Establishing the values for patient engagement (PE) in health-related quality of life (HRQoL) research: an international, multiple-stakeholder perspective

PurposeActive patient engagement is increasingly viewed as essential to ensuring that patient-driven perspectives are considered throughout the research process. However, guidance for patient engagement (PE) in HRQoL research does not exist, the evidence-base for practice is limited, and we know relatively little about underpinning values that can impact on PE practice. This is the first study to explore the values that should underpin PE in contemporary HRQoL research to help inform future good practice guidance. MethodsA modified ‘World Café’ was hosted as a collaborative activity between patient partners, clinicians and researchers: self-nominated conference delegates participated in group discussions to explore values associated with the conduct and consequences of PE. Values were captured via post-it notes and by nominated note-takers. Data were thematically analysed: emergent themes were coded and agreement checked. Association between emergent themes, values and the Public Involvement Impact Assessment Framework were explored. ResultsEighty participants, including 12 patient partners, participated in the 90-min event. Three core values were defined: (1) building relationships; (2) improving research quality and impact; and (3) developing best practice. Participants valued the importance of building genuine, collaborative and deliberative relationships—underpinned by honesty, respect, co-learning and equity—and the impact of effective PE on research quality and relevance. Conclusions An explicit statement of values seeks to align all stakeholders on the purpose, practice and credibility of PE activities. An innovative, flexible and transparent research environment was valued as essential to developing a trustworthy evidence-base with which to underpin future guidance for good PE practice.Peer reviewe

Communicative activism and human rights

University of Technology, Sydney. Faculty of Humanities and Social Sciences.Presented here is a theoretical, historical and analytical position that reexamines human rights as discursively generated cultural products, introducing a conceptual tool, 'communicative activism', which can be usefully employed to analyse and interpret forms of human rights discourse employed by non-governmental organisations and others who seek to support and promote human rights standards and practices. Theoretically, this is grounded in Habermasian notions of communicative rationality and Foucauldian notions of critique that, although usually positioned as contradictory, are here presented as having an important commonality - an emphasis on inter-discursive modes of cultural knowledge production and legitimisation. Historically, human rights theory and philosophy is positioned in a post-ontological phase, emphasising therefore that human rights are less 'self-evident' or pre-existing and therefore able to be 'recognised' than they are discursive products in an ongoing historical process of re-articulation. Analytically, the concept of 'communicative activism' is provided with a suggested methodological framework and employed to critically engage with some aspects of contemporary human rights discourse through a case study of Amnesty International

Developing standards for reporting implementation studies of complex interventions (StaRI): a systematic review and e-Delphi

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited

LBO Capital Structure: An Investigation in to European Private Equity Deals between 2004 and 2009

This dissertation report provides a recent, up-to-date and extensive investigation and analysis into LBO capital structure. Specifically this study will examine the phenomenon behind the LBO debt complexity by unravelling its composition and understanding through measurement its leverage. A sample of 147 European LBO deals between 2004 and 2009 comprising from within the UK, France and Germany have been taken from the CMBOR. There are three prominent features of this study. Firstly, a detailed collection of capital debt structuring has been broken down. Secondly, a dynamic comparison of leverage ratios over time and country; and lastly, a thorough regression analysis of the factors that may cause significant changes in leverage. Leverage was measured using D/E and D/EV ratios and the latter was found to be more useful in the regression modelling. The laissez faire approach to arranged loan syndications became a result of altered bank’s business models. A market fuelled by dispersed debt risk and consequential lacking transparency spurred them on. However, unknown risk and little trading forced a dry up in the syndicated loan market and a sharp but abrupt fall in the frequency of LBO deals. After all PE is a procyclical industry and the results in this study are consistent with the view that financing availability induces the inherent rise and fall patterns. In line with previous studies, this study has demonstrated that debt market conditions appear to be the main determinants of leverage. Regression results indicated the debt rate, total deal size and year of transaction as significant contributors while little significance was found when other variables were tested

Reinforcing occupational performance, engagement, and participation as the core concepts of occupational therapy

Background. The core concepts of occupational performance, occupational engagement, and occupational participation are unique to the occupational therapy profession. However, their definitions and applications are inconsistently presented across conceptual models of practice and have been challenged within the occupational therapy and occupational science literature. Objective. This study aimed to describe the discursive controversies presented within the occupational therapy literature for the inclusion or exclusion of the three core concepts within occupational therapy. Methods. A conceptual review of the literature was undertaken to uncover applications and controversies of the three core occupational concepts. Each concept was analysed based on its features, attributes, and characteristics (Podsakoff, 2016) through an anti-oppressive lens. An anti-oppressive lens within occupational therapy focuses on minimizing discourses and practices that exclude or limit certain social groups from achieving occupational equity and rights through autonomous informed decision making about their occupational lives. Results. The applications of the three core concepts appeared to be distinct, yet, related, and covered the breadth of occupational outcomes desired across social groups. Removing core concepts would lead to occupational inequities. Conclusions. The inclusion of all three concepts as core outcomes of occupation-centred practice ensures the professions focus on occupational equity across diverse social groups

Donation after circulatory death liver transplantation: consensus statements from the Spanish Liver Transplantation Society

Livers from donation after circulatory death (DCD) donors are an increasingly more common source of organs for transplantation. While there are few high-level studies in the field of DCD liver transplantation, clinical practice has undergone progressive changes during the past decade, in particular due to mounting use of postmortem normothermic regional perfusion (NRP). In Spain, uncontrolled DCD has been performed since the late 1980s/early 1990s, while controlled DCD was implemented nationally in 2012. Since 2012, the rise in DCD liver transplant activity in Spain has been considerable, and the great majority of DCD livers transplanted in Spain today are recovered with NRP. A panel of the Spanish Liver Transplantation Society was convened in 2018 to evaluate current evidence and accumulated experience in DCD liver transplantation, in particular addressing issues related to DCD liver evaluation, acceptance criteria, and recovery as well as recipient selection and postoperative management. This panel has created a series of consensus statements for the standard of practice in Spain and has published these statements with the hope they might help guide other groups interested in implementing new forms of DCD liver transplantation and/or introducing NRP into their clinical practices

An exploration into the occupational identity of women following breast cancer and treatment: A qualitative study

Introduction: The number of women surviving after breast cancer is increasing, along with the length of time they are living with the after-effects of treatment. Although the treatment’s effects are known to impact occupational participation, little is known about how breast cancer could affect occupational identity. This study aims to illuminate the lived experience of women long-term after breast cancer treatment through an occupational perspective in order to explore how they perceive their occupational identity. Methods: A qualitative study with semi-structured interviews was conducted with six women, who had all received a diagnosis of breast cancer and treatment for longer than a year. Reflexive Thematic Analysis was used to analyse the data. Findings: Three intertwined themes describe the participants’ experience. (1) ‘Disruptions in daily life and Environmental support’, (2) ‘Be able to do’ and identity, and (3) ‘Doing what matters and is possible’. Findings revealed that the occupational identities of the participants were maintained. Cancer treatment effects appear to impact occupational competence that corresponded to participants’ occupational identities, suggesting difficulties in the order of occupational adaptation. Conclusion: Our findings contribute to understanding the challenges to occupational participation related to the occupational identity of women following breast cancer and treatment

(Des)Connections between occupational justice and social justice: an interview with Gail Whitefordand Lilian Magalhães

Since its inception in the late 1990’s (Townsend & Wilcock, 2004), occupational justice has become a core concept for consideration within occupational therapy and occupational science (Durocher et al., 2014; Malfitano et al., 2016; Hammell, 2017). While the conversation surrounding occupational justice has started from the Western world, some non-Anglo-Saxon countries have been underpinning their occupational therapy practices on a concept called ‘social justice’ (Guajardo, 2021; Lopes & Malfitano, 2021). Occupational justice is defined as the “[...] access to and participation in the full range of meaningful and enriching occupations afforded to others, including opportunities for social inclusion and the resources to participate in occupations to satisfy personal, health, and societal needs [...]” (American Occupational Therapy Association, 2020, p. 79). On the other hand, ‘social justice’ is perceived to address “[...] important social goals, whether acting in ways that befits an equitable and compassionate world, respecting human dignity, or creating an inclusive society [...]” (Hocking, 2017, p. 29). The social and occupational justice concepts have been progressively debated in the field of occupational therapy as to whether they can be realistically translated into actual practice (Guajardo, 2021; Hammell & Beagan, 2017). These debates are seen as an opportunity to further develop the mentioned concepts rather than inducing potential conflicts, hence, this Editorial aims to examine these through a reflective conversation. Furthermore, as we incorporate the debate on social justice, as we also point out the importance of taking into account the diversity of theories - concepts, ideas, and language - that inform the practices and research of occupational therapists, globally. Based on the relevance of these concepts, we have proposed this special issue: “Bridging critical gaps in occupational justice and social justice in occupational therapy practices”. The aims of this special issue are to demonstrate how occupational therapists globally address the rights to inclusive participation in daily life for all people and to illuminate the opportunities for occupational therapists to serve from traditional to less known areas of practice. This editorial intends to ascertain the thoughts and opinions surrounding occupational justice and social justice from two experts in the field of occupational science and occupational therapy through expert interviewing, an approach to harvest knowledge and explore a concept under study (Meuser & Nagel, 2009). To do this, we invited Professors Gail Whiteford and Lilian Magalhães, to participate in a simultaneous interview. They were chosen because their research paths are related to the concepts being discussed and also because they are strategically located in different geographical places, Gail in Australia and Lilian in Brazil (she still maintains a close relationship with Canada). The interview was conducted by researchers of occupational therapy located in Chile/Australia (DCJ), Brazil (PB), and the Philippines (MS). Even though they share an interest in occupational therapy and social issues, their research has approached the topic from different perspectives. In this interview, we approach the central theme of occupational justice and its relationship with the concept of social justice. Additionally, both interviewees addressed the need for a more situated historical, socio-economic, and political analyses for the use of concepts in general within the fields of occupational therapy and occupational science. We reproduced below parts of the interview transcription. Interview questions are italicized in order to differentiate it to the interviewee’s responses which are labelled ‘GW’ for Gail Whiteford and ‘LM’ for Lilian Magalhães

Sleeve gastrectomy causes weight-loss independent improvements in hepatic steatosis

Background and Aims: Sleeve gastrectomy (VSG) leads to improvement in hepatic steatosis, associated with weight loss. The aims of this study were to investigate whether VSG leads to weight-loss independent improvements in liver steatosis in mice with diet-induced obesity (DIO); and to metabolically and transcriptomically profile hepatic changes in mice undergoing VSG. Methods: Mice with DIO were treated with VSG, sham surgery with subsequent food restriction to weight-match to the VSG group (Sham-WM), or sham surgery with return to unrestricted diet (Sham-Ad lib). Hepatic steatosis, glucose tolerance, insulin and glucagon resistance, and hepatic transcriptomics were investigated at the end of the study period and treatment groups were compared with mice undergoing sham surgery only (Sham-Ad lib). Results: VSG led to much greater improvement in liver steatosis than Sham-WM (liver triglyceride mg/mg 2.5 ± 0.1, 2.1 ± 0.2, 1.6 ± 0.1 for Sham-AL, Sham-WM and VSG respectively; p = 0.003). Homeostatic model assessment of insulin resistance was improved following VSG only (51.2 ± 8.8, 36.3 ± 5.3, 22.3 ± 6.1 for Sham-AL, Sham-WM and VSG respectively; p = 0.03). The glucagon-alanine index, a measure of glucagon resistance, fell with VSG but was significantly increased in Sham-WM (9.8 ± 1.7, 25.8 ± 4.6 and 5.2 ± 1.2 in Sham Ad-lib, Sham-WM and VSG respectively; p = 0.0003). Genes downstream of glucagon receptor signalling which govern fatty acid synthesis (Acaca, Acacb, Me1, Acly, Fasn and Elovl6) were downregulated following VSG but upregulated in Sham-WM. Conclusions: Changes in glucagon sensitivity may contribute to weight-loss independent improvements in hepatic steatosis following VSG

Chemical Constituents, Anticancer and Anti-Proliferative Potential of Limonium Species: A Systematic Review

Limonium species represent a source of bioactive compounds that have been widely used in folk medicine. This study aimed to synthesize the anticancer and anti-proliferative potential of Limonium species through a systematic review. Searches were performed in the electronic databases PubMed/MEDLINE, Scopus, and Scielo and via a manual search. In vivo or in vitro studies that evaluated the anticancer or anti-proliferative effect of at least one Limonium species were included. In total, 942 studies were identified, with 33 articles read in full and 17 studies included for qualitative synthesis. Of these, 14 (82.35%) refer to in vitro assays, one (5.88%) was in vivo, and two (11.76%) were designed as in vitro and in vivo assays. Different extracts and isolated compounds from Limonium species were evaluated through cytotoxic analysis against various cancer cells lines (especially hepatocellular carcinoma-HepG2; n = 7, 41.18%). Limonium tetragonum was the most evaluated species. The possible cellular mechanism involved in the anticancer activity of some Limonium species included the inhibition of enzymatic activities and expression of matrix metalloproteinases (MMPs), which suggested anti-metastatic effects, anti-melanogenic activity, cell proliferation inhibition pathways, and antioxidant and immunomodulatory effects. The results reinforce the potential of Limonium species as a source for the discovery and development of new potential cytotoxic and anticancer agents. However, further studies and improvements in experimental designs are needed to better demonstrate the mechanism of action of all of these compounds