Scientific Directors Research Articles

Focus on residents’ mental health: the Public Health Residents’ Anonymous Survey in Italy (PHRASI)

Abstract The ‘Public Health Residents’ Anonymous Survey in Italy” (PHRASI) represented the first study to specifically investigate mental health and its determinants among Italian public health residents (PHRs). Using a voluntary, anonymous, electronic, 88-item questionnaire, the PHRASI study generated evidence on well-being, eating disorders, sleep disorders, alcohol abuse, depressive symptoms, and anxious symptoms among PHRs. This highlights the correlation with sociodemographic, lifestyle, and work-related characteristics during COVID-19 pandemic. The data was collected in a nationally representative sample of PHRs enrolled in any of the four course years of Italian Public Health schools. The recruitment took place through the communication channels of the Medical Residents’ Council of the Italian Society of Hygiene and Preventive Medicine in the summer 2022. The key findings reveal prevalence rates of mental health conditions comparable to those seen in other healthcare workers during the COVID-19 pandemic: 61% of residents report depressive symptoms and 36% report anxious symptoms. The study also highlights a negative correlation of these symptoms with characteristics of the training and working environment, such as the level of supervision and peer-to-peer support. A stronger social network and higher levels of physical activity emerged to be positively associated with well-being and depression. These and other findings will be available in the final report of the survey that will be presented during the congress. PHRASI led the way to the Residents’ Mental health Investigation, a Dynamic longitudinal study in Italy (ReMInDIt), that aims to explore potential cause-effect relationships between risk/protective factors and mental health outcomes. This evidence could guide the scientific community, school directors, universities, and policymakers in the continuous process of improving the educational quality and working conditions of PHRs. Key messages • Residency training and work environment impact the mental health of the PHR workforce. • It is important to deploy concrete efforts into building healthy work environments and guarantee adequate training for PHRs.

The state of cancer-focused community outreach and engagement (COE): reflections of Black COE directors.

The requirement of community outreach and engagement (COE) as a major component of the National Cancer Institute (NCI) Cancer Center Support Grant has had an enormous impact on the way NCI-designated cancer centers identify, investigate, and address the needs of their catchment area (CA) communities. Given the wide-ranging diversity of our nation, COE's scope of work (SOW) is extremely demanding and complex. Yet, COE is often marginalized and viewed as void of scientific methods when, in fact, it requires specialized scientific knowledge and a broad range of proficiencies. Black COE scientific directors may be particularly attuned to this marginalization as they have often confronted workplace inequities that resemble the health inequities observed within their cancer center's CA. Thus, Black COE leaders are uniquely positioned to offer insight on the past, present, and future of COE. Key areas discussed include the low involvement of minoritized group members and those with appropriate expertise in national COE leadership; the lack of established, consistent criteria for evaluation of COE components and qualifications of evaluators; the need for substantial financial investment in COE; potential misalignment of community priorities and cancer center objectives; professional development and growth of COE staff and leaders; the expanding scope of COE across their respective cancer centers and CAs; and the need for center-wide involvement in COE and an "all-hands-on-deck" approach. These areas warrant thoughtful dialogue as COE evolves, for the benefit and success of all COE leaders. However, this dialogue must include diverse voices representing similarly diverse stakeholders at every level.

Health-related behaviour among managers of Slovenian hospitals and institutes of public health

Aim: Behavioural risk factors have a significant impact on health. We aimed to assess health-related behaviour, health status, and use of healthcare services among managers of Slovenian hospitals and institutes of public health. Methods: This was a cross-sectional study which included management (directors, scientific directors, directors’ deputies) of Slovenian hospitals and institutes of public health (63 respondents; 57% women; overall mean age: 51±7 years; response rate: 74%). Data were obtained using an anonymous self-administered questionnaire. Results: About 35% of respondents were directors. More than half of the respondents were overweight or obese (52%), the majority were not sufficiently physically active (59%) and overloaded with stress (87%). Hypercholesterolemia (36%), spinal disease (17%), and arterial hypertension (16%) were most common chronic diseases. Whilst only few participants visited their general practitioner due their health complaints, blood pressure (76%), cholesterol (51%), and glucose (54%) were measured within last year in most of the respondents. Conclusion: Our findings point to a high prevalence of overweight and obesity as well as workplace-related stress among Slovenian public health managers. Therefore, effective preventive strategies should be focused on stress management along with promotion of healthy behavioural patterns.

Effects of COVID-19 Quarantine Period on Fertility Patients and IVF Clinic Management Worldwide

Background: The initial months of 2020 experienced a rapid spread of a new Coronavirus named SARS-2. The World Health Organisation declared a global pandemic on 11th March 2020. Due to the new strain of the virus, little was known regarding COVID-19 and its effects on fertility and pregnancy. Aim: To explore how fertility clinics and ART treatments proceeded post COVID-19 lockdowns and how this affected fertility patients. Method: We surveyed fertility clinics world-wide with an online questionnaire through the platform RedCap. The questionnaire contained 33 questions focusing on the differences of country responses to guidelines and regulations. Scientific directors, medical directors and lab managers were contacted via email with the questionnaire link. The questionnaire was approved by Monash Health Human Research Ethics Committee and focused on the initial COVID-19 lockdown. Results: There were 34 individual country responses, Asia (11), Europe (10), Africa (3), North America (3), Oceania (2) and South America (5). Of the 34 countries, 7 countries did not experience a complete cessation of all procedures. Most countries followed their government health recommendations and clinic policies. IVF/ICSI and frozen embryo transfer (FET) procedures proved to be the most delayed treatments. Sixteen countries reported to have an increase in freeze-all cycles compared to fresh transfers. Patients had to undergo a SARS-CoV-2 test in 50% of countries. Additional counselling for patients during the pandemic was implemented in 22 countries. Conclusion: During the COVID-19 pandemic most fertility services were suspended, allowing insight into the implications of a shutdown. In conclusion, a protocol for scenarios of this nature would benefit future events. A protocol including increased phycological support, continuation of care, including telehealth and guidelines for prioritizing couples who need treatment most urgently.

Scientometrics in the Library as a Research Support Tool in the Ural Branch of the Russian Academy of Sciences

Scientometrics today is an effective tool to analyze and evaluate the activities of scientific organizations, as well as to form strategies and forecasts for the development of scientific research. To carry out scientometric research, specialists are required with the knowledge and skills to work with scientometric data. Such specialists can be employees of research libraries. The purpose of the study is to determine the role of the research library in carrying out scientometric works in the interests of research organizations. The article describes the experience of bibliometric analysis and the development of scientometrics in the Central Scientific Library of the Ural Branch of the Russian Academy of Sciences (UB RAS). The study of the state of scientometrics in research organizations of UD RAS was carried out by the method of questionnaires. As a result, it is revealed that most often work in scientometric databases is carried out by scientific secretaries and deputy directors for scientific work. In some answers one can see a limited use of scientometric databases capabilities. Thus, the need for a specialist in scientometrics has been identified. Despite the indicated advantages of library specialists, the importance of interaction between a research organization and a library is emphasized for conducting a high-quality scientometric analysis.

The impact of COVID-19 mitigation measures on fertility patients and clinics around the world

Research questionWhat is the impact of the response to COVID-19 on the management of fertility treatments and clinical practice around the world?DesignFertility clinic associates around the world were approached. They completed an online survey containing 33 questions focused on the country's response to the COVID-19 pandemic. Known fertility clinic associates that were contacted comprised scientific directors, medical directors and laboratory managers.ResultsThere were 43 individual country responses from Asia (13), Africa (3), Europe (17), North America (3), Oceania (2) and South America (5). In nine countries, clinics followed their government body recommendations, in 22 countries there was a combination of recommendations, in 3 countries changes were made by clinic initiative, and 9 countries did not specify. In 34 countries IVF/intracytoplasmic sperm injection (ICSI) and frozen embryo transfer (FET) treatments had an average delay of 56 days (IVF/ICSI) (minimum 0, maximum 160) and 57 days (FET) (minimum 0, maximum 166 days). During the shutdown, the number of freeze-all cycles increased in 22 countries. Only 23 countries reported patients having to undergo a SARS-CoV-2 test, and 20 countries did not report any COVID-19 testing in their clinic. Additional support counselling was offered in 28 countries, partner restrictions at clinics were reported in 41 countries and time between patients’ appointments was increased in 39 countries.ConclusionsThe implications of COVID-19 mitigation measures proved the need for government societies to introduce a set protocol that includes requirements such as increased patient counselling and additional guidelines for prioritizing couples who need care most urgently.

P–790 Effects of COVID–19 quarantine period on Fertility Treatment and IVF Clinic management

Abstract Study question What are the effects of the initial COVID–19 response on the management of fertility clinics and clinical practice around the world? Summary answer In the COVID–19 outbreak, the large majority of fertility clinics worldwide suspended fertility treatments. In cycles that continued, there was a shift to frozen embryo-transfer. What is known already After the initial months of 2020 showed a rapid spread of the new Coronavirus SARS-CoV–2, the World Health Organisation declared a global pandemic on 11 March 2020. Occupation of health care facilities with acutely sick patients and the need to reduce infection transmission led to a reduction in capacity to perform elective medical procedures. Little was known on the global impact of COVID–19 on fertility care. With the implication of ‘lockdowns’ in different countries around the world to stop the spread of the virus, the question was posed on how fertility clinics and treatments would proceed moving forward. Study design, size, duration We surveyed fertility clinics with an online questionnaire developed through the platform RedCap (HELIX). The questionnaire contained 33 questions focused on the differences of country responses to different body guidelines including American Society for Reproductive Medicine (ASRM) and European Society of Human Reproduction and Embryology (ESHRE). Fertility clinic associates were contacted through the use of a known contact list comprising scientific directors, medical directors and lab managers. Participants/materials, setting, methods Study participants were individuals associated with fertility clinics around the world with at least one representative from each country. The questionnaire was active from 13th October 2020 until 21st January 2021. The time frame was specific to the country’s response to their first lockdown. The survey was approved by Monash Health Human Research Ethics Committee(#65223). All survey answers were anonymous with only the countries’ name as a reference for analysis. Main results and the role of chance There were 34 individual country responses,Asia(11), Europe(10), Africa(3), North America(3), Oceania(2) and South America(5). Of the 34 countries, 7 countries did not experience a complete stop of all procedures. Most countries (18) followed their government body recommendations. One country followed local recommendations, 3 followed local and international recommendations, 3 countries changed by clinic initiative and 7 countries did not specify. ASRM and ESHRE were the two most common guidelines mentioned. IVF/ICSI treatment had delays in 28 countries ranging from 14 (Scotland) to 160 (Egypt) days. FETs were delayed in 29 countries ranging from 15 (Pakistan) to 228 (Scotland) days. Couples undergoing timed intercourse experienced the least delay in treatment (13 countries). AI/OI (artificial insemination/ovulation induction) patients were delayed treatment in 25 countries, fertility consultations were delayed in 20 countries. During the quarantine period, the amount of freeze-all cycles increased in 16 countries with the ratio of IVF-ICSI remaining constant pre and post lockdown. Patients were reported to undergo a SARS-CoV–2 test in 17 countries. 11 countries reported having a procedure in place for patients whom tested positive, 6 countries reported no procedure in place for positive patients. Additional support counselling was offered for patients during the pandemic in 22 countries. Limitations, reasons for caution Our survey does only represent a minute sample of countries. As only one representative from each country was used, the results obtained are specific to the individual’s anonymous clinic. However, the questionnaire includes questions that specifies if the clinic was performing outside the country’s scientific society recommendations. Wider implications of the findings: During the COVID–19 pandemic most fertility services were suspended, providing insight to the implications of a shutdown and whether a protocol for scenarios of this nature could benefit outcomes for future events. A protocol that allows continuation of care,including telehealth and guidelines for prioritizing couples who need care most urgently. Trial registration number N/A

Creating a diverse international user facility

The European XFEL is the first hard X-ray high-repetition-rate free-electron laser facility. Sakura Pascarelli, Serguei Molodtsov and Thomas Tschentscher, scientific directors of the European XFEL, discuss the challenges that lie ahead before the European XFEL can reach its full potential and cater for an international and diverse community of users.

Renin-Angiotensin System Inhibition in Cardiovascular Patients at the Time of COVID19: Much Ado for Nothing? A Statement of Activity from the Directors of the Board and the Scientific Directors of the Italian Society of Hypertension.

Cardiovascular diseases, in particular hypertension, as well as the cardiovascular treatment with Renin–Angiotensin System inhibitors such as Angiotensin Converting Enzyme (ACE) inhibitors and Angiotensin Receptor Blockers (ARBs), are claimed once again as mechanisms of Severe Acute Respiratory Syndrome (SARS) during the COVID-19 outbreak due to Cov-2 epidemics. In vitro studies are available to support the eventual role of ACE inhibitors and ARBs in both the promotion and antagonism of the disease. The available literature, indeed, presents contrasting results, all concentrated in experimental models. Evidence in humans is lacking that those mechanisms are actually occurring in the present COVID-19 outbreak. Here we present the reasoned statement of the Italian Society of Hypertension to maintain ongoing antihypertensive treatments. Furthermore, the Italian Society of Hypertension presents its own initiative to investigate the issue using an online questionnaire to collect relevant data in human disease.

Patriotism without Patriots? Perm΄-36 and Patriotic Legitimation in Russia

This article examines the takeover of the Perm’-36 Gulag museum as emblematic of the dynamics of patriotic legitimation in Russia. The museum was dedicated to preserving the memory of the victims of Soviet political repression and it grew in popularity into the 2000s, emerging as an opposition platform and target for self-styled patriots who accused it of distorting Soviet history. The regional government soon joined the battle, finally forcing the museum's takeover and transforming it into a site honoring the Gulag rather than its victims. Drawing on interviews conducted with the museum's former director and scientific directors in 2015 and extensive local press materials, this analysis of the struggle over Perm’-36 demonstrates the significance of patriotism in sustaining the regional government's attacks even in the absence of federal patronage. The findings thus challenge prevailing understandings of authoritarian regime politics as driven primarily by patronage and power-maximizing elites.

Careers in Core Facility Management.

The need for centralized shared core facilities and highly qualified core facility staff is becoming increasingly important in universities, research institutes, and commercial laboratories. With the continued advancement and sophistication of scientific equipment typically comes a larger price tag than can be handled by individual research laboratories. Moreover, the ever-increasing need for researchers to think and act in cross-disciplinary environments, coupled with the increasing sophistication of both the instrumentation and associated technologies, prevents most researchers from becoming "experts" in all areas.At all levels, core facility positions involve a love of technology, working with people, working on many diverse scientific questions, and days full of multitasking. Entry-level positions include basic and advanced technicians that require a BSc or MSc degree and some experience in the field. Midlevel management positions require experience in the field and an MSc or PhD degree. Management experience is a plus but not always required. Scientific directorship positions require a PhD and a keen interest in the technologies that are typically applied in the director's research program. Associate deans of core resources are often former core managers or scientific directors with a vision for the core and who are strong administrators.A career as a core facility staff member can be very rewarding. Successful managers and directors must be able to multitask, reassess priorities, and be adept at using logical reasoning to identify and solve issues as they arise. These positions will continue to be available over the long term with the increasing complexity and continued fast pace of technology development.

Suicide Deaths Climb Dramatically in U.S., Nearly Double for Women

Suicide Deaths Climb Dramatically in U.S., Nearly Double for Women

Confined to a tokenistic status: Social scientists in leadership roles in a national health research funding agency

The idea of interdisciplinarity has been taken up by academic and governmental organisations around the world and enacted through science policies, funding programs and higher education institutions. In Canada, interdisciplinarity led to a major transformation in health research funding. In 2000, the federal government closed the Medical Research Council (MRC) and created the Canadian Institutes of Health Research (CIHR). From the outset, CIHR's vision and goals were innovative, as it sought to include the social sciences within its purview alongside more traditional health research sectors. The extent to which it has been successful in this endeavour, however, remains unknown. The aim of our study was to examine how CIHR's intentions to foster inclusiveness and cooperation across disciplines were implemented in the agency's own organisational structure. We focused on social scientists' representation on committees and among decision-makers between 2000 and 2015, one of the key mandates of CIHR being to include the social sciences within its remit and support research in this area. We examined the composition of the Governing Council, the Institute Scientific Directors, the Chairs of the College of Reviewers, and two International Review Panels invited by CIHR. We targeted these committees and decision-makers since they hold the power to influence the field of Canadian health research through the decisions they make. Our findings show that, while CIHR was created with the mandate to support the entire spectrum of health-related research—including the social sciences—this call for inclusiveness has not yet been materialized in the agency's organisational structure. Social scientists, as well as researchers from neighbouring disciplines such as social epidemiology, health promotion and the humanities, are still confined to low levels of representation within CIHR's highest echelons. This imbalance limits social scientists' input into health research in Canada and undermines CIHR's interdisciplinary ambition.

Italian Supreme Court clarifies fair compensation for scientific directors for inventions made by their teams

Italian Supreme Court clarifies fair compensation for scientific directors for inventions made by their teams

Del abandono y la orfandad al cuidado y formación para la vida

Este artículo analiza la historia institucional de la Escuela de Oficios Domésticos y el Asilo San José para niños desamparados, dos instituciones creadas por la Beneficencia de Cundinamarca para la atención y educación de la niñez en orfandad y abandono. Este análisis se realiza a partir de los informes de protección infantil dados a la Junta General de Beneficencia por parte del secretario de Asistencia Social y de los directores científicos y administrativos de estos establecimientos durante los años 1938, 1939, 1944 y 1946. El interés se centra en analizar, describir y contextualizar el funcionamiento y la vida cotidiana de estas instituciones.

The art and science of engaging patients into medical research: using professional recruiters' experiences to inform physicians and scientific directors' strategic choices.

In order to advance medical care, it is necessary to invest resources, both human and financial, in medical research. However, these investments sometimes are not sufficient to ensure the success of research studies. No progress can be made without the participation of patients in research studies and clinical trials. These potential participants are normally identified by their physicians, or by professional recruiters, depending on the patient clinical profile. However, often patients are intimidated by the idea of engaging in clinical trials for several reasons, including the fear of side effects, to the difficulty of understanding specific research-related terms. The main objective of this project was to identify the communication strategies used by recruiters to help patients enroll into medical research projects. Another goal of the study was to identify key information that would help PIs and researchers make more effective decisions in terms of design and methodology. A total of 11 focus groups were conducted in two large, ethnically diverse cities: Indianapolis and Miami (USA). Our analyses indicated that recruiters use a variety of verbal and nonverbal communication strategies to create a relationship with potential participants. In addition, recruiters consider the cultural background of the people they interact with, the environment in which they live, the resources available, and the possible support of family members.

Identify and Rank the Barriers to Technology Transfer - Analytic Hierarchy Process

Transfer of technology as an inevitable necessity has been interested by scientific directors and executive directors in the past two decades. Obstacles facing this transition in modern countries (developed) in the countries such as Iran is considered significantly. This study is a descriptive survey, and applied in term of purpose. The purpose of this study is to identify and rank the barriers to transfer technology in Iran.Mentioned study uses literature research and expert opinions gathered through interviews and questionnaires, to identify high-impact barriers and has prioritized the major obstacles to transfer technology through the use of hierarchical analysis. The results show that technical, human, organizational information barriers were the most important barriers to transfer technology in Iran and technical barriers, in the infrastructure; in human barrier, managerial skills, the obstacle information, cost information and ultimately organizational barriers, have created the challenges.

Legacy: Professor Slawomir Magala (Slawek)

Purpose – Professor Slawomir Magala is a full professor of Cross-Management at the Department of Organization and Personnel Management in Rotterdam School of Management (RSM), Erasmus University (RSM, 2015). His education stems from Poland, Germany and the USA, and has taught and conducted research in China, Egypt, Kazakhstan, Croatia, Estonia, the United Kingdom and Namibia. He is a former Chair for Cross-Cultural Management at RSM and has achieved many things, from being editor-in-chief of the Journal of Organizational Change Management (JOCM), to receiving the Erasmus Research Institute in Management (ERIM) Book Award (2010), for The Management of Meaning in Organizations (Routledge, 2009). It has received honors for being the best book in one of the domains of management research. It was selected by an academic committee, consisting of the Scientific Directors of CentER (Tilburg University), METEOR (University of Maastricht) and SOM (University of Groningen). All these research schools are accredited by the Royal Netherlands Academy of Arts and Sciences (KNAW). The paper aims to discuss this issue. Design/methodology/approach – This is a review of Professor Slawomir Magala’s contributions as editor of Journal of Organizational Change Management. Findings – Slawomir (Slawek) Magala will be known for many contributions to social, organizational, managerial research, and it will be remembered that he has created a great legacy in the field of cross-cultural competence and communication on processes of sense making in professional bureaucracies. He has authored and co-authored many publications including articles, books, professional publications, book contributions and other outputs, and is an established professor of cross-cultural management at the Department of Organization and Personnel Management in RSM, Erasmus University. He will be known for his work as editor of Qualitative Sociology Review, and one of the founding members of the Association for Cross-Cultural Competence in Management, not to mention the Journal of Organizational Change Management. Many of his articles have appeared regularly in leading refereed journals, such as the European Journal of International Management, Public Policy, Critical Perspectives on International Business and Human Resources Development International. His greatest legacy is in the field of cross-cultural management, but branches out to many other management studies. Research limitations/implications – The research is limited to his work in capacity of editor of Journal of Organizational Change Management. Practical implications – This review provides a guide for positive role model of an excellent editorship of a journal. Social implications – Magala’s legacy acknowledges this research and its power to create numerous papers and attract a lot of attention (Flory and Magala, 2014). Because of these conferences, these empirical findings have led to disseminating the conference findings with JOCM (Flory and Magala, 2014). According to them, narrative research has become a respectable research method, but they also feel that it is still burdened with a lot of controversies on with difficulties linked to applying it across different disciplines (Flory and Magala, 2014). Originality/value – The review covers the creative accomplishment of Professor Magala as editor.

Challenges of the health research system in a medical research institute in Iran: a qualitative content analysis.

Background and Aim:Medical research institute is the main basis for knowledge production through conducting research, and paying attention to the research is one of the most important things in the scientific communities. At present, there is a large gap between knowledge production in Iran compared to that in other countries. This study aimed to identify the challenge of research system in a research institute of medical sciences in Iran.Matherials and Methods:This was a descriptive and qualitative study conducted in the first 6 months of 2013. A qualitative content analysis was conducted on 16 heads of research centers in a research institute of medical sciences. The required data were gathered using semi-structured interviews. The collected data were analyzed using MAXQDA 10.0 software.Results:Six themes identified as challenges of research system. The themes included barriers related to the design and development, and approval of research projects, the implementation of research projects, the administrative and managerial issues in the field of research, the personal problems, publishing articles, and guidelines and recommendations.Conclusion:Based on the results of the present study, the following suggestions can be offered: pushing the research towards solving the problems of society, employing the strong executive and scientific reseach directors in the field of research, providing training courses for researchers on how to write proposals, implementing administrative reforms in the Deputy of Research and Technology, accelerating the approval of the projects through automating the administrative and peer-reviewing processes.

Implementation of a registry for quality improvement

Presentation Crohns’ Disease and ulcerative colitis, or Inflammatory Bowel Disease (IBD), are rare in the pediatric population. Thus, conducting research centered on improving the quality of pediatric IBD care can be challenging for individual pediatric gastroenterology centers. By pooling data and sharing results across 35 care centers nationally, the ImproveCareNow network provides the opportunity for conducting quality improvement (QI) research aimed at improving care and outcomes for pediatric patients with IBD and their families [1]. The network serves as a platform for innovation and the establishment of evidencebased practices for IBD care. ImproveCareNow includes a registry database for clinical care, QI and research; a program to teach QI to each site’s QI team; and tools for QI interventions. The presentation at the Academy for Healthcare Improvement Methods meeting demonstrated how a registry can be a vital part of QI and QI research. The ImproveCareNow network uses the Model for Improvement to provide more reliable, pro-active care to pediatric patients with IBD [2]. Continuous improvement activities include examining registry data through detailed reports and acting appropriately based on these data. The centers receive monthly performance reports on 15 key clinical measures, a data quality report, and two population management reports. Control charts, benchmarking data, and care stratification data allow clinicians to identify high-risk patients and drill down to the patient level of analysis. The network also provides QI education and support, including monthly webinars, twice-yearly in-person learning sessions, and tools for effective system redesign. Network staff includes the network, scientific, and project directors, project manager, project coordinators, and QI consultants. Each center has its own QI team (physician leader, nurse leader, and improvement coordinator) that enrolls patients, enters data collected for each visit into a web-based database, and carries out QI activities to improve the site’s care delivery system. The network has demonstrated significant improvements in IBD remission rates, with approximately 75% of patients in remission in 2011 compared to 50% of patients in remission in 2007. The network recently received funding from the Agency for Healthcare Research and Quality (AHRQ) to enhance its capacity. Funding will facilitate the roll-out of innovative informatics techniques to automate data transfer from the electronic health record directly to the registry, which will eliminate the need for manual data entry. Automation will also improve data collection for QI activities, population management procedures, pre-visit planning, patientreported outcomes, comparative effectiveness research, and research focused on effectiveness of new biological agents to treat IBD. These informatics enhancements may reduce the time and personnel costs for the new centers anticipated to join a planned, larger sustainable network across 170 centers nationwide with over 50,000 patients. ImproveCareNow also received additional funding to create a Chronic Care Collaborative Network or C3N. The overall aim is to bring together stakeholders with the shared goal of improving patient self-management, clinical practice, and disease outcomes through innovative use of information technology and social media. Studying the value of the network, or how well it achieves better outcomes at lower costs, and conducting comparative effectiveness research are major priorities as the network moves toward becoming a C3N.