A form of voluntary workplace engagement, communities of practice are characterised in literature as providing entities with the potential to harness the multiplier effects of collaborative processes by building on informal networks within entities. As knowledge building and sharing institutions it would be reasonable to presume that communities of practice activities have been embraced to facilitate a level of connectedness and engagement in a university context. However, evidence from the Australian higher education environment suggests that the enlistment of communities of practice processes by universities faces a number of challenges that are peculiar to academe. We suggest that academic knowledge work practices are significantly different from the business/industry related applications of communities of practice and that an understanding of the unique aspects of such practices, together with the impediments posed by a 'corporate university' model, require acknowledgment before the knowledge building and sharing aspects of communities of practice activities in academia can emerge.

No abstract

Background The interaction between baseline kidney function and the performance of biomarkers of acute kidney injury (AKI) on the development of AKI is unclear. Study Design Post-hoc analysis of prospective cohort study. Setting & Participants The 1,219 TRIBE-AKI Consortium adult cardiac surgery cohort participants. Predictor Unadjusted post-operative urinary biomarkers of AKI measured within 6 hours of surgery. Outcome AKI was defined as greater than or equal to AKI Network stage 1 (any AKI) as well as a doubling of serum creatinine from the pre-operative value or the need for emergent dialysis (severe AKI). Measurements Stratified analyses by a pre-operative eGFR ≤ 60 ml/min/1.73 m2 vs. > 60 ml/min/1.73 m2. Results 180 (42%) patients with a pre-operative eGFR ≤ 60 ml/min/1.73m2 developed clinical AKI compared to 246 (31%) in those with an eGFR >60 ml/min//1.73m2 (p<0.001). For log2-transformed biomarker concentrations there was a significant interaction between any AKI and baseline eGFR for interleukin 18 (IL-18; p=0.007) and borderline significance for liver-type fatty acid binding protein (p=0.06). For all biomarkers, the adjusted relative risk (RR) point estimates for the risk of any AKI were higher in those with elevated baseline eGFRs compared to those with an eGFR ≤ 60 ml/min/1.73m2. However the difference in magnitude of these risks were quite low (adjusted RRs were 1.04 [95% CI, 0.99–1.09] and 1.11 [95% CI, 1.07–1.15] for those with a pre-operative eGFR ≤ 60 ml/min/1.73 m2 and those with higher eGFRs, respectively). Although no biomarker displayed an interaction for baseline eGFR and severe AKI, log2-transformed IL-18 and kidney injury molecule 1 (KIM-1) had significant adjusted RRs for severe AKI in those with and without baseline eGFR ≤ 60 ml/min/1.73 m2. Limitations Limited numbers of patients with severe AKI and emergent dialysis. Conclusions The association between early post-operative AKI urinary biomarkers and AKI is modified by preoperative eGFR. The degree of this modification and its impact on the biomarker-AKI association is small across biomarkers. Our findings suggest that distinct biomarker cut-offs for those with and without a pre-operative eGFR ≤ 60 ml/min/1.73 m2 is not necessary.

No abstract

No abstract