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.

Towards more systematic Twitter analysis : metrics for tweeting activities

Twitter is an important and influential social media platform, but much research into its uses remains centred around isolated cases – e.g. of events in political communication, crisis communication, or popular culture, often coordinated by shared hashtags (brief keywords, prefixed with the symbol ‘#’). In particular, a lack of standard metrics for comparing communicative patterns across cases prevents researchers from developing a more comprehensive perspective on the diverse, sometimes crucial roles which hashtags play in Twitter-based communication. We address this problem by outlining a catalogue of widely applicable, standardised metrics for analysing Twitter-based communication, with particular focus on hashtagged exchanges. We also point to potential uses for such metrics, presenting an indication of what broader comparisons of diverse cases can achieve.

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.

Video-based training combined with flotation tank recovery does not improve three-point shooting in basketball

Video-based training combined with flotation tank recovery may provide an additional stimulus for improving shooting in basketball. A pre-post controlled trial was conducted to assess the effectiveness of a 3 wk intervention combining video-based training and flotation tank recovery on three-point shooting performance in elite female basketball players. Players were assigned to an experimental (n=10) and control group (n=9). A 3 wk intervention consisted of 2 x 30 min float sessions a week which included 10 min of video-based training footage, followed by a 3 wk retention phase. A total of 100 three-point shots were taken from 5 designated positions on the court at each week to assess three-point shooting performance. There was no clear difference in the mean change in the number of successful three-point shots between the groups (-3%; ±18%, mean; ±90% confidence limits). Video-based training combined with flotation recovery had little effect on three-point shooting performance.

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?

The new normativity : the innovation imperative

At a quite fundamental level, the very way in which Public Service Broadcasting (PSB) may envisage its future usually captured in the semantic shift from PSB to Public Service Media (PSM) is at stake when considering the recent history of public value discourse and the public value test. The core Reithian PSB idea assumed that public value would be created through the application of core principles of universality of availability and appeal, provision for minorities, education of the public, distance from vested interests, quality programming standards, program maker independence, and fostering of national culture and the public sphere. On the other hand, the philosophical import of the public value test is that potentially any excursion into the provision of new media services needs to be justified ex ante. In this era of New Public Management, greater transparency and accountability, and the proposition that resources for public value deliverables be contestable and not sequestered in public sector institutions, what might be the new Archimedean point around which a contemporised normativity for PSM be built? This paper will argue for the innovation imperative as an organising principle for contemporary PSM. This may appear counterintuitive, as it is precisely PSB’s predilection for innovating in new media services (in online, mobile, and social media) that has produced the constraining apparatus of the ex ante/public value/Drei-Stufen-Test in Europe, based on principles of competitive neutrality and transparency in the application of public funds for defined and limited public benefit. However, I argue that a commitment to innovation can define as complementary to, rather than as competitive ‘crowding out’, the new products and services that PSM can, and should, be delivering into a post-scarcity, superabundant all-media marketplace. The evidence presented in this paper for this argument is derived mostly from analysis of PSM in the Australian media ecology. While no PSB outside Europe is subject to a formal public value test, the crowding out arguments are certainly run in Australia, particularly by powerful commercial interests for whom free news is a threat to monetising quality news journalism. Take right wing opinion leader, herself a former ABC Board member, Judith Sloan: ‘… the recent expansive nature of the ABC – all those television stations, radio stations and online offerings – is actually squeezing activity that would otherwise be undertaken by the private sector. From partly correcting market failure, the ABC is now causing it. We are now dealing with a case of unfair competition and wasted taxpayer funds’ (The Drum, 1 August http://www.abc.net.au/unleashed/2818220.html). But I argue that the crowding out argument is difficult to sustain in Australia because of the PSB’s non-dominant position and the fact that much of innovation generated by the two PSBs, the ABC and the SBS, has not been imitated by or competed for by the commercials. The paper will bring cases forward, such as SBS’ Go Back to Where you Came From (2011) as an example of product innovation, and a case study of process and organisational innovation which also has resulted in specific product and service innovation – the ABC’s Innovation Unit. In summary, at least some of the old Reithian dicta, along with spectrum scarcity and market failure arguments, have faded or are fading. Contemporary PSM need to justify their role in the system, and to society, in terms of innovation.

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.

Regional characteristics, opportunity perception and entrepreneurial activities

This paper seeks to better understand the link between regional characteristics and individual entrepreneurship. We combine individual-level GEM data for Western Germany with regional-level data, using multi-level analysis to test our hypotheses. We find no direct link between regional knowledge creation, the economic context and an entrepreneurial culture on the one side and individual business start-up intentions and start-up activity on the other side. However our findings point to the importance of an indirect effect of regional characteristics as knowledge creation, the economic context and an entrepreneurial culture have an effect on the individual perception of founding opportunities which in turn predicted start-up intentions and activity.