Implications for the design of a digital stethoscope for anaesthetic preadmission consultations

Background This research addresses the development of a digital stethoscope for use with a telehealth communications network to allow doctors to examine patients remotely (a digital telehealth stethoscope). A telehealth stethoscope would allow remote auscultation of patients who do not live near a major hospital. Travelling from remote areas to major hospitals is expensive for patients and a telehealth stethoscope could result in significant cost savings. Using a stethoscope requires great skill. To design a telehealth stethoscope that meets doctors’ expectations, the use of existing stethoscopes in clinical contexts must be examined. Method Observations were conducted of 30 anaesthetic preadmission consultations. The observations were video- taped. Interaction between doctor, patient and non-human elements in the consultation were “coded” to transform the video into data. The data were analysed to reveal essential aspects of the interactions. Results The analysis has shown that the doctor controls the interaction during auscultation. The conduct of auscultation draws heavily on the doctor’s tacit knowledge, allowing the doctor to treat the acoustic stethoscope as infrastructure – that is, the stethoscope sinks into the background and becomes completely transparent in use. Conclusion Two important, and related, implications for the design of a telehealth stethoscope have arisen from this research. First, as a telehealth stethoscope will be a shared device, doctors will not be able to make use of their existing expertise in using their own stethoscopes. Very simply, a telehealth stethoscope will sound different to a doctor’s own stethoscope. Second, the collaborative interaction required to use a telehealth stethoscope will have to be invented and refined. A telehealth stethoscope will need to be carefully designed to address these issues and result in successful use. This research challenges the concept of a telehealth stethoscope by raising questions about the ease and confidence with which doctors could use such a device.

Fear and danger in nocturnal urban environments

At the centre of this research is an ethnographic study that saw the researcher embedded within the fabric of inner city life to better understand what characteristics of user activity and interaction could be enhanced by technology. The initial research indicated that the experience of traversing the city after dark unified an otherwise divergent user group through a shared concern for personal safety. Managing this fear and danger represented an important user need. We found that mobile social networking systems are not only integral for bringing people together, they can help in the process of users safely dispersing as well. We conclude, however, that at a time when the average iPhone staggers under the weight of a plethora of apps that do everything from acting as a carpenter’s level to a pregnancy predictor, we consider the potential for the functionality of a personal safety device to be embodied within a stand alone artifact.

Identifying parents' perceptions about physical activity : a qualitative exploration of salient behavioural, normative and control beliefs among mothers and fathers of young children

Drawing on the belief-based framework of the Theory of Planned Behaviour, this study employs qualitative methodology involving individual and group interviews to examine the beliefs associated with regular physical activity performance among parents of young children (N = 40). The data were analysed using thematic content analysis. A range of advantages (e.g. improves parenting practices), disadvantages (e.g. interferes with commitments), barriers (e.g. time), and facilitators (e.g. social support) to performing physical activity are identified. Normative pressures are also identified as affecting parents’ activity behaviour. These identified beliefs can be used to inform interventions to challenge inactivity among this at-risk group.

Treating an unhealthy organisational culture : the implications of the Bundaberg Hospital inquiry for managerial ethical decision making

This paper explores the interplay between individual values, espoused organisational values and the values of the organisational culture in practice in light of a recent Royal Commission in Queensland, Australia, which highlighted systematic failures in patient care. The lack of congruence among values at these levels impacts upon the ethical decision making of health managers. The presence of institutional ethics regimes such as the Public Sector Ethics Act 1994 (Qld) and agency codes of conduct are not sufficient to counteract the negative influence of informal codes of practice that undermine espoused organisational values and community standards. The ethical decision-making capacity of health care managers remains at the front line in the battle against unethical and unprofessional practice. What is known about the topic? Value congruence theory focusses on the conflicts between individual and organisational values. Congruence between individual values, espoused values and values expressed in everyday practice can only be achieved by ensuring that such shared values are an ever-present factor in managerial decision making. What does this paper add? The importance of value congruence in building and sustaining a healthy organisational culture is confirmed by the evidence presented in the Bundaberg Hospital Inquiry. The presence of strong individual values among staff and strong espoused values in line with community expectations and backed up by legislation and ethics regimes were not, in themselves, sufficient to ensure a healthy organisational culture and prevent unethical, and possibly illegal, behaviour. What are the implications for practitioners? Managers must incorporate ethics in decision making to establish and maintain the nexus between individual and organisational values that is a vital component of a healthy organisational culture.

Weighted fairness with MCR guarantee and a general-purpose explicit rate allocation algorithm for ATM ABR service

In this paper, weighted fair rate allocation for ATM available bit rate (ABR) service is discussed with the concern of the minimum cell rate (MCR). Weighted fairness with MCR guarantee has been discussed recently in the literature. In those studies, each ABR virtual connection (VC) is first allocated its MCR, then the remaining available bandwidth is further shared among ABR VCs according to their weights. For the weighted fairness defined in this paper, the bandwidth is first allocated according to each VC's weight; if a VC's weighted share is less than its MCR, it should be allocated its MCR instead of the weighted share. This weighted fairness with MCR guarantee is referred to as extended weighted (EXW) fairness. Certain theoretical issues related to EXW, such as its global solution and bottleneck structure, are first discussed in the paper. A distributed explicit rate allocation algorithm is then proposed to achieve EXW fairness in ATM networks. The algorithm is a general-purpose explicit rate algorithm in the sense that it can realise almost all the fairness principles proposed for ABR so far whilst only minor modifications may be needed.

Fair flow control of ABR service by per-VC virtual queuing

In this paper, a rate-based flow control scheme based upon per-VC virtual queuing is proposed for the Available Bit Rate (ABR) service in ATM. In this scheme, each VC in a shared buffer is assigned a virtual queue, which is a counter. To achieve a specific kind of fairness, an appropriate scheduler is applied to the virtual queues. Each VC's bottleneck rate (fair share) is derived from its virtual cell departure rate. This approach of deriving a VC's fair share is simple and accurate. By controlling each VC with respect to its virtual queue and queue build-up in the shared buffer, network congestion is avoided. The principle of the control scheme is first illustrated by max–min flow control, which is realised by scheduling the virtual queues in round-robin. Further application of the control scheme is demonstrated with the achievement of weighted fairness through weighted round robin scheduling. Simulation results show that with a simple computation, the proposed scheme achieves the desired fairness exactly and controls network congestion effectively.

Contextualizing the tensions and weaknesses of information privacy and data breach notification laws

Data breach notification laws have detailed numerous failures relating to the protection of personal information that have blighted both corporate and governmental institutions. There are obvious parallels between data breach notification and information privacy law as they both involve the protection of personal information. However, a closer examination of both laws reveals conceptual differences that give rise to vertical tensions between each law and shared horizontal weaknesses within both laws. Tensions emanate from conflicting approaches to the implementation of information privacy law that results in different regimes and the implementation of different types of protections. Shared weaknesses arise from an overt focus on specified types of personal information which results in ‘one size fits all’ legal remedies. The author contends that a greater contextual approach which promotes the importance of social context is required and highlights the effect that contextualization could have on both laws.

Performance optimization for parallel processing on a multiple-CPU server

Symmetric multi-processor (SMP) systems, or multiple-CPU servers, are suitable for implementing parallel algorithms because they employ dedicated communication devices to enhance the inter-processor communication bandwidth, so that a better performance can be obtained. However, the cost for a multiple-CPU server is high and therefore, the server is usually shared among many users. The work-load due to other users will certainly affect the performance of the parallel programs so it is desirable to derive a method to optimize parallel programs under different loading conditions. In this paper, we present a simple method, which can be applied in SPMD type parallel programs, to improve the speedup by controlling the number of threads within the programs.

Modelling complex resource requirements in Business Process Management Systems

Real-world business processes are resource-intensive. In work environments human resources usually multitask, both human and non-human resources are typically shared between tasks, and multiple resources are sometimes necessary to undertake a single task. However, current Business Process Management Systems focus on task-resource allocation in terms of individual human resources only and lack support for a full spectrum of resource classes (e.g., human or non-human, application or non-application, individual or teamwork, schedulable or unschedulable) that could contribute to tasks within a business process. In this paper we develop a conceptual data model of resources that takes into account the various resource classes and their interactions. The resulting conceptual resource model is validated using a real-life healthcare scenario.

Levels of awareness of professional ethics used as a sensitizing method in project-based learning

There is a need for educational frameworks for computer ethics education. This discussion paper presents an approach to developing students’ moral sensitivity, an awareness of morally relevant issues, in project-based learning (PjBL). The proposed approach is based on a study of IT professionals’ levels of awareness of ethics. These levels are labelled My world, The corporate world, A shared world, The client’s world and The wider world. We give recommendations for how instructors may stimulate students’ thinking with the levels and how the levels may be taken into account in managing a project course and in an IS department. Limitations of the recommendations are assessed and issues for discussion are raised.

Knowledge transfer in project-based organisations : the need for a unique approach

Effective knowledge transfer between infrastructure projects plays a significant role in organisational success and discovery of new technologies, helping to achieve and maintain competitive advantage and, in effect, sustainable infrastructure development. Knowledge is recognised as an important organisational asset that adds value while being shared. To date, research on knowledge transfer has focused on traditional (functional) types of organisations. However, existing knowledge transfer approaches fail to address the issue of unique characteristics of project-based organisations, and the fact that functional and project-based organisations significantly differ in terms of structure, processes, and characteristics. Therefore, there is a need for a different, separate approach for managing knowledge in the project environment. The aim of this chapter is to highlight this need. An extensive literature review is provided on the areas of project management, knowledge management, and organisational structure; this is further supported by empirical evidence from interviews with project management practitioners. Conducting a ‘cross-field’ literature review provides a better understanding of the knowledge transfer mechanisms and its application to projects, and of the importance of knowledge transfer across projects. This research is crucial to gaining a better understanding of knowledge transfer in the project environment. It stresses that there are dissimilarities between project-based organisations and functional organisations in terms of organisational structure, duration of processes, viewpoint of time, response to change, and mobility of people, and that there is a need for a unique strategic approach in order to achieve effective transfer of knowledge. Furthermore, findings presented in this chapter reveal key elements that play an important role in across project knowledge transfer. These elements include: social communication, lessons learned databases, and project management offices.

Identifying key belief-based targets for promoting regular physical activity among mothers and fathers with young children

We investigated the key beliefs to target in interventions aimed at increasing physical activity (PA) among mothers and fathers of young children. Parents (288 mothers and 292 fathers) completed a Theory of Planned Behaviour belief-based questionnaire and a 1-week follow-up of PA behaviour. We found that a range of behavioural, normative, and control beliefs were significantly correlated with parents’ PA intentions and behaviour, with only a few differences observed in correlations between PA beliefs and intention and behaviour by gender. A range of key beliefs was identified as making independent contributions to parents’ PA intentions; however, the behavioural beliefs about improving parenting practices (β = 0.13), interfering with other commitments (β = −0.29); normative beliefs about people I exercise with (β = 0.20); and control beliefs about lack of time (β = −0.24), inconvenience (β = −0.14), lack of motivation (β = −0.34), were revealed as significant independent predictors of actual PA behaviour. Furthermore, we found that a limited amount of parents already hold these beliefs, suggesting that these key beliefs warrant changing and, therefore, are appropriate targets for subsequent intervention. The current study fills an empirical gap in the PA literature by investigating an at-risk group and using a well established theoretical framework to identify key beliefs that guide parents’ PA decision-making. Overall, we found support for parents being a unique group who hold distinctive behavioural, normative, and control beliefs toward PA. Attention to these key underlying beliefs will assist intervention work aimed at combating inactivity among this at-risk population.

Young children’s active citizenship : storytelling, stories, and social actions

This thesis inquires into possibilities for young children‘s active citizenship as provoked through a practice of social justice storytelling with one Preparatory1 class of children aged five to six years. The inquiry was practitioner-research, through a living educational theory approach cultivating an interrelational view of existing with others in evolving processes of creation. Ideas of young children‘s active citizenship were provoked and explored through storytelling, by a storytelling teacher-researcher, a Prep class of children and their teacher. The three major foci of the study were practice, narrative and action. A series of storytelling workshops with a Prep class was the practice that was investigated. Each workshop began with a story that made issues of social justice visible, followed by critical discussion of the story, and small group activities to further explore the story. The focus on narrative was based on the idea of story as a way knowing. Stories were used to explore social justice issues with young children. Metanarratives of children and citizenship were seen to influence possibilities for young children‘s active citizenship. Stories were purposefully shared to provoke and promote young children‘s active citizenship through social actions. It was these actions that were the third focus of the study. Through action research, a social justice storytelling practice and the children‘s responses to the stories were reflected on both in action and after. These reflections informed and shaped storytelling practice. Learning in a practice of social justice storytelling is explained through living theories of social justice storytelling as pedagogy. Data of the children‘s participation in the study were analysed to identify influences and possibilities for young children‘s active citizenship creating a living theory of possibilities for young children‘s active citizenship.

Dealing with the problem of cybercrime

Lack of a universally accepted and comprehensive taxonomy of cybercrime seriously impedes international efforts to accurately identify, report and monitor cybercrime trends. There is, not surprisingly, a corresponding disconnect internationally on the cybercrime legislation front, a much more serious problem and one which the International Telecommunication Union (ITU) says requires „the urgent attention of all nations‟. Yet, and despite the existence of the Council of Europe Convention on Cybercrime, a proposal for a global cybercrime treaty was rejected by the United Nations (UN) as recently as April 2010. This paper presents a refined and comprehensive taxonomy of cybercrime and demonstrates its utility for widespread use. It analyses how the USA, the UK, Australia and the UAE align with the CoE Convention and finds that more needs to be done to achieve conformance. We conclude with an analysis of the approaches used in Australia, in Queensland, and in the UAE, in Abu Dhabi, to fight cybercrime and identify a number of shared problems.

Values, controversial issues and interfaith understanding

Values are fundamental to human activity. What makes us distinctive is our ability to understand the challenges we face in life, and to make choices about how to respond. Yet, as the Cheshire Cat from Lewis Carroll’s Alice’s Adventures in Wonderland observed, if we don’t care about how we make such choices, the outcome of our decision-making is diminished. Values education is a broad, complex and controversial area, and, while it has shifted in emphasis and focus, it continues to be an essential part of many education systems. For example, some international education systems are exploring the links between values education and student wellbeing. In Australia, the values basis for ethical behaviour is receiving emphasis as a general capability, or important component of education, that can be developed across the curriculum. Indeed, some syllabus and policy documents require that particular values are emphasised, while numerous schools aim to inculcate and foster a range of personal social, moral and spiritual values in their students, many of which are shared by members of the wider community. However, because values are also contested in the community, values education involves the exploration of controversial issues. Similarly, values education explores the underlying belief systems of different world views and how they influence value commitments, ways of behaving, and interfaith understanding in today’s globalised world. This chapter explores the significance and teaching possibilities of values, controversial issues and interfaith understanding.