A socio-technical analytical framework on the EHR-organizational innovation interplay: Insights from a public hospital in Greece

The healthcare sector globally is confronted with increasing internal and external pressures that urge for a radical reform of health systems' status quo. The role of technological innovations such as Electronic Health Records (EHR) is recognized as instrumental in this transition process as it is expected to accelerate organizational innovations. This is why the widespread uptake of EHR systems is a top priority in the global healthcare agenda. The successful co-deployment though of EHR systems and organizational innovations within the context of secondary healthcare institutions is a complex and multifaceted issue. Existing research in the field has made little progress thus emphasizing the need for further research contribution that will incorporate a holistic perspective. This paper presents insights about the EHR-organizational innovation interplay from a public hospital in Greece into a socio-technical analytical framework providing a multilevel set of action points for the eHealth roadmap with worldwide relevance

Comic heroes or saviours? Constructing alternative identities in a social critical approach to the teaching of English as a foreign language.

Current educational systems primarily focus on the verbal and logico-mathematical aptitude of students, thus neglecting the cultivation of visual literacy and critical literacy skills, although the ubiquity of images in school textbooks necessitates the inclusion of a ‘visual grammar’ metalanguage in educational practices. The aim of the present paper is to present and analyse how a group of eighteen sixth grade students of an EFL classroom in a state primary school in Thessaloniki managed to ‘deconstruct’ the depiction of superheroes/heroines in comic books or action movies, in an effort to represent them in a more humane and mundane way, where their super powers are summoned to the advantage of a society in need. The overall organization of the instructional intervention is built on an introductory phase, a main phase and a follow-up phase. The analysis of the students’ compositions relies on the application of the principles of critical visual literacy and the results display that through the process of scaffolding, the students can reject dominant representations of power and reconstruct cliché identities by re-exploring pre-existing roles. The end result, that is the classroom calendar compiled by twelve multimodal texts, manifests the students’ skilful utilization of both visual and verbal semiotic resources in a balanced way, with a view to transmitting their social messages taking into account the broader social, cultural and political context within which power relations and social roles constantly evolve and are constructed

Comic heroes or saviours? Constructing alternative identities in a social critical approach to the teaching of English as a foreign language.

Current educational systems primarily focus on the verbal and logico-mathematical aptitude of students, thus neglecting the cultivation of visual literacy and critical literacy skills, although the ubiquity of images in school textbooks necessitates the inclusion of a ‘visual grammar’ metalanguage in educational practices. The aim of the present paper is to present and analyse how a group of eighteen sixth grade students of an EFL classroom in a state primary school in Thessaloniki managed to ‘deconstruct’ the depiction of superheroes/heroines in comic books or action movies, in an effort to represent them in a more humane and mundane way, where their super powers are summoned to the advantage of a society in need. The overall organization of the instructional intervention is built on an introductory phase, a main phase and a follow-up phase. The analysis of the students’ compositions relies on the application of the principles of critical visual literacy and the results display that through the process of scaffolding, the students can reject dominant representations of power and reconstruct cliché identities by re-exploring pre-existing roles. The end result, that is the classroom calendar compiled by twelve multimodal texts, manifests the students’ skilful utilization of both visual and verbal semiotic resources in a balanced way, with a view to transmitting their social messages taking into account the broader social, cultural and political context within which power relations and social roles constantly evolve and are constructed

Deregulation of calcium homeostasis mediates secreted aesynuclein - induced neurotoxicity

α-Synuclein (AS) plays a crucial role in Parkinson's disease pathogenesis. AS is normally secreted from neuronal cells and can thus exert paracrine effects. We have previously demonstrated that naturally secreted AS species, derived from SH-SY5Y cells inducibly overexpressing human wild type AS, can be toxic to recipient neuronal cells. In the current study, we show that application of secreted AS alters membrane fluidity and increases calcium (Ca2+) entry. This influx is reduced on pharmacological inhibition of voltage-operated Ca2+ channels. Although no change in free cytosolic Ca2+ levels is observed, a significantly increased mitochondrial Ca2+ sequestration is found in recipient cells. Application of voltage-operated Ca2+ channel blockers or Ca2+ chelators abolishes AS-mediated toxicity. AS-treated cells exhibit increased calpain activation, and calpain inhibition greatly alleviates the observed toxicity. Collectively, our data suggest that secreted AS exerts toxicity through engagement, at least in part, of the Ca2+ homeostatic machinery. Therefore, manipulating Ca2+ signaling pathways might represent a potential therapeutic strategy for Parkinson's disease

A framework for accessible m-government implementation

The great popularity and rapid diffusion of mobile technologies at worldwide level has also been recognised by the public sector, leading to the creation of m-government. A major challenge for m-government is accessibility – the provision of an equal service to all citizens irrespective of their psychical, mental or technical capabilities. This paper sketches the profiles of six citizen groups: Visually Impaired, Hearing Impaired, Motor Impaired, Speech Impaired, Cognitive Impaired and Elderly. M-government examples that target the aforementioned groups are discussed and a framework for accessible m-government implementation with reference to the W3C Mobile Web Best Practices is proposed

Metastasis to the breast from an adenocarcinoma of the lung with extensive micropapillary component: a case report and review of the literature

Breast metastasis from extra-mammary malignancy is rare. Based on the literature an incidence of 0.4-1.3% is reported. The primary malignancies most commonly metastasizing to the breast are leukemia-lymphoma, and malignant melanoma. We present a case of metastasis to the breast from a pulmonary adenocarcinoma, with extensive micropapillary component, diagnosed concomitantly with the primary tumor. A 73-year-old female presented with dyspnea and dry cough of 4 weeks duration and a massive pleural effusion was found on a chest radiograph. Additionally, on physical examination a poorly defined mass was noted in the upper outer quadrant of the left breast. The patient underwent bronchoscopy, excisional breast biopsy and medical thoracoscopy. By cytology, histology and immunohistochemistry primary lung adenocarcinoma with metastasis to the breast and parietal pleura was diagnosed. Both the primary and metastatic anatomic sites demonstrated histologically extensive micropapillary component, which is recently recognized as an important prognostic factor. The patient received chemotherapy but passed away within 7 months. Accurate differentiation of metastatic from primary carcinoma is of crucial importance because the treatment and prognosis differ significantly

Digital auscultation in PERCH: Associations with chest radiography and pneumonia mortality in children.

BACKGROUND: Whether digitally recorded lung sounds are associated with radiographic pneumonia or clinical outcomes among children in low-income and middle-income countries is unknown. We sought to address these knowledge gaps. METHODS: We enrolled 1 to 59monthold children hospitalized with pneumonia at eight African and Asian Pneumonia Etiology Research for Child Health sites in six countries, recorded digital stethoscope lung sounds, obtained chest radiographs, and collected clinical outcomes. Recordings were processed and classified into binary categories positive or negative for adventitial lung sounds. Listening and reading panels classified recordings and radiographs. Recording classification associations with chest radiographs with World Health Organization (WHO)-defined primary endpoint pneumonia (radiographic pneumonia) or mortality were evaluated. We also examined case fatality among risk strata. RESULTS: Among children without WHO danger signs, wheezing (without crackles) had a lower adjusted odds ratio (aOR) for radiographic pneumonia (0.35, 95% confidence interval (CI): 0.15, 0.82), compared to children with normal recordings. Neither crackle only (no wheeze) (aOR: 2.13, 95% CI: 0.91, 4.96) or any wheeze (with or without crackle) (aOR: 0.63, 95% CI: 0.34, 1.15) were associated with radiographic pneumonia. Among children with WHO danger signs no lung recording classification was independently associated with radiographic pneumonia, although trends toward greater odds of radiographic pneumonia were observed among children classified with crackle only (no wheeze) or any wheeze (with or without crackle). Among children without WHO danger signs, those with recorded wheezing had a lower case fatality than those without wheezing (3.8% vs. 9.1%, p = .03). CONCLUSIONS: Among lower risk children without WHO danger signs digitally recorded wheezing is associated with a lower odds for radiographic pneumonia and with lower mortality. Although further research is needed, these data indicate that with further development digital auscultation may eventually contribute to child pneumonia care

The Internet of Healthcare Things: A European Perspective and a Review of Ethical Concerns

The Internet of Things (IoT) is a disruptive technological paradigm that is at the center of the digital evolution by integrating physical and virtual worlds leading to the creation of extended interconnected ecosystems that are characterized as smart environments. The concept of the IoT has a broad range of applications in different industries including the healthcare sector. The Internet of Healthcare Things (IoHT), a branch of the IoT, is expected to bring promising benefits to all involved stakeholders and accelerate the revolution of the healthcare sector through a transition towards preventive and personalized medicine. The socio-economic challenges that the healthcare sector is facing further emphasize the need for a radical transformation of healthcare systems in both developed and developing countries with the role of pervasive technological innovations, such as IoHT, recognized as key to counteract the relevant challenges. Besides the number of potential opportunities that IoHT presents, there are fundamental ethical concerns that need to be considered and addressed in relation to the application of IoHT. This paper contributes to the discussion of the emerging topic of IoHT by providing an overview of the role and potential of IoHT, highlighting the characteristics of the current and future healthcare landscape, reporting on the up-to-date status of IoHT in Europe and reflecting upon existing research in the ethics of IoHT by incorporating additional ethical dimensions that have been ignored which can provide pathways for future research in the field