Software quality assurance : in large scale and complex software-intensive systems

In recent decades we have seen enormous increases in the capabilities of software intensive systems, resulting in exponential growth in their size and complexity. Software and systems engineers routinely develop systems with advanced functionalities that would not even have been conceived of 20 years ago. This observation was highlighted in the Critical Code report commissioned by the US Department of Defense in 2010, which identified a critical software engineering challenge as theability to deliver “software assurance in the presence of...architectural innovation and complexity, criticality with respect to safety, (and) overall complexity and scale”.

"Tomorrow's car" : Deakin Universities new cross vehicle that combines the best of 2 worlds

Motorbike riders are 34-times more likely to die in a crash compared to car drivers per km travelled (1). Such safety risks together with special skill requirements for the driver and much lower comfort compared to normal cars are the main reasons why motorbikes represent only a fraction of all vehicle sales in developed countries. Deakin University is developing a revolutionary cross-over fun vehicle with ultra low fuel consumption and emissions. This new vehicle generation combines the best of two worlds: the fun to drive, low cost, and small size of a scooter together with the safety, comfort and easiness to operate of a car. The result is a vehicle that is more fuel efficient than most cars or even scooters.

Various tilting cross over vehicles have been presented over the last decade that were trying to automate the tilting control of narrow vehicles to make them safer. Examples of these concepts are the Carver, Clever and in some way also the MP3 scooter from Piaggio. The problem with fully enclosed concepts like the Carver or Clever is that they require very complex and therefore also expensive tilting control systems so that the vehicles are not price competitive compared to low cost micro cars or even normal small cars. The MP3 on the other hand comes with a tilting control system which is only semi automatic so that typical car advantages - comprehensive safety features like crush zones, roll over protection, air bags, safety belts or comfort features like full weather protection including heating and cooling – can not be provided.

Deakin’s approach is quite different to the above mentioned concepts. The requirements were derived based on two different investigations: The first step was a critical evaluation of social trends and the second step was an in-depth benchmarking study of existing concepts which identified the typical strengths and weaknesses of these concepts. In a critical next step a new concept was created that addresses most of the weaknesses of existing tilting three-wheelers in a holistic approach by setting clear priority rankings for the vehicle targets, based on current trends. The priorities were set in the following order: Safety, Affordability, Fun and Efficiency (SAFE).

The key feature that enables an enclosed tilting vehicle is a fully automatic tilting control system. With an automatic tilting control system the driver does not need to put the feet on the ground to balance the vehicle when he stops, so the vehicle can be built with a full enclosure. This allows the implementation of typical car like safety features (seat belts, roll over structure, crush zones, air bags). The SafeRide™ tilting control system is a passive system that involves the driver’s balancing sense in its feedback control system. The vehicle has typical scooter like steering characteristics, where the steering is initiated through countersteering. Another safety critical design feature is the crush zone between the two front wheels which is not possible with only one front wheel or with the powertrain positioned between the front wheels, as the powertrain can’t absorb a lot of energy due to its structural stiffness and density. The passive tilting control system is quite simple and therefore makes the vehicle very affordable, an important factor for successful commercialisation.

Another advantage of integrating the human balancing senses in the feedback control of the tilting system is that the system kicks in slightly after the human balancing reacts. In some instances that can generate the typical adrenalin thrill known from riding a bike. This fun factor is quite common with many trend sports like mountain biking, surfing, roller-skating, snowboarding, or skateboarding. Some of these sports have seen very rapid growth only a short time after they have been invented. Utilising the human balancing system during driving also makes the vehicle safer as the adrenalin is produced after reaching a semi-stable driving condition that is controlled by the vehicles tilting control system, but before the vehicle reaches an unstable driving condition that can not be controlled by the vehicle but only (eventually) by the driver – if he has got the required driving skill and if he is alert enough.

Efficiency superior to most cars and scooters is achieved by the aerodynamics of a fully enclosed body structure in combination with the small frontal area of a typical scooter and the droplet shape enabled by the relatively wide front with 2 wheels and the very narrow tail with only one rear wheel. The passive tilting system also contributes to the extreme efficiency as the system only draws some small electrical power for the electronic control unit. Another feature is a low cost exhaust energy recovery system which is discussed in another paper.

FESTAL: fault-tolerant elastic scheduling algorithm for real-time tasks in virtualized clouds

As clouds have been deployed widely in various fields, the reliability and availability of clouds become the major concern of cloud service providers and users. Thereby, fault tolerance in clouds receives a great deal of attention in both industry and academia, especially for real-time applications due to their safety critical nature. Large amounts of researches have been conducted to realize fault tolerance in distributed systems, among which fault-tolerant scheduling plays a significant role. However, few researches on the fault-tolerant scheduling study the virtualization and the elasticity, two key features of clouds, sufficiently. To address this issue, this paper presents a fault-tolerant mechanism which extends the primary-backup model to incorporate the features of clouds. Meanwhile, for the first time, we propose an elastic resource provisioning mechanism in the fault-tolerant context to improve the resource utilization. On the basis of the fault-tolerant mechanism and the elastic resource provisioning mechanism, we design novel fault-tolerant elastic scheduling algorithms for real-time tasks in clouds named FESTAL, aiming at achieving both fault tolerance and high resource utilization in clouds. Extensive experiments injecting with random synthetic workloads as well as the workload from the latest version of the Google cloud tracelogs are conducted by CloudSim to compare FESTAL with three baseline algorithms, i.e., Non-M igration-FESTAL (NMFESTAL), Non-Overlapping-FESTAL (NOFESTAL), and Elastic First Fit (EFF). The experimental results demonstrate that FESTAL is able to effectively enhance the performance of virtualized clouds.

Adoption and maintenance of environmental management systems: critical success factors

The implementation of various management systems and standards has become an important activity for organisations irrespective of their size, sector or nature of the business. Even with a history of implementing change across the organisation, managers continue to experience resistance and challenges when implementing and maintaining the systems/standards, whether they be in quality, occupational health and safety, environmental or any other area. Based on a major research project recently completed, this paper presents the critical success factors for successful implementation of an environmental management system. The project involved three phases of fieldwork: preliminary interviews, a questionnaire survey and in-depth interviews. A brief summary of the findings from each of these phases of research is presented. Based on the findings, the paper discusses the critical success factors for the successful implementation and maintenance of EMS.

Occupational safety and health management systems in Australia: barriers to success

The growing popularity of occupational safety and health management systems in Australia has stimulated critical debate about their effectiveness. This paper asks whether the performance of such systems lives up to expectations. Making use of a research review and an extensive interviewing programme, the paper draws several conclusions. First, it observes that the definitional requirements for an occupational safety and health management system have been watered down, making it more likely that organisations can claim to have a system, but less likely that it will be effective. Second, a review of empirical research reinforces the view that systems can improve health and safety outcomes, but only if they meet strict conditions concerning senior management commitment, effective workforce involvement and programme integration. Third, several barriers to successful implementation are identified, including the failure to meet essential success factors, the inappropriate application of audit tools to ensure compliance, and their problematic application in certain sectors such as small business, contractors, and the part-time and temporary workforce. The paper concludes that occupational safety and health management systems can live up to their promise, but often fail to do so because of inadequate implementation or application in hostile environments.

Key stakeholders' expectations of educational outcomes from Australian critical care nursing courses: a Delphi study

Background
Educational preparation for critical care nursing in Australia varies considerably in terms of the level of qualification resulting in a lack of clarity for key stakeholders about student outcomes.

Objectives
The study aim was to identify and reach consensus regarding the desired learning outcomes from Australian post-registration critical care education programs as demonstrated through the graduate's knowledge, skills and attitudes.

Design
A Delphi technique was used to establish consensus between educators, managers, clinicians and students regarding learning outcomes expected of graduates with a Graduate Certificate, Graduate Diploma and Master level qualification in critical care nursing.

Participants
A total of 164 critical care nurses (66 clinicians, 48 educators, 32 managers and 18 students) participated and 99 questionnaires were returned in the first round (response rate 60%). Fifty-seven questionnaires were returned for Round 2 (response rate 58%).

Methods
Learning outcomes were obtained from the Australian College of Critical Care Nurses Competency Standards for Specialist Critical Care Nurses. Some statements included more than one characteristic, and these were split to create learning outcomes with one characteristic per item. A survey of Australian higher education providers of critical care education provided additional learning outcomes, for a total of 73 learning outcomes for the first Delphi round.

Results
Findings suggest that patient comfort, safety, professional responsibility and ethical conduct are deemed most important for all three levels of educational preparation. There was a lack of emphasis on clinical practice issues for all levels. Participants placed higher emphasis on learning outcomes related to complex decision-making, leadership, supervision, policy development and research for Graduate Diploma and Master level programs.

Conclusion
The findings have implications for curriculum development and the profession with regards to the level of educational preparation required of critical care nurses and suggest that further work is required before clear recommendations can be made for desired educational outcomes from critical care nursing programs in Australia.

Critical infrastructure systems modelling : benchmarking CPN tools

This paper reports on the application of systems modelling benchmarks to determine the viability of systems modelling software and its suitability for modelling critical infrastructure systems. This research applies the earlier research that related to developing benchmarks that when applied to systems modelling software will indicate its likely suitability to modelling critical infrastructure systems. In this context, the systems modelling benchmarks will assess the practicality of CPNTools to the task of modelling critical infrastructure systems.

Engaging patients as safety partners : some considerations for ensuring a culturally and linguistically appropriate approach

Engaging patients as ‘safety partners’ with health service providers to help identify and rectify preventable adverse events in health care is being increasingly accepted in the USA, Australia, and elsewhere as a promising strategy to improve patient safety outcomes. The implications of this trend for patients and families of minority cultural and language backgrounds have not, however, been comprehensively considered. In this article, attention is given to briefly exploring the notion of patient participation in health care and the problematic transposition of the concept into patient safety discourse. The importance of recognising and responding to the critical relationship between culture, language and
patient safety outcomes, and the possible benefits and risks of engaging patients of minority ethnic backgrounds in safety partnership programs are explored. It is suggested that if patient safety engagement/partnership programs are to perform well in cross-cultural health care contexts, they need to be supported by research evidence and appropriately informed by the perspectives and experiences of patients and families/nominated carers from minority cultural and language backgrounds. They also need to be appropriately supported by culturally competent policies and practices across the entire health care system. The importance of robust internationally comparative research on this issue is highlighted.

Implementation of a medication guideline to improve medication safety for patients

Although the incidence of medication error remains unknown, in Australian hospitals, they are thought to occur in 5-20 % of drug administrations 1. Not surprisingly, international debate has focused on the mechanisms to improve the safety of patients. Thus a new National Inpatient Medication Chart (NIMC) was endorsed to improve communication and reduce medication errors 2. This study aimed to investigate the documentation practices of clinicians following the implementation of a medication guideline and NIMC.
A pre and post-test design was used to evaluate the adoption of and adherence to the medication guideline at Western Health, an 850 bed healthcare network in Australia. Audits of inpatient medication charts (N=265) were conducted at 3 months prior to and repeated 4 months (N=290) after implementation. The pre-test data was used to formulate an interdisciplinary organizational strategy that included mandatory education for all clinical staff, practice reminders, decision prompts, a telephone hotline for support, an intranet information website and electronically distributed Frequently Asked Questions.
Pre and post implementation audits highlighted areas of potential medication error. The post-test showed an overall trend towards improvement in documentation. There were significant improvements in 4 critical practices: Drug name clear (p=0.0003); Drug dose clear (p=0.0002); Prescribed frequency equals documented frequency (p=0) and; No signature by administrator (p=0).
The majority of documentation errors showed poor attention to detail and would be considered a slip or lapse in skill based judgment 3. Although this study was designed to evaluate documentation practices, future research should include observation methods to increase our understanding of the context behind the judgments such as work place interruptions, skill mix and knowledge levels. While evidence based guidelines enable work, they are not the actual work or substance of patient care. Organisational systems can assist in preventing unconscious aberrations that lead to error.

Culture, language, and patient safety : making the link

It has been well recognized internationally that hospitals are not as safe as they should be. In order to redress this situation, health care services around the world have turned their attention to strategically implementing robust patient safety and quality care programmes to identify circumstances that put patients at risk of harm and then acting to prevent or control those risks. Despite the progress that has been made in improving hospital safety in recent years, there is emerging evidence that patients of minority cultural and language backgrounds are disproportionately at risk of experiencing preventable adverse events while in hospital compared with mainstream patient groups. One reason for this is that patient safety programmes have tended to underestimate and understate the critical relationship that exists between culture, language, and the safety and quality of care of patients from minority racial, ethno-cultural, and language backgrounds. This article suggests that the failure to recognize the critical link between culture and language (of both the providers and recipients of health care) and patient safety stands as a ‘resident pathogen’ within the health care system that, if not addressed, unacceptably exposes patients from minority ethno-cultural and language backgrounds to preventable adverse events in hospital contexts. It is further suggested that in order to ensure that minority as well as majority patient interests in receiving safe and quality care are properly protected, the culture–language–patient-safety link needs to be formally recognized and the vulnerabilities of patients from minority cultural and language backgrounds explicitly identified and actively addressed in patient safety systems and processes.

Clinical risk management and patient safety education for nurses : a critique

Nurses have a pivotal role to play in clinical risk management (CRM) and promoting patient safety in health care domains. Accordingly, nurses need to be prepared educationally to manage clinical risk effectively when delivering patient care. Just what form the CRM and safety education of nurses should take, however, remains an open question. A recent search of the literature has revealed a surprising lack of evidence substantiating models of effective CRM and safety education for nurses. In this paper, a critical discussion is advanced on the question of CRM and safety education for nurses and the need for nurse education in this area to be reviewed and systematically researched as a strategic priority, nationally and internationally. It is a key contention of this paper that without ‘good’ safety education research it will not be possible to ensure that the educational programs that are being offered to nurses in this area are evidence-based and designed in a manner that will enable nurses to develop the capabilities they need to respond effectively to the multifaceted and complex demands that are inherent in their ethical and professional responsibilities to promote and protect patient safety and quality care in health care domains.

Critical success factors for the requirements engineering process, with reference to quality management of information systems development

Preliminary research into the critical factors associated with software development/implementation identified three dimensions for successful implementation based on alignment of the requirements engineering process with business needs, change management process and quality of the implementation process. Research results demonstrate the link between the conceptual model for process quality and the process management attributes determined during the research.

A review of clozapine safety

Clozapine is a distinctive antipsychotic agent, having a unique clinical profile and an idiosyncratic safety profile. More so than with other agents, the weighting of its adverse event profile is critical, in order to counterbalance its clear clinical advantages. The safety issues with clozapine are in a number of areas, some of which are considered medical emergencies and potentially life-threatening. These include haematological (neutropenia and agranulocytosis), CNS (seizures), cardiovascular (myocarditis and cardiomyopathy), metabolic (diabetes), gastrointestinal and neuromuscular. Understanding the safety profile of clozapine allows an informed use of the agent that can maximise its clear clinical benefit and minimise the known risks.

Quality of life in restless legs syndrome: A systematic review of clinical trials and a critical review of instruments

Restless legs syndrome (RLS) is a neurological movement disorder characterized by sensory symptoms and motor disturbances. While the underlying cause remains unknown, it is suggested that 20–25% of people with RLS are affected seriously enough to require pharmacological treatment. Dopamine agonists (DAs) are the most common treatment and act by increasing the low levels of dopamine to which RLS is often attributed. A growing literature highlights the debilitating and distressing nature of this condition from the patient's perspective. While sleep problems are most commonly reported, the impact of RLS on quality of life (QOL) is wide ranging, affecting relationships with partners, sex life, family life, social life, leisure activities, friendships, everyday activities, concentration, travel, career/work, sleep, and health.

We conducted a systematic review of clinical trials in which DAs have been evaluated in terms of RLS-specific QOL, i.e. their impact on the QOL of people with RLS, and critically reviewed the development history and measurement properties of RLS-specific QOL instruments.

A systematic search using terms synonymous with RLS, DAs and QOL was conducted using Scopus software, which includes MEDLINE, PsycINFO, EMBASE, and CINAHL. Our search covered publications from 2000 (prior to which RLS-specific QOL measures did not exist) to August 2009. Trials were included in our review if they evaluated DAs for the treatment of adults with RLS and reported evaluation using an RLS-specific QOL measure. We also ran citation searches to identify papers reporting the development history and measurement properties of the identified RLS-specific QOL instruments.

Three measures of RLS-specific QOL have been developed in recent years and are reviewed here: the Restless Legs Syndrome Quality of Life (RLSQOL) questionnaire, the Restless Legs Syndrome Quality of Life Instrument (RLS-QLI), and the Quality of Life Restless Legs Syndrome (QOL-RLS) measure. Critical review indicates that each has limitations (particularly in terms of published developmental history and content validity). Eleven trials of DAs were identified that included assessment of RLS-specific QOL (nine using the RLSQOL and two using the QOL-RLS). In all studies, significant improvements in RLS-specific QOL were observed, although these were mostly short term (12 weeks) and large placebo effects were also noted.

In people with RLS, the use of DAs has been shown to improve RLS-specific QOL. Longer-term, large-scale studies may be needed to confirm these findings and demonstrate statistically significant improvements in RLS-specific QOL at lower doses. Further development of the RLS-specific QOL measures is needed to ensure that the full impact of RLS (and the full benefit of new treatments) on aspects of life identified as important to individuals is captured in future studies.

Building nature’s safety net 2011 : the state of protected areas for Australia’s ecosystems and wildlife.

This report is the third in a series with the two previous reports published in 2006 and 2008. This report details major conservation initiatives that have occurred in Australia since the last report, in which data was current to 2006, and highlights emerging issues. A major enhancement on previous reports is the inclusion of ecosystem and threatened species gap analyses, and the reporting on Australia's protected area systems on both land and sea. We define a minimum standard for an adequate, representative, and comprehensive reserve system by sampling ecosystem and species level diversity. Using the latest protected area and national species and ecosystem spatial data, we quantify the gaps: those areas needing to move from the current reserve system to one which meets the minimum standard. We also use data provided by various parks agencies, from responses to a questionnaire or as published by the agencies, to detail financial investments in protected areas, and estimate the investment levels needed to fill the documented gaps. We also identify critical policy changes needed to more effectively fill the identified gaps.