Moving from institutional dependence to entrepreneurialism. Creating and funding a collaborative research and practice development position

Aims of the paper. The paper describes the creation of, the rationale behind and the external funding of a collaborative research‐clinical practice development position. The paper also demonstrates the benefits of nursing's collaboration with external funding bodies and the value of moving from our traditional position of assuming that ‘the hospital’ will always provide. Background. There is a constant refrain that nursing must become more ‘research‐based’ and develop an active research culture. In harsh financial times however, funding for research development is scarce. Nurses can respond to this by bemoaning the lack of money or by taking an entrepreneurial approach, creating innovative project proposals that develop new partnerships and attract external funding. Discussion. Institutional support for clinical research is often more verbal than financial as most health care systems are experiencing extreme financial stringencies. Nurses need to reconsider the notion that every initiative must automatically be funded by the institution. In this paper we show how in a busy major hospital, clinicians and researchers collaborated to create and fund the kind of innovative research and practice development position that may be impossible to fund through existing budgets. Conclusion. With creativity and determination, nurses can challenge the orthodoxy that they are solely dependent on institutional funding. If there is a clear project vision, a convincing rationale, a strongly argued ‘business case’ and a passionate and persistent team, then innovative new projects and positions can be realized. Relevance to clinical practice. Developing clinical focused, practice based research is now a worldwide policy and practice imperative for nurses. Unfortunately, current levels of institutional funding are unlikely to support research promotion positions and initiatives. This paper outlines an approach to securing funding for research initiatives that can create exciting new positions and develop productive partnerships between researchers, clinicians and external agencies.     

依托科学基金促进高校青年科技人才快速成长

本文分析了我校医科35岁以下青年科技人才面临的现状,他们申报、承担的以资助基础研究为主的科学基金的相关情况,探讨了科学基金对他们资助和培养中存在的问题,提出了青年科学人才适应科学基金发展要求以促进自身成长等建议.     

再生障碍性贫血治疗中超适应证用药调查分析及管理建议

目的:了解再生障碍性贫血常用药品中超适应证用药情况,为加强超适应证用药管理、减少不合理用药、规避执业风险提供依据。方法:选择2011年1—5月所有住院再生障碍性贫血患者,针对本病治疗药品的使用情况进行统计分析。结果:共调查再生障碍性贫血患者590例,其中有超说明书适应证用药的患者537例,占总病例数的91.02%。结论:再生障碍性贫血治疗中,超适应证用药广泛存在,应对超适应证用药进行分类管理以提高工作效率、规避执业风险。     

The Natural Evolutionary Relationships among Prokaryotes

Two contrasting and very different proposals have been put forward to account for the evolutionary relationships among prokaryotes. The currently widely accepted three domain proposal by Woese et al. (Proc. Natl. Acad. Sci. USA (1990) 87: 4576-4579) calls for the division of prokaryotes into two primary groups or domains, termed archaebacteria (Archaea) and eubacteria (Bacteria), both of which are suggested to have originated independently from a universal ancestor. However, this proposal, which is based primarily on genes involved in the information transfer processes, is inconsistent with the ultrastructural characteristics of prokaryotes as well as with many gene phylogenies and provides no explanation as to how the structural and molecular differences seen between these groups arose and how other prokaryotic taxa are related or evolved from the common ancestor. It also postulates that the last common ancestor of all organisms was a hypothetical entity lacking a cell membrane, which is contrary to the basic requirement of a cell membrane to define and separate all forms of life from the surrounding environment. A second alternate proposal for the evolutionary relationships among prokaryotes has emerged from extensive analyses of numerous conserved inserts and deletions found in various proteins (Gupta, R. S., Microbiol. Mol. Biol. Rev. (1998) 62: 1435-1491; FEMS Microbiol. Rev. (2000) 24: in press. This proposal points to a specific relationship between archaebacteria and Gram-positive bacteria, both of which are prokaryotes bounded by a single cell membrane (monoderm prokaryotes). Gram-negative bacteria, which are bounded by two different membranes (diderm prokaryotes), are indicated to comprise a structurally and phylogenetically distinct taxa originating from Gram-positive bacteria. This proposal postulates that the earliest prokaryote was a Gram-positive bacteria from which both archaebacteria and diderm prokaryotes evolved by normal evolutionary mechanisms in response to the strong selection pressure exerted by antibiotics produced by certain groups of gram-positive bacteria. This proposal accounts for both the molecular as well structural differences seen among the main groups of prokaryotes by known evolutionary mechanisms without invoking any hypothetical process or entity and thus is a closer representation of the natural relationships among prokaryotes than the proposal for two distinct domains. Based on this new proposal, it is now possible to logically deduce the branching order of different prokaryotic taxa from the common ancestor, which is as follows: Gram-positive bacteria (Low G + C) (? Archaebacteria) ? Gram-positive bacteria (High G + C) (? Archaebacteria)? Deinococcus-Thermus ? Green nonsulfur bacteria ? Cyanobacteria ? Spirochetes ? Chlamydia- Cytophaga-Green sulfur bacteria ? Proteobacteria-1 (ε, δ)? Proteobacteria-2 (α) ? Proteobacteria-3 (β) ? Proteobacteria-4 (γ). A surprising but very important aspect of the relationship deduced here is that the main eubacterial phyla are related to each other linearly rather than in a tree-like manner, suggesting that the major evolutionary changes within prokaryotes (bacteria) have occurred in a directional manner.     

¿Cómo elaborar un proyecto de investigación en ciencias de la salud?

Knowing how to properly prepare a research proposal is a real challenge — and being able to prepare an excellent research proposal is increasingly a requirement to compete for funding with assurances of success. With this in mind, we aim to share with the reader our experience (in many cases, unsuccessful) as applicants on the most important aspects of preparing a research proposal and securing its approval and funding. This article aims not only to list theoretical recommendations but also to share some personal and eminently practical suggestions on the following elements of a research proposal: the title, the abstract, the introduction, the objectives, the methodology, the work plan or schedule, the proposal's consistency and coherence, its viability, its applicability, the importance of the principal investigator and the research team, the proposal's limitations and alternatives, its budget, its references, and, finally, the research proposal's form or wording. In summary, a research proposal is a carefully written plan that includes all the scientific, ethical and logistical aspects of the study to be conducted. Writing a good research proposal requires considerable effort and a great deal of time, but it's worth it.     

The Rehabilitation Nursing Foundation Celebrates 20+ Years of Funded Research

The history and trajectory of the Rehabilitation Nursing Foundation (RNF), the research arm of the Association of Rehabilitation Nurses, is presented in this article. From 1988 through 2008, 52 RNF research grants have been awarded to 49 researchers. Since 1995, this research award program has been guided by the Rehabilitation Nursing Research Agenda. Funded studies have varied in focus from pediatrics to geriatrics, to specific chronic conditions, and to administrative and management issues, providing a basis for the development of rehabilitation nursing science. Strategies for successful RNF grant writing are also included in this article.     

基于区域建议策略的视盘定位方法

视盘定位对利用眼底图像进行眼科疾病的计算机辅助诊疗十分重要。提出一种基于区域建议策略的视盘定位方法。首先,将眼底图像从像素域映射到特征域,在得到的特征图上利用区域建议策略生成视盘的初始候选区域;然后,按照一定准则对候选区域进行采样,构建全连接层对其进行深层特征提取,并利用损失函数的约束实现候选区域的位置精修;最后,通过置信度阈值的过滤对视盘可见性进行判断,若视盘可见,则将置信度最大的候选区域中心作为该眼底图像的视盘坐标,从而实现视盘的正确定位。在3个公开的眼底图像数据库(DRIVE(40张)、MESSIDOR(1 200张)和STARE(400张))中进行实验,定位准确率分别为100%、99.9%和98.8%。实验证明,该方法能够实现视盘的准确、快速、鲁棒定位,优于现有的视盘定位方法,且预先进行视盘可见性的判断更符合实际应用的要求,能够辅助眼底疾病的诊断处理。     

放射检查存在的安全隐患及对策探讨

随着医学影像学的发展，放射检查已经成为诊断疾病的主要方法之一。放射检查在提供医疗便利的同时，其安全臆患日益显现，危害日趋增大，而社会与医院均没有给予足够的重视。从医院临床的角度分析归纳了在放射检查中易造成危害的6条主要因素，并提出10条防范措施，以期达到满足临床需要、减少辐射危害的目的。     

关于完善医院经济管理和职工收入分配改革方案的探讨

财政部、卫生部颁布和印发的《医院财务制度》、《医院会计制度》对药品分开核算，分别管理、固定资产分类核算、采用折旧方法计提修购基金、医疗药品成本核算、结余分配模式等诸多医院经济管理内容提出了新的要求和规范。文章就医院在医疗机构改革、医疗保险改革、执行新的医院财会制度框架下，如何进一步推进改革进程，继续搞好职工收入分配，提高经济管理水平的问题，提出探讨性意见。