Medical Data Access Accountability in EHR Systems, A Practical Perspective

The world has experienced a large increase in the amount of available data. Therefore, it requires better and more specialized tools for data storage and retrieval and information privacy. Recently Electronic Health Record (EHR) Systems have emerged to fulfill this need in health systems. They play an important role in medicine by granting access to information that can be used in medical diagnosis. Traditional systems have a focus on the storage and retrieval of this information, usually leaving issues related to privacy in the background. Doctors and patients may have different objectives when using an EHR system: patients try to restrict sensible information in their medical records to avoid misuse information while doctors want to see as much information as possible to ensure a correct diagnosis. One solution to this dilemma is the Accountable e-Health model, an access protocol model based in the Information Accountability Protocol. In this model patients are warned when doctors access their restricted data. They also enable a non-restrictive access for authenticated doctors. In this work we use FluxMED, an EHR system, and augment it with aspects of the Information Accountability Protocol to address these issues. The Implementation of the Information Accountability Framework (IAF) in FluxMED provides ways for both patients and physicians to have their privacy and access needs achieved. Issues related to storage and data security are secured by FluxMED, which contains mechanisms to ensure security and data integrity. The effort required to develop a platform for the management of medical information is mitigated by the FluxMED's workflow-based architecture: the system is flexible enough to allow the type and amount of information being altered without the need to change in your source code.

A manager-centred perspective on work-life integration

Decades of research has shown that the uptake of workplace ‘flexibility’ provisions set out in organizational/HR policies rests heavily on the support of line managers. However, the majority of scholarship addressing the intersection of managers’ roles and work-life integration has been employee-centred. That is, the literature primarily situates managers as gatekeepers to the effective implementation of work and family policies as they affect employees or workers, examining their role in, for example, approving requests to adjust or personalise employees’ work schedules; influencing whether employees are cross-trained to undertake the work of others during absences; publicising available policies; and creating norms supporting the use of formal provisions (Ryan & Ernst Kossek, 2008). Managers’ actions are primarily seen as key, contingent phenomena affecting the adoption and diffusion of work-life initiatives in an organization; consequently impacting on the work-life outcomes of subordinate employees (Bardoel, 2003; Gregory & Milner, 2012).

MnOx/carbon nanotube/reduced graphene oxide nanohybrids as high-performance supercapacitor electrodes

Nanohybrids consisting of both carbon and pseudocapacitive metal oxides are promising as high-performance electrodes to meet the key energy and power requirements of supercapacitors. However, the development of high-performance nanohybrids with controllable size, density, composition and morphology remains a formidable challenge. Here, we present a simple and robust approach to integrating manganese oxide (MnOx) nanoparticles onto flexible graphite paper using an ultrathin carbon nanotube/reduced graphene oxide (CNT/RGO) supporting layer. Supercapacitor electrodes employing the MnOx/CNT/RGO nanohybrids without any conductive additives or binders yield a specific capacitance of 1070 F g−1 at 10 mV s−1, which is among the highest values reported for a range of hybrid structures and is close to the theoretical capacity of MnOx. Moreover, atmospheric-pressure plasmas are used to functionalize the CNT/RGO supporting layer to improve the adhesion of MnOx nanoparticles, which results in theimproved cycling stability of the nanohybrid electrodes. These results provide information for the utilization of nanohybrids and plasma-related effects to synergistically enhance the performance of supercapacitors and may create new opportunities in areas such as catalysts, photosynthesis and electrochemical sensors

The return to work experiences of middle-aged Australian workers diagnosed with colorectal cancer: a matched cohort study

Background Few studies have been undertaken to understand the employment impact in patients with colorectal cancer and none in middle-aged individuals with cancer. This study described transitions in, and key factors influencing, work participation during the 12 months following a diagnosis of colorectal cancer. Methods We enrolled 239 adults during 2010 and 2011who were employed at the time of their colorectal cancer diagnosis and were prospectively followed over 12 months. They were compared to an age- and gender-matched general population group of 717 adults from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Data were collected using telephone and postal surveys. Primary outcomes included work participation at 12 months, changes in hours worked and time to work re-entry. Multivariable logistic and Cox proportional hazards models were undertaken. Results A significantly higher proportion of participants with colorectal cancer (27%) had stopped working at 12 months than participants from the comparison group (8%) (p < 0.001). Participants with cancer who returned to work took a median of 91 days off work (25–75 percentiles: 14–183 days). For participants with cancer, predictors of not working at 12 months included: being older, lower BMI and lower physical well-being. Factors related to delayed work re-entry included not being university-educated, working for an employer with more than 20 employees in a non-professional or managerial role, longer hospital stay, poorer perceived financial status and having or had chemotherapy. Conclusions In middle-adulthood, those working and diagnosed with colorectal cancer can expect to take around three months off work. Individuals treated with chemotherapy, without a university degree and from large employers could be targeted for specific assistance for a more timely work entry.

FlexAnalytics: A flexible data analytics framework for big data applications with I/O performance improvement

Increasingly larger scale applications are generating an unprecedented amount of data. However, the increasing gap between computation and I/O capacity on High End Computing machines makes a severe bottleneck for data analysis. Instead of moving data from its source to the output storage, in-situ analytics processes output data while simulations are running. However, in-situ data analysis incurs much more computing resource contentions with simulations. Such contentions severely damage the performance of simulation on HPE. Since different data processing strategies have different impact on performance and cost, there is a consequent need for flexibility in the location of data analytics. In this paper, we explore and analyze several potential data-analytics placement strategies along the I/O path. To find out the best strategy to reduce data movement in given situation, we propose a flexible data analytics (FlexAnalytics) framework in this paper. Based on this framework, a FlexAnalytics prototype system is developed for analytics placement. FlexAnalytics system enhances the scalability and flexibility of current I/O stack on HEC platforms and is useful for data pre-processing, runtime data analysis and visualization, as well as for large-scale data transfer. Two use cases – scientific data compression and remote visualization – have been applied in the study to verify the performance of FlexAnalytics. Experimental results demonstrate that FlexAnalytics framework increases data transition bandwidth and improves the application end-to-end transfer performance.

Street-level perceptions of procedural rights for young unemployed people - a comparative study between Sweden and Australia

Two types of welfare states are compared in this article. Differences in procedural rights for young unemployed at the level of service delivery are analyzed. In Australia, rights are regulated through a rigid procedural justice system. The young unemployed within the social assistance system in Sweden encounter staff with high discretionary powers, which makes the legal status weak for the unemployed but, on the other hand, the system is more flexible. Despite the differences, there is striking convergence in how the young unemployed describe how discretionary power among street-level staff affects their procedural rights. This result can be understood as a result of similar professional norms, work customs and occupational cultures of street-level staff, and that there is a basic logic of conditionality in all developed welfare states where procedural rights are tightly coupled with responsibilities.

Multifunctional three-dimensional T-junction graphene micro-wells: Energy-efficient, plasma-enabled growth and instant water-based transfer for flexible device applications

The “third-generation” 3D graphene structures, T-junction graphene micro-wells (T-GMWs) are produced on cheap polycrystalline Cu foils in a single-step, low-temperature (270 °C), energy-efficient, and environment-friendly dry plasma-enabled process. T-GMWs comprise vertical graphene (VG) petal-like sheets that seemlessly integrate with each other and the underlying horizontal graphene sheets by forming T-junctions. The microwells have the pico-to-femto-liter storage capacity and precipitate compartmentalized PBS crystals. The T-GMW films are transferred from the Cu substrates, without damage to the both, in de-ionized or tap water, at room temperature, and without commonly used sacrificial materials or hazardous chemicals. The Cu substrates are then re-used to produce similar-quality T-GMWs after a simple plasma conditioning. The isolated T-GMW films are transferred to diverse substrates and devices and show remarkable recovery of their electrical, optical, and hazardous NO2 gas sensing properties upon repeated bending (down to 1 mm radius) and release of flexible trasparent display plastic substrates. The plasma-enabled mechanism of T-GMW isolation in water is proposed and supported by the Cu plasma surface modification analysis. Our GMWs are suitable for various optoelectronic, sesning, energy, and biomedical applications while the growth approach is potentially scalable for future pilot-scale industrial production.

Burnout and work engagement in occupational therapists

Introduction Work engagement, characterized by vigour, dedication, and absorption, is often perceived as the opposite of burnout. Occupational therapists with burnout feel exhausted and disengaged from their work. This study aims to investigate demographic and work-related psychosocial factors associated with burnout and work engagement. Method A cross-sectional postal survey of 951 occupational therapists was conducted. Findings Two models representing factors associated with burnout (F(15,871) = 28.01, p < .001) and work engagement (F(10,852) = 16.15, p < .001) accounted for 32.54% and 15.93% of the variance respectively. Burnout and work engagement were inversely associated (χ2(n = 941) = 55.16, p < .001). Conclusion Factors associated with burnout and work engagement were identified. The variables associated with burnout included: low psychological detachment from work during out-of-work hours, low income satisfaction, perceived work overload, difficulty saying ‘no’, < 10 years' experience, low frequency of having a ‘belly laugh’, and not having children. High levels of work engagement were reported by therapists with the following: low psychological detachment from work, high income satisfaction, postgraduate qualifications, > 40 hours work/week, high frequency of having a ‘belly laugh’, and having children. Understanding the factors associated with burnout and work engagement provides prerequisite information to inform strategies aimed at building healthy workforces.

Controlling routine front line service workers: an Australian retail supermarket case

Food retail is known for its use of flexible labour and for the centralisation of functions at head office, resulting in a reduction of managerial autonomy at store level. This article employs a typology of controls developed from labour process scholarship to explore how retail managers negotiate the control of their predominantly part-time workforce. Using an Australian supermarket chain as a case, and mixed methods, the article demonstrates that supermarkets use a multiplicity of forms of control across their workforce. For front line service workers, the article identifies a new configuration of controls which intersects with employment status and acts differentially for checkout operators on different employment contracts.

Ink-jet printing of graphene for flexible electronics: An environmentally-friendly approach

Mechanical flexibility is considered an asset in consumer electronics and next-generation electronic systems. Printed and flexible electronic devices could be embedded into clothing or other surfaces at home or office or in many products such as low-cost sensors integrated in transparent and flexible surfaces. In this context inks based on graphene and related two-dimensional materials (2DMs) are gaining increasing attention owing to their exceptional (opto)electronic, electrochemical and mechanical properties. The current limitation relies on the use of solvents, providing stable dispersions of graphene and 2DMs and fitting the proper fluidic requirements for printing, which are in general not environmentally benign, and with high boiling point. Non-toxic and low boiling point solvents do not possess the required rheological properties (i.e., surface tension, viscosity and density) for the solution processing of graphene and 2DMs. Such solvents (e.g., water, alcohols) require the addition of stabilizing agents such as polymers or surfactants for the dispersion of graphene and 2DMs, which however unavoidably corrupt their properties, thus preventing their use for the target application. Here, we demonstrate a viable strategy to tune the fluidic properties of water/ethanol mixtures (low-boiling point solvents) to first effectively exfoliate graphite and then disperse graphene flakes to formulate graphene-based inks. We demonstrate that such inks can be used to print conductive stripes (sheet resistance of ~13 kΩ/□) on flexible substrates (polyethylene terephthalate), moving a step forward towards the realization of graphene-based printed electronic devices.

Signs of driver sleepiness and risky sleepy driving behaviours: the associations with demographic, work and sleep-related factors

Driving while sleepy is regarded as a substantial crash risk factor. Reducing the risk of sleep-related crashes predominately rests with the driver’s awareness of experiencing signs that are common when sleepy; such as yawning, frequent eye blinks, and difficulty keeping eyes open. However the relationship between the signs of sleepiness and risky sleepy driving behaviours is largely unknown. The current study sought to examine the relationships between drivers’ experiences of the signs of sleepiness, risky sleepy driving behaviours, and the associations with demographic, work and sleep-related factors. In total 1,608 participants completed a questionnaire administered via a telephone interview that assessed their experiences and behaviours of driving while sleepy. The results revealed a number of demographic, work and sleep-related factors were associated with experiencing signs of sleepiness when driving. Signs of sleepiness were also found to mediate the relationship between continuing to drive while sleepy and having a sleep-related close call event. A subgroup analysis based on age (under 30 and 30 years or older) found younger drivers were more likely to continue to drive when sleepy despite experiencing more signs of sleepiness. The results suggest participants had considerable experience with the signs of sleepiness and driving while sleepy. Actions to be taken from this research include informing the content of driver education campaigns regarding the importance of the signs of sleepiness. Working together to educate all drivers about the dangerousness of driving when experiencing signs of sleepiness is an important road safety outcome.

The trend toward pre-graduation professional work experience for Australian young planners: Essential experience or essentially exploitation

This paper explores the changing employment expectations that frame the early professional work experiences of young planners in Australia. In particular, it considers the rising popularity of pre-graduation professional work experience as a precursor to formal entry into the workforce as a practising planner. This shift is being driven in part by employer expectations that graduates will already have ‘real world’ and relevant work experience. However, an equally significant driver appears to be a growing desire for early career and graduate planners to find ways to distinguish themselves from their peers in an increasingly tight labour market. Using data from an ongoing research project into the formative work experiences of young people this paper describes the three main types of pre-graduation professional work experience undertaken by young planners. It highlights the potential challenges and benefits of pre-graduation work experience from a legal, social and ethical perspective as well as from the perspective of young planners themselves. The paper concludes by reflecting on the role of the planning profession – employers, peak bodies and planning educators – in managing the tensions between producing ‘work ready’ graduates and safeguarding the employment conditions of early career planning professionals.

Destinations: 3 Large Cast Plays for Young People

This book is a collection of three large-cast plays written in response to a very specific problem. My work as a teacher of drama often required me to locate a script that would somehow miraculously work for a cast of unknown number and gender, and most likely uneven skills and enthusiasm, who I hadn’t even met yet. It’s a familiar dilemma for teachers and students of drama in education contexts, at whatever level you’re teaching. I’d first addressed this creative problem with scripts such as Gate 38 (2010). I had tried using scripts that already existed, but found they required such extensive editing to suit the parameters of cast and performance duration that I may as well have been writing them myself. Even in the setting of a closed studio, in altering these plays I felt I was bending the vision of the playwright, and certainly their narrative structure, out of shape. Everyone who’s attempted to stage a performance with a large cast of students in an educational setting knows it takes time to truly connect with a play, its social contexts, themes and characters. It also takes a lot of time to get on top of the practicalities of learning, rehearsing, directing and running a performance with young people. Often the curtain goes up on something unfinished and unstable. I was looking for ways to reduce the complexity of staging a script, while maintaining the potential of this process as a site of rich, enjoyable learning. Two of the plays (Duty Free and Please Be Seated) are comprised of multiple monologues, combined with music-driven ensemble sequences. The monologues enable individuals to develop and polish their own performances, work in small groups, and cut down on the laborious detail of directing naturalistic scenes based in character interaction. The third (Australian Drama) involves a lot of duologues, meaning that its rehearsal process can happily employ that mainstay of the drama classroom: small group work. There’s plenty of room to move in terms of gender-blind casting as well. Please be Seated is mainly young women. The scripts also contain ensemble-based interludes which are non-verbal, music driven, with a choreographic element. They have also springboarded further explorations in form. The ethical and aesthetic complexities of verbatim works; the interaction between music and theatre; and meta-concerns related to the performing of performance: ‘how can the act of acting ‘acted’. The narratives of all three of these plays are deliberately open, enabling the flexible casting and on-the hop editing that large-group, time-poor processes sometimes necessitate. Duty Free is about the overseas ‘adventures’ of young people. Please Be Seated is based in verbatim text about young people falling in and out of love. Australian Drama is about young people in a drama classroom trying to connect with each other and put their own shine on dull fragments of the theatrical canon. The plays were published as a collection in hardcopy and digital editions by Playlab Press in 2015. Please be Seated is a co-write with a large group. These co-author’s names are listed in the publication, and below in ‘additional information’.

Assistance arrangements and use of services among persons with multiple sclerosis and their caregivers

A large population-based survey of persons with multiple sclerosis (MS) and their caregivers was conducted in Ontario using self-completed mailed questionnaires. The objectives included describing assistance arrangements, needs, and use of and satisfaction with services, and comparing perceptions of persons with MS and their caregivers. Response rates were 83% and 72% for those with MS and caregivers, respectively. Based on 697 respondents with MS whose mean age is 48 years, 70% are female, and 75% are married. While 24% experience no mobility restrictions, the majority require some type of aid or a wheelchair for getting around. Among 345 caregivers, who have been providing care for 9 years on average, the majority are spouses. Caregivers report providing more frequent care than do persons with MS report receiving it, particularly for the following activities of daily living: eating, meal preparation, and help with personal finances. Caregivers also report assistance of longer duration per day than do care recipients with MS. Frequency and duration of assistance are positively associated with increased MS symptom severity and reduced mobility. Generally there is no rural-urban disparity in service provision, utilization or satisfaction, and although there is a wide range of service utilization, satisfaction is consistently high. Respite care is rarely used by caregivers. Use of several services is positively associated with increased severity of MS symptoms and reduced mobility. Assistance arrangements and use of services, each from the point of view of persons with MS and their caregivers, must be taken into account in efforts to prolong home care and to postpone early institutionalization of persons with MS.

Haemodialysis work environment contributors to job satisfaction and stress: A sequential mixed methods study

Background: Haemodialysis nurses form long term relationships with patients in a technologically complex work environment. Previous studies have highlighted that haemodialysis nurses face stressors related to the nature of their work and also their work environments leading to reported high levels of burnout. Using Kanters (1997) Structural Empowerment Theory as a guiding framework, the aim of this study was to explore the factors contributing to satisfaction with the work environment, job satisfaction, job stress and burnout in haemodialysis nurses. Methods: Using a sequential mixed-methods design, the first phase involved an on-line survey comprising demographic and work characteristics, Brisbane Practice Environment Measure (B-PEM), Index of Work Satisfaction(IWS), Nursing Stress Scale (NSS) and the Maslach Burnout Inventory (MBI). The second phase involved conducting eight semi-structured interviews with data thematically analyzed. Results: From the 417 nurses surveyed the majority were female (90.9 %), aged over 41 years of age (74.3 %), and 47.4 % had worked in haemodialysis for more than 10 years. Overall the work environment was perceived positively and there was a moderate level of job satisfaction. However levels of stress and emotional exhaustion (burnout) were high. Two themes, ability to care and feeling successful as a nurse, provided clarity to the level of job satisfaction found in phase 1. While two further themes, patients as quasi-family and intense working teams, explained why working as a haemodialysis nurse was both satisfying and stressful. Conclusions: Nurse managers can use these results to identify issues being experienced by haemodialysis nurses working in the unit they are supervising.