Early intervention with erythropoietin does not affect the outcome of acute kidney injury (the EARLYARF trial)

We performed a double-blind placebo-controlled trial to study whether early treatment with erythropoietin could prevent the development of acute kidney injury in patients in two general intensive care units. As a guide for choosing the patients for treatment we measured urinary levels of two biomarkers, the proximal tubular brush border enzymes γ-glutamyl transpeptidase and alkaline phosphatase. Randomization to either placebo or two doses of erythropoietin was triggered by an increase in the biomarker concentration product to levels above 46.3, with a primary outcome of relative average plasma creatinine increase from baseline over 4 to 7 days. Of 529 patients, 162 were randomized within an average of 3.5 h of a positive sample. There was no difference in the incidence of erythropoietin-specific adverse events or in the primary outcome between the placebo and treatment groups. The triggering biomarker concentration product selected patients with more severe illness and at greater risk of acute kidney injury, dialysis, or death; however, the marker elevations were transient. Early intervention with high-dose erythropoietin was safe but did not alter the outcome. Although these two urine biomarkers facilitated our early intervention, their transient increase compromised effective triaging. Further, our study showed that a composite of these two biomarkers was insufficient for risk stratification in a patient population with a heterogeneous onset of injury.

Learning in both worlds : academic journalism as a research outcome

Works of journalism by journalism academics can be valuable outcomes of research without making the claim that they are scholarly works per se. In the discussion of the feature article Learning in both worlds that follows, I make a case for the importance of writing and publishing this piece of journalism as an outcome of my research on the interplay of news media and bilingual education policy in Australia’s Northern Territory 1988-2008. I also advocate the ‘experimental’ possibilities such works of journalism offer for ‘testing’ research findings, concepts and theories.

Understanding aspirations and expectations of international students in Australian higher education

The aspirations and expectations of the growing international student cohort in Australia are implicitly incorporated into recruitment and internationalization strategies but have received little academic analysis. To address this gap in the literature, this paper develops a conceptual model built upon earlier research by Tim Mazzarol and Geoffrey Soutar, which focuses on the push and pull factors relating to home country and country of destination, respectively, in relation to students’ decisions to seek international study. Focusing predominantly on Chinese and Indian students, we conceptualize, extend and place the push and pull factors within a social psychological framework in relation to students’ aspirations and expectations of international education, indicating factors that can be influenced by higher education (HE) institutions and their programmes, and those which cannot. We then interrogate the model and its applicability in Australian HE through the case study of an Indian international Study Tour conducted in our Australian HE institution in 2009. In the present context of decreased international student enrolments in Australia in 2010, where we seek to better understand our international students, the proposed model provides a basis for identifying international students’ expectations and aspirations and developing prospective international relations.

It can be quite difficult to have your creativity on tap : balancing client expectations and artistic practice in the tattoo industry

Tattoo artists work in a commission structure. Their artistic practice, possibly more than in any other creative career, requires the complete approval of the client prior to the creation of the final work. An unsatisfactory tattoo cannot be on-sold, discarded or easily replaced. Rarely can a tattooer practice their art without external participation. Therefore, tattoo artists come up with a number of strategies to manage their client base to ensure that the art they are asked to create satisfies both the client and their own artistic skills and preferences. Drawing on phenomenological research conducted for my PhD investigating artistic persona, this paper will explore the strategies tattoo artists use to construct their portfolios, manage the tattoo consultation and design process, and develop their own artistic skills, in order to build a successful and rewarding career in the tattoo industry.

The frontotemporal-orbitozygomatic approach : reconstructive technique and outcome

Background The frontotemporal-orbitozygomatic (FTOZ) approach, also known as "the workhorse of skull base surgery," has captured the interest of many researchers throughout the years. Most of the studies published have focused on the surgical technique and the gained exposure. However, few studies have described reconstructive techniques or functional and cosmetic outcomes. The goal of this study was to describe the surgical reconstruction after the FTOZ approach and analyze the functional and cosmetic outcomes. Methods Seventy-five consecutive patients who had undergone FTOZ craniotomy for different reasons were selected. The same surgical (one-piece FTOZ) and reconstructive techniques were applied in all patients. The functional outcome was measured by complications related to the surgical approach: retro-orbital pain, exophthalmos, enophthalmos, ocular movement restriction, cranial nerve injuries, pseudomeningocele (PMC) and secondary surgeries required to attain a reconstructive closure. The cosmetic outcome was evaluated by analyzing the satisfaction of the patients and their families. Questionnaires were conducted later in the postoperative period. A statistical analysis of the data obtained from the charts and questions was performed. Results Of the 75 patients studied, 59 had no complications whatsoever. Ocular movement restriction was found in two patients (2.4 %). Cranial nerve injury was documented in seven patients (8.5 %). One patient (1.2 %) underwent surgical repair of a cerebrospinal fluid (CSF) leak from the initial surgery. Two patients (2.4 %) developed delayed postoperative pseudomenigocele. One patient (1.2 %) developed intraparenchymal hemorrhage (IPH). Full responses to the questionnaires were collected from 28 patients giving an overall response rate of 34 %. Overall, 22 patients (78.5 %) were satisfied with the cosmetic outcome of surgery. Conclusion The reconstruction after FTOZ approach is as important as the performance of the surgical technique. Attention to anatomical details and the stepwise reconstruction are a prerequisite to the successful preservation of function and cosmesis. In our series, the orbitozygomatic osteotomy did not increase surgical complications or alter cosmetic outcomes.

Managing expectations : a changing landscape

Expectations of, and by, students and staff in the classroom have been well researched. Yet, still there is a gap between the expectations of students and what they experience in their studies. The classroom itself is changing with the introduction of Web 2.0 technologies into the mix. Further changes are being driven by the changing profile of a tertiary student in the twenty first century. Education will not fulfill its goal if the gap in expectations is not addressed. The discrepancy in expectations is explored from the perspective of students and staff and strategies for bridging the gap and enhancing eLearning in the Web 2.0 environment are offered. The chapter begins with a scenario that demonstrates the issues and concludes with suggestions to avoid them in the future. In doing so, the key drivers of change in the learning landscape in Australia are identified and the impact these may have on staff and student expectations is explored.