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This research announcement outlines the fundamentals, initial reflections, objectives, and methodology of a research project developed jointly by the University of West Attica, Greece, and the Federal University of Minas Gerais, Brazil. It presents the variability of the concept of value in the context of the preservation of cultural assets, the diversity of the terminology and the scarcity of specific discussions in the area of paper conservation. It outlines the conceptual contribution based on the relationship between values, historical evidence, and layers of data in cultural objects, as well as on the impact of conservation procedures on their interconnections. Finally, this article supports both the societal and material approach to decision-making in preservation and conservation through the interdisciplinary investigation of paper-based objects to understand them as complex artefacts. El presente artículo describe la fundamentación, reflexiones iniciales, objetivos y metodología de un proyecto de investigación desarrollado entre la Universidad West Attica, Atenas, Grecia, y la Universidad Federal de Minas Gerais, Brasil. Aborda la variabilidad del concepto de valor en el contexto de preservación del patrimonio, la diversidad de la terminología y la escasez de discusiones específicas en el área de conservación de papel. Presenta una contribución conceptual basada en la relación entre valores, evidencias históricas y de datos/informaciones presentes en objetos culturales, así como en el impacto de procedimientos de conservación en dichos datos. Los autores defienden el abordaje social y material para la toma de decisiones en relación a la preservación de la complejidad en los artefactos gráficos. Este artigo descreve os fundamentos, reflexões iniciais, objetivos e metodologia de um projeto de pesquisa desenvolvido em conjunto pela University of West Attica, Grécia, e pela Universidade Federal de Minas Gerais, Brasil. Apresenta a variabilidade do conceito de valor no contexto da preservação dos bens culturais, a diversidade da terminologia e a escassez de discussões específicas na área da conservação de papel. Delineia a contribuição conceitual baseada na relação entre valores, evidências históricas e camadas de dados em objetos culturais, bem como no impacto dos procedimentos de conservação nestas camadas. Finalmente, o artigo apoia a abordagem social e material para a tomada de decisão em preservação e conservação por meio da investigação interdisciplinar de documentos gráficos, compreendendo-os como artefatos complexos.

BackgroundHealth information systems are crucial to provide data for decision-making and demand for data is constantly growing. However, the link between data and decisions is not always rational or linear and the management of data ends up overloading frontline health workers, which may compromise quality of healthcare delivery. Despite limited evidence, there is an increasing push for the digitalization of health information systems, which poses enormous challenges, particularly in remote, rural settings in low- and middle-income countries. Paper-based tools will continue to be used in combination with digital solutions and this calls for efforts to make them more responsive to local needs. Paper-based Health Information Systems in Comprehensive Care (PHISICC) is a transdisciplinary, multi-country research initiative to create and test innovative paper-based health information systems in three sub-Saharan African countries.Methods/DesignThe PHISICC initiative is being carried out in remote, rural settings in Côte d’Ivoire, Mozambique and Nigeria through partnership with ministries of health and research institutions. We began with research syntheses to acquire the most up-to-date knowledge on health information systems. These were coupled with fieldwork in the three countries to understand the current design, patterns and contexts of use, and healthcare worker perspectives. Frontline health workers, with designers and researchers, used co-creation methods to produce the new PHISICC tools. This suite of tools is being tested in the three countries in three cluster-randomized controlled trials. Throughout the project, we have engaged with a wide range of stakeholders and have maintained the highest scientific standards to ensure that results are relevant to the realities in the three countries.DiscussionWe have deployed a comprehensive research approach to ensure the robustness and future policy uptake of findings. Besides the innovative PHISICC paper-based tools, our process is in itself innovative. Rather than emphasizing the technical dimensions of data management, we focused instead on frontline health workers’ data use and decision-making. By tackling the whole scope of primary healthcare areas rather than a subset of them, we have developed an entirely new design and visual language for a suite of tools across healthcare areas. The initiative is being tested in remote, rural areas where the most vulnerable live.

The economic action of any individual seems to be guided by psychological components belonging, often more to the sphere of the intuitive rather than to the logical mind. Cognitive Economics, unlike other critical approaches to neoclassical rationality, is aware of this reality and moves the center of gravity of the theory of the mind of the economic actor from the aspects of conscious, explicit, intentional, and rational towards the tacit, sub-conscious, intuitive and emotional. Cognitive Economics, as empirical theory, par excellence, does not refuse to consider the contribution of the mind to an economic decision. The role of the psyche in many situations of choice is undeniable. It is not, however, the only cognitive reality responsible for economic choices. From this point of view, the concept of limited rationality, remaining within a vision of intentionality in cognitive activities, loses much of its explanatory capacity. One of the motives for economic action is limited rationality because there is not enough computational capacity for calculating the consciousness and the intentions of the human mind. Rationality is also limited through the influence of intuitive, affective, emotional, and silent factors, which all characterize what we have called the intuitive mind. The economic actor’s mind theory is based on cognitive duplicity, integrating the insensitive and the intuitive component depending on the situations and contexts of a decision. However, there are few situations in which we can say that the insensitive component takes the decision without influence of that intuitive. A small part of the mind emerges to the surface image of the economic actor, which characterizes some of the intuitive. But it rests on the larger submerged body of the mind, which is not visible but responsible for guiding the inferential paths of homo-economicus. The’ cognitive economy assumes that this duality of the human mind and the primacy of the intuitive component explains economic action.

Early in the COVID-19 pandemic there was widespread concern that healthcare systems would be overwhelmed, and specifically, that there would be insufficient critical care capacity in terms of beds, ventilators or staff to care for patients. In the UK, this was avoided by a threefold approach involving widespread, rapid expansion of critical care capacity, reduction of healthcare demand from non-COVID-19 sources by temporarily pausing much of normal healthcare delivery, and by governmental and societal responses that reduced demand through national lockdown. Despite high-level documents designed to help manage limited critical care capacity, none provided sufficient operational direction to enable use at the bedside in situations requiring triage. We present and describe the development of a structured process for fair allocation of critical care resources in the setting of insufficient capacity. The document combines a wide variety of factors known to impact on outcome from critical illness, integrated with broad-based clinical judgement to enable structured, explicit, transparent decision-making founded on robust ethical principles. It aims to improve communication and allocate resources fairly, while avoiding triage decisions based on a single disease, comorbidity, patient age or degree of frailty. It is designed to support and document decision-making. The document has not been needed to date, nor adopted as hospital policy. However, as the pandemic evolves, the resumption of necessary non-COVID-19 healthcare and economic activity mean capacity issues and the potential need for triage may yet return. The document is presented as a starting point for stakeholder feedback and discussion.

DuMontier, C., et al. (2019). "Arti Hurria and the progress in integrating the geriatric assessment into oncology: Young international society of geriatric oncology review paper." J Geriatr Oncol. Abstract Until recently, the progress in the diagnosis and management of cancer has not been matched by similar progress in the assessment of the increasing numbers of older and more complex patients with cancer. Dr. Arti Hurria identified this gap at the outset of her career, which she dedicated toward studying the geriatric assessment (GA) as an improvement over traditional methods used in oncology to assess vulnerability in older patients with cancer. This review documents the progress of the GA and its integration into oncology. First, we detail the GA's origins in the field of geriatrics. Next, we chronicle the early rise of geriatric oncology, highlighting the calls of early thought-leaders to meet the demands of the rapidly aging cancer population. We describe Dr. Hurria's early efforts toward meeting these calls though the implementation of the GA in oncology research. We then summarize some of the seminal studies constituting the evidence base supporting GA's implementation. Finally, we lay out the evolution of cancer-focused guidelines recommending the GA, concluding with future needs to advance the next steps toward more widespread implementation in routine cancer care. Throughout, we describe Dr. Hurria's vision and its execution in driving progress of the GA in oncology, from her fellowship training to her co-authored guidelines recommending GA for all older adults with cancer-published in the year of her untimely death.

This is the first in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE). The SHARE Program is an investigation of concepts, opportunities, methods and implications for evidence-based investment and disinvestment in health technologies and clinical practices in a local healthcare setting. The papers in this series are targeted at clinicians, managers, policy makers, health service researchers and implementation scientists working in this context. This paper presents an overview of the organisation-wide, systematic, integrated, evidence-based approach taken by one Australian healthcare network and provides an introduction and guide to the suite of papers reporting the experiences and outcomes.

The purpose of this study is to systematically review guidelines, position papers, and reports on living kidney donation by minors. We systematically searched the databases such as Medline, Embase, ISI Web of knowledge, Google scholar as well as the websites of various bioethics committees, transplant organizations and societies. Guidelines were included if they provided recommendations for or against living kidney donation by minors. Data were analyzed using qualitative content analysis. We included 39 documents in this study. Twenty seven of these endorse an absolute prohibition of living kidney donation by minors, because of concerns regarding the decision-making capacity of minors, the impartiality of parental authorization, the best interests of the minor, and the necessity of the donation. Twelve guidelines, however, would exceptionally allow living kidney donation by minors, provided that adequate safeguards are put in place, including an assessment of the minor's autonomy and maturity, authorization by an independent body, assuring that the anticipated psychosocial benefits outweigh the medical and psychosocial risks for the donor and the restriction to situations of last resort. A more adequate medical and psychosocial follow-up of living kidney donors may likely contribute to a more unified approach towards living kidney donation by minors.

The purpose of this study is to systematically review guidelines, position papers, and reports on living kidney donation by minors. We systematically searched the databases such as Medline, Embase, ISI Web of knowledge, Google scholar as well as the websites of various bioethics committees, transplant organizations and societies. Guidelines were included if they provided recommendations for or against living kidney donation by minors. Data were analyzed using qualitative content analysis. We included 39 documents in this study. Twenty seven of these endorse an absolute prohibition of living kidney donation by minors, because of concerns regarding the decision-making capacity of minors, the impartiality of parental authorization, the best interests of the minor, and the necessity of the donation. Twelve guidelines, however, would exceptionally allow living kidney donation by minors, provided that adequate safeguards are put in place, including an assessment of the minor's autonomy and maturity, authorization by an independent body, assuring that the anticipated psychosocial benefits outweigh the medical and psychosocial risks for the donor and the restriction to situations of last resort. A more adequate medical and psychosocial follow-up of living kidney donors may likely contribute to a more unified approach towards living kidney donation by minors.