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PubMed2006

Policy characterization of ecosystem management.

This paper provides a comparison of ecosystem management (EM) to the traditional regulatory management approach and outlines the characteristics of EM from a policy perspective, defining the conditions under which this management tool can be successfully implemented. Ecosystem management is a collaborative and integrative tool focused on balancing societal needs, economic growth, and environmental protection to ensure the long-term ecological integrity of a particular ecosystem. The characteristics of this particular tool include: (1) its holistic approach to environmental problems; (2) its integration of values (economic, social, and environmental) through a collaborative, multi-partner, decision making structure; (3) its reliance on science to guide decisions and set boundaries; and (4) its ability to learn from the implementation of decisions (adaptive management). Examples are draw from Environment Canada's various regional ecosystem initiatives.

Canada↗

PubMed2001

Science and technology: new drivers in health care.

During the next year, Healthcare Leadership and Management Report will intensify its coverage of the use of science and technology to improve readiness, and financial and operational performance in hospitals and health systems. We will do this through a series of case studies from organizations that have had success in implementing programs that exploit technology, explaining the nuts and bolts of how the success was achieved. Look for a regular science and technology column beginning in January.--Lee Reeder, editor.

Biomedical Technology↗

PubMed1976

Training the renaissance medical illustrator.

The professional training of the medical illustration student has been a subject of controvery for the last few years. Curricula of the schools accredited by the Association of Medical Illustrators have, to varying degrees, undergone change due to new demands on the practicing illustrator. The curriculum in Biomedical Illustration at The University of Texas Health Science Center at Dallas attempts to balance time-proven courses with contemporary problem-solving approaches to the training of the medical illustrator. This paper reflects the history, philosophy and methods of implementation of the course of study leading to the M.A. degree in Biomedical Communication at the University of Texas Health Science Center at Dallas.

Curriculum↗

PubMed2002

Toward the implementation of metabolomic assessments of human health and nutrition.

Metabolomics is emerging as an exciting post-genomic science with applications that span the scope of biotechnology and medicine. Although metabolomics is still in its infancy, it has already been used to identify the function of genes, describe the effects of toxicological, pharmaceutical, nutritional and environmental interventions, and to build integrated databases of metabolite concentrations across human and research animal populations. Metabolomics provides nutrition with an invaluable tool for determining the distributions of metabolite concentrations in humans, the relationship of these metabolite concentrations to disease, and the extent to which nutrition can modulate metabolite concentrations.

Animals↗

PubMed2002

An online astrobiology course for teachers.

A continuing challenge for scientists is to keep K-12 teachers informed about new scientific developments. Over the past few years, this challenge has increased as new research findings have come from the field of astrobiology. In addition to trying to keep abreast of these new discoveries, K-12 teachers must also face the demands of the content and pedagogical goals imposed by state and national science education standards. Furthermore, many teachers lack the scientific content knowledge or training in current teaching methods to create their own activities or to implement appropriately new teaching materials designed to meet the standards. There is a clear need for special courses designed to increase the scientific knowledge of K-12 science teachers. In response to this need, the authors developed a suite of innovative, classroom-ready lessons for grades 5-12 that emphasize an active engagement instructional strategy and focus on the recent discoveries in the field of astrobiology. They further created a graduate-level, Internet-based distance-learning course for teachers to help them become familiar with these astrobiology concepts and to gain firsthand experience with the National Science Education Standards-based instructional strategies.

Computer-Assisted Instruction↗

PubMed2002

1.4 Research and the dental student.

There has been significant concern that the dental curriculum and system of clinical education, in particular, is not designed to take advantage of the explosion in knowledge in biomedical science and its application to the health of the public. Although there are some examples of innovations in dental education on a global scale that have the capacity to increase the assimilation of basic and clinical knowledge, most of the dental education models are mired in the traditional '2 + 2' approach to education. This can be seen in North America and the European '2 + 3' model or the stomatological '4 + 2' approach. In each of these systems, the basic and behavioural science courses continue to be perceived as hurdles over which students must leap in order to reach the clinical programmes where there is little opportunity to use basic science information to advance patient care and treatment. Examples of issues that are not well represented include: innovations in imaging; diagnosis; bio-materials; science-based approaches to clinical practice; novel approaches to therapeutics; interactions between the oral, dental and craniofacial complex and systemic health and disorders; the role of oral infections and systemic disease; the increasing appreciation of chronic diseases and disorders such as osteoporosis and diabetes that affect oral tissues; the promise of bioengineering, tissue engineering and biomimetics; the potential use of saliva as a diagnostic tool; the understanding of oral complications of cancer treatment; the treatments of HIV/AIDS diseases and hepatitis; the use of dental and dental hygiene staff on health-care teams to deal with issues such as birth defects, orofacial trauma, head and neck cancer, chronic pain management and so on. There seems to be an excessive emphasis on restorative dentistry and, to a lesser extent, on the more biological approaches to diagnosis, prevention and therapeutics. This continued lack of integration of basic and clinical sciences in the curriculum continues to foster a dental workforce that is highly technically competent to provide specific clinical services but poorly equipped to evaluate and implement new biological approaches to diagnosis, therapeutics and intervention. Unfortunately, after many attempts by organized dental symposia aimed at the integration of basic and clinical sciences, there has been little discernible curricular change. It appears that there is an opportunity through this global congress to identify the best practices in the various global curricula that could change this paradigm in dental education and lead us toward the education of a more scientifically orientated practitioner-one who can take advantage of innovations in new and emerging technologies in their application to patient care. It is the challenge of this section to try to ascertain the best method or methods by which dental education promotes research to the dental student and what research represents in terms of critical thinking and evidence-based approaches to dental education and clinical practice.

Competency-Based Education↗

PubMed1980

A model for a health career information center.

A model health career information center was developed and evaluated at a university health science center. One part of the information center is a statewide, toll-free health careers hotline which provides information about health careers to high school and college students, parents, counselors, and teachers, especially in small schools and rural areas, which are not usually included in recruiting circuits. Evaluation of the hotline after one year of operation has indicated that it fills a need, is considered useful by callers, and is of a relatively small cost, considering the geographical coverage. The model information system proposed can be implemented in phases with only slight modifications to meet the unique needs of specific health science centers or their geographical location.

Career Choice↗

PubMed2006

Neuroscience workshops for fifth-grade school children by undergraduate students: a university-school partnership.

The National Science Education Standards recommend that science be taught using inquiry-based approaches. Inspired by the Dana Alliance for Brain Initiatives, we examined whether undergraduate students could learn how to conduct field research by teaching elementary school children basic neuroscience concepts in interactive workshops. In an inquiry-based learning experience of their own, undergraduate psychology students working under the close supervision of their instructor designed and provided free, interactive, hour-long workshops focusing on brain structure and function, brain damage and disorders, perception and illusions, and drugs and hormones to fifth-graders from diverse backgrounds, and we assessed the effectiveness of the workshops using a pretest-post-test design. The results suggest that the workshops enhanced the children's knowledge of neuroscience concepts as measured using pre- and post-open-ended assessments. The undergraduates also found their learning experience engaging and productive. The article includes detailed descriptions of the workshop activities, procedures, the course in which the undergraduates implemented the workshops, and guidance for future university-school collaborations aimed at enhancing science literacy.

Adolescent↗

PubMed2003

An XML message broker framework for exchange and integration of microarray data.

MOTIVATION: Microarrays are an important research tool for the advancement of basic biological sciences. However this technology has yet to be integrated with clinical decision making. We have implemented an information framework based on the Microarray Gene Expression Markup Language (MAGE-ML) specification. We are using this framework to develop a test-bed integrated database application to identify genomic and imaging markers for diagnosis of breast cancer. RESULTS: We developed extensible software architecture for retrieving data from different microarray databases using MAGE-ML and for combining microarray data with breast cancer image analysis and clinical data for correlation studies. The framework we developed will provide the necessary data integration to move microarray research from basic biological sciences to clinical applications. AVAILABILITY: Open source software will be available from SourceForge (http://sourceforge.net/projects/microsoap/).

Database Management Systems↗

PubMed2004

Mobility and maternal position during childbirth in Tanzania: an exploratory study at four government hospitals.

BACKGROUND: Emerging research evidence suggests a potential benefit in being upright in the first stage of labour and a systematic review of trials suggests both benefits and harmful effects associated with being upright in the second stage of labour. Implementing evidence-based obstetric care in African countries with scarce resources is particularly challenging, and requires an understanding of the cumulative nature of science and commitment to applying the most up to date evidence to clinical decisions. In this study, we documented current practice rates, explored the barriers and opportunities to implementing these procedures from the provider perspective, and documented women's preferences and satisfaction with care. METHODS: This was an exploratory study using quantitative and qualitative methods. Practice rates were determined by exit interviews with a consecutive sample of postnatal women. Provider views were explored using semi-structured interviews (with doctors and traditional birth attendants) and focus group discussions (with midwives). The study was conducted at four government hospitals, two in Dar es Salaam and two in the neighbouring Coast region, Tanzania. MAIN OUTCOME MEASURES: Practice rates for mobility during labour and delivery position; women's experiences, preferences and views about the care provided; and provider views of current practice and barriers and opportunities to evidence-based obstetric practice. RESULTS: Across all study sites more women were mobile at home (15.0%) than in the labour ward (2.9%), but movement was quite restricted at home before women were admitted to labour ward (51.6% chose to rest with little movement). Supine position for delivery was used routinely at all four hospitals; this was consistent with women's preferred choice of position, although very few women are aware of other positions. Qualitative findings suggest obstetricians and midwives favoured confining to bed during the first stage of labour, and supine position for delivery. CONCLUSIONS: The barriers to change appear to be complicated and require providers to want to change, and women to be informed of alternative positions during the first stage of labour and delivery. We believe that highlighting the gap between actual practice and current evidence provides a platform for dialogue with providers to evaluate the threats and opportunities for changing practice.

Journal Article↗

PubMedDate not supplied

Burnout and internal medicine resident work-hour restrictions.

BACKGROUND: Burnout is very common in internal medicine residents. Effective July 2003, all residents were restricted to work less than an average of 80 hours per week and no more than 30 hours of continuous duty for patient care and educational obligations. We evaluated rates of burnout in internal medicine residents before and after the implementation of the new work-hour restriction. METHODS: University of Colorado Health Science Center internal medicine residents were surveyed in May 2003 and May 2004. The survey contained the Maslach Burnout Inventory, organized into 3 subscales (ie, emotional exhaustion, depersonalization, and personal accomplishment); the Primary Care Evaluation of Mental Disorders depression screen; and self-reported quality of care and education. RESULTS: The response rate was 87% (121 of 139 residents) and 74% (106 of 143 residents) in 2003 and 2004, respectively. Self-reported hours worked decreased from a mean of 74.6 to 67.1 (P = .003). In 2004, 13% fewer residents experienced high emotional exhaustion (42% vs 29%; P = .03). There was a trend toward fewer residents with high depersonalization (61% vs 55%; P = .13) and fewer residents with a positive depression screen (51% vs 41%; P = .11). Personal accomplishment did not change. The assessment of self-reported quality of care did not significantly change from 2003 to 2004. Residents reported attending fewer educational conferences per month (18.99 vs 15.56; P = .01). Overall residency satisfaction decreased 6 mm on a 100-mm visual analogue score (P = .02). CONCLUSIONS: Burnout continues to be a major problem. Reducing hours may be the first step to reduce burnout but may also affect education and quality of care.

Adult↗

PubMed2001

Improved process control alarm operation.

Alarms are the main connection from the automation to the operator, when addressing process operation outside of its normal function. They are often as much a source of operator overload and consternation as help. Better engineering of the relative role of the operator and automation would materially help overcome the difficulties. Expert systems have been proposed as a solution. But Expert systems are really another form of automation. There remains that aspect of the alarms, which must address our inability to cover and understand a possibly larger domain of the operation not appropriate to traditional controls or present-day automation. Appropriate tools for this domain must support operator discretion and initiative. The paper suggests a set of such general, computer science based, tools requiring only the most basic configuration. They are viewed as implemented on top of those properly detailed alarm displays and interlocks, which reflect the more formal plant operating policies. They include: (a) Various forms of alarm logging and trending; (b) Short, automatically generated, word summaries of alarm activity, which allow low level data to propagate to the highest levels, including: one word and priority summaries; (c) Causal alarm pattern analyses that help the operator to predict or diagnose alarm behavior; (d) Automatic adaptation of alarms and alarm limits to varying process situations; (e) Uniform use of alarm policies to simplify alarm configuration.

Journal Article↗

PubMed2006

Sample size planning for the standardized mean difference: accuracy in parameter estimation via narrow confidence intervals.

Methods for planning sample size (SS) for the standardized mean difference so that a narrow confidence interval (CI) can be obtained via the accuracy in parameter estimation (AIPE) approach are developed. One method plans SS so that the expected width of the CI is sufficiently narrow. A modification adjusts the SS so that the obtained CI is no wider than desired with some specified degree of certainty (e.g., 99% certain the 95% CI will be no wider than omega). The rationale of the AIPE approach to SS planning is given, as is a discussion of the analytic approach to CI formation for the population standardized mean difference. Tables with values of necessary SS are provided. The freely available Methods for the Behavioral, Educational, and Social Sciences (K. Kelley, 2006a) R (R Development Core Team, 2006) software package easily implements the methods discussed.

Confidence Intervals↗

PubMed2001

Evolutionary computation.

Evolution does not require DNA, or even living organisms. In computer science, the field known as 'evolutionary computation' uses evolution as an algorithmic tool, implementing random variation, reproduction and selection by altering and moving data within a computer. This harnesses the power of evolution as an alternative to the more traditional ways to design software or hardware. Research into evolutionary computation should be of interest to geneticists, as evolved programs often reveal properties - such as robustness and non-expressed DNA - that are analogous to many biological phenomena.

Algorithms↗

PubMed1993

The reform of medical education: an outsider's reflections.

After reviewing some of the major structural changes that have altered American medical education over the last 80 years, the author depicts the recent climate that has fostered a number of proposals for educational reform to better prepare physicians for the next century. He lists the five major types of reform that have been suggested (for example, the integration of basic sciences and clinical knowledge) and then reflects on each type, asking questions about implementation such as: Who will accomplish the reform? How will it be carried out? What and where are the financial, knowledge, and other resources that will be needed? What must be overcome to accomplish the reform? He then discusses the forms of instruction that should accompany the proposed reforms in educational content (such as decreasing lectures and increasing small-group discussions). He observes that there is often a serious conflict between the need to provide students some free hours and departments' perceptions of the time needed to educate students properly. He closes with a review of some aspects of reform that have been neglected or minimized, such as the length of time and the costs that medical students must face to complete their education, and the economics of educational innovations.

Curriculum↗

PubMed2006

Transfer of accountability: transforming shift handover to enhance patient safety.

Communication of information between healthcare providers is a fundamental component of patient care. The information shared between providers who are changing shifts, referred to as "handover," helps plan patient care, identifies safety concerns and facilitates continuity of information. Absent or inaccurate information can have deleterious effects on patient care. According to the Joint Commission on Accreditation of Healthcare Organizations (JCAHO 2003), almost 70% of all sentinel events are caused by breakdown in communication. Issues and concerns regarding the effectiveness of handover at shift change were raised by nurses throughout Hamilton Health Sciences (HHS), leading to the approval of a hospital-wide project to implement evidenced-based Transfer of Accountability (TOA) Guidelines and a bedside patient safety checklist. This article describes the development of the guidelines, the results of the pilot study and the ongoing implementation of the project. The observed impact on patient safety within HHS is presented.

Communication↗

PubMed2002

Use of animals in research: a science - society controversy? The European perspective.

The use of animals for research and testing purposes has decreased substantially during the last two decades but is now increasing again, mainly because of the increased use of transgenic animal models. Presently, 10-12 millions of vertebrate animals are used per year within EU Member States. Scientists who are using animals in research are frequently criticised by animal protection groups and blamed that they do not respect the integrity of an animal's life. The European Science Foundation (ESF) is recognising that legislation cannot be the only answer to those worries in society and that it is essential to take a stand and to clearly explain what the Foundation's position with regard to the use of animals is. In a recently published position paper, ESF has discussed its views and has adopted guidelines for the use of animals in research. The document explicitly states that laboratory animals have an intrinsic value, which must be respected. The consequences of recognising the intrinsic value have been elaborated in the position paper and include, among others, strong endorsement of the replacement, reduction, refinement principles. It is stated that, prior to the performance of an animal experiment, the protocol should be subjected to independent expert review including the weighing of the likely benefit versus the likely animal suffering. Also, the development and organisation of accredited courses on laboratory animal science, including information on animal alternatives, welfare and ethics are encouraged. The guidelines, as formulated in the position paper, can be seen as reinforcement of developments that have already been started in several countries, but have not always received full support from the scientific community. With this document, the association of 70 leading national science organisations in Europe has taken a position that, in several aspects, exceeds current European legislative regulations. For bridging the science - society controversy, it is essential to continue this initiative by promoting the implementation of the guidelines at all levels of the scientific community. This requires commitment and scientific leadership.

Animal Testing Alternatives↗

PubMed2002

[Analyzing the drug resistance of Mycobacterium tuberculosis in Russia's experimental areas introducing the WHO tuberculosis control programme].

The authentic data on the drug resistance of Mycobacterium tuberculosis can be obtained only provided that standard laboratory procedures and the unified standardized method for determining the resistance are used along with a compulsory outside quality control over the performance of this test. The supervisory activities of the researchers of the Central Research Institute of Tuberculosis (CRIT), Russian Academy of Medical Sciences, made in some regions of Russia included standardization of methods and their implementation quality control allowed them to reveal and to correct main errors in drug resistance testing. In this connection, this made it to record the true level of M. tuberculosis resistance to essential antituberculous agents in the areas investigated by the researchers of CRIT. Analyzing the data on the drug resistance of M. tuberculosis in the above areas leads to the conclusion that 2000 was marked by rather high rates of primary drug resistance; nearly a fourth of all new and prior cases of pulmonary tuberculosis studied for its drug resistance were carriers of a M. tuberculosis resistant to at least one antituberculous agent.

Bacteriological Techniques↗