Discordant age and sex-specific trends in the incidence of a first coronary heart disease event in Western Australia from 1996 to 2007

OBJECTIVE: To determine age- and sex-specific population trends in fatal and non-fatal first coronary heart disease (CHD) events in Western Australia from 1996 to 2007. DESIGN: Longitudinal retrospective population study. SETTING: State-wide population. PATIENTS: All residents aged 35-84 years during 1996-2007 who died or were hospitalised with a principal diagnosis of acute CHD. DATA SOURCES: Person-linked file of mortality and morbidity records. MAIN OUTCOME MEASURES: Age-standardised (35-84 years) and age-specific (35-54, 55-69, 70-84 years) rates by gender for a first CHD event were calculated with a 10-year lead-in period to define first events. RESULTS: From 1996 to 2007 there were 36 631 first CHD events, including 8518 (23%) fatal cases in those aged 35-84 years. Overall, age-adjusted rates for fatal first CHD declined 5.3%/year in men (95% CI -6.1% to -4.6%) and 6.5%/year in women (95% CI -7.5% to -5.5%). However, age-specific fatal first CHD rates were neutral in both men aged 35-54 years (0.1%/year; 95% CI -1.8% to 2.1%) and women of the same age, (-1.6%/year; 95% CI -5.6% to 2.5%). Age-specific trends in non-fatal CHD rates reflected the same trends in fatal CHD events in men and women, with rates reportedly increasing in women aged 35-54 years (2.5%/year (95% CI 1.1% to 3.9%). CONCLUSION: The age-specific decline in fatal and non-fatal first CHD rates in older men and women was not observed in those aged 35-54 years. These novel findings provide evidence for a levelling in the CHD incidence rates in younger adults and puts renewed importance on primary prevention in this group.

The prevalence and selected characteristics of non-fatal opioid overdoses attended by ambulance in Australia

Key Points
1. Ambulance attendance at non-fatal opioid overdose is a common event in mainland Australia (among heroin users in particular).
2. The monthly rate of non-fatal opioid overdose attended by ambulance was generally highest in Victoria (Melbourne) followed by NSW with the rates substantially lower in the remaining mainland states over the period Jan  1999 - Feb 2001.
3. Non-fatal opioid overdose victims were most likely to be male in all states with the proportion of males highest in Victoria (77%).
4. Non-fatal opioid overdose victims were aged around 28 years with ages lowest in WA (26) and highest in NSW (30).
5. The rates of transportation varied according to ambulance service practice across the states with around 94% of cases transported in WA and around 19% and 30% of cases transported in Melbourne and NSW respectively.

Bystander resuscitation attempts at heroin overdose: does it improve outcomes?

Study objective: To document the characteristics and effectiveness of cardiopulmonary resuscitation (CPR) at non-fatal heroin overdose events in Melbourne, Australia. Methods: A retrospective analysis of a computerised database of ambulance attendance records at non-fatal heroin overdose cases for the period 1/12/1998 to 31/7/2000 was undertaken.

Main outcome measures: The main outcome measure was the rate of patient hospitalisation. The rate of CPR administration at heroin overdose cases was also examined, along with characteristics of the attendance, such as the age and sex of the overdose case, the relationship of person providing CPR to the overdose case as well as the location, time and date of the event.

Results: CPR was administered prior to ambulance arrival in 579 heroin overdose cases (9.4% of total heroin overdose cases attended) between 1/12/98 and 31/7/2000. A greater proportion of female overdose cases were administered CPR than males and CPR administrations were evenly distributed across attendances occurring in private and public locations. Bystander administration of CPR prior to ambulance attendance resulted in a significantly lower rate of heroin user hospitalisation (14.5%) compared to cases where bystander CPR was not administered (18.8%).

Conclusions: While CPR administration prior to ambulance attendance at heroin overdose events is relatively uncommon (especially compared to out-of-hospital cardiac arrest), such administration was associated with a statistically significant improvement in clinical outcomes in cases of non-fatal heroin overdose. These findings suggest that the provision of CPR training to people likely to come into contact with heroin overdose events may be an effective strategy at minimising consequent overdose-related harm.

Is the treatment of economic loss by the Australian courts in torts cases anomalous?

The well developed economic theory of tort liability has never been able to comfortably accommodate negligence cases causing pure economic loss as opposed to physical damage or injury. In fact, contrary to received opinion, Australian Courts at least, are increasingly allocating pure economic losses to achieve predominantly an efficiency objective, with corrective justice notions relegated into the background. Consequently, it is difficult to classify these cases as anomalous in the sense of falling outside the efficiency paradigm.

Generalising the Cinderella Effect to unintentional childhood fatalities

We investigated whether the repeatedly demonstrated increase in risk of child abuse and infanticide associated with living with a step parent generalized to cases of unintentional childhood fatal injury, the most common cause of death in children across the developed world. Reports were drawn from the Australian National Coroners' Information System (NCIS) on all cases of intentionally (n=32) and unintentionally (n=319) produced fatal injury in children aged under 5 years between 2000 and 2003. Even when using the most conservative possible analytic approach, in which all cases in which family type was unclear were classified as being from an ‘intact biological family’, step children under 5 years of age were found to be at significantly increased risk of unintentional fatal injury of any type, and of drowning in particular. Children from single-parented families were generally not found to be at significantly increased risk of intentional or unintentional fatal injury, while children who lived with neither of their biological parents were at greatest risk overall for fatal injury of any type.

Zinc deficiency and its inherited disorders - A review

Zinc is an essential trace element required by all living organisms because of its critical roles both as a structural component of proteins and as a cofactor in enzyme catalysis. The importance of zinc in human metabolism is illustrated by the effects of zinc deficiency, which include a diminished immune response, reduced healing and neurological disorders. Furthermore, nutritional zinc deficiency can be fatal in newborn or growing animals. While zinc deficiency is commonly caused by dietary factors, several inherited defects of zinc deficiency have been identified. Acrodermatitis enteropathica is the most commonly described inherited condition found in humans. In several of the few cases that have been reported, this disorder is associated with mutations in the hZIP4 gene, a member of the SLC39 family, whose members encode membranebound putative zinc transporters. Mutations in other members of this family or in different genes may account for other cases of acrodermatitis in which defects in hZIP4 have not been detected. Another inherited form of zinc deficiency occurs in the lethal milk mouse, where a mutation in ZnT4 gene, a member of the SLC30 family of transmembrane proteins results in impaired secretion of zinc into milk from the mammary gland. A similar disorder to the lethal milk mouse occurs in humans. In the few cases studied, no changes in ZnT4 orthologue, hZnT4, were detected. This, and the presence of several minor phenotypic differences between the zinc deficiency in humans and mice, suggests that the human condition is caused by defects in genes that are yet to be identified. Taking into account the fact that there are no definitive tests for zinc deficiency and that this disorder can go undiagnosed, plus the recent identification of multiple members of the SCL30 and SLC39, it is likely that mutations in other genes may underlie additional inherited disorders of zinc deficiency.

Descriptions of rajid egg cases from southeastern Australian waters

Egg cases from nine skate species occurring in Tasmanian waters were examined and measured. A species-specific identification key is provided for eight of these species. The key was developed primarily from fresh egg cases dissected from the oviduct, although specimens collected from the ocean floor or found dried on the beach were also used to test the key. Egg cases for the ninth species could not be included because the only egg case pair recovered was partially fomled. A diagnosis of the posterior end of this egg case is provided.

The media and the development of the tourism industry during the 20th and 21st centuries: an analysis of four noteworthy cases

The aim of this paper was to explore the role of the media within the context of tourism, specifically with regard to how the media has influenced the activities and perceptions of the tourism sector. In this paper, the term ‘media’ is referred to as mass communication, specifically with regard to newspapers, magazines and broadcasting. It is important to gain a better understanding of the ways in which the media has interacted with the tourism sector, as this information can provide practitioners and academics with insights as to how the media can best be employed to benefit stakeholders of the tourism industry. Lessons can be learned from the past so that the experience gained from it can contribute to best practice in the future. In this way, strategies can be developed to minimise the vulnerability of the tourism sector to damaging or erroneous portrayals of it and its activities in the media.
The case study method was used to explore the role of the media within the context of tourism. Four case studies provided insights on this topic. The four case studies were selected based on their diversity, within the context of the tourism sector, and because they covered a considerable period of time. These variables provided the researchers with a wide-ranging perspective on the topic.
The paper firstly focuses on the 1920’s Waiters’ Strike in the resort town of San Sebastián, Spain, and discusses the role of the media in relation to this event. The second case investigates the use of the media as a destination-marketing tool and reflects on an early manipulation of this process by the German authorities in the documentary Olympia, a film produced for the summer Olympics in 1936. The third case study reports on the manner in which the media has created tensions between connoisseurs of fine food and drink and hospitality industry professionals, and its subsequent implications on service quality. The final case investigates the role of the media in reducing demand for hospitality services in Melbourne on New Year’s Eve 2000.
Through an analysis of these diverse, but important case studies, it can be seen that the media has had, and continues to have, an impact on the development of the tourism industry in both positive and negative ways. The limitations of this research are discussed and recommendations are made for further research that will assist in developing a more comprehensive typology of the media’s role in tourism.

The development of cultural entrepreneurs through new venture cases in the business classroom

Artists and workers in the creative industries who embody the essence of creativity are thwart by economic values in delivering their art work or creative concept to consumers. This is particularly evident for students in courses in creative industries who graduate with entrepreneurial aspirations, but not the means to pitch their creative concept or build the business model for the new venture. This paper analyses a university business course developed to take cultural entrepreneurs through venture building as a live case in the creative economy.

The dynamics of business ethics: a function of time and culture-cases and models

Examines the construct of ethics in general and of business ethics in particular. Provides a conceptual discussion of the dynamics of ethics in society and the dynamics of business ethics in the marketplace. Ethics and business ethics constructs are dependent upon two principal parameters – time and culture. Eventually, ethics and business ethics are about what is perceived as acceptable or unacceptable at a specific time and in a specific cultural setting. What was ethical yesterday may not be ethical today, and what is ethical today may not be ethical tomorrow. Furthermore, both the company’s view and the views of others may determine what is acceptable or unacceptable in business ethics. This is a social construction that may differ between the parties involved in a specific context. The discussion is supported by two brief and different cases from the automobile industry. This research contributes a set of generic models that examine business ethics dynamics.

Flexible delivery in the Australian vocational education and training sector: Barrier to success identified in cases studies of four adult learners

Government policy in Australia is increasingly encouraging training organisations in the Vocational Education and Training (VET) sector to adopt flexible delivery approaches, but some researchers are sounding a note of caution. Evidence is emerging that Australian VET learners are not universally ready for flexible delivery, and this is reflected in high attrition rates and low pass rates. The literature on flexible delivery identifies a number of specific factors that can impact on the success of adult learners. However, there seems to be agreement that failure or dropout is not determined by a single factor, but by the interaction of a number of factors that build up over time. To understand these factors, we need to understand the learners - what their participation in education means to them, the context in which they are studying, and the numerous inter-connected factors that contribute to their failure to achieve a successful outcome. This paper discusses four case studies from a research project that followed up a small number of adult learners who enrolled in flexible delivery VET courses but did not achieve a successful outcome.

Child testimony in custody cases: a review

The authors provide a brief historical review of judicial trends in child custody placement. In contrast to the start of the 19th century, by its end, courts took into consideration children's best interests, maternal rights, and prevailing sex role ideologies. Statutory changes began to reflect similar concerns by the end of that century. Modern practices, relying on the best interests of the child standard, also include consistent consideration of children's preferences in making custody determinations. An important factor in this context is the accuracy with which a child describes domestic relations, especially in contested cases with contradictory allegations by parents. Research dealing with children's report accuracy and techniques to enhance it are reviewed, and a description of various practical considerations when questioning children is provided.

Income tax test, materials & essential cases

A comprehensive cases and materials book intended for commerce or law students undertaking semester-length courses in Australian income tax law.