Development Of Best Practices Research Articles

Commentary: integrating environmental DNA into applied ecological practice

Environmental DNA (eDNA) methods and technologies are increasingly being explored and applied in research studies and environmental monitoring. Although eDNA has some limitations, there is the potential for major advantages to using this method within a regulatory context for characterizing and assessing species, populations, communities, and whole ecosystems. This commentary explores some of the challenges and solutions to acceptance of eDNA methods by regulators and regulated communities as an option for environmental monitoring. Increased collaborative eDNA forums and eDNA studies among researchers, regulators, applied ecologists, and regulated communities would help delineate the benefits, limitations, and appropriate applications of eDNA methods. This could facilitate development of best practices and industry standards which could, in turn, lead to acceptance by regulators and regulated communities. Finally, opportunities for applying eDNA to complement or even improve conventional monitoring methods are illustrated using three examples of regulatory environmental monitoring studies for protecting species at risk.

EXTENT OF TEACHER PREPAREDNESS AND CAPACITY TO IMPLEMENT INFORMATION AND COMMUNICATION TECHNOLOGIES IN THE NEPAD E-SCHOOLS, KENYA

Purpose: The purpose of this study was to determine the extent to which teachers and principals are prepared and capacitated to implement ICTs in the NEPAD e-Schools, Kenya.
 Methodology: This study adopted a descriptive survey design. Both quantitative and qualitative data were collected. The target population for the study were all principals and 256 teachers from 6 model e-Schools. Sampling was done employing a mixture of methods. Stratified sampling was used to pick schools, while purposive sampling was used to pick principals and teachers. Five principals and 110 teachers were sampled. Data was collected using questionnaire for teachers, and structured interview for principals. The collected data was coded, run for descriptive analysis; including frequencies, percentages, measures of central tendency and measures of variability/spread, and presented with the aid of appropriate notes, frequency tables, percentages, charts and figures.
 Findings: The study established that despite most teachers and principals having been trained, they had not been sufficiently empowered towards effectively and successfully applying ICTs. Moreover, majority of the untrained teachers and principal had not trained because no training had occurred since they joined the schools. However, despite their status, most teachers believed they could still perform some tasks involving ICTs. Most trained teachers and principals needed to be trained, retrained and/or trained further on several skills, especially in the preparation and use of multimedia instructional tools, and on-line research and communication. The study concluded that most teachers and principals may be willing to apply ICTs but are limited by the nature and extent of their empowerment. Moreover, ICTs application programmes are likely to succeed better if they employ regular, on-going training.
 Unique contribution to theory, practice and policy: The study could inform education planners and trainers about necessary adjustments to future pre-service and in-service teacher training programmes involving application of ICTs. It would also contribute to the body of knowledge in educational technology, which might inform theory and practice in ICTs integration. It could also inform the development of best practices in the application and integration of ICTs in instruction.

Acc-MobileCheck: a Checklist for Usability and Accessibility Evaluation of Mobile Applications

Mobile devices have gained more attention from the society that is using them increasingly for a variety of purposes. For complete insertion of the population in this constant digital evolution it is fundamental that mobile applications also offer access to different user profiles, regardless of their disabilities or limitations. Considering quality, productivity, and speed of application creation, there is a wide range of good development practices and evaluations. However, methods that involve usability and accessibility are still developing. The purpose of this article is to present the Acc-MobileCheck, which is a checklist of accessibility and usability for mobile devices apps, based on good software development practices and guided by Design Patterns. The Acc-MobileCheck, composed of 47 verification items, consists of questions that look for evidence of problems of comprehension, operation, perception, and adaptation in mobile apps. The evaluation method aims to address difficulties that can be faced by people with hearing, visual, intellectual, or mobility impairment. Five experts and three developers of mobile apps had evaluated the Acc-MobileCheck. The conclusive results show that the checklist is usable and includes essential issues for the evaluation of accessibility and usability. The data obtained allowed a restructuring of the evaluation method developed, and the positive comments about the checklist demonstrate its adequacy to attend the demand.

"Stop the Bleed" Education Assessment Tool (SBEAT): Development and Validation.

As part of the national Stop the Bleed campaign in the United States, more than a million people have received bleeding control training through the work of many organizations. These public and professional educational experiences are ideally grounded in health sciences, clinical, and educational evidence to be most effective. However, there is currently no standard tool for evaluating the educational quality of these programs. We developed and validated the Stop the Bleed Education Assessment Tool (SBEAT) to provide a standard measure of life-threatening bleeding educational programs knowledge learning outcomes to aid in evaluation and development of this public health program.The SBEAT development included medical, clinical, and educational experts to derive and validate learning outcomes. Specific item writing incorporated focus groups for input on language and then pilot testing before a full community pilot test established a data set, for which a Rasch methodology was applied. The resulting tool used 34 items embedded in 19 survey questions, with item separation statistic of 5.56 (0.97 reliability) and person separation statistic of 2.09 (0.81 reliability) for 171 persons. Overall, the Cronbach Alpha (KR-20) person score “test reliability” equaled 0.85 (SEM = 2.24).The SBEAT project establishes a standardized assessment tool to evaluate the cognitive aspects of first aid for life threatening bleeding. Comparison of outcomes from different teaching styles and methods will allow for the development of best practices for future bleeding control education and help organizations demonstrate value to learners, funders, and policy makers, and advance health sciences education. SBEAT offers a measure for which educational efficiency and efficacy can be judged within a larger effort to prepare people for personal emergencies or large-scale disasters.

Lack of Coordination between Health Care and Social Care in Multi-Professional Teamwork - the Obstacle for Coherent Care of Older People Suffering from Multi-Morbidity

The lack of a cohesive health and social care is a well-known problem of significance for ageing people in general and frail older people in particular. Responsibility for organising and conducting social care and healthcare for the elderly rests on different principals in different countries but difficulties with organisational coordination and collaboration between professions and authorities in social care and healthcare is an extensive concern worldwide. Regardless of the distribution of responsibilities, collaboration and coordination structures are complex and often lead to problems. However, the gap in the coordination between different organisations and the collaboration between professions, implying that frail older people with major care needs still living in their own homes are pinched, has received hardly any recognition. By closely following an implementation project focused on teamwork in order to improve collaboration and coordination between social care and healthcare, the purpose of this article is to fill this gap with the help of an example from Sweden. Data consisted of event diaries, observations, focus groups, structured questionnaires and interviews. Findings showed that multi-professional teams certainly were established, but did not work or last. Among the obstacles found the most prominent features were the various professions’ own organisations, territorial thinking and rivalries. The whole idea of the initiative to achieve a cohesive healthcare and social care for ageing frail older people fell through. By letting this happen, not only did the project hinder the development of better practice in serving older adults, but also cemented the problematic structures it was intended to dissolve.

Systematic narrative review of pediatric-to-adult care transition models for youth with pediatric-onset chronic conditions

Abstract Pediatric-to-adult transition in chronic disease care is often poorly managed. While there is growing interest in this field, existing reviews of transition models, which are critical in informing the development of best practices and evaluation metrics in transitional care, do not explore the critical design features of models that best improve health outcomes. This systematic review compares existing such models and the design features that positively impact clinical outcomes. Five databases were searched (Medline, CINAHL, EMBASE, PubMed, CENTRAL) until 2018. English-language evaluations (with defined clinical outcomes) of existing models for patients aged 13–28 with a pediatric-onset chronic disease were pulled. Cochrane tools were used for data extraction and risk-of-bias assessment. Twenty-nine studies showed improvements in outcomes for 10 pediatric-onset chronic diseases. A narrative synthesis of findings revealed two broad model types: transition clinics involving single or multiple appointments and/or multidisciplinary team, and transition program facilitators. Both model types included examples of remote (online or telephone) care. Most studies focused on a standardized multidisciplinary transition process that emphasized care coordination. All types resulted in improvements in access to medical care, reduced acute and chronic complications, and increased rates of follow-up. Commonly used strategies in successful programs were patient/family education, transition clinics jointly staffed by pediatric/adult physicians, or clinics dedicated to young adults within adult services. Despite the importance of effective transitional care, there are no commonly agreed upon quality metrics in transition care. Standardized evaluation metrics to compare models across disease types are needed.

Ontologies relevant to behaviour change interventions: a method for their development

Background: Behaviour and behaviour change are integral to many aspects of wellbeing and sustainability. However, reporting behaviour change interventions accurately and synthesising evidence about effective interventions is hindered by lacking a shared, scientific terminology to describe intervention characteristics. Ontologies are knowledge structures that provide controlled vocabularies to help unify and connect scientific fields. To date, there is no published guidance on the specific methods required to develop ontologies relevant to behaviour change. We report the creation and refinement of a method for developing ontologies that make up the Behaviour Change Intervention Ontology (BCIO). Aims: (1) To describe the development method of the BCIO and explain its rationale; (2) To provide guidance on implementing the activities within the development method. Method and results: The method for developing ontologies relevant to behaviour change interventions was constructed by considering principles of good practice in ontology development and identifying key activities required to follow those principles. The method’s details were refined through application to developing two ontologies. The resulting ontology development method involved: (1) defining the ontology’s scope; (2) identifying key entities; (3) refining the ontology through an iterative process of literature annotation, discussion and revision; (4) expert stakeholder review; (5) testing inter-rater reliability; (6) specifying relationships between entities, and; (7) disseminating and maintaining the ontology. Guidance is provided for conducting relevant activities for each step. Conclusions: We have developed a detailed method for creating ontologies relevant to behaviour change interventions, together with practical guidance for each step, reflecting principles of good practice in ontology development. The most novel aspects of the method are the use of formal mechanisms for literature annotation and expert stakeholder review to develop and improve the ontology content. We suggest the mnemonic SELAR3, representing the method’s first six steps as Scope, Entities, Literature Annotation, Review, Reliability, Relationships.

Development of Best Practices of Peer Review for Lung Radiation Therapy.

Peer review (PR) is an important component in ensuring high-quality lung radiotherapy (RT) plans. However, there are inconsistencies in the extent, timing, and minimum requirements for PR. We sought to develop guidelines of best practices for PR in curative lung RT through an expert consensus process. A modified Delphi process was conducted that consisted of an initial review by a dedicated steering committee followed by a pan-Canadian, multidisciplinary Delphi panel with 3 rounds (premeeting survey, face-to-face meeting, and postmeeting ratification survey). Candidate PR elements were ranked by importance and stratified by treatment of locally advanced (LA) disease with conventional RT or stereotactic ablative body RT (SABR) for early-stage disease. For the LA case, 6 elements (indications for RT, gross tumor volume [GTV], clinical target volume [CTV], internal target volume [ITV], dose/fractionation, and normal lung dosimetry) were considered as essential PR elements. Of these, 90%-100% of the panel endorsed them to be important to PR, and 80% believed that the PR should be done by a second radiation oncologist (RO). In the SABR case, 6 PR elements (indications for RT, GTV, CTV/ITV, organs at risk contours, dose/fractionation, and composite plan review) were deemed essential. Of these, 90%-100% of panel members believed these elements to be important to PR and unanimously agreed that PR should be done by a second RO. A suite of PR elements for lung RT has been developed and endorsed with high consensus. This suite should serve as a basis to help to harmonize PR practices across centers and to help to develop novel PR approaches going forward.

Prehospital interventions to prevent hypothermia in trauma patients: a scoping review

Objective: The aim of this review is to map the prehospital rewarming measures used to prevent hypothermia among trauma victims. Background: Hypothermia is responsible for an increase of the mortality and morbidity in trauma victims and its recognition and early treatment are crucial for the victim’s haemodynamic stabilisation. Prehospital interventions are particularly important, especially those that target bleeding control, haemodynamic stability, and safe body temperature. Registered nurses may be pivotal to prevention and minimisation of the dangerous effects of hypothermia. Study design and methods: A scoping review was used to identify articles from several online databases from 2010 to 2018. Studies in English, Spanish, and Portuguese were included. Two reviewers performed data extractions independently. Results: Seven studies were considered eligible for this review: two quantitative research studies, one qualitative research study, and four literature reviews. Rewarming measures can be divided into two main groups: passive rewarming, which includes the use of blankets, positioning the response unit to act as a windbreak, removing the patients’ wet clothes, drying the patient’s body, and increasing the ambient temperature; and active rewarming which includes the use of heating pads, heated oxygen, warmed intravenous fluids, peritoneal irrigation, arteriovenous rewarming, and haemodialysis. Discussion: Active measures reported by the included studies were always used as a complement to the passive measures. Active rewarming produced an increase in core temperature, and passive rewarming was responsible for intrinsic heat-generating mechanisms that will counteract heat loss. Patients receiving passive warming in addition to active warming measures presented a statistically significant increase in body core temperature as well as an improvement in the discomfort caused by cold. Conclusion: Rewarming measures seem to be essential for the prevention of hypothermia and to minimise the discomfort felt by the patient. In many countries registered nurses can play important roles in the prehospital context of trauma victim’s assistance. Greater understanding of these roles is necessary to the development of better practices.

Ontologies relevant to behaviour change interventions: a method for their development

Background: Behaviour and behaviour change are integral to many aspects of wellbeing and sustainability. However, reporting behaviour change interventions accurately and synthesising evidence about effective interventions is hindered by lacking a shared, scientific terminology to describe intervention characteristics. Ontologies are knowledge structures that provide controlled vocabularies to help unify and connect scientific fields. To date, there is no published guidance on the specific methods required to develop ontologies relevant to behaviour change. We report the creation and refinement of a method for developing ontologies that make up the Behaviour Change Intervention Ontology (BCIO). Aims: (1) To describe the development method of the BCIO and explain its rationale; (2) To provide guidance on implementing the activities within the development method. Method and results: The method for developing ontologies relevant to behaviour change interventions was constructed by considering principles of good practice in ontology development and identifying key activities required to follow those principles. The method’s details were refined through application to developing two ontologies. The resulting ontology development method involved: (1) defining the ontology’s scope; (2) identifying key entities; (3) refining the ontology through an iterative process of literature annotation, discussion and revision; (4) expert stakeholder review; (5) testing inter-rater reliability; (6) specifying relationships between entities, and; (7) disseminating and maintaining the ontology. Guidance is provided for conducting relevant activities for each step. Conclusions: We have developed a detailed method for creating ontologies relevant to behaviour change interventions, together with practical guidance for each step, reflecting principles of good practice in ontology development. The most novel aspects of the method are the use of formal mechanisms for literature annotation and expert stakeholder review to develop and improve the ontology content. We suggest the mnemonic SELAR3, representing the method’s first six steps as Scope, Entities, Literature Annotation, Review, Reliability, Relationships.

A priori assessment of a smart-navigated unmanned aerial vehicle disaster cargo fleet

The United Nations Office for the Coordination of Humanitarian Affairs has asserted that risks in deployment of unmanned aerial vehicles (UAVs) within disaster response must be reduced by careful development of best-practice standards before implementing such systems. With recent humanitarian field tests of cargo UAVs as indication that implementation may soon become reality, a priori assessment of a smart-navigated (autonomous) UAV disaster cargo fleet via simulation modeling and analysis is vital to the best-practice development process. Logistical problems with ground transport of relief supplies in Puerto Rico after Hurricane Maria (2017) pose a compelling use scenario for UAV disaster cargo delivery. In this context, we introduce a General Purpose Assessment Model (GPAM) that can estimate the potential effectiveness of a cargo UAV fleet for any given response region. We evaluate this model using the following standards: (i) realistic specifications; (ii) stable output for various realistic specifications; and (iii) support of humanitarian goals. To this end, we discuss data from humanitarian cargo delivery field tests and feedback from practitioners, perform sensitivity analyses, and demonstrate the advantage of using humanitarian rather than geographic distance in making fleet delivery assignments. We conclude with several major challenges faced by those who wish to implement smart-navigated UAV cargo fleets in disaster response, and the need for further GPAM development. This paper proposes the GPAM as a useful simulation tool to encourage and guide steps toward humanitarian use of UAVs for cargo delivery. The model’s flexibility can allow organizations to quickly and effectively determine how best to respond to disasters.

Incorporating Sex as a Biological Variable into Clinical and Translational Research Training.

Incorporating sex as a biological variable (SABV) into basic and medical research requires a deliberate plan that weaves concepts of basic genetics, cellular and molecular physiology, and pharmacology into translational medicine. An R4 approach (Right content to the Right learner at the Right time with the Right modality) allows for content to be available in a variety of formats that reinforces the concepts at staged levels of integration. Weaving SABV throughout the varied formats of the R4 approach within the Clinical and Translational Research Training Programs, into the mentoring and training of scholars in NIH Building Interdisciplinary Careers in Women's Health (BIRCWH), and into the Career Enhancement Core of the Specialized Centers of Research Excellence (SCORE) on sex differences through curriculum, case-based approach and journal clubs, and workshops ensures that learners grasp its fundamental relevancy to their own research and beyond. In addition, the collaborative work among the BIRCWH and SCORE programs brings collective expertise from centers around the United States to individual programs through development of best practices and materials. These collective efforts assure that the next generation of basic, clinical, and translational scientists will bring the dimension of SABV into their research and clinical practice.

Financial reporting quality, audit fees and risk committees

PurposeThe purpose of this paper is to examine the association between the existence of a risk committee (RC) in a firm and financial reporting quality. We also investigate whether having an RC has an effect on audit pricing. We argue that the existence of an RC in a firm contributes to higher financial reporting quality and this, eventually, affects audit pricing.Design/methodology/approachThis study uses two different proxies for RC measures and investigates the impact on financial reporting quality and audit pricing. Multivariate regression analysis and propensity score matching techniques are both applied to data from the Australian Stock Exchange's listed companies for the years 2001–2013.FindingsThe results indicate that the existence of an RC reduces the discretionary accruals; this means the financial reporting quality improves when RCs are in operation. Our findings also indicate that the existence of an RC increases audit fees.Practical implicationsThe findings from this study will be beneficial to the regulatory authorities responsible for improving the compliance of corporate governance (CG). An RC can serve as a risk-mitigating tool in the investment decision-making process. Finally, the results are beneficial for the development of best practices in CG by promoting the existence of an RC.Originality/valueThis study goes beyond the traditional focus on CG as we use the existence of an RC as an indicator of better governance practices to mitigate financial and non-financial risk factors. To the best of our knowledge, this paper is among the first to investigate the consequences for firms operating with RCs. This issue has implications for investors, auditors, directors and regulators.

Effect of COVID-19 on Urology Residency Training: A Nationwide Survey of Program Directors by the Society of Academic Urologists.

Coronavirus disease (COVID-19) has profoundly impacted residency training and education. To date, there has not been any broad assessment of urological surgery residency changes and concerns during the COVID-19 pandemic. The Society of Academic Urologists distributed a questionnaire to urology residency program directors on March 30, 2020 exploring residency program changes related to the COVID-19 pandemic. Descriptive statistics are presented. A qualitative analysis of free response questions was undertaken. A post hoc analysis of differences related to local COVID-19 incidence is described. The survey was distributed to 144 residency programs with 65 responses for a 45% response rate. Reserve staffing had started in 80% of programs. Patient contact time had decreased significantly from 4.7 to 2.1 days per week (p <0.001). Redeployment was reported by 26% of programs. Sixty percent of programs reported concern that residents will not meet case minimums due to COVID-19. Wellness activities centered on increased communication. All programs had begun to use videoconferencing and the majority planned to continue. Programs in states with a higher incidence of COVID-19 were more likely to report resident redeployment (48% vs 11%, p=0.002) and exposure to COVID-19 positive patients (70% vs 40%, p=0.03), and were less likely to report concerns regarding exposure (78% vs 97%, p=0.02) and personal protective equipment availability (62% vs 89%, p=0.02). As of April 1, 2020 the COVID-19 pandemic had resulted in significant changes in urology residency programs. These findings inform a rapidly changing landscape and aid in the development of best practices.

A stakeholder theory approach to creating value in higher education institutions

PurposeThis paper aims to empirically verify whether the development of improved relationships between higher education institutions (HEIs) and their stakeholders based on the principles of stakeholder theory creates more value.Design/methodology/approachThe methods involve a quantitative approach, with the data collection being carried out through a survey of 88 heads of HEIs in Brazil. The paper uses the Spearman’s correlation coefficient to analyze the data and test the hypotheses.FindingsThe findings reinforce the arguments found in the stakeholder theory literature, in which relationships are based on the following principles: knowledge and information sharing, mutual trust, involvement in the decision-makin g process and alignment of stakeholders’ interests in the strategic planning process, all of which create more value for organizations.Practical implicationsThis study seeks to improve the knowledge of stakeholder theory in relation to HEIs. It identifies the stakeholder relationships that create the most value and have the potential to generate a sustainable competitive advantage. The results can help managers to improve their relationships with stakeholders and may encourage the implementation of practices and policies that consider stakeholders’ influence on the strategic direction of HEIs.Social implicationsThe studies present a social contribution by evidencing the importance of the development of best practices, processes and strategies in the management of educational institutions, which are important actors in the development of society.Originality/valueThe originality of this paper is that it empirically tests the principles of stakeholder theory and their relationships with value creation for organizations in the higher education context. Whilst stakeholder theory has been explored in multiples contexts, there is a lack of studies addressing stakeholder management in HEIs.

Ethical, Legal, and Social Challenges in the Development and Implementation of Disaster Telemedicine

In recent years, advances in communications technology and market factors have led to a substantial expansion of telemedicine practice. One potential use of telemedicine is in disaster response, both as a resource for responders as well as a direct link to patients. The advantages of using telehealth to assist in disaster response are accompanied by important questions related to social impact, ethical implications, and regulatory oversight. A narrative review of several of these issues is presented here. The next steps in the development of a robust disaster telemedicine system will include the development of best practices and ethical guidelines agreed upon by all stakeholders, as well as the development of public-private partnerships geared at providing the highest quality disaster telemedicine to the greatest possible number of patients.

Sustainable Higher Education Development through Technology Enhanced Learning

Higher education is incorporating Information and Communication Technology (ICT) at a fast rate for different purposes. Scientific papers include within the concept of Technology Enhanced Learning (TEL) the myriad applications of information and communication technology, e-resources, and pedagogical approaches to the development of education. TEL’s specific application to higher education is especially relevant for countries under rapid development for providing quick and sustainable access to quality education (UN sustainable development goal 4). This paper presents the research results of an online pedagogical experience in collaborative academic research for analyzing good practice in TEL-supported higher education development. The results are obtained through a pilot implementation providing curated data on TEL competency’s development of faculty skills and analysis of developing sustainable higher education degrees through TEL cooperation, for capacity building. Given the increased volume and complexity of the knowledge to be delivered, and the exponential growth of the need for skilled workers in emerging economies, online training is the most effective way of delivering a sustainable higher education. The results of the PETRA Erasmus+ capacity-building project provides evidence of a successful implementation of a TEL-supported methodology for collaborative faculty development focused on future online degrees built collaboratively and applied locally.

Treponema spp., the dominant pathogen in the lesion of bovine digital dermatitis and its characterization in dairy cattle

This study examined the presence of Treponema in lesions using conventional PCR detection methods and investigated the microbiome by performing high-throughput DNA sequencing. Twenty-nine bovine digital dermatitis (BDD) lesions were collected from 25 dairy farms in South Korea that were tested by PCR amplification using sets of one universal, one genus-specific, and three species specific Treponema PCR primers. Three BDD samples were randomly selected and normal tissue samples were submitted for 16S rRNA sequencing using the Illumina MiSeq platform. The dominant phylum present in all tested BDD lesions was Spirochaetes with a mean relative abundance of 46.9 %, and Treponema was the most abundant genus. Spirochaetes abundance was followed by the phyla Tenericutes and Bacteroidetes with 14.1 % and 11.8 % mean abundances, respectively. Co-infecting bacteria from phyla Tenericutes and Bacteroidetes may be involved in the progression of BDD. Bovine digital dermatitis infection is polymicrobial in nature, but Treponema spp. are the main etiologic agents of the disease. In the microbiome results, Treponema pedis had the highest mean relative abundance (20.9 %) in the BDD lesions in this study followed by T. denticola, T. medium, T. lecithinolyricum, Spirochaeta africana, and Sediminispirochaeta bajacalifoniensis. All 29 samples were positive in the genus-specific Treponema PCR results. The species-specific PCR resulted in 75.9 %, 86.2 %, and 69.0 % of samples in groups T. medium/T. vincentii-like, T. phagedenis-like, and T. pedis, respectively. Understanding how these microorganisms mutually interact in the host during certain stages of infection may help in the development of better practices for controlling BDD.

Whose Data Is It Anyway? Lessons in Data Management and Sharing from Resurrecting and Repurposing Lidar Data for Archaeology Research in Honduras

As a response to Hurricane Mitch and the resulting widespread loss of life and destruction of Honduran infrastructure in 1998, the United States Geological Survey (USGS) conducted the first wide-area airborne lidar topographic mapping project in Central America. The survey was executed by the Bureau of Economic Geology at the University of Texas at Austin (BEG) in 2000, and it was intended to cover 240 square kilometers distributed among 15 flood-prone communities throughout Honduras. The original data processing produced basic digital elevation models at 1.5-meter grid spacing which were used as inputs for hydrological modeling. The USGS published the results in a series of technical reports in 2002. The authors became interested in this dataset in 2013 while searching for geospatial data that would provide additional context and comparative references for an archaeological lidar project conducted in 2012 in the Honduran Mosquitia. After multiple requests to representatives from the USGS and BEG, we found various types of processed data in personal and institutional archives, culminating in the identification of 8-mm magnetic tapes that contained the original point clouds. Point clouds for the 15 communities plus a test area centered on the Maya site of Copan were recovered from the tapes (16 areas totaling 700 km2). These point clouds have been reprocessed by the authors using contemporary software and methods into higher resolution and fidelity products. Within these new products, we have identified and mapped multiple archaeological sites in proximity to modern cities, many of which are not part of the official Honduran site registry. Besides improving our understanding of ancient Honduras, our experiences dealing with issues of data management and access, ethics, and international collaboration have been informative. This paper summarizes our experiences in the hope that they will contribute to the discussion and development of best practices for handling geospatial datasets of archaeological value.

Overcoming barriers to the adoption and implementation of predictive modeling and machine learning in clinical care: what can we learn from US academic medical centers?

There is little known about how academic medical centers (AMCs) in the US develop, implement, and maintain predictive modeling and machine learning (PM and ML) models. We conducted semi-structured interviews with leaders from AMCs to assess their use of PM and ML in clinical care, understand associated challenges, and determine recommended best practices. Each transcribed interview was iteratively coded and reconciled by a minimum of 2 investigators to identify key barriers to and facilitators of PM and ML adoption and implementation in clinical care. Interviews were conducted with 33 individuals from 19 AMCs nationally. AMCs varied greatly in the use of PM and ML within clinical care, from some just beginning to explore their utility to others with multiple models integrated into clinical care. Informants identified 5 key barriers to the adoption and implementation of PM and ML in clinical care: (1) culture and personnel, (2) clinical utility of the PM and ML tool, (3) financing, (4) technology, and (5) data. Recommendation to the informatics community to overcome these barriers included: (1) development of robust evaluation methodologies, (2) partnership with vendors, and (3) development and dissemination of best practices. For institutions developing clinical PM and ML applications, they are advised to: (1) develop appropriate governance, (2) strengthen data access, integrity, and provenance, and (3) adhere to the 5 rights of clinical decision support. This article highlights key challenges of implementing PM and ML in clinical care at AMCs and suggests best practices for development, implementation, and maintenance at these institutions.