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"Wolff, Alan"
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Rising to the Challenge
America's position as the source of much of the world's global innovation has been the foundation of its economic vitality and military power in the post-war. No longer is U.S. pre-eminence assured as a place to turn laboratory discoveries into new commercial products, companies, industries, and high-paying jobs. As the pillars of the U.S. innovation system erode through wavering financial and policy support, the rest of the world is racing to improve its capacity to generate new technologies and products, attract and grow existing industries, and build positions in the high technology industries of tomorrow.
Rising to the Challenge: U.S. Innovation Policy for Global Economy emphasizes the importance of sustaining global leadership in the commercialization of innovation which is vital to America's security, its role as a world power, and the welfare of its people. The second decade of the 21st century is witnessing the rise of a global competition that is based on innovative advantage. To this end, both advanced as well as emerging nations are developing and pursuing policies and programs that are in many cases less constrained by ideological limitations on the role of government and the concept of free market economics. The rapid transformation of the global innovation landscape presents tremendous challenges as well as important opportunities for the United States.
This report argues that far more vigorous attention be paid to capturing the outputs of innovation - the commercial products, the industries, and particularly high-quality jobs to restore full employment. America's economic and national security future depends on our succeeding in this endeavor.
eBook
Exploring reasoning mechanisms in ward rounds: a critical realist multiple case study
Background
Ward rounds are an important and ubiquitous element of hospital care with a history extending well over a century. Although originally intended as a means of educating medical trainees and junior doctors, over time they have become focused on supporting clinical practice. Surprisingly, given their ubiquity and importance, they are under-researched and inadequately understood. This study aims to contribute knowledge in human reasoning within medical teams, meeting a pressing need for research concerning the reasoning occurring in rounds.
Methods
The research reported here aimed to improve the understanding of ward round reasoning by conducting a critical realist case study exploring the collaborative group reasoning mechanisms in the ward rounds of two hospitals in Victoria, Australia. The data collection involved observing rounds, interviewing medical practitioners and holding focus group meetings.
Results
Nine group reasoning mechanisms concerning sharing, agreeing and recording information in the categories of information accumulation, sense-making and decision-making were identified, together forming a program theory of ward round reasoning. In addition, themes spanning across mechanisms were identified, further explaining ward round reasoning and suggesting avenues for future exploration. Themes included the use of various criteria, tensions involving mechanisms, time factors, medical roles and hierarchies.
Conclusions
This paper contributes to the literature by representing rounds in a manner that strengthens understanding of the form of the group reasoning occurring within, thus supporting theory-based evaluation strategies, redesigned practices and training enhancements.
Journal Article
Angioedema From Triple Therapy: A Case Report
Angioedema is a rare but potentially life-threatening complication associated with angiotensin-converting enzyme (ACE) inhibitors. Although the pathophysiology is well understood, cases involving the concurrent use of other medications are less explored. We present a unique case of ACE inhibitor-induced angioedema in a 57-year-old male, which developed soon after receiving intravenous contrast. The patient's medication list included a dipeptidyl peptidase-IV inhibitor and a calcium channel blocker. Studies have shown an increased risk of angioedema with the combined use of these medications, likely due to alterations in bradykinin metabolism. This case highlights the importance of medication review and consideration of potential drug interactions when prescribing ACE inhibitors. It emphasizes the significance of diagnostic accuracy to avoid the mislabeling of allergies and consideration of other etiologies in angioedema. Healthcare providers ought to be mindful of the increased risk of angioedema when prescribing dipeptidyl peptidase-IV inhibitors and calcium-channel blockers with ACE inhibitors, as these are frequently used medications.
Journal Article
Integrated Pathology Informatics Enables High-Quality Personalized and Precision Medicine: Digital Pathology and Beyond
- The critical role of pathology in diagnosis, prognosis, and prediction demands high-quality subspecialty diagnostics that integrates information from multiple laboratories.
- To identify key requirements and to establish a systematic approach to providing high-quality pathology in a health care system that is responsible for services across a large geographic area.
- This report focuses on the development of a multisite pathology informatics platform to support high-quality surgical pathology and hematopathology using a sophisticated laboratory information system and whole slide imaging for histology and immunohistochemistry, integrated with ancillary tools, including electron microscopy, flow cytometry, cytogenetics, and molecular diagnostics.
- These tools enable patients in numerous geographic locations access to a model of subspecialty pathology that allows reporting of every specimen by the right pathologist at the right time. The use of whole slide imaging for multidisciplinary case conferences enables better communication among members of patient care teams. The system encourages data collection using a discrete data synoptic reporting module, has implemented documentation of quality assurance activities, and allows workload measurement, providing examples of additional benefits that can be gained by this electronic approach to pathology.
- This approach builds the foundation for accurate big data collection and high-quality personalized and precision medicine.
Journal Article
Meeting current challenges: The job at hand for the WTO
Before 2020, the closest our species came to a truly shared experience was the landing of the first human being on the moon. That changed, and in a horribly negative way with COVID-19. In early April, more than half of the global population was under some sort of lockdown. People everywhere feared for the health of their loved ones and worried about their own economic prospects.
Journal Article
