Re-examining the evidence in radiation dermatitis management literature : an overview and a critical appraisal of systematic reviews

Purpose: To provide an overview and a critical appraisal of systematic reviews (SRs) of published interventions for the prevention/management of radiation dermatitis. Methods and Materials: We searched Medline, CINAHL, Embase, and the Cochrane Library. We also manually searched through individual reference lists of potentially eligible articles and a number of key journals in the topic area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using AMSTAR (the measurement tool for “assessment of multiple systematic reviews”). Results: Of 1837 potential titles, 6 SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/nonsteroidal topical agents, systemic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews might create biases to the overall results or recommendations for clinical practice. Conclusions: An up-to-date high-quality SR in the prevention/management of radiation dermatitis is needed to guide practice and direction for future research. We recommend that clinicians or guideline developers critically evaluate the information of SRs in their decision making.

Learning in and beyond small business advisory programmes

The purpose of this paper is to analyse how participants learn in small business advisory programmes and to explore the impact of these learning programmes on the development of reflective learning dispositions in participants. The research involves two case studies of small business advisory programmes in Queensland, a state of Australia. One involves training in the use of GPS/GIS technology amongst rural SMEs and the other seeks to develop improved management and operational capabilities in regional and metropolitan manufacturing SMEs. Face to face semi-structured interviews were conducted throughout rural, regional and metropolitan Queensland with participants, trainers and senior executives in the administering organisations that ran the programmes. Learning in these programmes occurs through a combination of interaction with others and the adoption of practice-based and learner-centred processes. The impact of the programmes on participants includes the development of reflective learning dispositions, improved confidence in learning and appreciation of the value of new knowledge to their business. The research suggests that small business training programmes have the potential to affect the development of critical reflective learning dispositions in participants which is of fundamental importance to the development of a learning or knowledge economy.

Outcomes following operative and non-operative management of humeral midshaft fractures: a prospective, observational cohort study of 47 patients

Background Although the non-operative management of closed humeral midshaft fractures has been advocated for years, the increasing popularity of operative intervention has left the optimal treatment choice unclear. Objective To compare the outcomes of operative and non-operative treatment of traumatic closed humeral midshaft fractures in adult patients. Methods A multicentre prospective comparative cohort study across 20 centres was conducted. Patients with AO type 12 A2, A3 and B2 fractures were treated with a functional brace or a retrograde-inserted unreamed humeral nail. Follow-up measurements were taken at 6, 12 and 52 weeks after the injury. The primary outcome was fracture healing after 1 year. Secondary outcomes included sub-items of the Constant score, general patient satisfaction, complications and cost-effectiveness parameters. Functions of the uninjured extremity were used as reference parameters. Intention-to-treat analysis was applied with the use of t-tests, Fisher’s exact tests, Mann–Whitney U-tests and adjusted analysis of variance (ANOVA). Results Forty-seven patients were included. The patient sample consisted of 23 women and 24 men, with a mean age of 52.7 years (range 17–86 years). Of the 47 cases, 14 were treated non-operatively and 33 operatively. The follow-up rate at 1 year was 81%. After 1 year, 11 fractures (100%) healed in the non-operative group and at least 24 fractures (≥89%) healed in the operative group [1 non-union patient (4%) and no data for 2 patients (7%)]. There were no significant differences in pain, range of motion (ROM) of the shoulder and elbow, and return to work after 6 weeks, 12 weeks and 1 year. Although operatively treated patients showed significantly greater shoulder abduction strength (p = 0.036), elbow flexion strength (p = 0.021), functional hand positioning (p = 0.008) and return to recreational activities (p = 0.043) after 6 weeks, no statistically significant differences existed in any outcome measure at the 1-year follow-up. Conclusions Our findings indicate that the non-operative management of humeral midshaft fractures can be expected to have similar functional outcomes and patient satisfaction at 1 year, despite an early benefit to operative treatment. If no radiological evidence of fracture healing exists in non-operatively treated patients during early follow-up, a switch to surgical treatment results in good functional outcomes and patient satisfaction. Keywords: Humeral shaft fracture, Non-operative treatment, Functional brace, Operative treatment, Unreamed humeral nail (UHN), Prospective, Cohort study

Automated support for versioning compliance checking between workflow management and product lifecycle management (in Chinese)

With the development of enterprise informatisation, Product Lifecycle Management (PLM) systems have been widely deployed and applied in enterprises. This paper analyzes the requirement that conducting version operations on business objects as specified in process models should be compliant with the versioning policies imposed by product lifecycles. This leads to the introduction of the concept of versioning compliance, and the approach of compliance checking that we proposed in our earlier work, which comprises both syntactical compatibility and behavioural compatibility checking. The paper then focuses on the tool implementation for providing automated support to the versioning compliance checking. An empirical evaluation of the tool was also performed with industrial partners using the well-known questionnaire-based method. The evaluation and feedback from practitioners further evidence the practical significance of this research question in the PLM field and demonstrate that the proposed solution with its automated tool support possesses a high application potential.

Four obstacles facing the management accounting professionals as they seek to step up as global leaders

No matter how aspirational they are, management accountants face a series of roadblocks in the course of building careers in organisations. Experts reveal the four key obstacles that need to be addressed in the course of becoming global leaders.

Operational semantics of aspects in business process management

Aspect orientation is an important approach to address complexity of cross-cutting concerns in Information Systems. This approach encapsulates these concerns separately and compose them to the main module when needed. Although there a different works which shows how this separation should be performed in process models, the composition of them is an open area. In this paper, we demonstrate the semantics of a service which enables this composition. The result can also be used as a blueprint to implement the service to support aspect orientation in Business Process Management area.

Dynamic weaving of aspects for business process management systems

Reducing complexity in Information Systems is a main concern in both research and industry. One strategy for reducing complexity is separation of concerns. This strategy advocates separating various concerns, like security and privacy, from the main concern. It results in less complex, easily maintainable, and more reusable Information Systems. Separation of concerns is addressed through the Aspect Oriented paradigm. This paradigm has been well researched and implemented in programming, where languages such as AspectJ have been developed. However, the rsearch on aspect orientation for Business Process Management is still at its beginning. While some efforts have been made proposing Aspect Oriented Business Process Modelling, it has not yet been investigated how to enact such process models in a Workflow Management System. In this paper, we define a set of requirements that specifies the execution of aspect oriented business process models. We create a Coloured Petri Net specification for the semantics of so-called Aspect Service that fulfils these requirements. Such a service extends the capability of a Workflow Management System with support for execution of aspect oriented business process models. The design specification of the Aspect Service is also inspected through state space analysis.