A dynamic real time scheduling methodology for the emergency department

This project constructs a scheduling solution for the Emergency Department. The schedules are generated in real-time to adapt to new patient arrivals and changing conditions. An integrated scheduling formulation assigns patients to beds and treatment tasks to resources. The schedule efficiency is assessed using waiting time and total care time experienced by patients. The solution algorithm incorporates dispatch rules, meta-heuristics and a new extended disjunctive graph formulation which provide high quality solutions in a fast time-frame for real time decision support. This algorithm can be implemented in an electronic patient management system to improve patient flow in the Emergency Department.

Mandatory reporting laws: Their origin, nature, and development over time

Dozens of countries have enacted mandatory reporting laws in various forms to respond to child abuse and neglect. Other countries including England are currently considering whether to introduce them, and if so in what form. It is important for policymakers, practitioners and researchers to understand these laws’ background, nature and purpose. This chapter outlines the origins and provenance of the first mandatory reporting laws; discusses their nature; describes major developments over time; and identifies some major effects and their consequences. It is shown that the laws are a heterogeneous, organic, flexible mechanism enabling social intervention where otherwise such intervention is severely compromised or impossible. Their primary function is to comprise but one aspect of a multifaceted child welfare system by identifying cases of serious maltreatment which would not otherwise come to light: sexual abuse and severe physical abuse are paradigm examples. The essential role of these laws is therefore primarily a tertiary aspect of a public health model, rather than a purely preventative strategy. Mandatory reporting laws are made by each specific jurisdiction according to its preferred design and function within its socio-political system. There is a spectrum of different approaches from which a jurisdiction can choose: they can apply to a broad or a narrow range of reporter groups, a broad or a narrow range of types of maltreatment, and a broad or a narrow range of instances where abuse or neglect occurs.

Assessing acculturation over time: A four-year prospective study of Asian American young adults

Acculturation is commonly defined as a dynamic and multidimensional process in which individuals and groups change over time when coming into contact with another culture. Despite the emphasis on acculturation as a process of change over time, few researchers have directly assessed this hypothesis. The current study first identifies and then examines "stable" and "dynamic" dimensions of acculturation within a 4-year prospective study of 433 first- and second-generation Chinese- and Korean-American college students. Separate growth model analyses revealed significant linear change for first-generation students toward greater U.S. acculturation. In comparison, tests of linear and quadratic change for second-generation students were not significant. When stratifying by gender, acculturation increased for women but there was no significant change in acculturation for men. While all students reported increases in alcohol consumption over the study period, changes in acculturation predicted changes in alcohol consumption only for women. Chinese men showed greater increases in alcohol consumption than Korean men but there was no effect for ethnicity among women. There was significant individual variability in the models, which underscores the importance of examining change prospectively through within and between person analyses. The findings highlight the importance of examining acculturation changes over time for different migrant groups with implications for further development of acculturation measures, research methodologies, and health interventions. More prospective research designs of acculturation are needed to examine changes in health behavior and overall adaptation across migrant groups at varying stages of development.

Assessment of antenna characteristic effects on pedestrian and cyclists travel-time estimation based on Bluetooth and WiFi MAC addresses

Monitoring pedestrian and cyclists movement is an important area of research in transport, crowd safety, urban design and human behaviour assessment areas. Media Access Control (MAC) address data has been recently used as potential information for extracting features from people’s movement. MAC addresses are unique identifiers of WiFi and Bluetooth wireless technologies in smart electronics devices such as mobile phones, laptops and tablets. The unique number of each WiFi and Bluetooth MAC address can be captured and stored by MAC address scanners. MAC addresses data in fact allows for unannounced, non-participatory, and tracking of people. The use of MAC data for tracking people has been focused recently for applying in mass events, shopping centres, airports, train stations etc. In terms of travel time estimation, setting up a scanner with a big value of antenna’s gain is usually recommended for highways and main roads to track vehicle’s movements, whereas big gains can have some drawbacks in case of pedestrian and cyclists. Pedestrian and cyclists mainly move in built distinctions and city pathways where there is significant noises from other fixed WiFi and Bluetooth. Big antenna’s gains will cover wide areas that results in scanning more samples from pedestrians and cyclists’ MAC device. However, anomalies (such fixed devices) may be captured that increase the complexity and processing time of data analysis. On the other hand, small gain antennas will have lesser anomalies in the data but at the cost of lower overall sample size of pedestrian and cyclist’s data. This paper studies the effect of antenna characteristics on MAC address data in terms of travel-time estimation for pedestrians and cyclists. The results of the empirical case study compare the effects of small and big antenna gains in order to suggest optimal set up for increasing the accuracy of pedestrians and cyclists’ travel-time estimation.

Real time maximum power conversion tracking and resonant frequency modification for high power piezoelectric ultrasound transducer

Piezoelectric ultrasound transducers are commonly used to convert mechanical energy to electrical energy and vice versa. The transducer performance is highly affected by the frequency at which it is excited. If excitation frequency and main resonant frequency match, transducers can deliver maximum power. However, the problem is that main resonant frequency changes in real time operation resulting in low power conversion. To achieve the maximum possible power conversion, the transducer should be excited at its resonant frequency estimated in real time. This paper proposes a method to first estimate the resonant frequency of the transducer and then tunes the excitation frequency accordingly in real time. The measurement showed a significant difference between the offline and real time resonant frequencies. Also, it was shown that the maximum power was achieved at the resonant frequency estimated in real time compare to the one measured offline.

Race against time: The export of essential medicines to Rwanda

This article considers the significance of the first export of essential medicines under the WTO General Council Decision 2003. In July 2007, Rwanda became the first country to provide a notification under the WTO General Council Decision 2003 of its intent to import a fixed-dose, triple combination HIV/AIDS drug manufactured by the Canadian generic pharmaceuticalmanufacturer Apotex, Inc. In September 2007, Apotex was granted the first compulsory licence application under Canada's Access to Medicines Regime. This article considers the convoluted and protracted negotiations between the Government of Rwanda, Apotex and three patent holders, GlaxoSmithKline, Boehringer Ingleheim Canada and Shire BioChemical, Inc. It questions the efficiency of this process. This article considers the review of the Jean Chretien Pledge to Africa Act 2004 (Canada). It is critical of the refusal of the Conservative Government of Canada to make any amendments to the legislation to improve the cost-effective delivery of essential medicines. This article queries the proposed Hong Kong Amendment to the TRIPS Agreement 1994, given the concerns of the Africa Group. It is submitted that it is undesirable to codify the WTO General Council Decision 2003, given its failure to provide a speedy, efficient and cost-effective delivery of essential medicines.

Translating road safety research on night-time visibility to the context of mining

In recent years a significant amount of research has been undertaken in collision avoidance and personnel location technology in order to reduce the number of incidents involving pedestrians and mobile plant equipment which are a high risk in underground coal mines. Improving the visibility of pedestrians to drivers would potentially reduce the likelihood of these incidents. In the road safety context, a variety of approaches have been used to make pedestrians more conspicuous to drivers at night (including vehicle and roadway lighting technologies and night vision enhancement systems). However, emerging research from our group and others has demonstrated that clothing incorporating retroreflective markers on the movable joints as well as the torso can provide highly significant improvements in pedestrian visibility in reduced illumination. Importantly, retroreflective markers are most effective when positioned on the moveable joints creating a sensation of “biological motion”. Based only on the motion of points on the moveable joints of an otherwise invisible body, observers can quickly recognize a walking human form, and even correctly judge characteristics such as gender and weight. An important and as yet unexplored question is whether the benefits of these retroreflective clothing configurations translate to the context of mining where workers are operating under low light conditions. Given that the benefits of biomotion clothing are effective for both young and older drivers, as well as those with various eye conditions common in those >50 years reinforces their potential application in the mining industry which employs many workers in this age bracket. This paper will summarise the visibility benefits of retroreflective markers in a biomotion configuration for the mining industry, highlighting that this form of clothing has the potential to be an affordable and convenient way to provide a sizeable safety benefit. It does not involve modifications to vehicles, drivers, or infrastructure. Instead, adding biomotion markings to standard retroreflective vests can enhance the night-time conspicuity of mining workers by capitalising on perceptual capabilities that have already been well documented.

Energy based time equivalent approach to determine the fire resistance ratings of light gauge steel frame walls exposed to realistic design fire curves

Structural fire safety has become one of the key considerations in the design and maintenance of the built infrastructure. Conventionally the fire resistance rating of load bearing Light gauge Steel Frame (LSF) walls is determined based on the standard time-temperature curve given in ISO 834. Recent research has shown that the true fire resistance of building elements exposed to building fires can be less than their fire resistance ratings determined based on standard fire tests. It is questionable whether the standard time-temperature curve truly represents the fuel loads in modern buildings. Therefore an equivalent fire severity approach has been used in the past to obtain fire resistance rating. This is based on the performance of a structural member exposed to a realistic design fire curve in comparison to that of standard fire time-temperature curve. This paper presents the details of research undertaken to develop an energy based time equivalent approach to obtain the fire resistance ratings of LSF walls exposed to realistic design fire curves with respect to standard fire exposure. This approach relates to the amount of energy transferred to the member. The proposed method was used to predict the fire resistance ratings of single and double layer plasterboard lined and externally insulated LSF walls. The predicted fire ratings were compared with the results from finite element analyses and fire design rules for three different wall configurations exposed to both rapid and prolonged fires. The comparison shows that the proposed energy method can be used to obtain the fire resistance ratings of LSF walls in the case of prolonged fires.

Ethical leadership in a time of increasing accountability

Australia, like many other countries, has embraced national testing as part of wider reforms and increased accountability in schooling. Results for standardised testing programs, such as NAPLAN, are widely published yet form only one part of accountability for educators. We argue that accountability also has moral, ethical and professional dimensions. In this paper we offer a discussion of background to our study of ethical leadership in a time of data driven or contractual accountability. Based on Starratt’s (1996) model, we define ethical leadership as a social, relational practice concerned with the moral purpose of education (Angus, 2006). Our central thesis is that given increasing accountabilities, school leaders need to consider approaches to ethical leadership to improve quality and equity in education and achieve equitable outcomes for all students. The paper concludes with key implications for school leaders.

The role of time pressure and different psychological safety climate referents in the prediction of nurses’ hand hygiene compliance

In this study of 638 Australian nurses, compliance to hand hygiene (HH), as defined by the “five moments” recommended by the World Health Organisation (2009), was examined. Hypotheses focused on the extent to which time pressure reduces compliance and safety climate (operationalised in relation to HH using colleagues, manager, and hospital as referents) increases compliance. It also was proposed that HH climate would interact with time pressure, such that the negative effects of time pressure would be less marked when HH climate is high. The extent to which the three HH climate variables would interact among each other, either in the form of boosting or compensatory effects, was tested in an exploratory manner. A prospective research design was used in which time pressure and the HH climate variables were assessed at Time 1 and compliance was assessed by self-report two weeks later. Compliance was high but varied significantly across the 5 HH Moments, suggesting that nurses make distinctions between inherent and elective HH and also seemed to engage in some implicit rationing of HH. Time pressure dominated the utility of HH climate to have its positive impact on compliance. The most conducive workplace for compliance was one low in time pressure and high in HH climate. Colleagues were very influential in determining compliance, more so than the manager and hospital. Manager and hospital support for HH enhanced the positive effects of colleagues on compliance. Providing training and enhancing knowledge was important, not just for compliance, but for safety climate.

Time and cost performance of design–build projects

The design-build (DB) delivery method has been widely used in the United States due to its reputed superior cost and time performance. However, rigorous studies have produced inconclusive support and only in terms of overall results, with few attempts being made to relate project characteristics with performance levels. This paper provides a larger and more finely grained analysis of a set of 418 DB projects from the online project database of the Design-Build Institute of America (DBIA), in terms of the time-overrun rate (TOR), early start rate (ESR), early completion rate (ECR) and cost overrun rate (COR) associated with project type (e.g., commercial/institutional buildings and civil infrastructure projects), owners (e.g., Department of Defense and private corporations), procurement methods (e.g., ‘best value with discussion’ and qualifications-based selection), contract methods (e.g., lump sum and GMP) and LEED levels (e.g., gold and silver). The results show ‘best value with discussion’ to be the dominant procurement method and lump sum the most frequently used contract method. The DB method provides relatively good time performance, with more than 75% of DB projects completed on time or before schedule. However, with more than 50% of DB projects cost overrunning, the DB advantage of cost saving remains uncertain. ANOVA tests indicate that DB projects within different procurement methods have significantly different time performance and that different owner types and contract methods significantly affect cost performance. In addition to contributing to empirical knowledge concerning the cost and time performance of DB projects with new solid evidence from a large sample size, the findings and practical implications of this study are beneficial to owners in understanding the likely schedule and budget implications involved for their particular project characteristics.

Channel selection in the short-time modulation domain for distant speech recognition

Automatic speech recognition from multiple distant micro- phones poses significant challenges because of noise and reverberations. The quality of speech acquisition may vary between microphones because of movements of speakers and channel distortions. This paper proposes a channel selection approach for selecting reliable channels based on selection criterion operating in the short-term modulation spectrum domain. The proposed approach quantifies the relative strength of speech from each microphone and speech obtained from beamforming modulations. The new technique is compared experimentally in the real reverb conditions in terms of perceptual evaluation of speech quality (PESQ) measures and word error rate (WER). Overall improvement in recognition rate is observed using delay-sum and superdirective beamformers compared to the case when the channel is selected randomly using circular microphone arrays.

Low delta18O zircon grains in the Neoarchean Rum Jungle Complex, northern Australia: An indicator of emergent continental crust

The timing of widespread continental emergence is generally considered to have had a dramatic effect on the hydrological cycle, atmospheric conditions, and climate. New secondary ion mass spectrometry (SIMS) oxygen and laser-ablation–multicollector–inductively coupled plasma–mass spectrometry (LA-MC-ICP-MS) Lu-Hf isotopic results from dated zircon grains in the granitic Neoarchean Rum Jungle Complex provide a minimum time constraint on the emergence of continental crust above sea level for the North Australian craton. A 2535 ± 7 Ma monzogranite is characterized by magmatic zircon with slightly elevated δ18O (6.0‰–7.5‰ relative to Vienna standard mean ocean water [VSMOW]), consistent with some contribution to the magma from reworked supracrustal material. A supracrustal contribution to magma genesis is supported by the presence of metasedimentary rock enclaves, a large population of inherited zircon grains, and subchondritic zircon Hf (εHf = −6.6 to −4.1). A separate, distinct crustal source to the same magma is indicated by inherited zircon grains that are dominated by low δ18O values (2.5‰–4.8‰, n = 9 of 15) across a range of ages (3536–2598 Ma; εHf = −18.2 to +0.4). The low δ18O grains may be the product of one of two processes: (1) grain-scale diffusion of oxygen in zircon by exchange with a low δ18O magma or (2) several episodes of magmatic reworking of a Mesoarchean or older low δ18O source. Both scenarios require shallow crustal magmatism in emergent crust, to allow interaction with rocks altered by hydrothermal meteoric water in order to generate the low δ18O zircon. In the first scenario, assimilation of these altered rocks during Neoarchean magmatism generated low δ18O magma with which residual detrital zircons were able to exchange oxygen, while preserving their U-Pb systematics. In the second scenario, wholesale melting of the altered rocks occurred in several distinct events through the Mesoarchean, generating low δ18O magma from which zircon crystallized. Ultimately, in either scenario, the low δ18O zircons were entrained as inherited grains in a Neoarchean granite. The data suggest operation of a modern hydrological cycle by the Neoarchean and add to evidence for the increased emergence of continents by this time

Determination of dimethyl sulfide in gas samples by single photon ionization time of flight mass spectrometry

It is difficult to determine sulfur-containing volatile organic compounds in the atmosphere because of their reactivity. Primary off-line techniques may suffer losses of analytes during the transportation from field to laboratory and sample preparation. In this study, a novel method was developed to directly measure dimethyl sulfide at parts-per-billion concentration levels in the atmosphere using vacuum ultraviolet single photon ionization time-of-flight mass spectrometry. This technique offers continuous sampling at a response rate of one measurement per second, or cumulative measurements over longer time periods. Laboratory prepared samples of different concentrations of dimethyl sulfide in pure nitrogen gas were analyzed at several sampling frequencies. Good precision was achieved using sampling periods of at least 60 seconds with a relative standard deviation of less than 25%. The detection limit for dimethyl sulfide was below the 3 ppb olfactory threshold. These results demonstrate that single photon ionization time-of-flight mass spectrometry is a valuable tool for rapid, real-time measurements of sulfur-containing organic compounds in the air.

Dynamic, invivo, real-time detection of retinal oxidative status in a model of elevated intraocular pressure using a novel, reversibly responsive, profluorescent nitroxide probe

Changes to the redox status of biological systems have been implicated in the pathogenesis of a wide variety of disorders including cancer, Ischemia-reperfusion (I/R) injury and neurodegeneration. In times of metabolic stress e.g. ischaemia/reperfusion, reactive oxygen species (ROS) production overwhelms the intrinsic antioxidant capacity of the cell, damaging vital cellular components. The ability to quantify ROS changes in vivo, is therefore essential to understanding their biological role. Here we evaluate the suitability of a novel reversible profluorescent probe containing a redox-sensitive nitroxide moiety (methyl ester tetraethylrhodamine nitroxide, ME-TRN), as an in vivo, real-time reporter of retinal oxidative status. The reversible nature of the probe's response offers the unique advantage of being able to monitor redox changes in both oxidizing and reducing directions in real time. After intravitreal administration of the ME-TRN probe, we induced ROS production in rat retina using an established model of complete, acute retinal ischaemia followed by reperfusion. After restoration of blood flow, retinas were imaged using a Micron III rodent fundus fluorescence imaging system, to quantify the redox-response of the probe. Fluorescent intensity declined during the first 60 min of reperfusion. The ROS-induced change in probe fluorescence was ameliorated with the retinal antioxidant, lutein. Fluorescence intensity in non-Ischemia eyes did not change significantly. This new probe and imaging technology provide a reversible and real-time response to oxidative changes and may allow the in vivo testing of antioxidant therapies of potential benefit to a range of diseases linked to oxidative stress