National audit of post-operative management in spinal surgery

BACKGROUND: There is some evidence from a Cochrane review that rehabilitation following spinal surgery may be beneficial. METHODS: We conducted a survey of current post-operative practice amongst spinal surgeons in the United Kingdom in 2002 to determine whether such interventions are being included routinely in the post-operative management of spinal patients. The survey included all surgeons who were members of either the British Association of Spinal Surgeons (BASS) or the Society for Back Pain Research. Data on the characteristics of each surgeon and his or her current pattern of practice and post-operative care were collected via a reply-paid postal questionnaire. RESULTS: Usable responses were provided by 57% of the 89 surgeons included in the survey. Most surgeons (79%) had a routine post-operative management regime, but only 35% had a written set of instructions that they gave to their patients concerning this. Over half (55%) of surgeons do not send their patients for any physiotherapy after discharge, with an average of less than two sessions of treatment organised by those that refer for physiotherapy at all. Restrictions on lifting, sitting and driving showed considerable inconsistency both between surgeons and also within the recommendations given by individual surgeons. CONCLUSION: Demonstrable inconsistencies within and between spinal surgeons in their approaches to post-operative management can be interpreted as evidence of continuing and significant uncertainty across the sub-speciality as to what does constitute best care in these areas of practice. Conducting further large, rigorous, randomised controlled trials would be the best method for obtaining definitive answers to these questions

Structural change and foreign direct investment : globalization and regional economic integration

This paper investigates flows of inward and outward foreign direct investment (FDI) and FDI-to-GDP ratios in a sample of 62 countries over a 30 year time span. Using several endogenous structural break procedures (allowing for one and two break points), we find that: (1) the great majority of the series have structural breaks in the last 15 years, (2) post-break FDI and FDI/GDP ratios are substantially higher than the pre-break values, and (3) most breaks seem to be related to globalization, regional economic integration, economic growth, or political instability. Static and dynamic panel-data analy- ses accounting for and/or addressing endogeneity, simultaneity, nonstationar- ity, heterogeneity and cross-sectional dependence show that FDI is negatively related to exchange rate volatility and GDP per capita, but positively related to some regional integration agreements, trade openness, GDP, and GDP growth. Most notably, the European Union is the only regional economic integration unit found to consistently have significant and positive effects on FDI.info:eu-repo/semantics/publishedVersio

Revisiting globalization challenges and opportunities in the development of cooperatives

Cooperatives have gained prominent attention in recent years as strategic elements to achieve sustainable economic development and greater social cohesion in the context of neoliberal globalization. This article explores, theoretically, the current challenges and opportunities for cooperatives to develop successfully in the globalizing economy. To this end, we provide an analytical, critical review of the key bibliography concerning some fundamental aspects that shape the relationship between economic globalization and cooperatives, an issue that has been generally neglected by previous literature. Three key fields are addressed: 1) the viability of cooperatives, based on their strengths and possible weaknesses, under current globalization; 2) the role of these organizations in promoting the local development and stability of local communities; and 3) the tensions and potentialities that internationalization entails for cooperatives. Based on the analytical review and the organization of the literature, we propose an agenda for further research. This includes some hypotheses and strategies for testing them that would be essential to assess the role of cooperatives in economic globalization, and sheds light on key areas for future research that could provide a better understanding of the complexity surrounding the relationship between globalization and cooperatives

Tourism and Economic Globalization: An Emerging Research Agenda

Globalization characterizes the economic, social, political, and cultural spheres of the modern world. Tourism has long been claimed as a crucial force shaping globalization, while in turn the developments of the tourism sector are under the influences of growing interdependence across the world. As globalization proceeds, destination countries have become more and more susceptible to local and global events. By linking the existing literature coherently, this study explores a number of themes on economic globalization in tourism. It attempts to identify the forces underpinning globalization and assess the implications on both the supply side and the demand side of the tourism sector. In view of a lack of quantitative evidence, future directions for empirical research have been suggested to investigate the interdependence of tourism demand, the convergence of tourism productivity, and the impact of global events

The Science Performance of JWST as Characterized in Commissioning

This paper characterizes the actual science performance of the James Webb Space Telescope (JWST), as determined from the six month commissioning period. We summarize the performance of the spacecraft, telescope, science instruments, and ground system, with an emphasis on differences from pre-launch expectations. Commissioning has made clear that JWST is fully capable of achieving the discoveries for which it was built. Moreover, almost across the board, the science performance of JWST is better than expected; in most cases, JWST will go deeper faster than expected. The telescope and instrument suite have demonstrated the sensitivity, stability, image quality, and spectral range that are necessary to transform our understanding of the cosmos through observations spanning from near-earth asteroids to the most distant galaxies.Comment: 5th version as accepted to PASP; 31 pages, 18 figures; https://iopscience.iop.org/article/10.1088/1538-3873/acb29

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Corporate ecologies of business travel : working towards a research agenda.

International business travel has always been an important labour process in the accumulation of capital for the firm. It is surprising, therefore, that relatively little time has been devoted to the study of business travel, both as a facet of contemporary mobility and as an economic practice. In this article we review how existing literatures provide insights that can be used to understand the role of business travel as international labour mobility in the contemporary professional service economy. In doing so, we reach the conclusion that there seem to be at least two significant voids preventing a more sophisticated understanding from emerging. First, we suggest that international business travel needs to be studied not in isolation but instead as one component in a wider ecology of mobility which `produces' the global firm. Second, we argue that it is important to know more about the time-space dynamics of international business travel in terms of how spatial relations are produced and reproduced by different forms and geographies of travel. We make these arguments and explore their implications using data collected through interviews in advertising, architecture and legal professional service firms.We conclude by identifying a research agenda designed to allow a better understanding of business travel to emerge in corporate and mobility discourses

Prevalence and Outcomes of Anemia and Hematinic Deficiencies in Patients With Chronic Heart Failure

IMPORTANCE: Detailed information on the prevalence, associations, and consequences of anemia and iron deficiency in epidemiologically representative outpatients with chronic heart failure (HF) is lacking. OBJECTIVE: To investigate the epidemiology of anemia and iron deficiency in a broad range of patients referred to a cardiology clinic with suspected HF. DESIGN, SETTING, AND PARTICIPANTS: We collected clinical data, including hemoglobin, serum iron, transferrin saturation, and serum ferritin concentrations, on consecutive patients referred with suspected HF to a single outpatient clinic serving a local community from January 1, 2001, through December 31, 2010. Follow-up data were censored on December 13, 2011. Patients underwent phenotyping by echocardiography and plasma N-terminal pro-brain natriuretic peptide measurement and were followed for up to 10 years. MAIN OUTCOME MEASURES: Prevalences of anemia and iron deficiency and their interrelationship, all-cause mortality, and cardiovascular mortality. RESULTS: Of 4456 patients enrolled in the study, the median (interquartile range) age was 73 (65-79) years, 2696 (60.5%) were men, and 1791 (40.2%) had left ventricular systolic dysfunction (LVSD). Of those without LVSD, plasma N-terminal pro-brain natriuretic peptide concentration was greater than 400 pg/mL in 1172 (26.3%), less than 400 pg/mL in 841 (18.9%), and not measured in 652 (14.6%). Overall, 1237 patients (27.8%) had anemia, with a higher prevalence (987 [33.3%]) in patients who met the criteria for HF with or without LVSD. Depending on the definition applied, iron deficiency was present in 270 (43.2%) to 425 (68.0%) of patients with and 260 (14.7%) to 624 (35.3%) of patients without anemia. Lower hemoglobin (hazard ratio 0.92; 95% CI, 0.89-0.95; P < .001) and serum iron (hazard ratio 0.98; 95% CI, 0.97-0.99; P = .007) concentrations were independently associated with higher all-cause and cardiovascular mortality in multivariable analyses. CONCLUSIONS AND RELEVANCE: Anemia is common in patients with HF and often associated with iron deficiency. Both anemia and iron deficiency are associated with an increase in all-cause and cardiovascular mortality and might both be therapeutic targets in this population

Airline data for global city network research: reviewing and refining existing approaches.

Information on air passenger flows is potentially a prime data source for assessing spatial patterns in the global city network, but previous analyses have been hampered by inadequate and/or partial data. The ensuing analytical deficiencies have reduced the overall value of these analyses, and this paper examines how some of these deficiencies may be rectified. First, we review the rationale for using airline data to analyse the global city network. Second, we assess the data problems encountered in previous research. Third, we elaborate on the construction of datasets that may circumvent some of these problems. The proposed refinements include the omission of the hub function of major airports and ways to extract relevant business flows from the data