Prospective five-year subsidence analysis of a cementless fully hydroxyapatite-coated femoral hip arthroplasty component

Early subsidence >1.5 mm is considered to be a predictive factor for later aseptic loosening of the femoral component following total hip arthroplasty (THA). The aim of this study was to assess five-year subsidence rates of the cementless hydroxyapatite-coated twinSys (R) stem (Mathys Ltd., Bettlach, Switzerland). This prospective single-surgeon series examined consecutive patients receiving a twinSys (R) stem at Maria Middelares Hospital, Belgium. Patients aged >85 years or unable to come to follow-up were excluded. Subsidence was assessed using Ein Bild Roentgen Analyse - Femoral Component Analysis (EBRA-FCA). Additional clinical and radiographic assessments were performed. Follow-ups were prospectively scheduled at two, five, 12, 24, and 60 months. In total, 218 THA (211 patients) were included. At five years, mean subsidence was 0.66 mm (95% CI: 0.43-0.90). Of the 211 patients, 95.2% had an excellent or good Harris Hip Score. There were few radiological changes. Kaplan-Meier analysis indicated five-year stem survival to be 98.4% (95% CI: 97.6-100%). Subsidence levels of the twinSys (R) femoral stem throughout the five years of follow-up were substantially lower than the 1.5 mm level predictive of aseptic loosening. This was reflected in the high five-year survival rate

The Belgian policy of funding antimicrobial stewardship in hospitals and trends of selected quality indicators for antimicrobial use, 1999-2010: a longitudinal study

Objectives: In order to improve antimicrobial (AM) use, a policy of providing technical and financial support to AM management teams (AMTs) was rolled out in all Belgian hospitals between 2002 and 2008. We aimed to analyse the association of this policy with AM use for the two indications accounting for the largest number of patients receiving AM: prophylaxis for major lower limb orthopaedic surgery and pneumonia. Design, setting, participants: We used patient-level data routinely collected in all Belgian acute care hospitals between 1999 and 2010. We modelled trends for selected quality indicators (QIs) using the year of AMT implementation in each hospital as the main 'change point', with fine-tuned case-mix adjustment. Of all admissions for lower limb orthopaedic surgery, and pneumonia between 1999 and 2010, 90% (325 094) and 95% (327 635), respectively, were found eligible for analyses. Outcomes: The surgery QI was defined as: cefazolin, dose in the expected range, and no use of other AM. For pneumonia, QIs were: ratio of oral/parenteral defined daily doses (DDD, O/P QI), and mean number of DDD minus penicillin, per 100 days of hospitalisation (DDD QI). Results: Between 1999 and 2010, the surgery QI improved from 59% to 71%, the O/P QI from 0.72 to 0.97, and the DDD QI from 96 to 64. Heterogeneity between hospitals was high. Overall, no association was found with the year of implementation of the AMT. Conclusions: Improvements have been observed but could not be related at the national level to the policy under study. However, these results cannot be extrapolated to other QIs for AM use in hospitals. Our findings do not question the need for AMT, nor the need for continuation of AMT funding. Several recommendations can be made in order to make the best of Belgium's unique political and financial commitments in that field

Démarches collaboratives de conception du projet urbain et de paysage : le cas du quartier de Tilff

Les démarches participatives traditionnelles initiées à l’occasion de la définition et de la légitimation de projets urbains donnent aux citoyens une capacité réelle ou ressentie très relative à influencer véritablement les décisions. Alors qu’il s’agit de le responsabiliser, le citoyen se retrouve souvent, malgré lui, dans un rôle d’opposant, distrait de tout débat et enjeux de fond réels, ou encore pris en otage. Le laboratoire Ville-Territoire et Paysage expérimente de nouvelles démarches de type collaboratives visant la co-production de connaissances et la création de médium liant naturellement l’ensemble des intervenants autour de la définition progressive d’un projet « ouvert » de territoire et des valeurs qui le fondent. Un des exercices consiste à élaborer des cartes cognitives et sensibles du milieu vécu au départ : de tables rondes mettant en présence différentes catégories d’habitants (usagers, personnes qualifiées) et des chercheurs, de promenades exploratoires, et de temps de restitution/interprétation/synthèse ; pour ensuite les entretenir de manière continue à travers une plateforme d’échanges. Le projet s’inscrit pleinement dans les trois axes prioritaires de la MSH; en considérant la dimension culturelle comme condition première de tout projet réellement durable.Démarches collaboratives de conception du projet urbain et de paysage : le cas du quartier de Tilff3. Good health and well-being11. Sustainable cities and communitie

Interface Modeling for Quality and Resource Management

We develop an interface-modeling framework for quality and resource management that captures configurable working points of hardware and software components in terms of functionality, resource usage and provision, and quality indicators such as performance and energy consumption. We base these aspects on partially-ordered sets to capture quality levels, budget sizes, and functional compatibility. This makes the framework widely applicable and domain independent (although we aim for embedded and cyber-physical systems). The framework paves the way for dynamic (re-)configuration and multi-objective optimization of component-based systems for quality- and resource-management purposes

Intercultural education for integrated education system

This paper is a brief description of the current developments in the educational system in the country and the need reform it. In terms of inter-ethnic relations in education, more prominent is the need for its interethnic integration. One of the ways to save and overcome the misunderstandings, and the integration of this system is seen precisely in the intercultural education that acknowledges and respects diversity and supports diversity or diversity in all areas of human life. That kind of education makes the students sensitive to the idea that people have naturally developed a different way of life, customs, traditions, values and worldview. The intercultural education tends to overcome the passive coexistence and to create a developed and sustainable way of living in a multicultural society as ours. This kind of upbringing and education should build individuals with intercultural competences who are capable of living and working in a multicultural environment. Hence, by analysing the advantages, principles, objectives and principles of intercultural education we will point out its necessity and a suitable way for introducing it into the curriculum, with the aim of improving and integrating the inter-ethnicity in the educational system, where it is most necessary and would give productive results in terms of building a healthy, stable and prosperous society. Keywords: multiculturalism, inter-culturalism, integration, educational system reform