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At least 19 recordsLinked to original sources
PubMed2025

Advancing the fight against tuberculosis: integrating innovation and public health in diagnosis, treatment, vaccine development, and implementation science.

Tuberculosis (TB) remains one of the leading causes of infectious disease mortality worldwide, increasingly complicated by the emergence of drug-resistant strains and limitations in existing diagnostic and therapeutic strategies. Despite decades of global efforts, the disease continues to impose a significant burden, particularly in low- and middle-income countries (LMICs) where health system weaknesses hinder progress. This comprehensive review explores recent advancements in TB diagnostics, antimicrobial resistance (AMR surveillance), treatment strategies, and vaccine development. It critically evaluates cutting-edge technologies including CRISPR-based diagnostics, whole-genome sequencing, and digital adherence tools, alongside therapeutic innovations such as shorter multidrug-resistant TB regimens and host-directed therapies. Special emphasis is placed on the translational gap-highlighting barriers to real-world implementation such as cost, infrastructure, and policy fragmentation. While innovations like the Xpert MTB/RIF Ultra, BPaLM regimen, and next-generation vaccines such as M72/AS01E represent pivotal progress, their deployment remains uneven. Implementation science, cost-effectiveness analyses, and health equity considerations are vital to scaling up these tools. Moreover, the expansion of the TB vaccine pipeline and integration of AI in diagnostics signal a transformative period in TB control. Eliminating TB demands more than biomedical breakthroughs-it requires a unified strategy that aligns innovation with access, equity, and sustainability. By bridging science with implementation, and integrating diagnostics, treatment, and prevention within robust health systems, the global community can accelerate the path toward ending TB.

diagnostic innovation↗
PubMed2026

The role of pathology laboratories in integrating genetic testing into Australian primary care: an implementation science perspective.

As genomic testing moves into mainstream healthcare, non-genetic healthcare professionals, including general practitioners (GPs), play a critical role as gatekeepers to genetic services. Laboratories are essential in supporting this transition by providing not only high-quality genetic tests but also point-of-care tools, educational materials and clinical guidance to support their use. This study aimed to explore how these tools and supports are conceptualized, developed, implemented and evaluated and how laboratories integrate them into their relationships with GPs, an essential process for paving the way toward better use of genomics in primary care. A qualitative study design was employed using semi-structured, in-depth interviews with representatives from genetic laboratories across Australia. The Consolidated Framework for Implementation Research (CFIR) guided deductive content analysis of data. Findings spanned the four CFIR domains (Intervention Characteristics, Outer Setting, Inner Setting and Implementation Process) across 34 constructs. Participants reported that laboratories viewed point-of-care tools and resources as essential responses to persistent genomic knowledge gaps among GPs. Development of evidence-based, practice-driven and adaptable resources was supported and rewarded within laboratory organisations. A strong culture of clinical responsibility and implementation readiness, combined with robust networks and communications, enabled timely support for GPs. Gaps identified included lack of implementation planning, misalignments between laboratory-developed resources and GPs' real-world needs and inadequate mechanisms for obtaining GPs' feedback, which made evaluation problematic. By applying an implementation science framework, these findings provide insights for future efforts to build and sustain the provision of point-of-care tools and support, ultimately improving the integration of genomics in primary care.

Journal Article↗
PubMed2006

Implementation science: a role for parallel dual processing models of reasoning?

BACKGROUND: A better theoretical base for understanding professional behaviour change is needed to support evidence-based changes in medical practice. Traditionally strategies to encourage changes in clinical practices have been guided empirically, without explicit consideration of underlying theoretical rationales for such strategies. This paper considers a theoretical framework for reasoning from within psychology for identifying individual differences in cognitive processing between doctors that could moderate the decision to incorporate new evidence into their clinical decision-making. DISCUSSION: Parallel dual processing models of reasoning posit two cognitive modes of information processing that are in constant operation as humans reason. One mode has been described as experiential, fast and heuristic; the other as rational, conscious and rule based. Within such models, the uptake of new research evidence can be represented by the latter mode; it is reflective, explicit and intentional. On the other hand, well practiced clinical judgments can be positioned in the experiential mode, being automatic, reflexive and swift. Research suggests that individual differences between people in both cognitive capacity (e.g., intelligence) and cognitive processing (e.g., thinking styles) influence how both reasoning modes interact. This being so, it is proposed that these same differences between doctors may moderate the uptake of new research evidence. Such dispositional characteristics have largely been ignored in research investigating effective strategies in implementing research evidence. Whilst medical decision-making occurs in a complex social environment with multiple influences and decision makers, it remains true that an individual doctor's judgment still retains a key position in terms of diagnostic and treatment decisions for individual patients. This paper argues therefore, that individual differences between doctors in terms of reasoning are important considerations in any discussion relating to changing clinical practice. SUMMARY: It is imperative that change strategies in healthcare consider relevant theoretical frameworks from other disciplines such as psychology. Generic dual processing models of reasoning are proposed as potentially useful in identifying factors within doctors that may moderate their individual uptake of evidence into clinical decision-making. Such factors can then inform strategies to change practice.

Journal Article↗
PubMedDate not supplied

The International Space Station human life sciences experiment implementation process.

The selection, definition, and development phases of a Life Sciences flight research experiment has been consistent throughout the past decade. The implementation process, however, has changed significantly within the past two years. This change is driven primarily by the shift from highly integrated, dedicated research missions on platforms with well defined processes to self contained experiments with stand alone operations on platforms which are being concurrently designed. For experiments manifested on the International Space Station (ISS) and/or on short duration missions, the more modular, streamlined, and independent the individual experiment is, the more likely it is to be successfully implemented before the ISS assembly is completed. During the assembly phase of the ISS, science operations are lower in priority than the construction of the station. After the station has been completed, it is expected that more resources will be available to perform research. The complexity of implementing investigations increases with the logistics needed to perform the experiment. Examples of logistics issues include- hardware unique to the experiment; large up and down mass and volume needs; access to crew and hardware during the ascent or descent phases; maintenance of hardware and supplies with a limited shelf life,- baseline data collection schedules with lengthy sessions or sessions close to the launch or landing; onboard stowage availability, particularly cold stowage; and extensive training where highly proficient skills must be maintained. As the ISS processes become better defined, experiment implementation will meet new challenges due to distributed management, on-orbit resource sharing, and adjustments to crew availability pre- and post-increment.

Biological Science Disciplines↗
PubMed2006

Recruiting medical groups for research: relationships, reputation, requirements, rewards, reciprocity, resolution, and respect.

BACKGROUND: In order to conduct good implementation science research, it will be necessary to recruit and obtain good cooperation and comprehensive information from complete medical practice organizations. The goal of this paper is to report an effective example of such a recruitment effort for a study of the organizational aspects of depression care quality. METHODS: There were 41 medical groups in the Minnesota region that were eligible for participation in the study because they had sufficient numbers of patients with depression. We documented the steps required to both recruit their participation in this study and obtain their completion of two questionnaire surveys and two telephone interviews. RESULTS: All 41 medical groups agreed to participate and consented to our use of confidential data about their care quality. In addition, all 82 medical directors and quality improvement coordinators completed the necessary questionnaires and interviews. The key factors explaining this success can be summarized as the seven R's: Relationships, Reputation, Requirements, Rewards, Reciprocity, Resolution, and Respect. CONCLUSION: While all studies will not have all of these factors in such good alignment, attention to them may be important to other efforts to add to our knowledge of implementation science.

Journal Article↗
PubMed2026

Beyond risk factors: A capacity framework for cancer survivorship research.

Cancer survivorship research has identified numerous biological, behavioral, psychosocial, health care, and structural factors that influence recovery. However, these factors are typically studied as separate determinants rather than interacting influences. This commentary proposes available survivorship capacity as a unifying framework that explains how these diverse determinants collectively shape recovery and survivorship outcomes. Concepts from geroscience, health care delivery, rehabilitation, occupational therapy, and human factors science were synthesized to develop a conceptual framework of available survivorship capacity. The framework conceptualizes recovery as a function of the capacity remaining after competing health care and life demands draw upon survivors' finite physical, cognitive, emotional, social, financial, temporal, and health care resources. It generates testable propositions for measurement, intervention research, health care delivery, and implementation science while positioning available survivorship capacity as a common mechanism linking diverse determinants of recovery and identifying actionable targets for intervention. Available capacity offers a unifying conceptual framework for understanding heterogeneity in survivorship outcomes and intervention effectiveness while generating a research agenda for future survivorship science. Measuring and strengthening survivors' available capacity, while reducing unnecessary demands, may improve engagement in care, health behaviors, and long-term recovery.

Humans↗
PubMed1999

Partnership to engage St. Louis high school students in investigative genetics.

The authors describe the Modern Genetics Project, based on a successful hands-on science implementation model that was developed and field-tested in St. Louis area high schools between 1992 and 1998. The project, begun in 1991, features a curriculum enhancement unit, "Modern Genetics for All Students," that combines strong scientific content, hands-on investigations, and human health applications, with reference to developing national and state science-teaching standards for this topic. The unit provides a significantly higher level of hands-on involvement throughout the school year for students than is found in traditional biology classrooms. This project aims to enhance scientific literacy among St. Louis high school students (all grades) of all learning levels and all socioeconomic, racial, and ethnic backgrounds; many of the students using the curriculum are from underrepresented minorities. This long-term project is carried out by a strong partnership among scientists at Washington University, implementation specialists from the Mathematics and Science Education Center of the Cooperating School Districts of St. Louis, project evaluators from Southern Illinois University at Edwardsville, and biology teachers at local high schools. Funding was originally from the National Institutes of Health and is now from the Howard Hughes Medical Institute. In 1998, there were 31 teachers and approximately 3,200 students participating in the project. Both quantitative and qualitative evaluations of the project during the 1995-96 and 1996-97 school years indicate that there were significant gains in knowledge and attitudes among the students of all racial, ethnic, and socioeconomic groups represented, and among both boys and girls.

Adolescent↗
PubMed2006

Strategies for promoting organizational and practice change by advancing implementation research.

BACKGROUND: The persistence of a large quality gap between what we know about how to produce high quality clinical care and what the public receives has prompted interest in developing more effective methods to get evidence into practice. Implementation research aims to supply such methods. PURPOSE: This article proposes a set of recommendations aimed at establishing a common understanding of what implementation research is, and how to foster its development. METHODS: We developed the recommendations in the context of a translation research conference hosted by the VA for VA and non-VA health services researchers. IMPACTS: Health care organizations, journals, researchers and academic institutions can use these recommendations to advance the field of implementation science and thus increase the impact of clinical and health services research on the health and health care of the public.

Evidence-Based Medicine↗
PubMed1993

Rhythms and blood pressure.

The time (chronos) structure of life (bios) is the topic of a computer-implemented science (logos), chronobiology. Chronobiologic methods for resolving physiologic time structure provide a more reliable mean, the MESOR, and other parametric dynamic measures of blood pressure variability. The amplitude is a measure of predictable extent of change and the acrophase a measure of timing of overall high values within each cycle of the rhythmic function. Such chronobiologic endpoints are often more sensitive than the mean for separating groups at different risk of developing high blood pressure. About 24-h (circadian) rhythms account for a sizeable part of predictable variability in blood pressure. Methodology to assess the characteristics of circadian blood pressure rhythms also provides time-varying reference limits for the interpretation of single measurements. Deviant blood pressures can be quantified by reference to such circadian-stage-dependent limits, derived from the automatically monitored blood pressure profiles of healthy peer groups. Excess or deficit in blood pressure can also be assessed as a hypertensive or hypotensive index integrated over 24 h. Chronobiologic monitoring has wide uses in practice as well as research, whether it is carried out by self- or automatic measurements, once the data are analyzed by appropriate computer methods that are now readily available.

Adult↗
PubMed1996

[Arterial hypertension in an ambulatory population of elderly subjects. Epidemiologic and clinical study in Isonzo].

The authors examine the clinical connotations of arterial hypertension in a geographical population of 1002 patients attending the Cardiological Outpatient Clinic of Unit no.2 in the Isonzo area (Monfalcone) using the most appropriate statistical methods, such as SPSS (Statistical Package for the Social Sciences) implemented on PC IBM AT 286, for multiple linear regression using a stepwise method. 1) Arterial hypertension was the result of a phenomenon which was striking owing to its mean value of 184.7 +/- 20.915 mmHg with equal mode and median of 180 mmHg. In the subgroup of 720 elderly patients this mean value differed slightly, 186.9 +/- 20.648 mmHg, with the same mode and median, whereas in the group of 282 adults the mean was 170.0 +/- 20.540 mmHg with a mode and median of 160 and 175 mmHg respectively. In the overall population 154 cases (15.4%) were affected by slight arterial hypertension with a mean of 158.9 mmHg, and 848 cases (84.8%) presented moderate-severe arterial hypertension with mean values of 189.4 mmHg. In elderly patients the mean rose to 190.4 mmHg whereas it was 186.3 mmHg in adults. 2) Mean age was 65.3 +/- 11.093 years: 70.7 +/- 7.396 years in older patients and 51.7 +/- 6.106 years in adults. Surface ECG showed signs of left ventricular hypertrophy in 292 elderly patients (40.5%) and 85 adults (30.0%), signs of ischemic cardiopathy due to T wave alteration in 246 elderly patients (34.1%) and 101 adults (35.7%), and due to ST tract in 340 (47.2%) and 102 (36.2%) respectively, with equal involvement of the free surface of the left ventricle. The radiographic enlargement of the cardiac shadow in elderly patients was observed in slight form in 153 cases (21.3%) and in moderate and marked form in 222 cases (30.8%), and in adults in 36 (12.8%) and 43 (15.2%) cases respectively. 3) Body weight was normal on average and equivalent to 77.3 +/- 13.578 kg, but of this series 713 cases were overweight and 237 were obese; 504 of elderly patients (70%) were pathological with 346 (48.1%) overweight and 158 (21.9%) obese, and of 209 pathological adults (74.1%), 130 (46.1%) and 79 (28.0%) were respectively overweight and obese. BMI oscillated from 1.70 to 5.60 with a mean of 2.80 +/- 0.409: from 1.70 to 4.21 in elderly patients with a mean of 2.70 +/- 0.379 and in adults from 2.00 to 5.60 with a mean of 2.90 +/- 0.460. 4) Mean cholesterolemia was 237 +/- 48.029 mg% and levels were normal in 203 cases and high in 799 subjects. Elderly patients showed the same mean level with a total of 580 pathological cases (80.5%) divided into 305 (42.3%) cases of slight hypercholesterolemia with a mean of 227.2 mg% and 275 (38.2%) severe cases with levels of 283.7 mg%. Adults presented a mean serum level of 236 +/- 47.588 mg%: 63 (22.3%) cases of normocholesterolemia, 117 (41.5%) cases of slight cholesterolemia with mean serum level of 224.8 mg%, and 102 (36.2%) severe cases with a mean level of 286.2 mg%, resulting in a total of 219 pathological cases (77.7%).

Adult↗
PubMed2001

Development and implementation of a science training course for breast cancer activists: Project LEAD (leadership, education and advocacy development).

OBJECTIVE: To develop and implement Project LEAD (leadership, education, and advocacy development), a science course for breast cancer activists. POPULATION: Students were breast cancer activists and other consumers, mainly affiliated with advocacy organizations in the United States of America. SETTING: Project LEAD is offered by the National Breast Cancer Coalition; the course takes place over 5 days and is offered 4 times a year, in various cities in the United States of America. RESULTS: The Project LEAD curriculum has developed over 5 years to include lectures, problem-based study groups, case studies, interactive critical appraisal sessions, a seminar by an 'expert' scientist, role play, and homework components. A core faculty has been valuable for evaluating and revising the course and has proved necessary to provide consistent high quality teaching. Course evaluations indicated that students gained critical appraisal skills, enhanced their knowledge and developed confidence in selected areas of basic science and epidemiology. CONCLUSIONS: Project LEAD comprises a unique curriculum for training breast cancer activists in science and critical appraisal. Course evaluations indicate that students gain confidence and skills from the course.

Adult↗
PubMed1992

Developing and implementing a "basic science clerkship" for first-year students.

For over 15 years, human genetics at the University of Illinois College of Medicine at Chicago (UICMC) was taught exclusively through lectures. In 1989-90 the authors revised this course for the graduating class of 1993 in order to incorporate many features found in a clerkship experience, such as oral presentations and the exploration of differential diagnoses through patient cases. In addition to lectures, the revised course consisted of small-group work in concentrated blocks of time, involving both a library research project and problem-based learning, each of which contributed to (1) significant gains in student achievement compared with data from the class of 1992 and (2) extremely favorable assessments from the students and faculty. The format of a basic science clerkship is being adopted by other departments at UICMC. The authors suggest that this format could be used by other medical schools to integrate the basic and clinical sciences.

Clinical Clerkship↗