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Boyden GL, Brisbois MD, Kellogg MB, Foli KJ. Understanding Resilience Among Generation Z Baccalaureate Nursing Students: A Hermeneutical Phenomenology Study. J Nurs Educ 2024; 63:460-469. [PMID: 38979737 DOI: 10.3928/01484834-20240505-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
BACKGROUND Supporting resilience for nursing student success is critical to future health care. This study explored the meaning and process of resilience among Generation Z traditional baccalaureate nursing students. METHOD Using a qualitative hermeneutical phenomenology approach, 13 Generation Z nursing students with the lived experience of resilience were surveyed and interviewed. Results were analyzed interpretively. RESULTS Themes of resilience among Generation Z nursing students were identified relative to study questions. Identified themes included "Maneuvering the Murky Water" and "This Can Either Ruin Me or I Can Keep Moving With It," as well as a resilience process within the context of nursing education. Open-response data provided further reflective insights on resilience and recommendations for resilience in nursing education programs. CONCLUSION Supporting resilience begins with understanding students' individual and generational perspective. Future nursing education research should include innovative interventions wherein the perspectives of Generation Z students are central to design. [J Nurs Educ. 2024;63(7):460-469.].
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Sanchez N, Chen M, Ho S, Spinner H, Vagadori J, Neiser A, Padilla K, Bristol M, Winfield E, Thorstad I, Gulley LD, Lucas-Thompson RG, Pyle L, Thompson T, Estrada DE, Basch M, Tanofsky-Kraff M, Kelsey MM, Mackey ER, Shomaker LB. Mindfulness-based intervention for depression and insulin resistance in adolescents: Protocol for BREATHE, a multisite, pilot and feasibility randomized controlled trial. Contemp Clin Trials 2024; 141:107522. [PMID: 38580104 DOI: 10.1016/j.cct.2024.107522] [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: 01/04/2024] [Revised: 03/18/2024] [Accepted: 04/02/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Elevated depression symptoms have been associated with higher insulin resistance in adolescents, and consequently, greater risk for type 2 diabetes (T2D). Mindfulness-based intervention (MBI) may be suited for adolescents at risk for T2D given its potential to decrease depression and improve stress-related behavior/physiology underpinning insulin resistance. To prepare for a future multisite efficacy randomized controlled trial, a rigorous, multisite, pilot and feasibility study is needed to test this approach. The current paper describes the design and protocol for a multisite, pilot and feasibility randomized controlled trial of six-week MBI, cognitive-behavioral therapy (CBT), and health education (HealthEd) group interventions, to assess multisite fidelity, feasibility, and acceptability. METHODS Participants are N = 120 adolescents ages 12-17, with body mass index (BMI) ≥85th percentile, elevated depression symptoms (20-item Center for Epidemiologic Studies-Depression Scale total score > 20), and family history of diabetes. Enrollment occurs across four United States (US) sites, two in Colorado, one in Washington, D·C., and one in Maryland. Group interventions are delivered virtually by trained psychologists and co-facilitators. Assessments occur at baseline, six-week follow-up, and one-year follow-up. RESULTS Primary outcomes are intervention implementation fidelity, based upon expert ratings of audio-recorded sessions (≥80% adherence/competence), and recruitment feasibility, based upon percentage enrollment of eligible youth (≥80%). Secondary outcomes are intervention training fidelity/feasibility/acceptability, recruitment timeframe, and retention/assessment feasibility. CONCLUSION Findings will inform optimization of training, recruitment, intervention delivery, retention, and assessment protocols for a multisite, efficacy randomized controlled trial evaluating MBI for decreasing depression and improving insulin resistance in adolescents at risk for developing T2D.
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Affiliation(s)
- Natalia Sanchez
- Department of Human Development and Family Studies, Colorado State University, USA.
| | - Michele Chen
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine and Children's Hospital Colorado, USA
| | - Sally Ho
- Center for Translational Research, Children's National Hospital, USA
| | - Holly Spinner
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, USA
| | - Jack Vagadori
- Center for Translational Research, Children's National Hospital, USA
| | - Abigail Neiser
- Department of Human Development and Family Studies, Colorado State University, USA
| | - Kimberly Padilla
- Department of Human Development and Family Studies, Colorado State University, USA
| | - Madison Bristol
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine and Children's Hospital Colorado, USA
| | - Elijah Winfield
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine and Children's Hospital Colorado, USA
| | - Isabel Thorstad
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, USA
| | - Lauren D Gulley
- Department of Human Development and Family Studies, Colorado State University, USA; Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine and Children's Hospital Colorado, USA
| | - Rachel G Lucas-Thompson
- Department of Human Development and Family Studies, Colorado State University, USA; Colorado School of Public Health, Fort Collins, Colorado, USA
| | - Laura Pyle
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine and Children's Hospital Colorado, USA
| | - Talia Thompson
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine and Children's Hospital Colorado, USA
| | - Doris E Estrada
- Center for Translational Research, Children's National Hospital, USA; Department of Pediatrics, Division of Diabetes and Endocrinology, Children's National Hospital, USA
| | - Molly Basch
- Center for Translational Research, Children's National Hospital, USA
| | - Marian Tanofsky-Kraff
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, USA; Department of Medical and Clinical Psychology, Uniformed Services University, USA
| | - Megan M Kelsey
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine and Children's Hospital Colorado, USA
| | - Eleanor R Mackey
- Center for Translational Research, Children's National Hospital, USA
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, Colorado State University, USA; Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine and Children's Hospital Colorado, USA; Colorado School of Public Health, Fort Collins, Colorado, USA
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Anderson JT, Roth JD, Rosenau KA, Dwyer PS, Kuo AA, Martinez-Agosto JA. Enhancing multi-site autism research through the development of a collaborative data platform. Autism Res 2024. [PMID: 38794841 DOI: 10.1002/aur.3167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 05/02/2024] [Indexed: 05/26/2024]
Abstract
Data repositories, particularly those storing data on vulnerable populations, increasingly need to carefully consider not only what data is being collected, but how it will be used. As such, the Autism Intervention Research Network on Physical Health (AIR-P) has created the Infrastructure for Collaborative Research (ICR) to establish standards on data collection practices in Autism repositories. The ICR will strive to encourage inter-site collaboration, amplify autistic voices, and widen accessibility to data. The ICR is staged as a three-tiered framework consisting of (1) a request for proposals system, (2) a REDCap-based data repository, and (3) public data dashboards to display aggregate de-identified data. Coupled with a review process including autistic and non-autistic researchers, this framework aims to propel the implementation of equitable autism research, enhance standardization within and between studies, and boost transparency and dissemination of findings. In addition, the inclusion of a contact registry that study participants can opt into creates the base for a robust participant pool. As such, researchers can leverage the platform to identify, reach, and distribute electronic materials to a greater proportion of potential participants who likely fall within their eligibility criteria. By incorporating practices that promote effective communication between researchers and participants, the ICR can facilitate research that is both considerate of and a benefit to autistic people.
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Affiliation(s)
- Jeffrey T Anderson
- Department of Medicine, University of California, Los Angeles, California, USA
| | - Jeffrey D Roth
- Department of Medicine, University of California, Los Angeles, California, USA
| | - Kashia A Rosenau
- Department of Medicine, University of California, Los Angeles, California, USA
| | - Patrick S Dwyer
- Department of Psychology, University of California, Los Angeles, California, USA
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Alice A Kuo
- Department of Medicine, University of California, Los Angeles, California, USA
- Department of Pediatrics, University of California, Los Angeles, California, USA
| | - Julian A Martinez-Agosto
- Department of Pediatrics, University of California, Los Angeles, California, USA
- Department of Human Genetics, University of California, Los Angeles, California, USA
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Ray-Barruel G, Pather P, Schults JA, Rickard CM. Handheld Ultrasound Devices for Peripheral Intravenous Cannulation: A Scoping Review. JOURNAL OF INFUSION NURSING 2024; 47:75-95. [PMID: 38422403 DOI: 10.1097/nan.0000000000000540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Ultrasound-guided insertion of peripheral intravenous catheters (PIVCs) is recommended for patients with difficult intravenous access, but access to ultrasound equipment is often limited to specialty departments. Compact, affordable handheld ultrasound devices are available, but the extent of their clinical adoption and impact on patient outcomes is unknown. This scoping review aimed to explore evidence regarding handheld and pocket ultrasound devices for PIVC insertion. Databases were searched for studies published in English between January 2000 and January 2023 evaluating handheld or pocket ultrasound devices weighing ≤3 kg for PIVC insertion. Data were extracted using standardized forms and summarized using descriptive statistics. Seventeen studies reporting the use of handheld or pocket ultrasound devices were identified. Most studies were conducted in adult inpatient facilities; 3 included pediatrics, and 2 reported out-of-hospital use. Participants with difficult intravenous access featured in 9 studies. Ultrasound training programs were described in 12 studies, with competency defined by number of successful PIVC insertions. Five studies reported clinician and/or patient perspectives. Ultrasound for PIVC insertion is not widely accessible in nonspecialist areas, but more compact and affordable handheld models could provide a solution, especially for patients with difficult access. More research evidence using handheld ultrasound is needed.
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Affiliation(s)
- Gillian Ray-Barruel
- School of Nursing, Midwifery and Social Work, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Herston Infectious Diseases Institute and Metro North Hospital and Health Service, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Alliance for Vascular Access Teaching and Research, School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia (Ray-Barruel, Pather, Schults, Rickard); ICU Outreach, QEII Jubilee Hospital, Coopers Plains, Queensland, Australia (Pather); Department of Anaesthesia and Pain Management, Queensland Children's Hospital, Brisbane, Queensland, Australia (Schults)
- Gillian Ray-Barruel, PhD, RN, is a senior research fellow with the University of Queensland School of Nursing, Midwifery and Social Work and the Herston Infectious Diseases Institute (HeIDI), as well as an adjunct senior research fellow with Griffith University in Brisbane, Australia. She is also education director with the Alliance for Vascular Access Teaching and Research (AVATAR) and associate editor for the ACIPC journal Infection, Disease & Health. Following a successful 20-year career in critical care nursing and project management, Dr Ray-Barruel established her career as an internationally respected nurse researcher with over 70 peer-reviewed publications. Her research focuses on improving assessment and decision-making by bedside clinicians to prevent device-related patient complications and improve health care outcomes
- Priscilla Pather, RN, MAppSc (Research), is an emerging early career researcher and a clinical nurse consultant working with ICU Outreach at Queen Elizabeth II Jubilee Hospital, Brisbane, and a registered intensive care unit (ICU) nurse at Mater Health Services, South Brisbane. As a front-line clinician focused on early detection and management of the deteriorating patient, she has strong cannulation skills and is ideally placed between academia and clinical settings to conduct research and audits, as well as to promote and monitor developments in this field. She is invested in safety and quality, adopting evidence-based practice into clinical care to promote and preserve vessel health
- Jessica Schults, PhD, RN, is a conjoint senior research fellow with The University of Queensland School of Nursing, Midwifery and Social Work and Metro North's Herston Infectious Disease Institute. Her research themes to date have focused on ventilation strategies to reduce ventilator-associated pneumonia and interventions to improve the safety and quality of care related to invasive medical devices. Dr Schults's developing research themes focus on enhancing health service surveillance using electronic health information in 2 major spheres: hospital-level surveillance for hospital-acquired complications and unit-level surveillance for vascular access device complications and ventilator-associated events. She is particularly interested in advances in infectious disease surveillance and tracking, using a combination of mature platforms and new electronic platforms
- Claire M. Rickard, PhD, RN, is professor of infection prevention and vascular access at the University of Queensland and Metro North Health in Brisbane, Australia. She is also adjunct professor with Griffith University and board cochair of the Australian and New Zealand Intensive Care Foundation. She established and coleads the Alliance for Vascular Access Teaching and Research (avatargroup.org.au), a large collaborative with the vision to "make vascular access complications history." Her background is in critical care and med-surg nursing followed by a focus on clinical research leading to >300 publications, including 45 randomized controlled trials. She was recognized in the International Nurse Researcher Hall of Fame in 2013, and elected to the Australian Academy of Health and Medical Sciences in 2015 and the American Academy of Nursing in 2021
| | - Priscilla Pather
- School of Nursing, Midwifery and Social Work, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Herston Infectious Diseases Institute and Metro North Hospital and Health Service, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Alliance for Vascular Access Teaching and Research, School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia (Ray-Barruel, Pather, Schults, Rickard); ICU Outreach, QEII Jubilee Hospital, Coopers Plains, Queensland, Australia (Pather); Department of Anaesthesia and Pain Management, Queensland Children's Hospital, Brisbane, Queensland, Australia (Schults)
- Gillian Ray-Barruel, PhD, RN, is a senior research fellow with the University of Queensland School of Nursing, Midwifery and Social Work and the Herston Infectious Diseases Institute (HeIDI), as well as an adjunct senior research fellow with Griffith University in Brisbane, Australia. She is also education director with the Alliance for Vascular Access Teaching and Research (AVATAR) and associate editor for the ACIPC journal Infection, Disease & Health. Following a successful 20-year career in critical care nursing and project management, Dr Ray-Barruel established her career as an internationally respected nurse researcher with over 70 peer-reviewed publications. Her research focuses on improving assessment and decision-making by bedside clinicians to prevent device-related patient complications and improve health care outcomes
- Priscilla Pather, RN, MAppSc (Research), is an emerging early career researcher and a clinical nurse consultant working with ICU Outreach at Queen Elizabeth II Jubilee Hospital, Brisbane, and a registered intensive care unit (ICU) nurse at Mater Health Services, South Brisbane. As a front-line clinician focused on early detection and management of the deteriorating patient, she has strong cannulation skills and is ideally placed between academia and clinical settings to conduct research and audits, as well as to promote and monitor developments in this field. She is invested in safety and quality, adopting evidence-based practice into clinical care to promote and preserve vessel health
- Jessica Schults, PhD, RN, is a conjoint senior research fellow with The University of Queensland School of Nursing, Midwifery and Social Work and Metro North's Herston Infectious Disease Institute. Her research themes to date have focused on ventilation strategies to reduce ventilator-associated pneumonia and interventions to improve the safety and quality of care related to invasive medical devices. Dr Schults's developing research themes focus on enhancing health service surveillance using electronic health information in 2 major spheres: hospital-level surveillance for hospital-acquired complications and unit-level surveillance for vascular access device complications and ventilator-associated events. She is particularly interested in advances in infectious disease surveillance and tracking, using a combination of mature platforms and new electronic platforms
- Claire M. Rickard, PhD, RN, is professor of infection prevention and vascular access at the University of Queensland and Metro North Health in Brisbane, Australia. She is also adjunct professor with Griffith University and board cochair of the Australian and New Zealand Intensive Care Foundation. She established and coleads the Alliance for Vascular Access Teaching and Research (avatargroup.org.au), a large collaborative with the vision to "make vascular access complications history." Her background is in critical care and med-surg nursing followed by a focus on clinical research leading to >300 publications, including 45 randomized controlled trials. She was recognized in the International Nurse Researcher Hall of Fame in 2013, and elected to the Australian Academy of Health and Medical Sciences in 2015 and the American Academy of Nursing in 2021
| | - Jessica A Schults
- School of Nursing, Midwifery and Social Work, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Herston Infectious Diseases Institute and Metro North Hospital and Health Service, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Alliance for Vascular Access Teaching and Research, School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia (Ray-Barruel, Pather, Schults, Rickard); ICU Outreach, QEII Jubilee Hospital, Coopers Plains, Queensland, Australia (Pather); Department of Anaesthesia and Pain Management, Queensland Children's Hospital, Brisbane, Queensland, Australia (Schults)
- Gillian Ray-Barruel, PhD, RN, is a senior research fellow with the University of Queensland School of Nursing, Midwifery and Social Work and the Herston Infectious Diseases Institute (HeIDI), as well as an adjunct senior research fellow with Griffith University in Brisbane, Australia. She is also education director with the Alliance for Vascular Access Teaching and Research (AVATAR) and associate editor for the ACIPC journal Infection, Disease & Health. Following a successful 20-year career in critical care nursing and project management, Dr Ray-Barruel established her career as an internationally respected nurse researcher with over 70 peer-reviewed publications. Her research focuses on improving assessment and decision-making by bedside clinicians to prevent device-related patient complications and improve health care outcomes
- Priscilla Pather, RN, MAppSc (Research), is an emerging early career researcher and a clinical nurse consultant working with ICU Outreach at Queen Elizabeth II Jubilee Hospital, Brisbane, and a registered intensive care unit (ICU) nurse at Mater Health Services, South Brisbane. As a front-line clinician focused on early detection and management of the deteriorating patient, she has strong cannulation skills and is ideally placed between academia and clinical settings to conduct research and audits, as well as to promote and monitor developments in this field. She is invested in safety and quality, adopting evidence-based practice into clinical care to promote and preserve vessel health
- Jessica Schults, PhD, RN, is a conjoint senior research fellow with The University of Queensland School of Nursing, Midwifery and Social Work and Metro North's Herston Infectious Disease Institute. Her research themes to date have focused on ventilation strategies to reduce ventilator-associated pneumonia and interventions to improve the safety and quality of care related to invasive medical devices. Dr Schults's developing research themes focus on enhancing health service surveillance using electronic health information in 2 major spheres: hospital-level surveillance for hospital-acquired complications and unit-level surveillance for vascular access device complications and ventilator-associated events. She is particularly interested in advances in infectious disease surveillance and tracking, using a combination of mature platforms and new electronic platforms
- Claire M. Rickard, PhD, RN, is professor of infection prevention and vascular access at the University of Queensland and Metro North Health in Brisbane, Australia. She is also adjunct professor with Griffith University and board cochair of the Australian and New Zealand Intensive Care Foundation. She established and coleads the Alliance for Vascular Access Teaching and Research (avatargroup.org.au), a large collaborative with the vision to "make vascular access complications history." Her background is in critical care and med-surg nursing followed by a focus on clinical research leading to >300 publications, including 45 randomized controlled trials. She was recognized in the International Nurse Researcher Hall of Fame in 2013, and elected to the Australian Academy of Health and Medical Sciences in 2015 and the American Academy of Nursing in 2021
| | - Claire M Rickard
- School of Nursing, Midwifery and Social Work, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Herston Infectious Diseases Institute and Metro North Hospital and Health Service, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Alliance for Vascular Access Teaching and Research, School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia (Ray-Barruel, Pather, Schults, Rickard); ICU Outreach, QEII Jubilee Hospital, Coopers Plains, Queensland, Australia (Pather); Department of Anaesthesia and Pain Management, Queensland Children's Hospital, Brisbane, Queensland, Australia (Schults)
- Gillian Ray-Barruel, PhD, RN, is a senior research fellow with the University of Queensland School of Nursing, Midwifery and Social Work and the Herston Infectious Diseases Institute (HeIDI), as well as an adjunct senior research fellow with Griffith University in Brisbane, Australia. She is also education director with the Alliance for Vascular Access Teaching and Research (AVATAR) and associate editor for the ACIPC journal Infection, Disease & Health. Following a successful 20-year career in critical care nursing and project management, Dr Ray-Barruel established her career as an internationally respected nurse researcher with over 70 peer-reviewed publications. Her research focuses on improving assessment and decision-making by bedside clinicians to prevent device-related patient complications and improve health care outcomes
- Priscilla Pather, RN, MAppSc (Research), is an emerging early career researcher and a clinical nurse consultant working with ICU Outreach at Queen Elizabeth II Jubilee Hospital, Brisbane, and a registered intensive care unit (ICU) nurse at Mater Health Services, South Brisbane. As a front-line clinician focused on early detection and management of the deteriorating patient, she has strong cannulation skills and is ideally placed between academia and clinical settings to conduct research and audits, as well as to promote and monitor developments in this field. She is invested in safety and quality, adopting evidence-based practice into clinical care to promote and preserve vessel health
- Jessica Schults, PhD, RN, is a conjoint senior research fellow with The University of Queensland School of Nursing, Midwifery and Social Work and Metro North's Herston Infectious Disease Institute. Her research themes to date have focused on ventilation strategies to reduce ventilator-associated pneumonia and interventions to improve the safety and quality of care related to invasive medical devices. Dr Schults's developing research themes focus on enhancing health service surveillance using electronic health information in 2 major spheres: hospital-level surveillance for hospital-acquired complications and unit-level surveillance for vascular access device complications and ventilator-associated events. She is particularly interested in advances in infectious disease surveillance and tracking, using a combination of mature platforms and new electronic platforms
- Claire M. Rickard, PhD, RN, is professor of infection prevention and vascular access at the University of Queensland and Metro North Health in Brisbane, Australia. She is also adjunct professor with Griffith University and board cochair of the Australian and New Zealand Intensive Care Foundation. She established and coleads the Alliance for Vascular Access Teaching and Research (avatargroup.org.au), a large collaborative with the vision to "make vascular access complications history." Her background is in critical care and med-surg nursing followed by a focus on clinical research leading to >300 publications, including 45 randomized controlled trials. She was recognized in the International Nurse Researcher Hall of Fame in 2013, and elected to the Australian Academy of Health and Medical Sciences in 2015 and the American Academy of Nursing in 2021
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McCausland D, Haigh M, McCallion P, McCarron M. IRB challenges in multisite studies: A case report and commentary from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA). HRB Open Res 2024; 7:3. [PMID: 38784966 PMCID: PMC11109535 DOI: 10.12688/hrbopenres.13854.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 05/25/2024] Open
Abstract
A shift from single to multi-site health studies enabled a range of research benefits including faster recruitment of larger and more diverse samples; increased statistical power, greater rigour, generalisability, and external reliability; and increased likelihood of impacting policy and clinical practice. However, ethical review of multi-site studies by Institutional Review Boards (IRBs) raises specific challenges compared with single site studies, with requirements to apply to multiple local IRBs increasing the burden on research, possibly endangering the integrity of the research process or inhibiting development of multi-site studies. The option of a single centralised IRB may offer a clearer, more consistent and efficient review process. This study presents a case report and commentary from 15 years engaging with IRBs in multiple sites in Ireland by the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA). It examines the ethics review process for IDS-TILDA through its first four waves. While the majority of 48 IRBs granted ethical approval within 13 weeks, six IRBs took 21-47 weeks to approve, leading to delays in data collection of up to 11 months. Despite additional review time, no changes were required to the study protocol. Therefore, a critical impact of the process was the delay in starting data collection within a small number of organisations, and reduced involvement in the study for one organisation. The ethical review process with multiple IRBs increased the degree of complexity of the process, with added bureaucracy and far greater communication required across 48 IRBs, substantially adding to the resource commitment for the review process. The relatively quick approval from the majority of IRBs was partially a result of the longitudinal study building relationships with organisations throughout multiple waves. That other health studies may not accrue this benefit supports calls for a single IRB system for multi-site health studies.
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Affiliation(s)
- Darren McCausland
- Trinity Centre for Ageing and Intellectual Disability, The University of Dublin Trinity College, Dublin, Leinster, Ireland
| | - Margaret Haigh
- Trinity Centre for Ageing and Intellectual Disability, The University of Dublin Trinity College, Dublin, Leinster, Ireland
| | | | - Mary McCarron
- Trinity Centre for Ageing and Intellectual Disability, The University of Dublin Trinity College, Dublin, Leinster, Ireland
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Lancaster RJ, Gentile DL, Hlebichuk JL, Cleary MB, Hook ML, Vizgirda VM. Building research infrastructure and multisite studies in merged health care settings: A framework for nurse scientists and health care leaders. Nurs Outlook 2023; 71:102083. [PMID: 37949034 DOI: 10.1016/j.outlook.2023.102083] [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: 08/13/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Merged healthcare settings, particularly those with Magnet designated sites, present distinct opportunities for PhD nurse scientists developing nursing research infrastructure. PURPOSE This article aims to assist nurse scientists and healthcare leaders in defining nurse scientist roles, and in developing research infrastructure for conducting multi-site research in merged settings. METHOD Practical strategies and a framework are provided to assist in building and navigating nurse scientist roles and research infrastructure development. DISCUSSION Emphasizing the necessity of organizational support, the article underscores the importance of clear role delineation and leadership support. CONCLUSION To optimize the contributions of nurse scientists in merged healthcare settings, especially in Magnet organizations, clear role definitions, robust research infrastructure, and strong organizational support are imperative.
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Affiliation(s)
| | | | | | - Meagan B Cleary
- Magnet Department, Advocate Christ Medical Center, Oak Lawn, IL
| | - Mary L Hook
- Institute of Nursing Excellence, Advocate Health, Charlotte, NC
| | - Vida M Vizgirda
- Institute of Nursing Excellence, Advocate Health, Charlotte, NC
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LaFond CM, Hanrahan K, Bohr NL, McCarthy AM. Using a Cascading Approach to Improve Multisite Study Procedures. Nurs Res 2023; 72:377-385. [PMID: 37625180 PMCID: PMC10534019 DOI: 10.1097/nnr.0000000000000665] [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] [Indexed: 05/06/2023]
Abstract
BACKGROUND Multisite studies offer larger, more diverse samples to successfully capture populations and clinical practices of interest at the point of care. However, investigators face challenges with site recruitment and sampling, differences in clinical practices across sites, and data integrity. Addressing these issues a priori can improve the rigor and reproducibility of the research. OBJECTIVE This article aims to describe a cascading approach to multisite research. An exemplar is provided of a study using this approach, which aimed to evaluate the prevalence of pain and the pain management practices provided to critically ill children in pediatric intensive care units in the United States. METHODS The cascading approach includes two or more pilot study procedures with a progressively increasing number of sites prior to a full-scale study. Following each pilot, study procedures are evaluated; feedback was obtained from site personnel and content experts; procedures were revised accordingly; approvals were obtained; sites were trained; and the revised procedures are repeated with a larger, more diverse number of sites. RESULTS In the exemplar provided, improvements in the efficiency and integrity of data collection were noted for the full-scale study following the pilots. All sites that completed the agreements and approvals for study participation were retained for the duration of the two pilots and full-scale study. DISCUSSION Borrowing from principles of process improvement, the cascading approach allows knowledge to be gained regarding site differences and informs the revision of study procedures while potentially maximizing efficiency and data integrity, minimizing site burden, and maintaining site engagement for multisite studies.
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Patil DJ, Vyas T, Kataria APS, Rajput R, Ashem A, Kumar M. Multi-centric clinic trials in evidence-based research - A narrative review on the Indian scenario. J Family Med Prim Care 2023; 12:863-867. [PMID: 37448913 PMCID: PMC10336936 DOI: 10.4103/jfmpc.jfmpc_2257_22] [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: 11/20/2022] [Revised: 01/26/2023] [Accepted: 02/02/2023] [Indexed: 07/18/2023] Open
Abstract
Evidence-based health care is gaining prominence since the past many decades. The ultimate goal of evidence-based medicine is providing the best available treatment to patients. The boom in pharmacy sector has seen a rapid rise in randomised controlled clinical trials. Novel medicines or diagnostic tests must be tested before introducing to the target population. Randomised controlled trials are at the top hierarchy of evidence-based health care, especially for testing newly invented drugs. The results obtained from randomised controlled trials cannot be generalised to the entire population. This has led to the evolvement of multi-centre trials in evidence-based research. Multi-centre trials can overcome the barriers associated with single-centre clinical trials. The conduct of multi-centre trials is still in a budding stage in India. Although there are many ongoing multi-centre trials in India, very few trials are conducted among the dental fraternity. The conduct of such trials has its own set of challenges involving funding, ethical committee approval, and logistic requirements. This paper will discuss the growth of multi-centre research, steps involved in conduct of multi-centre trials, and the challenges faced in conducting these trials by the dental specialists in India.
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Affiliation(s)
- Deepa J. Patil
- Department of Oral Medicine and Radiology, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
| | - Tarun Vyas
- Department of Oral Medicine and Radiology, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India
| | - Ajay P. S. Kataria
- Department of Oral Medicine and Radiology, Desh Bhagat Dental College and Hospital, Mandi, Gobindgarh, Punjab, India
| | - Rajan Rajput
- Department of Oral Medicine and Radiology, National Dental College and Hospital, Derabassi, Punjab, India
| | - Albert Ashem
- Department of Oral Medicine and Radiology, Dental College, RIMS, Imphal, Manipur, India
| | - Mukesh Kumar
- Vyas Dental College and Hospital, Jodhpur, Rajasthan, India
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9
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de Bles NJ, Gast DAA, van der Slot AJC, Didden R, van Hemert AM, Rius-Ottenheim N, Giltay EJ. Lessons learned from two clinical trials on nutritional supplements to reduce aggressive behaviour. J Eval Clin Pract 2022; 28:607-614. [PMID: 35040231 PMCID: PMC9543803 DOI: 10.1111/jep.13653] [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: 08/29/2021] [Accepted: 12/14/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Setting up and conducting a randomised controlled trial (RCT) has many challenges-particularly trials that include vulnerable individuals with behavioural problems or who reside in facilities that focus on care as opposed to research. These populations are underrepresented in RCTs. APPROACH In our paper, we describe the challenges and practical lessons learned from two RCTs in two care settings involving long-stay psychiatric inpatients and people with intellectual disabilities. We describe five main difficulties and how these were overcome: (1) multisite setting, (2) inclusion of vulnerable participants, (3) nutritional supplements and placebos, (4) assessment of behavioural outcomes, and (5) collecting bio samples. CONCLUSIONS By sharing these practical experiences, we hope to inform other researchers how to optimally design their trials, while avoiding and minimising the difficulties that we encountered, and to facilitate the implementation of a trial. Both trials were registered in the Clinical Trials Register (RCT A: NCT02498106; RCT B: NCT03212092).
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Affiliation(s)
- Nienke J de Bles
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - David A A Gast
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.,Gemiva-SVG Group, Gouda, The Netherlands
| | - Abe J C van der Slot
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert Didden
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Trajectum, Zwolle, The Netherlands
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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10
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Overcoming Challenges in Multisite Trials: Erratum. Nurs Res 2019; 68:316. [PMID: 31261234 DOI: 10.1097/nnr.0000000000000377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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