What are big data? the term 'big data' is now frequently used in medicine. but what does this really mean and how is it relevant to the clinician as well as researcher? the background of this increasingly popular term is discussed here; what it means in clinical practice, for patients and for research; and why scotland is poised to take advantage of this big data revolution. there is no universal agreement on the meaning of big data. indeed to many the term is vague, ill-defi ned and confusing. it generally refers to large or complex data, often requiring terabytes or petabytes of storage. it might refer to large amounts of information at a population, regional or local level or span different geographical areas. to put this in context, a terabyte could hold 1,000 copies of the Encyclopaedia Britannica and a petabyte 20 million four-door fi ling cabinets of information. 1

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The findings can assist nurses in states with low managed-care concentration to create their preferred future within health care delivery. A more highly educated nurse workforce will be needed for 21st century health systems in which more care is likely to be delivered outside hospitals.

The ethical challenges of caring for the chronically ill are of increasing concern to nurses as they attempt to create humanitarian environments for long-term care. This article suggests two ethical perspectives to guide the agenda of the nursing profession to achieve social change in the care of the chronically ill and aging. First, a reemphasis on the public duties of the professions is recommended which extends beyond serving the interests of the nursing profession to recognizing the need to serve the common good. Second, the limitations of the autonomy paradigm are explored and the foundation for the development of a new moral paradigm is analyzed in terms of its' potential usefulness in addressing ethical problems of chronic illness. Several initiatives that nursing must undertake to facilitate the emergence of this paradigm are proposed.