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.

Stop whining and make the best of it: a cross-national comparison of response to regional disadvantage in the wine industry

Our cross-national field study of wine entrepreneurship in the “wrong” places provides some redress to the focus of the “regional advantage” literature on places that have already won and on the firms that benefit from “clusters” and other centers of industry advantage. Regional “disadvantage” is at best a shadowy afterthought to this literature. By poking around in these shadows, we help to synthesize and extend the incipient yet burgeoning literature on entrepreneurial “resourcefulness” and we contribute to the developing body of insights and theory pertinent to the numerous but often ignored firms and startups that mostly need to worry about how they will compete at all now if they are ever to have of chance of “winning” in the future. The core of our findings suggests that understandable – though contested – processes of ingenuity underlie entrepreneurial responses to regional disadvantage. Because we study entrepreneurship that from many angles simply does not make sense, we are also able to proffer a novel perspective on entrepreneurial sensemaking.

Young, inexperienced and on the road: Do novice drivers comply with road rules?

Young novice drivers are at considerable risk of injury and fatality, particularly when they first drive independently. Graduated Driver Licensing (GDL) has been introduced in numerous jurisdictions to allow more driving experience in conditions of reduced risk and increasing driving privileges over a longer duration. Queensland, Australia, enhanced GDL July 2007. Learners must record 100 hours in a logbook (10 hours at night) over 1 year, no mobile handsfree/loudspeaker by driver or any passenger. Provisional 1 (P1) drivers must not carry 2 or more peer passengers 11pm - 5am, no mobile handsfree/loudspeaker by any passenger. Self-reported compliance with new GDL and general road rules has not been examined.

For blood, sweat and tears : the severing of subconscious connections with company and business model

Humans have altered environments and enhanced their well being unlike any other creature on the planet (Heilman & Donna, 2007); this is no different whether the environment is ecological, social or organisational. In recent times business modelling techniques have become intricately detailed in the pre-designing and evaluating of business flow before the final implementation (Ou-Yang & Lin, 2008). The importance of the organisation change and business process model is undeniable. The feedback received from real business process users is that the notation is easy to learn; the models do help people to understand the process better; the models can be used to improve the (business) process; and the notation is expressive enough to capture the essential information (Bennett, Doshi, Do Vale Junior, Kumar, Manikam, & Madavan, 2009).

Pathways to employment for migrants and refugees? The case of social enterprise

This paper examines the use of social enterprise – that is, not for personal profit businesses that have a strong social purpose- to support training and employment pathways for migrants and refugees facing multiple forms of exclusion. Drawing on an evaluation of a program that supports seven social enterprises in the Australian state of Victoria, the study finds that social enterprise affords unique local opportunities for economic and social participation for the program’s participants. Nevertheless, there are limits to the impacts of programs that mediate transitions within an increasingly flexible labour market without redressing the broader social determinants of labour market segmentation.

Stop whining and make the best of it : a cross-national comparison of responses to regional disadvantage in the wine industry

Our cross-national field study of wine entrepreneurship in the “wrong” places provides some redress to the focus of the “regional advantage” literature on places that have already won and on the firms that benefit from “clusters” and other centers of industry advantage. Regional “disadvantage” is at best a shadowy afterthought to this literature. By poking around in these shadows, we help to synthesize and extend the incipient yet burgeoning literature on entrepreneurial “resourcefulness” and we contribute to the developing body of insights and theory pertinent to the numerous but often ignored firms and startups that mostly need to worry about how they will compete at all now if they are ever to have of chance of “winning” in the future. The core of our findings suggests that understandable – though contested – processes of ingenuity underlie entrepreneurial responses to regional disadvantage. Because we study entrepreneurship that from many angles simply does not make sense, we are also able to proffer a novel perspective on entrepreneurial sensemaking.

Measurable progress? Teaching artsworkers to assess and articulate the impact of their work

The National Cultural Policy Discussion Paper—drafted to assist the Australian Government in developing the first national Cultural Policy since Creative Nation nearly two decades ago—envisages a future in which arts, cultural and creative activities directly support the development of an inclusive, innovative and productive Australia. "The policy," it says, "will be based on an understanding that a creative nation produces a more inclusive society and a more expressive and confident citizenry by encouraging our ability to express, describe and share our diverse experiences—with each other and with the world" (Australian Government 3). Even a cursory reading of this Discussion Paper makes it clear that the question of impact—in aesthetic, cultural and economic terms—is central to the Government's agenda in developing a new Cultural Policy. Hand-in-hand with the notion of impact comes the process of measurement of progress. The Discussion Paper notes that progress "must be measurable, and the Government will invest in ways to assess the impact that the National Cultural Policy has on society and the economy" (11). If progress must be measurable, this raises questions about what arts, cultural and creative workers do, whether it is worth it, and whether they could be doing it better. In effect, the Discussion Paper pushes artsworkers ever closer to a climate in which they have to be skilled not just at making work, but at making the impact of this work clear to stakeholders. The Government in its plans for Australia's cultural future, is clearly most supportive of artsworkers who can do this, and the scholars, educators and employers who can best train the artsworkers of the future to do this.

Melbourne and Brisbane: The Claims of Suburbs

This chapter critiques the imagined geography of creative cities and the creative industries, which presumes that inner cities are densely clustered hubs of urban culture and creativity while suburbs are dull, homogeneous dormitories from which creative people must escape in order to realize their potential. Drawing upon a study on creative industries workers in Melbourne and Brisbane, the authors argue that these workers are as likely to be located in the suburbs as in the inner city, and that they clearly identify advantages to being in outer suburban locations. Their findings provide a corrective to dominant urban cultural policy narratives that stress cultural amenity in the inner cities.

Stop and revive? : the effectiveness of nap and active rest breaks for reducing driver sleepiness

The incidence of sleep-related crashes has been estimated to account for approximately 20% of all fatal and severe crashes. The use of sleepiness countermeasures by drivers is an important component to reduce the incidence rates of sleep-related crashes. Taking a brief nap and stopping for a rest break are two highly publicised countermeasures for driver sleepiness and are also believed by drivers to be the most effective countermeasures. Despite this belief, there is scarce evidence to support the utility of these countermeasures for reducing driver sleepiness levels. Therefore, determining the effectiveness of these countermeasures is an important road safety concern. The current study utilised a young adult sample (N = 20) to investigate the effectiveness of a nap and an active rest break. The countermeasures effects were evaluated by physiological, behavioural (hazard perception skill), and subjective measures previously found sensitive to sleepiness. Participants initially completed two hours of a simulated driving task followed by a 15 minute nap opportunity or a 15 minute active rest break that included 10 minutes of brisk walking. After the break, participants completed one final hour of the simulated driving task. A within-subjects design was used so that each participant completed both the nap and the active rest break conditions on separate occasions. The analyses revealed that only the nap break provided any meaningful reduction in physiological sleepiness, reduced subjective sleepiness levels, and maintained hazard perception performance. In contrast, the active rest break had no effect for reducing physiological sleepiness and resulted in a decrement in hazard perception performance (i.e., an increase of reaction time latencies), with a transient reduction in subjective sleepiness levels. A number of theoretical, empirical and practical issues were identified by the current study.

After the testing : talking and reading and writing the world

This critical essay discusses the challenges and prospects for the reform of school-based literacy programs. It begins with an overview of the effects of a decade of test-driven accountability policy on research and teachers’ work, noting the continuing challenges of new demographics, cultures and technologies for literacy education. The case is made that whole school literacy programs can make a difference in improving the overall education of students and youth from low socioeconomic and cultural minority backgrounds. But this requires a strong emphasis on engagement with substantive readings of cultural, social and scientific worlds through talk, reading and writing. The key questions facing teachers, then, are not simply around basic skills instruction and acquisition, but about sustained, intellectually demanding and scaffolded talk around texts, print and multimodal.

Qualitative inquiry as transformation and agency : the black sheep and workplace mobbing

This chapter discusses an action research project into the lived experience of the workplace mobbing phenomenon. The action research methodology is based on the exemplarian model (Coenen & Khonraad, 2003) from the Netherlands Group. This model requires positive outcomes for those immersed in the problem to reduce the adversity of their circumstances. The findings challenge the psychological perspective of the existing bullying literature that tends to focus on individual behaviour. This research, undertaken over a three year period with 212 participants, identified the dysfunctional nature of public sector bureaucracies and the power gained through gossip and rumour as some of the key emergent themes to explain the workplace mobbing problem. In addition, resistance, conscientisation, and agency were identified as the key to transformation for those targeted. The discussion focuses on the crystallisation phase of the exemplarian model where the participants identified themselves as the Black Sheep and adopted the motto that “a black sheep is a biting beast” (Bastard, 1565 or 6-1618, p. 90), reflecting a sense of empowerment, individual agency, and a sense of humour in dealing with the serious yet seemingly absurd reality of their situations. The identity of the Black Sheep was consolidated when the group organised a 2 day conference with over 200 attendees to discuss how best to prevent workplace mobbing. This self-affirming action was a proactive step towards metaphorically “biting back” at the problem. A number of positive outcomes were achieved including the conference with over 200 attending leading to national media coverage across Australia and additional interviews with magazines, newspapers, and radio.

Modeling and analyzing the carbon footprint of business processes

Many corporations and individuals realize that environmental sustainability is an urgent problem to address. In this chapter, we contribute to the emerging academic discussion by proposing two innovative approaches for engaging in the development of environmentally sustainable business processes. Specifically, we describe an extended process modeling approach for capturing and documenting the dioxide emissions produced during the execution of a business process. For illustration, we apply this approach to the case of a government Shared Service provider. Second, we then introduce an analysis method for measuring the carbon dioxide emissions produced during the execution of a business process. To illustrate this approach, we apply it in the real-life case of a European airport and show how this information can be leveraged in the re-design of "green" business processes.