Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Ideology The neglected element of industrial organisational decision making and culture

SIGLEAvailable from British Library Document Supply Centre- DSC:DX183162 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

The concept of ideology and work motivation

Shamir (1991: 405) noted that 'current reviews of work-motivation theories are unanimous in their dissatisfaction with the state-of-the-art'. He concluded that existing theories offer an inadequate account of the impetus of employ ment and should be 'supplemented by a self-concept based theory of work motivation'. This paper suggests that the concept of ideology can provide a foundation for this kind of theory. First, it attempts to elucidate the explanatory power of the concept of ideology in the context of understanding the effective performance of organizational members. Second, it indicates how ideology can be shown to address the issues of organizational dynamism which Shamir found to be problematic. Third, it shows how the nature of ideologic, in con junction with the substance of ideological belief, offers an explanation of the variety to be found in organizational behaviour

The importance of water management in hotels: A framework for sustainability through innovation

This paper highlights the global phenomenon of the crisis in the quality and quantity of water supplies and how tourism generally and hotels specifically may have contributed to the situation. The major internal and external barriers for Small Medium Enterprises adopting Environmental Management Systems, including water, are listed. The paper proposes a water management framework for hotels and other types of accommodation that leverages on the concept of innovation. Taking into account the various levels of knowledge and technological capabilities in water management, the framework is developed based on the commonly known 3R approach in environmental management, with the addition of another R (Reaching). It is proposed that hotels can innovate and enhance their water management approaches under these 4Rs: Innovative Reducing, Innovative Reusing, Innovative Reaching and Innovative Recycling. The framework offers examples and strategies about how hotels of different sizes, with differing financial, technical, knowledge and managerial capacities could address the challenge of implementing water management and obtain commercial benefit. A detailed case study is provided of a gray and black water recycling system in a Malaysian resort. Other examples of a range of water management methods are also discussed

Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between Mar