Feasibility of using telecommunications technology in a Cardiac-Diabetes Self-Management Program

Background: Evidence demonstrates self-management programs are an effective approach to assist patients with chronic diseases such as type 2 diabetes or cardiac conditions to modify their lifestyle for better managing their conditions. Using information technology (IT) has great potential to support self-management programs and assist patients to fulfill their goals in managing their conditions more efficiently and effectively. Examples of different types of technology used in self-management programs that have limited research support include: text messages, telephone followup, web-based programs, and other internet-assisted education. But little is known about the applicability and feasiability of different forms of technology for patients with chronic diseases such as those with type 2 diabetes and critical cardiac conditions. Furthermore, although there is some evidence of the benefits of using IT in supporting self-management programs, further research on the use of IT in such programs is recommended. Objective: To develop and pilot test an integrated Cardiac- Diabetes Self-Management Program (CDSMP) incorporating telephone and text-message follow-up. Methods: A pilot study using randomised controlled trial is conducted in the coronary care unit (CCU) in a Brisbane metropolitan hospital in Australia to collect data on patients with type 2 diabetes admitted to CCU. The main outcomes included self-efficacy levels, knowledge, and quality of life. Results: Initial results reveal that patients with diabetes admitted to the CCU in the experimental group did improve their self-efficacy, and knowledge levels. Acknowledgements: This Project is funded by QUT Early Career Researcher Research Grant

Multidisciplinary team approach for a peer-support based cardiac-diabetes self-management program

Background: Cardiac patients with diabetes are at higher readmission rates (22%) compared to only 6% for those patients without diabetes. Evidence shows benefits of peer support and using information technology to improve chronic illness and achieve better health outcomes. However limited evidence suggests that cardiac or diabetes self-management programs incorporating peer supporters (patients with similar conditions) or telephone and text-messaging, have improved health outcomes and reduce health care utilisations. A multidisciplinary research team approach is crucial to accommodate the complex aspects of delivering intervention programs for these at-risk patients. However, challenges such as the inconsistency in significance of key concepts across research fields, as well as practical and operational issues within different contexts are often experienced. Aims: To develop an effective multidisciplinary team approach to deliver a peer support based cardiac-diabetes self-management program incorporating the preparation of lay personnel to provide telephone and text-messaging follow up support. Methods: The approach was used for a multidisciplinary project using randomised controlled trial. Results: The findings from multidisciplinary team approach reveal the feasibility of a Peer support based cardiac-diabetes self-management program.

‘Working with the team’ : an exploratory study of improved type 2 diabetes management in a new model of integrated primary/secondary care

This study aimed to explore how a new model of integrated primary/secondary care for type 2 diabetes management, the Brisbane South Complex Diabetes Service (BSCDS), related to improved diabetes management in a selected group of patients. We used a qualitative research design to obtain detailed accounts from the BSCDS via semi-structured interviews with 10 patients. The interviews were fully transcribed and systematically coded using a form of thematic analysis. Participants’ responses were grouped in relation to: (1) Patient-centred care; (2) Effective multiprofessional teamwork; and (3) Empowering patients. The key features of this integrated primary/secondary care model were accessibility and its delivery within a positive health care environment, clear and supportive interpersonal communication between patients and health care providers, and patients seeing themselves as being part of the team-based care. The BSCDS delivered patient-centred care and achieved patient engagement in ways that may have contributed to improved type 2 diabetes management in these participants.

Proceedings of the Fourth Australasian Workshop on Health Informatics and Knowledge Management [Volume 120]

We are pleased to present the papers from the Australasian Health Informatics and Knowledge Management (HIKM) conference stream held on 20 January 2011 in Perth as a session of the Australasian Computer Science Week (ASCW) 2011. Formerly HIKM was named Health Data and Knowledge Management, however the inclusion of the health informatics term is timely given the current health reform. The submissions to HIKM 2011 demonstrated that Australasian researchers lead with many research and development innovations coming to fruition. Some of these innovations can be seen here, and we believe further recognition will accomplish by continuation to HIKM in the future. The HIKM conference is a review of health informatics related research, development and education opportunities. The conference papers were written to communicate with other researchers and share research findings, capturing each and every aspect of the health informatics field. They are namely: conceptual models and architectures, privacy and quality of health data, health workflow management patient journey analysis, health information retrieval, analysis and visualisation, data integration/linking, systems for integrated or coordinated care, electronic health records (EHRs) and personally controlled electronic health records (PCEHRs), health data ontologies, and standardisation in health data and clinical applications.

Intra-specific variation for host plant use in Helicoverpa armigera (Hubner) (Lepidoptera : Noctuidae) : implications for management

The polyphagous moth Helicoverpa armigera (Hübner) is one of the world's most important agricultural pests. A number of existing approaches and future designs for management of H. armigera rely on the assumption that moths do not exhibit either genetically and/or non-genetically based variation for host plant utilization. We review recent empirical evidence demonstrating that both these forms of variation influence host plant use in this moth. The significance of this variation in H. armigera in relation to current and future pest management strategies is examined. We provide recommendations on future research needs and directions for sustainable management of H. armigera, under a framework that includes consideration of intra-specific variation for host use relevant in this and other similar pest species.

Local on-ramp queue management strategy with mainline speed recovery

Ramp metering is an effective motorway control tool beneficial for mainline traffic, but the long on-ramp queues created interfere with surface traffic profoundly. This study deals with the conflict between mainline benefits and thecosts of on-ramp and surface traffic. A novel local on-ramp queue management strategy with mainline speed recovery is proposed. Microscopic simulation is used to test the new strategy and compare it with other strategies. Simulation results reveal that the ramp metering with queue management strategy provides a good balance between the mainline and on-ramp performances.

An integrated framework for assessing community resilience in disaster management

Climate change is predicted to increase the frequency and severity of extreme weather events which pose significant challenges to the ability of government and other relief agencies to plan for, cope with and respond to disasters. Consequently, it is important that communities in climate sensitive and potential disaster prone areas strengthen their resilience to natural disasters in order to expeditiously recover from potential disruptions and damage caused by disasters. Building self reliance and, particularly in the immediate aftermath of a disaster, can facilitate short-term and long-term community recovery. To build stronger and more resilient communities, it is essential to have a better understanding of their current resilience capabilities by assessing areas of strength, risks and vulnerabilities so that their strengths can be enhanced and the risks and vulnerability can be appropriately addressed and mitigated through capacity building programs. While a number of conceptual frameworks currently exist to assess the resilience level of communities to disasters, they have tended to differ on their emphasis, scope and definition of what constitutes community resilience and how community resilience can be most effectively and accurately assessed. These limitations are attributed to the common approach of viewing community resilience through a mono-disciplinary lens. To overcome this, this paper proposes an integrated conceptual framework that takes into account the complex interplay of environmental, social, governance, infrastructure and economic attributes associated with community resilience. The framework can be operationalised using a range of resilience indicators to suit the nature of a disaster and the specific characteristics of a study region.

Climate change adaptation for public buildings management : stakeholder roles and responsibilities

Climate change is expected to increase earth’s temperatures and consequently result in more frequent extreme weather events such as cyclones, storms, droughts and floods and rising global sea levels. This phenomenon will affect all assets. This paper discusses the impact of climate change and its consequences on public buildings. Public building management encompasses the building life cycle from planning, procurement, operation, repair and maintenance and building disposal. This paper recommends climate change adaptation strategies to be integrated into public building management. The roles and responsibilities of asset managers and users are discussed within the framework of planning and implementation of public building management and the integration of climate change adaptation strategies. A key point is that climate change can induce premature obsolescence of public buildings and services, which will increase the maintenance and refurbishment costs. This in turn will affect the life cycle cost of the building. Furthermore, a business continuity plan is essential for public building management in the context of disasters. The paper also highlights the significant role that the occupants of public buildings can play in the development and implementation of climate change adaptation strategies.