The view from the trenches : satisfaction with eHealth systems by a group of health professionals

The integration and adoption of eHealth systems within the health sector faces challenges. As health care practitioners are the end users of eHealth systems, their perceptions of these systems are critical in order to address the issues surrounding their implementation and application. This paper presents the views that a group of health care professionals hold regarding the eHealth systems that they use as part of their day to day work. These views were analysed according to the perceptions of satisfaction and dissatisfaction with eHealth systems that these professionals expressed. They expressed satisfaction with the information consistency, work efficiency, access to information, quality of information, and availability of technical support associated with their systems use. They expressed dissatisfaction with a lack of communication and compatibility between systems, deficiency in terms of system functionality, a lack of system reliability, a lack of initial and ongoing training, and a need to develop workarounds in order to achieve work goals. Overall this research indicates that satisfaction with eHealth systems is a complex issue, and that the negative aspects of system satisfaction need to be addressed and the positive aspects carefully built upon.

Approximation of riemanns zeta function by finite dirichlet series: A multiprecision numerical approach

The finite Dirichlet series of the title are defined by the condition that they vanish at as many initial zeros of the zeta function as possible. It turns out that such series can produce extremely good approximations to the values of Riemanns zeta function inside the critical strip. In addition, the coefficients of these series have remarkable number-theoretical properties discovered in large-scale high-precision numerical experiments. So far, we have found no theoretical explanation for the observed phenomena.

Mark-aided distributed filtering by using neural network for DDoS defense

Currently Distributed Denial of Service (DDoS) attacks have been identified as one of the most serious problems on the Internet. The aim of DDoS attacks is to prevent legitimate users from accessing desired resources, such as network bandwidth. Hence the immediate task of DDoS defense is to provide as much resources as possible to legitimate users when there is an attack. Unfortunately most current defense approaches can not efficiently detect and filter out attack traffic. Our approach is to find the network anomalies by using neural network, deploy the system at distributed routers, identify the attack packets, and then filter them. The marks in the IP header that are generated by a group of IP traceback schemes, Deterministic Packet Marking (DPM)/Flexible Deterministic Packet Marking (FDPM), assist this process of identifying attack packets. The experimental results show that this approach can be used to defend against both intensive and subtle DDoS attacks, and can catch DDoS attacks’ characteristic of starting from multiple sources to a single victim. According to results, we find the marks in IP headers can enhance the sensitivity and accuracy of detection, thus improve the legitimate traffic throughput and reduce attack traffic throughput. Therefore, it can perform well in filtering DDoS attack traffic precisely and effectively.

Short term reoffending by child victim sex offenders in New Zealand : a comparison of those with and without extended supervision

Sexual offenders with child victims in New Zealand who are considered at high risk for reoffending are subject to an Extended Supervision Order. This allows for a period of supervision of up to ten years following release to the community. The present study examined 89 offenders given Extended Supervision Orders over the 33 month period since the legislation was enacted. All types of reoffending resulting in criminal convictions by this group were included. A matched sample of sexual offenders with child victims released prior to this legislation and a sample of offenders judged to be lower risk were compared to those under extended supervision. Offenders under extended supervision reoffended faster and at a higher rate for both sexual and general offences than those deemed lower risk, but at a lower rate than pre-extended supervision high risk offenders. The relationship between specialist treatment programme attendance and completion, actuarial risk level, and recidivism in the extended supervision sample were also investigated. These variables were found not to be significant predictors of sexual recidivism.

Modelling income group differences in the health and economic impacts of targeted food taxes and subsidies

Objective : To examine the effects, by income group, of targeted food taxes and subsidies on nutrition, health and expenditure in the UK.

Methods : A model based on consumption data and demand elasticity was constructed to predict the effects of four food taxation-subsidy regimens. Resulting changes in demand, expenditure, nutrition, cardiovascular disease (CVD) and cancer mortality were estimated.

Data : Expenditure data were taken from the Expenditure and Food Survey; estimates of price elasticities of demand for food were taken from a report based on the National Food Survey 1988–2000. Estimates of effect on CVD and cancer mortality of changing fat, salt, fruit and vegetable intake were taken from previous meta-analyses.

Results : (i) Taxing principal sources of dietary saturated fat is unlikely to reduce cardiovascular disease (CVD) or cancer mortality. (ii) Taxing ‘less healthy’ foods (defined by the WXYfm nutrient profiling model) could increase CVD and cancer deaths by 35–1300 yearly. (iii) Taxing ‘less healthy’ foods and subsidising fruits and vegetables by 17.5% could avert up to 2900 CVD and cancer deaths yearly. (iv) Taxing ‘less healthy’ foods and using all tax revenue to subsidize fruits and vegetables could avert up to 6400 CVD and cancer deaths yearly. Few obesity-related CVD deaths are averted by any of the regimens. All four regimens would be economically regressive and positive health effects will not necessarily be greater in lower-income groups where the need for dietary improvement is higher.

Conclusions : A targeted food tax combined with the appropriate subsidy on fruits and vegetables could reduce deaths from CVD and cancer.

Assessing the strain experienced by managers and professional Australian footballers using an augmented job strain model

Generic models of job stress, such as the Job Strain Model (JSM), have recently been criticised for focusing on a small number of general work characteristics while ignoring those that are occupation-specific (Sparks & Cooper, 1999). However this criticism is based on limited research that has not examined the relative influence of all three dimensions of the JSM - job demand, job control and social support - and job-specific stressors. The JSM is the most commonly used model underpinning large-scale occupational stress research (Fox, Dwyer, & Ganster, 1993) and is regarded as the most influential model in the research on the psycho-social work environment, stress and disease in recent times (Kristensen, 1995). This thesis addresses the lack of information on the relative influence of the JSM and job-specific stressors by assessing the capacity of an augmented JSM to predict the strain experienced by managers and professional Australian footballers. The augmented JSM consisted of job-specific stressors in addition to the generic components of the model. Managers and professional Australian footballers represent two very different occupational groups. While the day-today roles of a manager include planning, organising, monitoring and controlling (Carroll & Gillen, 1987), the working life of a professional Australian footballer revolves around preparing for and playing football (Shanahan, 1998). It was expected that the large differences in the work undertaken by managers and professional Australian footballers would maximise the opportunities for identifying job-specific stressors and measuring the extent that these vary from one group to the next. The large disparity between managers and professional footballers was also used to assess the cross-occupational versatility of the JSM when it had been augmented by job-specific stressors. This thesis consisted of three major studies. Study One involved a survey of Australian managers, while studies Two and Three focused on professional Australian footballers. The latter group was under-represented in the literature, and as a result of the lack of information on the stressors commonly experienced by this group, an in-depth qualitative study was undertaken in Study Two. The results from Study Two then informed the survey of professional footballers that was conducted in Study Three. Contrary to previous research examining the relative influence of generic and job-specific stressors, the results only provided moderate support for augmenting the JSM with job-specific stressors. Instead of supporting the versatility of the augmented JSM, the overall findings reinforced the broad relevance of the original JSM. Of the four health outcomes measured in Studies One and Three, there was only one - the psychological health of professional Australian footballers - where the proportion of total variance explained by job-specific stressors exceeded 13%. Despite the generally strong performance of the JSM across the two occupational groups, the importance of demand, control and support diminished when examining the less conventional occupation of professional football. The generic model was too narrow to capture the highly specific work characteristics that are important for this occupational group and, as a result, the job-specific stressors explained significantly more of the strain over and above that already provided by the generic model. These findings indicate that when investigating the stressors experienced by conventional occupational groups such as managers, the large amount resources required to identify job-specific stressors are unlikely to be cost-effective. In contrast, the influence of the more situation specific stressors is significantly greater in unconventional occupations and thus the benefits of identifying these non-generic stressors are more likely to outweigh the costs. Studies One and Three identified strong connections between job-specific stressors and important characteristics of the occupation being studied. These connections were consistent with previous research and suggest that before attempting to identify job-specific stressors, researchers need to first become familiar with the nature and context of the occupation. The final issue addressed in this thesis was the role of work and non-work support. The findings indicate that the support provided by supervisors and colleagues was a significant predictor of wellbeing for both managers and professional footballers. In contrast, the level of explained strain accounted for by non-work support was not significant. These results indicate that when developing strategies to protect and enhance employee well-being, particular attention should be given to monitoring and, where necessary, boosting the effectiveness of work-based support. The findings from this thesis have been fed back to the management and sporting communities via conference presentations and peer-reviewed journals (refer pp 220-221). All three studies have been presented at national and international conferences and, overall, were well received by participants. Similarly, the methods, results and major findings arising from Studies One and Two have been critiqued by anonymous reviewers from two international journals. These papers have been accepted for publication in 2001 and 2002 and feedback from the reviewers indicates that the findings represent a significant and unique contribution to the literature. The results of Study Three are currently under review by a sports psychology journal.

Duration of unemployment and suicide in Australia over the period 1985–2006: an ecological investigation by sex and age during rising versus declining national unemployment rates

Background The relationship between unemployment and suicide may be sensitive to demographic factors, national unemployment rates, and length of time without employment. This study investigated these factors in relation to suicide in Australia for the period 1985–2006, in an ecological study. Methods The outcome variable was annual suicide rate by age group, sex and the eight states and territories over 22 years of observation (total observations=1760). The main predictor variable was the average duration of unemployment in the population, categorised into three time periods (<2 weeks, 2–4 weeks, >4 weeks). Poisson regression models were used to investigate the relationship between duration of unemployment and suicide over the years 1985–2006 in a series of cross-sectional analyses. Interaction analyses indicated significant differences during periods of declining or increasing labour market opportunity and by age group. Results During periods of declining unemployment rates in the country, longer durations of unemployment were associated with higher male suicide rates. During periods of increasing unemployment in the country, longer unemployment duration was associated with lower male suicide rates. Effect modification was also apparent by age-group, with stronger associations between unemployment duration and male suicide evident in those aged 25–34 and 55–64, and weaker associations in those aged 15–24 and 44–54 years. Longer length of unemployment was not associated with an increase in female suicide rates. Conclusions The labour market opportunities in Australia modified the effect of duration of unemployment on suicide, and the effect was more prominent in men and older age groups. This may reflect social norms and acceptability about unemployment, as well as life-stage influences associated with transitions into and out of the labour market.

Gradient structure produced by three roll planetary milling: numerical simulation and microstructural observations

In this study a gradient grain structure was produced by processing rod billets through three roll planetary milling (also known as PSW process). This kind of gradient structure is reported to provide an excellent combination of strength and ductility owing to an ultrafine-grained surface layer and a coarse-grained interior of the billet. Specifically, copper rod samples were subjected to up to six passes of PSW at room temperature. To study the evolution of the microstructure during the deformation, microhardness measurements and Electron Backscatter Diffraction (EBSD) analysis were performed after one, three and six passes. Additionally, the distributions of the equivalent stress during PSW and the equivalent strain after processing were studied by finite element analysis using the commercial software QFORM. The results showed the efficacy of PSW as a means of imparting a gradient ultrafine-grained structure to copper rods. A good correlation between the simulated equivalent strain distribution and the measured microhardness distribution was demonstrated.

Communication changes experienced by adults with cerebral palsy as they age

PURPOSE: Adults with cerebral palsy (CP) experience multiple, functional changes as they age, including changes to communication modes and methods that enable development and maintenance of relationships, communicative participation and quality-of-life. Little is known about the nature of communication changes experienced by this group. The aim of this study was to better understand how adults with CP experience changes in their communication abilities as they age and the subsequent psychosocial impact.

METHOD: Twenty adults with cerebral palsy aged 40-72 years with complex communication needs (CCN) participated in a series of in-depth interviews, framing their experiences of loss and grief throughout their lives. The impact of changing communication abilities emerged as an important area of focus. Data were analysed using constructivist grounded theory methodology.

RESULT: Themes arising from the participants' perceptions of their communication included experiencing communication change as a loss with subsequent impact on self-concept; and how communication is integral to the process of managing losses associated with older age.

CONCLUSION: Implications for speech-language pathologists working with older people with cerebral palsy and CCN include the need to understand the psychosocial impact of communication changes on social interaction, relationships and communicative participation. It is important to promote positive and meaningful communication options that maintain a coherent sense of self in addition to promoting functional communication skills and communicative participation.

Sexual function and the menopausal woman: the importance of age and partner`s sexual functioning

The aim of this study was to investigate age, menopausal status, and the male partner's sexual function on the sexual function of the menopausal woman. Sexual functioning of 304 women (120 premenopausal, 76 perimenopausal, 108 postmenopausal) aged between 35 and 65 years from a community sample was investigated. Multiple regression analyses found that sexual satisfaction within the relationship was better predicted by age group than by menopausal status. Younger women were more likely to be satisfied with their sexual relationship than older women. Age group was also a better predictor than menopausal status of current frequency of intercourse, with younger women being likely to have more frequent intercourse than older women. Whether a female respondent had experienced a sexual dysfunction was better predicted by menopausal status than by age. Women who were menopausal were more likely to report a sexual problem such as lack of sexual interest, poor lubrication, and failure to have an orgasm. However, age group appeared to be a better predictor of whether the male partner had experienced a sexual dysfunction. Older men were more likely to have experienced failure to have an erection, for example. The findings of this study indicate that age and the sexual function of the partner are important factors to take into consideration when investigating the sexual function of the menopausal woman.

A framework for environmental management system adoption and maintenance : an Australian perspective

Purpose – The purpose of this paper is to present a framework for environmental management system (EMS) adoption which can be used by managers to enable them to achieve a faster, smoother, effective and sustainable EMS implementation. This is termed by the authors as “successful” EMS implementation.
Design/methodology/approach – The framework presented is based on an extensive field study conducted in Australia that included a questionnaire survey and in-depth interviews conducted with practitioners, the results of which have been reported in this and other journals.
Findings – The framework presented covers three distinct phases, namely development, certification and maintenance and continuous improvement. Preliminary assessment of this framework by a group of Australian experts that included four senior managers, one academic and one consultant suggests that this framework is a useful tool for implementing an effective EMS.
Practical implications – Each of the three phases of the framework provides a step-by-step approach and a sequential map towards a successful EMS implementation.
Originality/value – The framework has been developed from extensive fieldwork and has been validated by a group of “experts” which comprised of four industry practitioners, one management academic, and one EMS consultant. The framework provides a detailed understanding of the steps involved in the implementation, certification, and maintenance of EMS.

Game geek's goss: linguistic creativity in young males within an online university forum (94/\/\3 933k’5 9055oneone)

In this paper the authors explore the use and adaptation of a language specifically developed for, and by, a community of young people who play computer games. Leet speak or 1337 5p34k, the language used by the participants in this study, incorporates symbols and numbers as substitutes for the letters contained in words. Described by the group as an ‘elite’ language or ‘leet speak’, the authors’ interest was captured by the derisive and ironic use of the language in an online forum for a tertiary first year unit of study. Rather than merely defining its participants within an elite cultural boundary, ‘leet speak’ is utilised ironically to unearth ‘wannabees’ (those seeking entrance and acceptance into the game world, generally 12 –16 year olds). Of particular fascination to the authors was that despite the clear self- demarcation of the group from the users of ‘leet speak’, and their insistence on its use solely by ‘newbs and wannabees’, the group continued to use the language to communicate with each other online. In this research, language defines the cultural group of games technology students in terms of the group’s continual subversion of the language’s very foundations whilst still using it to communicate. Perhaps most interesting was the group’s nonchalant admission that they perceived this to be the function of all languages ‘all languages are created purely for communication so dont [sic] have a cry about ppl been [sic] lazy’.