Search

Academic health centres (AHCs) are organisations that aim to mobilise knowledge into practice by improving the responsiveness of health systems to emerging evidence. This study aims to explore the population health role of AHCs in Australia and England, where AHCs represent novel organisational forms.A multiple-case study design using qualitative methods was used to explore population health goals and activities in four discrete AHCs in both countries during 2017 and 2018. Data from 85 interviews with AHC leaders, clinicians and researchers, direct observation, and documentation were analysed within and across the cases.Comparison across cases produced four cross-case themes: health care rather than population health; incremental rather than major health system change; different conceptions of "translation" and "innovation"; and unclear pathways to impact. The ability of the AHCs to define and enact a population health role was hindered during the study period by gaps in knowledge mobilisation strategies at a health system and policy level, the biomedical orientation of government designation schemes for AHCs in Australia and England, and competing expectations of the sovereign partner organisations in AHCs against a backdrop of limited operational resources.The study identifies several institutional elements that are likely to be needed for AHCs in Australia and England to deliver on both internal and external expectations of their population health role.

ObjectivesEvidence on the current status of gender equity in academic rheumatology in Europe and potential for its improvement is limited. The EULAR convened a task force to obtain empirical evidence on the potential unmet need for support of female rheumatologists, health professionals and non-clinical scientists in academic rheumatology.MethodsThis cross-sectional study comprised three web-based surveys conducted in 2020 among: (1) EULAR scientific member society leaders, (2) EULAR and Emerging EULAR Network (EMEUNET) members and (3) EULAR Council members. Statistics were descriptive with significance testing for male/female responses assessed by χ2 test and t-test.ResultsData from EULAR scientific member societies in 13 countries indicated that there were disproportionately fewer women in academic rheumatology than in clinical rheumatology, and they tended to be under-represented in senior academic roles. From 324 responses of EULAR and EMEUNET members (24 countries), we detected no gender differences in leadership aspirations, self-efficacy in career advancement and work–life integration as well as the share of time spent on research, but there were gender differences in working hours and the levels of perceived gender discrimination and sexual harassment. There were gender differences in the ranking of 7 of 26 factors impacting career advancement and of 8 of 24 potential interventions to aid career advancement.ConclusionsThere are gender differences in career advancement in academic rheumatology. The study informs a EULAR task force developing a framework of potential interventions to accelerate gender-equitable career advancement in academic rheumatology.

Background The need to improve gender equity (GE) in academic medicine is well documented. Biomedical Research Centres (BRCs), partnerships between leading National Health Service (NHS) organisations and universities in England, conduct world-class translational research funded by the National Institute for Health Research (NIHR). In 2011, eligibility for BRC funding was restricted to universities demonstrating sustained GEsuccess recognised by the Athena SWAN Charter for Women in Science Silver awards. Despite this structural change, GE research in BRC settings is underdeveloped, yet critical to the acceleration of women’s advancement and leadership.Objectives To explore both women’s and men’s perceptions of GE and current markers of achievement in a BRC setting.Methods Thematic analysis of data from two discrete research projects: 53 GE survey respondents’ free text comments (34 women, 16 men), and 16 semi structured interviews with women affiliated to the NIHR Oxford BRC.Results: Four major themes emerged from the analysis: perceptions of the Athena Swan Charter for Women in Science (GE policy); views on monitoring GE in BRCs; views on current markers of achievement in academia and GE; and recommendations for actions to improve GE in BRC settings. Monitoring of GE in BRCs was deemed to be important, but complex. Participants felt current markers of achievement were not equitable to women as theydid not take contextual factors into account such as maternity leave and caring responsibilities. BRC specific organisational policies and metrics are required to monitor and catalyseGE.Conclusions Markers of achievement for monitoring GE in BRCs should take intoaccount contextual factors specific to BRCs and women’s career progression and professional advancement. GE markers of achievement should be complimented with broader aspects of equality, diversity and inclusion.

Background The need to improve gender equity (GE) in academic medicine is well documented. Biomedical Research Centres (BRCs), partnerships between leading National Health Service (NHS) organizations and universities in England, conduct world-class translational research funded by the National Institute for Health and Care Research (NIHR). In 2011, eligibility for BRC funding was restricted to universities demonstrating sustained GE success recognized by the Athena SWAN Charter for Women in Science Silver awards. Despite this structural change, GE research in BRC settings is underdeveloped, yet critical to the acceleration of women’s advancement and leadership. To explore both women’s and men’s perceptions of GE and current markers of achievement in a BRC setting. Methods Thematic analysis of data from two research projects: 53 GE survey respondents’ free-text comments (34 women, 16 men), and 16 semi-structured interviews with women affiliated to the NIHR Oxford BRC. Results Four major themes emerged from the analysis: perceptions of the Athena SWAN Charter for Women in Science (GE policy); views on monitoring GE in BRCs; views on current markers of achievement in academia and GE; and recommendations for actions to improve GE in BRC settings. Monitoring of GE in BRCs was deemed to be important, but complex. Participants felt that current markers of achievement were not equitable to women, as they did not take contextual factors into account such as maternity leave and caring responsibilities. BRC-specific organizational policies and metrics are needed in order to monitor and catalyse GE. Conclusions Markers of achievement for monitoring GE in BRCs should consider contextual factors specific to BRCs and women’s career progression and professional advancement. GE markers of achievement should be complemented with broader aspects of equality, diversity and inclusion.

Objectives This study aimed to explore gender equity in rheumatology leadership in the Asia-Pacific region as represented by the member national organizations (MNOs) of the Asia-Pacific League of Associations for Rheumatology (APLAR). Methods We conducted a retrospective cross-sectional review of gender representation among the presidents of MNOs of APLAR in April 2022. We used the official website of each organization to acquire names and terms in the office of current and past presidents of each organization. The binary gender of each president was estimated using the name-to-gender inference platform Gender API (https://gender-api.com/). Proportions of male and female presidents were estimated for each organization. Data were compared for presidencies commencing before and in/after the year 2000. Results We found a significant gap in gender parity, with most presidents in the region being men (210 of 252, 83%). More than one-third (7 of 19, 36.8%) of the MNOs had all male presidents, although the proportion of women improved from 7 to 25% in/after 2000 (P = 0.0002). A statistically significant increase in female representation was observed in Australia (P = 0.0268, from 7 to 39%) and New Zealand (P = 0.0011, where the proportion of female presidents increased from 0 to 45%), but not in other countries. Conclusion A significant gap in gender parity exists in rheumatology leadership in the MNOs of APLAR. Trends suggest improvement over the last two decades, although statistically significant improvement is limited to a small number of countries.

BackgroundThe need to improve gender equity (GE) in academic medicine is well documented. Biomedical Research Centres (BRCs), partnerships between leading National Health Service (NHS) organisations and universities in England, conduct world-class translational research funded by the National Institute for Health Research (NIHR). In 2011, eligibility for BRC funding was restricted to universities demonstrating sustained GE success recognised by the Athena SWAN Charter for Women in Science Silver awards. Despite this structural change, GE research in BRC settings is underdeveloped, yet critical to the acceleration of women’s advancement and leadership.ObjectivesTo explore both women’s and men’s perceptions of GE and current markers of achievement in a BRC setting.MethodsThematic analysis of data from two discrete research projects: 53 GE survey respondents’ free text comments (34 women, 16 men), and 16 semi structured interviews with women affiliated to the NIHR Oxford BRC.ResultsFour major themes emerged from the analysis: perceptions of the Athena Swan Charter for Women in Science (GE policy); views on monitoring GE in BRCs; views on current markers of achievement in academia and GE; and recommendations for actions to improve GE in BRC settings. Monitoring of GE in BRCs was deemed to be important, but complex. Participants felt current markers of achievement were not equitable to women as they did not take contextual factors into account such as maternity leave and caring responsibilities. BRC specific organisational policies and metrics are required to monitor and catalyse GE.ConclusionsMarkers of achievement for monitoring GE in BRCs should take into account contextual factors specific to BRCs and women’s career progression and professional advancement. GE markers of achievement should be complimented with broader aspects of equality, diversity and inclusion.

Higher academic institutions in the UK need to drive improvements in equity, diversity, and inclusion (EDI) through sustainable practical interventions. A broad view of inclusivity is based on an intersectional approach that considers race, geographical location, caring responsibilities, disability, neurodiversity, religion, and LGBTQIA+ identities. We describe the establishment of a diverse stakeholder group to develop practical grass-roots recommendations through which improvements can be advanced. We have developed a manifesto for change, comprising six domains through which academic institutions can drive progress through setting short, medium, and long-term priorities. Interventions will yield rewards in recruitment and retention of a diverse talent pool, leading to enhanced impact and output.

Analysis shows that funding incentives can work and more funders should trial them, say Pavel V Ovseiko and colleagues

Background The underrepresentation of women in academic medicine at senior level and in leadership positions is well documented. Biomedical Research Centres (BRC), partnerships between leading National Health Service (NHS) organisations and universities, conduct world class translational research funded by the National Institute for Health Research (NIHR) in the UK. Since 2011 BRCs are required to demonstrate significant progress in gender equity (GE) to be eligible to apply for funding. However, the evidence base for monitoring GE specifically in BRC settings is underdeveloped. This is the first survey tool designed to rank and identify new GE markers specific to the NIHR BRCs. Methods An online survey distributed to senior leadership, clinical and non-clinical researchers, trainees, administrative and other professionals affiliated to the NIHR Oxford BRC (N = 683). Participants ranked 13 markers of GE on a five point Likert scale by importance. Data were summarised using frequencies and descriptive statistics. Interrelationships between markers and underlying latent dimensions (factors) were determined by exploratory and confirmatory factor analyses. Results The response rate was 36% (243 respondents). Respondents were more frequently female (55%, n = 133), aged 41–50 years (33%, n = 81), investigators (33%, n = 81) affiliated to the BRC for 2–7 years (39.5%, n = 96). Overall participants ranked ‘BRC senior leadership roles’ and ‘organisational policies on gender equity’, to be the most important markers of GE. 58% (n = 141) and 57% (n = 139) respectively. Female participants ranked ‘organisational policies’ (64.7%, n = 86/133) and ‘recruitment and retention’ (60.9%, n = 81/133) most highly, whereas male participants ranked ‘leadership development’ (52.1%, n = 50/96) and ‘BRC senior leadership roles’ (50%, n = 48/96) as most important. Factor analyses identified two distinct latent dimensions: “organisational markers” and “individual markers” of GE in BRCs. Conclusions A two-factor model of markers of achievement for GE with “organisational” and “individual” dimensions was identified. Implementation and sustainability of gender equity requires commitment at senior leadership and organisational policy level.

Background The In the Trenches series of cutting-edge knowledge sharing events on impact for front-line experts and practitioners provides an engagement platform for diverse stakeholders across government, research funding organizations, industry, and academia to share emerging knowledge and practical experiences. The second event of the series In the Trenches: Implementation to Impact International Summit was held in Banff, Alberta, Canada, on June 7–8, 2019. The overarching vision for the Summit was to create an engagement platform for addressing key challenges and finding practical solutions to move from implementation (i.e. putting findings into effect) to impact (i.e. creating benefits to society and the economy). Processes and proceedings The Summit used diverse approaches to facilitate active engagement and knowledge sharing between 80 delegates across sectors and jurisdictions. Summit sessions mostly consisted of short talks and moderated panels grouped into eight thematic sessions. Each presentation included a summary of Key Messages, along with a summary of the Actionable Insights which concluded each session. The presentations and discussions are analysed, synthesized and described in this proceedings paper using a systems approach. This demonstrates how the Summit focused on each of the necessary functions (and associated components) that should be undertaken, and combined, for effective research and innovation: stewardship and governance, securing finance, creating capacity, and producing and using research. The approach also identifies relevant challenges. Conclusions There is increased interest globally in the benefits that can accrue from adopting a systems approach to research and innovation. Various organizations in Canada and internationally have made considerable progress on Implementation to Impact, often as a result of well-planned initiatives. The Summit highlights the value of 1) collaboration between researchers and potential users, and 2) the adoption by funders of approaches involving an increasing range of responsibilities and activities. The Summit website (https://inthetrenchessummit.com/) will be periodically updated with new resources and information about future In the Trenches events.

ObjectiveScientific authorship is a vital marker of success in academic careers and gender equity is a key performance metric in research. However, there is little understanding of gender equity in publications in biomedical research centres funded by the National Institute for Health Research (NIHR). This study assesses the gender parity in scientific authorship of biomedical research.DesignA retrospective descriptive study.SettingNIHR Oxford Biomedical Research Centre.Data2409 publications accepted or published from 1 April 2012 to 31 March 2017.Main outcome measuresGender of authors, defined as a binary variable comprising either male or female categories, in six authorship categories: first author, joint first authors, first corresponding author, joint corresponding authors, last author and joint last authors.ResultsPublications comprised clinical research (39%, n=939), basic research (27%, n=643), and other types of research (34%, n=827). The proportion of female authors as first author (41%), first corresponding authors (34%) and last author (23%) was statistically significantly lower than male authors in these authorship categories. Of total joint first authors (n=458), joint corresponding authors (n=169), and joint last authors (n=229), female only authors comprised statistically significant smaller proportions i.e. 15% (n=69), 29% (n=49) and 10% (n=23) respectively, compared to male only authors in these joint authorship categories. There was a statistically significant association between gender of the last author(s) with gender of the first author(s) (χ 2 33.742, P < 0.001), corresponding author(s) (χ2 540.774, P < 0.001) and joint last author(s) (χ 2 91.291, P < 0.001).ConclusionsAlthough there are increasing trends of female authors as first authors (41%) and last authors (23%), female authors are underrepresented compared to male authors in all six categories of scientific authorship in biomedical research. Further research is needed to encourage gender parity in different categories of scientific authorship.Strengths and limitations of this studyThis is the first study to investigate gender parity in six categories of scientific authorship: first authors, first corresponding authors, last authors and three joint authorship categories i.e. joint first authors, joint corresponding authors and joint last authors in biomedical research.This study provides an important benchmark on gender equity in scientific authorship for other NIHR funded centres and organisations in England.The generalisability of the findings of this study may be limited due to differences in medical specialities, research areas, institutional cultures, and levels of support to individual researchers.Using secondary sources for determining the gender of authors may have limitations, which could be avoided by seeking relevant information from original authors and institution affiliation at the time of submission.

BackgroundThe underrepresentation of women in academic medicine at senior level and in leadership positions is well documented. In the United Kingdom, the National Institute for Health Research (NIHR) announced that eligibility for funding for Biomedical Research Centres (BRCs) required at least Silver award status of the Athena SWAN Charter. However, the evidence base for monitoring gender equity (GE) in BRCs is underdeveloped.MethodsAn exploratory online survey distributed to an entire population of NIHR Oxford BRC affiliates (N=683) who ranked the importance of 13 markers of GE on a five point Likert scale. Data were summarised using frequencies and descriptive statistics. Interrelationships between the markers and underlying latent dimensions (factors) were determined by exploratory and confirmatory factor analyses. Thematic analysis was used to analyse open-ended comments.ResultsThe response rate was 36% (243 respondents). Respondents were more frequently female (55%, n=133), aged 41-50 years (33%, n=81), investigators (33%, n=81) and had been affiliated with the BRC for 2-7 years (39.5%, n=96). Participants ranked BRC senior leadership roles and organisational policies on gender equity, as very important, 58% (n=141) and 57% (n=139) respectively. The top two markers ranked as very important by female participants were organisational policies (64.7%, n=86/133) and recruitment and retention (60.9%, n=81/133), whereas male participants ranked leadership development (52.1%, n=50/96) and BRC senior leadership roles (50%, n=48/96) as being very important. The factor analyses showed two distinct latent dimensions: organisational markers and individual markers of GE in BRCs. Open ended comments suggested three key areas of actions: monitoring and benchmarking, organisational support for those with childcare responsibilities, and leadership and Institutional support for GE.ConclusionsThe findings suggest a two-factor model of markers of achievement for GE with organisational and individual dimensions. Implementation and sustainability of gender equity requires commitment at senior leadership and organisational policy level.

Background Given the complex mix of structural, cultural and institutional factors that produce barriers for women in science, an equally complex intervention is required to understand and address them. The Athena SWAN Award Scheme for Gender Equality has become a widespread means to address barriers for women’s advancement and leadership in the United Kingdom, Ireland, Australia, the United States of America and Canada, while the European Commission is exploring the introduction of a similar award scheme across Europe. Methods This study analyses the design and implementation of 16 departmental Athena SWAN Silver Action Plans in Medical Sciences at one of the world’s leading universities in Oxford, United Kingdom. Data pertaining to the design and implementation of gender equality interventions were extracted from the action plans, analysed thematically, coded using categories from the 2015 Athena SWAN Charter Awards Handbook and synthesised against a typology of gender equality interventions in the European Research Area. The results were further analysed against the complexity research literature framework, where research organisations are perceived as dynamic systems that adapt, interact and co-evolve with other systems. Results Athena SWAN is a complex contextually embedded system of action planning within the context of universities. It depends on a multitude of contextual variables that relate in complex, non-linear ways and dynamically adapt to constantly moving targets and new emergent conditions. Athena SWAN Silver Action Plans conform to the key considerations of complexity – (1) multiple actions and areas of intervention with a focus on the complex system being embedded in local dynamics, (2) the non-linearity of interventions and the constantly emerging conditions, and (3) impact in terms of contribution to change, improved conditions to foster change and the increased probability that change can occur. Conclusions To enact effective sustainable structural and cultural change for gender equality, it is necessary to acknowledge and operationalise complexity as a frame of reference. Athena SWAN is the single most comprehensive and systemic gender equality scheme in Europe. It can be further strengthened by promoting the integration of sex and gender analysis in research and education. Gender equality policies in the wider European Research Area can benefit from exploring Athena SWAN’s contextually embedded systemic approach to dynamic action planning and inclusive focus on all genders and categories of staff and students.

Higher academic institutions in the UK need to drive improvements in equity, diversity, and inclusion (EDI) through sustainable practical interventions. A broad view of inclusivity is based on an intersectional approach that considers race, geographical location, caring responsibilities, disability, neurodiversity, religion, and LGBTQIA+ identities. We describe the establishment of a diverse stakeholder group to develop practical grass-roots recommendations through which improvements can be advanced. We have developed a manifesto for change, comprising six domains through which academic institutions can drive progress through setting short, medium, and long-term priorities. Interventions will yield rewards in recruitment and retention of a diverse talent pool, leading to enhanced impact and output.

Results of two C-Change surveys of 4997 faculty and staff in medical and social sciences are analysed quantitatively and qualitatively and presented with illustrative quotations giving voice to critical personal perceptions of the culture and efforts to improve it. The C-Change survey included 12 dimensions of the culture: Vitality; Self-Efficacy in Career Advancement; Institutional Support; Relationships/Inclusion/Trust; Values Alignment; Ethical/Moral Distress; Leadership Aspirations; Work-Life Integration; Gender Equity; Black and Minority Ethnic Equity; Institutional Change Efforts for Diversity; Institutional Change Efforts for Faculty Support. Women were less positive than men on six dimensions in medical and ten dimensions in social sciences, suggesting that women’s experiences are different to those of men. Both women and men were more positive about the culture in medical than social sciences. A more positive culture in medical sciences is attributed to the wide-spread implementation of Athena SWAN gender equality action plans linked to the NIHR funding incentives.

Introduction Academic health centres (AHCs) are complex organisations often defined by their ‘tripartite’ mission: to achieve high standards of clinical care, undertake clinical and laboratory research and educate health professionals. In the last decade, AHCs have moved away from what was a dominant focus on high impact (clinical) interventions for individuals, towards a more population-oriented paradigm requiring networked institutions and responsiveness to a range of issues including distribution of health outcomes and health determinants. Reflective of this paradigm shift is a growing interest in the role of AHCs in addressing health disparities and improving health system equity. This protocol outlines a systematic review that seeks to synthesise and critically appraise the current state of evidence on the role of AHCs in contributing to equitable health systems locally and globally. Methods and analysis Electronic searches will be conducted on a pilot list of bibliographic databases, including Google Scholar, Scopus, MEDLINE, PsycInfo, CINAHL, ERIC, ProQuest Dissertations & Theses, Cochrane Library, Evidence Based Medicine Reviews, Campbell Library and A+ Education, from 1 January 2000 to 31 December 2016. Apart from studies reporting clinical interventions or trials, all types of published peer-reviewed and grey literature will be included in the review. The single screening method will be employed in selecting studies, with two additional reviewers consulted where allocation is unclear. Quality and relevance appraisal utilising Joanna Briggs Institute critical appraisal tools will follow data extraction to a preprepared template. Thematic synthesis will be undertaken to develop descriptive themes and inform analysis. Ethics and dissemination As the review is focused on the analysis of secondary data, it does not require ethics approval. The results of the study will be disseminated through articles in peer-reviewed journals and trade publications as well as presentations at relevant national and international conferences. Results will be further disseminated through networks and associations of AHCs. Protocol registration International Prospective Register for Systematic Reviews (PROSPERO) number CRD42016051802.

International audience; No abstract available

Background:A growing number of professional societies in clinical and medically related disciplines investigate evidence, make recommendations, and take action to advance gender equity. Evidence on women’s advancement and leadership in the context of the European Alliance of Associations for Rheumatology, EULAR, is limited [1].Objectives:The objective of the EULAR Task Force on Gender Equity in Academic Rheumatology was to establish the extent of the unmet need for support of female rheumatologists, health professionals and non-clinical scientists in academic rheumatology and develop a framework to address this through EULAR and Emerging EULAR Network (EMEUNET).Methods:Potential interventions to accelerate gender-equitable career advancement in academic rheumatology were gathered from a narrative review of the relevant literature, expert opinion of a multi-disciplinary Task Force (comprised of 23 members from 11 countries), data from the surveys of EULAR scientific member society leaders, EULAR and EMEUNET members, and EULAR Executive Committee members. These interventions were rated by Task Force members, who ranked each according to perceived priority on a five-point numeric scale from 1 = very low to 5 = very high.Results:A framework of 29 potential interventions was formulated, which covers six thematic areas, namely, EULAR policies, advocacy and communication, EULAR Congress and associated symposia, training courses, mentoring/peer support, and EULAR funding (Figure 1).Figure 1.A framework of potential interventions with the levels of priority, mean and standard deviation (SD)Conclusion:The framework provides structured interventions for accelerating gender-equitable career advancement in academic rheumatology.References:[1]Andreoli L, Ovseiko PV, Hassan N, et al. Gender equity in clinical practice, research and training: Where do we stand in rheumatology? Joint Bone Spine 2019;86(6):669-72.Acknowledgements:The task force is grateful to EULAR for funding this activity under project number EPI 024.Disclosure of Interests:None declared

Domestic violence and assault (DVA) against women is a serious concern in India. This affects the health and wellbeing of victims and their dependents. Published evidence has documented a variety of reasons for such violence in Indian societies, paving a pathway to design, implement, and evaluate intervention models to address this issue. DEVELOP is a research study designed by UK and Indian research teams to plan future projects to address gender-based discrimination and DVA against women and girls in India. This study protocol provides detailed information on the objectives, research methods, data collection, storage, analysis, and dissemination plans of the DEVELOP phase 1 work (2018-19). The first component is a survey of adolescent boys and girls from rural areas of the Maharashtra state of India to understand their gender equality related knowledge and beliefs. The insight gathered will be used to design interventions targeted at adolescent populations through future research and development programmes. Secondly, an evaluation of the ‘Responsible Couples’ project will be conducted to assess its success and challenges, and to inform future programme activities and strategy. The ‘Responsible Couples’ project is implemented in 40 villages of Maharashtra state to improve relationships in married couples, prevent violence against women, intervene during violence, and to provide support services for women and their family members. Research findings will be disseminated though public engagement events in India, international conferences, and peer reviewed publications. Secondly, our two key partners (SWISSAID and HMF) will benefit from such evidence to inform their on-going as well as forthcoming projects on gender equality in India. Research findings will be also useful for local government authorities and non-government agencies striving to advance gender equality.

In Australia and New Zealand (ANZ), clinical academics are an important part of the workforce needed to deliver social and economic returns from health and medical research investment. This review aims to examine the extent and nature of the empirical evidence base addressing the development of the multi-professional clinical academic workforce in ANZ and to synthesise policy-relevant findings. The review adopts a scoping review design. Literature searches were undertaken in February 2019 in Medline (Ovid), Scopus, and CINAHL, with reference lists and websites also searched for additional literature. Papers eligible for inclusion were those published in English in 2000–2018 that reported results of empirical studies that addressed factors relating to developing the ANZ clinical academic workforce size, composition or role through building, enabling or sustaining its research functions. Results were reported narratively using a labour market policy framework. A total of 43 studies representing a diverse range of health professions and study designs were included in the review, only two of which reported on the New Zealand context. The majority were focused on building, supporting and sustaining research capacity and engagement among groups of clinicians within clinical settings. Use of three labour market policy levers to frame analysis enabled identification of issues relating to rural/urban workforce maldistribution, in addition to more widely reported clinical academic workforce production and retention issues. The literature addressing the development of the clinical academic health workforce in ANZ frames this workforce either as clinicians who routinely engage in research activity, or as a workforce cadre comprised of distinct, formalised research-related clinical roles. As such, developing the clinical academic workforce requires both: i) policy attention to the availability of research training opportunities for health professional students and graduates and of dedicated research-related career pathways; and ii) structures and processes that enable or inhibit research engagement among clinicians at a mid-career level.

In the digital era, social media has become a space for the socialization and interaction of citizens, who are using social networks to express themselves and to discuss scientific advances with citizens from all over the world. Researchers are aware of this reality and are increasingly using social media as a source of data to explore citizens’ voices. In this context, the methods followed by researchers are mainly based on the content analysis using manual, automated or combined tools. The aim of this article is to share a protocol for Social Media Analytics that includes a Communicative Content Analysis (CCA). This protocol has been designed for the Horizon 2020 project Allinteract, and it includes the social impact in social media methodology. The novel contribution of this protocol is the detailed elaboration of methods and procedures to capture emerging realities in citizen engagement in science in social media using a Communicative Content Analysis (CCA) based on the contributions of Communicative Methodology (CM).

The 2010–2015 Conservative and Liberal Democrat coalition government proposed introducing a radical decentralisation reform of the organisation, financing, and planning of medical workforce education and training in England. However, following public deliberation and parliamentary scrutiny of the government's proposals, it had to abandon and alter its original proposals to the extent that they failed to achieve their original decentralisation objectives. This failed decentralisation attempt provides important lessons about the policy process and content of both workforce governance and health system reforms in Europe and beyond. The organisation, financing, and planning of medical workforce education is as an issue of national importance and should remain in the stewardship of the national government. Future reform efforts seeking to enhance the skills of the workforce needed to deliver high-quality care for patients in the 21st century will have a greater chance of succeeding if they are clearly articulated through engagement with stakeholders, and focus on the delivery of undergraduate and postgraduate multi-professional education and training in universities and teaching hospitals.

Background:Women represent an increasing proportion of the overall rheumatology workforce, but are underrepresented in academic rheumatology, especially in leadership roles [1].Objectives:The EULAR Task Force on Gender Equity in Academic Rheumatology has been convened to establish the extent of the unmet need for support of female rheumatologists, health professionals and non-clinical scientists in academic rheumatology and develop a framework to address this through EULAR and EMEUNET.Methods:To investigate gender equity in academic rheumatology, an anonymous web-based survey was targeted at the membership of EULAR and Emerging EULAR Network (EMEUNET) and their wider networks. The survey was developed based on a narrative literature review [1], best practice from The Association of Women in Rheumatology, a survey of task force members and face-to-face task force discussions. Personal experiences were explored and 24 potential interventions to aid career advancement were ranked. Statistics were descriptive with significance testing for male/female responses compared using chi-squared/t-tests. The level of significance was set at pResults:A total of 301 respondents from 24 countries fully completed the survey. By profession, 290 (86.4%) were rheumatologists, 19 (6.3%) health professionals, and 22 (7.3%) non-clinical scientists. By gender, 217 (72.1%) were women, 83 (27.6%) men, and 1 (0.3%) third gender. By age, 203 (67.5%) were 40 or under. By ethnicity, 30 (10.0%) identified themselves as ethnic minority. A high proportion of respondents reported having experienced gender discrimination (47.2% total: 58.1% for women and 18.1% for men) and sexual harassment (26.2%: 31.8% and 10.8% respectively) (Figure 1). Chi-squared tests on the numbers on which these proportions were based showed statistically significant differences between women and men in having experienced gender discrimination (Χ2=36.959 (df=1), p Figure 1.Perceived gender discrimination and sexual harassment, 301 responsesFigure 2.Mean perceived utility of potential interventions for career advancement by gender and statistically significant gender differences (pConclusion:The results of the survey will inform the development of task force policy proposals for interventions to support career advancement among EULAR and EMEUNET members. The identified interventions have potential to support career advancement of all rheumatologists, health professionals and non-clinical scientists regardless of gender.References:[1]Andreoli L, Ovseiko PV, Hassan N, Kiltz U, van Mens L, Gossec L, et al. Gender equity in clinical practice, research and training: Where do we stand in rheumatology? Joint, Bone, Spine: Revue du Rhumatisme. 2019;86(6):669-672.Acknowledgments:We gratefully acknowledge the rheumatologists, health professionals and non-clinical scientists who responded to the survey.Disclosure of Interests:Pavel V Ovseiko: None declared, Laure Gossec Grant/research support from: Lilly, Mylan, Pfizer, Sandoz, Consultant of: AbbVie, Amgen, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Sandoz, Sanofi-Aventis, UCB, Laura Andreoli: None declared, Uta Kiltz Grant/research support from: AbbVie, Amgen, Biogen, Novartis, Pfizer, Consultant of: AbbVie, Biocad, Eli Lilly and Company, Grünenthal, Janssen, Novartis, Pfizer, UCB, Speakers bureau: AbbVie, MSD, Novartis, Pfizer, Roche, UCB, Leonieke van Mens: None declared, Neelam Hassan: None declared, Marike van der Leeden: None declared, Heidi J Siddle: None declared, Alessia Alunno: None declared, Iain McInnes Grant/research support from: Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Janssen, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Gilead, Janssen, Novartis, Pfizer, and UCB, Nemanja Damjanov Grant/research support from: from AbbVie, Pfizer, and Roche, Consultant of: AbbVie, Gedeon Richter, Merck, Novartis, Pfizer, and Roche, Speakers bureau: AbbVie, Gedeon Richter, Merck, Novartis, Pfizer, and Roche, Florence Apparailly: None declared, Caroline Ospelt Consultant of: Consultancy fees from Gilead Sciences., Irene van der Horst-Bruinsma Grant/research support from: AbbVie, Novartis, Eli Lilly, Bristol-Myers Squibb, MSD, Pfizer, UCB Pharma, Consultant of: AbbVie, Novartis, Eli Lilly, Bristol-Myers Squibb, MSD, Pfizer, UCB Pharma, Elena Nikiphorou: None declared, Katie Druce Speakers bureau: Pfizer and Lilly, Zoltán Szekanecz Grant/research support from: Pfizer, UCB, Consultant of: Sanofi, MSD, Abbvie, Pfizer, Roche, Novertis, Lilly, Gedeon Richter, Amgen, Alexandre Sepriano: None declared, Tadej Avcin: None declared, George Bertsias Grant/research support from: GSK, Consultant of: Novartis, Georg Schett Speakers bureau: AbbVie, BMS, Celgene, Janssen, Eli Lilly, Novartis, Roche and UCB, Anne Maree Keenan: None declared, Laura C Coates: None declared

BACKGROUND Promoting Responsible Research and Innovation (RRI) is a major strategy of the “Science with and for Society” work program of the European Union’s Horizon 2020 Framework Programme for Research and Innovation. RRI aims to achieve a better alignment of research and innovation with the values, needs, and expectations of society. The RRI strategy includes the “keys” of public engagement, open access, gender, ethics, and science education. The Structural Transformation to Attain Responsible BIOSciences (STARBIOS2) project promotes RRI in 6 European research institutions and universities from Bulgaria, Germany, Italy, Slovenia, Poland, and the United Kingdom, in partnership with a further 6 institutions from Brazil, Denmark, Italy, South Africa, Sweden, and the United States. OBJECTIVE The project aims to attain RRI structural change in 6 European institutions by implementing action plans (APs) and developing APs for 3 non-European institutions active in the field of biosciences; use the implementation of APs as a learning process with a view to developing a set of guidelines on the implementation of RRI; and develop a sustainable model for RRI in biosciences. METHODS The project comprises interrelated research and implementation designed to achieve the aforementioned specific objectives. The project is organized into 6 core work packages and 5 supporting work packages. The core work packages deal with the implementation of institutional APs in 6 European institutions based on the structural change activation model. The supporting work packages include technical assistance, learning process on RRI-oriented structural change, monitoring and assessment, communication and dissemination, and project management. RESULTS The project is funded by Horizon 2020 and will run for 4 years (May 2016-April 2020). As of June 2018, the initial phase has been completed. The participating institutions have developed and approved APs and commenced their implementation. An observation tool has been launched by the Technical Assistance Team to collect information from the implementation of APs; the Evaluation & Assessment team has started monitoring the advancement of the project. As part of the communication and dissemination strategy, a project website, a Facebook page, and a Twitter account have been launched and are updated periodically. The International Scientific Advisory Committee has been formed to advise on the reporting and dissemination of the project’s results. CONCLUSIONS In the short term, we anticipate that the project will have a considerable impact on the organizational processes and structures, improving the RRI uptake in the participating institutions. In the medium term, we expect to make RRI-oriented organizational change scalable across Europe by developing guidelines on RRI implementation and an RRI model in biosciences. In the long term, we expect that the project would help increase the ability of research institutions to make discoveries and innovations in better alignment with societal needs and values. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11745

Purpose Academic health centres (AHCs) are organisations that pursue a “tripartite” mission to deliver high-quality care to patients, undertake clinical and laboratory research, and train future health professionals. The last decade has seen a global spread of AHC models and a growing interest in the role of AHCs in addressing health system equity. The purpose of this paper is to synthesise and critically appraise the evidence on the role of AHCs in improving health equity. Design/methodology/approach Peer-reviewed and grey literature published in English between 2000 and 2016 were searched. Articles that identified AHCs as the primary unit of analysis and that also addressed health equity concepts in relation to the AHC’s activity or role were included. Findings In total, 103 publications met the inclusion criteria of which 80 per cent were expert opinion. Eight descriptive themes were identified through which health equity concepts in relation to AHCs were characterised, described and operationalised: population health, addressing health disparities, social determinants of health, community engagement, global health, health system reform, value-based and accountable financing models, and role clarification/recalibration. There was consensus that AHCs can and should address health disparities, but there is a lack of empirical evidence to show that AHCs have a capacity to contribute to health equity goals or are demonstrating this contribution. Originality/value This review highlights the relevance of health equity concepts in discussions about the role and missions of AHCs. Future research should improve the quality of the evidence base by empirically examining health equity strategies and interventions of AHCs in multiple countries and contexts.

BACKGROUND: Women's participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité - Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). CASE: The percentage of female medical students and doctors in all four countries is now well within the 40-60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the 'glass ceiling' effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. CONCLUSION: Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises and newly created management structures. Developing comprehensive gender-sensitive health workforce monitoring systems and comparing progress across academic health centres in Europe could help to identify the gender leadership gap and utilise health human resources more effectively.

Background While in the United Kingdom, Ireland, and Australia, higher education and research institutions are widely engaged with the Athena SWAN Charter for Women in Science to advance gender equality, empirical research on this process and its impact is rare. This study combined two data sets (free- text comments from a survey and qualitative interviews) to explore the range of experiences and perceptions of participation in Athena SWAN in medical science departments of a research-intensive university in Oxford, United Kingdom. Methods The study is based on the secondary analysis of data from two projects: 59 respondents to an anonymous online survey (42 women, 17 men) provided relevant free-text comments and, separately, 37 women participated in face-to-face narrative interviews. Free-text survey comments and narrative interviews were analysed thematically using constant comparison. Results Both women and men said that participation in Athena SWAN had brought about important structural and cultural changes, including increased support for women’s careers, greater appreciation of caring responsibilities, and efforts to challenge discrimination and bias. Many said that these positive changes would not have happened without linkage of Athena SWAN to government research funding, while others thought there were unintended consequences. Concerns about the programme design and implementation included a perception that Athena SWAN has limited ability to address longstanding and entrenched power and pay imbalances, persisting lack of work-life balance in academic medicine, questions about the sustainability of positive changes, belief that achieving the award could become an end in itself, resentment about perceived positive discrimination, and perceptions that further structural and cultural changes were needed in the university and wider society. Conclusions The findings from this study suggest that Athena SWAN has a positive impact in advancing gender equality, but there may be limits to how much it can improve gender equality without wider institutional and societal changes. To address the fundamental causes of gender inequality would require cultural change and welfare state policies incentivising men to increase their participation in unpaid work in the family, which is beyond the scope of higher education and research policy. Electronic supplementary material The online version of this article (doi:10.1186/s12961-017-0177-9) contains supplementary material, which is available to authorized users.

Global investment in biomedical research has grown significantly over the last decades, reaching approximately a quarter of a trillion US dollars in 2010. However, not all of this investment is distributed evenly by gender. It follows, arguably, that scarce research resources may not be optimally invested (by either not supporting the best science or by failing to investigate topics that benefit women and men equitably). Women across the world tend to be significantly underrepresented in research both as researchers and research participants, receive less research funding, and appear less frequently than men as authors on research publications. There is also some evidence that women are relatively disadvantaged as the beneficiaries of research, in terms of its health, societal and economic impacts. Historical gender biases may have created a path dependency that means that the research system and the impacts of research are biased towards male researchers and male beneficiaries, making it inherently difficult (though not impossible) to eliminate gender bias. In this commentary, we - a group of scholars and practitioners from Africa, America, Asia and Europe - argue that gender-sensitive research impact assessment could become a force for good in moving science policy and practice towards gender equity. Research impact assessment is the multidisciplinary field of scientific inquiry that examines the research process to maximise scientific, societal and economic returns on investment in research. It encompasses many theoretical and methodological approaches that can be used to investigate gender bias and recommend actions for change to maximise research impact. We offer a set of recommendations to research funders, research institutions and research evaluators who conduct impact assessment on how to include and strengthen analysis of gender equity in research impact assessment and issue a global call for action. La inversión global en investigación biomédica ha crecido significativamente en las últimas décadas, alcanzando aproximadamente un cuarto de billón de dólares en 2010. Sin embargo, no toda esta inversión se distribuye de manera uniforme por género. De ello se deduce que los escasos recursos de investigación no pueden invertirse de manera óptima (ya sea porque no apoyan a la mejor ciencia o porque no se investigan temas que beneficien equitativamente a mujeres y hombres). Las mujeres en todo el mundo tienden a estar significativamente subrepresentadas en la investigación, tanto como investigadoras como participantes en la investigación, reciben menos fondos para la investigación y aparecen con menos frecuencia que los hombres como autoras en publicaciones de investigación. También hay cierta evidencia de que las mujeres se encuentran en una situación de desventaja relativa como beneficiarias de la investigación, en términos de su salud, impacto social y económico. Los sesgos históricos de género pueden haber creado una dependencia de ruta que significa que el sistema de investigación y los impactos de la investigación están sesgados hacia los investigadores hombres y los beneficiarios masculinos, por lo que es intrínsecamente difícil (aunque no imposible) eliminar el sesgo de género. En este comentario, nosotros, un grupo de académicos y profesionales de África, América, Asia y Europa, argumentamos que la evaluación de impacto de investigación sensible al género podría convertirse en una fuerza para bien al mover la política y la práctica científica hacia la equidad de género. La evaluación del impacto de la investigación es el campo multidisciplinario de la investigación científica que examina el proceso de investigación para maximizar el rendimiento científico, social y económico de la inversión en investigación. Abarca muchos enfoques teóricos y metodológicos que se pueden utilizar para investigar el sesgo de género y recomendar acciones para el cambio a fin de maximizar el impacto de la investigación. Ofrecemos un conjunto de recomendaciones para las fundaciones de investigación, instituciones de investigación y evaluadores de investigación que realizan evaluaciones de impacto sobre cómo incluir y fortalecer el análisis de equidad de género en la evaluación de impacto de la investigación y emitir una llamamiento global a la acción. La inversió global en recerca biomèdica ha crescut significativament en les últimes dècades, arribant a aproximadament un quart de bilió de dòlars en 2010. No obstant això, no tota aquesta inversió es distribueix de manera uniforme per gènere. D'això es dedueix que els escassos recursos d'investigació no poden invertir-se de manera òptima (ja sigui perquè no donen suport a la millor ciència o perquè no s'investiguen temes que beneficiïn equitativament a dones i homes). Les dones a tot el món tendeixen a estar significativament subrepresentades en la investigació, tant com a investigadores com a participants en la investigació, reben menys fons per a la investigació i apareixen amb menys freqüència que els homes com a autores en publicacions d'investigació. També hi ha certa evidència que les dones es troben en una situació de desavantatge relatiu com a beneficiàries de la investigació, en termes de la seva salut, impacte social i econòmic. Els biaixos històrics de gènere poden haver creat una dependència de ruta que vol dir que el sistema de recerca i els impactes de la investigació estan esbiaixats cap als investigadors homes i els beneficiaris masculins, per la qual cosa és intrínsecament difícil (encara que no impossible) eliminar el biaix de gènere. En aquest comentari, nosaltres, un grup d'acadèmics i professionals de l'Àfrica, Amèrica, Àsia i Europa, vam argumentar que l'avaluació d'impacte d'investigació sensible al gènere podria convertir-se en una força per bé en moure la política i la pràctica científica cap a l'equitat de gènere. L'avaluació de l'impacte de la recerca és el camp multidisciplinari de la recerca científica que examina el procés de recerca per maximitzar el rendiment científic, social i econòmic de la inversió en recerca. Abasta molts enfocaments teòrics i metodològics que es poden utilitzar per investigar el biaix de gènere i recomanar accions per al canvi per tal de maximitzar l'impacte de la investigació. Oferim un conjunt de recomanacions per a les fundacions de recerca, institucions de recerca i avaluadors d'investigació que realitzen avaluacions d'impacte sobre com incloure i enfortir l'anàlisi d'equitat de gènere en l'avaluació d'impacte de la investigació i emetre una crida global a l'acció .

Revitalizing the Oslerian ideal of the clinician-scientist-teacher may help in the training of the next generation of translational researchers.

Background Around the world, the last two decades have been characterised by an increase in the numbers of mergers between healthcare providers, including some of the most prestigious university hospitals and academic health centres. However, many mergers fail to bring the anticipated benefits, and successful post-merger integration in university hospitals and academic health centres is even harder to achieve. An increasing body of literature suggests that organisational culture affects the success of post-merger integration and academic-clinical collaboration. Methods This paper reports findings from a mixed-methods single-site study to examine 1) the perceptions of organisational culture in academic and clinical enterprises at one National Health Service (NHS) trust, and 2) the major cultural issues for its post-merger integration with another NHS trust and strategic partnership with a university. From the entire population of 72 clinician-scientists at one of the legacy NHS trusts, 38 (53%) completed a quantitative Competing Values Framework survey and 24 (33%) also provided qualitative responses. The survey was followed up by semi-structured interviews with six clinician-scientists and a group discussion including five senior managers. Results The cultures of two legacy NHS trusts differed and were primarily distinct from the culture of the academic enterprise. Major cultural issues were related to the relative size, influence, and history of the legacy NHS trusts, and the implications of these for respective identities, clinical services, and finances. Strategic partnership with a university served as an important ameliorating consideration in reaching trust merger. However, some aspects of university entrepreneurial culture are difficult to reconcile with the NHS service delivery model and may create tension. Conclusions There are challenges in preserving a more desirable culture at one of the legacy NHS trusts, enhancing cultures in both legacy NHS trusts during their post-merger integration, and in aligning academic and clinical cultures following strategic partnership with a university. The seeds of success may be found in current best practice, good will, and a near identical ideal of the future preferred culture. Strong, fair leadership will be required both nationally and locally for the success of mergers and post-merger integration in university hospitals and academic health centres. Electronic supplementary material The online version of this article (doi:10.1186/s12913-014-0673-3) contains supplementary material, which is available to authorized users.