Investigation of decision making issues in the use of current clinical information systems

Clinical information systems have become important tools in contemporary clinical patient care. However, there is a question of whether the current clinical information systems are able to effectively support clinicians in decision making processes. We conducted a survey to identify some of the decision making issues related to the use of existing clinical information systems. The survey was conducted among the end users of the cardiac surgery unit, quality and safety unit, intensive care unit and clinical costing unit at The Prince Charles Hospital (TPCH). Based on the survey results and reviewed literature, it was identified that support from the current information systems for decision-making is limited. Also, survey results showed that the majority of respondents considered lack in data integration to be one of the major issues followed by other issues such as limited access to various databases, lack of time and lack in efficient reporting and analysis tools. Furthermore, respondents pointed out that data quality is an issue and the three major data quality issues being faced are lack of data completeness, lack in consistency and lack in data accuracy. Conclusion: Current clinical information systems support for the decision-making processes in Cardiac Surgery in this institution is limited and this could be addressed by integrating isolated clinical information systems.

Analyzing the factors influencing the successful design and uptake of interactive systems to support social networks in urban neighborhoods

In urban residential environments in Australia and other developed countries, Internet access is on the verge of becoming a ubiquitous utility like gas or electricity. From an urban sociology and community informatics perspective, this article discusses new emerging social formations of urban residents that are based on networked individualism and the potential of Internet-based systems to support them. It proposes that one of the main reasons for the disappearance or nonexistence of urban residential communities is a lack of appropriate opportunities and instruments to encourage and support local interaction in urban neighborhoods. The article challenges the view that a mere reappropriation of applications used to support dispersed virtual communities is adequate to meet the place and proximity-based design requirements that community networks in urban neighborhoods pose. It argues that the key factors influencing the successful design and uptake of interactive systems to support social networks in urban neighborhoods include the swarming social behavior of urban dwellers; the dynamics of their existing communicative ecology; and the serendipitous, voluntary, and place-based quality of interaction between residents on the basis of choice, like-mindedness, mutual interest and support needs. Drawing on an analysis of these factors, the conceptual design framework of a prototype system — the urban tribe incubator — is presented.

Student feedback systems in higher education: a focused literature review and environmental scan

In recent times, higher education institutions have paid increasing attention to the views of students to obtain feedback on their experience of learning and teaching through internal surveys. This article reviews research in the field and reports on practices in other Australian universities. Findings demonstrate that while student feedback is valued and used by all Australian universities, survey practices are idiosyncratic and in the majority of cases, questionnaires lack validity and reliability; data are used inadequately or inappropriately; and they offer limited potential for cross-sector benchmarking. The study confirms the need for institutions to develop an overarching framework for evaluation in which a valid, reliable, multidimensional and useful student feedback survey constitutes just one part. Given external expectations and internal requirements to collect feedback from students on their experience of learning and teaching, the pursuit of sound evaluation practices will continue to be of interest at local, national and international levels.

A dual-polarized microstrip antenna array with port decoupling for MIMO systems

Utilization of multiport-antennas represents an appropriate way for the mitigation of multi-path fading in wireless communication systems. However, to obtain low correlation between the signals from different antenna ports and to prevent gain reduction by cross-talk, large antenna elements spacing is expected. Polarization diversity allows signal separation even with small antenna spacing. Although it is effective, polarization diversity alone does not suffice once the number of antennas exceeds the number of orthogonal polarizations. This paper presents an approach which combines a novel array concept with the use of dual polarization. The theory is verified by a compact dual polarized patch antenna array, which consists of four elements and a decoupling network.

Human factors at the interface between road and rail systems

Railway level crossings present an arguably unique interface between two transport systems that differ markedly in their performance characteristics, their degrees of regulation and their safety cultures. Railway level crossings also differ dramatically in the importance they represent as safety issues for the two modes. For rail, they are the location of a large proportion of fatalities within the system and are therefore the focus of much safety concern. For the road system, they comprise only a few percent of all fatalities, although the potential for catastrophic outcomes exist. Rail operators and regulators have traditionally required technologies to be failsafe and to demonstrate high levels of reliability. The resultant level of complexity and cost has both limited their extent of application and led to a need to better understand how motorists comprehend and respond to these systems.

Does the use of store-and-forward telehealth systems improve outcomes for clinicians managing diabetic foot ulcers? : A pilot study

Diabetic foot ulcers are one of the most hospitalised diabetes complications and contribute to many leg amputations. Trained diabetic foot teams and specialists managing diabetic foot ulcers have demonstrated reductions in amputations and hospitalisation by up to 90%. Few such teams exist in Australia. Thus, access is limited for all geographical populations and may somewhat explain the high rates of hospitalisation. Aim: This pilot study aims to analyse if local clinicians managing diabetic foot complications report improved access to diabetic foot specialists and outcomes with the introduction of a telehealth store-and-forward system. Method: A store-and-forward telehealth system was implemented in six different Queensland locations between August 2009 and February 2010. Sites were offered ad hoc and/or fortnightly telehealth access to a diabetic foot speciality service. A survey was sent six months following commencement of the trial to the 14 eligible clinicians involved in the trial to gauge clinical perception of the telehealth system. Results: Eight participants returned the surveys. The majority of responding clinicians reported that the telehealth system was easy to use (100%), improved their access to diabetic foot speciality services (75%), improved upskilling of local diabetes service staff (100%), and improved patient outcomes (100%). Conclusion: This pilot study suggests that clinicians found the use of a telehealth store-and-forward system very useful in improving access to speciality services, clinical skills and patient outcomes. This study supports the recommendation that telehealth systems should be made available for diabetic foot ulcer management.

Performance assessment of exponential Rosenbrock method for large systems of ODE

This paper studies time integration methods for large stiff systems of ordinary differential equations (ODEs) of the form u'(t) = g(u(t)). For such problems, implicit methods generally outperform explicit methods, since the time step is usually less restricted by stability constraints. Recently, however, explicit so-called exponential integrators have become popular for stiff problems due to their favourable stability properties. These methods use matrix-vector products involving exponential-like functions of the Jacobian matrix, which can be approximated using Krylov subspace methods that require only matrix-vector products with the Jacobian. In this paper, we implement exponential integrators of second, third and fourth order and demonstrate that they are competitive with well-established approaches based on the backward differentiation formulas and a preconditioned Newton-Krylov solution strategy.

An integrated approach to enhance sustainability in industrialised building systems

Building prefabrication is known as Industrialised Building Systems (IBS) in Malaysia. This construction method possesses unique characteristics that are central to sustainable construction. For example, offsite construction enables efficient management of construction wastage by identifying major causes of waste arising during both the design and construction stages. These causes may then be eliminated by the improvement process in IBS component's manufacturing. However, current decisions on using IBS are typically financial driven and hinder the wider ranged adoption. In addition, current IBS misconceptions and the failure of rating schemes in evaluating the sustainability of IBS affect its implementation. A new approach is required to provide better understanding on the sustainability potential of IBS among stakeholders. Such approach should also help project the outcomes of each levels of decision-making to respond to social, economy and environmental challenges. This paper presents interim findings of research aimed at developing a framework for sustainable IBS development and suggests a more holistic approach to achieve sustainability. A framework of embedding sustainability factors is considered in three main phases of IBS construction; 1) Pre-construction, 2) Construction and 3) Post-construction phase. SWOT analysis was used to evaluate the strengths, weaknesses, opportunities and threats involved in the IBS implementations. The action plans are formulated from the analysis of sustainable objectives. This approach will show where and how sustainability should be integrated to improve IBS construction. A mix of quantitative and qualitative methodology was used in this research to explore the potential of IBS in integrating sustainability. The tools used in the study are questionnaires and semi-structured interviews. Outcomes from these tools lead to the identification of viable approaches involving 18 critical factors to improve sustainability in IBS constructions. Finally, guidelines for decision-making are being developed to provide a useful source of information and support to mutual benefit of the stakeholders in integrating sustainability issues and concepts into IBS applications.

Subcarrier pairing and relay assignment with improved user fairness in a multi-user cooperative OFDM system

We consider a joint relay selection and subcarrier allocation problem that minimizes the total system power for a multi-user, multi-relay and single source cooperative OFDM based two hop system. The system is constrained to all users having a specific subcarrier requirement (user fairness). However no specific fairness constraints for relays are considered. To ensure the optimum power allocation, the subcarriers in two hops are paired with each other. We obtain an optimal subcarrier allocation for the single user case using a similar method to what is described in [1] and modify the algorithm for multiuser scenario. Although the optimality is not achieved in multiuser case the probability of all users being served fairly is improved significantly with a relatively low cost trade off.

Solving tri-diagonal linear systems using field programmable gate arrays

In this paper, we present the outcomes of a project on the exploration of the use of Field Programmable Gate Arrays(FPGAs) as co-processors for scientific computation. We designed a custom circuit for the pipelined solving of multiple tri-diagonal linear systems. The design is well suited for applications that require many independent tri diagonal system solves, such as finite difference methods for solving PDEs or applications utilising cubic spline interpolation. The selected solver algorithm was the Tri Diagonal Matrix Algorithm (TDMA or Thomas Algorithm). Our solver supports user specified precision thought the use of a custom floating point VHDL library supporting addition, subtraction, multiplication and division. The variable precision TDMA solver was tested for correctness in simulation mode. The TDMA pipeline was tested successfully in hardware using a simplified solver model. The details of implementation, the limitations, and future work are also discussed.

Surveillance of dengue fever virus: a review of epidemiological models and early warning systems

Dengue fever is one of the world’s most important vector-borne diseases. The transmission area of this disease continues to expand due to many factors including urban sprawl, increased travel and global warming. Current preventative techniques are primarily based on controlling mosquito vectors as other prophylactic measures, such as a tetravalent vaccine are unlikely to be available in the foreseeable future. However, the continually increasing dengue incidence suggests that this strategy alone is not sufficient. Epidemiological models attempt to predict future outbreaks using information on the risk factors of the disease. Through a systematic literature review, this paper aims at analyzing the different modeling methods and their outputs in terms of accurately predicting disease outbreaks. We found that many previous studies have not sufficiently accounted for the spatio-temporal features of the disease in the modeling process. Yet with advances in technology, the ability to incorporate such information as well as the socio-environmental aspect allowed for its use as an early warning system, albeit limited geographically to a local scale.

Ergodic capacity of the slotted amplify and forward relay channel with finite relays

Abstract—In this paper we investigate the capacity of a general class of the slotted amplify and forward (SAF) relaying protocol where multiple, though a finite number of relays may transmit in a given cooperative slot and the relay terminals being half-duplex have a finite slot memory capacity. We derive an expression for the capacity per channel use of this generalized SAF channel assuming all source to relay, relay to destination and source to destination channel gains are independent and modeled as complex Gaussian. We show through the analysis of eigenvalue distributions that the increase in limiting capacity per channel use is marginal with the increase of relay terminals.

Cross layer optimization of VANET routing with multi-objective decision making

Vehicular Ad-hoc Networks (VANET) have different characteristics compared to other mobile ad-hoc networks. The dynamic nature of the vehicles which act as routers and clients are connected with unreliable radio links and Routing becomes a complex problem. First we propose CO-GPSR (Cooperative GPSR), an extension of the traditional GPSR (Greedy Perimeter Stateless Routing) which uses relay nodes which exploit radio path diversity in a vehicular network to increase routing performance. Next we formulate a Multi-objective decision making problem to select optimum packet relaying nodes to increase the routing performance further. We use cross layer information for the optimization process. We evaluate the routing performance more comprehensively using realistic vehicular traces and a Nakagami fading propagation model optimized for highway scenarios in VANETs. Our results show that when Multi-objective decision making is used for cross layer optimization of routing a 70% performance increment can be obtained for low vehicle densities on average, which is a two fold increase compared to the single criteria maximization approach.

Accountable-eHealth systems : the next step forward for privacy

EHealth systems promise enviable benefits and capabilities for healthcare. But, the technologies that make these capabilities possible brings with them undesirable drawback such as information security related threats which need to be appropriately addressed. Lurking in these threats are patient privacy concerns. Fulfilling these privacy concerns have proven to be difficult since they often conflict with information requirements of care providers. It is important to achieve a proper balance between these requirements. We believe that information accountability can achieve this balance. In this paper we introduce accountable-eHealth systems. We will discuss how our designed protocols can successfully address the aforementioned requirement. We will also compare characteristics of AeH systems with Australia’s PCEHR system and identify similarities and highlight the differences and the impact those differences would have to the eHealth domain.