Optimising Multi-stakeholder Practices in Patient Engagement: A Gap Analysis to Enable Focused Evolution of Patient Engagement in the Development and Lifecycle Management of Medicines

Background The PARADIGM consortium aimed to make patient engagement in the development and lifecycle management of medicines easier and more effective for all, with the development of new tools that fulfil robustly defined gaps where engagement is suboptimal. Aims To generate an inventory of gaps in patient engagement practices and process from existing global examples. Methods A large set of criteria for effective patient engagement previously defined via a multi-stakeholder Delphi method, were mapped under fourteen overarching themes. A gap analysis was then performed by twenty-seven reviewers against the resulting forty-six mapped criteria, on a sample of seventy initiatives from global databases. Results An inventory of gaps was identified including contextual information as to why the gaps exist. Our work identified general patterns where patient engagement was suboptimal—defined as; fragmented reporting and dissemination of patient engagement activities, and the fundamental principles defined in frameworks or guidance being poorly adhered to in actual practice. Specific gaps were identified for sixteen criteria. Additionally, it was also common to observe primary aspects of a process were addressed for a given criteria (i.e. training for roles and responsibilities) but a secondary context element was lacking (i.e. making training material accessible/understandable/meaningful to all participants). Conclusion The results show that the evolution towards meaningful and systematic patient engagement is occurring, yet more importantly they provide clear directional insights to help enhance collaborative practices and co-design solutions. This targeted impact to catalyse a needs-oriented health system that integrates patient engagement at its core is essential.

The Shifts of Conventional Context Element Aspects: Towards a Cyberpragmatics Perspective

This study aims to describe the forms of shifting conventional context elements to a virtual external context in the cyberpragmatics perspective. The data of this study were manifestations of the shifts in the contexts. The substantive data source of this study was various kinds of utterances and the formulation of the context containing realizations of the shifts in the conventional external context. The locative data source was social media that published a variety of utterances and the context in which there was a shift in the context elements that could be collected by the researcher around the time of the study. The data collection method applied was the listening method, focusing on the free engaged and profound method of listening. The technique used in applying the listening method was the note-taking technique. The data were then classified and verified further. The verified data were then triangulated to experts of pragmatics, especially cyberpragmatics. Data analysis was carried out by applying distributional method to cover the linguistic dimension of this study. As for the non-linguistic dimension, the researcher applied the extralingual equivalent method. The results of this study were the manifestations of the context shifts as follow: (1) shifting aspects of context element of speech setting, (2) shifting aspects of context element of objectives of speaking, (3) shifting aspects of context element of speech participants, (4) shifting aspects of context element of speech atmosphere, (5) shifting aspects of context element of speech channel, (6) shifting aspects of context element of speech genre and (7) shifting aspects of context element of verbal acts.

Capture by Context Elements, Not Attentional Suppression of Distractors, Explains the PD with Small Search Displays

Top–down control of attention allows us to resist attentional capture by salient stimuli that are irrelevant to our current goals. Recently, it was proposed that attentional suppression of salient distractors contributes to top–down control by biasing attention away from the distractor. With small search displays, attentional suppression of salient distractors may even result in reduced RTs on distractor-present trials. In support of attentional suppression, electrophysiological measures revealed a positivity between 200 and 300 msec contralateral to the distractor, which has been referred to as distractor positivity (PD). We reexamined distractor benefits with small search displays and found that the positivity to the distractor was followed by a negativity to the distractor. The negativity, referred to as N2pc, is considered an index of attentional selection of the contralateral element. Thus, attentional suppression of the distractor (PD) preceded attentional capture (N2pc) by the distractor, which is at odds with the idea that attentional suppression avoids attentional capture by the distractor. Instead, we suggest that the initial “PD” is not a positivity to the distractor but rather a negativity (N2pc) to the contralateral context element, suggesting that, initially, the context captured attention. Subsequently, the distractor was selected because, paradoxically, participants searched all lateral target positions (even when irrelevant) before they examined the vertical positions. Consistent with this idea, search times were shorter for lateral than vertical targets. In summary, the early voltage difference in small search displays is unrelated to distractor suppression but may reflect capture by the context.

A New Contextual Influencer User Measure to Improve the Accuracy of Recommender System

In the last decade, social-based recommender systems have become the best way to resolve a user's cold start problem. In fact, it enriches the user's model by adding additional information provided from his social network. Most of those approaches are based on a collaborative filtering and compute similarities between the users. The authors' preliminary objective in this work is to propose an innovative context aware metric between users (called contextual influencer user). These new similarities are called C-COS, C-PCC and C-MSD, where C refers to the category. The contextual influencer user model is integrated into a social based recommendation system. The category of the items is considered as the most pertinent context element. The authors' proposal is implemented and tested within the food dataset. The experimentation proved that the contextual influencer user measure achieves 0.873, 0.874, and 0.882 in terms of Mean Absolute Error (MAE) corresponding to C-cos, C-pcc and C-msd, respectively. The experimental results showed that their model outperforms several existing methods.

Analysis of Healthcare Workflows in Accordance with Access Control Policies

Healthcare information systems deal with sensitive data across complex workflows. They often allow various stakeholders from different environments to access data across organizational boundaries. This elevates the risk of exposing sensitive healthcare information to unauthorized personnel, leading ‘controlling access to resources' a major concern. To prevent unwanted access to sensitive information, healthcare organizations need to adopt effective workflows and access control mechanisms. Many healthcare organizations are not yet considering or do not know how to accommodate the ‘context' element as a crucial element in their workflows and access control policies. The authors envision the future of healthcare where ‘context' will be considered as a crucial element. They can accommodate context through a new element ‘environment' in workflows, and can accommodate context in policies through well-known attribute based access control mechanism (ABAC). This research mainly addresses these problems by proposing a model to integrate workflows and access control policies and thereby identifying workflow activities that are not being protected by access control policies and improving the workflow activities and/or existing access control policies using SARE (Subject, Action, Resource, and environment) elements.

PERSPEKTIF IDEOLOGI DALAM WACANA SILANG TUTUR “KONVENSI PARTAI GOLKAR”

The study on the ideological perspective in this articleuses a critical discourse analysis that views discourse as action byconsidering certain context, historical context, element of power,and ideology. The material of analysis consists of newspaper reportsabout the discourse coming from various figures during the time ofthe Golkar Party Convention from its beginning to Wiranto’s electionas the presidential candidate nominated by the party. The articleshows the emergence, in the reports, of various pro- and contraconventionperspectives coming from figures outside the party aswell as various ideological perspectives brought up by party figuresin their attempts to win the convention as the presidential candidatenominated by the party.Keywords: ideological perspective, party convention, criticaldiscourse analysisA. Pendahuluan

Two Kinds of Wrong: On the Context Element of Crimes against Humanity

It can be shown that – as with the tie between crimes against humanity and the perpetration of other international crimes in the Charter of the International Military Tribunal in Nuremberg – the context element of the crimes against humanity as set out in the Rome Statute is based on the international law principle of non-interference in the affairs of a foreign country, and only serves to justify ‘international’ jurisdiction in respect of crimes which are typically already punishable pursuant to the lex loci commissii. As a consequence, the feature of a ‘widespread or systematic attack directed against any civilian population’ is not an aggravating circumstance in respect of the material facts of the case that define the wrong of the act (Unrecht) or the offender's blameworthiness (Schuld), but a jurisdictional element which is a mere precondition for prosecution only.

Identification of cis-acting intron and exon regions in influenza virus NS1 mRNA that inhibit splicing and cause the formation of aberrantly sedimenting presplicing complexes

In in vitro splicing reactions, influenza virus NS1 mRNA was not detectably spliced, but nonetheless very efficiently formed ATP-dependent 55S complexes containing the U1, U2, U4, U5, and U6 small nuclear ribonucleoproteins (snRNPs) (C. H. Agris, M. E. Nemeroff, and R. M. Krug, Mol. Cell. Biol. 9:259-267, 1989). We demonstrate that the block in splicing was caused by two regions in NS1 mRNA: (i) a large intron region (not including the branchpoint sequence) and (ii) an 85-nucleotide 3' exon region near the 3' end of the exon. After removal of both of these regions, the 5' and 3' splice sites and branchpoint of NS1 mRNA functioned efficiently in splicing, indicating that they were not defective. The two inhibitory regions shared one property: splicing inhibition was independent of the identity of the nucleotide sequence in either region. In other respects, however, the two inhibitory regions differed. The inhibitory activity of the intron region was proportional to its length, indicating that the inhibition was probably due to size only. In contrast, the 3' exon, which was of small size, was a context element; i.e., it functioned only when it was located at a specific position in the 3' exon of NS1 mRNA. To determine how these intron and exon regions inhibited splicing, we compared the types of splicing complexes formed by intact NS1 mRNA with those formed by spliceable NS1 mRNA lacking the intron and exon regions. Splicing complexes were formed by using purified splicing factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Identification of cis-acting intron and exon regions in influenza virus NS1 mRNA that inhibit splicing and cause the formation of aberrantly sedimenting presplicing complexes.

In in vitro splicing reactions, influenza virus NS1 mRNA was not detectably spliced, but nonetheless very efficiently formed ATP-dependent 55S complexes containing the U1, U2, U4, U5, and U6 small nuclear ribonucleoproteins (snRNPs) (C. H. Agris, M. E. Nemeroff, and R. M. Krug, Mol. Cell. Biol. 9:259-267, 1989). We demonstrate that the block in splicing was caused by two regions in NS1 mRNA: (i) a large intron region (not including the branchpoint sequence) and (ii) an 85-nucleotide 3' exon region near the 3' end of the exon. After removal of both of these regions, the 5' and 3' splice sites and branchpoint of NS1 mRNA functioned efficiently in splicing, indicating that they were not defective. The two inhibitory regions shared one property: splicing inhibition was independent of the identity of the nucleotide sequence in either region. In other respects, however, the two inhibitory regions differed. The inhibitory activity of the intron region was proportional to its length, indicating that the inhibition was probably due to size only. In contrast, the 3' exon, which was of small size, was a context element; i.e., it functioned only when it was located at a specific position in the 3' exon of NS1 mRNA. To determine how these intron and exon regions inhibited splicing, we compared the types of splicing complexes formed by intact NS1 mRNA with those formed by spliceable NS1 mRNA lacking the intron and exon regions. Splicing complexes were formed by using purified splicing factors.(ABSTRACT TRUNCATED AT 250 WORDS)