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Communication is a core component of a clinician’s role; however, when clinicians conduct research, communicating the emerging findings and recommendations to different types of stakeholders can be unfamiliar territory. Communicating research to advocate for change can be even more challenging. Clinician researchers seeking to be agents for change need to conceive and craft specific, evidence-based messages and communicate these effectively to different stakeholders to negotiate action. As part of a global health research program, we developed and tested a novel game-based model to strengthen the communication skills of clinician researchers, from 4 countries, for improving services for chronic obstructive pulmonary disease. This model focused on communication with 3 key stakeholder groups for knowledge translation: Patients/carers, healthcare providers and policy makers/healthcare managers. Delivered through a series of facilitated, online meetings, this model consisted of 2 parts: developing and rehearsing advocacy messages with coaching support, and then testing them with a panel of 3 representative stakeholders, and an audience of fellow researchers. All the country teams reported increased confidence in crafting advocacy messages for specific stakeholders and have applied lessons learned from the model. Delivering this model within a global health research program requires mentoring, time, commitment, resources and translation support to address language barriers. It offers an exemplar to build the communication skills of clinician and non-clinician researchers so that they can go beyond dissemination toward translation of evidence into policy and practice.

Abstract Contained vascular injuries (CVI) of spleen include pseudoaneurysms (PSA) and arterio-venous fistulae (AV-fistulae), and their reported prevalence varies. Our purpose was to assess the prevalence of early splenic CVI seen on admission CT in patients with splenic trauma admitted to a single level 1 trauma center in 2013–2021, and its detection in different CT protocols. A retrospective, single-center longitudinal cohort study. Nine-year data (2013–2021) of all patients with suspected or manifest abdominal trauma were retrieved. All patients, > 15 years with an ICD code for splenic trauma (S36.0XX) were included. CT and angiographic examinations were identified. Reports and images were reviewed. Splenic CVI CT criterion was a focal collection of vascular contrast that decreases in attenuation with delayed imaging. Number of CVIs and treatment was based on medical records and/or available angioembolization data. Of 2805 patients with abdominal trauma, 313 patients (313/2805; 11.2%) fulfilled the study entry criteria. 256 patients (256/313; 81.8%) had a CT examination. Sixteen patients had splenectomy before CT, and the final study group included 240 patients (240/313; 76.7%). Median New Injury Severity Score (NISS) was 27 and 87.5% of patients had NISS > 15. Splenic CVI was found in 20 patients, which yields a prevalence of 8.3% (20/240; 95% CI 5.2–12.6%). In those cases with both late arterial and venous phase images available, CVI was seen in 14.5% of cases (18/124, 95% CI 8.6–22.0%). None of the patients with CVI died within 30 days of the injury. The prevalence of early splenic CVI in patients with a splenic trauma was 8.3–14.5% (95% CI 5.2–22.0%). Our data suggests that both arterial and venous phase are needed for CT diagnosis. The 30-day outcome in terms of mortality was good.

Abstract Background Effective stakeholder engagement in health research is increasingly being recognised and promoted as an important pathway to closing the gap between knowledge production and its use in health systems. However, little is known about its process and impacts, particularly in low-and middle-income countries. This opinion piece draws on the stakeholder engagement experiences from a global health research programme on Chronic Obstructive Pulmonary Disease (COPD) led by clinician researchers in Brazil, China, Georgia and North Macedonia, and presents the process, outcomes and lessons learned. Main body Each country team was supported with an overarching engagement protocol and mentored to develop a tailored plan. Patient involvement in research was previously limited in all countries, requiring intensive efforts through personal communication, meetings, advisory groups and social media. Accredited training programmes were effective incentives for participation from healthcare providers; and aligning research findings with competing policy priorities enabled interest and dialogue with decision-makers. The COVID-19 pandemic severely limited possibilities for planned engagement, although remote methods were used where possible. Planned and persistent engagement contributed to shared knowledge and commitment to change, including raised patient and public awareness about COPD, improved skills and practice of healthcare providers, increased interest and support from clinical leaders, and dialogue for integrating COPD services into national policy and practice. Conclusion Stakeholder engagement enabled relevant local actors to produce and utilise knowledge for small wins such as improving day-to-day practice and for long-term goals of equitable access to COPD care. For it to be successful and sustained, stakeholder engagement needs to be valued and integrated throughout the research and knowledge generation process, complete with dedicated resources, contextualised and flexible planning, and commitment.

Purpose: This study investigated the use of surface guided radiotherapy (SGRT) in combination with a tomotherapy treatment mode using discrete delivery angles for deep inspiration breath hold (DIBH) treatments of breast cancer (bc). We aimed to assess the feasibility and dosimetric advantages of this approach. Materials and methods: We evaluated camera occlusion in the Radixact treatment system bore and the stability of DIBH signals during couch movement. The SGRT system's ability to maintain signal and surface image accuracy was analyzed at different depths within the bore. Dosimetric parameters were compared and measured for 20 left‐sided bc patients receiving TomoDirect (TD) tangential radiotherapy in both DIBH and free breathing (FB). Results: The SGRT system maintained surface coverage and precise DIBH‐signal at depths up to 40 cm beyond the treatment center. Camera occlusion occurred in the clavicular and neck regions due to the patient's morphology and gantry geometry. Nonetheless, the system accurately detected respiratory motion for all measurements. The DIBH plans significantly (p < 0.001) reduced mean heart and left anterior descending artery (LAD) radiation doses by up to 40%, with a 50% reduction in near‐maximum heart and LAD doses, respectively. No significant dosimetric differences between DIBH and FB were observed in other investigated parameters and volumes. Conclusions: Camera occlusion and couch movement minimally impacted the real‐time surface image accuracy needed for DIBH treatments of bc. DIBH reduced heart and LAD radiation doses significantly compared to FB, indicating the feasibility and dosimetric benefits of combining these modalities. [ABSTRACT FROM AUTHOR]

Contained vascular injuries (CVI) of spleen include pseudoaneurysms (PSA) and arterio-venous fistulae (AV-fistulae), and their reported prevalence varies. Our purpose was to assess the prevalence of early splenic CVI seen on admission CT in patients with splenic trauma admitted to a single level 1 trauma center in 2013–2021, and its detection in different CT protocols. A retrospective, single-center longitudinal cohort study. Nine-year data (2013–2021) of all patients with suspected or manifest abdominal trauma were retrieved. All patients, > 15 years with an ICD code for splenic trauma (S36.0XX) were included. CT and angiographic examinations were identified. Reports and images were reviewed. Splenic CVI CT criterion was a focal collection of vascular contrast that decreases in attenuation with delayed imaging. Number of CVIs and treatment was based on medical records and/or available angioembolization data. Of 2805 patients with abdominal trauma, 313 patients (313/2805; 11.2%) fulfilled the study entry criteria. 256 patients (256/313; 81.8%) had a CT examination. Sixteen patients had splenectomy before CT, and the final study group included 240 patients (240/313; 76.7%). Median New Injury Severity Score (NISS) was 27 and 87.5% of patients had NISS > 15. Splenic CVI was found in 20 patients, which yields a prevalence of 8.3% (20/240; 95% CI 5.2–12.6%). In those cases with both late arterial and venous phase images available, CVI was seen in 14.5% of cases (18/124, 95% CI 8.6–22.0%). None of the patients with CVI died within 30 days of the injury. The prevalence of early splenic CVI in patients with a splenic trauma was 8.3–14.5% (95% CI 5.2–22.0%). Our data suggests that both arterial and venous phase are needed for CT diagnosis. The 30-day outcome in terms of mortality was good. [ABSTRACT FROM AUTHOR]

Background: Effective stakeholder engagement in health research is increasingly being recognised and promoted as an important pathway to closing the gap between knowledge production and its use in health systems. However, little is known about its process and impacts, particularly in low-and middle-income countries. This opinion piece draws on the stakeholder engagement experiences from a global health research programme on Chronic Obstructive Pulmonary Disease (COPD) led by clinician researchers in Brazil, China, Georgia and North Macedonia, and presents the process, outcomes and lessons learned. Main body: Each country team was supported with an overarching engagement protocol and mentored to develop a tailored plan. Patient involvement in research was previously limited in all countries, requiring intensive efforts through personal communication, meetings, advisory groups and social media. Accredited training programmes were effective incentives for participation from healthcare providers; and aligning research findings with competing policy priorities enabled interest and dialogue with decision-makers. The COVID-19 pandemic severely limited possibilities for planned engagement, although remote methods were used where possible. Planned and persistent engagement contributed to shared knowledge and commitment to change, including raised patient and public awareness about COPD, improved skills and practice of healthcare providers, increased interest and support from clinical leaders, and dialogue for integrating COPD services into national policy and practice. Conclusion: Stakeholder engagement enabled relevant local actors to produce and utilise knowledge for small wins such as improving day-to-day practice and for long-term goals of equitable access to COPD care. For it to be successful and sustained, stakeholder engagement needs to be valued and integrated throughout the research and knowledge generation process, complete with dedicated resources, contextualised and flexible planning, and commitment. [ABSTRACT FROM AUTHOR]

Communication is a core component of a clinician's role; however, when clinicians conduct research, communicating the emerging findings and recommendations to different types of stakeholders can be unfamiliar territory. Communicating research to advocate for change can be even more challenging. Clinician researchers seeking to be agents for change need to conceive and craft specific, evidence-based messages and communicate these effectively to different stakeholders to negotiate action. As part of a global health research program, we developed and tested a novel game-based model to strengthen the communication skills of clinician researchers, from 4 countries, for improving services for chronic obstructive pulmonary disease. This model focused on communication with 3 key stakeholder groups for knowledge translation: Patients/carers, healthcare providers and policy makers/healthcare managers. Delivered through a series of facilitated, online meetings, this model consisted of 2 parts: developing and rehearsing advocacy messages with coaching support, and then testing them with a panel of 3 representative stakeholders, and an audience of fellow researchers. All the country teams reported increased confidence in crafting advocacy messages for specific stakeholders and have applied lessons learned from the model. Delivering this model within a global health research program requires mentoring, time, commitment, resources and translation support to address language barriers. It offers an exemplar to build the communication skills of clinician and non-clinician researchers so that they can go beyond dissemination toward translation of evidence into policy and practice., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: J Correia-De-Sousa declares grant funding to his institution from AstraZeneca and GSK, advisory board and consulting fees paid to himself from Boheringer Ingelheim, GSK, AstraZeneca, Bial, Medinfar, Payment for lectures from GSK, AstraZeneca and Sanofi Pasteur, support for attending meetings from Mundipharma and Mylan, leadership role for International Primary Care Respiratory Group (IPCRG); A Dickens declares grant funding paid to his institution from NIHR GHR for current manuscript; A Farley declares grant funding paid to her institution from NIHR GHR for the present manuscript, grant funding from NIHR HTA, NIHR EME, MRC and Ethicon (Johnson and Johnson) for other work, membership on DMEC for NIHR funded e-cigarette trial (no honorarium), leadership role for International Primary Care Respiratory Group (IPCRG); R Jordan declares grant funding to her institution from NIHR, membership of Boehringer Ingelheim Primary Care Advisory Board, leadership role for International Primary Care Respiratory Group (IPCRG)—research sub-committee; S Martins declares leadership or fiduciary role in Brazilian Society of Medicine and Family and Community; ABC School of Medicine, GEPRAPS ( respiratory group of study and research in primary care), IPCRG (International Primary Care Respiratory Group); A Sitch declares grant funding to her institution from NIHR GHR for present manuscript, NIHR Birmingham BRC and AstraZeneca; A Turner declares grant funding to her institution from NIHR GHR for present manuscript, grant funding from AstraZeneca and Chiesi for other work, payment of honoraria from GSK and Boehringer, support for attending meetings and/or travel from AstraZeneca and Chiesi; S Williams declares grants from the University of Birmingham paid to her institution; G Fernandes, P Adab, R Adams, C Chi, A Enocson, T Maghlakelidze, M Maglakelidze, A Stamenova, K Stavrikj, R Stelmach, Z Pan, H Pang, and J Zhang have no conflicts to declare.