eResearch
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This community contains a collection of research publications and outputs from the University, and includes:
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Item Sustainable and scalable TNE partnerships in Europe: the case of Queen Margaret University and Metropolitan College(2025-09-12) Makellaraki, Vicky; Flouris, TriantItem Pharmacist Review of Medicines Following Ambulance-Attended Falls—A Multi-Methods Evaluation of a Quality Improvement Initiative(MDPI AG, 2025-10-18) Mulrooney, William; Wilson, Caitlin; Pilbery, Richard; Fisher, Ruth; Whiterod, Sarah; Smith, Heather; Turner, Emily; Edmonds, Heather; Webster, Peter; Prestwich, Graham; Bell, Fiona; McLaren, RebeccaBackground: Falls in older adults are a leading cause of morbidity, particularly when compounded by polypharmacy. There is mixed evidence of the efficacy of medicine reviews, but there is little work exploring this in the ambulance setting. A new referral pathway enabling ambulance staff to connect patients to primary care pharmacists aimed to address this. This study explored staff and patient experiences with the pathway and its potential to improve medication safety after a fall. Methods: A mixed-method service evaluation was conducted to assess the implementation and impact of this pathway. Routine data from an ambulance trust and pharmacist proformas were used to address objectives relating to referral rates, clinical appropriateness, and fall recurrence. Patient and staff stakeholder perspectives were gathered through two cross-sectional surveys designed to explore emotional, behavioral, and practical responses to the intervention. Quantitative data were analyzed descriptively and using ordinal logistic regression where appropriate. Free-text responses were analyzed thematically. Results: Between May 2019 and March 2020, referrals were initiated for 775 older adults after ambulance attendance for a fall, with pharmacists completing medicine reviews on 340 patients. Survey data revealed improvements in patients’ emotional responses to their medicines. Ambulance clinicians identified patient disclosure, stockpiling, and the presence of expired medicines as key indicators of poor medicines management and valued the ability to refer patients. Conclusions: Overall, referral to the pathway demonstrates a marginal improvement in recontact rates in the short-term but does not necessarily represent an improvement in overall patient safety. The cost of such an intervention and patient expectations need further exploration to prove efficacy and patient satisfaction.Item Contextual constraints and dilemmas influencing health providers’ prescription practices in a conflict-affected area: Qualitative insights from Mopti, Mali(Public Library of Science, 2025-10-16) Coulibaly, Issa; Diarra, Yacouba; Ahmed, Mohamed Ali Ag; Ravinetto, Raffaella; Doumbi, Seydou; Kielmann, KarinaArmed conflicts present complex, multidimensional challenges that severely compromise both access to and the quality of healthcare, including the adequate prescription of essential medicines. This study aimed to identify and understand the factors underlying the irrational prescribing of medicine in areas affected by armed conflict in the Mopti region in Mali. An exploratory qualitative study was conducted using a semi-structured interview guide to collect data from 30 participants, including health professionals from three health districts, representatives of the regional health directorate, members of community health associations, and staff from non-governmental organisations (NGOs) working in health sector. Interviews were recorded, transcribed, and subjected to thematic content analysis, using NVIVO 14 (2023 version) to support coding and data retrieval. Study participants reported a range of health system- and patient-related factors contributing to irrational prescribing practices in these conflict-affected areas. Health systems factors included: an imbalance between workload and the availability of qualified staff; limited access to professional training and training resources; poor adherence to prescription guidelines and procedures -often a consequence of contextual constraints; and coercion from armed terrorist groups. Administrative and political challenges were also highlighted, including weak monitoring and supervision mechanisms within the local health system; a lack of oversight by health and regulatory authorities in blockaded areas; the development of an informal pharmaceutical sector to compensate for deficiencies in the formal system; and overprescription of medicines linked to insurance schemes. Patient-related factors included delayed care-seeking linked to regional insecurity and contributing to increased morbidity and worsened health outcomes. Our results show that the multiple contextual factors influencing prescribing of medicines are deeply inter-linked. Efforts to improve the quality of prescribing in conflict zones must recognise that practices often deemed ‘irrational’ are shaped by complex contextual constraints. A coordinated and comprehensive approach involving all health systems stakeholders is required.Item Integrating healthcare financing for refugees into national health systems: findings from a rapid review of the literature(Elsevier, 2025-10-16) Bertone, Maria Paola; Palmer, Natasha; Witter, SophieAs the number of refugees increases and displacement becomes protracted, providing equitable healthcare in sustainable ways is increasingly challenging. The Global Compact for Refugees calls for greater inclusion of refugees in national health systems. However, evidence is limited on the most suitable approaches to achieve integration, including from a health financing perspective. This study reviewed normative and empirical literatures on health financing for refugees, reflecting on existing arrangements, and their level of integration with national health systems. A total of 52 documents were reviewed following a purposeful search of grey and published literature. Data were analysed according to core health financing sub-functions as defined by the WHO, specifically reflecting on pathways and approaches to integration for each. The analysis found that challenges remains in relation to funding for refugee healthcare, and areas of focus concern fair burden-sharing and engagement of development funders. Fund pooling proves to be a potential entry point for integration to reduce fragmentation in health financing through use of existing mechanisms (budgets or social health insurance schemes), despite challenges highlighted in the empirical literature. Fewer documents look at purchasing and benefit packages, and they highlight the importance of tailoring those to the specific needs of refugees. In relation to equity and efficiency, integration is often assumed to lead to improvements, but evidence is limited and issues related to the underlying weaknesses of the national health system might hamper the benefits of integration. Overall, the review findings support the development of hypotheses as to how best support health financing integration processes, and highlight areas for further research.Item Developing person-centred care in hospices through the voice and leadership of nursing: lessons from the United Kingdom(Frontiers Media, 2025-10-15) Haraldsdottir, Erna; McCormack, BrendanIntroduction: Nursing leadership and the voice of nurses are crucial for developing person-centred care in hospices. Concerns have been raised that, as palliative care has evolved from its original vision and become more integrated into the mainstream healthcare system, it has increasingly become medicalised. This paper presents an emancipatory practice development programme aimed at enhancing the visibility and voice of nursing and nurse leadership to improve person-centred care in hospices across the United Kingdom. Methods: The project was a 10-month collaborative education programme for nursing practice leaders in hospices throughout the United Kingdom, running from September 2023 to July 2024. A total of 24 clinical and practice development leaders from eight different hospices participated. The Kirkpatrick model for evaluating learning programmes was adapted to create a framework for assessing the programme's outcomes and impact. The evaluation process utilised Collaborative Critical Creative Inquiry. Results: The key findings from the evaluation indicate that the programme created conditions for the participants to gain transformative insights and understanding that positively impacted their practice through emancipatory practice development. Discussion: The programme enabled leaders of person-centred care in hospices to rekindle their vision for palliative care practice. The participants became more aware of how care was constructed within their organisations and recognised the assumptions that were often taken for granted—assumptions that influenced daily care practices that sometimes leaned towards a traditional medical model. They acquired new skills and knowledge that empowered them to engage more intentionally in making changes to enhance person-centred care. Conclusion and implications for practice: Humanising healthcare is a global agenda, and within hospice care, nurses are at the heart of transforming care to be more person-centred. They are well-positioned to reclaim the core principles of palliative care, as developed by Cicely Saunders, and push back against the medical model that has overshadowed the development and integration of palliative care into current healthcare systems. Nurses are expert practitioners and leaders who hold positions of authority within their organisations. Yet, for many, their change-making potential is not realised. Innovative learning and development programmes are an essential part of humanising healthcare, and emancipatory practice development programmes can unlock nurses' potential to lead this transformation.Item Lived experience must be properly recognised [Letter](BMJ Publishing Group, 2025-10-09) Gautam, Araya; Johnson, SanathItem Are we getting better at identifying and diagnosing neurodivergent girls and women? Insights into sex ratios and age of diagnosis from clinical population data in Scotland(Sage, 2025) Maciver, Donald; Roy, Anusua Singh; Johnston, Lorna; Boilson, Marie; Curnow, Eleanor; Johnstone-Cooke, Victiora; Rutherford, MarionThis study examined differences in referral and diagnosis based on sex recorded at birth (hereafter, ‘sex’), using case notes from 408 individuals diagnosed by 30 multidisciplinary teams across Scotland. Analyses focused on male-to-female ratios and median ages at referral and diagnosis across attention-deficit/hyperactivity disorder, autism and intellectual disability. The lifespan male-to-female ratio across all diagnoses was 1.31, varying by category and age. In autism, the male-to-female ratio was 2.21 for children under 10 years, but there were more females in adolescence (male-to female ratio=0.79) and adulthood (male-to-female ratio=0.94). Across the lifespan, combining all diagnoses, females were referred later (median ages: 14.4 vs 19.7 years; p<0.001) and diagnosed later (median ages: 15.2 vs 20.2 years; p<0.001), indicating a 5-year delay. Among autistic children and adolescents, females were referred later (median age: 7.5 vs 10.5years; p=0.002) and diagnosed later (median age: 9.3 vs 11.9years; p=0.003). However, no significant differences were found in age of referral or diagnosis for autistic adults. Overall, the results indicate partial equalisation of sex ratios across the lifespan, pronounced asymmetry in younger age groups, andconsistent delays in referral and diagnosis ages for females.Item Equality, Diversity, Inclusion (EDI) in Event Management and Event Tourism(Goodfellow Publishers, 2026) Sharp, Briony; Finkel, Rebecca; Fletcher, T.In event tourism, equality involves ensuring that international and domestic visitors alike can access and enjoy events, regardless of language, mobility, or cultural background. Diversity in this context includes the representation of global cultures, while inclusion ensures that all tourists feel welcomed and respected throughout their event experience. In recent years, the concepts of equality, diversity, and inclusion (EDI) have gained significant traction across various sectors, including education, healthcare, business, and the creative industries (see Finkel, Sharp & Sweeney, 2018; Calver et al., 2023; Fletcher, Dashper & Albert 2023; Walters & Higgins-Desbiolles 2024; Liu, Hao & Qiu, 2025). These principles are not only ethical imperatives, but also practical necessities in a globalized and increasingly interconnected world. In the events industry—where people from diverse backgrounds come together for shared experiences—EDI plays a particularly crucial role. Events have the power to shape cultural narratives, foster community, and influence public discourse. As such, the way they are designed, managed, and delivered must reflect a commitment to fairness, representation, and accessibility. Inclusive events can enhance a destination’s reputation as welcoming and progressive, which is increasingly important for socially conscious travellers. Conversely, exclusionary practices can damage a destination’s appeal and lead to reputational risk. For example, Pride festivals, Indigenous cultural events, and diasporic heritage festivals often attract international visitors, and serve as platforms for cultural diplomacy and tourism development. Event tourism professionals must navigate diverse cultural expectations and ensure that events are not only inclusive for attendees, but also respectful of, and beneficial to, host communities. This includes cross-cultural communication, inclusive tourism infrastructure, and ethical engagement with local communities. Despite the benefits and expectations of contemporary audiences, research suggests that EDI remains a marginal concern in mainstream events management literature and practice. A recent audit of leading events management journals found that EDI-related research is often confined to special issues and lacks integration into the core body of knowledge. This raises important questions about how EDI is understood, critiqued, and operationalised within the field (Calver et al., 2023). Also, in event tourism, performative inclusion may manifest in destination marketing that highlights diversity without ensuring inclusive infrastructure or community engagement. Tourism boards may promote multicultural festivals without addressing accessibility or the needs of local communities, raising concerns about authenticity and equity (Swartjes & Berkers, 2021). This entry explores the meaning and usage of EDI, critiques surrounding its implementation, and its relevance to both the academic fields of events, event tourism, and the professional practice of events management. The discussion is structured into four main sections: definitions of EDI, critiques of its usage, how EDI plays out in the context of events and event tourism, and its practical implications for event managers.Item Reset: Designing Community-Based, Resilience-Affirming Support for Older Adults Through Participatory Action Research - An Environmental Perspective(Emerald, 2025) Górska, Sylwia; Desogus, S.; Moffat, P.; Gunn, L.; Irvine Fitzpatrick, L.Purpose: This paper presents key learning from the Reset programme, an innovative, intersectoral collaboration designed to transform community-based health and social care (HSC) for older adults. The programme aimed to deepen understanding of and enhance post-hospitalisation resilience, improve access to existing resources, and strengthen community connections. Methodology: The programme employed a Participatory Action Research methodology to co-produce and implement resilience-focused, evidence-based HSC across four localities in the city of Edinburgh, Scotland. Data was collected through interviews and focus groups with older adults, referring agencies, community partners, informal carers, and the HSC support team. Narrative data was also gathered by HSC support staff through one-to-one key work, while ongoing reflective practice informed continuous learning and adaptation. Findings: The research confirmed a dynamic, reciprocal relationship between older adults and their environment in shaping resilience outcomes. It expanded understanding of how physical, digital, and social environments can enable or hinder resilience, highlighting the impact of systemic cultural factors within HSC, and broader societal structures. Originality/value: This study offers original insights into participatory, intersectoral approaches to supporting ageing in place. It deepens understanding of environmental determinants of resilience in later life and provides evidence-based recommendations for policy, practice, and research. The co-produced, community-centred approach highlights the value of relational support in improving outcomes for older adults.