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Single-stage revision in the management of prosthetic joint infections after total knee arthroplasty - A review of current concepts
Get PDF© 2024 The AuthorsProsthetic joint infection (PJI) is a devastating complication following total knee arthroplasty (TKA); and the gold standard surgical approach involves a two-staged, revision TKA (TSR). Owing to the newer, emerging evidence on this subject, there has been gradual shift towards a single-stage revision approach (SSR), with the purported benefits of mitigated patient morbidity, decreased complications and reduced costs. However, there is still substantial lacuna in the evidence regarding the safety and outcome of the two approaches in chronic PJI. This study aimed to comprehensively review of the literature on SSR; and evaluate its role within Revision TKA post PJI. The narrative review involved a comprehensive search of the databases (Embase, Medline and Pubmed), conducted on 20th of January 2024 using specific key words. All the manuscripts discussing the use of SSR for the management of PJI after TKA were considered for the review. Among the screened manuscripts, opinion articles, letters to the editor and non-English manuscripts were excluded. The literature search yielded a total 232 studies. Following a detailed scrutiny of these manuscripts, 26 articles were finally selected. The overall success rate following SSR is reported to range from 73 % to 100 % (and is comparable to TSR). SSR is performed in PJI patients with bacteriologically-proven infection, adequate soft tissue cover, immuno-competent host and excellent tolerance to antibiotics. The main difference between SSR and TSR is that the interval between the 2 stages is only a few minutes instead of 6 weeks. Appropriate topical, intraoperative antibiotic therapy, followed by adequate postoperative systemic antibiotic cover are necessary to ascertain good outcome. Some of the major benefits of SSR over TSR include reduced morbidity, decreased complications (such as arthrofibrosis or anesthesia-associated adverse events), meliorated extremity function, earlier return to activities, mitigated mechanical (prosthesis-associated) complications and enhanced patient satisfaction. SSR is a reliable approach for the management of chronic PJI. Based on our comprehensive review of the literature, it may be concluded that the right selection of patients, extensive debridement, sophisticated reconstruction strategy, identification of the pathogenic organism, initiation of appropriate antibiotic therapy and ensuring adequate follow-up are the key determinants of successful outcome. To achieve this will undoubtedly require an MDT approach to be taken on a case-by-case basis. [Abstract copyright: © 2024 The Authors.]Unfunde
Participatory Approaches in Research
No full textThis presentation is based upon a co-produced exhibition created by Social Justice Chester and West Cheshire Poverty Truth Commission that explored the lived experience of poverty.n/
Inclusion and Social Justice in Teacher Education
No full textThe chapter, written by university lecturers based in the United Kingdom, is aimed at teachers (and child practitioners) who work with children, aged 0-11 years in education and early years settings. Inspired by the work of Australian academics Kerry Robinson and Criss Jones-Diaz (2016), this chapter emphasises the need for teachers to adopt a more critical stance relating to issues of social justice and social inequalities. It examines some of the sociological and psychological perspectives that can be drawn upon to understand and address social inequalities. It provides models (Umbrella of Social Justice, Wheel of Inclusion, Reflecting Window of Prejudice, CAB), principles, and practical approaches that teachers may find useful when delivering social justice and inclusive education to children.Unfunde
Book Review: Pablo Alonso González, Cuban Cultural Heritage: A Rebel Past for a Revolutionary Nation (Gainesville, FL: University Press of Florida, 2018), pp. xiv + 335, $84.95, hb.
No full textThis book review is not available on ChesterRepBook reviewUnfunde
Utilising a community cultural wealth model to explore African heritage social work student stories from placement: A critical ethnographic study
No full textPost-graduate qualifying social work education programs in England generally recruit higher numbers of minoritised ethnic students than other post-graduate programmes. However, longstanding inequalities in outcomes and progression for ethnically minoritised social work students persist. Unpaid work placements constitute a key component of qualifying social work programmes but can pose additional barriers for ethnically minoritised students. Nonetheless, most successfully complete their placements and their programmes. This study utilised critical ethnography to identify the strengths and strategies employed by seven African heritage M.A. social work students as they navigated placements arranged by a higher education institution (HEI) in north-west England. Discourse in social work education regarding unequal outcomes for minoritised ethnic students is dominated by deficit thinking, whereby the assets of marginalised students are frequently overlooked, and interventions focus on 'fixing' students, ignoring HEI practice. This study challenged such discourse by illuminating the assets that seven African heritage students, four of whom were classified as ‘home’ students and three as ‘international’, brought to their practice placements. Arts-based engagement ethnography was utilised to gather stories from the participants, employing creative techniques, generating artefacts that informed individual interviews and a focus group. Participants' voices were privileged throughout, and rich, nuanced detail obtained. The impact of intersecting factors, including gender, religion, and immigration status, was apparent throughout the study. The data chronicled participants’ counter storytelling narratives, uncovering the multiple strategies they applied to 'fit' into their placements. Furthermore, elevated levels of individual agency were evidenced, utilised by participants to secure essential learning. The study illustrated the critical role dispersed families and kin, alongside religious faith, and values, contributed to sustaining participants' endeavours. However, the data also highlighted students' efforts as predominantly unnoticed, therefore unsupported by their HEI and placements. Analysis of their stories, utilising a community cultural wealth model, evidenced extensive cultural knowledge, skills, and resources. Aspirational, familial, linguistic, navigational, social, resistant, and spiritual capital were present in abundance: their interconnected nature evident. Actions to empower students to use their cultural assets were identified, with the significance of supporting social, linguistic, and spiritual capital emphasised. The study contributed new knowledge taking a strength-based perspective to identify the cultural assets a group of African heritage social work students brought to their practice placements in England. The applicability and value in using community cultural wealth models in practice settings, to identify students’ assets, was established. The findings have implications for HEIs and placement agencies, with potential to improve support and outcomes for African heritage social work students on placement
Reshaping the Ethical Framework: New Lenses for a Different Time?
No full text© This article was published in Therapy Today, the journal of the British Association for Counselling and Psychotherapy. https://www.bacp.co.uk/bacp-journals/therapy-today/BACP's Ethical Framework is currently going through a process of development and re-structure. This article looks at the key factors informing the reshaping of this key document that informs practice for all 67,000 members of BACP. Specifically, it considers the importance of adopting a decolonizing approach to ethics, as well as embedding Relational Ethics into the new Framework. Some of the challenges of this are discussed and explored
Correction: Wiśniewska et al. Heterospecific Fear and Avoidance Behaviour in Domestic Horses (Equus caballus). Animals 2021, 11, 3081
Get PDF© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) licenseCorrection to original articlen/
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