Contextualising co-creation of value in electronic personal health records

This conceptual paper is a preliminary part of an ongoing study into take-up of electronic personal health records (ePHRs). The purpose of this work is to contextually ‘operationalise' Grönroos’ (2012) model of value co-creation in service for ePHRs. Using findings in the extant literature we enhance theoretical and practical understanding of the potential for co-creation of value with ePHRs for relevant stakeholders. The research design focused on the selection and evaluation of relevant literature to include in the discussion. The objective was to demonstrate which articles can be used to 'contextualise' the concepts in relation to relevant healthcare providers and patient engagement in the co-creation of value from having shared ePHRs. Starting at the service concept, that is, what the service provider wants to achieve and for whom, there is little doubt that there are recognised benefits that co-create value for both healthcare providers and healthcare consumers (i.e. patients) through shared ePHRs. We further highlight both alignments and misalignments in the resources and activities concepts between stakeholder groups. Examples include the types of functionalities as well as the interactive and peer communication needs perceived as useful for healthcare providers compared to healthcare consumers. The paper has implications for theory and practice and is an original and innovative approach to studying the co-creation of value in eHealth delivery.

Modeling conditional correlations of asset returns : a smooth transition approach

In this paper we propose a new multivariate GARCH model with time-varying conditional correlation structure. The time-varying conditional correlations change smoothly between two extreme states of constant correlations according to a predetermined or exogenous transition variable. An LM–test is derived to test the constancy of correlations and LM- and Wald tests to test the hypothesis of partially constant correlations. Analytical expressions for the test statistics and the required derivatives are provided to make computations feasible. An empirical example based on daily return series of five frequently traded stocks in the S&P 500 stock index completes the paper.

The psychological and economic factors that influence energy consumption habits of low-income earners

Social marketers and governments have often targeted hard to reach or vulnerable groups (Gordon et al., 2006) such as young adults and low income earners. Past research has shown that low-income earners are often at risk of poor health outcomes and diminished lifestyle (Hampson et al., 2009; Scott et al., 2012). Young adults (aged 18 to 35) are in a transition phase of their life where lifestyle preferences are still being formed and are thus a useful target for long-term sustainable change. An area of focus for all levels of government is the use of energy with an aim to reduce consumption. There is little research to date that combines both of these groups and in particular in the context of household energy usage. Research into financially disadvantaged consumers is challenging the notion that that low income consumer purchasing and usage of products and services is based upon economic status (Sharma et al., 2012). Prior research shows higher income earners view items such as televisions and computers as necessities rather than non-essential (Karlsson et al., 2004). Consistent with this is growing evidence that low income earners purchase non-essential, energy intensive electronic appliances such as multiple big screen TV sets and additional refrigerators. With this in mind, there is a need for knowledge about how psychological and economic factors influence the energy consumption habits (e.g. appliances on standby power, leaving appliances turned on, running multiple devices at one time) of low income earners. Thus, our study sought to address the research question of: What are the factors that influence young adult low-income earners energy habits?

Onset of transition in mixed convection of a lid-driven trapezoidal enclosure filled with water-Al2O3 nanofluid

A numerical study is carried out to investigate the transition from laminar to chaos in mixed convection heat transfer inside a lid-driven trapezoidal enclosure. In this study, the top wall is considered as isothermal cold surface, which is moving in its own plane at a constant speed, and a constant high temperature is provided at the bottom surface. The enclosure is assumed to be filled with water-Al2O3 nanofluid. The governing Navier–Stokes and thermal energy equations are expressed in non-dimensional forms and are solved using Galerkin finite element method. Attention is paid in the present study on the pure mixed convection regime at Richandson number, Ri = 1. The numerical simulations are carried out over a wide range of Reynolds (0.1 ≤ Re ≤ 103) and Grashof (0.01 ≤ Gr ≤ 106) numbers. Effects of the presence of nanofluid on the characteristics of mixed convection heat transfer are also explored. The average Nusselt numbers of the heated wall are computed to demonstrate the influence of flow parameter variations on heat transfer. The corresponding change of flow and thermal fields is visualized from the streamline and the isotherm contour plots.

The professional socialisation of paramedics : the transition from intern to qualified paramedic

The professional socialisation of paramedics encompasses preconceptions developed during childhood and early adulthood, and subsequent changes in perceptions resulting from university studies, clinical placements and encountering the professional workplace as an employee. This study investigates the professional socialisation of university educated paramedics making the transition from paramedic intern to qualified paramedic. Participants were sought from several of Australia’s larger ambulance services and UK NHS Ambulance Trusts to take part in this study. Participants were recruited through Ambulance Service Research Institutes, Clinical Governance Departments and university databases. To be included in this study, participants were required to be university educated, have completed a professional internship year and achieved qualified or registered paramedic status. Data collection was via face to face semi-structured interviews. Transcripts were analysed using socialisation models from the nursing and allied health disciplines and a grounded theory approach. The study found that participants initially enjoyed their new professional status after completing their internship and becoming qualified paramedics. However, for many the excitement of becoming a qualified paramedic was short lived. Newly qualified paramedics experienced increased levels of responsibility and were required to develop mentoring skills while still adjusting to their new roles. Participants had to contend with inner conflicting views about the reality of paramedic work which were developed though preconceptions and experiences as paramedic interns. The transition from paramedic intern to qualified paramedic is reportedly a challenging experience, as newly qualified paramedics are required to deal with added complexities while still adjusting to their new roles.

Kallikrein 4 (hK4) and prostate-specific antigen (PSA) are associated with the loss of E-cadherin and an epithelial-mesenchymal transition (EMT)-like effect in prostate cancer cells

Prostate-specific antigen (PSA) and the related kallikrein family of serine proteases are current or emerging biomarkers for prostate cancer detection and progression. Kallikrein 4 (KLK4/hK4) is of particular interest, as KLK4 mRNA has been shown to be elevated in prostate cancer. In this study, we now show that the comparative expression of hK4 protein in prostate cancer tissues, compared with benign glands, is greater than that of PSA and kallikrein 2 (KLK2/hK2), suggesting that hK4 may play an important functional role in prostate cancer progression in addition to its biomarker potential. To examine the roles that hK4, as well as PSA and hK2, play in processes associated with progression, these kallikreins were separately transfected into the PC-3 prostate cancer cell line, and the consequence of their stable transfection was investigated. PC-3 cells expressing hK4 had a decreased growth rate, but no changes in cell proliferation were observed in the cells expressing PSA or hK2. hK4 and PSA, but not hK2, induced a 2.4-fold and 1.7-fold respective increase, in cellular migration, but not invasion, through Matrigel, a synthetic extracellular matrix. We hypothesised that this increase in motility displayed by the hK4 and PSA-expressing PC-3 cells may be related to the observed change in structure in these cells from a typical rounded epithelial-like cell to a spindle-shaped, more mesenchymal-like cell, with compromised adhesion to the culture surface. Thus, the expression of E-cadherin and vimentin, both associated with an epithelial-mesenchymal transition (EMT), was investigated. E-cadherin protein was lost and mRNA levels were significantly decreased in PC-3 cells expressing hK4 and PSA (10-fold and 7-fold respectively), suggesting transcriptional repression of E-cadherin, while the expression of vimentin was increased in these cells. The loss of E-cadherin and associated increase in vimentin are indicative of EMT and provides compelling evidence that hK4, in particular, and PSA have a functional role in the progression of prostate cancer through their promotion of tumour cell migration.

Towards inclusion: Provision for diversity in the transition to school

Policies of inclusion challenge the construct of readiness and require schools to prepare for the diversity of children as they transition to school. However, there is limited empirical evidence concerning how this challenge is met. This paper presents two Australian studies that investigate inclusive practices in the transition to school. Study 1 examined the predictors of child outcomes across a sample of 1831 children in 39 schools. The results indicate that both quantity and quality of programme provision influenced outcomes and that programme effects were particularly potent for children with diverse abilities and backgrounds. Study 2 focuses on pedagogy in three of the schools to highlight how this provision can be achieved. Results show that provisions were reactive, that saliency of children’s needs directed school practices and that professional knowledge impacted on measures of quality. Inclusive processes accounting for both child progress and broader family and teaching influences are necessary for improved transition to school.

Sharing of clinical data in a maternity setting: How do paper hand-held records and electronic health records compare for completeness?

Background Historically, the paper hand-held record (PHR) has been used for sharing information between hospital clinicians, general practitioners and pregnant women in a maternity shared-care environment. Recently in alignment with a National e-health agenda, an electronic health record (EHR) was introduced at an Australian tertiary maternity service to replace the PHR for collection and transfer of data. The aim of this study was to examine and compare the completeness of clinical data collected in a PHR and an EHR. Methods We undertook a comparative cohort design study to determine differences in completeness between data collected from maternity records in two phases. Phase 1 data were collected from the PHR and Phase 2 data from the EHR. Records were compared for completeness of best practice variables collected The primary outcome was the presence of best practice variables and the secondary outcomes were the differences in individual variables between the records. Results Ninety-four percent of paper medical charts were available in Phase 1 and 100% of records from an obstetric database in Phase 2. No PHR or EHR had a complete dataset of best practice variables. The variables with significant improvement in completeness of data documented in the EHR, compared with the PHR, were urine culture, glucose tolerance test, nuchal screening, morphology scans, folic acid advice, tobacco smoking, illicit drug assessment and domestic violence assessment (p = 0.001). Additionally the documentation of immunisations (pertussis, hepatitis B, varicella, fluvax) were markedly improved in the EHR (p = 0.001). The variables of blood pressure, proteinuria, blood group, antibody, rubella and syphilis status, showed no significant differences in completeness of recording. Conclusion This is the first paper to report on the comparison of clinical data collected on a PHR and EHR in a maternity shared-care setting. The use of an EHR demonstrated significant improvements to the collection of best practice variables. Additionally, the data in an EHR were more available to relevant clinical staff with the appropriate log-in and more easily retrieved than from the PHR. This study contributes to an under-researched area of determining data quality collected in patient records.

Transition metal layered double hydroxides for energy storage

Various types of layered double hydroxides, a type of clay, were synthesised. They were then electrochemically tested to determine whether the samples would be suitable to store energy as supercapacitors. A manganese aluminium layered double hydroxide was electrochemically tested for the first time and found to have a large capacitance.