Medical Rehabilitation: Guidelines to Advance the Field With High-Impact Clinical Trials

The purpose of this Special Communication is to summarize guidelines and recommendations stemming from an expert panel convened by the National Institutes of Health, National Center for Medical Rehabilitation Research (NCMRR) for a workshop entitled The Future of Medical Rehabilitation Clinical Trials, held September 29-30, 2016, at the NCMRR offices in Bethesda, Maryland. The ultimate goal of both the workshop and this summary is to offer guidance on clinical trials design and operations to the medical rehabilitation research community, with the intent of maximizing the effect of future trials.     

Turning Data Into Information: Opportunities to Advance Rehabilitation Quality,Research, and Policy

Attention to health care quality and safety has increased dramatically. The internal focus of an organization is not without influence from external policy and research findings. Compared with other specialties, efforts to align and advance rehabilitation research, practice, and policy using electronic health record data are in the early stages. This special communication defines quality, applies the dimensions of quality to rehabilitation, and illustrates the feasibility and utility of electronic health record data for research on rehabilitation care quality and outcomes. Using data generated at the point of care provides the greatest opportunity for improving the quality of health care, producing generalizable evidence to inform policy and practice, and ultimately benefiting the health of the populations served.     

Health Services Research in Rehabilitation and Disability—The Time is Now

Policy drives practice, and health services research (HSR) is at the intersection of policy, practice, and patient outcomes. HSR specific to rehabilitation and disability is particularly needed. As rehabilitation researchers and providers, we are uniquely positioned to provide the evidence that guides reforms targeting rehabilitative care. We have the expertise to define the value of rehabilitation in a policy-relevant context. HSR is a powerful tool for providing this evidence. We need to continue building capacity for conducting rigorous, timely rehabilitation-related HSR. Fostering stakeholder engagement in these research efforts will ensure we maintain a patient-centered focus as we address the “Triple Aim” of better care, better health, and better value. In this Special Communication we discuss the role of rehabilitation researchers in HSR. We also provide information on current resources available in our field for conducting HSR and identify gaps for capacity building and future research. Health care reforms are a reality, and through HSR we can give rehabilitation a strong voice during these transformative times.     

国外图书馆生物医学科研数据管理服务及启示

通过调研印第安纳大学图书馆和马萨诸塞大学图书馆的科研数据管理的服务模式,对比分析了科研数据管理服务工作的内容、方法、工具等提出了我国图书馆科研数据管理服务模式的设想。     

Participatory action as a research method with public health nurses

Aim

This article explores and describes participatory action research (PAR) as a preferred method in addressing nursing practice issues. This is the first study that used PAR with public health nurses (PHNs) in Canada to develop a professional practice model.

Background

Participatory action research is a sub‐category of action research that incorporates feminist and critical theory with foundations in the field of social psychology. For nurses, critical analysis of long‐established beliefs and practices through PAR contributes to emancipatory knowledge regarding the impact of traditional hierarchies on their practice.

Design

This study used participatory action, a non‐traditional but systematic research method, which assisted participants to develop a solution to a long‐standing organizational issue.

Method

The stages of generating concerns, participatory action, acting on concerns, reflection and evaluation were implemented from 2012 ‐ 2013 in an urban Canadian city, to develop a professional practice model for PHNs.

Findings

Four sub‐themes specific to PAR are discussed. These are “participatory action research engaged PHNs in development of a professional practice model;” “the participatory action research cycles of “Look, Think, Act” expanded participants’ views;” “participatory action research increased awareness of organizational barriers;” and “participatory action research promoted individual empowerment and system transformation.”

Conclusions

This study resulted in individual and system change that may not have been possible without the use of PAR. The focus was engagement of participants and recognition of their lived experience, which facilitated PHNs’ empowerment, leadership and consciousness‐raising.     

Recent Highlights of Experimental Research for Inhibiting Tumor Growth by Using Chinese Medicine

To give an overview of contemporary experimental research using Chinese medicine (CM) for the treatment of cancer. As an integral part of mainstream medicine in the People''s Republic of China, CM emphasizes improvements in holistic physical condition instead of merely killing tumor cells, which is consistent with the current medical model that advocates patient-oriented treatment. Great progress has been made in experimental research, and the principle aspects include anti-tumor angiogenesis, inducing apoptosis and differentiation, reversing multidrug resistance, and improving immune function. As a current hot topic in cancer research, tumor microenvironment (TME) highlights the mutual and interdependent interaction between tumor cells and their surrounding tissues, and the CM treatment concept bears a striking resemblance to it. To date, primary points of TME include extracellular matrix remodeling, inflammation, hypoxia, and angiogenesis, but trials using CM with a focus on TME are rare. Despite considerable recent development, experimental research on CM for solving cancer issues appears insufficient. Greater efforts in this field are urgently needed.     

基于信誉的新药发现平台信任机制

针对新药研发需要跨地域、跨学科合作的特点,建立了一个面向天然产物的新药发现平台。为了促进平台上各参与方进行联合研发,进而提高新药研发效率和成功率,需要支持参与方相互间进行可信度的评估,并在合作方间建立可靠的信任关系。本文将基于信誉的信任机制引入到新药发现平台中,通过收集各研发主体相互间的评价信息,综合考虑了节点能力、在系统中的参与度、时间因素,计算节点在整个网络中的全局信誉及节点间的局部信誉。最后,对所提出信任机制的有效性和抗攻击能力进行了实验验证,结果表明,该信任机制能够有效应用于新药联合研发中。