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

Brivanib alaninate, a dual inhibitor of vascular endothelial growth factor receptor and fibroblast growth factor receptor tyrosine kinases, induces growth inhibition in mouse models of human hepatocellular carcinoma

PURPOSE: Hreceptor (VEGFR) and FGF receptor (FGFR) signaling pathways. EXPERIMENTAL DESIGN: Six different s.c. patient-derived HCC xenografts were implanted into mice. Tumor growth was evaluated in mice treated with brivanib compared with control. The effects of brivanib on apoptosis and cell proliferation were evaluated by immunohistochemistry. The SK-HEP1 and HepG2 cells were used to investigate the effects of brivanib on the VEGFR-2 and FGFR-1 signaling pathways in vitro. Western blotting was used to determine changes in proteins in these xenografts and cell lines. RESULTS: Brivanib significantly suppressed tumor growth in five of six xenograft lines. Furthermore, brivanib-induced growth inhibition was associated with a decrease in phosphorylated VEGFR-2 at Tyr(1054/1059), increased apoptosis, reduced microvessel density, inhibition of cell proliferation, and down-regulation of cell cycle regulators. The levels of FGFR-1 and FGFR-2 expression in these xenograft lines were positively correlated with its sensitivity to brivanib-induced growth inhibition. In VEGF-stimulated and basic FGF stimulated SK-HEP1 cells, brivanib significantly inhibited VEGFR-2, FGFR-1, extracellular signal-regulated kinase 1/2, and Akt phosphorylation. CONCLUSION: This study provides a strong rationale for clinical investigation of brivanib in patients with HCC.

Inhibition of orexin-1/hypocretin-1 receptors inhibits yohimbine-induced reinstatement of ethanol and sucrose seeking in Long-Evans rats

Abstract RATIONALE: Previous studies have shown that orexin-1/hypocretin-1 receptors play a role in self-administration and cue-induced reinstatement of food, drug, and ethanol seeking. In the current study, we examined the role of orexin-1/hypocretin-1 receptors in operant self-administration of ethanol and sucrose and in yohimbine-induced reinstatement of ethanol and sucrose seeking. MATERIALS AND METHODS: Rats were trained to self-administer either 10% ethanol or 5% sucrose (30 min/day). The orexin-1 receptor antagonist SB334867 (0, 5, 10, 15, 20 mg/kg, i.p.) was administered 30 min before the operant self-administration sessions. After these experiments, the operant self-administration behaviors were extinguished in both the ethanol and sucrose-trained rats. Upon reaching extinction criteria, SB334867 (0, 5, 10 mg/kg, i.p.) was administered 30 min before yohimbine (0 or 2 mg/kg, i.p.). In a separate experiment, the effect of SB334867 (0, 15, or 20 mg/kg, i.p.) on general locomotor activity was determined using the open-field test. RESULTS: The orexin-1 receptor antagonist, SB334867 (10, 15 and 20 mg/kg) decreased operant self-administration of 10% ethanol but not 5% sucrose self-administration. Furthermore, SB334867 (5 and 10 mg/kg) significantly decreased yohimbine-induced reinstatement of both ethanol and sucrose seeking. SB334867 did not significantly affect locomotor activity measured using the open-field test. CONCLUSIONS: The results suggest that inhibition of OX-1/Hcrt-1 receptors modulates operant ethanol self-administration and also plays a significant role in yohimbine-induced reinstatement of both ethanol and sucrose seeking in rats.

Influencing pre-service teachers, skills and attitudes towards diversity. Is DOL the Answer?

Abstract: This paper reports on a preliminary investigation into the success of an undergraduate course, in helping preservice teachers at a regional university develop the skills and attitudes necessary to design inclusive learning environments that cater for, and celebrate, difference. The study is particularly relevant given recommendations by the Education Queensland Ministerial Taskforce (Queensland Government, 2004) that all pre-service teacher education programs must ensure that inclusive education is a pervasive theme. The paper starts by providing an overview of inclusive contexts and a rationale for inclusive education including critical elements. This leads into an overview of the undergraduate course EDED11400 Managing Diversity and discussion, based on feedback from the teaching team, on the capacity for the course to help pre-service teachers develop inclusive curriculum and pedagogical practices. The pedagogical framework Dimensions of Learning* is then discussed, with consideration given to whether this framework with its focus on critical thinking and habits of mind, might improve future learning outcomes in the course EDED11400 Managing Diversity. (*Dimensions of Learning is a pedagogical framework designed to teach thinking skills (Marzano et al., 1988). It explores five types of thinking represented in the framework by five dimensions of learning.)

A multidisciplinary examination of fast bowling talent development in cricket

Research on expertise, talent identification and development has tended to be mono-disciplinary, typically adopting geno-centric or environmentalist positions, with an overriding focus on operational issues. In this thesis, the validity of dualist positions on sport expertise is evaluated. It is argued that, to advance understanding of expertise and talent development, a shift towards a multidisciplinary and integrative science focus is necessary, along with the development of a comprehensive multidisciplinary theoretical rationale. Dynamical systems theory is utilised as a multidisciplinary theoretical rationale for the succession of studies, capturing how multiple interacting constraints can shape the development of expert performers. Phase I of the research examines experiential knowledge of coaches and players on the development of fast bowling talent utilising qualitative research methodology. It provides insights into the developmental histories of expert fast bowlers, as well as coaching philosophies on the constraints of fast bowling expertise. Results suggest talent development programmes should eschew the notion of common optimal performance models and emphasize the individual nature of pathways to expertise. Coaching and talent development programmes should identify the range of interacting constraints that impinge on the performance potential of individual athletes, rather than evaluating current performance on physical tests referenced to group norms. Phase II of this research comprises three further studies that investigate several of the key components identified as important for fast bowling expertise, talent identification and development extrapolated from Phase I of this research. This multidisciplinary programme of work involves a comprehensive analysis of fast bowling performance in a cross-section of the Cricket Australia high performance pathways, from the junior, emerging and national elite fast bowling squads. Briefly, differences were found in trunk kinematics associated with the generation of ball speed across the three groups. These differences in release mechanics indicated the functional adaptations in movement patterns as bowlers’ physical and anatomical characteristics changed during maturation. Second to the generation of ball speed, the ability to produce a range of delivery types was highlighted as a key component of expertise in the qualitative phase. The ability of athletes to produce consistent results on different surfaces and in different environments has drawn attention to the challenge of measuring consistency and flexibility in skill assessments. Examination of fast bowlers in Phase II demonstrated that national bowlers can make adjustments to the accuracy of subsequent deliveries during performance of a cricket bowling skills test, and perform a range of delivery types with increased accuracy and consistency. Finally, variability in selected delivery stride ground reaction force components in fast bowling revealed the degenerate nature of this complex multi-articular skill where the same performance outcome can be achieved with unique movement strategies. Utilising qualitative and quantitative methodologies to examine fast bowling expertise, the importance of degeneracy and adaptability in fast bowling has been highlighted alongside learning design that promotes dynamic learning environments.

An innovative design and studio-based CS degree

The University of Queensland has recently established a new design-focused, studio-based computer science degree. The Bachelor of Information Environments degree augments the core courses from the University's standard CS degree with a stream of design courses and integrative studio-based projects undertaken every semester. The studio projects integrate and reinforce learning by requiring students to apply the knowledge and skills gained in other courses to open-ended real-world design projects. The studio model is based on the architectural studio and involves teamwork, collaborative learning, interactive problem solving, presentations and peer review. This paper describes the degree program, its curriculum and rationale, and reports on experiences in the first year of delivery.

Philosophy, behaviour disorders, and the school

The recent exponential rise in the number of behaviour disorders has been the focus of a wide range of commentaries, ranging from the pedagogic and the administrative, to the sociological, and even the legal. This book will be the first to apply, in a systematic and thorough manner, the ideas of the foundational discipline of philosophy. A number of philosophical tools are applied here, tools arising through the medium of the traditional philosophical debates, such as those concerning governance, truth, logic, ethics, free-will, law and language. Each forms a separate chapter, but together they constitute a comprehensive, rigorous and original insight into what is now an important set of concerns for all those interested in the governance of children. The intention is threefold: first, to demonstrate the utility, accessibility and effectiveness of philosophical ideas within this important academic area. Philosophy does not have to be regarded an arcane and esoteric discipline, with only limited contemporary application, far from it. Second, the book offers a new set of approaches and ideas for both researchers and practitioners within education, a field is in danger of continually using the same ideas, to endlessly repeat the same conclusions. Third, the book offers a viable alternative to the dominant psychological model which increasingly employs pathology as its central rationale for conduct. The book would not only be of interest to mainstream educators, and to those students and academics interested in philosophy, and more specifically, the application of philosophical ideas to educational issues, it would also be an appropriate text for courses on education and difference, and due to the breadth of the philosophical issues addressed, courses on applied philosophy.

Be my buddy: IM and the future of virtual reference

In 2006, the administrators of the Australian virtual reference service, AskNow, entered the Instant Messaging (IM) arena. One of the first large scale, collaborative IM services in the world, the AskNow IM trial provided a unique opportunity to prove IM virtual reference as a concept, as well as to test the technology itself. This paper will discuss the rationale and impetus for the trial, explore the successes and stumbling blocks encountered during the establishment and evolution of the trial and the service model, examine the lessons learnt throughout the trial, and conclude by discussing the way forward for IM services and virtual reference.

Not for profit income tax exemption : is there a hole in the bucket, dear Henry?

Australia’s Future Tax System Review, headed by the then head of the Australian Treasury, and the Productivity Commission’s Research Report on the not for profit sector, both examined the state of tax concessions to Australia’s not for profit sector in the light of the High Court’s decision in Commissioner of Taxation v Word Investments Ltd. Despite being unable to quantify with any certainty the pre- or post-Word Investments cost of the tax concessions, both Reports indicated their support for continuation of the income tax exemption. However, the government acted in the 2011 Budget to target the not for profit income tax concessions more precisely, mainly on competitive neutrality grounds. This article examines the income tax exemption by applying the five taxation design principles, proposed in the Australia’s Future Tax System Review, for assessing tax expenditure. The conclusion is that the exemptions can be justified and, further, that a rationale for the exemption can be consistent with the reasoning in the Word Investments case.

Sub-tropical high-density, low rise residential buildings: case study 3

The case study 3 team viewed the mitigation of noise and air pollution generated in the transport corridor that borders the study site to be a paramount driver of the urban design solution. These key urban planning strategies were adopted: * Spatial separation from transport corridor pollution source. A linear green zone and environmental buffer was proposed adjacent to the transport corridor to mitigate the environmental noise and air quality impacts of the corridor, and to offer residents opportunities for recreation * Open space forming the key structural principle for neighbourhood design. A significant open space system underpins the planning and manages surface water flows. * Urban blocks running on east-west axis. The open space rationale emphasises an east-west pattern for local streets. Street alignment allows for predominantly north-south facing terrace type buildings which both face the street and overlook the green courtyard formed by the perimeter buildings. The results of the ESD assessment of the typologies conclude that the design will achieve good outcomes through: * Lower than average construction costs compared with other similar projects * Thermal comfort; A good balance between daylight access and solar gains is achieved * The energy rating achieved for the units is 8.5 stars.

Charity law, advocacy and the aid/watch decision : compatibility of charitable purposes and political objects — the view from Australia

Introduction In 1952 the Nathan report stated that: Some of the most valuable activities of voluntary societies consist, however, in the fact that they may be able to stand aside from and criticize State action or inaction, in the interests of the inarticulate man in the street. Some 60 years later it remained the case that if a voluntary society wanted to gain or retain charitable status then, contrary to the Nathan report, the one thing it could not do was set itself up with the purpose of criticizing State action or inaction. This legal position was adopted by the authorities in Australia with the Australian Taxation Office (ATO) noting in Taxation Ruling TR2005/21: 102. An institution or fund is not charitable if its purpose is advocating a political party or cause, attempting to change the law or government policy, or propagating or promoting a particular point of view. So, why, if it is such a valuable activity, have governments steadfastly refused to allow charities to have as their purpose the freedom to advocate in this way and how has this situation been affected by the recent High Court of Australia decision in Aid/Watch v Commissioner of Taxation? This article proposes to address such questions. Beginning with some background history, it explains that, initially, the current constraints did not apply. Then it looks at the nature of these constraints: how does the law define what constitutes the type of political activity that a charity must not undertake? What is the rationale for prohibition? How has the judiciary contributed to the development of the law in this area in recent years? This will lead into a consideration of the Aid/Watch case and the implications arising from the recent final decision. The article concludes by reflecting on what has changed and why the view on this contentious matter now looks different from Australia.

Heterogeneity in auditory alarm sets makes them easier to learn

The primary objective of the experiments reported here was to demonstrate the effects of opening up the design envelope for auditory alarms on the ability of people to learn the meanings of a set of alarms. Two sets of alarms were tested, one already extant and one newly-designed set for the same set of functions, designed according to a rationale set out by the authors aimed at increasing the heterogeneity of the alarm set and incorporating some well-established principles of alarm design. For both sets of alarms, a similarity-rating experiment was followed by a learning experiment. The results showed that the newly-designed set was judged to be more internally dissimilar, and easier to learn, than the extant set. The design rationale outlined in the paper is useful for design purposes in a variety of practical domains and shows how alarm designers, even at a relatively late stage in the design process, can improve the efficacy of an alarm set.

Vulnerable and invisible : depictions of trafficking victims in public awareness campaigns

Public concern about the crime of human trafficking has dramatically risen over the last two decades. . This concern and panic has both spawned and been fuelled by an array of public awareness campaigns that aim to educate the public about this crime. Campaigns such as the Blue Blindfold Campaign in the UK, the UN-driven Blue Heart Campaign, and the worldwide Body Shop campaign have contributed to the public’s awareness and, to an extent, understanding of the phenomenon of human trafficking. This research explores these and other government and non-government campaigns aimed at raising public awareness of human trafficking. It questions the rationale, call to action and impact of these efforts, and analyses the depiction of trafficking victims in these campaigns. In particular, this research argues that some of these campaigns perpetuate an understanding of a hierarchy of victimisation of trafficking. A public focus on sex trafficking often results in the conflation of prostitution and trafficking, and renders invisible the male and female victims of trafficking for other forms of labour.

Developing tools to facilitate integrated reflection

Much has been said and documented about the key role that reflection can play in the ongoing development of e-portfolios, particularly e-portfolios utilised for teaching and learning. A review of e-portfolio platforms reveals that a designated space for documenting and collating personal reflections is a typical design feature of both open source and commercial off-the-shelf software. Further investigation of tools within e-portfolio systems for facilitating reflection reveals that, apart from enabling personal journalism through blogs or other writing, scaffolding tools that encourage the actual process of reflection are under-developed. Investigation of a number of prominent e-portfolio projects also reveals that reflection, while presented as critically important, is often viewed as an activity that takes place after a learning activity or experience and not intrinsic to it. This paper assumes an alternative, richer conception of reflection: a process integral to a wide range of activities associated with learning, such as inquiry, communication, editing, analysis and evaluation. Such a conception is consistent with the literature associated with ‘communities of practice’, which is replete with insight into ‘learning through doing’, and with a ‘whole minded’ approach to inquiry. Thus, graduates who are ‘reflective practitioners’ who integrate reflection into their learning will have more to offer a prospective employer than graduates who have adopted an episodic approach to reflection. So, what kinds of tools might facilitate integrated reflection? This paper outlines a number of possibilities for consideration and development. Such tools do not have to be embedded within e-portfolio systems, although there are benefits in doing so. In order to inform future design of e-portfolio systems this paper presents a faceted model of knowledge creation that depicts an ‘ecology of knowing’ in which interaction with, and the production of, learning content is deepened through the construction of well-formed questions of that content. In particular, questions that are initiated by ‘why’ are explored because they are distinguished from the other ‘journalist’ questions (who, what, when, where, and where) in that answers to them demand explanative, as opposed to descriptive, content. They require a rationale. Although why questions do not belong to any one genre and are not simple to classify — responses can contain motivational, conditional, causal, and/or existential content — they do make a difference in the acquisition of understanding. The development of scaffolding that builds on why-questioning to enrich learning is the motivation behind the research that has informed this paper.

Active ageing : developing a quantitative multi-dimensional measure

With estimates that two billion of the world’s population will be 65 years or older by 2050, ensuring that older people ‘age well’ is an international priority. To date, however, there is significant disagreement and debate about how to define and measure ‘ageing well’, with no consensus on either terminology or measurement. Thus, this chapter describes the research rationale, methodology and findings of the Australian Active Ageing Study (Triple A Study), which surveyed 2620 older Australians to identify significant contributions to quality of life for older people: work, learning, social participation, spirituality, emotional wellbeing, health, and life events. Exploratory factor analyses identified eight distinct elements (grouped into four key concepts) which appear to define ‘active ageing’ and explained 55% of the variance: social and life participation (25%), emotional health (22%), physical health and functioning (4%) and security (4%). These findings highlight the importance of understanding and supporting the social and emotional dimensions of ageing, as issues of social relationships, life engagement and emotional health dominated the factor structure. Our intension is that this paper will prompt informed debate and discussion on defining and measuring active ageing, facilitating exploration and understanding of the complexity of issues that intertwine, converge and enhance the ageing experience.