Hormones down under: Hormone therapy use after the Women's Health Initiative

Aims:  The primary objective was to describe the usage pattern of hormone therapy (HT) in a sample of urban Australian women in 2001 and to assess the characteristics of users vs. non-users. The second objective was to determine whether there had been any change in usage since the publication of the results of the combined oestrogen plus progestagen arm of the Women's Health Initiative (WHI) in 2002. Methods:  A cohort of 374 postmenopausal women aged 50–80 years participated in this substudy of the LAW (Longitudinal Assessment of Ageing in Women) project: a 5-year multidisciplinary, observational study. Participants completed an annual medical assessment including details of the use of HT and the reasons for use, as well as demographic and psychosocial data. Results:  In December 2001, 30.8% of the participants were using HT, whereas 55.4% were ever users. The management of vasomotor symptoms and mood disturbance were the primary reasons for use. Of those who had been using HT in December 2001 (24.4%) women ceased using HT in the 3 months following publication of the WHI results. The percentage of women using HT in December 2003 (13.9%) was less than half of that of December 2001. Conclusion:  The rate of HT use and the reasons for use, in 2001 in Brisbane was similar to that of other Australian regions. Usage of HT decreased since the publication of the WHI results in 2002 which may reflect changing attitudes by patients and practitioners regarding HT.

Make-buy decisions in the face of technological change: does industry clockspeed matter?

Some evidence in the area of make-buy decisions for new technologies suggests that it is a good idea for a company to pursue a fairly rigorous ''make'' policy in the early days of a potentially disruptive innovation. Other studies prescribe exactly the opposite, promoting instead a ''buy'' strategy. This paper seeks to bridge the gap between these perspectives by suggesting that both strategies are valid, but that they are most successfully applied in different market environments. The ''make'' prescription may be more suited to either extremely fast or extremely slow rates of technological change, while a ''buy'' strategy might be more appropriate in market sectors where technologies evolve at a medium pace. This paper highlights the importance of industry clockspeed and supplier relationships in make-buy decisions for new technologies, and puts forward two new hypotheses that require empirical testing.

High speed rail and regional competitiveness

The presence of High Speed Rail (HSR) systems influences market shares of road and air transport, and the development of cities and regions they serve. With the deployment of HSR infrastructure, changes in accessibility have occurred. These changes have lead researchers to investigate effects on the economic and spatial derived variables. Contention exists when managing the trade off between efficiency, and access points which are usually in the range of hundreds of kilometres apart. In short, it is argued that intermediate cities, bypassed by HSR services, suffer a decline in their accessibility and developmental opportunities. The present Chapter will analyse possible impacts derived from the presence of HSR infrastructure. In particular, it will consider small and medium agglomerations in the vicinity of HSR corridors, not always served by HSR stations. Thus, a methodology is developed to quantify accessibility benefits and their distribution. These benefits will be investigated in relation to different rail transit strategies integrating HSR infrastructure where a HSR station cannot be positioned. These strategies are selected principally for the type of service offered: (i) cadenced, (ii) express, (iii) frequent or (iv) non-stopping. Furthermore, to ground the theoretical approach linking accessibility and competitiveness, a case study in the North-Eastern Italian regions will be used for the application of the accessibility distributive patterns between the HSR infrastructure and the selected strategies. Results indicate that benefits derive from well informed decisions on HSR station positioning and the appropriate blend of complementary services in the whole region to interface HSR infrastructure. The results are significant for all countries in Europe and worldwide, not only for investing in HSR infrastructure, but mostly in terms of building territorial cohesion, while seeking international recognition for developing successful new technology and systems.

Estimating the loading condition of a diesel engine using instantaneous angular speed analysis

Continuing monitoring of diesel engine performance is critical for early detection of fault developments in the engine before they materialize and become a functional failure. Instantaneous crank angular speed (IAS) analysis is one of a few non intrusive condition monitoring techniques that can be utilized for such tasks. In this experimental study, IAS analysis was employed to estimate the loading condition of a 4-stroke 4-cylinder diesel engine in a laboratory condition. It was shown that IAS analysis can provide useful information about engine speed variation caused by the changing piston momentum and crankshaft acceleration during the engine combustion process. It was also found that the major order component of the IAS spectrum directly associated with the engine firing frequency (at twice the mean shaft revolution speed) can be utilized to estimate the engine loading condition regardless of whether the engine is operating at normal running conditions or in a simulated faulty injector case. The amplitude of this order component follows a clear exponential curve as the loading condition changes. A mathematical relationship was established for the estimation of the engine power output based on the amplitude of the major order component of the measured IAS spectrum.

Regulating greenhouse gas emissions from coal mining activities in the context of climate change

Current approaches to the regulation of coal mining activities in Australia have facilitated the extraction of substantial amounts of coal and coal seam gas. The regulation of coal mining activities must now achieve the reduction or mitigation of greenhouse gas emissions in order to address the challenge of climate change and achieve ecologically sustainable development. Several legislative mechanisms currently exist which appear to offer the means to bring about the reduction or mitigation of greenhouse gas emissions from coal mining activities, yet Australia’s emissions from coal mining continue to rise. This article critiques these existing legislative mechanisms and presents recommendations for reform.

The role of human rights in environmental governance : the challenge of climate change

The role of human rights in environmental governance is increasingly gaining attention. This is particularly the case in relation to the challenge of climate change, where there is growing recognition of a real threat to human rights. This chapter argues in favour of greater reference to human rights principles in environmental governance. It refers to the experiences of Torres Strait Islanders to demonstrate the impact of climate change on human rights, and the many benefits which can be gained from a greater consideration of human rights norms in the development of strategies to combat climate change. The chapter also argues that a human rights perspective can help address the underlying injustice of climate change: that it is the people who have contributed least to the problem who will bear the heaviest burden of its effects.

Effects of climate change on the wash-off of volatile organic compounds from urban roads

The predicted changes in rainfall characteristics due to climate change could adversely affect stormwater quality in highly urbanised coastal areas throughout the world. This in turn will exert a significant influence on the discharge of pollutants to estuarine and marine waters. Hence, an in-depth analysis of the effects of such changes on the wash-off of volatile organic compounds (VOCs) from urban roads in the Gold Coast region in Australia was undertaken. The rainfall characteristics were simulated using a rainfall simulator. Principal Component Analysis (PCA) and Multicriteria Decision tools such as PROMETHEE and GAIA were employed to understand the VOC wash-off under climate change. It was found that low, low to moderate and high rain events due to climate change will affect the wash-off of toluene, ethylbenzene, meta-xylene, para-xylene and ortho-xylene from urban roads in Gold Coast. Total organic carbon (TOC) was identified as predominant carrier of toluene, meta-xylene and para-xylene in <1µm to 150µm fractions and for ethylbenzene in 150µm to >300µm fractions under such dominant rain events due to climate change. However, ortho-xylene did not show such affinity towards either TOC or TSS (total suspended solids) under the simulated climatic conditions.

Nurses driving change to improve access to education and quality in lcinical teaching : A partnership between Australia and Viet Nam

In Viet Nam, standards of nursing care fail to meet international competency standards. This increases risks to patient safety (eg. hospital acquired infection), consequently the Ministry of Health identified the need to strengthen nurse education in Viet Nam. This paper presents experiences of a piloted clinical teaching model developed in Ha Noi, to strengthen nurse led institutional capacity for in-service education and clinical teaching. Historically 90% of nursing education was conducted by physicians and professional development in hospitals for nurses was limited. There was minimal communication between hospitals and nursing schools about expectations of students and assessment and quality of the learning experience. As a result when students came to the clinical sites, no-one understood how to plan their learning objectives and utilise teaching and learning approaches appropriate to their level. Therefore student learning outcomes were variable. They focussed on procedures and techniques and “learning how to do” rather than learning how to plan, implement and evaluate patient care. This project is part of a multi-component capacity building program designed to improve nurse education in Viet Nam. The project was funded jointly by Queensland University of Technology (QUT) and the Australian Agency for International Development. Its aim was to develop a collaborative clinically-based model of teaching to create an environment that encourages evidence-based, student-centred clinical learning. Accordingly, strategies introduced promoted clinical teaching of competency based nursing practice utilising the regionally endorsed nurse core competency standards. Thirty nurse teachers from Viet Duc University Hospital and Hanoi Medical College participated in the program. These nurses and nurse teachers undertook face to face education in three workshops, and completed three assessment items. Assessment was applied, where participants integrated the concepts learned in each workshop and completed assessment tasks related to planning, implementing and evaluating teaching in the clinical area. Twenty of these participants were then selected to undertake a two week study tour in Brisbane, Australia where the clinical teaching model was refined and an action plan developed to integrate into both organisations with possible implementation across Viet Nam. Participants on this study tour also experienced clinical teaching and learning at QUT by attending classes held at the university, and were able to visit selected hospitals to experience clinical teaching in these settings as well. Effectiveness of the project was measured throughout the implementation phase and in follow up visits to the clinical site. To date changes have been noted on an individual and organisational level. There is also significant planning underway to incorporate the clinical teaching model developed across the organisation and how this may be implemented in other regions. Two participants have also been involved in disseminating aspects of this approach to clinical teaching in Ho Chi Minh, with further plans for more in-depth dissemination to occur throughout the country.

Cost efficiency v quality service : using CHAT as a tool for understanding change and transformation in work practices

This chapter provides an analysis of feedback from key stakeholders, collected as part of a research project, on the problems and tensions evident in the collective work practices of learning advisers employed in learning assistance services at an Australian metropolitan university (Peach, 2003). The term 'learning assistance' is used in the Australian higher education sector generally to refer to student support services that include assistance with academic writing and other study skills. The aim of the study was to help learning advisers and other key stakeholders develop a better understanding of the work activity with a view to using this understanding to generate improvements in service provision. Over twenty problems and associated tensions were identified through stakeholder feedback however the focus of this chapter is the analysis of tensions related to a cluster of problems referred to as cost-efficiency versus quality service. Theoretical modelling derived from the tools made available through cultural historical activity theory and expansive visibilsation (Engestrom and Miettinen, 1999) and excerpts from data are used to illustrate how different understandings of the purpose of learning assistance services impacts on the work practices of learning advisers and creates problems and tensions in relation to the type of service available (including use of technology),level of service available, and learning adviser workload.

Conceptualising climate change in rural Australia : community perceptions, attitudes and (in) actions

Public engagement and support is essential for ensuring adaptation to climate change. The first step in achieving engagement is documenting how the general public currently perceive and understand climate change issues, specifically the importance they place on this global problem and identifying any unique challenges for individual communities. For rural communities, which rely heavily on local agriculture industries, climate change brings both potential impacts and opportunities. Yet, to date, our knowledge about how rural residents conceptualise climate change is limited. Thus, this research explores how the broader rural community – not only farmers – conceptualise climate change and responsive activities, focussing on documenting the understandings and risk perceptions of local residents from two small Australian rural communities. Twenty-three semi-structured interviews were conducted in communities in the Eden/Gippsland region on the border of New South Wales and Victoria, and the North-East of Tasmania. There are conflicting views on how climate change is conceptualised, the degree of concern and need for action, the role of local industry, who will 'win' and 'lose', and the willingness of rural communities to adapt. In particular, residents who believed in anthropogenic or human-induced factors described the changing climate as evidence of 'climate change', whereas those who were more sceptical termed it 'weather variability', suggesting that there is a divide in rural Australia that, unless urgently addressed, will hinder local and national policy responses to this global issue. Engaging these communities in the 21st century climate change debate will require a significant change in terminology and communication strategies.

Retrofitting commercial office buildings for sustainability : tenants’ expectations and experiences

Introduction Buildings, which account for approximately half of all annual energy and greenhouse gas emissions, are an important target area for any strategy addressing climate change. Whilst new commercial buildings increasingly address sustainability considerations, incorporating green technology in the refurbishment process of older buildings is technically, financially and socially challenging. This research explores the expectations and experiences of commercial office building tenants, whose building was under-going green refurbishment. Methodology Semi-structured in-depth interviews with seven residents and neighbours of a large case-study building under-going green refurbishment in Melbourne, Australia. Built in 1979, the 7,008m² ‘B’ grade building consists of 11 upper levels of office accommodation, ground floor retail, and a basement area leased as a licensed restaurant. After refurbishment, which included the installation of chilled water pumps, solar water heating, waterless urinals, insulation, disabled toilets, and automatic dimming lights, it was expected that the environmental performance of the building would move from a non-existent zero ABGR (Australian Building Greenhouse Rating) star rating to 3.5 stars, with a 40% reduction in water consumption and 20% reduction in energy consumption. Interviews were transcribed, with responses analysed using a thematic approach, identifying categories, themes and patterns. Results Commercial property tenants are on a journey to sustainability - they are interested and willing to engage in discussions about sustainability initiatives, but the process, costs and benefits need to be clear. Critically, whilst sustainability was an essential and non-negotiable criterion in building selection for government and larger corporate tenants, sustainability was not yet a core business value for smaller organisations – whilst they could see it as an emerging issue, they wanted detailed cost-benefit analyses, pay-back calculations of proposed technologies and, ideally, wished they could trial the technology first-hand in some way. Although extremely interested in learning more, most participants reported relatively minimal knowledge of specific sustainability features, designs or products. In discussions about different sustainable technologies (e.g., waterless urinals, green-rated carpets), participants frequently commented that they knew little about the technology, had not heard of it or were not sure exactly how it worked. Whilst participants viewed sustainable commercial buildings as the future, they had varied expectations about the fate of existing older buildings – most felt that they would have to be retrofitted at some point to meet market expectations and predicted the emergence of a ‘non-sustainability discount’ for residing in a building without sustainable features. Discussion This research offers a beginning point for understanding the difficulty of integrating green technology in older commercial buildings. Tenants currently have limited understandings of technology and potential building performance outcomes, which ultimately could impede the implementation of sustainable initiatives in older buildings. Whilst the commercial property market is interested in learning about sustainability in the built environment, the findings highlight the importance of developing a strong business case, communication and transition plan for implementing sustainability retrofits in existing commercial buildings.

Rethinking regulatory design : The Australian National Classification Scheme review

This paper considers issues of methodological innovation in communication, media and cultural studies, that arise out of the extent to which we now live in a media environment characterised by an digital media abundance, the convergence of media platforms, content and services, and the globalisation of media content through ubiquitous computing and high-speed broadband networks. These developments have also entailed a shift in the producer-consumer relationships that characterised the 20th century mass communications paradigm, with the rapid proliferation of user-created content, accelerated innovation, the growing empowerment of media users themselves, and the blurring of distinctions between public and private, as well as age-based distinctions in terms of what media can be accessed by whom and for what purpose. It considers these issues through a case study of the Australian Law Reform Commission's National Classification Scheme Review.

Impact of urban traffic and climate change on water quality from road runoff

Urban traffic and climate change are two phenomena that have the potential to degrade urban water quality by influencing the build-up and wash-off of pollutants, respectively. However, limited knowledge has made it difficult to establish any link between pollutant buildup and wash-off under such dynamic conditions. In order to safeguard urban water quality, adaptive water quality mitigation measures are required. In this research, pollutant build-up and wash-off have been investigated from a dynamic point of view which incorporated the impacts of changed urban traffic as well as changes in the rainfall characteristics induced by climate change. The study has developed a dynamic object classification system and thereby, conceptualised the study of pollutant build-up and wash-off under future changes in urban traffic and rainfall characteristics. This study has also characterised the buildup and wash-off processes of traffic generated heavy metals, volatile, semi-volatile and non-volatile hydrocarbons under dynamic conditions which enables the development of adaptive mitigation measures for water quality. Additionally, predictive frameworks for the build-up and wash-off of some pollutants have also been developed.