Impact of a data warehouse model for improved decision-making process in healthcare

The health system is one sector dealing with a deluge of complex data. Many healthcare organisations struggle to utilise these volumes of health data effectively and efficiently. Also, there are many healthcare organisations, which still have stand-alone systems, not integrated for management of information and decision-making. This shows, there is a need for an effective system to capture, collate and distribute this health data. Therefore, implementing the data warehouse concept in healthcare is potentially one of the solutions to integrate health data. Data warehousing has been used to support business intelligence and decision-making in many other sectors such as the engineering, defence and retail sectors. The research problem that is going to be addressed is, "how can data warehousing assist the decision-making process in healthcare". To address this problem the researcher has narrowed an investigation focusing on a cardiac surgery unit. This research used the cardiac surgery unit at the Prince Charles Hospital (TPCH) as the case study. The cardiac surgery unit at TPCH uses a stand-alone database of patient clinical data, which supports clinical audit, service management and research functions. However, much of the time, the interaction between the cardiac surgery unit information system with other units is minimal. There is a limited and basic two-way interaction with other clinical and administrative databases at TPCH which support decision-making processes. The aims of this research are to investigate what decision-making issues are faced by the healthcare professionals with the current information systems and how decision-making might be improved within this healthcare setting by implementing an aligned data warehouse model or models. As a part of the research the researcher will propose and develop a suitable data warehouse prototype based on the cardiac surgery unit needs and integrating the Intensive Care Unit database, Clinical Costing unit database (Transition II) and Quality and Safety unit database [electronic discharge summary (e-DS)]. The goal is to improve the current decision-making processes. The main objectives of this research are to improve access to integrated clinical and financial data, providing potentially better information for decision-making for both improved from the questionnaire and by referring to the literature, the results indicate a centralised data warehouse model for the cardiac surgery unit at this stage. A centralised data warehouse model addresses current needs and can also be upgraded to an enterprise wide warehouse model or federated data warehouse model as discussed in the many consulted publications. The data warehouse prototype was able to be developed using SAS enterprise data integration studio 4.2 and the data was analysed using SAS enterprise edition 4.3. In the final stage, the data warehouse prototype was evaluated by collecting feedback from the end users. This was achieved by using output created from the data warehouse prototype as examples of the data desired and possible in a data warehouse environment. According to the feedback collected from the end users, implementation of a data warehouse was seen to be a useful tool to inform management options, provide a more complete representation of factors related to a decision scenario and potentially reduce information product development time. However, there are many constraints exist in this research. For example the technical issues such as data incompatibilities, integration of the cardiac surgery database and e-DS database servers and also, Queensland Health information restrictions (Queensland Health information related policies, patient data confidentiality and ethics requirements), limited availability of support from IT technical staff and time restrictions. These factors have influenced the process for the warehouse model development, necessitating an incremental approach. This highlights the presence of many practical barriers to data warehousing and integration at the clinical service level. Limitations included the use of a small convenience sample of survey respondents, and a single site case report study design. As mentioned previously, the proposed data warehouse is a prototype and was developed using only four database repositories. Despite this constraint, the research demonstrates that by implementing a data warehouse at the service level, decision-making is supported and data quality issues related to access and availability can be reduced, providing many benefits. Output reports produced from the data warehouse prototype demonstrated usefulness for the improvement of decision-making in the management of clinical services, and quality and safety monitoring for better clinical care. However, in the future, the centralised model selected can be upgraded to an enterprise wide architecture by integrating with additional hospital units’ databases.

Inward internationalization of services : Exploring satisfaction and dissatisfaction of overseas students in Australia

Most research has assessed the outward internationalization process of service firms and less is known in the literature about the inward internationalization of services, or companies that provide the service to overseas customers in the domestic market (i.e., tourism, education, healthcare). Specifically, there is scant research looking at the overseas customer perspective. This study attempts to identify the main drivers of satisfaction and dissatisfaction for overseas customers. The critical incident technique (CIT) method was used to collect and analyse the data. A total of 107 critical incidents regarding drivers of satisfaction and dissatisfaction for overseas customers in a higher educational service context were collected. Findings of this study show that drivers of service satisfaction and dissatisfaction for overseas customers derive from elements of the core service and peripheral service. However, the findings show that elements of the peripheral service (living environment, socialization and interaction with others, and personal performance) are more important for international students.

Legal issues in carbon farming : biosequestration, carbon pricing, and carbon rights

This paper critically analyses the proposed Australian regulatory approach to the crediting of biological sequestration activities (biosequestration) under the Australian Carbon Farming Initiative and its interaction with State-based carbon rights, the national carbon-pricing mechanism, and the international Kyoto Protocol and carbon-trading markets. Norms and principles have been established by the Kyoto Protocol to guide the creation of additional, verifiable, and permanent credits from biosequestration activities. This paper examines the proposed arrangements under the Australian Carbon Farming Initiative and Carbon Pricing Mechanism to determine whether they are consistent with those international norms and standards. This paper identifies a number of anomalies associated with the legal treatment of additionality and permanence and issuance of carbon credits within the Australian schemes. In light of this, the paper considers the possible legal implications for the national and international transfer, surrender and use of these offset credits.

Application of operations research techniques to improve efficiency in the emergency department

The main aim of this thesis is to analyse and optimise a public hospital Emergency Department. The Emergency Department (ED) is a complex system with limited resources and a high demand for these resources. Adding to the complexity is the stochastic nature of almost every element and characteristic in the ED. The interaction with other functional areas also complicates the system as these areas have a huge impact on the ED and the ED is powerless to change them. Therefore it is imperative that OR be applied to the ED to improve the performance within the constraints of the system. The main characteristics of the system to optimise included tardiness, adherence to waiting time targets, access block and length of stay. A validated and verified simulation model was built to model the real life system. This enabled detailed analysis of resources and flow without disruption to the actual ED. A wide range of different policies for the ED and a variety of resources were able to be investigated. Of particular interest was the number and type of beds in the ED and also the shift times of physicians. One point worth noting was that neither of these resources work in isolation and for optimisation of the system both resources need to be investigated in tandem. The ED was likened to a flow shop scheduling problem with the patients and beds being synonymous with the jobs and machines typically found in manufacturing problems. This enabled an analytic scheduling approach. Constructive heuristics were developed to reactively schedule the system in real time and these were able to improve the performance of the system. Metaheuristics that optimised the system were also developed and analysed. An innovative hybrid Simulated Annealing and Tabu Search algorithm was developed that out-performed both simulated annealing and tabu search algorithms by combining some of their features. The new algorithm achieves a more optimal solution and does so in a shorter time.

Polymer self assembly on carbon nanotubes

This chapter analyses the poly(3-hexylthiophene) self-assembly on carbon nanotubes and the interaction between the two materials forming a new hybrid nanostructure. The chapter starts with a review of the several studies investigating polymers and biomolecules self-assembled on nanotubes. Then conducting polymers and polythiophenes are briefly introduced. Accordingly, carbon nanotube structure and properties are reported in Sect. 3. The experimental section starts with the bulk characterisation of polymer thin films with the inclusion of uniformly distributed carbon nanotubes. By using volume film analysis techniques (AFM, TEM, UV–Vis and Raman), we show how the polymer’s higher degree of order is a direct consequence of interaction with carbon nanotubes. Nevertheless, it is through the use of nanoscale analysis and molecular dynamic simulations that the self-assembly of the polymer on the nanotube surface can be clearly evidenced and characterised. In Sect. 6, the effect of the carbon templating structure on the P3HT organisation on the surface is investigated, showing the chirality-driven polymer assembly on the carbon nanotube surface. The interaction between P3HT and CNTs brings also to charge transfer, with the modification of physical properties for both species. In particular, the alteration of the polymer electronic properties and the modification of the nanotube mechanical structure are a direct consequence of the P3HT p-p stacking on the nanotube surface. Finally, some considerations based on molecular dynamics studies are reported in order to confirm and support the experimental results discussed.

Mobile applications of focused link discovery

Interaction with a mobile device remains difficult due to inherent physical limitations. This dif-ficulty is particularly evident for search, which re-quires typing. We extend the One-Search-Only search paradigm by adding a novel link-browsing scheme built on top of automatic link discovery. A prototype was built for iPhone and tested with 12 subjects. A post-use interview survey suggests that the extended paradigm improves the mobile information seeking experience.

Developing tools to facilitate integrated reflection

Much has been said and documented about the key role that reflection can play in the ongoing development of e-portfolios, particularly e-portfolios utilised for teaching and learning. A review of e-portfolio platforms reveals that a designated space for documenting and collating personal reflections is a typical design feature of both open source and commercial off-the-shelf software. Further investigation of tools within e-portfolio systems for facilitating reflection reveals that, apart from enabling personal journalism through blogs or other writing, scaffolding tools that encourage the actual process of reflection are under-developed. Investigation of a number of prominent e-portfolio projects also reveals that reflection, while presented as critically important, is often viewed as an activity that takes place after a learning activity or experience and not intrinsic to it. This paper assumes an alternative, richer conception of reflection: a process integral to a wide range of activities associated with learning, such as inquiry, communication, editing, analysis and evaluation. Such a conception is consistent with the literature associated with ‘communities of practice’, which is replete with insight into ‘learning through doing’, and with a ‘whole minded’ approach to inquiry. Thus, graduates who are ‘reflective practitioners’ who integrate reflection into their learning will have more to offer a prospective employer than graduates who have adopted an episodic approach to reflection. So, what kinds of tools might facilitate integrated reflection? This paper outlines a number of possibilities for consideration and development. Such tools do not have to be embedded within e-portfolio systems, although there are benefits in doing so. In order to inform future design of e-portfolio systems this paper presents a faceted model of knowledge creation that depicts an ‘ecology of knowing’ in which interaction with, and the production of, learning content is deepened through the construction of well-formed questions of that content. In particular, questions that are initiated by ‘why’ are explored because they are distinguished from the other ‘journalist’ questions (who, what, when, where, and where) in that answers to them demand explanative, as opposed to descriptive, content. They require a rationale. Although why questions do not belong to any one genre and are not simple to classify — responses can contain motivational, conditional, causal, and/or existential content — they do make a difference in the acquisition of understanding. The development of scaffolding that builds on why-questioning to enrich learning is the motivation behind the research that has informed this paper.

Understanding user experience of mobile video : framework, measurement, and optimization

Since users have become the focus of product/service design in last decade, the term User eXperience (UX) has been frequently used in the field of Human-Computer-Interaction (HCI). Research on UX facilitates a better understanding of the various aspects of the user’s interaction with the product or service. Mobile video, as a new and promising service and research field, has attracted great attention. Due to the significance of UX in the success of mobile video (Jordan, 2002), many researchers have centered on this area, examining users’ expectations, motivations, requirements, and usage context. As a result, many influencing factors have been explored (Buchinger, Kriglstein, Brandt & Hlavacs, 2011; Buchinger, Kriglstein & Hlavacs, 2009). However, a general framework for specific mobile video service is lacking for structuring such a great number of factors. To measure user experience of multimedia services such as mobile video, quality of experience (QoE) has recently become a prominent concept. In contrast to the traditionally used concept quality of service (QoS), QoE not only involves objectively measuring the delivered service but also takes into account user’s needs and desires when using the service, emphasizing the user’s overall acceptability on the service. Many QoE metrics are able to estimate the user perceived quality or acceptability of mobile video, but may be not enough accurate for the overall UX prediction due to the complexity of UX. Only a few frameworks of QoE have addressed more aspects of UX for mobile multimedia applications but need be transformed into practical measures. The challenge of optimizing UX remains adaptations to the resource constrains (e.g., network conditions, mobile device capabilities, and heterogeneous usage contexts) as well as meeting complicated user requirements (e.g., usage purposes and personal preferences). In this chapter, we investigate the existing important UX frameworks, compare their similarities and discuss some important features that fit in the mobile video service. Based on the previous research, we propose a simple UX framework for mobile video application by mapping a variety of influencing factors of UX upon a typical mobile video delivery system. Each component and its factors are explored with comprehensive literature reviews. The proposed framework may benefit in user-centred design of mobile video through taking a complete consideration of UX influences and in improvement of mobile videoservice quality by adjusting the values of certain factors to produce a positive user experience. It may also facilitate relative research in the way of locating important issues to study, clarifying research scopes, and setting up proper study procedures. We then review a great deal of research on UX measurement, including QoE metrics and QoE frameworks of mobile multimedia. Finally, we discuss how to achieve an optimal quality of user experience by focusing on the issues of various aspects of UX of mobile video. In the conclusion, we suggest some open issues for future study.

From supply to demand-driven opportunities : unravelling the role of the customer in opportunity identification processes

Successful identification and exploitation of opportunities has been an area of interest to many entrepreneurship researchers. Since Shane and Venkataraman’s seminal work (e.g. Shane and Venkataraman, 2000; Shane, 2000), several scholars have theorised on how firms identify, nurture and develop opportunities. The majority of this literature has been devoted to understanding how entrepreneurs search for new applications of their technological base or discover opportunities based on prior knowledge (Zahra, 2008; Sarasvathy et al., 2003). In particular, knowledge about potential customer needs and problems that may present opportunities is vital (Webb et al., 2010). Whereas the role of prior knowledge of customer problems (Shane, 2003; Shepherd and DeTienne, 2005) and positioning oneself in a so-called knowledge corridor (Fiet, 1996) has been researched, the role of opportunity characteristics and their interaction with customer-related mechanisms that facilitate and hinder opportunity identification has received scant attention.

eBILITY : from tool use to partnerships

In this article we identify how computational automation achieved through programming has enabled a new class of music technologies with generative music capabilities. These generative systems can have a degree of music making autonomy that impacts on our relationships with them; we suggest that this coincides with a shift in the music-equipment relationship from tool use to a partnership. This partnership relationship can occur when we use technologies that display qualities of agency. It raises questions about the kinds of skills and knowledge that are necessary to interact musically in such a partnership. These are qualities of musicianship we call eBility. In this paper we seek to define what eBility might consist of and how consideration of it might effect music education practice. The 'e' in eBility refers not only to the electronic nature of computing systems but also to the ethical, enabling, experiential and educational dimensions of the creative relationship with technologies with agency. We hope to initiate a discussion around differentiating what we term representational technologies from those with agency and begin to uncover the implications of these ideas for music educators in schools and communities. We hope also to elucidate the emergent theory and practice that has enabled the development of strategies for optimising this kind of eBility where the tool becomes partner. The identification of musical technologies with agency adds to the authors’ list of metaphors for technology use in music education that previously included tool, medium and instrument. We illustrate these ideas with examples and with data from our work with the jam2jam interactive music system. In this discussion we will outline our experiences with jam2jam as an example of a technology with agency and describe the aspects of eBility that interaction with it promotes.

A subject-specific model of human buttocks and thighs in a seated posture

Finite element analyses of the human body in seated postures requires digital models capable of providing accurate and precise prediction of the tissue-level response of the body in the seated posture. To achieve such models, the human anatomy must be represented with high fidelity. This information can readily be defined using medical imaging techniques such as Magnetic Resonance Imaging (MRI) or Computed Tomography (CT). Current practices for constructing digital human models, based on the magnetic resonance (MR) images, in a lying down (supine) posture have reduced the error in the geometric representation of human anatomy relative to reconstructions based on data from cadaveric studies. Nonetheless, the significant differences between seated and supine postures in segment orientation, soft-tissue deformation and soft tissue strain create a need for data obtained in postures more similar to the application posture. In this study, we present a novel method for creating digital human models based on seated MR data. An adult-male volunteer was scanned in a simulated driving posture using a FONAR 0.6T upright MRI scanner with a T1 scanning protocol. To compensate for unavoidable image distortion near the edges of the study, images of the same anatomical structures were obtained in transverse and sagittal planes. Combinations of transverse and sagittal images were used to reconstruct the major anatomical features from the buttocks through the knees, including bone, muscle and fat tissue perimeters, using Solidworks® software. For each MR image, B-splines were created as contours for the anatomical structures of interest, and LOFT commands were used to interpolate between the generated Bsplines. The reconstruction of the pelvis, from MR data, was enhanced by the use of a template model generated in previous work CT images. A non-rigid registration algorithm was used to fit the pelvis template into the MR data. Additionally, MR image processing was conducted to both the left and the right sides of the model due to the intended asymmetric posture of the volunteer during the MR measurements. The presented subject-specific, three-dimensional model of the buttocks and thighs will add value to optimisation cycles in automotive seat development when used in simulating human interaction with automotive seats.

Problem-solving courts, therapeutic jurisprudence and the constitution : if two is company, is three a crowd?

Court costs, resource-intensive trials, booming prison populations and the obduracy of recidivism rates all present as ugly excesses of the criminal law adversarial paradigm. To combat these excesses, problem-solving courts have evolved with an edict to address the underlying issues that have caused an individual to commit a crime. When a judge seeks to help a problem-solving court participant deal with issues like addiction, mental health or poverty, they are performing a very different role to that of a judicial officer in the traditional court hierarchy. They are no longer the removed, independent arbiter — a problem-solving court judge steps into the ‘arena’ with the participant and makes active use of their judicial authority to assist in rehabilitation and positive behavioural change. Problem-solving court judges employing the principles of therapeutic jurisprudence appreciate that their interaction with participants can have therapeutic and anti-therapeutic consequences. This article will consider how the deployment of therapeutic measures (albeit with good intention) can lead to the behavioural manifestation of partiality and bias on the part of problem-solving court judges. Chapter III of the Commonwealth Constitution will then be analysed to highlight why the operation and functioning of problem solving courts may be deemed unconstitutional. Part IV of this article will explain how a problem-solving court judge who is not acting impartially or independently will potentially contravene the requirements of the Constitution. It will finally be suggested that judges who possess a high level of emotional intelligence will be the most successful in administering an independent and impartial problem solving court.

Vulnerabilities in the courtroom

Book summary: In a constantly evolving context of performance management, accountability and risk assessment, police organisations and frontline police officers are required to pay careful attention to what has come to be known as ‘at risk people’, ‘vulnerable populations’ or ‘vulnerable people’. Vulnerable people have become a key focus of policy. Concurrently, there have been stronger demands on police, and a steep increase in police powers in relation to their interaction with vulnerable people. The premise of this protectionist and interventionist agenda is threefold: to protect the rights of vulnerable individuals proactively cater for their vulnerability within the justice system; and to secure police operations and protocols within strict guidelines. This collection unpacks ‘vulnerable people policing’ in theory and practice and guides the reader through the policing process as it is experienced by police officers, victims, offenders, witnesses and justice stakeholders. Each chapter features a single step of the policing process: from police recruit education through to custody, and the final transfer of vulnerable people to courts and sentencing. This edited collection provides analytical, theoretical and empirical insights on vulnerable people policing, and reflects on critical issues in a domain that is increasingly subject to speedy conversion from policy to practice, and heightened media and political scrutiny. It breaks down policing practices, operations and procedures that have vulnerable populations as a focus, bringing together original and innovative academic research and literature, practitioner experience and discussion of policy implications (from local and international perspectives). The particular nature of this collection highlights the multi-disciplinary nature of police work, sheds light on how specific, mandatory policies guide police officers steps in their interaction with vulnerable populations, and discusses the practicalities of police decision making at key points in this process.

Force controlled hexapod walking

In this paper we describe the dynamic simulation of an 18 degrees of freedom hexapod robot with the objective of developing control algorithms for smooth, efficient and robust walking in irregular terrain. This is to be achieved by using force sensors in addition to the conventional joint angle sensors as proprioceptors. The reaction forces on the feet of the robot provide the necessary information on the robots interaction with the terrain. As a first step we validate the simulator by implementing movement control by joint torques using PID controllers. As an unexpected by-product we find that it is simple to achieve robust walking behaviour on even terrain for a hexapod with the help of PID controllers and by specifying a trajectory of only a few joint configurations.

Semantic service discovery in the service ecosystem

Electronic services are a leitmotif in ‘hot’ topics like Software as a Service, Service Oriented Architecture (SOA), Service oriented Computing, Cloud Computing, application markets and smart devices. We propose to consider these in what has been termed the Service Ecosystem (SES). The SES encompasses all levels of electronic services and their interaction, with human consumption and initiation on its periphery in much the same way the ‘Web’ describes a plethora of technologies that eventuate to connect information and expose it to humans. Presently, the SES is heterogeneous, fragmented and confined to semi-closed systems. A key issue hampering the emergence of an integrated SES is Service Discovery (SD). A SES will be dynamic with areas of structured and unstructured information within which service providers and ‘lay’ human consumers interact; until now the two are disjointed, e.g., SOA-enabled organisations, industries and domains are choreographed by domain experts or ‘hard-wired’ to smart device application markets and web applications. In a SES, services are accessible, comparable and exchangeable to human consumers closing the gap to the providers. This requires a new SD with which humans can discover services transparently and effectively without special knowledge or training. We propose two modes of discovery, directed search following an agenda and explorative search, which speculatively expands knowledge of an area of interest by means of categories. Inspired by conceptual space theory from cognitive science, we propose to implement the modes of discovery using concepts to map a lay consumer’s service need to terminologically sophisticated descriptions of services. To this end, we reframe SD as an information retrieval task on the information attached to services, such as, descriptions, reviews, documentation and web sites - the Service Information Shadow. The Semantic Space model transforms the shadow's unstructured semantic information into a geometric, concept-like representation. We introduce an improved and extended Semantic Space including categorization calling it the Semantic Service Discovery model. We evaluate our model with a highly relevant, service related corpus simulating a Service Information Shadow including manually constructed complex service agendas, as well as manual groupings of services. We compare our model against state-of-the-art information retrieval systems and clustering algorithms. By means of an extensive series of empirical evaluations, we establish optimal parameter settings for the semantic space model. The evaluations demonstrate the model’s effectiveness for SD in terms of retrieval precision over state-of-the-art information retrieval models (directed search) and the meaningful, automatic categorization of service related information, which shows potential to form the basis of a useful, cognitively motivated map of the SES for exploratory search.