Cerclage, evolution and potential of a Cinderella Technology : an overview with reference to periprosthetic fractures

Periprosthetic fractures are increasingly frequent. The fracture may be located over the shaft of the prosthesis, at its tip or below (21). The treatment of explosion fractures is difficult because the shaft blocks the application of implants, like screws, which need to penetrate the medullary cavity. The cerclage, as a simple periosteal loop, made of wire or more recently cable, does not only avoid the medullary cavity. Its centripetal mode of action is well suited for reducing and maintaining radially displaced fractures. Furthermore, the cerclage lends itself well for minimally invasive internal fixation. New insight challenges the disrepute of which the cerclage technology suffered for decades. The outcome of cerclage fixation benefits from an improved understanding of its technology, mechano-biology and periosteal blood supply. Preconceived and generally accepted opinions like "strangulation of blood supply" need to be re-examined. Recent mechanical evaluations (22) demonstrate that the wire application may be improved but cable is superior in hand- ling, maintenance of tension and strength. Beside the classical concepts of absolute and relative stability a defined stability condition needs consideration. It is typical for cerclage. Called "loose-lock stability" it specifies the situation where a loosened implant allows first unimpeded displacement changing abruptly into a locked fixation preventing further dislocation.

An architecture for enhanced assurance in e-health systems

Notwithstanding the obvious potential advantages of information and communications technology (ICT) in the enhanced provision of healthcare services, there are some concerns associated with integration of and access to electronic health records. A security violation in health records, such as an unauthorised disclosure or unauthorised alteration of an individual's health information, can significantly undermine both healthcare providers' and consumers' confidence and trust in e-health systems. A crisis in confidence in any national level e-health system could seriously degrade the realisation of the system's potential benefits. In response to the privacy and security requirements for the protection of health information, this research project investigated national and international e-health development activities to identify the necessary requirements for the creation of a trusted health information system architecture consistent with legislative and regulatory requirements and relevant health informatics standards. The research examined the appropriateness and sustainability of the current approaches for the protection of health information. It then proposed an architecture to facilitate the viable and sustainable enforcement of privacy and security in health information systems under the project title "Open and Trusted Health Information Systems (OTHIS)". OTHIS addresses necessary security controls to protect sensitive health information when such data is at rest, during processing and in transit with three separate and achievable security function-based concepts and modules: a) Health Informatics Application Security (HIAS); b) Health Informatics Access Control (HIAC); and c) Health Informatics Network Security (HINS). The outcome of this research is a roadmap for a viable and sustainable architecture for providing robust protection and security of health information including elucidations of three achievable security control subsystem requirements within the proposed architecture. The successful completion of two proof-of-concept prototypes demonstrated the comprehensibility, feasibility and practicality of the HIAC and HIAS models for the development and assessment of trusted health systems. Meanwhile, the OTHIS architecture has provided guidance for technical and security design appropriate to the development and implementation of trusted health information systems whilst simultaneously offering guidance for ongoing research projects. The socio-economic implications of this research can be summarised in the fact that this research embraces the need for low cost security strategies against economic realities by using open-source technologies for overall test implementation. This allows the proposed architecture to be publicly accessible, providing a platform for interoperability to meet real-world application security demands. On the whole, the OTHIS architecture sets a high level of security standard for the establishment and maintenance of both current and future health information systems. This thereby increases healthcare providers‘ and consumers‘ trust in the adoption of electronic health records to realise the associated benefits.

Feedback information and consumer motivation : the moderation role of positive and negative reference values in self-regulation

Marketers spend considerable resources to motivate people to consume their products and services as a means of goal attainment (Bagozzi and Dholakia, 1999). Why people increase, decrease, or stop consuming some products is based largely on how well they perceive they are doing in pursuit of their goals (Carver and Scheier, 1992). Yet despite the importance for marketers in understanding how current performance influences a consumer’s future efforts, this topic has received little attention in marketing research. Goal researchers generally agree that feedback about how well or how poorly people are doing in achieving their goals affects their motivation (Bandura and Cervone, 1986; Locke and Latham, 1990). Yet there is less agreement about whether positive and negative performance feedback increases or decreases future effort (Locke and Latham, 1990). For instance, while a customer of a gym might cancel his membership after receiving negative feedback about his fitness, the same negative feedback might cause another customer to visit the gym more often to achieve better results. A similar logic can apply to many products and services from the use of cosmetics to investing in mutual funds. The present research offers managers key insights into how to engage customers and keep them motivated. Given that connecting customers with the company is a top research priority for managers (Marketing Science Institute, 2006), this article provides suggestions for performance metrics including four questions that managers can use to apply the findings.

Reliability of ultrasonographic measurement of the architecture of the vastus lateralis and gastrocnemius medialis muscles in older adults

Objective To determine the test-retest reliability of measurements of thickness, fascicle length (Lf) and pennation angle (θ) of the vastus lateralis (VL) and gastrocnemius medialis (GM) muscles in older adults. Participants Twenty-one healthy older adults (11 men and ten women; average age 68·1 ± 5·2 years) participated in this study. Methods Ultrasound images (probe frequency 10 MHz) of the VL at two sites (VL site 1 and 2) were obtained with participants seated with knee at 90º flexion. For GM measures, participants lay prone with ankle fixed at 15º dorsiflexion. Measures were taken on two separate occasions, 7 days apart (T1 and T2). Results The ICCs (95% CI) were: VL site 1 thickness = 0·96(0·90–0·98); VL site 2 thickness = 0·96(0·90–0·98), VL θ = 0·87(0·68–0·95), VL Lf = 0·80(0·50–0·92), GM thickness = 0·97(0·92–0·99), GM θ = 0·85(0·62–0·94) and GM Lf =0·90(0·75–0·96). The 95% ratio limits of agreement (LOAs) for all measures, calculated by multiplying the standard deviation of the ratio of the results between T1 and T2 by 1·96, ranged from 10·59 to 38·01%. Conclusion The ability of these tests to determine a real change in VL and GM muscle architecture is good on a group level but problematic on an individual level as the relatively large 95% ratio LOAs in the current study may encompass the changes in architecture observed in other training studies. Therefore, the current findings suggest that B-mode ultrasonography can be used with confidence by researchers when investigating changes in muscle architecture in groups of older adults, but its use is limited in showing changes in individuals over time.

Be my buddy: IM and the future of virtual reference

In 2006, the administrators of the Australian virtual reference service, AskNow, entered the Instant Messaging (IM) arena. One of the first large scale, collaborative IM services in the world, the AskNow IM trial provided a unique opportunity to prove IM virtual reference as a concept, as well as to test the technology itself. This paper will discuss the rationale and impetus for the trial, explore the successes and stumbling blocks encountered during the establishment and evolution of the trial and the service model, examine the lessons learnt throughout the trial, and conclude by discussing the way forward for IM services and virtual reference.

Enterprise architecture and the integration of service-oriented architecture

In recent years, enterprise architecture (EA) has captured a growing attention as a means to systematically consolidate and interrelate diverse business and IT artefacts in order to provide holistic decision support. The recent popularity of a service-orientation has added “service “and related constructs as a new element that requires consideration within an Enterprise Architecture. Since the emergence of the Service-Oriented Architecture (SOA), many attempts have been made to incorporate SOA artefacts in existing EA frameworks. Yet, the approaches taken to achieve this goal differ substantially for the most commonly used EA frameworks to date. SOA in the context of enterprise architecture is one of the future research challenges. Several authors argue that further research is needed in order to understand how SOA impacts prior enterprise architecture frameworks. This study explores SOA integration within EA, identifies SOA integration approaches within EA and identifies factors that impact SOA integration within Enterprise Architecture.

A natural model for architecture

In John Frazer's seminal book An Evolutionary Architecture (1995), from which this essay is extracted, a fundamental approach is established for have natural systems can unfold mechanisms for negotiating the complex design space inherent in architectural systems. In this essay, which forms a critical part of the book, Frazer draws both correlations and distinctions from natural processes as emulated in design processes and form as active manifestations within natural systems. Form is seen as an evolving agent generated via the rules of descriptive genetic coding, functioning as a part of a metabolic environment. Frazer's process-model establishes the realm in which computation must manoeuvre to produce a valid solution space, including the operations of self-organisation, complexity and emergent behaviour. Addressing design as an authored practice, he extends the transference of 'creativity' from the explicit impression into form, to the investment of though, organisation and strategy in the computational processes which produce form. Frazer's text concentrates astutely on the practising of the evolutionary paradigm, the output of which postulates an architecture born of the relationships to dynamic environmental and socio-economic contexts, and realised through morphogenetic materialisation.

Building information modeling in the Australian architecture engineering and construction industry

Building Information Modeling (BIM) is a modern approach to the design, documentation, delivery, and life cycle management of buildings through the use of project information databases coupled with object-based parametric modeling. BIM has the potential to revolutionize the Architecture, Engineering and Construction (AEC) industry in terms of the positive impact it may have on information flows, working relationships between project participants from different disciplines and the resulting benefits it may achieve through improvements to conventional methods. This chapter reviews the development of BIM, the extent to which BIM has been implemented in Australia, and the factors which have affected the up-take of BIM. More specifically, the objectives of this chapter are to investigate the adoption of BIM in the Australian AEC industry and factors that contribute towards the uptake (or non uptake) of BIM. These objectives are met by a review of the related literature in the first instance, followed by the presentation of the results of a 2007 postal questionnaire survey and telephone interviews of a random sample of professionals in the Australian AEC industry. The responses suggest that less than 25 percent of the sample had been involved in BIM – rather less than might be expected from reading the literature. Also, of those who have been involved with BIM, there has been very little interdisciplinary collaboration. The main barriers impeding the implementation of BIM widely across the Australian AEC industry are also identified. These were found to be primarily a lack of BIM expertise, lack of awareness and resistance to change. The benefits experienced as a result of using BIM are also discussed. These include improved design consistency, better coordination, cost savings, higher quality work, greater productivity and increased speed of delivery. In terms of conclusion, some suggestions are made concerning the underlying practical reasons for the slow up-take of BIM and the successes for those early adopters. Prospects for future improvement are discussed and proposals are also made for a large scale worldwide comparative study covering industry-wide participants

Badge : Brisbane Office

This two-storey office building and upper floor interior fit-out, completed for the 25th anniversary of Adelaide-based construction firm, Badge Constructions, is a signature building for the client, and its recently established Brisbane-based operations, and a showpiece for their commercial and industrial construction prowess and dynamic, collaborative and transparent work ethic. Situated in the industrial precinct of Bulimba’s Oxford Street, the building is a continuation of the street’s nearby commercial heart, whilst its architectural language references the adjacent industrial structures. The building’s shed-like skillion roof and western wall have been considered as a folded plane, allowing space to be considered as the inhabitation of the inner surface of this plane. The analogy of a lined garment, tailored to suit its wearer, clarifies the relationship between the western façade plane’s unadorned, monochromatic outer surface and the coloured and patterned inner surface, celebrating inhabitation. The use of typically external construction materials are re-positioned as an integral part of the building’s interior fit-out, alluding to Badge’s construction repertoire, and weakening traditional barriers between interior and exterior commercial space. In reference to its Queensland context, the external glazed line of the building is pulled back from the street, providing an eastern verandah edge and a northern court, as a part of the public realm. The upper floor office incorporates a cantilevered outdoor mezzanine within the northern court, whilst the adjacent reception area and stairwell utilises clear glazing in order to visually connect to the street. The building is designed to take advantage of natural light to the east, whilst shading habitable spaces from the north, a building strategy that reduces solar heat gain and energy consumption. Placement of the building’s amenities core to the west provides substantial bracing and allows maximum activation of the north and east street edge. A collaborative design process has resulted in an affordable commercial building with a high level of design resolution and relationship to its Brisbane context, while also challenging the traditional relationships between exterior and interior commercial space, and informed client and consultant team of allied disciplines.