743 resultados para Patient Experiences in ED


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The Bouncing Back research study, which began after the Queensland flooding in January 2011, has organically expanded through a number of architectural student design projects and exhibitions, which have sought to respond to catastrophic flooding events. In September 2011, 10 Queensland University of Technology architecture students travelled to Sydney to help construct a 1:1 true-to-life scale shelter, for the Emergency Shelter Exhibition at Customs House in Circular Quay. During the construction of the shelter, data were collected in situ, through dynamic interviews with the students. Using a grounded theory methodology, data were coded and then thematically analysed, to reveal three influential factors that positively impacted the students’ learning in this informal context. These were the student experience, the process of learning through physical making/fabrication, and development of empathy with the community. Analysis of these three factors demonstrated how this informal situated learning activity promoted vitally important learning in a real-world context, which is difficult to replicate in a physical on-campus environment.

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The world has experienced a large increase in the amount of available data. Therefore, it requires better and more specialized tools for data storage and retrieval and information privacy. Recently Electronic Health Record (EHR) Systems have emerged to fulfill this need in health systems. They play an important role in medicine by granting access to information that can be used in medical diagnosis. Traditional systems have a focus on the storage and retrieval of this information, usually leaving issues related to privacy in the background. Doctors and patients may have different objectives when using an EHR system: patients try to restrict sensible information in their medical records to avoid misuse information while doctors want to see as much information as possible to ensure a correct diagnosis. One solution to this dilemma is the Accountable e-Health model, an access protocol model based in the Information Accountability Protocol. In this model patients are warned when doctors access their restricted data. They also enable a non-restrictive access for authenticated doctors. In this work we use FluxMED, an EHR system, and augment it with aspects of the Information Accountability Protocol to address these issues. The Implementation of the Information Accountability Framework (IAF) in FluxMED provides ways for both patients and physicians to have their privacy and access needs achieved. Issues related to storage and data security are secured by FluxMED, which contains mechanisms to ensure security and data integrity. The effort required to develop a platform for the management of medical information is mitigated by the FluxMED's workflow-based architecture: the system is flexible enough to allow the type and amount of information being altered without the need to change in your source code.

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With new national targets for patient flow in public hospitals designed to increase efficiencies in patient care and resource use, better knowledge of events affecting length of stay will support improved bed management and scheduling of procedures. This paper presents a case study involving the integration of material from each of three databases in operation at one tertiary hospital and demonstrates it is possible to follow patient journeys from admission to discharge. What is known about this topic? At present, patient data at one Queensland tertiary hospital are assembled in three information systems: (1) the Hospital Based Corporate Information System (HBCIS), which tracks patients from in-patient admission to discharge; (2) the Emergency Department Information System (EDIS) containing patient data from presentation to departure from the emergency department; and (3) Operation Room Management Information System (ORMIS), which records surgical operations. What does this paper add? This paper describes how a new enquiry tool may be used to link the three hospital information systems for studying the hospital journey through different wards and/or operating theatres for both individual and groups of patients. What are the implications for practitioners? An understanding of the patients’ journeys provides better insight into patient flow and provides the tool for research relating to access block, as well as optimising the use of physical and human resources.

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Driving can be a lonely activity. While there has been a lot of research and technical inventions concerning car-to-car communication and passenger entertainment, there is still little work concerning connecting drivers. Whereas tourism is very much a social activity, drive tourists and road trippers have few options to communicate with fellow travelers. Our study is placed at the intersection of tourism and driving. It aims to enhance the trip experience during driving through social interaction. This paper explores how a mobile application that allows instant messaging between travelers sharing similar context can establish a temporary, ad hoc community and enhance the road trip experience. A prototype was developed and evaluated in various user and field studies. The study’s outcomes are relevant for the design of future mobile tourist guides that benefit from community design, social encounters and recommendations.

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Background: Eosinophilic esophagitis (EE) is an emerging condition where patients commonly present with symptoms of gastroesophageal reflux disease and fail to respond adequately to anti-reflux therapy. Food allergy is currently recognized as the main immunological cause of EE; recent evidence suggests an etiological role for inhalant allergens. The presence of EE appears to be associated with other atopic illnesses. Objectives: To report the sensitization profile of both food and inhalant allergens in our EE patient cohort in relation to age, and to profile the prevalence of other allergic conditions in patients with EE. Method: The study prospectively analyzed allergen sensitization profiles using skin prick tests to common food allergens and inhalant allergens in 45 children with EE. Patch testing to common food allergens was performed on 33 patients in the same cohort. Comorbidity of atopic eczema, asthma, allergic rhinitis and anaphylaxis were obtained from patient history. Results: Younger patients with EE showed more IgE and patch sensitization to foods while older patients showed greater IgE sensitization to inhalant allergens. The prevalence of atopic eczema, allergic rhinitis and asthma was significantly increased in our EE cohort compared with the general Australian population. A total of 24% of our cohort of patients with EE had a history of anaphylaxis. Conclusion: In children with EE, the sensitization to inhalant allergens increases with age, particularly after 4 years. Also, specific enquiry about severe food reactions in patients presenting with EE is strongly recommended as it appears this patient group has a high incidence of anaphylaxis. © 2007 The Authors.

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New media technologies and the narrative turn in qualitative research has expanded the methods through which we gather data about and share findings of groups who have traditionally been written about by others rather than telling their own stories to reveal the complexities of their experiences. This chapter explores two projects that use storytelling and technology in an effort to change public perceptions about disadvantaged a community or cohort that have specific circumstances but are a result of policies beyond their control.

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The growing interest in co-created reading experiences in both digital and print formats raises interesting questions for creative writers who work in the space of interactive fiction. This essay argues that writers have not abandoned experiments with co-creation in print narratives in favour of the attractions of the digital environment, as might be assumed by the discourse on digital development. Rather, interactive print narratives, in particular ‘reader-assembled narratives’ demonstrate a rich history of experimentation and continue to engage writers who wish to craft individual reading experiences for readers and to experiment with their own creative process as writers. The reader-assembled narrative has been used for many different reasons and for some writers, such as BS Johnson it is a method of problem solving, for others, like Robert Coover, it is a way to engage the reader in a more playful sense. Authors such as Marc Saporta, BS Johnson, and Robert Coover have engaged with this type of narrative play. This examination considers the narrative experimentation of these authors as a way of offering insights into creative practice for contemporary creative writers.

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Twelve nasal swabs were collected from yearling horses with respiratory distress and tested for equid herpesvirus 1 (EHV-1) and equid herpesvirus 4 (EHV-4) by real-time PCR targeting the glycoprotein B gene. All samples were negative for EHV-1; however, 3 were positive for EHV-4. When these samples were tested for EHV-2 and EHV-5 by PCR, all samples were negative for EHV-2 and 11 were positive for EHV-5. All three samples that were positive for EHV-4 were also positive for EHV-5. These three samples gave a limited CPE in ED cells reminiscent of EHV-4 CPE. EHV-4 CPE was obvious after 3 days and was characterised by syncytia. None of the samples produced cytopathic effect (CPE) on African green monkey kidney (Vero) cells or hamster kidney (BSR) cells. Four of the samples, which were positive in the EHV-5 PCR, produced CPE on rabbit kidney (RK13) cells and equine dermis (ED) cells. EHV-5 CPE on both cell lines was slow and was apparent after four 7-day passages. On RK13 cells, the CPE was characteristic of equid herpesvirus, with the formation of syncytia. However, in ED cells, the CPE was characterised by ring-shaped syncytia. For the first time, a case of equine respiratory disease involving dual infection with EHV-4 and EHV-5 has been reported in Queensland (Australia). This was shown by simultaneously isolating EHV-4 and EHV-5 from clinical samples. EHV5 was recovered from all samples except one, suggesting that EHV5 was more prevalent in young horses than EHV2.

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The use of head-mounted displays (HMDs) can produce both positive and negative experiences. In an effort increase positive experiences and avoid negative ones, researchers have identified a number of variables that may cause sickness and eyestrain, although the exact nature of the relationship to HMDs may vary, depending on the tasks and the environments. Other non-sickness-related aspects of HMDs, such as users opinions and future decisions associated with task enjoyment and interest, have attracted little attention in the research community. In this thesis, user experiences associated with the use of monocular and bi-ocular HMDs were studied. These include eyestrain and sickness caused by current HMDs, the advantages and disadvantages of adjustable HMDs, HMDs as accessories for small multimedia devices, and the impact of individual characteristics and evaluated experiences on reported outcomes and opinions. The results indicate that today s commercial HMDs do not induce serious sickness or eyestrain. Reported adverse symptoms have some influence on HMD-related opinions, but the nature of the impact depends on the tasks and the devices used. As an accessory to handheld devices and as a personal viewing device, HMDs may increase use duration and enable users to perform tasks not suitable for small screens. Well-designed and functional, adjustable HMDs, especially monocular HMDs, increase viewing comfort and usability, which in turn may have a positive effect on product-related satisfaction. The role of individual characteristics in understanding HMD-related experiences has not changed significantly. Explaining other HMD-related experiences, especially forward-looking interests, also requires understanding more stable individual traits and motivations.

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Purpose – The purpose of this paper is to discuss residents’ views of social and physical environments in a co-housing and in a senior housing setting in Finland. Also, the study aims to point out important connections between well-being and built environment. Design/methodology/approach – The data include interviews and survey responses gathered in the cases. The results and analysis are presented at different case study levels, with the discussion and conclusions following this. Findings – The findings show that the physical environment and common areas have an important role to activate residents. When well-designed common areas exist, a higher level of engagement can be achieved by getting residents involved in the planning and running of activities. Research limitations/implications – This paper discusses residents’ experiences in two Finnish housing settings and it focuses on the housing market in Finland. Practical implications – The findings encourage investors and housing operators to design and invest common areas which could activate residents and create social contacts. Also, investors have to pay attention to the way these developments are managed. Originality/value – This study is the first to investigate the Finnish co-housing setting and compare social and physical environments in a co-housing and a senior house.

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In our earlier work ([1]) we proposed WLAN Manager (or WM) a centralised controller for QoS management of infrastructure WLANs based on the IEEE 802.11 DCF standards. The WM approach is based on queueing and scheduling packets in a device that sits between all traffic flowing between the APs and the wireline LAN, requires no changes to the AP or the STAs, and can be viewed as implementing a "Split-MAC" architecture. The objectives of WM were to manage various TCP performance related issues (such as the throughput "anomaly" when STAs associate with an AP with mixed PHY rates, and upload-download unfairness induced by finite AP buffers), and also to serve as the controller for VoIP admission control and handovers, and for other QoS management measures. In this paper we report our experiences in implementing the proposals in [1]: the insights gained, new control techniques developed, and the effectiveness of the WM approach in managing TCP performance in an infrastructure WLAN. We report results from a hybrid experiment where a physical WM manages actual TCP controlled packet flows between a server and clients, with the WLAN being simulated, and also from a small physical testbed with an actual AP.

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Manuscript: "Embattled Selves. Jewish Identity in the Face of Nazi Persecution". Table of contents and partial draft of a book on the impact of experiences in the Nazi era on the Jewish identity of four persons.

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This article argues that an indigenous approach to communication research allows us to re-think academic approaches of engaging in and evaluating participatory communication research. It takes as its case study the Komuniti Tok Piksa project undertaken in the Highlands of Papua New Guinea. The project explores ways in which visual methods when paired with a community action approach embedded within an indigenous framework can be used to facilitate social change through meaningful participation. It involves communities to narrate their experiences in regard to HIV and AIDS and assists them in designing and recording their own messages. Local researchers are trained in using visual tools to facilitate this engagement with the communities.

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Background There has been considerable publicity regarding population ageing and hospital emergency department (ED) overcrowding. Our study aims to investigate impact of one intervention piloted in Queensland Australia, the Hospital in the Nursing Home (HiNH) program, on reducing ED and hospital attendances from residential aged care facilities (RACFs). Methods A quasi-experimental study was conducted at an intervention hospital undertaking the program and a control hospital with normal practice. Routine Queensland health information system data were extracted for analysis. Results Significant reductions in the number of ED presentations per 1000 RACF beds (rate ratio (95 % CI): 0.78 (0.67–0.92); p = 0.002), number of hospital admissions per 1000 RACF beds (0.62 (0.50–0.76); p < 0.0001), and number of hospital admissions per 100 ED presentations (0.61 (0.43–0.85); p = 0.004) were noticed in the experimental hospital after the intervention; while there were no significant differences between intervention and control hospitals before the intervention. Pre-test and post-test comparison in the intervention hospital also presented significant decreases in ED presentation rate (0.75 (0.65–0.86); p < 0.0001) and hospital admission rate per RACF bed (0.66 (0.54–0.79); p < 0.0001), and a non-significant reduction in hospital admission rate per ED presentation (0.82 (0.61–1.11); p = 0.196). Conclusions Hospital in the Nursing Home program could be effective in reducing ED presentations and hospital admissions from RACF residents. Implementation of the program across a variety of settings is preferred to fully assess the ongoing benefits for patients and any possible cost-savings.

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School is regarded as a site of moral training for the younger generation to encounter nation’s future challenges as well as to re-energize nation’s cultural identity. The more competitive global society led by free market trade in terms of ASEAN Economic Community (AEC), requires the school to adapt and change its curriculum more frequently. Like many other countries, Indonesian Ministry of Education and Culture has introduced and nurtured universal values and traditional values respectively through school curriculum reforms to develop students’ ability to participating in global society. This paper will describe classical and contemporary theories related to moral education that have been implemented in Indonesia’s school curriculum and school activities. The theories developed by Durkheim, Alastair MacIntyre, and Basil Bernstein will be discussed. This includes explaining how far the theories have been adopted in Indonesia and how the approaches are currently being used in Indonesian schooling. This paper suggests despite the implementation of those theories in Indonesian schools, the government needs to optimise the operation of those theories to gain significant outcomes.