Implant design influences the joint-specific outcome after total knee arthroplasty: data from a randomised controlled trial at a minimum 12 years' follow-up

AimsThe aims were to assess whether joint-specific outcome after total knee arthroplasty (TKA) was influenced by implant design over a 12-year follow-up period, and whether patient-related factors were associated with loss to follow-up and mortality risk.MethodsLong-term follow-up of a randomized controlled trial was undertaken. A total of 212 patients were allocated a Triathlon or a Kinemax TKA. Patients were assessed preoperatively, and one, three, eight, and 12 years postoperatively using the Oxford Knee Score (OKS). Reasons for patient lost to follow-up, mortality, and revision were recorded.ResultsA total of 94 patients completed 12-year functional follow-up (62 females, mean age 66 years (43 to 82) at index surgery). There was a clinically significantly greater improvement in the OKS at one year (mean difference (MD) 3.0 (95% CI 0.4 to 5.7); p = 0.027) and three years (MD 4.7 (95% CI 1.9 to 7.5); p = 0.001) for the Triathlon group, but no differences were observed at eight (p = 0.331) or 12 years’ (p = 0.181) follow-up. When assessing the OKS in the patients surviving to 12 years, the Triathlon group had a clinically significantly greater improvement in the OKS (marginal mean 3.8 (95% CI 0.2 to 7.4); p = 0.040). Loss to functional follow-up (53%, n = 109/204) was independently associated with older age (p = 0.001). Patient mortality was the major reason (56.4%, n = 62/110) for loss to follow-up. Older age (p < 0.001) and worse preoperative OKS (p = 0.043) were independently associated with increased mortality risk. An age at time of surgery of ≥ 72 years was 75% sensitive and 74% specific for predicting mortality with an area under the curve of 78.1% (95% CI 70.9 to 85.3; p < 0.001).ConclusionThe Triathlon TKA was associated with clinically meaningful greater improvement in knee-specific outcome when compared to the Kinemax TKA. Loss to follow-up at 12 years was a limitation, and studies planning longer-term functional assessment could limit their cohort to patients aged under 72 years

Arctic childhood in data-driven culture: wearable technology and children’s right to privacy in Finland

The article discusses the definition of ‘Arctic childhood’: how it affects the ideal of childhood in the Arctic countries while differentiating it from understandings of childhood in more temperate climates. Arctic childhood offers novel viewpoints to the concept of childhood. It grants agency to the non-human world: environment, weather and design solutions such as clothes and wearable technology. It also highlights how these shape the concept of childhood in the Arctic and beyond. The article focuses on wearable technology, which brings new legal issues to considerations of childhood in data-driven culture. The central argument is two-fold. As design solutions, wearable technology may preserve the ideal of the active child, essential to Arctic and Finnish childhoods. Legally, however, there are some issues: since wearable technology is designed to bring forth and share with others the vital functions of the child’s body, it raises concerns about children’s fundamental right to privacy and data protection. By bringing together fashion studies and the doctrinal study of law, and by using wearable technology as an example, the article argues that multidisciplinary approaches are needed when new technologies designed to track and monitor individuals are offered to minors in the name of staying healthy

The personal statement: a tool for developing the pedagogical potential of storytelling in business management education?

This chapter explores use of the Personal Statement (PS) in creating instructional interventions designed to nurture, encourage, facilitate and help students become better learners. It contributes to the literature on passion-inspired learning by presenting the student-written PS as a starting point for identifying and developing passions to support student learning throughout the Higher Education curriculum. The chapter is presented in a play script format. It describes and reflects on an attempt to formally embed academic skills development in to a revised Business Management degree. But sometimes things do not go according to plan. We highlight the challenges and delineate lessons learned

Transfer of microorganisms from dry surface biofilms and the influence of long survival under conditions of poor nutrition and moisture on the virulence of Staphylococcus aureus

Background: Biofilms on dry hospital surfaces can enhance the persistence of micro-organisms on dry harsh clinical surfaces and can potentially act as reservoirs of infectious agents on contaminated surfaces. Aim: This study was conducted to quantify the transfer of viable Staphylococcus aureus cells from dry biofilms through touching and to investigate the impact of nutrient and moisture deprivation on virulence levels in S. aureus. Methods: Dry biofilms of S. aureus ATCC 25923 and a defective biofilm-forming ability mutant, S. aureus 1132, were formed in 24-well plates under optimized conditions mimicking dry biofilm formation on clinical surfaces. Microbial cell transfer was induced through the touching of the dry biofilms, which were quantified on nutrient agar. To investigate the impact of nutrient and moisture deprivation on virulence levels, dry and standard biofilms as well as planktonic cells of S. aureus ATCC 25923 were inoculated into Galleria mellonella and their kill rates compared. Findings: Results of this study showed that viable cells from dry biofilms of S. aureus ATCC 25923 were significantly more virulent and readily transferrable from dry biofilms through a touch test, therefore representing a greater risk of infection. The biofilm-forming capability of S. aureus strains had no significant impact on their transferability with more cells transferring when biofilm surfaces were wet. Conclusions: These findings indicate that dry biofilms on hospital surfaces may serve as a reservoir for the dissemination of pathogenic micro-organisms in hospitals, thus highlighting the importance of regular cleaning and adequate disinfection of hospital surfaces.</p

Women and the Preston Lock-Out: not just 'ten per cent'

Women and girls comprised the majority of the striking cotton operatives during the Preston lock-out of 1853–1854. While history has acknowledged women’s participation, their story has been neglected in favour of the strike’s importance to the labour movement, both locally and nationally. This article highlights how working-class women’s strike participation formed part of broader women’s activism and was motivated by labour and domestic considerations. Utilising newspapers, strike papers and contemporary accounts, this article argues that women operatives were respected co-workers with men and received equal strike pay to men – something that was reflected in later Lancashire strikes. Married women’s sustained support was influenced by a decrease in domestic violence, increased educational opportunities for children and adults, and more family time. More broadly, if we are to fully understand women’s complex decision-making related to their dual role as workers and household managers, a gendered approach to labour activism is needed

Efficacy of hydroxypropyl-guar drops in improving tear film index and ocular surface dynamics using two treatment methods under a controlled desiccating environment

Aim: This study aimed to assess the efficacy of hp-guar eye drops on tear film index and ocular surface dynamics under desiccating conditions using protection and relief treatment modalities.Methodology: The 12 normal, non-dry eye participants were subjected to adverse environmental conditions using a Controlled Environment Chamber (CEC) where the relative humidity (RH) was 5% and the ambient temperature was 21 °C. The participants were screened for ocular symptoms, tear osmolarity, ocular surface temperature (OST), tear production using the Ocular Surface Disease Index questionnaire (OSDI), OcuSense TearLab Osmometer, FLIR System ThermaCAM P620, and Schirmer strips. Tear production was calculated by the Tear Function Index test (TFI).Results: The mean tear film osmolarity decreased significantly from 296 mOsm/L at 40% RH to 285 mOsm/L at 5% RH (p = 0.01). Conflicting responses were seen for osmolarity in protection and relief. Mean tear osmolarity was significantly higher in the protection method in comparison to the relief method (p = 0.005). The mean TFI increased from 557 at 40% to 854 at 5% (p = 0.02). A significant increase in TFI was observed in the relief method in comparison with both 40% (p = 0.001) and 5% (p = 0.04). In the relief method, the mean TFI score went up to 1139 when hp-guar was installed. A significant improvement in ocular comfort was experienced in both the protection (p = 0.041) and relief (p = 0.010) methods at 5% RH. The instillation of hp-guar drops in the relief method resulted in a significant reduction in OST. The mean OST dropped to 33.01 ºC, significantly lower than the recorded OST for both normal (p = 0.040) and dry (p = 0.014) environmental conditions. Conclusion: Hp-guar drops significantly improve tear film parameters under a desiccating environment, however, tear film parameters respond differently to the management modalities. In the protection method, tear film osmolarity was protected against a dry environment, while in the relief mode, an improvement in tear production and a decrease in ocular surface temperature were seen. Hp-guar performance could be maximized for the management of exposure to adverse environments by using a treatment protocol that targets the most affected parameters in each group of patients. Using CEC has the potential to provide researchers with a readily available method to evaluate the efficiency of tear supplementation.</p

“You don’t get resilience overnight”: a grounded theory framework of the A-R-C sporting resilience development

Resilience in sport is growing as a topic of investigation but comparatively less focus is placed on how resilience develops in athletes. This study explored sporting resilience development in elite athletes over time using grounded theory. Participants included 10 competitive-elite athletes (5 men and women) who scored high, competing in individual/team sports from diverse cultural contexts. Experiential life-story interviews on sporting resilience development over time was conducted. Grounded theory was employed across ideation, data collection and analysis with structured methodological quality criteria to ensure rigour. Findings are synthesised into A-R-C Development Model of sporting resilience indicating that antecedent protective factors (A) enable the engine of sporting resilience (R) which through metacognition-emotion-behaviour produces consequences (C) of positive adaptation or critical adaptation failure. The emergent theory is the first comprehensive outline providing an understanding of how sporting resilience develops over time in competitive-elite athletes. Implications for developing athlete resilience for performance and mental health are discussed.<br/

The impact of compliance, board committees and insider CEOs on firm survival during crisis

This study investigates the relationship between internal corporate governance mechanisms and firm survival during a financial crisis. Using a sample of FTSE 350 listed companies for the time period 2003–2010, our results show significant differences in the corporate governance mechanisms of firms that survived and those that failed during the 2007–2009 financial crisis. The findings indicate that compliance with the UK Corporate Governance Code is negatively associated with the survival of firms when they experience exogenous shocks. However, the existence of insider CEOs and a higher number of board committees in organisations increase the chances of survival during an economic downturn. These findings have policy implications and show that non-compliance with a prescribed code of corporate governance does not necessarily lead to poor governance. Moreover, the establishment of extra board committees and CEO succession planning are shown as important dynamics in firms’ strategic decisions, as they have implications for the survival of firms during difficult economic conditions

Treatment effect analysis of the Frailty Care Bundle (FCB) in a cohort of patients in acute care settings

Purpose: The aim of this study is to explore the feasibility of using machine learning approaches to objectively differentiate the mobilization patterns, measured via accelerometer sensors, of patients pre- and post-intervention.Methods: The intervention tested the implementation of a Frailty Care Bundle to improve mobilization, nutrition and cognition in older orthopedic patients. The study recruited 120 participants, a sub-group analysis was undertaken on 113 patients with accelerometer data (57 pre-intervention and 56 post-intervention), the median age was 78 years and the majority were female. Physical activity data from an ankle-worn accelerometer (StepWatch 4) was collected for each patient during their hospital stay. These data contained daily aggregated gait variables. Data preprocessing included the standardization of step counts and feature computation. Subsequently, a binary classification model was trained. A systematic hyperparameter optimization approach was applied, and feature selection was performed. Two classifier models, logistic regression and Random Forest, were investigated and Shapley values were used to explain model predictions.Results: The Random Forest classifier demonstrated an average balanced accuracy of 82.3% (± 1.7%) during training and 74.7% (± 8.2%) for the test set. In comparison, the logistic regression classifier achieved a training accuracy of 79.7% (± 1.9%) and a test accuracy of 77.6% (± 5.5%). The logistic regression model demonstrated less overfitting compared to the Random Forest model and better performance on the hold-out test set. Stride length was consistently chosen as a key feature in all iterations for both models, along with features related to stride velocity, gait speed, and Lyapunov exponent, indicating their significance in the classification.Conclusion: The best performing classifier was able to distinguish between patients pre- and post-intervention with greater than 75% accuracy. The intervention showed a correlation with higher gait speed and reduced stride length. However, the question of whether these alterations are part of an adaptive process that leads to improved outcomes over time remains.<br/