Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

A Methodological Proposal for the Development of Natura 2000 Sites Management Plans

This paper makes recommendations for the development of Management Plans for Natura 2000 Sites, enabling future managers and decision-makers to elaborate and implement their own plans more efficiently and in a more informed fashion. The original methodology entailed a 10 phase plan, starting with “Problem Classification and Stakeholder Identification” and ending with Revision and/or Reformulation of the Management Plan”. It was utilized during the Pico da Vara Special Protected Area Management Plan elaboration process in 2005 by SPEA, on the behalf of the LIFE Priolo Project. Subsequent feedback led to an improved, more complete and balanced methodology capable of avoiding the repetition of similar and future errors (about 80% of scheduled activities were achieved). Although it was not successful in obtaining full financing, this process succeed in characterizing the SPA and its conservation issues and in unifying the divergent interests of public and private organizations by involving them in the plan’s development . This proved that the success of effective Nature conservation and particularly of Natura 2000 depends on the synergy of fundamental practices, such as the production and sharing of accurate thematic geographic data (for characterization, analysis and monitoring), and also on guaranteeing the participation and co-responsibility of all stakeholders in the site management.Peer Reviewe