Rehabilitation in bariatrics: opportunities for practice and research

Purpose.?Obesity is associated with a wide range of chronic illnesses and disabilities familiar to rehabilitation researchers and practitioners. Obesity discourse in the area of rehabilitation science and practice is limited.

Method.?A meeting of rehabilitation researchers, practitioners, industry and decision makers was held for the purpose of identifying research and practice priorities in the area of bariatric rehabilitation.

Results.?Areas of common ground in terms of the identification of gaps in research, practice and knowledge about obesity in the context of rehabilitation science were identified. Participants developed a concept for a bariatric rehabilitation treatment and research institute. A commitment to embark on priority action items was made.

Conclusions.?This article describes a process that successfully gathered a diverse group of researchers, clinicians, industries and decision makers for the purpose of collectively advancing the area of bariatric rehabilitation in Canada.     

Trigeminal neuralgia: opportunities for research and treatment

Trigeminal neuralgia was the focus of a recent workshop convened by the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institute of Dental and Craniofacial Research (NIDCR). The workshop brought together basic scientists, clinicians, epidemiologists, and patient advocates. New research directions for epidemiology, diagnosis and assessment, pain mechanisms, and treatment were identified. (The workshop was held in Rockville MD on September 14, 1999, with financial support from NINDS, NIDCR, the NIH Office of Rare Diseases, and the NIH Pain Research Consortium.)     

Including qualitative research in systematic reviews: opportunities and problems

Qualitative research has been increasingly recognized in recent years as having a distinctive and important contribution to make to health care research. It is capable of being used as a methodologically sufficient approach in its own right, as a precursor to quantitative studies, during or after trials to explain processes and outcomes, and as a means of enhancing the link between evidence and practice. However, qualitative research has been little used as an evidence resource for systematic reviews. We argue that formal synthesis of both qualitative and quantitative forms of research is essential, and we discuss some of the problems that need to be overcome in carrying out such syntheses. These include methodological prejudice, problems in searching for qualitative evidence, and issues in synthesizing qualitative data. We call for progress to be made on the science and methods of including qualitative research in the evidence base of medicine.     

Practice-based research: opportunities for the clinician

Practice-based research is the performance of clinical trials in physicians' offices, often involving multiple sites in multicenter studies. The purpose of this presentation is to inform the clinician of the opportunities available in practice-based research, discussing both the contributions that clinicians can make and the advantages to them of participating in practice-based research. Clinician contributions to medical research include the addition of vital clinical perspective to preliminary findings from institutional research and the performance of long-term patient evaluation. Advantages to the physician include the opportunity to continue the scientific inquiry that is too often left behind upon entering private practice, a greater appreciation of the drug evaluation process, and new skills in office procedures and documentation.     

Developing the research pipeline: increasing minority nursing research opportunities

The need to increase the number of minority nurses in policy and leadership positions in health care administration, academia, and research has been acknowledged. Limited academic and research training opportunities are available specifically designed to develop a cadre of minority nurse scientists to conduct the research needed to ultimately reduce health disparities within racial and ethnic minority populations. This article describes a collaborative approach to research career development at the doctoral level.     

Nursing research opportunities in enteral nutrition

The concepts of individual adaptations, environmental, and person factors have been suggested as components of a framework for considering existing and potential investigations of enteral feeding as a therapeutic modality. Much of the work regarding adaptations to enteral feeding have described the pathophysiological and experimental responses of individuals--that there is less emphasis on the physiological and behavioral responses is evident in the literature. Also, little investigation has been focused on the environmental risk factors or the person vulnerability factors that are associated with less than optimal adaptations to enteral feeding. However, it is the understanding of all three of these aspects that will lead to comprehensive strategies for promoting satisfactory adaptations. To date, the majority of clinical therapeutic studies have focused on obviating or managing untoward reactions to enteral feeding by manipulating environmental physical factors. Certainly, more needs to be done, particularly with respect to temporal and rhythmicity considerations. However, there is an obvious lack of information about manipulating social circumstances or person factors (such as, knowledge deficit) for therapeutic ends. Examination of the multiple dimensions of patient responses to enteral nutrition modalities, the interaction of these various dimensions (concentrating on the social and person), and the physical elements is congruent with the holistic and caring nature of nursing practice and should guide future study.     

Behavioral science research in the prevention of diabetes : status and opportunities

Recent studies show diabetes can be prevented. Growing knowledge of its biological bases opens further prevention opportunities. This article focuses on behavioral science research that may advance these opportunities. An ecological model guides attention to how prevention research may be pursued at the individual, group, or community levels. Three key areas are reviewed: risk communication, screening, and preventive interventions. Research on diabetes risk communication is limited but suggests that many are relatively unaware of risks and may have misconceptions about the disease. Amid policy debates and research regarding the potential benefits and costs of screening, identification of diabetes may itself be risky in terms of psychological and social consequences. The Diabetes Prevention Program and other studies make clear that diabetes can be prevented, both by the combination of weight loss and physical activity and by medications. Research needs to address promoting these methods to individuals as well as to groups and even whole communities. Fundamental as well as applied research should address how risks of diabetes are understood and may be communicated; how to enhance benefits and minimize psychological and other risks of screening; how to promote healthy eating and weight loss, physical activity, and appropriate use of medications to prevent diabetes; and how to reduce socioeconomic and cultural disparities in all these areas.     

Maximizing research opportunities: secondary data analysis.

Knowledge development in nursing can be enhanced by broadening the understanding of legitimate scientific inquiry. SDA uses existing data to answer research questions and can be especially useful for nurse researchers. Advantages of SDA include its potential for resource savings and its cost-effectiveness. Also, the investigator can circumvent data collection challenges such as finding appropriate participants. However, SDA does not require less rigor. A sound conceptualization of the research problem is still required, and identifying and obtaining appropriate data for SDA can be quite time-consuming. Nevertheless, SDA can be both a practical and appropriate research process that enables nurses to maximize their opportunities for answering important clinical questions.     

Genomics pipelines and data integration: challenges and opportunities in the research setting

Introduction: The emergence and mass utilization of high-throughput (HT) technologies, including sequencing technologies (genomics) and mass spectrometry (proteomics, metabolomics, lipids), has allowed geneticists, biologists, and biostatisticians to bridge the gap between genotype and phenotype on a massive scale. These new technologies have brought rapid advances in our understanding of cell biology, evolutionary history, microbial environments, and are increasingly providing new insights and applications towards clinical care and personalized medicine.

Areas covered: The very success of this industry also translates into daunting big data challenges for researchers and institutions that extend beyond the traditional academic focus of algorithms and tools. The main obstacles revolve around analysis provenance, data management of massive datasets, ease of use of software, interpretability and reproducibility of results.

Expert commentary: The authors review the challenges associated with implementing bioinformatics best practices in a large-scale setting, and highlight the opportunity for establishing bioinformatics pipelines that incorporate data tracking and auditing, enabling greater consistency and reproducibility for basic research, translational or clinical settings.     

Drug delivery research in Australasia: creating opportunities through collaboration.

This paper gives a brief overview of drug delivery research in Australia and New Zealand, known collectively as Australasia, in order to indicate future directions in this area of pharmaceutical research. It describes some of the relevant statistics of the two countries and briefly indicates some of the government incentives to foster the pharmaceutical industries. Examples of Australian drug delivery research such as a controlled release pelleted system for delivery of morphine are presented. The examples for New Zealand relate to veterinary systems such as an intraruminal device for zinc. The paper alludes to the need for collaboration among the various institutions in order to achieve successful outcomes.     

Qualitative research in rehabilitation science: opportunities,challenges, and future directions

Purpose: Qualitative research has had a significant impact within rehabilitation science over time. During the past 20 years the number of qualitative studies published per year in Disability and Rehabilitation has markedly increased (from 1 to 54). In addition, during this period there have been significant changes in how qualitative research is conceptualized, conducted, and utilized to advance the field of rehabilitation. The purpose of this article is to reflect upon the progress of qualitative research within rehabilitation to date, to explicate current opportunities and challenges, and to suggest future directions to continue to strengthen the contribution of qualitative research in this field.

Methods: Relevant literature searches were conducted in electronic data bases and reference lists. Pertinent literature was examined to identify current opportunities and challenges for qualitative research use in rehabilitation and to identify future directions.

Results: Six key areas of opportunity and challenge were identified: (a) paradigm shifts, (b) advancements in methodology, (c) emerging technology, (d) advances in quality evaluation, (e) increasing popularity of mixed methods approaches, and (f) evolving approaches to knowledge translation. Two important future directions for rehabilitation are posited: (1) advanced training in qualitative methods and (2) engaging qualitative communities of research.

Conclusion: Qualitative research is well established in rehabilitation and has an important place in the continued growth of this field. Ongoing development of qualitative researchers and methods are essential.

• Implications for Rehabilitation

• Qualitative research has the potential to improve rehabilitation practice by addressing some of the most pervasive concerns in the field such as practitioner–client interaction, the subjective and lived experience of disability, and clinical reasoning and decision making. This will serve to better inform those providing rehabilitation services thereby benefiting patients that are utilizing these services.

• Changes over time in how qualitative research is conceptualized, conducted, and utilized to advance rehabilitation science have resulted in a number of unique opportunities and challenges in using qualitative research that must be considered within this field.

• Advances in methodology and increased expectations for evaluation must be considered to ensure quality and credibility of qualitative rehabilitation research within rehabilitation. Improved quality and credibility may increase likelihood of research dissemination and use by clinicians intervening within the rehabilitation process in order to improve clinical practice.

• In order to maximize opportunities and mitigate challenges there are two principal future directions for rehabilitation scientists to consider: (1) advancing training in qualitative methods to adequately prepare future rehabilitation scientists and (2) engaging qualitative communities of research.

     

An interprofessional international research collaboration: exploration of key opportunities and challenges

ABSTRACT

Interprofessional research has made substantive progress in Brazil over the past decade, in line with globalization and the worldwide expansion of university international relationships. This sustained growth of interprofessional research in many other countries around the world has been increasingly reported in the literature. Interprofessional international research involves interactions and exchanges between researchers from different countries with different professional and disciplinary backgrounds who collaborate to undertake scholarly work. The benefits of interprofessional international research are many and varied. In this paper, we explore the opportunities and challenges related to interprofessional international research collaboration while reflecting on our personal experiences of a study focused on interprofessional collaboration in primary care which spanned two countries – Brazil and UK. A key element in our international research has been regular discussion, negotiation, and agreement. Collectively, these elements have helped to ensure that our international empirical work can be sustained.