Is it necessary to re-fuse a non-union of a hallux metatarsophalangeal joint arthrodesis?

BACKGROUND: The standard treatment for a non-union of the hallux metatarsophalangeal joint fusion has been to revise the fusion. Revision fusion is technically more demanding, often involving bone grafting, more substantial fixation and prolonged period of immobilization postoperatively. We present data to suggest that removal of hardware and debridement alone is an alternative treatment option. ---------- MATERIALS AND METHODS: A case note review identified patients with a symptomatic non-union after hallux metatarsophalangeal joint (MTPJ) fusion. It is our practice to offer these patients revision fusion or removal of hardware and debridement. For the seven patients that chose hardware removal and were left with a pseudarthrosis, a matched control group was selected from patients who had had successful fusions. Three outcome scores were used. Hallux valgus and dorsiflexion angles were recorded.---------- RESULTS: One hundred thirty-nine hallux MTPJ arthrodeses were carried out. Fourteen non-unions were identified. The rate of non-union in males and following previous hallux MTPJ surgery was 19% and 24%, respectively. In females undergoing a primary MTPJ fusion, the rate was 2.4%. Twelve non-union patients were reviewed at 27 months (mean). Eleven patients had elected to undergo removal of hardware and debridement. Four patients with pseudarthrosis were unhappy with the results and proceeded to either revision fusion or MTPJ replacement. Seven non-union patients, who had removal of hardware alone, had outcome scores marginally worse compared to those with successful fusions.---------- CONCLUSION: Removal of hardware alone is a reasonable option to offer as a relatively minor procedure following a failed arthrodesis of the first MTPJ. This must be accepted on the proviso that in this study four out of 11 (36%) patients proceeded to a revision first MTPJ fusion or first MTPJ replacement. We also found that the rate of non-union in primary first MTPJ fusion was significantly higher in males and those patients who had undergone previous surgery.

Automatic generation of assertions to detect potential security vulnerabilities in C programs that use union and pointer types

Type unions, pointer variables and function pointers are a long standing source of subtle security bugs in C program code. Their use can lead to hard-to-diagnose crashes or exploitable vulnerabilities that allow an attacker to attain privileged access over classified data. This paper describes an automatable framework for detecting such weaknesses in C programs statically, where possible, and for generating assertions that will detect them dynamically, in other cases. Exclusively based on analysis of the source code, it identifies required assertions using a type inference system supported by a custom made symbol table. In our preliminary findings, our type system was able to infer the correct type of unions in different scopes, without manual code annotations or rewriting. Whenever an evaluation is not possible or is difficult to resolve, appropriate runtime assertions are formed and inserted into the source code. The approach is demonstrated via a prototype C analysis tool.

Defending the patch : a labour geography analysis of unions’ construction of and responses to the problem of declining union membership amongst youth

If the trade union movement is to remain an influential force in the industrial, economic and socio/political arenas of industrialised nations it is vital that its recruitment of young members improve dramatically. Australian union membership levels have declined markedly over the last three decades and youth union membership levels have decreased more than any age group. Currently around 10% of young workers aged between 16-24 years are members of unions in Australia compared to 26% of workers aged 45-58 (Oliver, 2008). This decline has occurred throughout the union movement, in all states and in almost all industries and occupations. This research, which consists of interviews with union organisers and union officials, draws on perspectives from the labour geography literature to explore how union personnel located in various places, spaces and scales construct the issue of declining youth union membership. It explores the scale of connections within the labour movement and the extent to which these connections are leveraged to address the problem of youth union membership decline. To offer the reader a sense of context and perspective, the thesis firstly outlines the historical development of the union movement. It also reviews the literature on youth membership decline. Labour geography offers a rich and apposite analytical tool for investigation of this area. The notion of ‘scale’ as a dynamic, interactive, constructed and reconstructed entity (Ellem, 2006) is an appropriate lens for viewing youth-union membership issues. In this non-linear view, scale is a relational element which interplays with space, place and the environment (Howett, in Marston, 2000) rather than being ‘sequential’ and hierarchical. Importantly, the thesis investigates the notion of unions as ‘spaces of dependence’ (Cox, 1998a, p.2), organisations whose space is centred upon realising essential interests. It also considers the quality of unions’ interactions with others – their ‘spaces of engagement‘(Cox, 1998a, p.2), and the impact that this has upon their ability to recruit youth. The findings reveal that most respondents across the spectrum of the union movement attribute the decline in youth membership levels to factors external to the movement itself, such as changes to industrial relations legislation and the impact of globalisation on employment markets. However, participants also attribute responsibility for declining membership levels to the union movement itself, citing factors such as a lack of resourcing and a need to change unions’ perceived identity and methods of operation. The research further determined that networks of connections across the union movement are tenuous and, to date, are not being fully utilised to assist unions to overcome the youth recruitment dilemma. The study concludes that potential connections between unions are hampered by poor resourcing, workload issues and some deeply entrenched attitudes related to unions ‘defending (and maintaining) their patch’.

Access to medicine and the dangers of patent linkage : lessons from Bayer Corp v. Union of India

In February 2010, the Delhi High Court delivered its decision in Bayer Corp v Union of India in which Bayer had appealed against an August 2009 decision of the same court. Both decisions prevented Bayer from introducing the concept of patent linkage into India’s drug regulatory regime. Bayer appealed to the Indian Supreme Court, the highest court in India, which agreed on 2 March 2010 to hear the appeal. Given that India is regarded as a global pharmaceutical manufacturer of generic medications, how its judiciary and government perceive their international obligations has a significant impact on the global access to medicines regime. In rejecting the application of patent linkage, the case provides an opportunity for India to further acknowledge its international human rights obligations.

The psychological impact of industrial strikes: Does involvement in union activity during strikes make a difference?

The current study investigated the psychological impact of a United Steelworkers of America strike on the steelworkers involved, and the relationship between psychological well-being and individuals' levels of involvement in union activity during the strike. Three hundred and fifty-one steelworkers (302 `strikers' and 49 `non-strikers') completed surveys measuring a range of demographic and psychological well-being variables. Strikers, compared to non-strikers, reported higher levels of depression, anxiety, and irritation, and lower levels of mental health. For strikers, engaging in higher levels of union activity during the strike was associated with better psychological well-being. Jahoda's theory of deprivation during unemployment is used as the lens through which to explain some of the results, supporting the view that latent benefits associated with work are important for psychological well-being. A range of practical implications are offered for unions and their members.

Manipulating task constraints to improve tactical knowledge and collective decision-making in rugby union

In team sports such as rugby union, a myriad of decisions and actions occur within the boundaries that compose the performance perceptual- motor workspace. The way that these performance boundaries constrain decision making and action has recently interested researchers and has involved developing an understanding of the concept of constraints. Considering team sports as complex dynamical systems, signifies that they are composed of multiple, independent agents (i.e. individual players) whose interactions are highly integrated. This level of complexity is characterized by the multiple ways that players in a rugby field can interact. It affords the emergence of rich patterns of behaviour, such as rucks, mauls, and collective tactical actions that emerge due to players’ adjustments to dynamically varying competition environments. During performance, the decisions and actions of each player are constrained by multiple causes (e.g. technical and tactical skills, emotional states, plans, thoughts, etc.) that generate multiple effects (e.g. to run or pass, to move forward to tackle or maintain position and drive the opponent to the line), a prime feature in a complex systems approach to team games performance (Bar- Yam, 2004). To establish a bridge between the complexity sciences and learning design in team sports like rugby union, the aim of practice sessions is to prepare players to pick up and explore the information available in the multiple constraints (i.e. the causes) that influence performance. Therefore, learning design in training sessions should be soundly based on the interactions amongst players (i.e.teammates and opponents) that will occur in rugby matches. To improve individual and collective decision making in rugby union, Passos and colleagues proposed in previous work a performer- environment interaction- based approach rather than a traditional performer- based approach (Passos, Araújo, Davids & Shuttleworth, 2008).

Effective attacking strategies in rugby union

Evasive change-of-direction manoeuvres (agility skills) are a fundamental ability in rugby union. In this study, we explored the attributes of agility skill execution as they relate to effective attacking strategies in rugby union. Seven Super 14 games were coded using variables that assessed team patterns and individual movement characteristics during attacking ball carries. The results indicated that tackle-breaks are a key determinant of try-scoring ability and team success in rugby union. The ability of the attacking ball carrier to receive the ball at high speed with at least two body lengths from the defence line against an isolated defender promoted tackle-breaks. Furthermore, the execution of a side-step evasive manoeuvre at a change of direction angle of 20–60° and a distance of one to two body lengths from the defence, and then straightening the running line following the initial direction change at an angle of 20–60°, was associated with tackle-breaks. This study provides critical insight regarding the attributes of agility skill execution that are associated with effective ball carries in rugby union.

Declining youth membership : the views of union officials

Across the industrialized west there has been a sharp decline in union membership (Frege and Kelly2003, Peetz 2002). Even more alarming are the lower unionization rates of young people and the steeper decline in these rates compared to older workers (Serrano and Waddington 2000). At the same time increasing numbers of young people still at school are participating in the labour market. There have been a number of explorations internationally of young people's union membership, but most either track membership decline over time, comparing adult and youth union density (Blanden and Machin 2003, Bryson et al. 2005, Haynes, Vowles and Boxall 2005, Canny 2002, OECD 2006), explore the general experience of young people in the labour market (for example, Lizen, Bolton and Pole 1999) or examine young people's view of unions (for example, Bulbeck 2008). This chapter however takes a different approach, exploring union officials' constructions of 'the problem' of low union density amongst youth. While the data in this study was obtained from Australia, the Australian context has strong similarities with those in other industrialized economies, not least because globalization has meant the spread of neo-liberal industrial relations (IR) policies and structures. Assuming that unions have choices open to them as to how they recruit and retain young people, it is important to analyse officials' construction of 'the problem', as this affects union strategizing and action.

Comparing retail union strategy in a neoliberal context : the case of Australia and New Zealand

Retail employees are amongst the most vulnerable workers in the context of neoliberal market economies. In many countries, low paid retail employees comprise around 10 per cent of the workforce (ABS 2011). The retail labour market is typically highly feminised and youthful, with many employees in part time and various forms of precarious employment (Tailby & Pollert 2011). However, the industry and its trade unions have rarely been the focus of academic study (Tilly & Carré 2011). This paper thus aims to analyse and compare trade union strategies in the retail industry in Australia and New Zealand, by utilising findings from a larger comparative study. The respective unions studied are the Shop Distributive and Allied Workers Union (SDA) in Australia and the National Distribution Union (NDU) in New Zealand. Data from interviews with union officials at different levels and from different regional locations in Australia and NZ are analysed. Union policy documents are also utilised to support the empirical data. Key findings from the comparison of retail unions’ strategy in Australia and NZ include: 1) the importance of institutional factors and internal political differences in shaping and constraining union strategies; 2) different emphases on external relationships and variations in partnership approaches; 3) the need to recruit to ‘stand still’ by retail unions in both countries; and, 4) similarities and differences in the unions’ organising approaches. The paper concludes by examining the implications of these findings for retail unions’ strategic choices and their ability to deliver workplace justice for employees.

Purine Nucleoside Phosphorylase mediated molecular chemotherapy and conventional chemotherapy: A tangible union against chemoresistant cancer

Background Late stage Ovarian Cancer is essentially incurable primarily due to late diagnosis and its inherent heterogeneity. Single agent treatments are inadequate and generally lead to severe side effects at therapeutic doses. It is crucial to develop clinically relevant novel combination regimens involving synergistic modalities that target a wider repertoire of cells and lead to lowered individual doses. Stemming from this premise, this is the first report of two- and three-way synergies between Adenovirus-mediated Purine Nucleoside Phosphorylase based gene directed enzyme prodrug therapy (PNP-GDEPT), docetaxel and/or carboplatin in multidrug-resistant ovarian cancer cells. Methods The effects of PNP-GDEPT on different cellular processes were determined using Shotgun Proteomics analyses. The in vitro cell growth inhibition in differentially treated drug resistant human ovarian cancer cell lines was established using a cell-viability assay. The extent of synergy, additivity, or antagonism between treatments was evaluated using CalcuSyn statistical analyses. The involvement of apoptosis and implicated proteins in effects of different treatments was established using flow cytometry based detection of M30 (an early marker of apoptosis), cell cycle analyses and finally western blot based analyses. Results Efficacy of the trimodal treatment was significantly greater than that achieved with bimodal- or individual treatments with potential for 10-50 fold dose reduction compared to that required for individual treatments. Of note was the marked enhancement in apoptosis that specifically accompanied the combinations that included PNP-GDEPT and accordingly correlated with a shift in the expression of anti- and pro-apoptotic proteins. PNP-GDEPT mediated enhancement of apoptosis was reinforced by cell cycle analyses. Proteomic analyses of PNP-GDEPT treated cells indicated a dowregulation of proteins involved in oncogenesis or cancer drug resistance in treated cells with accompanying upregulation of apoptotic- and tumour- suppressor proteins. Conclusion Inclusion of PNP-GDEPT in regular chemotherapy regimens can lead to significant enhancement of the cancer cell susceptibility to the combined treatment. Overall, these data will underpin the development of regimens that can benefit patients with late stage ovarian cancer leading to significantly improved efficacy and increased quality of life.

Comparing retail union strategy in a neoliberal context

Amongst the most vulnerable workers in a neoliberal world are retail employees. In many countries these low paid workers comprise around 10 per cent of the workforce. The retail labour market is highly feminised, in some countries quite youthful and often part time or in various forms of precarious employment. The industry and its unions have however rarely been studied by academics. A three-country research team (United Kingdom, Australia and New Zealand) is investigating retail union strategy across these Anglophone countries in order to determine how, and how effectively, unions are contributing to workplace justice for retail workers.