Design and rationale of a Prospective, Observational European Multicenter study on the efficacy of acute surgical decompression after traumatic Spinal Cord Injury: the SCI-POEM study

Objectives:Despite many years of research, there is currently no treatment available that results in major neurological or functional recovery after traumatic spinal cord injury (tSCI). In particular, no conclusive data related to the role of the timing of decompressive surgery, and the impact of injury severity on its benefit, have been published to date. This paper presents a protocol that was designed to examine the hypothesized association between the timing of surgical decompression and the extent of neurological recovery in tSCI patients.Study design: The SCI-POEM study is a Prospective, Observational European Multicenter comparative cohort study. This study compares acute (<12 h) versus non-acute (>12 h, <2 weeks) decompressive surgery in patients with a traumatic spinal column injury and concomitant spinal cord injury. The sample size calculation was based on a representative European patient cohort of 492 tSCI patients. During a 4-year period, 300 patients will need to be enrolled from 10 trauma centers across Europe. The primary endpoint is lower-extremity motor score as assessed according to the 'International standards for neurological classification of SCI' at 12 months after injury. Secondary endpoints include motor, sensory, imaging and functional outcomes at 3, 6 and 12 months after injury.Conclusion:In order to minimize bias and reduce the impact of confounders, special attention is paid to key methodological principles in this study protocol. A significant difference in safety and/or efficacy endpoints will provide meaningful information to clinicians, as this would confirm the hypothesis that rapid referral to and treatment in specialized centers result in important improvements in tSCI patients.Spinal Cord advance online publication, 17 April 2012; doi:10.1038/sc.2012.34.

Re-examining the evidence in radiation dermatitis management literature : an overview and a critical appraisal of systematic reviews

Purpose: To provide an overview and a critical appraisal of systematic reviews (SRs) of published interventions for the prevention/management of radiation dermatitis. Methods and Materials: We searched Medline, CINAHL, Embase, and the Cochrane Library. We also manually searched through individual reference lists of potentially eligible articles and a number of key journals in the topic area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using AMSTAR (the measurement tool for “assessment of multiple systematic reviews”). Results: Of 1837 potential titles, 6 SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/nonsteroidal topical agents, systemic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews might create biases to the overall results or recommendations for clinical practice. Conclusions: An up-to-date high-quality SR in the prevention/management of radiation dermatitis is needed to guide practice and direction for future research. We recommend that clinicians or guideline developers critically evaluate the information of SRs in their decision making.

Democratization and Violence: European and International Perspectives

It is a startling fact that when in the mid-80s a ‘third wave’ of democracy took hold in Latin America and Eastern Europe, both democracy and violence were simultaneously on the rise worldwide. Almost by definition democracies represent an institutionalized framework and a way of life that ensures non-violent means to share power between communities of people with widely differing values and beliefs. As Keane (2004) points out, ‘violence is anathema to [democracy’s] spirit and substance’ (p. 1). Accordingly, the process of democratization was accompanied by expectations that violence would generally decrease, and that these countries would embark on a process of reducing levels of violence as Western European countries had done earlier in the 19th and 20th century.

The influence of service quality and trade show effectiveness on post-show purchase intention

Purpose The purpose of this paper is to develop and test an integrative services framework to investigate the role of perceived trade show effectiveness on overall trade show service outcome, conceptualised as the intention to purchase a related product after, rather than during, a show. Design/methodology/approach Drawing on the services marketing and trade show literature, the authors test a model of trade show effectiveness with data collected from 592 attendees at a major automotive trade show in a large metropolitan centre. Findings Results show that improving trade show visitors' perceived service quality positively affects visitor perceptions of trade show effectiveness. Furthermore, both trade show effectiveness and service quality directly influence future purchase intention. Research limitations/implications Employing a services theoretical framework to evaluate trade show visitor experiences provides an alternative to the traditional marketing communications approach. By viewing such visits as service encounters, managers must inevitably consider the effects of service quality and service outcomes in determining the likely success of their shows. The study primarily focuses on one large consumer show and therefore does not constitute a complete, nor necessarily representative, sample of the trade show industry. Originality/value The original contribution of the paper stems from the paucity of research conceptualising trade shows as services and the comparative lack of emphasis placed on visitors rather than exhibitors in the literature. The research not only has utility for trade show organisers but also provides necessary theory-based research in the trade show domain.

Enabling innovation and facilitating learning in kifs: the role of HRM practices

The aim of this paper is to contribute to our understanding of the link between HR practices, learning orientation and types of innovation in knowledge-intensive firms (KIFs). To this end, we first compiled a comprehensive overview of the existing literature on HR practices aimed at supporting innovation. On the basis of this literature, we then collected and analyzed data from a qualitative study of 19 Danish KIFs recognized for their innovation performance, focusing on links between the HR practices they use to support exploratory and exploitive learning behaviors to enhance incremental and/or radical innovation. The findings from this study demonstrate that KIFs utilize a range of HR practices that enable different learning orientations, based on the type of innovation compatible with their organizational goals.

A token to the future : a digital ‘archive’ of early Australian children’s literature

This essay considers a specific digital ‘archive’ of early Australian children’s literature, known as the Children’s Literature Digital Resources (CLDR), which is located in AustLit: The Australian Literature Resource ( http://www.austlit.edu.au ). We examine what the CLDR collection can tell us about Australia’s history. To narrow the scope, we focus on how Australia was constructing itself as a nation with its own character, or national identity, in texts written for children from the latter part of the nineteenth century up until the end of World War II. Our approach is to consider how early Australian children’s literature included in the CLDR collection rhetorically constructs nation and place, and in so doing constructs an Australian identity for its implied readers.

Nanoparticles in European cities and associated health impacts

Atmospheric nanoparticles are one of those pollutants currently unregulated through ambient air quality standards. The aim of this chapter is to assess the environmental and health impacts of atmospheric nanoparticles in European environments. The chapter begins with the conventional information on the origin of atmospheric nanoparticles, followed by their physical and chemical characteristics. A brief overview of recently published review articles on this topic is then presented to guide those readers interested in exploring any specific aspect of nanoparticles in greater detail. A further section reports a summary of recently published studies on atmospheric nanoparticles in European cities. This covers a total of about 45 sampling locations in 30 different cities within 15 European countries for quantifying levels of roadside and urban background particle number concentrations (PNCs). Average PNCs at roadside and urban background sites were found to be 3.82±3.25 ×104 cm–3 and 1.63±0.82 ×104 cm–3, respectively, giving a roadside to background PNC ratio of ~2.4. Engineered nanoparticles are one of the key emerging categories of airborne nanoparticles, especially for the indoor environments. Their ambient concentrations may increase in future due to widespread use of nanotechnology integrated products. Evaluation of their sources and probable impacts on air quality and human health are briefly discussed in the following section. Respiratory deposition doses received by the public exposed to roadside PNCs in numerous European locations are then estimated. These were found to be in the 1.17–7.56 1010 h–1 range over the studied roadside European locations. The following section discusses the potential framework for airborne nanoparticle regulations in Europe and, in addition, the existing control measures to limit nanoparticle emissions at source. The chapter finally concludes with a synthesis of the topic areas covered and highlights important areas for further work.

Paranoid prizing : the facts and fictions of Australia’s Eve Pownall Award for Information Books, 2001-2010

Ghassan Hage asserts the “core element of Australia’s colonial paranoia is a fear of loss of Europeanness or Whiteness and the lifestyle and privileges that are seen to emanate directly from them. This is a combination of the fragility of White European colonial identity in general and the specificity of the Australian situation” (419). This ‘White paranoia’ can be traced through a range of popular cultural formations, including contemporary Australian children’s literature. The Children’s Book Council of Australia (CBCA) awards an annual prize for “outstanding books which have the prime intention of documenting factual material with consideration given to imaginative presentation, interpretation and variation of style” (“Awards”) published in the preceding year. Although not often included in critical debates, non-fictional texts overtly seek to shape young readers’ understandings of their national context and their own location as national subjects. Thus, the books named as winners and honours of this prize from 2001-2010 provide a snapshot of which facts and whose fictions are salient in shaping the Australian nation in the twenty-first century. Using Hage’s concept of Australian colonial paranoia, this paper considers the relationship between ‘factual material’ and ‘imaginative presentation’ in the ongoing revision and renewal of national myths in award-winning Australian non-fiction for children.

Tax morale, Eastern Europe and European enlargement

This study tries to remedy the current lack of tax compliance research analyzing tax morale in 10 Eastern European countries that joined the European Union in 2004 or 2007. By exploring tax morale differences between 1999 and 2008 we show that tax morale has decreased in 7 out of 10 Eastern European countries. This lack of sustainability may support the incentive based conditionality hypothesis that European Union has only a limited ability to influence tax morale over time. We observe that events and processes at the country level are crucial to understanding tax morale. Factors such as perceived government quality, trust in the justice system and the government are positively correlated with tax morale in 2008.

Understanding the relationships between the calf muscle pump, ankle range of motion and healing for adults with venous leg ulcers: a review of the literature

Exercise offers the potential to improve circulation, wound healing outcomes, and functional and emotional wellbeing for adults experiencing venous leg ulceration. Individuals with chronic leg ulcers typically have multiple comorbidities such as arthritis, asthma, chronic obstructive airways disease, cardiac disease or neuromuscular disorders, which would also benefit from regular exercise. The aim of this review is to highlight the relationships between the calf muscle pump and venous return and range of ankle motion for adults with venous leg ulcers. The effect of exercise will also be considered in relation to the healing rates for adults experiencing venous leg ulceration. The findings suggest there is evidence that exercises which engage the calf muscle pump improve venous return. Ankle range of motion, which is crucial for complete activation of the calf muscle pump, can also be improved with simple, home-based exercise programs. However, observational studies still report that venous leg ulcer patients are less physically active than age-matched controls. Therefore, the behavioural reasons for not exercising must be considered. Only two studies, both underpowered, have assessed the effect of exercise on the healing rates of venous leg ulcers. In conclusion, exercise is feasible with this patient population. However, future studies with larger sample sizes are needed to provide stronger evidence to support the therapeutic benefit of exercise as an adjunct therapy in wound care.

The relationship between firm survival and innovation : an introduction to the literature

The rapid growth in use of the Internet as a business tool provides a new perspective in the study of the organizational challenges of new technologies. The innovation literature has grown vastly since its establishment in the 1920s, covering a broad range of disciplines (Foxall 1984) and measures a wide variety of variables (Rogers 1995). At first glance, studies that look at the relationship between innovation and firm survival appear contradictory. However, the results appear compatible when additional factors, such as industry type, organizational age, company size or the duration of the study are taken into account.