Available evidence does not support routine administration of antipyretics to reduce duration of fever or illness

Commentary on : Carey JV. Literature review : should antipyretic therapies routinely be administered to patients with [corrected] fever? J Clin Nurs 2010;19:2377–93.

What the experts think : fast bowling expertise acquisition and talent development

For applied sport scientists charged with developing talented performers an essential requirement is to identify components contributing to the development and maintenance of expertise. Previous qualitative analysis has revealed several psychological (e.g., mental focus, goal-setting and selfevaluation), socio-cultural (e.g. community and family support, cultural influence), physical (e.g., strength, height) and environmental (e.g., access to facilities and climate) constraints on successful Olympian development (Abbott et al., 2005). Open-ended interviews with expert athletes and/or expert coaches have been used to reveal competencies of elite performers to derive factors associated with success (Durand-Bush et al., 2002). However, the influence of these factors is likely to be sport-specific due to different task constraints and the changing nature of the performer-environment relationship through practice, coaching and competing (Vaeyens et al., 2008). So far, only one study on expertise acquisition in cricket has been undertaken. Weissensteiner, et al. (2009) found that development of expertise in cricket batting in Australia may be facilitated by early unstructured play (i.e. ‘backyard cricket’), a wide range of sport experience during development, and early exposure to playing with seniors.

Building support for learning within a Doctor of Education programme

Professional doctorates were introduced in the 1990s for practitioners to research ‘real-world’ problems relevant to their respective workplace communities and contexts. An array of difficulties faces professional doctoral students as they transition from professionals to practitioner researchers. This study sought to understand the learning journey of a cohort of students at an Australian university and to assess whether the cohort approach provided the necessary support for students to reach their scholarly destinations. Throughout the first 18 months of the programme, focus group interviews and surveys were conducted to gauge students’ experiences and to evaluate developments for support within the programme. Utilising a socio-cultural perspective helped identify and explain the importance of shared practice in fostering learning, the development of academic and researcher identities, and the role of communities of practice. Challenges of managing time and overcoming the professional and academe divide were facilitated by the evolving developments of the programme.

The ecological dynamics of decision-making in sailing

Competitive sailing is characterised by continuous interdependencies of decisions and actions. All actions imply a permanent monitoring of the environmental conditions, such as intensity and direction of the wind, sea characteristics, and the behaviour of the opponent sailors. These constraints on sailors’ behavior are in constant change implying continuous adjustments in sailors’ actions and decisions. Among the different parts of a regatta, tactics and strategy at the start are particularly relevant. Among coaches there is an adage that says that “the start is 50% of a regatta” (Houghton, 1984; Saltonstall, 1983/1986). Olympic sailing regattas are performed with boats of the same class, by one, two or three sailors, depending on the boat class. Normally before the start, sailors visit the racing venue and analyse wind and sea characteristics, in order to fine- tune their boats accordingly. Then, five minutes before the start, sailors initiate starting procedures in order to be in a favourable position at the starting line (at the “second zero”). This position is selected during the start period according to wind shifts tendencies and the actions of other boats (Figure 11.1). Only after the start signal can the boats cross the imaginary starting line between the race committee signal boat “A” and the pin end boat. The start takes place against the wind (upwind), and the boats start racing in the direction of mark 1. Based on the evaluation of the sea and wind characteristics (e.g. if the wind is stronger at a particular place on the course), sailors re- adjust their strategy for the regatta. This strategy may change during the regatta, according to wind changes and adversary actions. More to the point, strategic decisions constrain and are constrained by on- line decisions during the regatta.

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.

Employer-based support for registered nurses undertaking postgraduate study via distance education

Previous literature has focused on the need for support of undergraduate nursing students during clinical placements. Little is known about the support provided by employers for registered nurses (RNs) who pursue further education. This study sought to identify and describe the types, levels and perceived need for support in the workplace for RNs as they undertake further postgraduate nursing study by distance education (DE).Using an exploratory descriptive design a self-report questionnaire was distributed to a convenient sample of 270 RNs working in one acute care public hospital in Tasmania, Australia.92 questionnaires (response rate 34%) were returned with 26 (28%) reporting being currently enrolled in further study by DE and a further 50 (54)% of RNs planning future study. Results revealed that 100% of participants with a Masters degree completed this by DE. There were differences between the support sought by RNs to that offered by employers, and 16 (34%) who had done or were currently doing DE study, received no support to undertake DE. There was an overwhelming desire by RNs for support; 87 (94%), with a majority believing some support should be mandatory 76 (83%).This study may encourage employers to introduce structured support systems that will actively assist nurses to pursue further study. © 2010.

Decision support to green technology implementation on Australian university campuses

As the societal awareness on sustainability is gaining momentum worldwide, the higher education sector is expected to take the lead in education, research and the promotion of sustainable development. Universities have the diversity of skills and knowledge to explore new concepts and issues, the academic freedom to offer unbiased observations, and the capacity to engage in experimentation for solutions. There is a global trend that universities have realized and responded to sustainability challenge. By adopting green technologies, buildings on university campuses have the potential to offer highly productive and green environments for a quality learning experience for students, while minimising environmental impacts. Despite the potential benefits and metaphorical link to sustainability, few universities have moved towards implementing Green Roof and Living Wall on campuses widely, which have had more successful applications in commercial and residential buildings. Few past research efforts have examined the fundamental barriers to the implementation of sustainable projects on campuses from organizational level. To address this deficiency, an on-going research project is undertaken by Queensland University of Technology in Australia. The research is aimed at developing a comprehensive framework to facilitate better decision making for the promotion of Green Roof and Living Wall application on campuses. It will explore and highlight organizational factors as well as investigate and emphasize project delivery issues. Also, the critical technical indicators for Green Roof and Living Wall implementation will be identified. The expected outcome of this research has the potential to enhance Green Roof and Living Wall delivery in Australian universities, as a vital step towards realizing sustainability in higher education sectors.

Ensuring student success : the role of support services in improving the quality of the student learning experience

This paper is based on the premise that universities have an obligation to provide adequate student support services, such as learning assistance (that is, assistance with academic writing and other study skills) and that in order to be effective such services must be responsive to the wider policy and social implications of student attrition and retention. The paper outlines briefly some of the factors that have influenced the development of learning assistance practices in Australia and America. This is followed by an account of experiences at one Australian metropolitan university where learning assistance service provision shifted from a decentralised, faculty-based model to a centralised model of service delivery. This shift was in response to concerns about lack of quality and consistency in a support model dependent upon faculty resources yet a follow up study identified other problems in the centralised delivery of learning assistance services. These problems, clustered under the heading contextualised versus decontextualised learning assistance, include the relevance of generic learning assistance services to students struggling with specific course related demands; the apparent tensions between challenging students and assisting students at risk of failure; and variations in the level of collaboration between learning advisers and academic staff in supporting students in the learning environment. These problems are analysed using the theoretical modelling derived from the tools made available through cultural historical activity theory and expansive visibilisation (Engeström & Miettinen, 1999).

The Chronic Heart-Failure Assistance by Telephone (CHAT) Study: Assessment of Telephone Support for Vulnerable Patients with Chronic Disease

Aim: To determine whether telephone support using an evidence-based protocol for chronic heart failure (CHF) management will improve patient outcomes and will reduce hospital readmission rates in patients without access to hospital-based management programs. Methods: The rationale and protocol for a cluster-design randomised controlled trial (RCT) of a semi-automated telephone intervention for the management of CHF, the Chronic Heart-failure Assistance by Telephone (CHAT) Study is described. Care is coordinated by trained cardiac nurses located in Heartline, the national call center of the National Heart Foundation of Australia in partnership with patients’ general practitioners (GPs). Conclusions: The CHAT Study model represents a potentially cost-effective and accessible model for the Australian health system in caring for CHF patients in rural and remote areas. The system of care could also be readily adapted for a range of chronic diseases and health systems. Key words: chronic disease management; chronic heart failure; integrated health care systems; nursing care, rural health services; telemedicine; telenursing

The impact of the Malaysian code on corporate governance: compliance, institutional investors and stock performance

In 2001, the Malaysian Code on Corporate Governance (MCCG) became an integral part of the Bursa Malaysia Listing Rules, which requires all listed firms to disclose the extent of compliance with the MCCG. Our panel analysis of 440 firms from 1999 to 2002 finds that corporate governance reform in Malaysia has been successful, with a significant improvement in governance practices. The relationship between ownership by the Employees Provident Fund (EPF) and corporate governance has strengthened during the period subsequent to the reform, in line with the lead role taken by the EPF in establishing the Minority Shareholders Watchdog Group. The implementation of MCCG has had a substantial effect on shareholders' wealth, increasing stock prices by an average of about 4.8%. Although there is no evidence that politically connected firms perform better, political connections do have a significantly negative effect on corporate governance, which is mitigated by institutional ownership.