Collaboration Of Experts Research Articles

Teaming and Thinking Outside the Box for Trainee Redeployment During the COVID-19 Pandemic.

We applaud Meo and colleagues' article, “Redeploying Residents and Fellows in Response to COVID-19: Tensions, Guiding Principles, and Lessons from the University of Washington,”1 for outlining 10 tenets based on the University of Washington redeployment experience. Furthermore, we suggest that hospital strategic and educational leaders could think outside the box and seek additional workforce reinforcements from trainees outside of Accreditation Council for Graduate Medical Education programs.Per the Interprofessional Education Collaborative Expert Panel,2 clinical practice is shifting toward team-based collaboration to deliver optimal patient-centered care. Yet, clinicians have limited training working within interprofessional teams. The COVID-19-related challenges of increased clinical demands combined with workforce shortages create unique opportunities for novel interprofessional models of redeployment.During the first wave of the pandemic, emergency department (ED) and internal medicine (IM) personnel found they needed more staff to facilitate communication with patients and families, given high caseloads, restricted visitations, and over-extended clinicians. As stated in guiding principle No. 3, program directors are the point persons to determine the scope of training for trainees. With buy-in from dental and oral pathology (D/OP) program directors and residents, we executed a novel redeployment model with D/OP residents at our academic community hospital. D/OP residents were trained as “communication partners” for ED and IM staff in anticipation of a second surge.We trained 9 residents over 3 weeks, with goals to identify appropriate surrogates for patients and to provide brief updates and emotional support. The curriculum highlighted role introduction, advance directives (AD), and empathic communication skills. Each resident practiced the skills with standardized patient actors, with real-time feedback.Educational and clinical leaders from IM and ED collaborated across disciplines with palliative medicine leaders and D/OP program directors to prepare and execute this redeployment plan. D/OP residents would be supervised by palliative care faculty.Per guiding principle No. 8, trainees should have opportunities to provide feedback and program evaluation. Post training, D/OP residents completed anonymous surveys. Their comments reflected both appreciation for the training and reluctance to engage in high-stakes communication with families of severely ill patients. Comments included:Even though the D/OP residents completed communication skills training, the ED and IM teams reported hesitation for using them in the role of “communication partner,” due to uncertainty in D/OP residents' ability to engage in difficult discussions around complex medical issues. Similarly, D/OP residents' confidence level for carrying out this new role varied by individual. Lipworth et al3 reported successful implementation of a communication liaison program to provide support and medical updates to family members of critically ill patients, utilizing subspecialists such as ophthalmologists and pathologists.The COVID-19 pandemic has brought havoc to our health care system, but also has provided opportunities for exploring new roles, more interprofessional “teaming,”4 and innovative thinking outside the box strategies for patient care.

Bioblitz Assessment of Rocky Intertidal Biodiversity within the Boston Harbor Islands National Recreation Area

Bioblitzes are rapid assessments of local biodiversity that provide opportunities for science, outreach, and management. Here, we present results from a bioblitz motivated by the National Park Service All Taxa Biodiversity Inventory to catalog species diversity in the rocky intertidal zones of the Boston Harbor Islands National Recreation Area. Through a combination of structured, quantitative surveys and opportunistic sampling, public participants, experienced scientists, and naturalists worked together to identify more than 130 species in the rocky intertidal zones of 8 of the Boston Harbor Islands. Sampling by experts alone yielded greater diversity than sampling conducted in collaboration with public participants. However, quantitative, structured sampling by expert-only and collaborative expert–public teams both revealed the expected negative relationship between algal species richness and intertidal elevation, suggesting that, with structure, public bioblitzes can feasibly document ecological patterns. We discuss these results in the context of rocky intertidal ecology, island biogeography, and the role of technology in the growing popularity of bioblitzes as a tool for collaborative engagement of scientists and the public in the study and management of natural systems.

An assessment of the determinants of licensing of university patents: a survey of Spanish universities

PropósitoEste trabajo intenta arrojar luz sobre qué factores pueden influir, positiva o negativamente, en la decisión de licenciar una patente de una universidad, con el fin de ofrecer algunas recomendaciones que puedan contribuir a aumentar el número de patentes universitarias.Diseño de la investigaciónBasado en una muestra de investigadores en universidades españolas que ya han registrado patentes, este trabajo muestra que los factores individuales superan a los factores institucionales a la hora de determinar la decisión de patentar una invención. Asimismo, la probabilidad de patentar una invención es mayor cuando el nivel de participación del investigador en el proceso es mayor.RecomendacionesLos resultados de nuestro estudio nos permiten afirmar que, en el ámbito universitario español, los factores individuales juegan un papel más importante en la decisión de solicitar una patente que los factores institucionales. En este sentido, la colaboración de empresas o expertos de fuera de la academia en la investigación a partir de la cual se otorgó la patente es el factor más relevante.OriginalidadEste trabajo es el primer estudio de este tipo que se realiza en Europa y concluye con una recomendación para reforzar la estructura y la funcionalidad de las oficinas de transferencia de tecnología (OTRI) como política básica para la promoción de la explotación comercial de la innovación en las universidades.

Success and limiting factors in health service innovation: a theory-generating mixed methods evaluation of UK projects

ObjectivesTo explore and explain success and limiting factors in UK health service innovation.DesignMixed methods evaluation of a series of health service innovations involving a survey and interviews, with theory-generating analysis.SettingThe...

Progress in the esophagogastric anastomosis and the challenges of minimally invasive thoracoscopic surgery.

The esophagogastric anastomosis is most commonly performed to restore digestive tract continuity after esophagectomy for cancer. Despite a long history of clinical research and development of high-tech staplers, this procedure is still feared by most surgeons and associated with a 10% leakage rate. Among specific factors that may contribute to failure of the esophageal anastomosis are the absence of serosa layer, longitudinal orientation of muscle fibers, and ischemia of the gastric conduit. It has recently been suggested that the gut microbiome may influence the healing process of the anastomosis through the presence of collagenolytic bacterial strains, indicating that suture breakdown is not only a matter of collagen biosynthesis. The esophagogastric anastomosis can be performed either in the chest or neck, and can be completely hand-sewn, completely stapled (circular or linear stapler), or semi-mechanical (linear stapler posterior wall and hand-sewn anterior wall). Because of the lack of randomized clinical trials, no conclusive evidence is available, and the debate between the hand-sewn and the stapling technique is still ongoing even in the present era of robotic surgery. Centralization of care has improved the overall postoperative outcomes of esophagectomy, but the esophagogastric anastomosis remains the Achille’s heel of the procedure. More research and network collaboration of experts is needed to improve safety and clinical outcomes.

Converging disciplines for assessing child development

It was evident from the start that tackling a challenge as complex as this would require collaboration of experts from a variety of disciplines including global mental health, developmental pediatrics, developmental psychology, neuroscience and computer science, all working closely with engineers and designers who could fashion the assessments onto mobile devices and present them in formats which are engaging for young children.Working across these silos did pose some challenges such as the discomfort of having expertise which was only part of the solution, implicit hierarchies about which expertise was more salient, and difficulties in communication due to differing concepts and vocabularies.

Competências colaborativas à formação do estudante: análise segundo domínios do Interprofessional Education Collaborative Expert Panel

OBJETIVO: Analisar, segundo os domínios do Interprofessional Education Collaborative Expert Panel, as competências colaborativas desenvolvidas pelo programa PermanecerSUS à formação dos estudantes de saúde. MÉTODO: Estudo qualitativo, sob a perspectiva da etnografia institucional, realizado em instituições de saúde públicas com estudantes, trabalhadores e usuários do sistema público de saúde. Os dados foram coletados por meio da observação participante e entrevista semiestruturada, e analisados com a análise de conteúdo temática, em consonância aos domínios do Interprofessional Education Collaborative Expert Panel. RESULTADOS: Participaram do estudo 60 pessoas, predominantemente do sexo feminino, divididas igualmente entre as unidades. Constatou-se que os indivíduos com menor idade e inseridos o mais precocemente em projetos interprofissionais, desenvolvem competências colaborativas com mais facilidade do que os trabalhadores dos serviços de saúde já atuantes dos serviços. CONCLUSÃO: O PermanecerSUS favorece aos estudantes ética/valores para a prática profissional, trabalho em equipe e corresponsabilidade. Entretanto, é preciso desenvolver entre os trabalhadores dos serviços de saúde a competência da comunicação interprofissional.

Curating and Visualizing Dense Networks of Monsoon Precipitation Data: Integrating Computer Science Into Forward Looking Climate Services Development

Monsoon precipitation demonstrates a wide range of spatial and temporal variability in the U.S. Southwest. A variety of precipitation monitoring networks, including official networks, municipal flood control districts, and citizen science observers, can help improve our characterization and understanding of the monsoon. The data management challenges of integrating these diverse data sources can be formidable. Computer science and data management techniques provide a pathway for the design of forward looking climate services, especially those developed in collaboration with experts in this field. In this paper we present such a collaboration, integrating natural, social and computer science expertise. We document how we identified data networks and their sources and the computer science and data management workflow we employed to integrate and curate these data. We also present the web based data visualization tool and API that we developed as part of this process (monsoon.environment.arizona.edu). We use case study examples from the Tucson, AZ region to demonstrate the visualizer. We also discuss how this type of collaboration could be extended to existing or potential stakeholder collaborations, as we facilitate access to a curated set of data that gives an increasingly granular perspective on monsoon precipitation variability. We also discuss what this collaborative approach integrating natural, social and computer science perspectives can add to the evolution of climate services.

Susu Steril Kurma Minuman Sehat untuk Masa Pandemi Covid-19: Studi Takhrij dan Syarah Hadis Pendekatan Bidang Kesehatan

The purpose of this study is to discuss the hadith syarah related to sterile date milk as a healthy drink during the Covid-19 pandemic. This study uses a qualitative approach that emphasizes literature study through the takhrij and syarah hadith methods with contemporary analysis. The results of this study found that the quality status of the hadith about dates is considered valid according to the takhrij hadith. Meanwhile, the hadith syarah shows that dates are known to be processed ingredients for health drinks, including sterile date milk which is useful for increasing immunity during the Covid-19 pandemic. The conclusion of this study is that the hadith about dates can be referred to as an Islamic practice because it has a valid status and dates can be used as sterile date milk products to increase immunity during the Covid-19 pandemic according to health sector instructions. This study recommends the collaboration of hadith experts and health experts in experimental processing of sterile dates milk for health during the Covid-19 period.

System design and demonstration of performance monitoring of a butterfly‐shaped arch footbridge

This paper presents an overview of the structural performance monitoring system for a butterfly-shaped arch footbridge located at The Hong Kong Polytechnic University. The system is the product of a multidisciplinary academic collaboration of the pooling expertise of four academic departments, namely, structural engineering, traffic engineering, surveying, and optical communication engineering. This system consists of 88 sensors of 13 types, including an advanced Brillouin optical time-domain analysis technology, an optical fiber Bragg grating technology, a global navigation satellite system (GNSS), and high-performance video cameras. The paper summarizes the modular design, subsystem framework, and advanced features of the monitoring system. Preliminary monitoring results, such as high spatial resolution distributed temperature/strain measurement, global heat-transfer analysis, pedestrian traffic analysis, dynamic characteristics, and GNSS measurements, are introduced. A fire accident is employed to demonstrate the function and value of the monitoring system and provided a rare opportunity to detect damages in a real structure. The monitoring system not only monitors the performance of the bridge in real-time but also provides a multifunctional platform, including an Internet-based software for research and teaching and a touchscreen visualization platform for public education.

Developing experiences: creative process behind the design and production of immersive exhibitions

ABSTRACT Visitors’ criticisms demand a shift from passive, encyclopaedic exhibitions with curatorial authority, to ones that engage visitors and place them at the centre of focus. This has ignited a change in approaches to exhibition design. One of them is the employment of immersive approaches together with strong storytelling, which can create memorable experiences and redefine the visitor experience. This study investigates the design and production process behind immersive exhibitions, which requires the close collaboration of multidisciplinary experts.

A three-phased model to support the design and development of core competency education for liaison mental health clinicians

Purpose This paper aims to provide an insight into the design, development and delivery proposals for a first of its kind “Liaison Mental Health Training Programme”. In the UK, there has been a significant investment in Liaison Mental Health Services and an expansion of the workforce (NHS England, 2016). However, the complexity and varied presentations of patients who attend to acute physical health services now requires a dedicated strategy to address any skills deficit in the mental health liaison workforce and to support core competency development (DOH, 2016). Design/methodology/approach This paper provides an overview of preparations to develop a regional educational pilot programme using a three-phased model: Phase 1 – Review of policy and best practice guidelines; Phase 2 – Stakeholder Data Collection; and Phase 3 – Synthesis and Development. Findings An insight into the developmental processes undertaken to shape a core competency liaison mental health training programme is presented. Additionally, the authors provide insight into educational theory and an overview of the LMH Core Competency Curricula. Practical implications This paper provides the reader with an insight into our findings and a focussed core competency training model for those working within LMH services. This programme development was reviewed throughout by both those using LMH services and the LMH practitioners working within them, ensuring the curriculum proposed was endorsed by key stakeholders. The three-phased model has transferable benefits to other training development initiatives. Originality/value To the best of the authors’ knowledge, this training is the first of its kind in the UK and addresses the education of essential core competencies of a regional liaison mental health workforce. The collaboration of clinical and academic expertise and model of co-production makes this endeavour unique.

What do the terms resistance, tolerance, and resilience mean in the case of Ostrea edulis infected by the haplosporidian parasite Bonamia ostreae

The decline of the European flat oyster Ostrea edulis represents a loss to European coastal economies both in terms of food security and by affecting the Good Environmental Status of the marine environment as set out by the European Council’s Marine Strategy Framework Directive (2008/56/EC). Restoration of O. edulis habitat is being widely discussed across Europe, addressing key challenges such as the devastating impact of the haplosporidian parasite Bonamia ostreae. The use of resistant, tolerant, or resilient oysters as restoration broodstock has been proposed by restoration practitioners, but the definitions and implications of these superficially familiar terms have yet to be defined and agreed by all stakeholders. This opinion piece considers the challenges of differentiating Bonamia resistance, tolerance, and resilience; challenges which impede the adoption of robust definitions. We argue that, disease-resistance is reduced susceptibility to infection by the parasite, or active suppression of the parasites ability to multiply and proliferate. Disease-tolerance is the retention of fitness and an ability to neutralise the virulence of the parasite. Disease-resilience is the ability to recover from illness and, at population level, tolerance could be interpreted as resilience. We concede that further work is required to resolve practical uncertainty in applying these definitions, and argue for a collaboration of experts to achieve consensus. Failure to act now might result in the future dispersal of this disease into new locations and populations, because robust definitions are important components of regulatory mechanisms that underpin marine management.

"The SOFTVETS Competence Model" - a preliminary project report.

Aim: Recent developments measured using statistics and surveys among veterinarians show that integrating key competence training into veterinary education is becoming increasingly important.This article describes the collaborative development process of the first work package within the SOFTVETS project. The SOFTVETS project aims to create a competence model and an ideal version of a soft skills curriculum that can be implemented in veterinary higher education throughout Europe.Method: In the course of a desk research phase, a literature review and an inventory of the current practice of key competence training within veterinary education was carried out. An initial set of recommendations for three competence areas was developed using the Handbook for Internal Quality Management in Competence-Based Higher Education. Finally, an alternating sequence of individual and collaborative expert reviews was carried out.Result: Experts from five European countries participated in the process. The derived competence model consisted of the following three competence areas with the corresponding number of defined competences: ten communication, nine entrepreneurial and eight digital competences.Conclusion: In the next work packages, learning objectives, teaching and assessment methods will be collected. Training concepts for facilitators to provide professional competence training will be established. In addition, an evaluation toolkit will be developed to standardise the implementation, evaluation and assessment of competence training events.The SOFTVETS competence model should help educators to be able to integrate the training of key competence training into the veterinary curriculum. This detailed list of competences can also be used as a tool to identify existing deficiencies and thus enable further curricular changes.

Examining mechanisms for creating shared value by Asian firms

This paper examines the home-based creating shared value (CSV) projects of two multinational corporations (MNCs), and three small and medium-sized enterprises (SMEs). One CSV project was examined in each firm. Based on qualitative case studies, we developed two bricolage-based models to represent different motives, different processes of resource acquisition, and different processes of resource utilization when implementing CSV. For the MNCs, both based in Hong Kong, institutional advocacy and recognition provided encouragement to engage in CSV. Internal resource slack underpinned their ability to implement their respective CSV projects by repurposing internal resources or infusing them with purpose. By contrast, the SMEs, two from Pakistan and one from Hong Kong, found it necessary to adopt collective bricolage for their respective CSV projects, involving repurposing external human resources while drawing on donations or grants and enlisting the collaboration of benevolent external experts or giants. Interviewees indicated that all the focal CSV projects were distinguishable from corporate social responsibility (CSR) projects, in that the former (but not the latter) were designed to create economic revenue for the respective focal firms, while concurrently generating social/environmental benefits. Most of the CSV projects were reported to have created significant economic value for external beneficiaries.

Tool wear monitoring in roughing and finishing processes based on machine internal data

Data analytics plays a significant role in the realization of Industry 4.0. By generating context-related persistent datasets, every manufacturing process in real production becomes an experiment. The vision of Internet of Production (IoP) is to enable real-time diagnosis and prediction in smart productions by acquiring datasets seamlessly from different data silos. This requires interdisciplinary collaboration and domain-specific expertise. In this paper, we present a novel tool wear monitoring system for milling process developed in the context of IoP. This system is based on high-frequency data from the numerical control of the production machine without additional sensors. The novelty of this paper lies in the introduction of virtual workpiece quality and fusion of multiple build-in sensor signals and a force model as decision support. This bridges the time gap between quality inspection and production at the shop floor level, establishes an automated statistical process control system, and provides a more plausible prediction of tool lifetime. The monitoring of two different milling processes in a real production environment is exemplary demonstrated in this paper. The first case is a face roughing process with the aim of rapidly removing large amounts of material. The second case is a face finishing operation that follows roughing and aims to achieve the desired surface quality.

27363 Forging Collaboration and the Scalable Dissemination of Biomedical Research Commercialization Education

ABSTRACT IMPACT: A robust and collaborative network of expertise and services is essential for successful research commercialization, including timely and scalable educational support for CTSA institutions and individual faculty investigators with biomedical innovations. OBJECTIVES/GOALS: Leverage expertise at the University of Michigan (UM) by creating collaborative and scalable interactive online courses to instruct and prepare internal and external faculty to navigate critical stages of life science academic research commercialization. METHODS/STUDY POPULATION: UM’s Fast Forward Medical Innovation created two online courses with the UM Office of Technology Transfer and the Michigan Institute for Clinical & Health Research (MICHR). Collaborative planning committees, with content and educational experts, set course goals and learning objectives based on audience needs (e.g. preparation for consultations, commercialization concepts, etc.). Draft content was developed, peer reviewed, and revised before Articulate Storyline was used to convert didactic content to active learning content (e.g. interactive slides, scenarios, quizzes, and forms). Pilot testing was conducted prior to the launch to faculty investigators throughout the UM network. RESULTS/ANTICIPATED RESULTS: Intellectual Property in the Academic Setting launched via the FFMI website and newsletter in July 2020 and has had 66 learners to date. Medical Device Regulations launched in October 2020 and has 22 learners. OTT and MICHR have successfully integrated the courses into their consultation process by requesting review from faculty investigators. We suspect that this will lead to more in-depth and meaningful conversation. Additionally, these courses have been integrated into an FFMI commercialization course to instruct on critical concepts. Evaluation and refinement for both use cases will ensue, as well as inform future collaborative courses. DISCUSSION/SIGNIFICANCE OF FINDINGS: Early results suggest that the courses are advantageous and can serve as a model for future collaborations. The opportunity to disseminate the courses across the CTSA network, as well as collaborate with other institutions, to scale localized expertise to a broader network is promising.

Implementation of the Quality Oncology Practice Initiative Program in Spain: First Results and Implications.

Measuring and tracking quality of care is highly relevant in today's health care. The Quality Oncology Practice Initiative (QOPI) program is a referral for evaluating oncology practices worldwide. Excellence and Quality in Oncology Foundation, a collaboration of oncology experts from major Spanish hospitals involved in cancer treatment, reached an agreement with QOPI to include Spanish hospitals in this program. We analyzed the results of the QOPI Core module measures from 19 Spanish hospitals over nine rounds (from fall 2015 to fall 2019). Of the 19 hospitals, 15 completed more than one round; none participated in all nine (two hospitals participated in eight rounds). The highest scores were for pathology report confirming malignancy, documenting a plan of care for moderate or severe pain and chemotherapy dose, and chemotherapy administered to patients with metastatic solid tumor with performance status undocumented. Measures regarding a summary of chemotherapy treatment, tobacco use cessation counseling, and assessment of patient emotional well-being were among the lowest scored measures. Six of the 15 practices that participated repeatedly achieved a better score in their last round compared with their first. Overall, scores of Spanish hospitals improved from 67.79% in fall 2015 to 68.91% in fall 2019. To our knowledge, this is the first study to evaluate QOPI scores in Spain. There was high variability in scores, with quality of care improving with repeated participation in some hospitals, but worsening in others. Excellence and Quality in Oncology Foundation will support practices to increase their participation to improve oncology care and implement strategies that address the areas for improvement.

A Novel Patient Values Tab for the Electronic Health Record: A User-Centered Design Approach.

BackgroundThe COVID-19 pandemic has shined a harsh light on a critical deficiency in our health care system: our inability to access important information about patients’ values, goals, and preferences in the electronic health record (EHR). At Memorial Sloan Kettering Cancer Center (MSK), we have integrated and systematized health-related values discussions led by oncology nurses for newly diagnosed cancer patients as part of routine comprehensive cancer care. Such conversations include not only the patient’s wishes for care at the end of life but also more holistic personal values, including sources of strength, concerns, hopes, and their definition of an acceptable quality of life. In addition, health care providers use a structured template to document their discussions of patient goals of care.ObjectiveTo provide ready access to key information about the patient as a person with individual values, goals, and preferences, we undertook the creation of the Patient Values Tab in our center’s EHR to display this information in a single, central location. Here, we describe the interprofessional, interdisciplinary, iterative process and user-centered design methodology that we applied to build this novel functionality as well as our initial implementation experience and plans for evaluation.MethodsWe first convened a working group of experts from multiple departments, including medical oncology, health informatics, information systems, nursing informatics, nursing education, and supportive care, and a user experience designer. We conducted in-depth, semistructured, audiorecorded interviews of over 100 key stakeholders. The working group sought consensus on the tab’s main content, homing in on high-priority areas identified by the stakeholders. The core content was mapped to various EHR data sources. We established a set of high-level design principles to guide our process. Our user experience designer then created wireframes of the tab design. The designer conducted usability testing with physicians, nurses, and other health professionals. Data validation testing was conducted.ResultsWe have already deployed the Patient Values Tab to a pilot sample of users in the MSK Gastrointestinal Medical Oncology Service, including physicians, advanced practice providers, nurses, and administrative staff. We have early evidence of the positive impact of this EHR innovation. Audit logs show increasing use. Many of the initial user comments have been enthusiastically positive, while others have provided constructive suggestions for additional tab refinements with respect to format and content.ConclusionsIt is our challenge and obligation to enrich the EHR with information about the patient as a person. Realization of this capability is a pressing public health need requiring the collaboration of technological experts with a broad range of clinical leaders, users, patients, and families to achieve solutions that are both principled and practical. Our new Patient Values Tab represents a step forward in this important direction.

Advantages and disadvantages of targeted therapy in patients with rheumatoid arthritis

With the recent understanding of the pathogenesis of rheumatoid arthritis at the cellular and molecular levels, as well as the rapid progress of biotechnology, targeted therapies have been developed and used since 2000. Starting with the development of biological products, which were early targeted therapeutics, small molecule inhibitors have recently been developed that target Janus kinase, a signaling molecule for intracellular inflammatory cytokines. The use of targeted therapies has dramatically improved the treatment outcomes and prognosis of rheumatoid arthritis. However, there is still concern around long-term safety of drugs and the rise in the economic burden on individuals and society due to the high price of biological products and Janus kinase inhibitors. To use those targeted therapeutics efficiently to ensure that suitable patients can fully benefit, both a multidisciplinary approach and the collaboration of experts are required. From the patient’s perspective, it is necessary to develop a system of patient’ education and to support shared decision-making between patients and physician. From the perspective of medical personnel, it is necessary to ensure the autonomy of experts. In addition, from a socio-economic viewpoint, it is necessary to adjust drug prices and review biosimilar utilization plans to reduce medical costs. The expanding use of these drugs among rheumatoid arthritis patients will eventually lead to greater social benefits by reducing disability among patients, facilitating their economic activity, and improving their quality of life. However, it is time to discuss their appropriate selection and safe long-term use with well-trained experts.