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.

An approach to develop flexible systems with organizational-interoperability requirements

Flexibility of information systems (IS) have been studied to improve the adaption in support of the business agility as the set of capabilities to compete more effectively and adapt to rapid changes in market conditions (Glossary of business agility terms, 2003). However, most of work on IS flexibility has been limited to systems architecture, ignoring the analysis of interoperability as a part of flexibility from the requirements. This paper reports a PhD project, which proposes an approach to develop IS with flexibility features, considering some challenges of flexibility in small and medium enterprises (SMEs) such as the lack of interoperability and the agility of their business. The motivation of this research are the high prices of IS in developing countries and the usefulness of organizational semiotics to support the analysis of requirements for IS. (Liu, 2005).

A clocking technique for FPGA pipelined designs

This paper presents a clocking pipeline technique referred to as a single-pulse pipeline (PP-Pipeline) and applies it to the problem of mapping pipelined circuits to a Field Programmable Gate Array (FPGA). A PP-pipeline replicates the operation of asynchronous micropipelined control mechanisms using synchronous-orientated logic resources commonly found in FPGA devices. Consequently, circuits with an asynchronous-like pipeline operation can be efficiently synthesized using a synchronous design methodology. The technique can be extended to include data-completion circuitry to take advantage of variable data-completion processing time in synchronous pipelined designs. It is also shown that the PP-pipeline reduces the clock tree power consumption of pipelined circuits. These potential applications are demonstrated by post-synthesis simulation of FPGA circuits. (C) 2004 Elsevier B.V. All rights reserved.

Categories & order systems: Claude Parent and The Serving Library intersections of architecture, art and editorial design

This paper discusses the work of Claude Parent and The Serving Library, considering the critiques generated by their intersecting of architecture, art and editorial design. Through focus on the ways in which hosting environment, architecture and forms of expanded publishing can serve to dissolve disciplinary boundaries and activities of production, spectatorship and reception, it draws on the lineage of 1960s/70s Conceptual Art in considering these practices as a means through which to escape medium specificity and spatial confinement. Relationships between actual and virtual space are then read against this broadening of aesthetic ideas and the theory of critical modernity.

Memory-based Embodied Cognition: a computational architecture

At its most fundamental, cognition as displayed by biological agents (such as humans) may be said to consist of the manipulation and utilisation of memory. Recent discussions in the field of cognitive robotics have emphasised the role of embodiment and the necessity of a value or motivation for autonomous behaviour. This work proposes a computational architecture – the Memory-Based Cognitive (MBC) architecture – based upon these considerations for the autonomous development of control of a simple mobile robot. This novel architecture will permit the exploration of theoretical issues in cognitive robotics and animal cognition. Furthermore, the biological inspiration of the architecture is anticipated to result in a mobile robot controller which displays adaptive behaviour in unknown environments.

Architecture for Living Neuronal Network Control of a mobile robot

The intelligent controlling mechanism of a typical mobile robot is usually a computer system. Research is however now ongoing in which biological neural networks are being cultured and trained to act as the brain of an interactive real world robot – thereby either completely replacing or operating in a cooperative fashion with a computer system. Studying such neural systems can give a distinct insight into biological neural structures and therefore such research has immediate medical implications. The principal aims of the present research are to assess the computational and learning capacity of dissociated cultured neuronal networks with a view to advancing network level processing of artificial neural networks. This will be approached by the creation of an artificial hybrid system (animat) involving closed loop control of a mobile robot by a dissociated culture of rat neurons. This paper details the components of the overall animat closed loop system architecture and reports on the evaluation of the results from preliminary real-life and simulated robot experiments.

Innovative approach to building systems integration problems: Using systems theory, technological forecasting and scenario planning

Building services are worth about 2% GDP and are essential for the effective and efficient operations of the building. It is increasingly recognised that the value of a building is related to the way it supports the client organisation’s ongoing business operations. Building services are central to the functional performance of buildings and provide the necessary conditions for health, well-being, safety and security of the occupants. They frequently comprise several technologically distinct sub-systems and their design and construction requires the involvement of numerous disciplines and trades. Designers and contractors working on the same project are frequently employed by different companies. Materials and equipment is supplied by a diverse range of manufacturers. Facilities managers are responsible for operation of the building service in use. The coordination between these participants is crucially important to achieve optimum performance, but too often is neglected. This leaves room for serious faults. The need for effective integration is important. Modern technology offers increasing opportunities for integrated personal-control systems for lighting, ventilation and security as well as interoperability between systems. Opportunities for a new mode of systems integration are provided by the emergence of PFI/PPP procurements frameworks. This paper attempts to establish how systems integration can be achieved in the process of designing, constructing and operating building services. The essence of the paper therefore is to envisage the emergent organisational responses to the realisation of building services as an interactive systems network.

A system's model for maintenance support and decision making in building services systems

Modern buildings are designed to enhance the match between environment, spaces and the people carrying out work, so that the well-being and the performance of the occupants are all in harmony. Building services are systems that facilitate a healthy working environment within which workers productivity can be optimised in the buildings. However, the maintenance of these services is fraught with problems that may contribute to up to 50% of the total life cycle cost of the building. Maintenance support is one area which is not usually designed into the system as this is not common practice in the services industry. The other areas of shortfall for future designs are; client requirements, commissioning, facilities management data and post occupancy evaluation feedback which needs to be adequately planned to capture and document this information for use in future designs. At the University of Reading an integrated approach has been developed to assemble the multitude of aspects inherent in this field. The means records required and measured achievements for the benefit of both building owners and practitioners. This integrated approach can be represented in a Through Life Business Model (TLBM) format using the concept of Integrated Logistic Support (ILS). The prototype TLBM developed utilises the tailored tools and techniques of ILS for building services. This TLBM approach will facilitate the successful development of a databank that would be invaluable in capturing essential data (e.g. reliability of components) for enhancing future building services designs, life cycle costing and decision making by practitioners, in particular facilities managers.

The internet, information architecture and community memory

This article reviews current technological developments, particularly Peer-to-Peer technologies and Distributed Data Systems, and their value to community memory projects, particularly those concerned with the preservation of the cultural, literary and administrative data of cultures which have suffered genocide or are at risk of genocide. It draws attention to the comparatively good representation online of genocide denial groups and changes in the technological strategies of holocaust denial and other far-right groups. It draws on the author's work in providing IT support for a UK-based Non-Governmental Organization providing support for survivors of genocide in Rwanda.

Workflow data exchange semantics, object discovery & integration architecture for cross media production & distribution

There has been a clear lack of common data exchange semantics for inter-organisational workflow management systems where the research has mainly focused on technical issues rather than language constructs. This paper presents the neutral data exchanges semantics required for the workflow integration within the AXAEDIS framework and presents the mechanism for object discovery from the object repository where little or no knowledge about the object is available. The paper also presents workflow independent integration architecture with the AXAEDIS Framework.

Architecture for neuronal cell control of a mobile robot

It is usually expected that the intelligent controlling mechanism of a robot is a computer system. Research is however now ongoing in which biological neural networks are being cultured and trained to act as the brain of an interactive real world robot - thereby either completely replacing or operating in a cooperative fashion with a computer system. Studying such neural systems can give a distinct insight into biological neural structures and therefore such research has immediate medical implications. In particular, the use of rodent primary dissociated cultured neuronal networks for the control of mobile `animals' (artificial animals, a contraction of animal and materials) is a novel approach to discovering the computational capabilities of networks of biological neurones. A dissociated culture of this nature requires appropriate embodiment in some form, to enable appropriate development in a controlled environment within which appropriate stimuli may be received via sensory data but ultimate influence over motor actions retained. The principal aims of the present research are to assess the computational and learning capacity of dissociated cultured neuronal networks with a view to advancing network level processing of artificial neural networks. This will be approached by the creation of an artificial hybrid system (animal) involving closed loop control of a mobile robot by a dissociated culture of rat neurons. This 'closed loop' interaction with the environment through both sensing and effecting will enable investigation of its learning capacity This paper details the components of the overall animat closed loop system and reports on the evaluation of the results from the experiments being carried out with regard to robot behaviour.