Integrated clinical pathway management for medical quality improvement-based on a semiotically inspired systems architecture

Clinical pathway is an approach to standardise care processes to support the implementations of clinical guidelines and protocols. It is designed to support the management of treatment processes including clinical and non-clinical activities, resources and also financial aspects. It provides detailed guidance for each stage in the management of a patient with the aim of improving the continuity and coordination of care across different disciplines and sectors. However, in the practical treatment process, the lack of knowledge sharing and information accuracy of paper-based clinical pathways burden health-care staff with a large amount of paper work. This will often result in medical errors, inefficient treatment process and thus poor quality medical services. This paper first presents a theoretical underpinning and a co-design research methodology for integrated pathway management by drawing input from organisational semiotics. An approach to integrated clinical pathway management is then proposed, which aims to embed pathway knowledge into treatment processes and existing hospital information systems. The capability of this approach has been demonstrated through the case study in one of the largest hospitals in China. The outcome reveals that medical quality can be improved significantly by the classified clinical pathway knowledge and seamless integration with hospital information systems.

Poverty, migration and sex work: youth transitions in Ethiopia

Despite an emerging body of work on youth transitions, research has yet to explore the often unconventional routes to adulthood for young people marginalised through poverty. By drawing on interviews with 60 young commercial sex workers in Ethiopia, this paper explores the connections between poverty, migration and sex work and demonstrates that sex work provides a risky alternative, but often successful, path to independence for some rural-urban migrants. The paper concludes by offering recommendations for policies that seek to support young sex workers by enabling them to maintain their independence while seeking different employment.

Poverty, migration and sex work: youth transitions in Ethiopia

Despite an emerging body of work on youth transitions, research has yet to explore the often unconventional routes to adulthood for young people marginalised through poverty. By drawing on interviews with 60 young commercial sex workers in Ethiopia, this paper explores the connections between poverty, migration and sex work and demonstrates that sex work provides a risky alternative, but often successful, path to independence for some rural-urban migrants. The paper concludes by offering recommendations for policies that seek to support young sex workers by enabling them to maintain their independence while seeking different employment.

Supporting Computer-supported collaborative work (CSCW) in conceptual design

In order to gain a better understanding of online conceptual collaborative design processes this paper investigates how student designers make use of a shared virtual synchronous environment when engaged in conceptual design. The software enables users to talk to each other and share sketches when they are remotely located. The paper describes a novel methodology for observing and analysing collaborative design processes by adapting the concepts of grounded theory. Rather than concentrating on narrow aspects of the final artefacts, emerging “themes” are generated that provide a broader picture of collaborative design process and context descriptions. Findings on the themes of “grounding – mutual understanding” and “support creativity” complement findings from other research, while important themes associated with “near-synchrony” have not been emphasised in other research. From the study, a series of design recommendations are made for the development of tools to support online computer-supported collaborative work in design using a shared virtual environment.

Interdisciplinarity: perceptions of the value of computer-supported collaborative work in design for the built environment

This paper presents the findings from a study into the current exploitation of computer-supported collaborative working (CSCW) in design for the built environment in the UK. The research is based on responses to a web-based questionnaire. Members of various professions, including civil engineers, architects, building services engineers, and quantity surveyors, were invited to complete the questionnaire. The responses reveal important trends in the breadth and size of project teams at the same time as new pressures are emerging regarding team integration and efficiency. The findings suggest that while CSCW systems may improve project management (e.g., via project documentation) and the exchange of information between team members, it has yet to significantly support those activities that characterize integrated collaborative working between disparate specialists. The authors conclude by combining the findings with a wider discussion of the application of CSCW to design activity-appealing for CSCW to go beyond multidisciplinary working to achieve interdisciplinary working.

Design for design: support for creative practice in computer-supported collaborative work (CSCW) in design

This paper describes a novel methodology for observing and analysing collaborative design by using the concepts of cognitive dimensions related to concept-based misfit analysis. The study aims at gaining an insight into support for creative practice of graphical communication in collaborative design processes of designers while sketching within a shared white board and audio conferencing environment. Empirical data on design processes have been obtained from observation of groups of student designers solving an interior space-planning problem of a lounge-diner in a shared virtual environment. The results of the study provide recommendations for the design and development of interactive systems to support such collaborative design activities.

From activity to active learning: drawing and dialogue interaction in virtual learning environments for computer-supported collaborative work in design.

Virtual learning environments (VLEs) would appear to be particular effective in computer-supported collaborative work (CSCW) for active learning. Most research studies looking at computer-supported collaborative design have focused on either synchronous or asynchronous modes of communication, but near-synchronous working has received relatively little attention. Yet it could be argued that near-synchronous communication encourages creative, rhetorical and critical exchanges of ideas, building on each other’s contributions. Furthermore, although many researchers have carried out studies on collaborative design protocol, argumentation and constructive interaction, little is known about the interaction between drawing and dialogue in near-synchronous collaborative design. The paper reports the first stage of an investigation into the requirements for the design and development of interactive systems to support the learning of collaborative design activities. The aim of the study is to understand the collaborative design processes while sketching in a shared white board and audio conferencing media. Empirical data on design processes have been obtained from observation of seven sessions with groups of design students solving an interior space-planning problem of a lounge-diner in a virtual learning environment, Lyceum, an in-house software developed by the Open University to support its students in collaborative learning.

An inspector's-eye view - The prospective enforcement of work-related fatality cases

This paper concerns the prospective implementation of the proposed 'corporate killing' offence. These proposals suggested that the Health and Safety Executive (HSE)-the body currently responsible for regulating work-related health and safety issues-should handle cases in which a 'corporate killing' charge is a possibility. Relatively little attention has been paid to this issue of implementation. An empirical investigation was undertaken to assess the compatibility of the HSE's methodology and enforcement philosophy with the new offence. It was found that inspectors categorize themselves as enforcers of criminal law, see enforcement action as valuable and support the new offence, but disagree over its use. They also broadly supported the HSE taking responsibility for the new offence. This suggests that 'corporate killing' may not necessarily be incompatible with the HSE's modus operandi, and there may be positive reasons forgiving the HSE this responsibility.

Quantitative thermal imaging analysis of aircraft materials: through skin sensing (Invited Paper)

Thermal non-destructive testing (NDT) is commonly used for assessing aircraft structures. This research work evaluates the potential of pulsed -- transient thermography for locating fixtures beneath aircraft skins in order to facilitate accurate automated assembly operations. Representative aluminium and carbon fibre aircraft skin-fixture assemblies were modelled using thermal modelling software. The assemblies were also experimentally investigated with an integrated pulsed thermographic evaluation system, as well as using a custom built system incorporating a miniature un-cooled camera. Modelling showed that the presence of an air gap between skin and fixture significantly reduced the thermal contrast developed, especially in aluminium. Experimental results show that fixtures can be located to accuracies of 0.5 mm.

The impact of ICT on the work patterns of managers and their organisations

Purpose – The main aim of this paper is to present the results of a study examining managers' attitudes towards the deployment and use of information and communications technology (ICT) in their organisations. The study comes at a time when ICT is being recognised as a major enabler of innovation and new business models, which have the potential to have major impact on western economies and jobs. Design/methodology/approach – A questionnaire was specially designed to collect data relating to three research questions. The questionnaire also included a number of open-ended questions. A total of 181 managers from a wide range of industries across a number of countries participated in the electronic survey. The quantitative responses to the survey were analysed using SPSS. Exploratory factor analysis using Varimax rotation was used and ANOVA to compare responses by different groups. Findings – The survey showed that many of the respondents appeared equipped to work “any place, any time”. However, it also highlighted the challenges managers face in working in a connected operation. Also, the data suggested that many managers were less than confident about their companies' policies and practices in relation to information management. Originality/value – A next step from this exploratory research could be the development of a model exploring the impact of ICT on management and organisational performance in terms of personal characteristics of the manager, the role performed, the context and the ICT provision. Also, further research could focus on examining in more detail differences between management levels.

Work performance, productivity and indoor air

Temperature, relative humidity, and air quality all affect the sensory system via thermo receptors in the skin and the olfactory system. Air quality is mainly defined by the contaminants in the air. However, the most persistent memory of any space is often its odor. Strong, emotional, and past experiences are awakened by the olfactory sense. Odors can also influence cognitive processes that affect creative task performance, as well as personal memories and moods. Besides nitrogen and oxygen, the air contains particles and many chemicals that affect the efficiency of the oxygenation process in the blood, and ultimately the air breathed affects thinking and concentration. It is important to show clients the value of spending more capital on high-quality buildings that promote good ventilation. The process of achieving indoor-air quality is a continual one throughout the design, construction, commissioning, and facilities management processes. This paper reviews the evidence.

Use of thermography and fibre optics microscopy for the evaluation of railway structures in the Athens Metro in Greece (Invited Paper)

Rolling Contact Fatigue (RCF) is one of the main issues that concern, at least initially, the head of the railway; progressively they can be of very high importance as they can propagate inside the material with the risk of damaging the railway. In this work, two different non-destructive techniques, infrared thermography (IRT) and fibre optics microscopy (FOM), were used in the inspection of railways for the tracing of defects and deterioration signs. In the first instance, two different approaches (dynamic and pulsed thermography) were used, whilst in the case of FOM, microscopic characterisation of the railway heads and classification of the deterioration -- damage on the railways according to the UIC (International Union of Railways) code, took place. Results from both techniques are presented and discussed.

The eMinerals project: developing the concept of the virtual organisation to support collaborative work on molecular-scale environmental simulations

The eMinerals project has established an integrated compute and data minigrid infrastructure together with a set of collaborative tools,. The infrastructure is designed to support molecular simulation scientists working together as a virtual organisation aiming to understand a number of strategic processes in environmental science. The eMinerals virtual organisation is now working towards applying this infrastructure to tackle a new generation of scientific problems. This paper describes the achievements of the eMinerals virtual organisation to date, and describes ongoing applications of the virtual organisation infrastructure.

Eye gaze in virtual environments: evaluating the need and initial work on implementation

For efficient collaboration between participants, eye gaze is seen as being critical for interaction. Video conferencing either does not attempt to support eye gaze (e.g. AcessGrid) or only approximates it in round table conditions (e.g. life size telepresence). Immersive collaborative virtual environments represent remote participants through avatars that follow their tracked movements. By additionally tracking people's eyes and representing their movement on their avatars, the line of gaze can be faithfully reproduced, as opposed to approximated. This paper presents the results of initial work that tested if the focus of gaze could be more accurately gauged if tracked eye movement was added to that of the head of an avatar observed in an immersive VE. An experiment was conducted to assess the difference between user's abilities to judge what objects an avatar is looking at with only head movements being displayed, while the eyes remained static, and with eye gaze and head movement information being displayed. The results from the experiment show that eye gaze is of vital importance to the subjects correctly identifying what a person is looking at in an immersive virtual environment. This is followed by a description of the work that is now being undertaken following the positive results from the experiment. We discuss the integration of an eye tracker more suitable for immersive mobile use and the software and techniques that were developed to integrate the user's real-world eye movements into calibrated eye gaze in an immersive virtual world. This is to be used in the creation of an immersive collaborative virtual environment supporting eye gaze and its ongoing experiments. Copyright (C) 2009 John Wiley & Sons, Ltd.