Wound problems following hip arthroplasty before and after the introduction of a direct thrombin inhibitor for thromboprophylaxis

NICE guidelines have stated that patients undergoing elective hip surgery are at increased risk for venous thromboembolic events (VTE) following surgery and have recommended thromboprophylaxis for 28-35 days1, 2. However the studies looking at the new direct thrombin inhibitors have only looked at major bleeding. We prospectively looked at wound discharge in patients who underwent hip arthroplasty and were given dabigatran postoperatively between March 2010 and April 2010 (n=56). We retrospectively compared these results to a matched group of patients who underwent similar operations six months earlier when all patients were given dalteparin routinely postoperatively until discharge, and discharged home on 150mg aspirin daily for 6 weeks (n=67). Wound discharge after 5 days was significantly higher in the patients taking dabigatran (32% dabigatran n=18, 10% dalteparin n=17, p=0.003) and our rate of delayed discharges due to wound discharge significantly increased from 7% in the dalteparin group (n=5) to 27% for dabigatran (n=15, p=0.004). Patients who received dabigatran were more than five times as likely to return to theatre with a wound complication as those who received dalteparin (7% dabigatran n=4, vs. 1% dalteparin n=1), however, this was not statistically significant (p=0.18). The significantly higher wound discharge and return to theatre rates demonstrated in this study have meant that we have changed our practice to administering dalteparin until the wound is dry and then starting dabigatran. Our study demonstrates the need for further clinical studies regarding wound discharge and dabigatran.

The child, the text and the teacher : reading primers and reading instruction

From the late sixteenth century, in response to the problem of how best to teach children to read, a variety of texts such as primers, spellers and readers were produced in England for vernacular instruction. This paper describes how these materials were used by teachers to develop first, a specific religious understanding according to the stricture of the time and second, a moral reading practice that provided the child with a guide to secular conduct. The analysis focuses on the use of these texts as a productive means for shaping the child-reader in the context of newly emerging educational spaces which fostered a particular, morally formative relation among teacher, child and text.

Rethinking comprehension and strategy use in second language listening instruction

In second language classrooms, listening is gaining recognition as an active element in the processes of learning and using a second language. Currently, however, much of the teaching of listening prioritises comprehension without sufficient emphasis on the skills and strategies that enhance learners’ understanding of spoken language. This paper presents an argument for rethinking the emphasis on comprehension and advocates augmenting current teaching with an explicit focus on strategies. Drawing on the literature, the paper provides three models of strategy instruction for the teaching and development of listening skills. The models include steps for implementation that accord with their respective approaches to explicit instruction. The final section of the paper synthesises key points from the models as a guide for application in the second language classroom. The premise underpinning the paper is that the teaching of strategies can provide learners with active and explicit measures for managing and expanding their listening capacities, both in the learning and ‘real world’ use of a second language.

Verbal instruction abolishes fear conditioned to racial out-group faces

Previous research has shown resistance to extinction of fear conditioned to racial out-group faces, suggesting that these stimuli may be subject to prepared fear learning. The current study replicated and extended previous research by using a different racial out-group, and testing the prediction that prepared fear learning is unaffected by verbal instructions. Four groups of Caucasian participants were trained with male in-group (Caucasian) or out-group (Chinese) faces as conditional stimuli; one paired with an electro-tactile shock (CS+) and one presented alone (CS). Before extinction, half the participants were instructed that no more shocks would be presented. Fear conditioning, indexed by larger electrodermal responses to, and blink startle modulation during the CS+, occurred during acquisition in all groups. Resistance to extinction of fear learning was found only in the racial out-group, no instruction condition. Fear conditioned to a racial out-group face was reduced following verbal instructions, contrary to predictions for the nature of prepared fear learning.

The effects of verbal instruction on affective and expectancy learning

The current research assessed the effects of verbal instruction on affective and expectancy learning during repeated contingency reversals (Experiment 1 and during extinction (Experiment 2) in a picture–picture paradigm. Affective and expectancy learning displayed contingency reversal and extinction, but changes were slower for affective learning. Instructions facilitated reversal and extinction of expectancy learning but did not impact on affective learning. These findings suggest a differential susceptibility of affective and expectancy learning to verbal instruction and question previous reports that verbal instructions can accelerate the extinction of non-prepared fear learning in humans.

L1 Learning Strategy Instruction does make a difference in EFL listening: An empirical study.

In language learning, listening is the basic skill which learners should begin to develop other skills, namely speaking, reading and writing. This sequence of language learning in most English as Foreign Language (EFL) settings goes against the stream, learning first reading and writing and later listening and speaking. This study investigates the effects of cognitive, process-based approach to instructing EFL listening strategies over 11 weeks during a semester in Persian (L1). Lower intermediate female participants (N = 50) came from a couple of EFL classrooms in an English Language Institute in Iran. The experimental group (n = 25) listened to their classroom activities using a methodology that led learners through four cognitive processes (guessing, making inference, identifying topics and repetition) in Persian was basically successful in EFL listening. The same teacher taught the control group (n = 25), which listened to the same classroom listening activities without any guided attention to the learning strategy process in Persian. A pre and post listening test made by a group of experts in the language institute tracked any development in light of cognitive learning strategy instruction in EFL listening through L1. The hypothesis was that the experimental group received the guided attention in L1 during the classroom listening activities made greater gains and was verified despite the partial improvement of the control group.

An analysis of tax expenditure versus direct expenditure

Each financial year concessions, benefits and incentives are delivered to taxpayers via the tax system. These concessions, benefits and incentives, referred to as tax expenditure, differ from direct expenditure because of the recurring fiscal impact without regular scrutiny through the federal budget process. There are approximately 270 different tax expenditures existing within the current tax regime with total measured tax expenditures in the 2005-06 financial year estimated to be around $42.1 billion, increasing to $52.7 billion by 2009-10. Each year, new tax expenditures are introduced, while existing tax expenditures are modified and deleted. In recognition of some of the problems associated with tax expenditure, a Tax Expenditure Statement, as required by the Charter of Budget Honesty Act 1988, is produced annually by the Australian Federal Treasury. The Statement details the various expenditures and measures in the form of concessions, benefits and incentives provided to taxpayers by the Australian Government and calculates the tax expenditure in terms of revenue forgone. A similar approach to reporting tax expenditure, with such a report being a legal requirement, is followed by most OECD countries. The current Tax Expenditure Statement lists 270 tax expenditures and where it is able to, reports on the estimated pecuniary value of those expenditures. Apart from the annual Tax Expenditure Statement, there is very little other scrutiny of Australia’s Federal tax expenditure program. While there has been various academic analysis of tax expenditure in Australia, when compared to the North American literature, it is suggested that the Australian literature is still in its infancy. In fact, one academic author who has contributed to tax expenditure analysis recently noted that there is ‘remarkably little secondary literature which deals at any length with tax expenditures in the Australian context.’ Given this perceived gap in the secondary literature, this paper examines fundamental concept of tax expenditure and considers the role it plays in to the current tax regime as a whole, along with the effects of the introduction of new tax expenditures. In doing so, tax expenditure is contrasted with direct expenditure. An analysis of tax expenditure versus direct expenditure is already a sophisticated and comprehensive body of work stemming from the US over the last three decades. As such, the title of this paper is rather misleading. However, given the lack of analysis in Australia, it is appropriate that this paper undertakes a consideration of tax expenditure versus direct expenditure in an Australian context. Given this proposition, rather than purport to undertake a comprehensive analysis of tax expenditure which has already been done, this paper discusses the substantive considerations of any such analysis to enable further investigation into the tax expenditure regime both as a whole and into individual tax expenditure initiatives. While none of the propositions in this paper are new in a ‘tax expenditure analysis’ sense, this debate is a relatively new contribution to the Australian literature on the tax policy. Before the issues relating to tax expenditure can be determined, it is necessary to consider what is meant by ‘tax expenditure’. As such, part two if this paper defines ‘tax expenditure’. Part three determines the framework in which tax expenditure can be analysed. It is suggested that an analysis of tax expenditure must be evaluated within the framework of the design criteria of an income tax system with the key features of equity, efficiency, and simplicity. Tax expenditure analysis can then be applied to deviations from the ideal tax base. Once it is established what is meant by tax expenditure and the framework for evaluation is determined, it is possible to establish the substantive issues to be evaluated. This paper suggests that there are four broad areas worthy of investigation; economic efficiency, administrative efficiency, whether tax expenditure initiatives achieve their policy intent, and the impact on stakeholders. Given these areas of investigation, part four of this paper considers the issues relating to the economic efficiency of the tax expenditure regime, in particular, the effect on resource allocation, incentives for taxpayer behaviour and distortions created by tax expenditures. Part five examines the notion of administrative efficiency in light of the fact that most tax expenditures could simply be delivered as direct expenditures. Part six explores the notion of policy intent and considers the two questions that need to be asked; whether any tax expenditure initiative reaches its target group and whether the financial incentives are appropriate. Part seven examines the impact on stakeholders. Finally, part eight considers the future of tax expenditure analysis in Australia.

Direct evaluation of IEC 61850-9-2 process bus network performance

This letter presents a technique to assess the overall network performance of sampled value process buses based on IEC 61850-9-2 using measurements from a single location in the network. The method is based upon the use of Ethernet cards with externally synchronized time stamping, and characteristics of the process bus protocol. The application and utility of the method is demonstrated by measuring latency introduced by Ethernet switches. Network latency can be measured from a single set of captures, rather than comparing source and destination captures. Absolute latency measures will greatly assist the design testing, commissioning and maintenance of these critical data networks.

Metacognitive instruction does improve listening comprehension

This paper reports on a small-scale study, which looked into the impact of metacognitive instruction on listeners’ comprehension. Twenty-eight adult, Iranian, high-intermediate level EFL listeners participated in a “strategy-based” approach of advance organisation, directed attention, selective attention, and self-management in each of four listening lessons focused on improving listeners’ comprehension of IELTS listening texts. A comparison of pretest and posttest scores showed that the “less-skilled” listeners improved more than “more-skilled” listeners in the IELTS listening tests. Findings also supported the view that metacognitive instruction assisted listeners in considering the process of listening input and promoting listening comprehension ability.

Non-destructive evaluation of articular cartilage defects using near-infrared (NIR) spectroscopy in osteoarthritic rat models and its direct relation to Mankin Score

Objective The aim of this study was to demonstrate the potential of near-infrared (NIR) spectroscopy for categorizing cartilage degeneration induced in animal models. Method Three models of osteoarthritic degeneration were induced in laboratory rats via one of the following methods: (i) menisectomy (MSX); (ii) anterior cruciate ligament transaction (ACLT); and (iii) intra-articular injection of mono-ido-acetete (1 mg) (MIA), in the right knee joint, with 12 rats per model group. After 8 weeks, the animals were sacrificed and tibial knee joints were collected. A custom-made nearinfrared (NIR) probe of diameter 5 mm was placed on the cartilage surface and spectral data were acquired from each specimen in the wavenumber range 4 000 – 12 500 cm−1. Following spectral data acquisition, the specimens were fixed and Safranin–O staining was performed to assess disease severity based on the Mankin scoring system. Using multivariate statistical analysis based on principal component analysis and partial least squares regression, the spectral data were then related to the Mankinscores of the samples tested. Results Mild to severe degenerative cartilage changes were observed in the subject animals. The ACLT models showed mild cartilage degeneration, MSX models moderate, and MIA severe cartilage degenerative changes both morphologically and histologically. Our result demonstrate that NIR spectroscopic information is capable of separating the cartilage samples into different groups relative to the severity of degeneration, with NIR correlating significantly with their Mankinscore (R2 = 88.85%). Conclusion We conclude that NIR is a viable tool for evaluating articularcartilage health and physical properties such as change in thickness with degeneration.

Metacognitive strategy instruction in English as Foreign Language (EFL) listening skill

Listening skill is a critical part of language learning in general, and second, and foreign language learning, in particular. However, the process of this basic skill has been overlooked compared to other skills such as speaking, reading and writing, in terms of an explicit instruction, and the product of listening is instead mainly tested indirectly through comprehension questions in classrooms. Instruction of metacognitive strategies demonstrates the pivotal impact on second language listening skill development. In this vein, this study used a mixed method with an experimental male group (N = 30) listened to texts using process-approach pedagogy directed students through metacognitive strategies over a semester (10 weeks) in Iran. To investigate the impact of metacognitive strategy instruction, the following approaches were implemented. First, IELTS listening test was used to track any development of listening comprehension. Second, using Vandergrift et al. (2006) Metacognitive Awareness Listening Questionnaire (MALQ) helped examine students’ use of metacognitive strategies in listening comprehension. Finally, interviews were used to examine students’ use of strategies in listening. The results showed that students had a development in comprehension of IELTS listening test, but no statistical significant development of metacognitive awareness in listening was demonstrated. Students and teacher reported in the interviews students used multiple strategies to approach listening comprehension besides metacognitive strategies.