Mitigating surgical risk in patients undergoing hip arthroplasty for fractures of the proximal femur

Recently the National Patient Safety Agency in the United Kingdom published a report entitled "Mitigating surgical risk in patients undergoing hip arthroplasty for fractures of the proximal femur". A total of 26 deaths had been reported to them when cement was used at hemiarthroplasty between October 2003 and October 2008. This paper considers the evidence for using cement fixation of a hemiarthroplasty in the treatment of hip fractures.

They also serve who only stand and wait

Purpose Waiting for service by customers is an important problem for many financial service marketers. Two new approaches are proposed. First, customer evaluation of the service is increased with an ambient scent. Second a cognitive variable is identified which different iates customers by the way they value time so that they can be segmented. Methodology Pretests included focus groups which highlighted financial services and a pilot test were foll owed by a main sample of 607 subjects. Structural equation modelling and multivariate analysis of covariance were used for analysis. Findings A cognitive variable, the need for time management can be used, together with demographic and customer net worth data, to segment a customer base. Two environmental interventions, music and scent, can increase customer satisfaction among customers kept waiting in a line. Research implications Two original approaches to a rapidly growing service marketing problem are identified. Practical implications Service contact points can reduce incidence of "queue rage" and enhance customer satisfaction by either or both of two simple modifications to the service environment or a preventive strategy of offering targeted customers an alternative. Originality A new method of segmentation and a new environmental intervention are proposed .

Cultural selection and its influence on perceptions of reputation within organisations

The capacity to identify, interpret, and prioritise environmental issues is critical in the management of corporate reputation. In spite of the significance of these abilities for corporate reputation management, there has been little effort to document and describe internal organizational influences on these capacities. Contrary to this state of affairs in the discipline of public relations, a long history of ethnographic research in cultural anthropology documents how sets of shared environmental perceptions can influence and moderate environmental factors in cultural populations (see for example, Durham, 1991 ). This study explores how cultural “frames of reference” derived from shared values and assumptions among organizational members influence organizational perceptions, and consequently, organizational actions. Specifically, this study explores how a central attribute of organizational culture--the property of cultural selection-- influences perceptions of organizational reputation held by organizational members. Perceptions of reputation among organizational members are obvious drivers to both the nature of and rationale for organizational communication strategies and responses. These perceptions are the result of collective processes that synthesise (with varying degrees of consensus) member conceptualisations, interpretations, and representations of the environmental realities in which their organization operate. To explore how cultural selection influences member perceptions of organizational reputation, this study employs ethnographic research including 20 depth interviews and six months of organizational observation in the focal organization. We argue that while external indicators of organizational reputation are acknowledged by members as significant, the internal action of cultural selection is a far stronger influence on organizational action.

Levels of cardiac knowledge and cardiopulmonary resuscitation training among older people in Queensland

Objectives: The current study was conducted to determine levels of cardiac knowledge and cardiopulmonary resuscitation (CPR) training in older people in Queensland, Australia.---------- Methods: A telephone survey of 4490 Queensland adults examined respondents’ knowledge of coronary heart disease (CHD) risk factors, knowledge of heart attack symptoms, knowledge of the local emergency telephone number, as well as respondents’ rates and recency of training in CPR.---------- Results: Older participants, aged 60 years and over, were approximately one and a half times more likely than the 30–39 year-old reference group to have limited knowledge of heart disease risk factors (OR = 1.53), and low knowledge of heart attack symptoms (OR = 1.60). Knowledge of the local emergency telephone number also decreased with age. Older participants had significantly lower rates of training in CPR, with almost three quarters (71.7%) reporting that they had never been trained. Older people who had completed CPR training were significantly less likely to have done so recently.---------- Conclusions: Cardiac knowledge levels and CPR training rates in older Queensland persons were lower than those found in the younger population.

Integrating eco-efficiency assessment of commercial buildings into the design process : LCADesign

The ability to assess a commercial building for its impact on the environment at the earliest stage of design is a goal which is achievable by integrating several approaches into a single procedure directly from the 3D CAD representation. Such an approach enables building design professionals to make informed decisions on the environmental impact of building and its alternatives during the design development stage instead of at the post-design stage where options become limited. The indicators of interest are those which relate to consumption of resources and energy, contributions to pollution of air, water and soil, and impacts on the health and wellbeing of people in the built environment as a result of constructing and operating buildings. 3D object-oriented CAD files contain a wealth of building information which can be interrogated for details required for analysis of the performance of a design. The quantities of all components in the building can be automatically obtained from the 3D CAD objects and their constituent materials identified to calculate a complete list of the amounts of all building products such as concrete, steel, timber, plastic etc. When this information is combined with a life cycle inventory database, key internationally recognised environmental indicators can be estimated. Such a fully integrated tool known as LCADesign has been created for automated ecoefficiency assessment of commercial buildings direct from 3D CAD. This paper outlines the key features of LCADesign and its application to environmental assessment of commercial buildings.

LCADesign : an integrated approach to automatic eco-efficiency assessment of commercial buildings

Buildings consume resources and energy, contribute to pollution of our air, water and soil, impact the health and well-being of populations and constitute an important part of the built environment in which we live. The ability to assess their design with a view to reducing that impact automatically from their 3D CAD representations enables building design professionals to make informed decisions on the environmental impact of building structures. Contemporary 3D object-oriented CAD files contain a wealth of building information. LCADesign has been designed as a fully integrated approach for automated eco-efficiency assessment of commercial buildings direct from 3D CAD. LCADesign accesses the 3D CAD detail through Industry Foundation Classes (IFCs) - the international standard file format for defining architectural and constructional CAD graphic data as 3D real-world objects - to permit construction professionals to interrogate these intelligent drawing objects for analysis of the performance of a design. The automated take-off provides quantities of all building components whose specific production processes, logistics and raw material inputs, where necessary, are identified to calculate a complete list of quantities for all products such as concrete, steel, timber, plastic etc and combines this information with the life cycle inventory database, to estimate key internationally recognised environmental indicators such as CML, EPS and Eco-indicator 99. This paper outlines the key modules of LCADesign and their role in delivering an automated eco-efficiency assessment for commercial buildings.

Life cycle inventory for Australian building materials

This paper discusses challenges to developers of a national Life Cycle Inventory (LCI) database on which to base assessment of building environmental impacts and a key to development of a fully integrated eco-design tool created for automated eco-efficiency assessment of commercial building design direct from 3D CAD. The scope of this database includes Australian and overseas processing burdens involved in acquiring, processing, transporting, fabricating, finishing and using metals, masonry, timber, glazing, ceramics, plastics, fittings, composites and coatings. Burdens are classified, calculated and reported for all flows of raw materials, fuels, energy and emissions to and from the air, soil and water associated with typical products and services in building construction, fitout and operation. The aggregated life cycle inventory data provides the capacity to generate environmental impact assessment reports based on accepted performance indicators. Practitioners can identify hot spots showing high environmental burdens of a proposed design and drill down to report on specific building components. They can compare assessments with case studies and operational estimates to assist in eco-efficient design of a building, fitout and operation.

The cost-effectiveness of routine follow-up after primary total hip arthroplasty

Routine postsurgery assessment of primary total hip arthroplasty (THA) is recommended in many countries. Whether the benefits of this activity are justified by the costs is not known. We used a decision-analytic Markov model to compare the costs and health outcomes of 3 different follow-up strategies after primary THA. If there is no routine follow-up of patients for 7 years after primary THA, there would be cost savings between AU$6.5 and $11.9 million and gains of between 1.8 and 8.8 quality-adjusted life years. Policy makers should investigate less resource-intensive alternatives to common routine postsurgical assessment.

Embodied vulnerabilities : responding to violent encounters through installation practices

This practice-led research was initiated in response to a series of violent encounters that occurred between my fragile installations and viewers. The central focus of this study was to recuperate my installation practice in the wake of such events. This led to the development of a ‘responsive practice’ methodology, which reframed the installation process through an ethical lens developed from Emmanuel Levinas’ ethical phenomenology. The central propositions of this research are the reconceptualisation of ‘violent encounters’ in terms of difference whereby I accept viewers responses, even those which are violent, destructive or damaging, and secondly that the process operates as a generative excess for practice through which recuperative strategies can be found and implemented. By re-examining this process as it unfolded in the three phases of the practical component, I developed strategies whereby violated, destroyed or damaged works could be recuperated through the processes of reconfiguration, reparation and regeneration. Therefore my installations embody and articulate vulnerability but also demonstrate resilience and renewal.