Endoscopic treatment of prepatellar bursitis

Operative treatment of prepatellar bursitis is indicated in intractable bursitis. The most common complication of surgical treatment for prepatellar bursitis is skin problems. For traumatic prepatellar bursitis, we propose a protocol of outpatient endoscopic surgery under local anaesthesia. From September 1996 to February 2001, 60 cases of failed nonoperative treatment for prepatellar bursitis were included. The average age was 33.5 ± 11.1 years (range 21–55). The average operation duration was 18 minutes. Two to three mini-arthroscopic portals were used in our series. No sutures or a simple suture was needed for the portals after operation. After follow-up for an average of 36.3 months, all patients are were symptom-free and had regained knee function. None of the population had local tenderness or hypo-aesthesia around their wound. Their radiographic and sonographic examinations showed no recurrence of bursitis. Outpatient arthroscopic bursectomy under local anaesthesia is an effective procedure for the treatment of post-traumatic prepatellar bursitis after failed conservative treatments. Both the cosmetic results and functional results were satisfactory

Relevance of large litter bag burial for the study of leaf breakdown in the hyporheic zone

Particulate organic matter is the major source of energy for most low-order streams, but a large part of this litter is buried within bed sediment during floods and thus become poorly available for benthic food webs. The fate of this buried litter is little studied. In most cases, measures of breakdown rates consist of burying a known mass of litter within the stream sediment and following its breakdown over time. We tested this method using large litter bags (15 x 15 cm) and two field experiments. First, we used litter large bags filled with Alnus glutinosa leaves (buried at 20 cm depth with a shovel) in six stations within different land-use contexts and with different sediment grain sizes. Breakdown rates were surprisingly high (0.0011–0.0188 day-1) and neither correlate with most of the physico-chemical characteristics measured in the interstitial habitats nor with the land-use around the stream. In contrast, the rates were negatively correlated with a decrease in oxygen concentrations between surface and buried bags and positively correlated with both the percentage of coarse particles (20–40 mm) in the sediment and benthic macro-invertebrate richness. These results suggest that the vertical exchanges with surface water in the hyporheic zone play a crucial role in litter breakdown. Second, an experimental modification of local sediment (removing fine particles with a shovel to increase vertical exchanges) highlighted the influence of grain size on water and oxygen exchanges, but had no effect on hyporheic breakdown rates. Burying large litter bags within sediments may thus not be a relevant method, especially in clogged conditions, due to changes induced through the burial process in the vertical connectivity between surface and interstitial habitats that modify organic matter processing

Gender Equality and Corporate Social Responsibility in the Middle East

This chapter focuses on corporate social responsibility (CSR) in relation to gender equality in the Arab Middle East. It examines the relationship between CSR and gender in the workplace whilst exploring the link between CSR and human resource management (HRM) policies and practices. The chapter first presents some seminal work on gender equality and diversity management, looking at the business case for gender equality within the CSR and HRM contexts, before engaging with relevant work on gender equality in the Arab Middle East. It concludes by offering recommendations on advancing the equality agenda at the macro- and meso-levels, within a framework which recognises the centrality of agency of women, as well as the potential of positive changes through corporations being seen as ‘agents of change’. The chapter advocates for organisational and governmental policies to promote gender equality in the Arab Middle East

Effects of laterally wedged insoles on symptoms and disease progression in medial knee osteoarthritis: a protocol for a randomised, double-blind, placebo controlled trial

<p>Abstract</p> <p>Background</p> <p>Whilst laterally wedged insoles, worn inside the shoes, are advocated as a simple, inexpensive, non-toxic self-administered intervention for knee osteoarthritis (OA), there is currently limited evidence to support their use. The aim of this randomised, double-blind controlled trial is to determine whether laterally wedges insoles lead to greater improvements in knee pain, physical function and health-related quality of life, and slower structural disease progression as well as being more cost-effective, than control flat insoles in people with medial knee OA.</p> <p>Methods/Design</p> <p>Two hundred participants with painful radiographic medial knee OA and varus malalignment will be recruited from the community and randomly allocated to lateral wedge or control insole groups using concealed allocation. Participants will be blinded as to which insole is considered therapeutic. Blinded follow up assessment will be conducted at 12 months after randomisation. The outcome measures are valid and reliable measures recommended for OA clinical trials. Questionnaires will assess changes in pain, physical function and health-related quality-of-life. Magnetic resonance imaging will measure changes in tibial cartilage volume. To evaluate cost-effectiveness, participants will record the use of all health-related treatments in a log-book returned to the assessor on a monthly basis. To test the effect of the intervention using an intention-to-treat analysis, linear regression modelling will be applied adjusting for baseline outcome values and other demographic characteristics.</p> <p>Discussion</p> <p>Results from this trial will contribute to the evidence regarding the effectiveness of laterally wedged insoles for the management of medial knee OA.</p> <p>Trial registration</p> <p>ACTR12605000503628; NCT00415259.</p

Understanding the influence of race/Ethnicity, gender, and class on inequalities in academic and non-academic outcomes among eighth-grade students: findings from an intersectionality approach

Socioeconomic, racial/ethnic, and gender inequalities in academic achievement have been widely reported in the US, but how these three axes of inequality intersect to determine academic and non-academic outcomes among school-aged children is not well understood. Using data from the US Early Childhood Longitudinal Study—Kindergarten (ECLS-K; N = 10,115), we apply an intersectionality approach to examine inequalities across eighth-grade outcomes at the intersection of six racial/ethnic and gender groups (Latino girls and boys, Black girls and boys, and White girls and boys) and four classes of socioeconomic advantage/disadvantage. Results of mixture models show large inequalities in socioemotional outcomes (internalizing behavior, locus of control, and self-concept) across classes of advantage/disadvantage. Within classes of advantage/disadvantage, racial/ethnic and gender inequalities are predominantly found in the most advantaged class, where Black boys and girls, and Latina girls, underperform White boys in academic assessments, but not in socioemotional outcomes. In these latter outcomes, Black boys and girls perform better than White boys. Latino boys show small differences as compared to White boys, mainly in science assessments. The contrasting outcomes between racial/ethnic and gender minorities in self-assessment and socioemotional outcomes, as compared to standardized assessments, highlight the detrimental effect that intersecting racial/ethnic and gender discrimination have in patterning academic outcomes that predict success in adult life. Interventions to eliminate achievement gaps cannot fully succeed as long as social stratification caused by gender and racial discrimination is not addressed

What can health inequalities researchers learn from an intersectionality perspective?:Understanding social dynamics with an inter-categorical approach

The concept of intersectionality was developed by social scientists seeking to analyse the multiple interacting influences of social location, identity and historical oppression. Despite broad take-up elsewhere, its application in public health remains underdeveloped. We consider how health inequalities research in the United Kingdom has predominantly taken class and later socioeconomic position as its key axis in a manner that tends to overlook other crucial dimensions. We especially focus on international research on ethnicity, gender and caste to argue that an intersectional perspective is relevant for health inequalities research because it compels researchers to move beyond (but not ignore) class and socioeconomic position in analysing the structural determinants of health. Drawing on these theoretical developments, we argue for an inter-categorical conceptualisation of social location that recognises differentiation without reifying social groupings – thus encouraging researchers to focus on social dynamics rather than social categories, recognising that experiences of advantage and disadvantage reflect the exercise of power across social institutions. Such an understanding may help address the historic tendency of health inequalities research to privilege methodological issues and consider different axes of inequality in isolation from one another, encouraging researchers to move beyond micro-level behaviours to consider the structural drivers of inequalities