Panel Three: Challenges and Best Practice

Format: 5 minute introduction, 15 min per speaker, 70 minute discussion Moderator: Raphael Rogers, Clark University

Best practice in transdisciplinary research - Swiss td-award Winners 2013

Transdisciplinary research plays an increasing role in topics of societal relevance and impact. The td-net of the Swiss Academies of Arts and Sciences awards innovative transdisciplinary research every other year. The last td-award was given in 2013. This special focus of GAIA features the six prize-winning projects, presenting short summaries of their work. Explaining its selection in the following introduction, the Jury of the td-net honours the awardees, and puts their work into a global perspective.

Pulmonary neuroendocrine (carcinoid) tumors: European Neuroendocrine Tumor Society expert consensus and recommendations for best practice for typical and atypical pulmonary carcinoids.

BACKGROUND Pulmonary carcinoids (PCs) are rare tumors. As there is a paucity of randomized studies, this expert consensus document represents an initiative by the European Neuroendocrine Tumor Society to provide guidance on their management. PATIENTS AND METHODS Bibliographical searches were carried out in PubMed for the terms 'pulmonary neuroendocrine tumors', 'bronchial neuroendocrine tumors', 'bronchial carcinoid tumors', 'pulmonary carcinoid', 'pulmonary typical/atypical carcinoid', and 'pulmonary carcinoid and diagnosis/treatment/epidemiology/prognosis'. A systematic review of the relevant literature was carried out, followed by expert review. RESULTS PCs are well-differentiated neuroendocrine tumors and include low- and intermediate-grade malignant tumors, i.e. typical (TC) and atypical carcinoid (AC), respectively. Contrast CT scan is the diagnostic gold standard for PCs, but pathology examination is mandatory for their correct classification. Somatostatin receptor imaging may visualize nearly 80% of the primary tumors and is most sensitive for metastatic disease. Plasma chromogranin A can be increased in PCs. Surgery is the treatment of choice for PCs with the aim of removing the tumor and preserving as much lung tissue as possible. Resection of metastases should be considered whenever possible with curative intent. Somatostatin analogs are the first-line treatment of carcinoid syndrome and may be considered as first-line systemic antiproliferative treatment in unresectable PCs, particularly of low-grade TC and AC. Locoregional or radiotargeted therapies should be considered for metastatic disease. Systemic chemotherapy is used for progressive PCs, although cytotoxic regimens have demonstrated limited effects with etoposide and platinum combination the most commonly used, however, temozolomide has shown most clinical benefit. CONCLUSIONS PCs are complex tumors which require a multidisciplinary approach and long-term follow-up.

Revisión de la best practice “red española de ciudades por el clima”, desde la estrategia europea medioambiental

En el siglo pasado la comunidad internacional comenzó un período de reflexión relacionado con los problemas ambientales de nuestro planeta, que ha llegado hasta hoy, situándose en el centro de discusión el problema del cambio limático. El modelo territorial impuesto ha contribuido notablemente al aumento del problema, teniendo como principal exponente el modelo de ordenación territorial y urbana. Gran parte de la transformación está en poder de los municipios, que tienen la responsabilidad de modificar el diseño y gestión de las áreas urbanas, así como del desarrollo y ejecución de políticas públicas para enfrentarnos a estos desafíos. Los programas presentados por los gobiernos nacionales o las agencias de la UE, pueden parecer ajenos o de difícil gestión por los municipios, pero en realidad sus atribuciones son adecuadas para atender a las realidades territoriales y además, de mayor comprensión por los ciudadanos.

Putting customers first : serving the American public : best practice in telephone service : Federal Consortium Benchmark Study Report /

Mode of access: Internet.

Plant closing checklist : a guide to best practice /

"BLMR 107."

Electronic patient records: Achieving best practice in information transfer between hospital and community providers - an integration success story

Effective healthcare integration is underpinned by clinical information transfer that is timely, legible and relevant. The aim of this study was to describe and evaluate a method for best practice information exchange. This was achieved based on the generic Mater integration methodology. Using this model the Mater Health Services have increased effective community fax discharge from 34% in 1999 to 86% in 2002. These results were predicated on applied information technology excellence involving the development of the Mater Electronic Health Referral Summary and effective change management methodology, which included addressing issues around patient consent, engaging clinicians, provision of timely and appropriate education and training, executive leadership and commitment and adequate resourcing. The challenge in achieving best practice information transfer is not solely in the technology but also in implementing the change process and engaging clinicians. General practitioners valued the intervention highly. Hospital and community providers now have an inexpensive, effective product for critical information exchange in a timely and relevant manner, enhancing the quality and safety of patient care.