Background Application of knowledge translation (KT) theories, models, and frameworks (TMFs) is one method for successfully incorporating evidence into clinical care. However, there are multiple KT TMFs and little guidance on which to select. This study sought to identify and describe available full-spectrum KT TMFs to subsequently guide users. Methods A scoping review was completed. Articles were identified through searches within electronic databases, previous reviews, grey literature, and consultation with KT experts. Search terms included combinations of KT terms and theory-related terms. Included citations had to describe full-spectrum KT TMFs that had been applied or tested. Titles/abstracts and full-text articles were screened independently by two investigators. Each KT TMF was described by its characteristics including name, context, key components, how it was used, primary target audience, levels of use, and study outcomes. Each KT TMF was also categorized into theoretical approaches as process models, determinant frameworks, classic theories, implementation theories, and evaluation frameworks. Within each category, KT TMFs were compared and contrasted to identify similarities and unique characteristics. Results Electronic searches yielded 7160 citations. Additional citations were identified from previous reviews (n = 41) and bibliographies of included full-text articles (n = 6). Thirty-six citations describing 36 full-spectrum were identified. In 24 KT TMFs, the primary target audience was multi-level including patients/public, professionals, organizational, and financial/regulatory. The majority of the KT TMFs were used within public health, followed by research (organizational, translation, health), or in multiple contexts. Twenty-six could be used at the individual, organization, or policy levels, five at the individual/organization levels, three at the individual level only, and two at the organizational/policy level. Categorization of the KT TMFs resulted in 18 process models, eight classic theories, three determinant frameworks, three evaluation frameworks, and four that fit more than one category. There were no KT TMFs that fit the implementation theory category. Within each category, similarities and unique characteristics emerged through comparison. Conclusions A systematic compilation of existing full-spectrum KT TMFs, categorization into different approaches, and comparison has been provided in a user-friendly way. This list provides options for users to select from when designing KT projects and interventions. Trial registration A protocol outlining the methodology of this scoping review was developed and registered with PROSPERO (CRD42018088564).
Objective: No universal definition for treatment-resistant depression (TRD) exists. This lack of consensus reduces the generalizability of study findings and limits the ability to study TRD. In addition, anecdotally, there may be a difference between the definitions of TRD within research and those applied in practice. Thus, the objective of this work was to identify current common definitions of TRD used in both research and clinical practice. Method: A systematic review of published literature was conducted to document TRD definitions. Extracted data were grouped based on patient cohort and method of defining TRD. Validation studies were narratively summarized. Interviews with 6 key informants were conducted to understand how definitions are applied in practice. Results: In total, 155 definitions for TRD were identified in the published literature, and 48.4% of all definitions specified requirement of at least 2 treatment failures. Key informant interviews indicated the concept of TRD is rarely employed in clinical practice. Instead, concepts like "complex needs," "struggling with their disease," and "chronic" are used. When asked directly about how they would define TRD, interview participants said an adequate trial of psychotherapy as well as an adequate trial of at least 2 to 3 antidepressant medications. Conclusions: There is no universally accepted definition of TRD, and substantial heterogeneity exists. This study indicates discordance between the use of the term in research and clinical practice, with several key informants emphasizing that the terminology is rarely used in their clinical experience. Development of a shared, common definition across practice and research is required. Abré gé Objectif : Il n'existe aucune définition universelle de la dépression réfractaire au traitement (DRT). Cette absence de consensus réduit la généralisabilité des résultats d'études et limite la capacité d'étudier la DRT. En outre, fait intéressant, il peut y avoir une différence entre les définitions de la DRT utilisées dans la recherche et celles qui sont appliquées à la pratique. Ainsi, l'objectif de ce projet était d'identifier les définitions communes actuelles de la DRT utilisées à la fois en recherche et dans la pratique clinique.
Visual word recognition is a relatively effortless process, but recent research suggests the system involved is malleable, with evidence of increases in behavioural efficiency after prolonged lexical decision task (LDT) performance. However, the extent of neural changes has yet to be characterized in this context. The neural changes that occur could be related to a shift from initially effortful performance that is supported by control-related processing, to efficient task performance that is supported by domain-specific processing. To investigate this, we replicated the British Lexicon Project, and had participants complete 16 h of LDT over several days. We recorded electroencephalography (EEG) at three intervals to track neural change during LDT performance and assessed event-related potentials and brain signal complexity. We found that response times decreased during LDT performance, and there was evidence of neural change through N170, P200, N400, and late positive component (LPC) amplitudes across the EEG sessions, which suggested a shift from control-related to domain-specific processing. We also found widespread complexity decreases alongside localized increases, suggesting that processing became more efficient with specific increases in processing flexibility. Together, these findings suggest that neural processing becomes more efficient and optimized to support prolonged LDT performance.
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