes
- Michael Smith Health Research BC, Vancouver, BC, Canada
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Shen M, Liang X, Li L, Wu Y, Yang Y, Zingg R. The Association of Attending Physicians' Publications and Patients' Readmission Rates: Evidence from Tertiary Hospitals in China Using a Retrospective Data Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9760. [PMID: 35955113 PMCID: PMC9368559 DOI: 10.3390/ijerph19159760] [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: 07/06/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Physicians play a unique role in scientific and clinical research, which is the cornerstone of evidence-based medical practice. In China, tertiary public hospitals link promotions and bonuses with publications. However, the weight placed on research in the clinician's evaluation process and its potential impact on clinical practice have come under controversy. Despite the heated debate about physicians' role in research, there is little empirical evidence about the relationship between physicians' publications and their clinical outcomes. METHOD This paper examines the association of the quantity and quality of tertiary hospitals' attending physicians' publications and inpatient readmission rates in China. We analyzed a 20% random sample of inpatient data from the Urban Employee Basic Medical Health Insurance scheme in one of the largest cities in China from January 2018 through October 2019. We assessed the relationship between the quantity and impact factor of physicians' publications and 30-day inpatient readmission rates using logistic regression. There were 111,965 hospitalizations treated by 5794 physicians in our sample. RESULTS Having any first-author publications was not associated with the rate of readmission. Among internists, having clinical studies published in journals with an average impact factor of 3 or above was associated with lower readmission rates (OR = 0.849; 95% CI (0.740, 0.975)), but having basic science studies published in journals with an average impact factor of 3 or above was not associated with the rate of readmission. Among surgeons, having clinical studies published in journals with an average impact factor of 3 or above was likewise associated with lower readmission rates (OR = 0.708 (0.531, 0.946)), but having basic science studies published in journals with an average impact factor of 3 or above was associated with higher readmission rates (OR = 1.230 (1.051, 1.439)).
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Affiliation(s)
- Menghan Shen
- Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou 510275, China
| | - Xiaoxia Liang
- Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou 510275, China
| | - Linyan Li
- School of Data Science, City University of Hong Kong, Kowloon Tong, Hong Kong 999077, China
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong 999077, China
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Yushan Wu
- The Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, N.T. HKSAR, Shatin, Hong Kong 999077, China
| | - Yuanfan Yang
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Raphael Zingg
- Waseda Institute for Advanced Study, Waseda University, Tokyo 169-0051, Japan
- ETH Zurich, Center for Law & Economics, 8029 Zurich, Switzerland
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Meecham L. The Collaborative Big Bang and Introduction to the European Vascular Research Collaborative. Eur J Vasc Endovasc Surg 2022; 64:153-154. [PMID: 35487391 DOI: 10.1016/j.ejvs.2022.03.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/21/2022] [Accepted: 03/27/2022] [Indexed: 01/12/2023]
Affiliation(s)
- Lewis Meecham
- Department of Vascular Surgery, University Hospital Wales, Cardiff, UK.
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Alinani A, Mills B, Gause E, Vavilala MS, Lele AV. National Institutes of Health Clinical Research Funding and All-Cause In-Hospital Traumatic Brain Injury-Related Mortality. Cureus 2022; 14:e27228. [PMID: 36035060 PMCID: PMC9400552 DOI: 10.7759/cureus.27228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction Higher federal research funding levels may improve patient outcomes. We examined this relationship between traumatic brain injury (TBI) funding and all-cause in-hospital TBI-related mortality. Methods Using an ecological series analysis, we examined the linear trend in both clinical TBI research funding in year 2000 United States dollars ($) (National Institutes of Health [NIH] RePORTER) and in-hospital isolated TBI mortality among patients aged 15 and older (National Trauma Data Bank [NTDB], TBI-related ICD-9 or ICD-10 code, abbreviated head injury score >2 and body region score <2 with ICU admission) between 2007-2015 with data from centers contributing all years of data for the study period. Linear regression was used to assess the relationship between mortality rate and total funding, lagged one to three years, both overall and within ten-year age groups. Results The mean annual NIH-TBI research funding was $64.36 million (lowest: 2008; $48.79 million, highest: 2015; $71.42 million). 192,597 encounters of patients 15 years and older, predominantly male (67.5%) and with polytrauma (59.9%), were included. There was no statistically significant reduction in in-hospital TBI-related mortality (14.15% in 2007 to 13.36% in 2015) for the cohort overall, but the mortality rate decreased for patients over 55 years. The greatest mortality reduction occurred in patients 85 years and older (-62.35, 95% CI -92.45-32.25), followed by patients 75-84 years (-44.41, 95% CI -61.72, -27.09), patients 65-74 years (-47.60, 95% CI -67.39, -27.81), and patients 55-64 years of age (-15.15, 95% CI -27.59, -2.72). During the study period, annual NIH funding for TBI varied from the lowest level of $48.79 million (in 2007) to the highest level of $77.34.43 million (in 2005). There was no association between funding in the previous three years and the in-hospital TBI-related mortality rate. Conclusion This study found a variable pattern in NIH funding for clinical TBI research and a contemporaneous reduction in moderate-severe TBI-related deaths only for those aged 55 years and older, but no association between funding and mortality.
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Henshall C, Jones L, Armitage C, Tomlinson L. Empowering nurses through inclusive leadership to promote research capacity building: A James Lind Alliance priority setting Partnership in Community Nursing. J Adv Nurs 2022; 78:2765-2774. [PMID: 35765768 PMCID: PMC9546327 DOI: 10.1111/jan.15342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/23/2022] [Accepted: 06/13/2022] [Indexed: 12/01/2022]
Abstract
Aims This paper focuses on the benefits of inclusive leadership when undertaking a priority setting partnership in community nursing, through providing a collaborative and committed nurse‐led forum for initiating impactful changes, identifying evidence uncertainties and driving research capacity‐building initiatives. Design This is a Discussion paper. The project was undertaken between 2020 and 2021. Data sources This paper is based on shared reflections as 70@70 Senior Nurse Research Leaders and is supported by literature and theory. It draws on issues relating to collective leadership, stakeholder engagement, diversity, inclusivity and COVID‐19. Implications for nursing The James Lind Alliance Priority Setting Partnership catalysed the development of a rigorous evidence‐base in community nursing. The collaborative opportunities, networks and connections developed with patients, carers, nursing leaders, policy makers and healthcare colleagues raised the profile of community nursing research. This will benefit nursing research, practice, education and patients in receipt of community nursing care. Collective buy in from national leaders in policy, education, funding and commissioning has secured a commitment that the evidence uncertainties will be funded. Conclusion Four key learnings emerged: collective leadership can ensure learning is embedded and sustained; developing an engaged stakeholder community to promote community nursing research is essential; a diverse membership ensures inclusivity and representation; and insights into the impact of COVID‐19 aid progress. The process increased research engagement and created capacity and capability‐building initiatives. This will help community nurses feel empowered to lead changes to practice. Sustained engagement and commitment are required to integrate research priorities into community nursing research, education and practice and to drive forward changes to commissioning and service delivery. Impact The study promoted research capacity building through inclusive leadership. This can increase community nurses' research engagement and career development and patient care quality and safety; this can incentivize funders and policy makers to prioritize community nursing research.
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Affiliation(s)
- Catherine Henshall
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Louise Jones
- Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Claire Armitage
- Directorate of Mental Health, Partnership NHS Trust, Leicestershire, UK
| | - Lee Tomlinson
- Kent Community Health NHS Foundation Trust, London, UK
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Almeshari MA, Alshehri Z, Alqahtani JS, Alasmari AM, Alzahrani AA, Alahmadi FH, Alsulayyim AS, Alenezi FK, Alwadeai KS. The Status of Respiratory Care Education in Saudi Arabia: A National Survey of Program Directors. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:619-628. [PMID: 35712027 PMCID: PMC9196280 DOI: 10.2147/amep.s360658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Respiratory Care Practitioner (RCP) is a vital healthcare professional in Saudi Arabia (SA). Many factors regarding the education of RCPs in SA are unknown, including the number of active institutions, levels of education and barriers to promoting the profession. METHODS A cross sectional-based survey was conducted between June 1st, 2020 and September 20th, 2020 in SA to explore the status of RCPs education. Institutions that offered RCP programs were identified through the Ministry of Education and Ministry of Defense academic programs websites. The RCP program directors were invited to participate in an electronic survey. RESULTS Among the 74 institutions searched, 23 indicated that they offered RC programs. Only 13 (56.52%) responded to the survey. Among all programs, four (17.39%) were inactive, 17 (73.91%) were governmental institutions, and only one (4.35%) obtained a national accreditation. From the 13 respondents, there were 1297 students enrolled and 123 full-time faculty members. None of the institutions reported offering postgraduate RC degrees. The respondents reported many barriers; however, shortage of staff (76.92%), lack of postgraduate programs (69.23%), lack of research activity (69.23%), and ineffective communications between institutions (61.54%) were the most reported barriers. CONCLUSION The RC education in SA is developing but not well distributed throughout the country. The shortage of staff and the limited number of postgraduate degree holders potentially contributed to the delay in establishing postgraduate RC degrees, obtaining accreditation, and implementing subspecialties to advance the profession in terms of research and quality of care.
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Affiliation(s)
- Mohammed A Almeshari
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Ziyad Alshehri
- Department of Respiratory Therapy, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia
| | - Jaber S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Ali M Alasmari
- Department of Respiratory Therapy, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia
| | - Ahmed A Alzahrani
- Department of Respiratory Therapy, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia
| | - Fahad H Alahmadi
- Department of Respiratory Therapy, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia
| | - Abdullah S Alsulayyim
- Department of Respiratory Care, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Faraj K Alenezi
- College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Khalid S Alwadeai
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Matetic A, Mohamed MO, Roberts DJ, Rana JS, Alraies MC, Patel B, Sauer AJ, Diaz-Arocutipa C, Sattar Y, Van Spall HGC, Mamas MA. Real-world management and outcomes of 7 million patients with acute coronary syndrome according to clinical research trial enrolment status: a propensity matched analysis. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2022; 8:409-419. [PMID: 34940843 DOI: 10.1093/ehjqcco/qcab098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/16/2021] [Indexed: 01/01/2023]
Abstract
AIMS We aimed to determine whether clinical outcomes and invasive care of acute coronary syndrome (ACS) patients participating in trials differed from those of non-participants, particularly including those who were trial eligible. METHODS AND RESULTS We included all hospitalizations with a principal diagnosis of ACS in the US National Inpatient Sample between January 2004 and September 2015, stratified by trial enrolment and eligibility using the International Classification of Diseases, ninth revision. We conducted propensity score matching to investigate the following outcomes: all-cause mortality; major bleeding; stroke; composite of mortality, stroke, and cardiac complications [major adverse cardiovascular and cerebrovascular events (MACCEs)]; coronary angiography (CA); and percutaneous coronary intervention (PCI). A total of 7 091 179 weighted ACS hospitalizations were analysed, including 19 684 (0.3%) trial participants and 7 071 495 non-participants (3 485 514 of whom were trial eligible). Trial participants were more likely to receive CA [Δ% 28.73%, 95% confidence interval (CI) 27.22-30.24, P < 0.001] and PCI (Δ% 27.13%, 95% CI 24.86-29.41, P < 0.001), with decreased mortality (Δ% -3.51%, 95% CI -4.72 to -2.31, P < 0.001), MACCEs (Δ% -3.04%, 95% CI -4.55 to -1.53, P < 0.001), and bleeding (Δ% -0.89%, 95% CI -1.59 to -0.19, P = 0.013) compared with non-participants. After accounting for eligibility, trial participants were more likely to undergo CA (Δ% 22.78%, 95% CI 21.58-23.99, P < 0.001) and PCI (Δ% 23.95%, 95% CI 21.77-26.13, P < 0.001), and had no difference in mortality (Δ% -0.21%, 95% CI -0.65 to 0.24, P = 0.362). CONCLUSION Among ACS patients, trial enrolment was associated with significantly greater invasive care and lower mortality than among matched non-participants. Trial participants were more likely to be invasively managed even when compared with eligible non-participants, even though there was no difference in mortality.
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Affiliation(s)
- Andrija Matetic
- Department of Cardiology, University Hospital of Split, Split, Croatia.,Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, UK
| | - Mohamed O Mohamed
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, UK
| | - Derek J Roberts
- Division of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Jamal S Rana
- Department of Cardiology, Kaiser Permanente Northern California, Oakland, CA, USA
| | - M Chadi Alraies
- Division of Interventional Cardiology, Detroit Medical Center, Detroit, MI, USA
| | - Brijesh Patel
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Andrew J Sauer
- Department of Cardiovascular Medicine, University of Kansas School of Medicine, Kansas City, KS, USA
| | | | - Yasar Sattar
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Harriette G C Van Spall
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.,Division of Cardiology, Department of Medicine, Population Health Research Institute, Hamilton Canada
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, UK
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Menzies JC, Jennings C, Marshall R. A Survey of Resources and Nursing Workforce for Clinical Research Delivery in Paediatric Intensive Care Within the UK / Ireland. Front Pediatr 2022; 10:848378. [PMID: 35586827 PMCID: PMC9108499 DOI: 10.3389/fped.2022.848378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/08/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Clinical research within Paediatric Intensive Care (PICU) is necessary to reduce morbidity and mortality associated within this resource-intensive environment. With UK PICUs encouraged to be research-active there was a drive to understand how centres support research delivery. Aim To identify the research workforce available within UK/Ireland PICUs to support clinical research delivery. Method An electronic survey, endorsed by the Paediatric Critical Care Society (PCCS), was designed and reported in accordance with CHERRIES guidelines. The survey was distributed by email to all UK/Ireland Nurse Managers and Medical/ Nursing Research leads, aiming for one response per site during the period of April-June 2021. Only one response per site was included in analysis. Results 44 responses were received, representing 24/30 UK/Ireland sites (80% response rate). Responses from n = 21/30 units are included (three excluded for insufficient data). 90% (n = 19/21) units were research active, although only 52% (n = 11) had permanent research roles funded within their staffing establishment. The majority of units (n = 18, 86%) had less than two WTE research nurses. Resources were felt to be sufficient for current research delivery by 43% of units (n = 9), but this confidence diminished to 19% (n = 4) when considering their ability to support future research. The top barriers to research conduct were insufficiently funded/unfunded studies (52%; n = 11), clinical staff too busy to support research activity (52%; n = 11) and short-term/fixed-term contracts for research staff (38%; n = 8). Conclusion Despite the perceived importance of research and 90% of responding UK/Ireland PICUs being research active, the majority have limited resources to support research delivery. This has implications for their ability to participate in future multi-centre trials and opportunities to support the development of future medical/nursing clinical academics. Further work is required to identify optimum models of clinical research delivery.
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Affiliation(s)
- Julie C. Menzies
- Paediatric Intensive Care Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
- College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Claire Jennings
- Paediatric Critical Care Unit, Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - Rebecca Marshall
- Paediatric Critical Care Unit, Royal Manchester Children's Hospital, Manchester, United Kingdom
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Cooper S, Sanders J, Pashayan N. Implementing a novel programme for nurses and allied health professionals to develop capacity for evidence-informed clinical practice. J Res Nurs 2022; 26:395-404. [PMID: 35251268 PMCID: PMC8894637 DOI: 10.1177/17449871211013074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Nurses and allied health professionals (AHPs) require skills and support to access, appraise, interpret and use research evidence in clinical practice. We describe the process of designing and implementing the Evidence in Practice (EiP) programme at a UK hospital. Methods Key stakeholders were engaged to identify learning needs and priorities in appraising and implementing research evidence. To address these, we designed a multi-strategy bespoke programme of activities. Results The programme comprised the development of (a) a visual summary of a research paper, (b) five skills development masterclasses and (c) a six-month mentoring scheme to develop and implement plans for translating evidence into practice. Discussion The programme overcame many of the traditional barriers (lack of access, skills and time) to increase engagement of nurses and AHP staff in accessing, reviewing and using evidence in clinical practice. Conclusion With clinical leadership support, it is feasible to use a multi-strategy approach to promote and enable nurses and AHPs to use evidence in clinical practice.
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Affiliation(s)
- Silvie Cooper
- Lecturer (Teaching), Department of Applied Health Research, University College London, UK
| | - Julie Sanders
- Director of Clinical Research, St Bartholomew's Hospital, Barts Health NHS Trust, UK; Clinical Professor in Cardiovascular Nursing, William Harvey Research Institute, Queen Mary University of London, UK
| | - Nora Pashayan
- Professor in Applied Cancer Research, Department of Applied Health Research, University College London, UK
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47
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Tinkler L. Multi-professional perceptions of clinical research delivery and the Clinical Research Nurse role: a realist review. J Res Nurs 2022; 27:9-29. [PMID: 35392190 PMCID: PMC8980584 DOI: 10.1177/17449871211068017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction & Background The delivery of clinical research and the Clinical Research Nurse (CRN) role is fundamental to the wider health agenda, yet both remain misunderstood outwith research teams. Methods A realist review was conducted to identify factors that influence how clinical research is perceived by healthcare professionals operating outside NHS clinical research teams. Keyword searches were undertaken across four healthcare databases including grey literature, with iterative snowball searching. Data were extracted from 42/387 sources. Coding generated 3664 extracts of text across 160 themes. Theories generated were presented as 'If-Then' statements. Results Thirteen theory statements described factors that may influence how clinical research is perceived by healthcare professionals operating outside clinical research teams across three contextual levels: • Micro: Individual characteristics/behaviours/CRN perceptions• Meso: Interpersonal relationships at the interface between CRN roles and healthcare delivery• Macro: Systemwide/infrastructural/cultural issues impacting clinical research delivery. Conclusion Factors at micro, meso and macro level contexts may influence how clinical research is perceived by healthcare professionals operating outside clinical research teams. This has the potential to affect the success of clinical research delivery. Meso level theories regarding the perceptions of healthcare professionals outwith research teams may provide insight. Empirical testing of one such theory is underway.
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Affiliation(s)
- Linda Tinkler
- Royal College of Nursing Strategic Research Alliance PhD Scholar, Department of Nursing and Midwifery, University of Sheffield, Sheffield, UK; Florence Nightingale Leadership Scholar 2018, NIHR 70@70 Senior Nurse Research Leader; Trust Lead for Nursing, Midwifery and AHP Research, The Newcastle upon Tyne Hospitals NHS Foundation Trust
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48
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Whitehouse CL, Raven JL, Keable J, Parslow-Williams S, Smith HA. Midwifery research in areas of deprivation and need: the MeRIDiAN project. J Res Nurs 2022; 27:131-140. [PMID: 35392192 PMCID: PMC8980571 DOI: 10.1177/17449871211067990] [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: 11/17/2022] Open
Abstract
Background Areas with high levels of deprivation often have the lowest numbers of research participation. In January 2020, a maternity research service was established at a UK National Health Service (NHS) Trust incorporating a project monitoring equity of access to pregnant people from areas of deprivation and need. Aims The aim is to monitor maternity research opportunities for pregnant people in areas of deprivation and need. Method A collaborative working group was established. Using the Index of Multiple Deprivation levels (IMD) levels; 1-4 were considered 'areas in need'. Data were collected over a 12-month period from January 2020. Results Fifty-four pregnant people (3.1%), out of 1762 who delivered during 2020, were recruited to one of three research studies ('Big Baby', 'POOL' and 'PAN-COVID'). The majority of pregnant people (65.9%) who delivered a baby were in IMD levels 1-4. Recruitment within IMD levels 1-4: 'PAN-COVID' at 86.7%, followed by 'Big Baby' with 77.3% and 'POOL' at 70.6%. COVID-19 pandemic presented challenges which impacted research delivery, including availability of research studies. Conclusion This project was founded due to concerns that pregnant people from areas of need would be under-represented in research. We have found that this has not occurred. Recommendations are being put in place to ensure equity of access for all.
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Affiliation(s)
- Claire L Whitehouse
- Claire Whitehouse, Senior Nurse for Nursing, Midwifery and Allied Health Professions Research, The James Paget University Hospitals NHS Foundation Trust, Lowestoft Road, Gorleston, Great Yarmouth NR31 6LA, UK.
| | - Jamie-Louise Raven
- Clinical Research Midwife, The James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
| | - Joanna Keable
- Deputy Head of Midwifery and Gynaecology, The James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
| | | | - Hazel A Smith
- Honorary Midwife Researcher, Corporate Nursing, The James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
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Shepherd M, Endacott R, Quinn H. Bridging the gap between research and clinical care: strategies to increase staff awareness and engagement in clinical research. J Res Nurs 2022; 27:168-181. [PMID: 35392210 PMCID: PMC8980567 DOI: 10.1177/17449871211034545] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Research active hospitals have better patient outcomes and improvements in healthcare are associated with greater staff engagement in research. However, barriers to research activity include inadequate knowledge/training and perceptions that research is a specialist activity. Nursing is an academic discipline but the infrastructure supporting nursing research worldwide is variable and sustaining clinical academic careers remains challenging. The National Institute of Health Research 70@70 Senior Nurse Research Leader programme provides dedicated time to increase clinical academic opportunities and foster a research culture across England; we describe initiatives developed by one National Institute of Health Research 70@70 leader to increase clinical staff engagement in research. Aim The purpose of this work was to develop initiatives to facilitate clinical research opportunities and bridge the gap between clinical care and research. Methods New strategies were developed in one health service to increase clinical staff engagement in research activity. This included: (a) Chief Nurse Research Fellows: clinical staff undertaking bespoke research training to identify local clinical research priorities, (b) an exemplar nurse-led Embedding Research In Care unit to pioneer innovation, evaluation and research participation supported by a research facilitator and (c) a Clinical Academic Network for nursing, midwifery and allied healthcare professionals to aid collaborative working. Results The first cohort of Chief Nurse Research Fellows have successfully completed a bespoke training programme and, with mentoring, developed projects to tackle clinical problems. The Embedding Research In Care unit initiative was configured and the first Embedding Research In Care unit has been awarded. A Clinical Academic Network group of 25+ nurses, midwives and allied health professionals was established and provides peer support and mentoring. Conclusions This multi-faceted approach has successfully supported research training/engagement, enabled career development and identified nurses/midwives with potential to undertake clinical academic careers. A range of strategies, such as those described in this paper, are required to successfully bridge the gap between clinical care and research and provide additional opportunities for clinical staff to become engaged in a research active career.
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Affiliation(s)
- Maggie Shepherd
- Maggie Shepherd, L3 RILD, Barrack Road, Exeter, EX2 5DW, UK.
| | - Ruth Endacott
- Clinical School, Royal Devon and Exeter NHS Foundation Trust and University of Plymouth, UK; Clinical School, University of Plymouth UK, School of Nursing & Midwifery, Monash University, Australia
| | - Helen Quinn
- Research and Development Director, Research and Development, Royal Devon and Exeter NHS Foundation Trust, UK
- University of Exeter, UK
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Kirk J, Willcocks J, Boyle P, Brocklehurst P, Morris K, Kearney R, Holden M, Brookes M. Developing chief investigators within the NHS: the West Midlands clinical trials scholars programme. Clin Med (Lond) 2022; 22:149-152. [PMID: 38589177 DOI: 10.7861/clinmed.2021-0606] [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: 11/27/2022]
Abstract
Consecutive Royal College of Physicians' Research for all surveys have highlighted the challenges for doctors becoming involved in research. Local issues included under-representation of chief investigators (CIs) and reduction in dedicated research time. The West Midlands National Institute for Health Research (NIHR) Clinical Research Network (CRN) established a clinical trials scholarship (CTS) initiative in 2019 to develop research-active consultants in smaller trusts, with a dedicated day per week embedded in a local clinical trials unit. In the initial round of 41 applications from 13 partner organisations, 17 CTSs were appointed, including nine consultant physicians, with one subsequently deferring. After 2 years, the remaining 16 CTSs have been awarded 40 grants totalling £18.35 million as CI or co-CI, including 10 NIHR grants, plus >200 publications. These scholarships are a proven cost-effective way to develop CIs, provide academic leadership and promote a research culture, even in small, previously less research-active trusts.
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Affiliation(s)
- Jeremy Kirk
- National Institute for Health Research Clinical Research Network West Midlands, Birmingham, UK.
| | - Jane Willcocks
- National Institute for Health Research Clinical Research Network West Midlands, Birmingham, UK
| | - Pauline Boyle
- National Institute for Health Research Clinical Research Network West Midlands, Birmingham, UK
| | | | | | | | | | - Matthew Brookes
- National Institute for Health Research Clinical Research Network West Midlands, Birmingham, UK
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