scholarly journals Finding common (research) ground between general practitioners and neuroscientists: the vital role of knowledge circulation in closing the evidence-to-practice gap

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Astrid Eich-Krohm ◽  
Bernt-Peter Robra ◽  
Yvonne Marx ◽  
Markus Herrmann
Keyword(s):  
General Practitioners ◽  
Research Collaboration ◽  
Knowledge Exchange ◽  
Research Process ◽  
Structured Interviews ◽  
Joint Research ◽  
Treatment Pathways ◽  
Hermeneutic Approach ◽  
Knowledge Circulation ◽  
Practice Gap

Abstract Background It may take 15 years or longer before research evidence is integrated into clinical practice. This evidence-to-practice gap has deleterious effects on patients as well as research and clinical processes. Bringing clinical knowledge into the research process, however, has the potential to close the evidence-to-practice gap. The NEUROTRANS-Project attempts to bring research and practice together by focusing on two groups that usually operate separately in their communities: general practitioners and neuroscientists. Although both groups focus on dementia as an area of work, they do so in different contexts and without opportunities to share their expertise. Finding new treatment pathways for patients with dementia will require an equal knowledge exchange among researchers and clinicians along with the integration of that knowledge into research processes, so that both groups will benefit from the expertise of the other. Methods The NEUROTRANS-Project uses a qualitative, multi-stage research design to explore how neuroscientists and general practitioners (GPs) approach dementia. Using a grounded theory methodology, it analyzes semi-structured interviews, case vignettes, focus groups with GPs in Saxony-Anhalt, Germany, and informal conversations with, and observations of, neuroscientists from the German Center for Neurodegenerative Diseases in Magdeburg. Results The NEUROTRANS-Project identified a clear division of labor between two highly specialized professional groups. Neuroscientists focus abstractly on nosology whereas general practitioners tend to patient care following a hermeneutic approach integrating the patients’ perspective of illness. These different approaches to dementia create a barrier to constructive dialogue and the capacity of these groups to do research together with a common aim. Additionally, the broader system of research funding and health care within which the two groups operate reinforces their divide thereby limiting joint research capacity. Conclusions Overcoming barriers to research collaboration between general practitioners and neuroscientists requires a shift in perspective in which both groups actively engage with the other’s viewpoints to facilitate knowledge circulation (KC). Bringing ‘art into science and science into art’, i.e. amalgamating the hermeneutic approach with the perspective of nosology, is the first step in developing joint research agendas that have the potential to close the evidence-to-practice gap.

scholarly journals Primary care management of chronic insomnia: a qualitative analysis of the attitudes and experiences of Australian general practitioners

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jenny Haycock ◽  
Nicole Grivell ◽  
Anne Redman ◽  
Bandana Saini ◽  
Andrew Vakulin ◽  
...  
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Best Practice ◽  
Geographic Location ◽  
Behavioural Therapy ◽  
Chronic Insomnia ◽  
Structured Interviews ◽  
Treatment Pathways ◽  
Falling Asleep ◽  
Australian General Practice

Abstract Background Chronic insomnia is a highly prevalent disorder, with ten to thirty percent of Australian adults reporting chronic difficulties falling asleep and/or staying asleep such that it causes significant daytime impairment. Current Australian general practice guidelines recommend cognitive behavioural therapy for insomnia (CBTi) as first line treatment for insomnia, however research suggests that most general practice consultations for insomnia result in a prescription for hypnotic or sedative medicines. Although the first point of contact for patients experiencing symptoms of insomnia is often general practice, little is known about the current role, experiences and capacity of Australian general practitioners to manage insomnia. This study aimed to address that gap by exploring the attitudes and opinions of general practitioners regarding insomnia management, to inform the development and implementation of new models of best practice insomnia care within general practice. Methods A descriptive, pragmatic qualitative study. Purposive sampling was used to recruit practising Australian general practitioners, varying in age, years of experience and geographic location. Semi-structured interviews were conducted, and data analysed using thematic analysis.  Results Twenty-eight general practitioners participated in the study. Three major themes were identified: 1) Responsibility for insomnia care; 2) Complexities in managing insomnia; and 3) Navigating treatment pathways. Whilst general practitioners readily accepted responsibility for the management of insomnia, provision of care was often demanding and difficult within the funding and time constraints of general practice. Patients presenting with comorbid mental health conditions and insomnia, and decision-making regarding long-term use of benzodiazepines presented challenges for general practitioners. Whilst general practitioners confidently provided sleep hygiene education to patients, their knowledge and experience of CBTi, and access and understanding of specialised referral pathways for insomnia was limited.  Conclusions General practitioners report that whilst assessing and managing insomnia can be demanding, it is an integral part of general practice. Insomnia presents complexities for general practitioners. Greater clarity about funding options, targeted education about effective insomnia treatments, and referral pathways to specialist services, such as benzodiazepine withdrawal support and psychologists, would benefit insomnia management within general practice.

scholarly journals Field configuration or field reproduction?

2014 ◽  
Vol 58 (1) ◽  
Author(s):  
Rachael Gibson ◽  
Harald Bathelt
Keyword(s):  
Knowledge Exchange ◽  
Field Configuration ◽  
Knowledge Flows ◽  
Structured Interviews ◽  
Fundamental Field ◽  
Ideal Types ◽  
Technological Trajectories ◽  
Knowledge Circulation ◽  
Global Cycles

AbstractThis paper builds on discussions about field-configuring events (FCEs) and cyclical/temporary clusters by investigating the role of trade fairs in structuring processes of knowledge creation in an industry or technology field. It argues that while fundamental field-configuring activities, such as shifts in technological trajectories, are not typically associated with trade fairs, these events play an important role in field reproduction through decentralized processes of knowledge exchange and learning, supported by the global cycles of events. Yet, knowledge flows across different events are rarely as continuous and fluid as in an ideal-type cyclical cluster context. Despite some overlap in their goals and audiences, different trade fairs generally serve different functions and are characterized by diverse knowledge practices. This is illustrated through an empirical analysis of the global trade fair cycle of the lighting industry, which is based on semi-structured interviews and systematic observations conducted at three international/national trade fairs: LightFair International (USA), IIDEX/NeoCon Canada and Light + Building (Germany). From this, we suggest that most trade fairs establish a permanent middle-ground between, but quite distant from, the extreme ideal-types of discrete field-configuration and continuous knowledge circulation.

scholarly journals Primary Care Management of Chronic Insomnia: A Qualitative Analysis of the Attitudes and Experiences of Australian General Practitioners

2020 ◽  
Author(s):  
Jenny Haycock ◽  
Nicole Grivell ◽  
Anne Redman ◽  
Bandana Saini ◽  
Andrew Vakulin ◽  
...  
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Best Practice ◽  
Geographic Location ◽  
Behavioural Therapy ◽  
Chronic Insomnia ◽  
Structured Interviews ◽  
Treatment Pathways ◽  
Falling Asleep ◽  
Australian General Practice

Abstract Background Chronic insomnia is a highly prevalent disorder, with ten to thirty percent of Australian adults reporting chronic difficulties falling asleep and/or staying asleep such that it causes significant daytime impairment. Current Australian general practice guidelines recommend Cognitive Behavioural Therapy for insomnia (CBTi) as first line treatment for insomnia however, research suggests that most general practice consultations for insomnia result in a prescription for hypnotic or sedative medicines. Although the first point of contact for patients experiencing symptoms of insomnia is often general practice, little is known about the current role, experiences and capacity of Australian general practitioners to manage insomnia. This study aimed to address that gap by exploring the attitudes and opinions of general practitioners regarding insomnia management, to inform the development and implementation of new models of best practice insomnia care within general practice. Methods A descriptive, pragmatic qualitative study. Purposive sampling was used to recruit practising Australian general practitioners, varying in age, years of experience and geographic location. Semi-structured interviews were conducted, and data analysed using Thematic Analysis. Results Twenty-eight general practitioners participated in the study. Three major themes were identified: 1) Responsibility for insomnia care; 2) Complexities in managing insomnia; and 3) Navigating treatment pathways. Whilst general practitioners readily accepted responsibility for the management of insomnia, provision of care was often demanding and difficult within the funding and time constraints of general practice. Patients presenting with comorbid mental health conditions and insomnia, and decision-making regarding long-term use of benzodiazepines presented challenges for general practitioners. Whilst general practitioners confidently provided sleep hygiene education to patients, their knowledge and experience of CBTi, and access and understanding of specialised referral pathways for insomnia was limited. Conclusions General practitioners report that whilst assessing and managing insomnia can be demanding, it is an integral part of general practice. Insomnia presents complexities for general practitioners, and greater clarity about funding options, targeted education about effective insomnia treatments, and referral pathways to specialist services would benefit insomnia management within general practice.

scholarly journals ‘Motivational work’: a qualitative study of preventive health dialogues in general practice

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Marie Broholm-Jørgensen ◽  
Siff Monrad Langkilde ◽  
Tine Tjørnhøj-Thomsen ◽  
Pia Vivian Pedersen
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Support System ◽  
Preventive Intervention ◽  
Digital Health ◽  
Clinical Encounter ◽  
Preventive Health ◽  
Structured Interviews ◽  
General Practices ◽  
Municipal Health

Abstract Background The aim of this article is to explore preventive health dialogues in general practice in the context of a pilot study of a Danish primary preventive intervention ‘TOF’ (a Danish acronym for ‘Early Detection and Prevention’) carried out in 2016. The intervention consisted of 1) a stratification of patients into one of four groups, 2) a digital support system for both general practitioners and patients, 3) an individual digital health profile for each patient, and 4) targeted preventive services in either general practice or a municipal health center. Methods The empirical material in this study was obtained through 10 observations of preventive health dialogues conducted in general practices and 18 semi-structured interviews with patients and general practitioners. We used the concept of ‘motivational work’ as an analytical lens for understanding preventive health dialogues in general practice from the perspectives of both general practitioners and patients. Results While the health dialogues in TOF sought to reveal patients’ motivations, understandings, and priorities related to health behavior, we find that the dialogues were treatment-oriented and structured around biomedical facts, numeric standards, and risk factor guidance. Overall, we find that numeric standards and quantification of motivation lessens the dialogue and interaction between General Practitioner and patient and that contextual factors relating to the intervention framework, such as a digital support system, the general practitioners’ perceptions of their professional position as well as the patients’ understanding of prevention —in an interplay—diminished the motivational work carried out in the health dialogues. Conclusion The findings show that the influence of different kinds of context adds to the complexity of prevention in the clinical encounter which help to explain why motivational work is difficult in general practice.

scholarly journals Mapping domain characteristics influencing Analytics initiatives: The example of Supply Chain Analytics

2020 ◽  
Vol 13 (1) ◽  
pp. 56
Author(s):  
Tino Herden
Keyword(s):  
Supply Chain ◽  
Supply Chain Management ◽  
Success Factors ◽  
Research Collaboration ◽  
Future Research ◽  
Structured Interviews ◽  
Chain Management ◽  
Domain Specific ◽  
The Status ◽  
The Impact

Purpose: Analytics research is increasingly divided by the domains Analytics is applied to. Literature offers little understanding whether aspects such as success factors, barriers and management of Analytics must be investigated domain-specific, while the execution of Analytics initiatives is similar across domains and similar issues occur. This article investigates characteristics of the execution of Analytics initiatives that are distinct in domains and can guide future research collaboration and focus. The research was conducted on the example of Logistics and Supply Chain Management and the respective domain-specific Analytics subfield of Supply Chain Analytics. The field of Logistics and Supply Chain Management has been recognized as early adopter of Analytics but has retracted to a midfield position comparing different domains.Design/methodology/approach: This research uses Grounded Theory based on 12 semi-structured Interviews creating a map of domain characteristics based of the paradigm scheme of Strauss and Corbin.Findings: A total of 34 characteristics of Analytics initiatives that distinguish domains in the execution of initiatives were identified, which are mapped and explained. As a blueprint for further research, the domain-specifics of Logistics and Supply Chain Management are presented and discussed.Originality/value: The results of this research stimulates cross domain research on Analytics issues and prompt research on the identified characteristics with broader understanding of the impact on Analytics initiatives. The also describe the status-quo of Analytics. Further, results help managers control the environment of initiatives and design more successful initiatives.

Complicated grief knowledge and practice: a qualitative study of general practitioners in Ireland

2021 ◽  
pp. 1-6
Author(s):  
Abiola Muhammed ◽  
Anne Dodd ◽  
Suzanne Guerin ◽  
Susan Delaney ◽  
Philip Dodd
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Current Knowledge ◽  
Complicated Grief ◽  
Phenomenological Approach ◽  
Structured Interviews ◽  
Relevant Research ◽  
Loved One ◽  
Knowledge And Practice ◽  
Purposive Sample

Objective: Complicated grief is a debilitating condition that individuals may experience after losing a loved one. General practitioners (GPs) are well positioned to provide patients with support for grief-related issues. Traditionally, Irish GPs play an important role in providing patients with emotional support regarding bereavement. However, GPs have commonly reported not being aptly trained to respond to bereavement-related issues. This study explores GPs’ current knowledge of and practice regarding complicated grief. Methods: A qualitative study adopting a phenomenological approach to explore the experiences of GPs on this issue. Semi-structured interviews were carried out with a purposive sample of nine GPs (five men and four women) in Ireland. Potential participants were contacted via email and phone. Interviews were audio-recorded, transcribed and analysed using Braun & Clarke’s (2006) model of thematic analysis. Results: GPs had limited awareness of the concept of complicated grief and were unfamiliar with relevant research. They also reported that their training was either non-existent or outdated. GPs formed their own knowledge of grief-related issues based on their intuition and experiences. For these reasons, there was not one agreed method of how to respond to grief-related issues reported by patients, though participants recognised the need for intervention, onward referral and review. Conclusions: The research highlighted that GPs felt they required training in complicated grief so that they would be better able to identify and respond to complicated grief.

‘They’re a very sick group of individuals’: Correctional officers, emotions, and sex offenders

2016 ◽  
Vol 21 (3) ◽  
pp. 380-394 ◽  
Author(s):  
Dale Spencer ◽  
Rose Ricciardelli
Keyword(s):  
Sex Offenders ◽  
New Brunswick ◽  
Prince Edward Island ◽  
Prison Population ◽  
Correctional Officers ◽  
Occupational Culture ◽  
Structured Interviews ◽  
Men And Women ◽  
Hermeneutic Approach

In this article, we analyze the politics of emotions within the occupational culture of correctional officers by focusing attention on how sex offenders are constituted as objects of fear and disgust. We draw on in-depth semi-structured interviews with 100 Canadian men and women with experience working as correctional officers in provincial prisons (e.g. New Brunswick, Ontario, Alberta, Nunavut, Prince Edward Island) to understand how sex offenders are viewed within their occupational culture. Utilizing an interpretive hermeneutic approach, this article analyzes Canadian correctional officers’ interpretations of sex offenders. We show the effects of sex offenders’ construction as objects of fear and disgust, in terms of their identities and positionality in the general prison population, and the level of protection and services they receive while in prison.

Models for Integrating Medical Acupuncture into Practice: An Exploratory Qualitative Study of Physicians— Experiences

2016 ◽  
Vol 34 (4) ◽  
pp. 280-289 ◽  
Author(s):  
Ellen T Crumley
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Full Time ◽  
Snowball Sampling ◽  
Core Concept ◽  
Structured Interviews ◽  
The Core ◽  
Individual Physician ◽  
Part Time ◽  
Medical Acupuncture

Background Internationally, physicians are integrating medical acupuncture into their practice. Although there are some informative surveys and reviews, there are few international, exploratory studies detailing how physicians have accommodated medical acupuncture (eg, by modifying schedules, space and processes). Objective To examine how physicians integrate medical acupuncture into their practice. Methods Semi-structured interviews and participant observations of physicians practising medical acupuncture were conducted using convenience and snowball sampling. Data were analysed in NVivo and themes were developed. Despite variation, three principal models were developed to summarise the different ways that physicians integrated medical acupuncture into their practice, using the core concept of ‘helping’. Quotes were used to illustrate each model and its corresponding themes. Results There were 25 participants from 11 countries: 21 agreed to be interviewed and four engaged in participant observations. Seventy-two per cent were general practitioners. The three models were: (1) appointments (44%); (2) clinics (44%); and (3) full-time practice (24%). Some physicians held both appointments and regular clinics (models 1 and 2). Most full-time physicians initially tried appointments and/or clinics. Some physicians charged to offset administration costs or compensate for their time. Discussion Despite variation within each category, the three models encapsulated how physicians described their integration of medical acupuncture. Physicians varied in how often they administered medical acupuncture and the amount of time they spent with patients. Although 24% of physicians surveyed administered medical acupuncture full-time, most practised it part-time. Each individual physician incorporated medical acupuncture in the way that worked best for their practice.

Studying gendered embodied consumption with poststructuralist feminist hermeneutics

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Carly Drake ◽  
Scott K. Radford
Keyword(s):  
Cultural Landscape ◽  
Research Process ◽  
The Body ◽  
Methodological Framework ◽  
Structured Interviews ◽  
Content Type ◽  
Research Participants ◽  
Textual Data ◽  
Recreational Runners ◽  
Feminist Hermeneutics

Purpose This study aims to consider how research methodologies and methods can afford holistic inquiry into gendered embodied consumption. Noting the salience of gender in past and present discourse surrounding the body and building on poststructuralist feminist hermeneutic philosophy and practice, the authors introduce a novel methodological framework situated within three considerations borne of the current socio-cultural landscape: the politics of embodiment, embodied identity and intersectionality. Design/methodology/approach To assist scholars and practitioners in interpreting themes of gendered embodiment in textual data surrounding consumption topics, the authors orient the framework around three principles of listening, questioning and hospitality. This framework fosters embodied empathy by linking the researcher’s body to those of research participants. To illustrate the method, the authors interpret consumption narratives extracted from semi-structured interviews with 26 women-identified recreational runners on the topics of embodiment, sport and media. Findings The interpretations of gendered consumption narratives show that using the principles of listening, questioning and hospitality invites an understanding of consumers as multifaceted, contradictory and agentic. The authors argue that consumers’ everyday experiences are often simple and quiet but embedded in history wherein bodies are both biological and inescapably social. Originality/value The methodological framework allows both the researcher’s and research participants’ embodiment to play a role in the research process. It also illuminates the entanglement of embodiment and consumption in a fraught, politicized context. The authors show that by listening to consumers, questioning their narratives and traditional interpretations thereof and inviting consumers to feel comfortable and heard, researchers can see what other approaches may overlook.

scholarly journals An exploration of the attitudes and views of general practitioners on the use of video consultations in a primary healthcare setting: a qualitative pilot study

2018 ◽  
Vol 20 ◽  
Author(s):  
Ratan S. Randhawa ◽  
Joht S. Chandan ◽  
Tom Thomas ◽  
Surinder Singh
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Healthcare Setting ◽  
List Type ◽  
Structured Interviews ◽  
Convenience Sample ◽  
Telephone Consultation ◽  
Video Consultation ◽  
Mixed Feelings ◽  
The Government

AbstractBackgroundIn 2014, in the United Kingdom, the government made a commitment to spend £3.6 million on the introduction of Skype video calling consultations in general practice, however the efficacy of such technology has not yet been explored fully.AimThe study aimed to explore the views and attitudes of General Practitioners (GPs) towards video consultation in primary care; specifically, in three broad areas∙The benefits of video consultations to patients and healthcare professionals.∙Potential problems with video consultation and its implementation.∙The cost-effectiveness of video consultation in this setting.MethodA convenience sample of the views of 12 general practitioners across two primary care centres in North London were identified using topic guide based semi-structured interviews. A thematic framework approach was used to analyse the data collected to isolate main and sub-themes.FindingsThree main themes were identified1.Technology – GPs expressed concerns about the ability of patients to use technology, the availability of technology and the quality of technology available.2.Utility – encompassing GP’s ideas about the usefulness of video consultations to patients, practitioners and the doctor–patient relationship. GPs presented mixed views on the extent to which video consultation would be useful.3.Practicality – covering the views of GPs on implementation and effects on workload. GPs unanimously felt that it was not a practical substitute for face-to-face consultation. There were mixed feelings about it being used as an alternative to telephone consultation.ConclusionGPs did see potential benefits to using video consultations but also expressed concerns that need to be addressed if they are to have full confidence in the system. The views of those who are going to use video consultation as a means of increasing patient access are paramount if such tools are to be a core part of primary care.

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