Although there appears to be an increased incidence of malignancy among patients with dermatomyositis, demonstration of definitive statistical significance is precluded by the lack of large, controlled series. Patients with the two diseases tend to be older than the general dermatomyositis population and younger than those with cancer alone; and there is a preponderance of female patients. Tumors of the ovary and stomach are more frequently observed than in the general population, while colorectal malignancies are underrepresented. Most reported cases show development of the diseases within a year of one another, and, in some patients, the course of the myopathy follows that of the tumor. No definitive cause for the myopathy in these patients has been established.
BackgroundDerived from multiple disciplines and established in industries outside of medicine, Implementation Science (IS) seeks to move evidence-based approaches into widespread use to enable improved outcomes to be realized as quickly as possible by as many as possible.MethodsThis review highlights selected IS theories and models, chosen based on the experience of the authors, that could be used to plan and deliver medical education activities to help learners better implement and sustain new knowledge and skills in their work settings.ResultsIS models, theories and approaches can help medical educators promote and determine their success in achieving desired learner outcomes. We discuss the importance of incorporating IS into the training of individuals, teams, and organizations, and employing IS across the medical education continuum. Challenges and specific strategies for the application of IS in educational settings are also discussed.ConclusionsUtilizing IS in medical education can help us better achieve changes in competence, performance, and patient outcomes. IS should be incorporated into curricula across disciplines and across the continuum of medical education to facilitate implementation of learning. Educators should start by selecting, applying, and evaluating the teaching and patient care impact one or two IS strategies in their work.
In response to public concerns about the consequences of research misconduct, academic institutions have become increasingly cognizant of the need to implement comprehensive, effective training in the responsible conduct of research (RCR) for faculty, staff, students, and external collaborators. The ability to meet this imperative is challenging as universities confront declining financial resources and increasing complexity of the research enterprise. The authors describe the University of Pittsburgh's design, implementation, and evaluation of a Web-based, institution-wide RCR training program called Research and Practice Fundamentals (RPF). This project, established in 2000, was embedded in the philosophy, organizational structure, and technology developed through the Integrated Advanced Information Management Systems grant from the National Library of Medicine. Utilizing a centralized, comprehensive approach, the RPF system provides an efficient mechanism for deploying content to a large, diverse cohort of learners and supports the needs of research administrators by providing access to information about who has successfully completed the training. During its first 3 years of operation, the RPF served over 17,000 users and issued more than 38,000 training certificates. The 18 modules that are currently available address issues required by regulatory mandates and other content areas important to the research community. RPF users report high levels of satisfaction with content and ease of using the system. Future efforts must explore methods to integrate non-RCR education and training into a centralized, cohesive structure. The University of Pittsburgh's experience with the RPF demonstrates the importance of developing an infrastructure for training that is comprehensive, scalable, reliable, centralized, affordable, and sustainable.
4. Human subjects research: undercover tests show the institutional review board system is vulnerable to unethical manipulation [GAO-09-448T, March 26, 2009]. US Government Accountability Office Web site. http://www.gao.gov/products /GAO-09-448T. Accessed November 1, 2010. 5. Smith M, Evans D. Miami test center lures poor immigrants as human guinea pigs. Bloomberg News.
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