A thematic analysis of factors influencing recruitment to maternal and perinatal trials

Background: Recruitment of eligible participants remains one of the biggest challenges to successful completion of randomised controlled trials (RCTs). Only one third of trials recruit on time, often requiring a lengthy extension to the recruitment period. We identified factors influencing recruitment success and potentially effective recruitment strategies. Methods: We searched MEDLINE and EMBASE from 1966 to December Week 2, 2006, the Cochrane Library Methodology Register in December 2006, and hand searched reference lists for studies of any design which focused on recruitment to maternal/perinatal trials, or if no studies of maternal or perinatal research could be identified, other areas of healthcare. Studies of nurses' and midwives' attitudes to research were included as none specifically about trials were located. We synthesised the data narratively, using a basic thematic analysis, with themes derived from the literature and after discussion between the authors. Results: Around half of the included papers (29/53) were specific to maternal and perinatal healthcare. Only one study was identified which focused on factors for maternal and perinatal clinicians and only seven studies considered recruitment strategies specific to perinatal research. Themes included: participant assessment of risk; recruitment process; participant understanding of research; patient characteristics; clinician attitudes to research and trials; protocol issues; and institutional or organisational issues. While no reliable evidence base for strategies to enhance recruitment was identified in any of the review studies, four maternal/perinatal primary studies suggest that specialised recruitment staff, mass mailings, physician referrals and strategies targeting minority women may increase recruitment. However these findings may only be applicable to the particular trials and settings studied. Conclusion: Although factors reported by both participants and clinicians which influence recruitment were quite consistent across the included studies, studies comparing different recruitment strategies were largely missing. Trials of different recruitment strategies could be embedded in large multicentre RCTs, with strategies tailored to the factors specific to the trial and institution.Rebecca L Tooher, Philippa F Middleton and Caroline A Crowthe

Policy analysis for entrepreneurship education in necessity-based contexts: a Sri Lankan case study

The development of entrepreneurs in order to stimulate economic growth is a key component of government policies (Hannon, 2006), and policy makers appear to consider entrepreneurship education and training as ‘an efficient mechanism for increasing entrepreneurial activity’ (Martinez, Levie, Kelley, Sæmundsson and Schøtt, 2010, p. 43). Government policies encouraging the education and development of entrepreneurs are evident in countries around the globe (Xavier, Kelley, Kew, Herrington and Vorderwülbecke, 2012), however evaluating the contribution of entrepreneurship education to a country and its economy has proved challenging (O’Connor, 2013). In this chapter we analyze policies for entrepreneurship education in a country that exhibits a high level of necessity-based entrepreneurship. Necessity-driven entrepreneurs are defined as ‘those who are pushed into starting businesses because they have no other work options and need a source of income’. This is contrasted with opportunity-driven entrepreneurs who undertake entrepreneurial activities in order to pursue a perceived opportunity (Xavier et al., 2012, p. 8). There is very little academic research regarding necessity-driven entrepreneurs, and even less so in countries that are in relatively early stages of development.Eva Balan-Vnuk, Manjula Dissanyake and Allan O’Conno

Ovariectomy of a brown bear (Ursus arctos): a case report

ABSTRACT: Reproductive control is regularly implemented in bear facilities to prevent crowding of enclosures and surplus animals. Ovariectomy may represent an efficient method of sterilizing bears yet has not been reported in the literature. A 73 kg female brown bear, age two years and three months, was anesthetized for ovariectomy with tiletamin and zolazepam (Zoletil ® , Virbac S.A., Carros Cedex, France) and medetomidin hydrochloride (Domitor ® , Pfizer Animal Health, New York, USA). A 25 cm midline incision that extended from the umbilicus to the pubic brim was made. The suspensory ligament was stretched and blunt dissected so that ovaries in bursa were exposed on the surgical field. A &quot