The anatomical and biomechanical consequences of anterior vertebral stapling for the fusionless correction of scoliosis

Fusionless scoliosis surgery is an emerging treatment for idiopathic scoliosis as it offers theoretical advantages over current forms of treatment. Anterior vertebral stapling using a nitinol staple is one such treatment. Despite increasing interest in this technique, little is known about the effects on the spine following insertion, or the mechanism of action of the staple. The aims of this study were threefold; (1) to measure changes in the bending stiffness of a single motion segment following staple insertion, (2) to describe the forces that occur within the staple during spinal movement, and (3) to describe the anatomical changes that occur following staple insertion. Results suggest that staple insertion consistently decreased stiffness in all directions of motion. An explanation for the finding may be found in the outcomes of the strain gauge testing and micro-CT scan. The strain gauge testing showed that once inserted, the staple tips applied a baseline compressive force to the surrounding trabecular bone and vertebral end-plate. This finding would be consistent with the current belief that the clinical effect of the staples is via unilateral compression of the physis. Interestingly however, as each specimen progressed through the five cycles of each test, the baseline load on the staple tips gradually decreased, implying that the force at the staple tip-bone interface was decreasing. We believe that this was likely occurring as a result of structural damage to the trabecular bone and vertebral end-plate by the staple effectively causing ‘loosening’ of the staple. This hypothesis is further supported by the findings of the micro-CT scan. The pictures depict significant trabecular bone and physeal injury around the staple blades. These results suggest that the current hypothesis that stapling modulates growth through physeal compression may be incorrect, but rather the effect occurs through mechanical disruption of the vertebral growth plate.

Hypercapitalism: language, new media and social perceptions of value

Using examples from contemporary policy and business discourses, and exemplary historical texts dealing with the notion of value, I put forward an argument as to why a critical scholarship that draws on media history, language analysis, philosophy and political economy is necessary to understand the dynamics of what is being called 'the global knowledge economy'. I argue that the social changes associated with new modes of value determination are closely associated with new media forms.

Experiential knowledge representation and the design of product usability

The topic of designers’ knowledge and how they conduct design process has been widely investigated in design research. Understanding theoretical and experiential knowledge in design has involved recognition of the importance of designers’ experience of experiencing, seeing, and absorbing ideas from the world as points of reference (or precedents) that are consulted whenever a design problem arises (Lawson, 2004). Hence, various types of design knowledge have been categorized (Lawson, 2004), and the nature of design knowledge continues to be studied (Cross, 2006); nevertheless, the study of the experiential aspects embedded in design knowledge is a topic not fully addressed. In particular there has been little emphasis on the investigation of the ways in which designers’ individual experience influences different types of design tasks. This research focuses on the investigation of the ways in which designers inform a usability design process. It aims to understand how designers design product usability, what informs their process, and the role their individual experience (and episodic knowledge) plays within the design process. This paper introduces initial outcomes from an empirical study involving observation of a design task that emphasized usability issues. It discusses the experiential knowledge observed in the visual representations (sketches) produced by designers as part of the design tasks. Through the use of visuals as means to represent experiential knowledge, this paper presents initial research outcomes to demonstrate how designers’ individual experience is integrated into design tasks and communicated within the design process. Initial outcomes demonstrate the influence of designers’ experience in the design of product usability. It is expected that outcomes will help identify the causal relationships between experience, context of use, and product usability, which will contribute to enhance our understanding about the design of user-product interactions.

Safety culture research, lead indicators, and the development of safety effectiveness indicators in the construction sector

Construction sector application of Lead Indicators generally and Positive Performance Indicators (PPIs) particularly, are largely seen by the sector as not providing generalizable indicators of safety effectiveness. Similarly, safety culture is often cited as an essential factor in improving safety performance, yet there is no known reliable way of measuring safety culture. This paper proposes that the accurate measurement of safety effectiveness and safety culture is a requirement for assessing safe behaviours, safety knowledge, effective communication and safety performance. Currently there are no standard national or international safety effectiveness indicators (SEIs) that are accepted by the construction industry. The challenge is that quantitative survey instruments developed for measuring safety culture and/ or safety climate are inherently flawed methodologically and do not produce reliable and representative data concerning attitudes to safety. Measures that combine quantitative and qualitative components are needed to provide a clear utility for safety effectiveness indicators.

An institutional understanding of triple bottom line evaluations and the use of social and environmental metrics

Measuring social and environmental metrics of property is necessary for meaningful triple bottom line (TBL) assessments. This paper demonstrates how relevant indicators derived from environmental rating systems provide for reasonably straightforward collations of performance scores that support adjustments based on a sliding scale. It also highlights the absence of a corresponding consensus of important social metrics representing the third leg of the TBL tripod. Assessing TBL may be unavoidably imprecise, but if valuers and managers continue to ignore TBL concerns, their assessments may soon be less relevant given the emerging institutional milieu informing and reflecting business practices and society expectations.