Towards the realisation of an integratated decision support environment for organisational decision making

Traditional decision support systems are based on the paradigm of a single decision maker working at a stand‐alone computer or terminal who has a specific decision to make with a specific goal in mind. Organizational decision support systems aim to support decision makers at all levels of an organization (from executive, middle management managers to operators), who have a variety of decisions to make, with different priorities, often in a distributed and dynamic environment. Such systems need to be designed and developed with extra functionality to meet the challenges such as collaborative working. This paper proposes an Integrated Decision Support Environment (IDSE) for organizational decision making. The IDSE distinguishes itself from traditional decision support systems in that it can flexibly configure and re‐configure its functions to support various decision applications. IDSE is an open software platform which allows its users to define their own decision processes and choose their own exiting decision tools to be integrated into the platform. The IDSE is designed and developed based on distributed client/server networking, with a multi‐tier integration framework for consistent information exchange and sharing, seamless process co‐ordination and synchronisation, and quick access to packaged and legacy systems. The prototype of the IDSE demonstrates good performance in agile response to fast changing decision situations

The nature of engineering change in a complex product development cycle

The complex dynamics of modern business mean companies are constantly exposed to rapid and radical change. The way by which a company copes with change, can act as an insight into its propensity for sustainable profitability and hence predicted longevity. In complex product development cycles, engineering change must be managed as efficiently and effectively as possible. This paper presents a case study of one hundred engineering changes, taken over a sixty seven day period, of a complex product development cycle, during the detailed design phase of the project. It establishes the specific engineering change process utilised as a reactive process, which takes a mean of 126 days to complete its impact analysis phase and compliments this with a review of change stimuli and effects. It was found that the stimuli behind change are frequently not understood, with 68.4% reasons being classified as 'other'. The most effected entities were found to be the bill of materials, baseline and structural changes respectively; however it was found that each specific stimulus had a unique effect profile, which differed from the cumulative effect profile for all change stimuli

Small bowel haemangioma with local lymph node involvement presenting as intussusception

Gastrointestinal haemangiomas make up 0.05% of all intestinal neoplasms. They are sometimes multiple and usually present with pain, bleeding, and obstruction. An associated haemangiomatous change in regional lymph nodes has not been reported previously. A woman of 21 years presented with abdominal pain and vomiting. Abdominal ultrasound and computed tomography scan showed a lower abdominal mass. Laparotomy revealed a small bowel tumour causing an intussusception together with enlarged mesenteric lymph nodes. Pathological examination revealed a small bowel haemangioma with mesenteric node involvement. The pathogenesis of haemangiomatous involvement of lymph nodes is discussed. Hamartomatous change is the likely cause in this patient. Key Words: haemangioma • lymph node • intussusception • small bowe

Gestational diabetes is associated with postpartum hemorrhage in Indigenous Australian women in the PANDORA study: a prospective cohort.

Objective To assess associations of hyperglycemia in pregnancy with the risk of postpartum hemorrhage (PPH) in a prospective cohort of Indigenous and non-Indigenous women, compared to normoglycemia.MethodsData were from 1,102 (48% Indigenous) women of the Pregnancy And Neonatal Diabetes Outcomes in Remote Australia (PANDORA) Study. Age-adjusted associations of gestational diabetes mellitus (GDM) or pre-existing type 2 diabetes mellitus (T2DM), obstetric and demographic covariables with PPH (blood loss ≥500ml) were assessed using logistic regression. Multivariable-adjusted models included Indigenous ethnicity, diabetes type and their interaction.ResultsA higher proportion of Indigenous women developed PPH than non-Indigenous women (32% vs. 22%; p<0.001). Compared to non-Indigenous women with normoglycemia, risks of PPH for Indigenous women with GDM or T2DM were (OR=1.83 [95%CI: 1.11-3.02] and 1.72 [0.99-3.00] after age adjustment, 1.84 [1.06-3.19] and 1.33 [0.70-2.54] after adjustment for school education and delivery mode, and 1.62 [0.95-2.77] and 0.99 [0.53-1.86] after adjustment for birth weight). Importantly, Indigenous women without hyperglycemia in pregnancy were not at increased risk of PPH. Conclusion The significantly higher rates of PPH experienced by Indigenous compared to non-Indigenous women may be explained by a greater effect of GDM among Indigenous women that was only partly accounted for by birth weight.Isabelle M. Lucas, Elizabeth L. M. Barr, Federica Barzi, Danielle K. Longmore, I-Lynn Lee, Marie Kirkwood ... et al