92 research outputs found
'Skating on thin ice?' consultant surgeon's contemporary experience of adverse surgical events
A biomechanical study of the effects of simulated ulnar deviation on silicone finger joint implant failure
Silicone finger arthroplasties are used widely, especially for metacarpophalangeal joint replacement in patients with inflammatory arthritis. Implant failure is well recognized. The rates of failure in vivo differ substantially from experience in vivo. One cause of failure is felt to be post-operative ulnar deviation. The aim of our study was to test the effect of ulnar deviation testing on silicone finger implants. We tested 12 implants in three groups of four implants. The implants were submerged in a bath of Ringer’s solution at 370 °C throughout the experiment and tested in a rig held in 0°, 10° and 20° deviation. The rig was cycled at 1.5 Hz from 0°–90°. The implants were inspected every 500,000 cycles until a total of 4 million cycles. There was consistently increased wear and supination plastic deformity in going from 0°–20° deviation. This study confirms the adverse effects of ulnar deviation on silicone finger implant wear. It is likely that this combines with lateral pinch forces and sharp bone edges to cause catastrophic silicone implant failure. Level of evidence: III </jats:p
Ethical leadership in an age of evaluation: implications for whole—school well-being
The evaluation and inspection of many public services, including education, has become increasingly common in most countries in the developed world (McNamara & O’Hara, 2004; MacBeath & McGlynn, 2002). There are various reasons why this may be the case. It can be argued that it is, on the one hand, part of the movement towards low trust policies derived from the ideology of neo-liberalism which seeks to apply the values of the market to the public sector. On the other hand, it can be argued that increased evaluation is a necessary and defensible component of democratic accountability, responsibility and transparency (O’Neill, 2002). The research reported here sets out to explore the idea of a personal vision or core of ethics as being central to educational leadership, through in-depth interviews with a number of school leaders. The chapter begins by briefly placing educational leadership in the modern context, characterised by the paradox of apparently greater decentralisation of responsibility to schools being in fact coupled with a further centralisation of actual power and greatly increased surveillance of performance (Neave, 1998). Relevant developments internationally, and then specifically in the context of Ireland, are described. It is suggested that in Ireland the modern educational context may indeed be creating difficult ethical and moral dilemmas for leaders to face. To see if this is so in practice, five in-depth interviews with school principals are reported. The evidence arising from these interviews indicates that school leaders do feel guided by a strong moral or ethical compass
Investigating the role of the interleukin-23/-17A axis in rheumatoid arthritis
Objective. IL-23 is a pro-inflammatory cytokine proposed to be central to the development of autoimmune disease. We investigated whether IL-23, together with the downstream mediator IL-17A, was present and functional in RA in humans
Effects of Land Crabs on Leaf Litter Distributions and Accumulations in a Mainland Tropical Rain Forest 1
The effect of the fossorial land crab Gecarcinus quadratus (Gecarcinidae) on patterns of accumulation and distribution of leaf litter was studied for two years in the coastal primary forests of Costa Rica's Corcovado National Park. Within this mainland forest, G, quadratus achieve densities up to 6 crabs/m 2 in populations extending along the Park's Pacific coastline and inland for ca 600 m. Crabs selectively forage for fallen leaf litter and relocate what they collect to burrow chambers that extend from 15 to 150 cm deep ( N = 44), averaging (±SE) 48.9 ± 3.0 cm. Preference trials suggested that leaf choice by crabs may be species-specific. Excavated crab burrows revealed maximum leaf collections of 11.75 g dry mass– 2.5 times more leaf litter than collected by square-meter leaf fall traps over several seven-day sampling periods. Additionally, experimental crab exclosures (25 m 2 ) were established using a repeated measures randomized block design to test for changes in leaf litter as a function of reduced crab density. Exclosures accumulated significantly more (5.6 ± 3.9 times) leaf litter than did control treatments during the wet, but not the dry, seasons over this two-year study. Such extensive litter relocation by land crabs may affect profiles of soil organic carbon, rooting, and seedling distributions.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73250/1/j.1744-7429.2003.tb00590.x.pd
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