Facilitators of expanded and extended scope of paramedic practice - what makes them work?

Introduction Better integration of health services and redefinition of health workforce roles through expanding and extending traditional scope of clinical practice have been explored nationally and internationally. This paper aims to extend our earlier work by examining models of expanded and extended scope of paramedic practice for attributes which facilitate such a practice. Methods An exploratory multi-case study analysis of Australia, New Zealand, Canada and the United Kingdom expanded and extended paramedic practices were analysed. Results Successful models of advanced practice harness the capacity and personality of the paramedic practitioner, and are supported by enabling infrastructures, specifically: professional development/ education; clinical guideline and policy (boundary); access to physical infrastructure and clinical support from senior medical practitioners; and, ability to directly refer to other health services (service integration). The scope of advanced practice is however influenced by individual employers’ capacity, perceived needs and preference/ prioritises. The potential for advanced paramedic practice is equally applicable to urban as well as rural Australia. The Council of Ambulance Authorities’ Professional Competency Standard provides the form and functions for building on advanced paramedic practice. Recognition of such advanced paramedic practice provides a structure for professional growth, process for career progression and will support workforce retention. Conclusion The achievement of advanced knowledge and skills has positioned the paramedic profession to be recognized as a valuable clinician. The Council of Ambulance Authorities’ Professional Competency Standards provides the form and function for supporting advanced paramedic practice.

Single 2×1 domain orientation on Si(001) surfaces using aperiodic Bi line arrays

Studies of Bi heteroepitaxy on Si(001) have shown that lines grow to lengths of up to 500nm if the substrate is heated to above the Bi desorption temperature (500°C) during or after Bi deposition. Unlike many other nanoline systems, the lines formed by this nonequilibrium growth process have no detectable width dispersion. Although much attention has been given to the atomic geometery of the line, in this paper, we focus on how the lines can be used to create a majority 2×1 domain orientation. It is demonstrated that the Bi lines can be used to produce a single-domain orientation on Si(001) if the lines are grown on Si(001) surfaces with a regular distribution of single height steps. This is a compelling example of how a nanoscale motif can be used to modify mesoscopic surface structure on Si(001).

Fatigue crack propagation analysis of plaque rupture

Rupture of atheromatous plaque is the major cause of stroke or heart attack. Considering that the cardiovascular system is a classic fatigue environment, plaque rupture was treated as a chronic fatigue crack growth process in this study. Fracture mechanics theory was introduced to describe the stress status at the crack tip and Paris' law was used to calculate the crack growth rate. The effect of anatomical variation of an idealized plaque cross-section model was investigated. The crack initiation was considered to be either at the maximum circumferential stress location or at any other possible locations around the lumen. Although the crack automatically initialized at the maximum circumferential stress location usually propagated faster than others, it was not necessarily the most critical location where the fatigue life reached its minimum. We found that the fatigue life was minimum for cracks initialized in the following three regions: the midcap zone, the shoulder zone, and the backside zone. The anatomical variation has a significant influence on the fatigue life. Either a decrease in cap thickness or an increase in lipid pool size resulted in a significant decrease in fatigue life. Comparing to the previously used stress analysis, this fatigue model provides some possible explanations of plaque rupture at a low stress level in a pulsatile cardiovascular environment, and the method proposed here may be useful for further investigation of the mechanism of plaque rupture based on in vivo patient data.

Internetalisation : the Internet's influence on international market growth in the firm's outward internationalisation process

It has been suggested that the Internet is the most significant driver of international trade in recent years to the extent that the term =internetalisation‘ has been coined (Bell, Deans, Ibbotson & Sinkovics, 2001; Buttriss & Wilkinson, 2003). This term is used to describe the Internet‘s affect on the internationalisation process of the firm. Consequently, researchers have argued that the internationalisation process of the firm has altered due to the Internet, hence is in need of further investigation. However, as there is limited research and understanding, ambiguity remains in how the Internet has influenced international market growth. Thus, the purpose of this study was to explore how the Internet influences firms‘ internationalisation process, specifically, international market growth. To this end, Internet marketing and international market growth theories are used to illuminate this ambiguity in the body of knowledge. Thus, the research problem =How and why does the Internet influence international market growth of the firm’ is justified for investigation. To explore the research question a two-stage approach is used. Firstly, twelve case studies were used to evaluate key concepts, generate hypotheses and to develop a model of Internetalisation for testing. The participants held key positions within their firm, so that rich data could be drawn from international market growth decision makers. Secondly, a quantitative confirmation process analysed the identified themes or constructs, using two hundred and twenty four valid responses. Constructs were evaluated through an exploratory factor analysis, confirmatory factor analysis and structural equation modelling process. Structural equation modelling was used to test the model of =internetalisation‘ to examine the interrelationships between the internationalisation process components: information availability, information usage, interaction communication, international mindset, business relationship usage, psychic distance, the Internet intensity of the firm and international market growth. This study found that the Internet intensity of the firm mediates information availability, information usage, international mindset, and business relationships when firms grow in international markets. Therefore, these results provide empirical evidence that the Internet has a positive influence on international information, knowledge, entrepreneurship and networks and these in turn influence international market growth. The theoretical contributions are three fold. Firstly, the study identifies a holistic model of the impact the Internet has had on the outward internationalisation of the firm. This contribution extends the body of knowledge pertaining to Internet international marketing by mapping and confirming interrelationships between the Internet, internationalisation and growth concepts. Secondly, the study highlights the broad scope and accelerated rate of international market growth of firms. Evidence that the Internet influences the traditional and virtual networks for the pursuit of international market growth extends the current understanding. Thirdly, this study confirms that international information, knowledge, entrepreneurship and network concepts are valid in a single model. Thus, these three contributions identify constructs, measure constructs in a multi-item capacity, map interrelationships and confirm single holistic model of ‗internetalisation‘. The main practical contribution is that the findings identified information, knowledge and entrepreneurial opportunities for firms wishing to maximise international market growth. To capitalise on these opportunities suggestions are offered to assist firms to develop greater Internet intensity and internationalisation capabilities. From a policy perspective, educational institutions and government bodies need to promote more applied programs for Internet international marketing. The study provides future researchers with a platform of identified constructs and interrelationships related to internetalisation, with which to investigate. However, a single study has limitations of generalisability; thus, future research should replicate this study. Such replication or cross validation will assist in the verification of scales used in this research and enhance the validity of causal predications. Furthermore, this study was undertaken in the Australian outward-bound context. Research in other nations, as well as research into inbound internationalisation would be fruitful.

Growth of boehmite nanofibers by assembling nanoparticles with surfactant micelles

It is known that boehmite (AlOOH) nanofibers formed in the presence of nonionic poly(ethylene oxide) (PEO) surfactant at 373 K. A novel approach is proposed in this study for the growth of the boehmite nanofibers: when fresh aluminum hydrate precipitate was added at regular interval to initial mixture of boehmite and PEO surfactant at 373 K, the nanofibers grow from 40 to 50 nm long to over 100 nm. It is believed that the surfactant micelles play an important role in the nanofiber growth: directing the assembly of aluminum hydrate particles through hydrogen bonding with the hydroxyls on the surface of aluminum hydrate particles. Meanwhile a gradual improvement in the crystallinity of the fibers during growth is observed and attributed to the Ostwald ripening process. This approach allows us to precisely control the size and morphology of boehmite nanofibers using soft chemical methods and could be useful for low temperature, aqueous syntheses of other oxide nanomaterials with tailorable structural specificity such as size, dimension and morphology.

A Framework of Issues in Large Process Modelling Projects

As process management projects have increased in size due to globalised and company-wide initiatives, a corresponding growth in the size of process modeling projects can be observed. Despite advances in languages, tools and methodologies, several aspects of these projects have been largely ignored by the academic community. This paper makes a first contribution to a potential research agenda in this field by defining the characteristics of large-scale process modeling projects and proposing a framework of related issues. These issues are derived from a semi -structured interview and six focus groups conducted in Australia, Germany and the USA with enterprise and modeling software vendors and customers. The focus groups confirm the existence of unresolved problems in business process modeling projects. The outcomes provide a research agenda which directs researchers into further studies in global process management, process model decomposition and the overall governance of process modeling projects. It is expected that this research agenda will provide guidance to researchers and practitioners by focusing on areas of high theoretical and practical relevance.

Does venture opportunity variation matter? investigating systematic process differences between innovative and imitative new ventures

The central thesis in the article is that the venture creation process is different for innovative versus imitative ventures. This holds up; the pace of the process differs by type of venture as do, in line with theory-based hypotheses, the effects of certain human capital (HC) and social capital (SC) predictors. Importantly, and somewhat unexpectedly, the theoretically derived models using HC, SC, and certain controls are relatively successful explaining progress in the creation process for the minority of innovative ventures, but achieve very limited success for the imitative majority. This may be due to a rationalistic bias in conventional theorizing and suggests that there is need for considerable theoretical development regarding the important phenomenon of new venture creation processes. Another important result is that the building up of instrumental social capital, which we assess comprehensively and as a time variant construct, is important for making progress with both types of ventures, and increasingly, so as the process progresses. This result corroborates with stronger operationalization and more appropriate analysis method what previously published research has only been able to hint at.

Entrepreneurship and family firms : a case study in growth and survival

Entrepreneurial marketing has gained popularity in both the entrepreneurship and marketing disciplines in recent times. The success of ventures that have pursued what are considered non-traditional marketing approaches has been attributed to entrepreneurial marketing practices. Despite the multitude of marketing concepts and models, there are prominent venture successes that do not conform to these and have thus been put in the ''entrepreneurial'' box. One only has to look to the ''Virgin'' model to put this in context. Branson has proven for example that not ''sticking to the knitting'' can work with the ways the Virgin portfolio has been diversified. Consequently, an entrepreneurial orientation is considered a desirable philosophy and has become prominent in such industries as airlines and information technology. Miles and Arnold (1991) found that entrepreneurial orientation is positively correlated to marketing orientation. They propose that entrepreneurial orientation is a strategic response by firms to turbulence in the environment. While many marketing successes are analysed in hindsight using traditional marketing concepts and strategies, there are those that challenge standard marketing textbook recommendations. Marketing strategy is often viewed as a process of targeting, segmenting and positioning (STP). Academics and consultants advocate this approach along with the marketing and business plans. The reality however is that a number of businesses do not practice these and pursue alternative approaches. Other schools of thought and business models have been developing to explain differences in orientation such as branding (Keller 2001), the service-dominant logic (Vargo and Lusch 2004) and effectuation logic (Sarasvathy 2001). This indicates that scholars are now looking to cognate fields to explain a given phenomenon beyond their own disciplines. Bucking this trend is a growing number of researchers working at the interface between entrepreneurship and marketing. There is now an emerging body of work dedicated to this interface, hence the development of entrepreneurial marketing as an alternative to the traditional approaches. Hills and Hultman (2008:3) define entrepreneurial marketing as ''a spirit, an orientation as well as a process of passionately pursuing opportunities and launching and growing ventures that create perceived customer value through relationships by employing innovativeness, creativity, selling, market immersion, networking and flexibility.'' Although it started as a special interest group, entrepreneurial marketing is now gaining recognition in mainstream entrepreneurship and marketing literature. For example new marketing textbooks now incorporate an entrepreneurial marketing focus (Grewal and Levy 2008). The purpose of this paper is to explore what entrepreneurial approaches are used by entrepreneurs and their impact on the success of marketing activities. Methodology/Key Propositions In order to investigate this, we employ two cases: 42Below, vodka producers from New Zealand and Penderyn Distillery, whisky distillers from Wales. The cases were chosen based on the following criteria. Firstly, both companies originate from small economies. Secondly, both make products (spirits) from locations that are not traditionally regarded as producers of their flagship products and thirdly, the two companies are different from each other in terms of their age. Penderyn is an old company established in 1882, whereas 42Below was founded only in 1999. Vodka has never been associated with New Zealand. By the same token, whisky has always been associated with Scotland and Ireland but never been with Wales. Both companies defied traditional stereotypes in marketing their flagship products and found international success. Using a comparative a case study approach, we use Covin and Slevin's (1989) set of items that purport to measure entrepreneurial orientation and apply a qualitative lens on the approaches of both companies. These are: 1. cultural emphases on innovation and R&D 2. high rate of new product introduction 3. bold, innovative product development 4. initiator proactive posture 5. first to introduce new technologies and products 6. competitive posture toward competitor 7. strong prolictivity for high risk, high return projects 8. environment requires boldness to achieve objectives 9. when faced with risk, adopts aggressive, bold posture. Results and Implications We find that both companies have employed entrepreneurial marketing approaches but with different intensities. While acknowledging that they are different from the norm, the specifics of their individual approaches are dissimilar. Both companies have positioned their products at the premium end of their product categories and have emphasised quality and awards in their communication strategies. 42Below has carved an image of irreverence and being non-conformist. They have unashamedly utilised viral marketing and entered international markets by training bartenders and hosting unconventional events. They use edgy language such as vodka university, vodka professors and vodka ambassadors. Penderyn Distillery has taken a more traditional approach to marketing its products and portraying romantic images of age-old tradition of distilling as key to their positioning. Both companies enjoy success as evidenced by industry awards and international acclaim.

Communication of business process models via virtual environment simulations

Games and related virtual environments have been a much-hyped area of the entertainment industry. The classic quote is that games are now approaching the size of Hollywood box office sales [1]. Books are now appearing that talk up the influence of games on business [2], and it is one of the key drivers of present hardware development. Some of this 3D technology is now embedded right down at the operating system level via the Windows Presentation Foundations – hit Windows/Tab on your Vista box to find out... In addition to this continued growth in the area of games, there are a number of factors that impact its development in the business community. Firstly, the average age of gamers is approaching the mid thirties. Therefore, a number of people who are in management positions in large enterprises are experienced in using 3D entertainment environments. Secondly, due to the pressure of demand for more computational power in both CPU and Graphical Processing Units (GPUs), your average desktop, any decent laptop, can run a game or virtual environment. In fact, the demonstrations at the end of this paper were developed at the Queensland University of Technology (QUT) on a standard Software Operating Environment, with an Intel Dual Core CPU and basic Intel graphics option. What this means is that the potential exists for the easy uptake of such technology due to 1. a broad range of workers being regularly exposed to 3D virtual environment software via games; 2. present desktop computing power now strong enough to potentially roll out a virtual environment solution across an entire enterprise. We believe such visual simulation environments can have a great impact in the area of business process modeling. Accordingly, in this article we will outline the communication capabilities of such environments, giving fantastic possibilities for business process modeling applications, where enterprises need to create, manage, and improve their business processes, and then communicate their processes to stakeholders, both process and non-process cognizant. The article then concludes with a demonstration of the work we are doing in this area at QUT.

Selective growth of carbon nanotubes on bare silicon : MWNT sinthesys on patterned substrates without predeposition of metal catalyst

Carbon nanotubes (CNTs) are expected to become the ideal constituent of many technologes, in particular for future generation electronics. This considerable interest is due to their unique electrical and mechanical properties. They show indeed super-high current-carrying capacity, ballistic electron transport and good field-emission properties. Then, these superior features make CNTs the most promising building blocks for electronic devices, as organic solar cells and organic light emitting devices (OLED). By using Focused Ion Beam (FIB) patterning it is possible to a obtain a high control on position, relative distances and diameter of CNTs. The present work shows how to grow three-dimensional architecture made of vertical-aligned CNTs directly on silicon. Thanks to the higher activity of a pre-patterned surface the synthesis process results very quick, cheap and simple. Such large area growths of CNTs could be used in preliminary test for application as electrodes for organic solar cells.

Small firm growth

We review and discuss the literature on small firm growth with an intention to provide a useful vantage point for new research studies regarding this important phenomenon. We first discuss conceptual and methodological issues that represent critical choices for those who research growth and which make it challenging to compare results from previous studies. The substantial review of past research is organized into four sections representing two smaller and two larger literatures. The first of the latter focuses on internal and external drivers of small firm growth. Here we find that much has been learnt and that many valuable generalizations can be made. However, we also conclude that more research of the same kind is unlikely to yield much. While interactive and non-linear effects may be worth pursuing it is unlikely that any new and important growth drivers or strong, linear main effects would be found. The second large literature deals with organizational life-cycles or stages of development. While deservedly criticized for unwarranted determinism and weak empirics this type of approach addresses problems of high practical and also theoretical relevance, and should not be shunned by researchers. We argue that with a change in the fundamental assumptions and improved empirical design, research on the organizational and managerial consequences of growth is an important line of inquiry. With this, we overlap with one of the smaller literatures, namely studies focusing on the effects of growth. We argue that studies too often assume that growth equals success. We advocate instead the use of growth as an intermediary variable that influences more fundamental goals in ways that should be carefully examined rather than assumed. The second small literature distinguishes between different modes or forms of growth, including, e.g., organic vs. acquisition-based growth, and international expansion. We note that modes of growth is an important topic that has been under studied in the growth literature, whereas in other branches of research aspects of it may have been studied intensely, but not primarily from a growth perspective. In the final section we elaborate on ways forward for research on small firm growth. We point at rich opportunities for researchers who look beyond drivers of growth, where growth is viewed as a homogenous phenomenon assumed to unambiguously reflect success, and instead focus on growth as a process and a multi-dimensional phenomenon, as well as on how growth relates to more fundamental outcomes.

Economic growth, inequality and technology adoption in transitional economies

The stylized facts that motivate this thesis include the diversity in growth patterns that are observed across countries during the process of economic development, and the divergence over time in income distributions both within and across countries. This thesis constructs a dynamic general equilibrium model in which technology adoption is costly and agents are heterogeneous in their initial holdings of resources. Given the households‟ resource level, this study examines how adoption costs influence the evolution of household income over time and the timing of transition to more productive technologies. The analytical results of the model constructed here characterize three growth outcomes associated with the technology adoption process depending on productivity differences between the technologies. These are appropriately labeled as „poverty trap‟, „dual economy‟ and „balanced growth‟. The model is then capable of explaining the observed diversity in growth patterns across countries, as well as divergence of incomes over time. Numerical simulations of the model furthermore illustrate features of this transition. They suggest that that differences in adoption costs account for the timing of households‟ decision to switch technology which leads to a disparity in incomes across households in the technology adoption process. Since this determines the timing of complete adoption of the technology within a country, the implications for cross-country income differences are obvious. Moreover, the timing of technology adoption appears to be impacts on patterns of growth of households, which are different across various income groups. The findings also show that, in the presence of costs associated with the adoption of more productive technologies, inequalities of income and wealth may increase over time tending to delay the convergence in income levels. Initial levels of inequalities in the resources also have an impact on the date of complete adoption of more productive technologies. The issue of increasing income inequality in the process of technology adoption opens up another direction for research. Specifically increasing inequality implies that distributive conflicts may emerge during the transitional process with political- economy consequences. The model is therefore extended to include such issues. Without any political considerations, taxes would leads to a reduction in inequality and convergence of incomes across agents. However this process is delayed if politico-economic influences are taken into account. Moreover, the political outcome is sub optimal. This is essentially due to the fact that there is a resistance associated with the complete adoption of the advanced technology.

In vivo knockdown of the androgen receptor results in growth inhibition and regression of well-established, castration-resistant prostate tumours

Purpose: Progression to the castration-resistant state is the incurable and lethal end stage of prostate cancer, and there is strong evidence that androgen receptor (AR) still plays a central role in this process. We hypothesize that knocking down AR will have a major effect on inhibiting growth of castration-resistant tumors. Experimental Design: Castration-resistant C4-2 human prostate cancer cells stably expressing a tetracycline-inducible AR-targeted short hairpin RNA (shRNA) were generated to directly test the effects of AR knockdown in C4-2 human prostate cancer cells and tumors. Results:In vitro expression of AR shRNA resulted in decreased levels of AR mRNA and protein, decreased expression of prostate-specific antigen (PSA), reduced activation of the PSA-luciferase reporter, and growth inhibition of C4-2 cells. Gene microarray analyses revealed that AR knockdown under hormone-deprived conditions resulted in activation of genes involved in apoptosis, cell cycle regulation, protein synthesis, and tumorigenesis. To ensure that tumors were truly castration-resistant in vivo, inducible AR shRNA expressing C4-2 tumors were grown in castrated mice to an average volume of 450 mm3. In all of the animals, serum PSA decreased, and in 50% of them, there was complete tumor regression and disappearance of serum PSA. Conclusions: Whereas castration is ineffective in castration-resistant prostate tumors, knockdown of AR can decrease serum PSA, inhibit tumor growth, and frequently cause tumor regression. This study is the first direct evidence that knockdown of AR is a viable therapeutic strategy for treatment of prostate tumors that have already progressed to the castration-resistant state.

An alginate-based hybrid system for growth factor delivery in the functional repair of large bone defects

The treatment of challenging fractures and large osseous defects presents a formidable problem for orthopaedic surgeons. Tissue engineering/regenerative medicine approaches seek to solve this problem by delivering osteogenic signals within scaffolding biomaterials. In this study, we introduce a hybrid growth factor delivery system that consists of an electrospun nanofiber mesh tube for guiding bone regeneration combined with peptide-modified alginate hydrogel injected inside the tube for sustained growth factor release. We tested the ability of this system to deliver recombinant bone morphogenetic protein-2 (rhBMP-2) for the repair of critically-sized segmental bone defects in a rat model. Longitudinal [mu]-CT analysis and torsional testing provided quantitative assessment of bone regeneration. Our results indicate that the hybrid delivery system resulted in consistent bony bridging of the challenging bone defects. However, in the absence of rhBMP-2, the use of nanofiber mesh tube and alginate did not result in substantial bone formation. Perforations in the nanofiber mesh accelerated the rhBMP-2 mediated bone repair, and resulted in functional restoration of the regenerated bone. [mu]-CT based angiography indicated that perforations did not significantly affect the revascularization of defects, suggesting that some other interaction with the tissue surrounding the defect such as improved infiltration of osteoprogenitor cells contributed to the observed differences in repair. Overall, our results indicate that the hybrid alginate/nanofiber mesh system is a promising growth factor delivery strategy for the repair of challenging bone injuries.