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.

Poem for my father at Sanssouci

Poem

Six Curses

This creative writing work was selected for publication in a bi-lingual anthology, published in China, as suitable to be culturally applicable to both Chinese and Australian social contexts. The poem raises six social/ethical issues and comments on them. It is based on research into Chinese traditional poetry that focuses on an image, and after each image this poem provides an ethical comment. It is based in the ethical hypothesis that moral evaluation of individual and social behaviour can not be achieved without ethical judgement which questions social norms. In particular, the poem questions the validity of fundamentalism – the belief in religious, scientific and moral absolutes. This is a key issue in contemporary research into the effect of religion on politics. It also draws on contemporary psychological theory, especially the concept of narcissism. The sociological basis of the work is in drawing parallels between eastern and western ethical issues, stressing similarity by inference. The imagery on which the poem is based selects objects such a single ‘stone’ that take on symbolic connotations common to both Australian and Chinese readers. This is innovative, since very little creative writing has been dome to address commonalities between Australian and Chinese ethical thinking, especially by adopting Chinese motifs.

Thin

This poem anticipates the feelings generated by age and lingering illness – a sense of mental as well as physical wasting, and a gradual detachment from the world, becoming almost insubstantial. It is an attempt at empathy with my father during the months leading up to his death from pancreatic cancer, during which his physical changes were paralleled by the relinquishment of his plans, intentions and hopes.

Hunger

Poet's statement: My father died of pancreatic cancer a few years ago, and since then other family members and friends have developed cancer. Some have recovered, perhaps temporarily, while for others the prospect is one of inevitable decline, raising questions about when the point is reached where death is preferable to life. This poem expresses the ambiguity of visceral urges which could be towards either continued life or a relieving death.

Identities

A poem about the multiple facets of identity

'In the hands of the Receivers': The Politics of Literacy in The Savage by David Almond and Dave McKean

David Almond and Dave McKean's The Savage is a hybrid prose and graphic novel which tells the story of one young man’s maturation through literacy. The protagonist learns to deal with the death of his father and his own 'savage' self by writing a graphic novel. This article reads The Savage in the context of earlier, 'Northern' literacy narrative - particularly Tony Harrison's poem "Them & [uz]" and Barry Hines' Kes — through the discourse of neoliberalism and the notion of the reluctant boy reader. It is suggested that Almond and McKean are influenced by currently dominant ideologies of gender and literacy.

Then I let you

In this video, a male voice recites a teenage love poem. Words flash on screen in time with the spoken words. Sometimes the two sets of words match, and sometimes they differ. This work examines processes of signification. It emphasizes disruption and disconnection as fundamental and generative operations in making meaning. Extending on post-structural and deconstructionist ideas, this work questions the relationship between written and spoken words. By actively disrupting the sincerity of a teenage love poem, it questions the sites and mechanisms of comprehension, poetry and signification.

The divine right of ...judges

Poem published in Free Speech segment of NTEU Newletter.

Threshold

In this video, the words of a translated poem fade in and out above an abstract, moving horizon line. The animated words are set to an emotive stock music track. This work examines processes of signification. It emphasizes abstraction and disconnection as fundamental and generative operations in making meaning. Extending on post-structural and deconstructionist ideas, this work questions the signifying processes of translation and metaphor. By emphasizing the abstract qualities of a translated love poem, it questions the sites and mechanisms of signification.

Shades of grey

Poem published in Islet

This landscape before me

Poem

Galah's Skull

Poem