Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings:protocol for a systematic review of qualitative studies

Introduction: There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support. Methods and analysis: Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method. Ethics and dissemination: The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.

A methodology for formally modeling and analyzing software architecture of mobile agent systems

A methodology for formally modeling and analyzing software architecture of mobile agent systems provides a solid basis to develop high quality mobile agent systems, and the methodology is helpful to study other distributed and concurrent systems as well. However, it is a challenge to provide the methodology because of the agent mobility in mobile agent systems.^ The methodology was defined from two essential parts of software architecture: a formalism to define the architectural models and an analysis method to formally verify system properties. The formalism is two-layer Predicate/Transition (PrT) nets extended with dynamic channels, and the analysis method is a hierarchical approach to verify models on different levels. The two-layer modeling formalism smoothly transforms physical models of mobile agent systems into their architectural models. Dynamic channels facilitate the synchronous communication between nets, and they naturally capture the dynamic architecture configuration and agent mobility of mobile agent systems. Component properties are verified based on transformed individual components, system properties are checked in a simplified system model, and interaction properties are analyzed on models composing from involved nets. Based on the formalism and the analysis method, this researcher formally modeled and analyzed a software architecture of mobile agent systems, and designed an architectural model of a medical information processing system based on mobile agents. The model checking tool SPIN was used to verify system properties such as reachability, concurrency and safety of the medical information processing system. ^ From successful modeling and analyzing the software architecture of mobile agent systems, the conclusion is that PrT nets extended with channels are a powerful tool to model mobile agent systems, and the hierarchical analysis method provides a rigorous foundation for the modeling tool. The hierarchical analysis method not only reduces the complexity of the analysis, but also expands the application scope of model checking techniques. The results of formally modeling and analyzing the software architecture of the medical information processing system show that model checking is an effective and an efficient way to verify software architecture. Moreover, this system shows a high level of flexibility, efficiency and low cost of mobile agent technologies. ^

Carbon nanotube based systems for high energy efficient applications

In the current age of fast-depleting conventional energy sources, top priority is given to exploring non-conventional energy sources, designing highly efficient energy storage systems and converting existing machines/instruments/devices into energy-efficient ones. ‘Energy efficiency’ is one of the important challenges for today’s scientific and research community, worldwide. In line with this demand, the current research was focused on developing two highly energy-efficient devices – field emitters and Li-ion batteries, using beneficial properties of carbon nanotubes (CNT). Interface-engineered, directly grown CNTs were used as cathode in field emitters, while similar structure was applied as anode in Li-ion batteries. Interface engineering was found to offer minimum resistance to electron flow and strong bonding with the substrate. Both field emitters and Li-ion battery anodes were benefitted from these advantages, demonstrating high energy efficiency. Field emitter, developed during this research, could be characterized by low turn-on field, high emission current, very high field enhancement factor and extremely good stability during long-run. Further, application of 3-dimensional design to these field emitters resulted in achieving one of the highest emission current densities reported so far. The 3-D field emitter registered 27 times increase in current density, as compared to their 2-D counterparts. These achievements were further followed by adding new functionalities, transparency and flexibility, to field emitters, keeping in view of current demand for flexible displays. A CNT-graphene hybrid structure showed appreciable emission, along with very good transparency and flexibility. Li-ion battery anodes, prepared using the interface-engineered CNTs, have offered 140% increment in capacity, as compared to conventional graphite anodes. Further, it has shown very good rate capability and an exceptional ‘zero capacity degradation’ during long cycle operation. Enhanced safety and charge transfer mechanism of this novel anode structure could be explained from structural characterization. In an attempt to progress further, CNTs were coated with ultrathin alumina by atomic layer deposition technique. These alumina-coated CNT anodes offered much higher capacity and an exceptional rate capability, with very low capacity degradation in higher current densities. These highly energy efficient CNT based anodes are expected to enhance capacities of future Li-ion batteries.

Efficiency and power density improvement of grid-connected hybrid renewable energy systems utilizing high frequency-based power converters

High efficiency of power converters placed between renewable energy sources and the utility grid is required to maximize the utilization of these sources. Power quality is another aspect that requires large passive elements (inductors, capacitors) to be placed between these sources and the grid. The main objective is to develop higher-level high frequency-based power converter system (HFPCS) that optimizes the use of hybrid renewable power injected into the power grid. The HFPCS provides high efficiency, reduced size of passive components, higher levels of power density realization, lower harmonic distortion, higher reliability, and lower cost. The dynamic modeling for each part in this system is developed, simulated and tested. The steady-state performance of the grid-connected hybrid power system with battery storage is analyzed. Various types of simulations were performed and a number of algorithms were developed and tested to verify the effectiveness of the power conversion topologies. A modified hysteresis-control strategy for the rectifier and the battery charging/discharging system was developed and implemented. A voltage oriented control (VOC) scheme was developed to control the energy injected into the grid. The developed HFPCS was compared experimentally with other currently available power converters. The developed HFPCS was employed inside a microgrid system infrastructure, connecting it to the power grid to verify its power transfer capabilities and grid connectivity. Grid connectivity tests verified these power transfer capabilities of the developed converter in addition to its ability of serving the load in a shared manner. In order to investigate the performance of the developed system, an experimental setup for the HF-based hybrid generation system was constructed. We designed a board containing a digital signal processor chip on which the developed control system was embedded. The board was fabricated and experimentally tested. The system's high precision requirements were verified. Each component of the system was built and tested separately, and then the whole system was connected and tested. The simulation and experimental results confirm the effectiveness of the developed converter system for grid-connected hybrid renewable energy systems as well as for hybrid electric vehicles and other industrial applications.

Ethics, Value Systems And The Professionalization Of Hoteliers

In the discussion - Ethics, Value Systems And The Professionalization Of Hoteliers by K. Michael Haywood, Associate Professor, School of Hotel and Food Administration, University of Guelph, Haywood initially presents: “Hoteliers and executives in other service industries should realize that the foundation of success in their businesses is based upon personal and corporate value systems and steady commitment to excellence. The author illustrates how ethical issues and manager morality are linked to, and shaped by the values of executives and the organization, and how improved professionalism can only be achieved through the adoption of a value system that rewards contributions rather than the mere attainment of results.” The bottom line of this discussion is, how does the hotel industry reconcile its behavior with that of public perception? “The time has come for hoteliers to examine their own standards of ethics, value systems, and professionalism,” Haywood says. And it is ethics that are at the center of this issue; Haywood holds that component in an estimable position. “Hoteliers must become value-driven,” advises Haywood. “They must be committed to excellence both in actualizing their best potentialities and in excelling in all they do. In other words, the professionalization of the hotelier can be achieved through a high degree of self-control, internalized values, codes of ethics, and related socialization processes,” he expands. “Serious ethical issues exist for hoteliers as well as for many business people and professionals in positions of responsibility,” Haywood alludes in defining some inter-industry problems. “The acceptance of kickbacks and gifts from suppliers, the hiding of income from taxation authorities, the lack of interest in installing and maintaining proper safety and security systems, and the raiding of competitors' staffs are common practices,” he offers, with the reasoning that if these problems can occur within ranks, then there is going to be a negative backlash in the public/client arena as well. Haywood divides the key principles of his thesis statement - ethics, value systems, and professionalism – into specific elements, and then continues to broaden the scope of each element. Promotion, product/service, and pricing are additional key components in Haywood’s discussion, and he addresses each with verve and vitality. Haywood references the four character types - craftsmen, jungle fighters, company men, and gamesmen – via a citation to Michael Maccoby, in the portion of the discussion dedicated to morality and success. Haywood closes with a series of questions derived from Lawrence Miller's American Spirit, Visions of a New Corporate Culture, each question designed to focus, shape, and organize management's attention to the values that Miller sets forth in his piece.

Research-to-Practice (R2P) Tools for Improving Safety in Nighttime Highway Construction Work Zones

The safety of workers in nighttime roadway work zones has become a major concern for state transportation agencies due to the increase in the number of work zone fatalities. During the last decade, several studies have focused on the improvement of safety in nighttime roadway work zones; but the element that is still missing is a set of tools for translating the research results into practice. This paper discusses: 1) the importance of translating the research results related to the safety of workers and safety planning of nighttime work zones into practice, and 2) examples of tools that can be used for translating the results of such studies into practice. A tool that can propose safety recommendations in nighttime work zones and a web-based safety training tool for workers are presented in this paper. The tools were created as a component of a five-year research study on the assessment of the safety of nighttime roadway construction. The objectives of both tools are explained as well as their functionalities (i.e., what the tools can do for the users); their components (e.g., knowledge base, database, and interfaces); and their structures (i.e., how the components of the tools are organized to meet the objectives). Evaluations by the proposed users of each tool are also presented.

Extended Coverage for Public Safety and Critical Communications Using Multi-hop and D2D Communications

In this thesis, we proposed the use of device-to-device (D2D) communications for extending the coverage area of active base stations, for public safety communications with partial coverage. A 3GPP standard compliant D2D system level simulator is developed for HetNets and public safety scenarios and used to evaluate the performance of D2D discovery and communications underlying cellular networks. For D2D discovery, the benefits of time-domain inter-cell interference coordi- nation (ICIC) approaches by using almost blank subframes were evaluated. Also, the use of multi-hop is proposed to improve, even further, the performance of the D2D discovery process. Finally, the possibility of using multi-hop D2D communications for extending the coverage area of active base stations was evaluated. Improvements in energy and spectral efficiency, when compared with the case of direct UE-eNB communi- cations, were demonstrated. Moreover, UE power control techniques were applied to reduce the effects of interference from neighboring D2D links.

Availability estimation and management for complex processing systems

“Availability” is the terminology used in asset intensive industries such as petrochemical and hydrocarbons processing to describe the readiness of equipment, systems or plants to perform their designed functions. It is a measure to suggest a facility’s capability of meeting targeted production in a safe working environment. Availability is also vital as it encompasses reliability and maintainability, allowing engineers to manage and operate facilities by focusing on one performance indicator. These benefits make availability a very demanding and highly desired area of interest and research for both industry and academia. In this dissertation, new models, approaches and algorithms have been explored to estimate and manage the availability of complex hydrocarbon processing systems. The risk of equipment failure and its effect on availability is vital in the hydrocarbon industry, and is also explored in this research. The importance of availability encouraged companies to invest in this domain by putting efforts and resources to develop novel techniques for system availability enhancement. Most of the work in this area is focused on individual equipment compared to facility or system level availability assessment and management. This research is focused on developing an new systematic methods to estimate system availability. The main focus areas in this research are to address availability estimation and management through physical asset management, risk-based availability estimation strategies, availability and safety using a failure assessment framework, and availability enhancement using early equipment fault detection and maintenance scheduling optimization.

Commodification of health care systems: The Catalan case

Commodification of the public healthcare system has been a growing process in recent decades, especially in universal healthcare systems and in high-income countries like Spain.  There are substantial differences in the healthcare systems of each autonomous region of Spain, among which Catalonia is characterized by having a mixed healthcare system with complex partnerships and interactions between the public and private healthcare sectors.  Using a narrative review approach, this article addresses various aspects of the Catalan healthcare system, characterizing the privatization and commodification of health processes in Catalonia from a historical perspective with particular attention to recent legislative changes and austerity measures.  The article approximates, the eventual effects that commodification and austerity measures will have on the health of the population and on the structure, accessibility, effectiveness, equity and quality of healthcare services.

Field Testing and Development of Novel SHM systems at Queen’s University Belfast

Ageing and deterioration of infrastructure is a challenge facing transport authorities. In
particular, there is a need for increased bridge monitoring in order to provide adequate
maintenance and to guarantee acceptable levels of transport safety. The Intelligent
Infrastructure group at Queens University Belfast (QUB) are working on a number of aspects
of infrastructure monitoring and this paper presents summarised results from three distinct
monitoring projects carried out by this group. Firstly the findings from a project on next
generation Bridge Weight in Motion (B-WIM) are reported, this includes full scale field testing
using fibre optic strain sensors. Secondly, results from early phase testing of a computer
vision system for bridge deflection monitoring are reported on. This research seeks to exploit
recent advances in image processing technology with a view to developing contactless
bridge monitoring approaches. Considering the logistical difficulty of installing sensors on a
‘live’ bridge, contactless monitoring has some inherent advantages over conventional
contact based sensing systems. Finally the last section of the paper presents some recent
findings on drive by bridge monitoring. In practice a drive-by monitoring system will likely
require GPS to allow the response of a given bridge to be identified; this study looks at the
feasibility of using low-cost GPS sensors for this purpose, via field trials. The three topics
outlined above cover a spectrum of SHM approaches namely, wired monitoring, contactless
monitoring and drive by monitoring

Passivity Framework for Modeling, Composing and Mitigating Cyber Attacks

Thesis (Ph.D.)--University of Washington, 2016-08

A Mobile High Sensitivity On-field Organophosphorous Compounds Detecting System for IoT Based Food Safety Tracking

Food safety has always been a social issue that draws great public attention. With the rapid development of wireless communication technologies and intelligent devices, more and more Internet of Things (IoT) systems are applied in the food safety tracking field. However, connection between things and information system is usually established by pre-storing information of things into RFID Tag, which is inapplicable for on-field food safety detection. Therefore, considering pesticide residue is one of the severe threaten to food safety, a new portable, high-sensitivity, low-power, on-field organophosphorus (OP) compounds detection system is proposed in this thesis to realize the on-field food safety detection. The system is designed based on optical detection method by using a customized photo-detection sensor. A Micro Controller Unit (MCU) and a Bluetooth Low Energy (BLE) module are used to quantize and transmit detection result. An Android Application (APP) is also developed for the system to processing and display detection result as well as control the detection process. Besides, a quartzose sample container and black system box are also designed and made for the system demonstration. Several optimizations are made in wireless communication, circuit layout, Android APP and industrial design to realize the mobility, low power and intelligence.

Rational Function Interpolation of Electromagnetic Transfer Functions of High-Speed Interconnect Systems from Discrete Time-Domain and Frequency-Domain Data

We present new methodologies to generate rational function approximations of broadband electromagnetic responses of linear and passive networks of high-speed interconnects, and to construct SPICE-compatible, equivalent circuit representations of the generated rational functions. These new methodologies are driven by the desire to improve the computational efficiency of the rational function fitting process, and to ensure enhanced accuracy of the generated rational function interpolation and its equivalent circuit representation. Toward this goal, we propose two new methodologies for rational function approximation of high-speed interconnect network responses. The first one relies on the use of both time-domain and frequency-domain data, obtained either through measurement or numerical simulation, to generate a rational function representation that extrapolates the input, early-time transient response data to late-time response while at the same time providing a means to both interpolate and extrapolate the used frequency-domain data. The aforementioned hybrid methodology can be considered as a generalization of the frequency-domain rational function fitting utilizing frequency-domain response data only, and the time-domain rational function fitting utilizing transient response data only. In this context, a guideline is proposed for estimating the order of the rational function approximation from transient data. The availability of such an estimate expedites the time-domain rational function fitting process. The second approach relies on the extraction of the delay associated with causal electromagnetic responses of interconnect systems to provide for a more stable rational function process utilizing a lower-order rational function interpolation. A distinctive feature of the proposed methodology is its utilization of scattering parameters. For both methodologies, the approach of fitting the electromagnetic network matrix one element at a time is applied. It is shown that, with regard to the computational cost of the rational function fitting process, such an element-by-element rational function fitting is more advantageous than full matrix fitting for systems with a large number of ports. Despite the disadvantage that different sets of poles are used in the rational function of different elements in the network matrix, such an approach provides for improved accuracy in the fitting of network matrices of systems characterized by both strongly coupled and weakly coupled ports. Finally, in order to provide a means for enforcing passivity in the adopted element-by-element rational function fitting approach, the methodology for passivity enforcement via quadratic programming is modified appropriately for this purpose and demonstrated in the context of element-by-element rational function fitting of the admittance matrix of an electromagnetic multiport.

Iluminação em ambientes fabris: otimização e análise técnica-e-económica

Esta Dissertação aborda a temática da eficiência energética em sistemas de iluminação fabris. Desde os primórdios da história da humanidade que a iluminação tem representado um papel importante. Não só garante condições de segurança, como começou por ser o intuito primordial das fogueiras pré-históricas, traduzindo-se num elemento de conforto. Atualmente seria impensável conceber as mais diversas atividades económicas e produtivas de um país sem iluminação. Nesse sentido a iluminação representa também um elemento fomentador de produtividade. Não é bem conhecido o impacto que a iluminação tem nos custos operacionais de uma unidade fabril. Principalmente por ser difícil de quantificar separadamente na fatura de eletricidade qual a percentagem correspondente à iluminação. Tipicamente estes custos podem ascender a 20% do orçamento global da autarquia em países desenvolvidos. Por esse motivo, o sector da iluminação tem investido esforço no sentido de promover melhores soluções de iluminação capazes de por um lado de satisfazer os requisitos do espaço a iluminar, e por outro propiciar soluções eficientes do ponto de vista energético. Estas soluções assentam essencialmente no uso de dispositivos mais eficientes (como por exemplo os LED´s ou as lâmpadas compactas fluorescentes) bem como em estratégias de controlo eficientes baseadas em dados sensoriais (como por exemplo deteção de movimento/presença). A combinação destas estratégias permite reduzir os consumos em cerca de 80% quando comparadas com soluções passivas. A empresa Amorim Cork Research Lda. é uma empresa prestadora de serviços ao universo das empresas da Corticeira Amorim, uma das maiores multinacionais de origem portuguesa. Teve origem no negócio da cortiça, em 1870, sendo hoje líder destacada no sector a nível mundial. Dada a dimensão da empresa e a sua subdivisão em várias Unidades Industriais com requisitos individuais, será expectável que a iluminação represente uma parte significativa da fatura de eletricidade. Atualmente, os vários setores encontram-se equipados com soluções de iluminação diferentes, na sua maioria empregando tecnologias passivas, noutros casos com dispositivos eficientes. Há algum interesse em migrar para soluções mais eficientes, em parte suportadas em DALI (com interface de comunicação PLC ou Zigbee).

Capacity analysis in CDMA systems using GIS based planning tools

We show a simulation model for capacity analysis in mobile systems using a geographic information system (GIS) based tool, used for coverage calculations and frequency assignment, and MATLAB. The model was developed initially for “narrowband” CDMA and TDMA, but was modified for WCDMA. We show also some results for a specific case in “narrowband” CDMA