4D printing of biocompatible, hierarchically porous shape memory polymeric structures.

Conventional implants tend to have significant limitations, as they are one-size-fits-all, require monitoring, and have the potential for immune rejection. However, 4D Printing presents a method to manufacture highly personalized, shape-changing, minimally invasive biomedical implants. Shape memory polymers (SMPs) with a glass transition temperature (Tg) between room and body temperature (20-38 °C) are particularly desirable for this purpose, as they can be deformed to a temporary shape before implantation, then undergo a shape change within the body. Commonly used SMPs possess either an undesirable Tg or lack the biocompatibility or mechanical properties necessary to match soft biological tissues. In this work, Poly(glycerol dodecanoate) acrylate (PGDA) with engineered pores is introduced to solve these issues. Pores are induced by porogen leaching, where microparticles are mixed with the printing ink and then are dissolved in water after 3D printing, creating a hierarchically porous texture to improve biological activity. With this method, highly complex shapes were printed, including overhanging structures, tilted structures, and a "3DBenchy". The porous SMP has a Tg of 35.6 °C and a Young's Modulus between 0.31 and 1.22 MPa, comparable to soft tissues. A one-way shape memory effect (SME) with shape fixity and recovery ratios exceeding 98 % was also demonstrated. Cultured cells had a survival rate exceeding 90 %, demonstrating cytocompatibility. This novel method creates hierarchically porous shape memory scaffolds with an optimal Tg for reducing the invasiveness of implantation and allows for precise control over elastic modulus, porosity, structure, and transition temperature.

The voices of lived experience: reflections from citizen team members in a long-term care research program.

BACKGROUND: The Translating Research in Elder Care (TREC) program is a partnered health services research team that aims to improve the quality of care and quality of life for residents and quality of worklife for staff in nursing homes. The TREC team undertook several activities to enhance the collaboration between the academic researchers and us, the citizen members. Known as VOICES (Voice Of (potential) Incoming residents, Caregivers Educating uS) we aim to share our experience working with a large research team. METHODS: We reflect on the findings reported in the paper by Chamberlain et al. (2021). They described the findings from two surveys (May 2018, July 2019) that were completed by TREC team members (researchers, trainees, staff, decision-makers, citizens). The survey questions asked about the respondents' experience with citizen engagement, their perceptions of the benefits and challenges of citizen engagement, and their unmet needs for training. RESULTS: The paper reported on the survey findings from all the survey respondents (research team, decision-makers, citizens), but much of the results focused on the researcher perspective. They reported that respondents believed that citizen engagement was a benefit to their research but noted many challenges. While we appreciate the researchers' positive perceptions of citizen engagement, much work remains to fully integrate us into all stages of the research. We offer our reflections and suggestions for how to work with citizen members and identify areas for more training and support. CONCLUSIONS: Despite the increased interest in citizen engagement, we feel there is a lack of understanding and support to truly integrate non-academic team members on research teams. We hope the discussion in this commentary identifies specific areas that need to be addressed to support the continued engagement of citizens and show how the lived experience can bring value to research teams.

Engaging people with lived experience on research teams is becoming more of an expectation for researchers. Published research on this type of engaged research often focuses on the researcher experience with partnered research and neglects the citizen perspective. We are the citizen members of the Translating Research in Elder Care (TREC) program of research, a research program focused on older adults living in nursing homes. Known as VOICES (Voice Of (potential) Incoming residents, Caregivers Educating uS) we aim to share our experiences of working within a large research team. In this commentary we reflect on the pitfalls and opportunities for citizen engagement and reflect on findings from a recent paper published by the research team on the experience of citizen engagement over time.

Evolving partnerships: engagement methods in an established health services research team.

BACKGROUND: The Translating Research in Elder Care (TREC) program is a partnered health services research team that aims to improve the quality of care and quality of life for residents and quality of worklife for staff in nursing homes. This team includes academic researchers, trainees, research staff, citizens (persons living with dementia and family/friend caregivers of persons living in nursing homes), and decision-makers (ministries of health, health authorities, operators of nursing homes). The TREC team has experience working with health system partners but wanted to undertake activities to enhance the collaboration between the academic researchers and citizen members. The aim of this paper is to describe the TREC team members' experiences and perceptions of citizen engagement and identify necessary supports to promote meaningful engagement in health research teams. METHODS: We administered two online surveys (May 2018, July 2019) to all TREC team members (researchers, trainees, staff, decision-makers, citizens). The surveys included closed and open-ended questions guided by regional and international measures of engagement and related to respondents' experience with citizen engagement, their perceptions of the benefits and challenges of citizen engagement, and their needs for training and other tools to support engagement. We analyzed the closed-ended responses using descriptive statistics. RESULTS: We had a 78% response rate (68/87) to the baseline survey, and 27% response rate (21/77) to the follow-up survey. At baseline, 30 (44%) of respondents reported they were currently engaged in a research project with citizen partners compared to 11(52%) in the follow-up survey. Nearly half (10(48%)) of the respondents in the follow-up reported an increase in citizen engagement over the previous year. Respondents identified many benefits to citizen engagement (unique perspectives, assistance with dissemination) and challenges (the need for specific communication skills, meeting organizing and facilitation, and financial/budget support), with little change between the two time points. Respondents reported that the amount of citizen engagement in their research (or related projects) had increased or stayed the same. CONCLUSIONS: Despite increasing recognition of the benefits of including persons with lived experience and large-scale promotion efforts, the research team still lack sufficient training and resources to engage non-academic partners. Our research identified specific areas that could be addressed to improve the engagement of citizens in health research.

Engaging non-academic research partners is becoming an expectation for Canadian health research teams. Research specifically on citizen (patient) engagement has identified benefits and challenges of partnered research; however, most research has only examined one time point. Less is known about how the perception of engagement may change with exposure to engagement in research activities. Translating Research in Elder Care (TREC) is a research program that aims to improve the quality of care and quality of life for residents, and quality of work life of staff in nursing homes. The team includes academic researchers, citizens (the term preferred by our members to reflect persons with dementia, family/friend caregivers of individuals living in nursing homes), decision-maker stakeholders (e.g., ministries of health, operators of nursing homes), trainees (Masters, PhD, postdoctoral fellows), and staff. The TREC team initiated several activities to deepen the partnerships with our citizen members. This paper describes the teams' perceptions of engagement and the benefits and challenges of citizen engagement in an established health research team. We invited the TREC team to complete an online survey (May 2018) before undertaking engagement activities (e.g., training, priority setting) and after 15 months of activities (July 2019). We asked respondents questions about their experience with citizen engagement, their perceptions of the potential research activities citizens could be engaged in, and the benefits and challenges of citizen engagement. Research team respondents reported an increase in citizen engagement in their research but that needs for support persisted. We identify specific areas where research teams need more training and support to ensure that engaged research is possible and sustainable.