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Research Network (research + network)
Kinds of Research Network Selected AbstractsTrajectories of smoking among freshmen college students with prior smoking history and risk for future smoking: data from the University Project Tobacco Etiology Research Network (UpTERN) studyADDICTION, Issue 9 2008Craig R. Colder ABSTRACT Aims Little is known about smoking during the transition to college. The current study examined trajectories of smoking among college freshmen, how trajectories predicted later smoking and the social context of smoking. Design Weekly assessments of daily smoking were collected via the web during the first year of college for a large cohort with a previous history of smoking. Participants and setting A total of 193 college freshmen from a large public university with a previous history of smoking who smoked frequently enough to be included in trajectory analysis. Measurements Measures included weekly reports of daily smoking, family smoking, perceived peer attitudes and smoking, social norms and social smoking environment. Findings Seven trajectories were identified: one of low-level sporadic smoking, one of low-level smoking with a small increase during the year, two classes with a substantial decrease during the year, two classes with relatively small decreases and one class with a substantial increase in smoking. Trajectories of smoking in the freshman year predicted levels of sophomore year smoking, and some social context variables tended to change as smoking increased or decreased for a given trajectory class. Conclusions The transition into college is marked by changes in smoking, with smoking escalating for some students and continuing into the sophomore year. Shifts in social context that support smoking were associated with trajectories of smoking. Despite the focus of developmental models on smoking in early adolescence, the transition into college warrants further investigation as a dynamic period for smoking. [source] The skin as a mirror of the ageing process in the human organism , results of the ageing research in the German National Genome Research Network 2EXPERIMENTAL DERMATOLOGY, Issue 8 2006CH. C. Zouboulis Intrinsic human skin ageing is influenced by the individual genetic predisposition and reflects degradation processes of the body. Hormones are decisively involved in intrinsic ageing with reduced secretion of pituitary, adrenal glands, and gonads, which leads to characteristic body and skin phenotypes. A number of advances were recently made in understanding skin ageing mechanisms and major molecular changes, especiallly of the extracellular matrix, were identified. Gene expression patterns compatible with mitotic misregulation and alterations in intracellular transport and metabolism were identified in fibroblasts of ageing humans and humans with progeria. Age-associated changes of extracellular matrix of the skin correlate well with changes been detected in the extracellular matrix of other organs of the human body. Within the National Genome Research Network 2 (NGFN-2) in Germany, the explorative project ,Genetic etiology of human longevity' targets the identification of age-related molecular pathways. For this purpose, skin models of ageing are used. Expression profiling employing cDNA microarrays from known and novel genes and RT-PCR are employed for gene detection and confirmation. Among the potential candidate genes several interesting target genes have been identified. The evaluation of ageing-associated genes in skin models will facilitate the understanding of global molecular ageing mechanisms in the future. [source] The influence of economic incentives and regulatory factors on the adoption of treatment technologies: a case study of technologies used to treat heart attacksHEALTH ECONOMICS, Issue 10 2009Mickael Bech Abstract The Technological Change in Health Care Research Network collected unique patient-level data on three procedures for treatment of heart attack patients (catheterization, coronary artery bypass grafts and percutaneous transluminal coronary angioplasty) for 17 countries over a 15-year period to examine the impact of economic and institutional factors on technology adoption. Specific institutional factors are shown to be important to the uptake of these technologies. Health-care systems characterized as public contract systems and reimbursement systems have higher adoption rates than public-integrated health-care systems. Central control of funding of investments is negatively associated with adoption rates and the impact is of the same magnitude as the overall health-care system classification. GDP per capita also has a strong role in initial adoption. The impact of income and institutional characteristics on the utilization rates of the three procedures diminishes over time. Copyright © 2008 John Wiley & Sons, Ltd. [source] Neurodevelopmental impairment: Predictors of its impact on the families of extremely low birth weight infants at 18 months,INFANT MENTAL HEALTH JOURNAL, Issue 6 2008Bonnie E. Stephens Effects on a family of a child with chronic illness have been described. The Impact on Family Scale (IOF) was developed to measure these effects. The impact of extremely low birth weight (ELBW) infants with neurodevelopmental impairment on families is unknown. This study determined IOF scores for families of ELBW infants with increasing degree of impairment at 18 months and identified factors that increase vulnerability to impact. A total of 3,849 ELBW infant survivors born at the 16 centers of the National Institute of Child Health and Human Development Neonatal Research Network between January 1993 and February 2001 were assessed at 18 to 22 months. Infants were divided into four groups by degree of impairment. IOF scores were analyzed by impairment group. Multivariate analyses assessed effects of impairment, social/demographic factors, unmet service needs, and resource utilization on the IOF. A total of 1,624 (42.2%) infants had moderate/severe impairment. Increasing severity of impairment was associated with higher IOF scores. Severity of impairment contributed 6% of variance to the IOF scores. Twenty-one percent of variance was contributed by additional medical needs, low socioeconomic status (SES), and lack of social support. Although increasing severity of impairment impacts families of ELBW infants, significantly more impact is contributed by additional medical needs, low SES, and lack of social support. [source] Language Attrition Research NetworkINTERNATIONAL JOURNAL OF APPLIED LINGUISTICS, Issue 1 2008Monika S. Schmid No abstract is available for this article. [source] Language and Migration Research NetworkINTERNATIONAL JOURNAL OF APPLIED LINGUISTICS, Issue 1 2008Mike Baynham No abstract is available for this article. [source] The Critical Care Research Network: a partnership in community-based research and research transferJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2000.FRCPC, MSc(Epid), Sean P. Keenan MD The objectives of this study were to present a short history of the Critical Care Research Network (CCR-Net), describe its approach to health services research and to summarize completed and current research projects. In doing this, we explored the question is this research network accomplishing its goals? We reviewed the medical literature to identify studies on similar types of Networks and also the evidence supporting the methodology used by CCR-Net to conduct research using MEDLINE, HEALTHSTAR, CINAHL and the keywords network and health care or healthcare, benchmarking and health care or healthcare, and research transfer or research utilization. We also reviewed the bibliographies of retrieved articles and our personal files. In addition, we summarized the results of studies conducted by CCR-Net and outlined those currently in progress. A review of the literature identified studies on two similar networks that appeared to be succeeding. In addition, the literature was also supportive of the general process used by CCR-Net, although the level of evidence varied. Finally, the studies conducted to date within CCR-Net follow the suggested methodology. At the time of this preliminary communication CCR-Net appears to have adopted a valid approach to health services research within the area of Critical Care Medicine. Further direct evidence is required and appropriate studies are planned. [source] A New Diagnosis Grouping System for Child Emergency Department VisitsACADEMIC EMERGENCY MEDICINE, Issue 2 2010Evaline A. Alessandrini MD Abstract Objectives:, A clinically sensible system of grouping diseases is needed for describing pediatric emergency diagnoses for research and reporting. This project aimed to create an International Classification of Diseases (ICD)-based diagnosis grouping system (DGS) for child emergency department (ED) visits that is 1) clinically sensible with regard to how diagnoses are grouped and 2) comprehensive in accounting for nearly all diagnoses (>95%). The second objective was to assess the construct validity of the DGS by examining variation in the frequency of targeted groups of diagnoses within the concepts of season, age, sex, and hospital type. Methods:, A panel of general and pediatric emergency physicians used the nominal group technique and Delphi surveys to create the DGS. The primary data source used to develop the DGS was the Pediatric Emergency Care Applied Research Network (PECARN) Core Data Project (PCDP). Results:, A total of 3,041 ICD-9 codes, accounting for 98.9% of all diagnoses in the PCDP, served as the basis for creation of the DGS. The expert panel developed a DGS framework representing a clinical approach to the diagnosis and treatment of pediatric emergency patients. The resulting DGS has 21 major groups and 77 subgroups and accounts for 96.5% to 99% of diagnoses when applied to three external data sets. Variations in the frequency of targeted groups of diagnoses related to seasonality, age, sex, and site of care confirm construct validity. Conclusions:, The DGS offers a clinically sensible method for describing pediatric ED visits by grouping ICD-9 codes in a consensus-derived classification scheme. This system may be used for research, reporting, needs assessment, and resource planning. ACADEMIC EMERGENCY MEDICINE 2010; 17:204,213 © 2010 by the Society for Academic Emergency Medicine [source] Rare Diseases Clinical Research NetworkNURSING FOR WOMENS HEALTH, Issue 1 2004Article first published online: 9 MAR 200 No abstract is available for this article. [source] Seven successful years of Omics research: The Human Brain Proteome Project within the National German Research Network (NGFN)PROTEINS: STRUCTURE, FUNCTION AND BIOINFORMATICS, Issue 6 2008Michael Hamacher No abstracts. [source] Knowledge, Attitudes, Beliefs, and Personal Practices Regarding Colorectal Cancer Screening Among Health Care Professionals in Rural Colorado: A Pilot SurveyTHE JOURNAL OF RURAL HEALTH, Issue 3 2009Sun Hee Rim MPH ABSTRACT:,Purpose: This study reports the baseline knowledge, attitudes, beliefs, and personal practices of health care professionals regarding colorectal cancer (CRC) screening in the High Plains Research Network (HPRN) of rural Colorado prior to a community-based educational intervention. It also examines the association between health care staff members' knowledge, attitudes, beliefs, and personal practices for CRC screening and patient screening levels by practice. Methods: Surveys were mailed to health care professionals in the HPRN. Participating clinics (n = 21) distributed patient surveys on CRC screening to persons aged ,50 for a 2-week period in 2006. Results: The survey response rate was 81% for providers (n = 46) and 90% for nursing staff (n = 63). Only 54% of health care professionals knew CRC is a leading cause of cancer deaths. When surveyed on their attitudes toward colon cancer, 92%"strongly agreed" or "agreed" that colon cancer is preventable. About 99% (n = 107) of providers and nurses "strongly agreed" or "agreed" that testing could identify problems before colon cancer starts. Most health care professionals (61%) aged ,50 years had previously been tested and were up-to-date (52%) with screening. Provider knowledge was significantly associated with higher patient screening (P = .02), but provider attitudes and beliefs were not. Moreover, personal screening practices of health care professionals did not correlate with more patients screened. Conclusion: Background knowledge of CRC among HPRN health care professionals could be improved. The results of this pilot study may help focus effective approaches such as increasing provider knowledge to enhance CRC screening in the relevant population. [source] Determinants of hospital costs associated with traumatic brain injury in England and Wales,ANAESTHESIA, Issue 5 2008S. Morris Summary Using data from the Trauma Audit Research Network, we investigated the costs of acute care in patients , 18 years of age hospitalised for traumatic brain injury between January 2000 and December 2005 in England and Wales. Traumatic brain injury patients were defined and stratified using the Abbreviated Injury Scale. A total of 6484 traumatic brain injury patients were identified; 22.3% had an Abbreviated Injury Scale score of three, 38.0% of four and 39.7% of five. Median age (IQR) was 42 years (28,59) and 76.7% were men. Primary cause of injury was motor vehicle collisions (42.4%) followed by falls (38.0%). In total 23.7% of the patients died before discharge. Hospitalisation costs averaged £15 462 (SD £16 844). Costs varied significantly by age, Glasgow Coma Score, Injury Severity Score, coexisting injuries of the thorax, spine and lower limb, hospital mortality, availability of neurosurgical services, and specialty of attendants seen in the Accident and Emergency department. [source] Unique Characteristics of Emergency Care Research: Scope, Populations, and InfrastructureACADEMIC EMERGENCY MEDICINE, Issue 10 2009D. Mark Courtney MD Abstract The National Institutes of Health (NIH) Clinical and Translational Science Awards (CTSA) program and the 2006 Institute of Medicine (IOM) Report on the future of emergency care highlight the need for coordinated emergency care research (ECR) to improve the outcomes of acutely ill or injured patients. In response, the Society for Academic Emergency Medicine (SAEM) and the American College of Emergency Physicians (ACEP) sponsored the Emergency Care Research Network (ECRN) Conference in Washington, DC, on May 28, 2008. The conference objectives were to identify the unique nature of ECR and the infrastructure needed to support ECR networks and to understand the optimal role of emergency medicine (EM) and other acute care specialties in research networks. Prior to the conference, participants responded to questions addressing the relevant issues that would form the basis of breakout session discussions; two of these breakout questions are summarized in this report: 1) what makes EM research unique? and 2) what are the critical components needed to establish and maintain networked ECR? Emergency care research was defined as "the systematic examination of patient care that is expected to be continuously available to diverse populations presenting with undifferentiated symptoms of acute illness, or acutely decompensated chronic illness, and whose outcomes depend on timely diagnosis and treatment." The chain of ECR may extend beyond the physical emergency department (ED) in both place and time and integrate prehospital care, as well as short- and long-term outcome determination. ECR may extend beyond individual patients and have as the focus of investigation the actual system of emergency care delivery itself and its effects on the community with respect to access to care, use of resources, and cost. Infrastructure determinants of research network success identified by conference participants included multidisciplinary collaboration, accurate long-term outcome determination, novel information technology, intellectual infrastructure, and wider network relationships that extend beyond the ED. [source] Involving older people in community-based research: Developing a guiding framework for researchers and community organisationsAUSTRALASIAN JOURNAL ON AGEING, Issue 1 2009Jeni Warburton The purpose of this paper is to outline the development of a guiding framework for both researchers and community organisations seeking to involve older people in research. Such a framework is needed to facilitate good quality, multidisciplinary research that can be used to inform policy and practice responses to the challenges of ageing. There is increased recognition that involving older people in the research process can lead to increased benefits for all involved. The guidelines outlined below put forward the following six principles: (i) acknowledge research as a process; (ii) clarify roles and levels of involvement; (iii) communicate effectively; (iv) recognise different expectations; (v) recognise difference; and (vi) ensure representativeness and diversity. These guidelines are now being promoted through the ARC/NHMRC Research Network in Ageing Well and collaborating stakeholder organisations that will be working together to implement these principles in future research involving older people. [source] Interobserver Agreement in Assessment of Clinical Variables in Children with Blunt Head TraumaACADEMIC EMERGENCY MEDICINE, Issue 9 2008Marc H. Gorelick MD Abstract Objectives:, To be useful in development of clinical decision rules, clinical variables must demonstrate acceptable agreement when assessed by different observers. The objective was to determine the interobserver agreement in the assessment of historical and physical examination findings of children undergoing emergency department (ED) evaluation for blunt head trauma. Methods:, This was a prospective cohort study of children younger than 18 years evaluated for blunt head trauma at one of 25 EDs in the Pediatric Emergency Care Applied Research Network (PECARN). Patients were excluded if injury occurred more than 24 hours prior to evaluation, if neuroimaging was obtained at another hospital prior to evaluation, or if the patient had a clinically trivial mechanism of injury. Two clinicians independently completed a standardized clinical assessment on a templated data form. Assessments were performed within 60 minutes of each other and prior to clinician review of any neuroimaging (if obtained). Agreement between the two observers beyond that expected by chance was calculated for each clinical variable, using the kappa (,) statistic for categorical variables and weighted kappa for ordinal variables. Variables with a lower 95% confidence limit (LCL) of , > 0.4 were considered to have acceptable agreement. Results:, Fifteen-hundred pairs of observations were obtained. Acceptable agreement was achieved in 27 of the 32 variables studied (84%). Mechanism of injury (low, medium, or high risk) had , = 0.83. For subjective symptoms, kappa ranged from 0.47 (dizziness) to 0.93 (frequency of vomiting); all had 95% LCL > 0.4. Of the physical examination findings, kappa ranged from 0.22 (agitated) to 0.89 (Glasgow Coma Scale [GCS] score). The 95% LCL for kappa was <0.4 for four individual signs of altered mental status and for quality (i.e., boggy or firm) of scalp hematoma if present. Conclusions:, Both subjective and objective clinical variables in children with blunt head trauma can be assessed by different observers with acceptable agreement, making these variables suitable candidates for clinical decision rules. [source] Productive pedagogies and the challenge of inclusionBRITISH JOURNAL OF SPECIAL EDUCATION, Issue 4 2003Julie Allan Julie Allan is Professor of Education at the Institute of Education, University of Stirling, where she also directs the Participation, Inclusion and Equity Research Network. In this article, she explores the challenges involved in achieving an inclusive education system. Her argument draws on recommendations from two separate studies, undertaken in Queensland, Australia and Scotland, which are attempting to shape inclusion policy and practice. The Queensland School Reform Longitudinal Study identified a set of productive pedagogies in which issues of social justice, equity and inclusion are foregrounded. The Scottish Parliamentary Inquiry into special needs, to which Professor Allan was adviser, recommended a number of changes aimed at establishing an inclusive education system for all pupils. Comparisons of the two sets of recommendations, which formed the basis of a series of workshops with teachers, school leaders and administrators within Education Queensland, have prompted two major questions which are addressed in this paper: what gets in the way of inclusive practice and what will it take to be inclusive? Julie Allan's responses to these questions take account of the ways in which we think about ,special education' teacher training and professional development; and educational policies and practices. She represents a fascinating set of ,double-edged responsibilities' that will challenge practitioners, policy makers and teacher educators to refocus and reframe their thinking about special educational needs and inclusion. [source] A phase II study of gemcitabine and docetaxel therapy in patients with advanced urothelial carcinomaCANCER, Issue 9 2003Barbara J. Gitlitz M.D. Abstract BACKGROUND The objectives of the current study were to evaluate the safety and efficacy of gemcitabine plus docetaxel in patients with unresectable (Stage T4 or , N1) metastatic or locally advanced transitional cell carcinoma (TCC) of the urothelial tract. METHODS A total of 27 patients were enrolled in the current multisite study, which was performed within the University of California-Los Angeles Community Oncology Research Network. The first 10 patients in the study received 800 mg/m2 of gemcitabine intravenously on Days 1, 8, and 15 of a 28-day treatment cycle. In addition, on Day 1, the first 10 patients received 80 mg/m2 of docetaxel intravenously after completion of the gemcitabine infusion. Because of dose-limiting toxicity (neutropenia), the initial dose of docetaxel was reduced to 60 mg/m2 for the remaining patients who entered the study (n = 17 patients). RESULTS Neutropenia was the most common adverse event that occurred in patients at the Grade 3 level (in 10 of 27 patients; 37.0%) and the Grade 4 level (in 6 of 27 patients; 22.2%). There were no other adverse events at the Grade 4 toxicity level. Twenty-five of 27 patients (92.6%) completed more than 1 cycle of combination therapy and were evaluated for antitumor responses. The frequency of objective clinical responses was 33.3% (9 of 27 patients). Complete responses to therapy were observed in 2 of 27 patients (7.4%), and partial responses were observed in 7 of 27 patients (25.9%). The median duration of response was 20 weeks (range, 12+ weeks to 152 weeks). The median survival duration was 52 weeks (range, 12 weeks to 160+ weeks). Four of 27 patients (14.8%) remained alive at the time of the current data analysis. CONCLUSIONS The results of the current study suggested that combination therapy with gemcitabine and docetaxel was an effective treatment for patients with unresectable (Stage T4 or , N1) metastatic or locally advanced TCC of the urothelial tract. Gemcitabine plus docetaxel appeared to be tolerated well, and treatment-related toxicities were limited to hematologic toxicities. Because cisplatin-containing regimens are contraindicated for patients with impaired renal function, the gemcitabine plus docetaxel combination may prove to be an effective and well tolerated treatment option for these patients. Cancer 2003. © 2003 American Cancer Society. [source] Revisiting the Emergency Medicine Services for Children Research Agenda: Priorities for Multicenter Research in Pediatric Emergency CareACADEMIC EMERGENCY MEDICINE, Issue 4 2008Steven Zane Miller MD Abstract Objectives:, To describe the creation of an Emergency Medical Services for Children (EMSC) research agenda specific to multicenter research. Given the need for multicenter research in EMSC and the unique opportunity afforded by the creation of the Pediatric Emergency Care Applied Research Network (PECARN), the authors revisited existing EMSC research agendas to develop a PECARN-specific research agenda. They sought to prioritize PECARN research efforts, to guide investigators planning to conduct research in PECARN, and to describe the creation of a prioritized EMSC research agenda specific for multicenter research. Methods:, The authors used the Nominal Group Process and Hanlon Process of Prioritization (HPP), which are recognized research prioritization methods incorporating both quantitative and qualitative data collection in group settings. The formula used to generate the final priority list heavily weighted practicality of conduct in a multicenter research network. By using size, seriousness, and practicality measures of each health priority, PECARN was able to identify factors that could be scored individually and were weighted relative to each other. Results:, The prioritization processes resulted in a ranked list of 16 multicenter EMSC research topics. Top among these priorities were 1) respiratory illnesses/asthma, 2) prediction rules for high-stakes/low-likelihood diseases, 3) medication error reduction, 4) injury prevention, and 5) urgency and acuity scaling. Conclusions:, The PECARN prioritization process identified high-priority EMSC research topics specific to multicenter research. PECARN has the capacity to answer long-standing, important clinical controversies in EMSC, largely due to its ability to conduct randomized controlled trials and observational studies on a large scale. [source] Variation in Ancillary Testing among Pediatric Asthma Patients Seen in Emergency DepartmentsACADEMIC EMERGENCY MEDICINE, Issue 6 2007MHSA, Rachel M. Stanley MD Background:Variation in the management of acute pediatric asthma within emergency departments is largely unexplored. Objectives:To investigate whether ancillary testing for patients with asthma would be associated with patient, physician, and hospital characteristics. Methods:The authors performed an analysis of a subset of patients from an extensive retrospective chart review of randomly selected charts at all 25 member emergency departments of the Pediatric Emergency Care Applied Research Network. Patients with a diagnosis of asthma were selected for supplemental review and included in this study. Ancillary tests analyzed were chest radiographs and selected blood tests. Hierarchical analyses were performed to describe the associations between ancillary testing and the variables of interest. Results:A total of 12,744 chart abstractions were completed, of which 734 (6%) were patients with acute exacerbations of asthma. Overall, 302 patients with asthma (41%) had ancillary testing. Of the 734 patients with asthma, 198 (27%) had chest radiographs and 104 (14%) had blood tests. Chest radiographs were more likely to be ordered in patients with fever. Less blood testing was associated with physician subspecialty training in pediatric emergency medicine, patients treated at children's hospitals, higher patient oxygen saturation, and patient disposition to home. Conclusions:Ancillary testing occurred in more than one third of children with asthma, with chest radiographs ordered most frequently. Efforts to reduce the use of chest radiographs should target the management of febrile patients with asthma, whereas efforts to reduce blood testing should target providers without subspecialty training in pediatric emergency medicine and patients treated in nonchildren's hospitals who are more ill. [source] CLIL and immersion classrooms: applied linguistic perspectivesINTERNATIONAL JOURNAL OF APPLIED LINGUISTICS, Issue 2 2007Ute Smit In the last issue, in accordance with InJAL's new relationship with AILA, the idea and rationale of AILA Research Networks was explained in general terms. In this issue and the next, individual co-ordinators present their ReNs and the particular activities they are engaged in. [source] The 2008 Emergency Care Research Networks (ECRN) Conference: Design, Summary of Findings, and an UpdateACADEMIC EMERGENCY MEDICINE, Issue 10 2009Roger J. Lewis MD First page of article [source] Structure and Function of Emergency Care Research Networks: Strengths, Weaknesses, and ChallengesACADEMIC EMERGENCY MEDICINE, Issue 10 2009Linda Papa MD Abstract The ability of emergency care research (ECR) to produce meaningful improvements in the outcomes of acutely ill or injured patients depends on the optimal configuration, infrastructure, organization, and support of emergency care research networks (ECRNs). Through the experiences of existing ECRNs, we can learn how to best accomplish this. A meeting was organized in Washington, DC, on May 28, 2008, to discuss the present state and future directions of clinical research networks as they relate to emergency care. Prior to the conference, at the time of online registration, participants responded to a series of preconference questions addressing the relevant issues that would form the basis of the breakout session discussions. During the conference, representatives from a number of existing ECRNs participated in discussions with the attendees and provided a description of their respective networks, infrastructure, and challenges. Breakout sessions provided the opportunity to further discuss the strengths and weaknesses of these networks and patterns of success with respect to their formation, management, funding, best practices, and pitfalls. Discussions centered on identifying characteristics that promote or inhibit successful networks and their interactivity, productivity, and expansion. Here the authors describe the current state of ECRNs and identify the strengths, weaknesses, and potential pitfalls of research networks. The most commonly cited strengths of population- or disease-based research networks identified in the preconference survey were access to larger numbers of patients; involvement of physician experts in the field, contributing to high-level study content; and the collaboration among investigators. The most commonly cited weaknesses were studies with too narrow a focus and restrictive inclusion criteria, a vast organizational structure with a risk of either too much or too little central organization or control, and heterogeneity of institutional policies and procedures among sites. Through the survey and structured discussion process involving multiple stakeholders, the authors have identified strengths and weaknesses that are consistent across a number of existing ECRNs. By leveraging the strengths and addressing the weaknesses, strategies can be adopted to enhance the scientific value and productivity of these networks and give direction to future ECRNs. [source] Facilitating Emergency Care Research Networks: Integration into the Clinical Translational and Science Award (CTSA) InfrastructureACADEMIC EMERGENCY MEDICINE, Issue 10 2009Judd E. Hollander MD Abstract Emergency care research (ECR) does not fit neatly into the traditional National Institutes of Health (NIH) funding model, because emergency research involves undifferentiated disease presentations involving multiple disciplines and time-sensitive interventions. A task force of emergency care researchers and other stakeholders was convened to discuss the present and future state of clinical research networks. Integration of ECR with the Clinical Translational and Science Award (CTSA) program through a multidisciplinary emergency care research network (ECRN) would obviate the duplication of research efforts by disease-specific or institute-specific multicenter networks and reduce startup and maintenance costs. Strategies to enhance integration must include the training of emergency physician investigators in biostatistical and epidemiologic methods, as well as educating collaborative investigators in emergency care,related methodologies. Thus, an ECRN would be of great benefit to CTSA awardees and applicants and should be considered a priority. [source] Evaluating Emergency Care Research Networks: What Are the Right Metrics?ACADEMIC EMERGENCY MEDICINE, Issue 10 2009Jill M. Baren MD Abstract Research networks can enable the inclusion of large, diverse patient populations in different settings. However, the optimal measures of a research network's failure or success are not well defined or standardized. To define a framework for metrics used to measure the performance and effectiveness of emergency care research networks (ECRN), a conference for emergency care investigators, funding agencies, patient advocacy groups, and other stakeholders was held and yielded the following major recommendations: 1) ECRN metrics should be measurable, explicitly defined, and customizable for the multiple stakeholders involved and 2) continuing to develop and institute metrics to evaluate ECRNs will be critical for their accountability and sustainability. [source] Heterogeneity, Group Size and Collective Action: The Role of Institutions in Forest ManagementDEVELOPMENT AND CHANGE, Issue 3 2004Amy R. Poteete Collective action for sustainable management among resource-dependent populations has important policy implications. Despite considerable progress in identifying factors that affect the prospects for collective action, no consensus exists about the role played by heterogeneity and size of group. The debate continues in part because of a lack of uniform conceptualization of these factors, the existence of non-linear relationships, and the mediating role played by institutions. This article draws on research by scholars in the International Forestry Resources and Institutions (IFRI) research network which demonstrates that some forms of heterogeneity do not negatively affect some forms of collective action. More importantly, IFRI research draws out the interrelations among group size, heterogeneity, and institutions. Institutions can affect the level of heterogeneity or compensate for it. Group size appears to have a non-linear relationship to at least some forms of collective action. Moreover, group size may be as much an indicator of institutional success as a precondition for such success. [source] A clinical research network in diabetes for the UKDIABETIC MEDICINE, Issue 10 2004S. Heller No abstract is available for this article. [source] Procedural sedation in children in the emergency department: A PREDICT studyEMERGENCY MEDICINE AUSTRALASIA, Issue 1 2009Meredith Borland Abstract Objective: To investigate current procedural sedation practice and compare clinical practice guidelines (CPG) for procedural sedation at Paediatric Research in Emergency Departments International Collaborative (PREDICT) sites. This will determine areas for improvement and provide baseline data for future multicentre studies. Methods: A questionnaire of specialist emergency physicians regarding demographics, general procedural sedation practice and specific sedation agents given to children. CPG for general sedation and sedation agents were obtained for each site. Results: Seventy-five (71%) useable surveys returned from 105 potential respondents. Most commonly used agents were nitrous oxide (N2O) (75, 100%), ketamine (total 72, 96%; i.v. 59, 83% and i.m. 22, 31%) and midazolam (total 68, 91%; i.v. 52, 81%, oral 47, 73%, intranasal 26, 41% and i.m. 6, 9%). Sedation was used for therapeutic and diagnostic procedures. Forty-three (57%) used formal sedation records and sedation checklists and thirty-one (41%) respondents reported auditing sedations. Four sites ran staff education and competency programmes. Nine sites had general sedation CPG, eight for ketamine, nine for N2O, eight for midazolam (four parenteral, five oral and six intranasal) and three for fentanyl. No site had a guideline for propofol administration. Conclusion: Procedural sedation in this research network commonly uses N2O, ketamine and midazolam for a wide range of procedures. Areas of improvement are the lack of guidelines for certain agents, documentation, staff competency training and auditing processes. Multicentre research could close gaps in terms of age cut-offs, fasting times and optimal indications for various agents. [source] Climatology at Urban Long-Term Ecological Research Sites: Baltimore Ecosystem Study and Central Arizona,PhoenixGEOGRAPHY COMPASS (ELECTRONIC), Issue 1 2009Anthony J. Brazel The Baltimore Ecosystem Study (BES) and Central Arizona,Phoenix (CAP) Long-Term Ecological Research (LTER) programs, established in 1997, are part of an international National Science Foundation long-term ecology monitoring and research network. The study sites are excellent laboratories to integrate ideas on climate of urban areas and how climate change and local variability of climate relate to social, political, economic, and ecological processes over a long time period. A large variety of research data are available online from individual LTER Web sites and a combined database called CLIMDB/HYDRODB is available for climate and ecology researchers and others, to investigate climate and hydrology in LTER study regions including those of BES and CAP. The basic program, climate aspects of these two areas, selected past research, and current ongoing work is briefly reviewed. A large benefit of this National Science Foundation program is the maintenance of support over a very long period of time. With the advent of a National Ecological Observatory Network, continuing collection of climate and environmental information over the coming decades at the local and regional scales, and maintenance of protocols of measurement, it is hoped that a more meaningfully integrated urban climatology with urban ecology will emerge. This will better prepare scientists to gage the impending rapid global warming expected not only of natural environments, but also of burgeoning urban places around the world. [source] Research and development at the health and social care interface in primary care: a scoping exercise in one National Health Service regionHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2002Jo Cooke MA Abstract The present project aimed to identify research activity at the health and social care interface in primary care within one National Health Service region, and to determine levels of research capacity and support within social services. The study was commissioned by a primary care research network (PCRN) in order to assess opportunities to increase research capacity within social services. Data were collected in two phases from 61 managers, team leaders and senior practitioners in social care, and six public health representatives in health authorities, using telephone interviews and focus groups. The findings highlighted a lack of infrastructure and support for research and development in social care. However, many social care respondents wanted opportunities to develop research skills with healthcare colleagues. Despite poor support, many small-scale projects were described, and many respondents showed an enthusiasm for engaging with research. Methods in use included surveys, action research, needs analysis and evaluation of service developments. Many examples of user involvement were given. Interface projects were usually instigated by interagency forums and funded from multiple sources. Most project work was motivated by service improvement or development, rather than aiming to produce generalisable knowledge. Barriers to conducting research included lack of confidence, research skills and time, as well as workload demands, lack of cover to release staff for research and lack of supervision. Research was not seen as legitimate work in some social care environments or as part of a career path. Existing joint working initiatives (such as the National Service Frameworks) were highlighted as flashpoints for potential research and evaluation activity. The findings suggest clear opportunities for PCRNs to develop research capacity at the interface with social care; for example, by signposting available resources, providing training grants and secondments for social care staff, and supporting interagency networks with a focus on evaluation. In turn, experience in promoting user involvement in social services could add value to research expertise at the primary care,social care interface. [source] Providing and verifying advanced IP services in hierarchical DiffServ networks-the case of GEANTINTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 4 2004Athanassios Liakopoulos Abstract The differentiated services (DiffServ) framework is widely proposed as an efficient method for providing advanced IP services to large-scale networks, with QoS requirements. However, the provisioning of such services in production networks has proved to be more difficult than initially expected, in defining, setting and verifying appropriate Service Level Agreements (SLAs). GEANT, the Gigabit core pan-European research network, on a pilot basis introduced ,Premium IP' service, offering bounded delay and negligible packet loss to the European National Research & Education Networks (NRENs) that it interconnects. However, large scale provisioning of this new service requires the definition of efficient interaction procedures between administrative domains involved and methods for SLA monitoring. This paper focuses on these issues and presents the experience acquired from the early experiments in GEANT, as an example of hierarchical Gigabit multi-domain environment, enabled with QoS provisioning to its constituent NRENs. This model scales more efficiently than the common peering Internet Service provider (ISP) commercial paradigm. Finally, we outline other options that promise QoS, such as Layer 2 VPNs in MPLS backbones, with non-standard (yet) mechanisms. Copyright © 2004 John Wiley & Sons, Ltd. [source] | |||||||||||||||||||||||||||||||