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.

Current trends and challenges for sport and exercise psychology – What now for our discipline?

With an ever changing landscape including National Registration, endorsed areas of practice, establishment of Sport and Exercise Psychology coordinators within National Sporting Organisations, changes to the National and State Sporting Insitutions, this forum looks to explore through collegiate discussion the impacts, current and future implications for our profession across training, supervision, research and applied practice in Australia.

Commercial Leases in Australia [7th ed.]

Commercial Leases in Australia is a comprehensive guide to understanding and drafting commercial leases agreements in Australia and to managing disputes when they arise.

Competition Law in Australia [6th ed.]

Competition Law in Australia, 6th edition provides a comprehensive discussion of the provisions of the Competition and Consumer Act 2010 (Cth) (CCA) dealing with the regulation of competition and markets in Australia. This book covers disparate topics, such as restrictions in horizontal and vertical agreements, horizontal mergers and acquisitions, misuse of market power, and access to services necessary to compete in upstream or downstream markets. However, the unifying theme of this text is that it is not possible to use a formalistic approach in applying the CCA. The decisions of the courts, and the competition authorities responsible for implementing and enforcing the CCA, underline the need to undertake a detailed substantive economic analysis of the effect of the agreement or conduct at issue on competition, efficiency and consumer welfare.

Ecological and Behavioral Methods for the Study of Bats [2nd. Ed.]

"First published in 1988, Ecological and Behavioral Methods for the Study of Bats is widely acknowledged as the primary reference for both amateur and professional bat researchers. Bats are the second most diverse group of mammals on the earth. They live on every continent except Antarctica, ranging from deserts to tropical forests to mountains, and their activities have a profound effect on the ecosystems in which they live. Despite their ubiquity and importance, bats are challenging to study. This volume provides researchers, conservationists, and consultants with the ecological background and specific information essential for studying bats in the wild and in captivity. Chapters detail many of the newest and most commonly used field and laboratory techniques needed to advance the study of bats, describe how these methods are applied to the study of the ecology and behavior of bats, and offer advice on how to interpret the results of research. The book includes forty-three chapters, fourteen of which are new to the second edition, with information on molecular ecology and evolution, bioacoustics, chemical communication, flight dynamics, population models, and methods for assessing postnatal growth and development. Fully illustrated and featuring contributions from the world’s leading experts in bat biology, this reference contains everything bat researchers and natural resource managers need to know for the study and conservation of this wide-ranging, ecologically vital, and diverse taxon."--Publisher website

Tech Ed students strut their stuff: information literacy and a practical assignment

This reports a study that seeks to explore the experience of students majoring in technology and design in an undergraduate education degree. It examines their experiences in finding and using information for a practical assignment. In mapping the variation of the students' experience, the study uses a qualitative, interpretive approach to analyse the data, which was collected via one-to-one interviews. The analysis yielded five themes through which technology education students find and use information: interaction with others; experience (past and new); formal educational learning; the real world; and incidental occurrences. The intentions and strategies that form the students' approaches to finding and using information are discussed. So too are the implications for teaching practice.

Questions and Answers : Contract Law [5th ed.]

LexisNexis Questions & Answers - Contract Law provides an understanding of contract law and gives a clear and systematic approach to analysing and answering problem and exam questions. Each chapter commences with a summary of the relevant cases and identification of the key issues. Each question is followed by a suggested answer plan, a sample answer and comments on how the answer might be assessed by an examiner. The author also offers advice on common errors to avoid and practical hints and tips on how to achieve higher marks.

Legal Theories : Contexts and Practices [2nd ed.]

Legal Theories: Contexts and Practices presents legal theory as a living and evolving entity. The reader is brought into its story as an active participant who is challenged to think about where they sit within the history and traditions of legal theory and jurisprudence. This second edition explores how lawyers and the courts adopt theoretical and jurisprudential positions and how they are influenced by the historical, social, cultural, and legal conditions characteristic of the time in which they live. It considers how legal theories, too, are influenced by those conditions, and how these combined forces influence and continue to affect contemporary legal thinking and legal interpretation.