Unity in diversity: electronic patient record use in multidisciplinary practice

In this paper we examine the use of electronic patient records (EPR) by clinical specialists in their development of multidisciplinary care for diagnosis and treatment of breast cancer. We develop a practice theory lens to investigate EPR use across multidisciplinary team practice. Our findings suggest that there are oppositional tendencies towards diversity in EPR use and unity which emerges across multidisciplinary work, and this influences the outcomes of EPR use. The value of this perspective is illustrated through the analysis of a year-long, longitudinal case study of a multidisciplinary team of surgeons, oncologists, pathologists, radiologists, and nurse specialists adopting a new EPR. Each group adapted their use of the EPR to their diverse specialist practices, but they nonetheless orientated their use of the EPR to each others' practices sufficiently to support unity in multidisciplinary teamwork. Multidisciplinary practice elements were also reconfigured in an episode of explicit negotiations, resulting in significant changes in EPR use within team meetings. Our study contributes to the growing literature that questions the feasibility and necessity of achieving high levels of standardized, uniform health information technology use in healthcare.

A Stochastic Model for Electron Multiplication Charge-Coupled Devices - From Theory to Practice

Electron multiplication charge-coupled devices (EMCCD) are widely used for photon counting experiments and measurements of low intensity light sources, and are extensively employed in biological fluorescence imaging applications. These devices have a complex statistical behaviour that is often not fully considered in the analysis of EMCCD data. Robust and optimal analysis of EMCCD images requires an understanding of their noise properties, in particular to exploit fully the advantages of Bayesian and maximum-likelihood analysis techniques, whose value is increasingly recognised in biological imaging for obtaining robust quantitative measurements from challenging data. To improve our own EMCCD analysis and as an effort to aid that of the wider bioimaging community, we present, explain and discuss a detailed physical model for EMCCD noise properties, giving a likelihood function for image counts in each pixel for a given incident intensity, and we explain how to measure the parameters for this model from various calibration images. © 2013 Hirsch et al.

Closely correlating lower and upper bound plastic analysis of real slabs

An engineer assessing the load-carrying capacity of an existing reinforced concrete slab is likely to use elastic analysis to check the load at which the structure might be expected to fail in flexure or in shear. In practice, many reinforced concrete slabs are highly ductile in flexure, so an elastic analysis greatly underestimates the loads at which they fail in this mode. The use of conservative elastic analysis has led engineers to incorrectly condemn many slabs and therefore to specify unnecessary and wasteful flexural strengthening or replacement. The lower bound theorem is based on the same principles as the upper bound theorem used in yield line analysis, but any solution that rigorously satisfies the lower bound theorem is guaranteed to be a safe underestimate of the collapse load. Jackson presented a rigorous lower bound method that obtains very accurate results for complex real slabs.

Reliability analysis of deep excavation based on a semi-empirical approach

The design and construction of deep excavations in urban environment is often governed by serviceability limit state related to the risk of damage to adjacent buildings. In current practice, the assessment of excavation-induced building damage has focused on a deterministic approach. This paper presents a component/system reliability analysis framework to assess the probability that specified threshold design criteria for multiple serviceability limit states are exceeded. A recently developed Bayesian probabilistic framework is used to update the predictions of ground movements in the later stages of excavation based on the recorded deformation measurements. An example is presented to show how the serviceability performance for excavation problems can be assessed based on the component/system reliability analysis. © 2011 ASCE.

Numerical analysis of shallow foundations under combined horizontal and torsional loading

Foundations of subsea infrastructure in deep water subjected to asymmetric environmental loads have underscored the importance of combined torsional and horizontal loading effects on the bearing capacity of rectangular shallow foundations. The purpose of this study is to investigate the undrained sliding and torsional bearing capacity of rectangular and square shallow foundations together with the interaction response under combined loading using three-dimensional finite element (3D-FE) analysis. Upper bound plastic limit analysis is employed to establish a reference value for horizontal and torsional bearing capacity, and an interaction relationship for the combined loading condition. Satisfactory agreement of plastic limit analysis (PLA) and 3D-FE results for ultimate capacity and interaction curves ensures that simple PLA solution could be used to evaluate the bearing capacity problem of foundation under combined sliding and torsion.

Factor analysis and structural equation modelling of sustainable behaviour in contaminated land remediation

Contaminated land remediation has traditionally been viewed as sustainable practice because it reduces urban sprawl and mitigates risks to human being and the environment. However, in an emerging green and sustainable remediation (GSR) movement, remediation practitioners have increasingly recognized that remediation operations have their own environmental footprint. The GSR calls for sustainable behaviour in the remediation industry, for which a series of white papers and guidance documents have been published by various government agencies and professional organizations. However, the relationship between the adoption of such sustainable behaviour and its underlying driving forces has not been studied. This study aims to contribute to sustainability science by rendering a better understanding of what drives organizational behaviour in adopting sustainable practices. Factor analysis (FA) and structural equation modelling (SEM) were used to investigate the relationship between sustainable practices and key factors driving these behaviour changes in the remediation field. A conceptual model on sustainability in the environmental remediation industry was developed on the basis of stakeholder and institutional theories. The FA classified sustainability considerations, institutional promoting and impeding forces, and stakeholder's influence. Subsequently the SEM showed that institutional promoting forces had significant positive effects on adopting sustainability measures, and institutional impeding forces had significant negative effects. Stakeholder influences were found to have only marginal direct effect on the adoption of sustainability; however, they exert significant influence on institutional promoting forces, thus rendering high total effect (i.e. direct effect plus indirect effect) on the adoption of sustainability. This study suggests that sustainable remediation represents an advanced sustainable practice, which may only be fully endorsed by both internal and external stakeholders after its regulatory, normative and cognitive components are institutionalized. © 2014 Elsevier Ltd. All rights reserved.

Articulating current service development practices: a qualitative analysis of eleven mental health projects.

BACKGROUND: The utilisation of good design practices in the development of complex health services is essential to improving quality. Healthcare organisations, however, are often seriously out of step with modern design thinking and practice. As a starting point to encourage the uptake of good design practices, it is important to understand the context of their intended use. This study aims to do that by articulating current health service development practices. METHODS: Eleven service development projects carried out in a large mental health service were investigated through in-depth interviews with six operation managers. The critical decision method in conjunction with diagrammatic elicitation was used to capture descriptions of these projects. Stage-gate design models were then formed to visually articulate, classify and characterise different service development practices. RESULTS: Projects were grouped into three categories according to design process patterns: new service introduction and service integration; service improvement; service closure. Three common design stages: problem exploration, idea generation and solution evaluation - were then compared across the design process patterns. Consistent across projects were a top-down, policy-driven approach to exploration, underexploited idea generation and implementation-based evaluation. CONCLUSIONS: This study provides insight into where and how good design practices can contribute to the improvement of current service development practices. Specifically, the following suggestions for future service development practices are made: genuine user needs analysis for exploration; divergent thinking and innovative culture for idea generation; and fail-safe evaluation prior to implementation. Better training for managers through partnership working with design experts and researchers could be beneficial.

Analysis on suspended sediment deposition rate for muddy coast of reclaimed land

A new expression for calculating suspended fine-sediment deposition rate is developed based on theoretic analysis and experiments. The resulting equation is applied to simulation of fine sediment deposition in the reclaimed land in the Hangzhou Bay, China. The hydrodynamic environment in this area is solved by use of a long wave model, which gives the 2D-velocity field and considers bathymetric changes due to fine sediment deposition. The expression is proved convenient to use in engineering practice, and the predicted deposition rate agrees with the annual data available from field measurements from the first year to the third year after the construction of the long groin as a reclaiming method.

Exploring human resource development: a level of analysis approach.

Levels of analysis perform an important function in framing research and practice in human resource development (HRD). The purpose of this paper is to examine the concept of HRD from the individual, organizational and community/societal levels of analysis. The paper highlights both the distinctiveness and usefulness of each level of analysis, identifies tensions within and between them, and outlines differences in underpinning assumptions, characteristics of HRD provision and delivery of HRD interventions. By adopting this approach, the paper draws attention to variations in meaning, intent, content and practice with implications for developing both the theory and practice of HRD.

Design thinking - a critical analysis.

The latest buzz phrase to enter the world of design research is “Design Thinking”. But is this anything new and does it really have any practical or theoretical relevance to the design world? Many sceptics believe the term has more to do with business strategy and little to do with the complex process of designing products, services and systems. Moreover, many view the term as misleading and a cheap attempt to piggyback the world of business management onto design. This paper seeks to ask is design thinking anything new? Several authors have explicitly or implicitly articulated the term “Design Thinking” before, such as Peter Rowe’s seminal book “Design Thinking” [1] first published in 1987 and Herbert Simon’s “The Sciences of the Artificial” [2] first published in 1969. In Tim Brown’s “Change by Design” [3], design thinking is thought of as a system of three overlapping spaces rather than a sequence of orderly steps namely inspiration – the problem or opportunity that motivates the search for solutions; ideation – the process of generating, developing and testing ideas; and implementation – the path that leads from the design studio, lab and factory to the market. This paper seeks to examine and critically analyse the tenets of this new design thinking manifesto set against three case studies of modern design practice. As such, the paper will compare design thinking theory with the reality of design in practice.

The Sales Process Practice of Food and Drink SMEs - A Holistic Conceptual Framework: Steps, dimensions, barriers and enablers.

Purpose –The research examines the sales process practised by SMEs, and barriers and enablers that hinder and support effective selling practices from the selling organisation’s perspective in Scottish-based Food and Drink firms. Design/methodology approach - – The paper adopts an interpretivist perspective with qualitative data gathered through face-to-face semi-structured interviews. 20 people involved in selling activities were interviewed from 15 SMEs across Scotland. Thematic analysis established key findings regarding the sales process practice. Findings – Five themes emerged that affect the operationalisation of the selling process: the owner manager has considerable involvement in the sales process, SMEs with some degree of sales knowledge take a more systematic approach, SMEs lack awareness of how CRM technology can assist them, power is tipped in favour of the buyer and, the geographic location of the SME places constraints on how SMEs conduct business Research limitation/implication – Thematic analysis was chosen over other more traditional methods due to the lack of relevant quantitative data. The phenomenon of the research and research methodology means that it will not be possible to repeat this study and replicate its findings. However, the process that has been adopted does provide a basis for future research. Originality/value - The paper identifies areas where future research is required in the field alongside suggestions where policy makers and government business agencies might focus intervention to assist SMEs improve delivery of the sales process and selling effectiveness

Theory and practice in strategic planning for health information systems

Bradshaw, K. & Urquhart, C. (2005). Theory and practice in strategic planning for health information systems. In: D. Wainwright (Ed.), UK Academy for Information Systems 10th conference 2005, 22-24 March 2005 (CD-ROM). Newcastle upon Tyne: Northumbria University.

Training needs analysis of healthcare library staff, undertaken for South Yorkshire Workforce Development Confederation

Urquhart, C., Durbin, J. & Spink, S. (2004). Training needs analysis of healthcare library staff, undertaken for South Yorkshire Workforce Development Confederation. Aberystwyth: Department of Information Studies, University of Wales Aberystwyth. Sponsorship: South Yorkshire WDC (NHS)

An assessment of international best practice in visitor attraction management: does Scotland really lag behind?

Garrod, Brian, Leask, Anna and Fyall, Alan (2007) An assessment of ?international best practice? in visitor attraction management: does Scotland really lag behind? International Journal of Tourism Research, 9 (1), 21-42. RAE2008

The Practice and Understanding of the Eucharist in the United Church of Christ: A Practical Theological Study

This dissertation explores the complexity of the understanding and practice of the Eucharist in the United Church of Christ as revealed in a textual analysis of the UCC Book of Worship (1986) and a qualitative study of five representative UCC congregations. Little has been written on this topic, save for several brief articles on the history of the theology of the sacrament in the two bodies that merged to form the UCC in 1957: the Congregational Christian Churches (CC) and the Evangelical and Reformed Church (E&R). This dissertation advances the topic through a practical-theological study that brings into critical conversation contemporary eucharistic practices in five congregations and a historical theological analysis of liturgical traditions in the UCC and antecedent denominations. Through this conversation, the study articulates common themes of a UCC eucharistic theology and explores implications for ongoing theology and practice in the denomination. The introduction explicates the methodology employed in this study, guided by Don Browning's work. The first two chapters present the findings of the focus group interviews and an interpretation of those results respectively. Chapter three analyzes the eucharistic liturgies in three historic books of worship used in the E&R heritage. In chapter four, two of the antecedent resources utilized in the CC tradition are analyzed. The short-lived Hymnal of the United Church of Christ, published in 1974, includes liturgies that would find fuller expression in the 1986 Book of Worship. That hymnal is examined in chapter five. Chapter six interprets the two services of "Word and Sacrament" found in the Book of Worship. Chapter seven offers a comparative analysis of the focus group findings and the theology inherent in the Book of Worship. The final chapter offers strategic recommendations for revised theory and practice. The conclusion points toward areas for further research: it propels a critical conversation around the notion of covenant, Christ's presence in the meal, and who can receive and officiate at the Eucharist. This dissertation concludes that the UCC lives within a balance of multiple, complementary theologies and challenges the denomination to make stronger connections between the meal and mission, reconciliation, and tradition.