The Oxford hip score: the patient's perspective

BACKGROUND: In the last 25 years, assessment of orthopaedic intervention has become patient focused, with the development of self-completion patient-centred outcome measures. The Oxford hip score (OHS) is a joint specific outcome measure tool designed to assess disability in patients undergoing total hip replacement (THR). Although the psychometric properties of the OHS have been rigorously examined, there is little research on the patient's perspective of the OHS. Therefore, the aim of this study is to assess whether the OHS is an adequate disability measure from the patient's perspective using qualitative analysis of annotations written on the OHS by patients. METHODS: In total, 276 orthopaedic patients completed an OHS between April 2004 and May 2005. One hundred and fifty six pre-operative patients listed for a THR completed the OHS during a pre-admission assessment clinic, and 120 post-operative patients completed the OHS postally in the home setting. Patient's unprompted annotations in response to the questions on the OHS were recorded and grouped into thematic categories. RESULTS: In total, 46 (17%) patients made 52 annotations when completing the OHS. These annotations identified five main areas of difficulty that patients experienced: lack of question clarity (particularly concerning the use of aids), difficulty in reporting measurements of pain, restrictive and irrelevant questions, the influence of co-morbidities on responses, and double-barrelled questions. CONCLUSION: Although the OHS is a useful short tool for the assessment of disability in patients undergoing THR, this study identified several problem areas that are applicable to patient-centred outcome tools in general. To overcome these current limitations, further work is underway to develop a more individualised patient-centred outcome measure of disability for use in patients with osteoarthritis

Role of antiplatelet therapy in cardiovascular disease II: Ischemic stroke.

The etiology of cerebrovascular disease is heterogeneous, with the majority of strokes being of ischemic origin. Transient ischemic attack is now considered to be an important precursor and long-term risk factor for ischemic stroke. Given the lack of acute therapies for ischemic stroke, current treatments focus on secondary prevention through risk-factor management, pharmacotherapy and interventional approaches. As illustrated in this paper, antiplatelet agents (e.g. clopidogrel, aspirin, dipyridamole) are the cornerstone of therapy for prevention of recurrent ischemic stroke

Thermal noise limitations to force measurements with torsion pendulums: Applications to the measurement of the Casimir force and its thermal correction

A general analysis of thermal noise in torsion pendulums is presented. The specific case where the torsion angle is kept fixed by electronic feedback is analyzed. This analysis is applied to a recent experiment that employed a torsion pendulum to measure the Casimir force. The ultimate limit to the distance at which the Casimir force can be measured to high accuracy is discussed, and in particular the prospects for measuring the thermal correction are elaborated upon.Comment: one figure, five pages, to be submitted to Phys Rev

Vitalism in Early Modern Medical and Philosophical Thought

Vitalism is a notoriously deceptive term. It is very often defined as the view, in biology, in early modern medicine and differently, in early modern philosophy, that living beings differ from the rest of the physical universe due to their possessing an additional ‘life-force’, ‘vital principle’, ‘entelechy’, enormon or élan vital. Such definitions most often have an explicit pejorative dimension: vitalism is a primitive or archaic view, that has somehow survived the emergence of modern science (the latter being defined in many different ways, from demystified Cartesian reductionism to experimental medicine, biochemistry or genetics: Cimino and Duchesneau eds. 1997, Normandin and Wolfe eds. 2013). Such dismissive definitions of vitalism are meant to dispense with argument or analysis. Curiously, the term has gained some popularity in English-language scholarship on early modern philosophy in the past few decades, where it is used without any pejorative dimension, to refer to a kind of ‘active matter’ view, in which matter is not reducible to the (mechanistic) properties of size, shape and motion, possessing instead some internal dynamism or activity (see e.g. James 1999, Boyle 2018, Borcherding forthcoming). The latter meaning is close to what the Cambridge Platonist Ralph Cudworth termed ‘hylozoism’, namely the attribution of life, agency or mind to matter, and he implicitly targeted several figures I shall mention here, notably Margaret Cavendish and Francis Glisson, for holding this view. However, one point I shall make in this entry is that when vitalism first appears by name, and as a self-designation, in the Montpellier School (associated with the Faculty of Medicine at the University of Montpellier, in the second half of the eighteenth century; thus vitalisme appears first, followed shortly thereafter by Vitalismus in German, with ‘vitalism’ appearing in English publications only in the early nineteenth century: Toepfer 2011), it is quite different from both the more ‘supernatural’ view described above – chiefly espoused by its rather obsessive opponents – and from the more neutral, but also de-biologized philosophical view (that of e.g. Cavendish or Conway who are, broadly speaking naturalists). Rather than appealing to a metaphysics of vital force, or of self-organizing matter, this version of vitalism, which I shall refer to as ‘medical vitalism’, seems to be more of a ‘systemic’ theory: an attempt to grasp and describe top-level (‘organizational’, ‘organismic’, ‘holistic’) features of living systems (Wolfe 2017, 2019). In this entry I seek to introduce some periodization in our thinking about early modern (and Enlightenment) vitalism, emphasizing the difference between the seventeenth-century context and that of the following generations – culminating in the ideas of the Montpellier School. This periodization should also function as a kind of taxonomy or at least distinction between some basic types of vitalism. As I discuss in closing, these distinctions can cut across the texts and figures we are dealing with, differently: metaphysical vs. non-metaphysical vitalism, philosophical vs. medical vitalism, medical vs. ‘embryological’ vitalism, and so on. A difference I can only mention but not explore in detail is that the more medically grounded, ‘organismic’ vitalism is significantly post-Cartesian while the more biological/embryological vitalism is, inasmuch as it is a dynamic, self-organizing matter theory, an extension of Renaissance ideas (chymiatry, Galenism and in general theories of medical spirits). I examine successively vitalism’s Renaissance prehistory, its proliferation as ‘vital matter theory’ in seventeenth-century England (in authors such as Cavendish, Conway and Glisson, with brief considerations on Harvey and van Helmont), and its mature expression in eighteenth-century Montpellier (notably with Bordeu and Ménuret de Chambaud)

Organisational participation and women - an attitude problem?

Employee participation is a dynamic and contested area of organisational behaviour, attracting continuing academic, practitioner and policy interest and debate. This chapter focuses on organisational participation and women

How being appreciative creates change – theory in practice from health and social care in Scotland

This paper develops understanding of appreciative action research that generates curiosity and motivation as a better platform for collaborative change. Blending theory and practice it draws on the example of the My Home Life leadership programme in Scotland that explores the concepts and approaches of ‘Caring Conversations’ and ‘playful provocation’ in care homes for older people. The paper shows how they expand notions of appreciation and help people to deepen inquiry, explore values, acknowledge and express emotion without dispute or judgement, articulate tacit knowledge and give voice to things previously thought to be ‘unsayable’. We explore how these generative approaches act as a powerful positive ‘disruption’ that brings existing relationships to life, supports a positive attitude to risk-taking and helps to devise new approaches to the local design and testing of approaches to problems. Ultimately these approaches play an important part in developing understanding of how to do appreciative action research to enhance relationships and more strengths or assets-based and collaborative ways of working and so, to develop new possibilities for changing social systems and a more future-making orientation to action research

Psychometric Evaluation of the Arabic Version of the Spiritual Well-Being Scale on a Sample of Jordanian Arab Christians

This paper assesses the psychometric properties of the Arabic version of the Spiritual Well-Being Scale (SWBS) in an Arab Christian sample by analyzing its internal structure. A convenience sample of 340 Arab Christians was recruited from the adult community population of northern Jordan. Data were collected through a self-completion, anonymous questionnaire distributed through church and community groups. Principal Components factor analysis, non-parametric bivariate statistics, and Cronbach's alpha were used to assess the psychometric properties of the total scale and its subscales. The findings broadly supported the factor structure of the SWBS in other Arab samples in that the scale consists of three factors, representing positive existential well-being, affiliation, and alienation subscales. In conclusion, these preliminary findings suggest that the Arabic version of the SWBS can be used as an instrument to measure levels of spiritual well-being in Arab Christian populations. </jats:p

Dealing with daily emotions—supportive activities for the elderly in a municipal care setting

There are diverse descriptions of supportive activities in nursing to be found in the literature. What they have in common is their association with good care outcomes, but they may differ depending on the context in which the care is given. In a Swedish municipal elderly care setting, registered nurses (RN) work in a consultative way and they describe a part of their tasks as comprising supportive activities without specifying what kind of supportive activities they mean. The aim of the study was to explore the main concern of the support given by RN to a group of patients in an elderly home care setting. The study was conducted using Grounded Theory. Data were collected using nonparticipant observations regarding the supportive activities of 12 RN at the home of 36 patients between the ages of 80 and 102. Most of the home visit lasted about 40 min but some lasted for 90 min. The central category was about dealing with daily emotions. This was done by encouraging the situation and reducing the patient's limitations, but situations also occurred in which there was a gap of support. Support was about capturing the emotions that the patient expressed for a particular moment, but there were also situations in which RN chose not to give support. To develop a holistic eldercare, more knowledge is needed about the factors causing the RN to choose not to provide support on some occasions