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Research is a critical component of the public health enterprise, and a key component of universities and schools of public health and medicine. To satisfy varying levels of stakeholders in the field of public health research, accurately measuring the return on investment (ROI) is important; unfortunately, there is no approach or set of defined metrics that are universally accepted for such assessment. We propose a research metrics framework to address this gap in higher education. After a selected review of existing frameworks, we identified seven elements of the generic research lifecycle (five internal to an institution and two external). A systems approach was then used to broadly define four parts of each element: inputs, processes, outputs, and outcomes (or impacts). Inputs include variables necessary to execute research activities such as human capital and finances. Processes are the pathways of measurement to track research performance through all phases of a study. Outputs entail immediate products from research; and outcomes/impacts demonstrate the contribution research makes within and beyond an institution. This framework enables the tracking and measurement of research investments to outcomes. We acknowledge some of the challenges in applying this framework including the lack of standardization in research metrics, disagreement on defining impact among stakeholders, and limitations in resources for implementing the framework and collecting relevant data. However, we suggest that this proposed framework is a systematic way to raise awareness about the role of research and standardize the measurement of ROI across health science schools and universities.
RESUMO
OBJECTIVE: The George Washington University (GW) in Washington, D.C., USA established the Public Health Laboratory and Campus COVID-19 Support Team (CCST) to develop and implement its SARS-CoV-2 surveillance testing and outbreak response for the 2020-2021 academic year. PARTICIPANTS AND METHODS: Approximately 4,000 GW members had access to campus for living accommodations, limited in-person instruction, athletics, research, and university operations. The outbreak response included daily risk assessment surveys, weekly surveillance testing, symptomatic and voluntary testing, case investigation, and contact tracing. RESULTS: Between August 17 - November 24, 2020, 42,350 SARS-CoV-2 PCR tests were performed, and 194 (0.46%) of tests were positive. Surveillance testing identified 59 (30.4%); voluntary testing 97 (50%); and symptomatic testing 30 (15.5%) of the cases, respectively. CONCLUSIONS: Robust testing of asymptomatic people and rapid isolation and quarantine of members who are exposed or infected effectively limited the spread of SARS-CoV-2 during the Fall 2020 semester.
RESUMO
BACKGROUND: The lumbosacral junction is a difficult area for spine surgery because of the complex anatomy. In the era of minimally invasive spine surgery, the presence of the iliac wing has, at the level of lumbosacral junction, created a major obstacle in the paths of two of the major approaches, namely, the direct lateral and percutaneous posterolateral endoscopic approaches. A trans-iliac cadaver study published by the senior author and co-workers in 1997, suggested the possibility of an alternative approach to the lumbosacral junction. PURPOSE: To determine the feasibility of percutaneous, endoscopic trans-iliac approach to the L5-S1 disc and foramen. STUDY DESIGN: Prospective case series study. MATERIALS AND METHODS: 15 consecutive patients undergoing the transiliac approach to L5-S1 disc and foramen were included in the study. Pre- and postoperative visual analogue scale (VAS); Oswestry Disability Index (ODI); and intra-operative blood loss and operative time, were obtained for the study. Preoperative MRI or CT scan was used to determine the need for trans-iliac access. The procedure was performed with the patient in prone position and under monitored sedation for decompression. Endotracheal anesthesia was used for fusion cases. The transiliac access was established with a cannulated drill or core drill through the iliac wing. Once the trans-iliac window had been created, the rest of the procedure proceeded as for percutaneous endoscopic transforaminal decompression and fusion. RESULTS: 15 patients (9 male and 6 female) participated in the study. The VAS for back and leg pain significantly improved in all patients. The ODI dropped by more than 50%. There was minimal blood loss, and transient post-operative dysesthesia in 2 cases which resolved after 3 weeks. CONCLUSION: Endoscopic trans-iliac approach to the L5-S1 disc and foramen is feasible and safe. Decompression can be performed safely via trans-iliac access with minimal blood loss, and in a short operative time.
