Effectiveness of an acellular synthetic matrix in the treatment of hard-to-heal leg ulcers

Hard-to-heal leg ulcers are a major cause of morbidity in the elderly population. Despite improvements in wound care, some wounds will not heal and they present a significant challenge for patients and health care providers. A multi-centre cohort study was conducted to evaluate the effectiveness and safety of a synthetic, extracellular matrix protein as an adjunct to standard care in the treatment of hard-to-heal venous or mixed leg ulcers. Primary effectiveness criteria were (i) reduction in wound size evaluated by percentage change in wound area and (ii) healing assessed by number of patients healed by end of the 12 week study. Pain reduction was assessed as a secondary effectiveness criteria using VAS. A total of 45 patients completed the study and no difference was observed between cohorts for treatment frequency. Healing was achieved in 35·6% and wound size decreased in 93·3% of patients. Median wound area percentage reduction was 70·8%. Over 50% of patients reported pain on first visit and 87·0% of these reported no pain at the end of the study. Median time to first reporting of no pain was 14 days after treatment initiation. The authors consider the extracellular synthetic matrix protein an effective and safe adjunct to standard care in the treatment of hard-to-heal leg ulcers.

The role and contribution of the Queensland public sector employed nurse educator : a grounded theory study

This thesis applied a grounded theory methodology to generate a theoretical understanding of the challenging and ambiguous dimensions of the contemporary role of the public-sector nurse educator within Australia. New knowledge provides a useful structure to examine nurse educator support and mechanisms to foster constructive workplace learning, collaborative relationships and effective contributions to better health care.

2010–2011 Queensland floods : using Haddon's Matrix to define and categorise public safety strategies

Objective The 2010–2011 Queensland floods resulted in the most deaths from a single flood event in Australia since 1916. This article analyses the information on these deaths for comparison with those from previous floods in modern Australia in an attempt to identify factors that have contributed to those deaths. Haddon's Matrix, originally designed for prevention of road trauma, offers a framework for understanding the interplay between contributing factors and helps facilitate a clearer understanding of the varied strategies required to ensure people's safety for particular flood types. Methods Public reports and flood relevant literature were searched using key words ‘flood’, ‘fatality’, ‘mortality’, ‘death’, ‘injury’ and ‘victim’ through Google Scholar, PubMed, ProQuest and EBSCO. Data relating to reported deaths during the 2010–2011 Queensland floods, and relevant data of previous Australian flood fatality (1997–2009) were collected from these available sources. These sources were also used to identify contributing factors. Results There were 33 deaths directly attributed to the event, of which 54.5% were swept away in a flash flood on 10 January 2011. A further 15.1% of fatalities were caused by inappropriate behaviours. This is different to floods in modern Australia where over 90% of deaths are related to the choices made by individuals. There is no single reason why people drown in floods, but rather a complex interplay of factors. Conclusions The present study and its integration of research findings and conceptual frameworks might assist governments and communities to develop policies and strategies to prevent flood injury and fatalities.

Toward biomimetic materials in bone regeneration : functional behavior of mesenchymal stem cells on a broad spectrum of extracellular matrix components

Bone defect treatments can be augmented by mesenchymal stem cell (MSC) based therapies. MSC interaction with the extracellular matrix (ECM) of the surrounding tissue regulates their functional behavior. Understanding of these specific regulatory mechanisms is essential for the therapeutic stimulation of MSC in vivo. However, these interactions are presently only partially understood. This study examined in parallel, for the first time, the effects on the functional behavior of MSCs of 13 ECM components from bone, cartilage and hematoma compared to a control protein, and hence draws conclusions for rational biomaterial design. ECM components specifically modulated MSC adhesion, migration, proliferation, and osteogenic differentiation, for example, fibronectin facilitated migration, adhesion, and proliferation, but not osteogenic differentiation, whereas fibrinogen enhanced adhesion and proliferation, but not migration. Subsequently, the integrin expression pattern of MSCs was determined and related to the cell behavior on specific ECM components. Finally, on this basis, peptide sequences are reported for the potential stimulation of MSC functions. Based on the results of this study, ECM component coatings could be designed to specifically guide cell functions.

A stochastic thermostat algorithm for coarse-grained thermomechanical modeling of large-scale soft matters : theory and application to microfilaments

As all-atom molecular dynamics method is limited by its enormous computational cost, various coarse-grained strategies have been developed to extend the length scale of soft matters in the modeling of mechanical behaviors. However, the classical thermostat algorithm in highly coarse-grained molecular dynamics method would underestimate the thermodynamic behaviors of soft matters (e.g. microfilaments in cells), which can weaken the ability of materials to overcome local energy traps in granular modeling. Based on all-atom molecular dynamics modeling of microfilament fragments (G-actin clusters), a new stochastic thermostat algorithm is developed to retain the representation of thermodynamic properties of microfilaments at extra coarse-grained level. The accuracy of this stochastic thermostat algorithm is validated by all-atom MD simulation. This new stochastic thermostat algorithm provides an efficient way to investigate the thermomechanical properties of large-scale soft matters.

Towards an Australian Indigenous women's standpoint theory : a methodological tool

In this article I outline an Australian Indigenous women's standpoint theory. I argue that an Indigenous women's standpoint generates problematics informed by our knowledges and experiences. Acknowledging that Indigenous women's individual experiences will differ due to intersecting oppressions produced under social, political, historical and material conditions that we share consciously or unconsciously. These conditions and the sets of complex relations that discursively constitute us in the everyday are also complicated by our respective cultural differences and the simultaneity of our compliance and resistance as Indigenous sovereign female subjects.

Early childhood Australia's Best of Sustainability : Research, Practice and Theory

ECA Best of Sustainability: Research, theory and practice by Elliott, Edwards, Davis and Cutter-MacKenzie collates a range of key articles focussing on sustainability from past editions of the Australasian Journal of Early Childhood and Every Child. Sustainable service operation and promoting children’s responsibility and care for the environment are now part of the National Quality Standards and more importantly, all early childhood services must engage with sustainability in this time of increasing global environmental concerns. The publication documents the best of research, theory and practice to date and questions where has early childhood education for sustainability come from and more importantly, where is it going? There are multiple possibilities for educators, researchers, policy makers and managers to take action in early childhood settings for an environmentally sustainable future.

Interleukin-1β stimulates human renal fibroblast proliferation and matrix protein production by means of a transforming growth factor-β-dependent mechanism

One of the hallmarks of progressive renal disease is the development of tubulointerstitial fibrosis. This is frequently preceded by macrophage infiltration, raising the possibility that macrophages relay fibrogenic signals to resident tubulointerstitial cells. The aim of this study was to investigate the potentially fibrogenic role of interleukin-1beta (IL-1beta), a macrophage-derived inflammatory cytokine, on cortical fibroblasts (CFs). Primary cultures of human renal CFs were established and incubated for 24 hours in the presence or absence of IL-1beta. We found that IL-1beta significantly stimulated DNA synthesis (356.7% +/- 39% of control, P <.003), fibronectin secretion (261.8 +/- 11% of control, P <.005), collagen type 1 production, (release of procollagen type 1 C-terminal-peptide, 152.4% +/- 26% of control, P <.005), transforming growth factor-beta (TGF-beta) secretion (211% +/- 37% of control, P <.01), and nitric oxide (NO) production (342.8% +/- 69% of control, P <.002). TGF-beta (1 ng/mL) and the phorbol ester phorbol 12-myristate 13-acetate (PMA, 25 nmol/L) produced fibrogenic effects similar to those of IL-1beta. Neither a NO synthase inhibitor (N(G)-methyl-l-arginine, 1 mmol/L) nor a protein kinase C (PKC) inhibitor (bis-indolylmaleimide 1, 1 micromol/L) altered the enhanced level of fibronectin secretion or DNA synthesis seen in response to IL-1beta treatment. However, addition of a TGF-beta-neutralizing antibody significantly reduced IL-1beta-induced fibronectin secretion (IL-1beta + IgG, 262% +/- 72% vs IL-1beta + alphaTGF-beta 156% +/- 14%, P <.02), collagen type 1 production (IL-1beta + IgG, 176% +/- 28% vs IL-1beta + alphaTGF-beta, 120% +/- 14%, P <.005) and abrogated IL-1beta-induced DNA synthesis (245% +/- 49% vs 105% +/- 21%, P <.005). IL-1beta significantly stimulated CF DNA synthesis and production of fibronectin, collagen type 1, TGFbeta, and NO. The fibrogenic and proliferative action of IL-1beta on CF appears not to involve activation of PKC or production of NO but is at least partly TGFbeta-dependent.

Greener workplace : understanding senior management's adoption decisions through the Theory of Planned Behaviour

Human Resources (HR) policies and practices have changed due to global environmental instability. These policies and practices are key factors for successful environmental management. Using the Theory of Planned Behaviour, this article aims to understand the critical factors which influence senior management’s decision to adopt ‘green’ HR practices. Data were collected from 210 organisations in Australia using two separate surveys. Survey one, which was addressed directly to HR managers and directors, contained questions relating to HR policies (the dependent variables), while survey two, which was addressed directly to CEOs and senior managers, contained questions about environmental-related attitudes, subjective norms and perceived control (the independent variables). Results indicated that senior management’s environmental-related attitudes, subjective norms from stakeholders and perceived green resource readiness influenced their decision to adopt green HR initiatives. However, attitudes and green resource readiness in particular had greater impacts than subjective norms. Limitations, implications and future research are also outlined.

General theory of stigmergy : modelling stigma semantics

Stigmergy is a biological term used when discussing a sub-set of insect swarm-behaviour describing the apparent organisation seen during their activities. Stigmergy describes a communication mechanism based on environment-mediated signals which trigger responses among the insects. This phenomenon is demonstrated in the behavior of ants and their food gathering process when following pheromone trails, where the pheromones are a form of environment-mediated communication. What is interesting with this phenomenon is that highly organized societies are achieved without an apparent management structure. Stigmergy is also observed in human environments, both natural and engineered. It is implicit in the Web where sites provide a virtual environment supporting coordinative contributions. Researchers in varying disciplines appreciate the power of this phenomenon and have studied how to exploit it. As stigmergy becomes more widely researched we see its definition mutate as papers citing original work become referenced themselves. Each paper interprets these works in ways very specific to the research being conducted. Our own research aims to better understand what improves the collaborative function of a Web site when exploiting the phenomenon. However when researching stigmergy to develop our understanding we discover a lack of a standardized and abstract model for the phenomenon. Papers frequently cited the same generic descriptions before becoming intimately focused on formal specifications of an algorithm, or esoteric discussions regarding sub-facets of the topic. None provide a holistic and macro-level view to model and standardize the nomenclature. This paper provides a content analysis of influential literature documenting the numerous theoretical and experimental papers that have focused on stigmergy. We establish that stigmergy is a phenomenon that transcends the insect world and is more than just a metaphor when applied to the human world. We present from our own research our general theory and abstract model of semantics of stigma in stigmergy. We hope our model will clarify the nuances of the phenomenon into a useful road-map, and standardise vocabulary that we witness becoming confused and divergent. Furthermore, this paper documents the analysis on which we base our next paper: Special Theory of Stigmergy: A Design Pattern for Web 2.0 Collaboration.

Experimental verification of the modified spring-mass theory of fiber Bragg grating accelerometers using transverse forces

A fiber Bragg grating (FBG) accelerometer using transverse forces is more sensitive than one using axial forces with the same mass of the inertial object, because a barely stretched FBG fixed at its two ends is much more sensitive to transverse forces than axial ones. The spring-mass theory, with the assumption that the axial force changes little during the vibration, cannot accurately predict its sensitivity and resonant frequency in the gravitational direction because the assumption does not hold due to the fact that the FBG is barely prestretched. It was modified but still required experimental verification due to the limitations in the original experiments, such as the (1) friction between the inertial object and shell; (2) errors involved in estimating the time-domain records; (3) limited data; and (4) large interval ∼5 Hz between the tested frequencies in the frequency-response experiments. The experiments presented here have verified the modified theory by overcoming those limitations. On the frequency responses, it is observed that the optimal condition for simultaneously achieving high sensitivity and resonant frequency is at the infinitesimal prestretch. On the sensitivity at the same frequency, the experimental sensitivities of the FBG accelerometer with a 5.71 gram inertial object at 6 Hz (1.29, 1.19, 0.88, 0.64, and 0.31 nm/g at the 0.03, 0.69, 1.41, 1.93, and 3.16 nm prestretches, respectively) agree with the static sensitivities predicted (1.25, 1.14, 0.83, 0.61, and 0.29 nm/g, correspondingly). On the resonant frequency, (1) its assumption that the resonant frequencies in the forced and free vibrations are similar is experimentally verified; (2) its dependence on the distance between the FBG’s fixed ends is examined, showing it to be independent; (3) the predictions of the spring-mass theory and modified theory are compared with the experimental results, showing that the modified theory predicts more accurately. The modified theory can be used more confidently in guiding its design by predicting its static sensitivity and resonant frequency, and may have applications in other fields for the scenario where the spring-mass theory fails.

Can Business Continuity Management Create Reliability in Airports? (Issues from Theory into Practice)

The advances made within the aviation industry over the past several decades have significantly improved the availability, affordability and convenience of air travel and have been greatly beneficial in both social and economic terms. Air transport has developed into an irreplaceable service being relied on by millions of people each day and as such airports have become critical elements of national infrastructure to facilitate the movement of people and goods. As components of critical infrastructure (CI), airports are integral parts of a national economy supporting regional as well as national trade, commercial activity and employment. Therefore, any disruption or crisis which impacts the continuity of operations at airports can have significant negative consequences for the airport as a business, for the local economy and other nodes of transport infrastructure as well as for society. Due to the highly dynamic and volatile environment in which airports operate in, the aviation industry has faced many different challenges over the years ranging from terrorist attacks such as September 11, to health crises such as the SARS epidemic to system breakdowns such as the recent computer system outage at Virgin Blue Airlines in Australia. All these events have highlighted the vulnerability of airport systems to a range of disturbances as well as the gravity and widespread impact of any kind of discontinuity in airport functions. Such incidents thus emphasise the need for increasing resilience and reliability of airports and ensuring business continuity in the event of a crisis...

Matrix metalloproteinases during wound healing - a double edged sword

The extracellular matrix (ECM) provides a framework for cells and gives skin its tensile strength and elasticity. Loss of its integrity necessitates the clearing of damaged components and the deposition of firstly a provisional matrix and later remodelling of the ECM to support a functionally intact tissue. Matrix metalloproteinases (MMPs) are an important family of enzymes that function in the breakdown of the ECM and modulate the function of many biologically active molecules housed in the ECM. Through their enzymatic actions MMPs play a role in fundamental processes such as immune cell infiltration and ECM remodelling during wound repair. Their tight control is necessary for timely wound healing and excessive MMP activity participates in the development and persistence of chronic wounds, while reduced activity contributes to fibrosis. A number of inhibitors have been designed to target this activity and improve wound healing with limited success. Novel strategies are currently being investigated to improve wound healing by targeting MMP modulating molecules.

Affective events theory as a framework for understanding third-party consumer complaints

Poor complaint management may result in organizations losing customers and revenue. Consumers exhibit negative emotional responses when dissatisfied and this may lead to a complaint to a third-party organization. Since little information is available on the role of emotion in the consumer complaint process or how to manage complaints effectively, we offer an emotions perspective by applying Affective Events Theory (AET) to complaint behavior. This study presents the first application of AET in a consumption context and advances a theoretical framework supported by qualitative research for emotional responses to complaints. In contrast to commonly held views on gender and emotion, men as well as women use emotion-focused coping to complain.