Load on osseointegrated fixation of a transfemoral amputee during a fall : loading, descent, impact and recovery analysis

Falling represents a health risk for lower limb amputees fitted with an osseointegrated fixation mainly because of the potential damage to the fixation. The purpose of this study was to characterise a real forward fall that occurred inadvertently to a transfemoral amputee fitted with an osseointegrated fixation while attending a gait measurement session to assess the load applied on the residuum. The objective was to analyse the load applied on the fixation with an emphasis on the sequence of events, the pattern and the magnitude of the forces and moments. The load was measured directly at 200 Hz using a six-channel transducer. Complementary video footage was also studied. The fall was divided into four phases: loading (240 ms), descent (620 ms), impact (365 ms) and recovery (2495 ms). The main impact forces and moments occurred 870 ms and 915 ms after the heel contact, and corresponded to 133 %BW and 17 %BWm, or 1.2 and 11.2 times the maximum forces and moments applied during the previous steps of the participant, respectively. This study provided key information to engineers and clinicians facing the challenge to design equipment, and rehabilitation and exercise programs to restore safely the locomotion of lower limb amputees.

Innovation

Innovation can be defined broadly to include the development and uptake of new technology, the introduction of new products, the utilisation of new market opportunities and the implementation of new business processes including new forms of work organisation or management structures and approaches. Innovation, or the commercial application of new knowledge, is of increasing importance to economic competitiveness given the growth in production and trade in high technology industries and knowledge intensive service sectors such as business services (Edquist, Hommen and McKelvey 2001). An important field of innovation in modern economies is associated with the rapid development and application of information and communications technologies (ICTs). ICTs constitute an increasing share of value added, growth and employment and also impact on employment and productivity in other industry sectors. The structural transformation of modern economies associated with ICTs has led to an increase in the importance of information and knowledge resources (rather than physical capital) as inputs or factors of production. Technology and product innovations are often given central attention in innovation research, however, organisational and managerial changes have been recognised as critical. Over the last two decades, understandings of the nature and process of innovation have advanced significantly. In the 1950s and 1960s, there was a view that innovation resulted from basic research, or in essence that scientific research acted as a 'push' for innovation. As such there was a great deal of emphasis on formal research and development, undertaken either by governments or research and development units within business organisations. Radical innovations involving new products and new technological trajectories were thought to derive from basic research (Freeman 1995).

Can venous occlusion plethysmography be used to measure high rates of arterial inflow?

To investigate whether venous occlusion plethysmography (VOP) may be used to measure high rates of arterial inflow associated with exercise, venous occlusions were performed at rest, and following dynamic handgrip exercise at 15, 30, 45, and 60 % of maximum voluntary contraction (MVC) in seven healthy males. The effect of including more than one cardiac cycle in the calculation of blood flow was assessed by comparing the cumulative blood flow over one, two, three, or four cardiac cycles. The inclusion of more than one cardiac cycle at 30 and 60 % MVC, and more than two cardiac cycles at 15 and 45 % MVC resulted in a lower blood flow compared to using only the first cardiac cycle (P < 0.05). Despite the small time interval over which arterial inflow was measured (~1 second), this did not affect the reproducibility of the technique. Reproducibility (coefficient of variation for arterial inflow over three trials) tended to be poorer at the higher workloads, although this was not significant (12.7 ± 6.6 %, 16.2 ± 7.3 %, and 22.9 ± 9.9 % for the 15, 30, and 45 % MVC workloads; P=0.102). There was also a tendency for greater reproducibility with the inclusion of more cardiac cycles at the highest workload, but this did not reach significance (P=0.070). In conclusion, when calculated over the first cardiac cycle only during venous occlusion, high rates of FBF can be measured using VOP, and this can be achieved without a significant decrease in the reproducibility of the measurement.

Public health and clinical dilemmas resulting from imprecise vitamin D tests

Objective: To determine whether there are clinical and public health dilemmas resulting from the reproducibility of routine vitamin D assays. Methods: Blinded agreement studies were conducted in eight clinical laboratories using two commonly used assays to measure serum 25-hydroxyvitamin D (25(OH)D) levels in Australasia and Canada (DiaSorin Radioimmunoassay (RIA) and DiaSorin LIAISON® one). Results: Only one laboratory measured 25(OH)D with excellent precision. Replicate 25(OH)D measurements varied by up to 97% and 15% of paired results differed by more than 50%. Thirteen percent of subjects received one result indicating insufficiency [25-50 nmol/l] and another suggesting adequacy [>50 nmol/l]). Agreement ranged from poor to excellent for laboratories using the manual RIA, while the precision of the semi-automated Liaison® system was consistently poor. Conclusions: Recent interest in the relevance of vitamin D to human health has increased demand for 25(OH)D testing and associated costs. Our results suggest clinicians and public health authorities are making decisions about treatment or changes to public health policy based on imprecise data. Clinicians, researchers and policy makers should be made aware of the imprecision of current 25(OH)D testing so that they exercise caution when using these assays for clinical practice, and when interpreting the findings of epidemiological studies based on vitamin D levels measured using these assays. Development of a rapid, reproducible, accurate and robust assay should be a priority due to interest in populationbased screening programs and research to inform public health policy about the amount of sun exposure required for human health. In the interim, 25(OH)D results should routinely include a statement of measurement uncertainty.

Traceability : retracing law and public policy on measurement standards

This presentation outlines key aspects of public policy in broad terms insofar as they relate to establishment, implementation and compliance with legal measurement standards. It refers in particular to traceability of a legal measurement unit from its source in a single international standard as a compliance issue. It comments on accreditation of legal measurement and liability concerned with errors in measurement.

Development of a method to measure upper eyelid pressure on the cornea

Purpose: The cornea is known to be susceptible to forces exerted by eyelids. There have been previous attempts to quantify eyelid pressure but the reliability of the results is unclear. The purpose of this study was to develop a technique using piezoresistive pressure sensors to measure upper eyelid pressure on the cornea. Methods: The technique was based on the use of thin (0.18 mm) tactile piezoresistive pressure sensors, which generate a signal related to the applied pressure. A range of factors that influence the response of this pressure sensor were investigated along with the optimal method of placing the sensor in the eye. Results: Curvature of the pressure sensor was found to impart force, so the sensor needed to remain flat during measurements. A large rigid contact lens was designed to have a flat region to which the sensor was attached. To stabilise the contact lens during measurement, an apparatus was designed to hold and position the sensor and contact lens combination on the eye. A calibration system was designed to apply even pressure to the sensor when attached to the contact lens, so the raw digital output could be converted to actual pressure units. Conclusions: Several novel procedures were developed to use tactile sensors to measure eyelid pressure. The quantification of eyelid pressure has a number of applications including eyelid reconstructive surgery and the design of soft and rigid contact lenses.

The measurement of perceived ontological deficiencies of conceptual modeling grammars

Over recent years, many scholars have studied the conceptual modeling of information systems based on a theory of ontological expressiveness. This theory offers four constructs that inform properties of modeling grammars in the form of ontological deficiencies, and their implications for development and use of conceptual modeling in IS practice. In this paper we report on the development of a valid and reliable instrument for measuring the perceptions that individuals have of the ontological deficiencies of conceptual modeling grammars. We describe a multi-stage approach for instrument development that incorporates feedback from expert and user panels. We also report on a field test of the instrument with 590 modeling practitioners. We further study how different levels of modeling experience influence user perceptions of ontological deficiencies of modeling grammars. We provide implications for practice and future research.

Curriculum design innovation in flexible science teaching

In this paper you will be introduced to a number of principles which can be used to inform good teaching practice and rigorous curriculum design. Principles relate to: * Application of a common sequence of events for how learners learn; * Accommodating different learning styles; * Adopting a purposeful approach to teaching and learning; * Using assessment as a central driving force in the curriculum and as an organising structure leading to coherence of teaching and learning approach; and * The increasing emphasis that is being placed on the development of generic graduate competencies over and above discipline content knowledge. The principles are particularly significant in relation to adult learning. The paper will use three specific applications as illustrations to help you to learn how these principles can be applied. The illustrations are taken from a second year subject in supercomputing that uses scientific case studies. The subject has been developed (with support from Silicon Graphics Inc. and Intel) to be taught entirely via the Internet.

Alternate reality games and education innovation

An Alternate Reality Game (ARG) is a unique experience that blurs the edges between our everyday lives and imagined game worlds. Players are invited to interact with each other and fictional characters using familiar tools such as emails, websites, telephones, and sometimes newspapers, radio and television. ARGs come in all shapes and sizes, tell a variety of different stories and inspire all kinds of interactions between people, their networks and the very streets in which they live. Some ARGs simply immerse you in fictional scenarios and indulge you in quirky challenges. While others reveal hidden histories of a city and teach us about important political causes. But the most exciting thing about ARGs is that they have the potential to inspire participants to imagine their everyday tools and places as resources for their own creative endeavors. Deb Polson will be presenting some of the most inspiring ARGs of recent years and revealing some of the design techniques that were used to create them. Most significantly Deb will discuss ways in which educators can imagine using ARGs as rich teaching tools that inspire collaborative learning and motivate students to engage in all kinds of subject matter.

Complexity and learning behaviors in product innovation

Successful product innovation and the ability of companies to continuously improve their innovation processes are rapidly becoming essential requirements for competitive advantage and long-term growth in both manufacturing and service industries. It is now recognized that companies must develop innovation capabilities across all stages of the product development, manufacture, and distribution cycle. These Continuous Product Innovation (CPI) capabilities are closely associated with a company’s knowledge management systems and processes. Companies must develop mechanisms to continuously improve these capabilities over time. Using results of an international survey on CPI practices, sets of companies are identified by similarities in specific contingencies related to their complexity of product, process, technological, and customer interface. Differences between the learning behaviors found present in the company groups and in the levers used to develop and support these behaviors are identified and discussed. This paper also discusses appropriate mechanisms for firms with similar complexities, and some approaches they can use to improve their organizational learning and product innovation.

Practice-led research and the innovation agenda : beyond the postgraduate research degree in the arts, design and media

The rise of the ‘practice-led’ research approach has given us a new way of understanding what creative practice in art, design and media can do in the academy and the world— it can materialise new ideas and forms into being as a form of experimental research. Yet, to date, attention around the world, and especially in Australia, has been chiefly directed at the postgraduate research degrees, most notably the PhD or doctoral equivalents. Recent mapping projects and surveys of practice-led research in Australia reveal much about the institutional conditions of higher degree researchers, supervisors, examiners and research training (Baker et al 2009; Evans et al 2003; Dally et al 2004; Paltridge et al 2009; Phillips et al 2009). Given this focus, we might well ask: is the practice-led approach destined to be a part of the higher degree ghetto only, or does it have an afterlife? What is the place of ‘practice-led’ beyond the postgraduate degree? After all postgraduate researchers do not remain postgraduates forever, and perhaps the practice-led approach to research may have benefits in wider university, professional and communal contexts.

Exploration and exploitation : the interplay between knowledge and continuous innovation

In rapidly changing environments, organisations require dynamic capabilities to integrate, build and reconfigure resources and competencies to achieve continuous innovation. Although tangible resources are important to promoting the firm’s ability to act, capabilities fundamentally rest in the knowledge created and accumulated by the firm through human capital, organisational routines, processes, practices and norms. The exploration for new ideas, technologies and knowledge – to one side – and – on the other one – the exploitation of existing and new knowledge is essential for continuous innovation. Firms need to decide how best to allocate their scarce resources for both activities and at the same time build dynamic capabilities to keep up with changing market conditions. This in turn, is influenced by the absorptive capacity of the firm to assimilate knowledge. This paper presents a case study that investigates the sources of knowledge in an engineering firm in Australia, and how it is organised and processed. As information pervades the firm from both internal and external sources, individuals integrate knowledge using both exploration and exploitation approaches. The findings illustrate that absorptive capacity can encourage greater leverage for exploration potential leading to radical innovation; and reconfiguring exploitable knowledge for incremental improvements. This study provides an insight for managers in quest of improving knowledge strategies and continuous innovation. It also makes significant theoretical contributions to the literature through extending the concepts of

Performance measurement and continuous improvement : are they linked to manufacturing strategy?

To maintain or achieve competitiveness and profitability, a manufacturing firm or enterprise must respond to a range of challenges, including rapid improvements in technology; declining employment and output; globalisation of markets and environmental requirements. In addition, substantial changes in government policy have had important impacts in many countries, as have the increasing levels of global trade. Manufacturing enterprises need to have a clear understanding of what their customers want and why customers purchase their products rather than purchase from their competitors. They need to fully understand the aims of the business in terms of its customers, market segments, product attributes, geographical markets and performance. Continuous Improvement (CI) methods have become widely adopted and regarded as providing an important component of increased company competitiveness. This article examines the extent to which continuous improvement activities have contributed to the different areas of business performance.

Learning barriers in continuous product innovation

In today's dynamic and turbulent environment companies are required to increase their effectiveness and efficiency, exploit synergy and learn product innovation processes in order to build competitive advantage. To be able to stimulate and facilitate learning in product innovation, it is necessary to gain an insight into factors that hinder learning and to design effective intervention strategies that may help remove barriers to learning. This article reports on learning barriers identified by product innovation managers in over 70 companies in the UK, Ireland, Italy, Netherlands, Sweden and Australia. The results show that the majority of the barriers identified can be labelled as organisational defensive routines leading to a chain of behaviours; lack of resources leads to under-appreciation of the value of valid information, absence of informed choice and lack of personal responsibility. An intervention theory is required which enables individuals and organisations to interrupt defensive patterns in ways that prevents them from recurring.

Incidental walking activity is sufficient to induce time-dependent conditioning of the Achilles tendon

The Achilles tendon has been seen to exhibit time-dependent conditioning when isometric muscle actions were of a prolonged duration, compared to those involved in dynamic activities, such as walking. Since, the effect of short duration muscle activation associated with dynamic activities is yet to be established, the present study aimed to investigate the effect of incidental walking activity on Achilles tendon diametral strain. Eleven healthy male participants refrained from physical activity in excess of the walking required to carry out necessary daily tasks and wore an activity monitor during the 24 h study period. Achilles tendon diametral strain, 2 cm proximal to the calcaneal insertion, was determined from sagittal sonograms. Baseline sonographic examinations were conducted at ∼08:00 h followed by replicate examinations at 12 and 24 h. Walking activity was measured as either present (1) or absent (0) and a linear weighting function was applied to account for the proximity of walking activity to tendon examination time. Over the course of the day the median (min, max) Achilles tendon diametral strain was −11.4 (4.5, −25.4)%. A statistically significant relationship was evident between walking activity and diametral strain (P < 0.01) and this relationship improved when walking activity was temporally weighted (AIC 131 to 126). The results demonstrate that the short yet repetitive loads generated during activities of daily living, such as walking, are sufficient to induce appreciable time-dependant conditioning of the Achilles tendon. Implications arise for the in vivo measurement of Achilles tendon properties and the rehabilitation of tendinopathy.