Impact of a data warehouse model for improved decision-making process in healthcare

The health system is one sector dealing with a deluge of complex data. Many healthcare organisations struggle to utilise these volumes of health data effectively and efficiently. Also, there are many healthcare organisations, which still have stand-alone systems, not integrated for management of information and decision-making. This shows, there is a need for an effective system to capture, collate and distribute this health data. Therefore, implementing the data warehouse concept in healthcare is potentially one of the solutions to integrate health data. Data warehousing has been used to support business intelligence and decision-making in many other sectors such as the engineering, defence and retail sectors. The research problem that is going to be addressed is, "how can data warehousing assist the decision-making process in healthcare". To address this problem the researcher has narrowed an investigation focusing on a cardiac surgery unit. This research used the cardiac surgery unit at the Prince Charles Hospital (TPCH) as the case study. The cardiac surgery unit at TPCH uses a stand-alone database of patient clinical data, which supports clinical audit, service management and research functions. However, much of the time, the interaction between the cardiac surgery unit information system with other units is minimal. There is a limited and basic two-way interaction with other clinical and administrative databases at TPCH which support decision-making processes. The aims of this research are to investigate what decision-making issues are faced by the healthcare professionals with the current information systems and how decision-making might be improved within this healthcare setting by implementing an aligned data warehouse model or models. As a part of the research the researcher will propose and develop a suitable data warehouse prototype based on the cardiac surgery unit needs and integrating the Intensive Care Unit database, Clinical Costing unit database (Transition II) and Quality and Safety unit database [electronic discharge summary (e-DS)]. The goal is to improve the current decision-making processes. The main objectives of this research are to improve access to integrated clinical and financial data, providing potentially better information for decision-making for both improved from the questionnaire and by referring to the literature, the results indicate a centralised data warehouse model for the cardiac surgery unit at this stage. A centralised data warehouse model addresses current needs and can also be upgraded to an enterprise wide warehouse model or federated data warehouse model as discussed in the many consulted publications. The data warehouse prototype was able to be developed using SAS enterprise data integration studio 4.2 and the data was analysed using SAS enterprise edition 4.3. In the final stage, the data warehouse prototype was evaluated by collecting feedback from the end users. This was achieved by using output created from the data warehouse prototype as examples of the data desired and possible in a data warehouse environment. According to the feedback collected from the end users, implementation of a data warehouse was seen to be a useful tool to inform management options, provide a more complete representation of factors related to a decision scenario and potentially reduce information product development time. However, there are many constraints exist in this research. For example the technical issues such as data incompatibilities, integration of the cardiac surgery database and e-DS database servers and also, Queensland Health information restrictions (Queensland Health information related policies, patient data confidentiality and ethics requirements), limited availability of support from IT technical staff and time restrictions. These factors have influenced the process for the warehouse model development, necessitating an incremental approach. This highlights the presence of many practical barriers to data warehousing and integration at the clinical service level. Limitations included the use of a small convenience sample of survey respondents, and a single site case report study design. As mentioned previously, the proposed data warehouse is a prototype and was developed using only four database repositories. Despite this constraint, the research demonstrates that by implementing a data warehouse at the service level, decision-making is supported and data quality issues related to access and availability can be reduced, providing many benefits. Output reports produced from the data warehouse prototype demonstrated usefulness for the improvement of decision-making in the management of clinical services, and quality and safety monitoring for better clinical care. However, in the future, the centralised model selected can be upgraded to an enterprise wide architecture by integrating with additional hospital units’ databases.

Evidence for CRHR1 in multiple sclerosis using supervised machine learning and meta-analysis in 12 566 individuals

The primary genetic risk factor in multiple sclerosis (MS) is the HLA-DRB1*1501 allele; however, much of the remaining genetic contribution to MS has yet to be elucidated. Several lines of evidence support a role for neuroendocrine system involvement in autoimmunity which may, in part, be genetically determined. Here, we comprehensively investigated variation within eight candidate hypothalamic-pituitary-adrenal (HPA) axis genes and susceptibility to MS. A total of 326 SNPs were investigated in a discovery dataset of 1343 MS cases and 1379 healthy controls of European ancestry using a multi-analytical strategy. Random Forests, a supervised machine-learning algorithm, identified eight intronic SNPs within the corticotrophin-releasing hormone receptor 1 or CRHR1 locus on 17q21.31 as important predictors of MS. On the basis of univariate analyses, six CRHR1 variants were associated with decreased risk for disease following a conservative correction for multiple tests. Independent replication was observed for CRHR1 in a large meta-analysis comprising 2624 MS cases and 7220 healthy controls of European ancestry. Results from a combined meta-analysis of all 3967 MS cases and 8599 controls provide strong evidence for the involvement of CRHR1 in MS. The strongest association was observed for rs242936 (OR = 0.82, 95% CI = 0.74-0.90, P = 9.7 × 10-5). Replicated CRHR1 variants appear to exist on a single associated haplotype. Further investigation of mechanisms involved in HPA axis regulation and response to stress in MS pathogenesis is warranted. © The Author 2010. Published by Oxford University Press. All rights reserved.

Transferring knowledge through peer-reviewed assessment : the creation of a community of practice and the threats to its survival

While it is generally accepted in the learning and teaching literature that assessment is the single biggest influence on how students approach their learning, assessment methods within higher education are generally conservative and inflexible. Constrained by policy and accreditation requirements and the need for the explicit articulation of assessment standards for public accountability purposes, assessment tasks can fail to engage students or reflect the tasks students will face in the world of practice. Innovative assessment design can simultaneously deliver program objectives and active learning through a knowledge transfer process which increases student participation. This social constructivist view highlights that acquiring an understanding of assessment processes, criteria and standards needs active student participation. Within this context, a peer-assessed, weekly, assessment task was introduced in the first “serious” accounting subject offered as part of an undergraduate degree. The positive outcomes of this assessment innovation was that student failure rates declined 15%, tutorial participation increased fourfold, tutorial engagement increased six-fold and there was a 100% approval rating for the retention of the assessment task. In contributing to the core conference theme of “seismic” shifts within higher education, in stark contrast to the positive student response, staff-related issues of assessment conservatism and the necessity of meeting increasing research commitments, threatened the assessment task’s survival. These opposing forces to change have the potential to weaken the ability of higher education assessment arrangements to adequately serve either a new generation of students or the sector's community stakeholders.

Transferring knowledge through peer-reviewed assessment : the creation of a community of practice and the threats to its survival

While it is generally accepted in the learning and teaching literature that assessment is the single biggest influence on how students approach their learning, assessment methods within higher education are generally conservative and inflexible. Constrained by policy and accreditation requirements and the need for the explicit articulation of assessment standards for public accountability purposes, assessment tasks can fail to engage students or reflect the tasks students will face in the world of practice. Innovative assessment design can simultaneously deliver program objectives and active learning through a knowledge transfer process which increases student participation. This social constructivist view highlights that acquiring an understanding of assessment processes, criteria and standards needs active student participation. Within this context, a peer-assessed, weekly, assessment task was introduced in the first “serious” accounting subject offered as part of an undergraduate degree. The positive outcomes of this assessment innovation was that student failure rates declined 15%, tutorial participation increased fourfold, tutorial engagement increased six-fold and there was a 100% approval rating for the retention of the assessment task. In contributing to the core conference theme of “seismic” shifts within higher education, in stark contrast to the positive student response, staff-related issues of assessment conservatism and the necessity of meeting increasing research commitments, threatened the assessment task’s survival. These opposing forces to change have the potential to weaken the ability of higher education assessment arrangements to adequately serve either a new generation of students or the sector's community stakeholders.

The value of smart metering household electricity consumption

Smart metering presents opportunities for business model creation. However the viability of many potential business models in a smart metering scenario may be dictated by privacy regulation and data sharing arrangements. An understanding by businesses of customers’ preferences for the visualisation of their electricity consumption and the degree to which they are willing to share it, is valuable. We present results from two interviews exploring data visualisation and willingness to share personal electricity consumption information. Participants displayed a high willingness to share and a preference for access to additional information when visualising their electricity consumption.

me as al, you as bobby, me as bobby, you as al

In ‘me as al, you as bobby, me as bobby, you as al’, appropriated footage is looped and supplemented with superimposed text, creating a scenario where Robert De Niro and Al Pacino endlessly stalk each other, with their readied-guns chased by hovering words. These titans of Hollywood screen acting represent opposing approaches to the construction of filmic identity, and as the text labels loosely adhere to one weapon and the next, the action on screen becomes an investigation of the subjective and objective potential within screen surrogate constructions of personalized identity. The work was included in the group show 'Vernacular Terrain' (curated by Lubi Thomas and Steven Danzig) for the Songzhuang Art Museum, Beijing.

Anonymity and one-way authentication in key exchange protocols

Key establishment is a crucial cryptographic primitive for building secure communication channels between two parties in a network. It has been studied extensively in theory and widely deployed in practice. In the research literature a typical protocol in the public-key setting aims for key secrecy and mutual authentication. However, there are many important practical scenarios where mutual authentication is undesirable, such as in anonymity networks like Tor, or is difficult to achieve due to insufficient public-key infrastructure at the user level, as is the case on the Internet today. In this work we are concerned with the scenario where two parties establish a private shared session key, but only one party authenticates to the other; in fact, the unauthenticated party may wish to have strong anonymity guarantees. We present a desirable set of security, authentication, and anonymity goals for this setting and develop a model which captures these properties. Our approach allows for clients to choose among different levels of authentication. We also describe an attack on a previous protocol of Øverlier and Syverson, and present a new, efficient key exchange protocol that provides one-way authentication and anonymity.

Greener and leaner : unleashing capacity of railroad concrete ties via limit states concept

New knowledge has raised a concern about the cost-ineffective design methods and the true performance of railroad prestressed concrete ties. Because of previous knowledge deficiencies, railway civil and track engineers have been aware of the conservative design methods for structural components in any railway track that rely on allowable stresses and material strength reductions. In particular, railway sleeper (or railroad tie) is an important component of railway tracks and is commonly made of prestressed concrete. The existing code for designing such components makes use of the permissible stress design concept, whereas the fiber stresses over cross sections at initial and final stages are limited by some empirical values. It is believed that the concrete ties complying with the permissible stress concept possess unduly untapped fracture toughness, based on a number of proven experiments and field data. Collaborative research run by the Australian Cooperative Research Centre for Railway Engineering and Technologies (Rail CRC) was initiated to ascertain the reserved capacity of Australian railway prestressed concrete ties that were designed using the existing design code. The findings have led to the development of a new limit-states design concept. This paper highlights the conventional and the new limit-states design philosophies and their implication to both the railway community and the public. © 2011 American Society of Civil Engineers.

Associations between young children's emotion attributions and prediction of outcome in differing social situations

Associations between young children's attributions of emotion at different points in a story, and with regard to their own prediction about the story's outcome, were investigated using two hypothetical scenarios of social and emotional challenge (social entry and negative event). First grade children (N = 250) showed an understanding that emotions are tied to situational cues by varying the emotions they attributed both between and within scenarios. Furthermore, emotions attributed to the main protagonist at the beginning of the scenarios were differentially associated with children's prediction of a positive or negative outcome and with the valence of the emotion attributed at the end of the scenario. Gender differences in responses to some items were also found. © 2010 The British Psychological Society.

Towards improving mission execution for autonomous gliders with an ocean model and Kalman filter

In this paper, we examine the use of a Kalman filter to aid in the mission planning process for autonomous gliders. Given a set of waypoints defining the planned mission and a prediction of the ocean currents from a regional ocean model, we present an approach to determine the best, constant, time interval at which the glider should surface to maintain a prescribed tracking error, and minimizing time on the ocean surface. We assume basic parameters for the execution of a given mission, and provide the results of the Kalman filter mission planning approach. These results are compared with previous executions of the given mission scenario.

From social foresight to social entrepreneurship: pathways to sustainability

This study asks the central question, ‘Are social entrepreneurs using foresight to create innovation based on triple bottom line sustainability measures?’ and ‘if so, how?’ Sustainability is the emergent criteria for evaluating many aspects of the social world, including corporate governance, health systems, economics, social welfare and the environment. All the while, innovation is one of the key factors in the constitution of our social worlds, be this legislative, organisational, social or technical change. Therefore, it appears that the drive toward sustainability should be coupled with an emphasis on innovation – in particular creating innovation toward sustainability. Yet unexamined assumptions exist behind such language. Sustainability is a concept within the context of ‘the future’, requiring one to question ‘what is the future’ – in essence a utilisation of the strategic capacity for foresight. Foresight, moreover, ranges from the tacit assumed personal foresight of the ordinary individual to the specialised foresight of the professional forecaster, scenario planner, or foresight practitioner.

Helping undergraduate students across disciplines and cultures actively engage and collaborate as equal members of a community of scholars : peer review within an e-learning environment

At the international level, the higher education sector is currently being subjected to increased calls for public accountability and the current move by the OECD to rank universities based on the quality of their teaching and learning outcomes. At the national level, Australian universities and their teaching staff face numerous challenges including financial restrictions, increasing student numbers and the reality of an increasingly diverse student population. The Australian higher education response to these competing policy and accreditation demands focuses on precise explicit systems and procedures which are inflexible and conservative and which ignore the fact that assessment is the single biggest influence on how students approach their learning. By seriously neglecting the quality of student learning outcomes, assessment tasks are often failing to engage students or reflect the tasks students will face in the world of practice. Innovative assessment design, which includes new paradigms of student engagement and learning and pedagogically based technologies have the capacity to provide some measure of relief from these internal and external tensions by significantly enhancing the learning experience for an increasingly time-poor population of students. That is, the assessment process has the ability to deliver program objectives and active learning through a knowledge transfer process which increases student participation and engagement. This social constructivist view highlights the importance of peer review in assisting students to participate and collaborate as equal members of a community of scholars with both their peers and academic staff members. As a result of increasing the student’s desire to learn, peer review leads to more confident, independent and reflective learners who also become more skilled at making independent judgements of their own and others' work. Within this context, in Case Study One of this project, a summative, peer-assessed, weekly, assessment task was introduced in the first “serious” accounting subject offered as part of an undergraduate degree. The positive outcomes achieved included: student failure rates declined 15%; tutorial participation increased fourfold; tutorial engagement increased six-fold; and there was a 100% student-based approval rating for the retention of the assessment task. However, in stark contrast to the positive student response, staff issues related to the loss of research time associated with the administration of the peer-review process threatened its survival. This paper contributes to the core conference topics of new trends and experiences in undergraduate assessment education and in terms of innovative, on-line, learning and teaching practices, by elaborating the Case Study Two “solution” generated to this dilemma. At the heart of the resolution is an e-Learning, peer-review process conducted in conjunction with the University of Melbourne which seeks to both create a virtual sense of belonging and to efficiently and effectively meet academic learning objectives with minimum staff involvement. In outlining the significant level of success achieved, student-based qualitative and quantitative data will be highlighted along with staff views in a comparative analysis of the advantages and disadvantages to both students and staff of the staff-led, peer review process versus its on-line counterpart.

Numerical Modelling of LiteSteel Beams Subject to Shear

Abstract: LiteSteel beam (LSB) is a new cold-formed steel hollow flange channel beam produced using a patented manufacturing process involving simultaneous cold-forming and dual electric resistance welding. It has the beneficial characteristics of torsionally rigid closed rectangular flanges combined with economical fabrication processes from a single strip of high strength steel. Although the LSB sections are commonly used as flexural members, no research has been undertaken on the shear behaviour of LSBs. Therefore experimental and numerical studies were undertaken to investigate the shear behaviour and strength of LSBs. In this research finite element models of LSBs were developed to investigate their nonlinear shear behaviour including their buckling characteristics and ultimate shear strength. They were validated by comparing their results with available experimental results. The models provided full details of the shear buckling and strength characteristics of LSBs, and showed the presence of considerable improvements to web shear buckling in LSBs and associated post-buckling strength. This paper presents the details of the finite element models of LSBs and the results. Both finite element analysis and experimental results showed that the current design rules in cold-formed steel codes are very conservative for the shear design of LSBs. The ultimate shear capacities from finite element analyses confirmed the accuracy of proposed shear strength equations for LSBs based on the North American specification and DSM design equations. Developed finite element models were used to investigate the reduction to shear capacity of LSBs when full height web side plates were not used or when only one web side plate was used, and these results are also presented in this paper.

New design rules for the shear strength of LiteSteel Beams

Abstract: The LiteSteel Beam (LSB) is a new cold-formed hollow flange channel section produced using dual electric resistance welding and automated continuous roll-forming technologies. The innovative LSB sections have many beneficial characteristics and are commonly used as flexural members in building construction. However, limited research has been undertaken on the shear behaviour of LSBs. Therefore a detailed investigation including both numerical and experimental studies was undertaken to investigate the shear behaviour of LSBs. Finite element models of LSBs in shear were developed to simulate the nonlinear ultimate strength behaviour of LSBs including their elastic buckling characteristics, and were validated by comparing their results with experimental test results. Validated finite element models were then used in a detailed parametric study into the shear behaviour of LSBs. The parametric study results showed that the current design rules in cold-formed steel structures design codes are very conservative for the shear design of LSBs. Significant improvements to web shear buckling occurred due to the presence of torsionally rigid rectangular hollow flanges while considerable post-buckling strength was also observed. This paper therefore proposes improved shear strength design rules for LSBs within the current cold-formed steel code guidelines. It presents the details of the parametric study and the new shear strength equations. The new equations were also developed based on the direct strength method. The proposed shear strength equations have the potential to be used with other conventional cold-formed steel sections such as lipped channel sections.

New design rules for the shear strength of LiteSteel Beams with web openings

Abstract: LiteSteel beam (LSB) is a new cold-formed steel hollow flange channel section produced using a patented manufacturing process involving simultaneous cold-forming and dual electric resistance welding. The LSBs are commonly used as floor joists and bearers with web openings in residential, industrial and commercial buildings. Their shear strengths are considerably reduced when web openings are included for the purpose of locating building services. However, no research has been undertaken on the shear behaviour and strength of LSBs with web openings. Therefore experimental and numerical studies were undertaken to investigate the shear behaviour and strength of LSBs with web openings. In this research, finite element models of LSBs with web openings in shear were developed to simulate the shear behaviour and strength of LSBs including their buckling characteristics. They were then validated by comparing their results with available experimental test results and used in a detailed parametric study. The results showed that the current design rules in cold-formed steel structures design codes are very conservative for the shear design of LSBs with web openings. Improved design equations have been proposed for the shear capacity of LSBs with web openings based on both experimental and parametric study results. An alternative shear design method based on an equivalent reduced web thickness was also proposed. It was found that the same shear strength design rules developed for LSBs without web openings can be used for LSBs with web openings provided the equivalent reduced web thickness equation developed in this paper is used. This is a significant advancement as it simplifies the shear design methods of LSBs with web openings considerably.