Workshop Recommendations Research Articles

Search Workshop on Large-Scale Atmosphere–Cryosphere Observations

Abstract Although certain regions of the Arctic have experienced periods of decadal warming during the last 100 years, recent decades show an ongoing suite of Arctic-wide, interrelated atmospheric, oceanic, terrestrial, and human dimension changes. A major workshop conclusion stresses the necessity for coordination between arctic disciplines to form a continuing and enhanced dataset of arctic change. A major workshop recommendation is to increase the use of past and evolving datasets for understanding arctic change through, for example, an arctic change protocol, an aaaarctic system reanalysis, timely intercalibration of satellite products, and multidisciplinary, multiregional analyses. Understanding of the Arctic can improve change detection due to the roles of vegetation type, sea ice, and other feedbacks in providing a multiyear memory for the climate system.

ASCUS in Papanicolaou smears. Problems, controversies, and potential future directions.

Each year, an estimated 2 to 3 million women in the United States receive a Papanicolaou smear diagnosis of atypical squamous cells of undetermined significance (ASCUS). There is no uniform practice for the diagnosis or management of these patients, and the annual cost of aggressively treating ASCUS lesions is estimated to be billions of dollars. Since its introduction in 1988, ASCUS has been problematic and controversial. ASCUS is a problem to define, to diagnose, to reproduce, and to manage. The following article reviews the various aspects and problems of ASCUS, its controversies regarding diagnosis, reproducibility, and management, and discusses the possible future directions of this category in light of the recent Bethesda System 2001 Workshop recommendations.

Adverse drug effects and adverse drug reactions in pediatric patients: Workshop summary and recommendations

Adverse drug effects and adverse drug reactions in pediatric patients: Workshop summary and recommendations

Report from the NOAA workshops to standardize protocols for monitoring toxic Pfiesteria species and associated environmental conditions.

Long-term monitoring of water quality, fish health, and plankton communities in susceptible bodies of water is crucial to identify the environmental factors that contribute to outbreaks of toxic Pfiesteria complex (TPC) species. In the aftermath of the 1997 toxic Pfiesteria outbreaks in North Carolina and Maryland, federal and several state agencies agreed that there was a need to standardize monitoring protocols. The National Oceanic & Atmospheric Administration convened two workshops that brought together state, federal, and academic resource managers and scientific experts to a) seek consensus on responding to and monitoring potential toxic Pfiesteria outbreaks; b) recommend standard parameters and protocols to characterize water quality, fish health, and plankton at historical event sites and potentially susceptible sites; and c) discuss options for integrating monitoring data sets from different states into regional and national assessments. Workshop recommendations included the development of a three-tiered TPC monitoring strategy: Tier 1, rapid event response; Tier 2, comprehensive assessment; and Tier 3, routine monitoring. These tiers correspond to varying levels of water quality, fish health, and plankton monitoring frequency and intensity. Under the strategy, sites are prioritized, depending upon their history and susceptibility to TPC events, and assigned an appropriate level of monitoring activity. Participants also agreed upon a suite of water quality parameters that should be monitored. These recommendations provide guidance to state and federal agencies conducting rapid-response and assessment activities at sites of suspected toxic Pfiesteria outbreaks, as well as to states that are developing such monitoring programs for the first time.

NCI Image Archive Management Workshop: A Preliminary Report

The National Cancer Institute organized a workshop entitled “Image Archive Management” that was presented on August 28 and 29, 2000, at the Natcher Conference Center on the National Institutes of Health (NIH) campus. The purpose of this workshop was to solicit expert input for the planned development of an archival system to make imaging databases readily accessible by the broad scientific community. The specific goals were to ( a) define the technical requirements for a virtual archive of images used in oncology, ( b) define the policy issues for access to these images, ( c) recommend a process and phases for implementation of a robust imaging archival system, ( d) review how this effort could be expanded and coupled with other ongoing efforts by NIH and other organizations interested in imaging, and ( e) form an overall plan and policy to allow interoperability of image data archives. Representatives who attended the workshop came from academia, government agencies, and large and small businesses. A preliminary report was generated, as outlined herein, and additional reports are anticipated from the steering committee being organized as one of this workshop's recommendations, which is expected to be active by summer 2001. Additional information, including the list of participants in this workshop, is available at the Biomedical Imaging Program Web site ( http://www.nci.nih.gov/bip/ ).

NCI-Funded Small Animal Imaging Programs

The use of small animal models as surrogates for humans in the study of normal and disease states has a long history. The models used have ranged from the simplest possible to those as complex as the investigator’s imagination and skills allow. Growing opportunities to apply methods of molecular and cellular biology to the study and treatment of human disease have increased demand for the creation of animal models with more humanlike diseases. Cultures of cancer cells growing in vitro, or as tumors on the flank of a small animal, no longer suffice because treatment agents and techniques that enjoy even great success in such milieus too frequently prove to be utter failures in phase I testing in humans. These failures propel investigators to understand disease, and its progression and treatment, by better means than observations of less-faithful models, such as a growing cell line. They see more fruitful approaches in molecular and cellular manipulations of animals to model the whole disease process more faithfully. Successful creations of live, whole animals that more faithfully model human diseases led to an obvious desire for a way to image disease progression in each animal, without resort to biopsy or sacrifice to answer every question. Most early animal imaging studies used instruments and techniques designed for human use, during hours when this equipment was not in clinical use. However, systems optimized for human use frequently yield suboptimal results for small animal studies. In addition, there are other problems associated with mixing animal and patient studies on clinical instruments. The growing need for dedicated small animal imaging systems was noticed by the Biomedical Imaging Program of the National Cancer Institute (NCI) and was included among other issues explored in series of workshops held to better define the needs for cancer imaging and areas in which special NCI initiatives might provide the most impetus for change and advancement. One subgroup addressing small animal imaging—the In vivo Molecular/Functional Imaging Subgroup (MIS), chaired by Elias Zerhouni, MD—recommended that the National Institutes of Health (NIH) and NCI should support dedicated small animal imaging facilities focusing on the study of genetically engineered tumor models (http://cancer.gov/bip/ISWG3.htm). They also recommended that the greater part of the efforts of the facilities be directed toward imaging, not the creation of new instruments. Workshop participants concluded that the facilities should provide imaging by more than one technique because they did not like the prospect of limiting the range of scientific questions open to investigation by having only one modality at hand. With this workshop recommendation in mind, the Biomedical Imaging Program developed a concept for Small Animal Imaging Resource Project (SAIRP) grants, which the May 1998 NCI Board of Scientific Advisors approved enthusiastically. The concept was for the Biomedical Imaging Program to budget support for approximately four SAIRPs under the R24 mechanism, which specifies the development of research resource centers. Each grantee would be expected to provide access to at least two different imaging modalities and serve at least six funded cancer research projects by the end of the 2nd year of operation. The Biomedical Imaging Program translated the concept into a request for applications, set a receipt date of November 1998, and defined the objectives and scope as follows: (a) multiple imaging technologies for small animals, emphasizing, but not limited to those technologies that can provide biochemical, genetic or Acad Radiol 2001; 8:372–374

Risks of repeat pregnancy after peripartum cardiomyopathy: Double jeopardy

Peripartum cardiomyopathy is a relatively infrequent disorder (1 to 1,800 to 1 to 4,000 deliveries in the United States) that results in severe systolic dysfunction in the hearts of previously healthy women in and around the time of pregnancy ( 1 Pearson GD Veille JC Rahimtoola S Hsia J Oakley CM Hosenpud JD Ansari A Baughman KL Peripartum cardiomyopathy:National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) workshop recommendations and review. JAMA. 2000; 283: 1183-1188 Crossref PubMed Scopus (717) Google Scholar ). The cause of the condition is unknown, and inflammatory, autoimmune, and environmental causes have been considered. Patients submitted to endomyocardial biopsy early after their diagnosis often display myocarditis ( 2 Felker GM Jaeger CJ Klodas E Thiemann DR Hare JM Hruban RH Kasper EK Baughman KL Myocarditis and long-term survival in peripartum cardiomyopathy. Am Heart J. 2000; 140: 785-791 Abstract Full Text Full Text PDF PubMed Scopus (134) Google Scholar ). The natural history of this disorder is not well understood. From the early observations of Demakis and Rahimtoola, it was evident that some patients have a dramatic recovery of heart function, whereas others develop a dilated cardiomyopathy ( 3 Demakis JG Rahimtoola SH: Peripartum cardiomyopathy.. Circulation. 1971; 44: 964-968 Crossref PubMed Scopus (298) Google Scholar ). More recent data imply that the prognosis may be better for patients with this condition than previously considered ( 2 Felker GM Jaeger CJ Klodas E Thiemann DR Hare JM Hruban RH Kasper EK Baughman KL Myocarditis and long-term survival in peripartum cardiomyopathy. Am Heart J. 2000; 140: 785-791 Abstract Full Text Full Text PDF PubMed Scopus (134) Google Scholar , 4 Felker GM Thompson RE Hare JM Hruban RH Clemetson DE Howard DL Baughman KL Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy. N Engl J Med. 2000; 342: 1077-1084 Crossref PubMed Scopus (1263) Google Scholar ).

Nuclear DNA Amounts in Pteridophytes

DNA amounts (C-value and genome size) are much-used biodiversity characters. A workshop held at Kew in 1997 identified major gaps in our knowledge of plant DNA amounts, recommending targets for new work to fill them. Murray reviewed non-angiosperm plants noting that representation of pteridophyte species (approx. 0.42%) was poor, while locating C-value data for them was very difficult. The workshop confirmed the need to make data for other groups besides angiosperms accessible for reference purposes. This paper pools DNA C-values for 48 pteridophyte species from eight original sources into one reference source, and fulfils a key workshop recommendation for this group. Comparing these data shows that nuclear 1C-values in pteridophytes vary approx. 1000-fold, from 0.055pg in Selaginella species to about 55pg in Ophioglossum petiolatum. Genome size estimates for 25 pteridophytes vary approx. 200-fold from 0.055 to 10.7pg, and the mean genome sizes in diploids and polyploids (5.15 and 4.59pg, respectively) are not significantly different. Wider comparisons show that ranges of genome sizes in the major groups of land plants are very different. Those in bryophytes and pteridophytes are narrow compared with those in gymnosperms and angiosperms. The data indicate that the origin of land plants possibly involved a first major increase in genome size in the evolution of vascular plants, while a second such increase occurred later in gymnosperms. C-values for pteridophytes remain very few, but conversely opportunities for new work on them are many.

American Cancer Society guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal, and endometrial cancers. Also: update 2001--testing for early lung cancer detection.

Updates to the American Cancer Society (ACS) guidelines regarding screening for the early detection of prostate, colorectal, and endometrial cancers, based on the recommendations of recent ACS workshops, are presented. Additionally, the authors review the "cancer-related check-up," clinical encounters that provide case-finding and health counseling opportunities. Finally, the ACS is issuing an updated narrative related to testing for early lung cancer detection for clinicians and individuals at high risk of lung cancer in light of emerging data on new imaging technologies. Although it is likely that current screening protocols will be supplanted in the future by newer, more effective technologies, the establishment of an organized and systematic approach to early cancer detection would lead to greater utilization of existing technology and greater progress in cancer control.

Peripartum Cardiomyopathy: National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) Workshop Recommendations and Review

Objective Peripartum cardiomyopathy (PPCM) is a rare life-threatening cardiomyopathy of unknown cause that occurs in the peripartum period in previously healthy women. In April 1997, the National Heart, Lung, and Blood Institute (NHLBI) and the Office of Rare Diseases of the National Institutes of Health (NIH) convened a Workshop on Peripartum Cardiomyopathy to foster a systematic review of information and to develop recommendations for research and education. Participants Fourteen workshop participants were selected by NHLBI staff and represented cardiovascular medicine, obstetrics, immunology, and pathology. A representative subgroup of 8 participants and NHLBI staff formed the writing group for this article and updated the literature on which the conclusions were based. The workshop was an open meeting, consistent with NIH policy. Evidence Data presented at the workshop were augmented by a MEDLINE search for English-language articles published from 1966 to July 1999, using the terms peripartum cardiomyopathy, cardiomyopathy, and pregnancy. Articles on the epidemiology, pathogenesis, pathophysiology, diagnosis, treatment, and prognosis of PPCM were included. RECOMMENDATION PROCESS: After discussion of data presented, workshop participants agreed on a standardized definition of PPCM, a general clinical approach, and the need for a registry to provide an infrastructure for future research. Conclusions Peripartum cardiomyopathy is a rare lethal disease about which little is known. Diagnosis is confined to a narrow period and requires echocardiographic evidence of left ventricular systolic dysfunction. Symptomatic patients should receive standard therapy for heart failure, managed by a multidisciplinary team. If subsequent pregnancies occur, they should be managed in collaboration with a high-risk perinatal center. Systematic data collection is required to answer important questions about incidence, treatment, and prognosis.

Dietary intake of polyunsaturated fatty acids by pregnant or lactating women in the United States

Dietary intakes of specific polyunsaturated fatty acids (PUFAs), particularly docosahexaenoic acid, and the ratio between omega-6 and omega-3 consumption during pregnancy and lactation affect maternal and infant PUFA status and may play a role in infant neurodevelopment. The 1994–1996 U.S. Department of Agriculture/ARS Continuing Survey of Food Intakes by Individuals, a nationally representative analysis of consumption, provides data on the five major PUFAs in the food supply, including intakes from a subset of 112 pregnant or lactating women. Mean individual daily intakes of omega-6 fats are more than 200% of recommended upper limits proposed by a recent National Institutes of Health workshop, and intakes of omega-3 fats are only 20–60% of recommended adequate intakes.Intakes of omega-3, eicosapentaenoic acid, and docosahexaenoic acid are highest in women older than 40 years of age, those of Asian/Pacific descent, households with income greater than 350% of the poverty level, and women with at least 1 year of college education. Finally, PUFA intakes are compared with intakes in other countries, with U.S. consumption of omega-6 higher and omega-3 lower than those in Japan and several other European nations. PUFAMean daily intake (g)NIH Workshop recommendation (g/d)Linoleic acid14.1486.67Arachidonic acid0.118Linolenic acid1.4072.22Eicosapentaenoic acid0.0220.22Docosahexaenoic acid0.0540.30

ECVAM’s in-house prevalidation/validation studies in the areas of haematotoxicity, reproductive toxicity, metabolism-mediated toxicity and epithelial barrier function

The European Centre for the Validation of Alternative Methods (ECVAM) facilitates, co-ordinates and participates in validation activities at the European Union level. Various experimental studies, e.g. in the areas of haematotoxicity, reproductive toxicity, nephrotoxicity and epithelial barrier function, and metabolism-mediated toxicity, are underway in ECVAM’s laboratories. ECVAM itself is currently involved in the prevalidation/validation of two assays, the colony-forming unit granulocyte/macrophage (CFU-GM) assays for predicting acute neutropenia and the embryonic stem cell test for predicting embryotoxicity. In the areas of metabolism-mediated toxicity and nephrotoxicity and epithelial barrier function, several assays are in the course of development. In many cases, the recommendations of various ECVAM workshops are being followed.

A multi-spacecraft synthesis of relativistic electrons in the inner magnetosphere using LANL, GOES, GPS, SAMPLEX, HEO and POLAR

One of the Brussels Radiation Belt Workshop recommendations was the establishment of a near-real-time data driven model of the inner magnetospheric energetic particle population ( L < 8). Although the “ideal” missions and data sets for such a model do not exist at present, more spacecraft than ever before are currently sampling the inner magnetosphere. We attempt here in a case study of the January 10, 1997 magnetic cloud event to construct such a model with the energetic electron data available from 5 geosynchronous and 5 elliptically orbiting satellites. We examine the constraints and difficulties of putting together a large number of datasets which are measured near-simultaneously at very different locations in the inner magnetosphere. First results indicate that we can achieve a time resolution of about 3 hours for a given “snapshot” of the inner magnetosphere, and that large azimuthal asymmetries of the energetic electron population can be observed during large storms.

A multi-spacecraft synthesis of relativistic electrons in the inner magnetosphere using LANL, GOES, GPS, SAMPEX, HEO and POLAR

One of the Brussels Radiation Belt Workshop recommendation was the establishment of a near-real-time data driven model of the inner magnetospheric energetic particle population ( L<8). Although the “ideal” missions and data sets for such a model do not exist at present, more spacecraft than ever before are currently sampling the inner magnetosphere. We attempt here in a case study of the 10 January, 1997 magnetic cloud event to construct such a model with the energetic electron data available from 5 geosynchronous and 6 elliptically orbiting satellites. We examine the constraints and difficulties of putting together a large number of datasets which are measured near-simultaneously at very different locations in the inner magnetosphere. First results indicate that we can achieve a time resolution of about 3 h for a given “snapshot” of the inner magnetosphere, and that large azimuthal asymmetries of the energetic electron population can be observed during large storms.

Human environmental interactions in Upper Lapland, Finland: Development of participatory research strategies

The paper outlines strategies for participatory research by comparing the results of a participatory workshop on research needs in human‐environmental interaction in Finnish Lapland with an analysis of official Finnish policy documents on the same subject. The workshop was organized in Anár/Inari, Finland in October 1997 as part of the Human Environmental Interactions theme (HEI) of the European Commission's Arctic‐Alpine Terrestrial Ecosystems Research Initiative (ARTERI). The mandate of ARTERI was to develop research themes and encourage their implementation to allow for discussions among local residents, natural and social scientists, and policy‐makers concerned with environmental protection and management in arctic and alpine regions of Europe. The objective of the Anár/Inari workshop was to discuss central issues of human‐environmental interaction in the region in a participatory mode with local interest groups, generate alternative scenarios for the region, and develop research and development project proposals on the basis of the scenarios. The paper discusses the scenarios and the project proposals that the workshop developed, and compares them with official Finnish policies on forestry and reindeer management in Lapland. From methodological and theoretical perspectives, the workshop was a unique empirical setting within which to investigate the dynamic interaction between traditional and modern knowledge sets on human‐environmental interaction. From the policy perspective, the comparison of workshop recommendations and official policies offers valuable indications for future directions in participatory policy‐making in the region and novel ways of balancing the conflicting demands on environmental resources, such as reindeer management, forestry, and tourism.

Defining predoctoral prosthodontic curriculum: a workshop sponsored by the American College of Prosthodontists and the prosthodontic forum.

Prosthodontic educators participated in a workshop held at The American College of Prosthodontists annual session in Kansas City, MO, in October 1996. Their goal was to review elements of the predoctoral prosthodontic curriculum to establish a consensus on the levels of expected skill and knowledge. Skill components were designated at the competency and exposure levels, while knowledge components were designated at the understanding and familiarity levels. The workshop recommendations were distributed to American and Canadian dental schools and the communities of interest for comments in January 1997. The workshop recommendations were reviewed and finalized at the American Association of Dental Schools annual meeting in Orlando, FL, in March 1997. The recommendations may be used by dental educators to prioritize curricular elements in relation to limited time dedicated to the prosthodontic curriculum. Outcomes assessment methods will be needed to ensure competency in the new dentist.

Agroforestry innovations for Imperata grassland rehabilitation: workshop recommendations

Agroforestry innovations for Imperata grassland rehabilitation: workshop recommendations

INNOVATIVE INTERACTIVE MULTIDISCIPLINARY WORKSHOPS

ABSTRACT: In the context of difficulties experienced by rural health practitioners in accessing appropriate continuing education, a pilot project was undertaken by the Monash University Centre for Rural Health and the Monash School of Health Sciences (Nursing) in association with the Victorian Medical Postgraduate Foundation Inc. and La Trobe University Faculty of Health Sciences in Bendigo. Two innovative interactive mental health workshops were held, one in Bendigo and the other in Traralgon. This article outlines the process followed, problems encountered and lessons learned from the project. Drawing on this experience, the article then develops a series of recommendations for successful multidisciplinary workshops. Key features include: a multidisciplinary organising committee, carefully selected topics, high profile guest speakers, an interactive format and targeted marketing of the workshop. For appropriate topics interactive multidisciplinary workshops are an effective form of continuing education for rural health professionals.

Cachexia-Anorexia-Asthenia

The National Cancer Institute (Canada) sponsored a workshop on symptom control in Banff, Alberta, in October 1993. This article reports on the workshop recommendations for research on one symptom complex, the cachexia-anorexia-asthenia syndrome. In addition to encouraging study generation, the recommendations provide a baseline for assessing the scope and strength of future Canadian research initiatives on cachexia-anorexia-asthenia.

Workshop recommendations

Workshop recommendations