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Training and education provided to local change champions within implementation trials: a rapid systematic review
Get PDFBACKGROUND: Translating research into clinical practice is challenging. One implementation intervention that supports translation is employment of a change champion. It is important to understand how individuals are prepared for the change champion role. This rapid systematic review aimed to identify the education, training, and support provided to individuals in change champion roles within implementation trials.METHOD: Rapid review approach. We searched the Scopus database to identify systematic reviews on champions, knowledge brokers, facilitators, and implementation support practitioners. The most recent reviews on each topic were screened to find eligible studies. To identify studies published after these reviews, we searched Medline, PsycINFO, OVID, CINAHL, ProQuest, SCOPUS, and EBSCO. We included randomised and cluster randomised controlled trials that reported on implementation interventions in healthcare settings involving a local change champion.RESULTS: Fifteen cluster randomised controlled trials were included. Specific champion training was provided in 12 studies (80%), but none reported incorporating adult learning principles into their education program. Some form of post-training support was reported in 11 studies (73%). Only two studies included content on behaviour or organizational change in the champion preparation program. Most programs were not individualized, and details of training and support were poorly reported.CONCLUSIONS: Training needs and educational outcomes of change champions are poorly reported in implementation trials. Training tends not to align with adult learning. More rigorous development and reporting of programs to prepare change champions to support implementation of evidence in healthcare is recommended.REGISTRATION: PROSPERO registration number CRD42022368276
Benchmarking person-centered simulated participant programs: A Delphi consensus study in an Australian context
Get PDFBackground:Simulated participants (SPs) are well established in health education. Frameworks exist for benchmarking quality Simulated Participant Programs (SPPs); however, there is limited literature evaluating these frameworks in an Australian context and from the perspective of SPs. This study aimed to explore the perspectives of SPs and SPP faculty in Australia on a benchmarking tool.Method:Using a three-round modified Delphi technique, a panel of SPs and SPP Managers (N = 37) rated the importance of 18 statements derived from Health Education England's (HEE) SP Common Framework. Consensus was defined as 80% agreement. Qualitative comments were sought to contextualize responses and provide insight into factors perceived to contribute to a high-quality SPP.Results:Seventeen of the 18 statements within the HEE SP Common Framework reached consensus by the end of Round three. The item that did not reach consensus related to the importance of a SP program documenting SP completion of training. Thematic analysis indicated perceived characteristics of high-quality SPPs related to: employing the ‘right people’, clear and transparent communication, valuing the SP, a collaborative approach, and professional development.Conclusions:Overall, the HEE SP Common Framework was perceived by both SPs and SPP Managers to be applicable in an Australian context, with the suggestion the framework be extended to encourage SPPs to have an explicit recruitment strategy to employ SPs that represent diverse and priority communities.<br/
Get Ready for the Next Generation of AI Quantum Technologies
No full textA new form of artificial intelligence is on the horizon that will transform healthcare and other industries in unimaginable ways. The purpose of this book chapter is to foreshadow the next generation of quantum technologies that are ideally suited to healthcare artificial intelligence applications. Early adopters, innovators, and other thought leaders in healthcare can champion actions today (regarding technology, processes, and people) to guide their organizations to a quantum technologies ecosystem to optimize caregiving
Curbing the Spread of Communicable Diseases in Residential Aged Care Facilities Through Design Considerations
No full textCommunicable diseases such as COVID-19 have emerged as a serious threat to residents of residential aged care (RAC) facilities. Given that the RAC’s residents are already at an increased health risk due to their ages, exposure to COVID-19 increases their vulnerabilities. RACs, supposedly safe havens for the aged populations, may be putting their residents at higher risk due to poorly designed facilities. Accordingly, there is a dire need to investigate the RACs’ design features and improve the building layouts. The current study examines the impact of RAC facilities’ architectural design on mitigating COVID-19 transmission in RACs through a systematic literature review (SLR) guided by preferred reporting items for systematic reviews and meta-analysis (PRISMA) technique. Scholarly databases, including Scopus and Web of Science, were used to retrieve 34 relevant articles. VOSviewer was used to conduct bibliometric analysis followed by detailed content analyses. The findings exhibit that the primary design and environmental factors (spatial layouts, ventilation rate, airflow patterns, and outdoor spaces) can reduce infectious disease transmission in RACs. Architectural designs and spatial layouts, including Green Care or Household models, were viable built-up interventions to curtail the COVID-19 spread. Recommendations are provided for architects, policymakers, and facility managers to utilize building design with adequate ventilation, green walls, open spaces, and thermal comfort to control COVID-19 sprawl in RACs
Forum response
Get PDFThank you to the authors of the comments on our Forum Article Voice: A Third Space in Archaeology to Advance Indigenous Emancipation, for their praise and constructive comments. We note the overwhelmingly positive receipt of our Forum Article, and we welcome the range of constructive critiques. In our response below, we selectively address those comments that are most conducive to deepening future work related to Voice. In the spirit of Voice, Australian Archaeology, sought and obtained a review by a community-based Aboriginal organisation. This is critical to strengthening local Indigenous Voices and ensuring academic research becomes more accessible to Aboriginal and Torres Strait Islander community organisations. This diversifies the content of Australian Archaeology and averts epistemic injustice in the sense articulated by Miranda Fricker (Citation2007). Fricker (Citation2007:69) defines epistemic injustice as the wrong that occurs when a testimony to something is received with doubt due to the prejudice or bias of the receiver of the testimony, for example, in the context of a litigated dispute
Variability in interstitial fluid glucose response to an acute change in energy availability in endurance athletes
No full textObjectives To determine whether an acute change in energy availability (EA) causes perturbations in interstitial glucose in athletes. Methods Using a randomized crossover design, five trained endurance athletes (n = 3 men, 26.4 ± 7.5 y, VO2 max 53.1 ± 4.7 mL·kg-1·min-1), completed a morning high-intensity interval cycling session (AM HIT; 6 × 5 min @ 85% VO2 max) and an afternoon steady-state cycling session (PM SS; 80 min @ 63% VO2 max) under dietary conditions of either (1) high energy availability (HEA: 42.6 ± 3.8 kcal·kg-1 FFM·d-1, 10.0 ± 1.4 g·kg-1·CHO) or (2) low energy availability (LEA: 11.3 ± 2.4 kcal·kg-1 FFM, 5.2 ± 0.3 g·kg-1·CHO) following 3 days of dietary harmonization (DH; 46.1 ± 1.5 kcal·kg-1 FFM·d-1, 8.3 ± 0.6 g·kg-1·CHO). Interstitial glucose data was measured with Freestyle Libre 2 continuous glucose monitors (Abbott Diabetes Care, Chicago IL; CGM’s) with 15-min epochs to determine glycemic variability, calculated as mean interstitial glucose (MG), mean amplitude of glycemic excursions (MAGE), and coefficient of variation (CV). Results CGM-derived overnight MG was lower during LEA and HEA compared to DH (LEA 4.5 ± 0.3 mmol·L-1 HEA 4.9 ± 0.1 mmol·L-1 vs 5.5 ± 0.4 mmol·L-1; P = 0.01, d > 1.9). MAGE was lower in the LEA trial compared to HEA, although this was not statistically significant (1.7 ± 0.7 mmol·L-1 vs 2.1 ± 0.3 mmol·L-1, P = 0.26, d = 0.8). Conclusions. Contrary to our hypothesis, perturbations to overnight glucose variability occurred in both LEA and HEA conditions which may be related to changes in daily training load compared with athletes’ habitual training
Virtual Tourism Microdosing: A New Prescription for Tourist Wellbeing
No full textResearch on the hedonic and eudaimonic benefits of virtual tourism has grown exponentially. However, few studies have considered its potential as a positive psychological intervention to enhance wellbeing. Through the lens of the recently conceptualised DREAMA model of tourist wellbeing, this conceptual paper critically examines the nuanced role of virtual tourism in enabling wellbeing. This research contends that microdosing, an innovative concept which initially emerged in psychotherapy, can be applied through virtual tourism as a non-pharmacological intervention to foster the DREAMA dimensions of wellbeing. This paper is amongst the first to apply the concept of microdosing to tourist wellbeing in virtual travel. The paper proposes a conceptual model designed to articulate how regular engagement with short, immersive virtual tourism experiences can integrate the therapeutic benefits of travel into everyday life. The manuscript introduces microdosing as a low-barrier, low-risk way to engage with virtual tourism experiences and potentially mitigate cybersickness issues
Risk of Major Congenital Malformations Following Prenatal Exposure to Smoking Cessation Medicines
Get PDFImportance: Nicotine replacement therapy (NRT), varenicline, and bupropion are effective smoking cessation pharmacotherapies, but evidence on fetal safety is limited. Objective: To assess whether prenatal use of smoking cessation pharmacotherapies was associated with increased risks of major congenital malformations (MCMs). Design, Setting, and Participants: This retrospective cohort study was conducted across 4 countries, and results were pooled via meta-analyses. Records of all births (2001-2020) in New South Wales (NSW; Australia), New Zealand (NZ), Norway, and Sweden were linked to prescribed medicine dispensings, hospital admission, outpatient, and death data. Follow-up ended December 31, 2021, and the data were analyzed between August and October 2023. The base cohort comprised 391474 infants among 267522 women who smoked during the first trimester or were dispensed a smoking cessation pharmacotherapy 90 days before conception or during the first trimester. Exposures: Supply of NRT, varenicline, and bupropion overlapping the first trimester. Unexposed infants were born to women who smoked but were not dispensed a pharmacotherapy 90 days preconception and the first trimester. Propensity score matching (1:10) was used. Main Outcomes and Measures: MCM overall and subgroups.Results: The mean (SD) maternal age at childbirth was 27.2 (6.0) years. Analyses included 9325 infants exposed to NRT (NSW, NZ), 3031 to varenicline (NSW, NZ, Norway, and Sweden), and 1042 to bupropion (NSW, NZ). Compared with unexposed infants, there were no differences in prevalence of MCMs overall following NRT exposure (37.6 vs 34.4 per 1000 live births; adjusted relative risk [aRR], 1.10; 95% CI, 0.98-1.22), varenicline (32.7 vs 36.6; aRR, 0.90; 95% CI, 0.73-1.10), or bupropion (35.5 vs 38.8; aRR, 0.93; 95% CI, 0.67-1.29). NRT analyses showed no difference in the risk of MCMs of the heart, limbs, genital organs, kidney/urinary tract, respiratory system, and orofacial clefts but a higher risk of digestive organ MCMs (3.8 vs 2.5 per 1000 live births; aRR, 1.53; 95% CI, 1.05-2.23; P =.41 after multiple comparison adjustment). Varenicline analyses revealed no difference in the risk of heart, limb, and genital MCMs but a higher risk of kidney/urinary tract MCMs (11.5 vs 4.2 per 1000 live births; aRR, 2.75; 95% CI, 1.42-5.34; P =.09 after multiple comparison adjustment), with findings for other MCMs being too imprecise. For bupropion, data were too sparse to estimate the risk of MCM subgroups. Conclusions and Relevance: The results of this cohort study suggest that there is no clear increased risk of MCMs associated with prenatal use of NRT and varenicline compared with smoking during the first trimester
Involvement of microRNA-146a-5p, but not -155-5p and -29b-5p, in left ventricular remodeling and dysfunction in spontaneously hypertensive rats
Get PDFThe contribution of microRNAs remains poorly understood in the context of hypertensive cardiac pathology. The role of miR-146a-5p, miR-155-5p, and miR-29b-5p in cardiac hypertrophy and dysfunction was investigated in spontaneously hypertensive rats (SHRs). Seven-month-old SHR (n ¼ 7 male, n ¼ 9 female) and normotensive Wistar Kyoto rats (WKY; n ¼ 7 male, n ¼ 9 female) underwent echocardiography. Plasma concentrations of inflammatory markers were measured by ELISA. Interstitial and perivascular fibrosis and percentage macrophage infiltration were determined by histology. Left ventricular (LV) mRNA expressions of cardiac remodeling markers and miRNA expressions were determined by RT-PCR. Circulating vascular cell adhesion molecule-1 (VCAM-1), macrophage infiltration, interstitial and perivascular fibrosis, relative wall thickness (RWT), early diastolic mitral inflow to tissue lengthening velocity at lateral mitral annulus (E/e0), and LV mRNA expression of NFKBIA and SOD2 were greater in SHRs. MidFS, e0, and a0 were lower in SHRs. Expression of LOX1, Col1a/Col3a ratio, circulating c-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-a), and RWT were greater in females. No difference in miR-29b-5p expression was noted. MiR-155-5p expression was lower in female and associated with stroke volume and absolute heart and LV masses. MiR-146a-5p expression was greater in SHRs and associated with systolic blood pressure (SBP), circulating VCAM-1, macrophage infiltration, interstitial fibrosis, normalized heart and LV masses, RWT, and a’. MiR-146a-5p was also associated with circulating VCAM-1 after adjustments for SBP. In addition, greater expression of miRNA-146a-5p reversed the relationship between circulating VCAM-1 and macrophage infiltration. Changes in the expression of miR-155-5p may be involved with a cardiac phenotype related to sexual dimorphism. Conversely, upregulation of miR-146a-5p expression may act as a countermechanism induced by myocardial inflammation in the setting of reactive fibrosis, established LV hypertrophy, and impaired diastolic function
From theory to practice of organizational project management maturity models – systematic literature review
Get PDFPurposeProject management maturity significantly influences project success by enhancing efficiency, adaptability and strategic alignment. However, existing maturity models face challenges due to rigid structures, limited adaptability and inadequate attention to emerging technological and human-centric factors. This study reviews the literature to identify key determinants of project management maturity and proposes insights for refining these models for broader industry applicability.Design/methodology/approachA systematic literature review was conducted using established guidelines to ensure rigor and transparency. A total of 16,572 articles were initially identified through comprehensive searches in key academic databases, including Scopus, Web of Science and IEEE Xplore, using keywords related to project management maturity.FindingsThe review categorizes maturity determinants into five key domains: organizational culture and leadership, project-related characteristics, external environmental influences, technological advancements and individual project management competencies. Structured maturity models support project governance and risk management but face practical limitations due to inflexible frameworks, insufficient focus on soft skills and minimal integration of digital tools. This study underscores the need for adaptable, industry-specific maturity models that accommodate dynamic project environments, evolving stakeholder expectations and digital advancements.Originality/valueThis research synthesizes current knowledge on project management maturity, bridging the gap between theoretical frameworks and practical application. By emphasizing adaptability, leadership, and digital transformation, it offers valuable insights for organizations seeking to enhance project management maturity and align frameworks with real-world challenges