Health

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    Simulated Artificial Human Vision: The Effects of Spatial Resolution and Frame Rate on Mobility
    (IOS Press, 2006) Dowling, Jason A ; Boles, Wageeh ; Maeder, Anthony
    Electrical stimulation of the human visual system can result in the perception of blobs of light, known as phosphenes. Artificial Human Vision (AHV or visual prosthesis) systems use this method to provide a visual substitute for the blind. This paper reports on our experiments involving normally sighted participants using a portable AHV simulation. A Virtual Reality Head Mounted Display is used to display the phosphene simulation. Custom software converts captured images from a head mounted USB camera to a DirectX based phosphene simulation. The effects of frame rate (1, 2 and 4 FPS) and phosphene spatial resolution (16x12 and 32x24) on participant Percentage of Preferred Walking Speed (PPWS) and mobility errors were assessed during repeated trials on an artificial indoor mobility course. Results indicate that spatial resolution is a significant factor in reducing contact with obstacles and following a path without veering, however the phosphene display frame rate is a better predictor of a person’s preferred walking speed. These findings support the development of an adaptive display which could provide a faster display with reduced spatial resolution when a person is walking comfortably and a slower display with higher resolution when a person has stopped moving.
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    Addressing men's health policy concerns in Australia: what can be done?
    (BioMed Central - http://www.biomedcentral.com, 2007-10-10) Smith, James
    There is a lack of consensus about what men's health constitutes in Australia. The absence of a widely accepted definition has been problematic for establishing state and national men's health policies. I consider that one impediment to the implementation of state and federal men's health policies has been a lack of willingness to approach men's health from a broad public health perspective. In particular, scant attention has been paid to exploring lay perspectives of how men define and understand health, and in turn, how these relate to significant policy problems such as men's health service use. I conclude by suggesting that a focus on men's lay perspectives of their health emerging from the United Kingdom and the Republic of Ireland provides a useful framework to guide men's health policy discussion in Australia.
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    e-Research Meets e-Health
    (Australian Computer Society, 2008) Maeder, Anthony
    This paper considers some key aspects of e-Research methodology and infrastructure which are relevant to e-Health, and identifies some promising areas in e-Health where these aspects could be used beneficially .
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    The cultural relations of water in remote South Australian towns
    (The Australian Sociological Association, 2009) Wadham, Benjamin Allan ; Willis, Eileen Mary ; Pearce, Meryl Winsome
    Water is an increasingly scarce resource and the decline in rainfall presupposes people and communities adapting to live in drier, and very different, social and environmental conditions. In rural and remote South Australia residents have always considered water a reflexive resource that requires them to consider their relationship to water and its availability and access. These are material concerns. Yet, lifestyle, identity, sense of place and community is profoundly shaped by the inclusion of ‘water’ in one’s habitus. ‘Water’ is also a social concern and its material management arises within cultural relations.
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    Gendered relations to working time: enterprise bargaining outcomes in acute care and community nursing settings in Australia
    (The Association of Industrial Relations Academics of Australia and New Zealand, 2009) Willis, Eileen Mary ; Toffoli, Luisa Patrizia ; Henderson, Julie Anne ; Walter, Bronwyn Kay
    In this paper we examine the outcomes of the 2001, 2004, 2007 Enterprise Bargaining Agreements between the Australian Nursing Federation (SA) and the South Australian Government with particular focus on union-based strategies for de-intensifying nurses’ labour in the acute and community sectors. Consistent with the theoretical and empirical research on time, the strategies employed in the acute sector reflect rational, linear, bureaucratic, logical and masculinist relations to time through the use of computerised time and task measures. Community sector solutions are characterised by cyclical, messy and highly relational feminised approaches to reducing work intensification. We argue that the outcomes of these two approaches are contradictory. The community-based solution of case management is less successful in reducing workload, but maintains worker control over the labour process, while in the acute sector, the highly Taylorist approach is successful in de-intensifying workload but at the cost of reduced control over the labour processes.
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    Assessing Viewing Pattern Consistency in Mammogram Readers
    (Australian Computer Society, 2009) Maeder, Anthony ; Fookes, C
    Breast cancer screening programs typically require very large volumes of x-ray images (mammograms) to be viewed by highly experienced human readers. The readers can recognise a wide range of different visible features indicative of clinically abnormal situations, which they use as a basis to generate a report on their findings. Errors in reporting can occur if the readers fail to identify a particular feature of interest for further visual inspection during the viewing process. This risk is typically reduced by training readers to follow a particular viewing path through an image, which they should be able to apply consistently. Knowledge of the extent of consistency in this viewing behaviour within and between viewers would inform the development of an automated checking approach, based on monitoring of viewer visual attention. This paper presents an analysis of some reader viewing pattern profiles obtained using eye tracking with an infra red computer vision system, as a basis for developing a suitable consistency assessment model. .
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    The provision of water infrastructure in Aboriginal communities in South Australia
    (ANU E Press, 2009) Willis, Eileen Mary ; Pearce, Meryl Winsome ; McCarthy, Carmel Marie ; Ryan, Fiona Therese ; Wadham, Benjamin Allan
    The provision of water supplies to Aboriginal people in South Australia, particularly to communities covered under the Commonwealth–State (South Australia) Bilateral Agreement is considered world class in terms of the suitability of the technology to the remoteness of many of the communities and the harsh arid environment. This article explores the history of domestic water supplies to these Aboriginal communities. The article begins with a brief outline of pre-contact Aboriginal technologies for the maintenance of water supplies and reflects on the continuity of these approaches through the early years of pastoralist and missionary settlement. This is followed by a description of the services offered by the state and federal governments since the late 1970s to the present.
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    Characterizing Image Properties for Digital Mammograms
    (Australian Computer Society, 2009) Nguyen, Anthony ; Dowling, Jason A ; Maeder, Anthony ; Nguyen, Phuong ; Brunton, Emma
    Adoption of computed radiology (CR) and direct radiology (DR) imaging for screening mammograms in many countries alongside digitally scanned film mammograms has resulted in a wide range of different intrinsic (physical) characteristics of images becoming commonplace. It is sometimes conjectured that viewer performance could be adversely affected by this wider variability, as compared with the variability that was formerly experienced with film only. This paper identifies several aspects of the image characteristics relevant to viewer perception, including intensity properties (such as contrast), spatial properties (such as texture) and structure properties (such as breast density). We then provide quantitative descriptions of the variability of these properties over a test set of 12 screening mammograms drawn from three different modalities and containing a typical mix of screening cases..
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    Expressive phenomenology and critical approaches in the classroom: process and risks for students of health sciences
    (University of Adelaide, 2010) Willis, Eileen Mary
    This article explores the use of expressive phenomenological and critical approaches to the teaching of health policy to a large class of first year health professional students studying both internally and through distance education. The phenomenological approach to classroom teaching attempts to provide students with opportunities to immerse themselves in the lived experiences of populations and individuals who are ill and in need of care. The critical approach brings the political, social and cultural realities of professional practice into the classroom discussion and reflection. The transition from the expressive phenomenological to critical analysis requires careful management by the teacher when reacting to the mood, responses and capacities of students. Managing these processes online for students studying at a distance presents additional pedagogical issues. These are: the problem of capturing ‘real time’ mood, managing the chaos of multiple student narratives, allowing time to dwell on the phenomena and dealing with the impact of violent films.
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    Constructing a Synthetic Longitudinal Health Dataset for Data Mining
    (IARIA, 2012) Ghassem Pour, S ; Maeder, Anthony ; Jorm, L
    The traditional approach to epidemiological research is to analyse data in an explicit statistical fashion, attempting to answer a question or test a hypothesis. However, increasing experience in the application of data mining and exploratory data analysis methods suggests that valuable information can be obtained from large datasets using these less constrained approaches. Available data mining techniques, such as clustering, have mainly been applied to cross-sectional point-in-time data. However, health datasets often include repeated observations for individuals and so researchers are interested in following their health trajectories. This requires methods for analysis of multiple-points-over-time or longitudinal data. Here, we describe an approach to construct a synthetic longitudinal version of a major population health dataset in which clusters merge and split over time, to investigate the utility of clustering for discovering time sequence based patterns.
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    Comparing Data Mining with Ensemble Classification of Breast Cancer Masses in Digital Mammograms
    (AIH, 2012) Ghassem Pour, S ; McLeod, P ; Verma, B ; Maeder, Anthony
    Medical diagnosis sometimes involves detecting subtle indi-cations of a disease or condition amongst a background of diverse healthy individuals. The amount of information that is available for discover-ing such indications for mammography is large and has been growing at an exponential rate, due to population wide screening programmes. In order to analyse this information data mining techniques have been utilised by various researchers. A question that arises is: do flexible data mining techniques have comparable accuracy to dedicated classification techniques for medical diagnostic processes? This research compares a model-based data mining technique with a neural network classification technique and the improvements possible using an ensemble approach. A publicly available breast cancer benchmark database is used to determine the utility of the techniques and compare the accuracies obtained.
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    Effectiveness of a website and mobile phone based physical activity and nutrition intervention for middle-aged males: Trial protocol and baseline findings of the ManUp Study
    (BioMed Central, 2012-08-15) Duncan, Mitch J ; Vandelanotte, Corneel ; Rosenkranz, Richard R ; Caperchione, Cristina M ; Ding, Hang ; Ellison, Marcus ; George, Emma S ; Hooker, Cindy ; Karunanithi, Mohan ; Kolt, Gregory S ; Maeder, Anthony ; Noakes, Manny ; Tague, Rhys ; Taylor, Pennie ; Viljoen, Pierre ; Mummery, W Kerry
    Background: Compared to females, males experience higher rates of chronic disease and mortality, yet few health promotion initiatives are specifically aimed at men. Therefore, the aim of the ManUp Study is to examine the effectiveness of an IT-based intervention to increase the physical activity and nutrition behaviour and literacy in middle-aged males (aged 35–54 years). Method/Design: The study design was a two-arm randomised controlled trial, having an IT-based (applying website and mobile phones) and a print-based intervention arm, to deliver intervention materials and to promote self-monitoring of physical activity and nutrition behaviours. Participants (n = 317) were randomised on a 2:1 ratio in favour of the IT-based intervention arm. Both intervention arms completed assessments at baseline, 3, and 9 months. All participants completed self-report assessments of physical activity, sitting time, nutrition behaviours, physical activity and nutrition literacy, perceived health status and socio-demographic characteristics. A randomly selected sub-sample in the IT-based (n = 61) and print-based (n = 30) intervention arms completed objective measures of height, weight, waist circumference, and physical activity as measured by accelerometer (Actigraph GT3X). The average age of participants in the IT-based and print-based intervention arm was 44.2 and 43.8 years respectively. The majority of participants were employed in professional occupations (IT-based 57.6%, Print-based 54.2%) and were overweight or obese (IT-based 90.8%, Print-based 87.3%). At baseline a lower proportion of participants in the IT-based (70.2%) group agreed that 30 minutes of physical activity each day is enough to improve health compared to the print-based (82.3%) group (p = .026). The IT-based group consumed a significantly lower number of serves of red meat in the previous week, compared to the print-based group (p = .017). No other significant between-group differences were observed at baseline. Discussion: The ManUp Study will examine the effectiveness of an IT-based approach to improve physical activity and nutrition behaviour and literacy. Study outcomes will provide much needed information on the efficacy of this approach in middle aged males, which is important due to the large proportions of males at risk, and the potential reach of IT-based interventions.
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    Validating Synthetic Health Datasets for Longitudinal Clustering
    ( 2013) Ghassem Pour, S ; Maeder, Anthony ; Jorm, L
    Clustering methods partition datasets into subgroups with some homogeneous properties, with information about the number and particular characteristics of each subgroup unknown a priori. The problem of predicting the number of clusters and quality of each cluster might be overcome by using cluster validation methods. This paper presents such an approach in-corporating quantitative methods for comparison be-tween original and synthetic versions of longitudinal health datasets. The use of the methods is demon-strated by using two different clustering algorithms, K-means and Latent Class Analysis, to perform clus-tering on synthetic data derived from the 45 and Up Study baseline data, from NSW in Australia.
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    A conceptual framework for secure mobile health
    (International Society for Telemedicine and eHealth, 2013) William, P ; Maeder, Anthony
    Mobile health is characterised by its diversity of applicability, in a multifaceted and multidisciplinary healthcare delivery continuum. In an environment of rapid change with the increasing development of mobile health, issues related to security and privacy must be well thought out. The different competing tensions in the development of mobile health from the device technologies and associated regulation, to clinical workflow and patient acceptance, require a framework for security that reflects the complex structure of this emerging field. There are three distinct associated elements that require investigation: technology, clinical, and human factors. Each of these elements consists of multiple aspects and there are specific risk factors to be addressed successively and co-dependently in each case. The fundamental approach to defining a conceptual framework for secure use of mobile health requires systematic identification of properties for the tensions and critical factors which impact these elements. The resulting conceptual framework presented here can be used for new critique, augmentation or deployment of mobile health solutions from the perspective of data protection and security.
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    'I mean I expect that it's pretty safe': Perceptions of food trust in pregnancy-implications for primary health care practice
    (Australasian Medical Journal, 2013) House, Elizabeth ; Coveney, John David
    Background Pregnancy is a time in which food choice is of particular importance. Trust in the food supply and those who regulate it is receiving greater acknowledgement because of the influence of trust on food choice. No prior investigation into pregnant women and food trust has been conducted. Aims This paper identifies factors that determine the nature and extent of pregnant women's trust in food; sources of information which influence pregnant women's food choices; and how trust impacts on pregnant women's food choices. Method In-depth interviews were conducted with 13 pregnant women; nine were pregnant with their first child and four were in their second or subsequent pregnancy. Results Food choices of pregnant women w ere predominantly influenced by nutrition and perceived quality of food. Risk-taking behaviour, such as the consumption of foods considered high risk during pregnancy, was common amongst participants. The sample was characterised by a dependence on expert information, limited reflexivity in relation to food safety, and contradictory practice such as risk-taking behaviours in regard to high risk foods were observed. Conclusion Further research is needed to confirm findings in this study. Research into consumption of high-risk foods and the information received from healthcare providers would be useful in creating a clearer understanding of whether provision of information is sufficient in communicating risks and promoting a healthy pregnancy.
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    WALK 2.0 - Using Web 2.0 applications to promote health-related physical activity: A randomised controlled trial protocol
    (BioMed Central, 2013-05-03) Kolt, Gregory S ; Rosenkranz, Richard R ; Savage, Trevor N ; Maeder, Anthony ; Vandelanotte, Corneel ; Duncan, Mitch J ; Caperchione, Cristina M ; Tague, Rhys ; Hooker, Cindy ; Mummery, W Kerry
    Background: Physical inactivity is one of the leading modifiable causes of death and disease in Australia. National surveys indicate less than half of the Australian adult population are sufficiently active to obtain health benefits. The Internet is a potentially important medium for successfully communicating health messages to the general population and enabling individual behaviour change. Internet-based interventions have proven efficacy; however, intervention studies describing website usage objectively have reported a strong decline in usage, and high attrition rate, over the course of the interventions. Web 2.0 applications give users control over web content generated and present innovative possibilities to improve user engagement. There is, however, a need to assess the effectiveness of these applications in the general population. The Walk 2.0 project is a 3-arm randomised controlled trial investigating the effects of “next generation” web-based applications on engagement, retention, and subsequent physical activity behaviour change. Methods/design: 504 individuals will be recruited from two sites in Australia, randomly allocated to one of two web-based interventions (Web 1.0 or Web 2.0) or a control group, and provided with a pedometer to monitor physical activity. The Web 1.0 intervention will provide participants with access to an existing physical activity website with limited interactivity. The Web 2.0 intervention will provide access to a website featuring Web 2.0 content, including social networking, blogs, and virtual walking groups. Control participants will receive a logbook to record their steps. All groups will receive similar educational material on setting goals and increasing physical activity. The primary outcomes are objectively measured physical activity and website engagement and retention. Other outcomes measured include quality of life, psychosocial correlates, and anthropometric measurements. Outcomes will be measured at baseline, 3, 12 and 18 months. Discussion: The findings of this study will provide increased understanding of the benefit of new web-based technologies and applications in engaging and retaining participants on web-based intervention sites, with the aim of improved health behaviour change outcomes.
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    Evaluating success of mobile health projects in the developing world
    (IOS Press, 2014) Ginige, J A ; Maeder, Anthony ; Long, V
    Many mobile health (mHealth) projects, typically deploying pilot or small scale implementations, have been undertaken in developing world settings and reported with a widely varying range of claims being made on their effectiveness and benefits. As a result, there is little evidence for which aspects of such projects lead to successful outcomes. This paper describes a literature review of papers from PubMed undertaken to identify strong contributions to execution and evaluation of mHealth projects in developing world settings, and suggests a template for classifying the main success factors to assist with collating evidence in the future.
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    Effectiveness of a Web- and Mobile Phone-Based Intervention to Promote Physical Activity and Healthy Eating in Middle-Aged Males: Randomized Controlled Trial of the ManUp Study
    (Journal of Medical Internet Research, 2014) Duncan, Mitch J ; Vandelanotte, Corneel ; Kolt, Gregory S ; Rosenkranz, Richard R ; Caperchione, Cristina M ; George, Emma S ; Ding, Hang ; Hooker, Cindy ; Karunanithi, Mohan ; Maeder, Anthony ; Noakes, Manny ; Tague, Rhys ; Taylor, Pennie ; Viljoen, Pierre ; Mummery, W Kerry
    Background: The high number of adult males engaging in low levels of physical activity and poor dietary practices, and the health risks posed by these behaviors, necessitate broad-reaching intervention strategies. Information technology (IT)-based (Web and mobile phone) interventions can be accessed by large numbers of people, yet there are few reported IT-based interventions targeting males’ physical activity and dietary practices. Objective: This study examines the effectiveness of a 9-month IT-based intervention (ManUp) to improve the physical activity, dietary behaviors, and health literacy in middle-aged males compared to a print-based intervention. Methods: Participants, recruited offline (eg, newspaper ads), were randomized into either an IT-based or print-based intervention arm on a 2:1 basis in favor of the fully automated IT-based arm. Participants were adult males aged 35-54 years living in 2 regional cities in Queensland, Australia, who could access the Internet, owned a mobile phone, and were able to increase their activity level. The intervention, ManUp, was based on social cognitive and self-regulation theories and specifically designed to target males. Educational materials were provided and self-monitoring of physical activity and nutrition behaviors was promoted. Intervention content was the same in both intervention arms; only the delivery mode differed. Content could be accessed throughout the 9-month study period. Participants’ physical activity, dietary behaviors, and health literacy were measured using online surveys at baseline, 3 months, and 9 months. Results: A total of 301 participants completed baseline assessments, 205 in the IT-based arm and 96 in the print-based arm. A total of 124 participants completed all 3 assessments. There were no significant between-group differences in physical activity and dietary behaviors (P≥.05). Participants reported an increased number of minutes and sessions of physical activity at 3 months (exp(β)=1.45, 95% CI 1.09-1.95; exp(β)=1.61, 95% CI 1.17-2.22) and 9 months (exp(β)=1.55, 95% CI 1.14-2.10; exp(β)=1.51, 95% CI 1.15-2.00). Overall dietary behaviors improved at 3 months (exp(β)=1.07, 95% CI 1.03-1.11) and 9 months (exp(β)=1.10, 95% CI 1.05-1.13). The proportion of participants in both groups eating higher-fiber bread and low-fat milk increased at 3 months (exp(β)=2.25, 95% CI 1.29-3.92; exp(β)=1.65, 95% CI 1.07-2.55). Participants in the IT-based arm were less likely to report that 30 minutes of physical activity per day improves health (exp(β)=0.48, 95% CI 0.26-0.90) and more likely to report that vigorous intensity physical activity 3 times per week is essential (exp(β)=1.70, 95% CI 1.02-2.82). The average number of log-ins to the IT platform at 3 and 9 months was 6.99 (SE 0.86) and 9.22 (SE 1.47), respectively. The average number of self-monitoring entries at 3 and 9 months was 16.69 (SE 2.38) and 22.51 (SE 3.79), respectively. Conclusions: The ManUp intervention was effective in improving physical activity and dietary behaviors in middle-aged males with no significant differences between IT- and print-based delivery modes.
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    Monitoring falls in elderly people: Lessons from a community-based project
    (IOS Press, 2014) Pirnejad, H ; Huq, G ; Basilakis, J ; Maeder, Anthony
    Objectives. This paper describes an evaluation of a community-based fall-detection project using smart phone based tri-axial accelerometry to identify factors that affect adoption and use of such technology by elderly people. Methods. A mixed methods study using questionnaires and semi-structured interviews was conducted to evaluate attitudes of the elderly people participating, as well as project stakeholders involved in the project. Information registered in a web-based fall management system was analyzed both qualitatively and quantitatively, using an adapted version of Unified Theory of Acceptance and Use of Technology (UTAUT). Results. Adoption rate was 61.7% and attrition rate was 57%, the most common reasons for attrition being health deterioration (50%) and problems with the device and the network (26.2%). Conclusion. We identified a number of challenges that affected the success of this project, including problems with the software, usability issues with the device, coverage of the network, training of participants, and
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    Health intelligence: Discovering the process model using process mining by constructing Start-to-End patient journeys
    (Australian Computer Society, 2014) Perimal-Lewis, Lua ; de Vries, Denise Bernadette ; Thompson, Campbell Henry
    Australian Public Hospitals are continually engaged in various process improvement activities to improve patient care and to improve hospital efficiency as the demand for service intensifies. As a consequence there are many initiatives within the health sector focusing on gaining insight into the underlying health processes which are assessed for compliance with specified Key Performance Indicators (KPIs). Process Mining is classified as a Business Intelligence (BI) tool. The aim of process mining activities is to gain insight into the underlying process or processes. The fundamental element needed for process mining is a historical event log of a process. Generally, these event logs are easily sourced from Process Aware Information Systems (PAIS). Simulation is widely used by hospitals as a tool to study the complex hospital setting and for prediction. Generally, simulation models are constructed by ‘hand’. This paper presents a novel way of deriving event logs for health data in the absence of PAIS. The constructed event log is then used as an input for process mining activities taking advantage of existing process mining algorithms aiding the discovery of knowledge of the underlying processes which leads to Health Intelligence (HI). One such output of process mining activity, presented in this paper, is the discovery of process model for simulation using the derived event log as an input for process mining by constructing start-to-end patient journey. The study was undertaken using data from Flinders Medical Centre to gain insight into patient journeys from the point of admission to the Emergency Department (ED) until the patient is discharged from the hospital. .