Using a Mixed-Methods Approach to Develop an Evidence-Based Intervention to Improve Understanding of Medication Risks and Benefits in a Multiple Sclerosis Patient Population

This research project case focuses on designing an evidence-based intervention that could improve understanding of patients with multiple sclerosis about treatment risks and benefits. The case provides an overview of multiple sclerosis and the kinds of treatments that patients may take when they are diagnosed with this condition. The background of this research also explores why understanding treatment information is important. We then discuss how we employ different methodologies to ensure that we develop an effective evidence-based intervention for patients, namely, systematic reviews, surveys, experiments, and a crossover randomized controlled trial. As our research project is conducted with a patient population, this research case also explores the challenges faced while conducting research with patients

Using a Mixed-Methods Approach to Develop an Evidence-Based Intervention to Improve Understanding of Medication Risks and Benefits in a Multiple Sclerosis Patient Population

This research project case focuses on designing an evidence-based intervention that could improve understanding of patients with multiple sclerosis about treatment risks and benefits. The case provides an overview of multiple sclerosis and the kinds of treatments that patients may take when they are diagnosed with this condition. The background of this research also explores why understanding treatment information is important. We then discuss how we employ different methodologies to ensure that we develop an effective evidence-based intervention for patients, namely, systematic reviews, surveys, experiments, and a crossover randomized controlled trial. As our research project is conducted with a patient population, this research case also explores the challenges faced while conducting research with patients

Building improvement capability in frontline staff: a UK perspective

This paper gives a narrative account of how the Oxford Healthcare Improvement Centre has embedded continuous quality improvement (CQI) across both mental health and community services in Oxford, UK. The aim of the centre is to develop capability across healthcare services, with frontline staff leading CQI independently. The paper discusses the various methods employed to achieve this aim, including the provision of training, mentoring and support to those undertaking improvement work, alongside developing the required governance for CQI

Environmental changes to reduce self-harm on an adolescent inpatient psychiatric ward: an interrupted time series analysis

Existing interventions to reduce self-harm in adolescents admitted to psychiatric wards are usually focused on individual psychological treatments. However, the immediate ward environment in which treatment takes place is an important factor in the success of the treatment and can also influence the likelihood of self-harming behaviours. The aim of the current study was to evaluate changes made to a psychiatric ward environment on incidence of self-harm in adolescents. A quasi-experimental interrupted time series study was conducted on one child and adolescent psychiatric ward. An intervention was developed alongside staff and patients to address the high incidence of self-harm on weekday evenings on the ward. The intervention components involved adding a regular twilight shift (3-11 pm) for nursing staff and introducing a structured evening activity programme on the ward. A segmented regression analysis of an interrupted time series found that the rate of self-harm per 100 bed days was already declining at baseline and continued to decline post-intervention, but the rate of decline was not significant (p = 0.415). However, the proportion of patients self-harming was increasing at baseline and significantly reduced post-intervention (p = 0.001), and this reduction was significantly larger in the evenings (p = 0.004) compared to other times of day (p = 0.09). A tailored intervention targeting the psychiatric ward environment helped to reduce the proportion of adolescents self-harming on the ward. An interrupted time series analysis should be considered for future interventions making changes to health systems over time

Hybridisation of Australian chickpea cultivars with wild Cicer spp. increases resistance to root-lesion nematodes (Pratylenchus thornei and P. neglectus)

Australian and international chickpea (Cicer arietinum) cultivars and germplasm accessions, and wild annual Cicer spp. in the primary and secondary gene pools, were assessed in glasshouse experiments for levels of resistance to the root-lesion nematodes Pratylenchus thornei and P. neglectus. Lines were grown in replicated experiments in pasteurised soil inoculated with a pure culture of either P. thornei or P. neglectus and the population density of the nematodes in the soil plus roots after 16 weeks growth was used as a measure of resistance. Combined statistical analyses of experiments (nine for P. thornei and four for P. neglectus) were conducted and genotypes were assessed using best linear unbiased predictions. Australian and international chickpea cultivars possessed a similar range of susceptibilities through to partial resistance. Wild relatives from both the primary (C. reticulatum and C. echinospermum) and secondary (C. bijugum) gene pools of chickpea were generally more resistant than commercial chickpea cultivars to either P. thornei or P. neglectus or both. Wild relatives of chickpea have probably evolved to have resistance to endemic root-lesion nematodes whereas modern chickpea cultivars constitute a narrower gene pool with respect to nematode resistance. Resistant accessions of C. reticulatum and C. echinospermum were crossed and topcrossed with desi chickpea cultivars and resistant F 4 lines were obtained. Development of commercial cultivars with the high levels of resistance to P. thornei and P. neglectus in these hybrids will be most valuable for areas of the Australian grain region and other parts of the world where alternating chickpea and wheat crops are the preferred rotatio