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Search Results: 1 - 10 of 17501 matches for " Andrew Georgiou "
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The performance and assessment of hospital trauma teams
Andrew Georgiou, David J Lockey
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2010, DOI: 10.1186/1757-7241-18-66
Abstract: Trauma teams are a key component of most programmes which set out to improve trauma care. This article reviews the background of trauma teams, the evidence for benefit and potential techniques of performance assessment. The review was written after a PubMed, Ovid, Athens, Cochrane and guideline literature review of English language articles on trauma teams and their performance and hand searching of references from the relevant searched articles.Trauma is the leading cause of death in the 1-44 year old age group [1] and the fourth leading cause of death in the western world [2]. Despite the widespread recognition of simple principles of trauma care which have the potential to reduce mortality and the implementation of trauma education initiatives such as the American College of Surgeons Advanced Trauma Life Support courses (ATLS?) [3], the uptake and implementation of many of these principles has been sporadic and variable. In the UK for example, The Royal College of Surgeons of England highlighted important deficiencies in the management of severely injured patients in a report in 1988 [4]. A second report in 2000 [5] addressed the lack of ongoing improvement in the last six years of the twentieth century [6], recommending amongst other things, the introduction of a system of trauma audit and the establishment of hospital trauma teams. In 2007 a report by the UK National Confidential Enquiry into Patient Outcomes and Death [2] found that trauma teams were only available in 20% of hospitals, and a trauma team response was documented for only 59.7% of patients with injury severity scores (ISS) >16. The report strongly recommended that hospitals in the UK ensure that a trauma team is available twenty four hours a day, seven days a week. This problem is not confined to the UK. Data from Australia in 2003 show that only 56% of adult trauma hospitals [7] and 75% of tertiary paediatric hospitals which receive trauma [8] provided a trauma team reception.The trauma team usu
Non-homogeneous random walks on a semi-infinite strip
Nicholas Georgiou,Andrew R. Wade
Mathematics , 2014, DOI: 10.1016/j.spa.2014.05.005
Abstract: We study the asymptotic behaviour of Markov chains $(X_n,\eta_n)$ on $\mathbb{Z}_+ \times S$, where $\mathbb{Z}_+$ is the non-negative integers and $S$ is a finite set. Neither coordinate is assumed to be Markov. We assume a moments bound on the jumps of $X_n$, and that, roughly speaking, $\eta_n$ is close to being Markov when $X_n$ is large. This departure from much of the literature, which assumes that $\eta_n$ is itself a Markov chain, enables us to probe precisely the recurrence phase transitions by assuming asymptotically zero drift for $X_n$ given $\eta_n$. We give a recurrence classification in terms of increment moment parameters for $X_n$ and the stationary distribution for the large-$X$ limit of $\eta_n$. In the null case we also provide a weak convergence result, which demonstrates a form of asymptotic independence between $X_n$ (rescaled) and $\eta_n$. Our results can be seen as generalizations of Lamperti's results for non-homogeneous random walks on $\mathbb{Z}_+$ (the case where $S$ is a singleton). Motivation arises from modulated queues or processes with hidden variables where $\eta_n$ tracks an internal state of the system.
An empirically-derived approach for investigating Health Information Technology: the Elementally Entangled Organisational Communication (EEOC) framework
Andrew Georgiou, Johanna I Westbrook, Jeffrey Braithwaite
BMC Medical Informatics and Decision Making , 2012, DOI: 10.1186/1472-6947-12-68
Abstract: The framework was synthesised from multiple research studies undertaken across a major metropolitan hospital pathology service during the period 2005 to 2008. These studies evaluated the impact of new HIT systems in pathology departments (Laboratory Information System) and an Emergency Department (Computerised Provider Order Entry) located in Sydney, Australia.Key dimensions of EEOC are illustrated by the following case studies: 1) the communication infrastructure between the Blood Bank and the ward for the coordination and distribution of blood products; 2) the organisational environment in the Clinical Chemistry and Haematology departments and their attempts to organise, plan and control the processing of laboratory specimens; and 3) the temporal make up of the organisation as revealed in changes to the way the Central Specimen Reception allocated, sequenced and synchronised work tasks.The case studies not only highlight the pre-existing communication architecture within the organisation but also the constitutive role communication plays in the way organisations go about addressing their requirements. HIT implementation involves a mutual transformation of the organisation and the technology. This is a vital consideration because of the dangers associated with poor organisational planning and implementation of HIT, and the potential for unintended adverse consequences, workarounds and risks to the quality and safety of patient care. The EEOC framework aims to account for the complex range of contextual factors and triggers that play a role in the success or otherwise of new HITs, and in the realisation of their innovation potential.
Medication incident reporting in residential aged care facilities: Limitations and risks to residents’ safety
Tariq Amina,Georgiou Andrew,Westbrook Johanna
BMC Geriatrics , 2012, DOI: 10.1186/1471-2318-12-67
Abstract: Background Medication incident reporting (MIR) is a key safety critical care process in residential aged care facilities (RACFs). Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs. Methods The study was undertaken in three RACFs (part of a large non-profit organisation) in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach. Results The findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a) design MIR artefacts that facilitate identification of the root causes of medication incidents, b) integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c) support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs. Conclusions This study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes.
A Global Solution of the Einstein-Maxwell Field Equations for Rotating Charged Matter  [PDF]
Andreas Georgiou
Journal of Modern Physics (JMP) , 2012, DOI: 10.4236/jmp.2012.329168
Abstract: A stationary axially symmetric exterior electrovacuum solution of the Einstein-Maxwell field equations was obtained. An interior solution for rotating charged dust with vanishing Lorentz force was also obtained. The two spacetimes are separated by a boundary which is a surface layer with surface stress-energy tensor and surface electric 4-current. The layer is the spherical surface bounding the charged matter. It was further shown, that all the exterior physical quantities vanished at the asymptotic spatial infinity where spacetime was shown to be flat. There are two different sets of junction conditions: the electromagnetic junction conditions, which were expressed in the traditional 3-dimensional form of classical electromagnetic theory; and the considerably more complicated gravitational junction conditions. It was shown that both—the electromagnetic and gravitational junction conditions—were satisfied. The mass, charge and angular momentum were determined from the metric. Exact analytical formulae for the dipole moment and gyromagnetic ratio were also derived. The conditions, under which the latter formulae gave Blackett’s empirical result for rotating stars, were investigated.
The Angular Momenta Dipole Moments and Gyromagnetic Ratios of the Electron and the Proton  [PDF]
A. Georgiou
Journal of Modern Physics (JMP) , 2014, DOI: 10.4236/jmp.2014.514125
Abstract:

We had previously obtained analytical formulae for the dipole moments and angular momenta of rotating spherical bodies. The resulting formulae were applied to the Sun, the star 78 Virginis and the Earth. The agreement of the theoretical formulae with the actual real situations is indeed remarkable. In this note we apply the same formulae to the electron and the proton, using the classical values of the radii, so no quantum mechanical treatment is considered.

The Angular Momenta, Dipole Moments and Gyromagnetic Ratios of the Neutron and the Muon  [PDF]
Andreas Georgiou
Journal of Modern Physics (JMP) , 2015, DOI: 10.4236/jmp.2015.67104
Abstract: The dipole moments, angular momenta and gyromagnetic ratios of the electron and the proton were obtained earlier. In this note, we derive the corresponding expressions for the neutron and the muon. This work relies on the results obtained earlier for the angular momenta and dipole moments of rotating spherical bodies.
The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments
Julie Li, Johanna Westbrook, Joanne Callen, Andrew Georgiou
BMC Medical Informatics and Decision Making , 2012, DOI: 10.1186/1472-6947-12-27
Abstract: A cross-sectional qualitative study was undertaken in the Emergency Departments (EDs) of two large Australian metropolitan public teaching hospitals. Semi-structured, in-depth interviews were conducted with five nurse practitioners, four senior physicians and five senior nurses. Transcribed interviews were analysed using a grounded theory approach to develop themes in relation to the conceptualisation of the ED nurse practitioner role and the influences of ICT upon the role. Member checking of results was achieved by revisiting the sites to clarify findings with participants and further explore emergent themes.The role of the ENP was distinguished from those of Emergency nurses and physicians by two elements: advanced practice and holistic care, respectively. ICT supported the advanced practice dimension of the NP role in two ways: availability and completeness of electronic patient information enhanced timeliness and quality of diagnostic and therapeutic decision-making, expediting patient access to appropriate care. The ubiquity of patient data sourced from a central database supported and improved quality of communication between health professionals within and across sites, with wider diffusion of the Electronic Medical Record holding the potential to further facilitate team-based, holistic care.ICT is a facilitator through which the disruptive impact of NPs can be extended. However, integration of ICT into work practices without detracting from provider-patient interaction is crucial to ensure utilisation of such interventions and realisation of potential benefits.The concept of "disruptive" innovations arose over fifteen years ago to describe new technologies or interventions which create significant impacts on a commercial market [1]. In contrast to "sustaining" technologies, which provide incremental improvements to the performance and outcomes of existing technologies, disruptive innovations replace existing processes and eventually change the face of the m
Examining the role of information exchange in residential aged care work practices-a survey of residential aged care facilities
Gaskin Sarah,Georgiou Andrew,Barton Donna,Westbrook Johanna
BMC Geriatrics , 2012, DOI: 10.1186/1471-2318-12-40
Abstract: Background The provision of residential aged care is underpinned by information, and is reliant upon systems that adequately capture and effectively utilise and communicate this information. The aim of this study was to explicate and quantify the volume and method by which information is collected, exchanged within facilities and with external providers, and retrieved from facility information systems and hospitals. Methods A survey of staff (n = 119), including managers, health informatics officers (HIOs), quality improvement staff, registered nurses (RNs), enrolled nurses (ENs)/endorsed enrolled nurses (EENs) and assistants in nursing (AINs) was carried out in four residential aged care facilities in New South Wales and Victoria, Australia. Sites varied in size and displayed a range of information technology (IT) capabilities. The survey investigated how and by whom information is collected, retrieved and exchanged, and the frequency and amount of time devoted to these tasks. Descriptive analysis was performed using SPSS, and open responses to questions were coded into key themes. Results Staff completed a median of six forms each, taking a median of 30 min per shift. 68.8% of staff reported transferring information from paper to a computer system, which took a median of 30 min per shift. Handover and face-to-face communication was the most frequently used form of information exchange within facilities. There was a large amount of faxing and telephone communication between facility staff and General Practitioners and community pharmacists, with staff reporting sending a median of 2 faxes to pharmacy and 1.5 faxes to General Practitioners, and initiating 2 telephone calls to pharmacies and 1.5 calls to General Practitioners per shift. Only 38.5% of respondents reported that they always had information available at the point-of-care and only 35.4% of respondents reported that they always had access to hospital stay information of residents after hospital discharge. Conclusions This survey identified a high volume of information exchange activities, as well as inefficient procedures, such as the transfer of information from paper to computer systems and the reliance upon faxes for communication with external providers. These findings contribute to evidence for the need for interoperable IT systems to allow more efficient and reliable information exchange between facilities and external providers.
Anomalous recurrence properties of many-dimensional zero-drift random walks
Nicholas Georgiou,Mikhail V. Menshikov,Aleksandar Mijatovi?,Andrew R. Wade
Mathematics , 2015,
Abstract: Famously, a $d$-dimensional, spatially homogeneous random walk whose increments are non-degenerate, have finite second moments, and have zero mean is recurrent if $d \in \{1,2\}$ but transient if $d \geq 3$. Once spatial homogeneity is relaxed, this is no longer true. We study a family of zero-drift spatially non-homogeneous random walks (Markov processes) whose increment covariance matrix is asymptotically constant along rays from the origin, and which, in any ambient dimension $d \geq 2$, can be adjusted so that the walk is either transient or recurrent. Natural examples are provided by random walks whose increments are supported on ellipsoids that are symmetric about the ray from the origin through the walk's current position; these \emph{elliptic random walks} generalize the classical homogeneous Pearson--Rayleigh walk (the spherical case). Our proof of the recurrence classification is based on fundamental work of Lamperti.
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