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Research Team (research + team)
Selected AbstractsBridging the Gap between Clinical Research and Knowledge Translation in Pediatric Emergency MedicineACADEMIC EMERGENCY MEDICINE, Issue 11 2007Lisa Hartling MSc In 2006, a multidisciplinary group of researchers from across Canada submitted a successful application to the Canadian Institutes for Health Research for a Canadian Institutes for Health Research Team in Pediatric Emergency Medicine. The conceptual foundation for the proposal was to bring together two areas deemed critical for optimizing health outcomes: clinical research and knowledge translation (KT). The framework for the proposed work is an iterative figure-eight model that provides logical steps for research and a seamless flow between the development and evaluation of therapeutic interventions (clinical research) and the implementation and uptake of those interventions that prove to be effective (KT). Under the team grant, we will conduct seven distinct projects relating to the two most common medical problems affecting children in the emergency department: respiratory illness and injury. The projects span the research continuum, with some projects targeting problems for which there is little evidence, while other projects involve problems with a strong evidence base but require further work in the KT realm. In this article, we describe the history of the research team, the research framework, the individual research projects, and the structure of the team, including coordination and administration. We also highlight some of the many advantages of bringing this research program together under the umbrella of a team grant, including opportunities for cross-fertilization of ideas, collaboration among multiple disciplines and centers, training of students and junior researchers, and advancing a methodological research agenda. [source] Results from the International Cataract Surgery Outcomes StudyACTA OPHTHALMOLOGICA, Issue thesis2 2007Jens Christian Norregaard MD Abstract It is widely accepted that cataract extraction with intraocular lens implantation is a highly effective and successful procedure. However, quality assessments and studies of effectiveness should still be undertaken. As with any surgical treatment modality, complications may occur, leading to suboptimal outcomes, additional health costs and deterioration in patients' functional capacity. International variation in clinical practice patterns and outcomes can serve as important pointers in the attempt to identify areas amenable to improvements in quality and cost-effectiveness. Once demonstrated, similar clinical results obtained in different health care systems can improve the level of confidence in a clinical standard against which the quality of care can be evaluated. The International Cataract Surgery Outcomes Study was established in 1992. The objective of this international comparative research project was to compare cataract management, outcomes of surgery and quality of care in four international sites. The study was conducted in the 1990s, since when many developments and refinements have emerged within cataract surgery. The actual figures reported in this thesis may no longer be of specific relevance as a decade has passed since their collection. However, the research questions and methods used in the study are still highly important and justify the publication of this report. The report deals with problems related to quality assessment, benchmarking, and the establishment and design of nationwide clinical databases , issues that are currently the focus of much attention. Moreover, the problems related to cross-national comparisons are increasingly relevant as more international databases are established. The study makes suggestions on how to report and compare objective as well as subjective criteria for surgery. The issue of how to report subjective criteria is a particular subject of current discussion. Four sites with high-quality health care systems were examined in this study: the USA, Denmark, the Province of Manitoba (Canada), and Barcelona (Spain). The design of the international research programme was based on methods developed by the US National Cataract Surgery Outcomes Study conducted by the US Cataract Patients Outcomes Research Team. The International Cataract Surgery Outcomes Study comprised three separate studies: a survey of ophthalmologists; a prospective cohort study, and a retrospective register-based cohort study. The survey study was based on data generated by a self-administered questionnaire completed by ophthalmologists in the four study areas. The questionnaire examined routine clinical practice involving patients considered for cataract surgery, and included questions on anaesthesia, monitoring and surgical techniques. The prospective cohort study was a large-scale, longitudinal observational study of patients undergoing first-eye cataract surgery in each study site. Patients were sampled consecutively from multiple clinics and followed for 4 months postoperatively. The retrospective cohort study was based on the Danish National Patient Register and claims data from the USA. This study could not be carried out in Barcelona or Manitoba as no suitable administrative databases were available. The papers based on register databases deal with retinal detachment and endophthalmitis but are not included in this thesis as the material was previously reported in my PhD thesis. The application of the studies was highly co-ordinated among the four sites and similar methods and instruments were used for data collection. The development of the data collection strategy, questionnaires, clinical data forms and data analyses were co-ordinated through weekly telephone conferences, annual in-person conferences, correspondence by mail or fax, and the exchange of sas programs and data files via the Internet. The survey study was based on responses from 1121 ophthalmologists in the four sites and results were presented in two papers. Within the previous year the participating ophthalmologists had performed a total of 212 428 cataract surgeries. With regard to preoperative ophthalmic testing, the present study reveals that refraction, fundus examination and A-scanning were performed routinely by most surgeons in all four sites. Other tests were reported to be performed routinely by some surgeons. It is unclear why any surgeon would use these other tests routinely in cataract patients with no ocular comorbidity. It appears that if this recommendation from the US Clinical Practice Guidelines Panel was broadly accepted, the use of these procedures and costs of care could be reduced, especially in Barcelona, the USA and Canada. Restricted use of medical screening tests was reported in Denmark. If this restricted screening were to be implemented in the USA, Canada and Barcelona, it would have significant resource implications. The most striking finding concerned the difference in monitoring practice between Denmark and each of the other three sites. In Denmark, monitoring equipment is seldom used and only occasionally is an anaesthesiologist present during cataract surgery. By contrast, in the other study sites, the presence of an anaesthesiologist using monitoring equipment is the norm. Adopting the Danish model in other sites would potentially yield significant cost savings. The results represent part of the background data used to inform the decision to conduct the two large-scale, multicentre Studies of Medical Testing for Cataract Surgery. The current study is an example of how surveys of clinical practice can pinpoint topics that need to be examined in randomized clinical trials. For the second study, 1422 patients were followed from prior to surgery until 4 months postoperatively. Preoperatively, a medical history was obtained and an ophthalmic examination of each patient performed. After consent had been obtained, patients were contacted for an in-depth telephone interview. The interview was repeated 4 months postoperatively. The interview included the VF-14, an index of functional impairment in patients with cataract. Perioperative data were available for 1344 patients (95%). The 4-month postoperative interview and clinical examination were completed by 1284 patients (91%). Main reasons for not re-evaluating patients were: surgery was cancelled (3%); refusal to participate (2%); lost to follow-up (1%), and death or being too sick (1%). The results have been presented in several papers, of which four are included in this thesis. One paper compared the preoperative clinical status of patients across the four sites and showed differences in both visual acuity (VA) and VF-14 measures. The VF-14 is a questionnaire scoring disability related to vision. The findings suggest that indications for surgery in comparable patients were similar in the USA and Denmark and were more liberal than in Manitoba and Barcelona. The results highlight the need to control for patient case mix when making comparisons among providers in a clinical database. This information is important when planning national databases that aim to compare quality of care. A feasible method may be to use one of the recently developed systems for case severity grading before cataract surgery. In another paper, perioperative clinical practice and rates of early complications following cataract surgery were compared across the four health care systems. Once again, the importance of controlling for case mix was demonstrated. Significant differences in clinical practice patterns were revealed, suggesting a general trend towards slower diffusion of new medical technology in Europe compared with North America. There were significant differences across sites in rates of intra- and early postoperative events. The most important differences were seen for rates of capsular rupture, hyphaema, corneal oedema and elevated pressure. Rates of these adverse events might potentially be minimized if factors responsible for the observed differences could be identified. Our results point towards the need for further research in this area. In a third paper, 4-month VA outcomes were compared across the four sites. When mean postoperative VA or crude proportions of patients with a visual outcome of <,0.67 were compared across sites, a much poorer outcome was seen in Barcelona. However, higher age, poorer general health status, lower preoperative VA and presence of ocular comorbidity were found to be significant risk factors associated with increased likelihood of poorer postoperative VA. The proportions of patients with these risk factors varied across sites. After controlling for the different distributions of these factors, no significant difference remained across the four sites regarding risk of a poor visual outcome. Once again the importance of controlling for case mix was demonstrated. In the fourth paper, we examined the postoperative VF-14 score as a measure of visual outcomes for cataract surgery in health care settings in four countries. Controlling for case mix was also necessary for this variable. After controlling for patient case mix, the odds for achieving an optimal visual function outcome were similar across the four sites. Age, gender and coexisting ocular pathology were important predictors of visual functional outcome. Despite what seemed to be an optimal surgical outcome, a third of patients still experienced visual disabilities in everyday life. A measure of the VF-14 might help to elucidate this issue, especially in any study evaluating the benefits of cataract surgery in a public health care context. [source] Effects of fully established Sure Start Local Programmes on 3-year-old children and their families living in England: a quasi-experimental observational studyCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2009Richard Reading Effects of fully established Sure Start Local Programmes on 3-year-old children and their families living in England: a quasi-experimental observational study . MelhuishE., BelskyJ., LeylandA. H., BarnesJ. & the National Evaluation of Sure Start Research Team ( 2008 ) The Lancet , 372 , 1641 , 1647 . DOI: 10.1016/S0140-6736(08)61687-6 . Background Sure Start Local Programmes (SSLPs) are area-based interventions to improve services for young children and their families in deprived communities, promote health and development, and reduce inequalities. We therefore investigated whether SSLPs affect the well-being of 3-year-old children and their families. Methods In a quasi-experimental observational study, we compared 5883 3-year-old children and their families from 93 disadvantaged SSLP areas with 1879 3-year-old children and their families from 72 similarly deprived areas in England who took part in the Millennium Cohort Study. We studied 14 outcomes , children's immunizations, accidents, language development, positive and negative social behaviours and independence; parenting risk; home-learning environment; father's involvement; maternal smoking, body-mass index and life satisfaction; family's service use; and mother's rating of area. Findings After we controlled for background factors, we noted beneficial effects associated with the programmes for five of 14 outcomes. Children in the SSLP areas showed better social development than those in the non-SSLP areas, with more positive social behaviour (mean difference 0.45, 95% CI 0.09 to 0.80, P = 0.01) and greater independence (0.32, 0.18 to 0.47, P < 0.0001). Families in SSLP areas showed less negative parenting (,0.90, ,1.11 to ,0.69, P < 0.0001) and provided a better home-learning environment (1.30, 0.75 to 1.86, P < 0.0001). These families used more services for supporting child and family development than those not living in SSLP areas (0.98, 0.86 to 1.09, P < 0.0001). Effects of SSLPs seemed to apply to all subpopulations and SSLP areas. Interpretation Children and their families benefited from living in SSLP areas. The contrast between these and previous findings on the effect of SSLPs might indicate increased exposure to programmes that have become more effective. Early interventions can improve the life chances of young children living in deprived areas. [source] Design and performance analysis of impulse turbine for a wave energy power plantINTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 1 2005A. Thakker Abstract Wave energy is the most abundant source of renewable energy in the World. For the last two decades, engineers have been investigating and defining different methods for power extraction from wave motion. Two different turbines, namely Wells turbine and impulse turbine with guide vanes, are most commonly used around the world for wave energy power generation. The ultimate goal is to optimize the performance of the turbine under actual sea conditions. The total research effort has several strands; there is the manufacture and experimental testing of new turbines using the Wave Energy Research Team's (WERT) 0.6 m turbine test rig, the theoretical and computational analysis of the present impulse turbine using a commercial software package and finally the prediction of the performance of the turbine in a representative wave power device under real sea conditions using numerical simulation. Also, the WERT 0.6 m turbine test rig was upgraded with a data acquisition and control system to test the turbine in the laboratory under real sea conditions using the computer control system. As a result, it is proven experimentally and numerically that the turbine efficiency has been raised by 7% by reducing the hub-to-tip ratio from 0.7 to 0.6. Effect of tip clearance on performance of the turbine has been studied numerically and designed tip clearance ratio of 1% has been validated. From the numerical simulation studies, it is computed that the mean conversion efficiency is reduced around 5% and 4.58% due to compressible flow and damping effects inside OWC device. Copyright © 2005 John Wiley & Sons, Ltd. [source] Using Buyer,Supplier Performance Frontiers to Manage Relationship Performance,DECISION SCIENCES, Issue 1 2009Anthony D. Ross ABSTRACT This article presents a consensus-building methodology to implement dyadic performance measurement. It focuses on transmuting supplier performance and buyer performance metrics on several important attributes into actionable relationship management plans using Clark's (1996) theory of performance frontiers. Access to the supplier performance management program of a Fortune 100 corporation was granted to the research team. Direct observation of practice and in-depth discussions with several managers provided a roadmap for investigating both the literature on quantitative evaluation methods and the empirically derived theory on buyer,supplier relationships from several perspectives. This study describes a multiphase, iterative framework that uses current methods and theory on dyadic buyer,supplier evaluation to consider: (i) evaluation criteria and their importance; (ii) whether the improvement focus should be on strengths, weaknesses, or both; and (iii) whether the referent role supplier should be the ideal supplier, best supplier, or best-in-strategic-group supplier in the focal supply base. We illustrate a unifying approach by reporting results from a large buyer and 35 of its key suppliers. This research makes the case for managing supplier relationships through the dyadic performance lens. The outputs from this framework provide individual supplier improvement paths which are actionable prescriptions for each buyer,supplier dyad, as well as recommendations for strategic group formation. [source] Development of the International Classification of Mental Health Care (ICMHC)ACTA PSYCHIATRICA SCANDINAVICA, Issue 2000A. De Jong Objective: Evaluations of the process of providing mental health care have been hampered because a tool to systematically describe the interventions actually provided by the services was lacking. In this paper the development of such a tool (the International Classification of Mental Health Care; ICMHC) is described. Method: Subsequent versions of the ICMHC were developed, using comments from experts in 24 WHO field centres and results from a number of field trials. In the final version 10 Modalities of Care can be used to describe Modules of Care, using the Level of Specialization scale. The inter-rater reliability of this version was evaluated by the Italian research team, using data from 43 services. Results: Reliability ranged from excellent for nine modalities to reasonably good for the remaining modality. Conclusion: In the context of evaluation studies, the ICMHC can be used to describe systematically mental health care interventions. [source] Advanced silicon microstructures, sensors, and systemsIEEJ TRANSACTIONS ON ELECTRICAL AND ELECTRONIC ENGINEERING, Issue 3 2007Oliver Paul Non-Member Abstract This paper presents the progress in silicon-based biomedical microstructures, material characterization techniques, and mechanical microsystems by the authors' research team. Microneedle and microelectrode arrays with fluidic through-wafer vias and electrical contacts were developed. The structures are designed for dermatological and biological applications such as allergy testing, surface electromyography, and spatially resolved impedance spectroscopy. The characterization of thin films has relied on the bulge test. By the formulation of more powerful models, the application range of the bulge test was extended to elastically supported thin-film multilayers. This enables the mechanical properties of thin films to be determined reliably. Finally, progress in the operation and application of novel stress sensors based on CMOS diffusions and field effect transistors and exploiting the pseudo-Hall effect is reported. Their integration into powerful single-chip microsystems is described. Applications include stress mapping, force and torque measurements, and tactile surface probing of microcomponents. Copyright © 2007 Institute of Electrical Engineers of Japan© 2007 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc. [source] The DSM-IV ,minor depression' disorder in the oldest-old: prevalence rate, sleep patterns, memory function and quality of life in elderly people of Italian descent in Southern BrazilINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2002Flávio M. F. Xavier Abstract Objectives (1) To describe the prevalence of minor depression in a community-dwelling population aged 80 years and over. (2) To compare the sleep pattern, memory function and the prevalence rate of other psychiatric diagnoses between normal controls and subjects with minor depressive disorder. Design A random representative sample (sample,=,77 subjects/county population of oldest-old,=,219,35%) aged 80 years or more was selected from the county of Veranópolis in the Brazilian rural southern region. Of this group, eight subjects who met the DSM-IV criteria for minor depression, and 50 subjects without diagnosed delirium disorder, cognitive or affective problems were compared. Results The prevalence rate of minor depression was 12%. Subjects with this diagnosis were more likely to complain about sleep and memory problems than elderly people without any other affective disorder (major depression or dysthymic disorder). Otherwise, objective evaluation of these two areas, memory and sleep, did not show differences between the groups. Moreover, in terms of factors such as life satisfaction and some domains from the Short-form 36 Quality of Life Scale (SF-36), subjects with minor depression presented worse self-reported evaluations. Female gender was associated (p,=,0.01) with a more frequent presence of minor depression disorder, and those with this diagnosis were more likely to have co-morbidity with generalized anxiety disorder (p,=,0.007) when compared with elderly people without any depressive disorder. Conclusion In this study, minor depression has been significantly associated with lower life satisfaction and worse indexes of life quality. The results supported the current concept that minor depression is prevalent in later life, especially among the oldest-old. Subjects with minor depression had worse self-reported opinions about memory and sleep patterns, but when these variables were objectively measured, no meaningful differences could be determined by the research team. Female gender and the concurring presence of generalized anxiety disorder were both significantly associated with the presence of minor depression diagnosis. Copyright © 2002 John Wiley & Sons, Ltd. [source] Nursing Diagnosis Extension and Classification: Ongoing PhaseINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Martha Craft-Rosenberg BACKGROUND The Nursing Diagnosis Extension and Classification Project (NDEC) has been active for almost a decade. The team began with the formation of a team of investigators at The University of Iowa College of Nursing. From 1994 until 2000 the research team consisted of 16 investigators who were experts in nursing care across the lifespan. They also represented expertise in both qualitative and quantitative research. The aims of the NDEC research are to evaluate and revise NANDA diagnoses, to validate the diagnoses using a clinical information system, and to develop candidate diagnoses. MAIN CONTENT POINTS Phase 1 of the NDEC research has yielded 116 refined and developed nursing diagnoses that have been submitted to NANDA. Of these, 65 have been approved and 54 appeared in Nursing Diagnoses: Definitions and Classification, 1999,2000 along with 39 NDEC products. In the 2000,2001 edition, 7 diagnoses refined by NDEC and 7 new diagnoses submitted by NDEC are included. As only about half the NDEC products have appeared in NANDA publications, the three-level review process (Diagnosis Review Committee, membership, and Board) has been discussed with the NANDA board. This request is currently being honored by the Diagnosis Review Committee; however, review by the membership and review by the NANDA board is just beginning to move in this direction. Phase 2, clinical validation of the NDEC work, is being conducted at a long-term care facility. It will also be conducted at a large teaching hospital. All the NDEC refinement and development work has been submitted for clinical validation. Currently validation is planned at the label level only. Phase 3 involves identification of candidate diagnoses. Many of the candidate diagnoses were developed during the concept analysis phase, when NDEC team members identified the need for additional diagnoses. Nurses in practice have submitted other candidate diagnoses. In total 195 candidate diagnoses have been identified and placed into a database. In order for the NDEC team to make decisions regarding priorities for diagnosis development, the diagnoses in the candidate database are compared to diagnoses in other classifications that have already been developed. Several classifications are used for comparison including the Omaha System and the Home Health Care Classification. A large table is used to compare candidate label to other labels. Candidate diagnosis included in other classifications will be given lower priority for development by NDEC. CONCLUSIONS The NDEC work plan includes work on diagnoses to be resubmitted to the NANDA Diagnosis Review Committee. It is hoped that the Web site for NLINKS will facilitate the work of diagnosis refinement and development. NDEC will continue to work with any investigator who is seeking assistance. The last part of the work plan is resource acquisition and recruitment of investigators to continue the refinement and development of diagnoses. [source] Delirium and older people: what are the constraints to best practice in acute care?INTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 3 2008BHSc (Nursing), Jenny Day ADCHN, MEd (Adult Education) An Australian research team conducted a six-month acute care pilot study in a medical ward of a large hospital in New South Wales. Aim., To explore ways health practitioners might redesign their practice to include prevention, early detection and management of delirium in older people based on the best current practice. Method and design., Participatory action research (PAR) was selected as the best approach for involving ward staff to make sustainable clinical practice decisions. The PAR group comprised research academics and eight clinicians from the ward. Thirteen PAR sessions were held over 5 months. Clinicians described care of patients with delirium. Stories were analysed to identify constraints to best practice. Following PAR group debate about concerns and issues, there were actions toward improved practice taken by clinicians. Relevance to clinical practice., The following constraints to best practice were identified: delayed transfer of patients from the Emergency Department; routine ward activities were not conducive to provision of rest and sleep; assisting with the patient's orientation was not possible as relatives were not able to accompany and/or stay with the older patient. Underreporting of delirium and attributing confusion to dementia was viewed as an education deficit across disciplines. A wide range of assessment skills was identified as prerequisites for working in this acute care ward, with older people and delirium. Clinicians perceived that management driven by length of a patient's stay was incongruent with best practice delirium care which required more time for older patients to recover from delirium. Two significant actions towards practice improvement were undertaken by this PAR group: (i) development of a draft delirium alert prevention protocol and (ii) a separate section of the ward became a dedicated space for the care of patients with delirium. A larger study is being planned across a variety of settings. [source] The ethics of research using electronic mail discussion groupsJOURNAL OF ADVANCED NURSING, Issue 5 2005Debbie Kralik PhD RN Aim., The aim of this paper is to identify and discuss the ethical considerations that have confronted and challenged the research team when researchers facilitate conversations using private electronic mail discussion lists. Background., The use of electronic mail group conversations, as a collaborative data generation method, remains underdeveloped in nursing. Ethical challenges associated with this approach to data generation have only begun to be considered. As receipt of ethics approval for a study titled; ,Describing transition with people who live with chronic illness' we have been challenged by many ethical dilemmas, hence we believe it is timely to share the issues that have confronted the research team. These discussions are essential so we can understand the possibilities for research interaction, communication, and collaboration made possible by advanced information technologies. Discussion., Our experiences in this study have increased our awareness for ongoing ethical discussions about privacy, confidentiality, consent, accountability and openness underpinning research with human participants when generating data using an electronic mail discussion group. We describe how we work at upholding these ethical principles focusing on informed consent, participant confidentiality and privacy, the participants as threats to themselves and one another, public,private confusion, employees with access, hackers and threats from the researchers. Conclusion., A variety of complex issues arise during cyberspace research that can make the application of traditional ethical standards troublesome. Communication in cyberspace alters the temporal, spatial and sensory components of human interaction, thereby challenging traditional ethical definitions and calling to question some basic assumptions about identity and ones right to keep aspects of it confidential. Nurse researchers are bound by human research ethics protocols; however, the nature of research by electronic mail generates moral issues as well as ethical concerns. Vigilance by researchers is required to ensure that data are viewed within the scope of the enabling ethics approval. [source] Towards a decision support system for health promotion in nursingJOURNAL OF ADVANCED NURSING, Issue 2 2003Kate Caelli PhD RN RM Aims. This study was designed to investigate what type of models, techniques and data are necessary to support the development of a decision support system for health promotion practice in nursing. Specifically, the research explored how interview data can be interpreted in terms of Concept Networks and Bayesian Networks, both of which provide formal methods for describing the dependencies between factors or variables in the context of decision-making in health promotion. Background. In nursing, the lack of generally accepted examples or guidelines by which to implement or evaluate health promotion practice is a challenge. Major gaps have been identified between health promotion rhetoric and practice and there is a need for health promotion to be presented in ways that make its attitudes and practices more easily understood. New tools, paradigms and techniques to encourage the practice of health promotion would appear to be beneficial. Concept Networks and Bayesian Networks are techniques that may assist the research team to understand and explicate health promotion more specifically and formally than has been the case, so that it may more readily be integrated into nursing practice. Methods. As the ultimate goal of the study was to investigate ways to use the techniques described above, it was necessary to first generate data as text. Textual descriptions of health promotion in nursing were derived from in-depth qualitative interviews with nurses nominated by their peers as expert health promoting practitioners. Findings. The nurses in this study gave only general and somewhat vague outlines of the concepts and ideas that guided their practice. These data were compared with descriptions from various sources that describe health promotion practices in nursing, then examples of a Conceptual Network and a representative Bayesian Network were derived from the data. Conclusions. The study highlighted the difficulty in describing health promotion practice, even among nurses recognized for their expertise in health promotion. Nevertheless, it indicated the data collection and analysis methods necessary to explicate the cognitive processes of health promotion and highlighted the benefits of using formal conceptualization techniques to improve health promotion practice. [source] Inducements for medical and health research: issues for the profession of nursingJOURNAL OF CLINICAL NURSING, Issue 7 2007FRCNA, Linda Shields PhD Aims and objectives., Inducements, incentives, reimbursements and payment to subjects for participation in research projects raise many practical, professional and philosophical issues for nurses. Nurses are enjoined, either formally as research co-participants or informally as patients' professional carers, in any research which involves their patients. This role inescapably brings significant ethical obligations, which include those of bioethical audit. Background., A review of current international guidelines on reimbursement recommendations indicates that researchers select one of several paradigms which range from the ,commercial market model' of supply and demand to that of pure un-reimbursed altruism. In this latter, volunteers not only give their bodies and emotional commitment, but also sacrifice their time and convenience. Inducement is defined as the provision of resources or rewards which exceed the ,resource neutral' compensation for legitimate expense. If potential volunteers are truly free to make an informed choice to participate in research, no ethical compromise exists if inducements are offered; but by so doing both the research team and the volunteer patients have shifted the ethos of their research from caritas and altruism to one of a simple commercial relationship. Conclusions., Inducements are inappropriate when offered to those who are ,ethically captive' in the sense that autonomy of choice may be compromised. Relevance to clinical practice., In contemporary nursing practice, research involvement is both frequent and desirable. A perspective of current debate about inducements for volunteering, including legal and ethical issues, empowers nurses to protect the patients or clients in their care. [source] Literature review: considerations in undertaking focus group research with culturally and linguistically diverse groupsJOURNAL OF CLINICAL NURSING, Issue 6 2007Elizabeth J Halcomb BN, IC Cert Aims., This integrated literature review seeks to identify the key considerations in conducting focus groups and discusses the specific considerations for focus group research with culturally and linguistically diverse groups. Background., The focus group method is a technique of group interview that generates data through the opinions expressed by participants. Focus groups have become an increasingly popular method of data collection in health care research. Although focus groups have been used extensively with Western populations, they are a particularly useful tool for engaging culturally and linguistically diverse populations. The success of focus groups in this context is dependent upon the cultural competence of the research team and the research questions. Methods., The electronic databases Medline, CINAHL, Embase, Psychlit and the Internet using the Google Scholar search engine were explored using the search terms ,focus group', ,cultural sensitivity', ,transcultural nursing', ,transcultural care', ,cultural diversity' and ,ethnic groups'. Hand searching of reference lists and relevant journals was also undertaken. English language articles were selected for the review if they discussed the following issues: (i) methodological implications of the focus group method; (ii) strengths and limitations of the focus group method; (iii) recommendations for researchers and (iv) use of the focus group in culturally and linguistically diverse groups. Conclusions were drawn from each of the articles and consensus regarding a summary of recommendations was derived from a minimum of two authors. Results., Findings from this review revealed several key issues involving focus group implementation including recruitment, sample size, data collection, data analysis and use within multicultural populations. Strengths and limitations of the focus group method were also identified. Conclusions., Focus groups are a useful tool to expand existing knowledge about service provision and identify consumer needs that will assist in the development of future intervention programmes, particularly within multicultural populations. Careful planning related to methodological and pragmatic issues are critical in deriving effective data and protecting participants. Relevance to clinical practice., Focus groups can facilitate increased understanding of perspectives of culturally and linguistically diverse groups and thereby shape clinical practice to better meet the needs of these groups. [source] The Beavers Systems Model of Family FunctioningJOURNAL OF FAMILY THERAPY, Issue 2 2000Robert Beavers Family competence and family style are the two main dimensions of the Beavers Systems Model of Family Functioning. The competence dimension ranges from optimal through adequate, midrange and borderline to severely dysfunctional. The style dimension ranges from centripetal to centrifugal. When the two dimensions are combined, they diagramatically define nine distinct family groupings, three of which are relatively functional and six of which are thought to be sufficiently problematic to require clinical intervention. A family's status on the competence and style dimensions may be established with the Beavers interactional scales. The self-report family inventory may be used to evaluate family members' perceptions of their status on the competence dimension. The reliability and validity of the self-report instrument and observational rating scales have been documented in over thirty papers and books published by the Beavers research team since 1970. The model has proved useful in training, research and clinical work. [source] What is the enabling state?JOURNAL OF INTERNATIONAL DEVELOPMENT, Issue 6 2004The views of textiles, garments entrepreneurs in Zimbabwe This paper summarizes the approach and findings of a piece of research sponsored by the Department for International Development (DFID) in the UK and carried out in 1998 and 1999 mainly in Harare and Bulawayo. The primary aim of the work was to contribute to an improvement in facilitating an enabling environment for the private sector in Zimbabwe. It aimed to achieve this objective by developing and testing a participative methodology based on the use of historical profiles, checklists, Venn diagrams, master charts, workshops and other participative methodologies. These processes were introduced and developed with a group of 40 entrepreneurs and managers and several representatives from trade unions, government, and agencies. The design aimed to allow participants to express their own agendas, ideas and approaches instead of reacting to a more rigid approach reflecting the agendas of the research team. The research team adopted a broad structure based around three main areas affecting firms: the policy, agency and firm environments. The use of semi-structured interviews and workshops allowed a detailed exploration of these issues and produced a comprehensive list of problems identified and proposed solutions. The importance of the research is in its ability to construct a firm level, rather than government or donor level view of the enabling environment. Copyright © 2004 John Wiley & Sons, Ltd. [source] Missed opportunities for a diagnosis of acute otitis media in Aboriginal childrenJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 7 2003KB Gibney Objective: Severe otitis media and its sequelae are common in rural and remote Aboriginal children. Identification of acute otitis media (AOM) is likely to reduce the number of children who go on to develop chronic suppurative otitis media and associated complications. The aim of this study was to compare the diagnoses made by researchers with that documented in the medical records of children admitted to the paediatric isolation ward of the Royal Darwin Hospital, Darwin, Northern Territory. Methods: Children aged <8 years admitted to Royal Darwin Hospital were eligible for assessment by pneumatic otoscopy, video-otoscopy and tympanometry. A diagnosis was made for each child according to the state of their worst ear. Comparisons were made between the researcher diagnoses of ear disease and those documented in the hospital notes by medical staff. Results: Thirty-one children were enrolled during 32 admissions. Most were aged <2 years, Aboriginal, and resided in remote communities. Sixty-one video-otoscopic assessments were attempted and sufficiently good images to allow diagnosis were obtained in 105 of 122 ears. Acute otitis media was diagnosed by the research team in 20 of 32 child admissions. Of 29 children who had ear examinations documented by hospital staff, only seven had a diagnosis of AOM recorded. Overall, the research team were almost three times more likely to make this diagnosis (relative risk 2.9, 95% confidence interval 1.6, 5.2). This difference was unlikely to have occurred by chance (P = 0.0002, McNemar's Chi-squared test). Conclusions: In this small study, young Aboriginal children with clear bulging of their tympanic membrane were not diagnosed with AOM by medical staff. Further training in diagnosis, including cleaning of the ear canal, may lead to more accurate assessment and appropriate recommendations for ongoing management. [source] Preparing teachers to create a mainstream science classroom conducive to the needs of English-language learners: A feminist action research projectJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 9 2005Gayle Buck A feminist action research team, which consisted of a science educator, an English-language learner (ELL) educator, a first-year science teacher, and a graduate assistant, set a goal to work together to explore the process a beginning teacher goes through to establish a classroom conducive to the needs of middle-level ELL learners. The guiding questions of the study were answered by gathering a wealth of data over the course of 5 months and taken from the classroom, planning sessions, and researchers and students. These data were collected by observations, semistructured interviews, and written document reviews. The progressive analysis ultimately revealed that: (a) successful strategies a beginning teacher must utilize for teaching middle-level ELL children in a mainstream classroom involve complex structural considerations that are not part of the teacher's preparation; (b) learning increases for all children, but there are differences in learning achievement between ELL and non-ELL children; and (c) student and peer feedback proved to be an effective means of enhancing the growth of a beginning teacher seeking to increase her skills in teaching ELL learners. The experiences and findings from this project have implications for teacher preparation programs committed to preparing educators to teach science to all children. © 2005 Wiley Periodicals, Inc. J Res Sci Teach 42: 1013,1031, 2005 [source] Expanding our understandings of urban science education by expanding the roles of students as researchersJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 7 2005Rowhea Elmesky In this article, we explore the roles of student researchers as they have emerged over 5 years of studies on the teaching and learning of science in urban high schools. These studies incorporate sociocultural theory in an approach to research that explores the capital that urban students bring to school and situates student researchers as active participants who exercise agency by accessing and appropriating a variety of resources. We provide examples of students engaged as productive, central members of a research team and describe the roles in which they have participated, from teacher educators and science learners to curriculum developers and ethnographers. We show how the involvement of students as researchers, within these roles, allows them to produce and select artifacts and data resources for interpretation that offer unique insider perspectives on how to improve the teaching and learning of science for urban high school students. © 2005 Wiley Periodicals, Inc. J Res Sci Teach 42: 807,828, 2005 [source] Case-based pedagogy as a context for collaborative inquiry in the PhilippinesJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 5 2001Elvira L. Arellano The purpose of this study was to investigate the potential for using case-based pedagogy as a context for collaborative inquiry into the teaching and learning of elementary science. The context for this study was the elementary science teacher preparation program at West Visayas State University on the the island of Panay in Iloilo City, the Philippines. In this context, triple linguistic conventions involving the interactions of the local Ilonggo dialect, the national language of Philipino (predominantly Tagalog) and English create unique challenges for science teachers. Participants in the study included six elementary student teachers, their respective critic teachers and a research team composed of four Filipino and two U.S. science teacher educators. Two teacher-generated case narratives serve as the centerpiece for deliberation, around which we highlight key tensions that reflect both the struggles and positive aspects of teacher learning that took place. Theoretical perspectives drawn from assumptions underlying the use of case-based pedagogy and scholarship surrounding the community metaphor as a referent for science education curriculum inquiry influenced our understanding of tensions at the intersection of re-presentation of science, authority of knowledge, and professional practice, at the intersection of not shared language, explicit moral codes, and indigenization, and at the intersection of identity and dilemmas in science teaching. Implications of this study are discussed with respect to the building of science teacher learning communities in both local and global contexts of reform. © 2001 John Wiley & Sons, Inc. J Res Sci Teach 38: 502,528, 2001 [source] The Future of Purchasing and Supply: A Ten-Year Forecast,JOURNAL OF SUPPLY CHAIN MANAGEMENT, Issue 1 2000Phillip L Carter SUMMARY The purpose of this research was the development of the 10-year forecasts for purchasing and supply based upon a close examination of key change drivers. The authors aimed at highlighting the most important areas of concern for purchasing executives. The research included trends of importance for organizations of all sizes, in all major industries , profit and nonprofit, private and public. To this end, the research team: ,,Identified the major economic, demographic, societal, competitive, and technological trends most likely to have major implications for the purchasing and supply management profession, its professionals, and organizationalprocesses ,,Projected the identified trends for 10 years (2008) ,,Determined the impact of these trends on purchasing and supply executives ,,Forecasted the environment for purchasing and supply in 10 years (2008) ,,Projected the changes to the purchasing and supply profession, its professionals, and organizational processes implied as a result of the research [source] Managing evaluation for program improvement at the Wilder FoundationNEW DIRECTIONS FOR EVALUATION, Issue 121 2009Paul W. Mattessich The authors tell about their heterogeneous 91 person research and evaluation unit at an operating foundation in St. Paul, Minnesota. They focus on evaluation for program improvement, one of several purposes of studies they work on. The three authors write from their different manager positions within the unit. Included are the context of the organization, strategic principles of their work and how it fits into a program improvement model. Mattessich writes as the executive director and details his day-to-day evaluation work. Mueller writes as the associate director, who oversees most of the unit's evaluation work, while Holm-Hansen writes as a consulting scientist who leads a core research team of four to six. © Wiley Periodicals, Inc. [source] Insight from multiple disciplinary angles: A case study of an interdisciplinary research teamNEW DIRECTIONS FOR TEACHING & LEARNING, Issue 102 2005Elizabeth G. Creamer A commitment to pursue problems from multiple angles, methods, and theoretical positions means that research teams require strategies to navigate the tensions and conflict that inevitably emerge, particularly when the intent is to find ways to integrate different disciplinary perspectives. [source] Critical inquiry and knowledge translation: exploring compatibilities and tensionsNURSING PHILOSOPHY, Issue 3 2009Sheryl Reimer-Kirkham PhD RN Abstract Knowledge translation has been widely taken up as an innovative process to facilitate the uptake of research-derived knowledge into health care services. Drawing on a recent research project, we engage in a philosophic examination of how knowledge translation might serve as vehicle for the transfer of critically oriented knowledge regarding social justice, health inequities, and cultural safety into clinical practice. Through an explication of what might be considered disparate traditions (those of critical inquiry and knowledge translation), we identify compatibilities and discrepancies both within the critical tradition, and between critical inquiry and knowledge translation. The ontological and epistemological origins of the knowledge to be translated carry implications for the synthesis and translation phases of knowledge translation. In our case, the studies we synthesized were informed by various critical perspectives and hence we needed to reconcile differences that exist within the critical tradition. A review of the history of critical inquiry served to articulate the nature of these differences while identifying common purposes around which to strategically coalesce. Other challenges arise when knowledge translation and critical inquiry are brought together. Critique is one of the hallmark methods of critical inquiry and, yet, the engagement required for knowledge translation between researchers and health care administrators, practitioners, and other stakeholders makes an antagonistic stance of critique problematic. While knowledge translation offers expanded views of evidence and the complex processes of knowledge exchange, we have been alerted to the continual pull toward epistemologies and methods reminiscent of the positivist paradigm by their instrumental views of knowledge and assumptions of objectivity and political neutrality. These types of tensions have been productive for us as a research team in prompting a critical reconceptualization of knowledge translation. [source] Cultural safety and the challenges of translating critically oriented knowledge in practiceNURSING PHILOSOPHY, Issue 3 2009Annette J. Browne PhD RN Abstract Cultural safety is a relatively new concept that has emerged in the New Zealand nursing context and is being taken up in various ways in Canadian health care discourses. Our research team has been exploring the relevance of cultural safety in the Canadian context, most recently in relation to a knowledge-translation study conducted with nurses practising in a large tertiary hospital. We were drawn to using cultural safety because we conceptualized it as being compatible with critical theoretical perspectives that foster a focus on power imbalances and inequitable social relationships in health care; the interrelated problems of culturalism and racialization; and a commitment to social justice as central to the social mandate of nursing. Engaging in this knowledge-translation study has provided new perspectives on the complexities, ambiguities and tensions that need to be considered when using the concept of cultural safety to draw attention to racialization, culturalism, and health and health care inequities. The philosophic analysis discussed in this paper represents an epistemological grounding for the concept of cultural safety that links directly to particular moral ends with social justice implications. Although cultural safety is a concept that we have firmly positioned within the paradigm of critical inquiry, ambiguities associated with the notions of ,culture', ,safety', and ,cultural safety' need to be anticipated and addressed if they are to be effectively used to draw attention to critical social justice issues in practice settings. Using cultural safety in practice settings to draw attention to and prompt critical reflection on politicized knowledge, therefore, brings an added layer of complexity. To address these complexities, we propose that what may be required to effectively use cultural safety in the knowledge-translation process is a ,social justice curriculum for practice' that would foster a philosophical stance of critical inquiry at both the individual and institutional levels. [source] The Kalgoorlie Otitis Media Research Project: rationale, methods, population characteristics and ethical considerationsPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2008Deborah Lehmann Summary Otitis media (OM) is one of the most common paediatric illnesses for which medical advice is sought in developed countries. Australian Aboriginal children suffer high rates of OM from early infancy. The resultant hearing loss can affect education and quality of life. As numerous factors contribute to the burden of OM, interventions aimed at reducing the impact of single risk factors are likely to fail. To identify key risk factors and understand how they interact in complex causal pathways, we followed 100 Aboriginal and 180 non-Aboriginal children from birth to age 2 years in a semi-arid zone of Western Australia. We collected demographic, obstetric, socio-economic and environmental data, breast milk once, and nasopharyngeal samples and saliva on seven occasions. Ear health was assessed by clinical examination, tympanometry, transient evoked otoacoustic emissions and audiometry. We considered the conduct of our study in relation to national ethical guidelines for research in Aboriginal and Torres Strait Islander health. After 1 year of community consultation, the study was endorsed by local committees and ethical approval granted. Fieldwork was tailored to minimise disruption to people's lives and we provided regular feedback to the community. We saw 81% of non-Aboriginal and 65% of Aboriginal children at age 12 months. OM was diagnosed on 55% and 26% of routine clinical examinations in Aboriginal and non-Aboriginal children respectively. Aboriginal mothers were younger and less educated, fewer were employed and they lived in more crowded conditions than non-Aboriginal mothers. Sixty-four per cent of Aboriginal and 40% of non-Aboriginal babies were exposed to environmental tobacco smoke. Early consultation, provision of a service while undertaking research, inclusion of Aboriginal people as active members of a research team and appropriate acknowledgement will assist in ensuring successful completion of the research. [source] Crisis planning: Survey results from Hurricane Katrina and implications for performance improvement professionalsPERFORMANCE IMPROVEMENT QUARTERLY, Issue 3-4 2008Holly M. Hutchins Modern organizations constantly face unparalleled changes and uncertainty in the competitive world, thus requiring strategic planning to mitigate crisis conditions. Underscoring crisis plans are performance interventions that prepare employees, technological systems, and the organizational culture to effectively respond to a crisis event. However, crisis planning has been an overlooked area in the performance improvement literature. In the present study, we review results of a survey on crisis planning conducted by the research team seven months after Hurricane Katrina. Specifically, performance improvement professionals (n=129) employed by organizations located along the western Gulf Coast were surveyed on the existence and composition of their organization's crisis planning before and after Hurricane Katrina. Results indicate that organizations did increase crisis planning during the post-Katrina period, and that crisis plans consisted of components and activities supported in the literature. We use these results to identify and discuss how performance improvement professionals might leverage their knowledge of human performance technology (HPT) in supporting organizational crisis planning efforts. [source] Teaching Healthy Anger ManagementPERSPECTIVES IN PSYCHIATRIC CARE, Issue 2 2001Sandra P. Thomas PhD TOPIC. Teaching anger management in the community. PURPOSE. To describe anger management and offer guidelines for assessing potential participants and teaching healthy behaviors. SOURCES. Drawing from the literature, more than 10 years of quantitative and qualitative studies by our research team, and 5 years of experience in conducting anger management groups, the author presents basic principles of teaching anger management. A model is described for a 4-week group for women. CONCLUSIONS. Anger management has wide applicability to a variety of constituencies for both primary and secondary prevention. Advanced practice psychiatric nurses are well-qualified to provide this psychoeducational intervention. [source] Longitudinal weight gain of immunized infants and toddlers in Moroto District, Uganda (Karamoja subregion)AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 1 2010Sandra Gray This study examines longitudinal weight gain of a sample of 123 immunized children from Moroto District, northeast Uganda. The weight data were combined from two sources: (1) anthropometric examinations carried out between 1998 and 2004 by a research team from the University of Kansas, and (2) weights recorded on children's immunization records by local health care practitioners. Our findings conform generally to the pattern described in previous studies in this as well as other pastoralist populations in sub-Sahara. Relative to international standards, the weight-for-age status of Karimojong children was best during the first 3 months of infancy. Noticeable declines in weight velocity occurred in the fourth month and after the sixth month. Weight gain was static after the second year, when upward of 40% of children were clinically underweight. Factors influencing weight gain in this sample include immunization status and maternal height, weight, and parity, but these effects explain relatively little of the variance in weight gain. We conclude that immunization is not sufficient to buffer Karimojong children from multiple stressors during teething and weaning. Of these, the practice of canine follicle extraction (CFE) is of most interest, although its effects in this study are ambiguous. The data also are suggestive of variability in the pattern of weight gain between closely spaced birth cohorts. This finding may be of particular importance for the interpretation of growth patterns described for other pastoralist populations in sub-Saharan Africa. Am. J. Hum. Biol. 2010. © 2009 Wiley-Liss, Inc. [source] Path Dependency and the Reform of English Local GovernmentPUBLIC ADMINISTRATION, Issue 1 2005Francesca Gains This paper uses the concept of path dependency to examine the changes to the political management structures of English local government. We note how the possible experience of decreasing returns among some local authority actors combined with the powerful intervention of politicians within New Labour at the national level led to a significant break from past policy and the imposition of measures to establish a separate executive that was claimed as a radical step forward for local democracy. Using survey data from the Evaluating Local Governance research team (http://www.elgnce.org.uk), we explore the establishment of a separate political executive in all major local authorities and map out the style of decision-making that is emerging. We find that some established institutional patterns reasserted themselves in the process of implementation, but that increasing returns are not as great as some theorists of path dependency would suggest and they may be a force for system change as well as for stability. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||