Sterilization of allograft bone: is 25 kGy the gold standard for gamma irradiation?

For several decades, a dose of 25 kGy of gamma irradiation has been recommended for terminal sterilization of medical products, including bone allografts. Practically, the application of a given gamma dose varies from tissue bank to tissue bank. While many banks use 25 kGy, some have adopted a higher dose, while some choose lower doses, and others do not use irradiation for terminal sterilization. A revolution in quality control in the tissue banking industry has occurred in line with development of quality assurance standards. These have resulted in significant reductions in the risk of contamination by microorganisms of final graft products. In light of these developments, there is sufficient rationale to re-establish a new standard dose, sufficient enough to sterilize allograft bone, while minimizing the adverse effects of gamma radiation on tissue properties. Using valid modifications, several authors have applied ISO standards to establish a radiation dose for bone allografts that is specific to systems employed in bone banking. These standards, and their verification, suggest that the actual dose could be significantly reduced from 25 kGy, while maintaining a valid sterility assurance level (SAL) of 10−6. The current paper reviews the methods that have been used to develop radiation doses for terminal sterilization of medical products, and the current trend for selection of a specific dose for tissue banks.

Developing context-aware pervasive computing applications: Models and approach

There is growing interest in the use of context-awareness as a technique for developing pervasive computing applications that are flexible, adaptable, and capable of acting autonomously on behalf of users. However, context-awareness introduces a variety of software engineering challenges. In this paper, we address these challenges by proposing a set of conceptual models designed to support the software engineering process, including context modelling techniques, a preference model for representing context-dependent requirements, and two programming models. We also present a software infrastructure and software engineering process that can be used in conjunction with our models. Finally, we discuss a case study that demonstrates the strengths of our models and software engineering approach with respect to a set of software quality metrics.

Global engineering education: Australia and the Bologna process

This paper presents a critical comparison of major changes in engineering education in both Australia and Europe. European engineering programs are currently being reshaped by the Bologna process, representing a move towards quality assurance in higher education and the mutual recognition of degrees among universities across Europe. Engineering education in Australia underwent a transformation after the 1996 review of engineering education1. The paper discusses the recent European developments in order to give up-to-date information on this fast changing and sometimes obscure process. The comparison draws on the implications of the Bologna Process on the German engineering education system as an example. It concludes with issues of particular interest, which can help to inform the international discussion on how to meet today’s challenges for engineering education. These issues include ways of achieving diversityamong engineering programs, means of enabling student and staff mobility, and the preparation of engineering students for professional practic e through engineering education. As a result, the benefits of outcomes based approaches in education are discussed. This leads to an outlook for further research into the broader attributes required by future professional engineers. © 2005, Australasian Association for Engineering Education

Antioxidants and protein oxidation

Proteins are susceptible to oxidation by reactive oxygen species, where the type of damage induced is characteristic of the denaturing species. The induction of protein carbonyls is a widely applied biomarker, arising from primary oxidative insult. However, when applied to complex biological and pathological conditions it can be subject to interference from lipid, carbohydrate and DNA oxidation products. More recently, interest has focused on the analysis of specific protein bound oxidised amino acids. Of the 22 amino acids, aromatic and sulphydryl containing residues have been regarded as being particularly susceptible to oxidative modification, with L-DOPA from tyrosine, ortho-tyrosine from phenylalanine; sulphoxides and disulphides from methionine and cysteine respectively; and kynurenines from tryptophan. Latterly, the identification of valine and leucine hydroxides, reduced from hydroperoxide intermediates, has been described and applied. In order to examine the nature of oxidative damage and protective efficacy of antioxidants the markers must be thoroughly evaluated for dosimetry in vitro following damage by specific radical species. Antioxidant protection against formation of the biomarker should be demonstrated in vitro. Quantification of biomarkers in proteins from normal subjects should be within the limits of detection of any analytical procedure. Further to this, the techniques for isolation and hydrolysis of specific proteins should demonstrate that in vitro oxidation is minimised. There is a need for the development of standards for quality assurance material to standardise procedures between laboratories. At present, antioxidant effects on protein oxidation in vivo are limited to animal studies, where dietary antioxidants have been reported to reduce dityrosine formation during rat exercise training. Two studies on humans have been reported last year. The further application of these methods to human studies is indicated, where the quality of the determinations will be enhanced through inter-laboratory validation.

The impact of learning outcomes in business education: assessing value, relevance and graduate ability in a multi-country study of employers and business graduates

This paper discusses critical findings from a two-year EU-funded research project involving four European countries: Austria, England, Slovenia and Romania. The project had two primary aims. The first of these was to develop a systematic procedure for assessing the balance between learning outcomes acquired in education and the specific needs of the labour market. The second aim was to develop and test a set of meta-level quality indicators aimed at evaluating the linkages between education and employment. The project was distinctive in that it combined different partners from Higher Education, Vocational Training, Industry and Quality Assurance. One of the key emergent themes identified in exploratory interviews was that employers and recent business graduates in all four countries want a well-rounded education which delivers a broad foundation of key business knowledge across the various disciplines. Both groups also identified the need for personal development in critical skills and competencies. Following the exploratory study, a questionnaire was designed to address five functional business areas, as well as a cluster of 8 business competencies. Within the survey, questions relating to the meta-level quality indicators assessed the impact of these learning outcomes on the workplace, in terms of the following: 1) value, 2) relevance and 3) graduate ability. This paper provides an overview of the study findings from a sample of 900 business graduates and employers. Two theoretical models are proposed as tools for predicting satisfaction with work performance and satisfaction with business education. The implications of the study findings for education, employment and European public policy are discussed.

Measuring performance of virtual learning environment system in higher education

Purpose – The purpose of this paper is to measure the performance of commercial virtual learning environment (VLE) systems, which helps the decision makers to select the appropriate system for their institutions. Design/methodology/approach – This paper develops an integrated multiple criteria decision making approach, which combines the analytic hierarchy process (AHP) and quality function deployment (QFD), to evaluate and select the best system. The evaluating criteria are derived from the requirements of those who use the system. A case study is provided to demonstrate how the integrated approach works. Findings – The major advantage of the integrated approach is that the evaluating criteria are of interest to the stakeholders. This ensures that the selected system will achieve the requirements and satisfy the stakeholders most. Another advantage is that the approach can guarantee the benchmarking to be consistent and reliable. From the case study, it is proved that the performance of a VLE system being used at the university is the best. Therefore, the university should continue to run the system in order to support and facilitate both teaching and learning. Originality/value – It is believed that there is no study that measures the performance of VLE systems, and thus decision makers may have difficulties in system evaluation and selection for their institutions.

Inquiring how a lecturer keeps learning about their teaching:a personal case history on reflective imagination

In order to reverse the use of lecture-based teaching, it is argued that personal reflection can be used as part of the quality assurance process. This paper proposes one response to personal reflection - reflective imagination, which is summarised as an action plan with six activities. It combines two conceptual issues raised in the US, the need to think creatively about learning and the reflective mindset, and one issue raised in the UK, cultivating the entrepreneurial imagination. Reflective imagination is linked to wider social science research, the place of self and reflexivity in scholarship. Finally, a personal history case study is presented which records a visit to Harvard Business School. The visit implements the six activities associated with reflective imagination. This is a method paper exploring reflective imagination.

A new tool for measurement of process-based performance of multispecialty tertiary care hospitals

There is an increasing need of a model for the process-based performance measurement of multispecialty tertiary care hospitals for quality improvement. Analytic hierarchy process (AHP) is utilized in this study to evolve such a model. Each step in the model was derived by group-discussions and brainstorming sessions among experienced clinicians and managers. This tool was applied to two tertiary care teaching hospitals in Barbados and India. The model enabled identification of specific areas where neither hospital performed very well, and helped to suggest recommendations to improve those areas. AHP is recommended as a valuable tool to measure the process-based performance of multispecialty tertiary care hospitals. © Emerald Group Publishing Limited.

Reliability management of machine tool technology: a case study of current practice

Considerable attention has been given in the literature to identifying and describing the effective elements which positively affect the improvement of product reliability. These have been perceived by many as the 'state of the art' in the manufacturing industry. The applicability, diffusion and effectiveness of such methods and philosophies, as a means of systematically improving the reliability of a product, come in the main from case studies and single and infra-industry empirical studies. These studies have both been carried out within the wider context of quality assurance and management, and taking reliability as a discipline in its own right. However, it is somewhat of a surprise that there are no recently published findings or research studies on the adoption of these methods by the machine tool industry. This may lead one to construct several hypothesised paradigms: (a) that machine tool manufacturers compared to other industries, are slow to respond to propositions given in the literature by theorists or (b) this may indicate that a large proportion of the manufacturers make little use of the reliability improvement techniques as described in the literature, with the overall perception that they will not lead to any significant improvements? On the other hand, it is evident that hypothetical verification of the operational and engineering methods of reliability achievement and improvement adopted in the machine tool industry is less widely researched. Therefore, research into this area is needed in order to explore the 'state of the art' practice in the machine tool industry. This is in terms of the status, structure and activities of the operation of the reliability function. This paper outlines a research programme being conducted with the co-operation of a leading machine tool manufacturer, whose UK manufacturing plant produces in the main Vertical Machining Centres (VMCs) and is continuously undergoing incremental transitions in product reliability improvement.

An evaluation of pharmacy education and pre-registration training

This thesis covers two major aspects of pharmacy education; undergraduate education and pre-registration training. A cohort of pharmacy graduates were surveyed over a period of four years, on issues related to undergraduate education, pre-registration training and continuing education. These graduates were the first-ever to sit the pre-registration examination. In addition, the opinions of pre-registration tutors were obtained on pre-registration training, during the year that competence-based assessment was introduced. It was concluded that although the undergraduate course provided a broad base of knowledge suitable for graduates in all branches of pharmacy, several issues were identified which would require attention in future developments of the course. These were: 1. the strong support for the expansion of clinical, social and practice-based teaching. 2. the strong support to retain the scientific content to the same extent as in the three-year course. 3. a greater use of problem-based learning methods. The graduates supported the provision of a pre-registration continuing education course to help prepare for the examination and in areas inadequately covered in the undergraduate course. There was also support for the introduction of some form of split branch training. There was no strong evidence to suggest that the training had been an application of undergraduate education. In general, competence-based training was well regarded by tutors as an appropriate and effective method of skill assessment. However, community tutors felt it was difficult to carry out effectively due to day-to-day time constraints. The assistant tutors in hospital pharmacy were found to have a very important role in provision of training, and should be adequately trained and supported. The study recommends the introduction of uniform training and a quality assurance mechanism for all tutors and assistants undertaking this role.

Satisfaction with knowledge and competencies:a multi-country study of employers and business graduates

This study critically discusses findings from a research project involving four European countries. The project had two main aims. The first was to develop a systematic procedure for assessing the balance between knowledge and competencies acquired in higher, further and vocational education and the specific needs of the labor market. The second aim was to develop and test a set of meta-level quality indicators aimed at evaluating the linkages between education and employment. The project was designed to address the lack of employer input concerning the requirements of business graduates for successful workplace performance and the need for more specific industry-driven feedback to guide administrative heads at universities and personnel at quality assurance agencies in curriculum development and revision. Approach: The project was distinctive in that it combined different partners from higher education, vocational training, industry and quality assurance. Project partners designed and implemented an innovative approach, based on literature review, qualitative interviews and surveys in the four countries, in order to identify and confirm key knowledge and competency requirements. This study presents this step-by-step approach, as well as survey findings from a sample of 900 business graduates and employers. In addition, it introduces two Partial Least Squares (PLS) path models for predicting satisfaction with work performance and satisfaction with business education. Results: Survey findings revealed that employers were not very confident regarding business graduates’ abilities in key knowledge areas and in key generic competencies. In subsequent analysis, these graduate abilities were tested and identified as important predictors of employers’ satisfaction with graduates’ work performance. Conclusion: The industry-driven approach introduced in this study can serve as a guide to assist different types of educational institutions to better align study programs with changing labor market requirements. Recommendations for curriculum improvement are discussed.

Grading and disease management in national screening for diabetic retinopathy in England and Wales

Aims - A National Screening Programme for diabetic eye disease in the UK is in development. We propose a grading and early disease management protocol to detect sight-threatening diabetic retinopathy and any retinopathy, which will allow precise quality assurance at all steps while minimizing false-positive referral to the hospital eye service. Methods - Expert panel structured discussions between 2000 and 2002 with review of existing evidence and grading classifications. Proposals - Principles of the protocol include: separate grading of retinopathy and maculopathy, minimum number of steps, compatible with central monitoring, expandable for established more complex systems and for research, no lesion counting, no ‘questionable’ lesions, attempt to detect focal exudative, diffuse and ischaemic maculopathy and fast track referral from primary or secondary graders. Sight-threatening diabetic retinopathy is defined as: preproliferative retinopathy or worse, sight-threatening maculopathy and/or the presence of photocoagulation. In the centrally reported minimum data set retinopathy is graded into four levels: none (R0), background (R1), preproliferative (R2), proliferative (R3). Maculopathy and photocoagulation are graded as absent (M0, P0) or present (M1, P1). Discussion - The protocol developed by the Diabetic Retinopathy Grading and Disease Management Working Party represents a new consensus upon which national guidelines can be based leading to the introduction of quality-assured screening for people with diabetes.

Requirements Management and Acquisition Management experiences in Spanish Public Administrations

As a part of the activities of the first Symposium on Process Improvement Models and Software Quality of the Spanish Public Administration, working groups were formed to discuss the current state of the Requirements Management and Supplier Agreement Management processes. This article presents general results and main contributions of those working groups. The results have allowed the obtention of a preliminary appraisal of the current state of these two processes in the Spanish Public Administration.

Benefit segmentation of international travelers to Macau, China

The purpose of this study is threefold: (1) to identify the underlying benefits sought by international visitors to Macau, China, which has emerged as a popular gambling destination in Asia; (2) to segment tourists visiting Macau by employing a cluster analysis based on the benefits sought; and (3) to examine any salient differences between the segment groups with regard to their behavioral characteristics, socio-economic characteristics, and demographic profiles. A convenience sample was used to collect data in the Macau International Airport, in the Macau Ferry Terminal, and at the border gate with Mainland China. A total 1,513 useful surveys were retained for data analysis. Cluster analysis discloses four distinct clusters: "convention and business seekers," "family and vacation seekers," "gambling and shopping seekers," and "multi-purpose seekers." Based on the results of our findings, several managerial implications are discussed. © Taylor & Francis Group, LLC.