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A Survey on the Effectiveness of Existing Smart Home Cyber Attacks Detection Solution: A Broadband Service Providers’ Perspective
No full textThe Internet of Things (IoT) is rapidly reshaping smart homes with innovative technologies for everyday convenience. Although smart home technologies are becoming more popular, many homeowners lack the expertise and skills to operate them. Particularly mismanaged networking technologies often result in homeowners complaining to their Broadband Service Providers (BSPs) when there are disruptions to the performance of the smart home devices and services. Current remote management solutions used by BSPs offer limited functionality and accuracy in identifying the causes of these disruptions. Causes may include legitimate factors, such as misconfiguration, interference, and congestion, but they could also be the result of cyber attacks. This review exposes knowledge gaps that impede the development of effective troubleshooting tools (particularly related to cyber attacks) for BSPs, including network-related challenges and dataset limitations. We also discuss future research directions, emphasising scalable and data-efficient methods to reduce storage requirements, costs, and privacy concerns, which will enable BSPs to manage millions of customer networks more effectively.</p
Graded Lithium-Ion Battery Pouch Cells to Homogenise Current Distributions and Reduce Lithium Plating
No full textSpatial distributions in current, temperature, state-of-charge and degradation across the plane of large format lithium-ion battery pouch cells can significantly impact their performance, especially at high C-rates. In this paper, a method to smooth out these spatial distributions by grading the electrode microstructure in-the-plane is proposed. A mathematical model of a large format pouch cell is developed and validated against both temperature and voltage experimental data. An analytical solution for the optimal graded electrode that achieves a uniform current distribution across the pouch cell is then derived. The model predicts that the graded electrodes could significantly reduce the likelihood of lithium plating in large format pouch cells, with grading increasing the C-rate at which plating occurs from 2.4C to 4.3C. These results indicate the potential of designing spatially varying electrode architectures to homogenise the response of large format pouch cells and improve their high rate performance.</p
Circular Data Diagnostics in Regression and Time Series Models
No full textCircular data and their applications are pervasive across numerous disciplines. In the field of circular data analytics and statistical learning, distributional studies, regression and time series models have played crucial roles. In this paper, we present a comprehensive framework for circular regression and time series models. We employ the maximum likelihood estimation approach coupled with local and global influence methods to provide a robust methodology. Furthermore, we explore several specific models for analysing circular data and investigate techniques to identify influential observations within these models. To demonstrate the effectiveness of our proposed methods, we provide simulated and real data examples
Best Practice Pathways for Knee Osteoarthritis:Project report
No full textBackgroundWaiting time between GP referral and consultation by a specialist (known as ‘Wait 2’ time) has not previously been reported in the Australian Capital Territory (ACT), but in other states it can be prolonged. A Canberra Health Service (CHS) internal review in 2020, The Reboot Project, found 1,590 patients awaiting orthopaedic consultation at Canberra Hospital; after 2 years only 38% had been seen, with a mean wait time of 3.6 years. Yet there is excellent evidence, from the ACT and internationally, that advanced practice physiotherapists (APP) can provide an efficient and accurate diagnostic and screening service. This project was developed in collaboration between University of Canberra (UC), CHS and local and national stakeholders to translate the best evidence from research into clinical practice. In our project, we investigated how implementing strategies aligned with best practice care of knee osteoarthritis could impact the care pathways and wait time for patients referred to see an orthopaedic surgeon in the ACT public health system.The aim of this project was to sustainably eradicate Wait 2 and ensure that public patients have access to best practice care, including shared decision-making and non-surgical interventions. To unravel and remove access barriers to best practice interventions, we needed to:1. Use a systems approach to implement an expert review that was responsive, cost-effective and followed best practice interventions.2. Establish strong collaboration between consumers, primary health care, public orthopaedic triage and surgeons, and across public and private sectors.3. Develop pathways to ensure patients have knee replacement surgery at the right time. MethodA knowledge translation approach was taken, including qualitative, quantitative and economic analyses. We gathered evidence to determine best practice and used collaborative strategies for decision-making guided by deliberative democratic principles. The governance model of this project included the project executive, whole of team meetings (investigators, project manager and Trauma and Orthopaedic Research Unit staff), a steering committee (including stakeholders and consumers) and working parties, variously including academic team members, CHS members, health professionals, stakeholders and consumers. Evaluation for the knowledge translation approach included quantitative, qualitative and economic analyses. We gathered baseline data on waiting times and patient and stakeholder experiences to identify issues, barriers and enablers to implementation of best practice in March 2023. Waiting times were measured for patients with a new referral for knee osteoarthritis and those already waiting for a consultation between 1 March and 30 September for baseline capture in 2022, then each year’s cohort in 2023 and 2024. Characteristics of the cohorts, wait time and pathways – either seen by an APP, a surgeon or both – and the outcome of those visits were analysed for predictive factors.Interviews, conducted by UC academic members Angie Fearon and Jennie Scarvell, were recorded, transcribed and de-identified. Member checking of emerging themes and quotes resulted in some requests for revision or redaction by participants. Four investigators used thematic analysis, based in phenomenology, against a framework to organise the findings based on the aims of the project: to understand what is working well, what needs improvement, what a model of care would look like, and the barriers and enablers to implementation of that model of care. Participants were drawn through purposive sampling, and included patients (n = 6), primary care practitioners in general practice (GPs) (n = 4) and other primary care (n = 3), surgeons and registrars (n = 6), physiotherapists in the community, acute service and private care (n = 5), and the CHS Executive (n = 5).Changes to the healthcare service during the period included those implemented by CHS as part of the implementation working party discussions and those serendipitously occurring as part of IT improvements in CHS. Acute care physiotherapy increased resources to the APP clinic so that more patients with knee osteoarthritis could be seen (from 0.8 to 1.5 FTE), connections with community osteoarthritis and obesity programs were streamlined, CHS Community Care expanded the availability of the hip and knee osteoarthritis education and exercise program GLA:D (Good Living with osteoArthritis: Denmark) (Barton et al., 2021; Roos et al., 2018) and several stakeholder engagement activities were conducted. Serendipitously, EPIC Digital Health Record (DHR) was established in November 2022, the HealthLink e-referral system was upgraded, and CHS Quality and Safety initiated the Osteoarthritis of the Knee Clinical Care Standard for knee osteoarthritis.We evaluated the wait times measured for the 2023 and 2024 cohorts and the pathways for patients. To evaluate project impact, we held further interviews and focus groups in 2023 and 2024. Participants were invited from patient (n = 9), GP (n = 4), physiotherapy (n = 5), surgeon and registrar (n = 5) and health executive groups (n = 5). Three researchers used thematic analysis, based in phenomenology, to derive themes against the questions outlined above, with the addition of ‘what changes have you noticed?’To assess the economic impact of waiting, and the economic considerations and decisions that influence current and future decisions, we conducted three tasks:1. To calculate the costs to patients of living with osteoarthritis, using the Canadian Cost to Patients Questionnaire, 16 participants collected data for 6 or 12 months on out-of-pocket costs incurred.2. To evaluate the costs of the three different patient pathways and outcomes, we modelled them using a Markov chain. Patients could either be seen in the APP clinic; be seen in APP clinic and then referred to a surgeon; or wait to see a surgeon. Their outcomes could be discharge; referral to community programs; or total knee replacement. Costs and the likelihood of successful outcomes were built into the model.3. To describe optimal pathways and decisions and to inform policy, we fed information from the Markov model and from GLA:D outcomes data into a general algebraic model of optimising pathways and decisions. This work will be reported at the end of 2025.Key findingsCompared to 2022, wait times to see a surgeon were 0.14 times shorter in 2023 and 0.10 times shorter in 2024. The waiting time improved from 50% of patients seen within 114 days in 2022 to within 45 and 46 days in 2023 and 2024 respectively, and from 90% seen within 1,248 days to within 91 and 84 days respectively. The proportion of patients seen in the APP clinic increased from 20% in 2022 to 81% in 2023 and 76% in 2024. Patients seen in the APP clinic risked fewer delays than those seen only in the surgical clinic (APP clinic incidence rate ratio [IRR]: 0.55; 95%CI: 0.43, 0.72; and if seen in both APP and surgical clinics IRR: 0.54; 95%CI:0.41, 0.70). Patients in 2023 and 2024 had reduced risk of extended wait times to see a surgeon (adjusted odds ratio [AOR]: 0.11; 95% CI: 0.04, 0.31; AOR: 0.02; 95% CI: 0.004, 0.09). The number of patients referred to orthopaedics and listed for surgery fell from 46% in 2022 to 38% in 2023 and then to 35% in 2024. There was no difference between the year cohorts for people referred back to see a surgeon by their GP after APP consultation. The surgeons saw more patients ready for surgery, in that patients referred in 2023–2024 were 1.9 times more likely to be listed for surgery than a patient seen in the surgical clinic in 2022 (odds ratio 1.9, chi2 = 6.5, p = 0.011). Wait times analysis incorporated all of the changes that occurred to the health service during the period, since this is an ecological study.The first round of interviews showed consistently that APP clinical assessment of patients is highly valued. Patients appreciated early advice and interventions; surgeons appreciated filtering of patients. The high quality of surgery was recognised, but all participants noted that waits were unacceptably long, especially for high-risk complex patients unsuitable for elective surgery outsourced to the private hospital and at risk of deterioration. A community-based program that provided assessment, advice and review was recommended. APPs were acknowledged as skilled and appropriate to conduct this clinic, working at top of scope. Mechanisms to escalate deteriorating patients were needed. Several funding models were proposed, but success was felt to depend on access to imaging, ability to refer directly to the orthopaedic list, and quick access to surgeon advice. Good communication with the community to promote allied health interventions prior to considering surgery and for prehabilitation was essential. Facilitating the right patients having responsive access to surgery was essential for an efficient system. Good communication and listening to stakeholder voices are essential effective drivers of practice change.The second round of interviews evaluating the changes made was synthesised into themes as follows. A responsive system had empowered confidence in self-management for patients. APP clinics were highly regarded by patients and health professionals. An imperative has arisen to expand this model of care to patients with other orthopaedic conditions and to other specialist clinics across the health service. There has been a major improvement for those patients with knee osteoarthritis, and other patients now face inequity in access to care. Barriers to expanding the successful model include training sufficient APPs to resource APP clinics. The program for knee osteoarthritis relied on strong community allied health programs available as a non-surgical pathway, but such programs do not exist for problematic foot or shoulder conditions with long delays to consultation. Participants told us that community health services need resourcing to meet demand, particularly in podiatry and dietetics, where demand is great. Some quick wins were identified, such as utilising the DHR to send notifications to patients on the progress of their referral, and for tracking referrals. There is a widespread request for education in self-management for patients, particularly in pain management. Changes have improved patients’ experience and responsiveness of the system. Stakeholder engagement has been essential to the success of the project, to staying grounded in patient-centred decision-making, and to meeting demands within resource priorities and constraints.Costs to patients, including only out-of-pocket costs, ranged from 83 in 6 months (median 1,824, SD 1,421). Total costs per day ranged from 0.45 (median 7.98 per day, SD 4.63). Total costs comprised direct costs of 233 (median) over 6 months. There were no relationships confirmed between financial stress and costs, income category or quality of life metrics. This study is limited by its small sample size, but given the absence of more recent data, this information provides cost estimates for subsequent economic modelling.Economic evaluation using the Markov chain to model costs to the health sector and patients found that Wait 2 was a key determinant in the costs and benefits of knee osteoarthritis care for public patients. Policy changes to increase resources to the APP clinic and screen all patients with knee osteoarthritis will direct patients to care earlier. Reduced Wait 2 time and earlier direction to care pathways that exhaust conservative care for public patients with knee osteoarthritis decrease public healthcare costs by approximately 36% and indirect patient costs by 24%. It is reasonable to expect that such significant changes will affect the relative demand for, and supply of, knee osteoarthritis care in both the public and private sectors.An optimisation modelling platform (GAMS, general algebraic modelling system) was used to find (solve for) optimal care solutions in response to a user-defined objective function. The objective function was set to maximise Knee Osteoarthritis Outcome Scores for patients, reflecting outcomes important to patients and their function. Final modelling will be available for the next report.ConclusionsVery positive changes may be attributed to an increased proportion of people with knee osteoarthritis being seen by APPs, to DHRs reducing the risk of lost referrals, to the availability of community exercise and education programs and to compliance with the clinical standards for management of knee osteoarthritis. Care has improved for patients with these improved pathways.There is now an urgent imperative to expand this model of care to patients with other conditions in orthopaedics and to other specialist clinics across CHS, where it has been identified that advanced clinical practitioners would benefit from patients’ elevated access to care.Key recommendationsRecommendations arising from this project are based in the qualitative and quantitative evaluation of the project. The CHS is recommended to: Monitor and report on wait times and the impact of waiting1. Be accountable for wait times for patients. Wait times should be monitored and reported. Develop a report in EPIC-DHR that will report on wait times for specialist clinics.2. Adopt the clinically recommended timeframes (AIHW, 2022) for specialist clinics.3. Embed in EPIC-DHR patient-reported outcomes measures. Good planning for care is based in sound data, and to embed patient-centred principles both consumer engagement and patient-reported outcomes are required. Otherwise, the impact of changes is not measured. Expand and resource the APP clinic concept, and monitor the efficacy of that expansion4. Expand and resource the APP clinic to see patients with other conditions in orthopaedic clinics.5. Adopt clinically recommended timeframes for APP clinics.6. Support resourcing of APPs to see Category 2, not only Category 3 urgency patients.7. Commit to exploring expanding the APP concept to other specialist clinics.8. Develop agreements with specialists to mentor and communicate regularly with APPs.Improve cross-sector communication9. Carry out the planned review of the CHN Health Pathways for GPs to refer to Canberra Hospital orthopaedic clinics.10. Provide information via CHN that will assist GPs to refer to CHS Community Care services.Communicate with patients about wait times11. Provide simple phone text communication with patients about their waiting position. Expand the advanced clinical practitioner workforce12. Train more advanced clinical practitioners.13. Address gaps in training pathways for advanced clinical practitioners.14. Address issues in recruitment of advanced clinical practitioners.Provide CHS Community Care health services with sufficient resources 15. CHS Community Care services need increased resourcing to provide the services that will: (1) meet the demand of patients living with complex chronic conditions requiring allied health services, and (2) to take the strain from specialist clinics for treatment of those chronic conditions where evidence shows allied health interventions can be most effective.16. Address barriers to GPs referring patients to Community Care. My Aged Care, Central Health Intake and long wait times all present barriers to GP referral. 17. Develop services in Community Care to meet emerging demand. This may include implementing needs assessment for conditions that impact on patient quality of life, and where management in the community is appropriate and keeps people living effectively in their communities.18. Develop patient education programs for managing osteoarthritis. Patients clearly asked for education programs to train themselves in self-management. Education can effectively change belief systems for those with osteoarthritis to enable good self-care and less reliance on surgical solutions. <br/
The impact of COVID-19 on the trajectory of Australian tertiary students' mental health, 2017-2023
No full textAIMS: It is purported that tertiary students are at greater risk for poor mental health outcomes in comparison with their non-tertiary peers and those not in education, although the evidence for this is mixed. This paper examines the mental health differences between tertiary and non-tertiary students, and those not enrolled in study, and then examines the changes in mental health in the years prior to, during and post the COVID-19 pandemic.METHODS: Participants were from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, a longitudinal household panel survey. For this study, N = 21,385 participants provided at least one observation on the relevant education and mental health measures between 2017 and 2023. Mental Health was operationalised with the four mental health subscales from the Short Form-36 and included the MHI-5, a measure of psychological distress, Vitality, Social Functioning, and Role Emotion subscales.RESULTS: Over the study period, there were no differences in levels of Vitality or Social Functioning between education status. Those enrolled in undergraduate programs reported lower MHI-5 (b = -1.17 (SE = 0.38); P = .011) and Role Emotional (b = -2.49 (SE = 0.79); P = .010) scores, but these differences were substantively smaller than the differences reported between age, employment and sex. There were substantive changes in all mental health outcomes with the onset of COVID, particularly for Role Emotion. Two-way interactions between education and time were reported for the MHI, Vitality and Social Functioning subscales with those enrolled in undergraduate and postgraduate reporting slightly larger declines.CONCLUSIONS: In comparison with the magnitude of differences between sex, employment and age groups, there was only weak evidence for differences between education levels. There was weak evidence for changes in mental health between education levels over the study period. Stabilisation in more recent years suggest some adaptation to the COVID-19 pandemic.</p
Building Legitimacy Inside the IIEP:Balancing Technical Advice with International Politics
No full text© Helen Weir and Will Brehm, 2026 | DOI:10.1163/9789004689121_009This is an open access chapter distributed under the terms of the CC BY-NC-ND 4.0 license.chapter 9Building Legitimacy Inside the IIEPBalancing Technical Advice with International PoliticsHelen Weir and Will BrehmAbstractResearch into international organisations in the field of comparative and internationaleducation has frequently focused on large multilaterals. Mostly absent is an explorationof minor international organisations that do not have significant amounts of power,money, or human resources at their disposal. How do such organisations influenceglobal and national education policy? The International Institute of EducationalPlanning (IIEP) is an autonomous institute within the United Nations Educational,Scientific, and Cultural Organization (UNESCO). With 147 staff, the IIEP accounts forroughly 5 percent of UNESCO’s 2022–2023 budget. Despite its size, the IIEP continuesto be a key player in educational planning. This chapter explores how IIEP impactseducation at the national level despite its financial limitations. Through a desk-reviewof IIEP documents and semi-structured interviews with participants who have beenemployed by IIEP at different strategic levels over the last twenty years, this chapterexamines how IIEP has survived due to its organisational legitimacy. Our analysisuncovers tensions that arise for the IIEP as it navigates maintaining legitimacy withboth donors and beneficiary countries
Repatriation or political theatre? How the return of stolen artefacts can distort history
No full textManagement: An Interactive Approach, 1st edition:Management: An Interactive Approach, 1st edition
No full textConflict considerations in the United Nations Framework Convention on Climate Change’s National Adaptation Plans
No full textMany places affected by violent conflict are also those with the lowest capacity to respond to the impacts of climate change and, therefore, some the most vulnerable. Consequently, it is here where climate change most likely results in social tensions that could escalate into or sustain conflicts. This double burden of compounding conflict and climate risks suggests an urgent need for climate adaptation interventions. However, so far adaptation agendas are often poorly aligned with those reducing conflict risk. Seeking to overcome this gap, the United Nations Framework Convention on Climate Change (UNFCCC) National Adaptation Plan (NAP) process has been highlighted as an important opportunity to align adaptation and peacebuilding agendas. Based on qualitative analysis of the ten least peaceful countries’ NAPs (submitted by November 2022), and developing a novel analytical framework on climate, conflict and adaptation interactions, the paper examines whether and to what extent countries bring conflict considerations into their NAPs, and account for interactions between climate change, conflict and adaptation. Findings suggest that by and large, conflict considerations are not systematically brought into adaptation planning – an omission that might ultimately prove irresponsible, highly costly and dangerous. The paper concludes with recommendations that countries faced by the double-burden of climate change and fragility, and international actors supporting them in their NAP process, could employ