Research Funding Research Articles

Methods to advance health equity and social justice in healthcare: Protocol for a scoping review on the utilisation of routinely collected data.

Many areas of healthcare are impacted by a paucity of research that is translatable to clinical practice. Research utilising real-world data, such as routinely collected patient data, may be one option to efficiently create evidence to inform practice and service delivery. Such studies are also valuable for exploring (in)equity of services and outcomes, and benefit from using non-selected samples representing the diversity of the populations served in the 'real world'. This scoping review aims to identify and map the published research which utilises routinely collected clinical healthcare data. A secondary aim is to explore the extent to which this literature supports the pursuit of social justice in health, including health inequities and intersectional approaches. This review utilises Arksey and O'Malley's methodological framework for scoping reviews and draws on the recommended enhancements of this framework to promote a team-based and mixed methods approach. This includes searching electronic databases and screening papers based on a pre-specified inclusion and exclusion criteria. Data relevant to the research aims will be extracted from included papers, including the clinical/professional area of the topic, the source of data that was used, and whether it addresses elements of social justice. All screening and reviewing will be collaborative and iterative, drawing on strengths of the research team and responsive changes to challenges will be made. Quantitative data will be analysed descriptively, and conceptual content analysis will be utilised to understand qualitative data. These will be collectively synthesised in alignment to the research aims. Our findings will highlight the extent to which such research is being conducted and published, including gaps and make recommendations for future endeavours for real-world data studies. The findings from this scoping review will be relevant for practitioners and researchers, as well as health service managers, commissioners, and research funders.

Exploring virtual funding committee practices in the allocation of National Institute for Health and Care Research funding: A netnographic study

Background Funding committees, comprising members with a range of knowledge, skills, and experience, are considered integral to the decision-making process of funding organisations for recommending or allocating research funding. However, there is limited research investigating the decision-making processes, the role of members and their social interactions during funding committee meetings conducted both virtually and face-to-face. Methods Using a mixed-methods design and following netnography principles, the study observed nine National Institute for Health and Care Research programmes funding committee meetings conducted virtually during October 2020 to December 2021; complemented by interviews with committee chairs and members (18 interviews) and NIHR staff (12 interviews); an online survey (50 responses); and documentary analysis. Personal reflections through immersive journals also formed part of the analysis. Results Three main themes were identified from the observations, interviews, and online survey: efficiency of virtual committee meetings (importance of preparation, and the role of formality, process, and structure); understanding the effect of virtual committee meetings on well-being (effects of fatigue and apprehension, and the importance of work life balance); understanding social interactions and engagement (levels of engagement, contribution and inclusivity, awareness of unconscious bias and the value of social networking). Conclusions Examining the decision-making practices of one funding organisation across several research programmes, across multiple committee meetings over one year has generated new insights around funding committee practices that previous studies have not been able to explore or investigate. Overall, it was observed that fair and transparent funding recommendations and outcomes can be achieved through virtual funding committees. However, whilst virtual funding committees have many benefits and opportunities, such as the potential to increase membership diversity and inclusivity, and be more environmentally sustainable, more evidence is needed to evaluate their effectiveness, with particular focus on issues of fatigue, engagement, and committee cohesion, especially when new committee members join.

A scoping review on what constitutes a good research culture

Background The crisis in research culture is well documented, covering issues such as a tendency for quantity over quality, unhealthy competitive environments, and assessment based on publications, journal prestige and funding. In response, research institutions need to assess their own practices to promote and advocate for change in the current research ecosystem. The purpose of the scoping review was to explore ‘What does the evidence say about the ‘problem’ with ‘poor’ research culture, what are the benefits of ‘good’ research culture, and what does ‘good’ look like?’ Aims To examine the peer-reviewed and grey literature to explore the interplay between research culture, open research, career paths, recognition and rewards, and equality, diversity, and inclusion, as part of a larger programme of activity for a research institution. Methods A scoping review was undertaken. Six databases were searched along with grey literature. Eligible literature had relevance to academic research institutions, addressed research culture, and were published between January 2017 to May 2022. Evidence was mapped and themed to specific categories. The search strategy, screening and analysis took place between April-May 2022. Results 1666 titles and abstracts, and 924 full text articles were assessed for eligibility. Of these, 253 articles met the eligibility criteria for inclusion. A purposive sampling of relevant websites was drawn from to complement the review, resulting in 102 records included in the review. Key areas for consideration were identified across the four themes of job security, wellbeing and equality of opportunity, teamwork and interdisciplinary, and research quality and accountability. Conclusions There are opportunities for research institutions to improve their own practice, however institutional solutions cannot act in isolation. Research institutions and research funders need to work together to build a more sustainable and inclusive research culture that is diverse in nature and supports individuals’ well-being, career progression and performance.

Living labs in agrifood studies: An opportunity to revisit fundamental questions about participatory research?

The use of the term ‘living lab’ is now widespread, and in agrifood studies has been incorporated into research funding requirements. However, the methodological skills and prerequisites for successful living labs are not particularly well articulated. Based on our experience (five national and EU research projects) and our research backgrounds in (interdisciplinary) social science and participatory research, we highlight several risks associated with the use of living labs in agrifood studies without having the resources, reflectivity or skills required. These risks include: 1) imposing predefined agendas that are masked as participatory processes, 2) placing an overemphasis on confidentiality or knowledge sharing, and 3) getting lost in researcher roles. We argue that there is a need to discuss and improve understanding of these risks in order to produce successful living labs in agrifood studies, as well as avoid conceptual dilution or confusion.

Orthopedic Research Funding: Assessing the Relationship between Investments and Breakthroughs.

Orthopedic research plays a crucial role in improving patient outcomes for musculoskeletal disorders. This narrative review explores the intricate interplay between funding patterns and the trajectory of breakthroughs achieved in this dynamic field. A meticulous search strategy identified studies illuminating the diverse sources of orthopedic research funding, including public funding (government agencies), philanthropic organizations, private sector investment, and international funding bodies. The review further delved into the spectrum of breakthroughs, encompassing fundamental scientific discoveries, technological advancements, and personalized medicine approaches. Public funding emerged as a significant pillar, supporting foundational research that lays the groundwork for future advancements. Philanthropic organizations addressed specific musculoskeletal disorders, often focusing on patient-centric applications. International funding bodies played a role in supporting research in low- and middle-income countries. Breakthroughs extended beyond cutting-edge prosthetics and minimally invasive surgeries, encompassing fundamental discoveries in areas like gene therapy and biomaterials science. Technological advancements included brain-computer interface prosthetics and 3D-printed implants. Personalized medicine offered the potential for tailored treatments based on individual needs and genetic profiles. This review underscores the complex interplay between funding patterns and breakthroughs in orthopedic research. A multifaceted approach is essential for continued progress. Fostering collaboration, optimizing funding models, and prioritizing both foundational and translational research hold the key to unlocking the true potential of orthopedic research and transforming the lives of patients suffering from musculoskeletal disorders.

Approving Academic Advancement: Crafting Customized Recommendations for Grant Seekers within the Centralized Research Grant Management System

Introducing a groundbreaking Centralized Framework for Research Grant Management, poised to revolutionize grant lifecycles. This innovative system offers a unified interface, enhancing efficiency, transparency, and accountability. It includes features like rigorous peer review, real-time tracking, and personalized recommendations using machine learning algorithms. Despite limited existing research papers, this platform significantly aids grant seekers in identifying opportunities aligned with their specific department or research interests, filling a crucial gap in the grant-seeking process. Robust online security ensures data integrity, while adaptability supports diverse funding models and interdisciplinary collaboration. KEYWORD’S Centralized Grant Platform, Research Funding, Grant Allocation, AI Recommendations, Machine learning, Web Scrapping

How can meta-research be used to evaluate and improve the quality of research in the field of traditional, complementary, and integrative medicine?

The field of traditional, complementary, and integrative medicine (TCIM) has garnered increasing attention due to its holistic approach to health and well-being. While the quantity of published research about TCIM has increased exponentially, critics have argued that the field faces challenges related to methodological rigour, reproducibility, and overall quality. This article proposes meta-research as one approach to evaluating and improving the quality of TCIM research. Meta-research, also known as research about research, can be defined as “the study of research itself: its methods, reporting, reproducibility, evaluation, and incentives”. By systematically evaluating methodological rigour, identifying biases, and promoting transparency, meta-research can enhance the reliability and credibility of TCIM research. Specific topics of interest that are discussed in this article include the following: 1) study design and research methodology, 2) reporting of research, 3) research ethics, integrity, and misconduct, 4) replicability and reproducibility, 5) peer review and journal editorial practices, 6) research funding: grants and awards, and 7) hiring, promotion, and tenure. For each topic, we provide case examples to illustrate meta-research applications in TCIM. We argue that meta-research initiatives can contribute to maintaining public trust, safeguarding research integrity, and advancing evidence based TCIM practice, while challenges include navigating methodological complexities, biases, and disparities in funding and academic recognition. Future directions involve tailored research methodologies, interdisciplinary collaboration, policy implications, and capacity building in meta-research.

Life Extension Should Come with Wisdom: Reflections and Questions for the Geroscience and Longevity Community.

Geroscience, or longevity biotechnology, has made impressive advances in recent years that have led to the founding of dozens of start-ups, nonprofits and advocacy organizations, and the formation of a global movement to defeat aging. The community envisions changes at the regulatory and policy levels and calls for increased funding for research. Nevertheless, progress in the field has not been matched by discussions about ethical, legal, and social implications, as longevity advocates assume that seeking to expand lifespan or health span is inherently desirable and permissible. In this article, I make the case for the importance of putting ethics and society back into geroscience, along with three considerations for the longevity community. First, it should seek to understand the needs and attitudes of the public. Second, the community needs to define whether the field is primarily striving for healthy aging (increasing health span) or for extending years of life (lifespan). Third, it needs to define the role of investors and tech millionaires in shaping the field's priorities and direction. This last point raises the question of who is setting the direction of a field that can reshape the meaning of being human.

Association of the triglyceride–glucose index with all-cause and cause-specific mortality: a population-based cohort study of 3.5 million adults in China

The triglyceride-glucose (TyG) index has been recognized as a crucial risk factor for cardiovascular diseases. However, the association between the TyG index and mortality in the general population remains elusive. Participants were enrolled from the China Health Evaluation And risk Reduction through nationwide Teamwork (ChinaHEART), a nationwide prospective cohort study. The outcomes of interest were all-cause, cardiovascular, and cancer mortality. Restricted cubic splines and Cox regression models were used to assess the associations between the TyG index and outcomes. In total, 3,524,459 participants with a median follow-up of 4.6 (IQR, 3.1-5.8) years were included. The associations of the TyG index with all-cause and cardiovascular mortality were reverse L-shaped, with cut-off values of 9.75 for all-cause mortality and 9.85 for cardiovascular mortality. For each 1-unit increase in the TyG index, when below the cut-off values, the TyG index was not significantly associated with all-cause mortality (HR=1.02, 95% CI: 1.00-1.03) and was only modestly associated with cardiovascular mortality (HR=1.09, 95% CI: 1.06-1.11). Conversely, when the cut-off values were exceeded, the HRs (95% CI) were 2.10 (1.94-2.29) for all-cause mortality and 1.99 (1.72-2.30) for cardiovascular mortality. However, the association between the TyG index and cancer mortality was linearly negative (HR=0.97, 95% CI: 0.94-0.99). The associations of the TyG index with all-cause and cardiovascular mortality displayed reverse L-shaped patterns, while an elevated TyG index showed a slight negative association with cancer mortality. We suggest that <9.75 could be the optimal TyG index cut-off value among the Chinese general population. Individuals at high risk of mortality might benefit from proper management of a high TyG index. The National High Level Hospital Clinical Research Funding (2023-GSP-ZD-2, 2023-GSP-RC-01), the Ministry of Finance of China and National Health Commission of China.

Twenty years, twenty studies: what can we learn from San Diego’s innovation ecosystem?

ABSTRACT This study conducts a systematic literature review of San Diego’s innovation ecosystem to analyse its evolution, dynamics, the most influential (key) stakeholders, and success factors. 1,405 documents from Scopus and 809 documents from Web of Science (WoS) were retrieved and analysed to obtain a final sample of twenty articles. The ecosystem’s key organisational stakeholders were identified as UC San Diego, research institutes, venture capitalists, pioneer and leading companies and intermediary organisations. Regarding success factors, key political factors include research funding, other public funding and policies that foster, for example, the actors’ geographical proximity. Key economic factors include start-up support systems, company acquisitions and initial public offerings (IPOs). Several vital social factors, such as collaboration, social networks and risk-taking culture, were also identified. Finally, the key technological success factors include technology transfer, specific focus areas and critical mass in research and development. This systematic review, complemented by expert interviews, provides a comprehensive view and validation of the stakeholders and factors that have contributed to the emergence, evolution and dynamics of the innovation ecosystem. The study also exemplifies an originally nonleading city’s path to success, which can provide valuable innovation policy and planning insights for other nonleading regions.

Integrating 3D Technology in Sculpture Courses: Challenges, Strategies, and Recommendations

The integration of 3D technology into sculpture courses presented both opportunities and challenges for students and educators alike. This research investigated the current landscape, challenges, strategies, and recommendations associated with incorporating 3D technology in sculptural courses. Through a comprehensive review and analysis, key challenges emerged, including the complexity of technology, inadequate educational resources, varying levels of instructor expertise, and practical issues such as equipment maintenance and material properties. These challenges highlighted the need for targeted interventions to enhance educational effectiveness and accessibility. Strategies proposed included curriculum enhancements to integrate 3D technology, professional development programs for educators, improvements in technology interfaces, and collaborations between industry and academia. These strategies aimed to address identified challenges and optimize learning experiences in sculpture courses. Recommendations emphasized the development of centralized educational platforms, increased funding for 3D research, advocacy for regulatory standards, and the establishment of peer learning networks. These initiatives sought to foster a supportive environment conducive to innovation and creativity in sculptural arts education. By addressing these technological complexities, enhancing educational resources, improving instructor proficiency, and overcoming practical barriers, this study advocated for a comprehensive approach to integrating 3D technology effectively into sculpture courses, ultimately empowering students and educators to use their full potential in artistic expression and professional practice.

Sustainable Management Practices of Sio-River Wetland, Nambale Sub-County, Busia County

Wetlands are vital resources on the earth's surface and their roles and functions cannot be underestimated. The unique nature of the wetlands is recognized both at global and local levels. The objective of this study is to examine the sustainable management of the Sio-River Wetland in Nambale Sub-County. There is scanty research done to examine and document the sustainable management of the wetlands for the residents of Nambale Sub-County hence the need for study. To underscore the objective, a mixed research approach coupled with cross-sectional research design was used. Questionnaires, observation, interview guides, Geographical Information System and Remote Sensing were used in data collection. Questionnaires were administered to 400 inhabitants through cluster, simple random and purposive sampling. Qualitative data was thematically analysed while quantitative data was analysed using the Statistical Package for Social Sciences (SPSS Ver.21). Results showed that human activities, more so, agriculture degrade the wetlands by 80%. It, therefore, concluded that there was no balance between human activities and sustainable management of Sio-River Wetland due to the irresponsibility of the local community, inadequate policies and laws and lack of integrated approach in management. In this aspect, this study recommends rehabilitation and restoration of fragile ecosystems, allocation of funds for research and development and adoption of an integrated approach in wetland management to enhance the sustainability of wetlands in Nambale Sub-County and other parts of the world. The study recommends participatory management of wetland resources and additional knowledge in the field of Sustainable Management of Rivers and Wetland Ecosystems

Impact of global smoking prevalence on mortality: a study across income groups

BackgroundSmoking significantly contributes to the mortality rates worldwide, particularly in non-communicable and preventable diseases such as cardiovascular ailments, respiratory conditions, stroke, and lung cancer. This study aims to analyse the impact of smoking on global deaths, and its association with mortality across the main income groups.MethodsThe comprehensive analysis spans 199 countries and territories from 1990 to 2019. The study categorises countries into four income groups: high income, upper middle income, lower middle income, and low income.ResultsThe findings underscore the profound impact of global tobacco smoking on mortality. Notably, cardiovascular disease mortality is notably affected in both upper-middle-income and high-income groups. Chronic respiratory disease mortality rates show a significant impact across all income groups. Moreover, stroke-related mortality is observed in the lower-middle, upper-middle, and high-income groups. These results highlight the pervasive influence of smoking prevalence on global mortality, affecting individuals across various socioeconomic levels.ConclusionThe study underscores the critical implications of smoking on mortality rates, particularly in high-income countries. It emphasises the urgency of targeted interventions in these regions to address the specific challenges posed by tobacco smoking on public health. Policy recommendations include implementing prohibitive measures extending to indoor public areas such as workplaces and public transportation services. Furthermore, allocating funds for research on tobacco and health, is imperative to ensure policymakers are consistently informed about emerging facts and trends in this complex domain.

A review of authorship in herpes simplex virus type-2 (HSV-2) research conducted in low-income and middle-income countries between 2000 and 2020

IntroductionEquitable inclusion of low-income and middle-income country (LMIC) researchers and women in research authorship is a priority. A review of progress in addressing WHO-identified priorities provided an opportunity to examine...

Psychological distress and health behaviours in people living with and beyond cancer: a cross-sectional study

This study aimed to examine whether psychological distress was cross-sectionally associated with meeting World Cancer Research Fund (WCRF) recommendations in people living with and beyond cancer. Participants were adults living with and beyond breast, prostate and colorectal cancer, participating in the baseline wave of the Advancing Survivorship after Cancer Outcomes Trial (ASCOT). Anxiety/depression was assessed using the EQ-5D-5L and dichotomised into any/no problems. WCRF recommendations were assessed via pedometers, 24-h dietary recalls, self-reported alcohol intake (AUDIT-C), and self-reported smoking status. Participants were categorised as meeting WCRF recommendations using the following cut-offs: average daily steps (≥ 10,000/day), average weekly aerobic steps (≥ 15,000/day), fruit and vegetables (≥ 400 g/day), fibre (≥ 30 g/day), red meat (< 500 g/week), processed meat (0 g/day), high calorie food (fat ≤ 33% of total daily energy intake and free sugar ≤ 5% of total daily energy intake), alcohol (≤ 14 units/week) and smoking (non-smoking). A composite health behaviour risk index (CHBRI) was calculated by summing the number of WCRF recommendations met (range: 0–9). Among 1348 participants (mean age = 64 years (SD = 11.4)), 41.5% reported anxiety/depression problems. The mean CHBRI score was 4.4 (SD = 1.4). Anxiety/depression problems were associated with lower odds of meeting WCRF recommendations for average daily steps (odds ratio (OR) = 0.73; 95% CI 0.55, 0.97), but not for any other health behaviour. Psychological distress is associated with lower adherence to WCRF recommendations for physical activity in people living with and beyond cancer. Physical activity may be a mechanism linking psychological distress and poorer outcomes among people living with and beyond cancer, and this should be explored in longitudinal studies.

O-288 Pro

Abstract Currently and globally, the majority of ART treatments are performed either fully in the private medical sector or are partially subsidized in the public sector but with common treatments spill-over to the private sector; countries where there is sufficient public coverage of ART are in fact rare. While private clinics and hospital have been the norm in ART for decades, in recent years the field has undergone significant consolidation, and this has resulted in an influx of large financial players such as private equity (PE) firms. The results are a series of mergers and acquisitions that are shaping the geography of ART provision. In this debate, I will take on the “pro” side and I will highlight the scholarship around the changes in care brought about by PE ownership of medical practices, bringing examples from branches of medicine such as dermatology, dentistry, long term care or Ob&amp;Gyn that have experienced market consolidation in the last decades. I will show that available evidence indicate that the change in ownership to PE of private medical practices is associated with an increase in the number of patients treated and a net increase in payments to clinicians. Moreover, PE ownership has been repeatedly associated with a perception of higher quality care by patients, while clinical KPIs have not gotten worse and, if anything, have improved. This is usually due to greater intentional focus on standardization and quality control, streamline and protocolization of treatments, and centralization of certain administrative areas. I will further argue that, in large PE owned networks, best practices tend to be enhanced by peer to peer sharing and central medical boards, while centralization and digitalization of patient data collection favors research and development in a field that sorely lacks public funding for reproductive research.

Using Interventional Pharmacoeconomic Clinical Trials and Outcomes-Based Contracts to Repurpose Generic Drugs with Cost-Savings

The inability to enforce a monopoly price over low-cost therapies, such as repurposed generic drugs by using patents for new medical uses, means that pharmaceutical companies are not interested to develop these potentially lifesaving therapies, even if clinical trials would be significantly cheaper. With the cost of new drugs increasing unsustainably, new financial models are needed that can incentivize the development of such low-cost therapies, by leveraging the cost-savings they generate for payors. For example, by conducting a trial comparing a low-cost generic drug to an expensive patented drug, the cost-savings from patients taking a low-cost therapy rather than an expensive drug during the trial itself can exceed the cost of running the clinical trial, which means it is “self-funding,” while also potentially improving patient outcomes due to better safety, efficacy, convenience, or accessibility. This is referred to as “interventional pharmacoeconomics” or a “revolving research fund” and allows the sponsorship of clinical trials that can be entirely funded by payors. “Prize-like” outcomes-based contracts or advance market commitments can also be combined with such self-funding trials to incentivize obtaining regulatory approval and solve the “last-mile” problem. Self-funding trials can provide significant cost-savings for payors without financial risk. This article illustrates a four-step process for conducting such self-funding trials and other ethical, commercial, political, and legal barriers that need to be overcome in order to scale this novel and practically unlimited source of funding for the development of low-cost therapies.

Nicholas Avrion Mitchison. 5 May 1928 — 28 December 2022

Avrion Mitchison, universally known as Av, made enormous contributions to the field of cellular immunity. Working under Peter Medawar FRS during his PhD in Oxford, Av made the crucial discovery that viable lymphocytes were responsible for rejection of grafts of foreign tissue, initiating the field of cellular immunology, which was to preoccupy him throughout his career. In 1962 he was appointed head of the Division of Experimental Biology at the National Institute for Medical Research and began using proteins decorated with small synthetic molecules termed haptens, enabling him to make his second major discovery. He showed that optimal antibody responses to a hapten required the cooperation of two cell populations: bone-marrow-derived ‘B’ lymphocytes, which synthesized the antibody, and thymus-derived ‘T’ lymphocytes, which recognized moieties in the carrier protein molecule and provided help to the B cells. In 1971 Av became the Jodrell Professor of Zoology at University College London and head of the Imperial Cancer Research Fund Tumour Immunology Unit (TIU), where he continued to investigate how antibody and cytotoxic T cell responses are regulated and the role of major histocompatibility genes in this process. The TIU was a mecca for immunologists from around the world, and Av inspired those who passed through to make major contributions to cellular immunity, neuroimmunology, leukaemogenesis, tumour immunology and autoimmune disease. In 1991 he became the first director of the Rheumatism Research Centre in Berlin, and in a few short years after the fall of the Berlin wall established a flourishing institute. The annual award of the Mitchison Prize for Young Researchers honours his legacy.

Novel approaches to enable equitable access to monoclonal antibodies in low- and middle-income countries.

Monoclonal antibodies (mAbs) are revolutionizing management of non-communicable diseases in high-income countries and are increasingly being advanced for a range of infectious diseases (IDs). However, access to existing mAbs is limited in low- and middle-income countries (LMICs), and investment in developing fit-for-purpose mAbs for IDs that disproportionately affect LMICs has been limited. Underlying these access barriers are systemic challenges, including a lack of commercial incentives to target LMIC markets and complexity in manufacturing and regulatory processes. Novel strategies are needed to overcome systemic access barriers for mAbs. We outline key areas where new approaches could address these barriers, based on a multistakeholder consultation in March 2023. Three disease-market archetypes are identified to guide thinking about business models tailored to different contexts. New business models are needed to incentivize development and manufacturing of ID mAbs and to ensure mAbs are optimized with a target product profile and cost of goods that enable use in diverse LMIC settings. Lessons can be applied from voluntary licensing strategies and product development partnerships that have shown success in catalysing development and affordable supply for a range of infectious diseases. Technology transfer will be key to expand LMIC research and manufacturing capacity and to enable sustainable and diversified supply. Improved market intelligence, demand aggregation mechanisms, and portfolio-based manufacturing models could be used to de-risk commercial investment and establish a sustainable manufacturing ecosystem for affordable mAbs. Novel regulatory approaches and robust technology transfer may reduce data requirements and timelines for biosimilar approvals. Trailblazer products, with coordinated "end-to-end" support from funders, can demonstrate proof of concept for pathways to accessible mAbs across a broader range of LMICs. Research funders; local, regional, global health agencies; and, private sector partners should commit to implementing innovative partnerships and end-to-end strategies that enable equitable access to mAbs for infectious diseases in LMICs.

The Need for Enhancing Funding for Research on Children in Immigrant Families

The Need for Enhancing Funding for Research on Children in Immigrant Families