Privacy and trust management for electronic health records

Establishing a nationwide Electronic Health Record system has become a primary objective for many countries around the world, including Australia, in order to improve the quality of healthcare while at the same time decreasing its cost. Doing so will require federating the large number of patient data repositories currently in use throughout the country. However, implementation of EHR systems is being hindered by several obstacles, among them concerns about data privacy and trustworthiness. Current IT solutions fail to satisfy patients’ privacy desires and do not provide a trustworthiness measure for medical data. This thesis starts with the observation that existing EHR system proposals suer from six serious shortcomings that aect patients’ privacy and safety, and medical practitioners’ trust in EHR data: accuracy and privacy concerns over linking patients’ existing medical records; the inability of patients to have control over who accesses their private data; the inability to protect against inferences about patients’ sensitive data; the lack of a mechanism for evaluating the trustworthiness of medical data; and the failure of current healthcare workflow processes to capture and enforce patient’s privacy desires. Following an action research method, this thesis addresses the above shortcomings by firstly proposing an architecture for linking electronic medical records in an accurate and private way where patients are given control over what information can be revealed about them. This is accomplished by extending the structure and protocols introduced in federated identity management to link a patient’s EHR to his existing medical records by using pseudonym identifiers. Secondly, a privacy-aware access control model is developed to satisfy patients’ privacy requirements. The model is developed by integrating three standard access control models in a way that gives patients access control over their private data and ensures that legitimate uses of EHRs are not hindered. Thirdly, a probabilistic approach for detecting and restricting inference channels resulting from publicly-available medical data is developed to guard against indirect accesses to a patient’s private data. This approach is based upon a Bayesian network and the causal probabilistic relations that exist between medical data fields. The resulting definitions and algorithms show how an inference channel can be detected and restricted to satisfy patients’ expressed privacy goals. Fourthly, a medical data trustworthiness assessment model is developed to evaluate the quality of medical data by assessing the trustworthiness of its sources (e.g. a healthcare provider or medical practitioner). In this model, Beta and Dirichlet reputation systems are used to collect reputation scores about medical data sources and these are used to compute the trustworthiness of medical data via subjective logic. Finally, an extension is made to healthcare workflow management processes to capture and enforce patients’ privacy policies. This is accomplished by developing a conceptual model that introduces new workflow notions to make the workflow management system aware of a patient’s privacy requirements. These extensions are then implemented in the YAWL workflow management system.

Controller structure and design of firing angle controllers for (unit connected) HVDC systems

This paper investigates the control of a HVDC link, fed from an AC source through a controlled rectifier and feeding an AC line through a controlled inverter. The overall objective is to maintain maximum possible link voltage at the inverter while regulating the link current. In this paper the practical feedback design issues are investigated with a view of obtaining simple, robust designs that are easy to evaluate for safety and operability. The investigations are applicable to back-to-back links used for frequency decoupling and to long DC lines. The design issues discussed include: (i) a review of overall system dynamics to establish the time scale of different feedback loops and to highlight feedback design issues; (ii) the concept of using the inverter firing angle control to regulate link current when the rectifier firing angle controller saturates; and (iii) the design issues for the individual controllers including robust design for varying line conditions and the trade-off between controller complexity and the reduction of nonlinearity and disturbance effects

Requirements for enhancing trust, security and integrity of GNSS location services

The paper describes a number of requirements for enhancing the trust of location acquisition from Satellite Navigation Systems, particularly for those applications where the location is monitored through a remote GNSS receiver. We discuss how the trust of a location acquisition could be propagated to an application through the use of a proposed tamper-­resistant GNSS receiver which quantifies the trust of a location solution from the signaling used (ie. P(Y) code, Galileo SOL, PRS, CS) and provides a cryptographic proof of this to a remote application. The tamper­-resistance state of the receiver is also included in this cryptographic proof.

The provision of patient personal hygiene in the intensive care unit : a descriptive exploratory study of bed-bathing practice

Background/objectives The provision of the patient bed-bath is a fundamental nursing care activity yet few quantitative data and no qualitative data are available on registered nurses’ (RNs) clinical practice in this domain in the intensive care unit (ICU). The aim of this study was to describe ICU RNs current practice with respect to the timing, frequency and duration of the patient bed-bath and the cleansing and emollient agents used. Methods The study utilised a two-phase sequential explanatory mixed method design. Phase one used a questionnaire to survey RNs and phase two employed semi-structured focus group (FG) interviews with RNs. Data was collected over 28 days across four Australian metropolitan ICUs. Ethical approval was granted from the relevant hospital and university human research ethics committees. RNs were asked to complete a questionnaire following each episode of care (i.e. bed-bath) and then to attend one of three FG interviews: RNs with less than 2 years ICU experience; RNs with 2–5 years ICU experience; and RNs with greater than 5 years ICU experience. Results During the 28-day study period the four ICUs had 77.25 beds open. In phase one a total of 539 questionnaires were returned, representing 30.5% of episodes of patient bed-baths (based on 1767 bed occupancy and one bed-bath per patient per day). In 349 bed-bath episodes 54.7% patients were mechanically ventilated. The bed-bath was given between 02.00 and 06.00 h in 161 episodes (30%), took 15–30 min to complete (n = 195, 36.2%) and was completed within the last 8 h in 304 episodes (56.8%). Cleansing agents used were predominantly pH balanced soap or liquid soap and water (n = 379, 71%) in comparison to chlorhexidine impregnated sponges/cloths (n = 86, 16.1%) or other agents such as pre-packaged washcloths (n = 65, 12.2%). In 347 episodes (64.4%) emollients were not applied after the bed-bath. In phase two 12 FGs were conducted (three FGs at each ICU) with a total of 42 RN participants. Thematic analysis of FG transcripts across the three levels of RN ICU experience highlighted a transition of patient hygiene practice philosophy from shades of grey – falling in line for inexperienced clinicians to experienced clinicians concrete beliefs about patient bed-bath needs. Conclusions This study identified variation in process and products used in patient hygiene practices in four ICUs. Further study to improve patient outcomes is required to determine the appropriate timing of patient hygiene activities and cleansing agents used to improve skin integrity.

Nonprofit organizational and work unit identification and the occupational stress process

Research investigating the transactional approach to the work stressor-employee adjustment relationship has described many negative main effects between perceived stressors in the workplace and employee outcomes. A considerable amount of literature, theoretical and empirical, also describes potential moderators of this relationship. Organizational identification has been established as a significant predictor of employee job-related attitudes. To date, research has neglected investigation of the potential moderating effect of organizational identification in the work stressor-employee adjustment relationship. On the basis of identity, subjective fit and sense of belonging literature it was predicted that higher perceptions of identification at multiple levels of the organization would mitigate the negative effect of work stressors on employee adjustment. It was expected, further, that more proximal, lower order identifications would be more prevalent and potent as buffers of stressors on strain. Predictions were tested with an employee sample from five organizations (N = 267). Hierarchical moderated multiple regression analyses revealed some support for the stress-buffering effects of identification in the prediction of job satisfaction and organizational commitment, particularly for more proximal (i.e., work unit) identification. These positive stress-buffering effects, however, were present for low identifiers in some situations. The present study represents an extension of the application of organizational identity theory by identifying the effects of organizational and workgroup identification on employee outcomes in the nonprofit context. Our findings will contribute to a better understanding of the dynamics in nonprofit organizations and therefore contribute to the development of strategy and interventions to deal with identity-based issues in nonprofits.

Project-based organisations : overcoming lack of trust and social networks within small and medium project teams

In sustainable development projects, as well as other types of projects, knowledge transfer is important for the organisations managing the project. Nevertheless, knowledge transfer among employees does not happen automatically and it has been found that the lack of social networks and the lack of trust among employees are the major barriers to effective knowledge transfer. Social network analysis has been recognised as a very important tool for improving knowledge transfer in the project environment. Transfer of knowledge is more effective where it depends heavily on social networks and informal dialogue. Based on the theory of social capital, social capital consists of two parts: conduits network and resource exchange network. This research studies the relationships among performance, the resource exchange network (such as the knowledge network) and the relationship network (such as strong ties network, energy network, and trust network) at the individual and project levels. The aim of this chapter is to present an approach to overcoming the lack of social networks and lack of trust to improve knowledge transfer within project-based organisations. This is to be done by identifying the optimum structure of relationship networks and knowledge networks within small and medium projects. The optimal structure of the relationship networks and knowledge networks is measured using two dimensions: intra-project and inter-project. This chapter also outlines an extensive literature review in the areas of social capital, knowledge management and project management, and presents the conceptual model of the research approach.

Longitudinal evaluations of student satisfaction with a postgraduate unit using importance-performance analysis

The Australian tourism tertiary education sector operates in a competitive and dynamic environment, which necessitates a market orientation to be successful. Academic staff and management in the sector must regularly assess the perceptions of prospective and current students and monitor the satisfaction levels of current students. This study is concerned with the setting and monitoring of satisfaction levels of current students, reporting the results of three longitudinal investigations of student satisfaction in a postgraduate unit. The study also addresses a limitation of a university’s generic teaching evaluation instrument. Importance-Performance Analysis (IPA) has been recommended as a simple but effective tool for overcoming the deficiencies of many student evaluation studies, which have generally measured only attribute performance at the end of a semester. IPA was used to compare student expectations of the unit at the beginning of a semester with their perceptions of performance 10 weeks later. The first stage documented key benchmarks for which amendments to the unit based on student feedback could be evaluated during subsequent teaching periods.

Engaging operations management students by designing the unit with industry focus

Operations management is an area concerned with the production of goods and services ensuring that business operations are efficient in utilizing resource and effective to meet customer requirements. It deals with the design and management of products, processes, services and supply chains and considers the acquisition, development, and effective and efficient utilization of resources. Unlike other engineering subjects, content of these units could be very wide and vast. It is therefore necessary to cover the content that is most related to the contemporary industries. It is also necessary to understand what engineering management skills are critical for engineers working in the contemporary organisations. Most of the operations management books contain traditional Operations Management techniques. For example ‘inventory management’ is an important topic in operations management. All OM books deal with effective method of inventory management. However, new trend in OM is Just in time (JIT) delivery or minimization of inventory. It is therefore important to decide whether to emphasise on keeping inventory (as suggested by most books) or minimization of inventory. Similarly, for OM decisions like forecasting, optimization and linear programming most organisations now a day’s use software. Now it is important for us to determine whether some of these software need to be introduced in tutorial/ lab classes. If so, what software? It is established in the Teaching and Learning literature that there must be a strong alignment between unit objectives, assessment and learning activities to engage students in learning. Literature also established that engaging students is vital for learning. However, engineering units (more specifically Operations management) is quite different from other majors. Only alignment between objectives, assessment and learning activities cannot guarantee student engagement. Unit content must be practical oriented and skills to be developed should be those demanded by the industry. Present active learning research, using a multi-method research approach, redesigned the operations management content based on latest developments in Engineering Management area and the necessity of Australian industries. The redesigned unit has significantly helped better student engagement and better learning. It was found that students are engaged in the learning if they find the contents are helpful in developing skills that are necessary in their practical life.

The impact of online reviews on hotel booking intentions and trust

A growing reliance on the Internet as an information source when making choices about tourism products raises the need for more research into electronic word of mouth. Within a hotel context, this study explores the role of four key factors that influence perceptions of trust and consumer choice. An experimental design is used to investigate four independent variables: the target of the review (core or interpersonal); overall valence of a set of reviews (positive or negative); framing of reviews (what comes first: negative or positive information); and whether or not a consumer generated numerical rating is provided together with the written text. Consumers seem to be more influenced by early negative information, especially when the overall set of reviews is negative. However, positively framed information together with numerical rating details increases both booking intentions and consumer trust. The results suggest that consumers tend to rely on easy-to-process information, when evaluating a hotel based upon reviews. Higher levels of trust are also evident when a positively framed set of reviews focused on interpersonal service.

A survey on the relationship between trust and interest similarity in online social networks

A remarkable growth in quantity and popularity of online social networks has been observed in recent years. There is a good number of online social networks exists which have over 100 million registered users. Many of these popular social networks offer automated recommendations to their users. This automated recommendations are normally generated using collaborative filtering systems based on the past ratings or opinions of the similar users. Alternatively, trust among the users in the network also can be used to find the neighbors while making recommendations. To obtain the optimum result, there must be a positive correlation exists between trust and interest similarity. Though the positive relations between trust and interest similarity are assumed and adopted by many researchers; no survey work on real life people’s opinion to support this hypothesis is found. In this paper, we have reviewed the state-of-the-art research work on trust in online social networks and have presented the result of the survey on the relationship between trust and interest similarity. Our result supports the assumed hypothesis of positive relationship between the trust and interest similarity of the users.

Developing trust networks based on user tagging information for recommendation making

Recommender systems are one of the recent inventions to deal with ever growing information overload. Collaborative filtering seems to be the most popular technique in recommender systems. With sufficient background information of item ratings, its performance is promising enough. But research shows that it performs very poor in a cold start situation where previous rating data is sparse. As an alternative, trust can be used for neighbor formation to generate automated recommendation. User assigned explicit trust rating such as how much they trust each other is used for this purpose. However, reliable explicit trust data is not always available. In this paper we propose a new method of developing trust networks based on user’s interest similarity in the absence of explicit trust data. To identify the interest similarity, we have used user’s personalized tagging information. This trust network can be used to find the neighbors to make automated recommendations. Our experiment result shows that the proposed trust based method outperforms the traditional collaborative filtering approach which uses users rating data. Its performance improves even further when we utilize trust propagation techniques to broaden the range of neighborhood.

SimTrust : a new method of trust network generation

Trust can be used for neighbor formation to generate automated recommendations. User assigned explicit rating data can be used for this purpose. However, the explicit rating data is not always available. In this paper we present a new method of generating trust network based on user’s interest similarity. To identify the interest similarity, we use user’s personalized tag information. This trust network can be used to find the neighbors to make automated recommendation. Our experiment result shows that the precision of the proposed method outperforms the traditional collaborative filtering approach.

Managing Trust in Online Social Networks

In recent years, there is a dramatic growth in number and popularity of online social networks. There are many networks available with more than 100 million registered users such as Facebook, MySpace, QZone, Windows Live Spaces etc. People may connect, discover and share by using these online social networks. The exponential growth of online communities in the area of social networks attracts the attention of the researchers about the importance of managing trust in online environment. Users of the online social networks may share their experiences and opinions within the networks about an item which may be a product or service. The user faces the problem of evaluating trust in a service or service provider before making a choice. Recommendations may be received through a chain of friends network, so the problem for the user is to be able to evaluate various types of trust opinions and recommendations. This opinion or recommendation has a great influence to choose to use or enjoy the item by the other user of the community. Collaborative filtering system is the most popular method in recommender system. The task in collaborative filtering is to predict the utility of items to a particular user based on a database of user rates from a sample or population of other users. Because of the different taste of different people, they rate differently according to their subjective taste. If two people rate a set of items similarly, they share similar tastes. In the recommender system, this information is used to recommend items that one participant likes, to other persons in the same cluster. But the collaborative filtering system performs poor when there is insufficient previous common rating available between users; commonly known as cost start problem. To overcome the cold start problem and with the dramatic growth of online social networks, trust based approach to recommendation has emerged. This approach assumes a trust network among users and makes recommendations based on the ratings of the users that are directly or indirectly trusted by the target user.

Trust and reputation management in web-based social network

know personally. They also communicate with other members of the network who are the friends of their friends and may be friends of their friend’s network. They share their experiences and opinions within the social network about an item which may be a product or service. The user faces the problem of evaluating trust in a service or service provider before making a choice. Opinions, reputations and ecommendations will influence users' choice and usage of online resources. Recommendations may be received through a chain of friends of friends, so the problem for the user is to be able to evaluate various types of trust recommendations and reputations. This opinion or ecommendation has a great influence to choose to use or enjoy the item by the other user of the community. Users share information on the level of trust they explicitly assign to other users. This trust can be used to determine while taking decision based on any recommendation. In case of the absence of direct connection of the recommender user, propagated trust could be useful.