Online Toolkit Research Articles

Metabonomic Profile of Macrosteatotic Allografts for Orthotopic Liver Transplantation in Patients With Initial Poor Function: Mechanistic Investigation and Prognostic Prediction.

BackgroundOur previous study revealled amplified hazardous effects of macrosteatosis (MaS) on graft failure (GF) in recipients with severe liver damage in short post-operative days, with vague mechanism inside.AimWe aimed to uncover the molecular mechanism of donor MaS on GF, and construct the predictive model to monitor post-transplant prognosis based on “omics” perspective.MethodsUltra-performance liquid chromatography coupled to mass spectrometry metabolomic analysis was performed in allograft tissues from 82 patients with initial poor function (IPF) from multi-liver transplant (LT) centers. Pathway analysis was performed by on-line toolkit Metaboanalyst (v 3.0). Predictive model was constructed based on combinative metabonomic and clinical data extracted by stepwised cox proportional analysis.ResultsPrinciple component analysis (PCA) analysis revealled stratification on metabolic feature in organs classified by MaS status. Differential metabolits both associated with MaS and GF were significantly enriched on pathway of glycerophospholipid metabolism (P < 0.05). Phosphatidylcholine (PC) and phosphatidylethanolamine (PE) involved in glycerophospholipid metabolism was significantly decreased in cases with MaS donors and GF (P < 0.05). Better prediction was observed on graft survival by combinative model (area under the curve = 0.91) and confirmed by internal validation.ConclusionMetabonomic features of allografts can be clearly distinguished by MaS status in patients with IPF. Dysfunction on glycerophospholipid metabolism was culprit to link donor MaS and final GF. Decrement on PC and PE exerted the fatal effects of MaS on organ failure. Metabonomic data might help for monitoring long-term graft survival after LT.

Synthesis, Characterization, Antitubercular Activity and Docking Studies of 2-(benzo [d]oxazol-2-ylthio)-1-(3-(4-fluoro-3- methylphenyl)-5-(substituted aryl)-4,5-dihydro-1H-pyrazol-1-yl) ethanone

A new series of 2-(benzo[d]oxazol-2-ylthio)-1-(3-(4-fluoro-3-methylphenyl)-5- (substituted aryl)-4,5-dihydro-1H-pyrazol-1-yl)ethanone (6a-6j) were designed and synthesized from the intermediate chalcones (1a-1j). The synthesized compounds were characterized by FT-IR, 1H-NMR, Mass spectroscopy and bases of elemental analysis. The agar dilution method (In vitro M. tuberculosis method) was employed for anti-tubercular screening. From the study, it was revealed that compounds 6b and 6h showed increased potency. In phenyl ring attached to 4,5-dihydropyrazole ring presence of electron donating substituent like dimethylamino, hydroxy and methoxy moiety mightbe responsible for the powerful anti-mycobacterial activity displayed by derivatives 6b and 6h. Further docking studies were performed to predict the interactions of the target compounds 6a-6j within the Mycobacterium tuberculosis enoyl reductase enzyme by their scores and mode of binding to amino acids. In addition, drug-likeness score and molecular properties responsible for a good pharmacokinetic profile were calculated by Osiris property explorer and Molinspiration online toolkit, respectively. From the results, it was revealed that the synthesized compounds with electron releasing groups showed the most potent activity compared to that of standard drug. Key words: Anti-tubercular activity, Benzo[d]oxazole-2-thiol, Chalcones, Docking studies, Pyrazolines.

Systems Analysis and Design Toolkit Based on Work System Theory and Its Extensions

This article describes proposed content of an online toolkit for users of the work system modeling method (WSMM), an extension of the work system method (WSM), which was developed to help business professionals understand IT-reliant systems and collaborate with IT professionals. A summary of work system theory (WST) and WSM provides a background. A two-dimensional design space for modeling methods illustrates WSMM's context. Two limitations of WSMM imply the need for a toolkit that overcomes those limitations. An auto rental example is used to illustrate a series of modeling, analysis, and design modules related to different stakeholder purposes. Most of the modules reflect components of Word documents used as outlines to produce over 700 management briefings, mostly by MBA and Executive MBA students, between 2003 and 2017. A concluding section summarizes the main ideas, explains how the use of different modules based on the work system metaphor flexibly supports systems analysis and design, and identifies challenges for future research.

Increasing adult immunization rates in a rural state through targeted pharmacist education

BackgroundMost immunization rates fall below the Healthy People 2020 goals for adults. Pharmacists have the potential to have a positive effect on immunization rates through vaccine administration. ObjectiveThe purpose of this study was to assess if an educational program developed for pharmacists could increase pharmacist-delivered statewide immunization rates. Practice descriptionThis study was conducted in the state of North Dakota. North Dakota law allows authorized pharmacists to provide any immunization to individuals aged 11 years or older. Practice innovationIn collaboration with the state health department, a needs assessment of North Dakota pharmacists was conducted to determine what resources and education could increase the delivery of immunizations within the pharmacy. The results were used to develop focused continuing pharmacy education material, create an online toolkit, and provide immunization administration certification. EvaluationThe number and proportion of pharmacist-delivered immunizations and overall adult immunizations rates were compared pre- and postintervention. The North Dakota Immunization Information System was used for data comparison. In addition, the number of pharmacists registered to provide immunizations with the State Board of Pharmacy was tabulated. ResultsThe number of pharmacist-provided immunizations increased by more than 3900 doses. In addition, the percentage of adult immunizations provided by pharmacists and overall adult immunization rates increased throughout the state. After adjusting for seasonality, there was an increase in the number of pharmacist-delivered pneumococcal polysaccharide vaccine immunizations (P < 0.001). The number of pharmacists registered to provide immunizations increased throughout the study period by 39%. ConclusionThis study suggests that focused education and resources delivered to pharmacists can increase pharmacy-based immunization rates and adult immunization rates overall. Improving adult immunization rates through greater pharmacist engagement may help to decrease overall infectious disease threats.

2561. Doxycycline Saves Lives! Educating Healthcare Providers on Tickborne Rickettsial Diseases in the United States Using an Online Toolkit

BackgroundTickborne rickettsial diseases (TBRDs), including Rocky Mountain spotted fever (RMSF), are major causes of illness in the United States. Doxycycline is the first-line treatment for patients of all ages; delay in treatment is the single most important predictor of fatal outcome. Recent assessments have identified a lack of knowledge in recognition and treatment of RMSF among providers. CDC developed an online toolkit to address the need for increased awareness in the medical and public health communities.MethodsIn August 2018, CDC released the Rocky Mountain Spotted Fever (and other tickborne diseases) Toolkit for Healthcare Providers, an online platform including: (1) Narrated video discussing RMSF clinical presentation, diagnosis, and treatment, (2) Physician pocket card, (3) Clinical timeline with images to aid diagnosis, and (4) Tickborne Diseases of the United States Manual. Participants receive free continuing education (CE) by scoring ≥75% on a posttest and providing an evaluation. We summarized post-test scores and evaluations to assess impact on participant knowledge and satisfaction with the format.ResultsAs of April 30, 2019, there have been 14,103 visits to the toolkit website. In total, 247 participants registered for CE and completed the posttest; 245 (99%) passed. The majority of participants self-reported as nurses (121, 49%), followed by other professionals (32, 13%) and physicians (31, 13%). All posttest questions except one indicated correct responses were selected by ≥80%. In all, 245 provided a course evaluation; 94% agreed the content and materials addressed a gap in their knowledge, and 84% agreed the knowledge gained from the activity could be applied to practice. Nearly all (96%) agreed the delivery methods used was appropriate and aided in learning the content. Suggested improvements included integration of case-based scenarios, Spanish-language materials, and more information on epidemiology and information on TBRDs in vulnerable populations.ConclusionParticipation in this online toolkit led to improved knowledge and confidence among providers regarding timely diagnosis and treatment of TBRDs, highlighting the utility of online education in addressing gaps in provider awareness of TBRDs in the United States.Disclosures All authors: No reported disclosures.

1881. The Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Antibiotic Use: Results From a National Antibiotic Stewardship Intervention of 402 United States (US) Hospitals

BackgroundThe AHRQ Safety Program for Improving Antibiotic Use aims to improve antibiotic (abx) use in acute, long-term, and outpatient care settings by enhancing abx stewardship programs (ASP) and engaging frontline providers to incorporate stewardship into daily abx decision-making, with an emphasis on viewing appropriate prescribing as a patient safety issue. We report on the impact of implementation of the Acute Care Safety Program on abx use and Clostridioides difficile in a cohort of US hospitals.MethodsThe Acute Care Safety Program was implemented from December 2017 to November 2018. At least one unit from each hospital participated. The Safety Program trained local ASP leaders and assisted ASPs and frontline staff to: (a) address attitudes and culture that pose challenges to judicious abx use and (b) incorporate best practices for the management of common infections into daily practice using the Four Moments of Antibiotic Decision Making framework (Figure 1). Education occurred via 17 live Webinars and an online toolkit that included recorded Webinars, narrated presentations, and other tools to assist with the development and dissemination of syndrome-specific local guidelines (Table 1). Units submitted days of abx therapy (DOT) per 1,000 patient-days (PD), C. difficile LabID events per 10,000 PD, and 10 review forms per month documenting structured discussions between the ASP and frontline staff about patients on abx. Linear and generalized linear mixed-effects models were employed to calculate pre-post intervention changes in abx use and C. difficile LabID events, respectively.Results402 hospitals completed the Safety Program, including 28 (7%) academic medical centers (AMC), 289 (72%) community hospitals, and 85 (21%) critical access hospitals. 476 participating units consisted of 165 (35%) ICUs, 300 (63%) medical-surgical floors, and 11 (2%) other units. Both abx use and C. difficile LabID events decreased when comparing pre-post data (−41 DOT per 1,000 PD, [from 886.56, Figure 2], P = 0.001 and −1.2 LabID events per 10,000 PD [from 6.3], P = 0.027), respectively.ConclusionBy targeting both improving abx prescribing culture and knowledge of best practices, the AHRQ Safety Program led to reductions in abx use across a diverse cohort of hospitals. DisclosuresSara E. Cosgrove, MD, MS, Basilea: Consultant; Theravance: Consultant.

How do we teach clinicians where the resources for best evidence are?

The Sinai Health System (SHS) Library created an online tool kit that groups electronic resources into tiers based on the hierarchy of evidence, in a step-by-step approach. Mobile application options are available for most of the resources. The goal is to provide a simple, practical teaching tool to help clinicians easily find quality health information from the vast offerings of publishers. Since its publication in 2008, the original tool kit received positive feedback from medical students and in-house clinical staff. As well, the tool kit has been incorporated into the teachings of the Royal College of Surgeons and Physicians of Ontario, Ministry of Public Health, and various hospital and patient libraries across the Greater Toronto Area. The SHS Library encourages other libraries and institutions to adapt the tool kit for their users. In the future, this tool kit will be revised to tailor to the research needs of nursing and allied health staff.

SHARE IT: Co-designing a sustainability impact assessment framework for urban food sharing initiatives

Urban food systems must undergo a significant transformation if they are to avoid impeding the achievement of UN Sustainable Development Goals. One reconfiguration with claimed sustainability benefits is ICT-mediated food sharing – an umbrella term used to refer to technologically-augmented collective or collaborative practices around growing, cooking, eating and redistributing food – which some argue improves environmental efficiencies by reducing waste, providing opportunities to make or save money, building social networks and generally enhancing well-being. However, most sustainability claims for food sharing have not been evidenced by systematically collected and presented data. In this paper we document our response to this mismatch between claims and evidence through the development of the SHARECITY sustainability Impact assessment Toolkit (SHARE IT); a novel Sustainability Impact Assessment (SIA) framework which has been co-designed with food sharing initiatives to better indicate the impact of food-sharing initiatives in urban food systems. We demonstrate that while several SIA frameworks have been developed to evaluate food systems at the urban scale, they contain few measures that specifically account for impacts of the sharing that initiatives undertake. The main body of the paper focuses on the co-design process undertaken with food sharing initiatives based in Dublin and London. Attention is paid to how two core goals were achieved: 1) the identification of a coherent SIA framework containing appropriate indicators for the activities of food sharing initiatives; and 2) the development of an open access online toolkit for in order to make SIA reporting accessible for food sharing initiatives. In conclusion, the co-design process revealed a number of technical and conceptual challenges, but it also stimulated creative responses to these challenges.

Perspectives from 2037—Can Environmental Impact Assessment be the Solution for an Early Consideration of Climate Change-related Impacts?

Consideration of climate change in environmental impact assessment (EIA) is a rather novel topic, which became partly mandatory through the revised EU Directive on EIA. Through a mixed-methods approach involving key-actors from EIA practice, decision making and climate adaptation planning, this study presents a transdisciplinary point of view on barriers and opportunities to tackle climate change adaptation in the environmental assessment of large-scale projects. It is based on both a retrospective ex-post evaluation of existing practices in Austria and Germany as well as prescriptive examination and development of outcomes for practice through the development of a climate-fit toolkit that supports the incorporation of climate change impacts into EIAs. The scenario analysis applied with a backcasting approach provided the opportunity to look beyond limitations related to legal compliance and partly lack of data identified by previous research. Three scenario narratives were elaborated based on nine key impact factors based on literature review, content analysis of EIA documents and interviews with EIA actors. The groups of actors carried out a prioritization of actions towards consideration of climate change in EIA. Finally, the actors were involved in co-production of an online tool-kit for Austrian and German EIA practice.

IPASTIC: An online toolkit to estimate plant abiotic stress indices.

PremiseIn crop breeding programs, breeders use yield performance in both optimal and stressful environments as a key indicator for screening the most tolerant genotypes. During the past four decades, several yield‐based indices have been suggested for evaluating stress tolerance in crops. Despite the well‐established use of these indices in agronomy and plant breeding, a user‐friendly software that would provide access to these methods is still lacking.Methods and ResultsThe Plant Abiotic Stress Index Calculator (iPASTIC) is an online program based on JavaScript and R that calculates common stress tolerance and susceptibility indices for various crop traits including the tolerance index (TOL), relative stress index (RSI), mean productivity (MP), harmonic mean (HM), yield stability index (YSI), geometric mean productivity (GMP), stress susceptibility index (SSI), stress tolerance index (STI), and yield index (YI). Along with these indices, this easily accessible tool can also calculate their ranking patterns, estimate the relative frequency for each index, and create heat maps based on Pearsonʼs and Spearmanʼs rank‐order correlation analyses. In addition, it can also render three‐dimensional plots based on both yield performances and each index to separate entry genotypes into Fernandezʼs groups (A, B, C, and D), and perform principal component analysis. The accuracy of the results calculated from our software was tested using two different data sets obtained from previous experiments testing the salinity and drought stress in wheat genotypes, respectively.Conclusions iPASTIC can be widely used in agronomy and plant breeding programs as a user‐friendly interface for agronomists and breeders dealing with large volumes of data. The software is available at https://mohsenyousefian.com/ipastic/.

Evaluating the use of multiteam systems to manage the complexity of inpatient falls in rural hospitals.

To evaluate the implementation and outcomes of evidence-based fall-risk-reduction processes when those processes are implemented using a multiteam system (MTS) structure. Fall-risk-reduction process and outcome measures from 16 small rural hospitals participating in a research demonstration and dissemination study from August 2012 to July 2014. Previously, these hospitals lacked a fall-event reporting system to drive improvement. A one-group pretest-posttest embedded in a participatory research framework. We required hospitals to implement MTSs, which we supported by conducting education, developing an online toolkit, and establishing a fall-event reporting system. Hospitals used gap analyses to assess the presence of fall-risk-reduction processes at study beginning and their frequency and effectiveness at study end; they reported fall-event data throughout the study. The extent to which hospitals implemented 21 processes to coordinate the fall-risk-reduction program and trained staff specifically about the program predicted unassisted and injurious fall rates during the end-of-study period (January 2014-July 2014). Bedside fall-risk-reduction processes were not significant predictors of these outcomes. Multiteam systems that effectively coordinate fall-risk-reduction processes may improve the capacity of hospitals to manage the complex patient, environmental, and system factors that result in falls.

Soiled Instrument Handling in Outpatient Clinics; Our process to compliance

BACKGROUND: The outpatient clinic system of about 35 centers, including 4 ambulatory surgery centers (ASCs) with central sterilization (CS) services, was incorrectly handling and transporting soiled instruments. Non-ASC instruments were hand-carried through hallways to collection bins on countertops in clerical areas. Bins did not meet standards. Bins from outreach centers were left in mailrooms for courier collection, and were mixed with clean items. Some bins still contained a portion of the water/enzymatic soak solution. METHODS: A task force was formed to improve the process at the clinic site with the largest ASC first. The other clinic sites with ASCs and then the remaining outreach centers followed suite. New instrument bins were purchased and a new instrument spray replaced soaking. Soiled utility rooms were constructed where there were none. A policy, procedure, checklist, algorithm and training video were made and placed in an online toolkit. Couriers were given turn-by-turn directions to all the soiled utility rooms and were educated on maintaining separation of clean and dirty within the transport vans. RESULTS: With support starting at the executive level, safe soiled instrument handling and transportation resulted system-wide after seven months. Joint Commission accreditation was achieved. I, along with my coworkers, continue to educate staff as necessary to make this process their “new normal” for soiled instrument handling. CONCLUSIONS: Process change across a large healthcare system requires commitment at the executive level including funding and educational tools.

Translating probiotic science into practice

AbstractScientific and clinical evidence on the health effects of probiotics has expanded rapidly in recent years and points towards benefits for a number of specific health conditions, particularly those related to the gut. Healthcare professionals are important conduits in the transfer of evidence‐based messages on probiotics, but research indicates many do not consider themselves to have good knowledge in this area. To identify potential solutions to support healthcare professionals, the British Nutrition Foundation held a one‐day roundtable event on 7 February 2019 to gather expert views on the content of, and best delivery mode for, evidence‐based resources to guide healthcare professional advice about the use of probiotics. This report describes the main themes emerging from the discussions and the group's recommendation for the development of a UK‐focused online toolkit for healthcare professionals, which assimilates, appraises and translates current scientific knowledge of probiotics to promote evidence‐based practice for the benefit of patients.

Towards a toolkit for estate records

ABSTRACTThe purpose of this paper is to report on a collaborative project that investigated the value and use of the contents of estate archives. Context is provided by outlining the type of information often found within estate records, its potential value to a wide range of users, indicating some of the initiatives which have helped to open up estate archives, before exploring some of the difficulties associated with accessing these records and making optimal use of them. This is followed by a description and evaluation of the initial stage of the project, which collected data about the significance, discoverability, accessibility and use of estate archives. This was achieved by inviting a purposive sample of archive users to attend one of the three knowledge exchange workshops in different parts of Wales. Participants were asked for their views on the value of estate archives, current and potential uses of estate records, and they were asked to suggest ways in which these records could be promoted more widely and used more effectively. Finally, opinions were gathered about the desirability of creating an online toolkit for estate records. Data gathered at these events was used to create a detailed blueprint of the proposed toolkit.

PROFESSIONALS FOR INTELLECTUAL SERVICE-ORIENTED DISTRIBUTED COMPUTING ENVIRONMENTS

A new programming paradigm is considered, not related to objects, but to business processes and their components — business functions, when the layout of applications is carried out by identifying and calling services (special software components with unified interfaces), available on the network to perform the necessary task. This approach is independent of specific programming languages ​​and operating systems, and involves the use of a service-oriented architecture (SOA) of applications built on formalized business processes whose functions are presented as reusable services with transparently described interfaces. The fundamentals of the educational program for the training of specialists are considered who are able to meet the need for effective implementation of new paradigms of distributed computing (on the example of cloud computing, microservice architecture, semantic technologies); for creating an online toolkit that allows end users to dynamically compile application workflows according to their scripts in different subject areas; for filling and merging repositories of web services that can run on different cloud sites in distributed computing environments.

Perceptions of an online 'train-the-champion' approach to increase workplace movement.

Prolonged sitting is now recognized as an emergent work health and safety issue. To address the need for a scalable sitting-reduction intervention for workplaces, the BeUpstanding™ Champion Toolkit was developed. This free, online toolkit uses a 'train-the-champion' approach, providing a step-by-step guide and resources to workplace champions to assist them in raising awareness and building a supportive culture to reduce sitting time in their team. This qualitative study explored champion and staff perceptions of the beta (test) version of the toolkit. Seven work teams, from a range of workplace sectors (blue-/white-collar), sizes (small/medium/large) and locations (urban/regional) participated; all team members were exposed to the program (n = 603). Approximately 4 months after program initiation, semi-structured interviews were conducted with all champions (n = 7); focus groups were conducted with a random sample of staff (n = 40). Champions were followed-up again at 12 months (n = 5). Transcripts were coded by two researchers, with codes organized into overarching themes. All champions found the 'train-the-champion' approach, and the toolkit acceptable. Common enablers for intervention delivery included: champion passion for staff health and wellbeing; perceived fit of the program within existing practice; and, management support. Champions and staff reported improvements in knowledge/awareness about sitting, cultural norms, perceived stress, productivity and resilience. Facilitators for sustained change over time included a stable organizational climate and ongoing management support; barriers included workload intensification. The beta version of the BeUpstanding™ Champion Toolkit was highly acceptable to workplace champions and staff, and was perceived to have benefits for team culture and staff knowledge and wellbeing.

Bastion3: a two-layer ensemble predictor of type III secreted effectors.

Type III secreted effectors (T3SEs) can be injected into host cell cytoplasm via type III secretion systems (T3SSs) to modulate interactions between Gram-negative bacterial pathogens and their hosts. Due to their relevance in pathogen-host interactions, significant computational efforts have been put toward identification of T3SEs and these in turn have stimulated new T3SE discoveries. However, as T3SEs with new characteristics are discovered, these existing computational tools reveal important limitations: (i) most of the trained machine learning models are based on the N-terminus (or incorporating also the C-terminus) instead of the proteins' complete sequences, and (ii) the underlying models (trained with classic algorithms) employed only few features, most of which were extracted based on sequence-information alone. To achieve better T3SE prediction, we must identify more powerful, informative features and investigate how to effectively integrate these into a comprehensive model. In this work, we present Bastion3, a two-layer ensemble predictor developed to accurately identify type III secreted effectors from protein sequence data. In contrast with existing methods that employ single models with few features, Bastion3 explores a wide range of features, from various types, trains single models based on these features and finally integrates these models through ensemble learning. We trained the models using a new gradient boosting machine, LightGBM and further boosted the models' performances through a novel genetic algorithm (GA) based two-step parameter optimization strategy. Our benchmark test demonstrates that Bastion3 achieves a much better performance compared to commonly used methods, with an ACC value of 0.959, F-value of 0.958, MCC value of 0.917 and AUC value of 0.956, which comprehensively outperformed all other toolkits by more than 5.6% in ACC value, 5.7% in F-value, 12.4% in MCC value and 5.8% in AUC value. Based on our proposed two-layer ensemble model, we further developed a user-friendly online toolkit, maximizing convenience for experimental scientists toward T3SE prediction. With its design to ease future discoveries of novel T3SEs and improved performance, Bastion3 is poised to become a widely used, state-of-the-art toolkit for T3SE prediction. http://bastion3.erc.monash.edu/. selkrig@embl.de or wyztli@163.com or or trevor.lithgow@monash.edu. Supplementary data are available at Bioinformatics online.

DIGREM: an integrated web-based platform for detecting effective multi-drug combinations.

Synergistic drug combinations are a promising approach to achieve a desirable therapeutic effect in complex diseases through the multi-target mechanism. However, in vivo screening of all possible multi-drug combinations remains cost-prohibitive. An effective and robust computational model to predict drug synergy in silico will greatly facilitate this process. We developed DIGREM (Drug-Induced Genomic Response models for identification of Effective Multi-drug combinations), an online tool kit that can effectively predict drug synergy. DIGREM integrates DIGRE, IUPUI_CCBB, gene set-based and correlation-based models for users to predict synergistic drug combinations with dose-response information and drug-treated gene expression profiles. http://lce.biohpc.swmed.edu/drugcombination. Supplementary data are available at Bioinformatics online.

Using corticosteroids appropriately in inflammatory bowel disease: a guide for primary care.

Inflammatory bowel disease (IBD) is a chronic relapsing–remitting inflammatory condition of the gastrointestinal tract, with extra-intestinal manifestations that can affect the skin, joints, eyes, and liver. The two main subtypes are Crohn’s disease (CD) and ulcerative colitis (UC). IBD affects 1 in 250 people in the UK, with the typical GP practice having 30–40 registered patients with the condition. Oral corticosteroids are highly effective in inducing remission in IBD and have been the mainstay of treatment of flare-ups since the 1950s. However, judicious prescribing is essential to avoid potential side effects. Doses of 20 mg or higher of prednisolone per day for more than 2 weeks increase the risk of infection.1 Patients with IBD flare-ups usually present with a combination of diarrhoea, abdominal pain, or rectal bleeding, although atypical presentations including weight loss, anaemia, and failure to thrive can occur, and the severity of symptoms may not reflect the severity of inflammation, particularly in children. The Royal College of Physicians national IBD audits have shown that patients are often seen by a GP in the month before emergency admission, but medical therapy is not escalated. Half of the GPs surveyed as part of the Royal College of General Practitioners Inflammatory Bowel Disease Spotlight Project in 2017 say they lack confidence in managing IBD, and two-thirds requested further education. An online toolkit (www.rcgp.org.uk/ibd) and an eLearning resource are now available (www.elearning.rcgp.org.uk/ibd). Wherever possible, objective evidence of disease activity …

Building BRYT: A Case Study in Developing an Online Toolkit to Promote Business Information Literacy in Higher Education

This paper highlights the design and development process that two academic business librarians employed to create an online toolkit of eLearning supports for business students. After receiving funding from their institution’s internal teaching innovation fund, they hired and worked with two eLearning design companies to produce the toolkit. The toolkit includes videos and PDF resources that show students how to retrieve specialized resources for key business research tasks. The librarians undertook this project to increase the online business information literacy offerings at their university and better support their institution’s diverse commuter, distance, and part-time student population. To develop a student-centered toolkit, the librarians used a curriculum mapping exercise, online surveying, focus groups, usability tests, and a student review group. They also adapted the ADDIE instructional design model and consulted adult learning theory to develop a series of micro-learning supports that were relevant and useful for undergraduate and graduate business students.