what is needed to close the implementation gaps?

Funding Information: SH is funded by the National Institute for Health Research (NIHR Advanced Fellowship NIHR300072), the Academy of Medical Sciences (SBF005\1111), and the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) through an ESCMID Study Group for Infections in Travellers and Migrants (ESGITM) research grant. MP is supported by the National Institute for Health Research (NIHR Post-Doctoral Fellowship, PDF-2015-08-102). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the UK Department of Health. Funding Information: SH is funded by the National Institute for Health Research ( NIHR Advanced Fellowship NIHR300072 ), the Academy of Medical Sciences ( SBF005\1111 ), and the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) through an ESCMID Study Group for Infections in Travellers and Migrants ( ESGITM ) research grant. MP is supported by the National Institute for Health Research ( NIHR Post-Doctoral Fellowship , PDF-2015-08-102 ). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the UK Department of Health. Publisher Copyright: © 2020 The AuthorsMigration to the European Union (EU)/European Economic Area (EEA) affects the epidemiology of infectious diseases, including tuberculosis (TB), HIV, hepatitis B/C, and parasitic diseases. Some sub-populations of migrants are also considered to be an under-immunised group and thus at risk of vaccine-preventable diseases. Providing high-risk migrants access to timely and efficacious screening and vaccination, and understanding how best to implement more integrated screening and vaccination programmes into European health systems ensuring linkage to care and treatment, is key to improving the health of migrants and their communities, alongside meeting national and regional targets for infection surveillance, control, and elimination. The European Centre for Disease Prevention and Control (ECDC) has responded to calls to action to improve migrant health and strengthen universal health coverage by developing evidence-based guidance for policy makers, public health experts, and front-line healthcare professionals on how to approach screening and vaccination in newly arrived migrants within the EU/EEA. In this Commentary, we provide a perspective towards developing efficacious screening and vaccination of newly arrived migrants, with a focus on defining implementation challenges and evidence gaps in high-migrant receiving EU/EEA countries. There is a need now to leverage the increasing momentum around migrant health to both strengthen the evidence-base and to advocate for universal access to health care for all migrants in the EU/EEA, including undocumented migrants. This should include voluntary, confidential, and non-stigmatising screening and vaccination that should be free of charge and facilitate linkage to appropriate care and treatment.publishersversionpublishe

Going beyond defining: Preschool educators\u27 use of knowledge in their pedagogical reasoning about vocabulary instruction

Previous research investigating both the knowledge of early childhood educators and the support for vocabulary development present in early childhood settings has indicated that both educator knowledge and enacted practice are less than optimal, which has grave implications for children\u27s early vocabulary learning and later reading achievement. Further, the nature of the relationship between educators\u27 knowledge and practice is unclear, making it difficult to discern the best path towards improved knowledge, practice, and children\u27s vocabulary outcomes. The purpose of the present study was to add to the existing literature by using stimulated recall interviews and a grounded approach to examine how 10 preschool educators used their knowledge to made decisions about their moment-to-moment instruction in support of children\u27s vocabulary development. Results indicate that educators were thinking in highly context-specific ways about their goals and strategies for supporting vocabulary learning, taking into account important knowledge of their instructional history with children and of the children themselves to inform their decision making in the moment. In addition, they reported thinking about research-based goals and strategies for supporting vocabulary learning that went beyond simply defining words for children. Implications for research and professional development are discussed

Evaluation of the impact of National Breast Cancer Foundation-funded research

© Copyright 2014. The Medical Journal of Australia - reproduced with permission.Objective: To evaluate the impact of the National Breast Cancer Foundation’s (NBCF’s) research investment. Design and participants: Surveys based on the Payback Framework were sent to chief investigators involved in research funded by the NBCF during 1995–2012; a bibliometric analysis of NBCF-funded publications in 2006–2010 was conducted; and a purposive, stratified sample of case studies was obtained. Main outcome measures: Research impact on knowledge production, the research system, informing policy, product development and broader health and economic benefits. Results: Of 242 surveys sent, 153 (63%) were returned. The average impact of journals in which NBCF publications appeared was double that of world publications. Seventy surveys (46%) reported career progression, and 185 higher degrees were obtained or expected, including 121 PhDs. One hundred and one grants (66%) produced tools that built capacity across the research system, and research teams leveraged an additional $1.40 in funding for every dollar invested. Fifteen applied grants and one basic grant impacted on policy. Ten basic and four applied grants led to the development of drugs, prognostic tools or diagnostic technologies. Twenty applied and two basic grants led to changes in practice and behaviour of health care staff, consumers and the public, with further impacts anticipated. Case studies provided illustrations of high impact. Conclusions: NBCF’s strategy of investing in a mixed portfolio of research areas and mechanisms encouraged a broad range of impacts across all Payback categories. The impacts from basic research tended to focus on knowledge production and drug development; while applied research generated greater impacts within the other Payback categories. The funding of shared infrastructure stimulated impact across the research system

Management of Children With Chronic Wet Cough and Protracted Bacterial Bronchitis CHEST Guideline and Expert Panel Report

BACKGROUND: Wet or productive cough is common in children with chronic cough. We formulated recommendations based on systematic reviews related to the management of chronic wet cough in children (aged METHODS: We used the CHEST expert cough panel\u27s protocol for systematic reviews and the American College of Chest Physicians (CHEST) methodologic guidelines and GRADE framework (the Grading of Recommendations Assessment, Development and Evaluation). Data from the systematic reviews in conjunction with patients\u27 values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain consensus for the recommendations/suggestions made. RESULTS: Combining data from the systematic reviews, we found high-quality evidence in children aged 4 weeks\u27 duration) wet/productive cough that using appropriate antibiotics improves cough resolution, and further investigations (eg, flexible bronchoscopy, chest CT scans, immunity tests) should be undertaken when specific cough pointers (eg, digital clubbing) are present. When the wet cough does not improve following 4 weeks of antibiotic treatment, there is moderate-quality evidence that further investigations should be considered to look for an underlying disease. New recommendations include the recognition of the clinical diagnostic entity of protracted bacterial bronchitis. CONCLUSIONS: Compared with the 2006 Cough Guidelines, there is now high-quality evidence for some, but not all, aspects of the management of chronic wet cough in specialist settings. However, further studies (particularly in primary health) are required

Counteracting the climate effects of volcanic eruptions using short-lived greenhouse gases

A large volcanic eruption might constitute a climate emergency, significantly altering global temperature and precipitation for several years. Major future eruptions will occur, but their size or timing cannot be predicted. We show, for the first time, that it may be possible to counteract these climate effects through deliberate emissions of short-lived greenhouse gases, dampening the abrupt impact of an eruption. We estimate an emission pathway countering a hypothetical eruption 3 times the size of Mount Pinatubo in 1991. We use a global climate model to evaluate global and regional responses to the eruption, with and without counteremissions. We then raise practical, financial, and ethical questions related to such a strategy. Unlike the more commonly discussed geoengineering to mitigate warming from long-lived greenhouse gases, designed emissions to counter temporary cooling would not have the disadvantage of needing to be sustained over long periods. Nevertheless, implementation would still face significant challenges

Performance and standards for the process of head and neck cancer care: South and West audit of head and neck cancer 1996–1997 (SWAHN I)

Evidence suggests wide variation in cancer care between different hospitals in the UK. To establish bench-marking data, we designed a prospective, 1 year regional study comparing key performance measures with established standards for the 28 hospital Trusts in the South and West of England involved in head and neck cancer care. 566 sequential patients with a newly-diagnosed head and neck cancer were included. Numbers referred and treated per hospital Trust were 1–58 and 1–65 respectively. 59% of patients received a pretreatment chest X-ray (standard 95%). 45% of patients were seen in a multidisciplinary clinic pretreatment (standard 95%), and this was proportional to the frequency of clinics held (P< 0.0001). Median number of cases treated per surgeon was 4 (1–26), and by radiotherapist was 10 (1–51). Times between parts of the process of oral cancer care were closer to the standards than those for laryngeal cancer. Two patients were entered into a clinical trial. One had a quality-of-life score. Thus, in 1996–1997, in the South and West of England, there were major discrepancies between actual performance and established standards in many fundamental aspects of head and neck cancer care. Re-audit is essential to determine if the implementation of the Calman–Hine report has resulted in improvements. © 2000 Cancer Research Campaig