Training for interdisciplinary health research: defining the required competencies.

Although interdisciplinary research is becoming the dominant model for understanding complex health issues, little is known about the competencies required for successful interdisciplinary collaboration. Published research has discussed attitudes about interdisciplinary work and organizational resources but not the needed competencies. This report describes the method and results of the competency specification process for health research. Based on an established definition of interdisciplinary research, a preliminary set of competencies was developed from expert opinion of key informants and a review of the interdisciplinary research literature. A Delphi panel of interdisciplinary researchers then reached consensus on 17 competencies necessary for interdisciplinary research.

Defining interdisciplinary research: conclusions from a critical review of the literature.

OBJECTIVE: To summarize findings from a systematic exploration of existing literature and views regarding interdisciplinarity, to discuss themes and components of such work, and to propose a theoretically based definition of interdisciplinary research. DATA SOURCES/STUDY SETTING: Two major data sources were used: interviews with researchers from various disciplines, and a systematic review of the education, business, and health care literature from January 1980 through January 2005. STUDY DESIGN: Systematic review of literature, one-on-one interviews, field test (survey). DATA COLLECTION/EXTRACTION METHODS: We reviewed 14 definitions of interdisciplinarity, the characteristics of 42 interdisciplinary research publications from multiple fields of study, and 14 researcher interviews to arrive at a preliminary definition of interdisciplinary research. That definition was then field tested by 12 individuals with interdisciplinary research experience, and their responses incorporated into the definition of interdisciplinary research proposed in this paper. PRINCIPAL FINDINGS: Three key definitional characteristics were identified: the qualitative mode of research (and its theoretical underpinnings), existence of a continuum of synthesis among disciplines, and the desired outcome of the interdisciplinary research. CONCLUSION: Existing literature from several fields did not provide a definition for interdisciplinary research of sufficient specificity to facilitate activities such as identification of the competencies, structure, and resources needed for health care and health policy research. This analysis led to the proposed definition, which is designed to aid decision makers in funding agencies/program committees and researchers to identify and take full advantage the interdisciplinary approach, and to serve as a basis for competency-based formalized training to provide researchers with interdisciplinary skills.

Effectiveness of barrier precautions and surveillance cultures to control transmission of multidrug-resistant organisms: a systematic review of the literature.

BACKGROUND: Despite the priority placed on preventing transmission of multidrug-resistant organisms (MDROs) in health care facilities, there is a lack of consensus among recommended infection control guidelines. We focused on control measures that have a great potential to affect patient care, patient services, and hospital cost/resources: barrier precautions/patient isolation and surveillance cultures. METHODS: We conducted a systematic review of the literature and published English-language guidelines pertaining to the use of barrier precautions/patient isolation and surveillance cultures to prevent the transmission of MDROs. The recommendations made by the published guidelines were summarized and compared. The primary research studies identified through our literature search were evaluated for study quality. We then summarized the outcomes of the studies with the highest quality scores and made recommendations for future work. RESULTS: A total of 29 studies were included in our assessment of study quality; of those, 7 studies were of high quality. CONCLUSION: This systematic review identified key gaps in the literature including a need for greater monitoring of implementation of the interventions, more cost analyses of interventions, determining the independent contribution of specific interventions, and identifying the minimum interventions needed to reduce transmission.

Physiological response properties of displaced amacrine cells of the adult ferret retina.

The ganglion cell layer (GCL) of the mammalian retina contains a large number of neurons called displaced amacrine cells (DACs) that do not project to the optic nerve. However, with the exception of the rabbit starburst amacrine cell little is known regarding the function of this large population due to the difficulty experienced in making physiological recordings from these neurons. We have overcome these difficulties and have used whole-cell patch-clamp techniques to examine the intrinsic membrane properties of DACs in the ferret retina. Our results indicate a large degree of diversity in their intrinsic membrane properties. In response to maintained depolarizing current injection, DACs responded with graded depolarization or by eliciting either transient or sustained bursts of spiking activity. At the resting membrane potential, 10% of the DACs generated spontaneous spikes in either an apparently random manner or at the peak of intrinsic waves of depolarization. The resting membrane activity of the remaining DACs recorded could be classified into three groups that were quiescent (28%), had robust uncorrelated synaptic activity (30%), or underwent slow waves of depolarization (42%). Diversity was also revealed in the membrane currents recorded in voltage-clamp where some DACs were quiescent (19%), or exhibited robust nonrhythmic synaptic events (42%). The remaining DACs exhibited waves of oscillatory activity (39%), characterized by either rhythmic bursts of synaptic events (17%) or slow inward currents (22%). Bath application of 50 microM biccuculine or 150 microM picrotoxin had no effect on the waves of activity, however, the gap junction blocker, carbenoxolone (100 microm), blocked both oscillatory patterns. By including Lucifer yellow and biocytin in the recording pipette, it was possible to determine the morphology of recorded neurons and group them based on dendritic extent as small-, medium-, or large-field DACs. There were few relationships between these morphologically defined groups and their intrinsic membrane properties. The present study provides the first in-depth examination of the intrinsic membrane properties of DACs in the ferret retina and provides new insights into the potential roles these neurons play in the processing of visual information in the mammalian retina.