Matthew Egan

Incidence of free colorectal cancer cells on the peritoneal surface

BACKGROUND: The etiology and significance of port site recurrence occurring after laparoscopic-assisted resection for colorectal cancers will not be determined until controlled clinical trials determine if it is a predictor of out-come. Indirect evidence in support of transcoelomic spread of viable cancer cells to port sites during resection can be postulated by the presence of free cells on the fresh surface of colorectal specimens during primary resection. PURPOSE: The study contained herein was undertaken to determine the incidence of free surface colorectal cancer cells by cytology during elective open resection and to correlate their presence with clinicopathologic variables. METHODS: Fresh clamped and ligated consecutive colorectal cancer specimens were assessed in the operating room during primary resection for the presence of free colorectal cancer cells during an 18 month period at one institution. Clinicopathologic variables were assessed prospectively and blinded to cytology results. Interobserver reliability of cytologists was excellent (unweighted kappa, 0.93). RESULTS: Overall, 15 of 103 (14.6 percent) colorectal cancers had positive cytology for cancer cells on the peritoneal or perirectal surface of the bowel. T3 and T4 tumors, the size or site of the tumor, lymph node status, mucinous characteristic, degree of differentiation, and the presence of vascular or neural invasion did not reach statistical significance as predictors of positive cytology in this study sample. The operative procedure performed was a statistically significant predictor of positive cytology. More than 50 percent of lymph nodes involved (28 percent), poorly differentiated tumors (28 percent), and the presence of liver metastases (22 percent) demonstrated a higher incidence of positive cytology, but this did not reach significant levels because of the limited power of the study sample for subgroup analysis. DISCUSSION: The presence of free surface colorectal cancer cells gives only indirect support to the transcoelomic route to port site recurrence. The significance and true incidence will only be determined by prospective database analysis and randomized, controlled trials.

Making water count: water accountability change within an Australian university

Purpose - – Drought conditions affected an acute water scarcity crisis across large parts of Australia through the late 1990s and into the 2000s. Public policy responses emphasised demand management strategies. This study aims to examine the response to these challenges within a large Australian university from 1999 to 2010. Design/methodology/approach - – Case study utilising semi-structured interviews. Findings - – Staff empowered to take an emergent approach to issues of social concern, initiated water accountability change focused on water efficiency from 1999, and “water principles” from 2002. A growing network had some success translating and enrolling others over coming years. However into the late 2000s, as drought conditions abated and with a renewed focus on financial control, developments that had not established clear links to core accountability mechanisms eroded. This study demonstrates that measurement is essential to understanding patterns of water usage, but also needs to establish links to core systems of accountability to broadly change behaviour. Practical implications - – Higher education continues to be an environment where creative responses to community challenges can be nurtured. Despite increasing pressures to focus on financial outcomes, the sector should continue to nurture opportunities to shape issues of community concern through leading practice. Originality/value - – This study provides insight into the development, fragility, and contested meaning of emergent systems of water accountability within the context of a university.

Sydney water sector change and industrial water management

Purpose – The purpose of this paper is to explain three phases of modernisation change in the Sydney water sector from the early 1980s to 2007 and comments on how those phases of change are likely to be impacting the nascent development of water management processes in Sydney‐based water consuming organisations.Design/methodology/approach – A framework of modernisation reform in the Sydney water sector has been determined through literature review.Findings – This paper demonstrates that only moderate modernisation reform occurred in the Sydney water sector in the period from the early 1980s to 2007 tempered by water scarcity and a thrust to sustainability. As a result of these reforms, it is argued that water management processes in water consuming organisations are likely to have accelerated into the early 2000s.Research limitations/implications – This paper calls for empirical research to understand why organisations in the Sydney region have recently developed water management practices.Practical impli...

Progress towards institutionalising field-wide water efficiency change

Purpose - – The purpose of this paper is to explore how a heterogeneous range of water efficiency responses were driven across a field of seven water consuming organisations in Australia at a time of acute drought conditions into the late 2000s. Design/methodology/approach - – Semi-structured interviews were conducted with a range of individuals from 2008 to 2010. Findings - – A loosely coordinated range of drivers motivated pervasive water efficiency responses in two of the seven case organisations. Would-be leaders sought to invoke a water efficiency field, and champion nascent logics and theorisation in order to gain some competitive advantage. There was little sense among others of any normative, mimetic or coercive pressure to adopt homogeneous practices. While the field lacked effective champions for change, an institutionalisation of novel water efficiency practices continued across the field into 2010. Research limitations/implications - – Further research could investigate how water efficiency responses continued to develop or decline into the 2010s, and how such practices integrate with the management of other sustainability issues (including carbon). Practical implications – - Global water resources are subject to increasing supply constraints. This paper responds by exploring how the institutionalisation of water efficiency change can be driven across a field of organisations. Originality/value - – Relatively little is understood about “institutionalization” as an unfinished process. This paper responds by contributing an understanding of how institutional logics developed, and how theorisation for water efficiency progressed in the context of water scarcity in Australia in the late 2000s.

A “green” accountant is difficult to find: Can accountants contribute to sustainability management initiatives?

The purpose of this paper is to empirically explore how accountants can contribute to organisational sustainability initiatives.,The paper adopts a critical case study methodology, focused on a large Australian company in which senior management sought to engage accounting staff in an internal sustainability reporting initiative focused on eco-efficiency. Bourdieu’s concepts of habitus, capitals and field enable a relational analysis of the findings.,While accountants adapted well to early changes aligned to cost efficiency, they struggled to engage with more creative sustainability improvements. The paper explains both adaptions and constraints as interactions between accountants’ professional habitus, capitals and their broader organisational field. Prior strategies to engage accountants (e.g. training) only partially address these factors.,The accounting profession has persistently urged members to contribute to organisational sustainability initiatives. This paper provides insight into how organisations might combine professional acculturation and appropriate capitals to advance this agenda.,Although eco-efficiency is only one potential element of comprehensive organisational sustainability management, the paper’s insights into engaging accountants contributes to understanding how broader social sustainability agendas might be advanced.,The study addresses calls for empirical insights into how accountants can contribute to corporate sustainability practices. Prior studies have polarised between interpreting accountants as either enablers or barriers to sustainability change. This paper explores how shifting configurations of habitus, capital and organisational field can enable either outcome.

Drought Resettlement and Accounting

Walker’s paper provides a fascinating insight into the significant impact of accounting innovations during a period of drought in the USA in the 1930s. Through the ‘Red River’ project, authorities provided loans to more than 10,000 families to help them to resettle in more productive farmland. Impacted families were required to manage two key accounting innovations; annual ‘Farm and Home Plans’, and a continuous ‘Farm Family Record Book’. These innovations were boldly experimental, initially unpalatable, and yet ultimately proved to be invaluable. Their success can, in part, be attributed to the fact that they were constructed around a ‘tried and true’ model of accounting focused on continuously redeveloping plans based on actual outcomes. The paper contributes to studies exploring the role for novel accounting constructs in support of ‘social’, or ‘environmental’, or ‘sustainability’ challenges. Walker’s paper should encourage us to persist with these studies, as it demonstrates that experimental accounting, undertaken by individuals with sometimes little education, can add significant value where designed to address decision-making processes of clear value to users. Nonetheless, I find myself asking a number of questions which are not well addressed in the paper. How did these disadvantaged groups cope with regular and invasive recordkeeping, the shame of mistakes, and the close scrutiny of officials? How did they come to appreciate the value of these reports? How did the more capable families innovate and provide feedback? How did officials cope with the onerous and confrontational process of training and auditing? The project was wound down into the mid-1940s and the government was ultimately criticised for only recovering a percentage of its investment. This raises further questions about whether the right questions were being asked, and the right accounting instruments being developed. For example, the paper acknowledges that droughts have a huge social cost. Should broader accounting instruments therefore have been developed to complement those detailed family-level accounting instruments, which could have helped to identify the broader social benefits and savings associated with the project? All of these additional questions suggest potential for further empirical research focused on both the Red River project, and other examples of similar ‘heroic bureaucracy’.