Opportunities and challenges of using web 2.0 technologies in government

Public administration has endured signification transformation over the last decade enabled largely through Information and Communication Technology. In recent times, second generation web technologies (Web 2.0) such as social media and networking sites are increasingly being used by governments for its digital activities ranging from public relations to knowledge management. However, as Web 2.0 technologies are more interactive than the traditional models of information provision or creation of digital services, these technologies have brought about a new set of opportunities and challenges to those government authorities. This study draws on the extant literature to examine the opportunities that Web 2.0 technologies offer to public authorities and the challenges they may need to overcome when integrating these technologies into their work practices

The role of e-participation and open data in evidence-based policy decision making in local government

The relationships between policies, their values and outcomes are often difficult for citizens and policy makers to assess due to the complex nature of the policy lifecycle. With the opening of data by public administrations there is now a greater opportunity for transparency, accountability and evidence-based decision making in the policy making process. In representative democracies, citizens rely on their elected representatives and local administrations to take policy decisions that address societal challenges and add value to their local communities. Citizens now have the opportunity to assess the impact and values of the policies introduced by their elected representatives and hold them accountable by utilising historical open data that is publicly available. Using a qualitative case study in a UK Local Government Authority, this paper examines how e-participation platforms and the use of open data can facilitate more factual, evidence based and transparent policy decision making and evaluation. From a theoretical stance, this paper contributes to the policy lifecycle and e-participation literature. The paper also offers valuable insights to public administrations on how open data can be utilised for evidence-based policy decision making and evaluationThis work evolved in the context of the project Policy Compass (http://policycompass.eu/), a project co-funded by the EC within FP7, Grant agreement no: 612133

Case report: The management of advanced oral cancer in a Jehovah's Witness using the Ultracision Harmonic Scalpel

We present the first case of a head and neck oncological procedure accomplished in a Jehovah's Witness using the Ultracision Harmonic Scalpel (Ethicon, Cincinnati, OH). Jehovah's Witnesses present a serious challenge to the head and neck cancer surgeon due to their refusal to accept transfusion of any blood products. However, our experience reinforces the view that surgical management of head and neck cancer is possible in these patients. We show the Harmonic Scalpel, an ultrasonic tissue dissector, to be a useful surgical tool in obviating the need for blood transfusion. Preoperative optimisation, intra-operative surgical and anaesthetic techniques are also fully discussed

Implementation of neuro-oncology service reconfiguration in accordance with NICE guidance provides enhanced clinical care for patients with glioblastoma multiforme.

BACKGROUND: Brain tumours account for <2% of all primary neoplasms but are responsible for 7% of the years of life lost from cancer before age 70 years. The latest survival trends for patients with CNS malignancies have remained largely static. The objective of this study was to evaluate the change in practice as a result of implementing the Improving Outcomes Guidance from the UK National Institute for Health and Clinical Excellence (NICE). METHODS: Patients were identified from the local cancer registry and hospital databases. We compared time from diagnosis to treatment, proportion of patients discussed at multidisciplinary team (MDT) meetings, treatment received, length of inpatient stay and survival. Inpatient and imaging costs were also estimated. RESULTS: Service reconfiguration and implementation of NICE guidance resulted in significantly more patients being discussed by the MDT--increased from 66 to 87%, reduced emergency admission in favour of elective surgery, reduced median hospital stay from 8 to 4.5 days, increased use of post-operative MRI from 17 to 91% facilitating early discharge and treatment planning, and reduced cost of inpatient stay from £2096 in 2006 to £1316 in 2009. Patients treated with optimal surgery followed by radiotherapy with concomitant and adjuvant temozolomide achieved outcomes comparable to those reported in clinical trials: median overall survival 18 months (2-year survival 35%). CONCLUSIONS: Advancing the management of neuro-oncology patients by moving from an emergency-based system of patient referral and management to a more planned elective outpatient-based pattern of care improves patient experience and has the potential to deliver better outcomes and research opportunities

High-Pitch, Low-Voltage and Low-Iodine-Concentration CT Angiography of Aorta: Assessment of Image Quality and Radiation Dose with Iterative Reconstruction

Objective: To assess the image quality of aorta obtained by dual-source computed tomography angiography (DSCTA), performed with high pitch, low tube voltage, and low iodine concentration contrast medium (CM) with images reconstructed using iterative reconstruction (IR). Methods: One hundred patients randomly allocated to receive one of two types of CM underwent DSCTA with the electrocardiogram-triggered Flash protocol. In the low-iodine group, 50 patients received CM containing 270 mg I/mL and were scanned at low tube voltage (100 kVp). In the high-iodine CM group, 50 patients received CM containing 370 mg I/mL and were scanned at the tube voltage (120 kVp). The filtered back projection (FBP) algorithm was used for reconstruction in both groups. In addition, the IR algorithm was used in the low-iodine group. Image quality of the aorta was analyzed subjectively by a 3-point grading scale and objectively by measuring the CT attenuation in terms of the signal- and contrast-to-noise ratios (SNR and CNR, respectively). Radiation and CM doses were compared.Results: The CT attenuation, subjective image quality assessment, SNR, and CNR of various aortic regions of interest did not differ significantly between two groups. In the low-iodine group, images reconstructed by FBP and IR demonstrated significant differences in image noise, SNR, and CNR (p<0.05). The low-iodine group resulted in 34.3% less radiation (4.4 ± 0.5 mSv) than the high-iodine group (6.7 ± 0.6 mSv), and 27.3% less iodine weight (20.36 ± 2.65 g) than the high-iodine group (28 ± 1.98 g). Observers exhibited excellent agreement on the aortic image quality scores (κ = 0.904). Conclusions: CT images of aorta could be obtained within 2 s by using a DSCT Flash protocol with low tube voltage, IR, and low-iodine-concentration CM. Appropriate contrast enhancement was achieved while maintaining good image quality and decreasing the radiation and iodine doses

Functional Changes in Muscle Afferent Neurones in an Osteoarthritis Model: Implications for Impaired Proprioceptive Performance

Impaired proprioceptive performance is a significant clinical issue for many who suffer osteoarthritis (OA) and is a risk factor for falls and other liabilities. This study was designed to evaluate weight-bearing distribution in a rat model of OA and to determine whether changes also occur in muscle afferent neurones.Intracellular recordings were made in functionally identified dorsal root ganglion neurones in acute electrophysiological experiments on the anaesthetized animal following measurements of hind limb weight bearing in the incapacitance test. OA rats but not naïve control rats stood with less weight on the ipsilateral hind leg (P = 0.02). In the acute electrophysiological experiments that followed weight bearing measurements, action potentials (AP) elicited by electrical stimulation of the dorsal roots differed in OA rats, including longer AP duration (P = 0.006), slower rise time (P = 0.001) and slower maximum rising rate (P = 0.03). Depolarizing intracellular current injection elicited more APs in models than in naïve muscle afferent neurones (P = 0.01) indicating greater excitability. Axonal conduction velocity in model animals was slower (P = 0.04).The present study demonstrates changes in hind limb stance accompanied by changes in the functional properties of muscle afferent neurones in this derangement model of OA. This may provide a possible avenue to explore mechanisms underlying the impaired proprioceptive performance and perhaps other sensory disorders in people with OA

e-Diplomacy: a systematic literature review

Digital diplomacy (also popularly known as e-Diplomacy), is generally defined as the use of information and communication technology for purposes of attaining foreign policy goals. Many experts have particularly defined digital diplomacy as an electronic component of public diplomacy. Although digital diplomacy is an emerging new field with a wide range of important applications in international relations, only a few previous studies have been conducted in this area. This has contributed to a significant research gap. The primary aim of this paper is to provide an analysis of the current e-diplomacy studies based on a systematic literature review research methodology. The results have highlighted two key findings. Firstly, most of the previous studies have been primarily conducted in North America and Europe. Secondly, the majority of studies adopted qualitative methods to gather new empirical evidence to support existing literature and develop new propositions on e-Diplomacy. Finally, based on the findings, the paper highlights a few areas in which further research may be needed in order to help develop the emerging concept of e-Diplomacy