Impact of a data warehouse model for improved decision-making process in healthcare

The health system is one sector dealing with a deluge of complex data. Many healthcare organisations struggle to utilise these volumes of health data effectively and efficiently. Also, there are many healthcare organisations, which still have stand-alone systems, not integrated for management of information and decision-making. This shows, there is a need for an effective system to capture, collate and distribute this health data. Therefore, implementing the data warehouse concept in healthcare is potentially one of the solutions to integrate health data. Data warehousing has been used to support business intelligence and decision-making in many other sectors such as the engineering, defence and retail sectors. The research problem that is going to be addressed is, "how can data warehousing assist the decision-making process in healthcare". To address this problem the researcher has narrowed an investigation focusing on a cardiac surgery unit. This research used the cardiac surgery unit at the Prince Charles Hospital (TPCH) as the case study. The cardiac surgery unit at TPCH uses a stand-alone database of patient clinical data, which supports clinical audit, service management and research functions. However, much of the time, the interaction between the cardiac surgery unit information system with other units is minimal. There is a limited and basic two-way interaction with other clinical and administrative databases at TPCH which support decision-making processes. The aims of this research are to investigate what decision-making issues are faced by the healthcare professionals with the current information systems and how decision-making might be improved within this healthcare setting by implementing an aligned data warehouse model or models. As a part of the research the researcher will propose and develop a suitable data warehouse prototype based on the cardiac surgery unit needs and integrating the Intensive Care Unit database, Clinical Costing unit database (Transition II) and Quality and Safety unit database [electronic discharge summary (e-DS)]. The goal is to improve the current decision-making processes. The main objectives of this research are to improve access to integrated clinical and financial data, providing potentially better information for decision-making for both improved from the questionnaire and by referring to the literature, the results indicate a centralised data warehouse model for the cardiac surgery unit at this stage. A centralised data warehouse model addresses current needs and can also be upgraded to an enterprise wide warehouse model or federated data warehouse model as discussed in the many consulted publications. The data warehouse prototype was able to be developed using SAS enterprise data integration studio 4.2 and the data was analysed using SAS enterprise edition 4.3. In the final stage, the data warehouse prototype was evaluated by collecting feedback from the end users. This was achieved by using output created from the data warehouse prototype as examples of the data desired and possible in a data warehouse environment. According to the feedback collected from the end users, implementation of a data warehouse was seen to be a useful tool to inform management options, provide a more complete representation of factors related to a decision scenario and potentially reduce information product development time. However, there are many constraints exist in this research. For example the technical issues such as data incompatibilities, integration of the cardiac surgery database and e-DS database servers and also, Queensland Health information restrictions (Queensland Health information related policies, patient data confidentiality and ethics requirements), limited availability of support from IT technical staff and time restrictions. These factors have influenced the process for the warehouse model development, necessitating an incremental approach. This highlights the presence of many practical barriers to data warehousing and integration at the clinical service level. Limitations included the use of a small convenience sample of survey respondents, and a single site case report study design. As mentioned previously, the proposed data warehouse is a prototype and was developed using only four database repositories. Despite this constraint, the research demonstrates that by implementing a data warehouse at the service level, decision-making is supported and data quality issues related to access and availability can be reduced, providing many benefits. Output reports produced from the data warehouse prototype demonstrated usefulness for the improvement of decision-making in the management of clinical services, and quality and safety monitoring for better clinical care. However, in the future, the centralised model selected can be upgraded to an enterprise wide architecture by integrating with additional hospital units’ databases.

A people-to-people recommendation system using Tensor Space Models

Existing recommendation systems often recommend products to users by capturing the item-to-item and user-to-user similarity measures. These types of recommendation systems become inefficient in people-to-people networks for people to people recommendation that require two way relationship. Also, existing recommendation methods use traditional two dimensional models to find inter relationships between alike users and items. It is not efficient enough to model the people-to-people network with two-dimensional models as the latent correlations between the people and their attributes are not utilized. In this paper, we propose a novel tensor decomposition-based recommendation method for recommending people-to-people based on users profiles and their interactions. The people-to-people network data is multi-dimensional data which when modeled using vector based methods tend to result in information loss as they capture either the interactions or the attributes of the users but not both the information. This paper utilizes tensor models that have the ability to correlate and find latent relationships between similar users based on both information, user interactions and user attributes, in order to generate recommendations. Empirical analysis is conducted on a real-life online dating dataset. As demonstrated in results, the use of tensor modeling and decomposition has enabled the identification of latent correlations between people based on their attributes and interactions in the network and quality recommendations have been derived using the 'alike' users concept.

Perceptions of data quality dimensions and data roles

Several authors stress the importance of data’s crucial foundation for operational, tactical and strategic decisions (e.g., Redman 1998, Tee et al. 2007). Data provides the basis for decision making as data collection and processing is typically associated with reducing uncertainty in order to make more effective decisions (Daft and Lengel 1986). While the first series of investments of Information Systems/Information Technology (IS/IT) into organizations improved data collection, restricted computational capacity and limited processing power created challenges (Simon 1960). Fifty years on, capacity and processing problems are increasingly less relevant; in fact, the opposite exists. Determining data relevance and usefulness is complicated by increased data capture and storage capacity, as well as continual improvements in information processing capability. As the IT landscape changes, businesses are inundated with ever-increasing volumes of data from both internal and external sources available on both an ad-hoc and real-time basis. More data, however, does not necessarily translate into more effective and efficient organizations, nor does it increase the likelihood of better or timelier decisions. This raises questions about what data managers require to assist their decision making processes.

Interactive axial shortening of columns and walls in high rise buildings

Concrete is commonly used as a primary construction material for tall building construction. Load bearing components such as columns and walls in concrete buildings are subjected to instantaneous and long term axial shortening caused by the time dependent effects of "shrinkage", "creep" and "elastic" deformations. Reinforcing steel content, variable concrete modulus, volume to surface area ratio of the elements and environmental conditions govern axial shortening. The impact of differential axial shortening among columns and core shear walls escalate with increasing building height. Differential axial shortening of gravity loaded elements in geometrically complex and irregular buildings result in permanent distortion and deflection of the structural frame which have a significant impact on building envelopes, building services, secondary systems and the life time serviceability and performance of a building. Existing numerical methods commonly used in design to quantify axial shortening are mainly based on elastic analytical techniques and therefore unable to capture the complexity of non-linear time dependent effect. Ambient measurements of axial shortening using vibrating wire, external mechanical strain, and electronic strain gauges are methods that are available to verify pre-estimated values from the design stage. Installing these gauges permanently embedded in or on the surface of concrete components for continuous measurements during and after construction with adequate protection is uneconomical, inconvenient and unreliable. Therefore such methods are rarely if ever used in actual practice of building construction. This research project has developed a rigorous numerical procedure that encompasses linear and non-linear time dependent phenomena for prediction of axial shortening of reinforced concrete structural components at design stage. This procedure takes into consideration (i) construction sequence, (ii) time varying values of Young's Modulus of reinforced concrete and (iii) creep and shrinkage models that account for variability resulting from environmental effects. The capabilities of the procedure are illustrated through examples. In order to update previous predictions of axial shortening during the construction and service stages of the building, this research has also developed a vibration based procedure using ambient measurements. This procedure takes into consideration the changes in vibration characteristic of structure during and after construction. The application of this procedure is illustrated through numerical examples which also highlight the features. The vibration based procedure can also be used as a tool to assess structural health/performance of key structural components in the building during construction and service life.

Editorial : Decolonising action research (Electronic Version)

This edition of the ALAR Action learning action research journal aims to capture some of the current dilemmas, solutions and actions researchers experience in the decolonising space. This collection of papers demonstrates that researchers are not only undertaking action research with and within Indigenous and non-Indigenous contexts, but that they are doing so in exciting and dynamic ways across a diversity of situations. First we will address some of the literature on decolonisation. Then we will explain how this specific edition of the Journal came to fruition and aspects of action research.

For blood, sweat and tears : the severing of subconscious connections with company and business model

Humans have altered environments and enhanced their well being unlike any other creature on the planet (Heilman & Donna, 2007); this is no different whether the environment is ecological, social or organisational. In recent times business modelling techniques have become intricately detailed in the pre-designing and evaluating of business flow before the final implementation (Ou-Yang & Lin, 2008). The importance of the organisation change and business process model is undeniable. The feedback received from real business process users is that the notation is easy to learn; the models do help people to understand the process better; the models can be used to improve the (business) process; and the notation is expressive enough to capture the essential information (Bennett, Doshi, Do Vale Junior, Kumar, Manikam, & Madavan, 2009).

Editorial : Decolonising action research

This edition of the ALAR Action learning action research journal aims to capture some of the current dilemmas, solutions and actions researchers experience in the decolonising space. This collection of papers demonstrates that researchers are not only undertaking action research with and within Indigenous and non-Indigenous contexts, but that they are doing so in exciting and dynamic ways across a diversity of situations. First we will address some of the literature on decolonisation. Then we will explain how this specific edition of the Journal came to fruition and aspects of action research. This is a condensed version of the Editorial that appears in the electronic version of the Journal.

Power relations and small and medium-sized enterprise strategies for capturing value in global production networks: visual effects (VFX) service firm in the Hollywood film industry

Power relations and small and medium-sized enterprise strategies for capturing value in global production networks: visual effects (VFX) service firms in the Hollywood film industry, Regional Studies. This paper provides insights into the way in which non-lead firms manoeuvre in global value chains in the pursuit of a larger share of revenue and how power relations affect these manoeuvres. It examines the nature of value capture and power relations in the global supply of visual effects (VFX) services and the range of strategies VFX firms adopt to capture higher value in the global value chain. The analysis is based on a total of thirty-six interviews with informants in the industry in Australia, the United Kingdom and Canada, and a database of VFX credits for 3323 visual products for 640 VFX firms.

Graph rigidity for near-coplanar structure from motion

Recent algorithms for monocular motion capture (MoCap) estimate weak-perspective camera matrices between images using a small subset of approximately-rigid points on the human body (i.e. the torso and hip). A problem with this approach, however, is that these points are often close to coplanar, causing canonical linear factorisation algorithms for rigid structure from motion (SFM) to become extremely sensitive to noise. In this paper, we propose an alternative solution to weak-perspective SFM based on a convex relaxation of graph rigidity. We demonstrate the success of our algorithm on both synthetic and real world data, allowing for much improved solutions to marker less MoCap problems on human bodies. Finally, we propose an approach to solve the two-fold ambiguity over bone direction using a k-nearest neighbour kernel density estimator.

Expressive interactions : tablet usability for young mobile learners

In this paper we examine the usability of tablets for students in middle school in the context of mobile environmental education. Our study focuses on the expressive qualities of three input methods – text, audio and drawing – and the extent to which these methods support on-task behaviour. In our study 28 small groups of children were given iPads and asked to record ecological observations from around their schoolyard. The effectiveness of the devices and their core utility for expressive, on-task data capture is assessed.

Peer state assessment of TxDOT maintenance program and practices, part I : workshop findings and recommendations

To assess and improve their practices, and thus ensure the future excellence of the Texas highway system, the Texas Department of Transportation (TxDOT) sought a forum in which experts from other State Departments of Transportation could evaluate the TxDOT maintenance program and practices based on their expertise. To meet this need, a Peer State Review of TxDOT Maintenance Practices project was organized and conducted by the Center for Transportation Research (CTR) at The University of Texas at Austin. CTR researchers, along with TxDOT staff, conducted a workshop to present TxDOT’s maintenance practices to the visiting peer reviewers and invite their feedback. Directors of maintenance from six different states—California, Kansas, Georgia, Missouri, North Carolina, and Washington—participated in the workshop. CTR and TxDOT worked together to design a questionnaire with 15 key questions to capture the peers’ opinions on maintenance program and practices. This paper compiles and summarizes this information. The examination results suggested that TxDOT should use a more state-wide approach to funding and planning, in addition to funding and planning for each district separately. Additionally, the peers recommended that criteria such as condition and level of service of the roadways be given greater weight in the funding allocation than lane miles or vehicle miles traveled (VMT). The Peer Reviewers also determined that TxDOT maintenance employee experience and communications were strong assets. Additional strengths included the willingness of TxDOT to invite peer reviews of their practices and a willingness to consider opportunities for improvement.

Classifying external causes of injury : history, current approaches, and future directions

The International Classification of Diseases (ICD) is used to categorise diseases, injuries and external causes, and is a key epidemiological tool enabling the storage and retrieval of data from health and vital records to produce core international mortality and morbidity statistics. The ICD is updated periodically to ensure the classification remains current and work is now underway to develop the next revision, ICD-11. There have been almost 20 years since the last ICD edition was published and over 60 years since the last substantial structural revision of the external causes chapter. Revision of such a critical tool requires transparency and documentation to ensure that changes made to the classification system are recorded comprehensively for future reference. In this paper, the authors provide a history of external causes classification development and outline the external cause structure. Approaches to manage ICD-10 deficiencies are discussed and the ICD-11 revision approach regarding the development of, rationale for and implications of proposed changes to the chapter are outlined. Through improved capture of external cause concepts in ICD-11, a stronger evidence base will be available to inform injury prevention, treatment, rehabilitation and policy initiatives to ultimately contribute to a reduction in injury morbidity and mortality.

Exploring the opportunities and challenges of using mobile sensing for gamification and achievements

Gamified services delivered on smart phones, such as Foursquare, are able to utilise the sensors on the phone to capture user contexts as a means of triggering game elements. This paper identifies and discusses opportunities and challenges that exist when using mobile sensors as input for game elements. We present initial findings from a field study of a gamified mobile application made to support the university orientation event for new students using game achievements. The study showed that overall the use of context was well received by participants when compared to game elements that required no context to complete. It was also found that using context could help validate that an activity was completed however there were still technical challenges when using sensors that led to exploits in the game elements, or cheating.

Breaching the standardised assessment boundary : assessment for learning as a field of exchange

The introduction of the Australian curriculum, the use of standardised testing (e.g. NAPLAN) and the My School website are couched in a context of accountability. This circumstance has stimulated and in some cases renewed a range of boundaries in Australian Education. The consequences that arise from standardised testing have accentuated the boundaries produced by social reproduction in education which has led to an increase in the numbers of students disengaging from mainstream education and applying for enrolment at the Edmund Rice Education Australia Flexible Learning Centre Network (EREAFLCN). Boundaries are created for many young people who are denied access to credentials and certification as a result of being excluded from or in some way disengaging from standardised education and testing. Young people who participate at the EREAFLCN arrive with a variety of forms of cultural capital that are not valued in current education and employment fields. This is not to say that these young people’s different forms of cultural capital have no value, but rather that such funds of knowledge, repertoires and cultural capital are not valued by the majority of powerful agents in educational and employment fields. How then can the qualitative value of traditionally unorthodox - yet often intricate, ingenious, and astute - versions of cultural capital evident in the habitus of many young people be made to count, be recognised, be valuated? Can a process of educational assessment be a field of capital exchange and a space which breaches boundaries through a valuating process? This paper reports on the development of an innovative approach to assessment in an alternative education institution designed for the re-engagement of ‘at risk’ youth who have left formal schooling. A case study approach has been used to document the engagement of six young people, with an educational approach described as assessment for learning as a field of exchange across two sites in the EREAFLCN. In order to capture the broad range of students’ cultural and social capital, an electronic portfolio system (EPS) is under trial. The model draws on categories from sociological models of capital and reconceptualises the eportfolio as a sociocultural zone of learning and development. Results from the trial show a general tendency towards engagement with the EPS and potential for the attainment of socially valued cultural capital in the form of school credentials. In this way restrictive boundaries can be breached and a more equitable outcome achieved for many young Australians.

Towards general capabilities through technology : assessment for learning as a field of exchange

The introduction of the Australian curriculum, the use of standardised testing (e.g. NAPLAN) and the My School website have stimulated and in some cases renewed a range of boundaries for young people in Australian Education. Standardised testing has accentuated social reproduction in education with an increase in the numbers of students disengaging from mainstream education and applying for enrolment at the Edmund Rice Education Australia Flexible Learning Centre Network (EREAFLCN). Many young people are denied access to credentials and certification as they become excluded from standardised education and testing. The creativity and skills of marginalised youth are often evidence of general capabilities and yet do not appear to be recognised in mainstream educational institutions when standardised approaches are adopted. Young people who participate at the EREAFLCN arrive with a variety of forms of cultural capital, frequently utilising general capabilities, which are not able to be valued in current education and employment fields. This is not to say that these young people‟s different forms of cultural capital have no value, but rather that such funds of knowledge, repertoires and cultural capital are not valued by the majority of powerful agents in educational and employment fields. How then can the inherent value of traditionally unorthodox - yet often intricate, ingenious, and astute-versions of cultural capital evident in the habitus of many young people be made to count, be recognised, be valuated?Can a process of educational assessment be a field of capital exchange and a space which crosses boundaries through a valuating process? This paper reports on the development of an innovative approach to assessment in an alternative education institution designed for the re engagement of „at risk‟ youth who have left formal schooling. A case study approach has been used to document the engagement of six young people, with an educational approach described as assessment for learning as a field of exchange across two sites in the EREAFLCN. In order to capture the broad range of students‟ cultural and social capital, an electronic portfolio system (EPS) is under trial. The model draws on categories from sociological models of capital and reconceptualises the eportfolio as a sociocultural zone of learning and development. Results from the trial show a general tendency towards engagement with the EPS and potential for the attainment of socially valued cultural capital in the form of school credentials. In this way restrictive boundaries can be breached and a more equitable outcome achieved for many young Australians.