Marilyn May Lombardi

Opening the Metaverse

Virtual worlds (VWs) have the ability to deliver enhanced visualization and simulation capabilities, and to support contextualized copresence, so they have the potential to serve large numbers of work organizations, educators, trainers, and scholars. To accomplish this, they must evolve into a metaverse that would make it easy for anyone to create and distribute 3D virtual information spaces that are collaborative, persistent, and interoperable, and that provide a shared social context for unifying and integrating resources, multimedia content, along with grid and cloud-based computing services on demand. On the basis of the example of the Web, the new global metamedium supporting the open metaverse must (1) be open and nonproprietary, (2) include a VW browser analogous to today’s open source web browsers for viewing and interacting with VWs, and (3) provide 3D hyperlink capability for traversing VW contexts. The Open Cobalt project seeks to accomplish this revolution by building and deploying a virtual-machine-based technology that functions as a VW browser and construction toolkit, and as an integrated development environment for accessing, creating, and publishing hyperlinked VWs.

Measuring Organizational Capacity to Accelerate Health Care Innovation in Academic Health Centers

In an era of rising clinical costs and shrinking federal research dollars, the survival of the academic health center may depend on its capacity to cultivate high-impact innovations in care delivery on an accelerated basis. Yet, the health sciences literature offers little guidance regarding the key organizational determinants most likely to facilitate such innovation. We report on the conceptualization, development, and preliminary testing of a new 21-item Accelerated Healthcare Innovation Capacity scale for addressing that knowledge gap. Instrument development followed a standardized process, including expert panel testing of the new scales content relevance validity. A sample (N = 53) of academic health center administrators, clinicians, and faculty affiliated with a single organization volunteered to complete the Accelerated Healthcare Innovation Capacity scale in survey form. Data were analyzed to evaluate scale reliability, internal consistency, and construct validity. High-expert agreement (overall S-CVI of 0.91) was obtained on content relevance validity. Cronbach &agr; for the scale was 0.941. Exploratory factor analysis confirmed the theoretical soundness of the scales conceptual framework, which showed high-impact health care innovation support to be a complex, multidimensional concept involving key facilitating factors across 3 major constructs—that is, Culture, Structure, and Policy—with implications for future research and managerial practice, particularly for staff development educators engaged in evaluating quality management and organizational change strategies.

Pillars for the Care of Older Persons in the Caribbean

Pillars for the Care of Older Persons in the Caribbean: A Comprehensive Community-Based Framework (Pillars) is a hybrid of multiple public health frameworks developed through community-based participatory research processes. Health and social service professionals, governmental organizations, elderly persons, and others from across the English-speaking Caribbean countries developed the Pillars framework to address the growing elderly population and with an aim to increase the number of healthy and active years of life. The Pillars framework consists of four interrelated pillars organized across multiple sectors of society: primary care with care management; integrated services coordination; population-based health promotion and disease prevention; and planning and accountability. Pillars is enabled by an envisioned integrated system of information technology that will increase community-based services delivery, interprofessional communication and coordination, and will aggregate data with all identifiers removed for surveillance, planning, forecasting, policy making, evaluation, and research.