The Art of Digital Curation

Artists have long engaged with digital and networked technologies in critical and creative ways to explore both new art forms and novel ways of disseminating artworks. Net-based artworks are often created with the intent to circulate outside traditional institutional spaces, and many are shared via artist-run platforms that involve curatorial practices distinct from those of museums or commercial galleries. This article focuses on a particular artist-run platform called Paper-Thin, characterizing the activities involved in managing the platform as digital curation in a polysemous sense – as both the curation of digital artworks and the stewardship of digital information in a complex technological ecosystem. While scholars and cultural heritage professionals have developed innovative preservation strategies for digital and new media artworks housed in institutional collections, the ongoing care of artworks shared through networked alternative spaces is largely carried out co-operatively by the artists and curators of these platforms. Drawing on Howard Becker’s sociological theory of art worlds as networks of co-operative actors, this article describes the patterns of co-operative work involved in creating, exhibiting, and then caring for Net-based art. The article outlines the importance, for cultural heritage professionals, of understanding the digital-curation practices of artists, as these artist-run networked platforms demonstrate emergent approaches to the stewardship of digital culture that move beyond a custodial paradigm.

Personalizing the BioPsychoSocial Approach: “Add-Ons” and “Add-Ins” in Generalist Practice

Generalist practitioners often find interacting with patients deeply satisfying and joyful; they also experience encounters that are challenging and complex. In both cases, they must be aware of the many issues that affect the processes and outcomes of patient care. Although using the BioPsychoSocial approach is an important, time-tested framework for cultivating one's awareness of patients' presenting concerns, recent developments suggest that additional frames of reference may enhance communication and relationships with patients. In this article, we describe several additions to the BioPsychoSocial approach, considerations we call “add-ons” and “add-ins”. We invite generalist practitioners and, indeed, all health care practitioners, to consider how they can improve their ongoing care of patients by personalizing these and other additions in their day-to-day work with patients.

British Gynaecological Cancer Society recommendations for women with gynecological cancer who received non-standard care during the COVID-19 pandemic

During the COVID-19 pandemic, pressures on clinical services required adaptation to how care was prioritised and delivered for women with gynecological cancer. This document discusses potential ‘salvage’ measures when treatment has deviated from the usual standard of care. The British Gynaecological Cancer Society convened a multidisciplinary working group to develop recommendations for the onward management and follow-up of women with gynecological cancer who have been impacted by a change in treatment during the pandemic. These recommendations are presented for each tumor type and for healthcare systems, and the impact on gynecological services are discussed. It will be important that patient concerns about the impact of COVID-19 on their cancer pathway are acknowledged and addressed for their ongoing care.

The Role of the Primary Care Physician in the Management of Parkinson’s Disease Dementia

Dementia is a frequent complication of Parkinson’s disease with an annual incidence of around 10% of patients with Parkinson’s disease. If dementia occurs in patients with Parkinson’s disease, it is typically many years or decades after the onset of Parkinson’s disease. It is devastating for both patient and family or caretaker when a patient with Parkinson’s disease develops dementia. Primary care physician is at the center of the care team for the patient. This chapter discusses the pivotal role of the primary care physicians in the management of patients with Parkinson’s disease dementia. A guide is provided to emphasize the art of practice for Primary care physicians which consists of knowing when and how to introduce a comprehensive ongoing care plan for individual patient with Parkinson’s disease dementia. Recommendations for maintaining some patients with Parkinson’s disease dementia in a status of relative independence are discussed. Indications for initiation of palliative care are also discussed.

O021 Preferred attributes of care pathways for obstructive sleep apnoea from the perspective of diagnosed patients and high-risk individuals: a discrete choice experiment

Background The current health care system is challenged with a large and rising demand for obstructive sleep apnoea (OSA) services. A paradigm shift in OSA management is required to incorporate the preferences of diagnosed patients and individuals at high-risk of OSA. This study aimed to provide empirical evidence of the values and preferences of individuals diagnosed with OSA and high-risk populations regarding distinct OSA care pathway features. Methods A discrete choice experiment (DCE) was undertaken in two groups: those with a formal diagnosis of OSA (n=421) and those undiagnosed but at high-risk of having OSA (n=1033). The DCE approach used mixed logit regression models to determine preferences relating to eight salient features of OSA management pathway, i.e. initial assessment, setting and diagnosis costs, waiting times, results interpretation, treatment options, provider of ongoing care and frequency of follow up visits. Results The findings indicate that all eight attributes investigated were statistically significant factors for respondents. Generally, both groups preferred low diagnostic costs, fewer follow-up visits, minimum waiting time for sleep study results, and sleep specialists to recommend treatment and as ongoing care providers. Management of OSA in primary care was acceptable to both groups and was the most preferred option by the high-risk group for sleep study testing and ongoing care provision. Discussion The DCE results offer a promising approach for systematic incorporation of patient and high-risk groups preferences into the future design and delivery of care pathways for OSA management.

The Quality of Primary Care Performance in Private Sector Facilities in Nairobi, Kenya: A Cross-Sectional Descriptive Survey

BackgroundIntegrated health services with an emphasis on primary care are needed for effective primary health care and achievement of universal health coverage. The key elements of high quality primary care are first-contact access, continuity, comprehensiveness, coordination, and person-centredness. In Kenya, there is little information on these key elements and such information is needed to improve service delivery. This study aimed to evaluate the quality of primary care performance in a group of private sector clinics in Nairobi, Kenya.Methods A cross-sectional descriptive study adapted the Primary Care Assessment Tool for the Kenyan context and surveyed 412 systematically sampled primary care users, from 13 PC clinics. Data was analysed to measure 11 domains of primary care performance and two aggregated primary care scores using the Statistical Package for Social Sciences.Results Mean primary care score was 2.64 (SD=0.23) and the mean expanded primary care score was 2.68 (SD=0.19), implying poor overall performance. The domains of first contact-utilisation, coordination (information system), family-centredness and cultural competence had mean scores of >3.0 (acceptable to good performance). The domains of first contact (access), coordination, comprehensiveness (provided and available), ongoing care and community-orientation had mean scores of < 3.0 (poor performance). Older respondents (p=0.05) and those with higher affiliation to the clinics (p=0.01) were more likely to rate primary care as acceptable to good.Conclusion These primary care clinics in Nairobi had a poor overall performance. There was a report of acceptable-to-good performance in first-contact utilisation, the information systems, family centredness and cultural competence. However, patients rated first-contact access, ongoing care, coordination of care, comprehensiveness of services, community orientation and availability of a complete primary health care team, as poor. Performance could be improved by deploying family physicians, increasing the scope of practice to become more comprehensive, improving access after-hours and marketing the use of the clinics to the practice population.

Shared decision-making in patient–doctor consultations – How does it relate to other patient-centred aspects and satisfaction?

Background This study was designed to investigate how patient-reported shared decision-making relates to other aspects of patient centredness and satisfaction. Methods Questionnaire study with patients. Consecutive patients in primary care responding post visit. Associations are presented as proportions, positive predictive values, with 95% confidence intervals. Results 223 patient questionnaires were included. 62% (95% Confidence interval (CI): 55–69) of the patients indicated the highest possible rating of being involved in the decisions about their ongoing care (self-reported SDM). Self-reported SDM had a positive predictive value (PPV) of between 85% (CI: 77–90) and 95% (CI: 90–98) for five other patient-centred aspects and satisfaction. Conclusion The results suggest that shared decision making is the patient-centred aspect hardest to achieve and that a patient-centred process leading up to the decision-making increases the chance of the patient being involved in the decision-making.

Multimorbid Patient Experiences With Primary Care at Community Health Centers in Shanghai, China

Objective: Primary care in China is facing mounting challenges with multimorbidity as the aging population grows. Knowing how patients experience primary care may highlight the deficiencies of the care system and guide health system reform. The purpose of this study was to compare the quality of primary care experienced by patients with and without multimorbidity at community health centers (CHCs) in Shanghai, China and to examine the factors influencing these experiences.Methods: A cross-sectional survey was conducted from August to December 2019 using the validated Chinese Primary Care Assessment Tool-Adult Edition (PCAT-AE). ANOVA was performed to compare the overall and domain-specific quality of primary care for patients with and without multimorbidity. Multivariate linear regressions were used to assess the factors associated with primary care quality while controlling for patients' sociodemographic and healthcare characteristics.Results: From 2,404 completed questionnaires, patients with multimorbidity reported higher PCAT scores in the domains of first contact-utilization (3.54 ± 0.55 vs. 3.48 ± 0.56, P &lt; 0.01), accessibility (2.93 ± 0.49 vs. 2.86 ± 0.47, P &lt; 0.001), and ongoing care (3.20 ± 0.39 vs. 3.14 ± 0.43, P &lt; 0.001), while reporting lower scores in coordination (information system) (2.72 ± 0.41 vs. 2.79 ± 0.35, P &lt; 0.001) and family-centeredness (3.23 ± 0.63 vs. 3.30 ± 0.64, P &lt; 0.01). Multimorbidity (ß = 0.355, P &lt; 0.01), education level (ß = 0.826, P &lt; 0.01), district (suburb: ß = 1.475, P &lt; 0.001), and self-perceived good health status (ß = 0.337, P &lt; 0.05) were associated with better patient experiences in primary care. Patients between the age 61 and 70 (ß = −0.623, P &lt; 0.001; &gt;70 years: ß = −0.573, P &lt; 0.01), with a monthly household income ≥6,000 RMB (ß = −1.385, P &lt; 0.001) and with more than 20 outpatient visits the previous year (ß = −1.883, P &lt; 0.001) reported lower total PCAT scores.Conclusion: The findings of our study suggest that CHCs in China have contributed to better primary care experiences for patients with multimorbidity in certain quality domains, including first contact-utilization, accessibility, and ongoing care. However, there is still room for improvement in care coordination and family-centeredness.

Development and Evaluation of Antibacterial Polyherbal Bath Soap

Bacterial skin infections are the most prevalent among individuals, necessitating immediate treatment as well as ongoing care to preserve healthy skin. Because some herbal plant extracts have antibacterial properties, the goal of this research is to make an antibacterial poly herbal bath soap using curcuma longa[Turmeric] and Organum Vulgare [Oregano The antibacterial activity of prepared soap was evaluated against staphylococcus aureus, E. coli, and Aspergillus Niger using the agar well diffusion technique. The developed Polyherbal formulation had a good antibacterial activity, and it was analysed for several physicochemical parameters and whether it has good characteristics. Plants are easily obtainable, and their efficacy helps manufacturers in achieving cost-effective outcomes with few or no side effects.