Exploring research capacity and culture of allied health professionals: a mixed methods evaluation.

BACKGROUND: Despite the myriad benefits of research to patients, professionals, and organisations, fewer than 0.1% of the Allied Health Professions workforce are employed in clinical academic roles. Identified barriers include a lack of role modelling, management support, funding, and availability of clinical academic roles. Research capacity building is critical to improving Allied Health Professional research capability. The aim of this evaluation was to explore the current research capacity and culture of Allied Health Professionals to inform future tailored research capacity building strategies at a local level. METHODS: A mixed methods evaluation of research capacity and culture was conducted within the Allied Health Professions department of a large National Health Service Foundation Trust using an online research capacity and culture questionnaire, followed by focus groups. Staff were recruited using a purposive method with the questionnaire and subsequent focus groups completed between July and September 2020. Data from the questionnaire was analysed using simple descriptive statistics and after inductive coding, focus group data was analysed thematically. RESULTS: 93 out of 278 staff completed the questionnaire and 60 staff members attended seven focus groups. The research capacity and culture survey reported the department's key strength as promoting clinical practice based on evidence (median=8, range=6-9). A key reported weakness of the department was insufficient resources to support staff research training (med=4, 3-6). Respondents considered themselves most skilled in finding relevant literature (med=6, 5-8) and least skilled at securing research funding (med=1, 1-2). Greater than half of the respondents (n=50) reported not currently being involved with research. Five themes were identified from the focus groups: empowerment; building research infrastructure; fostering research skills; access for all; and positive research culture. CONCLUSIONS: Allied Health Professionals recognise the benefits of research at teams and departmental level, but marginally at an individual level. Local research capacity building strategies should aim to address the role, responsibilities and barriers to Allied Health Profession research development at an individual level. To ensure all staff can engage, research infrastructure and empowerment are essential.

Cortical dynamics of disfluency in adults who stutter.

Stuttering is a disorder of speech production whose origins have been traced to the central nervous system. One of the factors that may underlie stuttering is aberrant neural miscommunication within the speech motor network. It is thus argued that disfluency (any interruption in the forward flow of speech) in adults who stutter (AWS) could be associated with anomalous cortical dynamics. Aberrant brain activity has been demonstrated in AWS in the absence of overt disfluency, but recording neural activity during disfluency is more challenging. The paradigm adopted here took an important step that involved overt reading of long and complex speech tokens under continuous EEG recording. Anomalies in cortical dynamics preceding disfluency were assessed by subtracting out neural activity for fluent utterances from their disfluent counterparts. Differences in EEG spectral power involving alpha, beta, and gamma bands, as well as anomalies in phase-coherence involving the gamma band, were observed prior to the production of the disfluent utterances. These findings provide novel evidence for compromised cortical dynamics that directly precede disfluency in AWS.

Anomaly in neural phase coherence accompanies reduced sensorimotor integration in adults who stutter.

Despite advances in our understanding of the human speech system, the neurophysiological basis of stuttering remains largely unknown. Here, it is hypothesized that the speech of adults who stutter (AWS) is susceptible to disruptions in sensorimotor integration caused by neural miscommunication within the speech motor system. Human speech unfolds over rapid timescales and relies on a distributed system of brain regions working in a parallel and synchronized manner, and a breakdown in neural communication between the putative brain regions could increase susceptibility to dysfluency. Using a speech motor adaptation paradigm under altered auditory feedback with simultaneous recording of EEG, the oscillatory cortical dynamics was investigated in stuttering and fluent adults (FA). Auditory feedback perturbation involved the shifting of the formant frequencies of the target vowel sound. Reduced adaptation in response to the feedback error was observed in AWS and was accompanied by differences in EEG spectral powers and anomalies in phase coherence evolving over the course of speech motor training. It is understood that phase coherence possibly captures neural communication within speech motor networks. Thus, the phase coherence network of the two groups exhibited differences involving the EEG frequency bands. These findings in anomalous neural synchrony provide novel evidence for compromised neuronal communication at short time scales within the speech motor network of AWS.