The effect of intraoperative force on scoliosis correction at the apex : a biomechanical investigation

Adolescent idiopathic scoliosis (AIS) is a complex 3D deformity of the spine, which may require surgical correction in severe cases. Computer models of the spine provide a potentially powerful tool to virtually ‘test’ various surgical scenarios prior to surgery. Using patient-specific computer models of seven AIS patients who had undergone a single rod anterior procedure, we have recently found that the majority of the deformity correction occurs at the apical joint or the joint immediately cephalic to the apex. In the current paper, we investigate the biomechanics of the apical joint for these patients using clinically measured intra-operative compressive forces applied during implant placement. The aim of this study is to determine a relationship between the compressive joint force applied intra-operatively and the achievable deformity correction at the apical joint.

Not a dirty word : arts entrepreneurship and higher education

While the majority of creative, performing, and literary artists are self-employed, relatively few tertiary arts schools attempt to develop capabilities for venture creation and management (and entrepreneurship more broadly) and still fewer do so effectively. This article asks why this is the case. It addresses underlying conceptual and philosophical issues encountered by arts educators, arguing that in all three senses of the term: new venture creation; career self-management; and being enterprising, entrepreneurship is essential to career success in the arts. However, the practice of entrepreneurship in the arts is significantly different from the practice of entrepreneurship in business, in terms of the artist’s drivers and aims, as well as the nature of entrepreneurial opportunities, contexts and processes. These differences mean that entrepreneurship curricula cannot simply be imported from Business schools. This article also examines the arts-idiosyncratic challenge of negotiating distinctive and potentially conflicting entrepreneurial aims, using career identity theory. It concludes by suggesting strategies by which adaptive entrepreneurial artist identities can be developed through higher education programs.

Selective essays in competitive environments

This thesis is a collection of essays that utilises descriptive and empirical tools to examine competitive environments such as in academia, superrich and sport. The essays capture different aspects of the winner-take-all phenomenon by looking at citation and publication inequality in a top tier economics journal namely the American Economic Review. How globalisation and corruption influence the accumulation of extraordinary wealth and finally, how in a fairly equal competition, that is in the National Rugby League in Australia, wearing red shirts could lead to a comparative advantage and hence, tip the balance between winning and losing. The results within academia indicate that a highly unequal distribution exist, in which only a few top authors or institutions produce the majority of output. Furthermore, the results obtained in the superrich environment indicate that corruption and globalisation enhances the accumulation of extraordinary wealth. Finally, the results in the sport environment are mixed. While we find support for a positive effect of wearing red jerseys in our descriptive analysis, we find a negative effect when we control at the team level. However, when we investigate the relative difference in the degree of redness between home and away team, we find a quite strong positive effect of wearing red shirts even after controlling at the team level.

Sentencing and public confidence : results from a national Australian survey on public opinions towards sentencing

This paper examines the critical issue of public confidence in sentencing, and presents findings from Phase I of an Australia-wide sentencing and public confidence project. Phase I comprised a nationally representative telephone survey of 6005 participants. The majority of respondents expressed high levels of punitiveness and were dissatisfied with sentences imposed by the courts. Despite this, many were strongly supportive of the use of alternatives to imprisonment for a range of offences. These nuanced views raise questions regarding the efficacy of gauging public opinion using opinion poll style questions; indeed the expected outcome from this first phase of the four phase sentencing and public confidence project. The following phases of this project, reported on elsewhere, examined the effects of various interventions on the robustness and nature of these views initially expressed in a standard ‘top of the head’ opinion poll.

The identification of therapeutic targets in metastatic melanoma

Metastatic melanoma, a cancer historically refractory to chemotherapeutic strategies, has a poor prognosis and accounts for the majority of skin cancer related mortality. Although the recent approval of two new drugs combating this disease, Ipilimumab and Vemurafenib (PLX4032), has demonstrated for the first time in decades an improvement in overall survival; the clinical efficacy of these drugs has been marred by severe adverse immune reactions and acquired drug resistance in patients, respectively. Thus, understanding the etiology of metastatic melanoma will contribute to the improvement of current therapeutic strategies while leading to the development of novel drug approaches. In order to identify recurrently mutated genes of therapeutic relevance in metastatic melanoma, a panel of stage III local lymph node melanomas were extensively characterised using high-throughput genomic technologies. This led to the identification of mutations in TFG in 5% of melanomas from a candidate gene sequencing approach using SNP array analysis, 24% of melanomas with mutations in MAP3K5 or MAP3K9 though unbiased whole-exome sequencing strategies, and inactivating mutations in NF1 in BRAF/NRAS wild type tumours though pathway analysis. Lastly, this thesis describes the development of a melanoma specific mutation panel that can rapidly identify clinically relevant mutation profiles that could guide effective treatment strategies through a personalised therapeutic approach. These findings are discussed in respect to a number of important issues raised by this study including the current limitation of next-generation sequencing technology, the difficulty in identifying ‘driver’ mutations critical to the development of melanoma due to high carcinogenic exposure by UV radiation, and the ultimate application of mutation screening in a personalised therapeutic setting. In summary, a number novel genes involved in metastatic melanoma have been identified that may have relevance for current therapeutic strategies in treating this disease.

Normative influences across cultures : conceptual differences and potential confounders among drivers in Australia and China

Normative influences on road user behaviour have been well documented and include such things as personal, group, subjective and moral norms. Commonly, normative factors are examined within one cultural context, although a few examples of exploring the issue across cultures exist. Such examples add to our understanding of differences in perceptions of the normative factors that may exert influence on road users and can assist in determining whether successful road safety interventions in one location may be successful in another. Notably, the literature is relatively silent on such influences in countries experiencing rapidly escalating rates of motorization. China is one such country where new drivers are taking to the roads in unprecedented numbers and authorities are grappling with the associated challenges. This paper presents results from qualitative and quantitative research on self-reported driving speeds of car drivers and related issues in Australia and China. Focus group interviews and questionnaires conducted in each country examined normative factors that might influence driving in each cultural context. Qualitative findings indicated perceptions of community acceptance of speeding were present in both countries but appeared more widespread in China, yet quantitative results did not support this difference. Similarly, with regard to negative social feedback from speeding, qualitative findings suggested no embarrassment associated with speeding among Chinese participants and mixed results among Australian participants, yet quantitative results indicated greater embarrassment for Chinese drivers. This issue was also examined from the perspective of self-identity and findings were generally similar across both samples and appear related to whether it is important to be perceived as a skilled/safe driver by others. An interesting and important finding emerged with regard to how Chinese drivers may respond to questions about road safety issues if the answers might influence foreigners’ perceptions of China. In attempting to assess community norms associated with speeding, participants were asked to describe what they would tell a foreign visitor about the prevalence of speeding in China. Responses indicated that if asked by a foreigner, people may answer in a manner that portrayed China as a safe country (e.g., that drivers do not speed), irrespective of the actual situation. This ‘faking good for foreigners’ phenomenon highlights the importance of considering ‘face’ when conducting research in China – a concept absent from the road safety literature. An additional noteworthy finding that has been briefly described in the road safety literature is the importance and strength of the normative influence of social networks (guanxi) in China. The use of personal networks to assist in avoiding penalties for traffic violations was described by Chinese participants and is an area that could be addressed to strengthen the deterrent effect of traffic law enforcement. Overall, the findings suggest important considerations for developing and implementing road safety countermeasures in different cultural contexts.

Teachers as advocates for widening participation

In England and Australia, higher education institutions (HEIs) are expected to widen participation (WP) in higher education (HE) to enhance social justice and improve individual and national economic returns. Furthermore, HEIs are the major providers of initial and in-service teacher education. This article surveys international literature to explore ways in which teacher education programmes could and do contribute to preparing teachers to advocate for WP, including drawing on learning from WP research that demonstrates the value of current HE students engaging young people in schools and colleges to support them in seriously considering progressing to HE. We conclude that teachers and pre-service teachers are well placed to be advocates for WP. In the majority of higher education institutions, however, WP and teacher education functions are not working collaboratively to embed advocacy for WP into teacher education programmes.

An evolving perspective on physical activity counselling by medical professionals

Background Physical inactivity is a modifiable risk factor for many chronic conditions and a leading cause of premature mortality. An increasing proportion of adults worldwide are not engaging in a level of physical activity sufficient to prevent or alleviate these adverse effects. Medical professionals have been identified as potentially powerful sources of influence for those who do not meet minimum physical activity guidelines. Health professionals are respected and expected sources of advice and they reach a large and relevant proportion of the population. Despite this potential, health professionals are not routinely practicing physical activity promotion. Discussion Medical professionals experience several known barriers to physical activity promotion including lack of time and lack of perceived efficacy in changing physical activity behaviour in patients. Furthermore, evidence for effective physical activity promotion by medical professionals is inconclusive. To address these problems, new approaches to physical activity promotion are being proposed. These include collaborating with community based physical activity behaviour change interventions, preparing patients for effective brief counselling during a consultation with the medical professional, and use of interactive behaviour change technology. Summary It is important that we recognise the latent risk of physical inactivity among patients presenting in clinical settings. Preparation for improving patient physical activity behaviours should commence before the consultation and may include physical activity screening. Medical professionals should also identify suitable community interventions to which they can refer physically inactive patients. Outsourcing the majority of a comprehensive physical activity intervention to community based interventions will reduce the required clinical consultation time for addressing the issue with each patient. Priorities for future research include investigating ways to promote successful referrals and subsequent engagement in comprehensive community support programs to increase physical activity levels of inactive patients. Additionally, future clinical trials of physical activity interventions should be evaluated in the context of a broader framework of outcomes to inform a systematic consideration of broad strengths and weaknesses regarding not only efficacy but cost-effectiveness and likelihood of successful translation of interventions to clinical contexts.

Micro-business community responsibility in Australia : approaches, motivations and barriers

Micro and small businesses contribute the majority of business activity in most developed economies. They are typically embedded in local communities and therefore well placed to influence community wellbeing. While there has been considerable theoretical and empirical analysis of corporate citizenship and corporate social responsibility (CSR), the nature of micro-business community responsibility (mBCR) remains relatively under-explored. This article presents findings from an exploratory study of mBCR that examined the approaches, motivations and barriers of this phenomenon. Analysis of data from 36 semi structured interviews with micro-business owner-operators in the Australian city of Brisbane revealed three mBCR approaches, suggesting an observable mBCR typology. Each mBCR type was at least partly driven by enlightened self interest (ESI). In addition to a pure ESI approach, findings revealed ESI combined with philanthropic approaches and ESI combined with social entrepreneurial approaches. The combination of doing business and doing good found amongst participants in this study suggests that many micro-business owner-operators are supporters of their local communities, and therefore driven by more than profit. This study provides a fine-grained understanding of micro-business involvement in community wellbeing through a lens of responsible business behaviour.

Occupational Access and Wage Discrimination

This article presents a study on the quantification of the level of occupational access and wage discrimination in Great Britain. The traditional approach to quantifying the level of sex discrimination is to distinguish gender differences in productive characteristics from the unequal treatment of characteristics according to gender. The role of inter- versus intra-occupational effects in determining the magnitude of wage differences between men and women was examined. The econometric results provided estimates of the wage differential in six broad occupational classifications together with an aggregate picture of how important the occupational distribution of females is in explaining their lower average wage. In summary, the results of the study suggest that the vast majority of the male and female wage differential arises from intra-occupation effects. The results provide evidence to suggest that occupational segregation is not a major contributor to the observed male/female wage differential.

Impact of wind power development on transmission planning at Midwest ISO

The Midwest Independent Transmission System Operator (MISO) has experienced significant amounts of wind power development within the last decade. The MISO footprint spans the majority of the upper Midwest region of the country, from the Dakotas to Indiana and as far east as Michigan. These areas have a rich wind energy resource. States in the MISO footprint have passed laws or set goals that require load serving entities to supply a portion of their load using renewable energy. In order to meet these requirements, significant investments are needed to build the transmission infrastructure necessary to deliver the power from these often remote wind energy resources to the load centers. This paper presents some of the transmission planning related work done at MISO which was largely influenced by current and future needs for increased wind power generation in the footprint. Specifically, topics covered are generator interconnection, long-term planning coordination, and cost-allocation for new transmission lines.

Examination of socio-demographics and job satisfaction in Australian registered nurses

Aims and Objectives To examine relationships between socio-demographic factors and job satisfaction and to identify if these factors predict job satisfaction levels in an Australian registered nurses. Background Reports indicate that in Australia there are 30,000 qualified nurses no longer working in the healthcare and that current nursing shortages vary as a result of certain socio-demographic variables including type of nurse, geographic, location, sector, service and organisation. Furthermore it has been revealed that there is not only a real shortage but also a pseudo-shortage (i.e. either there are not enough nurses are available, or not enough are willing to work under existing workplace conditions). International studies have found significant relationships exist between some socio-demographic factors and job satisfaction in registered nurses however there is limited information available on relationships between socio-demographic factors and job satisfaction in nurses in the Australian context. Design A cross sectional survey was undertaken of Australian registered nurses. Methods Two thousand Australian registered nurses who were members of an industrial and professional organisation were sent the questionnaire in 2008. They were stratified and randomised according to gender. Six hundred and thirty-nine registered nurses responded. Descriptive analyses, correlation analyses, one- way ANOVA tests, simple linear regression and multivariable analyses were conducted to examine further if any relationships existed between the variables. Results The majority of respondents showed positive job satisfaction scores. An ANOVA found significant positive relationships existed between job satisfaction, specialty area, health sector and Australian states. Multivariable analyses found relationships existed between specialty area, health sector, and job satisfaction. Conclusions The variables specialty area and health sector were found to be significantly associated with job satisfaction. The different specialty areas and health sectors in relation to job satisfaction should be investigated further. Clinical Relevance The study results have provided new knowledge for policy makers, organisational and nursing leaders of the socio-demographic variables that may affect job satisfaction in registered nurses in the Australian context.

Symptoms of heat illness in surface mine workers

Objective: To assess the symptoms of heat illness experienced by surface mine workers. Methods: Ninety-one surface mine workers across three mine sites in northern Australia completed a heat stress questionnaire evaluating their symptoms for heat illness. A cohort of 56 underground mine workers also participated for comparative purposes. Participants were allocated into asymptomatic, minor or moderate heat illness categories depending on the number of symptoms they reported. Participants also reported the frequency of symptom experience, as well as their hydration status (average urine colour). Results: Heat illness symptoms were experienced by 87 and 79 % of surface and underground mine workers, respectively (p = 0.189), with 81–82 % of the symptoms reported being experienced by miners on more than one occasion. The majority (56 %) of surface workers were classified as experiencing minor heat illness symptoms, with a further 31 % classed as moderate; 13 % were asymptomatic. A similar distribution of heat illness classification was observed among underground miners (p = 0.420). Only 29 % of surface miners were considered well hydrated, with 61 % minimally dehydrated and 10 % significantly dehydrated, proportions that were similar among underground miners (p = 0.186). Heat illness category was significantly related to hydration status (p = 0.039) among surface mine workers, but only a trend was observed when data from surface and underground miners was pooled (p = 0.073). Compared to asymptomatic surface mine workers, the relative risk of experiencing minor and moderate symptoms of heat illness was 1.5 and 1.6, respectively, when minimally dehydrated. Conclusions: These findings show that surface mine workers routinely experience symptoms of heat illness and highlight that control measures are required to prevent symptoms progressing to medical cases of heat exhaustion or heat stroke.

Corneal sensitivity is related to established measures of diabetic peripheral neuropathy

Purpose:  The objective was to investigate the association between corneal sensitivity and established measures of diabetic peripheral neuropathy (DPN). Methods:  Corneal sensitivity was measured in 93 individuals with diabetes, 146 diabetic individuals without neuropathy and 61 control individuals without diabetes or neuropathy using a non-contact corneal aesthesiometer at the baseline visit of a five-year longitudinal natural history study of DPN. The correlation between corneal sensitivity and established measures of neuropathy was estimated and multi-dimensional scaling was used to represent similarities and dissimilarities between variables. Results:  The corneal sensitivity threshold was significantly correlated with a majority of established measures of DPN. Correlation coefficients ranged from -0.32 to 0.26. Using multi-dimensional scaling, non-contact corneal aesthesiometry was closer to the neuropathy disability score, diabetic neuropathy symptom score and Neuropad and most dissimilar to electrophysiological parameters and quantitative sensory testing. Conclusion:  Corneal sensitivity, although not strongly related, is associated with other functional measures of DPN and might provide a useful adjunct in identifying functional loss of small nerve fibre integrity.

Performance evaluation of onsite wastewater treatment : field sampling and preliminary evaluation of results

Background The onsite treatment of sewage and effluent disposal within the premises is widely prevalent in rural and urban fringe areas due to the general unavailability of reticulated wastewater collection systems. Despite the seemingly low technology of the systems, failure is common and in many cases leading to adverse public health and environmental consequences. Therefore it is important that careful consideration is given to the design and location of onsite sewage treatment systems. It requires an understanding of the factors that influence treatment performance. The use of subsurface effluent absorption systems is the most common form of effluent disposal for onsite sewage treatment and particularly for septic tanks. Additionally in the case of septic tanks, a subsurface disposal system is generally an integral component of the sewage treatment process. Therefore location specific factors will play a key role in this context. The project The primary aims of the research project are: • to relate treatment performance of onsite sewage treatment systems to soil conditions at site; • to identify important areas where there is currently a lack of relevant research knowledge and is in need of further investigation. These tasks were undertaken with the objective of facilitating the development of performance based planning and management strategies for onsite sewage treatment. The primary focus of the research project has been on septic tanks. Therefore by implication the investigation has been confined to subsurface soil absorption systems. The design and treatment processes taking place within the septic tank chamber itself did not form a part of the investigation. In the evaluation to be undertaken, the treatment performance of soil absorption systems will be related to the physico-chemical characteristics of the soil. Five broad categories of soil types have been considered for this purpose. The number of systems investigated was based on the proportionate area of urban development within the Brisbane region located on each soil types. In the initial phase of the investigation, though the majority of the systems evaluated were septic tanks, a small number of aerobic wastewater treatment systems (AWTS) were also included. This was primarily to compare the effluent quality of systems employing different generic treatment processes. It is important to note that the number of different types of systems investigated was relatively small. As such this does not permit a statistical analysis to be undertaken of the results obtained. This is an important issue considering the large number of parameters that can influence treatment performance and their wide variability. The report This report is the second in a series of three reports focussing on the performance evaluation of onsite treatment of sewage. The research project was initiated at the request of the Brisbane City Council. The work undertaken included site investigation and testing of sewage effluent and soil samples taken at distances of 1 and 3 m from the effluent disposal area. The project component discussed in the current report formed the basis for the more detailed investigation undertaken subsequently. The outcomes from the initial studies have been discussed, which enabled the identification of factors to be investigated further. Primarily, this report contains the results of the field monitoring program, the initial analysis undertaken and preliminary conclusions. Field study and outcomes Initially commencing with a list of 252 locations in 17 different suburbs, a total of 22 sites in 21 different locations were monitored. These sites were selected based on predetermined criteria. To obtain house owner agreement to participate in the monitoring study was not an easy task. Six of these sites had to be abandoned subsequently due to various reasons. The remaining sites included eight septic systems with subsurface effluent disposal and treating blackwater or combined black and greywater, two sites treating greywater only and six sites with AWTS. In addition to collecting effluent and soil samples from each site, a detailed field investigation including a series of house owner interviews were also undertaken. Significant observations were made during the field investigations. In addition to site specific observations, the general observations include the following: • Most house owners are unaware of the need for regular maintenance. Sludge removal has not been undertaken in any of the septic tanks monitored. Even in the case of aerated wastewater treatment systems, the regular inspections by the supplier is confined only to the treatment system and does not include the effluent disposal system. This is not a satisfactory situation as the investigations revealed. • In the case of separate greywater systems, only one site had a suitably functioning disposal arrangement. The general practice is to employ a garden hose to siphon the greywater for use in surface irrigation of the garden. • In most sites, the soil profile showed significant lateral percolation of effluent. As such, the flow of effluent to surface water bodies is a distinct possibility. • The need to investigate the subsurface condition to a depth greater than what is required for the standard percolation test was clearly evident. On occasion, seemingly permeable soil was found to have an underlying impermeable soil layer or vice versa. The important outcomes from the testing program include the following: • Though effluent treatment is influenced by the physico-chemical characteristics of the soil, it was not possible to distinguish between the treatment performance of different soil types. This leads to the hypothesis that effluent renovation is significantly influenced by the combination of various physico-chemical parameters rather than single parameters. This would make the processes involved strongly site specific. • Generally the improvement in effluent quality appears to take place only within the initial 1 m of travel and without any appreciable improvement thereafter. This relates only to the degree of improvement obtained and does not imply that this quality is satisfactory. This calls into question the value of adopting setback distances from sensitive water bodies. • Use of AWTS for sewage treatment may provide effluent of higher quality suitable for surface disposal. However on the whole, after a 1-3 m of travel through the subsurface, it was not possible to distinguish any significant differences in quality between those originating from septic tanks and AWTS. • In comparison with effluent quality from a conventional wastewater treatment plant, most systems were found to perform satisfactorily with regards to Total Nitrogen. The success rate was much lower in the case of faecal coliforms. However it is important to note that five of the systems exhibited problems with regards to effluent disposal, resulting in surface flow. This could lead to possible contamination of surface water courses. • The ratio of TDS to EC is about 0.42 whilst the optimum recommended value for use of treated effluent for irrigation should be about 0.64. This would mean a higher salt content in the effluent than what is advisable for use in irrigation. A consequence of this would be the accumulation of salts to a concentration harmful to crops or the landscape unless adequate leaching is present. These relatively high EC values are present even in the case of AWTS where surface irrigation of effluent is being undertaken. However it is important to note that this is not an artefact of the treatment process but rather an indication of the quality of the wastewater generated in the household. This clearly indicates the need for further research to evaluate the suitability of various soil types for the surface irrigation of effluent where the TDS/EC ratio is less than 0.64. • Effluent percolating through the subsurface absorption field may travel in the form of dilute pulses. As such the effluent will move through the soil profile forming fronts of elevated parameter levels. • The downward flow of effluent and leaching of the soil profile is evident in the case of podsolic, lithosol and kransozem soils. Lateral flow of effluent is evident in the case of prairie soils. Gleyed podsolic soils indicate poor drainage and ponding of effluent. In the current phase of the research project, a number of chemical indicators such as EC, pH and chloride concentration were employed as indicators to investigate the extent of effluent flow and to understand how soil renovates effluent. The soil profile, especially texture, structure and moisture regime was examined more in an engineering sense to determine the effect of movement of water into and through the soil. However it is not only the physical characteristics, but the chemical characteristics of the soil also play a key role in the effluent renovation process. Therefore in order to understand the complex processes taking place in a subsurface effluent disposal area, it is important that the identified influential parameters are evaluated using soil chemical concepts. Consequently the primary focus of the next phase of the research project will be to identify linkages between various important parameters. The research thus envisaged will help to develop robust criteria for evaluating the performance of subsurface disposal systems.