Supporting awareness in heterogeneous collaboration environments

Rapid technological advancements have made it possible for humans to collaborate as never before. However demands of group work necessitate distributed collaboration in very heterogeneous environments. Heterogeneity as in various applications, platforms, hardware and communication infrastructure. User mobility, lack of availability and cost often make imposing a common collaboration environment infeasible. Awareness is essential for successful collaboration. Awareness is a key design criterion in groupware but often collaboration occurs with applications not designed to support useful awareness. This dissertation deals with the issue of effective group awareness support in heterogeneous environments.;Awareness propagation is effective if the appropriate amount of information, relevant to the user\u27s sphere of activity is delivered in a timely, unobtrusive fashion. Thus issues such as information overload, and distraction have to be addressed. Furthermore ability to establish the appropriate balance between awareness and privacy is essential. Enhanced forms of awareness such as intersubjectivity and historical awareness are often invaluable. Heterogeneous environments significantly impact the above quality factors impeding effective awareness propagation. Users are unable to tailor the quality of awareness received.;Heterogeneity issues that affect awareness quality are identified. An awareness framework is proposed that binds various sources of awareness information. However for effective awareness support, physical integration must be augmented by information integration. As a solution, an awareness model is proposed. Specification of the awareness model and framework\u27s architecture and features is the key contribution. The proposed model has been validated through simulations of realistic collaboration involving human participation. Scenarios created, have tested the model\u27s usefulness in enhancing the quality of group work by propagating effective awareness among users. To accomplish the same, an Awareness Simulator application has been created. In the validation process, efforts made to create an experimental methodology revealed some techniques related to awareness evaluation in CSCW, which are proposed. Various issues required to successfully engineer such awareness frameworks are identified and their impact on requirements such as security and performance, discussed. With various standards and technologies that can be harnessed to create awareness frameworks, there is great promise that barriers in heterogeneous collaboration environments can be overcome

Web-based workflow in secure collaborative telemedicine

Workflow involves the automation of a business process in whole or part with movement of information and tasks between parties according to a set of rules. The ubiquitous nature of the Internet and WWW prompts us to investigate how these entities can be fully exploited to improve the efficiency of any workflow process in a reliable, secure fashion.;This research effort alms to investigate the utility of the internet and specifically the WWW in providing a substrate for complex workflow and to demonstrate that workflow with a high degree of automation and ability to interface with disparate data sources can be conducted in a reliable, secure fashion with synchronous and asynchronous communication between mobile participants.;Paper based administrative workflow in healthcare has been automated to validate the claims made in this thesis. Web pages substitute paper forms and information needed is obtained from disparate data sources. Information is transferred across the Internet is using strict security protocols and communication is supported with the help of messaging. Users are not tied to any system and are mobile. Automation techniques decrease manual effort, minimize errors and improve the overall efficiency of the workflow process

Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients from 29 Countries

Importance: Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events. Objective: To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients. Design, Setting, and Participants: The International Observational Study to Understand the Impact and Best Practices of Airway Management in Critically Ill Patients (INTUBE) study was an international, multicenter, prospective cohort study involving consecutive critically ill patients undergoing tracheal intubation in the intensive care units (ICUs), emergency departments, and wards, from October 1, 2018, to July 31, 2019 (August 28, 2019, was the final follow-up) in a convenience sample of 197 sites from 29 countries across 5 continents. Exposures: Tracheal intubation. Main Outcomes and Measures: The primary outcome was the incidence of major adverse peri-intubation events defined as at least 1 of the following events occurring within 30 minutes from the start of the intubation procedure: cardiovascular instability (either: systolic pressure <65 mm Hg at least once, <90 mm Hg for >30 minutes, new or increase need of vasopressors or fluid bolus >15 mL/kg), severe hypoxemia (peripheral oxygen saturation <80%) or cardiac arrest. The secondary outcomes included intensive care unit mortality. Results: Of 3659 patients screened, 2964 (median age, 63 years; interquartile range [IQR], 49-74 years; 62.6% men) from 197 sites across 5 continents were included. The main reason for intubation was respiratory failure in 52.3% of patients, followed by neurological impairment in 30.5%, and cardiovascular instability in 9.4%. Primary outcome data were available for all patients. Among the study patients, 45.2% experienced at least 1 major adverse peri-intubation event. The predominant event was cardiovascular instability, observed in 42.6% of all patients undergoing emergency intubation, followed by severe hypoxemia (9.3%) and cardiac arrest (3.1%). Overall ICU mortality was 32.8%. Conclusions and Relevance: In this observational study of intubation practices in critically ill patients from a convenience sample of 197 sites across 29 countries, major adverse peri-intubation events - in particular cardiovascular instability - were observed frequently