A psycho-social-environmental lens on radon air pollutant: authorities', mitigation contractors', and residents' perceptions of barriers and facilitators to domestic radon mitigation.

Introduction: Radon is a major indoor air pollutant that poses a significant risk of lung cancer to those exposed in their homes. While mitigation of high radon levels in homes has been shown to be effective, home mitigation rates remain low. This study examines the barriers and facilitators to radon mitigation in homes from the perspectives of authorities responsible for radon risk management, the mitigation industry (contractors), and residents in four European countries (Belgium, Ireland, Slovenia, and the UK) with high radon risks and low mitigation rates. Methods: A multi-method approach was used to gather data from various stakeholders, including online surveys, content analysis of legal documents, group interviews, workshops, and focus groups. Results: Authorities, contractors, and residents identified various facilitators to radon mitigation, including legal requirements for mitigation, awareness campaigns, low mitigation costs, availability of financial support, accreditation of mitigation contractors, and a perception of radon as a health threat. However, barriers to mitigation were also identified, such as a lack of awareness, fragmented mitigation processes, and inadequate communication between stakeholders. Discussion: The study highlights the complexity of the radon mitigation process and suggests that interventions aimed at increasing mitigation rates should target stakeholders beyond just residents, such as constructors, health professionals, and policy makers. An integrated approach to radon mitigation, from policy to provision, is necessary to effectively lower levels of this indoor air pollutant.

Outcomes following the single-incision anterior approach to total hip arthroplasty: a multicenter observational study.

The authors conducted a retrospective, multicenter cohort study of 1,152 patients across nine clinical sites across the United States, evaluating complications and function associated with the anterior approach to total hip arthroplasty using an orthopedic table. Eligible patients included those with primary diagnosis of hip arthritis. Outcomes included hospital stay, use of assistive devices, complications, and function. In the cohort of 1,152 patients treated with the anterior approach to total hip arthroplasty, the authors found (i) an acceptable complication profile with a very low dislocation rate, (ii) an early return to function, and (iii) a decline in complications in surgeons with greater than 100 case experiences.

Multicenter collaboration in observational research: improving generalizability and efficiency.

Utilizing a multicenter approach in observational clinical research allows for improved generalizability of the results, a larger sample size, and, consequently, improved efficiency. This paper highlights important issues with regard to the organization of multicenter observational studies in orthopaedic research. Specifically, we emphasize the development of trial committees, stress the importance of having a methods center for the purpose of coordinating day-to-day study activities, and describe the roles of the participating clinical sites. The successful conduct of multicenter studies requires careful study organization, a dedicated and experienced methods center, and motivated participating surgeons and study staff at the clinical sites. To illustrate the organization of a multicenter initiative, we use the example of a total hip arthroplasty collaborative.

Speciation/fractionation of nickel in airborne particulate matter: improvements in the Zatka sequential leaching procedure.

Modifications are reported to the sequential leaching analytical method for nickel speciation/fractionation specified by Zatka so that larger sample masses can be analyzed. Improvements have been made in the completeness of the sulfide/metallic separation during the peroxide-citrate leach step by use of a larger volume of leachant, a longer leach duration and an orbital shaker. Minimal extraction of metallic nickel in this prolonged sulfidic nickel extraction has been confirmed. An increase in the number of samples analyzed simultaneously using these modifications has resulted in substantial productivity improvements and concomitant lower costs. It is critical for practitioners of sequential leaching techniques to recognize potential limitations and to use professional judgment when interpreting results. For example, results obtained may not be biologically relevant in assessing health risks; the acts of sampling and storage may result in changes in fractionation with time; surface coatings/films may alter the ability of a leachant to react with the target compound; and leaching behaviours may be different for samples differing only in particle size distributions.

Accurate femur repositioning is critical during intraoperative total hip arthroplasty length and offset assessment.

Techniques for intraoperative leg length equalization are based on measurements between fixed points on the pelvis and femur. These techniques have not been reliable because they are based on accurate femur repositioning. We examined the error that results from inaccurate femur repositioning during total hip arthroplasty. Total hip arthroplasty was simulated on a calibrated test bench and changes in leg length and femoral offset were measured. Before dislocation, the femur was held in neutral alignment. Total hip arthroplasty was simulated without changing length or offset and the femur was returned to neutral. Length and offset changes were measured with the femur held in 5 degrees and 10 degrees of abduction/adduction and flexion/extension. Five degrees of abduction/adduction malpositioning caused 8 mm of apparent change in leg length. Errors in femoral offset followed a similar trend. When using common techniques for intraoperative leg length equalization and offset restoration, inaccurate abduction/adduction repositioning of the femur with respect to the pelvis can cause substantial errors in the measurement of length and offset change.