Multidisciplinary Partnerships Research Articles

Regional anaesthesia research priorities: a Regional Anaesthesia UK (RA-UK) priority setting partnership involving patients, carers and healthcare professionals.

Regional anaesthesia provides important clinical benefits to patients but is underutilised. A barrier to widespread adoption may be the focus of regional anaesthesia research on novel techniques rather than evaluating and optimising existing approaches. Research priorities in regional anaesthesia identified by anaesthetists have been published, but the views of patients, carers and other healthcare professionals have not been considered previously. Therefore, we launched a multidisciplinary research priority setting partnership that aimed to establish key regional anaesthesia research priorities for the UK. Research suggestions from key stakeholders (defined by their interaction with regional anaesthesia) were gathered using an online survey. These suggestions were analysed to identify common themes and then combined to formulate indicative research questions. After an extensive literature review, unanswered and partially answered questions were prioritised via an interim online survey and then ranked as a top 10 list during a final live virtual multidisciplinary prioritisation workshop. In total, 210 individuals completed the initial survey and suggested 518 research questions. Fifty-seven indicative questions were formed, of which three were considered fully answered after literature review and one not feasible. The interim online survey received 335 responses, which identified the 24 highest priority questions from the 53 presented. At the final live prioritisation workshop, through a nominal group process, we identified the top 10 regional anaesthesia research priorities. These aligned with three broad thematic areas: pain management (two questions); patient safety (six questions); and recovery from surgery (two questions). This initiative has resulted in a list of research questions prioritised by patients, carers and a multidisciplinary group of healthcare professionals that should be used to inform and support future regional anaesthesia research in the UK.

Leadership as a situated practice: Critical connections and liberated networks

Learning Development is founded on multidisciplinary partnerships and collaboration, which can make it difficult for practitioners to recognise leadership in themselves and have it recognised by others, stymieing progression and confidence. This study aims to explore what leadership looks like in a collaborative, community-driven, third space field of practice, and how Learning Development practitioners might recognise leadership in themselves and enact it in practice. Based on based on semi-structured interviews, a phenomenological approach is taken to explore the perceptions and experiences of 20 participants who self-identify as Learning Developers with an interest in leadership. Four key themes emerged from the analysis: Being in the role; Being part of a team; Being part of a community; and Taking a wider view. Each indicates how leadership in Learning Development is values-driven, social, networked, critical, and operates on the three levels of team, community, and field. The interrelationships between these are expressed as a model for strategic influence driven by collaborative connections, and findings suggest that practitioners act as a hub through which knowledge and connections can flow. Given the challenges currently facing the higher education sector, it is vital that institutions are able to harness these crucial roles to remain flexible, responsive, and effective. This study provides a means for recognition and advancement in fields that lack the clear progression routes of academic and professional services colleagues.

Addressing gun violence through social work education

ABSTRACT Gun violence is a critical public health issue in the United States, with firearms involved in over 48,000 deaths in 2021. However, social workers receive limited training to address the risks and impacts of gun violence despite frequently working with affected populations. This paper examines how social work education can better prepare students through a framework developed by the Police Executive Research Forum categorizing gun violence into four types: suicide, criminal homicide, domestic violence homicide, and mass shootings. Each section explores prevention and intervention strategies related to each category and innovative recommendations for integrating these topics into social work curricula and field placements. A comprehensive approach addressing prevention and intervention strategies across the areas of suicide, homicide, domestic violence, and mass shootings is key to producing social workers ready to effectively address gun violence. This paper provides specific examples of assignments, class discussions, field experiences, and other educational strategies for training social work students to meet this urgent need. Enhanced education around gun violence will equip social workers to advocate for policy changes, educate communities, provide trauma-informed care, and collaborate with multidisciplinary partners to promote safety and well-being.

Key Research Areas and Trends in Bibliometric Analysis of Microgrids

Microgrids represent a novel breed of sustainable energy sources that have gained widespread adoption within the energy domain. This investigation employs bibliometric analysis techniques to scrutinize prior scientific publications on microgrids, utilizing quantitative and statistical methodologies to unveil distribution trends of articles across specific themes and time frames. Furthermore, the exploration pinpoints principal contributors and collaborative trends within the field. The findings of this study reveal a noteworthy surge in scholarly publications pertaining to intelligent grid frameworks, with a particular emphasis on cutting-edge technologies and multidisciplinary partnerships. Furthermore, the study highlights the adoption of blockchain technology in smart grids and the inclusion of renewable energy sources into microgrids. Moreover, this scholarly inquiry furnishes researchers and industry professionals with valuable insights into the current technological landscape and prospects for future research endeavors.

Establishing Vitreoretinal Surgery Capacity in Sierra Leone: Challenges and Opportunities to Address Retinal Health Disparities in Resource-limited Settings.

A range of challenges exists regarding vitreoretinal (VR) surgical services in resource-limited settings, including Sierra Leone. As a result, retinal pathologies may contribute to vision loss and blindness. In the wake of the 2013 to 2016 outbreak of Ebola virus disease in West Africa, gaps in ophthalmic care were underscored as survivors were experiencing a constellation of sequelae, including uveitis and VR disease. Given the unmet needs in addressing VR disease, systems for retinal surgical care were required. To further understand long-term ocular complications in Ebola survivors and molecular and immunologic factors associated with this, research infrastructure was developed for retinal evaluation and surgery. The 5 "S'" framework was implemented and considered staff, space, stuff, systems, and social support. The ongoing development of retinal health infrastructure has helped to address challenges related to program implementation, development of surgical capacity, and alignment with local stakeholders and collaborator objectives. VR surgical services have been established in Sierra Leone through multidisciplinary partnerships and collaboration and serve patients in-country, as well as others in West Africa who have traveled for care. Continued engagement across stakeholders can aim to address challenges and promote effective care delivery.

Cardiovascular disease management and healthcare delivery for people experiencing homelessness: a scoping review

BackgroundPeople experiencing homelessness have increased prevalence, morbidity, and mortality of cardiovascular disease (CVD), attributable to several traditional and non-traditional risk factors. While this burden is well-known, mainstream CVD management plans and healthcare delivery have not been developed with people experiencing homelessness in mind nor tailored to their unique context. The overall objective of this work was to explore and synthesize what is known about CVD management experiences, programs, interventions, and/or recommendations specifically for people experiencing homelessness.MethodsWe conducted a scoping review to combine qualitative and quantitative studies in a single review using the Arksey and O’Malley framework and lived experience participation. We performed a comprehensive search of OVID Medline, Embase, PsychINFO, CINAHL, Web of Science, Social Sciences Index, Cochrane, and the grey literature with key search terms for homelessness, cardiovascular disease, and programs. All dates, geographic locations, and study designs were included. Articles were analyzed using conventional content analysis.ResultsWe included 37 articles in this review. Most of the work was done in the USA. We synthesized articles’ findings into 1) barriers/challenges faced by people experiencing homelessness and their providers with CVD management and care delivery (competing priorities, lifestyle challenges, medication adherence, access to care, and discrimination), 2) seven international programs/interventions that have been developed for people experiencing homelessness and CVD management with learnings, and 3) practical recommendations and possible solutions at the patient encounter level (relationships, appointment priorities, lifestyle, medication), clinic organization level (scheduling, location, equipment, and multi-disciplinary partnership), and systems level (root cause of homelessness, and cultural safety).ConclusionsThere is no ‘one-size-fits all’ approach to CVD management for people experiencing homelessness, and it is met with complexity, diversity, and intersectionality based on various contexts. It is clear, however, we need to move to more practically-implemented, community-driven solutions with lived experience and community partnership at the core. Future work includes tackling the root cause of homelessness with affordable housing, exploring ways to bring cardiac specialist care to the community, and investigating the role of digital technology as an avenue for CVD management in the homeless community. We hope this review is valuable in providing knowledge gaps and future direction for health care providers, health services research teams, and community organizations.

"One Health" Perspective on Prevalence of ESKAPE Pathogens in Africa: A Systematic Review and Meta-Analysis.

The leading cause of hospital-acquired infections worldwide includes Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. (ESKAPE) infections. These bacteria are commonly isolated from clinical settings and linked to a number of potentially fatal diseases associated with hospitals. The objective of this study was to review the prevalence of ESKAPE pathogens in Africa. We gathered and systematically reviewed the literature concerning the prevalence of ESKAPE pathogens, published in the English language from January 2014 to February 2024, from three databases (PubMed, Web of Science and ScienceDirect). Our overall results revealed that S. aureus was the most prevalent species (79.5%), followed by A. baumannii (27.6%), K. pneumoniae (24.2%), Enterobacter spp. (20%), P. aeruginosa (9.0%), and E. faecium (5.1%). Moreover, stool samples had the highest Pooled Prevalence Estimates (PPEs) of 44.0%, followed by urine, nasal, and blood samples with 37.3%, 26.9%, and 22.9%, respectively. For the diagnostic method used to identify these ESKAPE pathogens, VITEK-MS had the highest PPE of 55.2%, followed by whole genome sequencing and PCR with 37.1% and 33.2%, respectively. The highest PPE of ESKAPE pathogens was recorded in West Africa with 77.3%, followed by Central/Middle Africa and East Africa with 43.5% and 25.1%, respectively. The overall PPE of ESKAPE pathogens from humans, animals, the environment (water, soil, and surfaces) and food sources was 35.8%, 37.3%, 47.7%, and 34.2%, respectively. Despite their prevalence in nosocomial settings, studies have shown that the ESKAPE pathogens may be isolated from a range of environmental reservoirs, including soil, dumping sites, beach sand, wastewater, food, and fish farms, among others. This wide source of ESKAPE pathogens substrates indicates the need for a multidisciplinary collaborative partnership for epidemiological studies and intervention efforts by the human, veterinary, and environmental health sectors in Africa.

Pediatric Cancer Screening in Hereditary Gastrointestinal Cancer Risk Syndromes: An Update from the AACR Childhood Cancer Predisposition Working Group.

Gastrointestinal (GI) polyposis and cancer in pediatric patients is frequently due to an underlying hereditary cancer risk syndrome requiring ongoing cancer screening. Identification of at-risk patients through family history, clinical features of a syndrome, or symptom onset ensures appropriate cancer risk assessment and management in childhood and beyond. In this 2024 perspective, we outline updates to the hereditary GI cancer screening guidelines first published by the American Association of Cancer Research Pediatric Cancer Predisposition Workshop in 2017. These guidelines consider existing recommendations by pediatric and adult gastroenterology consortia to ensure alignment with gastroenterology practices in managing polyposis conditions. We specifically address the recommendations for pediatric screening in familial adenomatous polyposis, Peutz-Jeghers syndrome, and juvenile polyposis syndrome. Further, we emphasize the importance of multidisciplinary care and partnership with gastroenterology, as it is crucial in management of children and families with these conditions.

Genome Tunisia Project: paving the way for precision medicine in North Africa

BackgroundKey discoveries and innovations in the field of human genetics have led to the foundation of molecular and personalized medicine. Here, we present the Genome Tunisia Project, a two-phased initiative (2022–2035) which aims to deliver the reference sequence of the Tunisian Genome and to support the implementation of personalized medicine in Tunisia, a North African country that represents a central hub of population admixture and human migration between African, European, and Asian populations.The main goal of this initiative is to develop a healthcare system capable of incorporating omics data for use in routine medical practice, enabling medical doctors to better prevent, diagnose, and treat patients.MethodsA multidisciplinary partnership involving Tunisian experts from different institutions has come to discern all requirements that would be of high priority to fulfill the project’s goals. One of the most urgent priorities is to determine the reference sequence of the Tunisian Genome. In addition, extensive situation analysis and revision of the education programs, community awareness, appropriate infrastructure including sequencing platforms and biobanking, as well as ethical and regulatory frameworks, have been undertaken towards building sufficient capacity to integrate personalized medicine into the Tunisian healthcare system.ResultsIn the framework of this project, an ecosystem with all engaged stakeholders has been implemented including healthcare providers, clinicians, researchers, pharmacists, bioinformaticians, industry, policymakers, and advocacy groups. This initiative will also help to reinforce research and innovation capacities in the field of genomics and to strengthen discoverability in the health sector.ConclusionsGenome Tunisia is the first initiative in North Africa that seeks to demonstrate the major impact that can be achieved by Human Genome Projects in low- and middle-income countries to strengthen research and to improve disease management and treatment outcomes, thereby reducing the social and economic burden on healthcare systems. Sharing this experience within the African scientific community is a chance to turn a major challenge into an opportunity for dissemination and outreach. Additional efforts are now being made to advance personalized medicine in patient care by educating consumers and providers, accelerating research and innovation, and supporting necessary changes in policy and regulation.

Advancing Cancer Care Infrastructure in Cambodia: Summary of the First 100 Patients with Cervical Cancer Treated at the National Cancer Centre

Background: Cervical cancer is Cambodia’s leading cause of female malignancy in both incidence and mortality. Cambodia’s first dedicated multidisciplinary cancer center, the National Cancer Centre (NCC), opened in January 2018 in Phnom Penh, and serves as the main public referral center for the region. Methods: This cross-sectional study retrospectively reviewed the care experience of the first 100 patients with cervical cancer treated at the NCC to collect demographic, diagnostic, and treatment characteristics. Results: The most common FIGO Stage was IIB (T2bN0M0) (n = 17). Squamous cell carcinoma represented 85% of cases. Definitive-intent therapy was recommended for 65 patients; neoadjuvant chemotherapy followed by external beam radiotherapy (EBRT) & tandem and ovoid (T&O) brachytherapy +/- concurrent cisplatin was the most common treatment regimen (n=23). Thirty-five patients presented with recurrent (n=22) or metastatic (n=13) disease and were treated with salvage/palliative intent; neoadjuvant chemotherapy followed by EBRT +/- concurrent cisplatin was the most common treatment regimen (n=10). Of the patients treated with definitive-intent treatment, 92% were prescribed an EBRT dose of 45 Gy in 25 fractions, and the median prescribed T&O brachytherapy dose was 28 Gy in 4 fractions. Mean cumulative EQD2 HR-CTV D90 dose was 91.8 Gy, or ~69-70 Gy to Point A, depending on planning technique. Follow-up data was limited to 27 patients; of the 14 patients whose follow-up period exceeded 1 year, 13 (93%) were alive and disease-free at their last assessment. Conclusion: With multidisciplinary partnership, the NCC has demonstrated that high quality complex cancer care can be delivered in a resource-constrained setting. This early sample of patients treated for cervical cancer is an initial step towards a better understanding of Cambodia’s patient population and an early snapshot of their cancer care delivery capacity.

The bench to community initiative: community-based participatory research model for translating research discoveries into community solutions.

The BCI program was established to understand sociocultural determinants of personal care product use, evaluate the biological impact of endocrine disrupting chemicals, and develop community interventions. The three pillars of the program include research, outreach and engagement as well as advocacy activities. The research pillar of the BCI includes development of multidisciplinary partnerships to understand the sociocultural and biological determinants of harmful chemical (e.g., endocrine disrupting chemicals) exposures from personal care products and to implement community interventions. The outreach and engagement pillar includes education and translation of research into behavioral practice. The research conducted through the initiative provides the foundation for advocacy engagement with applicable community-based organizations. Essential to the mission of the BCI is the participation of community members and trainees from underrepresented backgrounds who are affected by breast cancer disparities. Two behavioral interventions will be developed building on prior research on environmental exposures with the focus on personal care products including findings from the BCI. In person and virtual education activities include tabling at community events with do-it-yourself product demonstrations, Salon Conversations-a virtual platform used to bring awareness, education, and pilot behavior change interventions, biennial symposiums, and social media engagement. BCI's community advisory board members support activities across the three pillars, while trainees participate in personal and professional activities that enhance their skills in research translation. This paper highlights the three pillars of the BCI, lessons learned, testimonies from community advisory board members and trainees on the impact of the initiative, as well as BCI's mission driven approaches to achieving health equity.

A Systematic Review of Teleophthalmology Services Post-COVID-19 Pandemic in New Zealand, the United Kingdom, Australia, the United States of America, and Canada.

Background: This systematic review of teleophthalmology services in Australia, the United States of America (USA), Canada, and the United Kingdom (UK) during the COVID-19 pandemic is aimed to evaluate changes in teleophthalmology, comparing them to New Zealand (NZ). Methods: A literature search of electronic databases Scopus, Proquest, PubMed, Embase, Web of Science, Cochrane Library, Google Scholar, and Google was conducted using search terms: telemedicine, ophthalmology, teleophthalmology/teleophthalmology, and COVID/COVID-19/coronavirus/covid-pandemic. Studies describing teleophthalmology services created in response to COVID-19 restrictions from March 1, 2020, to January 31, 2024, were analyzed. Results: Of the articles, 37 describing 29 discrete teleophthalmology services were included. There were 15 services in the USA, seven in the UK, two in Canada, two in Australia, and three in NZ. The models of care in the USA were well described, and teleophthalmology was used for general, external, anterior segment, neuro-ophthalmology, and oculoplastic consults, as well as for grading of fundus images in the emergency department setting. In the UK, teleophthalmology was used for general eye care, oculoplastics, and pediatric ophthalmology. In Australia, teleophthalmology was used for postglaucoma surgery monitoring of Intraocular Pressure. In NZ, teleophthalmology was used for general eye consults and triaging, but no formal models were described. Conclusion: COVID-19 offered a unique opportunity for re-examination and expansion of teleophthalmology services globally. Video-based and home-screening teleophthalmology services are feasible but have limitations. Investing in multidisciplinary and community-based technology partnerships can create more equitable teleophthalmology care models (to complement and, when necessary, replace traditional in-person consults), within existing frameworks, making eye care more accessible and efficient.

Research Hotspots and Trends of Interventions for Sarcopenic Obesity: A Bibliometric Analysis.

Sarcopenic obesity, characterized by both obesity and sarcopenia, significantly impacts health and independence of affected individuals. There is an urgent need to explore effective strategies for addressing or preventing sarcopenic obesity. An initial critical step is to promptly assess the impact of academic research in this field, considering factors such as geographical regions, authors, journals, and institutions. It is also essential to analyze current trends and identify potential areas that may inspire future researchers to conduct further studies, ultimately improving public health outcomes for individuals with sarcopenic obesity. To achieve this, bibliometric research was conducted using the Web of Science Core Collection database to identify English language articles and reviews focusing on sarcopenic obesity interventions published between January 1, 2004, and June 15, 2024, followed by a literature review. A total of 929 English-language articles were collected, consisting of 645 research articles and 284 reviews. Research output in the field has shown significant growth since 2017, reaching a peak of 139 papers in 2022. The United States leads in publication output with 234 papers and a total of 13,971 citations, highlighting substantial international collaboration. Both the United States and Europe are recognized as key academic hubs for sarcopenic obesity intervention research, characterized by robust academic interactions. Moreover, there has been a notable increase in publication volume from China, South Korea, and Japan. Noteworthy authors in this field include Boirie Y from Université Clermont Auvergne in France, Prado CM from the University of Alberta in Canada, Cruz-Jentoft AJ from Hospital Universitario Ramon y Cajal in Spain, and Prado CM from the University of Alberta, known for their high citation count. The University of Alberta leads in the number of publications, while the University of Verona in Italy leads in citation frequency. Journals with higher publication volumes in sarcopenic obesity intervention include Nutrients, Clinical Nutrition, and Journal of Cachexia Sarcopenia and Muscle. Among the top 20 keywords, the most relevant interventions for sarcopenic obesity are exercise, nutrition, resistance training, physical activity, and muscle strength.The primary evidence currently available suggests that resistance training is the most effective method for enhancing muscle strength in sarcopenic obesity patients. Additionally, combining protein supplementation with resistance exercise has shown encouraging results in reducing fat mass in these individuals. To progress in this field, it is crucial to foster collaboration among countries, regions, and academic institutions, promoting multidisciplinary partnerships.

Integrated and collaborative care across the spectrum of alcohol-associated liver disease and alcohol use disorder.

The public health impact of alcohol-associated liver disease (ALD), a serious consequence of problematic alcohol use, and alcohol use disorder (AUD) is growing, with ALD becoming a major cause of alcohol-associated death overall and the leading indication for liver transplantation in the United States. Comprehensive care for ALD often requires treatment of AUD. Although there is a growing body of evidence showing that AUD treatment is associated with reductions in liver-related morbidity and mortality, only a minority of patients with ALD and AUD receive this care. Integrated and collaborative models that streamline both ALD and AUD care for patients with ALD and AUD are promising approaches to bridge this treatment gap and rely on multidisciplinary and interprofessional teams and partnerships. Here, we review the role of AUD care in ALD treatment, the effects of AUD treatment on liver-related outcomes, the impact of comorbid conditions such as other substance use disorders, obesity, and metabolic syndrome, and the current landscape of integrated and collaborative care for ALD and AUD in various treatment settings. We further review knowledge gaps and unmet needs that remain, including the role of precision medicine, the application of harm reduction approaches, the impact of health disparities, and the need for additional AUD treatment options, as well as further efforts to support implementation and dissemination.

Circular horizons: Pioneering sustainable paths in the oil and gas Industry's journey to net‐zero resilience

AbstractIn this study, we explore the adoption of circular economy within the oil and gas sector, particularly focusing on the Gulf Cooperation Council (GCC) and Middle East/North Africa (MENA) regions. Through semi‐structured interviews with senior managers from various backgrounds, we gain insights into the skills and challenges of the larger industry and explore the managerial ramifications. Broadly, our findings underscore the importance and criticality of circular economic capabilities (i.e. transparency reporting and resource efficiency, among others) in realizing ‘net‐zero’ goals and for building climate‐resilient businesses. We also emphasize the challenging trajectory towards sustainability and advocate for greater innovation, stakeholder engagement and strategic foresight. Based on the same, we develop conceptual frameworks that offer tangible representations of the evolving industrial landscape. Future research directions that have been suggested include stakeholder dynamics, technology integrations, policy implications and worldwide comparisons. Comprehensive case studies, longitudinal evaluations and multidisciplinary partnerships are required to further our understanding of the subtleties of circularity.

Digital transitions in healthcare: the need for transdisciplinary research to overcome barriers of privacy enhancing technologies uptake

PurposeAdopting Privacy Enhancing Technologies (PETs) is key to accelerating digitisation of the healthcare sector while simultaneously upholding data protection rights and increasing cybersecurity. While such technologies are market-ready, the uptake of PETs in healthcare is lagging behind. In this study we explore how conflicting logics and disciplinary disparities impact PET adoption, and how transdisciplinary (TD) methods can facilitate collaboration and mutual learning to overcome these hurdles.MethodsA sequential mixed-methods case analysis is employed, focusing on a specific multidisciplinary partnership within the healthcare sector. TD methods are used to examine challenges and underlying value systems related to PET adoption.ResultsConflicting institutional logics in healthcare, driven by missions and value systems, hinder collaborative efforts. TD methods promote awareness of disciplinary disparities, fostering an appreciative attitude toward diverse viewpoints, with an active facilitator playing a crucial role. Mutual learning aids in identifying collective actions to address challenges but may lead to tensions when issues are framed differently. TD methods, however, fall short in guiding decision-making when preferences diverge.ConclusionsSustainable PET adoption in healthcare requires addressing underlying value systems, effective communication, interdisciplinary consciousness and mutual learning. Acknowledging and managing tensions, particularly in diverse data governance contexts, proves important for successful PET adoption. Our research highlights the complexity of multidisciplinary partnerships, urging additional research to guide decision-making and governmental interventions. Ultimately, understanding these dynamics is a constructive approach for improving healthcare practices and outcomes through PET adoption.

Prospective, Multicenter, Head-to-Head Comparison Between Allergists Versus Nonallergists in Low-Risk Penicillin Allergy Delabeling: Effectiveness, Safety, and Quality of Life (HK-DADI2)

BackgroundPenicillin “allergy” labels are prevalent but frequently misdiagnosed. Mislabelled allergies are associated with adverse outcomes and increased antimicrobial resistance. With an urgent need to delabel the overwhelming number of mislabelled allergies, non-allergist evaluations have been advocated for low-risk individuals. Despite growing interest in non-allergist-led initiatives; evidence on their effectiveness, safety, and impact by direct comparisons are lacking. ObjectiveWe assessed the comparative outcomes of penicillin allergy evaluations conducted by allergists vs. non-allergists. MethodsA prospective, multi-centre, pragmatic study was conducted at four tertiary hospitals (one allergist- vs. three non-allergist-led) for low-risk penicillin allergy patients in Hong Kong – the Hong Kong Drug Allergy Delabelling Initiative 2 (HK-DADI2). ResultsAmong 228 low-risk patients who underwent testing (32.9% by allergists, 67.1% by non-allergists), only 14 (6.1%) had positive penicillin allergy testing. Delabelling rates (94.1% vs. 93.3%, p=0.777), positive skin tests (2.6% vs. 2.7%, p=1.000) and drug provocation tests (3.3% vs. 2.7%, p=1.000) were similar between allergists and non-allergists. There were no systemic reactions in either cohort. All patients had significant improvements in health-related quality-of-life (DrHy-Q scores −5.00 vs. −8.33, p=0.072). Non-allergist evaluations had shorter waiting times (0.57 vs. 15.7 months, p<0.001), while allergists required fewer consultations with higher rate of completing evaluations within a single-visit (OR=0.04, p<0.001). ConclusionWith training and support, non-allergists can independently evaluate low-risk penicillin allergies. Compared to allergists, evaluation of low-risk penicillin allergy by non-allergists can be comparably effective, safe, and impactful on quality-of-life. More multi-disciplinary partnerships to empower non-allergists to conduct allergy evaluations, should be encouraged.

Antimicrobial resistance and stewardship: What do pharmacists know and practice in a major Nigerian tertiary health facility: A cross-sectional study

Background: Multidrug-resistant bacterial infections are still a global challenge and successful antimicrobial stewardship (AMS) requires multidisciplinary collaborative partnership. Studies have highlighted the knowledge and perceptions of pharmacists, but there is a paucity of data about practices of pharmacists in teaching hospitals in Nigeria. We set out to determine the knowledge and practices of pharmacists in a major tertiary health facility (THF) in Lagos, Nigeria, before starting an AMS intervention program. Methods: This cross-sectional survey used electronic forms to find out the knowledge and practices of pharmacists employed in a large tertiary health facility. Data were collected during a Commonwealth Partnerships for AMS program to support low- and middle-income countries to produce antimicrobial consumption surveillance data, quality improvement initiatives, and infection prevention and control (IPC) processes. Results: Two-thirds of respondents knew that antibiotics were effective against bacteria, and 48.6% knew the causes of antimicrobial resistance. Almost all (97.1%) agreed that AMS must be done, IPC is important, and they were confident to point out inappropriate prescribing. Three-quarters had advised colleagues or been involved in AMS activities; however, 62.9% had fully or mostly changed their practices based on information received, and 26.5% had participated in World Antibiotic Awareness Week. Conclusion: There are still gaps in knowledge and practices, which underscore the need to entrench regular training on the job. However, there is overall awareness of AMS and a desire for it to be carried out at all levels. Pharmacists are useful for choosing appropriate antibiotics and can play a vital role in AMS.

Plant-Derived Natural Products: A Source for Drug Discovery and Development

For thousands of years, nature has been a source of medical substances, and an astounding numeral of contemporary remedies have been identified from natural origins. Plants have long been used as folk herbal medicines to treat various disorders, and their different natural products have inspired the design, discovery, and development of new drugs. With the invention of recent molecular targets based on proteins, there is a growing need for fresh chemical diversification in screening. Natural products will play a vital part in supplying this need via the continuous exploration of global biodiversity, the majority of which remains unexplored. Even though drug discovery from medicinal plants remains an important source of novel therapeutic leads, various hurdles exist, including identifying and executing suitable high-throughput screening bioassays, scaling up the supply of bioactive molecules, and acquiring plant materials. Investigating these natural resources takes multi-disciplinary, nationwide, and global partnerships in design, synthesis, discovery, and drug development techniques. This review article discusses current advancements and future approaches for discovering natural items such as health- and wellness-promoting remedies. It also summarizes strategies to unify the therapeutic use of plant-derived natural products worldwide to support future drug discoveries derived from plant sources.

A framework for more equitable, diverse, and inclusive Patient and Public Involvement for palliative care research

BackgroundThere are marked inequalities in palliative care provision. Research is needed to understand how such inequalities can be addressed, so that everyone living with advanced illness can receive the care they need, when they need it. Research into inequalities in palliative care should be guided by Patient and Public Involvement (PPI) that includes people from diverse backgrounds, who are less likely to receive specialist services. Multi-disciplinary research partnerships, bringing together primary care (the main providers of palliative care to diverse communities) and specialist palliative care, have the potential to work together in new ways to do research to address inequalities and improve palliative care in practice. This report describes a research partnership between primary care and palliative care that aimed to: (1) create opportunities for more inclusive PPI in palliative care research, (2) co-design new resources to support more equitable, diverse and inclusive PPI for palliative care, (3) propose a new framework for inclusive PPI in palliative care research.MethodsPPI members were recruited via primary care and palliative care research networks from three diverse areas of the UK. A pragmatic, collaborative approach was taken to achieve the partnership aims. Online workshops were carried out to understand barriers to inclusive PPI in palliative care and to co-design resources. Evaluation included a “you said, we did” impact log and a short survey. The approach was informed by good practice principles from previous PPI, and existing theory relating to equity, equality, diversity, and inclusion.ResultsIn total, 16 PPI members were recruited. Most were White British (n = 10), other ethnicities were Asian (n = 4), Black African (n = 1) and British mixed race (n = 1). The research team co-ordinated communication and activities, leading to honest conversations about barriers to inclusive PPI. Resources were co-designed, including a role description for an Equity, Equality, Diversity and Inclusion Champion, a “jargon buster”, an animation and an online recipe book (http://www.re-equipp.co.uk/) to inform future PPI. Learning from the partnership has been collated into a new framework to inform more inclusive PPI for future palliative care research.ConclusionCollaboration and reciprocal learning across a multi-disciplinary primary care and palliative care research partnership led to the development of new approaches and resources. Research team commitment, shared vision, adequate resource, careful planning, relationship building and evaluation should underpin approaches to increase equality, diversity and inclusivity in future PPI for palliative care research.