Multidisciplinary Research Team Research Articles

A team-based approach to cardiogenomic education.

While many genetic professionals are involved in the education of lay and professional audiences, most do not have formal training in education theory and program design. Partnerships with adult education experts can provide additional resources and improve the level of instruction, thereby increasing the impact of an educational intervention. This report discusses the experience of a multidisciplinary team of educators, clinicians, and researchers partnering to develop evidence-based education for cardiology practitioners. It includes practical advice for how clinicians and educators can develop more effective education through collaboration, needs assessment, instructional design, and iterative content development.

University–Business Collaboration for the Design, Development, and Delivery of Critical Thinking Blended Apprenticeships Curricula: Lessons Learned from a Three-Year Project

University–Business partnership for collaborative curriculum design, development, and delivery is an important dimension of University–Business Collaboration (UBC), but scarce information exists on how to enhance partnership for the design, development, and implementation of new curricula. With these questions in focus, this article intends to present and discuss the perceived experience during a three-year European funded project, namely, Think4Jobs. This project exemplifies the significance and benefits of UBC in the design, development, and delivery of curricula that meet the evolving demands of the labour market while promoting Critical Thinking (CT) as a foundational 21st century skill to contribute to graduates’ employability. Think4Jobs project brought together a multidisciplinary team of researchers and business organisations from five European countries (Germany, Greece, Lithuania, Portugal, and Romania) with interests in promoting and developing CT and mitigating eventual competence gaps. The project’s success was attributed to key practices, including defining a common conceptualization of CT, employing Participatory Co-Design, and providing common training for university and business partners. Clear objectives, explicit roles, effective communication, and ongoing evaluation further enhanced the collaboration. Experiential learning, real-work problems, and case studies reinforced the curricula, bridging the gap between academia and the labour market. By embracing these insights, future UBC initiatives can empower graduates with the necessary skills to stand out in an ever-changing labour market, contributing to enhanced education and successful careers.

Lessons learnt from a nationally funded training and mentoring programme for early-mid career musculoskeletal researchers in Australia.

Quality training and mentoring are crucial components of successful career development for early mid career researchers (EMCRs). This paper describes the overarching framework of novel ongoing national Training and Mentoring Programme Melbourne University Sydney Queensland:Impact (MUSQ:Impact) for musculoskeletal researchers, including a description of how it was set up and established, and lessons learned from its implementation. The MUSQ:Impact programme spans four multidisciplinary musculoskeletal research teams across three universities in Australia, comprising 40-60 EMCR members. It was established to provide EMCRs with a unique learning environment and opportunities to gain exposure to, and network with, other national musculoskeletal research teams. Specific goals are to focus on core research competencies (e.g. writing skills, managing grant budgets, public speaking and media engagement, research translation), provide career mentoring, fund development activities (e.g. conference attendance, laboratory visits, skill development courses), and share training resources (e.g. data dictionaries, project summaries). A Steering Committee of 10-12 EMCR members, co-chaired by a senior researcher and one EMCR, is responsible for overseeing MUSQ:Impact and organising regular activities, including a monthly webinar series, a mentor/mentee scheme, annual group research retreats, annual infographic competition, and funding awards. An evaluation survey found that most participants perceived each activity to be beneficial and of value to their research career and development. This paper presents the structure of national training and mentoring programme that serves as a potential template for other research teams to adapt within their own contexts.

Development and Integration of Machine Learning Algorithm to Identify Peripheral Arterial Disease: Multistakeholder Qualitative Study.

Machine learning (ML)-driven clinical decision support (CDS) continues to draw wide interest and investment as a means of improving care quality and value, despite mixed real-world implementation outcomes. This study aimed to explore the factors that influence the integration of a peripheral arterial disease (PAD) identification algorithm to implement timely guideline-based care. A total of 12 semistructured interviews were conducted with individuals from 3 stakeholder groups during the first 4 weeks of integration of an ML-driven CDS. The stakeholder groups included technical, administrative, and clinical members of the team interacting with the ML-driven CDS. The ML-driven CDS identified patients with a high probability of having PAD, and these patients were then reviewed by an interdisciplinary team that developed a recommended action plan and sent recommendations to the patient's primary care provider. Pseudonymized transcripts were coded, and thematic analysis was conducted by a multidisciplinary research team. Three themes were identified: positive factors translating in silico performance to real-world efficacy, organizational factors and data structure factors affecting clinical impact, and potential challenges to advancing equity. Our study found that the factors that led to successful translation of in silico algorithm performance to real-world impact were largely nontechnical, given adequate efficacy in retrospective validation, including strong clinical leadership, trustworthy workflows, early consideration of end-user needs, and ensuring that the CDS addresses an actionable problem. Negative factors of integration included failure to incorporate the on-the-ground context, the lack of feedback loops, and data silos limiting the ML-driven CDS. The success criteria for each stakeholder group were also characterized to better understand how teams work together to integrate ML-driven CDS and to understand the varying needs across stakeholder groups. Longitudinal and multidisciplinary stakeholder engagement in the development and integration of ML-driven CDS underpins its effective translation into real-world care. Although previous studies have focused on the technical elements of ML-driven CDS, our study demonstrates the importance of including administrative and operational leaders as well as an early consideration of clinicians' needs. Seeing how different stakeholder groups have this more holistic perspective also permits more effective detection of context-driven health care inequities, which are uncovered or exacerbated via ML-driven CDS integration through structural and organizational challenges. Many of the solutions to these inequities lie outside the scope of ML and require coordinated systematic solutions for mitigation to help reduce disparities in the care of patients with PAD.

‘Together We Prepare a Feast, Each Person Stirring Up Memory’

Our story starts in April 2020, in the early stages of the UK’s first national COVID-19 lockdown. A multidisciplinary team of researchers and artists began a collaboration with Migrateful, a charity that runs cookery classes led by refugees, asylum seekers, and migrants struggling to integrate and access employment. Teaching classes and sharing their cuisine and stories helps the chefs develop their confidence and sense of belonging, and food is central to the enterprise. The focus of the project was a series of interactive online cookery classes delivered by Migrateful chefs, with ongoing involvement from the researchers and artists. In this paper, we weave together the research team’s reflections on the project with commentary from the participants and artists. We outline our methods and our learning from the collaboration and explain how it inspired new ways of thinking about refugee representation, food and belonging, co-creative storytelling, and virtual engagement. We discuss the ways in which Migrateful’s model helps to support the production of counter-narratives that value, foreground, and amplify migrants’ perspectives and voices while acknowledging the tensions involved in adapting this model to the virtual space. We emphasise the power dynamics inherent in engaging and researching with marginalised people and their stories while considering whether artistic involvement and creation may help to navigate some of these challenges, and we address how the virtual environment affected the potential for collaborative storytelling, interaction, and engagement levels among participants. Together, these reflections form a ‘recipe’ for what we hope to be a more meaningful and ethical model of engagement activity that builds on this learning.

Development of a transdiagnostic digital interactive application for eating disorders: psychometric properties, satisfaction, and perceptions on implementation in clinical practice

BackgroundGiven limited availability of informed treatments for people affected by eating disorders (EDs), there has been increasing interest in developing self-administered, technology-based ED interventions. However, many available interventions are limited to a specific ED diagnosis or assume that participants are ready to change. We developed a digital self-help application (called ASTrA) that was explicitly designed to be transdiagnostic and to help increase motivation for change. The aim of the present study was to describe the development and examine the psychometric properties, user satisfaction and rated potentials for practical use of our application.MethodsThe content of our application was based on concepts derived from self-determination theory, the transtheoretical model of change, and cognitive theory. The application was developed by a multidisciplinary team of clinicians, researchers, staff members and individuals with lived ED experience, each being involved in all steps of the application’s development. We tested validity, reliability, satisfaction and perceived feasibility for clinical implementation in an independent sample of 15 patients with an ED and 13 clinicians specialized in ED treatment. Psychometric properties were evaluated using descriptive statistics, correlations, content validity indices and intraclass coefficients. Differences in satisfaction ratings and perceived potential for clinical implementation of the application between clinicians and patients were examined using Mann–Whitney U tests.ResultsThe digital application showed excellent validity (mean i-CVI: .93, range: .86–.96) and internal reliability (all Cronbach alpha’s > .88). Patients and clinicians both considered the application acceptable, appropriate, and feasible for use in clinical practice.ConclusionsFindings suggest that our transdiagnostic interactive application has excellent psychometric properties. Furthermore, patients and clinicians alike were positive about the possible use of the application in clinical practice. The next step will be to investigate the application's effectiveness as an intervention to promote autonomous motivation and to facilitate remission in people on the waitlist for specialized ED treatment.

Quality evaluation index development for nutritional management in patients with nasopharyngeal carcinoma during peri-radiotherapy

ObjectivesIt is necessary to construct an evaluation index for patients with nasopharyngeal carcinoma during peri-radiotherapy to provide a reference for the evaluation of the quality of nutritional management of patients with nasopharyngeal carcinoma during peri-radiotherapy. The aim of this study was to construct a set of scientific, comprehensive, and feasible indicators for evaluating the quality of nutrition management in patients with nasopharyngeal carcinoma during peri-radiotherapy to provide a unified reference basis for objective nutritional evaluation of these patients during the peri-radiotherapy period and to provide insights to the clinical treatment and care of these patients. MethodsA multidisciplinary research team was set up from December 2021 to April 2022. We took the three-dimensional quality structure model as the theoretical framework; based on the literature review, the first draft of the nutrition management quality evaluation index for patients with nasopharyngeal carcinoma during peri-radiotherapy was formed by a semi-structured interview. The Delphi correspondence method was used to survey 18 experts from 12 cities in China. The multidimensional analytical hierarchy process was used to determine the evaluation index and weight of nutrition management quality of patients with nasopharyngeal carcinoma during peri-radiotherapy. ResultsThe effective questionnaire recovery rates of the two rounds of letters were 90.005% and 100%, respectively, and the expert authority coefficients were 0.906 and 0.918, respectively. The Kendall harmony coefficients of the two rounds of letters were 0.271 to 0.313 and 0.309 to 0.349, respectively. The nutrition management quality evaluation index of patients with nasopharyngeal carcinoma during peri-radiotherapy was constructed and included 3 first-level indexes, 10 second-level indexes, and 71 third-level indexes. ConclusionThe evaluation index of the nutrition management quality of patients with nasopharyngeal carcinoma during peri-radiotherapy is scientific and reliable, and it may have a certain guiding significance for nurses to evaluate the quality of nutrition management of these patients during this period.

Engaging Patients and Caregivers to Develop a Patient-Centered Agenda for Comparative Effectiveness Research Focused on the Treatment of Complex Knee Problems.

Complex articular cartilage loss in the knee is being diagnosed more frequently and earlier in life, and patients are faced with major decisions regarding invasive surgical interventions at increasingly younger ages. There is a critical unmet need to provide patient-centered comparative effectiveness research for the hundreds of thousands of patients faced with these treatment decisions each year. Toward filling the need, we developed the Patient AdvisoR Team iN Orthopaedic ReSearch (PARTNORS) program. We recruited a diverse group of patients and caregivers with lived experiences in dealing with complex knee problems to define patient-centered research priorities for comparative biological and artificial knee surgery research for middle-aged adults. Adapting the Stakeholder Engagement in Question Development and Prioritization Method, PARTNORS defined a 20-question list of patient-centered research questions of factors influencing a patients' choice between biological and artificial knee surgeries. The highest prioritized research question related to functional level postsurgery as it relates to daily activities and recreational activities. The second highest prioritized research questions related to insurance coverage and financial costs. Other prioritized research areas included caregiving needs, implant longevity, recovery and rehabilitation time, patient satisfaction and success rates, individual characteristics, and risks. By engaging a group of patients and caregivers and including them as members of a multidisciplinary research team, comparative effectiveness research that includes patient-centered factors that go beyond typical clinical success indicators for knee surgery can be designed to allow physicians and patients to work together toward evidence-based shared decisions. This shared decision-making process helps to align patients' and health care team's goals and expectations to improve outcomes.

Fact-finding survey of doctors at the departments of pediatrics and pediatric surgery on the transition of patients with childhood-onset chronic disease from pediatric to adult healthcare.

The number of adult patients with childhood-onset chronic diseases is increasing. However, the process of transitioning these patients from child- to adult-centered medical services faces many difficulties. Despite the key role that doctors in the pediatric field are considered to play in transition, few fact-finding surveys about transition have been conducted among these doctors. The aim of this study was to demonstrate the current status and challenges in the transition of patients with childhood-onset chronic diseases by a fact-finding survey of pediatricians and pediatric surgeons at a university hospital. A cross-sectional survey was performed using an anonymous self-administered questionnaire. Seventy-six doctors of pediatrics and pediatric surgery (excluding junior residents) in a university hospital were asked to answer an anonymous self-report questionnaire. A multidisciplinary research team selected items related to the transitional process. Sixty (79%) doctors participated, of whom 52 (87%) showed awareness of transition. No doctor answered that "Transition is conducted smoothly." Doctors with shorter pediatric department experience had lower awareness and poorer experience with transition. In contrast to pediatric surgeons, pediatricians explained "job-seeking activities" and "contraceptive methods" to the patient, and reported a higher patient age at which to initiate explanation of transition to the patient and his/her family. Among factors inhibiting transition, 39 (65%) respondents selected "The patient's family members do not desire transition" and 34 (57%) selected "Although a relevant adult healthcare department is available, it will not accept the patient." The medical providers most frequently considered to have responsibility for playing a central role in the transition process were "pediatrician/pediatric surgeon," "medical social worker," and "regional medical liaison office." To promote transition, pediatric and adult healthcare departments should share concerns about and cooperate in the establishment of more effective methods of transition, and provide multidisciplinary collaboration to support patients and their families.

Outcomes of codesign workshops to create a digital resource that builds skills for student nurses in ASsessing cardiovascular risk, MOtivating change, and SUStaining healthier lifestyles: ASMOSUS

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Burdett Trust for Nursing. Background Student nurses are the workforce of the future, but cardiovascular (CV) risk factors are highly prevalent across this group, despite ‘Health Promotion’ being a component of nursing curricula. This theory-practice gap diminishes student nurses’ personal health and their capacity to influence the adoption of cardioprotective lifestyles by others. Purpose To conduct co-design workshops with undergraduate nursing students to create a user-friendly intervention that improves their knowledge and skills regarding CV risk management and healthy lifestyle implementation. Methods The co-design process comprised two steps: Step 1 (Design): Undergraduate nursing students (n=6) across two Universities in the UK agreed to participate in two virtual workshops, with each lasting approximately three hours and facilitated by members of the research team. Figure 1 displays the structure of each workshop. Step 2 (Prototype development): Information obtained in Step 1 was consolidated and used by the multidisciplinary research team (academics, students, and registered nurses) to draft, refine and re-draft content and structure for the intervention, which were subsequently sent to expert digital resource designers for prototype development. Results The co-design process resulted in development of a website that is ‘open for all’ (i.e., to enable users to complete different parts during different times and on different devices). The students identified the following topics as essential educational content: 1. Lifestyle behaviours and CV risk; 2. CV risk assessment; and 3. Motivational interviewing (see Figure 2). Students discussed their busy schedules (study and placement) and expressed a requirement for the information across these topics to be presented in an easily accessible format (i.e., short, comprehensible descriptions), to improve understanding and adherence. Moreover, students wanted the intervention to incorporate animations, quizzes, and simulated scenarios to facilitate enjoyable, interactive learning. In terms of intervention delivery, the consensus across students was for the beforementioned educational topics to be delivered via self-directed learning for one week (approximately 30 minutes to complete), followed by a group-work activity at a tutor-led, in-person workshop (approximately 90 minutes), which involves applying knowledge gained about CV risk assessment and motivational interviewing to simulated scenarios whilst receiving tailored guidance from the tutor. Conclusion Through co-creation, this study has developed a prototype educational intervention that is tailored to the requirements of nursing students for improving the core skills underpinning effective CV risk management and healthy lifestyle implementation. This work will progress to user testing and refinement prior to large-scale evaluation of acceptability and effectiveness.Fig 1.Structure of WorkshopsFig 2.Educational Content of Resource

The quest to develop automated systems for monitoring animal behavior

Automated behavior analysis (ABA) strategies are being researched at a rapid rate to detect an array of behaviors across a range of species. There is growing optimism that soon ethologists will not have to manually decode hours (and hours) of animal behavior videos, but that instead computers will process them for us. However, before we assume ABA is ready for practical use, it is important to take a realistic look at exactly what ABA is being developed, the expertise being used to develop it, and the context in which these studies occur. Once we understand common pitfalls occurring during ABA development and identify limitations, we can construct robust ABA tools to achieve automated (ultimately even continuous and real time) analysis of behavioral data, allowing for more detailed or longer-term studies of behavior on larger numbers of animals than ever before. ABA is only as good as it is trained to be. A key starting point is having manually annotated data for model training and assessment. However, most ABA developers are not trained in ethology. Often no formal ethogram is developed and descriptions of target behaviors in ABA publications are limited or inaccurate. In addition, ABA is also frequently developed using small datasets, which lack sufficient variability in animal morphometrics, activities, camera viewpoints, and environmental features to be generalizable. Thus, ABA often needs to be further validated before being used satisfactorily on different populations or under other conditions, even for research purposes. Multidisciplinary teams of researchers including ethologists and ethicists as well as computer scientists, data scientists, and engineers are needed to help address problems when applying computer vision ABA to measure behavior. Reference datasets that can be used for behavior detection should be generated and shared that include image data, annotations, and baseline analyses for benchmarking. Also critical is the development of standards for creating such reference datasets and descriptions of best practices for methods for validating results from detection tools to ensure they are robust and generalizable. At present, only a handful of publicly available datasets exist that can be used for development of ABA tools. As we work to realize the promise of ABA (and subsequent precision livestock farming technologies) to detect animal behavior, a clear understanding of best practices, access to accurately annotated datasets, and networking among ethologists and ABA developers will increase our chances for rapid and robust successes.

THE CRUCIAL ROLE OF RESEARCH MIDWIVES: SIGNIFICANCE AND IMPLEMENTATION

In the pursuit of providing women with the most current evidence-based care, high-quality research becomes paramount. Midwives, being uniquely positioned to understand the needs of pregnant women, can play a vital role in multidisciplinary research teams. They possess a range of skills essential for research, making them invaluable contributors. The role of a research midwife encompasses diverse responsibilities such as study design, participant recruitment and consent, data collection and analysis, as well as result dissemination. Engaging in this role not only allows midwives to refine existing skills but also presents ample opportunities for acquiring new ones. The experience gained as research midwives can pave the way for a gratifying career in research or significantly enhance their clinical practice.

The Efficacy, Safety, and Efficiency of the Off-Label Use of Bevacizumab in Patients Diagnosed With Age-Related Macular Degeneration: Protocol for a Systematic Review and Meta-Analysis

Background Age-related macular degeneration (AMD) is recognized as the leading cause of vision loss in older people. Considering the phenomenon of aging societies worldwide, the prevalence of AMD is expected to increase gradually in the future. AMD can be divided into early, intermediate, and late stages, with the early and intermediate stages being mainly asymptomatic, and the late stage being classified as geographic atrophy, neovascular AMD, or both. Current pharmacological treatments for neovascular AMD include anti–vascular endothelial growth factor agents, such as ranibizumab, pegaptanib, and aflibercept. Additionally, it has been reported that the off-label use of intravitreally administered bevacizumab is effective. It is also lower cost than other agents, which makes it an interesting pharmacological approach. Objective This review aims to evaluate the efficacy, safety, and efficiency of bevacizumab for the treatment of neovascular AMD. Methods This review will only consider randomized controlled clinical trials that compare the use of bevacizumab with another pharmacological agent or a placebo in patients aged 50 years and older who are diagnosed with vascular AMD. It will exclude studies that include participants diagnosed with polypoidal choroidal vasculopathy or retinal angiomatous proliferation. To identify and select relevant articles, we will develop a highly sensitive search strategy and apply it in MEDLINE via the PubMed platform. Upon selection of the studies and analysis of the titles, abstracts, and full texts, the results will be presented according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The analysis and extraction of the data will be performed by 2 independent reviewers. Risk of bias will be evaluated with the Critical Appraisal Skills Programme (CASP) checklist. Finally, the same reviewers will also perform a quality assessment of the included studies with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool. Results The search strategy, after the application of the inclusion and exclusion criteria, identified 15 randomized clinical trials, which are currently being analyzed. This project has no funding and it has been developed by a multidisciplinary research team of pharmacologists and orthoptists. The study was initiated in May 2021 and it is expected to conclude by the end of 2023. Conclusions This review will provide a synthesis of current information and underlying evidence about the off-label use of bevacizumab in neovascular AMD. It will provide a clearer vision of a possible new pharmacological approach, as well as the most suitable treatment designs, for the treatment of neovascular AMD. Trial Registration PROSPERO CRD42021244931; https://tinyurl.com/p6m5ycpk International Registered Report Identifier (IRRID) DERR1-10.2196/38658

Team principles for successful interdisciplinary research teams

Interdisciplinary research teams can be extremely beneficial when addressing difficult clinical problems. The incorporation of conceptual and methodological strategies from a variety of research disciplines and health professions yields transformative results. In this setting, the long-term goal of team science is to improve patient care, with emphasis on population health outcomes. However, team principles necessary for effective research teams are rarely taught in health professional schools. To form successful interdisciplinary research teams in cardio-oncology and beyond, guiding principles and organizational recommendations are necessary. Cardiovascular disease results in annual direct costs of $220 billion (about $680 per person in the US) and is the leading cause of death for cancer survivors, including adult survivors of childhood cancers. Optimizing cardio-oncology research in interdisciplinary research teams has the potential to aid in the investigation of strategies for saving hundreds of thousands of lives each year in the United States and mitigating the annual cost of cardiovascular disease. Despite published reports on experiences developing research teams across organizations, specialties and settings, there is no single journal article that compiles principles for cardiology or cardio-oncology research teams. In this review, recurring threads linked to working as a team, as well as optimal methods, advantages, and problems that arise when managing teams are described in the context of career development and research. The worth and hurdles of a team approach, based on practical lessons learned from establishing our multidisciplinary research team and information gleaned from relevant specialties in the development of a successful team are presented.

Examining the publicness of spaces on European social housing estates: a position paper

The concept of ‘publicness’ addresses the intersection between people and their physical surroundings, and the ways in which they affect each other in an ongoing process. This point of relational exchange is the core concept behind ‘Public Space in European Social Housing’ (PuSH), a three-year HERA-funded project conducted by a transnational, multidisciplinary team of researchers. Large-scale modernist postwar housing estates, often used for social, cooperative, or mass rental housing, tend to be problematised as places of segregation and disintegration in European cities. Yet they are potentially also primary sites for integration between people of different cultural origins and social backgrounds. By investigating publicness in relation to social housing, including cooperative housing and mass rental housing estates, PuSH aims to better understand how cultural encounters happen, and ultimately to reflect on how integration can be better sustained. In this paper, we take a relational conception of publicness as our point of departure to explore the differentiations and intersections between sites and modes of public life in relation to our approach and the social housing estates we investigate. Moreover, we present our conceptual contribution to the concept of publicness, both theoretically and methodologically using multidisciplinary theories and methodologies, and four analytical categories: heritage, practices/policies, democracy, informality, and moreover exhibitions are used as a research tool. This paper is a collaborative output whereby different researchers on the project present their theoretical developments and positions, identify the analytical categories and theoretical vocabularies on which they daw, and reflect on potential ways in which these concepts can be operationalised, and on the synergies that may develop between them. Taken together, our approach offers significant interpretations of publicness in relation to questions of public space, and tackles some of the most pronounced tensions in discussions of public space.

Standardized Suicide Prevention Program for Gatekeeper Intervention of North Korean Defectors in South Korea.

North Korean defectors (NKDs) have experienced substantial difficulties during the migration and settlement in South Korea. They have a high prevalence of depression, post-traumatic stress disorder, and suicidal behaviors. The high prevalence of mental disorders among NKDs can lead to a high suicide rate. However, there are no suicide prevention programs for NKDs. This study aims to customize a suicide prevention program with content suitable for NKDs' particular circumstances. A multidisciplinary research team developed this program based on domestic and international gatekeeper training programs for suicide prevention and articles related to suicide prevention. We developed a multi-part gatekeeper training program, "Suicide CARE for NKDs." In the "Introduction," trainees learn about the need for the program and its importance. In "Careful observation," trainees learn to recognize linguistic, behavioral, and situational signals of suicide risk. In "Active listening," trainees learn how to ask about suicidal thoughts and to listen empathetically. In "Risk evaluation and expert referral," trainees learn to evaluate suicide risk and to connect NKDs with institutes or services. We expect this program to become useful for training gatekeepers to prevent suicide among NKD. A future follow-up study is needed to confirm the efficacy of the program.

A 7-Step Guideline for Qualitative Synthesis and Meta-Analysis of Observational Studies in Health Sciences.

Objectives: To provide a step-by-step, easy-to-understand, practical guide for systematic review and meta-analysis of observational studies. Methods: A multidisciplinary team of researchers with extensive experience in observational studies and systematic review and meta-analysis was established. Previous guidelines in evidence synthesis were considered. Results: There is inherent variability in observational study design, population, and analysis, making evidence synthesis challenging. We provided a framework and discussed basic meta-analysis concepts to assist reviewers in making informed decisions. We also explained several statistical tools for dealing with heterogeneity, probing for bias, and interpreting findings. Finally, we briefly discussed issues and caveats for translating results into clinical and public health recommendations. Our guideline complements "A 24-step guide on how to design, conduct, and successfully publish a systematic review and meta-analysis in medical research" and addresses peculiarities for observational studies previously unexplored. Conclusion: We provided 7 steps to synthesize evidence from observational studies. We encourage medical and public health practitioners who answer important questions to systematically integrate evidence from observational studies and contribute evidence-based decision-making in health sciences.

Research and practice in harmonising nature and culture in Jaipur City, Rajasthan, India

PurposePlanning for Jaipur City in Rajasthan, north-western India, which was added to the World Heritage List in 2019, considers the surrounding hills and water systems. Rapid urbanisation is currently placing strain on the area, and natural resources and city green spaces are deteriorating. A multidisciplinary team of academicians, researchers and practitioners was assembled under the Heritage Place Lab (HPL) initiative with the aim of developing a research agenda to complement the city's Special Area Heritage Plan (SAHP) that is currently in development.Design/methodology/approachGiven the complicated urban structure of Jaipur, an interdisciplinary approach involving experts from various fields and engagement from all levels of the city's stakeholders was necessary. The partnership proceeded following the parameters provided under the HPL to jointly build a research agenda focussing on the management challenges of the World Heritage Site.FindingsThe co-produced research programme narrowed its initial emphasis on documenting of the natural heritage of the city to reflect the functions it served in a social setting. It was also revealed that the conflicting nature of activities within the World Heritage Site is caused by overlapping jurisdictions of several administrative and legislative components.Originality/valueJaipur, examined here by an interdisciplinary Research-Practice Team, provides a valuable and unique case study for heritage management, particularly given that most historic cities in India are facing comparable concerns surrounding urbanisation with rising pressures on natural resources.

Partners in research: The success with therapies research consortium and the CF community unite to improve self-management

BackgroundThe daily treatment regimen for an individual with cystic fibrosis (CF) can take more than 2 h to complete, and chronic treatment adherence rates are low. Developing partnerships between CF clinical researchers and the CF community is essential in developing acceptable, feasible, and effective strategies to improve self-management and adherence. MethodsThe Success with Therapies Research Consortium (STRC) was formed as a multi-center US collaborative to conduct rigorous research studies of adherence to CF treatments. A multidisciplinary team of researchers from 15 sites, collaborating with members of the CF community, is charged with developing, implementing, and disseminating real-world, patient-centered interventions for people living with CF. ResultsSince 2014, the STRC has conducted 8 studies. The CF community, people with CF (pwCF), and caregivers have come to serve in multiple valuable capacities on the STRC, including as members of the Steering Committee and Co-Principal Investigators. Additionally, while people with CF are irreplaceable participants in STRC studies, their influence, and that of their families and healthcare professionals, extends beyond the traditional research participant role. ConclusionsEngaging broadly with the CF community is the optimal model for developing interventions to support those living with CF in sustaining daily care. Input and direct involvement from people with CF, their families, and their caregivers has enabled the STRC to advance its mission through innovative clinical research approaches.

Non-metric distance judgements are influenced by image projection geometry and field of view.

Despite its mathematical simplicity and ubiquity in imaging technology, there has long been doubt about the ability of linear perspective to best represent human visual space, especially at wide-angle fields of view under natural viewing conditions. We investigated whether changes to image geometry had an impact on participants' performance, specifically in terms of non-metric distance estimates. Our multidisciplinary research team developed a new open-source image database to study distance perception in images by systematically manipulating target distance, field of view, and image projection using non-linear natural perspective projections. The database consists of 12 outdoor scenes of a virtual three-dimensional urban environment in which a target ball is presented at increasing distance, visualised using both linear perspective and natural perspective images, rendered, respectively, with three different fields of view: 100°, 120°, and 140° horizontally. In the first experiment (N = 52), we tested the effects of linear versus natural perspective on non-metric distance judgements. In the second experiment (N = 195), we investigated the influence of contextual and previous familiarity with linear perspective, and individual differences in spatial skills on distance estimations. The results of both experiments showed that distance estimation accuracy improved in natural compared with linear perspective images, particularly at wide-angle fields of view. Moreover, undertaking a training session with only natural perspective images led to more accurate distance judgements overall. We argue that the efficacy of natural perspective may stem from its resemblance to the way objects appear under natural viewing conditions, and that this can provide insights into the phenomenological structure of visual space.