title: Grounded Theory of (Dis)Empowered Outcomes in Healthcare Interventions

authors: Mandlik, Milind A.

subjects: Consumer Empowerment

abstract: The human body is a complex, finely-tuned, and ever-evolving “open system” which is always trying to regain good health. Being an open system, the human body relies on surrounding ecological systems for its sustenance, survival, and growth, making it susceptible to the consequences of these ecological systems. One of the biggest concerns for human health in the 21st century is the ever-increasing obesity rate and its associated mortality rate. Of equal concern is the resultant loss of productivity and the net impact of this on publicly-funded healthcare expenditures. Years of research and investment in health-promotive programmes have failed to stymie the growing obesity epidemic. Evidently, current intervention strategies are not working and are in desperate need of remodelling. Obese individuals attempt to remedy the status quo, but often fail to achieve healthy changes in their lives. These individuals appear to be disempowered entities who seem to have given up on their quest for a better quality of life.

The purpose of this grounded theory based enquiry was to develop a substantive theory of the phenomenon of consumer empowerment. The study was designed to explore the multi-level, cross-disciplinary complexities associated with the obesity epidemic and to find a workable solution that would assist with curtailing its growth. The key aim of this research was to understand the social processes that either empower or dis-empower individuals during episodes of consumption. In total, 24 individuals participated in this enquiry by sharing their stories of weight gain and their personal experiences with the weight-management programmes they tried to help them improve their quality of life. The data collection and analysis was guided by the philosophical viewpoints of constructivist grounded theory.  

This study revealed two core categories that helped explain the processes that either empowered or disempowered individuals during episodes of consumption: feeling entrapped and co-creating empowerment.  Data analysis revealed that the processes which either empowered or disempowered individuals during various episodes of consumption were mediated through individually-acting and ecologically-acting influences. Analysis results further suggested if empowered outcomes were desired, then they could only be attained through genuine cooperation and participation amongst members of society at all levels: individual, communal, institutional, and political. Over-reliance on either the individual actor or ecological actor to contribute while the other refrains from contributing would not achieve the desired outcome. This is a significant departure from the current conceptualisation of achieving empowered outcomes. This situation can only be resolved by redefining and operationalising empowerment as a co-created endeavour, one that depends on multi-actor participation. 

This enquiry presents the impetus for researchers to conceive broader definitions of empowerment as well as consumer empowerment phenomenon that includes not just individual participation, but also ecological contributions to the process. This research has the potential to inform the broader literature on empowerment theory.

text: Grounded Theory of (Dis)Empowered Outcomes in Healthcare Interventions The human body is a complex, finely-tuned, and ever-evolving “open system” which is always trying to regain good health. Being an open system, the human body relies on surrounding ecological systems for its sustenance, survival, and growth, making it susceptible to the consequences of these ecological systems. One of the biggest concerns for human health in the 21st century is the ever-increasing obesity rate and its associated mortality rate. Of equal concern is the resultant loss of productivity and the net impact of this on publicly-funded healthcare expenditures. Years of research and investment in health-promotive programmes have failed to stymie the growing obesity epidemic. Evidently, current intervention strategies are not working and are in desperate need of remodelling. Obese individuals attempt to remedy the status quo, but often fail to achieve healthy changes in their lives. These individuals appear to be disempowered entities who seem to have given up on their quest for a better quality of life.

The purpose of this grounded theory based enquiry was to develop a substantive theory of the phenomenon of consumer empowerment. The study was designed to explore the multi-level, cross-disciplinary complexities associated with the obesity epidemic and to find a workable solution that would assist with curtailing its growth. The key aim of this research was to understand the social processes that either empower or dis-empower individuals during episodes of consumption. In total, 24 individuals participated in this enquiry by sharing their stories of weight gain and their personal experiences with the weight-management programmes they tried to help them improve their quality of life. The data collection and analysis was guided by the philosophical viewpoints of constructivist grounded theory.  

This study revealed two core categories that helped explain the processes that either empowered or disempowered individuals during episodes of consumption: feeling entrapped and co-creating empowerment.  Data analysis revealed that the processes which either empowered or disempowered individuals during various episodes of consumption were mediated through individually-acting and ecologically-acting influences. Analysis results further suggested if empowered outcomes were desired, then they could only be attained through genuine cooperation and participation amongst members of society at all levels: individual, communal, institutional, and political. Over-reliance on either the individual actor or ecological actor to contribute while the other refrains from contributing would not achieve the desired outcome. This is a significant departure from the current conceptualisation of achieving empowered outcomes. This situation can only be resolved by redefining and operationalising empowerment as a co-created endeavour, one that depends on multi-actor participation. 

This enquiry presents the impetus for researchers to conceive broader definitions of empowerment as well as consumer empowerment phenomenon that includes not just individual participation, but also ecological contributions to the process. This research has the potential to inform the broader literature on empowerment theory.

year: 2017

title: Surrogate-Assisted Evolutionary Algorithms for Wind Farm Layout Optimisation Problem

authors: Zheng, Chen

subjects: surrogate-assisted evolutionary optimisation

abstract: Due to the increasing need for computationally expensive optimisation in many real-world applications, surrogate-assisted evolutionary algorithms have attracted growing attention. In the literature, surrogate-assisted evolutionary approaches have been successful in highly computational expensive optimisation problems. However, surrogates have not been used with the Wind Farm Layout Optimisation Problem (WFLOP) before.

In this work, an evolutionary approach using surrogate modelling techniques to reduce the computational cost of the WFLOP is studied. The WFLOP mainly focuses on finding the optimal geographical placement of wind turbines within a wind farm in order to maximise power generation. But evaluating wind farm layout is very computationally expensive. The purpose of using surrogates is to approximate the real evaluation function of an evolutionary algorithm, but the surrogates can be computed more efficiently. The aim of this study is try to discover whether if surrogate-assisted evolutionary approach is effective on the WFLOP.

An analytical wake model is used to calculate the velocity deficits in the downstream generated by individual turbines. A set of initial offline experiments was conducted based on a dataset of wind farm layouts sampled from the space of all layouts, using biased random walk. These experiments were designed to discover which features lead to construction of an accurate surrogate model. According to the results of these experiments, polar coordinates (sorted according to distance) as features are selected for learning. A multilayer perceptron (MLP) neural network and a tree-based regression model (M5P) are chosen as the surrogate models to approximate the real fitness function in conjunction with an (mu, lambda) evolutionary strategy. Two previously presented BlockCopy operators are used in the evolutionary strategy. The surrogate models are managed using a modified version of the Pre-selection strategy and the Best strategy.

Our evaluation used four benchmark wind farm scenarios with dimensionality ranging from 200 to 1420 dimensions. The evaluation results show that our preliminary MLP and M5P surrogate models did not improve the optimisation results over traditional evolutionary strategies due to scalability issues. The scalability is a known weakness of many surrogate-assisted evolutionary approaches for the reason that most of them are designed for low-dimensionality problems. However, the research should continue on this topic because of its importance to renewable energy.

text: Surrogate-Assisted Evolutionary Algorithms for Wind Farm Layout Optimisation Problem Due to the increasing need for computationally expensive optimisation in many real-world applications, surrogate-assisted evolutionary algorithms have attracted growing attention. In the literature, surrogate-assisted evolutionary approaches have been successful in highly computational expensive optimisation problems. However, surrogates have not been used with the Wind Farm Layout Optimisation Problem (WFLOP) before.

In this work, an evolutionary approach using surrogate modelling techniques to reduce the computational cost of the WFLOP is studied. The WFLOP mainly focuses on finding the optimal geographical placement of wind turbines within a wind farm in order to maximise power generation. But evaluating wind farm layout is very computationally expensive. The purpose of using surrogates is to approximate the real evaluation function of an evolutionary algorithm, but the surrogates can be computed more efficiently. The aim of this study is try to discover whether if surrogate-assisted evolutionary approach is effective on the WFLOP.

An analytical wake model is used to calculate the velocity deficits in the downstream generated by individual turbines. A set of initial offline experiments was conducted based on a dataset of wind farm layouts sampled from the space of all layouts, using biased random walk. These experiments were designed to discover which features lead to construction of an accurate surrogate model. According to the results of these experiments, polar coordinates (sorted according to distance) as features are selected for learning. A multilayer perceptron (MLP) neural network and a tree-based regression model (M5P) are chosen as the surrogate models to approximate the real fitness function in conjunction with an (mu, lambda) evolutionary strategy. Two previously presented BlockCopy operators are used in the evolutionary strategy. The surrogate models are managed using a modified version of the Pre-selection strategy and the Best strategy.

Our evaluation used four benchmark wind farm scenarios with dimensionality ranging from 200 to 1420 dimensions. The evaluation results show that our preliminary MLP and M5P surrogate models did not improve the optimisation results over traditional evolutionary strategies due to scalability issues. The scalability is a known weakness of many surrogate-assisted evolutionary approaches for the reason that most of them are designed for low-dimensionality problems. However, the research should continue on this topic because of its importance to renewable energy.

year: 2016

title: Understanding the context of hospital transfers and away-from-home hospitalisations for Māori

authors: Cormack, Donna

subjects: Humans

abstract: In Aotearoa New Zealand, people regularly travel away from their home to receive hospital care. While the role of whānau support for patients in hospital is critical for Māori, there is little information about away-from-home hospitalisations. This paper describes the frequency and patterning of away-from-home hospitalisations and inter-hospital transfers for Māori. Data from the National Minimum Dataset (NMDS), for the 6-year period of 1 January 2009-31 December 2014, were analysed. Basic frequencies, means and descriptive statistics were produced using SAS software. We found that more than 10% of all routine hospitalisations constituted an away-from-home hospitalisation for Māori; that is, a hospitalisation that was in a district health board (DHB) other than the DHB of usual residence for the patient. One quarter (25.19%) of transfer hospitalisations were to a DHB other than the patient's DHB of domicile. Away-from-home hospital admissions increase for Māori as deprivation increases for both routine and transfer admissions, with over half of Māori hospital admissions among people who live in areas of high deprivation. This analysis aids in understanding away-from-home hospitalisations for Māori whānau, the characteristics associated with these types of hospitalisations and supports the development and implementation of policies which better meet whānau Māori needs. The cumulative impact of the need to travel to hospital for care, levels of poverty and a primarily reimbursement-based travel assistance system all perpetuate an unequal cost burden placed upon Māori whānau.

text: Understanding the context of hospital transfers and away-from-home hospitalisations for Māori In Aotearoa New Zealand, people regularly travel away from their home to receive hospital care. While the role of whānau support for patients in hospital is critical for Māori, there is little information about away-from-home hospitalisations. This paper describes the frequency and patterning of away-from-home hospitalisations and inter-hospital transfers for Māori. Data from the National Minimum Dataset (NMDS), for the 6-year period of 1 January 2009-31 December 2014, were analysed. Basic frequencies, means and descriptive statistics were produced using SAS software. We found that more than 10% of all routine hospitalisations constituted an away-from-home hospitalisation for Māori; that is, a hospitalisation that was in a district health board (DHB) other than the DHB of usual residence for the patient. One quarter (25.19%) of transfer hospitalisations were to a DHB other than the patient's DHB of domicile. Away-from-home hospital admissions increase for Māori as deprivation increases for both routine and transfer admissions, with over half of Māori hospital admissions among people who live in areas of high deprivation. This analysis aids in understanding away-from-home hospitalisations for Māori whānau, the characteristics associated with these types of hospitalisations and supports the development and implementation of policies which better meet whānau Māori needs. The cumulative impact of the need to travel to hospital for care, levels of poverty and a primarily reimbursement-based travel assistance system all perpetuate an unequal cost burden placed upon Māori whānau.

year: 2022-11-11