Continuity of care and general wellbeing of patients with comorbidities requiring joint replacement

Aim. The aim of this paper is to examine the continuity of care and general wellbeing of patients with comorbidities undergoing elective total hip or knee joint replacement.
Background. Advances in medical science and improved lifestyles have reduced mortality rates in most Western countries. As a result, there is an ageing population with a concomitant growth in the number of people who are living with multiple chronic illnesses, commonly referred to as comorbidities. These patients often require acute care services, creating a blend of acute and chronic illness needs. For example, joint replacement surgery is frequently performed to improve impaired mobility associated with osteoarthritis.
Method. A purposive sample of twenty participants with multiple comorbidities who required joint replacement surgery was recruited to obtain survey, interview and medical record audit data. Data were collected during 2004 and 2005.
Findings. Comorbidity care was poorly co-ordinated prior to having surgery, during the acute care stay and following surgery and primarily entailed prescribed medicines. The main focus in acute care was patient throughput following joint replacement surgery according to a prescribed clinical pathway. General wellbeing was less than optimal: participants reported pain, fatigue, insomnia and alterations in urinary elimination as the chief sources of discomfort during the course of the study.
Conclusion. Continuity of care of comorbidities was lacking. Comorbidities affected patient general wellbeing and delayed recovery from surgery. Acute care, clinical pathways and the specialisation of medicine and nursing subordinated the general problem of patients with comorbidities. Systems designed to integrate and co-ordinate chronic illness care had limited application in the acute care setting. A multidisciplinary, holistic approach is required. Recommendations for further research conclude this paper.

Understanding the factors contributing to inter-partner trust in joint ventures

Forming an international joint venture (IJV) with a local (Chinese) partner is one of the popular ways available for an overseas investor to enter into small and medium business sectors in China. A joint venture is commonly viewed as a cooperative, rather than a competitive, business relationship between two or more partners. Interpartner trust is widely acknowledged as a key prerequisite for genuine cooperation between joint venture partners. Although the importance of trust in the context of joint ventures is well recognized, the question of how interpartner trust is formed has received only scant attention in academic as well as professional literatures. Drawing from diverse academic literature bearing on the formation of trust between partner firms, this paper explores the factors that may contribute to inter-partner trust in the context of joint ventures. The primary argument in this paper is that trust between IJV partners is determined by observable and objective social, economic and structural factors. In other words, it is argued that interpartner trust is rational and it does not require a 'leap of faith'.

OzBot TM - Haptic augmentation of a teleoperated robotic platform for search and rescue operations

A continued increase in computing power, sensor capability, software functionality, immersive interfaces and hardware modularity has given robot designers seemingly endless potential in the area of mobile robotics.  While some mobile robotic system designers are focusing on expensive, full-featured platforms, developers are realising the advantages of emerging technology in providing small, low-cost mobile reconnaissance vehicles as expendable teleoperated robotic systems.  The OzBot^TM mobile reconnaissance platform presents one such system.  The design objectives of the OzBot^TM platform focus on the development of inexpensive, lightweight carry-case sized robots for search and rescue operations, law enforcement scenarios and hazardous environment inspection.  The incorporation of Haptic augmentation provides the teleoperator with improved task immersion for an outdoor search and rescue scenario.  Achieved in cooperation with law enforcement agencies within Australia, this paper discusses the performance of the first four revisions of the OzBot^TM platform.

Technical and scale efficiency of Islamic banking operations in Malaysia: an empirical investigation with a longitudinal perspective

Against the background of increasing competition from globalization and the trend towards consolidation, diversification and rationalization, the study of efficiency is most relevant in the Malaysian Islamic banking context, where all domestic commercial banks operate Islamic banking schemes. Using the non-parametric method of Data Envelopment Analysis (DEA), this study investigates the recent efficiency of the Malaysian Islamic Banking system. The attributions of technical efficiency (utilization of capacity) and scale efficiency (optimality of scale achieved) are identified. Further, Islamic Banking Schemes operating under the dual banking system of foreign and domestic commercial banks were benchmarked to the country's two full-fledged Islamic banks to provide insight of the relative efficiencies. Amidst an overall improvement in TE and SE, it was noted that foreign banks (FB) increased efficiency levels to achieve full efficiency over the six-year period, and domestic banks (DB) followed by smaller improvement while the fully-fledged Islamic banks (FFIE) experienced a general decline in efficiency which was solely attributed to scale inefficiency. The findings provide useful guidelines for policy implications and may also assist banks concerned with their strategic planning with regard to the future of Islamic banking.