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Enhancing Clinical Decision Support Systems through Hospital Information System Integration and Machine Learning in a Context of the Emergency Department
No full textThis study conducts design science research (DSR) aimed at addressing the challenge of improving clinical decision support (CDS) in Emergency Departments (EDs). Making timely decisions by physicians to meet the diverse demands within hospital EDs is a challenge as the inadequacies of current Hospital Information Systems (HIS) can host fragmented Electronic Health Record (EHR) data across multiple sub-systems. The advancement of Information Technology (IT), notably machine learning (ML), brings new initiatives for addressing this issue. To tackle this complexity, this research deploys DSR to design a novel system integration architecture. This architecture provides a comprehensive framework that orchestrates HIS integration across multiple strata, encompassing the business, application, and technology layers, to facilitate the integration of ML-based Clinical Decision Support Systems (CDSS) within the ED setting. Two design artefacts are developed as outcomes of DSR: firstly, the development of the system integration architecture, and secondly, the creation of the ML-based CDSS. The former serves as a meticulously designed blueprint for HIS integration, ensuring the effective functioning of ML-based CDSS at the point of care. The latter represents a pioneering CDSS system, harnessing the power of ML algorithms to furnish real-time, context-aware decision support. The impact of the ML-based CDSS on ED efficiency is subjected to rigorous evaluation. This evaluation is conducted by leveraging historical Electronic Health Record (EHR) data within a simulated ED environment. The simulation, calibrated with parameters drawn from a real-world hospital ED setting, yields promising results. These findings underscore the feasibility and the manifold benefits of integrating ML-based CDSS to augment ED efficiency. Furthermore, this research makes a noteworthy contribution to the theoretical underpinnings of information system design. It achieves this by pioneering the development of a novel system integration architecture. This architecture serves as a bridge, alleviating the knowledge gap that traditionally separates HIS integration from ML-based CDSS. The study advances the understanding of strategic design and integration of hospital information systems to support ML and CDSS. Ultimately, this advancement holds the potential to catalyse substantial improvements in patient care and outcomes, especially within the intricate and high-stakes environment of the Emergency Department
Posthumous documentary theatre: Re-presenting historical documentary material on stage
No full textA practice predicated upon the verbatim re-presentation of non-fiction documents, interviews, personal writings, and other historical source materials on stage, documentary theatre frequently claims to produce theatrical experiences that represent ‘reality’ and ‘truth’. Yet, the symbiosis of real-world source material and a dynamic dramaturgy can be an intricate balancing act, as the theatre maker is often faced with the challenge of how to best navigate the tension between accurately representing ‘the real’ on stage and producing a dynamic theatre experience.
Much of the scholarship engaging with documentary theatre has addressed the complex ethical-political process of speaking for others and the risk of misrepresentation that comes with making a real person into a documentary character. Consequently, theatre makers often strive to not only represent their documentary subjects accurately but also aim to increase their agency in the documentary theatre process by facilitating opportunities for dialogue, connection, and collaboration. Yet what happens when the theatre maker is unable to communicate with their subjects or extend a collaborative hand? Posthumous Documentary Theatre: Re-presenting Historical Documentary Material on Stage addresses a gap in the documentary theatre discourse and explores how the potential ethical considerations associated with the form may be further complicated when the documentary subjects are no longer living.
This research takes the form of a PhD with a creative practice component that involved the creation of What Remains: The Love and Letters of Vita Sackville-West & Harold Nicolson. An original documentary play constructed primarily from posthumously published letters and personal writings; What Remains enabled a practical exploration of how theatre makers' ethical considerations for their deceased documentary subjects might influence their dramaturgical processes. Synthesising critical reflection on that creative process with existing documentary theatre theories and practices, this thesis offers findings that aim to be practically useful to others navigating the intersecting ethical and dramaturgical demands of representing the dead on stage in documentary theatre
Cyberbystanders: Behind the screens
Get PDFBehaviour that occurs online is an important component of many people’s social interactions. It is, therefore, crucial that the detrimental impacts of cyberbullying and similar behaviour (i.e., online aversive behaviour) are addressed. To this end, I present research that progresses from an exploration of online social behaviour in general (Chapter 2) through to quantitative discounting studies that examine an avenue for behaviour change initiatives that improve the online social environment.
In the exploratory phase (Chapter 2), I conducted a series of focus groups with young people between 12- and 21-years old on the broad topic of Social Networking Site use (SNS). Participants spoke about how they manage their use of SNS, which coalesced around several key themes. One of these ideas was the importance of showing and receiving support from their online social communities, especially in instances of adversity.
An effective way to show support for another person online is to actively intervene when witnessing adverse (or aversive) behaviour directed toward that person. In Chapter 3, I explored a novel application of discounting methods to assess whether social outcomes related to online bystander (i.e., cyberbystander) intervention are discounted similarly to outcomes more common within the discounting literature. I used discounting methods in conjunction with the framework of the Bystander Intervention Model (BIM; Latané & Darley, 1970), reframing the latter to be congruent with the concepts of behaviour analysis.
In Chapter 4, I tested the applicability of discounting methods to the decision-making of young adult cyberbystanders. As discounting studies using monetary outcomes have been well-established, I compared the probabilistic discounting of money to that of social outcomes related to cyberbystander behaviour. Having established that probability discounting can be applied to cyberbystander’s decision-making, in Chapter 5, I examined whether scenario severity, audience size, or locus of responsibility (i.e., whether responses related to participant’s own behaviour or their perception of how someone else would respond) impacted the willingness of young adults to intervene in online aversive behaviour. Intervention was marginally more likely when participants considered whether someone else would intervene (rather than themselves) and if the severity were high, but the larger audience size had a negligible effect. Chapter 6 contains a study designed to follow up on the promising findings regarding the impact that perceived scenario severity had on cyberbystander’s decisions to intervene themselves, particularly when compared to what participants considered the social norm to be (i.e., how they thought someone else would respond). The difference between the likelihood of intervention when participants responded for themselves versus what they considered normative was most evident when the scenario was moderate-to-high in severity.
In all, my research supports the premise that discounting methods can be applied to cyberbystander decision-making and used to assess aspects of the BIM to identify avenues for cyberbystander behaviour change initiatives. Cyberbystanders’ actions can fundamentally change whether acts of aversive behaviour are reinforced (or punished), as well as mitigate the extent of the harm experienced by a target of online aversive behaviour
Ka ora | Ka mate
No full textEkphrasis in response to the artwork 'Matariki' by Hariata Ropata-Tangahoe (Ngāti Toa, Ngāti Raukawa, Te Āti Awa). Written for the One Hundred Years exhibition held at RAMP Gallery, in celebration of the establishment of the first iteration of the technical college a century earlier in 1924. Alumni of the art program were invited to contribute works to the show and local writers were asked to respond to the art, with their works being published in the exhibition catalogue
A Thai culture-centred study of communication between Thai immigration police officers and English-speaking travellers at the northern borders of Thailand
No full textThis qualitative study explores communication where English is the 'third' language used between participants whose cultures are different. The purpose was to investigate the communication experiences of Thai Immigration Police Officers (ITIPOs) and travellers to understand TIPOs' role within an orgnaisational and cultural context. I took a Thai culture-centred approach incorporating Thai values, Buddhist teachings, the organisational context, and TIPO's communication goals in the interactions. My thesis is that individual language skills, communication competence and goals, organisational roles and functions, and Thai cultural values influence communication at the border.
Data-collection methods included: (1) Semi-structured interviews with 18 TIPOs and 71 travellers at five immigration offices in two Thai provinces (January-April 2018); (2) Documents from the Thai Royal Police and Thai Immigration Bureau that informed the TIPO role. The thematic analysis resulted in three main findings.
The first finding centred on TIPO and travellers’ perceptions of each other's communication politeness. Results suggest that TIPOs' English-language competence influenced travellers' perceptions of the TIPO’s ability to communicate politely. Travellers saw TIPOs’ competence in spoken language as essential for TIPOs to communicate successfully with them. Also, travellers perceived politeness in TIPOs’ ability to engage in relational communication rather than just focusing on the task. This finding has implications for TIPOs’ communicating relational and identity goals at the border. Limited English-language competence impacted TIPOs' ability to communicate politely (relational goals), undermining their identity communication goals to be seen and respected as police officers.
The second finding concerned the influence of the role requirements for TIPOs in their interactions with travellers. First, TIPOs needed to enact Buddhist values upheld by the Thai Royal Police and Thai Immigration Bureau while managing the power distance between themselves as law enforcers and travellers. Second, TIPOs needed to enact a “service mind” when serving travellers while exercising the authority inherent in the role. The implications centre on TIPOs communicating their instrumental, relational, and identity communication goals; that is, they need to be seen as Thai Immigration Police (identity) while simultaneously enforcing the law (task) and serving the traveller (relational).
The third finding featured the practicalities, benefits, restraints, and opportunities for TIPOs in enacting Thai values and Buddhist teachings in their service provision interaction with travellers. At the interaction level, TIPOs responded to travellers' communications with Thai terms incorporating Thai values. However, the TIPO’s responsibility to enforce the law constrained TIPOs in fully enacting Thai values and Buddhist teachings. Even so, TIPO had some latitude in observing Thai values. The findings have implications for organisational commitment to Thai and Buddhist values (identity goals) and support for TIPOs to serve travellers (relational goals) in carrying out tasks associated with enforcing the law (instrumental goals).
Taking a Thai culture-centred approach to investigate TIPO-traveller interactions at the border, was significant in revealing the task, identity and relational communication challenges for TIPOs in enacting their role. Further research opportunities lie in investigating how the organisation’s values, processes and training can help TIPO in managing such challenges at the border
Genomic tools in biological invasions: Current state and future frontiers
No full textHuman activities are accelerating rates of biological invasions and climate-driven range expansions globally, yet we understand little of how genomic processes facilitate the invasion process. Although most of the literature has focused on underlying phenotypic correlates of invasiveness, advances in genomic technologies are showing a strong link between genomic variation and invasion success.
Here, we consider the ability of genomic tools and technologies to: (i) inform mechanistic understanding of biological invasions; and (ii) solve real-world issues in predicting and managing biological invasions. For both, we examine the current state of the field and discuss how genomics can be leveraged in the future. In addition, we make recommendations pertinent to broader research issues, such as data sovereignty, metadata standards, collaboration, and science communication best practices that will require concerted efforts from the global invasion genomics community
Characterisation and prediction of state of health of rechargeable batteries
No full textElectrochemical impedance spectroscopy (EIS) is used extensively in battery research, but usually at frequencies that do not reflect real-world usage patterns. This has resulted in equivalent circuit models (ECMs) that are over-complicated, and suboptimal battery management systems. It is logical to measure batteries at frequencies reflecting their daily or weekly charge-discharge cycles, i.e., of the order of microhertz. This is generally not done, however, because of difficulties that include extreme measurement durations and the need for care to avoid issues such as charge distribution problems, charge drift, and the risk of overcharging or flattening the battery. This research demonstrates the feasibility of extra-low frequency (ELF) EIS measurement using standard, non-specialised measurement equipment, and the optimisation of frequency domain data through the superimposition of small-signal measurement tones on larger square wave currents.
Study of charge movement rates in the frequency domain and voltage responses in the time domain in batteries indicates connections between voltage sweep rate in cyclic voltammetry (CV) and current magnitude in incremental capacity analysis (ICA). The key factor determining what the investigator sees, e.g., reversibility of electrode processes or evidence of individual electrochemical reactions, is rate of movement of charge. Thus, controlled current can be used to obtain CV-type data from a battery, something that would be hazardous if done conventionally using a voltage ramp.
Repeatable, low-error EIS measurements at ELFs are essential for inferring battery ECM components, including constant phase elements (CPEs). The fractional order of a CPE is linked to battery state of health (SoH) and energy efficiency. This thesis shows that efficiency measurements with waveforms representative of real battery usage can be used to track battery SoH accurately
Te Tiriti o Waitangi
No full textWhakawātea. Lyrics composed by Te Kahautu Maxwell. Performed by Ōpōtiki Mai Tawhiti (Kapa Haka group)
Waiata ā Tira: Aroha
Whakaeke: Pinepine Te Kura
Mōteatea: Tērā te haeata
Waiata ā Ringa: Tiaho Mai
Poi: E ia, e ia
Haka: Ranginui
Whakawātea: Te Tiriti o Waitang
Work hardening of quaternary powder metallurgy Ti alloys
No full textThe concurrent addition of Al as α stabiliser and Nb and Cu or Mn as β stabilisers was used to design new powder metallurgy quaternary Ti alloys and investigate their manufacturability and consequent performance. It is found that the powder blend's compressibility decreases with the total amount of alloying elements due to the characteristics of the powders used. Consequently, the sintered density of the quaternary Ti alloys decreases and slightly higher values are achieved if Mn instead of Cu is used, despite the higher diffusivity of Cu at the sintering temperature. The quaternary Ti alloys are characterised by a lamellar microstructure comprising α grain boundaries and α+β lamellae where the amount and type of alloying elements determine the coarseness of the microstructural features. This results in stronger and harder but less ductile quaternary Ti alloys for higher alloying elements contents and for stronger β stabilisers, although of their overall elastoplastic behaviour. Because of their lamellar microstructure, the quaternary Ti alloys show similar deformation behaviour but the actual work hardening rate is governed by the fineness of the microstructure
