Design challenges for electronic medication administration record systems in residential aged care facilities: A formative evaluation

Introduction Electronic medication administration record (eMAR) systems are promoted as a potential intervention to enhance medication safety in residential aged care facilities (RACFs). The purpose of this study was to conduct an in-practice evaluation of an eMAR being piloted in one Australian RACF before its roll out, and to provide recommendations for system improvements. Methods A multidisciplinary team conducted direct observations of workflow (n=34 hours) in the RACF site and the community pharmacy. Semi-structured interviews (n=5) with RACF staff and the community pharmacist were conducted to investigate their views of the eMAR system. Data were analysed using a grounded theory approach to identify challenges associated with the design of the eMAR system. Results The current eMAR system does not offer an end-to-end solution for medication management. Many steps, including prescribing by doctors and communication with the community pharmacist, are still performed manually using paper charts and fax machines. Five major challenges associated with the design of eMAR system were identified: limited interactivity; inadequate flexibility; problems related to information layout and semantics; the lack of relevant decision support; and system maintenance issues.We suggest recommendations to improve the design of the eMAR system and to optimize existing workflows. Discussion Immediate value can be achieved by improving the system interactivity, reducing inconsistencies in data entry design and offering dedicated organisational support to minimise connectivity issues. Longer-term benefits can be achieved by adding decision support features and establishing system interoperability requirements with stakeholder groups (e.g. community pharmacies) prior to system roll out. In-practice evaluations of technologies like eMAR system have great value in identifying design weaknesses which inhibit optimal system use.

Location of concentrators in a computer communication network: a stochastic automation search method

The following problem is considered. Given the locations of the Central Processing Unit (ar;the terminals which have to communicate with it, to determine the number and locations of the concentrators and to assign the terminals to the concentrators in such a way that the total cost is minimized. There is alao a fixed cost associated with each concentrator. There is ail upper limit to the number of terminals which can be connected to a concentrator. The terminals can be connected directly to the CPU also In this paper it is assumed that the concentrators can bo located anywhere in the area A containing the CPU and the terminals. Then this becomes a multimodal optimization problem. In the proposed algorithm a stochastic automaton is used as a search device to locate the minimum of the multimodal cost function . The proposed algorithm involves the following. The area A containing the CPU and the terminals is divided into an arbitrary number of regions (say K). An approximate value for the number of concentrators is assumed (say m). The optimum number is determined by iteration later The m concentrators can be assigned to the K regions in (mk) ways (m > K) or (km) ways (K>m).(All possible assignments are feasible, i.e. a region can contain 0,1,…, to concentrators). Each possible assignment is assumed to represent a state of the stochastic variable structure automaton. To start with, all the states are assigned equal probabilities. At each stage of the search the automaton visits a state according to the current probability distribution. At each visit the automaton selects a 'point' inside that state with uniform probability. The cost associated with that point is calculated and the average cost of that state is updated. Then the probabilities of all the states are updated. The probabilities are taken to bo inversely proportional to the average cost of the states After a certain number of searches the search probabilities become stationary and the automaton visits a particular state again and again. Then the automaton is said to have converged to that state Then by conducting a local gradient search within that state the exact locations of the concentrators are determined This algorithm was applied to a set of test problems and the results were compared with those given by Cooper's (1964, 1967) EAC algorithm and on the average it was found that the proposed algorithm performs better.

Positional Consensus in Multi-Agent Systems using a Broadcast Control Mechanism

In this paper a strategy for controlling a group of agents to achieve positional consensus is presented. The proposed technique is based on the constraint that every agents must be given the same control input through a broadcast communication mechanism. Although the control command is computed using state information in a global framework, the control input is implemented by the agents in a local coordinate frame. We propose a novel linear programming formulation that is computationally less intensive than earlier proposed methods. Moreover, we introduce a random perturbation input in the control command that helps us to achieve perfect consensus even for a large number of agents, which was not possible with the existing strategy in the literature. Moreover, we extend the method to achieve positional consensus at a pre-specified location. The effectiveness of the approach is illustrated through simulation results.

Autonomous Line Scanning for SPC Telephone Switching Systems

An Autonomous Line Scanning Unit (ALSU) for completely autonomous detection of call originations in the SPC Telephone Switching System is described. Through its own memories, ALSU maintains an up-to-date record of subscribers' statuses, detects call originations, performs 'hit timing check' and informs the Switching System of the identity of calling subscribers. The ALSU needs minimum interaction with the Central Processor, resulting in increased call handling capacity

Trajectory sensitivity modification in optimal linear systems

A new procedure for reducing trajectory sensitivity for the optimal linear regulator is described. The design is achieved without increase in the order of optimization and without the feedback of trajectory sensitivity. The procedure is also used in the input signal design problem for linear system identification by interpreting it as increasing trajectory sensitivity with respect to parameters to be estimated.

Cochannel Interference in Partially Coherent Communication

Effects of cochannel interference and synchronization error of the carrier phase on the probability of error in binary communications are considered. Several bounds on the probability of error are proposed. The bounds are easy to compute and do not require complete statistical characterization of the errors. They turn out to be simple linear combinations of error probabilities with no cochannel interferences and no phase errors. Several illustrative examples are given which show that the bounds can be tight.

Low ML-Decoding Complexity, Large Coding Gain, Full-Rate, Full-Diversity STBCs for 2 x 2 and 4 x 2 MIMO Systems

This paper deals with low maximum-likelihood (ML)-decoding complexity, full-rate and full-diversity space-time block codes (STBCs), which also offer large coding gain, for the 2 transmit antenna, 2 receive antenna (2 x 2) and the 4 transmit antenna, 2 receive antenna (4 x 2) MIMO systems. Presently, the best known STBC for the 2 2 system is the Golden code and that for the 4 x 2 system is the DjABBA code. Following the approach by Biglieri, Hong, and Viterbo, a new STBC is presented in this paper for the 2 x 2 system. This code matches the Golden code in performance and ML-decoding complexity for square QAM constellations while it has lower ML-decoding complexity with the same performance for non-rectangular QAM constellations. This code is also shown to be information-lossless and diversity-multiplexing gain (DMG) tradeoff optimal. This design procedure is then extended to the 4 x 2 system and a code, which outperforms the DjABBA code for QAM constellations with lower ML-decoding complexity, is presented. So far, the Golden code has been reported to have an ML-decoding complexity of the order of for square QAM of size. In this paper, a scheme that reduces its ML-decoding complexity to M-2 root M is presented.

High-Rate Space-Time Coded Large-MIMO Systems: Low-Complexity Detection and Channel Estimation

In this paper, we present a low-complexity algorithm for detection in high-rate, non-orthogonal space-time block coded (STBC) large-multiple-input multiple-output (MIMO) systems that achieve high spectral efficiencies of the order of tens of bps/Hz. We also present a training-based iterative detection/channel estimation scheme for such large STBC MIMO systems. Our simulation results show that excellent bit error rate and nearness-to-capacity performance are achieved by the proposed multistage likelihood ascent search (M-LAS) detector in conjunction with the proposed iterative detection/channel estimation scheme at low complexities. The fact that we could show such good results for large STBCs like 16 X 16 and 32 X 32 STBCs from Cyclic Division Algebras (CDA) operating at spectral efficiencies in excess of 20 bps/Hz (even after accounting for the overheads meant for pilot based training for channel estimation and turbo coding) establishes the effectiveness of the proposed detector and channel estimator. We decode perfect codes of large dimensions using the proposed detector. With the feasibility of such a low-complexity detection/channel estimation scheme, large-MIMO systems with tens of antennas operating at several tens of bps/Hz spectral efficiencies can become practical, enabling interesting high data rate wireless applications.

A method of fraud & intrusion detection for e-payment systems in mobile

The need for paying with mobile devices has urged the development of payment systems for mobile electronic commerce. In this paper we have considered two important abuses in electronic payments systems for detection. The fraud, which is an intentional deception accomplished to secure an unfair gain, and an intrusion which are any set of actions that attempt to compromise the integrity, confidentiality or availability of a resource. Most of the available fraud and intrusion detection systems for e-payments are specific to the systems where they have been incorporated. This paper proposes a generic model called as Activity-Event-Symptoms(AES) model for detecting fraud and intrusion attacks which appears during payment process in the mobile commerce environment. The AES model is designed to identify the symptoms of fraud and intrusions by observing various events/transactions occurs during mobile commerce activity. The symptoms identification is followed by computing the suspicion factors for event attributes, and the certainty factor for a fraud and intrusion is generated using these suspicion factors. We have tested the proposed system by conducting various case studies, on the in-house established mobile commerce environment over wired and wire-less networks test bed.

Enhancing sensor network lifetime using interactive communication

We are concerned with maximizing the lifetime of a data-gathering wireless sensor network consisting of set of nodes directly communicating with a base-station. We model this scenario as the m-message interactive communication between multiple correlated informants (sensor nodes) and a recipient (base-station). With this framework, we show that m-message interactive communication can indeed enhance network lifetime. Both worst-case and average-case performances are considered.

Interactive Distributed Source Coding in Asymmetric Communication Scenarios

We provide a new unified framework, called "multiple correlated informants - single recipient" communication, to address the variations of the traditional Distributed Source Coding (DSC) problem. Different combinations of the assumptions about the communication scenarios and the objectives of communication result in different variations of the DSC problem. For each of these variations, the complexities of communication and computation of the optimal solution is determined by the combination of the underlying assumptions. In the proposed framework, we address the asymmetric, interactive, and lossless variant of the DSC problem, with various objectives of communication and provide optimal solutions for those. Also, we consider both, the worst-case and average-case scenarios.

On the Average Case Communication Complexity for Detection in Sensor Networks

The problem of sensor-network-based distributed intrusion detection in the presence of clutter is considered. It is argued that sensing is best regarded as a local phenomenon in that only sensors in the immediate vicinity of an intruder are triggered. In such a setting, lack of knowledge of intruder location gives rise to correlated sensor readings. A signal-space viewpoint is introduced in which the noise-free sensor readings associated to intruder and clutter appear as surfaces $\mathcal{S_I}$ and $\mathcal{S_C}$ and the problem reduces to one of determining in distributed fashion, whether the current noisy sensor reading is best classified as intruder or clutter. Two approaches to distributed detection are pursued. In the first, a decision surface separating $\mathcal{S_I}$ and $\mathcal{S_C}$ is identified using Neyman-Pearson criteria. Thereafter, the individual sensor nodes interactively exchange bits to determine whether the sensor readings are on one side or the other of the decision surface. Bounds on the number of bits needed to be exchanged are derived, based on communication complexity (CC) theory. A lower bound derived for the two-party average case CC of general functions is compared against the performance of a greedy algorithm. The average case CC of the relevant greater-than (GT) function is characterized within two bits. In the second approach, each sensor node broadcasts a single bit arising from appropriate two-level quantization of its own sensor reading, keeping in mind the fusion rule to be subsequently applied at a local fusion center. The optimality of a threshold test as a quantization rule is proved under simplifying assumptions. Finally, results from a QualNet simulation of the algorithms are presented that include intruder tracking using a naive polynomial-regression algorithm.

A systematic design of high-rate full-diversity space-frequency codes for MIMO-OFDM systems

This paper presents a systematic construction of high-rate and full-diversity space-frequency block codes for MIMO-OFDM systems. While all prior constructions offer only a maximum rate of one complex symbol per channel use, our construction yields rate equal to the number of transmit antennas and simultaneously achieves full-diversity. The proposed construction works for arbitrary number of transmit antennas and arbitrary channel power delay profile. A key step in this construction is the generalization of the stacked matrix code design criteria given by Bolcskei et.al., (IEEE WCNC 2000). Explicit equivalence of our generalized code design criteria with the Hadamard-product based criteria of W. Su et.al., (lEEE Trans. Sig. Proc. Nov 2003) is established and new high-rate codes are constructed using our criteria.

BER-optimized linear parallel interference cancellers for multicarrier DS-CDMA systems

In this paper, we consider the design and bit-error performance analysis of linear parallel interference cancellers (LPIC) for multicarrier (MC) direct-sequence code division multiple access (DS-CDMA) systems. We propose an LPIC scheme where we estimate and cancel the multiple access interference (MAT) based on the soft decision outputs on individual subcarriers, and the interference cancelled outputs on different subcarriers are combined to form the final decision statistic. We scale the MAI estimate on individual subcarriers by a weight before cancellation. In order to choose these weights optimally, we derive exact closed-form expressions for the bit-error rate (BER) at the output of different stages of the LPIC, which we minimize to obtain the optimum weights for the different stages. In addition, using an alternate approach involving the characteristic function of the decision variable, we derive BER expressions for the weighted LPIC scheme, matched filter (MF) detector, decorrelating detector, and minimum mean square error (MMSE) detector for the considered multicarrier DS-CDMA system. We show that the proposed BER-optimized weighted LPIC scheme performs better than the MF detector and the conventional LPIC scheme (where the weights are taken to be unity), and close to the decorrelating and MMSE detectors.