A comparative analysis of risk stratification tools for emergency department patients with chest pain

Background: Appropriate disposition of emergency department (ED) patients with chest pain is dependent on clinical evaluation of risk. A number of chest pain risk stratification tools have been proposed. The aim of this study was to compare the predictive performance for major adverse cardiac events (MACE) using risk assessment tools from the National Heart Foundation of Australia (HFA), the Goldman risk score and the Thrombolysis in Myocardial Infarction risk score (TIMI RS). Methods: This prospective observational study evaluated ED patients aged ≥30 years with non-traumatic chest pain for which no definitive non-ischemic cause was found. Data collected included demographic and clinical information, investigation findings and occurrence of MACE by 30 days. The outcome of interest was the comparative predictive performance of the risk tools for MACE at 30 days, as analyzed by receiver operator curves (ROC). Results: Two hundred eighty-one patients were studied; the rate of MACE was 14.1%. Area under the curve (AUC) of the HFA, TIMI RS and Goldman tools for the endpoint of MACE was 0.54, 0.71 and 0.67, respectively, with the difference between the tools in predictive ability for MACE being highly significant [chi2 (3) = 67.21, N = 276, p < 0.0001]. Conclusion: The TIMI RS and Goldman tools performed better than the HFA in this undifferentiated ED chest pain population, but selection of cutoffs balancing sensitivity and specificity was problematic. There is an urgent need for validated risk stratification tools specific for the ED chest pain population.

Participation in science and technology : young people's achievement-related choices in late modern societies

Young people’s participation in science, technology, engineering and mathematics (STEM) is a matter of international concern. Studies and careers that require physical sciences and advanced mathematics are most affected by the problem and women in particular are under-represented in many STEM fields. This article views international research about young people’s relationships to, and participation in, STEM subjects and careers through the lens of an expectancy value model of achievement-related choices. In addition it draws on sociological theories of late-modernity and identity, which situate decision-making in a cultural context. The article examines how these frameworks are useful in explaining the decisions of young people – and young women in particular – about participating in STEM and proposes possible strategies for removing barriers to participation.

Management [5th Asia-Pacific Edition]

The fifth edition of this text has been thoroughly updated, continuing its strong emphasis on the importance of the Asian region to contemporary Australian and New Zealand organisations. Many Asian case examples are featured to illustrate key management concepts, and these provide a useful basis for comparison with management practices in Australia and New Zealand. Numerous practical examples throughout the text highlight contemporary management issues, such as: •workplace diversity •sustainability •ethics/corporate social responsibility •the impact of technology •innovation in the workplace •globalisation •employee engagement •flexible working arrangements •work-life balance •generational issues in the workplace •skills shortages in various industries •the importance of effective employee recruitment and training •organisational culture •workforce flexibility and casualisation •the ‘24/7’ nature of contemporary communication technology, including social media •outsourcing Management, 5th Asia Pacific edition, has also retained the features that have made previous editions so popular with students and lecturers, including the Career Readiness Workbook activities at the end of the book, and the accompanying Interactive Study Guide with its vast array of multimedia resources.

Management : Foundations and Applications (2nd Asia-Pacific Edition)

The second edition of this text has been thoroughly updated, continuing its strong emphasis on the importance of the Asian region to contemporary Australian and New Zealand organisations. Many Asian case examples are featured to illustrate key management concepts, and these provide a useful basis for comparison with management practices in Australia and New Zealand. Numerous practical examples throughout the text highlight contemporary management issues, such as: •workplace diversity •sustainability •ethics/corporate social responsibility •the impact of technology •innovation in the workplace •globalisation •employee engagement •flexible working arrangements •work-life balance •generational issues in the workplace •skills shortages in various industries •the importance of effective employee recruitment and training •organisational culture •workforce flexibility and casualisation •the ‘24/7’ nature of contemporary communication technology, including social media •outsourcing Management, Foundation and Applications, 2nd Asia-Pacific edition, has also retained the features that made its previous edition so popular with students and lecturers, including the Career Readiness Workbook activities at the end of the book, and the accompanying Interactive Study Guide with its vast array of multimedia resources.

Iterative intersections

Iterative Intersectioning is a body of art works that comes out of the collaboration between author and electronic artist Jen Seevinck and a community of print artists, most particularly Elizabeth Saunders (EJ) and Robert Oakman. The work shown here is concerned with the creative process of collaboration, specifically as this informs visual forms. This is through our focus on process. This process has facilitated a 'conversational' exchange between all artists and a corresponding evolution in the artworks. In each case the dialogue is either between the author, Jen and EJ or between Jen and Robert. It consists of passing work between parties, interpreting it and working into it, before passing it back. The result is a series of art works including those shown here. The concept evolves in parallel to this. Importantly, at each of her iterations of creative work, the author Jen determines a similar 'treatment' or 'interpretation' across both print artists works at that time. A synthesis of EJ and Robert's creative interpretation -- at a high level -- occurs. In this sense the concept and works can be understood to intersect with one another.

Collaborative practices that support creativity in design

Design is a ubiquitous, collaborative and highly material activity. Because of the embodied nature of the design profession, designers apply certain collaborative practices to enhance creativity in their everyday work. Within the domain of industrial design, we studied two educational design departments over a period of eight months. Using examples from our fieldwork, we develop our results around three broad themes related to collaborative practices that support the creativity of design professionals: 1) externalization, 2) use of physical space, and; 3) use of bodies. We believe that these themes of collaborative practices could provide new insights into designing technologies for supporting a varied set of design activities. We describe two conceptual collaborative systems derived from the results of our study.

Eutrophication weakens stabilizing effects of diversity in natural grasslands

Studies of experimental grassland communities have demonstrated that plant diversity can stabilize productivity through species asynchrony, in which decreases in the biomass of some species are compensated for by increases in others. However, it remains unknown whether these findings are relevant to natural ecosystems, especially those for which species diversity is threatened by anthropogenic global change. Here we analyse diversity-stability relationships from 41 grasslands on five continents and examine how these relationships are affected by chronic fertilization, one of the strongest drivers of species loss globally. Unmanipulated communities with more species had greater species asynchrony, resulting in more stable biomass production, generalizing a result from biodiversity experiments to real-world grasslands. However, fertilization weakened the positive effect of diversity on stability. Contrary to expectations, this was not due to species loss after eutrophication but rather to an increase in the temporal variation of productivity in combination with a decrease in species asynchrony in diverse communities. Our results demonstrate separate and synergistic effects of diversity and eutrophication on stability, emphasizing the need to understand how drivers of global change interactively affect the reliable provisioning of ecosystem services in real-world systems.

The prevention of childhood anxiety and promotion of resilience among preschool-aged children : a universal school based trial

This study is the first to examine the effectiveness of the Fun FRIENDS programme, a school-based, universal preventive intervention for early childhood anxiety and promotion of resilience delivered by classroom teachers. Participants (N = 488) included children aged 4–7 years attending 1 of 14 Catholic Education schools in Brisbane, Australia. The schools were randomly allocated to one of three groups, the intervention, active comparison and waitlist control group. Parents completed standardized measures of anxiety and behavioural inhibition (BI), resilience, social and emotional functioning and behaviour difficulties in addition to parental stress and anxiety, at pre- and post- and 12-month follow-up. Teachers also completed a parallel measure of social and emotional strength at the three time points. Comparable results were obtained for the intervention and comparison groups; however, the intervention group (IG) achieved greater reductions in BI, child behavioural difficulties and improvements in social and emotional competence. In addition, significant improvements in parenting distress and parent–child interactions were found for the IG, with gains maintained at 12-month follow-up. Teacher reports revealed more significant improvement in social and emotional competence for the IG. Clinical implications of the findings are discussed, along with limitations and directions for future research.

Herbivores and nutrients control grassland plant diversity via light limitation

Human alterations to nutrient cycles1, 2 and herbivore communities3, 4, 5, 6, 7 are affecting global biodiversity dramatically2. Ecological theory predicts these changes should be strongly counteractive: nutrient addition drives plant species loss through intensified competition for light, whereas herbivores prevent competitive exclusion by increasing ground-level light, particularly in productive systems8, 9. Here we use experimental data spanning a globally relevant range of conditions to test the hypothesis that herbaceous plant species losses caused by eutrophication may be offset by increased light availability due to herbivory. This experiment, replicated in 40 grasslands on 6 continents, demonstrates that nutrients and herbivores can serve as counteracting forces to control local plant diversity through light limitation, independent of site productivity, soil nitrogen, herbivore type and climate. Nutrient addition consistently reduced local diversity through light limitation, and herbivory rescued diversity at sites where it alleviated light limitation. Thus, species loss from anthropogenic eutrophication can be ameliorated in grasslands where herbivory increases ground-level light.

Reactive stepping behaviour in response to forward loss of balance predicts future falls in community-dwelling older adults

Background: a fall occurs when an individual experiences a loss of balance from which they are unable to recover. Assessment of balance recovery ability in older adults may therefore help to identify individuals at risk of falls. The purpose of this 12-month prospective study was to assess whether the ability to recover from a forward loss of balance with a single step across a range of lean magnitudes was predictive of falls. Methods: two hundred and one community-dwelling older adults, aged 65–90 years, underwent baseline testing of sensorimotor function and balance recovery ability followed by 12-month prospective falls evaluation. Balance recovery ability was defined by whether participants required either single or multiple steps to recover from forward loss of balance from three lean magnitudes, as well as the maximum lean magnitude participants could recover from with a single step. Results: forty-four (22%) participants experienced one or more falls during the follow-up period. Maximal recoverable lean magnitude and use of multiple steps to recover at the 15% body weight (BW) and 25%BW lean magnitudes significantly predicted a future fall (odds ratios 1.08–1.26). The Physiological Profile Assessment, an established tool that assesses variety of sensori-motor aspects of falls risk, was also predictive of falls (Odds ratios 1.22 and 1.27, respectively), whereas age, sex, postural sway and timed up and go were not predictive. Conclusion: reactive stepping behaviour in response to forward loss of balance and physiological profile assessment are independent predictors of a future fall in community-dwelling older adults. Exercise interventions designed to improve reactive stepping behaviour may protect against future falls.

Building the science and innovation base: work, skills and employment issues

This Special Issue of New Technology, Work and Employment has been prompted by the increasing awareness in many countries of the need to maintain and grow their science and innovation base. The development of science, engineering, technology and mathematics (STEM) skills and capacity is seen as vital for economic development and prosperity through its impact on national and regional research and development (R&D), technological advancement, and innovation potential.

Correlates of perceiving human resource management as a 'problem' in smaller firms

In this paper we investigate factors likely to correlate with human resource management (HRM) being perceived as a problem in smaller firms. The owner-manager and firm characteristics identified recognise that managerial ‘problems’ can result from a firm���s phase of growth, as well as the way in which an owner-manager’s capacity and characteristics affect their interpretation of such. From a survey of 1200 smaller firms in south east Melbourne (Australia), we use logistic regression on data from 428 respondents to assess organisational and individual factors correlating with perceiving HRM, broadly defined, to be a problem. The highest odds of this occurring were associated with being a larger manufacturing firm which was in a phase of growth other than diversification and which had a long-tenured manager who based the firm���s competitive success on factors other than the quality of staff. Knowing these correlates means assistance to help solve the perceived ‘problem��� with HRM can be more effectively targeted.

Health and safety regulatory reform in Australia : challenges and issues for smaller ethnic firms

In recent times significant change has occurred to the Australian health and safety regulatory context. In this paper we consider the potential response of smaller firms in general, and ethnic owned and/or operated smaller firms in particular. We draw on literature examining smaller firms' responses to regulation and apply this to what little we know about smaller ethnic firms in Australia in the context of the regulatory change. We highlight the challenges to owner managers and what could be done to engage and support smaller ethnic firms to realise the opportunities resulting from this regulatory change.

Small firms and the challenge of equality, diversity and difference

Purpose The purpose of this paper is to introduce the papers contributing to this special issue and to locate them within the broader questions about the role of small firms in enabling or alleviating issues of equality, diversity, and difference for various groups in society. Design/methodology/approach The literature dealing with the issues of equality, diversity, and difference pertaining to the operation of and/or working in smaller firms was reviewed prior to drawing out the key points from the submitted papers and considering the contribution they make to this literature. Findings Overall, one's these five papers contribute to one's understanding of the issues facing those in business or self‐employment, working in small business or wanting to pursue enterprise. Originality/value Rarely are questions asked about the assumed role small firms play in mitigating social exclusion for a range of groups in society. By addressing questions which explore the challenge of equality, diversity, and difference for small business in their establishment, management, and effective operation using interdisciplinary frameworks and different methodologies, a better understanding of the role of small business in society can be developed.

Small firms and health and safety harmonisation : potential regulatory effects of a dominant narrative

Small firms are popularly viewed as resistant to complying with regulation. Harmonisation of Australia’s state-based work health and safety regimes is a significant regulatory change. In this article, we consider the likely responses of small firms to work health and safety harmonisation and argue that a range of choices are open to small firm owner-managers. These choices are shaped by individuals’ world views and are influenced by elements in the firms’ context. A significant element is the public narrative of work health and safety harmonisation, which can be understood by using discourse and sense-making concepts. Our analysis of small firm owner-manager choices takes into account small firms’ embeddedness in their regulatory context and the influence on organisational decision-making of the narrative of work health and safety harmonisation. The dominant narrative is arguably silent on the benefits of the work health and safety regulatory change and therefore the response of small firms is likely to be avoidance or minimalism. Non-compliance could be the result due to poor awareness of opportunities arising from this regulatory change.