Wound problems following hip arthroplasty before and after the introduction of a direct thrombin inhibitor for thromboprophylaxis

NICE guidelines have stated that patients undergoing elective hip surgery are at increased risk for venous thromboembolic events (VTE) following surgery and have recommended thromboprophylaxis for 28-35 days1, 2. However the studies looking at the new direct thrombin inhibitors have only looked at major bleeding. We prospectively looked at wound discharge in patients who underwent hip arthroplasty and were given dabigatran postoperatively between March 2010 and April 2010 (n=56). We retrospectively compared these results to a matched group of patients who underwent similar operations six months earlier when all patients were given dalteparin routinely postoperatively until discharge, and discharged home on 150mg aspirin daily for 6 weeks (n=67). Wound discharge after 5 days was significantly higher in the patients taking dabigatran (32% dabigatran n=18, 10% dalteparin n=17, p=0.003) and our rate of delayed discharges due to wound discharge significantly increased from 7% in the dalteparin group (n=5) to 27% for dabigatran (n=15, p=0.004). Patients who received dabigatran were more than five times as likely to return to theatre with a wound complication as those who received dalteparin (7% dabigatran n=4, vs. 1% dalteparin n=1), however, this was not statistically significant (p=0.18). The significantly higher wound discharge and return to theatre rates demonstrated in this study have meant that we have changed our practice to administering dalteparin until the wound is dry and then starting dabigatran. Our study demonstrates the need for further clinical studies regarding wound discharge and dabigatran.

The conceptual and operational compatibility of data breach notification and information privacy laws

Mandatory data breach notification laws are a novel and potentially important legal instrument regarding organisational protection of personal information. These laws require organisations that have suffered a data breach involving personal information to notify those persons that may be affected, and potentially government authorities, about the breach. The Australian Law Reform Commission (ALRC) has proposed the creation of a mandatory data breach notification scheme, implemented via amendments to the Privacy Act 1988 (Cth). However, the conceptual differences between data breach notification law and information privacy law are such that it is questionable whether a data breach notification scheme can be solely implemented via an information privacy law. Accordingly, this thesis by publications investigated, through six journal articles, the extent to which data breach notification law was conceptually and operationally compatible with information privacy law. The assessment of compatibility began with the identification of key issues related to data breach notification law. The first article, Stakeholder Perspectives Regarding the Mandatory Notification of Australian Data Breaches started this stage of the research which concluded in the second article, The Mandatory Notification of Data Breaches: Issues Arising for Australian and EU Legal Developments (‘Mandatory Notification‘). A key issue that emerged was whether data breach notification was itself an information privacy issue. This notion guided the remaining research and focused attention towards the next stage of research, an examination of the conceptual and operational foundations of both laws. The second article, Mandatory Notification and the third article, Encryption Safe Harbours and Data Breach Notification Laws did so from the perspective of data breach notification law. The fourth article, The Conceptual Basis of Personal Information in Australian Privacy Law and the fifth article, Privacy Invasive Geo-Mashups: Privacy 2.0 and the Limits of First Generation Information Privacy Laws did so for information privacy law. The final article, Contextualizing the Tensions and Weaknesses of Information Privacy and Data Breach Notification Laws synthesised previous research findings within the framework of contextualisation, principally developed by Nissenbaum. The examination of conceptual and operational foundations revealed tensions between both laws and shared weaknesses within both laws. First, the distinction between sectoral and comprehensive information privacy legal regimes was important as it shaped the development of US data breach notification laws and their subsequent implementable scope in other jurisdictions. Second, the sectoral versus comprehensive distinction produced different emphases in relation to data breach notification thus leading to different forms of remedy. The prime example is the distinction between market-based initiatives found in US data breach notification laws compared to rights-based protections found in the EU and Australia. Third, both laws are predicated on the regulation of personal information exchange processes even though both laws regulate this process from different perspectives, namely, a context independent or context dependent approach. Fourth, both laws have limited notions of harm that is further constrained by restrictive accountability frameworks. The findings of the research suggest that data breach notification is more compatible with information privacy law in some respects than others. Apparent compatibilities clearly exist as both laws have an interest in the protection of personal information. However, this thesis revealed that ostensible similarities are founded on some significant differences. Data breach notification law is either a comprehensive facet to a sectoral approach or a sectoral adjunct to a comprehensive regime. However, whilst there are fundamental differences between both laws they are not so great to make them incompatible with each other. The similarities between both laws are sufficient to forge compatibilities but it is likely that the distinctions between them will produce anomalies particularly if both laws are applied from a perspective that negates contextualisation.

The impact of knowledge integration on enterprise system success

Despite promising benefits and advantages, there are reports of failures and low realisation of benefits in Enterprise System (ES) initiatives. Among the research on the factors that influence ES success, there is a dearth of studies on the knowledge implications of multiple end-user groups using the same ES application. An ES facilitates the work of several user groups, ranging from strategic management, management, to operational staff, all using the same system for multiple objectives. Given the fundamental characteristics of ES – integration of modules, business process views, and aspects of information transparency – it is necessary that all frequent end-users share a reasonable amount of common knowledge and integrate their knowledge to yield new knowledge. Recent literature on ES implementation highlights the importance of Knowledge Integration (KI) for implementation success. Unfortunately, the importance of KI is often overlooked and little about the role of KI in ES success is known. Many organisations do not achieve the potential benefits from their ES investment because they do not consider the need or their ability to integrate their employees’ knowledge. This study is designed to improve our understanding of the influence of KI among ES end-users on operational ES success. The three objectives of the study are: (I) to identify and validate the antecedents of KI effectiveness, (II) to investigate the impact of KI effectiveness on the goodness of individuals’ ES-knowledge base, and (III) to examine the impact of the goodness of individuals’ ES-knowledge base on the operational ES success. For this purpose, we employ the KI factors identified by Grant (1996) and an IS-impact measurement model from the work of Gable et al. (2008) to examine ES success. The study derives its findings from data gathered from six Malaysian companies in order to obtain the three-fold goal of this thesis as outlined above. The relationships between the antecedents of KI effectiveness and its consequences are tested using 188 responses to a survey representing the views of management and operational employment cohorts. Using statistical methods, we confirm three antecedents of KI effectiveness and the consequences of the antecedents on ES success are validated. The findings demonstrate a statistically positive impact of KI effectiveness of ES success, with KI effectiveness contributing to almost one-third of ES success. This research makes a number of contributions to the understanding of the influence of KI on ES success. First, based on the empirical work using a complete nomological net model, the role of KI effectiveness on ES success is evidenced. Second, the model provides a theoretical lens for a more comprehensive understanding of the impact of KI on the level of ES success. Third, restructuring the dimensions of the knowledge-based theory to fit the context of ES extends its applicability and generalisability to contemporary Information Systems. Fourth, the study develops and validates measures for the antecedents of KI effectiveness. Fifth, the study demonstrates the statistically significant positive influence of the goodness of KI on ES success. From a practical viewpoint, this study emphasises the importance of KI effectiveness as a direct antecedent of ES success. Practical lessons can be drawn from the work done in this study to empirically identify the critical factors among the antecedents of KI effectiveness that should be given attention.

A deductive system for proving workflow models from operational procedures

Many modern business environments employ software to automate the delivery of workflows; whereas, workflow design and generation remains a laborious technical task for domain specialists. Several differ- ent approaches have been proposed for deriving workflow models. Some approaches rely on process data mining approaches, whereas others have proposed derivations of workflow models from operational struc- tures, domain specific knowledge or workflow model compositions from knowledge-bases. Many approaches draw on principles from automatic planning, but conceptual in context and lack mathematical justification. In this paper we present a mathematical framework for deducing tasks in workflow models from plans in mechanistic or strongly controlled work environments, with a focus around automatic plan generations. In addition, we prove an associative composition operator that permits crisp hierarchical task compositions for workflow models through a set of mathematical deduction rules. The result is a logical framework that can be used to prove tasks in workflow hierarchies from operational information about work processes and machine configurations in controlled or mechanistic work environments.

Points of convergence and divergence : normative, institutional and operational relationships between R2P and POC

As an international norm, the Responsibility to Protect (R2P) has gained substantial influence and institutional presence—and created no small controversy—in the ten years since its first conceptualisation. Conversely, the Protection of Civilians in Armed Conflict (PoC) has a longer pedigree and enjoys a less contested reputation. Yet UN Security Council action in Libya in 2011 has thrown into sharp relief the relationship between the two. UN Security Council Resolutions 1970 and 1973 follow exactly the process envisaged by R2P in response to imminent atrocity crimes, yet the operative paragraphs of the resolutions themselves invoke only PoC. This article argues that, while the agendas of PoC and R2P converge with respect to Security Council action in cases like Libya, outside this narrow context it is important to keep the two norms distinct. Peacekeepers, humanitarian actors, international lawyers, individual states and regional organisations are required to act differently with respect to the separate agendas and contexts covered by R2P and PoC. While overlap between the two does occur in highly visible cases like Libya, neither R2P nor PoC collapses normatively, institutionally or operationally into the other.

Identification of selection criteria for operational variations of the design-build system : a delphi study in China

The design-build (DB) system has been demonstrated as an effective delivery method and has gained popularity worldwide. However it is observed that a number of operational variations of DB system have emerged since the last decade to cater for different client’s requirements. After the client decides to procure his project through the DB system, he still has to choose an appropriate configuration to deliver their projects optimally. However, there is little research on the selection of DB operational variations. One of the main reasons for this is the lack of evaluation criteria for determining the appropriateness of each operational variation. To obtain such criteria, a three-round Delphi survey has been conducted with 20 construction experts in the People’s Republic of China (PRC). Seven top selection criteria were identified. These are: (1) availability of competent design-builders; (2) client’s capabilities; (3) project complexity; (4) client’s control of project; (5) early commencement & short duration; (6) reduced responsibility or involvement; and (7) clearly defined end user’s requirements. These selection criteria were found to have a statistically significant agreement. These findings may furnish various stakeholders, DB clients in particular, with better insight to understand and compare the different operational variations of the DB system.

Developing a fuzzy multi-criteria decision-making model for selecting design-build operational variations

Many academic researchers have conducted studies on the selection of design-build (DB) delivery method; however, there are few studies on the selection of DB operational variations, which poses challenges to many clients. The selection of DB operational variation is a multi-criteria decision making process that requires clients to objectively evaluate the performance of each DB operational variation with reference to the selection criteria. This evaluation process is often characterized by subjectivity and uncertainty. In order to resolve this deficiency, the current investigation aimed to establish a fuzzy multicriteria decision-making (FMCDM) model for selecting the most suitable DB operational variation. A three-round Delphi questionnaire survey was conducted to identify the selection criteria and their relative importance. A fuzzy set theory approach, namely the modified horizontal approach with the bisector error method, was applied to establish the fuzzy membership functions, which enables clients to perform quantitative calculations on the performance of each DB operational variation. The FMCDM was developed using the weighted mean method to aggregate the overall performance of DB operational variations with regard to the selection criteria. The proposed FMCDM model enables clients to perform quantitative calculations in a fuzzy decision-making environment and provides a useful tool to cope with different project attributes.

An analysis of tax expenditure versus direct expenditure

Each financial year concessions, benefits and incentives are delivered to taxpayers via the tax system. These concessions, benefits and incentives, referred to as tax expenditure, differ from direct expenditure because of the recurring fiscal impact without regular scrutiny through the federal budget process. There are approximately 270 different tax expenditures existing within the current tax regime with total measured tax expenditures in the 2005-06 financial year estimated to be around $42.1 billion, increasing to $52.7 billion by 2009-10. Each year, new tax expenditures are introduced, while existing tax expenditures are modified and deleted. In recognition of some of the problems associated with tax expenditure, a Tax Expenditure Statement, as required by the Charter of Budget Honesty Act 1988, is produced annually by the Australian Federal Treasury. The Statement details the various expenditures and measures in the form of concessions, benefits and incentives provided to taxpayers by the Australian Government and calculates the tax expenditure in terms of revenue forgone. A similar approach to reporting tax expenditure, with such a report being a legal requirement, is followed by most OECD countries. The current Tax Expenditure Statement lists 270 tax expenditures and where it is able to, reports on the estimated pecuniary value of those expenditures. Apart from the annual Tax Expenditure Statement, there is very little other scrutiny of Australia’s Federal tax expenditure program. While there has been various academic analysis of tax expenditure in Australia, when compared to the North American literature, it is suggested that the Australian literature is still in its infancy. In fact, one academic author who has contributed to tax expenditure analysis recently noted that there is ‘remarkably little secondary literature which deals at any length with tax expenditures in the Australian context.’ Given this perceived gap in the secondary literature, this paper examines fundamental concept of tax expenditure and considers the role it plays in to the current tax regime as a whole, along with the effects of the introduction of new tax expenditures. In doing so, tax expenditure is contrasted with direct expenditure. An analysis of tax expenditure versus direct expenditure is already a sophisticated and comprehensive body of work stemming from the US over the last three decades. As such, the title of this paper is rather misleading. However, given the lack of analysis in Australia, it is appropriate that this paper undertakes a consideration of tax expenditure versus direct expenditure in an Australian context. Given this proposition, rather than purport to undertake a comprehensive analysis of tax expenditure which has already been done, this paper discusses the substantive considerations of any such analysis to enable further investigation into the tax expenditure regime both as a whole and into individual tax expenditure initiatives. While none of the propositions in this paper are new in a ‘tax expenditure analysis’ sense, this debate is a relatively new contribution to the Australian literature on the tax policy. Before the issues relating to tax expenditure can be determined, it is necessary to consider what is meant by ‘tax expenditure’. As such, part two if this paper defines ‘tax expenditure’. Part three determines the framework in which tax expenditure can be analysed. It is suggested that an analysis of tax expenditure must be evaluated within the framework of the design criteria of an income tax system with the key features of equity, efficiency, and simplicity. Tax expenditure analysis can then be applied to deviations from the ideal tax base. Once it is established what is meant by tax expenditure and the framework for evaluation is determined, it is possible to establish the substantive issues to be evaluated. This paper suggests that there are four broad areas worthy of investigation; economic efficiency, administrative efficiency, whether tax expenditure initiatives achieve their policy intent, and the impact on stakeholders. Given these areas of investigation, part four of this paper considers the issues relating to the economic efficiency of the tax expenditure regime, in particular, the effect on resource allocation, incentives for taxpayer behaviour and distortions created by tax expenditures. Part five examines the notion of administrative efficiency in light of the fact that most tax expenditures could simply be delivered as direct expenditures. Part six explores the notion of policy intent and considers the two questions that need to be asked; whether any tax expenditure initiative reaches its target group and whether the financial incentives are appropriate. Part seven examines the impact on stakeholders. Finally, part eight considers the future of tax expenditure analysis in Australia.

A classification framework for design-build variants from an operational perspective

Design-build (DB) is a generic form of construction procurement, and, rather than simply representing a single system, it has evolved in practice into a variety of forms, each of which is similar to, and yet different from each other. Although the importance of selecting an appropriate DB variant has been widely accepted, difficulties occur in practice due to the multiplicity of terms and concepts used. What is needed is some kind of taxonomy or framework within which the individual variants can be placed and their relative attributes identified and understood. Through a comprehensive literature review and content analysis, this paper establishes a systematic classification framework for DB variants based on their operational attributes. In addition to providing much needed support for decision-making, this classification framework provides client/owners with perspectives to understand and examine different categories of DB variants from an operational perspective.

Direct evaluation of IEC 61850-9-2 process bus network performance

This letter presents a technique to assess the overall network performance of sampled value process buses based on IEC 61850-9-2 using measurements from a single location in the network. The method is based upon the use of Ethernet cards with externally synchronized time stamping, and characteristics of the process bus protocol. The application and utility of the method is demonstrated by measuring latency introduced by Ethernet switches. Network latency can be measured from a single set of captures, rather than comparing source and destination captures. Absolute latency measures will greatly assist the design testing, commissioning and maintenance of these critical data networks.

Non-destructive evaluation of articular cartilage defects using near-infrared (NIR) spectroscopy in osteoarthritic rat models and its direct relation to Mankin Score

Objective The aim of this study was to demonstrate the potential of near-infrared (NIR) spectroscopy for categorizing cartilage degeneration induced in animal models. Method Three models of osteoarthritic degeneration were induced in laboratory rats via one of the following methods: (i) menisectomy (MSX); (ii) anterior cruciate ligament transaction (ACLT); and (iii) intra-articular injection of mono-ido-acetete (1 mg) (MIA), in the right knee joint, with 12 rats per model group. After 8 weeks, the animals were sacrificed and tibial knee joints were collected. A custom-made nearinfrared (NIR) probe of diameter 5 mm was placed on the cartilage surface and spectral data were acquired from each specimen in the wavenumber range 4 000 – 12 500 cm−1. Following spectral data acquisition, the specimens were fixed and Safranin–O staining was performed to assess disease severity based on the Mankin scoring system. Using multivariate statistical analysis based on principal component analysis and partial least squares regression, the spectral data were then related to the Mankinscores of the samples tested. Results Mild to severe degenerative cartilage changes were observed in the subject animals. The ACLT models showed mild cartilage degeneration, MSX models moderate, and MIA severe cartilage degenerative changes both morphologically and histologically. Our result demonstrate that NIR spectroscopic information is capable of separating the cartilage samples into different groups relative to the severity of degeneration, with NIR correlating significantly with their Mankinscore (R2 = 88.85%). Conclusion We conclude that NIR is a viable tool for evaluating articularcartilage health and physical properties such as change in thickness with degeneration.

The Operational Policing of Domestic Violence in Singapore: An Exploratory Study

This article examines the formal processing of domestic violence as accomplished by institutionalized policing in Singapore. The description of the process through which domestic calls for assistance were shaped and translated into relevant categories for appropriating a particular police response was facilitated through the use of the participant observation method. The ethnographic fieldwork reported here, including observations of call screening in action, is an attempt to explicate the phenomenological grounds employed by organizational members to constitute calls as instances of categories for practical policing purposes. Theoretically, the data point to the need for a reconceptualization of the problem of policing domestic violence by emphasizing the point that the eventual institutional response be understood as a product of the relationship that exists between police subculture and structural conditions of policing unique to contemporary Singapore society.

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.

Design and fabrication of tubular scaffolds via direct writing in a melt electrospinning mode

Flexible tubular structures fabricated from solution electrospun fibers are finding increasing use in tissue engineering applications. However it is difficult to control the deposition of fibers due to the chaotic nature of the solution electrospinning jet. By using non-conductive polymer melts instead of polymer solutions the path and collection of the fiber becomes predictable. In this work we demonstrate the melt electrospinning of polycaprolactone in a direct writing mode onto a rotating cylinder. This allows the design and fabrication of tubes using 20 μm diameter fibers with controllable micropatterns and mechanical properties. A key design parameter is the fiber winding angle, where it allows control over scaffold pore morphology (e.g. size, shape, number and porosity). Furthermore, the establishment of a finite element model as a predictive design tool is validated against mechanical testing results of melt electrospun tubes to show that a lesser winding angle provides improved mechanical response to uniaxial tension and compression. In addition, we show that melt electrospun tubes support the growth of three different cell types in vitro and are therefore promising scaffolds for tissue engineering applications.