Patient expectations, outcomes and satisfaction : related, relevant or redundant?

Abstract Study design: A prospective investigation of patients undergoing lumbar spine surgery. Objective: Is there a correlation between patient’s expectations before lumbar surgery, postoperative outcomes and satisfaction levels? Methods: A prospective study of 145 patients undergoing primary, single-level surgery for degenerative lumbar conditions was conducted. Oswestry Disability Index (ODI), back visual analogue scale (VAS) and leg VAS were assessed pre-operatively and at 6 weeks and 6 months post-surgery. Patients’ expectations were measured pre-operatively by asking them to score the level of pain and disability that would be least acceptable for them to undergo surgery and be satisfied. Satisfaction was assessed six weeks post-operatively with a Likert scale. Differences in patient expectations between actual and expected improvements were quantified. Results: Most patients had a clinically relevant improvement, but only about half achieved their expectation. Satisfaction did not correlate with pre-operative pain or disability, or with patient expectation of improvement. Instead, satisfaction correlated with positive outcomes. Conclusions Patient expectations have little bearing on final outcome and satisfaction.

First year design "Visualisation II": The hybridisation of analogue and digital tools

This paper discusses first year students’ responses and outcomes to the integration of digital technologies in their second semester foundational visualisation class; ‘Visualisation II’. As the second class in the Visualisation series, previous analogue knowledge taught in ‘Visualisation I’ is compounded with new digital technologies establishing the introduction to a myriad of hybrid visualisation tools and techniques for design exploration and design artefact. This research examines the differentiation between analogue and digital design, common precedents of the two, and reflects upon the environment and class structure with the learning experiences and confidence of surveyed participants.

The preferences of private equity investors in selecting target acquisitions : an international investigation

This study investigates the characteristics and attributes that private equity investors prefer when selecting target acquisitions. These characteristics are examined against a matched sample of firms subject to corporate acquisitions via tender/merger offer during 2000-2009, across seven countries: Australia, Canada, the United Kingdom, the USA, France, Germany and Sweden. We show that firm-specific characteristics are more influential in target selection than external or institutional variables. In particular, private equity targets exhibit lower stock volatility and long-term growth prospects, are larger, and have greater abnormal operating income relative to tender/merger offer target firms. Further, private equity bidders exhibit 'home bias', implying that familiarity motivates target selection. Institutional factors remain largely insignificant across all tests.

Preservice teachers’ views : Issues for learning to teach SOSE in an overcrowded curriculum

A cohort of third-year preservice teachers (n=24) was given the opportunity to observe and participate in Studies of Society and Environment (SOSE) in primary classrooms through a series of school visits during a semester-long unit. These visits were designed to give preservice teachers opportunities to connect SOSE teaching theories studied in the university setting to SOSE teaching practices within schools. This study investigates the extent of the preservice teachers’ opportunities to observe SOSE teaching in the primary school. Responses from a survey showed that the majority of preservice teachers only agreed with 6 of the 25 items associated with the six categories (personal-professional skill development, system requirements, teaching practices, student behavior, feedback to students, and reflection on practice). Written responses from the questionnaire concurred that most had not experienced SOSE teaching. Various issues are discussed around providing preservice teachers with SOSE teaching experiences. School executives, teachers and university staff need to be part of the process to ensure preservice teachers are receiving quality SOSE teaching experiences that will assist in their pedagogical development. A wider question is also raised through this paper. If preservice teachers are unable to experience quality SOSE teaching in school visits designed for such a purpose, does this signal a changing emphasis in education that leaves the social sciences and humanities off the education agenda?

Process based synthesis to evaluate design flexibility in airport terminal layout

Flexible design concept is a relatively new trend in airport terminal design which is believed to facilitate the ever changing needs of a terminal. Current architectural design processes become more complex every day because of the introduction of new building technologies where the concept of flexible airport terminal would apparently make the design process even more complex. Previous studies have demonstrated that ever growing aviation industry requires airport terminals to be planned, designed and constructed in such a way that should allow flexibility in design process. In order to adopt the philosophy of ‘design for flexibility’ architects need to address a wide range of differing needs. An appropriate integration of the process models, prior to the airport terminal design process, is expected to uncover the relationships that exist between spatial layout and their corresponding functions. The current paper seeks to develop a way of sharing space adjacency related information obtained from the Business Process Models (BPM) to assist in defining flexible airport terminal layouts. Critical design parameters are briefly investigated at this stage of research whilst reviewing the available design alternatives and an evaluation framework is proposed in the current paper. Information obtained from various design layouts should assist in identifying and defining flexible design matrices allowing architects to interpret and to apply those throughout the lifecycle of the terminal building.

"Are there any right or wrong answers in teaching philosophy": ethics, epistemology, and philosophy in the classroom

This article assesses undergraduate teaching students’ assertion that there are no right and wrong answers in teaching philosophy. When asked questions about their experiences of philosophy in the classroom for primary children, their unanimous declaration that teaching philosophy has ‘no right and wrong answers’ is critically examined across the three sub-disciplinary areas to which they were generally referring, namely, pedagogy, ethics, and epistemology. From a pedagogical point of view, it is argued that some teaching approaches may indeed be more effective than others, and some pupils’ opinions less defensible, but pedagogically, in terms of managing the power relations in the classroom, it is counter-productive to continually insist on notions of truth and falsity at every point. From an ethical point of view, it is contended that anti-realist approaches to meta-ethics may represent a viable intellectual position, but from the point of view of normative ethics, notions of right and wrong still retain significant currency. From an epistemological point of view, it is argued using Karl Poppers’ work that while it may be difficult to determine what constitutes a right answer, determining a wrong one is far more straightforward. In conclusion, it is clear that prospective teachers engaging in philosophy in the classroom, and also future teachers in general, require a far more nuanced philosophical understanding of the notions of right and wrong and truth and falsity. In view of this situation, it we wish to promote the effective teaching of philosophical thinking to children, or produce educators who can understand the conceptual limits of the claims they make and their very real and often serious practical and social consequences, it is recommended that philosophy be reinstated to a fundamental, foundational place within the pre-service teaching curriculum.

Complications related to therapeutic anticoagulation in total hip arthroplasty

Bleeding related wound complications cause significant morbidity in lower limb arthroplasty surgery. Patients who require therapeutic anticoagulation in the peri operative period are potentially at higher risk of these complications. This is a retrospective case control study reviewing all primary total hip replacements performed in a single center over a five year period and comparing outcomes of the patients on warfarin with a double-matched control group of patients not on warfarin. The warfarin group had significantly higher risk of deep joint infection (9% vs 2.2%), haematoma/ wound ooze (28% vs 4%) and superficial infection (13.5% vs 2.2%). Managing the total hip arthroplasty patient with therapeutic anticoagulation is a balance between the risk of thromboembolic disease and bleeding related complications. Improved understanding of this risk will better allow the patient to make an informed decision regarding their elective arthroplasty surgery.

Welfare reform, surveillance and new paternalism

This paper discusses the situation of welfare claimants, often constructed as faulty citizens and flawed welfare subjects. Many are on the receiving end of complex, multi-layered forms of surveillance aimed at securing socially responsible and compliant behaviours. In Australia, as in other Western countries, neoliberal economic regimes with their harsh and often repressive treatment of welfare recipients operate in tandem with a burgeoning and costly arsenal of CCTV and other surveillance and governance assemblages. The Australian Government’s Centrelink BasicsCard is but one example of welfare surveillance, whereby a percentage of a welfare claimant’s allowances must be spent on ‘approved’ items. The BasicsCard which has perhaps slipped under the radar of public discussion and is expanding nationally, raises significant questions about whether it is possible to encourage people to take responsibility for themselves if they no longer have real control over the most important aspects of their lives. Resistance and critical feedback, particularly from Indigenous people, points to a loss of dignity around the imposition of income management, operational complexity and denial of individual agency in using the BasicsCard, alongside the contradiction of apparently becoming ‘self-reliant’ through being income managed by the welfare state. This paper highlights the lack of solid evidence for the implementation/imposition of the BasicsCard and points to the importance of developing critically based research to inform the enactment of evidence based policy, also acting as a touchstone for governmental accountability. In highlighting issues around the BasicsCard this paper makes a contribution to the largely under discussed area of income management and the growth of welfare surveillance in Australia.

Benefits of using modern cementing techniques in the acetabulum : the rim cutter

Purpose. To compare radiological records of 90 consecutive patients who underwent cemented total hip arthroplasty (THA) with or without use of the Rim Cutter to prepare the acetabulum. Methods. The acetabulum of 45 patients was prepared using the Rim Cutter, whereas the device was not used in the other 45 patients. Postoperative radiographs were evaluated using a digital templating system to measure (1) the positions of the operated hips with respect to the normal, contralateral hips (the centre of rotation of the socket, the height of the centre of rotation from the teardrop, and lateralisation of the centre of rotation from the teardrop) and (2) the uniformity and width of the cement mantle in the 3 DeLee Charnley acetabular zones, and the number of radiolucencies in these zones. Results. The study group showed improved radiological parameters and were closer to the anatomic centre of rotation both vertically (1.5 vs. 3.7 mm, p<0.001) and horizontally (1.8 vs. 4.4 mm, p<0.001) and had consistently thicker and more uniform cement mantles (p<0.001). There were 2 radiolucent lines in the control group but none in the study group. Conclusion. The Rim Cutter resulted in more accurate placement of the centre of rotation of a cemented prosthetic socket, and produced a thicker, more congruent cement mantle with fewer radiolucent lines.

A systematic review of psychological interventions for excessive alcohol consumption among people with psychotic disorders

Objective: Excessive alcohol consumption is common among people with psychotic disorders. While there is an extensive literature on the efficacy of psychological treatments for excessive drinking, few studies have examined interventions addressing this issue among people with psychotic disorders. Method: Systematic searches in PubMed and PsycINFO were conducted to identify randomized controlled trials comparing manual guided psychological interventions for excessive alcohol consumption among individuals with psychotic disorders. Of the 429 articles identified, 7 met inclusion criteria. Data were extracted from each study regarding study sample characteristics, design, results, clinical significance of alcohol consumption results, and methodological limitations. Results: Assessment interviews, brief motivational interventions and lengthier cognitive behavior therapy have been associated with reductions in alcohol consumption among people with psychosis. While brief interventions (i.e., 1-2 sessions) were generally as effective as longer duration psychological interventions (i.e., 10 session) for reducing alcohol consumption, longer interventions provided additional benefits for depression, functioning and other alcohol outcomes. Conclusion: Excessive alcohol consumption among people with psychotic disorders is responsive to psychological interventions. It is imperative that such approaches are integrated within standard care for people with psychosis.

Policy, citizenship and governance : the case of disability and employment policy in Australia

Current discussions regarding the relationship between welfare governance systems and employment promotion in disability policy appeal to a rejuvenated neo-liberal and paternalistic understanding of welfare governance. At the core of this rationality is the argument that people with disabilities not only have rights, but also duties, in relation to the State. In the Australia welfare system, policy tools are deployed to produce a form of self-discipline, whereby the State emphasises personal responsibility via assessment tools, ‘mutual obligation’ policy, and motivational strategies. Drawing on a two-year semi-longitudinal study with 80 people with a disability accessing welfare benefits, we examine how welfare governance subject recipients to strategies to produce productive citizens who are able to contribute to the national goal of maintaining competitiveness in the global economy. Participants’ interviews reveal the intended and unintended effects of this activation policy, including some acceptance of the logic of welfare-to-work and counter-hegemonic resistance to de-valued social identities.

Life cycle of the eel

Poem

Envoi

Poem

A comparison of safety climate and safety outcomes between construction and resource functions in a large case study organisation

The research described in this paper forms part of an in-depth investigation of safety culture in one of Australia’s largest construction companies. The research builds on a previous qualitative study with organisational safety leaders and further investigates how safety culture is perceived and experienced by organisational members, as well as how this relates to their safety behaviour and related outcomes at work. Participants were 2273 employees of the case study organisation, with 689 from the Construction function and 1584 from the Resources function. The results of several analyses revealed some interesting organisational variance on key measures. Specifically, the Construction function scored significantly higher on all key measures: safety climate, safety motivation, safety compliance, and safety participation. The results are discussed in terms of relevance in an applied research context.