Collaboration as the best medicine

Objective To explore the application effect of multidisciplinary collaborative nursing model in nursing elderly patients with diabetes mellitus complicated with acute cholecystitis. Methods A total of 134 elderly patients with diabetes mellitus and acute cholecystitis admitted to the First Affiliated Hospital of Zhengzhou University from April 2015 to June 2017 were selected for the study and were divided into collaborative group and control group according to admission time. The two groups had routine surgery, and after surgery, the control group was given routine nursing care while the collaborative group was given nursing care under the guidance of multidisciplinary collaborative model. The random blood glucose level, postoperative fasting blood glucose level as well as 2 h postprandial blood glucose level, blood glucose fluctuation, intraoperative blood loss, operation time, postoperative exhaust time, hospitalization time, hospitalization cost and complications were recorded in the two groups; the patients body mass index (BMI) , plasma albumin (ALB) , prealbumin (PAB) and other indicators on admission and discharge were measured; the patient satisfaction survey was conducted when they got discharged. Results The fasting blood glucose and postoperative 2 h blood glucose levels, as well as the blood glucose fluctuation range in the collaborative group were lower than those in the control group after surgery with statistical significance (P<0.01) . The operation time, intraoperative blood loss, postoperative exhaustion time, hospitalization time and hospitalization expenses of the collaborative group were lower than those of the control group with statistical significance (P<0.05) . The levels of BMI, ALB and PAB on discharge were higher than those in the control group with statistical significance (P<0.05) . The difference in terms of the overall satisfaction rate between the collaborative group (97.10%) and the control group (86.15%) was statistically significant (P<0.05) . The incidence of postoperative cognitive dysfunction and overall complications in the collaborative group was statistically lower than that in the control group (P<0.05) . Conclusions Multidisciplinary collaborative nursing for elderly patients with diabetes mellitus complicated with acute cholecystitis can reduce the patients' perioperative blood glucose fluctuations, improve their nutritional status, promote postoperative recovery, reduce incidence of complications, and improve patients' satisfaction towards nursing services. Key words: Diabetes mellitus; Cholecystitis, acute; Aged; Multidisciplinary collaborative nursing model

Novel scientific insights in iron metabolism

The collaborative fieldwork supervision model is one supervisory approach that is used to prepare future healthcare providers. Currently, the literature describing the model is limited, making it difficult to identify key factors impacting its use. Further, there is not a known measurement tool of factors influencing collaborative model use. The purpose of this study was two-fold. First, the Collaborative Fieldwork Supervision Tool was created and disseminated nationally to occupational therapy practitioners to collect data about their beliefs regarding the benefits and limitations of the collaborative fieldwork supervision model, their use of the model’s strategies, and collaborative fieldwork supervision supports. The second goal was to create a model which was entitled The Collaborative Fieldwork Supervision Process Model. Within the graphic Model, four factors were identified which included Perceived Value of the Collaborative Fieldwork Supervision Model, Pragmatic Considerations for the Collaborative Fieldwork Supervision Model, Fieldwork Educator Considerations for the Collaborative Fieldwork Supervision Model, and Site Considerations for the Collaborative Fieldwork Supervision Model. This Model has potential to be used as a foundation for academic fieldwork coordinators to train both students and fieldwork educators when using the collaborative fieldwork supervision approach.

Background This study is set in rural Victoria, Australia, during the period of 2006 to 2012. In 2006, as a consequence of the contracting medical workforce in rural areas, the number of doctors willing and able to provide on-call service to rural hospitals was diminishing. The doctors remaining were increasingly dissatisfied with the impost that on-call rosters had on their private lives and preferred not to be called in, particularly for less-urgent, non-complicated patient conditions. In order to develop and test a model in which nurses could practice more autonomously and call the doctor less frequently, the Queensland Rural and Isolated Practice Registered Nursing (RIPRN) model was trialled as part of the government funded Rural Collaborative Practice Model Pilot. This PhD study was based on the Rural Collaborative Practice Model Pilot. Aim and research questions This study aimed “To pilot a collaborative approach to enhancing nurses’ ability to practice autonomously” in order to answer the question: “What are the conditions required to establish the model and does this model improve access to emergency care in rural Victoria?” Methodology Action research design was adopted and included qualitative and quantitative data generation and analysis methods. The study focused on emergency departments in four rural health services and a Bush Nursing Centre, and involved twenty-nine people including clinical nurses, hospital managers, General Practitioner Visiting Medical Officers, pharmacists and a paramedic. From early 2007 until April 2008, there were four action research cycles which commenced with the initial diagnosis of the current situation, followed by the first 2-day planning forum and thereafter three full-day action learning sets held at approximately 2-monthly intervals. While the data were collected during this period of time, the changes that resulted from this study extended into 2012 and have been included in this study. Results The results of this action research study relate to four key elements: 1. Firstly, diagnosis of the existing emergency care situation in the participating organisations, which confirmed that General Practitioner Visiting Medical Officers were attending most emergency presentations regardless of their level of medical urgency or complexity. 2. Secondly, the factors impeding nursing autonomy were identified as relating to the individual nurse, the clinical team and structures within which nurses work (culture, policy and legislation). 3. Thirdly, the strategies planned and implemented to create the conditions needed to improve nursing autonomy. The preparation for the new advanced nursing role, the development of clinical guidelines and providing legal authority were central features of the Queensland Rural and Isolated Practice Registered Nursing model. While these factors are important, they were not sufficient on their own to support nurses to practice within the Autonomous Collaborative Practice Model developed in this study. A key strategy implemented as a result of this study was the change to the Victorian Drugs, Poisons and Controlled Substances Act to authorize these nurses to supply drugs without a medical practitioner’s order. 4. Fourthly, this study measured the impact of the Autonomous Collaborative Practice Model, which included an increase in nurses’ autonomy and a concomitant reduction in the call on the local General Practice Visiting Medical Officer. Conclusion This study confirmed that nurses have a central role in creating a better emergency care service system in rural Victoria. This study found that the Autonomous Collaborative Practice Model delivered a more sustainable model of emergency care in rural health services by reducing the call on the local General Practitioner Visiting Medical Officer and possibly improving service access. Integral to the success of this model is the ability of nurses to practice autonomously in collaboration with other health professionals and their managers. The conditions needed to support this more sustainable model are 1) clinically confident and competent clinicians working collaboratively, where 2) their roles are flexible, but their individual responsibility clear, within 3) cultural, organisational and state structures that engender authority and support for autonomous and collaborative practice.

Panelists will discuss a mentoring model for graduate students that emphasizes collaborative, task-oriented practices that build mentorship and professionalization practices. Participants will brainstorm ways to develop their own task-oriented, high-impact mentorship relationships with graduate students within and across institutions. Participants wil be able to describe several small, task-oriented changes to their program that impact graduate student growth and professional development; list several strategies for connecting graduate students to mentorship opportunities at other institutions; and describe the roles that outside funding, administrative, and university/community/disciplinary resources play in mentorship. ________________________________________________________________ FULL ABSTRACT: As graduate students face competitive job markets and consider non-academic career paths, it is essential that faculty members and graduate students recognize the full potential of the mentoring relationship as a key component to professionalization. Such work requires thinking outside of traditional, classroom-based forms of mentoring and asks faculty to engage in practices beyond what they might have experienced themselves as students. This panel discusses how to create a more intentional mentoring relationship between graduate students and their advisors collaborating in project-based initiatives. Specifically, we draw upon our experiences launching the Virginia Colloquium on the Rhetoric of Health and Medicine (VCRHM), a collaborative research-focused event that brought together students and faculty from seven universities. VCRHM is designed to offer graduate students expanded mentoring options by connecting them to scholars at other institutions and including them intentionally in the planning and development process for the colloquium itself. The methods we identified and put into practice during this project development, we argue, offer a set of useful best practices and lessons learned that might be applied to other situations to help graduate students and their mentors brainstorm new ways to work together. During this presentation, panelists will share their experiences, with additional insights from a survey of colloquium participants, during the first 20 minutes, briefly focusing on the following areas: Defining mentoring: We will offer alternative definitions mentoring within the context of a task-oriented, collaborative relationship. Small tasks/high impact: We will discuss ways that that mentors and students can distribute time and expertise to complete collaborative tasks. Outcomes: We will discuss how such projects can produce outcomes that benefit both mentors and students, in the forms of traditional academic professional development (publication) as well as non-academic paths (budgeting, administrative, and networking skills), as an additional benefit to gaining the learned experience. Funding: Finally, we offer some practical advice on navigating the logistical support required to facilitate such mentoring practices, such as funding sources throughout the university system including grants and student organization funding streams. The remaining 20 minutes of the panel will be devoted to a brainstorming session for attendees, using these four topics as a heuristic for articulating the challenges of mentoring for them, their programs, and their own disciplinary-based expectations.

Internet2 is a consortium of leading U.S. universities working in partnership with industry and the U.S. government's Next Generation Internet (NGI) initiative to develop a faster, more reliable Internet for research and education including enhanced, high-performance networking services and the advanced applications that are enabled by those services [1]. By facilitating and coordinating the development, deployment, operation, and technology transfer of advanced, network-based applications and network services, Internet2 and NGI are working together to fundamentally change the way scientists, engineers, clinicians, and others work together. [http://www.internet2.edu] The NGI Program has three tracks: research, network testbeds, and applications. The aim of the research track is to promote experimentation with the next generation of network technologies. The network testbed track aims to develop next generation network testbeds to connect universities and federal research institutions at speeds that are sufficient to demonstrate new technologies and support future research. The aim of the applications track is to demonstrate new applications, enabled by the NGI networks, to meet important national goals and missions [2]. [http://www.ngi.gov/] The Internet2/NGI backbone networks, Abilene and vBNS (very high performance Backbone Network Service), provide the basis of collaboration and development for a new breed of advanced medical applications. Academic medical centers leverage the resources available throughout the Internet2 high-performance networking community for high-capacity broadband and selectable quality of service to make effective use of national repositories. The Internet2 Health Sciences Initiative enables a new generation of emerging medical applications whose architecture and development have been restricted by or are beyond the constraints of traditional Internet environments. These initiatives facilitate a variety of activities to foster the development and deployment of emerging applications that meet the requirements of clinical practice, medical and related biological research, education, and medical awareness throughout the public sector. Medical applications that work with high performance networks and supercomputing capabilities offer exciting new solutions for the medical industry. Internet2 and NGI,strive to combine the expertise of their constituents to establish a distributed knowledge system for achieving innovation in research, teaching, learning, and clinical care.

<b>Proposal submitted to the NSF CyberTraining program, January 2017 </b>----- AWARDED July 2017 --------<br><b>Proposal Summary </b><br><i>Overview</i>This project will develop “The Code Maker,” a training program for engineering undergraduates that embeds computing in the curriculum with interactive, context-based learning modules. It will deliver 8 or more modules, each consisting of a series of four or more lessons, written as a Jupyter Notebook. The modules will be available online and can be completed asynchronously, or assigned as a graded course component. Success in the modules will be a requirement for completion, i.e., they adopt a mastery-learning approach. The training program will be supported by a team of learning assistants and a program of maker-inspired events at a newly created space in the Library, the “STEM Lab.” It will use cloud infrastructure, both public and private: an instance of Open edX on AWS that effectively allows running the program publicly as a MOOC; and a local JupyterHub server to eliminate installation friction and ensure a consistent compute environment for local students. The evaluation will apply a combination of 4-level training evaluation and a Technology Acceptance model. Student performance will be tracked in courses that use computing and additional qualitative assessment will be done with think-aloud interviews. All materials will be openly developed on the web and shared under permissive licenses, allowing reuse and derivative works. The project has secured three external collaborators that commit to peer review, modify for local conditions and/or trial the modules. Informal advisors from large industry (e.g., Boeing, GE Global) will counsel on authentic, industry relevant computing skills.<br>Keywords: contextual learning, computational thinking, just-in-time teaching, interactive computing, blended learningCognizant Program Officer Consulted: Sushil K. Prasad, CISE/ACI<br><i>Intellectual Merit</i>Contextual learning of computing is an evidence-based approach (e.g., media computing courses). PI Barba has previously published computational modules that have been used in the classroom effectively: CFD Python and AeroPython. She also led a MOOC based on Jupyter Notebooks: “Practical Numerical Methods with Python,” which surpasses 7,000 people registered. The design of the modules will be supported by co-investigator Ryan Watkins who is an expert in e-learning and assessment. Co-PI Wickenheiser (robotics expert) will lead a maker-inspired program of events at the STEM Lab. The evaluation will apply the Technology Acceptance model: acceptance of a technological innovation is determined by judgements on perceived usefulness and perceived ease of use. Application of this model to study the acceptance of educational technology by both students and faculty is well documented.<br><br><i>Broader Impacts</i>This project will train computationally skilled engineers who are prepared to enter the workforce competitively, and ready to use computing effectively as a research tool if joining a PhD program in computational science and engineering. They will develop confidence and computational literacy and be ready to become cyberinfrastructure users in both industry or research. The material will be built around core engineering content so that the program may be adopted fully or in part at other universities. External collaborators will trial the program at other institutions and help build a community around the materials and pedagogical methods of this project. Community building efforts online will gain from previous efforts of the PI, including an independent MOOC that attracted more than 7,000 users. The impact will be reinforced from applying the collaborative ethos of open source. Using open-source tools and teaching learners about the open-source world has the added value of showing effective coordination of teams via online platforms. Open-source projects are able to create value from collective work thanks to a culture of commitment and transparency. Our training will emulate this culture, building an online community and enticing local students with activities at the STEM lab. The local engineering student cohort is 40% female, and we commit to a target of 50% female learning assistants.<br>

The role of the pharmacist has evolved in recent years from a specialist responsible for the preparation of medicines through distributor of finished pharmaceutical products to a provider of pharmaceutical care. Increasingly, health systems in many countries are based on the knowledge and skills of pharmacists to meet the increased expectations of society and to cope with rising deficits in healthcare. This change in focus of the pharmaceutical profession is even more significant in Bulgaria as a result of changes in the socio-political and economic life of the country. Along with the opening of new career prospects, the requirements of the pharmaceutical business and the labor market for what kind of knowledge and competences Masters of Pharmacy should possess have been significantly increased and changed. Through the system of continuing medical education Masters of Pharmacy could meet these requirements by being aware of the innovations in the field of Medicine and Pharmacy and by acquiring knowledge and skills that are applicable in their daily practice.The system of continuing education established by Bulgarian Pharmaceutical Union combines models and best practices proven to be effective and professional experience of a number of specialists from universities and pharmaceutical business and practice. At the same time constantly changing business environment in terms of financial and economic uncertainty, creates new needs and the need for new models of collaboration between stakeholders. Their main function is to ensure the sustainability of the process of acquiring knowledge, in addition, to help decrease costs and increase the quality and accessibility of continuing education.

This thesis concerns the influence of healthcare systems regulation on firm-level capabilities and affordable healthcare technologies. Regulatory change is highly contentious, critics arguing that regulatory changes interfere with the efficiency of the market, and advocates arguing that well designed regulatory changes make markets more efficient and ensure market outcomes are more equitable. To date, very few studies analyze the influence of regulatory change on the medical device industry, and its ability to manufacture and supply affordable healthcare technologies. To respond to this gap, this research employs the Sectoral Systems of Innovation (SSI) approach as a theoretical framework to analyze the influence of regulatory changes on industrial capabilities in medical device industries and affordable healthcare technologies in South Africa and the United Kingdom. A mixed-method approach, focusing on three cases of regulatory change, emphasised documentary analysis and questionnaire-guided interviews to collect primary and secondary data from different sources in the healthcare systems of the two study countries. Regulatory changes facilitated some firms to create new strategies and innovative capabilities. Regulatory changes enabled some firms to develop close collaborative linkages with external providers in search of competitive advantage and improved market positioning. One reactive regulatory change, in particular, illustrated negative influence on innovative capabilities. Smaller firms were at a particular disadvantage in adapting to regulatory change. In the South Africa case, the more stringent regulatory requirements made it hard for domestic suppliers to enter the supply chain and led to joint ventures mainly with multinational corporations. The thesis argues, with empirical evidence, that a more enabling and discriminating regulation that takes into consideration of firms’ technological capabilities can achieve intended goals more efficiently and effectively, than constraining and indiscriminate regulation.

Geography, business strategy and accruals-based earnings management

Knowledge Management is a vast and diverse topic that must be addressed by all modern industrial companies, from the smallest SMEs to the most complex organizations. Knowledge is a critical and strategic asset and the key to competitiveness in the modern manufacturing environment, as it facilitates capacities essential for achieving the required responsiveness, flexibility, agility and innovation. Nevertheless, knowledge itself is difficult to explicate and capture, and often can be recognized only in the improvements it brings to products, technologies and enterprise organizations. Four years ago, members of the CIRP community submitted a proposal to the 6th EU Framework Programme to establish a Network of Excellence (NoE). The European Community accepted this proposal, and thus the Virtual Research Laboratory - Knowledge Community in Production (VRL-KCiP) network was launched. The network set out to create a Knowledge Community in Production that would provide support and knowledge to EU industry. This goal was achieved thanks to (a) the ongoing cooperation and collaboration among the network partners, who represent leading universities worldwide, and (b) additional strong member partnerships with laboratories outside of Europe (Japan, Australia, South Africa, USA, and others). The main efforts of the VRL-KCiP NoE were aimed at aiding European manufacturing industry in defining and structuring its strategic knowledge in order to meet worldwide strategic challenges. These challenges, detailed below, have remained constant over the four years of the network s activities: Manufacturing must become knowledge intensive, given the demand for high-tech products (e.g. electronics, medicines). Given the relatively high labor costs in Europe compared to those in developing countries, manufacturing processes in Europe require high levels of expertise to realize required productivity. As a result of these challenges, over the past 30 years knowledge management (KM) has become a major issue in Europe, in academia as well as in industry. Indeed, firms have recognized that cultivating the "knowledge resource" is essential for management as well as for operations. The aim of this book is to help readers understand the complex topic of knowledge. Moreover, it underlines why knowledge is one of the most important strategic issues in achieving future manufacturing competitiveness. The book is a collection of 34 complementary contributions written by researchers from multinational locations and multidisciplinary perspectives. This book is unique in that it is based on the collective experience of these researchers and represents the status and current issues in the study and implementation of Knowledge Management today. The book describes fundamental concepts in knowledge and knowledge management and provides several case studies in the fields of design and manufacturing. In particular, the book presents several very original examples of knowledge management and knowledge sharing in the context of European manufa cturing. Actual experiences and feedbacks are presented with respect to knowledge engineering approaches for design, manufacturing, and more generally for enterprise engineering. Moreover, methods and tools for knowledge integration within the extended enterprise and the value chain are described, and the role of knowledge management and documents in supporting radical innovation projects is also highlighted. The book discusses ontology, which constitutes the basis for formalizing and mapping knowledge from different points of view. Concrete examples are described and elaborated, mainly with respect to product, process and resource description and management along the lifecycle of mechanical systems.

Objective To study the effect of health care collaborative mode on intravenous infusion of emergency patients in order to provide a reference for intravenous infusion mode.Methods Between January 2012 and September 2013, 528 cases of patients admitted to hospital for intravenous infusion therapy, depending on whether the application of health care collaborative model were divided into experiment group （n=264） and control group （n=264）.Control group adopted the process and standardization of infusion nursing work mode, experiment group received collaborative care model of health care on its basis.Then, observed and compared the way of infusion, transfusion complications, satisfaction of two groups.Results The rate of ordinary infusion needle, peripherally inserted central venous catheter in experiment group respectively was 14.39%and 18.93%, and that in control group was 24.24%and 50.83%,respectively.In experiment group, the incidence of infusion fluid extravasation （4.55%vs 16.67%）, adverse drug reactions （2.65% vs 10.98%） were respectively lower than that in control group （χ2 =4.349,2.971, respectively;P〈0.05）.Patients satisfaction were significantly increased from （89.35 ±5.49） to （97.47 ±6.43） （t =8.441,P〈0.05）.Conclusions Collaborative care model can improve the safety of intravenous infusion, reduce complications, strengthen the health care exchanges, and promote the upgrading of clinical job satisfaction. Key words: Intravenous infusion; Emergency treatment; Collaborative care model

We propose a collaborative 3D modeling system that deconstructs the complex 3D modeling process into a collection of simple tasks to be executed by nonprofessional crowd workers. Given a 2D image showing a target object, each crowd worker is directed to draw a simple sketch representing an orthographic view of the object, using their visual cognition and real-world knowledge. The system then synthesizes a 3D model by integrating the geometrical information obtained from a collection of gathered sketches. We show a set of algorithms that generates clean line drawings and a 3D model from a collection of incomplete sketches containing a considerable amount of errors and inconsistencies. We also discuss a crowdsourcing workflow that iteratively improves the quality of submitted sketches. It introduces competition between workers using extra rewards based on peer-reviewing as well as an example-sharing mechanism to help workers understand the task requirements and quality standards. The proposed system can produce decent-quality 3D geometries of various objects within a few hours.

Innovation and entrepreneurial activities are regarded as twin engines of long-term economic growth. Open Innovation is a contemporary concept that has been postulated to improve research and development, commercialization capabilities and organisational performance. Open Innovation has also been said to be applicable in complex industries that have high levels of uncertainty. The regenerative medicine industry is one such example. According to the Resource Based View, firms must possess both technology- and market-related capabilities in order to realize the value of their innovations. Unfortunately, faced with resource constraints and high cash burn rates; regenerative medicine start-ups are typically forced to forgo process development until the last possible moment. Early evidence of business model failures have made regenerative medicine start-ups with strong scientific cultures, realize that achieving superior therapeutic efficacy is no longer a guarantee of competitiveness or success in the healthcare market. While open innovation encourages start-ups to reach beyond its organizational boundaries to acquire or leverage upon the competencies of their partners, little is known about how internal and external resources interact to bring about competitive advantages. To address this gap in knowledge, a number of research questions were developed to determine if the pharmaceutical supply chain could support regenerative medicine business strategies and the applicability of open innovation in the Australian regenerative medicine industry. Management research in regenerative medicine lacks empirical literature. The ability to generalize is complicated due to different types of therapies requiring different business models. In addition, the commercialization process involves a variety of entities and myriad of possible collaboration methods, which may vary from therapy to therapy. Therefore, a case study design was selected in my research, for its ability to derive and convey rich information obtained from complex real world contexts. The case studies showed that by adopting open innovation practices, new manufacturing capabilities can be developed through process innovations. These new manufacturing capabilities have the potential to assist in process development by reducing the impact of environmental factors such as contamination, to create an ideal environment for cellular therapy production. From a business point of view, process innovations resulting from open innovation practices not only improved the cost of quality but also enabled start-ups to patent their manufacturing process to protect its intellectual property. Furthermore, my thesis argues that regenerative medicine firms should not adopt the pharmaceutical supply chain due to potential incompatibilities between the manufacture and distribution of their therapies against the pharmaceutical model. Therefore, the development of new manufacturing capabilities via open innovation practices is important for regenerative medicine firms as manufacturing capabilities are critical in developing both supply chains and business models that are appropriate for their therapies.

Collaboration between academics and library staff: a comparative study of two universities in Australia and Vietnam