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The purpose of this article is to illuminate our troubles with, and troubling of, the trustworthiness dimension of balancing subjectivity and reflexivity, in qualitative research. This article evolved from debriefing sessions between three novice researchers working on a qualitative research study aimed at building understandings of the relational dynamics between adults with developmental disability diagnoses (ADevD) and their caregiving families. Following data collection, coauthors discussed interview experiences they had personally found challenging. These experiences constitute a point of departure for our examination of our researcher positions. We present a delineation of three research tensions, in the form of short “reflexive vignettes,” each rooted in concern with possibly contradicting our goals of facilitating and expanding participant autonomy. We follow with recommendations about how, as researchers, our endeavor to understand participants with less conventional communication can be used to reflect and inform navigating difficulties universal to qualitative research. [ABSTRACT FROM AUTHOR]

Background: Health literacy is an essential social determinant for promoting and maintaining the health of a population. Aim: From a health promotion perspective, explore health literacy issues, concerns and future challenges among Nordic practitioners and researchers. Methods: Data were collected in a workshop at the 8th Nordic Health Promotion Conference, and in a literature review, with articles from five databases. The search included title and abstract with the search terms health literacy* and health literacy as a MeSH term and all the Nordic countries. Qualitative and quantitative analysis were used. Results: Twenty-five persons participated in the workshop. The discussions were summarized in six themes: concept of health literacy in national language; risk of victim blaming; measuring health literacy; content in school curricula on health literacy; new technologies for information and communication; communication and collaboration between different actors in support of health. Forty-three articles on health literacy were identified, mainly conducted within three fields: development, test and adaptation of instruments for measuring health literacy; measurement of health literacy among patients, or other defined target groups and on populations; and developing and evaluating methods/tools for the training of personnel groups or different target groups. Conclusions: There is a need for further studies providing a more in-depth understanding of the health literacy concept, knowledge on how to measure health literacy, ethical aspects, application in intersectoral collaboration as well as the adaptation to new technologies for information and communication in education supporting health literacy. As health literacy is an essential social health determinant, a concern and a future challenge must be, to make the health literacy concept familiar and visible in health promotion policies, research and practice such as health education. [ABSTRACT FROM AUTHOR]

Research in health care occurs within interdisciplinary teams that include clinician–researchers who have multiple epistemological orientations. Rigor in collaborative projects requires reflexive attention to how the paradigmatic questions raised by diverse epistemological orientations, and the ethical stances of each researcher, shape findings. This methodological article draws on three events during an ethnography of stigma in psychiatry to define and illustrate how we used double hermeneutics in data analysis. This allowed us to examine the metaphors that emerged from what we are conceptualizing as “epistemological bumps.” This heightened the team’s awareness of the epistemological horizons and mixing that occurred, as well as revealing what mattered to each researcher, during the crafting of our research decisions and findings. We argue that interdisciplinary research on complex processes in health care requires this close examination of team experiences and moral stakes during collaborative analysis, and offer conceptual suggestions for reflexivity and rigor. [ABSTRACT FROM AUTHOR]

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Hypothesizing after the results are known, or HARKing, occurs when researchers check their research results and then add or remove hypotheses on the basis of those results without acknowledging this process in their research report (Kerr, 1998). In the present article, I discuss 3 forms of HARKing: (a) using current results to construct post hoc hypotheses that are then reported as if they were a priori hypotheses; (b) retrieving hypotheses from a post hoc literature search and reporting them as a priori hypotheses; and (c) failing to report a priori hypotheses that are unsupported by the current results. These 3 types of HARKing are often characterized as being bad for science and a potential cause of the current replication crisis. In the present article, I use insights from the philosophy of science to present a more nuanced view. Specifically, I identify the conditions under which each of these 3 types of HARKing is most and least likely to be bad for science. I conclude with a brief discussion about the ethics of each type of HARKing. [ABSTRACT FROM AUTHOR]

Health research participants want the results of the studies in which they participate but do not typically receive them. Researchers generally express support for sharing results with participants but, in practice, may be unprepared or unwilling to do so. Many funders call for increased dissemination of research results beyond academic and clinical audiences, but few funders sponsor research to improve result sharing with participants. Although the solution appears straightforward (e.g., funders could incentivize researchers to share results with participants), there are critical gaps in knowledge that suggest the need for a more deliberate approach. For example, what ethical or practical concerns discourage researchers from returning results to participants? What exactly do participants plan to do with the results that they would like to receive? What are the best channels of communication for sharing results with particular participant populations? To address these knowledge gaps, we argue for a collaborative process to develop a research agenda related to result sharing with participants. With support and encouragement by funders, such research should evaluate the effects of different types of results (and results from different types of studies) on participants' behaviors, attitudes, and emotions; it should also examine the researchers' ethical, financial, logistical, methodological, and skill-related concerns and constraints related to sharing results with participants. Over time, collaborative research between researchers and participants can yield an evolving set of evidence-based guidelines for ethical, effective result sharing with participants. [ABSTRACT FROM AUTHOR]

Research collaboration in 'real world' practice settings may enhance the meaningfulness of the findings and reduce barriers to implementation of novel intervention strategies. This study describes an initiative to integrate research into a hospital-based outpatient psychiatric clinic within an academic medical center, focusing on collaborative processes across three research projects. We report on the varied outcomes of the projects and utilize data from two focus groups to identify the key elements that contributed to the challenges and successes. We identify barriers to practice-research collaborations that emerged even when the initial circumstances of the partnership were favorable. These barriers include the presence of varied agendas across clinicians and investigators, resource constraints, limited staff buy-in, and staff turnover. In highlighting the lessons learned in this collaborative process, we hope to facilitate successful partnerships in other clinical settings. [ABSTRACT FROM AUTHOR]

Background: Studies exploring parents' trial experiences generally relate to their understanding of the consent process and the development of researcher strategies to facilitate recruitment and retention. The aim was to better understand parents' experience of being part of a trial at the time and their perceptions of trial participation in retrospect.Methods: Data were collected in a number of ways: from recorded discussions between parents and clinicians about the MRI or ultrasound, in open-text responses to questionnaires and in qualitative interviews at 1 and 2 years after participation. Thematic analysis was undertaken using NVivo10.Results: Key themes identified were 'deciding to take part', with subthemes associated with 'benefitting self', 'benefitting others' and 'being prepared'; 'the randomisation process' with subthemes relating to 'acceptance' and 'understanding' and 'actual engagement' with subthemes of 'practicalities' and 'care from responsive staff'.Conclusion: Parents' perspectives on the trial and the processes and information received reflect their understanding and experience of the trial and the value of parent-friendly information-giving about participation, randomisation and follow-up. The practical and logistical points raised confirm the key issues and parents' need for sensitive care and support in the course of a trial. Looking back, almost all parents were positive about their experience and felt that the family had benefitted from participation in the trial and follow-up studies, even when the developmental outcomes were poor.Trial Registration: ClinicalTrials.gov, ID: NCT01049594. https://clinicaltrials.gov/ct2/show/NCT01049594 . Registered on 13 January 2010. EudraCT: EudraCT: 2009-011602-42. https://www.clinicaltrialsregister.eu/ . [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this inquiry was to examine the research skill building and career development lived experiences of a Native American who is blind serving as a disability and rehabilitation researcher at a National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR)-sponsored Rehabilitation Research and Training Center based at a historically Black college/university. Acknowledging that growing as a researcher is a lifelong process, this autoethnography presents challenges, lessons learned, and strategies for overcoming obstacles that may confront ethnic minorities with disabilities seeking to improve their research skills and develop research careers in the disability and rehabilitation field. Methods: Through the method of autoethnography, self-reflective stories and narratives were examined to expose marginalized position as an ethnic minority with a disability in terms of research skill enhancement and participation barriers. Results: Emerging themes and skill building factors included familial and postsecondary educational supports, assistive technology, professional and community engagement opportunities, and peer-to-peer mentorship. Skill building challenges were also presented. Conclusions: Autoethnographic style is appropriate for not only presenting the lived research skill building and career development experiences of a minority early career investigator but also exploring factors that could be important in helping ethnic minorities with disabilities desiring to become disability and rehabilitation researchers. [ABSTRACT FROM AUTHOR]

Purpose: In the previous analysis of key informant perspectives on minority research leaders' career development factors, we identified individual and sociocultural, institutional, and federal research agency (i.e., National Institute on Disability, Independent Living, and Rehabilitation Research; National Institutes of Health; Agency for Healthcare Quality and Research; Office of Disability, Aging, and Long-Term Care Policy) policy and systems-induced challenges. An analysis of their viewpoints about what policy and systems-induced facilitators can be considered as actionable for increasing the pool of seasoned minority researchers was not undertaken. Here in this companion study, data collected on 15 key informants' perspectives regarding policy initiatives and strategies that can be considered by these agencies to diversify the behavioral, social science, clinical, and biomedical scientific workforce were analyzed. Methods: This companion analysis employed the same methods as reflected in the previous study. Results: Select federal research agency policy and systems-induced factors (i.e., research career pathways, social justice context, designated funding streams, and interprofessional multidisciplinary collaborations) emerged as important. Conclusions: The findings can inform the development of new or modified federal research agency sponsored field initiated strategies and internal policy and systems that could lead to an increased supply of seasoned minority investigators. [ABSTRACT FROM AUTHOR]

We argue here that auto/biography is an epistemological approach challenging traditional claims to objectivity, recognising the personhood of researchers as well as respondents and the complex relationship between the self and other (in both face-to-face encounters and ‘texts’ of various kinds). After outlining some of the fundamental benefits of an auto/biographical approach – within the social sciences generally, and death studies specifically – we, with reference to some of our research and writing experiences, reflect on each of our positions on the auto/biographical continuum. We explore the differences and the similarities in our epistemological approach and make the case for the significance of auto/biography. [ABSTRACT FROM PUBLISHER]

Background: The Cord Pilot Trial compared alternative policies for timing of cord clamping at very preterm birth at eight UK hospitals. Preterm birth can be rapid and unexpected, allowing little time for the usual consent process. Therefore, in addition to the usual procedure for written consent, a two-stage pathway for consent for use when birth was imminent was developed. The aims of this study were to explore clinicians' views and experiences of offering two consent pathways for recruitment to a randomised trial of timing of cord clamping at very preterm birth.Methods: This was a qualitative study using semi-structured interviews. Clinicians from eight hospitals in the UK who had been involved in offering consent to the Cord Pilot Trial were invited to take part in an interview. Clinicians were interviewed in person or by telephone. Interviews were analysed using inductive systematic thematic analysis.Results: Seventeen clinicians who had either offered usual written consent only (n = 6) or both the two-stage pathway (with oral assent before the birth and written consent after the birth) and usual written consent (n = 11) were interviewed. Six themes were identified: (1) team approach to offering participation; (2) consent form as a record; (3) consent and participation as a continual process; (4) different consent pathways for different trials; (5) balance between time, information, and understanding; and (6) validity of consent. Overall, clinicians were supportive of the two-stage consent pathway. Some clinicians felt that in time-critical situations oral assent presented an advantage over the usual written consent as they provided information on a "need to know" basis. However, there was some concern about how much information should be given for oral assent, and how this is understood by women when birth is imminent.Conclusions: The two-stage pathway for consent developed for use in the Cord Pilot Trial when birth was imminent was acceptable to clinicians for comparable low-risk studies, although some concerns were raised about the practicalities of obtaining oral assent.Trial Registration: ISRCTN Registry, ISRCTN21456601 . Registered on 28 February 2013. [ABSTRACT FROM AUTHOR]

Background: Traditional reporting of research outcomes and impacts, which tends to focus on research product publications and grant success, does not capture the value, some contributions, or the complexity of research projects. The purpose of this study was to understand the contributions of five systems-level research projects as they were unfolding at the Bruyère Centre for Learning, Research and Innovation (CLRI) in long-term care (LTC) in Ottawa, Ontario, Canada. The research questions were, (1) How are partnerships with research end-users (policymakers, administrators and other public/private organisations) characterised? (2) How have interactions with the CLRI Management Committee and Steering Committee influenced the development of research products? (3) In what way have other activities, processes, unlinked actors or organisations been influenced by the research project activities?Methods: The study was guided by Kok and Schuit's concept of research impacts, using a multiple case study design. Data were collected through focus groups and interviews with research teams, a management and a steering committee, research user partners, and unlinked actors. Documents were collected and analysed for contextual background.Results: Cross-case analysis revealed four major themes: (1) Benefits and Perceived Tensions: Working with Partners; (2) Speaking with the LTC Community: Interactions with the CLRI Steering Committee; (3) The Knowledge Broker: Interactions with the Management Committee; and (4) All Forms of Research Contributions.Conclusions: Most contributions were focused on interactions with networks and stimulating important conversations in the province about LTC issues. These contributions were well-supported by the Steering and Management Committees' research-to-action platform, which can be seen as a type of knowledge brokering model. It was also clear that researcher-user partnerships were beneficial and important. [ABSTRACT FROM AUTHOR]

Primary healthcare research strives for high-quality, priority-driven research to inform policy and practice. This relies on a robust and sustainable workforce to tackle complex problems faced in primary health care locally and globally. The current study investigated characteristics, experiences and career paths of the Australian primary healthcare research workforce. Thirty-seven former Research Higher Degree students from University Departments of General Practice and Rural Health completed a survey. Number of provisions for researchers and career path clarity were associated with job satisfaction. Motivators to stay in research included job satisfaction, research in role descriptions, and identification of problems requiring change. Barriers related to funding, time, and other work roles taking priority were identified. Comparisons were made between participants self-identifying as working in primary healthcare research ('stayers'; n = 22) and those no longer part of this workforce ('leavers'; n = 15). Leavers were more likely to be in permanent full-time work whereas stayers had experienced more career progression and mentoring. This study raises challenges faced by primary healthcare researchers and will inform strategies for supporting the sustainability of this workforce. [ABSTRACT FROM AUTHOR]

The Belmont Report's distinction between research and the practice of accepted therapy has led various authors to suggest that these purportedly distinct activities should be governed by different ethical principles. We consider some of the ethical consequences of attempts to separate the two and conclude that separation fails along ontological, ethical, and epistemological dimensions. Clinical practice and clinical research, as with yin and yang, can be thought of as complementary forces interacting to form a dynamic system in which the whole exceeds the sum of its parts. Just as effective clinical practice cannot exist without clinical research, meaningful clinical research requires the context of clinical practice. We defend this thesis by triangulation, that is, by outlining how multiple investigators have reached this conclusion on the basis of varied theoretical and applied approaches. More confidence can be placed in a result if different methods/viewpoints have led to that result. [ABSTRACT FROM AUTHOR]

This article reports on qualitative research conducted in KwaZulu-Natal, South Africa, among researchers and gate-keepers of health facilities in the province. Results suggest disparate but not irreconcilable perceptions of the social value of research in provincial health facilities. This study found that researchers tended to emphasize the contribution of research to the generation of knowledge and to the health of future patients while gate-keepers of health facilities tended to emphasize its contribution to the healthcare system and to current patients. Furthermore, relations between research stakeholders were perceived to be somewhat fragile, making it difficult for stakeholders to achieve consensus about the social value of research, as well as on ways to maximize value. Interventions to negotiate a shared perspective on the social value of research would appear to be warranted, and the findings of this study suggest some focus areas for such intervention. [ABSTRACT FROM AUTHOR]

Given that death is a universal concept, the idea that a researcher must be objective when studying this topic is common place and problematic. Thus, this article adds to the literature by discussing the complexity of subjectivity within death studies. Three key elements of subjectivity form the basis of this discussion: (a) the researcher’s cultural background, (b) the researcher’s personal experiences, and (c) the emotional impact of research on the researcher. It is argued that transparency about the subjective nature of death studies research can be fruitful in understanding the research process before, during, and after fieldwork. [ABSTRACT FROM PUBLISHER]

The authors discuss several studies related to capacity building of early stage psychosocial dementia researchers in Europe. Topics covered include the needs and quality of life of people with dementia and their caregivers, the use and implementation of Dementia Care Mapping with the RE-AIM Framework to support care experts working in 12 group homes, and the effectiveness and acceptability of training interventions with a communication component aimed at target groups.

Background: Primary care reforms should be supported by high-quality evidence across the entire life cycle of research. Front-line healthcare providers play an increasing role in implementation research. We recently evaluated two interventions for people with type 2 diabetes (T2D) in partnership with four Primary Care Networks (PCNs) in Alberta, Canada. Here, we report healthcare professionals perspectives on participating in primary care implementation research.Methods: Guided by the RE-AIM framework, we collected qualitative data before, during, and after both interventions. We conducted 34 in-person or telephone interviews with 17 individual PCN professionals. We used content analysis to identify emerging codes and concepts.Results: Two major themes emerged from the data. First, healthcare managers were eager to conduct implementation research in a primary care setting. Second, regardless of willingness to conduct research, there were challenges to implementing experimental study designs for both interventions. PCN professionals presumed the interventions were better than usual care, expressed role conflict, and reported administrative burdens related to research participation. Perceptions of patient vulnerability and an obligation to intervene exacerbated these issues.Conclusions: Healthcare professionals with limited practical research experience might not foresee the challenges in implementing experimental study designs in primary care settings to generate high-quality evidence. These issues are intensified when healthcare professionals perceive target patient populations as vulnerable and in need of intervention based on the presenting illness. Possible solutions include further research training, involving healthcare professionals in study design development, and using non-clinical staff to conduct research activities, particularly among acutely unwell patient populations. [ABSTRACT FROM AUTHOR]

Background: Scoping studies (or reviews) are a method used to comprehensively map evidence across a range of study designs in an area, with the aim of informing future research practice, programs and policy. However, no universal agreement exists on terminology, definition or methodological steps. Our aim was to understand the experiences of, and considerations for conducting scoping studies from the perspective of academic and community partners. Primary objectives were to 1) describe experiences conducting scoping studies including strengths and challenges; and 2) describe perspectives on terminology, definition, and methodological steps.Methods: We conducted a cross-sectional web-based survey with clinicians, educators, researchers, knowledge users, representatives from community-based organizations, graduate students, and policy stakeholders with experience and/or interest in conducting scoping studies to gain an understanding of experiences and perspectives on the conduct and reporting of scoping studies. We administered an electronic self-reported questionnaire comprised of 22 items related to experiences with scoping studies, strengths and challenges, opinions on terminology, and methodological steps. We analyzed questionnaire data using descriptive statistics and content analytical techniques. Survey results were discussed during a multi-stakeholder consultation to identify key considerations in the conduct and reporting of scoping studies.Results: Of the 83 invitations, 54 individuals (65 %) completed the scoping questionnaire, and 48 (58 %) attended the scoping study meeting from Canada, the United Kingdom and United States. Many scoping study strengths were dually identified as challenges including breadth of scope, and iterative process. No consensus on terminology emerged, however key defining features that comprised a working definition of scoping studies included the exploratory mapping of literature in a field; iterative process, inclusion of grey literature; no quality assessment of included studies, and an optional consultation phase. We offer considerations for the conduct and reporting of scoping studies for researchers, clinicians and knowledge users engaging in this methodology.Conclusions: Lack of consensus on scoping terminology, definition and methodological steps persists. Reasons for this may be attributed to diversity of disciplines adopting this methodology for differing purposes. Further work is needed to establish guidelines on the reporting and methodological quality assessment of scoping studies. [ABSTRACT FROM AUTHOR]

This article explores the impact of the researcher’s reflexivity on the data collection and analysis process in the context of a videographic study of home-based family caregivers of older adults. Going beyond a discussion of the role of the researcher’s subjectivity, the article builds on current literature by exploring how the researcher’s embodied self-reflexivity can be used to enrich video based research. The article addresses the researcher’s personal social location and shifting roles throughout the study and how these impacted on her work with the camera, her moment to moment ethical decisions and her perceptions of the participants’ realities. The author illustrates, through the use of journal and transcript excerpts, how the dynamic relationship between the researcher, the participants and the camera creates overlapping and complementary layers of information that together form a cohesive portrait of the action. Throughout, the article discusses the contribution of reflexivity to both the creation and resolution of ethical tensions in the research space. [ABSTRACT FROM AUTHOR]

Launch of clinical investigation represents a substantial escalation in commitment to a particular clinical translation trajectory; it also exposes human subjects to poorly understood interventions. Despite these high stakes, there is little to guide decision-makers on the scientific and ethical evaluation of early phase trials. In this article, we review policies and consensus statements on human protections, drug regulation, and research design surrounding trial launch, and conclude that decision-making is largely left to the discretion of research teams and sponsors. We then review what is currently understood about how research teams exercise this discretion, and close by laying out a research agenda for characterizing the way investigators, sponsors, and reviewers approach decision-making in early phase research. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to explore what data emerge when former carergivers (co-researchers) are trained to interview current care-givers about their experiences. Background Despite a trend of involving service users in conducting research interviews, there have been few examinations of how and whether a common service user identity has an impact on the data generated. Design Four co-researchers were recruited, trained and supported to conduct qualitative interviews with 11 current carers of people receiving palliative services. Conversation analysis was used to examine the conversational characteristics of the research interviews. Data were collected in 2010-2011. Results Conversation analysis identified that interactional difficulties were evident across the data. When co-researchers talked about their own experiences as carers, interviewees frequently changed the topic of conversation, thereby closing-down opportunities for further disclosure or elaboration from the interviewee about the original topic. Conclusion Conversation analysis identifies how caregiving identities are co-constructed and points where there is agreement and disagreement in the co-construction. [ABSTRACT FROM AUTHOR]

The broaden ‐ and ‐ build theory of positive emotions suggests that positive emotions can widen the range of potential coping strategies that come to mind and subsequently enhance one's resilience against stress. Studies have shown that high stress, especially chronic levels of stress, strongly contributes to the development of anxiety and depressive symptoms. However, researchers have also found that individuals who possess high levels of resilience are protected from stress and thus report lower levels of anxiety and depressive symptoms. Using a sample of 200 postdoctoral research fellows, the present study examined if (a) positive emotions were associated with greater resilience, (b) coping strategies mediated the link between positive emotions and resilience and (c) resilience moderated the influence of stress on trait anxiety and depressive symptoms. Results support the broaden ‐ and ‐ build theory in that positive emotions may enhance resilience directly as well as indirectly through the mediating role of coping strategies—particularly via adaptive coping. Resilience also moderated the association of stress with trait anxiety and depressive symptoms. Although stress is unavoidable and its influences on anxiety and depressive symptoms are undeniable, the likelihood of postdocs developing anxiety or depressive symptoms may be reduced by implementing programmes designed to increase positive emotions, adaptive coping strategies and resilience. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Following government commitments to reducing health inequalities from 1997 onwards, the UK has been recognised as a global leader in health inequalities research and policy. Yet health inequalities have continued to widen by most measures, prompting calls for new research agendas and advocacy to facilitate greater public support for the upstream policies that evidence suggests are required. However, there is currently no agreement as to what new research might involve or precisely what public health egalitarians ought to be advocating. This article presents an analysis of discussions among 52 researchers to consider the feasibility that research-informed advocacy around particular solutions to health inequalities may emerge in the UK. The data indicate there is a consensus that more should be been done to learn from post-1997 efforts to reduce health inequalities, and an obvious desire to provide clearer policy guidance in future. However, discussions as to where researchers should now focus their efforts and with whom researchers ought to be engaging reveal three distinct ways of approaching health inequalities, each of which has its own epistemological foundations. Such differences imply that a consensus on reducing health inequalities is unlikely to materialise. Instead, progress seems most likely if all three approaches are simultaneously enabled. [ABSTRACT FROM AUTHOR]

The influence of intersectional identities on social experiences is most often explored within research on minority populations (e.g. LGBT, African American women, etc.). However few, if any, studies have extended the subject of intersectionality to address the intersectional identities of researchers or their influence on the conduct of qualitative research in international settings. Through reflexive memoirs offered from student researchers that engaged in an international collaborative research project, this article highlights the challenges intersectional identities posed while conducting community-engaged qualitative research in Durban, South Africa. Within each memoir, particular attention is paid to (a) how the intersection of the student researchers’ perceived and actual racial, gendered, class, and national identities determined or obfuscated their statuses as ‘outsiders’ or ‘insiders’, (b) the influential nature of these mutually constitutive identities on the interview process, and (c) how the student researchers successfully or unsuccessfully negotiated the collective impact of their intersecting positions and identities in the field. By critically examining the complex and interdependent influence of race, ethnicity, gender, nationality, and class on researchers’ collection and interpretation of qualitative data, this article extends the application and relevance of the intersectionality framework to an international context and to the experiences of the interviewer/researcher. [ABSTRACT FROM AUTHOR]

In an era of accelerated international mobility, migrant researchers are increasingly studying their migrant co-nationals in a language different from the language in which they report their findings. This raises very significant considerations regarding language experience and translation of research data. While crucial for understanding production of knowledge, these issues have not yet been given adequate attention. In response, this article focuses first on the challenges related to the assumed shared relationship with language between migrant researchers and their migrant informants. In doing so, it contributes to the discussion about positionality of a migrant researcher. Second, it recognizes the role of a translator researcher and discusses the implications of collecting data in one language and presenting the findings in another. As such, it addresses essential methodological queries many migrant researchers face when conducting studies involving their compatriot communities. [ABSTRACT FROM AUTHOR]

Background: The interest and activity in measuring and reporting the impact of publicly funded health and medical research has grown rapidly in recent years. Research evaluation typically relies on researchers for much of the information for an impact assessment. However, the acceptability and feasibility of this activity among health researchers is unknown. The aim of this study was to understand the role and opinions of cancer researchers in the growing area of impact evaluation activity, to inform the logistics of a sustainable program of impact evaluation.Methods: A brief anonymous online survey was administered to 95 current and past grant recipients funded through the external grants program at Cancer Council New South Wales. Eleven survey statements were constructed with Likert responses and supplemented with two open-ended questions. The statements covered the conceptual, attitudinal and practical aspects of impact evaluation. The survey targeted researchers from the full spectrum of cancer control research classifications. Descriptive analyses obtained response frequencies and percentages.Results: Forty-five cancer researchers completed the survey (response rate 47%) and 77% were Associate Professors or Professors. Responses were polarised for questions relating to engaging with research end-users, perceived time-pressure to collate data, and pressure to produce research outputs. Some researchers emphasised that quality was an important goal over quantity and warned that collecting impact data created incentives and disincentives for researchers.Conclusion: There was mixed support and acceptance among senior cancer researchers in Australia on their perceived role and engagement with research impact activities. Sole reliance on researchers for collating and reporting impact data may be problematic. Requesting information from researchers could be minimised and confined to final reports and possible verification of externally-led evaluations. [ABSTRACT FROM AUTHOR]

Background: Effective recruitment is an essential element of successful research but notoriously difficult to achieve. This article examines health care professionals' views on the factors influencing decision-making regarding referral to a stroke rehabilitation trial.Methods: Semi-structured interviews and a card-sorting task were undertaken with stroke service staff in acute and community hospital trusts. Data analysis used a thematic framework approach.Results: Twenty-seven qualified health care professionals from 12 (6 acute and 6 community) hospital trusts and one charity participated. Four main factors emerged: patient-related, professional views, the organisation and research logistics, which all contributed to staff's decision about whether to refer patients to a trial. Clinicians identified patient-related factors as the most frequent influence and considered themselves the patients' advocate. They used their knowledge of the patient to anticipate the patients' reaction to possible participation and tended to only refer those whom they perceived would respond positively. Participants also identified experience of research, a sense of ownership of the project and a positive view of the intervention being evaluated as factors influencing referral. The need to prioritise clinical matters, meet managerial demands and cope with constant change were organisational factors impacting negatively on referral. Staff often simply forgot about recruitment in the face of other higher priorities. Quick, simple, flexible research processes that were closely aligned with existing ways of working were felt to facilitate recruitment.Conclusions: Patient- and professional-related factors were the most frequent influence on clinicians' recruitment decisions, which often had a 'gate-keeping' effect. Managerial and clinical responsibility to juggle multiple (often higher) priorities was also an important factor. To facilitate recruitment, researchers need to develop strategies to approach potential participants as directly as possible to enable them to make their own decisions about participation; ensure that research processes are as quick and simple as possible; align with existing clinical pathways and systems; and give regular reminders and ongoing support to promote recruitment.Trial Registration: ISRCTN, 98287938 . Registered 6 May 2015. [ABSTRACT FROM AUTHOR]

This commentary reflects on what the four research articles in this issue of Medical Teacher tell us about adaptive learning and how adaptive medical education research can be conducted. Adaptive medical education researchers must think disruptively and embrace nontraditional collaborations, research methods, and means of dissemination in pursuit of evidence that enhances adaptive learning. [ABSTRACT FROM AUTHOR]

Background: Recruitment to clinical trials remains a challenge, particularly in primary care settings. Initial projections of participant recruitment need to be as accurate as possible in order to avoid the financial, clinical and ethical costs of trial extensions or failures. However, estimation of recruitment rates is challenging and often poorly executed, if attempted at all. We used qualitative methods to explore the experiences and views of researchers on the planning of recruitment in this setting.Methods: Participants had registered accrual to a UK-based primary care research study between April 2009 and March 2012. We conducted nine interviews with chief investigators or study managers, using a semi-structured topic guide. Analysis was conducted using the framework approach.Results: Three themes are presented: 1) the factors affecting recruitment rates, 2) the use of planning techniques, and 3) influences on poor estimation. 1) A large number of factors affecting recruitment rates were discussed, including those relating to the study protocol, the clinical setting and the research setting. Use of targeted mail-outs to invite apparently eligible individuals to participate was preferred in order to eliminate some of the uncertainty in the recruitment rate associated with opportunistic clinician referrals. 2) The importance of pilot work was stressed. We identified significant uncertainty as to how best to schedule trial timelines to maximise efficiency. 3) Several potential sources of bias involved in the estimation of recruitment rates were explored and framed as technological, psychological or political factors.Conclusions: We found a large number of factors that interviewees felt impact recruitment rates to primary care research and highlighted the complexity of realistic estimation. Suitable early planning of the recruitment process is essential, and there may be potential to improve the projection of trial timelines by reducing biases involved in the process. Further research is needed to develop formal approaches that would be suitable for use in this setting. [ABSTRACT FROM AUTHOR]

Background: Recruitment to randomised controlled trials (RCTs) is often difficult. Clinician related factors have been implicated as important reasons for low rates of recruitment. Clinicians (doctors and other health professionals) can experience discomfort with some underlying principles of RCTs and experience difficulties in conveying them positively to potential trial participants. Recruiter training has been suggested to address identified problems but a synthesis of this research is lacking. The aim of our study was to systematically review the available evidence on training interventions for recruiters to randomised trials.Methods: Studies that evaluated training programmes for trial recruiters were included. Those that provided only general communication training not linked to RCT recruitment were excluded. Data extraction and quality assessment were completed by two reviewers independently, with a third author where necessary.Results: Seventeen studies of 9615 potentially eligible titles and abstracts were included in the review: three randomised controlled studies, two non-randomised controlled studies, nine uncontrolled pre-test/post-test studies, two qualitative studies, and a post-training questionnaire survey. Most studies were of moderate or weak quality. Training programmes were mostly set within cancer trials, and usually consisted of workshops with a mix of health professionals over one or two consecutive days covering generic and trial specific issues. Recruiter training programmes were well received and some increased recruiters' self-confidence in communicating key RCT concepts to patients. There was, however, little evidence that this training increased actual recruitment rates or patient understanding, satisfaction, or levels of informed consent.Conclusions: There is a need to develop recruiter training programmes that can lead to improved recruitment and informed consent in randomised trials. [ABSTRACT FROM AUTHOR]

Just over 2 years ago on 20 May 2014, we celebrated the first International Clinical Trial Day (ICTD) in Ethiopia at the College of Health Sciences, Addis Ababa University. The main aim of the celebration was to express solidarity with clinical researchers, particularly clinical trialists, across the world. Since this first celebration, several major steps have been taken with potential for improving the conduct of clinical trials in our institution and more broadly within the country. These have included policy impact, particularly commitment from the government and the institution for supporting clinical trials and for the broader improvement of access to medicines. A Clinical Trial Unit, led by a multi-disciplinary team of researchers, has been established. A regional centre of excellence is being established to build regional capacity for translational research and clinical trials. These are important outputs attributable to the celebration of the ICTD. We encourage ICTD celebration at institutions conducting clinical research. This is likely to have unanticipated positive institutional, national and even regional consequences. [ABSTRACT FROM AUTHOR]

Objective: The recent increase in physiotherapy research has led to more physiotherapists being involved in research. Consequently, leaders must make a standpoint on whether the department should engage in research, whereas individual physiotherapists have to decide if they want to play an active role in carrying out a research project. The purpose of this study was to explore perceptions and experiences of both participating physiotherapists and their leaders regarding taking part in clinical physiotherapy research projects. Methods: A qualitative study using face‐to‐face interviews was conducted. All (n = 8) leaders were interviewed individually. Physiotherapists (n = 18) were interviewed either individually (n = 5) or in small groups including two to three persons (n = 13). The interviews were analysed using inductive conventional content analysis. Results: There was a consensus that engagement of the leaders was a prerequisite for entering research projects and that the research had to be in line with the department's regular assignment. For the physiotherapists, the key factors for success were having designated time and having support from their leader, especially when feelings of responsibility became overwhelming. The leaders stressed the importance of being well informed. Participating in clinical research created value such as personal and professional growth for the physiotherapists, who also inspired their colleagues and thus positively affected the organization. Engaging in research contributed to being an attractive employer and gave a boost to evidence‐based practice. Conclusion: The study provides perspectives from leaders and physiotherapists on engaging in research. There was a consensus that participating in a research project was beneficial for the organization, the individual physiotherapist, and the patients. However, clinical applicability, support, sufficient time, and early involvement of leaders are significant prerequisites. [ABSTRACT FROM AUTHOR]

Background: Conducting university-based research is important for informing primary care, especially in lower- and middle- income countries (LMICs) such as Indonesia. Syiah Kuala University (SKU), the largest educational institution in Aceh province, Indonesia, is actively establishing itself as a leader in research innovation; however, this effort has not yet demonstrated optimum results. Understanding faculty members' perceptions of how research is conducted in this setting is crucial for the design and implementation of successful and sustainable research strategies to increase the quantity and quality of primary care research conducted at LMIC universities. The objective of this study was to identify current attitudes, barriers and enablers/facilitators towards primary care research participation and implementation in this higher education institution. Methods: A descriptive-interpretive qualitative study was conducted. 29 participants, representing 90% of all faculty members providing primary care, were included. A mixed-methods approach was used, combining the use of a participant survey with 10 focus group discussions. Participants were encouraged to complete the survey in either English or Bahasa Indonesia. All of the focus group discussions were recorded, transcribed and translated into English. Thematic content analysis of these transcripts was carried out. Results: The majority of participants agreed that SKU has set research as a priority, as it is one of the three pillars of higher education, mandatory in all Indonesian higher education institutions. This research identified many barriers in conducting research, i.e. weak research policy, lack of research funding and infrastructure, complicated research bureaucracy and administrative process, as well as time constraints for conducting research relative to other duties. Participants expressed that personal motivation was a very important enabler/facilitator for increasing research activities. In order to improve research productivity, the majority of participants suggested that having local awards and formal recognition, having the opportunity to partner with local business and communities, provision of incentives, and having access to a research help-desk would be beneficial. Conclusions: Generally, participants showed a supportive and positive attitude towards research, and provided examples of how to improve research productivity in the Asian university context. [ABSTRACT FROM AUTHOR]

Community health workers (CHWs) are frequently put forward as a remedy for lack of health system capacity, including challenges associated with health service coverage and with low community engagement in the health system, and expected to enhance or embody health system accountability. During a 'think in', held in June of 2017, a diverse group of practitioners and researchers discussed the topic of CHWs and their possible roles in a larger "accountability ecosystem." This jointly authored commentary resulted from our deliberations. While CHWs are often conceptualized as cogs in a mechanistic health delivery system, at the end of the day, CHWs are people embedded in families, communities, and the health system. CHWs' social position and professional role influence how they are treated and trusted by the health sector and by community members, as well as when, where, and how they can exercise agency and promote accountability. To that end, we put forward several propositions for further conceptual development and research related to the question of CHWs and accountability. [ABSTRACT FROM AUTHOR]

Homeless people experience a unique set of challenges leading to pervasive health and social problems. An increasing number of researchers have harnessed photographic data to gain a unique perspective of marginalised groups. The aim of the study is to explore the feasibility of using photographs in research to understand the complex environment experienced by homeless people, with a special interest in mental health. Individuals who frequently attend homeless facilities in London were sensitively approached and asked if they would be interested in taking part in the 'Views From the Street' pilot study. Once agreement was confirmed through a formal consenting procedure, participants were asked to visually capture and upload their own digital photos, along with a brief description. The collection of data highlighted a number of barriers to engagement and acceptability, including issues around the level of familiarity with the recruiter, practicalities of participation, public perception of phone use, poor technical literacy, anonymity, and disassociation with the 'homeless' label. Recommendations are made for future research utilising photographic participatory designs with the homeless population. [ABSTRACT FROM AUTHOR]