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Lessons learned from Mir--a payload perspective.

Among the principal objectives of the Phase 1 NASA/Mir program were for the United States to gain experience working with an international partner, to gain working experience in long-duration space flight, and to gain working experience in planning for and executing research on a long-duration space platform. The Phase 1 program was to provide the US early experience prior to the construction and operation of the International Space Station (Phase 2 and 3). While it can be argued that Mir and ISS are different platforms and that programmatically Phase 1 and ISS are organized differently, it is also clear that many aspects of operating a long-duration research program are platform independent. This can be demonstrated by a review of lessons learned from Skylab, a US space station program of the mid-1970s, many of which were again "learned" on Mir and are being "learned" on ISS. Among these are optimum crew training strategies, on-orbit crew operations, ground support, medical operations and crew psychological support, and safety certification processes.

Aerospace Medicine↗

Families as full research partners: what's in it for us?

This article describes a children's managed mental health care program that incorporates both a family participation service model and a family-initiated evaluation model. The authors begin by tracing the evolution of the family support and the participatory research movements leading to current developments in children's mental health services research. In the King County Blended Funding Project, three service systems pool funds that are spent flexibly by child and family teams. Family advocates have led efforts to design and implement the project evaluation. During this process, many tensions have arisen between meeting the demands of both scientific rigor and multiple community stakeholders. Examples are given of the issues raised by family advocates and research scientists as together they established a theory of change, identified meaningful outcomes, selected measurement tools, and implemented the evaluation protocol. Guidelines are given for how services research partnerships can be successfully built to better address community needs. This article was selected as a distinguished research paper based on a presentation by the authors at the 1998 11th annual research conference titled "A system of Care for Children's Mental Health: Expanding the Research Base." This conference is sponsored annually by the Research and Training Center for Children's Mental Health, Department of Child and Family Studies, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa.

Child↗

Antiviral and immunomodulating inhibitors of experimentally-induced Punta Toro virus infections.

A major component of a US Army Medical Research and Development Command-supported program to discover and develop new drugs for the treatment of Rift Valley fever, sandfly fever, and Crimean-Congo hemorrhagic fever has been to study candidate test materials against hepatotropic infections of C57BL/6 mice induced by the related but less biohazardous Punta Toro virus (PTV). The effects of 75 compounds, some of which were considered immunomodulators in their primary mechanism of activity, were studied in the PTV infection model. Of these, ribavirin, ribamidine, ribavirin 2',3',5'-triacetate, tiazofurin, tiazofurin-5'-monophosphate, tiazofurin-2',3',5'-triacetate, selenazofurin, pyrazofurin, 3-deazaguanine, and 3-deazaguanosine were considered significantly inhibitory, acting against the infection by a direct antiviral (non-immunomodulatory) fashion. These compounds had therapeutic indices (TI) ranging from > or = 5 to 65, using increased survivors as the evaluation parameter. Immunomodulators considered significantly inhibitory to this infection were poly (ICLC), ampligen, human recombinant interferon-alpha-A/D, MVE-1, MVE-2, AM-3, AM-5, mannozym, bropirimine, CL246,738, phenyleneamine, and 7-thia-8-oxoguanosine. Utilizing increased survivor numbers as measure of activity, these inhibitors had TI ranging from > or = 16 to 1000. Other antiviral effects exerted by the active compounds included reduction of hepatic icterus, lowered serum glutamic oxaloacetic and pyruvic acid transaminases, and inhibition of recoverable serum and liver virus titers. The active immunomodulators were significantly effective when therapy was initiated as late as 48 h after virus inoculation, at a time when clinical signs of the PTV disease were being manifested in the animal.

Adjuvants, Immunologic↗

Modeling the growth kinetics of Bacillus cereus as a function of temperature, pH, sodium lactate and sodium chloride concentrations.

Mathematical models describing the growth kinetic parameters (lag phase duration and growth rate) of Bacillus cereus as a function of temperature, pH, sodium lactate and sodium chloride concentrations were obtained in this study. In order to get a residual distribution closer to a normal distribution, the natural logarithm of the growth kinetic parameters were used in modeling. For reasons of parsimony, the polynomial models were reduced to contain only the coefficients significant at a level of p<or=0.05. Using the reduced polynomial models (R2 of 95.2% and 93.9% for ln LAG and ln GR models, respectively), three-dimensional graphs were drawn illustrating the effects of the independent variables on the growth parameters. Predicted data were compared with the predictions from Pathogen Modeling Program (PMP-US Department of Agriculture-Agricultural Research Service) and validated against data extracted from the literature. The mean absolute relative error (MARE) and the median relative error (MRE) of the predicted generation times with the derived model were 25.6% and -16.7%, respectively, showing that the growth rate model accurately and safely predicted the growth kinetics of B. cereus. Results of the modeling study indicated that all of the studied factors had a significant effect on the growth of B. cereus in the experimental range studied.

Bacillus cereus↗

Integrating developmentally supportive caregiving into practice through education.

Implementation of developmental caregiving is occurring in intensive care nurseries across the country. Sound theories of adult learning, program planning, and change principles must be utilized to guide this process and to provide a framework for program design. If leaders and change agents are aware of these concepts and use them to make the process easier, integration should be less painful and the concepts promptly instituted into routine practices. Neonatal Individualized Developmental Care and Assessment Program research has demonstrated positive outcomes. This research has provided us with a vision to guide our practice, but change theory and education of staff also need to be addressed in this process.

Education, Nursing, Continuing↗

BNL accelerator-based radiobiology facilities.

For the past several years, the Alternating Gradient Synchrotron (AGS) at Brookhaven National Laboratory (USA) has provided ions of iron, silicon and gold, at energies from 600 MeV/nucleon to 10 GeV/nucleon, for the US National Aeronautics and Space Administration (NASA) radiobiology research program. NASA has recently funded the construction of a new dedicated ion facility, the Booster Applications Facility (BAF). The Booster synchrotron will supply ion beams ranging from protons to gold, in an energy range from 40-3000 MeV/nucleon with maximum beam intensities of 10(10) to 10(11) ions per pulse. The BAF Project will be described and the future AGS and BAF operation plans will be presented.

Animals↗

In vivo performance of a matrix-based quantitative ultrasound imaging device dedicated to calcaneus investigation.

We developed a prototype of an ultrasound (US) bone matrix densitometer, the BEAM scanner, in the context of a European Space Agency research program. This device, which is a contact imaging device, was designed to overcome the limitations of immersion devices in space. Broadband US attenuation (BUA) and speed of sound (SOS) parameters were calculated from the radiofrequency (RF) signal. The principle aim of this study was to evaluate in vivo performance in direct comparison with a currently available device (UBIS 3000, DMS, France). The short-term precision of the BEAM scanner for BUA was estimated at 2.8%, whereas it was 2.3% with UBIS 3000. The short-term precision for SOS was 0.3%, and this was the same as the coefficient of variation (CV) of the UBIS 3000. CVs of 3.4% and 0.6% for midterm precision were found for BUA and SOS, respectively, and UBIS 3000 scores were 3% and 0.4%, respectively. This preliminary study demonstrates the high performance of the BEAM scanner and its new concept offers a wide range of improvements and new applications.

Adult↗

Should we establish a North American school of global health sciences?

Since 1997, an unprecedented amount of American philanthropy from both private and federal sources has been directed toward research and control programs for the major tropical infectious diseases of developing countries. The US and Canadian capacity to respond to these new initiatives might prove inadequate, however, as tropical disease research and training infrastructures have deteriorated at most North American academic health centers over the last three decades. Training opportunities in clinical tropical medicine, parasitology laboratory diagnostics, vector control, and public health practice are especially depleted and portend a lost generation of experts in these areas. In addition, unlike some of the European schools of tropical medicine, no North American medical or public health school currently boasts a comprehensive faculty in the global health sciences, with expertise that spans laboratory investigation, clinical and translational research, health policy, and international development. To meet the challenge presented by the new philanthropy targeting the global diseases of poverty, a North American school of global health sciences should be established. The North American school, possibly in association with one of the existing schools of medicine or public health, would provide interdisciplinary training to produce a new generation of global health scientists.

Canada↗

Survey of the impact of National Institutes of Health clinical research curriculum awards (K30) between 1999 and 2004.

BACKGROUND: This report summarizes a survey conducted in 2004 by the Association of Clinical Research Training Program Directors' Evaluation Committee. The purpose of this survey was to determine the early capacity of the 59 National Institutes of Health (NIH) K30 programs (funded between 1999 and 2004) to produce clinical investigators trained in core skills required in clinical research. METHODS: In July 2004, a 37-item Web-based survey was distributed to institutions funded by the NIH K30 award mechanism. Frequencies and proportions were computed for each categorical response, and means were calculated for nominal responses using SPSS, version 11.5 (SPSS, Chicago, IL). Items 7 (funding year) and 8 (recruitment year) were cross-tabulated to ascertain the tempo at which programs were able to establish their enrolment processes. RESULTS: Forty-five of the 59 programs funded by the K30 award (76%) responded to this survey. The average number of active trainees in each program is 32. Women constitute 53% of active trainees, and 22% of them are underrepresented minorities. Ninety-six percent of active trainees have medical degrees. The average number of graduates over the 5-year funding period is 18. Of the graduates, 50% are women and 17% are underrepresented minorities. Fifty-six percent of them earned certificates, 44% earned master of science degrees, and 13% earned other degrees. Sixty-one percent of K30 program graduates have some extramural funding to support their research. The average number of publications per trainee for all trainees (active and graduate) is 2.3. CONCLUSION: The K30 program has been a catalyst at multiple US institutions for improving the pedagogy for clinical research training. It has successfully fulfilled the mandate set forth by the 1998 NIH Director's Panel on Clinical Research (Nathan Report).

Biomedical Research↗

United States Department of Agriculture-Agricultural Research Service research on managing insect resistance to insecticides.

Insecticide resistance has developed within many classes of pesticide, and over 500 species of insects and mites are resistant to one or more insecticides. Insecticide resistance and the consequent losses of food and fiber caused by failure to control insect and mite pests causes economic losses of several billion dollars worldwide each year. It is the goal of insect resistance management (IRM) to preserve useful pesticides by slowing, preventing or reversing development of resistance in pests. Important aspects of this goal are understanding the development of resistance and monitoring to determine ways to prevent its development. We describe programs specific to missions of the US Department of Agriculture, Agricultural Research Service, which are designed to characterize insecticide resistance in insects and mites with the goal of managing pests in an ecologically acceptable manner. Resistance management of cotton, potatoes, vegetables, melons, ornamentals, greenhouse crops, corn, stored grains, livestock, honeybees and mites, as well as management of transgenic crops are evaluated. We conclude that IRM is a vital part of stewardship of any pest management product and must be a combined effort of manufacturers, growers, consultants, extension services and grower organizations, working closely with regulators, to achieve logistically and economically feasible systems that prolong the effectiveness of all pest-control products.

Agriculture↗

Implementing planetary protection requirements for sample return missions.

NASA is committed to exploring space while avoiding the biological contamination of other solar system bodies and protecting the Earth against potential harm from materials returned from space. NASA's planetary protection program evaluates missions (with external advice from the US National Research Council and others) and imposes particular constraints on individual missions to achieve these objectives. In 1997 the National Research Council's Space Studies Board published the report, Mars Sample Return: Issues and Recommendations, which reported advice to NASA on Mars sample return missions, complementing their 1992 report, The Biological Contamination of Mars Issues and Recommendations. Meanwhile, NASA has requested a new Space Studies Board study to address sample returns from bodies other than Mars. This study recognizes the variety of worlds that have been opened up to NASA and its partners by small, relatively inexpensive, missions of the Discovery class, as well as the reshaping of our ideas about life in the solar system that have been occasioned by the Galileo spacecraft's discovery that an ocean under the ice on Jupiter's moon Europa might, indeed, exist. This paper will report on NASA's planned implementation of planetary protection provisions based on these recent National Research Council recommendations, and will suggest measures for incorporation in the planetary protection policy of COSPAR.

Containment of Biohazards↗

[Image fusion of different tomographic methods (PET/CT/MRI) effectively contribute to therapy planning].

Image fusion (and image registration) is a fundamental topic of three-dimensional (3D) medical image processing. The need to register different imaging modalities arises for several reasons: some anatomical details, especially soft tissues, are more easily seen in MRI than CT images, but the bony structures are better visualised by CT. The visualisation of any morphological volume with a functional data set which may come from SPECT or PET is a very important method both for research purposes and for routine diagnostics. Our developed programs allowing us to solve image fusion tasks also contained some free available softwares. These packages helped us to start additional software development for more advanced applications having elaborated this way the informatical background of multimodality image processing. This paper presents three oncological applications of the image fusion: PET-CT-MRI registration for 3D radiotherapy planning, PET-MRI registration in planning surgery and metastasis localization. All these registration processes were solved by the landmark-matching registration method.

Decision Making↗

Family practice residents aren't getting enough training in reproductive health care.

Most doctors who graduate from family practice programs in the US receive little or no clinical training in reproductive health care, according to a study published in the September/October issue of Family Planning Perspectives. Researchers report that the majority of respondents to a 1995 survey of program directors and chief residents at 244 family medicine residency programs in the US reported they had no clinical experience in cervical cap fitting, diaphragm fitting, or IUD insertion and removal. What's more, only 15% of chief residents had gained clinical experience providing first-trimester abortions before graduating, despite the fact that 29% of programs included the training as either optional or routine. Only 5% of residents surveyed answered "yes" when asked whether they would "certainly" or "probably" provide abortions in their future practices. 65% responded that they "certainly would not" provide abortions. The study also found that residents who attended a program in which abortion training was offered were more likely to have a favorable attitude toward abortion training and services.

Abortion, Induced↗

Overview of areawide programs and the program for suppression of codling moth in the western USA directed by the United States Department of Agriculture--Agricultural Research Service.

An areawide suppression program for codling moth (Cydia pomonella L) populations was initiated in 1995 in Washington, Oregon and California under the direction of the US Department of Agriculture, Agricultural Research Service in cooperation with Washington State University, Oregon State University and University of California, Berkeley. Mating disruption was used to reduce the pest population while reducing and eliminating the use of organophosphate insecticides. During the 5-year program, the original 1064 hectares were expanded to 8400 hectares and from 66 grower participants to more than 400 participants. The acreage under mating disruption in the three states increased from 6000 hectares in 1994 to 54000 hectares in the year 2000.

Agriculture↗

International student enrollment in US dental hygiene schools.

PURPOSE: The purpose of this study was to determine the international student enrollment in US dental hygiene programs, identify methods used to recruit and retain international students, and describe accommodations used for them. METHOD: A 27-item, closed-ended questionnaire was mailed to all dental hygiene program directors (n = 216) in the US. Data were analyzed using descriptive statistics. RESULTS: Responses were received from 154 dental hygiene program directors for a response rate of 71%. Of the 154 returned questionnaires, 70 (45%) dental hygiene program directors indicated that international students were enrolled in their programs, totalling 4% of the total student population, with female students outnumbering males. The highest international student population came from Canada (42%) followed by Asia (32%), Europe (10%), Central America (9%), South America (3%), and Africa and the Caribbean (2%). Six percent of dental hygiene programs actively recruited international students, 3% had an articulation agreement with institutions outside the US, and 96% did not offer special orientation for incoming international students. CONCLUSION: Research showed a need for professional oral health services in other countries. US dental hygiene programs do not actively recruit nor retain international students. The benefits of US dental hygiene programs actively recruiting and retaining international students would be: 1) international students would be equipped to provide comprehensive, preventive oral health services upon returning to their native country 2) international students would foster a better understanding of cultural diversity, which could transfer to social and professional settings among students in US dental hygiene programs.

Dental Hygienists↗

Evolution of infection control in Egypt: achievements and challenges.

BACKGROUND: The high prevalence of hepatitis C virus (HCV) infection in Egypt highlighted the urgent need for implementing infection control (IC) programs in Egypt. OBJECTIVES: The Ministry of Health and Population (MOHP), in collaboration with the US Naval Medical Research Unit No. 3, and the World Health Organization (WHO), developed a national plan to initiate an IC program with the objectives of improving quality of care and reducing transmission of hospital-acquired infections. METHODS: The strategic plan for this program included setting up an organizational structure, developing IC national guidelines, training health care workers, promoting occupational safety, and establishing a system for monitoring and evaluation. Implementation of the program started in late 2001. RESULTS: The achievements to date include developing a national organizational structure, IC guidelines, and a comprehensive IC training program. To date, a total of 72 hospitals in 13 governorates have been enrolled in the program, and 235 IC professionals have been trained. CONCLUSIONS: Many challenges were faced, including administrative, financial, and motivational difficulties. Future plans include expansion of the program to cover all 27 governorates of Egypt and establishment of a surveillance system for hospital-acquired infections. The process of developing the IC program in Egypt may serve as a model for other resource-limited countries that seek to initiate similar programs.

Cross Infection↗

A maximum likelihood procedure for the analysis of group and individual data in aphasia research.

The limitations inherent in group versus case studies appear to lie in a complementary distribution, underscoring the importance of combining both strategies within a single research program. However, this compromise approach requires analytic tools that permit us to combine and evaluate individual and group data in a common format. Maximum likelihood estimation (MLE) belongs to a family of procedures for determining goodness of fit. MLE can be used in conjunction with a linear or nonlinear model of the way that sources of information combine to determine a given behavioral outcome; such models can be used to estimate the distance between two groups, the degree to which an individual case deviates from a given empirically or theoretically defined group profile, and the degree to which one individual case resembles another. We offer a demonstration of how MLE can be used to evaluate group and individual profiles, in a cross-linguistic study of sentence comprehension in nonfluent aphasic speakers of English, Italian, and German. This includes a demonstration in which the MLE models for each language are "lesioned" to simulate several competing accounts of receptive agrammatism.

Aphasia↗

Governing stem cell research in California and the USA: towards a social infrastructure.

Owing to the restrictive human embryonic stem cell (hESC) policies of the US government, the question of whether to pursue human embryonic stem cell experiments has dominated the ethical and political discourse concerning such research. Explicit attention must now turn to problems of implementing the research on a large scale: in the 2004 US elections, California voters approved a state initiative for stem cell research, earmarking $3 billion in direct spending over 10 years. This article explores three ethical and political problem areas emerging out of the California program, the resolution of which will help set the trajectory of hESC research in the US and abroad, and then proposes an institutional approach to help address them: a network of public stem cell banks in the US that feature transparent and shared governance.

California↗