Reliability of clinical measurement for assessing spinal fusion: An experimental sheep study

Study Design. A sheep study designed to compare the accuracy of static radiographs, dynamic radiographs, and computed tomographic (CT) scans for the assessment of thoracolumbar facet joint fusion as determined by micro-CT scanning. Objective. To determine the accuracy and reliability of conventional imaging techniques in identifying the status of thoracolumbar (T13-L1) facet joint fusion in a sheep model. Summary of Background Data. Plain radiographs are commonly used to determine the integrity of surgical arthrodesis of the thoracolumbar spine. Many previous studies of fusion success have relied solely on postoperative assessment of plain radiographs, a technique lacking sensitivity for pseudarthrosis. CT may be a more reliable technique, but is less well characterized. Methods. Eleven adult sheep were randomized to either attempted arthrodesis using autogenous bone graft and internal fixation (n = 3) or intentional pseudarthrosis (IP) using oxidized cellulose and internal fixation (n = 8). After 6 months, facet joint fusion was assessed by independent observers, using (1) plain static radiography alone, (2) additional dynamic radiographs, and (3) additional reconstructed spiral CT imaging. These assessments were correlated with high-resolution micro-CT imaging to predict the utility of the conventional imaging techniques in the estimation of fusion success. Results. The capacity of plain radiography alone to correctly predict fusion or pseudarthrosis was 43% and was not improved using plain radiography and dynamic radiography with also a 43% accuracy. Adding assessment by reformatted CT imaging to the plain radiography techniques increased the capacity to predict fusion outcome to 86% correctly. The sensitivity, specificity, and accuracy of static radiography were 0.33, 0.55, and 0.43, respectively, those of dynamic radiography were 0.46, 0.40, and 0.43, respectively, and those of radiography plus CT were 0.88, 0.85, and 0.86, respectively. Conclusion. CT-based evaluation correlated most closely with high-resolution micro-CT imaging. Neither plain static nor dynamic radiographs were able to predict fusion outcome accurately. © 2012 Lippincott Williams & Wilkins.

Sequential Fusion Using Correlated Decisions for Controlled Verification Errors

Fusion techniques have received considerable attention for achieving lower error rates with biometrics. A fused classifier architecture based on sequential integration of multi-instance and multi-sample fusion schemes allows controlled trade-off between false alarms and false rejects. Expressions for each type of error for the fused system have previously been derived for the case of statistically independent classifier decisions. It is shown in this paper that the performance of this architecture can be improved by modelling the correlation between classifier decisions. Correlation modelling also enables better tuning of fusion model parameters, ‘N’, the number of classifiers and ‘M’, the number of attempts/samples, and facilitates the determination of error bounds for false rejects and false accepts for each specific user. Error trade-off performance of the architecture is evaluated using HMM based speaker verification on utterances of individual digits. Results show that performance is improved for the case of favourable correlated decisions. The architecture investigated here is directly applicable to speaker verification from spoken digit strings such as credit card numbers in telephone or voice over internet protocol based applications. It is also applicable to other biometric modalities such as finger prints and handwriting samples.

An empirical investigation of health information system failure in regional Sri Lanka

Public health decision making is critically dependant on accurate, timely and reliable information. There is a widespread belief that most of the national and sub-national health information systems fail in providing much needed information support for evidence based health planning and interventions. This situation is more acute in developing nations where resources are either stagnant or decreasing, coupled with the situations of demographic transition and double burden of diseases. Literature abounds with publications, which provide information on misguided health interventions in developing nations, leading to failure and waste of resources. Health information system failure is widely blamed for this situation. Nevertheless, there is a dearth of comprehensive evaluations of existing national or sub-national health information systems, especially in the region of South-East Asia. This study makes an attempt to bridge this knowledge gap by evaluating a regional health information system in Sri Lanka. It explores the strengths and weaknesses of the current health information system and related causative factors in a decentralised health system and then proposes strategic recommendations for reform measures. A mix methodological and phased approach was adopted to reach the objectives. An initial self administered questionnaire survey was conducted among health managers to study their perceptions in relation to the regional health information system and its management support. The survey findings were used to establish the presence of health information system failure in the region and also as a precursor to the more in-depth case study which was followed. The sources of data for the case study were literature review, document analysis and key stake holder interviews. Health information system resources, health indicators, data sources, data management, data quality, and information dissemination were the six major components investigated. The study findings reveal that accurate, timely and reliable health information is unavailable and therefore evidence based health planning is lacking in the studied health region. Strengths and weaknesses of the current health information system were identified and strategic recommendations were formulated accordingly. It is anticipated that this research will make a significant and multi-fold contribution for health information management in developing countries. First, it will attempt to bridge an existing knowledge gap by presenting the findings of a comprehensive case study to reveal the strengths and weaknesses of a decentralised health information system in a developing country. Second, it will enrich the literature by providing an assessment tool and a research method for the evaluation of regional health information systems. Third, it will make a rewarding practical contribution by presenting valuable guidelines for improving health information systems in regional Sri Lanka.

Sequential fusion of decisions with favorable dependence for controlled verification errors

Statistical dependence between classifier decisions is often shown to improve performance over statistically independent decisions. Though the solution for favourable dependence between two classifier decisions has been derived, the theoretical analysis for the general case of 'n' client and impostor decision fusion has not been presented before. This paper presents the expressions developed for favourable dependence of multi-instance and multi-sample fusion schemes that employ 'AND' and 'OR' rules. The expressions are experimentally evaluated by considering the proposed architecture for text-dependent speaker verification using HMM based digit dependent speaker models. The improvement in fusion performance is found to be higher when digit combinations with favourable client and impostor decisions are used for speaker verification. The total error rate of 20% for fusion of independent decisions is reduced to 2.1% for fusion of decisions that are favourable for both client and impostors. The expressions developed here are also applicable to other biometric modalities, such as finger prints and handwriting samples, for reliable identity verification.

Factors influencing the adoption of information technology in a construction business

Construction firms are increasingly utilizing information technologies to better manage geographically dispersed projects. Often these technologies involve changes to existing working practices and processes and are viewed as disruptive by members of the organization. Understanding the factors that can influence individuals’ intention to utilize technology can assist managers to implement strategies to increase and improve the uptake of technologies and improve the innovation adoption process. Using a case study organization, factors identified in the Unified Theory of Acceptance and Use of Technology (UTAUT) are examined and the UTAUT is extended and by including resistance to change and top management support. The findings indicate effort expectancy, internal facilitating conditions and top management support all influence individuals’ intention to use information technology. The results also show that resistance to change or fear of change does not always play a role in innovation adoption. The findings reinforce the need to support new technologies from both a managerial and technical perspective.

Visual support for work assignment in process-aware information systems : framework formalisation and implementation

Process-aware information systems, ranging from generic workflow systems to dedicated enterprise information systems, use work-lists to offer so-called work items to users. In real scenarios, users can be confronted with a very large number of work items that stem from multiple cases of different processes. In this jungle of work items, users may find it hard to choose the right item to work on next. The system cannot autonomously decide which is the right work item, since the decision is also dependent on conditions that are somehow outside the system. For instance, what is “best” for an organisation should be mediated with what is “best” for its employees. Current work-list handlers show work items as a simple sorted list and therefore do not provide much decision support for choosing the right work item. Since the work-list handler is the dominant interface between the system and its users, it is worthwhile to provide an intuitive graphical interface that uses contextual information about work items and users to provide suggestions about prioritisation of work items. This paper uses the so-called map metaphor to visualise work items and resources (e.g., users) in a sophisticated manner. Moreover, based on distance notions, the work-list handler can suggest the next work item by considering different perspectives. For example, urgent work items of a type that suits the user may be highlighted. The underlying map and distance notions may be of a geographical nature (e.g., a map of a city or office building), but may also be based on process designs, organisational structures, social networks, due dates, calendars, etc. The framework proposed in this paper is generic and can be applied to any process-aware information system. Moreover, in order to show its practical feasibility, the paper discusses a full-fledged implementation developed in the context of the open-source workflow environment YAWL, together with two real examples stemming from two very different scenarios. The results of an initial usability evaluation of the implementation are also presented, which provide a first indication of the validity of the approach.

A framework for the education of the information professions in Australia.

In recent years there has been considerable discussion afforded to the challenges facing the future of library and information science (LIS) education in Australia. This paper outlines a twelve-month project funded by the Australian Learning and Teaching Council that was undertaken by eleven institutions representing university and vocational LIS education in Australia. The project established a Framework for the Education of the Information Professions in Australia that provides a set of strategic recommendations that will inform future directions of Australian LIS education. This national project represented a bold move within Australian LIS education, and provided a unique opportunity for LIS educators across Australia to collectively unite in order to ‘future-proof’ education for future generations of LIS professionals.

A risk simulation framework for information infrastructure protection

Information communication and technology (ICT) systems are almost ubiquitous in the modern world. It is hard to identify any industry, or for that matter any part of society, that is not in some way dependent on these systems and their continued secure operation. Therefore the security of information infrastructures, both on an organisational and societal level, is of critical importance. Information security risk assessment is an essential part of ensuring that these systems are appropriately protected and positioned to deal with a rapidly changing threat environment. The complexity of these systems and their inter-dependencies however, introduces a similar complexity to the information security risk assessment task. This complexity suggests that information security risk assessment cannot, optimally, be undertaken manually. Information security risk assessment for individual components of the information infrastructure can be aided by the use of a software tool, a type of simulation, which concentrates on modelling failure rather than normal operational simulation. Avoiding the modelling of the operational system will once again reduce the level of complexity of the assessment task. The use of such a tool provides the opportunity to reuse information in many different ways by developing a repository of relevant information to aid in both risk assessment and management and governance and compliance activities. Widespread use of such a tool allows the opportunity for the risk models developed for individual information infrastructure components to be connected in order to develop a model of information security exposures across the entire information infrastructure. In this thesis conceptual and practical aspects of risk and its underlying epistemology are analysed to produce a model suitable for application to information security risk assessment. Based on this work prototype software has been developed to explore these concepts for information security risk assessment. Initial work has been carried out to investigate the use of this software for information security compliance and governance activities. Finally, an initial concept for extending the use of this approach across an information infrastructure is presented.

Experiencing religious information literacy : informed learning in church communities

This paper reports an exploration of religious information literacy in terms of how people use information to learn in the context of church communities. The research approach of phenomenography was used to explore Uniting Church in Australia members' experience of using information to learn as participants in their church communities. Five ways of experiencing religious information literacy were identified, using information to learn about: growing faith, developing relationships, managing the church, serving church communities and reaching out beyond church communities. It is anticipated that such findings will be of interest to information professionals, including information literacy specialists, as well as leaders and members of church communities.

Approaches to learning information literacy : a phenomenographic study

This paper reports on an empirical study that explores the ways students approach learning to find and use information. Based on interviews with 15 education students in an Australian university, this study uses phenomenography as its methodological and theoretical basis. The study reveals that students use three main strategies for learning information literacy: 1) learning by doing; 2) learning by trial and error; and 3) learning by interacting with other people. Understanding the different ways that students approach learning information literacy will assist librarians and faculty to design and provide more effective information literacy education.

Project alliancing and information technology in building construction : the National Museum of Australia

The construction industry demands priority from all governments because it impacts economically and socially on all citizens. A number of recent studies have identified inefficiencies in the Australian construction industry by modelling the building process. A culture of reform supported by industry and government is now emerging in the industry – one in which alternate forms of project delivery are being trialed. The Australian Building and Construction Industry Action Agenda brought together industry and government to identify actions necessary to lift Australia’s innovative and knowledge creating capacity at the sector level. A central activity under this Action Agenda was dissemination of information relating to industry best practice initiatives in innovation, project delivery and the use of information technology. Government and industry identified project alliance contracting and more advanced information technology as means to increase efficiency in construction as part of a new innovative procurement environment.

Towards semantic search and inference in electronic medical records : an approach using concept-based information retrieval

Background This paper presents a novel approach to searching electronic medical records that is based on concept matching rather than keyword matching. Aim The concept-based approach is intended to overcome specific challenges we identified in searching medical records. Method Queries and documents were transformed from their term-based originals into medical concepts as defined by the SNOMED-CT ontology. Results Evaluation on a real-world collection of medical records showed our concept-based approach outperformed a keyword baseline by 25% in Mean Average Precision. Conclusion The concept-based approach provides a framework for further development of inference based search systems for dealing with medical data.