Diabetes MILES - Australia (Management and Impact for Long-Term Empowerment and Success) : methods and sample characteristics of a national survey of the psychological aspects of living with type 1 or type 2 diabetes in Australian adults

Background Successful management of diabetes requires attention to the behavioural, psychological and social aspects of this progressive condition. The Diabetes MILES (Management and Impact for Long-term Empowerment and Success) Study is an international collaborative. Diabetes MILES-Australia, the first Diabetes MILES initiative to be undertaken, was a national survey of adults living with type 1 or type 2 diabetes in Australia. The aim of this study was to gather data that will provide insights into how Australians manage their diabetes, the support they receive and the impact of diabetes on their lives, as well as to use the data to validate new diabetes outcome measures.

Methods The survey was designed to include a core set of self-report measures, as well as modules specific to diabetes type or management regimens. Other measures or items were included in only half of the surveys. Cognitive debriefing interviews with 20 participants ensured the survey content was relevant and easily understood. In July 2011, the survey was posted to 15,000 adults (aged 18-70 years) with type 1 or type 2 diabetes selected randomly from the National Diabetes Services Scheme (NDSS) database. An online version of the survey was advertised nationally. A total of 3,338 eligible Australians took part; most (70.4%) completed the postal survey. Respondents of both diabetes types and genders, and of all ages, were adequately represented in both the postal and online survey sub-samples. More people with type 2 diabetes than type 1 diabetes took part in Diabetes MILES-Australia (58.8% versus 41.2%). Most respondents spoke English as their main language, were married/in a de facto relationship, had at least a high school education, were occupied in paid work, had an annual household income > $AUS40,000, and lived in metropolitan areas.

Discussion A potential limitation of the study is the under-representation of respondents from culturally and linguistically diverse backgrounds (including Aboriginal and Torres Strait Islander origin). Diabetes MILES-Australia represents a major achievement in the study of diabetes in Australia, where for the first time, the focus is on psychosocial and behavioural aspects of this condition at a national level.

Stream management within the CloudMiner

Nowadays cloud computing has become a major trend that enterprises and research organizations are pursuing with increasing zest. A potentially important application area for clouds is data analytics. In our previous publication, we introduced a novel cloud infrastructure, the CloudMiner, which facilitates data mining on massive scientific data. By providing a cloud platform which hosts data mining cloud services following the Software as a Service (SaaS) paradigm, CloudMiner offers the capability for realizing cloud-based data mining tasks upon traditional distributed databases and other dataset types. However, little attention has been paid to the issue of data stream management on the cloud so far. We have noticed the fact that some features of the cloud meet very well the requirements of data stream management. Consequently, we developed an innovative software framework, called the StreamMiner, which is introduced in this paper. It serves as an extension to the CloudMiner for facilitating, in particular, real-world data stream management and analysis using cloud services. In addition, we also introduce our tentative implementation of the framework. Finally, we present and discuss the first experimental performance results achieved with the first StreamMiner prototype.

Social intelligence and top management team: an exploratory study of external knowledge acquisition for strategic change in global IT service providers in India

This paper focuses on the processes by which firms, particularly knowledge intensive firms, can augment their overall knowledge stock by tapping into external sources of knowledge. It is argued that Top Management Teams' (TMTs') social intelligence is a critical learning capability in acquiring external knowledge that leads to strategic change. Social intelligence involves social awareness, social understanding and social skills. The study draws from the experience of 11 of the largest Information Technology Service Providers (ITSPs) in India and based on in-depth interviews. The findings show that TMTs' learning capability in the context of social intelligence to interact with external stakeholders is important to ITSPs in facilitating external knowledge acquisition and allowing new knowledge emerge within and across networks. The findings provide significant insights into ITSPs emerging in other developing countries such as in China. Research limitation and future research direction are also provided.

International outsourcing of information technology services : review and future directions

Purpose – The purpose of this paper is to review the development of the empirical literature on international outsourcing of information technology services (ITS) over the 1992-2007 period and to identify future research areas.

Design/methodology/approach – A sample of 78 empirical academic publications on international outsourcing of ITS conducted between 1992 and 2007 across 46 scholarly journals constitutes the main data for analytical purposes. The sample is compiled following extensive electronic searches of the main academic databases. After clustering the studies in the sample according to their main research areas, a narrative approach is used to review developments in each cluster and to identify emerging research areas.

Findings – Four main areas of research are identified, namely outsourcing decision, outsourcing management (OSM), outsourcing outcome and the role of offshore service providers (OSPs). The review suggests that research efforts to date have been predominantly on outsourcing decision and OSM, mostly from the perspective of clients. Future research opportunities exist in the areas of outsourcing strategy and performance, the behaviour and performance of OSPs particularly within the context of firms from less-developed countries competing globally, and the nature of competition among OSPs both within and among countries.

Originality/value – This is the first review which focuses on empirical studies of outsourcing for ITS. This paper identifies several gaps in the literature and points to the need for more research on outsourcing from the perspective of OSPs.

Patent management and social software

The worldwide increase of patent applications and the important role patents play in economic development make the management of intellectual property (IP) an important area for many companies. At the same time, the complexity in decision-making and IP process management necessitates a high degree of collaboration between various enterprise divisions such as strategy and policy making and market research. In this paper we present an ongoing case study at a large international automotive manufacturer that is exploring the potential of social software to support patent management. We conducted 31 semi-structured interviews to identify relevant patent processes at the company as well as typical operational problems within these processes. This leads us to derive four propositions on how social software can support patent processes. We conclude by providing an overview of the next steps in our research project. Our results present a first step in understanding the role of emerging social software services in enabling collaborative patent management.

Management of service level agreement for service-oriented content adaptation platform

It is paramount to provide seamless and ubiquitous access to rich contents available online to interested users via a wide range of devices with varied characteristics. Recently, a service-oriented content adaptation scheme has emerged to address this content-device mismatch problem. In this scheme, content adaptation functions are provided as services by third-party providers. Clients pay for the consumed services and thus demand service quality. As such, negotiating for the QoS offers, assuring negotiated QoS levels and accuracy of adapted content version are essential. Any non-compliance should be handled and reported in real time. These issues elevate the management of service level agreement (SLA) as an important problem. This chapter presents prior work, important challenges, and a framework for managing SLA for service-oriented content adaptation platform.

Factors limiting participation in arthritis self-management programmes : an exploration of barriers and patient preferences within a randomized controlled trial

Objective. To improve understanding of barriers to participation in community-based arthritis self-management programmes and patient preferences for self-management education.

Methods. Individuals with hip or knee OA referred to orthopaedic surgeons or rheumatologists at six public and private hospitals in Victoria, Australia, were recruited for a randomized controlled trial (RCT) of the Stanford Arthritis Self-Management Programme (ASMP). As part of the study design, potential participants were asked during the screening and recruitment process about reasons for being unable to attend the course, reasons for not participating in the study and individual preferences for course scheduling.

Results. Of 1125 individuals assessed, 216 (19%) were unable to attend six ASMP sessions. This was commonly due to physical limitations, including illness, restricted mobility and pain (22%), difficulty getting to or from courses (22%), work commitments (22%), the time commitment required (17%) and family roles (12%). Among those who did not want to participate in the study (n = 258), the overwhelming reason was disinterest (74%). Specific preferences for course scheduling were frequent, confirming the practical challenges faced in organizing courses for the RCT.

Conclusion. Incorporating patients from public and private settings, this study has elicited new insights into barriers to ASMP participation. Many people with hip or knee OA have limited capacity and motivation to attend community-based group programmes. Future self-management programmes and research should include more accessible options for those who cannot attend group-based programmes.

Hierarchical workflow management in wireless sensor network

To build the service-oriented applications in a wireless sensor network (WSN), the workflow can be utilized to compose a set of atomic services and execute the corresponding pre-designed processes. In general, WSN applications rely closely on the sensor data which are usually inaccurate or even incomplete in the resource-constrained WSN. Then, the erroneous sensor data will affect the execution of atomic services and furthermore the workflows, which form an important part in the bottom-to-up dynamics of WSN applications. In order to alleviate this issue, it is necessary to manage the workflow hierarchically. However, the hierarchical workflow management remains an open and challenging problem. In this paper, by adopting the Bloom filter as an effective connection between the sensor node layer and the upper application layer, a hierarchical workflow management approach is proposed to ensure the QoS of workflow-based WSN application . The case study and experimental evaluations demonstrate the capability of the proposed approach.

Barriers to the detection and management of depression by palliative care professional carers among their patients : perspectives from professional carers and patients' family members

Introduction: Clinical depression is highly prevalent yet underdetected and poorly managed within palliative care settings.

Objectives: This qualitative study explored the identification, monitoring, and management of symptoms of depression in patients receiving palliative care from 2 juxtaposed perspectives that are of care providers and care recipients' family members. Examining the barriers that restrict professional carers detecting and managing depression in their patients was a central focus of the study.

Methods: Focus groups were held with 18 professional carers, including 8 holding managerial positions, across 2 palliative care services, 1 regional and 1 metropolitan, which provided both inpatient and community-based care. Individual interviews were conducted with 10 family members of patients who had received or were receiving palliative care through these services.

Results: Thematic analysis of these data identified that both professional carers and family members perceived that depression is a wide-spread concern for patients receiving palliative care; however, numerous barriers were identified that affect professional carers’ ability to identify depression. These included knowledge and training deficits, low self-efficacy, prioritization of physical concerns and time constraints, patient/family characteristics, and system/process issues. These themes (and related subthemes) are discussed in this article.

Conclusions: Specialized training in depression is recommended for professional carers in order to improve their depression-related knowledge, detection skills, and self-efficacy. The ultimate goal of such training is to increase the rate of recognition of depression that in turn will lead to appropriate treatment for depressed patients.

Implementation of a quality care management system for patients with arthritis of the hip and knee

The Orthopaedic Unit of the Repatriation General Hospital (RGH) in Adelaide, South Australia has implemented a quality care management system for patients with arthritis of the hip and knee. The system not only optimises conservative management but ensures that joint replacement surgery is undertaken in an appropriate and timely manner. This new service model addresses identified barriers to service access and provides a comprehensive, coordinated strategy for patient management. Over 4 years the model has reduced waiting times for initial outpatient assessment from 8 to 3 months and surgery from 18 to 8 months, while decreasing length of stay from 6.3 to 5.3 days for hips and 5.8 to 5.3 days for knees. The service reforms have been accompanied by positive feedback from patients and referring general practitioners in relation to the improved coordination of care and enhanced efficiency in service delivery.

What is known about the topic? Several important initiatives both overseas and within Australia have contributed significantly to the development of this model of care. These include the UK National Health Service ‘18 weeks’ Project, the Western Canada Waiting List Project, the New Zealand priority criteria project, the Queensland Health Orthopaedic Physiotherapy Screening Clinic, and most importantly the Melbourne Health–University of Melbourne Orthopaedic Waiting List Project where a wide range of models were explored across Victorian hospitals from 2005 and the Multi-Attribute Prioritisation Tool (MAPT) was developed, validated and tested. This project became the Osteoarthritis Hip and Knee Service (OAHKS) and was operationalised in the Victorian healthcare system from 2012. These initiatives examined and addressed various aspects of management systems for patients with arthritis of the hip and knee in their particular setting.

What does this paper add? The development of this system is an extension of what is already known and is the first to encompass a comprehensive and coordinated strategy across all stages of the care management pathway for this patient group. Their management extends from the initial referral to development and implementation of a management plan, including surgery if assessed as necessary and organisation of long-term post operative follow up as required. By detailing the elements, key processes and measurable outcomes of the service redesign this paper provides a model for other institutions to implement a similar initiative.

What are the implications for practitioners? An important aspect of the design process was practitioner acceptance and engagement and the ability to improve their capacity to deliver services within an efficient and effective model. Intrinsic to the model’s development was assessment of practitioner satisfaction. Data obtained including practitioner surveys indicated an increased level of both satisfaction with the redesigned management service, and confidence in it to deliver its intended improvements.

Offshoring of IT services : survey of literature and research agenda

Although international outsourcing or offshoring of information technology services by advanced industrialised countries from less developed countries is a relatively new phenomenon, a plethora of research exists on the subject. And, given the multidisciplinary nature of the subject, the literature on offshoring is often disparate and subject to confusion. This paper surveys the developments in the empirical literature on offshoring over the 1992-2007 period and identifies potential areas for future research. The main findings are that while the intensity of research on the subject has increased rapidly over a short period of time, research efforts to date have focussed mostly on offshoring decision and offshoring management particularly from the perspective of the offshorer. Future research opportunities exist in the area of offshoring strategy and performance relationship, the behaviour and performance of offshore service providers particularly within the context of firms from less developed countries competing globally, and the nature of competition among offshore service providers both within and among countries.

Inequitable provision of optimal services for patients with chronic heart failure : a national geo-mapping study

Objective : To compare the location and accessibility of current Australian chronic heart failure (CHF) management programs and general practice services with the probable distribution of the population with CHF. Design and setting : Data on the prevalence and distribution of the CHF population throughout Australia, and the locations of CHF management programs and general practice services from 1 January 2004 to 31 December 2005 were analysed using geographic information systems (GIS) technology. Outcome measures : Distance of populations with CHF to CHF management programs and general practice services. Results : The highest prevalence of CHF (20.3–79.8 per 1000 population) occurred in areas with high concentrations of people over 65 years of age and in areas with higher proportions of Indigenous people. Five thousand CHF patients (8%) discharged from hospital in 2004–2005 were managed in one of the 62 identified CHF management programs. There were no CHF management programs in the Northern Territory or Tasmania. Only four CHF management programs were located outside major cities, with a total case load of 80 patients (0.7%). The mean distance from any Australian population centre to the nearest CHF management program was 332 km (median, 163 km; range, 0.15–3246 km). In rural areas, where the burden of CHF management falls upon general practitioners, the mean distance to general practice services was 37 km (median, 20 km; range, 0–656 km). Conclusion : There is an inequity in the provision of CHF management programs to rural Australians.

Integrated depression management: a proposed trial of a new model of care in a low vision rehabilitation setting

Purpose:
Depression is a common problem among people with visual impairment and contributes to functional decline. This article presents a study protocol to evaluate a new model of care for those patients with depressive symptoms in which psychological treatment is integrated into low vision rehabilitation services. Low vision staff will be trained to deliver "problem solving therapy for primary care" (PST-PC), an effective psychological treatment developed specifically for delivery by non-mental health care staff. PST-PC is delivered in 8 weekly telephone sessions of 30-45 minutes duration and 4 monthly maintenance sessions. We predict this new integrated model of care will significantly reduce depressive symptoms and improve the quality of life for people with visual impairment.

Methods and Design:
A randomized controlled trial of PST-PC will be implemented nationally across low vision rehabilitation services provided by Vision Australia. Clients who screen positive for depressive symptoms and meet study criteria will be randomized to receive PST-PC or usual care, consisting of a referral to their general practitioner for more detailed assessment and treatment. Outcome measures include depressive symptoms and behaviors, quality of life, coping and psychological adjustment to visual impairment. Masked assessments will take place pre- and post-intervention as well as at 6- and 12-month follow-up.

Conclusion:
We anticipate that this innovative service delivery model will lead to sustained improvements in clients' quality of life in a cost effective manner and provide an innovative service delivery model suitable for other health care areas in which depression is co-morbid.