Patient self-management in chronic heart failure – establishing concordance between guidelines and practice

 Chronic heart failure (CHF) is a progressive and debilitating disease with a broad symptom profile, intermittently marked by periods of acute decompensation. CHF patients are encouraged to self-manage their illness, such as adhering to medical regimens and monitoring symptoms, to optimise health outcomes and quality of life. In so doing, patients are asked to collaborate with their health service providers with regard to their care. However, patients generally do not self-manage well, even with specialist support. Moreover, self- management interventions are yet to demonstrate morbidity or mortality benefits. Social network approaches to self-management consider the availability and mobilisation of all resources, beyond those of only the patient and healthcare providers. Used in conjunction with e-health platforms, social network approaches may offer a means by which to optimise self-management programmes of the future.

Midwives experiences of establishing partnerships: working with pregnant women who use illicit drugs

OBJECTIVE: To present the interpreted experiences of midwives who choose to work with pregnant women who also use illicit drugs. DESIGN: Twelve (n=12) Australian midwives were interviewed. Each interview was audio-taped, de-identified and transcribed. The interviews were analysed using a systematic, thematic analysis approach informed by Heideggarian hermeneutic phenomenology. FINDINGS: Three themes identified from the data that encapsulate the experience were establishing partnerships, making a difference, and letting go and redefining practice. The interpretations of establishing partnerships which includes engagement, genuine regard and compassion, with a subtheme courting the system are presented in this paper. The midwives' experiences were both positive and negative, as they were rewarded and challenged by the needs of women who use illicit drugs and the systems in which they worked. CONCLUSION: The midwives in this study found that establishing partnerships was essential to their work. They appraised their experience of working with pregnant women who used illicit drugs and found strategies that attempted to meet the needs of the women, the system and themselves. The participants revealed that to support women and families who use illicit drugs in their community, partnerships must be based on deep respect and trust. Significant components engagement, genuine regard and compassion that are central to midwifery partnerships require revisiting to address the needs of this vulnerable population of women.

How do SMEs with single and multiple owners finance their operations differently? Empirical evidence from China

We study the impact of firm-level characteristics on the capital structures of private small and medium-sized enterprises (SMEs) as well as the differences between the capital structures adopted by SMEs with single and multiple owners in China. Our findings highlight the limited use of asset-based financing by Chinese SMEs. We also find that the propensity of SMEs with single-owners to use external debt was significantly less than those with multiple owners. Furthermore, our findings suggest that single-owned firms are subject to a more constrained pecking order than those with multiple owners.

Critical design features for establishing a childhood obesity monitoring program in Australia

Efforts to combat childhood obesity in Australia are hampered by the lack of quality epidemiological data to routinely monitor the prevalence and distribution of the condition. This paper summarises the literature on issues relevant to childhood obesity monitoring and makes recommendations for implementing a school-based childhood obesity monitoring program in Australia. The primary purpose of such a program would be to collect population-level health data to inform both policy and the development and evaluation of community-based obesity prevention interventions. Recommendations are made for the types of data to be collected, data collection procedures and program management and evaluation. Data from an obesity monitoring program are crucial for directing and informing policies, practices and services, identifying subgroups at greatest risk of obesity and evaluating progress towards meeting obesity-related targets. Such data would also increase the community awareness necessary to foster change.

Complex simulation of stockyard mining operations

Conflicts between resources in stockyards cause mining companies millions of dollars a year. An effective planning strategy needs to be established in order to reduce these operational conflicts. In this research a stockyard simulation model of a mining operation is proposed. The simulation uses discrete event and continuous strategies to create a high detail level of visualization and animation that closely resemble actual stockyard operation. The proposed simulation model is tightly integrated with a stockpile planner and it is used to evaluate the feasibility of a given production plan. The high detail visualization of the simulation model allows planner to determine the source of conflict, which can be used to guide the elimination of these conflicts.

Establishing trust relationships in OppNets using Merkle trees

Opportunistic Networks (OppNets) are exposed to a variety of attacks, among them are packet dropping attacks. The security challenges in OppNets is to effectively and securely forward data and guarantee their delivery without any loss. Security and trust in OppNets have gained popularity in research because of their inherent features, including frequent partitions, long delays and intermittent connectivity. This paper presents an efficient malicious path and malicious node detection technique against selective packet dropping attacks. In our algorithm we have developed a solid detection mechanism using the Merkle tree hashing technique. The result of malicious path detection is used to build trust by destination nodes for each path, the built trust value of nodes is then used to detect malicious nodes. Simulation results show that the technique accurately detects malicious paths. The results also show that with the increase of simulation time, node detection accuracy also increases as intermediate nodes have more time to establish trust with destination nodes.