The role of perceived usefulness and attitude on electronic health record acceptance : an empirical investigation using response surface analysis

Information and communications technologies are a significant component of the healthcare domain and electronic health records play a major role within it. As a result, it is important that they are accepted en masse by healthcare professionals. How healthcare professionals perceive the usefulness of electronic health records and their attitudes towards them have been shown to have significant effects on their overall acceptance. This paper investigates the role of perceived usefulness and attitude on the intention to use electronic health records by future healthcare professionals using polynomial regression with response surface analysis. Results show that the relationship is more complex than predicted in prior research. The paper concludes that the predicting properties of the above determinants must be further investigated to clearly understand their role in predicting the intention to use electronic health records and in designing systems that are better adopted by healthcare professionals of the future.

Investigation of megavoltage beams and detectors for electronic portal imaging

Accuracy of dose delivery in external beam radiotherapy is usually verified with electronic portal imaging (EPI) in which the treatment beam is used to check the positioning of the patient. However the resulting megavoltage x-ray images suffer from poor quality. The image quality can be improved by developing a special operating mode in the linear accelerator. The existing treatment beam is modified such that it produces enough low-energy photons for imaging. In this work the problem of optimizing the beam/detector combination to achieve optimal electronic portal image quality is addressed. The linac used for this study was modified to produce two experimental photon beams. These beams, named Al6 and Al10, were non-flat and were produced by 4MeV electrons hitting aluminum targets, 6 and 10mm thick respectively. The images produced by a conventional EPI system (6MV treatment beam and camera-based EPID with a Cu plate & Gd2O2S screen ) were compared with the images produced by the experimental beams and various screens with the same camera). The contrast of 0.8cm bone equivalent material in 5 cm water increased from 1.5% for the conventional system to 11% for the combination of Al6 beam with a 200mg/cm2 Gd2O2S screen. The signal-to-noise ratio calculated for 1cGy flood field images increased by about a factor of two for the same EPI systems. The spatial resolution of the two imaging systems was comparable. This work demonstrates that significant improvements in portal image contrast can be obtained by simultaneous optimization of the linac spectrum and EPI detector.

Verification of patient position and delivery of IMRT by electronic Portal Imaging

We have taken a new method of calibrating portal images of IMRT beams and used this to measure patient set-up accuracy and delivery errors, such as leaf errors and segment intensity errors during treatment. A calibration technique was used to remove the intensity modulations from the images leaving equivalent open field images that show patient anatomy that can be used for verification of the patient position. The images of the treatment beam can also be used to verify the delivery of the beam in terms of multileaf collimator leaf position and dosimetric errors. A series of controlled experiments delivering an IMRT anterior beam to the head and neck of a humanoid phantom were undertaken. A 2mm translation in the position of the phantom could be detected. With intentional introduction of delivery errors into the beam this method allowed us to detect leaf positioning errors of 2mm and variation in monitor units of 1%. The method was then applied to the case of a patient who received IMRT treatment to the larynx and cervical nodes. The anterior IMRT beam was imaged during four fractions and the images calibrated and investigated for the characteristic signs of patient position error and delivery error that were shown in the control experiments. No significant errors were seen. The method of imaging the IMRT beam and calibrating the images to remove the intensity modulations can be a useful tool in verifying both the patient position and the delivery of the beam.

Trends in nurse-administered procedural sedation and analgesia across cardiac catheterisation laboratories in Australia and New Zealand : results of an electronic survey

Background Knowledge of current trends in nurse-administered procedural sedation and analgesia (PSA) in the cardiac catheterisation laboratory (CCL) may provide important insights into how to improve safety and effectiveness of this practice. Objective To characterise current practice as well as education and competency standards regarding nurse-administered PSA in Australian and New Zealand CCLs. Design A quantitative, cross-sectional, descriptive survey design was used. Methods Data were collected using a web-based questionnaire on practice, educational standards and protocols related to nurse-administered PSA. Descriptive statistics were used to analyse data. Results A sample of 62 nurses, each from a different CCL, completed a questionnaire that focused on PSA practice. Over half of the estimated total number of CCLs in Australia and New Zealand was represented. Nurse-administered PSA was used in 94% (n = 58) of respondents CCLs. All respondents indicated that benzodiazepines, opioids or a combination of both is used for PSA (n = 58). One respondent indicated that propofol was also used. 20% (n = 12) indicated that deep sedation is purposefully induced for defibrillation threshold testing and cardioversion without a second medical practitioner present. Sedation monitoring practices vary considerably between institutions. 31% (n = 18) indicated that comprehensive education about PSA is provided. 45% (n = 26) indicated that nurses who administer PSA should undergo competency assessment. Conclusion By characterising nurse-administered PSA in Australian and New Zealand CCLs, a baseline for future studies has been established. Areas of particular importance to improve include protocols for patient monitoring and comprehensive PSA education for CCL nurses in Australia and New Zealand.

Contributing factors to optimal project portfolio selection

A modified Delphi approach has been applied in this study to investigate best practice and to determine the factors that contribute to optimal selection of projects. There are various standards and practices that some may recognise as representing best practice in this area. Many of these have similar characteristics and this study has found no single best practice. The study identified the factors that contribute to the optimal selection of projects as: culture, process, knowledge of the business, knowledge of the work, education, experience, governance, risk awareness, selection of players, preconceptions, and time pressures. All these factors were found to be significant; to be appropriate to public sector organisations, private sector organisations and government owned corporations; and to have a strong linkage to research on strategic decision making. These factors can be consolidated into two underlying factors of organisation culture and leadership.

Does board gender diversity have a financial impact? Evidence using stock portfolio performance.

There is growing regulatory pressure on firms worldwide to address the under-representation of women in senior positions. Regulators have taken a variety of approaches to the issue. We investigate a jurisdiction that has issued recommendations and disclosure requirements, rather than implementing quotas. Much of the rhetoric surrounding gender diversity centres on whether diversity has a financial impact. In this paper we take an aggregate (market-level) approach and compare the performance of portfolios of firms with gender diverse boards to those without. We also investigate whether having multiple women on the board is linked to performance, and if there is a within-industry effect. Overall, we do not find evidence of an association between diversity and performance. We find some weak evidence of a negative correlation between having multiple women on the board and performance, but that in some industries diversity is positively correlated with performance.

A class E resonant inverter for use as electronic fluorescent lamp ballast

Class E Resonant Inverters are theoretically capable of delivering any power to a load and achieve 100% efficiency at any frequency of operation. In practice efficiency in the “high 90's” can be achieved into megahertz frequencies regardless of inverter output powers. The topology also allows the manipulation of output power through sub-optimal operation, with a negligible efficiency penalty. The 24W inverter discussed in this paper was specifically designed to harness the benefits, and discuss the shortcomings, of the Class E topology for use in the growing market for portable, battery powered lighting. It exhibits a peak recorded power efficiently of over 98%, and a conservatively measured efficiency of 95% across a range of dimming settings.

Creative entrepreneurship education for graduate employability in the creative arts

The higher education sector in Australia is under increasing pressure to prove quality and efficacy of education provision, including graduate outcomes. One of the central tasks of higher education has become to prepare nascent professionals as far as possible for initial employment and future working lives beyond this (Boden & Nedeva, 2010). Tertiary educators in the creative arts face significant and distinctive challenges in demonstrating graduate employability, and creative graduates consistently have the poorest outcomes of any subject grouping. In part, this is because the national graduate destinations survey (Graduate Careers Council of Australia, 2012) does not cater to the distinctive ‘portfolio’ nature of creative careers, or take account of the fact that creative careers can take concerted effort over several years to establish (e.g., McCowan & Wyganowska, 2010). However, it is worth asking whether we as tertiary arts educators are doing enough to prepare creative arts students for the world of work, particularly given that the majority of them will be self-employed to some degree (Bureau of Labour Statistics, 2011, Throsby & Zednik, 2010), and will be challenged to build their own careers without recourse to the support of HR departments or intra-firm promotion schemes. It has been demonstrated empirically that career management and creative enterprise skills are among the most important graduate capabilities in determining early creative career success (Bridgstock, 2011), although these skills do not appear in the Learning and Teaching Academic Standards for the Creative and Performing Arts (2010). This paper explores the nature and development of enterprise capabilities for creative arts students (as distinct from students of the business school), examines best practice in the field internationally, and proposes a theoretically-driven creative arts-specific enterprise curriculum model which commences in first year, for demonstrable impact on student enterprise behaviours (such as grant seeking, professional networking and intention to start an enterprise) and employability.

Privacy oriented access control for electronic health records

Information privacy is a critical success/failure factor in information technology supported healthcare (eHealth). eHealth systems utilise electronic health records (EHR) as the main source of information, thus, implementing appropriate privacy preserving methods for EHRs is vital for the proliferation of eHealth. Whilst information privacy may be a fundamental requirement for eHealth consumers, healthcare professionals demand non-restricted access to patient information for improved healthcare delivery, thus, creating an environment where stakeholder requirements are contradictory. Therefore, there is a need to achieve an appropriate balance of requirements in order to build successful eHealth systems. Towards achieving this balance, a new genre of eHealth systems called Accountable-eHealth (AeH) systems has been proposed. In this paper, an access control model for EHRs is presented that can be utilised by AeH systems to create information usage policies that fulfil both stakeholders’ requirements. These policies are used to accomplish the aforementioned balance of requirements creating a satisfactory eHealth environment for all stakeholders. The access control model is validated using a Web based prototype as a proof of concept.

Voltammetric monitoring of gold nanoparticle formation facilitated by glycyl-L-tyrosine : relation to electronic spectra and transmission electron microscopy images

Voltammetric techniques have been introduced to monitor the formation of gold nanoparticles produced via the reaction of the amino acid glycyl-L-tyrosine with Au(III) (bromoaurate) in 0.05 M KOH conditions. The alkaline conditions facilitate amino acid binding to Au(III), inhibit the rate of reduction to Au(0), and provide an excellent supporting electrolyte for voltammetric studies. Data obtained revealed that a range of time-dependent gold solution species are involved in gold nanoparticle formation and that the order in which reagents are mixed is critical to the outcome. Concomitantly with voltammetric measurements, the properties of gold nanoparticles formed are probed by examination of electronic spectra in order to understand how the solution environment present during nanoparticle growth affects the final distribution of the nanoparticles. Images obtained by the ex situ transmission electron microscopy (TEM) technique enable the physical properties of the nanoparticles isolated in the solid state to be assessed. Use of this combination of in situ and ex situ techniques provides a versatile framework for elucidating the details of nanoparticle formation.

Gambling revenues as a public administration issue : electronic gaming machines in Victoria

Gambling activities and the revenues derived have been seen as a way to increase economic development in deprived areas. There are also, however, concerns about the effects of gambling in general and electronic gaming machines (EGMs) in particular, on the resources available to the localities in which they are situated. This paper focuses on the factors that determine the extent and spending of community benefit-related EGM-generated resources within Victoria, Australia, focusing in particular on the relationships between EGM activity and socio-economic and social capital indicators, and how this relates to the community benefit resources generated by gaming.

Volatility timing : how best to forecast portfolio exposures

This paper investigates how best to forecast optimal portfolio weights in the context of a volatility timing strategy. It measures the economic value of a number of methods for forming optimal portfolios on the basis of realized volatility. These include the traditional econometric approach of forming portfolios from forecasts of the covariance matrix, and a novel method, where a time series of optimal portfolio weights are constructed from observed realized volatility and directly forecast. The approach proposed here of directly forecasting portfolio weights shows a great deal of merit. Resulting portfolios are of equivalent economic benefit to a number of competing approaches and are more stable across time. These findings have obvious implications for the manner in which volatility timing is undertaken in a portfolio allocation context.