Alternative models of cardiac rehabilitation : a systematic review

The traditional hospital-based model of cardiac rehabilitation faces substantial challenges, such as cost and accessibility. These challenges have led to the development of alternative models of cardiac rehabilitation in recent years. The aim of this study was to identify and critique evidence for the effectiveness of these alternative models. A total of 22 databases were searched to identify quantitative studies or systematic reviews of quantitative studies regarding the effectiveness of alternative models of cardiac rehabilitation. Included studies were appraised using a Critical Appraisal Skills Programme tool and the National Health and Medical Research Council's designations for Level of Evidence. The 83 included articles described interventions in the following broad categories of alternative models of care: multifactorial individualized telehealth, internet based, telehealth focused on exercise, telehealth focused on recovery, community- or home-based, and complementary therapies. Multifactorial individualized telehealth and community- or home-based cardiac rehabilitation are effective alternative models of cardiac rehabilitation, as they have produced similar reductions in cardiovascular disease risk factors compared with hospital-based programmes. While further research is required to address the paucity of data available regarding the effectiveness of alternative models of cardiac rehabilitation in rural, remote, and culturally and linguistically diverse populations, our review indicates there is no need to rely on hospital-based strategies alone to deliver effective cardiac rehabilitation. Local healthcare systems should strive to integrate alternative models of cardiac rehabilitation, such as brief telehealth interventions tailored to individual's risk factor profiles as well as community- or home-based programmes, in order to ensure there are choices available for patients that best fit their needs, risk factor profile, and preferences.

CPAP apparatus : an inexpensive alternative

Objective: To describe an effective and inexpensive CPAP-mask apparatus for use in the emergency department. Conclusion: CPAP is an effective tool in the treatment of acute pulmonary oedema in the emergency department. The mask apparatus described is an inexpensive alternative to the commercially produced machines.

Young people, public space and new urbanism

The first of three articles in this issue addressing the public space topic considers public space and young people in the light of a range of papers delivered at the 27th International Conference on 'Making Cities Livable', held in Vienna, Austria, in July 2000. Under the overarching concept of the "liveable city" the conference themes of 'Rediscovery of public space' and 'Cities for the wellbeing of children' attracted a broad mix of those interested in the planning, design and management of urban space. A number of themes percolated through the conference which stimulated the writers to examine the nexus between urban development, young people and public space. There is an ongoing need to examine the meaning of public space in the face of powerful urban development trends. A model of public space practice is required which incorporates a vision of inclusive public spaces, fosters the interactivity of design, planning, social policy and management, and resources for greater communication and strategic action between stake holders from the most local of levels to those at state and international levels. The speed and magnitude of contemporary urban development makes community input and influence difficult, particularly for those impacted on by the exclusionary tendencies of much urban development. It is critical that a range of meaningful and sustainable mechanisms are developed which allow young people’s conceptions of what constitutes youth-friendly space to be directly made and taken account of.

Patients with terminal cancer who use alternative therapies: their beliefs and practices

This paper examines the extent to which patients who have been diagnosed as having terminal cancer choose to use non-medical therapies. In particular it is concerned with the illness behaviour of patients who are receiving conventional cytotoxic drug and radiation treatments, who also decide to use a wide range of ‘alternative’ medications and therapies. The paper discusses the findings of a study of 152 patients with metastatic cancer that examined the extent to which they used alternative cancer therapies, as well as the beliefs and attitudes they have about their cancer, its treatment, and the practitioners providing that treatment. Four groups of users of alternative therapies, who differ according to their commitment to and the type of therapies they use, were identified. Results of logistic regression analyses indicate that those using alternative therapies were different in range of social attitudes. These differences were primarily their greater reported ‘will to live’ and desire for control over treatment decisions, and the differing beliefs they hold about their disease.

The Cube : a very large-scale interactive engagement space

“The Cube” is a unique facility that combines 48 large multi-touch screens and very large-scale projection surfaces to form one of the world’s largest interactive learning and engagement spaces. The Cube facility is part of the Queensland University of Technology’s (QUT) newly established Science and Engineering Centre, designed to showcase QUT’s teaching and research capabilities in the STEM (Science, Technology, Engineering, and Mathematics) disciplines. In this application paper we describe, the Cube, its technical capabilities, design rationale and practical day-to-day operations, supporting up to 70,000 visitors per week. Essential to the Cube’s operation are five interactive applications designed and developed in tandem with the Cube’s technical infrastructure. Each of the Cube’s launch applications was designed and delivered by an independent team, while the overall vision of the Cube was shepherded by a small executive team. The diversity of design, implementation and integration approaches pursued by these five teams provides some insight into the challenges, and opportunities, presented when working with large distributed interaction technologies. We describe each of these applications in order to discuss the different challenges and user needs they address, which types of interactions they support and how they utilise the capabilities of the Cube facility.

Children and young people using public space : models of rights, optimism and wellbeing

This presentation discusses topics and issues that connect closely with the Conference Themes and themes in the ARACY Report Card. For example, developing models of public space that are safe, welcoming and relevant to children and young people will impact on their overall wellbeing and may help to prevent many of the tensions occurring in Australia and elsewhere around the world. This area is the subject of ongoing international debate, research and policy formation, relevant to concerns in the ARACY Report Card about children and young people’s health and safety, participation, behaviours and risks and peer and family relationships.

Young people and the social exclusion of their public and private space

This paper explores the concept of social exclusion as it impacts on young people within their local communities and the wider British, European and Australian context in terms of surveillance and other control measures.

Children's understanding of graphic representations of quantitative data

Children are encountering more and more graphic representations of data in their learning and everyday life. Much of this data occurs in quantitative forms as different forms of measurement are incorporated into the graphics during their construction. In their formal education, children are required to learn to use a range of these quantitative representations in subjects across the school curriculum. Previous research that focuses on the use of information processing and traditional approaches to cognitive psychology concludes that the development of an understanding of such representations of data is a complex process. An alternative approach is to investigate the experiences of children as they interact with graphic representations of quantitative data in their own life-worlds. This paper demonstrates how a phenomenographic approach may be used to reveal the qualitatively different ways in which children in Australian primary and secondary education understand the phenomenon of graphic representations of quantitative data. Seven variations of the children’s understanding were revealed. These have been described interpretively in the article and confirmed through the words of the children. A detailed outcome space demonstrates how these seven variations are structurally related.

Dreams and nightmares of alternative powers' futures

This chapter argues the importance of the role and nature of other powers to world order. The author suggests that, if the US are not prepared to take a lead in creating a rules-based legal order, they should and can do so – and it is in their interests to do so. America should be a natural leader in this process, taking part in a global dialogue just as they did in the transatlantic dialogue during the late eighteenth century.

Review : alternative splicing (AS) of genes as an approach for generating protein complexity

Prior to the completion of the human genome project, the human genome was thought to have a greater number of genes as it seemed structurally and functionally more complex than other simpler organisms. This along with the belief of “one gene, one protein”, were demonstrated to be incorrect. The inequality in the ratio of gene to protein formation gave rise to the theory of alternative splicing (AS). AS is a mechanism by which one gene gives rise to multiple protein products. Numerous databases and online bioinformatic tools are available for the detection and analysis of AS. Bioinformatics provides an important approach to study mRNA and protein diversity by various tools such as expressed sequence tag (EST) sequences obtained from completely processed mRNA. Microarrays and deep sequencing approaches also aid in the detection of splicing events. Initially it was postulated that AS occurred only in about 5%; of all genes but was later found to be more abundant. Using bioinformatic approaches, the level of AS in human genes was found to be fairly high with 35-59%; of genes having at least one AS form. Our ability to determine and predict AS is important as disorders in splicing patterns may lead to abnormal splice variants resulting in genetic diseases. In addition, the diversity of proteins produced by AS poses a challenge for successful drug discovery and therefore a greater understanding of AS would be beneficial.

Sense-making across space and time : implications for the organization and findability of information

This paper presents the results from a study of information behaviors, with specific focus on information organisation-related behaviours conducted as part of a larger daily diary study with 34 participants. The findings indicate that organization of information in everyday life is a problematic area due to various factors. The self-evident one is the inter-subjectivity between the person who may have organized the information and the person looking for that same information (Berlin et. al., 1993). Increasingly though, we are not just looking for information within collections that have been designed by someone else, but within our own personal collections of information, which frequently include books, electronic files, photos, records, documents, desktops, web bookmarks, and portable devices. The passage of time between when we categorized or classified the information, and the time when we look for the same information, poses several problems of intra-subjectivity, or the difference between our own past and present perceptions of the same information. Information searching, and hence the retrieval of information from one's own collection of information in everyday life involved a spatial and temporal coordination with one's own past selves in a sort of cognitive and affective time travel, just as organizing information is a form of anticipatory coordination with one's future information needs. This has implications for finding information and also on personal information management.