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.

Peter Alwast talks to Grant Stevens

This interview was published in the catalogue for Peter Alwast's solo exhibition, "Future Perfect", at the Institute of Modern Art, Brisbane, in August 2011.

Accused headmaster turned me into pedophile, says convicted cleric Peter Gilbert

A CLERGYMAN who allegedly raped boys at a north Queensland boarding school in the 1960s has claimed he was ordered to take female hormones by his headmaster, who encouraged the "romantic love" of children among staff. Former Anglican brother Peter Gilbert - sentenced to seven years' jail in 2006 for the rape and indecent assault of children in the 1980s in South Australia - has blamed St Barnabas headmaster the late Robert Waddington for turning him into a pedophile. In a statement to one of his alleged victims, Gilbert said Waddington was molesting children himself and the Anglican priest would absolve the young teacher of his abuse of children in the confessional. The account has emerged as the top ranks of the Anglican church in Australia and Britain have been rocked by allegations of the covering-up of complaints made in 1999 and 2003 about Waddington's abuse while headmaster at the boarding school in Ravenshoe, north Queensland, and later, when he was dean of Manchester. A full investigation is being demanded into the handling of the complaints by the former Archbishop of York, now Lord (David) Hope of Thornes, and Australian church officials, including the former bishop of north Queensland, Clyde Wood.

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.

Cungellela by William ‘Dura Danje’ Leisha and Shem ‘Curan Danje’ Leisha

Research background: Cungelela is an intercultural music project undertaken in collaboration with William ‘Dura Danje’ Leisha and Shem ‘Curan Danje’ Leisha. The project contributes to cultural maintenance for Australian First Nations peoples, and is informed by prior work in this area by scholars including Peter Dunbar-Hall, Chris Gibson and Karl Neuenfeldt. These existing studies have discussed the complexities of intercultural collaboration, and the types of cultural politics that are involved when Indigenous and non-Indigenous musicians and scholars work together on projects of cultural significance. Critical race theory has also informed the creative work, as a means of interpreting the implicit and explicit discourses of race that arise through intercultural creative practice. The project asked the research question, in what ways can collaborative music making contribute to intercultural understanding and support cultural maintenance for Australian First Nations people affected by the Stolen Generations? Research contribution: This project has identified that collaborative production of recorded popular music can produce shared affective, embodied and transformative forms of knowledge about the impact of the Stolen Generations on Australian First Nations peoples. Research significance: The compact disc was presented by Aunty Anne Leisha as part of an invited presentation at the World Indigenous Nations Higher Education Consortium in New Mexico, 2013. The work also formed part of a refereed conference presentation at the 2013 conference of the International Association for the Study of Popular Music held at the University of Oviedo, Gijon, Spain.

Security and legal issues in E-tendering

The Queensland Department of Public Works (QDPW) and the Queensland Department of Main Roads (QDMR) have identified a need for industry e-contracting guidelines in the short to medium term. Each of these organisations conducts tenders and contracts for over $600 million annually. This report considers the security and legal issues relating to the shift from a paper-based tendering system to an electronic tendering system. The research objectives derived from the industry partners include: • a review of current standards and e-tendering systems; • a summary of legal requirements impacting upon e-tendering; • an analysis of the threats and requirements for any e-tendering system; • the identification of outstanding issues; • an evaluation of possible e-tendering architectures; • recommendations for e-tendering systems.

Defining an Identity : The Evolution of Science Education

Research in science education is now an international activity. This book asks for the first time, Does this research activity have an identity?-It uses the significant studies of more than 75 researchers in 15 countries to see to what extent they provide evidence for an identity as a distinctive field of research.-It considers trends in the research over time, and looks particularly at what progression in the research entails.-It provides insight into how researchers influence each other and how involvement in research affects the being of the researcher as a person.-It addresses the relation between research and practice in a manner that sees teaching and learning in the science classroom as interdependent with national policies and curriculum traditions about science. It gives graduate students and other early researchers an unusual overview of their research area as a whole. Established researchers will be interested in, and challenged by, the identity the author ascribes to the research and by the plea he makes for the science content itself to be seen as problematic.

Generalising unitary time evolution

In this third Quantum Interaction (QI) meeting it is time to examine our failures. One of the weakest elements of QI as a field, arises in its continuing lack of models displaying proper evolutionary dynamics. This paper presents an overview of the modern generalised approach to the derivation of time evolution equations in physics, showing how the notion of symmetry is essential to the extraction of operators in quantum theory. The form that symmetry might take in non-physical models is explored, with a number of viable avenues identified.

St. John’s wort and Kava in treating major depressive disorder with comorbid anxiety : a randomised double-blind placebo-controlled pilot trial

Objective - We report the first randomised controlled trial (RCT) using a combination of St. John’s wort (SJW) and Kava for the treatment of major depressive disorder (MDD) with comorbid anxiety. Methods - Twenty-eight adults with MDD and co-occurring anxiety were recruited for a double-blind RCT. After a placebo run-in of 2 weeks, the trial had a crossover design testing SJW and Kava against placebo over two controlled phases, each of 4 weeks. The primary analyses used intention-to-treat and completer analyses. Results - On both intention-to-treat ( p¼0.047) and completer analyses ( p¼0.003), SJW and Kava gave a significantly greater reduction in self-reported depression on the Beck Depression Inventory (BDI-II) over placebo in the first controlled phase. However, in the crossover phase, a replication of those effects in the delayed medication group did not occur. Nor were there significant effects on anxiety or quality of life. Conclusion - There was some evidence of antidepressant effects using SJW and Kava in a small sample with comorbid anxiety. Possible explanations for the absence of anxiolysis may include a potential interaction with SJW, the presence of depression, or an inadequate dose of Kava.

Tackling the burden of injury in Australasia : developing a binational trauma registry

Existing trauma registries in Australia and New Zealand play an important role in monitoring the management of injured patients. Over the past decade, such monitoring has been translated into changes in clinical processes and practices. Monitoring and changes have been ad hoc, as there are currently no Australasian benchmarks for “optimal” injury management. A binational trauma registry is urgently needed to benchmark injury management to improve outcomes for injured patients.

Kava and St. John's wort : current evidence for use in mood and anxiety disorders

Background: Mood and anxiety disorders pose significant health burdens on the community. Kava and St John’s wort (SJW) are the most commonly used herbal medicines in the treatment of anxiety and depressive disorders, respectively. Objectives: To conduct a comprehensive review of kava and SJW, to review any evidence of efficacy, mode of action, pharmacokinetics, safety and use in Major Depressive Disorder (MDD), Bipolar Disorder (BP), Seasonal Affective Disorder (SAD), Generalized Anxiety Disorder (GAD), Social Phobia (SP), Panic Disorder (PD), Obsessive-Compulsive Disorder (OCD), and Post Traumatic Stress Disorder (PTSD). Methods: A systematic review was conducted using the electronic databases MEDLINE, CINAHL, and The Cochrane Library during late 2008. The search criteria involved mood and anxiety disorder search terms in combination with kava, Piper methysticum, kavalactones, St John’s wort, Hypericum perforatum, hypericin and hyperforin. Additional search criteria for safety, pharmacodynamics , and pharmacokinetics was employed. A subsequent forward search was conducted of the papers using Web of Science cited reference search. Results: Current evidence supports the use of SJW in treating mild-moderate depression, and for kava in treatment of generalized anxiety. In respect to the other disorders, only weak preliminary evidence exists for use of SJW in SAD. Currently there is no published human trial on use of kava in affective disorders, or in OCD, PTSD, PD or SP. These disorders constitute potential applications that warrant exploration. Conclusions: Current evidence for herbal medicines in the treatment of depression and anxiety only supports the use of Hypericum perforatum for depression, and Piper methysticum for generalized anxiety.

Development of descriptor tools for the characterization of Australian sugar mill evaporator scale

Cleaning of sugar mill evaporators is an expensive exercise. Identifying the scale components assists in determining which chemical cleaning agents would result in effective evaporator cleaning. The current methods (based on x-ray diffraction techniques, ion exchange/high performance liquid chromatography and thermogravimetry/differential thermal analysis) used for scale characterisation are difficult, time consuming and expensive, and cannot be performed in a conventional analytical laboratory or by mill staff. The present study has examined the use of simple descriptor tests for the characterisation of Australian sugar mill evaporator scales. Scale samples were obtained from seven Australian sugar mill evaporators by mechanical means. The appearance, texture and colour of the scale were noted before the samples were characterised using x-ray fluorescence and x-ray powder diffraction to determine the compounds present. A number of commercial analytical test kits were used to determine the phosphate and calcium contents of scale samples. Dissolution experiments were carried out on the scale samples with selected cleaning agents to provide relevant information about the effect the cleaning agents have on different evaporator scales. Results have shown that by simply identifying the colour and the appearance of the scale, the elemental composition and knowing from which effect the scale originates, a prediction of the scale composition can be made. These descriptors and dissolution experiments on scale samples can be used to provide factory staff with an on-site rapid process to predict the most effective chemicals for chemical cleaning of the evaporators.