Why are they not accessing it? User barriers to clinical information access

The Medical Library Association''s InSight Initiative provides an open and collaborative environment for library and industry partners to discuss vexing problems and find solutions to better serve their users. The initiative''s fifth summit, continuing work from the previous summit, focused on understanding how users discover and access information in the clinical environment. During the summit, participants were divided into working groups and encouraged to create a tangible product as a result of their discussions. At the end of the summit, participants established a framework for understanding users'' pain points, discussed possible solutions to those points, and received feedback on their work from an End User Advisory Board comprising physicians, clinical researchers, and clinical faculty in biomedicine. In addition to the pain point framework, participants are developing MLA InSight Initiative Learning content with modules to educate librarians and publishers about critical aspects of user behavior. The 2020 Insight Initiative Fall Forum will serve as a virtual home for constructive dialogue between health sciences librarians and publishers on improving discovery and access to information.     

Differences between physical and social sciences in university graduate departments

The greater articulation of scientific fields with well-developed paradigms — in Kuhn's sense of the term — is viewed as facilitating scientific activities within those fields. Contrasting two physical science with two social science fields, earlier research reported greater consensus in the physical sciences, greater willingness to work with graduate students, and large advantages in research support and funding as compared to the social sciences.Data on influence in decision-making indicate that physical science departments enjoy greater autonomy from their central administrations, although physicists in lower-quality departments report some administrative pressures over choices of research areas. While social science departments feel less autonomous from their central administrations, they grant more autonomy to individual members. Decisions related to teaching processes are made differently across fields, with the physical sciences relying more heavily on committees, and the social sciences relying on individual-chairman negotiations.Across all four fields (physics, chemistry, sociology, and political science), departments with relatively high reputations exhibit collegial structures, while departments with lower reputations show marked tendencies toward bureaucratization. These findings hold when size of department or university is controlled, although departments in smaller universities report more administrative influence than those in extremely large ones.It is argued: (1) Departmental autonomy in the physical sciences is enhanced by the visibility of consequences made possible by greater paradigm development. (2) Maintenance of individual autonomy in the social sciences is necessitated by the lower visibility of consequences and the uncertainty of outcomes of those fields. (3) The maintenance of collegiality within universities may depend on visibility of favorable consequences relative to socially approved goals.The authors would like to acknowledge the support of the New York State School of Industrial and Labor Relations; of the Science, Technology, and Society Group at Cornell; and of Cornell University. Requests for reprints should be sent to Janice B. Lodahl, School of Management, Crosby Hall, State University of New York at Buffalo, Buffalo, N.Y. 14214.     

EcoWellness: integrating the natural world into wilderness therapy settings with intentionality

Wilderness Therapy (WT) programming has been criticized for underutilizing nature as an active co-facilitator in treatment. Although some concept models in the field take into account nature’s contributions in WT, an abundance of multidisciplinary research suggests that nature contact and connection could be of greater emphasis. The purpose of this article is to introduce the EcoWellness model as one empirically based approach for facilitating intentional nature connection in WT. The state of WT research and supporting theory are reported. The EcoWellness framework is overviewed and embedded within the multidisciplinary literature. A case example is presented and implications for integrating EcoWellness into WT practice, training, and research are discussed.     

Softwaretechnische Instrumentenunterstützung für ein leistungssteuerndes HNO Navigationssystem

Zusammenfassung  Durch Einsatz von Softwaretechnik k?nnen immer komplexere Funktionalit?ten in Medizinger?ten realisiert werden. In der computerunterstützten Chirurgie werden Assistenzsysteme entwickelt mit dem Ziel, die Risiken bestehender Behandlungsmethoden zu minimieren und in neue chirurgische Anwendungsbereiche vorzudringen. Um die steigende Komplexit?t solcher Systeme zu beherrschen, müssen anstelle von hardwarenahen Implementierungen Abstraktionskonzepte gefunden werden, die überschaubare Programmstrukturen und problemlose Erweiterbarkeit erm?glichen. Für das bereits klinisch evaluierte Navigationssystem FESS-Control wird mit Hilfe von bekannten Softwaretechnikmethoden ein Modell entwickelt und implementiert, das im Gegensatz zur bestehenden Implementierung die Beschreibung leistungsgesteuerter chirurgischer Instrumente auf einer abstrakten Ebene und deren sichere automatisierte Erkennung erm?glicht. FESS (functional endonasal sinus surgery) ist eine minimal invasive Behandlungsmethode für die Nase und Nebenh?hlen, bei der der Chirurg keine direkte Sicht zum Operationssitus und den Instrumenten hat. Mit dem Ziel, den Chirurgen w?hrend des Eingriffs zu unterstützen, verwendet FESS-Control eine optische Navigationskamera, um die r?umliche Lage eines Shavers bezüglich des Patienten und dessen Bilddaten w?hrend der Operation zu bestimmen. Gleichzeitig erfolgt zum Schutz sensibler Strukturen eine Leistungssteuerung des Instruments. Mit Hilfe des neuen Modells wird die Beschr?nkung des existierenden Systems, welches nur gerade Shaverans?tze navigiert, aufgehoben und die Verwendung weiterer in der medizinischen Anwendung ben?tigter Shaverans?tze erm?glicht. Die neue L?sung für das FESS-Control System ist ein überzeugendes Beispiel dafür, dass Methoden der Softwaretechnik auch in den Anwendungen der Medizintechnik gewinnbringend eingesetzt werden k?nnen. CR subject classification  J.3 ; I.6.5