Structured Telephone Support or Telemonitoring Programs for Patients with Chronic Heart Failure

Background: Specialised disease management programmes for chronic heart failure (CHF) improve survival, quality of life and reduce healthcare utilisation. The overall efficacy of structured telephone support or telemonitoring as an individual component of a CHF disease management strategy remains inconclusive. Objectives: To review randomised controlled trials (RCTs) of structured telephone support or telemonitoring compared to standard practice for patients with CHF in order to quantify the effects of these interventions over and above usual care for these patients. Search strategy: Databases (the Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment Database (HTA) on The Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED and Science Citation Index Expanded and Conference Citation Index on ISI Web of Knowledge) and various search engines were searched from 2006 to November 2008 to update a previously published non-Cochrane review. Bibliographies of relevant studies and systematic reviews and abstract conference proceedings were handsearched. No language limits were applied. Selection criteria: Only peer reviewed, published RCTs comparing structured telephone support or telemonitoring to usual care of CHF patients were included. Unpublished abstract data was included in sensitivity analyses. The intervention or usual care could not include a home visit or more than the usual (four to six weeks) clinic follow-up. Data collection and analysis: Data were presented as risk ratio (RR) with 95% confidence intervals (CI). Primary outcomes included all-cause mortality, all-cause and CHF-related hospitalisations which were meta-analysed using fixed effects models. Other outcomes included length of stay, quality of life, acceptability and cost and these were described and tabulated. Main results: Twenty-five studies and five published abstracts were included. Of the 25 full peer-reviewed studies meta-analysed, 16 evaluated structured telephone support (5613 participants), 11 evaluated telemonitoring (2710 participants), and two tested both interventions (included in counts). Telemonitoring reduced all-cause mortality (RR 0.66, 95% CI 0.54 to 0.81, P < 0.0001) with structured telephone support demonstrating a non-significant positive effect (RR 0.88, 95% CI 0.76 to 1.01, P = 0.08). Both structured telephone support (RR 0.77, 95% CI 0.68 to 0.87, P < 0.0001) and telemonitoring (RR 0.79, 95% CI 0.67 to 0.94, P = 0.008) reduced CHF-related hospitalisations. For both interventions, several studies improved quality of life, reduced healthcare costs and were acceptable to patients. Improvements in prescribing, patient knowledge and self-care, and New York Heart Association (NYHA) functional class were observed. Authors' conclusions: Structured telephone support and telemonitoring are effective in reducing the risk of all-cause mortality and CHF-related hospitalisations in patients with CHF; they improve quality of life, reduce costs, and evidence-based prescribing.

Managing knowledge for enterprise systems in indian organizations: Case study insights

Many Enterprise Systems (ES) projects have reported nil or detrimental impacts despite the substantial investment in the system. Having expected positive outcomes for the organization and its functions through the weighty spend, the effective management of ES-related knowledge has been suggested as a critical success factor for these ES projects in ES implementations. This paper suggests theoretical views purporting the importance of understanding on knowledge management for ES success. To explain the complex, dynamic and multifaceted of knowledge management, we adopt the concepts in Learning Network Theory. We then conceptualized the impact of knowledge management on ES by analyzing five case studies in several industries in India, based on the Knowledge-based Theory of the Firm that captures the performance of the system.

Aerial image analysis using spiking neural networks with application to power line corridor monitoring

Trees, shrubs and other vegetation are of continued importance to the environment and our daily life. They provide shade around our roads and houses, offer a habitat for birds and wildlife, and absorb air pollutants. However, vegetation touching power lines is a risk to public safety and the environment, and one of the main causes of power supply problems. Vegetation management, which includes tree trimming and vegetation control, is a significant cost component of the maintenance of electrical infrastructure. For example, Ergon Energy, the Australia’s largest geographic footprint energy distributor, currently spends over $80 million a year inspecting and managing vegetation that encroach on power line assets. Currently, most vegetation management programs for distribution systems are calendar-based ground patrol. However, calendar-based inspection by linesman is labour-intensive, time consuming and expensive. It also results in some zones being trimmed more frequently than needed and others not cut often enough. Moreover, it’s seldom practicable to measure all the plants around power line corridors by field methods. Remote sensing data captured from airborne sensors has great potential in assisting vegetation management in power line corridors. This thesis presented a comprehensive study on using spiking neural networks in a specific image analysis application: power line corridor monitoring. Theoretically, the thesis focuses on a biologically inspired spiking cortical model: pulse coupled neural network (PCNN). The original PCNN model was simplified in order to better analyze the pulse dynamics and control the performance. Some new and effective algorithms were developed based on the proposed spiking cortical model for object detection, image segmentation and invariant feature extraction. The developed algorithms were evaluated in a number of experiments using real image data collected from our flight trails. The experimental results demonstrated the effectiveness and advantages of spiking neural networks in image processing tasks. Operationally, the knowledge gained from this research project offers a good reference to our industry partner (i.e. Ergon Energy) and other energy utilities who wants to improve their vegetation management activities. The novel approaches described in this thesis showed the potential of using the cutting edge sensor technologies and intelligent computing techniques in improve power line corridor monitoring. The lessons learnt from this project are also expected to increase the confidence of energy companies to move from traditional vegetation management strategy to a more automated, accurate and cost-effective solution using aerial remote sensing techniques.

Improving service innovation through structured process-oriented knowledge infrastructure design

Formalised service innovation is a central tenet of enterprise systems lifecycle phases. Event driven process models extended with knowledge objects are found to be not useful in early lifecycle phases. When an upgrade is required, a map of the knowledge infrastructure is needed to better design further service innovation because functional maps no longer adequately describe the context adequately. By looking at formal changes to business processes as service innovations, and recognising the knowledge infrastructure inherent in services generally, changes driven through technology such as ES can be better understood with the application of frameworks such as B-KIDE.

Evaluation framework for focused link discovery

Information has no value unless it is accessible. Information must be connected together so a knowledge network can then be built. Such a knowledge base is a key resource for Internet users to interlink information from documents. Information retrieval, a key technology for knowledge management, guarantees access to large corpora of unstructured text. Collaborative knowledge management systems such as Wikipedia are becoming more popular than ever; however, their link creation function is not optimized for discovering possible links in the collection and the quality of automatically generated links has never been quantified. This research begins with an evaluation forum which is intended to cope with the experiments of focused link discovery in a collaborative way as well as with the investigation of the link discovery application. The research focus was on the evaluation strategy: the evaluation framework proposal, including rules, formats, pooling, validation, assessment and evaluation has proved to be efficient, reusable for further extension and efficient for conducting evaluation. The collection-split approach is used to re-construct the Wikipedia collection into a split collection comprising single passage files. This split collection is proved to be feasible for improving relevant passages discovery and is devoted to being a corpus for focused link discovery. Following these experiments, a mobile client-side prototype built on iPhone is developed to resolve the mobile Search issue by using focused link discovery technology. According to the interview survey, the proposed mobile interactive UI does improve the experience of mobile information seeking. Based on this evaluation framework, a novel cross-language link discovery proposal using multiple text collections is developed. A dynamic evaluation approach is proposed to enhance both the collaborative effort and the interacting experience between submission and evaluation. A realistic evaluation scheme has been implemented at NTCIR for cross-language link discovery tasks.

The Use of Social Technology to Support Organisational Knowledge

In the current economy, knowledge has been recognized to be a valuable organisational asset, a crucial factor that aids organisations to succeed in highly competitive environments. Many organisations have begun projects and special initiatives aimed at fostering better knowledge sharing amongst their employees. Not surprisingly, information technology (IT) has been a central element of many of these projects and initiatives, as the potential of emerging information technologies such as Web 2.0 for enabling the process of managing organisational knowledge is recognised. This technology could be used as a collaborative system for knowledge management (KM) within enterprises. Enterprise 2.0 is the application of Web 2.0 in an organisational context. Enterprise 2.0 technologies are web-based social software that facilitate collaboration, communication and information flow in a bidirectional manner: an essential aspect of organisational knowledge management. This chapter explains how Enterprise 2.0 technologies (Web 2.0 technologies within organisations) can support knowledge management. The chapter also explores how such technologies support the codifying (technology-centred) and social network (people-centred) approaches of KM, towards bridging the current gap between these two approaches.

Managing specialised knowledge in technopreneurial firms : evidence from Australian SMEs

This paper analyses particularities of the knowledge management process in technopreneurial firms with particular focus on knowledge identification, acquisition, utilisation and integration. Using a qualitative investigation from a sample of Australian SMEs, a number of key observations are derived which show the challenges of managing knowledge and how important knowledge management is as a management tool for R&D and innovation process in technology-oriented SMEs. Findings suggest that knowledge management and integration processes in these firms are very much project focused and mainly based on ad hoc and informal processes and not embedded within the overall organisational routines.

The inherent challenges of knowledge transfer across countries and cultures

Purpose — The purpose of this chapter is to outline the findings of research into knowledge transfer across countries and culture and the implications of the findings for human resource practitioners. Methodology/approach — Use of a qualitative case study methodology approach was employed. Findings — The findings highlight the inherent difficulty of knowledge transfer and the broad range of factors that influence the knowledge transfer process and which are connected together in a complex and non-linear manner. Research implications — The research revealed insight into those managers most likely to be effective at knowledge transfer and what characteristics and experiences had supported this openness to knowledge from outside of their cultural context. The lessons from the research can be incorporated into the selection and development processes for expatriates. Originality value — The study affirmed the critical importance of face-to-face interaction in knowledge transfer. The research also resulted in the development of a practical model and tool, which pulls together the broad range of factors that impact on knowledge transfer.

The impact of knowledge integration on enterprise system success

Despite promising benefits and advantages, there are reports of failures and low realisation of benefits in Enterprise System (ES) initiatives. Among the research on the factors that influence ES success, there is a dearth of studies on the knowledge implications of multiple end-user groups using the same ES application. An ES facilitates the work of several user groups, ranging from strategic management, management, to operational staff, all using the same system for multiple objectives. Given the fundamental characteristics of ES – integration of modules, business process views, and aspects of information transparency – it is necessary that all frequent end-users share a reasonable amount of common knowledge and integrate their knowledge to yield new knowledge. Recent literature on ES implementation highlights the importance of Knowledge Integration (KI) for implementation success. Unfortunately, the importance of KI is often overlooked and little about the role of KI in ES success is known. Many organisations do not achieve the potential benefits from their ES investment because they do not consider the need or their ability to integrate their employees’ knowledge. This study is designed to improve our understanding of the influence of KI among ES end-users on operational ES success. The three objectives of the study are: (I) to identify and validate the antecedents of KI effectiveness, (II) to investigate the impact of KI effectiveness on the goodness of individuals’ ES-knowledge base, and (III) to examine the impact of the goodness of individuals’ ES-knowledge base on the operational ES success. For this purpose, we employ the KI factors identified by Grant (1996) and an IS-impact measurement model from the work of Gable et al. (2008) to examine ES success. The study derives its findings from data gathered from six Malaysian companies in order to obtain the three-fold goal of this thesis as outlined above. The relationships between the antecedents of KI effectiveness and its consequences are tested using 188 responses to a survey representing the views of management and operational employment cohorts. Using statistical methods, we confirm three antecedents of KI effectiveness and the consequences of the antecedents on ES success are validated. The findings demonstrate a statistically positive impact of KI effectiveness of ES success, with KI effectiveness contributing to almost one-third of ES success. This research makes a number of contributions to the understanding of the influence of KI on ES success. First, based on the empirical work using a complete nomological net model, the role of KI effectiveness on ES success is evidenced. Second, the model provides a theoretical lens for a more comprehensive understanding of the impact of KI on the level of ES success. Third, restructuring the dimensions of the knowledge-based theory to fit the context of ES extends its applicability and generalisability to contemporary Information Systems. Fourth, the study develops and validates measures for the antecedents of KI effectiveness. Fifth, the study demonstrates the statistically significant positive influence of the goodness of KI on ES success. From a practical viewpoint, this study emphasises the importance of KI effectiveness as a direct antecedent of ES success. Practical lessons can be drawn from the work done in this study to empirically identify the critical factors among the antecedents of KI effectiveness that should be given attention.

Beyond the positivist mirror : towards a project management 'Gnosis'

This paper aims to clarify the foundations of the discipline of project management (PM). Historically, PM has evolved from a conceptual approach based on a positivist paradigm. The author questions the appropriateness of such foundations for the kind of project management which claims to deal with complex problems. To answer this question, a brief history of project management emphasizes key concepts useful to the discussion. Comprehensive definitions of knowledge, competencies, performance and knowledge management are reviewed to provide a better understanding of the project environment in terms of its present positivist epistemological position. This paper explores the tensions and paradoxes encountered in PM practice, when set within the boundaries of a normative approach; it also highlights the polysemic nature of PM, for which an extended framework is proposed. Dialectic, qualitative and interpretative aspects of PM are presented alongside its quantitative body of Knowledge. The author finally introduces an innovative overview of project management, set in the greater context of the learning organization. Implications and applications of this perspective are discussed and lead to the presentation of the MAP metamethod, a systemic practical approach.

Enacting strategy through projects : an archetypal approach

Project management is increasingly regarded as a strategic competency because projects play an active part in defining an organization’s relationship to its environment. It is now widely accepted that projects and programmes are at the centre of strategy implementation. However, the conditions and underlying assumptions of this dynamic relationship are still unclear. This paper aims to clarify the dynamics of the strategy process, by defining traditional approaches (corporate/business) and introducing three strategy core logics (archetypes). Building on this 'archetypology' the authors demonstrate how project management, through enactment and sense-making of strategy, enables organizations to face the challenge of complexity and uncertainty. While recognizing that the "traditional" methods of analysis and management remain valid under certain conditions, this paper offers new avenues of reflection concerning the necessary contextualization of the project management approaches in order to ensure coherence between archetypes, enactment, learning and decision-making.

Organisational knowledge integration: towards a conceptual framework

This study analyses organisational knowledge integration processes from a multi-level and systemic perspective, with particular reference to the case of Fujitsu. A conceptual framework for knowledge integration is suggested focusing on team-building capability, capturing and utilising individual tacit knowledge, and communication networks for integrating dispersed specialist knowledge required in the development of new products and services. The research highlights that knowledge integration occurring in the innovation process is a result of knowledge exposure, its distribution and embodiment and finally its transfer, which leads to innovation capability and competitive advantage in firm.

Using social media to facilitate knowledge transfer in complex engineering environments : a primer for educators

While highly cohesive groups are potentially advantageous they are also often correlated with the emergence of knowledge and information silos based around those same functional or occupational clusters. Consequently, an essential challenge for engineering organisations wishing to overcome informational silos is to implement mechanisms that facilitate, encourage and sustain interactions between otherwise disconnected groups. This paper acts as a primer for those seeking to gain an understanding of the design, functionality and utility of a suite of software tools generically termed social media technologies in the context of optimising the management of tacit engineering knowledge. Underpinned by knowledge management theory and using detailed case examples, this paper explores how social media technologies achieve such goals, allowing for the transfer of knowledge by tapping into the tacit and explicit knowledge of disparate groups in complex engineering environments.