Arthroscopic observation was useful to detect loosening of the femoral component of unicompartmental knee arthroplasty in a recurrent hemoarthrosis

A case of recurrent hemarthrosis of the knee after a mobile-bearing unicompartmental knee arthroplasty (UKA; Oxford UKA) is described. A 58-year-old man met with a road traffic accident 10 months after UKA. He developed anteromedial pain and hemarthrosis of the knee joint 1 month after the accident, which required multiple aspirations. Physical examination showed no instability. Plain radiograph revealed no signs of loosening. All laboratory data, including bleeding and coagulation times, were within normal limits. Diagnostic arthroscopy demonstrated loosening of the femoral component. Any intraarticular pathology other than nonspecific synovitis was ruled out. The loose femoral component and polyethylene meniscal bearing were revised. Since then, hemarthrosis has not recurred

Capturing complexity: Mixing methods in the analysis of a European tobacco control policy network

Social network analysis (SNA), a method which can be used to explore networks in various contexts, has received increasing attention. Drawing on the development of European smoke-free policy, this paper explores how a mixed method approach to SNA can be utilised to investigate a complex policy network. Textual data from public documents, consultation submissions and websites were extracted, converted and analysed using plagiarism detection software and quantitative network analysis, and qualitative data from public documents and 35 interviews were thematically analysed. While the quantitative analysis enabled understanding of the network's structure and components, the qualitative analysis provided in-depth information about specific actors' positions, relationships and interactions. The paper establishes that SNA is suited to empirically testing and analysing networks in EU policymaking. It contributes to methodological debates about the antagonism between qualitative and quantitative approaches and demonstrates that qualitative and quantitative network analysis can offer a powerful tool for policy analysis

Public perceptions of shale gas in the UK : framing effects and decision heuristics

Using two equivalent descriptions of the shale gas development process, we asked individuals to indicate their levels of support as well as their perceptions of the risks and costs involved. In version 1, shale gas development was framed as ‘fracking’, whereas under version 2 it was framed as ‘using hydraulic pressure to extract natural gas from the ground’. We find that individuals’ support for shale gas development is much lower when using the term ‘fracking’ as opposed to the synonymous descriptive term, and moreover, these differences were substantive. Our analysis suggests that these differences appear to be largely the result of different assessments of the risks associated with ‘fracking’ as opposed to ‘using hydraulic pressure to extract natural gas from the ground’. Our proposed explanation for these differences rests on the idea that shale gas development is a technical and complex process and many individuals will be bounded by the rationality of scientific knowledge when it comes to understanding this process. In turn, individuals may be relying on simple decision heuristics shaped by the way this issue is framed by the media and other interested parties which may constrain meaningful discourse on this topic with the public. Our findings also highlight some of the potential pitfalls when it comes to relying on survey research for assessing the public’s views towards complex environmental issues

The choice for EU theorists: Establishing a common framework for analysis

European Union (EU) studies have entered a highly contentious and, arguably, creative phase. A range of theoretical perspectives, seemingly quite highly differentiated from one another, now compete for influence and lsquospacersquo. However, the questions remain: is EU studies developing theories which are truly competing theories? Or is it developing theories that do not compete so much as they aim to explain distinctly different pieces of the EU puzzle? This paper responds directly to these two questions, while reviewing recent literature on EU governance. It argues, first, that we lack theories of EU governance that are true rivals; and, second, that leading models explain different outcomes at different levels in a multi-level system of governance. The result is somewhat phoney debates between compatible theories masquerading as rivals, and between lsquocomparative politicsrsquo and lsquointernational relationsrsquo approaches. Above all, perhaps, we find middle range theories posing as general or lsquometa-theoriesrsquo. In the absence of a plausible general theory of EU governance, theorists must choose precisely which type of outcome theywish to explain

Techniques to assess the role of various components in retarding aging of rigid, faced thermal insulating foams

As industry began to evaluate CFC-replacements, it became apparent that foam performance characterizations have been based primarily on empirical evidence collected over a long period of gradualimprovements. Much of the existing wealth of knowledge was simply not applicable to new systems. The development of new products with CFC replacements requires understanding how formulation variables(polyol, isocyanate, blowing agent, catalyst) and manufacturing conditions affect foam properties, how conditions in use affect foam performance and how the process of sample selection and testing may be used to provide feedback to design improved foams.Lorsque l?industrie a commenc\ue9 \ue0 \ue9valuer des solutions de rechange aux chlorofluorocarbures (CFC), il est devenu apparent que les caract\ue9risations de la performance de la mousse \ue9taient jusque l\ue0 fond\ue9es essentiellement sur des preuves empiriques recueillies au fil d?une longue p\ue9riode d?am\ue9liorations graduelles. Une part importante des connaissances existantes n?\ue9tait tout simplement pas applicable aux nouveaux syst\ue8mes. Le d\ue9veloppement de nouveaux produits avec solutions de rechange aux CFC requiert une compr\ue9hension de la fa\ue7on dont les variables de formulation (polyol, isocyanate, agent d?expansion, catalyseur) et les conditions de fabrication influent sur les propri\ue9t\ue9s de la mousse, dont les conditions en service influent \ue0 leur tour sur sa performance et dont le processus de s\ue9lection et de mise \ue0 l?essai des \ue9chantillons peut \ueatre utilis\ue9 pour g\ue9n\ue9rer une r\ue9troaction aux fins de la conception de mousses am\ue9lior\ue9es.Also presented at the World Congress : Polyurethane '93Peer reviewed: YesNRC publication: Ye

Mental Health in Anesthesiology and ICU Staff: Sense of Coherence Matters

Background: Hospitals, and particularly intensive care units (ICUs), are demanding and stressful workplaces. Physicians and nurse staff are exposed to various stressors: emergency situations, patients' deaths, and team conflicts. Correspondingly, several studies describe increased rates of PTSD symptoms and other mental health problems in hospital staff. Therefore, it is important to identify factors that lower the risk of psychopathological symptoms. High levels of sense of coherence (SOC) and general resilience as well as an internal locus of control (LOC) have already been identified as important health-benefitting factors in medical staff. The current study aimed to evaluate their unique impact in an ICU and an anesthesiology unit.Method: The cross-sectional online survey investigated SOC, LOC, general resilience, general mental health problems as well as PTSD symptoms in nurses and physicians within an ICU and an anesthesiology unit (N = 52, 65.4% female). General mental health problems were assessed using the ICD-10-Symptom-Rating (ISR) and PTSD symptoms were measured using the PTSD Checklist for DSM-5 (PCL-5). The Sense of Coherence Scale (SOC-L9) assessed SOC, the Resilience Scale (RS-11) measured general resilience, and LOC was determined using a 4-item scale for the assessment of control beliefs (IE-4).Results: As expected, SOC, r = −0.72, p < 0.001, general resilience, r = −0.46, p < 0.001, and internal LOC, r = −0.51, p < 0.001, were negatively correlated with general mental health problems while an external LOC showed a positive association, r = 0.35, p = 0.010. However, in a multiple regression model, R2 = 53.9%, F(4, 47) = 13.73, p < 0.001, only SOC significantly predicted general mental health problems by uniquely accounting for 13% of the variance. For PTSD symptoms, which were highly correlated with general mental health problems, a similar pattern of results was found.Conclusion: SOC was found to be the most important correlate of both general mental health problems and PTSD symptoms in an ICU and an anesthesiology unit. Thus, if further evidenced by longitudinal studies, implementing interventions focusing on an enhancement of SOC in training programs for ICU and anesthesiology unit staff might be a promising approach to prevent or reduce psychopathological symptoms