Prevention of surgical site infection in total joint arthroplasty : an international tertiary care center survery

Background Prevention strategies are critical to reduce infection rates in total joint arthroplasty (TJA), but evidence-based consensus guidelines on prevention of surgical site infection (SSI) remain heterogeneous and do not necessarily represent this particular patient population. Questions/Purposes What infection prevention measures are recommended by consensus evidence-based guidelines for prevention of periprosthetic joint infection? How do these recommendations compare to expert consensus on infection prevention strategies from orthopedic surgeons from the largest international tertiary referral centers for TJA? Patients and Methods A review of consensus guidelines was undertaken as described by Merollini et al. Four clinical guidelines met inclusion criteria: Centers for Disease Control and Prevention's, British Orthopedic Association, National Institute of Clinical Excellence's, and National Health and Medical Research Council's (NHMRC). Twenty-eight recommendations from these guidelines were used to create an evidence-based survey of infection prevention strategies that was administered to 28 orthopedic surgeons from members of the International Society of Orthopedic Centers. The results between existing consensus guidelines and expert opinion were then compared. Results Recommended strategies in the guidelines such as prophylactic antibiotics, preoperative skin preparation of patients and staff, and sterile surgical attire were considered critically or significantly important by the surveyed surgeons. Additional strategies such as ultraclean air/laminar flow, antibiotic cement, wound irrigation, and preoperative blood glucose control were also considered highly important by surveyed surgeons, but were not recommended or not uniformly addressed in existing guidelines on SSI prevention. Conclusion Current evidence-based guidelines are incomplete and evidence should be updated specifically to address patient needs undergoing TJA.

Towards an international approach for geography education

"Geography education is indispensable to the development of responsible and active citizens in the present and future world" is one of the main statements in the International Charter on Geographical Education. This charter was edited in 1992 by Haubrich, chair of the Commission on Geographical Education of the International Geographical Union (IGU). Twenty years later this statement is still true. Geography educators all over the world are looking for ways to talk with young people about their image of their world and to help them to develop their knowledge, skills and ideas about the complex world we live in. However, different ideas exist about what geography we should learn and teach and how. The Commission on Geographical Education of the International Geographical Union tries to help to improve the quality and position of geography education worldwide promoting the dissemination of good practices and research results in the field of geography education.

Considering a whole-of-community approach to integrating nature in cities, an international case study of Vauban, Germany

Globally, cities face a convergence of complex and rapidly evolving challenges, including climate change, resource shortages, population growth and urbanization, and financial pressures. Biophilic urbanism is an emerging design principle capable of considering the multidimensional and interdependent complexities of urban systems and infrastructure, which through the use of natural design features, can meet society’s inherent need for contact with nature, and assist efforts to respond to these growing challenges. Considering the imperative for addressing these challenges, this paper proposes that significant lessons can be learned from existing examples of biophilic urbanism, avoiding ‘re-invention of the wheel’ and facilitating accelerated innovation in other areas. Vauban is a 38-hectare brownfield development located 3 kilometers from the centre of Germany’s ‘ecological capital’ of Freiburg city. It was developed using an innovative process with strong community participation and reinterpreted developer roles to produce an example of integrated sustainability. Innovation in transport, energy, housing, development and water treatment has enabled a relatively high-density, mixed-use development that integrates a considerable amount of nature. This paper discusses Vauban in light of research undertaken over the last two years through the Sustainable Built Environment National Research Centre in Australia, to investigate emerging elements of ‘biophilic urbanism’ (nature-loving cities), and their potential to be mainstreamed within urban environments. The paper considers the interplay between the policies, community dynamics and innovations in Vauban, within the context of the culture, history and practice of sustainability in Germany, and how these have enabled nature to be integrated into the urban environment of Vauban while achieving other desirable goals for urban areas. It highlights potential applications from Vauban for Australian cities.

Understanding the information literacy experiences of EFL (English as a Foreign Language) students

This thesis investigated the information literacy experiences of EFL (English as a Foreign Language) students in a higher education institution in the United Arab Emirates (UAE). Phenomenography was used to investigate how EFL students' 'used information to learn' (ie. information literacy). The study revealed that EFL students' experienced information literacy across four categories and had varying experiences of information and learning. The research also showed that EFL students' faced a number of challenges and barriers due to language that impacted on their experiences of reading, understanding, accessing and translating information.

Is there an international duty to protect persons in the event of an epidemic?

In 2006, the International Law Commission began a study into the role of states and international organizations in protecting persons in the event of a disaster. Special Rapporteur Mr. Eduardo Valencia-Ospina was appointed to head the study, and in 2011 the findings of the study will be presented to the United Nations General Assembly. Of interest to this paper has been the inclusion of “epidemics” under the natural disaster category in all of the reports detailing the Commission’s program of work on the protection of persons. This paper seeks to examine the legal and political ramifications involved in including “epidemic” into the concept of protection by exploring where sovereign responsibility for epidemic control begins and ends, particularly in light of the revisions to the International Health Regulations by the World Health Assembly in 2005. The paper will first analyze the findings already presented by the Special Rapporteur, examining the existing “responsibilities” of both states and international organizations. Then, the paper will consider to what extent the concept of protection entails the duty to assist individuals when an affected state proves unwilling or unable to assist their own population in the event of a disease outbreak. In an attempt to answer this question, the third part of the paper will examine the recent cholera outbreak in Zimbabwe.

Indigenous epistemology : creating an international Indigenous higher education space in the wake of the western “university of excellence”

Interest in the participation of Indigenous peoples in higher education has, in recent times, gained momentum with an increasing number of advocates challenging the global history of culturally inept policies and practices imposed within the western higher education system. To address the challenges being presented by Indigenous communities and other groups (often relegated under the banner of disadvantaged or equity) Western Universities are promoting a shift toward inclusive policies and practices. Frustrated with the offerings of the Western Higher Education system, a global movement of Indigenous academics, Elders and knowledge holders are developing strategies to meet the educational needs of their own communities, in order to find a way forward. The mobilization of Elders and Indigenous academics has resulted in the development of a global higher education network which is proving to be a significant force in changing the position of Indigenous participation in higher education. The World Indigenous Network Higher Education Consortium (WINHEC) has presented a significant challenge to those barriers within the western higher education system that has historically demonstrated an inability to develop culturally inclusive practices within their institutions. This paper examines the development of a world Indigenous higher education movement and its contribution to the history of the “university” within the context of western higher education institutions. Outlined in this examination will be a synopsis of the development of the “University of Excellence” and the creation of an international Indigenous space within higher education.

Graduated driver licensing : an international review

Graduated driver licensing (GDL) aims to gradually increase the exposure of new drivers to more complex driving situations and typically consists of learner, provisional and open licence phases. The first phase, the learner licence, is designed to allow novice drivers to obtain practical driving experience in lower risk situations. The learner licence can delay licensure, encourage novice drivers to learn under supervision, mandate the number of hours of practice required to progress to the next phase and encourage parental involvement. The second phase, the provisional licence, establishes various driving restrictions and thereby reduces exposure to situations of higher risk, such as driving at night, with passengers or after drinking alcohol. Parental involvement with a GDL system appears essential in helping novices obtain sufficient practice and in enforcing compliance with restrictions once the new driver obtains a provisional licence. Given the significant number of young drivers involved in crashes within Oman, GDL is one countermeasure that may be beneficial in reducing crash risk and involvement for this group.

On the need for an international effort to capture, share and use crystallization screening data

When crystallization screening is conducted many outcomes are observed but typically the only trial recorded in the literature is the condition that yielded the crystal(s) used for subsequent diffraction studies. The initial hit that was optimized and the results of all the other trials are lost. These missing results contain information that would be useful for an improved general understanding of crystallization. This paper provides a report of a crystallization data exchange (XDX) workshop organized by several international large-scale crystallization screening laboratories to discuss how this information may be captured and utilized. A group that administers a significant fraction of the worlds crystallization screening results was convened, together with chemical and structural data informaticians and computational scientists who specialize in creating and analysing large disparate data sets. The development of a crystallization ontology for the crystallization community was proposed. This paper (by the attendees of the workshop) provides the thoughts and rationale leading to this conclusion. This is brought to the attention of the wider audience of crystallographers so that they are aware of these early efforts and can contribute to the process going forward. © 2012 International Union of Crystallography All rights reserved.

Developing an international survey of bicycle and helmet usage

The European Union‐funded collaborative network, COST Action TU1101: Towards safer bicycling through optimization of bicycle helmets and usage, aims to increase scientific knowledge about bicycle helmets in regards to traffic safety and to disseminate this knowledge to stakeholders, including cyclists, legislators, manufacturers, and the scientific community. The COST research team has developed a uniform international survey to better understand attitudinal and other factors that may influence bicycle and helmet usage, as well as crash risk. The online survey is being distributed by project partners in Europe, Israel, Australia, and potentially the US and Canada. The survey contains four types of questions: (1) biographical data, (2) frequency of cycling and amount of cycling for different purposes (e.g., commuting, health, recreation) and in different environments (e.g., bicycle trails, bike lanes, on sidewalks, in traffic), (3) frequency and circumstances for use and non‐use of helmets, attitudes and reasons for it, and; (4) crash involvement and level of reporting to the police. While the potential value of comparative data across countries with very different cycling cultures and safety levels is substantial, there are numerous challenges in developing, conducting, and analyzing the results of the survey. This presentation will focus on the scope of the international study, methodological issues and pitfalls of such a collaborative effort, and on initial results from one country (Israel). To illustrate, two findings from the preliminary Israeli survey indicate that: (1) none of the crashes were reported to the police including the ones involving hospital admission. Although underreporting of bicycle crashes by police is well documented in all countries the extent is unknown, and can be extreme. (2) Older riders tend to ride more for health/exercise reasons, while younger riders tend to ride more for commuting. Thus there is an interaction between riders’ age and the place and times of riding.

Developing an international assurance standard on greenhouse gas statements

Worldwide public concern over climate change and the need to limit greenhouse gas (hereafter, GHG) emissions has increasingly motivated public officials to consider more stringent environmental regulation and standards. The authors argue that the development of a new international assurance standard on GHG disclosures is an appropriate response by the auditing and assurance profession to meet these challenges. At its December 2007 meeting, the International Auditing and Assurance Standards Board (hereafter, IAASB) approved a project to consider the development of such a standard aimed at promoting trust and confidence in disclosures of GHG emissions, including disclosures required under emissions trading schemes. The authors assess the types of disclosures that can be assured, and outline the issues involved in developing an international assurance standard on GHG emissions disclosures. The discussion synthesizes the insights gained from four international roundtables on the proposed IAASB assurance standard held in Asia-Pacific, North America, and Europe during 2008, and an IAASB meeting addressing this topic in December 2008.

How does Australian diabetic foot screening rate on an international Stage?

Background From the conservative estimates of registrants with the National Diabetes Supply Scheme, we will be soon passing 1.1 Million Australians affected by all types of diabetes. The diabetes complications of foot ulceration and amputation are costly to all. These costs can be reduced with appropriate prevention strategies, starting with identifying people at risk through primary care diabetic foot screening. However, levels of diabetic foot screening in Australia are difficult to quantify. Methods This presentation reports on foot screening rates as recorded in the academic literature, national health surveys and national database reports. The focus is on type 1 and type 2 diabetes in adults, and not gestational diabetes or children. Literature searches included diabetic foot screening that occurred in the primary care setting for populations over 2000 people from 2002 to 2014. Searches were performed using Medline and CINAHL as well as internet searches of OECD health databases. The primary outcome measure was foot -screening rates as a percentage of adult diabetic population. Results The lack of a national diabetes database and register hampers efforts to analyse diabetic foot screening levels. The most recent and accurate level for Australian population review was in the AUSDIAB (Australian Diabetes and lifestyle survey) from 2004. This survey reported screening in primary care to be as low as 50%. Countries such as the United Kingdom and United States of America report much higher rates of foot screening (67-88%) using national databases and web based initiatives that involve patients and clinicians. Conclusions Australian rates of diabetic foot screening in primary care centres is ambiguous. Uptake of national registers, incentives and web based systems improve levels of diabetic foot assessment which are the first steps to a healthier diabetic population.

An international comparison of the continuing professional development process (CPD) in Australia, New Zealand and the United Kingdom

Background: The Pharmacy Board of Australia stipulated that for renewal of registration, pharmacists must have accrued a minimum of 20 CPD credits over the 2010-11 registration years (1). Mandatory CPD is not new in Pharmacy. The UK and New Zealand have both established systems of CPD in recent years. The purpose of this study is to investigate established CPD processes in the UK and New Zealand with the view to making recommendations for the implementation of the CPD process in Australia. Objectives: To compare the acquisition and guidance on documentation of CPD credit points in Australia, New Zealand and the United Kingdom. Methodology: A comparative online search of the websites of each of the registering authorities was undertaken. Any practice standards or guidelines which relate to registration or continuing professional development were analysed and compared. Results: In New Zealand the Pharmacy Council require Pharmacists to have a minimum of 12 outcome credits over a 3-year period for recertification (2, 3). The outcome credit related to each CPD action and is based on relevance to the pharmacist and their practice. It is graded between one, for CPD which has occasional relevance to practice and three which have considerable relevance to practice. There are examples of completed CPD recording sheets on their website (8). In the UK, The General Pharmaceutical Council require Pharmacists to make a minimum of nine CPD entries per year (4) and detailed guidance on how to record CPD activities is provided (5,7). The Pharmacy Board of Australia divides CPD activities into three groups (6). Of the 20 credits required annually only 10 can be gained from group one activities, which is information accessed without assessment. There is only brief guidance on the recording of CPD. Discussion: The GPhC in the UK provided the most comprehensive guidance on acquisition of CPD credit points and documentation (5,7) The Pharmacy Council of New Zealand made CPD points relevant to practice.(2,8) The Pharmacy Board of Australia provided limited information for pharmacists on CPD activities, which may impede pharmacist participation. Information may assist in increasing pharmacists’ engagement in CPD activities. In conclusion, there is variation between the three countries in the amount and type of information provided about CPD requirements.

An international benchmark for the Australian OHS Body of Knowledge (BoK)

Benchmarking was used to compare the Australian SIA’s (Safety Institute of Australia) OHS BoK with three different approaches to systemize the knowledge that should be taught by universities. The Australian Health and Safety Professionals Alliance (HaSPA) Core Body of Knowledge for Generalist OHS Professionals was benchmarked against three other international bodies of knowledge, the German Ergonomic Society’s Body of Knowledge Ergonomics – Core Definition, Object Catalogue and Research Domains, the IEEE Computer Society Software Engineering Body of Knowledge and the American ‘Association of Schools of Public Health’ Master’s Degree in Public Health Core Competency Model. It was found that quality, structure and content of the OHS BoK ranked lowest when compared with the other benchmarked documents. The HaSPA body of knowledge was ranked poorly when compared to the German Ergonomic Society’s Body of Knowledge for Ergonomics, IEEE Computer Society Software Engineering Body of Knowledge and the American Association of Schools of Public Health Core Competency Model. Analysis and discussion of the HaSPA BoK is important given its use as an audit tool for tertiary education in Australia. Furthermore the International Network of Safety & Health Practitioner Organisations (INSHPO) is apparently promoting the Australian SIA’s OHS BoK as the basis of an international standard.