Roadblocks In Research Research Articles

566 Identifying barriers to the inclusion of pregnant patients in hepatitis C research and treatment programs

The rising prevalence of hepatitis C virus (HCV) infection and the availability of direct acting antivirals for HCV treatment has prompted a public health goal of HCV eradication. However, treatment studies and programs have largely excluded pregnant individuals, despite compelling reasons why treatment during pregnancy may be an effective public health strategy. Our objective was to query patient and clinician stakeholders to identify barriers to including pregnant patients in HCV research and treatment programs. This qualitative investigation included obstetricians (ob/gyn specialists and MFM subspecialists) and pregnant and previously-pregnant patients (ages 27-44) with HCV. Participants completed semi-structured individual interviews regarding knowledge of HCV in pregnancy and HCV treatment, perceived barriers to treatment/research during pregnancy, and attitudes toward treatment. Data were analyzed using the constant comparative method to identify themes. Participants (N=18 obstetricians, N=21 patients) addressed multiple perceived barriers to HCV treatment in pregnancy (Table). Obstetrician-specific themes included inadequate evidence base and lack of professional guidelines, perceived patient burdens (e.g. low health literacy), and research roadblocks. Themes shared by obstetricians and patients included cost and access barriers, insufficient provider knowledge, and safety concerns (Figure). Patient-specific themes were provider communication challenges, psychological barriers, and unclear rationale for treatment during pregnancy. Nevertheless, patients were well-informed and largely desirous of treatment. Although cost, safety, and provider knowledge concerns regarding HCV treatment in pregnancy were shared by patients and obstetricians, these groups diverged regarding perceived patient preferences. Importantly, patients did not endorse obstetrician concerns about low health literacy and patient logistical burdens. To ensure appropriate and equitable access to HCV treatment for pregnant individuals, these patient and provider barriers must be addressed.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Fourth Annual Clinician Scientist Trainee Symposium at the Schulich School of Medicine and Dentistry

The Annual Clinician Scientist Trainee Symposium (CSTS) gathers the local medical research community at the Schulich School of Medicine and Dentistry, including research trainees at the medical student, resident and fellow levels. Trainees showcase their current and upcoming work, and leaders in the community impart their perspectives on the importance and future of research in medicine. At the 4th Annual CSTS, perseverance and cautious optimism emerged as the characteristics that trainees should foster through their future careers as clinician scientists. This was echoed by the challenges and encouraging findings presented by trainees, who conducted their work as part of research projects within the MD, MD/PhD and clinical investigator programs. The four oral presentations and 10 three-minute thesis presentations covered the full breadth of medical disciplines across the spectrum of translational medicine, from fundamental sciences through knowledge translation. The CSTS concluded with the keynote presentation by Michael Strong, current president of the Canadian Institutes of Health Research, who gave a glimpse into his decades-long path of overcoming and overturning dogmatic views in the world of amyotrophic lateral sclerosis research, demonstrating how roadblocks in research can become an impulse for stronger science.

Tapping and assessing the concept of educational regret: methodological techniques for opening up biographical reflection

ABSTRACTRegret, a negative assessment of an action committed or a path not taken, is a common biographical experience. However, it is a difficult concept to study in social science research. Participants are likely to enact protective barriers to avoid confronting personal responsibility for ‘bad’ decisions. Drawing on examples from an in-depth interview study of postsecondary educational experiences, we examine a technique and set of questions that can move beyond these biographical research roadblocks. We argue that a highly structured and comprehensive, yet flexible interview guide is ideal for exploring this concept. This article also outlines two questions that can elicit biographical regret, particularly educational regret. The first question asks respondents what they would change about their college experience. The second question asks respondents what advice they would provide to new college students. Together, these methodological techniques are effective at overcoming potential research roadblocks because they allow for an agentic, positive reframing of the experience of regret.

Arctic nations strike down research roadblocks

Arctic nations strike down research roadblocks

Overcoming the translational roadblocks: a cancer care and research model.

There are many challenges to the process of translating the knowledge gained in the laboratory into new clinical approaches that can meet the needs of patients, clinicians and the wider community. We describe here an initiative that has borrowed concepts and principles from participatory research to produce a new process embedded in a cancer center aiming to facilitate translational research and overcome the three translational roadblocks. The centre-wide project named Personal Response Determinants in Cancer Therapy (PREDICT) operates with the support of the centre’s leadership, staff, volunteers and patients to contribute to current and future cancer research successes. We describe the different phases of the project, the current structure and lessons learned during its evolution, highlighting how PREDICT contributes to translational research and its linkage to participatory research concepts. Despite the contextualized nature of the PREDICT initiative, we believe that the framework developed for the project has the potential to help other clinical centers to overcome the translational research roadblocks.

Short‐Stay Nursing Home Rehabilitation Patients: Transitional Care Problems Pose Research Challenges

A clinical intervention pilot study to improve depression care for short-stay nursing home Medicare-reimbursed rehabilitation patients funded by the National Institute on Aging was conducted. Despite solid theoretical and clinical grounding and the support of a large nursing home company, several roadblocks to implementation were encountered, including involving patients and families, communication between providers, involving community primary care physicians, staff time constraints, and conducting research with short-stay patients. Although frustrating from a research standpoint, these roadblocks closely reflect problems identified by the American Geriatrics Society as impeding the delivery of high-quality transitional care in geriatrics. These research roadblocks are described as they were encountered in the clinical setting, and each is placed within the larger context of challenges associated with care transitions, especially for older persons with complex health needs receiving nursing home rehabilitation. Finally, recommendations are offered for researchers conducting much-needed research within geriatric transitional care settings, including starting early in the care transition chain and assisting patients and families with providing continuity across care settings.