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A prologue on science and statistics focuses attention on the role of statistics in science. Statisticians must be trained as scientists and to meet the needs of science. Those needs surely involve the formulation, modification and verification of stochastic models designed to represent natural phenomena. The method of paired comparisons provides a simple experimental technique but one with a literature rich in model development.
The nursing care of cancer patients has increased in complexity over the past 20 years. Cancer nurses are offering highly specialized care that is frequently delivered in teamwork in hospitals as well as in the community. Cancer nursing uses the development of nursing science and research. Nurses could not be accountable for their practice if this expert knowledge was not made accessible to them. This article focuses on nursing science as a new development in clinical nursing practice in Germany, it identifies why cancer nursing is so demanding on part of the patients, their families (significant others) and professional nurses. Research studies are discussed to demonstrate how scientific knowledge can support the nursing expert in the development of cancer nursing care, a well developed domain of nursing science.
Psychoactive drugs are used almost universally for the pleasure and benefits which they can provide, but they also cause sufficient harm that most societies have adopted policies to control and limit the amount of use. Science is increasingly called upon to provide a rational basis for these policies. However, the biological sciences and modern sociology have fundamentally different approaches to such issues, the former being based on the concept that there is an external reality which can be discovered only by objective means, the latter holding that social problems are defined strictly subjectively and can not be separated from the values and ideologies of the researchers. Since social policy affects all members of a society, and must reflect all of their attitudes, values and traditions, science can contribute only facts and probabilities, but society as a whole must assign the values and make the required choices.
The University of North Carolina at Chapel Hill evaluated five curricular models designed to improve education for health sciences librarianship. Three of the models enhanced existing degree and certificate programs, and two were new programs for working information professionals. Models were developed with input from experts and a Delphi study; the marketability of the models was tested through surveys of potential students and employers; and recommendations were made as a guide to implementation. The results demonstrated a demand for more specialized curricula and for retraining opportunities. Marketing data showed a strong interest from potential students in a specialized master's degree, and mid-career professionals indicated an interest in postmaster's programs that provided the ability to maintain employment. The study pointed to the opportunity for a center of excellence in health sciences information education to enable health sciences librarians to respond to their evolving roles.
This paper explores the perceptions of staff and students regarding the supporting sciences within nursing education and how they feel such content relates to the 'real world' of nursing. A qualitative study examining the perceptions of students and teaching staff, particularly the concept of relevance, was conducted to explore factors which impact upon the integration of theory and practice. The teaching approaches used, assessment items selected, and the perceptions held about what nurses actually do all impinge upon what, and how, students learn in subjects which are essentially non-nursing in their orientation. Through an awareness of factors affecting how students and teaching staff actually approach supporting sciences content, better informed curriculum decisions can be made.
The scope of medical science has broadened to embrace subject areas in the behavioral and social sciences. Medical school curricula have responded to this trend, and the response is inevitably making itself felt in the medical school library. One medical school library's efforts to identify significant library materials in this area are presented as an example of a technique and as an indication of an order of magnitude. A master list of appropriate journal titles is appended.
The National Institutes of Health (NIH) is the world's largest biomedical research agency, with a 75-year record of responding to the nation's key medical challenges. Today, medical science is entering a revolutionary period marked by a shift in focus from acute to chronic diseases, rapidly escalating health care costs, a torrent of biological data generated by the sequencing of the human genome, and the development of advanced high-throughput technologies that allow for the study of vast molecular networks in health and disease. This unique period offers the unprecedented opportunity to identify individuals at risk of disease based on precise molecular knowledge, and the chance to intervene to preempt disease before it strikes. Conceptually, this represents the core scientific challenge of the coming century. The NIH is committed to the discoveries that will change the practice of medicine as we know it in order to meet this challenge. The NIH Roadmap constitutes an important vehicle for generating change-a most critical element of this plan is the reengineering of the national clinical research enterprise. This reinvention will call for the transformation of translational clinical science and for novel interdisciplinary approaches that will advance science and enhance the health of the nation.
The radical changes and improvements in health sciences libraries during the last quarter century have been primarily achieved through the leadership of the National Library of Medicine (NLM) in the application of technology and in the creation of a biomedical communications network. This article describes principal programs and activities of the National Library of Medicine and their effects on health sciences libraries: the Medical Literature Analysis and Retrieval System (MEDLARS), implementation of the Medical Library Assistance Act (MLAA), and defense of "fair use" of copyrighted material. The article briefly summarizes more recent Federal activities which directly affect access to and dissemination of health information and concludes with a summary of problems for which solutions must be found if health sciences libraries are to be prepared to meet the future. It is clear from comparing the programs described with current government attitudes that, although the Federal government has promoted advancement in the dissemination of biomedical information in the past, this trend is reversing, and Federal funding to libraries is decreasing while the cost of accessing information is increasing.
Mathematical modeling is an effective tool for guiding cervical cancer screening, diagnosis, and treatment decisions for patients and policymakers. This article describes the use of mathematical modeling as outlined in five presentations from the Decision Science and Cervical Cancer session of the Second International Conference on Cervical Cancer held at The University of Texas M. D. Anderson Cancer Center, April 11-14, 2002. The authors provide an overview of mathematical modeling, especially decision analysis and cost-effectiveness analysis, and examples of how it can be used for clinical decision making regarding the prevention, diagnosis, and treatment of cervical cancer. Included are applications as well as theory regarding decision science and cervical cancer. Mathematical modeling can answer such questions as the optimal frequency for screening, the optimal age to stop screening, and the optimal way to diagnose cervical cancer. Results from one mathematical model demonstrated that a vaccine against high-risk strains of human papillomavirus was a cost-effective use of resources, and discussion of another model demonstrated the importance of collecting direct non-health care costs and time costs for cost-effectiveness analysis. Research presented indicated that care must be taken when applying the results of population-wide, cost-effectiveness analyses to reduce health disparities. Mathematical modeling can encompass a variety of theoretical and applied issues regarding decision science and cervical cancer. The ultimate objective of using decision-analytic and cost-effectiveness models is to identify ways to improve women's health at an economically reasonable cost.
Plaud (J Clin Psychol 57, 1089-1102, 1109-1111, 1119-1120) and Ilardi and Feldman (J Clin Psychol 57, 1067-1088, 1103-1107, 1113-1117, 1121-1124) argue for two very different approaches to clinical science and practice (i.e., behavior analysis and cognitive neuroscience, respectively). We comment on the assets and liabilities of both perspectives as presented and attempt to achieve some semblance of balance between the three protagonists embroiled in this current debate. The vision of clinical science we articulate is more ecumenical and evolutionary, rather than paradigmatic and revolutionary. As we see it, the problem clinical psychology faces is much larger than the authors let on; namely, how best to make clinical science meaningful and relevant to practitioners, consumers, the general public, and the behavioral health-care community. Clinical psychology's immediate internal problem is not pluralism with regard to subject matter, worldview, methodology, or school of thought, but pluralism in clinical psychologists' adherence to a scientific epistemology as the only legitimate form of clinical psychology. On this latter point, we still have a very long way to go.
A proposed multiyear plan of funding mechanisms by the National Center for Nursing Research (NCNR) to increase the use of biological theory and measurements in nursing research has been developed for both research training and research programs. The objectives of the research training programs are (a) to develop a cadre of nurse scientists with solid research training in the biological sciences, (b) to upgrade to state-of-the-art biological research for mid-career nurse scientists, and (c) to ensure adequate highly trained biological-nurse manpower will be available to accomplish the nation's nursing research agenda. The objectives of the research programs are (a) to stimulate nurse scientists to undertake novel, innovative research using state-of-the-art biological technology, (b) to link the behavioral and biological underpinnings of nursing science in specified areas of biomedical clinical research, and (c) to ensure that, in the coming decade, nursing science and behavioral research will be inextricably interwoven with biological research. The research training programs include: targeted predoctoral-postdoctoral transitional training, targeted predoctoral or postdoctoral fellowships, training awards for existing institutional training grants in other disciplines, mid-career awards, the Nurse Scientist award, and institutional training grants for biological nursing. The research programs include: small grants programs, augmentation of existing projects in other Institutes, Requests For Applications (RFA) in biobehavioral nursing, cluster studies, and clinical trials.
Multiple chemical sensitivities (MCS) defies diagnostic categorization because of its pansystemic manifestations, its lack of consistent symptomatology, and its absence of specific, measurable endpoints, either physical stigmata or laboratory findings. Controlled studies have been few and difficult to perform. Moreover, the phenomenon resists systematic investigation for two reasons. First, it has coalesced into a movement championed by zealous proponents and organized adherents. Second, it has gained support in the courts, the legislatures, and the regulatory agencies which have provided special protection and monetary awards to this phenomenon before science and medicine have defined it as a medical disorder. One hotly contested issue in the MCS debate is the relative role of organic versus psychological contribution to the symptoms of MCS patients. This is a critical issue most importantly because it determines approaches to treatment, secondarily because it affects regulatory action, disability determination, and compensability. The interest of the ISRTP in this phenomenon derives from the significant regulatory impact of this diagnosis on OSHA standards, EPA regulations, and FDA standards. The symposium was convened to explore the quality of the science underlying MCS with respect to diagnosis, and, particularly, to cause. The general objective of the symposium was to discuss the state of the science regarding MCS and its implications in regulatory toxicology and public health. The panel of speakers represented a variety of disciplines including toxicology, immunology, occupational medicine, psychiatry, psychology, epidemiology, and public health. The symposium was attended by a diverse audience representing the medical, scientific, business, legal, and regulatory communities. The majority of speakers critically questioned the characterization of MCS as a clinical entity, in light of historical comparisons to earlier false diagnoses, toxicological implausibility, and clinical inconsistencies.
A study was done during 1991-1992 to determine the perceived impact of electronic mail (E-mail) relative to other forms of communication in health sciences institutions. E-mail subscribers at two major health sciences institutions were sent 2919 surveys, and 823 (28%) completed survey instruments were returned. A significant positive impact of E-mail was found relative to other forms of communication (e.g., paper, phone) with regard to E-mail messaging, response rates, influence, value, formality, perceptions, errors in communication, cost-effectiveness, communication style, and other factors. Areas where no differences were found between communication mechanisms were also revealing. Technical problems, maintenance, and confidentiality of E-mail messaging were not found to be significant problems. Trends, value, and impact of E-mail use in health sciences institutions are also discussed.
Chemistry, molecular biology and biology have turned into visive sciences in which ideas and information are communicated by artistic impressions and cartoons. These sciences have, in fact, become dominated by what we term the Pictographic molecular paradigm under which reality is acritically approximated by drawings of some kind. But it goes further than this and has both social and philosophical implications of which, we feel, there is insufficient general awareness. Important questions should be asked in connection with this way of doing science, including, for example, as to whether drawings of chemical formulae and graphical representation in biology meet the criterion of objectivity. This paper discusses some of the implications of the pictographic molecular paradigm and its limits and dangers.
It is increasingly obvious that social science, while not a sufficient condition for making ecosystem management effective, is a necessary condition. A social science typology of ecosystems is developed, applied, and shown to have substantial and unexpected implications for the practice of ecosystem management. Ecologists and environmental scientists, in particular, will find some conclusions uncomfortable. The application involves a case material from the California northern spotted owl controversy.KEY WORDS: Ecosystem management; Social science; Adaptive management; Top-down versus bottom-up planning; Outside-in versus inside-out planning
The current research agenda in environmental science is dominated by calls to integrate science and policy to better understand and manage links between social (human) and natural (nonhuman) processes. Freshwater resource management is one area where such calls can be heard. Designing computer-based models for integrated environmental science poses special challenges to the research community. At present it is not clear whether such tools, or their outputs, receive much practical policy or planning application. It is argued that this is a result of (1) a lack of appreciation within the research modeling community of the characteristics of different decision-making processes including policy, planning, and (2) participation, (3) a lack of appreciation of the characteristics of different decision-making contexts, (4) the technical difficulties in implementing the necessary support tool functionality, and (5) the socio-technical demands of designing tools to be of practical use. This article presents a critical synthesis of ideas from each of these areas and interprets them in terms of design requirements for computer-based models being developed to provide scientific information support for policy and planning. Illustrative examples are given from the field of freshwater resources management. Although computer-based diagramming and modeling tools can facilitate processes of dialogue, they lack adequate simulation capabilities. Component-based models and modeling frameworks provide such functionality and may be suited to supporting problematic or messy decision contexts. However, significant technical (implementation) and socio-technical (use) challenges need to be addressed before such ambition can be realized.
Critical life events (e. g. disease, loss of be loved one) biographically represent important turning points, which concerned people have to cope and deal with. While biographical research, which is established in the human and social sciences, has been dealing for a long time with typical features, such as on the type of a disease-dependent burden and coping processes, biographical oriented research approaches in nursing science are in their early stages. The article at hand has its goal in discussing the connectivity, particularly the social-interpretative biographical research in nursing science and their relevance for the development of supporting concepts regarding nursing; with the intention to rehabilitate the sufferer as the author of his own life story.
Positron emission tomography (PET) is a 3-dimensional imaging technique that has undergone tremendous developments during the last decade. Non-invasive tracing of molecular pathways in vivo is the key capability of PET. It has become an important tool in the diagnosis of human diseases as well as in biomedical and pharmaceutical research. In contrast to other imaging modalities, radiotracer concentrations can be determined quantitatively. By application of appropriate tracer kinetic models, the rate constants of numerous different biological processes can be determined. Rapid progress in PET radiochemistry has significantly increased the number of biologically important molecules labelled with PET nuclides to target a broader range of physiologic, metabolic, and molecular pathways. Progress in PET physics and technology strongly contributed to better scanners and image processing. In this context, dedicated high resolution scanners for dynamic PET studies in small laboratory animals are now available. These developments represent the driving force for the expansion of PET methodology into new areas of life sciences including food sciences. Small animal PET has a high potential to depict physiologic processes like absorption, distribution, metabolism, elimination and interactions of biologically significant substances, including nutrients, 'nutriceuticals', functional food ingredients, and foodborne toxicants. Based on present data, potential applications of small animal PET in food sciences are discussed.