Rural and Urban Differentials in Primary Care Management of Chronic Heart Failure: New Data from the CASE Study

Objective: To determine whether primary care management of chronic heart failure (CHF) differed between rural and urban areas in Australia. Design: A cross-sectional survey stratified by Rural, Remote and Metropolitan Areas (RRMA) classification. The primary source of data was the Cardiac Awareness Survey and Evaluation (CASE) study. Setting: Secondary analysis of data obtained from 341 Australian general practitioners and 23 845 adults aged 60 years or more in 1998. Main outcome measures: CHF determined by criteria recommended by the World Health Organization, diagnostic practices, use of pharmacotherapy, and CHF-related hospital admissions in the 12 months before the study. Results: There was a significantly higher prevalence of CHF among general practice patients in large and small rural towns (16.1%) compared with capital city and metropolitan areas (12.4%) (P < 0.001). Echocardiography was used less often for diagnosis in rural towns compared with metropolitan areas (52.0% v 67.3%, P < 0.001). Rates of specialist referral were also significantly lower in rural towns than in metropolitan areas (59.1% v 69.6%, P < 0.001), as were prescribing rates of angiotensin-converting enzyme inhibitors (51.4% v 60.1%, P < 0.001). There was no geographical variation in prescribing rates of β-blockers (12.6% [rural] v 11.8% [metropolitan], P = 0.32). Overall, few survey participants received recommended “evidence-based practice” diagnosis and management for CHF (metropolitan, 4.6%; rural, 3.9%; and remote areas, 3.7%). Conclusions: This study found a higher prevalence of CHF, and significantly lower use of recommended diagnostic methods and pharmacological treatment among patients in rural areas.

Implementing dance in a Queensland primary school : a descriptive case study

This research documents and analyses the modes of implementation of the Dance component of The Arts Essential Learnings in a Queensland school. The research identifies what makes good practice in dance education and the multiple modes of implementation that support this practice. The primary purpose of this research is to describe the factors that influence dance education, as it is delivered, in a Queensland primary school to inform the development of further support for primary teachers and to improve the quality of dance education in Prep -7 schooling. The literature review investigates dance education both in Queensland, Australia and internationally, identifying current issues related to the delivery of dance in a primary school environment including barriers to implementation of dance, authentic learning and integrated approaches to learning. Based on Engestrom.s reformulation of Vygotsky.s theory of socially mediated learning, the implementation of dance education curriculum was explored through descriptive case study method. The case study was conducted in a regional Queensland school identified as delivering the dance curriculum in a variety of ways. The research project provided opportunities to observe, document and analyse how teachers deal with pedagogical dilemmas and solve logistical problems associated with teaching the dance component of the Arts curriculum in this school. Teachers. practices were contextualised through investigation of the whole school context of dance curriculum development. The findings revealed a range of teaching approaches that influenced teachers. interpretation and children.s experience of the dance curriculum. The features of a supportive whole school and cultural environment for dance were identified. These have been captured in a reworked version of Engestrom.s Second Generation Activity Theory that can be applied to the implementation of dance education in primary schools.

Crisis communication under transformative change : the emergent context and roles of primary and secondary organisations

In an era of complex challenges that draw sustained media attention and entangle multiple organisational actors, this thesis addresses the gap between current trends in society and business, and existing scholarship in public relations and crisis communication. By responding to calls from crisis communication researchers to develop theory (Coombs, 2006a), to examine the interdependencies of crises (Seeger, Sellnow, & Ulmer, 1998), and to consider variation in crisis response (Seeger, 2002), this thesis contributes to theory development in crisis communication and public relations. Through transformative change, this thesis extends existing scholarship built on a preservation or conservation logic where public relations is used to maintain stability by incrementally responding to changes in an organisation‘s environment (Cutlip, Center, & Broom, 2006; Everett, 2001; Grunig, 2000; Spicer, 1997). Based on the opportunity to contribute to ongoing theoretical development in the literature, the overall research problem guiding this thesis asks: How does transformative change during crisis influence corporate actors’ communication? This thesis adopts punctuated equilibrium theory, which describes change as alternating between long periods of stability and short periods of revolutionary or transformative change (Gersick, 1991; Romanelli & Tushman, 1994; Siggelkow, 2002; Tushman, Newman, & Romanelli, 1986; Tushman & Romanelli, 1985). As a theory for change, punctuated equilibrium provides an opportunity to examine public relations and transformative change, building on scholarship that is based primarily on incremental change. Further, existing scholarship in public relations and crisis communication focuses on the actions of single organisations in situational or short-term crisis events. Punctuated equilibrium theory enables the study of multiple crises and multiple organisational responses during transformative change. In doing so, punctuated equilibrium theory provides a framework to explain both the context for transformative change and actions or strategies enacted by organisations during transformative change (Tushman, Newman, & Romanelli, 1986; Tushman & Romanelli, 1985; Tushman, Virany, & Romanelli, 1986). The connections between context and action inform the research questions that guide this thesis: RQ1: What symbolic and substantive strategies persist and change as crises develop from situational events to transformative and multiple linked events? RQ2: What features of the crisis context influence changes in symbolic and substantive strategies? To shed light on these research questions, the thesis adopts a qualitative approach guided by process theory and methods to explicate the events, sequences and activities that were essential to change (Pettigrew, 1992; Van de Ven, 1992). Specifically, the thesis draws on an alternative template strategy (Langley, 1999) that provides several alternative interpretations of the same events (Allison, 1971; Allison & Zelikow, 1999). Following Allison (1971) and Allison and Zelikow (1999), this thesis uses three alternative templates of crisis or strategic response typologies to construct three narratives using media articles and organisational documents. The narratives are compared to identify and draw out different patterns of crisis communication strategies that operate within different crisis contexts. The thesis is based on the crisis events that affected three organisations within the pharmaceutical industry for four years. The primary organisation is Merck, as its product recall crisis triggered transformative change affecting, in different ways, the secondary organisations of Pfizer and Novartis. Three narratives are presented based on the crisis or strategic response typologies of Coombs (2006b), Allen and Caillouet (1994), and Oliver (1991). The findings of this thesis reveal different stories about crisis communication under transformative change. By zooming in to a micro perspective (Nicolini, 2009) to focus on the crisis communication and actions of a single organisation and zooming out to a macro perspective (Nicolini, 2009) to consider multiple organisations, new insights about crisis communication, change and the relationships among multiple organisations are revealed at context and action levels. At the context level, each subsequent narrative demonstrates greater connections among multiple corporate actors. By zooming out from Coombs‘ (2006b) focus on single organisations to consider Allen and Caillouet‘s (1994) integration of the web of corporate actors, the thesis demonstrates how corporate actors add accountability pressures to the primary organisation. Next, by zooming further out to the macro perspective by considering Oliver‘s (1991) strategic responses to institutional processes, the thesis reveals a greater range of corporate actors that are caught up in the process of transformative change and accounts for their varying levels of agency over their environment. By zooming in to a micro perspective and out to a macro perspective (Nicolini, 2009) across alternative templates, the thesis sheds light on sequences, events, and actions of primary and secondary organisations. Although the primary organisation remains the focus of sustained media attention across the four-year time frame, the secondary organisations, even when one faced a similar starting situation to the primary organisation, were buffered by the process of transformative change. This understanding of crisis contexts in transforming environments builds on existing knowledge in crisis communication. At the action level, the thesis also reveals different interpretations from each alternative template. Coombs‘ (2006b) narrative shows persistence in the primary organisation‘s crisis or strategic responses over the four-year time frame of the thesis. That is, the primary organisation consistently applies a diminish crisis response. At times, the primary organisation drew on denial responses when corporate actors questioned its legitimacy or actions. To close the crisis, the primary organisation uses a rebuild crisis posture (Coombs, 2006). These finding are replicated in Allen and Caillouet‘s (1994) narrative, noting this template‘s limitation to communication messages only. Oliver‘s (1991) narrative is consistent with Coombs‘ (2006b) but also demonstrated a shift from a strategic response that signals conformity to the environment to one that signals more active resistance to the environment over time. Specifically, the primary organisation‘s initial response demonstrates conformity but these same messages were used some three years later to set new expectations in the environment in order to shape criteria and build acceptance for future organisational decisions. In summary, the findings demonstrate the power of crisis or strategic responses when considered over time and in the context of transformative change. The conclusions of this research contribute to scholarship in the public relations and management literatures. Based on the significance of organisational theory, the primary contribution of the theory relates to the role of interorganisational linkages or legitimacy buffers that form during the punctuation of equilibrium. The network of linkages among the corporate actors are significant also to the crisis communication literature as they form part of the process model of crisis communication under punctuated equilibrium. This model extends existing research that focuses on crisis communication of single organisations to consider the emergent context that incorporates secondary organisations as well as the localised contests of legitimacy and buffers from regulatory authorities. The thesis also provides an empirical base for punctuated equilibrium in public relations and crisis communication, extending Murphy‘s (2000) introduction of the theory to the public relations literature. In doing this, punctuated equilibrium theory reinvigorates theoretical development in crisis communication by extending existing scholarship around incrementalist approaches and demonstrating how public relations works in the context of transformative change. Further research in this area could consider using alternative templates to study transformative change caused by a range of crisis types from natural disasters to product tampering, and to add further insight into the dynamics between primary and secondary organisations. This thesis contributes to practice by providing guidelines for crisis response strategy selection and indicators related to the emergent context for crises under transformative change that will help primary and secondary organisations‘ responses to crises.

A case study of how primary school teachers in Papua New Guinea understand outcomes-based education

This case study explored how a group of primary school teachers in Papua New Guinea (PNG) understood Outcomes-based Education (OBE). OBE measures students. learning against specific outcomes. These outcomes are derived from a country.s vision of the kind of citizen that the education system should produce. While countries such as Australia, South Africa, New Zealand and the United States have abandoned OBE, others such as PNG have adopted it in various ways. How teachers understand OBE in PNG is important because such understandings are likely to influence how they implement the OBE curriculum. There has been no research to date which has investigated PNG primary school teachers. understandings and experiences with OBE. This study used a single exploratory case study design to investigate how twenty primary school teachers from the National Capital District (NCD) in PNG understood OBE. The study, underpinned by an intepretivist paradigm, explored the research question: How do primary school teachers understand outcomes-based education in PNG? The data comprised surveys, in-depth interviews and documents. Data were analysed thematically and using explanation building techniques. The findings revealed that OBE is viewed by teachers as a way to equip them with additional strategies for planning and programming, teaching and learning, and assessment. Teachers also described how OBE enabled both students and teachers to become more engaged and develop positive attitudes towards teaching and learning. There was also a perception that OBE enhanced students. future life skills through increased local community support. While some teachers commented on how the OBE reforms provided them with increased professional development opportunities, the greatest impediment to implementing OBE was perceived to be a lack of sufficient teaching and learning resources. The process of planning and programming classroom activities was also regarded as onerous. Some teachers indicated that they had been required to implement OBE without adequate in-service training support. The social constructivist theory of knowledge which underpins OBE.s student-centred pedagogy can cause tensions within PNG.s cultural contexts of teaching and learning. Teachers need to be aware of these tensions when conducting peer or group learning under OBE in PNG. By exploring how these PNG primary teachers understood OBE, the study highlighted how teachers engaged with OBE concepts when interpreting syllabus documents and how they applied these concepts to curriculum. Identifying differences in teacher understanding of OBE provides guidance for both the design of materials to support the implementation of OBE and for the design of in-service training. Thus, the outcomes of this study will inform educators about the implementation of OBE in PNG. In addition, the outcomes will provide much needed insight into how a mandated curriculum and pedagogical reform impacts teachers‟ practices in PNG.

History in the Australian Curriculum F-10 : providing answers without asking questions

This paper examines the most recent version of the Australian Curriculum: History F-10. It does so in two ways. First, it explores some of the strengths and weaknesses of this curriculum with reference to the decision to frame aspects of Australian history within the context of a world history approach. Whilst the positioning of Indigenous Histories is applauded, the curriculum’s lack of attention to the significance of the recent history of Australia’s Asian neighbours, and Australia’s relationship with them, is critiqued. This part of the paper also emphasises the need for comparative approaches and calls for greater emphasis on providing students with opportunities to critique and contest the construction of narratives about the past. Second, the paper introduces four invited articles that examine different aspects of the Australian Curriculum: History. Collectively these papers reiterate the significance of the richness of integrated and child-centred approaches and the importance of developing historical thinking, empathy and the historical imagination in the classroom.

Enlightening, balancing and transcending entrepreneurial orientation : the 4th annual EO3 research PDW

Entrepreneurial Orientation (EO) has a 30 year history as one of the most used concepts in entrepreneurship research. “Recent attention in formal sessions at the Academy of Management conference programs confirm Entrepreneurial Orientation as a primary construct with a majority of Entrepreneurship Division sponsored sessions devoted to studies using EO related measures”, as reported by the 2010 division program chair, Per Davidson (Roberts, 2010: 9). However, questions continue to be raised concerning over-dependence on parts of one strategic scale, possible inappropriate or under-theorized adaptations, and the lack of theoretical development on application and performance variance in emergent, organizational, and socioeconomic settings. One recent area of investigation in analysis, methods, theory and application concerns an “EO gestalt”, focusing on the family of EO-related measures and theory, rather than on one or more dimensions, in order to explore the theory and process of the Entrepreneurial Orientation phenomenon. The goals of the 4th Annual EO3 PDW are to enlighten researchers on the development of Entrepreneurial Orientation theory and related scales, balance the use of Entrepreneurial Orientation current knowledge with new research frontiers suggested by EO3 scholars’ questions, and transcend boundaries in the discoveries undertaken in the shared interdisciplinary and cross-cultural research agenda currently developing for Entrepreneurial Orientation concepts. Going into its forth year, the EO3 PDW has been pivotal in formalizing discussion, pushing research forward, and gaining insights from experienced and cutting edge scholars, as it provides a point of reference for coalescing research questions and findings surrounding this important concept.

Scaffolding techniques : a teacher training for cooperative learning in Thailand primary education

In general, the benefits of using cooperative learning include academic achievement, communication skills, problem-solving, social skills and student motivation. Yet cooperative learning as a Western educational concept may be ineffective in a different learning system. The study aims to investigate scaffolding techniques for cooperative learning in Thailand primary education. The program was designed to foster Thai primary school teachers’ cooperative learning implementation that includes the basic tenets of cooperative learning and socio-cognitive based learning. Two teachers were invited to participate in this experimental teacher training program for one and a half weeks. Then the teachers implemented a cooperative learning in their mathematics class for six weeks. The data from teacher interview and classroom observation indicated that the both teachers are able to utilise questions to scaffold their students’ engagement in cooperative learning. This initiative study showed that difficulty or failure of implementing cooperative learning in Thailand education may not be derived from cultural difference. The paper discussed the techniques the participant teachers applied with proactive scaffolding, reactive scaffolding and scaffolding questions that can be used to facilitate the implementation of cooperative learning in Thai school.

Collaborative inquiries into literacy, place and identity in changing policy contexts : implications for teacher development

In this chapter we describe a history of collaboration between university-based literacy researchers and school-based teachers in teacher development programs and practitioner inquiries designed to improve literacy outcomes for students living in low-socioeconomic circumstances. We consider how an inquiry stance has informed teachers working for social justice through curriculum and pedagogy designed to connect children’s developing literacy repertoires with their changing material, social and linguistic contexts. We use examples from the practices of two of our long-term teacher-collaborators to show what has been possible to achieve, even in radically different policy contexts, because of teachers’ continued commitment to themes of place and belonging, and language and identity.

The differential recognition of children’s cultural practices in middle primary literacy classrooms

This paper argues that teachers’ recognition of children’s cultural practices is an important positive step in helping socio-economically disadvantaged children engage with school literacies. Based on twenty-one longitudinal case studies of children’s literacy development over a three-year period, the authors demonstrate that when children’s knowledges and practices assembled in home and community spheres are treated as valuable material for school learning, children are more likely to invest in the work of acquiring school literacies. However they show also that whilst some children benefit greatly from being allowed to draw on their knowledge of popular culture, sports and the outdoors, other children’s interests may be ignored or excluded. Some differences in teachers’ valuing of home and community cultures appeared to relate to gender dimensions.

Right to the city, desire for the suburb?

The 2000s have been a lively decade for cities. The Worldwatch Institute estimated that 2007 was the first year in human history that more people worldwide lived in cities than the countryside. Globalisation and new digital media technologies have generated the seemingly paradoxical outcome that spatial location came to be more rather than less important, as combinations of firms, industries, cultural activities and creative talents have increasingly clustered around a select node of what have been termed “creative cities,” that are in turn highly networked into global circuits of economic capital, political power and entertainment media. Intellectually, the period has seen what the UCLA geographer Ed Soja refers to as the spatial turn in social theory, where “whatever your interests may be, they can be significantly advanced by adopting a critical spatial perspective”. This is related to the dynamic properties of socially constructed space itself, or what Soja terms “the powerful forces that arise from socially produced spaces such as urban agglomerations and cohesive regional economies,” with the result that “what can be called the stimulus of socio-spatial agglomeration is today being assertively described as the primary cause of economic development, technological innovation, and cultural creativity”

CDKN2A mutation in a non-FAMMM kindred with cancers at multiple sites results in a functionally abnormal protein

The CDKN2A gene encodes p16 (CDKN2A), a cell-cycle inhibitor protein which prevents inappropriate cell cycling and, hence, proliferation. Germ-line mutations in CDKN2A predispose to the familial atypical multiple-mole melanoma (FAMMM) syndrome but also have been seen in rare families in which only 1 or 2 individuals are affected by cutaneous malignant melanoma (CMM). We therefore sequenced exons 1alpha and 2 of CDKN2A using lymphocyte DNA isolated from index cases from 67 families with cancers at multiple sites, where the patterns of cancer did not resemble those attributable to known genes such as hMLH1, hMLH2, BRCA1, BRCA2, TP53 or other cancer susceptibility genes. We found one mutation, a mis-sense mutation resulting in a methionine to isoleucine change at codon 53 (M531) of exon 2. The individual tested had developed 2 CMMs but had no dysplastic nevi and lacked a family history of dysplastic nevi or CMM. Other family members had been diagnosed with oral cancer (2 persons), bladder cancer (1 person) and possibly gall-bladder cancer. While this mutation has been reported in Australian and North American melanoma kindreds, we did not observe it in 618 chromosomes from Scottish and Canadian controls. Functional studies revealed that the CDKN2A variant carrying the M531 change was unable to bind effectively to CDK4, showing that this mutation is of pathological significance. Our results have confirmed that CDKN2A mutations are not limited to FAMMM kindreds but also demonstrate that multi-site cancer families without melanoma are very unlikely to contain CDKN2A mutations.

Scientia temporum & rerum : History or Antiquarianism? The collection of examples in Georg Calixtus' De studio historiarum oratio (1629)

This paper explores an early modern application of the Stoic principle of similitudo temporum to the study of history. In so doing, it highlights the tension between historiography and antiquarianism, suggesting that the collection of remains – whether material or immaterial – was understood in at least some early modern circles as an integral part of the historiographic process. It also emphasises the evolving meaning of “history” during this time, drawing attention to the perceived novelty of such antiquarian approaches to the study of the past, and briefly exploring subtle differences between the example at hand and the work and activities of better-known figures such as Nicolas-Claude Fabri de Peiresc and Justus Lipsius. As such, this paper makes a contribution to our evolving understanding of early modern scholarship, and draws attention to the variegated approaches of its practitioners to contemporary issues.