Comparative effectiveness of population interventions to improve access to reperfusion for ST-segment–elevation myocardial infarction in Australia

Background Improving timely access to reperfusion is a major goal of ST-segment–elevation myocardial infarction care. We sought to compare the population impact of interventions proposed to improve timely access to reperfusion therapy in Australia. Methods and Results Australian hospitals, population, and road network data were integrated using Geographical Information Systems. Hospitals were classified into those that provided primary percutaneous coronary intervention (PPCI) or fibrinolysis. Population impact of interventions proposed to improve timely access to reperfusion (PPCI, fibrinolysis, or both) were modeled and compared. Timely access to reperfusion was defined as the proportion of the population capable of reaching a fibrinolysis facility ≤60 minutes or a PPCI facility ≤120 minutes from emergency medical services activation. The majority (93.2%) of the Australian population has timely access to reperfusion, mainly (53%) through fibrinolysis. Only 40.2% of the population had timely access to PPCI, and access to PPCI services is particularly limited in regional and nonexistent in remote areas. Optimizing the emergency medical services’ response or increasing PPCI services resulted in marginal improvement in timely access (1.8% and 3.7%, respectively). Direct transport to PPCI facilities and interhospital transfer for PPCI improves timely access to PPCI for 19.4% and 23.5% of the population, respectively. Prehospital fibrinolysis markedly improved access to timely reperfusion in regional and remote Australia. Conclusions Significant gaps in timely provision of reperfusion remain in Australia. Systematic implementation of changes in service delivery has potential to improve timely access to PPCI for a majority of the population and improve access to fibrinolysis to those living in regional and remote areas.

Fashion, the body and technology : tracing early 20th century techno-utopian ideas, aesthetics and impulses in 21st century wearable technology

‘Wearable technology’, or the use of specialist technology in garments, is promoted by the electronics industry as the next frontier of fashion. However the story of wearable technology’s relationship with fashion begins neither with the development of miniaturised computers in the 1970s nor with sophisticated ‘smart textiles’ of the twenty-first century, despite what much of the rhetoric suggests. This study examines wearable technology against a longer history of fashion, highlighted by the influential techno-sartorial experiments of a group of early twentieth century avant-gardes including Italian Futurists Giacomo Balla and F.T. Marinetti, Russian Constructivists Varvara Stepanova and Liubov Popova, and Paris-based Cubist, Sonia Delaunay. Through the interdisciplinary framework of fashion studies, the thesis provides a fuller picture of wearable technology framed by the idea of utopia. Using comparative analysis, and applying the theoretical formulations of Fredric Jameson, Louis Marin and Michael Carter, the thesis traces the appearance of three techno-utopian themes from their origins in the machine age experiments of Balla, Marinetti, Stepanova, Popova and Delaunay to their twenty-first century reappearance in a dozen wearable technology projects. By exploring the central thesis that contemporary wearable technology resurrects the techno-utopian ideas and expressions of the early twentieth century, the study concludes that the abiding utopian impetus to embed technology in the aesthetics (prints, silhouettes, and fabrication) and functionality of fashion is to unify subject, society and environment under a totalising technological order.

Explorations into the Sociology of Criminal Justice and Punishment. Leaving the Modernist Project Behind

Law has been a close partner to sociology from its very beginning, and the partnership often has proven to be extremely prolific for sociology. Grand theories as well as vital conceptual tools can be counted among its offspring. Both disciplines share the common ground of socio-legal studies, which has developed into a nearly independent interdisciplinary enterprise where legal scholars and sociologists happily meander between the normative and the analytical. From the vast array of topics in the field of socio-legal studies I select the sociology of criminal justice and punishment in order to demonstrate the characteristics of this relationship. The partnership between sociology and law emerged as part of the modernization project in the 19th and 20th centuries, and the sociology of punishment was part of this endeavour. Rooted in a strong tradition of old (Durkheim) and new (Elias, Foucault) classics, recent developments in this field are leaving the idea of an `unproblematically modern punishment' (Whitman, 2005a) behind, and new fields of inquiry for comparative lawyers and sociologists are opening up.

Responsibilisation and Rights: Explorations in Comparative Youth Criminology

Studies of international youth justice, punishment and control are in their infancy but the issues of globalisation, transnationalisation, policy transfer and localisation are gradually being addressed. There also appears a growing demand in policy and pressure group circles in the UK to learn more about other jurisdictions in order to emulate ‘best practice’ and avoid the worst excesses of punitive populism. However, existing comparative work in this area rarely ventures much beyond country specific descriptions of historical development, powers and procedures. Statistical comparisons – predominantly of custody rates – are becoming more sophisticated but remain beset with problems of partial and inaccurate data collection. The extent to which different countries do things differently, and how and why such difference is maintained, remains a relatively unexcavated territory. This article suggests a conceptually comparative framework in which degrees of international, national and local convergence and divergence can begin to be revealed and assessed.

Illusions of Difference: Comparative Youth Justice in the Devolved UK

Surprisingly, there has been little or no systematic research to date that has explored the significance of UK devolution for youth justice policy and practice. This article explores the extent of differential justice in the United Kingdom, particularly as it is expressed in the myriad action plans, criminal justice reviews, frameworks for action, delivery plans and offending strategies that have surfaced since 1998. In particular, the article considers how far policy convergence and divergence are reflected through the discourses of risk, welfare, restoration and children's rights in the four administrations of England, Scotland, Wales and Northern Ireland. For comparative criminology, the United Kingdom offers a unique opportunity to explore how international and national pressures towards convergence and/or divergence can be challenged, rebranded, versioned, adapted or resisted at sub-national and local levels.

Health status and use of health services among recently arrived men with refugee backgrounds: A comparative analysis of urban and regional settlement in South-east Queensland

Approximately one-third of refugee and humanitarian entrants to Australia are adult men. Many of these men and their families settle in regional areas. Little is known about the health status of refugee men and the use of health services, and whether or not there are differences between those living in urban and regional areas. This paper reports on the cross-sectional differences in health status and use of health services among a group of 233 recently arrived refugee men living in urban and regional areas of South-east Queensland. Overall, participants reported good levels of subjective health status, moderate to good levels of well-being, and low prevalence of mental illness. Men living in urban areas were more likely to have a longstanding illness and report poorer health status than those settled in regional areas. In contrast, men living in regional areas reported poorer levels of well-being in the environment domain and were more likely to visit hospital emergency departments. Targeted health promotion programs will ensure that refugee men remain healthy and develop their full potential as members of the Australian community. Programs that facilitate refugees’ access to primary health care in regional areas may promote more appropriate use of hospital emergency departments by these communities.