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The Australian healthcare sector is a complex mix of government departments, associations, providers, professionals, and consumers. Cybersecurity attacks, which have recently increased, challenge the sector in many ways; however, the best approaches for the sector to manage the threat are unclear. This study will report on a semi-structured focus group conducted with five representatives from the Australian healthcare and computer security sectors. An analysis of this focus group transcript yielded four themes: 1) the challenge of securing the Australian healthcare landscape; 2) the financial challenges of cybersecurity in healthcare; 3) balancing privacy and transparency; 4) education and regulation. The results indicate the need for sector-specific tools to empower the healthcare sector to mitigate cybersecurity threats, most notably using a self-evaluation tool so stakeholders can proactively prepare for incidents. Despite the vast amount of research into cybersecurity, little has been conducted on proactive cybersecurity approaches where security weaknesses are identified weaknesses before they occur. [ABSTRACT FROM AUTHOR]

Health-related data is stored in a number of repositories that are managed and controlled by different entities. For instance, Electronic Health Records are usually administered by governments. Electronic Medical Records are typically controlled by health care providers, whereas Personal Health Records are managed directly by patients. Recently, Blockchain-based health record systems largely regulated by technology have emerged as another type of repository. Repositories for storing health data differ from one another based on cost, level of security and quality of performance. Not only has the type of repositories increased in recent years, but the quantum of health data to be stored has increased. For instance, the advent of wearable sensors that capture physiological signs has resulted in an exponential growth in digital health data. The increase in the types of repository and amount of data has driven a need for intelligent processes to select appropriate repositories as data is collected. However, the storage allocation decision is complex and nuanced. The challenges are exacerbated when health data are continuously streamed, as is the case with wearable sensors. Although patients are not always solely responsible for determining which repository should be used, they typically have some input into this decision. Patients can be expected to have idiosyncratic preferences regarding storage decisions depending on their unique contexts. In this paper, we propose a predictive model for the storage of health data that can meet patient needs and make storage decisions rapidly, in real-time, even with data streaming from wearable sensors. The model is built with a machine learning classifier that learns the mapping between characteristics of health data and features of storage repositories from a training set generated synthetically from correlations evident from small samples of experts. Results from the evaluation demonstrate the viability of the machine learning technique used. [ABSTRACT FROM AUTHOR]

An Electronic Health Record (EHR) is an individual's record of all health events that enables critical information to be documented and shared electronically amongst health care providers and patients. The introduction of an EHR, particularly a patient-accessible EHR, can be expected to lead to an escalation of enquiries, complaints and ultimately, disputes. Prevailing opinion is that Online Dispute Resolution (ODR) systems can help with the mediation of certain types of disputes electronically, particularly systems which deploy Artificial Intelligence (AI) to reduce the need for a human mediator. However, disputes regarding health tend to invoke emotional responses from patients that may conceivably impact ODR efficacy. This raises an interesting question on the influence of emotional intelligence (EI) in the process of mediation. Using a phenomenological research methodology simulating doctor–patient disputes mediated with an AI Smart ODR system in place of a human mediator, we found an association between EI and the propensity for a participant to change their previously asserted claims. Our results indicate participants with lower EI tend to prolong resolution compared to those with higher EI. Future research include trialling larger scale ODR systems for specific cohorts of patients in the area of health related dispute resolution are advanced. [ABSTRACT FROM AUTHOR]

Background: Recent investigations have questioned the role of hydration and electrolytes in cramp susceptibility and thus the efficacy of consuming electrolyte-rich carbohydrate beverages (EB) to control/prevent cramping.Methods: Nine euhydrated, cramp-prone participants had their cramp susceptibility assessed by measuring the nerve stimulation threshold frequency at which cramping occurs (TF) before and after consumption of an EB (kCal: 120, Na: 840 mg, K: 320 mg, Mg: 5 mg) and placebo beverage (PB: kCal: 5, Na: 35 mg). Cramp intensity was assessed using a verbal pain scale and poststimulation electromyography (EMG).Results: TF was greater in EB (14.86 ± 7.47 Hz) than PB (14.00 ± 5.03 Hz; P = .038) and reported pain was lower in EB (2.0 ± 0.6) than PB (2.7 ± 0.8; P = .025) while EMG was similar (P = .646).Discussion: EB consumption decreased cramp susceptibility and pain but did not prevent cramping in any participants. These results suggest that electrolyte consumption independent of hydration can influence cramp susceptibility in young people. [ABSTRACT FROM AUTHOR]

Continuous monitoring of patient’s physiological signs has the potential to augment traditional medical practice, particularly in developing countries that have a shortage of healthcare professionals. However, continuously streamed data presents additional security, storage and retrieval challenges and further inhibits initiatives to integrate data to form electronic health record systems. Blockchain technologies enable data to be stored securely and inexpensively without recourse to a trusted authority. Blockchain technologies also promise to provide architectures for electronic health records that do not require huge government expenditure that challenge developing nations. However, Blockchain deployment, particularly with streamed data challenges existing Blockchain algorithms that take too long to place data in a block, and have no mechanism to determine whether every data point in every stream should be stored in such a secure way. This article presents an architecture that involves a Patient Agent, coordinating the insertion of continuous data streams into Blockchains to form an electronic health record. [ABSTRACT FROM AUTHOR]

The purpose of this study was to quantify the acute cardiometabolic responses to a novel training rope (TR) protocol in children. Fifteen boys (10.6 ± 1.4 years) were tested for peak oxygen uptake (...O2) on a treadmill and subsequently (2--7 days later) performed a progressive 10-minute protocol of 5 TR exercises (EX): EX1: standing side-to-side waves, EX2: seated alternating waves, EX3: standing alternating waves, EX4: jumping jacks, and EX5: double-arm slams. Participants performed 2 sets of each TR exercise for 30 seconds per set with a 30-second rest interval between sets and exercises. A 12.8-m TR (4.1 kg) was used for all trials, and a metronome was used to standardize cadence. Peak values for ...O2 and HR during the treadmill test were 47.4 ± 8.8 ml⋅kg-1⋅min-1 and 195.1 ± 6.6 b•min-1, respectively. During the TR protocol, mean ...O2 and HR significantly increased (p ≤ 0.05) from set 1 of EX1 (10.3 ± 2.6 ml⋅kg-1⋅min-1and 103.2 ± 11.6 b⋅min-1, respectively) to set 2 of EX5 (30.0 ± 3.9 ml⋅kg-1⋅min-1 and 168.6 ± 11.8 b⋅min-1, respectively). Percentage of peak ...O2 and peak HR values attained during the TR protocol ranged from 21.5 to 64.8% and from 52.9 to 86.4%, respectively. These descriptive data indicate that TR exercise can pose a moderate to vigorous cardiometabolic stimulus in children and with proper supervision and instruction may serve as a worthwhile complement to youth fitness programs. [ABSTRACT FROM AUTHOR]

Many complementary and alternative medical practices (CAM) are readily assessable in Australia alongside Allopathic practitioners. Although CAM practices are prevalent, little is known about how patients seek and use information when deciding which system to consult. We report some preliminary findings of a longitudinal study, designed to solicit factors that influence the Australian public when selecting from diverse medical systems. Fifty-four general public participants, willing to provide their confidential and anonymous opinion were included. The magnitudes of importance, critical in influencing factors, were screened. Results indicated a medical system was selected for its effectiveness, safety, credentials and care (p<0.001). Consultation time, convenience, cost, empowerment and rapport were less important factors (p<0.001) influencing selection of a medical system. The level of choices by participants [χ² (1, N=54) = 53.445, p<0.001] follow similar trends found for those in conventional medical systems. This contrasts with findings in other locations, where cost and time were major contributing factors when selecting medical systems. [ABSTRACT FROM AUTHOR]

Background: This regional pilot site 'end-user attitudes' study explored nurses' experiences and impressions of using the Nurses' Behavioural Assistant (NBA) (a knowledge-based, interactive ehealth system) to assist them to better respond to behavioural and psychological symptoms of dementia (BPSD) and will be reported here. Methods: Focus groups were conducted, followed by a four-week pilot site 'end-user attitudes' trial of the NBA at a regional aged care residential facility (ACRF). Brief interviews were conducted with consenting nursing staff. Results: Focus group feedback (N = 10) required only minor cosmetic changes to the NBA prototype. Post pilot site end-user interview data (N = 10) indicated that the regional ACRF nurses were positive and enthusiastic about the NBA, however several issues were also identified. Conclusions: Overall the results supported the utility of the NBA to promote a person centred care approach to managing BPSD. Slight modifications may be required to maximise its uptake across all ACRF nursing staff. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this research was to conduct a cost-analysis, from a public healthcare perspective, comparing the cost and benefits of face-to-face patient examination assessments conducted by a dentist at a residential aged care facility (RACF) situated in rural areas of the Australian state of Victoria, with two teledentistry approaches utilizing virtual oral examination.Methods: The costs associated with implementing and operating the teledentistry approach were identified and measured using 2014 prices in Australian dollars. Costs were measured as direct intervention costs and programme costs. A population of 100 RACF residents was used as a basis to estimate the cost of oral examination and treatment plan development for the traditional face-to-face model vs. two teledentistry models: an asynchronous review and treatment plan preparation; and real-time communication with a remotely located oral health professional.Results: It was estimated that if 100 residents received an asynchronous oral health assessment and treatment plan, the net cost from a healthcare perspective would be AU$32.35 (AU$27.19-AU$38.49) per resident. The total cost of the conventional face-to-face examinations by a dentist would be AU$36.59 ($30.67-AU$42.98) per resident using realistic assumptions. Meanwhile, the total cost of real-time remote oral examination would be AU$41.28 (AU$34.30-AU$48.87) per resident.Discussion: Teledental asynchronous patient assessments were the lowest cost service model. Access to oral health professionals is generally low in RACFs; however, the real-time consultation could potentially achieve better outcomes due to two-way communication between the nurse and a remote oral health professional via health promotion/disease prevention delivered in conjunction with the oral examination. [ABSTRACT FROM AUTHOR]

Prevention through Design has been identified as an effective means to enhance construction safety. However, design professionals, clients and other stakeholders often have limited experience of construction processes. Although processes and tools have been advanced to support stakeholders, very few have been adopted in practice. The complexities inherent in designing for safe construction suggest this to be a wicked problem using criteria advanced by Rittel and Weber. Approaches advanced to solve wicked problems outside construction are not applicable for solving construction design problems, largely because they require that stakeholders expend an impractical amount of time and energy to arrive at amenable solutions. Instead, an approach that utilises information visualisation addresses criteria for wicked problem resolution. The promise of information visualisation for this wicked problem has been illustrated through a case study involving façade design. An infographic was generated following structured interviews with building designers and safety experts. A workshop involving 20 designers, engineers and safety experts demonstrated that the infographic prompted participants to identify risks not previously considered and stimulated discussion about mitigation or reduction. There was unanimous agreement that the information visualisation could feasibly be adopted within the construction industry’s tight time and resource constraints. [ABSTRACT FROM PUBLISHER]

Recent studies have demonstrated that Multi-Disciplinary Meetings (MDM) practiced in some medical contexts can contribute to positive health care outcomes. The group reasoning and decision-making in MDMs has been found to be most effective when deliberations revolve around the patient’s needs, comprehensive information is available during the meeting, core members attend and the MDM is effectively facilitated. This article presents a case study of the MDMs in cancer care in a region of Australia. The case study draws on a group reasoning model called the Reasoning Community model to analyse MDM deliberations to illustrate that many factors are important to support group reasoning, not solely the provision of pertinent information. The case study has implications for the use of data analytics in any group reasoning context. [ABSTRACT FROM PUBLISHER]

Background: The use of homoeopathic remedies to prevent infectious diseases, homoeoprophylaxis (HP), was first described over 100 years ago. To date, no systematic studies have been performed to identify the attitudes that current practitioners hold about HP or current trends in the use of HP. Aims: This study aimed to discover attitudes to HP amongst accredited homeopathic practitioners particularly with respect to overall acceptance, the context of use, and preferred remedies. Methodology: Two international surveys were conducted in 2014. Responses were received from 1,124 homeopaths in 35 countries; 104 of whom responded to both surveys. Results: A large proportion of respondents have positive attitudes to HP and currently use HP in their practice. However, responses also indicate that knowledge about HP is chequered. Confidence in the evidence base of HP also is variable. Conclusion: Results indicate that HP is widely practiced, however, further research is needed to improve confidence in the evidence base of HP, and better programs are needed to ensure that education about HP is enhanced. [ABSTRACT FROM AUTHOR]

Background: With the growing use of social media in health care settings, there is a need to measure outcomes resulting from its use to ensure continuous performance improvement. Despite the need for measurement, a unified approach for measuring the value of social media used in health care remains elusive.Objective: This study aimed to elucidate how the value of social media in health care settings can be ascertained and to taxonomically identify steps and techniques in social media measurement from a review of relevant literature.Methods: A total of 65 relevant articles drawn from 341 articles on the subject of measuring social media in health care settings were qualitatively analyzed and synthesized. The articles were selected from the literature from diverse disciplines including business, information systems, medical informatics, and medicine.Results: The review of the literature showed different levels and focus of analysis when measuring the value of social media in health care settings. It equally showed that there are various metrics for measurement, levels of measurement, approaches to measurement, and scales of measurement. Each may be relevant, depending on the use case of social media in health care.Conclusions: A comprehensive yardstick is required to simplify the measurement of outcomes resulting from the use of social media in health care. At the moment, there is neither a consensus on what indicators to measure nor on how to measure them. We hope that this review is used as a starting point to create a comprehensive measurement criterion for social media used in health care. [ABSTRACT FROM AUTHOR]

The Internet of Things (IoT) has facilitated services without human intervention for a wide range of applications, including underwater monitoring, where sensors are located at various depths, and data must be transmitted to surface base stations for storage and processing. Ensuring that data transmitted across hierarchical sensor networks are kept secure and private without high computational cost remains a challenge. In this paper, we propose a multilevel sensor monitoring architecture. Our proposal includes a layer-based architecture consisting of Fog and Cloud elements to process and store and process the Internet of Underwater Things (IoUT) data securely with customized Blockchain technology. The secure routing of IoUT data through the hierarchical topology ensures the legitimacy of data sources. A security and performance analysis was performed to show that the architecture can collect data from IoUT devices in the monitoring region efficiently and securely. [ABSTRACT FROM AUTHOR]

Electronic Health Records (EHRs) constitute evidence of online health information management. Critical healthcare information technology (HIT) infrastructure facilitates health information exchange of 'modern' health systems. The growth and implementation of EHRs are progressing in many countries while the adoption rate is lagging and lacking momentum amidst privacy and security concerns. This paper uses an interrupted time series (ITS) analysis of OECD data related to EHRs from many countries to make predictions about EHR adoption. The ITS model can be used to explore the impact of various HIT on adoption. Assumptions about the impact of Information Accountability are entered into the model to generate projections if information accountability technologies are developed. In this way, the OECD data and ITS analysis can be used to perform simulations for improving EHR adoption.

Introduction: The purpose of this research was to conduct a cost-analysis, from a public healthcare perspective, comparing the cost and benefits of face-to-face patient examination assessments conducted by a dentist at a residential aged care facility (RACF) situated in rural areas of the Australian state of Victoria, with two teledentistry approaches utilizing virtual oral examination., Methods: The costs associated with implementing and operating the teledentistry approach were identified and measured using 2014 prices in Australian dollars. Costs were measured as direct intervention costs and programme costs. A population of 100 RACF residents was used as a basis to estimate the cost of oral examination and treatment plan development for the traditional face-to-face model vs. two teledentistry models: an asynchronous review and treatment plan preparation; and real-time communication with a remotely located oral health professional., Results: It was estimated that if 100 residents received an asynchronous oral health assessment and treatment plan, the net cost from a healthcare perspective would be AU$32.35 (AU$27.19-AU$38.49) per resident. The total cost of the conventional face-to-face examinations by a dentist would be AU$36.59 ($30.67-AU$42.98) per resident using realistic assumptions. Meanwhile, the total cost of real-time remote oral examination would be AU$41.28 (AU$34.30-AU$48.87) per resident., Discussion: Teledental asynchronous patient assessments were the lowest cost service model. Access to oral health professionals is generally low in RACFs; however, the real-time consultation could potentially achieve better outcomes due to two-way communication between the nurse and a remote oral health professional via health promotion/disease prevention delivered in conjunction with the oral examination., (© The Author(s) 2015.)