Upgrading a ColdFusion-Based Academic Medical Library Staff Intranet

This article details the process of upgrading and expanding an existing academic medical library intranet to include a wiki, blog, discussion forum, and photo collection manager. The first version of the library\u27s intranet from early 2002 was powered by ColdFusion software and existed primarily to allow staff members to author and store minutes of library team meetings. Other ColdFusion-based applications and functions were subsequently added, as were various other library documents and procedures. As a follow-up to the library\u27s strategic plan, a library Staff Intranet Team was organized in early 2008 to reorganize the content of the intranet and to identify software tools that would allow greater staff participation in maintaining and updating intranet content. Early steps in the process included brainstorming, a card-sorting exercise, product research, a staff survey, and paper prototyping. The team focused on implementing various open-source, ColdFusion-based tools in order to accommodate existing technology, available budget, and time constraints. Challenges in implementing the tools included bypassing or modifying existing authentication systems and applying modifications that led to loss of native functionality. Despite usability testing and staff training, library staff have not universally welcomed or adopted all the new tools. Notwithstanding these challenges, the renovated staff intranet has shown promise in furthering the goals in the library\u27s strategic plan to improve communication and facilitate collaboration among library staff

The Children and Young People's Health Partnership Evelina London Model of Care: process evaluation protocol

Introduction Children and young people (CYP) in the UK have poor health outcomes, and there is increasing emergency department and hospital outpatient use. To address these problems in Lambeth and Southwark (two boroughs of London, UK), the local Clinical Commissioning Groups, Local Authorities and Healthcare Providers formed The Children and Young People’s Health Partnership (CYPHP), a clinical-academic programme for improving child health. The Partnership has developed the CYPHP Evelina London model, an integrated healthcare model that aims to deliver effective, coordinated care in primary and community settings and promote better self-management to over approximately 90 000 CYP in Lambeth and Southwark. This protocol is for the process evaluation of this model of care. Methods and analysis Alongside an impact evaluation, an in-depth, mixed-methods process evaluation will be used to understand the barriers and facilitators to implementing the model of care. The data collected mapped onto a logic model of how CYPHP is expected to improve child health outcomes. Data collection and analysis include qualitative interviews and focus groups with stakeholders, a policy review and a quantitative analysis of routine clinical and administrative data and questionnaire data. Information relating to the context of the trial that may affect implementation and/or outcomes of the CYPHP model of care will be documented. Ethics and dissemination The study has been reviewed by NHS REC Cornwall & Plymouth (17/SW/0275). The findings of this process evaluation will guide the scaling up and implementation of the CYPHP Evelina London Model of Care across the UK. Findings will be disseminated through publications and conferences, and implementation manuals and guidance for others working to improve child health through strengthening health systems. Trial registration number NCT03461848

Plasmodium falciparum malaria and Parvovirus B19; a case of acute co-infection

<p>Abstract</p> <p>Background</p> <p>Co-infection with Plasmodium falciparum malaria and Parvovirus B19 in adults is an extremely rare occurrence and, apparently, only one case has been previously reported. Herein we describe a case of acute co-infection with severe anemia and renal failure.</p> <p>Case presentation</p> <p>The patient was a 34-year-old African man presenting myalgia, fatigue, headache, anemia and hepatosplenomegaly. A thin peripheral smear showed Plasmodium falciparum trophozoites and the patient was treated with oral mefloquine. After an initial amelioration, fever, fatigue and myalgia reappeared, the anemia worsened and there was evidence of acute renal failure. No malarial parasites were found with a blood smear. A bone marrow aspiration showed marked erythroid hypoplasia. Parvovirus B19-specific IgM and IgG and viremia were positive. The patient was treated with steroids and blood cell transfusions. After ten days, anemia and renal failure progressively decreased. When last seen, the patient was asymptomatic and the blood values were within the normal range.</p> <p>Conclusions</p> <p>The diagnosis of Parvovirus B19 acute infection should be considered in any case of persistent severe anemia and/or renal failure, even in clinical conditions that are well-known causes of anemia and renal failure, such as malaria.</p

InternationaL cross-sectIonAl and longItudinal assessment on aSthma cONtrol in European adult patients : the LIAISON study protocol

The study is funded by Chiesi Farmaceutici S.p.A., Parma, ItalyPeer reviewedPublisher PD

Fish mitigate trophic depletion in marine cave ecosystems.

Dark marine habitats are often characterized by a food-limited condition. Peculiar dark habitats include marine caves, characterized by the absence of light and limited water flow, which lead to reduced fluxes of organic matter for cave-dwelling organisms. We investigated whether the most abundant and common cave-dwelling fish Apogon imberbis has the potential to play the role of trophic vector in Mediterranean marine caves. We first analysed stomach contents to check whether repletion changes according to a nycthemeral cycle. We then identified the prey items, to see whether they belong to species associated with cave habitats or not. Finally, we assessed whether A. imberbis moves outside marine caves at night to feed, by collecting visual census data on A. imberbis density both inside and outside caves, by day and by night. The stomach repletion of individuals sampled early in the morning was significantly higher than later in the day. Most prey were typical of habitats other than caves. A. imberbis was on average more abundant within caves during the day and outside during the night. Our study supports the hypothesis regarding the crucial trophic role of A. imberbis in connecting Mediterranean marine caves with external habitat

Psychological symptoms and Quality of Life in adults with Chiari malformation type I: an Assessment by the Italian version of Chiari Symptom Profile

Chiari malformation type I (CM-I) is a rare condition with physical and neurological manifestation changing across people. Being a chronic and debilitating disease, a comprehensive multidisciplinary approach is needed for evaluating patient’s experienced Quality of Life (QoL) and psychological correlates of CM. Objectives: The aim of this study was to develop the Italian adaptation of Chiari Symptom Profile (CSP), a questionnaire assessing the core symptoms of Chiari malformation and their impact on people’s lives. Secondly, the occurrence of anxiety/depression symptoms and associations with patient-reported QoL were explored. Methods: 172 adults with diagnosed CM-I (N=79 with neurosurgery) completed an online questionnaire measuring general QoL (WHOQOL-brief), disease-related QoL (CSP), and symptoms of anxiety/depression (HADS). Participant’s demographic and clinical data were also collected. Results: The Italian version of CSP showed excellent reliability both in total (Cronbach alpha = .97) and factorial scores (alphas from .87 to .95) assessing four domains of Chiari-related QoL (functional, physical, social, and psychological). For construct validity, significant correlations (p .001) resulted among severity of CM symptoms, social and daily limitations assessed by CSP and general QoL. Participants’ age at neurosurgery and condition (with/without neurosurgery treatment) did not significantly impact QoL scores, but perceived QoL worsened with increasing age. Among participants, 32% reported clinical anxiety and 14% depression symptoms (with higher incidence of depression in non-operated participants). Participants with clinical anxiety/depression reported a worse QoL in all domains of CSP (functional, physical, social, and psychological). Conclusion: Findings suggest the need to include in CM treatment a continuous psychological support, identifying the patients most at risk who, in time, they may experience greater psychological suffering