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.

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).

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.

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.

Effects of acute multinutrient supplementation on rugby union game performance and recovery

Purpose: To investigate the effects of an acute multinutrient supplement on game-based running performance, peak power output, anaerobic by-products, hormonal profiles, markers of muscle damage, and perceived muscular soreness before, immediately after, and 24 h following competitive rugby union games. Methods: Twelve male rugby union players ingested either a comprehensive multinutrient supplement (SUPP), [RE-ACTIVATE:01], or a placebo (PL) for 5 d. Participants then performed a competitive rugby union game (with global positioning system tracking), with associated blood draws and vertical jump assessments pre, immediately post and 24 h following competition. Results: SUPP ingestion resulted in moderate to large effects for augmented 1st half very high intensity running (VHIR) mean speed (5.9 ± 0.4 vs 4.8 ± 2.3 m·min–1; d= 0.93). Further, moderate increases in 2nd half VHIR distance (137 ± 119 vs 83 ± 89 m; d= 0.73) and VHIR mean speed (5.9 ± 0.6 v 5.3 ± 1.7 m·min–1; d= 0.56) in SUPP condition were also apparent. Postgame aspartate aminotransferase (AST; 44.1 ± 11.8 vs 37.0 ± 3.2 UL; d= 1.16) and creatine kinase (CK; 882 ± 472 vs. 645 ± 123 UL; d= 0.97) measures demonstrated increased values in the SUPP condition, while AST and CK values correlated with 2nd half VHIR distance (r= –0.71 and r= –0.76 respectively). Elevated C-reactive protein (CRP) was observed postgame in both conditions; however, it was significantly blunted with SUPP (P= .05). Conclusions: These findings suggest SUPP may assist in the maintenance of VHIR during rugby union games, possibly via the buffering qualities of SUPP ingredients. However, correlations between increased work completed at very high intensities and muscular degradation in SUPP conditions, may mask any anticatabolic properties of the supplement.

Effects of acute multi-nutrient supplementation on rugby union match performance and recovery

Aim: To determine the effects of an acute multi-nutrient supplement on physiological, performance and recovery responses to intermittent-sprint running and muscular damage during rugby union matches. Methods: Using a randomised, double-blind, cross-over design, twelve male rugby union players ingested either 75 g of a comprehensive multi-nutrient supplement (SUPP), [Musashi] or 1 g of a taste and carbohydrate matched placebo (PL) for 5 days pre-competition. Competitive rugby union game running performance was then measured using 1 Hz GPS data (SPI10, SPI elite, GPSports), in addition to associated blood draws, vertical jump assessments and ratings of perceived muscular soreness (MS) pre, immediately post and 24 h post-competition. Baseline (BL) GPS data was collected during six competition rounds preceding data collection. Results: No significant differences were observed between supplement conditions for all game running, vertical jump, and ratings of perceived muscular soreness. However, effect size analysis indicated SUPP ingestion increased 1st half very high intensity running (VHIR) mean speed (d = 0.93) and 2nd half relative distance (m/min) (d = 0.97). Further, moderate increases in 2nd half VHIR distance (d = 0.73), VHIR m/min (d = 0.70) and VHIR mean speed (d = 0.56) in SUPP condition were also apparent. Moreover, SUPP demonstrated significant increases in 2nd half dist m/min, total game dist m/min and total game HIR m/min compared with BL data (P < 0.05). Further, large ES increases in VHIR time (d = 0.88) and moderate increases in 2nd half HIR m/min (d = 0.65) and 2nd half VHIR m/min (d = 0.74) were observed between SUPP and BL. Post-game aspartate aminotransferase (AST) (d = 1.16) and creatine kinase (CK) (d = 0.97) measures demonstrated increased ES values with SUPP, while AST and CK values correlated with 2nd half VHIR distance (r = −0.71 and r = −0.76 respectively). Elevated c-reactive protein (CRP) was observed post-game in both conditions, however was significantly blunted with SUPP (P = 0.05). Additionally, pre-game (d = 0.98) and post-game (d = 0.96) increases in cortisol (CORT) were apparent with SUPP. No differences were apparent between conditions for pH, lactate, glucose, HCO3, vertical jump assessments and MS (P > 0.05). Conclusion: These findings suggest SUPP may assist in the maintenance of VHIR speeds and distances covered during rugby union games, possibly via the buffering qualities of SUPP ingredients (i.e. caffeine, creatine, bicarbonate). While the mechanisms for these findings are unclear, the similar pH between conditions despite additional VHIR during SUPP may support this conclusion. Finally, correlations between increased work completed at very high intensities and muscular degradation in SUPP conditions, may mask any anti-catabolic properties of supplementation.

Varieties of collaboration: The case of an Australian retail union

Much has been written about varieties of collaboration and the interplay between conflict and collaboration in industrial relations. This paper explores the preconditions, processes and outcomes associated with the collaborative strategies of an Australian retail trade union: the Shop, Distributive and Allied Employees' Association. The data were collected from an extensive series of interviews with officials and organisers within the union across all Australian states. We find that despite taking a servicing approach, and indeed never aggressively organising members, the union has managed to achieve a range of outcomes that exceed retail employment conditions in other countries. We argue that this is partly a result of the Australian legislative framework, which is inherently pluralist and supportive of collective bargaining. This environment, whereby unions are not forced to fight to represent members, can be conducive to collaborative employment relations, particularly in industries where the parties do not adopt an adversarialist stance.

Paradoxes of participation : non-union workplace partnerships in John Lewis

The extent to which workplace partnership delivers mutual gains is subject to considerable debate amongst practitioners and scholars. One of the oldest and largest examples of workplace partnership is the John Lewis Partnership that began using forms of non-union employee representation in 1929. Despite ongoing interest from researchers in employee representation, and specifically non-union forms of employee voice, there have been few in-depth studies of the Partnership's organisational structure and practices since the 1980s. This paper explores in detail the operation of representation structures in the John Lewis Partnership, which is a significant case of non-union workplace partnership with the potential for mutual gains. A key finding of the paper was that the decision-making structures that characterise the Partnership, and that are protected by a constitution, are under constant threat from the discursive struggle to define partnership in a way that privileges managerial interests. The paper argues, therefore, that mutual gains need to be secured both structurally and discursively to address the tensions and paradoxes at the heart of debates about the meaning and aims of employee representation.

Integrating robotics in primary school activities

This article outlines the integration of robotics in two settings in a primary school. This initiative was part of an Australian Research Council project which was undertaken at this school. The article highlights how robotics was integrated in a technology unit in a year four class. It also explains how it was embedded into an after-school program which catered for students from years five to seven. From these experiences further possibilities of engaging with robotics are also discussed.

Practice and Procedures - Cross v Queensland Rugby Football Union Ltd [2001] QSC 173

The decision of Chesterman J in Cross v Queensland Rugby Football Union Ltd [2001] QSC 173 (Supreme Court of Queensland, No 3426 of 1997), Chesterman J, 30.5.2001) opens the possibilities for delivering interrogatories, particularly in the context of interrogatories relating to an opponent's version of events.