Designing an information accountability framework for eHealth

Information privacy is a crucial aspect of eHealth. Appropriate privacy management measures are therefore essential for its success. However, traditional measures for privacy preservation such as rigid access controls (i.e., preventive measures) are not suitable to eHealth because of the specialised and information - intensive nature of healthcare itself, and the nature of the information. Healthcare professionals (HCP) require easy, unrestricted access to as much information as possible towards making well - informed decisions. On the other end of the scale however, consumers (i.e., patients) demand control over their health information and raise concerns for privacy arising from internal activities (i.e., information use by HCPs). A proper balance of these competing concerns is vital for the implementation of successful eHealth systems. Towards reaching this balance, we propose an information accountability framework (IAF) for eHealth systems.

Safety culture in supply chains : 'Customer is king'

Despite the presence of many regulations governing the operation of heavy vehicles and supply chains in Australia, the truck driving sector continues to have the highest incidence of fatal injuries compared to all other industries. The working environment has been the focus of attention by safety researchers during the past few decades, with particular consideration been given to the concept ‘safety culture’ and how to maintain, modify and advance responses to occupational risk. One important aspect of the heavy industry which sets it apart is the existence of cultural or sub-cultural influences at an industry wide and occupation-specific level rather than organisational level. This paper reports on the findings of stakeholder’s perceptions of the influences of power and control, and culture on industry safety. In-depth structured interviews were conducted during 2011 with Australian industry stakeholders (n=31). The questioning surrounded decision-making processes with regards to identifying risks, self-monitoring and reducing risky activities; as well as how power-affected relationships may influence the operational performance of supply chains and impacts on driver safety. One of the most significant findings from these interviews relates to the notion of power. The perception that the ‘Customer is King’ was widely viewed, with the majority of stakeholders believing that there exists a ‘master slave mentality’ in the industry. There appears to be great frustration in the industry as to the apparent immunity of customers (particularly retail supply chains) to their responsibilities. There was also a strong perception that the customer holds the balance of power by covertly employing remuneration-related incentives and pressures. Smaller trucking companies are perceived as being more vulnerable to the pressure of customer expectations.

Decision-making about hormone replacement therapy by women in England and Scotland

OBJECTIVE: The aim of this study was to explore women's decision-making about the balance of risks and benefits of taking hormone replacement therapy (HRT) based on the latest evidence from the Women's Health Initiative (WHI) trial of combined HRT. METHODS: Women aged 50-69 years, who were eligible for the Women's International Study of long Duration Oestrogen after Menopause (WISDOM) trial, were invited to participate in one of eight focus groups. Participants were asked to discuss their views about taking HRT based on the latest international evidence. RESULTS AND CONCLUSIONS: Eighty-two women participated overall. Qualitative content analysis was applied to the discussion transcripts. Women regarded the decisions they make about taking HRT as highly personal, and, for women currently taking HRT, the overwhelming reason for continuation was perceived improvement in quality of life regardless of either the risks or the benefits in the longer term.

Combined electrophoretic deposition–anodization method to fabricate reduced graphene oxide–TiO2 nanotube films

We directly constructed reduced graphene oxide–titanium oxide nanotube (RGO–TNT) film using a single-step, combined electrophoretic deposition–anodization (CEPDA) method. This method, based on the simultaneous anodic growth of tubular TiO2 and the electrophoretic-driven motion of RGO, allowed the formation of an effective interface between the two components, thus improving the electron transfer kinetics. Composites of these graphitic carbons with different levels of oxygen-containing groups, electron conductivity and interface reaction time were investigated; a fine balance of these parameters was achieved.

Developing and sustaining successful mentoring relationships

As mentor teachers hold the balance of power in the relationship, how do they build and sustain positive mentor-mentee relationships? This study involved eleven pairs of mentors and mentees (n=22) with audio-recorded interviews to explore their relationships, mentors’ support and mentors’ expectations for mentees’ involvement in the school. Findings suggested ways to build and sustain mentoring relationships (e.g., professionalism, respect, and support). Indeed, support in providing information for planning, access to resources, two-way dialoguing with feedback and reflections, and establishing safe, risk-taking environments to trial and evaluate newly-learnt teaching practices were considered as a ways to build and sustain relationships.

What the plaintiff would have done in informed consent cases

Both at common law and under the various civil liability acts, in deciding liability for breach of duty, the plaintiff always bears the onus of proving, on the balance of probabilities, any fact relevant to the issue of causation. For plaintiffs in medical negligence claims founded on negligent failure to provide sufficient information (informed consent cases), this onus involves persuading the court to make a favourable determination as to what a particular patient would have done (from a subjective perspective) in the hypothetical situation of the defendant not being negligent (that is, in the event that the medical practitioner had provided sufficient information to the patient)

Accountable-eHealth systems : the next step forward for privacy

eHealth systems promise enviable benefits and capabilities for healthcare delivery. However, the technologies that make these capabilities possible introduce undesirable drawbacks such as information security related threats, which need to be appropriately addressed. Lurking in these threats are information privacy concerns. Addressing them has proven to be difficult because they often conflict with information access requirements of healthcare providers. Therefore, it is important to achieve an appropriate balance between these requirements. We contend that information accountability (IA) can achieve this balance. In this paper, we introduce accountable-eHealth (AeH) systems, which are eHealth systems that utilise IA as a measure of information privacy. We discuss how AeH system protocols can successfully achieve the aforementioned balance of requirements. As a means of implementation feasibility, we compare characteristics of AeH systems with Australia’s Personally Controlled Electronic Health Record (PCEHR) sys-tem and identify similarities and highlight the differences and the impact those differences would have to the eHealth domain.

Getting published — and cited in entrepreneurship : reflections on ten papers

I grew up in academic heaven. At least for me it was. Not only was Sweden in the late 1980s paradise for any kind of empirical research, with rich and high-quality business statistics being made available to researchers without them having to sign away their lives; 70+ percent response rates achieved in mail surveys to almost any group (if you knew how to do them), and boards of directors opening their doors to more qualitatively orientated researchers to sit in during their meetings. In addition, I perceived an environment with a very high degree of academic freedom, letting me do whatever I found interesting and important. I’m sure for others it was sheer hell, with very unclear career paths and rules of the game. Career progression (something which rarely entered my mind) meant that you tried as best you could and then you put all your work – reports, books, book chapters, conference papers, maybe even published articles – in a box and had some external committee of professors look at it. If you were lucky they liked what they saw for whatever reasons their professorial wisdom dictated, and you got hired or promoted. If you were not so lucky you wouldn’t get the job or the promotion, without quite knowing why. So people could easily imagine an old boys club – whose members were themselves largely unproven in international, peer review publishing – picking whoever they wanted by whatever criteria they choose to apply. Neither the fact that assessors were external nor the presence of an appeals system might have completely appeased your suspicious and skeptical mind, considering the balance of power.

Cardiac parasympathetic reactivation following exercise : implications for training prescription

The objective of exercise training is to initiate desirable physiological adaptations that ultimately enhance physical work capacity. Optimal training prescription requires an individualized approach, with an appropriate balance of training stimulus and recovery and optimal periodization. Recovery from exercise involves integrated physiological responses. The cardiovascular system plays a fundamental role in facilitating many of these responses, including thermoregulation and delivery/removal of nutrients and waste products. As a marker of cardiovascular recovery, cardiac parasympathetic reactivation following a training session is highly individualized. It appears to parallel the acute/intermediate recovery of the thermoregulatory and vascular systems, as described by the supercompensation theory. The physiological mechanisms underlying cardiac parasympathetic reactivation are not completely understood. However, changes in cardiac autonomic activity may provide a proxy measure of the changes in autonomic input into organs and (by default) the blood flow requirements to restore homeostasis. Metaboreflex stimulation (e.g. muscle and blood acidosis) is likely a key determinant of parasympathetic reactivation in the short term (0–90 min post-exercise), whereas baroreflex stimulation (e.g. exercise-induced changes in plasma volume) probably mediates parasympathetic reactivation in the intermediate term (1–48 h post-exercise). Cardiac parasympathetic reactivation does not appear to coincide with the recovery of all physiological systems (e.g. energy stores or the neuromuscular system). However, this may reflect the limited data currently available on parasympathetic reactivation following strength/resistance-based exercise of variable intensity. In this review, we quantitatively analyse post-exercise cardiac parasympathetic reactivation in athletes and healthy individuals following aerobic exercise, with respect to exercise intensity and duration, and fitness/training status. Our results demonstrate that the time required for complete cardiac autonomic recovery after a single aerobic-based training session is up to 24 h following low-intensity exercise, 24–48 h following threshold-intensity exercise and at least 48 h following high-intensity exercise. Based on limited data, exercise duration is unlikely to be the greatest determinant of cardiac parasympathetic reactivation. Cardiac autonomic recovery occurs more rapidly in individuals with greater aerobic fitness. Our data lend support to the concept that in conjunction with daily training logs, data on cardiac parasympathetic activity are useful for individualizing training programmes. In the final sections of this review, we provide recommendations for structuring training microcycles with reference to cardiac parasympathetic recovery kinetics. Ultimately, coaches should structure training programmes tailored to the unique recovery kinetics of each individual.

Privacy oriented access control for electronic health records

Information privacy is a critical success/failure factor in information technology supported healthcare (eHealth). eHealth systems utilise electronic health records (EHR) as the main source of information, thus, implementing appropriate privacy preserving methods for EHRs is vital for the proliferation of eHealth. Whilst information privacy may be a fundamental requirement for eHealth consumers, healthcare professionals demand non-restricted access to patient information for improved healthcare delivery, thus, creating an environment where stakeholder requirements are contradictory. Therefore, there is a need to achieve an appropriate balance of requirements in order to build successful eHealth systems. Towards achieving this balance, a new genre of eHealth systems called Accountable-eHealth (AeH) systems has been proposed. In this paper, an access control model for EHRs is presented that can be utilised by AeH systems to create information usage policies that fulfil both stakeholders’ requirements. These policies are used to accomplish the aforementioned balance of requirements creating a satisfactory eHealth environment for all stakeholders. The access control model is validated using a Web based prototype as a proof of concept.

Effective punishment experiences : the need for a more comprehensive approach to conceptualising behavioural punishers and reinforcers in a road safety context

Determining what consequences are likely to serve as effective punishment for any given behaviour is a complex task. This chapter focuses specifically on illegal road user behaviours and the mechanisms used to punish and deter them. Traffic law enforcement has traditionally used the threat and/or receipt of legal sanctions and penalties to deter illegal and risky behaviours. This process represents the use of positive punishment, one of the key behaviour modification mechanisms. Behaviour modification principles describe four types of reinforcers: positive and negative punishments and positive and negative reinforcements. The terms ‘positive’ and ‘negative’ are not used in an evaluative sense here. Rather, they represent the presence (positive) or absence (negative) of stimuli to promote behaviour change. Punishments aim to inhibit behaviour and reinforcements aim to encourage it. This chapter describes a variety of punishments and reinforcements that have been and could be used to modify illegal road user behaviours. In doing so, it draws on several theoretical perspectives that have defined behavioural reinforcement and punishment in different ways. Historically, the main theoretical approach used to deter risky road use has been classical deterrence theory which has focussed on the perceived certainty, severity and swiftness of penalties. Stafford and Warr (1993) extended the traditional deterrence principles to include the positive reinforcement concept of punishment avoidance. Evidence of the association between punishment avoidance experiences and behaviour has been established for a number of risky road user behaviours including drink driving, unlicensed driving, and speeding. We chose a novel way of assessing punishment avoidance by specifying two sub-constructs (detection evasion and punishment evasion). Another theorist, Akers, described the idea of competing reinforcers, termed differential reinforcement, within social learning theory (1977). Differential reinforcement describes a balance of reinforcements and punishments as influential on behaviour. This chapter describes comprehensive way of conceptualising a broad range of reinforcement and punishment concepts, consistent with Akers’ differential reinforcement concept, within a behaviour modification framework that incorporates deterrence principles. The efficacy of three theoretical perspectives to explain self-reported speeding among a sample of 833 Australian car drivers was examined. Results demonstrated that a broad range of variables predicted speeding including personal experiences of evading detection and punishment for speeding, intrinsic sensations, practical benefits expected from speeding, and an absence of punishing effects from being caught. Not surprisingly, being younger was also significantly related to more frequent speeding, although in a regression analysis, gender did not retain a significant influence once all punishment and reinforcement variables were entered. The implications for speed management, as well as road user behaviour modification more generally, are discussed in light of these findings. Overall, the findings reported in this chapter suggest that a more comprehensive approach is required to manage the behaviour of road users which does not rely solely on traditional legal penalties and sanctions.

Towards fairer assessment

Drawing on the largest Australian collection and analysis of empirical data on multiple facets of Aboriginal and Torres Strait Islander education in state schools to date, this article critically analyses the systemic push for standardized testing and improved scores, and argues for a greater balance of assessment types by providing alternative, inclusive, participatory approaches to student assessment. The evidence for this article derives from a major evaluation of the Stronger Smarter Learning Communities. The first large-scale picture of what is occurring in classroom assessment and pedagogy for Indigenous students is reported in this evaluation yet the focus in this article remains on the issue of fairness in student assessment. The argument presented calls for “a good balance between formative and summative assessment” (OECD, Synergies for Better Learning An International Perspective on Evaluation and Assessment, Pointers for Policy Development, 2013) at a time of unrelenting high-stakes, standardized testing in Australia with a dominance of secondary as opposed to primary uses of NAPLAN data by systems, schools and principals. A case for more “intelligent accountability in education” (O’Neill, Oxford Review of Education 39(1):4–16, 2013) together with a framework for analyzing efforts toward social justice in education (Cazden, International Journal of Educational Psychology 1(3):178–198, 2012) and fairer assessment make the case for more alternative assessment practices in recognition of the need for teachers’ pedagogic practice to cater for increased diversity.

Analysing governance categories used on project alliances in the construction industry

In Australia, collaborative contracts, and in particular, project alliances, have been increasingly used to govern infrastructure projects. These contracts use formal and informal governance mechanisms to manage the delivery of infrastructure projects. Formal mechanisms such as financial risk sharing are specified in the contract, while informal mechanisms such as integrated teams are not. Given that the literature contains a multiplicity of often untestable definitions, this paper reports on a review of the literature to operationalize the concepts of formal and informal governance. This work is the first phase of a study that will examine the optimal balance of formal and informal governance structures. Desk-top review of leading journals in the areas of construction management and business management, as well as recent government documents and industry guidelines, was undertaken to to conceptualise and operationalize formal and informal governance mechanisms. The study primarily draws on transaction-cost economics (e.g. Williamson 1979; Williamson 1991), relational contract theory (Feinman 2000; Macneil 2000) and social psychology theory (e.g. Gulati 1995). Content analysis of the literature was undertaken to identify key governance mechanisms. Content analysis is a commonly used methodology in the social sciences area. It provides rich data through the systematic and objective review of literature (Krippendorff 2004). NVivo 9, a qualitative data analysis software package, was used to assist in this process. A previous study by the authors identified that formal governance mechanisms can be classified into seven measurable categories: (1) negotiated cost, (2) competitive cost, (3) commercial framework, (4) risk and reward sharing, (5) qualitative performance, (6) collaborative multi-party agreement, and (7) early contractor involvement. Similarly, informal governance mechanisms can be classified into four measureable categories: (1) leadership structure, (2) integrated team, (3) team workshops, and (4) joint management system. This paper explores and further defines the key operational characteristics of each mechanism category, highlighting its impact on value for money in alliance project delivery. The paper’s contribution is that it provides the basis for future research to compare the impact of a range of individual mechanisms within each category, as a means of improving the performance of construction projects.

Empowerment in nursing : paternalism or maternalism?

The aim of this article is to explore whether patient empowerment flourishes in the wake of current health reforms or if there is a power struggle between nursing and medicine as to what is in the patients' best interest. Shifting the balance of power from healthcare professionals to patients has become a key element of healthcare policy in England. The RCN's definition of nursing places patient empowerment as a central remit of nurses. However, achieving genuine patient empowerment is not easy and requires individuals and organizations to alter their beliefs, values and behaviours. To empower patients nurses must be in a position to share power and this may require a realignment of the traditional power base within health care. Although empowerment is often viewed on a one-to-one level between professionals and patients, for true patient empowerment to occur, issues of power and control must also be addressed at a national and political level.

Knowledge Based Urban Development

The changing and challenging conditions of the 21st century have been significantly impacting our economy, society and built and natural environments. Today generation of knowledge—mostly in the form of technology and innovation—is seen as a panacea for the adaptation to changes and management of challenges (Yigitcanlar, 2010a). Making space and place that concentrate on knowledge generation, thus, has become a priority for many nations (van Winden, 2010). Along with this movement, concepts like knowledge cities and knowledge precincts are coined as places where citizenship undertakes a deliberate and systematic initiative for founding its development on the identification and sustainable balance of its shared value system, and bases its ability to create wealth on its capacity to generate and leverage its knowledge capabilities (Carrillo, 2006; Yigitcanlar, 2008a). In recent years, the term knowledge precinct (Hu & Chang, 2005) in its most contemporary interpretation evolved into knowledge community precinct (KCP). KCP is a mixed-use post-modern urban setting—e.g., flexible, decontextualized, enclaved, fragmented—including a critical mass of knowledge enterprises and advanced networked infrastructures, developed with the aim of collecting the benefits of blurring the boundaries of living, shopping, recreation and working facilities of knowledge workers and their families. KCPs are the critical building blocks of knowledge cities, and thus, building successful KCPs significantly contributes to the formation of prosperous knowledge cities. In the literature this type of development—a place containing economic prosperity, environmental sustainability, just socio‐spatial order and good governance—is referred as knowledge-based urban development (KBUD). This chapter aims to provide a conceptual understanding on KBUD and its contribution to the building of KCPs that supports the formation of prosperous knowledge cities.