Effective technologies for noninvasive remote monitoring in heart failure

Background Trials of new technologies to remotely monitor for signs and symptoms of worsening heart failure are continually emerging. The extent to which technological differences impact the effectiveness of non-invasive remote monitoring for heart failure management is unknown. Objective To examine the effect of specific technology used for non-invasive remote monitoring of people with heart failure on all-cause mortality and heart failure-related hospitalisations. Methods A sub-analysis of a large systematic review and meta-analysis was conducted. Studies were stratified according to the specific type of technology used and separate meta-analyses were performed. Four different types of non-invasive remote monitoring technologies were identified including structured telephone calls, videophone, interactive voice response devices and telemonitoring. Results Only structured telephone calls and telemonitoring were effective in reducing the risk of all-cause mortality (RR 0.87; 95% CI=0.75-1.01; p=0.06 and 0.62; 95% CI=0.50-0.77; p<0.0001) and heart failure-related hospitalisations (RR 0.77; 95% CI=0.68-0.87; p<0.001) and 0.75; 95% CI=0.63-0.91; p=0.003). More research data is required for videophone and interactive voice response technologies. Conclusions This sub-analysis identified that only two of the four specific technologies used for non-invasive remote monitoring in heart failure improved outcomes. When results of studies that involved these disparate technologies were combined in previous meta-analyses, significant improvements in outcomes were identified. As such, this study has highlighted implications for future meta-analyses of randomised controlled trials focused on evaluating the effectiveness of remote monitoring in heart failure.

The effectiveness of non-pharmacological interventions in improving psychological outcomes for heart transplant recipients : a systematic review

Background Post-heart transplant psychological distress may both directly hinder physiological health as well as indirectly impact on clinical outcomes by increasing unhealthy behaviours, such as immunosuppression non-adherence. Reducing psychological distress for heart transplant recipients is therefore vitally important, in order to improve patients’ overall health and well-being but also clinical outcomes, such as morbidity and mortality. Evidence from other populations suggests that non-pharmacological interventions may be an effective strategy. Aim To appraise the efficacy of non-pharmacological interventions on psychological outcomes after heart transplant. Method A systematic review was conducted using the Joanna Briggs Institute methodology. Experimental and quasi-experimental studies that involved any non-pharmacological intervention for heart transplant recipients were included, provided that data on psychological outcomes were reported. Multiple electronic databases were searched for published and unpublished studies and reference lists of retrieved studies were scrutinized for further primary research. Data were extracted using a standardised data extraction tool. Included studies were assessed by two independent reviewers using standardised critical appraisal instruments. Results Three studies fulfilled the inclusion and exclusion criteria, which involved only 125 heart transplant recipients. Two studies reported on exercise programs. One study reported a web-based psychosocial intervention. While psychological outcomes significantly improved from baseline to follow-up for the recipients who received the interventions, between-group comparisons were not reported. The methodological quality of the studies was judged to be poor. Conclusions Further research is required, as we found there is insufficient evidence available to draw conclusions for or against the use of non-pharmacological interventions after heart transplant.

An early assessment of silicone hydrogel safety : pearls and pitfalls, and current status

The contact lens industry has evolved and now provides many choices, including continuous wear, overnight orthokeratology, frequent-replacement lenses, daily-disposable lenses, and many alternatives in systems of care and maintenance. Epidemiologic studies to date have shown that how a lens is worn, particularly if worn overnight, can increase the risk of microbial keratitis. However, the risk of silicone hydrogel contact lenses worn on a continuous-wear basis has been evaluated only recently. This article summarizes the recent research data on extended-wear silicone hydrogel lenses and discusses the challenges of early evaluations of silicone hydrogel lens safety. Finally, the relevance of this information is discussed to practitioners and contact lens wearers making choices about the risks and benefits of different products and how they are used.

Impact of passenger group dynamics on an airport evacuation process using an agent-based model

The safety of passengers is a major concern to airports. In the event of crises, having an effective and efficient evacuation process in place can significantly aid in enhancing passenger safety. Hence, it is necessary for airport operators to have an in-depth understanding of the evacuation process of their airport terminal. Although evacuation models have been used in studying pedestrian behaviour for decades, little research has been done in considering the evacuees’ group dynamics and the complexity of the environment. In this paper, an agent-based model is presented to simulate passenger evacuation process. Different exits were allocated to passengers based on their location and security level. The simulation results show that the evacuation time can be influenced by passenger group dynamics. This model also provides a convenient way to design airport evacuation strategy and examine its efficiency. The model was created using AnyLogic software and its parameters were initialised using recent research data published in the literature.

Databases at QUT

Presentation by Dr Amadeo Pugliese, QUT Business School at Managing your research data seminar, 2012

Agent-based modelling simulation case study : assessment of airport check-in and evacuation process by considering group travel behaviour of air passengers

Passenger experience has become a major factor that influences the success of an airport. In this context, passenger flow simulation has been used in designing and managing airports. However, most passenger flow simulations failed to consider the group dynamics when developing passenger flow models. In this paper, an agent-based model is presented to simulate passenger behaviour at the airport check-in and evacuation process. The simulation results show that the passenger behaviour can have significant influences on the performance and utilisation of services in airport terminals. The model was created using AnyLogic software and its parameters were initialised using recent research data published in the literature.

Ten principles of good business process management

Purpose The purpose of this paper is to foster a common understanding of business process management (BPM) by proposing a set of ten principles that characterize BPM as a research domain and guide its successful use in organizational practice. Design/methodology/approach The identification and discussion of the principles reflects our viewpoint, which was informed by extant literature and focus groups, including 20 BPM experts from academia and practice. Findings We identify ten principles which represent a set of capabilities essential for mastering contemporary and future challenges in BPM. Their antonyms signify potential roadblocks and bad practices in BPM. We also identify a set of open research questions that can guide future BPM research. Research limitation/implication Our findings suggest several areas of research regarding each of the identified principles of good BPM. Also, the principles themselves should be systematically and empirically examined in future studies. Practical implications – Our findings allow practitioners to comprehensively scope their BPM initiatives and provide a general guidance for BPM implementation. Moreover, the principles may also serve to tackle contemporary issues in other management areas. Originality/value This is the first paper that distills principles of BPM in the sense of both good and bad practice recommendations. The value of the principles lies in providing normative advice to practitioners as well as in identifying open research areas for academia, thereby extending the reach and richness of BPM beyond its traditional frontiers.

Measuring up! Bringing everything we know together to make the researcher profile “sing”.

The search is ongoing for the perfect researcher profile with fully integrated citations, plus links to publications, research data, esteem measures, media releases, plus social media feeds and links to the researchers place of work.

A review of the effects of sedation on thermoregulation : insights for the cardiac catheterisation laboratory

Purpose To examine the effects that the sedative and analgesic medications which are commonly used in the cardiac catheterisation laboratory have on thermoregulation. Design A structured review strategy was used. Methods Medline and CINAHL were searched for published studies and reference lists of retrieved studies were scrutinized for further research. Data were extracted using a standardised extraction tool. Results A total of nine studies examined the effect that sedative and analgesic medications have on thermoregulation. Midazolam has minimal impact on thermoregulation while opioids, dexmedetomidine and propofol markedly decrease vasoconstriction and shivering thresholds. Conclusions Patients who receive sedation in the cardiac catheterisation laboratory may be at risk of hypothermia, due to the use of medications that impair thermoregulation. Further research is required to identify the prevalence of unplanned hypothermia during sedation in the cardiac catheterisation laboratory.

A collaborative rapid persona-building workshop : creating design personas with health researchers

In the HealthMap project for People With HIV, (PWHIV) designers employed a collaborative rapid ‘persona-building' workshop with health researchers to develop patient personas that embodied patient-centred design goals and contextual awareness from a variety of qualitative and quantitative data. On reflection, this collaborative rapid workshop was a process for drawing together the divergent user research insights and expertise of stakeholders into focus for a chronic disease self-management design. This paper discusses, (i) an analysis of the transcript of the workshop and, (ii) interviews with five practising senior designers, in order to reflect on how the persona-building process was enacted and its role in the HealthMap design evolution. The collaborative rapid persona-building methodology supported: embedding user research insights, eliciting domain expertise, introducing design thinking, facilitating stakeholder collaboration and defining early design requirements. The contribution of this paper is to model the process of collaborative rapid persona-building and to introduce the collaborative rapid persona-building framework as a method to generate design priorities from domain expertise and user research data.

Analysis of passenger group behaviour and its impact on passenger flow using an agent-based model

Group interaction within crowds is a common phenomenon and has great influence on pedestrian behaviour. This paper investigates the impact of passenger group dynamics using an agent-based simulation method for the outbound passenger process at airports. Unlike most passenger-flow models that treat passengers as individual agents, the proposed model additionally incorporates their group dynamics as well. The simulation compares passenger behaviour at airport processes and discretionary services under different group formations. Results from experiments (both qualitative and quantitative) show that incorporating group attributes, in particular, the interactions with fellow travellers and wavers can have significant influence on passengers activity preference as well as the performance and utilisation of services in airport terminals. The model also provides a convenient way to investigate the effectiveness of airport space design and service allocations, which can contribute to positive passenger experiences. The model was created using AnyLogic software and its parameters were initialised using recent research data published in the literature.

A qualitative exploration of parental experiences of stigma while living with HIV in Bangladesh

With much of the focus on the “risk” groups, families have often been less studied in HIV research. Further, because of a focus on the aetiology and epidemiology of HIV, the social impacts associated with HIV on families and neighbours are sometimes overlooked. This study examined parental experiences of stigma and discrimination while living with HIV within a family context in Bangladesh. A qualitative research design using a grounded theory approach was used for this research. Data was collected through in-depth interviews with 19 HIV-positive parents, recruited with the support of two self-help groups of HIV-positive people, in two settings namely Khulna and Dhaka in Bangladesh. The findings indicate that HIV-positive parents held the view that they continue to experience significant stigma and their narratives clearly show how this affected them and their children. A range of informal practices were enacted in everyday contexts by extended family and community members to identify, demarcate and limit the social interaction of HIV-positive parents. Parents highlighted a number of factors including negative thoughts and behaviours, rejection, isolation and derogatory remarks as manifestations of stigma and discrimination, impacting upon them and their children because of their association with HIV.

More than thirty years of ultimatum bargaining experiments: Motives, variations, and a survey of the recent literature

Take-it or leave-it offers are probably as old as mankind. Our objective here is, first, to provide a, probably subjectively colored, recollection of the initial ultimatum game experiment, its motivation and the immediate responses. Second, we discuss extensions of the standard ultimatum bargaining game in a unified framework, and, third, we offer a survey of the experimental ultimatum bargaining literature containing papers published since the turn of the century. The paper argues that the ultimatum game is a versatile tool for research in bargaining and on social preferences. Finally, we provide examples for open research questions and directions for future studies.

Kulttuurierot ja kielimuuri valtanäkökulmasta suomalais-puolalaisessa työyhteisössä

The thesis deals with cultural differences and language barrier in a Finnish-Polish working environment. The object is to find out what kind of language and cultural practices prevail and what are their consequences. This qualitative research focuses on problem solving strategies used to manage language barrier and cultural differences and their effect on power relations within the working environment and in relation to e.g. parent company, business partners or customers. The research data was collected by half-structured individual interviews of 24 Finns and Poles in seven companies in Poland. The research indicates that language practices as well as Polish employees' language skills significantly affect information flows: those Poles, who have good language skills, are less dependent on their Finnish superior and thanks to their contacts with Finnish parent company they gain adequate information. Different time perceptions next to the perceived slowness of Finns are one of the most important factors causing cultural conflicts in the researched working environments. Most often mentioned by Finns were issues of trust. However, the problematic issues brought up most were often things that the respondents could not influence since they did not concern the closest working environment but others. It seems that the contrast that used to be strong between superiors and subordinates in Poland has - partly due to the Finns' informal management style - in these mixed working environments transformed into a contrast between own working environment and the outsiders.

Parasta ennen : Tasa-arvotyön projektitapaistuminen

This book is a study of equality work, that is, the activities which have involved the promotion of gender equality in Finland. The study focuses on the period when the public sector has become more market-oriented, and business-oriented thinking has penetrated activities that have not traditionally emphasised profit-making. I have asked about the kind of power relations that have led to equality work in Finland. In addition to marketisation, publicly funded projects, especially by the European Union, have permeated the public sector. I have analysed the effects this turn has had on the aims and activities of equality work. Despite marketisation, equality work has remained for decades, and problems related to equality have also been recognised. The question of agency is a central focus of this study. I have analysed the kind of agency that has been offered and possible in equality work. With my previous “equality project career”, I have also participated in the formation of my research subject. This study also represents a description of a researcher taking on the responsibility for being involved in the formation of her own research subject. The study data includes national and EU-level political and governmental documents as well as articles and other publications related to equality issues. The data also includes documents from 99 publicly funded equality projects. Notable research data have been drawn from research interviews with 30 people who have been engaged in equality work in different parts of Finland and who have also worked in publicly funded equality projects. As a research method, I have combined Foucault’s discourse analysis and genealogical analysis as well as deconstructive reading. Political and governmental programmes have called for equality work, such as teaching, training, research and other political influencing in order to promote the political interests of the welfare state. Alliance with the state offers the opportunity to accomplish professionalism and continuity. Although equality work has not achieved similar legitimisation compared to other public sector professions. Equality work has fulfilled the interests of welfare state despite current trends towards marketisation. Publicly and budgetary funded equality work has evolved into business-oriented projects in a situation where the project itself has become a new governing mechanism for society. To analyse this trend, I have developed the concept of projectisation. The concept refers to a form of power that has directed discussions of equality in order to be heard. On the other hand, projectisation has contributed to the visibility of problems related to equality while maintaining heteronormativity and hierarchical order of societal differences, especially of gender, as well as harnessing equality for market use, thereby becoming somewhat useful and productive. Equality has been labelled as women’s work and being something that women do and continuity of the equality work has required a complex form of competence. The persistence of problems concerning equality as well as co-operation between women and the “discourse virtuosity ” of equality work has also opened up opportunities for situational change. Key words: Equality work, project, projectisation, genealogical method, discourse analysis, deconstructive reading, heteronormativity, agency, discourse virtuosity.