Methodology for the development of a Canadian national EMS research agenda

<p>Abstract</p> <p>Background</p> <p>Many health care disciplines use evidence-based decision making to improve patient care and system performance. While the amount and quality of emergency medical services (EMS) research in Canada has increased over the past two decades, there has not been a unified national plan to enable research, ensure efficient use of research resources, guide funding decisions and build capacity in EMS research. Other countries have used research agendas to identify barriers and opportunities in EMS research and define national research priorities. The objective of this project is to develop a national EMS research agenda for Canada that will: 1) explore what barriers to EMS research currently exist, 2) identify current strengths and opportunities that may be of benefit to advancing EMS research, 3) make recommendations to overcome barriers and capitalize on opportunities, and 4) identify national EMS research priorities.</p> <p>Methods/Design</p> <p>Paramedics, educators, EMS managers, medical directors, researchers and other key stakeholders from across Canada will be purposefully recruited to participate in this mixed methods study, which consists of three phases: 1) qualitative interviews with a selection of the study participants, who will be asked about their experience and opinions about the four study objectives, 2) a facilitated roundtable discussion, in which all participants will explore and discuss the study objectives, and 3) an online Delphi consensus survey, in which all participants will be asked to score the importance of each topic discovered during the interviews and roundtable as they relate to the study objectives. Results will be analyzed to determine the level of consensus achieved for each topic.</p> <p>Discussion</p> <p>A mixed methods approach will be used to address the four study objectives. We anticipate that the keys to success will be: 1) ensuring a representative sample of EMS stakeholders, 2) fostering an open and collaborative roundtable discussion, and 3) adhering to a predefined approach to measure consensus on each topic. Steps have been taken in the methodology to address each of these <it>a priori </it>concerns.</p

Is oxidative damage the fundamental pathogenic mechanism of Alzheimer’s and other neurodegenerative diseases?

In less than a decade, beginning with the demonstration by Floyd, Stadtman, Markesbery et al. [1] of increased reactive carbonyls in the brains of patients with Alzheimer’s disease (AD), oxidative damage has been established as a feature of the disease. Here, we review the types of oxidative damage seen in AD, sites involved, possible origin, relationship to lesions, and compensatory changes, and we also consider other neurodegenerative diseases where oxidative stress has been implicated. Although much data remain to be collected, the broad spectrum of changes found in AD are only seen, albeit to a lesser extent, in normal aging with other neurodegenerative diseases showing distinct spectrums of change.Work in the authors’ laboratories is supported by funding from the National Institutes of Health (NS38648, AG19356, AG14249) and the Alzheimer’s Association (IIRG-98-136, ZEN-99-1789, IIRG-00-2163-Stephanie B. Overstreet Scholars, IIRG-98-140, TLL-99-1872).Peer reviewe

Photodisintegration of 4^4He into p+t

The two-body photodisintegration of $^4$He into a proton and a triton has been studied using the CEBAF Large-Acceptance Spectrometer (CLAS) at Jefferson Laboratory. Real photons produced with the Hall-B bremsstrahlung-tagging system in the energy range from 0.35 to 1.55 GeV were incident on a liquid $^4$He target. This is the first measurement of the photodisintegration of $^4$He above 0.4 GeV. The differential cross sections for the $\gamma$$^4$He$\to pt$ reaction have been measured as a function of photon-beam energy and proton-scattering angle, and are compared with the latest model calculations by J.-M. Laget. At 0.6-1.2 GeV, our data are in good agreement only with the calculations that include three-body mechanisms, thus confirming their importance. These results reinforce the conclusion of our previous study of the three-body breakup of $^3$He that demonstrated the great importance of three-body mechanisms in the energy region 0.5-0.8 GeV .Comment: 13 pages submitted in one tgz file containing 2 tex file and 22 postscrip figure

Transcriptional profiling of the ovine abomasal lymph node reveals a role for timing of the immune response in gastrointestinal nematode resistance

Gastrointestinal nematodes are a serious cause of morbidity and mortality in grazing ruminants. The major ovine defence mechanism is acquired immunity, with protective immunity developing over time in response to infection. Nematode resistance varies both within and between breeds and is moderately heritable. A detailed understanding of the genes and mechanisms involved in protective immunity, and the factors that regulate this response, is required to aid both future breeding strategies and the development of effective and sustainable nematode control methods. The aim of this study was to compare the abomasal lymph node transcriptome of resistant and susceptible lambs in order to determine biological processes differentially expressed between resistant and susceptible individuals. Scottish Blackface lambs, with divergent phenotypes for resistance, were challenged with 30,000 Teladorsagia circumcincta larvae (L3), and abomasal lymph nodes recovered at 7 and 14 days post-infection (dpi). High-throughput sequencing of cDNA from the abomasal lymph node was used to quantitatively sample the transcriptome with an average of 32 million reads per sample. A total of 194 and 144 genes were differentially expressed between resistant and susceptible lambs at 7 and 14 dpi respectively. Differentially expressed networks and biological processes were identified using Ingenuity Pathway Analysis. Genes involved in the inflammatory response, attraction of T lymphocytes and binding of leukocytes were more highly expressed in resistant animals at 7 dpi and in susceptible animals at 14 dpi indicating that resistant animals respond to infection earlier than susceptible animals. Twenty-four Single Nucleotide Polymorphisms (SNP) within 11 differentially expressed genes, were tested for association with gastrointestinal nematode resistance in the Scottish Blackface lambs. Four SNP, in 2 genes (SLC30A2 and ALB), were suggestively associated with faecal egg count. In conclusion, a large number of genes were differentially expressed in the abomasal lymph node of resistant and susceptible lambs responding to gastrointestinal nematode challenge. Resistant Scottish Blackface lambs appear to generate an earlier immune response to T. circumcincta. In susceptible lambs this response appears to be delayed. SNP in 2 differentially expressed genes were suggestively associated with faecal egg count indicating that differentially expressed genes may be considered candidate loci for mediating nematode resistance

Polarized Structure Function σLT′\sigma_{LT'} for p(e⃗,e′K+)Λp({\vec e},e'K^+)\Lambda in the Nucleon Resonance Region

The first measurements of the polarized structure function $\sigma_{LT'}$ for the reaction $p(\vec e,e'K^+)\Lambda$ in the nucleon resonance region are reported. Measurements are included from threshold up to $W$=2.05 GeV for central values of $Q^2$ of 0.65 and 1.00 GeV$^2$, and nearly the entire kaon center-of-mass angular range. $\sigma_{LT'}$ is the imaginary part of the longitudinal-transverse response and is expected to be sensitive to interferences between competing intermediate s-channel resonances, as well as resonant and non-resonant processes. The results for $\sigma_{LT'}$ are comparable in magnitude to previously reported results from CLAS for $\sigma_{LT}$, the real part of the same response. An intriguing sign change in $\sigma_{LT'}$ is observed in the high $Q^2$ data at $W\approx 1.9$ GeV. Comparisons to several existing model predictions are shown.Comment: 2 tex files and 12 figures (14 eps files), 33 pages in one column forma

Separated Structure Functions for the Exclusive Electroproduction of K+ΛK^+\Lambda and K+Σ0K^+\Sigma^0 Final States

We report measurements of the exclusive electroproduction of $K^+\Lambda$ and $K^+\Sigma^0$ final states from a proton target using the CLAS detector at the Thomas Jefferson National Accelerator Facility. The separated structure functions $\sigma_T$, $\sigma_L$, $\sigma_{TT}$, and $\sigma_{LT}$ were extracted from the $\Phi$- and $\epsilon$-dependent differential cross sections taken with electron beam energies of 2.567, 4.056, and 4.247 GeV. This analysis represents the first $\sigma_L/\sigma_T$ separation with the CLAS detector, and the first measurement of the kaon electroproduction structure functions away from parallel kinematics. The data span a broad range of momentum transfers from $0.5\leq Q^2\leq 2.8$ GeV$^2$ and invariant energy from $1.6\leq W\leq 2.4$ GeV, while spanning nearly the full center-of-mass angular range of the kaon. The separated structure functions reveal clear differences between the production dynamics for the $\Lambda$ and $\Sigma^0$ hyperons. These results provide an unprecedented data sample with which to constrain current and future models for the associated production of strangeness, which will allow for a better understanding of the underlying resonant and non-resonant contributions to hyperon production.Comment: 61 pages, 26 figures, 5 table