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PubMed1994

Connecting the health sciences community to the Internet: the NLM/NSF grant program.

In 1992, as part of its high-performance computing and communications initiative, the National Library of Medicine decided to provide health sciences institutions with Internet connection grants similar to those offered to universities by the National Science Foundation. Although library involvement is not required, librarian and library uses have been the most common category in the applications received.

Computer Communication Networks↗

PubMed2001

Building capacity for health disparity research at minority institutions.

The science and technology enterprise of the United States has consistently produced seminal work and cutting-edge technologies. It has responded promptly to both new opportunities and urgent crises. The success of this enterprise derives largely from the diversity of the types of institutions doing the work and from the many sources of public and private funding available to accomplish it. To those who argue that public-sector funds should support only the best science at the premier research institutions on the nation's East and West coasts, Dr. Rita Colwell, the director of the National Science Foundation (NSF) eloquently responds, "No one region, no one group of institutions, and no special communities have a corner on the market of good and great ideas, smart people, or outstanding researchers. Great ideas can come from just about anywhere."

Education↗

PubMed2001

Building capacity for health disparity research at minority institutions.

Education↗

PubMed1995

[Clinical research: where does it come from? Where is it going?].

In this editorial the author examines briefly the past, present and future of clinical investigation in general and particularly in Switzerland, where the same problems are encountered as in other European countries and North America. The main problems reside in the fragmentation of internal medicine into subspecialities with their own separate meetings and journals, at the expense of multidisciplinary sources of information on medical progress, thus widening the gap between the practitioners and the scientific community. Through examples, it is pointed out that the progression of medical knowledge follows the path from basic research in biochemistry, cellular biology, animal experiments, clinical investigation and finally clinical medicine not unidirectionally but bidirectionally. Thanks to the Swiss National Science Foundation, the Medical Schools of the five Universities and many private foundations, a considerable effort has been made in past decades to foster basic and clinical research, resulting in a most favorable position for our country on the international scene. There is a fear that political and administrative decision could jeopardize the present situation and imperil the future. Finally, citing Osler from his work "Aequanimitas", the author stresses that "the true test of a nation's life... is to be found in its intellectual and moral standards", and that "the measure of the value of a nation to the world is neither the bushel nor the barrel, but mind".

Clinical Trials as Topic↗

PubMed1981

[A general view of the ambulatory care sector: Structural and functional study in the cantons of Vaud and Fribourg].

The project "Quantification and qualification of ambulatory health care", financed by the Swiss National Science Foundation and covering the Cantons of Vaud and Fribourg, has two main goals: --a structural study of the elements of the ambulatory care sector. This is done through inventories of the professions concerned (physicians, public health nurses, physiotherapists, pharmacists, medical laboratories), allowing to better characterize the "offer". This inventory work includes the collect and analysis of existing statistical data as well as surveys, by questionnaires sent (from September 1980) to the different professions and by interviews. --a functional study, inspired from the US National Ambulatory Medical Care Survey and from similar studies elsewhere, in order to investigate the modes of practice of various providers, with particular regard to interprofessional collaboration (through studying referrals from the ones to the others). The first months of the project have been used for a methodological research in this regard, centered on the use of systems analysis, and for the elaboration of adequate instruments.

Ambulatory Care↗

PubMed2000

Future opportunities for life science programs in space.

Most space-related life science programs are expensive and time-consuming, requiring international cooperation and resources with trans-disciplinary expertise. A comprehensive future program in "life sciences in space" needs, therefore, well-defined research goals and strategies as well as a sound ground-based program. The first half of this review will describe four key aspects such as the environment in space, previous accomplishments in space (primarily focusing on amphibian embryogenesis), available resources, and recent advances in bioinformatics and biotechnology, whose clear understanding is imperative for defining future directions. The second half of this review will focus on a broad range of interdisciplinary research opportunities currently supported by the National Aeronautics and Space Administration (NASA), National Institute of Health (NIH), and National Science Foundation (NSF). By listing numerous research topics such as alterations in a diffusion-limited metabolic process, bone loss and skeletal muscle weakness of astronauts, behavioral and cognitive ability in space, life in extreme environment, etc., we will attempt to suggest future opportunities.

Animals↗

PubMed1995

The scientific growth of gastroenterology during the 20th century. The 1994 G. Brohee Lecture.

Energized by the growth of the basic sciences during the latter half of the 20th century, gastroenterology advanced from a modest clinical activity to an increasingly scientific discipline. The decisive change followed World War II, when the Office of Scientific Research and Development transferred university and industry wartime research contracts to the National Institutes of Health (NIH), followed by establishment of the National Science Foundation and the General Medicine Study Section (NIH). Other factors contributing to the progress of gastroenterology included: (1) the increasing body of scientific knowledge; (2) innovative technological advances; (3) philanthropic, pharmaceutical, and governmental (NIH) support of research; (4) emphasis on controlled clinical and laboratory studies; and (5) the enlarging global scientific communication network. Selected highlights on the evolving knowledge of gastrointestinal hormones and the discovery of cholecystography illustrate some of the pathways of gastroenterology's 20th century advance.

Cholecystography↗

PubMed1997

The ethics of scientific research: an analysis of focus groups of scientists and institutional representatives.

BACKGROUND: Little is known about scientists' views on normative research ethics and how these compare with the views of the institutional representatives (IRs) involved in matters of scientific conduct. We qualitatively evaluated scientist and IR perceptions of the norms of science, ethical violations and their harms, factors contributing to violations, and approaches to improve scientific conduct. METHODS: Focus groups were conducted with National Science Foundation investigators and with IRs. Themes were extracted from observation, notes, and transcripts. Consensus and contrasts within and between groups were described. RESULTS: Scientists described a rich set of norms including honesty, integrity, service, sharing, openness, mentoring, and meticulous work habits. Institutional representatives focused on good citizenship and abiding by administrative rules. Both groups listed similar ethical violations, though scientists felt that severe violations were rare, that science was self-correcting, and that the greatest harm from misconduct disclosure was the loss of public trust and funding. Institutional representatives called for increased and less confidential misconduct investigations. Reporting misconduct was strongly supported by IRs but rejected by scientists. Both scientists and IRs believed that formal research ethics education was needed for trainees. CONCLUSIONS: Scientists in these focus groups upheld a complex set of norms that mirror prior codes of science and exceed national misconduct rules. The sharply contrasting views of scientists and IRs concerning responsibility to report misconduct, the utility of misconduct investigation, and penalties for misconduct highlight areas where open discussion and constructive resolution are needed to formulate a functional mechanism to enhance the ethical conduct of science.

Biomedical Research↗

PubMed1980

The evaluation of performance and cost in a hypertension control program.

This article examines the Performance Measurement System (PMS), a new approach to evaluating performance and cost of public health departments, developed under the sponsorship of the National Science Foundation. Four weaknesses characterizing presently used evaluation designs are described. The PMS method is briefly summarized and one practical application of the method, to hypertension control, is discussed in detail. PMS is an adaptation of the systems approach to evaluating human service programs, using both epidemiologic and industrial engineering concepts. The method was developed to serve the needs of on-line managers who are responsible for day-today supervision and evaluation. Six steps are described for the implementation of PMS: systems design; formulation of explicit quantified, time-limited objectives; the development of gauges; the construction of performance appraisal indicators (PAIs); the development of activity efficiency indicators (AEIs) and cost-effectiveness indicators (CEIs); and the development of staff support indicators (SSIs). Metods for the analysis of PMS indicators are examined. PMS has been incorporated into the evaluation plan of the Detroit Hypertension Control Program, a 5-year demonstration project funded by the National Heart, Lung, and Blood Institute. Other applications have included an implementation of the method in the Preventable Disease Division of the Connecticut State Health Department. The development and use of PMS performance and cost indicators for the Detroit project are thoroughly examined.

Community Health Services↗

PubMed1998

Evaluation of the research norms of scientists and administrators responsible for academic research integrity.

CONTEXT: The professional integrity of scientists is important to society as a whole and particularly to disciplines such as medicine that depend heavily on scientific advances for their progress. OBJECTIVE: To characterize the professional norms of active scientists and compare them with those of individuals with institutional responsibility for the conduct of research. DESIGN: A mailed survey consisting of 12 scenarios in 4 domains of research ethics. Respondents were asked whether an act was unethical and, if so, the degree to which they considered it unethical and to select responses and punishments for the act. PARTICIPANTS: A total of 924 National Science Foundation research grantees in 1993 or 1994 in molecular or cellular biology and 140 representatives from the researchers' institutions to the US Department of Health and Human Services Office of Research Integrity. MAIN OUTCOME MEASURES: Percentage of respondents considering an act unethical and the mean malfeasance rating on a scale of 1 to 10. RESULTS: A total of 606 research grantees and 91 institutional representatives responded to the survey (response rate of 69% of those who could be contacted). Respondents reported a hierarchy of unethical research behaviors. The mean malfeasance rating was unrelated to the characteristics of the investigator performing the hypothetical act or to its consequences. Fabrication, falsification, and plagiarism received malfeasance ratings higher than 8.6, and virtually all thought they were unethical. Deliberately misleading statements about a paper or failure to give proper attribution received ratings between 7 and 8. Sloppiness, oversights, conflicts of interest, and failure to share were less serious still, receiving malfeasance ratings between 5 and 6. Institutional representatives proposed more and different interventions and punishments than the scientists. CONCLUSIONS: Surveyed scientists and institutional representatives had strong and similar norms of professional behavior, but differed in their approaches to an unethical act.

Biomedical Research↗

PubMed1991

Progress in psychosocial and behavioral cancer research. The need for enabling strategies.

A major component of the Second Workshop on Methodology in Behavioral and Psychosocial Cancer Research was a discussion of enabling strategies, that is, strategies by which future goals and needs in the area of psychosocial and behavioral oncology might be accomplished. This report describes and comments on the discussion that took place at a special plenary session at which representatives from four funding agencies, the American Cancer Society, National Cancer Institute, National Institute of Mental Health, and National Science Foundation, presented their views and their agencies' programs for promoting research in psychosocial and behavioral oncology. It is concluded that much progress has been made in the field and that strategies are in place for ensuring continued progress. However, suggestions are also made for new strategies that might accelerate and broaden that progress.

Attitude to Health↗

PubMed1989

The human experience in Antarctica: applications to life in space.

The increasing prominence of polar, spaceflight, and subaquatic environments has renewed interest in understanding human performance under conditions of isolation and confinement. In 1987, the National Aeronautics and Space Administration and the National Science Foundation co-sponsored a conference intended to revitalize behavioral research in such settings, and to explore the use of Antarctica as a behavioral laboratory for outer space. The present paper reviews recent research on men and women in isolation and confinement, with special reference to the proceedings of the NASA/NSF conference. The literature reviewed, which focuses on living systems and cuts across the individual, small group, organization, and community levels, suggests that researchers have become more systems-oriented, and have broadened their perspectives to encompass missions' larger temporal and social contexts. Among the topics reviewed are states of consciousness, stress, health, small group dynamics, personnel selection, crew training, and environmental engineering. Methodological and logistical problems are discussed, and the review concludes with recommendations for agencies that sponsor groups in isolation and confinement and for researchers who seek to study such groups.

Adaptation, Psychological↗

PubMed1981

[ROBETH: a library for robust statistical procedures].

In the past 20 years the theory of robust estimation has become an important topic of mathematical statistics. We discuss here some basic concepts of this theory with the help of simple examples. Furthermore we describe a subroutine library for the application of robust statistical procedures, which was developed with the support of the Swiss National Science Foundation.

Humans↗

PubMed1982

[Technical equipment in the offices of practicing physicians in Vaud and Fribourg].

In the framework of health services research sponsored by the Swiss National Science Foundation, a survey by questionnaire was undertaken among the practicing physicians in two Swiss cantons, Vaud and Fribourg (total population 700,000), in order to gather information on their personal and professional characteristics (including type of medical activity, personnel employed, and equipment). Out of 1121 physicians concerned, 60% answered. (The respondent group is representative for the relevant parameters.) This article presents the findings regarding the medico-technical equipment doctors have in their offices and gives also indications on the relationship between the presence of equipment and the auxiliary personnel employed. General practitioners and internal medicine specialists are usually equipped for laboratory analyses, with a photometer (69% of them) or more simply (24%), for X-rays (47% for chest and skeleton radiography, 22% with radioscopy); they also generally have an ECG apparatus (81%) and one or several physiotherapy appliances (52% of them). 42% of the generalists and 22% of the internists have all those four types of equipment. Rates of availability are much lower among other medical specialties. Pediatricians in particular are clearly less equipped technically than the other groups of primary care physicians. Surgeons are often well equipped for physiotherapy. The differences according to physician age are examined; this shows that younger generations are not much more equipped than older ones. The devices which we regrouped as "other diagnostic equipment" however tend to replace radioscopy in the equipment of younger physicians. These results constitute a new contribution to the knowledge on the ambulatory medical care system in Switzerland and should be useful in the present discussions on the medical coverage of the country.

Adult↗

PubMed1982

[Physiotherapists in French-speaking Switzerland--basic data].

In the framework of health services research sponsored by the Swiss National Science Foundation, a survey was made among the physiotherapists of the French-speaking part of Switzerland (six cantons), in order to gather information on --their personal and professional characteristics, --conditions of professional practice, --therapeutic methods used, medical indications of treatments and some data on the patients seen --the personnel, facilities and equipment of physiotherapy offices, institutes (several professionals) and services (in hospitals). Out of a total of 771 physiotherapists (i.e. 5.4 per 10,000 persons, in an area with 1.5 million population), 40% of them answered the questionnaire which was sent. They are a representative sample as regards region of practice, sex, age, employment status, and working environment. Physiotherapy is experiencing in Switzerland since the middle 1970's a quantitative increase and an accelerated diversification in the modes of practice. One observes in particular that many women enter the profession, working often part-time. According to the data gathered, it appears that, in spite of a marked differentiation in structural terms, physiotherapy is able to conserve its unity as regards therapeutic methods and types of care, thanks to keeping a practice of a generalist character. Thus, this discipline shows a potential for adaptation which could be of interest to other health professions. This paper introduces the main axes of a research in a yet largely undocumented field.

Adult↗

PubMed1982

[Consultations on adolescents in medical practice: a study of ambulatory care in 2 Swiss cantons].

Based on the data of a NAMCS type survey undertaken in two Swiss cantons, Vaud and Fribourg, in early 1981 (in the framework of a programme of the Swiss National Science Foundation), in which 205 physicians participated, a study was made to better delineate the characteristics of medical visits by adolescents (10 to 19 years of age). The sample used includes data of over 6000 physician visits. (Every seventh visit was recorded.) It was found that, in general, adolescents consult less often than either children or adults. They see more frequently a doctor whom they did not know before (p less than .001). General practitioners are their main source of care, pediatricians playing only, especially for teenagers over 15 years of age, a very limited role. The most frequent reasons for the visit are ENT and respiratory affections, then skin and musculo-skeletal problems. A psychiatric diagnosis is only rarely given. As compared with children and adults, adolescents show a high rate of short visits (less than 5 minutes - p less than .001) and a low rate of visits including therapeutic counseling/exchange (p less than .05). This trend is more marked in the pediatricians' visits than in the general practitioners' (p less than .001). These results illustrate the difficulty teenagers experience in deciding whether and where to go to a doctor on the one hand and, on the other hand, the difficulty physicians have in adequately addressing their demand. Information about youth's health needs should be intensified among the medical profession as well as among the adolescents themselves.

Adolescent↗

PubMed1982

[Structure of work times of public health nurses: effect of the age of patients, nature of care given and location of contact].

In the framework of health services research sponsored by the Swiss National Science Foundation, a research was undertaken of the activity of the large majority of the public health nurses working in the Swiss cantons of Vaud and Fribourg (total population 700,000). During one week, 130 nurses gathered, with a specially devised instrument, data on 4165 patient visits. Studying the duration of the contacts, one has distinguished contact duration per se (DC), duration of the travel time preceding the contact (DD), and total duration in relation with the contact (DTC-addition of the first two). It was noted that the three durations increased significantly with patient age (as regard travel time, this is explained by the higher proportion of home visits in higher age groups, as compared with visits at a health center). Examined according to location of the visit, contact duration per se (without travel) is higher for visits at home and in nursing homes than for those taking place at a health center. Looked at in respect to the care given (technical care, or basic nursing care, or both simultaneously), our data show that the provision of basic nursing care (alone or with technical care) doubles contact duration (from 20 to 42-45'). The analyses according to patient age shows that, at an advanced age (beyond 80 years particularly), there is an important increase of the visits where both types of care are given. However, contact duration per se shows a significant raise with age only for the group "technical care only"; it can be demonstrated that this is due to the fact that older patients require more complex technical acts (e.g., bladder care, as compared with simpler acts such as injection). A model of the relationships between patient age and contact duration is proposed: it is because of the increase in the proportions of home visits, of visits including basic nursing care, and of more complex technical acts that older persons require more of the working time of public health nurses.

Adult↗

PubMed1992

Tissue engineering in the USA.

Tissue engineering is the application of the principles and methods of engineering and the life sciences towards the development of biological substitutes to restore, maintain or improve functions. It is an area which is emerging in importance worldwide. In the USA it has been actively fostered by the National Science Foundation, both through research grants and the sponsorship of a series of workshops starting in 1988. This brief review of activities in the USA focuses on cell culture technology as a foundation for tissue engineering and then discusses examples of applications. These include artificial skin and the use of encapsulated cells in the development of bioartificial organs. Also discussed is the reconstitution of a blood vessel in culture, both for use in basic research and for implantation as an artificial blood vessel in bypass surgery. In conclusion, other potential applications are mentioned as well as generic areas of technology for future development.

Artificial Organs↗