National Research Infrastructure Research Articles

Networking strategies of the microscopy community for improved utilisation of advanced instruments: (1) The Australian Microscopy and Microanalysis Research Facility (AMMRF)

Abstract This paper describes the strategy underpinning the formation and operation of the Australian Microscopy & Microanalysis Research Facility (AMMRF). The governance and funding of the organisation are described and the advantages and achievements of a nationally coordinated facility for microscopy and microanalysis are set out. Selected data are presented that benchmark the performance of the facility, describe the economic impact and demonstrate the impact on the quality of research outcomes as a result of operating national collaborative research infrastructure for microscopy and microanalysis.

ARIADNE: Advanced Research Infrastructures for Archaeological Dataset Networking in Europe

Archaeologists regularly deal with large and diverse data sets, which are frequently the only record of excavated and destroyed archaeological sites. They need digital research infrastructures to preserve and provide access to this fragile digital data and to develop tools to manipulate and analyse it. Digital data is also increasing in quantity and size, and is often born digital, but there is a high degree of fragmentation and difficulty of accessing data in an integrated way. There is a small but growing number of national discipline-specific research infrastructures, and there have been a few project based attempts to provide European exemplars. This paper describes ARIADNE, a new research infrastructure for archaeologists, funded by the European Commission. It discusses some of the major issues and challenges and introduces some of the activities that ARIADNE partners will undertake. Given the transnational nature of many archaeological research questions, there is a clear value-added for organising research infrastructures in archaeology at a European level.

The Patient-Centered Outcomes Research Institute (PCORI) National Priorities for Research and Initial Research Agenda

THE PATIENT PROTECTION AND AFFORDABLE CARE ACT of 2010 created the Patient-Centered Outcomes Research Institute (PCORI) to fund and promote comparative clinical effectiveness research (CER) that will “assist patients, clinicians, purchasers, and policymakers in making informed health decisions by advancing the quality and relevance of evidence concerning the manner in which diseases, disorders, and other health conditions can effectively and appropriately be prevented, diagnosed, treated, monitored, and managed through research and evidence synthesis.” CER is not a new concept, but appreciation of its potential for providing patients and their clinicians with uniquely valuable information on what works, tailored to the clinical situation and to patient priorities, has increased rapidly in recent years. The research institute founded by this legislation was named to emphasize the critical importance of a patientcentered perspective in conducting this research. The PCORI Board of Governors determined early on that taking this name seriously, placing patients at the center of CER and actively engaging clinicians and other stakeholders was an ideal strategy to ensure that the PCORI research agenda stays focused on practical questions, relevant outcomes and study populations, and the possibility that treatment effects may differ across patient populations. The institute developed a definition of patient-centered outcomes research that emphasizes the voice of the patient in assessing health care options. The PCORI mission statement commits to producing and promoting high-integrity research that is “guided by patients, caregivers, and the broader healthcare community.” The institute’s first funding announcement solicited projects focused on methods for engaging patients and other stakeholders in all aspects of the research process. Merit review of more than 800 responses to this announcement is being conducted by the Center for Scientific Review of the National Institutes of Health (NIH). PCORI has modified the process in 2 ways. First, stakeholders, including patients, caregivers, and clinicians, were invited via the PCORI website to sign up if they were interested in participating in the merit reviews. A total of 48 individuals were subsequently recruited, trained by the NIH, and included as voting members of the 16 study sections (3 per section). Second, proposed scoring criteria included an additional criterion—extent of patient engagement. The founding legislation required PCORI to develop national priorities for research and a research agenda, and to post both for a 45to 60-day public comment period before major funding for research could begin. The development process extended from July to December 2011. It included examination of other recent prioritization efforts and consideration of 9 criteria cited in the statute (BOX), of the PCORI definition of patient-centered outcomes research, and of input received through discussions with stakeholder groups, including patients and their caregivers, clinicians, hospitals and health care systems, payers, the life sciences industry, and the research community. The process produced 5 national priorities (Box) and the research agenda, which are available on the PCORI website. The national priorities encompass many research areas cited by earlier priority-setting groups, but add a patientcentered perspective. Helping patients make informed health care choices will not be achieved solely by producing more CER evidence on prevention, diagnostic, or treatment strategies. New evidence is unlikely to be rapidly adopted unless the systems in which patients and clinicians make decisions are improved, removing current barriers to acting on the new information. Better methods for making CER results available and for communication about those results between patients and their clinicians are needed. Similar to studies evaluating health disparities, CER seeks evidence on possible differences in the effectiveness of treatments, in preferences for various outcomes, and in information needs across various populations. CER evidence can be further purposed to reduce or eliminate health disparities among vulnerable populations. Another priority addresses the need to build and sustain a national research infrastructure that facilitates learning from clinical experience. It calls for building clinical research databases, improving analytic methods for conducting this research, and train-

Mentoring the next researcher generation: Reflections on three years of building VET research capacity and infrastructure

During 2008–2011, the National Centre for Vocational Education Research (NCVER) funded a programme to build Australian VET research capacity and rejuvenate what has been seen as the existing ‘greying’ researcher pool. This paper is a reflective narrative about experiences of constructing the programme with a specific focus on the mentoring activity. It is about researching how we develop VET researchers, and specifically the role that experienced researchers can play. In the first three years, more than 40 experienced VET researchers have been associated with the programme, mainly as mentors and facilitators. These mentors have supported 30 new VET researchers undertaking an initial local VET research project and supervising them through to their subsequent publication with NCVER. This paper focuses on the mentoring that took place and what researchers and research managers can learn from those experiences in terms of building research capacity.This paper reviews the first stages of what has been a participatory action research project for those associated with the programme as the national research infrastructure for new VET researchers was constructed. It evaluates what actions have had the greatest impact and what we can lean from the initiative. It traces the project development from the initial project dilemmas through to the completion and publication of papers. This paper provides a narrative of the relationships that built the programme, focusing upon the mentoring relations striving to bridge both cognitive and geographical divides.The findings indicate that mentoring has played a critical role, and has been established as a essential role in this new VET researcher development pathway. The paper concludes by comparing the components of the Australian programme to a theoretical model and producing guidelines for research mentoring practice that have applicability to related research fields.

O3-5.3 String of pearls, a successful example of a consortium of clinical biobanks

The eight Dutch university hospitals in the Netherlands have joined forces to create a national research infrastructure for translational research. Initially eight national patient cohorts (the “pearls” are created, with...

National Institute of Nursing Research Has Widened the Blue Highway of Translation Research

Congratulations the authors for clearly connecting the grand achievements and potential in science contemporary health research needs, specifically the need advance translational science. Woods and Magyary (2010) aptly underscore the quality improvement barriers created by restricted pathways between efficacy research and broad utilization of evidence improve clinical decision making. It was these narrow blue highways (Westfall, Mold, & Fagnan, 2007) that precipitated the National Institutes of Health (NIH) reinvent major portions of the health research enterprise in the 2004 NIH Roadmap, using Clinical and Translational Science Awards (CTSAs) as a key design. With this letter, I briefly describe activities that match the authors' recommendations and highlight recent activities already set in motion. Now only 7 years after the NIH Roadmap, nurse scientists are building a new infrastructure with significant funding from National Institute of Nursing Research (NINR)/NIH. This new structure is intended be our super highway as a national research network in translational science. This entity, the Improvement Science Research Network (ISRN, n.d.; Fohn, 2009), directly addresses Woods and Magyary's (2010) wise recommendation that magnify . . . efforts seek out and obtain funding support nursing's leadership and participation in collaborative endeavors through practice-based translational research networks that are interdisciplinary or primarily focused on nursing (p. 20). The ISRN proposal was a response NIH Request for Applications (RFA) Number RFA-OD-09-004, Recovery Act Limited Competition for NIH Grants: Research and Research Infrastructure Grand Opportunities (RC2). To the great benefit of nursing, the NINR was a participating organization, providing opportunity for nurses lead in collaborative, practice-based research. The RFA called for projects to support high impact ideas that lend themselves short-term funding, and may lay the foundation for new fields of investigation (NIH Grants Guide, 2009). With opportunity for large budgets (minimum of $1 million per year for 2 years), these were known as Grand Opportunity or GO grants. The NIH requested novel approaches in areas that addressed specific knowledge gaps, scientific opportunities, new technologies, data generation, or research methods that would benefit from an influx of funds quickly advance the area in significant ways. Applicants were requested propose either a specific research question or propose the creation of a unique infrastructure/resource designed accelerate scientific progress in the future (NIH Grants Guide, 2009). The ISRN proposed the latter. With the NIH/NINR funding, the ISRN has become a national research infrastructure that provides a test bed for the nascent field of improvement science (Fohn, 2009). Because of the very nature of health care improvement, the ISRN is interprofessional; because of the very nature of health care systems, it is decidedly focused. It offers a research coordinating center with a solid foundation in the decade-old Academic Center for Evidence-Based Practice (ACE). Key strategies include harnessing the energy created by the improvement and patient safety movements and capturing the motion created by the emphasis on clinical excellence such as the Magnet Recognition Program. The ISRN capitalizes on the core values of CTSAs, including community engagement through academic-practice partnership and commitment of moving knowledge through T1, T2, T3, and so forth. In addition, the ISRN honors the need for rigor in quality improvement testing (Berenholtz, Needham, Lubomski, Goeschel, & Pronovost, 2010) by applying scientific standards the evaluation of improvement strategies. To these ends, the ISRN has accomplished the following: (a) established stakeholder-based research priorities in improvement science, (b) coalesced almost 200 research associates, (c) created a forum for advancing capacity in improvement research methods (Improvement Science Summit), (d) launched three multisite improvement research studies, and (e) crafted a cyber environment for capacity building and conduct of multisite improvement research. …

Comparative Effectiveness Research: Who Will Do The Studies?

A key tenet of comparative effectiveness research is that it should be conducted in real-world health care settings. This article addresses a basic question: What is the capacity of the clinical research enterprise to conduct such studies? We argue that the clinical trial system is already at capacity and will not be able to absorb large amounts of comparative effectiveness research without diverting resources from other needs. We propose a federally funded national clinical research infrastructure that would increase comparative effectiveness research capacity by encouraging community-based clinicians and their patients to participate in trials.

Patents of Introduction and the Spanish Innovation System

From a long-term perspective, technological innovation could have come from local or domestic inventive and research activity, or from the transfer of foreign technology. In reality either option produces similar effects and often it was a combination of both which drove the historical acceleration of the rhythm of innovation and expansion of industry. This was fundamental for Great Britain and its early followers, and even more so for the latecomers and the underdeveloped countries. Spain, for example, suffered from scientific, technological and industrial backwardness which impeded the implementation of a national research and development infrastructure capable of generating competitive inventive activity. However, the national innovation system was designed, from the 18th century onwards, to favour the transfer of technology and human capital from abroad and thus establish the basis of modern economic growth and the process of industrialization. In this paper we will reflect on the design of the Spanish Innovation System, especially in one of its institutional aspects (the patent system), in order to understand the real role and function of a curios legal process the “patent of introduction”, which in practice promoted and permitted anyone to protect foreign third-person technologies in order to implement them locally, providing they were not already established. Although this legal practice represents a very clear declaration of intentions concerning the innovation policy and despite its existence in other patent systems in lagging countries, economic and technology historians have paid little or no attention to the subject. Therefore it is unclear how patents of introduction functioned and what consequences they had on the innovation and industrialization processes, especially in underdeveloped countries such as Spain, which, incredibly, maintained this practice until joining the European Union in 1986. We will attempt to shed light on how patents of introduction were established and how they evolved, the role they played in the promotion of innovation, who used them and how, and the real impact they had. The conclusions point out that, as with protectionism as a commercial policy, forcing national processes of innovation that take advantage of foreign inventions with or without respecting the original inventors rights – as generally occurs with the transfer of technology from abroad – could have positive consequences on the industrialization processes as well as helping lagging countries such as Spain to catch up with modern societies.

The Australian preventive health agenda: what will this mean for workforce development?

The formation of the National Health and Hospitals Reform Commission (NHHRC) and the National Preventative Task Force in 2008, demonstrate a renewed Australian Government commitment to health reform. The re-focus on prevention, bringing it to the centre of health care has significant implications for health service delivery in the primary health care setting, supportive organisational structures and continuing professional development for the existing clinical and public health workforce. It is an opportune time, therefore, to consider new approaches to workforce development aligned to health policy reform. Regardless of the actual recommendations from the NHHRC in June 2009, there will be an emphasis on performance improvements which are accountable and aligned to new preventive health policy, organisational priorites and anticipated improved health outcomes.To achieve this objective there will be a need for the existing population health workforce, primary health care and non-government sectors to increase their knowledge and understanding of prevention, promotion and protection theory and practice within new organisational frameworks and linked to the community. This shift needs to be part of a national health services research agenda, infrastructure and funding which is supportive of quality continuing professional development.This paper discusses policy and practice issues related to workforce development as part of an integrated response to the preventive agenda.

'Stim-Novation': Investing in Research to Spur Innovation and Boost Jobs

The ideal fiscal stimulus measure not only creates jobs and drives economic activity in the short run but also boosts quality of life and economic growth in the medium and long run. Support for scientific research in the stimulus package accomplishes both goals. In this report, ITIF finds that spurring an additional $20 billion investment in our national research infrastructure will create or retain approximately 402,000 American jobs for one year.

Five Strategies for Accelerating the War on Cancer in an Era of Budget Deficits

In recent years, the National Institutes of Health's largest institute, the National Cancer Institute (NCI), has adapted to difficult economic conditions by leveraging its robust infrastructure -- which includes risk factor surveillance and population monitoring, research centers (focused on basic, translation, clinical, and behavioral sciences), clinical trials and health care research networks, and rigorously validated statistical models -- to maximize the impact of scientific progress on the public health. To continue advancement and realize the opportunity of significant, population-level changes in cancer mortality, the NCI recommends that five national-level actions be taken: (1) significantly increase enrollment of Medicare patients into cancer clinical trials through adequate physician reimbursement, (2) increase NCI/Centers for Medicare and Medicaid Services collaboration on clinical trials research to evaluate the therapeutic efficacy of anticancer drugs, (3) establish a national outcomes research demonstration project to test strategies for measuring and improving health care quality and provide an evidence base for public policy, (4) leverage existing tobacco-control collaborations and possible new authorities at the U.S. Food and Drug Administration to realize the outstanding health gains possible from a reduction in tobacco use, and (5) increase colorectal cancer screening rates though intensified collaboration between federal agencies working to address barriers to access and use of screening. These cost-effective strategies provide the opportunity for extraordinary results in an era of budget deficits. Of the chronic diseases, cancer has the strongest national research infrastructure that can be leveraged to produce rapid results to inform budget prioritization and public policy, as well as mobilize new projects to answer critical public health questions.

DataONE: Protecting the future of environmental and ecological data

AbstractThis interactive panel addresses the theme of the conference “Thriving on Diversity‐ Information Opportunities in a Pluralistic World” by exploring the role of librarians and information scientists in DataONE (Observation Network for Earth), a cyberinfrastructure project that supports the full data lifecycle for scientists in the diverse domains that are embodied in environmental and ecological science. Collaborations like this between scientists and information professionals ((see Table 1 for full list of DataONE team members), are increasingly important, which is reflected by the “Science and Metadata Community” that is forming within the Dublin Core Metadata Initiative.The research activities of environmental and ecological scientists produce diverse multi‐scale, multi‐discipline, and multi‐national observational data. These data provide insights to address new environmental, social and technological challenges caused by climate variability, altered land use, population shifts, and changes in resource availability (e.g., food, water, and oil). Therefore scientists, educators, librarians, land managers, and the public need open, persistent, and secure access to well‐described and easily discovered Earth observational data. These data are critical because they form the basis for good scientific decisions, wise management and use of resources, and informed decision‐making.Securing our global scientific knowledge base by preserving these documents and datasets requires active management of the resources and the supporting technology, as well as, an awareness of current research. DataONE is one of two National Science Foundation DataNet Partners. The DataNet Partners serve as exemplars for national and global data management and research infrastructure organizations, and also provide unique opportunities to communities of researchers to advance science and engineering research and learning. Eventually there will be five DataNet Partners.DataONE focuses on multi‐disciplinary observational data collected by biological (genome to ecosystem) and environmental (atmospheric, ecological, hydrological, and oceanographic) scientists, national and international research networks, and environmental observatories. However, the DataONE structure is designed to be domain‐agnostic, so that it can be extended to serve a broader range of science domains both directly and through interoperability with other DataNet Partners.This panel of DataONE investigators focuses on four areas related to the challenges of the preservation of digital scientific data in any setting, not just for DataONE. The panel will be facilitated to encourage the audience to provide feedback, exchange ideas, and ask questions related to the role of information science, libraries and librarians in the process of creation, discovery, access, and manipulation of electronic scientific data.

Access to and Documentation of Publicly Financed Survey Data

The topic of this paper is access to and documentation of survey data financed through public funds. We distinguish between four types of publicly financed survey data: (1) Academic survey data from the national or international research infrastructures; (2) data from DFG projects or similarly funded projects; (3) survey data collected in research projects funded by the Federal State and the Lander (Ressortforschung); (4) Population and Household surveys from national and international statistical agencies. For each of these types of data we describe the current situation and present recommendations for future developments.

Consortium GARR and the European National Research and Education Networks Optical Infrastructure Developments

GARR is engineering its next generation of the Italian Research and Education Network (GARR-X), which will exploit a countrywide optical infrastructure based on DWDM equipment and advanced multi-domain services. The trend is common in all National Research and Education Networks [1] in Europe and worldwide. NRENs are relying more and more on direct use of optical equipment to fulfill the researchers' requirements. These hybrid networks are built to provide services on a multi-domain environment both at the circuit and at the IP layer for researchers in, for example, radio astronomy (eVLBI [2]), GRID computing (EGEE [3], LHC [4]), high-performance computing (DEISA [5]). This article outlines the status and issues of ongoing research activities in GARR [6] and NRENs to provide, manage, and evolve dedicated optical-based networks for providing multi-domain end-to-end services. The research is performed mainly in the framework of the European Commission co-funded project GÉANT2 [7].

Pharmaceutical Care in Community Pharmacies: Practice and Research in the US

To describe the state of community pharmacy, including patient care services, in the US. Chain pharmacies, including traditional chains, mass merchandisers, and supermarkets, comprise more than 50% of community pharmacies in the US. Dispensing of drugs remains the primary focus, yet the incidence of patients being counseled on medications appears to be increasing. More than 25% of independent community pharmacy owners report providing some patient clinical care services, such as medication counseling and chronic disease management. Most insurance programs pay pharmacists only for dispensing services, yet there are a growing number of public and private initiatives that reimburse pharmacists for cognitive services. Clinical care opportunities exist in the new Medicare prescription drug benefit plan, as it requires medication therapy management services for specific enrollees. The private market approach to healthcare delivery in the US, including pharmacy services, precludes national and statewide strategies to change the basic business model. To date, most pharmacies remain focused on dispensing prescriptions. With lower dispensing fees and higher operating costs, community pharmacies are focused on increasing productivity and efficiency through technology and technicians. Pharmacists remain challenged to establish the value of their nondispensing-related pharmaceutical care services in the private sector. As the cost of suboptimal drug therapy becomes more evident, medication therapy management may become a required pharmacy benefit in private drug insurance plans. Pharmacy school curricula, as well as national and state pharmacy associations, continually work to train and promote community pharmacists for these roles. Practice research is driven primarily by interested academics and, to a lesser degree, by pharmacy associations. Efficient dispensing of prescriptions is the primary focus of community pharmacies in the US. Some well designed practice-based research has been conducted, but there is no national research agenda or infrastructure. Reimbursement for cognitive services remains an infrequent, but growing, activity.

Cancer Survivorship—Genetic Susceptibility and Second Primary Cancers: Research Strategies and Recommendations

Cancer survivors constitute 3.5% of the United States population, but second primary malignancies among this high-risk group now account for 16% of all cancer incidence. Although few data currently exist regarding the molecular mechanisms for second primary cancers and other late outcomes after cancer treatment, the careful measurement and documentation of potentially carcinogenic treatments (chemotherapy and radiotherapy) provide a unique platform for in vivo research on gene-environment interactions in human carcinogenesis. We review research priorities identified during a National Cancer Institute (NCI)-sponsored workshop entitled "Cancer Survivorship--Genetic Susceptibility and Second Primary Cancers." These priorities include 1) development of a national research infrastructure for studies of cancer survivorship; 2) creation of a coordinated system for biospecimen collection; 3) development of new technology, bioinformatics, and biomarkers; 4) design of new epidemiologic methods; and 5) development of evidence-based clinical practice guidelines. Many of the infrastructure resources and design strategies that would facilitate research in this area also provide a foundation for the study of other important nonneoplastic late effects of treatment and psychosocial concerns among cancer survivors. These research areas warrant high priority to promote NCI's goal of eliminating pain and suffering related to cancer.

NICHD research initiative in newborn screening

Recent changes in genetics research have created new opportunities to improve the scope and quality of newborn screening services. Changes in newborn screening should be supported and directed by an organized program of research. The NICHD Research Initiative in Newborn Screening includes the development of systematic methods to identify additional conditions appropriate for newborn screening; development and testing innovative interventions and treatments to improve outcomes; education of the provider workforce; development and implementation of appropriate information and communication systems for parents and providers; and, sponsoring an ongoing program of research and research training. Future needs will include the development of a national translational research infrastructure, prevention research and research into behavioral and social sciences issues. The NICHD Research Initiative in Newborn Screening is expected to be an ongoing and vital initiative that adapts itself to new scientific findings, technological developments, changes in the public and personal health care system, and our evolving understanding of the needs of affected individuals, families and the community.

Current Translational Research in Australia and Translational Research Supporting Center in Japan

This paper summarizes the current status of the Translational Research in Australia and an ideal design of Japanese National Translational Research Supporting Center (NTRSC). This summary is based on an investigative report for Australian Translational Research as a Japanese national delegate. The objective of this investigation was to elucidate basic requirements and financial basis for national translational research infrastructure. The investigation was carried out through previous information exchange, having discussion with representatives of major Australian facilities, and field studies as a Japanese national delegate. We discussed the details with representatives of each facilities having pre-collected information of both parties. The Australian definition of translational research was clear and reasonable than the Japanese one. The Australian infrastructure for translational research was constructed with care and works effectively. This paper elucidates the important features of the ideal infrastructure for translational research facilities. With these considerations in mind, this paper discusses an ideal infrastructural design of Japanese NTRSC.

Proceedings for the 5th Asia-Pacific Conference on Disaster Medicine: creating an agenda for action.

Disaster medicine has come to the forefront and has become the focus of interest not only in the medical community, but also in the eyes of the public. The 5th APCDM was convened in Vancouver, Canada, 27-30 September 2000. It brought together over 300 delegates from 32 countries to share their experiences and thoughts regarding disaster events and how to effectively manage them. The conference was devoted to the task of establishing priorities and creating an Agenda for Action. From the discussions, key actions required were defined: COMMUNICATIONS: (1) Identify existing regional telehealth groups and gather lessons to be learned from them; (2) Form a telehealth advisory group to work with regional groups to compile telehealth initiatives, identify international protocols in telehealth already in existence, and solicit feedback before setting international standards; and (3) Increase corporate partnerships in the fields of telehealth and telecommunications, and invite corporations to send delegates to future APCDM meetings. This should be an initiative of the APCDM, the World Association of Disaster and Emergency Medicine (WADEM), or the European Society of Emergency Medicine. EDUCATION AND RESEARCH: (1) Formalize education in disaster medicine and management. The World Health Organization and WADEM should take a leadership role; (2) WADEM is requested to hold a conference with a focus on qualitative research; (3) WHO is requested to continue the provision of international research teams, but to advocate for the development of national disaster research infrastructure; (4) Make research findings and reports available on web sites of such organizations as WHO and PAHO; (5) Develop the translation of research for community utilization. The WHO and PAHO are organizations that are requested to consider this action; and (6) WADEM/APCDM are requested to focus future conferences on applied research. INFORMATION AND DATA: (1) Create an "Information and Data Clearinghouse on Disaster Management" to collect, collate, and disseminate information; (2) Collect data using standardized tools, such as CAR or Hazmat indices; (3) Analyze incentives and disincentives for disaster readiness and establish mechanisms for addressing the obstacles to preparedness; and (4) WADEM is requested to develop a web site providing a resource list of interdisciplinary institutions and response activities, organized by country, topic, and research interests. Links to other pertinent web sites should be provided. INTERDISCIPLINARY DEVELOPMENT: (1) Focus on the interdisciplinary nature of disaster response through more conferences encompassing grassroots efforts and through WADEM publications; (2) Develop and apply a standardized template of Needs Assessment for use by multidisciplinary teams. Team Needs Assessment is essential to determine the following: (a) Local response and international assistance required; (b) Appropriate command system; and (c) Psychosocial impact and support necessary. PSYCHOSOCIAL ASPECTS: (1) Incorporate relief for caregivers into action plans. This should include prime family members who also are caregivers; and (2) Implement measures that give survivors control over the recovery process. RESPONSE MANAGEMENT: (1) Define relationships and roles between governments, military and security personnel, non-governmental organizations (NGOs), and civic groups. Use an international legal framework and liability to reinforce accountability of disaster responders; (2) Establish a more sophisticated use of the media during disasters; (3) Establish standards in key areas. WADEM is requested to write "White Papers" on standards for the following areas: (a) management, (b) health/public health, (c) education/training, (d) psychosocial, and (e) disaster plans; (4) Establish task forces to anticipate and resolve issues around evolving and emerging disasters (e.g., chemical and biological terrorism, landmines, emerging infectious diseases). WADEM was again identified as the vehicle for promoting this action. The responsibility of the next meeting of the Asia-Pacific Conference on Disaster Medicine will be to measure progress made in these areas by assessing how well these collective decisions have been implemented.

Divining the Oracle of Big Science: Steps on the Path to a New Republicanism

On 18 July 1995, Charles M. Vest, President of the Massachusetts Institute of Technology (MIT), delivered a speech to the National Press Club entitled 'In Search of Mediocrity: Is America Losing Its Will to Excel?' Vest asserted that Americans lack a bold vision of the future.1 As evidence Vest cited a looming federal budget cut in civilian research and development. Arguing that '. . .research universities are the foundation of our entire national research infrastructure ...', Vest reminded his audience of a rationale that '. . . was articulated over fifty years ago in a report to President Truman entitled Science The Endless Frontier, This presented the vision of Vannevar Bush, who had helped direct the nation's wartime scientific effort. Bush's vision set a confident America on a search for