Using a community of practice to evaluate falls prevention activity in a residential aged care organisation: a clinical audit

Objective This study evaluates whether a community of practice (CoP) could conduct a falls prevention clinical audit and identify gaps in falls prevention practice requiring action. Methods Cross-sectional falls prevention clinical audits were conducted in 13 residential aged care (RAC) sites of a not-for-profit organisation providing care to a total of 779 residents. The audits were led by an operationalised CoP assisted by site clinical staff. A CoP is a group of people with a shared interest who get together to innovate for change. The CoP was made up of self-nominated staff representing all RAC sites and comprised of staff from various disciplines with a shared interest in falls prevention. Results All 13 (100%) sites completed the audit. CoP conduct of the audit met identified criteria for an effective clinical audit. The priorities for improvement were identified as increasing the proportion of residents receiving vitamin D supplementation (mean 41.5%, s.d. 23.7) and development of mandatory falls prevention education for staff and a falls prevention policy, as neither was in place at any site. CoP actions undertaken included a letter to visiting GPs requesting support for vitamin D prescription, surveys of care staff and residents to inform falls education development, defining falls and writing a falls prevention policy. Conclusion A CoP was able to effectively conduct an evidence-based falls prevention activity audit and identify gaps in practice. CoP members were well positioned, as site staff, to overcome barriers and facilitate action in falls prevention practice

Private Data System Enabling Self-Sovereign Storage Managed by Executable Choreographies

With the increased use of Internet, governments and large companies store and share massive amounts of personal data in such a way that leaves no space for transparency. When a user needs to achieve a simple task like applying for college or a driving license, he needs to visit a lot of institutions and organizations, thus leaving a lot of private data in many places. The same happens when using the Internet. These privacy issues raised by the centralized architectures along with the recent developments in the area of serverless applications demand a decentralized private data layer under user control. We introduce the Private Data System (PDS), a distributed approach which enables self-sovereign storage and sharing of private data. The system is composed of nodes spread across the entire Internet managing local key-value databases. The communication between nodes is achieved through executable choreographies, which are capable of preventing information leakage when executing across different organizations with different regulations in place. The user has full control over his private data and is able to share and revoke access to organizations at any time. Even more, the updates are propagated instantly to all the parties which have access to the data thanks to the system design. Specifically, the processing organizations may retrieve and process the shared information, but are not allowed under any circumstances to store it on long term. PDS offers an alternative to systems that aim to ensure self-sovereignty of specific types of data through blockchain inspired techniques but face various problems, such as low performance. Both approaches propose a distributed database, but with different characteristics. While the blockchain-based systems are built to solve consensus problems, PDS's purpose is to solve the self-sovereignty aspects raised by the privacy laws, rules and principles.Comment: DAIS 201

Better Together: Regional Alliances and Small Community Foundation Sustainability

Examines the role regional alliances play in helping community foundations achieve financial sustainability, focusing on those with less than $20 million in assets. Includes five case studies that represent a distinct alliance model

Progress in implementing the 2010 adult autism strategy

Update on the Supporting people with autism through adulthood published in June 2009

Collaborative working within UK NHS secondary care and across sectors for COPD and the impact of peer review : qualitative findings from the UK National COPD Resources and Outcomes Project

Introduction: We investigated the effects on collaborative work within the UK National Health Service (NHS) of an intervention for service quality improvement: informal, structured, reciprocated, multidisciplinary peer review with feedback and action plans. The setting was care for chronic obstructive pulmonary disease (COPD). Theory and methods: We analysed semi-structured interviews with 43 hospital respiratory consultants, nurses and general managers at 24 intervention and 11 control sites, as part of a UK randomised controlled study, the National COPD Resources and Outcomes Project (NCROP), using Scott’s conceptual framework for action (inter-organisational, intra-organisational, inter-professional and inter-individual). Three areas of care targeted by NCROP involved collaboration across primary and secondary care. Results: Hospital respiratory department collaborations with commissioners and hospital managers varied. Analysis suggested that this is related to team responses to barriers. Clinicians in unsuccessful collaborations told ‘atrocity stories’ of organisational, structural and professional barriers to service improvement. The others removed barriers by working with government and commissioner agendas to ensure continued involvement in patients’ care. Multidisciplinary peer review facilitated collaboration between participants, enabling them to meet, reconcile differences and exchange ideas across boundaries. Conclusions: The data come from the first randomised controlled trial of organisational peer review, adding to research into UK health service collaborative work, which has had a more restricted focus on inter-professional relations. NCROP peer review may only modestly improve collaboration but these data suggest it might be more effective than top-down exhortations to change when collaboration both across and within organisations is required

Sciunits: Reusable Research Objects

Science is conducted collaboratively, often requiring knowledge sharing about computational experiments. When experiments include only datasets, they can be shared using Uniform Resource Identifiers (URIs) or Digital Object Identifiers (DOIs). An experiment, however, seldom includes only datasets, but more often includes software, its past execution, provenance, and associated documentation. The Research Object has recently emerged as a comprehensive and systematic method for aggregation and identification of diverse elements of computational experiments. While a necessary method, mere aggregation is not sufficient for the sharing of computational experiments. Other users must be able to easily recompute on these shared research objects. In this paper, we present the sciunit, a reusable research object in which aggregated content is recomputable. We describe a Git-like client that efficiently creates, stores, and repeats sciunits. We show through analysis that sciunits repeat computational experiments with minimal storage and processing overhead. Finally, we provide an overview of sharing and reproducible cyberinfrastructure based on sciunits gaining adoption in the domain of geosciences

Technical alignment

This essay discusses the importance of the areas of infrastructure and testing to help digital preservation services demonstrate reliability, transparency, and accountability. It encourages practitioners to build a strong culture in which transparency and collaborations between technical frameworks are valued highly. It also argues for devising and applying agreed-upon metrics that will enable the systematic analysis of preservation infrastructure. The essay begins by defining technical infrastructure and testing in the digital preservation context, provides case studies that exemplify both progress and challenges for technical alignment in both areas, and concludes with suggestions for achieving greater degrees of technical alignment going forward