Australian inflammatory bowel disease (IBD) patients want biopsychosocial healthcare: a content analysis.

This item is only available electronically.Background & Aims: Inflammatory Bowel Disease (IBD) is a biopsychosocial illness. The prevalence of IBD is increasing in Australia, which presses the need to improve healthcare for patients with IBD. To date, no study has examined the views or preferences that Australian IBD patients have for their healthcare. This article reports on Australian patient’s with IBD perspectives and preferences for healthcare. Methods: Patients with IBD (n=477) responded to an open-ended survey question ‘What changes if any would you make for your IBD healthcare? And why?’ within a larger, previously conducted cross-sectional survey. These previously unanalysed responses were content analysed with open coding using NVivo. Results: Nine categories were formulated. Respondents expressed a desire to have greater access to (1) multidisciplinary services (17.70%), (2) proactive healthcare with increased follow up and long-term care planning (8.50%), and (3) treatment, services and specialist care (16.40%). Participants also requested (4) better communication (23.52%), and (5) whole of person care (10.24%). In addition, participants wanted (6) health promotion (i.e. public awareness and support groups) (10.42%). Finally, a proportion of participants were (7) happy with their healthcare (9.72%). Two minor categories – (8) administrative issues, (2.34%) and (9) improving the hospital experience also emerged (1.04%). Conclusions: The results support existing research outlining multidisciplinary care is better suited to meet the needs of patients with IBD. Healthcare professionals should focus on facilitating patients’ access to multidisciplinary services (i.e. psychologists, IBD nurses and dieticians), and increasing proactive care (i.e. follow up and long-term care planning). Asking patients about their mental health and communicating respectfully should also be priorities.Thesis (M.Psych(Health)) -- University of Adelaide, School of Psychology, 202

How Independent are Independent Directors? The Case of Italy

In this article, we provide an interpretation for the voluntary independence requirements contained in the Italian Corporate Governance Code (Preda Code) checking them against a proxy for international best practice, the independence criteria provided in the EC Recommendation on non-executive and supervisory directors of 2005. We then check to what extent company disclosure for 2003 allows the verification of the independence of directors qualified as independent by the Italian 40 blue chips. We find that the Preda Code (currently under revision) should be updated in several respects in order to make it abreast with best practice in the European Union. We also find that for two key independence requirements (not to have business relationships with the company and not to have too many concurrent commitments outside of the company) the level of compliance is dramatically low (4% and 16% respectively). Overall, for only 5 out of the 284 directors declared as independent by the Italian blue chips is it possible to verify the respect of all the Italian independence standards (and for only 4 directors with respect to the EC standards). This raises the problem of who should monitor what listed companies declare.Independent directors, Corporate governance

HOW INDEPENDENT ARE INDEPENDENT DIRECTORS? THE CASE OF ITALY

In this article, we provide an interpretation for the voluntary independence requirements contained in the Italian Corporate Governance Code (Preda Code) checking them against a proxy for international best practice, the independence criteria provided in the EC Recommendation on non-executive and supervisory directors of 2005. We then check to what extent company disclosure for 2003 allows the verification of the independence of directors qualified as independent by the Italian 40 blue chips. We find that the Preda Code (currently under revision) should be updated in several respects in order to make it abreast with best practice in the European Union. We also find that for two key independence requirements (not to have business relationships with the company and not to have too many concurrent commitments outside of the company) the level of compliance is dramatically low (4% and 16% respectively). Overall, for only 5 out of the 284 directors declared as independent by the Italian blue chips is it possible to verify the respect of all the Italian independence standards (and for only 4 directors with respect to the EC standards). This raises the problem of who should monitor what listed companies declare.Independent directors, Corporate governance,

Validating archetypes for the Multiple Sclerosis Functional Composite

Background Numerous information models for electronic health records, such as openEHR archetypes are available. The quality of such clinical models is important to guarantee standardised semantics and to facilitate their interoperability. However, validation aspects are not regarded sufficiently yet. The objective of this report is to investigate the feasibility of archetype development and its community-based validation process, presuming that this review process is a practical way to ensure high-quality information models amending the formal reference model definitions. Methods A standard archetype development approach was applied on a case set of three clinical tests for multiple sclerosis assessment: After an analysis of the tests, the obtained data elements were organised and structured. The appropriate archetype class was selected and the data elements were implemented in an iterative refinement process. Clinical and information modelling experts validated the models in a structured review process. Results Four new archetypes were developed and publicly deployed in the openEHR Clinical Knowledge Manager, an online platform provided by the openEHR Foundation. Afterwards, these four archetypes were validated by domain experts in a team review. The review was a formalised process, organised in the Clinical Knowledge Manager. Both, development and review process turned out to be time- consuming tasks, mostly due to difficult selection processes between alternative modelling approaches. The archetype review was a straightforward team process with the goal to validate archetypes pragmatically. Conclusions The quality of medical information models is crucial to guarantee standardised semantic representation in order to improve interoperability. The validation process is a practical way to better harmonise models that diverge due to necessary flexibility left open by the underlying formal reference model definitions. This case study provides evidence that both community- and tool- enabled review processes, structured in the Clinical Knowledge Manager, ensure archetype quality. It offers a pragmatic but feasible way to reduce variation in the representation of clinical information models towards a more unified and interoperable model

A matter of words: NLP for quality evaluation of Wikipedia medical articles

Automatic quality evaluation of Web information is a task with many fields of applications and of great relevance, especially in critical domains like the medical one. We move from the intuition that the quality of content of medical Web documents is affected by features related with the specific domain. First, the usage of a specific vocabulary (Domain Informativeness); then, the adoption of specific codes (like those used in the infoboxes of Wikipedia articles) and the type of document (e.g., historical and technical ones). In this paper, we propose to leverage specific domain features to improve the results of the evaluation of Wikipedia medical articles. In particular, we evaluate the articles adopting an "actionable" model, whose features are related to the content of the articles, so that the model can also directly suggest strategies for improving a given article quality. We rely on Natural Language Processing (NLP) and dictionaries-based techniques in order to extract the bio-medical concepts in a text. We prove the effectiveness of our approach by classifying the medical articles of the Wikipedia Medicine Portal, which have been previously manually labeled by the Wiki Project team. The results of our experiments confirm that, by considering domain-oriented features, it is possible to obtain sensible improvements with respect to existing solutions, mainly for those articles that other approaches have less correctly classified. Other than being interesting by their own, the results call for further research in the area of domain specific features suitable for Web data quality assessment

Validating archetypes for the Multiple Sclerosis Functional Composite

Background Numerous information models for electronic health records, such as openEHR archetypes are available. The quality of such clinical models is important to guarantee standardised semantics and to facilitate their interoperability. However, validation aspects are not regarded sufficiently yet. The objective of this report is to investigate the feasibility of archetype development and its community-based validation process, presuming that this review process is a practical way to ensure high-quality information models amending the formal reference model definitions. Methods A standard archetype development approach was applied on a case set of three clinical tests for multiple sclerosis assessment: After an analysis of the tests, the obtained data elements were organised and structured. The appropriate archetype class was selected and the data elements were implemented in an iterative refinement process. Clinical and information modelling experts validated the models in a structured review process. Results Four new archetypes were developed and publicly deployed in the openEHR Clinical Knowledge Manager, an online platform provided by the openEHR Foundation. Afterwards, these four archetypes were validated by domain experts in a team review. The review was a formalised process, organised in the Clinical Knowledge Manager. Both, development and review process turned out to be time- consuming tasks, mostly due to difficult selection processes between alternative modelling approaches. The archetype review was a straightforward team process with the goal to validate archetypes pragmatically. Conclusions The quality of medical information models is crucial to guarantee standardised semantic representation in order to improve interoperability. The validation process is a practical way to better harmonise models that diverge due to necessary flexibility left open by the underlying formal reference model definitions. This case study provides evidence that both community- and tool- enabled review processes, structured in the Clinical Knowledge Manager, ensure archetype quality. It offers a pragmatic but feasible way to reduce variation in the representation of clinical information models towards a more unified and interoperable model

The NASA Engineering and Safety Center (NESC) GN and C Technical Discipline Team (TDT): Its Purpose, Practices and Experiences

This paper will briefly define the vision, mission, and purpose of the NESC organization. The role of the GN&C TDT will then be described in detail along with an overview of how this team operates and engages in its objective engineering and safety assessments of critical NASA projects. This paper will then describe key issues and findings from several of the recent GN&C-related independent assessments and consultations performed and/or supported by the NESC GN&C TDT. Among the examples of the GN&C TDT s work that will be addressed in this paper are the following: the Space Shuttle Orbiter Repair Maneuver (ORM) assessment, the ISS CMG failure root cause assessment, the Demonstration of Autonomous Rendezvous Technologies (DART) spacecraft mishap consultation, the Phoenix Mars lander thruster-based controllability consultation, the NASA in-house Crew Exploration Vehicle (CEV) Smart Buyer assessment and the assessment of key engineering considerations for the Design, Development, Test & Evaluation (DDT&E) of robust and reliable GN&C systems for human-rated spacecraft