Pathways to research impact in primary healthcare: What do Australian primary healthcare researchers believe works best to facilitate the use of their research findings?

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background Primary healthcare researchers are under increasing pressure to demonstrate measurable and lasting improvement in clinical practice and healthcare policy as a result of their work. It is therefore important to understand the effectiveness of the research dissemination strategies used. The aim of this paper is to describe the pathways for research impact that have been achieved across several government-funded primary healthcare projects, and the effectiveness of these methods as perceived by their Chief Investigators. Methods The project used an online survey to collect information about government-funded primary healthcare research projects. Chief Investigators were asked how they disseminated their findings and how this achieved impact in policy and practice. They were also asked to express their beliefs regarding the most effective means of achieving research impact and describe how this occurred. Results Chief Investigators of 17 projects indicated that a number of dissemination strategies were used but that professional networks were the most effective means of promoting uptake of their research findings. Utilisation of research findings for clinical practice was most likely to occur in organisations or among individual practitioners who were most closely associated with the research team, or when research findings were included in educational programmes involving clinical practice. Uptake of both policy- and practice-related research was deemed most successful if intermediary organisations such as formal professional networks were engaged in the research. Successful primary healthcare researchers had developed critical relationships with intermediary organisations within primary healthcare before the initiation of the research and had also involved them in the design. The scale of research impact was influenced by the current policy environment, the type and significance of the results, and the endorsement (or lack thereof) of professional bodies. Conclusions Chief Investigators believed that networks were the most effective means of research dissemination. Researchers who were embedded in professional, clinical or policy-focussed intermediary organisations, or had developed partnerships with clinical services, which had a vested interest in the research findings, were more able to describe a direct impact of their research. This suggests that development of these relationships and engagement of these stakeholders by primary healthcare researchers is a vital step for optimal research utilisation in the primary healthcare setting

A randomised trial of the Flinders Program to improve patient self-management competencies in a range of chronic conditions: study rationale and protocol

Supporting self management is seen as an important health service strategy in dealing with the large and increasing health burden of chronic conditions. Several types of self-management programs are available. Evidence to date suggests that disease-specific and lay-led self management programs provide only part of the support needed for improved outcomes. The Flinders Program is promising as a generic self management intervention, which can be combined with targeted disease-specific and lay-led interventions, but it has yet to be evaluated for a range of chronic conditions using a rigorous controlled trial design. This paper gives the rationale for a randomised controlled trial and process evaluation of the Flinders Program of chronic condition self-management in community practice, and details and justifies the design of such a study

Promoting Clinical Engagement and Cross-sector Collaboration Through Changes in Workforce, Use of Technology, and Improved Business Systems

Published version made available here with permission from publisher.Background: Cross-sectoral collaboration across health care settings has the potential to deliver efficiencies as well as improve health care outcomes. There is a need for better understanding and awareness of models, mechanisms and strategies that enhance crosssectoral collaboration in Australia. Improved cross-sectoral collaboration is supported by a number of changes in workforce, use of technology and improved business systems. This review seeks to summarise these programs for those who may be seeking to engage in this area as a means of determining the range of options and possible proven benefits. Methodology: This study employs a mixed methods approach. A pragmatic literature review was undertaken to determine the relevant collaborative care models and review current programs Australia-wide that implement these models. Programs were selected from searching the grey and indexed medical literature as well as suggestions obtained from relevant stakeholders. Criteria for inclusion included having description in the peer reviewed and grey literature, ability to represent a unique model, extent of current use and description of outcomes of the intervention. Additional qualitative semi-structured interviews were conducted to elucidate more detailed information about technology, workforce and business systems. This information is summarised in the report and details about the individual programs are included as an appendix to this report. Results: Fifteen models were reviewed for this report. Qualitative semi-structured interview data were employed to supplement findings from the literature review. Key mechanisms of these models are described specifically focusing on the use of technology, workforce and business systems. Facilitators and barriers were identified and explored

Fragmentation in Australian Commonwealth and South Australian State policy on mental health and older people: A governmentality analysis

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(https://us.sagepub.com/en-us/nam/open-access-at-sage).Mental health care for older people is a significant and growing issue in Australia and internationally. This article describes how older people’s mental health is governed through policy discourse by examining Australian Commonwealth and South Australian State government policy documents, and commentaries from professional groups, advocacy groups and non-governmental organisations. Documents published between 2009 and 2014 were analysed using a governmentality approach, informed by Foucault. Discourses of ‘risk’, ‘ageing as decline/dependence’ and ‘healthy ageing’ were identified. Through these discourses, different neo-liberal governmental strategies are applied to ‘target’ groups according to varying risk judgements. Three policy approaches were identified where older people are (1) absent from policy, (2) governed as responsible, active citizens or (3) governed as passive recipients of health care. This fragmented policy response to older people’s mental health reflects fragmentation in the Australian policy environment. It constructs an ambiguous place for older people within neo-liberal governmental rationality, with significant effects on the health system, older people and their carers

What skills do primary health care professionals need to provide effective self-management support?: seeking consumer perspectives

Author version made available in accordance with the publisher's policyObjective This research aimed to identify the skills required by primary health care (PHC) professionals to provide effective chronic condition prevention and self -management (CCPSM) support, according to the perceptions of a sample of Australian consumers and carers. Methods Qualitative data was collected and integrated from a focus group, key informant interviews and National Stakeholder meetings and a National Workshop, supported by an extensive literature review. Results With the exception of health professionals specifically trained or currently working in this area, consumers and carers perceive there is a lack of understanding, competence and practice of CCPSM support among PHC professionals. Discussion The PHC workforce appears not to have the full set of skills needed to meet the growing burden of chronic conditions on the health system. Recommendations include education and training that focuses on improved communication skills, knowledge of community support resources, identification of consumers' strengths and current capacities, collaborative care with other health professionals, consumers and carers, and psychosocial skills to understand the impact of chronic conditions from the person’s perspective

Experiments at the W.M. Keck Observatory to support the Thirty Meter Telescope design work

In order to validate various assumptions about the operating environment of the Thirty Meter Telescope (TMT), to validate the modeling packages being used to guide the design work for the TMT and to directly investigate the expected operation of several subsystems we have embarked on an extensive campaign of environmental measurements at the Keck telescopes. We have measured and characterized the vibration environment around the observatory floor and at certain locations on the telescope over a range of operating conditions. Similarly the acoustic environment around the telescope and primary mirror has been characterized for frequencies above 2 Hz. The internal and external wind and temperature fields are being measured using combined sonic anemometer and PRT sensors. We are measuring the telescope position error and drive torque signals in order to investigate the wind induced telescope motions. A scintillometer mounted on the telescope is measuring the optical turbulence inside the telescope tube. This experimental work is supplemented by an extensive analysis of telescope and engineering sensor log files and measurements, primarily those of accelerometers located on the main telescope optics, primary mirror segment edge sensor error signals (residuals), telescope structure temperature measurements and the telescope status information

Know the Star, Know the Planet. III. A Stellar Companion to the Host Star of the Eccentric Exoplanet HD 8673b

HD 8673 hosts a massive exoplanet in a highly eccentric orbit (e = 0.723). Based on two epochs of speckle interferometry a previous publication identified a candidate stellar companion. We observed HD 8673 multiple times with the 10 m Keck II telescope, the 5 m Hale telescope, the 3.63 m Advanced Electro-Optical System telescope, and the 1.5 m Palomar telescope in a variety of filters with the aim of confirming and characterizing the stellar companion. We did not detect the candidate companion, which we now conclude was a false detection, but we did detect a fainter companion. We collected astrometry and photometry of the companion on six epochs in a variety of filters. The measured differential photometry enabled us to determine that the companion is an early M dwarf with a mass estimate of 0.33–0.45 M_☉. The companion has a projected separation of 10 AU, which is one of the smallest projected separations of an exoplanet host binary system. Based on the limited astrometry collected, we are able to constrain the orbit of the stellar companion to a semimajor axis of 35–60 AU, an eccentricity ≤0.5, and an inclination of 75°–85°. The stellar companion has likely strongly influenced the orbit of the exoplanet and quite possibly explains its high eccentricity

The Lantern Vol. 18, No. 3, Spring 1950

• The Rise and Fall of Mr. Fluff • Thoughts by the Sea • Equality of Men • On Radio Comedians • After Hours • Rain • Morning • Escape from Fear • Book of Red • Poems by a Guy Named Mike • We are the People • Spirit Disrupted • Light • Sonnethttps://digitalcommons.ursinus.edu/lantern/1051/thumbnail.jp