Conflict and collaboration in cross-cultural health care.
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Cultural Characteristics↗
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The future for nursing. Crossing boundaries through collaboration.
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Delivery of Health Care↗
Ethnic comparisons of obesity in the Asia-Pacific region: protocol for a collaborative overview of cross-sectional studies.
The prevalence of overweight and obesity has been rapidly increasing within countries of the Asia-Pacific region, with adverse consequences for health. The Obesity in Asia Collaboration (OAC) was initiated to provide reliable evidence concerning the relationships between anthropometrical markers of adiposity with cardiovascular risk factors within, and across, ethnic groups. This is to be achieved through the collection of cross-sectional studies from the Asia-Pacific region. These data will be used to examine the ethnic-specific associations of different anthropometric measures of adiposity (such as body mass index, waist circumference, waist-hip ratio and waist-height ratio) with cardiovascular risk factors (fasting blood glucose and blood pressure). Estimates of the relative risks for type 2 diabetes and hypertension with increased adiposity will be obtained using data from contributing studies in conjunction with those from the previously established Asia Pacific Cohort Studies Collaboration. To date, 12 countries and regions from the Asia-Pacific region with information on nearly 300,000 individuals, are participants in the OAC. Data from other eligible studies are sought. The findings from the OAC will provide reliable evidence concerning the association of adiposity with cardiovascular risk factors across ethnic groups. It will also provide a strong evidence base upon which to define ethnic-specific cut-points for overweight and obesity.
Anthropometry↗
Addressing health disparities through dental-medical collaborations, part II. Cross-cutting themes in the care of special populations.
This article introduces the second group in a series of articles in this journal on dental-medical collaborations to reduce oral health disparities. This group targets the needs of the elderly and individuals with mental retardation, developmental disabilities, and other special health problems. Five themes are common to these populations: the importance of oral-systemic interactions and need for interprofessional collaboration in care and training; the possibility of diminished mental and motor capacities and ability to provide self-care; difficulty accessing appropriate dental care; complex social and cultural factors; and the lack of a sufficient evidence base on basic mechanisms and clinical interventions. Gaps in training of dental, medical, and other health professionals contribute to disparities. Few programs provide integrated, interdisciplinary approaches, despite the growing numbers of elderly and the increasing life span of individuals with developmental disabilities. The inability of many such individuals to advocate for themselves, limitations in financial mechanisms, and societal biases fuel health disparities. These articles propose recommendations for key changes in dental and other health professional training, advocate increased commitment to special populations in research agendas, and encourage collaboration across health professions and with community and advocacy groups. A strong emphasis on prevention must be a part of these changes.
Adolescent↗
Teaching Filipino physiotherapists on-shore: an Australian-Filipino collaborative postgraduate health education initiative.
INTRODUCTION: This paper outlines a collaborative, cross-national educational initiative, commenced in 2001, in which an Australian university provided clinical and research education assistance to a Filipino University. The aim was to establish the first Filipino Master of Science in Physical Therapy program that would train physiotherapists in their home country using best available content and teaching expertise. PROCESS: Principles of quality transnational education underpinned the program design and contractual agreements. Australian educational input was tailored to local constraints to ensure efficient and effective delivery of high quality, relevant material. Approximately 60% of the inaugural program was delivered by Australian educators in one-week intensive courses on-shore in the Philippines, using local facilities and case-scenarios. Follow-up support and evaluation were provided by video, email, written workbooks and assignments once these educators returned to Australia. Filipino graduates, who were competent with course content, taught the remaining subjects. In line with an aim of empowering Filipino graduates to assume responsibility for teaching all aspects of the program by 2006, the Australian educators are now teaching less than 25% of the course content to subsequent student cohorts. After 2006, they will provide mentorship only to the program. RESULTS: In 2003, 12 students in the first cohort graduated with Master of Science in Physical Therapy from the University of Santo Tomas (UST). Twenty-four students subsequently enrolled in the second cohort (commenced 2003) and 21 students into the third cohort (commenced 2004). Six of the inaugural graduate cohort are currently acting as tutors for the Australian educators and will assume full teaching roles in 2006. Comparison of feedback from student evaluations at UST indicates significant improvements in teaching quality for the graduates from the inaugural program. Research activity and publications have also increased as a result of completion of the program. DISCUSSION: Such a cross-institutional, cross-national program has not been described previously for physiotherapy, and no other similar health program (for nursing) evaluated the educational processes in the manner used in this program. The program met its aims and has produced sustainable educational outcomes and outputs. CONCLUSION: Future scholarly activities between the two institutions include extension of postgraduate training to other health disciplines, cross-institutional PhD student enrollments and collaborative research.
Australia↗
Health informatics and the humanities.
Researchers and professionals from the Humanities are new within the science of health informatics, where researchers and professionals from the natural sciences have so far de-fined the problems and their solutions. A cross-disciplinary collaboration can be difficult due to factors such as status and competition, to insufficient co-operation qualifications, and due to different definitions of problems. This paper presents examples of differently formulated health informatics problems. Cross-disciplinary collaboration is necessary but collaboration demands openness, curiosity, and readiness from researchers and professionals as well as it demands know-edge of the processes in cross-disciplinary cooperation. Considerations for cross-disciplines were actualized with the foundation in Denmark of the cross-disciplinary institution: The Virtual Centre for Health Informatics.
Cooperative Behavior↗
Discontinuation reactions to alprazolam in panic disorder.
Panic disorder is a chronic illness with only some degree of spontaneous recovery. It is not surprising therefore that discontinuation of an effective medical treatment may be followed by relapse. Therefore the timing and methodology of discontinuing that treatment are now recognized as essential facets of optimal clinical management. In addition to relapse, rebound and the withdrawal syndrome have been reported with many psychotropic agents, particularly with the benzodiazepines. This paper discusses data from three discontinuation studies with alprazolam i.e. the Phase I Cross-National Collaborative Panic discontinuation study after short-term treatment, the Phase I discontinuation study after long-term treatment, and data from the Montreal site of the Alprazolam SR discontinuation study. Phase I of the Cross-National Collaborative Study of Panic Disorder investigated the discontinuation of alprazolam in two populations. There was an intensive, placebo-controlled, time-limited study of discontinuation after short-term treatment (8 weeks) in the first population. For the second, there was a less rigorous open follow-up of patients who had been treated for 5-12 months with alprazolam. The dose-reduction regimen of alprazolam in both studies was approximately the same--a 1 mg decrease every 3-7 days. In the short-term treatment study, 109 patients were treated for 8 weeks, tapered for 4 weeks and observed for another 2 weeks post discontinuation. Significant relapse in the alprazolam-treated group occurred during discontinuation. Rebound of panic attacks occurred in 27% of patients given alprazolam, and distinct transient withdrawal syndrome occurred in 35%. Indicative of the withdrawal syndrome were confusion, clouded sensorium, heightened sensory perception, dysosmia, paresthesias, muscle cramps, muscle twitch, blurred vision, diarrhea, decreased appetite, and weight loss. The clinical course in the alprazolam-treated patients revealed a marked exacerbation of symptoms during the end of the tapering period and the first week without medication, which was followed by improvement during the second post-taper week. In the long-term treatment study, 142 patients were treated with alprazolam for periods ranging from 5 months to 1 year (mean, 27.5 weeks). In this naturalistic study, 76% of the patients reported improvement, 6.3% reported no change, and 10.6% reported that they were worse. During discontinuation, 12.8% of the 128 patients whose dosage was tapered reported some kind of nonspecified withdrawal symptoms. Of the 142 patients, 47.2% were able to taper their medication dosage and to discontinue treatment; 19.7% tapered but restarted alprazolam shortly after discontinuation; 33.1% were unable or unwilling to taper or discontinue alprazolam.(ABSTRACT TRUNCATED AT 400 WORDS)
Agoraphobia↗
IHF and The Health Research and Education Trust enter into new collaboration to encourage cross-national health research.
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Global Health↗
Virtual network computing: cross-platform remote display and collaboration software.
VNC (Virtual Network Computing) is a computer program written to address the problem of cross-platform remote desktop/application display. VNC uses a client/server model in which an image of the desktop of the server is transmitted to the client and displayed. The client collects mouse and keyboard input from the user and transmits them back to the server. The VNC client and server can run on Windows 95/98/NT, MacOS, and Unix (including Linux) operating systems. VNC is multi-user on Unix machines (any number of servers can be run are unrelated to the primary display of the computer), while it is effectively single-user on Macintosh and Windows machines (only one server can be run, displaying the contents of the primary display of the server). The VNC servers can be configured to allow more than one client to connect at one time, effectively allowing collaboration through the shared desktop. I describe the function of VNC, provide details of installation, describe how it achieves its goal, and evaluate the use of VNC for molecular modelling. VNC is an extremely useful tool for collaboration, instruction, software development, and debugging of graphical programs with remote users.
Chemistry↗
Cross-linguistic study of lateral misarticulation using electropalatography.
This paper reports on some preliminary aspects of a collaborative cross-linguistic study of normal and disordered Japanese and British English speech. The investigation compares lateralised productions of parallel s which are abnormal in the two languages. EPG and acoustic recordings were made of four Japanese and four British subjects. The EPG patterns were classified according to certain criteria, such as the presence or absence of complete constriction between the tongue and the hard palate, and the area and location of this contact. Findings revealed that lateralised articulations varied between individual speakers, but that Japanese and English productions were broadly similar. Acoustically, misarticulations in both languages were characterised by a lower frequency of peak energy than would be expected in normal productions.
Adolescent↗
Research into depressive disorder in later life: who is doing what? A literature search from 1998-2001.
AIMS AND BACKGROUND: The International Psychogeriatric Association (IPA) aims to improve the mental health care of older people globally. With regard to depression, a number of key publications over the past decade have highlighted areas of progress and areas requiring further research. In order to help clarify what progress has been made, the author conducted a literature review of original research subsequent to three recent major reviews. METHOD: A literature search of four databases over the period 1998-October 2001. Publications with an abstract in English were studied to ascertain number of relevant publications; type of research methodology; topics; and where the research originated. RESULTS: A total of 1,002 publications meeting predefined criteria were located. Fifty-nine percent were cross-sectional studies; less than 10% were randomized controlled studies. The most common themes were depression with comorbidity and etiology, accounting for almost half the papers, with stroke and Parkinson's disease the most frequently researched comorbid medical disorders, although interest in Alzheimer's disease, heart disease, hip fracture, and chronic lung disease appears to be increasing. There were comparatively few studies of psychological and psychosocial interventions. A quarter of the publications concerned major depressive disorder. There were striking variations in the origin of publications with two regions, North America and Northern Europe, accounting for two thirds of all publications but only 13.7% of the world's population aged 65 and over. CONCLUSIONS: Progress is being made but it might occur more rapidly and with greater scope with more international and cross-center collaboration.
Aged↗
Sex offender management: the public policy challenges.
Few issues within the crime policy arena are as volatile as those involving sex offending, yet there is an enormous "knowledge gap" between research, science, and clinical practice, on the one hand, and the policy and criminal justice practitioner communities, on the other. Recent highly publicized cases involving sex offending, which have elevated the issue in the public eye, provide an opportunity for experts in this field to play an aggressive role in informing this debate. In particular, high priority should be given to developing more effective means of communicating to policymakers, practitioners, the media, elected officials, and the public what is known from science and clinical practice about sex offending and about what works in addressing it. A strong commitment to greater cross-disciplinary collaboration is also needed, as is federal leadership, particularly in supporting a cross-department research agenda. Researchers and other experts in this field can play a valuable role in helping ensure rational and effective public policy relating to sex offending that can achieve public safety and help reduce future victimization.
Child↗
Linking science to policy. The role of international collaborative research.
This article traces the modern history of alcohol policy research on an international level, focusing on cross-national collaborative studies, a recent phenomenon that has dramatically increased our scientific understanding of how alcohol-related problems can be prevented or reduced through organized action by governments and public health organizations. The studies reviewed here show that during the past 25 years, a small but growing cadre of alcohol research professionals has used a problem-focused, integrative research approach to more closely align alcohol research with public policy.
Alcohol Drinking↗
Collaboration among nurse executives in complex environments: fostering administrative best practice.
In the past decade, many healthcare institutions have formed new partnerships, alliances, and networks. Collaboration among chief nursing officers and other leaders from affiliating institutions is essential to the success of these new organizational structures. The authors explore the nature of the collaboration among chief nursing officers and senior nurse leaders at 5 Harvard-affiliated teaching hospitals that provide cancer care. In particular, this article examines how collaborative relationships have been fostered and highlights the challenges, benefits, and outcomes of successful cross-institutional collaboration.
Benchmarking↗
The governance and management of effective community health partnerships: a typology for research, policy, and practice.
Community health partnerships (CHPs) are voluntary collaborations of diverse community organizations that have joined forces in order to pursue a shared interest in improving community health. Although these cross-sectoral collaborations represent a way to address social determinants of health and disease in society, they suffer from governance and management problems associated with interorganizational relationships in general and health care challenges specifically. A typology of effective governance and management characteristics provides a systematic, theoretically based way of addressing dimensions of governance and management and serves as a guide in constructing, maintaining, and measuring successful partnerships. It offers a multidisciplinary perspective for classifying important organizational issues, identifying barriers to successful development and sustainability, and facilitating the attainment of goals.
Community Health Planning↗
Dietary assessment tools for developing countries for use in multi-centric, collaborative protocols.
In recent years, increasing interest in the format of multi-centric studies among different populations in developing nations has evolved in the field of health surveys and epidemiology. Dietary intake data are most often part of these cross-cultural and cross-national collaborative efforts. Various questions have been raised about the appropriate endeavours for dietetics and nutritional sciences in developing societies, the instruments available for application, and the pitfalls and caveats in their use. An important consideration is that studies be hypothesis-driven and not mere 'fishing expeditions' of unfocused data gathering. All known dietary intake measurement tools are within the preview of developing country research, but they often must be adapted individually and differentially to suit a given population. In a multi-centric context, this is complicated. The watchword should be collecting comparable information across sites, not using identical approaches. Choice of dietary intake measurement tools must be honed to the hypotheses and assumptions, on the one hand, and the exigencies and pitfalls of working in the developing country milieu, in which linguistics, seasonality, migration, uncommonness of food systems and ethical considerations present barriers and caveats, on the other. Within the hypotheses, the assumptions regarding the penetration of the measured exposures must be borne in mind. Multi-centre studies in developing countries have relevance and importance in the context of food security, diet and disease, eating behaviour and satiety regulation, and nutritional anthropology.
Adult↗
Transmission of human T-lymphotropic virus types I and II by blood transfusion. A retrospective study of recipients of blood components (1983 through 1988). The American Red Cross HTLV-I/II Collaborative Study Group.
We studied results of a "lookback" program involving laboratory testing and interviews of 133 recipients of prior donations from blood donors seropositive for human T-lymphotropic virus types I and II (HTLV-I/II) identified at 28 American Red Cross blood centers. The study was designed to explore the natural course of posttransfusion HTLV-I/II infection among individuals who received blood components from donors subsequently identified as being HTLV-I/II seropositive. Seventeen recipients were seropositive, an apparent transmission rate of 12.8%. Red blood cells and platelets were the implicated components, and red blood cells that were less than 6 days old had a transmission efficiency of 80%. Virus typing enabled documentation of primary and secondary transfusion transmission of HTLV-I and HTLV-II, including the direct transmission of HTLV-II by a donor with a history of intravenous drug use. We conclude that transfusion transmission of HTLV-I/II to approximately 700 recipients per year occurred in the United States before routine donor testing began in 1988.
Adolescent↗
Journey across the disciplines: a foundation for scientific communication in bioastronomy.
As an increasing number of fascinating discoveries within the realm of bioastronomy appear in media headlines, participating scientists continue to pursue ways of insuring the long-term success of the scientific discipline. In an effort to foster cross-disciplinary collaboration, communication, and training for scientists involved in bioastronomy research, a team of scientists and science education professionals have developed a survey to assess (1) the degree to which scientists in bioastronomy define themselves as interdisciplinary scientists, (2) the extent to which scientists identify their needs for professional development opportunities to become more effective interdisciplinary collaborators, and (3) what services and infrastructure the bioastronomy community needs to develop for long-term productive interdisciplinary communication, collaboration, research and training. The results of a survey, distributed at the 2004 Astrobiology Science Conference (held at Moffett Field, CA), serve the bioastronomy science community by providing a sound research baseline that informs decisions and targeted efforts to increase cross-disciplinary communication, gathering information about needed professional development opportunities for scientists, and generating insights for training of the next generation of astrobiologists. Results indicate that members of the community feel that interdisciplinary communication and collaboration can best be supported by (1) increased funding opportunities, (2) scheduled time for collaboration at professional meetings, (3) reduction of concurrent sessions at professional meetings, and (4) creation of professional development opportunities for scientists.
Astronomical Phenomena↗