Achieving change in the NHS: a feasibility study to introduce a home-based cancer chemotherapy service

A major focus of current health policyin the United Kingdom is the development of services that meet the public’s expectations. To achieve this there is a need to evaluate current provision to ensure that the best use is made of finite resources. The studyreported here adopted an interview approach to examine an existing outpatient chemotherapy service, and to consider the feasibilityof introducing a home based model. Following a review of literature on this topic data were obtained from in-depth interviews with patients and professionals regarding the present service. These were then combined with an analysis of service contracts and financial estimates. The poor quality of much of the costrelated information limited the conclusions which could be drawn, and emphasised the need for access to more accessible and robust financial information upon which to base change. The studyalso illustrated the benefits of feasibility studies; especially when cost-effectiveness and patient satisfaction are the driving forces behind proposed changes to clinical services

A systematic review and meta-synthesis of the impact of low back pain on people's lives

Copyright @ 2014 Froud et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.Background - Low back pain (LBP) is a common and costly problem that many interpret within a biopsychosocial model. There is renewed concern that core-sets of outcome measures do not capture what is important. To inform debate about the coverage of back pain outcome measure core-sets, and to suggest areas worthy of exploration within healthcare consultations, we have synthesised the qualitative literature on the impact of low back pain on people’s lives. Methods - Two reviewers searched CINAHL, Embase, PsycINFO, PEDro, and Medline, identifying qualitative studies of people’s experiences of non-specific LBP. Abstracted data were thematic coded and synthesised using a meta-ethnographic, and a meta-narrative approach. Results - We included 49 papers describing 42 studies. Patients are concerned with engagement in meaningful activities; but they also want to be believed and have their experiences and identity, as someone ‘doing battle’ with pain, validated. Patients seek diagnosis, treatment, and cure, but also reassurance of the absence of pathology. Some struggle to meet social expectations and obligations. When these are achieved, the credibility of their pain/disability claims can be jeopardised. Others withdraw, fearful of disapproval, or unable or unwilling to accommodate social demands. Patients generally seek to regain their pre-pain levels of health, and physical and emotional stability. After time, this can be perceived to become unrealistic and some adjust their expectations accordingly. Conclusions - The social component of the biopsychosocial model is not well represented in current core-sets of outcome measures. Clinicians should appreciate that the broader impact of low back pain includes social factors; this may be crucial to improving patients’ experiences of health care. Researchers should consider social factors to help develop a portfolio of more relevant outcome measures.Arthritis Research U

The Undergraduate–Postgraduate–Faculty Triad: Unique Functions and Tensions Associated with Undergraduate Research Experiences at Research Universities

We present an exploratory study of how undergraduates' involvement in research influences postgraduates (i.e., graduate and postdoctoral researchers) and faculty. We used a qualitative approach to examine the relationships among undergraduates, postgraduates, and the faculty head in a research group. In this group, undergraduates viewed postgraduates as more approachable than the faculty head both literally and figuratively. Mentorship by postgraduates presented unique challenges for undergraduates, including unrealistic expectations and varying abilities to mentor. The postgraduates and faculty head concurred that undergraduates contributed to the group's success and served as a source of frustration. Postgraduates appreciated the opportunity to observe multiple approaches to mentoring as they saw the faculty head and other postgraduates interact with undergraduates. The faculty head viewed undergraduate research as important for propagating the research community and for gaining insights into undergraduates and their postgraduate mentors. These results highlight how the involvement of undergraduates and postgraduates in research can limit and enhance the research experiences of members of the undergraduate–postgraduate–faculty triad. A number of tensions emerge that we hypothesize are intrinsic to undergraduate research experiences at research universities. Future studies can focus on determining the generalizability of these findings to other groups and disciplines