Reducing School Dropout in Malawi and Lesotho

‘School in a bag’, buddy systems and catch-up clubs have paved the way for improved learning and reduced dropout in schools in Malawi and Lesotho. These pioneering techniques have been used by researchers from University College London’s Ins tute of Educa on and their Southern African partners to help ensure that disadvantaged children, particularly those affected by HIV/ AIDS, stay in school. Between April 2007 and July 2010, the team developed and piloted these distance- and flexible- learning techniques in 20 primary schools in Malawi and 16 secondary schools in Lesotho, all of which were located in areas where HIV/AIDS was highly prevalent and where school dropout rates were high. In both countries, the schools saw reduced dropout rates (up to 45 percent in Malawi), particularly for older children

The Changing Landscape of Scholarly Publishing: Will Radiation Research Survive?

As a society published journal, Radiation Research has been a successful and enduring project of the Radiation Research Society (RRS). In 59 years of publication, the journal has produced 732 issues and 10,712 articles. As a nonprofit organization, RRS, like most societies, has used revenues from subscriptions to support, in part, the life of the organization (meetings, conferences and grants to new scholars). The model for scientific publishing, however, continues to evolve. Radiation Research has weathered the rise of electronic publishing, consolidation in the commercial publishing industry, the aggregation of library subscriptions and library subscription cuts. Recent years have seen dramatic changes in how scholarly publishing is financed and new funder and institution policies will accelerate these changes. The growth of open access to journal articles reflects the information habits of readers and facilitates the dissemination of new knowledge. The Radiation Research Society, however, will need to account for and adapt to changes in the publishing market if it intends to support the communication of peer reviewed scholarship in the future

Getting off obesity island: how informationists can enhance clinical decision support

Clinical decision support (CDS) will play a key role in improving the health of patients; informationists can support the development of CDS systems by indexing rule libraries and mapping the system logic. This work can help rule developers make more informed choices and understand how rules are related conceptually and operationally. With a map, rules can be written to bridge isolated concepts (islands) and rules that are no longer needed can be weeded. Here we explore the added value that informationists bring to projects by reporting on the role of informationists working on a pediatric CDS

Reducing School Dropout Rates in Malawi and Lesotho

School in a bag’, buddy systems and catch-up clubs have paved the way for improved learning and reduced dropout in schools in Malawi and Lesotho. These pioneering techniques have been used by researchers from University College London’s Institute of Education and their Southern African partners to help ensure that disadvantaged children, particularly those affected by HIV/AIDS, stay in schoo

Early childhood development through an integrated program : evidence from the Philippines

More attention and resources have been devoted in recent years to early childhood development (ECD) in low- and middle-income countries. Rigorous studies on the effectiveness of ECD-related programs for improving children's development in various dimensions in the developing world are scant. The authors evaluate an important ECD initiative of the Philippine government using longitudinal data collected over three years on a cohort of 6,693 children age 0-4 years at baseline in two"treatment"regions and a"control"region that did not receive the intervention. The initiative includes a wide range of health, nutrition, early education, and social services programs. The authors estimate its impact by using"intent-to-treat"difference-in-difference propensity score matching estimators to control for a variety of observed characteristics measured at the municipality, barangay, household, and child level and unobserved fixed characteristics, with differential impacts by age of children and duration of exposure to the program. There has been a significant improvement in the cognitive, social, motor, and language development, and in short-term nutritional status of children who reside in ECD program areas compared to those in non-program areas, particularly for those under age four at the end of the evaluation period. The proportions of children below age four with worms and diarrhea also have been lowered significantly in program compared to non-program areas, but there are effects in the opposite direction for older children so the overall impact on these two indicators is mixed.Health Monitoring&Evaluation,Early Childhood Development,Youth and Governance,Primary Education,Educational Sciences

Mapping the rules: conceptual and logical relationships in a system for pediatric clinical decision support

The Child Health Improvement through Computer Automation (CHICA) system uses evidence-based guidelines and information collected in the clinic and stored in an electronic medical record (EMR) to inform physician and patient decision making. CHICA helps physicians to identify and select relevant screenings and also provides personalized, just-in-time information for patients. This system relies on a database of Medical Logic Modules (MLMS) written in the Arden Rules syntax. These MLMs store observations (StorObs) during the clinical encounter which trigger potential screenings and preventive health interventions for discussion with the patient or for follow up at the next visit. This poster shows how informationists worked with the CHICA team to describe the MLMs using standard vocabularies, including Medical Subject Headings (MeSH) and Logical Observation Identifiers Names and Codes (LOINC). After assigning keywords to the database of MLMs, the informationists used visualization tools to generate maps. These maps show how rules are related by logic (shared StorObs) and by concept (shared vocabulary). The CHICA team will use these maps to identify gaps in the clinical decision support database and (if needed) to develop rules which bridge related but currently isolated concepts.NIH 1R01LM010923-0

Data visualization for truth maintenance in clinical decision support systems

Background and objectives The goal is to inform proactive initiatives to expand the knowledge base of clinical decision support systems. Design and setting We describe an initiative in which research informationists and health services researchers employ visualization tools to map logic models for clinical decision support within an electronic health record. Materials and methods We mapped relationships using software for social network analysis: NodeXL and CMAP. We defined relationships by shared observations, such as two Arden rules within medical logic modules that consider the same clinical observation, or by the presence of common keywords that were used to label rules according to standardized vocabularies. Results We studied the Child Health Improvement through Computer Automation (CHICA) system, an electronic medical record that contains 170 unique variables representing discrete clinical observations. These variables were used in 300 medical logic modules (MLM's) that prompted health care providers to deliver preventive counseling or otherwise served as clinical decision support. Using data visualization tools, we generated maps that illustrate connections, or lack thereof, between clinical topics within CHICA's MLMs. Conclusions The development of such maps may allow multiple disciplines commonly interacting over EMR platforms, and various perspectives (clinicians, programmers, informationists) to work more effectively as teams to refine the EMR by programming logic routines to address co-morbidities or other instances where domains of medical knowledge should be connected

The role of informationists in delivering geospatial intelligence to health care professionals

Three informationists at the Indiana University School of Medicine were awarded NLM supplement to work on the Child Health Improvement through Computer Automation (CHICA) system. CHICA is a computer decision support system that interfaces with existing electronic medical record systems (EMRS) and delivers "just in time" patient-relevant guidelines to physicians during the clinical encounter. CHICA-GIS integrates a geographic information system (GIS) with CHICA to refer pediatricians and parents to relevant health services (as needed, for physical activity, dental care, or tutoring) near the patient's neighborhood. The informationists are enhancing the CHICA-GIS system by: improving the accuracy and accessibility of information, managing and mapping the knowledge which undergirds the CHICA-GIS decision support tool, supporting community engagement and consumer health information outreach, and facilitating the dissemination of new CHICA-GIS research results and services. This presentation describes the initial process for approaching and collaborating with researchers, writing the grant and getting funded, and progress on the project goals to date.NIH R01 LM-01092

Family Background, Service Providers, and Early Childhood Development in the Philippines: Proxies and Interactions

We examine the importance of family background for early childhood development (ECD) using data collected in 2001 from 3,556 children ages 0–36 months in three regions of the Philippines. We focus on four main research questions: (1) Are associations of family background with ECD in part proxying for health and ECD‐related programs? (2) Are associations of family background with ECD biased due to omission of unobserved community characteristics that may be related to placement of health and ECD‐related services? (3) Are there important interactions between family background and health and ECD‐related programs in their effect on ECD? (4) Are there important interactions among the components of family background? Physical assets and human assets have a number of important positive associations with ECD. These include the positive relations between physical assets and the anthropometrics and hemoglobin levels of children, as well as lower occurrence of worms. Each parent’s schooling and height also have notable positive effects on these outcomes and the motor and language skills of children. The failure to account for community characteristics is related to often substantial bias in the estimated effect of family background on ECD. We do not find strong evidence that interactions are important

Enhancing research on a clinical decision support and geographic information system: getting involved as informationists

In 2012, the National Library of Medicine (NLM) funded its first ever administrative supplement for informationists. The purpose of these grants is to enhance multidisciplinary basic and clinical research by integrating information specialists (informationists) on research teams in order to improve the capture, organization, and management of biomedical research data. Three informationists at the Indiana University School of Medicine were awarded one of these supplements to work on the Child Health Improvement through Computer Automation (CHICA) system. CHICA is a computer decision support system that interfaces with existing electronic medical record systems (EMRS) and delivers "just in time" patient-relevant guidelines to physicians during the clinical encounter. CHICA-GIS integrates a geographic information system (GIS) with CHICA to refer pediatricians and parents to relevant health services (as needed, for physical activity, dental care, or tutoring) near the patient's neighborhood. The informationists are enhancing the CHICA-GIS system by: improving the accuracy and accessibility of information, managing and mapping the knowledge which undergirds the CHICA-GIS decision support tool, supporting community engagement and consumer health information outreach, and facilitating the dissemination of new CHICA-GIS research results and services. This paper describes the initial process for approaching and collaborating with researchers, writing the grant and getting funded, and progress on the project goals to date.NIH R01 LM-010923, "Delivering Geospatial Intelligence to Health Care Professionals