ABSTRACT
Schleider and colleagues' paper on the application of single-session interventions (SSIs) to eating disorders is timely given the broader focus in mental health on flexible approaches to delivering support at the time the person needs it most. The eating disorder field needs to embrace these innovations including developing a "single-session mindset" with greater attention paid to testing the relevance of SSI for eating disorders. The use of well-powered trials of brief, focused and rapidly scalable interventions is an ideal vehicle for generation and evaluation of new and longer interventions. Our future research agenda needs to carefully consider our target audience, the primary outcome variable of most relevance, and the SSI topic that would be most likely to effect change. Research in prevention might focus on weight concern and evaluation of SSIs that focus on self-compassion or cognitive dissonance related to appearance ideals in the media. Work in early intervention could target denial and disordered eating using SSIs on growth mindset, behavioral activation, and imagery rescripting. Treatment waitlists provide another suitable opportunity, evaluating SSIs that aim to increase hope for change, treatment retention, and kick start early change in therapy, a robust predictor of better treatment outcome.
Subject(s)
Biomedical Research , Cognitive Behavioral Therapy , Feeding and Eating Disorders , Humans , Biomedical Research/organization & administration , Cognitive Behavioral Therapy/methods , Feeding and Eating Disorders/psychology , Feeding and Eating Disorders/therapy , Treatment OutcomeABSTRACT
BACKGROUND: Most studies examining complementary and alternative medicine (CAM) stakeholder engagement with evidence-based practice have relied on quantitative research methods, which often fail to capture the nuances of this phenomena. Using qualitative methods, this study aimed to explore the experiences of CAM stakeholders regarding the barriers and enablers to the conduct and application of research. METHODS: This research was guided by a qualitative descriptive framework. CAM practitioners and researchers of multiple CAM disciplines from across Australia and New Zealand were invited to share their personal perspectives of the study phenomena. Semi-structured interviews were conducted via Zoom, which were audio-recorded and transcribed verbatim. Rigour strategies were applied to ensure the credibility of results. The transcript was analysed using thematic analysis. RESULTS: CAM stakeholders identified an array of barriers and enablers to the conduct and application of research within their disciplines. The barriers and enablers that emerged were found to be inter-connected with two similar constructs: capacity and culture. Captured within the construct of capacity were five themes-lack of resources, inadequate governance/leadership, lack of competency, bias directed from outside and within CAM, and lack of time for research. Within the construct of culture were two themes-intrinsic perceptions in CAM, and lack of communication within and outside CAM. CONCLUSIONS: Promoting evidence-based practice and engaging with research in CAM continues to face challenges. This study, for the first time, has highlighted the multitude of interlinked barriers that confront CAM stakeholders when engaging with research. These findings highlight the need for a concerted and targeted approach to tackle these challenges.
Subject(s)
Complementary Therapies/psychology , Stakeholder Participation , Attitude , Australia , Biomedical Research/organization & administration , Biomedical Research/statistics & numerical data , Causality , Complementary Therapies/organization & administration , Complementary Therapies/statistics & numerical data , Humans , New ZealandABSTRACT
Biomedical research accuracy and relevance for improving healthcare are increasingly identified as costly problems. Basic research data quality, reporting and methodology, and reproducibility are common factors implicated in this challenge. Preclinical models of disease and therapy, largely conducted in rodents, have known deficiencies in replicating most human conditions. Their translation to human results is acknowledged to be poor for decades. Clinical data quality and quantity is also recognized as deficient; gold standard randomized clinical trials are expensive. Few solid conclusions from clinical studies are replicable and many remain unpublished. The translational pathway from fundamental biomedical research through to innovative solutions handed to clinical practitioners is therefore highly inefficient and costly in terms of wasted resources, early claims from fundamental discoveries never witnessed in humans, and few new, improved solutions available clinically for myriad diseases. Improving this biomedical research strategy and resourcing for reliability, translational relevance, reproducibility and clinical impact requires careful analysis and consistent enforcement at both funding and peer review levels.
Subject(s)
Biomedical Research/organization & administration , Animals , Biomedical Research/standards , Data Accuracy , Disease Models, Animal , Drug Evaluation, Preclinical/methods , Drug Evaluation, Preclinical/standards , Humans , Reproducibility of Results , Translational Research, Biomedical/organization & administrationSubject(s)
Biomedical Research , Complementary Therapies , Biomedical Research/organization & administration , Biomedical Research/standards , Complementary Therapies/organization & administration , Complementary Therapies/standards , Humans , Integrative Medicine/organization & administration , Integrative Medicine/standardsABSTRACT
Published results of efficacy and effectiveness studies on complementary health approaches should lead to widespread uptake of evidence-based practices, but too often, the scientific pathway ends prematurely, before the best ways to improve adoption, implementation, and sustainability can be determined. The National Center for Complementary and Integrative Health (NCCIH) supports the full continuum of the biomedical research pipeline, whereby a complementary health intervention moves from basic and mechanistic research through efficacy trials and through dissemination and implementation. Implementation science has traditionally been thought of as something that only happens after efficacy and effectiveness have been demonstrated, but it can be prudent to evaluate implementation measures earlier in the process. Implementation science assesses more than just barriers and facilitators; it evaluates specific implementation strategies and characterizes the extent that the intervention is modified within the context of the implementation strategy and health care delivery setting. The best choices for implementation science in complementary health interventions depend on the research questions. Implementation science that tests strategies to address implementation at multiple ecologic levels is a high priority to NCCIH.
Subject(s)
Biomedical Research , Complementary Therapies/organization & administration , Implementation Science , Integrative Medicine/organization & administration , Biomedical Research/methods , Biomedical Research/organization & administration , Humans , Models, OrganizationalABSTRACT
There is a persistent variation in cancer outcomes among and within European countries suggesting (among other causes) inequalities in access to or delivery of high-quality cancer care. European policy (EU Cancer Mission and Europe's Beating Cancer Plan) is currently moving towards a mission-oriented approach addressing these inequalities. In this study, we used the quantitative and qualitative data of the Organisation of European Cancer Institutes' Accreditation and Designation Programme, relating to 40 large European cancer centres, to describe their current compliance with quality standards, to identify the hallmarks common to all centres and to show the distinctive features of Comprehensive Cancer Centres. All Comprehensive Cancer Centres and Cancer Centres accredited by the Organisation of European Cancer Institutes show good compliance with quality standards related to care, multidisciplinarity and patient centredness. However, Comprehensive Cancer Centres on average showed significantly better scores on indicators related to the volume, quality and integration of translational research, such as high-impact publications, clinical trial activity (especially in phase I and phase IIa trials) and filing more patents as early indicators of innovation. However, irrespective of their size, centres show significant variability regarding effective governance when functioning as entities within larger hospitals.
Subject(s)
Cancer Care Facilities , Neoplasms/therapy , Quality of Health Care , Academies and Institutes/standards , Academies and Institutes/statistics & numerical data , Biomedical Research/organization & administration , Biomedical Research/standards , Biomedical Research/statistics & numerical data , Cancer Care Facilities/organization & administration , Cancer Care Facilities/statistics & numerical data , Cohort Studies , Europe/epidemiology , Humans , Medical Oncology/standards , Medical Oncology/statistics & numerical data , Neoplasms/epidemiology , Patient Care Team/organization & administration , Patient Care Team/standards , Patient Care Team/statistics & numerical data , Patient-Centered Care/organization & administration , Patient-Centered Care/standards , Patient-Centered Care/statistics & numerical data , Translational Research, Biomedical/methods , Translational Research, Biomedical/organization & administration , Translational Research, Biomedical/statistics & numerical dataSubject(s)
Biomedical Research/organization & administration , COVID-19/therapy , Clinical Trials as Topic , Pandemics , Biomedical Research/history , Biomedical Research/standards , COVID-19/diagnosis , COVID-19/epidemiology , Canada/epidemiology , Clinical Trials as Topic/methods , Clinical Trials as Topic/organization & administration , Clinical Trials as Topic/standards , Community Networks/organization & administration , Community Networks/standards , Drug Evaluation, Preclinical/methods , Drug Evaluation, Preclinical/standards , Europe/epidemiology , History, 21st Century , Humans , International Cooperation , Learning , Neural Networks, Computer , Organizational Innovation , Pandemics/history , Patient Selection , Pragmatic Clinical Trials as Topic/methods , Pragmatic Clinical Trials as Topic/standards , Research Design , Scandinavian and Nordic Countries/epidemiology , United Kingdom/epidemiology , World Health Organization/organization & administrationABSTRACT
The COVID-19 pandemic has become the leading societal concern. The pandemic has shown that the public health concern is not only a medical problem, but also affects society as a whole; so, it has also become the leading scientific concern. We discuss in this treatise the importance of bringing the world's scientists together to find effective solutions for controlling the pandemic. By applying novel research frameworks, interdisciplinary collaboration promises to manage the pandemic's consequences and prevent recurrences of similar pandemics.
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Biomedical Research/organization & administration , Coronavirus Infections/epidemiology , Delivery of Health Care, Integrated/organization & administration , Emergencies , Health Services Needs and Demand , Pandemics , Pneumonia, Viral/epidemiology , Betacoronavirus/pathogenicity , Biomedical Research/methods , COVID-19 , Coronavirus Infections/therapy , Coronavirus Infections/virology , Delivery of Health Care, Integrated/methods , History, 21st Century , Humans , Interdisciplinary Communication , Interdisciplinary Studies , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Public Health/history , Public Health/standards , SARS-CoV-2ABSTRACT
OBJECTIVE: Vascular Ehlers-Danlos syndrome (vEDS) is a rare, syndromic, heritable condition with life-threatening complications that include aortic and arterial aneurysms, dissection, and rupture. This study describes the formation of the vEDS Research Collaborative and methods used for stakeholder engagement. METHODS: The vEDS Research Collaborative was established with an engagement award from the Patient-Centered Outcomes Research Institute to create a framework for a patient-researcher partnership. Between October 1, 2017, and September 30, 2018, the Collaborative used the Patient-Centered Outcomes Research Institute Engagement Rubric to conduct stakeholder engagement to develop a patient-centered research agenda. A modified Delphi technique was used to develop and to refine research topics and questions, gathering input from all stakeholders during three rounds of feedback. RESULTS: Four topic areas were deemed important: mental health and quality of life issues, creating a care team, a holistic approach to vEDS management (medical and surgical), and pregnancy management. An online survey to rank a list of 12 research questions in these topic areas in order of importance was disseminated. The questions were ranked in order of importance through an online survey (N = 197 responses). The survey showed a high degree of alignment in the top priorities among stakeholders. There was a high degree of interest in pragmatic clinical trials evaluating medical management options and health-related quality of life outcomes. CONCLUSIONS: The vEDS Research Collaborative has built a sustainable, coalition model of patient and stakeholder engagement, supported by the vEDS community, to identify a patient-centered, prioritized list of research questions. In articulating a shared vision for the future of vEDS research, the Collaborative has laid the groundwork for developing research protocols aligned with the highest priority questions for the individuals affected by this serious condition that can be translated into future clinical trials.
Subject(s)
Biomedical Research/organization & administration , Ehlers-Danlos Syndrome , Intersectoral Collaboration , Patient Participation , Stakeholder Participation , Clinical Trials as Topic , Delphi Technique , Holistic Health , Humans , Mental Health , Quality of Life , Research Design , Surveys and QuestionnairesABSTRACT
The United States has witnessed enormous changes concerning the acceptance of medicinal and recreational cannabis use. Sixty-three percent of the US population has access to medicinal cannabis markets, which offer increasingly diverse and potent cannabis products. Considering the rapidly changing cultural, political, and legal landscape, the scientific literature does not adequately inform public policy, medical decision making, or harm reduction approaches. The goals of this paper are to (1) investigate the state of cannabis research on medical conditions commonly treated with cannabis, (2) review the barriers that have led to large gaps between cannabis use and available empirical data, and (3) suggest a path forward with new research designs to address these gaps. Thus, we aim to advance a more nuanced understanding of the barriers to cannabis research and suggest innovative research designs necessary for rapid development of a meaningful knowledge base.
Subject(s)
Biomedical Research/organization & administration , Medical Marijuana/therapeutic use , Drug and Narcotic Control/legislation & jurisprudence , Humans , Information Dissemination , Knowledge , Medical Marijuana/administration & dosage , Medical Marijuana/adverse effects , Randomized Controlled Trials as Topic , Research Design , United StatesABSTRACT
Purpose The EU-funded research project EVOTION has brought together clinical, technical, and public health experts with the aim to offer a solution for the holistic management of hearing loss. This report presents the challenges, strengths, and key take-home messages of working in this multidisciplinary consortium. Method Fifteen consortium members completed an online survey with 6 open-ended questions. Responses were analyzed using a thematic approach. Results Analysis identified 4 main themes: (a) communication, that is, cross-disciplinary communication difficulties but also range of expertise; (b) opportunities, that is, innovation, learning, and collaborations; (c) technology, that is, technical requirements and data collection and management issues; and (d) local constraints, that is, institutional limitations, resources, and planning. Conclusions Although the challenges reported differed by country and specialty, there was consensus about the value, expertise, and opportunities of the project. It is recommended that in future similar multidisciplinary projects in audiology, researchers establish a common language and assess technical requirements and local constraints prior to initiating research activities.
Subject(s)
Audiology/methods , Biomedical Research/methods , Interdisciplinary Research , Audiology/organization & administration , Biomedical Research/organization & administration , European Union , Hearing Loss/therapy , Humans , Interdisciplinary Research/methods , Interdisciplinary Research/organization & administration , Surveys and QuestionnairesABSTRACT
OBJECTIVES: To conduct a UK-wide survey of young people who have experienced cancer, carers and professionals, to identify and prioritise research questions to inform decisions of research funders and support the case for research with this unique cancer population. DESIGN: James Lind Alliance Priority Setting Partnership. SETTING: UK health service and community. METHODS: A steering group oversaw the initiative and partner organisations were recruited. Unanswered questions were collected in an online survey. Evidence searching verified uncertainties. An interim survey was used to rank questions prior to a final prioritisation workshop. PARTICIPANTS: Young people aged 13-24 years with a current or previous cancer diagnosis, their families, friends, partners and professionals who work with this population. RESULTS: Two hundred and ninety-two respondents submitted 855 potential questions. Following a refining process and removal of 'out of scope' questions, 208 unique questions remained. Systematic evidence checking identified seven answered questions and 16 were the subject of ongoing studies. The interim survey was completed by 174 participants. The top 30 questions were prioritised at a workshop attended by 25 young people, parents and multidisciplinary professionals. The top three priorities are: (1) What psychological support package improves psychological well-being, social functioning and mental health during and after treatment? (2) What interventions, including self-care, can reduce or reverse adverse short-term and long-term effects of cancer treatment? (3) What are the best strategies to improve access to clinical trials? The remaining questions reflect the complete cancer pathway: new therapies, life after cancer, support, education/employment, relapse and end-of-life care. CONCLUSIONS: We have identified shared research priorities for young people with cancer using a rigorous, person-centred approach involving stakeholders typically not involved in setting the research agenda. The breadth of priorities suggest future research should focus on holistic and psychosocial care delivery as well as traditional drug/biology research.
Subject(s)
Academies and Institutes , Biomedical Research/organization & administration , Health Priorities , Neoplasms , Adolescent , Cooperative Behavior , Health Status , Humans , United Kingdom , Young AdultSubject(s)
Acupuncture/organization & administration , Chronic Pain/therapy , Low Back Pain/therapy , Medicare/organization & administration , Acupuncture Therapy , Biomedical Research/methods , Biomedical Research/organization & administration , Humans , Medicaid/organization & administration , Practice Guidelines as Topic , United StatesABSTRACT
According to the 2015 Global Burden of Disease Study, diarrhea ranked ninth among causes of death for all ages, and fourth among children under 5 years old, accounting for an estimated 499,000 deaths in this young age group. It was also the second most common cause of years lived with disability (2.39â¯billion YLDs). The goal of the WHO/UNICEF Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea (GAPPD) is to reduce deaths from diarrhea in children under 5 years of age to less than 1 per 1000 live births, by 2025. Development of new and improved vaccines against diarrheal infections is a fundamental element of the strategy towards achieving this goal. Enterotoxigenic Escherichia coli (ETEC) and Shigella are enteropathogens that cause significant global mortality and morbidity, particularly in low- and middle-income countries. In 2016, WHO's Product Development for Vaccines Advisory Committee (PDVAC) recommended that the WHO's Initiative for Vaccine Research (IVR) engage in this area, based on PDVAC's criteria of prioritizing the development of vaccines against pathogens that will address a major unmet public health need, and for which clinical candidates with a good probability of technical success are in the pipeline. As a first step, WHO's IVR convened global subject matter experts to discuss the current global ETEC and Shigella disease burden estimates, including the current understanding of the long-term indirect effects of ETEC and Shigella infection, and how these data may affect future decision making on vaccine development for both pathogens. The available global burden estimates for ETEC and Shigella differ with respect to the relative importance of these two pathogens. The mortality estimates vary between iterations published by the same group, as well as between estimates of different groups, although the uncertainty intervals are broad and overlapping. These variances are attributable to differences in the data available and incorporated in the models; the methods used to detect the pathogens; the modelling methodologies; and, to actual changes in the total number of diarrheal deaths over time. The changes in the most recently reported mortality estimates for these pathogens, as compared to previous iterations, has led to debate as to whether investment in development of stand-alone vaccines, rather than combined vaccines, is warranted from cost-effectiveness and vaccine impact perspectives. Further work will be needed to understand better the variances and uncertainties in the reported mortality estimates to support investment decision making, and ultimately policy recommendations for vaccine use. In addition, a comprehensive assessment of the value proposition for vaccines against these pathogens is needed and will be strengthened if the long-term health consequences associated with diarrhea and dysentery due to these pathogens are better defined.