Part 1. Chemical and Physical Restraints in the Management of Mechanically Ventilated Patients in the ICU: Contributing Factors

Chemical and physical restraints are frequently used in the intensive care unit (ICU) to control agitated patients and to prevent self-harm and unplanned extubations. Published work relating to the numerous issues of the care and treatment strategies for these patients remains conflicting and unclear. Literature regarding sedation and chemical restraint reveals a trend towards management with lighter sedation, use of sedation assessment tools and sedation protocols. It remains unclear which treatment is best for agitated and delirious patients, and the evidence on the effect of sedation is conflicting. A large portion of the literature on the use of physical restraint is from general hospital wards and residential homes, and not from the ICU environment. The purpose of this paper is to provide a summary of the existing literature on the use of physical and chemical restraints in the ICU setting. In Part 1 of this two-part paper, the evidence on chemical and physical restraints is explored with specific focus on definition of terms, unplanned

Fixed argument pairings

A common scenario in many pairing-based cryptographic protocols is that one argument in the pairing is fixed as a long term secret key or a constant parameter in the system. In these situations, the runtime of Miller's algorithm can be significantly reduced by storing precomputed values that depend on the fixed argument, prior to the input or existence of the second argument. In light of recent developments in pairing computation, we show that the computation of the Miller loop can be sped up by up to 37 if precomputation is employed, with our method being up to 19.5 faster than the previous precomputation techniques.

ERTP : Energy-efficient and reliable transport protocol for data streaming in wireless sensor networks

Emerging data streaming applications in Wireless Sensor Networks require reliable and energy-efficient Transport Protocols. Our recent Wireless Sensor Network deployment in the Burdekin delta, Australia, for water monitoring [T. Le Dinh, W. Hu, P. Sikka, P. Corke, L. Overs, S. Brosnan, Design and deployment of a remote robust sensor network: experiences from an outdoor water quality monitoring network, in: Second IEEE Workshop on Practical Issues in Building Sensor Network Applications (SenseApp 2007), Dublin, Ireland, 2007] is one such example. This application involves streaming sensed data such as pressure, water flow rate, and salinity periodically from many scattered sensors to the sink node which in turn relays them via an IP network to a remote site for archiving, processing, and presentation. While latency is not a primary concern in this class of application (the sampling rate is usually in terms of minutes or hours), energy-efficiency is. Continuous long-term operation and reliable delivery of the sensed data to the sink are also desirable. This paper proposes ERTP, an Energy-efficient and Reliable Transport Protocol for Wireless Sensor Networks. ERTP is designed for data streaming applications, in which sensor readings are transmitted from one or more sensor sources to a base station (or sink). ERTP uses a statistical reliability metric which ensures the number of data packets delivered to the sink exceeds the defined threshold. Our extensive discrete event simulations and experimental evaluations show that ERTP is significantly more energyefficient than current approaches and can reduce energy consumption by more than 45% when compared to current approaches. Consequently, sensor nodes are more energy-efficient and the lifespan of the unattended WSN is increased.

Localization and navigation assisted by cooperating networked sensors and robots

In this paper we discuss how a network of sensors and robots can cooperate to solve important robotics problems such as localization and navigation. We use a robot to localize sensor nodes, and we then use these localized nodes to navigate robots and humans through the sensorized space. We explore these novel ideas with results from two large-scale sensor network and robot experiments involving 50 motes, two types of flying robot: an autonomous helicopter and a large indoor cable array robot, and a human-network interface. We present the distributed algorithms for localization, geographic routing, path definition and incremental navigation. We also describe how a human can be guided using a simple hand-held device that interfaces to this same environmental infrastructure.

Data collection, storage and retrieval with an underwater sensor network

In this paper we present a novel platform for underwater sensor networks to be used for long-term monitoring of coral reefs and �sheries. The sensor network consists of static and mobile underwater sensor nodes. The nodes communicate point-to-point using a novel high-speed optical communication system integrated into the TinyOS stack, and they broadcast using an acoustic protocol integrated in the TinyOS stack. The nodes have a variety of sensing capabilities, including cameras, water temperature, and pressure. The mobile nodes can locate and hover above the static nodes for data muling, and they can perform network maintenance functions such as deployment, relocation, and recovery. In this paper we describe the hardware and software architecture of this underwater sensor network. We then describe the optical and acoustic networking protocols and present experimental networking and data collected in a pool, in rivers, and in the ocean. Finally, we describe our experiments with mobility for data muling in this network.

Networked robots : flying robot navigation using a sensor net

This paper introduces the application of a sensor network to navigate a flying robot. We have developed distributed algorithms and efficient geographic routing techniques to incrementally guide one or more robots to points of interest based on sensor gradient fields, or along paths defined in terms of Cartesian coordinates. The robot itself is an integral part of the localization process which establishes the positions of sensors which are not known a priori. We use this system in a large-scale outdoor experiment with Mote sensors to guide an autonomous helicopter along a path encoded in the network. A simple handheld device, using this same environmental infrastructure, is used to guide humans.

Attribute-based authenticated key exchange

We introduce the concept of attribute-based authenticated key exchange (AB-AKE) within the framework of ciphertext policy attribute-based systems. A notion of AKE-security for AB-AKE is presented based on the security models for group key exchange protocols and also taking into account the security requirements generally considered in the ciphertext policy attribute-based setting. We also extend the paradigm of hybrid encryption to the ciphertext policy attribute-based encryption schemes. A new primitive called encapsulation policy attribute-based key encapsulation mechanism (EP-AB-KEM) is introduced and a notion of chosen ciphertext security is de�ned for EP-AB-KEMs. We propose an EP-AB-KEM from an existing attribute-based encryption scheme and show that it achieves chosen ciphertext security in the generic group and random oracle models. We present a generic one-round AB-AKE protocol that satis�es our AKE-security notion. The protocol is generically constructed from any EP-AB-KEM that satis�es chosen ciphertext security. Instantiating the generic AB-AKE protocol with our EP-AB-KEM will result in a concrete one-round AB-AKE protocol also secure in the generic group and random oracle models.

Generic one round group key exchange in the standard model

Minimizing complexity of group key exchange (GKE) protocols is an important milestone towards their practical deployment. An interesting approach to achieve this goal is to simplify the design of GKE protocols by using generic building blocks. In this paper we investigate the possibility of founding GKE protocols based on a primitive called multi key encapsulation mechanism (mKEM) and describe advantages and limitations of this approach. In particular, we show how to design a one-round GKE protocol which satisfies the classical requirement of authenticated key exchange (AKE) security, yet without forward secrecy. As a result, we obtain the first one-round GKE protocol secure in the standard model. We also conduct our analysis using recent formal models that take into account both outsider and insider attacks as well as the notion of key compromise impersonation resilience (KCIR). In contrast to previous models we show how to model both outsider and insider KCIR within the definition of mutual authentication. Our analysis additionally implies that the insider security compiler by Katz and Shin from ACM CCS 2005 can be used to achieve more than what is shown in the original work, namely both outsider and insider KCIR.

The use of visual analogue scales to assess motivation to eat in human subjects: a review of their reliability and validity with an evaluation of new hand-held computerized stsytems for temporal tracking of appetite ratings.

This present paper reviews the reliability and validity of visual analogue scales (VAS) in terms of (1) their ability to predict feeding behaviour, (2) their sensitivity to experimental manipulations, and (3) their reproducibility. VAS correlate with, but do not reliably predict, energy intake to the extent that they could be used as a proxy of energy intake. They do predict meal initiation in subjects eating their normal diets in their normal environment. Under laboratory conditions, subjectively rated motivation to eat using VAS is sensitive to experimental manipulations and has been found to be reproducible in relation to those experimental regimens. Other work has found them not to be reproducible in relation to repeated protocols. On balance, it would appear, in as much as it is possible to quantify, that VAS exhibit a good degree of within-subject reliability and validity in that they predict with reasonable certainty, meal initiation and amount eaten, and are sensitive to experimental manipulations. This reliability and validity appears more pronounced under the controlled (but more arti®cial) conditions of the laboratory where the signal : noise ratio in experiments appears to be elevated relative to real life. It appears that VAS are best used in within-subject, repeated-measures designs where the effect of different treatments can be compared under similar circumstances. They are best used in conjunction with other measures (e.g. feeding behaviour, changes in plasma metabolites) rather than as proxies for these variables. New hand-held electronic appetite rating systems (EARS) have been developed to increase reliability of data capture and decrease investigator workload. Recent studies have compared these with traditional pen and paper (P&P) VAS. The EARS have been found to be sensitive to experimental manipulations and reproducible relative to P&P. However, subjects appear to exhibit a signi®cantly more constrained use of the scale when using the EARS relative to the P&P. For this reason it is recommended that the two techniques are not used interchangeably

To err (on the road) is human? An on-road study of driver errors

Human error, its causes and consequences, and the ways in which it can be prevented, remain of great interest to road safety practitioners. This paper presents the findings derived from an on-road study of driver errors in which 25 participants drove a pre-determined route using MUARC's On-Road Test Vehicle (ORTeV). In-vehicle observers recorded the different errors made, and a range of other data was collected, including driver verbal protocols, forward, cockpit and driver video, and vehicle data (speed, braking, steering wheel angle, lane tracking etc). Participants also completed a post trial cognitive task analysis interview. The drivers tested made a range of different errors, with speeding violations, both intentional and unintentional, being the most common. Further more detailed analysis of a sub-set of specific error types indicates that driver errors have various causes, including failures in the wider road 'system' such as poor roadway design, infrastructure failures and unclear road rules. In closing, a range of potential error prevention strategies, including intelligent speed adaptation and road infrastructure design, are discussed.

Multitasking, cognitive coordination and cognitive shifts during web searching

As Web searching becomes more prolific for information access worldwide, we need to better understand users’ Web searching behaviour and develop better models of their interaction with Web search systems. Web search modelling is a significant and important area of Web research. Searching on the Web is an integral element of information behaviour and human–computer interaction. Web searching includes multitasking processes, the allocation of cognitive resources among several tasks, and shifts in cognitive, problem and knowledge states. In addition to multitasking, cognitive coordination and cognitive shifts are also important, but are under-explored aspects of Web searching. During the Web searching process, beyond physical actions, users experience various cognitive activities. Interactive Web searching involves many users’ cognitive shifts at different information behaviour levels. Cognitive coordination allows users to trade off the dependences among multiple information tasks and the resources available. Much research has been conducted into Web searching. However, few studies have modelled the nature of and relationship between multitasking, cognitive coordination and cognitive shifts in the Web search context. Modelling how Web users interact with Web search systems is vital for the development of more effective Web IR systems. This study aims to model the relationship between multitasking, cognitive coordination and cognitive shifts during Web searching. A preliminary theoretical model is presented based on previous studies. The research is designed to validate the preliminary model. Forty-two study participants were involved in the empirical study. A combination of data collection instruments, including pre- and post-questionnaires, think-aloud protocols, search logs, observations and interviews were employed to obtain users’ comprehensive data during Web search interactions. Based on the grounded theory approach, qualitative analysis methods including content analysis and verbal protocol analysis were used to analyse the data. The findings were inferred through an analysis of questionnaires, a transcription of think-aloud protocols, the Web search logs, and notes on observations and interviews. Five key findings emerged. (1) Multitasking during Web searching was demonstrated as a two-dimensional behaviour. The first dimension was represented as multiple information problems searching by task switching. Users’ Web searching behaviour was a process of multiple tasks switching, that is, from searching on one information problem to searching another. The second dimension of multitasking behaviour was represented as an information problem searching within multiple Web search sessions. Users usually conducted Web searching on a complex information problem by submitting multiple queries, using several Web search systems and opening multiple windows/tabs. (2) Cognitive shifts were the brain’s internal response to external stimuli. Cognitive shifts were found as an essential element of searching interactions and users’ Web searching behaviour. The study revealed two kinds of cognitive shifts. The first kind, the holistic shift, included users’ perception on the information problem and overall information evaluation before and after Web searching. The second kind, the state shift, reflected users’ changes in focus between the different cognitive states during the course of Web searching. Cognitive states included users’ focus on the states of topic, strategy, evaluation, view and overview. (3) Three levels of cognitive coordination behaviour were identified: the information task coordination level, the coordination mechanism level, and the strategy coordination level. The three levels of cognitive coordination behaviour interplayed to support multiple information tasks switching. (4) An important relationship existed between multitasking, cognitive coordination and cognitive shifts during Web searching. Cognitive coordination as a management mechanism bound together other cognitive processes, including multitasking and cognitive shifts, in order to move through users’ Web searching process. (5) Web search interaction was shown to be a multitasking process which included information problems ordering, task switching and task and mental coordinating; also, at a deeper level, cognitive shifts took place. Cognitive coordination was the hinge behaviour linking multitasking and cognitive shifts. Without cognitive coordination, neither multitasking Web searching behaviour nor the complicated mental process of cognitive shifting could occur. The preliminary model was revisited with these empirical findings. A revised theoretical model (MCC Model) was built to illustrate the relationship between multitasking, cognitive coordination and cognitive shifts during Web searching. Implications and limitations of the study are also discussed, along with future research work.

Designing ePortfolios for music postgraduate study : a practice-led inquiry

In this research I have examined how ePortfolios can be designed for Music postgraduate study through a practice led research enquiry. This process involved designing two Web 2.0 ePortfolio systems for a group of five post graduate music research students. The design process revolved around the application of an iterative methodology called Software Develop as Research (SoDaR) that seeks to simultaneously develop design and pedagogy. The approach to designing these ePortfolio systems applied four theoretical protocols to examine the use of digitised artefacts in ePortfolio systems to enable a dynamic and inclusive dialogue around representations of the students work. The research and design process involved an analysis of existing software and literature with a focus upon identifying the affordances of available Web 2.0 software and the applications of these ideas within 21st Century life. The five post graduate music students each posed different needs in relation to the management of digitised artefacts and the communication of their work amongst peers, supervisors and public display. An ePortfolio was developed for each of them that was flexible enough to address their needs within the university setting. However in this first SoDaR iteration data gathering phase I identified aspects of the university context that presented a negative case that impacted upon the design and usage of the ePortfolios and prevented uptake. Whilst the portfolio itself functioned effectively, the university policies and technical requirements prevented serious use. The negative case analysis of the case study found revealed that Access and Control and Implementation, Technical and Policy Constraints protocols where limiting user uptake. From the semistructured interviews carried out as part of this study participant feedback revealed that whilst the participants did not use the ePortfolio system I designed, each student was employing Web 2.0 social networking and storage processes in their lives and research. In the subsequent iterations I then designed a more ‘ideal’ system that could be applied outside of the University context that draws upon the employment of these resources. In conclusion I suggest recommendations about ePortfolio design that considers what the applications of the theoretical protocols reveal about creative arts settings. The transferability of these recommendations are of course dependent upon the reapplication of the theoretical protocols in a new context. To address the mobility of ePortfolio design between Institutions and wider settings I have also designed a prototype for a business card sized USB portal for the artists’ ePortfolio. This research project is not a static one; it stands as an evolving design for a Web 2.0 ePortfolio that seeks to refer to users needs, institutional and professional contexts and the development of software that can be incorporated within the design. What it potentially provides to creative artist is an opportunity to have a dialogue about art with artefacts of the artist products and processes in that discussion.