Team communications in surgery - creating a culture of safety

As a key department within a healthcare organisation, the operating room is a hazardous environment, where the consequences of errors are high, despite the relatively low rates of occurrence. Team performance in surgery is increasingly being considered crucial for a culture of safety. The aim of this study was to describe team communication and the ways it fostered or threatened safety culture in surgery. Ethnography was used, and involved a 6-month fieldwork period of observation and 19 interviews with 24 informants from nursing, anaesthesia and surgery. Data were collected during 2009 in the operating rooms of a tertiary care facility in Queensland, Australia. Through analysis of the textual data, three themes that exemplified teamwork culture in surgery were generated: ‘‘building shared understandings through open communication’’; ‘‘managing contextual stressors in a hierarchical environment’’ and ‘‘intermittent membership influences team performance’’. In creating a safety culture in a healthcare organisation, a team’s optimal performance relies on the open discussion of teamwork and team expectation, and significantly depends on how the organisational culture promotes such discussions.

An in-vitro 3-D cell culture model for studying pathomechanisms in AMD

Purpose To develop a novel 3-D cell culture model with the view to studying the pathomechanisms underlying the development of age-related macular degeneration (AMD). Our central hypothesis is that the silk structural protein fibroin used in conjunction with cultured human cells can be used to mimic the structural relationships between the RPE and choriocapillaris in health and disease. Methods Co-cultures of human RPE cells (ARPE-19 cells grown in Miller’s medium) and microvascular endothelial cells (HMEC-1 cells grown in endothelial culture medium) were established on opposing sides of a synthetic Bruch’s membrane (3 microns thick) constructed from B mori silk fibroin. Cell attachment was facilitated by pre-coating the fibroin membrane with vitronectin (for ARPE-19 cells) and gelatin (for HMEC-1 cells) respectively. The effects of tropoelastin on attachment of ARPE-19 cells was also examined. Barrier function was examined by measurement of trans-epithelial resistance (TER) using a voltohmmeter (EVOM-2). The phagocytic activity of the synthetic RPE was tested using vitronectin-coated microspheres (2 micron diameter FluoSpheres). In some cultures, membrane defects were created by puncturing within a 24 G needle. The architecture of the synthetic tissue before and after wounding was examined by confocal microscopy after staining for ZO-1 and F-actin. Results The RPE layer of the 3D model developed a cobblestoned morphology (validated by staining for ZO-1 and F-actin), displayed barrier function (validated by measurement of TER) and demonstrated cytoplasmic uptake of vitronectin-coated microspheres. Attachment of ARPE-19 cells to fibroin was unaffected by tropoelastin. Microvascular endothelial cells attached well to the gelatin-coated surface of the fibroin membrane and remained physically separated from the overlaying RPE layer. The fibroin membranes were amenable to puncturing without collapse thus providing the opportunity to study transmembrane migration of the endothelial cells. Conclusions Synthetic Bruch’s membranes constructed from silk fibroin, vitronectin and gelatin, support the co-cultivation of RPE cells and microvascular endothelial cells. The resulting RPE layer displays functions similar to that of native RPE and the entire tri-layered structure displays potential to be used as an in vitro model of choroidal neovascularization.

The International Film and Television School in Cuba : for a stronger media culture in the global south

A little-known facet of Cuban internationalism is the Cuba shares in the education of young people who want to help build a stronger media culture that represents voices from the global South. Cuba was instrumental in the establishment and operation of the International Film and Television School at San Antonio de los Baños. The Cuban government provided the location and buildings for the school, and among the range of international media professionals who teach the students are selected Cuban professors from the Institute of the Arts, based n Havana. The International Film and Television School is supported by funding from Spain and other countries, and by the willingness of international media professionals to teach short courses for little more than an honorarium. Cuba used to provide full scholarships for student from the South to study a two-year course in film or television, but now charges fees for its three-year diploma course.

Michel Foucault : the unconscious of history and culture

Michel Foucault: The unconscious of history and culture The French thinker, Michel Foucault (1926–84), is noted for his extensive and controversial forays into the historical disciplines. When his work first began to circulate in the 1950s and 1960s, historians did not quite know what to make of it and philosophers resented the appearance of what they saw as the importation of the tedium of concrete events into the pure untainted realm of ideas. If these responses to his work remain alive and well decades after Foucault's death, the uptake of his work has become far more complex. To restrict ourselves to the discipline of history here: if one very visible and vocal camp of historians remains deeply ambivalent about his work, this merely disguises the fact that a far larger contingent of historians of all kinds – not just those located in history departments – use his ideas quite unremarkably ...

Utilization and optimization of a waste stream cellulose culture medium for pigment production by Penicillium spp

Aims This research sought to determine optimal corn waste stream–based fermentation medium C and N sources and incubation time to maximize pigment production by an indigenous Indonesian Penicillium spp., as well as to assess pigment pH stability. Methods and Results A Penicillium spp. was isolated from Indonesian soil, identified as Penicillium resticulosum, and used to test the effects of carbon and nitrogen type and concentrations, medium pH, incubation period and furfural on biomass and pigment yield (PY) in a waste corncob hydrolysate basal medium. Maximum red PY (497·03 ± 55·13 mg l−1) was obtained with a 21 : 1 C : N ratio, pH 5·5–6·0; yeast extract-, NH4NO3-, NaNO3-, MgSO4·7H2O-, xylose- or carboxymethylcellulose (CMC)-supplemented medium and 12 days (25°C, 60–70% relative humidity, dark) incubation. C source, C, N and furfural concentration, medium pH and incubation period all influenced biomass and PY. Pigment was pH 2–9 stable. Conclusions Penicillium resticulosum demonstrated microbial pH-stable-pigment production potential using a xylose or CMC and N source, supplemented waste stream cellulose culture medium. Significance and Impact of the Study Corn derived, waste stream cellulose can be used as a culture medium for fungal pigment production. Such application provides a process for agricultural waste stream resource reuse for production of compounds in increasing demand.

School culture matters

Schools today are subjected to a vast array of accountability measures including professional standards and high-stakes testing, to name but two. These measures and the implementation of new curricula inevitably result in change and put pressure on schools and teachers to perform. During these times of change, a positive school culture can make a difference for all school stakeholders: staff, students and parents. As a school leader, what can you do to ensure a positive school culture is maintained in your school environment during these changing times?

Consuming Urban Culture in Contemporary Vietnam

Vietnam is currently undergoing a metamorphosis from a relatively closed society with a centrally planned economy, to a rapidly urbanising one with a global outlook. These changes have been the catalyst for an exciting ferment of activity in popular culture. This volume contains contributions from scholars engaged in the most up-to-date social research in Vietnam, as well as some of Vietnam's most popular cultural producers who are forging new ways of imagining the present whilst at the same time engaging actively in reinterpreting the past. The diverse ways that Vietnam is culturally and socially negotiating the future are examined as the book addresses issues of indigenisation of cultural influences, ambivalence surrounding change, and the consistent blurring of boundaries between informal, non-state cultural activities and formal institutional structures in the evolution of a civil society in Vietnam.

Alter/Asians : Asian-Australian Identities in Art, Media and Popular Culture

Exploration of how Australia and Asia are intertwined in everyday culture, and in the imagined worlds of Australians of all backgrounds. Investigates Asian cultural production of art, literature, media and performance that embody Asian social and cultural experiences. Includes endnotes, bibliography and index. Ang and Chalmers work in the School of Cultural Studies at University of Western Sydney. Law and Thomas are Australian Research Council Postdoctoral Fellows at Australian National University and the Research Centre in Inter-communal Studies respectively.

Organizational culture in airworthiness management programmes : extending an existing measurement model

All civil and private aircraft are required to comply with the airworthiness standards set by their national airworthiness authority and throughout their operational life must be in a condition of safe operation. Aviation accident data shows that over 20% of all fatal accidents in aviation are due to airworthiness issues, specifically aircraft mechanical failures. Ultimately it is the responsibility of each registered operator to ensure that their aircraft remain in a condition of safe operation, and this is done through both effective management of airworthiness activities and the effective programme governance of safety outcomes. Typically, the projects within these airworthiness management programmes are focused on acquiring, modifying and maintaining the aircraft as a capability supporting the business. Programme governance provides the structure through which the goals and objectives of airworthiness programmes are set along with the means of attaining them. Whilst the principal causes of failures in many programmes can be traced to inadequate programme governance, many of the failures in large-scale projects can have their root causes in the organizational culture and more specifically in the organizational processes related to decision-making. This paper examines the primary theme of project and programme-based enterprises, and introduces a model for measuring organizational culture in airworthiness management programmes using measures drawn from 211 respondents in Australian airline programmes. The paper describes the theoretical perspectives applied to modifying an original model to specifically focus it on measuring the organizational culture of programmes for managing airworthiness; identifying the most important factors needed to explain the relationship between the measures collected, and providing a description of the nature of these factors. The paper concludes by identifying a model that best describes the organizational culture data collected from seven airworthiness management programmes.

Safety culture in supply chains : 'Customer is king'

Despite the presence of many regulations governing the operation of heavy vehicles and supply chains in Australia, the truck driving sector continues to have the highest incidence of fatal injuries compared to all other industries. The working environment has been the focus of attention by safety researchers during the past few decades, with particular consideration been given to the concept ‘safety culture’ and how to maintain, modify and advance responses to occupational risk. One important aspect of the heavy industry which sets it apart is the existence of cultural or sub-cultural influences at an industry wide and occupation-specific level rather than organisational level. This paper reports on the findings of stakeholder’s perceptions of the influences of power and control, and culture on industry safety. In-depth structured interviews were conducted during 2011 with Australian industry stakeholders (n=31). The questioning surrounded decision-making processes with regards to identifying risks, self-monitoring and reducing risky activities; as well as how power-affected relationships may influence the operational performance of supply chains and impacts on driver safety. One of the most significant findings from these interviews relates to the notion of power. The perception that the ‘Customer is King’ was widely viewed, with the majority of stakeholders believing that there exists a ‘master slave mentality’ in the industry. There appears to be great frustration in the industry as to the apparent immunity of customers (particularly retail supply chains) to their responsibilities. There was also a strong perception that the customer holds the balance of power by covertly employing remuneration-related incentives and pressures. Smaller trucking companies are perceived as being more vulnerable to the pressure of customer expectations.

Returning to the roots of culture : a review and re-conceptualisation of safety culture

Despite significant research, there is still little agreement over how to define safety culture or of what it is comprised. Due to this lack of agreement, much of the safety culture research has little more than safety management strategies in common. There is, however, a degree of acceptance of the close relationship between safety culture and organisational culture. Organisational culture can be described using traditional views of culture drawn from the anthropology and cultural psychology literature. However, the safety culture literature rarely ventures beyond organisational culture into discussions of these more traditional concepts of culture. There is a need to discuss how these concepts of culture can be applied to safety culture to provide greater understanding of safety culture and additional means by which to approach safety in the workplace. This review explores how three traditional conceptualisations of culture; the normative, anthropological and pragmatist conceptualisations, can and have been be applied to safety culture. Finally the review proposes a synthesised conceptualisation of safety culture which can be used to provide greater depth and practical applicability of safety culture, by increasing our understanding of the interactions between cultural and contextual variables in a given workplace and the effect they have on safety.

Chinese teaching English as a foreign language (TEFL) academics' perceptions about research in a transitional culture

Research capacity building has become a prominent theme in higher education institutions in China and across the world. However, Chinese Teaching English as a Foreign Language academics' research output has been quite limited. In order to build their research capacity, it is necessary to understand their perceptions about research. This case study presents the perceptions about research of six Chinese Teaching English as a Foreign Language academics in a context of growing institutional demands for research. One-on-one interviews of 35-60 minutes' duration were conducted with these academics from an institution in north China. Thematic analysis of the transcribed interviews indicated that the Chinese Teaching English as a Foreign Language academics held positive perceptions about the teaching-research nexus. However, the value of research to them seemed to be limited to teaching and career advancement. They also expressed varied concerns about the institutional research requirements. The findings suggested several implications for the institution's administrators to further enhance academics' research capacity building.

Culture as a driver of entrepreneurship : contrasting independent entrepreneurship versus employee entrepreneurship

Principal Topic Counties in Northern Europe, such as Sweden, Finland and Denmark, have comparatively low per capita rates of entrepreneurship as measured by independent new venture start-up rates – as for example measured by the Global Entrepreneurship Monitor (GEM) Total entrepreneurial activity (TEA) rate. However, the latest 2011 GEM data reveals that these same countries have comparatively very high Employee Entrepreneurship Activity (EEA) rates – that is a high rate per capita of employees involved in new product development or new enterprise activities. This observation has prompted us to investigate the role of national culture in driving independent versus employee entrepreneurial activities. Prior research has established that national (and regional) culture plays an important role in forming an “entrepreneurial culture” that encourages (or discourages) independent business start-ups and TEA (e.g. Davidsson, 1995; Beugelsdijk, 2007). However, the relationship of culture and EEA has not received research attention. Moreover, empirical relationships between elements of national culture and independent entrepreneurship have revealed some surprising results. For example, Wildeman et al. (1999) report an unexpected higher share of individual business ownership in countries that have higher uncertainty avoidance, higher power distance and lower individualism according to Hofstede’s dimensions of culture. They speculate that dissatisfaction can be a source of entrepreneurship: in countries with a high power distance, a high uncertainty avoidance and low individualism, there may be relatively more business owners since enterprising individuals cannot satisfy their needs within existing organizations. Yet it remains a rather open question whether entrepreneurial behaviour in existing organisations provides a satisfactory explanation for these empirical findings. Methods We will conduct a cross sectional study of the influence of national culture according to the five / six dimensions of Hofstede (1980; 2001) on both TEA and EEA for the 54 countries that participated in GEM 2011. Since it is well established that the opportunities for entrepreneurship vary substantially with a country’s level of economic development, we intend to conduct separate analyses for the three categories of development – innovation driven economies, efficient driven economies and factor driven economies. We also intend to restrict our assessment of TEA to opportunity driven entrepreneurship, as necessity driven entrepreneurship has a different relationship to the “entrepreneurial culture” that is the focus of our study. We will control for a range of factors such as GDP growth, ease of doing business index and unemployment. Results and Implications Descriptive analyses of the GEM TEA and EEA data reveal clusters of countries that appear to be have similar national culture. We are yet to conduct regression analyses.

Large-scale community projects in regional Queensland : unlocking creative potential and community identity : Artspoken Queensland Regional Arts and Culture Conference 2011

In this presentation, renowned arts practitioner, Sean Mee, and Nigel Lavender, Executive Director of the Queensland Music Festival, talk about how community arts practice can be used to build cultural captial in communities, using examples such large-scale musicals such as The Road We're ON (Charleville) and Behind the Cand (Bowen), Mee and Lavender highlight the importance of community-driven narrative and particiaption.