The Chronic Heart-Failure Assistance by Telephone (CHAT) Study: Assessment of Telephone Support for Vulnerable Patients with Chronic Disease

Aim: To determine whether telephone support using an evidence-based protocol for chronic heart failure (CHF) management will improve patient outcomes and will reduce hospital readmission rates in patients without access to hospital-based management programs. Methods: The rationale and protocol for a cluster-design randomised controlled trial (RCT) of a semi-automated telephone intervention for the management of CHF, the Chronic Heart-failure Assistance by Telephone (CHAT) Study is described. Care is coordinated by trained cardiac nurses located in Heartline, the national call center of the National Heart Foundation of Australia in partnership with patients’ general practitioners (GPs). Conclusions: The CHAT Study model represents a potentially cost-effective and accessible model for the Australian health system in caring for CHF patients in rural and remote areas. The system of care could also be readily adapted for a range of chronic diseases and health systems. Key words: chronic disease management; chronic heart failure; integrated health care systems; nursing care, rural health services; telemedicine; telenursing

The measurement of information system use: preliminary considerations

The concept of system use has suffered from a "too simplistic definition" (DeLone and McLean [9], p. 16). This paper reviews various attempts at conceptualization and measurement of system use and then proposes a re-conceptualization of it as "the level of incorporation of an information system within a user's processes." We then go on to develop the concept of a Functional Interface Point and four dimensions of system usage: automation level, the proportion of the business process encoded by the information system; extent, the proportion of the FIPs used by the business process; frequency, the rate at which FIPs are used by the participants in the process; and thoroughness, the level of use of information/functionality provided by the system at an FIP. The article concludes with a discussion of some implications of this re-conceptualization and areas for follow on research.

Towards a global carbon integrity system : learning from the GFC and avoiding a GCC

This paper examines some of the central global ethical and governance challenges of climate change and carbon emis-sions reduction in relation to globalization, the “global financial crisis” (GFC), and unsustainable conceptions of the “good life”, and argues in favour of the development of a global carbon “integrity system”. It is argued that a funda-mental driver of our climate problems is the incipient spread of an unsustainable Western version of the “good life”, where resource-intensive, high-carbon western lifestyles, although frequently criticized as unsustainable and deeply unsatisfying, appear to have established an unearned ethical legitimacy. While the ultimate solution to climate change is the development of low carbon lifestyles, the paper argues that it is also important that economic incentives support and stimulate that search: the sustainable versions of the good life provide an ethical pull, whilst the incentives provide an economic push. Yet, if we are going to secure sustainable low carbon lifestyles, it is argued, we need more than the ethical pull and the economic push. Each needs to be institutionalized—built into the governance of global, regional, national, sub-regional, corporate and professional institutions. Where currently weakness in each exacerbates the weaknesses in others, it is argued that governance reform is required in all areas supporting sustainable, low carbon versions of the good life.