The implementation of a guideline of care for patients with a Sengstaken-Blakemore tube in situ in a general intensive care unit using transitional change theory

The use of the Sengstaken–Blakemore tube as a life-saving treatment for bleeding oesophageal varices is slowly becoming the least preferred method possibly due to the potential complications associated with its placement. Nursing practice pertaining to the care of this patient group appears ad hoc and reliant on local knowledge and experience as opposed to recognised evidence of best practice. Therefore, this paper focuses on the application of Lewin's transitional change theory used to introduce a change in nursing practice with the application of a guideline to enhance the care of patients with a Sengstaken–Blakemore tube in situ within a general intensive care unit. This method identified some of the complexities surrounding the change process including the driving and restraining forces that must be harnessed and minimised in order for the adoption of change to be successful.

Automatic de-identification of electronic health records : an Australian perspective

We present an approach to automatically de-identify health records. In our approach, personal health information is identified using a Conditional Random Fields machine learning classifier, a large set of linguistic and lexical features, and pattern matching techniques. Identified personal information is then removed from the reports. The de-identification of personal health information is fundamental for the sharing and secondary use of electronic health records, for example for data mining and disease monitoring. The effectiveness of our approach is first evaluated on the 2007 i2b2 Shared Task dataset, a widely adopted dataset for evaluating de-identification techniques. Subsequently, we investigate the robustness of the approach to limited training data; we study its effectiveness on different type and quality of data by evaluating the approach on scanned pathology reports from an Australian institution. This data contains optical character recognition errors, as well as linguistic conventions that differ from those contained in the i2b2 dataset, for example different date formats. The findings suggest that our approach compares to the best approach from the 2007 i2b2 Shared Task; in addition, the approach is found to be robust to variations of training size, data type and quality in presence of sufficient training data.

The potential of XML technology as an answer to the data interchange problems of the construction industry

The complex supply chain relations of the construction industry, coupled with the substantial amount of information to be shared on a regular basis between the parties involved, make the traditional paper-based data interchange methods inefficient, error prone and expensive. The successful information technology (IT) applications that enable seamless data interchange, such as the Electronic Data Interchange (EDI) systems, have generally failed to be successfully implemented in the construction industry. An alternative emerging technology, Extensible Markup Language (XML), and its applicability to streamline business processes and to improve data interchange methods within the construction industry are analysed, as is the EDI technology to identify the strategic advantages that XML technology provides to overcome the barriers to implementation. In addition, the successful implementation of XML-based automated data interchange platforms for a large organization, and the proposed benefits thereof, are presented as a case study.

Curriculum to the classroom : investigating the spatial practices of curriculum implementation in Queensland schools and its implications for teacher education

Change is something that both pre-service and practising teachers face regularly throughout their professional lives. Curriculum change and consequential implementation is a case in point. This paper investigates the perspectives of a number of school-based stakeholders in regard to the implementation of the C2C materials in Queensland schools and how this has potential consequences for teacher education programs. It shows that often contradictory spaces emerge in regard to curriculum enactment and argues that a ‘one size fits all’ approach is not the most effective way to implement new curriculum. A transformative third space is offered whereby teachers are accorded with a voice in the way in which implementation occurs; ultimately allowing pre-service teachers to learn important skills required to be effective teachers.

Security analysis of Australian and E.U. e-passport implementation

This paper makes a formal security analysis of the current Australian e-passport implementation using model checking tools CASPER/CSP/FDR. We highlight security issues in the current implementation and identify new threats when an e-passport system is integrated with an automated processing system like SmartGate. The paper also provides a security analysis of the European Union (EU) proposal for Extended Access Control (EAC) that is intended to provide improved security in protecting biometric information of the e-passport bearer. The current e-passport specification fails to provide a list of adequate security goals that could be used for security evaluation. We fill this gap; we present a collection of security goals for evaluation of e-passport protocols. Our analysis confirms existing security weaknesses that were previously identified and shows that both the Australian e-passport implementation and the EU proposal fail to address many security and privacy aspects that are paramount in implementing a secure border control mechanism. ACM Classification C.2.2 (Communication/Networking and Information Technology – Network Protocols – Model Checking), D.2.4 (Software Engineering – Software/Program Verification – Formal Methods), D.4.6 (Operating Systems – Security and Privacy Protection – Authentication)

An ICT Implementation Strategy for Primary Schools in Fiji

Information and Communication Technology (ICT) has been embraced with hope and optimism in both developing and developed countries. While in the developed countries most citizens have access to one or many of the devices which utilize this technology (e.g. desktop, laptop, tablet, mobile phone), in developing countries this “luxury” can only be afforded by a privileged few. The use of these technologies in primary schools in developing countries is low. This is due to the fact that there are other bigger issues that some of these countries have to grapple with such as meeting the basic health and education needs of its citizens. Quality primary education and global development partnerships are two of the eight Millennium Development Goals of the United Nations (UNDP, 2012). Many Governments, NGO’s, service organizations, and individuals in developing countries are always looking at ways in which the disparity (not just in terms of ICT) can be narrowed. There has to be a greater collaboration between stakeholders in developing and developed countries (Mutonyi & Norton, 2007). How do stakeholders from developed countries engage with partners in developing countries to deliver meaningful and relevant outcomes for primary school students using ICT? As a first step getting the key stakeholders on side is critical. In the Fijian context, schools are managed and run by committees who are members of the community. Therefore, getting the committee on side together with the head-teachers and teachers is critical. Conversations about teaching and learning with technology can then follow with greater ease. The sustainability of any innovative approaches is also an essential element of this equation. Through this lens, this chapter investigates how ICT can be implemented in primary schools in Fiji. It proposes a three-layered approach which focuses on: (1) the community, school leadership, and teachers; (2) content, pedagogy, and technology, and (3) sustainability.

Motor controller simulation and embedded implementation for a blood pump

This study was a step forward in modeling, simulation and microcontroller implementation of a high performance control algorithm for the motor of a blood pump. The rotor angle is sensed using three Hall effect sensors and an algorithm is developed to obtain better angular resolution from the three signals for better discrete-time updates of the controller. The performance of the system was evaluated in terms of actual and reference speeds, stator currents and power consumption over a range of reference speeds up to 4000 revolutions per minute. The use of fewer low cost Hall effect sensors compared to expensive high resolution sensors could reduce the cost of blood pumps for total artificial hearts.

A fair e-tendering protocol

Implementation of an electronic tendering (e-tendering) systems requires careful attention to the needs of the system and its various participants. Fairness in an e-tendering is of utmost importance. Current proposals and implementations do not provide fairness and thus, are vulnerable to collusion and favourism. Dishonest participants, either the principal or tenderer may collude to alter or view competing tenders which would give the favoured tenderer a greater chance of winning the contract. This paper proposes an e-tendering system that is secure and fair to all participants. We employ the techniques of anonymous token system along with signed commitment approach to achieve a publicly verifiable fair e-tendering protocol. We also provide an analysis of the protocol that confirms the security of our proposal against security goals for an e-tendering system.

Safe perioperative fasting : implementation of evidence based guidelines and an ‘at risk’ checklist

Introduction Guidelines existed at the Royal Children’s Hospital (RCH) to direct preoperative/pre-procedural fasting in day patients undergoing general anaesthetic. However audit, risk analyses and a recent research project at the RCH identified prolonged pre-procedural fasting times in children undergoing day surgical and gastroenterology procedures. Aims 1. Reduce median fasting time to <8 hrs for children admitted for a day procedure under general anaesthetic; 2. Identify children at risk of perioperative hypoglycaemia. Methods The study was conducted in 4 phases: 1) revision and implementation of evidence-based perioperative fasting guidelines with staff education relating to these guidelines; 2) cross-sectional descriptive study with day surgical patients (n = 377) requiring preoperative fasting. ‘Normal risk’ and ‘High risk’ groups were identified for fasting hypoglycaemia using an ‘at risk’ checklist. Venous blood glucose (BGL) testing was performed at a) anaesthetic induction; b) prior to first caloric food/fluid postoperatively; 3) chart audit to evaluate efficacy of guidelines and parent information; 4) development of recommendations for clinical practice. Results The median fasting time for children having morning surgery (14 hrs, IQ range 5–22 hrs) was twice as long compared to afternoon lists (7 hrs, IQ range 6–22 hrs) (p < 0.001). Median fasting times were not significantly different between ‘at risk’ and control groups (p = 0.496). However the proportion of children who experienced hypoglycaemia (BGL <3 mmol/L) was greater in the ‘at risk’ group (5, 8%) compared to the control group (18, 4.3%). Although not statistically significant (x2 = 2.254, p = 0.133), ‘at risk’ children appear more likely to experience hypoglycaemia as children in the control group, constituting a clinically significant finding. Conclusion Appropriate identification and management of ‘high risk’ children, will reduce the risk of deleterious sequelae in children undergoing surgical or investigative procedures requiring general anaesthesia.

An on-line secure e-passport protocol

The first generation e-passport standard is proven to be insecure and prone to various attacks. To strengthen, the European Union (EU) has proposed an Extended Access Control (EAC) mechanism for e-passports that intends to provide better security in protecting biometric information of the e-passport bearer. But, our analysis shows, the EU proposal fails to address many security and privacy issues that are paramount in implementing a strong security mechanism. In this paper we propose an on-line authentication mechanism for electronic passports that addresses the weakness in existing implementations, of both The International Civil Aviation Organisation (ICAO) and EU. Our proposal utilises ICAO PKI implementation, thus requiring very little modifications to the existing infrastructure which is already well established.

Critical factors affecting the implementation of sustainable housing in Australia

Improved public awareness of the environment and available technologies will continue to highlight the importance of sustainable housing in the coming years. Despite this potential, the majority of new housing development in Australia is still “project homes” with few tangible sustainability measures. Stakeholders tend to have different perceptions and priorities on sustainability. To promote the uptake of sustainable housing products, a study of the critical issues affecting the implementation of sustainable housing is necessary. This research investigates multiple factors that may influence key stakeholders’ decision-making towards sustainable housing adoption. Drawing insights from combined questionnaire and interview studies, 12 critical factors and their interrelationships are identified based on professional views in the Australian housing industry. The mutual influences, or driving force and dependency, of these factors are further investigated via Interpretive Structural Modelling (ISM) to distinguish those requiring prominent and immediate attention. A hierarchical model is developed to help key stakeholders prioritise actions when implementing sustainable housing.

Mindfulness-meditation on the move : implementation of an ACT-based mindfulness practice intervention and training within a University Dance program

As part of the introduction of a broader dance medicine and science related health and wellbeing program, a 9 week mindfulness-meditation ACT-based program was delivered to all students undertaking full-time University dance training (N = 106). The aim of the program was to assist students in the further development of performance psychology skills that could be applied in both performance and non-performance settings. Participant groups were comprised of both male (N = 12) and female (N = 94) students from across all three year levels of two undergraduate dance courses, divided into three groups by mixed year levels due to timetable scheduling requirements. Pre- and post-testing was undertaken utilising the Mindful Attention Awareness Scale (MAAS-15), a uni-dimensional measure of mindfulness, in addition to qualitative questions checking the current level of awareness and understanding of mindfulness practice and its application. Weekly sessions were conducted by qualified sport and exercise psychologists and covered key practices such as: Mindfulness of Body, Mindfulness of Breathing, Mindfulness of Sounds, ACT-based and general Imagery exercises, Developing Open Awareness, Mindfulness of Emotions, and Developing Inner Stillness. Students were required to maintain a reflective journal that was utilised at the end of each weekly session, in addition to completion of a mid-Semester reflective debrief. Teaching staff additionally attended the weekly sessions and linked the mindfulness practice learnings into the student’s practical dance and academic classes where appropriate. Anecdotal feedback indicates that participation in the mindfulness-meditation sessions and the development of these mental skills has resulted in positive performance and personal outcomes. Observations collated from staff and students, results from the data collection phases and recommendations regarding future applications within dance training settings will be discussed within the presentation.

Challenges for implementation of a new model of collaborative design management: Analyzing the impact of human factor

The ineffectiveness of current design processes has been well studied and has resulted in widespread calls for the evolution and development of new management processes. Even following the advent of BIM, we continue to move from one stage to another without necessarily having resolved all the issues. CAD design technology, if well handled, could have significantly raised the level of quality and efficiency of current processes, but in practice this was not fully realized. Therefore, technology alone can´t solve all the problems and the advent of BIM could result in a similar bottleneck. For a precise definition of the problem to be solved we should start by understanding what are the main current bottlenecks that have yet to be overcome by either new technologies or management processes, and the impact of human behaviour-related issues which impact the adoption and utilization of new technologies. The fragmented and dispersed nature of the AEC sector, and the huge number of small organizations that comprise it, are a major limiting factor. Several authors have addressed this issue and more recently IDDS has been defined as the highest level of achievement. However, what is written on IDDS shows an extremely ideal situation on a state to be achieved; it shows a holistic utopian proposition with the intent to create the research agenda to move towards that state. Key to IDDS is the framing of a new management model which should address the problems associated with key aspects: technology, processes, policies and people. One of the primary areas to be further studied is the process of collaborative work and understanding, together with the development of proposals to overcome the many cultural barriers that currently exist and impede the advance of new management methods. The purpose of this paper is to define and delimit problems to be solved so that it is possible to implement a new management model for a collaborative design process.

Using a smartphone application for customer-centric banking

The banking industry is under pressure. In order to compete, banks should adapt to concentrating on the specific customer needs, following an outside-in perspective. This paper presents the design of a business model for banks that considers this development by providing flexible and comprehensive support for retail banking clients. It is demonstrated that the identification of customer processes and the consequent alignment of banking services to those processes implies great potential to increase customer retention in banking. It will be shown that information technology – especially smartphones – can serve as an interface between customer and suppliers to enable an alignment of offerings to customer processes. This approach enables the integration of banks into their customers’ lifestyle, creating emotional value added, improving the personal relationship and the customers’ affiliation with the bank. The paper presents the design of such a customer-process-centric smartphone application and derives success factors for implementation.