Financial Support For Research Research Articles

Surgery in Developing Countries: Lessons from Uganda

The World Journal of Surgery represents a global forumfor general surgical matters in all their dimensions andcomplexity, not the least in the problem of the burden ofsurgical disease and the provision of surgical care. Theburden of surgical disease in developing countries has beenthoroughly assessed by Debas and colleagues [1], whohave quantified surgical burden by world area, using costper disability-adjusted life year (DALY) per 1,000 popu-lation. They found that the surgical burden by area, indescending order of disadvantage, was as follows: Africa,Southeast Asia, Eastern Mediterranean, Europe, WesternPacific, and finally the Americas. They went on to definethe requirements and obligations at each of the primary,secondary, and tertiary levels of surgical provision. In2007, at a Conference hosted by the Rockefeller Founda-tion’s Bellagio Centre, surgical focus was brought down tosub-Saharan Africa, and surgical burden and access wasexamined in selected countries there [2]. The participantsdeveloped a program which included advocacy and par-ticularly emphasized evidence building as a roadmap forthe future.Against this background, it is particularly appropriatethat this issue of the World Journal of Surgery carries adetailed and valuable analysis of surgical services inUganda, the first analysis of its kind from that country [3].Uganda is located in Central Africa and has a population of30,262,610 [4]. It is landlocked, and is about the size of theState of Oregon. The economy and population are largelyrural. Its health indicators show a life expectancy of 52years, but a remarkably low (for Africa) HIV prevalence of4.1%. In most ways it reflects the surgical problems ofmany sub-Saharan African countries, and the article issobering reading.The authors calculate that the Ugandan population isserved by 75 specialist-trained general surgeons, with anadditional 12 subspecialists in neurosurgery, plastic sur-gery, and urological surgery. This means there is astaggering surgical ratio of 1/400,000 population. Theauthors then outline the population catchment of nineselected hospitals in Uganda (that includes the main citiesof Kampala and Entebbe). In their outline they provide thenumber of beds and the operations performed, as well asthe make-up of the attending medical staff of the ninehospitals. The information at this point gives a surgeon-reader at this point the first world pause: only four of thenine hospitals have any general surgeons on their staff, twowith one each, and the remaining two with two each. Fivehospitals with over 100 beds and performing several hun-dred operations a year rely entirely on (nonsurgical)medical officers. The problem is that as much as 90% ofthe medical workforce is located in the two cities, thisdespite—in exact contradistinction—the fact that 90% ofthe population is rural. This maldistribution problem res-onates throughout the developing world.The authors identify many challenges to building asurgical workforce: these are the basic and critical trio ofrecruitment, training, and retention. Recruitment to surgeryis challenged by international collaborations and financialsupport for research that draws trainees to the fields ofpublic health and infectious diseases rather than to surgery.It has long been argued that surgical diseases are seen as ‘‘apoor relative’’ of infectious diseases in the assessment,financing, and management of the disease burden in thedeveloping world.Training in medicine has been difficult in Uganda, butimprovements to undergraduate training programs have

Development of nontraditional power engineering

Analysis of the current state and forecasts of the development of nontraditional renewable energy sources (NRESs1 is presented. Competitiveness of nontraditional power engineering at the current phase of its development and in the future is assessed. The role of the State in introducing the objects of nontraditional power engineering by enhancing financial support of research and development work and legislative controlling of the processes of the development of NRESs is shown.

Expanding participation to non-group members in phase III cooperative group treatment trials

6533 Background: The NCI initiated the Cancer Trials Support Unit (CTSU) Independent Clinical Research Site (CICRS) Program at the ASCO Annual meeting in 2002. Building upon the CTSU's initial aim to expand participation of any NCI-sponsored Cooperative Group (Group) phase 3 trial to all Group and Community Clinical Oncology Program (CCOP) members, the CICRS initiative has enabled unaffiliated sites to enroll patients in a wide variety of Group trials. Methods: Interested oncology practices submitted applications that were reviewed by a committee, including external reviewers, to select the most qualified sites. They had to meet standards similar to those for Group members and were assessed for the quality of investigator credentials and site preparedness. Sites were required to demonstrate functioning IRBs, pharmacy facilities, and data management standard operating procedures to ensure a high level of clinical trials practice. A CTSU research nurse mentor was added to address challenges faced by the sites. Sites were required to enroll at least 5 patients per year to remain active participants. Results: Via the CTSU, a trial menu of over 60 Group phase 3 studies, and selected phase 2 trials, were made available to CICRS participants. Active CICRS sites are distributed over 19 states and 6 of the 7 highest accruers are in population areas with less than 300,000 persons. Participating sites were surveyed in January 2006 to better understand barriers to clinical trials enrollment and 68% percent reported the main barriers were dedicated staff, time, adequate IRB and financial support for research. Conclusions: Obstacles for participation in the CICRS program have been defined and strategies to overcome them are being implemented. Results of these efforts will be updated, including provision of survey results, updated accrual, audit results and a review of successful enrollment strategies. No significant financial relationships to disclose. [Table: see text]

How should financial support for research be distributed to Universities? The Research Assessment Exercise (RAE) in England and Wales

In the United Kingdom, the "Research Assessment Exercise" is used by central government as a way of distributing infra-structure funds to University departments to support research. Departments with the highest ratings get extra support, while departments with low ratings may have their existing support withdrawn. The paper describes an exercise aimed at improving the rating obtained by one such department.

Factors driving the development of forest energy in Finland

Renewable energy sources play an important role in the Finnish energy and climate strategies which are implemented partly through the Action Plan for Renewable Energy Sources. Enhancement of wood energy plays a key role in the plan. A special emphasis is given to forest chips produced from small-sized trees from early thinnings and above-ground and below-ground residual biomass from regeneration cuttings. The production goal of forest chips is 5 million m 3 solid (10 TWh) in 2010. The use of forest chips is promoted by means of environmental taxes, financial aid for investments, and financial support for research, development and commercialization of technology. In 2002, altogether 365 heating and power plants larger than 0.4 MW used forest chips. The total consumption was 1.7 million m 3 , the use of small houses and farms included. The growth of use is presently about 350 000 m 3 per annum, but reaching the official goal will require an annual growth of 400 000 m 3 during this decade. The consumption of roundwood per capita, 15 m 3 per annum, is in Finland 20 times as high as the average consumption of the EU countries, respectively. Consequently, residual forest biomass is abundantly available. The capacity of heating and power plants to use forest chips is large enough to meet the goal. However, users require competitive chip prices, good quality control of fuel and reliable supply chains, and new efficient procurement systems are being developed. The paper deals with the drivers of this development: support measures of the Government; strong support to research, development and commercialization of forest chip production from the National Technology Agency Tekes; advanced infrastructure for the procurement of timber for the forest industries; positive attitude and active participation of the forest industries; the active role of leading forest machine and boiler manufacturers, and the possibility to cofire wood and peat fuels in large fluidized bed boilers so as to secure the availability of fuel in all conditions, stabilize the moisture content of fuel and reduce the emissions from combustion.

ACQUIRED COLOR BLINDNESS IN AN ELDERLY MALE PATIENT FROM RECURRENT METASTATIC PROSTATE CANCER

ACQUIRED COLOR BLINDNESS IN AN ELDERLY MALE PATIENT FROM RECURRENT METASTATIC PROSTATE CANCER

Modern management of children with haemophagocytic lymphohistiocytosis.

Modern management of children with haemophagocytic lymphohistiocytosis.

Financial support for research in otolaryngology

Objectives: This project describes the use of computer-assisted searches of medical literature in an attempt to track the prevalence and type of funding of medical research. Study design and setting: The study is a computer-assisted observational survey of the medical literature. To establish a database and track funding trends, a computer-assisted Medline search (CAMS) of the literature from 1986 to 1991 and 1992 to August 1996 was undertaken for 3 areas of interest: (1) sources of support, (2) comparison with other specialties, and (3) the validity of CAMS. A journal-based search examined the field of otolaryngology, which includes all the head and neck related sciences, and an institution-based search examined the clinical specialty of otolaryngology. Results: By selected journal search, the field of otolaryngology has about one-third funding (34% of 20,751 papers), and about one-half of that is supported by the National Institutes of Health. This proportion of federal support increased over time. By institution line search, the specialty of otolaryngology is less well funded (26% of 15,480 papers) as might be expected. However, in contrast to basic sciences, there is a trend of decreased funding over the 11-year period of the study. Significance: It appears that while the field of otolaryngology (basic scientists and clinicians) may be enjoying increasing support of research, the clinical specialty of otolaryngology is among the many specialties that exhibit a trend of decreasing level of NIH support. Conclusions: Computer-assisted surveys are an effective method of tracking funding for research in otolaryngology and other specialties. CAMS may be a valuable tool for monitoring efforts to improve funding resources for otolaryngology.

Resident perception of academic skills training and impact on academic career choice.

1) To evaluate residents' perceptions of the quality of training in basic academic skills and the availability and quality of research resources during residency; 2) to evaluate the association between these attitudes and choice of an academic career; and 3) to assess residents' attitudes toward the importance of postgraduate fellowship training for success in an academic career. A 15-item survey was administered to all U.S. emergency medicine (EM) residents in conjunction with the February 1997 American Board of Emergency Medicine (ABEM) In-service Examination. The survey assessed resident interest in a career in academic EM, and resident perception of the general quality of training in academic (research and teaching) skills. Residents were also asked to rate the quality of their training in the following specific academic skills: medical and grant writing, bedside teaching, lecturing, the use of computers, study design, statistics, and the use of audiovisual aids. Resident perceptions of the availability of the following resources were also assessed: teaching and research role models, data collection and analysis support, laboratory facilities, financial support of research, research fundamentals lectures, and computers. The response rate was 93%. Forty-four percent of the respondents were interested in academic EM, 36.6% were undecided, and 19.6% were not interested in an academic career. On a scale of 1 (unprepared) to 5 (well prepared), the residents rated their overall preparedness for an academic career fairly high (3.97 [0.86]). In contrast, they perceived the quality of their training in the specific academic skill areas assessed and research resource availability to be only fair. Despite resident perception of relatively inadequate training in basic academic skills, only 24% of the respondents indicated that they believed fellowship training was important for success in an academic career. Logistic regression analyses demonstrated that participation in a research project in medical school, the length of the training program (4- vs 3-year), being a first-year resident, and a better perception of one's overall academic skill preparation were factors independently associated with having a greater interest in an academic career. A relatively high percentage of residents initially express an interest in an academic career, but this interest wanes as residency progresses. A minority of residents believe that their training provides them with the specific skills needed to succeed in academics, or with adequate exposure to research resources or mentors. Emergency medicine may be able to increase the number of qualified academic faculty by recruiting medical students with prior research experience, and providing residents with better research training and role models.

What cannot be said in science

The scientific enterprise is full of experts on specialist areas but woefully short of people with a unified world-view. This state of affairs can only inhibit progress, and could threaten political and financial support for research.

Wirtschaftspolitische Perspektiven des Industriestandortes Nordrhein-Westfalen

Abstract Due to the progressive globalization of the economy the industry in Northrhine Westfalia faces new challenges. Structural changes are necessary in order to adopt successfully to the changing environment. Northrhine Westfalia possesses locational assets such as its infrastructure, stable political conditions and the qualification of its employees, which are rated positively by enterprises. In order to strengthen the competitiveness of its economy there is, however, still a need for political action. Examples of a successful industrial policy include support for a co-ordinated initiative by the car industry, the development of a transport registration system in order to make the transport infrastructure more efficient, support for an initiative by trade unions and business associations aimed at improving the educational system, financial support for research and development in high tech sectors and the setting up of new enterprises.

Financial support for research in otolaryngology

Financial support for research in otolaryngology

Research and emergence of the Lifeline Foundation

Research and emergence of the Lifeline Foundation

Effektivit�t pr�klinischer Notfallversorgung Fiktion oder Fakt?

The current increase in the cost of health care must be considered as a severe threat to the prehospital emergency services system. Two examples have been selected--the patient with polytrauma and the patient in cardiac arrest--to demonstrate the dilemma between a need for objective data and the requirements of emergency patients. Study results obtained in trauma patients indicating that total prehospital time, including scene time, is correlated to patient outcome have led to the conclusion that at the scene treatment by emergency physicians may be dispensable. It has, however also been demonstrated that the time required for medical treatment at the scene is equivalent to 20% of the total scene time, thus representing only a fraction of the total prehospital time. Correlating the total prehospital time or scene time to outcome therefore appears absurd. The treatment principle of aggressive shock treatment in polytrauma needs critical reevaluation on the basis of results obtained by recent preclinical studies in patients with penetrating torso injuries. Small volume resuscitation could not be demonstrated to improve outcome in polytrauma patients, although a slight improvement in patients with brain injury may be assumed. Endotracheal intubation and early artificial ventilation are proven therapeutic principles in polytraumatized patients. Unfortunately, for ethical reasons randomised carefully controlled comparative studies can not be performed in polytrauma patients unless the patient is fully conscious. The importance of endotracheal intubation and artificial ventilation in unconscious trauma patients becomes apparent under conditions of anaesthesia where the application of the endotracheal tube averts regurgitation, aspiration and concomitant morbidity and mortality. The common causes of cardiovascular collapse and their pathomechanisms, as well as the mechanisms of cardiopulmonary resuscitation, have been widely investigated. Nevertheless, various aspects of their application are still controversial. The most recent study results have recommended initial ventilation prior to thoracic compression. New methods of assisting mechanical cardiopulmonary resuscitation, such as ACD CPR or vest CPR, have shown promising results in animal experiments. However, the importance of results obtained by preclinical randomised controlled investigations in humans need to be confirmed by further studies as to outcome. The efficacy of defibrillation in cases of ventricular fibrillation has been clearly demonstrated, particularly with a view to the interval between ventricular fibrillation and defibrillation. It has further been demonstrated that basic cardiopulmonary resuscitation preserves ventricular fibrillation and thus improves the chance of survival. The present generation of defibrillators has been further improved, particularly by the introduction of biphasic defibrillator wave forms, which may reduce the required energy, as well as possible complications, while offering an increase in the efficacy of defibrillation and a reduction in defibrillator size. Scientific emergency medicine is responsible not only for the development and validation of new methods and concepts, but in particular for their application under quality control conditions. Politicians require an improvement in the quality of the validation of emergency measures, although the instruments available for the investigation of these measures are known to be obsolete (experimental models, experimental design). Additionally, the financial support of research in emergency medicine suffers from being accourded low priority by public research funds such as the German Research Fund. However, in view of the rapid application of experimental results to daily practice it should be emphasized that patients also support research in emergency medicine via their direct financial contributions to the health insurance companies.

Factors Influencing the Development of Psychology in Latin America

Among the factors impeding the development of the discipline of psychology in Latin America, emphasis must be given to the lack of infrastructural conditions. Also important is the lack of social, economic, and political stability, leading to inadequate administrative and financial support for research. The high degree of uncertainty as to the future of societal outcomes leads to short‐term planning, and weakens the possibility of sustained lines of research. Yet, the same economic and political crises have positive consequences: A growing awareness of social problems and a realization of the utility of psychology in their solutions. The resultant job opportunities for graduates, and a generation of “engaged” professionals, are all helping the growth of an indigenous psychology. Increasing participation of Latin American psychologists in international congresses, particularly those of the Interamerican Society of Psychology, has had laudatory effects on the development of the discipline in the region.

Stratégies de vaccination contre la péripneumonie contagieuse bovine en Afrique

Contagious bovine pleuropneumonia (CBPP) is regarded as the second most important disease of cattle in Africa. The disease was eradicated from Europe through drastic slaughter campaigns with quarantine and restriction of cattle movements. CBPP was mastered in Australia using these methods combined with vaccination. However, the disease remains endemic in Asia and Africa, where it inhibits livestock farming. In these continents, vaccination is the preferred means of control; the aim is to reduce incidence until complementary disease control measures can be applied. The success of a vaccination campaign depends on four main factors: good planning and good organisation; staff who are well-trained, fully equipped and highly motivated; high quality vaccines; good international co-operation. Vaccine strains recommended for use in Africa are strain T1/44 and its variant T1-SR. To improve the immunogenicity of these strains, the Pan African Rinderpest Campaign (PARC) secured financial support for research into immunostimulating complexes (ISCOM). It is hoped that this technology can improve vaccines, leading to effective eradication of the disease. In the meanwhile, systematic and repeated vaccination is the method of choice against CBPP in Africa.

Financial support for research in radiology: a survey of original investigations published in the AJR and Radiology.

This study was done to determine how often the original research published in AJR and Radiology is formally funded by external sources of explicit intramural institutional research grants and to explore the association of financial support with the subspecialty field; type of research (clinical vs basic); number of coauthors; number of departments, nonradiology departments, and institutions participating per paper; country of origin; and citation impact of investigations. All 736 original articles published in AJR and Radiology in 1990 were surveyed. The following information was abstracted: the presence or absence of specific funding, as determined from the footnote acknowledgments given by the authors (for the 560 papers from the United States, financial support was further classified according to the funding agency listed first); the subspecialty field of research, as determined from the indexing of the paper in the table of contents; the type of research (clinical, basic, combined clinical and basic); the number of coauthors; the number of departments, nonradiology departments, and institutions participating; the first author's department (radiology, medicine, surgery, medical physics); the first author's institution (university-affiliated medical institution, medical institution not affiliated with a university, National Institutes of Health center); and the country of the first author's institution. Research impact was assessed by using citation counts. Only 17% of the surveyed studies were formally funded. The 95 funded studies from the United States were federally sponsored (63%), funded by private industry (11%), supported by nonprofit foundations (16%), or funded from explicit intramural institutional monies (11%). Funding was significantly related to the subspecialty field (p = .00007), the type of research (p < .000001), and the category of the first author's department (p < .000001). When papers on contrast media research were excluded from the analysis, the association of funding to the field of research became statistically insignificant (p = .21). Financial support was not significantly related to the category of the first author's institution (p = .71) or to whether the research was done in the United States (p = .71). A statistically significant positive association was found between funding and the number of coauthors (p = .013), the number of departments (p = .049), nonradiology departments (p = .004), and institutions participating per paper (p = .018). Funded papers were cited more extensively than nonfunded papers (p = .015). Only a small percentage of radiology research attracts formal, especially extramural, financial support. This should be a cause for concern. As the informal funding of investigations from redirected clinical revenues is diminishing, action will be required to procure funds to support the radiology research necessary for the vitality of the specialty.

Removable prosthodontics research—quo vadis?

The need to improve removable prosthodontic treatment through research has not diminished. Most recent research reports in prosthodontics are in fixed prosthodontics, indicating a declining interest in removable prosthodontics. A survey of dental schools in the United States and Canada reveals that the financial support for research in removable prosthodontics is a mean of $42,500 per year. Present research is not directed toward solving the major problems in removable prosthodontics. The key to making progress in removable prosthodontic research is to interest capable trainees in securing the necessary basic science and clinical training. Adequate financial support is then needed to conduct the research.

Bibliometric studies of research collaboration: A review

Scientific research is becoming an increasingly collaborative endeavour. The nature and magnitude of collaboration vary from one discipline to another, and depend upon such factors as the nature of the research problem, the research environ ment, and demographic factors. Earlier studies have shown a high degree of correlation between collaboration and research productivity, and between collaboration and financial support for research. The extent of collaboration cannot be easily determined by traditional methods of survey and observation. Bibliometric methods offer a convenient and non-reactive tool for studying collaboration in research. In this paper, several types of collaboration have been identified, and earlier research on collaboration has been reviewed. Further research is needed to refine the methods of defining and assessing collaboration and its impact on the organization of research and communica tion in science.

Funded research, multiple authorship, and subauthorship collaboration in four disciplines

Increased financial support for science has contributed to a change in the social structure of research, as evidenced by the increase in collaborative research. The present paper examines the relationship between financial support, multiple authorship, and subauthorship in four disciplines. It is shown that financial support for research is associated with an increase in the total number of persons involved in the production of knowledge per journal article. However, the impact of funding is not the same for all modes of collaboration nor the same for all disciplines.