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Your doctor may have said that you are eligible for a clinical trial, or you may have seen an ad for a clinical research study. What is clinical research, and is it right for you?

Clinical research is the comprehensive study of the safety and effectiveness of the most promising advances in patient care. Clinical research is different than laboratory research. It involves people who volunteer to help us better understand medicine and health. Lab research generally does not involve people — although it helps us learn which new ideas may help people.

Every drug, device, tool, diagnostic test, technique and technology used in medicine today was once tested in volunteers who took part in clinical research studies.

At Johns Hopkins Medicine, we believe that clinical research is key to improve care for people in our community and around the world. Once you understand more about clinical research, you may appreciate why it’s important to participate — for yourself and the community.

What Are the Types of Clinical Research?

There are two main kinds of clinical research:

Observational Studies

Observational studies are studies that aim to identify and analyze patterns in medical data or in biological samples, such as tissue or blood provided by study participants.

Clinical Trials

Clinical trials, which are also called interventional studies, test the safety and effectiveness of medical interventions — such as medications, procedures and tools — in living people.

Clinical research studies need people of every age, health status, race, gender, ethnicity and cultural background to participate. This will increase the chances that scientists and clinicians will develop treatments and procedures that are likely to be safe and work well in all people. Potential volunteers are carefully screened to ensure that they meet all of the requirements for any study before they begin. Most of the reasons people are not included in studies is because of concerns about safety.

Both healthy people and those with diagnosed medical conditions can take part in clinical research. Participation is always completely voluntary, and participants can leave a study at any time for any reason.

“The only way medical advancements can be made is if people volunteer to participate in clinical research. The research participant is just as necessary as the researcher in this partnership to advance health care.” Liz Martinez, Johns Hopkins Medicine Research Participant Advocate

Types of Research Studies

Within the two main kinds of clinical research, there are many types of studies. They vary based on the study goals, participants and other factors.

Biospecimen studies

Healthy volunteer studies.

 Goals of Clinical Trials

Because every clinical trial is designed to answer one or more medical questions, different trials have different goals. Those goals include:

Treatment trials

Prevention trials, screening trials, phases of a clinical trial.

In general, a new drug needs to go through a series of four types of clinical trials. This helps researchers show that the medication is safe and effective. As a study moves through each phase, researchers learn more about a medication, including its risks and benefits.

Is the medication safe and what is the right dose?   Phase one trials involve small numbers of participants, often normal volunteers.

Does the new medication work and what are the side effects?   Phase two trials test the treatment or procedure on a larger number of participants. These participants usually have the condition or disease that the treatment is intended to remedy.

Is the new medication more effective than existing treatments?  Phase three trials have even more people enrolled. Some may get a placebo (a substance that has no medical effect) or an already approved treatment, so that the new medication can be compared to that treatment.

Is the new medication effective and safe over the long term?   Phase four happens after the treatment or procedure has been approved. Information about patients who are receiving the treatment is gathered and studied to see if any new information is seen when given to a large number of patients.

“Johns Hopkins has a comprehensive system overseeing research that is audited by the FDA and the Association for Accreditation of Human Research Protection Programs to make certain all research participants voluntarily agreed to join a study and their safety was maximized.” Gail Daumit, M.D., M.H.S., Vice Dean for Clinical Investigation, Johns Hopkins University School of Medicine

Is It Safe to Participate in Clinical Research?

There are several steps in place to protect volunteers who take part in clinical research studies. Clinical Research is regulated by the federal government. In addition, the institutional review board (IRB) and Human Subjects Research Protection Program at each study location have many safeguards built in to each study to protect the safety and privacy of participants.

Clinical researchers are required by law to follow the safety rules outlined by each study's protocol. A protocol is a detailed plan of what researchers will do in during the study.

In the U.S., every study site's IRB — which is made up of both medical experts and members of the general public — must approve all clinical research. IRB members also review plans for all clinical studies. And, they make sure that research participants are protected from as much risk as possible.

Earning Your Trust

This was not always the case. Many people of color are wary of joining clinical research because of previous poor treatment of underrepresented minorities throughout the U.S. This includes medical research performed on enslaved people without their consent, or not giving treatment to Black men who participated in the Tuskegee Study of Untreated Syphilis in the Negro Male. Since the 1970s, numerous regulations have been in place to protect the rights of study participants.

Many clinical research studies are also supervised by a data and safety monitoring committee. This is a group made up of experts in the area being studied. These biomedical professionals regularly monitor clinical studies as they progress. If they discover or suspect any problems with a study, they immediately stop the trial. In addition, Johns Hopkins Medicine’s Research Participant Advocacy Group focuses on improving the experience of people who participate in clinical research.

Clinical research participants with concerns about anything related to the study they are taking part in should contact Johns Hopkins Medicine’s IRB or our Research Participant Advocacy Group .

Learn More About Clinical Research at Johns Hopkins Medicine

For information about clinical trial opportunities at Johns Hopkins Medicine, visit our trials site.

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NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

StatPearls [Internet].

How to write and publish a scientific manuscript.

Martin R. Huecker ; Jacob Shreffler .

Affiliations

Last Update: October 31, 2022 .

• Definition/Introduction

A clinician should continuously strive to increase knowledge by reviewing and critiquing research papers and thoughtfully considering how to integrate new data into practice. This is the essence of evidence-based medicine (EBM). [1]  When new clinical queries arise, one should seek answers in the published literature. The ability to read a scientific or medical manuscript remains vitally important throughout a clinician's career. When gaps exist in the literature, clinicians should consider researching these questions. Though typically performed by academic doctors or physician-scientists, medical research is open to all clinicians in informal and formal methods. Anyone who treats patients can collect data on outcomes to assess the quality of care delivered (quality improvement is research). [2]  Though beyond the scope of this chapter, many resources provide instruction for clinicians on conducting research and contributing to medical science. [3] [4] [5]  Additionally, a clinician integrating a new practice can study its effects on patient outcomes retroactively or prospectively. Continuous practice improvement need not be shared with the larger population of treating providers. Still, dissemination to the entire scientific community allows widespread adoption, criticism, or further testing for replication of findings.

• Issues of Concern

Clinicians who seek to conduct retrospective chart reviews, prospective studies, or even randomized, controlled clinical trials should access the many resources to ensure quality methodology. [5] Once you have followed the appropriate steps to conduct a study (Table 1), you should complete the process by writing a manuscript to describe your findings and share it with other clinicians and researchers. Other resources detail the steps in writing a review article, but this StatPearls chapter focuses on writing a scientific manuscript for original research. See also the StatPearls chapter for the different types of research manuscripts. [6]

• Clinical Significance

Steps to Conducting Research

• Develop a research question
• Perform a literature search
• Identify a gap in the literature
• Design a study protocol (including personnel)
• Submit to an institutional review board for approval
• Collect, responsibly store, and then analyze data
• Write a manuscript to interpret and describe your research.

After conducting a quality investigation or a study, one should assemble an abstract and manuscript to share results. Researchers can write an abstract in a short amount of time, though the abstract evolves as the full manuscript moves to completion. Many published and presented abstracts do not reach full manuscript publication. [7] [8]  Although journals and conferences often publish abstracts, studies with important results should be published in full manuscript form to ensure dissemination and allow attempts at replication. [9]  IRB protocols, study design, and data collection and aggregation require a team effort. Those involved in the research should discuss who contributes to the full manuscript (ie, qualify as an author) and, thus, the planned order of authorship to reduce complications at the time of manuscript submission. The author who devotes the most effort to the paper is typically the first and corresponding author. In contrast, the last author is often the team's most senior member and often the study's principal investigator. All individuals listed as authors should contribute to the manuscript and overall project in some fashion. [10]  The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist is perhaps the most valuable tool for preparing a manuscript for submission [11] . Original research manuscripts have the following sections (in chronologic order):

• Introduction (Background and Objectives)
• Methods (Design, Setting, Participants, Variables, Statistics)
• Results (Participants, Descriptives, Outcomes, Subgroups)
• Tables and Figures     
• Discussion (Key findings, Limitations, Interpretations)
• Conflict of Interest (COI), Author affiliations, Acknowledgments, Funding
• References [11]

Individuals involved in the IRB submission (before data collection) can write the introduction and methods of the manuscript before and during the data collection and analysis process. This head start on writing makes the full manuscript composition task less formidable. The content of the introduction and methods should be well-known to the study group before data collection and analysis. The introduction should be organized into a “problem/gap/hook” order: what problem this study addresses, the precise gap in the literature, and the study's objectives (in addressing the gap). [12]  The methods should provide enough detail so readers who want to replicate the study can do so.

Once data is collected and analyzed, authors can write an abstract to organize the major themes of the research, understanding that the abstract undergoes edits once the manuscript is complete. Similarly, the title can change with revisions as authors determine the most salient trends in the data. Most readers only read the title +/- abstract. Thus, these are the most important sections of the paper. The title should be concise and directly describe the trial result, which also helps generate more citations. The abstract must convey the crucial findings of the paper, ideally divided into sections for easier reading (unless the desired journal does not allow this). [13]  With the larger picture in mind, authors should create tables and figures that visually convey the themes of the data analysis. Working with statisticians or data experts, authors should devote much time to this manuscript component. Some general concepts: [14]

• Only include tables/figures that you believe are necessary.
• Make sure tables/figures are high-quality, simple, clear, and have concise captions.
• Do not repeat language in results that appear in tables/figures; the tables/figures should stand alone.
• Consider how the figure looks in grayscale (in case the journal is not in color)

As with the abstract and title, the tables and figures likely undergo further edits before the manuscript's completion. The abstract and tables/figures should intuitively evolve together to convey the story of the research project. Now, refer back to the introduction and methods composed during data collection. Make revisions as necessary to reflect the overall narrative of the project. Ensure you have adhered to the originally determined objectives or hypotheses. Next, focus on the results and discussion. The results should contain only objective data with no interpretation of significance. Describe salient results that have not been explained in the figures and tables. The discussion section begins with a lead paragraph highlighting the most important findings from the study. Then, the discussion interprets the current results in light of prior published literature. Ensure citation of keystone papers on this topic, including new papers published since embarking on the current project. Frame your results, describing how this study adds to the literature. The discussion section usually includes study limitations. Attempt to anticipate criticisms of the methodology, the results, the organization of the manuscript itself, and the (ability to draw) conclusions. A stronger limitations section preempts journal reviewer feedback, potentially simplifying the revision/resubmission process.

The conclusion section should be concise, conveying the main take-home points from your study. You can make recommendations for current clinical practice and for future research endeavors. Finally, consider using citation management software such as Endnote or Mendeley. Though initially cumbersome, these software platforms drastically improve revision efforts and allow easy reference reformatting. All authors should review the manuscript multiple times, potentially sharing it with other uninvolved colleagues for objective feedback. Consider who should receive acknowledgment for supporting the project and prepare to disclose conflicts of interest and funding. Although authors should have an initial idea of which journal to submit to, this decision is more straightforward once the manuscript is near completion. Journal rankings are beyond the scope of this StatPearls chapter. Still, generally, one should devise a list of the journals within a specialty in order of highest to lowest impact factor (some sites categorize into tiers). High-quality prospective research and clinical trials have a higher likelihood of acceptance into the more prestigious journals within a specialty or to the high-quality general science or medicine journals. Although many journals have an option for open access publication, and numerous legitimate, open access journals now exist, beware of ‘predatory journals’ that charge a fee to publish and may not be indexed in Pubmed or other databases. [12]

Journals have diverse guidelines for formatting and submission, and the manuscript submission process can be tedious. Before submission, review Bordage’s paper on reasons for manuscript rejection. [15]  Most journals require a title page and cover letter, representing an opportunity to lobby for your paper’s importance. When (not if) you experience manuscript rejections, take reviewer comments and recommendations seriously. Use this valuable feedback for resubmission to the original journal (when invited) or subsequent submission to other journals. When submitting a requested revision, compose a point-by-point response to the reviewers and attach a new manuscript with tracked changes. Attempt to resubmit manuscripts as promptly as possible, keeping your work in the hands of journals (allowing you to work on other research). [14]

• Nursing, Allied Health, and Interprofessional Team Interventions

The above logistic steps differ for review articles, case reports, editorials, and other submissions. [16]  However, the organization, precise methods, and adherence to journal guidelines remain important. See work by Provenzale on principles to increase the likelihood of acceptance for original and revised manuscripts. After submission, revision, resubmission, and proofing, you may experience the fulfillment of an official publication. Academics should promote their scientific work, enhancing the dissemination of research to the wider scientific community. [17] [18] [17] [19]

• Review Questions
• Access free multiple choice questions on this topic.
• Comment on this article.

Disclosure: Martin Huecker declares no relevant financial relationships with ineligible companies.

Disclosure: Jacob Shreffler declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

• Cite this Page Huecker MR, Shreffler J. How To Write And Publish A Scientific Manuscript. [Updated 2022 Oct 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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The Medical Science Liaison: A Critical Link Between Research and Clinical Practice

Anna Naim, PharmD

Oct 15, 2024

12 minutes read

What is the role of a MSL? 

In the evolving field of the pharmaceutical industry, the role of a Medical Science Liaison (MSL) has become increasingly vital. The MSL role is a specialized role within Medical Affairs that focuses on cultivating relationships with Key Opinion Leaders (KOLs) (may also be termed External Experts or Thought Leaders) and facilitating the exchange of scientific information acting as a linker between the organization and the health care professionals. These individuals act as the bridge between clinical practice, research, and commercial interests linking the internal environment–such as organizationals dynamics and resources within a pharmaceutical company– to the external environment, which includes healthcare professionals, researchers, and patient advocacy groups. The key role of the MSL is to ensure that scientific insights translate to meaningful patient outcomes by ensuring that healthcare professionals have a deep understanding of the therapeutic area as well as the specific products. 

The Interview Process: 

Candidates typically meet with various members of the Medical Affairs team and the Medical Science Liaison manager or director. At the end of the interview process , applicants are often asked to present on a clinical or scientific topic of their choice to assess their ability to articulate and communicate information effectively. Typically the interview process has 3 steps. The first step is a phone screen by the recruiter. Step two involves talking with the hiring manager by phone. Step 3 is the final step in the process where you usually interview with a panel of internal stakeholders and are asked to do a clinical presentation. Step 3 can be virtual or in person.

MSL Compensation/Salary: 

The starting base salary of a MSL can range from $125,000 to $130,000 and go up to over $200,000. The starting base salary is dependent on the experience and degree of the individual. MDs will typically have a higher starting base salary compared to a PharmD or PhD. Additionally, MSLs may receive a bonus of 15 to 25% of the base salary, stocks, and sometimes a company car or car stipend depending on the company, although these benefits can change depending on location, company size, and specific employer, making this a very lucrative role from a financial standpoint. 

Choosing Your Company

The choice between the size or type of the company may be difficult as both have their advantages and disadvantages. 

Big Pharma: Large pharmaceutical companies are well known and have established processes with more job security.However, the financial stability and pipeline of the particular company you work for might have a significant impact on your ability to grow in the field. 

Biotech Companies: These are mid sized companies making it easier for individuals to enter due to less competition. There is a potential for rapid growth and significant stock value increases if the company is acquired by big pharma. At the same token, there is a higher risk due to the possibility of disbanding the medical affairs team if products do not get approval, essentially offering less job security compared to big pharma. 

Travel and Territory Sizes: Some companies have very large territories that cover several states. This would require several overnight trips per month. Some companies have very small territories where very little overnight travel is required.

Day to Day of a MSL

The primary goal for the day to day activities for a MSL is to be in the field every day meeting with healthcare professionals. These interactions can include live meetings, virtual meetings, phone calls, and/or emails - depending on the HCP. Striving to maximize daily interactions is crucial. MSLs are tasked with several critical responsibilities that are composed of three main buckets - education, support for medical meetings, and clinical research in addition to other key responsibilities. Furthermore, MSLs devote an incredible amount of time to keeping up with the most current research in their therapeutic area. This frequently entails reading scientific literature, attending conferences, and participating in webinars to stay informed on clinical knowledge.

Education: MSLs provide training and education to healthcare professionals ensuring that they are well informed about the latest advancements, new therapies, clinical data and the best practices to be used. MSLs provide product training to healthcare professionals about the mechanism, efficacy, and safety of the company's products. MSLs provide disease education offering insights into disease state management and up to date guidelines and medical advancements in a balanced and timely manner to keep healthcare professionals up to date. MSLs can also be responsible for internal training to the sales and marketing teams on the scientific aspects of the products and therapeutic area(s). Although common, this is not the case for all organizations. MSLs are responsible for communicating and educating complex scientific and clinical information to healthcare professionals. With this, MSLs should be prepared to respond to questions from healthcare providers about the company’s products. This extensive knowledge allows the MSL to answer unsolicited requests for a broad range of information. Delivering presentations at medical conferences and meetings can also be expected to educate a broader crowd. 

Support: This includes one of the primary responsibilities of an MSL which is to engage with key opinion leaders to build collaborative, non-promotional relationships in the medical community and facilitate scientific discussions. MSLs build and maintain relationships with KOLs to gather insights on clinical practices and/or unmet medical needs as well as providing updates on new research findings and ongoing clinical trials. Liaisons also gather cutting edge knowledge from researchers and thought leaders and bring insights back to the company.

Clinical Research: This role entails assisting in the design and execution of clinical trials by providing scientific insights and ensuring the clinical relevance of the study. MSLs have the ability to nominate investigators sites which have the appropriate patient population for the trial. MSLs also build and maintain relationships with the clinical trial investigators since they assist in the identification and initiation of clinical trial sites. While MSLs are not responsible for data collection and analysis, clinical research is crucial for data collection and analysis since gathering and analyzing the data from these ongoing trials will provide insights to the clinical development team. MSLs assist in clinical trial support, site and investigator nominations, support site initiation visits, educate sites and communicate trial results based on approved content. 

Skills and Qualifications of a MSL 

To be effective, MSLs must possess a unique set of skills and qualifications. A Medical Science Liaison at minimum should have a doctoral degree whether that be a PhD, PharmD, MD, OD, etc. While a doctorate degree is essential to facilitate peer to peer discussions (doctor to doctor), not all companies require it. MSLs should build a strong background in the relevant therapeutic area that they cover. It is important to recognize that specifications can be learned within the company, but real life clinical and research experience in the relevant therapeutic field is more beneficial. The real life clinical and research experience are what make the conversations with the health care professionals more impactful and relatable. 

Communication: Communication skills are critical as the role depends on the ability to convey complex scientific information clearly and effectively to diverse audiences. MSLs should be able to relay this information in a clear manner and possess strong verbal skills with an ability to tailor messages depending on the audience. 

Relationship building and Interpersonal skills: Relationship building and interpersonal skills is a pivotal requirement for the MSL role. Strong interpersonal skills are required to establish and maintain relationships. This skill is especially important to the MSL role as MSLs are responsible for data dissemination. Establishing a level of trust and credibility with KOLs, HCPs, and other stakeholders ensures that they are receptive to the information shared by MSLs. 

Build relationships with your clinical background leveraging your clinical expertise to establish more credibility when engaging with KOLs 

Relationships with KOLs can be built by seeking introductions from existing contacts rather than making cold calls 

Most MSL roles involve taking over territories with pre-existing relationships and companies typically provide this list of KOLs

Use technology platforms to identify and engage with KOLs. This can be started with an email and using cross-functional relationships to compliantly collaborate and get introductions to form new relationships 

Analytical skills: Analytical skills may be significant to analyze clinical data and derive insights to inform strategic decisions. 

Independence and Time Management: The role of a MSL involves being able to work independently and manage one’s own territory. A MSL is responsible for all activities within their assigned therapeutic area and structuring their own schedule. 

Attitude and Emotional Intelligence: These skills are essential as individuals are typically hired for the medical science liaison role based on attitude. While skills can be taught, a positive attitude and emotional intelligence are crucial. 

Adaptability: As the healthcare field is constantly evolving, MSLs should be adaptable and open to continuous learning to stay ahead and updated on the latest scientific advancements and regulatory changes. MSLs should have a passion for lifelong learning as that is what the role entails. 

Resilience and Patience: In the scientific community, the role of the MSL can often be misunderstood by other healthcare professionals. It is imperative to communicate the role and expertise a MSL has and establish oneself as a scientific expert. 

Gathering and Utilizing Insights to Drive Medical Strategy 

Gathering Insights begins with identifying the gaps in knowledge and guidelines, ensuring diversity within clinical trials, staying on top of new technology and advancements and addressing roadblocks that may arise. 

Identify Knowledge Gaps: Identify the areas where more education is needed

Diversity in Trials: Ensure diversity and inclusion within clinical trials. 

Gaps within Guidelines: Educate around clinical guidelines and identify unmet needs 

New Advancements: Stay informed and up to date about compounds and new research 

Roadblocks: Identify and address institutional roadblocks that may arise. Ask what can your company do to assist in overcoming roadblocks 

Utilizing Insights: enter insights into the CRM and other platforms and these insights should drive medical strategies to help meet the needs of your specific area

Challenges within the MSL Role

Regulatory and Compliance Challenges: MSLs engage in non-promotional scientific discussion. Ensuring that communication between healthcare professionals and key opinion leaders are compliant and non promotional requires a deep understanding of regulatory requirements and being able to adapt to strategies accordingly. MSLs may potentially have conflicts of interest, especially when talking about off-label usage or communicating with medical professionals who are also involved in clinical trials. 

Rapidly changing environment: The rapid pace of scientific advancements can pose a challenge for MSLs as they may not be able to keep up the pace with the most recent scientific advancements. MSLs must stay current with the latest research and clinical developments to provide accurate and up to date information to KOLs, HCPs, and other stakeholders. 

Balance: The role of a MSL requires them to be present for multiple stakeholders. MSLs should balance the needs and expectations of various KOLs, HCPs, and other stakeholders as well as their own organization. The different stakeholders may have different priorities, concerns, wants and needs which makes it especially important for MSLs to be able to create this balance. 

Tools for Success for MSLs

A rapidly changing environment is a challenge that MSLs face on a day to day basis in their role. To be successful, it is important for them to stay updated on therapeutic areas, especially their assigned therapeutic area. 

Training Programs: Most companies provide robust programs and training tailored to the specific therapeutic area a MSL works in. This ensures that MSLs have a solid foundation of knowledge in their tailored therapeutic area

Skill development: Continuous development of training skills to consistently stay proficient and effective in communicating scientific information 

Attending Conferences: Participating in major regional and CMA conferences provides valuable opportunities to learn about the latest advancements

Identifying Gaps in Therapy: To be successful, MSLs should have an understanding of the current gaps in therapeutic areas and staying informed about upcoming products and treatments in the company's pipelines as well as the products of competitors 

Patient Insights: MSLs primarily interact with healthcare professionals who communicate patient experiences. Listening to how treatments have positively impacted patients can offer a unique perspective that can enhance a MSL’s understanding of the product to a new level 

Continuous Learning: Engaging in ongoing learning through peer interaction, webinars, educational sessions and company programs can ensure that MSL’s stay at the forefront of their field and effectively communicate to their team

The Future of the MSL Role

Digital Technology: The future of the role will heavily be based on integration of digital technology since digital tools can enhance data collection, improve engagement and provide new platforms for scientific communication. Furthermore, in order to stay connected and keep up with technology changes, MSLs may have to acquire new skills including advanced data analysis and efficient use of digital communication platforms. This is because the demand for real-world evidence is only growing. For MSLs to continue to be successful in their profession, these abilities must continue to develop.

Real World Evidence: The demand for real world evidence grows daily which requires MSLs to gather and interpret real world data to support safety and efficacy of new and current therapies. This will require a closer collaboration with healthcare providers to collect meaningful data and insights

Patient Centered Focus: There has been a shift toward patient centered care that continues to shape the role of a MSL. MSLs will need to engage more closely with healthcare professionals and patient advocacy groups to incorporate patient perspectives into their strategies. 

Evolving Skill Sets: Future MSLS will most likely need to be proficient in digital and AI technology, pharmacogenomics, bioinformatics and have a diverse set of knowledge in healthcare information. The role will evolve to be more involved in virtual engagements and MSLs will be required to act as the first line of information for healthcare providers. The future of the MSL role will most likely take away from an individual being an expert in one therapeutic area and having a more broader and diverse understanding 

Advice for Aspiring Medical Science Liaisons

Set Your Goal: MSL role is widely regarded as one of the most rewarding positions in the pharmaceutical industry. Aim to secure a role as a MSL

Interview Proactively: Apply for every available MSL position regardless of your perceived qualifications. You might possess qualities or experiences that apply to employers even if they are not immediately obvious to you. The MSL role is more than what is on your CV/resume. Engaging in as many interview as possible is key to gain experience and improve your chances of landing the role of a MSL

Networking: Networking is crucial. Network internally within your organization and externally. Connect with current MSLs and seek opportunities to shadow current MSLs. This will give you valuable insight into the role and help you understand the specific requirements and skills that MSLs possess. Connect with colleagues and industry professionals and reach out to learn from their experiences. Many successful MSLs have benefited from the advice and insights shared by other MSLs in the field

Contract MSL Role: If you lack direct experience, consider starting with a contract MSL position. The contract MSL position can carve a pathway into a permanent role in the future 

Self Reflection: Reflect on whether the MSL role suits your lifestyle and preferences. The MSL position often involves travel, requires adaptability and independence that comes with an extensive amount of responsibilities. If you prefer a predictable schedule this role may not be the best for you

The Medical Science Liaison role is a dynamic position that is critical to the success of Medical Affairs. By fostering relationships with KOLs, facilitating scientific exchange and supporting clinical development these individuals ensure that the latest scientific insights are effectively translated into improved patient care. 

References:

Dixson, K., Kelly, T., Mastanduono, J. Everything you need to know about being a medical science liaison (MSL) . Jul 2024. YouTube. https://www.youtube.com/watch?v=Tm6xJLwZaPE&t=1s&ab_channel=AccreditationCouncilforMedicalAffairs 

Solimon, W. Medical science liaison role| insider secrets .  Dec 2022. YouTube. https://www.youtube.com/watch?v=BtIL03M4Grc&ab_channel=WilliamSoliman 

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Medical Honey for Wound Care—Still the ‘Latest Resort’?

Kirsten traynor, gisela blaser, peter molan.

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For reprints and all correspondence: Dr med. Arne Simon, Paediatric Haematology and Oncology, Children's Hospital Medical Centre, University of Bonn, Adenauerallee 119, 53113 Bonn, Germany. Tel: 0049 (0) 2282873-3254/3255/3305; Fax: 0049 (0) 2282873-3301; E-mail: [email protected]

Corresponding author.

Received 2007 Jul 19; Accepted 2007 Nov 5; Issue date 2009 Jun.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/2.0/uk/ ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

While the ancient Egyptians and Greeks used honey for wound care, and a broad spectrum of wounds are treated all over the world with natural unprocessed honeys from different sources, Medihoney™ has been one of the first medically certified honeys licensed as a medical product for professional wound care in Europe and Australia. Our experience with medical honey in wound care refers only to this product. In this review, we put our clinical experience into a broader perspective to comment on the use of medical honey in wound care. More prospective randomized studies on a wider range of types of wounds are needed to confirm the safety and efficacy of medical honey in wound care. Nonetheless, the current evidence confirming the antibacterial properties and additional beneficial effects of medical honey on wound healing should encourage other wound care professionals to use CE-certified honey dressings with standardized antibacterial activity, such as Medihoney™ products, as an alternative treatment approach in wounds of different natures.

Keywords: Medical honey, wound care, MRSA

Introduction

In our paediatric oncology department at the Children's Hospital Medical Centre, University of Bonn, Germany most patients suffer from a profoundly suppressed immune system, due to their underlying disease (i.e. leukemia) ( 1 ) and the chemotherapy they undergo. This frequently results in wound healing problems ( 2 , 3 ), leaving the patient susceptible to wound infections. Unfortunately these infections spread easily in immunocompromized patients and can cause secondary potentially life-threatening bloodstream infections ( 4 ).

Five years ago a 12-year old patient was submitted to our unit. Doctors at another hospital had removed an abdominal lymphoma, leaving an open drainage site on his abdomen. On admission, his wound was infected with methicillin-resistant Staphylococcus aureus (MRSA). In order to avoid nosocomial spread, the patient was immediately isolated, a difficult situation for the child to comprehend with significant additional costs from the perspective of the hospital. Although the patient was scheduled to receive chemotherapy, treatment could not commence until the infection cleared. The wound was treated with a local antiseptic (octenidin) for 12 days. Since no improvement occurred, we decided to use an Australian medical honey (Medihoney™), which contains leptospermum honey, a type with excellent in vitro activity against MRSA ( 5–7 ). The wound was free of bacteria two days later, and the chemotherapy against the underlying illness could be started.

While the ancient Egyptians and Greeks used honey for wound care, a broad spectrum of wounds are treated all over the world with natural unprocessed honeys from different sources ( 8–13 ), Medihoney™ has been one of the first medically certified honeys licensed as medical product for professional wound care in Europe and Australia ( 14 , 15 ). Our experience with medical honey in wound care refers only to this product. We were asked by one of the editors of eCAM to put our clinical experience ( 2 , 16 ) into a broader perspective and to comment on the use of medical honey in wound care (Table 1).

Key information from this review

#For the medical use of honey in general please refer to the outstanding review of Peter Molan from 2006 ( 15 )

What Makes Medical Honey Effective?

Honey works differently from antibiotics, which attack the bacteria's cell wall or inhibit intracellular metabolic pathways. Honey is hygroscopic, meaning it draws moisture out of the environment and thus dehydrates bacteria. Its sugar content is also high enough to hinder the growth of microbes, but the sugar content alone is not the sole reason for honey's antibacterial properties.

When honey is diluted with water, reducing its high sugar content, it still inhibits the growth of many different bacterial species that cause wound infections ( 14 , 15 , 17–20 ).

Leptospermum spp. are known by a number of common names in Australia and New Zealand including Tea Tree, Manuka, Goo Bush and Jelly Bush. A least 79 species of Leptospermum have been described in Australia and New Zealand ( 21 ). The medical honey, our clinical experience refers to (Medihoney™), consists of standard mixture of different Leptospermum spp. honeys ( Fig. 1 ), and exhibits a standard antibacterial activity as confirmed by appropriate in vitro testing methods ( 22 ).

Pictures of different Leptospermum spp. plants from Australia.

Unlike glucose oxidase, the antibacterial properties from Leptospermum spp. honeys are light- and heat-stable. Neither type of activity is influenced by the final sterilizing procedure of gamma-irradiation ( 23 ). Over 100 substances are candidates for the particular antibacterial property of these honeys, but the active ingredient has not yet been identified. Even if the hydrogen peroxide activity is blocked and the osmotic effect of honey is circumvented by dilution, selected honeys from Leptospermum spp. still display significant antibacterial effects. Natural honey of other sources can vary as much as 100-fold in the potency of their antibacterial activity (which is due to hydrogen peroxide) ( 5–7 , 24–27 ).

In addition to its antibacterial properties, medical honey hastens the healing of wounds through its anti-inflammatory effects. The amount of wound exudate is related to the activity of the local inflammatory process, in particular in wounds, which are colonized or infected with bacteria. Thus, the anti-inflammatory action of honey reduces oedema and the amount of exudate by down regulating the inflammatory process. It also reduces pain, as the pain in wounds results from the nerve endings being sensitized by prostaglandins produced in the process of inflammation, as well from the pressure on tissues resulting from oedema.

Due to its high sugar content, honey also prevents pain on dressing changes as it keeps the wound surface moist by mobilizing the oedema from the surrounding tissues.

The anti-inflammatory action of honey has been extensively observed clinically ( 19 , 28 , 29 ) and in animal models ( 15 ). Animals do not demonstrate any placebo effects, as they are incapable of having attitudes influence their healing process, such as believing that natural products would be more effective, or from hearing via the news media of the effectiveness of honey in wound treatment ( 30 ). Thus, these observational and histological studies can be cited as convincing evidence for the positive results with honey not being due to a placebo effect. Similarly, this can be concluded also for the observations in wounds in animal models of honey stimulating the rate of angiogenesis, granulation and epithelialization ( 31 , 32 ), which would explain the findings in clinical trials that honey speeds up the healing process ( 15 ).

Although the mechanism(s) by which honey speeds up the healing process have not been determined, there are some findings, which provide possible explanations. One way in which honey may work is through its stimulation of an inflammatory response in leukocytes ( 28 , 29 , 33 ), as inflammation is what triggers the cascade of cellular events that give rise to the production of growth factors which control angiogenesis and proliferation of fibroblasts and epithelial cells. Very recently, Tonks et al . discovered a 5.8 kDA component of manuka honey which stimulates the production of TNF-α in macrophages via Toll-like receptor 4 ( 34 ).

Another mechanism may be related to the pH level of honey being low (3.4–5.5; mean 4.4) ( 35 , 36 ). Bacterial colonization or infection and recalcitrant wound healing situations are often accompanied by pH values >7.3 in wound exudates ( 37 , 38 ). It has been demonstrated that acidification of wounds speeds healing ( 39 ), this being attributed to the low pH increasing the amount of oxygen off-loaded from hemoglobin in the capillaries. More recently it has also been attributed to suppression of protease activity in wounds by getting away from the neutral pH that is the optimum for their activity ( 37 ). Excessive protease activity in a wound can slow or prevent healing by destroying growth factors (which are proteins) and destroying the protein fibres and fibronectin in the wound matrix, attachment to which activates fibroblasts and is necessary for the migration of these and of epithelial cells ( http://www.worldwidewounds.com/2005/august/Schultz/Extrace-Matric-Acute-Chronic-Wounds.html ). This protease activity results from excessive inflammation. The anti-inflammatory activity of honey would thus remove this impediment to healing, as would the antibacterial activity working through removing infecting bacteria stimulating the inflammatory response.

The remarkable debriding action of honey that has been noted by many would also assist in this by removing slough which is a rich source of bacteria to stimulate an inflammatory response ( 19 ).

Last but not least, medical honey successfully manages the problem of malodour from chronic colonized wounds, which results in severe discomfort and social isolation in these patients. We relate the experience of one female patient with relapsed breast cancer after chemotherapy and irradiation. Her husband informed us, that other members of the family would not enter her room, because her wound smelled like a ‘dead rabbit’. This malodour problem was successfully eliminated with the application of medical honey in 2 weeks.

Why is the Final Product Irradiated?

Clostridium botulinum spores pervade our environment, existing in the soil, air, dust and raw agricultural products. Due to the possibility of Clostridial contamination and many reports of infant botulism in the literature since the first description of this syndrome in 1976, it has been recommended by paediatricians, not to feed infants with honey and to place warning labels on packaging, as done in the United Kingdom and Norway ( 36 ).

In deep wound cavities the possibility exists of an anaerobic environment, where the spores could proliferate and produce botulinum toxin. Negative effects such as paralysis and cardiac arrhythmia have been described related to systemic effects of the toxin. To eliminate botulism spores with heat, honey must be heated to 120°C (248°F) for 10 min, which results in adverse changes to some of honeys’ beneficial properties. Since spores have occasionally been found in honey, each batch of Medihoney™ is gamma irradiated to inactivate spores such as those from Clostridium spp. This does not have a detrimental impact on the antibacterial activity of honey. On the other hand, irradiating honey is only a safety measure on the side of caution since we ( 40 ) could not detect a single case report in the literature of C. botulinum wound infection related to the use of non-irradiated honey in wound care ( 41 ).

Medihoney is not an Antiseptic

An ideal wound antiseptic would meet the following criteria ( 42 ):

Fast onset of bactericidal action and a remnant, broad spectrum effect against bacteria and fungi, even under the unfavorable conditions of exudating, colonized or infected wounds.

Enhancement and acceleration of the physiologic process of wound healing (debridement, granulation), even if applied for prolonged periods.

No adverse local or systemic effects (allergy, toxicity related to absorption).

Moderate cost even if applied two times daily.

Medihoney meets all of the above criteria except ‘a fast onset of activity’, as it does not seem to produce the desired reduction of bacteria (more than five log steps) and fungi in 1–10 min to be qualified as an antiseptic.

What About Conventional Wound Care Products in Paediatric Oncology?

Some of the parents in our unit have at first been sceptical about the benefits of honey in wound care. However, the scientific evidence for using conventional wound care products in paediatric oncology patients is non-existent, since no prospective randomized studies have been performed in this particular population and no research has been done on the long-term effects of modern conventional treatments such as silver dressings.

There has been a report of a Silver-coated dressing which caused raised liver enzymes and an argyria -like syndrome in an adolescent burn patient ( 43 ). Another common treatment is povidone iodine, which has the advantage of antiseptic properties and is well suited for skin disinfection prior to invasive procedures. However, the antiseptic activity of iodine products is hampered by interactions with the protein content of the wound exudate and severe adverse effects of systemic absorption of iodine on thyroid function must be considered in infants and toddlers as well as in adult patients with latent hyperthyreosis.

In principle, the same problem exists with alcohol-containing antiseptics, since they are almost completely absorbed and need to be metabolized by the children, who are treated concomitantly with many other drugs. In contrast, medical honey does not display the problem of systemic absorption and thus can even be utilized in patients with diabetes mellitus without adverse effects on blood glucose levels.

Medical Honey in Severely Immunocompromized Patients?

One of our patients with acute myeloic leukemia in relapse had a wound infection with methicillin-resistant coagulase-negative staphylococci after thoracic surgery for invasive Aspergillus infection of the lung, but was allocated to allogenic bone marrow transplantation. Using medical honey, the infection was eliminated.

The patient continued to receive medical honey applications during and after the transplantation ( Fig. 2 ), leading to a successful healing without further local or systemic complications.

Thoracotomy wound of a patient with acute myeloic leukemia after surgical site infection (Medihoney™ was applied on a calcium-alginate dressing and left in the wound for 24 h).

Medical Honey for Recalcitrant Wounds

Many of the 150 wound care patients we have treated with medical honey had previously received specialist attention for recalcitrant wounds ( 2 , 3 , 16 , 44 ). When treatment with honey was commenced, their wound status changed to healing from non-healing ( 2 , 3 , 16 , 44 ). Similar findings have been reported by others ( 19 , 45 ).

Medihoney™ for the protection Of Catheter Entry Sites

The clinical usefulness of hemodialysis catheters is limited by increased infectious morbidity and mortality. Topical antiseptic agents, such as mupirocin, are effective at reducing this risk but have been reported to select for antibiotic-resistant strains. Johnson et al . ( 46 ) performed a randomized, controlled trial comparing the effect of thrice-weekly exit-site application of Medihoney™ versus mupirocin on infection rates in patients who were receiving hemodialysis via tunnelled, cuffed central venous catheters. A total of 101 patients were enrolled. The incidences of catheter-associated bacteremia in honey-treated ( n  = 51) and mupirocin-treated ( n  = 50) patients were comparable (0.97 versus 0.85 episodes per 1000 catheter-days, respectively; NS). No exit-site infections occurred. During the study period, 2% of staphylococcal isolates within the hospital were mupirocin resistant. Thrice-weekly application of standardized antibacterial honey to hemodialysis catheter exit sites was safe, cheap, and effective and resulted in a comparable rate of catheter-associated infection to that obtained with mupirocin (although the study was not adequately powered to assess therapeutic equivalence).

The effectiveness of honey against antibiotic-resistant microorganisms and its low likelihood of selecting for further resistant strains suggest that this agent may represent a satisfactory alternative means of chemoprophylaxis in patients with central venous catheters. In our paediatric oncology unit, all entry sites of tunnelled central venous catheters, which show any sign of inflammation or dehiscence, are covered with medical honey.

Honey Treatment for Prevention of Oral Mucositis and for Gingivitis

Many cancer patients suffer from mucositis, a side effect of chemotherapy that attacks the entire gastrointestinal tract from the mouth to the anus. The cancer treatment breaks down the epithelial cells lining the tract, leaving the patient prone to ulcerations and infections. These important and beneficial cells replicate and divide rapidly, which is why in a typical healthy individual wounds in the mouth heal quickly. Chemotherapy does not distinguish between healthy and malignant cells, attacking all that reproduce rapidly, including these epithelial cells.

Thus 20–40% of all cancer patients receiving intensive chemotherapy suffer from mucositis, the number climbs to 80% when chemotherapy and radiation are combined, and staggers even higher in patients receiving treatment for cancer in the head and neck area. Open sores in cancer patients suffering from mucositis leave them susceptible to infection. In a study conducted in 2003, Biswal et al . ( 47 ) investigated the use of honey in 40 adult patients with head and neck cancer. Patients consumed 20 ml (one and one-third teaspoon) of pure honey 15 min before, 15 min after and 6 h post-treatment. There was significant reduction in the symptomatic grade three-fourth mucositis (which describes the necessity for morphine infusion and parenteral nutrition) among honey-treated patients compared with controls; i.e. 20% versus 75% ( P < 0.001).

The compliance of the honey-treated group of patients was better than controls. A total of 55%patients treated with topical honey showed no change or a positive gain in body weight compared with only 25% in the control arm ( P  = 0.05). According to a recent review, honey has potential for the treatment of periodontal disease, mouth ulcers and other problems of oral health ( 48 ), and a trial has demonstrated a statistically significant difference between chewing gelled honey and chewing chewing-gum in decreasing the number of bleeding sites on gums with gingivitis ( 49 ).

Use of Honey for Wound Care in Neonates

Due to the safeness of Medihoney™, we used this product for wound care in premature neonates. One infant patient had a recalcitrant wound after surgical intervention for meningomyelocele. The wound stagnated, and during intensive care treatment, it became colonized with multiresistant Klebsiella oxitoca . Before treatment with Medihoney™ was initiated, the child had received numerous intravenous antibiotics and many other conventional wound care treatments to clear the wound, spending the first 3 months of its life in the hospital. Medihoney™ dressings cleared the wound of the pathogen and allowed the patient to be discharged after 3 weeks. The wound healed completely without further surgical intervention. Viardi et al . ( 40 ) published an impressive case series including nine neonates with polymicrobial wound infection after surgery for congenital heart disease. All infants were considered as treatment failures, since chlorhexidine 0.05% plus fusidic acid ointment plus systemic antibiotics did not result in any improvement of the sternal wound infection. All infants showed marked clinical improvement after 5 days of treatment with topical application of 5–10 ml of fresh unprocessed (non-pasteurized, non-irradiated) honey twice daily. The wounds were closed, clean and sterile in all infants after 21 days of honey application. There were no adverse reactions to the treatment. In a recent review for Neonatal Network , Susan Bell reviewed the current literature dealing with the medical use of medical honey in neonatal wound care. Nurses in her unit are using medical honey for this purpose since 2005. She came to the conclusion that the scientific evidence regarding the use of honey for wound treatment in neonates and infants is interesting, but still not strong. The sample sizes in the available clinical studies were small; there were no comparison groups and no randomization. She stated that double-blinded randomized controlled clinical trials with sufficient power are needed to determine the efficacy of honey in both initial wound management and secondary treatment of infected and poorly healing wounds. It has to be questioned, how double or even single (on the side of the patent) blinding can be established in studies, which investigate medical honey for wound care and compare it with other conventional modes of treatment.

Honey Treatment Against Viral Disease

Al-Waili et al . published a cross over trial ( 9 ) in which 16 adult patients with a history of recurrent attacks of herpetic lesions, 8 labial and 8 genital, were treated by topical application of honey for one attack and acyclovir cream for another attack. For labial herpes, the mean duration of attacks and pain, occurrence of crusting and mean healing time with honey treatment were 35, 39, 28 and 43% shorter, respectively, than with acyclovir treatment. For genital herpes, the mean duration of attacks and pain, occurrence of crusting and mean healing time with honey treatment were 53, 50, 49 and 59% shorter, respectively, than with acyclovir. Two cases of labial herpes and one case of genital herpes remitted completely with the use of honey. No side effects were observed with repeated applications of honey, whereas three patients developed local itching with acyclovir. The authors came to the conclusion that topical honey application is safe and effective in the management of the signs and symptoms of recurrent lesions from labial and genital herpes ( 9 ). According to this experience, we treat children and adults with recurrent herpetic lesions on the lips with medical honey, as soon as a new lesion is developing. In addition, we use topical medical honey in addition to systemic acyclovir in immunocompromized patients with zoster to prevent secondary bacterial skin infection and to accelerate healing of the herpetic lesions.

Medical Honey in Chronic Ocular Surface Diseases

Albietz et al . ( 50 ) recently published the results of a study that assessed the effect of Medihoney™ antibacterial honey on the ocular flora in patients with dry eye caused by tear deficiency and/or Meibomian gland disease. In this prospective, open-label pilot study, bacteria isolated from the eyelid margin and conjunctiva were identified and quantified before and at 1 and 3 months after initiation of treatment with topical application of antibacterial honey thrice daily. The total colony-forming units (CFUs) isolated from each of the dry eye subgroups before antibacterial honey use was significantly greater than the total CFU isolated from the non-dry eye group.

Use of Medihoney™ Antibacterial honey significantly reduced total CFUs for the eyelids and the conjunctiva of dry eye subjects from baseline at month 1 and 3. At month 3, the total CFUs for all dry eye subgroups were not significantly different from those of the non-dry eye group. A review of the medical uses of honey ( 8 ) has cited several other reports of honey, an ancient treatment for sore eyes, being found to be successful in modern ophthalmology.

Comparing Different Types of Honey

A comparison of different types of honey, which is beyond the scope of this article, may be an important issue in future trials ( 24 ). In particular the results obtained by Prof. Descotte from France, presented during several international Apitherapy meetings, point into this direction; unfortunately they have not been published in a medline listed journal. Irish et al . ( 51 ) found Jarrah honey (derived from Eucalyptus marginata ), which contains higher amounts of glucose oxidase, to be significantly more effective against Candida spp. in vitro ; the activity of the other honeys including Medihoney™ against Candida spp. with minimal inhibitory concentrations above 40% (w/v) were not distinguishable from the activity of an artificial honey.

Minimal Requirements for Clinical Use

From a professional medical perspective honey used in wound care should have a proven antibacterial activity against the most important pathogens in wound infection ( S. aureus, Pseudomonas aeruginosa ) ( 16 , 52 ) measured with an appropriate microbiological in vitro method ( 5 , 25 , 27 , 51 , 52 ). In addition, it should be irradiated ( 23 ) in particular if it is used in deep or partially necrotic wounds ( 53 ) which possess a potential of anaerobic wound conditions. Surely, we do not criticize the emergency care use of raw honey directly derived from local bee keepers in countries with extremely limited medical resources ( 54 ) in which physicians or other health care workers do not have access to conventional wound care products ( 13 , 55–57 ).

Who Should Supervise the Use of Medical Honey in Clinical Practice?

For safety reasons, wound care with medical honey should always be supervised by a physician or an experienced wound care nurse in patients with chronic complicated wounds or with significant comorbidities. The ‘honey approach’ to wound care must be part of a comprehensive wound care concept. Any comorbidity which contributes to the problems in wound healing should be diagnosed and treated thoroughly with state of the art interventions (e.g. bypass surgery in patients with reduced arterial perfusion, compressive bandages in patients with chronic venous ulcers, sufficient control of blood glucose levels in patients with diabetic food syndrome) ( 58 ).

Honey Must be Kept in Contact to the Wound

Medical honey dressings should keep the honey in contact with the wound for at least 12 h, but preferably for 24 h. Some patients apply the wound dressing overnight, so as not to restrict their mobility during the day. If the dressing is inappropriate, the honey may be washed out of the wound by exudate. The clinical benefits of medical honey including antibacterial protection, wound cleaning and pH modulation may as a result be reduced. From our experience ( 2 ) and the experience of others ( 59 ), the best way to keep the honey in the wound is to soak medical honey into a calcium-alginate or hydrofiber dressing, which forms a gel with the honey as it absorbs the exudate. The various registered medical honey products available, some in the form of prepared honey-impregnated dressings, have been described ( 14 , 45 ).

When to Use Systemic Antibiotics Concomitantly

In case of an infected wound or in case of colonization with a multiresistant bacterial isolate, a hospital grade, licensed antiseptic (e.g. octenidine) is applied to the wound in addition to Medihoney™ on the first 2 days of treatment. In patients with neutropenia (neutrophil count <0.5 × 10 9  l −1 or leukocyte counts <1 × 10 9  l −1 and no differential count available) systemic antibiotics have to be administered concomitantly after a local wound swab has been taken if fever or local sign reveals soft tissue infection. With hospitals facing increasing problems of bacterial resistance, it is important to note that the use of medical honey has never been observed to foster bacterial resistance ( 20 ).

Frequency of Dressing Changes

The frequency of dressing changes depends on the amount of exudate. In early stages, fresh surgical wounds infected with pathogenic bacteria may necessitate a dressing change twice a day. In stable wound care situations, the Medihoney™ dressing has been left in place for up to 7 days ( 58 , 60 ). Prospective studies confirming the safety of such an extended dressing change interval are not yet available.

Compliance Issues

Dunford et al . ( 61 ) undertook a four-center feasibility study to determine whether Medihoney™ is an acceptable treatment for patients with leg ulcers in terms of pain relief, odour control and overall patient satisfaction. A total of 40 patients whose leg ulcers had not responded to 12 weeks of compression therapy were recruited. Medihoney dressings were applied on their ulcers for the 12-week study period. All other aspects of their care, including the use of compression bandaging, remained unchanged. Overall, ulcer pain and size decreased significantly and odorous wounds were deodorized promptly.

These results revealed a high patient acceptance for and concordance with this treatment. The same first author reported the care of an adolescent with multiple wounds, infected with resistant bacterial pathogens after meningococcal sepsis and limb amputation ( 62 ). Before the use of medical honey, each dressing change had to be performed under general anaesthesia to alleviate pain and anxiety. Shortly after the introduction of medical honey dressings, the wounds improved and dressing changes could be performed without any analgesic medication. We have had similar experiences with children in our clinic. If the medical honey dressing is completely moistened with sterile Ringer solution, it can easily and painlessly be removed without any negative attachment to the wound. In our unit and our wound care ambulance, parents or relatives are educated in the aseptic procedure of the dressing change and thus, they are enabled to perform it at home.

Adverse Effects

There are two important adverse effects related to the use of medical honey. We have observed in about 5% of our patients stinging pain after administration. This problem may be circumvented by the conditioning of the wound surface with a sterile anaesthetic cream. Unfortunately, local anaesthetics cause vasoconstriction. Thus, the application of an anaesthetic to the wound surface may result in an objectionable reduction of local perfusion. In some patients who experienced pain after administration, treatment with medical honey had to be stopped ( 16 ) or postponed to later phases of wound healing after the acute inflammatory process has been controlled by other approaches. Two of 150 patients from our patient population showed reproducible local atopic reactions to Medihoney™. Both children had an underlying atopic disposition. We are not aware of any severe systemic atopic reaction related to the use of medical honey from our experience and from the published literature.

Cost Issues

Ingle et al . ( 63 ) from South Africa performed a randomized controlled trail to investigated the use of natural honey (monofloral aloe honey) in shallow wounds, donor sites for skin grafting and partial thickness burns in 44 goldmine workers. They compared this group with another group of 43 workers whose wounds were treated with IntraSite™ Gel (Smith and Nephew Ltd). They did not find significant differences in healing time, adverse events (itching, pain) and satisfaction with treatment but the average cost of the use of honey was 4% that of IntraSite™ treatment. More prospective studies investigating the overall cost of treatment with medical honey compared with conventional wound care approaches are awaited ( 64 ) in particular in chronic, recalcitrant wounds. In clinical practice, the use of calcium alginate or hydrofiber gauzes and semipermeable dressings to keep the honey in the wound has to be added to the acquisition cost of the medical honey. To contain the demands on personnel resources, it would be of outstanding interest to develop ready to use medical honey dressings, which have to be changed only every 2–3 days even in acute wound care situations.

WoundViewer © Database

We recently developed a database for the standardized prospective collection of datasets considering the clinical use of medical honey products in wound care to foster the collection of clinical evidence to help design prospective comparative studies in the near future.

More prospective randomized studies on a wider range of types of wounds are needed to confirm the safety and efficacy of medical honey in wound care ( 65 ). Nonetheless, the current evidence ( 15 ) confirming the antibacterial properties and additional beneficial effects of medical honey on wound healing should encourage other wound care professionals to use CE-certified honey dressings with standardized antibacterial activity, such as Medihoney™ products, as an alternative treatment approach in wounds of different natures.

Acknowledgements

The research of K.T. was made possible by the generous support of the Humboldt Foundation through a German Chancellor Scholarship to the author. The development of the WoundvViewer© database for the prospective standardized documentation of wound care courses in patients treated with medical honey has been financially supported by Medihoney Inc. ( http:/www.medihoney.com ).

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Medical Devices and Equipment Logistics Market Size & Share Analysis - Growth Trends & Forecasts (2024 - 2029)

The Medical Devices and Equipment Logistics Market Report is Segmented by Product Type (Medical Devices and Medical Equipment) and Geography (North America, Europe, Asia-Pacific, Latin America, and Middle East and Africa). The Report Offers Market Size and Forecasts for all the Above Segments in Value (USD).

Medical Devices and Equipment Logistics Market Size

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Medical Devices and Equipment Logistics Market Analysis

The Medical Devices And Equipment Logistics Market size is estimated at USD 63.70 billion in 2024, and is expected to reach USD 93.95 billion by 2029, growing at a CAGR of 7.81% during the forecast period (2024-2029).

The medical devices and equipment logistics market is rapidly expanding, fueled by surging demand for advanced healthcare services and technological advancements in medical devices. Manufacturers and healthcare providers are increasingly streamlining their supply chain operations to ensure the timely global delivery of critical equipment. This efficiency drive is further empowered by automation, real-time tracking systems, and advanced inventory management techniques to boost transparency and cut costs.

In February 2024, GobalMed Logistix (GMLx) made headlines by unveiling a 200% expansion of its Atlanta campus, introducing a new 65,000-sq. ft facility. This move directly responds to the escalating need for medical device logistics and third-party services, marking a significant stride in the industry's logistics capabilities.

In collaboration with Wing, groundbreaking initiatives like Medtronic's drone delivery trials are revolutionizing last-mile healthcare logistics and promising swifter and more adaptable supply chain solutions. Moreover, the ongoing global expansion of healthcare infrastructure, especially in emerging economies, is creating a ripe environment for logistics providers to establish robust distribution networks and cater to mounting demands.

For instance, UK-based Apian partnered with Zipline in December 2023 to enhance NHS medical supply deliveries, underscoring the continuous wave of innovation in healthcare logistics.

Medical Devices and Equipment Logistics Market Trends

Medical devices manufacturer integrate cutting-edge logistics solutions.

Medtronic is a multinational producer of medical devices and therapies, such as insulin pumps, pacemakers, and diabetes therapies. Since 2022, Medtronic has embarked on a massive overhaul of its logistics and supply chain operations that will culminate in 2024. The company has focused on three key areas: global operations and supply chain (GOSC), core technology, and commercial strategies targeting large enterprise customers. It represents a significant shift in direction.

In July 2024, Medtronic was among the first companies in Ireland to use the drone delivery company Wing to deliver medical supplies and devices to hospitals. The two companies are teaming up with Blackrock Health and St. Vincent's Private Hospital in Dublin to launch a drone delivery trial to demonstrate how drones can be used in healthcare.

Medtronic's initiative with Wing underscores the growing importance of integrating cutting-edge logistics solutions in the medical devices market. Competitors and industry stakeholders may follow suit, accelerating the adoption of innovative technologies to enhance supply chain efficiency and customer service.

UK Medical Devices Manufacturing Propels the Logistics Industry

In 2022, the Office for National Statistics reported that the UK manufacturing industry for medical and dental instruments and supplies saw its gross value added (GVA) climb to around GBP 2.98 billion (USD 3.81 billion). This consistent growth highlights the industry’s economic significance and mirrors the escalating production and demand for medical instruments within the United Kingdom.

With the industry’s expansion, robust supply chains and distribution networks become paramount. These networks are vital for the efficient global transportation of medical products, ensuring they reach healthcare facilities promptly and comply with stringent regulations. The industry’s heightened manufacturing output also spurs investments in cutting-edge logistics technologies, including temperature-controlled storage, automated inventory systems, and specialized transportation solutions.

Recent humanitarian endeavors, like the country’s provision of medical supplies to civilians affected by the Russian invasion of Ukraine through UK-Med, further underscore the industry's global healthcare support role.

In essence, the escalating GVA in the UK medical and dental supplies manufacturing industry accentuates the indispensable role of logistics in broadening the accessibility and availability of crucial healthcare equipment, both domestically and internationally.

Medical Devices and Equipment Logistics Industry Overview

The medical devices and equipment logistics market boasts a competitive landscape, hosting a diverse array of players, from global logistics powerhouses to niche service providers. Logistics giants like UPS Healthcare, DHL Supply Chain, FedEx Healthcare Solutions, Kuehne + Nagel, and Ceva Logistics lead the charge. These industry giants leverage their expansive global networks, cutting-edge technology, and a robust suite of services. Conversely, specialized players such as Cardinal Health, Owens & Minor, and DB Schenker carve their niche by tailoring logistics solutions for the healthcare sector, encompassing warehousing, distribution, and inventory management.

Collaborations between logistics entities and healthcare stakeholders are rising to broaden market penetration and enrich service portfolios. Embracing technologies like IoT, AI, and blockchain is pivotal, as they bolster efficiency and transparency in the logistics chain. Moreover, given the stringent oversight in medical device logistics, a steadfast commitment to regulatory compliance and quality assurance remains paramount.

Medical Devices and Equipment Logistics Market Leaders

UPS Healthcare

DHL Supply Chain

FedEx Healthcare Solutions

Kuehne + Nagel

Ceva Logistics

*Disclaimer: Major Players sorted in no particular order

Medical Devices and Equipment Logistics Market News

• April 2024: UPS Healthcare channeled EUR 55 million (USD 60 million) into expanding its footprint in Italy. This investment sees the addition of 100,000 sq. m of warehouse space, split between Passo Corese, near Rome, and Somaglia in Lodi. With this financial commitment, UPS Healthcare aims to align the Passo Corese and Somaglia facilities with stringent distribution and manufacturing practices, ensuring the safe storage of medical and pharmaceutical products.
• February 2024: FedEx Express, a subsidiary of FedEx Corp., inaugurated the 'FedEx Life Science Center' in Mumbai, marking a milestone in India's and the global clinical trial supply chain. This new center is designed to cater to the storage and logistics needs of healthcare clients participating in clinical trials, both domestically in India and internationally shipping to the country.

Medical Devices and Equipment Logistics Market Report - Table of Contents

1. INTRODUCTION

1.1 Study Deliverables

1.2 Study Assumptions

1.3 Scope of the Study

2. RESEARCH METHODOLOGY

2.1 Analysis Methodology

2.2 Research Phases

3. EXECUTIVE SUMMARY

4. MARKET INSIGHTS

4.1 Current Market Scenario

4.2 Technological Trends

4.3 Insights on Supply Chain/Value Chain Analysis

4.4 Insights into Governement Regualtions in the Industry

4.5 Insights into Technological Advancements in the Industry

4.6 Impact of Geopolitics and Pandemics on the Market

5. MARKET DYNAMICS

5.1 Market Drivers

5.1.1 Global Expansion of Healthcare Services

5.1.2 Technological Advancements

5.2 Market Restraints

5.2.1 High Operational Costs

5.2.2 Regulatory Complexity

5.3 Market Opportunities

5.3.1 Expansion into Emerging Markets

5.3.2 Forging Strategic Partnerships and Collaborations With Healthcare Providers

5.4 Industry Attractiveness - Porter's Five Forces Analysis

5.4.1 Threat of New Entrants

5.4.2 Bargaining Power of Buyers/Consumers

5.4.3 Bargaining Power of Suppliers

5.4.4 Threat of Substitute Products

5.4.5 Intensity of Competitive Rivalry

6. MARKET SEGMENTATION

6.1 By Product Type

6.1.1 Medical Devices

6.1.2 Medical Equipment

6.2 By Geography

6.2.1 North America

6.2.1.1 United States

6.2.1.2 Canada

6.2.1.3 Mexico

6.2.2 Europe

6.2.2.1 Germany

6.2.2.2 United Kingdom

6.2.2.3 France

6.2.2.4 Italy

6.2.2.5 Spain

6.2.2.6 Rest of Europe

6.2.3 Asia-Pacific

6.2.3.1 China

6.2.3.2 Japan

6.2.3.3 India

6.2.3.4 Australia

6.2.3.5 South Korea

6.2.3.6 Rest of Asia-Pacific

6.2.4 Middle East and Africa

6.2.4.1 GCC

6.2.4.2 South Africa

6.2.4.3 Rest of Middle East and Africa

6.2.5 South America

6.2.5.1 Brazil

6.2.5.2 Argentina

6.2.5.3 Rest of South America

7. COMPETITIVE LANDSCAPE

7.1 Market Concentration Overview

7.2 Company Profiles

7.2.1 UPS Healthcare

7.2.2 DHL Supply Chain

7.2.3 FedEx Healthcare Solutions

7.2.4 Kuehne + Nagel

7.2.5 Ceva Logistics

7.2.6 Cardinal Health

7.2.7 Owens & Minor

7.2.8 DB Schenker

7.2.10 World Courier*

• *List Not Exhaustive

7.3 Other Companies

8. MARKET OPPORTUNITIES AND FUTURE TRENDS

9. APPENDIX

9.1 Macroeconomic Indicators

9.2 Insight Into Capital Flows (Investments In Transport and Storage Sector)

9.3 E-commerce and Consumer Spending-related Statistics

9.4 External Trade Statistics

Medical Devices and Equipment Logistics Industry Segmentation

The medical devices and equipment logistics industry involves transporting, storing, and distributing medical devices and equipment. It encompasses a spectrum of activities, services, and stakeholders committed to the efficient, safe, and compliant delivery of medical products from manufacturers to end-users, including hospitals, clinics, and patients. A complete background analysis of the medical devices and equipment logistics market, including the assessment of the economy and contribution of sectors in the economy, market overview, market size estimation for key segments, and emerging trends in the market segments, market dynamics, and geographical trends is covered in the report.

The medical devices and equipment logistics market report is segmented by product type (medical devices and medical equipment) and geography (North America, Europe, Asia-Pacific, Latin America, and Middle East and Africa). The report offers market size and forecasts for all the above segments in value (USD).

By Geography
		North America United States Canada Mexico Europe Germany United Kingdom France Italy Spain Rest of Europe Asia-Pacific China Japan India Australia South Korea Rest of Asia-Pacific Middle East and Africa GCC South Africa Rest of Middle East and Africa South America Brazil Argentina Rest of South America Medical Devices and Equipment Logistics Market Research FAQs How big is the medical devices and equipment logistics market. The Medical Devices And Equipment Logistics Market size is expected to reach USD 63.70 billion in 2024 and grow at a CAGR of 7.81% to reach USD 93.95 billion by 2029. What is the current Medical Devices And Equipment Logistics Market size? In 2024, the Medical Devices And Equipment Logistics Market size is expected to reach USD 63.70 billion. Who are the key players in Medical Devices And Equipment Logistics Market? UPS Healthcare, DHL Supply Chain, FedEx Healthcare Solutions, Kuehne + Nagel and Ceva Logistics are the major companies operating in the Medical Devices And Equipment Logistics Market. Which is the fastest growing region in Medical Devices And Equipment Logistics Market? Asia Pacific is estimated to grow at the highest CAGR over the forecast period (2024-2029). Which region has the biggest share in Medical Devices And Equipment Logistics Market? In 2024, the Asia Pacific accounts for the largest market share in Medical Devices And Equipment Logistics Market. What years does this Medical Devices And Equipment Logistics Market cover, and what was the market size in 2023? In 2023, the Medical Devices And Equipment Logistics Market size was estimated at USD 58.73 billion. The report covers the Medical Devices And Equipment Logistics Market historical market size for years: 2019, 2020, 2021, 2022 and 2023. The report also forecasts the Medical Devices And Equipment Logistics Market size for years: 2024, 2025, 2026, 2027, 2028 and 2029. Medical Devices and Equipment Logistics Industry Report Statistics for the 2024 Medical Devices And Equipment Logistics market share, size and revenue growth rate, created by Mordor Intelligence™ Industry Reports. Medical Devices And Equipment Logistics analysis includes a market forecast outlook for 2024 to 2029 and historical overview. Get a sample of this industry analysis as a free report PDF download. Please enter a valid email id! Please enter a valid message! Medical Devices And Equipment Logistics Market Get a free sample of this report Please enter your name Business Email Please enter a valid email Please enter your phone number Get this Data in a Free Sample of the Medical Devices And Equipment Logistics Market Report Please enter your requirement Thank you for choosing us for your research needs! A confirmation has been sent to your email. 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This position may assist with study coordination but will not be assigned clinical trials independently.   This position may provide coordination for clinical research projects such as registries, retrospective data reviews, studies in long-term follow-up, and other non-interventional studies. Our mission is to improve the quality of life of people with pain. Achieving personalized pain management will transform care, while dedication to our guiding principles enriches the lives of our team members and those in the community.  Mission Statement Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally.  Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society. Why Join Michigan Medicine? Michigan Medicine is one of the largest health care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School in 1850. Michigan Medicine is comprised of over 30,000 employees and our vision is to attract, inspire, and develop outstanding people in medicine, sciences, and healthcare to become one of the world's most distinguished academic health systems.  In some way, great or small, every person here helps to advance this world-class institution. Work at Michigan Medicine and become a victor for the greater good. What Benefits can you Look Forward to? Excellent medical, dental and vision coverage effective on your very first day 2:1 Match on retirement savings Competitive salary commensurate with experience. Comprehensive healthcare benefits package. Retirement savings plan with employer contribution. Professional development opportunities and support for continuing education. Paid time off and holiday leave. Responsibilities* Knowledge of all 8 competency domains is expected: Scientific Concepts and Research Design Ethical Participant Safety Considerations Investigational Products Development and Regulation Clinical Study Operations (GCPs) Study and Site Management Data Management and Informatics Leadership and Professionalism Communication and Teamwork Clinical Coordinator Responsibilities Demonstrates ability to screen participants for study eligibility & enroll with accuracy in various databases. Performs simple study procedures with accuracy. Understands protocol structure and how to interpret study requirements to ensure study compliance. Understands proper documentation techniques as outlined in the ICH-GCP guidelines. May complete simple study reimbursement with partners such as the Human Subjects Incentive Program (HSIP) and the CTSU finance team. Demonstrates the ability to find and utilize information from EMR and databases/CTMS/EDC. May mark visits as planned/occurred in OnCore. May provide lab results, not interpretation, to participants. May maintain essential regulatory documents. May assist research coordinator in conduct of SIV; attends SIV.  May assist in and attends monitor visits and or audits. May conduct site selection/qualification visits for potentially incoming clinical trials. Data Coordinator Responsibilities  Demonstrates the ability to complete simple data collection during study visits  Enters data to complete forms (CRFs) on paper, databases, or EDCs. Assists with collection of external medical records, CLIAs, CAPs, and radiology CDs as assigned. May administer minimal risk consents, surveys, and questionnaires. Checks own work and confirms accuracy.  Demonstrates ability to perform concomitant medications abstraction. Uses various NCI AE grading scales. Builds patient research study charts. Demonstrates ability to resolve simple queries. Regulatory Coordinator Responsibilities  May work with regulatory support to collect essential documents and maintain regulatory binder  Assists with AEs and SAEs, ORIOS reporting Uses proper documentation techniques as outlined in the ICH-GCP guidelines Administrative Responsibilities  Demonstrates understanding of the clinical research objectives associated with the program. May communicate with study participants such as sending study correspondence via mail or email. May schedule subjects for research visits and FU appointments. May check study calendar for completion of study procedures. May manage study supply inventory. May utilize documents and systems to track recruitment and retention of participants. May complete and activate postings (advertisements, flyers, etc.) independently. May work with regulatory support to maintain regulatory binder (CVs, MD licenses, lab certifications, IRB rosters, UM lab norms, etc.) Gains appropriate training & knowledge of EMR, CTMS, EDC, databases, etc. as assigned. Willing to learn and use available technology and systems to accomplish job requirements. Understands the disease process per program. Attends and participates in all training classes assigned to this level Supervision Received: This position receives direct supervision and reports directly to a CRC-Senior or Research Area Specialist Lead. Supervision Exercised: None Required Qualifications* High school diploma or GED is necessary.  Desired Qualifications* Associate Degree in Health Science or an equivalent combination of related education and experience is desirable.  An understanding of medical terminology, experience in a large complex health care setting, ability to effectively communicate with staff and faculty of all levels, and knowledge of university policies and procedures is desirable.  1+ years of experience in clinical pain research Has previously built forms in REDCap and Qualtrics Experience with investigator-initiated and federally sponsored clinical trials PEERRS, CITI, or NIH Protection of Human Subjects Training Certification Work Schedule The work schedule for this position consists of regular business hours, M-F from 8-4:00pm. There will be Saturday hours once a month. Work Locations Burlington Building, Ste 100, Room 1025. Modes of Work Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes . Additional Information Michigan Medicine is firmly committed to advancing inclusion, diversity, equity, accessibility, and belonging, which are core to the culture and values of the Medical School Office of Research. Our community supports recruiting and cultivating a diverse workforce as a reflection of our commitment to serve the diverse people of Michigan and the world. We strive to create a work culture where each team member feels respected, valued, and safe.  This is a one year term-limited position. Extensions will be based on available funding and performance. At the end of the stated term, your appointment will terminate, and will not be eligible for Reduction-in-Force (RIF) benefits.   This term-limited appointment does not create a contract or guarantee of employment for any period of time as you will remain subject to disciplinary or other performance measures, up to and including termination, at the will of the University in accordance with existing University policy and standards for employee performance and conduct. Background Screening Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings.  Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses. Application Deadline Job openings are posted for a minimum of seven calendar days.  The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended. U-M EEO/AA Statement The University of Michigan is an equal opportunity/affirmative action employer. An official website of the United States government Here's how you know Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. 2024 Scientific/Medical - Research Guidelines Recognition of an individual or group(s) within the NIH scientific and/or medical community that has made outstanding contributions to advancing research in support of the NIH mission. Eligibility All NIH employees, staff, or groups of staff (which can also include contractors) performing research, administering clinical/scientific disciplines, or working in scientific research professions. Exceptional display of leadership in promoting the advancement of the understanding or application of scientific phenomena, processes, or problems. Extraordinary achievement in the application of scientific/medical principles and methods to support and advance the mission of NIH. Such could include the discovery or invention of a new scientific/medical principle, process, or device resulting in substantial benefits. Outstanding contributions, beyond regular attendance, to a special committee or task force dealing with NIH-wide scientific policies, initiatives, procedures, or operations. Some examples could include, but are not limited to The candidate or group may include Medical Officers, Health Science Researchers/Administrators, Biologists, Chemists, Veterinarians, Dentists, and Nurses. Support staff who were essential to the achievement should also be included in groups. These examples are not inclusive of all potential positions at NIH. An official website of the NIH Office of Human Resources SAOG unites Ob/Gyns of Sakhalin Oblast SAOG Objectives: Aug 25, 2014 200 likes | 320 Views Problem Analysis: Low Effectiveness of Cervical Cancer Preventive Measures in Yuzhno-Sakhalinsk City 02.01.2003 – 09.15.2003 Funded by ACCP. SAOG unites Ob/Gyns of Sakhalin Oblast SAOG Objectives: Share Presentation liudmila uchaeva cervical cancer women survey results sakhalin state university high cc incidence rate REGIONAL SLIDES REGIONAL SLIDES EUROPE The Black Triangle, Czech Republic Cop şa Micâ, Romania Chernobyl Nuclear Accident, Ukraine London, England Moskva, Russia Paris, France Atat ürk Dam, Turkey Gabcikova, Slovakia Arkhangelsk, Russia Lappi, Finland Sakhalin, Russia Almeria, Spain 739 views • 19 slides Goals and Objectives Goals and Objectives. Writing Instructional Objectives. Instructional objectives are statements of educational expectations for students. . Research has NOT demonstrated a strong link between writing objectives and student achievement. Writing Instructional Objectives. 972 views • 49 slides Learning Objectives Learning Objectives. After studying this chapter, you should be able to: Define performance. Define performance appraisal. Explain management by objectives. Describe multi-rater assessment. Describe the graphic rating scale. Explain critical-incident appraisal. Learning Objectives (cont.). 1.04k views • 55 slides Writing Behavioral Objectives Writing Behavioral Objectives. BTE363/364. What is the Purpose of Learning Objectives?. By knowing where you intend to go, you increase the chances of you and the learner ending up there 1.53k views • 24 slides RE. DISCOVERING KNOWN . UN. Poland. POLAND AT A GLANCE. Location: Central Europe Neighbouring Countries: 7 – Germany, Czech Republic, Slovakia, Ukraine, Belarus, Lithuania, Kaliningrad Oblast. Seas: Balitc Sea Area: 312,679 km ² Topography: plains, grasslands, 1.04k views • 65 slides Analytic Geometry Analytic Geometry. Chapter 4. Analytic Geometry. Unites geometry and algebra Coordinate system enables Use of algebra to answer geometry questions Proof using algebraic formulas Requires understanding of points on the plane. Points. Consider Activity 4.1 Number line 1.03k views • 40 slides Writing Language and Content Objectives Writing Language and Content Objectives . CESDP. Discuss and Create a Venn Diagram. What is a content objective? What is a language objective? What is the difference between the two objectives? What do both objectives have in common?. Objective for Today. 977 views • 18 slides Objectives. For unit objectives see : Scope & Sequence. Weather Factors. Energy in the Earth’s Atmosphere. Energy from the Sun A. Electromagnetic waves ( ondas electromagnèticas ) 1.01k views • 85 slides Objectives Overview Objectives Overview. See Page 3 for Detailed Objectives. Objectives Overview. See Page 3 for Detailed Objectives. A World of Computers. Computers are everywhere. Pages 4 - 5 Figure 1-1. What Is Enterprise Computing?. 735 views • 63 slides Objectives Overview. See Page 187 for Detailed Objectives. Objectives Overview. See Page 187 for Detailed Objectives. What Is Input?. Input is any data and instructions entered into the memory of a computer. Pages 188– 189 Figure 5-1. What Is Input?. Page 188. 762 views • 67 slides Objectives Overview. See Page 1 for Detailed Objectives. Objectives Overview. See Page 1 for Detailed Objectives. A World of Computers. Computers are everywhere. Pages 2 - 3 Figure 1-1. What Is a Computer?. 889 views • 74 slides GPC. How. Unites the Supply Chain?. GSMP Brussels April 15, 2008. Housekeeping Slide. GS1 Antitrust All mobile devices on silent mode Please take all personal items with you when you leave the meeting rooms. GSMP nor the hotel can be responsible for items left unattended in the room. 717 views • 52 slides 717 views • 63 slides Electronic Commerce MIS 4108 Electronic Commerce MIS 4108. Planning E-commerce Initiatives. Session Objectives. The objectives of this session are: To describe how to prepare a simple business plan To describe how to develop objectives To analyse strategies used to fulfil objectives 1.09k views • 89 slides Chapter 2 Objectives Chapter 2 Objectives. Understand the fundamentals of numerical data representation and manipulation in digital computers. Master the skill of converting between various radix systems. Understand how errors can occur in computations because of overflow and truncation. Chapter 2 Objectives. 1.51k views • 124 slides 1. 개요 [편집] 2. 역사 [편집]. 다시 5km 더 나아가면 1881년에 징역 노동을 관리하던 블라디미르의 이름을 따서 세워진 블라디미로프카 마을이 있으며 마을 사람들은 그곳을 "검은 강"이라고 부른다. [2] 주민은 91명으로 55명이 남성이고 46명이 여성이다. 세대주는 46명으로 이들 중 19명은 독신이며 직접 소의 젖을 짠다. 스물일곱 세대 중에 단 여섯 세대만이 합법적이다. 농업식민지로서 이 마을은 북부의 두 지구를 합한 것보다 값어치가 있으나, 남편을 따라 사할린으로 왔으며 감옥의 때가 묻지 않은 자유민, 즉 식민지에 매우 가치 있는 여성으로 이곳에 이주한 여성은 단 한 명뿐이었다. 그러나 그마저도 최근에 남편 살해 혐의로 교도소에 수감되었다. 북부의 관리들이 두에의 ‘가족용 감방’에서 괴로움을 당하도록 내버려둔 자유민 신분의 불행한 여성들이라면 이곳에서는 더할 나위 없이 유익할 것이다. 블라디미로프카 마을에는 소 한 종류로만 100마리가 넘고, 말이 40마리에다 훌륭한 건초지가 있으나 주부가 없으니, 즉 진정한 가정경제가 없다는 말이 된다. 안톤 체호프, 사할린 섬 3. 도시 정보 [편집] 4. 인구 [편집] 5. 교통 [편집], 6. 스포츠 [편집], 7. 그외 [편집]. 유즈노사할린스크에는 맥도날드 , 버거킹 , KFC , 헤스버거 [14] 등 유명 패스트푸드 브랜드가 없다. 대신 이곳만의 햄버거 체인이 있어서 간단히 식사하기가 어렵지는 않다. 주러시아 대한민국 대사관 의 주(駐)유즈노사할린스크 출장소가 있다. 일본령 가라후토 시절 개칭된 '도요하라'는 그 유래가 불분명하다. 다른 홋카이도~사할린 인근 지역과는 달리 아이누어 지명은 알려져있지 않다. 어쩌면 정말 문자 그대로 푸른 초원이 있어서 그렇게 이름을 지었는지도 모를 일이다. 이 도시 인근은 산 이 많은 사할린 중에서 몇 안 되게 평지의 비율이 높은 곳으로, 위 안톤 체호프의 인용문에서도 "농업식민지로서 가치가 높다"라고 평가하고 있다. Category : People of Yuzhno-Sakhalinsk   Instance of Category combines topics Category contains Yuzhno-Sakhalinsk  image   flag image   coat of arms image      Instance of (1991–) (1905–) (1969–) Location , , Russia Inception Population Area Elevation above sea level Replaces Authority file   Subcategories This category has the following 2 subcategories, out of 2 total. Births in Yuzhno-Sakhalinsk (2 C) Deaths in Yuzhno-Sakhalinsk (1 C) Media in category "People of Yuzhno-Sakhalinsk" This category contains only the following file. People of Russia by city People of Sakhalin Oblast Yuzhno-Sakhalinsk Uses of Wikidata Infobox Uses of Wikidata Infobox with subinfoboxes Uses of Wikidata Infobox with maps Pages with coordinates Navigation menu 359 IMAGES The Future of Medical Research Explored by Industry Experts Understanding Medical Research: MedlinePlus Medical Research Medical Researcher In Medical Research Lab Stock Footage SBV-312915562 Test tubes in clinic, pharmacy and medical research laboratory Clinical Research VIDEO Medical student research at Marshall University The National Institutes of Health Medical Research Scholars "Why I chose MRSP..." Who can take part in health and care research 02_Review of Epidemiologic Study Design 1-2- Types of Medical Research CRA Basics: Literature Review in Clinical Research COMMENTS PubMed PubMed® comprises more than 37 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full text content from PubMed Central and publisher web sites. The New England Journal of Medicine The New England Journal of Medicine (NEJM) is a weekly general medical journal that publishes new medical research and review articles, and editorial opinion on a wide variety of topics of ... Medical research The University of Florida Cancer and Genetics Research Complex is an integrated medical research facility. Medical research (or biomedical research), also known as health research, refers to the process of using scientific methods with the aim to produce knowledge about human diseases, the prevention and treatment of illness, and the promotion ... National Library of Medicine DiscoverWHR is a centralized resource for women's health research and information from NIH that supports NIH-wide efforts to close the gaps in women's health across the life course. This innovative resource simplifies the finding women's health information by patients, caregivers, medical professionals, researchers, and the public. Medical research Medical research involves research in a wide range of fields, such as biology, chemistry, pharmacology and toxicology with the goal of developing new medicines or medical procedures or improving ... Methodology for clinical research The planning and execution of clinical research is of vital importance for the advancement of medical science. The validity of clinical research findings depends on a variety of factors, such as study design, sampling techniques and statistical analysis. Choosing an appropriate study design requires detailed knowledge of the types of clinical ... Reducing bias and improving transparency in medical research: a Significant problems in medical research undermine efficient scientific discovery and efforts to achieve improved outcomes for patients. Across scientific disciplines, a diverse range of issues has resulted in a situation where published research findings frequently cannot be replicated ('the reproducibility crisis'). ... Clinical Research What is It Clinical research is the comprehensive study of the safety and effectiveness of the most promising advances in patient care. Clinical research is different than laboratory research. It involves people who volunteer to help us better understand medicine and health. Lab research generally does not involve people — although it helps us learn ... What Is a Medical Researcher? A medical researcher, also known as a medical scientist, studies diseases and conditions to help improve and protect public health. They design studies, perform research and collect and analyze data. The purpose of their studies may be to find ways to prevent or treat diseases or identify connections between certain conditions and illnesses. 10 Careers You Can Pursue in Medical Research 10 careers in medical research. Here are 10 careers you can pursue in the field of medical research: 1. Clinical laboratory scientist. National average salary: $89,291 per year Primary duties: A clinical laboratory scientist is a scientist who specializes in using lab equipment to perform tests on biological specimens. National Institutes of Health (NIH) Official website of the National Institutes of Health (NIH). NIH is one of the world's foremost medical research centers. An agency of the U.S. Department of Health and Human Services, the NIH is the Federal focal point for health and medical research. The NIH website offers health information for the public, scientists, researchers, medical professionals, patients, educators, How To Write And Publish A Scientific Manuscript A clinician should continuously strive to increase knowledge by reviewing and critiquing research papers and thoughtfully considering how to integrate new data into practice. This is the essence of evidence-based medicine (EBM).[1] When new clinical queries arise, one should seek answers in the published literature. The ability to read a scientific or medical manuscript remains vitally ... Health & Medicine News -- ScienceDaily Medical Research News. Health news on everything from cancer to nutrition. Updated daily. Medical research Breast cancer blocked by multiple natural lines of defence. Cancer-promoting mutations are common in healthy tissue but rarely lead to tumour formation. A study of the mouse mammary gland reveals ... Medical Research Medical Research. Scientists and physicians in academic medicine conduct groundbreaking biomedical research that improves our knowledge of human health and promotes the development of treatments from bench to bedside to community. Through policy and advocacy initiatives, data and research projects, professional learning and networking ... The Medical Science Liaison: A Critical Link Betwe Clinical Research: This role entails assisting in the design and execution of clinical trials by providing scientific insights and ensuring the clinical relevance of the study. MSLs have the ability to nominate investigators sites which have the appropriate patient population for the trial. MSLs also build and maintain relationships with the ... Medical Honey for Wound Care—Still the 'Latest Resort'? 1 Children's Hospital Medical Centre, University of Bonn, Bonn, 2 Institute for Bee Research, Celle, Germany and 3 Department of Biological Sciences, University of Waikato, ... Medical honey dressings are easy to change without pain and without harm to the regenerating tissue. Malodour from recalcitrant wounds as a result of critical ... Clinical Research Medical Director 2 years of clinical research experience and/or basic science research. Preferred Qualifications. Five (5) years of experience in late clinical development as part of a pharmaceutical organization. Five (5) years of clinical research experience and/or basic science research combined with clinical teaching and patient care activities Associate Clinical Research Coordinator at Mayo Clinic As an Associate Clinical Research Coordinator, you will have the opportunity to work with a variety of people, from patients to care teams, enabling you to be a part of the legacy that puts the needs of the patients first. We have several Associate Clinical Research Coordinator positions available in multiple locations and departments. Medical Devices And Equipment Logistics Market Size & Share Analysis The Medical Devices And Equipment Logistics Market is expected to reach USD 63.70 billion in 2024 and grow at a CAGR of 7.81% to reach USD 93.95 billion by 2029. UPS Healthcare, DHL Supply Chain, FedEx Healthcare Solutions, Kuehne + Nagel and Ceva Logistics are the major companies operating in this market. Clinical Research Assistant An understanding of medical terminology, experience in a large complex health care setting, ability to effectively communicate with staff and faculty of all levels, and knowledge of university policies and procedures is desirable. 1+ years of experience in clinical pain research; Has previously built forms in REDCap and Qualtrics 2024 Scientific/Medical All NIH employees, staff, or groups of staff (which can also include contractors) performing research, administering clinical/scientific disciplines, or working in scientific research professions. Criteria. Exceptional display of leadership in promoting the advancement of the understanding or application of scientific phenomena, processes, or ... SAOG unites Ob/Gyns of Sakhalin Oblast SAOG Objectives: Problem Analysis: Low Effectiveness of Cervical Cancer Preventive Measures in Yuzhno-Sakhalinsk City 02.01.2003 - 09.15.2003 Funded by ACCP. SAOG unites Ob/Gyns of Sakhalin Oblast SAOG Objectives: Slideshow 3568313 by lily Yuzhno-Sakhalinsk Yuzhno-Sakhalinsk began as a small Russian settlement called Vladimirovka, founded by convicts in 1882. [2] The Treaty of Portsmouth in 1905, which brought an end to the Russo-Japanese War of 1904-1905, awarded the southern half of the Sakhalin Island to Japan.Vladimirovka was renamed Toyohara (meaning "bountiful plain"), and was the prefect capital of the Japanese Karafuto Prefecture. 유즈노사할린스크 유즈노사할린스크에는 맥도날드, 버거킹, KFC, 헤스버거 [7] 등 유명 패스트푸드 브랜드가 없다. 대신 이곳만의 햄버거 체인이 있어서 간단히 식사하기가 어렵지는 않다. 주러시아 대한민국 대사관 의 주 (駐)유즈노사할린스크 출장소가 있다. [1] 따라서 토요하라 ... Category : People of Yuzhno-Sakhalinsk Wikivoyage. Instance of. administrative territorial entity of Russia (1991-) city or town (1905-) big city (1969-) Location. Yuzhno-Sakhalinsk Urban Okrug, Sakhalin Oblast, Russia. Inception. 1882. assignment essay homework paper phd report resume review speech thesis