Which components of heart failure programs are effective? A meta-analysis of the outcomes of structured telephone support or telemonitoring as the primary component of heart failure management in 9,560 patients (Abridged Cochrane Review)

Aims--Telemonitoring (TM) and structured telephone support (STS) have the potential to deliver specialised management to more patients with chronic heart failure (CHF), but their efficacy is still to be proven. Objectives To review randomised controlled trials (RCTs) of TM or STS on all- cause mortality and all-cause and CHF-related hospitalisations in patients with CHF, as a non-invasive remote model of specialised disease-management intervention.--Methods and Results--Data sources:We searched 15 electronic databases and hand-searched bibliographies of relevant studies, systematic reviews, and meeting abstracts. Two reviewers independently extracted all data. Study eligibility and participants: We included any randomised controlled trials (RCT) comparing TM or STS to usual care of patients with CHF. Studies that included intensified management with additional home or clinic visits were excluded. Synthesis: Primary outcomes (mortality and hospitalisations) were analysed; secondary outcomes (cost, length of stay, quality of life) were tabulated.--Results: Thirty RCTs of STS and TM were identified (25 peer-reviewed publications (n=8,323) and five abstracts (n=1,482)). Of the 25 peer-reviewed studies, 11 evaluated TM (2,710 participants), 16 evaluated STS (5,613 participants) and two tested both interventions. TM reduced all-cause mortality (risk ratio (RR 0•66 [95% CI 0•54-0•81], p<0•0001) and STS showed similar trends (RR 0•88 [95% CI 0•76-1•01], p=0•08). Both TM (RR 0•79 [95% CI 0•67-0•94], p=0•008) and STS (RR 0•77 [95% CI 0•68-0•87], p<0•0001) reduced CHF-related hospitalisations. Both interventions improved quality of life, reduced costs, and were acceptable to patients. Improvements in prescribing, patient-knowledge and self-care, and functional class were observed.--Conclusion: TM and STS both appear effective interventions to improve outcomes in patients with CHF.

Improving governance : practical methods and an analytic framework for the enhancement of democracy

Seven endemic governance problems are shown to be currently present in governments around the globe and at any level of government as well (for example municipal, federal). These problems have their roots traced back through more than two thousand years of political, specifically ‘democratic’, history. The evidence shows that accountability, transparency, corruption, representation, campaigning methods, constitutionalism and long-term goals were problematic for the ancient Athenians as well as modern international democratisation efforts encompassing every major global region. Why then, given the extended time period humans have had to deal with these problems, are they still present? At least part of the answer to this question is that philosophers, academics and NGOs as well as MNOs have only approached these endemic problems in a piecemeal manner with a skewed perspective on democracy. Their works have also been subject to the ebbs and flows of human history which essentially started and stopped periods of thinking. In order to approach the investigation of endemic problems in relation to democracy (as the overall quest of this thesis was to generate prescriptive results for the improvement of democratic government), it was necessary to delineate what exactly is being written about when using the term ‘democracy’. It is common knowledge that democracy has no one specific definition or practice, even though scholars and philosophers have been attempting to create a definition for generations. What is currently evident, is that scholars are not approaching democracy in an overly simplified manner (that is, it is government for the people, by the people) but, rather, are seeking the commonalities that democracies share, in other words, those items which are common to all things democratic. Following that specific line of investigation, the major practiced and theoretical versions of democracy were thematically analysed. After that, their themes were collapsed into larger categories, at which point the larger categories were comparatively analysed with the practiced and theoretical versions of democracy. Four democratic ‘particles’ (selecting officials, law, equality and communication) were seen to be present in all practiced and theoretical democratic styles. The democratic particles fused with a unique investigative perspective and in-depth political study created a solid conceptualisation of democracy. As such, it is argued that democracy is an ever-present element of any state government, ‘democratic’ or not, and the particles are the bodies which comprise the democratic element. Frequency- and proximity-based analyses showed that democratic particles are related to endemic problems in international democratisation discourse. The linkages between democratic particles and endemic problems were also evident during the thematic analysis as well historical review. This ultimately led to the viewpoint that if endemic problems are mitigated the act may improve democratic particles which might strengthen the element of democracy in the governing apparatus of any state. Such may actively minimise or wholly displace inefficient forms of government, leading to a government specifically tailored to the population it orders. Once the theoretical and empirical goals were attained, this thesis provided some prescriptive measures which government, civil society, academics, professionals and/or active citizens can use to mitigate endemic problems (in any country and at any level of government) so as to improve the human condition via better democratic government.

Bitrate modeling of scalable videos using quantization parameter, frame rate and spatial resolution

The quality and bitrate modeling is essential to effectively adapt the bitrate and quality of videos when delivered to multiplatform devices over resource constraint heterogeneous networks. The recent model proposed by Wang et al. estimates the bitrate and quality of videos in terms of the frame rate and quantization parameter. However, to build an effective video adaptation framework, it is crucial to incorporate the spatial resolution in the analytical model for bitrate and perceptual quality adaptation. Hence, this paper proposes an analytical model to estimate the bitrate of videos in terms of quantization parameter, frame rate, and spatial resolution. The model can fit the measured data accurately which is evident from the high Pearson correlation. The proposed model is based on the observation that the relative reduction in bitrate due to decreasing spatial resolution is independent of the quantization parameter and frame rate. This modeling can be used for rate-constrained bit-stream adaptation scheme which selects the scalability parameters to optimize the perceptual quality for a given bandwidth constraint.

Academic practice as explanatory framework : reconceptualising international student academic engagement and university teaching

This paper joins growing interest in the concept of practice, and uses it to reconceptualise international student engagement with the demands of study at an Australian university. Practice foregrounds institutional structures and student agency and brings together psychologically- and socially-oriented perspectives on international student learning approaches. Utilising discourse theory, practice is defined as habitual and individual instances of socially-contextualised configurations of elements such as actions and interactions, roles and relations, identities, objects, values, and language. In the university context, academic practice highlights the institutionally-sanctioned ways of knowing, doing and being that constitute academic tasks. The concept is applied here to six international students’ ‘readings’ of and strategic responses to academic work in a Master of Education course. It is argued that academic practice provides a comprehensive framework for explaining the interface between university academic requirements and international student learning, and the crucial role that teaching has in facilitating the experience.

Departures from tradition : the early years learning framework for Australia

In 2009, the Commonwealth Government of Australia published the first national learning framework for use with children aged birth to five years. The framework marks a departure from tradition in that it emphasizes intentional teaching, learning as well as child development, a particular type of play-based learning, outcomes, and equity. This article analyzes aspects of the document that depart from well established approaches to early childhood education in Australia and identifies challenges for educators who are required to use the document. It concludes that ongoing and supportive professional learning opportunities must accompany the introduction and enactment of the document.

The importance of project governance framework in project procurement planning

Project Procurement is a ‘great’ environment for ethical issues with its low-price state of mind and competition. It has many opportunities that could contribute to illegal activities or unethical behavior especially in the construction industry. In 2006 alone, 17.3% of 417 Malaysian government contract projects were considered sick due to the poor performance by the contractors. Therefore it is important to govern the project procurement, especially the plan procurement stage to ensure the accountability and transparency of the decision made in awarding the right contract to the best contractor. This is where project governance framework (PGF) is really needed in project procurement planning. Project governance is a subset of corporate governance focusing on the areas of corporate governance related to project activities, including: portfolio direction, project sponsorship, project and program management and efficiency and disclosure and reporting. This paper highlights the importance of implementing project governance framework (PGF) to ensure that the decision makers are answerable and accountable to the stakeholders, and the decision making is transparent to avoid any ethical issues arises. A comprehensive preliminary literature is carried out to discover the importance of executing PGF in project procurement in Malaysian public sector. By understanding the important of PGF, it is hoped that this will bring a signal to other developing countries to implement the similar method in ensuring the transparency of the decision making in project procurement planning in their countries.

A conceptual framework for ethical decision making in project procurement

There is a lack of research which identifies the role of the public-sector client in relation to ethical practice in plan procurement. This paper discusses a conceptual framework for ethical decision making in project procurement, focusing on public sector clients within the Malaysian construction industry. A framework is proposed to ensure that effective ethical decision making strategies are deployed to ensure that plan procurement is carried out with a transparent process so that the public sector clients are able to adopt. The conceptual framework adopts various factors that contribute to ethical decision making at the early stage of procurement and consists of the procurement system, individual factors, project characteristics, and organizational culture as the internal factors and professional code of conduct and government policies as the external factors. This framework rationalizes the relationships between systems, psychology and organizational theory to form an innovative understanding of making ethical decisions in plan procurement. It is expected that this proposed framework will be useful as a foundation for identifying the factors that contribute to ethical decision making focusing on the planning stage of procurement process.

Developing a knowledge-based urban development analysis framework : the case of multimedia super corridor, Malaysia

Purpose: In the global knowledge economy, investment in knowledge-intensive industries and information and communication technology (ICT) infrastructures are seen as significant factors in improving the overall socio-economic fabric of cities. Consequently knowledge-based urban development (KBUD) has become a new paradigm in urban planning and development, for increasing the welfare and competitiveness of cities and regions. The paper discusses the critical connections between KBUD strategies and knowledge-intensive industries and ICT infrastructures. In particular, it investigates the application of the knowledge-based urban development concept by discussing one of South East Asia’s large scale manifestations of KBUD; Malaysia’s Multimedia Super Corridor. ----- ----- Design/methodology/approach: The paper provides a review of the KBUD concept and develops a knowledge-based urban development assessment framework to provide a clearer understanding of development and evolution of KBUD manifestations. Subsequently the paper investigates the implementation of the KBUD concept within the Malaysian context, and particularly the Multimedia Super Corridor (MSC). ----- ----- Originality/value: The paper, with its KBUD assessment framework, scrutinises Malaysia’s experince; providing an overview of the MSC project and discussion of the case findings. The development and evolution of the MSC is viewed with regard to KBUD policy implementation, infrastructural implications, and the agencies involved in the development and management of the MSC. ----- ----- Practical implications: The emergence of the knowledge economy, together with the issues of globalisation and rapid urbanisation, have created an urgent need for urban planners to explore new ways of strategising planning and development that encompasses the needs and requirements of the knowledge economy and society. In light of the literature and MSC case findings, the paper provides generic recommendations, on the orchestration of knowledge-based urban development, for other cities and regions seeking to transform to the knowledge economy.

Sustainability : driver for decision making in infrastructure

With the growing importance of sustainability assessment in the construction industry, many green building rating schemes have been adopted in the building sector of Australia. However, there is an abnormal delay in the similar adoption in the infrastructure sector. This prolonged delay in practice poses a challenge in mapping the project objectives with sustainability outcomes. Responding to the challenge of sustainable development in infrastructure, it is critical to create a set of decision indicators for sustainability in infrastructure, which to be used in conjunction with the emerging infrastructure sustainability assessment framework of the Australian Green Infrastructure Council. The various literature sources confirm the lack of correlation between sustainability and infrastructure. This theoretical missing link signifies the crucial validation of the interrelationship and interdependency in sustainability, decision making and infrastructure. This validation is vital for the development of decision indicators for sustainability in infrastructure. Admittedly, underpinned by the serious socio-environmental vulnerability, the traditional focus on economic emphasis in infrastructure development needs to be drifted towards the appropriate decisions for sustainability enhancing the positive social and environmental outcomes. Moreover, the research findings suggest sustainability being observed as powerful socio-political and influential socio-environmental driver in deciding the infrastructure needs and its development. These newly developed sustainability decision indicators create the impetus for change leading to sustainability in infrastructure by integrating the societal cares, environmental concerns into the holistic financial consideration. Radically, this development seeks to transform principles into actions for infrastructure sustainability. Lastly, the thesis concludes with knowledge contribution in five significant areas and future research opportunities. The consolidated research outcomes suggest that the development of decision indicators has demonstrated sustainability as a pivotal driver for decision making in infrastructure.

Information dependencies between architects and services engineers for early design evaluation : a framework for an energy design tool for architects

Effective strategies for the design of effi cient and environmentally sensitive buildings require a close collaboration between architects and engineers in the design of the building shell and environmental control systems at the outset of projects. However, it is often not practical for engineers to be involved early on in the design process. It is therefore essential that architects be able to perform preliminary energy analyses to evaluate their proposed designs prior to the major building characteristics becoming fi xed. Subsequently, a need exists for a simplifi ed energy design tool for architects. This paper discusses the limitations of existing analysis software in supporting early design explorations and proposes a framework for the development of a tool that provides decision support by permitting architects to quickly assess the performance of design alternatives.

A construction safety competency framework : development, industry application, and future benefits

View from the Construction sector as to the need to improve OHS culture What were the goals and the outcomes of the CRC Construction Innovation research Leadership behaviours to drive OHS culture change in industry What benefits to the construction sector have occurred through these initiatives What we have learnt on the journey

A statistical framework for natural feature representation

This paper presents a robust stochastic framework for the incorporation of visual observations into conventional estimation, data fusion, navigation and control algorithms. The representation combines Isomap, a non-linear dimensionality reduction algorithm, with expectation maximization, a statistical learning scheme. The joint probability distribution of this representation is computed offline based on existing training data. The training phase of the algorithm results in a nonlinear and non-Gaussian likelihood model of natural features conditioned on the underlying visual states. This generative model can be used online to instantiate likelihoods corresponding to observed visual features in real-time. The instantiated likelihoods are expressed as a Gaussian mixture model and are conveniently integrated within existing non-linear filtering algorithms. Example applications based on real visual data from heterogenous, unstructured environments demonstrate the versatility of the generative models.

Learning articulated motion structures with Bayesian Networks

This paper presents a general methodology for learning articulated motions that, despite having non-linear correlations, are cyclical and have a defined pattern of behavior Using conventional algorithms to extract features from images, a Bayesian classifier is applied to cluster and classify features of the moving object. Clusters are then associated in different frames and structure learning algorithms for Bayesian networks are used to recover the structure of the motion. This framework is applied to the human gait analysis and tracking but applications include any coordinated movement such as multi-robots behavior analysis.

Rich probabilistic representations for bearing only decentralised data fusion

The aim of this paper is to demonstrate the validity of using Gaussian mixture models (GMM) for representing probabilistic distributions in a decentralised data fusion (DDF) framework. GMMs are a powerful and compact stochastic representation allowing efficient communication of feature properties in large scale decentralised sensor networks. It will be shown that GMMs provide a basis for analytical solutions to the update and prediction operations for general Bayesian filtering. Furthermore, a variant on the Covariance Intersect algorithm for Gaussian mixtures will be presented ensuring a conservative update for the fusion of correlated information between two nodes in the network. In addition, purely visual sensory data will be used to show that decentralised data fusion and tracking of non-Gaussian states observed by multiple autonomous vehicles is feasible.

Towards a relational contracting framework in the Australian construction industry : an initial framework

The Australian construction industry is characterized as being a competitive and risky business environment due to lack of cooperation, insufficient trust, ineffective communication and adversarial relationships which are likely lead to poor project performance. Relational contracting (RC) is advocated by literature as an innovative approach to improve the procurement process in the construction industry. Various studies have collectively added to the current knowledge of known RC norms, but there seem to be little effort on investigating the determinants of RC and its impact on project outcomes. In such circumstances, there is lack of evidence and explanation on the manner on how these issues lead to different performance. Simultaneously, the New Engineering Contract (NEC) that embraced the concept of RC is seen as a modern way of contracting and also considered as one of the best approaches to the perennial problem of improving adversarial relationships within the industry. The reality of practice of RC in Australia is investigated through the lens of the NEC. A synthesis of literature views on the concept, processes and tools of RC is first conducted to develop the framework of RC. A case study approach is proposed for an in-depth analysis to explore the critical issues addressed by RC in relation to project performance. Understanding the realities of RC will assist stakeholders in the construction industry with their investment in RC.