Certified Registered Nurse Anesthetist Performance and Perceptions: Use of a Handheld, Computerized, Decision Making Aid During Critical Events in a High-fidelity Human Simulation Environment

With the increasing focus on patient safety and human error, understanding how practitioners make decisions during critical incidents is important. Despite the move towards evidence-based practice, research shows that much decision making is based on intuition and heuristics (“rules of thumb”). The purpose of this study was to examine and evaluate the methodologic feasibility of a strategy for comparing traditional cognition versus the use of algorithms programmed on a personal digital assistant (FDA) in the management of unanticipated critical events by certified registered nurse anesthetists (CRNAs). A combined qualitative-quantitative methodology was utilized. The quantitative element consists of a pilot study using a cross-over trial design. Two case scenarios were carried out in a full-scale, high fidelity, simulated anesthesia care delivery environment. Four subjects participated in both scenarios, one without and one with a PDA containing a catalog of approximately 30 events with diagnostic and treatment related information in second scenario. Audio—videotaping of the scenarios allowed for definitive descriptive analysis of items of interest, including time to correct diagnosis and definitive intervention. The qualitative approach consisted of a phenomenological investigation of problem solving and perceptions of FDA use and the simulation experience by the participants using “think aloud” and retrospective verbal reports, semi-structured group interviews, and written evaluations. Qualitative results revealed that participants found the PDA algorithms useful despite some minor technical difficulties and the simulated environment and case scenarios realistic, but also described feelings of expectation, anxiety, and pressure. Problem solving occurred in a hypothetico-deductive manner. More hypotheses were considered when using the PDA. Time to correct diagnosis and treatment varied by scenario, taking less time with the PDA for one but taking longer with the PDA for the other, likely due to differences in pace and intensity of the two scenarios. The methodologic investigation revealed several areas for improvement including more precise control of case scenarios. All participants agreed with the value of using high fidelity simulation, particularly for problem solving of critical events, and provided useful information for more effective utilization of this tool for education and research

Automating Content Extraction of HTML Documents

Web pages often contain clutter (such as unnecessary images and extraneous links) around the body of an article that distracts a user from actual content. Extraction of 'useful and relevant' content from web pages has many applications, including cell phone and PDA browsing, speech rendering for the visually impaired, and text summarization. Most approaches to making content more readable involve changing font size or removing HTML and data components such as images, which takes away from a webpage's inherent look and feel. Unlike 'Content Reformatting', which aims to reproduce the entire webpage in a more convenient form, our solution directly addresses 'Content Extraction'. We have developed a framework that employs an easily extensible set of techniques. It incorporates advantages of previous work on content extraction. Our key insight is to work with DOM trees, a W3C specified interface that allows programs to dynamically access document structure, rather than with raw HTML markup. We have implemented our approach in a publicly available Web proxy to extract content from HTML web pages. This proxy can be used both centrally, administered for groups of users, as well as by individuals for personal browsers. We have also, after receiving feedback from users about the proxy, created a revised version with improved performance and accessibility in mind

An information assistant system for the prevention of tunnel vision in crisis management

In the crisis management environment, tunnel vision is a set of bias in decision makers’ cognitive process which often leads to incorrect understanding of the real crisis situation, biased perception of information, and improper decisions. The tunnel vision phenomenon is a consequence of both the challenges in the task and the natural limitation in a human being’s cognitive process. An information assistant system is proposed with the purpose of preventing tunnel vision. The system serves as a platform for monitoring the on-going crisis event. All information goes through the system before arrives at the user. The system enhances the data quality, reduces the data quantity and presents the crisis information in a manner that prevents or repairs the user’s cognitive overload. While working with such a system, the users (crisis managers) are expected to be more likely to stay aware of the actual situation, stay open minded to possibilities, and make proper decisions

Personal mobile grids with a honeybee inspired resource scheduler

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The overall aim of the thesis has been to introduce Personal Mobile Grids (PMGrids) as a novel paradigm in grid computing that scales grid infrastructures to mobile devices and extends grid entities to individual personal users. In this thesis, architectural designs as well as simulation models for PM-Grids are developed. The core of any grid system is its resource scheduler. However, virtually all current conventional grid schedulers do not address the non-clairvoyant scheduling problem, where job information is not available before the end of execution. Therefore, this thesis proposes a honeybee inspired resource scheduling heuristic for PM-Grids (HoPe) incorporating a radical approach to grid resource scheduling to tackle this problem. A detailed design and implementation of HoPe with a decentralised self-management and adaptive policy are initiated. Among the other main contributions are a comprehensive taxonomy of grid systems as well as a detailed analysis of the honeybee colony and its nectar acquisition process (NAP), from the resource scheduling perspective, which have not been presented in any previous work, to the best of our knowledge. PM-Grid designs and HoPe implementation were evaluated thoroughly through a strictly controlled empirical evaluation framework with a well-established heuristic in high throughput computing, the opportunistic scheduling heuristic (OSH), as a benchmark algorithm. Comparisons with optimal values and worst bounds are conducted to gain a clear insight into HoPe behaviour, in terms of stability, throughput, turnaround time and speedup, under different running conditions of number of jobs and grid scales. Experimental results demonstrate the superiority of HoPe performance where it has successfully maintained optimum stability and throughput in more than 95% of the experiments, with HoPe achieving three times better than the OSH under extremely heavy loads. Regarding the turnaround time and speedup, HoPe has effectively achieved less than 50% of the turnaround time incurred by the OSH, while doubling its speedup in more than 60% of the experiments. These results indicate the potential of both PM-Grids and HoPe in realising futuristic grid visions. Therefore considering the deployment of PM-Grids in real life scenarios and the utilisation of HoPe in other parallel processing and high throughput computing systems are recommended

Effects of Decision Support Tools on Cardiac Telephone Consultation Process

The Nursing Coordinators (NCs) at the University of Ottawa Heart Institute (UOHI) fields phone calls from patients who have been discharged and are undergoing home care procedures at a daily basis. The project described in this thesis aims to provide tools for the Personal Digital Assistant (PDA) that the NCs can use during the phone calls. The Cognitive Work Analysis (CWA) and Ecological Interface Design (EID) approach are used to identify the information requirements to design the system. Major challenges of the telephone consultation process that are additionally identified by literature review and interviewing the NCs included visibility of patients, individual differences, and lack of standardized procedures. A combination of decision trees and visualization techniques is proposed to aid the process. Implementation of decision trees would help unload mental workload especially accesses to "knowledge in the head" as well as facilitate expert knowledge transfer to less experienced nurses. Visualization tools display integration of multiple-cues from patients in an abstract nature and can be accessed by users at any point of decision process. Preliminary experiment with static images showed that visualization tools helped the decision makers more when the judgement tasks were more complex. The effects of different types of decision support on the cardiac nurses in simulated telephone consultation processes were examined. The system improved the performance of the decision makers and induced different types of strategic behaviours: a standardized checklist, OLDCAR, induced more through assessment, the decision algorithms induced efficient and more detailed recommendation, and the semantic network symptom map induced information gathering more relevant to diagnosis. The research also explored methodologies to examine multi-layered decision process, where many decision makers with varying expertise are involved in modeling the strategic behaviours. This type of process can be applicable when the primary decision makers do not monitor the work domain, but can be alerted when something goes wrong

Ubiquitous Scalable Graphics: An End-to-End Framework using Wavelets

Advances in ubiquitous displays and wireless communications have fueled the emergence of exciting mobile graphics applications including 3D virtual product catalogs, 3D maps, security monitoring systems and mobile games. Current trends that use cameras to capture geometry, material reflectance and other graphics elements means that very high resolution inputs is accessible to render extremely photorealistic scenes. However, captured graphics content can be many gigabytes in size, and must be simplified before they can be used on small mobile devices, which have limited resources, such as memory, screen size and battery energy. Scaling and converting graphics content to a suitable rendering format involves running several software tools, and selecting the best resolution for target mobile device is often done by trial and error, which all takes time. Wireless errors can also affect transmitted content and aggressive compression is needed for low-bandwidth wireless networks. Most rendering algorithms are currently optimized for visual realism and speed, but are not resource or energy efficient on mobile device. This dissertation focuses on the improvement of rendering performance by reducing the impacts of these problems with UbiWave, an end-to-end Framework to enable real time mobile access to high resolution graphics using wavelets. The framework tackles the issues including simplification, transmission, and resource efficient rendering of graphics content on mobile device based on wavelets by utilizing 1) a Perceptual Error Metric (PoI) for automatically computing the best resolution of graphics content for a given mobile display to eliminate guesswork and save resources, 2) Unequal Error Protection (UEP) to improve the resilience to wireless errors, 3) an Energy-efficient Adaptive Real-time Rendering (EARR) heuristic to balance energy consumption, rendering speed and image quality and 4) an Energy-efficient Streaming Technique. The results facilitate a new class of mobile graphics application which can gracefully adapt the lowest acceptable rendering resolution to the wireless network conditions and the availability of resources and battery energy on mobile device adaptively

Freeform User Interfaces for Graphical Computing

報告番号: 甲15222 ; 学位授与年月日: 2000-03-29 ; 学位の種別: 課程博士 ; 学位の種類: 博士(工学) ; 学位記番号: 博工第4717号 ; 研究科・専攻: 工学系研究科情報工学専

Energy Awareness and Scheduling in Mobile Devices and High End Computing

In the context of the big picture as energy demands rise due to growing economies and growing populations, there will be greater emphasis on sustainable supply, conservation, and efficient usage of this vital resource. Even at a smaller level, the need for minimizing energy consumption continues to be compelling in embedded, mobile, and server systems such as handheld devices, robots, spaceships, laptops, cluster servers, sensors, etc. This is due to the direct impact of constrained energy sources such as battery size and weight, as well as cooling expenses in cluster-based systems to reduce heat dissipation. Energy management therefore plays a paramount role in not only hardware design but also in user-application, middleware and operating system design. At a higher level Datacenters are sprouting everywhere due to the exponential growth of Big Data in every aspect of human life, the buzz word these days is Cloud computing. This dissertation, focuses on techniques, specifically algorithmic ones to scale down energy needs whenever the system performance can be relaxed. We examine the significance and relevance of this research and develop a methodology to study this phenomenon. Specifically, the research will study energy-aware resource reservations algorithms to satisfy both performance needs and energy constraints. Many energy management schemes focus on a single resource that is dedicated to real-time or nonreal-time processing. Unfortunately, in many practical systems the combination of hard and soft real-time periodic tasks, a-periodic real-time tasks, interactive tasks and batch tasks must be supported. Each task may also require access to multiple resources. Therefore, this research will tackle the NP-hard problem of providing timely and simultaneous access to multiple resources by the use of practical abstractions and near optimal heuristics aided by cooperative scheduling. We provide an elegant EAS model which works across the spectrum which uses a run-profile based approach to scheduling. We apply this model to significant applications such as BLAT and Assembly of gene sequences in the Bioinformatics domain. We also provide a simulation for extending this model to cloud computing to answers “what if” scenario questions for consumers and operators of cloud resources to help answers questions of deadlines, single v/s distributed cluster use and impact analysis of energy-index and availability against revenue and ROI

An information presentation method based on tree-like super entity component

Information systems are increasingly oriented in the direction of large-scale integration due to the explosion of multi-source information. It is therefore important to discuss how to reasonably organize and present information from multiple structures and sources on the same information system platform. In this study, we propose a 3C (Components, Connections, Container) component model by combining white-box and black-box methods, design a tree-like super entity based on the model, present its construction and related algorithm, and take a tree-like super entity as the information organization method for multi-level entities. In order to represent structural, semi-structural and non-structural data on the same information system platform, an information presentation method based on an editable e-book component has been developed by combining the tree-like super entity component, QQ-style menu and 1/K switch connection component, which has been successfully applied in the Flood Protection Project Information System of the Yangtze River in China. © 2011 Elsevier Inc