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Traditional approaches for evaluating the impact of scientific research – mainly scholarship (i.e., publications, presentations) and grant funding – fail to capture the full extent of contributions that come from larger scientific initiatives. The Translational Science Benefits Model (TSBM) was developed to support more comprehensive evaluations of scientific endeavors, especially research designed to translate scientific discoveries into innovations in clinical or public health practice and policy-level changes. Here, we present the domains of the TSBM, including how it was expanded by researchers within the Implementation Science Centers in Cancer Control (ISC3) program supported by the National Cancer Institute. Next, we describe five studies supported by the Penn ISC3, each focused on testing implementation strategies informed by behavioral economics to reduce key practice gaps in the context of cancer care and identify how each study yields broader impacts consistent with TSBM domains. These indicators include Capacity Building, Methods Development (within the Implementation Field) and Rapid Cycle Approaches, implementing Software Technologies, and improving Health Care Delivery and Health Care Accessibility. The examples highlighted here can help guide other similar scientific initiatives to conceive and measure broader scientific impact to fully articulate the translation and effects of their work at the population level.
A standardised multi-site approach to manage paediatric post-operative chylothorax does not exist and leads to unnecessary practice variation. The Chylothorax Work Group utilised the Pediatric Critical Care Consortium infrastructure to address this gap.
Methods:
Over 60 multi-disciplinary providers representing 22 centres convened virtually as a quality initiative to develop an algorithm to manage paediatric post-operative chylothorax. Agreement was objectively quantified for each recommendation in the algorithm by utilising an anonymous survey. “Consensus” was defined as ≥ 80% of responses as “agree” or “strongly agree” to a recommendation. In order to determine if the algorithm recommendations would be correctly interpreted in the clinical environment, we developed ex vivo simulations and surveyed patients who developed the algorithm and patients who did not.
Results:
The algorithm is intended for all children (<18 years of age) within 30 days of cardiac surgery. It contains rationale for 11 central chylothorax management recommendations; diagnostic criteria and evaluation, trial of fat-modified diet, stratification by volume of daily output, timing of first-line medical therapy for “low” and “high” volume patients, and timing and duration of fat-modified diet. All recommendations achieved “consensus” (agreement >80%) by the workgroup (range 81–100%). Ex vivo simulations demonstrated good understanding by developers (range 94–100%) and non-developers (73%–100%).
Conclusions:
The quality improvement effort represents the first multi-site algorithm for the management of paediatric post-operative chylothorax. The algorithm includes transparent and objective measures of agreement and understanding. Agreement to the algorithm recommendations was >80%, and overall understanding was 94%.
Background: Eye movements reveal neurodegenerative disease processes due to overlap between oculomotor circuitry and disease-affected areas. Characterizing oculomotor behaviour in context of cognitive function may enhance disease diagnosis and monitoring. We therefore aimed to quantify cognitive impairment in neurodegenerative disease using saccade behaviour and neuropsychology. Methods: The Ontario Neurodegenerative Disease Research Initiative recruited individuals with neurodegenerative disease: one of Alzheimer’s disease, mild cognitive impairment, amyotrophic lateral sclerosis, frontotemporal dementia, Parkinson’s disease, or cerebrovascular disease. Patients (n=450, age 40-87) and healthy controls (n=149, age 42-87) completed a randomly interleaved pro- and anti-saccade task (IPAST) while their eyes were tracked. We explored the relationships of saccade parameters (e.g. task errors, reaction times) to one another and to cognitive domain-specific neuropsychological test scores (e.g. executive function, memory). Results: Task performance worsened with cognitive impairment across multiple diseases. Subsets of saccade parameters were interrelated and also differentially related to neuropsychology-based cognitive domain scores (e.g. antisaccade errors and reaction time associated with executive function). Conclusions: IPAST detects global cognitive impairment across neurodegenerative diseases. Subsets of parameters associate with one another, suggesting disparate underlying circuitry, and with different cognitive domains. This may have implications for use of IPAST as a cognitive screening tool in neurodegenerative disease.
To describe availability and frequency of use of local snack-food outlets and determine whether reported use of these outlets was associated with dietary intakes.
Design
Data were cross-sectional. Availability and frequency of use of three types of local snack-food outlets were reported. Daily dietary intakes were based on the average of up to four 24 h dietary recalls. Multivariable linear regression models estimated average daily intakes of energy, sugar-sweetened beverages (SSB) and snack foods/sweets associated with use of outlets.
Setting
Multi-site, observational cohort study in the USA, 2004–2006.
Subjects
Girls aged 6–8 years (n 1010).
Results
Weekly frequency of use of local snack-food outlets increased with number of available types of outlets. Girls with access to only one type of outlet reported consuming food/beverage items less frequently than girls with access to two or three types of outlets (P <0·001). Girls’ daily energy, SSB and snack foods/sweets intakes increased with greater use of outlets. Girls who reported using outlets>1 to 3 times/week consumed 0·27 (95 % CI 0·13, 0·40) servings of SSB more daily than girls who reported no use. Girls who reported using outlets>3 times/week consumed 449·61 (95 % CI 134·93, 764·29) kJ, 0·43 (95 % CI 0·29, 0·58) servings of SSB and 0·38 (95 % CI 0·12, 0·65) servings of snack foods/sweets more daily than those who reported no use.
Conclusions
Girls’ frequency of use of local snack-food outlets increases with the number of available types of outlets and is associated with greater daily intakes of energy and servings of SSB and snack foods/sweets.
The visit of Prime Minister Yitzhak Shamir to Liberia, Cameroun, Côte d'Ivoire, and Togo in June 1987 confirmed that Israeli-African relations have entered a third phase that is more pragmatic and more limited than the first two. For Israel and Africa, this is an era of tachlis, or unadorned realism.2
The oil crises of the 1970s ended a distinct historical period in the control of oil. While the demise of the first oil regime is clear to all, the nature of that regime itself is less well understood. What, in particular, was the distribution of power among the actors in the regime? What were the structures and goals of this system during the long period (approximately the first seventy years of the twentieth century) during which petroleum became vital to industrial society and emerged as the most important commodity in world commerce?
This article analyses the nature of ideology in Nigeria and relates ideological competition to conflict between federal and local (especially urban) interests. It is argued that two strong ideologies exist: nationalism and populism. These two perspectives provide competing justifications for authority, and reflect the contradictory interests held by local-urban politicians and by the functional élites that dominate federal politics.
Recent excavations in Belize have resulted in the discovery of an earlier period of sedentary occupation than has hitherto been documented in the Maya Lowlands. The Swasey phase is stratigraphically antecedent to occupations of the early Middle Formative, the earliest horizon located until now, and associated radiocarbon dates suggest a persistence from 2000–1000 b.c./2500–1300 B.C. The ceramic and lithic material culture of the phase are described, together with architectural construction and burial practice, and the overall cultural identity is recognized as ancestral to the known Maya Lowland Formative. External contacts of the Cuello site are documented by exotic minerals, and the possible external antecedents for the Swasey ceramic tradition are canvassed.
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