Assessment of Ubiquitous Healthcare Information Systems Benefits

Health is a fully individualized concern, and is therefore inherently mobile. Thus, Ubiquitous Healthcare Information Systems can enable a much-needed patient-centered care environment. This paper presents a decision support system that makes use of system dynamics methodologies in order to assess the improved health benefits that may be realized within the context of ubiquitous healthcare information systems in support of managing diabetes

Nonocular Melanocytic Neoplasia in Cats: Characterization and Proposal of a Histologic Classification Scheme to More Accurately Predict Clinical Outcome

Nonocular melanocytic neoplasia is considered uncommon in cats yet is routinely encountered in diagnostic pathology and recognized to exhibit a wide variation in biological behavior. Accurate prediction of clinical outcomes is challenging with no widely recognized prognostic criteria. Signalment and tumor location were retrospectively evaluated in 324 cats diagnosed with nonocular melanocytic neoplasia. Histologic features were described in 141 neoplasms and outcome data were available in 79 cases. Immunohistochemistry using Melan-A, PNL-2, cyclooxygenase 2 (COX-2), and E-cadherin was performed in a subset (n = 24). Multivariate analysis identified tumor site, mitotic count, and the presence of intratumoral necrosis to be independent predictors of tumor-related death. On the basis of these findings, we propose a novel histologic grading scheme in which nonocular melanocytic neoplasms involving the lips, oral or nasal mucosa, or nasal planum are considered high grade if they fulfill 1 or both of the following criteria: at least 4 mitoses in 10 high-power fields (HPF) or presence of intratumoral necrosis; those arising elsewhere are considered high grade if they fulfill both of the above criteria. Of 79 tumors with outcome data, 43 (54%) were low grade and 36 (46%) were high grade. The grading system had an 80% sensitivity and 92% specificity for predicting tumor-related death in this population of cats. Median survival for cats with low-grade tumors was not reached, and the median survival was 90 days for those with a high-grade tumor. PNL-2 and Melan-A were sensitive markers for feline nonocular melanocytic neoplasia, and although not significantly associated with prognosis, a large proportion expressed COX-2, suggesting a potential therapeutic role for COX-2 inhibitors

Diagnosis of anaplastic large-cell lymphoma in a dog using CD30 immunohistochemistry

Anaplastic large-cell lymphoma or null-cell lymphoma is a clinical entity reported in people, classified according to the unique appearance of large pleomorphic cells that express CD30. Null-cell lymphoma has also been described in dogs when neither CD3 nor CD79α is expressed by the tumor. We describe a case of lymphoma in the dog in which neoplastic cells did not express routine B- or T-lymphocyte markers on flow cytometry or immunohistochemistry; however, cells immunohistochemically labeled for CD30. The dog in our case died 5 mo after initial presentation, confirming a poor prognosis. Identification of further similar cases in dogs would provide additional prognostic information for this subset of lymphomas. CD30 may also serve as a potential therapeutic target in anaplastic large-cell lymphomas

Motivating CIO Advice Networking to Improve Firm Performance

Prior research has examined factors that motivate executives in general to seek advice from external peers. The literature is silent however regarding what IT governance mechanisms motivate CIOs to mindfully seek advice in their external advice networks. Our research shows that simply applying the advice of the prior literature in the CIO and IT governance context can be counterproductive. We analyze data from a survey of 99 municipal corporations to show that an effective configuration of IT governance mechanisms fits and changes over time with the firm’s financial performance and state of IT enactment. The lessons learned are instructive for practitioners, while also highlighting the importance of attending to context in IT governance research

The Association between Seasonal Variation in Vitamin D, Postural Sway, and Falls Risk: An Obversational Cohort Study

Introduction: Low serum vitamin D levels are associated with increased postural sway. Vitamin D varies seasonally. This study investigates whether postural sway varies seasonally and is associated with serum vitamin D and falls. Methods: In a longitudinal observational study, eighty-eight independently mobile community-dwelling older adults (69.7 ± 7.6 years) were evaluated on five occasions over one year, measuring postural sway (force platform), vitamin D levels, fall incidence, and causes and adverse outcomes. Mixed-methods Poisson regression was used to determine associations between measures. Results: Postural sway did not vary over the year. Vitamin D levels varied seasonally (P < 0.001), peaking in summer. Incidence of falls (P=0.01) and injurious falls (P=0.02) were lower in spring, with the highest fall rate at the end of autumn. Postural sway was not related to vitamin D (P=0.87) or fall rates, but it was associated with fall injuries (IRR 1.59 (CI 1.14 to 2.24, P=0.007). Conclusions: Postural sway remained stable across the year while vitamin D varied seasonally. Participants with high values for postural sway demonstrated higher rates of injurious falls. This study provides important evidence for clinicians and researchers providing interventions measuring balance outcomes across seasons

An analysis of Australia's carbon pollution reduction scheme

The authors review the decision-making since the Labour Government came into office (November 2007). The Australian Government’s ‘Carbon Pollution Reduction Scheme’ White Paper (15 December 2008) proposes that an Australian Emissions Trading Scheme (AETS) be implemented in mid-2010. Acknowledging that the scheme is comprehensive, the paper finds that in many cases, Australia will take a softer approach to climate change through the AETS than the European Union ETS(EUETS). The paper assesses key issues in the White Paper such as emissions reduction targets, GHG coverage, sectoral coverage, inclusion of unlimited quantities of offsets from Kyoto international markets and exclusion of deforestation activities

Innovation and deadlock in governing disasters and climate change collaboratively - Lessons from the Northern Rivers region of New South Wales, Australia

Both scholars and global policy point to the need for, and effectiveness of, locally-led and collaborative disaster and climate change practices. However, there is a need for analysing how these collaborative approaches are developed and used in practice in different contexts. This paper outlines the use of collaborative approaches by a climate change and disaster community of practice across seven local government areas in the Northern Rivers region, New South Wales, Australia. The region has experienced multiple large-scale flood and bushfire disasters since 2017. This ethnographic study uses established collaborative governance and adaptive governance theoretical frameworks to draw findings from: lived experiences of researchers, 22 interviews with diverse stakeholder groups, in-person and online events and the first author's research diary. The findings indicate that collaborative practice in response to disasters and climate change has resulted in both effective outcomes and multi-dimensional challenges, which have lasting implications for communities across the Northern Rivers region. Three critical leverage points for enhanced collaboration and effectiveness were identified. First, improved use and flow of information such as climate projections and place- and needs-based information. Second, mindset shifts that value community knowledge and contributions, and improved practice through enhancing skills in community development and community-led recovery in disaster and climate change practitioners. Lastly, collectively moving from reactive to proactive responses to climate change and disasters. These insights provide an opportunity for improving the design of community-based risk reduction programs and multi-stakeholder governance arrangements into the future, in the state of New South Wales and beyond

Where do graduates Develop their Enterprise Skills? The Value of the Contribution of Higher Education Institutions’ Context

This study investigates the value of the contribution of HEIs’ context in developing graduates enterprise skills. HEIs are under pressure to develop more enterprising graduates, particularly with the increasing numbers of graduates seeking employment and the growing dissatisfaction of employers. This study explores where graduates develop enterprise skills through investigating the impact of HE and employment contexts on their development. The paper draws on a qualitative study in the social constructionist paradigm within the pharmacy context, where interviews were conducted with pharmacy academics and employers. Results show that ability to demonstrate skills in one context does not necessarily mean ability to demonstrate them in another since the development and demonstration of enterprise skills is impacted by the contexts in which they are developed and demonstrated. The study adds value by highlighting the significant role of both HE and employment contexts in developing enterprise skills, while emphasising that these skills become more transferable through exposure to more contexts