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The authors propose a blockchain platform for managing clinical trial data to enhance data validity, integrity, trust and transparency in the pharmaceutical research process. The authors also provide an extensive review of how blockchain technology supports the business processes of clinical trials.

A systematic literature review was conducted to identify the existing applications of blockchain in pharmaceutical process management. A conceptual design for a blockchain infrastructure to address clinical trial challenges is developed by outlining the entire clinical trial value chain and identifying the coordination and communication among its stakeholders. A stakeholder analysis is conducted to ensure that the clinical trial processes satisfy the requirements and preferences of each stakeholder.

The proposed blockchain platform offers a promising solution for enhancing integrity, trust and transparency in the clinical trial process. Additionally, blockchain can help streamline communication and collaboration between stakeholders by enabling multiple parties to access and share data in real time, lowering the possibility of delays or errors in data analysis and reporting.

The proposed blockchain platform can benefit patients by empowering them to have better-controlled access to their data and by allowing researchers to maintain adherence to reporting requirements. Additionally, the platform can benefit granting agencies, researchers and decision-makers by ensuring the integrity of clinical trial data and streamlining communication and collaboration between stakeholders.

This study builds on existing blockchain applications in pharmaceutical process management by developing a blockchain framework that can address clinical trial concerns from an integrated perspective.

The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.

This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.

The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.

The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.

The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.

The current national patient safety strategy for the National Health Service (NHS) in England states that actions need to be taken to support the development of a patient safety culture. This includes that local systems should seek to understand staff perceptions of the fairness and effectiveness of serious incident management. This study aims to explore the perspectives of patient safety professionals about what works well and what could be done better to support a patient safety culture at the level of Trust strategy and serious incident governance.

A total of 15 professionals with a role in serious incident management, from five mental health trusts in England, were interviewed using a semi-structured interview guide. Thematic analysis and qualitative description were used to analyse the data.

Participants felt that actions to support a patient safety culture were challenging and required long-term and clinical commitment. Broadening the scope of serious incident investigations was felt to be one way to better understand patient safety culture issues. Organisational influences during the serious incident management process were highlighted, informing approaches to maximise the fairness and objectivity of investigation findings.

The findings of this study offer original insights that the NHS safety system can use to facilitate progression of the patient safety culture agenda. In particular, local mental health trusts could consider the findings in the context of their current strategic objectives related to patient safety culture and operational delivery of serious incident management frameworks.

This paper aims to examine the barriers and facilitators of conducting and implementing research in frontline child and youth mental health settings in the UK.

Researchers, clinicians and commissioners who attended a workshop at the Big Emerging Minds Summit in October 2022 provided their expert views on the structural barriers and possible solutions to integrating research in clinical practice based on their experiences of child and young people mental health research.

The identified barriers encompass resource constraints, administrative burdens and misalignment of research priorities, necessitating concerted efforts to foster a research-supportive culture. This paper proposes the potential actionable solutions aimed at overcoming challenges, which are likely applicable across various other health-care systems and frontline NHS services. Solutions include ways to bridge the gap between research and practice, changing perceptions of research, inclusive engagement and collaboration, streamlining ethics processes, empowering observational research and tailored communication strategies. Case examples are outlined to substantiate the themes presented and highlight successful research initiatives within NHS Trusts.

This paper provides an insight into the views of stakeholders in child and youth mental health. The themes will hopefully support and influence clinicians and academics to come together to improve the integration of research into clinical practice with the hope of improving service provision and outcomes for our children and young people.

The effect of vicarious learning during clinical or medical internships on graduates' adaptive career behaviours has attracted scant attention from healthcare researchers, particularly, in the developing world context. Drawing upon the social cognitive career theory model of career self-management (SCCT-CSM), the current study examines how vicarious learning influences the clinical graduates' adaptive career behaviours (i.e. career exploration and decision-making) via career exploration and decision-making self-efficacy (CEDSE) and career intention.

Data were collected from 293 nursing graduates undertaking clinical internships in 25 hospitals across Nigeria who willingly participated in this study as they were also assured of confidentiality at two-waves. The proposed hypotheses were tested using a path analysis.

The findings showed that vicarious learning during clinical internship had a direct effect on career exploration, decision-making and career decision self-efficacy among graduate trainees. Also, the findings revealed that the effects of vicarious learning on the graduates' career exploration and career decision-making were significantly mediated by career decision self-efficacy and career intentions.

The findings of this study have important practical implications for higher education institutions and industries that send and receive clinical graduates for clinical internships to gain more skills. More emphasis should be on encouraging learners to learn vicariously in addition to other forms of learning experiences available during clinical internships.

The study explains that the graduates' higher engagement in clinical career exploration and decision-making was based on a higher level of vicarious learning during internships. The results suggest that higher education institutions and healthcare service providers can derive greater benefits from more emphasis on promoting vicarious learning during clinical internships.

The emergence of the COVID-19 pandemic changed the way in which education was delivered in early 2020, and the impacts of these changes continue to be questionable. The aims of this study were to evaluate: (1) the results obtained by students of the Dentistry course in the progress test carried out both before and after the pandemic, (2) the results obtained by a specific group of students who took the test in 2019–2022, and compare their results and (3) subjects that showed a reduction in the percentage of correct answers when the two tests were compared.

The progress test consisting of 100 multiple choice questions was applied before and after the pandemic to all students in the Dentistry course. The analyses were performed using the IBM SPSS for Statistics v.26 software program. The level of significance of 5% was adopted (<0.05).

The test was applied to 320 students in 2019 and to 272 in 2022, of whom the sample of this study was composed. The mean score values in 2019 (M = 49.10; SD = 12.03) were significantly (p = 0.026) higher than those in the year 2022 (M = 46.97; SD = 12.15), with the disciplines in the area of specific knowledge showing a greater drop in the percentage of correct answers by students. This study showed that the emergency remote education had a negative effect on the academic performance of students, based on the progress testing as an evaluation method.

Many studies that assessed the impacts of the pandemic on teaching were focused on the opinions of students. However, the great advantage of our study was the use of a theoretical assessment tool to verify student performance. The post-pandemic landscape beckons for comprehensive inquiries into these domains. This type of research would be valuable for gathering evidence relative to the performance of students after the emergency remote education.

Borderline personality disorder (BPD) is a debilitating illness characterised by a pervasive pattern of emotional instability, interpersonal difficulties and impulsive behaviour in association with repeated self-injury and chronic suicidal ideation. People diagnosed with BPD also have high rates of co-occurring psychopathology, including disorders associated with disturbed impulse control, such as substance use disorder (SUD) and disordered eating behaviours. The co-occurrence of BPD and impulse control disorders contributes to the severity and complexity of clinical presentations and negatively impacts the course of treatment and recovery. This study qualitatively documents aspects of the lived experience and recovery journeys of people diagnosed with BPD and co-occurring SUD and/or disordered eating. This study aims to identify similarities with respect to themes reported at different stages of the recovery process, as well as highlight important factors that may hinder and/or foster recovery.

In-person, in-depth, semi-structured interviews were conducted with 12 specialist service consumers within a clinical setting. Ten women and two men (22–58 years; mean: 35.5 years) were recruited. Interview transcripts were analysed using thematic analysis principles.

As expected, participants with co-occurring disorders experienced severe forms of psychopathology. The lived experience descriptions aligned with the proposition that people with BPD engage in impulsive behaviours as a response to extreme emotional states. Key emergent themes and sub-themes relating to recovery comprised three domains: factors hindering adaptive change; factors assisting adaptive change and factors that constitute change. An inability to regulate negative affect appears to be an important underlying mechanism that links the three disorders.

This study highlights the potential shortcomings in the traditional approach of treating co-occurring disorders of BPD, SUD and eating disorders as separate diagnoses. The current findings strongly support the adoption of an integrative approach to treating complex mental health issues while concurrently emphasising social connection, support and general health and lifestyle changes.

The findings of this study contribute to the burgeoning BPD recovery literature. A feature of the current study was its use of in-depth face-to-face interviews, which provided rich, many layered, detailed and nuanced data, which is a major goal of qualitative research (Fusch and Ness, 2015). Furthermore, the interviews were conducted within a safe clinical setting with engagement facilitated by a clinically trained professional. There was also a genuine willingness among participants to share their stories in the belief that doing so would inform effective future clinical practice. Their willingness and engagement as participants may reflect their progress along the path to recovery in comparison to others with similar diagnoses. Finally, most of the interviewees were engaging in dialectical behavioural therapy (DBT)-style therapies; two were receiving mentalisation-based therapy treatment, and most had previously engaged in cognitive behavioural therapy or acceptance and commitment therapy-based approaches. The predominance of DBT-style therapy may have influenced the ways that themes were articulated. Future studies could supplement this area of research by interviewing participants receiving therapeutic interventions other than DBT for the treatment of BPD and heightened impulsivity.

The COVID-19 pandemic has had a significant impact on medical education and training, with many medical schools and training programs having to adapt to remote or online learning, social distancing measures and other challenges. This paper aimed to examine the disruption for clinical training, as it has reduced the opportunities for students and trainees to gain hands-on experience and interact with patients in person.

The ethnographic qualitative research design was chosen as the research methodology. Using Gibbs' reflective cycle, the researcher explored the psychiatry clerks' (final-year medical students) reflections on the disruption of their clinical training during the COVID-19 pandemic.

The findings demonstrated that the students had a significant psychological impact on their coping capacities as the crisis progressed from shock and depression to resilience. The students being the key stakeholders provided a concrete foundation for the development of a framework for improving practices during uncertain times.

Students' reflections provided valuable insight into the pandemic’s impact on their psychosocial lives with uncertainty and incapacity to cope up with changing stressful dynamics. The results will assist in planning how to best support medical students' well-being during interruptions of their educational process brought about by similar future crises.

This paper aims to critically compare the impact and preparedness for practice of two types of mental health nurse training in the UK. One being a hospital-based apprenticeship model from the 1980s; the other a university-based and more academically focussed approach from this millennium.

This autoethnographic reflective commentary describes and reviews the effectiveness of two training curricula for Registered Mental Nurse (RMN) training. The first being the certificate-level 1983 syllabus of the UK Central Council for Nursing, Midwifery and Health Visiting, which was replaced in the late 1990s by diploma and degree-level Project 2000 training of the General Nursing Council. Using a reflective narrative approach to describe the lived experience of two qualified nurses, it compares, reviews and critiques both initiatives.

The author/researchers found both benefits and negatives inherent in each model. These were grouped into five key headings, which are a sense of belonging/identity; exposure to clinical practice; differences in training modality; development of clinical management skills and clinical preparedness; and academic merit. The older curriculum lacked an academic or research base, whereas the more recent approach encouraged and enhanced this element. However, with regard to preparing the clinician/registered nurse to feel confident in addressing a range of clinical and managerial challenges, the older style training seems to deliver better outcomes. They conclude that a move towards a “middle ground” between the two models may be of benefit to future RMN preparation.

This study reports on the experience of two registered nurses. Therefore, the sample size is small. However, autoethnography is acknowledged as an effective means of delivering qualitative research; in addition, the authors access and use material from the wider literature to triangulate and critique their approach. This paper adds to the literature but also allows for duplication by others to further test the findings.

This type of study provides an opportunity for others to review, compare and contrast nursing or other multi-discipline changes in training/curriculum. The research method is one that is transferable and can be used within areas of practice, which have resource limitations. It provides an opportunity to replicate it in other services or jurisdictions.

Nursing in the UK has experienced significant change over the past four decades. For RMNs, the move from hospitals into the community has been transformational. In addition, the influence of higher academic standards and the influence of the recent pandemic have challenged the profession and individuals within it. This study demonstrates positive and negative elements of the dilemma faced by nurses and offers a further contribution to this area.

There are a number of academic papers, media stories, statutory reports and guidance that explore the impact of changes within nurse training. This paper uses a first person autoethnographic study of the impact and effectiveness of these changes at a human level, the nurse on the ground. It uses the ward medicine keys as the vehicle to represent the huge responsibility that newly qualified nurses must face; this is not widely represented elsewhere in the literature!

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.