A pilot randomised control trial of general practitioner and exercise physiologist interventions to reduce primary cardiovascular risk in overweight patients [Abstract]

Aims & Rationale/Objectives: With the knowledge that overweight is a major public health concern in Australia, that a multidisciplinary team approach to the management of lifestyle-related conditions is supported, and that the Australian Government recently recognised the role of the exercise physiologist (EP) in reducing the health burden of disease by their inclusion for reimbursement under the Medicare Plus scheme, this study sought to undertake a pilot RCT to compare GP and EP interventions to reduce primary cardiovascular risk in the overweight general practice population. Methods and Measures: Overweight patients recruited by a convenience sample of GPs were randomised into one of three arms: the control group, or the GP or EP intervention group (in which patients received either five GP or five EP consultations over 24 weeks). Patients had baseline, 12- and 24-week measures of body composition and cardio-respiratory fitness, and completed baseline and end-of-study surveys, fasting lipids and glucose. GPs and EPs completed an end-of-study survey. Results:Sixty-seven patients attended the baseline assessment. Overall retention rate was 67%. Patients were generally satisfied with the effectiveness of the interventions and their weight reduction. Favourable trends in BMI, weight, glucose and exercise levels for GP and EP intervention groups and in physical activity levels for all groups Conclusions: This study supports the feasibility of a RCT of GP and EP interventions for decreasing primary cardiovascular risk in the overweight general practice population.

Soft-biometrics : unconstrained authentication in a surveillance environment

Soft biometrics are characteristics that can be used to describe, but not uniquely identify an individual. These include traits such as height, weight, gender, hair, skin and clothing colour. Unlike traditional biometrics (i.e. face, voice) which require cooperation from the subject, soft biometrics can be acquired by surveillance cameras at range without any user cooperation. Whilst these traits cannot provide robust authentication, they can be used to provide coarse authentication or identification at long range, locate a subject who has been previously seen or who matches a description, as well as aid in object tracking. In this paper we propose three part (head, torso, legs) height and colour soft biometric models, and demonstrate their verification performance on a subset of the PETS 2006 database. We show that these models, whilst not as accurate as traditional biometrics, can still achieve acceptable rates of accuracy in situations where traditional biometrics cannot be applied.

FPGA implementation of dual-microphone delay-and-sum beamforming for in-car speech enhancement and recognition

In an automotive environment, the performance of a speech recognition system is affected by environmental noise if the speech signal is acquired directly from a microphone. Speech enhancement techniques are therefore necessary to improve the speech recognition performance. In this paper, a field-programmable gate array (FPGA) implementation of dual-microphone delay-and-sum beamforming (DASB) for speech enhancement is presented. As the first step towards a cost-effective solution, the implementation described in this paper uses a relatively high-end FPGA device to facilitate the verification of various design strategies and parameters. Experimental results show that the proposed design can produce output waveforms close to those generated by a theoretical (floating-point) model with modest usage of FPGA resources. Speech recognition experiments are also conducted on enhanced in-car speech waveforms produced by the FPGA in order to compare recognition performance with the floating-point representation running on a PC.

Extraction of road lanes from high-resolution stereo aerial imagery based on maximum likelihood segmentation and texture enhancement

Accurate road lane information is crucial for advanced vehicle navigation and safety applications. With the increasing of very high resolution (VHR) imagery of astonishing quality provided by digital airborne sources, it will greatly facilitate the data acquisition and also significantly reduce the cost of data collection and updates if the road details can be automatically extracted from the aerial images. In this paper, we proposed an effective approach to detect road lanes from aerial images with employment of the image analysis procedures. This algorithm starts with constructing the (Digital Surface Model) DSM and true orthophotos from the stereo images. Next, a maximum likelihood clustering algorithm is used to separate road from other ground objects. After the detection of road surface, the road traffic and lane lines are further detected using texture enhancement and morphological operations. Finally, the generated road network is evaluated to test the performance of the proposed approach, in which the datasets provided by Queensland department of Main Roads are used. The experiment result proves the effectiveness of our approach.

Building the toolkit of quality monitoring clinical outcomes as a means of assessing quality in residential care

Residential aged care in Australia does not have a system of quality assessment related to clinical outcomes, creating a significant gap in quality monitoring. Clinical outcomes represent the results of all inputs into care, thus providing an indication of the success of those inputs. To fill this gap, an assessment tool based on resident outcomes (the ResCareQA) was developed and evaluated in collaboration with residential care providers. A useful output of the ResCareQA is a profile of resident clinical status, and this paper will use such outputs to present a snapshot of nine residential facilities. Such comprehensive data has not yet been available within Australia, so this will provide an important insight. ResCareQA data was collected from all residents (N=498) of nine aged care facilities from two major aged care providers. For each facility, numerator–denominator data were calculated to assess the degree of potential clinical problems. Results varied across clinical areas and across facilities, and rank-ordered facility results for selected clinical areas are reviewed and discussed. Use of the ResCareQA to generate clinical outcome data provides a concrete means of monitoring care quality within residential facilities; regular use of the ResCareQA could thus contribute to improved care outcomes within residential aged care.

Security of employee entitlements : corporate governance issues

Following the collapse across the last decade of a number of large organizations such as Enron in the USA and several domestic organizations including Ansett Airlines, HIH Insurance and One.Tel, much discussion has ensued about the need to secure employee entitlements. However, tangible improvements in this area are elusive. Good corporate governance policies would suggest that deferred obligations as well as current debts should not be neglected and that appropriate arrangements be put in place to adequately fund employee entitlements. In this paper we consider recent Australian attempts to introduce better governance of employee entitlements.

Changes in accountancy costs for Tasmanian SMEs implementing computerised accounting systems

There have been powerful incentives for Tasmanian Small and Medium-sized Enterprises (SMEs) to adopt information technology to enable them to remain competitive and to comply with legislative regulations. This research study was undertaken to establish whether SMEs implementing computerised accounting systems have a subsequent change in their external accountancy fees. The research study employed a quantitative methodology using survey questionnaires. The study found that in less than 3% of cases SMEs reported a decrease in accountancy fees, in almost 45% of cases the organisation actually experienced a slight to substantial fee increase while 52% reported no change in accountancy fees.

Examination of social demographic status, disease status, health behaviours and quality of life in older Australians using the theory of planned behaviour model

The increase of life expectancy worldwide during the last three decades has increased age-related disability leading to the risk of loss of quality of life. How to improve quality of life including physical health and mental health for older people and optimize their life potential has become an important health issue. This study used the Theory of Planned Behaviour Model to examine factors influencing health behaviours, and the relationship with quality of life. A cross-sectional mailed survey of 1300 Australians over 50 years was conducted at the beginning of 2009, with 730 completed questionnaires returned (response rate 63%). Preliminary analysis reveals that physiological changes of old age, especially increasing waist circumference and co morbidity was closely related to health status, especially worse physical health summary score. Physical activity was the least adherent behaviour among the respondents compared to eating healthy food and taking medication regularly as prescribed. Increasing number of older people living alone with co morbidity of disease may be the barriers that influence their attitude and self control toward physical activity. A multidisciplinary and integrated approach including hospital and non hospital care is required to provide appropriate services and facilities toward older people.

Listening to late discovery adoption and donor offspring stories : adoption, ethics and implications for contemporary donor insemination practices

For most of the 20th Century a ‘closed’ system of adoption was practised throughout Australia and other modern Western societies. This ‘closed’ system was characterised by sealed records; amended birth certificates to conceal the adoption, and prohibited contact with all biological family. Despite claims that these measures protected these children from the taint of illegitimacy the central motivations were far more complex, involving a desire to protect couples from the stigma of infertility and to provide a socially acceptable family structure (Triseliotis, Feast, & Kyle, 2005; Marshall & McDonald, 2001). From the 1960s significant evidence began to emerge that many adopted children and adults were experiencing higher incidences of psychological difficulties, characterised by problems with psychological adjustment, building self-esteem and forming a secure personal identity. These difficulties became grouped under the term ‘genealogical bewilderment’. As a result, new policies and practices were introduced to try to place the best interests of the child at the forefront. These changes reflected new understandings of adoption; as not only an individual process but also as a social and relational process that continues throughout life. Secrecy and the withholding of birth information are now prohibited in the overwhelming majority of all domestic adoptions processed in Australia (Marshall & McDonald, 2001). One little known consequence of this ‘closed’ system of adoption was the significant number of children who were never told of their adoptive status. As a consequence, some have discovered or had this information disclosed to them, as adults. The first study that looked at the late discovery of genetic origins experiences was conducted by the Post Adoption Resource Centre in New South Wales in 1999. This report found that the participants in their study expressed feelings of disbelief, confusion, anger, sorrow and loss. Further, the majority of participants continued to struggle with issues arising from this intentional concealment of their genetic origins (Perl & Markham, 1999). A second and more recent study (Passmore, Feeney & Foulstone, 2007) looked at the issue of secrecy in adoptive families as part of a broader study of 144 adult adoptees. This study found that secrecy and/or lies or misinformation on the part of adoptive parents had negative effects on both personal identity and relationships with others. The authors noted that those adoptees who found out about their adoption as adults were ‘especially likely to feel a sense of betrayal’ (p.4). Over recent years, stories of secrecy and late discovery have also started to emerge from sperm donor conceived adults (Spencer, 2007; Turner & Coyle, 2000). Current research evidence shows that although a majority of couples during the donor assisted conception process indicate that they intend to tell the offspring about their origins, as many as two-thirds or more of couples continue to withhold this information from their children (Akker, 2006; Gottlieb, A. McWhinnie, 2001; Salter-Ling, Hunter, & Glover, 2001). Why do they keep this secret? Infertility involves a range of complex factors that are often left unresolved or poorly understood by those choosing insemination by donor as a form of family building (Schaffer, J. A., & Diamond, R., 1993). These factors may only impact after the child is born, when resemblance talk becomes most pronounced. Resemblance talk is an accepted form of public discourse and a social convention that legitimises the child as part of the family and is part of the process of constructing the child’s identity within the family. Couples tend to become focused on resemblance as this is where they feel most vulnerable, and the lack of resemblance to the parenting father may trigger his sense of loss (Becker, Butler, & Nachtigall, 2005).

Designing spatial story-telling software

What does it mean when we design for accessibility, inclusivity and "dissolving boundaries" -- particularly those boundaries between the design philosophy, the software/interface actuality and the stated goals? This paper is about the principles underlying a research project called 'The Little Grey Cat engine' or greyCat. GreyCat has grown out of our experience in using commercial game engines as production environments for the transmission of culture and experience through the telling of individual stories. The key to this endeavour is the potential of the greyCat software to visualize worlds and the manner in which non-formal stories are intertwined with place. The apparently simple dictum of "show, don't tell" and the use of 3D game engines as a medium disguise an interesting nexus of problematic issues and questions, particularly in the ramifications for cultural dimensions and participatory interaction design. The engine is currently in alpha and the following paper is its background story. In this paper we discuss the problematic, thrown into sharp relief by a particular project, and we continue to unpack concepts and early designs behind the greyCat itself.

Service driven asset management

Local governments are service driven rather than asset driven. Understanding this distinction is critical to ensuring that community needs are appropriately addressed. Translating community needs and desires into infrastructure is a complex yet little understood process. In this paper, we look at two case studies that explore the interface between service outcomes and the specification of performance requirements for the assets. The two case studies we look at are: a public health issue resulting from inadequate public amenities in a beach resort and the prioritisation of maintenance work in a world of increasing service demands and declining funding. The case studies all use the same investment logic mapping framework to establish clear drivers as to the problem that councils are responding to in delivering their services. The key to the framework is the separation of concern between service management and asset management.

Reflection on the use of rating and score cards for asset and service assessment

The concept of star rating council facilities has progressively gained traction in Australia following the work of Dean Taylor at Marochy Shire Council in Queensland in 2006 – 2007 and more recently by the Victorian STEP asset management program. The following paper provides a brief discussion on the use and merits of star rating within community asset management. We suggest that the current adoption of the star rating system to manage community investment in services is lacking in consistency. It is suggested that the major failing is a lack of clear understanding in the purpose being served by the systems. The discussion goes on to make some recommendations on how the concept of a star system could be further enhanced to serve the needs of our communities better.

Modelling sustainable and optimal solutions for building services integration in early architectural design : confronting the software and professional interoperability deficit

Decisions made in the earliest stage of architectural design have the greatest impact on the construction, lifecycle cost and environmental footprint of buildings. Yet the building services, one of the largest contributors to cost, complexity, and environmental impact, are rarely considered as an influence on the design at this crucial stage. In order for efficient and environmentally sensitive built environment outcomes to be achieved, a closer collaboration between architects and services engineers is required at the outset of projects. However, in practice, there are a variety of obstacles impeding this transition towards an integrated design approach. This paper firstly presents a critical review of the existing barriers to multidisciplinary design. It then examines current examples of best practice in the building industry to highlight the collaborative strategies being employed and their benefits to the design process. Finally, it discusses a case study project to identify directions for further research.

Motivating construction organisations through incentives : a case study for client-side project managers

Client-side project managers face challenges in motivating project organisations to pursue exceptional design and construction performance. One approach to improving the motivation of project organisations is by offering a financial incentive reward for the achievement of voluntary performance standards above the minimum required standard. However, little investigation has been undertaken into the features of a successful incentive system as a part of an overall procurement strategy. In response to a lack of information available to client-side project managers tasked with the initial design of an incentive system, the paper explores motivation under a successful incentive and identifies key learnings for client-side project managers to consider when designing incentives. Our findings are based on the results of a large Australian case study which is interpreted against a conceptual framework based on both economic and psychological perspectives of motivation. The results suggest that motivation towards incentive goals is influenced by the value the project organisations place on the incentive reward as a commercial opportunity to increase their profit margins. However, perhaps more important are the relationship management processes that promote commitment to the project; and pride in the achievement of project goals. In the case study, these processes intensified the direct motivational effect of the incentive reward on offer. The findings also highlight the importance of ensuring that incentive goals and performance measurement processes remain relevant to the organisations throughout a project to continuously encourage motivation under changing project conditions.