Ikääntyvä henkilöstö ja osaamispääoman säilyttäminen

Siirretty Doriast

Movement pattern of the Exeter femoral stem: A radiostereometric analysis of 22 primary hip arthroplasties followed for 5 years

Background The design of the Exeter stem may facilitate distal migration, but radiostereometric analysis (RSA) studies have been limited to 2 years of follow-up. Patients and methods We followed migration of the Exeter femoral stems in 22 primary hip arthroplasties for 5 years with RSA. Results All stems migrated distally and the median migration at 2 years was 1.34 mm, while at 5 years it was 1.77 mm. 7 stems migrated above accuracy between 3 and 5 years. (RSA) evaluation of the cement mantle could be performed in 14 cases, and in 5 slight migration was found. Most of the stems rotated towards retroversion and the median rotation at 2 years was 1.2°, while at 5 years it was 1.6°. We found 1 patient with impending clinical failure but no deviation in the RSA migration pattern, and 1 patient with unstable migration pattern but no clinical symptoms. Interpretation We found a greater distal migration of the Exeter stem for longer periods of time than seen with other types of cemented implants

Doubtful effect of continuous intraarticular analgesia after total knee arthroplasty.

Background and purpose - Local infiltration analgesia (LIA) is well established for effective postoperative pain relief in total knee arthroplasty (TKA). To prolong the effect of LIA, infusion pumps with local intraarticular analgesia can be used. We evaluated the effect of such an infusion pump for the first 48 h postoperatively regarding pain, knee function, length of stay (LOS) in hospital, and complications. Patients and methods - 200 patients received peroperative LIA and a continuous intraarticular elastomeric infusion pump set at 2 mL/h. The patients were randomized either to ropivacaine (7.5 mg/mL) or to NaCl (9 mg/mL) in the pump. Visual analog scale (VAS) pain (0-100 mm), analgesic consumption, side effects of medicine, range of motion (ROM), leg-raising ability, LOS, and complications during the first 3 months were recorded. Results - On the first postoperative day, the ropivacaine group had lower VAS pain (33 vs. 40 at 12 noon and 36 vs. 43 at 8 p.m.; p = 0.02 and 0.03, respectively), but after that all recorded variables were similar between the groups. During the first 3 months, the ropivacaine group had a greater number of superficial and deep surgical wound infections (11 patients vs. 2 patients, p = 0.02). There were no other statistically significant differences between the groups. Interpretation - Continuous intraarticular analgesia (CIAA) with ropivacaine after TKA has no relevant clinical effect on VAS pain and does not affect LOS, analgesic consumption, ROM, or leg-raising ability. There may, however, be a higher risk of wound-healing complications including deep infections

Hur ett företag arbetar med sin uppförandekod

Medvetenheten om hållbarhet för företag och hållbarhetsarbete har under senaste decenniet blivit en självklar ”aspekt” att ta ställning till. Termen hållbarhetsarbete kan bestå av flera olika företeelser och som exempel kan nämnas gröna strategier, tillhandahållande av hållbarhetsredovisning samt upprättandet av efterlevnadsprinciper. Det senare kallas för Code of Conduct, CoC, och är huvudområdet för denna uppsats. För denna uppsats utfördes en fallstudie av Volvokoncernen i syfte att undersöka en funktion inom företaget som benämns “företagsuniversitetet”. Företagsuniversitetet har haft som syfte att erbjuda alla inom organisationen samma utbildningsmöjligheter samt att förmå de anställda att anamma de principer som skall efterföljas. Primärdata insamlades och en intervju genomfördes med en respondent på företagsuniversitet. Sekundärdata har bestått av Volvokoncernens CoC samt offentlig information om företagsuniversitetet. Tidigare forskning har inte i speciellt undersökt hur företag operationaliserar/sprider CoC. I ett företags globala organisation, som Volvokoncernen, har det beskrivits som komplext att få alla att arbeta mot samma mål och efter samma hållbara principer. Här kan det vara intressant att undersöka hur företagsuniversitet hos Volvokoncernen operationaliserar CoC. Tidigare studier visat att kommunikationen med CoC inom en global organisation ofta brister så fanns även ett intresse av att undersöka hur kommunikationen av CoC ser ut. För att undersöka detta närmare har denna studie fokuserat på teorier om hållbarhet t.ex. Corporate Social Responsibility, CSR, där fokus har legat på hållbara strategier och CoC. Dessutom har denna studie även handlat om hur kommunikation kan se ut. Genom att ha insamlat empiriska data samt analyserat dessa mot valda teorier, visar denna studie att företagsuniversitetet hos Volvokoncernen operationaliserar CoC via de utbildningar som företagsuniversitetet står för. CoC vävs där samman med utbildningar. Företagsuniversitetet är utformat så att en gemensam företagskultur efterfrågas och därmed läggs stor vikt vid att utbildningarna får samma betydelse för alla oavsett var i den globala koncernen en person befinner sig. Operationaliseringen öppnar för kommunikationen. Den semiotiska kommunikationsmodellen kan på ett bra sätt beskriva hur kommunikationen ser ut då betydelsen av budskapet enligt denna modell är av central betydelse framför en enklare linjär kommunikationsmodell.Awareness of sustainability and sustainable performance has become a matter for organizations and companies. Sustainable performance or work consists of several specializations, for example green strategies and code of conduct. It has been stated in earlier studies that the importance of the code of conduct to get through to everyone in the whole organization in order to make the organization fulfill the code of conduct in a satisfactory way. A case study of Volvo Group was performed in order to answer the questions about how an organization operationalize the code of conduct through a phenomena called “Volvo Group University”. Volvo Group University has the purpose of educating the employees. Futhermore, it is of importance to investigate how the code of conduct is communicated in a globalized organization, especially since earlier studies have shown that it is a complex problem to make the meaning of the code of conduct the same for everyone in a global organization. Theories used in this paper are based on sustainability and operationalizing/communications and include for example corporate social responsibility and the communication model of semiotics. This studys conclusions states that the Volvo Groups code of conduct is operationalized through the educations that are existing in the Volvo Group University where it can be described as interwoven. Volvo Group University helps the individuals in the organization to understand the meaning of the code of conduct no matter where you live or what cultural basis you rely upon on

The Swedish Knee Arthroplasty Register: a review.

We are entering a new era with governmental bodies taking an increasingly guiding role, gaining control of registries, demanding direct access with release of open public information for quality comparisons between hospitals. This review is written by physicians and scientists who have worked with the Swedish Knee Arthroplasty Register (SKAR) periodically since it began. It reviews the history of the register and describes the methods used and lessons learned. Cite this article: Bone Joint Res 2014;3:217-22

Hip revision using the Exeter stem, impacted morselized allograft bone and cement: A consecutive 5-year radiostereometric and radiographic study in 15 hips

Background: Impaction grafting in hip revision surgery is widely used but studies with mid- and long-term follow-up are scarce. Patients, methods and results A 5-year radiostereometric (RSA) follow-up of 15 hip revisions with the Exeter stem, morselized impacted allograft bone and cement revealed that 3 stems had not migrated between 2 and 5 years after revision, 11 stems had migrated to a minor degree in at least 1 direction, and 1 stem was loose according to RSA but without any radiographic signs of loosening or pain. The pain score was comparable to primary arthroplasties. Interpretation From a 5-year perspective, first-time hip revisions for aseptic loosening with impacted morselized allograft bone and cement appear to yield good clinical results, although stem migration continues to a minor degree 2 years after revision

Extended geometry of magical supergravities

We provide, through the framework of extended geometry, a geometrisation of the duality symmetries appearing in magical supergravities. A new ingredient is the general formulation of extended geometry with structure group of non-split real form. A simple diagrammatic rule for solving the section constraint by inspection of the Satake diagram is derived.Comment: 25 p

Higher risk of revision for infection using systemic clindamycin prophylaxis than with cloxacillin

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked FilesBackground and purpose - Clindamycin has not been compared with other antibiotics for prophylaxis in arthroplasty. Since 2009, the Swedish Knee Arthroplasty Register (SKAR) has been collecting information on the prophylactic antibiotic regime used at every individual operation. In Sweden, when there is allergy to penicillin, clindamycin has been the recommended alternative. We examined whether there were differences in the rate of revision due to infection depending on which antibiotic was used as systemic prophylaxis. Patients and methods - Patients who had a total knee arthroplasty (TKA) performed due to osteoarthritis (OA) during the years 2009-2015 were included in the study. Information on which antibiotic was used was available for 80,018 operations (55,530 patients). Survival statistics were used to calculate the rate of revision due to infection until the end of 2015, comparing the group of patients who received cloxacillin with those who received clindamycin as systemic prophylaxis. Results - Cloxacillin was used in 90% of the cases, clindamycin in 7%, and cephalosporins in 2%. The risk of being revised due to infection was higher when clindamycin was used than when cloxacillin was used (RR =1.5, 95% CI: 1.2-2.0; p = 0.001). There was no significant difference in the revision rate for other causes (p = 0.2). Interpretation - We advise that patients reporting allergic reaction to penicillin should have their allergic history explored. In the absence of a clear history of type-I allergic reaction (e.g. urticaria, anaphylaxis, or bronchospasm), we suggest the use of a third-generation cephalosporin instead of clindamycin as perioperative prophylaxis when undergoing a TKR. No recommendation can be given regarding patients with type-1 allergy

Effects of delayed sealing during silo filling

Swedish farmers have generally a good understanding of the recommendations for silage making provided by advisory services. However, few farmers apply the recommendation to seal the silo temporarily when the filling process is interrupted (e.g. overnight break or machinery failure). We believe this might be due to a prevailing uncertainty about the negative effects of delayed sealing. The objective of this study was to evaluate effects of delayed sealing on silage quality

Reconstruction of Phonated Speech from Whispers Using Formant-Derived Plausible Pitch Modulation

Whispering is a natural, unphonated, secondary aspect of speech communications for most people. However, it is the primary mechanism of communications for some speakers who have impaired voice production mechanisms, such as partial laryngectomees, as well as for those prescribed voice rest, which often follows surgery or damage to the larynx. Unlike most people, who choose when to whisper and when not to, these speakers may have little choice but to rely on whispers for much of their daily vocal interaction. Even though most speakers will whisper at times, and some speakers can only whisper, the majority of today’s computational speech technology systems assume or require phonated speech. This article considers conversion of whispers into natural-sounding phonated speech as a noninvasive prosthetic aid for people with voice impairments who can only whisper. As a by-product, the technique is also useful for unimpaired speakers who choose to whisper. Speech reconstruction systems can be classified into those requiring training and those that do not. Among the latter, a recent parametric reconstruction framework is explored and then enhanced through a refined estimation of plausible pitch from weighted formant differences. The improved reconstruction framework, with proposed formant-derived artificial pitch modulation, is validated through subjective and objective comparison tests alongside state-of-the-art alternatives