Feasibility test of WORK-ON: a vocational rehabilitation intervention for people with chronic inflammatory arthritis.

BACKGROUND: People with chronic inflammatory arthritis (IA) often have a reduced work ability. Consequently, they are at high risk of losing their jobs and being permanently excluded from the labor market. Therefore, we developed a new context-specific vocational rehabilitation intervention for people with IA based on the Medical Research Council's framework for complex interventions. This intervention is called "WORK-ON" and consists of: (1) Initial assessment and goal setting by an occupational therapist experienced in rheumatology rehabilitation; (2) coordinated support from the same occupational therapist, including assistance in navigating the primary and secondary healthcare and social care systems; (3) group sessions for peer support; and (4) individually tailored consultations with physiotherapists, nurses, and/or social workers. This study investigates the feasibility of WORK-ON. METHODS: A 6-month single-arm feasibility study with a pre-test post-test design was conducted to evaluate recruitment, intervention fidelity and delivery, data collection, and possible outcome measures. Work ability was the primary outcome, and sick leave, quality of life, fatigue, pain, physical activity, sleep, and well-being were the secondary outcomes evaluated. RESULTS: In total, 19 participants (17 women and 2 men) with a median age of 55 years (range, 34-64) participated and completed WORK-ON. Of these, 17 participants completed patient-reported outcomes at baseline and follow-up, and the results indicated a tendency to improvement in work ability, quality of life, level of physical activity, decrease in pain, and increase in days of sick leave during the 6-month intervention period. The rehabilitation clinicians spent an average of 15.3 h per participant, and the participants spent an average of 13.5 h in the intervention. CONCLUSIONS: WORK-ON is considered feasible and has the potential to increase work ability among people with IA who are concerned about their future ability to keep working. Though, an adjustment of the intervention is needed before testing in a randomized controlled trial.

Development, feasibility, and preliminary effects of a culturally adapted, evidence-based, and theory-driven diabetes self-management programme for Chinese adults with type 2 diabetes receiving insulin injection therapy.

AIMS: To describe the development of a culturally adapted, evidence-based, and theory-driven diabetes self-management programme for Chinese adults with type 2 diabetes receiving insulin injection therapy and to assess the feasibility, acceptability, and preliminary effects of the newly developed intervention. METHODS: The Medical Research Council framework was adopted to guide the intervention development and a feasibility study. A prospective, two-arm, parallel-group, assessor-blinded randomised controlled trial was conducted. Participants were randomly allocated to receive either the newly developed intervention or parallel attention control contact from community nurses. Between-group differences in changes in outcome variables were analysed using the Mann-Whitney U test. RESULTS: The newly developed intervention consists of one individual interview session, three group-based education sessions, and two telephone-based maintenance sessions. A total of 24 participants were recruited with the recruitment rate and overall retention rate of 77.4 % and 95.8 %, respectively. The results indicated that the intervention participants reported significantly greater improvements in self-efficacy (Hedge's g = 1.69) and self-management behaviours (Hedge's g = 3.24), and reductions in diabetes-related distress (Hedge's g = 1.49) compared with those in the control group (all p< 0.05). CONCLUSION: The diabetes self-management programme was feasible and acceptable. The intervention showed promising patient-centred benefits. A future large-scale randomised controlled trial is warranted.

Raising the Academic Authority of Clinical Experience: The Department of Internal Medicine at Keijo Imperial University and Its Periodical Imsangnaegwahak.

This paper examines the periodical Clinical Internal Medicine published by the Department of Internal Medicine at Keijo Imperial University in colonial Korea. Previous studies on medical research at Keijo Imperial University have primarily focused on preclinical departments such as anatomy, hygiene, pharmacology, and microbiology which produced knowledge that supported Japan's imperialistic expansion. This approach has overlooked the research contributions of clinical departments, often viewing the roles of preclinical and clinical departments through a dichotomy between research versus clinician training. However, Clinical Internal Medicine demonstrates that the Department of Internal Medicine at Keijo Imperial University was actively engaged in research. By analyzing the purpose and content of Clinical Internal Medicine, this paper reveals that its publication was an effort by the Department of Internal Medicine to address the demand for practical knowledge among clinicians practicing outside the university. At the same time, it reflects a commitment to enhancing the academic value of clinical experience and critiques the blind pursuit of experimental medicine in the Japanese medical community in the 1920s and 1930s. The case of the Department of Internal Medicine at Keijo Imperial University illustrates the transformation of clinical experience into "worthy" academic knowledge in colonial Korea. Based on these findings, this paper provides insights into the role of clinical departments at Keijo Imperial University in research and post-graduation education.

Aptitude for Research Among Medical Students in India: Identifying the Challenges.

Introduction Understanding the reasons behind the undervaluation of research among undergraduate medical students in India is crucial for advancing medical knowledge. This cross-sectional study aims to investigate the knowledge, interest, and barriers faced by 606 Indian medical students through an online questionnaire distributed via social media platforms. Aims To identify the knowledge of research and the challenges faced by medical students to pursue research in their undergraduate education. Methods and material This was a prospective observational study carried out over a period of one month in October 2022. Study approval was taken from the Genebandhu Independent Ethics Committee (Reference Number- ECG004/2022). The responses obtained from the questionnaire were recorded in Google Sheets and transferred to Microsoft Excel (Redmond, WA, USA). Results Among the participants, 46.53% were male and 53.47% were female, primarily from the first (11.39%) and second (9.90%) years of their medical education. Notably, the majority had undertaken United States Medical Licensing Examination (USMLE) (54.95%), followed by National Eligibility cum Entrance Test (Postgraduate) (NEET-PG) (34.65%) and Professional and Linguistic Assessments Board (PLAB) (7.92%). The study revealed that 78.22% considered research pivotal to their academic trajectory, with a mean age of 23.14 years (SD=2.82) and an average research knowledge score of 2.75 (SD=1.31). The type of postgraduate exam significantly influenced enthusiasm for research activities (p<0.001), with higher enthusiasm among those preparing for exams abroad. Nonetheless, the type of medical college did not significantly affect interest in research activities (p=0.4879). Conclusion Addressing the undervaluation of research among undergraduate medical students in India is imperative. The curriculum should integrate robust support mechanisms to nurture research skills, emphasizing its importance for future medical practitioners. This could involve seminars, courses, and interactive sessions aimed at fostering research acumen among students.

"Publish or Perish" Paradigm and Medical Research: Replication Crisis in the Context of Artificial Intelligence Trend.

The "publish or perish" culture in academia has intensified trends in medical research, particularly around artificial intelligence (AI) and machine learning. This letter highlights how the pressure to publish positive findings during research trends, such as artificial intelligence in medicine, exacerbates the replication crisis. Issues like data leakage and lack of cross-institutional validation in AI models, particularly in clinical radiology, raise concerns about their reliability. The letter urges authors, reviewers, and editors to enforce rigorous standards to ensure reproducibility and safeguard the integrity of medical research.

The new EU-US data protection framework's implications for healthcare.

In July 2023, the United States and the European Union introduced the Data Privacy Framework (DPF), introducing the third generation of cross-border data transfer agreements constituting adequacy with respect to personal data transfers under the General Data Protection Regulation (GDPR) between the European Union (EU) and the US. This framework may be used in cross-border healthcare and research relationships, which are highly desirable and increasingly essential to innovative health technology development and health services deployment. A reliable model meeting EU adequacy requirements could enhance the transfer of patient and research participant data. While the DPF might present a familiar terrain for US organizations, it also brings unique challenges. A notable concern is the ability of individual EU Member States to establish individual and additional requirements for health data that are more restrictive than GDPR requirements, which are not anticipated by the DPF. This article highlights the DPF's potential impact on the healthcare and research sectors, finding that the DPF may not provide the degree of lawful health data transfer desirable for healthcare entities. We examine the DPF against a background of existing Health Insurance Portability and Accountability Act obligations and other GDPR transfer tools to offer alternatives that can improve the likelihood of reliable, lawful health data transfer between the US and EU.

A cross-sectional study assessing visual abstracts of randomized trials revealed inadequate reporting and high prevalence of spin.

OBJECTIVE: Visual abstracts (VAs) lack study-specific reporting guidelines and are increasingly used as stand-alone sources in medical research dissemination although not designed for this purpose. Therefore, our objectives were to describe 1) completeness of reporting in VAs and corresponding written abstracts (WAs) of randomised controlled trials (RCTs), and 2) the extent and type of spin (i.e., any reporting pattern that could distort result interpretation and mislead readers) in VAs and WAs of RCTs with a statistically nonsignificant primary outcome. STUDY DESIGN AND SETTING: We conducted a cross-sectional study evaluating VAs and WAs of RCTs published between 01/01/2021 and 03/31/2023. We searched MEDLINE via PubMed for reports of RCTs published in the 15 highest impact factor journals from six medical fields (among which 34 journals producing VAs of RCTs were identified). One reviewer identified primary reports of RCTs published with a VA and randomly selected a maximum of 10 reports from each journal to avoid overrepresentation. Completeness of reporting assessment was based on the CONSORT extension for Abstracts. Spin was explored using a standardized spin classification for RCTs with statistically nonsignificant primary outcome results. Both assessments were conducted in duplicate, with discussion until consensus in case of discrepancy. RESULTS: A random sample of 253 reports from 34 journals was identified. The information provided in VAs was frequently incomplete: primary outcome identification, primary outcome results, and harms were respectively described or displayed in only 47% (n=116/247), 30% (n=75/247), and 35% (n=88/253). Reporting was slightly better for some items in WAs, although still unsatisfactory. Among trials with nonsignificant primary outcome results (n=101), 57% (n=58) of VAs and 55% (n=56) of WAs exhibited at least one type of spin. Post-hoc analyses showed VAs produced by journal editors of high impact general medical journals were more complete and more accurate than those produced by specialty journals or authors. CONCLUSIONS: The information conveyed in VAs was frequently incomplete and inaccurate, highlighting the urgent need to refer to appropriate specific reporting guidelines to avoid misinterpretation by readers.

Perceptions of ChatGPT in healthcare: usefulness, trust, and risk.

Introduction: This study explores the perceptions of ChatGPT in healthcare settings in Taiwan, focusing on its usefulness, trust, and associated risks. As AI technologies like ChatGPT increasingly influence various sectors, their potential in public health education, promotion, medical education, and clinical practice is significant but not without challenges. The study aims to assess how individuals with and without healthcare-related education perceive and adopt ChatGPT, contributing to a deeper understanding of AI's role in enhancing public health outcomes. Methods: An online survey was conducted among 659 university and graduate students, all of whom had prior experience using ChatGPT. The survey measured perceptions of ChatGPT's ease of use, novelty, usefulness, trust, and risk, particularly within clinical practice, medical education, and research settings. Multiple linear regression models were used to analyze how these factors influence perception in healthcare applications, comparing responses between healthcare majors and non-healthcare majors. Results: The study revealed that both healthcare and non-healthcare majors find ChatGPT more useful in medical education and research than in clinical practice. Regression analysis revealed that for healthcare majors, general trust is crucial for ChatGPT's adoption in clinical practice and influences its use in medical education and research. For non-healthcare majors, novelty, perceived general usefulness, and trust are key predictors. Interestingly, while healthcare majors were cautious about ease of use, fearing it might increase risk, non-healthcare majors associated increased complexity with greater trust. Conclusion: This study highlights the varying expectations between healthcare and non-healthcare majors regarding ChatGPT's role in healthcare. The findings suggest the need for AI applications to be tailored to address specific user needs, particularly in clinical practice, where trust and reliability are paramount. Additionally, the potential of AI tools like ChatGPT to contribute to public health education and promotion is significant, as these technologies can enhance health literacy and encourage behavior change. These insights can inform future healthcare practices and policies by guiding the thoughtful and effective integration of AI tools like ChatGPT, ensuring they complement clinical judgment, enhance educational outcomes, support research integrity, and ultimately contribute to improved public health outcomes.

The status quo and influencing factors of clinical research nurses' participation in preoperative blood sampling in patients with pulmonary nodules.

Background: Under-recruitment in clinical trials has become a worldwide problem, and has many causes that need to be understood. Clinical Research Nurses (CRNs) provide a new research perspective. Aim: To understand the current situation about the informed consent rate after the participation of CRNs and analyse the possible influencing factors. Methods: This cross-sectional study was conducted at a hospital. A convenience sample was used to study patients with pulmonary nodules who underwent day surgery from March to May 2023. Patients first received information from doctors and a second session by CRNs was provided for those who initially were hesitant about the research. A questionnaire survey was conducted using an online survey platform to collect information. Results: After education by doctors, 208 patients were hesitant and CRNs conducted a second education session, the CICARE model was used for communication. Following this session a further 161 patients were willing to participate. Finally, 374 patients were willing to participate. Related factors include age, education level and the attitude of self-assessed family members towards their participation in clinical projects. Conclusions: CRNs' participation can improve patients' willingness to participate. It is crucial to pay attention to the role of CRNs and propose a new model of CRNs involvement in clinical research based on identifying factors.

Barriers and facilitators to faecal immunochemical testing in symptomatic populations: A rapid systematic scoping review and gap analysis.

AIM: Faecal immunochemical testing (FIT) is used to triage people with signs or symptoms of a colorectal cancer (CRC). Recent guidelines have recommended further research to improve access, uptake and return of FIT. This systematic scoping review aims to understand the barriers and facilitators to FIT testing in symptomatic patients. METHOD: Qualitative, quantitative and mixed-methods studies published after September 2013 were included. MEDLINE, EMBASE and PsycINFO databases were searched to identify publications examining barriers and facilitators to FIT. Initially, the data underwent thematic analysis, and subsequently, factors were aligned to components of the Capability, Opportunity, Motivation, Behaviour model. All outcomes are presented in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: One thousand two hundred thirty-two papers were identified; 11 met the inclusion criteria. Barriers and facilitators were identified at the patient (e.g., knowledge), provider (e.g., general practitioner awareness) and service level (e.g., method of providing FIT kits). Factors were categorised into the subcomponents of the model: psychological capability (e.g., lack of FIT knowledge), reflective motivation (e.g., beliefs regarding FIT sampling and faeces being unhygienic) and automatic motivation (e.g., embarrassment, scary, anxiety provoking). Gaps in knowledge emerged in three domains: (1) patient experience, (2) FIT pathway and (3) healthcare professionals experience of FIT. CONCLUSION: This systematic scoping review provides a summary of the literature on FIT uptake, and identified factors across multiple levels and components. To increase adherence to FIT completion within primary care, a multifaceted theory and evidence-based approach is needed to underpin future behavioural science interventions.