Differences in Treatment and Management of Indigenous and Non-Indigenous Patients Presenting with Chest Pain: Results of the Heart Protection Partnership (HPP) Study

BACKGROUND: Indigenous patients with acute coronary syndromes represent a high-risk group. There are however few contemporary datasets addressing differences in the presentation and management of Indigenous and non-Indigenous patients with chest pain. METHODS: The Heart Protection Project, is a multicentre retrospective audit of consecutive medical records from patients presenting with chest pain. Patients were identified as Indigenous or non-Indigenous, and time to presentation and cardiac investigations as well as rates of cardiac investigations and procedures were compared between the two groups. RESULTS: Of the 2380 patients included, 199 (8.4%) identified as Indigenous, and 2174 (91.6%) as non-Indigenous. Indigenous patients were younger, had higher rates hyperlipidaemia, diabetes, smoking, known coronary artery disease and a lower rate of prior PCI; and were significantly less likely to have private health insurance, be admitted to an interventional facility or to have a cardiologist as primary physician. Following adjustment for difference in baseline characteristics, Indigenous patients had comparable rates of cardiac investigations and delay times to presentation and investigations. CONCLUSIONS: Although the Indigenous population was identified as a high-risk group, in this analysis of selected Australian hospitals there were no significant differences in treatment or management of Indigenous patients in comparison to non-Indigenous.

Business Process Quality Management

Process modeling is a central element in any approach to Business Process Management (BPM). However, what hinders both practitioners and academics is the lack of support for assessing the quality of process models – let alone realizing high quality process models. Existing frameworks are highly conceptual or too general. At the same time, various techniques, tools, and research results are available that cover fragments of the issue at hand. This chapter presents the SIQ framework that on the one hand integrates concepts and guidelines from existing ones and on the other links these concepts to current research in the BPM domain. Three different types of quality are distinguished and for each of these levels concrete metrics, available tools, and guidelines will be provided. While the basis of the SIQ framework is thought to be rather robust, its external pointers can be updated with newer insights as they emerge.

Business process management education in academia: Status, challenges, and recommendations

In response to the growing proliferation of Business Process Management (BPM) in industry and the demand this creates for BPM expertise, universities across the globe are at various stages of incorporating knowledge and skills in their teaching offerings. However, there are still only a handful of institutions that offer specialized education in BPM in a systematic and in-depth manner. This article is based on a global educators’ panel discussion held at the 2009 European Conference on Information Systems in Verona, Italy. The article presents the BPM programs of five universities from Australia, Europe, Africa, and North America, describing the BPM content covered, program and course structures, and challenges and lessons learned. The article also provides a comparative content analysis of BPM education programs illustrating a heterogeneous view of BPM. The examples presented demonstrate how different courses and programs can be developed to meet the educational goals of a university department, program, or school. This article contributes insights on how best to continuously sustain and reshape BPM education to ensure it remains dynamic, responsive, and sustainable in light of the evolving and ever-changing marketplace demands for BPM expertise.

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.

Developing reflective practitioners online: The business of blogs in work integrated learning

Reflective practice is widely considered across discussions around educational psychology, professional identity, employability of graduates, and generic or graduate capabilities. Critical reflection is essential for providing a bridge between the university and the workplace, and for ultimately preparing work ready graduates (Patrick et al, 2008). Work integrated learning, particularly through internships and work placements for students, is viewed as a valuable approach for students developing skills in reflective practice. Reflective journals are one of the tools often used to encourage and develop student reflection. Shifting the reflective journal to an online interface as a reflective blog presents opportunities for more meaningful, frequent and richer interaction between the key players in a work integrated learning experience. This paper examines the adoption, implementation and refinement of the use of reflective blogs in a work integrated learning unit for business students majoring in advertising, marketing and public relations disciplines. The reflective blog is discussed as a learning and assessment tool, including the approaches taken to integrate and scaffold the blog as part of the work integrated learning experience. Graduate capabilities were used as cornerstones for students to frame students’ thinking, experiences and reflection. These capabilities emphasise the value of coherent theoretical and practical knowledge, coupled with critical, creative and analytical thinking, problem solving skills, self reliance and resilience. Underlying these graduate capabilities is a focus on assessment for learning matched with assessment of learning. Using specific triggers and prompts as part of the reflective process, and incorporating ongoing feedback from academic supervisors, students moved from descriptive levels of reflection, to more meaningful and critical reflection. Students’ blogs are analysed to identify key themes, challenges and achievements in the work integrated learning experience. Suggestions for further development and improvement, together with a model of best practice, are proposed.

Maintenance person or architect? The role of academic advertising research in building better understanding

This paper suggests that, while advertising has changed, advertising research has not. Indeed, questions asked of advertising research more than 20 years ago have still not been answered. The enormity of change in advertising compounded by the lack of response from researchers suggests the traditional academic advertising research model requires more than routine maintenance. It seeks an architect with vision to redesign an academic research model that is probably broken or badly outdated. Five areas of the academic research approach are identified as needing rethinking: (1) the advertising problem, (2) sample frame and subjects, (3) assumptions regarding consumer behaviour, (4) research methodologies and (5) findings. Suggestions are made for improvement. But perhaps the biggest challenge is academic leadership. This paper proposes the establishment of a blue-ribbon panel to report back on recommended changes or improvements.

A novel load transfer scheme for peak load management in rural areas

This paper proposes a novel peak load management scheme for rural areas. The scheme transfers certain customers onto local nonembedded generators during peak load periods to alleviate network under voltage problems. This paper develops and presents this system by way of a case study in Central Queensland, Australia. A methodology is presented for determining the best location for the nonembedded generators as well as the number of generators required to alleviate network problems. A control algorithm to transfer and reconnect customers is developed to ensure that the network voltage profile remains within specification under all plausible load conditions. Finally, simulations are presented to show the performance of the system over a typical maximum daily load profile with large stochastic load variations.

Export decisions within Taiwanese electrical and electronic SMEs : the role of management characteristics and attitudes

In this globalized environment, Taiwanese firms have been very successful in achieving growth via international market expansion. In particular, the Taiwanese electronics industry has shown a dynamism lacking in comparable industries around the world. However, in recent years there has been a move by many of the larger Taiwanese manufacturing firms to outsource their manufacturing to low-cost producers such as China in order to remain competitive. Conversely, most Taiwanese small- to medium-sized enterprises (SMEs) have retained their production facilities in Taiwan. These SMEs seek to expand their sales beyond the domestic market by employing an export strategy, making a significant socioeconomic contribution to the domestic and regional economies. This paper highlights the key dimensions such as enhancing factors (benefits/advantages), inhibiting factors (barriers/costs), and managerial factors (characteristics/commitment) that play an important role in the internationalization of SMEs located within the Taiwanese electronics industry. A logistic regression model is used to predict the probability of a firm being an exporter.

Longitudinal evaluations of student satisfaction with a postgraduate unit using importance-performance analysis

The Australian tourism tertiary education sector operates in a competitive and dynamic environment, which necessitates a market orientation to be successful. Academic staff and management in the sector must regularly assess the perceptions of prospective and current students and monitor the satisfaction levels of current students. This study is concerned with the setting and monitoring of satisfaction levels of current students, reporting the results of three longitudinal investigations of student satisfaction in a postgraduate unit. The study also addresses a limitation of a university’s generic teaching evaluation instrument. Importance-Performance Analysis (IPA) has been recommended as a simple but effective tool for overcoming the deficiencies of many student evaluation studies, which have generally measured only attribute performance at the end of a semester. IPA was used to compare student expectations of the unit at the beginning of a semester with their perceptions of performance 10 weeks later. The first stage documented key benchmarks for which amendments to the unit based on student feedback could be evaluated during subsequent teaching periods.

The key to successful implementation : project management of sustainable infrastructure provision

Delivering infrastructure projects involves many stakeholders. Their responsibilities and authorities vary over the course of the project lifecycle - from establishing the project parameters and performance requirements, to operating and maintaining the completed infrastructure. To ensure the successful delivery of infrastructure projects, it is important for the project management team to identify and manage the stakeholders and their requirements. This chapter discusses the management of stakeholders in delivering infrastructure projects, from their conception to completion. It includes managing the stakeholders for project selection and involving them to improve project constructability, operability and maintainability.

Preface : rethinking sustainable development : urban management, engineering, and design

In an atmosphere where civilization is progressing and becoming more aware of the consequences of careless development decisions, rethinking sustainable development - particularly sustainable urban and infrastructure development - has become an inevitable necessity. ------ ----- Rethinking Sustainable Development: Urban Management, Engineering, and Design considers the role of urban, regional and infrastructure planning in achieving sustainable urban and infrastructure development, providing insights into overcoming the consequences of unsustainable development. This companion volume to Sustainable Urban and Regional Infrastructure: Technology, Planning and Management, overviews all aspects of sustainable urban and infrastructure development.

Destination competitiveness through the lens of brand positioning : the case of Australia’s Sunshine Coast

The purpose of the paper is to provide a collaborative practitioner/academic interpretation of a destination’s competitiveness through the lens of brand positioning in the domestic short break drive market. A 173 item questionnaire, which was mailed to a systematic random sample of 3000 households in the target market, attracted a 17% useable response. The paper compares how one destination, the Sunshine Coast, is positioned in its most important market, in relation to the brand identity intended by the destination marketing organisation (DMO). Key constructs were brand salience, brand associations and brand resonance. The Sunshine Coast was found to hold a leadership position in the minds of consumers, and the results indicated a strong level of congruence between actual market perceptions and the brand identity intended by the DMO. There were strong associations between brand salience, brand associations and brand resonance. The findings provided the destination of interest with both a measure of past marketing effectiveness as well as positive indicators of future performance. The paper represents collaboration between a tourism practitioner and a tourism academic, and attempts a contribution to the emerging literature on destination competitiveness through the lens of positioning theory.

An examination of factors influencing effective and continuous improvement of Indonesian contractors' quality management systems

This paper presents the results of a pilot study examining the factors that impact most on the effective implementation of, and improvement to, Quality Mangement Sytems (QMSs) amongst Indonesian construction companies. Nine critical factors were identified from an extensive literature review, and a survey was conducted of 23 respondents from three specific groups (Quality Managers, Project Managers, and Site Engineers) undertaking work in the Indonesian infrastructure construction sector. The data has been analyzed initially using simple descriptive techniques. This study reveals that different groups within the sector have different opinions of the factors regardless of the degree of importance of each factor. However, the evaluation of construction project success and the incentive schemes for high performance staff, are the two factors that were considered very important by most of the respondents in all three groups. In terms of their assessment of tools for measuring contractor’s performance, additional QMS guidelines, techniques related to QMS practice provided by the Government, and benchmarking, a clear majority in each group regarded their usefulness as ‘of some importance’.

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.

Delegation constraint management

The paper addresses the issue of providing access control via delegation and constraint management across multiple security domains. Specifically, this paper proposes a novel Delegation Constraint Management model to manage and enforce delegation constraints across security domains. An algorithm to trace the authority of delegation constraints is introduced as well as an algorithm to form a delegation constraint set and detect/prevent potential conflicts. The algorithms and the management model are built upon a set of formal definitions of delegation constraints. In addition, a constraint profile based on XACML is proposed as a means to express the delegation constraint. The paper also includes a protocol to exchange delegation constraints (in the form of user commitments) between the involved entities in the delegation process.