Divination: Exemplifying and Configuring Archetypes in Ceramics

Abstract/Summary Dissertation Divination: Exemplifying and Configuring Archetypes in Ceramics is a study of my research practice. The cards of the tarot can be used as a conceptual framework and source of inspiration for making ceramic sculptures. The cards can be used to understand the creative process as an expression of archetypes. My dissertation discusses these archetypes from the tarot cards, both in their historical operation, their manifestation in my art practice, as well as, examining approaches taken to these archetypes by other artists such as Salvador Dali and Niki de Saint Phalle. The theoretical basis for the dissertation is informed by the writings of Carl G. Jung who has proposed concepts dealing with creativity, coincidence, a collective unconscious and archetypes. These ideas form a model for the understanding of my studio work. As background, the dissertation examines examples of artworks that could be seen to be drawn from a collective unconscious. Studio Work The studio work consists of a series of ceramic sculptures formulating the archetypes that I have derived from the tarot cards. The three dimensional clay, with found inclusions, examines the idea of specific archetypes. These archetypes are titled in the works including: The Fool, Strength, The Magician, Tarot Sun, The Empress II, The Lovers, Empress l, The Chariot I and II The Angel Temperance, The Tarot Devil and The World. The ceramic objects have been created in clay using handbuilding techniques. The clay was such that it could include found ceramic pieces and be refired. The pieces have been re-fired many times to achieve a variety of glaze effects. The works range in size from 30-60 cms approximately and include freestanding sculptures and complementing flat wall works

Use of human GH in elderly patients with accidental hip fracture

OBJECTIVE: To investigate whether early intervention with recombinant human growth hormone (hGH) after hip fracture improves functional recovery and long-term outcome. SUBJECTS AND METHODS: Functional recovery after hip fracture is often incomplete. The catabolic situation that develops after the hip fracture accident, and a state of malnutrition either pre-existing or developing after surgery, are main contributing factors for the poor clinical outcome. hGH has been used to promote anabolism in a variety of clinical catabolic situations. The study design was randomized, double-blind and placebo-controlled. A total of 111 patients older than 60 years with an accidental hip fracture (mean age 78.5+/-9.1 (s.d.) years) were randomized to receive either hGH (20 microg/kg per day) or placebo for a period of 6 weeks, starting within 24 h after the hip fracture accident. Thereafter patients were followed up for an additional period of 18 weeks. Efficacy was assessed by comparing the changes in the Barthel Index score of activities of daily living and in a patient's living situation between the hGH- and the placebo-treated subjects. RESULTS: Eighty-five (78.5%) patients completed the first 8 weeks of the study and 76 (68.5%) the entire study period of 24 weeks. When split according to age, a trend was found that for patients older than 75 years the changes in Barthel Index score from baseline were less in the hGH group than in the placebo group (-18.6+/-18 vs -28.1+/-26) at 6 weeks after surgery (P<0.075). There was an overall trend to a higher rate of return to the pre-fracture independent living situation in the hGH group than in the placebo group. Analysis by age revealed a significantly higher proportion of hGH- than placebo-treated patients returning to the pre-fracture living situation for subjects older than 75 years (93.8 vs 75.0%, P=0.034). hGH treatment increased IGF-I values to levels in the range of those of normal subjects of 50-60 years of age. CONCLUSIONS: A 6 week treatment with hGH (20 microg/kg per day) of otherwise healthy patients after an accidental hip fracture may be of benefit if given to subjects older than 75 years of age. The rate of return to the pre-fracture living situation in subjects of this age treated with hGH was significantly increased when compared with the placebo-treated group. The treatment intervention was well tolerated and no safety issues were recorded

Prediction of torsional failure in 22 cadaver femora with and without simulated subtrochanteric metastatic defects: a CT scan-based finite element analysis

BACKGROUND: In metastatic bone disease, prophylactic fixation of impending long bone fracture is preferred over surgical treatment of a manifest fracture. There are no reliable guidelines for prediction of pathological fracture risk, however. We aimed to determine whether finite element (FE) models constructed from quantitative CT scans could be used for predicting pathological fracture load and location in a cadaver model of metastatic bone disease. MATERIAL AND METHODS: Subject-specific FE models were constructed from quantitative CT scans of 11 pairs of human femora. To simulate a metastatic defect, a transcortical hole was made in the subtrochanteric region in one femur of each pair. All femora were experimentally loaded in torsion until fracture. FE simulations of the experimental set-up were performed and torsional stiffness and strain energy density (SED) distribution were determined. RESULTS: In 15 of the 22 cases, locations of maximal SED fitted with the actual fracture locations. The calculated torsional stiffness of the entire femur combined with a criterion based on the local SED distribution in the FE model predicted 82% of the variance of the experimental torsional failure load. INTERPRETATION: In the future, CT scan-based FE analysis may provide a useful tool for identification of impending pathological fractures requiring prophylactic stabilization

Agreement of general practitioners with the guideline-based stepped-care strategy for patients with osteoarthritis of the hip or knee: A cross-sectional study

Background: To improve the management of hip or knee osteoarthritis (OA), a multidisciplinary guideline-based stepped-care strategy (SCS) with recommendations regarding the appropriate non-surgical treatment modalities and optimal sequence for care has been developed. Implementation of this SCS in the general practice may be hampered by the negative attitude of general practitioners (GPs) towards the strategy. In order to develop a tailored implementation plan, we assessed the GPs' views regarding specific recommendations in the SCS and their working procedures with regard to OA. Methods. A survey was conducted among a random sample of Dutch GPs. Questions included the GP's demographical characteristics and the practice setting as well as how the management of OA was organized and whether the GPs supported the SCS recommendations. In particular, we assessed GP's views regarding the effectiveness of 14 recommended and non-recommended treatment modalities. Furthermore, we calculated their agreement with 7 statements based on the SCS recommendations regarding the sequence for care. With a linear regression model, we identified factors that seemed to influence the GPs' agreement with the SCS recommendations. Results: Four hundred fifty-six GPs (37%) aged 30-65 years, of whom 278 males (61%), responded. Seven of the 11 recommended modalities (i.e. oral Non-Steroidal Anti-Inflammatory Drugs, physical therapy, glucocorticoid intra-articular injections, education, lifestyle advice, acetaminophen, and tramadol) were considered effective by the majority of the GPs (varying between 95-60%). The mean agreement score, based on a 5-point scale, with the recommendations regarding the sequence for care was 2.8 (SD = 0.5). Ten percent of the variance in GPs' agreement could be explained by the GPs' attitudes regarding the effectiveness of the recommended and non-recommended non-surgical treatment modalities and the type of practice. Conclusion: In general, GPs support the recommendations in the SCS. Therefore, we expect that their attitudes will not impede a successful implementation in general practice. Our results provide sev

Tromboembolische complicaties na totale heuparthroplastiek : een onderzoek naar de profylactische waarde van laag-gedoseerde pre- en postoperatieve orale anticoagulantia

Medisch-technische ontwikkelingen gedurende de afgelopen 25 jaar hebben het mogelijk gemaakt een pijnlijk en verstijfd gewricht met een grate kans van slagen te vervangen door een nieuw gewricht in de vorm van een prothese. De heup is thans het meest vervangen gewricht. In Nederland werden in 1984 meer dan 10.000 totale heuparthroplastieken verricht.Bij het merendeel van deze operaties werden een acetabulumprothese van polyethyl een en een kophalsprothese van een metaallegering met acrylcement gefixeerd. Een scherpe indicatiestelling, een geestelijke en lichamelijke voorbereiding van de (veelal bejaarde} patient, een optimale operatietechniek, een zonodig individueel aangepast revalidatieschema, en leefregels voor de langere termijn dragen er mede toe bi j dat globaal 90% van de ingebrachte heupprotheses na 10 jaar nag probleemloos functioneert. Zowel het gebied van de endoprothesiologie in engere zin als dat van de verankeringstechnieken is nag volop in beweging, en een hoger succespercentage in de toekomst is niet uitgesloten. De meest gevreesde complicatie na een totale heuparthroplastiek is een infectie random de prothese. Preoperatief onderzoek naar potentiele infectiebronnen (zeals urineweginfecties) en behandeling daarvan, peroperatieve antibiotische bescherming en het gebruik van een kiemvrije operatiekamer kunnen het infectiepercentage tot ongeveer een procent reducere

Low revision rate of dual mobility cups after arthroplasty for acute hip fractures: report of 11,857 hip fractures in the Dutch Arthroplasty Register (2007-2019).

Background and purpose - Dislocation is one of the most frequent reasons for cup revision after total hip arthroplasty (THA) for an acute fracture. A dual mobility cup (DMC) might reduce this risk. We determined the cup revision rate after THA for an acute fracture according to type of cup.Patients and methods - All THAs for an acute fracture registered in the Dutch Arthroplasty Register (LROI) during 2007-2019 were included (n = 11,857). Type of cup was divided into DMC and unipolar cup (UC). Competing risk analyses were performed with cup revision for any reason as endpoint. Multivariable Cox regression analyses with outcome cup revision were performed adjusted for sex, age, ASA class, and surgical approach, stratified for UC THA with femoral head size of 32 mm and 22-28 mm.Results - A DMC was used in 1,122 (9%) hips. The overall 5-year cup revision rate for any reason after THA for acute fracture was 1.9% (95% CI 1.6-2.2). Cup revision for dislocation within 5 years was performed in 1 of 6 DMC THAs versus 108 of 185 (58%) UC THAs. Univariable Cox regression analyses showed no statistically significant difference in cup revision rate between DMC and UC (HR = 0.8; CI 0.4-1.5). Multivariable Cox regression analyses showed lower risk of cup revision in DMC THA (n = 1,122) compared with UC THA with 22-28 mm femoral head size (n = 2,727) (HR = 0.4; CI 0.2-0.8).Interpretation - The 5-year cup cumulative incidence of revision after THA for acute fracture was comparable for DMC and UC THA. However, DMC THA had a lower risk of cup revision than UC THA with 22-28 mm femoral head

[Unexplained pain in the ankle and foot. Consider transient osteoporosis]

Item does not contain fulltextTransient osteoporosis is an increasingly recognized condition that causes severe pain in weight-bearing joints and is characterized by otherwise unexplained bone-marrow oedema on MRI. We present two patients, a 40-year-old man and a 60-year-old woman, with longstanding severe pain in the foot and ankle. Both had invalidating pain with only mild swelling of the foot or ankle. Laboratory investigation was unremarkable, and conventional X-ray showed osteopenia of the bones involved. In both cases, consecutive MRIs showed migrating bone marrow oedema. The patients were treated with analgesics, immobilization of the body parts concerned and an intravenous bisphosphonate

Conservatieve behandeling van heup- en knieartrose: systematische en stapsgewijze behandelstrategie.

In the Netherlands the current, conservative management of osteoarthritis of the hip and knee is heterogeneous and suboptimal. Existing guidelines only provide indications for certain interventions, but they do not provide recommendations about the sequence of these treatments. A step-by-step treatment strategy has now been developed in addition to the guidelines. Its aim is to optimize and clarify the conservative policy for osteoarthritis. In addition, communication between patients and professionals and between professionals themselves must be encouraged. According to the treatment strategy, relatively advanced interventions are considered only after simpler interventions have had insufficient results. A care booklet has also been developed that contains information for patients about osteoarthritis, treatment options, healthcare professionals and the treatment strategy

"Beating osteoARThritis": Development of a stepped care strategy to optimize utilization and timing of non-surgical treatment modalities for patients with hip or knee osteoarthritis

Item does not contain fulltextInadequacies in health care practices have been reported despite existing guidelines to manage hip or knee osteoarthritis. To facilitate guideline implementation and improve utilization of non-surgical treatment options a care strategy should be developed. This study describes the development of an evidence-based, multidisciplinary, patient-centered, stepped care strategy. A national, multidisciplinary, steering group developed the strategy in three phases: (1) consensus among steering group members (first draft); (2) written consultation of 23 representatives of patient organizations and professional associations involved in osteoarthritis care (second draft); (3) consensus of the final draft after discussion in two rounds during a conference with representatives from the different disciplines. The final stepped care strategy presents, in three tiers, the optimal order for non-surgical treatment modalities. It recommends that more advanced options should only be considered if options listed in previous steps failed to produce satisfactory results. Hence, the first step treatment options can be offered to all patients but may also be provided through self care (education, life style advice, and acetaminophen). The second step (exercise therapy, dietary therapy, and non-steroidal anti-inflammatory drugs) and third step treatment options (multidisciplinary care, intra-articular injections, and transcutaneous electrical nerve stimulation) can be considered for people with persisting complaints. Trough a consensus procedure, we succeeded to develop a multidisciplinary, patient-centered, stepped care strategy based on national guidelines. This strategy provides a framework for health care providers and patients with hip or knee osteoarthritis to discuss the optimal timing of the various treatment options