The intra-aortic balloon pump in heart failure management : implications for nursing practice

Management of acute heart failure is an important consideration in critical care. Mechanical support of the failing heart is crucial for improving health outcomes. The most common Australasian application of intraaortic balloon counterpulsation (IABP) is in the setting of cardiogenic shock. High end users of IABP (>37/annum) demonstrate significantly lower mortality for cardiogenic shock managed with IABP (p <0.001) in contrast to hospitals which employ limited IABP (<4/annum). This underscores the importance of proficiency in managing patient receiving IABP support. Nurses play a crucial role in carding for patients with acute heart failure. This paper summarises care considerations for management of the IABP.

Australasian horror special issue editorial : putting Australian and New Zealand horror movies on the map of cinema studies

This Australasian horror special issue is an important step forward in putting Australian and New Zealand horror movies on the map of film and cinema studies as a subject worthy of intellectual debate. The journal issue is the first devoted solely to the academic discussion of Australasian horror movies. While an Australian horror movie tradition has produced numerous titles since the 1970s achieving commercial success and cult popularity worldwide, the horror genre is largely missing from Australian film history. While there have been occasional essays on standout titles such as Wolf Creek (Mclean, 2005), an increasing number of articles on ‘Ozploitation’ movies, and irregular discussion about Australian Gothic, overall the nature of Australian horror as a genre remains poorly understood. In terms of New Zealand, debate has tended to revolve around ‘Kiwi Gothic’ and of course Peter Jackon’s early splatter films, rather than Kiwi horror as a specific filmmaking tradition.

The skin awareness study : promoting thorough skin self-examination for skin cancer among men 50 years or older

Background: Incidence and mortality from skin cancers including melanoma are highest among men 50 years or older. Thorough skin self-examination may be beneficial to improve skin cancers outcomes.--------- Objectives: To develop and conduct a randomized-controlled trial of a video-based intervention to improve skin self-examination behavior among men 50 years or older.--------- Methods: Pilot work ascertained appropriate targeting of the 12-minute intervention video towards men 50 years or older. Overall, 968 men were recruited and 929 completed baseline telephone assessment. Baseline analysis assessed randomization balance and demographic, skin cancer risk and attitudinal factors associated with conducting a whole-body skin self-examination or receiving a whole-body clinical skin examination by a doctor during the past 12 months.--------- Results: Randomization resulted in well-balanced intervention and control groups. Overall 13% of men reported conducting a thorough skin self-examination using a mirror or the help of another person to check difficult to see areas, while 39% reported having received a whole-body skin examination by a doctor within the past 12 months. Confidence in finding time for and receiving advice or instructions by a doctor to perform a skin self-examination were among the factors associated with thorough skin self-examination at baseline.---------- Conclusions: Men 50 years or older can successfully be recruited to a video-based intervention trial with the aim reduce their burden through skin cancer. Randomization by computer generated randomization list resulted in good balance between control and intervention group and baseline analysis determined factors associated with skin cancer early detection behavior at baseline.

Technical note : modelling a complex micro-multileaf collimator using the standard BEAMnrc distribution

Purpose: The component modules in the standard BEAMnrc distribution may appear to be insufficient to model micro-multileaf collimators that have tri-faceted leaf ends and complex leaf profiles. This note indicates, however, that accurate Monte Carlo simulations of radiotherapy beams defined by a complex collimation device can be completed using BEAMnrc's standard VARMLC component module.---------- Methods: That this simple collimator model can produce spatially and dosimetrically accurate micro-collimated fields is illustrated using comparisons with ion chamber and film measurements of the dose deposited by square and irregular fields incident on planar, homogeneous water phantoms.---------- Results: Monte Carlo dose calculations for on- and off-axis fields are shown to produce good agreement with experimental values, even upon close examination of the penumbrae.--------- Conclusions: The use of a VARMLC model of the micro-multileaf collimator, along with a commissioned model of the associated linear accelerator, is therefore recommended as an alternative to the development or use of in-house or third-party component modules for simulating stereotactic radiotherapy and radiosurgery treatments. Simulation parameters for the VARMLC model are provided which should allow other researchers to adapt and use this model to study clinical stereotactic radiotherapy treatments.

The key lessons learnt from producing the ABC programme Talking Heads a talk show/documentary hybrid in a fast turnaround environment

The following exegesis will detail the key advantages and disadvantages of combining a traditional talk show genre with a linear documentary format using a small production team and a limited budget in a fast turnaround weekly environment. It will deal with the Australian Broadcasting Corporation series Talking Heads, broadcast weekly in the early evening schedule for the network at 18.30 with the presenter Peter Thompson. As Executive Producer for the programme at its inception I was responsible for setting it up for the ABC in Brisbane, a role that included selecting most of the team to work on the series and commissioning the music, titles and all other aspects required to bring the show to the screen. What emerged when producing this generic hybrid will be examined at length, including: „h The talk show/documentary hybrid format needs longer than 26¡¦30¡¨ to be entirely successful. „h The type of presenter ideally suited to the talk show/documentary format requires someone who is genuinely interested in their guests and flexible enough to maintain the format against tangential odds. „h The use of illustrative footage shot in a documentary style narrative improves the talk show format. iv „h The fast turnaround of the talk show/documentary hybrid puts tremendous pressure on the time frames for archive research and copyright clearance and therefore needs to be well-resourced. „h In a fast turnaround talk show/documentary format the field components are advantageous but require very low shooting ratios to be sustainable. „h An intimate set works best for a talk show hybrid like this. Also submitted are two DVDs of recordings of programmes I produced and directed from the first and third series. These are for consideration in the practical component of this project and reflect the changes that I made to the series.

Use of micro-ATR/FTIR imaging to study heterogeneous polymer oxidation by direct solvent casting onto the ATR IRE

A technique is described whereby micro-ATR/FTIR imaging can be used to follow polymer degradation reactions in situ in real time. The internal reflection element (IRE) assembly is removed from the ATR objective and polymer is solvent cast directly onto the IRE surface. The polymer is then subjected to degradation conditions and molecular structural changes monitored by periodically replacing the IRE assembly back in the ATR objective and collecting spectra which can be used to construct images. This approach has the benefit that the same part of the sample is always studied, and that contact by pressure which might damage the polymer surface is not required. The technique is demonstrated using the polymer Topas which was degraded by exposure to UVC light in air.

Did the goodwill accounting standard impose material economic consequences on Australian acquirers?

This research explores the empirical association between takeover bid premium and acquired (purchased) goodwill, and tests whether the strength of the association changes after the passage of approved accounting standard AASB 1013 in Australia in 1988. AASB 1013 mandated capitalization and amortization of acquired goodwill to the income statement over a maximum period of 20 years. We use regressions to assess how the association between bid premium and acquired goodwill varies in the pre-AASB and post-AASB 1013 periods after controlling for confounding factors. Our results show that reducing the variety of accounting policy options available to bidder management after an acquisition results in a systematic reduction in the strength of the association between premium and goodwill.

Social capital in a tolerant society? a response to treasurer Costello’s presentation to the Sydney Institute

On 16 July 2003 the Australian Government’s Treasurer, the Honourable Peter Costello, addressed the Sydney Institute on his vision for a tolerant Australian society. Drawing from Putnam’s research Costello argued that tolerance will flow from an active voluntary sector. However, Costello’s proposed model for a “tolerant” society fails to acknowledge that all behaviour is strategic and that voluntary association based on disinterested action is not possible. Ultimately, Treasurer Costello’s notion of tolerant society fuelled by an active voluntary sector may not lead to his desired end. Indeed, the promotion of voluntary association may contribute to the ongoing exclusion of citizens with low social capital. Amid the dynamism of the modern era some citizens such as ageing workers, slow or ineffective learners and women may be especially at risk. Accordingly, rather than advocating a policy approach that seeks to build inclusiveness through an active voluntary sector this paper recommends a policy approach that explores ways in which to strengthen learning and the wider involvement of individuals through both formal and informal means.

The vernacular terrain : Songzhang Art Museum, Beijing, China

The field was the curation of cross-cultural new media/ digital media practices within large-scale exhibition practices in China. The context was improved understandings of the intertwining of the natural and the artificial with respect to landscape and culture, and their consequent effect on our contemporary globalised society. The research highlighted new languages of media art with respect to landscape and their particular underpinning dialects. The methodology was principally practice-led. --------- The research brought together over 60 practitioners from both local and diasporic Asian, European and Australian cultures for the first time within a Chinese exhibition context. Through pursuing a strong response to both cultural displacement and re-identification the research forged and documented an enduring commonality within difference – an agenda further concentrated through sensitivities surrounding that year’s Beijing’s Olympics. In contrast to the severe threats posed to the local dialects of many of the world’s spoken and written languages the ‘Vernacular Terrain’ project evidenced that many local creative ‘dialects’ of the environment-media art continuum had indeed survived and flourished. --------- The project was co-funded by the Beijing Film Academy, QUT Precincts, IDAProjects and Platform China Art Institute. A broad range of peer-reviewed grants was won including from the Australia China Council and the Australian Embassy in China. Through invitations from external curators much of the work then traveled to other venues including the Block Gallery at QUT and the outdoor screens at Federation Square, Melbourne. The Vernacular Terrain catalogue featured a comprehensive history of the IDA project from 2000 to 2008 alongside several major essays. Due to the reputation IDA Projects had established, the team were invited to curate a major exhibition showcasing fifty new media artists: The Vernacular Terrain, at the prestigious Songzhang Art Museum, Beijing in Dec 07-Jan 2008. The exhibition was designed for an extensive, newly opened gallery owned by one of China's most important art historians Li Xian Ting. This exhibition was not only this gallery’s inaugural non-Chinese curated show but also the Gallery’s first new media exhibition. It included important works by artists such as Peter Greenway, Michael Roulier, Maleonn and Cui Xuiwen. --------- Each artist was chosen both for a focus upon their own local environmental concerns as well as their specific forms of practice - that included virtual world design, interactive design, video art, real time and manipulated multiplayer gaming platforms and web 2.0 practices. This exhibition examined the interconnectivities of cultural dialogue on both a micro and macro scale; incorporating the local and the global, through display methods and design approaches that stitched these diverse practices into a spatial map of meanings and conversations. By examining the contexts of each artist’s practice in relationship to the specificity of their own local place and prevailing global contexts the exhibition sought to uncover a global vernacular. Through pursuing this concentrated anthropological direction the research identified key themes and concerns of a contextual language that was clearly underpinned by distinctive local ‘dialects’ thereby contributing to a profound sense of cross-cultural association. Through augmentation of existing discourse the exhibition confirmed the enduring relevance and influence of both localized and globalised languages of the landscape-technology continuum.

Business on-line? An empirical study of factors leading to the adoption of Internet technologies by Australian SMEs

E-commerce technologies such as a website, email and the use of web browsers enables access to large amounts of information, facilitates communication and provides niche companies with an effective mechanism for competing with larger organisations world-wide. However recent literature has shown Australian SMEs have been slow in the uptake of these technologies. The aim of this research was to determine which factors were important in impacting on small firms' decision making in respect of information technology and e-commerce adoption. Findings indicate that generally the more a firm was concerned about its competitive position such a firm was likely to develop a web site. Moreover the 'Industry and Skill Demands' dimension suggested that as the formal education of the owner/manager increased, coupled with the likelihood that the firm was in the transport and storage or communication services industries, and realising the cost of IT adoption was in effect an investment, then such a firm would be inclined to develop a web site.

Darjeeling, a feature-rich VM for the resource poor

The programming and retasking of sensor nodes could benefit greatly from the use of a virtual machine (VM) since byte code is compact, can be loaded on demand, and interpreted on a heterogeneous set of devices. The challenge is to ensure good programming tools and a small footprint for the virtual machine to meet the memory constraints of typical WSN platforms. To this end we propose Darjeeling, a virtual machine modelled after the Java VM and capable of executing a substantial subset of the Java language, but designed specifically to run on 8- and 16-bit microcontrollers with 2 - 10 KB of RAM. The Darjeeling VM uses a 16- rather than a 32-bit architecture, which is more efficient on the targeted platforms. Darjeeling features a novel memory organisation with strict separation of reference from non-reference types which eliminates the need for run-time type inspection in the underlying compacting garbage collector. Darjeeling uses a linked stack model that provides light-weight threads, and supports synchronisation. The VM has been implemented on three different platforms and was evaluated with micro benchmarks and a real-world application. The latter includes a pure Java implementation of the collection tree routing protocol conveniently programmed as a set of cooperating threads, and a reimplementation of an existing environmental monitoring application. The results show that Darjeeling is a viable solution for deploying large-scale heterogeneous sensor networks. Copyright 2009 ACM.

Meniscal repair in the elite athlete : results of 45 repairs with a minimum 5-year follow-up

Background The preservation of meniscal tissue is important to protect joint surfaces. Purpose We have an aggressive approach to meniscal repair, including repairing tears other than those classically suited to repair. Here we present the medium- to long-term outcome of meniscal repair (inside-out) in elite athletes. Study Design Case series; Level of evidence, 4. Methods Forty-two elite athletes underwent 45 meniscal repairs. All repairs were performed using an arthroscopically assisted inside-out technique. Eighty-three percent of these athletes had ACL reconstruction at the same time. Patients returned a completed questionnaire (including Lysholm and International Knee Documentation Committee [IKDC] scores). Mean follow-up was 8.5 years. Failure was defined by patients developing symptoms of joint line pain and/or locking or swelling requiring repeat arthroscopy and partial meniscectomy. Results The average Lysholm and subjective IKDC scores were 89.6 and 85.4, respectively. Eighty-one percent of patients returned to their main sport and most to a similar level at a mean time of 10.4 months after repair, reflecting the high level of ACL reconstruction in this group. We identified 11 definite failures, 10 medial and 1 lateral meniscus, that required excision; this represents a 24% failure rate. We identified 1 further patient who had possible failed repairs, giving a worst-case failure rate of 26.7% at a mean of 42 months after surgery. However, 7 of these failures were associated with a further injury. Therefore, the atraumatic failure rate was 11%. Age and size and location of the tears were not associated with a higher failure rate. Medial meniscal repairs were significantly more likely to fail than lateral meniscal repairs, with a failure rate of 36.4% and 5.6%, respectively (P < .05). Conclusion Meniscal repair and healing are possible, and most elite athletes can return to their preinjury level of activity.

Telephone reliability of the Frenchay Activity Index and EQ-5D amongst older adults

Background Older adults may find it problematic to attend hospital appointments due to the difficulty associated with travelling to, within and from a hospital facility for the purpose of a face-to-face assessment. This study aims to investigate equivalence between telephone and face-to-face administration for the Frenchay Activities Index (FAI) and the Euroqol-5D (EQ-5D) generic health-related quality of life instrument amongst an older adult population. Methods Patients aged >65 (n = 53) who had been discharged to the community following an acute hospital admission underwent telephone administration of the FAI and EQ-5D instruments seven days prior to attending a hospital outpatient appointment where they completed a face-to-face administration of these instruments. Results Overall, 40 subjects' datasets were complete for both assessments and included in analysis. The FAI items had high levels of agreement between the two modes of administration (item kappa's ranged 0.73 to 1.00) as did the EQ-5D (item kappa's ranged 0.67–0.83). For the FAI, EQ-5D VAS and EQ-5D utility score, intraclass correlation coefficients were 0.94, 0.58 and 0.82 respectively with paired t-tests indicating no significant systematic difference (p = 0.100, p = 0.690 and p = 0.290 respectively). Conclusion Telephone administration of the FAI and EQ-5D instruments provides comparable results to face-to-face administration amongst older adults deemed to have cognitive functioning intact at a basic level, indicating that this is a suitable alternate approach for collection of this information.

From the cathedral to the classroom : the emergence of new discourses on religious education

In 2009, Religious Education is a designated key learning area in Catholic schools in the Archdiocese of Brisbane and, indeed, across Australia. Over the years, though, different conceptualisations of the nature and purpose of religious education have led to the construction of different approaches to the classroom teaching of religion. By investigating the development of religious education policy in the Archdiocese of Brisbane from 1984 to 2003, the study seeks to trace the emergence of new discourses on religious education. The study understands religious education to refer to a lifelong process that occurs through a variety of forms (Moran, 1989). In Catholic schools, it refers both to co-curricula activities, such as retreats and school liturgies, and the classroom teaching of religion. It is the policy framework for the classroom teaching of religion that this study explores. The research was undertaken using a policy case study approach to gain a detailed understanding of how new conceptualisations of religious education emerged at a particular site of policy production, in this case, the Archdiocese of Brisbane. The study draws upon Yeatman’s (1998) description of policy as occurring “when social actors think about what they are doing and why in relation to different and alternative possible futures” (p. 19) and views policy as consisting of more than texts themselves. Policy texts result from struggles over meaning (Taylor, 2004) in which specific discourses are mobilised to support particular views. The study has a particular interest in the analysis of Brisbane religious education policy texts, the discursive practices that surrounded them, and the contexts in which they arose. Policy texts are conceptualised in the study as representing “temporary settlements” (Gale, 1999). Such settlements are asymmetrical, temporary and dependent on context: asymmetrical in that dominant actors are favoured; temporary because dominant actors are always under challenge by other actors in the policy arena; and context - dependent because new situations require new settlements. To investigate the official policy documents, the study used Critical Discourse Analysis (hereafter referred to as CDA) as a research tool that affords the opportunity for researchers to map and chart the emergence of new discourses within the policy arena. As developed by Fairclough (2001), CDA is a three-dimensional application of critical analysis to language. In the Brisbane religious education arena, policy texts formed a genre chain (Fairclough, 2004; Taylor, 2004) which was a focus of the study. There are two features of texts that form genre chains: texts are systematically linked to one another; and, systematic relations of recontextualisation exist between the texts. Fairclough’s (2005) concepts of “imaginary space” and “frameworks for action” (p. 65) within the policy arena were applied to the Brisbane policy arena to investigate the relationship between policy statements and subsequent guidelines documents. Five key findings emerged from the study. First, application of CDA to policy documents revealed that a fundamental reconceptualisation of the nature and purpose of classroom religious education in Catholic schools occurred in the Brisbane policy arena over the last twenty-five years. Second, a disjuncture existed between catechetical discourses that continued to shape religious education policy statements, and educational discourses that increasingly shaped guidelines documents. Third, recontextualisation between policy documents was evident and dependent on the particular context in which religious education occurred. Fourth, at subsequent links in the chain, actors created their own “imaginary space”, thereby altering orders of discourse within the policy arena, with different actors being either foregrounded or marginalised. Fifth, intertextuality was more evident in the later links in the genre chain (i.e. 1994 policy statement and 1997 guidelines document) than in earlier documents. On the basis of the findings of the study, six recommendations are made. First, the institutional Church should carefully consider the contribution that the Catholic school can make to the overall pastoral mission of the diocese in twenty-first century Australia. Second, policymakers should articulate a nuanced understanding of the relationship between catechesis and education with regard to the religion classroom. Third, there should be greater awareness of the connections among policies relating to Catholic schools – especially the connection between enrolment policy and religious education policy. Fourth, there should be greater consistency between policy documents. Fifth, policy documents should be helpful for those to whom they are directed (i.e. Catholic schools, teachers). Sixth, “imaginary space” (Fairclough, 2005) in policy documents needs to be constructed in a way that allows for multiple “frameworks for action” (Fairclough, 2005) through recontextualisation. The findings of this study are significant in a number of ways. For religious educators, the study highlights the need to develop a shared understanding of the nature and purpose of classroom religious education. It argues that this understanding must take into account the multifaith nature of Australian society and the changing social composition of Catholic schools themselves. Greater recognition should be given to the contribution that religious studies courses such as Study of Religion make to the overall religious development of a person. In view of the social composition of Catholic schools, there is also an issue of ecclesiological significance concerning the conceptualisation of the relationship between the institutional Catholic Church and Catholic schools. Finally, the study is of significance because of its application of CDA to religious education policy documents. Use of CDA reveals the foregrounding, marginalising, or excluding of various actors in the policy arena.