Differences in Treatment and Management of Indigenous and Non-Indigenous Patients Presenting with Chest Pain: Results of the Heart Protection Partnership (HPP) Study

BACKGROUND: Indigenous patients with acute coronary syndromes represent a high-risk group. There are however few contemporary datasets addressing differences in the presentation and management of Indigenous and non-Indigenous patients with chest pain. METHODS: The Heart Protection Project, is a multicentre retrospective audit of consecutive medical records from patients presenting with chest pain. Patients were identified as Indigenous or non-Indigenous, and time to presentation and cardiac investigations as well as rates of cardiac investigations and procedures were compared between the two groups. RESULTS: Of the 2380 patients included, 199 (8.4%) identified as Indigenous, and 2174 (91.6%) as non-Indigenous. Indigenous patients were younger, had higher rates hyperlipidaemia, diabetes, smoking, known coronary artery disease and a lower rate of prior PCI; and were significantly less likely to have private health insurance, be admitted to an interventional facility or to have a cardiologist as primary physician. Following adjustment for difference in baseline characteristics, Indigenous patients had comparable rates of cardiac investigations and delay times to presentation and investigations. CONCLUSIONS: Although the Indigenous population was identified as a high-risk group, in this analysis of selected Australian hospitals there were no significant differences in treatment or management of Indigenous patients in comparison to non-Indigenous.

The determinants of multinational contractors' willingness to bid for Australian public sector major infrastructure projects : towards deploying the eclectic paradigm of internationalisation

Against a background of already thin markets in some sectors of major public sector infrastructure in Australia and the desire of Australian federal government to leverage private finance, concerns about ensuring sufficient levels of competition are prompting federal government to seek new sources of in-bound Foreign Direct Income. The aim of this paper is to justify and develop a means to deploying the eclectic paradigm of internationalisation that forms part of an Australian federally funded research project designed to explain the determinants of multinational contractors' willingness to bid for Australian public sector major infrastructure projects. Despite the dominance of the eclectic paradigm as a theory of internationalisation for over two decades, it has seen limited application in terms of multinational construction. It is expected that the research project will be the first empirical study to deploy the eclectic paradigm to inbound FDI to Australia whilst using the dominant economic theories advocated for use within the eclectic paradigm. Furthermore, the research project is anticipated to yield a number of practical benefits. These include estimates of the potential scope to attract more multinational contractors to bid for Australian public sector infrastructure, including the nature and extent to which this scope can be influenced by Australian governments responsible for the delivery of infrastructure. On the other hand, the research is also expected to indicate the extent to which indigenous and other multinational contractors domiciled in Australia are investing in special purpose technology and achieving productivity gains relative to foreign multinational contractors.

Value for money : procuring infrastructure

Australia is just one of many developed countries facing the challenge of delivering value for money in the provision of a substantial infrastructure pipeline amidst severe construction and private finance constraints. To help address this challenge, this chapter focuses on developing an understanding of the determinants of value at key procurement decision points that range from the make-or-buy decision, to buying in the context of market structures, including the exchange relationship and contractual arrangement decision. This understanding is based on theoretical pluralism and illustrated by research in the field of construction and maintenance, and in public-private partnerships.

Sapporo World Window : urban interaction through public and private screens

This paper introduces Sapporo World Window, a screen-based application that is currently under development for the new underway passage at the centre of Sapporo City. There are ten large public screens installed in the space, displaying user-generated videos about various aspects of the city and a real-time map that visualises users’ interaction with the city. The application aims to engage the general public by functioning as a unique ‘point of connection’ for socio-cultural and technological interactions, making the space a lively social place where people can have meaningful experiences of interacting with people and places of Sapporo through mobile phones (keitai) and the public screens in the space. This paper first outlines the contextual background and key concept for the application’s design. Then the paper discusses the user interaction processes, technical specifications, and interface design, followed by the conclusions and outlook.

Three primary school students’ cognition about 3D rotation in a virtual reality learning environment

This paper reports on three primary school students’ explorations of 3D rotation in a virtual reality learning environment (VRLE) named VRMath. When asked to investigate if you would face the same direction when you turn right 45 degrees first then roll up 45 degrees, or when you roll up 45 degrees first then turn right 45 degrees, the students found that the different order of the two turns ended up with different directions in the VRLE. This was contrary to the students’ prior predictions based on using pen, paper and body movements. The findings of this study showed the difficulty young children have in perceiving and understanding the non-commutative nature of 3D rotation and the power of the computational VRLE in giving students experiences that they rarely have in real life with 3D manipulations and 3D mental movements.

A comparative review of quantitative VFM methodology for PPP infrastructure project in Indonesia and Australia

The Government of Indonesia (GoI) increasingly relies on the private sector financing to build and operate infrastructures through public private partnership (PPP) schemes. However, PPP does not automatically provide the solution for the financing scheme due to value for money (VFM) issues. The procurement authority must show whether a PPP proposal is the optimal solution that provides best VFM outcome. The paper presents a literature review of comparing quantitative VFM methodology for PPP infrastructure project procurement in Indonesia and Australia. Public Sector Comparator (PSC) is used to assess the potential project VFM quantitatively in Australia. In Indonesia, the PSC has not been applied, where the PPP procurement authority tends to utilize a common project evaluation method that ignores the issues of risk. Unlike the conventional price bid evaluation, the PSC enables a financial comparison including costs/gains and risks. Since the construction of PSC is primarily on risk management approach, it can facilitate risk negotiation processes between the involved parties. The study indicates that the quantitative VFM methodology of PSC is potentially applicable in Indonesia for water supply sector. Various supporting regulations are available that emphasize the importance of VFM and risk management in infrastructure investment. However, the study also reveals a number of challenges that need to be anticipated, such as the need of a more comprehensive PPP policy at both central and local government level, a more specific legal instrument for bidding evaluation method and the issue of institutional capacity development in PPP Units at the local level.

Tendering theory revisited

This paper discusses the content, origin and development of Tendering Theory as a theory of price determination. It demonstrates how tendering theory determines market prices and how it is different from game and decision theories, and that in the tendering process, with non-cooperative, simultaneous, single sealed bids with individual private valuations, extensive public information, a large number of bidders and a long sequence of tendering occasions, there develops a competitive equilibrium. The development of a competitive equilibrium means that the concept of the tender as the sum of a valuation and a strategy, which is at the core of tendering theory, cannot be supported and that there are serious empirical, theoretical and methodological inconsistencies in the theory.

Providing a law degree for the “real world” : perspective of an Australian law school

The Queensland University of Technology badges itself as “a university for the real world”. For the last decade the Law Faculty has aimed to provide its students with a ‘real world’ degree, that is, a practical law degree. This has seen skills such as research, advocacy and negotiation incorporated into the undergraduate degree under a University Teaching & Learning grant, a project that gained international recognition and praise. In 2007–2008 the Law Faculty undertook another curriculum review of its undergraduate law degree. As a result of the two year review, QUT’s undergraduate lawdegree has fewer core units, a focus on first year student transition, scaffolding of law graduate capabilities throughout the degree,work integrated learning and transition to the workplace. The revised degree commenced implementation in 2009. This paper focuses on the “real world” approach to the degree achieved through the first year programme, embedding and scaffolding law graduate capabilities through authentic and valid assessment and work integrated learning.

Informational city

Many cities worldwide face the prospect of major transformation as the world moves towards a global information order. In this new era, urban economies are being radically altered by dynamic processes of economic and spatial restructuring. The result is the creation of ‘informational cities’ or its new and more popular name, ‘knowledge cities’. For the last two centuries, social production had been primarily understood and shaped by neo-classical economic thought that recognized only three factors of production: land, labor and capital. Knowledge, education, and intellectual capacity were secondary, if not incidental, factors. Human capital was assumed to be either embedded in labor or just one of numerous categories of capital. In the last decades, it has become apparent that knowledge is sufficiently important to deserve recognition as a fourth factor of production. Knowledge and information and the social and technological settings for their production and communication are now seen as keys to development and economic prosperity. The rise of knowledge-based opportunity has, in many cases, been accompanied by a concomitant decline in traditional industrial activity. The replacement of physical commodity production by more abstract forms of production (e.g. information, ideas, and knowledge) has, however paradoxically, reinforced the importance of central places and led to the formation of knowledge cities. Knowledge is produced, marketed and exchanged mainly in cities. Therefore, knowledge cities aim to assist decision-makers in making their cities compatible with the knowledge economy and thus able to compete with other cities. Knowledge cities enable their citizens to foster knowledge creation, knowledge exchange and innovation. They also encourage the continuous creation, sharing, evaluation, renewal and update of knowledge. To compete nationally and internationally, cities need knowledge infrastructures (e.g. universities, research and development institutes); a concentration of well-educated people; technological, mainly electronic, infrastructure; and connections to the global economy (e.g. international companies and finance institutions for trade and investment). Moreover, they must possess the people and things necessary for the production of knowledge and, as importantly, function as breeding grounds for talent and innovation. The economy of a knowledge city creates high value-added products using research, technology, and brainpower. Private and the public sectors value knowledge, spend money on its discovery and dissemination and, ultimately, harness it to create goods and services. Although many cities call themselves knowledge cities, currently, only a few cities around the world (e.g., Barcelona, Delft, Dublin, Montreal, Munich, and Stockholm) have earned that label. Many other cities aspire to the status of knowledge city through urban development programs that target knowledge-based urban development. Examples include Copenhagen, Dubai, Manchester, Melbourne, Monterrey, Singapore, and Shanghai. Knowledge-Based Urban Development To date, the development of most knowledge cities has proceeded organically as a dependent and derivative effect of global market forces. Urban and regional planning has responded slowly, and sometimes not at all, to the challenges and the opportunities of the knowledge city. That is changing, however. Knowledge-based urban development potentially brings both economic prosperity and a sustainable socio-spatial order. Its goal is to produce and circulate abstract work. The globalization of the world in the last decades of the twentieth century was a dialectical process. On one hand, as the tyranny of distance was eroded, economic networks of production and consumption were constituted at a global scale. At the same time, spatial proximity remained as important as ever, if not more so, for knowledge-based urban development. Mediated by information and communication technology, personal contact, and the medium of tacit knowledge, organizational and institutional interactions are still closely associated with spatial proximity. The clustering of knowledge production is essential for fostering innovation and wealth creation. The social benefits of knowledge-based urban development extend beyond aggregate economic growth. On the one hand is the possibility of a particularly resilient form of urban development secured in a network of connections anchored at local, national, and global coordinates. On the other hand, quality of place and life, defined by the level of public service (e.g. health and education) and by the conservation and development of the cultural, aesthetic and ecological values give cities their character and attract or repel the creative class of knowledge workers, is a prerequisite for successful knowledge-based urban development. The goal is a secure economy in a human setting: in short, smart growth or sustainable urban development.

Preface [From The Third Knowledge City World Summit 2010 proceedings]

‘Knowledge’ is a resource, which relies on the past for a better future. In the 21st century, more than ever before, cities around the world depend on the knowledge of their citizens, their institutions and their firms and enterprises. The knowledge image, the human competence and the reputation of their public and private institutions and corporations profiles a city. It attracts investment, qualified labour and professionals, as well as students and researchers. And it creates local life spaces and professional milieus, which offer the quality of life to the citizens that are seeking to cope with the challenges of modern life in a competitive world. Integrating knowledge-based development in urban strategies and policies, beyond the provision of schools and locations for higher education, has become a new ambitious arena of city politics. Coming from theory to practice, and bringing together the manifold knowledge stakeholders in a city and preparing joint visions for the knowledge city is a new challenge for city managers, urban planners and leaders of the civic society . It requires visionary power, creativity, holistic thinking, the willingness to cooperate with all groups of the local civil society, and the capability to moderate communication processes to overcome conflicts and to develop joint action for a sustainable future.

A controlled rapid approach to curriculum change : addressing the pressures of increased test-based accountability on schools

Increasingly, large amounts of public and private money are being invested in education and as a result, schools are becoming more accountable to stakeholders for this financial input. In terms of the curriculum, governments worldwide are frequently tying school funding to students‟ and schools‟ academic performances, which are monitored through high-stakes testing programs. To accommodate the resultant pressures from these testing initiatives, many principals are re-focussing their school‟s curriculum on the testing requirements. Such a re-focussing, which was examined critically in this thesis, constituted an externally facilitated rapid approach to curriculum change. In line with previously enacted change theories and recommendations from these, curriculum change in schools has tended to be a fairly slow, considered, collaborative process that is facilitated internally by a deputy-principal (curriculum). However, theoretically based research has shown that such a process has often proved to be difficult and very rarely successful. The present study reports and theorises the experiences of an externally facilitated process that emerged from a practitioner model of change. This case study of the development of the controlled rapid approach to curriculum change began by establishing the reasons three principals initiated curriculum change and why they then engaged an outsider to facilitate the process. It also examined this particular change process from the perspectives of the research participants. The investigation led to the revision of the practitioner model as used in the three schools and challenged the current thinking about the process of school curriculum change. The thesis aims to offer principals and the wider education community an alternative model for consideration when undertaking curriculum change. Finally, the thesis warns that, in the longer term, the application of study‟s revised model (the Controlled Rapid Approach to Curriculum Change [CRACC] Model) may have less then desirable educational consequences.

Enhancing security and continuity management at international airports

Operators of busy contemporary airports have to balance tensions between the timely flow of passengers, flight operations, the conduct of commercial business activities and the effective application of security processes. In addition to specific onsite issues airport operators liaise with a range of organisations which set and enforce aviation-related policies and regulations as well as border security agencies responsible for customs, quarantine and immigration, in addition to first response security services. The challenging demands of coordinating and planning in such complex socio-technical contexts place considerable pressure on airport management to facilitate coordination of what are often conflicting goals and expectations among groups that have standing in respect to safe and secure air travel. What are, as yet, significantly unexplored issues in large airports are options for the optimal coordination of efforts from the range of public and private sector participants active in airport security and crisis management. A further aspect of this issue is how airport management systems operate when there is a transition from business-as-usual into an emergency/crisis situation and then, on recovery, back to ‘normal’ functioning. Business Continuity Planning (BCP), incorporating sub-plans for emergency response, continuation of output and recovery of degraded operating capacity, would fit such a context. The implementation of BCP practices in such a significant high security setting offers considerable potential benefit yet entails considerable challenges. This paper presents early results of a 4 year nationally funded industry-based research project examining the merger of Business Continuity Planning and Transport Security Planning as a means of generating capability for improved security and reliability and, ultimately, enhanced resilience in major airports. The project is part of a larger research program on the Design of Secure Airports that includes most of the gazetted ‘first response’ international airports in Australia, key Aviation industry groups and all aviation-related border and security regulators as collaborative partners. The paper examines a number of initial themes in the research, including: ? Approaches to integrating Business Continuity & Aviation Security Planning within airport operations; ? Assessment of gaps in management protocols and operational capacities for identifying and responding to crises within and across critical aviation infrastructure; ? Identification of convergent and divergent approaches to crisis management used across Austral-Asia and their alignment to planned and possible infrastructure evolution.

The variant concept of transportation disadvantaged : evidence from Aydin, Turkey and Yamaga, Japan

Transportation disadvantaged groups, in the previous studies, are defined as those who are low income earners, family dependent, limited access to private motor vehicles and public transport services, and also those who oblige to spend relatively more time and money on their trips. Additionally those disable, young and elderly are considered among the natural groups of transportation disadvantaged. Although in general terms this definition seems correct, it is not specific enough to become a common universal definition that could apply to all urban contexts. This paper investigates whether travel difficulty perceptions vary and so does the definition of transportation disadvantaged in socio-culturally different urban contexts. For this investigation the paper undertakes a series of statistical analysis in the case study of Yamaga, Japan, and compares the findings with a previous case study, where the same methodology, hypothesis, and assumptions were utilized in a culturally and demographically different settlement of Aydin, Turkey. After comparing the findings observed in Aydin with the statistical analysis results of Yamaga, this paper reveals that there can be no explicitly detailed universal definition of transportation disadvantaged. The paper concludes by stating characteristics of transportation disadvantage is not globally identical, and policies and solutions that work in a locality may not show the same results in another socio-cultural context.

Networks cities and ecological habitats

As the world’s rural populations continue to migrate from farmland to sprawling cities, transport networks form an impenetrable maze within which monocultures of urban form erupt from the spaces in‐between. These urban monocultures are as problematic to human activity in cities as cropping monocultures are to ecosystems in regional landscapes. In China, the speed of urbanisation is exacerbating the production of mono‐functional private and public spaces. Edges are tightly controlled. Barriers and management practices at these boundaries are discouraging the formation of new synergistic relationships, critical in the long‐term stability of ecosystems that host urban habitats. Some urban planners, engineers, urban designers, architects and landscape architects have recognised these shortcomings in contemporary Chinese cities. The ideology of sustainability, while critically debated, is bringing together thinking people in these and other professions under the umbrella of an ecological ethic. This essay aims to apply landscape ecology theory, a conceptual framework used by many professionals involved in land development processes, to a concept being developed by BAU International called Networks Cities: a city with its various land uses arranged in nets of continuity, adjacency, and superposition. It will consider six lesser‐known concepts in relation to creating enhanced human activity along (un)structured edges between proposed nets and suggest new frontiers that might be challenged in an eco‐city. Ecological theory suggests that sustaining biodiversity in regions and landscapes depends on habitat distribution patterns. Flora and fauna biologists have long studied edge habitats and have been confounded by the paradox that maximising the breadth of edges is detrimental to specialist species but favourable to generalist species. Generalist species of plants and animals tolerate frequent change in the landscape, frequenting two or more habitats for their survival. Specialist species are less tolerant of change, having specific habitat requirements during their life cycle. Protecting species richness then may be at odds with increasing mixed habitats or mixed‐use zones that are dynamic places where diverse activities occur. Forman (1995) in his book Land Mosaics however argues that these two objectives of land use management are entirely compatible. He postulates that an edge may be comprised of many small patches, corridors or convoluting boundaries of large patches. Many ecocentrists now consider humans to be just another species inhabiting the ecological environments of our cities. Hence habitat distribution theory may be useful in planning and designing better human habitats in a rapidly urbanising context like China. In less‐constructed environments, boundaries and edges provide important opportunities for the movement of multi‐habitat species into, along and from adjacent land use areas. For instance, invasive plants may escape into a national park from domestic gardens while wildlife may forage on garden plants in adjoining residential areas. It is at these interfaces that human interactions too flow backward and forward between land types. Spray applications of substances by farmers on cropland may disturb neighbouring homeowners while suburban residents may help themselves to farm produce on neighbouring orchards. Edge environments are some of the most dynamic and contested spaces in the landscape. Since most of us require access to at least two or three habitats diurnally, weekly, monthly or seasonally, their proximity to each other becomes critical in our attempts to improve the sustainability of our cities.