Best practice for prevention and treatment of cardiovascular disease through an equity lens : a review

Background: Despite declining rates of cardiovascular disease (CVD) mortality in developed countries, lower socioeconomic groups continue to experience a greater burden of the disease. There are now many evidence-based treatments and prevention strategies for the management of CVD and it is essential that their impact on the more disadvantaged group is understood if socioeconomic inequalities in CVD are to be reduced. Aims: To determine whether key interventions for CVD prevention and treatment are effective among lower socioeconomic groups, to describe barriers to their effectiveness and the potential or actual impact of these interventions on the socioeconomic gradient in CVD. Methods: Interventions were selected from four stages of the CVD continuum. These included smoking reduction strategies, absolute risk assessment, cardiac rehabilitation, secondary prevention medications, and heart failure self-management programmes. Electronic searches were conducted using terms for each intervention combined with terms for socioeconomic status (SES). Results: Only limited evidence was found for the effectiveness of the selected interventions among lower SES groups and there was little exploration of socioeconomic-related barriers to their uptake. Some broad themes and key messages were identified. In the majority of findings examined, it was clear that the underlying material, social and environmental factors associated with disadvantage are a significant barrier to the effectiveness of interventions. Conclusion: Opportunities to reduce socioeconomic inequalities occur at all stages of the CVD continuum. Despite this, current treatment and prevention strategies may be contributing to the widening socioeconomic-CVD gradient. Further research into the impact of best-practice interventions for CVD upon lower SES groups is required.

Striving to realise the European idea : judging the news media’s accounts of how the Berlin Wall gave impetus to a new order across Europe

The 1990 European Community was taken by surprise, by the urgency of demands from the newly-elected Eastern European governments to become member countries. Those governments were honouring the mass social movement of the streets, the year before, demanding free elections and a liberal economic system associated with “Europe”. The mass movement had actually been accompanied by much activity within institutional politics, in Western Europe, the former “satellite” states, the Soviet Union and the United States, to set up new structures – with German reunification and an expanded EC as the centre-piece. This paper draws on the writer’s doctoral dissertation on mass media in the collapse of the Eastern bloc, focused on the Berlin Wall – documenting both public protests and institutional negotiations. For example the writer as a correspondent in Europe from that time, recounts interventions of the German Chancellor, Helmut Kohl, at a European summit in Paris nine days after the “Wall”, and separate negotiations with the French President, Francois Mitterrand -- on the reunification, and EU monetary union after 1992. Through such processes, the “European idea” would receive fresh impetus, though the EU which eventuated, came with many altered expectations. It is argued here that as a result of the shock of 1989, a “social” Europe can be seen emerging, as a shared experience of daily life -- especially among people born during the last two decades of European consolidation. The paper draws on the author’s major research, in four parts: (1) Field observation from the strategic vantage point of a news correspondent. This includes a treatment of evidence at the time, of the wishes and intentions of the mass public (including the unexpected drive to join the European Community), and those of governments, (e.g. thoughts of a “Tienanmen Square solution” in East Berlin, versus the non-intervention policies of the Soviet leader, Mikhail Gorbachev). (2) A review of coverage of the crisis of 1989 by major news media outlets, treated as a history of the process. (3) As a comparison, and a test of accuracy and analysis; a review of conventional histories of the crisis appearing a decade later.(4) A further review, and test, provided by journalists responsible for the coverage of the time, as reflection on practice – obtained from semi-structured interviews.

Tyrosine monitoring in children with early and continuously treated phenylketonuria: Results of an international practice survey

Investigations into the biochemical markers associated with executive function (EF) impairment in children with early and continuously treated phenylketonuria (ECT-PKU) remain largely phenylalanine-only focused, despite experimental data showing that a high phenylalanine:tyrosine (phe:tyr) ratio is more strongly associated with EF deficit than phe alone. A high phe:tyr ratio is hypothesized to lead to a reduction in dopamine synthesis within the brain, which in turn results in the development of EF impairment. This paper provides a snapshot of current practice in the monitoring and/or treatment of tyrosine levels in children with PKU, across 12 countries from Australasia, North America and Europe. Tyrosine monitoring in this population has increased over the last 5 years, with over 80% of clinics surveyed reporting routine monitoring of tyrosine levels in infancy alongside phe levels. Twenty-five percent of clinics surveyed reported actively treating/managing tyrosine levels (with supplemental tyrosine above that contained in PKU formulas) to ensure tyrosine levels remain within normal ranges. Anecdotally, supplemental tyrosine has been reported to ameliorate symptoms of both attention deficit hyperactivity disorder and depression in this population. EF assessment of children with ECT-PKU was likewise highly variable, with 50% of clinics surveyed reporting routine assessments of intellectual function. However when function was assessed, test instruments chosen tended towards global measures of IQ prior to school entry, rather than specific assessment of EF development. Further investigation of the role of tyrosine and its relationship with phe and EF development is needed to establish whether routine tyrosine monitoring and increased supplementation is recommended.

User-created content and everyday cultural practice : lessons from YouTube

This chapter sets out the debates about the changing role of audiences in relation to user-created content as they appear in New Media and Cultural Studies. The discussion moves beyond the simple dichotomies between active producers and passive audiences, and draws on empirical evidence, in order to examine those practices that are most ordinary and widespread. Building on the knowledge of television’s role in facilitating public life, and the everyday, affective practices through which it is experienced and used, I focus on the way in which YouTube operates as a site of community, creativity and cultural citizenship; and as an archive of popular cultural memory.

Good practice for enhancing the engagement and success of commencing students

There is widespread recognition that higher education institutions (HEIs) must actively support commencing students to ensure equity in access to the opportunities afforded by higher education. This role is particularly critical for students who because of educational, cultural or financial disadvantage or because they are members of social groups currently under-represented in higher education, may require additional transitional support to “level the playing field.” The challenge faced by HEIs is to provide this “support” in a way that is integrated into regular teaching and learning practices and reaches all commencing students. The Student Success Program (SSP) is an intervention in operation at the Queensland University of Technology (QUT) designed to identify and support those students deemed to be at risk of disengaging from their learning and their institution. Two sets of evidence of the impact of the SSP are presented: First, its expansion (a) from a one-faculty pilot project (Nelson, Duncan & Clarke, 2009) to all faculties and (b) into a variety of applications mirroring the student life cycle; and second, an evaluation of the impact of the SSP on students exposed to it. The outcomes suggest that: the SSP is an example of good practice that can be successfully applied to a variety of learning contexts and student enrolment situations; and the impact of the intervention on student persistence is sustained for at least 12 months and positively influences student retention. It is claimed that the good practice evidenced by the SSP is dependent on its integration into the broader First Year Experience Program at QUT as an example of transition pedagogy in action.

Australian ePortfolio Project–Stage 2 ePortfolio use by university students in Australia : Developing a sustainable community of practice Case studies extracted from the final project report December 2009

Fourteen sase studies extracted from the final project report - December 2009 Australian Flexible Learning Framework: E-portfolios Community of Practice (Aus) Personal learning plans and ePortfolio (Aus) RMIT University: Introducing ePortfolios (Aus) ePortfolio Practice: ALTC Exchange (Aus) Australian PebblePad User Group (APpUG) (Aus) ePortfolios in the library and information services sector (Aus) PDP and ePortfolios UK (UK) SURF NL Portfolio (Netherlands) University of Canterbury ePortfolio (NZ) AAEEBL: Association for Authentic, Experiential and Evidence-Based Learning (USA) Midlands Eportfolio Group, West Midlands(UK) EPAC: Electronic Portfolio Action and Communication (USA) Scottish Higher Education PDP Forum (UK) Centre for Recording Achievement (CRA)(UK)

Leveraging R&D to advance digital modelling practice in Australian construction

This paper describes a lead project currently underway through Australia’s Sustainable Built Environment National Research Centre, evaluating impacts, diffusion mechanisms and uptake of R&D in the Australian building and construction industry. Building on a retrospective analysis of R&D trends and industry outcomes, a future-focused industry roadmap will be developed to inform R&D policies more attuned to future industry needs to improve investment effectiveness. In particular, this research will evaluate national R&D efforts to develop, test and implement advanced digital modelling technologies into the design/construction/asset management cycle. This research will build new understandings and knowledge relevant to R&D funding strategies, research team formation and management (with involvement from public and private sectors, and research and knowledge institutions), dissemination of outcomes and uptake. This is critical due to the disaggregated nature of the industry, intense competition, limited R&D investment; and new challenges (e.g. digital modelling, integrated project delivery, and the demand for packaged services). The evaluation of leading Australian and international efforts to integrate advanced digital modelling technologies into the design/construction/asset management cycle will be undertaken as one of three case studies. Employing the recently released Australian Guidelines for Digital Modelling developed with buildingSMART (International Alliance for Interoperability) and the Australian Institute of Architects, technical and business benefits across the supply chain will be highlighted as drivers for more integrated R&D efforts.

Building the foundations : skill acquisition in children

Introduction: Why we need to base childrens’ sport and physical education on the principles of dynamical systems theory and ecological psychology As the childhood years are crucial for developing many physical skills as well as establishing the groundwork leading to lifelong participation in sport and physical activities, (Orlick & Botterill, 1977, p. 11) it is essential to examine current practice to make sure it is meeting the needs of children. In recent papers (e.g. Renshaw, Davids, Chow & Shuttleworth, in press; Renshaw, Davids, Chow & Hammond, in review; Chow et al., 2009) we have highlighted that a guiding theoretical framework is needed to provide a principled approach to teaching and coaching and that the approach must be evidence- based and focused on mechanism and not just on operational issues such as practice, competition and programme management (Lyle, 2002). There is a need to demonstrate how nonlinear pedagogy underpins teaching and coaching practice for children given that some of the current approaches underpinning children’s sport and P.E. may not be leading to optimal results. For example, little time is spent undertaking physical activities (Tinning, 2006) and much of this practice is not representative of the competition demands of the performance environment (Kirk & McPhail, 2002; Renshaw et al., 2008). Proponents of a non- linear pedagogy advocate the design of practice by applying key concepts such as the mutuality of the performer and environment, the tight coupling of perception and action, and the emergence of movement solutions due to self organisation under constraints (see Renshaw, et al., in press). As skills are shaped by the unique interacting individual, task and environmental constraints in these learning environments, small changes to individual structural (e.g. factors such as height or limb length) or functional constraints (e.g. factors such as motivation, perceptual skills, strength that can be acquired), task rules, equipment, or environmental constraints can lead to dramatic changes in movement patterns adopted by learners to solve performance problems. The aim of this chapter is to provide real life examples for teachers and coaches who wish to adopt the ideas of non- linear pedagogy in their practice. Specifically, I will provide examples related to specific issues related to individual constraints in children and in particular the unique challenges facing coaches when individual constraints are changing due to growth and development. Part two focuses on understanding how cultural environmental constraints impact on children’s sport. This is an area that has received very little attention but plays a very important part in the long- term development of sporting expertise. Finally, I will look at how coaches can manipulate task constraints to create effective learning environments for young children.

The changing face of practice for developing perception : action skill in cricket

The use of bowling machines is common practice in cricket. In an ideal world all batters would face real bowlers in practice sessions, but this is not always possible, for many reasons. The clear advantage of using bowling machines is that they alleviate the workload required from bowlers (Dennis, Finch & Farhart, 2005) and provide relatively consistent and accurate ball delivery which may not be otherwise available to many young batters. Anecdotal evidence suggests that many, if not most of the world’s greatest players use these methods within their training schedules. For example, Australian internationals, Michael Hussey and Matthew Hayden extensively used bowling machines (Hussey & Sygall, 2007). Bowling machines enable batsmen to practice for long periods, developing their endurance and concentration. However, despite these obvious benefits, in recent times the use of bowling machines has been questioned by sport scientists, coaches, ex- players and commentators. For example, Hussey’s batting coach comments “…we never went near a bowling machine in [Michael’s] first couple of years, I think there’s something to that …” (Hussey & Sygall, 2007, p. 119). This chapter will discuss the efficacy of using bowling machines with reference to research findings, before reporting new evidence that provides support for an alternative, innovative and possibly more representative practice design. Finally, the chapter will provide advice for coaches on the implications of this research, including a case study approach to demonstrate the practical use of such a design.

Consumer misbehaviour during professional service encounters

To date, consumer behaviour research is still over-focused on the functional rather than the dysfunctional. Both empirical and anecdotal evidence suggest that service organisations are burdened with the concept of consumer sovereignty, while consumers freely flout the ‘rules’ of social exchange and behave in deviant and dysfunctional ways. Further, the current scope of consumer misbehaviour research suggests that the phenomenon has principally been studied in the context of economically-focused exchange. This limits our current understanding of consumer misbehaviour to service encounters that are more transactional than relational in nature. Consequently, this thesis takes a Social Exchange approach to consumer misbehaviour and reports a three-stage multi-method study that examined the nature and antecedents of consumer misbehaviour in professional services. It addresses the following broad research question: What is the nature of consumer misbehaviour during professional service encounters? Study One initially explored the nature of consumer misbehaviour in professional service encounters using critical incident technique (CIT) within 38 semi-structured in-depth interviews. The study was designed to develop a better understanding of what constitutes consumer misbehaviour from a service provider’s perspective. Once the nature of consumer misbehaviour had been qualified, Study Two focused on developing and refining calibrated items that formed Guttman-like scales for two consumer misbehaviour constructs: one for the most theoretically-central type of consumer misbehaviour identified in Study One (i.e. refusal to participate) and one for the most well-theorised and salient type of consumer misbehaviour (i.e. verbal abuse) identified in Study One to afford a comparison. This study used Rasch modelling to investigate whether it was possible to calibrate the escalating severity of a series of decontextualised behavioural descriptors in a valid and reliable manner. Creating scales of calibrated items that capture the variation in severity of different types of consumer misbehaviour identified in Study One allowed for a more valid and reliable investigation of the antecedents of such behaviour. Lastly, Study Three utilised an experimental design to investigate three key antecedents of consumer misbehaviour: (1) the perceived quality of the service encounter [drawn from Fullerton and Punj’s (1993) model of aberrant consumer behaviour], (2) the violation of consumers’ perceptions of justice and equity [drawn from Rousseau’s (1989) Psychological Contract Theory], and (3) consumers’ affective responses to exchange [drawn from Weiss and Cropanzano’s (1996) Affective Events Theory]. Investigating three key antecedents of consumer misbehaviour confirmed the newly-developed understanding of the nature of consumer misbehaviour during professional service encounters. Combined, the results of the three studies suggest that consumer misbehaviour is characteristically different within professional services. The most salient and theoretically-central behaviours can be measured using increasingly severe decontextualised behavioural descriptors. Further, increasingly severe forms of consumer misbehaviour are likely to occur as a response to consumer anger at low levels of interpersonal service quality. These findings have a range of key implications for both marketing theory and practice.

Understanding the role of knowledge in the practice of expert nephrology nurses in Australia

This paper, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, aims to explore the role of knowledge in expert practice. Using grounded theory methodology, the study involved 17 registered nurses who were practicing in a metropolitan renal unit in New South Wales, Australia. Concurrent data collection and analysis was undertaken, incorporating participants' observations and interviews. Having extensive nephrology nursing knowledge was a striking characteristic of a nursing expert. Expert nurses clearly relied on and utilized extensive nephrology nursing knowledge to practice. Of importance for nursing, the results of this study indicate that domain-specific knowledge is a crucial feature of expert practice.

Exploring the role of the governing body (board) in information technology governance : a study of Australian universities

In this thesis, I advance the understanding of information technology (IT) governance research and corporate governance research by considering the question “How do boards govern IT?” The importance of IT to business has increased over the last decade, but there has been little academic research which has focused on boards and their role in the governance of IT (Van Grembergen, De Haes and Guldentops, 2004). Most of the research on information technology governance (ITG) has focused on advancing the understanding and measurement of the components of the ITG model (Buckby, Best & Stewart, 2008; Wilkin & Chenhall, 2010), a model recommended by the IT Governance Institute (2003) as ‘best practice’ for boards to use in governing IT. IT governance is considered to be the responsibility of the board and is said to form an important subset of an organisation’s corporate governance processes (Borth & Bradley, 2008). Boards need to govern IT as a result of the large capital investment in IT resources and high dependency on IT by organisations. Van Grembergen, De Haes and Guldentops (2004) and De Haes & Van Grembergen (2009) indicate that corporate governance matters are not able to be effectively discharged unless IT is being governed properly, and call for further specific research on the role of the board in ITG. Researchers also indicate that the link between corporate governance and IT governance has been neglected (Borth & Bradley, 2008; Musson & Jordan, 2005; Bhattacharjya & Chang, 2008). This thesis will address this gap in the ITG literature by providing the bridge between the ITG and corporate governance literatures. My thesis uses a critical realist epistemology and a mixed method approach to gather insights into my research question. In the first phase of my research I develop a survey instrument to assess whether boards consider the components of the ITG model in governing IT. The results of this first study indicated that directors do not conceptualise their role in governing IT using the elements of the ITG model. Thus, I moved to focus on whether prominent corporate governance theories might elucidate how boards govern IT. In the second phase of the research, I used a qualitative inductive case based study to assess whether agency, stewardship and resource dependence theories explain how boards govern IT in Australian universities. As the first in-depth study of university IT governance processes, my research contributes to the ITG research field by revealing that Australian university board governance of IT is characterized by a combination of agency theory and stewardship theory behaviours and processes. The study also identified strong links between a university’s IT structure and evidence of agency and stewardship theories. This link provides insight into the structures element of the emerging enterprise governance of IT framework (Van Grembergen, De Haes & Guldentops, 2004; De Haes & Van Grembergen, 2009; Van Grembergen & De Haes, 2009b; Ko & Fink, 2010). My research makes an important contribution to governance research by identifying a key link between corporate and ITG literatures and providing insight into board IT governance processes. The research conducted in my thesis should encourage future researchers to continue to explore the links between corporate and IT governance research.

The WIL (Work Integrated Learning) report : a national scoping study [Final Report]

This report provides an account of the first large-scale scoping study of work integrated learning (WIL) in contemporary Australian higher education. The explicit aim of the project was to identify issues and map a broad and growing picture of WIL across Australia and to identify ways of improving the student learning experience in relation to WIL. The project was undertaken in response to high levels of interest in WIL, which is seen by universities both as a valid pedagogy and as a means to respond to demands by employers for work-ready graduates, and demands by students for employable knowledge and skills. Over a period of eight months of rapid data collection, 35 universities and almost 600 participants contributed to the project. Participants consistently reported the positive benefits of WIL and provided evidence of commitment and innovative practice in relation to enhancing student learning experiences. Participants provided evidence of strong partnerships between stakeholders and highlighted the importance of these relationships in facilitating effective learning outcomes for students. They also identified a range of issues and challenges that face the sector in growing WIL opportunities; these issues and challenges will shape the quality of WIL experiences. While the majority of comments focused on issues involved in ensuring quality placements, it was recognised that placements are just one way to ensure the integration of work with learning. Also, the WIL experience is highly contextualised and impacted by the expectations of students, employers, the professions, the university and government policy.

Sing & Grow : the co-existence of evaluation research and clinical practice in an early intervention music therapy project

Sing & Grow is a short term early intervention music therapy program for at risk families. Sing & Grow uses music to strengthen parent-child relationships by increasing positive parent-child interactions, assisting parents to bond with their children, and extending the repertoire of parents’ skills in relating to their child through interactive . Both the Australian and New Zealand governments are looking for evidence based research to highlight the effectiveness of funded programs in early childhood. As a government funded program, independent evaluation is a requirement of the delivery of the service. This paper explains the process involved in setting up and managing this large scale evaluation from engaging the evaluators and designing the project, to the data gathering stage. It describes the various challenges encountered and concludes that a highly collaborative and communicative partnership bet en researchers and clinicians is essential to ensure data can be gathered with minimal disturbance to clinical music therapy practice.