The degree to which Open Educational Resources (OER) reflect the values of its institutional provider depends on questions of economics and the level of support amongst its academics. For project managers establishing OER repositories, the latter question-how to cultivate, nurture and maintain academic engagement-is critical. Whilst participating in the HEFCE funded institutional OER programme (2009-10), the team at the University of Exeter encountered a range of academic opinions on OER, and followed many as they rode the peaks and troughs of opportunities and challenges that this kind of work entails. This paper discusses the potential motivators for academics in providing OER material, as an understanding of these is helpful when introducing the subject to new contributors, and when informing planning decisions-both procedural and financial-so that key incentives are protected. We will also look at the reasons for some academic scepticism surrounding OER and how these views can be-if not tempered-then at least understood with a view to informing future policy. The enthusiastic advocacy that some academics possess in relation to OER is borne of their vision of its use. It is important to ensure that the high priority objective of obtaining academic support does not overlook instances where there is tension between this vision, and what can be achieved with available resources. We will discuss the key information that OER managers need in order to mitigate this scenario. OER projects do not work in isolation from internal competition and it has been essential to be sensitive to the conflicting pressures that academics have to contend with in their work profile. We will discuss the value of establishing where an OER project sits within an institution's educational and research strategies, and its financial framework, the questions to ask and the signs to spot to obtain this information, and how managers can use this knowledge to make decisions, avoid pitfalls and garner support. This will involve addressing academic initiatives and reward schemes, including a discussion of how IPR and copyright can not only present challenges but also play an important role in motivating and demonstrating academic engagement. This paper draws upon formal and informal engagement with a range of stakeholders who have been involved in the project, including the many colleagues who attended several staff development sessions.

Background A paucity of evidence currently exists regarding factors affecting the success of lower extremity reconstruction at restoring a functional limb. We aim to determine the effect of foot fracture on outcome measures of ambulatory success after lower extremity salvage in a trauma population.Methods A retrospective chart review was performed on 63 patients presenting to an urban level 1 trauma center between 01/2007 and 01/2015 who received soft tissue coverage of a lower extremity traumatic wound. Demographics, injury, and perioperative data were recorded. Patients were administered the Lower Extremity Functional Scale (LEFS) questionnaire via phone. The LEFS is out of 80 possible points. Ambulatory success is measured on a scale of 0 to 4 across 20 activities, with 0 indicating “extreme difficulty or inability to perform activity”, and 4 indicating “no difficulty”. Functional outcomes were compared using a two-tailed two-sample unequal variances t-test.Results This study represents data on the 63 unique patients treated with vascularized flaps whom we attempted to contact. A total of 21 patients completed the LEFS questionnaire, representing an overall response rate of 33%. Responders to the surveys included 4 (19%) patients with foot fractures and 17 (81%) without foot fractures. Average total LEFS scores were significantly lower in patients with foot fractures (23.8 ± 5.9) than in patients without (36.2 ± 19.2) foot fractures (p = 0.04). With respect to the SF36 functional scale, patients with foot fractures paradoxically reported significantly higher measures of physical functioning (81 ± 11) in comparison to those without a foot fracture (59 ± 25) at a p-value of 0.02, and role limitation due to physical health (98 ± 3) versus those with no foot fracture (74 ± 37) at a p-value of 0.02.Conclusion Sustaining a foot fracture during severe traumatic injury that necessitates lower extremity reconstruction may result in significantly decreased ambulatory success scores. Fractures of the foot may predict poor patient reported functional outcomes following lower extremity reconstruction and should be considered as a factor in the pre-operative risk and benefit assessment when deciding whether to attempt reconstruction of the mangled limb.

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