Burnet Oration: living in the Burnet lineage.
Scientific discoveries are not made in isolation. Innovation depends on resources, both intellectual and physical. A primary requirement is the development and maintenance of appropriate institutions. Such structures do not emerge by chance, but arise from opportunity, political will and the continued efforts and commitment of many people over long periods. Suitable buildings, laboratories and state-of-the-art equipment are obviously necessary, but hardware alone is of little value in the absence of a vibrant research culture. The key characteristics of the latter are intellectual foment, open debate and a body of wisdom and knowledge about the particular subject area. Rolf Zinkernagel and 1 played a part in triggering a paradigm shift in the understanding of T cell recognition, a contribution recognized by the 1996 Nobel Prize for Physiology or Medicine. In our Nobel lectures, we both discussed briefly why it was that the John Curtin School of Medical Research (JCSMR) of 1973-75 provided a milieu that facilitated the emergence of the underlying experiments and ideas. My intention here is to discuss in more detail the scientific lineages that put this physical and intellectual environment in place, focusing particularly on the influence of Sir Frank Macfarlane (Sir Mac) Burnet as we celebrate his centenary year. (+info
Informatics at the National Institutes of Health: a call to action.
Biomedical informatics, imaging, and engineering are major forces driving the knowledge revolutions that are shaping the agendas for biomedical research and clinical medicine in the 21st century. These disciplines produce the tools and techniques to advance biomedical research, and continually feed new technologies and procedures into clinical medicine. To sustain this force, an increased investment is needed in the physics, biomedical science, engineering, mathematics, information science, and computer science undergirding biomedical informatics, engineering, and imaging. This investment should be made primarily through the National Institutes of Health (NIH). However, the NIH is not structured to support such disciplines as biomedical informatics, engineering, and imaging that cross boundaries between disease- and organ-oriented institutes. The solution to this dilemma is the creation of a new institute or center at the NIH devoted to biomedical imaging, engineering, and informatics. Bills are being introduced into the 106th Congress to authorize such an entity. The pathway is long and arduous, from the introduction of bills in the House and Senate to the realization of new opportunities for biomedical informatics, engineering, and imaging at the NIH. There are many opportunities for medical informaticians to contribute to this realization. (+info
Health related research in Bangladesh: MEDLINE based analysis.
BACKGROUND: Health research is not a priority sector in Bangladesh. By and large, physicians and academicians are neither interested nor are they properly trained to conduct quality research. The objective of this study is to quantify the volume of researches related to health in Bangladesh with a view to propose remedial measures. METHODS: Data regarding health research, originating from Bangladesh during the period of 1990-1996, were extracted from MEDLINE database using certain inclusion criteria. Data on name of the institution, main author (Bangladeshi or foreigner), country of publication, and research topics were abstracted and analyzed using descriptive statistics. RESULTS: A total of 580 (on average 83 per year) articles met the inclusion criteria. About two-third (64.0%) of the researches were from International Center for Diarrheal Disease Research, Bangladesh, followed by Institute of Post Graduate Medicine & Research with 5.7%. Seven medical colleges and one dental college collectively contributed 5.8%. Infectious diseases was the single largest (54.8%) topic dealt with, followed by non-infectious diseases (7.7%), and nutrition and nutrition-related diseases (6.9%). CONCLUSION: The number of research articles from Bangladesh is very small possibly owing to the lack of proper training and funding shortage. Incorporating research methodology in both graduate and postgraduate medical education, appointing researchers in clinical and academic departments and allocating more funding towards research activities are necessary to boost health related research activities in Bangladesh. (+info
A treasure house of comparative embryology.
The Embryo Collection of the Hubrecht Laboratory is a treasure house of comparative embryology. It is the largest and most important collection of its kind in the world, and consists of thousands of vertebrate embryos stored in alcohol, or prepared as histological sections. Many elusive species are included in the collection, some represented by complete developmental series. The accompanying archives offer a remarkable insight into the methods used to collect embryos form wild animals, as well as the motives behind the founders of the collection. Carefully maintained, documented and catalogued, the collection is available for study by all interested scientists. We argue that this collection is one of the greatest biodiversity resources in existence. (+info
The EFQM excellence model: European and Dutch experiences with the EFQM approach in health care. European Foundation for Quality Management.
One way to meet the challenges in creating a high performance organization in health care is the approach of the European Foundation for Quality Management (EFQM). The Foundation is in the tradition of the American Malcolm Baldrige Award and was initiated by the European Commission and 14 European multi-national organizations in 1988. The essence of the approach is the EFQM Model, which can be used as a self-assessment instrument on all levels of a health care organization and as an auditing instrument for the Quality Award. In 1999 the EFQM Model was revised but its principles remained the same. In The Netherlands many health care organizations apply the EFQM Model. In addition to improvement projects, peer review of professional practices, accreditation and certification, the EFQM Approach is used mainly as a framework for quality management and as a conceptualization for organizational excellence. The Dutch National Institute for Quality, the Instituut Nederlandse Kwaliteit, delivers training and supports self-assessment and runs the Dutch quality award programme. Two specific guidelines for health care organizations, 'Positioning and Improving' and 'Self-Assessment', have been developed and are used frequently. To illustrate the EFQM approach in The Netherlands, the improvement project of the Jellinek Centre is described. The Jellinek Centre conducted internal and external assessments and received in 1996, as the first health care organization, the Dutch Quality Prize. (+info
A national survey of policies on disclosure of conflicts of interest in biomedical research.
BACKGROUND: Conflicts of interest pose a threat to the integrity of scientific research. The current regulations of the U.S. Public Health Service and the National Science Foundation require that medical schools and other research institutions report the existence of conflicts of interest to the funding agency but allow the institutions to manage conflicts internally. The regulations do not specify how to do so. METHODS: We surveyed all medical schools (127) and other research institutions (170) that received more than $5 million in total grants annually from the National Institutes of Health or the National Science Foundation; 48 journals in basic science and clinical medicine; and 17 federal agencies in order to analyze their policies on conflicts of interest. RESULTS: Of the 297 institutions, 250 (84 percent) responded by March 2000, as did 47 of the 48 journals and 16 of the 17 federal agencies. Fifteen of the 250 institutions (6 percent)--5 medical schools and 10 other research institutions--reported that they had no policy on conflicts of interest. Among the institutions that had policies, there was marked variation in the definition and management of conflicts. Ninety-one percent had policies that adhered to the federal threshold for disclosure ($10,000 in annual income or equity in a relevant company or 5 percent ownership), and 9 percent had policies that exceeded the federal guidelines. Only 8 percent had policies requiring disclosure to funding agencies, only 7 percent had such policies regarding journals, and only 1 percent had policies requiring the disclosure of information to the relevant institutional review boards or to research subjects. Twenty journals (43 percent) reported that they had policies requiring disclosure of conflicts of interest. Only four federal agencies had policies that explicitly addressed conflicts of interest in extramural research, and all but one of the agencies relied primarily on institutional discretion. CONCLUSIONS: There is substantial variation among policies on conflicts of interest at medical schools and other research institutions. This variation, combined with the fact that many scientific journals and funding agencies do not require disclosure of conflicts of interest, suggests that the current standards may not be adequate to maintain a high level of scientific integrity. (+info
Community outreach at biomedical research facilities.
For biomedical researchers to fulfill their responsibility for protecting the environment, they must do more than meet the scientific challenge of reducing the number and volume of hazardous materials used in their laboratories and the engineering challenge of reducing pollution and shifting to cleaner energy sources. They must also meet the public relations challenge of informing and involving their neighbors in these efforts. The experience of the Office of Community Liaison of the National Institutes of Health (NIH) in meeting the latter challenge offers a model and several valuable lessons for other biomedical research facilities to follow. This paper is based on presentations by an expert panel during the Leadership Conference on Biomedical Research and the Environment held 1--2 November 1999 at NIH, Bethesda, Maryland. The risks perceived by community members are often quite different from those identified by officials at the biomedical research facility. The best antidote for misconceptions is more and better information. If community organizations are to be informed participants in the decision-making process, they need a simple but robust mechanism for identifying and evaluating the environmental hazards in their community. Local government can and should be an active and fully informed partner in planning and emergency preparedness. In some cases this can reduce the regulatory burden on the biomedical research facility. In other cases it might simplify and expedite the permitting process or help the facility disseminate reliable information to the community. When a particular risk, real or perceived, is of special concern to the community, community members should be involved in the design, implementation, and evaluation of targeted risk assessment activities. Only by doing so will the community have confidence in the results of those activities. NIH has involved community members in joint efforts to deal with topics as varied as recycling and soil testing. These ad hoc efforts are more likely to succeed if community members and groups have also been included in larger and longer term advisory committees. These committees institutionalize the outreach process. This can provide the facility with vocal and influential allies who create an independent line of communication with the larger community. (+info
Diet quality, nutrient intake, weight status, and feeding environments of girls meeting or exceeding recommendations for total dietary fat of the American Academy of Pediatrics.
OBJECTIVES: To compare the diet quality and weight status of girls consuming diets meeting the recommendation of the American Academy of Pediatrics for dietary fat with those of girls consuming >30% of energy from fat and to examine relationships between girls' dietary fat intake, mothers' nutrient intakes, and mothers' child-feeding practices. DESIGN: Participants were 192 white girls and their mothers, who were divided into 2 groups: >30% of energy from fat (high fat [HF]) or +info)