Expert Finding in Disparate Environments

Providing knowledge workers with access to experts and communities-of-practice is central to expertise sharing, and crucial to effective organizational performance, adaptation, and even survival. However, in complex work environments, it is difficult to know who knows what across heterogeneous groups, disparate locations, and asynchronous work. As such, where expert finding has traditionally been a manual operation there is increasing interest in policy and technical infrastructure that makes work visible and supports automated tools for locating expertise. Expert finding, is a multidisciplinary problem that cross-cuts knowledge management, organizational analysis, and information retrieval. Recently, a number of expert finders have emerged; however, many tools are limited in that they are extensions of traditional information retrieval systems and exploit artifact information primarily. This thesis explores a new class of expert finders that use organizational context as a basis for assessing expertise and for conferring trust in the system. The hypothesis here is that expertise can be inferred through assessments of work behavior and work derivatives (e.g., artifacts). The Expert Locator, developed within a live organizational environment, is a model-based prototype that exploits organizational work context. The system associates expertise ratings with expert’s signaling behavior and is extensible so that signaling behavior from multiple activity space contexts can be fused into aggregate retrieval scores. Post-retrieval analysis supports evidence review and personal network browsing, aiding users in both detection and selection. During operational evaluation, the prototype generated high-precision searches across a range of topics, and was sensitive to organizational role; ranking true experts (i.e., authorities) higher than brokers providing referrals. Precision increased with the number of activity spaces used in the model, but varied across queries. The highest performing queries are characterized by high specificity terms, and low organizational diffusion amongst retrieved experts; essentially, the highest rated experts are situated within organizational niches

This work was supported by The Department of the Interior Alaska Climate Adaptation Science Center, which is managed by the USGS National Climate Adaptation Science Center.

53 pages : color illustrations, color maps ; 28 cmThis report is designed as a living document to inform the community, decision makers, and academics and to serve as a learning and teaching tool. The nine key messages summarized on pages 6 and 7 are intended for use as a quick reference. Unique for this type of report, these key messages highlight actions by Juneau's civil society, including local nonprofit organizations.We thank the City and Borough of Juneau (CBJ) for its support in bringing this vital information on climate change to the Juneau community and to others. Thanks especially to all the co-authors and other contributors. The inclusion of such a diverse array of material, including local knowledge, was made possible by the many elders, scientists, and local experts who contributed their time and expertise. The report is online at acrc.alaska.edu/ juneau-climate-report. It is an honor to be the lead editor and project manager for this critical effort. We have a chance to save our world from the most extreme effects of climate change. Let us take it. Gunalchéesh, sincerely, James E. Powell (Jim), PhD, Alaska Coastal Rainforest Center, UASWelcome / Thomas F. Thornton -- Juneau's climate report: History and background / Bruce Botelho -- Using this report -- Acknowledgements / James E. Powell -- A regional Indigenous perspective on adaptation: The Central Council of Tlingit & Haida Indian Tribes of Alaska's Climate Change Adaptation Plan / Raymond Paddock -- Nine key messages -- What we're experiencing: Atmospheric, marine, terrestrial, and ecological effects. Climate. Setting and seasons / Tom Ainsworth -- More precipitation / Rick Thoman -- Higher temperatures / Rich Thoman -- Less snowfall / Eran Hood -- Ocean. Surface uplift and sea level rise / Eran Hood -- Extensive effects of a warming ocean / Heidi Pearson -- Increasing ocean acidification / Robert Foy -- Land. More landslides / Sonia Nagorski & Aaron Jacobs -- Mendenhall Glacier continues to retreat / Jason Amundson -- Tongass Forest impacts and carbon / Dave D'Amore -- Animals. Terrestrial vertebrates in A¿¿ak'w & T'aak¿łu Aani¿¿ / Richard Carstensen -- Three animals as indicators of change / Richard Carstensen -- Insects / Bob Armstrong -- What we're doing: Community response. Upgrading ifrastructure and mitigation / Katie Koester -- Upgrading utilities and other energy consumers / Alec Mesdag -- Growing demand for hydropower / Duff Mitchell -- Leading a shift in transportation / Duff Mitchell -- Maintaining mental health through community and recreation / Linda Kruger & Kevin Maier -- Food security / Darren Snyder & Jim Powell -- Large cruise ship air emissions / Jim Powell -- Tourists' views on climate change mitigation / Jim Powell -- Lowering greenhouse gas emissions / Jim Powell & Peggy Wilcox -- Residents taking action / Andy Romanoff & Jim Powell -- Summary and Recommendations -- References -- Graphics and data sources -- Appendix: Juneau nonprofit climate change organization

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Expert finding in disparate envirnoments

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