Interaction and mediation in preadmission clinics : implications for the design of a telehealth stethoscope

A telehealth stethoscope would make it possible for doctors to perform physical examinations on patients at great distances. In order to develop a useful and usable telehealth stethoscope we have conducted fieldwork observations of existing anaesthetic preadmission clinics to understand how stethoscopes are currently used. Both face-to-face consultations and videoconference consultations have been studied. Our results indicate that the stethoscope plays a minor role in the consultation and that consultations are mediated by the administrative work that is the reason for the consultation. We suggest that a stethoscope plays an infrastructural role in the consultation. The implications of considering stethoscopes as infrastructure are explored and considered in the context of a future telehealth stethoscope.

Health law in Australia

Health Law in Australia is the first book to deal with health law on a comprehensive national basis. In a field of law that is becoming increasingly important and where the demand for expertise is rapidly expanding, Health Law in Australia takes a logical, structured approach to an examination of the law in all Australian jurisdictions. By covering all the major areas in this diverse field of law, Health Law in Australia enhances the understanding of the discipline as a whole. Beginning with an exploration of the general principles of health law, including chapters on “Medical Negligence”, “Children and Consent”, and “Confidentiality, Privacy, and Access to Health Records”, the book goes on to consider beginning-of-life and end-of-life issues before concluding with chapters on emerging areas in health law, such as biotechnology and medical research. The contributing authors include national leaders in the field who are specialists in these areas of health law and who can therefore reveal to readers the results of their research. Health Law in Australia has been written for those with a legal background and is essential reading for undergraduate law students, postgraduate law students, researchers and scholars in the disciplines of law, health and medicine, as well as legal practitioners, government departments and bodies in the health area, and private health providers.

Students as decoders of graphics in mathematics

This paper reports on students’ ability to decode mathematical graphics. The findings were: (a) some items showed an insignificant improvement over time; (b) success involves identifying critical perceptual elements in the graphic and incorporating these elements into a solution strategy; and (c) the optimal strategy capitalises on how information is encoded in the graphic. Implications include a need for teachers to be proactive in supporting students’ to develop their graphical knowledge and an awareness that knowledge varies substantially across students.

Legislative and security requirements of audit material for evidentiary purpose

This research used the Queensland Police Service, Australia, as a major case study. Information on principles, techniques and processes used, and the reason for the recording, storing and release of audit information for evidentiary purposes is reported. It is shown that Law Enforcement Agencies have a two-fold interest in, and legal obligation pertaining to, audit trails. The first interest relates to the situation where audit trails are actually used by criminals in the commission of crime and the second to where audit trails are generated by the information systems used by the police themselves in support of the recording and investigation of crime. Eleven court cases involving Queensland Police Service audit trails used in evidence in Queensland courts were selected for further analysis. It is shown that, of the cases studied, none of the evidence presented was rejected or seriously challenged from a technical perspective. These results were further analysed and related to normal requirements for trusted maintenance of audit trail information in sensitive environments with discussion on the ability and/or willingness of courts to fully challenge, assess or value audit evidence presented. Managerial and technical frameworks for firstly what is considered as an environment where a computer system may be considered to be operating “properly” and, secondly, what aspects of education, training, qualifications, expertise and the like may be considered as appropriate for persons responsible within that environment, are both proposed. Analysis was undertaken to determine if audit and control of information in a high security environment, such as law enforcement, could be judged as having improved, or not, in the transition from manual to electronic processes. Information collection, control of processing and audit in manual processes used by the Queensland Police Service, Australia, in the period 1940 to 1980 was assessed against current electronic systems essentially introduced to policing in the decades of the 1980s and 1990s. Results show that electronic systems do provide for faster communications with centrally controlled and updated information readily available for use by large numbers of users who are connected across significant geographical locations. However, it is clearly evident that the price paid for this is a lack of ability and/or reluctance to provide improved audit and control processes. To compare the information systems audit and control arrangements of the Queensland Police Service with other government departments or agencies, an Australia wide survey was conducted. Results of the survey were contrasted with the particular results of a survey, conducted by the Australian Commonwealth Privacy Commission four years previous, to this survey which showed that security in relation to the recording of activity against access to information held on Australian government computer systems has been poor and a cause for concern. However, within this four year period there is evidence to suggest that government organisations are increasingly more inclined to generate audit trails. An attack on the overall security of audit trails in computer operating systems was initiated to further investigate findings reported in relation to the government systems survey. The survey showed that information systems audit trails in Microsoft Corporation's “Windows” operating system environments are relied on quite heavily. An audit of the security for audit trails generated, stored and managed in the Microsoft “Windows 2000” operating system environment was undertaken and compared and contrasted with similar such audit trail schemes in the “UNIX” and “Linux” operating systems. Strength of passwords and exploitation of any security problems in access control were targeted using software tools that are freely available in the public domain. Results showed that such security for the “Windows 2000” system is seriously flawed and the integrity of audit trails stored within these environments cannot be relied upon. An attempt to produce a framework and set of guidelines for use by expert witnesses in the information technology (IT) profession is proposed. This is achieved by examining the current rules and guidelines related to the provision of expert evidence in a court environment, by analysing the rationale for the separation of distinct disciplines and corresponding bodies of knowledge used by the Medical Profession and Forensic Science and then by analysing the bodies of knowledge within the discipline of IT itself. It is demonstrated that the accepted processes and procedures relevant to expert witnessing in a court environment are transferable to the IT sector. However, unlike some discipline areas, this analysis has clearly identified two distinct aspects of the matter which appear particularly relevant to IT. These two areas are; expertise gained through the application of IT to information needs in a particular public or private enterprise; and expertise gained through accepted and verifiable education, training and experience in fundamental IT products and system.

Implications for the design of a digital stethoscope for anaesthetic preadmission consultations

Background This research addresses the development of a digital stethoscope for use with a telehealth communications network to allow doctors to examine patients remotely (a digital telehealth stethoscope). A telehealth stethoscope would allow remote auscultation of patients who do not live near a major hospital. Travelling from remote areas to major hospitals is expensive for patients and a telehealth stethoscope could result in significant cost savings. Using a stethoscope requires great skill. To design a telehealth stethoscope that meets doctors’ expectations, the use of existing stethoscopes in clinical contexts must be examined. Method Observations were conducted of 30 anaesthetic preadmission consultations. The observations were video- taped. Interaction between doctor, patient and non-human elements in the consultation were “coded” to transform the video into data. The data were analysed to reveal essential aspects of the interactions. Results The analysis has shown that the doctor controls the interaction during auscultation. The conduct of auscultation draws heavily on the doctor’s tacit knowledge, allowing the doctor to treat the acoustic stethoscope as infrastructure – that is, the stethoscope sinks into the background and becomes completely transparent in use. Conclusion Two important, and related, implications for the design of a telehealth stethoscope have arisen from this research. First, as a telehealth stethoscope will be a shared device, doctors will not be able to make use of their existing expertise in using their own stethoscopes. Very simply, a telehealth stethoscope will sound different to a doctor’s own stethoscope. Second, the collaborative interaction required to use a telehealth stethoscope will have to be invented and refined. A telehealth stethoscope will need to be carefully designed to address these issues and result in successful use. This research challenges the concept of a telehealth stethoscope by raising questions about the ease and confidence with which doctors could use such a device.

The role of the audit committee and institutional investors in constraining earnings management : evidence from Chinese firms listed in Hong Kong

Using data from 2004 to 2008, we find that an audit committee is an important monitoring mechanism as audit committee independence, expertise and size are associated with reduced levels of abnormal accruals, our measure of earnings management. This study also attempts to discern when the monitoring role of the audit committee is more salient for the firm. We find that ownership concentration and the presence of government officials on the audit committee are important determinants of the negative association between audit committee characteristics and earnings management. In contrast, we find no significant associations between the audit committee and abnormal accruals for Chinese firms listed only on the Chinese domestic Stock Exchanges. The paper contributes to the corporate governance literature in a transitional economy. Identifying the role of audit committees of firms listed on markets other than the domicile market demonstrates the importance of considering the institutional setting in governance research.

Invention and business performance in the tissue-engineering industry

Tissue engineering is a young and interdisciplinary scientific discipline but it offers exciting opportunities to improve the quality of health care for hundreds of thousands of patients. Lured by its potential, several start-up companies, pharmaceutical corporations, and medical device enterprises alike are investing heavily in this sector. Invention is a key driver of competition in this sector. In this study, we aim to explain the variation in inventive output across the different firms in the sector. Our major premise is that firms that forge alliances will be able to tap into the expertise of their partners and thus improve their chances of inventive output. We further argue that alliances that enable technology acquisition or learning will enhance the inventive output of firms more than other kinds of alliances. We measure the inventive output of a company by the number of patents filed. On the basis of a preliminary analysis of seven companies, we find support for the hypotheses. We also argue that, to achieve commercial success, firms need to manage time to market (through alliances or otherwise), have a global outlook, nurture their financial resources, and attain critical mass through mergers.

Governors highway safety associations and transportation planning: Exploratory factor analysis and structural equation modeling

The Intermodal Surface Transportation Efficiency Act (ISTEA) of 1991 mandated the consideration of safety in the regional transportation planning process. As part of National Cooperative Highway Research Program Project 8-44, "Incorporating Safety into the Transportation Planning Process," we conducted a telephone survey to assess safety-related activities and expertise at Governors Highway Safety Associations (GHSAs), and GHSA relationships with metropolitan planning organizations (MPOs) and state departments of transportation (DOTs). The survey results were combined with statewide crash data to enable exploratory modeling of the relationship between GHSA policies and programs and statewide safety. The modeling objective was to illuminate current hurdles to ISTEA implementation, so that appropriate institutional, analytical, and personnel improvements can be made. The study revealed that coordination of transportation safety across DOTs, MPOs, GHSAs, and departments of public safety is generally beneficial to the implementation of safety. In addition, better coordination is characterized by more positive and constructive attitudes toward incorporating safety into planning.

Paediatric spinal deformity research at the Mater Children's Hospital, Brisbane, Australia.

The Paediatric Spine Research group was formed in 2002 to perform high quality research into the prevention and management of spinal deformity, with an emphasis on scoliosis. The group has successfully built collaborative bridges between the scientific and research expertise at QUT, and the clinical skills and experience of the spinal orthopaedic surgeons at the Mater Children’s Hospital in Brisbane. Clinical and biomechanical research is now possible as a result of the development of detailed databases of patients who have innovative and unique surgical interventions for spinal deformity such as thoracoscopic scoliosis correction, thoracoscopic staple insertion for juvenile idiopathic scoliosis and minimally invasive growing rods. The Mater in Brisbane provides these unique datasets of spinal deformity surgery patients, whose procedures are not being performed anywhere else in the Southern Hemisphere. The most detailed is a database of thoracoscopic scoliosis correction surgery which now contains 180 patients with electronic collections of X-Rays, photographs and patient questionnaires. With ethics approval, a subset of these patients has had CT scans, and a further subset have had MRI scans with and without a compressive load to simulate the erect standing position. This database has to date contributed to 17 international refereed journal papers, a further 7 journal papers either under review or in final preparation, 53 national conference presentations and 35 international conference presentations. Major findings from selected journal publications will be presented. It is anticipated that as the surgical databases grow they will continue to provide invaluable clinical data which will feed into clinically relevant projects driven by both medical and engineering researchers whose findings will benefit spinal deformity patients and scientific knowledge worldwide.

Access to meaningful relationships through virtual instruments and ensembles

This workshop focuses upon research about the qualities of community in music and of music in community facilitated by technologically supported relationships. Generative media systems present an opportunity for users to leverage computational systems to form new relationships through interactive and collaborative experiences. Generative music and art are a relatively new phenomenon that use procedural invention as a creative technique to produce music and visual media. Early systems have demonstrated the potential to provide access to collaborative ensemble experiences for users with little formal musical or artistic expertise. This workshop examines the relational affordances of these systems evidenced by selected field data drawn from the Network Jamming Project. These generative performance systems enable access to unique ensembles with very little musical knowledge or skill and offer the possibility of interactive relationships with artists and musical knowledge through collaborative performance. In this workshop we will focus on data that highlights how these simulated experiences might lead to understandings that may be of social benefit. Conference participants will be invited to jam in real time using virtual interfaces and to evaluate purposively selected video artifacts that demonstrate different kinds of interactive relationship with artists, peers, and community and that enrich the sense of expressive self. Theoretical insights about meaningful engagement drawn from the longitudinal and cross cultural experiences will underpin the discussion and practical presentation.

Green roofs : understanding their benefits for Australia

Summary of Actions Towards Sustainable Outcomes Environmental Issues / Principal Impacts The increased growth of cities is intensifying its impact on people and the environment through: • increased use of energy for the heating and cooling of more buildings, leading to urban heat islands and more greenhouse gas emissions • increased amount of hard surfaces contributing to higher temperatures in cities and more stormwater runoff • degraded air quality and noise impact • reduced urban biodiversity • compromised health and general well-being of people Basic Strategies In many design situations boundaries and constraints limit the application of cutting EDGe actions. In these circumstances designers should at least consider the following: • Consider green roofs early in the design process in consultation with all stakeholders to enable maximised integration with building systems and to mitigate building cost (avoid constructing as a retrofit). • Design of the green roof as part of a building’s structural, mechanical and hydraulic systems could lead to structural efficiency, the ability to optimise cooling benefits and better integrated water recycling systems. • Inform the selection of the type of green roof by considering its function, for example designing for social activity, required maintenance/access regime, recycling of water or habitat regeneration or a combination of uses. • Evaluate existing surroundings to determine possible links to the natural environment and choice of vegetation for the green roof with availability of local plant supply and expertise. Cutting EDGe Strategies • Create green roofs to contribute positively to the environment through reduced urban heat island effect and building temperatures, to improved stormwater quality, increased natural habitats, provision of social spaces and opportunity for increased local food supply. • Maximise solar panel efficiency by incorporating with design of green roof. • Integrate multiple functions for a single green roof such as grey water recycling, food production, more bio-diverse plantings, air quality improvement and provision of delightful spaces for social interaction. Synergies & references • BEDP Environment Design Guide DES 53: Roof and Facade Gardens GEN 4: Positive Development – designing for Net Positive Impacts TEC 26: Living Walls - a way to green the built environment • Green Roofs Australia: www.greenroofs.wordpress.com • International Green Roof Association: www.igra-world.com • Green Roofs for Healthy Cities (USA): www.greenroofs.org • Centre for Urban Greenery and Ecology (Singapore): http://research.cuge.com.sg

Celebrity entrepreneurship and celebrity endorsement : similarities, differences and the effect of deeper engagement

Increasingly, celebrities appear not only as endorsers for products but are apparently engaged in entrepreneurial roles as initiators, owners and perhaps even managers in the ventures that market the products they promote. Despite being extensively referred to in popular media, scholars have been slow to recognise the importance of this new phenomenon. This thesis argues theoretically and shows empirically that celebrity entrepreneurs are more effective communicators than typical celebrity endorsers because of their increased engagement with ventures. I theorise that greater engagement increases the celebrity‘s emotional involvement as perceived by consumers. This is an endorser quality thus far neglected in the marketing communications literature. In turn, emotional involvement, much like the empirically established dimensions trustworthiness, expertise and attractiveness, should affect traditional outcome variables such as attitude towards the advertisement and brand. On the downside, increases in celebrity engagement may lead to relatively stronger and worsening changes in attitudes towards the brand if and when negative information about the celebrity is revealed. A series of eight experiments was conducted on 781 Swedish and Baltic students and 151 Swedish retirees. Though there were nuanced differences and additional complexities in each experiment, participants‘ reactions to advertisements containing a celebrity portrayed as a typical endorser or entrepreneur were recorded. The overall results of these experiments suggest that emotional involvement can be successfully operationalised as distinct from variables previously known to influence communication effectiveness. In addition, emotional involvement has positive effects on attitudes toward the advertisement and brand that are as strong as the predictors traditionally applied in the marketing communications literature. Moreover, the celebrity entrepreneur condition in the experimental manipulation consistently led to an increase in emotional involvement and to a lesser extent trustworthiness, but not expertise and attractiveness. Finally, negative celebrity information led to a change in participants‘ attitudes towards the brand which were more strongly negative for celebrity entrepreneurs than celebrity endorsers. In addition, the effect of negative celebrity information on a company‘s brand is worse when they support the celebrity rather than fire them. However, this effect did not appear to interact with the celebrity‘s purported engagement.

Australian landscape architecture in China

Urbanisation of the Chinese landscape continues at a great pace. Landscape architecture is only a newly recognized profession here, in contemporary practice terms at least, but our expertise is in great demand. However only some Australian companies and a few Australian expats have managed to overcome the complexities of working in the Chinese context. It is worthwhile knowing how some of these individuals reflect on working in China and what they consider to be our strongest areas of expertise here.

Entertainment industries at university : designing a curriculum

Universities have not traditionally trained students to work as producers in the entertainment industries. This key entertainment role involves balancing creativity, business and legal skills in order to generate and run entertainment projects. Queensland University of Technology has recently introduced a program to train students for these jobs. The program is interdisciplinary, drawing on expertise from the Creative Industries, Law and Business faculties. This Scholarship of Teaching and Learning (SOTL) article details the course learning outcomes developed from extensive industry and academic consultation, and addresses some of the difficulties involved in developing such an interdisciplinary teaching program.

Peer-to-Patent Australia: First Anniversary Report, December 2010

Peer-to-Patent Australia will initially run as a 12 month pilot project designed to test whether an open community of reviewers can effectively locate prior art that might not otherwise be located by the patent office during a typical examination. Patent applications will be made available for peer review for a period of 6 months and there will follow a 6 month period of joint qualitative and quantitative assessment of the pilot project by IP Australia and QUT. The objective of Peer-to-Patent Australia is to improve the patent examination process and the quality of issued patents by utilising the knowledge and skills of experts in the broader community. It is a way of linking the scientific and technical expertise of anyone with an Internet connection with the expertise of a patent examiner. That community participation consists of members of the public reviewing patent applications and contributing relevant prior art references and comments within a web-based forum. The aim is to bring to light prior art, particularly non-patent prior art, that might otherwise not be identified by patent examiners. The better the prior art resources a patent examiner has at his or her disposal, the more likely a patent application will be assessed properly in terms of novelty and inventive step. The role of Peer-to-Patent Australia in this regard is to act as both a facilitator of discussion and a collector of prior art submissions. Peer-to-Patent Australia collects relevant prior art references on behalf of the reviewing community and forwards that prior art to IP Australia. Section 27 of the Patents Act 1990 (Cth) allows for the Commissioner of Patents to receive submissions of prior art by third parties relevant to the novelty and inventiveness of a particular patent application.