HRB open research最新文献

Student carers in higher education institutions (HEIs) is an emerging policy issue in many countries. Researchers have sought to synthesise the literature on student carers in HEIs. Runacres et al. (2024) conducted a scoping review, which included 14 studies, and Knopf et al. (2022) conducted a systematic review of university students who are caring for an older adult, which included six studies. These reviews identified some key themes discussed in the literature. However, there are further areas of discussion that have yet to be explored in the evidence to date. This observation is in the context of a growing body of international literature published on the topic and the greater visibility of family carers post-pandemic. One key area yet to be examined is the policy and practice responses to student carers in HEIs in different countries. The scope of this review will be broader than previous reviews with a specific focus on policy and practice responses regarding this population. This scoping review will: examine definitional issues concerning student carers in HEIs; summarise studies from different countries that provide estimates of the number of student carers in HEIs; identify theoretical perspectives and concepts underpinning research on this topic; and assess the available evidence on the value and outcomes of supports. The 5-stage methodological framework developed by Arksey and O'Malley (2005) will be used to guide this scoping review, as described in detail in this protocol. The findings of the scoping review will be used to inform the enhancement of supports for student carers in HEIs. A range of vehicles will be used to disseminate the findings, including conference presentations, publication in an international peer-reviewed journal, and preparation of a policy brief to disseminate the findings of this scoping review to policymakers and other relevant stakeholders.

Background: Individuals with first-episode psychosis (FEP) face an increased risk of physical comorbidities, notably cardiovascular diseases, metabolic disorders, respiratory disorders, and certain types of cancer. Previous reviews report pooled physical health prevalence from chronic psychosis and FEP groups. By contrast, this review will focus on antipsychotic-naïve FEP cohorts and incorporate data from observational longitudinal studies and antipsychotic intervention studies to understand the progression of physical health comorbidities from the onset to later stages of psychosis. This review aims to examine the short-, medium-, and long-term period prevalence of these comorbidities in FEP and variations related to demographic factors.

Methods: Using the PRISMA and MOOSE guidelines, Medline, Embase, PsycINFO, and CINAHL+, as well as Clinical Trials gov.uk, OpenGrey, WHO International Clinical Trials Registry Platform, Current Controlled Trials, United States National Institute of Health Trials Registry, and the Irish Health Repository, will be searched from inception. Longitudinal studies and antipsychotic intervention studies monitoring health outcomes in antipsychotic naïve FEP individuals will be eligible for inclusion. Two reviewers will independently screen titles, abstracts, and full-text articles. Risk of bias will be assessed using the Joanna Briggs Institute Critical Appraisal Checklist. A meta-analysis of the short-, medium-, and long-term prevalence of cardiovascular, metabolic, cancer, and respiratory outcomes and a narrative synthesis will be conducted. Where feasible, a meta-regression on the impact of demographic variables will be conducted. Potential limitations include the risk of diagnostic heterogeneity across studies and possible underreporting of certain comorbidities.

Conclusions: This systematic review will clarify the progression of physical health comorbidities in FEP, informing early intervention strategies and policies. Subsequent findings will be submitted to a leading journal, supplemented by a recovery education module and a lay summary for wider dissemination.

Registration: The study was registered in PROSPERO, the International Prospective Register of Systematic Reviews ( CRD42023431072; 17/06/2023).

Background: Breastfeeding rates in Ireland are among the lowest in the world. Lactation consultancy provides mothers with support and information on how to cope with any challenges they encounter. There is emerging evidence that COVID-19 restrictions impacted access to and the quality of breastfeeding support.The aim of this study was to explore breastfeeding mothers' and lactation consultants' experiences of breastfeeding support throughout the COVID-19 restrictions in Ireland. It also aimed to explore what adaptations had to be made to the delivery of lactation consultancy and how these changes impacted mothers' experiences of breastfeeding support.

Methods: A qualitative research design was chosen. Semi-structured interviews were conducted with eight participants, three breastfeeding mothers and five lactation consultants. Interviews were conducted online via Zoom, audio-recorded and transcribed. The data were analysed using thematic analysis.

Results: Five key themes were identified: 'Lack of Support', 'Adapting to COVID-19 Restrictions', Emotional Response to COVID-19 and Restrictions', Vaccination against SARS-CoV-2 as a Barrier to and Facilitator of Support' and Inconsistency of Lactation Support Across Ireland'. Both lactation consultants and mothers identified similar issues however, slight variations within lactation consultants' perceptions of mothers' and mothers' attitudes towards online services were seen. An notable finding was the lack of support in hospitals pre-COVID-19.

Conclusions: Both mothers' and lactation consultants' experiences of lactation consultancy were impacted by the COVID-19 restrictions. Although exacerbated by COVID-19, the lack of support in hospitals existed before COVID-19. Provision of better breastfeeding support is required.Increased availability of lactation consultants and the implementation of breastfeeding rooms within hospitals is required in addition to debrief counselling sessions for lactation consultants. Further research is required to understand the unavailability of lactation consultants in hospital settings and to identify how to manage breastfeeding support in future emergency situations.

Background: Patient safety is a key issue for health systems and a growing global public health challenge. Administrative healthcare data provide a coded summary of a patient and their encounter with the healthcare system. These aggregated datasets are often used to inform research and decisions relating to health service planning and therefore it is vital that they are accurate and reliable. Given the reported inaccuracy of these datasets for detecting and recording adverse events, there have been calls for validation studies to explore their reliability and investigate further their potential to inform research and health policy. Researchers have since carried out validation studies on the rates of adverse events in administrative data through chart reviews therefore, it seems appropriate to identify and chart the evidence and results of these studies within a scoping review.

Methods: The scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. A search of databases such as PubMed, CINAHL, ScienceDirect and Scopus will be conducted in addition to a search of the reference lists of sourced publications and a search for grey literature. Following this, Covidence will be used to screen the sourced publications and subsequently extract data from the included sources. A numerical summary of the literature will be presented in addition to a charting based on the qualitative content analysis of the studies included.

Conclusions: This protocol provides the structure for the conduct of a review to identify and chart the evidence on validation studies on rates of adverse events in administrative healthcare data. This review will aim to identify research gaps, chart the evidence of and highlight any flaws within administrative datasets to improve extraction and coding practices and enable researchers and policy makers to use these data to their full potential.

Background: People who are homeless are more likely to experience poor mental health and addiction as well as suffering from non-communicable diseases. There is evidence of frailty and accelerated physical ageing among people experiencing homelessness. Appropriate physical rehabilitation and nutritional supplementation strategies can stabilise or reverse frailty and general physical decline, but it is not known how this type of intervention would work in practice in this population.

Aim: To evaluate the feasibility and pre-post intervention impact of a low threshold physical rehabilitation intervention with protein supplementation to target physical functioning and frailty in people with problematic substance use who are experiencing homelessness.

Methods: The intervention will consist of a 12-week low threshold rehabilitation programme with protein supplementation. Participants will be service users of the Ballyfermot Advance Project, a day services centre for people with addiction issues and experiencing homelessness. Primary outcomes will be feasibility including numbers recruited, retention of participants and adherence to the exercise intervention and protein supplement. Any adverse events will be recorded. Secondary outcomes will be strength and muscular mass, physical performance and lower extremity physical function, pain, frailty and nutritional status.

Discussion: An immediate impact may be simply a distraction from difficult circumstances and potentially an improvement of physical health of participants, which can be a conduit for the emergence of other positive behaviours and recovery. Longer term, this study will generate preliminary data on which to inform the design of a definitive randomised controlled trial of physical rehabilitation and protein supplementation, if indicated.

Ethics and dissemination: Ethical approval was granted by the Faculty of Health Sciences Research Ethics Committee in TCD. Study findings will be disseminated through publication into an international peer-reviewed journal and presented at national and international conferences.

Background: HIV pre-exposure prophylaxis (PrEP) is a medication that prevents the acquisition of HIV, most commonly taken in the form of a pill. PrEP is an efficacious tool for HIV prevention, including among gay, bisexual, and other men who have sex with men (gbMSM). PrEP is often provided through formal PrEP programmes. Research on these programmes may employ discourses shaped by heteronormativity and homophobia. Given that expert language influences how HIV prevention is understood and delivered, problematic discourses in research likely extend into PrEP implementation. This study will use critical discourse analysis (CDA) to explore research on PrEP programme implementation for gbMSM. Within this literature, we will identify interpretive repertoires used to discuss gbMSM; the subject positions afforded to gbMSM; and the implications of these interpretive repertoires and subject positions for gbMSM engaging with HIV PrEP programmes.

Methods: Systematic search methods identified relevant articles through timebound searching (2012-2023) in ProQuest ASSIA, EBSCOhost PsycInfo, OVID Medline, OVID Embase, and EBSCOhost CINAHL, with forward and backward citation searching of included studies. Grey literature will be identified through ProQuest and Google Scholar. Screening will be conducted by two independent reviewers, who will conduct random partial double screening for titles and abstracts and for all full text articles. Data will be analysed and synthesised using CDA informed by critical realism (CR). CDA focuses on relationships between language and power, including how language enables inequality. The analytic process will explore the background of included studies, identify themes, and analyse external and internal relations in included studies.

Conclusions: Highlighting issues with discourses in PrEP implementation may enhance reflective engagement with assumptions underlying this research, preventing further stigmatisation of gbMSM's sexual and protective practices. As PrEP programmes become more common, diverse and inclusive perspectives in PrEP programme research may inform interventions that enhance their acceptability and implementation.

Background: Scientific publications have been growing exponentially, contributing to an oversaturated information environment. Quantifying a research output's impact and reach cannot be solely measured by traditional metrics like citation counts as these have a lag time and are largely focused on an academic audience. There is increasing recognition to consider 'alternative metrics' or altmetrics to measure more immediate and broader impacts of research. Better understanding of altmetrics can help researchers better navigate evolving information environments and changing appetites for different types of research.

Objectives: Our study aims to: 1) analyse the amount and medium of Altmetric coverage of health research produced by Irish organisations (2017 - 2023), identifying changes over time and 2) investigate differences in the amount of coverage between clinical areas (e.g., nutrition vs. neurology).

Methods: Using Altmetric institutional access, we will gather data on research outputs published 1 January 2017 through 31 December 2023 from active Irish organisations with Research Organisation Registry (ROR) IDs. Outputs will be deduplicated and stratified by their Australian and New Zealand Standard Research Classification relating to ≥1 field of health research: Biological Sciences, Biomedical and Clinical Sciences, Chemical Sciences, Health Sciences, and Psychology. We will clean data using R and perform descriptive analyses, establishing counts and frequencies of coverage by clinical area and medium (e.g., traditional news, X, etc.); data will be plotted on a yearly and quarterly basis where appropriate.

Results and conclusions: Improved understanding of one's information environment can help researchers better navigate their local landscapes and identify pathways for more effective communication to the public. All R code will be made available open-source, allowing researchers to adapt it to evaluate their local landscapes.

Background: Data and Safety Monitoring is integral to quality assurance of clinical trials. Although monitoring is a core legal component of regulated clinical trials, non-regulated trials are not mandated to incorporate monitoring. Consequently, the monitoring process has been underutilised and underreported in this setting. This research report outlines the development and plans for implementing a bespoke Clinical Monitoring Strategy within the ' Rehabilitation Strategies Following Oesophagogastric and Hepatopancreaticobiliary Cancer (ReStOre II) Trial', a non-regulated trial comparing a 12-week multidisciplinary programme of rehabilitation to standard care in a cohort of 120 cancer survivors.

Methods: This research note provides a detailed overview of the ReStOre II Clinical Monitoring Strategy and describes the development of the strategy pre and post awarding of the grant. The strategy consists of the establishment and implementation of a comprehensive trial governance structure, inclusive of a Trial Management Group, Trial Steering Committee Meeting, and Independent Data Monitoring Committee. In addition, external trial monitoring by the Clinical Research Facility at St James's Hospital. Three monitoring visits will be conducted during the trial; i) site initiation visit, ii) interim monitoring visit, and iii) close our visit.

Results: The Clinical Monitoring Strategy has been finalised and is currently being implemented within the ReStOre II Trial. Two site initiation visits and one interim monitoring visit have been completed to date.

Conclusion: This research note provides a template for implementation of a Clinical Monitoring Strategy in a non-regulated clinical trial.

Registration: ReStOre II Trial: https://clinicaltrials.gov/ct2/show/NCT03958019.

Background: In areas of social disadvantage up to 40-50% of children enter preschool with speech and language skills significantly poorer than would be expected for their age. The Happy Talk trial tests if a community embedded, targeted selective speech and language programme that simultaneously engages with parents and early childhood educators, (1) improves language outcomes in children aged between 2 years 10 months and 6 years and (2) is cost effective for the health care system.

Method: The Happy Talk trial is a large scale cluster randomised trial of a 12-week manualised intervention delivered in pre/school settings serving socially disadvantaged communities, in Ireland. Seventy-two clusters will receive the intervention (12 participants per cluster). Parents and pre/school staff engage in group training and coaching in the form of 12 1-hour sessions for parents and four staff workshops, over the course of the pre/school year. Training/coaching includes core interaction skills (modelling, expanding, balancing questions and comments), early literacy and phonological awareness. Blinded assessments pre- and immediately post-intervention and at 6 months follow up, will measure the primary outcomes of children's receptive and expressive language and functional impact, and secondary outcomes of quality of life. Parental responsiveness and educator-child interactions will also be evaluated.

Discussion: This robust study evaluates a public health approach to the delivery of speech language and communication intervention in the 'real world' in the community, which focuses on prevention and equity of access. Pilot work indicates that the programme is feasible, acceptable to parents and staff, cost effective, and suitable for implementation at scale. The trial includes a process evaluation, a well-developed economic evaluation and the outcomes are directly relevant to children, families and educators. This work has the potential to improve the long-term outcomes and life chances of people living in social disadvantage.

Trial registration: clinicaltrials.gov NCT06460090.

Trial management: There is a formal governance structure to oversee the conduct and running of the trial, consisting of a trial management group and a steering committee. More details on the composition, roles and responsibilities of each committee can be found in the supplemental material.

Background: The increasing necessity for specialised training in primary care cancer research stems from GPs' pivotal role in cancer detection and holistic care coupled with the unique primary care context. This has led to the development of the PRiCAN Scholars Network, an initiative to enhance the research capabilities of Graduate Entry Medicine (GEM) students in RCSI University of Medicine and Health Sciences, Dublin, Ireland. This protocol outlines a proposal for the systematic development, implementation, and evaluation of a curriculum aimed at improving the primary care cancer research skills of this cohort.

Methods: The curriculum development process will be guided by Kern's six-step approach. Initial stages involve comprehensive needs assessments via surveys and focus groups to identify educational needs. Subsequently, targeted learning objectives and aligned educational strategies will be defined to maximise learning opportunities and impact. The curriculum's impact will be evaluated in a pilot phase with selected students and faculty, utilising both qualitative and quantitative feedback to drive continuous improvements.

Conclusion: This protocol describes a detailed method for establishing a primary care cancer research curriculum within the PRiCAN Scholars Network. Designed with a focus on sustainability and adaptability, the curriculum will be structured to develop and support a generation of medical professionals' literate in primary care research, contributing to the advancement of medical education and cancer research.