Funding Criteria Research Articles

Listening to Stakeholders' Voices on Funding Social Inclusion in Sport for People with Disabilities-Proposal for Criteria.

The value of sport is extensively documented; however, there are still groups who do not have the opportunity to enjoy the benefits of sport due to lack of investment, particularly important for people with disabilities. A gap persists in understanding the effectiveness of inclusive sport programs in addressing equity-related targets, particularly on the effective methods of financing inclusion in sport for individuals with disabilities. Therefore, providing a platform for stakeholders to express their perspectives becomes crucial. Through focus groups and the World Café approach, the aim of this study was to gather insights from athletes, parents, professionals, and sport club managers regarding the funding of inclusive sport for people with disabilities. A total of 72 participants took part in nine focus groups in Portugal, Slovenia, and Hungary: 27 athletes with disabilities, 22 coaches, other technicians and parents, and 23 club managers/directors. Findings were divided into five topics: (1) perspectives on current funding satisfaction; (2) perspectives on sources and criteria for funding; (3) perspectives on ideal funding; (4) perspectives on ideas to reach decision-makers; and (5) proposals on ideal criteria for funding. Based on these findings, six measurable criteria for fair funding allocation were suggested that could develop a properly weighted system of criteria for decision-makers to assess the allocation of funding among inclusive sport organizations with the potential to catalyze broader policy and societal changes. Additionally, there is a pressing need to develop a funding model for inclusive sport for individuals with disabilities.

Biologic Drugs for Severe Asthma

Several biologic drugs are available to treat severe asthma. These biologics are designed to target specific inflammatory subtypes of asthma (eosinophilic or allergic). A Rapid Review was conducted to describe the evidence on the comparative efficacy and safety of biologics, and to characterize the patient populations studied. The Rapid Review was done to determine if a subsequent health technology assessment (HTA) was feasible which would be used to provide guidance on the alignment of the drug funding criteria by the public drug plans. The evidence included in the Rapid Review mainly focused on specific severe asthma subtypes. Comparing the efficacy of biologics for asthma was challenging because of differing definitions of asthma severity and inconsistent application of severity criteria in the included studies. Recruitment and outcome reporting among different asthma subgroups was limited and varied. An HTA of the existing data is unlikely to provide new insights to further inform the reimbursement of biologics in severe asthma.

Real world outcomes for maintenance avelumab treatment in locally advanced/metastatic urothelial cancer after platinum-based chemotherapy.

584 Background: Maintenance Avelumab after platinum-based chemotherapy in metastatic-/locally advanced urothelial carcinoma has shown overall and progression free survival benefit in the JAVELIN Bladder 100 trial. We analysed real world outcomes from 6 UK centres. Methods: Retrospective electronic patient records review was carried out for patients treated between January 2021 and September 2023 at 6 UK centres. Patients whose disease had not progressed after platinum-based chemotherapy were started on maintenance avelumab 800mg given at 2 weekly intervals, starting within 12 weeks of last day of chemotherapy as per the National Cancer Drug Fund criteria. Survival outcomes were established using the Kaplan Meier method and compared by a log rank test using SPSS. Results: In total 80 patients (median age 73 years-range 21-86) were included of which 68% were male and 32% were female. 31(38.8%) had prior upper tract and 49(61.2%) had bladder cancers. Metastases were in the nodes only in 33(41.5%) patients whilst 16.9% and 42.3% had bone and visceral metastases respectively. The number of patients with ECOG PS 0,1 and 2 were 36 (45.0%), 33 (41.3%), and 10 (12.5%), respectively. After a median of six cycles of platinum-based chemotherapy, 11.3% had a complete response, and 54.9% had a partial response. Patients then proceeded to maintenance avelumab treatment. Before treatment, the median Neutrophil to Lymphocyte Ratio (NLR) was 2.89. The number of patients with NLR ≤2.89 was 37 (46.3%), and with >2.89 were 38 (47.9%). Median number of cycles were 9 (range 1-66). At a median follow-up of 16.7 months, the median PFS was 8.3 months (95% CI 4.8-15.4). At the data cut-off, 37 patients had died, and 40 patients had progressed. Any grade of adverse event occurred in 34 (42.5%) patients. Grade 3 or higher toxicity rate was 7.5%. Two grade 3 allergic reactions were seen. One patient had Grade 3 immune mediated hepatitis and one patient had grade 3 immune mediated arthritis. Two grade 2 immune mediated colitis were reported. The ORR of avelumab maintenance therapy was 12.5%. 2 patients had a complete response, 8 had a partial response, and 43(53.7%) had stable disease. Within the limit of our small data set, univariate analysis for PFS revealed that there was no significant association between PFS and visceral metastases (p=0.2), bone metastases (p=0.2), node only metastases (p=0.6), primary site(p=0.9), and ECOG PS (p=0.6). However, NLR was a significant prognostic factor for PFS. The median PFS in patients with NLR ≤2.89 vs >2.89 was 16.9 vs 4.2 months, respectively (p=0.001). Conclusions: Our multi centre UK real world data confirms that maintenance Avelumab treatment is well tolerated, and its efficacy data is consistent with previously reported clinical studies.

Adalimumab vs placebo as add-on to Standard Therapy for autoimmune Uveitis: Tolerability, Effectiveness and cost-effectiveness—a protocol for a randomised controlled trial (ASTUTE trial)

IntroductionAdalimumab is an effective treatment for autoimmune non-infectious uveitis (ANIU), but it is currently only funded for a minority of patients with ANIU in the UK as it is restricted...

Improving access to advanced veterinary care for rescued cats and dogs.

The objectives of this study were as follows: (1) to describe the AMC to the Rescue (AMCTTR) funding criteria and the application process; (2) to describe the distribution of species cared for through the program, the medical conditions treated in cats compared with those treated in dogs and the cost of that care; and (3) to define the successes and challenges of the program. The AMCTTR database was reviewed for applications submitted between 1 January 2020 and 31 December 2022. Data collected included the following: the date of application; rescue organization seeking financial support; species; age of pet at time of application; expenditures funded by AMCTTR; and the method by which the rescue organization learned about AMCTTR. The animals in the AMCTTR database were sorted into two groups: those accepted for funding and those that did not meet funding criteria. The Animal Medical Center (AMC) medical record system was searched for the total number of individual animals, species and age seen at AMC during the study period. In total, 267 applications were reviewed and 190 applications from 134 cats, 52 dogs and four rabbits were accepted for advanced veterinary care funded by AMCTTR. Over the 3-year study period, US$612,564 were awarded and over half of those funds were awarded to cats. The average expenditure per animal during this time period was US$3224. The most common referrals to AMCTTR were made to ophthalmology, surgery and dentistry. The needs of cats differed from dogs in that feline applications were most commonly submitted for ophthalmology or dentistry. Expenditures per cat were less than per dog because dogs were referred for more expensive orthopedic surgery. The need for advanced veterinary care for rescue animals is enormous, especially for cats. Programs that subsidize advanced veterinary care increase access to that care.

Using Participatory Action Research to Connect Research Agendas with User Needs: A Crowdsourcing Case Study

Crowdsourcing is a digital method used in business and academia to engage public participation in the provision of services, ideas, or information. This original case study focuses on examining process-based challenges of combining knowledge and skills of diverse crowdsourcing stakeholders in a network for shared learning. Participatory action research (PAR) was selected as the method to reflect all stakeholder agendas during the network’s formation. Findings demonstrate a shift in emphasis from initially complying with university funding criteria, to meeting the group’s desire for a network that encourages collaboration and capacity development for its users. This result advances understanding of deploying PAR to foster collaboration between crowdsourcing stakeholders for the purpose of forming a sustainable network for shared learning, and thereby informs future critical research pertaining to crowdsourcing policies and practice.

Fairweather healthcare: Funding criteria and the abandonment of patients with surgical complications

Fairweather healthcare: Funding criteria and the abandonment of patients with surgical complications

Storage over Rendition. Call for a Sustainable Infrastructure in the Digital Textual Heritage Sector with a Particular Interest in Digital Scholarly Editions

A significant amount of human and pecuniary resources has gone into the production of the long line of digital scholarly editions that within recent decades have sprung to life in Scandinavia, in the Baltic region, as well as in the rest of Europe. Notwithstanding the heritage perspective, the sector is paradoxically characterized by a presentist preoccupation with instant results – first and foremost with the rendition of the given data set. Concerns for long-term data management perspectives – that is: interest in the post-production afterlife of the data – is relatively meagre. This goes for project managers, for project host institutions, and for the research foundations financially supporting the projects. So, despite harmonizing initiatives at production level and pre-edition compilation initiatives, such incentives promote a situation of insulated digital scholarly editions focusing on unique URLs and distinctive qualities of the given material. This hinders project synergy in the production phase. Moreover, it hinders the construction of long-term and sustainable data management solutions. To remedy this situation, we propose a clear division of labour between the tasks of data production, of data rendering, and of data storing. This division should ideally be sought at an institutional level. This will secure the accumulation of know-how in teams refining the respective workflows. In addition, we encourage private and public foundations to bolster this infrastructure by making project compliance a criterion for funding.

Exploring the Funding Challenges Faced by Small NGOs: Perspectives from an Organization with Practical Experience of Working in Rural Malawi.

Malawi is a small landlocked country in Southern Africa, which faces a number of development challenges. It is one of the world's poorest nations and over 70% of the population live below the International Poverty Line of $2.15 per day. Health inequalities are a well-documented problem and those most affected are women and children. Non-governmental organizations (NGOs) play a vital role in supplementing government efforts to provide health services to vulnerable people in areas that are difficult to reach. The World Medical Fund (WMF) is a small medical charity that operates in the central, rural, Nkhotakota region of Malawi where many children lack access to even basic health services. To date, WMF has successfully provided free care and treatment for over 400,000 sick children, but its initiatives, such as mobile clinics, rely entirely on external donations. Since 2000, the funding resources available to small NGOs have declined and efforts to attract funding have become increasingly competitive. Frequently, the criteria used for funding decisions are too rigid, and do not reflect the difficult operating conditions on the ground in rural Africa. As one of the world's most highly resource constrained healthcare environments, Malawi illustrates the need for more flexible funding criteria from donors so that NGOs can carry out their work to save children's lives.

School‐ and community‐based counselling services for children and young people aged 7–18 in the UK: A rapid review of effectiveness, implementation and acceptability

AbstractIntroductionProvision of school‐ and community‐based counselling services differs in terms of funding, implementation and eligibility criteria across the UK. The existing evidence of the effectiveness of counselling services is mixed, with little consideration of service context, implementation or acceptability. This rapid review seeks to address the gaps in the extant evidence syntheses by exploring the effectiveness, implementation and acceptability of school‐ and community‐based counselling services in the UK.MethodsA systematic literature search was conducted in five electronic databases. Grey literature searches were conducted in 23 national government and third‐sector organisational websites. The searches focussed on studies examining counselling interventions aimed at children aged 7–18 years that examined either effectiveness, implementation, acceptability or context.ResultsFifty‐four studies were included in the review. The few RCT studies suggest that there is no clear evidence of effectiveness of the therapeutic approach, due to mixed findings. There is some tentative evidence for weaker study designs that counselling may have positive impacts across different settings. The service is highly valued by learners, teachers and parents and is believed to improve well‐being; however, it is often seen as a discrete service that is not well‐embedded within the education system.ConclusionsThere is mixed evidence for the effectiveness of school‐ and community‐based counselling. However, this needs to be understood in the context of acceptability and implementation. Future work is needed to improve the implementation of services by considering the wider complexity of the systems in which these services are embedded.

Impact of a Regional Grant Program Through the Lens of Social Cognitive Career Theory: A Mixed-Method Evaluation.

Evaluations of educational grant programs have focused on research productivity, with few examining impacts on grantees or effective program characteristics. This evaluation examined the regional grant program sponsored by Group on Educational Affairs to examine if and how grantees' careers were affected by funding, and if these experiences aligned with program goals. In this concurrent, mixed-methods theory-driven evaluation, quantitative and qualitative data were analyzed independently and then integrated to examine complementarity. Quantitative data examined differences among 4 geographic regions and included proposal and grantee characteristics abstracted from administrative records of 52 funded proposals from 2010-2015 grant cycles. Qualitative data from 23 interviews conducted from 2018 to 2019 explored the impact on grantees, with Social Cognitive Career Theory (SCCT) serving as a framework for deductive thematic analysis. To facilitate integration of findings, quantitative data were layered onto each interview to permit exploration of associations between the 2 data types. Although significant regional differences existed in project length and amount of funding, there were few regional differences in grantee experiences. Despite small funding amounts, grants were perceived as career launching pads. The SCCT framework accounted for grantee experiences, including researcher identity formation and subsequent research, but did not capture collaboration phenomena. Integration of the 2 data types identified experience patterns unique to different groups of grantees (e.g., more or less research experience). The diversity among grantees suggests that clarification of program goals and stronger alignment with criteria for funding may be warranted. This evaluation illuminates why small educational grant programs may or may not impact interest and productivity in research. Implications exist for funders, including clarifying program goals and providing support for less experienced grantees. Future research should explore grantee subsets (e.g., underrepresented in medicine) to further identify what fosters or inhibits careers of medical education scholars.

Understanding caregiver experiences with disease-modifying therapies for spinal muscular atrophy: a qualitative study

ObjectiveSpinal muscular atrophy (SMA) is a neuromuscular disorder that manifests with motor deterioration and respiratory complications. The paradigm of care is shifting as disease-modifying therapies including nusinersen, onasemnogene abeparvovec and...

Aporias of North/South political ecologies

In this intervention, we explore the impacts of geopolitical bifurcation on the field of political ecology, specifically the divide between political ecology from the Global North and political ecology from the Global South. We argue that this divide perpetuates categorical essentialisms, flattens authors’ standpoints, and reproduces inequities in how scholarship is valued and circulated based on where it is written from. These issues are not limited to political ecology alone but can be relevant to environmental geography as well. Through our analysis of the perpetuation of aporia in political ecology, we challenge the normalcy of this North/South differentiation and advocate for recognizing the agency and capacity of political ecology practitioners, regardless of their geographic location, language, or nationality, to shape the field. Drawing from our experiences as Latin Americanist political ecologists, we argue that transhemispheric and polylingual projects that challenge power dynamics, create inclusive research processes, and recognize colonial legacies are crucial for more equitable and just approaches to addressing environmental and social justice issues. Furthermore, we examine the coloniality of institutions and technologies that move environmental knowledge as a commodity, such as universities, indexed journals, publishing houses, and research funding criteria.

Promoting a ‘new us’ for Switzerland through cultural participation: practice exchange on the basis of a citizen-art project

In 2020, the Swiss Federal Commission for Migration launched a new programme called ‘New us’. The national programme called for participatory projects that question the ‘us and them’ binary and present alternative models for strengthening cultural participation, social cohesion and a polyphonic ‘us’ in Switzerland. This contribution critically appraises a citizen-art project that met the funding criteria of ‘New us’. We argue that the scientific approach of developmental evaluation serves as a compass for the development and steering of open-ended participatory processes. The combined reflection on the artistic and scientific evaluation process engages social work research in the facilitation of cultural participation.

Legume consumption in adults and risk of cardiovascular disease and type 2 diabetes: a systematic review and meta-analysis.

This study aimed to systematically review the evidence for associations between consumption of legumes and cardiovascular disease (CVD), type 2 diabetes (T2D) and their risk factors among healthy adults. We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus up to 16 May 2022 for ≥4 weeks long randomized (RCT) and non-randomized controlled trials and prospective cohort studies with follow-up ≥12 months, assessing legume intake (beans/lentils/peas/soybeans, excluding peanuts and legume-products/protein/powder/flour) as the intervention or exposure. Outcomes were CVD, coronary heart disease (CHD), stroke, T2D and in intervention trials only: changes in blood lipids, glycemic markers, and blood pressure. Risk of bias (RoB) was evaluated with Cochrane's RoB2, ROBINS-I, and US Department of Agriculture (USDA)'s RoB-NObS. Effect sizes were pooled using random-effects meta-analyses and expressed as relative risk or weighed mean differences with 95% confidence intervals, heterogeneity quantified as I2. The evidence was appraised according to World Cancer Research Fund's criteria. Of the 181 full-text articles assessed for eligibility, 47 were included: 31 cohort studies (2,081,432 participants with generally low legume consumption), 14 crossover RCTs (448 participants), one parallel RCT and one non-randomized trial. Meta-analyses of cohort studies were suggestive of null associations for CVD, CHD, stroke and T2D. Meta-analyses of RCTs suggested a protective effect on total cholesterol (mean difference -0.22 mmol/L), low density lipoprotein (LDL)-cholesterol (-0.19 mmol/L), fasting glucose (-0.19 mmol/L), and HOMA-IR (-0.30). Heterogeneity was high (I2 = 52% for LDL-cholesterol, >75% for others). The overall evidence for associations between consumption of legumes and risk of CVD and T2D was considered limited - no conclusion. Legume consumption was not found to influence risk of CVD and T2D in healthy adult populations with generally low legume consumption. However, protective effects on risk factors, seen in RCTs, lend some support for recommending legume consumption as part of diverse and healthy dietary patterns for prevention of CVD and T2D.

Constraints on medication-based inflammatory bowel disease therapy in Aotearoa New Zealand-why medication adherence is important.

The therapeutic landscape for treating Inflammatory Bowel Disease (IBD) in Aotearoa New Zealand had remained largely unchanged for about a decade; however, just this year, two further biologic medications became available. In an international context, these medications are not exactly new, and several other highly efficacious, modern medications and treatment paradigms are available overseas but not in New Zealand. Medication adherence (MA), alongside factors including (relaxation of) medicines funding criteria, specialist availability, IBD awareness in primary healthcare etc., contributes to good patient care. Hence, we contend that MA remains of particular importance for New Zealand patients with IBD to derive maximum benefits from the limited therapeutic options available. Moreover, increased research and interventions for promoting MA, in IBD especially, are crucial.

Expected Impact

Jeremy Pitt probably expresses the doubts of many in criticizing the use of “expected impact” as a research funding criterion (IEEE Technology and Society Magazine, September 2022). The impossibility of predicting research impact has been documented well enough.

Nuts and seeds consumption and risk of cardiovascular disease, type 2 diabetes and their risk factors: a systematic review and meta-analysis.

We aimed to systematically review studies and evaluate the strength of the evidence on nuts/seeds consumption and cardiometabolic diseases and their risk factors among adults. A protocol was pre-registered in PROSPERO (CRD42021270554). We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials and Scopus up to September 20, 2021 for prospective cohort studies and ≥12-week randomized controlled trials (RCTs). Main outcomes were cardiovascular disease (CVD), coronary heart disease (CHD), stroke and type 2 diabetes (T2D), secondary total-/low density lipoprotein (LDL)-cholesterol, blood pressure and glycaemic markers. Data extraction and risk of bias (RoB) assessments (using RoB 2.0 and RoB-NObS) were performed in duplicate. Effect sizes were pooled using random-effects meta-analyses and expressed as relative risk (RR) or weighted mean differences with 95% confidence intervals (CI); heterogeneity quantified as I 2. One-stage dose-response analyses assessed the linear and non-linear associations with CVD, CHD, stroke and T2D. The strength of evidence was classified per the World Cancer Research Fund criteria. After screening 23,244 references, we included 42 papers from cohort studies (28 unique cohorts, 1,890,573 participants) and 18 RCTs (2,266 participants). In the cohorts, mainly populations with low consumption, high versus low total nuts/seeds consumption was inversely associated with total CVD (RR 0.81; 95% CI 0.75, 0.86; I 2 = 67%), CVD mortality (0.77; 0.72, 0.82; I 2 = 59.3%), CHD (0.82; 0.76, 0.89; I 2 = 64%), CHD mortality (0.75; 0.65, 0.87; I 2 = 66.9%) and non-fatal CHD (0.85; 0.75, 0.96; I 2 = 62.2%). According to the non-linear dose-response analyses, consumption of 30 g/day of total nuts/seeds was associated with RRs of similar magnitude. For stroke and T2D the summary RR for high versus low intake was 0.91 (95% CI 0.85, 0.97; I 2 = 24.8%) and 0.95 (0.75, 1.21; I 2 = 82.2%). Intake of nuts (median ~50 g/day) lowered total (-0.15 mmol/L; -0.22, -0.08; I 2 = 31.2%) and LDL-cholesterol (-0.13 mmol/L; -0.21, -0.05; I 2 = 68.6%), but not blood pressure. Findings on fasting glucose, HbA1c and insulin resistance were conflicting. The results were robust to sensitivity and subgroup analyses. We rated the associations between nuts/seeds and both CVD and CHD as probable. There was limited but suggestive evidence for no association with stroke. No conclusion could be made for T2D. There is a probable relationship between consumption of nuts/seeds and lower risk of CVD, mostly driven by CHD, possibly in part through effects on blood lipids. More research on stroke and T2D may affect the conclusions. The evidence of specific nuts should be further investigated.

Losing Your Budget Without Losing Your Mind: Communicating in a Crisis

Managing a significant budget cut is always challenging for libraries. After years of flat budgets with reduced spending power, compounded with a large budget reduction brought on by a pandemic, this quickly becomes a crisis. While the logistics of determining the most essential parts of the collection to retain are important, communicating with faculty and ensuring transparency during this difficult process is even more so. The University of South Florida Libraries navigated these murky waters in the 2020/2021 fiscal year. This article provides a clearer understanding of our funding and collections criteria and details how we established a communication plan.

Focused Jurisdictional Scan of Glomerulonephritis Medication Access in Canada: A Program Report.

Glomerulonephritis (GN) is a group of rare kidney diseases that is increasingly being managed with higher cost immunosuppressive (IS) agents in Canada. Ontario Health's Ontario Renal Network (ORN) oversees the management and delivery of GN services in the province. Stakeholder surveys previously conducted by ORN identified that both clinicians and patients do not perceive access to GN medications as comprehensive or timely. The program conducted a focused jurisdictional scan among 7 provinces to inform ORN initiatives to improve access to GN medications. Specifically, the program examined clinician experience with GN access, public drug coverage criteria, and timelines for public coverage for select IS agents (ie, tacrolimus, cyclosporine, mycophenolate mofetil [MMF], mycophenolate sodium, rituximab, and eculizumab) used to manage GN in adults who live in Canada. For the selected IS agents, a focused jurisdictional scan on medication access was conducted by ORN in 2018 and updated in July 2022. Information was obtained by searching the gray literature and/or credible online sources for public funding policies and eligibility criteria. Findings were supplemented by personal communications with provincial drug programs and consulting GN clinical experts from 7 provinces (ie, Alberta, British Columbia, Saskatchewan, Manitoba, Ontario, Nova Scotia, and Quebec). Clinicians from different provinces prescribe IS agents similarly for GN indications, despite distinctions in public drug funding policies. While patients can obtain public funding for many IS agents, for GN, most provinces rely on case-by-case review processes. In addition, provinces can vary in their funding criteria and which IS agents are listed on the public formulary. For IS agents that require prior authorization or case-by-case review, timelines vary by province with decisions taking a few days to weeks. British Columbia, with a GN-specific drug formulary, had the most integrated and efficient system for patients and prescribers. This scan primarily relied on publicly available information for drug coverage criteria and clinician experience with access in their province. Since this scan was conducted, public drug coverage criteria and/or application processes may have changed. While patients in most provinces have similar needs and nephrologists similar prescribing patterns, gaps still exist for publicly funded GN medications. Interprovincial differences in the drugs funded, funding criteria, and application process may affect timely and equitable access to GN medications across Canada. Given the rarity of GN, a pan-Canadian funding approach may be warranted to improve the current state.