Knowledge-based approach for planning healthy cities : the case of Logan-Beaudesert, Australia

Introduction - The planning for healthy cities faces significant challenges due to lack of effective information, systems and a framework to organise that information. Such a framework is critical in order to make accessible and informed decisions for planning healthy cities. The challenges for planning healthy cities have been magnified by the rise of the healthy cities movement, as a result of which, there have been more frequent calls for localised, collaborative and knowledge-based decisions. Some studies have suggested that the use of a ‘knowledge-based’ approach to planning will enhance the accuracy and quality decision-making by improving the availability of data and information for health service planners and may also lead to increased collaboration between stakeholders and the community. A knowledge-based or evidence-based approach to decision-making can provide an ‘out-of-the-box’ thinking through the use of technology during decision-making processes. Minimal research has been conducted in this area to date, especially in terms of evaluating the impact of adopting knowledge-based approach on stakeholders, policy-makers and decision-makers within health planning initiatives. Purpose – The purpose of the paper is to present an integrated method that has been developed to facilitate a knowledge-based decision-making process to assist health planning Methodology – Specifically, the paper describes the participatory process that has been adopted to develop an online Geographic Information System (GIS)-based Decision Support System (DSS) for health planners. Value – Conceptually, it is an application of Healthy Cities and Knowledge Cities approaches which are linked together. Specifically, it is a unique settings-based initiative designed to plan for and improve the health capacity of Logan-Beaudesert area, Australia. This setting-based initiative is named as the Logan-Beaudesert Health Coalition (LBHC). Practical implications - The paper outlines the application of a knowledge-based approach to the development of a healthy city. Also, it focuses on the need for widespread use of this approach as a tool for enhancing community-based health coalition decision making processes.

Asset renewal decision modelling with application to the water utility industry

Reliable infrastructure assets impact significantly on quality of life and provide a stable foundation for economic growth and competitiveness. Decisions about the way assets are managed are of utmost importance in achieving this. Timely renewal of infrastructure assets supports reliability and maximum utilisation of infrastructure and enables business and community to grow and prosper. This research initially examined a framework for asset management decisions and then focused on asset renewal optimisation and renewal engineering optimisation in depth. This study had four primary objectives. The first was to develop a new Asset Management Decision Framework (AMDF) for identifying and classifying asset management decisions. The AMDF was developed by applying multi-criteria decision theory, classical management theory and life cycle management. The AMDF is an original and innovative contribution to asset management in that: · it is the first framework to provide guidance for developing asset management decision criteria based on fundamental business objectives; · it is the first framework to provide a decision context identification and analysis process for asset management decisions; and · it is the only comprehensive listing of asset management decision types developed from first principles. The second objective of this research was to develop a novel multi-attribute Asset Renewal Decision Model (ARDM) that takes account of financial, customer service, health and safety, environmental and socio-economic objectives. The unique feature of this ARDM is that it is the only model to optimise timing of asset renewal with respect to fundamental business objectives. The third objective of this research was to develop a novel Renewal Engineering Decision Model (REDM) that uses multiple criteria to determine the optimal timing for renewal engineering. The unique features of this model are that: · it is a novel extension to existing real options valuation models in that it uses overall utility rather than present value of cash flows to model engineering value; and · it is the only REDM that optimises timing of renewal engineering with respect to fundamental business objectives; The final objective was to develop and validate an Asset Renewal Engineering Philosophy (AREP) consisting of three principles of asset renewal engineering. The principles were validated using a novel application of real options theory. The AREP is the only renewal engineering philosophy in existence. The original contributions of this research are expected to enrich the body of knowledge in asset management through effectively addressing the need for an asset management decision framework, asset renewal and renewal engineering optimisation based on fundamental business objectives and a novel renewal engineering philosophy.

Using GIS to visualise and evaluate student travel behaviour

Using GIS to evaluate travel behaviour is an important technique to increase our understanding of the relationship between accessibility and transport demand. In this paper, the activity space concept was used to identify the nature of participation in activities (or lack of it) amongst a group of students using a 2 day travel-activity diary. Three different indicators such as the number of unique locations visited, average daily distance travelled, and average daily activity duration were used to measure the size of activity spaces. These indicators reflect levels of accessibility, personal mobility, and the extent of participation respectively. Multiple regression analyses were used to assess the impacts of students socio-economic status and the spatial characteristics of home location. Although no differences were found in the levels of accessibility and the extent of participation measures, home location with respect to a demand responsive transport (DRT) service was found to be the most important determinant of their mobility patterns. Despite being able to travel longer distances, students who live outside of the DRT service area were found to be temporally excluded from some opportunities. Student activity spaces were also visualised within a GIS environment and a spatial analysis was conducted to underpin the evaluation of the performance of the DRT. This approach was also used to identify the activity spaces of individuals that are geographically excluded from the service. Evaluation of these results indicated that although the service currently covers areas of high demand, 90% of the activity spaces remained un-served by the DRT service. Using this data six new routes were designed to meet the coverage goal of public transport based on a measure of network impedance based on inverse activity density. Following assessment of public transport service coverage, the study was extended using a Spatial Multi Criteria Evaluation (SMCE) technique to assess the effect of service provision on patronage.

Online environmental information systems

In today’s information society, electronic tools, such as computer networks for the rapid transfer of data and composite databases for information storage and management, are critical in ensuring effective environmental management. In particular environmental policies and programs for federal, state, and local governments need a large volume of up-to-date information on the quality of water, air, and soil in order to conserve and protect natural resources and to carry out meteorology. In line with this, the utilization of information and communication technologies (ICTs) is crucial to preserve and improve the quality of life. In handling tasks in the field of environmental protection a range of environmental and technical information is often required for a complex and mutual decision making in a multidisciplinary team environment. In this regard e-government provides a foundation of the transformative ICT initiative which can lead to better environmental governance, better services, and increased public participation in environmental decision- making process.

Towards a service framework for remote sales support via augmented reality

Real-time sales assistant service is a problematic component of remote delivery of sales support for customers. Solutions involving web pages, telephony and video support prove problematic when seeking to remotely guide customers in their sales processes, especially with transactions revolving around physically complex artefacts. This process involves a number of services that are often complex in nature, ranging from physical compatibility and configuration factors, to availability and credit services. We propose the application of a combination of virtual worlds and augmented reality to create synthetic environments suitable for remote sales of physical artefacts, right in the home of the purchaser. A high level description of the service structure involved is shown, along with a use case involving the sale of electronic goods and services within an example augmented reality application. We expect this work to have application in many sales domains involving physical objects needing to be sold over the Internet.

CARDIAC-ARIA: Measuring the Accessibility to Cardiovascular Services in Rural and Remote Australia Via Applied Geographical Spatial Technology (GIS)

Background/aims: Cardiovascular disease (CVD) continues to impose a heavy burden in terms of cost, disability and death in Australia. Recent evidence suggests that increasing remoteness, where cardiac services are scarce, is linked to an increased risk of dying from CVD. Fatal CVD events are reported to be between 20% and 50% higher in rural areas compared to major cities. Method: This project, with its extensive use of Geographic Information Systems (GIS) technology, will rank 11,338 rural and remote population centres to identify geographical ‘hotspots’ where there is likely to be a mismatch between the demand for and actual provision of cardiovascular services. It will, therefore, guide more equitable provision of services to rural and remote communities. Outcomes: The CARDIAC-ARIA project is designed to; map the type and location of cardiovascular services currently available in Australia, relative to the distribution of individuals who currently have symptomatic CVD; determine, by expert panel, what are the minimal requirements for comprehensive cardiovascular health support in metropolitan and rural communities and derive a rating classification based on the Accessibility and Remoteness Index of Australia (ARIA) for each of Australia's 11,338 rural and remote population centres. Conclusion: This unique, innovative and highly collaborative project has the potential to deliver a powerful tool to highlight and combat the burden imposed by cardiovascular disease (CVD) in Australia.

Quality of work life and turnover intention in primary healthcare organisations : a cross-sectional study of registered nurses in Saudi Arabia

Purpose: The purpose of this study was to improve the retention of primary healthcare (PHC) nurses through exploring and assessing their quality of work life (QWL) and turnover intention. Design and methods: A cross-sectional survey design was used in this study. Data were collected using a questionnaire comprising four sections (Brooks’ survey of Quality of Nursing Work Life [QNWL], Anticipated Turnover Intention, open-ended questions and demographic characteristics). A convenience sample was recruited from 143 PHC centres in Jazan, Saudi Arabia. A response rate of 87% (n = 508/585) was achieved. The SPSS v17 for Windows and NVivo 8 were used for analysis purposes. Procedures and tests used in this study to analyse the quantitative data were descriptive statistics, t-test, ANOVA, General Linear Model (GLM) univariate analysis, standard multiple regression, and hierarchical multiple regression. Qualitative data obtained from responses to the open-ended questions were analysed using the NVivo 8. Findings: Quantitative findings suggested that PHC nurses were dissatisfied with their work life. Respondents’ scores ranged between 45 and 218 (mean = 139.45), which is lower than the average total score on Brooks’ Survey (147). Major influencing factors were classified under four dimensions. First, work life/home life factors: unsuitable working hours, lack of facilities for nurses, inability to balance work with family needs and inadequacy of vacations’ policy. Second, work design factors: high workload, insufficient workforce numbers, lack of autonomy and undertaking many non-nursing tasks. Third, work context factors: management practices, lack of development opportunities, and inappropriate working environment in terms of the level of security, patient care supplies and unavailability of recreation room. Finally, work world factors: negative public image of nursing, and inadequate payment. More positively, nurses were notably satisfied with their co-workers. Conversely, 40.4% (n = 205) of the respondents indicated that they intended to leave their current employment. The relationships between QWL and demographic variables of gender, age, marital status, dependent children, dependent adults, nationality, ethnicity, nursing tenure, organisational tenure, positional tenure, and payment per month were significant (p < .05). The eta squared test for these demographics indicates a small to medium effect size of the variation in QWL scores. Using the GLM univariate analysis, education level was also significantly related to the QWL (p < .05). The relationships between turnover intention and demographic variables including gender, age, marital status, dependent children, education level, nursing tenure, organisational tenure, positional tenure, and payment per month were significant (p < .05). The eta squared test for these demographics indicates a small to moderate effect size of the variation in the turnover intention scores. Using the GLM univariate analysis, the dependent adults’ variable was also significantly related to turnover intention (p < .05). Turnover intention was significantly related to QWL. Using standard multiple regression, 26% of the variance in turnover intention was explained by the QWL F (4,491), 43.71, p < .001, with R² = .263. Further analysis using hierarchical multiple regression found that the total variance explained by the model as a whole (demographics and QWL) was 32.1%, F (17.433) = 12.04, p < .001. QWL explained an additional 19% of the variance in turnover intention, after controlling for demographic variables, R squared change =.19, F change (4, 433) = 30.190, p < .001. The work context variable makes the strongest unique contribution (-.387) to explain the turnover intention, followed by the work design dimension (-.112). The qualitative findings reaffirmed the quantitative findings in terms of QWL and turnover intention. However, the home life/work life and work world dimensions were of great important to both QWL and turnover intention. The qualitative findings revealed a number of new factors that were not included in the survey questionnaire. These included being away from family, lack of family support, social and cultural aspects, accommodation facilities, transportation, building and infrastructure of PHC, nature of work, job instability, privacy at work, patients and community, and distance between home and workplace. Conclusion: Creating and maintaining a healthy work life for PHC nurses is very important to improve their work satisfaction, reduce turnover, enhance productivity and improve nursing care outcomes. Improving these factors could lead to a higher QWL and increase retention rates and therefore reinforcing the stabilisation of the nursing workforce. Significance of the research: Many countries are examining strategies to attract and retain the health care workforce, particularly nurses. This study identified factors that influence the QWL of PHC nurses as well as their turnover intention. It also determined the significant relationship between QWL and turnover intention. In addition, the present study tested Brooks’ survey of QNWL on PHC nurses for the first time. The qualitative findings of this study revealed a number of new variables regarding QWL and turnover intention of PHC nurses. These variables could be used to improve current survey instruments or to develop new research surveys. The study findings could be also used to develop and appropriately implement plans to improve QWL. This may help to enhance the home and work environments of PHC nurses, improve individual and organisational performance, and increase nurses’ commitment. This study contributes to the existing body of research knowledge by presenting new data and findings from a different country and healthcare system. It is the first of its kind in Saudi Arabia, especially in the field of PHC. It has examined the relationship between QWL and turnover intention of PHC nurses for the first time using nursing instruments. The study also offers a fresh explanation (new framework) of the relationship between QWL and turnover intention among PHC nurses, which could be used or tested by researchers in other settings. Implications for further research: Review of the extant literature reveals little in-depth research on the PHC workforce, especially in terms of QWL and organisational turnover in developing countries. Further research is required to develop a QWL tool for PHC nurses, taking into consideration the findings of the current study along with the local culture. Moreover, the revised theoretical framework of the current study could be tested in further research in other regions, countries or healthcare systems in order to identify its ability to predict the level of PHC nurses’ QWL and their intention to leave. There is a need to conduct longitudinal research on PHC organisations to gain an in-depth understanding of the determents of and changes in QWL and turnover intention of PHC nurses at various points of time. An intervention study is required to improve QWL and retention among PHC nurses using the findings of the current study. This would help to assess the impact of such strategies on reducing turnover of PHC nurses. Focusing on the location of the current study, it would be valuable to conduct another study in five years’ time to examine the percentage of actual turnover among PHC nurses compared with the reported turnover intention in the current study. Further in-depth research would also be useful to assess the impact of the local culture on the perception of expatriate nurses towards their QWL and their turnover intention. A comparative study is required between PHC centres and hospitals as well as the public and private health sector agencies in terms of QWL and turnover intention of nursing personnel. Findings may differ from sector to sector according to variations in health systems, working environments and the case mix of patients.

Critical sustainability factors in industrialised building systems

Purpose – This paper presents findings of a research study aimed at identifying critical sustainability factors for improved implementation of Industrialised Building Systems (IBS). It also highlights the importance of decision support, through the establishment of decision making guidelines, for sustainability deliverables in IBS development. Design/methodology/approach – A broad range of sustainability factors, as perceived by researchers and practitioners, are identified through a comprehensive literature study. A study of the survey and statistical data analysis is conducted to examine the criticality of these sustainability factors in IBS implementation. Findings – 18 sustainability factors are identified as critical to IBS implementation. Their interrelationships and driving forces are explored, which leads to the development of a conceptual model to map these factors for actions or potential solutions. The work provides a sound basis towards a set of decision making guidelines for sustainable IBS implementation. Originality/value – Compared with previous studies that focus on technical or economical aspects, this study extends existing knowledge on construction prefabrication by linking all aspects of sustainability issues with the design process. It also covers industry characteristics of developing countries, as represented by Malaysia’s scenarios.

An integrated approach to supporting land-use decisions in site redevelopment for urban renewal in Hong Kong

Urban renewal is a significant issue in developed urban areas, with a particular problem for urban planners being redevelopment of land to meet demand whilst ensuring compatibility with existing land use. This paper presents a geographic information systems (GIS)-based decision support tool (called LUDS) to quantitatively assess land-use suitability for site redevelopment in urban renewal areas. This consists of a model for the suitability analysis and an affiliated land-information database for residential, commercial, industrial, G/I/C (government/institution/community) and open space land uses. Development has occurred with support from interviews with industry experts, focus group meetings and an experimental trial, combined with several advanced techniques and tools, including GIS data processing and spatial analysis, multi-criterion analysis, as well as the AHP method for constructing the model and database. As demonstrated in the trial, LUDS assists planners in making land-use decisions and supports the planning process in assessing urban land-use suitability for site redevelopment. Moreover, it facilitates public consultation (participatory planning) by providing stakeholders with an explicit understanding of planners' views.

Application of Resilience concept for enhanced management of water supply systems

This paper presents an approach to developing indicators for expressing resilience of a generic water supply system. The system is contextualised as a meta-system consisting of three subsystems to represent the water catchment and reservoir, treatment plant and the distribution system supplying the end-users. The level of final service delivery to end-users is considered as a surrogate measure of systemic resilience. A set of modelled relationships are used to explore relationships between system components when placed under simulated stress. Conceptual system behaviour of specific types of simulated pressure is created for illustration of parameters for indicator development. The approach is based on the hypothesis that an in-depth knowledge of resilience would enable development of decision support system capability which in turn will contribute towards enhanced management of a water supply system. In contrast to conventional water supply system management approaches, a resilience approach facilitates improvement in system efficiency by emphasising awareness of points-of-intervention where system managers can adjust operational control measures across the meta-system (and within subsystems) rather than expansion of the system in entirety in the form of new infrastructure development.

Predictive modelling : parents’ decision making to use online child health information to increase their understanding and/or diagnose or treat their child’s health

Abstract Background The quantum increases in home Internet access and available online health information with limited control over information quality highlight the necessity of exploring decision making processes in accessing and using online information, specifically in relation to children who do not make their health decisions. Objectives To understand the processes explaining parents’ decisions to use online health information for child health care. Methods Parents (N = 391) completed an initial questionnaire assessing the theory of planned behaviour constructs of attitude, subjective norm, and perceived behavioural control, as well as perceived risk, group norm, and additional demographic factors. Two months later, 187 parents completed a follow-up questionnaire assessing their decisions to use online information for their child’s health care, specifically to 1) diagnose and/or treat their child’s suspected medical condition/illness and 2) increase understanding about a diagnosis or treatment recommended by a health professional. Results Hierarchical multiple regression showed that, for both behaviours, attitude, subjective norm, perceived behavioural control, (less) perceived risk, group norm, and (non) medical background were the significant predictors of intention. For parents’ use of online child health information, for both behaviours, intention was the sole significant predictor of behaviour. The findings explain 77% of the variance in parents’ intention to treat/diagnose a child health problem and 74% of the variance in their intentions to increase their understanding about child health concerns. Conclusions Understanding parents’ socio-cognitive processes that guide their use of online information for child health care is important given the increase in Internet usage and the sometimes-questionable quality of health information provided online. Findings highlight parents’ thirst for information; there is an urgent need for health professionals to provide parents with evidence-based child health websites in addition to general population education on how to evaluate the quality of online health information.

Will the application of spatial multi criteria evaluation technique enhance the quality of decision-making to resolve boundary conflicts in the Philippines?

Systematic studies that evaluate the quality of decision-making processes are relatively rare. Using the literature on decision quality, this research develops a framework to assess the quality of decision-making processes for resolving boundary conflicts in the Philippines. The evaluation framework breaks down the decision-making process into three components (the decision procedure, the decision method, and the decision unit) and is applied to two ex-post (one resolved and one unresolved) and one ex-ante cases. The evaluation results from the resolved and the unresolved cases show that the choice of decision method plays a minor role in resolving boundary conflicts whereas the choice of decision procedure is more influential. In the end, a decision unit can choose a simple method to resolve the conflict. The ex-ante case presents a follow-up intended to resolve the unresolved case for a changing decision-making process in which the associated decision unit plans to apply the spatial multi criteria evaluation (SMCE) tool as a decision method. The evaluation results from the ex-ante case confirm that the SMCE has the potential to enhance the decision quality because: a) it provides high quality as a decision method in this changing process, and b) the weaknesses associated with the decision unit and the decision procedure of the unresolved case were found to be eliminated in this process.

Embedding human expert cognition into autonomous UAS trajectory planning

This paper presents a new approach for the inclusion of human expert cognition into autonomous trajectory planning for unmanned aerial systems (UASs) operating in low-altitude environments. During typical UAS operations, multiple objectives may exist; therefore, the use of multicriteria decision aid techniques can potentially allow for convergence to trajectory solutions which better reflect overall mission requirements. In that context, additive multiattribute value theory has been applied to optimize trajectories with respect to multiple objectives. A graphical user interface was developed to allow for knowledge capture from a human decision maker (HDM) through simulated decision scenarios. The expert decision data gathered are converted into value functions and corresponding criteria weightings using utility additive theory. The inclusion of preferences elicited from HDM data within an automated decision system allows for the generation of trajectories which more closely represent the candidate HDM decision preferences. This approach has been demonstrated in this paper through simulation using a fixed-wing UAS operating in low-altitude environments.