Marshfield Clinic: Health Information Technology Paves the Way for Population Health Management

Highlights Fund-defined attributes of an ideal care delivery system and best practices, including an internal electronic health record, primary care teams, physician quality metrics and mentors, and standardized care processes for chronic care management

Managing access to the internet in public libraries in the UK: the findings of the MAIPLE project

One of the key purposes of the public library is to provide access to information (UNESCO, 1994). In the UK, information is provided in printed formats and for the last decade via public access Internet workstations installed as part of the People’s Network initiative. Recent figures reveal that UK public libraries provide approximately 40,000 computer terminals offering users around 80,000 hours across more than 4,000 service points (CIPFA, 2012). In addition, increasing numbers of public libraries allow users to connect devices such as tablets or smart phones to the Internet via a wireless network access point (Wi-Fi). How do public library staff manage this? What about users viewing harmful or illegal content? And what are the implications for a profession committed to freedom of access to information and opposition to censorship? MAIPLE, a two-year project funded by the Arts and Humanities Research Council has been investigating this issue as little was known about how UK public libraries manage Internet content control including illegal material. MAIPLE has drawn on an extensive review of the literature, an online survey to which all UK public library services were invited to participate (39 per cent response rate) and case studies with five services (two in England, one in Scotland, one in Wales and one in Northern Ireland) to examine the ways these issues are managed and their implications for staff. This presentation will explore the prevalence of tools such as filtering software, Acceptable Use Policies, user authentication, booking software and visual monitoring by staff and consider their efficacy and desirability in the provision of public Internet access. It will consider the professional dilemmas inherent within managing content and access. Finally, it will highlight some of the more important themes emerging from the findings and their implications for practitioners and policy makers

Core Services in the Architecture of the National Digital Library for Science Education (NSDL)

We describe the core components of the architecture for the (NSDL) National Science, Mathematics, Engineering, and Technology Education Digital Library. Over time the NSDL will include heterogeneous users, content, and services. To accommodate this, a design for a technical and organization infrastructure has been formulated based on the notion of a spectrum of interoperability. This paper describes the first phase of the interoperability infrastructure including the metadata repository, search and discovery services, rights management services, and user interface portal facilities

Review of precision cancer medicine: Evolution of the treatment paradigm.

In recent years, biotechnological breakthroughs have led to identification of complex and unique biologic features associated with carcinogenesis. Tumor and cell-free DNA profiling, immune markers, and proteomic and RNA analyses are used to identify these characteristics for optimization of anticancer therapy in individual patients. Consequently, clinical trials have evolved, shifting from tumor type-centered to gene-directed, histology-agnostic, with innovative adaptive design tailored to biomarker profiling with the goal to improve treatment outcomes. A plethora of precision medicine trials have been conducted. The majority of these trials demonstrated that matched therapy is associated with superior outcomes compared to non-matched therapy across tumor types and in specific cancers. To improve the implementation of precision medicine, this approach should be used early in the course of the disease, and patients should have complete tumor profiling and access to effective matched therapy. To overcome the complexity of tumor biology, clinical trials with combinations of gene-targeted therapy with immune-targeted approaches (e.g., checkpoint blockade, personalized vaccines and/or chimeric antigen receptor T-cells), hormonal therapy, chemotherapy and/or novel agents should be considered. These studies should target dynamic changes in tumor biologic abnormalities, eliminating minimal residual disease, and eradicating significant subclones that confer resistance to treatment. Mining and expansion of real-world data, facilitated by the use of advanced computer data processing capabilities, may contribute to validation of information to predict new applications for medicines. In this review, we summarize the clinical trials and discuss challenges and opportunities to accelerate the implementation of precision oncology

Evaluating the effectiveness of the Emergency Neurological Life Support educational framework in low-income countries.

BackgroundThe Emergency Neurological Life Support (ENLS) is an educational initiative designed to improve the acute management of neurological injuries. However, the applicability of the course in low-income countries in unknown. We evaluated the impact of the course on knowledge, decision-making skills and preparedness to manage neurological emergencies in a resource-limited country.MethodsA prospective cohort study design was implemented for the first ENLS course held in Asia. Knowledge and decision-making skills for neurological emergencies were assessed at baseline, post-course and at 6 months following course completion. To determine perceived knowledge and preparedness, data were collected using surveys administered immediately post-course and 6 months later.ResultsA total of 34 acute care physicians from across Nepal attended the course. Knowledge and decision-making skills significantly improved following the course (p=0.0008). Knowledge and decision-making skills remained significantly improved after 6 months, compared with before the course (p=0.02), with no significant loss of skills immediately following the course to the 6-month follow-up (p=0.16). At 6 months, the willingness to participate in continuing medical education activities remained evident, with 77% (10/13) of participants reporting a change in their clinical practice and decision-making, with the repeated use of ENLS protocols as the main driver of change.ConclusionsUsing the ENLS framework, neurocritical care education can be delivered in low-income countries to improve knowledge uptake, with evidence of knowledge retention up to 6 months

Outlook Magazine, Autumn 2018

https://digitalcommons.wustl.edu/outlook/1205/thumbnail.jp

Download the full PDF of Jefferson Surgical Solutions Fall 2011, Volume 6, Number 2

Download the full PDF of Jefferson Surgical Solutions Fall 2011, Volume 6, Number 2