Dead Man Walking

Dead Man Walking a staged reading of the script by Tim Robbins, based on the book by Sr. Helen Prejean was presented at John Carroll University as part of the Dean Man Walking School Theatre Project. March 18-20, 2005.https://collected.jcu.edu/plays/1140/thumbnail.jp

Evaluation of patient perception towards dynamic health data sharing using blockchain based digital consent with the Dovetail digital consent application : a cross sectional exploratory study

Background New patient-centric integrated care models are enabled by the capability to exchange the patient’s data amongst stakeholders, who each specialise in different aspects of the patient’s care. This requires a robust, trusted and flexible mechanism for patients to offer consent to share their data. Furthermore, new IT technologies make it easier to give patients more control over their data, including the right to revoke consent. These characteristics challenge the traditional paper-based, single-organisation-led consent process. The Dovetail digital consent application uses a mobile application and blockchain based infrastructure to offer this capability, as part of a pilot allowing patients to have their data shared amongst digital tools, empowering patients to manage their condition within an integrated care setting. Objective To evaluate patient perceptions towards existing consent processes, and the Dovetail blockchain based digital consent application as a means to manage data sharing in the context of diabetes care. Method Patients with diabetes at a General Practitioner practice were recruited. Data were collected using focus groups and questionnaires. Thematic analysis of the focus group transcripts and descriptive statistics of the questionnaires was performed. Results There was a lack of understanding of existing consent processes in place, and many patients did not have any recollection of having previously given consent. The digital consent application received favourable feedback, with patients recognising the value of the capability offered by the application. Patients overwhelmingly favoured the digital consent application over existing practice. Conclusions Digital consent was received favourably, with patients recognising that it addresses the main limitations of the current process. Feedback on potential improvements was received. Future work includes confirmation of results in a broader demographic sample and across multiple conditions

Debt as Power

FROM THE EDITOR’S INTRODUCTION: In Debt as Power, Di Muzio and Robbins present a historical account of the modern origins of capitalist debt by looking at how commercial money is produced as debt in the late seventeenth and early eighteenth centuries. They expertly demonstrate their key contention -- that debt is a technology of power -- and identify the ways in which the control, production, and distribution of money, as interest-bearing debt, are used to discipline populations. Their sharp analysis brings together histories of the development of the Bank of England and the establishment of permanent national debt with the intensification and expansion of debt, as a “technology of power”, under colonialism in a global context. The latter part of the book addresses the consequences of modern regimes of debt and puts forward proposals of what needs to be done, politically, to reverse the problems generated by debt-based economies. The final chapter presents a convincing case for the 99% to use the power of debt to challenge present inequalities and outlines a platform for action suggesting possible alternatives

Debt as Power

capitalization of the state national debt money power warFROM THE EDITOR’S INTRODUCTION: In Debt as Power, Di Muzio and Robbins present a historical account of the modern origins of capitalist debt by looking at how commercial money is produced as debt in the late seventeenth and early eighteenth centuries. They expertly demonstrate their key contention -- that debt is a technology of power -- and identify the ways in which the control, production, and distribution of money, as interest-bearing debt, are used to discipline populations. Their sharp analysis brings together histories of the development of the Bank of England and the establishment of permanent national debt with the intensification and expansion of debt, as a “technology of power”, under colonialism in a global context. The latter part of the book addresses the consequences of modern regimes of debt and puts forward proposals of what needs to be done, politically, to reverse the problems generated by debt-based economies. The final chapter presents a convincing case for the 99% to use the power of debt to challenge present inequalities and outlines a platform for action suggesting possible alternatives

Reorganisation of cortical oscillatory dynamics underlying disinhibition in frontotemporal dementia

The distribution of pathology in frontotemporal dementia is anatomically selective, to distinct cortical regions and with differential neurodegeneration across the cortical layers. The cytoarchitecture and connectivity of cortical laminae preferentially supports frequency-specific oscillations and hierarchical information transfer between brain regions. We therefore predicted that in frontotemporal dementia, core functional deficits such as disinhibition would be associated with differences in the frequency spectrum and altered cross-frequency coupling between frontal cortical regions. We examined this hypothesis using a “Go-NoGo” response inhibition paradigm with eighteen patients with behavioural variant frontotemporal dementia and 20 healthy aged-matched during magnetoencephalography. During Go and NoGo trials, beta desynchronisation was severely attenuated in patients. Beta power was associated with increased impulsivity, as measured by the Cambridge Behavioural Inventory, a carer based questionnaire of changes in everyday behaviour. To quantify the changes in cross-frequency coupling in the frontal lobe, we used Dynamic Causal Modeling to test a family of hierarchical casual models, which included the inferior frontal gyrus, pre-supplementary motor area (preSMA) and primary motor cortex. This analysis revealed evidence for cross-frequency coupling in a fully connected network in both groups. However, in the patient group, we identified a significant loss of reciprocal connectivity of the inferior frontal gyrus, particularly for interactions in the gamma band and for theta to alpha coupling. Importantly, although prefrontal coupling was diminished, gamma connectivity between preSMA and motor cortex was enhanced in patients. We propose that the disruption of behavioural control arises from reduced frequency-specific connectivity of the prefrontal cortex, together with a hyper-synchronous reorganisation of connectivity among preSMA and motor regions. These results are supported by preclinical evidence of the selectivity of frontotemporal lobar degeneration on oscillatory dynamics, and provide a clinically relevant yet precise neurophysiological signature of behavioural control as a potential pharmacological target for early phase experimental medicines studies.This work was primarily funded by the Wellcome Trust (103838) with additional support from the Medical Research Council (MC-A060-5PQ30, and RG62761) and the NIHR Cambridge Biomedical Research Centre and Cambridge Brain Bank. The BCNI is supported by a joint award from the Wellcome Trust and Medical Research Council

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Study on “employment aspects of slum upgrading” practices and opportunities identified i

Factors associated with poor outcomes when patients with diabetes are discharged from hospital : a health informatics approach

Background: People with diabetes are at increased risk of adverse events, whilst admitted to hospital. Significant research has characterised this increased risk. There is also evidence that patients with diabetes are at increased risk, following hospital discharge; however, much less research has considered this area. This thesis aims to explore approaches and associations to understanding the risk of readmission and mortality, when patients are discharged from hospital with diabetes. Methods: Initial patient public involvement grounded this research in areas that were most important to patients themselves. A systematic review of known risk factors for readmission, when patients are discharged from hospital with diabetes, was conducted. A subsequent comparison was made to risk factors identified in the literature for mortality outcomes. Extraction of retrospective data was performed for all adult patients discharged, with a diagnosis of diabetes, from a major UK tertiary referral centre over a 3-year period. The data extraction and subsequent analysis were directly informed by systematic review results. Associations between risk factors and adverse events were identified and evaluated with calculation of effect size statistics. Results: Forty-seven studies identified statistically significant risk factors for readmission. This resulted in 72 distinct risk factors divided across 7 separate categories. Similar categories could be identified when considering mortality outcomes, however a much smaller number of studies and risk factors were identified. Analysis of extracted retrospective data identified utility of effect size measures in evaluating associations, with particularly important associations noted for socio-economic and biochemistry related factors. Clear associations are reported between socio-economic status and readmission for patients with T1DM and socioeconomic status and mortality for patients with T2DM. Hba1c values are further demonstrated statistically significantly associated with 30-day readmission and 365-day mortality Discussion: This thesis identifies new knowledge regarding negative outcomes when patients with diabetes are discharged from hospital. This understanding is important to developing interventions to reduce such outcomes. Future work will look to understand causal links between these risk factors and outcomes, as well as developing informatics-based algorithms targeting at understanding each person’s individual risk

E-health for active ageing : a systematic review

Enabling successful active ageing is an international priority to meet the challenges of increasing life expectancy. Digital strategies, such as telemedicine and e-health, offer the potential to deliver active ageing in a cost-effective manner at scale. This article aims to establish the extent to which the research literature considers e-health-based and telemedicine-based active ageing interventions. A systematic review was conducted according to PRISMA standards. Independently, two authors searched the Cochrane, EMBASE & CINAHL databases, with subsequent independent extraction and semi-quantitative analysis. We report a considerable breadth in digital active ageing research, which is truly international in its scope. There is a diverse range of both interventions and technologies, including a reassuring focus on community-based interventions. Whilst there are a number of quantitative studies, sample sizes are small, with a limited amount of statistical testing of the results. There is significant variation in the outcome measures reported and little consensus as to the most effective intervention strategies. Overall, whilst there is considerable breadth to the research published in the literature, there is a clear restriction in the depth of this research. There is little overall consensus. This lack of depth and consensus may be due to the need to recognize the important role of technical research elements alongside more traditional research methodologies, such as randomized controlled trials. Enabling both technical and clinical research methods to be recognized, in tandem, has enormous potential to support individuals, communities, clinicians and policy makers to make more informed decisions in relation to active ageing

Public Awareness of Medical Imaging as a Source of Ionizing Radiation Exposure

Background. Biological effects of exposure to ionizing radiation (IR) are well known. Literature suggests most patients and physicians lack proficient understanding of risks associated with ionizing radiation. Our study goals were to: assess the extent to which productive, informed conversations regarding ionizing radiation are occurring between patients and providers; characterize public awareness of medical imaging procedures as sources of IR exposure; and investigate best practices in patientprovider communications. Methods. We developed and administered a 17-question survey to 303 adults at five locations across Chittenden County, Vermont, over a 6-week period in fall 2016. Descriptive and statistical analyses were conducted using SPSS. Results. The three age groups of respondents had different knowledge levels about ionizing radiation (p Conclusions/Recommendations. 1. A standard oral presentation for pre-imaging patient-provider communication, along with a written handout, be developed; 2. A section of the electronic medical record (also accessible through the patient portal) containing IR exposure be created for patients and physicians to track individuals\u27 information.https://scholarworks.uvm.edu/comphp_gallery/1249/thumbnail.jp