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At least 613 records · Page 34Linked to original sources
PubMed2006

An operational model for implementing conservation action.

The preoccupation of many conservation planners with the refinement of systematic assessment techniques has manifested an "implementation crisis" in conservation planning. This preoccupation has provided systematic assessments with well-tested tools (e.g., area selection algorithms) and principles (e.g., representation, complementarity), but our understanding of these techniques currently far exceeds our ability to apply them effectively to pragmatic conservation problems. The science is informative about where one needs to do conservation, but silent on how to achieve it. Operational models, defined as simplified conceptualizations of processes for implementing conservation action at priority conservation areas, are essential for guiding conservation planning initiatives because they assist understanding of how these processes function. Operational models developed to date have largely been linear, simplistic, and focused on the systematic assessment of biological entities. Experience in the real world indicates that operational models for conducting conservation planning initiatives should explicitly complement a systematic conservation assessment with activities that empower individuals and institutions (enabling) and explicitly aim to secure conservation action (implementation). Specifically, implementing effective conservation action requires that systematic assessments be integrated functionally with a process for developing an implementation strategy and processes for stakeholder collaboration while maintaining a broad focus on the implementation of conservation action. A suite of hallmarks define effective operational models (e.g., stakeholder collaboration, links with land-use planning, social learning, and action research). Greater development and testing of the practical application of operational models should lead to higher levels of effective implementation and alleviate the implementation crisis. Social learning institutions are essential for ensuring ongoing improvement in the development and application of operational models that deliver effective conservation action.

Algorithms↗
PubMed1993

Drug utilization review in ambulatory settings: state of the science and directions for outcomes research.

There are escalating national pressures to analyze pharmaceutical outcomes and to develop drug-related clinical guidelines. These interests coincide with passage of the Medicaid Rebate Law (OBRA, 1990), which mandates the implementation of prospective and retrospective drug utilization review (DUR) programs by Medicaid in 1993. This report investigates DUR programs that target outpatient drug therapies. The authors present a conceptual framework that identifies the factors influencing drug prescribing and the range of potential patient outcomes. Current types of DUR interventions and their applications are described, in addition to problems that hinder implementation or evaluation of DUR programs. DUR evaluation studies are reviewed, and a critique identifies the limitations of available DUR research. The authors recommend an expanded DUR policy research agenda, strongly suggesting that priority be given to studies in the following areas: DUR criteria development and validation; prevalence of prescribing problems and their association with patient outcomes; efficacy, toxicity and costs of therapeutic alternatives; and DUR program evaluation. The overall conclusion is that the state of the science pertaining to DUR is not well developed. The potential of DUR may not be realized due to the lack of resources needed to design, implement, and evaluate effective programs. Instead, DUR efforts may be limited to cost-containment issues without due consideration of quality-of-care outcomes. The authors call for rigorous evaluation efforts to inform DUR design and implementation, thereby assuring more rational prescribing and enhancing patient outcomes.

Ambulatory Care Facilities↗
PubMed1980

Automated information retrieval in science and technology.

The rapid advances in computer and communication technology in the 1970's have enabled large interactive scientific and technical information retrieval systems to be implemented. Major search services today offer on-line access to millions of bibliographic citations and an increasing number of "electronic handbooks." In addition, development of knowledge bases is well under way. Despite the impressive speed and flexibility of interactive retrieval systems, their impact has been lessened by limited awareness of their existence, uneven quality of retrieval, inadequate linkages among data bases, and reliance on specially trained intermediaries.

Computers↗
PubMed2006

Application of knowledge-driven spatial modelling approaches and uncertainty management to a study of Rift Valley fever in Africa.

BACKGROUND: There are few studies that have investigated uncertainties surrounding the scientific community's knowledge of the geographical distribution of major animal diseases. This is particularly relevant to Rift Valley fever (RVF), a zoonotic disease causing destructive outbreaks in livestock and man, as the geographical range of the disease is widening to involve previously unaffected regions. In the current study we investigate the application of methods developed in the decision sciences: multiple criteria decision making using weighted linear combination and ordered weighted averages, and Dempster-Shafer theory, implemented within the geographical information system IDRISI, to obtain a greater understanding of uncertainty related to the geographical distribution of RVF. The focus is on presenting alternate methods where extensive field data are not available and traditional, model-based approaches to disease mapping are impossible to conduct. RESULTS: Using a compensatory multiple criteria decision making model based on weighted linear combination, most of sub-Saharan Africa was suitable for endemic circulation of RVF. In contrast, areas where rivers and lakes traversed semi-arid regions, such as those bordering the Sahara, were highly suitable for RVF epidemics and wet, tropical areas of central Africa had low suitability. Using a moderately non-compensatory model based on ordered weighted averages, the areas considered suitable for endemic and epidemic RVF were more restricted. Varying the relative weights of the different factors in the models did not affect suitability estimates to a large degree, but variations in model structure had a large impact on our suitability estimates. Our Dempster-Shafer analysis supported the belief that a range of semi-arid areas were suitable for RVF epidemics and the plausibility that many other areas of the continent were suitable. Areas where high levels of uncertainty were highlighted included the Ethiopian Highlands, southwest Kenya and parts of West Africa. CONCLUSION: We have demonstrated the potential of methods developed in the decision sciences to improve our understanding of uncertainties surrounding the geographical distribution of animal diseases, particularly where information is sparse, and encourage wider application of the decision science methodology in the field of animal health.

Africa South of the Sahara↗
PubMed1977

Developing behavioral science for a family practice residency.

The development of behavioral science in a family practice residency has first to be structured around a statement of purpose and adequate goals. These goals can only be implemented when the purely custodial function of the medical profession is rejected and the ethical responsiblity of the physician to society is allowed to direct the role innovations that must be incorporated. It is the person of the physician as a diagnostic and therapeutic tool that must be cultivated. The curriculum presented has included behavioral science conferences, a one-month behavioral science rotation, a two-month orientation program, behavioral science clinical attendings, and a personal counseling program for each resident throughout the three years of training. To be complete, such a program requires the further refinement of behavioral objectives that allow reliable evaluation and redefinition by residents and faculty.

Behavioral Sciences↗
PubMed1997

[The problem of reforms in the European medicine between 16th and 19th century in the light of selected concepts of methodology of the history of science].

The article depicts major concepts present in the contemporary historiography of medicine (positivistic and social-cultural trends) and some of the concepts of modern methodology of the history of science, reviewing the possibilities of its use in the analysis of the process of modernizing the European medicine that was implemented between the 16th and the 19th century. The author advocates the social-cultural trend that dominates the contemporary historiography of medicine. She discusses and analyzes the concepts developed by Ludwik Fleck, Samuel Kuhn, Imre Lakatos, Kurt Godl, Stefan Amsterdamski in respect of their sue to a historian of modern medicine.

Europe↗
PubMed2006

Neonatal SEP - back to bedside with basic science.

Scalp-recorded somatosensory evoked potentials (SEPs) have been successfully used in neonatal assessment for several decades. The current routine SEP paradigm is markedly predictive for future cerebral palsy (CP) or other neurocognitive sequelae in brain-injured babies. Recent advances in basic science have dramatically increased our knowledge about structural-functional development of SEP-related brain mechanisms. It has thereby become apparent that preterm SEP differs from that in more mature counterparts in that it also comprises responses from transient brain structures, and hence being unique to the preterm period. It is now obvious also that several aspects in the current SEP paradigm, ranging from the type of stimulation to the methods of recording and analysis, are suboptimal for preterm babies. Recent progress in recording and analysis techniques have made it possible to combine SEP studies with EEG recordings, as well as to implement advanced analyses (e.g. time-frequency analysis) into routine practice. This review summarizes literature from relevant areas in basic science, and proposes a novel, integrated approach in neonatal SEP studies in order to significantly increase the fidelity of testing somatosensory system.

Cerebral Palsy↗
PubMed2004

Current status of programmes to measure and reduce radon exposure in Irish workplaces.

National legislation, which implements European Council Directive 96/29/EURATOM in Ireland, sets a reference level of 400 Bq m(-3) averaged over any 3 month period for radon exposure in the workplace and also empowers the Radiological Protection Institute of Ireland to direct employers to have radon measurements carried out. This legislation came into effect in May 2000. Radon measurements have already been completed in show caves and other underground workplaces. Between 1998 and 2001, over 33 800 individual radon measurements were carried out in all ground floor offices and classrooms in 3444 schools nationwide as part of a programme undertaken jointly with the Department of Education and Science. Where the average indoor radon concentration in one or more rooms exceeded 200 Bq m(-3), remedial measures were implemented. For concentrations up to 400 Bq m(-3) this involved increased ventilation while for higher concentrations an active sump was normally installed. The results of the survey, as well as the effectiveness of the different remedial strategies, are discussed. In the case of other above ground workplaces, different approaches have been adopted. As a first step, workplaces in two known high radon areas were directed to have radon measurements carried out. This programme had limited success because of problems in obtaining accurate workplace databases and a general lack of awareness on the part of employers of the issues involved. From a sample of 2610 employers directed to measure radon, only 408 actually completed measurements and 37 workplaces were identified as having average 3 month average radon concentrations above 400 Bq m(-3). A total of 1356 employers ignored all correspondence, some of which was sent by registered post and signed for on receipt. Current initiatives are focused on the provision of information and include newspaper advertising as well as publications aimed specifically at both employer and employee representative groups. The ability to provide accurate information that encourages both measurement and remediation is seen as central to an effective radon workplace programme.

Environmental Exposure↗
PubMed2006

Design and implementation of a library-based information service in molecular biology and genetics at the University of Pittsburgh.

SETTING: In summer 2002, the Health Sciences Library System (HSLS) at the University of Pittsburgh initiated an information service in molecular biology and genetics to assist researchers with identifying and utilizing bioinformatics tools. PROGRAM COMPONENTS: This novel information service comprises hands-on training workshops and consultation on the use of bioinformatics tools. The HSLS also provides an electronic portal and networked access to public and commercial molecular biology databases and software packages. EVALUATION MECHANISMS: Researcher feedback gathered during the first three years of workshops and individual consultation indicate that the information service is meeting user needs. NEXT STEPS/FUTURE DIRECTIONS: The service's workshop offerings will expand to include emerging bioinformatics topics. A frequently asked questions database is also being developed to reuse advice on complex bioinformatics questions.

Computational Biology↗
PubMed1994

Capacity building for health social science: the International Clinical Epidemiology Network (INCLEN) social science program and the International Forum for Social Science in Health (IFSSH).

This paper describes the unfolding of two complementary efforts to build global capacity in health social science. The INCLEN model aims to infuse a genuine transdisciplinary perspective into international health through equipping social scientists to speak a common language with clinical epidemiologists and sensitising clinicians to the ways social sciences contribute to research and policy. Issues are raised pertinent to the model's viability, including recruitment of scholars for fellowships, curriculum substance, and mechanisms for integrating social science fellows when they return home. The future success of the INCLEN program, and comparable donor initiatives, depends upon a wider infrastructure of career supports played out at the international level in which donor and operating agencies nourish the emergence of an expanded body of health social scientists. The International Forum for Social Sciences in Health (IFSSH) has been formed to help build this infrastructure and provide impetus for a viable scientific community of health social scientists. The IFSSH 'global agenda' is portrayed and an illustration is given of how this agenda is being implemented in the Asia and Pacific region.

Career Choice↗
PubMed2000

Development and implementation of a decision support system for carotid artery stenosis: the Carotid Ultrasound Report Enhancement (CURE).

The management of carotid artery stenosis is an art evolving into a science, increasingly informed by clinical trials of medical management versus carotid endarterectomy (CEA). Ideas about optimal management depend on the confluence of patient-specific variables, surgical expertise, and the state of medical knowledge. In this complex and progressing setting, an up-to-date decision support system could help physicians apply the latest evidence to patient care. Carotid ultrasonography (US) studies provide an excellent opportunity to aid in the therapy of carotid stenosis. We developed a Carotid US Report Enhancement (CURE) to augment carotid US reports with treatment-specific prognostic information and patient-specific portions of the American Heart Association's 1998 guideline for the management of carotid artery stenosis. In the process of designing and implementing the CURE software, we encountered and eventually solved a variety of problems. The first problem was that US test was not always precise enough to distinguish between a moderate and mild carotid stenosis. Likewise, the standard US reports did not elucidate several technical problems that decreased the reliability of the US result. Third, although 17 of 18 physicians agreed to receive the CURE reports, they requested non-incriminating wording. Fourth, vascular surgeons supervising the US laboratories were reluctant to support the CURE report if they thought it would be construed as prompting self-referral. Finally, information about some comorbid conditions (e.g. a history of atrial fibrillation) could not be obtained reliably from the patients. The result of responding to these problems is a decision support program that is increasingly robust, able to detect many of its own limitations, and capable of integrating data from multiple sources. A randomized controlled trial now in progress will evaluate the clinical impact of the CURE program.

Algorithms↗
PubMedDate not supplied

Developments on the implementation of the Three Rs in research and education.

More than 40 years ago, Russell and Burch published their views on the implementation of the 'Three Rs' in animal experimentation. Since then, much has been achieved in this area. Recently, the European Science Foundation (ESF) has made a further step forward. In a position paper on the use of animals, ESF has formulated what it sees as prerequisites for the humane use of animals in research, testing and education. In this paper, we briefly report on these ESF guidelines. Also, an overview is presented on European legislative regulations for the (ethical) review of research protocols and for the education and training of persons involved in animal experiments. The great diversity between countries is illustrated with some examples and the need for harmonization is emphasised. The paper ends by highlighting the special role that editorial boards of journals can play in the further implementation of the Three Rs.

Animal Testing Alternatives↗
PubMedDate not supplied

Positron emission tomography imaging of small animals in anticancer drug development.

Positron emission tomography (PET) imaging of small animals enables researchers to bridge the gap between in vitro science and in vivo human studies. The imaging paradigm can be established and refined in animals before implementation in humans and image data related to ex vivo assays of biological activity. Small animal PET (saPET) imaging enables assessment of baseline focal pathophysiology, pharmacokinetics, biological target modulation and the efficacy of novel drugs. The potential and challenge of this technology as applied to anticancer drug development is discussed here.

Animals↗
PubMed2006

Concepts for developing a collaborative in silico model of the acute inflammatory response using agent-based modeling.

The complexity of the acute inflammatory response (AIR) is, by now, generally recognized. The primary manifestation of this property has been the difficulty in translating the information derived from reductionist, basic science research into effective clinical treatment regimens for sepsis. However, the recognition of the "complexity" of the AIR is not without its pitfalls. Despite its limitations, reductionism remains the primary means of obtaining scientific information. Furthermore, a functional shortcoming of use of the term complex has been to make it equivalent to "essentially unsolvable." Therefore, a mechanism is needed to integrate the apparatus of reductionist analysis into a complex synthetic methodology that overcomes the current limitations of both. Toward this end, I propose a structure for a class of collaborative, community-wide in silico models that use the framework of agent-based modeling. Agent-based modeling is a type of mathematical modeling that focuses on the behaviors of the components of complex systems and is well suited for translating the results of basic science experiments. I will also introduce a preliminary version of a syntactical "grammar" that can potentially be used to facilitate the transfer of basic science data into computer code. It is hoped that when a mature version of this framework is implemented, the resulting models will provide a functional, synthetic data base on the AIR that could be used for directing research, testing hypotheses, teaching and training, and drug discovery/testing.

Acute Disease↗
PubMed1996

Screening for prostate cancer is neither appropriate nor cost-effective.

Seen from a societal perspective, the health gains that might result from prostate screening are too uncertain to justify the substantial associated costs and adverse health effects. Clinicians who rely on observational screening studies to justify current screening practices should be aware of the potential biases that render conclusions suspect. Medical history documents numerous cases of medical interventions that appeared reasonable at the time, but ultimately proved worthless and even harmful. Before embarking on an ambitious screening program for prostate cancer, clinicians should demand that five basic criteria are satisfied: (1) that prostate cancer is a significant health burden, (2) that screening can identify localized disease, (3) that tests used in screening programs have acceptable performance among the population being tested, (4) that the potential for cure is greater among patients with screen-detected disease, and (5) that screen-detected patients have improved health outcomes compared with those who are not screened. Randomized trials provide the best methodology for determining the efficacy of screening and treatment. Clinicians are often too quick to credit medical intervention for successful outcomes and blame tumor biology for disease progression. Furthermore, when faced with a decision of administering or withholding therapy, physicians generally wish to err on the side of having done everything possible. Data modeling can provide critical insights concerning these issues using currently available information. Three recently published models suggest that the overall benefit to a population of men screened for prostate cancer can be measured in days of additional time of life gained, not months or years. Furthermore, models suggest that a substantial number of men need to undergo treatment in order to avert a single cancer death. The costs of implementing a screening program are enormous and deflect resources away from alternative uses, such as increased basic science funding to identify a cure for this disease. Therefore, based on the evidence presented, I believe that without more substantial data supporting the efficacy of screening programs, screening for prostate cancer is neither appropriate nor cost-effective.

Cost-Benefit Analysis↗
PubMed1997

Associative List Memory.

This paper introduces an Associative List Memory (ALM) that has high recall fidelity with low memory and low processing requirements. This permits a simple implementation in software on a personal computer or space instrument microprocessor. Associative List Memory has a performance comparable with Sparse Distributed Memory (SDM) but differs from SDM in that convergence occurs during learning, rather than on recall, and in that the memory is in the form of a dynamic list rather than static randomly distributed locations. Associative List Memory is suitable for unsupervised finding of classes of phenomena in large databases. In particular, all of the class exemplars deduced can be easily accessed at any time to provide a summary of current database knowledge, being essentially the contents of the list. Examples are given where patterns of 1000 bits length with > 30% noise can be learned unsupervised to deduce the original pattern's noise free. A second pass through the data in recall mode can be used to assign to each input the appropriate original pattern, effectively removing all noise from the input data. At large input bit sizes the recall fidelity approaches closely to the maximum possible value. Associative List Memory compares well in recall fidelity with SDM and other associative memories. Its processing times on a personal computer are found to be practical for database applications. Implemented within a space instrument processor, ALM would greatly reduce downlink data transmission rates. Copyright 1997 Elsevier Science Ltd.

Journal Article↗
PubMed1978

Behavioral scientists as clinical educators of primary care practitioners.

Behavioral scientists on the faculty of the Johns Hopkins University Health Associate Program work in teams with medical preceptors in the clinical education and supervision of students during their first year of training. The rationale, objectives, and methods of implementation for this aspect of the program are discussed. This approach answers current concerns that relevant behavioral science content must be integrated into clinical training, and it appears to be useful at all levels of medical education.

Allied Health Personnel↗