A secure framework and related protocols for ubiquitous access to electronic health records using Java sim cards

Ubiquitous access to patient medical records is an important aspect of caring for patient safety. Unavailability of sufficient medical information at the point-ofcare could possibly lead to a fatality. The U.S. Institute of Medicine has reported that between 44,000 and 98,000 people die each year due to medical errors, such as incorrect medication dosages, due to poor legibility in manual records, or delays in consolidating needed information to discern the proper intervention. In this research we propose employing emergent technologies such as Java SIM Cards (JSC), Smart Phones (SP), Next Generation Networks (NGN), Near Field Communications (NFC), Public Key Infrastructure (PKI), and Biometric Identification to develop a secure framework and related protocols for ubiquitous access to Electronic Health Records (EHR). A partial EHR contained within a JSC can be used at the point-of-care in order to help quick diagnosis of a patient’s problems. The full EHR can be accessed from an Electronic Health Records Centre (EHRC) when time and network availability permit. Moreover, this framework and related protocols enable patients to give their explicit consent to a doctor to access their personal medical data, by using their Smart Phone, when the doctor needs to see or update the patient’s medical information during an examination. Also our proposed solution would give the power to patients to modify the Access Control List (ACL) related to their EHRs and view their EHRs through their Smart Phone. Currently, very limited research has been done on using JSCs and similar technologies as a portable repository of EHRs or on the specific security issues that are likely to arise when JSCs are used with ubiquitous access to EHRs. Previous research is concerned with using Medicare cards, a kind of Smart Card, as a repository of medical information at the patient point-of-care. However, this imposes some limitations on the patient’s emergency medical care, including the inability to detect the patient’s location, to call and send information to an emergency room automatically, and to interact with the patient in order to get consent. The aim of our framework and related protocols is to overcome these limitations by taking advantage of the SIM card and the technologies mentioned above. Briefly, our framework and related protocols will offer the full benefits of accessing an up-to-date, precise, and comprehensive medical history of a patient, whilst its mobility will provide ubiquitous access to medical and patient information everywhere it is needed. The objective of our framework and related protocols is to automate interactions between patients, healthcare providers and insurance organisations, increase patient safety, improve quality of care, and reduce the costs.

Identification of acoustic emission wave modes for accurate source location in plate-like structures

Acoustic emission (AE) technique is a popular tool used for structural health monitoring of civil, mechanical and aerospace structures. It is a non-destructive method based on rapid release of energy within a material by crack initiation or growth in the form of stress waves. Recording of these waves by means of sensors and subsequent analysis of the recorded signals convey information about the nature of the source. Ability to locate the source of stress waves is an important advantage of AE technique; but as AE waves travel in various modes and may undergo mode conversions, understanding of the modes (‘modal analysis’) is often necessary in order to determine source location accurately. This paper presents results of experiments aimed at finding locations of artificial AE sources on a thin plate and identifying wave modes in the recorded signal waveforms. Different source locating techniques will be investigated and importance of wave mode identification will be explored.

Implementing an emergency department patient admission predictive tool : insights from practice

Purpose: This paper aims to show that identification of expectations and software functional requirements via consultation with potential users is an integral component of the development of an emergency department patient admissions prediction tool. ---------- Design/methodology/approach: Thematic analysis of semi-structured interviews with 14 key health staff delivered rich data regarding existing practice and future needs. Participants included emergency department staff, bed managers, nurse unit managers, directors of nursing, and personnel from health administration. ---------- Findings: Participants contributed contextual insights on the current system of admissions, revealing a culture of crisis, imbued with misplayed communication. Their expectations and requirements of a potential predictive tool provided strategic data that moderated the development of the Emergency Department Patient Admissions Prediction Tool, based on their insistence that it feature availability, reliability and relevance. In order to deliver these stipulations, participants stressed that it should be incorporated, validated, defined and timely. ---------- Research limitations/implications: Participants were envisaging a concept and use of a tool that was somewhat hypothetical. However, further research will evaluate the tool in practice. ---------- Practical implications: Participants' unsolicited recommendations regarding implementation will not only inform a subsequent phase of the tool evaluation, but are eminently applicable to any process of implementation in a healthcare setting. ---------- Originality/value: The consultative process engaged clinicians and the paper delivers an insider view of an overburdened system, rather than an outsider's observations.

Grassland management activity data : current sources and future needs

Estimates of potential and actual C sequestration require areal information about various types of management activities. Forest surveys, land use data, and agricultural statistics contribute information enabling calculation of the impacts of current and historical land management on C sequestration in biomass (in forests) or in soil (in agricultural systems). Unfortunately little information exists on the distribution of various management activities that can impact soil C content in grassland systems. Limited information of this type restricts our ability to carry out bottom-up estimates of the current C balance of grasslands or to assess the potential for grasslands to act as C sinks with changes in management. Here we review currently available information about grassland management, how that information could be related to information about the impacts of management on soil C stocks, information that may be available in the future, and needs that remain to be filled before in-depth assessments may be carried out. We also evaluate constraints induced by variability in information sources within and between countries. It is readily apparent that activity data for grassland management is collected less frequently and on a coarser scale than data for forest or agricultural inventories and that grassland activity data cannot be directly translated into IPCC-type factors as is done for IPCC inventories of agricultural soils. However, those management data that are available can serve to delineate broad-scale differences in management activities within regions in which soil C is likely to change in response to changes in management. This, coupled with the distinct possibility of more intensive surveys planned in the future, may enable more accurate assessments of grassland C dynamics with higher resolution both spatially and in the number management activities.

Identification and control of induction machines using artificial neural networks

The use of artificial neural networks (ANNs) to identify and control induction machines is proposed. Two systems are presented: a system to adaptively control the stator currents via identification of the electrical dynamics, and a system to adaptively control the rotor speed via identification of the mechanical and current-fed system dynamics. Both systems are inherently adaptive as well as self-commissioning. The current controller is a completely general nonlinear controller which can be used together with any drive algorithm. Various advantages of these control schemes over conventional schemes are cited, and the combined speed and current control scheme is compared with the standard vector control scheme

Identification and control of induction machines using artificial neural networks

This paper proposes the use of artificial neural networks (ANNs) to identify and control an induction machine. Two systems are presented: a system to adaptively control the stator currents via identification of the electrical dynamics; and a system to adaptively control the rotor speed via identification of the mechanical and current-fed system dynamics. Various advantages of these control schemes over other conventional schemes are cited and the performance of the combined speed and current control scheme is compared with that of the standard vector control scheme

Elements of public asset management framework for local governments in developing countries

There is a widespread recognition to the need of better manage municipal property in most cities in the world. Structural problems across regional, state, and territorial governments that have legal powers to own and maintain real property are similar, regardless of the level of development of each country. Start from a very basic level of property inventory records. The need for better manage to the local government owned property is the result of widespread decentralisation initiatives that often have devolved huge property portfolios from central to local governments almost “overnight”. At the same time municipal or regional governments were and continue to be unprepared to deal with multiple issues related to the role of property owners and managers. The lack of discussion of public asset management especially the elements that should be incorporated in the framework creates an important challenge to study the discipline of public asset management further. The aim of this paper is to study the practices of public asset management in developed countries, especially the elements of public asset management framework, and its transferability to developing countries. A case study was selected and conducted to achieve this aim. They involved interviews and a focus group. The study found that in public asset management framework, proper asset identification, public asset needs analysis, asset life cycle and performance measurements are an important element that should be incorporated in the framework. Those elements are transferable and applicable to developing countries’ local governments. Finally, findings from this study provide useful input for the local government policy makers, scholars and asset management practitioners to establish a public asset management framework toward more efficient and effective local governments in managing their assets as well as increasing public services quality.

Experimental evaluation of hotspot identification methods

Identifying crash “hotspots”, “blackspots”, “sites with promise”, or “high risk” locations is standard practice in departments of transportation throughout the US. The literature is replete with the development and discussion of statistical methods for hotspot identification (HSID). Theoretical derivations and empirical studies have been used to weigh the benefits of various HSID methods; however, a small number of studies have used controlled experiments to systematically assess various methods. Using experimentally derived simulated data—which are argued to be superior to empirical data, three hot spot identification methods observed in practice are evaluated: simple ranking, confidence interval, and Empirical Bayes. Using simulated data, sites with promise are known a priori, in contrast to empirical data where high risk sites are not known for certain. To conduct the evaluation, properties of observed crash data are used to generate simulated crash frequency distributions at hypothetical sites. A variety of factors is manipulated to simulate a host of ‘real world’ conditions. Various levels of confidence are explored, and false positives (identifying a safe site as high risk) and false negatives (identifying a high risk site as safe) are compared across methods. Finally, the effects of crash history duration in the three HSID approaches are assessed. The results illustrate that the Empirical Bayes technique significantly outperforms ranking and confidence interval techniques (with certain caveats). As found by others, false positives and negatives are inversely related. Three years of crash history appears, in general, to provide an appropriate crash history duration.

Socioeconomic inequality profiles in physical and developmental health from 0-7 years : Australian National Study

Background: Early and persistent exposure to socioeconomic disadvantage impairs children’s health and wellbeing. However, it is unclear at what age health inequalities emerge or whether these relationships vary across ages and outcomes. We address these issues using cross-sectional Australian population data on the physical and developmental health of children at ages 0-1, 2-3, 4-5 and 6-7 years. Methods: 10 physical and developmental health outcomes were assessed in 2004 and 2006 for two cohorts each comprising around 5000 children. Socioeconomic position was measured as a composite of parental education, occupation and household income. Results: Lower socioeconomic position was associated with increased odds for poor outcomes. For physical health outcomes and socio-emotional competence, associations were similar across age groups and were consistent with either threshold effects (for poor general health, special healthcare needs and socio-emotional competence) or gradient effects (for illness with wheeze, sleep problems and injury). For socio-emotional difficulties, communication, vocabulary and emergent literacy, stronger socioeconomic associations were observed. The patterns were linear or accelerated and varied across ages. Conclusions: From very early childhood, social disadvantage was associated with poorer outcomes across most measures of physical and developmental health and showed no evidence of either strengthening or attenuating at older compared to younger ages. Findings confirm the importance of early childhood as a key focus for health promotion and prevention efforts.

Stakeholder engagement by governance networks

As the problems involving infrastructure delivery have become more complex and contentious, there has been an acknowledgement that these problems cannot be resolved by any one body working alone. This understanding has driven multi-sectoral collaboration and has led to an expansion of the set of actors, including stakeholders, who are now involved in delivery of infrastructure projects and services. However, more needs to be understood about how to include stakeholders in these processes and ways of developing the requisite combination of stakeholders to achieve effective outcomes. This thesis draws on stakeholder theory and governance network theory to obtain insights into how three multi-level networks within the Roads Alliance in Queensland engage with stakeholders in the delivery of complex and sensitive infrastructure services and projects. New knowledge about stakeholders will be obtained by testing a model of Stakeholder Salience and Engagement which combines and extends the stakeholder identification and salience theory, ladder of stakeholder management and engagement and the model of stakeholder engagement and moral treatment of stakeholders. By applying this model, the broad research question: “Who or what decides how stakeholders are engaged by governance networks delivering public outcomes?” will be addressed. The case studies will test a theoretical model of stakeholder salience and engagement which links strategic decisions about stakeholder salience with the quality and quantity of engagement strategies for engaging different types of stakeholders. A multiple embedded case study design has been selected as the overall approach to explore, describe, explain and evaluate how stakeholder engagement occurs in three governance networks delivering road infrastructure in Queensland. The research design also incorporates a four stage approach to data collection: observations, stakeholder analysis, telephone survey questionnaire and semi-structured interviews. The outcomes of this research will contribute to and extend stakeholder theory by showing how stakeholder salience impacts on decisions about the types of engagement processes implemented. Governance network theory will be extended by showing how governance networks interact with stakeholders through the concepts of stakeholder salience and engagement. From a practical perspective this research will provide governance networks with an indication of how to optimise engagement with different types of stakeholders. 2

Nonprofit organizational and work unit identification and the occupational stress process

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

Planning for sustainable urban futures : an ecological approach to sustainable urban development

In recent years, cities have shown increasing signs of environmental problems due to the negative impacts of urban activities. The degradation and depletion of natural resources, climate change, and development pressure on green areas have become major concerns for cities. In response to these problems, urban planning policies have shifted to a sustainable focus and authorities have begun to develop new strategies for improving the quality of urban ecosystems. An extremely important function of an urban ecosystem is to provide healthy and sustainable environments for both natural systems and communities. Therefore, ecological planning is a functional requirement in the establishment of sustainable built environment. With ecological planning, human needs are supplied while natural resources are used in the most effective and sustainable manner and ecological balance is sustained. Protecting human and environmental health, having healthy ecosystems, reducing environmental pollution and providing green spaces are just a few of the many benefits of ecological planning. In this context, this chapter briefly presents a short overview of the importance of the implementation of ecological planning into sustainable urban development. Furthermore, it presents a conceptual framework for a new methodology for developing sustainable urban ecosystems through ecological planning approach.

Fusing curricula : science, technology and ICT

Curriculum demands continue to increase on school education systems with teachers at the forefront of implementing syllabus requirements. Education is reported frequently as a solution to most societal problems and, as a result of the world’s information explosion, teachers are expected to cover more and more within teaching programs. How can teachers combine subjects in order to capitalise on the competing educational agendas within school timeframes? Fusing curricula requires the bonding of standards from two or more syllabuses. Both technology and ICT complement the learning of science. This study analyses selected examples of preservice teachers’ overviews for fusing science, technology and ICT. These program overviews focused on primary students and the achievement of two standards (one from science and one from either technology or ICT). These primary preservice teachers’ fused-curricula overviews included scientific concepts and related technology and/or ICT skills and knowledge. Findings indicated a range of innovative curriculum plans for teaching primary science through technology and ICT, demonstrating that these subjects can form cohesive links towards achieving the respective learning standards. Teachers can work more astutely by fusing curricula; however further professional development may be required to advance thinking about these processes. Bonding subjects through their learning standards can extend beyond previous integration or thematic work where standards may not have been assessed. Education systems need to articulate through syllabus documents how effective fusing of curricula can be achieved. It appears that education is a key avenue for addressing societal needs, problems and issues. Education is promoted as a universal solution, which has resulted in curriculum overload (Dare, Durand, Moeller, & Washington, 1997; Vinson, 2001). Societal and curriculum demands have placed added pressure on teachers with many extenuating education issues increasing teachers’ workloads (Mobilise for Public Education, 2002). For example, as Australia has weather conducive for outdoor activities, social problems and issues arise that are reported through the media calling for action; consequently schools have been involved in swimming programs, road and bicycle safety programs, and a wide range of activities that had been considered a parental responsibility in the past. Teachers are expected to plan, implement and assess these extra-curricula activities within their already overcrowded timetables. At the same stage, key learning areas (KLAs) such as science and technology are mandatory requirements within all Australian education systems. These systems have syllabuses outlining levels of content and the anticipated learning outcomes (also known as standards, essential learnings, and frameworks). Time allocated for teaching science in obviously an issue. In 2001, it was estimated that on average the time spent in teaching science in Australian Primary Schools was almost an hour per week (Goodrum, Hackling, & Rennie, 2001). More recently, a study undertaken in the U.S. reported a similar finding. More than 80% of the teachers in K-5 classrooms spent less than an hour teaching science (Dorph, Goldstein, Lee, et al., 2007). More importantly, 16% did not spend teaching science in their classrooms. Teachers need to learn to work smarter by optimising the use of their in-class time. Integration is proposed as one of the ways to address the issue of curriculum overload (Venville & Dawson, 2005; Vogler, 2003). Even though there may be a lack of definition for integration (Hurley, 2001), curriculum integration aims at covering key concepts in two or more subject areas within the same lesson (Buxton & Whatley, 2002). This implies covering the curriculum in less time than if the subjects were taught separately; therefore teachers should have more time to cover other educational issues. Expectedly, the reality can be decidedly different (e.g., Brophy & Alleman, 1991; Venville & Dawson, 2005). Nevertheless, teachers report that students expand their knowledge and skills as a result of subject integration (James, Lamb, Householder, & Bailey, 2000). There seems to be considerable value for integrating science with other KLAs besides aiming to address teaching workloads. Over two decades ago, Cohen and Staley (1982) claimed that integration can bring a subject into the primary curriculum that may be otherwise left out. Integrating science education aims to develop a more holistic perspective. Indeed, life is not neat components of stand-alone subjects; life integrates subject content in numerous ways, and curriculum integration can assist students to make these real-life connections (Burnett & Wichman, 1997). Science integration can provide the scope for real-life learning and the possibility of targeting students’ learning styles more effectively by providing more than one perspective (Hudson & Hudson, 2001). To illustrate, technology is essential to science education (Blueford & Rosenbloom, 2003; Board of Studies, 1999; Penick, 2002), and constructing technology immediately evokes a social purpose for such construction (Marker, 1992). For example, building a model windmill requires science and technology (Zubrowski, 2002) but has a key focus on sustainability and the social sciences. Science has the potential to be integrated with all KLAs (e.g., Cohen & Staley, 1982; Dobbs, 1995; James et al., 2000). Yet, “integration” appears to be a confusing term. Integration has an educational meaning focused on special education students being assimilated into mainstream classrooms. The word integration was used in the late seventies and generally focused around thematic approaches for teaching. For instance, a science theme about flight only has to have a student drawing a picture of plane to show integration; it did not connect the anticipated outcomes from science and art. The term “fusing curricula” presents a seamless bonding between two subjects; hence standards (or outcomes) need to be linked from both subjects. This also goes beyond just embedding one subject within another. Embedding implies that one subject is dominant, while fusing curricula proposes an equal mix of learning within both subject areas. Primary education in Queensland has eight KLAs, each with its established content and each with a proposed structure for levels of learning. Primary teachers attempt to cover these syllabus requirements across the eight KLAs in less than five hours a day, and between many of the extra-curricula activities occurring throughout a school year (e.g., Easter activities, Education Week, concerts, excursions, performances). In Australia, education systems have developed standards for all KLAs (e.g., Education Queensland, NSW Department of Education and Training, Victorian Education) usually designated by a code. In the late 1990’s (in Queensland), “core learning outcomes” for strands across all KLA’s. For example, LL2.1 for the Queensland Education science syllabus means Life and Living at Level 2 standard number 1. Thus, a teacher’s planning requires the inclusion of standards as indicated by the presiding syllabus. More recently, the core learning outcomes were replaced by “essential learnings”. They specify “what students should be taught and what is important for students to have opportunities to know, understand and be able to do” (Queensland Studies Authority, 2009, para. 1). Fusing science education with other KLAs may facilitate more efficient use of time and resources; however this type of planning needs to combine standards from two syllabuses. To further assist in facilitating sound pedagogical practices, there are models proposed for learning science, technology and other KLAs such as Bloom’s Taxonomy (Bloom, 1956), Productive Pedagogies (Education Queensland, 2004), de Bono’s Six Hats (de Bono, 1985), and Gardner’s Multiple Intelligences (Gardner, 1999) that imply, warrant, or necessitate fused curricula. Bybee’s 5 Es, for example, has five levels of learning (engage, explore, explain, elaborate, and evaluate; Bybee, 1997) can have the potential for fusing science and ICT standards.

Facilitating needs based cancer care for people with a chronic disease : evaluation of an intervention using a multi-centre interrupted time series design

Background: Palliative care should be provided according to the individual needs of the patient, caregiver and family, so that the type and level of care provided, as well as the setting in which it is delivered, are dependent on the complexity and severity of individual needs, rather than prognosis or diagnosis. This paper presents a study designed to assess the feasibility and efficacy of an intervention to assist in the allocation of palliative care resources according to need, within the context of a population of people with advanced cancer. ---------- Methods/design: People with advanced cancer and their caregivers completed bi-monthly telephone interviews over a period of up to 18 months to assess unmet needs, anxiety and depression, quality of life, satisfaction with care and service utilisation. The intervention, introduced after at least two baseline phone interviews, involved a) training medical, nursing and allied health professionals at each recruitment site on the use of the Palliative Care Needs Assessment Guidelines and the Needs Assessment Tool: Progressive Disease - Cancer (NAT: PD-C); b) health professionals completing the NAT: PD-C with participating patients approximately monthly for the rest of the study period. Changes in outcomes will be compared pre-and post-intervention.---------- Discussion: The study will determine whether the routine, systematic and regular use of the Guidelines and NAT: PD-C in a range of clinical settings is a feasible and effective strategy for facilitating the timely provision of needs based care.