Contralateral non-simultaneous proximal femoral fractures in patients over 65 years old

Purpose Epidemiological and clinical parameters according to the Parker-Palmer Index (PPI) have not been specifically studied as predictors of re-fracture time in patients over 65 years old with contralateral hip fracture. The main purpose of this study was to assess whether these parameters could represent a prognostic factor in this population. Methods This retrospective study included all consecutive patients older than 65 years that suffered from a proximal femoral fracture, 31 according to Association for Osteosynthesis/Orthopaedic Trauma Association classification, treated at our unit between Feb 1st 2019 and Feb 1st 2020. Results This study enrolled 387 patients. Thirty-seven of them had already incurred a contralateral hip fracture: seven males and 30 females. The median time between the first and second hip fractures was 3.5 years. This study revealed that increasing age (p = 0.003), male sex (p = 0.029) and a PPI value ≥ 5 between the first and second hip fracture (p = 0.015) are risk factors associated with a contralateral hip fracture in the first three years after the first episode. There were no statistically significant differences regarding anti-osteoporotic therapy and the anatomic site of the first hip fracture episode. Conclusion The results of the present study suggest that several risk factors have a crucial role in hip re-fracture time in patients over 65 years old.

Osteosynthesis of intertrochanteric fractures by PFN and DHS – A prospective randomized comparative study

Introduction: As the geriatric population increases, the incidence of intertrochanteric fractures (ITF) has also increased significantly. There are various modalities to treat these fractures. In this study our aim is to analyse outcomes of Proximal Femoral Nail (PFN) in comparison to those of Dynamic Hip Screw (DHS) for the treatment of ITF. Materials and Methods: This study was carried out during 2017–20. 150 patients of unstable ITF (AO type 31-A2, 31-A3) in elderly were randomly divided into two groups of 75 each and were treated either by DHS or PFN and were followed up regularly. Results: The results were compared between the groups and statistical analyses were performed. The results were assessed with Harris Hip Score(HHS) & Parker Palmer mobility score (PPMS) which were better in PFN group. Conclusion: PFN is a better fixation device for unstable ITF (31 A2 and 31 A3) in elderly patients.

Yoga Therapy: Building a Holding Environment for Somatic and Psyche Change

Drawing on ideas from D.W. Winnicott and the work of Quaker theologian Parker Palmer, this article discusses the concept of a holding environment, its refined understanding in the literature over the years, and how it can be optimally used in yoga therapy. The evidence shows that effectively establishing a holding environment can facilitate both somatic and deep structural change in a client, facilitating healing from primal wounding as well as the potential reconnection to the true self.

Cultivating a Community of Truth Through Critical Pedagogy When Faced with Resistance

This essay will identify how the authors confronted a community of resistance in a Gender and Communication classroom and turned it into a community of truth and tolerance. Working from a theoretical framework of Critical Pedagogy and the work of Parker Palmer, the authors will explore how the classroom is often seen as a culture of fear and disrespect. This culture of fear needs to be confronted by identifying a community of truth as found in two different models of truth. After exploring how to achieve a community of truth when faced with resistance, the authors will explain in great detail the application of a metaphor about “riding the bus” and how this metaphor has sustained them when faced with resistance.

Tratamento das fraturas femorais subtrocantéricas com placas de bloqueio lateral da parte proximal do fêmur

OBJETIVO: Estudar o desfecho de fraturas subtrocantéricas de quadril tratadas com placa de bloqueio lateral da parte proximal do fêmur. MÉTODO: Revisamos retrospectivamente os resultados clínicos de 48 casos de fraturas subtrocantéricas tratadas com placas de bloqueio lateral da parte proximal do fêmur de janeiro de 2008 a maio de 2010. Registrou-se o progresso da consolidação da fratura, assim como a ocorrência de complicações. A função da articulação do quadril foi avaliada pelo índice social de Harris e o escore de mobilidade de Parker-Palmer, um ano após a cirurgia. RESULTADO: Quarenta e cinco pacientes foram acompanhados até a união da fratura ou a revisão da cirurgia. Entre os 45 pacientes, 43 atingiram a união da fratura sem outra intervenção. Trinta e oito fraturas consolidaram sem perda da posição no acompanhamento de um ano. Não houve casos de perfuração da cabeça do fêmur pelo parafuso. O escore médio do índice social de Harris foi 86,5 ± 9,8 (73 ~95). A média do escore de mobilidade de Parker e Palmer foi 7,4 ± 2,1 (3~ 9). CONCLUSÃO: A placa de bloqueio lateral da parte proximal do fêmur é o tipo de fixação interna estável e efetiva para tratar as fraturas subtrocantéricas de quadril e tem a vantagem de fixação estável, em especial em fratura da parede lateral do fêmur. Nível de evidência IV, Série de Casos.

Creating An “Invitational Classroom” In The Online Educational Milieu

Parker Palmer, a scholar who studied effective face-to-face teaching, introduced the term the “invitational classroom” (1993, p. 71). In particular Palmer emphasized that “an air of hospitality” facilitated an inviting educational environment (p. 71). Hospitality in Palmer’s words means “receiving each other, our struggles, our newborn ideas, with openness and care” (p. 74). Palmer concludes that both teachers and learners experience positive consequence when the class environment is invitational. This paper explores a category of innovative teaching strategies, called artistic pedagogical technologies (APTs) that facilitate the experience of an invitational classroom in online courses (Perry & Edwards, 2010). APTs are teaching strategies founded in the arts. APTs described in this paper include photovoice, parallel poetry, and conceptual quilting. A study of the effect of these APTs on graduate students and instructors from a Canadian online university is described. The data collection and data analysis processes used in the study are detailed. Both students and instructors found the online classroom environment changed in a positive way in part because of APTs. Research participants reported that APTs initiated, sustained, and enhanced interactions among students and between students and the instructors (Perry & Edwards, 2010). These findings are analyzed using Palmer’s concepts of hospitality and the invitational classroom and Wenger’s Social Theory of Learning (1990). Practical ideas for educators regarding the use of APTS in teaching and course design are reviewed.

Identity Formation through Classroom Conversations and Collaboration with the Spirit

Miroslav Volf argues that God intends human beings to be co-workers with God in completing creation. Teachers in the classroom can be co-workers with God through the formation of students. Formation occurs, in part, through mutual relationships such as those between the person of the teacher and the person of the pupil. Conversations are important to formation and the Holy Spirit makes a major contribution to revelatory conversations. Martin Buber, Parker Palmer, Rowan Williams, and Simone Weil show how conversations contribute to formation and to the creation of a mutual presence and grace between conversational partners so that there is an exchange of words and feelings that resonates with the creative word of God working in the depths of the identity of each person. This process is described as a spiritual theology of teaching.