Linking ambulance, emergency department and hospital admissions data : understanding the emergency journey

Objective: to assess the accuracy of data linkage across the spectrum of emergency care in the absence of a unique patient identifier, and to use the linked data to examine service delivery outcomes in an emergency department setting. Design: automated data linkage and manual data linkage were compared to determine their relative accuracy. Data were extracted from three separate health information systems: ambulance, ED and hospital inpatients, then linked to provide information about the emergency journey of each patient. The linking was done manually through physical review of records and automatically using a data linking tool (Health Data Integration) developed by the CSIRO. Match rate and quality of the linking were compared. Setting: 10, 835 patient presentations to a large, regional teaching hospital ED over a two month period (August-September 2007). Results: comparison of the manual and automated linkage outcomes for each pair of linked datasets demonstrated a sensitivity of between 95% and 99%; a specificity of between 75% and 99%; and a positive predictive value of between 88% and 95%. Conclusions: Our results indicate that automated linking provides a sound basis for health service analysis, even in the absence of a unique patient identifier. The use of an automated linking tool yields accurate data suitable for planning and service delivery purposes and enables the data to be linked regularly to examine service delivery outcomes.

Policy into practice : adoption of hazard mitigation measures by local government in Queensland : a collaborative research project between Queensland University of Technology and Emergency Management Queensland in association with Local Government of Queensland Disaster Management Alliance

The focus of the present research was to investigate how Local Governments in Queensland were progressing with the adoption of delineated DM policies and supporting guidelines. The study consulted Local Government representatives and hence, the results reflect their views on these issues. Is adoption occurring? To what degree? Are policies and guidelines being effectively implemented so that the objective of a safer, more resilient community is being achieved? If not, what are the current barriers to achieving this, and can recommendations be made to overcome these barriers? These questions defined the basis on which the present study was designed and the survey tools developed. While it was recognised that LGAQ and Emergency Management Queensland (EMQ) may have differing views on some reported issues, it was beyond the scope of the present study to canvass those views. The study resolved to document and analyse these questions under the broad themes of: • Building community capacity (notably via community awareness). • Council operationalisation of DM. • Regional partnerships (in mitigation/adaptation). Data was collected via a survey tool comprising two components: • An online questionnaire survey distributed via the LGAQ Disaster Management Alliance (hereafter referred to as the “Alliance”) to DM sections of all Queensland Local Government Councils; and • a series of focus groups with selected Queensland Councils

Generation of profluorescent isoindoline nitroxides using click chemistry

Novel profluorescent nitroxides bearing a triazole linker between the coumarin fluorophore and an isoindoline nitroxide were prepared in good yields using the coppercatalyzed azide�alkyne 1,3-dipolar cycloaddition reaction (CuAAC). Nitroxides containing 7-hydroxy and 7-diethylamino substitution on their coumarin rings displayed significant fluorescence suppression, and upon reaction with methyl radicals, normal fluorescence emission was returned. The fluorescence emission for the 7-hydroxycoumarin nitroxide and its diamagnetic analogue was found to be strongly influenced by pH with maximal fluorescence emission achieved in basic solution. Solvent polarity was also shown to affect fluorescence emission. The significant difference in fluorescence output between the nitroxides and their corresponding diamagnetic analogues makes these compounds ideal tools for monitoring processes involving free-radical species.

Empirical minimization

We investigate the behavior of the empirical minimization algorithm using various methods. We first analyze it by comparing the empirical, random, structure and the original one on the class, either in an additive sense, via the uniform law of large numbers, or in a multiplicative sense, using isomorphic coordinate projections. We then show that a direct analysis of the empirical minimization algorithm yields a significantly better bound, and that the estimates we obtain are essentially sharp. The method of proof we use is based on Talagrand’s concentration inequality for empirical processes.

Implicit online learning

Online learning algorithms have recently risen to prominence due to their strong theoretical guarantees and an increasing number of practical applications for large-scale data analysis problems. In this paper, we analyze a class of online learning algorithms based on fixed potentials and nonlinearized losses, which yields algorithms with implicit update rules. We show how to efficiently compute these updates, and we prove regret bounds for the algorithms. We apply our formulation to several special cases where our approach has benefits over existing online learning methods. In particular, we provide improved algorithms and bounds for the online metric learning problem, and show improved robustness for online linear prediction problems. Results over a variety of data sets demonstrate the advantages of our framework.

Active Notch1 confers a transformed phenotype to primary human melanocytes

The importance of mitogen-activated protein kinase signaling in melanoma is underscored by the prevalence of activating mutations in N-Ras and B-Raf, yet clinical development of inhibitors of this pathway has been largely ineffective, suggesting that alternative oncogenes may also promote melanoma. Notch is an interesting candidate that has only been correlated with melanoma development and progression; a thorough assessment of tumor-initiating effects of activated Notch on human melanocytes would clarify the mounting correlative evidence and perhaps identify a novel target for an otherwise untreatable disease. Analysis of a substantial panel of cell lines and patient lesions showed that Notch activity is significantly higher in melanomas than their nontransformed counterparts. The use of a constitutively active, truncated Notch transgene construct (N(IC)) was exploited to determine if Notch activation is a "driving" event in melanocytic transformation or instead a "passenger" event associated with melanoma progression. N(IC)-infected melanocytes displayed increased proliferative capacity and biological features more reminiscent of melanoma, such as dysregulated cell adhesion and migration. Gene expression analyses supported these observations and aided in the identification of MCAM, an adhesion molecule associated with acquisition of the malignant phenotype, as a direct target of Notch transactivation. N(IC)-positive melanocytes grew at clonal density, proliferated in limiting media conditions, and also exhibited anchorage-independent growth, suggesting that Notch alone is a transforming oncogene in human melanocytes, a phenomenon not previously described for any melanoma oncogene. This new information yields valuable insight into the basic epidemiology of melanoma and launches a realm of possibilities for drug intervention in this deadly disease.

Nitrone [2]rotaxanes: Simultaneous chemical protection and electrochemical activation of a functional group

We report on the use of the hydrogen bond accepting properties of neutral nitrone moieties to prepare benzylic-amide-macrocycle-containing [2]rotaxanes in yields as high as 70 %. X-Ray crystallography shows the presence of up to four intercomponent hydrogen bonds between the amide groups of the macrocycle and the two nitrone groups of the thread. Dynamic 1H NMR studies of the rates of macrocycle pirouetting in nonpolar solutions indicate that amide-nitrone hydrogen bonds are particularly strong, ~1.3 and ~0.2 kcal mol-1 stronger than similar amide-ester and amide-amide interactions, respectively. In addition to polarizing the N-O bond through hydrogen bonding, the rotaxane structure affects the chemistry of the nitrone groups in two significant ways: The intercomponent hydrogen bonding activates the nitrone groups to electrochemical reduction, a one electron reduction of the rotaxane being stablized by a remarkable 400 mV (8.1 kcal mol-1) with respect to the same process in the thread; encapsulation, however, protects the same functional groups from chemical reduction with an external reagent (and slows down electron transfer to and from the electroactive groups in cyclicvoltammetry experiments). Mechanical interlocking with a hydrogen bonding molecular sheath thus provides a route to an encapsulated polarized functional group and radical anions of significant kinetic and thermodynamic stability.

Digit recognition using trispectral features

Features derived from the trispectra of DFT magnitude slices are used for multi-font digit recognition. These features are insensitive to translation, rotation, or scaling of the input. They are also robust to noise. Classification accuracy tests were conducted on a common data base of 256× 256 pixel bilevel images of digits in 9 fonts. Randomly rotated and translated noisy versions were used for training and testing. The results indicate that the trispectral features are better than moment invariants and affine moment invariants. They achieve a classification accuracy of 95% compared to about 81% for Hu's (1962) moment invariants and 39% for the Flusser and Suk (1994) affine moment invariants on the same data in the presence of 1% impulse noise using a 1-NN classifier. For comparison, a multilayer perceptron with no normalization for rotations and translations yields 34% accuracy on 16× 16 pixel low-pass filtered and decimated versions of the same data.

New variational Bayesian approaches for statistical data mining : with applications to profiling and differentiating habitual consumption behaviour of customers in the wireless telecommunication industry

This thesis investigates profiling and differentiating customers through the use of statistical data mining techniques. The business application of our work centres on examining individuals’ seldomly studied yet critical consumption behaviour over an extensive time period within the context of the wireless telecommunication industry; consumption behaviour (as oppose to purchasing behaviour) is behaviour that has been performed so frequently that it become habitual and involves minimal intentions or decision making. Key variables investigated are the activity initialised timestamp and cell tower location as well as the activity type and usage quantity (e.g., voice call with duration in seconds); and the research focuses are on customers’ spatial and temporal usage behaviour. The main methodological emphasis is on the development of clustering models based on Gaussian mixture models (GMMs) which are fitted with the use of the recently developed variational Bayesian (VB) method. VB is an efficient deterministic alternative to the popular but computationally demandingMarkov chainMonte Carlo (MCMC) methods. The standard VBGMMalgorithm is extended by allowing component splitting such that it is robust to initial parameter choices and can automatically and efficiently determine the number of components. The new algorithm we propose allows more effective modelling of individuals’ highly heterogeneous and spiky spatial usage behaviour, or more generally human mobility patterns; the term spiky describes data patterns with large areas of low probability mixed with small areas of high probability. Customers are then characterised and segmented based on the fitted GMM which corresponds to how each of them uses the products/services spatially in their daily lives; this is essentially their likely lifestyle and occupational traits. Other significant research contributions include fitting GMMs using VB to circular data i.e., the temporal usage behaviour, and developing clustering algorithms suitable for high dimensional data based on the use of VB-GMM.

Managing the project learning paradox : a set-theoretic approach toward project knowledge transfer

Managing project-based learning is becoming an increasingly important part of project management. This article presents a comparative case study of 12 cases of knowledge transfer between temporary inter-organizational projects and permanent parent organizations. Our set-theoretic analysis of these data yields two major findings. First, a high level of absorptive capacity of the project owner is a necessary condition for successful project knowledge transfer, which implies that the responsibility for knowledge transfer seems to in the first place lie with the project parent organization, not with the project manager. Second, none of the factors are sufficient by themselves. This implies that successful project knowledge transfer is a complex process always involving configurations of multiple factors. We link these implications with the view of projects as complex temporary organizational forms in which successful project managers need to cope with complexity by simultaneously paying attention to both relational and organizational processes.

A 'click approach' to the generation of novel profluorescent nitroxides

This project focused on the first application of the copper catalyzed azide alkyne cycloaddition reaction for the generation of novel profluorescent systems. Through this approach four novel profluorescent nitroxides were prepared both rapidly and in good yield from coumarin and nitroxide CuAAC coupling partners. Specifically, 7-hydroxy, 7-diethylamino, 6-bromo and unsubstituted coumarin analogues bearing an azide group in the 3-position were prepared and conjugatively joined to an alkyne isoindoline nitroxide previously reported by our group. To explore the impact of the nitroxide moiety on the fluorescence of these systems, methoxyamine analogues of the corresponding nitroxide analogues were prepared. Spectrophotometric analysis of these methoxyamine analogues revealed that the aromatic systems possessed high quantum yields. However, the quantum yield efficiency was found to be dependent on the presence of electron donating substituents in the 7-position of the coumarin motif, which enhanced the charge-transfer character of the system. Furthermore, spectrophotometric analysis of nitroxide analogues demonstrated that the triazole effectively mediated fluorophore-nitroxide communication, as evidenced by the low quantum yield values of the nitroxide analogues. These results suggest that this technique can be used to conjugatively join any azide bearing fluorescent system with the key alkyne isoindoline coupling partner allowing for the rapid generation of diverse profluorescent systems.

Corporate governance mechanisms and earnings management in transitional countries – evidence from Chinese listed firms

The objective of this thesis is to investigate whether the corporate governance practices adopted by Chinese listed firms are associated with the quality of earnings information. Based on a review of agency and institutional theory, this study develops hypotheses that predict the monitoring effectiveness of the board and the audit committee. Using a combination of univariate and multivariate analyses, the association between corporate governance mechanisms and earnings management are tested from 2004 to 2008. Through analysing the empirical results, a number of findings are summarised as below. First, board independence is weakened by the introduction of government officials as independent directors on the boards. Government officials acting as independent directors, claim that they meet the definition of independent director set by the regulation. However, they have some connection with the State, which is the controlling shareholder in listed SOEs affiliated companies. Consequently, the effect of the independent director’s expertise in constraining earnings management is mitigated as demonstrated by an insignificant association between board expertise and earnings management. An alternative explanation for the inefficiency of board independence may point to the pre-selection of independent directors by the powerful CEO. It is argued that a CEO can manipulate the board composition and choose the "desirable" independent directors to monitor themselves. Second, a number of internal mechanisms, such as board size, board activities, and the separation of the roles of the CEO and chair are found to be significantly associated with discretionary accruals. This result suggests that there are advantages in having a large and active board in the Chinese setting. This can offset the disadvantages associated with large boards, such as increased bureaucracy, and hence, increase the constraining effects of a large and resourceful board. Third, factor analysis identifies two factors: CEO power and board power. CEO power is the factor which consists of CEO duality and turnover, and board power is composed of board size and board activity. The results of CEO power show that if a Chinese listed company has CEO duality and turnover at the same time, it is more likely to have a high level of earnings management. The significant and negative relationship between board power and accruals indicate that large boards with frequent meetings can be associated with low level of earnings management. Overall, the factor analysis suggests that certain governance mechanisms complement each other to become more efficient monitors of opportunistic earnings management. A combination of board characteristics can increase the negative association with earnings management. Fourth, the insignificant results between audit committees and earnings management in Chinese listed firms suggests that the Chinese regulator should strengthen the audit committee functions. This thesis calls for listed firms to disclose more information on audit committee composition and activities, which can facilitate future research on the Chinese audit committee’s monitoring role. Fifth, the interactive results between State ownership and board characteristics show that dominant State ownership has a moderating effect on board monitoring power as the State totally controls 42% of the issued shares. The high percentage of State ownership makes it difficult for the non-controlling institutional shareholders to challenge the State’s dominant status. As a result, the association between non-controlling institutional ownership and earnings management is insignificant in most situations. Lastly, firms audited by the international Big4 have lower abnormal accruals than firms audited by domestic Chinese audit firms. In addition, the inverse U-shape relationship between audit tenure and earnings quality demonstrates the changing effects of audit quality after a certain period of appointment. Furthermore, this thesis finds that listing in Hong Kong Stock Exchanges can be an alternative governance mechanism to discipline Chinese firms to follow strict Hong Kong listing requirements. Management of Hong Kong listed companies are exposed to the scrutiny of international investors and Hong Kong regulators. This in turn reduces their chances of conducting self-interested earnings manipulation. This study is designed to fill the gap in governance literature in China that is related to earnings management. Previous research on corporate governance mechanisms and earnings management in China is not conclusive. The current research builds on previous literature and provides some meaningful implications for practitioners, regulators, academic, and international investors who have investment interests in a transitional country. The findings of this study contribute to corporate governance and earnings management literature in the context of the transitional economy of China. The use of alternative measures for earnings management yields similar results compared with the accruals models and produces additional findings.

Validating the is-impact model in the Malaysian public sector

This research is one of several ongoing studies conducted within the IT Professional Services (ITPS) research programme at Queensland University of Technology (QUT). In 2003, ITPS introduced the IS-Impact model, a measurement model for measuring information systems success from the viewpoint of multiple stakeholders. The model, along with its instrument, is robust, simple, yet generalisable, and yields results that are comparable across time, stakeholders, different systems and system contexts. The IS-Impact model is defined as “a measure at a point in time, of the stream of net benefits from the Information System (IS), to date and anticipated, as perceived by all key-user-groups”. The model represents four dimensions, which are ‘Individual Impact’, ‘Organizational Impact’, ‘Information Quality’ and ‘System Quality’. The two Impact dimensions measure the up-to-date impact of the evaluated system, while the remaining two Quality dimensions act as proxies for probable future impacts (Gable, Sedera & Chan, 2008). To fulfil the goal of ITPS, “to develop the most widely employed model” this research re-validates and extends the IS-Impact model in a new context. This method/context-extension research aims to test the generalisability of the model by addressing known limitations of the model. One of the limitations of the model relates to the extent of external validity of the model. In order to gain wide acceptance, a model should be consistent and work well in different contexts. The IS-Impact model, however, was only validated in the Australian context, and packaged software was chosen as the IS understudy. Thus, this study is concerned with whether the model can be applied in another different context. Aiming for a robust and standardised measurement model that can be used across different contexts, this research re-validates and extends the IS-Impact model and its instrument to public sector organisations in Malaysia. The overarching research question (managerial question) of this research is “How can public sector organisations in Malaysia measure the impact of information systems systematically and effectively?” With two main objectives, the managerial question is broken down into two specific research questions. The first research question addresses the applicability (relevance) of the dimensions and measures of the IS-Impact model in the Malaysian context. Moreover, this research question addresses the completeness of the model in the new context. Initially, this research assumes that the dimensions and measures of the IS-Impact model are sufficient for the new context. However, some IS researchers suggest that the selection of measures needs to be done purposely for different contextual settings (DeLone & McLean, 1992, Rai, Lang & Welker, 2002). Thus, the first research question is as follows, “Is the IS-Impact model complete for measuring the impact of IS in Malaysian public sector organisations?” [RQ1]. The IS-Impact model is a multidimensional model that consists of four dimensions or constructs. Each dimension is represented by formative measures or indicators. Formative measures are known as composite variables because these measures make up or form the construct, or, in this case, the dimension in the IS-Impact model. These formative measures define different aspects of the dimension, thus, a measurement model of this kind needs to be tested not just on the structural relationship between the constructs but also the validity of each measure. In a previous study, the IS-Impact model was validated using formative validation techniques, as proposed in the literature (i.e., Diamantopoulos and Winklhofer, 2001, Diamantopoulos and Siguaw, 2006, Petter, Straub and Rai, 2007). However, there is potential for improving the validation testing of the model by adding more criterion or dependent variables. This includes identifying a consequence of the IS-Impact construct for the purpose of validation. Moreover, a different approach is employed in this research, whereby the validity of the model is tested using the Partial Least Squares (PLS) method, a component-based structural equation modelling (SEM) technique. Thus, the second research question addresses the construct validation of the IS-Impact model; “Is the IS-Impact model valid as a multidimensional formative construct?” [RQ2]. This study employs two rounds of surveys, each having a different and specific aim. The first is qualitative and exploratory, aiming to investigate the applicability and sufficiency of the IS-Impact dimensions and measures in the new context. This survey was conducted in a state government in Malaysia. A total of 77 valid responses were received, yielding 278 impact statements. The results from the qualitative analysis demonstrate the applicability of most of the IS-Impact measures. The analysis also shows a significant new measure having emerged from the context. This new measure was added as one of the System Quality measures. The second survey is a quantitative survey that aims to operationalise the measures identified from the qualitative analysis and rigorously validate the model. This survey was conducted in four state governments (including the state government that was involved in the first survey). A total of 254 valid responses were used in the data analysis. Data was analysed using structural equation modelling techniques, following the guidelines for formative construct validation, to test the validity and reliability of the constructs in the model. This study is the first research that extends the complete IS-Impact model in a new context that is different in terms of nationality, language and the type of information system (IS). The main contribution of this research is to present a comprehensive, up-to-date IS-Impact model, which has been validated in the new context. The study has accomplished its purpose of testing the generalisability of the IS-Impact model and continuing the IS evaluation research by extending it in the Malaysian context. A further contribution is a validated Malaysian language IS-Impact measurement instrument. It is hoped that the validated Malaysian IS-Impact instrument will encourage related IS research in Malaysia, and that the demonstrated model validity and generalisability will encourage a cumulative tradition of research previously not possible. The study entailed several methodological improvements on prior work, including: (1) new criterion measures for the overall IS-Impact construct employed in ‘identification through measurement relations’; (2) a stronger, multi-item ‘Satisfaction’ construct, employed in ‘identification through structural relations’; (3) an alternative version of the main survey instrument in which items are randomized (rather than blocked) for comparison with the main survey data, in attention to possible common method variance (no significant differences between these two survey instruments were observed); (4) demonstrates a validation process of formative indexes of a multidimensional, second-order construct (existing examples mostly involved unidimensional constructs); (5) testing the presence of suppressor effects that influence the significance of some measures and dimensions in the model; and (6) demonstrates the effect of an imbalanced number of measures within a construct to the contribution power of each dimension in a multidimensional model.

Catalytic properties of 26 S and 20 S proteasomes and radiolabeling of MB1, LMP7, and C7 subunits associated with trypsin-like and chymotrypsin-like activities*

20 and 26 S proteasomes were isolated from rat liver. The procedure developed for the 26 S proteasome resulted in greatly improved yields compared with previously published methods. A comparison of the kinetic properties of 20 and 26 S proteasomes showed significant differences in the kinetic characteristics with certain substrates and differences in the effects of a protein substrate on peptidase activity. Observed differences in the kinetics of peptidylglutamyl peptide hydrolase activity suggest that the 26 S complex cannot undergo the conformational changes of 20 S proteasomes at high concentrations of the substrate benzyloxycarbonyl (Z) -Leu-Leu-Glu-b-naphthylamide. Various inhibitors that differentially affect the trypsin-like and chymotrypsin-like activities have been identified. Ala-Ala-Phe-chloromethyl (CH2Cl) inhibits chymotrypsin-like activity assayed with succinyl (Suc) -Leu-Leu-Val-Tyr-AMC, but surprisingly not hydrolysis of Ala-Ala-Phe-7-amido-4-methylcoumarin (AMC). Tyr-Gly-Arg-CH2Cl inhibits Suc-Leu-Leu-Val-Tyr-AMC hydrolysis as well as trypsinlike activity measured with t-butoxycarbonyl (Boc) -Leu-Ser-Thr-Arg-AMC, while Z-Phe-Gly-Tyr-diazomethyl (CHN2) was found to inhibit only the two chymotrypsin- like activities. Radiolabeled forms of peptidyl chloromethane and peptidyl diazomethane inhibitors, [3H]acetyl-Ala-Ala-Phe-CH2Cl, [3H]acetyland radioiodinated Tyr-Gly-Arg-CH2Cl, and Z-Phe-Gly- Tyr-(125I-CHN2), have been used to identify catalytic components associated with each of the three peptidase activities. In each case, incorporation of the label could be blocked by prior treatment of the proteasomes with known active site-directed inhibitors, calpain inhibitor 1 or 3,4-dichloroisocoumarin. Subunits of labeled proteasomes were separated either by reverse phase-HPLC and SDS-polyacrylamide gel electrophoresis or by twodimensional polyacrylamide gel electrophoresis followed by autoradiography/fluorography and immunoblotting with subunit-specific antibodies. In each case, label was found to be incorporated into subunits C7, MB1, and LMP7 but in different relative amounts depending on the inhibitor used, consistent with the observed effects on the different peptidase activities. The results strongly suggest a relationship between trypsin-like activity and chymotrypsin-like activity. They also help to relate the different subunits of the complex to the assayed multicatalytic endopeptidase activities

Pyrolysis of coconut shell for bio-oil

The conversion of coconut shell into pyrolytic oil by fixed bed fire-tube heating reactor has been taken into consideration in this study. The major components of the system were fixed bed fire-tube heating reactor, liquid condenser and collectors. The raw and crushed tamarind seed in particle form was pyrolized in an electrically heated 10 cm diameter and 27 cm high fixed bed reactor. The products are oil, char and gases. The parameters varied were reactor bed temperature, running time, gas flow rate and feed particle size. The parameters were found to influence the product yields significantly. The maximum liquid yield was 34.3 wt% at 4500C for a feed size of 0.6mm at a gas flow rate of 6 liter/min with a running time of minute. The pyrolysis oil was obtained at these optimum process conditions were analyzed for physical and chemical properties to be used as an alternative fuel.