Where do we go from here? - Opportunities and barriers to the career development of trial managers: a survey of UK-based trial management professionals

BackgroundClinical trials commonly have a dedicated trial manager and effective trial management is essential to the successful delivery of high-quality trials. Trial managers have diverse experience and currently there is no standardised structured career pathway. The UK Trial Managers’ Network (UKTMN) surveyed its members to understand what is important to them with respect to career development since this would be important in the development of any initiative intended to develop a skilled workforce.MethodsWe conducted an online survey of UKTMN members, who are trial management professionals, working on academic-led trials in the UK. Members were asked what they perceive as opportunities and barriers to career development. Two reminders were sent to facilitate completion of the survey, and responders were offered the opportunity to enter a prize draw for waived fees at the UKTMN annual meeting. Data were analysed descriptively by using Stata (version 15.1), and free-text responses were reviewed for themes.ResultsThe survey was sent to 819 UKTMN members; 433 responses were received, although 13 were from non-UKTMN members; thus 420 respondents' data were included in analyses. Respondents were representative of UKTMN membership; however, more responses were received by trial managers based in registered clinical trials units (CTUs). The top three opportunities for career development were (i) training, (ii) helping design trials and (iii) undertaking relevant qualifications. The top three barriers were (i) funding, (ii) few opportunities to get involved in development activities aside from managing a trial and (iii) unclear organisational career pathway. Almost all respondents (401/420, 95.4%) considered career development either very or quite important. Although all respondents had a day-to-day role in managing trials, there was huge disparity between job titles.ConclusionCareer development is important to trial managers yet there is a lack of a structured pathway. The enablers and disablers to career development for trial managers should be clearly considered by the clinical trial community and, in particular, employers, sponsors and funders in order to develop a highly skilled workforce of trial managers, who are key to the delivery of trials

A cross-sectional survey investigating the desensitisation of graphic health warning labels and their impact on smokers, non-smokers and patients with COPD in a London cohort.

OBJECTIVES: There is a lack of evidence regarding the effectiveness of graphic health warning labels (GHWL) in different individuals, including patients with chronic obstructive pulmonary disease (COPD). Investigating knowledge and attitudes may allow better implementation of future public health policies. We hypothesised that differences in the impact of GHWL exist between non-smokers, smokers and patients with COPD, with decreased efficacy in those groups who are longer and more frequently exposed to them. PARTICIPANTS AND SETTING: 163 participants (54% male, aged 21-80) including 60 non-smokers, 53 smokers and 50 patients with COPD (Gold stage II-IV), attending London respiratory outpatient clinics, participated in case-controlled surveys (50 items). OUTCOME MEASURES: Ten different GHWL were shown and demographics, smoking history, plans to quit, smoking-risk awareness, emotional response, processing and impact of GHWL on behaviour were recorded. Patients were further asked to prioritise the hypothetical treatment or prevention of five specific smoking-related diseases. RESULTS: Smokers, in particular those with COPD, were less susceptible to GHWL than non-smokers; 53.4% of all participants expressed fear when looking at GHWL, non-smokers (71.9%) more so than smokers (39.8%, p<0.001). COPD participants were less aware of the consequences than non-COPD participants (p<0.001), including an awareness of lung cancer (p=0.001). Lung cancer (95%), oral cancer (90.2%), heart disease (84.7%) and stroke (71.2%) were correctly associated with smoking, whereas blindness was least associated (23.9%). However, blindness was prioritised over oral cancer, stroke and in patients with COPD also over heart disease when participants were asked about hypothetical treatment or prevention. CONCLUSIONS: GHWL are most effective in non-smokers and a desensitisation effect was observed in smokers and patients with COPD. As a consequence, a tailored and concerted public health approach to use such messages is required and 'blindness' deserves to be mentioned in this context because of an unexpectedly high-deterring impact

Clinical trial management: a profession in crisis?

Clinical Trial Managers play a vital role in the design and conduct of clinical trials in the UK. There is a current recruitment and retention crisis for this specialist role due to a complex set of factors, most likely to have come to a head due to the Covid-19 pandemic. Academic clinical trials units and departments are struggling to recruit trial managers to vacant positions, and multiple influences are affecting the retention of this highly skilled workforce. Without tackling this issue, we face major challenges in delivery on the Department of Health and Social Care’s Future of UK Clinical Research Delivery implementation plan. This article, led by a leading network of and for UK Trial Managers, presents some of the issues and ways in which national stakeholders may be able to address this

The COVID University Challenge: A hazard analysis of critical control points assessment of the return of students to higher education establishments

The COVID-19 pandemic has disrupted economies and societies throughout the world since early 2020. Education is especially affected, with schools and universities widely closed for long periods. People under 25 years have the lowest risk of severe disease but their activities can be key to persistent ongoing community transmission. A challenge arose for how to provide education, including university level, without the activities of students increasing wider community SARS-CoV-2 infections. We used a Hazard Analysis of Critical Control Points (HACCP) framework to assess the risks associated with university student activity and recommend how to mitigate these risks. This tool appealed because it relies on multiagency collaboration and interdisciplinary expertise and yet is low cost, allowing rapid generation of evidence-based recommendations. We identified key critical control points associated with university student’ activities, lifestyle, and interaction patterns both on-and-off campus. Unacceptable contact thresholds and the most up-to-date guidance were used to identify levels of risk for potential SARS-CoV-2 transmission, as well as recommendations based on existing research and emerging evidence for strategies that can reduce the risks of transmission. Employing the preventative measures we suggest can reduce the risks of SARS-CoV-2 transmission among and from university students. Reduction of infectious disease transmission in this demographic will reduce overall community transmission, lower demands on health services and reduce risk of harm to clinically vulnerable individuals while allowing vital education activity to continue. HACCP assessment proved a flexible tool for risk analysis in a specific setting in response to an emerging infectious disease threat. Systematic approaches to assessing hazards and risk critical control points (#HACCP) enable robust strategies for protecting students and staff in HE settings during #COVID19 pandemic

Patient safety education at Japanese nursing schools: results of a nationwide survey

<p>Abstract</p> <p>Background</p> <p>Patient safety education is becoming of worldwide interest and concern in the field of healthcare, particularly in the field of nursing. However, as elsewhere, little is known about the extent to which nursing schools have adopted patient safety education into their curricula. We conducted a nationwide survey to characterize patient safety education at nursing schools in Japan.</p> <p>Results</p> <p>Response rate was 43% overall. Ninety percent of nursing schools have integrated the topic of patient safety education into their curricula. However, 30% reported devoting less than five hours to the topic. All schools use lecture based teaching methods while few used others, such as role playing. Topics related to medical error theory are widely taught, e.g. human factors and theories & models (Swiss Cheese Model, Heinrich's Law) while relatively few schools cover practical topics related to error analysis such as root cause analysis.</p> <p>Conclusions</p> <p>Most nursing schools in Japan cover the topic of patient safety, but the number of hours devoted is modest and teaching methods are suboptimal. Even so, national inclusion of patient safety education is a worthy, achievable goal.</p

User participation in urban green commons : exploring the links between access, voluntarism, biodiversity and well being

Polycentric governance and stakeholder participation in natural resource management have potential benefits for both human and environmental well-being. Researchers and decision-makers have attempted to conceptualise the ecological, social and political potential of such semi-formal approaches to urban green space management. However, few studies have quantified the actual benefits in terms of biodiversity and associated ecosystem service provision, or the factors that mediate levels of participation. The links between biodiversity potential, site access and user participation were explored in a case study comprising ten established examples of organised social-ecological initiatives in the inner-city area of Greater Manchester. At the micro-scale, the case study quantified the levels of community involvement (measured in volunteer hours month¯¹) in local green commons and the biodiversity potential (assessed using floristic and structural diversity as a surrogate) of the ten sites. Descriptive analysis identified that site spatial and design characteristics affected all three measures and subsequent correlational analyses revealed a high degree of synergy between site use and biodiversity. The study thereby provides quantitative evidence of the synergistic relationship between green space use and urban biodiversity and, importantly, the positive feedbacks which should result between volunteer input and the local generation of ecosystem services. The study provides support for the promotion of a highly decentralised, stakeholder-led stewardship of green space as a valid consideration in the management of urban ecosystem services

The tobacco industry’s challenges to standardised packaging : A comparative analysis of issue framing in public relations campaigns in four countries

Tobacco industry public relations campaigns have played a key role in challenges to standardised cigarette packaging. This paper presents a comparative analysis of industry campaigns in Australia and the United Kingdom, which have implemented standardised packaging legislation; Canada, where policy has been adopted but not yet implemented; and the Netherlands, which has considered, but not enacted regulation. Campaigns were identified via Google searches, tobacco industry websites, media coverage, government submissions and previous research; analysis focused on issue framing and supporting evidence. Public relations campaigns in all case study countries drew on similar frames - the illicit trade in tobacco products, the encroaching 'nanny state', lack of evidence for the effectiveness of standardised packaging, a slippery slope of regulation, and inherent threats to intellectual property rights. These claims were supported by industry research, front groups and commissioned reports by accountancy firms, but were not with verifiable research. Independent evidence that contradicted industry positions was overlooked. Similarities in structure and content of public relations campaigns in countries that have enacted or considered regulation points to a strategic co-ordinated approach by cigarette manufacturers. Countries considering standardised packaging policy can expect powerful opposition from the tobacco industry. Tobacco control communities and policy makers can learn from previous experience, and share best practise in countering industry arguments

On the fallibility of human memory for future actions

Human memory is a system that is inherently fallible and prone to distortion, and our memory for future actions is no exception. Prospective memory is defined either as remembering to carry out a task at a particular moment in the future or as the timely execution of a previously formed intention. For a variety of reasons, one may miss this prearranged moment and thus fail to fulfill an intention. This thesis focuses on the factors that may affect the fulfilment of a delayed intention and contribute to prospective memory failures. As the rather scant literature on the effect of stress on prospective memory functioning has produced contradictory findings, Part One of this Thesis investigates the role of stress in prospective memory failures in a strict sense, namely forgetting to carry out intended actions at the appointed time and place. One study involving healthy participants examines the disruptive effect of daily stress on prospective memory functioning and explores the moderating role of individual factors in modulating the harmful consequences associated with stress in everyday life. Another study carried out with healthcare workers investigates how work stress and burnout may contribute to forgetting clinical tasks, which may result in potential adverse events jeopardizing patient safety. Besides stress, misremembering future intentions may also arise from the lingering effect of misinformation on our memory, attitudes, and behaviors. Part Two of this Thesis, encompassing 6 experiments on healthy participants, shows how inaccurate and invalid information survive despite sophisticated correction attempts, influencing memory and reported future intentions. Overall, the results of the studies presented in this Thesis prove the fallibility of our memory for future actions. Various techniques to reduce the risks associated with memory failures are discussed

Western Wakefield district District local plan: draft proposals report

Inclds. mapsSIGLELD:f83/5761 / BLDSC - British Library Document Supply CentreGBUnited Kingdo