Regional Address Registries, Governance and Internet Freedom

Regional Internet Address Registries (RIRs) are private, nonprofit and transnational governance entities that evolved organically with the growth of the Internet to manage and coordinate Internet Protocol addresses. The RIR's management of Internet address resources is becoming more contentious and more central to global debates over Internet governance. This is happening because of two transformational problems: 1) the depletion of the IPv4 address space; and 2) the attempt to introduce more security into the Internet routing system. We call these problems "transformational" because they raise the stakes of the RIR's policy decisions, make RIR processes more formal and institutionalized, and have the potential to create new, more centralized control mechanisms over Internet service providers and users. A danger in this transition is that the higher stakes and centralized control mechanisms become magnets for political contention, just as ICANN's control of the DNS root did. In order to avoid a repeat of the problems of ICANN, we need to think carefully about the relationship between RIRs, governments, and Internet freedom. In particular, we need to shield RIRs from interference by national governments, and strengthen and institutionalize their status as neutral technical coordinators with limited influence over other areas of Internet governance

Internet Governance: the State of Play

The Global Forum on Internet Governance held by the UNICT Task Force in New York on 25-26 March concluded that Internet governance issues were many and complex. The Secretary-General's Working Group on Internet Governance will have to map out and navigate this complex terrain as it makes recommendations to the World Summit on an Information Society in 2005. To assist in this process, the Forum recommended, in the words of the Deputy Secretary-General of the United Nations at the closing session, that a matrix be developed "of all issues of Internet governance addressed by multilateral institutions, including gaps and concerns, to assist the Secretary-General in moving forward the agenda on these issues." This paper takes up the Deputy Secretary-General's challenge. It is an analysis of the state of play in Internet governance in different forums, with a view to showing: (1) what issues are being addressed (2) by whom, (3) what are the types of consideration that these issues receive and (4) what issues are not adequately addressed

A Primer on Quality Assurance and Performance Improvement for Interprofessional Chronic Kidney Disease Care: A Path to Joint Commission Certification.

Interprofessional care for chronic kidney disease facilitates the delivery of high quality, comprehensive care to a complex, at-risk population. Interprofessional care is resource intensive and requires a value proposition. Joint Commission certification is a voluntary process that improves patient outcomes, provides external validity to hospital administration and enhances visibility to patients and referring providers. This is a single-center, retrospective study describing quality assurance and performance improvement in chronic kidney disease, Joint Commission certification and quality outcomes. A total of 440 patients were included in the analysis. Thirteen quality indicators consisting of clinical and process of care indicators were developed and measured for a period of two years from 2009-2017. Significant improvements or at least persistently high performance were noted for key quality indicators such as blood pressure control (85%), estimation of cardiovascular risk (100%), measurement of hemoglobin A1c (98%), vaccination (93%), referrals for vascular access and transplantation (100%), placement of permanent dialysis access (61%), discussion of advanced directives (94%), online patient education (71%) and completion of office visit documentation (100%). High patient satisfaction scores (94-96%) are consistent with excellent quality of care provided

A Multi-perspective Analysis of Carrier-Grade NAT Deployment

As ISPs face IPv4 address scarcity they increasingly turn to network address translation (NAT) to accommodate the address needs of their customers. Recently, ISPs have moved beyond employing NATs only directly at individual customers and instead begun deploying Carrier-Grade NATs (CGNs) to apply address translation to many independent and disparate endpoints spanning physical locations, a phenomenon that so far has received little in the way of empirical assessment. In this work we present a broad and systematic study of the deployment and behavior of these middleboxes. We develop a methodology to detect the existence of hosts behind CGNs by extracting non-routable IP addresses from peer lists we obtain by crawling the BitTorrent DHT. We complement this approach with improvements to our Netalyzr troubleshooting service, enabling us to determine a range of indicators of CGN presence as well as detailed insights into key properties of CGNs. Combining the two data sources we illustrate the scope of CGN deployment on today's Internet, and report on characteristics of commonly deployed CGNs and their effect on end users

Advancing Pharmacist Collaborative Care within Academic Health Systems.

INTRODUCTION:The scope of pharmacy practice has evolved over the last few decades to focus on the optimization of medication therapy. Despite this positive impact, the lack of reimbursement remains a significant barrier to the implementation of innovative pharmacist practice models. SUMMARY:We describe the successful development, implementation and outcomes of three types of pharmacist collaborative care models: (1) a pharmacist with physician oversight, (2) pharmacist-interprofessional teams and (3) physician-pharmacist teams. The outcome measurement of these pharmacist care models varied from the design phase to patient volume measurement and to comprehensive quality dashboards. All of these practice models have been successfully funded by affiliated health systems or grants. CONCLUSIONS:The expansion of pharmacist services delivered by clinical faculty has several benefits to affiliated health systems: (1) significant improvements in patient care quality, (2) access to experts in specialty areas, and (3) the dissemination of outcomes with national and international recognition, increasing the visibility of the health system

The State of Network Neutrality Regulation

The Network Neutrality (NN) debate refers to the battle over the design of a regulatory framework for preserving the Internet as a public network and open innovation platform. Fueled by concerns that broadband access service providers might abuse network management to discriminate against third party providers (e.g., content or application providers), policymakers have struggled with designing rules that would protect the Internet from unreasonable network management practices. In this article, we provide an overview of the history of the debate in the U.S. and the EU and highlight the challenges that will confront network engineers designing and operating networks as the debate continues to evolve.BMBF, 16DII111, Verbundprojekt: Weizenbaum-Institut für die vernetzte Gesellschaft - Das Deutsche Internet-Institut; Teilvorhaben: Wissenschaftszentrum Berlin für Sozialforschung (WZB)EC/H2020/679158/EU/Resolving the Tussle in the Internet: Mapping, Architecture, and Policy Making/ResolutioNe

Trends in qualitative research in language teaching since 2000

This paper reviews developments in qualitative research in language teaching since the year 2000, focusing on its contributions to the field and identifying issues that emerge. Its aims are to identify those areas in language teaching where qualitative research has the greatest potential and indicate what needs to be done to further improve the quality of its contribution. The paper begins by highlighting current trends and debates in the general area of qualitative research and offering a working definition of the term. At its core is an overview of developments in the new millennium based on the analysis of papers published in 15 journals related to the field of language teaching and a more detailed description, drawn from a range of sources, of exemplary contributions during that period. Issues of quality are also considered, using illustrative cases to point to aspects of published research that deserve closer attention in future work, and key publications on qualitative research practice are reviewed

A Scientific Roadmap for Antibiotic Discovery: A Sustained and Robust Pipeline of New Antibacterial Drugs and Therapies is Critical to Preserve Public Health

In recent decades, the discovery and development of new antibiotics have slowed dramatically as scientific barriers to drug discovery, regulatory challenges, and diminishing returns on investment have led major drug companies to scale back or abandon their antibiotic research. Consequently, antibiotic discovery—which peaked in the 1950s—has dropped precipitously. Of greater concern is the fact that nearly all antibiotics brought to market over the past 30 years have been variations on existing drugs. Every currently available antibiotic is a derivative of a class discovered between the early 1900s and 1984.At the same time, the emergence of antibiotic-resistant pathogens has accelerated, giving rise to life-threatening infections that will not respond to available antibiotic treatment. Inevitably, the more that antibiotics are used, the more that bacteria develop resistance—rendering the drugs less effective and leading public health authorities worldwide to flag antibiotic resistance as an urgent and growing public health threat

Psychosis and Human Rights: Conflicts in Mental Health Policy and Practice

This paper examines conflicts in polices in England and Wales pertaining to the demand for alternative, non-medical crisis support for those experiencing ‘psychosis’. We examine the limitations of current treatment, policy and legislative frameworks in supporting these demands. In particular, we focus on the limitations of prevailing conceptualisations of ‘human rights’, ‘social inclusion’ and ‘recovery’. These concepts, we argue, are embedded within a broader treatment framework which renders medication as mandatory and all other treatment modalities as inherently subsidiary, and a broader policy framework which is complicit with bio-medical orthodoxies of ‘mental illness’ and prioritises treatment compliance and compulsion. Therefore, in order to advance a ‘human rights’ approach to mental health policy, we argue that reigning orthodoxies inherent within policy and practice must be explicitly challenged to open up spaces for the availability of alternatives