15 research outputs found
"I could have a proper ankle" - a qualitative study of patients' perceptions of total ankle replacement and ankle fusion surgery.
BACKGROUND: End-stage ankle osteoarthritis typically causes severe pain and impaired function. Surgical treatment involves total ankle replacement (TAR) or ankle fusion. Definitive evidence about which procedure is optimal is lacking. No previous studies have thoroughly explored patients' experiences across the entire TAR/ankle fusion pathway. This study aimed to address this gap by exploring perceptions of surgery, education, rehabilitation and outcomes among patients who had undergone TAR or ankle fusion. METHODS: Seven participants were purposively selected from an orthopaedic centre in northern England (3 females, 4 males). Participants had undergone primary TAR without revision (n = 2), TAR requiring revision (n = 3) or ankle fusion (n = 2). Each participant completed a single semi-structured interview. Interviews were digitally recorded, transcribed verbatim and analysed thematically. RESULTS: Three themes, each with two subthemes, were identified: decision-making (seeking help; surgical options), perceptions of support (information/education; clinical support) and impact on the individual (personal circumstances and beliefs; post-operative outcomes). Pain affecting participants' valued activities was key to their decision to seek help. Participants' decision between TAR and ankle fusion was influenced by multiple factors. Concerns regarding the lack of joint flexibility following fusion were highlighted, with some participants perceiving TAR as a "proper ankle" that would enable them to avoid limping. Participants obtained information from various sources, with most feeling that the education from their care team was inadequate. Participants' individual circumstances and beliefs influenced their decision-making and perceptions of their post-operative outcomes. Finally, whilst most participants were pleased with their outcomes, some experienced substantial ongoing problems such as difficulty walking and chronic pain. CONCLUSIONS: This study demonstrates the importance of providing adequate education about TAR and ankle fusion to enable patients to make informed decisions. Most participants felt that the education and clinical support they received did not fully meet their needs. Participants' personal circumstances and beliefs had a strong influence on their decision-making and perceptions of their post-operative outcomes, highlighting the need to personally tailor education and clinical support. Future work with a larger sample of patients and other key stakeholders is required to develop consensus-based guidelines on pre- and post-operative support for patients undergoing TAR/ankle fusion
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Labr3:Ce scintillators for gamma ray spectroscopy
In this paper, we report on a relatively new scintillator - LaBr3 for gamma ray spectroscopy. Crystals of this scintillator have been grown using Bridgman process. This material when doped with cerium has high light output (~;60,000 photons/MeV) and fast principal decay constant (less than 25 ns). Furthermore, it shows excellent energy resolution for gamma-ray detection. Energy resolution of 3.2 percent (FWHM) has been achieved for 662 keV photons (137Cs source) at room temperature. High timing resolution (260 ps - FWHM) has been recorded with LaBr3-PMT and BaF2-PMT detectors operating in coincidence mode using 511 keV positron annihilation gamma-ray pairs. Details of its scintillation properties, and variation of these properties with changing cerium concentration are reported. Potential applications of this material are also addressed
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LaCl{sub 3}:Ce scintillator for Gamma ray detection
In this paper, we report on a relatively new cerium doped scintillator - LaCl3 for gamma ray spectroscopy. Crystals of this scintillator have been grown using Bridgman method. This material when doped with 10% cerium has high light output (~50,000 photons/MeV) and fast principal decay time constant (~20 ns). Furthermore, it shows excellent energy resolution for gamma ray detection. For example, energy resolution as low as 3.2% (FWHM) has been achieved with 662 keV photons (137Cs source) at room temperature. Also high timing resolution (264 ps - FWHM) has been recorded with LaCl3-PMT and BaF2-PMT detectors operating in coincidence using 511 keV positron annihilation gamma ray pairs. Details of crystal growth, scintillation properties, and variation of these properties with cerium concentration are also reported
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RbGd{sub 2}Br{sub 7}:Ce scintillators for gamma ray and thermal neutron detection
In this paper, we report on gamma ray and thermal neutron detection with RbGd2Br7:Ce scintillators. RbGd2Br7:Ce (RGB) is a new scintillator material, which shows high light output (56,000 photons/MeV) and has a fast principal decay constant (45 ns) when doped with 10% Ce. These properties make RGB an attractive scintillator for g-ray detection. Also, due to the presence of Gd as a constituent, RGB has a high cross section for thermal neutron absorption and can achieve close to 100% stopping efficiency with 0.5 mm thick RGB crystals. Crystals of RGB with three different Ce concentrations (0.1, 5, and 10%) have been grown and their basic scintillation properties such as light output, decay time, and emission spectrum have been measured. In addition, high efficiency thermal neutron detection has been confirmed in our studies