Können "Blogs" den klassischen Journalismus ersetzen? Zum Strukturwandel durch den "Journalismus der Bürger"

Das Internet schafft vielfältige Möglichkeiten zur Partizipation. Via Mall, News-Liste, Chat-room oder eigenem Weblog (Kunstwort aus "Web" und "Logbuch") kann sich heute prinzipiell jeder Nutzer an den gesellschaftlichen Diskursen beteiligen. Die Wissenschaft spricht von einer Web(log)-Community. Auch die Medien laden ihre Leser, Zuhörer oder Zuschauer zum Mitmachen ein. Dabei geht es nicht mehr nur um Gewinnspiele, sondern um genuin journalistische Inhalte. Diese werden teilweise in Co-Produktion von Bürgern und Journalisten erstellt, teilweise auch ganz ohne das Zutun von Profis entwickelt. Das so entstandene Mit-, Neben- oder Gegeneinander von Laien und Profis setzt den klassischen Journalismus unter Druck. Der Aufsatz versucht zu zeigen, dass mit dem sogenannten Bürgerjournalismus weder systematisch noch strukturell wirklicher Journalismus vorliegt. Gleichwohl verändert sich der traditionelle Journalismus unter den neuen technischen Möglichkeiten. Sofern Journalismus als ein dem Gemeinwohl dienliches Publizieren verstanden wird, darf dieser bestimmte Standards (d.h. Streben nach Objektivität, Ausschluß von Partikularinteressen etc.) nicht leichthin verspielen. EnglishElvira Steppacher: Can Blogs Substitude Traditional Journalism? Consequences of Structural Changes by Civil Blagging The internetoperred new ways of communication and participation. Every user of the internet is able to participate in any public discussion via E-mail, news-lists, chat-rooms or own weblogs. So, there is a new Web(log)community around the world. The established media meanwhile invite their readers, listeners and viewers to participate in these activities even in their journalistic field. Journalistic peaces are produced either in co-production or by users themselves without help of journalists. This has become a great challenge for the traditional dassie journalism. This artide shows that the new so-called civil journalism can neither by its structure nor by its system be regarded as real journalism. On the other hand, due to modern technical possibilities, dassie journalism is chan- ging its structure. As far as journalism is understood as professional public service, it cannot give up its traditional standards.

Femoral Morphology Differs Between Deficient and Excessive Acetabular Coverage

Structural deformities of the femoral head occurring during skeletal development (eg, Legg-Calvé-Perthes disease) are associated with individual shapes of the acetabulum but it is unclear whether differences in acetabular shape are associated with differences in proximal femoral shape. We questioned whether the amount of acetabular coverage influences femoral morphology. We retrospectively compared the proximal femoral anatomy of 50 selected patients (50 hips) with developmental dysplasia of the hip (lateral center-edge angle [LCE]≤25°; acetabular index≥14°) with 45 selected patients (50 hips) with a deep acetabulum (LCE≥39°). Using MRI arthrography we measured head sphericity, epiphyseal shape, epiphyseal extension, and femoral head-neck offset. A deep acetabulum was associated with a more spherical head shape, increased epiphyseal height with a pronounced extension of the epiphysis towards the femoral neck, and an increased offset. In contrast, dysplastic hips showed an elliptical femoral head, decreased epiphyseal height with a less pronounced extension of the epiphysis, and decreased head-neck offset. Hips with different acetabular coverage are associated with different proximal femoral anatomy. A nonspherical head in dysplastic hips could lead to joint incongruity after an acetabular reorientation procedure. Level of Evidence: Level IV, retrospective comparative study. See the Guidelines for Authors for a complete description of levels of evidenc

Mean 20-year Followup of Bernese Periacetabular Osteotomy

The goal of the Bernese periacetabular osteotomy is to correct the deficient acetabular coverage in hips with developmental dysplasia to prevent secondary osteoarthrosis. We determined the 20-year survivorship of symptomatic patients treated with this procedure, determined the clinical and radiographic outcomes of the surviving hips, and identified factors predicting poor outcome. We retrospectively evaluated the first 63 patients (75 hips) who underwent periacetabular osteotomy at the institution where this technique was developed. The mean age of the patients at surgery was 29years (range, 13-56years), and preoperatively 24% presented with advanced grades of osteoarthritis. Four patients (five hips) were lost to followup and one patient (two hips) died. The remaining 58 patients (68 hips) were followed for a minimum of 19years (mean, 20.4years; range, 19-23years) and 41 hips (60%) were preserved at last followup. The overall mean Merle d'Aubigné and Postel score decreased in comparison to the 10-year value and was similar to the preoperative score. We observed no major changes in any of the radiographic parameters during the 20-year postoperative period except the osteoarthritis score. We identified six factors predicting poor outcome: age at surgery, preoperative Merle d'Aubigné and Postel score, positive anterior impingement test, limp, osteoarthrosis grade, and the postoperative extrusion index. Periacetabular osteotomy is an effective technique for treating symptomatic developmental dysplasia of the hip and can maintain the natural hip at least 19years in selected patients. Level of Evidence: Level III, prognostic study. See the Guidelines for Authors for a complete description of levels of evidenc

The Iliocapsularis Muscle: An Important Stabilizer in the Dysplastic Hip

Background: The iliocapsularis muscle is a little known muscle overlying the anterior hip capsule postulated to function as a stabilizer of dysplastic hips. Theoretically, this muscle would be hypertrophied in dysplastic hips and, conversely, atrophied in stable and well-constrained hips. However, these observations have not been confirmed and the true function of this muscle remains unknown. Questions/purposes: We quantified the anatomic dimensions and degree of fatty infiltration of the iliocapsularis muscle and compared the results for 45 hips with deficient acetabular coverage (Group I) with 40 hips with excessive acetabular coverage (Group II). Patients and Methods: We used MR arthrography to evaluate anatomic dimensions (thickness, width, circumference, cross-sectional area [CSA], and partial volume) and the amount of fatty infiltration. Results: We observed increased thickness, width, circumference, CSA, and partial volume of the iliocapsularis muscle in Group I when compared with Group II. Additionally, hips in Group I had a lower prevalence of fatty infiltration compared with those in Group II. The iliocapsularis muscle typically was hypertrophied, and there was less fatty infiltration in dysplastic hips compared with hips with excessive acetabular coverage. Conclusion: These observations suggest the iliocapsularis muscle is important for stabilizing the femoral head in a deficient acetabulum. This muscle serves as an anatomic landmark when performing a periacetabular osteotomy. Additionally, preoperative evaluation of morphologic features of the muscle can be used as an adjunct for decision making when treating patients with borderline hip dysplasia or femoroacetabular impingemen

A problem shared is a problem halved? Comparing burdens arising for family caregivers of patients with disorders of consciousness in institutionalized versus at home care

Steppacher I, Kißler J. A problem shared is a problem halved? Comparing burdens arising for family caregivers of patients with disorders of consciousness in institutionalized versus at home care. BMC Psychology. 2018;6(1): 58.Background Disorders-of-consciousness (DOC) are rare conditions leading to very severe physical and mental disabilities. Providing care for DOC patients has been described as a stressful experience, eroding the physical and psychological health of the caregiver. Different forms of care may have different impacts on the caregivers and institutionalized care has been suggested to have an unburdening effect, but this possibility has never been empirically studied. To address this issue, in this study caregiver-burden between family-caregivers who provide home care themselves and those who have placed their patients in a specialized care unit is compared. Method The demographics of the caregivers, life satisfaction, coping strategies, meaning in life, and grief reactions were assessed with questionnaires in 81 long term (m = 7.9 years) caregivers (44 patients in specialized care-units, 37 patients taken care of at home). Results Caregiver groups were similar on the vast majority of demographic factors. Remarkably, there were no major differences in self-assessed burden and distress between the two caregiver groups. They both demonstrated generally reduced life satisfaction, were especially dissatisfied with their amount of spare time, and many caregivers in both groups demonstrated long lasting grief reactions, as well as a somewhat enhanced crisis of meaning. However, caregivers with patients in institutionalized care exhibited enhanced self-accusation as well as reduced satisfaction with their own health. Home care caregivers, on the other hand, report below average opportunities to care for themselves. Conclusion Surprisingly, placement in institutionalized care in itself does not seem to disburden caregivers as much as expected as the amount of subjective care-giving burden and reported distress is on average similarly high, although profiles differ somewhat according to type of care. Moreover, vast inter-individual variability can be observed. Further research should address the mechanisms that foster positive adjustment and reduce negative impacts for care providers regardless of type of care, enabling the health care system, institutions and self-aid groups alike, to provide more specific support for caregivers by addressing the topics of quality-of-life, own health, self care, and grief reactions

Joint-preserving Surgery Improves Pain, Range of Motion, and Abductor Strength After Legg-Calvé-Perthes Disease

Background: Patients after Legg-Calvé-Perthes disease (LCPD) often develop pain, impaired ROM, abductor weakness, and progression of osteoarthritis (OA) in early adulthood. Based on intraoperative observations during surgical hip dislocation, we established an algorithm for more detailed characterization of the underlying pathomorphologies with a proposed joint-preserving surgical treatment. Questions/purposes: We asked if patients after LCPD treated with our algorithm experienced (1) reduced pain; (2) improved hip function; and/or (3) prevention of OA progression; we then determined (4) the intraoperative damage patterns; (5) the survival of the hip; and (6) factors predicting the need for a conversion to THA; radiographic progression of OA; a Merle d'Aubigné-Postel score below 15 at last followup; and/or the need for revision surgery. Methods: We retrospectively reviewed 53 patients after LCPD who underwent joint-preserving surgery (40 surgical hip dislocations, eight acetabular osteotomies, four combined procedures, and one intertrochanteric osteotomy). We obtained Merle d'Aubigné-Postel scores to assess pain; OA was assessed using Tönnis grades. Survival and predictive factors were calculated with the univariate Cox regression. Fifty of the 53 patients were evaluated at a minimum of 5.1years (mean, 8.2years; range, 5.1-12.8years). Results: Pain and hip function improved at followup from a median of 4 points to 5 points. The mean increase in Tönnis grades at last followup was 0.3 to 0.8. The survival of surgery at 5years was 86%; 13 factors related to survival. Conclusion: Patients with symptoms resulting from pathomorphologic deformities after LCPD benefit from joint-preserving surgery with specific treatment of individual structural abnormalities. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidenc

Validation of a statistical shape model-based 2D/3D reconstruction method for determination of cup orientation after THA

Purpose: The aim of this study was to validate the accuracy and reproducibility of a statistical shape model-based 2D/3D reconstruction method for determining cup orientation after total hip arthroplasty. With a statistical shape model, this method allows reconstructing a patient-specific 3D-model of the pelvis from a standard AP X-ray radiograph. Cup orientation (inclination and anteversion) is then calculated with respect to the anterior pelvic plane that is derived from the reconstructed model. Materials and methods: The validation study was conducted retrospectively on datasets of 29 patients (31 hips). Among them, there were 15 men (15 hips) and 14 women (16 hips). The average age of the patients was 69.4±8.5(49−82) years. Each dataset has one postoperative X-ray radiograph and one postoperative CT scan. The postoperative CT scan for each patient was used to establish the ground truth for the cup orientation. The cup anteversion and inclination that were calculated from the 2D/3D reconstruction method were compared to the associated ground truth. To validate reproducibility and reliability, two observers performed measurements for each dataset twice in order to measure the reproducibility and the reliability of the 2D/3D reconstruction method. Results: Our validation study demonstrated a mean accuracy of 0.4 ± 1.8°(−2.6° to 3.3°) for inclination and a mean accuracy of 0.6±1.5°(−2.0° to 3.9°) for anteversion. Through the Bland-Altman analysis, no systematic errors in accuracy were detected. The method showed very good consistency for both parameters. Conclusions: Our validation results demonstrate that the statistical shape model-based 2D/3D reconstruction-based method is an accurate, consistent, and reproducible technique to measure cup orientation from postoperative X-ray radiographs. The best results were achieved with radiographs including the bilateral anterior superior iliac spines and the cranial part of non-fractured pelvise