Mapping the Patient and Family Liaison Role in UK Helicopter Emergency Medical Services: A Service Evaluation.

Objective: Patient and family liaison practitioners are a relatively recent addition to UK helicopter emergency medical services to support patients with their recovery. A service evaluation was completed that mapped the current provision of patient and family liaison practitioner roles in helicopter emergency medical services in the United Kingdom.

Methods: An online survey was distributed to key stakeholders involved with UK helicopter emergency medical service patient and family liaison practitioner roles.

The addition of a flange does not improve the pressure generated during cemented acetabular cup implantation.

Flanged acetabular cups were developed with the rationale that, at insertion, they would increase the pressure of the cement and improve penetration of cement into the acetabular bone. Various studies have been inconclusive regarding their effectiveness. In this work, we aimed to eliminate all confounding factors and measure the pressures generated during acetabular pressurization and cup implantation using a simplified steel acetabulum, high precision pressure transducers, proper surgical techniques and two acetabular cups, identical apart from the addition of a flange to one.

Does vacuum mixing affect diameter shrinkage of a PMMA cement mantle during in vitro cemented acetabulum implantation?

Radiolucent lines on immediate postoperative cemented acetabular component radiographs between the PMMA bone cement mantle and bone are an indicator of an increased risk of early loosening. The cause of these lines has yet to be identified. Thermal and chemical necrosis, fluid interposition and cement shrinkage have all been suggested in the literature.

Development of a smart-fit system for CPAP interface selection.

Continuous Positive Airway Pressure (CPAP) therapy is commonly prescribed for longstanding, acute cases of Obstructive Sleep Apnea (OSA) during which patients must wear a tight-fitting breathing mask overnight for the duration of the treatment. Because this condition frequently leads to the permanent use of CPAP masks, interface selection is a crucial factor influencing the treatment quality and effectiveness. Masks/interface selection is normally performed on a trial an error basis with clinicians informing their selection based on OSA-related factors with basic fitting feedback from patients.

Mask interface for continuous positive airway pressure therapy: selection and design considerations.

Introduction: Continuous positive airway pressure (CPAP) therapy is a clinical treatment for moderate or severe obstructive sleep apnea (OSA). Commercial CPAP mask designs normally come in standard sizes and the configuration is not commonly tailored to the patients' characteristics such as face topology, skin sensitivity, and severity of OSA syndrome; however, an optimal mask/interface selection is a key factor influencing the compliance and effectiveness of CPAP treatment.

Areas Covered: This review investigates the conventional CPAP mask design, its effect on OSA treatment, and the related risk factors that can lead to skin damage after long-term repeated use.

Wear properties of poly-ether-ether-ketone bearing combinations under zero and cross shear kinematics in total knee arthroplasty.

Poly-ether-ether-ketone (PEEK), having shown favorable biocompatibility in spinal applications is being considered as an alternative biomaterial in orthopaedics, either as part of an all-polymer bearing couple, or a replacement for the metallic component in hard-on-soft bearings. Throughout the literature ultra-high molecular weight polyethylene exhibits a range of wear behavior dependent upon the amount of cross shear (CS) present in the bearing motion; in comparison, the behavior of PEEK bearing combinations subject to cross shear conditions is less understood. The aim of this study was to investigate the effect of cross shear on PEEK-on-PEEK and PEEK-on-Metal bearing couples.

Wear characteristics of an unconstrained lumbar total disc replacement under a range of in vitro test conditions.

The effect of kinematics, loading and centre of rotation on the wear of an unconstrained total disc replacement have been investigated using the ISO 18192-1 standard test as a baseline. Mean volumetric wear rate and surface morphological effects were reported. Changing the phasing of the flexions to create a low (but finite) amount of crossing path motion at the bearing surfaces resulted in a significant fall in wear volume.

Availability and utilisation of physician-based pre-hospital critical care support to the NHS ambulance service in England, Wales and Northern Ireland.

Background: Every day throughout the UK, ambulance services seek medical assistance in providing critically ill or injured patients with pre-hospital care.

Objective: To identify the current availability and utilisation of physician-based pre-hospital critical care capability across England, Wales and Northern Ireland.

Design: A postal and telephone survey was undertaken between April and December 2009 of all 13 regional NHS ambulance services, 17 air ambulance charities, 34 organisations affiliated to the British Association for Immediate Care and 215 type 1 emergency departments in England, Wales and Northern Ireland.

Cross-shear implementation in sliding-distance-coupled finite element analysis of wear in metal-on-polyethylene total joint arthroplasty: intervertebral total disc replacement as an illustrative application.

Computational simulations of wear of orthopaedic total joint replacement implants have proven to valuably complement laboratory physical simulators, for pre-clinical estimation of abrasive/adhesive wear propensity. This class of numerical formulations has primarily involved implementation of the Archard/Lancaster relationship, with local wear computed as the product of (finite element) contact stress, sliding speed, and a bearing-couple-dependent wear factor. The present study introduces an augmentation, whereby the influence of interface cross-shearing motion transverse to the prevailing molecular orientation of the polyethylene articular surface is taken into account in assigning the instantaneous local wear factor.

Pulseless electrical activity after rapid administration of fresh frozen plasma.

We present two extreme low birthweight preterm neonates who developed pulseless electrical activity during dilutional exchange transfusions with fresh frozen plasma (FFP). Both were polycythaemic recipient twins delivered prematurely because of foetal compromise as a result of twin-to-twin transfusion syndrome. The two events were associated with an acute fall in ionised calcium.

Diffusivity and distribution of vinblastine in three-dimensional tumour tissue: experimental and mathematical modelling.

The distribution of chemotherapeutics in solid tumours is poorly understood and the contribution it makes to treatment failure is unknown. Novel approaches are required to understand how the three-dimensional organisation of cancer cells in solid tumours affects drug availability. Since convective drug transport is limited by increased interstitial pressure in poorly vascularised cancers, the aim of this study was to measure the diffusive hindrance exerted by solid tumour tissue.