Tracking the patient journey by combining multiple hospital database systems

With new national targets for patient flow in public hospitals designed to increase efficiencies in patient care and resource use, better knowledge of events affecting length of stay will support improved bed management and scheduling of procedures. This paper presents a case study involving the integration of material from each of three databases in operation at one tertiary hospital and demonstrates it is possible to follow patient journeys from admission to discharge. What is known about this topic? At present, patient data at one Queensland tertiary hospital are assembled in three information systems: (1) the Hospital Based Corporate Information System (HBCIS), which tracks patients from in-patient admission to discharge; (2) the Emergency Department Information System (EDIS) containing patient data from presentation to departure from the emergency department; and (3) Operation Room Management Information System (ORMIS), which records surgical operations. What does this paper add? This paper describes how a new enquiry tool may be used to link the three hospital information systems for studying the hospital journey through different wards and/or operating theatres for both individual and groups of patients. What are the implications for practitioners? An understanding of the patients’ journeys provides better insight into patient flow and provides the tool for research relating to access block, as well as optimising the use of physical and human resources.

A stochastic exponential Euler scheme for simulation of stiff biochemical reaction systems

In order to simulate stiff biochemical reaction systems, an explicit exponential Euler scheme is derived for multidimensional, non-commutative stochastic differential equations with a semilinear drift term. The scheme is of strong order one half and A-stable in mean square. The combination with this and the projection method shows good performance in numerical experiments dealing with an alternative formulation of the chemical Langevin equation for a human ether a-go-go related gene ion channel mode

A clinical audit to compare peritonitis rates between peritoneal dialysis delivery systems

Peritonitis is a major problem for patients with end-stage kidney disease undergoing peritoneal dialysis (PD). It is the main cause of failure of PD. Two different PD delivery systems are used across Australia although there is inconsistent evidence comparing the systems. The aim of this retrospective audit is to compare the rates and risk of peritonitis in a cohort of incident patients using two PD delivery systems. All consecutive patients starting PD between 1 August 2010 and 31 March 2012 were included and followed until 30 June 2013. Data relating to accepted risk factors for peritonitis were collected and analysed. There were 50 patients (26 men; 24 women) aged between 30 and 87 years. There were 29 episodes of peritonitis in 17 patients. Rates of peritonitis were 1 episode per 69.19 patient-months compared with 1 episode per 18.67 patient-months. Mean times to first episode of peritonitis were 13.11 months compared to 7.13 months. The relative risk of PD-related peritonitis was twice as high (RR = 2.04, 95% CI = 0.85 to 4.94) for patients using the one system (44.4%) compared to a second system (21.7%). Since this is not a randomised trial no firm conclusions can be drawn. Centres should also monitor peritonitis rates for each system.

Condition monitoring and rating of bridge components in a rail or road network by using SHM systems within SRP

The safety and performance of bridges could be monitored and evaluated by Structural Health Monitoring (SHM) systems. These systems try to identify and locate the damages in a structure and estimate their severities. Current SHM systems are applied to a single bridge, and they have not been used to monitor the structural condition of a network of bridges. This paper propose a new method which will be used in Synthetic Rating Procedures (SRP) developed by the authors of this paper and utilizes SHM systems for monitoring and evaluating the condition of a network of bridges. Synthetic rating procedures are used to assess the condition of a network of bridges and identify their ratings. As an additional part of the SRP, the method proposed in this paper can continuously monitor the behaviour of a network of bridges and therefore it can assist to prevent the sudden collapses of bridges or the disruptions to their serviceability. The method could be an important part of a bridge management system (BMS) for managers and engineers who work on condition assessment of a network of bridges.

Pumping systems: Design and energy efficiency

Pumping systems are widely used in many applications, including municipal water/wastewater services, domestic, commercial and agricultural services, and industrial processes. They are a very significant energy user and consume nearly 20% of the world’s electrical energy demand. Therefore, improving the energy efficiency of pumping systems can provide great benefits in terms of energy, environment, and cost reduction. In this entry, an overview of pump classification with pros and cons of each type of pump is presented. The procedures used to design pumping systems are also outlined. This is then followed by a discussion on the opportunities for improving the energy efficiency of pumping systems during every stage of design, selection, operation, and maintenance.

Integrating LED lighting design strategies with side daylighting systems to improve interior lighting design of office buildings

A high contrast ratio between windows and surrounding walls may lead to office workers visual discomfort that could negatively affect their satisfaction and productivity. Consequently, occupants may try to adapt their working environment by closing blinds and/ or turning on the lights to enhance indoor visual comfort, which can reduce predicted energy savings. The hypothesis of this study is that reducing luminance contrast ratio on the window wall will improve window appearance which potentially will reduce visual discomfort and decrease workers interventions. Thus, this PhD research proposes a simple strategy to diminish the luminance contrast on the window wall by increasing the luminance of the areas surrounding the windows using supplementary light emitting diode (LED) systems. To test the hypothesis, this investigation will involve three experiments in different office layouts with various window types and orientations in Brisbane, Australia. It will assess user preferences for different luminance patterns in windowed offices featuring flexible, lowpower LED lighting installations that allows multiple lighting design options on the window wall. Detailed luminance and illuminance measures will be used to match quantitative lighting design assessment to user preferences.

ELISA: An Estimated Load Information Scheduling Algorithm for Distributed Computing Systems

In this paper, we present a decentralized dynamic load scheduling/balancing algorithm called ELISA (Estimated Load Information Scheduling Algorithm) for general purpose distributed computing systems. ELISA uses estimated state information based upon periodic exchange of exact state information between neighbouring nodes to perform load scheduling. The primary objective of the algorithm is to cut down on the communication and load transfer overheads by minimizing the frequency of status exchange and by restricting the load transfer and status exchange within the buddy set of a processor. It is shown that the resulting algorithm performs almost as well as a perfect information algorithm and is superior to other load balancing schemes based on the random sharing and Ni-Hwang algorithms. A sensitivity analysis to study the effect of various design parameters on the effectiveness of load balancing is also carried out. Finally, the algorithm's performance is tested on large dimensional hypercubes in the presence of time-varying load arrival process and is shown to perform well in comparison to other algorithms. This makes ELISA a viable and implementable load balancing algorithm for use in general purpose distributed computing systems.

Energetics of rare earth manganese perovskites A1-xA ' xMnO3 (A = La, Nd, Y and A ' = Sr, La) systems

High temperature reaction calorimetry using molten lead berate as solvent has been used to study the thermochemistry of NdMnO3, YMnO3, La1-xSrxMnO3 (with 0 < x < 0.5), and Ln(0.5)Ca(0.5)MnO(3) (with Ln = La, Nd, Y), The enthalpies of formation of these multicomponent oxides from their binary constituents have been calculated from the measured enthalpy of drop solution, The energetic stability of the perovskite depends on the size of the A cation, The enthalpy of formation of YMnO3 (smallest A cation) is more endothermic than those of NdMnO3 and LaMnO3. The energetics of the perovskite also depends on the oxidation state of the B site's ions. In the La1-xSrxMnO3 system, the energetic stability of the structure increases with the Mn4+/Mn3+ ratio, The new values of the enthalpies of oxidations, with reliable standard entropies, were used to plot the phase stability diagram of the lanthanum-manganese-oxygen system in the temperature range 300-1100 K, The LaMnO3/MnO phase boundary evaluated in this study agrees with the one published by Atsumi et nl. calculated from thermogravimetric and conductivity measurements.

Spin populations in one-dimensional alternant spin systems: A theoretical approach

Spin-density maps, deduced from polarized neutron diffraction experiments, for both the pair and chain compounds of the system Mn2+Cu2+ have been reported recently. These results have motivated us to investigate theoretically the spin populations in such alternant mixed-spin systems. In this paper, we report our studies on the one-dimensional ferrimagnetic systems (S-A,S-B)(N) where hi is the number of AB pairs. We have considered all cases in which the spin Sri takes on allowed values in the range I to 7/2 while the spin S-B is held fixed at 1/2. The theoretical studies have been carried out on the isotropic Heisenberg model, using the density matrix renormalization group method. The effect of the magnitude of the larger spin SA On the quantum fluctuations in both A and B sublattices has been studied as a function of the system size N. We have investigated systems with both periodic and open boundary conditions, the latter with a view to understanding end-of-chain effects. The spin populations have been followed as a function of temperature as well as an applied magnetic field. High-magnetic fields are found to lead to interesting re-entrant behavior. The ratio of spin populations P-A-P-B is not sensitive to temperature at low temperatures.

Agile innovation: Innovating with enterprise systems

The contemporary organisations are presented with an eclectic collection of technologies that has dramatically shifted the process of innovation. This thesis investigates the nature and the process of attaining innovation through the modern IT portfolio. A qualitative study of nine organizations was conducted. The results identified that the modern IT portfolio innovates through a new innovation process called 'agile innovation,' which differs from the existing innovation types.

Giant Magnetoresistance and Related Properties of Rare Earth Manganates and Other Oxide Systems

Giant magnetoresistance (GMR), which was until recently confined to magnetic layered and granular materials, as well as doped magnetic semiconductors, occurs in manganate perovskites of the general formula Ln(1-x)A(x)MnO(3) (Ln = rare earth; A = divalent ion). These manganates are ferromagnetic at or above a certain value of x (or Mn4+ content) and become metallic at temperatures below the curie temperature, T-c. GMR is generally a maximum close to T-c or the insulator-metal (I-M) transition temperature, T-im. The T-c and %MR are markedly affected by the size of the A site cation, [r(A)], thereby affording a useful electronic phase diagram when T-c or T-im is plotted against [r(A)]. We discuss GMR and related properties of manganates in polycrystalline, thin-film, and single-crystal forms and point out certain commonalities and correlations. We also examine some unusual features in the electron-transport properties of manganates, in particular charge-ordering effects. Charge ordering is crucially dependent on [r(A)] or the e(g) band width, and the charge-ordered insulating state transforms to a metallic ferromagnetic state on the application of a magnetic field.

Leveraging of software as a service by small and medium enterprises: Information systems capabilities and organisational complementarities

This research explored how small and medium enterprises can achieve success with software as a service (SaaS) applications from cloud. Based upon an empirical investigation of six growth oriented and early technology adopting small and medium enterprises, this study proposes a SaaS for small and medium enterprise success model with two approaches: one for basic and one for advanced benefits. The basic model explains the effective use of SaaS for achieving informational and transactional benefits. The advanced model explains the enhanced use of software as a service for achieving strategic and transformational benefits. Both models explicate the information systems capabilities and organizational complementarities needed for achieving success with SaaS.

Achieving meaningful use of eHealth through Accountable-eHealth (AeH) systems

Meaningful use of eHealth, as seen through four key lenses: Usability; Usefulness; Utility; and Safety, is achieved through Accountable-eHealth systems.

Empowering the consumer through Accountable-eHealth (AeH) systems

Allowing consumers to designate preferred healthcare professionals; Accountable-eHealth systems create a transparent and accountable eHealth environment for better healthcare delivery.

Thermopower and nature of the hole-doped states in LaMnO3 and related systems showing giant magnetoresistance

We have measured the thermopower (S) of hole-doped LaMnO3 systems in order to see its dependence on the Mn4+ content as well as to investigate other crucial factors that determine S. We have carried out hole doping (creation of Mn4+ by two distinct means, namely, by the substitution of La by divalent cations such as Ca and Sr and by self-doping without aliovalent substitution). The thermopower is sensitive not only to the hole concentration but also to the process employed for hole doping, which we explain as arising from the differences in the nature of the hole-doped states. We also point out a general trend in the dependence of S on hole concentration at high temperatures (T> T-c), similar to that found in the normal-state thermopower of the cuprates.