On-Farm Experimentation to transform global agriculture.

Restructuring farmer-researcher relationships and addressing complexity and uncertainty through joint exploration are at the heart of On-Farm Experimentation (OFE). OFE describes new approaches to agricultural research and innovation that are embedded in real-world farm management, and reflects new demands for decentralized and inclusive research that bridges sources of knowledge and fosters open innovation. Here we propose that OFE research could help to transform agriculture globally. We highlight the role of digitalization, which motivates and enables OFE by dramatically increasing scales and complexity when investigating agricultural challenges.

Spatial dynamics in the classroom: Does seating choice matter?

This study examines peer and seating effects on overall class performance and exams from a spatial perspective for principles of economics courses at a major Land Grand institution in the Midwest. Both spatial and student specific factors were identified that impact performance. The spatial relationships in the classroom were explored to determine if students' peers and seating choice affect their performance. Endogenous spatial peer effects were only found to impact performance on the first exam. Other findings found gender, being an economics major, sitting in the back of the class, and the year the class was taken all impacted overall exam and class performance.

Pilot study on the use of data mining to identify cochlear implant candidates.

OBJECTIVES: The goal of this pilot study was to determine the clinical utility of data-mining software that screens for cochlear implant (CI) candidacy. METHODS: The Auditory Implant Initiative developed a software module that screens for CI candidates via integration with a software system (Noah 4) that serves as a depository for hearing test data. To identify candidates, patient audiograms from one practice were exported into the screening module. Candidates were tracked to determine if any eventually underwent implantation. RESULTS: After loading 4836 audiograms from the Noah 4 system, the screening module identified 558 potential CI candidates. After reviewing the data for the potential candidates, 117 were targeted and invited to an educational event. Following the event, a total of six candidates were evaluated, and two were implanted. DISCUSSION: This objective approach to identifying candidates has the potential to address the gross underutilization of CIs by removing any bias or lack of knowledge regarding the management of severe to profound sensorineural hearing loss with CIs. CONCLUSION: The screening module was an effective tool for identifying potential CI candidates at one ENT practice. On a larger scale, the screening module has the potential to impact thousands of CI candidates worldwide.

Creating a framework for data sharing in cochlear implant research.

OBJECTIVES: To summarize the development process of a national database that was designed to facilitate communication and collaboration, improve care, and create a framework for aggregate data sharing in cochlear implant (CI) research. METHODS: A group of nationally represented, multidisciplinary CI providers cooperated to define a standard set of data elements to incorporate into a database built by them in association with a group of computer scientists and software designers. CI centers across the USA, then, joined the non-profit Auditory Implant Initiative to use the database for their own clinical purposes and to help contribute to the national de-identified dataset for research and analytics. RESULTS: Approximately 12 months after the full release of the database, clinical information on 373 patients has been entered from 17 different CI centers representing 61 hearing professionals. A blend of six academic, seven private, and four non-profit CI centers participated in this phase of the data sharing network. DISCUSSION: The adoption of a single, standardized database by 17 centers throughout the USA has begun a framework for data sharing in CI research. Future steps include (1) expanding adoption, (2) scaling the database to include more patients, (3) streamlining the legal hurdles required for adoption, and (4) integrating the database with other software platforms (e.g. electronic health records, processors). CONCLUSION: A standardized clinical outcomes database that is utilized by a growing network of CI centers can help strengthen research through aggregate data sharing.

Statistical and Economic Techniques for Site-specific Nematode Management.

Recent advances in precision agriculture technologies and spatial statistics allow realistic, site-specific estimation of nematode damage to field crops and provide a platform for the site-specific delivery of nematicides within individual fields. This paper reviews the spatial statistical techniques that model correlations among neighboring observations and develop a spatial economic analysis to determine the potential of site-specific nematicide application. The spatial econometric methodology applied in the context of site-specific crop yield response contributes to closing the gap between data analysis and realistic site-specific nematicide recommendations and helps to provide a practical method of site-specifically controlling nematodes.

A family-centered "visitation" policy in the neonatal intensive care unit that welcomes parents as partners.

Parents are important partners in the neonatal intensive care unit, collaborating with staff in caregiving and decision making for their infants. These essential and mutually beneficial partnerships between families and staff are the cornerstone of family-centered care and require that parents are welcomed to be with their baby at any time. This concept is not new and, yet, many neonatal intensive care units continue to have "visitation" policies that restrict parent's access to their infants, failing to recognize parents as partners. Changing the "visitation" policy is part of a welcoming approach in the context of family-centered care. Neonatal intensive care unit nurses may be accustomed to a more strict policy, needing communication tools and strategies to collaborate with parents and implement a family-centered "visitation" or welcoming policy.

Bringing change-of-shift report to the bedside: a patient- and family-centered approach.

Change-of-shift report is the time when responsibility and accountability for the care of a patient is transferred from one nurse to another. The communication that ensues during this process is linked to both patient safety and continuity of care giving. While many nurses already recognize the value of bringing report to the patient's bedside and have practiced in this manner, this remains relatively uncommon. Typically, nurse change-of-shift report has occurred at a nurses' station, conference room, or hallway and may be face to face, audio-taped, recorded on a telephone service, or in a written format. When report is given away from the bedside, the opportunity to visualize the patient and include the patient and family in an exchange of information and care planning is lost. Yet, patients and families, also stewards of patient safety, are given an opportunity to hear and participate in the exchange of information when report is brought to the bedside. Welcoming patients and families into the report process may be a new and challenging process for nursing staff.

Transition to home from the newborn intensive care unit: applying the principles of family-centered care to the discharge process.

Increasingly newborn intensive care units (NICUs) are embracing family-centered care principles. Family-centered newborn intensive care requires that families are welcomed as partners in caregiving and decision making. Traditionally, discharge planning has been done without significant family involvement. In fact, parent participation in caregiving may still be limited until discharge is imminent. By increasing parental involvement in caregiving throughout hospitalization and working with families to facilitate the discharge process, parents may emerge from the NICU experience with increased competence and confidence in infant caregiving. This article reviews common discharge practices and processes in the NICU and offers strategies to assist nurses in integrating a family-centered approach into discharge planning.

Family-centered care in the NICU.

Family-centered care is a philosophy of care that embraces a partnership between staff and families. Families, patients, and staff benefit in a family-centered care environment and the design of the newborn intensive care unit (NICU) must not interfere with its successful implementation. Unrestricted parental presence in the NICU, parental involvement in infant caregiving, and open communication with parents are basic tenets of family-centered care. By virtue of their continual presence and role in the NICU, nurses are in a unique position to support family-centered care.

Facing challenges to family-centered care. II: Anger in the clinical setting.

Common sources of parental anger in the hospital setting include visiting restrictions, an unexpected change in the child's health status, confusion resulting from conflicting or insufficient information provided by the staff, and feeling undervalued in the care of their infant or child. Principles of family-centered care can be applied to develop strategies that assist nurses in handling these stressful situations in a professional and therapeutic manner. Nurses' own defensiveness and anger in response to parental anger can also be eased by use of these techniques as well as by mentoring, education, and support.

Facing challenges to family-centered care. I: Conflicts over visitation.

Policies and practices related to parental presence and participation in the care of a hospitalized child can be a source of tension between nurses and families. Tensions often revolve around "visiting" hours, who may visit, the number of visitors allowed at the bedside at a time, and inconsistent enforcement of existing visitation policies. A family-centered framework for evaluating these policies and practices can provide direction that will help reduce these tensions. Visitation policies that are flexible and offer guidelines, not rules, will usually best meet the needs of families. Some nurses may need education, mentoring, skill-building, and role-playing opportunities to work comfortably with flexible guidelines and increased family presence and participation.