Development of an EMR implementation framework for public hospitals in Saudi Arabia

An Electronic Medical Record (EMR) is a system that has been embraced by healthcare providers worldwide. However, the implementation success of EMRs has varied widely. Studies have identified both barriers to and facilitators for implementing EMRs within healthcare organisations. In Saudi Arabia (SA), the majority of healthcare providers manage patient records manually. As public hospitals are a major provider of health services in SA and have been shown to face more EMR implementation barriers than private hospitals, there is a need for an implementation framework to guide EMR implementation in Saudi public hospitals. This doctoral project therefore aimed to develop an evidence-based EMR implementation framework for public hospitals in SA informed by those who work at the micro-implementation level and the macro-implementation level and the extant literature sensitive to the cultural, resource-related, and technological, organisational, and environmental issues of SA.

Implementation of parallel tridiagonal solvers for a heterogeneous computing environment

Tridiagonal diagonally dominant linear systems arise in many scientific and engineering applications. The standard Thomas algorithm for solving such systems is inherently serial forming a bottleneck in computation. Algorithms such as cyclic reduction and SPIKE reduce a single large tridiagonal system into multiple small independent systems which can be solved in parallel. We have developed portable cyclic reduction and SPIKE algorithm OpenCL implementations with the intent to target a range of co-processors in a heterogeneous computing environment including Field Programmable Gate Arrays (FPGAs), Graphics Processing Units (GPUs) and other multi-core processors. In this paper, we evaluate these designs in the context of solver performance, resource efficiency and numerical accuracy.

Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: Stakeholder perspectives, barriers, supports, and incentives

Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes. © 2014 Morris et al.

Implementation of a hybrid PCM encoding scheme

An improved encoding scheme is proposed wherein the quantizer step size incorporates both instantaneous and syllabic adaptation. The information needed to carry out this adaptation is extracted at the coder after the D/A conversion of the digital output, so that the coder and the decoder track each other. A 5-bit coder has been designed and built which has a dynamic range of 38 dB with a constant SNR of 30 dB, and the quality of its output signal is found to be comparable to that of other coding schemes

Implementation of CSP-S for description of distributed algorithms

The implementation of CSP-S (a subset of CSP)—a high level language for distributed programming—is presented in this paper. The language CSP-S features a parallel command, communication by message passing and the use of guarded command. The implementation consists of a compiler translating the CSP-S constructs into intermediate language. The execution is carried out by a scheduler which creates an illusion of concurrency. Using the CSP-S language constructs, distributed algorithms are written, executed and tested with the compiler designed.

Implementation costs of Agricultural Management Practices for Water Quality Improvement in the Great Barrier Reef Catchments. CSIRO: Water for Healthy Country National Research Flagship

Executive summary. In this report we analyse implementation costs and benefits for agricultural management practices, grouped into farming systems. In order to do so, we compare plot scale gross margins for the dominant agricultural production systems (sugarcane, grazing and banana cultivation) in the NRM regions Wet Tropics, Burdekin Dry Tropics and Mackay Whitsundays. Furthermore, where available, we present investment requirements for changing to improved farming systems. It must be noted that transaction costs are not captured within this project. For sugarcane, this economic analysis shows that there are expected benefits to sugarcane growers in the different regions through transitions to C and B class farming systems. Further transition to A-class farming systems can come at a cost, depending on the capital investment required and the length of the investment period. Obviously, the costs and benefits will vary for each individual grower and will depend on their starting point and individual property scenario therefore each circumstance needs to be carefully considered before making a change in management practice. In grazing, overall, reducing stocking rates comes at a cost (reduced benefits). However, when operating at low utilisation rates in wetter country, lowering stocking rates can potentially come at a benefit. With win-win potential, extension is preferred to assist farmer in changing management practices to improve their land condition. When reducing stocking rates comes at a cost, incentives may be applicable to support change among farmers. For banana cultivation, the results indicate that the transition to C and B class management practices is a worthwhile proposition from an economic perspective. For a change from B to A class farming systems however, it is not worthwhile from a financial perspective. This is largely due to the large capital investment associated with the change in irrigation system and negative impact in whole of farm gross margin. Overall, benefits will vary for each individual grower depending on their starting point and their individual property scenario. The results presented in this report are one possible set of figures to show the changes in profitability of a grower operating in different management classes. The results in this report are not prescriptive of every landholder. Landholders will have different costs and benefits from transitioning to improved practices, even if similar operations are practiced, hence it is recommended that landholders that are willing to change management undertake their own research and analysis into the expected costs and benefits for their own soil types and property circumstances.

NEESTIMATOR v2: re-implementation of software for the estimation of contemporary effective population size (N-e) from genetic data

NeEstimator v2 is a completely revised and updated implementation of software that produces estimates of contemporary effective population size, using several different methods and a single input file. NeEstimator v2 includes three single-sample estimators (updated versions of the linkage disequilibrium and heterozygote-excess methods, and a new method based on molecular coancestry), as well as the two-sample (moment-based temporal) method. New features include the following: (i) an improved method for accounting for missing data; (ii) options for screening out rare alleles; (iii) confidence intervals for all methods; (iv) the ability to analyse data sets with large numbers of genetic markers (10000 or more); (v) options for batch processing large numbers of different data sets, which will facilitate cross-method comparisons using simulated data; and (vi) correction for temporal estimates when individuals sampled are not removed from the population (Plan I sampling). The user is given considerable control over input data and composition, and format of output files. The freely available software has a new JAVA interface and runs under MacOS, Linux and Windows.

Overcoming barriers to the successful implementation of a classical biological control strategy for the exotic invasive weed Mikania micrantha in the Asia-Pacific region

Mikania micrantha (Asteraceae) commonly known as mikania, is a major invasive alien plant (IAP) in the tropical humid agricultural and forest zones of the Asia-Pacific region. This fast-growing Neotropical vine is able to smother plants in agricultural ecosystems, agroforestry and natural habitats, reducing productivity and biodiversity. Fungal pathogens were first investigated for the classical biological control of this weed in 1996. This resulted in the selection and screening of the highly host-specific and damaging rust pathogen, Puccinia spegazzinii (Pucciniales). It was first released in India and China in 2005/6, although it is not believed to have established. Since then, it has been released successfully in Taiwan, Papua New Guinea (PNG), Fiji and most recently Vanuatu. The rust has established and is spreading rapidly after applying lessons learned from the first releases on the best rust pathotype and release strategy. In PNG, direct monitoring of vegetation change has demonstrated that the rust is having a significant impact on M. micrantha, with no unpredicted non-target impacts. Despite this, the authorities in many countries where mikania is a problem remain cautious about releasing the rust. In Western Samoa, introduction of the rust was not pursued because of a conflict of interest, and the perception that mikania suppresses even worse weeds. For some, ‘pathophobia’ is still a major obstacle. In Indonesia, where insects for weed CBC have been introduced, pathogens will currently not be considered. In other countries such as Bhutan and Myanmar, there are no baseline data on the presence and impact of IAPs and, with no history of CBC, no institutional framework for implementing this approach. Malaysia has a well-developed framework, but capacity needs to be built in the country. Overall, it remains critical to have champions at decision making levels. Hence, even with an effective ‘off-the-shelf’ agent available, implementation of mikania CBC still requires significant inputs tailored to the countries’ specific needs.

Understanding the barriers to the implementation of precision agriculture in the central region

There is an increasing requirement for more astute land resource management through efficiencies in agricultural inputs in a sugar cane production system. A precision agriculture (PA) approach can provide a pathway for a sustainable sugarcane production system. One of the impediments to the adoption of PA practices is access to paddock-scale mapping layers displaying variability in soil properties, crop growth and surface drainage. Variable rate application (VRA) of nutrients is an important component of PA. However, agronomic expertise within PA systems has fallen well behind significant advances in PA technologies. Generally, advisers in the sugar industry have a poor comprehension of the complex interaction of variables that contribute to within-paddock variations in crop growth. This is regarded as a significant impediment to the progression of PA in sugarcane and is one of the reasons for the poor adoption of VRA of nutrients in a PA approach to improved sugar cane production. This project therefore has established a number of key objectives which will contribute to the adoption of PA and the staged progression of VRA supported by relevant and practical agronomic expertise. These objectives include provision of base soils attribute mapping that can be determined using Veris 3100 Electrical Conductivity (EC) and digital elevation datasets using GPS mapping technology for a large sector of the central cane growing region using analysis of archived satellite imagery to determine the location and stability of yield patterns over time and in varying seasonal conditions on selected project study sites. They also include the stablishment of experiments to determine appropriate VRA nitrogen rates on various soil types subjected to extended anaerobic conditions, and the establishment of trials to determine nitrogen rates applicable to a declining yield potential associated with the aging of ratoons in the crop cycle. Preliminary analysis of archived yield estimation data indicates that yield patterns remain relatively stable overtime. Results also indicate the where there is considerable variability in EC values there is also significant variation in yield.

Strategic tillage in no-till farming systems in Australia’s northern grains-growing regions: I. Drivers and implementation

Development of no-tillage (NT) farming has revolutionized agricultural systems by allowing growers to manage greater areas of land with reduced energy, labour and machinery inputs to control erosion, improve soil health and reduce greenhouse gas emission. However, NT farming systems have resulted in a build-up of herbicide-resistant weeds, an increased incidence of soil- and stubble-borne diseases and enrichment of nutrients and carbon near the soil surface. Consequently, there is an increased interest in the use of an occasional tillage (termed strategic tillage, ST) to address such emerging constraints in otherwise-NT farming systems. Decisions around ST uses will depend upon the specific issues present on the individual field or farm, and profitability and effectiveness of available options for management. This paper explores some of the issues with the implementation of ST in NT farming systems. The impact of contrasting soil properties, the timing of the tillage and the prevailing climate exert a strong influence on the success of ST. Decisions around timing of tillage are very complex and depend on the interactions between soil water content and the purpose for which the ST is intended. The soil needs to be at the right water content before executing any tillage, while the objective of the ST will influence the frequency and type of tillage implement used. The use of ST in long-term NT systems will depend on factors associated with system costs and profitability, soil health and environmental impacts. For many farmers maintaining farm profitability is a priority, so economic considerations are likely to be a primary factor dictating adoption. However, impacts on soil health and environment, especially the risk of erosion and the loss of soil carbon, will also influence a grower’s choice to adopt ST, as will the impact on soil moisture reserves in rainfed cropping systems.

Organisational culture and quality management system implementation in Indonesian construction companies

The study of the organisational culture in the construction industry is still in the stage of debate (Oney-Yazıcı et al., 2007). Despite the complexities involved in measuring the culture of the construction industry (Tijhuis and Fellows, 2012), this culture is regarded as being worthy of research, especially in relation to the organisational culture needed to support quality management systems (Koh and Low, 2008; Watson and Howarth, 2011) and to improve organisational effectiveness, and therefore, organisational performance (Coffey, 2010; Cheung et al., 2011). A number of recent studies have examined the construction companies’ organisational culture within the context of the use of Cameron and Quinn’s Competing Value Framework (CVF), as well as the use of their Organizational Culture Assessment Instrument (OCAI) as the conceptual paradigm for the analyses (Thomas et al., 2002; Nummelin, 2006; Oney- Yazıcı et al., 2007; Koh and Low, 2008). However, there has been little research based on the use of Cameron and Quinn’s CVF-OCAI tool for identifying types of construction companies’ organisational culture and their influences on the implementation of QMS-ISO 9001. Research output and information is also very limited relating to the strength of the companies’ organisational culture driving an effective QMS-ISO 9001 implementation, affecting the companies’ effectiveness. To rectify these research gaps, the research has been aimed to study organisational culture types (based on CVF) and their influences on the implementation of QMS-ISO 9001:2008 principles and elements, which eventually lead to improved companies’ quality performance. In order to fully examine the status of the QMS being implemented, the research has studied the relationships of the barriers of QMS implementation with the implementation of QMS-ISO 9001:2008 principles and elements and with the business performance of the companies, as well as the examination of the relationships of the implementation of QMS-ISO 9001:2008 principles and elements with the companies’ business performance. The research output has been the development of fundamental and original studies on the study topics, to provide the knowledge for improvements in Indonesian construction companies’ quality performance and quality outcomes.