Novel information sharing syntax for data sharing between police and community partners, using role-based security.

The exchange of information between the police and community partners forms a central aspect of effective community service provision. In the context of policing, a robust and timely communications mechanism is required between police agencies and community partner domains, including: Primary healthcare (such as a Family Physician or a General Practitioner); Secondary healthcare (such as hospitals); Social Services; Education; and Fire and Rescue services. Investigations into high-profile cases such as the Victoria Climbié murder in 2000, the murders of Holly Wells and Jessica Chapman in 2002, and, more recently, the death of baby Peter Connelly through child abuse in 2007, highlight the requirement for a robust information-sharing framework. This paper presents a novel syntax that supports information-sharing requests, within strict data-sharing policy definitions. Such requests may form the basis for any information-sharing agreement that can exist between the police and their community partners. It defines a role-based architecture, with partner domains, with a syntax for the effective and efficient information sharing, using SPoC (Single Point-of-Contact) agents to control in-formation exchange. The application of policy definitions using rules within these SPoCs is inspired by network firewall rules and thus define information exchange permissions. These rules can be imple-mented by software filtering agents that act as information gateways between partner domains. Roles are exposed from each domain to give the rights to exchange information as defined within the policy definition. This work involves collaboration with the Scottish Police, as part of the Scottish Institute for Policing Research (SIPR), and aims to improve the safety of individuals by reducing risks to the community using enhanced information-sharing mechanisms.

Increased hospital-based physical rehabilitation and information provision after intensive care unit discharge: the RECOVER randomized clinical trial.

Importance: critical illness results in disability and reduced health-related quality of life (HRQOL), but the optimum timing and components of rehabilitation are uncertain. Objective: to evaluate the effect of increasing physical and nutritional rehabilitation plus information delivered during the post–intensive care unit (ICU) acute hospital stay by dedicated rehabilitation assistants on subsequent mobility, HRQOL, and prevalent disabilities. Design, Setting, and Participants: a parallel group, randomized clinical trial with blinded outcome assessment at 2 hospitals in Edinburgh, Scotland, of 240 patients discharged from the ICU between December 1, 2010, and January 31, 2013, who required at least 48 hours of mechanical ventilation. Analysis for the primary outcome and other 3-month outcomes was performed between June and August 2013; for the 6- and 12-month outcomes and the health economic evaluation, between March and April 2014. Interventions: during the post-ICU hospital stay, both groups received physiotherapy and dietetic, occupational, and speech/language therapy, but patients in the intervention group received rehabilitation that typically increased the frequency of mobility and exercise therapies 2- to 3-fold, increased dietetic assessment and treatment, used individualized goal setting, and provided greater illness-specific information. Intervention group therapy was coordinated and delivered by a dedicated rehabilitation practitioner. Main Outcomes and Measures: the Rivermead Mobility Index (RMI) (range 0-15) at 3 months; higher scores indicate greater mobility. Secondary outcomes included HRQOL, psychological outcomes, self-reported symptoms, patient experience, and cost-effectiveness during a 12-month follow-up (completed in February 2014). Results: median RMI at randomization was 3 (interquartile range [IQR], 1-6) and at 3 months was 13 (IQR, 10-14) for the intervention and usual care groups (mean difference, −0.2 [95% CI, −1.3 to 0.9; P = .71]). The HRQOL scores were unchanged by the intervention (mean difference in the Physical Component Summary score, −0.1 [95% CI, −3.3 to 3.1; P = .96]; and in the Mental Component Summary score, 0.2 [95% CI, −3.4 to 3.8; P = .91]). No differences were found for self-reported symptoms of fatigue, pain, appetite, joint stiffness, or breathlessness. Levels of anxiety, depression, and posttraumatic stress were similar, as were hand grip strength and the timed Up & Go test. No differences were found at the 6- or 12-month follow-up for any outcome measures. However, patients in the intervention group reported greater satisfaction with physiotherapy, nutritional support, coordination of care, and information provision. Conclusions and Relevance: post-ICU hospital-based rehabilitation, including increased physical and nutritional therapy plus information provision, did not improve physical recovery or HRQOL, but improved patient satisfaction with many aspects of recovery.