The Contribution of Participatory Research: On-Farm Research

Participatory research in agriculture may range from research and technology development (R&D), carried out on a research station with some involvement of farmers, through to genuine participatory research involving researchers and farmers working together. The latter involves the end-user in actually carrying out aspects of the research and/or in the development and evaluation of technology that is appropriate to commercial enterprises. Researchers often question the validity of the ‘findings of on-farm participatory research’ as they are more comfortable with the ‘controlled’ environment of the research station. However if research is to be applied appropriately on farms, it must go through a period of evaluation on-farm. This paper summarises perspectives relating to participatory on-farm research, highlighting some opportunities that new technology is providing by considering five key areas as follows: • Participatory research within the agricultural research enterprise (current situation); • On-farm research compared with in-station research (options); • A New Zealand example of on-farm research; • New opportunities in on-farm research; • Future models for participatory on-farm research

Improving question formulation for use in evidence appraisal in a tertiary care setting: a randomised controlled trial [ISRCTN66375463]

BACKGROUND: The specificity of clinical questions is gauged by explicit descriptions of four dimensions: subjects, interventions, comparators and outcomes of interest. This study determined whether adding simple instructions and examples on clinical question formulation would increase the specificity of the submitted question compared to using a standard form without instructions and examples. METHODS: A randomised controlled trial was conducted in an evidence-search and appraisal service. New participants were invited to reformulate clinical queries. The Control Group was given no instructions. The Intervention Group was given a brief explanation of proper formulation, written instructions, and diagrammatic examples. The primary outcome was the change in the proportion of reformulated questions that described each the dimensions of specificity. RESULTS: Fifty-two subjects agreed to participate in the trial of which 13 were lost to follow-up. The remaining 17 Intervention Group and 22 Control Group participants were analysed. Baseline characteristics were comparable. Overall, 20% of initially submitted questions from both groups were properly specified (defined as an explicit statement describing all dimensions of specificity). On follow-up, 7/14 questions previously rated as mis-specified in the Intervention Group had all dimensions described at follow-up (p = 0.008) while the Control Group did not show any changes from baseline. Participants in the Intervention Group were also more likely to explicitly describe patients (p = 0.028), comparisons (p = 0.014), and outcomes (p = 0.008). CONCLUSIONS: This trial demonstrated the positive impact of specific instructions on the proportion of properly-specified clinical queries. The evaluation of the long-term impact of such changes is an area of continued research

Lifting back the waters: Marine geophysics provides new insights into the uThukela Banks Marine Protected Area

Using the first high-resolution geophysical data set collected from the uThukela Banks Marine Protected Area (MPA), we reveal a plethora of hitherto unknown or poorly resolved seabed features. In tandem with several remotely operated vehicle dives, we improve on the previous National Biodiversity Assessment map for the area and reveal a more complex picture of the seabed geology and geomorphology on which the MPA is predicated. The upper slope (-120 m and deeper) is dominated by small canyons, gullies and rills that occasionally extend to the shelf edge and form a series of slumps. Suspected cold-water corals were imaged on the interfluves of the Thukela Canyon. The mid to outer shelf (-60 to -100 m) is mostly rocky, and is composed of Pliocene-age siltstones for the most part. Aeolianite shorelines are found at depths of 60 m and 100 m, in which palaeo-lagoons and parabolic aeolian dune systems are also preserved. These features provide habitat for mesophotic corals and demersal fishes. Overlying and abutting hard rock substrates are unconsolidated sandy sediments that are mobilised by the inshore movement of the Agulhas Current. An inshore mud belt characterised by pockmarks associated with free gas expulsion is mapped for the first time. A well-developed palaeo-drainage pattern is also revealed, posing exciting new opportunities for the study of benthic communities associated with palaeo-estuaries and lagoons now exposed at the seabed. Several new habitats, both inside and out of the MPA boundaries, should form the basis for future research within the MPA, in addition to informing expansions of the MPA. Significance: Using a newly collected geophysical data set, we provide an unprecedented glimpse into the newly proclaimed uThukela Banks Marine Protected Area. We reveal a complexity of marine habitats hitherto unknown from previous biodiversity surveys. These habitats include areas of possible expansion given the recognition of keystone species that occur just outside the MPA limits

Marine megafauna interactions with small-scale fisheries in the southwestern Indian Ocean: a review of status and challenges for research and management

In developing regions, coastal communities are particularly dependent on small-scale fisheries for food security and income. However, information on the scale and impacts of small-scale fisheries on coastal marine ecosystems are frequently lacking. Large marine vertebrates (marine mammals, sea turtles and chondrichthyans) are often among the first species to experience declines due to fisheries. This paper reviews the interactions between small-scale fisheries and vulnerable marine megafauna in the southwestern Indian Ocean. We highlight an urgent need for proper documentation, monitoring and assessment at the regional level of small-scale fisheries and the megafauna affected by them to inform evidence-based fisheries management. Catch and landings data are generally of poor quality and resolution with compositional data, where available, mostly anecdotal or heavily biased towards easily identifiable species. There is also limited understanding of fisheries effort, most of which relies on metrics unsuitable for proper assessment. Management strategies (where they exist) are often created without strong evidence bases or understanding of the reliance of fishers on resources. Consequently, it is not possible to effectively assess the current status and ensure the sustainability of these species groups; with indications of overexploitation in several areas. To address these issues, a regionally collaborative approach between government and non-governmental organisations, independent researchers and institutions, and small-scale fisheries stakeholders is required. In combination with good governance practices, appropriate and effective, evidence-based management can be formulated to sustain these resources, the marine ecosystems they are intrinsically linked to and the livelihoods of coastal communities that are tied to them

Development of a data utility framework to support effective health data curation

Objectives: The value of healthcare data is being increasingly recognised, including the need to improve health dataset utility. There is no established mechanism for evaluating healthcare dataset utility making it difficult to evaluate the effectiveness of activities improving the data. To describe the method for generating and involving the user community in developing a proposed framework for evaluation and communication of healthcare dataset utility for given research areas. Methods: An initial version of a matrix to review datasets across a range of dimensions was developed based on previous published findings regarding healthcare data. This was used to initiate a design process through interviews and surveys with data users representing a broad range of user types and use cases, to help develop a focused framework for characterising datasets. Results: Following 21 interviews, 31 survey responses and testing on 43 datasets, five major categories and 13 subcategories were identified as useful for a dataset, including Data Model, Completeness and Linkage. Each sub-category was graded to facilitate rapid and reproducible evaluation of dataset utility for specific use-cases. Testing of applicability to >40 existing datasets demonstrated potential usefulness for subsequent evaluation in real-world practice. Discussion: The research has developed an evidenced-based initial approach for a framework to understand the utility of a healthcare dataset. It is likely to require further refinement following wider application and additional categories may be required. Conclusion: The process has resulted in a user-centred designed framework for objectively evaluating the likely utility of specific healthcare datasets, and therefore, should be of value both for potential users of health data, and for data custodians to identify the areas to provide the optimal value for data curation investment

Magnetic resonance-guided focused ultrasound surgery (MRgFUS) treatment for uterine fibroids

Magnetic Resonance-guided focused Ultrasound Surgery (MRgFUS) is gaining popularity as an alternative to medical and surgical interventions in the management of symptomatic uterine fibroids. Studies have shown that it is an effective non-invasive treatment with minimal associated risks as compared to myomectomy and hysterectomy. MRgFUS can be offered to a majority of patients suffering from symptomatic uterine fibroids. It has been suggested that the use of broader inclusion criteria as well as the mitigation techniques makes it possible to offer MRgFUS to a much larger subset of patients than previously believed. This paper will describe how MRgFUS treatment for uterine fibroids is performed at the University of Malaya Medical Centre, Kuala Lumpur, Malaysia

A synthesis of evidence for the effects of interventions to conserve peatland vegetation: Overview and critical discussion

Peatlandsare valuable but threatenedecosystems. Intervention to tackle direct threats is often necessary, but should be informed by scientific evidence to ensure it is effective and efficient. Herewe discuss a recent synthesis of evidence for the effects of interventions to conserve peatland vegetation -a fundamental component of healthy, functioning peatland ecosystems. The synthesis is unique in its broad scope (global evidence for a comprehensive list of 125 interventions) and practitioner-focused outputs (short narrative summaries in plain English, integrated into a searchable online database). Systematicliteraturesearches, supplemented by recommendationsfrom an international advisory board, identified162 publications containing 296 distinct tests of 66 of the interventions. Most of the articles studiedopen bogs or fens in Europe or North America. Only 36 interventions weresupported by sufficient evidence to assess their overall effectiveness. Mostof these interventions(85%) hadpositiveeffects, overall,on peatland vegetation-although this figure is likelyto have beeninflated by publication bias. We discuss how to use the synthesis, critically,to informconservation decisions.Reflecting on the content of the synthesiswe make suggestions for the future of peatland conservation,from monitoring overappropriate timeframes to routinely publishing resultsto build up the evidence base.MAVA, Arcadi

Uterine Fibroid Embolisation for Symptomatic Uterine Fibroids: A Survey of Clinical Practice in Europe

Item does not contain fulltextPURPOSE: To assess current uterine fibroid embolisation (UFE) practice in European countries and determine the clinical environment for UFE in different hospitals. MATERIAL AND METHODS: In May 2009, an invitation for an online survey was sent by e-mail to all members of the Cardiovascular and Interventional Radiologic Society of Europe, representing a total number of 1,250 different candidate European treatment centres. The survey covered 21 questions concerning local UFE practice. RESULTS: A total of 282 respondents completed the questionnaire. Fifteen questionnaires were excluded because they were doubles from centres that had already returned a questionnaire. The response rate was 267 of 1,250 centres (21.4%). Ninety-four respondents (33%) did not perform UFE and were excluded, and six centres were excluded because demographic data were missing. The remaining 167 respondents from different UFE centres were included in the study. Twenty-six percent of the respondents were from the United Kingdom (n = 43); 16% were from Germany (n = 27); 11% were from France (n = 18); and the remaining 47% (n = 79) were from other European countries. Most centres (48%, n = 80) had 5 to 10 years experience with UFE and performed 10 to 50 procedures annually (53% [n = 88]) of respondents). Additional demographic data, as well as specific data on referral of patients, UFE techniques used, and periprocedural and postprocedural, care will be provided. CONCLUSION: Although UFE as an alternative treatment for hysterectomy or myomectomy is widespread in Europe, its impact on the management of the patient with symptomatic fibroids seems, according to the overall numbers of UFE procedures, somewhat disappointing. Multiple factors might be responsible for this observation

Multicenter Phase 2 Trial of Sirolimus for Tuberous Sclerosis: Kidney Angiomyolipomas and Other Tumors Regress and VEGF- D Levels Decrease

Tuberous sclerosis (TSC) related tumors are characterized by constitutively activated mTOR signaling due to mutations in TSC1 or TSC2.We completed a phase 2 multicenter trial to evaluate the efficacy and tolerability of the mTOR inhibitor, sirolimus, for the treatment of kidney angiomyolipomas.36 adults with TSC or TSC/LAM were enrolled and started on daily sirolimus. The overall response rate was 44.4% (95% confidence intervals [CI] 28 to 61); 16/36 had a partial response. The remainder had stable disease (47.2%, 17/36), or were unevaluable (8.3%, 3/36). The mean decrease in kidney tumor size (sum of the longest diameters [sum LD]) was 29.9% (95% CI, 22 to 37; n = 28 at week 52). Drug related grade 1-2 toxicities that occurred with a frequency of >20% included: stomatitis, hypertriglyceridemia, hypercholesterolemia, bone marrow suppression (anemia, mild neutropenia, leucopenia), proteinuria, and joint pain. There were three drug related grade 3 events: lymphopenia, headache, weight gain. Kidney angiomyolipomas regrew when sirolimus was discontinued but responses tended to persist if treatment was continued after week 52. We observed regression of brain tumors (SEGAs) in 7/11 cases (26% mean decrease in diameter), regression of liver angiomyolipomas in 4/5 cases (32.1% mean decrease in longest diameter), subjective improvement in facial angiofibromas in 57%, and stable lung function in women with TSC/LAM (n = 15). A correlative biomarker study showed that serum VEGF-D levels are elevated at baseline, decrease with sirolimus treatment, and correlate with kidney angiomyolipoma size (Spearman correlation coefficient 0.54, p = 0.001, at baseline).Sirolimus treatment for 52 weeks induced regression of kidney angiomyolipomas, SEGAs, and liver angiomyolipomas. Serum VEGF-D may be a useful biomarker for monitoring kidney angiomyolipoma size. Future studies are needed to determine benefits and risks of longer duration treatment in adults and children with TSC.Clinicaltrials.gov NCT00126672