Background and objective
There has been growing emphasis on increasing impacts of academic health research by integrating research findings in healthcare. The concept of knowledge translation (KT) ...has been widely adopted in Canada to guide this work, although lack of recognition in tenure and promotion (T&P) structures have been identified as barrier to researchers undertaking KT. Our objective was to explore how KT is considered in institutional T&P documentation in Canadian academic health sciences.
Methods
We conducted content analysis of T&P documents acquired from 19 purposively sampled research-intensive or largest regional Canadian institutions in 2020–2021. We coded text for four components of KT (synthesis, dissemination, exchange, application). We identified clusters of related groups of documents interpreted together within the same institution. We summarized manifest KT content with descriptive statistics and identified latent categories related to how KT is considered in T&P documentation.
Results
We acquired 89 unique documents from 17 institutions that formed 48 document clusters. Most of the 1057 text segments were categorized as dissemination (n = 851, 81%), which was included in 47 document clusters (98%). 15 document clusters (31%) included all four KT categories, while one (2%) did not have any KT categories identified. We identified two latent categories: primarily implicit recognition of KT; and an overall lack of clarity on KT.
Conclusions
Our analysis of T&P documents from primarily research-intensive Canadian universities showed a lack of formal recognition for a comprehensive approach to KT and emphasis on traditional dissemination. We recommend that institutions explicitly and comprehensively consider KT in T&P and align documentation and procedures to reflect these values.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Nursing shortages, particularly in critical care units, are a major concern worldwide. Job satisfaction is a key factor associated with the high turnover of critical care nurses.
The purpose of this ...systematic review was to synthesize the evidence on critical care nurses’ job satisfaction. Specific research questions were: 1. How is job satisfaction defined and measured in studies of critical care nurses? 2a. What is the level of job satisfaction among critical care nurses? 2b. How has it changed over time? 2c. Do nurses’ levels of job satisfaction differ by type of critical care unit? 3. What factors are associated with critical care nurses’ job satisfaction?
Systematic review.
We searched five electronic databases from January 1980 to May 2015: MEDLINE, CINAHL, PsychINFO, EMBASE, and Proquest Nursing & Allied Health Source.
Two team members independently screened all titles and abstracts and extracted data and assessed methodological quality on all included papers. A narrative synthesis with vote counting was undertaken.
A total of 1995 titles were identified, of which 61 satisfied our inclusion criteria. Only 24 (39%) of the included studies reported a conceptual definition of job satisfaction. Forty-two different quantitative measures of job satisfaction were identified, of which only 10 (24%) were used in multiple studies. The weighted mean job satisfaction score for critical care nurses across all studies was 56% satisfied and demonstrated fluctuations over time. Four factors showed significant positive relationships to job satisfaction: 1. shift worked – rotating 8- to 12-h and rotating days, evenings or nights; 2. Autonomy; 3. personnel resources and staffing; and 4. teamwork and cohesion; while two factors showed significant negative relationships to job satisfaction: 1. job stress; and 2. burnout-emotional exhaustion.
From this review, we did not find any evidence to support relationships between individual (socio-demographic) factors and critical care nurses’ job satisfaction. We did however find evidence to support relationships between several employment and organizational factors and job satisfaction. Several of these factors are different from those reported among general hospital nurses and long-term care nursing staff, supporting the need for differential strategies to improve critical care nurses’ job satisfaction. While the findings from this review hold promise as potential targets of future job satisfaction interventions, there were several methodological problems inherent in many of the studies.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Health-promoting polyunsaturated fatty acids (PUFA) are abundant in forages grazed by ruminants and in vegetable and fish oils used as dietary supplements, but only a small proportion of PUFA finds ...its way into meat and milk, because of biohydrogenation in the rumen. Butyrivibrio fibrisolvens plays a major role in this activity. The aim of this study was to investigate the mechanisms by which PUFA affect the growth of B. fibrisolvens, how PUFA are metabolized and the metabolic response to growth in the presence of PUFA.
Linoleic acid (LA; cis-9, cis-12-18:2) and alpha-linolenic acid (LNA; cis-9, cis-12, cis-15-18:3) increased the lag phase of B. fibrisolvens JW11, LNA having the greater effect. Growth was initiated only when the PUFA had been converted to vaccenic acid (VA; trans-11-18:1). The major fish oil fatty acids, eicosapentaenoic acid (EPA; 20:5(n-3)) and docosahexaenoic acid (DHA; 22:6(n-3)), were not metabolized and prevented growth. Cellular integrity, as determined fluorimetrically by propidium iodide (PI) ingression, was affected as much by 18:1 fatty acids, including VA, as 18:2 fatty acids. The methyl esters of LNA, LA, EPA and DHA had no effect on growth or other measurements. The ATP pool decreased by 2/3 when LA was added to growing bacteria, whereas most acyl CoA pools decreased by >96%.
It was concluded that biohydrogenation occurs to enable B. fibrisolvens to survive the bacteriostatic effects of PUFA, and that the toxicity of PUFA is probably mediated via a metabolic effect rather than disruption of membrane integrity.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract Objective To provide an overview of the science and practice of knowledge translation. Study Design Narrative review outlining what knowledge translation is and a framework for its use. ...Results Knowledge translation is defined as the use of knowledge in practice and decision making by the public, patients, health care professionals, managers, and policy makers. Failures to use research evidence to inform decision making are apparent across all these key decision maker groups. There are several proposed theories and frameworks for achieving knowledge translation. A conceptual framework developed by Graham et al., termed the knowledge-to-action cycle, provides an approach that builds on the commonalities found in an assessment of planned action theories. Conclusions Review of the evidence base for the science and practice of knowledge translation has identified several gaps including the need to develop valid strategies for assessing the determinants of knowledge use and for evaluating sustainability of knowledge translation interventions.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Shared decision making (SDM) is a process by which a healthcare choice is made jointly by the practitioner and the patient and is said to be the crux of patient-centred care. Policy makers perceive ...SDM as desirable because of its potential to a) reduce overuse of options not clearly associated with benefits for all (e.g., prostate cancer screening); b) enhance the use of options clearly associated with benefits for the vast majority (e.g., cardiovascular risk factor management); c) reduce unwarranted healthcare practice variations; d) foster the sustainability of the healthcare system; and e) promote the right of patients to be involved in decisions concerning their health. Despite this potential, SDM has not yet been widely adopted in clinical practice.
To determine the effectiveness of interventions to improve healthcare professionals' adoption of SDM.
We searched the following electronic databases up to 18 March 2009: Cochrane Library (1970-), MEDLINE (1966-), EMBASE (1976-), CINAHL (1982-) and PsycINFO (1965-). We found additional studies by reviewing a) the bibliographies of studies and reviews found in the electronic databases; b) the clinicaltrials.gov registry; and c) proceedings of the International Shared Decision Making Conference and the conferences of the Society for Medical Decision Making. We included all languages of publication.
We included randomised controlled trials (RCTs) or well-designed quasi-experimental studies (controlled clinical trials, controlled before and after studies, and interrupted time series analyses) that evaluated any type of intervention that aimed to improve healthcare professionals' adoption of shared decision making. We defined adoption as the extent to which healthcare professionals intended to or actually engaged in SDM in clinical practice or/and used interventions known to facilitate SDM. We deemed studies eligible if the primary outcomes were evaluated with an objective measure of the adoption of SDM by healthcare professionals (e.g., a third-observer instrument).
At least two reviewers independently screened each abstract for inclusion and abstracted data independently using a modified version of the EPOC data collection checklist. We resolved disagreements by discussion. Statistical analysis considered categorical and continuous primary outcomes. We computed the standard effect size for each outcome separately with a 95% confidence interval. We evaluated global effects by calculating the median effect size and the range of effect sizes across studies.
The reviewers identified 6764 potentially relevant documents, of which we excluded 6582 by reviewing titles and abstracts. Of the remainder, we retrieved 182 full publications for more detailed screening. From these, we excluded 176 publications based on our inclusion criteria. This left in five studies, all RCTs. All five were conducted in ambulatory care: three in primary clinical care and two in specialised care. Four of the studies targeted physicians only and one targeted nurses only. In only two of the five RCTs was a statistically significant effect size associated with the intervention to have healthcare professionals adopt SDM. The first of these two studies compared a single intervention (a patient-mediated intervention: the Statin Choice decision aid) to another single intervention (also patient-mediated: a standard Mayo patient education pamphlet). In this study, the Statin Choice decision aid group performed better than the standard Mayo patient education pamphlet group (standard effect size = 1.06; 95% CI = 0.62 to 1.50). The other study compared a multifaceted intervention (distribution of educational material, educational meeting and audit and feedback) to usual care (control group) (standard effect size = 2.11; 95% CI = 1.30 to 2.90). This study was the only one to report an assessment of barriers prior to the elaboration of its multifaceted intervention.
The results of this Cochrane review do not allow us to draw firm conclusions about the most effective types of intervention for increasing healthcare professionals' adoption of SDM. Healthcare professional training may be important, as may the implementation of patient-mediated interventions such as decision aids. Given the paucity of evidence, however, those motivated by the ethical impetus to increase SDM in clinical practice will need to weigh the costs and potential benefits of interventions. Subsequent research should involve well-designed studies with adequate power and procedures to minimise bias so that they may improve estimates of the effects of interventions on healthcare professionals' adoption of SDM. From a measurement perspective, consensus on how to assess professionals' adoption of SDM is desirable to facilitate cross-study comparisons.
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NUK, OILJ, UL, UM, UPUK, VSZLJ
Summer annuals overwinter as seeds in the soil seed bank. This is facilitated by a cold-induced increase in dormancy during seed maturation followed by a switch to a state during seed imbibition in ...which cold instead promotes germination. Here, we show that the seed maturation transcriptome in Arabidopsis thaliana is highly temperature sensitive and reveal that low temperature during seed maturation induces several genes associated with dormancy, including DELAY OF GERMINATI0N1 DOG1), and influences gibberellin and abscisic acid levels in mature seeds. Mutants lacking DOG1, or with altered gibberellin or abscisic acid synthesis or signaling, in turn show reduced ability to enter the deeply dormant states in response to low seed maturation temperatures. In addition, we find that DOG1 promotes gibberellin catabolism during maturation. We show that C-REPEAT BINDING FACTORS (CBFs) are necessary for regulation of dormancy and of GA2OX6 and DOG1 expression caused by low temperatures. However, the temperature sensitivity of CBF transcription is markedly reduced in seeds and is absent in imbibed seeds. Our data demonstrate that inhibition of CBF expression is likely a critical feature allowing cold to promote rather than inhibit germination and support a model in which CBFs act in parallel to a low-temperature signaling pathway in the regulation of dormancy.
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BFBNIB, NMLJ, NUK, PNG, SAZU, UL, UM, UPUK
Plants must coordinate photosynthetic metabolism with the daily environment and adapt rhythmic physiology and development to match carbon availability. Circadian clocks drive biological rhythms which ...adjust to environmental cues. Products of photosynthetic metabolism, including sugars and reactive oxygen species (ROS), are closely associated with the plant circadian clock, and sugars have been shown to provide metabolic feedback to the circadian oscillator. Here, we report a comprehensive sugar-regulated transcriptome of
and identify genes associated with redox and ROS processes as a prominent feature of the transcriptional response. We show that sucrose increases levels of superoxide (O
), which is required for transcriptional and growth responses to sugar. We identify circadian rhythms of O
-regulated transcripts which are phased around dusk and find that O
is required for sucrose to promote expression of TIMING OF CAB1
in the evening. Our data reveal a role for O
as a metabolic signal affecting transcriptional control of the circadian oscillator in
.
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BFBNIB, NMLJ, NUK, PNG, SAZU, UL, UM, UPUK
Seasonal behavior is important for fitness in temperate environments but it is unclear how progeny gain their initial seasonal entrainment. Plants use temperature signals to measure time of year, and ...changes to life histories are therefore an important consequence of climate change. Here we show that in Arabidopsis the current and prior temperature experience of the mother plant is used to control germination of progeny seeds, via the activation of the florigen Flowering Locus T (FT) in fruit tissues. We demonstrate that maternal past and current temperature experience are transduced to the FT locus in silique phloem. In turn, FT controls seed dormancy through inhibition of proanthocyanidin synthesis in fruits, resulting in altered seed coat tannin content. Our data reveal that maternal temperature history is integrated through FT in the fruit to generate a metabolic signal that entrains the behavior of progeny seeds according to time of year.
Significance Seed behavior is known to be highly dependent on the temperature during seed set, but the mechanism is poorly understood. Here we show that the mother plant plays a central role in the control of progeny seed dormancy, integrating long-term temperature memories in fruit tissues using the same pathway that controls flowering time. Regulation of seed coat properties by maternal flowering time pathways effectively passes timing information across generations, aligning progeny behavior with time of year.
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BFBNIB, NMLJ, NUK, PNG, SAZU, UL, UM, UPUK
Leadership by point-of-care and senior managers is increasingly recognized as critical to the acceptance and use of research evidence in practice. The purpose of this systematic review was to ...identify the leadership behaviours of managers that are associated with research use by clinical staff in nursing and allied health professionals.
A mixed methods systematic review was performed. Eight electronic bibliographic databases were searched. Studies examining the association between leadership behaviours and nurses and allied health professionals' use of research were eligible for inclusion. Studies were excluded if leadership could not be clearly attributed to someone in a management position. Two reviewers independently screened abstracts, reviewed full-text articles, extracted data and performed quality assessments. Narrative synthesis was conducted.
The search yielded 7019 unique titles and abstracts after duplicates were removed. Three hundred five full-text articles were reviewed, and 31 studies reported in 34 articles were included. Methods used were qualitative (n = 19), cross-sectional survey (n = 9), and mixed methods (n = 3). All studies included nurses, and six also included allied health professionals. Twelve leadership behaviours were extracted from the data for point-of-care managers and ten for senior managers. Findings indicated that managers performed a diverse range of leadership behaviours that encompassed change-oriented, relation-oriented and task-oriented behaviours. The most commonly described behavior was support for the change, which involved demonstrating conceptual and operational commitment to research-based practices.
This systematic review adds to the growing body of evidence that indicates that manager-staff dyads are influential in translating research evidence into action. Findings also reveal that leadership for research use involves change and task-oriented behaviours that influence the environmental milieu and the organisational infrastructure that supports clinical care. While findings explain how managers enact leadership for research use, we now require robust methodological studies to determine which behaviours are effective in enabling research use with nurses and allied health professionals for high-quality evidence-based care.
PROSPERO CRD42014007660.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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