Total hip arthroplasty in young patients : with special references to patients under 55 years of age and to patients with developmental dysplasia of the hip

There is an ongoing controversy as to which methods in total hip arthroplasty (THA) could provide young patients with best long-term results. THA is an especially demanding operation in patients with severely dysplastic hips. The optimal surgical treatment for these patients also remains controversial. The aim of this study was to evaluate the long-term survival of THA in young patients (<55 years at the time of the primary operation) on a nation-wide level, and to analyze the long-term clinical and radio-graphical outcome of uncemented THA in patients with severely dysplastic joints. Survival of 4661 primary THAs performed for primary osteoarthritis (OA), 2557 primary THAs per-formed for rheumatoid arthritis (RA), and modern uncemented THA designs performed for primary OA in young patients, were analysed from the Finnish Arthroplasty Register. A total of 68 THAs were per-formed in 56 consecutive patients with high congenital hip dislocation between 1989-1994, and 68 THAs were performed in 59 consecutive patients with severely dysplastic hips and a previous Schanz osteotomy of the femur between 1988-1995 at the Orton Orthopaedic Hospital, Helsinki, Finland. These patients underwent a detailed physical and radiographical evaluation at a mean of 12.3 years and 13.0 years postoperatively, respectively. The risk of stem revision due to aseptic loosening in young patients with primary OA was higher for cemented stems than for proximally porous-coated or HA-coated uncemented stems implanted over the 1991-2001 period. There was no difference in the risk of revision between all-poly cemented-cups and press-fit porous-coated uncemented cups implanted during the same period, when the end point was defined as any revision (including exchange of liner). All uncemented stem designs studied in young patients with primary OA had >90% survival rates at 10 years. The Biomet Bi-Metric stem had a 95% (95% CI 93-97) survival rate even at 15 years. When the end point was defined as any revision, 10 year survival rates of all uncemented cup designs except the Harris-Galante II decreased to <80%. In young patients with RA, the risk of stem revision due to aseptic loosening was higher with cemented stems than with proximally porous-coated uncemented stems. In contrast, the risk of cup revision was higher for all uncemented cup concepts than for all-poly cemented cups with any type of cup revision as the end point. The Harris hip score increased significantly (p<0.001) both in patients with high con-genital hip dislocation and in patients with severely dysplastic hips and a previous Schanz osteotomy, treated with uncemented THA. There was a negative Trendelenburg sign in 92% and in 88% of hips, respectively. There were 12 (18%) and 15 (22%) perioperative complications. The rate of survival for the CDH femoral components, with revision due to aseptic loosening as the end point, was 98% (95% CI 97-100) at 10 years in patients with high hip dislocation and 92% (95% CI, 86-99) at 14 years in patients with a previous Schanz osteotomy. The rate of survival for press-fit, porous-coated acetabular components, with revision due to aseptic loosening as the end point, was 95% (95% CI 89-100) at 10 years in patients with high hip dislocation, and 98% (95% CI 89-100) in patients with a previous Schanz osteotomy. When revision of the cup for any reason was defined as the end point, 10 year sur-vival rates declined to 88% (95% CI 81-95) and to 69% (95% CI, 56-82), respectively. For young patients with primary OA, uncemented proximally circumferentially porous- and HA-coated stems are the implants of choice. However, survival rates of modern uncemented cups are no better than that of all-poly cemented cups. Uncemented proximally circumferentially porous-coated stems and cemented all-poly cups are currently the implants of choice for young patients with RA. Uncemented THA, with placement of the cup at the level of the true acetabulum, distal advancement of the greater trochanter and femoral shortening osteotomy provided patients with high congenital hip dislocation good long-term outcomes. Most of the patients with severely dysplastic hips and a previous Schanz osteotomy can be successfully treated with the same method. However, the subtrochanteric segmental shortening with angular correction gives better leg length correction for the patients with a previous low-seated unilateral Schanz osteotomy.

Stone baby: An exploration of affect and trauma in visual art

Stone Baby: An Exploration of Affect and Trauma in Visual Art was held at the Block, QUT Creative Industries Precinct on August 27-28, 2014. At the conclusion of my Masters project, this exhibition was a showcase of the outcomes of my material and digital explorations in the form of installation, sculpture and film. My primary motivation can be described as a relational and ethical attempt to find a balance between the erotic and the aggressive. This is experienced in the self as feelings of attraction and repulsion in response to the new and unknown "other". Consequently creative practice is necessarily a complex affair that is experienced as a completely immersive and self-contained psychological space. It is within this space that both physical sensation and raw emotion are able to tangibly and conceptually interact with psychoanalytic theory, and concrete materials video and sound.

The Art of Studio Teaching

This project began in 2013, with the award of an internal QUT Teaching and Learning grant. The task we wished to undertake was to document and better understand the role of studio teaching practice in the Creative Industries Faculty. While it was well understood that the Faculty had long used studio pedagogies as a key part of its teaching approach, organizational and other changes made it productive and timely to consider how the various study areas within the Faculty were approaching studio teaching. Chief among these changes were innovations in the use of technology in teaching, and at an organizational level the merging of what were once two schools within different faculties into a newly-structured Creative Industries Faculty. The new faculty consists of two schools, Media, Entertainment and Creative Art (MECA) and Design. We hoped to discover more about how studio techniques were developing alongside an ever-increasing number of options for content delivery, assessment, and interaction with students. And naturally we wanted to understand such developments across the broad range of nineteen study areas now part of the Creative Industries Faculty. This e-book represents the first part of our project, which in the main consisted in observing the teaching practices used in eight units across the Faculty, and then interviews with the unit coordinators involved. In choosing units, we opted for a broad opening definition of ‘studio’ to include not only traditional studios but also workshops and tutorials in which we could identify a component of studio teaching as enumerated by the Australian Learning and Teaching Council’s Studio Teaching Project: • A culture, a creative community created by a group of students and studio teachers working together for periods of time • A mode of teaching and learning where students and studio teachers interact in a creative and reflective process • A program of projects and activities where content is structured to enable ‘learning in action’ • A physical space or constructed environment in which the teaching and learning can take place (Source: http://www.studioteaching.org/?page=what_is_studio) The units we chose to observe, and which we hoped would represent something of the diversity of our study areas, were: • Dance Project 1 • Furniture Studies • Wearable Architecture • Fashion Design 4 • Industrial Design 6 • Advanced Writing Practice 3 • Introduction to Creative Writing • Studio Art Practice 2 Over the course of two semesters in 2013, we attended classes, presentations, and studio time in these units, and then conducted interviews that we felt would give further insight into both individual and discipline-specific approaches to studio pedagogies. We asked the same questions in each of the interviews: • Could you describe the main focus and aims of your unit? • How do you use studio time to achieve those aims? • Can you give us an example of the kind of activities you use in your studio teaching? • What does/do these example(s) achieve in terms of learning outcomes? • What, if any, is the role of technology in your studio teaching practice? • What do you consider distinctive about your approach to studio teaching, or the approach taken in your discipline area? The unit coordinators’ responses to these questions form some of the most interesting and valuable material in this book, and point to both consistencies in approach and teaching philosophies, as well as areas of difference. We believe that both can help to raise our critical awareness of studio teaching, and provide points of comparison for the future development of studio pedagogy in the Creative Industries. In each of the following pages, the interviews are placed alongside written descriptions of the units, their aims and outcomes, assessment models, and where possible photographs and video footage, as well as additional resources that may be useful to others engaged in studio teaching.

The Science and Art of Light

Architecture today often is praised for its tectonics, floating volumes, and sensational, gravity-defying stunts of “starchitecture.” Yet, very so often there is a building that inspires descriptions of the sublime, the experiential, and the power of light and architecture to transcend our expectations. The new Meinel Optical Sciences Research Building, designed by Phoenix-based Richärd+Bauer for the University of Arizona, Tucson, is one of these architectural rarities. Already drawing comparisons to Louis Kahn's 1965 Salk Institute for Biological Studies in La Jolla, California, the indescribable quality of light that characterizes the best of Kahn's work also resonates in Richärd+Bauer's new building. Both an expansion and renovation of the existing College of Optical Sciences facilities, the Meinel building includes teaching and research laboratories, six floors of offices, discussion areas, conference rooms, and an auditorium. The new 47,000 square-foot cast-in-place concrete structure, wrapped on three-sides in copper-alloy panels, harmonizes with the largely brick vocabulary of the campus while reflecting the ethereal quality of the wide Arizona sky. The façade, however, is merely a prelude for what awaits inside—where light and architecture seamlessly combine to create moments of pure awe.

Highlight: Yale University Art Gallery

Modern architecture, with its exposed concrete, glass, and steel expanses, does not age gracefully. The Yale University Art Gallery, designed by architecture great Louis Kahn, is no exception. As Yale's first modernist building, completed in 1953, and Kahn's first major commission and collaboration with pioneering lighting designer, Richard Kelly, the gallery is an important part of American architecture. Yet, despite its iconic status, the building suffered numerous architectural indignities in the years following its completion, including the insertion of permanent gallery partitions, which divided Kahn's open plan, and the enclosure of an exterior court, which blocked daylight to the lower galleries.

Reengaging, reenacting and reenvisaging discourses of disaster through public space performance: Austerity, art, and the art of protest

This paper offers a mediation on disaster, recovery, resilience, and restoration of balance, in both a material and a metaphorical sense, when ‘disaster’ befalls not the body politic of the nation but the body personal. In the past few decades, of course, artists, activists and scholars have deliberately tried to avoid describing personal, physical and phenomenological experiences of the disabled body in terms of difficulty and disaster. This has been part of a political move, from a medical model, in which disability, disease and illness are positioned as personal catastrophes, to a social model, in which disability is positioned as a social construct that comes from systems, institutions and infrastructure designed to exclude different bodies. It is a move that is responsible for a certain discomfort people with disabilities, and artists with disabilities, today feel towards performances that deploy disability as a metaphor for disaster, from Hijikata, to Theatre Hora. In the past five years, though, this particular discourse has begun rising again, particularly as people with disabilities fact their own anything but natural disasters as a result of the austerity measures now widespread across the US, UK, Europe and elsewhere. Measures that threaten people’s ability to live, and take part in social and institutional life, in any meaningful way. Measures that, as artist Katherine Araniello notes, also bring additional difficulty, danger, and potential for disaster as they ripple outwards across the tides of familial ties, threatening family, friends, and careers who become bound up in the struggle to do more with less. In this paper, I consider how people with disabilities use performance, particularly public space interventionalist performance, to reengage, renact and reenvisage the discourse of national, economic, environmental or other forms of disaster, the need for austerity, the need to avoid providing people with support for desires and interests as well as basic daily needs, particularly when fraud and corruption is so right, and other such ideas that have become an all too unpleasant reality for many people. Performances, for instance, like Liz Crow’s Bedding Out, where she invited people into her bed – for people with disabilities a symbolic space, which necessarily becomes more a public living room restaurant, office and so forth than a private space when poor mobility means they spend much time it in – to talk about their lives, their difficulties, and dealing with austerity. Or, for instance, like the Bolshy Divas, who mimic public and political policy, reports and advertising paranoia to undermine their discourses about austerity. I examine the effects, politics and ethics of such interventions, including examination of the comparative effect of highly bodied interventions (like Crow’s) and highly disembodied interventions (like the Bolshy Diva’s) in discourses of difficulty, disaster and austerity on a range of target spectator communities.