Monitoring care processes in the gynecologic oncology department

The care processes of healthcare providers are typically considered as human-centric, flexible, evolving, complex and multi-disciplinary. Consequently, acquiring an insight in the dynamics of these care processes can be an arduous task. A novel event log based approach for extracting valuable medical and organizational information on past executions of the care processes is presented in this study. Care processes are analyzed with the help of a preferential set of process mining techniques in order to discover recurring patterns, analyze and characterize process variants and identify adverse medical events.

The Role of the Law in Communicating Patient Safety

This chapter considers the role of the law in communicating patient safety. Downie, Lahey, Ford, et al’s (2006) preventing, knowing and responding theoretical framework is adopted to classify the different elements of patient safety law. Rather than setting out all relevant patient safety laws in detail, this chapter highlights key legal strategies which are employed to: prevent the occurrence of patient safety incidents (preventing); support the discovery and open discussion of patient safety incidents when they do occur (knowing),; and guide responses after they occur (responding) (Downie, Lahey, Ford, et al 2006). The law is increasingly being invoked to facilitate open discussion of and communication surrounding patient safety. After highlighting some legal strategies used to communicate patient safety, two practice examples are presented. The practice examples highlight different aspects of patient safety law and are indicative of communication issues commonly faced in practice. The first practice example focuses on the role of the Ccoroner in communicating patient safety. This example highlights the investigative role of the law in relation to patient safety (knowing). It also showcases the preventing responding and preventing elements in respect of the significant number of communication errors that can occur in a multi-disciplinary, networked health system. The main focus of the second practice example is responding example illustrates how the law responds to health service providers’ and professionals’ miscommunication (and subsequent incidents) during treatment, however it also touches upon knowing and preventing.

Death in the Bolivian High Plateau : Burials and Tiwanaku Society

My Ph.D. dissertation presents a multi-disciplinary analysis of the mortuary practices of the Tiwanaku culture of the Bolivian high plateau, situated at an altitude of c. 3800 m above sea level. The Tiwanaku State (c. AD 500-1150) was one of the most important pre-Inca civilisations of the South Central Andes. The book begins with a brief introductory chapter. In chapter 2 I discuss methodological and theoretical developments in archaeological mortuary studies from the late 1960s until the turn of the millennium. I am especially interested in the issue how archaeological burial data can be used to draw inferences on the social structure of prehistoric societies. Chapter 3 deals with the early historic sources written in the 16th and 17th centuries, following the Spanish Conquest of the Incas. In particular, I review information on how the Incas manifested status differences between and within social classes and what kinds of burial treatments they applied. In chapter 4 I compare the Inca case with 20th century ethnographic data on the Aymara Indians of the Bolivian high plateau. Even if Christianity has affected virtually every level of Aymara religion, surprisingly many traditional features can still be observed in present day Aymara mortuary ceremonies. The archaeological part of my book begins with chapter 5, which is an introduction into Tiwanaku archaeology. In the next chapter, I present an overview of previously reported Tiwanaku cemeteries and burials. Chapter 7 deals with my own excavations at the Late Tiwanaku/early post-Tiwanaku cemetery site of Tiraska, located on the south-eastern shore of Lake Titicaca. During the 1998, 2002, and 2003 field seasons, a total of 32 burials were investigated at Tiraska. The great majority of these were subterranean stone-lined tombs, each containing the skeletal remains of 1 individual and 1-2 ceramic vessels. Nine burials have been radiocarbon dated, the dates in question indicating that the cemetery was in use from the 10th until the 13th century AD. In chapter 8 I point out that considerable regional and/or ethnic differences can be noted between studied Tiwanaku cemetery sites. Because of the mentioned differences, and a general lack of securely dated burial contexts, I feel that at present we can do no better than to classify most studied Tiwanaku burials into three broad categories: (1) elite and/or priests, (2) "commoners", and (3) sacrificial victims and/or slaves and/or prisoners of war. On the basis of such indicators as monumental architecture and occupational specialisation we would expect to find considerable status-related differences in tomb size, grave goods, etc. among the Tiwanaku. Interestingly, however, such variation is rather modest, and the Tiwanaku seem to have been a lot less interested in expending considerable labour and resources in burial facilities than their pre-Columbian contemporaries of many parts of the Central Andes.

Shooting from the Wild Zone : A Study of the Chicana Art Photographers Laura Aguilar, Celia Álvarez Muñoz, Delilah Montoya, and Kathy Vargas

The dissertation analyzes and elaborates upon the changing map of U.S. ethno-racial formation from the vantage point of North American Studies, multi-disciplinary cultural studies, and the criticism of visual culture. The focus is on four contemporary Mexican American (Chicana) women photographers, whose art production is discussed, on the one hand, in the context of the Euro-American history of photographic genres and, on the other hand, in the context of so-called decolonizing cultural and academic discourses produced by Mexican Americans themselves. The manuscript consists of two parts. Part I outlines the theoretical and methodological domain of the study, positioning it in the interstices of American studies, European postmodern criticism, postcolonial feminist theory, and the theories of visual culture, particularly of art photography. In addition, the main issues and paradigms of Chicano Studies (Mexican American ethnic studies) are introduced. Part II consists of seven essays, each of which discusses rather independently a particular photographic work or a series of photographs, formulating and defending arguments about their meaning, position in the history of photographic genres, and their cultural and socio-political significance. The study closes with a discussion about ethno-racial identity formation and the role of Chicana photography therein - in embodying and reproducing new subjectivities, alternative categories of knowledge, and open ended historical narratives. It is argued that, symbolically, the "Wild Zone" of gendered and race-specific knowledge becomes associated with the body of the mother, a recurrent image in Chicana art works under discussion. Embedded in this image, the construction of an alternative notion of a family thus articulates the parameters of a matrifocal ethno-racial community unified by the proliferation of differences rather than by conformities typical of nationalistic ideologies. While focusing on art photography, the study as a whole simultaneously constructs, from a European vantage point, a "thick" description of Mexican American history, identities, communities, cultural practices, and self-representations about which very little is known in Finland.

New Generation Rollingstock Depot: Case Study Report

This report summarises the findings of a case study on Queensland’s New Generation Rollingstock (NGR) Project carried out as part of SBEnrc Project 2.34 Driving Whole-of-life Efficiencies through BIM and Procurement. This case study is one of three exemplar projects studied in order to leverage academic research in defining indicators for measuring tangible and intangible benefits of Building Information Modelling (BIM) across a project’s life-cycle in infrastructure and buildings. The NGR is an AUD 4.4 billion project carried out under an Availability Payment Public-Private Partnership (PPP) between the Queensland Government and the Bomabardier-led QTECTIC consortium comprising Bombardier Transportation, John Laing, ITOCHU Corporation and Aberdeen Infrastructure Investments. BIM has been deployed on the project from conceptual stages to drive both design and the currently ongoing construction at the Wulkuraka Project Site. This case study sourced information from a series of semi-structured interviews covering a cross-section of key stakeholders on the project. The present research identified 25 benefits gained from implementing BIM processes and tools. Some of the most prominent benefits were those leading to improved outcomes and higher customer satisfaction such as improved communications, data and information management, and coordination. There were also a number of expected benefits for future phases such as: • Improved decision making through the use of BIM for managing assets • Improved models through BIM maturity • Better utilisation of BIM for procurement on similar future projects • New capacity to specify the content of BIM models within contracts There were also three benefits that were expected to have been achieved but were not realised on the NGR project. These were higher construction information quality levels, better alignment in design teams as well as project teams, and capability improvements in measuring the impact of BIM on construction safety. This report includes individual profiles describing each benefit as well as the tools and processes that enabled them. Four key BIM metrics were found to be currently in use and six more were identified as potential metrics for the future. This case study also provides insights into challenges associated with implementing BIM on a project of the size and complexity of the NGR. Procurement aspects and lessons learned for managers are also highlighted, including a list of recommendations for developing a framework to assess the benefits of BIM across the project life-cycle.

Promoting articulated action from diverse stakeholders in response to public policy scenarios: A case analysis of the use of ‘scenario improvisation’ method

In this paper we present a novel application of scenario methods to engage a diverse constituency of senior stakeholders, with limited time availability, in debate to inform planning and policy development. Our case study project explores post-carbon futures for the Latrobe Valley region of the Australian state of Victoria. Our approach involved initial deductive development of two ‘extreme scenarios’ by a multi-disciplinary research team, based upon an extensive research programme. Over four workshops with the stakeholder constituency, these initial scenarios were discussed, challenged, refined and expanded through an inductive process, whereby participants took ‘ownership’ of a final set of three scenarios. These were both comfortable and challenging to them. The outcomes of this process subsequently informed public policy development for the region. Whilst this process did not follow a single extant structured, multi-stage scenario approach, neither was it devoid of form. Here, we seek to theorise and codify elements of our process – which we term ‘scenario improvisation’ – such that others may adopt it.

Molecular evidence of Ebola Reston virus infection in Philippine bats

Background: In 2008-09, evidence of Reston ebolavirus (RESTV) infection was found in domestic pigs and pig workers in the Philippines. With species of bats having been shown to be the cryptic reservoir of filoviruses elsewhere, the Philippine government, in conjunction with the Food and Agriculture Organization of the United Nations, assembled a multi-disciplinary and multi-institutional team to investigate Philippine bats as the possible reservoir of RESTV. Methods: The team undertook surveillance of bat populations at multiple locations during 2010 using both serology and molecular assays. Results: A total of 464 bats from 21 species were sampled. We found both molecular and serologic evidence of RESTV infection in multiple bat species. RNA was detected with quantitative PCR (qPCR) in oropharyngeal swabs taken from Miniopterus schreibersii, with three samples yielding a product on conventional hemi-nested PCR whose sequences differed from a Philippine pig isolate by a single nucleotide. Uncorroborated qPCR detections may indicate RESTV nucleic acid in several additional bat species (M. australis, C. brachyotis and Ch. plicata). We also detected anti-RESTV antibodies in three bats (Acerodon jubatus) using both Western blot and ELISA. Conclusions: The findings suggest that ebolavirus infection is taxonomically widespread in Philippine bats, but the evident low prevalence and low viral load warrants expanded surveillance to elaborate the findings, and more broadly, to determine the taxonomic and geographic occurrence of ebolaviruses in bats in the region. © 2015 Jayme et al.

What kind of sick person would see a Foot Doctor! The Foot Disease in Inpatients Study (FDIS)

Background Many different guidelines recommend people with foot complications, or those at risk, should attend multiple health professionals for foot care each year. However, few studies have investigated the characteristics of those attending health professionals for foot care and if those characteristics match those requiring foot care as per guideline recommendations. The aim of this paper was to determine the associated characteristics of people who attended a health professional for foot care in the year prior to their hospitalisation. Methods Eligible participants were all adults admitted overnight, for any reason, into five diverse hospitals on one day; excluding maternity, mental health and cognitively impaired patients. Participants underwent a foot examination to clinically diagnose different foot complications; including wounds, infections, deformity, peripheral arterial disease and peripheral neuropathy. They were also surveyed on social determinant, medical history, self-care, foot complication history, and, past health professional attendance for foot care in the year prior to hospitalisation. Results Overall, 733 participants consented; mean(±SD) age 62(±19) years, 408 (55.8%) male, 172 (23.5%) diabetes. Two hundred and fifty-six (34.9% (95% CI) (31.6-38.4)) participants had attended a health professional for foot care; including attending podiatrists 180 (24.5%), GPs 93 (24.6%), and surgeons 36 (4.9%). In backwards stepwise multivariate analyses attending any health professional for foot care was independently associated (OR (95% CI)) with diabetes (3.0 (2.1-4.5)), arthritis (1.8 (1.3-2.6)), mobility impairment (2.0 (1.4-2.9)) and previous foot ulcer (5.4 (2.9-10.0)). Attending a podiatrist was independently associated with female gender (2.6 (1.7-3.9)), increasing years of age (1.06 (1.04-1.08), diabetes (5.0 (3.2-7.9)), arthritis (2.0 (1.3-3.0)), hypertension (1.7 (1.1-2.6) and previous foot ulcer (4.5 (2.4-8.1). While attending a GP was independently associated with having a foot ulcer (10.4 (5.6-19.2). Conclusions Promisingly these findings indicate that people with a diagnosis of diabetes and arthritis are more likely to attend health professionals for foot care. However, it also appears those with active foot complications, or significant risk factors, may not be more likely to receive the multi-disciplinary foot care recommended by guidelines. More concerted efforts are required to ensure all people with foot complications are receiving recommended foot care.

Water management capacity building to support rapidly developing mining economies

Many developing countries are experiencing rapid expansion in mining with associated water impacts. In most cases mining expansion is outpacing the building of national capacity to ensure that sustainable water management practices are implemented. Since 2011, Australia's International Mining for Development Centre (IM4DC) has funded capacity building in such countries including a program of water projects. Five projects in particular (principally covering experiences from Peru, Colombia, Ghana, Zambia, Indonesia, Philippines and Mongolia) have provided insight into water capacity building priorities and opportunities. This paper reviews the challenges faced by water stakeholders, and proposes the associated capacity needs. The paper uses the evidence derived from the IM4DC projects to develop a set of specific capacity-building recommendations. Recommendations include: the incorporation of mine water management in engineering and environmental undergraduate courses; secondments of staff to suitable partner organisations; training to allow site staff to effectively monitor water including community impacts; leadership training to support a water stewardship culture; training of officials to support implementation of catchment management approaches; and the empowerment of communities to recognise and negotiate solutions to mine-related risks. New initiatives to fund the transfer of multi-disciplinary knowledge from nations with well-developed water management practices are called for.

Kehittämistutkimus: Tieto- ja viestintätekniikkaa kemian opetukseen

The main aim of the present study was to develop information and communication technology (ICT) based chemistry education. The goals for the study were to support meaningful chemistry learning, research-based teaching and diffusion of ICT innovations. These goals were used as guidelines that form the theoretical framework for this study. This Doctoral Dissertation is based on eight-stage research project that included three design researches. These three design researches were scrutinized as separate case studies in which the different cases were formed according to different design teams: i) one researcher was in charge of the design and teachers were involved in the research process, ii) a research group was in charge of the design and students were involved in the research process, and iii) the design was done by student teams, the research was done collaboratively, and the design process was coordinated by a researcher. The research projects were conducted using mixed method approach, which enabled a comprehensive view on education design. In addition, the three central areas of design research: problem analysis, design solution and design process were included in the research, which was guided by the main research questions formed according to these central areas: 1) design solution: what kind of elements are included in ICT-based learning environments that support meaningful chemistry learning and diffusion of innovation, 2) problem analysis: what kind of new possibilities the designed learning environments offer for the support of meaningful chemistry learning, and 3) design process: what kind of opportunities and challenges does collaboration bring to the design of ICT-based learning environments? The main research questions were answered according to the analysis of the survey and observation data, six designed learning environments and ten design narratives from the three case studies. Altogether 139 chemistry teachers and teacher students were involved in the design processes. The data was mainly analysed by methods of qualitative content analysis. The first main result from the study give new information on the meaningful chemistry learning and the elements of ICT-based learning environment that support the diffusion of innovation, which can help in the development of future ICT-education design. When the designed learning environment was examined in the context of chemistry education, it was evident that an ICT-based chemistry learning environment supporting the meaningful learning of chemistry motivates the students and makes the teacher s work easier. In addition, it should enable the simultaneous fulfilment of several pedagogical goals and activate higher-level cognitive processes. The learning environment supporting the diffusion of ICT innovation is suitable for Finnish school environment, based on open source code, and easy to use with quality chemistry content. According to the second main result, new information was acquired about the possibilities of ICT-based learning environments in supporting meaningful chemistry learning. This will help in setting the goals for future ICT education. After the analysis of design solutions and their evaluations, it can be said that ICT enables the recognition of all elements that define learning environments (i.e. didactic, physical, technological and social elements). The research particularly demonstrates the significance of ICT in supporting students motivation and higher-level cognitive processes as well as versatile visualization resources for chemistry that ICT makes possible. In addition, research-based teaching method supports well the diffusion of studied innovation on individual level. The third main result brought out new information on the significance of collaboration in design research, which guides the design of ICT education development. According to the analysis of design narratives, it can be said that collaboration is important in the execution of scientifically reliable design research. It enables comprehensive requirement analysis and multifaceted development, which improves the reliability and validity of the research. At the same time, it sets reliability challenges by complicating documenting and coordination, for example. In addition, a new method for design research was developed. Its aim is to support the execution of complicated collaborative design projects. To increase the reliability and validity of the research, a model theory was used. It enables time-pound documenting and visualization of design decisions that clarify the process. This improves the reliability of the research. The validity of the research is improved by requirement definition through models. This way learning environments that meet the design goals can be constructed. The designed method can be used in education development from comprehensive to higher level. It can be used to recognize the needs of different interest groups and individuals with regard to processes, technology and substance knowledge as well as interfaces and relations between them. The developed method has also commercial potential. It is used to design learning environments for national and international market.

Quasicrystals:Indian research accomplishments and imperatives

: Within two months of the first report on quasicrystals in PRL in November 1984, Indian research which had a 'premature discovery' in 1978 in this area got under way, In the past nine years these efforts have led to original discoveries relating to new types of quasicrystalline phases as well as extensive investigations involving tiling theory, hyperspace, positron annihilation and electrical properties, These researches have been multi-institutional and multi-disciplinary. Enlightened and generous funding was extended by DST from 1986 by recognizing it as a thrust area in basic research via SERC and US-India Funds. International recognition, subjective though it is, in the form of citation of Indian papers, invited lectures and reviews, books as well as the membership of International Advisory Committee has followed and is among the highest in the fields of condensed matter science covered at the Bangalore meeting, Future directions pertaining to the exploration of mechanical and electronic properties as well as structures beyond the quasicrystalline order will be pointed out.

An Empirical Model of the Process of Synthesis of Multiple State Mechanical Devices

Automated synthesis of mechanical designs is an important step towards the development of an intelligent CAD system. Research into methods for supporting conceptual design using automated synthesis has attracted much attention in the past decades. The research work presented here is based on the processes of synthesizing multiple state mechanical devices carried out individually by ten engineering designers. The designers are asked to think aloud, while carrying out the synthesis. The ten design synthesis processes are video recorded, and the records are transcribed and coded for identifying activities occurring in the synthesis processes, as well as for identifying the inputs to and outputs from the activities. A mathematical representation for specifying multi-state design task is proposed. Further, a descriptive model capturing all the ten synthesis processes is developed and presented in this paper. This will be used to identify the outstanding issues to be resolved before a system for supporting design synthesis of multiple state mechanical devices that is capable of creating a comprehensive variety of solution alternatives could be developed.

Combining ``chimie douce'' and green principles for the developing world: Improving industrial viability of photocatalytic water remediation

We highlight the need for a comprehensive, multi-disciplinary approach for the development of cost-effective water remediation methods. Combining ``chimie douce'' and green chemical principles seems essential for making these technologies economically viable and socially relevant (especially in the developing world). A comprehensive approach to water remediation will take into account issues such as nanotoxicity, chemical yield, cost, and ease of deployment in reactors. By considering technological challenges that lie ahead, we will attempt to identify directions that are likely to make photocatalytic water remediation a more global technology than it currently is. (C) 2013 Elsevier Ltd. All rights reserved

Aplicación de parámetros matemáticos en un trabajo multidisciplinario de composición musical asistida por computadora sobre una temática folklórica

Resumen: En el marco de un proyecto de la Vicerrectoría de Investigaciones de la Universidad de Caldas denominado “Resignificación músico-pictórica del mito de la Salamanca” surgió la conveniencia de aplicar y diseñar programas de fundamentación matemática que permitieran definir la estructura y el tratamiento acústico de la obra especialmente escrita para este proyecto. Principalmente nos basamos en la implementación de la Transformada Rápida de Fourier (Fast Fourier Transform) para el análisis de espectros armónicos y su modificación en vivo y en la utilización de un entorno de programación para procesamiento de sonido en tiempo real. El marco general de la investigación parte del enfoque de Regionalismo Crítico procedente de las propuestas de Kenneth Frampton referentes originalmente a la crítica de la arquitectura. El planteamiento como investigación mutidisciplinaria implica (1) una visión crítica de la substancia mítica y social subyacente, (2) una resignificación pictórica por medio de fotografía, animación y pintura, basada en la sustancia visual que contiene el mito, (3) un enfoque musical electroacústico, a partir del material que surge del folklor local, utilizando la intervención de instrumentos en vivo y procesamiento en tiempo real.

Vertical transport and exchange of materials in the upper waters of the oceans (VERTEX): introduction to the program, hydrographic conditions and major component fluxes during VERTEX I

This paper introduces VERTEX, a multi-disciplinary research program dealing with various aspects of particle transport in the upper, high-energy layers (0-2000 m) of the ocean. Background information is presented on hydrography, biological composition of trapped particulates, and major component fluxes observed on a cruise off central California (VERTEX I). Organic C fluxes measured with two trap systems are compared with several other estimates taken from the literature. The intent of this overview paper is to provide a common setting in an economical manner, and avoid undue repetition of background and ancillary information in subsequent publications. (PDF is 43 pages).