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

Characterization, cloning and immunogenicity of antigens released by lung-stage larvae of Schistosoma mansoni

Lung-stage schistosomula are the target of protective immunity in mice vaccinated with attenuated cercariae of Schistosoma mansoni. Therefore, proteins present at this developmental stage, and in particular those which are secreted, are a potential source of novel vaccine candidates. However, little information is available about such molecules. Here we describe the cDNA clones identified by screening expression libraries with serum raised against proteins released by lung-stage schistosomula. In total, 11 different cDNA species were identified, 6 of which have been described previously in S. mansoni; these included fructose 1,6-bisphosphate aldolase and Sm21.7 which together accounted for two-thirds of all positive clones. Of the 5 newly described schistosome genes, 1 cDNA had a high degree of homology to the s5a subunit of 26S proteasomes, most significant being with the human protein. The remaining 4 clones showed no significant homologies to any genes sequenced previously. Fructose 1,6-bisphosphate aldolase, Sm21.7, the proteasome homologue and 1 unknown clone (A26) have been expressed in a bacterial expression system and serum produced against each recombinant protein. Immunolocalization showed fructose 1,6-bisphosphate aldolase, Sm21.7 and the proteasome homologue to be most abundant in muscle cells whilst clone A26 was distributed throughout many tissues, but was most abundant in the tegument. Analysis of the cellular immune responses of vaccinated mice showed 3 of the 4 expressed clones to be highly immunogenic, inducing the secretion of large quantities of the Th1-type cytokine interferon gamma

Reconceptualising clinical handover: Information sharing for situation awareness

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Wide deviation phase modulator

Modulator produces phase-modulated waveform having high modulating linearity. Technique is inherently wideband with respect to carrier frequency and can operate over decade carrier frequency range without adjustments. Circuit performance is both mathematically predictable and highly reproducible

Phase modulating with odd and even finite power series of a modulating signal

Method and apparatus is presented for producing a phase-modulated waveform having a high degree of linearity between the modulating signal and the phase of the modulated carrier signal. Two signals representing finite odd and even power series transformations of the modulating signal are produced and multiplied with two quadrature components of the input carrier signal, respectively. One of the multiplied signals is subtracted from the other and the resulting signal is hard-limited to produce a phase-modulated output signal. The means for producing the two signals representing the odd and even power series of the modulating signal includes means for varying the coefficients of the two power series. By means of an existing computer program, the coefficients of the two power series are selected such that there is an extremely high degree of linearity between the modulating signal and the phase of the modulated carrier signal

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

Sickness certification system in the United Kingdom: qualitative study of views of general practitioners in Scotland

Objectives: To explore how general practitioners operate the sickness certification system, their views on the system, and suggestions for change. Design: Qualitative focus group study consisting of 11 focus groups with 67 participants. Setting: General practitioners in practices in Glasgow, Tayside, and Highland regions, Scotland. Sample: Purposive sample of general practitioners, with further theoretical sampling of key informant general practitioners to examine emerging themes. Results: General practitioners believed that the sickness certification system failed to address complex, chronic, or doubtful cases. They seemed to develop various operational strategies for its implementation. There appeared to be important deliberate misuse of the system by general practitioners, possibly related to conflicts about roles and incongruities in the system. The doctor-patient relationship was perceived to conflict with the current role of general practitioners in sickness certification. When making decisions about certification, the general practitioners considered a wide variety of factors. They experienced contradictory demands from other system stakeholders and felt blamed for failing to make impossible reconciliations. They clearly identified the difficulties of operating the system when there was no continuity of patient care. Many wished either to relinquish their gatekeeper role or to continue only with major changes. Conclusions: Policy makers need to recognise and accommodate the range and complexity of factors that influence the behaviour of general practitioners operating as gatekeepers to the sickness certification system, before making changes. Such changes are otherwise unlikely to result in improvement. Models other than the primary care gatekeeper model should be considered

Study of research and development requirements of small gas-turbine combustors

A survey is presented of the major small-engine manufacturers and governmental users. A consensus was undertaken regarding small-combustor requirements. The results presented are based on an evaluation of the information obtained in the course of the study. The current status of small-combustor technology is reviewed. The principal problems lie in liner cooling, fuel injection, part-power performance, and ignition. Projections of future engine requirements and their effect on the combustor are discussed. The major changes anticipated are significant increases in operating pressure and temperature levels and greater capability of using heavier alternative fuels. All aspects of combustor design are affected, but the principal impact is on liner durability. An R&D plan which addresses the critical combustor needs is described. The plan consists of 15 recommended programs for achieving necessary advances in the areas of liner thermal design, primary-zone performance, fuel injection, dilution, analytical modeling, and alternative-fuel utilization