Precaution, governance and the failure of medical implants: the ASR(TM) hip in the UK

Hip implants have provided life-changing treatment, reducing pain and improving the mobility and independence of patients. Success has encouraged manufacturers to innovate and amend designs, engendering patient hopes in these devices. However, failures of medical implants do occur. The failure rate of the Articular Surface Replacement metal-on-metal hip system, implanted almost 100,000 times world-wide, has re-opened debate about appropriate and timely implant governance. As commercial interests, patient hopes, and devices’ governance converge in a socio-technical crisis, we analyse the responses of relevant governance stakeholders in the United Kingdom between 2007 and 2014. We argue that there has been a systemic failure of the governance system entrusted with the safety of patients fitted with medical implants. Commercial considerations of medical implants and the status quo of medical implant governance have been given priority over patient safety despite the availability of significant failure data in an example of uncertainty about what constitutes appropriate precautionary action

The effect of a seven-week exercise program on golf swing performance and musculoskeletal measures

As most golf exercise studies have shown improved golf performance as a result of two or three sessions per week, the present study investigated the effects of a supervised exercise session performed once a week for seven weeks on golf swing variables and musculoskeletal screening measures. Professional Golfers Association of Australia International Golf Institute student golfers (n ¼ 43) with a mean standard deviation handicap of 8.6 8.3 participated in the study. Each golfer performed 10 musculoskeletal tests and a standardised 60-shot golf performance test (TrackMan, Vedbaek, Denmark) on separate days before and after the seven-week program. Significant improvements in a number of musculoskeletal tests (i.e. left leg bridging (6.6%), thoracic extension (62.5%), right thoracic rotation (23.3%), and right (20.8%) and left single leg squat (29.1%)) were observed (all p 0.024); however, no significant differences were observed for any golf swing variables. Future research investigating different training protocols may help to determine whether the type or frequency of training has the greatest influence on golf swing performance

Spartan Daily February 23, 2011

Volume 136, Issue 15https://scholarworks.sjsu.edu/spartandaily/1122/thumbnail.jp

High Impact Practices (HIPS) Assessment Model: 2015-2016 Pilot Mid-Year Report

A systematic institutional assessment model was developed to investigate the impact of high impact educational practices (HIPs) on undergraduate student success at Virginia Commonwealth University (VCU). The proposed VCU HIPs Assessment Model provides a systematic framework for assessing the impact of high impact educational practices on VCU undergraduates. Recommendations for institutionalizing the VCU HIPs Assessment Model are made

Early Development of Total Hip Replacement

Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone. First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2007. ©The Trustee of the Wellcome Trust, London, 2007. All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone,Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone,Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone,Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone,Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone,Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone,Total hip replacement effectively began in the UK in 1938 and has led to widely used, commercially successful, mass-produced devices that relieve pain for an ever increasing period. The Witness Seminar, chaired by Mr Alan Lettin, discussed the remarkable postwar collaboration of British surgeons, engineers and manufacturing firms in the development of efficient alloys, surgical procedures, instruments and the implementation of clean, bacteria-reduced air in enclosed operating theatres, as illustrated by successful prostheses and techniques developed in Norwich (Kenneth McKee), Wrightington (Sir John Charnley), Stanmore (John Scales), Redhill (Peter Ring), and Exeter (Robin Ling and Clive Lee). Early failures - such as loosening from infection, osteolysis, and wear debris - stimulated the search for improved materials and fixation methods, as well as the addition of antibiotics to bone cement to reduce infection. National hip registers that record the survival of different implants were adopted in Europe in the 1970s (2003 in the UK), and they pinpoint the successful devices, as measured by survival and low rates of revision. An introduction to the volume by Dr Francis Neary and Professor John Pickstone, and appendices on materials by Professor Alan Swanson; on international standards by Mr Victor Wheble; and of details of selected prosthesis supplement the transcript. Contributors include: Lady Charnley, the late Mr Harry Craven, Mr Graham Deane, Professor Duncan Dowson, Mr Reg Elson, Dr Alex Faulkner, Professor Michael Freeman, Mrs Phyllis Hampson, Mr Kevin Hardinge, Mr Mike Heywood-Waddington, Mr John Kirkup, Mr Krishna (Ravi) Kunzru, Miss Betty Lee, Mr Alan Lettin (chair), Mr John Older, Mr John Read, Mr Peter Ring, Mr Ian Stephen, Mr Malcolm Swann, Professor Alan Swanson, Sir Rodney Sweetnam, Mr Keith Tucker, Mr Victor Wheble and Professor Michael Wroblewski. Reynolds L A, Tansey E M. (eds) (2007) Early development of total hip replacement, Wellcome Witnesses to Twentieth Century Medicine, vol. 29. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Fair Shares for All? The development of needs based governmental funding in education, health and housing

Furthering equity as an achievable public policy objective is based on the ability to assess needs accurately, and distribute resources accordingly. This paper plots the development of the formulae governing resouce allocation in education, health and social housing, and charts their course as a tool with which governments attempted to achieve various objectives. The paper begins by suggesting that allocation systems can be explained through a form of public choice theory. It then charts the development of needs-based resource allocation from its origin in the nineteenth century, through the pre- and post Second World War period, and into the major flowering of needs-based formulae since 1970 - when resources were constrained and attempts were made to push allocation even further down and apply the formulae to smaller units. The conclusion looks at equity, public choice and technical ability as over-riding features governing the development of resource allocation within the English state sector.Resource allocation, funding formulae, geographical equity

Does acute passive stretching increase muscle length in children with cerebral palsy?

This article has been made available through the Brunel Open Access Publishing Fund. Copyright @ The Authors. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in anymedium, provided the original author(s) and the source are credited.Background: Children with spastic cerebral palsy experience increased muscle stiffness and reduced muscle length, which may prevent elongation of the muscle during stretch. Stretching performed either by the clinician, or children themselves is used as a treatment modality to increase/maintain joint range of motion. It is not clear whether the associated increases in muscle–tendon unit length are due to increases in muscle or tendon length. The purpose was to determine whether alterations in ankle range of motion in response to acute stretching were accompanied by increases in muscle length, and whether any effects would be dependent upon stretch technique. Methods: Eight children (6–14 y) with cerebral palsy received a passive dorsiflexion stretch for 5 × 20 s to each leg, which was applied by a physiotherapist or the children themselves. Maximum dorsiflexion angle, medial gastrocnemius muscle and fascicle lengths, and Achilles tendon length were calculated at a reference angle of 10° plantarflexion, and at maximum dorsiflexion in the pre- and post-stretch trials. Findings: All variables were significantly greater during pre- and post-stretch trials compared to the resting angle, and were independent of stretch technique. There was an approximate 10° increase in maximum dorsiflexion post-stretch, and this was accounted for by elongation of both muscle (0.8 cm) and tendon (1.0 cm). Muscle fascicle length increased significantly (0.6 cm) from pre- to post-stretch. Interpretation: The results provide evidence that commonly used stretching techniques can increase overall muscle, and fascicle lengths immediately post-stretch in children with cerebral palsy

Bambo Can Go

The author analyses Tuwim’s Bambo, the Black Boy and tries to point to a number of interpretative paradoxes that have accumulated around its multiple readings. Particular attention is paid to the racial readings of the poem. What is more, the author discusses a variety of contemporary contexts in which the famous poem functions; these are often politically incorrect readings and interpretations which make no sense of the historical context in which the work was originally written. The article offers a detailed analysis of the origins of the poem and the circumstances in which found its way to the school primer. The poem is seen as expressing the need for accepting otherness and fighting cultural stereotypes.Zadanie „Stworzenie anglojęzycznych wersji wydawanych publikacji” finansowane w ramach umowy nr 948/P-DUN/2016 ze środków Ministra Nauki i Szkolnictwa Wyższego przeznaczonych na działalność upowszechniającą naukę