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A centenary of academic and less learned food microbiology. Pitfalls of the past and promises for the future.

A review is presented of the development of Food Microbiology from its roots in different disciplines - including human and animal medicine, general microbiology, agricultural science and food chemistry - to an autonomous science with the main vocation to provide the knowledge allowing providing food that is wholesome, of high quality and acceptable in the microbiological sense. This evolution entailed a change in approach from mere, and often rather primitive inspection of end-products to intervention by (i) identification of hazard points ("critical points" or CPs) by ecological studies; (ii) elimination of CPs by elaboration of Good Manufacturing and Distribution Practices (GMPs); (iii) validation of GMPs by monitoring production lines and final products at point of sale and gauging the results by Risk Analysis. It is emphasized, that although advanced and ecologically sound techniques have become available, it will still require extensive education and training at all levels before the scientific advances outlined in this review will have been fully integrated in day-to-day food production and catering in developed as well developing areas of the world. Interdisciplinary instruction and co-operation cannot be missed in attempts to reach this goal.

Bacterial Infections↗

Science, politics, and peer review. An editor's dilemma.

The American Psychologist is the official journal of the American Psychological Association. As such, it is a valued outlet for articles dealing with reviews of current topics in psychology, policy issues, and critiques of current research. S. O. Lilienfeld submitted a manuscript to the journal that was accepted by the ad hoc action editor; however, the action editor's decision was later overruled by the editor, and additional changes to the manuscript were requested. Because of this editorial decision, a controversy arose that played out on various Internet discussion groups. The author presents his perspective as the editor in this controversy. Points of emphasis include the need to protect the integrity and the confidentiality of the peer review process for scientific journals.

Humans↗

Enteral nutrition and mucosal immunity: implications for feeding strategies in surgery and trauma.

Systemic inflammatory responses to severe trauma and surgical illnesses may be partly responsible for numerous complications, including sepsis, multiple organ failure and unregulated hypermetabolism leading to protein-calorie malnutrition. The integrity of the gastrointestinal tract appears to be an important factor in the pathogenesis of the systemic inflammatory response and sepsis. Resuscitation and nutrition support strategies for preserving gut mucosal integrity have therefore been strongly promoted. This review summarizes the scientific rationale for emphasizing enteral nutritional support of surgical patients, discusses some important limitations of enteral feeding and argues for a flexible approach to nutrition support for these complex patients.

Critical Illness↗

Principles and philosophy of modeling in biomedical research.

Despite widespread applications in biomedical research, the role of models and modeling is often controversial and ill understood. It is usual to find that fundamental definitions, axioms, and postulates used in the modeling process have become tacit assumptions. What is essential, however, is a clear vision of the fundamental principles of modeling. This is even more compelling for new and emerging interdisciplinary fields that use techniques from previously separate scientific disciplines. This article outlines and reviews the central nature and philosophy of modeling, the rules that govern it, and its underlying key integral relationship to the 'scientific method'. A comprehensive understanding of these issues is indispensable to successful research and meaningful progress in all facets of biomedicine.

Communication↗

An integrative review and meta-analysis of oncology nursing research: 1981-1990.

The systematic accumulation of widely scattered research results is essential to developing a scientific basis for clinical practice. The purposes of this study were to describe 10 years of patient-related oncology nursing research in the United States, assess effectiveness of interventions, and test a prototype for research synthesis projects. Using a nursing framework and strategies of integrative research review and meta-analysis, 428 studies were selected for the study. The studies were found to be predominantly descriptive (90%), with convenience samples (79%), and a median sample size of 48. Subjects were predominantly in treatment or rehabilitation (52%), with demographic and stage of disease characteristics largely unreported. Of the 428 studies, 42 met the criteria for meta-analytic treatment. Interventions were found to be significantly effective, with membership in the intervention group improving success rate by 22%. The prototype was judged highly for adherence to standards and usefulness for adaptation to other research syntheses. Because of wide diversity in topics studied, missing information on subjects, and lack of replication, implications for research-based practice are premature at this time. Recommendations for future research include new studies, replications, and new research syntheses with an international scope for nurses studying and providing cancer care.

Nursing Research↗

Interventions for children with neurodevelopmental delay.

OBJECTIVES: To review studies in the scientific literature of five physical interventions commonly recommended for children with neurodevelopmental delay. DESIGN: A literature search for and a review of the results of controlled and other studies conducted in the course of the last 25 years. SETTING: Institute of Child Health, University of Cape Town. SUBJECTS: Patterning; neurodevelopmental therapy; sensory integrative therapy; optometric visual training; auditory integration therapy. OUTCOME MEASURES: Findings and conclusions drawn in the studies reviewed. RESULTS: Controlled studies fail to provide evidence to support claims made for the five interventions examined. CONCLUSIONS: In the absence of scientific evidence for efficacy patterning, neurodevelopmental therapy, sensory integrative therapy, optometric visual training and auditory integrative therapy cannot be recommended for children with neurodevelopmental delay.

Behavior Therapy↗

Use of the genus Artemia in ecotoxicity testing.

Information related to varied uses of several species of the genus Artemia (commonly known as brine shrimp), is dispersed among literature from several scientific areas, such as Ecology, Physiology, Ecotoxicology, Aquaculture and Genetics. The present paper reviews information related to Artemia that may be considered relevant for ecotoxicity testing. Integration of different areas of scientific knowledge concerning biology, life cycle and environmental needs of Artemia is of crucial importance when considering the interpretation of results drawn from tests involving this genus. Furthermore, this paper provides suggestions to overcome problems related to toxicity assessment with the use of Artemia as test organism in bioassays, under the scope of estuarine, marine and hypersaline environments. Aspects related to variability in results, adoptable toxicity end-points, culture conditions, characteristics of species and strains, influence of geographical origins over physiological features and responses to exposure to chemical agents are considered.

Animals↗

Miniaturization technologies for molecular diagnostics.

BACKGROUND: Molecular diagnostics devices are becoming smaller. With the advancement of miniaturization technologies, microchip-based systems will soon be available for genetic testing. The purpose of this review is to highlight the underlying principles in miniaturization, the strategies being developed for bioanalysis, and the potential impact on the practice of this rapidly growing medical discipline. APPROACH: The author discusses DNA microchips and their practical importation into the clinical laboratory, based on his background in medical device and microchip design and development. His discussion is supported by a body of literature covering both biomedical and electrical engineering and more recent publications in the field of molecular genetics and pathology. CONTENT: This review is descriptive and intended to outline the technologic and methodologic approaches to the creation of an integrated genetic analysis instrument based on miniature components. The review draws on published scientific evaluations of these devices without regard to the companies involved in their development. SUMMARY: The intent of this review is that the reader will better understand the variety of technical approaches toward the miniaturization of molecular genetic testing for the clinical laboratory. With insight into the principles underlying the operation of these chips and the integrated systems, the end user can better evaluate the value to the field in terms of making molecular genetics testing simpler, faster, and less expensive.

Biosensing Techniques↗

Systematic reviews of medical evidence: the use of meta-analysis in obstetrics and gynecology.

OBJECTIVE: To review the technique of meta-analysis and its uses and limitations in obstetrics and gynecology. DATA SOURCES: We reviewed four major journals in obstetrics and gynecology (American Journal of Obstetrics and Gynecology, Fertility and Sterility, Journal of Reproductive Medicine, and Obstetrics & Gynecology). METHODS OF STUDY SELECTION: Journals were reviewed to determine frequency of meta-analysis as a method of systematic review in obstetrics and gynecology. We also summarized objectives and scientific guidelines for performing a meta-analysis. TABULATION, INTEGRATION, AND RESULTS: Meta-analysis is used with increased frequency in obstetrics and gynecology as a way of systematically reviewing medical evidence. This technique is an attempt to improve on traditional methods of narrative review by an expert and as a framework for evidence-based medicine and developing practice guidelines. By combining data from replicate studies, a meta-analysis can increase statistical power, more precisely estimate the typical effect size of treatment or risk factor, and attempt to resolve controversies in the medical literature. Meta-analysis is a retrospective look at data already collected and is therefore subject to the biases of all retrospective studies. CONCLUSIONS: The technique of meta-analysis requires all the scientific rigor of a randomized clinical trial with careful attention to study design, including a formal protocol for literature search strategies, quality assessment of candidate studies, specific inclusion and exclusion criteria, issues of sampling and publication bias, statistical tests of homogeneity, and sensitivity analysis.

Evidence-Based Medicine↗

Understanding paradigms used for nursing research.

AIMS: The aims of this paper are to add clarity to the discussion about paradigms for nursing research and to consider integrative strategies for the development of nursing knowledge. BACKGROUND: Paradigms are sets of beliefs and practices, shared by communities of researchers, which regulate inquiry within disciplines. The various paradigms are characterized by ontological, epistemological and methodological differences in their approaches to conceptualizing and conducting research, and in their contribution towards disciplinary knowledge construction. Researchers may consider these differences so vast that one paradigm is incommensurable with another. Alternatively, researchers may ignore these differences and either unknowingly combine paradigms inappropriately or neglect to conduct needed research. To accomplish the task of developing nursing knowledge for use in practice, there is a need for a critical, integrated understanding of the paradigms used for nursing inquiry. METHODS: We describe the evolution and influence of positivist, postpositivist, interpretive and critical theory research paradigms. Using integrative review, we compare and contrast the paradigms in terms of their philosophical underpinnings and scientific contribution. FINDINGS: A pragmatic approach to theory development through synthesis of cumulative knowledge relevant to nursing practice is suggested. This requires that inquiry start with assessment of existing knowledge from disparate studies to identify key substantive content and gaps. Knowledge development in under-researched areas could be accomplished through integrative strategies that preserve theoretical integrity and strengthen research approaches associated with various philosophical perspectives. These strategies may include parallel studies within the same substantive domain using different paradigms; theoretical triangulation to combine findings from paradigmatically diverse studies; integrative reviews; and mixed method studies. CONCLUSION: Nurse scholars are urged to consider the benefits and limitations of inquiry within each paradigm, and the theoretical needs of the discipline.

Attitude of Health Personnel↗

What can posturography tell us about vestibular function?

Patients with balance disorders want answers to the following basic questions: (1) What is causing my problem? and (2) What can be done about my problem? Information to fully answer these questions must include status of both sensory and motor components of the balance control systems. Computerized dynamic posturography (CDP) provides quantitative assessment of both sensory and motor components of postural control along with how the sensory inputs to the brain interact. This paper reviews the scientific basis and clinical applications of CDP. Specifically, studies describing the integration of vestibular inputs with other sensory systems for postural control are briefly summarized. Clinical applications, including assessment, rehabilitation, and management are presented. Effects of aging on postural control along with prevention and management strategies are discussed.

Posture↗

Misconduct and fraud in research: social and legislative issues symposium of the Society of University Surgeons.

The symposium was concluded with a question and answer period, which served to clarify and further emphasize the aforementioned issues. Many concerns of coauthorship responsibilities, due process, and potential sanctions were discussed. Moral and ethical issues reflecting the extent of punishment, reporting of misconduct to hospitals and specialty boards, and the almost assured litigation and counter-litigation were approached with considerable apprehension and concern. Misconduct in science will clearly be monitored more closely than in the past. Increasing coauthorship responsibility, conscientious senior investigator supervision, and institutional cooperation will provide the framework to discourage dishonesty in science and encourage proper educational development of both young and established investigators in a milieu of scientific integrity.

Biomedical Research↗

US EPA's IRIS pilot program: establishing IRIS as a centralized, peer-reviewed data base with agency consensus. Integrated Risk Information System.

The US EPA's Integrated Risk Information System (IRIS) contains Agency consensus scientific positions and quantitative values on cancer and noncancer health effects that may result from lifetime oral or inhalation exposure to specific chemical substances in the environment. Combined with specific exposure assessment information, the summary health information in IRIS may be used as a source in evaluating potential public health risks from environmental contaminants. IRIS is available to the public via EPA's Internet server at http://www.epa.gov/iris. Originally developed for internal EPA use, IRIS usage has broadened since being made publicly available in 1988 to include the private and public sectors nationally and internationally. Up to 1995, IRIS summaries were generated from within various EPA Offices and Regions and reviewed by Agency Workgroups, one for cancer and one for noncancer endpoints, before entry onto IRIS. In response to the increasing usage and recognition of IRIS and suggestions for improvement, an IRIS Pilot program was initiated in 1995. The purpose of the Pilot was 3-fold: To improve efficiency in getting information on to IRIS; to improve documentation for the positions reported in IRIS summaries, including applying new methodologies and guidance; and to improve opportunity for public input including external peer review. A new infrastructure was put in place, consisting of a cross-Agency team of 'Chemical Managers', a Pilot Program Manager, and a set of Agency 'Consensus Reviewers'. Cancer and noncancer assessments were prepared in an integrated fashion for Pilot chemical substances, documented in 'Toxicological Reviews' and derivative IRIS summaries. Public input was emphasized via an initial data call and rigorous external peer review. A final step was Agency-wide consensus review by senior staff scientists representing EPA's Offices and Regions. EPA's experience with the Pilot is forming the basis for designing operational aspects of the long-term IRIS program.

Benchmarking↗

One editor's views on conflict of interest.

The purpose of this article is to discuss the importance of recognizing conflict of interest or bias situations in the peer review and publication process of research papers and to identify some important guidelines or policies that help to minimize these situations. Communication of thoughts, ideas, and information is the basis of how we function as a society. Communicating research results requires us to clearly and accurately communicate all aspects of the research process, including the appropriate interpretation of results. A working definition for conflict of interest or bias with regard to publishing research results is that conflict of interest is a situation in which personal benefit (either direct or indirect) takes priority over the clarity and(or) accuracy of reporting research. These situations are ethical issues and can represent either real or assumed situations. It is true that the review and publication process is not perfect; thus, some bias probably is always present and can be brought to the review and publication process by either the author or those responsible for the process. However, conflict of interest or bias that detracts from the objective evaluation of research or the integrity of a scientific journal is inappropriate. Conflict of interest or bias situations can occur at all levels of the review and publication process and should be dealt with on a factual basis. This article describes several situations as examples and several important guidelines that help minimize the occurrence of conflict of interest or bias.

Bias↗

Biological effects of exposure to magnetic resonance imaging: an overview.

The literature on biological effects of magnetic and electromagnetic fields commonly utilized in magnetic resonance imaging systems is surveyed here. After an introduction on the basic principles of magnetic resonance imaging and the electric and magnetic properties of biological tissues, the basic phenomena to understand the bio-effects are described in classical terms. Values of field strengths and frequencies commonly utilized in these diagnostic systems are reported in order to allow the integration of the specific literature on the bio-effects produced by magnetic resonance systems with the vast literature concerning the bio-effects produced by electromagnetic fields. This work gives an overview of the findings about the safety concerns of exposure to static magnetic fields, radio-frequency fields, and time varying magnetic field gradients, focusing primarily on the physics of the interactions between these electromagnetic fields and biological matter. The scientific literature is summarized, integrated, and critically analyzed with the help of authoritative reviews by recognized experts, international safety guidelines are also cited.

Animals↗

[Research direction for syndromes of traditional Chinese medicine: differentiating diseases from syndromes and differentiating syndromes from diseases].

By historical review on integrative research of syndrome differentiation and disease differentiation and considering the scientific research method of traditional Chinese medicine (TCM), the syndrome is the key subject of clinical study on TCM. During the recent 10 years or more, many new diseases and diagnostic approaches have been found and developed in Western medicine, while in TCM, the advances in research on syndrome can not keep up with the requirements of clinical practice. This problem was caused by three matters as follows: (1) Syndrome differentiation and its classification have been conservative and lack of new discovery; (2) The thinking pattern of clinical practice has been focused on disease differentiation, and only complemented by syndrome differentiation; (3) The treatment has been concentrated on the disease instead of on the syndrome. Considering these problems, the author has put forward the thinking pattern of clinical research, that is "to differentiate diseases from syndromes and to differentiate syndromes from diseases". In this way, many new syndromes and diseases will be discovered with the improvement of disease and syndrome differentiations. These advances will provide rich resources for basic theoretical and pharmacal studies of TCM, and improve the common understanding of TCM in the world.

Clinical Medicine↗