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‣ Organizationally sponsored health services research.

Lovett, J E; Strum, D W
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /02/1985 Português
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Organizations, particularly large multi-institutional health delivery systems, have begun to sponsor their own research programs as a consequence of the scope and complexity of management and governance decisions they face. These research programs are functionally integrated into the organization and serve as a strategic management planning and decision-making tool. Their primary purpose is seen to be the comprehension, analysis, synthesis, application, and evaluation of the vast amount of information available within the organization and from the health delivery system. Their emphasis is on making research results relevant to organizational goals and objectives, applicable to organizational decisions, and utilized. Organizationally sponsored researchers, it has been shown, face a particularly complex set of management and research requirements in building their programs. Developing the research agenda and establishing an infrastructure for the conduct of research are critical to success. Once accomplished, the organizationally sponsored researcher does have particular advantages in conducting the research and in seeing the findings used to improve health care delivery. We have cited and addressed a number of concerns or issues relating to the emergence of organizationally sponsored research. Some are specious in origin; others arise out of an incomplete understanding of the systems of evaluation and reward which have traditionally applied to professional researchers. It is in terms of the intended beneficiary of the research and the extent to which the results are made to apply directly to the organizational manager that differences emerge--not in the quality or quantity of research accomplished...

‣ Health services research as a scientific process: the metamorphosis of an empirical research project from grant proposal to final report.

Luft, H S
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /10/1986 Português
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The process of health services research is rarely examined; attention is usually focused on results and policy implications. Large and small decisions made during the execution of a study, however, can have major impacts on its outcomes. This article describes a project that underwent major changes because of problems discovered in the basic data and threats to the valid interpretation of econometric results uncovered by qualitative case studies. Although the combination of difficulties encountered in this project may be unusual, it is likely that many similar problems and opportunities occur in other empirical studies.

‣ Expanding the frame of health services research in the drug abuse field.

Weisner, C; Schmidt, L A
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /12/1995 Português
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OBJECTIVE. This article examines the distribution of heavy drug users across health and social service agencies in a community, and ways in which organizational and social policy factors influence pathways to services. DATA SOURCES/STUDY SETTING. Data are from the Community Epidemiology Laboratory, a project that includes comparable surveys of a wide variety of client, service provider, and general population groups in a single northern California county. STUDY DESIGN. The design is a cross-sectional analysis of patterns of service use and referral by heavy drug users distributed across a variety of service settings and in the general population. DATA COLLECTION. In-person, structured interviews by trained interviewers were conducted using comparable instruments, measures, sampling strategies, and fieldwork procedures. PRINCIPAL FINDINGS. The specialty drug treatment system serves only a small proportion of heavy drug users in the community. Large proportions of drug users are found in criminal justice, primary health, and welfare agencies. Patterns of service encounter and referral suggest that drug treatment clients typically have been in jail or on welfare prior to attending treatment, and are far less likely to have been referred to or from treatment by health providers. CONCLUSIONS. Health services research on drug abuse should expand its frame of reference to include services outside the specialty treatment sector. Drug treatment facilities are somewhat remote from other agencies in community service networks and are organizationally dependent on criminal justice and welfare systems. Further research should investigate both the costs and benefits of screening and providing services at earlier points of institutional involvement with drug abusers and the implications of interorganizational dependencies among criminal justice...

‣ Improving the quality of healthcare for children: implementing the results of the AHSR research agenda conference.

Halfon, N; Schuster, M; Valentine, W; McGlynn, E
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /10/1998 Português
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OBJECTIVE: To describe the rationale, development, content, and results of the AHSR-sponsored conference on developing a research agenda focused on improving the quality of care for children. DATA SOURCES AND METHODS: Planning documents, background papers, and conference proceedings. PRINCIPAL FINDINGS: The conference developed the research agenda focused on (1) monitoring the health of children; (2) evaluating the efficacy and effectiveness of health services for children; (3) assessing the quality of healthcare provided to children; (4) improving the quality of healthcare within health systems; (5) assessing the performance of community systems for children; (6) exploring the impact of different financial incentives on the provision of pediatric healthcare; and (7) developing and disseminating clinical practice guidelines and other information to physicians, families, and consumers. Specific issues and research questions in each area are also presented. Strategies for implementing the research agenda are presented and include: (1) expanding the child health services research workforce; (2) developing child healthcare quality improvement research centers; (3) conducting research in specific high-priority areas; (4) focusing research on improving the health of vulnerable populations; (5) improving child health data and collection systems at the national level; (6) developing better community health monitoring for children; (7) building and supporting research networks and a consortium of research users; and (8) developing a coordinated interagency federal effort to advance this agenda and to provide accountability for its completion. CONCLUSION: The proposed research agenda should be a national priority so that all Americans can be assured that children are receiving the best quality of care that the United States can provide.

‣ Making Medicaid managed care research relevant.

Gold, M
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /02/1999 Português
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OBJECTIVE: To help researchers better understand Medicaid managed care and the kinds of research studies that will be both feasible and of value to policymakers and program staff. The article builds on our experience researching Medicaid managed care to provide insight for researchers who want to be policy relevant. PRINCIPAL FINDINGS: We draw four lessons from our work on Medicaid managed care in seven states. First, these are complex programs that differ substantially across states. Second, each program faces common challenges and issues. The need to address common design elements involving program eligibility, managed care and provider contracting, beneficiary enrollment, education, marketing, and administration and oversight provides a vehicle that researchers can use to help understand states and to provide them with relevant insight. Third, well-designed case studies can provide invaluable descriptive insights. Such case studies suggest that providing effective descriptions of state programs and experience, monitoring information on program performance and tradeoffs, and insight on implementation and design are all valuable products of such studies that have considerable potential to be converted into policy-actionable advice. And fourth...

‣ An occupational reproductive research agenda for the third millennium.

Lawson, Christina C; Schnorr, Teresa M; Daston, George P; Grajewski, Barbara; Marcus, Michele; McDiarmid, Melissa; Murono, Eisuke; Perreault, Sally D; Schrader, Steven M; Shelby, Michael
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /04/2003 Português
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There is a significant public health concern about the potential effects of occupational exposure to toxic substances on reproductive outcomes. Several toxicants with reported reproductive and developmental effects are still in regular commercial or therapeutic use and thus present potential exposure to workers. Examples of these include heavy metals, organic solvents, pesticides and herbicides, and sterilants, anesthetic gases, and anticancer drugs used in health care. Many other substances are suspected of producing reproductive or developmental toxicity but lack sufficient data. Progress has been limited in identifying hazards and quantifying their potencies and in separating the contribution of these hazards from other etiologic factors. Identifying the causative agents, mechanisms by which they act, and any potential target populations, present the opportunity to intervene and protect the reproductive health of workers. The pace of laboratory studies to identify hazards and to underpin the biologic plausibility of effects in humans has not matched the pace at which new chemicals are introduced into commerce. Though many research challenges exist today, recent technologic and methodologic advances have been made that allow researchers to overcome some of these obstacles. The objective of this article is to recommend future directions in occupational reproductive health research. By bridging interdisciplinary gaps...

‣ Current research on the influence of establishing operations on behavior in applied settings.

Iwata, B A; Smith, R G; Michael, J
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //2000 Português
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This article provides commentary on research published in the special section of the Journal of Applied Behavior Analysis devoted to establishing operations (EOs). Three major themes are highlighted: (a) identification of the influence of EOs on behavior in applied settings, (b) the use of EO manipulation as an assessment tool, and (c) the development of interventions based on the alteration of EO influences. Methodological issues pertaining to research on EOs are addressed, and suggestions for future investigation are provided.

‣ Monitoring clinical research: an obligation unfulfilled.

Weijer, C; Shapiro, S; Fuks, A; Glass, K C; Skrutkowska, M
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 15/06/1995 Português
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The revelation that data obtained for the US-based National Surgical Adjuvant Breast and Bowel Project (NSABP) from subjects enrolled at Hôpital Saint-Luc in Montreal was falsified has eroded public trust in research. Institutions can educate researchers and help prevent unethical research practices by establishing procedures to monitor research involving human subjects. Research monitoring encompasses four categories of activity: annual reviews of continuing research, monitoring of informed consent, monitoring of adherence to approved protocols and monitoring of the integrity of data. The authors describe characteristics of research projects that may call for monitoring procedures in each category. The form taken by such monitoring depends on the nature of the protocol. Although appropriate research monitoring requires substantial investment of personnel and financial resources, it is required under guidelines regulating research involving human subjects in Canada. Research monitoring is a step forward in re-establishing public confidence in medical research.

‣ Research on human embryos--a justification.

Brown, J
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /12/1986 Português
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The philosophical debate surrounding the moral status of the embryo has reached the public arena. The author of this paper examines some of the common arguments against embryo experimentation, including an influential article by Professor Ian Kennedy. He concludes that these arguments do not succeed in demonstrating that the intentional creation of embryos for research purposes is wrong, unless they also succeed in demonstrating that contemporary liberal abortion laws are also wrong. The author also criticises the conclusions of the Warnock Report, and suggests that the reasons for permitting embryo research must be given a wider public audience.

‣ Community panel discussions: from research to community action.

Alvarado, M; Smolenski, M C
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //1996 Português
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HYPERTENSION AND CARDIOVASCULAR DISEASE are increasing among minorities. Participants at the workshop on the Epidemiology of Hypertension in Hispanic Americans, Native Americans, and Asian/Pacific Islander Americans voiced a need to intensify a systemic approach for community-based strategies to guide prevention, treatment, and control. To answer this need, a panel addressed recommended community-based strategies from inclusion of community members in the research process to implementation and application of findings for community action. Recommended strategies include encouraging close cooperation and data sharing between investigators and community groups; including differences in culture, heritage, and local influences in hypertension research; training and working with minority researchers and health care professionals; and intensifying comprehensive and culturally appropriate education programs that focus on prevention, treatment, and control of hypertension. This article contains a summary of key areas of emphasis, as well as implementation strategies to decrease hypertension and other cardiovascular diseases in specific ethnic groups.

‣ Research on needle exchange: redefining the agenda.

Hantman, J. A.
Fonte: New York Academy of Medicine Publicador: New York Academy of Medicine
Tipo: Artigo de Revista Científica
Publicado em //1995 Português
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Researchers studying needle-exchange programs in the United States pursue a two-fold agenda that requires answers to these questions: (1) Do such programs successfully reduce HIV seroprevalence among injecting drug users? (2) Do they promote drug use? Several federal laws and regulations require convincing data on each question before the release of federal funds for needle exchange. Fears that needle exchange promotes drug use are at the core of federal concerns, and these fears are shared by community leaders, scientists, and public health professionals. Nonetheless, the manner in which the "drug use" question has been framed and addressed in scientific research has been given insufficient attention. This article aims to stimulate debate about current research, and restore a focus on HIV prevention, by addressing several methodological, logical, and ethical weaknesses that characterize the scientific inquiry into whether needle exchange promotes drug use.

‣ Use of the Internet and information technology for surgeons and surgical research.

Cartmell, Mark T.; Kingsnorth, Andrew N.
Fonte: Royal College of Surgeons of England Publicador: Royal College of Surgeons of England
Tipo: Artigo de Revista Científica
Publicado em /09/2002 Português
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423.78312%
The recent, and extensive, expansion in the use of computers and the Internet offers great potential for benefit in surgical research and, increasingly, surgical practice. However, in addition to the usefulness of information technology, much time can be spent achieving little and the potential missed because of the complexity and excess of information available. In this article, we examine some useful areas relevant to surgeons and surgical research, such as Internet service provision and E-mail, databases, medical Websites, and potential future directions.

‣ Research-tool patents: issues for health in the developing world.

Barton, John H.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica
Publicado em //2002 Português
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The patent system is now reaching into the tools of medical research, including gene sequences themselves. Many of the new patents can potentially preempt large areas of medical research and lay down legal barriers to the development of a broad category of products. Researchers must therefore consider redesigning their research to avoid use of patented techniques, or expending the effort to obtain licences from those who hold the patents. Even if total licence fees can be kept low, there are enormous negotiation costs, and one "hold-out" may be enough to lead to project cancellation. This is making it more difficult to conduct research within the developed world, and poses important questions for the future of medical research for the benefit of the developing world. Probably the most important implication for health in the developing world is the possible general slowing down and complication of medical research. To the extent that these patents do slow down research, they weaken the contribution of the global research community to the creation and application of medical technology for the benefit of developing nations. The patents may also complicate the granting of concessional prices to developing nations - for pharmaceutical firms that seek to offer a concessional price may have to negotiate arrangements with research-tool firms...

‣ Beyond procedural ethics: Foregrounding questions of justice in global health research ethics training for students

Hunt, Matthew R.; Godard, Beatrice
Fonte: Taylor & Francis Publicador: Taylor & Francis
Tipo: Artigo de Revista Científica
Português
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Interest in global health is growing among students across many disciplines and fields of study. In response, an increasing number of academic programmes integrate and promote opportunities for international research, service or clinical placements. These activities raise a range of ethical issues and are associated with important training needs for those who participate. In this paper, we focus on research fieldwork conducted in lower income nations by students from more affluent countries and the ethics preparation they would benefit from receiving prior to embarking on these projects. Global health research is closely associated with questions of justice and equity that extend beyond concerns of procedural ethics. Research takes place in and is shaped by matrices of political, social and cultural contexts and concerns. These realities warrant analysis and discussion during research ethics training. Training activities present an opportunity to encourage students to link global health research to questions of global justice, account for issues of justice in planning their own research, and prepare for ‘ethicsin-practice’ issues when conducting research in contexts of widespread inequality. Sustained engagement with questions of justice and equity during research ethics training will help support students for involvement in global health research.

‣ A Survey of the Barriers Associated with Academic-based Cancer Research Commercialization

Vanderford, Nathan L.; Weiss, L. Todd; Weiss, Heidi L.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 21/08/2013 Português
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Commercialization within the academic setting is associated with many challenges and barriers. Previous studies investigating these challenges/barriers have, in general, broadly focused on multiple disciplines and, oftentimes, several institutions simultaneously. The goal of the study presented here was to analyze a range of barriers that may be broadly associated with commercializing academic-based cancer research. This goal was addressed via a study of the barriers associated with cancer research commercialization at the University of Kentucky (UK). To this end, a research instrument in the form of an electronic survey was developed. General demographic information was collected on study participants and two research questions were addressed: 1) What are the general barriers inhibiting cancer research commercialization at UK? and 2) Would mitigation of the barriers potentially enhance faculty engagement in commercialization activities? Descriptive and statistical analysis of the data reveal that multiple barriers likely inhibit cancer research commercialization at UK with expense, time, infrastructure, and lack of industry partnerships being among the most commonly cited factors. The potential alleviation of these factors in addition to revised University policies/procedures...

‣ Differential Impact of Science Policy on Subfields of Human Embryonic Stem Cell Research

Moon, Seongwuk; Cho, Seong Beom
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 09/04/2014 Português
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In this research, we examine how restrictive policy influenced performance in human embryonic stem cell research (hESC) between 1998 and 2008. In previous research, researchers argued whether restrictive policy decreased the performance of stem cell research in some nations, especially in the US. Here, we hypothesize that this policy influenced specific subfields of the hESC research. To investigate the selective policy effects, we categorize hESC research publications into three subfields—derivation, differentiation, and medical application research. Our analysis shows that restrictive policy had different effects on different subfields. In general, the US outperformed in overall hESC research throughout these periods. In the derivation of hESC, however, the US almost lost its competence under restrictive policy. Interestingly, the US scientific community showed prominent resilience in hESC research through international collaboration. We concluded that the US resilience and performance stemmed from the wide breadth of research portfolio of US scientists across the hESC subfields, combined with their strategic efforts to collaborate internationally on derivation research.

‣ There is Room for Even More Doublethink: The Perilous Status of Psychoanalytic Research

Fonagy, Peter
Fonte: Taylor & Francis Publicador: Taylor & Francis
Tipo: Artigo de Revista Científica
Português
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423.78312%
The opposition between psychoanalysis and systematic interdisciplinary research is to be regretted. The target article attempts to bridge the intellectual divide and for this aim as well as the intellectual adroitness shown it is to be celebrated. Much harder to understand is the high level of affect generated by the debate. Accusations of “doublethink” are helpful. The present paper, like the target paper it follows, attempts to develop an understanding of the position of those who are categorically opposed to interdisciplinary systematic research linked to psychoanalysis. Appreciating the perspective of those deeply opposed to such work could help to create a shared agenda from which our troubled discipline could benefit. This is predicated on the possibility of an open collegial dialogue which this journal was founded to create.

‣ Progress in Human Embryonic Stem Cell Research in the United States between 2001 and 2010

Vakili, Keyvan; McGahan, Anita M.; Rezaie, Rahim; Mitchell, Will; Daar, Abdallah S.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 26/03/2015 Português
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On August 9th, 2001, the federal government of the United States announced a policy restricting federal funds available for research on human embryonic stem cell (hESCs) out of concern for the “vast ethical mine fields” associated with the creation of embryos for research purposes. Until the policy was repealed on March 9th, 2009, no U.S. federal funds were available for research on hESCs extracted after August 9, 2001, and only limited federal funds were available for research on a subset of hESC lines that had previously been extracted. This paper analyzes how the 2001 U.S. federal funding restrictions influenced the quantity and geography of peer-reviewed journal publications on hESC. The primary finding is that the 2001 policy did not have a significant aggregate effect on hESC research in the U.S. After a brief lag in early 2000s, U.S. hESC research maintained pace with other areas of stem cell and genetic research. The policy had several other consequences. First, it was tied to increased hESC research funding within the U.S. at the state level, leading to concentration of related activities in a relatively small number of states. Second, it stimulated increased collaborative research between US-based scientists and those in countries with flexible policies toward hESC research (including Canada...

‣ A review of racial differences in geriatric depression: implications for care and clinical research.

Steffens, D. C.; Artigues, D. L.; Ornstein, K. A.; Krishnan, K. R.
Fonte: National Medical Association Publicador: National Medical Association
Tipo: Artigo de Revista Científica
Publicado em /11/1997 Português
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How racial differences influence depressed elders' seeking and obtaining treatment for depression is poorly understood. Studies in other medical illnesses show older African Americans use fewer health-care services for heart disease, stroke, and renal dialysis. This article reviews the racial composition of Duke University's Clinical Research Center (CRC) for the Study of Depression in the Elderly. Possible explanations for low participation of African Americans in such programs also are discussed. During most of the first year of the CRC project, minority enrollment varied from 5% to 10%, at least one third the African-American population of the area. Active efforts to improve minority recruitment increased this percentage to 15% by the end of the project's second year. Likely explanations for low minority participation rates include 1) elders may recognize depressive symptoms, but do not seek or cannot obtain medical treatment, and 2) depressive symptoms may be attributed to a crisis of the spirit (so help is sought through prayer and the church), the "slowing down" process of aging, or part of life's burden to be endured. Future attempts at both treatment and clinical research recruitment efforts are needed to address these possibilities.

‣ The Brazilian Portuguese Lexicon: An Instrument for Psycholinguistic Research

Estivalet, Gustavo L.; Meunier, Fanny
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 02/12/2015 Português
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In this article, we present the Brazilian Portuguese Lexicon, a new word-based corpus for psycholinguistic and computational linguistic research in Brazilian Portuguese. We describe the corpus development, the specific characteristics on the internet site and database for user access. We also perform distributional analyses of the corpus and comparisons to other current databases. Our main objective was to provide a large, reliable, and useful word-based corpus with a dynamic, easy-to-use, and intuitive interface with free internet access for word and word-criteria searches. We used the Núcleo Interinstitucional de Linguística Computacional’s corpus as the basic data source and developed the Brazilian Portuguese Lexicon by deriving and adding metalinguistic and psycholinguistic information about Brazilian Portuguese words. We obtained a final corpus with more than 30 million word tokens, 215 thousand word types and 25 categories of information about each word. This corpus was made available on the internet via a free-access site with two search engines: a simple search and a complex search. The simple engine basically searches for a list of words, while the complex engine accepts all types of criteria in the corpus categories. The output result presents all entries found in the corpus with the criteria specified in the input search and can be downloaded as a.csv file. We created a module in the results that delivers basic statistics about each search. The Brazilian Portuguese Lexicon also provides a pseudoword engine and specific tools for linguistic and statistical analysis. Therefore...