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.

Nonprofit organisations and public policy : exploring the research role of the Brotherhood of St Laurence

This paper begins to explore the role of the Brotherhood of St Laurence as a nonprofit welfare organisation and its influence on public policy in Australia. The Brotherhood's impact on Australian social policy has been evident through a range of actions: the production of research on relevant social issues; the preparation of submissions and position papers and involvement in consultations with governments on social policy; and the personal influence of many of the charismatic (mostly) men who have led the organisation throughout its history. This paper highlights the Brotherhood���s research aspect and speculates upon the impact of its considerable research contribution. The Brotherhood has been involved in service delivery through a range of often innovative programs throughout its history, but the organisation's involvement in research and advocacy has rendered it unique in comparison to any other nonprofit welfare organisation in Australia. This paper finds that different kinds of research can be utilised in different ways; by studying the output of the Brotherhood it will explore and highlight how knowledge utilisation takes place. [Introduction]

Grey St. Xchange 2.0 by QUT

Partnerships between universities and public institutions such as this offer the beginning of a long term relationship to actively influence public policy, procedures and new ways to engage the many diverse communities to be integral in shaping the environments in which they live. It offers an opportunity to apply authentic positioning of research theories and build new methodologies for consulting, analysing and implementing innovation. SBC, as an established corporation offers a unique precinct to research and develop models with its different offers of tourism, leisure and neighbourhood. The Parklands and Little Stanley Street are well advanced in the goals however Grey Street, which connects the precinct to the greater surrounds, has been a complex issue that is now ready to be addressed. This project offers the ability to be of real worth at this critical time of development with the history of the past development combined with the desire for future visioning to be realised over the next 5 years. QUT has the unique opportunity to be part of this future.

Book review: "Ideologies of Breast Cancer : Feminist Perspectives" Edited by Laura K. Potts. New York: St. Martin���s Press

Laura K. Potts���s edited collection of research on the meanings of breast cancer includes authors from the United Kingdom, the United States, and Canada whose perspectives draw on literary criticism, sociology, psychology, and cultural studies among others. The research employs various methodological approaches���for example, media analysis (Saywell et al.), autobiographical narratives (Potts), and analysis of social activism (Fishman)���to elucidate the multiple dimensions and diversity of breast cancer experiences. The first of two parts, ���Meanings of Breast Cancer,��� presents the problematical relationship between biomedicine and women���s constructions of breast cancer knowledge, the sexualized and maternalized breast in the print media about breast cancer, environmental risks to women���s health in the Bay Area of San Francisco, and women���s narratives of breast cancer and situating the self. In part 2, ���Discourses of Risk and Breast Cancer,��� examination of the discourses of prevention and risks to health are taken up in relation to breast cancer screening, the problem of prophylactic mastectomy for hereditary breast cancer, and environmental activism...

Public policy, disaster risk management and climate change adaptation

Public policymakers are caught in a dilemma : there is a growing list of urgent issues to address, at the same time that public expenditure is being cut. Adding to this dilemma is a system of government designed in the 19th century and competing theories of policymaking dating back to the 1950s. The interlinked problems of disaster risk management and climate change adaptation are cases in point. As the climate changes, there will be more frequent, intense and/or prolonged disasters such as floods and bushfires. Clearly a well integrated whole of government response is needed, but how might this be achieved? Further, how could academic research contribute to resolving this dilemma in a way that would produce something of theoretical interest as well as practical outcomes for policymakers? These are the questions addressed by our research via a comparative analysis of the 2009 Victorian bushfires, the 2011 Perth Hills bushfires, and the 2011 Brisbane floods. Our findings suggest that there is a need to: improve community engagement and communication; refocus attention on resilience; improve interagency communication and collaboration; and, develop institutional arrangements that support continual improvement and policy learning. These findings have implications for all areas of public policy theory and practice.

The affordances of social technology : a BPM perspective

Increasingly, organizations are looking to employ Social Technology (ST) to enhance their capability with Business Process Improvement (BPI). However, little is known about how the characteristics or qualities of ST actually influence an organizations' capability at Business Process Improvement (BPI). This paper discusses the potential role of ST in process improvement by presenting an a-priory model derived by an investigation of extant research. First, the qualities of social technology that potentially support high level action possibilities related to BPI are presented (we refer to these as affordances), next these affordances are mapped to the De Bruin (2009) BPM Maturity model as a first step to understanding how ST influences BPI. This work is expected to contribute to our knowledge and understanding of the relationship between ST and BPI, and will extend existing theory on Business Process Management capability and maturity.

Review : "The Culture of Curating and the Curating of Culture(s)", Paul O���Neill (2012)

Paul O'Neill's book, 'The Culture of Curating and the Curating of Culture(s)provides a concise overview of how curating has changed art and how art has changed curating. The book is divided into three sections, each dealing with a key transitional development: (1) the historical development of curatorial discourse; (2) the influence of the Biennial phenomenon and, finally, (3) how art and curating have converged since the 1990s. This review discusses the publication as a significant contribution to the development of a curatorial history and discourse.

St Barnabas abuse allegations build up

MORE victims have made child-sex allegations against senior Anglican clergymen at a shut-down north Queensland boarding school, as church officials confirmed they had sat on a 2004 report about complaints from Britain into one of the suspected serial abusers. Former students Mark McClintock and Greg Shaw have this week come forward with allegations against Robert Waddington, headmaster at St Barnabas boarding school, in Ravenshoe southwest of Cairns, in the 1960s. Waddington later returned to Britain and rose to become head of education for the Church of England and Dean of Manchester. Another former student at St Barnabas, who does not want to be named, also contacted The Weekend Australian with allegations of abuse in the 60s by former Anglican brother Peter Gilbert, who was hired by Waddington and jailed in 2006 for child-sex offences in South Australia.

Negotiating the creative and the critical : Paul Dawson���s creative writing and the new humanities

In the first Modern Language Association newsletter for 2006, renowned poetry critic and MLA President, Marjorie Perloff, remarked on the growing ascendency of Creative Writing within English Studies in North America. In her column, Perloff notes that "[i]n studying the English Job Information List (JIL) so as to advise my own students and others I know currently on the market, I noticed what struck me as a curious trend: there are, in 2005, almost three times as many positions in creative writing as in the study of twentieth-century literature" (3). The dominance of Creative Writing in the English Studies job list in turn reflects the growing student demand for undergraduate and postgraduate degrees in the field���over the past 20 years, BA and MA degrees in Creative Writing in North American tertiary institutions have quadrupled (3)...

Comparison of high sensitivity troponin T and I assays in the diagnosis of non-ST elevation acute myocardial infarction in emergency patients with chest pain

Objectives: Concentrations of troponin measured with high sensitivity troponin assays are raised in a number of emergency department (ED) patients; however many are not diagnosed with acute myocardial infarction (AMI). Clinical comparisons between the early use (2 h after presentation) of high sensitivity cardiac troponin T (hs-cTnT) and I (hs-cTnI) assays for the diagnosis of AMI have not been reported. Design and methods: Early (0 h and 2 h) hs-cTnT and hs-cTnI assay results in 1571 ED patients with potential acute coronary syndrome (ACS) without ST elevation on electrocardiograph (ECG) were evaluated. The primary outcome was diagnosis of index MI adjudicated by cardiologists using the local cTnI assay results taken ���6 h after presentation, ECGs and clinical information. Stored samples were later analysed with hs-cTnT and hs-cTnI assays. Results: The ROC analysis for AMI (204 patients; 13.0%) for hs-cTnT and hs-cTnI after 2 h was 0.95 (95% CI: 0.94���0.97) and 0.98 (95% CI: 0.97���0.99) respectively. The sensitivity, specificity, PLR, and NLR of hs-cTnT and hs-cTnI for AMI after 2 h were 94.1% (95% CI: 90.0���96.6) and 95.6% (95% CI: 91.8���97.7), 79.0% (95% CI: 76.8���81.1) and 92.5% (95% CI: 90.9���93.7), 4.48 (95% CI: 4.02���5.00) and 12.86 (95% CI: 10.51���15.31), and 0.07 (95% CI: 0.04���0.13) and 0.05 (95% CI:0.03���0.09) respectively. Conclusions: Exclusion of AMI 2 h after presentation in emergency patients with possible ACS can be achieved using hs-cTnT or hs-cTnI assays. Significant differences in specificity of these assays are relevant and if using the hs-cTnT assay, further clinical assessment in a larger proportion of patients would be required.

SCRAMSPACE : Radical-Farming Scramjet for access to space

Scramjet-based launch systems offer considerable promise for safe, reliable and economical access to space. A general Scramjets introduction is first provided, followed by the specifics of Australian Scramjet Research and the recent progress in inlet-injection radical-farming scramjets as part of the SCRAMSPACE program. Through both flight and ground tests, leveraging Australias world leadership in scramjet R&D, the SCRAMSPACE project is designed to answer key scientific and technological questions and build an industry-ready talent pool for a future Australian space industry. An extensive descriptions of all phases of the development of the SCRAMSPACE I scramjet-powered free-flight experiment are described in these lecture notes.

ABC Conversations with Richard Fidler & Dr Paul Bennett, a forensic podiatrist

Podiatry is the medical science of the bones, muscle and skin of the foot. Paul Bennett is sometimes called on by police to help solve crime. He can provide vital evidence by applying his medical expertise and extraordinary talent for pattern recognition to footprints left at crime-scenes. Paul is a senior lecturer at the Quensland University of Technology's School of Clinical Sciences.