Adherence, adaptation and acceptance of elderly chronic heart failure patients to receiving healthcare via telephone-monitoring

Background: Although the potential to reduce hospitalisation and mortality in chronic heart failure (CHF) is well reported, the feasibility of receiving healthcare by structured telephone support or telemonitoring is not. Aims: To determine; adherence, adaptation and acceptability to a national nurse-coordinated telephone-monitoring CHF management strategy. The Chronic Heart Failure Assistance by Telephone Study (CHAT). Methods: Triangulation of descriptive statistics, feedback surveys and qualitative analysis of clinical notes. Cohort comprised of standard care plus intervention (SC + I) participants who completed the first year of the study. Results: 30 GPs (70% rural) randomised to SC + I recruited 79 eligible participants, of whom 60 (76%) completed the full 12 month follow-up period. During this time 3619 calls were made into the CHAT system (mean 45.81 SD ± 79.26, range 0-369), Overall there was an adherence to the study protocol of 65.8% (95% CI 0.54-0.75; p = 0.001) however, of the 60 participants who completed the 12 month follow-up period the adherence was significantly higher at 92.3% (95% CI 0.82-0.97, p ≤ 0.001). Only 3% of this elderly group (mean age 74.7 ±9.3 years) were unable to learn or competently use the technology. Participants rated CHAT with a total acceptability rate of 76.45%. Conclusion: This study shows that elderly CHF patients can adapt quickly, find telephone-monitoring an acceptable part of their healthcare routine, and are able to maintain good adherence for a least 12 months. © 2007.

Big, bigger, best? The impact of reforms on the not-for-profit sector in Queensland

Organisations within the not-for-profit sector provide services to individuals and groups that government and for-profit organisations cannot or will not consider. The not-for-profit sector has come to be a vibrant and rich agglomeration of services and programs that operate under a myriad of philosophical stances, service orientation, client groupings and operational capacities. In Australia these organisations and services are providing social support and service assistance to many people in the community; often targeting their assistance to the most difficult of clients. Initially, in undertaking this role, the not-for-profit sector received limited sponsorship from government. Over time governments assumed greater responsibility in the form of service grants to particular groups: ‘the worthy poor’. More recently, they have entered into contractual service agreements with the not-for-profit sector, which specify the nature of the outcomes to be achieved and, to a degree, the way in which the services will be provided. A consequence of this growing shift to a more marketised model of service contracting, often offered-up under the label of enhanced collaborative practice, has been increased competitiveness between agencies that had previously worked well together (Keast and Brown, 2006). Another trend emerging from the market approach is the entrance of for-profit providers. These larger organisations have higher levels of organisational capacity with considerable organisational slack to allow them to adopt new service roles. Shaped almost as ‘shadow governments’ they appear to be a strong preference for governments looking for greater accountability of outcomes and an easier way to control the interaction with the conventional not-for-profit sector. The question is will governments’ apparent preference for larger organisational arrangements lead to the demise of the vibrancy of the not-for-profit sector and impact on service provision to those people who fall outside of the remit of the new service providers? To address this issue, this paper uses information gleaned from a state-wide survey of not-for-profit organisations in Queensland, Australia which included organisational size, operational scope, funding arrangements and governance/management approaches. Supplementing this information is qualitative data derived from 17 focus groups and 120 interviews conducted over ten years of study of this sector. The findings contribute to greater understanding of the practice and theory of the future provision of social services.

Supporting Students for Flexible Learning

The changing roles for academics relates to a new emphasis on: •developing life-long learners, in addition to teaching 'content'; •ensuring long-term graduate outcomes not just short-term subject objectives are achieved by all students; and •collaborative course and subject design.

Gay men, intimate partner violence, and help-seeking : the incomprehensibility of being a victim

A recurring finding within the research on same-sex intimate partner violence (IPV) is that victims rarely seek assistance from police or other service providers. A study by William Leonard et al (2008: 47) in Victoria, Australia, found that around two thirds of gay, lesbian, bisexual and transgender victims did not report such violence. It also appears that men are less likely than women to seek help for IPV (Turell and Cornell-Swanson 2005:79–80), and for those that do, informal support networks are approached more often than formal services (Merrill and Wolfe 2000: 16; Farrell and Cerise 2006: 4).

goDesign travelling design workshop program for regional secondary students

goDesign Travelling Workshop Program for Regional Secondary Students was an initiative of Queensland University of Technology (QUT) and the Design Institute of Australia (DIA) Queensland Branch, which aligned with the DIA unleashed: Queensland design on tour 2010 Exhibition. It was designed be delivered by university design academics in state secondary schools in Chinchilla, Mt Isa, Quilpie, Emerald, Gladstone and Bundaberg between February and September 2010, to approximately 95 secondary students and 24 teachers from the subject areas of visual art, graphics and industrial technology and design. A talk by a visiting design practitioner whose work was displayed in the exhibition, also features in the final day of the program in each town, and student work from the workshop was displayed in the exhibition alongside the professional design work. The three-day workshop is a design immersion program for regional Queensland Secondary Schools, which responds to specific actions outlined in the Queensland Government Design Strategy 2020 to ‘Build Design Knowledge and Learning’ and ‘Foster a Design Culture’. Underpinned by a place-based approach and the integration of Dr Charles Burnette’s IDESIGN teaching model, the program gives students and teachers the opportunity to explore, analyse and reimagine their local town through a series of scaffolded problem solving activities around the theme of ‘place’. The program allows students to gain hands-on experience designing graphics, products, interior spaces and architecture to assist their local community, with the support of design professionals. Students work individually and in groups on real design problems learning sketching, making, communication, presentation and collaboration skills to improve their design process, while considering social, cultural and environmental opportunities. The program was designed to facilitate an understanding of the value of design thinking and its importance to regional communities, to give students more information about various design disciplines as career options, and provide a professional development opportunity for teachers. Advisory assistance for the program was gained through Kelvin Grove State College, Queensland Studies Authority and QMI/Manufacturing Skills Queensland Manager, Manufacturing & Engineering Gateway Schools Project.

Representational change and strategy use in children's number line estimation during the first years of primary school

Background: The objective of this study was to scrutinize number line estimation behaviors displayed by children in mathematics classrooms during the first three years of schooling. We extend existing research by not only mapping potential logarithmic-linear shifts but also provide a new perspective by studying in detail the estimation strategies of individual target digits within a number range familiar to children. Methods: Typically developing children (n = 67) from Years 1 – 3 completed a number-to-position numerical estimation task (0-20 number line). Estimation behaviors were first analyzed via logarithmic and linear regression modeling. Subsequently, using an analysis of variance we compared the estimation accuracy of each digit, thus identifying target digits that were estimated with the assistance of arithmetic strategy. Results: Our results further confirm a developmental logarithmic-linear shift when utilizing regression modeling; however, uniquely we have identified that children employ variable strategies when completing numerical estimation, with levels of strategy advancing with development. Conclusion: In terms of the existing cognitive research, this strategy factor highlights the limitations of any regression modeling approach, or alternatively, it could underpin the developmental time course of the logarithmic-linear shift. Future studies need to systematically investigate this relationship and also consider the implications for educational practice.