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To understand and handle the COVID-19 pandemic, digital tools and infrastructures were built in very short timeframes, resulting in stand-alone and non-interoperable solutions. To shape an interoperable, sustainable, and extensible ecosystem to advance biomedical research and healthcare during the pandemic and beyond, a short-term project called "Collaborative Data Exchange and Usage" (CODEX+) was initiated to integrate and connect multiple COVID-19 projects into a common organizational and technical framework. In this paper, we present the conceptual design, provide an overview of the results, and discuss the impact of such a project for the trade-off between innovation and sustainable infrastructures. [ABSTRACT FROM AUTHOR]

WHO and UNICEF highlight vaccination as the most cost-effective method of prevention of infectious diseases. An effective public health strategy requires efficient tracking of vaccination to assess coverage, safety, and efficacy of these vaccines. Paper-based immunization records are still being used in most low and middle-income countries. Adequate Electronic Logistic Management Information Systems, Immunization Registries and Records are crucial for proper data collection and analysis, and for making better decisions at an individual and at a population level. In this paper we share our experience in the redesign of an interoperable immunization record to track vaccination, including the recently developed vaccines for the novel coronavirus SARS-CoV-2 (COVID-19). [ABSTRACT FROM AUTHOR]

Emergency department (ED) overcrowding is an ongoing problem worldwide. Scoring systems are available for the detection of this problem. This study aims to combine a model that allows the detection and management of overcrowding. Therefore, it is crucial to implement a system that can reason model, rank ED resources and ED performance indicators based on environmental factors. Thus, we propose in this paper a new domain ontology (EDOMO) based on a new overcrowding estimation score (OES) to detect critical situations, specify the level of overcrowding and propose solutions to deal with these situations. Our approach is based on a real database created during more than four years from the Lille University Hospital Center (LUHC) in France. The resulting ontology is capable of modeling complete domain knowledge to enable semantic reasoning based on SWRL rules. The evaluation results show that the EDOMO is complete that can enhance the functioning of the ED. [ABSTRACT FROM AUTHOR]

Four pillars of learning identified in the UNESCO report in 1996 include four “L”s: Learning to know, Learning to do, Learning to live together, and Learning to be. Since then educators have been discussing how four pillars of learning can affect 21st century’s curriculum. Evidently, space-related education is based on traditional type curriculum. Therefore, integration of new approaches in aerospace engineering and science curriculum is often challenging. This paper argues that transdisciplinary and project-based approach can be used in building innovative aerospace engineering and other space-related disciplines core curricula. The paper proposes using SDTP/MSIP projects as foundation for creating multi-disciplinary curricula in different universities and countries. The proposed methodology includes pilot team projects performed during two-week summer workshop, task diversification between participating universities, comprehensive individual studies (analysis), and joint findings reports (synthesis). Such approach is proposed to be tested during SDTP-2017 and in 2017-2018 academic year in Russia (MGTU) and USA (University of Houston). The paper concludes with an analysis of potential opportunities and complications for the development and integration of presented academic strategy to increase adaptability of diverse hands-on experiences into already established educational programs in Russia and the US. In a summary, a platform for further inquiry into multi-disciplinary academic strategies is discussed for more in-depth investigation in the future. [ABSTRACT FROM AUTHOR]

Natural elements or biophilia in a workspace environment influences productivity. With the Covid-19 spread, tertiary education institutions shut down physical teaching and learning delivery methods and academics began to work from home. The literature however, lacks on the biophilic home workspace elements for online distance learning specifically because of the sudden shift from working in office to working from home. To contribute to the knowledge gap, this paper aims to identify the biophilia elements for home workspace and perform factors validity for a reliable measurement model. The research was based on a survey of UiTM academic staffs' perceived productivity. The biophilichome workspace elements are empirically tested using data from a questionnaire survey distributed online to 150 academicstaff. Confirmatory factor analysis was used for constructing validity to ascertain the prevalent biophilic elements for home workspace. The findings revealed the factorial validity of the model constructs were fit, hence providing a better understanding of the biophilia elements in the home workspace. The findings are significant for further research in the interior house design or plan for a healthy home workspace towards the restorative environment. [ABSTRACT FROM AUTHOR]

A Chatbot or Conversational Agent is a computer application that simulates the conversation with a human person (by text or voice), giving automated responses to people's needs. In the healthcare domain, chatbots can be beneficial to help patients, as a complement to care by health personnel, especially in times of high demand or constrained resources such as the COVID-19 Pandemic. In this paper we share the design and implementation of a healthcare chatbot called Tana at the Hospital Italiano de Buenos Aires. Considering best practices and being aware of possible unintended consequences, we must take advantage of information and communication technologies, such as chatbots, to analyze and promote useful conversations for the health of all people. [ABSTRACT FROM AUTHOR]

This paper investigates the perceptions and experiences of undergraduate nursing students involved in an embedded academic literacy support program at a multi-campus School of Nursing and Midwifery in an Australian university located in culturally diverse regions of Western Sydney. The study was conducted using three focus group interviews with students from the nursing program after their engagement with support. The focus group participants reported high levels of satisfaction with the support, improved capacities in using literacy and language skills, and increased confidence and success in their studies. They accessed the support to develop literacy skills for nursing subjects and specific assessment tasks, and some students from linguistically and culturally diverse (CALD) backgrounds specifically attended support to improve skills in written and spoken English as an additional language (EAL). Whilst this study aimed to explore the experiences of all students, the focus groups predominantly involved participants who were from CALD backgrounds with EAL. Thematic analysis of the focus group interviews revealed that the embedding of targeted Professional Communication Academic Literacy (PCAL) support involving workshops, consultations and a resource workbook that were tailored to the literacy and language needs of students were effective support strategies. The focus groups explored the students' experiences of the support including their uptake of support, improvements in literacy and language capacities, increases in confidence in using these skills, and how engaging with support enhanced their academic performance. The findings from this study are relevant to the embedding of academic literacy and language support in other nursing programs and would be transferable to meeting student learning needs in similar school contexts. [ABSTRACT FROM AUTHOR]

Electroencephalography (EEG) is the cornerstone of diagnostic testing for patients with epilepsy. However, EEG recording is easily contaminated by eye movement artefacts and other non-cerebral origin signals which affect the performance of available epileptic discharges (EDs) detection algorithm. The aim of this paper is to describe a new technique to improve the performance of an available EDs detection algorithm. An independent component analysis (ICA) based algorithm, Fast ICA is developed to extract eye movement artefacts from 10 hours sleep EEG data acquired from the National University of Malaysia Medical Center (PPUKM) database using the electrooculogram (EOG) of the corresponding subject. A clean EEG data without this artefact is then reconstructed. Data before and after the removal of ocular artefacts using ICA will be used for the following process to make a comparison on their statistical measure in the validation stage. A pre-trained support vector machine (SVM) model is used as a classifier between normal and epileptic discharge segments. The segments that contain EDs are further processed using a developed ED detection algorithm to count the number of EDs occurrence in a particular EEG channel. The EEG channels that contained EDs and the number of EDs occurrence are validated by a neurologist from PPUKM. Qualitative results show that a significant improvement of EDs detection sensitivity from 0% to 100% after the removal of ocular artefacts. Nevertheless, EDs detection specificity drops slightly from 81.3% to 75% while the accuracy remains unchanged at 76%. The drop on specificity is believed due to the two ways of contamination between EEG and EOG when EOG is used in the ocular artefact removal process. However, it helps in balancing the value of sensitivity and specificity to an optimum level which is preferable when introduced to the clinical environment. [ABSTRACT FROM AUTHOR]

Gestational diabetes and preterm birth are perinatal morbidities that significantly impact women and infants' health. While clinical factors like cesarean delivery, multiple gestation, preeclampsia, and hypertensive disorder are associated with these conditions, it is increasingly recognized that social determinants of health play a crucial role. This study aims to measure the associations between the social vulnerability index (SVI) and these perinatal morbidities using multivariate logistic regression models. The results indicate that factors across all four themes in SVI are significantly associated with these conditions. These findings suggest that interventions targeting these areas are needed to achieve better reproductive health. [ABSTRACT FROM AUTHOR]

The Intensive Care Unit (ICU) is an information-intense environment where more patient data points are recorded than in other wards. The electronic Record for Intensive Care (eRIC) is an ICU information system that integrates patient data every minute from multiple systems. Once implemented across New South Wales (NSW), eRIC will be one of the largest system-wide ICU clinical information systems in the world. This study explored experiences with the use of eRIC by ICU clinicians at an Australian metropolitan teaching hospital. Semistructured, in-depth interviews relating to physician electronic test management processes were conducted with 11 ICU clinicians and one clinical information system manager was observed in their use of the system. The introduction of eRIC resulted in an additional patient record, which was perceived to hold implications for workflow and patient safety. Study findings are valuable for informing implementation as the rollout of eRIC continues. [ABSTRACT FROM AUTHOR]

The article presents a study on the factors associated with the organizational review of adverse events within the complex setting of an academic medical center. The researchers conducted the research at Baker Medical Center in the U.S., which is affiliated with a popular medical school. They gathered the norms and practices for reviewing adverse events from in-depth interviews with heath care quality directors, physician department chairs and hospital senior executives. They found that organizational learning from error needs internal systems that effectively direct the communications and focus of managers to performance failures that carry the biggest value of learning.

This study presents an online psoriasis community developed with dermatologists in a PHR. We describe the interaction of users with this platform and the relationship between the use of self-report questionnaires, their results and users' subsequent contact with the healthcare system. Out of 2175 users that interacted with the platform, 477 visited the forums. 60% of those who completed questionnaires presented at least one abnormal result that prompted a recommendation for an outpatient visit. Although our data suggest a trend, we failed to find a statistically significant association between questionnaire severity and visits scheduling. To our knowledge, this is the first study that analyses the relationship between patient self-reported disease severity and the subsequent contact with the healthcare system. [ABSTRACT FROM AUTHOR]

Communication between patients and hospital staff is a vital part of patient satisfaction and can contribute to better healthcare outcomes. Especially in emergency departments, where the workload is high, it is difficult to always address the communication needs of patients. In a qualitative study, we interviewed 32 patients in emergency departments in Australia. We found that, in the context of the emergency department, the characteristics of the source assumes an essential role in the appraisal of information. Especially if patients show low health literacy hospital staff needs to engage with them. It is important that patients feel informed as this increases patient satisfaction, even though they may not fully understand the delivered information. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the feasibility of using an electronic clinical quality measure (eCQM) to assess inpatient respiratory depression rates following elective primary total hip or total knee arthroplasty using data routinely collected in electronic health records. Measure testing was conducted at two large urban, academic health systems -- Mass General Brigham and a geographically distant system in southern U.S. The risk-adjusted inpatient respiratory depression rates were 3.83 and 2.73% for the two health systems, respectively. Clinician group rates ranged from 1.40 to 4.35%, demonstrating opportunity for improvement. Both the data and measure specifications showed strong reliability and validity to allow for calculation of accurate and comparable rates of inpatient respiratory depression. [ABSTRACT FROM AUTHOR]

This paper explores the planning and implementation of corrective action in response to identified adverse events at a large high-performing teaching hospital. A mixed methodological approach that combined interviews with clinical and administrative actors and statistical analysis of 405 non-routine adverse events that occurred at the hospital over a 30-month period was employed to identify factors associated with corrective action prescription and completion. Analysis of qualitative and quantitative data indicated that corrective action planning and implementation in response to adverse events were shaped by institutional influences on the hospital's quality management practices, predominantly state-level regulation that required corrective action for externally-reportable events and professional norms that discouraged organizational intervention in autonomous clinician practice. In logistic regression models, odds of planning a corrective action in response to an adverse event increased with regulatory reportability of the event, litigation risk of the event, number of departments involved in the event, and full or partial event causation by protocol violation or coordination error. Severity of injury to the patient was not identified as a predictor of corrective action planning. The odds of corrective action implementation were greater for action types involving remedial retraining or reinforcement of standards and those involving interventions in the task environment, while corrective actions involving interventions in professional roles and interactions were associated with a statistically-significant decreased odds of completion. Rates of completion were generally low across action categories, which interviews and medical case data analysis indicate may have been a product of diffuse responsibility for implementation among practicing clinicians untrained in process change, unrealistic action planning, and normative barriers to intervention in professional practice. Findings from this case study site shed light on the resilience of work process failure in health care delivery organizations and emphasize the importance of resource appropriation, goal-setting and change management support that meet the formidable challenges of effecting change in these and other complex, high-risk task settings. [ABSTRACT FROM AUTHOR]

Emergency department (ED) overcrowding has been a pain point in hospitals across the globe. “Frequent flyers,” who visited the ED at a much higher rate than average, account for almost one third of ED visits even though they represent only a small proportion of all ED patients. In this study, we used datamining methods to cluster ED frequent flyers at a large academic medical center in the US. The objective was to identify distinct types of frequent flyers, and the common characteristics associated with each type. The results show that the frequent flyers at the ED have three subgroups each exhibiting distinct characteristics: (1) the elderly with chronic health conditions, (2) middle-aged males with unhealthy behavior, and (3) adult females who are generally healthy. These findings may inform targeted interventional strategies for patients of each subgroup, who likely have distinct reasons for visiting the ED frequently, to reduce ED overcrowding. [ABSTRACT FROM AUTHOR]

The article examines reasons why some quality improvement (QI) teams in U.S. academic medical centers (AMC) are better able than others to resolve the tension among competing QI goals. The importance of studying QI improvement efforts of AMC is believed to be valuable since they make contributions to American society in research, education and clinical care. The power differential between physicians and non-physicians in AMCs has been demonstrated to result in low levels of psychological safety and diminished outcomes in the team. A dichotomous leadership structure is also found in a number of AMCs with a chief executive officer leading the hospital and a dean leading the medical school.

The article reports on the efficiency of health care organizations in the U.S. There are an estimated 300 out of 5,500 hospitals in the U.S. classified as Academic Medical Centers (AMCs) which contribute to research, education, and clinical care in American society. AMCs have been effected by increasing medical care costs and work process inefficiency which they strove to counteract through reduced staff, higher occupancy, and increased market pricing power. However, research into AMCs shows that strict budgets, consumerism, and competition have reduced the efficiency of their responses.