Interdisciplinary Center Research Articles

Workshop on the Development and Evaluation of Digital Therapeutics for Health Behavior Change: Science, Methods, and Projects.

The health care field has integrated advances into digital technology at an accelerating pace to improve health behavior, health care delivery, and cost-effectiveness of care. The realm of behavioral science has embraced this evolution of digital health, allowing for an exciting roadmap for advancing care by addressing the many challenges to the field via technological innovations. Digital therapeutics offer the potential to extend the reach of effective interventions at reduced cost and patient burden and to increase the potency of existing interventions. Intervention models have included the use of digital tools as supplements to standard care models, as tools that can replace a portion of treatment as usual, or as stand-alone tools accessed outside of care settings or direct to the consumer. To advance the potential public health impact of this promising line of research, multiple areas warrant further development and investigation. The Center for Technology and Behavioral Health (CTBH), a P30 Center of Excellence supported by the National Institute on Drug Abuse at the National Institutes of Health, is an interdisciplinary research center at Dartmouth College focused on the goal of harnessing existing and emerging technologies to effectively develop and deliver evidence-based interventions for substance use and co-occurring disorders. The CTBH launched a series of workshops to encourage and expand multidisciplinary collaborations among Dartmouth scientists and international CTBH affiliates engaged in research related to digital technology and behavioral health (eg, addiction science, behavioral health intervention, technology development, computer science and engineering, digital security, health economics, and implementation science). This paper summarizes a workshop conducted on the Development and Evaluation of Digital Therapeutics for Behavior Change, which addressed (1) principles of behavior change, (2) methods of identifying and testing the underlying mechanisms of behavior change, (3) conceptual frameworks for optimizing applications for mental health and addictive behavior, and (4) the diversity of experimental methods and designs that are essential to the successful development and testing of digital therapeutics. Examples were presented of ongoing CTBH projects focused on identifying and improving the measurement of health behavior change mechanisms and the development and evaluation of digital therapeutics. In summary, the workshop showcased the myriad research targets that will be instrumental in promoting and accelerating progress in the field of digital health and health behavior change and illustrated how the CTBH provides a model of multidisciplinary leadership and collaboration that can facilitate innovative, science-based efforts to address the health behavior challenges afflicting our communities.

The Junior Research Academy 2017 of the German Research Foundation (DFG) - Promotion of Young Researchers in Health Services

The fourth Junior Research Academy in Health Services Research was once again funded by the German Research Foundation (DFG) in 2017. The academy was initiated by the Centre for Health and Society (chs) in Düsseldorf with the participation of the Centre for Health Services Research Cologne (ZVFK), the Research Centre for Health Communication and Health Services Research (CHSR) of the Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy of the University Hospital Bonn, the Interdisciplinary Centre for Health Services Research (IZVF) in Witten and the Institute for Health Services Research and Clinical Epidemiology (IVE) of the University Marburg. The aims of the Junior Research Academy are for imparting skills in the development and elaboration of innovative project ideas, to increase the number of proposals from the field of health services research to the DFG, to strengthen basic research within health services research in Germany and to network the scientific community. Young researchers from all over Germany were eligible to apply for participation by submitting an application in the form of a research proposal. A total of 83 applications were received. The 21 most promising applicants (14 women and 7 men) were selected in a 2-stage review process; 20 of these completed the Junior Research Academy program. After a one-day preparatory workshop, the preparation and review of a sample application, an academy week and a finalisation phase, all applications were submitted to the DFG on time. Of these proposals, 9 were funded. The first alumni meeting of the DFG Junior Research Academy took place in Düsseldorf in July 2019.

No Away

Phantom Limb Company's performance, Falling Out, examines the 2011 earthquake, tsunami and subsequent nuclear meltdown in Fukushima, Japan. The University of Utah will present the work in 2020, as part of an ongoing collaboration between the University's multidisciplinary presenter, sustainability office and an interdisciplinary faculty research centre. Timothy Morton states ‘…there is no “away” after the end of the world. It would make more sense to design in a dark ecological way, admitting our coexistence with toxic substances we have created and exploited'. Writing about Falling Out will serve as a record of the work's impact on the co-authors, and help grapple with our task of guardianship of the toxic world we have created for a future we cannot predict. Under the headings 1) Nature, 2) Body and 3) Time we consider ways that the work designs many bodies' coexistence with the toxic substances humans have created. In Nature, we introduce risk through questions of natural hazard resilience and representation. In Body, we use Mel Y. Chen's work on animacies and environmental justice scholarship on Fukushima to describe the entanglement of the puppet, human, human projected and garbage bag bodies in the work. In Time, we conclude with Amitav Ghosh's ideas of the uncanny to consider the cascading effects of the moment that strain in Earth’s crust reached the critical breaking point and the weight of the entire ocean propelled to land with the tsunami to the moment in an imagined future when the impacts of this fallout will no longer be felt. We consider how expanding our sense of time to include the millennia of geologic processes may make hope possible. On these time scales, all is renewed.

Old Believers in Belarus and neighboring countries: historical stage of research and methodological approaches

The article focuses on the historical stages of the study of the Old Believers in Belarus, Russia, Poland, Lithuania and Ukraine and main methodological strategies. The article notes the experience of creating interdisciplinary centers for the study of Old Believers (Lithuania, Russia, Poland) which is useful for Belarus in connection with the existence of its own tradition of security. The author makes a conclusion about the necessity of comprehensive interdisciplinary studies of Old Believers, as well as about development of regional dimension in the Belarusian religious studies.

Taking the Next Steps in Regenerative Rehabilitation: Establishment of a New Interdisciplinary Field

The growing field of regenerative rehabilitation has great potential to improve clinical outcomes for individuals with disabilities. However, the science to elucidate the specific biological underpinnings of regenerative rehabilitation–based approaches is still in its infancy and critical questions regarding clinical translation and implementation still exist. In a recent roundtable discussion from International Consortium for Regenerative Rehabilitation stakeholders, key challenges to progress in the field were identified. The goal of this article is to summarize those discussions and to initiate a broader discussion among clinicians and scientists across the fields of regenerative medicine and rehabilitation science to ultimately progress regenerative rehabilitation from an emerging field to an established interdisciplinary one. Strategies and case studies from consortium institutions—including interdisciplinary research centers, formalized courses, degree programs, international symposia, and collaborative grants—are presented. We propose that these strategic directions have the potential to engage and train clinical practitioners and basic scientists, transform clinical practice, and, ultimately, optimize patient outcomes.

Use of the Multidisciplinary Specialised Case Conference at the Freiburg Orbital Centre

The treatment of tumors increasingly takes place in specialised interdisciplinary centres. Therapeutic decisions are usually made at case conferences. Ophthalmologists, oromaximillofacial surgeons, ENT physicians, neurosurgeons, as well as pediatricians, radiotherapists and radiologists are all involved in the treatment of orbital diseases. The aim of this article is to present the concept of a multidisciplinary case conference for orbital diseases and to analyse case numbers, indications, and the influence on the patient's therapy. We analysed an anonymized data set of patients who presented in the case conference of the University Hospital Freiburg from 2008 to 2018 with regard to clinical diagnosis, histological diagnoses, number of surgical interventions, and number of interdisciplinary therapy decisions. From 2008 to 2018, 545 patients were presented in a weekly conference. Of these, 453 were available for anonymous evaluation. The median age was 56 years (quartiles 41; 69). The most frequent indication was an orbital tumour of unclear malignancy (n = 52; 11%). Further indications included Grave's orbitopathy (n = 39; 9%), orbital pseudotumour (n = 36; 8%), cranial nerve palsy (n = 22; 5%), and orbital lymphoma (n = 22; 5%). The most frequent histological diagnoses were B-cell lymphoma (n = 10; 2%), venous malformation (cavernoma, n = 8; 2%), marginal zone lymphoma (n = 8; 2%), and squamous cell carcinoma (n = 6; 1%). An interdisciplinary therapeutic approach was defined for 174 patients. A high demand for the interdisciplinary case conference was demonstrated. The high rate of primary or secondary interdisciplinary decisions indicates the value of such a conference. Hence, the patient is spared multiple examinations in the individual specialist areas and quick and effective therapy decisions can be achieved.

Cooperation behaviour of primary care paediatricians: facilitators and barriers to multidisciplinary obesity management.

Multidisciplinary management of obesity by primary care paediatricians, providing a promising approach to tackle childhood obesity includes cooperation with other health care professionals. However, facilitators for and barriers to multidisciplinary cooperation in ambulatory care are not yet well understood and are investigated in the present study. A nationwide, cross-sectional survey of 83% of German primary care paediatricians was conducted, using a questionnaire based on qualitative expert interviews. Frequency of paediatricians' cooperation with external partners (i.e. nutrition counsellors; sports groups; interdisciplinary obesity centres; inpatient rehabilitation centres; and endocrinologists) was assessed. Individual and structural factors were associated with cooperation patterns. Missing values were addressed using multiple imputation. Out of the 6081 primary care paediatricians approached, 2024 (33.3%) responded. Almost half of the respondents (40.8%) stated that they disengaged in the field of obesity prevention due to perceived inefficacy. Lack of financial reimbursement for consultation was agreed on by most of the respondents (90.4%). Identified barriers to cooperation included: higher proportion of patients with migration background, lack of time and available services. A more comprehensive conception of the professional role regarding overweight prevention, higher age, female gender, higher proportion of overweight/obese patients and practice location in urban or socially strained areas surfaced as facilitators for cooperation. Low-perceived self-efficacy in obesity management and insufficient financial reimbursement for consultation are commonly stated among German paediatricians. For cooperation behaviour, however, other individual and structural factors seem to be relevant, which provide indications on how multidisciplinary childhood obesity management can be improved.

Intraoperative and late complications after spinal tumour resection and dorsoventral reconstruction

Spinal tumors are acontinuously growing pathology group among the spinal diseases. The often-difficult circumstances increase vulnerability to awide range of intervention-related complications, which can occur at different times in the course of the disease and must be included in the consideration of the indication. The aim of the work is to present the wide spectrum of complications in the surgical treatment of spinal tumors, as well as their treatment and prophylaxis through optimal therapy management. The article summarizes the current literature. The literature describes complication rates of 10-67% after metastatic surgery of the spinal column. The most common complications are infections and internal, especially pulmonary, complications. Other relevant complications include surgical positioning/surgical access/instrumentation/mechanical failure, and anesthesiological, neurological, vascular and oncological complications. The socio-economic costs for patients with complications compared to those for patients without complications are twice as high. Aspecial risk situation exists with radical spinal tumor resections. Negative predictors are previous operations, previous irradiation and local recurrences. An early, interdisciplinary concept can reduce complications significantly. Due to the planning intensity, surgical expertise and comprehensive structural requirements, treatment in an interdisciplinary tumour centre is necessary.

The influence of neighbouring countries and sciences and the international spread of Viennese medicine: Carl Freiherr von Rokitansky's international relations.

The science-based Viennese School of Medicine arose from the collaboration between pathological anatomy and clinical medicine. The recognition of the clinical-pathological correlation enabled the Bohemian pathological anatomist Carl Rokitansky to describe the course of adisease and make adiagnosis. Rokitansky's systematic classification and explanation of diseases, documented in the Manual of Pathological Anatomy, was published in several languages and thus led to medical specialisation in Vienna and beyond the borders of Austria. It also contributed to the Medical Faculty of the University of Vienna becoming an interdisciplinary centre of expertise that attracted students from all over the world. Rokitansky's methodology was influenced by his early studies of the humanities in Prague. This article describes the impact of Rokitansky's handbook using new sources from the Rokitansky family archive, focusing in particular on its international reception and the relationships that were formed as aresult. The model of Viennese Medicine was transferred to universities abroad and implemented in new medical schools in Japan, Iran, Mexico, Greece and the USA that developed it further. Rokitansky's international network contributed greatly to this transfer of knowledge as shown by newly-discovered source material from the Rokitansky family archive.

Two hearts beating in a research centers’ chest: how scholars in interdisciplinary research settings cope with monodisciplinary deep structures

ABSTRACT Interdisciplinary research is a popular mode of knowledge production that becomes intensively promoted by research centers all across the globe. Despite the facilitation of interdisciplinary research, however, scholars working in these centers are ‘disciplined.’ Career promotions, funding decisions and scientific publishing are based on peer-review procedures that tend to favor monodisciplinary research. This paper builds on a qualitative study with scholars in interdisciplinary research centers in Germany and asks how scholars cope with these monodisciplinary demands. After deriving a conceptual framework, the study identifies four coping strategies: disciplinary innovation, strategic compliance, niche-seeking, and field creation. Each of these strategies is characterized by a different degree of openness to knowledge bases of other disciplines and a different degree of proactivity towards monodisciplinary demands from the scientific field. The results illuminate how research agendas become disciplined despite interdisciplinary motivation and organizational support of interdisciplinary research.

FAIR data for prehistoric mining archaeology

This paper presents an approach how to create FAIR data for prehistoric mining archaeology, based on the CIDOC CRM ontology and semantic web standards. The interdisciplinary Research Centre HiMAT (History of mining activities in the Tyrol and adjacent areas, University of Innsbruck) investigates mining history from prehistoric to modern times with an interdisciplinary approach. One of the projects carried out at the research centre is the multinational DACH project “Prehistoric copper production in the eastern and central Alps”. For a specific geographical region of the project, the data transformation to open and re-usable data is investigated in a separate Open Research Data pilot project. The methodological approach will use the FAIR principles to make data Findable, Accessible, Interoperable and Re-usable. Every archaeological investigation in Austria has to be documented according to the requirements of the Austrian Federal Monuments Office. This documentation is deposited in the CERN-based EU supported research data repository ZENODO. For each deposited file, metadata are created through the application of the conceptual metadata schema CIDOC CRM, an ISO standard for Cultural Heritage Information, which was adopted by ARIADNE, the European Union Research Infrastructure for archaeological resources. Concepts specific to mining archaeology research are organized with the DARIAH Back Bone Thesaurus, a model for sustainable interoperable thesauri maintenance, developed in the European Union Digital Research Infrastructure for the Arts and Humanities. Metadata are created through the extraction of information from the documentation and the transformation to a knowledge graph using semantic web standards. To facilitate usage, graph data are exported to hierarchical and tabular formats representing sites and objects with their geographic locations, temporal and typological assignments and links to the research activities and documents. Metadata are deposited together with the documentation into the repository.

The Israeli Peace Camp

75 Journal of South Asian and Middle Eastern Studies Vol. 43, No.3, Spring 2020 The Israeli Peace Camp Galia Golan* Israel has a very active civil society that includes quite a large array of peace organizations. In fact, the longer the occupation of the West Bank (including East Jerusalem) and the Gaza Strip that began in 1967 lasts, the more such groups multiply. However, this is not a contradiction. Rather the growth of this sector of civil society is commensurate with the growing frustration and even despair of many in the Israeli public regarding the possibilities for a peaceful resolution to the Israeli-Palestinian conflict and an end to the occupation. Therefore, individuals and groups have sought new, untried methods to promote the cause of peace, created new frameworks and the possibility of addressing more and different audiences. This article will try to address the various types of groups, their distinctive features, and their roles over the years with regard to this intractable conflict. What will be more difficult to ascertain is the efficacy of these groups.1 Indeed it is often impossible to judge the impact of civil society and social movement groups, especially those with the amorphous goal of peace. It is also almost impossible to draw a direct line of causality between groups’ actions and governmental decisions. Leaders are hesitant to credit a movement, or anyone but themselves, with the success of achieving peace. Moreover, many factors are at play in reaching a successful conclusion such as a peace agreement and end to the conflict. These might include the *Galia Golan is Darwin Professor emerita of the Hebrew University of Jerusalem, where she was chair of the Political Science Department. More recently, she was Head of the Program in Diplomacy and Conflict Studies at the Interdisciplinary Center, Herzliya. Golan has published 10 single-authored books, most recently Israeli Peacemaking Since 1967: Factors for the Breakthroughs and Failures. She has co-authored Non-state Actors in the Middle East: Factors for Peace and Democracy and co-edited Spoilers and Coping with Spoilers in the Israeli-Arab Conflict. Golan is the recipient of many honors, including the Israel Political Science Association 2007 Award for “Lifetime Contribution,” the 2019 Scholar/Activist Award from the International Studies Association, the International Studies Association “Distinguished Scholar” Award 2016, and the 1995 New Israel Fund “Alice Shalvi Women in Leadership” Award. 1 See Galia Golan, “The Impact of Peace and Human Rights NGOs on Israeli Policy,” in Galia Golan and Walid Salim (eds.), Non-State Actors in the Middle East for Peace and Democracy, Routledge, 2013, pp. 28-41. 76 parties themselves; third parties; the domestic, regional, and global environments; public opinion and public discourse; the media; and more. All this makes it difficult, if not impossible, to determine the contribution of peace groups in Israel, as well as anywhere else, to the end product. There were always peace groups in Israel, even in the pre-state Jewish community in Palestine before the United Nations granted statehood in 1948. The pre-state group, Brit Shalom, for example, was not an activist organization but, rather, a collection mainly of intellectuals (most notably, Martin Buber) who believed that Jews and Arabs could and should live together peacefully in a joint state. Intellectual groups like this were not uncommon while more activist peace organizations were often sponsored by local Communists.2 However, all of these, including the Communist groups, remained relatively limited in numbers. A virtually one-man peace protest appeared in the wake of the 1973 Yom Kippur War: a lone reserve officer, Mottie Ashkenazi, stood outside the Prime Minister’s residence, accusing the government of having failed to provide readiness in case of an attack such as that which occurred on October 6, 1973 when Egyptian and Syrian armies attacked Israel. Although this protest contributed, at least in part, to the resignations of Prime Minister Golda Meir and key players in her government some months later, no movement developed or ensued. (See Tamar Hermann for a detailed study of the history of the peace camp in Israel.3 ) In fact, the first, and only mass peace organization, Peace Now, was not created until some...

Percepción de la rehabilitación visual: Una mirada desde las personas con baja visión

Introducción: la baja visión es una categoría de discapacidad visual que requiere un proceso de rehabilitación para maximizar la función visual y permitir a la persona desarrollar habilidades compensatorias para mejorar su funcionalidad. Objetivo: describir las percepciones de las personas con baja visión que recibieron servicios de rehabilitación funcional visual en dos centros de atención, frente al aporte de los servicios y barreras identificadas en el proceso. Metodología: Estudio cualitativo de tipo exploratorio. Se realizaron 14 entrevistas semiestructuradas a personas que realizaron su rehabilitación visual en dos centros de atención: Uno en Bogotá con un proceso de atención interdisciplinario y otro en Bucaramanga con un proceso de atención de menor interdisciplinariedad. El análisis siguió el proceso de descubrimiento, codificación y relativización de los datos. Resultados: Las personas que asistieron al centro de menor interdisciplinariedad, reconocieron el aporte de la rehabilitación para el desarrollo de actividades cotidianas básicas e instrumentales. Quienes asistieron al centro de mayor interdisciplinariedad destacaron los aportes de psicología, orientación y movilidad, y trabajo social como fundamentales. Pese a lo anterior, en las dos ciudades persisten barreras: dificultades para adquirir ayudas ópticas, de movilidad, arquitectónicas y para la inclusión laboral. Discusión: Se evidencia la necesidad de garantizar una rehabilitación funcional interdisciplinaria que contemple intervenciones adicionales a la prescripción de ayudas ópticas. Conclusiones: Los servicios interdisciplinarios obtienen mejores resultados en cuanto a las transformaciones que logran las personas en: aceptación de la condición de baja visión, movilidad, acceso a tecnología, y reconocimiento de derechos.

Ian Donaldson (1935–2020)

Ian Donaldson (1935–2020) R. S. White, Martin Butler, and David McInnis Click for larger view View full resolution Ian Donaldson, FBA FRSE FAHA, was a much-valued member of the Parergon International Editorial Board and foundation Chairman of the Advisory Board for the ARC Centre of Excellence for the History of Emotions. After graduating from Trinity College, University of Melbourne (BA Honours, 1957), and Magdalen and Merton Colleges, Oxford (BA 1961, MA 1964), Ian began his career as Fellow and Lecturer in English at Wadham College, Oxford (1962–1969). At a remarkably young age, he was elected chair of the Oxford English Faculty, and later in his career he became chair of the Cambridge English Faculty (1999–2001), a possibly unique double honour at these august universities with their ancient rivalry. Perhaps only a courteous and diplomatic Australian could manage to satisfy both. In 1969 Ian returned to Australia as Professor of English at the Australian National University (1969–1991), and with apparent inevitability rapidly became Head of Department. A change which was to be prophetic in his career came in 1974, on Ian’s appointment as founding Director of the Humanities Research Centre at the Australian National University, a post which he held until 1990, and then again from 2004 to 2007. In a kind of interregnum he returned to teaching English, first from 1991–95 holding the Regius Professorship of Rhetoric and English Literature at Edinburgh University (1991–95; Head of Department, 1992–94; [End Page xiii] Director, Postgraduate School, 1992). This was a position which, he pointed out with bemusement, was an appointment made by the monarch personally, and was the oldest such chair in the world (instituted 1762 as the Regius Chair in Rhetoric and Belles Lettres). Then in 1995–2002 he moved to Cambridge as Grace 1 Professor of English at Cambridge University and Fellow of King’s College (1995–2002). His experience at the HRC in Canberra richly qualified him to set up a similar research environment as the Founding Director, Centre for Research in the Arts, Social Sciences, and Humanities, Cambridge University (2001–03) which is still thriving, despite its apparent train wreck acronym, CRASSH. Returning to Australia, Ian became Honorary Professorial Fellow in the School of Culture and Communication, University of Melbourne (2007–20), where he continued to research and supervise postgraduates. He was elected President of the Australian Humanities Academy (2007–09). Some of his experiences as a life-long research administrator and leader in the Humanities were drawn together in Taking Stock: The Humanities in Australian Life since 1968, edited with Mark Finnane (The University of Western Australia Publishing, 2012). Through his contribution on the Advisory Board for the interdisciplinary ARC Centre of Excellence for the History of Emotions (2011–17), he exerted continuing influence on the Humanities globally. It was a remarkable career, unrivalled in sustained prestige, peer admiration and research leadership. Ian Donaldson’s primary research field was Renaissance literature, and he was the undisputed world expert on the poet and playwright, Ben Jonson. He was chosen to edit authoritative editions, Ben Jonson: Poems (1975) and Ben Jonson (Oxford Authors, 1985). Those who work in early modern literature will know how massive and comprehensive was Jonson’s oeuvre and how significant he was in his age. Amongst Ian’s monographs were The World Upside-Down: Comedy from Jonson to Fielding (1970), The Rapes of Lucretia: A Myth and its Transformations (1982), and Jonson’s Magic Houses: Essays in Interpretation (1997). He wrote entries on Jonson and others for the Oxford Dictionary of National Biography, as well as many articles on a variety of topics, including insightful essays on Shakespeare. His own long-awaited and superbly readable biography, Ben Jonson: A Life (2011), hailed as erudite and definitive in historical and literary coverage, was short-listed for the James Tait Black Biography Prize and the H. W. Fisher Best First Biography Prize in 2012. Ian’s musings on the difficulties and craft of literary biography appeared in various essays and in his co-edited book, Shaping Lives: Reflections on Biography (1992), as well as a short monograph The Death of the Author and the Lives of the Poets...

EXERCÍCIOS FUNCIONAIS NA 'AUTOGESTÃO’ E ‘AUTONOMIA’ DE PESSOAS IDOSAS COM OSTEOARTROSE

This paper reports the project developed by the Interdisciplinary Center of Studies and Extension in Health Care to Families Living with Chronic Diseases – NIEFAM at the State University of Southeastern Bahia. The project aimed to perform and intervention, using physical activity, on the musculoskeletal system of elderly people in Osteoarthrosis treatment, and verify whether post-intervention patients presented improvement in their daily life functional capability, self-management and health autonomy. A mixed and interventionist method was implemented in the Urban Social Center of Jequie, BA, during the period March-June/2019, through a kinesiotherapy protocol, supported by instruments such as the Lawton Scale, Analog Visual Scale; semi-structured interview and clinical record and medical record for the treatment of five elderly women. The results showed positive impacts on the process of healthier longevity in the patients’ daily activities, in prevention/control of non-communicable chronic diseases, pain relief, and the significance of the interventionist method which provided the patients with the first proximal care actions.

Developing a Comprehensive, Interdisciplinary Concussion Program.

There has been a growing trend of local and national coverage of and interest in concussion injuries over the past 2 decades. Increasing public concern over potential catastrophic and unknown long-term effects of sports-related concussion injuries has led to an acknowledgment of the strong public health need for addressing all concussion injuries, regardless of mechanism of injury. In efforts to address this need for concussion prevention and management, both in sports and nonsports, The University of Kansas Health System initiated the interdisciplinary Center for Concussion Management program in 2012. The program was created as a virtual clinic concept and includes voluntary participation from various providers across the institution, limited budget, and space obstacles. Since its inception, the program has continued to operate as its initial design of a multidisciplinary team model outside the sole ownership of 1 department, and has expanded to include education and outreach to local and regional schools and groups.

Robustness on topology reconfiguration of complex networks: An entropic approach

Study on complex networks illustrates systems of real-world in disparate realms that incorporates a range of biological networks to technological systems and has, over the past years, become one of the most important and fascinating fields of the interdisciplinary research center. These complex networks share many topological features such as the small-worldness, scale-freeness, the existence of motifs and graphlets and self-similarity. In most cases, complex and real-networks are very large, and the description and analysis of them in explicit form is often faced with difficulty. We manage to head off aforementioned troubles by examining successful models amongst communication networks in some particular aspects, including important factors such as cost, security, integrity, scalability, and fault tolerant. The last factor is distinctly important for each communication network. Recently, some methods and mechanisms have been proposed to increase and improve the robustness of network by modifying its topology. The rewiring is the mechanism amongst the defensive strategies to increase the resilience of attacked networks in which the affected nodes are disconnected from faulty nodes and, possibly, connect to another profitable node with a specific probability. In this paper, a rewiring mechanism based on Shannon entropy concept is proposed to streamline the complex networks configuration in order to improve their resiliency. Network entropy is a quantitative criterion for describing its robustness and is acknowledged as one of the topological characteristic criteria. In practice, this quantity is related to the capacity of the network to tolerate changes in its configuration under various environmental constraints. We evaluate the network robustness based on the spectrum of degree distribution, heterogeneity, as well as the average size of the largest connected cluster during removing nodes with a sequence of systematic attacks based on the degree, betweenness, and Dangalchev’s closeness centralities. The proposed rewiring strategy is applied over six synthetic networks and six real datasets, and then we verified that through approximately 30% swapping of links, the overall robustness of networks can be reached.

Organizational Culture and Readiness for Change in German pediatric outpatient centres

Abstract Background Organizational readiness for implementing change (ORIC) is presumed key for successful change in healthcare settings. At the same time, ORIC is theorized to depend on cultural and other factors of the organizational context. Within the process evaluation of the PART-CHILD intervention in interdisciplinary pediatric outpatient centres (IPOC) for children with chronic health conditions in Germany, we assessed to what extent ORIC is associated with organizational culture and further contextual factors. Methods In 2019 data was collected from health care professionals in 12 IPOC, using a questionnaire comprising subjectively perceived ORIC (measure: ORIC, 5-point Likert scale), the organization’s culture (measure: Competing Values Framework, four domains: Group, Developmental, Rational, and Hierarchical Culture) and further contextual factors (e.g., size of the facility, number of patients per year). Results In all, responses from 206 health care professionals were included in the analyses (response rate: 47%; preliminary results). Analyses show a moderate ORIC (3,4; SD = 0,6), positively associated with Group Culture (r2=0,178, p = 0,01) and negatively associated with Rational Culture (r2=-0,273, p < 0,001). We found no correlations between ORIC and Developmental or Hierarchical Culture. In congress presentation we report to what extent ORIC depends on further contextual factors (e.g., size of the facility, patients’ demographic characteristics). Discussion IPOC with a strong Group Culture show a higher ORIC than those with prevailing Rational Culture. To potentially increase effective implementation of interventions in healthcare facilities in future, a preceding evaluation of the organizational culture might be valuable. Thereby, settings with prevailing Rational Culture could be identified at an early stage and receive additional implementation support, e.g. through enhancing the Group Culture among the health care professionals on-site (e.g, executive coaching). Key messages Both organizational readiness for implementing change and organizational culture are presumed to be important for implementing change in healthcare facilities‘ routine care. Assessing both constructs prior to implementing a costly intervention with demanding change processes within healthcare settings could be valuable.

Importance and feasibility of implementing child and parent centeredness in routine care

Abstract Background Child and parent centeredness (CPC) are important determinants of the quality of care for children with chronic health conditions. However, little is known about the perceptions of healthcare professionals on the importance and feasibility of implementing CPC in routine care, although both might be key for the successful implementation of CPC. We therefore assessed the perceptions of healthcare professionals concerning this matter and analysed, how familiarity with the International Classification of Functioning, Disability and Health (ICF) might strengthen CPC. Methods Cross-sectional data was collected in 12 specialized interdisciplinary outpatient centres providing treatment for children with chronic health conditions in Germany. The standardized questionnaire covered (1) the importance of implementing child (CC) and (2) parent centeredness (PC) as well as (3) the feasibility of implementing CC and (4) PC in routine care (based on Arnetz et al. 2008, Patient Involvement Subscale) and (5) the prior use of the ICF. Bivariate associations were assessed with permutation tests. Results In total, 206 healthcare professionals were surveyed (response rate: 47 %). The perceived feasibility of implementing CPC fell short of their importance (p < 0,001). Moreover, CC was ranked lower than PC in terms of both importance and implementation feasibility (p < 0,001, respectively). Prior use of the ICF was associated with higher importance of CC (p < 0,001) and PC (p = 0,01). Conclusions While the importance of CPC to healthcare professionals was high, the active involvement of children and the routine implementation of CPC were perceived as challenging. Interventions to facilitate the implementation of CPC should therefore comprise hands-on implementation strategies and put a special focus on how to involve children in routine care (e.g., through special communication techniques). Including the ICF as a conceptual framework in interventions to foster CPC could be a facilitator. Key messages While child and parent centeredness are important to healthcare professionals, their implementation in routine care and the active involvement of children are challenging. Interventions to foster the implementation of child and parent centeredness should include concrete practical implementation strategies and put a special focus on the involvement of children.

Provocations in Critical Disability Studies, Interdisciplinary Centre of the Social Sciences, University of Sheffield

Provocations in Critical Disability Studies, Interdisciplinary Centre of the Social Sciences, University of Sheffield