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Patients with chronic limb threatening ischemia may require a transmetatarsal amputation (TMA) or a transtibial amputation. When making an amputation-level decision, these patients face a tradeoff—a TMA preserves more limb and may provide better mobility but has a lower probability of primary wound healing and may therefore result in additional same or higher level amputation surgeries with an associated negative impact on function. Understanding differences in how patients and providers prioritize these tradeoffs and other outcomes may enhance shared decision-making.

This article outlines the evolution of communication studies within the university sector in Aotearoa New Zealand and how this diverse disciplinary field is situated within the academy through teaching and research. It identifies the highly competitive tertiary education structures and systems that can create disincentives for the collective organising of communication scholars both within and between tertiary institutions. At the same time, it acknowledges the international disciplinary contribution of Aotearoa New Zealand researchers, and recent successful inroads into gaining major grants. The article reflects on the challenges that come with the need to position ourselves as 'internationally relevant' while also finding ways of developing and supporting local communication studies initiatives, and contributing to the advancement of Aotearoa New Zealand as a bicultural nation.

Most research on people undergoing lower limb amputations (LLA) for dysvascular disease summarizes average patient outcome risks and average associations between patient factors and these outcomes. More recently, the importance of predicting patient-specific outcomes based on individual factors (i.e., personalized rehabilitation) has become evident. This paper reviews the evidence and discusses the importance of the following: (1) predicting outcomes to facilitate amputation-level and prosthesis prescription decisions, and (2) how prediction models can be leveraged to develop decision support tools to facilitate provider/patient shared decision-making to ensure decisions considering each individual patient’s priorities and preferences. Examples of these tools are discussed and referenced.

Highlights from the article: Lacie and Lexi love our caravan. Taking trade-in caravans Experience, using the caravan We reveal all the fantastic new caravans heading your way Copyright of Practical Caravan is the property of Future Publishing Ltd. and its content may.

My final report as ANZCA president begins on a note of sadness with a tribute to Anne Dunn, a dear friend and colleague of many ANZCA members, who passed away [...]

As I write this ANZCA report at the beginning of a new year, I would like to reflect on the role of professional associations like ANZCA, and in particular on [...]

As the incoming ANZCA president for 2011-12, it is my pleasure to report on ANZCA news to readers of MIA for the next twelve months. I look forward to working [...]

Among patients facing lower extremity amputation due to dysvascular disease, mortality risk is very high. Given this, as well as the importance of a patient-centered approach to medical care, informing patients about their possible risk of dying may be important during pre-operative shared decision-making. The goal of this investigation was to gain an understanding of patient and provider experiences discussing mortality within the context of amputation within the Veterans Health Administration.

The focus of this study is to provide a greater understanding of language use as an exercise of power and identity construction within political public relations through the use of media campaigns. Using Fairclough’s (1992) three dimensional discourse analysis, we examine the discourses employed by the New Zealand Green Party in the construction and reproduction of its identity and ideology, communicated through key messages in the “Buy Kiwi Made” media campaign from 2005 to 2009. The findings suggest that the Green Party contested the free trade discourse that has driven economic policy in Aotearoa New Zealand since the middle of the 1980s, and positioned itself as the lead political party for New Zealand’s sustainable development. The campaign enabled the public to identify with the philosophy of the Green Party through a process of meaning creation. It demonstrates language use as an exercise of power, through which the Green Party struggled for a stronger political position. The study also contributes to public relations theory building through incorporating a critical discourse perspective into understanding the dynamic functions of media campaigns, as well as the implications of political public relations.

The lymphatic vessels (lymphatics) play an important role in channeling fluid and leukocytes from the tissues to the secondary lymphoid organs. In addition to driving leukocyte egress from blood, chemokines have been suggested to contribute to leukocyte recirculation via the lymphatics. Previously, we have demonstrated that binding sites for several pro-inflammatory β-chemokines are found on the endothelial cells (ECs) of lymphatics in human dermis. Here, using the MIP-1α isoform MIP-1αP, we have extended these studies to further support the contention that the in situchemokine binding to afferent lymphatics exhibits specificity akin to that observed in vitrowith the promiscuous β-chemokine receptor D6. We have generated monoclonal antibodies to human D6 and showed D6 immunoreactivity on the ECs lining afferent lymphatics, confirmed as such by staining serial skin sections with antibodies against podoplanin, a known lymphatic EC marker. In parallel, in situhybridization on skin with antisense D6 probes demonstrated the expression of D6 mRNA by lymphatic ECs. D6-immunoreactive lymphatics were also abundant in mucosa and submucosa of small and large intestine and appendix, but not observed in several other organs tested. In lymph nodes, D6 immunoreactivity was present on the afferent lymphatics and also in subcapsular and medullary sinuses. Tonsilar lymphatic sinuses were also D6-positive. Peripheral blood cells and the ECs of blood vessels and high endothelial venules were consistently nonreactive with anti-D6 antibodies. Additionally, we have demonstrated that D6 immunoreactivity is detectable in some malignant vascular tumors suggesting they may be derived from, or phenotypically similar to, lymphatic ECs. This is the first demonstration of chemokine receptor expression by lymphatic ECs, and suggests that D6 may influence the chemokine-driven recirculation of leukocytes through the lymphatics and modify the putative chemokine effects on the development and growth of vascular tumors.