Transcendent Experiences Among Pilgrims to Lourdes: A Qualitative Investigation.

Millions of pilgrims visit Lourdes each year, often seeking revitalisation rather than miraculous cures. We sought to understand the phenomenon of transcendent experiences. We spoke with 67 pilgrims including assisted pilgrims, young volunteers and medical staff.

Factors associated with implant survival following total hip replacement surgery: A registry study of data from the National Joint Registry of England, Wales, Northern Ireland and the Isle of Man.

Background: Nearly 100,000 people underwent total hip replacement (THR) in the United Kingdom in 2018, and most can expect it to last at least 25 years. However, some THRs fail and require revision surgery, which results in worse outcomes for the patient and is costly to the health service. Variation in the survival of THR implants has been observed between units and reducing this unwarranted variation is one focus of the "Getting it Right First Time" (GIRFT) program in the UK.

Understanding public perceptions of healing: An arts-based qualitative study.

Background: Most healing research has focussed on the views of healers, complementary and alternative medical (CAM) practitioners or medical professionals, and little is known about how the general public conceives of healing. Because healing is a complex and often abstract concept, we addressed this gap in the knowledge using creative qualitative approaches with members of the public. We aimed to elucidate the views of members of the public about their healing, to help offer a better understanding to healthcare professionals.

Mental health in medical students: time to act.

Background: Mental health problems are prevalent amongst medical students. However, many students delay seeking medical help or support from the medical school for a variety of reasons, including a fear of facing fitness to practice proceedings. Tackling this problem of awareness and delayed presentation will need a strong and dedicated focus at all stages, with prevention being of great importance.

Clients of UK healers: A mixed methods survey of their demography, health problems, and experiences of healing.

Background: Healing has not been well researched, and very little is known about who goes to healers, and what they experience.

Methods: A survey of UK-based healers was undertaken with the help of The Confederation of Healing Organisations, asking healers to report on up to 20 consultations. Forms asked about the demography of healer and client, reasons for the consultation, type of healing, and outcomes.

One- and two-stage surgical revision of peri-prosthetic joint infection of the hip: a pooled individual participant data analysis of 44 cohort studies.

One-stage and two-stage revision strategies are the two main options for treating established chronic peri-prosthetic joint infection (PJI) of the hip; however, there is uncertainty regarding which is the best treatment option. We aimed to compare the risk of re-infection between the two revision strategies using pooled individual participant data (IPD). Observational cohort studies with PJI of the hip treated exclusively by one- or two-stage revision and reporting re-infection outcomes were retrieved by searching MEDLINE, EMBASE, Web of Science, The Cochrane Library, and the WHO International Clinical Trials Registry Platform; as well as email contact with investigators.

The characterisation of unexplained pain after knee replacement.

Background: The aims of this study were to characterise the pain experienced by patients with chronic pain after knee replacement (KR), in whom no apparent 'orthopaedic' problem could be identified, and to establish how many have pain sensitisation problems (including neuropathic pain).

Methods: A total of 44 patients were prospectively evaluated at a multidisciplinary tertiary referral clinic by an orthopaedic surgeon, pain specialist, rheumatologist and physiotherapist. These patients had been pre-screened by an orthopaedic surgeon to remove cases where there was an obvious cause of pain that could be treated with revision surgery.

Healing journey: a qualitative analysis of the healing experiences of Americans suffering from trauma and illness.

Objectives: To elucidate pathways to healing for people having suffered injury to the integrity of their function as a human being.

Methods: A team of physician-analysts conducted thematic analyses of in-depth interviews of 23 patients who experienced healing, as identified by six primary care physicians purposefully selected as exemplary healers.

Results: People in the sample experienced healing journeys that spanned a spectrum from overcoming unspeakable trauma and then becoming healers themselves to everyday heroes functioning well despite ongoing serious health challenges.

The Influence of Arthritis in Other Major Joints and the Spine on the One-Year Outcome of Total Hip Replacement: A Prospective, Multicenter Cohort Study (EUROHIP) Measuring the Influence of Musculoskeletal Morbidity.

Background: Although arthritis in other affected major joints and back pain are known to lead to worse outcomes following total hip replacement, to our knowledge, these risk factors have not previously been operationalized as a musculoskeletal morbidity profile. The aim of this study was to measure the influence of other major joints and the spine (as grades of musculoskeletal morbidity) on the 1-year outcome of primary total hip replacement.

Methods: The EUROHIP study consists of 1,327 patients undergoing primary total hip replacement for arthritis across 20 European orthopaedic centers.

Room for improvement: a randomised controlled trial with nested qualitative interviews on space, place and treatment delivery.

Objective: Healthcare-oriented design in hospitals can promote better clinical outcomes. Creating optimal facilities may increase treatment effects. We investigated the influence of the treatment room on effects of exercise therapy.

Transformational Changes in Health Status: A Qualitative Exploration of Healing Moments.

Background And Aims: Dramatic self-change is a familiar concept within religious experience and is recognized within psychotherapy and some fields of nursing. However, it has been given limited consideration in wider health research, including healing research. We sought to explore the phenomenon of "healing moments".

Rates of hip and knee joint replacement amongst different ethnic groups in England: an analysis of National Joint Registry data.

Objective: Despite a health care system that is free at the point of delivery, ethnic minorities may not always get care equitable to that of White patients in England. We examined whether ethnic differences exist in joint replacement rates and surgical practice in England.

Design: 373,613 hip and 428,936 knee National Joint Registry (NJR) primary replacement patients had coded ethnicity in Hospital Episode Statistics (HES).

Western medical acupuncture in a group setting for knee osteoarthritis: results of a pilot randomised controlled trial.

Background: Evidence suggests acupuncture may be effective for treating the symptoms of knee osteoarthritis. Offering this in a group setting may offer cost savings. The aim of this study was to establish the feasibility of a definitive trial to assess the clinical and cost-effectiveness of Western medical acupuncture given in groups, or given individually, for adults with severe knee pain attributable to osteoarthritis.

The power and value of placebo and nocebo in painful osteoarthritis.

This paper reviews some recent advances in our understanding of the effects of sham or dummy interventions on pain and other symptoms in osteoarthritis (OA), and outlines two new approaches to the investigation of placebo and nocebo effects. We argue that the placebo effect provides us with a valuable way of investigating the nature of conditions like OA. For example, by examining which symptoms, biochemical markers or imaging features do or do not respond to placebo, we might learn more about the relationships between pathology and symptoms in OA.

Central sensitization as a determinant of patients' benefit from total hip and knee replacement.

Background: Discrepancies exist between osteoarthritic joint changes and pain severity before and after total hip (THR) and knee (TKR) replacement. This study investigated whether the interaction between pre-operative widespread hyperalgesia and severity of radiographic osteoarthritis (OA) was associated with pain severity before and after joint replacement.

Methods: Data were analysed from 232 patients receiving THR and 241 receiving TKR.

Persistent pain after knee replacement: do factors associated with pain vary with degree of patient dissatisfaction?

Objective: Up to 20% of patients experience long-term pain and dissatisfaction following knee replacement. The aim of this study was to investigate factors associated with persistent pain following knee replacement and their implications for patient satisfaction.

Design: A case-controlled analysis compared patients with established persistent pain with patients who were pain-free.

Review of 99 self-report measures for assessing well-being in adults: exploring dimensions of well-being and developments over time.

Objective: Investigators within many disciplines are using measures of well-being, but it is not always clear what they are measuring, or which instruments may best meet their objectives. The aims of this review were to: systematically identify well-being instruments, explore the variety of well-being dimensions within instruments and describe how the production of instruments has developed over time.

Design: Systematic searches, thematic analysis and narrative synthesis were undertaken.

Selecting, assessing and interpreting measures of function for patients with severe hip pathology: The need for caution.

Introduction: It is not always possible to use a combination of patient-reported outcome measures (PROMs), performance tests and clinician-administrated measures to assess physical function prior to hip surgery. We hypothesised that there would be low correlations between these three types of measure and that they would be associated with different patients' characteristics.

Materials And Methods: We conducted a cross-sectional analysis of the preoperative information of 125 participants listed for hip replacement.

One-stage or two-stage revision surgery for prosthetic hip joint infection--the INFORM trial: a study protocol for a randomised controlled trial.

Background: Periprosthetic joint infection (PJI) affects approximately 1% of patients following total hip replacement (THR) and often results in severe physical and emotional suffering. Current surgical treatment options are debridement, antibiotics and implant retention; revision THR; excision of the joint and amputation. Revision surgery can be done as either a one-stage or two-stage operation.

Trajectories of Pain and Function after Primary Hip and Knee Arthroplasty: The ADAPT Cohort Study.

Background And Purpose: Pain and function improve dramatically in the first three months after hip and knee arthroplasty but the trajectory after three months is less well described. It is also unclear how pre-operative pain and function influence short- and long-term recovery. We explored the trajectory of change in function and pain until and beyond 3-months post-operatively and the influence of pre-operative self-reported symptoms.

A Consideration of the Perspectives of Healing Practitioners on Research Into Energy Healing.

Energy healing is a complex intervention with the purpose of enhancing wholeness within the client. Approaches to complex interventions require thoughtful utilization of a wide range of research methods. In order to advance the research in this field, we sought to understand the healing practitioners' point of view by reviewing qualitative literature, research reviews, and commentary written by and about practitioners.

A new responder criterion (relative effect per patient (REPP) > 0.2) externally validated in a large total hip replacement multicenter cohort (EUROHIP).

Objective: To validate a new method to identify responders (relative effect per patient (REPP) >0.2) using the OMERACT-OARSI criteria as gold standard in a large multicentre sample.

Method: The REPP ([score before - after treatment]/score before treatment) was calculated for 845 patients of a large multicenter European cohort study for THR.

Rest Pain and Movement-Evoked Pain as Unique Constructs in Hip and Knee Replacements.

Objective: There is limited information about the extent to which the association between preoperative and chronic postoperative pain is mediated via pain-on-movement or pain-at-rest. We explored these associations in patients undergoing total hip replacement (THR) and total knee replacement (TKR).

Methods: A total of 322 and 316 patients receiving THR and TKR, respectively, were recruited into a single-center UK cohort (Arthroplasty Pain Experience) study.