PaperChain: A Collaborative Healthcare System Grounded in Field Study Work

In this extended abstract we summarise our recent experiences of designing and deploying PaperChain, a system to support real-time information sharing in healthcare work. A guiding principle has been the development of a deep understanding of the work as the foundation for effective system design. We summarise the field work that motivated the development of PaperChain, some of the key findings and the resulting system. We briefly reflect on the benefits gained from undertaking substantial HCI work in the design of a healthcare system

Reconceptualising clinical handover: Information sharing for situation awareness

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Public yet private: the status, durability and visibility of handover sheets

Drawing on data from a multi-site case study of a range of clinical settings, this paper explores the form of nursing handover sheets and the processes through which they are created and updated. We argue that these documents function as both public and private documents, having relevance for the whole ward while also acting as a personal workspace. Such dual functionality needs to be supported by any technology that seeks to provide for the work of handover, if the handover sheet is to continue to act as a space for work, rather than just a repository of information

Late-onset bloodstream infection and perturbed maturation of the gastrointestinal microbiota in premature infants

Late-onset bloodstream infection (LO-BSI) is a common complication of prematurity, and lack of timely diagnosis and treatment can have life-threatening consequences. We sought to identify clinical characteristics and microbial signatures in the gastrointestinal microbiota preceding diagnosis of LO-BSI in premature infants.Daily faecal samples and clinical data were collected over two years from 369 premature neonates (<32 weeks gestation). We analysed samples from 22 neonates who developed LO-BSI and 44 matched control infants. Next-generation sequencing of 16S rRNA gene regions amplified by PCR from total faecal DNA was used to characterise the microbiota of faecal samples preceding diagnosis from infants with LO-BSI and controls. Culture of selected samples was undertaken, and bacterial isolates identified using MALDI-TOF. Antibiograms from bloodstream and faecal isolates were compared to explore strain similarity.From the week prior to diagnosis, infants with LO-BSI had higher proportions of faecal aerobes/facultative anaerobes compared to controls. Risk factors for LO-BSI were identified by multivariate analysis. Enterobacteriaceal sepsis was associated with antecedent multiple lines, low birth weight and a faecal microbiota with prominent Enterobacteriaceae. Staphylococcal sepsis was associated with Staphylococcus OTU faecal over-abundance, and the number of days prior to diagnosis of mechanical ventilation and of the presence of centrally-placed lines. In 12 cases, the antibiogram of the bloodstream isolate matched that of a component of the faecal microbiota in the sample collected closest to diagnosis.The gastrointestinal tract is an important reservoir for LO-BSI organisms, pathogens translocating across the epithelial barrier. LO-BSI is associated with an aberrant microbiota, with abundant staphylococci and Enterobacteriaceae and a failure to mature towards predominance of obligate anaerobes

The moral component of fighting power in the British Army Reserve: a qualitative study

The UK’s Army Reserve has undergone significant investment and transformation over the last decade under Future Reserves 2020; it now represents around 30% of the UK’s land forces. However, Reservists have legally enshrined options to defer or avoid mobilisation for permanent service. This could undermine the Army’s ability to deliver soldiers for operations. This potential is examined through an analysis of an under-researched cornerstone of British military doctrine, the Moral Component of Fighting Power, analogous to the academically contested concept of ‘morale’. Having operationalised the Moral Component, this thesis examines Army Reserve policy and strategy, as well as two autoethnographic case studies that illustrate precedent, to understand the demand on the organisation and the ideal-typical reservist. It then presents qualitative evidence from Focus Groups to argue that the Army Reserve has a Moral Component of Fighting Power characterised by Fighting Spirit, Pride and a Spiritual Foundation. Despite a drive toward professionalisation, the bonds between Reserve soldiers remain primarily social. The evidence suggests that the Moral Component is moderately well aligned with the needs of the organisation regarding the relationship between soldier and Army, but it may struggle where relationships with families and employers impinge upon military Service. Thematically, the Moral Component presents as more intrinsically than extrinsically influenced and might be diminished where the Army is perceived to undervalue reservists’ contribution, especially through administrative failings and short notice demands. In summary, this study finds that the Army Reserve has met the demands placed on it, in part by ensuring its operational aspirations do not exceed the availability of its soldiers. In presenting these findings, this thesis expands upon the existing literature on the Army Reserve and the Moral Component of Fighting Power and examines the prospects for the organisation in a new epoch of policy and strategy: Reserve Force 2030

OH rotational lines as a diagnostic of the warm neutral gas in galaxies

We present Infrared Space Observatory (ISO) observations of several OH, CH and H2O rotational lines toward the bright infrared galaxies NGC253 and NGC1068. As found in the Galactic clouds in SgrB2 and Orion, the extragalactic far-IR OH lines change from absorption to emission depending on the physical conditions and distribution of gas and dust along the line of sight. As a result, most of the OH rotational lines that appear in absorption toward NGC253 are observed in emission toward NGC1068. We show that the far-IR spectrum of OH can be used as a powerful diagnostic to derive the physical conditions of extragalactic neutral gas. In particular, we find that a warm (Tk~150 K, n(H2)< 5 10^4 cm^-3) component of molecular gas with an OH abundance of 10^{-7} from the inner <15'' can qualitatively reproduce the OH lines toward NGC253. Similar temperatures but higher densities (5 10^5 cm^-3) are required to explain the OH emission in NGC1068.Comment: 5 pages, 4 figures, accepted in ApJ Part I (2004, October 6

Stop, think SCORTCH: rethinking the traditional 'TORCH' screen in an era of re-emerging syphilis

BACKGROUND: The epidemiology of congenital infections is ever changing, with a recent resurgence in syphilis infection rates seen in the UK. Identification of congenital infection is often delayed; early recognition and management of congenital infections is important. Testing modalities and investigations are often limited, leading to missed diagnostic opportunities. METHODS: The SCORTCH (syphilis, cytomegalovirus (CMV), 'other', rubella, toxoplasmosis, chickenpox, herpes simplex virus (HSV) and blood-borne viruses) acronym increases the awareness of clinicians to the increased risk of congenital syphilis, while considering other infectious aetiologies including: zika, malaria, chagas disease, parvovirus, enterovirus, HIV, hepatitis B and C, and human T-lymphotropic virus 1, in addition to the classic congenital infections recognised in the 'TORCH screen' (toxoplasmosis, 'other', rubella, CMV, HSV). The SCORTCH diagnostic approach describes common signs present in infants with congenital infection, details serological testing for mother and infant and important direct diagnostics of the infant. Direct diagnostic investigations include: radiology, ophthalmology, audiology, microbiological and PCR testing for both the infant and placental tissue, the latter also warrants histopathology. CONCLUSION: The traditional 'TORCH screen' focuses on serology-specific investigations, often omits important direct diagnostic testing of the infant, and fails to consider emerging and re-emerging congenital infections. In recognition of syphilis as a re-emerging pathogen and the overlapping clinical presentations of various infectious aetiologies, we advocate for a broader outlook using the SCORTCH diagnostic approach

Answer Set Programming Modulo `Space-Time'

We present ASP Modulo `Space-Time', a declarative representational and computational framework to perform commonsense reasoning about regions with both spatial and temporal components. Supported are capabilities for mixed qualitative-quantitative reasoning, consistency checking, and inferring compositions of space-time relations; these capabilities combine and synergise for applications in a range of AI application areas where the processing and interpretation of spatio-temporal data is crucial. The framework and resulting system is the only general KR-based method for declaratively reasoning about the dynamics of `space-time' regions as first-class objects. We present an empirical evaluation (with scalability and robustness results), and include diverse application examples involving interpretation and control tasks

5-dimensional contact SO(3)-manifolds and Dehn twists

In this paper the 5-dimensional contact SO(3)-manifolds are classified up to equivariant contactomorphisms. The construction of such manifolds with singular orbits requires the use of generalized Dehn twists. We show as an application that all simply connected 5-manifoldswith singular orbits are realized by a Brieskorn manifold with exponents (k,2,2,2). The standard contact structure on such a manifold gives right-handed Dehn twists, and a second contact structure defined in the article gives left-handed twists.Comment: 16 pages, 1 figure; simplification of arguments by restricting classification to coorientation preserving contactomorphism