Barriers to information transfer for multi-trauma patients upon discharge from the Emergency Department in a tertiary level hospital

Purpose: Communication is integral to effective trauma care provision. This presentation will report on barriers to meaningful information transfer for multi-trauma patients upon discharge from the Emergency Department (ED) to the care areas of Intensive Care Unit, High Dependency Unit, and Perioperative Services. This is an ongoing study at one tertiary level hospital in Queensland. Method: This is a multi-phase, mixed method study. In Phase 1 data were collected about information transfer. This Phase was initially informed by a comprehensive literature review, then via focus groups, chart audit, staff survey and review of national and international trauma forms. Results: The barriers identified related to nursing handover, documented information, time inefficiency, patient complexity and stability and time of transfer. Specifically this included differences in staff expectations and variation in the nursing handover processes, no agreed minimum dataset of information handed over, missing, illegible or difficult to find information in documentation (both medical and nursing), low compliance with some forms used for documentation. Handover of these patients is complex with information coming from many sources, dealing with issues is more difficult for these patients when transferred out of hours. Conclusions and further directions: This study investigated the current communication processes and standards of information transfer to identify barriers and issues. The barriers identified were the structure used for documentation, processes used (e.g. handover), patient acuity and time. This information is informing the development, implementation and evaluation of strategies to ameliorate the issues identified.

Creating new narratives through shared time and space : the performer/audience connection in multi-site dance events

Site-specific performance provides choices in audience experience via degrees of scale, proximity, levels of immersion and viewing perspectives. Beyond these choices, multi-site promenade events also form a connected audience/performer relationship in which moving together in time and space can produce a shared narrative and aesthetic sensibility of collective, yet individuated and shifting meanings. This paper interrogates this notion through audience/performer experiences in two separate multi-site, dance-led events. here/there/then/now occurred in four intimate sites within the Brisbane Powerhouse, providing a theatricalised platform for audiences to create linked narratives through open-ended and fragmented intertextuality. Accented Body, based on the concept of “the body as site and in site” and notions of connectivity, provided a more expansive platform for a similar, but heightened, shared engagement. Audiences traversed 6 outdoor and 2 indoor Brisbane sites moving to varying levels of a large complex. Eleven, predominantly interactive, screens provided links to other sites as well as to distributed presences in Seoul and London. The differentiation in scale and travel time between sites deepened the immersive experiences of audiences who reported transformative engagements with both site and architecture, accompanied by a sense of extended and yet quickened time.

Practical improvements to simultaneous computation of multi-view geometry and radial lens distortion

This paper discusses practical issues related to the use of the division model for lens distortion in multi-view geometry computation. A data normalisation strategy is presented, which has been absent from previous discussions on the topic. The convergence properties of the Rectangular Quadric Eigenvalue Problem solution for computing division model distortion are examined. It is shown that the existing method can require more than 1000 iterations when dealing with severe distortion. A method is presented for accelerating convergence to less than 10 iterations for any amount of distortion. The new method is shown to produce equivalent or better results than the existing method with up to two orders of magnitude reduction in iterations. Through detailed simulation it is found that the number of data points used to compute geometry and lens distortion has a strong influence on convergence speed and solution accuracy. It is recommended that more than the minimal number of data points be used when computing geometry using a robust estimator such as RANSAC. Adding two to four extra samples improves the convergence rate and accuracy sufficiently to compensate for the increased number of samples required by the RANSAC process.

Multi-sensor data fusion for UAV navigation during landing operations

This paper presents a practical framework to synthesize multi-sensor navigation information for localization of a rotary-wing unmanned aerial vehicle (RUAV) and estimation of unknown ship positions when the RUAV approaches the landing deck. The estimation performance of the visual tracking sensor can also be improved through integrated navigation. Three different sensors (inertial navigation, Global Positioning System, and visual tracking sensor) are utilized complementarily to perform the navigation tasks for the purpose of an automatic landing. An extended Kalman filter (EKF) is developed to fuse data from various navigation sensors to provide the reliable navigation information. The performance of the fusion algorithm has been evaluated using real ship motion data. Simulation results suggest that the proposed method can be used to construct a practical navigation system for a UAV-ship landing system.

Collaboration : developing integration in multi-purpose services in rural New South Wales, Australia

Introduction: The Multi-purpose Service (MPS) Program was introduced to rural Australia in 1991 as a solution to poor health outcomes in rural compared with metropolitan populations, difficulty in attracting healthcare staff and a lack of viability and range of health services in rural areas. The aim of this study was to describe the main concerns of participants involved in the development of multi-purpose services in rural New South Wales (NSW). This article is abstracted from a larger study and discusses the extent to which collaboration occurred within the new multi-purpose service. Methods: A constructivist grounded theory methodology was used. Participants were from 13 multi-purpose services in rural NSW and 30 in-depth interviews were conducted with 6 community members, 11 managers and 13 staff members who had been involved in the process of developing a multi-purpose service. Results: The main concern of all participants was their anticipation of risk. This anticipation of risk manifested itself in either trust or suspicion and explained their progression through a phase of collaborating. Participants who had trust in other stakeholders were more likely to embrace an integrated health service identity. Those participants, who were suspicious that they would lose status or power, maintained that the previous hospital services provided a better health service and described a coexistence of services within the multi-purpose service. Conclusions: This study provided an insight into the perceptions of community members, staff members and managers involved in the process of developing a multi-purpose service. It revealed that the anticipation of risk was intrinsic to a process of changing from a traditional hospital service to collaborating in a new model of health care provided at a multi-purpose service.

Raman spectroscopy of the multi-anion mineral schlossmacherite (H3O,Ca)Al3(AsO4,PO4,SO4)2(OH)6

The mineral schlossmacherite (H3O,Ca)Al3(AsO4,PO4,SO4)2(OH)6 , a multi-cation-multi-anion mineral of the beudantite mineral subgroup has been characterised by Raman spectroscopy. The mineral and related minerals functions as a heavy metal collector and is often amorphous or poorly crystalline, such that XRD identification is difficult. The Raman spectra are dominated by an intense band at 864 cm-1, assigned to the symmetric stretching mode of the AsO43- anion. Raman bands at 809 and 819 cm-1 are assigned to the antisymmetric stretching mode of AsO43- . The sulphate anion is characterised by bands at 1000 cm-1 (ν1), and at 1031, 1082 and 1139 cm-1 (ν3). Two sets of bands in the OH stretching region are observed: firstly between 2800 and 3000 cm-1 with bands observed at 2850, 2868, 2918 cm-1 and secondly between 3300 and 3600 with bands observed at 3363, 3382, 3410, 3449 and 3537 cm-1. These bands enabled the calculation of hydrogen bond distances and show a wide range of H-bond distances.

Charting the system : the integrated master schedule as a multi-level and poly-temporal boundary object in complex projects

This paper investigates the use of visual artifacts to represent a complex adaptive system (CAS). The integrated master schedule (IMS) is one of those visuals widely used in complex projects for scheduling, budgeting, and project management. In this paper, we discuss how the IMS outperforms the traditional timelines and acts as a ‘multi-level and poly-temporal boundary object’ that visually represents the CAS. We report the findings of a case study project on the way the IMS mapped interactions, interdependencies, constraints and fractal patterns in a complex project. Finally, we discuss how the IMS was utilised as a complex boundary object by eliciting commitment and development of shared mental models, and facilitating negotiation through the layers of multiple interpretations from stakeholders.

A multi-level model of leadership in complex project management

Management (or perceived mismanagement) of large-scale, complex projects poses special problems and often results in spectacular failures, cost overruns, time blowouts and stakeholder dissatisfaction. While traditional project management responds with increasingly administrative constraints, we argue that leaders of such projects also need to display adaptive and enabling behaviours to foster adaptive processes, such as opportunity recognition, which requires an interaction of cognitive and affective processes of individual, project, and team leader attributes and behaviours. At the core of this model we propose is an interaction of cognitive flexibility, affect and emotional intelligence. The result of this interaction is enhanced leader opportunity recognition that, in turn, facilitates multilevel outcomes.

User behaviour modelling in a multi-dimensional environment for personalization and recommendation

Handling information overload online, from the user's point of view is a big challenge, especially when the number of websites is growing rapidly due to growth in e-commerce and other related activities. Personalization based on user needs is the key to solving the problem of information overload. Personalization methods help in identifying relevant information, which may be liked by a user. User profile and object profile are the important elements of a personalization system. When creating user and object profiles, most of the existing methods adopt two-dimensional similarity methods based on vector or matrix models in order to find inter-user and inter-object similarity. Moreover, for recommending similar objects to users, personalization systems use the users-users, items-items and users-items similarity measures. In most cases similarity measures such as Euclidian, Manhattan, cosine and many others based on vector or matrix methods are used to find the similarities. Web logs are high-dimensional datasets, consisting of multiple users, multiple searches with many attributes to each. Two-dimensional data analysis methods may often overlook latent relationships that may exist between users and items. In contrast to other studies, this thesis utilises tensors, the high-dimensional data models, to build user and object profiles and to find the inter-relationships between users-users and users-items. To create an improved personalized Web system, this thesis proposes to build three types of profiles: individual user, group users and object profiles utilising decomposition factors of tensor data models. A hybrid recommendation approach utilising group profiles (forming the basis of a collaborative filtering method) and object profiles (forming the basis of a content-based method) in conjunction with individual user profiles (forming the basis of a model based approach) is proposed for making effective recommendations. A tensor-based clustering method is proposed that utilises the outcomes of popular tensor decomposition techniques such as PARAFAC, Tucker and HOSVD to group similar instances. An individual user profile, showing the user's highest interest, is represented by the top dimension values, extracted from the component matrix obtained after tensor decomposition. A group profile, showing similar users and their highest interest, is built by clustering similar users based on tensor decomposed values. A group profile is represented by the top association rules (containing various unique object combinations) that are derived from the searches made by the users of the cluster. An object profile is created to represent similar objects clustered on the basis of their similarity of features. Depending on the category of a user (known, anonymous or frequent visitor to the website), any of the profiles or their combinations is used for making personalized recommendations. A ranking algorithm is also proposed that utilizes the personalized information to order and rank the recommendations. The proposed methodology is evaluated on data collected from a real life car website. Empirical analysis confirms the effectiveness of recommendations made by the proposed approach over other collaborative filtering and content-based recommendation approaches based on two-dimensional data analysis methods.

Active ageing : developing a quantitative multi-dimensional measure

With estimates that two billion of the world’s population will be 65 years or older by 2050, ensuring that older people ‘age well’ is an international priority. To date, however, there is significant disagreement and debate about how to define and measure ‘ageing well’, with no consensus on either terminology or measurement. Thus, this chapter describes the research rationale, methodology and findings of the Australian Active Ageing Study (Triple A Study), which surveyed 2620 older Australians to identify significant contributions to quality of life for older people: work, learning, social participation, spirituality, emotional wellbeing, health, and life events. Exploratory factor analyses identified eight distinct elements (grouped into four key concepts) which appear to define ‘active ageing’ and explained 55% of the variance: social and life participation (25%), emotional health (22%), physical health and functioning (4%) and security (4%). These findings highlight the importance of understanding and supporting the social and emotional dimensions of ageing, as issues of social relationships, life engagement and emotional health dominated the factor structure. Our intension is that this paper will prompt informed debate and discussion on defining and measuring active ageing, facilitating exploration and understanding of the complexity of issues that intertwine, converge and enhance the ageing experience.

Multi-body modelling of wagon trains for crashworthiness analysis

Three-dimensional wagon train models have been developed for the crashworthiness analysis using multi-body dynamics approach. The contributions of the train size (number of wagon) to the frontal crash forces can be identified through the simulations. The effects of crash energy management (CEM) design and crash speed on train crashworthiness are examined. The CEM design can significantly improve the train crashworthiness and the consequential vehicle stability performance - reducing derailment risks.

Developing a fuzzy multi-criteria decision-making model for selecting design-build operational variations

Many academic researchers have conducted studies on the selection of design-build (DB) delivery method; however, there are few studies on the selection of DB operational variations, which poses challenges to many clients. The selection of DB operational variation is a multi-criteria decision making process that requires clients to objectively evaluate the performance of each DB operational variation with reference to the selection criteria. This evaluation process is often characterized by subjectivity and uncertainty. In order to resolve this deficiency, the current investigation aimed to establish a fuzzy multicriteria decision-making (FMCDM) model for selecting the most suitable DB operational variation. A three-round Delphi questionnaire survey was conducted to identify the selection criteria and their relative importance. A fuzzy set theory approach, namely the modified horizontal approach with the bisector error method, was applied to establish the fuzzy membership functions, which enables clients to perform quantitative calculations on the performance of each DB operational variation. The FMCDM was developed using the weighted mean method to aggregate the overall performance of DB operational variations with regard to the selection criteria. The proposed FMCDM model enables clients to perform quantitative calculations in a fuzzy decision-making environment and provides a useful tool to cope with different project attributes.

Microstrip decoupling networks for low-order multi-port arrays with reduced element spacing

An array of monopole elements with reduced element spacing of λ/6 to λ/20 is considered for application in digital beam-forming and direction-finding. The small element spacing introduces strong mutual coupling between the array elements. This paper discusses that decoupling can be achieved analytically for arrays with three elements and describes Kuroda’s identities to realize the lumped elements of the derived decoupling network. Design procedures and equations are proposed. Experimental results are presented. The decoupled array has a bandwidth of 1% and a superdirective radiation pattern.

The reliability, accuracy and minimal detectable difference of a multi-segment kinematic model of the foot-shoe complex

Kinematic models are commonly used to quantify foot and ankle kinematics, yet no marker sets or models have been proven reliable or accurate when wearing shoes. Further, the minimal detectable difference of a developed model is often not reported. We present a kinematic model that is reliable, accurate and sensitive to describe the kinematics of the foot–shoe complex and lower leg during walking gait. In order to achieve this, a new marker set was established, consisting of 25 markers applied on the shoe and skin surface, which informed a four segment kinematic model of the foot–shoe complex and lower leg. Three independent experiments were conducted to determine the reliability, accuracy and minimal detectable difference of the marker set and model. Inter-rater reliability of marker placement on the shoe was proven to be good to excellent (ICC = 0.75–0.98) indicating that markers could be applied reliably between raters. Intra-rater reliability was better for the experienced rater (ICC = 0.68–0.99) than the inexperienced rater (ICC = 0.38–0.97). The accuracy of marker placement along each axis was <6.7 mm for all markers studied. Minimal detectable difference (MDD90) thresholds were defined for each joint; tibiocalcaneal joint – MDD90 = 2.17–9.36°, tarsometatarsal joint – MDD90 = 1.03–9.29° and the metatarsophalangeal joint – MDD90 = 1.75–9.12°. These thresholds proposed are specific for the description of shod motion, and can be used in future research designed at comparing between different footwear.