Effective technologies for noninvasive remote monitoring in heart failure

Background Trials of new technologies to remotely monitor for signs and symptoms of worsening heart failure are continually emerging. The extent to which technological differences impact the effectiveness of non-invasive remote monitoring for heart failure management is unknown. Objective To examine the effect of specific technology used for non-invasive remote monitoring of people with heart failure on all-cause mortality and heart failure-related hospitalisations. Methods A sub-analysis of a large systematic review and meta-analysis was conducted. Studies were stratified according to the specific type of technology used and separate meta-analyses were performed. Four different types of non-invasive remote monitoring technologies were identified including structured telephone calls, videophone, interactive voice response devices and telemonitoring. Results Only structured telephone calls and telemonitoring were effective in reducing the risk of all-cause mortality (RR 0.87; 95% CI=0.75-1.01; p=0.06 and 0.62; 95% CI=0.50-0.77; p<0.0001) and heart failure-related hospitalisations (RR 0.77; 95% CI=0.68-0.87; p<0.001) and 0.75; 95% CI=0.63-0.91; p=0.003). More research data is required for videophone and interactive voice response technologies. Conclusions This sub-analysis identified that only two of the four specific technologies used for non-invasive remote monitoring in heart failure improved outcomes. When results of studies that involved these disparate technologies were combined in previous meta-analyses, significant improvements in outcomes were identified. As such, this study has highlighted implications for future meta-analyses of randomised controlled trials focused on evaluating the effectiveness of remote monitoring in heart failure.

Commentary on Nutrition and older Indigenous Australians : service delivery implications in remote communities. A narrative review

Indigenous Australians are the most socially and economically disadvantaged population group in Australia and have the poorest health status. The statistics describe and highlight the degree of sicknesses and disadvantage along with lower life expectancy, elevated mortality rate and increased risk of cardiovascular disease, cancer, diabetes, respiratory disease and kidney disease. While these statistics reflect poor health status and a high level of illness within Indigenous communities, it is known that individual, family and community behaviours play a key role in Indigenous health and wellbeing outcomes. These behavioural issues include use of tobacco, alcohol and other substances along with lack of physical activity and poor nutrition. The paper Nutrition and older Indigenous Australians: Service delivery implications in remote communities. A narrative view explores some of the issues specific to nutrition. Bronwyn Fredericks was invited to provide this commentary by the Editor of the Australasian Journal on Aging.

Labour attraction and retention in rural and remote Queensland communities

Attracting and retaining a skilled labour force is a critical yet complex issue for rural and remote communities. This article reports the findings of a study investigating the current approaches to attraction and retention in two separate Australian regions. Building on previously developed models, this research analyses the roles employers and wider communities are playing, or potentially could play, in addressing issues that influence labour shortages. The findings of this research highlight the complexities of labour attraction and retention and emphasise the need for communities and businesses to work together to overcome labour shortages in rural and remote locations.

Design and flight testing of an integrated solar powered UAV and WSN for remote gas sensing

This paper describes a generic and integrated solar powered remote Unmanned Air Vehicles (UAV) and Wireless Sensor Network (WSN) gas sensing system. The system uses a generic gas sensing system for CH4 and CO2 concentrations using metal oxide (MoX) and non-dispersive infrared sensors, and a new solar cell encapsulation method to power the UASs as well as a data management platform to store, analyse and share the information with operators and external users. The system was successfully field tested at ground and low altitudes, collecting, storing and transmitting data in real time to a central node for analysis and 3D mapping. The system can be used in a wide range of outdoor applications, especially in agriculture, bushfires, mining studies, opening the way to a ubiquitous low cost environmental monitoring. A video of the bench and flight test performed can be seen in the following link https://www.youtube.com/watch?v=Bwas7stYIxQ.

The effect of retail store managers on aboriginal diet in remote communities

Key nutrient densities of the diet of two remote northern coastal Aboriginal communities were measured using the store-turnover method during the periods that three store managers were responsible for each store respectively. Individual store managers were a greater determinant of nutrient density than the community itself. Furthermore, nutrient densities tended to be highest in both communities when their stores were administered by one particular store manager. The results support the notion that store managers wield considerable power over the food supply of remote Aboriginal communities, and raise questions concerning the ability of Aboriginal community members to influence their own food supplies in retail stores. However, the study also confirms that store managers can be important allies in efforts to improve Aboriginal dietary intake.

Sustainability of a successful health and nutrition program in a remote Aboriginal community

OBJECTIVE: To assess the long term effect of a nutrition program in a remote Aboriginal community (Minjilang). DESIGN: Evaluation of nutritional outcomes over the three years before and the three years after a health and nutrition program that ran from June 1989 to June 1990. Turnover of food items at the community store was used as a measure of dietary intake at Minjilang and a comparison community. SETTING: A community of about 150 Aboriginal people live at Minjilang on Croker Island, 240 km north-east of Darwin. A similar community of about 300 people on another island was used as the comparison. RESULTS: The program produced lasting improvements in dietary intake of most target foods (including fruit, vegetables and wholegrain bread) and nutrients (including folate, ascorbic acid and thiamine). Sugar intake fell in both communities before the program, but the additional decrease in sugar consumption during the program at Minjilang "rebounded" in the next year. Dietary improvements in the comparison community were delayed and smaller than at Minjilang. CONCLUSIONS: The success of the program at Minjilang was linked to an ongoing process of social change, which in turn provided a stimulus for dietary improvement in the comparison community. When Aboriginal people themselves control and maintain ownership of community-based intervention programs, nutritional improvements can be initiated and sustained.

Measuring dietary intake in remote Australian Aboriginal communities

This paper reports a comparison of the practicality, acceptability and face validity of five dietary intake methods in two remote Australian Aboriginal communities: weighed dietary intake, 24‐hour recall, ‘store‐turnover’, diet history and food frequency methods. The methods used to measure individual dietary intake were poorly accepted by the communities. Quantitative data were obtained only from the first three methods. The 24‐hour recall method tended to produce higher nutrient intakes than the weighed intake method and certain foods appeared to be selectively recalled according to perceived nutritional desirability. The ‘store‐turnover’ method was most acceptable to the communities and had less potential for bias than the other methods. It was also relatively objective, non‐intrusive, rapid, easy and inexpensive. However, food distribution patterns within the communities could not be assessed by this method. Nevertheless, other similarly isolated communities may benefit by use of the ‘store‐turnover’ method.

Apparent dietary intake in remote Aboriginal communities

Apparent per capita food and nutrient intake in six remote Australian Aboriginal communities using the ‘store-turnover’ method is described. The method is based on the analysis of community-store food invoices. The face validity of the method supports the notion that, under the unique circumstances of remote Aboriginal communities, the turnover of foodstuffs from the community store is a useful measure of apparent dietary intake for the community as a whole. In all Aboriginal communities studied, the apparent intake of energy, sugars and fat was excessive, while the apparent intake of dietary fibre and several nutrients, including folic acid, was low. White sugar, flour, bread and meat provided in excess of 50 per cent of the apparent total energy intake. Of the apparent high fat intake, fatty meats contributed nearly 40 per cent in northern coastal communities and over 60 per cent in central desert communities. Sixty per cent of the apparent high intake of sugars was derived from sugar per se in both regions. Compared with national Australian apparent consumption data, intakes of sugar, white flour and sweetened carbonated beverages were much higher in Aboriginal communities, and intakes of wholemeal bread, fruit and vegetables were much lower. Results of the store-turnover method have important implications for community-based nutrition intervention programs.

Modeling Bus Rapid Transit station bus queuing for Bus Rapid Transit station bus operation analysis

Stations on Bus Rapid Transit (BRT) lines ordinarily control line capacity because they act as bottlenecks. At stations with passing lanes, congestion may occur when buses maneuvering into and out of the platform stopping lane interfere with bus flow, or when a queue of buses forms upstream of the station blocking inflow. We contend that, as bus inflow to the station area approaches capacity, queuing will become excessive in a manner similar to operation of a minor movement on an unsignalized intersection. This analogy is used to treat BRT station operation and to analyze the relationship between station queuing and capacity. In the first of three stages, we conducted microscopic simulation modeling to study and analyze operating characteristics of the station under near steady state conditions through output variables of capacity, degree of saturation and queuing. A mathematical model was then developed to estimate the relationship between average queue and degree of saturation and calibrated for a specified range of controlled scenarios of mean and coefficient of variation of dwell time. Finally, simulation results were calibrated and validated.

The combination of empirical mode decomposition and minimum entropy deconvolution for roller bearing diagnostics in non-stationary operation

Diagnostics is based on the characterization of mechanical system condition and allows early detection of a possible fault. Signal processing is an approach widely used in diagnostics, since it allows directly characterizing the state of the system. Several types of advanced signal processing techniques have been proposed in the last decades and added to more conventional ones. Seldom, these techniques are able to consider non-stationary operations. Diagnostics of roller bearings is not an exception of this framework. In this paper, a new vibration signal processing tool, able to perform roller bearing diagnostics in whatever working condition and noise level, is developed on the basis of two data-adaptive techniques as Empirical Mode Decomposition (EMD), Minimum Entropy Deconvolution (MED), coupled by means of the mathematics related to the Hilbert transform. The effectiveness of the new signal processing tool is proven by means of experimental data measured in a test-rig that employs high power industrial size components.

How technological change affects power relations in global markets : remote developers in the console and mobile games industry

This paper focuses on Australian development firms in the console and mobile games industry in order to understand how small firms in a geographically remote and marginal position in the global industry are able to relate to global firms and capture revenue share. This paper shows that, while technological change in the games industry has resulted in the emergence of new industry segments based on transactional rather than relational forms of economic coordination, in which we might therefore expect less asymmetrical power relations, lead firms retain a position of power in the global games entertainment industry relative to remote developers. This has been possible because lead firms in the emerging mobile devices market have developed and sustained bottlenecks in their segment of the industry through platform competition and the development of an intensely competitive ecosystem of developers. Our research shows the critical role of platform competition and bottlenecks in influencing power asymmetries within global markets.

NRM engagement between remote dryland communities and government agencies : success factors from Australia

The management of dryland environments involves the interaction of multiple government agencies and citizens, and is required to respond to a wide range of responsibilities and aspirations for a given region. This paper focuses on the characteristics of engagement between management agencies and citizens in a dryland region, presented here as a series of success factors. These factors are based on empirical research carried out in the Lake Eyre Basin in Australia, one of the world’s largest inwardly draining basins. The results reinforce generic and dryland-specific factors supporting successful community engagement. The former, such as building trust, working in partnership, supporting community champions, and maintaining transparency, are necessary but insufficient for achieving successful community engagement in the case study region. In addition, community engagement in the case study region also required respecting the extreme conditions and extraordinary variability of the Basin and committing to longer timeframes even if the outcomes of community engagement are slow to accrue, in order to take advantage of opportunities in more prosperous times.

Genuine community engagement in remote dryland regions : natural resource management in Lake Eyre Basin

Remote dryland regions are characterised by sparse populations and socially marginalised voices which pose particular challenges to natural resource management. This paper considers the issue of how to achieve community engagement in regions with these characteristics. In doing so, the paper contributes to an expanding international research agenda focusing on the distinct characteristics of arid and semi-arid regions under the heading of 'dryland syndrome'. The paper draws on government liaison officer and local community perspectives of successful engagement in the case-study region of Lake Eyre Basin, Australia. The results demonstrate that widely recognised characteristics of successful engagement are required but insufficient for genuine engagement in remote dryland regions. In addition to building trust through community ownership, being inclusive, effective communication, and adequate resources, genuine community engagement in drylands also requires respecting the extreme conditions and extraordinary variability of these areas. Residents of dryland regions seek genuine engagement yet engage opportunistically when seasons are conducive and when tangible outcomes are visible. © 2011 The Authors. Geographical Research © 2011 Institute of Australian Geographers.

How relevant are science curricula for rural and remote students?

This paper reports findings from the Choosing Science study (Lyons & Quinn, 2010) indicating that Australian Year 10 students in small rural or remote areas tend to regard their science lessons as less relevant than do students in larger towns and cities. Specifically, those in small rural or remote schools were significantly more inclined than their city peers to disagree that what they learned in science classes 'helped them make sense of the world'. They were also significantly more likely to strongly agree that they found science lessons boring, and to strongly disagree that science was one of the most interesting subjects. Potential explanations discussed include a mismatch between science curriculum content and the everyday experiences of students in these regions, the relative shortage of experienced specialist science teachers in rural or remote areas and a lack of opportunities to demonstrate the relevance of school science, among others. The paper considers the implications of these findings in relation to the Australian Science Curriculum and whether it is likely to better address the needs of rural and remote students.