A 2-h diagnostic protocol to assess patients with chest pain symptoms in the Asia-Pacific region (ASPECT): a prospective observational validation study

Background: Patients with chest pain contribute substantially to emergency department attendances, lengthy hospital stay, and inpatient admissions. A reliable, reproducible, and fast process to identify patients presenting with chest pain who have a low short-term risk of a major adverse cardiac event is needed to facilitate early discharge. We aimed to prospectively validate the safety of a predefined 2-h accelerated diagnostic protocol (ADP) to assess patients presenting to the emergency department with chest pain symptoms suggestive of acute coronary syndrome. Methods: This observational study was undertaken in 14 emergency departments in nine countries in the Asia-Pacific region, in patients aged 18 years and older with at least 5 min of chest pain. The ADP included use of a structured pre-test probability scoring method (Thrombolysis in Myocardial Infarction [TIMI] score), electrocardiograph, and point-of-care biomarker panel of troponin, creatine kinase MB, and myoglobin. The primary endpoint was major adverse cardiac events within 30 days after initial presentation (including initial hospital attendance). This trial is registered with the Australia-New Zealand Clinical Trials Registry, number ACTRN12609000283279. Findings: 3582 consecutive patients were recruited and completed 30-day follow-up. 421 (11•8%) patients had a major adverse cardiac event. The ADP classified 352 (9•8%) patients as low risk and potentially suitable for early discharge. A major adverse cardiac event occurred in three (0•9%) of these patients, giving the ADP a sensitivity of 99•3% (95% CI 97•9–99•8), a negative predictive value of 99•1% (97•3–99•8), and a specificity of 11•0% (10•0–12•2). Interpretation: This novel ADP identifies patients at very low risk of a short-term major adverse cardiac event who might be suitable for early discharge. Such an approach could be used to decrease the overall observation periods and admissions for chest pain. The components needed for the implementation of this strategy are widely available. The ADP has the potential to affect health-service delivery worldwide.

Get Into Vocational Education (GIVE) Rockhampton Region Pilot Project : Final Report to The John Villiers Trust

This report describes the Get Into Vocational Education (GIVE) pilot project run in the Rockhampton Region at two schools in 2011. The report includes a description of the project, including its aims, budget, and timeline; and the findings in relation to each of the three major objectives of the project, namely (a) build awareness of, interest in, and familiarity with, trades as a future vocation and opportunity for advancement; (b) enhance literacy, numeracy and science knowledge and performance; and (c) provide motivation and engagement to stay on at school and build towards a productive future. The clear findings of the GIVE Rockhampton Region pilot project are that, for students at risk in terms of school attendance, engagement and learning: (1) awareness of trade practices in horticulture, hospitality, retail, and design and engineering, literacy, mathematics and science knowledge, and motivation and engagement all improve and, in most cases, dramatically improve, in the GIVE structure; and (2) the crucial factor in the GIVE structure that gives the improvement is the integration of classroom work with trades experiences and not the classroom and trades experiences themselves (although it is better if these are good).

Enterprise systems curricula for Asia-Pacific region : a vision for 2020

Enterprise Systems (ES) have emerged as possibly the most important and challenging development in the corporate use of information technology in the last decade. Organizations have invested heavily in these large, integrated application software suites expecting improvments in; business processes, management of expenditure, customer service, and more generally, competitiveness, improved access to better information/knowledge (i.e., business intelligence and analytics). Forrester survey data consistently shows that investment in ES and enterprise applications in general remains the top IT spending priority, with the ES market estimated at $38 billion and predicted to grow at a steady rate of 6.9%, reaching $50 billion by 2012 (Wang & Hamerman, 2008). Yet, organizations have failed to realize all the anticipated benefits. One of the key reasons is the inability of employees to properly utilize the capabilities of the enterprise systems to complete the work and extract information critical to decision making. In response, universities (tertiary institutes) have developed academic programs aimed at addressing the skill gaps. In parallel with the proliferation of ES, there has been growing recognition of the importance of Teaching Enterprise Systems at tertiary education institutes. Many academic papers have discused the important role of Enterprise System curricula at tertiary education institutes (Ask, 2008; Hawking, 2004; Stewart, 2001), where the teaching philosophises, teaching approaches and challenges in Enterprise Systems education were discussed. Following the global trends, tertiary institutes in the Pacific-Asian region commenced introducing Enterprise System curricula in late 1990s with a range of subjects (a subject represents a single unit, rather than a collection of units; which we refer to as a course) in faculties / schools / departments of Information Technology, Business and in some cases in Engineering. Many tertiary educations commenced their initial subject offers around four salient concepts of Enterprise Systems: (1) Enterprise Systems implementations, (2) Introductions to core modules of Enterprise Systems, (3) Application customization using a programming language (e.g. ABAP) and (4) Systems Administration. While universities have come a long way in developing curricula in the enterprise system area, many obstacles remain: high cost of technology, qualified faculty to teach, lack of teaching materials, etc.

Tampere region under the microscope : a critical analysis from the knowledge perspective

Purpose – In the context of global knowledge economy, knowledge-based urban development (KBUD) is seen as an effective development strategy for city-regions to survive, flourish and become highly competitive urban agglomerations – i.e., a knowledge city-region. This paper aims to evaluate the KBUD dynamics, capacity and potentials of a rapidly emerging knowledge city-region of Finland – Tampere region. Design/methodology/approach – The paper undertakes a review of the literature on regional development in the knowledge economy era. It adopts a qualitative analysis technique to scrutinize the dynamics, capacity and potentials of Tampere region. The semi-structured interview process starts with the pre-determined key actors of the city-region with an aim of determining the other key players. Next, with the participation of all key players to the interviews, the research reveals the principal issues, assets and mechanisms that relate to KBUD, and portrays the strengths, weaknesses, opportunities and threats of the city-region. A critical analysis of the findings along with the previous studies is undertaken to provide a clear picture of the dynamics, capacity and potentials of the emerging knowledge city-region. Originality/value – This paper reports the findings of a pioneering study focusing on the investigation of the KBUD dynamics, capacity and potentials of Tampere region. The paper critically evaluates the city-region from the knowledge perspective with the lens of KBUD, and the lessons learned and the methodological approach of the paper shed light to other city-regions seeking such development. Practical implications – The paper discusses the findings of a study from Tampere region that critically scrutinizes the KBUD experience of the city-region. The research provides an invaluable opportunity to inform the regional decision-, policy- and plan-making mechanisms by determining key issues, actors, assets, processes and potential development directions for the KBUD of Tampere region.

Impact of region-of-interest video coding on perceived quality in mobile video

Effective streaming of video can be achieved by providing more bits to the most important region in the frame at the cost of reduced bits in the less important regions. This strategy can be beneficial for delivering high quality videos in mobile devices, especially when the availability of bandwidth is usually low and limited. While the state-of-the-art video codecs such as H.264 may have been optimised for perceived quality, it is hypothesised that users will give more attention to interesting region/object when watching videos. Therefore, giving a higher quality to region of interest (ROI)while reducing quality of other areas may result in improving the overall perceived quality without necessarily increasing the bitrate. In this paper, the impact of ROI-based encoded video on perceived quality is investigated by conducting a user study for varous target bitrates. The results from the user study demonstrate that ROI-based video coding has superior perceived quality compared to normal encoded video at the same bitrate in the lower bitrate range.

Nonprofit organisations face a restructuring state : the case of local social services in the Hunter region of New South Wales

This paper is concerned with certain of the characteristics of local social services, and their role in a restructuring Australian welfare state. I am particularly concerned with the distinctive gender characteristics of these organisations, because in comparison with most other organisations they have a feminised quality. This partly mirrors women's traditional role of undertaking the major part of the caring labour of society. However, simultaneously work in these organisation deviates from more traditional patterns where employed women occupy subordinate positions. In many community organisations, women occupy leadership roles. The analysis here is concerned with the apparently paradoxical nature of these organisations in their capacity to entrench traditional gender roles and to challenge these by allowing women to fill management positions. It is also concerned to examine whether changes that have been occurring in the community services sector over the last two decades are likely to enhance women's general position in the society, or diminish the power exercised by women. The paper draws in a preliminary way on a study of local services in the Hunter Region of NSW undertaken in the latter half of 1992. These preliminary findings are set against the broader picture of developments in the contemporary welfare state.

Waterfall : Nature and Culture

Many people take pleasure in visiting waterfalls and much has been written on the subject. Numerous accounts of Niagara Falls were published after Hennepin's late seventeenth-centure descriptions, particularly from the early nineteenth century, but is was only later that other waterfalls became the subject of books. George Holley's Niagara and Other Famous Cataracts of the World, published in 1883, and John Gibson's Great Waterfalls, Cataracts and Geysers, published in 1887, are early examples of global accounts of major falls. Most books about waterfalls are guides to the falls of a particular country, state or region. Apart from a few slim illustrated volumes, few books have been puslished on the world's waterfalls since Edward Rashleigh's Among the Waterfalls (1935). Most of these are slim pictorial volumes, some aimed at the children's market. Geologist Richard Maxwell Pearl published a series of waterfall articles in his journal Earth Science between 1973 and 1975, apparently with the intention of turning them into a book, but this never materialized. My book, the culmination of more than a decade of waterfalls research, is comprehensive in its approach, but is not intended to describe as many of the world's waterfalls as possible. This is far from my aim, and readers may be disappointed at my omission of falls they feel deserved mention. What I have attempted to do is celebrate the delights of these beautiful wonders of nature by considering them from many points of view, emphasizing the roles that they play in the human experience. To be as representative as possible, I draw on examples of waterfalls from all over the world, some famous, many not. North and South America, Europe, Africa, Asia and Oceania and, with recent global warming, the Earth's polar regions, all feature in the discussion. Even though there are already enough books and articles about Niagara Falls to fill a large library, it has been impossible to avoid making frequent reference to this great cataract, which has been so important in the history of travel and tourism, power generation, urban development and art. Amoung the issues that I consider is the human impact on waterfalls, particularly the effects of hydropower schemes and tourism development. Also considered are artificial waterfalls, which have long been features of the designed landscape. Their contemporay role is poignantly exemplified in the design of the National September 11 Memorial, in which the footprints of the Twin Towers are traced by walls of waterfalls. A geographer and urban and regional planner by training, I have ventured into many other fields of knowledge that are outside my areas of expertise. I apologize for any errors that I may have made in my book and invite correction.

Automatic region-of-interest detection and prioritisation for visually optimised coding of low bit rate videos

The increasing popularity of video consumption from mobile devices requires an effective video coding strategy. To overcome diverse communication networks, video services often need to maintain sustainable quality when the available bandwidth is limited. One of the strategy for a visually-optimised video adaptation is by implementing a region-of-interest (ROI) based scalability, whereby important regions can be encoded at a higher quality while maintaining sufficient quality for the rest of the frame. The result is an improved perceived quality at the same bit rate as normal encoding, which is particularly obvious at the range of lower bit rate. However, because of the difficulties of predicting region-of-interest (ROI) accurately, there is a limited research and development of ROI-based video coding for general videos. In this paper, the phase spectrum quaternion of Fourier Transform (PQFT) method is adopted to determine the ROI. To improve the results of ROI detection, the saliency map from the PQFT is augmented with maps created from high level knowledge of factors that are known to attract human attention. Hence, maps that locate faces and emphasise the centre of the screen are used in combination with the saliency map to determine the ROI. The contribution of this paper lies on the automatic ROI detection technique for coding a low bit rate videos which include the ROI prioritisation technique to give different level of encoding qualities for multiple ROIs, and the evaluation of the proposed automatic ROI detection that is shown to have a close performance to human ROI, based on the eye fixation data.

Quality of work life among primary health care nurses in the Jazan region, Saudi Arabia : a crosssectional study

Background: Quality of work life (QWL) is defined as the extent to which employee is satisfied with personal and working needs through participating in the workplace while achieving the organisation’s goals. QWL has been found to influence the commitment and productivity of employees in healthcare organisations, as well as in other industries. However, reliable information on the QWL of PHC nurses is limited. The purpose of this study was to assess the QWL among PHC nurses in the Jazan region, Saudi Arabia. Methods: A descriptive research design, namely, a cross-sectional survey was used in this study. Data were collected using Brooks’ survey of quality of nursing work life (QNWL) and demographic questions. A convenience sample was recruited from 143 PHC centres in Jazan, Saudi Arabia. The Jazan region is located in the southern part of Saudi Arabia. A response rate of 91% (N = 532/585) was achieved (effective RR = 87%, n = 508). Data analysis consisted of descriptive statistics, t-test and one way-analysis of variance. Total scores and sub-scores for QWL Items and item summary statistics were computed and reported, using SPSS version 17 for Windows. Results: Findings suggested that the respondents were dissatisfied with their work life. The major influencing factors were unsuitable working hours/shifts, lack of facilities for nurses, inability to balance work with family needs, inadequacy of family-leave time, poor staffing, management and supervision practices, lack of professional development opportunities, and inappropriate working environment in terms of the level of security, patient care supplies and equipment, and recreation facilities (Break-area). Other essential factors include the community’s view of nursing and inadequate salary. More positively, the majority of nurses were satisfied with their co-workers, satisfied to be nurses and had a sense of belonging in their workplaces. Significant differences were found according to gender, age, marital status, dependent children, dependent adults, nationality, ethnicity, nursing tenure, organisational tenure, positional tenure, and payment per month. No significant differences were found according to education level and location of PHC. Conclusions: These findings can be used by PHC managers and policy makers for developing and appropriately implementing successful plans to improve the QWL. This will help to enhance the home and work environments, improve individual and organisation performance and increase nurses’ commitment.

Identification of long intergenic region sequences involved in maize streak virus replication

The main cis-acting control regions for replication of the single-stranded DNA genome of maize streak virus (MSV) are believed to reside within an approximately 310 nt long intergenic region (LIR). However, neither the minimum LIR sequence required nor the sequence determinants of replication specificity have been determined experimentally. There are iterated sequences, or iterons, both within the conserved inverted-repeat sequences with the potential to form a stem-loop structure at the origin of virion-strand replication, and upstream of the rep gene TATA box (the rep-proximal iteron or RPI). Based on experimental analyses of similar iterons in viruses from other geminivirus genera and their proximity to known Rep-binding sites in the distantly related mastrevirus wheat dwarf virus, it has been hypothesized that the iterons may be Rep-binding and/or -recognition sequences. Here, a series of LIR deletion mutants was used to define the upper bounds of the LIR sequence required for replication. After identifying MSV strains and distinct mastreviruses with incompatible replication-specificity determinants (RSDs), LIR chimaeras were used to map the primary MSV RSD to a 67 nt sequence containing the RPI. Although the results generally support the prevailing hypothesis that MSV iterons are functional analogues of those found in other geminivirus genera, it is demonstrated that neither the inverted-repeat nor RPI sequences are absolute determinants of replication specificity. Moreover, widely divergent mastreviruses can trans-replicate one another. These results also suggest that sequences in the 67 nt region surrounding the RPI interact in a sequence-specific manner with those of the inverted repeat.

The governance of inter-organisational decision-making : understanding the impacts of informal networks on formal decision-making regimes in the Brisbane Airport region

Airports and cities inevitably recognise the value that each brings the other; however, the separation in decision-making authority for what to build, where, when and how provides a conundrum for both parties. Airports often want a say in what is developed outside of the airport fence, and cities often want a say in what is developed inside the airport fence. Defining how much of a say airports and cities have in decisions beyond their jurisdictional control is likely to be a topic that continues so long as airports and cities maintain separate formal decision-making processes for what to build, where, when and how. However, the recent Green and White Papers for a new National Aviation Policy have made early inroads to formalising relationships between Australia’s major airports and their host cities. At present, no clear indication (within practice or literature) is evident to the appropriateness of different governance arrangements for decisions to develop in situations that bring together the opposing strategic interests of airports and cities; thus leaving decisions for infrastructure development as complex decision-making spaces that hold airport and city/regional interests at stake. The line of enquiry is motivated by a lack of empirical research on networked decision-making domains outside of the realm of institutional theorists (Agranoff & McGuire, 2001; Provan, Fish & Sydow, 2007). That is, governance literature has remained focused towards abstract conceptualisations of organisation, without focusing on the minutia of how organisation influences action in real-world applications. A recent study by Black (2008) has provided an initial foothold for governance researchers into networked decision-making domains. This study builds upon Black’s (2008) work by aiming to explore and understand the problem space of making decisions subjected to complex jurisdictional and relational interdependencies. That is, the research examines the formal and informal structures, relationships, and forums that operationalise debates and interactions between decision-making actors as they vie for influence over deciding what to build, where, when and how in airport-proximal development projects. The research mobilises a mixture of qualitative and quantitative methods to examine three embedded cases of airport-proximal development from a network governance perspective. Findings from the research provide a new understanding to the ways in which informal actor networks underpin and combine with formal decision-making networks to create new (or realigned) governance spaces that facilitate decision-making during complex phases of development planning. The research is timely, and responds well to Isett, Mergel, LeRoux, Mischen and Rethemeyer’s (2011) recent critique of limitations within current network governance literature, specifically to their noted absence of empirical studies that acknowledge and interrogate the simultaneity of formal and informal network structures within network governance arrangements (Isett et al., 2011, pp. 162-166). The combination of social network analysis (SNA) techniques and thematic enquiry has enabled findings to document and interpret the ways in which decision-making actors organise to overcome complex problems for planning infrastructure. An innovative approach to using association networks has been used to provide insights to the importance of the different ways actors interact with one another, thus providing a simple yet valuable addition to the increasingly popular discipline of SNA. The research also identifies when and how different types of networks (i.e. formal and informal) are able to overcome currently known limitations to network governance (see McGuire & Agranoff, 2011), thus adding depth to the emerging body of network governance literature surrounding limitations to network ways of working (i.e. Rhodes, 1997a; Keast & Brown, 2002; Rethemeyer & Hatmaker, 2008; McGuire & Agranoff, 2011). Contributions are made to practice via the provision of a timely understanding of how horizontal fora between airports and their regions are used, particularly in the context of how they reframe the governance of decision-making for airport-proximal infrastructure development. This new understanding will enable government and industry actors to better understand the structural impacts of governance arrangements before they design or adopt them, particularly for factors such as efficiency of information, oversight, and responsiveness to change.

Characterization of sky-region morphological-temporal airborne collision detection

Automated airborne collision-detection systems are a key enabling technology for facilitat- ing the integration of unmanned aerial vehicles (UAVs) into the national airspace. These safety-critical systems must be sensitive enough to provide timely warnings of genuine air- borne collision threats, but not so sensitive as to cause excessive false-alarms. Hence, an accurate characterisation of detection and false alarm sensitivity is essential for understand- ing performance trade-offs, and system designers can exploit this characterisation to help achieve a desired balance in system performance. In this paper we experimentally evaluate a sky-region, image based, aircraft collision detection system that is based on morphologi- cal and temporal processing techniques. (Note that the examined detection approaches are not suitable for the detection of potential collision threats against a ground clutter back- ground). A novel collection methodology for collecting realistic airborne collision-course target footage in both head-on and tail-chase engagement geometries is described. Under (hazy) blue sky conditions, our proposed system achieved detection ranges greater than 1540m in 3 flight test cases with no false alarm events in 14.14 hours of non-target data (under cloudy conditions, the system achieved detection ranges greater than 1170m in 4 flight test cases with no false alarm events in 6.63 hours of non-target data). Importantly, this paper is the first documented presentation of detection range versus false alarm curves generated from airborne target and non-target image data.

Image Region Salience for Improving Appearance-Based Place Recognition using a Supervised Classifier System

Many state of the art vision-based Simultaneous Localisation And Mapping (SLAM) and place recognition systems compute the salience of visual features in their environment. As computing salience can be problematic in radically changing environments new low resolution feature-less systems have been introduced, such as SeqSLAM, all of which consider the whole image. In this paper, we implement a supervised classifier system (UCS) to learn the salience of image regions for place recognition by feature-less systems. SeqSLAM only slightly benefits from the results of training, on the challenging real world Eynsham dataset, as it already appears to filter less useful regions of a panoramic image. However, when recognition is limited to specific image regions performance improves by more than an order of magnitude by utilising the learnt image region saliency. We then investigate whether the region salience generated from the Eynsham dataset generalizes to another car-based dataset using a perspective camera. The results suggest the general applicability of an image region salience mask for optimizing route-based navigation applications.