Application of operations research techniques to improve efficiency in the emergency department

The main aim of this thesis is to analyse and optimise a public hospital Emergency Department. The Emergency Department (ED) is a complex system with limited resources and a high demand for these resources. Adding to the complexity is the stochastic nature of almost every element and characteristic in the ED. The interaction with other functional areas also complicates the system as these areas have a huge impact on the ED and the ED is powerless to change them. Therefore it is imperative that OR be applied to the ED to improve the performance within the constraints of the system. The main characteristics of the system to optimise included tardiness, adherence to waiting time targets, access block and length of stay. A validated and verified simulation model was built to model the real life system. This enabled detailed analysis of resources and flow without disruption to the actual ED. A wide range of different policies for the ED and a variety of resources were able to be investigated. Of particular interest was the number and type of beds in the ED and also the shift times of physicians. One point worth noting was that neither of these resources work in isolation and for optimisation of the system both resources need to be investigated in tandem. The ED was likened to a flow shop scheduling problem with the patients and beds being synonymous with the jobs and machines typically found in manufacturing problems. This enabled an analytic scheduling approach. Constructive heuristics were developed to reactively schedule the system in real time and these were able to improve the performance of the system. Metaheuristics that optimised the system were also developed and analysed. An innovative hybrid Simulated Annealing and Tabu Search algorithm was developed that out-performed both simulated annealing and tabu search algorithms by combining some of their features. The new algorithm achieves a more optimal solution and does so in a shorter time.

Crowded Diphosphinomethane Ligands in Catalysis: [(R2PCH2PR′2-κ2P)-NiR″]+ Cations for Ethylene Polymerization without Activators

The preparation of a series of nickel dichloride complexes with bulky diphosphinomethane chelate ligands R2PCH2PR′2 is reported. Reaction with the appropriate Grignard reagent leads to the corresponding dimethyl and dibenzyl complexes. Cationic monomethyl and mono-η3-benzyl complexes are generated from these dialkyl complexes by protonation with [H(OEt2)2]+[B(3,5-(CF3)2C6H3)4]−, while the complex [(dtbpm κ2P)Ni(η3-CH(CH2Ph)Ph]+[B(3,5-(CF3)2C6H3)4]−is obtained from protonation of the Ni(0) olefin complex (dtbpm-κ2P)N(η2-trans-stilbene). Crystal structures of examples of dichlorides, dimethyl, dibenzyl, cationic methyl, and cationic η3-benzyl complexes are reported. Solutions of the cations polymerize ethylene under mild conditions and without the necessity of an activating agent, to form polyethylene having high molecular weights and low degrees of chain branching. In comparison to the Ni methyl cations, the η3-benzyl cation complexes are more stable and somewhat less active but still very efficient in C2H4 polymerization. The effect on the resulting polyethylene of varying the substituents R, R′ on the phosphine ligand has been examined, and a clear trend for longer chain PE with less branching in the presence of more bulky substituents on the diphosphine has been found. Density functional calculations have been used to examine the rapid suprafacial η3 to η3 haptotropic shift processes of the[(R2PCH2PR′2)Ni] fragment and the η3−η1 change of the coordination mode of the benzyl group required for polymerization in those cations.

Developing and enhancing independent learning skills : using video tutorials as a means of helping students help themselves

Purpose – The purpose of this paper is to examine the use of short video tutorials in a post-graduate accounting subject, as a means of helping students develop and enhance independent learning skills. Design/methodology/approach – In total, five short (approximately five to 10 minutes) video tutorials were introduced in an effort to shift the reliance for learning from the lecturer to the student. Data on students’ usage of online video tutorials, and comments by students in university questionnaires were collated over three semesters from 2008 to 2009. Interviews with students were then conducted in late 2009 to more comprehensively evaluate the use and perceived benefits of video tutorials. Findings – Findings reveal preliminary but positive outcomes in terms of both more efficient and effective teaching and learning. Research limitations/implications – The shift towards more independent learning through the use of video tutorials has positive implications for educators, employers, and professional accounting bodies; each of whom has identified the need for this skill in accounting graduates. Practical implications – The use of video tutorials has the potential for more rewarding teaching and more effective learning. Originality/value – This study is one of the first to examine the use and benefits of video tutorials as a means of developing independent learning skills in accountancy students – addressing a key concern within the profession.

Grassroots leaders: Reclaiming 'Native Leadership' as content for enhancing formal leadership preparation

It is almost a truism that persons who occupy formal bureaucratic positions in schools may not actually be leaders if they were not role incumbents in a bureaucracy. It is also clear from studies of grassroots leaders that without the qualities of skills of leadership no one would follow them because they have no formal, hierarchical role upon which others were dependent to them. One of the reasons for re-examining the nature of grassroots leaders is to attempt to recapture those tactics or strategies which might be reconceptualized and utilized within more formal settings so that role dependent leadership becomes more effectual and trustworthy than one that is totally dependent on role authority. This reasoning is especially a critical need if there is a desire to work towards more democratic and collaborative working arrangements between leaders and followers, and where more flexible and dynamic relationships promise higher levels of commitment and productivity. Hecksher (1994) speaks of such a reconceptualization as part of a shift from an emphasis on power to one centered on influence. This paper examines the nature of leadership before it was subjected to positivistic science and later behavioural studies. This move follows the advice of Heilbrunn (1996) who trenchantly observed that for leadership studies to grow as a discipline, “it will have to cast a wider net” (p.11). Willis et. Al. (2008) make a similar point when they lament that social scientist have forced favoured understanding bureaucracies rather than grassroots community organizations, yet much can be gained by being aware of the tactics and strategies used by grassroots leaders who depend on influence as opposed to power. This paper, then, aims to do this by posing a tentative model of grassroots leadership and then considering how this model might inform and be used by those responsible for developing school leaders.

The uses of satire : unorthodox news, cultural chaos and the interrogation of power

This article focuses on the satirical Australian show The Chaser’s War on Everything, and uses it to critically assess the potential political and social ramifications of what McNair (2006) has called ‘cultural chaos’. Drawing upon and analysing several examples from this particular program, alongside interviews with its production team and qualitative audience research, this article argues that this TV show’s engagement with politicians and political issues, in a way that departs from the conventions of traditional journalism, offers a significant opportunity for the interrogation of power. The program’s use of often bizarre and unexpected comedic confrontation allows it to present a perhaps more authentic image of political agents than is often cultivated in mainstream journalism. This suggests therefore that the shift from homogeneity to heterogeneity in the news media – which McNair (2006) sees as a key feature of cultural chaos – presents a significant challenge to those who wish to retain control over what the public sees and understands about the political world, and is a development which should be viewed in positive terms.

Enlightenment out of chaos : power, politics and The Chaser’s War on Everything

This paper focuses on the satirical Australian television show The Chaser’s War on Everything, and uses it to critically explore the potential ramifications of what McNair (2006) has called ‘cultural chaos’. Through an analysis of several examples from this particular program, alongside interviews with its production team and qualitative audience research, this paper argues that this TV show’s engagement with political issues in a creative, entertaining way that departs from the conventions of traditional journalism, allows it to present a perhaps more authentic image of political agents than is often cultivated in the mainstream news media. This paper therefore provides clear evidence that the shift from homogeneity to heterogeneity in the news media presents a significant challenge to those who wish to heavily control public opinion. It also provides further support for an optimistic re-appraisal of entertainment which emphasises its central (not merely periphery) role in political discourse.

Design and implementation of a virtual world training simulation of ICU first hour handover processes

Nursing training for an Intensive Care Unit (ICU) is a resource intensive process. High demands are made on staff, students and physical resources. Interactive, 3D computer simulations, known as virtual worlds, are increasingly being used to supplement training regimes in the health sciences; especially in areas such as complex hospital ward processes. Such worlds have been found to be very useful in maximising the utilisation of training resources. Our aim is to design and develop a novel virtual world application for teaching and training Intensive Care nurses in the approach and method for shift handover, to provide an independent, but rigorous approach to teaching these important skills. In this paper we present a virtual world simulator for students to practice key steps in handing over the 24/7 care requirements of intensive care patients during the commencing first hour of a shift. We describe the modelling process to provide a convincing interactive simulation of the handover steps involved. The virtual world provides a practice tool for students to test their analytical skills with scenarios previously provided by simple physical simulations, and live on the job training. Additional educational benefits include facilitation of remote learning, high flexibility in study hours and the automatic recording of a reviewable log from the session. To the best of our knowledge, we believe this is a novel and original application of virtual worlds to an ICU handover process. The major outcome of the work was a virtual world environment for training nurses in the shift handover process, designed and developed for use by postgraduate nurses in training.

A strategy for delayed research method selection : deciding between grounded theory and phenomenology

This paper presents a strategy for delayed research method selection in a qualitative interpretivist research. An exemplary case details how explorative interviews were designed and conducted in accordance with a paradigm prior to deciding whether to adopt grounded theory or phenomenology for data analysis. The focus here is to determine the most appropriate research strategy in this case the methodological framing to conduct research and represent findings, both of which are detailed. Research addressing current management issues requires both a flexible framework and the capability to consider the research problem from various angles, to derive tangible results for academia with immediate application to business demands. Researchers, and in particular novices, often struggle to decide on an appropriate research method suitable to address their research problem. This often applies to interpretative qualitative research where it is not always immediately clear which is the most appropriate method to use, as the research objectives shift and crystallize over time. This paper uses an exemplary case to reveal how the strategy for delayed research method selection contributes to deciding whether to adopt grounded theory or phenomenology in the initial phase of a PhD research project. In this case, semi-structured interviews were used for data generation framed in an interpretivist approach, situated in a business context. Research questions for this study were thoroughly defined and carefully framed in accordance with the research paradigm‟s principles, while at the same time ensuring that the requirements of both potential research methods were met. The grounded theory and phenomenology methods were compared and contrasted to determine their suitability and whether they meet the research objectives based on a pilot study. The strategy proposed in this paper is an alternative to the more „traditional‟ approach, which initially selects the methodological formulation, followed by data generation. In conclusion, the suggested strategy for delayed research method selection intends to help researchers identify and apply the most appropriate method to their research. This strategy is based on explorations of data generation and analysis in order to derive faithful results from the data generated.

State convergence in the initialisation of the Sfinks stream cipher

Sfinks is a shift register based stream cipher designed for hardware implementation. The initialisation state update function is different from the state update function used for keystream generation. We demonstrate state convergence during the initialisation process, even though the individual components used in the initialisation are one-to-one. However, the combination of these components is not one-to-one.

China and the "Responsibility to Protect" (R2P) : the implications of the Libyan intervention

The emerging principle of a “responsibility to protect” (R2P) presents a direct challenge to China's traditional emphasis on the twin principles of non-intervention in the domestic affairs of other states and non-use of military force. This paper considers the evolution of China‟s relationship with R2P over the past ten years. In particular, it examines how China engaged with R2P during the recent Libyan crisis, and considers what impact this conflict may have first, on Chinese attitudes to R2P, and second, on the future development and implementation of the doctrine itself. This paper argues that China‟s decision to allow the passage of Security Council resolution 1973, authorising force in Libya, was shaped by an unusual set of pragmatic considerations, and should not be viewed as evidence of a dramatic shift in Chinese attitudes towards R2P. More broadly, controversy over the scope of NATO's military action in Libya has raised questions about R2P‟s legitimacy, which has contributed to a lack of timely international action in Syria and Yemen. In the short term at least, this post-Libya backlash against R2P is likely to constrain the Security Council‟s ability to respond decisively to other civilian protection situations.

A fragment of the LG3 peptide of endorepellin is present in the urine of physically active mining workers : a potential marker of physical activity

Biomarker analysis has been implemented in sports research in an attempt to monitor the effects of exertion and fatigue in athletes. This study proposed that while such biomarkers may be useful for monitoring injury risk in workers, proteomic approaches might also be utilised to identify novel exertion or injury markers. We found that urinary urea and cortisol levels were significantly elevated in mining workers following a 12 hour overnight shift. These levels failed to return to baseline over 24h in the more active maintenance crew compared to truck drivers (operators) suggesting a lack of recovery between shifts. Use of a SELDI-TOF MS approach to detect novel exertion or injury markers revealed a spectral feature which was associated with workers in both work categories who were engaged in higher levels of physical activity. This feature was identified as the LG3 peptide, a C-terminal fragment of the anti-angiogenic / anti-tumourigenic protein endorepellin. This finding suggests that urinary LG3 peptide may be a biomarker of physical activity. It is also possible that the activity mediated release of LG3 / endorepellin into the circulation may represent a biological mechanism for the known inverse association between physical activity and cancer risk / survival.

Algebraic analysis of the SSS stream cipher

Both the SSS and SOBER-t32 stream cipher designs use a single word-based shift register and a nonlinear filter function to produce keystream. In this paper we show that the algebraic attack method previously applied to SOBER-t32 is prevented from succeeding on SSS by the use of the key dependent substitution box (SBox) in the nonlinear filter of SSS. Additional assumptions and modifications to the SSS cipher in an attempt to enable algebraic analysis result in other difficulties that also render the algebraic attack infeasible. Based on these results, we conclude that a well chosen key-dependent substitution box used in the nonlinear filter of the stream cipher provides resistance against such algebraic attacks.

The nature of juristic paradigms : exploring the theoretical and conceptual relationship between adversarialism and therapeutic jurisprudence

Problem solving courts appear to achieve outcomes which are not common in mainstream courts. There are increasing calls for the adoption of more “therapeutic” and “problem solving” practices by mainstream judges in civil and criminal courts in a number of jurisdictions, most notably in the United States and Australia. Currently, a judge who sets out to exercise a significant therapeutic function is quite likely to be doing so in a specialist court or jurisdiction, outside the mainstream court system, and, arguably, from outside the adversarial paradigm itself. To some extent, his work is tolerated but marginalized. But do therapeutic and problem solving functions have the potential to define, rather than complement, the role of judicial officers? The basic question addressed in this paper is, therefore, whether the judicial role could evolve to be not just less adversarial, but fundamentally non-adversarial. In other words, could we see--or are we seeing--a paradigm shift not just in the colloquial, casual sense of the word, but in the strong, worldview changing sense meant by Thomas Kuhn?

eBILITY : from tool use to partnerships

In this article we identify how computational automation achieved through programming has enabled a new class of music technologies with generative music capabilities. These generative systems can have a degree of music making autonomy that impacts on our relationships with them; we suggest that this coincides with a shift in the music-equipment relationship from tool use to a partnership. This partnership relationship can occur when we use technologies that display qualities of agency. It raises questions about the kinds of skills and knowledge that are necessary to interact musically in such a partnership. These are qualities of musicianship we call eBility. In this paper we seek to define what eBility might consist of and how consideration of it might effect music education practice. The 'e' in eBility refers not only to the electronic nature of computing systems but also to the ethical, enabling, experiential and educational dimensions of the creative relationship with technologies with agency. We hope to initiate a discussion around differentiating what we term representational technologies from those with agency and begin to uncover the implications of these ideas for music educators in schools and communities. We hope also to elucidate the emergent theory and practice that has enabled the development of strategies for optimising this kind of eBility where the tool becomes partner. The identification of musical technologies with agency adds to the authors’ list of metaphors for technology use in music education that previously included tool, medium and instrument. We illustrate these ideas with examples and with data from our work with the jam2jam interactive music system. In this discussion we will outline our experiences with jam2jam as an example of a technology with agency and describe the aspects of eBility that interaction with it promotes.

Our neighbour's view : Australian media cover of PNG

This chapter reviews the incidence of coverage of Papua New Guinea affairs in the Australian press and in Australian broadcast media. It presents the findings of a formal monitoring of selected newspaper coverage and news broadcasts of the leading Australian television and radio outlets. The study also includes news stories published on ABC Online. The findings for print media suggest that coverage of PNG is inadequate and may be contributing towards negative images of that country in Australia. The broadcast monitoring found also that beyond the ABC's regular and balanced coverage, there was very little mention of PNG on Australian airwaves. The deployment of resources by the ABC was seen as a potential model for increased quantity and quality of coverage, with its maintenance of a correspondent and office in the country, and use of reports from PNG across a wide range of programs. The investigation noted some early indications of a shift in media attention, following the election of a new government in Australia in 2007, which gave some priority attention to PNG including a visit by the then Prime Minister.