A time-variant medical data trustworthiness assessment model

Electronic Health Record (EHR) systems are being introduced to overcome the limitations associated with paper-based and isolated Electronic Medical Record (EMR) systems. This is accomplished by aggregating medical data and consolidating them in one digital repository. Though an EHR system provides obvious functional benefits, there is a growing concern about the privacy and reliability (trustworthiness) of Electronic Health Records. Security requirements such as confidentiality, integrity, and availability can be satisfied by traditional hard security mechanisms. However, measuring data trustworthiness from the perspective of data entry is an issue that cannot be solved with traditional mechanisms, especially since degrees of trust change over time. In this paper, we introduce a Time-variant Medical Data Trustworthiness (TMDT) assessment model to evaluate the trustworthiness of medical data by evaluating the trustworthiness of its sources, namely the healthcare organisation where the data was created and the medical practitioner who diagnosed the patient and authorised entry of this data into the patient’s medical record, with respect to a certain period of time. The result can then be used by the EHR system to manipulate health record metadata to alert medical practitioners relying on the information to possible reliability problems.

Are library and information professionals ready for evidence based practice?

Evidence based practice (EBP) is recognised as a way of improving the quality of professional practice in many disciplines however its adoption within library and information sciences (LIS) has been gradual. The term was first introduced into the library and information profession‟s vocabulary a decade ago but an impediment to its uptake is the lack of clear understanding regarding how LIS practitioners understand the concept. Partridge, Thorpe, Edwards and Hallam (2007) identified the need to understand how LIS professionals experience or understand evidence based practice and proposed a model of four categories of experience to describe how LIS professionals experience EBP. This paper extends that framework by refining the different conceptions of evidence based practice and identifying relationships which exist between the categories of experience to provide a rich description of the EBP phenomenon. The paper also argues that the phrase “evidence based librarianship” and its variations be abandoned as practitioners do not see a distinction between EBP as applied to librarianship and information practice and industry specific jargon like “evidence based library and information practice”. This research will help current and future LIS practitioners, leaders and educators engage more actively in the establishment of an evidence based culture to improve library and information practice in Australia and internationally.

Nutritional status and information needs of medical oncology patients receiving treatment at an Australian public hospital

This study aimed to identify: i) the prevalence of malnutrition according to the scored Patient Generated-Subjective Global Assessment (PG-SGA); ii) utilization of available nutrition resources; iii) patient nutrition information needs; and iv) external sources of nutrition information. An observational, cross-sectional study was undertaken at an Australian public hospital on 191 patients receiving oncology services. According to PG-SGA, 49% of patients were malnourished and 46% required improved symptom management and/or nutrition intervention. Commonly reported nutrition-impact symptoms included: peculiar tastes (31%), no appetite (24%) and nausea (24%). External sources of nutrition information were accessed by 37%, with popular choices being media/internet (n=19) and family/friends (n=13). In a sub-sample (n=65), 32 patients were aware of the available nutrition resources, 23 thought the information sufficient and 19 patients had actually read them. Additional information on supplements and modifying side effects was requested by 26 patients. Malnutrition is common in oncology patients receiving treatment at an Australian public hospital and almost half require improved symptom management and/or nutrition intervention. Patients who read the available nutrition information found it useful, however awareness of these nutrition resources and the provision of information on supplementation and managing symptoms requires attention.

A constructivist approach to media literacy education: The role of the library

An informed citizenry is essential to the effective functioning of democracy. In most modern liberal democracies, citizens have traditionally looked to the media as the primary source of information about socio-political matters. In our increasingly mediated world, it is critical that audiences be able to effectively and accurately use the media to meet their information needs. Media literacy, the ability to access, understand, evaluate and create media content is therefore a vital skill for a healthy democracy. The past three decades have seen the rapid expansion of the information environment, particularly through Internet technologies. It is obvious that media usage patterns have changed dramatically as a result. Blogs and websites are now popular sources of news and information, and are for some sections of the population likely to be the first, and possibly only, information source accessed when information is required. What are the implications for media literacy in such a diverse and changing information environment? The Alexandria Manifesto stresses the link between libraries, a well informed citizenry and effective governance, so how do these changes impact on libraries? This paper considers the role libraries can play in developing media literate communities, and explores the ways in which traditional media literacy training may be expanded to better equip citizens for new media technologies. Drawing on original empirical research, this paper highlights a key shortcoming of existing media literacy approaches: that of overlooking the importance of needs identification as an initial step in media selection. Self-awareness of one’s actual information need is not automatic, as can be witnessed daily at reference desks in libraries the world over. Citizens very often do not know what it is that they need when it comes to information. Without this knowledge, selecting the most appropriate information source from the vast range available becomes an uncertain, possibly even random, enterprise. Incorporating reference interview-type training into media literacy education, whereby the individual will develop the skills to interrogate themselves regarding their underlying information needs, will enhance media literacy approaches. This increased focus on the needs of the individual will also push media literacy education into a more constructivist methodology. The paper also stresses the importance of media literacy training for adults. Media literacy education received in school or even university cannot be expected to retain its relevance over time in our rapidly evolving information environment. Further, constructivist teaching approaches highlight the importance of context to the learning process, thus it may be more effective to offer media literacy education relating to news media use to adults, whilst school-based approaches focus on types of media more relevant to young people, such as entertainment media. Librarians are ideally placed to offer such community-based media literacy education for adults. They already understand, through their training and practice of the reference interview, how to identify underlying information needs. Further, libraries are placed within community contexts, where the everyday practice of media literacy occurs. The Alexandria Manifesto stresses the link between libraries, a well informed citizenry and effective governance. It is clear that libraries have a role to play in fostering media literacy within their communities.

Library technician course recognition : meeting the challenge of a distributed national education program

This paper looks at the challenges presented for the Australian Library and Information Association by its role as the professional association responsible for ensuring the quality of Australian library technician graduates. There is a particular focus on the issue of course recognition, where the Association's role is complicated by the need to work alongside the national quality assurance processes that have been established by the relevant technical education authorities. The paper describes the history of course recognition in Australia; examines the relationship between course recognition and other quality measures; and describes the process the Association has undertaken recently to ensure appropriate professional scrutiny in a changing environment of accountability.

"I'm thinking 'bout moving in"... An examination of the issues impacting on the recruitment of secondary school graduates to the library and information profession

In recent years concern has been expressed internationally about the future of the library and information services (LIS) profession: recruitment and retention, changing skill sets and declining numbers of people choosing librarianship as a career are all factors contributing to an uncertain future. One area yet explored in any depth is the topic of why LIS studies are not perceived, let alone promoted, as a good first professional qualification for high school graduates. This paper considers the professional literature that examines the uptake of librarianship as a first qualification by school leavers and discusses, in the context of the Australian library sector, the role of professional associations, library schools, National and State Libraries, as well as individual libraries and librarians. Examples of best practice are presented to highlight the opportunities for inspiring and motivating students through well structured and stimulating work experience programs. The topic is relevant to all librarians who are interested in the future of the LIS profession. It is argued that the focus of the present conference on ‘moving up’ and ‘moving on’ can only have real significance when the profession has a more complete understanding of the barriers to and the opportunities for ‘moving in’.

Aligning policy with practice: an evaluation of vocational education and training in the library and information services sector

Vocational education and training for the library and information services (LIS) sector in Australia offers students the career pathway to become library technicians. Library technicians play a valuable role in drawing on sound practical knowledge and skills to support the delivery of library and information services that meet client needs. Over the past forty years, the Australian Library and Information Association (ALIA) has monitored the quality of library technician courses. Since 2005, ALIA has run national professional development days for library technician educators with the goal of establishing an alternative model for course recognition focusing on the process of peer review to benchmark good practice and stimulate continuous improvement in library technician education. This initial developmental work has culminated in 2009 with site visits to all library technician courses in Australia. The paper presents a whole-of-industry case study to critically review the work undertaken to date.

University library virtual reference services : best practices and continuous improvement

The inclusion or not of chat services within Virtual Reference (VR) is an important topic for university libraries. Increasingly, email supported by a Frequently Asked Questions (FAQ) database is suggested in the scholarly literature as the preferred, cost-effective means for providing university VR services. This paper examines these issues and identifies some best practices for university library VR services relating to chat and email service, collaborative service provision, services staffing, and staff training. Further studies are required to more completely identify best practices for the complete range of VR services.

neXus2. An investigation into the library and information services workforce in Australia: The institutional perspective. Final report prepared for the Australian Library and Information Association and National and State Libraries Australia

The neXus2 research project has sought to investigate the library and information services (LIS) workforce in Australia, from the institutional or employer perspective. The study builds on the neXus1 study, which collected data from individuals in the LIS workforce in order to present a snapshot of the profession in 2006, highlighting the demographics, educational background and career details of library and information professionals in Australia. To counterbalance this individual perspective, library institutions were invited to participate in a survey to contribute further data as employers. This final report on the neXus2 project compares the findings from the different library sectors, ie academic libraries, TAFE libraries, the National and State libraries, public libraries, special libraries and school libraries.

Queensland Emergency Medical System : a structural and organizational model for the emergency medical system in Australia

Objective: The emergency medical system (EMS) can be defined as a comprehensive, coordinated and integrated system of care for patients suffering acute illness and injury. The aim of the present paper is to describe the evolution of the Queensland Emergency Medical System (QEMS) and to recommend a strategic national approach to EMS development. Methods: Following the formation of the Queensland Ambulance Service in 1991, a state EMS committee was formed. This committee led the development and approval of the cross portfolio QEMS policy framework that has resulted in dynamic policy development, system monitoring and evaluation. This framework is led by the Queensland Emergency Medical Services Advisory Committee. Results: There has been considerable progress in the development of all aspects of the EMS in Queensland. These developments have derived from the improved coordination and leadership that QEMS provides and has resulted in widespread satisfaction by both patients and stakeholders. Conclusions: The strategic approach outlined in the present paper offers a model for EMS arrangements throughout Australia. We propose that the Council of Australian Governments should require each state and Territory to maintain an EMS committee. These state EMS committees should have a broad portfolio of responsibilities. They should provide leadership and direction to the development of the EMS and ensure coordination and quality of outcomes. A national EMS committee with broad representation and broad scope should be established to coordinate the national development of Australia's EMS.

Cost-effectiveness of an intervention to reduce emergency re-admissions to hospital among older patients

Background. The objective is to estimate the cost-effectiveness of an intervention that reduces hospital readmission among older people at high risk. A cost-effectiveness model to estimate the costs and health benefits of the intervention was implemented. Methodology/Principal Findings. The model used data from a randomised controlled trial conducted in an Australian tertiary metropolitan hospital. Participants were acute medical admissions aged >65 years with at least one risk factor for readmission: multiple comorbidities, impaired functionality, aged >75 years, 30 recent multiple admissions, poor social support, history of depression. The intervention was a comprehensive nursing and physiotherapy assessment and an individually tailored program of exercise strategies and nurse home visits with telephone follow-up; commencing in hospital and continuing following discharge for 24 weeks. The change to cost outcomes, including the costs of implementing the intervention and all subsequent use of health care services, and, the change to health benefits, represented by quality adjusted life years, were estimated for the intervention as compared to existing practice. The mean change to total costs and quality 38 adjusted life years for an average individual over 24 weeks participating in the intervention were: cost savings of $333 (95% Bayesian credible interval $-1,932:1,282) and 0.118 extra quality adjusted life years (95% Bayesian credible interval 0.1:0.136). The mean net41 monetary-benefit per individual for the intervention group compared to the usual care condition was $7,907 (95% Bayesian credible interval $5,959:$9,995) for the 24 week period. Conclusions/Significance. The estimation model that describes this intervention predicts cost savings and improved health outcomes. A decision to remain with existing practices causes unnecessary costs and reduced health. Decision makers should consider adopting this 46 program for elderly hospitalised patients.

Soundcipher : a music and sound library for processing

SoundCipher is a software library written in the Java language that adds important music and sound features to the Processing environment that is widely used by media artists and otherwise has an orientation toward computational graphics. This article introduces the SoundCipher library and its features, describes its influences and design intentions, and positions it within the field of computer music programming tools. SoundCipher enables the rich history of algorithmic music techniques to be accessible within one of today’s most popular media art platforms. It also provides an accessible means for learning to create algorithmic music and sound programs.

In vitro and in vivo analysis of co-electrospun scaffolds made of medical grade poly(epsilon-caprolactone) and porcine collagen

In this study, a nanofiber mesh made by co-electrospinning medical grade poly(epsilon-caprolactone) and collagen (mPCL/Col) was fabricated and studied. Its mechanical properties and characteristics were analyzed and compared to mPCL meshes. mPCL/Col meshes showed a reduction in strength but an increase in ductility when compared to PCL meshes. In vitro assays revealed that mPCL/Col supported the attachment and proliferation of smooth muscle cells on both sides of the mesh. In vivo studies in the corpus cavernosa of rabbits revealed that the mPCL/Col scaffold used in conjunction with autologous smooth muscle cells resulted in better integration with host tissue when compared to cell free scaffolds. On a cellular level preseeded scaffolds showed a minimized foreign body reaction.