Regulation of 26 May 1989 amending the Regulation for implementation of the Decree on stimulation of the birthrate.
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Bulgaria↗
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Results for “implementation science”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Program development in military toxicology laboratories.
Military toxicology evolved from needs identified during the World Wars. The Army, Navy and Air Force developed toxicological capabilities in response to their respective operational needs. These 3 previously separate military toxicology efforts have been integrated into Tri-Service Toxicology in response to the continually changing and growing operational needs of the military. The continual process of program development must be initiated in order for Tri-Service Toxicology to improve, grow and better serve its customers. Program development entails developing and maintaining good customer relationships and cooperative relationships with other governmental agencies, industry and academia. The benefits of identifying and obtaining customers and collaborators will substantially outweigh the costs incurred by committing to the implementation of program development within Tri-Service Toxicology.
Humans↗
Improving outcomes of coronary artery bypass graft infections with multiple interventions: putting science and data to the test.
In 2001, 7.58% of our coronary artery bypass graft (CABG) patients developed surgical-site infection (SSI) as compared with 3.57% in National Nosocomial Infections Surveillance System hospitals from January 1992 to June 2001. Seven new preventive measures were implemented and in 2002, the rate was 3.47%. Implementing evidence-based measures improved patient outcomes.
Anti-Bacterial Agents↗
Impact of technology on the emergence of infectious diseases.
Not all new threats from microorganisms result from changes within the microorganisms themselves. Innovative, progressive changes introduced by humans can provide advantages to microbes which, in turn, threaten the population. In most cases, advantages are provided unwittingly as a by-product of technology, and can be corrected when the problem is recognized. An end to progress is neither a practical nor desirable solution. Alertness (i.e., surveillance) for the emergence of new diseases and to changes in disease patterns will continue to be critical to ensure timely implementation of public health measures.
Communicable Diseases↗
A perspective on non-traditional academic programs in the health sciences.
In the 1970s, non-traditional academic programs began to gain impetus, aided by studies and recommendations by such groups as the Carnegie Commission on Higher Education and the Commission on Non-Traditional study. Schools of public health have taken the lead in implementing non-traditional, off-campus programs which are relevant to personnel in health service agencies. Reported in this monograph are three programs representing alternative approaches to off-campus public health programs. As our data base increases and new programs are reported, we may see rapid growth in non-traditional programs, resulting in significant changes in academic programs preparing public health practitioners.
Curriculum↗
Intellectual property conundrum for the biological sciences.
Policy regarding academically generated biomedical intellectual property (IP) has been shaped by two important events: the Vannevar Bush report to then President Roosevelt in 1945 and the Bayh-Dole Act of 1980. This policy, which vests the intellectual property produced from federally funded biomedical research from the government to the academic institution, was designed to promote technology transfer and thus promote the health of the U.S. economy. However, the policy has led to significant challenges, particularly in implementation. Here it is argued that the difficulties are due to differences in the structure of motivations between biomedical scientists, institutional officials, and private sector entrepreneurs. Understanding these differences may lead to a review of policy with the goal of enhancing technology transfer for the future.
Biological Science Disciplines↗
Antecedents of the people and organizational aspects of medical informatics: review of the literature.
People and organizational issues are critical in both implementing medical informatics systems and in dealing with the altered organizations that new systems often create. The people and organizational issues area--like medical informatics itself--is a blend of many disciplines. The academic disciplines of psychology, sociology, social psychology, social anthropology, organizational behavior and organizational development, management, and cognitive sciences are rich with research with significant potential to ease the introduction and on-going use of information technology in today's complex health systems. These academic areas contribute research data and core information for better understanding of such issues as the importance of and processes for creating future direction; managing a complex change process; effective strategies for involving individuals and groups in the informatics effort; and effectively managing the altered organization. This article reviews the behavioral and business referent disciplines that can potentially contribute to improved implementations and on-going management of change in the medical informatics arena.
Attitude to Computers↗
Steps toward a clinically relevant science of interventions in pediatric settings: introduction to the special issue.
OBJECTIVE: To describe methods and strategies to advance the science of interventions in pediatric psychology. METHODS: We consider the advantages of various strategies to develop and extend the applications of intervention research in pediatric practice settings. RESULTS: Strategies are needed to enhance application of empirically supported interventions to pediatric settings, including testing the generalizability of empirically supported interventions in clinical samples, developing interventions based on clinical experience and tested in controlled clinical trials, designing program evaluations in the context of practice settings, and conducting case studies and series. Critical next steps in intervention research include documenting the clinical significance of interventions, conducting multisite research concerning interventions, including interventions conducted in clinical settings, and implementing integrated clinical intervention and research. Training in empirically supported treatments and intervention research and developing policy related to intervention research would also promote a clinically relevant scientific agenda concerning intervention research with pediatric populations. CONCLUSIONS: Pediatric psychologists have the opportunity to develop a clinically relevant science of interventions in pediatric settings by using multiple methods and strategies.
Adolescent↗
Genethics: project accountability via evaluation of teacher and student growth.
Accountability through demonstrated learning is increasingly being demanded by agencies funding science education projects. For example, the National Science Foundation requires evidence of the educational impact of programs designed to increase the scientific understanding and competencies of teachers and their students. The purpose of this paper is to share our human genetics educational experiences and accountability model with colleagues interested in serving the genetics educational needs of in-service secondary school science teachers and their students. Our accountability model is facilitated through (1) identifying the educational needs of the population of teachers to be served, (2) articulating goals and measurable objectives to meet these needs, and (3) then designing and implementing pretest/posttest questions to measure whether the objectives have been achieved. Comparison of entry and exit levels of performance on a 50-item test showed that teacher-participants learned a statistically significant amount of genetics content in our NSF-funded workshops. Teachers, in turn, administered a 25-item pretest/posttest to their secondary school students, and collective data from 121 classrooms across the United States revealed statistically significant increases in student knowledge of genetics content. Methods describing our attempts to evaluate teachers' use of pedagogical techniques and bioethical decision-making skills are briefly addressed.
Bioethics↗
From clinical trial to prescription.
There are many steps between drug discovery and prescribing for a patient. Each step has problems. In this issue of ARCHIVES, Klein and colleagues propose changes in clinical trials that would result in more meaningful information for the treating physician. Of particular importance is the gap between what a physician needs to know and what is produced in the clinical trials that leads to approval of a new drug by the US Food and Drug Administration (FDA). Their recommendations for improving clinical trials are cogent, but broad-based implementation depends on an organizational structure and political effectiveness not presently in place. Most important, as the authors note, is an effective work group representing industry, regulatory agencies, and academic and federal science, addressing clinical trials issues with public participation. While improved quality and relevance of data from clinical trials will strengthen the scientific foundation of pharmacotherapy, other problems impede the delivery of objective information to the treating physician. Most hotly debated is the role of money in the creation and dissemination of knowledge.
Clinical Trials as Topic↗
'Fairness and reasonableness of the child's decision:' a proposed legal standard for children's participation in medical decision making.
Using as illustration the case of Nikolas E., a six-year-old child with HIV/AIDS, this article considers the competing rights of children, parents, and state in cases involving pediatric medical disputes. The article outlines arguments in favor of and against children's participation in medical decisions and describes legal standards currently used in resolving pediatric medical disputes. The article then proposes adoption of a new legal standard described as the 'fairness and reasonableness of the child's decision,' and articulates advantages and disadvantages of such an approach, as well as the factors that should be considered in implementing the standard. Finally, the article argues for a methodology for including children's wishes in pediatric medical decision making that is based upon Monahan and Walker's model for including social science evidence in legal contexts and evaluates alternative strategies for including children meaningfully in the process of making medical decisions that affect them.
Age Factors↗
A recurrent neural network for solving linear projection equations.
Linear projection equations arise in many optimization problems and have important applications in science and engineering. In this paper, we present a recurrent neural network for solving linear projection equations in real time. The proposed neural network has two layers and is amenable to parallel implementation with simple hardware. In the theoretical aspect, we prove that the proposed neural network can converge globally to the solution set of the problem when the matrix involved in the problem is positive semidefinite and can converge exponentially to a unique solution when the matrix is positive definite. In addition, we analyze the stability of the related dynamic system in detail. As an application, we show that the proposed neural network can be used directly to solve linear and convex quadratic programming problems and linear complementary problems with positive semidefinite matrices. The validity and transient behavior of the neural network are demonstrated by using three numerical examples.
Linear Models↗
A computer-aided drug discovery system for chemistry teaching.
The Schools Malaria Project (http://emalaria.soton.ac.uk/) brings together school students with university researchers in the hunt for a new antimalaria drug. The design challenge being offered to students is to use a distributed drug search and selection system to design potential antimalaria drugs. The system is accessed via a Web interface. This e-science project displays the results of the trials in an accessible manner, giving students an opportunity for discussion and debate both with peers and with the university contacts. The project has been implemented by using distributed computing techniques, spreading computer load over a network of machines that cross institutional boundaries, forming a grid. This provides access to greater computing power and allows a much more complex and detailed formulation of the drug design problem to be tackled for research, teaching, and learning.
Animals↗
Methodology for evaluating physician order entry (POE) implementations.
The body of physician order entry (POE) implementations literature uses statistical evaluation methods to demonstrate changes in specified variables after POE implementation. To understand and manage the holistic impact of POE on the health care institution, a methodology that utilizes feedback to guide the POE implementation towards the satisfaction of stakeholder objectives is presented. Stakeholders jointly define quantitative and qualitative metrics for their objectives, establish target value vectors for the metrics that represent acceptable implementation outcomes and specify evaluation milestones. These are used to compare pre- and post-POE implementation clinical performance, enabling a socio-technical feedback-improvement cycle. A case study is provided to illustrate how the methodology is being used at Sunnybrook and Women's College Health Science Centre in Toronto, Canada.
Drug Prescriptions↗
Background and principles of an African American targeted national anti-drug campaign.
This article provides a review of key African American community values drawn from the literature. Central to this article is how these values can be incorporated into anti-drug messages and materials targeted to African Americans as part of a national five-year campaign being implemented by the White House Office of National Drug Control Policy and the Partnership for a Drug-Free America. The campaign is the first national campaign to base messages on behavioral science research and theories and subsequently uses research about targeted audiences to design prevention messages that are culturally relevant. Specific implications for the format and content of messages directed to African Americans are discussed.
Adolescent↗
Tunable, proteolytic dosage control of CRISPR-Cas systems enables precise gene therapy for dosage sensitive disorders.
The ability to modulate gene expression through modular and universal genetic tools like CRISPR-Cas has greatly advanced gene therapy for therapeutics and basic science. Yet, the inherent stochasticity of delivery methods cause variation in target gene expression at the single-cell level, limiting their applicability in systems that require more precise expression. Thus, we implement a modular incoherent feedforward loop based on proteolytic cleavage of Cas to reduce gene expression variability against the variability of vector delivery. We target a genome-integrated marker and demonstrate dosage control of gene activation and repression, post-delivery tuning, and RNA-based compatibility of the system. To illustrate therapeutic relevance, we target the gene RAI1, the haploinsufficiency and triplosensitivity of which cause two autism-related syndromes. We demonstrate dosage-controlled gene activation for both human and mouse Rai1 via viral delivery to patient-derived cell lines and mouse cortical neurons. Overall, we established a robust dosage control circuit for uniform gene expression, beneficial for basic and translational research.
Journal Article↗
PLANT PATHOLOGY: a discipline at a crossroads.
The Department of Plant Pathology at the University of California at Berkeley was destroyed as a consequence of a contentious reorganization. The circumstances that led to the reorganization provide some insight into the challenges facing the discipline of plant pathology. The underlying basis for plant pathology as a science is to address problems of plant disease. This requires a balance between disciplinary and problem-solving research and a continuum from achieving fundamental advances in knowledge to the development and implementation of problem-solving approaches. Changes in colleges and universities have placed extreme stress on this essential structure. The dilemma that must be addressed is how to reestablish the problem-solving continuum where it has been broken and strengthen it where it has been weakened. Plants are essential for life, and they will always be affected by disease. The understanding and management of these diseases is the responsibility and the challenge of plant pathology today and in the future.
Journal Article↗
Combination of didactic lecture with problem-based learning sessions in physiology teaching in a developing medical college in Nepal.
Physiology teaching as an essential part of medical education faces tremendous criticism regarding curriculum design, methods of implementation, and application of knowledge in clinical practice. In the traditional method of medical education, physiology is taught in the first year and involves little interdisciplinary interaction. The Manipal College of Medical Sciences, Pokhara, Nepal (affiliated with the Kathmandu Univ.) started in 1994 and adopted an integrated curriculum drawn along the lines of the student-centered, problem-based, integrated, community-based, elective-oriented, and systematic (SPICES) medical curriculum. Here, physiology is taught for the first 2 yr of the 4.5-yr Bachelor of Medicine, Bachelor of Surgery course. Methodology adopted is as follows. For a particular topic, objectives are clearly defined and priority content areas are identified. An overview is given in a didactic lecture class to the entire batch of 100 students. Tutorial classes are conducted thereafter with smaller groups of students (25/batch) divided further into five subgroups of five students each. In these sessions, a problem is presented to the students as a focus for learning or as an example of what has just been taught. Each problem was accompanied with relevant questions to streamline the students' thought processes. A tutor is present throughout the session not as an instructor but as a facilitator of the learning process. A questionnaire sought students' opinion on the usefulness of this approach, relevance of the combination of problem-based learning (PBL) sessions and didactic lectures in understanding a particular topic and relating clinical conditions to basic mechanisms, and improvement of performance on the university final examination. The majority of the students opined that the combination of didactic lectures and PBL sessions was definitely beneficial regarding all the above-mentioned aspects of learning. The university results corroborated their opinion. Thus it may be considered that a judicious mixture of didactic lectures and PBL sessions is beneficial as a teaching module of physiology in medical schools.
Clinical Competence↗