A mixed-methods study of challenges and benefits of clinical academic careers for nurses, midwives and allied health professionals

Objectives: The clinical academic trajectory for doctors and dentists is well-established, with research embedded in their career development. Recent years have also seen a burgeoning interest and push for nurses, midwives and allied health professionals (NMAHPs) to pursue a clinical academic career. However, the NIHR 10 year review suggested that there may be problems with progression post Master’s degree level for this group, with nurses and midwives receiving less NIHR funding than AHPs. This study responds to these concerns, tracking the progression and exploring experiences of NMAHPs in the East Midlands region of England. Design: An online survey and in-depth interviews were used to capture a wide range of experiences.Participants: 67 NMAHPs who were pursuing a clinical academic career were surveyed, supplemented by 16 semi-structured in-depth interviews.Results: Three themes emerged during data analysis: Embarking on a clinical academic career; overcoming barriers; and benefits.Conclusions: NMAHPs are motivated to pursue a clinical academic career by a drive to improve services for the benefit of patients and the NHS more widely, as well as for personal development and career progression. People working in these roles have opportunities to explore possible solutions to issues that they encounter in their clinical role through academic study. Findings reveal benefits emanating from the individual level through to (inter)national levels, therefore academic study should be encouraged and supported. However, investment is needed to establish more clinical academic roles to enable NMAHPs to continue to utilise their experience and expertise post-PhD, otherwise the full extent of their value will not be recognised

Clinical academics’ experiences during the COVID-19 pandemic: a qualitative study of challenges and opportunities when working at the clinical frontline

Objectives: This study explored the experiences of clinical academics during the COVID-19 pandemic. The aim was to identify challenges and benefits associated with returning to, or increasing hours at, the clinical frontline.Design: Qualitative data were gathered from a combination of written responses to questions posed in an email and 10 semi-structured interviews between May and September 2020.Setting: Two higher education institutions and three NHS Trusts in the East Midlands of England.Participants: Written responses were received from 34 clinical academics including doctors, nurses, midwives and allied health professionals. A further 10 participants were interviewed either by telephone or online, via Microsoft Teams.Results: Participants described challenges experienced in returning full-time to the clinical frontline. These included having to refresh or learn new skills and the pressure of managing the competing priorities of NHS and higher education institutions. Benefits of being on the frontline included having the confidence and flexibility to deal with an evolving situation. Also, the ability to quickly assess and communicate the latest research and guidance to colleagues and patients. In addition, participants reported identifying areas for research during this time.Conclusion: Clinical academics can contribute their knowledge and skills to frontline patient care in times of pandemic. It is therefore important to ease that process in preparation for potential future pandemics

Suburban Neighbourhood Adaptation for a Changing Climate (SNACC) final report

The report presents findings from the Suburban Neighbourhood Adaptation to a Changing Climate (SNACC) project. The project tested the effectiveness, feasibility and acceptability of a range of adaptations to the physical environment (i.e. to homes, gardens, and public spaces) that could be used to both mitigate and adapt to climate change in the UK

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist

A fast new numerical tool for designing prestressed dies for backward extrusion: Part 2: numerical analysis

Reported is an original and innovative method for the stress determination based on an analytical function of the process parameters for the backward extrusion process. Awarded the 2001 Thomas Stephen Prize by the Institution of Mechanical Engineers.The economics of forging requires tools to be designed to ensure maximum service life. Ideally, this should be achieved by determining the maximum equivalent stress experienced by tools during service. However, the determination of the maximum equivalent stress in the dies through numerical simulations is very time consuming. For the case of a backward extrusion process, this paper proposes a method for its determination that is based on an analytical function of the process parameters. This function was obtained by generating a database that includes the maximum equivalent stress for a large range of process parameters. This database was then modelled by a function determined through statistical analysis. (Professional Engineering Publishing

A Fast New Numerical Tool for Designing Pre-stressed Dies for Backward Extrusion: Part 1: Die Behaviour

Reported is an original and innovative method for the stress determination based on an analytical function of the process parameters for the backward extrusion process. Awarded the 2001 Thomas Stephen Prize by the Institution of Mechanical Engineers.Prestressed die inserts are often used in the forging of axisymmetric parts. Their use enhances overall tool economy and can enhance the quality of the finished forging. The design of tooling that incorporates prestressed die inserts is, however, complex. The complexity arises from the interrelated phenomena that occur within the dies during the forging process. As a result, it is not possible to obtain an analytical expression for critical parameters such as die stresses and deflections. This paper shows the limitations of currently used design methods, and identifies, for the backward extrusion process, which physical phenomena should be taken into account when designing prestressed tooling. (Professional Engineering Publishing