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To lose weight or to weight the loss? Insights into the use of the body mass index in preoperative assessment before major orthopaedic surgery
No full textThe ERAS (Enhanced Recovery After Surgery) guidelines in major orthopaedic surgery do not address the issue of managing excess body weight in patients scheduled for hip and knee replacement or lumbar fusion. This aspect is relevant to practice due to the increasing number of obese individuals and to some evidence suggesting higher complication rates in patients with excess weight. There is a debate on whether obesity defined by the body mass index, i.e. the ratio of weight to squared height, can guide surgical eligibility and whether losing excess weight preoperatively can actually lead to better outcomes. In this practice development article, we explore opposing perspectives on the value of a high BMI as an indicator of increased preoperative risk and discuss the potential consequences of losing weight prior to a major orthopaedic surgery. The aim is to promote a conscious management of individuals with excess body fat based on the patient's overall health rather than BMI alone. In the absence of strong evidence on what is best to do, it is reasonable to suggest that any prehabilitation initiatives should not focus on a rigid weight loss mandate but on a multidisciplinary, multimodal, and personalised approach that does not necessarily include a reduction in body weight
Phylogenetic relatedness predicts extinction risk of native freshwater fishes from non-native fishes across a latitudinal gradient
No full textThe strength of the interspecific interactions between non-native and native species influences the subsequent invasion impacts, with stronger interactions and thus more severe impacts predicted when the species are phylogenetically close and co-exist at lower latitudes. Although work demonstrates non-native fish are more likely to invade areas which have phylogenetically closely related species present, the impacts of these invaders on the native species remain poorly understood. Accordingly, we conducted a comprehensive analysis of global freshwater fish occurrence data to test the phylogenetic niche conservatism hypothesis in co-occurring native and non-native freshwater fishes, assess whether non-native fishes drive extinctions of phylogenetically closely
related native species, and evaluate how this varies with latitude. Phylogenetic niche conservatism was evident in co- occurring non-native and native fishes, with their morphometric trait dissimilarity significantly correlated with their phylogenetic distance. Extinct freshwater fishes were found to be more closely related to co- occurred non-native species than were species of
other conservation statuses. However, the relationship between the extinction probability of native freshwater fishes and their phylogenetic relatedness to non-native species was context-dependent, varying with latitude and across biogeographical realms. At higher latitudes, native fishes closely related to non-native species had a higher probability of extinction, whereas at lower
latitudes, closely related native species were less likely to become extinct. Thus, the extinction risks posed by non-native fish vary spatially and depend on their phylogenetic relatedness to native species, both of which are recommended for consideration in
invasion risk management programmes
PFAS contamination: regulatory landscape and future perspectives for India
No full textThis article highlights the escalating concern of PFAS (Per- and Polyfluorinated Alkyl Substances) contamination, which poses significant global concern and potentially serve implications for India. It offers a comprehensive overview of the types of PFAS, including sources, pathways, and regulatory challenges they present. Additionally, the article examines the regulatory limits proposed and followed by United States Environmental Protection Agency (USEPA), European Union (EU) and guidelines followed in United Kingdom, Australia and New Zealand. Furthermore, it provides an update on the present status of PFAS research and contamination in India and outlines the necessary steps to mitigate this contaminant in the long-term following the non-sum zero approach derived from game theory
Which elective hand surgery would benefit most from preoperative therapy interventions to enhance surgical outcomes? A survey of hand therapists.
Get PDFBACKGROUND: An ageing population and increasing chronic health disorders explain the predicted rise in hand surgeries. Preoperative care has the potential to optimise patients' psychological and physical status, making it a promising area for enhancing surgical outcomes. Despite its established use in other surgical specialties, preoperative therapy in hand surgery remains underexplored. OBJECTIVE: This study uses an anonymous survey to gather therapists' opinions on the hand procedure whose outcomes benefit most from preoperative therapy. The research focuses on five common elective hand procedures: Carpal Tunnel Release (CTR); Cubital Tunnel Release (CuTR); Dupuytren's Fasciectomy (DF); Trapeziectomy (TZ); and Trigger Finger Release (TFR). METHOD: British Association of Hand Therapy members were targeted in an online survey. Thirty-seven respondents (5% response rate) participated over 3 months. Questions explored how preoperative therapy improves surgical outcomes, the efficacy of postoperative therapy, and the importance of patient compliance postoperatively. RESULTS: TZ emerged as the procedure with the highest potential for preoperative therapy benefit, TZ and DF as top procedures for postoperative therapy requirements and importance of patient engagement and compliance. CTR had contradictory responses, while TFR and CuTR received the fewest endorsements for preoperative therapy benefits. CONCLUSION: The survey offers insight into hand therapists' perspectives on preoperative therapy. TZ and DF stand out as having significant potential for optimisation. Uncertainty surrounding efficacy of therapy on Dupuytren's Disease indicates the necessity for further research. Education is considered an essential preoperative component. The small sample size warrants caution when interpreting results
Identifying critical success factors in the regeneration of English seaside resorts
Get PDFThis paper focuses on regeneration projects in ‘first-generation’ seaside resorts in England from the perspective of those leading and managing such projects. There have been numerous recent initiatives intended to revive seaside resorts and enable them to regain competitiveness, but limited analysis of what is necessary for such regeneration projects to be successful. This paper contributes to debates about the role of critical success factors (CSFs) in regeneration by identifying issues that apply to the specific context of seaside resorts. In-depth interviews were undertaken with ten managers responsible for individual projects focusing on the CSFs necessary for regeneration projects to succeed. Four such factors were identified: (1) the need to secure appropriate funding (and associated difficulties); (2) the importance of involving stakeholders (particularly the local authority and local community); (3) the need for a strong business plan (which must evolve as the project progresses); and (4) the importance of considering best practices elsewhere. The importance of each success factor varied by the sector (public/commercial/third) leading the regeneration initiative and varied at different stages of a regeneration project. These findings have practical implications for local authorities, commercial enterprises, and third-sector bodies in seaside destinations
Long-term impact of combat-related traumatic injury on heart rate variability: findings from the ADVANCE study.
Get PDFINTRODUCTION: Combat-related traumatic injury (CRTI) has been associated with adverse cardiovascular outcomes in veterans. However, the long-term impact of contemporary CRTI on heart rate variability (HRV, a marker of autonomic function) has never been investigated in combat veterans and personnel. This analysis aimed to examine the association between CRTI and short-term HRV in a contemporary cohort of British servicemen. METHODS: This analysis used the first follow-up data from the ArmeD serVices trAuma rehabilitatioN outComE (ADVANCE) prospective cohort study. Participants comprised 469 injured (those who sustained serious physical CRTI while on deployment in Afghanistan) and 506 uninjured servicemen [those who were uninjured and were frequency-matched to the injured based on age, sex (male), rank and deployment: Afghanistan 2003-2014 at recruitment]. Resting HRV was measured (5 min ECG) in the supine position. Root mean square of successive differences (RMSSD) and the sympathetic nervous system (SNS) index were reported as measures of parasympathetic and sympathetic activity, respectively. Multiple linear regression models reported the association between CRTI and HRV, adjusting for age, rank and ethnicity. RESULTS: Participants' median age was 37.5 years. The time from CRTI/deployment was approximately 11 years. Median RMSSD was significantly lower in the injured versus uninjured [37.7 ms (IQR: 25.3 to 55.9) vs 41.9 ms (IQR: 27.7 to 62.2); p=0.01]. After confounder adjustment, CRTI was significantly associated with lower RMSSD [geometric mean ratio: 0.92 (95% CI 0.85 to 0.99)] and relatively higher SNS index [coefficient: 0.19 (95% CI 0.05 to 0.34)] in the injured versus uninjured. Blast injury and traumatic amputation were associated with significantly lower RMSSD and greater SNS activity. CONCLUSION: CRTI is associated with greater relative autonomic imbalance. These findings may help understand the recovery pathway following CRTI in wounded combat veterans and personnel
Prioritising Non-Native Crayfish Species for Management in the Rhine-Main Observatory Using the Dispersal-Origin-Status-Impact (DOSI) Scheme
Get PDFManaging non-native species remains a critical challenge in biodiversity conservation, highlighting the need for effective prioritisation frameworks that integrate ecological, economic and policy considerations. Given that biological invasions are a population-level rather than a species-level phenomenon, more nuanced assessment schemes are needed. The Dispersal-Origin-Status-Impact (DOSI) scheme is such an example. Using the Rhine-Main-Observatory (RMO) Long-Term Ecological Research (LTER) site in Germany as a model system, we applied DOSI to rank the occurring non-native crayfish species to guide conservation actions. Our results classify the signal crayfish Pacifastacus leniusculus as the highest priority for management due to its expanding range, autonomous spread and severe ecological and economic impacts. The spiny-cheek crayfish Faxonius limosus follows as a medium-high priority species, while the red swamp crayfish Procambarus clarkii and the calico crayfish Faxonius immunis are ranked lower due to their shrinking or static populations despite their known potential impacts observed at other places. Our study highlights the utility of DOSI as a practical and scalable tool for invasion risk assessment, offering a targeted, data-driven approach to inform decision-making at the population level. By shifting the focus to population-level management, DOSI enhances conservation planning beyond traditional species-based assessments, providing a structured framework for mitigating the risks posed by invasive species in dynamic freshwater ecosystems
Understanding the Nature and Prevalence of Sexual Misconduct in the UK Prison and Probation Service
Get PDFSexual misconduct by prison and probation staff is a damaging behavior, both for the organisation and those in its care. The aim of this research is to identify and describe categories of behavior, and work towards a definition of sexual misconduct for the UK prison and probation service. A qualitative content analysis of 25 cases involving sexual contact between a staff member and incarcerated person was completed to explore the behaviors. With improved understanding of this behavior, findings can be used to develop interventions and investigation techniques to prevent this damaging behavior
Online grocery shopping in Europe: consumer research on the role of innovation and local food perceptions
Get PDFPurpose: This study investigates the determinants of online grocery shopping adoption in Europe, focusing on the effect of innovation adoption characteristics, food choice motives and local food perceptions on attitudes and purchase intentions. Based on the significant determinants for adoption, consumer segments are identified to gain insights into the diversity in online grocery shopping behaviour. Design/methodology/approach: A pan-European online survey was conducted in March 2024 with 2,899 respondents from Belgium, France, the UK, Spain and Croatia. The data were analysed using partial least squares structural equation modelling to examine relationships between innovation adoption, food preferences and local food perceptions. A segmentation analysis was also performed to identify distinct consumer groups. Findings: The research identifies the innovation adoption characteristics, perceived convenience and subjective norms as crucial in shaping purchase intentions across different countries. Additionally, the study reveals insights about the positive influence of e-commerce-related food choice motives on consumer attitudes, while perceived complexity, perceived product risk and local food perception showed negative effects. Five consumer segments were identified, with digital pioneers and complexity-averse consumers showing the highest engagement potential. Originality/value: This research provides a first multi-country assessment for the determinants of the adoption of online grocery shopping in a multi-country European context. New insights into the role of local food perceptions in online grocery shopping adoption are gathered, which can support the market access for small- and medium-sized producers
Hybrid Festival Visitors' Experience Using the Event Experience Theory in the Post-COVID-19 Era
Get PDFThe festival events sector has undergone a significant transformation with the rise of hybrid events, which blend physical and virtual components. This evolution has been notable since the COVID-19 pandemic, which necessitated innovative approaches to event organisation. The pandemic acted as a catalyst for the widespread adoption of hybrid events, reshaping the industry landscape and setting new standards for attendee engagement and experience. Structured interviews were conducted with 105 attendees from two major festivals. These interviews were designed based on the Event Experience Theory (EET), which provides a framework for understanding the dimensions of event experiences, including sensory perception, emotional engagement, cognitive involvement, and social interactions. The findings of this study contribute to the conceptualization of hybrid events experience. From a managerial perspective, research findings inform event organisers on effectively navigating the landscape of hybrid events with the aim to ensure event viability and attendees’ satisfaction