National audit of post-operative management in spinal surgery

Background: There is some evidence from a Cochrane review that rehabilitation following spinal surgery may be beneficial. Methods: We conducted a survey of current post-operative practice amongst spinal surgeons in the United Kingdom in 2002 to determine whether such interventions are being included routinely in the post-operative management of spinal patients. The survey included all surgeons who were members of either the British Association of Spinal Surgeons ( BASS) or the Society for Back Pain Research. Data on the characteristics of each surgeon and his or her current pattern of practice and post-operative care were collected via a reply-paid postal questionnaire. Results: Usable responses were provided by 57% of the 89 surgeons included in the survey. Most surgeons (79%) had a routine post-operative management regime, but only 35% had a written set of instructions that they gave to their patients concerning this. Over half (55%) of surgeons do not send their patients for any physiotherapy after discharge, with an average of less than two sessions of treatment organised by those that refer for physiotherapy at all. Restrictions on lifting, sitting and driving showed considerable inconsistency both between surgeons and also within the recommendations given by individual surgeons. Conclusion: Demonstrable inconsistencies within and between spinal surgeons in their approaches to post-operative management can be interpreted as evidence of continuing and significant uncertainty across the sub-speciality as to what does constitute best care in these areas of practice. Conducting further large, rigorous, randomised controlled trials would be the best method for obtaining definitive answers to these questions.

A cost-effectiveness analysis of heroin detoxification methods in the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD)

This economic evaluation was part of the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD) project. Data from four trials of heroin detoxification methods, involving 365 participants, were pooled to enable a comprehensive comparison of the cost-effectiveness of five inpatient and outpatient detoxification methods. This study took the perspective of the treatment provider in assessing resource use and costs. Two short-term outcome measures were used-achievement of an initial 7-day period of abstinence, and entry into ongoing post-detoxification treatment. The mean costs of the various detoxification methods ranged widely, from AUD $491 (buprenorphine-based outpatient); to AUD $605 for conventional outpatient; AUD $1404 for conventional inpatient; AUD $1990 for rapid detoxification under sedation; and to AUD $2689 for anaesthesia per episode. An incremental cost-effectiveness analysis was carried out using conventional outpatient detoxification as the base comparator. The buprenorphine-based outpatient detoxification method was found to be the most cost-effective method overall, and rapid opioid detoxification under sedation was the most costeffective inpatient method.

An empirical investigation of host country national categorization of expatriates in the United Kingdom

In recent times, some authors have argued that Host Country National (HCN) categorization of expatriate co-workers plays a major role in expatriate adjustment. Previous studies have argued that HCN categorization of expatriates maybe be based on gender, or national origin. In this study, using data from 331 HCNs in the U.K., we find that HCN expectations of foreigners may play a big role in categorization. Further, we find that categorization leads to lower levels of support offered by HCNs, which can affect expatriate adjustment. We discuss implications and offer suggestions for future research.

Two-nation study of host country national categorization of female expatriates - United States and India

This study was designed to study the role of Host Country National categorizationof female expatriate co-workers, in two samples – U.S., and India. Using data from 54participants in the U.S. and 52 participants in India, we found that respondents from Indiacategorized potential expatriate co-workers from the U.S. into in-group or out-groupsignificantly more than respondents from the U.S. Further, we found that femaleexpatriates from the U.S. are preferred by Indian HCNs as co-workers significantly morethan male expatriates from the U.S. We discuss implications for organizations and offersuggestions for future research.

A cross-national comparison of cultural value orientations of Indian, Polish, Russian and American employees

This study examines the cultural value orientations (VOs) of employees (managerial and non-managerial) working in three categories of organizations (professional, technical and local services) in India, Poland, Russia and the USA. The analysis is conducted at both the national and organizational levels. The paper hypothesizes cultural differences at the country level and cultural similarities among employees working for professional and technical oriented organizations and divergence in the VOs of employees working for local services organizations. It also hypothesizes differences in the VOs of managerial and non-managerial employees in the four countries. The investigation has been conducted with the help of a questionnaire survey of 1,852 respondents. The outcomes of the analysis show that there are both cross-country cultural differences and similarities among the VOs of employees of the four nations. Further, significant cultural convergence emerges in the VOs of employees working for both professional and technical organizations, however, no significant cultural similarities or differences are observed for employees of service-based organizations in the four countries. There are some similarities emerging between managerial employees in the research countries. The research contributes to the fields of cross-cultural management, international management and international human resource management.

National system of innovation and technological learning:an integrated framework for understanding technological capability development in the Russian forestry sector

One of the issues in the innovation system literature is examination of technological learning strategies of laggard nations. Two distinct bodies of literature have contributed to our insight into forces driving learning and innovation, National Systems of Innovation (NSI) and technological learning literature. Although both literatures yield insights on catch-up strategies of 'latecomer' nations, the explanatory powers of each literature by itself is limited. In this paper, a possible way of linking the macro- and the micro-level approaches by incorporating enterprises as active learning entities into the learning and innovation system is proposed. The proposed model has been used to develop research hypotheses and indicate research directions and is relevant for investigating the learning strategies of firms in less technologically intensive industries outside East Asia.