59 research outputs found

    Context and the evidence based paradigm: The potential for participatory research and systems thinking in oral health

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    The implementation of research evidence to promote oral health is critical, given the intransigent and emerging challenges for policy-makers at a population level. Despite this, little attention has been paid to implementation research within the evidence-based paradigm. This is important as getting research evidence into clinical practice is not a linear path that consists of simple sequential steps. In this article, we argue that we need to consider a broader range of conceptual and methodological approaches to increase the value of information generated. This should be undertaken either in parallel with empirical and experimental designs, or in some cases, instead of. This is important if we are going to understand the complexity and contextual knowledge of the ‘system’, within which interventions are implemented. Involving key stakeholders alongside empirical and experimental designs is one helpful approach. Examples of these approaches include Patient and Public Involvement and the development of Core Outcome Sets, where the views of those that will be potentially affected by the research, are included. The use of theoretical frameworks and process evaluations alongside trials are also important, if they are fully integrated into the approach taken to address the research question. A more radical approach is using participatory designs and ‘systems thinking’. Participatory approaches include subject matter 'experts by experience’. These include patients, their families, carers, healthcare professionals, services managers, policy-makers, commissioners and researchers. Participatory approaches raise important questions about who facilitates the process, when it should happen and how the diverse actors become meaningfully engaged so that their involvement is active, democratic and on-going. We argue that the issues of control, power and language are central to this and represent a paradigmatic shift to conventional approaches. Systems thinking captures the idea that public health problems commonly involve multiple interdependent and interconnected factors, which interact with each other dynamically. This approach challenges the simplicity of the hierarchy of evidence and linear sequential logic, when it doesn’t account for context. In contrast, systems thinking accepts complexity de novo and emphasises the need to understand the whole system rather than its individual component parts. We conclude with the idea that participatory and systems thinking helps to unpack the diverse agents that are often involved in the generation and translation of evidence into clinical dental practice. It moves our conception of research away from a simple exchange between ‘knowledge producers’ and ‘knowledge users’ and raises both methodological and epistemological challenges

    The Web@classroom project: portables computers and wireless technology in the classroom

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    The study was carried out in four European schools (pupils age 9 to13 years old) within four countries (Portugal, Spain, UK and Ireland). The adopted methodology was based in action-research procedures and it included multiple methods and techniques: systematic classroom observation of teachers and pupil work and learning activities; documentary evidence (teachers working sheets, schemes of work) interviews (with selected pupils); questionnaires to all pupils and staff at intervals. This methodology implied the construction and testing of data collection instruments. Data was submitted to a qualitative and quantitative analysis. A summary of the findings is presented in this text.The study was carried out in four European schools (pupils age 9 to13 years old) within four countries (Portugal, Spain, UK and Ireland). The adopted methodology was based in action-research procedures and it included multiple methods and techniques: systematic classroom observation of teachers and pupil work and learning activities; documentary evidence (teachers working sheets, schemes of work) interviews (with selected pupils); questionnaires to all pupils and staff at intervals. This methodology implied the construction and testing of data collection instruments. Data was submitted to a qualitative and quantitative analysis. A summary of the findings is presented in this text

    A randomised trial of robotic and open prostatectomy in men with localised prostate cancer

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    Background: Prostate cancer is the most common male cancer in the Western world however there is ongoing debate about the optimal treatment strategy for localised disease. While surgery remains the most commonly received treatment for localised disease in Australia more recently a robotic approach has emerged as an alternative to open and laparoscopic surgery. However, high level data is not yet available to support this as a superior approach or to guide treatment decision making between the alternatives. This paper presents the design of a randomised trial of Robotic and Open Prostatectomy for men newly diagnosed with localised prostate cancer that seeks to answer this question.Methods/design: 200 men per treatment arm (400 men in total) are being recruited after diagnosis and before treatment through a major public hospital outpatient clinic and randomised to 1) Robotic Prostatectomy or 2) Open Prostatectomy. All robotic prostatectomies are being performed by one surgeon and all open prostatectomies are being performed by one other surgeon. Outcomes are being measured pre-operatively and at 6 weeks and 3, 6, 12 and 24 months post-surgery. Oncological outcomes are being related to positive surgical margins, biochemical recurrence +/- the need for further treatment. Non-oncological outcome measures include: pain, physical and mental functioning, fatigue, summary (preference-based utility scores) and domain-specific QoL (urinary incontinence, bowel function and erectile function), cancer specific distress, psychological distress, decision-related distress and time to return to usual activities. Cost modelling of each approach, as well as full economic appraisal, is also being undertaken.Discussion: The study will provide recommendations about the relative benefits of Robotic and Open Prostatectomy to support informed patient decision making about treatment for localised prostate cancer; and to assist in treatment services planning for this patient group.Trial registration: ACTRN12611000661976

    Offering fragile X syndrome carrier screening: a prospective mixed-methods observational study comparing carrier screening of pregnant and non-pregnant women in the general population

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    Article focusâ–Ș This article is a protocol of a study that involves&nbsp;offering fragile X syndrome carrier screening to&nbsp;pregnant and non-pregnant women in the&nbsp;general population. We are undertaking a programme&nbsp;evaluation approach using mixed&nbsp;methods to collect data about informed decisionmaking&nbsp;and predictors of test uptake, with a&nbsp;focus on psychosocial measures. We are also&nbsp;undertaking an economic appraisal.Key messagesâ–Ș Carrier screening for fragile X syndrome is the&nbsp;subject of debate because of concerns around&nbsp;education and counselling for this complex conditionand the potential for psychosocial harms. â–Ș This study will inform policy and practice in the&nbsp;area of population carrier screening by examining&nbsp;psychosocial aspects of screening, including&nbsp;informed decision-making; models of screening,&nbsp;through antenatal care or other access points&nbsp;and health economics of carrier screening for&nbsp;fragile X syndrome.Strengths and limitations of this studyâ–Ș This study seeks to recruit 1000 women in total.&nbsp;This large sample size will give us sufficient&nbsp;power to address the aims of the study.â–Ș Collecting quantitative and qualitative data will&nbsp;provide a more in-depth picture of screening for&nbsp;fragile X syndrome.â–Ș A limitation of the study is that the data on&nbsp;models of screening may not be applicable to&nbsp;other countries that have different healthcare&nbsp;systems.</div

    Mobilising Knowledge through Global Partnerships to Support Research-informed Teaching: Five Models for Translational Research

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    Education Futures Collaboration Charity The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Improving the quality of teaching is of global concern: UNESCO’s Sustainable Development Goal (SDG) 4c in the Education 2030: Framework for Action calls for high quality teaching for all. The OECD challenges the education system to improve Knowledge Management. JET’s (2015) special issue: Translational Research (TR) and Knowledge Mobilisation in Teacher Education introduced the concept of ‘translational’ or ‘theory to practice’ research - well-established in medicine but not in education. Five TR models were subsequently developed by the MESH charity’s international network with organisations in South Africa, Bangladesh, Australia, Pakistan, UK. These distinct models engage 1) university staff and teachers 2) subject associations, 3) research units, 4) an international NGO working in crisis settings, 5) PhD tutors and students. Each model shares common features forming the MESH Translational Research methodology introduced in this article. A TR repository is part of the MESH knowledge mobilisation strategy giving teachers access to research summaries which, overtime, accumulate knowledge. TR publications called MESHGuides (www.meshguides.org) complement existing forms of publication. This article proposes the MESH TR methodology as one affordable and scalable solution to OECD and UNESCO’s challenges of keeping teachers up-to-date and making new knowledge accessible to teachers regardless of location

    Cohort profile for the STratifying Resilience and Depression Longitudinally (STRADL) study:A depression-focused investigation of Generation Scotland, using detailed clinical, cognitive, and neuroimaging assessments

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    Grant information: STRADL is supported by the Wellcome Trust through a Strategic Award (104036/Z/14/Z). GS:SFHS received core support from the CSO of the Scottish Government Health Directorates (CZD/16/6) and the Scottish Funding Council (HR03006). ADM is supported by Innovate UK, the European Commission, the Scottish Funding Council via the Scottish Imaging Network SINAPSE, and the CSO. HCW is supported by a JMAS SIM Fellowship from the Royal College of Physicians of Edinburgh, by an ESAT College Fellowship from the University of Edinburgh, and has received previous funding from the Sackler Trust. LR has previously received financial support from Pfizer (formerly Wyeth) in relation to imaging studies of people with schizophrenia and bipolar disorder. JDH is supported by the MRC. DJM is an NRS Clinician, funded by the CSO. RMR is supported by the British Heart Foundation. ISP-V and MRM are supported by the NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health; and MRM is also supported by the MRC MC_UU_12013/6). JMW is supported by MRC UK Dementia Research Institute and MRC Centre and project grants, EPSRC, Fondation Leducq, Stroke Association, British Heart Foundation, Alzheimer Society, and the European Union H2020 PHC-03-15 SVDs@Target grant agreement (666881). DJP is supported by Wellcome Trust Longitudinal Population Study funding (216767/Z/19/Z) the Eva Lester bequest to the University of Edinburgh. AMM is additionally supported by the MRC (MC_PC_17209, MC_PC_MR/R01910X/1, MR/S035818/1), The Wellcome Trust (216767/Z/19/Z ), The Sackler Trust, and has previously received research funding from Pfizer, Eli Lilly, and Janssen. Both AMM and IJD are members of The University of Edinburgh Centre for Cognitive Ageing and Cognitive Epidemiology, part of the cross council Lifelong Health and Wellbeing Initiative (MR/K026992/1); funding from the BBSRC and MRC is gratefully acknowledged. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscriptPeer reviewedPublisher PD

    A university-based model for supporting computer science curriculum reform

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    Computer science curriculum reform in the United Kingdom has been subject to substantial scrutiny—as it has in many other countries around the world—with England introducing a radical new computing curriculum from September 2014. However, in Wales—a devolved nation within the UK—political, geographical and socio-cultural issues have to date hindered any substantive educational policy or curriculum reform for computer science. In this paper, we present the activities of Technocamps, a national university-based schools outreach programme founded in 2003, and consider its wider impact on computer science education, schools, pupils and teachers in Wales. In contrast to successful interventions elsewhere in the UK in building and sustaining communities of practice, certain political and cultural challenges in Wales have largely prevented these successful models from being adopted. Through the consideration of the national case study presented in this paper, we demonstrate the necessity of the nation-wide school- and student-focused Technocamps model in building resilient and scalable practitioner-led support networks. Furthermore, with emerging curriculum reform in Wales, we frame the wider opportunity for computer science education and sustainably embedding cross-curricular digital competencies—along with changing the wider public perception and perceived value of computer science as an academic discipline—as a prospective replicable case study of a national engagement model for nations with similar aspirations of developing digitally confident and capable citizens. To this end, we conclude by drawing out the important lessons learnt for consideration when embarking on a programme of national curriculum reform and associated professional development

    Your professional development

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    This final chapter guides Higher Level Teaching Assistants through the choices available for their professional development including the use of ICT, career development frameworks and routes to Qualified Teacher Status
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