Ubiquitous Computing for Remote Cardiac Patient Monitoring: A Survey

New wireless technologies, such as wireless LAN and sensor networks, for telecardiology purposes give new possibilities for monitoring vital parameters with wearable biomedical sensors, and give patients the freedom to be mobile and still be under continuous monitoring and thereby better quality of patient care. This paper will detail the architecture and quality-of-service (QoS) characteristics in integrated wireless telecardiology platforms. It will also discuss the current promising hardware/software platforms for wireless cardiac monitoring. The design methodology and challenges are provided for realistic implementation

An Intelligent Multi-stage Channel Acquisition Model for CR-WBANs: A Context Aware Approach

Cognitive Radio (CR) came as a solution to mitigate challenges that wireless body area networks (WBANs) suffer from. CR is an intelligence-based technology that senses, observes, and learns from its operating environment to access licensed bands in the spectrum when they are not being utilized by primary users. Deploying a CR technology in WBANs applications, enhances spectrum scalability, increases system robustness, and decreases latency. Accordingly, CR-WBANs help in building a more efficient and reliable ubiquitous healthcare system than conventional WBANs do. However, CR-WBANs are still evolving, and many challenges need to be investigated, in particular, is how to acquire a channel and prioritize data streams among multiple CR-users (i.e., multiple patients) based on the severity of their health status, in a manner to decrease network latency and increase network scalability. To address this challenge, this work proposes a novel intelligent channel acquisition model for multiple CR-WBANs within ubiquitous healthcare system, whereby contextual data, namely, channel properties, intra-node characteristics, and patients’ profile information, is integrated in channel acquisition decision process. The proposed work is a multi-stage fusion system that is composed of local and global decisions units. A fuzzy logic system is utilized to make decisions in the local unit, which are sensing the channel availability and assessing the severity of patients' health status. Moreover, a neural network is employed as a global sensing decision center, whereby local sensing decisions, channel properties, and intra-node characteristics are augmented in the decision process. Furthermore, a cluster-based heuristic algorithm is formulated, in the global decision unit, to prioritize data streams among CR-users based on the criticality of their health conditions (i.e., acute, urgent, and normal). Patients' local health assessments and avatars (e.g., age, medical history, etc.) are exploited in the prioritization process

Evaluation of a task performance resource constraint model to assess the impact of offshore emergency management on risk reduction

In this age of safety awareness, technological emergencies still happen, occasionally with catastrophic results. Often human intervention is the only way of averting disaster. Ensuring that the chosen emergency managers are competent requires a combination of training and assessmentH. owever, assessmenct urrently relies on expert judgement of behaviour as opposed to its impact on outcome, therefore it would be difficult to incorporate such data into formal Quantitative Risk Assessments (QRA). Although there is, as yet, no suitable alternative to expert judgement, there is a need for methods of quantifying the impact of emergency management on risk reduction in accident and incidents. The Task Performance Resource Constraint (TPRC) model is capable of representing the critical factors. It calculates probability of task success with respect to time based on uncertainties associated with the task and resource variables. The results can then be used to assess the management performance based on the physical outcome in the emergency, thereby providing a measure of the impact of emergency management on risk with a high degree of objectivity. Data obtained from training exercises for offshore and onshore emergency management were measured and successfully used with the TPRC model. The resulting probability of success functions also demonstrated a high level of external validity when used with improvements in emergency management or design changes or real data from the Piper Alpha disaster. It also appeared to have more external validity than other HRQ/QRA techniques as it uses physical data that are a greater influence on outcome than psychological changes - though this could be because the current HRA/QRA techniques view human unreliability as probability of error rather than probability of failure. The simulation data were also used to build up distributions of timings for simple emergency management tasks. Using additional theoretical data, this demonstrated the model's potential for assessing the probability of successf or novel situations and future designs

Effectiveness of the Nigerian emergency management system with respect to building collapses, human stampedes and electrical power failures

One response to disaster incidents in Nigeria is to improve institutional preparedness and strengthen the capacity of the organisations involved. This requires adequate resources, improved communication and enhanced operations of the national emergency operations centre (EOC) to intensify coordination and better allocate resources. Factors affecting vulnerability to disasters such as building collapses, stampedes and blackouts, and the capacity of Nigeria’s emergency management organisations (considering resource availability, communication ability and operations of the EOC), were evaluated for the six main organisations involved in emergency response in Nigeria: National Emergency Management Agency, Federal Ministry of Health, Nigeria Police Force, Nigeria Security and Civil Defence Corps, Federal Road Safety Corps and National Hospital. Qualitative and quantitative approaches involving questionnaires and interviews were used. Poor housing and infrastructure, lack of disaster education, socio-economic challenges and institutional failures are the main factors that affect vulnerability to building collapses in Nigeria. Institutional failures, political issues and lack of disaster education affect blackouts, while socio-economic factors, institutional failures, political issues and lack of disaster education predominantly affect vulnerability to stampedes. Despite the need to have available resources, effective communications and functional EOCs, it appears that effective response and the implementation of emergency response activities in Nigeria are hindered by lack of adequate resources, lack of resource-sharing networks between federal, state and local government, lack of accountability, inadequate availability of equipment such as mobile phones and radios, and absence of communication networks such as LAN and WAN. Location and accessibility of each EOC, communication ability within the centre, and resources available to the EOC significantly influence the success or failure of operations of the EOC, which in return affects coordination, cooperation and integration among different levels of government and other organisations involved. In conclusion, there is a need for an emergency management plan that includes all elements and enhances resource availability and utilisation, effective communication, and coordination and allocation of resources to prevent, mitigate and respond rapidly to disasters

Towards UAV Assisted 5G Public Safety Network

Ensuring ubiquitous mission-critical public safety communications (PSC) to all the first responders in the public safety network is crucial at an emergency site. The first responders heavily rely on mission-critical PSC to save lives, property, and national infrastructure during a natural or human-made emergency. The recent advancements in LTE/LTE-Advanced/5G mobile technologies supported by unmanned aerial vehicles (UAV) have great potential to revolutionize PSC. However, limited spectrum allocation for LTE-based PSC demands improved channel capacity and spectral efficiency. An additional challenge in designing an LTE-based PSC network is achieving at least 95% coverage of the geographical area and human population with broadband rates. The coverage requirement and efficient spectrum use in the PSC network can be realized through the dense deployment of small cells (both terrestrial and aerial). However, there are several challenges with the dense deployment of small cells in an air-ground heterogeneous network (AG-HetNet). The main challenges which are addressed in this research work are integrating UAVs as both aerial user and aerial base-stations, mitigating inter-cell interference, capacity and coverage enhancements, and optimizing deployment locations of aerial base-stations. First, LTE signals were investigated using NS-3 simulation and software-defined radio experiment to gain knowledge on the quality of service experienced by the user equipment (UE). Using this understanding, a two-tier LTE-Advanced AG-HetNet with macro base-stations and unmanned aerial base-stations (UABS) is designed, while considering time-domain inter-cell interference coordination techniques. We maximize the capacity of this AG-HetNet in case of a damaged PSC infrastructure by jointly optimizing the inter-cell interference parameters and UABS locations using a meta-heuristic genetic algorithm (GA) and the brute-force technique. Finally, considering the latest specifications in 3GPP, a more realistic three-tier LTE-Advanced AG-HetNet is proposed with macro base-stations, pico base-stations, and ground UEs as terrestrial nodes and UABS and aerial UEs as aerial nodes. Using meta-heuristic techniques such as GA and elitist harmony search algorithm based on the GA, the critical network elements such as energy efficiency, inter-cell interference parameters, and UABS locations are all jointly optimized to maximize the capacity and coverage of the AG-HetNet

Exploring the Impact of Disaster Response Preparedness by the New York State Military Forces to the World Trade Center September 11, 2001, Terrorist Attacks

The problem identified in this study concerned the impact of disaster response preparedness (DRP) from the past, present, and future perspectives. The study explored the experiences of four survivors from the 1993 WTC bombing, the effectiveness of seven New York State Military Forces (NYSMF) deployed to Ground Zero (GZ), and perspectives of five Emergency Medical Services (EMS) professionals on DRP operations going forward from 9/11. Following an explorative heuristic research approach, the study utilized a qualitative and content analysis methodology (both qualitative and quantitative aspects) to investigate the problem using published archival interviews from the informants. Minimally, hypothesis testing, and descriptive and inferential statistics formed part of the data analysis. The results showed that the survivors of 1993 attack on the WTC experienced no interaction with first responders and were without DRP guidance. The NYSMF informants responded within 24 hours of the 9/11 WTC attacks, but were instructed to play a determinate role, as military force was deemed not appropriate to the situation on the ground. NYSMF augmented the roles of the New York Police Department (NYPD) and other first responders by conducting perimeter security at GZ. The EMS informants developed and implemented contingency plans to study DRP, and trained organizations and municipalities in the preparation for future disasters

WEHST: Wearable Engine for Human-Mediated Telepresence

This dissertation reports on the industrial design of a wearable computational device created to enable better emergency medical intervention for situations where electronic remote assistance is necessary. The design created for this doctoral project, which assists practices by paramedics with mandates for search-and-rescue (SAR) in hazardous environments, contributes to the field of human-mediated teleparamedicine (HMTPM). Ethnographic and industrial design aspects of this research considered the intricate relationships at play in search-and-rescue operations, which lead to the design of the system created for this project known as WEHST: Wearable Engine for Human-Mediated Telepresence. Three case studies of different teams were carried out, each focusing on making improvements to the practices of teams of paramedics and search-and-rescue technicians who use combinations of ambulance, airplane, and helicopter transport in specific chemical, biological, radioactive, nuclear and explosive (CBRNE) scenarios. The three paramedicine groups included are the Canadian Air Force 442 Rescue Squadron, Nelson Search and Rescue, and the British Columbia Ambulance Service Infant Transport Team. Data was gathered over a seven-year period through a variety of methods including observation, interviews, examination of documents, and industrial design. The data collected included physiological, social, technical, and ecological information about the rescuers. Actor-network theory guided the research design, data analysis, and design synthesis. All of this leads to the creation of the WEHST system. As identified, the WEHST design created in this dissertation project addresses the difficulty case-study participants found in using their radios in hazardous settings. As the research identified, a means of controlling these radios without depending on hands, voice, or speech would greatly improve communication, as would wearing sensors and other computing resources better linking operators, radios, and environments. WEHST responds to this need. WEHST is an instance of industrial design for a wearable “engine” for human-situated telepresence that includes eight interoperable families of wearable electronic modules and accompanying textiles. These make up a platform technology for modular, scalable and adaptable toolsets for field practice, pedagogy, or research. This document details the considerations that went into the creation of the WEHST design

Generative mechanisms of IT-enabled organisational performance in resource-constrained Emergency Medical Services organisations in South Africa

Problem Statement: Emergency medical services (EMS) organisations have one of the highest levels of dependence on and use of information technology (IT) to support delivery of emergency medical services. The need for EMS organisations to provide efficient and effective emergency medical services has emphasised the importance of performance management. Organisational performance which is monitored and evaluated through key performance indicators (KPIs) plays an important role in EMS organisations. Organisational performance helps to monitor, evaluate and communicate outcomes in the form of KPIs. Empirical evidence shows that quantitative KPIs have been designed with little in-depth understanding of the underlying IT usage mechanisms that influence organisational performance. Unfortunately, such quantitative KPI reports have been limited in explaining organisational performance underpinned by IT. Purpose / rationale of the research: The purpose of this research study was to identify the generative mechanisms associated with IT-enabled organisational performance and to explain how these mechanisms interact. In the context of resource-constrained EMS organisations, quantitatively defined KPIs are not suitable for explaining the underlying causes of performance variations and outcomes. The lack of empirical evidence on IT-enabled organisational performance as well as the lack of theoretical explanations of the underlying mechanisms provided the primary rationale for this study. In addition, this study sought to provide answers to the following research question: What generative mechanisms explain IT-enabled organisational performance in resource-constrained EMS organisations? Theoretical approach/methodology/design: This study was informed by the critical realist philosophy of science and used the complex adaptive systems theory together with institutional theory as the theoretical lenses to investigate the research question in a manner that jointly explained the generative mechanisms. Using interviews, participant observation, organisational performance data and documents collected from a single case study, the study used abduction and retroduction techniques to explicate the mechanisms of IT-enabled organisational performance. Findings: Findings indicate that the IT-enabled organisational performance mechanisms can be categorised into two types of generative mechanisms. These are structural and coordination mechanisms. The explanation of the mechanisms developed in this study take into consideration three important elements: (1) the technological, cultural and structural mechanisms that influence IT-enabled organisational performance; (2) the unpredictable, non-linear, adaptive nature of emergency medical services environments; and (3) the complexities that arise in the interactions between EMS organisations and their environments. Originality/contribution: In respect of IT-enabled organisational performance this study contributes to both organisational and health information systems literature by developing a multi-level research framework that is informed by the realist philosophical stance. The framework plays an explanatory role which relates to its inherent ability to offer explanatory insights into the necessary mechanisms that give rise to organisational performance. This framework has the potential to guide empirical research and provide theoretical explanations of different domains or disciplines that are concerned with identifying IT usage mechanisms which influence organisational performance. These include the significance of the coordination and structural mechanisms which, under differing conditions of uncertainty, produce variations in performance outcomes. Implications: Findings from this study can be integrated into broader emergency medical policy planning and health programme management. The model developed by the study provides a fresh understanding of the underpinning mechanisms enabling performance in resource-constrained EMS organisations. It can be used to assist emergency medical institutions and practitioners in South Africa and other sub-Saharan African countries, especially Southern African Development Community (SADC) countries to improve emergency medical service delivery to the public. The findings provide a guide for improving management of emergency medical situations and resources in their respective resource-constrained contexts. Furthermore, findings from the study can also guide improved design and implementation strategies and policies of EMS systems initiatives in South Africa and sub-Saharan developing countries