Circular frame fixation for calcaneal fractures risks injury to the medial neurovascular structures: a cadaveric description

Aim: There is a risk of iatrogenic injury to the soft tissues of the calcaneus and this study assesses the risk of injury to these structures in circular frame calcaneal fracture fixation. Materials and Methods: After olive tip wires were inserted, an L-shaped incision on the lateral and medial aspects of 5 formalin fixed cadaveric feet was performed to expose the underlying soft tissues. The calcaneus was divided into zones corresponding to high, medium and low risk using a grading system. Results: Structures at high risk included the posterior tibial artery, posterior tibial vein and posterior tibial nerve on the medial aspect. Soft tissue structures on the lateral side that were shown to be at lower risk of injury were the small saphenous vein and the sural nerve and the tendons of fibularis longus and fibularis brevis. Conclusion: The lateral surface of the calcaneus provides a lower risk area for external fixation. The risk of injury to significant soft tissues using a circular frame fixation approach has been shown to be greater on the medial aspect. Clinical Relevance: This study highlights the relevant anatomical relations in circular frame fixation for calcaneal fractures to minimize damage to these structures

Stay home, stay safe, save lives? An analysis of the impact of COVID-19 on the ability of victims of gender-based violence to access justice

On 23 March 2020, the United Kingdom (UK) government introduced new measures aimed at reducing the spread of coronavirus (Covid-19). These measures directed the closure of non-essential businesses and venues, prohibited all public gatherings of more than two people and required everyone to stay at home except for very limited purposes. The rationale behind the measures was clear: Stay Home, Stay Safe, Save Lives. Within days of the lockdown coming into force, reports emerged within the media that services supporting victims of gender-based violence (GBV) were facing an unprecedented increase in demand for assistance, indicating that cases of abuse were on the rise. Although GBV is not caused by lockdown measures, evidence indicates that they may increase the incidence rate and/or the severity of GBV in households where it is already being perpetrated. These findings are in line with existing research which demonstrates that natural disasters, disease and other forms of conflict leave citizens (particularly women and girls) vulnerable to GBV. Preventing and responding to GBV in times of humanitarian crises is a vital but challenging endeavour. Whilst support services struggle to secure adequate resources and capacity, restrictions on leaving the house mean that victims face barriers to reporting abuse and seeking help. Within this context, this article will analyse the impact of Covid-19 on the ability of victims of GBV to access justice. The first part of this article will explore the role of GBV organisations in the UK, the impact of humanitarian crises on reported rates of GBV, and how GBV can be mitigated during the Covid-19 outbreak. The second part of the article examines the effectiveness of the response to the crisis from government and public sector agencies including Her Majesty’s Courts and Tribunal Service (HMCTS), the Crown Prosecution Service (CPS) and the police. The third and final part of the article presents the findings of a UK wide study conducted by the authors into the impact of Covid-19 on GBV organisations and victims. Throughout the article, recommendations are made as to the ways in which GBV organisations could be more effectively supported to ensure justice for victims at this critical time

Online professional identity development in university teachers: how do specific concepts or practices utilised by university teachers influence their professional identity when teaching online?

Online learning has emerged in recent decades from the practice of enthusiasts and innovators and is now part of the offer of most universities. As a result, often alien and uncomfortable teaching concepts and practices have faced, and at times have been imposed on, teachers. The unique circumstances of the coronavirus pandemic in March 2020 brought this into sharp focus. Many teachers in universities in the UK were required to shift rapidly to online education. These included those already opting to teach online, indicating a level of comfort with that practice. It also brought those who did not want to make the change into focus, many of whom needed help to ‘find themselves’ online. The challenges to the professional identity of both sets of teachers were not well understood at the time and consequently could not be well supported. The research was conducted in a single university in Northwest England during the 2020/2021 academic year. An interpretative approach was adopted, guided by the principles of constructivist grounded theory. Recorded interviews captured the experiences of twelve teachers in two distinct phases over one year. Themes were generated relating both to how interviewees present and perceive their professional identity online, as well as the limitations of doing so in an online space. Analysis of shifts in professional identity during the move from face-to-face to online teaching environments generated a new understanding of this transition. Analysis of the themes revealed challenges to professional identity as teachers moved through a stage of liminality during the transition from a traditional face-to-face environment to operating remotely online. Understanding issues of change to subjectivity, otherness, context, and social interaction generated are central to addressing these challenges. Four simple but troublesome questions face university teachers as they establish online professional identity. • ‘Who am I?’, how do I present myself as a teacher? • ‘Who is there?’, who is watching me when I teach? • ‘Who are we?’, what shared identity do my students and I have as a group? • ‘Who is that?’, how do I relate to my image online? The generation and use of a reflective toolkit is described and further avenues for research in this field are highlighted. The toolkit is intended for utilisation particularly by academic developers or teachers themselves to support moving to online teaching and the development of professional identity in this space

The Law In The Community Module At Northumbria University- Working In Partnership With Citizens Advice As An Effective Teaching Tool

This article discusses the Law in the Community module, which has recently been introduced into the curriculum at Northumbria University. In this module, the students attend fortnightly workshops with their university tutor and volunteer each week at their local Citizens Advice. The aims of the module are to develop the students’ knowledge and professional skills and appreciation of access to justice challenges, whilst simultaneously advising members of the community through their volunteer work at the Citizens Advice. The purpose of this paper is twofold: firstly, to present and discuss data from a semi-structured interview with the academic responsible for the design and delivery of the module during the first year of its inception. Secondly, to evaluate the pedagogical benefits and the benefits to the wider community

A cooperative knock-on mechanism underpins Ca2+-selective cation permeation in TRPV channels

The selective exchange of ions across cellular membranes is a vital biological process. Ca2+-mediated signaling is implicated in a broad array of physiological processes in cells, while elevated intracellular concentrations of Ca2+ are cytotoxic. Due to the significance of this cation, strict Ca2+ concentration gradients are maintained across the plasma and organelle membranes. Therefore, Ca2+ signaling relies on permeation through selective ion channels that control the flux of Ca2+ ions. A key family of Ca2+-permeable membrane channels is the polymodal signal-detecting transient receptor potential (TRP) ion channels. TRP channels are activated by a wide variety of cues including temperature, small molecules, transmembrane voltage, and mechanical stimuli. While most members of this family permeate a broad range of cations non-selectively, TRPV5 and TRPV6 are unique due to their strong Ca2+ selectivity. Here, we address the question of how some members of the TRPV subfamily show a high degree of Ca2+ selectivity while others conduct a wider spectrum of cations. We present results from all-atom molecular dynamics simulations of ion permeation through two Ca2+-selective and two non-selective TRPV channels. Using a new method to quantify permeation cooperativity based on mutual information, we show that Ca2+-selective TRPV channel permeation occurs by a three-binding site knock-on mechanism, whereas a two-binding site knock-on mechanism is observed in non-selective TRPV channels. Each of the ion binding sites involved displayed greater affinity for Ca2+ over Na+. As such, our results suggest that coupling to an extra binding site in the Ca2+-selective TRPV channels underpins their increased selectivity for Ca2+ over Na+ ions. Furthermore, analysis of all available TRPV channel structures shows that the selectivity filter entrance region is wider for the non-selective TRPV channels, slightly destabilizing ion binding at this site, which is likely to underlie mechanistic decoupling.</p

Synthetic mean-field interactions in photonic lattices

Photonic lattices are usually considered to be limited by their lack of methods to include interactions. We address this issue by introducing mean-field interactions through optical components which are external to the photonic lattice. The proposed technique to realise mean-field interacting photonic lattices relies on a Suzuki-Trotter decomposition of the unitary evolution for the full Hamiltonian. The technique realises the dynamics in an analogous way to that of a step-wise numerical implementation of quantum dynamics, in the spirit of digital quantum simulation. It is a very versatile technique which allows for the emulation of interactions that do not only depend on inter-particle separations or do not decay with particle separation. We detail the proposed experimental scheme and consider two examples of interacting phenomena, self-trapping and the decay of Bloch oscillations, that are observable with the proposed technique.Comment: 7 pages, 5 figures, comments welcom

The Hall of Mirrors: a teaching team talking about talking about reflection

In order to review the teaching and assessment of reflection within the Student Law Office (SLO) at Northumbria University, an integral consideration must be the insight into experiences and perspectives of those directly involved with the students: the clinical supervisors. Clinical supervisors at Northumbria University explored the reflective aspect of the SLO teaching and assessment over the course of four, one-hour group discussions. This paper explores the themes that emerged from the group discussions and offers a consideration of how issues of reflective practice can be addressed to optimise the teaching, learning and assessment of reflection

Covid-19 and the Family Courts: Key Practitioner Findings in Children Cases

In March 2020, stringent social distancing measures were introduced across England and Wales to reduce the spread of Covid-19. These measures have presented significant challenges for the family justice system. This article sets out the findings of interviews conducted with professionals in the North East of England who have represented or otherwise supported litigants in private and public children proceedings since social distancing measures were introduced. The findings reveal that whilst practitioners are broadly positive about their experiences of shorter non-contested hearings, they nonetheless have concerns about the effectiveness of remote/hybrid hearings in ensuring a fair and just process in lengthy and complex cases. In particular, the findings indicate that the move to remote hearings has exacerbated pre-existing barriers to justice for unrepresented and vulnerable litigants. The aims of this article are not to ‘name and shame’ any particular court but to highlight evidence of good practice in the North East of England and provide scope for improving practitioners’ and litigants’ experiences within current restrictions