Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part II: Background to a research strategy.

STUDY DESIGN: Literature review/semi-structured interviews. OBJECTIVE: To develop a spinal cord injury (SCI) research strategy for Australia and New Zealand. SETTING: Australia. METHODS: The National Trauma Research Institute Forum approach of structured evidence review and stakeholder consultation was employed. This involved gathering from published literature and stakeholder consultation the information necessary to properly consider the challenge, and synthesising this into a briefing document. RESULTS: A research strategy 'roadmap' was developed to define the major steps and key planning questions to consider; next, evidence from published SCI research strategy initiatives was synthesised with information from four one-on-one semi-structured interviews with key SCI research stakeholders to create a research strategy framework, articulating six key themes and associated activities for consideration. These resources, combined with a review of SCI prioritisation literature, were used to generate a list of draft principles for discussion in a structured stakeholder dialogue meeting. CONCLUSION: The research strategy roadmap and framework informed discussion at a structured stakeholder dialogue meeting of 23 participants representing key SCI research constituencies, results of which are published in a companion paper. These resources could also be of value in other research strategy or planning exercises. SPONSORSHIP: This project was funded by the Victorian Transport Accident Commission and the Australian and New Zealand Spinal Cord Injury Network.

Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part III: outcomes.

STUDY DESIGN: Focus Group. OBJECTIVES: To develop a unified, regional spinal cord injury (SCI) research strategy for Australia and New Zealand. SETTING: Australia. METHODS: A 1-day structured stakeholder dialogue was convened in 2013 in Melbourne, Australia, by the National Trauma Research Institute in collaboration with the SCI Network of Australia and New Zealand. Twenty-three experts participated, representing local and international research, clinical, consumer, advocacy, government policy and funding perspectives. Preparatory work synthesised evidence and articulated draft principles and options as a starting point for discussion. RESULTS: A regional SCI research strategy was proposed, whose objectives can be summarised under four themes. (1) Collaborative networks and strategic partnerships to increase efficiency, reduce duplication, build capacity and optimise research funding. (2) Research priority setting and coordination to manage competing studies. (3) Mechanisms for greater consumer engagement in research. (4) Resources and infrastructure to further develop SCI data registries, evaluate research translation and assess alignment of research strategy with stakeholder interests. These are consistent with contemporary international SCI research strategy development activities. CONCLUSION: This first step in a regional SCI research strategy has articulated objectives for further development by the wider SCI research community. The initiative has also reinforced the importance of coordinated, collective action in optimising outcomes following SCI.

Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part I: rapid review of SCI prioritisation literature.

STUDY DESIGN: This is a rapid evidence review. OBJECTIVES: The objective of this study was to gain an overview of the volume, nature and findings of studies regarding priorities for spinal cord injury (SCI) research. SETTING: A worldwide literature search was conducted. METHODS: Six medical literature databases and Google Scholar were searched for reviews in which the primary aim was to identify SCI research priorities. RESULTS: Two systematic reviews were identified-one of quantitative and one of qualitative studies. The quality of the reviews was variable. Collectively, the reviews identified 31 primary studies; 24 quantitative studies totalling 5262 participants and 7 qualitative studies totalling 120 participants. Despite the difference in research paradigms, there was convergence in review findings in the areas of body impairments and relationships. The vast majority of literature within the reviews focused on the SCI patient perspective. CONCLUSION: The reviews inform specific research topics and highlight other important research considerations, most notably those pertaining to SCI patients' perspectives on quality of life, which may be of use in determining meaningful research outcome measures. The views of other SCI research stakeholders such as researchers, clinicians, policymakers, funders and carers would help shape a bigger picture of SCI research priorities, ultimately optimising research outputs and translation into clinical practice and health policy change. Review findings informed subsequent activities in developing a regional SCI research strategy, as described in two companion papers. SPONSORSHIP: This project was funded by the Victorian Transport Accident Commission and the Australian and New Zealand SCI Network.

[Polycardiography in the diagnosis of latent cardiac insufficiency]. / La policardiografia nella diagnostica della insufficienza cardiaca latente.

A group of heart patients and another group of healthy subjects have been studied and their systolic intervals (PEP-LVET - PEP/LVET ratio and the telediastolic index) evaluated using the mechanocardiographic system. In both long-standing and recent heart patients, the parameters studied showed significant deviations from the norm. These were even more marked after exercise on the ergonometer bicycle. Acute doses of digitalis reduced deviations from the norm observed under basal conditions and after exercise. Polycardiography, it is concluded, assists in the gathering of extremely valuable information about cardiac performance in relation to latent cardiac insufficiency. Especially useful information can be deduced from PEP indications and from the PEP/LVET ratio. The use of digitalis is suggested for physically active post-infarction subjects in order to give greater tolerance of physical exercise. The concept of long-term polygraphic studies as part of out-patient follow-ups on such patients is outlined.