Enabling electronic medicine at Kiwicare : the case of video conferencing adoption for psychiatry in New Zealand

Telemedicine emerges as a viable solution to New Zealand health providers in reaching out to rural patients, in offering medical services and conducting administrative meetings and training. No research exists about adoption of telemedicine in New Zealand. The purpose of this case study was to explain factors influencing adoption of telemedicine utilizing video conferencing technology (TMVC) within a New Zealand hospital known as KiwiCare. Since TMVC is part of IT, tackling it from within technological innovation literature may assist in providing an insight into its adoption within KiwiCare and into the literature. Findings indicate weak presence of critical assessment into technological innovation factors prior to the adoption decision, thereby leading to its weak utilization. Factors like complexity, compatibility and trialability were not assessed extensively by KiwiCare and would have hindered TMVC adoption. TMVC was mainly assessed according to its relative advantage and to its cost effectiveness along with other facilitating and accelerating factors. This is essential but should be alongside technological and other influencing factors highlighted in the literature.

Identifying supply chain management and e-commerce opportunities at PaperCo Australia

Established supply chain management techniques such as Quick Response (QR) or Customer Relationship Management (CRM) have proven the potential benefits of reorganizing an organization’s processes to take advantage of the characteristics of electronic information exchange. As the Internet and other proprietary networks expand, however, organizations have the opportunity to use this enabling infrastructure to exchange other, more varied types of information than traditional electronic data interchange (EDI) messages. This is especially true of companies with global operations and interests, which lead to a more diverse set of trading activities. This case presents the experiences of a large Australian paper products manufacturer in implementing an electronic document exchange strategy for supply chain management, including the drivers for change which spurred their actions, and describes the issues associated with trying to support existing and future requirements for document exchange across a wide variety of trading partners. The experiences of PaperCo will be relevant to organizations with diverse trading partners, especially small to medium enterprises (SMEs).

Surface coverage of filter medium in deep bed filtration : mathematical modelling and experiments

This paper highlights the importance of surface coverage in modeling the removal of particles in deep bed filtration. A model that considers the saturation of sites on which particle deposition occurs is used. Experimental results obtained with monodispersed suspensions of 0.46 and 0.816 μm latex particles at different influent concentrations and ionic strengths were used to calculate the fraction of filter grain surface (β1) on which actual particle deposition occurs. This will be useful in evaluating the filter performance in terms of the utilization of available surface area of the filter medium. Further, the level of dendrite formation of particles on filter grains during filtration is expressed in terms of β1 and the specific surface coverage, θT (the fraction of a filter grain surface that is covered by particles at time T, assuming that the filter grain is covered by a monolayer of particles). This can be used to compare the contribution of deposited particles in the removal efficiency of deep bed filtration for suspensions with different physical and chemical characteristics.

Surviving on cached foods - the energetics of egg-caching by arctic foxes

Food-caching by arctic foxes (Vulpes lagopus (L., 1758)) is a behavioural adaptation thought to increase winter survival, especially in bird colonies where a large number of eggs can be cached during a short nesting season. In this paper, we measured the energy content of greater snow goose (Chen caerulescens atlantica Kennard, 1927) eggs and evaluated their perishability when cached in tundra soil for a whole summer. We estimated that eggs lost only ~8% of their dry mass over 60 days of storage in the ground. We used published estimates on digestibility of nutrients by arctic foxes to estimate that fresh and stored goose eggs contained 816 and 730 kJ of metabolizable energy, respectively, a difference of 11%. Using information on arctic fox energetics, we evaluated that 145 stored eggs were required to sustain the growth of one pup from the age of 1 to 3 months (nutritional independence). Moreover, 23 stored eggs were energetically equivalent to the average fat deposit of an arctic fox during winter. Finally, we calculated that an adult arctic fox would need to recover 160-220 stored eggs to survive 6 months in resting conditions during cold winter temperatures. This value increased to 480 when considering activity cost. Based on egg acquisition and caching rates observed in many goose colonies, we conclude that cached eggs represent an important source of energy relative to the needs of an arctic fox during winter, and have thus a high fitness value.

Social desirability bias in the reporting of alcohol consumption: a randomized trial

OBJECTIVE: To investigate reporting of alcohol consumption, we manipulated the contexts of questions in ways designed to induce social desirability bias. METHOD: We undertook a two-arm, parallel-group, individually randomized trial at an Australian public university. Students were recruited by email to a web-based "Research Project on Student Health Behavior." Respondents answered nine questions about their physical activity, diet, and smoking. They were unknowingly randomized to a group presented with either (A) three questions about their alcohol consumption or (B) seven questions about their alcohol dependence and problems (under a prominent header labeled "Alcohol Use Disorders Identification Test"), followed by the same three alcohol consumption questions from (A). RESULTS: A total of 3,594 students (mean age = 27, SD = 10) responded and were randomized: 1,778 to Group A and 1,816 to Group B. Outcome measures were the number of days they drank alcohol, the typical number of drinks they consumed per drinking day, and the number of days they consumed six or more drinks. The primary analysis included participants with any alcohol consumption in the preceding 4 weeks (1,304 in Group A; 1,340 in Group B) using between-group, two-tailed t tests. RESULTS: In Groups A and B, respectively, means (and SDs) of the number of days drinking were 5.89 (5.92) versus 6.06 (6.12), p = .49; typical number of drinks per drinking day: 4.02 (3.87) versus 3.82 (3.76), p = .17; and number of days consuming six or more drinks: 1.69 (2.94) versus 1.67 (3.25), p = .56. CONCLUSIONS: We could not reject the null hypothesis because earlier questions about alcohol dependence and problems showed no sign of biasing the respondents' subsequent reports of alcohol consumption. These data support the validity of university students' reporting of alcohol consumption in web-based studies.

Clinical events reported by surgeons assessing their peers

BACKGROUND: All surgical deaths in Queensland, Australia are reviewed by external surgeon peers, and clinical events are recorded. The study objective was to classify clinical events in surgical patients who died.

METHODS: Deaths notified to the Queensland Audit of Surgical Mortality between 2007 and 2013 were assessed by surgeons' peers who decided whether a clinical event occurred. The most serious clinical event per patient was analyzed.

RESULTS: Peer surgeons reviewed 4,816 deaths. Most patients (70.7%) had no clinical event. Events were preventable in 58% of patients and less than 1 in 10 events was severe. The most frequent events were classified as patient assessment (34.5%), suboptimal therapy (15.3%), and delays (15.1%).

CONCLUSIONS: Peer review of all surgical deaths identifies preventable clinical events and provides opportunities to improve decision making, better therapy and reduce delay in implementing appropriate surgical care. Review feedback to surgeons and other stakeholders should improve patient safety and quality.