The document discusses models for evaluating translational research. It proposes a process marker model that views translational research as a continuous process from basic research to impacts on health outcomes. This model uses observable process markers along the continuum that can be measured, such as dates, to evaluate the duration between stages. This approach avoids debates around definitions and phases and allows for a common framework to link evaluation studies. Key challenges include developing clear yet complex models and relying on descriptive statistics for results.
Randomization is the process by which allocation of subjects to treatment groups is done by chance, without the ability to predict who is in what group. It is done in clinical trials. This presentation describes the methods of randmization used in clinical trials.
Describes in detail definition, purpose, participants and goal of good clinical practices (GCP). Gives history of GCP staring form Nuremberg code in 1948 to implementation of GCP guidance via WHO handbook in 2005. Also describes Nuremberg's code, declaration of Helsinki and Thirteen principles of GCP.
Randomization is the process by which allocation of subjects to treatment groups is done by chance, without the ability to predict who is in what group. It is done in clinical trials. This presentation describes the methods of randmization used in clinical trials.
Describes in detail definition, purpose, participants and goal of good clinical practices (GCP). Gives history of GCP staring form Nuremberg code in 1948 to implementation of GCP guidance via WHO handbook in 2005. Also describes Nuremberg's code, declaration of Helsinki and Thirteen principles of GCP.
An epidemiological experiment in which subjects in a population are randomly allocated into groups, usually called study and control groups to receive and not receive an experimental preventive or therapetuic procedure, maneuver, or intervention .
Biostatistics Roles and Responsibilities in Clinical Research | PubricaPubrica
This Presentation explains the Roles and Responsibilities of Biostatistics in clinical research
Biostatistics helps to find answer for research question in Biology, Medicine and Public health
- How a new drug works
- What causes cancer
- what is the reason for many diseases
- How long could a person survive with a particular disease?
Learn More: http://pubrica.com/services/research-services/biostatistics-and-statistical-programming-services/
Contact:
Web: www.pubrica.com
Email: sales@pubrica.com
WhatsApp : +91 9884350006
United kingdom : +44-1143520021
Webinar Series on Demystifying Phases in Clinical Trials & COVID-19 Updates organized by Institute for Clinical Research (ICR), NIH
Speaker: Dato Dr Chang Kian Meng, Haematologist from Sunway Medical Centre
More information, please visit: https://clinupcovid.mailerpage.com/resources/p9f2i7-introduction-to-phase-2-3-trial-s
A Clinical Research Associate (CRA) is a professional who plays a crucial role in the management and monitoring of clinical trials. CRAs are typically employed by pharmaceutical companies, contract research organizations (CROs), or academic research institutions. Their primary responsibility is to ensure that clinical trials are conducted in compliance with the study protocol, applicable regulations, and Good Clinical Practice (GCP) guidelines
The dream of any physician and consequently every patient is to receive the right treatment in the right time with cost effectiveness. To achieve this goal, the 3 pillars: evidence based medicine, clinical research innovation & resources utilization should be integrated efficiently.
In this presentation, I'll try to comprehensively review the following:
1- How are we used to perform clinical trials in Oncology?
2- Does it fits in today’s needs?
3- Integration of biology knowledge in shaping drug development
4- New Clinical trial designs “Can they offer solution for accelerating drug development?”
5- The supporting infrastructure role in clinical trial execution
An epidemiological experiment in which subjects in a population are randomly allocated into groups, usually called study and control groups to receive and not receive an experimental preventive or therapetuic procedure, maneuver, or intervention .
Biostatistics Roles and Responsibilities in Clinical Research | PubricaPubrica
This Presentation explains the Roles and Responsibilities of Biostatistics in clinical research
Biostatistics helps to find answer for research question in Biology, Medicine and Public health
- How a new drug works
- What causes cancer
- what is the reason for many diseases
- How long could a person survive with a particular disease?
Learn More: http://pubrica.com/services/research-services/biostatistics-and-statistical-programming-services/
Contact:
Web: www.pubrica.com
Email: sales@pubrica.com
WhatsApp : +91 9884350006
United kingdom : +44-1143520021
Webinar Series on Demystifying Phases in Clinical Trials & COVID-19 Updates organized by Institute for Clinical Research (ICR), NIH
Speaker: Dato Dr Chang Kian Meng, Haematologist from Sunway Medical Centre
More information, please visit: https://clinupcovid.mailerpage.com/resources/p9f2i7-introduction-to-phase-2-3-trial-s
A Clinical Research Associate (CRA) is a professional who plays a crucial role in the management and monitoring of clinical trials. CRAs are typically employed by pharmaceutical companies, contract research organizations (CROs), or academic research institutions. Their primary responsibility is to ensure that clinical trials are conducted in compliance with the study protocol, applicable regulations, and Good Clinical Practice (GCP) guidelines
The dream of any physician and consequently every patient is to receive the right treatment in the right time with cost effectiveness. To achieve this goal, the 3 pillars: evidence based medicine, clinical research innovation & resources utilization should be integrated efficiently.
In this presentation, I'll try to comprehensively review the following:
1- How are we used to perform clinical trials in Oncology?
2- Does it fits in today’s needs?
3- Integration of biology knowledge in shaping drug development
4- New Clinical trial designs “Can they offer solution for accelerating drug development?”
5- The supporting infrastructure role in clinical trial execution
College Writing II Synthesis Essay Assignment Summer Semester 2017.docxclarebernice
College Writing II Synthesis Essay Assignment Summer Semester 2017
Directions:
For this assignment you will be writing a synthesis essay. A synthesis is a combination of two or more summaries and sources. In a synthesis essay you will have three paragraphs, an introduction, a synthesis and a conclusion.
In the introduction you will give background information about your topic. You will also include a thesis statement at the end of the introduction paragraph. The thesis statement should describe the goal of your synthesis. (informative or argumentative)
The second paragraph is the synthesis. You will combine two summaries of two different articles on the same topic. You will follow all summary guidelines for these two paragraphs. The synthesis will most likely either argue or inform the reader about the topic.
The conclusion paragraph should summarize the points of your essay and restate the general ideas.
For this essay you will read two research articles on a similar topic to the previous critical review essay as you can use this research in your inquiry paper. You will summarize both articles in two paragraphs and combine the paragraphs for your synthesis. In the synthesis you must include the main ideas of the articles and the author, title, and general idea in the first sentences.
This essay will be three pages long and the first draft and peer review are due June 15. You must turn them in hardcopy in class so you can do a peer review.
Running head: THESIS DRAFT 1
THESIS DRAFT 3Thesis Draft
Katelyn B. Rhodes
D40375299
DeVry University
Point-of-Care Testing (PoCT) has dramatically taken over the field of clinical laboratory testing since it’s introduction approximately 45 years ago. The technologies utilized in PoCT have been refined to deliver accurate and expedient test results and will become even more sensitive and accurate in order to dominate the field of clinical laboratory testing. Furthermore, there will be a dramatic increase in the volume of clinical testing performed outside of the laboratory. New and emerging PoCT technologies utilize sophisticated molecular techniques such as polymerase chain reaction to aid in the treatment of major health problems worldwide, such as sexually transmitted infections (John & Price, 2014).
Historic Timeline
In the early-to-mid 1990’s, bench top analyzers entered the clinical laboratory scene. These analyzers were much smaller than the conventional analyzers being used, and utilized touch-screen PCs for ease of use. For this reason, they were able to be used closer to the patient’s bedside or outside of the laboratory environment. However, at this point in time, laboratory testing results were stored within the device and would have to then be sent to the main central laboratory for analysis.
Technology in the mid-to-late 1990’s permitted analyzers to be much smaller so that they may be easily carried to the patient’s location. Computers also became more ...
The Duty of Loyalty and Whistleblowing Please respond to the fol.docxcherry686017
"The Duty of Loyalty and Whistleblowing" Please respond to the following:
· Analyze the duty of loyalty in whistleblower cases to determine to whom loyalty is owed and who shows the greater duty of loyalty. Support your analysis with specific examples. Then, suggest at least one (1) change to an existing law.
· Reexamine the Citizens United decision in Chapter 1, and determine which of the following groups has the greatest free speech rights: corporations, public employees, or private employees. Provide a rationale for your determination.
11 Combining Research Methods: Case Studies and Action Research
Rebecca Jester
Introduction
In Chapters 7 and 8, we focused on the unique features of quantitative and qualitative research. In this chapter, we aim to demonstrate how research methods can be integrated and combined to address specific research questions. The chapter will provide an overview of two specific research designs: action research and case studies, together with examples from research projects conducted by the author. This chapter does not aim to provide an in-depth philosophical debate related to case study and action research approaches, but rather a practical discussion of the merits, limitations and application of these two approaches. We begin by discussing the concepts of ‘mixed methods’ and ‘triangulation', first introduced in Chapter 2.
Mixed methods approaches
Traditionally, within health and social research, individuals have aligned themselves with either the quantitative or qualitative paradigm. However, in reality, many real world research projects benefit from mixing or combining methods. Mixed methods research can be accomplished either by using specific approaches to research, such as action research or case study, as discussed within this chapter, or by adopting a phased approach within a study. This might involve the first stage being exploratory within the qualitative paradigm, and the results from this being used to form specific hypotheses for testing within an experimental design, such as a randomized controlled trial. Equally, a quantitative approach (say, a questionnaire) might be used to gather data from a wide range of people, with the results being used to develop a qualitative interview schedule for use with a small sample of respondents.
Triangulation
Very often a research study is undertaken with multiple datasets, mixed methodology or with different researchers, such as at different sites. Triangulation is a very useful technique that enables you to enhance and verify concepts. As Ramprogus (2005, p. 4) suggests, ‘triangulation … tries to reconcile the differences of two or more data sources, methodological approaches, designs, theoretical perspectives, investigators and data analysis to compensate for the weaknesses of any single strategy towards achieving completeness or confirmation of findings’. However, triangulation must be exercised with caution; it is no substitute for robust and well-established ...
Critical evaluation of an article titled " Systematic review of basket trials, umbrella trials, and platform trials: A landscape analysis of master protocols"
Chapter 7. The Evidence for Evidence-Based Practice Implem.docxspoonerneddy
Chapter 7. The Evidence for Evidence-Based Practice
Implementation
Marita G. Titler
Background
Overview of Evidence-Based Practice
Evidence-based health care practices are available for a number of conditions such as asthma,
heart failure, and diabetes. However, these practices are not always implemented in care
delivery, and variation in practices abound.1–4 Traditionally, patient safety research has focused
on data analyses to identify patient safety issues and to demonstrate that a new practice will lead
to improved quality and patient safety.5 Much less research attention has been paid to how to
implement practices. Yet, only by putting into practice what is learned from research will care be
made safer.5 Implementing evidence-based safety practices are difficult and need strategies that
address the complexity of systems of care, individual practitioners, senior leadership, and—
ultimately—changing health care cultures to be evidence-based safety practice environments.5
Nursing has a rich history of using research in practice, pioneered by Florence Nightingale.6–
9 Although during the early and mid-1900s, few nurses contributed to this foundation initiated
by Nightingale,10 the nursing profession has more recently provided major leadership for
improving care through application of research findings in practice.11
Evidence-based practice (EBP) is the conscientious and judicious use of current best
evidence in conjunction with clinical expertise and patient values to guide health care
decisions.12–15 Best evidence includes empirical evidence from randomized controlled trials;
evidence from other scientific methods such as descriptive and qualitative research; as well as
use of information from case reports, scientific principles, and expert opinion. When enough
research evidence is available, the practice should be guided by research evidence in conjunction
with clinical expertise and patient values. In some cases, however, a sufficient research base may
not be available, and health care decisionmaking is derived principally from nonresearch
evidence sources such as expert opinion and scientific principles.16 As more research is done in a
specific area, the research evidence must be incorporated into the EBP.15
Models of Evidence-Based Practice
Multiple models of EBP are available and have been used in a variety of clinical settings.16–36
Although review of these models is beyond the scope of this chapter, common elements of these
models are selecting a practice topic (e.g., discharge instructions for individuals with heart
failure), critique and syntheses of evidence, implementation, evaluation of the impact on patient
care and provider performance, and consideration of the context/setting in which the practice is
implemented.15, 17 The learning that occurs during the process of translating research into
practice is valuable information to capture and feed back into the process, so that.
Chapter 7. The Evidence for Evidence-Based Practice Implem.docxmccormicknadine86
Chapter 7. The Evidence for Evidence-Based Practice
Implementation
Marita G. Titler
Background
Overview of Evidence-Based Practice
Evidence-based health care practices are available for a number of conditions such as asthma,
heart failure, and diabetes. However, these practices are not always implemented in care
delivery, and variation in practices abound.1–4 Traditionally, patient safety research has focused
on data analyses to identify patient safety issues and to demonstrate that a new practice will lead
to improved quality and patient safety.5 Much less research attention has been paid to how to
implement practices. Yet, only by putting into practice what is learned from research will care be
made safer.5 Implementing evidence-based safety practices are difficult and need strategies that
address the complexity of systems of care, individual practitioners, senior leadership, and—
ultimately—changing health care cultures to be evidence-based safety practice environments.5
Nursing has a rich history of using research in practice, pioneered by Florence Nightingale.6–
9 Although during the early and mid-1900s, few nurses contributed to this foundation initiated
by Nightingale,10 the nursing profession has more recently provided major leadership for
improving care through application of research findings in practice.11
Evidence-based practice (EBP) is the conscientious and judicious use of current best
evidence in conjunction with clinical expertise and patient values to guide health care
decisions.12–15 Best evidence includes empirical evidence from randomized controlled trials;
evidence from other scientific methods such as descriptive and qualitative research; as well as
use of information from case reports, scientific principles, and expert opinion. When enough
research evidence is available, the practice should be guided by research evidence in conjunction
with clinical expertise and patient values. In some cases, however, a sufficient research base may
not be available, and health care decisionmaking is derived principally from nonresearch
evidence sources such as expert opinion and scientific principles.16 As more research is done in a
specific area, the research evidence must be incorporated into the EBP.15
Models of Evidence-Based Practice
Multiple models of EBP are available and have been used in a variety of clinical settings.16–36
Although review of these models is beyond the scope of this chapter, common elements of these
models are selecting a practice topic (e.g., discharge instructions for individuals with heart
failure), critique and syntheses of evidence, implementation, evaluation of the impact on patient
care and provider performance, and consideration of the context/setting in which the practice is
implemented.15, 17 The learning that occurs during the process of translating research into
practice is valuable information to capture and feed back into the process, so that ...
184 Deutsches Ärzteblatt International⏐⏐Dtsch Arztebl Int 2009.docxhyacinthshackley2629
184 Deutsches Ärzteblatt International⏐⏐Dtsch Arztebl Int 2009; 106(11): 184–9
M E D I C I N E
M edical research studies can be split into fivephases—planning, performance, documenta-
tion, analysis, and publication (1, 2). Aside from finan-
cial, organizational, logistical and personnel questions,
scientific study design is the most important aspect of
study planning. The significance of study design for
subsequent quality, the relability of the conclusions,
and the ability to publish a study are often underestimated
(1). Long before the volunteers are recruited, the study
design has set the points for fulfilling the study objec-
tives. In contrast to errors in the statistical evaluation,
errors in design cannot be corrected after the study has
been completed. This is why the study design must be
laid down carefully before starting and specified in the
study protocol.
The term "study design" is not used consistently in
the scientific literature. The term is often restricted to
the use of a suitable type of study. However, the term
can also mean the overall plan for all procedures in-
volved in the study. If a study is properly planned, the
factors which distort or bias the result of a test procedure
can be minimized (3, 4). We will use the term in a
comprehensive sense in the present article. This will
deal with the following six aspects of study design:
the question to be answered, the study population, the
type of study, the unit of analysis, the measuring tech-
nique, and the calculation of sample size—, on the
basis of selected articles from the international litera-
ture and our own expertise. This is intended to help
the reader to classify and evaluate the results in publi-
cations. Those who plan to perform their own studies
must occupy themselves intensively with the issue of
study design.
Question to be answered
The question to be answered by the research is of
decisive importance for study planning. The research
worker must be clear about the objectives. He must
think very carefully about the question(s) to be
answered by the study. This question must be opera-
tionalized, meaning that it must be converted into a
measurable and evaluable form. This demands an
adequate design and suitable measurement parameters.
A distinction must be made between the main questions
to be answered and secondary questions. The result of
the study should be that open questions are answered
R E V I E W A RT I C L E
Study Design in Medical Research
Part 2 of a Series on the Evaluation of Scientific Publications
Bernd Röhrig, Jean-Baptist du Prel, Maria Blettner
SUMMARY
Background: The scientific value and informativeness of
a medical study are determined to a major extent by the
study design. Errors in study design cannot be corrected
afterwards. Various aspects of study design are discussed
in this article.
Methods: Six essential considerations in the planning and
evaluation of medical research studies are presented and
discussed in the light.
'Demystifying Knowledge Transfer- an introduction to Implementation Science M...NEQOS
Powerpoint presentation from 'Demystifying Knowledge Transfer: an introduction to Implementation Science' - 28th May 2014.
Facilitated by Professor Jeremy Grimshaw and Dr Justin Presseau
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Translational research
1. Evaluating Translational Research:
A Process Marker Model
William Trochim , Ph.D. , Cathleen Kane ,
M.P.A., Mark J. Graham, Ph.D. , and
Harold A. Pincus , M.D.
2. What is Translational Research?
Translating knowledge gained from laboratory
science into clinical practice to improve health
Focus is on the integration of activities from
bench to bedside.
3. The aim of translational research is to
produce new:
•Therapeutics
•Medical devices
•Tools for diagnosing disease
•Avenues for community engagement research
4. The Translation Continuum
Source: National Cancer Institute
Basic
Scientific
Discovery
Early
Translation
Late
Translation
Dissemination Adoption
•Promising
gene
•Basic
epidemiological
finding
•Partnerships
•Intervention
development
•Phase III trials
•Regulatory
approval
•Partnerships
•Health services
research to
support
dissemination
and adoption
•To community
providers
•To patients and
public
•Adoption of
advance by
providers,
patients, and
public
•Payment
mechanisms to
enable adoption
5. The National Institutes of Health (NIH) have
made it a central priority, part of their
“Roadmap” initiative.
One of their primary programs, the Clinical and
Translational Science Awards (CTSAs)
350 million per year to fund 55 research centers
In 2012 - fund 60 centers at a cost of
approximately a half billion dollars per year,
making it the largest program at NIH
6. One of the most significant motivations comes
from a relatively small number of studies that
show that it takes a long time to move basic
scientific ideas to practice and health impacts
“It takes an estimated average of 17 years for
only 14% of new scientific discoveries to enter
day-to-day clinical practice”
7. This time lag is seen as too long, certainly longer
than necessary
Must be a better way to move research to practice
more quickly without sacrificing quality or
increasing costs.
Proposed solutions include everything from
better management of scientific research
increased process efficiency
wholesale rethinking of the biomedical research-practice
endeavor for the 21st century.
12. Khoury et all
Research that describes, interprets and predicts the impact of various
influences, especially (but not exclusively) interventions of final endpoints
that matter to decision makers
14. Multiple competing models
Different and conflicting numbers and
definitions of translational research phases
Complicate communication about translational
research generally
Risk of confusing interpretations of
evaluations
15. The particular dilemma for translational research
evaluators
translational “Tower of Babel”
Same phase label is used for very different
operational stages in the research practice
continuum,
makes cross-evaluation comparisons and syntheses
especially problematic.
16. First, and perhaps most important, all of them
characterize translational research as a
temporal process moving from basic to clinical
to postclinical research and ultimately to use
and public health impact
All of them also incorporate the idea of
bidirectionality
17. Second, the three alternative models to Sung
et al.’s T1/T2 model differ in how finely they
divide their T1 and T2 phases.
18. Westfall et al. believe that practice-based
research needs to be highlighted
Dougherty and Conway want to be sure to note the
distinction between efficacy and effectiveness
studies in clinical contexts
Khoury et al. want to preserve the efficacy–
effectiveness distinction and make one between
outcomes research and other types of
postguidelines work
19. Leading to ever more complex models, and
contradictory classification schemes
20. Third, all of the models make a basic
distinction between research that takes place
before and after the development of
synthesized clinical trial knowledge at the
point of demarcation between T1 and T2.
This distinction between pre- and postclinical
synthesis may represent a critical jump from
individual clinical studies (before) to more
synthesized general knowledge that cuts
across studies (after).
23. Process marker model, characterized by the two
components that constitute its name.
24. First, it views translational research as a
continuous process that moves from basic
research through clinical, postclinical, and
practice-based research and ultimately to
health policies, outcomes, and impacts.
Process may be bidirectional, variable, and
complex
25. Second, it assumes that there are many different
potential markers along this process.
26. The focus in this model
identifying a set of observable points in the process
that can be operationally defined and measured
to enable evaluation of the duration of segments of
the research-practice continuum.
27. Model assumes that one would define a number
of operational markers along a presumed
process continuum.
Assuming that all of the markers use a common
measurement scale (e.g., dates), it is then
relatively easy to operationally define the
difference between any two markers as the
duration of time between their dates.
28. What is the “correct” operational marker to
use?
A simple answer is that there is not a single
correct marker—different markers simply
represent different reference points in an
assumed continuous process.
That said, some markers may be better than
others for different purposes and in different
contexts
29. Another consideration is that some markers
are likely to be encountered by more protocols
than others.
Since protocols can take different pathways in
the process of translation, one would generally
want to select markers that are more likely to
be commonly passed
30. Another consideration is that there are likely
to be subprocesses that get repeated
throughout the overall translational process.
For instance, the subprocess of conducting,
replicating, and using a research study follows
the same basic steps regardless of whether it
is a basic, clinical, or postclinical study
Look at the durations between two steps in
this subprocess
31. Characteristics that commend the process marker
framework over multiphase models:
Avoids theoretical presumptions and undefined
abstractions
Emphasizes observable measurable phenomena,
allowing anyone to readily see how any marker is
defined
Avoids the debates about how many phases there
are in translational research, while enabling
evaluators to use phased-based approaches as long
as they operationally define what they mean.
32. Encourages replicability
Robust and forgiving ie, missing data and
variable protocol pathways can be
accommodated
Encourage development of new hypotheses
that involve more precise operational
definitions
33. Avoids debates about the scope of
translational research ie, the scope of
translation being examined in any given process
marker evaluation is simply the process that is
encompassed between the first and last
marker measured
Applied prospectively or retrospectively
34. The process marker model is firmly rooted in a
process modeling research tradition in biomedical
research as well as in other fields such as quality
control and assurance
35.
36. Important features of this approach
Evaluate translational research at any level of
scale
Provides a foundation for the evaluation of
interventions designed to improve translational
research and the integration of these findings
into a field of translational studies
37. The process marker model provides a common
framework that can link these many and varied
studies together
Assess whether such interventions contribute to
reducing time to translation
38. Important challenges
May lead to complex and difficult to
communicate models of translational research
Relies upon descriptive statistics—such as
median durations—as the heart of the results
39. Increased application of an operational process
marker approach to the study of translational
research is likely to lead to considerable
evolution and adaption over time.
The field will be able to determine empirically
the degree to which various markers are
feasible to measure and yield results that have
value for our understanding of translation
40. Conclusion
Translational research is critical to the evolution
of biomedical research and practice in the 21st
century
The key problems that led to its emergence—the
relatively long time from discovery to use and
impact—and the relatively low proportion of
discoveries that survive that journey—remain a
challenge
Significant investments in translational research
are already being made
41. Evaluation will be essential for managing
translational research effectively, learning
what works and what does not, and being
accountable for these investments
The current state of conceptual models and
definitions of translational research poses
significant challenges to our ability to evaluate
42. There is considerable disagreement about
many of the key characteristics associated
with translational research
Translational research involves movement along
the research-practice continuum, ultimately to
health impacts.
43. It is clear from that the “unit” of translation—
the “thing” that is being translated—can
change dramatically across the span of the
research-practice continuum
While there is also wide acceptance that the
end point of translational research is
ultimately in health outcomes and impacts,
many of the translational research activities
will not directly touch on health impacts
44. Stay with the data in the form of operationally
definable markers (measures) on the pathways
from basic research to health impacts.
If multiphase classification systems are used in
evaluations, indicate clearly whose definition of
phases are employed and how the different phases
are being operationalized.
In the meantime broader translational research
community to collect feedback regarding various
evaluation measurement challenges