Using Social Media to Enable Staff Knowledge Sharing in Higher Education Institutions

Higher education institutions (HEIs) are knowledge intensive environments by nature. However, the management of organisational knowledge and the promotion of staff knowledge sharing is largely neglected in these institutions. This study examines how enterprise social networks can enable staff knowledge sharing in communities of practice in that context. The study is framed as an Action Research project, covering three cycles over a 12 month period. A conceptual model was developed for empirical testing and data was collected through focus groups and interviews, supplemented by reflective journaling and content analysis. The findings support the conceptual model and provide insight into the antecedents necessary for the creation of an enterprise social network enabled knowledge sharing environment, the motivators for and barriers to participation, and the perceived organisational and individual benefits of increased staff knowledge sharing activity. The findings indicate that the barriers to participation are influenced by the prevalent organisation structure and culture, and a divide between faculty and other staff. However, individual benefits that accrue from participation may influence greater participation, and organisational benefits that accrue may influence organisational strategies that drive change in structure and culture to promote the development of the knowledge sharing environment. A number of findings have practical implications for the management of higher education institutions, such as the evidence of a divide between faculty and other staff, and the perceived existence of an organisational culture that inhibits staff communication, interaction and collaboration. In general, the study findings provide an opportunity for educationalists to better understand the scope and impact of employing social media platforms for knowledge sharing. This study adds to the growing body of work on organisational implementations of social media, and should be of interest to practitioners and researchers undertaking similar projects

Management Support for Staff Knowledge Sharing in Higher Education Institutions (JAHE)

Purpose of the research: This study focuses on staff knowledge sharing activity in higher education institutions (HEIs), which is recognised as being at low levels in these organisations. The advent of social media and its adoption by organisations in the form of enterprise social networks (ESN) is gathering pace, and its usefulness to organisational knowledge sharing can be seen through a number of characteristics it shares with a knowledge management technique known as communities of practice. A conceptual model is presented with enterprise social networks and virtual communities of practice (vCoP) at its core. The formal objective of the research is to investigate how ESN can enable staff knowledge sharing in vCoP in HEIs. Methodology: The study is based on a 12 month Action research project in the host organization, a medium-sized HEI in Ireland. The study is qualitative in nature and data collection instruments included focus groups and semi-structured interviews. Findings: The findings indicate that management support is a key antecedent for the establishment if an active knowledge sharing environment. Management must facilitate and encourage knowledge sharing activities rather than mandating or instructing them. Implications: The findings have implications for HEIs in their attitudes towards knowledge sharing and their understanding of its importance. The findings can also help in the creation and management of active knowledge sharing communities in HEIs and will be of interest to practitioners and researchers working in this area

Defining Prostatic Vascular Pedicle Recurrence and the Anatomy of Local Recurrence of Prostate Cancer on Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography.

Background The term local recurrence in prostate cancer is considered to mean persistent local disease in the prostatic bed, most commonly at the site of the vesicourethral anastomosis (VUA). Since the introduction of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging for assessment of early biochemical recurrence (BCR), we have found histologically confirmed prostate cancer in the prostatic vascular pedicle (PVP). If a significant proportion of local recurrences are distant to the VUA, it may be possible to alter adjuvant and salvage radiation fields in order to reduce the potential morbidity of radiation in selected patients. Objective To describe PVP local recurrence and to map the anatomic pattern of prostate bed recurrence on PSMA PET/CT. Design setting and participants This was a retrospective multicentre study of 185 patients imaged with PSMA PET/CT following radical prostatectomy (RP) between January 2016 and November 2018. All patient data and clinical outcomes were prospectively collected. Recurrences were documented according to anatomic location. For patients presenting with local recurrence, the precise location of the recurrence within the prostate bed was documented. Intervention PSMA PET/CT for BCR following RP. Results and limitations A total of 43 local recurrences in 41/185 patients (22%) were identified. Tumour recurrence at the PVP was found in 26 (63%), VUA in 15 (37%), and within a retained seminal vesicle and along the anterior rectal wall in the region of the neurovascular bundle in one (2.4%) each. Histological and surgical evidence of PVP recurrence was acquired in two patients. The study is limited by its retrospective nature with inherent selection bias. This is an observational study reporting on the anatomy of local recurrence and does not include follow-up for patient outcomes. Conclusions Our study showed that prostate cancer can recur in the PVP and is distant to the VUA more commonly than previously thought. This may have implications for RP technique and for the treatment of selected patients in the local recurrence setting. Patient summary We investigated more precise identification of the location of tumour recurrence after removal of the prostate for prostate cancer. We describe a new definition of local recurrence in an area called the prostatic vascular pedicle. This new concept may alter the treatment recommended for recurrent disease

Same day discharge for robot-assisted radical prostatectomy: a prospective cohort study documenting an Australian approach.

BACKGROUND The introduction of robotic surgical systems has significantly impacted urological surgery, arguably more so than other surgical disciplines. The focus of our study was length of hospital stay - patients have traditionally been discharged day 1 post-robot-assisted radical prostatectomy (RARP), however, during the ongoing COVID-19 pandemic and consequential resource limitations, our centre has facilitated a cohort of same-day discharges with initial success. METHODS We conducted a prospective tertiary single-centre cohort study of a series of all patients (n = 28) - undergoing RARP between January and April 2021. All patients were considered for a day zero discharge pathway which consisted of strict inclusion criteria. At follow-up, each patient's perspective on their experience was assessed using a validated post-operative satisfaction questionnaire. Data were reviewed retrospectively for all those undergoing RARP over the study period, with day zero patients compared to overnight patients. RESULTS Overall, 28 patients 20 (71%) fulfilled the objective criteria for day zero discharge. Eleven patients (55%) agreed pre-operatively to day zero discharge and all were successfully discharged on the same day as their procedure. There was no statistically significant difference in age, BMI, ASA, Charlson score or disease volume. All patients indicated a high level of satisfaction with their procedure. Median time from completion of surgery to discharge was 426 min (7.1 h) in the day zero discharge cohort. CONCLUSION Day zero discharge for RARP appears to deliver high satisfaction, oncological and safety outcomes. Therefore, our study demonstrates early success with unsupported same-day discharge in carefully selected and pre-counselled patients

National Self-Harm Registry Ireland annual report 2017.

This is the sixteenth annual report from the National Self-Harm Registry Ireland. It is based on data collected on persons presenting to hospital emergency departments following self-harm in 2017 in the Republic of Ireland. The Registry had near complete coverage of the country’s hospitals for the period 2002-2005 and, since 2006, all general hospital and paediatric hospital emergency departments in the Republic of Ireland have contributed data to the Registry. Role of alcohol in self-harm: Alcohol was involved in 31% of all cases. Alcohol was significantly more often involved in male episodes of self-harm than female episodes (33% and 29%, respectively). In line with previous years, misuse or abuse of alcohol is one of the factors associated with the higher rate of self-harm presentations on Sundays, Mondays and public holidays, around the hours of midnight. Recent publications from the Registry data have highlighted the role of alcohol in selfharm. Such complex presentations indicate the need for active consultation and collaboration between the mental health services and addiction treatment services for patients who present with dual diagnoses. In addition, alcohol involvement has been shown to be strongly associated with self-harm presentations out-of-hours, at weekends and on public holidays. The Registry findings related to alcohol provide further support for the full implementation of the Public Health (Alcohol) Bill, which would introduce evidence-based policies to reduce the burden of alcohol harm on our society by improving health, safety and wellbeing. Restricting access to means: …In line with previous years, drug overdose was the most common method of self-harm recorded. Over the years, the Registry has identified the drug types most frequently involved in intentional overdoses. New research has classified the range of drugs recorded by the Registry according to the World Health Organisation’s (WHO) Anatomical Therapeutic Chemical (ATC) classification system. This work has systematically classified the wide range of drugs involved in intentional overdoses, and will be instrumental in facilitating comparative work in this area. This system has allowed for examination of trends in specific drug types, with a recent publication highlighting the increasing involvement of gabapentinoids (prescription-only neuropathic pain medication). Despite a decrease in their involvement in intentional overdose in 2017, minor tranquillisers have been the most frequently used type of drug involved in intentional overdoses. Reducing access to frequently used drugs should be an ongoing priority

Inferring structural variant cancer cell fraction.

We present SVclone, a computational method for inferring the cancer cell fraction of structural variant (SV) breakpoints from whole-genome sequencing data. SVclone accurately determines the variant allele frequencies of both SV breakends, then simultaneously estimates the cancer cell fraction and SV copy number. We assess performance using in silico mixtures of real samples, at known proportions, created from two clonal metastases from the same patient. We find that SVclone's performance is comparable to single-nucleotide variant-based methods, despite having an order of magnitude fewer data points. As part of the Pan-Cancer Analysis of Whole Genomes (PCAWG) consortium, which aggregated whole-genome sequencing data from 2658 cancers across 38 tumour types, we use SVclone to reveal a subset of liver, ovarian and pancreatic cancers with subclonally enriched copy-number neutral rearrangements that show decreased overall survival. SVclone enables improved characterisation of SV intra-tumour heterogeneity

Androgen deprivation therapy promotes an obesity-like microenvironment in periprostatic fat

Prostate cancer is a leading cause of morbidity and cancer-related death worldwide. Androgen deprivation therapy (ADT) is the cornerstone of management for advanced disease. The use of these therapies is associated with multiple side effects, including metabolic syndrome and truncal obesity. At the same time, obesity has been associated with both prostate cancer development and disease progression, linked to its effects on chronic inflammation at a tissue level. The connection between ADT, obesity, inflammation and prostate cancer progression is well established in clinical settings; however, an understanding of the changes in adipose tissue at the molecular level induced by castration therapies is missing. Here, we investigated the transcriptional changes in periprostatic fat tissue induced by profound ADT in a group of patients with high-risk tumours compared to a matching untreated cohort. We find that the deprivation of androgen is associated with a pro-inflammatory and obesity-like adipose tissue microenvironment. This study suggests that the beneficial effect of therapies based on androgen deprivation may be partially counteracted by metabolic and inflammatory side effects in the adipose tissue surrounding the prostate

Active involvement of nursing staff in reporting and grading complication-intervention events-Protocol and results of the CAMUS Pilot Nurse Delphi Study.

Objectives The aim of this study is to gain experienced nursing perspective on current and future complication reporting and grading in Urology, establish the CAMUS CCI and quality control the use of the Clavien-Dindo Classification (CDC) in nursing staff. Subjects and Methods The 12-part REDCap-based Delphi survey was developed in conjunction with expert nurse, urologist and methodologist input. Certified local and international inpatient and outpatient nurses specialised in urology, perioperative nurses and urology-specific advanced practice nurses/nurse practitioners will be included. A minimum sample size of 250 participants is targeted. The survey assesses participant demographics, nursing experience and opinion on complication reporting and the proposed CAMUS reporting recommendations; grading of intervention events using the existing CDC and the proposed CAMUS Classification; and rating various clinical scenarios. Consensus will be defined as ≥75% agreement. If consensus is not reached, subsequent Delphi rounds will be performed under Steering Committee guidance. Results Twenty participants completed the pilot survey. Median survey completion time was 58 min (IQR 40-67). The survey revealed that 85% of nursing participants believe nurses should be involved in future complication reporting and grading but currently have poor confidence and inadequate relevant background education. Overall, 100% of participants recognise the universal demand for reporting consensus and 75% hold a preference towards the CAMUS System. Limitations include variability in nursing experience, complexity of supplemental grades and survey duration. Conclusion The integration of experienced nursing opinion and participation in complication reporting and grading systems in a modern and evolving hospital infrastructure may facilitate the assimilation of otherwise overlooked safety data. Incorporation of focused teaching into routine nursing education will be essential to ensure quality control and stimulate awareness of complication-related burden. This, in turn, has the potential to improve patient counselling and quality of care

Detection of ctDNA in plasma of patients with clinically localised prostate cancer is associated with rapid disease progression.

BACKGROUND DNA originating from degenerate tumour cells can be detected in the circulation in many tumour types, where it can be used as a marker of disease burden as well as to monitor treatment response. Although circulating tumour DNA (ctDNA) measurement has prognostic/predictive value in metastatic prostate cancer, its utility in localised disease is unknown. METHODS We performed whole-genome sequencing of tumour-normal pairs in eight patients with clinically localised disease undergoing prostatectomy, identifying high confidence genomic aberrations. A bespoke DNA capture and amplification panel against the highest prevalence, highest confidence aberrations for each individual was designed and used to interrogate ctDNA isolated from plasma prospectively obtained pre- and post- (24 h and 6 weeks) surgery. In a separate cohort (n = 189), we identified the presence of ctDNA TP53 mutations in preoperative plasma in a retrospective cohort and determined its association with biochemical- and metastasis-free survival. RESULTS Tumour variants in ctDNA were positively identified pre-treatment in two of eight patients, which in both cases remained detectable postoperatively. Patients with tumour variants in ctDNA had extremely rapid disease recurrence and progression compared to those where variants could not be detected. In terms of aberrations targeted, single nucleotide and structural variants outperformed indels and copy number aberrations. Detection of ctDNA TP53 mutations was associated with a significantly shorter metastasis-free survival (6.2 vs. 9.5 years (HR 2.4; 95% CIs 1.2-4.8, p = 0.014). CONCLUSIONS CtDNA is uncommonly detected in localised prostate cancer, but its presence portends more rapidly progressive disease