Context-awareness for mobile sensing: a survey and future directions

The evolution of smartphones together with increasing computational power have empowered developers to create innovative context-aware applications for recognizing user related social and cognitive activities in any situation and at any location. The existence and awareness of the context provides the capability of being conscious of physical environments or situations around mobile device users. This allows network services to respond proactively and intelligently based on such awareness. The key idea behind context-aware applications is to encourage users to collect, analyze and share local sensory knowledge in the purpose for a large scale community use by creating a smart network. The desired network is capable of making autonomous logical decisions to actuate environmental objects, and also assist individuals. However, many open challenges remain, which are mostly arisen due to the middleware services provided in mobile devices have limited resources in terms of power, memory and bandwidth. Thus, it becomes critically important to study how the drawbacks can be elaborated and resolved, and at the same time better understand the opportunities for the research community to contribute to the context-awareness. To this end, this paper surveys the literature over the period of 1991-2014 from the emerging concepts to applications of context-awareness in mobile platforms by providing up-to-date research and future research directions. Moreover, it points out the challenges faced in this regard and enlighten them by proposing possible solutions

Materialities of clinical handover in intensive care: challenges of enactment and education

Abstract The research is situated in a busy intensive care unit in a tertiary referral centre university hospital in Scotland. To date no research appears to have been done with a focus on handover in intensive care, across the professions involved, examining how handover is enacted. This study makes an original contribution to the practical and pedagogical aspects of handover in intensive care both in terms of the methodology used and also in terms of its findings. In order to study handover a mixed methods approach has been adopted and fieldwork has been done in the ethnographic mode. Data has been audio recorded and transcribed and analysed to explore the clinical handovers of patients by doctors and nurses in this intensive care unit. Texts of both handover, and the artefacts involved, are reviewed. Material from journals, books, lectures and websites, including those for health care professionals, patients and relatives, and those in industry are explicated. This study explores the role of material artefacts and texts, such as the intensive care-based electronic patient record, the whiteboards in the doctors’ office, and in the ward, in the enactment of handover. Through analysis of the data I explore some of the entanglements and ontologies of handover and the multiple things of healthcare: patients, information, equipment, activities, texts, ideas, diseases, staff, diagnoses, illnesses, floating texts, responsibility, a plan, a family. The doing of handover is framed theoretically through the empirical philosophy of Mol’s identification of multiple ontologies in clinical practice (Mol, 2002). Each chapter is prefaced by a poem, each of which has relevant socio-material elements embedded in it. The significance of the findings of the research for both patient care and clinical education and learning is surfaced

Social/energy policy: an inquiry into the intersection of two policy domains with Australia’s national electricity market

The introduction of competition to electricity markets has been a priority of energy policy in Australia for over 20 years. Throughout this process, economic efficiency objectives have had explicit primacy over social or environmental objectives. Neoliberalism, or economic rationalism as it is often referred to in Australia, not only radically changed the provision of electricity from the 1990s but recast the provision of welfare services by transferring many services from provision by government to provision by ‘private welfare agencies’. Energy policy and social policy can therefore be seen to have been placed on similar paths towards market-based provision of service to households. Importantly this has shifted many frontline responsibilities away from governments to energy retailers and community sector organisations. The electricity market’s consumer safety net has been described as a shared responsibility between industry, governments and community sector organisations. This shared responsibility represents the intersection of energy policy and social policy in Australia akin to fuel poverty policies internationally. However, this intersection is ill-defined and not systemically governed. The key role of community sector organisations in particular is rarely formalised. This research represents the first attempt to develop a coordinated national policy framework for the consumer safety net of Australia’s National Electricity Market. The research question that this thesis seeks to answer is: • When considering a consumer safety net for consumers in a liberalised electricity market, what is an appropriate analytical framework for policy and practice that can be used by stakeholders to improve governance and consumer outcomes? • Subsequently, what priorities emerge from this framework that could be advanced through the policy cycle? In response, this thesis provides a comprehensive, structured review and analysis of the relationship between energy policy and social policy at a time when electricity pricing is undergoing significant changes in terms of structures (tariff reform) and upward pressure as a result of climate change policies and the development of a natural gas export industry. - 4 - The theory and practice of public policy analysis is summarised and guides the structure of the thesis. The research argues for a systematic approach based on the pursuit of 5 public policy outcomes that reflect the interaction between household energy bills and energy, climate and social policies: ● Stable and Efficient Pricing AND ● Informed and engaged consumers AND ● Energy consumed efficiently and productively AND ● Robust consumer protections AND ● All households have a capacity to pay their energy bills This thesis provides context in Chapters 1 and 2 then a chapter is dedicated to each of the five policy outcomes. In each case, the research and analysis is presented in four parts that represent key stages of a policy cycle, the way in which public policy evolves over time: a review of the current arrangements; analysis to identify key issues; empirical analysis and; policy formulation. Consequently, priority policy issues are identified, and recommendations made in the concluding chapter

Report of Apollo 204 Review Board, Appendix D. Panels 1 Thru 4

No abstract availabl

Evaluation of health and social care provision for ventilator-dependent children in the UK : costs and outcomes

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Evaluating interventions to make healthcare safer : methodological analysis and case study

This thesis describes study designs for the robust evaluation of complex patient safety interventions. Fundamentally, study designs available to measure the effectiveness of patient safety interventions fall into two categories – those that use contemporaneous controls, and those that do not. A review of the recent literature (245 citations) revealed that most studies were single-centre (63%), and the majority of these did not use contemporaneous controls (84%); whilst in multi-centre studies (37%) the number of studies using contemporaneous controls (49%) equalled the number of studies that that did not (51%). Studies that do not use contemporaneous controls dominate the literature, but they are weak and subject to bias. The thesis further discussed a case-study, as an exemplar for the evaluation of a highly complex patient safety intervention – the Safer Patients Initiative (SPI), which sought to generically strengthen hospitals, whilst improving frontline activities. The evaluation was a before and after study, with contemporaneous controls. It used mixed-methods, so that the triangulation of a one type of research finding could be reinforced when corroborated by the finding of another type. Uniquely, it also, compared the rates of change across control and SPI hospitals – an approach referred to as the “difference-in-difference” method.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

The system of aseptic preparation of intravenous drugs in clinical care settings

Abstract A review of the literature on blood stream infections caused by contaminated intravenous infusates which are prepared in clinical care settings found that this common nursing procedure poses at times a significant and life-threatening risk to patients. The guidance and regulations surrounding the preparation of intravenous drugs in clinical care settings suggests that this procedure is extremely complex and poses many different potential hazards to patients. This thesis set out to determine how the infection risks are being addressed in practice by asking the questions: ‘What is the system of intravenous drug preparation in clinical care settings in NHS Scotland?’ and, ‘How does it work in practice?’ Several data sources were utilised: six locations, in specialities where the literature identified significant outbreaks had occurred, were examined for potential contamination risk. Observations (78) of infusate preparations were undertaken and, where available, written procedures were compared with observed practices. Finally, analyses were made of 71 questionnaires, completed by the nurses who prepare intravenous drugs, regarding their opinions of the procedures’ safety and when they perform redundancy checks. The conclusion of this study is that the system of preparing intravenous drugs in clinical care settings by nurses is, as a consequence of potential infusate contamination, error-prone and unreliable. The reasons for this conclusion are now detailed. o Due to a lack of mandatory environmental standards, and the provision of poor environments, there is a risk of infusate contamination from environmental sources and consequently, a risk to patients of infusate-related blood stream infections (IR-BSI). o Some in use equipment poses contamination risks to patients’ infusates. Equipment that could reduce the contamination risk is not always available and in some instances such safety-enhancing equipment has been removed. o There are no complete written procedures which mirror what is done in practice. At present, from a human-factors perspective, it is not easy for the nurse to do the right thing, or to be sure exactly what is the right thing to do. o The procedure, in practice, has the required elements of an aseptic procedure, but the execution of the procedure is more often not performed aseptically. o The procedure of intravenous drug preparation as observed is mainly an interrupted aseptic procedure and as such the recommencement of the aseptic procedure requires repeated hand hygiene. o The nurses’ opinions of safety vary, as did their assessment of the infection risk to their patients, but it is clear that intravenous drug preparation is not a much-loved nursing procedure and some nurses find it very stressful. o There is no asepsis quality control built into the system. Aseptic steps are the least likely to be performed as a redundancy check compared to the mandatory checks of ‘right patient, right drug and right dose’. o The information available to the nurses, from the drug companies, from the makers of equipment and from national agencies does not identify with sufficient clarity the infection risks, or detail how to negate them. Suggestions for improvement to the six procedures and environments are clear once the procedure steps are colour-coded as either aseptic or non-aseptic; validity testing of these improvements is however, still needed. The systems’ vulnerabilities observed in this research appear to stem from a chain of external influences including an underestimation of the problem size and the actions needed to prevent it in evidence-based guidelines and mandatory guidance. This leads to poor recognition of the risk of IR-BSI in clinical practice. The problem of infusate contamination causing IR-BSIs is further compounded by the fact that it is not caused by a single organism and does not always present as a disease in real time, that is, over the lifetime of the infusion. As a consequence, this presents surveillance difficulties in terms of definitions, data collection and analysis. Finally, although the diagnosis of a blood stream infection for an individual patient remains relatively easy, it is not easy to recognise a contaminated infusate as the origin of the problem. All these challenges make both the recognition of the problem and agreement on prevention strategies, extremely challenging. In summary, the main conclusion of this thesis is that the preparation of infusates in clinical care settings, which occurs approximately 3,000,000 times a year in NHSScotland, is from an aseptic perspective, error-prone and unreliable. Recommendations to optimise patient safety include, changing the procedure locally and, with the utmost urgency, the production of minimum environmental standards. The results of this study are relevant to all hospitals in Scotland and throughout the United Kingdom where the current regulations apply and similar procedures are performed