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BACKGROUND Problems of quality and safety persist in health systems worldwide. We conducted a large research programme to examine culture and behaviour in the English National Health Service (NHS). METHODS Mixed-methods study involving collection and triangulation of data from multiple sources, including interviews, surveys, ethnographic case studies,(More)
BACKGROUND AND PURPOSE We noticed that our instruments were often too hot to touch after preparing the femoral head for resurfacing, and questioned whether the heat generated could exceed temperatures known to cause osteonecrosis. PATIENTS AND METHODS Using an infra-red thermal imaging camera, we measured real-time femoral head temperatures during femoral(More)
Cutaneous scarring can cause patients symptoms ranging from the psychological to physical pain. Although the process of normal scarring is well described the ultimate cause of pathological scarring remains unknown. Similarly, exactly how early gestation fetuses can heal scarlessly remains unsolved. These questions are crucial in the search for a(More)
Advantages of the stapling procedure for haemorrhoids include reduced postoperative pain and shortened convalescence; however, there are few data with respect to functional and symptomatic outcome. At a dedicated clinic, we reviewed patients between Dec, 2001, and March, 2002, who had taken part in a randomised controlled trial undertaken at the unit in(More)
BACKGROUND AND PURPOSE Previously, we have documented surface temperatures recorded by thermography great enough to cause osteonecrosis of the femoral head during hip resurfacing. We now performed an in vitro investigation with 3 questions: (1) whether water irrigation reduced bone surface temperature, (2) whether external bone temperatures were similar to(More)
INTRODUCTION Total shoulder resurfacing (TSR) provides a reliable solution for the treatment of glenohumeral arthritis. It confers a number of advantages over traditional joint replacement with stemmed humeral components, in terms of bone preservation and improved joint kinematics. This study aimed to determine if humeral reaming instruments produce a(More)
Wear of ultra-high-molecular-weight polyethylene (UHMWPE) and the subsequent adverse tissue reaction to the wear particles has been cited as the predominant problem affecting total joint arthroplasties. Wear of the UHMWPE acetabular cup in total hip arthroplasties (THAs) is influenced by the sliding distance and direction of individual points on the femoral(More)
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