Support tools for paediatric inpatient prescribers:a review

Prescribing support for paediatrics is diverse and includes both standard texts and electronic tools. Evidence concerning who should be supported and by what method is limited. This review aims to collate the current information available on prescribing support in paediatrics. Many tools designed to support prescribers are technology based. For example, electronic prescribing and smart phone applications. There is a focus on prescriber education both at undergraduate and postgraduate level. In the UK, the majority of inpatient prescribing is done by junior medical staff. It is important to ensure they are competent on qualification and supported in this role. A UK national prescribing assessment is being trialled to test for competence on graduation and there are also tools available to test paediatric prescribing after qualification. No information is available on the tools and resources UK prescribers currently use to support their decision making. One US study reported a decrease in the availability of paediatric prescribing information in a popular reference text. There is limited evidence to show that decisionsupport tools improve patient outcomes, however, there is growing confirmation that electronic prescribing reduces medication errors. There have been reports of new error types, such as selection errors, occurring with the use of electronic prescribing. Another concern with computerised decision-support systems is deciding what alerts should be presented to the prescriber and when/how often in order to avoid alert fatigue. There is little published concerning paediatric alerts perhaps as a consequence of commercial systems often not including paediatric specific support.

Probabilistic multiple model neural network based leak detection system:experimental study

This paper presents an effective decision making system for leak detection based on multiple generalized linear models and clustering techniques. The training data for the proposed decision system is obtained by setting up an experimental pipeline fully operational distribution system. The system is also equipped with data logging for three variables; namely, inlet pressure, outlet pressure, and outlet flow. The experimental setup is designed such that multi-operational conditions of the distribution system, including multi pressure and multi flow can be obtained. We then statistically tested and showed that pressure and flow variables can be used as signature of leak under the designed multi-operational conditions. It is then shown that the detection of leakages based on the training and testing of the proposed multi model decision system with pre data clustering, under multi operational conditions produces better recognition rates in comparison to the training based on the single model approach. This decision system is then equipped with the estimation of confidence limits and a method is proposed for using these confidence limits for obtaining more robust leakage recognition results.

Classification-Based Method of Linear Multicriteria Optimization

The paper describes a classification-based learning-oriented interactive method for solving linear multicriteria optimization problems. The method allows the decision makers describe their preferences with greater flexibility, accuracy and reliability. The method is realized in an experimental software system supporting the solution of multicriteria optimization problems.

Support for paediatric prescribers:what is discussed at hospital board level?

Prescribing support tools range from traditional printed texts to state-of-the-art computerised decision support systems. Comparison between available literature is difficult due to country-specific resources often being the focus of the research. In the UK, it is widely accepted that hospitals take their own individualised approaches to reducing prescribing errors. Objective - This study focused on specialist paediatric hospitals. It aimed to identify the localised approaches taken by paediatric hospitals to reduce prescribing errors. Method - Applied thematic analysis was used to explore the publically published board meeting minutes from the four specialist stand-alone paediatric hospitals in England. Three years of data was collected from each hospital. Codes were collected into groups to identify themes from the data. Results - The main themes identified were clinician involvement in prescribing support is important; credit card-sized reminder tools are used to provide prescribing guidance; electronic prescribing is considered important for reducing prescribing errors; feedback from clinical pharmacists on prescribing errors is widely used; junior doctors require extra support when prescribing; medical records may be incomplete and specific prescribing support (eg, antibiotic prescribing support) is widely in use. Conclusions - There is no single collaborative approach taken to paediatric prescribing support in English paediatric hospitals. Success of electronic prescribing in English paediatric hospitals is considerably behind leaders such as the USA. Use of clinical pharmacists to support prescribers is important as supported by previous studies in Spain and the USA.

An Open Virtual World for Professional Development

The paper presents a study that focuses on the issue of sup-porting educational experts to choose the right combination of educational methodology and technology tools when designing training and learning programs. It is based on research in the field of adaptive intelligent e-learning systems. The object of study is the professional growth of teachers in technology and in particular that part of their qualification which is achieved by organizing targeted training of teachers. The article presents the process of creating and testing a system to support the decision on the design of training for teachers, leading to more effective implementation of technology in education and integration in diverse educational contexts. ACM Computing Classification System (1998): H.4.2, I.2.1, I.2, I.2.4, F.4.1.

Mit mérünk és hogyan? – A vállalati teljesítménymérés szemléletmódja és eszköztára a döntéstámogatás tükrében = Performance measurement serving decision making – approach and practice of Hungarian firms

Tanulmányunkban a hazai vállalatok teljesítménymérési és teljesítménymenedzsment gyakorlatát vizsgáljuk a Versenyben a világgal kutatási program 2009. évi felmérése adatainak felhasználásával. Célunk a döntéstámogatás hátterének vizsgálata: a vállalatok teljesítménymérési gyakorlatának jellemzése, konzisztenciájának értékelése, vizsgálva a korábbi (1996, 1999 és 2004 évi hasonló) kutatásaink során megfigyelt tendenciák további alakulását is. A vállalati teljesítménymérés gyakorlatát, a vállalatvezetők által fontosnak/hasznosnak tartott, illetve rendszeresen használt információforrásokat, teljesítménymutatókat, elemzési eszközöket a korábbi kutatásainkhoz kialakított elemzési keret (orientáció, egyensúly, konzisztencia, támogató szerep) felhasználásával értékeltük. Az információs rendszer különböző tevékenységeket támogató szerepének az értékelése során a különböző területekért felelős vezetők véleményét is összevetettük, s különböző vállalati jellemzők (vállalatméret, tulajdonosok típusa, fő tevékenység stb.) sajátosságait is vizsgáltuk. ___________ The paper analyses the performance measurement and performance management practice of Hungarian companies, based on the data of the Competitiveness research program (2009). Our goal was to evaluate the practice from the point of view of decision support, based on our previous framework, evaluating the orientation, the balance, the consistency and the supporting role of the performance measurement practice.

Vezetői döntéshozatal és versenyképesség (The managerial decision making and the competitiveness)

A tanulmány a vezetői döntéshozatal három lényeges aspektusát tárja fel. A Versenyben a világgal c. kutatási program eredményei alapján arra lehet következtetni, hogy a menedzserek döntéshozatali képességei és megközelítései, a vállalati teljesítménymérés és menedzsment döntéseket támogató szerepe, valamint a vállalatok érintettekhez fűződő viszonya meghatározó lehet a hatékony vezetői döntéshozatal során. A vállalati döntéshozatal jellemzőinek bemutatása után megvizsgáljuk azt is, hogy a különböző teljesítményű cégek döntéseit mennyire támogatja a menedzserek felkészültsége, a teljesítménymérési gyakorlat és az érintettek elvárásai. A szerzők úgy találták, hogy a fenti tényezők mindegyike hozzájárul a hazai cégek versenyképességéhez, általánosságban ugyanis elmondható, hogy a döntéseket támogató vállalati környezet jobb üzleti teljesítményhez és gyorsabb reagálóképességhez vezethet. Az eredmények összegzése mellett ajánlásokkal is éltek a vállalatok számára, amelyek alkalmazásával hatékonyabb döntéseket hozhatnak. _______ This study presents three main aspects of the managerial decision making. Based on the results of the research program In competition with the World it points to the fact that decision making abilities and approaches of the managers, the corporate performance appraisal and the management decision support role, and the corporate relations to the stakeholders will be determinant in the process of the efficient managerial decision making. After presentation of characteristics of the corporate decision making the authors examine that how the decisions of enterprises with different performances are supported by the preparedness of the managers, the performance appraisal practice and the stakeholders expectations. The authors have thought that every factor contributes to the competitiveness of the domestic enterprises, and generally the decision supporting corporate environment can lead to better business performance and faster responsive abilities. Besides the results summary the authors give useful recommendations to the corporations with which they can make more efficient decisions.

Visszutas logisztika és termeléstervezés (Reverse logistics and production planning)

A dolgozat a visszutas logisztikát, az újrahasznosítást igyekszik beilleszteni a vállalati termeléstervezés keretei közé. A szükséglettervezési rendszerek (material requirements planning, MRP) célja a készletek és beszerzendő anyagok, alkatrészek időben ütemezett gyártásának és beszerzésének megtervezése. A klasszikus MRP rendszereket az utóbbi időben próbálja a tudomány az újrahasznosítással kibővíteni. Mivel ebben az esetben az új, és újrafelhasználható anyagokat külön kell nyilvántartani, ezért az MRP-táblák és készletek növekednek. A rendelési tételnagyságok meghatározása is nehezebb, összetettebb tételnagysághoz vezet. A dolgozatban egy visszutas logisztikai készletmodellt ismertetünk, valamint annak dinamikus kiterjesztését, amely alapja lehet az SAP-ba beépíthető rendelés állomány meghatározó heurisztikának. ____ The aim of the paper is to extend production planning with reverse logistics and reuse. Material requirements planning (MRP) systems plan and control invetory levels and purchasing activities of the firm. In the last decade scientists on this field try to involve reverse logistics activities in MRP systems. Size of MRP-tables is growing in this case because of the alternative use of newly purchased products and reusable old items. Determination of order quantities will be more complex with these two modes of material supplies. An EOQ-type reverse logistics model is presented in the paper with a dynamic lot size generalization. The generalized model can be seen as a basic model to build in production planning and control system like SAP.

Cultural influence and learning to teach: Beginning teachers' perceptions of teacher preparation programs and school support systems

Beginning teachers in the field of English Language Arts and Reading are responsible for providing literacy instruction to students. Teachers need a broad background in teaching reading, writing, listening, speaking, and viewing, as well as critical thinking. In secondary schools in particular, beginning English Language Arts and Reading teachers are also faced with the challenge of preparing students to be proficient enough readers and writers to meet required State standards. Beginning teachers must navigate compelling challenges that exist during the first years of teaching. The school support systems available to new teachers are an integral part of their educational development. ^ This qualitative study was conceptualized as an in-depth examination of the experiences and perceptions of eight beginning teachers. They represented different racial/ethnic groups, attended different teacher preparation programs, and taught in different school cultures. The data were collected through formal and informal interviews and classroom observations. A qualitative system of data analysis was used to examine the patterns relating to the interrelationship between teacher preparation programs and school support systems. ^ The experiences of the beginning teachers in this study indicated that teacher education programs should provide preservice teachers with a critical knowledge base for teaching literature, language, and composition. A liberal arts background in English, followed by an extensive program focusing on pedagogy, seems to provide a thorough level of curriculum and instructional practices needed for teaching in 21st century classrooms. The data further suggested that a school support system should pair beginning teachers with mentor teachers and provide a caring, professional environment that seeks to nurture the teacher as she/he develops during the first years of teaching. ^

Digital surveillance based on video CODEC System-on-a-Chip (SoC) platforms

Today, most conventional surveillance networks are based on analog system, which has a lot of constraints like manpower and high-bandwidth requirements. It becomes the barrier for today's surveillance network development. This dissertation describes a digital surveillance network architecture based on the H.264 coding/decoding (CODEC) System-on-a-Chip (SoC) platform. The proposed digital surveillance network architecture includes three major layers: software layer, hardware layer, and the network layer. The following outlines the contributions to the proposed digital surveillance network architecture. (1) We implement an object recognition system and an object categorization system on the software layer by applying several Digital Image Processing (DIP) algorithms. (2) For better compression ratio and higher video quality transfer, we implement two new modules on the hardware layer of the H.264 CODEC core, i.e., the background elimination module and the Directional Discrete Cosine Transform (DDCT) module. (3) Furthermore, we introduce a Digital Signal Processor (DSP) sub-system on the main bus of H.264 SoC platforms as the major hardware support system for our software architecture. Thus we combine the software and hardware platforms to be an intelligent surveillance node. Lab results show that the proposed surveillance node can dramatically save the network resources like bandwidth and storage capacity.

Time, Cost, and Environmental Impact Analysis for Sustainable Design at Multiple Building Levels

Construction projects are complex endeavors that require the involvement of different professional disciplines in order to meet various project objectives that are often conflicting. The level of complexity and the multi-objective nature of construction projects lend themselves to collaborative design and construction such as integrated project delivery (IPD), in which relevant disciplines work together during project conception, design and construction. Traditionally, the main objectives of construction projects have been to build in the least amount of time with the lowest cost possible, thus the inherent and well-established relationship between cost and time has been the focus of many studies. The importance of being able to effectively model relationships among multiple objectives in building construction has been emphasized in a wide range of research. In general, the trade-off relationship between time and cost is well understood and there is ample research on the subject. However, despite sustainable building designs, relationships between time and environmental impact, as well as cost and environmental impact, have not been fully investigated. The objectives of this research were mainly to analyze and identify relationships of time, cost, and environmental impact, in terms of CO2 emissions, at different levels of a building: material level, component level, and building level, at the pre-use phase, including manufacturing and construction, and the relationships of life cycle cost and life cycle CO2 emissions at the usage phase. Additionally, this research aimed to develop a robust simulation-based multi-objective decision-support tool, called SimulEICon, which took construction data uncertainty into account, and was capable of incorporating life cycle assessment information to the decision-making process. The findings of this research supported the trade-off relationship between time and cost at different building levels. Moreover, the time and CO2 emissions relationship presented trade-off behavior at the pre-use phase. The results of the relationship between cost and CO2 emissions were interestingly proportional at the pre-use phase. The same pattern continually presented after the construction to the usage phase. Understanding the relationships between those objectives is a key in successfully planning and designing environmentally sustainable construction projects.

Progettazione e Sviluppo di un Sistema di Proactive Alerting all'interno di una piattaforma di Big Data Analytics

Il lavoro presentato in questo elaborato tratterà lo sviluppo di un sistema di alerting che consenta di monitorare proattivamente una o più sorgenti dati aziendali, segnalando le eventuali condizioni di irregolarità rilevate; questo verrà incluso all'interno di sistemi già esistenti dedicati all'analisi dei dati e alla pianificazione, ovvero i cosiddetti Decision Support Systems. Un sistema di supporto alle decisioni è in grado di fornire chiare informazioni per tutta la gestione dell'impresa, misurandone le performance e fornendo proiezioni sugli andamenti futuri. Questi sistemi vengono catalogati all'interno del più ampio ambito della Business Intelligence, che sottintende l'insieme di metodologie in grado di trasformare i dati di business in informazioni utili al processo decisionale. L'intero lavoro di tesi è stato svolto durante un periodo di tirocinio svolto presso Iconsulting S.p.A., IT System Integrator bolognese specializzato principalmente nello sviluppo di progetti di Business Intelligence, Enterprise Data Warehouse e Corporate Performance Management. Il software che verrà illustrato in questo elaborato è stato realizzato per essere collocato all'interno di un contesto più ampio, per rispondere ai requisiti di un cliente multinazionale leader nel settore della telefonia mobile e fissa.

Decision aids for people considering taking part in clinical trials

Peer reviewed

The Relationship Between Support Systems and Disease Burden for Families Coping with Sickle Cell Disease in South Africa and Cameroon

Background: Sickle cell disease (SCD) is a debilitating genetic blood disorder that seriously impacts the quality of life of affected individuals and their families. With 85% of cases occurring in sub-Saharan Africa, it is essential to identify the barriers and facilitators of optimal outcomes for people with SCD in this setting. This study focuses on understanding the relationship between support systems and disease outcomes for SCD patients and their families in Cameroon and South Africa.

Methods: This mixed-methods study utilizes surveys and semi-structured interviews to assess the experiences of 29 SCD patients and 28 caregivers of people with SCD across three cities in two African countries: Cape Town, South Africa; Yaoundé, Cameroon; and Limbe, Cameroon.

Results: Patients in Cameroon had less treatment options, a higher frequency of pain crises, and a higher incidence of malaria than patients in South Africa. Social support networks in Cameroon consisted of both family and friends and provided emotional, financial, and physical assistance during pain crises and hospital admissions. In South Africa, patients relied on a strong medical support system and social support primarily from close family members; they were also diagnosed later in life than those in Cameroon.

Conclusions: The strength of medical support systems influences the reliance of SCD patients and their caregivers on social support systems. In Cameroon the health care system does not adequately address all factors of SCD treatment and social networks of family and friends are used to complement the care received. In South Africa, strong medical and social support systems positively affect SCD disease burden for patients and their caregivers. SCD awareness campaigns are necessary to reduce the incidence of SCD and create stronger social support networks through increased community understanding and decreased stigma.

Peer Support to Facilitate Knowledge Sharing on Complex Tasks

This thesis explores how to design a peer support system to facilitate self-organized knowledge sharing in non-formal learning environments, in particular when learners work on complex tasks. The peer support system aims to replace two teacher-led didactic arrangements: selecting a tutor at the initial stage, and guidance during the interaction process (Dillenbourg, 1999; Topping, 1996). Such a system has previously been developed by Van Rosmalen (2008) and De Bakker (2010) and has been tentatively used to facilitate knowledge sharing on content-related questions. In this thesis, we would like to find out how to further improve the design of this peer support system, especially to facilitate knowledge sharing on complex tasks. Since little pedagogical theory is available to inform the design of our peer support system, this thesis attempts to apply cognitive load theory (Sweller, Van Merriënboer, & Paas, 1998; Van Merriënboer & Sweller, 2005) that informs instructional designs in classroom settings to the design of our peer support system in Learning Networks.