Lost in translation: a narrative review and synthesis of the published international literature on mental health research and translation priorities (2011-2023).

BACKGROUND: Priority setting in mental health research is arguably lost in translation. Decades of effort has led to persistent repetition in what the research priorities of people with lived-experience of mental ill-health are. AIM: This was a narrative review and synthesis of published literature reporting mental health research priorities (2011-2023). METHODS: A narrative framework was established with the questions: (1) who has been involved in priority setting? With whom have priorities been set? Which priorities have been established and for whom? What progress has been made? And, whose priorities are being progressed? RESULTS: Seven papers were identified. Two were Australian, one Welsh, one English, one was from Chile and another Brazilian and one reported on a European exercise across 28 countries (ROAMER). Hundreds of priorities were listed in all exercises. Prioritisation mostly occured from survey rankings and/or workshops (using dots, or post-it note voting). Most were dominated by clinicians, academics and government rather than people with lived-experience of mental ill-health and carer, family and kinship group members. CONCLUSION: One lived-experience research led survey was identified. Few studies reported lived-experience design and development involvement. Five of the seven papers reported responses, but no further progress on priorities being met was reported.

This review followed PRISMA guidance for search strategy development and systematic review and reporting. This was not a systematic review with or without meta-analysis and the method did not fit for registration with PROSPERO.

Poorly placed tracheostomy tubes: Effects on flow and resistance.

This study aimed to investigate the effects of an incorrectly positioned tracheostomy tube on flow resistance. A laboratory-based model of the trachea was used with both cuffed and uncuffed tracheostomy tubes inserted to variable depths. With a constant metered flow through the model, the pressure for given depths of insertion was recorded. The model was then re-run to test the effect of different flow rates on the system. A total of 468 individual results were grouped and statistically analysed. They showed that both over- and under-insertion increase the pressure within the circuit and that a cuffed tracheostomy tube offers a degree of protection against this. These results were statistically significant with P < 0.05 demonstrating that incorrect positioning has a greater resistance to flow. These results provide an essential scientific basis for further work to assess the clinical significance of incorrect positioning as well as suggesting the need to monitor tube position.