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Purpose Web-based courses are a practical way to engage in meaningful discussions with learners from a diverse set of communities. By gathering online to learn about a topic, learners can form communities that transcend geographic and political boundaries. This paper aims to investigate a partnership between the University of Wisconsin-Madison (UW-Madison) and Wisconsin Library Services, which brought open access online learning to thousands of lifelong learners around the state of Wisconsin. “Changing Weather and Climate in the Great Lakes Region”, a massive open online course the UW-Madison launched in 2015, paired a regional focus with face-to-face discussions at 21 public libraries to deepen learners’ personal connections to the subject matter. Through strategic partnership, targeted course development and marketing of events, intimate local discussion sessions and statewide events provided fora in which Wisconsin residents would explore changing weather and climate with university faculty, staff and students. Design/methodology/approach This paper uses a case study approach and firsthand interview feedback from librarians, library staff and university faculty and staff who were leading the effort. Findings This paper explores the lessons learned and practical implications from the project and offers insight into libraries and universities looking to engage specific communities in non-credit online learning projects into the future. Originality/value This effort was a first of its kind partnership for the University and the State of Wisconsin.

In precision medicine, Dynamic Treatment Regimes (DTRs) are treatment protocols that adapt over time in response to a patient's observed characteristics. A DTR is a set of decision functions that takes an individual patient's information as arguments and outputs an action to be taken. Building on observed data, the aim is to identify the DTR that optimizes expected patient outcomes. Multiple methods have been proposed for optimal DTR estimation with continuous outcomes. However, optimal DTR estimation with binary outcomes is more complicated and has received comparatively little attention. Solving a system of weighted generalized estimating equations, we propose a new balancing weight criterion to overcome the misspecification of generalized linear models' nuisance components. We construct binary pseudo-outcomes, and develop a doubly-robust and easy-to-use method to estimate an optimal DTR with binary outcomes. We also outline the underlying theory, which relies on the balancing property of the weights; provide simulation studies that verify the double-robustness of our method; and illustrate the method in studying the effects of e-cigarette usage on smoking cessation, using observational data from the Population Assessment of Tobacco and Health (PATH) study.

The objective of the study was to identify factors that affected the implementation of an inpatient case management program in rural hospitals. The hospitals studied were from the Western New York Rural Health Care Cooperative. Five of the hospitals implemented the program in 1992. A qualitative evaluation was conducted by analyzing tape-recorded interviews with nurses and chief executive officers to identify obstacles to and facilitators of program implementation. Many obstacles to implementation could be traced to workload and time constraints, physician autonomy concerns, and limited nursing staff and physician participation. Implementation was facilitated foremost by the effort and supportive attitudes of nursing leaders and hospital chief executive officers. This study concluded that it should be possible to successfully implement conceptually sound managed care and case management programs in rural hospitals, but it will require a relatively long period of support, especially from hospital administration and nursing leaders.