Chronicling the patient journey: Co-creating value with digital health ecosystems

With the introduction of the PCEHR (Personally Controlled Electronic Health Record), the Australian public is being asked to accept greater responsibility for the management of their health information. However, the implementation of the PCEHR has occasioned poor adoption rates underscored by criticism from stakeholders with concerns about transparency, accountability, privacy, confidentiality, governance, and limited capabilities. This study adopts an ethnographic lens to observe how information is created and used during the patient journey and the social factors impacting on the adoption of the PCEHR at the micro-level in order to develop a conceptual model that will encourage the sharing of patient information within the cycle of care. Objective: This study aims to firstly, establish a basic understanding of healthcare professional attitudes toward a national platform for sharing patient summary information in the form of a PCEHR. Secondly, the studies aims to map the flow of patient related information as it traverses a patient’s personal cycle of care. Thus, an ethnographic approach was used to bring a “real world” lens to information flow in a series of case studies in the Australian healthcare system to discover themes and issues that are important from the patient’s perspective. Design: Qualitative study utilising ethnographic case studies. Setting: Case studies were conducted at primary and allied healthcare professionals located in Brisbane Queensland between October 2013 and July 2014. Results: In the first dimension, it was identified that healthcare professionals’ concerns about trust and medico-legal issues related to patient control and information quality, and the lack of clinical value available with the PCEHR emerged as significant barriers to use. The second dimension of the study which attempted to map patient information flow identified information quality issues, clinical workflow inefficiencies and interoperability misconceptions resulting in duplication of effort, unnecessary manual processes, data quality and integrity issues and an over reliance on the understanding and communication skills of the patient. Conclusion: Opportunities for process efficiencies, improved data quality and increased patient safety emerge with the adoption of an appropriate information sharing platform. More importantly, large scale eHealth initiatives must be aligned with the value proposition of individual stakeholders in order to achieve widespread adoption. Leveraging an Australian national eHealth infrastructure and the PCEHR we offer a practical example of a service driven digital ecosystem suitable for co-creating value in healthcare.

It's all in the Team: Collaborations driving success in learning – a first year case

First year medical laboratory science students (up to 120) undertake a group e-poster project, based in a blended learning model Google Drive, encompassing Google’s cloud computing software, provides a readily accessible, transparent online space for students to collaborate with each other and realise tangible outcomes from their learning The Cube provides an inspiring digital learning display space for student ‘conference style’ presentations

Investigating the effectiveness of an ecological approach to learning design in a first year mathematics for engineering unit

This is presentation of the refereed paper accepted for the Conferences' proceedings. The presentation was given on Tuesday, 1 December 2015.

Laboratory information management software for genotyping workflows: Applications in high throughput crop genotyping

Background: With the advances in DNA sequencer-based technologies, it has become possible to automate several steps of the genotyping process leading to increased throughput. To efficiently handle the large amounts of genotypic data generated and help with quality control, there is a strong need for a software system that can help with the tracking of samples and capture and management of data at different steps of the process. Such systems, while serving to manage the workflow precisely, also encourage good laboratory practice by standardizing protocols, recording and annotating data from every step of the workflow Results: A laboratory information management system (LIMS) has been designed and implemented at the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) that meets the requirements of a moderately high throughput molecular genotyping facility. The application is designed as modules and is simple to learn and use. The application leads the user through each step of the process from starting an experiment to the storing of output data from the genotype detection step with auto-binning of alleles; thus ensuring that every DNA sample is handled in an identical manner and all the necessary data are captured. The application keeps track of DNA samples and generated data. Data entry into the system is through the use of forms for file uploads. The LIMS provides functions to trace back to the electrophoresis gel files or sample source for any genotypic data and for repeating experiments. The LIMS is being presently used for the capture of high throughput SSR (simple-sequence repeat) genotyping data from the legume (chickpea, groundnut and pigeonpea) and cereal (sorghum and millets) crops of importance in the semi-arid tropics. Conclusions: A laboratory information management system is available that has been found useful in the management of microsatellite genotype data in a moderately high throughput genotyping laboratory. The application with source code is freely available for academic users and can be downloaded from http://www.icrisat.org/bt-software-d-lims.htm

WHIPPET: a novel tool for prioritizing invasive plant populations for regional eradication

Large geographic areas can have numerous incipient invasive plant populations that necessitate eradication. However, resources are often deficient to address every infestation. Within the United States, weed lists (either state-level or smaller unit) generally guide the prioritization of eradication of each listed species uniformly across the focus region. This strategy has several limitations that can compromise overall effectiveness, which include spending limited resources on 1) low impact populations, 2) difficult to access populations, or 3) missing high impact populations of low priority species. Therefore, we developed a novel science-based, transparent, analytical ranking tool to prioritize weed populations, instead of species, for eradication and tested it on a group of noxious weeds in California. For outreach purposes, we named the tool WHIPPET (Weed Heuristics: Invasive Population Prioritization for Eradication Tool). Using the Analytic Hierarchy Process that included expert opinion, we developed three major criteria, four sub-criteria, and four sub-sub-criteria, taking into account both species and population characteristics. Subject matter experts weighted and scored these criteria to assess the relative impact, potential spread, and feasibility of eradication (major criteria) for 100 total populations of 19 species. Species-wide population scores indicated that conspecific populations do not necessarily group together in the final ranked output. Thus, priority lists based solely on species-level characteristics are less effective compared to a blended prioritization based on both species attributes and individual population and site parameters. WHIPPET should facilitate a more efficacious decision-making process allocating limited resources to target invasive plant infestations with the greatest predicted impacts to the region under consideration.

The current status of heart failure diagnostic biomarkers

Heart failure (HF) affects approximately 23 million individuals worldwide and this number is increasing, due to an aging and growing population. Early detection of HF is crucial in the management of this debilitating disease. Current diagnostic methods for HF rely heavily on clinical imaging techniques and blood analysis, which makes them less than ideal for population-based screening purposes. Studies focusing on developing novel biomarkers for HF have utilized various techniques and biological fluids, including urine and saliva. Promising results from these studies imply that these body fluids can be used in evaluating the clinical manifestation of HF and will one day be integrated into a clinical workflow and facilitate HF management.

Mannans as film formers and emulsion stabilizers

Mannans are abundant plant polysaccharides found in the endosperm of certain leguminous seeds (guar gum galactomannan, GG; locust bean gum galactomannan, LBG), in the tuber of the konjac plant (konjac glucomannan, KGM), and in softwoods (galactoglucomannan, GGM). This study focused on the effects of the chemical structure of mannans on their film-forming and emulsion-stabilizing properties. Special focus was on spruce GGM, which is an interesting new product from forest biorefineries. A plasticizer was needed for the formation of films from mannans other than KGM and the optimal proportion was 40% (w/w of polymers) glycerol or sorbitol. Galactomannans with lower galactose content (LBG, modified GG) produced films with higher elongation at break and tensile strength. The mechanical properties of GG-based films were improved by decreasing the degree of polymerization of the polysaccharide with moderate mannanase treatments. The improvement of mechanical properties of GGM-based films was sought by blending GGM with each of poly(vinyl alcohol) (PVOH), corn arabinoxylan (cAX), and KGM. Adding other polymers increased the elongation at break of GGM blend films. The tensile strength of films increased with increasing amounts of PVOH and KGM, but the effect of cAX was the opposite. Dynamic mechanical analysis showed two separate loss modulus peaks for blends of GGM and PVOH, but a single peak for all other films. Optical and scanning electron microscopy confirmed good miscibility of GGM with cAX and KGM. In contrast, films blended from GGM and PVOH showed phase separation. GGM and KGM were mixed with cellulose nanowhiskers (CNW) to form composite films. Addition of CNW to KGM-based films induced the formation of fiberlike structures with lengths of several millimeters. In GGM-based films, rodlike structures with lengths of tens of micrometers were formed. Interestingly, the notable differences in the film structure did not appear to be related to the mechanical and thermal properties of the films. Permeability properties of GGM-based films were compared to those of films from commercial mannans KGM, GG, and LBG. GGM-based films had the lowest water vapor permeability when compared to films from other mannans. The oxygen permeability of GGM films was of the same magnitude as that of commercial polyethylene / ethylene vinyl alcohol / polyethylene laminate film. The aroma permeability of GGM films was low. All films were transparent in the visible region, but GGM films blocked the light transmission in the ultraviolet region of the spectra. The stabilizing effect of GGM on a model beverage emulsion system was studied and compared to that of GG, LBG, KGM, and cAX. In addition, GG was enzymatically modified in order to examine the effect of the degree of polymerization and the degree of substitution of galactomannans on emulsion stability. Use of GGM increased the turbidity of emulsions both immediately after preparation and after storage of up to 14 days at room temperature. GGM emulsions had higher turbidity than the emulsions containing other mannans. Increasing the storage temperature to +45 ºC led to rapid emulsion breakdown, but a decrease in storage temperature increased emulsion stability after 14 days. A low degree of polymerization and a high degree of substitution of the modified galactomannans were associated with a decrease in emulsion turbidity.

Design challenges for electronic medication administration record systems in residential aged care facilities: A formative evaluation

Introduction Electronic medication administration record (eMAR) systems are promoted as a potential intervention to enhance medication safety in residential aged care facilities (RACFs). The purpose of this study was to conduct an in-practice evaluation of an eMAR being piloted in one Australian RACF before its roll out, and to provide recommendations for system improvements. Methods A multidisciplinary team conducted direct observations of workflow (n=34 hours) in the RACF site and the community pharmacy. Semi-structured interviews (n=5) with RACF staff and the community pharmacist were conducted to investigate their views of the eMAR system. Data were analysed using a grounded theory approach to identify challenges associated with the design of the eMAR system. Results The current eMAR system does not offer an end-to-end solution for medication management. Many steps, including prescribing by doctors and communication with the community pharmacist, are still performed manually using paper charts and fax machines. Five major challenges associated with the design of eMAR system were identified: limited interactivity; inadequate flexibility; problems related to information layout and semantics; the lack of relevant decision support; and system maintenance issues.We suggest recommendations to improve the design of the eMAR system and to optimize existing workflows. Discussion Immediate value can be achieved by improving the system interactivity, reducing inconsistencies in data entry design and offering dedicated organisational support to minimise connectivity issues. Longer-term benefits can be achieved by adding decision support features and establishing system interoperability requirements with stakeholder groups (e.g. community pharmacies) prior to system roll out. In-practice evaluations of technologies like eMAR system have great value in identifying design weaknesses which inhibit optimal system use.

On the expressive power of behavioral profiles

Behavioral profiles have been proposed as a behavioral abstraction of dynamic systems, specifically in the context of business process modeling. A behavioral profile can be seen as a complete graph over a set of task labels, where each edge is annotated with one relation from a given set of binary behavioral relations. Since their introduction, behavioral profiles were argued to provide a convenient way for comparing pairs of process models with respect to their behavior or computing behavioral similarity between process models. Still, as of today, there is little understanding of the expressive power of behavioral profiles. Via counter-examples, several authors have shown that behavioral profiles over various sets of behavioral relations cannot distinguish certain systems up to trace equivalence, even for restricted classes of systems represented as safe workflow nets. This paper studies the expressive power of behavioral profiles from two angles. Firstly, the paper investigates the expressive power of behavioral profiles and systems captured as acyclic workflow nets. It is shown that for unlabeled acyclic workflow net systems, behavioral profiles over a simple set of behavioral relations are expressive up to configuration equivalence. When systems are labeled, this result does not hold for any of several previously proposed sets of behavioral relations. Secondly, the paper compares the expressive power of behavioral profiles and regular languages. It is shown that for any set of behavioral relations, behavioral profiles are strictly less expressive than regular languages, entailing that behavioral profiles cannot be used to decide trace equivalence of finite automata and thus Petri nets.

Enhancing learning for research higher degree students

Universities’ push toward the production of high quality research is not limited to academic staff and experienced researchers. In this environment of research rich agendas, Higher Degree Research (HDR) students are increasingly expected to engage in the publishing of good quality papers in high impact journals. IFN001: Advanced Information Research Skills (AIRS) is a credit bearing mandatory coursework requirement for Queensland University of Technology (QUT) doctorates. Since its inception in 1989, this unique blended learning program has provided the foundations for new researchers to produce original and innovative research. AIRS was redeveloped in 2012, and has now been evaluated with reference to the university’s strategic research priorities. Our research is the first comprehensive evaluation of the program from the learner perspective. We measured whether the program develops essential transferrable skills and graduate capabilities to ensure best practice in the areas of publishing and data management. In particular, we explored whether AIRS prepares students to be agile researchers with the skills to adapt to different research contexts both within and outside academia. The target group for our study consisted of HDR students and supervisors at QUT. Both quantitative and qualitative research methods were used for data collection. Gathering data was by survey and focus groups with qualitative responses analyzed using NVivo. The results of the survey show that 82% of students surveyed believe that AIRS assisted their research process and helped them learn skills they need as a researcher. The 18% of respondents who expressed reservation about the benefits of AIRS were also examined to determine the key areas of concern. These included trends related to the timing of the program early in the candidature and a belief among some students that their previous research experience was sufficient for postgraduate study. New insights have been gained into how to better support HDR learners in partnership with supervisors and how to enhance learning experiences of specific cohorts, including international students and mature learners.

The importance of context in engaging students large first year management classes: A case study

Engaging large first year classes in tertiary education poses a number of significant challenges, most of which have been discussed by others. One area that has not received the kind of attention that it warrants is the context within which the engagement activities take place. This paper examines both the processes used to engage a large first year management class in a major city university and how the context of the classes shaped activities and student responses to these activities. It was recognised that students had certain types of learning styles, but given the total number of students (in excess of 1200) it was realised that is would be impossible to cater to all possibilities. A key outcome of the exercise was the importance of context in shaping student behaviours.

The pedagogic prosthetic: Augmented learning as content-in-motion in hybrid educational spheres

This article draws on the design and implementation of three mobile learning projects introduced by Flanagan in 2011, 2012 and 2014 engaging a total of 206 participants. The latest of these projects is highlighted in this article. Two other projects provide additional examples of innovative strategies to engage mobile and cloud systems describing how electronic and mobile technology can help facilitate teaching and learning, assessment for learning and assessment as learning, and support communities of practice. The second section explains the theoretical premise supporting the implementation of technology and promulgates a hermeneutic phenomenological approach. The third section discusses mobility, both in terms of the exploration of wearable technology in the prototypes developed as a result of the projects, and the affordances of mobility within pedagogy. Finally the quantitative and qualitative methods in place to evaluate m-learning are explained.

Low density polyethylene and grafted lignin polyblends using epoxy-functionalized compatibilizer: mechanical and thermal properties

Lignin was graft copolymerized with methyl methacrylate using manganic pyrophosphate as initiator. This modified lignin was then blended (up to 50 wt%) with low density polyethylene (LDPE) using a small quantity of poly[ethylene-co-(glycidyl methacrylate)] (PEGMA) compatibilizer. The mechanical properties of the blend were substantially improved by using modified lignin in contrast to untreated lignin. Differential scanning calorimetry studies showed loss of crystallinity of the LDPE phase owing to the interaction between the blend components. Thermogravimetric analysis showed higher thermal stability of modified lignin in the domain of blend processing. This suggested that there is scope for useful utilization of lignin, which could also lead to the development of eco-friendly products. (c) 2005 Society of Chemical Industry.

Drivers of ERP Systems´ Business Value

ERP system implementations have evolved so rapidly that now they represent a must-have within industries. ERP systems are viewed as the cost of doing business. Yet, the research that adopted the resource-based view on the business value of ERP systems concludes that companies may gain competitive advantage when they successfully manage their ERP projects, when they carefully reengineer the organization and when they use the system in line with the organizational strategies. This thesis contributes to the literature on ERP business value by examining key drivers of ERP business value in organizations. The first research paper investigates how ERP systems with different degrees of system functionality are correlated with the development of the business performance after the completion of the ERP projects. The companies with a better perceived system functionality obtained efficiency benefits in the first two years of post-implementation. However, in the third year there is no significant difference in efficiency benefits between successfully and less successfully managed ERP projects. The second research paper examines what business process changes occur in companies implementing ERP for different motivations and how these changes impact the business performance. The findings show that companies reported process changes mainly in terms of workflow changes. In addition, the companies having a business-led motivation focused more on observing average costs of each increase in the input unit. Companies having a technological-led motivation focused more on the benefits coming from the fit of the system with the organizational processes. The third research paper considers the role of alignment between ERP and business strategies for the realization of business value from ERP use. These findings show that strategic alignment and business process changes are significantly correlated with the perceived benefits of ERP at three levels: internal efficiency, customers and financial. Overall, by combining quantitative and qualitative research methods, this thesis puts forward a model that illustrates how successfully managed ERP projects, aligned with the business strategy, have automate and informate effects on processes that ultimately improve the customer service and reduce the companies’ costs.

Ecology of the swampy relic forests of Kathalekan from central Western Ghats, India

Introduction of agriculture three millennia ago in Peninsular India’s Western Ghats altered substantially ancient tropical forests. Early agricultural communities, nevertheless, strived to attain symbiotic harmony with nature as evident from prevalence of numerous sacred groves, patches of primeval forests sheltering biodiversity and hydrology. Groves enhanced heterogeneity of landscapes involving elements of successional forests and savannas favouring rich wildlife. A 2.25 km2 area of relic forest was studied at Kathalekan in Central Western Ghats. Interspersed with streams studded with Myristica swamps and blended sparingly with shifting cultivation fallows, Kathalekan is a prominent northernmost relic of southern Western Ghat vegetation. Trees like Syzygium travancoricum (Critically Endangered), Myristica magnifica (Endangered) and Gymnacranthera canarica (Vulnerable) and recently reported Semecarpus kathalekanensis, are exclusive to stream/swamp forest (SSF). SSF and non-stream/swamp forest (NSSF) were studied using 18 transects covering 3.6 ha. Dipterocarpaceae, its members seldom transgressing tropical rain forests, dominate SSF (21% of trees) and NSSF (27%). The ancient Myristicaceae ranks high in tree population (19% in SSF and 8% in NSSF). Shannon-Weiner diversity for trees is higher (>3) in six NSSF transects compared to SSF (<3). Higher tree endemism (45%), total endemic tree population (71%) and significantly higher above ground biomass (349 t/ha) cum carbon sequestration potential (131 t/ha) characterizes SSF. Faunal richness is evident from amphibians (35 species - 26 endemics, 11 in IUCN Red List). This study emphasizes the need for bringing to light more of relic forests for their biodiversity, carbon sequestration and hydrology. The lives of marginal farmers and forest tribes can be uplifted through partnership in carbon credits, by involving them in mitigating global climatic change through conservation and restoration of high biomass watershed forests.