Sharing of clinical data in a maternity setting: How do paper hand-held records and electronic health records compare for completeness?

Background Historically, the paper hand-held record (PHR) has been used for sharing information between hospital clinicians, general practitioners and pregnant women in a maternity shared-care environment. Recently in alignment with a National e-health agenda, an electronic health record (EHR) was introduced at an Australian tertiary maternity service to replace the PHR for collection and transfer of data. The aim of this study was to examine and compare the completeness of clinical data collected in a PHR and an EHR. Methods We undertook a comparative cohort design study to determine differences in completeness between data collected from maternity records in two phases. Phase 1 data were collected from the PHR and Phase 2 data from the EHR. Records were compared for completeness of best practice variables collected The primary outcome was the presence of best practice variables and the secondary outcomes were the differences in individual variables between the records. Results Ninety-four percent of paper medical charts were available in Phase 1 and 100% of records from an obstetric database in Phase 2. No PHR or EHR had a complete dataset of best practice variables. The variables with significant improvement in completeness of data documented in the EHR, compared with the PHR, were urine culture, glucose tolerance test, nuchal screening, morphology scans, folic acid advice, tobacco smoking, illicit drug assessment and domestic violence assessment (p = 0.001). Additionally the documentation of immunisations (pertussis, hepatitis B, varicella, fluvax) were markedly improved in the EHR (p = 0.001). The variables of blood pressure, proteinuria, blood group, antibody, rubella and syphilis status, showed no significant differences in completeness of recording. Conclusion This is the first paper to report on the comparison of clinical data collected on a PHR and EHR in a maternity shared-care setting. The use of an EHR demonstrated significant improvements to the collection of best practice variables. Additionally, the data in an EHR were more available to relevant clinical staff with the appropriate log-in and more easily retrieved than from the PHR. This study contributes to an under-researched area of determining data quality collected in patient records.

Regulating ride-sharing in the peer economy

The rise of the peer economy poses complex new regulatory challenges for policy-makers. The peer economy, typified by services like Uber and AirBnB, promises substantial productivity gains through the more efficient use of existing resources and a marked reduction in regulatory overheads. These services are rapidly disrupting existing established markets, but the regulatory trade-offs they present are difficult to evaluate. In this paper, we examine the peer economy through the context of ride-sharing and the ongoing struggle over regulatory legitimacy between the taxi industry and new entrants Uber and Lyft. We first sketch the outlines of ride-sharing as a complex regulatory problem, showing how questions of efficiency are necessarily bound up in questions about levels of service, controls over pricing, and different approaches to setting, upholding, and enforcing standards. We outline the need for data-driven policy to understand the way that algorithmic systems work and what effects these might have in the medium to long term on measures of service quality, safety, labour relations, and equality. Finally, we discuss how the competition for legitimacy is not primarily being fought on utilitarian grounds, but is instead carried out within the context of a heated ideological battle between different conceptions of the role of the state and private firms as regulators. We ultimately argue that the key to understanding these regulatory challenges is to develop better conceptual models of the governance of complex systems by private actors and the available methods the state has of influencing their actions. These struggles are not, as is often thought, struggles between regulated and unregulated systems. The key to understanding these regulatory challenges is to better understand the important regulatory work carried out by powerful, centralised private firms – both the incumbents of existing markets and the disruptive network operators in the peer-economy.

Regulating ride-sharing in the peer economy

The rise of the peer economy poses complex new regulatory challenges for policy-makers. The peer economy, typified by services like Uber and AirBnB, promises substantial productivity gains through the more efficient use of existing resources and a marked reduction in regulatory overheads. These services are rapidly disrupting existing established markets, but the regulatory trade-offs they present are difficult to evaluate. In this paper, we examine the peer economy through the context of ride-sharing and the ongoing struggle over regulatory legitimacy between the taxi industry and new entrants Uber and Lyft. We first sketch the outlines of ride-sharing as a complex regulatory problem, showing how questions of efficiency are necessarily bound up in questions about levels of service, controls over pricing, and different approaches to setting, upholding, and enforcing standards. We outline the need for data-driven policy to understand the way that algorithmic systems work and what effects these might have in the medium to long term on measures of service quality, safety, labour relations, and equality. Finally, we discuss how the competition for legitimacy is not primarily being fought on utilitarian grounds, but is instead carried out within the context of a heated ideological battle between different conceptions of the role of the state and private firms as regulators. We ultimately argue that the key to understanding these regulatory challenges is to develop better conceptual models of the governance of complex systems by private actors and the available methods the state has of influencing their actions. These struggles are not, as is often thought, struggles between regulated and unregulated systems. The key to understanding these regulatory challenges is to better understand the important regulatory work carried out by powerful, centralised private firms – both the incumbents of existing markets and the disruptive network operators in the peer-economy.

Japonica rice: Intellectual property, scientific publishing and data-sharing

This article examines a series of controversies within the life sciences over data sharing. Part 1 focuses upon the agricultural biotechnology firm Syngenta publishing data on the rice genome in the journal Science, and considers proposals to reform scientific publishing and funding to encourage data sharing. Part 2 examines the relationship between intellectual property rights and scientific publishing, in particular copyright protection of databases, and evaluates the declaration of the Human Genome Organisation that genomic databases should be global public goods. Part 3 looks at varying opinions on the information function of patent law, and then considers the proposals of Patrinos and Drell to provide incentives for private corporations to release data into the public domain.

Information encountering on social media and tacit knowledge sharing

The purpose of this paper is to investigate how social media may support information encountering (i.e., where individuals encounter useful and interesting information while seeking or browsing for some other information) and how this may lead to facilitation of tacit knowledge creation and sharing. The study employed a qualitative survey design that interviewed twenty-four physicians who were active users of social media to better understand the phenomenon of information encountering on social media. The data was analysed using the thematic analysis approach. The study found six main ways through which social media supports information encountering. Furthermore, drawing upon knowledge creation theories, the study concluded that information encountering on social media facilitates tacit knowledge creation and sharing among individuals. The study provides new directions for further empirical investigations to examine whether information encountering on social media actually leads to tacit knowledge creation and sharing. The findings of the study may also provide opportunities for users to adopt social media effectively or gain greater value from social media use.

Connected Viewing: Selling, Streaming and Sharing Media in the Digital Era

As patterns of media use become more integrated with mobile technologies and multiple screens, a new mode of viewer engagement has emerged in the form of connected viewing, which allows for an array of new relationships between audiences and media texts in the digital space. This exciting new collection brings together twelve original essays that critically engage with the socially-networked, multi-platform, and cloud-based world of today, examining the connected viewing phenomenon across television, film, video games, and social media. The result is a wide-ranging analysis of shifting business models, policy matters, technological infrastructure, new forms of user engagement, and other key trends affecting screen media in the digital era. Connected Viewing contextualizes the dramatic transformations taking place across both media industries and national contexts, and offers students and scholars alike a diverse set of methods and perspectives for studying this critical moment in media culture.

Knowledge sharing success and resistance in an engineering department: A case study

The centrality of knowledge sharing to organizations’ sustainability has been established. This research explores and illustrates the influences for individual professionals and paraprofessionals – specifically civil engineers and design drafters – to share their deep, personally constructed knowledge, in a public sector provider of railways infrastructure. It investigates the extent to which: (i) knowledge sharing will be positively influenced by the professional identity, values and knowledge culture to achieve organizational and project goals, and; (ii) sharing of deep personal expertise will be influenced by the quality of relational capital among individuals and individual perspectives. It finds that knowledge sharing develops within frameworks established through the alignment among sector, profession and organization values. However, individual behavior is found to be most strongly influenced by the presence and quality of relational capital and individuals’ personal perspectives.

Miami heat: Patent law, informed consent and benefit-sharing

This article considers whether the granting of patents in respect of biomedical genetic research should be conditional upon the informed consent of research participants. It focuses upon several case studies. In Moore v the Regents of the University Of California, a patient sued his physician for breach of fiduciary duty and lack of informed consent, because the doctor had obtained a patent on the patient's cell line, without the patient's authorisation. In Greenberg v Miami Children's Hospital, the research participants, the Greenbergs, the National Tay Sachs and Allied Diseases Association, and Dor Yeshorim brought a legal action against the geneticist Reubon Matalon and the Miami Children's Hospital over a patent obtained on a gene related to the Canavan disease and accompany genetic diagnostic test. PXE International entered into a joint venture with Charles Boyd and the University of Hawaii, and obtained a patent together for ‘methods for diagnosing Pseudoxanthoma elasticum’. In light of such case studies, it is contended that there is a need to reform patent law, so as to recognise the bioethical principles of informed consent and benefit-sharing. The 2005 UNESCO Declaration on Bioethics and Human Rights provides a model for future case law and policy-making.

An ethical approach to sharing school successes in times of high-stakes accountability

High-stakes testing has become an important element of the Australian educational landscape. As one part of the neo-liberal paradigm where beliefs in the individual and the free market are paramount, it is of concern how school leaders can respond to this phenomenon in an ethical manner. Ethics and ethical leadership have increased in prominence both in the educational administration literature and in the media (Cranston, Ehrich, & Kimber, 2006). In this paper we consider ethical theories on which school principals can draw, not only in the leadership of their own schools but in their relationships with other schools. We provide an example of a school leader sharing a successful intervention with other schools, illustrating that school leaders can create spaces for promoting the public good within the context of high-stakes testing.

Managing and sharing health data through information accountability protocols

Concerns over the security and privacy of patient information are one of the biggest hindrances to sharing health information and the wide adoption of eHealth systems. At present, there are competing requirements between healthcare consumers' (i.e. patients) requirements and healthcare professionals' (HCP) requirements. While consumers want control over their information, healthcare professionals want access to as much information as required in order to make well-informed decisions and provide quality care. In order to balance these requirements, the use of an Information Accountability Framework devised for eHealth systems has been proposed. In this paper, we take a step closer to the adoption of the Information Accountability protocols and demonstrate their functionality through an implementation in FluxMED, a customisable EHR system.

A legal perspective of carbon rights and benefit sharing under REDD+: A conceptual framework and examples from Cambodia and Kenya

This article discusses two key issues in REDD+ design and implementation at the national level – carbon rights, and benefit sharing. Both carbon rights and benefit sharing can be understood as new legal concepts (although they build on existing law), and as legal concepts they offer a framework for addressing related areas of REDD+ policy. Many countries are currently considering how to manage carbon rights and benefit sharing issues, including Cambodia and Kenya. Both of these countries host existing forest carbon projects and are also in the process of designing national REDD+ programmes. This article uses a conceptual framework for carbon rights and benefit sharing derived from legal analysis to consider the cases of both Cambodia and Kenya, and also includes a general discussion of the challenges countries might encounter when considering how to manage carbon rights and benefit sharing in the context of REDD+ implementation.

Sharing social space with strangers: Setting, signalling and policing informal rules of driving etiquette

Recent research suggests that aggressive driving may be influenced by driver perceptions of their interactions with other drivers in terms of ‘right’ or ‘wrong’ behaviour. Drivers appear to take a moral standpoint on ‘right’ or ‘wrong’ driving behaviour. However, ‘right’ or ‘wrong’ in the context of road use is not defined solely by legislation, but includes informal rules that are sometimes termed ‘driving etiquette’. Driving etiquette has implications for road safety and public safety since breaches of both formal and informal rules may result in moral judgement of others and subsequent behaviours designed to punish the ‘offender’ or ‘teach them a lesson’. This paper outlines qualitative research that was undertaken with drivers to explore their understanding of driving etiquette and how they reacted to other drivers’ observance or violation of their understanding. The aim was to develop an explanatory framework within which the relationships between driving etiquette and aggressive driving could be understood, specifically moral judgement of other drivers and punishment of their transgression of driving etiquette. Thematic analysis of focus groups (n=10) generated three main themes: (1) courtesy and reciprocity, and the notion of two-way responsibility, with examples of how expectations of courteous behaviour vary according to the traffic interaction; (2) acknowledgement and shared social experience: ‘giving the wave’; and (3) responses to breaches of the expectations/informal rules. The themes are discussed in terms of their roles in an explanatory framework of the informal rules of etiquette and how interactions between drivers can reinforce or weaken a driver’s understanding of driver etiquette and potentially lead to driving aggression.

Space in Musical Semiosis : An Abductive Theory of the Musical Composition Process

Space in musical semiosis is a study of musical meaning, spatiality and composition. Earlier studies on musical composition have not adequately treated the problems of musical signification. Here, composition is considered an epitomic process of musical signification. Hence the core problems of composition theory are core problems of musical semiotics. The study employs a framework of naturalist pragmatism, based on C. S. Peirce’s philosophy. It operates on concepts such as subject, experience, mind and inquiry, and incorporates relevant ideas of Aristotle, Peirce and John Dewey into a synthetic view of esthetic, practic, and semiotic for the benefit of grasping musical signification process as a case of semiosis in general. Based on expert accounts, music is depicted as real, communicative, representational, useful, embodied and non-arbitrary. These describe how music and the musical composition process are mental processes. Peirce’s theories are combined with current morphological theories of cognition into a view of mind, in which space is central. This requires an analysis of space, and the acceptance of a relativist understanding of spatiality. This approach to signification suggests that mental processes are spatially embodied, by virtue of hard facts of the world, literal representations of objects, as well as primary and complex metaphors each sharing identities of spatial structures. Consequently, music and the musical composition process are spatially embodied. Composing music appears as a process of constructing metaphors—as a praxis of shaping and reshaping features of sound, representable from simple quality dimensions to complex domains. In principle, any conceptual space, metaphorical or literal, may set off and steer elaboration, depending on the practical bearings on the habits of feeling, thinking and action, induced in musical communication. In this sense, it is evident that music helps us to reorganize our habits of feeling, thinking, and action. These habits, in turn, constitute our existence. The combination of Peirce and morphological approaches to cognition serves well for understanding musical and general signification. It appears both possible and worthwhile to address a variety of issues central to musicological inquiry in the framework of naturalist pragmatism. The study may also contribute to the development of Peircean semiotics.

Freddy, Ursula, Elizabeth, Hal, Walter, and Kurt Gottschalk sharing a bed with their parents.

From left to right: Fred Gottschalk, grandma, Ursula Gottschalk, Elizabeth Gottschalk, grandpa, Hal Gottschalk, Walter Gottschalk, and Kurt Gottschalk

Men Secretely Sharing a Smoke Artworks

Czech sign: dej mi sluka