Exploring the contextualisation of methods in research synthesis: Three studies in dementia and communication

This thesis constitutes a programme of research to adapt and test three review methodologies. The methodologies include: a Scoping Review, a Meta Study and a Narrative Synthesis. The objective of methodological development was to create systematised processes for identifying suitable forms of communication for participants from contextualised research evidence and synthesis. Communication (data collection) methods are pivotal in understanding lived experience and representing views. The empirical focus of the thesis surrounds forms of alternative communication methods in the context of people with dementia. These alternative research methods are particularly important for participants who may not use verbal forms of communication as their primary method of interaction. The thesis proposes the introduction of a new review genre called ‘methods contextualisation’ which could assist reviewers in critiquing data collection methods and interpreting voices in research. The thesis is structured in three phases: development, implementation, and conceptualisation of the methodologies. Outcomes of the thesis produced both methodological and empirical findings. The adapted methodologies are presented as a typology, offering different forms of critical understanding about communication methods to influence future choice and use of those methods. Findings identify and synthesise relevant forms of knowledge. The thesis proposes methods contextualisation processes could be embedded into dementia theory, research and practice

Contextualizing the findings of a systematic review on patient and carer experiences of dementia diagnosis and treatment : a qualitative study

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Involving service users in the systematic review process is seen as increasingly important. As systematic reviews often include studies from diverse settings and covering a time span of several decades, involving service users in consideration of applicability to specific populations or settings might make reviews more useful to practitioners and policymakers.Peer reviewedFinal Published versio

Developing interventions to improve health: a systematic mapping review of international practice between 2015 and 2016

Background Researchers publish the processes they use to develop interventions to improve health. Reflecting on this endeavour may help future developers to improve their practice. Methods Our aim was to collate, describe, and analyse the actions developers take when developing complex interventions to improve health. We carried out a systematic mapping review of empirical research studies that report the development of complex interventions to improve health. A search was undertaken of five databases over 2015–2016 using the term ‘intervention dev*’. Eighty-seven journal articles reporting the process of intervention development were identified. A purposive subset of 30 articles, using a range of published approaches to developing interventions, was selected for in-depth analysis using principles of realist synthesis to identify the actions of intervention development and rationales underpinning those actions. Results The 87 articles were from the USA (39/87), the UK (32/87), continental Europe (6/87), and the rest of the world (10/87). These mainly took a pragmatic self-selected approach (n = 43); a theory- and evidence-based approach, e.g. Intervention Mapping, Behaviour Change Wheel (n = 22); or a partnership approach, e.g. community-based participatory research, co-design (n = 10). Ten actions of intervention development were identified from the subset of 30 articles, including identifying a need for an intervention, selecting the intervention development approach to follow, considering the needs of the target population, reviewing published evidence, involving stakeholders, drawing or generating theory, and designing and refining the intervention. Rationales for these actions were that they would produce more engaging, acceptable, feasible, and effective interventions. Conclusions Developers take a variety of approaches to the international endeavour of complex intervention development. We have identified and described a set of actions taken within this endeavour regardless of whether developers follow a published approach or not. Future developers can use these actions and the rationales that underpin them to help them make decisions about the process of intervention development

Strategies to promote the impact of systematic reviews on healthcare policy: a systematic review of the literature

The last few decades have seen a growing emphasis on evidence-based decision making in health care. Systematic reviews synthesising research have been a key component of this movement. However, there is concern that such syntheses do not have the expected impact on policy with more work needed to enable us to maximise their potential. The aim of this review was to identify and evaluate potential strategies for increasing the impact of systematic reviews on policy. Such strategies may include incorporating active strategies for dissemination and knowledge transfer but more work is needed to evaluate their benefits.Peer reviewe

Sworn K: Strategies to promote the impact of systematic reviews on healthcare policy: a systematic review of the literature. Evid Pol: J Res Debate Pract 2011

Abstract The last few decades have seen a growing emphasis on evidence-based decision making in health care. Systematic reviews synthesising research have been a key component of this movement. However, there is concern that such syntheses do not have the expected impact on policy with more work needed to enable us to maximise their potential. The aim of this review was to identify and evaluate potential strategies for increasing the impact of systematic reviews on policy. Such strategies may include incorporating active strategies for dissemination and knowledge transfer but more work is needed to evaluate their benefits

Aspects of Nyerere's Economic Thought: A Study in the Dynamics of African Leaders' Aspirations in Directing Their Countries' Economic Grouth after Independence

African independence challenged the new nations of Africa with how best to bring about the betterment of life. Before independence, Africans were subordinated and given a low priority in the sharing of their countries' economic blessings. Therefore, with the withering away of colonialism, African leaders had to think of how best to bring about development for their respective countries. Developmental strategies that ensued ranged from trial and error to dogmatic. However, imperialism did not leave them alone. Many leaders were overthrown regardless of the endearment of their nationals. And, the resulting economic situation was in shambles. Natural disasters did not spare the African new states. Then again, Africans' own warrings retarded their economic growth. This paper looks into the ways and means of one of Africa's leaders, Julius Kambarage Nyerere of Tanzania, as for over two decades he struggled toward making Tanzania an economically viable nation-state

Guidance on how to develop complex interventions to improve health and health care

Objective: To provide researchers with guidance on actions to take during intervention development.Summary of key points: Based on a consensus exercise informed by reviews and qualitative interviews, we present key principles and actions for consideration when developing interventions to improve health. These include seeing intervention development as a dynamic iterative process, involving stakeholders, reviewing published research evidence, drawing on existing theories, articulating programme theory, undertaking primary data collection, understanding context, paying attention to future implementation in the real world, and designing and refining an intervention using iterative cycles of development with stakeholder input throughout.Conclusion: Researchers should consider each action by addressing its relevance to a specific intervention in a specific context, both at the start and throughout the development process. <br/

Risk assessment models for venous thromboembolism in hospitalised adult patients: a systematic review

Introduction Hospital-acquired thrombosis accounts for a large proportion of all venous thromboembolism (VTE), with significant morbidity and mortality. This subset of VTE can be reduced through accurate risk assessment and tailored pharmacological thromboprophylaxis. This systematic review aimed to determine the comparative accuracy of risk assessment models (RAMs) for predicting VTE in patients admitted to hospital. Methods A systematic search was performed across five electronic databases (including MEDLINE, EMBASE and the Cochrane Library) from inception to February 2021. All primary validation studies were eligible if they examined the accuracy of a multivariable RAM (or scoring system) for predicting the risk of developing VTE in hospitalised inpatients. Two or more reviewers independently undertook study selection, data extraction and risk of bias assessments using the PROBAST (Prediction model Risk Of Bias ASsessment Tool) tool. We used narrative synthesis to summarise the findings. Results Among 6355 records, we included 51 studies, comprising 24 unique validated RAMs. The majority of studies included hospital inpatients who required medical care (21 studies), were undergoing surgery (15 studies) or receiving care for trauma (4 studies). The most widely evaluated RAMs were the Caprini RAM (22 studies), Padua prediction score (16 studies), IMPROVE models (8 studies), the Geneva risk score (4 studies) and the Kucher score (4 studies). C-statistics varied markedly between studies and between models, with no one RAM performing obviously better than other models. Across all models, C-statistics were often weak (0.8). Similarly, estimates for sensitivity and specificity were highly variable. Sensitivity estimates ranged from 12.0% to 100% and specificity estimates ranged from 7.2% to 100%. Conclusion Available data suggest that RAMs have generally weak predictive accuracy for VTE. There is insufficient evidence and too much heterogeneity to recommend the use of any particular RAM

Summary of quality assessment domains.

<p>This figure shows review authors' judgements about each quality domain presented as percentages across all included studies.</p

Core principles of study quality assessment.

<p>Core principles of study quality assessment.</p