title: A decision support system for predicting the complications of diabetes mellitus: A design science research approach

authors: Madurapperumage, Anuradha

abstract: Health information systems (HIS) serve as the cornerstone of modern healthcare, seamlessly
weaving data into actionable insights and empowering professionals to make informed
decisions and elevate patient care. Decision support systems became a prominent research
area in the discipline of HIS, where clinical decision support systems (CDSSs) with the ability
to diagnose and prognosis of disease are recognised as the most common and beneficial
information systems. Moreover, the high prevalence and adverse effects of diabetes all over
the globe evidently make it vital to predict diabetes and its complications.
The current study aims to resolve an issue at Te Whatu Ora, by generating a CDSS which can
predict the complications of diabetes mellitus (CoDM) while answering the knowledge gap.
Although a rich data set of diabetes patients’ is maintained at Te Whatu Ora, their
involvement in decision-making is unsatisfactory. This study created a CDSS to resolve the
issue at Te Whatu Ora while considering two perspectives of the question: design and data
analysis. The system design followed design science research methodologies (DSRM) while
selecting suitable techniques in the steps of the empirical cycle to confirm their applicability
in the domain. The data analysis perspective of the study focused on survival analysis
methods due to their appropriateness in fulfilling the identified research gaps.
The created CDSS is the primary outcome of the research, which resolves the real-world issue
while addressing the recognised research gaps. The solution's design perspective confirms
the applicability of adopting design science research approaches in the context of a
systematic solution-design process. The data analytics perspective confirms the
appropriateness of survival techniques in the domain while validating the system’s
performance.
The outcome of this research has significant academical, and managerial implications. The
implemented CDSS is capable of providing a chronological risk percentage for 10 CoDM in a
cohort of New Zealand. The systematic procedure adopted in the research contributes to the
existing knowledge gaps while answering the design, implementation, and evaluation stages.
The managerial implications of the study expand through policy-makers, resource-allocators,
iii
and healthcare administrators to doctors, nurses, and patients. The predicted risk of CoDM
may be beneficial in managing the patients by issuing early warnings, starting treatment
plans, conducting diagnosis tests, recommending dietary/exercise routines and more from
the perspective of patient care. The visualisation of the statistical details and the survival
curves in the system may assist in managing diabetes data repositories efficiently.
This study creates a cohort-specific risk prediction model based on the New Zealand cohort.
The interoperability challenges in the CDSS could occur due to the variety of practices in real
life. Future research studies in this domain can concentrate on increasing the accuracy of the
models with more features of a rich dataset while protecting the patents’ confidentiality.
Additionally, the cohort specificity of the CDSS can be avoided with the engagement of a
global dataset.

text: A decision support system for predicting the complications of diabetes mellitus: A design science research approach Health information systems (HIS) serve as the cornerstone of modern healthcare, seamlessly
weaving data into actionable insights and empowering professionals to make informed
decisions and elevate patient care. Decision support systems became a prominent research
area in the discipline of HIS, where clinical decision support systems (CDSSs) with the ability
to diagnose and prognosis of disease are recognised as the most common and beneficial
information systems. Moreover, the high prevalence and adverse effects of diabetes all over
the globe evidently make it vital to predict diabetes and its complications.
The current study aims to resolve an issue at Te Whatu Ora, by generating a CDSS which can
predict the complications of diabetes mellitus (CoDM) while answering the knowledge gap.
Although a rich data set of diabetes patients’ is maintained at Te Whatu Ora, their
involvement in decision-making is unsatisfactory. This study created a CDSS to resolve the
issue at Te Whatu Ora while considering two perspectives of the question: design and data
analysis. The system design followed design science research methodologies (DSRM) while
selecting suitable techniques in the steps of the empirical cycle to confirm their applicability
in the domain. The data analysis perspective of the study focused on survival analysis
methods due to their appropriateness in fulfilling the identified research gaps.
The created CDSS is the primary outcome of the research, which resolves the real-world issue
while addressing the recognised research gaps. The solution's design perspective confirms
the applicability of adopting design science research approaches in the context of a
systematic solution-design process. The data analytics perspective confirms the
appropriateness of survival techniques in the domain while validating the system’s
performance.
The outcome of this research has significant academical, and managerial implications. The
implemented CDSS is capable of providing a chronological risk percentage for 10 CoDM in a
cohort of New Zealand. The systematic procedure adopted in the research contributes to the
existing knowledge gaps while answering the design, implementation, and evaluation stages.
The managerial implications of the study expand through policy-makers, resource-allocators,
iii
and healthcare administrators to doctors, nurses, and patients. The predicted risk of CoDM
may be beneficial in managing the patients by issuing early warnings, starting treatment
plans, conducting diagnosis tests, recommending dietary/exercise routines and more from
the perspective of patient care. The visualisation of the statistical details and the survival
curves in the system may assist in managing diabetes data repositories efficiently.
This study creates a cohort-specific risk prediction model based on the New Zealand cohort.
The interoperability challenges in the CDSS could occur due to the variety of practices in real
life. Future research studies in this domain can concentrate on increasing the accuracy of the
models with more features of a rich dataset while protecting the patents’ confidentiality.
Additionally, the cohort specificity of the CDSS can be avoided with the engagement of a
global dataset.

year: 2024

title: Grand Canyon landslide-dam and paleolake triggered by the Meteor Crater impact at 56 ka

authors: Karlstrom, KE

abstract: This paper hypothesizes that the Meteor Crater impact in Arizona, USA, 56,000 years ago triggered landslides in Grand Canyon that dammed the Colorado River and formed Nankoweap paleolake. This is compatible with shock and earthquake physics for the impact that infer a M5.4 seismic event, attenuated to an effective magnitude of M3.5 at Grand Canyon. Results that support the hypothesis include radiocarbon dating of driftwood and luminescence dating of associated slack-water lake sediments that are preserved in caves up to 60 m above the modern Colorado River. Radiocarbon ages from two locations, including Stanton’s Cave, date the driftwood as 55.25 ± 2.44 ka (n = 4). Sediments associated with the driftwood gave a luminescence age of 56.00 ± 6.39 ka (n = 2). These six Grand Canyon dates, and three published ages for the Meteor Crater impact, show statistically indistinguishable results that support the hypothesis for a geologically instantaneous series of events with a mean age of 55.60 ± 1.30 ka. This work highlights the value of radiocarbon dating near the limits of the technique, integration of multiple dating methods, and seismic and landslide hazards associated with meteorite impacts in regions of extreme topography like Grand Canyon.

text: Grand Canyon landslide-dam and paleolake triggered by the Meteor Crater impact at 56 ka This paper hypothesizes that the Meteor Crater impact in Arizona, USA, 56,000 years ago triggered landslides in Grand Canyon that dammed the Colorado River and formed Nankoweap paleolake. This is compatible with shock and earthquake physics for the impact that infer a M5.4 seismic event, attenuated to an effective magnitude of M3.5 at Grand Canyon. Results that support the hypothesis include radiocarbon dating of driftwood and luminescence dating of associated slack-water lake sediments that are preserved in caves up to 60 m above the modern Colorado River. Radiocarbon ages from two locations, including Stanton’s Cave, date the driftwood as 55.25 ± 2.44 ka (n = 4). Sediments associated with the driftwood gave a luminescence age of 56.00 ± 6.39 ka (n = 2). These six Grand Canyon dates, and three published ages for the Meteor Crater impact, show statistically indistinguishable results that support the hypothesis for a geologically instantaneous series of events with a mean age of 55.60 ± 1.30 ka. This work highlights the value of radiocarbon dating near the limits of the technique, integration of multiple dating methods, and seismic and landslide hazards associated with meteorite impacts in regions of extreme topography like Grand Canyon.

year: 2025

title: Reducing our prison population: Past failures and new approaches

authors: Tauri, Juan Marcellus

abstract: Earlier this year the Minister of Justice, Andrew Little announced the latest in a long line of reviews, taxpayer-funded summits and inter-agency, ‘wholeof-government’ projects stretching back to the late-1980s, all aimed in some form or other, at making the criminal justice system more ‘safe’ and ‘effective’. Officially launched at a summit held in Porirua in August 2018, the aim of the latest review is to reduce New Zealand’s prison muster by 30% over the next 15 years. And unsurprisingly, given our significant over-representation in prisons, a specific focus of the review is on identifying ways to significantly reduce Māori over-representation in the prison population. This commentary represents a modest offering in response to the current government’s stated aim of making the justice system safer and more effective, and to reduce the prison muster, and it is based on two core arguments, namely that successive governments and the public service have failed to reduce offending and imprisonment and that successful solutions require community empowerment and government/public service accountability.

text: Reducing our prison population: Past failures and new approaches Earlier this year the Minister of Justice, Andrew Little announced the latest in a long line of reviews, taxpayer-funded summits and inter-agency, ‘wholeof-government’ projects stretching back to the late-1980s, all aimed in some form or other, at making the criminal justice system more ‘safe’ and ‘effective’. Officially launched at a summit held in Porirua in August 2018, the aim of the latest review is to reduce New Zealand’s prison muster by 30% over the next 15 years. And unsurprisingly, given our significant over-representation in prisons, a specific focus of the review is on identifying ways to significantly reduce Māori over-representation in the prison population. This commentary represents a modest offering in response to the current government’s stated aim of making the justice system safer and more effective, and to reduce the prison muster, and it is based on two core arguments, namely that successive governments and the public service have failed to reduce offending and imprisonment and that successful solutions require community empowerment and government/public service accountability.

year: 2019