Data driven and practice-based evidence : design and development of efficient and effective clinical decision support system

Decision-making is such an integral aspect in health care routine that the ability to make the right decisions at crucial moments can lead to patient health improvements. Evidence-based practice, the paradigm used to make those informed decisions, relies on the use of current best evidence from systematic research such as randomized controlled trials. Limitations of the outcomes from randomized controlled trials (RCT), such as “quantity” and “quality” of evidence generated, has lowered healthcare professionals’ confidence in using EBP. An alternate paradigm of Practice-Based Evidence has evolved with the key being evidence drawn from practice settings. Through the use of health information technology, electronic health records (EHR) capture relevant clinical practice “evidence”. A data-driven approach is proposed to capitalize on the benefits of EHR. The issues of data privacy, security and integrity are diminished by an information accountability concept. Data warehouse architecture completes the data-driven approach by integrating health data from multi-source systems, unique within the healthcare environment.

Effective communication during disasters: What effects community decision making & action?

Study/Objective This paper describes a program of research examining emergency messaging during the response and early recovery phases of natural disasters. The objective of this suite of studies is to develop message construction frameworks and channels that maximise community compliance with instructional messaging. The research has adopted a multi-hazard approach and considers the impact of formal emergency messages, as well as informal messages (e.g., social media posts), on community compliance. Background In recent years, media reports have consistently demonstrated highly variable community compliance to instructional messaging during natural disasters. Footage of individuals watching a tsunami approaching from the beach or being over-run by floodwaters are disturbing and indicate the need for a clearer understanding of decision making under stress. This project’s multi-hazard approach considers the time lag between knowledge of the event and desired action, as well as how factors such as message fatigue, message ambiguity, and the interplay of messaging from multiple media sources are likely to play a role in an individual’s compliance with an emergency instruction. Methods To examine effective messaging strategy, we conduct a critical analysis of the literature to develop a framework for community consultation and design experiments to test the potential for compliance improvement. Results Preliminary results indicate that there is, as yet, little published evidence on which to base decisions about emergency instructional messages to threatened communities. Conclusion The research described here will contribute improvements in emergency instructional message compliance by generating an evidence-based framework that takes into account behavioural compliance theory, the psychology of decision making under stress, and multiple channels of communication including social media.

Effective communication during disasters

This paper describes a program of research examining emergency messaging during the response and early recovery phases of natural disasters. The objective of this suite of studies is to develop message construction frameworks and channels that maximise community compliance with instructional messaging. The research has adopted a multi-hazard approach and considers the impact of formal emergency messages, as well as informal messages (e.g., social media posts), on community compliance. In recent years, media reports have consistently demonstrated highly variable community compliance to instructional messaging during natural disasters. Footage of individuals watching a tsunami approaching from the beach or being over-run by floodwaters are disturbing and indicate the need for a clearer understanding of decision making under stress. This project’s multi-hazard approach considers the time lag between knowledge of the event and desired action, as well as how factors such as message fatigue, message ambiguity, and the interplay of messaging from multiple media sources are likely to play a role in an individual’s compliance with an emergency instruction. To examine effective messaging strategy, we conduct a critical analysis of the literature to develop a framework for community consultation and design experiments to test the potential for compliance improvement. Preliminary results indicate that there is, as yet, little published evidence on which to base decisions about emergency instructional messages to threatened communities. The research described here will contribute improvements in emergency instructional message compliance by generating an evidence-based framework that takes into account behavioural compliance theory, the psychology of decision making under stress, and multiple channels of communication including social media.

Effective emergency messaging during natural disasters: An application of message compliance theories

Study/Objective This research examines the types of emergency messages used in Australia during the response and early recovery phases of a natural disaster. The aim of the research is to develop theory-driven emergency messages that increase individual behavioural compliance during a disaster. Background There is growing evidence of non-compliant behaviour in Australia, such as refusing to evacuate and travelling through hazardous areas. This can result in personal injury, loss of life, and damage to (or loss of) property. Moreover, non-compliance can place emergency services personnel in life-threatening situations when trying to save non-compliant individuals. Drawing on message compliance research in psychology and sociology, a taxonomy of message types was developed to ascertain how emergency messaging can be improved to produce compliant behaviour. Method A review of message compliance literature was conducted to develop the taxonomy of message types previously found to achieve compliance. Seven categories were identified: direct-rational, manipulation, negative phrasing, positive phrasing, exchange appeals, normative appeals, and appeals to self. A content analysis was then conducted to assess the emergency messages evident in the Australian emergency management context. The existing messages were aligned with the literature to identify opportunities to improve emergency messaging. Results & Conclusion The results suggest there is an opportunity to improve the effectiveness of emergency messaging to increase compliance during the response and early recovery phases of a natural disaster. While some message types cannot legally or ethically be used in emergency communication (e.g. manipulative messaging), there is an opportunity to create more persuasive messages (e.g. appeals to self) that personalise the individual’s perception of risk, triggering them to comply with the message.

How everyday language can and will boost effective information retrieval

Typing 2 or 3 keywords into a browser has become an easy and efficient way to find information. Yet, typing even short queries becomes tedious on ever shrinking (virtual) keyboards. Meanwhile, speech processing is maturing rapidly, facilitating everyday language input. Also, wearable technology can inform users proactively by listening in on their conversations or processing their social media interactions. Given these developments, everyday language may soon become the new input of choice. We present an information retrieval (IR) algorithm specifically designed to accept everyday language. It integrates two paradigms of information retrieval, previously studied in isolation; one directed mainly at the surface structure of language, the other primarily at the underlying meaning. The integration was achieved by a Markov machine that encodes meaning by its transition graph, and surface structure by the language it generates. A rigorous evaluation of the approach showed, first, that it can compete with the quality of existing language models, second, that it is more effective the more verbose the input, and third, as a consequence, that it is promising for an imminent transition from keyword input, where the onus is on the user to formulate concise queries, to a modality where users can express more freely, more informal, and more natural their need for information in everyday language.

Effective intercalation of sodium dodecylsulfate (SDS) into hydrocalumite: Mechanism discussion via near-infrared and mid-infrared investigations

The intercalation of an anionic surfactant, sodium dodecylsulfate (SDS), into hydrocalumite (CaAl-LDH-Cl) was investigated in this study. To understand the intercalation behavior, X-ray diffraction (XRD), mid-infrared spectroscopy (MIR), near-infrared spectroscopy (NIR) and scanning electron microscopy (SEM) were undertaken. The near-infrared spectra indicated a special spectral range from 6000 to 5600cm-1and prominent bands of CaAl-LDH-Cl intercalated with SDS around 8388cm-1. This band was assigned to the second overtone of the first fundamental of CH stretching vibrations of SDS, and it could be used to determinate the result of CaAl-LDH-Cl modified by SDS. Moreover, the results revealed that different adsorption behaviors were observed at different (high and low) concentrations of SDS. When the SDS concentration was around 0.2molL-1, anion exchange intercalation occurred and the interlayer distance expanded to about 3.25nm. When SDS concentration was 0.005molL-1, the surface adsorption of DS- was the major anion exchange event.

Effective clinical decision-making from practice-based evidence

This is an ongoing research investigating the use of health information technologies (HIT) to improve clinical decision-making processes. Effective and timely clinical decision-making can lead to positive improvements in patient’s health outcome...

Making connections within the Asia-Pacific region: Case study around the Mentoring for Effective Teaching (MET) program

University strategic plans emphasise the essential nature of partnerships at national and international levels. Along with establishing collaborative research partnerships, providing professional development to key stakeholders is considered a crucial activity for making and sustaining partnerships. Utilising knowledge from professional development in Australian contexts can be managed creatively for making connections internationally. Indeed, knowledge transfer is a cornerstone for the globalisation of education and needs to occur as a multiplex dialogue between participating countries. This paper presents a qualitative study around the Mentoring for Effective Teaching (MET) program, its growth and development nationally (e.g., scope and impact) along with insights into making connections within the Asia-Pacific region. At a national level, we outline how to facilitate a program though relationship building and face-to-face implementation of professional learning. Internationally, we highlight how to mould and shape Australian professional learning for the Asia-Pacific region, particularly with regard to facilitating fluid interactions within environments outside of Australia. The contexts for the study include a university in Hong Kong and another university in the Philippines. In this presentation, examples will be provided from the MET program to demonstrate contextual differences and similarities for implementation in Australian and Asian contexts. For instance, determining strategies for mentoring pedagogical knowledge can elicit viewpoints that align between cultures (e.g., use of specific teaching and questioning strategies) and also present alternative ideas as a result of cultural differences. We have learnt about having a structured program that draws on the research yet has sufficient flexibility to cater for cultures and contexts. With openmindedness, facilitating professional learning can become a two-way knowledge transfer, where learnings from other cultures and contexts can be refined for advancing programs in Australia.

Authentically ambiguous, credibly anonymous: Perceptually reframing the personal narrative towards effective persuasion in aggressive human rights contexts

Testing the strategies of discourse and materiality, this practice-based and practice-led research experiments with how anonymous storytelling by vulnerable communities, like that of the sexual minorities and their allies in Malaysia, can better speak to their human rights issues without further subjecting them to personal attacks and targetted persecution. The research identifies the critical role of the voice in lending authenticity and credibility to first person narratives; and contextual credibility as a form of credibility which personal stories naturally aspire to achieve with audiences. Adopting a discursive view of persuasion and recognising too that the power of persuasion may in effect lie with those who receive these stories rather than with those who tell them, the insights and knowledge gained from the research informed the development of the field output, Persuasive Storytelling by Vulnerable Communities in Aggressive Contexts: A Human Rights Communication Framework.

Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language

Background Miscommunication in the healthcare sector can be life-threatening. The rising number of migrant patients and foreign-trained staff means that communication errors between a healthcare practitioner and patient when one or both are speaking a second language are increasingly likely. However, there is limited research that addresses this issue systematically. This protocol outlines a hospital-based study examining interactions between healthcare practitioners and their patients who either share or do not share a first language. Of particular interest are the nature and efficacy of communication in language-discordant conversations, and the degree to which risk is communicated. Our aim is to understand language barriers and miscommunication that may occur in healthcare settings between patients and healthcare practitioners, especially where at least one of the speakers is using a second (weaker) language. Methods/Design Eighty individual interactions between patients and practitioners who speak either English or Chinese (Mandarin or Cantonese) as their first language will be video recorded in a range of in- and out-patient departments at three hospitals in the Metro South area of Brisbane, Australia. All participants will complete a language background questionnaire. Patients will also complete a short survey rating the effectiveness of the interaction. Recordings will be transcribed and submitted to both quantitative and qualitative analyses to determine elements of the language used that might be particularly problematic and the extent to which language concordance and discordance impacts on the quality of the patient-practitioner consultation. Discussion Understanding the role that language plays in creating barriers to healthcare is critical for healthcare systems that are experiencing an increasing range of culturally and linguistically diverse populations both amongst patients and practitioners. The data resulting from this study will inform policy and practical solutions for communication training, provide an agenda for future research, and extend theory in health communication.

Building resilient communities: Creating effective multi-channel communication during disaster response and recovery

Our aim is to examine evidence-based strategies to motivate appropriate action and increase informed decision-making during the response and recovery phases of disasters. We combine expertise in communication, consumer psychology and marketing, disaster and emergency management, and law. This poster presents findings from a social media work package, and preliminary findings from the focus group work package on emergency warning message comprehension.

New England Youth Speeding Project: A pilot study of young drivers and risky driving: Effective strategies for preventing speeding amongst young Australians aged 16-25 years in the New England Region

Young Australian drivers aged 17 – 25 years are overwhelmingly represented in road fatalities where speed is a factor. In the combined LGAs of Armidale Dumaresq, Guyra, Uralla and Walcha in the 5 years 1999-2003 inclusive, 43% of speeding related casualty crashes involved a young driver aged less than 25 years. This is despite the fact that the 17-25 age group account for only 25% of the driving population in this area. Young male drivers account for the majority of these crashes and also tend to have a higher number of driving offences and accrue more penalties for road traffic offences, especially speeding. By analysing data from questionnaires by male and female participants this research project has been able to evaluate road safety advertisements to determine which ones are most effective to young drivers, what features of these advertisements are effective, how males differ from females in their receptiveness and preferences for road safety advertisements and specifically how to target young people especially young men in conveying road safety messages. Finally this research project has identified factors that are important in the production of media road safety advertisements and has made recommendations for how best to convey effective road safety messages to young Australian drivers in rural areas.

Towards development of a rapid and effective non-destructive testing strategy to identify brominated flame retardants in the plastics of consumer products

Polybrominated diphenyl ethers (PBDEs) are a class of brominated flame retardants (BFRs) once extensively used in the plastics of a wide range of consumer products. The listing of certain congeners that are constituents of commercial PBDE mixtures (including c-octaBDE) in the Stockholm Convention and tightening regulation of many other BFRs in recent years have created the need for a rapid and effective method of identifying BFR-containing plastics. A three-tiered testing strategy comparing results from non-destructive testing (X-ray fluorescence (XRF)) (n = 1714), a surface wipe test (n = 137) and destructive chemical analysis (n = 48) was undertaken to systematically identify BFRs in a wide range of consumer products. XRF rapidly identified bromine in 92% of products later confirmed to contain BFRs. Surface wipes of products identified tetrabromobisphenol A (TBBPA), c-octaBDE congeners and BDE-209 with relatively high accuracy (> 75%) when confirmed by destructive chemical analysis. A relationship between the amounts of BFRs detected in surface wipes and subsequent destructive testing shows promise in predicting not only the types of BFRs present but also estimating the concentrations present. Information about the types of products that may contain persistent BFRs will assist regulators in implementing policies to further reduce the occurrence of these chemicals in consumer products.

Graphene-covered perovskites: An effective strategy to enhance light absorption and resist moisture degradation

The long-term stability of methylammonium lead triiodide (MAPbI3) perovskite in moist environments is a paramount challenge to realise the commercialization of perovskite solar cells. In an attempt to address this concern, we have carried out systematic first-principles studies on the MAPbI3 perovskite with a hydrophobic graphene layer interfaced as a water barrier. We find there is a charge transfer at the graphene/MAPbI3 interface and electrons can be excited from graphene into the perovskite surface, leading to well separated electron–hole pairs, i.e. reduced recombination. By studying the optical properties, we find the hybrid graphene/MAPbI3 nanocomposite displays enhanced light absorption compared with the pristine MAPbI3. Furthermore, from an ab initio molecular dynamics simulation, the graphene/MAPbI3 nanocomposite is confirmed to be able to resist the reaction with water molecules, highlighting a great advantage of this nanocomposite in promoting long-term photovoltaic performance.