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Janssens O, Andreou V, Embo M, Valcke M, De Ruyck O, Robbrecht M, Haerens L. The identification of requirements for competency development during work-integrated learning in healthcare education. BMC Med Educ 2024; 24:427. [PMID: 38649850 PMCID: PMC11034030 DOI: 10.1186/s12909-024-05428-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Work-integrated learning (WIL) is widely accepted and necessary to attain the essential competencies healthcare students need at their future workplaces. Yet, competency-based education (CBE) remains complex. There often is a focus on daily practice during WIL. Hereby, continuous competency development is at stake. Moreover, the fact that competencies need to continuously develop is often neglected. OBJECTIVES To ultimately contribute to the optimization of CBE in healthcare education, this study aimed at examining how competency development during WIL in healthcare education could be optimized, before and after graduation. METHODS Fourteen semi-structured interviews with 16 experts in competency development and WIL were carried out. Eight healthcare disciplines were included namely associate degree nursing, audiology, family medicine, nursing (bachelor), occupational therapy, podiatry, pediatrics, and speech therapy. Moreover, two independent experts outside the healthcare domain were included to broaden the perspectives on competency development. A qualitative research approach was used based on an inductive thematic analysis using Nvivo12© where 'in vivo' codes were clustered as sub-themes and themes. RESULTS The analysis revealed eight types of requirements for effective and continuous competency development, namely requirements in the context of (1) competency frameworks, (2) reflection and feedback, (3) assessment, (4) the continuity of competency development, (5) mentor involvement, (6) ePortfolios, (7) competency development visualizations, and (8) competency development after graduation. It was noteworthy that certain requirements were fulfilled in one educational program whereas they were absent in another. This emphasizes the large differences in how competence-based education is taking shape in different educational programs and internship contexts. Nevertheless, all educational programs seemed to recognize the importance of ongoing competency development. CONCLUSION The results of this study indicate that identifying and meeting the requirements for effective and continuous competency development is essential to optimize competency development during practice in healthcare education.
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Affiliation(s)
- Oona Janssens
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium.
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000, Belgium.
| | - Vasiliki Andreou
- Department of Public Health and Primacy Care, Academic Center for General Practice, KU Leuven, Kapucijnenvoer 7, Leuven, 3000, Belgium
| | - Mieke Embo
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium
- Expertise Network Health and Care, Artevelde University of Applied Sciences, Voetweg 66, Ghent, 9000, Belgium
| | - Martin Valcke
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium
| | - Olivia De Ruyck
- Imec-mict-UGent, Miriam Makebaplein 1, Ghent, 9000, Belgium
- Department of Industrial Systems Engineering and Product Design, Faculty of Engineering and Architecture, Ghent University, Campus Kortrijk, Graaf Karel de Goedelaan 5, Kortrijk, 8500, Belgium
- Department of Communication Sciences, Ghent University, Campus Ufo Vakgroep Communicatiewetenschappen Technicum, T1, Sint‑Pietersnieuwstraat 41, Ghent, 9000, Belgium
| | - Marieke Robbrecht
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, Ghent, 9000, Belgium
| | - Leen Haerens
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000, Belgium
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Korkalainen H, Kainulainen S, Islind AS, Óskarsdóttir M, Strassberger C, Nikkonen S, Töyräs J, Kulkas A, Grote L, Hedner J, Sund R, Hrubos-Strom H, Saavedra JM, Ólafsdóttir KA, Ágústsson JS, Terrill PI, McNicholas WT, Arnardóttir ES, Leppänen T. Review and perspective on sleep-disordered breathing research and translation to clinics. Sleep Med Rev 2024; 73:101874. [PMID: 38091850 DOI: 10.1016/j.smrv.2023.101874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 09/18/2023] [Accepted: 11/09/2023] [Indexed: 01/23/2024]
Abstract
Sleep-disordered breathing, ranging from habitual snoring to severe obstructive sleep apnea, is a prevalent public health issue. Despite rising interest in sleep and awareness of sleep disorders, sleep research and diagnostic practices still rely on outdated metrics and laborious methods reducing the diagnostic capacity and preventing timely diagnosis and treatment. Consequently, a significant portion of individuals affected by sleep-disordered breathing remain undiagnosed or are misdiagnosed. Taking advantage of state-of-the-art scientific, technological, and computational advances could be an effective way to optimize the diagnostic and treatment pathways. We discuss state-of-the-art multidisciplinary research, review the shortcomings in the current practices of SDB diagnosis and management in adult populations, and provide possible future directions. We critically review the opportunities for modern data analysis methods and machine learning to combine multimodal information, provide a perspective on the pitfalls of big data analysis, and discuss approaches for developing analysis strategies that overcome current limitations. We argue that large-scale and multidisciplinary collaborative efforts based on clinical, scientific, and technical knowledge and rigorous clinical validation and implementation of the outcomes in practice are needed to move the research of sleep-disordered breathing forward, thus increasing the quality of diagnostics and treatment.
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Affiliation(s)
- Henri Korkalainen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.
| | - Samu Kainulainen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Anna Sigridur Islind
- Department of Computer Science, Reykjavik University, Reykjavik, Iceland; Reykjavik University Sleep Institute, Reykjavik University, Reykjavik, Iceland
| | - María Óskarsdóttir
- Department of Computer Science, Reykjavik University, Reykjavik, Iceland
| | - Christian Strassberger
- Centre for Sleep and Wake Disorders, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Sami Nikkonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Juha Töyräs
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia; Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Antti Kulkas
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Department of Clinical Neurophysiology, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Ludger Grote
- Centre for Sleep and Wake Disorders, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Sleep Disorders Centre, Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jan Hedner
- Centre for Sleep and Wake Disorders, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Sleep Disorders Centre, Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Reijo Sund
- School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Harald Hrubos-Strom
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Ear, Nose and Throat Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Jose M Saavedra
- Reykjavik University Sleep Institute, Reykjavik University, Reykjavik, Iceland; Physical Activity, Physical Education, Sport and Health (PAPESH) Research Group, Department of Sports Science, Reykjavik University, Reykjavik, Iceland
| | | | | | - Philip I Terrill
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia
| | - Walter T McNicholas
- School of Medicine, University College Dublin, and Department of Respiratory and Sleep Medicine, St Vincent's Hospital Group, Dublin Ireland
| | - Erna Sif Arnardóttir
- Reykjavik University Sleep Institute, Reykjavik University, Reykjavik, Iceland; Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Timo Leppänen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland; School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia
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Zhang H, Zheng MH. [Doctors' original intentionality in adherence to non-invasive diagnoses benefits MAFLD patients]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:1233-1234. [PMID: 38253064 DOI: 10.3760/cma.j.cn501113-20230904-00089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Precisely diagnosing metabolic dysfunction-associated fatty liver disease (MAFLD) and its severity degree can effectively delay disease progression and have important guiding values for treatment. In recent years, research on non-invasive diagnosis of metabolic dysfunction-associated fatty liver disease has made great progress, suggesting that we should not only give full play advantage to professional personnel in the field of liver disease but also actively cooperate with personnel in other fields to explore different high-performance non-invasive diagnostic methods to achieve early detection, diagnosis, and treatment.
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Affiliation(s)
- H Zhang
- Department of Biostatistics and Records Room, Medical Quality Management Office, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China Department of Hepatology, MAFLD Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - M H Zheng
- Department of Hepatology, MAFLD Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou 325000, China
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Janssens O, Embo M, Valcke M, Haerens L. When theory beats practice: the implementation of competency-based education at healthcare workplaces : Focus group interviews with students, mentors, and educators of six healthcare disciplines. BMC Med Educ 2023; 23:484. [PMID: 37386406 DOI: 10.1186/s12909-023-04446-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 06/13/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Work-integrated learning constitutes a large part of current healthcare education. During the last decades, a competency-based educational (CBE) approach has been introduced to reduce the theory-practice gap and to promote continuous competency development. Different frameworks and models have been developed to support CBE implementation in practice. Although CBE is now well-established, implementation at healthcare workplaces remains complex and controversial. This study aims to explore how students, mentors, and educators from different healthcare disciplines perceive the implementation of CBE at the workplace. The six-step model of Embo et al. (2015) was used as a base: (1) competency selection, (2) formulating learning goals, (3) self-monitoring performance, (4) self-assessing competency development, (5) summative assessment of individual competencies, and (6) summative assessment of global professional competence. METHODS Three semi-structured focus group interviews were conducted with (1) five students, (2) five mentors, and (3) five educators. We recruited participants from six different educational programs: audiology, midwifery, nursing (associate degree and bachelor), occupational therapy, or speech therapy. We used thematic analysis combining an inductive and deductive approach. RESULTS An overview of the predefined competencies was hard to find which complicated CBE implementation and resulted in a lack of consistency between the steps; e.g., the link between the selection of relevant competencies (step 1) and the formulation of learning goals based on these selected competencies (step 2) was absent. Furthermore, the analysis of the data helped identifying seven barriers for CBE implementation: (1) a gap between the educational program and the workplace, (2) a lacking overview of predefined competencies, (3) a major focus on technical competencies at the expense of generic competencies, (4) weak formulation of the learning goals, (5) obstacles related to reflection, (6) low feedback quality, and (7) perceived subjectivity of the assessment approach. CONCLUSION The present barriers to CBE implementation lead to a fragmentation of current work-integrated learning. In this way, theory beats practice when it comes to CBE implementation as the theory of CBE is not effectively implemented. However, the identification of these barriers might help to find solutions to optimize CBE implementation. Future research seems critical to optimize CBE so that theory can meet practice and the opportunities of CBE optimize healthcare education.
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Affiliation(s)
- Oona Janssens
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium.
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000, Belgium.
| | - Mieke Embo
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium
- Expertise Network Health and Care, Artevelde University of Applied Sciences, Voetweg 66, Ghent, 9000, Belgium
| | - Martin Valcke
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium
| | - Leen Haerens
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000, Belgium
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Lin F, Craswell A, Murray L, Brailsford J, Cook K, Anagi S, Muir R, Garrett P, Pusapati R, Carlini J, Ramanan M. Establishing critical care nursing research priorities for three Australian regional public hospitals: A mixed method priority setting study. Intensive Crit Care Nurs 2023; 77:103440. [PMID: 37104948 DOI: 10.1016/j.iccn.2023.103440] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To determine key priorities for critical care nursing research in three Australian regional public hospitals, representing the shared priorities of healthcare professionals and patient representatives. METHODS A three phase priority setting study, including consensus methods (nominal group), survey, qualitative interviews and focus groups were conducted between May 2021 and March 2022. Healthcare professionals and patient representatives from critical care units in regional public hospitals in Australia participated. A patient representative contributed to research design and co-authored this paper. RESULTS In phase one, 29 research topics were generated. In phase two, during a nominal group ranking process, the top 5 priority areas for each site were identified. In the final phase, three themes from focus groups and interviews included patient flow through intensive care, patient care through intensive care journey and intensive care patient recovery. CONCLUSION Identifying context specific research priorities through a priority setting exercise provides insight into the topics that are important to healthcare professionals and to patients in critical care. The top research priorities for nursing research in critical care in regional Australian hospitals include patient flow, patient recovery, and evidence based patient care through the intensive care journey, such as delirium management, pain and sedation, and mobilisation. These shared priorities will be used to guide future nursing research in critical care over the next 3-5 years. IMPLICATIONS FOR CLINICAL PRACTICE The method we used in identifying the research priorities can be used by other researchers and clinicians; close collaboration among researchers and clinicians will be beneficial for practice improvement; and how we can be reassured that our practice is evidence based is worthy of attention.
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Affiliation(s)
- Frances Lin
- School of Health, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia; Sunshine Coast Health Institute, Sunshine Coast, Queensland, Australia.
| | - Alison Craswell
- School of Health, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia; Sunshine Coast Health Institute, Sunshine Coast, Queensland, Australia; Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
| | - Lauren Murray
- Intensive Care Unit, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia
| | - Jane Brailsford
- Intensive Care Unit, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia
| | - Katrina Cook
- Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
| | - Shivaprasad Anagi
- Intensive Care Unit, Hervey Bay Hospital, Hervey Bay, Queensland, Australia
| | - Rachel Muir
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Kings College London, UK
| | - Peter Garrett
- Intensive Care Unit, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia
| | - Raju Pusapati
- Intensive Care Unit, Hervey Bay Hospital, Hervey Bay, Queensland, Australia
| | - Joan Carlini
- Department of Marketing, Griffith University, Gold Coast, Queensland, Australia; Consumer Advisory Group, Gold Coast Health, Queensland, Australia
| | - Mahesh Ramanan
- Intensive Care Unit, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
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Rosenfeld LE, LeBlanc K, Nagy A, Ego BK, McCray AT. Participation in a national diagnostic research study: assessing the patient experience. Orphanet J Rare Dis 2023; 18:73. [PMID: 37032333 PMCID: PMC10084693 DOI: 10.1186/s13023-023-02695-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/02/2023] [Indexed: 04/11/2023] Open
Abstract
INTRODUCTION The Undiagnosed Diseases Network (UDN), a clinical research study funded by the National Institutes of Health, aims to provide answers for patients with undiagnosed conditions and generate knowledge about underlying disease mechanisms. UDN evaluations involve collaboration between clinicians and researchers and go beyond what is possible in clinical settings. While medical and research outcomes of UDN evaluations have been explored, this is the first formal assessment of the patient and caregiver experience. METHODS We invited UDN participants and caregivers to participate in focus groups via email, newsletter, and a private participant Facebook group. We developed focus group questions based on research team expertise, literature focused on patients with rare and undiagnosed conditions, and UDN participant and family member feedback. In March 2021, we conducted, recorded, and transcribed four 60-min focus groups via Zoom. Transcripts were evaluated using a thematic analysis approach. RESULTS The adult undiagnosed focus group described the UDN evaluation as validating and an avenue for access to medical providers. They also noted that the experience impacted professional choices and helped them rely on others for support. The adult diagnosed focus group described the healthcare system as not set up for rare disease. In the pediatric undiagnosed focus group, caregivers discussed a continued desire for information and gratitude for the UDN evaluation. They also described an ability to rule out information and coming to terms with not having answers. The pediatric diagnosed focus group discussed how the experience helped them focus on management and improved communication. Across focus groups, adults (undiagnosed/diagnosed) noted the comprehensiveness of the evaluation. Undiagnosed focus groups (adult/pediatric) discussed a desire for ongoing communication and care with the UDN. Diagnosed focus groups (adult/pediatric) highlighted the importance of the diagnosis they received in the UDN. The majority of the focus groups noted a positive future orientation after participation. CONCLUSION Our findings are consistent with prior literature focused on the patient experience of rare and undiagnosed conditions and highlight benefits from comprehensive evaluations, regardless of whether a diagnosis is obtained. Focus group themes also suggest areas for improvement and future research related to the diagnostic odyssey.
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Affiliation(s)
- Lindsay E Rosenfeld
- Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA, 02115, USA
- Heller School for Social Policy and Management, Institute for Child, Youth, and Family Policy, Brandeis University, 415 South St., Waltham, MA, 02453, USA
| | - Kimberly LeBlanc
- Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA, 02115, USA
| | - Anna Nagy
- Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA, 02115, USA
| | - Braeden K Ego
- Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA, 02115, USA
- Department of Genetics, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA, 94305, USA
| | - Alexa T McCray
- Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA, 02115, USA.
- Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA.
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Rudyk M, Tolstanova G, Ostapchenko L, Skivka L. Inter-disciplinary team working in neuroimmunology can facilitate counteracting brain-drain in Ukraine due to war. Brain Behav Immun 2023; 109:269-270. [PMID: 36775075 DOI: 10.1016/j.bbi.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Affiliation(s)
- Mariia Rudyk
- Educational and Scientific Centre "Institute of Biology and Medicine", Taras Shevchenko National University of Kyiv, avenue Hlushkova 2, Kyiv 03022, Ukraine.
| | - Ganna Tolstanova
- Educational and Scientific Institute of High Technologies, Taras Shevchenko University of Kyiv, avenue Hlushkova 4-g, Kyiv 03022, Ukraine
| | - Liudmyla Ostapchenko
- Educational and Scientific Centre "Institute of Biology and Medicine", Taras Shevchenko National University of Kyiv, avenue Hlushkova 2, Kyiv 03022, Ukraine
| | - Larysa Skivka
- Educational and Scientific Centre "Institute of Biology and Medicine", Taras Shevchenko National University of Kyiv, avenue Hlushkova 2, Kyiv 03022, Ukraine
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Peresani M. Inspecting human evolution from a cave. Late Neanderthals and early sapiens at Grotta di Fumane: present state and outlook. J Anthropol Sci 2022; 100:71-107. [PMID: 36576952 DOI: 10.4436/jass.10016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Of the many critical phases of human evolution, one of the most investigated is the transition from the Middle to the Upper Palaeolithic with the pivotal bio-cultural substitution of Neanderthals by Homo sapiens in Western Eurasia. The complexity of this over ten thousands years phase raises from the ensemble of evidence ascribed to the diverse adaptations expressed by Neanderthals and the first representatives of our species. In countless archaeological records Neanderthals left clear traces of a cultural variability dotted with innovations in the technology of stone and bone tools, alongside with manifestations in the range of the symbolic sphere. Together with other aspects of daily life, this evidence contributes shedding light on the cognitive aptitudes of those hominins and reassessing gaps in Pleistocene human diversities. Among archaeological contexts, the cave of Fumane in the Monti Lessini (Veneto Pre-Alps, northeastern Italy) is a key site. It is positioned along the potential trajectory of hominins moving into southern Europe from eastern and southeastern regions and includes a finely layered sedimentary sequence with cultural layers ascribed to the Mousterian, Uluzzian, Aurignacian and Gravettian. The ensemble constitutes one of the most complete, detailed and dated continental stratigraphic series from a segment of the late Pleistocene between 50 and 30 ka cal BP in a cave context of Southern Europe. Assessments based on sedimentological and palaeontological record provide indicators for framing Neanderthals in their respective ecological contexts since the late Middle Pleistocene until their demise during MIS3. On-going research is producing data ascribable to the human ecological relations and the interaction with specific natural resources, thus contributing to shed light on the complexity of Neanderthal behavior. Thanks to the high-resolution archaeological record of the earliest appearances of Homo sapiens, Fumane also provides clues to compare life, subsistence, and cultures between these Pleistocene hominins for comprehensive reasonings on our unicity.
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Affiliation(s)
- Marco Peresani
- Department of Humanities, Anthropogenic and Prehistoric section, University of Ferrara, Corso Ercole I d'Este 32, Ferrara, Italy; Institute of Environmental Geology and Geoengineering, National Council of Research, Piazza della Scienza 1, 20126 Milano, Italy,
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Cherbuin N, Iijima K, Kalula S, Malhotra R, Rasmussen LJ, Chan A, Lafortune L, Harper S, Zheng X, Lindeman D, Walsh E, Hussain R, Burns R, Kristiansen M, Sugawara I, Son B, Tanaka T, Buckner S, Hoffman J, Combrinck M. Societal Need for Interdisciplinary Ageing Research: An International Alliance of Research Universities "Ageing, Longevity and Health" Stream (IARU-ALH) Position Statement. Biomed Hub 2021; 6:42-47. [PMID: 33791316 DOI: 10.1159/000513513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 11/24/2020] [Indexed: 11/19/2022] Open
Abstract
Ageing is a global concern with major social, health, and economic implications. While individual countries seek to develop responses to immediate, pressing needs, international attention and collaboration is required to most effectively address the multifaceted challenges and opportunities an ageing global population presents in the longer term. The Ageing, Longevity and Health stream of the International Alliance of Research Universities (IARU-ALH) was built on a solid foundation of first-class interdisciplinary research and on innovative outreach and communication centres. This interdisciplinary network conducts projects that span biology, medicine, social sciences, epidemiology, public health, policy, and demography, and actively engages with the public and other societal stakeholders. Here we posit that such international interdisciplinary networks are needed and uniquely placed to address major challenges related to health and ageing and ultimately will produce new understanding and knowledge to promote the awareness of healthy ageing and encourage societal change via novel, science-informed interventions. Global interdisciplinary research presents great potential and opportunities to accelerate our understanding of human ageing and to produce new, more effective solutions to a pressing, complex problem. However, more focused, strategic efforts and investments are required in order to deliver on these potentials and reap maximum benefits for individuals and societies. IARU-ALH members are determined to contribute, in collaboration with others, to delivering on this vision.
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Affiliation(s)
- Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Katsuya Iijima
- Institute of Gerontology, Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Sebastiana Kalula
- Albertina and Walter Sisulu Institute of Ageing in Africa, University of Cape Town, Cape Town, South Africa
| | - Rahul Malhotra
- Duke-National University of Singapore Medical School, Singapore, Singapore
| | | | - Angelique Chan
- Duke-National University of Singapore Medical School, Singapore, Singapore.,Department of Sociology, National University of Singapore, Singapore, Singapore
| | - Louise Lafortune
- Cambridge Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Harper
- Oxford Institute of Population Health, University of Oxford, Oxford, United Kingdom
| | - Xiaoying Zheng
- Institute of Population Research, Beijing University, Beijing, China
| | - David Lindeman
- Center for Information Technology Research in the Interest of Society, UC Berkeley, Berkeley, California, USA
| | - Erin Walsh
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Rafat Hussain
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Richard Burns
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Maria Kristiansen
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Ikuko Sugawara
- Institute of Gerontology, Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Bokyung Son
- Institute of Gerontology, Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Stefanie Buckner
- Cambridge Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Jaco Hoffman
- Albertina and Walter Sisulu Institute of Ageing in Africa, University of Cape Town, Cape Town, South Africa.,Oxford Institute of Population Health, University of Oxford, Oxford, United Kingdom
| | - Marc Combrinck
- Albertina and Walter Sisulu Institute of Ageing in Africa, University of Cape Town, Cape Town, South Africa
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Dugle G, Wulifan JK, Tanyeh JP, Quentin W. A critical realist synthesis of cross-disciplinary health policy and systems research: defining characteristic features, developing an evaluation framework and identifying challenges. Health Res Policy Syst 2020; 18:79. [PMID: 32664988 PMCID: PMC7359589 DOI: 10.1186/s12961-020-00556-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 03/27/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Health policy and systems research (HPSR) is an inherently cross-disciplinary field of investigation. However, conflicting conceptualisations about inter-, multi- and transdisciplinary research have contributed to confusion about the characteristics of cross-disciplinary approaches in HPSR. This review was conducted to (1) define the characteristic features of context-mechanism-outcome (CMO) configurations in cross-disciplinary HPSR, (2) develop criteria for evaluating cross-disciplinarity and (3) synthesise emerging challenges of the approach. METHOD The paper is a critical realist synthesis conducted in three phases, as follows: (1) scoping the literature, (2) searching for and screening the evidence, and (3) extracting and synthesising the evidence. Five databases, namely the International Bibliography of the Social Sciences and Web of Science, PubMed central, Embase and CINHAL, and reference lists of studies that qualified for inclusion in the review were searched. The search covered peer-reviewed original research, reviews, commentary papers, and institutional or government reports published in English between January 1998 and January 2020. RESULTS A total of 7792 titles were identified in the online search and 137 publications, comprising pilot studies as well as anecdotal and empirical literature were selected for the final review. The review draws attention to the fact that cross-disciplinary HPSR is not defined by individual characteristics but by the combination of a particular type of research question and setting (context), a specific way of researchers working together (mechanism), and research output (outcome) that is superior to what could be achieved under a monodisciplinary approach. This CMO framework also informs the criteria for assessing whether a given HPSR is truly cross-disciplinary. The challenges of cross-disciplinary HPSR and their accompanying coping mechanisms were also found to be context driven, originating mainly from conceptual disagreements, institutional restrictions, communication and information management challenges, coordination problems, and resource limitations. CONCLUSION These findings have important implications. First, the CMO framework of cross-disciplinary HPSR can provide guidance for researchers engaging in new projects and for policy-makers using their findings. Second, the proposed criteria for evaluating theory and practice of cross-disciplinary HPSR may inform the systematic development of new research projects and the structured assessment of existing ones. Third, a better understanding of the challenges of cross-disciplinary HPSR and potential response mechanisms may help researchers to avoid these problems in the future.
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Affiliation(s)
- Gordon Dugle
- Department of Management Studies, School of Business and Law, University for Development Studies, Box UPW 36, Wa Campus, Wa, Ghana
- Nottingham University Business School, Jubilee Campus, Nottingham, NG8 1BB UK
| | - Joseph Kwame Wulifan
- Department of Management Studies, School of Business and Law, University for Development Studies, Box UPW 36, Wa Campus, Wa, Ghana
| | - John Paul Tanyeh
- Department of Management Studies, School of Business and Law, University for Development Studies, Box UPW 36, Wa Campus, Wa, Ghana
| | - Wilm Quentin
- Department of Healthcare Management, TU, Berlin, Germany
- European Observatory on Health Systems and Policies, Berlin, Germany
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Kaisler RE, Missbach B. Co-creating a patient and public involvement and engagement 'how to' guide for researchers. Res Involv Engagem 2020; 6:32. [PMID: 32566249 PMCID: PMC7301967 DOI: 10.1186/s40900-020-00208-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 06/04/2020] [Indexed: 05/31/2023]
Abstract
PLAIN LANGUAGE SUMMARY Research should benefit society at large. Involving citizens those who are affected by research may not only increase the quality, but can also push research towards generating greater societal benefits and relevant outcomes for citizens. Including citizens in research also has ethical implications, which necessitate structured guidance on 'how to' meaningfully involve them. In our project, we invited a multi-stakeholder group consisting of researchers from multiple disciplines, citizen scientists, youth and patient advocates to co-create a guide on 'how to' meaningfully involve citizens in research. In five consecutive workshops, we discussed how the characteristics of interactions between researchers and citizens (e.g., building trustful relationships and communication) and what a possible project steering structure enabling meaningful public involvement in research could look like. As a result of these workshops, the PPIE 'How to' Guide for Researchers was developed to support the implementation of 'Patient and Public Involvement and Engagement' (PPIE) activities and informed a PPIE Implementation Programme funding public involvement activities in Austria. ABSTRACT Involving citizens in research is not widely utilised across research disciplines and countries. It requires the readiness of researchers and their organisations as well as guides on 'how to' successfully involve citizens in a meaningful way. Including the patient and citizen voice in research activities has been most frequently demonstrated in health research, however, is implemented along various degrees of involvement - from passively receiving information about science to actively involving the citizens in steering projects and research activities. In this commentary, we aim to report a multi-stakeholder co-creation process developing 'Patient and Public Involvement and Engagement' (PPIE) activities across disciplines to provide guidance for researchers and the public. We use Ludwig Boltzmann Society's (LBG) organisational framework as a case study, hence it consists of research institutes ranging from the life sciences to humanities and therefore represents a well-suited research environment for this endeavour. In a co-creation approach - to accomplish a shared understanding of public involvement in research among different stakeholders - a multi-stakeholder group comprising 11 researchers from natural sciences, life sciences, social sciences and humanities, and 13 citizens (such as patient advocates, young people and citizen scientists) were involved. In five consecutive workshops, we co-developed the nature of interactions between citizens and researchers, as well as governance structures enabling meaningful involvement in research. The workshops' content was informed by an initial literature review. As a result of this process, the PPIE 'How to' Guide for Researchers was developed to support the implementation of involvement activities in their research projects according to the public involvement principles. These principles informed assessment criteria for the newly established PPIE Implementation Programme at LBG. It provides funding and support for public involvement activities in research to embed a sustainable and meaningful implementation of public involvement activities in Austria.
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Affiliation(s)
- Raphaela E. Kaisler
- Ludwig Boltzmann Gesellschaft (LBG), LBG Open Innovation in Science Center, Nussdorferstraße 64/2, 1090 Vienna, Austria
| | - Benjamin Missbach
- Ludwig Boltzmann Gesellschaft (LBG), LBG Open Innovation in Science Center, Nussdorferstraße 64/2, 1090 Vienna, Austria
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Malik A. A good career start can open doors: the plusses and minuses of an international graduate student program-a student's perspective. Med Microbiol Immunol 2020; 209:225-227. [PMID: 32055979 PMCID: PMC7248028 DOI: 10.1007/s00430-020-00661-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/29/2020] [Indexed: 11/29/2022]
Abstract
There are many Ph.D. programs from various funding agencies that provide excellent starts to a scientific career. Multinational Ph.D. positions attract students because they provide students with much-required exposure to the international scientific community at an early stage of the career. For this reason, multinational Ph.D. positions can be considered as a better career opportunity over Ph.D. positions confined to a single country. In addition, these multidisciplinary research programs connect different organizations to deal with the problems of global interest. One of these multi-disciplinary research programs is the viral and bacterial adhesion network training-innovative training network (ViBrANT). ViBrANT is a multifaceted platform that develops the required skillsets in young researchers and thereby also contributes to building a multidisciplinary research community. Is this the only parameter to be considered or are there other factors that can also stimulate one’s career development? In this perspective article, I will discuss the key reasons why I chose a multinational Ph.D. program along with the merits of being part of ViBrANT. I also discuss the challenges I faced while moving from India to the United Kingdom.
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Affiliation(s)
- Anchal Malik
- Astbury Centre for Structural Molecular Biology, School of Biomedical Science, University of Leeds, Leeds, LS2 9JT, England, UK.
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13
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Halpaap B, Peeling RW, Bonnici F. The role of multilateral organizations and governments in advancing social innovation in health care delivery. Infect Dis Poverty 2019; 8:81. [PMID: 31514738 PMCID: PMC6743093 DOI: 10.1186/s40249-019-0592-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/28/2019] [Indexed: 11/10/2022] Open
Abstract
Background Despite great medical advances and scientific progress over the past century, one billion people globally still lack access to basic health care services. In the context of the 2030 Agenda for Sustainable Development social innovation models aim to provide effective solutions that bridge the health care delivery gap, address equity and create social value. This commentary highlights the roles of multilateral organizations and governments in creating an enabling environment where social innovations can more effectively integrate into health systems to maximize their impact on beneficiaries. Main text The integration of social innovations into health systems is essential to ensure their sustainability and the wide dissemination of their impact. Effective partnerships, strong engagement with and endorsement by governments and communities, regulations, trust and sometimes willingness are key factors to enhance system integration, replication and dissemination of the models. Three examples of social innovations selected by the Social Innovation in Health Initiative illustrate the importance of engaging with governments and communities in order to link, integrate and synergize their efforts. Key challenges that they encountered, and lessons learnt are highlighted. Multilateral organizations and governments increasingly engage in promoting and supporting the development, testing and dissemination of social innovations to address the health care delivery gap. They play an important role in creating an enabling environment. This includes promoting the concept of social innovation in health care delivery, spreading social innovation approach and lessons learnt, fostering partnerships and leveraging resources, convening communities, health system actors and various stakeholders to work together across disciplines and sectors, and nurturing capacity in countries. Conclusions Multilateral organizations and local and national governments have a critical role to play in creating an enabling environment where social innovations can flourish. In supporting and disseminating social innovation approach, multilateral organizations and governments have a great opportunity to accelerate Universal Health Coverage and the achievement of the Sustainable Development Goals. Electronic supplementary material The online version of this article (10.1186/s40249-019-0592-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Beatrice Halpaap
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland.
| | | | - François Bonnici
- Bertha Centre for Social Innovation & Entrepreneurship, University of Cape Town, Cape Town, South Africa
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Reeder JC, Kieny MP, Peeling R, Bonnici F. What if communities held the solutions for universal health coverage? Infect Dis Poverty 2019; 8:74. [PMID: 31484553 PMCID: PMC6727335 DOI: 10.1186/s40249-019-0586-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 08/07/2019] [Indexed: 11/18/2022] Open
Abstract
This commentary highlights the value of community-engaged social innovations to advance health care delivery in low- and middle-income countries and to accelerate universal health coverage. It emphasizes the importance of research to guide the innovators on what works, what does not work to make their innovations sustainable and to replicate and scale them up as relevant. It also helps to demonstrate impact and to enhance uptake within the health systems.
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Affiliation(s)
- John C Reeder
- Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland.
| | - Marie-Paule Kieny
- French National Institute of Health and Medical Research, Inserm (Institut national de la santé et de la recherche médicale), Paris, France
| | | | - François Bonnici
- Bertha Centre for Social innovation and entrepreneurship, University of Cape Town, Cape Town, South Africa
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Mady LJ, Lyu L, Owoc MS, Peddada SD, Thomas TH, Sabik LM, Johnson JT, Nilsen ML. Understanding financial toxicity in head and neck cancer survivors. Oral Oncol 2019; 95:187-193. [PMID: 31345389 DOI: 10.1016/j.oraloncology.2019.06.023] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 06/21/2019] [Accepted: 06/22/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES (1) Describe financial toxicity (FT) in head and neck cancer (HNC) survivors and assess its association with personal/health characteristics and health-related quality of life (HRQOL); (2) examine financial coping mechanisms (savings/loans); (3) assess relationship between COmprehensive Score for financial Toxicity (COST) and Financial Distress Questionnaire (FDQ). PATIENTS AND METHODS Cross-sectional survey from January - April 2018 of insured patients at a tertiary multidisciplinary HNC survivorship clinic who completed primary treatment for squamous cell carcinoma of the oral cavity, oropharynx, or larynx/hypopharynx. RESULTS Of 104 survivors, 30 (40.5%) demonstrated high FT. Patients with worse FT were more likely (1) not married (COST, 25.33 ± 1.87 vs. 30.61 ± 1.34, p = 0.008); (2) of lower education levels (COST, 26.12 ± 1.47 vs. 34.14 ± 1.47, p < 0.001); and (3) with larynx/hypopharynx primaries (COST, 22.86 ± 2.28 vs. 30.27 ± 1.50 vs. 32.72 ± 1.98, p = 0.005). Younger age (4.23, 95%CI 2.20 to 6.26, p < 0.001), lower earnings at diagnosis (1.17, 95%CI 0.76 to 1.58, p < 0.001), and loss in earnings (-1.80, 95%CI -2.43 to -1.16, p < 0.001) were associated with worse FT. COST was associated with HRQOL (0.08, p = 0.03). Most survivors (63/102, 60%) reported using savings and/or loans. Worse FT was associated with increased likelihood of using more mechanisms (COST, OR1.06, 95%CI 1.02 to 1.10, p = 0.004). Similar results were found with FDQ. CONCLUSIONS We found differences in FT by primary site, with worst FT in larynx/hypopharynx patients. This finding illuminates potential site-specific factors, e.g. workplace discrimination or inability to return to work, that may contribute to increased risk. FDQ correlates strongly with COST, encouraging further exploration as a clinically-meaningful screening tool.
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Affiliation(s)
- Leila J Mady
- Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| | - Lingyun Lyu
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA, United States
| | - Maryanna S Owoc
- Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Shyamal D Peddada
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA, United States
| | - Teresa H Thomas
- Department of Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, PA, United States
| | - Lindsay M Sabik
- Department of Health Policy and Management, University of Pittsburgh School of Public Health, Pittsburgh, PA, United States
| | - Jonas T Johnson
- Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Marci L Nilsen
- Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, PA, United States
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Heard JM, Bellettato C, van Lingen C, Scarpa M. Research activity and capability in the European reference network MetabERN. Orphanet J Rare Dis 2019; 14:119. [PMID: 31142374 PMCID: PMC6542047 DOI: 10.1186/s13023-019-1091-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/08/2019] [Indexed: 11/24/2022] Open
Abstract
Background MetabERN is one of the 24 European Reference Networks created according to the European Union directive 2011/24/EU on patient’s rights in cross border healthcare. MetabERN associates 69 centres in 18 countries, which provide care for patients with Hereditary Metabolic Diseases, and have the mission to reinforce research and provide training for health professionals in this field. MetabERN performed a survey in December 2017 with the aim to produce an overview documenting research activities and potentials within the network. As the centres are multidisciplinary, separated questionnaires were sent to the clinical, university and laboratory teams. Answers were received from 52 out of the 69 centres of the network, covering 16 countries. A descriptive analysis of the information collected is presented. Results The answers indicate a marked interest of the respondents for research, who expressed high motivation and commitment, and estimated that the conditions to do research in their institution were mostly satisfactory. They are active in research, which according to several indicators, is competitive and satisfies standards of excellence, as well as the education programs offered in the respondent’s universities. Research in the centres is primarily performed in genetics, pathophysiology, and epidemiology, and focuses on issues related to diagnosis. Few respondents declared having activity in human and social sciences, including research on patient’s quality of life, patient’s awareness, or methods for social support. Infrastructures offering services for medical research were rarely known and used by respondents, including national and international biobanking platforms. In contrast, respondents often participate to patient registries, even beyond their specific field of interest. Conclusions Taken as a whole, these results provide an encouraging picture of the research capacities and activities in the MetabERN network, which, with respect to the number and representativeness of the investigated centres, gives a comprehensive picture of research on Hereditary Metabolic Diseases in Europe, as well as the priorities for future actions. Marginal activity in human and social sciences points out the limited multidisciplinary constitution of the responding teams with possible consequences on their current capability to participate to patient’s empowerment programs and efficiently collaborate with patient’s advocacy groups. Electronic supplementary material The online version of this article (10.1186/s13023-019-1091-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jean-Michel Heard
- MetabERN, Regional Coordinating Center for Rare Diseases, Udine University Hospital, Piazzale Santa Maria della Misericordia, 15, 33100, Udine, Italy.
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Goetze TO, Al-Batran SE, Berlth F, Hoelscher AH. Multimodal Treatment Strategies in Esophagogastric Junction Cancer: a Western Perspective. J Gastric Cancer 2019; 19:148-156. [PMID: 31245159 PMCID: PMC6589422 DOI: 10.5230/jgc.2019.19.e19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 05/02/2019] [Accepted: 05/02/2019] [Indexed: 02/06/2023] Open
Abstract
Esophagogastric junction (EGJ) cancer is a solid tumor entity with rapidly increasing incidence in the Western countries. Given the high proportion of advanced cancers in the West, treatment strategies routinely employed include surgery and chemotherapy perioperatively, and chemoradiation in neoadjuvant settings. Neoadjuvant chemoradiation and perioperative chemotherapy are mostly performed in esophageal cancer that extends to the EGJ and gastric as well as EGJ cancers, respectively. Recent trials have tried to combine both strategies in a perioperative context, which might have beneficial outcomes, especially in patients with EGJ cancer. However, it is difficult to recruit patients for trials, exclusively for EGJ cancers; therefore, the results have to be carefully reviewed before establishing a standard protocol. Trastuzumab was the first drug for targeted therapy that was positively evaluated for this tumor entity, and there are several ongoing trials investigating more targeted drugs in order to customize effective therapies based on tissue characteristics. The current study reviews the multimodal treatment concept for EGJ cancers in the West and summarizes the latest reports.
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Affiliation(s)
- Thorsten Oliver Goetze
- Institute of Clinical Cancer Research, Krankenhaus Nordwest, UCT University Cancer Center, Frankfurt am Main, Germany
| | - Salah-Eddin Al-Batran
- Institute of Clinical Cancer Research, Krankenhaus Nordwest, UCT University Cancer Center, Frankfurt am Main, Germany
| | - Felix Berlth
- Department of Surgery, Division of Gastrointestinal Surgery, Seoul National University Hospital, Seoul, Korea
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Abstract
Purpose The purpose of this paper is to describe a hybrid approach to the research developed during a multi-researcher, ethnographic study of NHS management in the UK. Design/methodology/approach This methodological paper elaborates a hybrid approach to the sociological analysis - the critical-action theory - and indicates how it can contribute to the critical health management studies. Findings After exploring the various theoretical, methodological and philosophical options available, the paper discusses the main research issues that influenced the development of this perspective and the process by which the critical-action perspective was applied to the studies of managerial work in four health service sectors - acute hospitals, ambulance services, community services and mental healthcare. Research limitations/implications This methodological perspective enabled a critical analysis of health service organisation that considered macro, meso and micro effects, in particular and in this case, how new public management drained power from clinicians through managerialist discourses and practices. Practical implications Healthcare organisations are often responding to the decisions that lie outside of their control and may have to enact changes that make little sense locally. In order to make sense of these effects, micro-, meso- and macro-level analyses are necessary. Originality/value The critical-action perspective is presented as an adjunct to traditional approaches that have been taken to the study of health service organisation and delivery.
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Affiliation(s)
- John Hassard
- Alliance Manchester Business School, University of Manchester , Manchester, UK
| | - Paula Hyde
- Alliance Manchester Business School, University of Manchester , Manchester, UK
| | - Julie Wolfram Cox
- Department of Management, Monash Business School, Monash University , Caulfield East, Australia
| | - Edward Granter
- Alliance Manchester Business School, University of Manchester , Manchester, UK
| | - Leo McCann
- Alliance Manchester Business School, University of Manchester , Manchester, UK
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Paul MC, Figuié M, Kovitvadhi A, Valeix S, Wongnarkpet S, Poolkhet C, Kasemsuwan S, Ducrot C, Roger F, Binot A. Collective resistance to HPAI H5N1 surveillance in the Thai cockfighting community: Insights from a social anthropology study. Prev Vet Med 2015; 120:106-14. [PMID: 25800453 DOI: 10.1016/j.prevetmed.2015.02.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 02/16/2015] [Accepted: 02/20/2015] [Indexed: 11/17/2022]
Abstract
Farmers may organize themselves to collectively manage risks such as animal diseases. Our study shows some evidence of such organization among fighting cock owners in Thailand. Fighting cocks were specifically targeted by HPAI (Highly Pathogenic Avian Influenza) H5N1 surveillance and control measures in Thailand because they were thought to pose a high risk of spreading diseases. In this work, we used a social-anthropological approach to gain an inside view of the issues associated with HPAI H5N1 surveillance in the cockfighting community in Thailand. Based on a qualitative analysis of data collected through in-depth interviews and observation of cockfighters' practices, we found that fighting cock owners share a sense of belonging to the same community based on a common culture, values, interests, practices, and internal rules, including rules to manage poultry diseases. During the HPAI H5N1 outbreaks, these rules may have contributed to mitigating the potential risk associated with the intense movements of fighting cocks inside the country. Nevertheless, this community, despite the high awareness and know-how of its members regarding poultry diseases, has shown a strong reluctance to comply with HPAI surveillance programs. We suggest that this reluctance is due to important gaps between the logic and rationales underlying surveillance and those associated with cockfighting activities. Our study highlights the need for multi and trans-disciplinary research involving the social sciences to analyze interactions between stakeholders and the collective actions implemented by communities to face risks.
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Affiliation(s)
- Mathilde C Paul
- Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, ENVT, INRA, UMR 1225 IHAP Interactions Hôtes - Agents Pathogènes, Toulouse F-31076, France; Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), UR AGIRs, UPR22, TA C-22/E, Campus International de Baillarguet, Montpellier F-34398, France; Institut National de Recherche Agronomique (INRA), UR 346 Epidémiologie Animale, F-63122 Saint-Genès-Champanelle, France.
| | - Muriel Figuié
- Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), UMR MOISA, Campus de Lavalette, Montpellier F-34398, France
| | - Attawit Kovitvadhi
- Faculty of Veterinary Medicine, Department of Veterinary Public Health, Kasetsart University, 50 Ngam Wong Wan Road, Chatuchak, Bangkok 10900, Thailand; Department of Agricultural, Forest and Food Sciences, University of Torino, via Largo P. Braccini 2, 10095 Grugliasco, Torino, Italy
| | - Sophie Valeix
- Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), UR AGIRs, UPR22, TA C-22/E, Campus International de Baillarguet, Montpellier F-34398, France; Institute of Development Studies, University of Sussex, Library Road, Brighton BN1 9RE, United Kingdom
| | - Sirichai Wongnarkpet
- Faculty of Veterinary Medicine, Department of Veterinary Public Health, Kasetsart University, 50 Ngam Wong Wan Road, Chatuchak, Bangkok 10900, Thailand
| | - Chaithep Poolkhet
- Faculty of Veterinary Medicine, Department of Veterinary Public Health, Kasetsart University, 50 Ngam Wong Wan Road, Chatuchak, Bangkok 10900, Thailand
| | - Suwicha Kasemsuwan
- Faculty of Veterinary Medicine, Department of Veterinary Public Health, Kasetsart University, 50 Ngam Wong Wan Road, Chatuchak, Bangkok 10900, Thailand
| | - Christian Ducrot
- Institut National de Recherche Agronomique (INRA), UR 346 Epidémiologie Animale, F-63122 Saint-Genès-Champanelle, France
| | - François Roger
- Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), UR AGIRs, UPR22, TA C-22/E, Campus International de Baillarguet, Montpellier F-34398, France
| | - Aurélie Binot
- Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), UR AGIRs, UPR22, TA C-22/E, Campus International de Baillarguet, Montpellier F-34398, France
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Magalhães T, Santos A, Dinis-Oliveira RJ. Forensic medicine: a forgotten world of opportunities and challenges for research. Arch Med Res 2013; 44:479-81. [PMID: 23973198 DOI: 10.1016/j.arcmed.2013.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 06/29/2013] [Indexed: 11/25/2022]
Abstract
Forensic medicine deals with a wide variety of cases. To accomplish the main objectives, this professional field needs to adopt and apply findings from other sciences, namely, different medical specialties and other forensic sciences. The opposite is not yet entirely true due to the fact that forensic medicine deals with cases that are very far away from other medical and scientific interests. It is obvious that this forgotten world of forensic medicine … is also a new world of opportunities and challenges to research in all scientific areas.
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Affiliation(s)
- Teresa Magalhães
- Department of Legal Medicine and Forensic Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; National Institute of Legal Medicine and Forensic Sciences, North Branch, Porto, Portugal; Biomedical Sciences Institute "Abel Salazar", University of Porto, Porto, Portugal; Forensic Sciences Center-CENCIFOR, Portugal
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George LK, Palmore E, Cohen HJ. The Duke Center for the Study of Aging: one of our earliest roots. Gerontologist 2013; 54:59-66. [PMID: 23733867 DOI: 10.1093/geront/gnt049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The Duke University Center for the Study of Aging and Human Development (Duke CFA) was established by a multidisciplinary group of visionary scientists in 1955. It is the oldest continually operating center or institute dedicated to aging in the United States. This article outlines the origins of the Duke CFA and summarizes the major research initiatives conducted in its early years. The primary focus is on these landmark studies and their legacies. Those studies made important initial contributions to the knowledge base, introduced measurement tools and research designs that became standards in the field, and served as the impetus for later and current research. The hallmarks of these studies are their multidisciplinary foundations and their focus on the health and well-being of older adults. The Duke CFA's current research clearly builds upon the goals, insights, and empirical results of previous research initiatives. Although aging research is and has been the bedrock of the Duke CFA, developing services responsive to the needs of older adults and multidisciplinary training have also been hallmarks of the Duke CFA. Duke's Geriatric Evaluation and Treatment Clinic was established in 1974 and remains a national model for geriatric assessment. Our postdoctoral research training program has graduated more than 200 scholars and our Geriatric Fellowship program has graduated 113 geriatricians. Many of our graduates have exemplary careers in aging, contributing to important research advances, providing care to thousands of older adults, serving as leaders in the field, and training new generations of gerontologists and geriatricians.
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Affiliation(s)
- Linda K George
- *Address correspondence to Linda K. George, Center for the Study of Aging and Department of Sociology, Duke University, 2932 Welcome Drive, Durham, NC 27705. E-mail:
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