Access and Quality of Heart Failure Management Programs in Australia

Background/aim In response to the high burden of disease associated with chronic heart failure (CHF), in particular the high rates of hospital admissions, dedicated CHF management programs (CHF-MP) have been developed. Over the past five years there has been a rapid growth of CHF-MPs in Australia. Given the apparent mismatch between the demand for, and availability of CHF-MPs, this paper has been designed to discuss the accessibility to and quality of current CHF-MPs in Australia. Methods The data presented in this report has been combined from the research of the co-authors, in particular a review of the inequities in access to chronic heart failure which utilised geographical information systems (GIS) and the survey of heterogeneity in quality and service provision in Australian. Results Of the 62 CHF-MPs surveyed in this study 93% (58) centres had been located areas that are rated as Highly Accessible. This result indicated that most of the CHF-MPs have been located in capital cities or large regional cities. Six percent (4 CHF-MPs) had been located in Accessible areas which were country towns or cities. No CHF-MPs had been established outside of cities to service the estimated 72,000 individuals with CHF living in rural and remote areas. 16% of programs recruited NYHA Class I patients and of these 20% lacked confirmation (echocardiogram) of their diagnosis. Conclusion Overall, these data highlight the urgent need to provide equitable access to CHF-MP's. When establishing CHF-MPs consideration of current evidence based models to ensure quality in practice.

Haunted by the past : effects of poor management on employee attitudes and turnover

Change management research has largely ignored the effects of organizational change management history in shaping employee attitudes and behavior. This article develops and tests a model of the effects of poor change management history (PCMH) on employee attitudes (trust, job satisfaction, turnover intentions, change cynicism, and openness to change) and actual turnover. We found that PCMH, through PCMH beliefs, led to lower trust, job satisfaction and openness to change, and higher cynicism and turnover intentions. Also, PCMH beliefs predicted employee turnover over 2 years.

Beware of geeks bearing gifts? Online latent and untapped outlets for farmers' markets in South East Wales

This chapter sets out to identify related issues surrounding the use of Information and Computer Technology (ICT) in developing relationships between local food producers and consumers (both individuals and businesses). Three surveys were conducted in South- East Wales to consider the overlapping issues. The first concerned the role of ICT in relationships between farmers’ market (FMs) vendors and their traditional customers. The second survey examined potential new markets for farmers in the propensity of restaurants and hotels to buy locally, the types and sources of purchases made and the modes of advertising of these businesses. The final survey focused on the potential to expand local web- based selling of farmers’ produce in the future, by examining the potential market of high ICT- use small hotels. Despite the development of tailored ICT facilities, farmers’ market vendors and current individual customers are antipathetic to them. In addition, whilst there is a desire for more local produce particularly amongst independent local restaurants and hotels, this has not been capitalised upon and there is much work to be done even amongst high ICT-use small hotels, to expand the range and scope of farmers’ markets. This raises the need for creation and utilisation of enhanced logistics, payment and marketing management capacity available through a web- based presence, linked to promotion of FMs in business- to- business (B2B) links with local restaurants and hotels. This linked quantitative research highlights the potential value in substantial development of both web portals and supporting logistics to exploit this potential in the future.

Enhancing business continuity management capacities in the insurance industry : a Southeast Asian perspective

As a resilience enhancing practice, business continuity management (BCM) can play an important role in aiding preparation of the insurance industry for coping with the losses incurred by major discontinuity incidents: regardless of cause. Acknowledging the increasing frequency of unpredictable man-made disasters and natural catastrophes, the insurance industry would benefit from examining and implementing, where suitable, key elements of BCM. Such strategic decisions would assist insurers and re-insurers collectively to enhance mutual capability to respond to, and recover from, the impact of significant losses. This paper presents a comparison of opinions about BCM practitioners in both retail and re-insurance companies on the importance of generic continuity practices with actual levels of BCM practice across the two industry groups in Southeast Asia. It suggests means by which multi-lateral cooperation across Asian economies and between retail and re-insurance market segments might enhance the viability of the insurance industry in the face of increased stress from major natural and socio-technical hazards.

CD73 and CD29 concurrently mediate the mechanically induced decrease of migratory capacity of mesenchymal stromal cells

The assumption that mesenchymal stromal cell (MSC)-based therapies are capable of augmenting physiological regeneration processes has fostered intensive basic and clinical research activities. However, to achieve sustained therapeutic success in vivo, not only the biological, but also the mechanical microenvironment of MSCs during these regeneration processes needs to be taken into account. This is especially important for e.g., bone fracture repair, since MSCs present at the fracture site undergo significant biomechanical stimulation. This study has therefore investigated cellular characteristics and the functional behaviour of MSCs in response to mechanical loading. Our results demonstrated a reduced expression of MSC surface markers CD73 (ecto-5’-nucleotidase) and CD29 (integrin β1) after loading. On the functional level, loading led to a reduced migration of MSCs. Both effects persisted for a week after the removal of the loading stimulus. Specifi c inhibition of CD73/CD29 demonstrated their substrate dependent involvement in MSC migration after loading. These results were supported by scanning electron microscopy images and phalloidin staining of actin fi laments displaying less cell spreading, lamellipodia formation and actin accumulations. Moreover, focal adhesion kinase and Src-family kinases were identified as candidate downstream targets of CD73/CD29 that might contribute to the mechanically induced decrease in MSC migration. These results suggest that MSC migration is controlled by CD73 CD29, which in turn are regulated by mechanical stimulation of cells. We therefore speculate that MSCs migrate into the fracture site, become mechanically entrapped, and thereby accumulate to fulfil their regenerative functions.

Controlling chaos? The value and the challenges of applying complexity theory to project management

The literature abounds with descriptions of failures in high-profile projects and a range of initiatives has been generated to enhance project management practice (e.g., Morris, 2006). Estimating from our own research, there are scores of other project failures that are unrecorded. Many of these failures can be explained using existing project management theory; poor risk management, inaccurate estimating, cultures of optimism dominating decision making, stakeholder mismanagement, inadequate timeframes, and so on. Nevertheless, in spite of extensive discussion and analysis of failures and attention to the presumed causes of failure, projects continue to fail in unexpected ways. In the 1990s, three U.S. state departments of motor vehicles (DMV) cancelled major projects due to time and cost overruns and inability to meet project goals (IT-Cortex, 2010). The California DMV failed to revitalize their drivers’ license and registration application process after spending $45 million. The Oregon DMV cancelled their five year, $50 million project to automate their manual, paper-based operation after three years when the estimates grew to $123 million; its duration stretched to eight years or more and the prototype was a complete failure. In 1997, the Washington state DMV cancelled their license application mitigation project because it would have been too big and obsolete by the time it was estimated to be finished. There are countless similar examples of projects that have been abandoned or that have not delivered the requirements.

Performance analysis of business process models with advanced constructs

The importance of actively managing and analysing business processes is acknowledged more than ever in organisations nowadays. Business processes form an essential part of an organisation and their application areas are manifold. Most organisations keep records of various activities that have been carried out for auditing purposes, but they are rarely used for analysis purposes. This paper describes the design and implementation of a process analysis tool that replays, analyses and visualises a variety of performance metrics using a process definition and its corresponding execution logs. The replayer uses a YAWL process model example to demonstrate its capacity to support advanced language constructs.

Psychometric properties of the parents' fever management scale in a Turkish population

Aim: This paper reports a study designed to assess the psychometric properties (validity and reliability) of a Turkish version of the Australian Parents’ Fever Management Scale (PFMS). Background: Little is known about childhood fever management among Turkish parents. No scales to measure parents’ fever management practices in Turkey are available. Design: This is a methodological study. Methods: Eighty parents, of febrile children aged six months to five years, were randomly selected from the paedaitric hospital and two community family health centers in Sakarya, Turkey. The PFMS was back translated; language equivalence and content validity were validated. PFMS and socio-demographic data were collected in 2009. Means and standard deviations were calculated for interval level data and p values greater than 0.05 were considered statistically significant. Unrotated principal component analysis was used to determine construct validity and Cronbach’s coefficient alpha determined the internal consistency reliability. Results: The PFMS was psychometrically sound in this population. Construct validity, confirmed by confirmatory factor analysis [KMO 0.812, Bartlett’s Specificity (χ² = 182.799, df=28, P < 0·001)] revealed the Turkish version to be comprised of the eight original PFMS items. Internal consistency reliability coefficient was 0.80 and the scale’s total-item correlation coefficients ranged from 0.15 to 0.66 and were significant (p<0.001). Interestingly parents reported high scores on the PFMS 34.52±4.60 (range 8-40 with 40 indicating a high burden of care for febrile children). Conclusion: The PFMS was as psychometrically robust in a Turkish population as in an Australian population and is, therefore, a useful tool for health professionals to identify parents’ practices, provide targeted education thereby in reducing the unnecessary burden of care they place on themselves when caring for a febrile child. Relevance to clinical practice. Testing in different populations, cultures and healthcare systems will further assist in reporting the PFMS usefulness in clinical practice and research.

Applying social technology to Business Process Lifecycle Management

In recent years social technologies such as wikis, blogs or microblogging have seen an exponential growth in the uptake of their user base making this type of technology one of the most significant networking and knowledge sharing platforms for potentially hundreds of millions of users. However, the adoption of these technologies has been so far mostly for private purposes. First attempts have been made to embed features of social technologies in the corporate IT landscape, and Business Process Management is no exception. This paper aims to consolidate the opportunities for integrating social technologies into the different stages of the business process lifecycle. Thus, it contributes to a conceptualization of this fast growing domain, and can help to categorize academic and corporate development activities.

Seismic capacity of building constructed in slip formed load bearing wall panels

Constructing buildings using slip formed load bearing wall panels is becoming increasingly popular in Sri Lanka due to several advantages; low cost, environmental friendliness and rapid construction technique. These wall panels are already successfully implemented in many low rise buildings. However, the seismic capacities of these buildings have not been properly studied. Few seismic activities reported in Sri Lanka have not caused severe structural damage, but predictions can not be made as to whether this will continue to be the case in the future. This highlights the need to study the seismic capacity of buildings constructed in slip formed load bearing wall panels. This paper presents a study of the seismic capacity of the existing medium rise building.

Empirical research in business process management : introduction to the special issue

In this editorial letter, we provide the readers of Information Systems and e-Business Management with an introduction to Business Process Management and the challenges of empirical research in this field. We then briefly describe selected examples of current research efforts in this fields and how the papers accepted for this special issue contribute to extending our body of knowledge.

Developing a research method to test a new first-order decision making model for the procurement of public sector major infrastructure

Given global demand for new infrastructure, governments face substantial challenges in funding new infrastructure and simultaneously delivering Value for Money (VfM). The paper begins with an update on a key development in a new early/first-order procurement decision making model that deploys production cost/benefit theory and theories concerning transaction costs from the New Institutional Economics, in order to identify a procurement mode that is likely to deliver the best ratio of production costs and transaction costs to production benefits, and therefore deliver superior VfM relative to alternative procurement modes. In doing so, the new procurement model is also able to address the uncertainty concerning the relative merits of Public-Private Partnerships (PPP) and non-PPP procurement approaches. The main aim of the paper is to develop competition as a dependent variable/proxy for VfM and a hypothesis (overarching proposition), as well as developing a research method to test the new procurement model. Competition reflects both production costs and benefits (absolute level of competition) and transaction costs (level of realised competition) and is a key proxy for VfM. Using competition as a proxy for VfM, the overarching proposition is given as: When the actual procurement mode matches the predicted (theoretical) procurement mode (informed by the new procurement model), then actual competition is expected to match potential competition (based on actual capacity). To collect data to test this proposition, the research method that is developed in this paper combines a survey and case study approach. More specifically, data collection instruments for the surveys to collect data on actual procurement, actual competition and potential competition are outlined. Finally, plans for analysing this survey data are briefly mentioned, along with noting the planned use of analytical pattern matching in deploying the new procurement model and in order to develop the predicted (theoretical) procurement mode.

An efficient public key management system : an application in vehicular ad hoc networks

The major purpose of Vehicular Ad Hoc Networks (VANETs) is to provide safety-related message access for motorists to react or make a life-critical decision for road safety enhancement. Accessing safety-related information through the use of VANET communications, therefore, must be protected, as motorists may make critical decisions in response to emergency situations in VANETs. If introducing security services into VANETs causes considerable transmission latency or processing delays, this would defeat the purpose of using VANETs to improve road safety. Current research in secure messaging for VANETs appears to focus on employing certificate-based Public Key Cryptosystem (PKC) to support security. The security overhead of such a scheme, however, creates a transmission delay and introduces a time-consuming verification process to VANET communications. This paper proposes an efficient public key management system for VANETs: the Public Key Registry (PKR) system. Not only does this paper demonstrate that the proposed PKR system can maintain security, but it also asserts that it can improve overall performance and scalability at a lower cost, compared to the certificate-based PKC scheme. It is believed that the proposed PKR system will create a new dimension to the key management and verification services for VANETs.

Busway platform bus capacity analysis

Bus Rapid Transit (BRT), because of its operational flexibility and simplicity, is rapidly gaining popularity with urban designers and transit planners. Earlier BRTs were bus shared lane or bus only lane, which share the roadway with general and other forms of traffic. In recent time, more sophisticated designs of BRT have emerged, such as busway, which has separate carriageway for buses and provides very high physical separation of buses from general traffic. Line capacities of a busway are predominately dependent on bus capacity of its stations. Despite new developments in BRT designs, the methodology of capacity analysis is still based on traditional principles of kerbside bus stop on bus only lane operations. Consequently, the tradition methodology lacks accounting for various dimensions of busway station operation, such as passenger crowd, passenger walking and bus lost time along the long busway station platform. This research has developed a purpose made bus capacity analysis methodology for busway station analysis. Extensive observations of kerbside bus stops and busway stations in Brisbane, Australia were made and differences in their operation were studied. A large scale data collection was conducted using the video recording technique at the Mater Hill Busway Station on the South East Busway in Brisbane. This research identified new parameters concerning busway station operation, and through intricate analysis identified the elements and processes which influence the bus dwell time at a busway station platform. A new variable, Bus lost time, was defined and its quantitative descriptions were established. Based on these finding and analysis, a busway station platform bus capacity methodology was developed, comprising of new models for busway station lost time, busway station dwell time, busway station loading area bus capacity, and busway station platform bus capacity. The new methodology not only accounts for passenger boarding and alighting, but also covers platform crowd and bus lost time in station platform bus capacity estimation. The applicability of this methodology was shown through demonstrative examples. Additionally, these examples illustrated the significance of the bus lost time variable in determining station capacities.