Browsing by Subject "standardization"

Medication reviews have been highlighted as one of the most important strategies for improving medication safety and medication management especially in older adults. Current electronic health records document and communicate e-prescriptions but their medication use related patient information content should be extended to cover e.g. medication review documentation. The documentation should be in structured format to be useful in clinical practice and evidence-informed decision-making. The aim of this study was to identify medication review related patient information and other patient data that should be in a structured form in electronic health record systems (EHRs) at a national and organizational level. The aim was also to determine which medication review related patient information should be documented in electronic health record systems. The study was conducted as 3-round survey using the Delphi-method. The Delphi method is a qualitative consensus method based on the views of experts aiming at reaching consensus of the experts on the studied subject. The Delphi rounds were conducted as electronic surveys in September-December 2020. Expert panelists assessed which medication-related patient data and other data generated by healthcare providers should be documented in a structured form in EHRs and in which national digital data system services (Kanta and My Kanta Pages) the medication review related patient information should be accessible and by whom. The expert panel consisted of 41 participants: 12 physicians, 13 pharmacists, 10 nurses, and 6 information management professionals. The results of the study were analyzed both quantitatively and qualitatively. Consensus was reached on a total of 108 medication review related patient information topics that should be documented in a structured form in EHRs and that should be available for medication reviews through EHRs. Of the topics, 39 related to medication reviews in general, 25 to adverse drug reaction symptoms, 11 to the burden of adverse drug effects, 12 to laboratory tests and other test results, 12 to medication adherence and 9 to the use of intoxicants. Structuring the data was considered as important or important to some extent in most of the presented medication review related information topics. Especially, the documentation of renal function was rated by the expert panelists as a crucial piece of information to be structured. Medication adherence information and information related to the use of intoxicants were rated as less important to be documented in a structured form than other topics. Consensus was also reached on the accessibility of medication review documentation in the Kanta and My Kanta services. The expert panel of this study had a common and strong view that data related to medication reviews should be structured in EHRs. The expert panel reached a strong consensus that almost all of the data presented in the study should be structured. Based on this Delphi study, the expert panel identified the benefits of structuring and standardized recording. Because not all data can be structured at once, further prioritization of the data identified in this study is still needed. The practical implementation of the structured information could be accomplished in the form of a checklist. The study addresses a very current problem related to the shortcomings of medication information management and overall medication management.

Extracellular vesicles (EVs) are a very heterogeneous group of cell originated nanoparticles that act as mediators of intercellular communication. Accurate characterization of EVs is essential to enable their wider use and development as possible biomarkers, drug carriers, and vaccines. There is no validated reference material with EV-like properties currently available. A validated reference material would improve the reliability and reproducibility of EV studies. Nanoerythrosomes (NanoE) have been studied as a possible option for biological reference material. We aimed to further characterize and compare properties of NanoEs and erythrocyte-derived EVs (EryEV) and assess their stability concerning concentration and size distribution at most commonly applied storage temperatures, +4°C, -20°C, and -80°C for 12 weeks. Characterization was done using nanoparticle tracking analysis and flow cytometry. In addition, we studied the surface protein expression including CD235a, CD47, and CD41 of NanoEs and EryEV and conducted a preliminary cellular uptake test using PC-3 cells, CFSE-labeled NanoE, and EryEV particles. For both, NanoE and EryEV samples, 20°C was the worst storage condition. NanoEs stay stable at +4°C for a month and at -80°C, there were some drops in concentration during the 12 weeks of the experiment. EryEVs stay stable at +4°C and -80°C for 12 weeks. Both NanoE and EryEV particles seemed to be taken into the PC-3 cells, but due to problems with autofluorescence we conclude that confirming studies with different labeling protocols or another method need to be conducted. Both NanoEs and EryEVs samples had a significant number of CD47-positive particles.

My research has been motivated by a strong interest to understand the interplay of innovation and standardization. In the contemporary world, when the technological progress appeals as a leading factor in the development and growth, innovation becomes an important matter to research. At the same time distribution of information grows in scale, turning the interaction between innovation and standardization into more diverse and complicated interplay. This leads to the question of IPR and competition policies. Does standardization enhance innovation or does it become a barrier to it? What is the role of intellectual property rights in this? I use a dynamic general equilibrium model with innovation and standardization to study the interplay of intellectual property rights and innovation. The main references for the present research are papers by D. Acemoglu, G. Garcia and F. Zilibotti “Competing Engines of Growth: Innovation and Standardization” (2010) and by Y. Furukawa “Intellectual Property Protection and Innovation: An Inverted U-Relationship” (2010). The research yields a number of results. There exists a U-shaped relationship between growth and competition, formed by the tension between innovation and standardization. When the cost of innovation is relatively high, both strict and loose IPR policies limit innovation, thus a moderate approach is advised. Standardization can cause a multiple equilibria. The usefulness of IPR policy depends on the start-up cost of innovation.