Clinical Science Research Articles

Enhancing healthcare professionals' biopsychosocial perspective to chronic pain: assessing the impact of implementing an interdisciplinary training program

Abstract Advancements in clinical science have shown the necessity for a paradigm shift away from a biomedical toward a biopsychosocial approach. Yet, the translation from clinical science into clinical practice is challenging. The aim of this study was to assess the short-term and mid-term changes in pain knowledge and attitudes and guideline-adherent recommendations of healthcare professionals (HCP) by means of an interdisciplinary training program (ITP) about chronic pain. Belgian HCPs, with a priority for medical doctors, physiotherapists, occupational therapists, nurses, psychologists, and pharmacists in primary care, participated in the ITP, which contained 2 e-learning modules and two 7-hour workshops provided in small interdisciplinary groups in 5 cities. The objective of ITP was to improve HCP's competencies for integrating biopsychosocial chronic pain management with a cognitive behavioral approach into clinical practice. Primary outcomes were changes in knowledge and attitudes about pain and guideline-adherent recommendations for continuation of physical activity, sports, and work; avoiding bed rest; and not supporting opioid usage measured through 2 clinical vignettes. They were measured before, immediately after, and 6 months after the ITP. Changes were analyzed using (generalized) linear mixed models. A total of 405 HCPs participated. The knowledge and attitudes about pain scores improved at post-training (Δ = 9.04, 95% confidence interval 7.72-10.36) and at 6-month follow-up (Δ = 7.16, 95% confidence interval 5.73-8.59). After the training program, HCPs provided significantly more recommendations in accordance with clinical guidelines. Thus, an ITP can improve the biopsychosocial perspective of chronic pain management among HCPs in the short-term and mid-term.

Identifying barriers and opportunities to facilitate the uptake of whole genome sequencing in paediatric haematology and oncology practice

BackgroundThe clinical utility of whole genome sequencing (WGS) in paediatric cancer has been demonstrated in recent years. WGS has been routinely available in the National Health Service (NHS) England for all children with cancer in England since 2021, but its uptake has been variable geographically. To explore the underlying barriers to routine use of WGS in this population across England and more widely in the United Kingdom (UK) and the Republic of Ireland (ROI), a one-day workshop was held in Cambridge, United Kingdom in October 2022.MethodsFollowing a series of talks, delegates participated in open, round-table discussions to outline local and broader challenges limiting routine WGS for diagnostic work-up for children with cancer in their Principal Treatment Centres (PTCs) and Genomic Laboratory Hubs (GLHs). Within smaller groups, delegates answered structured questions regarding clinical capability, education and training needs, and workforce competence and requirements. Data was recorded, centrally collated, and analysed following the event using thematic analysis.ResultsSixty participants attended the workshop with broad representation from the 20 PTCs across the UK and ROI and the seven GLHs in England. All healthcare professionals involved in the WGS pathway were represented, including paediatric oncologists, clinical geneticists, clinical scientists, and histopathologists. The main themes highlighted by the group in ensuring equitable access to WGS identified were: lack of knowledge equity between NHS trusts, with a perception of WGS being for research only; and perception of lack of financial support for the clinical process surrounding WGS, including lack of time to take informed consent from patients. The latter also included limited trained staff available for data interpretation, affecting the turnaround time for reporting. Finally, the need for an integrated digital pathway to order, track, and return data to clinicians was highlighted.ConclusionAt the workshop, the general motivation for including WGS in the diagnostic work up for children with cancer was high throughout the UK, however a perceived lack of resources and education opportunities limit the widespread use of this commissioned assay. This workshop has led to some recommendations to increase access to WGS in this population in England and more widely in the devolved national of the UK and the ROI.

"I'm quite proud of how we've handled it": health professionals' experiences of returning additional findings from the 100,000 genomes project.

Participants in the 100,000 Genomes Project (100kGP) could consent to receive additional finding (AF) results, individual variants relating to genes associated with susceptibility to cancer and familial hypercholesterolemia (FH). In the study reported here, qualitative interviews were used to explore the experiences of National Health Service (NHS) professionals from across England who were tasked with returning over 80,000 "no AF" results and 700 positive AF results to 100kGP participants. Interviews were conducted with 45 professionals from a range of backgrounds, including Genetic Counsellors, Clinical Geneticists, FH Clinical Nurse Specialists and Clinical Scientists. Interviews were analysed using a codebook thematic analysis approach. Returning AF results has been a significant endeavour, with challenges for pathways, administrative processes and clinical and laboratory time when the capacity of NHS services is already stretched. Professionals discussed going "above and beyond" to prioritise patient care through pathway design, additional clinics, overtime, longer appointments and provision of follow-up appointments. Professionals also described facing practical and emotional challenges when returning AFs. Benefits for patients from receiving AFs in the 100kGP were highlighted and professionals were generally positive about offering clinically actionable AFs within routine NHS clinical care. Professionals were, however, cautious around the implementation of AFs into routine care and felt more research and discussion was needed to determine which AFs to offer, approaches to consent and communication of results, costs and the potential strain on NHS capacity and resources. Further consultation is required with careful review of pathways and resources before offering AFs in clinical practice.

Phytochemical Profiling and Pharmacological Evaluation of Methanolic Leaf Extract of C. digyna for Cytotoxic, Anti‐inflammatory, Antioxidant, Antiarthritic, and Analgesic Activities

ABSTRACTCaesalpinia digyna (Family: Fabaceae) is traditionally used in Ayurvedic medicine for various medicinal purposes, including as a treatment for wounds, leprosy, skin diseases, fever, diabetes, etc. Although the root and stem of this plant have a significant medicinal value, there was little research on the leaves of this plant. This study aimed to investigate the qualitative phytochemical profile and evaluate the in vitro cytotoxic, anti‐inflammatory, antioxidant, and antiarthritic activities, as well as the in vivo anti‐inflammatory and analgesic activities, of C. digyna leaf extract. The methanolic extract of C. digyna leaves was prepared using an ultrasonic‐assisted extraction process. In vitro and in vivo anti‐inflammatory activities were evaluated using the hypotonicity‐induced hemolysis and carrageenan‐induced paw edema methods, respectively. Additionally, the extract was assessed for in vitro DPPH (1, 1‐diphenyl‐2‐picrylhydrazyl) free radical scavenging, antiarthritic (protein denaturation), and in vivo analgesic (acetic acid‐induced writhing and tail immersion) activities. Brine shrimp lethality bioassay (BSLB) showed moderate cytotoxic activity (LC50 = 2.25 μg/mL) compared with the standard vincristine sulfate (LC50 = 1.61 μg/mL). In vitro, anti‐inflammatory activity exhibited 85.13% (IC50 value = 2.51 μg/mL) inhibition of Human Red Blood Cell (HRBC) membrane lysis at a concentration of 2000 μg/mL whereas in vivo anti‐inflammatory study exerted its maximum effect (p < 0.05) at 400 mg/kg bw dose. This extract also showed significant antioxidant (IC50 = 0.218 μg/mL), antiarthritic (83.61% inhibition) activity, and moderate analgesic effect (p < 0.05) in both methods. These research findings indicated that C. digyna leaves extract has potent antioxidant, analgesic, and anti‐inflammatory effects which can be used as a supplementary medication for inflammatory pain‐relieving factors. In future, finding the mechanism involved in these effects could have significant impact on clinical science.

Identifying and Prioritizing the Educational Needs Professors of Medical Sciences in the Field of E-Learning with the Analytic Hierarchy Process Approach

Background: Professors in universities and educational institutions hold a crucial role in crafting educational approaches utilizing cutting-edge technologies. They need to possess significant expertise in e-learning and tackle the obstacles associated with delivering education and utilizing Information and communication technologies within higher education. To effectively navigate these challenges and adaptations, professors need to equip themselves with new educational techniques through training and readiness to adeptly incorporate emerging technologies into their teaching practices, thus enhancing the educational journey for students. By identifying, understanding, and ranking professors' requirements and preferences, effective and diverse educational initiatives can be tailored to meet their needs. Objectives: This research aimed to recognize the educational needs of medical science professors in the field of e-learning from the experts' point of view and prioritize these needs utilizing the analytic hierarchy process (AHP). Methods: This practical study was conducted in 2022 using a process-oriented approach and AHP. The main stages included the creation of a hierarchical structure, comparative judgment, and determining priorities. In the first step, 13 criteria were identified, which were derived from scientific articles and previous research. In the second step, the pairwise comparison matrix was used for comparative judgment, and the weight of each criterion was calculated. The third step involved determining priorities based on the weight of each criterion and the inconsistency ratio. The participants of this study included professors of basic and clinical sciences from different faculties. Results: The results of this study demonstrated that from the point of view of experts and participants, among the 13 criteria, the skills of virtual teaching (with weights of 0.146 and 0.148), electronic content production (with weights of 0.093 and 0.092), and holding online training courses (with the weights of 0.092 and 0.100) formed the three main needs of medical science professors in the field of e-learning and had the highest degree of importance and necessity compared to other criteria. Conclusions: Identifying the educational needs of medical science professors for organizing and designing necessary programs to enhance knowledge, skills, and empowerment will lead to improving the quality of e-learning, and eventually, reducing professors’ concerns in this area.

Elements Supporting Translation of Evidence Into Practice: A Model for Clinical Nurse Specialist and Nurse Scientist Collaboration.

To present evidence-based elements supporting the synergistic relationship between nurse scientists and clinical nurse specialists to improve the translation of evidence into practice. Using best-practice elements to support the improvement of evidence-based translation, we define the roles and synergies between nurse scientists and clinical nurse specialists within clinical environments. Five themes were identified in the literature review:● Although clinical nurse specialists and nurse scientists differ in focus and competencies, they are in key positions to collaborate to meet healthcare demands.● Clinical nurse specialists are well-equipped to implement the science developed by nurse scientists.● To meet the increased demands and complexity of the healthcare system and patient needs, organizational leadership must lend support to clinical nurse specialists and nurse scientist collaboration.● Clinical nurse specialists are well-positioned to foster interprofessional partnerships and generate opportunities for evidence-based project initiatives across healthcare disciplines.● Clinical nurse specialists should utilize professional models to inform practice to improve the review, translation, and implementation of research into practice. Projects conducted using a collaborative structure had a system-level impact and long-term sustainability capabilities. Additionally, projects were more likely to be disseminated by clinical nurse specialists within a formal structure.

Three principles for the utility of simple tasks that assess elemental processes in parsing heterogeneity.

As clinical psychological science and biological psychiatry push to assess, model, and integrate heterogeneity and individual differences, approaches leveraging computational modeling, translational methods, and dimensional approaches to psychopathology are increasingly useful in establishing brain-behavior relationships. The field is ultimately interested in complex human behavior, and disruptions in such behaviors can arise through many different pathways, leading to heterogeneity in etiology for seemingly similar presentations. Parsing this complexity may be enhanced using "simple" tasks-which we define as those assaying elemental processes that are the building blocks to complexity. Using eyeblink conditioning as one illustrative example, we propose that simple tasks assessing elemental processes can be leveraged by and enhance computational psychiatry and dimensional approaches in service of understanding heterogeneity in psychiatry, especially when these tasks meet three principles: (a) an extensively mapped circuit, (b) clear brain-behavior relationships, and (c) relevance to understanding etiological processes and/or treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Network Control Theory of Dynamic Systems Approach to Personalize Therapy

Contemporary latent disease models of psychopathology have shown limited clinical utility and the efficacy of conventional treatments have been disappointing. An alternative approach offers the network approach and a dynamic systems perspective to psychopathology and treatment change. To understand and modify dynamic systems, engineering and mathematics have been relying on principles of network control theory. This article will discuss the application of network control theory of dynamic systems approach to personalize therapy. Network control theory can be used as a guide for personalizing treatment by choosing the most promising intervention strategy targeting the change processes based on the network structure. A composit case illustration will demonstrate the principles and application of network control theory to therapy in practice within the framework of process-based therapy. In conclusion, a network control theory of dynamic systems approach is highly relevant and applicable to clinical science.

Hispanic Faculty Trends in U.S. Medical Schools: A 50-Year Perspective

The U.S. Hispanic population has grown substantially over the past 50 years, and simultaneously, the number of U.S. medical schools and medical school faculty has increased. This study examines the trends for Hispanic faculty in clinical and basic science departments at U.S. medical schools. Method This retrospective, cross-sectional observational study analyzed data from the Association of American Medical Colleges Faculty Roster for faculty at all LCME-accredited medical schools from 1973 to 2022. Proportions of faculty were compared according to department, sex, rank, and Hispanic status using a 2-independent-sample t-test and simple linear regressions. Results The percentage of Hispanic medical school faculty increased from 1.7% in 1973 to 5.4% in 2022, with similar rates of increase in basic science and clinical departments. In 2022, departments with the highest representation of Hispanic faculty included family medicine and obstetrics and gynecology. The departments with the lowest representation of Hispanic faculty were orthopedic surgery and otolaryngology. In 2022, only 1.5% and 3.1% of all full professors were Hispanic females and males, respectively. Conclusion There was a minimal increase in the percentage of Hispanic faculty in medical schools over the last 50 years, and the rank was disproportionally higher at the Assistant Professor level, particularly for females. The combination of a rapid increase in the U.S. Hispanic population and a slow increase in Hispanic faculty has resulted in Hispanic medical school faculty being more underrepresented in academic medicine in 2022 than in 1973.

Reinforcement of Core Foundational Science Concepts during Clinical Rotations: A Strategy to Enhance Medical Student Learning and Diagnostic Reasoning.

Cognitive science principles can facilitate integrating and retaining basic science concepts during the clinical years of undergraduate medical education. We hypothesized that reinforcing foundational science concepts during the core clerkship experiences fosters the development of clinical reasoning in medical students. A patient simulation session on diabetic ketoacidosis (DKA) in the pediatric clerkship was chosen to pilot the program. We introduced an intervention in which a team of clinical and foundational science faculty facilitates student discussions, helping them connect important physiological and pathophysiological concepts to the disorder's clinical presentation, diagnosis, and management. The student survey reported that 87% strongly agreed that it helped them reinforce their understanding of foundational science concepts related to clinical cases. The NBME subject exam results of the pediatric clerkships from the corresponding years were subjected to a cognitive diagnostic assessment called the DINA model analysis. The student content mastery in acid-base disorders was improved following the intervention (student mastery of skills, 0.73 vs 0.80, P=0.035). Similarly, analysis of the Step 2 Clinical Knowledge (CK) skills from the NBME subject exam item analysis reports showed improvement in the skill "diagnosis" on the topic of diabetes (probability value- before and after the intervention, respectively, 0.73 and 0.85, p=0.04) following implementation. Our study shows the impact of foundational science reinforcement during clinical clerkships in developing undergraduate medical students' clinical reasoning and diagnostic skills.

Evolving Artificial Intelligence (AI) at the Crossroads: Potentiating Productive vs. Declining Disruptive Cancer Research

Artificial intelligence (AI), encompassing several tools and platforms such as artificial “general” intelligence (AGI) and generative artificial intelligence (GenAI), has facilitated cancer research, enhancing productivity in terms of research publications and translational value for cancer patients. AGI tools, such as ChatGPT, assist preclinical and clinical scientists in identifying tumor heterogeneity, predicting therapy outcomes, and streamlining research publications. However, this perspective review also explores the potential of AI’s influence on cancer research with regard to its impact on disruptive sciences and discoveries by preclinical and clinical scientists. The increasing reliance on AI tools may compromise biological intelligence, disrupting abstraction, creativity, and critical thinking. This could contribute to the declining trend of disruptive sciences, hindering landmark discoveries and innovations. This perspective review narrates the role of different forms of AI in the potentiation of productive cancer research and the potential disruption of disruptive sciences due to AI’s influence.

Natural Products with Potential for the Treatment of Pain: Global Evidence from the NAPRALERT Database.

Natural products (NPs) continue to inform the discovery and development of a diversity of drugs, both marketed and investigational. Pain, one of the most common of human experiences and profound challenges in medicine and biology, has emerged at the core of an urgent societal problem, in the United States and globally. The present study employs a retrospective analysis of an extensive set of published literature curated in the NAPRALERT database to identify NPs with experimental evidence of bioactivity supporting the selection and prioritization of NP leads with promise in pain management. The NAPRALERT pain data set currently documents >38,000 pain-relevant experiments reported in >1,750 distinct journals. The evidence presented here was annotated from >10,000 distinct scientific publications identifying NP extracts and isolates with experimental biological data indicating positive mitigation of pain, inflammation, and/or modulation of nociceptive signaling targets. Correlation of ethnomedical uses with experimental data represents a value-added approach to the selection and prioritization of leads. Dissemination of this unique NP/pain data set, with experimental data and information applicable to basic, translational, and clinical science stakeholders alike, furnishes practical evidence in support of a rational selection of NPs for directed pain research. A large portion of the NAPRALERT pain-relevant data set, along with a set of query tools designed to assist user-directed selection and prioritization of leads, are presented as Supporting Information in order to mitigate the limitations inherent in presenting such a large data set in (print) format. To support user efforts, this report involves explication of NAPRALERT data organization and the articulation of rational approaches to user-guided selection of evidence-based NP leads.

Optimisation of cone beam CT radiotherapy imaging protocols using a novel 3D printed head and neck anthropomorphic phantom

Objective.This study aimed to optimise Cone Beam Computed Tomography (CBCT) protocols for head and neck (H&N) radiotherapy treatments using a 3D printed anthropomorphic phantom. It focused on precise patient positioning in conventional treatment and adaptive radiotherapy (ART).Approach.Ten CBCT protocols were evaluated with the 3D-printed H&N anthropomorphic phantom, including one baseline protocol currently used at our centre and nine new protocols. Adjustments were made to milliamperage and exposure time to explore their impact on radiation dose and image quality. Additionally, the effect on image quality of varying the scatter correction parameter for each of the protocols was assessed. Each protocol was compared against a reference CT scan. Usability was assessed by three Clinical Scientists using a Likert scale, and statistical validation was performed on the findings.Main results. The work revealed variability in the effectiveness of protocols. Protocols optimised for lower radiation exposure maintained sufficient image quality for patient setup in a conventional radiotherapy pathway, suggesting the potential for reducing patient radiation dose by over 50% without compromising efficacy. Optimising ART protocols involves balancing accuracy across brain, bone, and soft tissue, as no single protocol or scatter correction parameter achieves optimal results for all simultaneously.Significance.This study underscores the importance of optimising CBCT protocols in H&N radiotherapy. Our findings highlight the potential to maintain the usability of CBCT for bony registration in patient setup while significantly reducing the radiation dose, emphasizing the significance of optimising imaging protocols for the task in hand (registering to soft tissue or bone) and aligning with the as low as reasonably achievable principle. More studies are needed to assess these protocols for ART, including CBCT dose measurements and CT comparisons. Furthermore, the novel 3D printed anthropomorphic phantom demonstrated to be a useful tool when optimising CBCT protocols.

The introduction of a dedicated cardiology clinic including a clinical scientist led pathway for women with turner's syndrome

Abstract Background There are more than 15,000 women living with Turner’s Syndrome (TS) in the UK, over 700 of whom are cared for within our linked Endocrinology services. Mortality is predominantly related to cardiovascular disease therefore close cardiology review with a focus on aortopathy is essential (1). However appropriate surveillance is challenging with growing pressures on all aortopathy services across the United Kingdom. Purpose To audit our current practise according to current international guidelines (2) and seek methods to improve the pathway for our growing population of TS patients including the feasibility of a Clinical Scientist led clinic, aiming to improve capacity and efficiency of our service. Methods A quality improvement project was conducted over a three-year period, piloting a dedicated clinical scientist-led clinic under close Cardiology Consultant supervision. Patients selected were deemed lower risk for cardiovascular complications according to American Heart Association (AHA) recommendations (2) (figure 1). Follow-up intervals of patients under both consultant-led and clinical scientist led pathways were analysed. Results Among a total of 226 patients analysed, 103 (46%) fell into the lowest risk category and therefore deemed suitable for prospective Clinical Scientist led pathway (figure 2). Analysis of all patients demonstrated that 60% had appropriate follow-up intervals according to guidelines, while 37% were too short and 3% were too long. A five-year projection indicated a consequential 96 unnecessary additional appointments for patients that were being seen too frequently. Further analysis showed that the time frame for follow up was too short in 25% of patients seen in the clinical scientist led clinic compared to 41% in the Consultant-led clinic. There were no aortic dissections in patients under surveillance during this period. In the last 10 years 1 patient on the waiting list for surgery (having presented with a type B dissection but requiring workup for liver cirrhosis) had a retrograde type A dissection (indexed aortic root dimension 2.4cm/m²). No other adverse events were recorded. Conclusion Auditing our service revealed safe management and improved adherence to guidelines in the clinical scientist-led clinic, identifying opportunities to optimize follow-up and enable physicians to focus upon high-risk patients. This pilot demonstrates the feasibility of a clinical scientist-led clinic in managing low risk TS patients, suggesting scalability to other conditions involving aortopathy to address capacity issues and improve pathways.

Modern aspects of pathology teaching

Introduction. Undergraduate medical curricula often fail to balance learning opportunities and integrate the study of basic and clinical sciences, allowing students to link theory and practice. The high educational potential of the experimental teaching method is due not only to its practical orientation but also to the possibility of reflection - critical analysis and synthesis of knowledge in the learning process.Aim of the study. Evaluate the possibility of introducing experiential learning in the study of pathology to improve the efficiency of students' perception of understanding the subject and subsequent application in clinical practice.Materials and methods. The study sample (n=362) consisted of 3rd year students of NAO «Karaganda Medical University», studying in the disciplines: «General pathology» and «Pathology of organs and systems» in the 2022-2023 academic year. The sample included 48.9% male and 51.1% female students aged 19 to 22. Respondents were divided into a main group (n=96) using an experimental training method and a control group (n=266) using a traditional training format. A specially designed questionnaire was used to study student satisfaction with training. Descriptive statistics methods were used to describe the assessments of students in the study groups. Thematic analysis was used to examine the data collected using open-ended questions.Results. The possibility of interaction and discussion with the teacher during the joint viewing of micropreparations of the studied cases was rated as «excellent» by 95.8% and 97.9% of students. With regard to the main characteristics of medical education in the study of pathology, four broad topics are verified, such as fundamental medical education, interaction with the teacher in obtaining medical education, teaching materials in medical education, and assessment in the field of medical education. The study used methods of descriptive statistics. Thematic analysis was used to process data collected using open-ended questions.Discussion. The high level of acceptance of interactive groups in the study of pathology and the general satisfaction of students reflect the desire and need for active teaching methodologies in modern medical education.Conclusion. Based on the findings, the practical teaching of pathology can be improved by revisiting the content and teaching strategies.

Going back to anatomy roots: Exploring the integration of anatomy sessions during clinical clerkships.

The topic of vertical integration of the basic and clinical sciences is an area of great concern and active investigation in medical education. To explore the feasibility of integrating basic sciences into the clinical phase of medical education, gross anatomy was selected as an appropriate discipline. Anatomy faculty, clerkship directors, medical students, and graduate students developed case-based anatomy modules with a design consistent with the principles of self-directed learning. This pilot study aimed to explore medical student responses to the integration of anatomy sessions during clinical clerkships. One-hour anatomy sessions were conducted during rotations of the following clerkships: internal medicine, pediatrics, family medicine, neurology, obstetrics and gynecology, and general surgery during the academic year 2022-2023. Each session consisted of four case-based stations. Voluntary, anonymous surveys were distributed at the end of each session. Descriptive statistics of survey responses from the 490 participants revealed the overall ratings of the anatomy sessions to be above an 8.50 on a scale of 1.00 (low) to 9.00 (high). A small q thematic analysis of the open-ended survey questions revealed the following themes: relevance of clinical correlations presented, a timely review of anatomical content, appreciation for the collaborative setting and interactivity among the participants, and constructive feedback regarding areas needing improvement. Students reported a high overall rating of the anatomy sessions and shared positive comments about these vertically integrated anatomy experiences. With a reduction in the amount of anatomy instruction during the pre-clinical years and limited exposure during the clinical years, anatomy sessions like the ones proposed could allow for the fluid incorporation of gross anatomy across all 4 years of medical school.

Questioning the status quo: Latino community members as researchers in the study of health equity.

Latinos experience disproportionate rates of obesity and related conditions like type 2 diabetes, which are projected to increase (Mohebi et al., 2022). Standard interventions for these issues often fall short due to individual-focused approaches and the lack of culturally sensitive definitions of health that include emotional, physical, political, and social domains (Gutierrez Chavez et al., 2022; Ritchie et al., 2020). Multilevel and multidimensional research efforts, integrating social justice-informed orientations, psychotherapy science, and behavioral medicine, are crucial for addressing these health inequities (Asnaani, 2023; Collins et al., 2018; Rodriguez Espinosa & Verney, 2021). Additionally, critically analyzing researcher and participant roles is essential to avoid perpetuating systemic racism (Cook et al., 2023). This article highlights the need for a paradigm shift in psychotherapy research by (a) describing Latino families' eating patterns and coping strategies for emotional distress through focus groups in the community and (b) illustrating the process behind the community-partnered development of a culturally responsive mindfulness-based health intervention. Importantly, this research approach emphasizes liberation psychology theory in the exploration of structural influences affecting health (Martín-Baró, 1996). While mindfulness techniques are feasible in this population (Cotter & Jones, 2020), Latino communities may not be amenable to the current presentation of mainstream psychological science interventions. Our research paradigm informed the conceptualization of mindfulness techniques through both clinical science and critical lenses. Thus, this study argues for reconceptualizing the definition of a successful psychotherapy study to include community engagement and liberatory principles, making the potential for big needle jumps in addressing health inequities incalculable. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Equitable community-based participatory research engagement with communities of color drives All of Us Wisconsin genomic research priorities.

The NIH All of Us Research Program aims to advance personalized medicine by not only linking patient records, surveys, and genomic data but also engaging with participants, particularly from groups traditionally underrepresented in biomedical research (UBR). This study details how the dialogue between scientists and community members, including many from communities of color, shaped local research priorities. We recruited area quantitative, basic, and clinical scientists as well as community members from our Community and Participant Advisory Boards with a predetermined interest in All of Us research as members of a Special Interest Group (SIG). An expert community engagement scientist facilitated 6 SIG meetings over the year, explicitly fostering openness and flexibility during conversations. We qualitatively analyzed discussions using a social movement framework tailored for community-based participatory research (CBPR) mobilization. The SIG evolved through CBPR stages of emergence, coalescence, momentum, and maintenance/integration. Researchers prioritized community needs above personal academic interests while community members kept discussions focused on tangible return of value to communities. One key outcome includes SIG-driven shifts in programmatic and research priorities of the All of Us Research Program in Southeastern Wisconsin. One major challenge was building equitable conversations that balanced scientific rigor and community understanding. Our approach allowed for a rich dialogue to emerge. Points of connection and disconnection between community members and scientists offered important guidance for emerging areas of genomic inquiry. Our study presents a robust foundation for future efforts to engage diverse communities in CBPR, particularly on healthcare concerns affecting UBR communities.

Self-directed learning and the student learning experience in undergraduate clinical science programs: a scoping review.

Health professional organisations are increasingly promoting the use of self-directed learning. Furthermore, the rapidly evolving field of healthcare has meant that there is greater emphasis within tertiary education for students to become self-directed learners and possess the skills to engage in life-long learning. The aim of this scoping review was to explore the drivers that improve the student learning experience, in undergraduate clinical science programs that utilise self-directed learning. The Joanna Briggs Institute Scoping Review Methodology guided this study. The electronic databases MEDLINE, Embase, Emcare, Scopus and ERIC were comprehensively searched in April 2022 and re-run August 2023, for peer-reviewed research articles published in English. The original search was developed in MEDLINE and then adapted to each database. Following the Joanna Briggs Scoping Review methodology, articles were screened first by title and abstract and then by full text. Included articles were assessment for methodological quality. The search strategy yielded 2209 articles for screening. 19 met the inclusion criteria. Five key factors were identified which improve the student learning experience in self-directed learning: (i) curricular elements; (ii) educator influence; (iii) impact of peers, (iv) environment; and (v) clinical placement experiences. There are many curricular, environmental, and external factors which can improve the student learning experience in programs that utilise self-directed learning. Greater understanding of these factors will allow educators within clinical science programs to implement self-directed learning strategies more effectively within curriculum.

Altmetric coverage of health research in Ireland 2017-2023: a protocol for a cross-sectional analysis

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.