Cloud computing for healthcare research information sharing

With the widespread application of healthcare Information and Communication Technology (ICT), constructing a stable and sustainable data sharing circumstance has attracted rapidly growing attention in both academic research area and healthcare industry. Cloud computing is one of long dreamed visions of Healthcare Cloud (HC), which matches the need of healthcare information sharing directly to various health providers over the Internet, regardless of their location and the amount of data. In this paper, we discuss important research tool related to health information sharing and integration in HC and investigate the arising challenges and issues. We describe many potential solutions to provide more opportunities to implement EHR cloud. As well, we introduce the development of a HC related collaborative healthcare research example, thus illustrating the prospective of applying Cloud Computing in the health information science research.

Outcomes following inpatient rehabilitation of lower limb amputees

Introduction: Lower-limb amputations are a serious adverse consequence of lifestyle related chronic conditions and a serious concern among the aging population in Australia. Lower limb amputations have severe personal, social and economic impacts on the individual, healthcare system and broader community. This study aimed to address a critical gap in the research literature by investigating the physical functioning and social characteristics of lower limb amputees at discharge from tertiary hospital inpatient rehabilitation. Method: A cohort study was implemented among patients with lower limb amputations admitted to a Geriatric Assessment and Rehabilitation Unit for rehabilitation at a tertiary hospital. Conventional descriptive statistics were used to examine patient demographic, physical functioning and social living outcomes recorded for patients admitted between 2005 and 2011. Results: A total of 423 admissions occurred during the study period, 313 (74%) were male. This sample included admissions for left (n = 189, 45%), right (n = 220, 52%) and bilateral (n = 14, 3%) lower limb amputations, with 15 (3%) patients dying whilst an inpatient. The mean (standard deviation) age was 65 (13.9) years. Amputations attributed to vascular causes accounted for 333 (78%) admissions; 65 (15%) of these had previously had an amputation. The mean (SD) length of stay in the rehabilitation unit was 56 (42) days. Prior to this admission, 123 (29%) patients were living alone, 289 (68%) were living with another and 3 (0.7%) were living in residential care. Following this amputation related admission, 89 (21%) patients did not return to their prior living situation. Of those admitted, 187 (44%) patients were discharged with a lower limb prosthesis. Conclusion: The clinical group is predominately older adults. The ratio of males to females was approximately 3:1. Over half did not return to walking and many were not able to return to their prior accommodation. However, few patients died during their admission.

Parking, parties and pets : disputes - the dark side of community living

In the last decade community living, in master planned communities or strata titled complexes, has increased. As land becomes scarcer, the popularity of these schemes is predicted to grow. Offsetting this popularity is the peculiarities of community living, in particular the often unthought-of difficulties arising from living in very close proximity to your neighbour. Such difficulties affect both amenity of life and property value. This paper seeks to inform practitioners of the issues arising from community living. It does this by identifying the more common forms of disputes and considering recent tribunal and court decisions. The paper concludes by identifying the dispute warning signs to assist to practitioners with the valuation process.

Funds of knowledge of sorting and patterning : networks of exchange in a Torres Strait Island community

The purpose of this article is to describe a project with one Torres Strait Islander Community. It provides some insights into parents’ funds of knowledge that are mathematical in nature, such as sorting shells and giving fish. The idea of funds of knowledge is based the premise that people are competent and have knowledge that has been historically and culturally accumulated into a body of knowledge and skills essential for their functioning and well-being. This knowledge is then practised throughout their lives and passed onto the next generation of children. Through using a community research approach, funds of knowledge that can be used to validate the community’s identities as knowledgeable people, can be used as foundations for future learnings for teachers, parents and children in the early years of school. They can be the bridge that joins a community’s funds of knowledge with schools validating that knowledge.

Future-proofing our community for natural disaster requires more attention on men

Response to the "2011 Brisbane floods affected residents' health"

Response to “Topical agent therapy for prevention and treatment of radiodermatitis : a meta-analysis”

To the Editor; It was with interest that I read the recent article by Zhang et al. published in Supportive Care in Cancer [1]. This paper highlighted the importance of radiodermatitis (RD) being an unresolved and distressing clinical issue in patients with cancer undergoing radiation therapy. However, I am concerned with a number of clinical and methodological issues within this paper: (i) the clinical and operational definition of prophylaxis and treatment of RD; (ii) the accuracy of the identification of trials; and (iii) the appropriateness of the conduct of the meta-analyses...

Gated and Guarded Community (GACOS) in Malaysia : worth or not?

A 'Gated and Guarded Community' has become a popular trend in the recent years, particularly for housing areas. The increasing in population and income has lead to the increase in housing demand. The 1991 Population Census Report showed that Malaysian population has increased with an average yearly rate of 2.7% per year, that is, from 13.74 million people in 1980 to 19.35 million in 1991, followed by 20.69 million in 1995 and increase to 23.27 in year 2000. This is followed by consistent increase in the average population monthly income. Started from 1995 to 1999, the average annual growth rate of mean monthly income in Malaysia is about 5.2 %, from RM2,020.00 in 1995 to RM2,472.00 in 1999 and increasing constantly. This shows that the human growth usually have correlation between demand, income and housing. This paper presents the factors that involved in determined the Gated and Guarded Community Investment in Malaysia either it is worth to invest or otherwise. Hopefully, the results will also indicate that there may be other factors affecting their investment decision besides security and privacy. This paper is actually to draw attention to some practitioner and collect more information in establishing my research analysis.

A New DER coordination in LV network based on the concept of distributed control

Given the paradigm of smart grid as the promising backbone for future network, this paper uses this paradigm to propose a new coordination approach for LV network based on distributed control algorithm. This approach divides the LV network into hierarchical communities where each community is controlled by a control agent. Different level of communication has been proposed for this structure to control the network in different operation modes.

Perceived social support and community adaptation in schizophrenia

Prompted by the continuing transition to community care, mental health nurses are considering the role of social support in community adaptation. This article demonstrates the importance of distinguishing between kinds of social support and presents findings from the first round data of a longitudinal study of community adaptation in 156 people with schizophrenia conducted in Brisbane, Australia. All clients were interviewed using the relevant subscales of the Diagnostic Interview Schedule to confirm a primary diagnosis of schizophrenia. The study set out to investigate the relationship between community adaptation and social support. Community adaptation was measured with the Brief Psychiatric Rating Scale (BPRS), the Life Skills Profile (LSP) and measures of dissatisfaction with life and problems in daily living developed by the authors. Social support was measured with the Arizona Social Support Interview Schedule (ASSIS). The BPRS and ASSIS were incorporated into a client interview conducted by trained interviewers. The LSP was completed on each client by an informal carer (parent, relative or friend) or a professional carer (case manager or other health professional) nominated by the client. Hierarchical regression analysis was used to examine the relationship between community adaptation and four sets of social support variables. Given the order in which variables were entered in regression equations, a set of perceived social support variables was found to account for the largest unique variance of four measures of community adaptation in 96 people with schizophrenia for whom complete data are available from the first round of the three-wave longitudinal study. A set of the subjective experiences of the clients accounted for the largest unique variance in measures of symptomatology, life skills, dissatisfaction with life, and problems in daily living. Sets of community support, household support and functional variables accounted for less variance. Implications for mental health nursing practice are considered.

Characterizing multi-agent team behavior from partial team tracings : evidence from the English Premier League

Real-world AI systems have been recently deployed which can automatically analyze the plan and tactics of tennis players. As the game-state is updated regularly at short intervals (i.e. point-level), a library of successful and unsuccessful plans of a player can be learnt over time. Given the relative strengths and weaknesses of a player’s plans, a set of proven plans or tactics from the library that characterize a player can be identified. For low-scoring, continuous team sports like soccer, such analysis for multi-agent teams does not exist as the game is not segmented into “discretized” plays (i.e. plans), making it difficult to obtain a library that characterizes a team’s behavior. Additionally, as player tracking data is costly and difficult to obtain, we only have partial team tracings in the form of ball actions which makes this problem even more difficult. In this paper, we propose a method to overcome these issues by representing team behavior via play-segments, which are spatio-temporal descriptions of ball movement over fixed windows of time. Using these representations we can characterize team behavior from entropy maps, which give a measure of predictability of team behaviors across the field. We show the efficacy and applicability of our method on the 2010-2011 English Premier League soccer data.

Feasibility of agent-based modelling of articular cartilage including a conceptual representation of its structure

Articular cartilage is a complex structure with an architecture in which fluid-swollen proteoglycans constrained within a 3D network of collagen fibrils. Because of the complexity of the cartilage structure, the relationship between its mechanical behaviours at the macroscale level and its components at the micro-scale level are not completely understood. The research objective in this thesis is to create a new model of articular cartilage that can be used to simulate and obtain insight into the micro-macro-interaction and mechanisms underlying its mechanical responses during physiological function. The new model of articular cartilage has two characteristics, namely: i) not use fibre-reinforced composite material idealization ii) Provide a framework for that it does probing the micro mechanism of the fluid-solid interaction underlying the deformation of articular cartilage using simple rules of repartition instead of constitutive / physical laws and intuitive curve-fitting. Even though there are various microstructural and mechanical behaviours that can be studied, the scope of this thesis is limited to osmotic pressure formation and distribution and their influence on cartilage fluid diffusion and percolation, which in turn governs the deformation of the compression-loaded tissue. The study can be divided into two stages. In the first stage, the distributions and concentrations of proteoglycans, collagen and water were investigated using histological protocols. Based on this, the structure of cartilage was conceptualised as microscopic osmotic units that consist of these constituents that were distributed according to histological results. These units were repeated three-dimensionally to form the structural model of articular cartilage. In the second stage, cellular automata were incorporated into the resulting matrix (lattice) to simulate the osmotic pressure of the fluid and the movement of water within and out of the matrix; following the osmotic pressure gradient in accordance with the chosen rule of repartition of the pressure. The outcome of this study is the new model of articular cartilage that can be used to simulate and study the micromechanical behaviours of cartilage under different conditions of health and loading. These behaviours are illuminated at the microscale level using the socalled neighbourhood rules developed in the thesis in accordance with the typical requirements of cellular automata modelling. Using these rules and relevant Boundary Conditions to simulate pressure distribution and related fluid motion produced significant results that provided the following insight into the relationships between osmotic pressure gradient and associated fluid micromovement, and the deformation of the matrix. For example, it could be concluded that: 1. It is possible to model articular cartilage with the agent-based model of cellular automata and the Margolus neighbourhood rule. 2. The concept of 3D inter connected osmotic units is a viable structural model for the extracellular matrix of articular cartilage. 3. Different rules of osmotic pressure advection lead to different patterns of deformation in the cartilage matrix, enabling an insight into how this micromechanism influences macromechanical deformation. 4. When features such as transition coefficient were changed, permeability (representing change) is altered due to the change in concentrations of collagen, proteoglycans (i.e. degenerative conditions), the deformation process is impacted. 5. The boundary conditions also influence the relationship between osmotic pressure gradient and fluid movement at the micro-scale level. The outcomes are important to cartilage research since we can use these to study the microscale damage in the cartilage matrix. From this, we are able to monitor related diseases and their progression leading to potential insight into drug-cartilage interaction for treatment. This innovative model is an incremental progress on attempts at creating further computational modelling approaches to cartilage research and other fluid-saturated tissues and material systems.

Community interventions for physical activity : the role of a new Cochrane systematic review

Introduction: Systematic reviews are essential in summarising the results of a range of research studies on a specific topic into a single report. They serve as a key source of evidence-based information to support and develop policy and practice for healthy communities. This presentation will examine a new review of community-wide strategies to increase population levels of physical activity and compare it to an earlier Community Guide Review (CGR) of Community-wide campaigns to increase physical activity which recommended community wide interventions. Methods: We registered a Cochrane Systematic Review (CSR) title, published a protocol and recently completed the review of Community-wide interventions to increase physical activity. We compared the definitions, design and findings of the CSR to the CGR. Results: The two reviews differed remarkably in their conclusions with the CGR recommending “strong evidence exists that community-wide campaigns are effective in increasing levels of physical activity”, and the new CSR stating “The body of evidence in this review does not support the hypothesis that multi-component community wide interventions effectively increase population levels of physical activity”. We observed that both reviews examined multi-component interventions as a “combined package”. Possible explanations for the different conclusions may be due to the definition of community (CSR defined community as “comprising those persons residing in a geographically defined community, such as a village, town, or city”, excluding interventions which were whole of state or country, and CGR as “a group of individuals who share one or more characteristics. The CSR utilised a logic model at various stages of the review process and explicitly defined a combination of strategies encompassed within the intervention. The CSR included 25 and CGR 10 studies, respectively. Six of the 10 studies that were included in CGR were excluded from the CSR due to issues relating to study design, intervention definition or duration. The two reviews also differ in function as the CSR seeks to summarise global evidence and included 7 studies in low-income countries, where as the CGR contained only studies deemed relevant to the USA context. Discussion: Differences in the findings between older and newer reviews can be due to a variety of factors. For example, in updating a review the definition of an intervention can be changed. Further, differences may also be due to improvements in the standards and methodologies for systematic reviews as well as the inclusion of newer studies. These factors need to be understood whenever differences between newer and older reviews are considered.

Methodological challenges in conducting a systematic review of community wide interventions to increase physical activity

Introduction: Evaluating the effectiveness of interventions designed to increase the physical activity in communities is often a difficult and complex task, requiring considerable expertise and investment, and often constrained by methodological limitations. These limitations, in turn, create additional challenges when these studies are used in systematic reviews as they hinder the confidence, precision and interpretation of results. The objective of this paper is to summarise the methodological challenges posed in conducting a systematic review of community-wide physical activity interventions to help inform those conducting future primary research and systematic reviews. Methods: We conducted a Cochrane systematic review of community-wide interventions to increase physical activity. We assessed the methodological quality of the included studies. We will investigate these in greater detail, particularly in relation to the potential impact on measures of effect, confidence in results, generalizability of results and general interpretation. Results: The systematic review was conducted and has been published in the Cochrane Library. A logic model was helpful in defining and interpreting the studies. Many studies of unsuitable study design were excluded; however several important methodological limitations of the primary studies evaluating community-wide physical activity interventions emerged. These included: - the failure to use validated tools to measure physical activity; - issues associated with pre and post test designs; - inadequate sampling of populations; - poor control groups; and - intervention and measurement protocols of inadequate duration. Although it is challenging to undertake rigorous evaluations of complex interventions, these issues result in significant uncertainty over the effectiveness of these interventions, and the possible factors required for a community-wide intervention to be successful. In particular, the combination of several of these limitations (e.g. un-validated tools, inadequate sampling, and short duration) is that studies may lack the sensitivity to detect any meaningful change. Multiple publications of findings for the same study also made interpretation difficult; however, interventions with parallel qualitative publications were helpful. Discussion: Evaluating community wide interventions to increase physical activity in a rigorous way is incredibly challenging. These findings reflect these challenges but have important ramifications for researchers conducting primary studies to determine the efficacy of such interventions, as well as for researchers conducting systematic reviews. This new review shows that the inadequacies of design and evaluation are continuing. It is hoped that the adoption of such suggestions may aid in the development of systematic reviews, but more importantly, in enabling translation of such findings into policy and practice.

Disaster strikes, then what? Using evaluation in narrative driven (oral history & digital storytelling) community-based projects

In 2011 Queensland suffered both floods and cyclones, leaving residents without homes and their communities in ruins (2011). This paper presents how researchers from QUT, who are also members of the Oral History Association of Australia (OHAA) Queensland’s chapter, are using oral history, photographs, videography and digital storytelling to help heal and empower rural communities around the state and how evaluation has become a key element of our research. QUT researchers ran storytelling workshops in the capital city of Brisbane i early 2011, after the city suffered sever flooding. Cyclone Yasi then struck the town of Cardwell (in February 2011) destroying their historical museum and recording equipment. We delivered an 'emergency workshop', offering participants hands on use of the equipment, ethical and interviewing theory, so that the community could start to build a new collection. We included oral history workshops as well as sessions on how best to use a video camera, digital camera and creative writing sessions, so the community would also know how to make 'products' or exhibition pieces out of the interviews they were recording. We returned six months later to conduct follow-up workshops and the material produced by and with the community had been amazing. More funding has now been secured to replicate audio/visual/writing workshops in other remote rural Queensland communities including Townsville, Mackay and Cunnamulla and Toowoomba in 2012, highlighting the need for a multi media approach, to leverage the most out of OH interviews as a mechanism to restore and promote community resilience and pride.