Building capacity in a health sciences library to support global health projects

This paper describes how a large, academic health sciences library built capacity for supporting global health at its university and discusses related outcomes. Lean budgets require prioritization and organizational strategy. A committee, with leadership responsibilities assigned to one librarian, guided strategic planning and the pursuit of collaborative, global health outreach activities. A website features case studies and videos of user stories to promote how library partnerships successfully contributed to global health projects. Collaborative partnerships were formed through outreach activities and from follow-up to reference questions. The committee and a librarian's dedicated time established the library's commitment to help the university carry out its ambitious global agenda

Without Face-to-Face Limits: Using Online Modules to Expand Specialty Focused Residency EBM Instruction for the ACGME Milestone Project

Objective: The Accreditation Council for Graduate Medical Education (ACGME) Milestone Project has created the need for specialty focused, developmentally tiered and competency based evidence-based medicine (EBM) instruction. The University of North Carolina at Chapel Hill Health Sciences Library is extending current staff capacity for face-to-face sessions by creating online module templates that can be adapted to meet the specific needs of more residency programs. Method: Testing the effectiveness, quality and usability of the draft templates is part of the project development plan. The specialty focused EBM face-to-face instruction session of the Clinical Based Year (CBY) anesthesiology residents' Academic Medicine Rotation is the model for the online template. In order to be able to compare the validity of the online modules in comparison with face-to-face sessions, baseline data was gathered from a pre-test/post-test completed by the ten anesthesiology resident participants in the 2015 program. The pre-test/post-test included five knowledge questions and two self-perception questions. After the face-to-face session, the anesthesiology residents were asked to review the online module version of the instruction and answer a brief survey about ease of use and preferred learning mode. Results: Seven of ten residents increased their number of correct answers on the post-test. There were no perfect scores on the pre-test and five perfect scores on the post-test. Three of ten residents indicated a higher self-perceived comfort level for completing a PubMed EBM search. Two of ten residents had an increase level of agreement that their PubMed searching skills are sufficient. Seven of ten residents evaluated the online module and rated it as clearly organized and easy to understand and use. Four would prefer to learn and practice the EBM content in a group session with an instructor, two did not have a preference and one strongly preferred to learn online. Conclusion: Pre-test/post-test data confirmed face-to-face instruction had a positive impact on EBM knowledge and moderately improved self-perceived comfort with EBM searching. This baseline data will be used to compare with residents who only use the online format in the future. Positive feedback on ease of using the online module confirms that the template is functional. A more formal objective evaluation is planned. The variety of learning preferences within this small group indicates that face-to-face instruction is preferred by some, but that online modules will better meet the needs of others and appear to be an adequate way to expand our overall reach

The Advanced Study Program in Science: challenging, motivating and inspiring our best science students

The Advanced Study Program in Science is an enrichment program for science students at The University of Queensland (UQ) which targets highly motivated, high achieving students with an interest in research and a career in science. The program is coordinated across the full three years of the degree with the core aims of: • providing a cohort experience with a group of like-minded individuals which becomes a closely bonded learning community throughout the undergraduate experience and beyond; • exposing motivated and interested students to the research culture of the university and the myriad of career opportunities in science; • allowing these students to gain genuine research laboratory experience earlier and more intensely than in a regular undergraduate degree program; and • challenging these students to develop complex problem solving skills. The program has an enrolment of approximately 40 students per year and these students participate in a number of cohort building exercises including science camps, team assignments and social activities. The students gain academic credit for three specific courses, one in each year, which consist of seminar attendance, research projects, discussion groups and advanced laboratory exercises. The results of the research projects completed in second and third year are presented within an authentic science context at an Annual Undergraduate Research Symposium as either oral or poster presentations. The Advanced Study Program has been very successful in providing immediate and accessible links between the science research occurring at UQ and the undergraduate learning environment

Blaming Active Volcanoes or Active Volcanic Blame? Volcanic Crisis Communication and Blame Management in the Cameroon

This chapter examines the key role of blame management and avoidance in crisis communication with particular reference to developing countries and areas that frequently experience volcanic episodes and disasters. In these contexts, the chapter explores a key paradox prevalent within crisis communication and blame management concepts that has been rarely tested in empirical terms (see De Vries 2004; Brändström 2016a). In particular, the chapter examines, what it calls, the ‘paradox of frequency’ where frequency of disasters leads to twin dispositions for crisis framed as either: (i) policy failure (active about volcanic blame on others), where issues of blame for internal incompetency takes centre stage, and blame management becomes a focus of disaster managers, and/or: (ii) as event failure (in this case, the blaming of lack of external capacity on active volcanoes and thereby the blame avoidance of disaster managers). Put simply, the authors investigate whether perceptions of frequency itself is a major determinant shaping the existence, operation, and even perceived success of crisis communication in developing regions, and countries experiencing regular disaster episodes. The authors argue frequency is important in shaping the behaviour of disaster managers and rather ironically as part of crisis communication can shape expectations of community resilience and (non)-compliance. In order to explore the implications of the ‘paradox of frequency’ further, the chapter examines the case of the Cameroon, where volcanic activity and events have been regular, paying particular attention to the major disasters in 1986 (Lake Nyos Disaster - LND) and 1999 (Mount Cameroon volcanic eruption - MCE)

Inter-rater reliability of data elements from a prototype of the Paul Coverdell National Acute Stroke Registry

<p>Abstract</p> <p>Background</p> <p>The Paul Coverdell National Acute Stroke Registry (PCNASR) is a U.S. based national registry designed to monitor and improve the quality of acute stroke care delivered by hospitals. The registry monitors care through specific performance measures, the accuracy of which depends in part on the reliability of the individual data elements used to construct them. This study describes the inter-rater reliability of data elements collected in Michigan's state-based prototype of the PCNASR.</p> <p>Methods</p> <p>Over a 6-month period, 15 hospitals participating in the Michigan PCNASR prototype submitted data on 2566 acute stroke admissions. Trained hospital staff prospectively identified acute stroke admissions, abstracted chart information, and submitted data to the registry. At each hospital 8 randomly selected cases were re-abstracted by an experienced research nurse. Inter-rater reliability was estimated by the kappa statistic for nominal variables, and intraclass correlation coefficient (ICC) for ordinal and continuous variables. Factors that can negatively impact the kappa statistic (i.e., trait prevalence and rater bias) were also evaluated.</p> <p>Results</p> <p>A total of 104 charts were available for re-abstraction. Excellent reliability (kappa or ICC > 0.75) was observed for many registry variables including age, gender, black race, hemorrhagic stroke, discharge medications, and modified Rankin Score. Agreement was at least moderate (i.e., 0.75 > kappa ≥; 0.40) for ischemic stroke, TIA, white race, non-ambulance arrival, hospital transfer and direct admit. However, several variables had poor reliability (kappa < 0.40) including stroke onset time, stroke team consultation, time of initial brain imaging, and discharge destination. There were marked systematic differences between hospital abstractors and the audit abstractor (i.e., rater bias) for many of the data elements recorded in the emergency department.</p> <p>Conclusion</p> <p>The excellent reliability of many of the data elements supports the use of the PCNASR to monitor and improve care. However, the poor reliability for several variables, particularly time-related events in the emergency department, indicates the need for concerted efforts to improve the quality of data collection. Specific recommendations include improvements to data definitions, abstractor training, and the development of ED-based real-time data collection systems.</p

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Existential Loneliness and end-of-life care: A Systematic Review

Contains fulltext : 88662.pdf (publisher's version ) (Closed access)Patients with a life-threatening illness can be confronted with various types of loneliness, one of which is existential loneliness (EL). Since the experience of EL is extremely disruptive, the issue of EL is relevant for the practice of end-of-life care. Still, the literature on EL has generated little discussion and empirical substantiation and has never been systematically reviewed. In order to systematically review the literature, we (1) identified the existential loneliness literature; (2) established an organising framework for the review; (3) conducted a conceptual analysis of existential loneliness; and (4) discussed its relevance for end-of-life care. We found that the EL concept is profoundly unclear. Distinguishing between three dimensions of EL-as a condition, as an experience, and as a process of inner growth-leads to some conceptual clarification. Analysis of these dimensions on the basis of their respective key notions-everpresent, feeling, defence; death, awareness, difficult communication; and inner growth, giving meaning, authenticity-further clarifies the concept. Although none of the key notions are unambiguous, they may function as a starting point for the development of care strategies on EL at the end of life.1 april 201

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment