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Although epidemiologic studies of tibial plateau fractures have been conducted, none have included geographically defined populations or a validated fracture classification based on computed tomography (CT). The goals of this study were to provide up-to-date information on the incidence and basic epidemiology of tibial plateau fractures in a large unselected patient population and to report the mechanisms of injury involved and the distribution of fractures according to a validated CT-based fracture classification. The authors conducted a population-based epidemiologic study of all patients treated for tibial plateau fracture over a 6-year period from 2005 to 2010. The study was based on an average background population of 576,364 citizens. A retrospective review of hospital records was performed. During this time, a total of 355 patients were treated for tibial plateau fracture. This group included 166 men and 189 women, and mean age was 52.6 years (SD, 18.3). The most common fracture type was AO type 41-B3, representing 35% of all tibial plateau fractures. The second most common fracture type was AO type 41-C3, representing 17% of all tibial plateau fractures. The incidence of tibial plateau fractures was 10.3 per 100,000 annually. Compared with women, men younger than 50 years had a higher incidence of fractures. The incidence of fractures increased markedly in women older than 50 years but decreased in men older than 50 years. In both sexes, the highest frequency was between the ages of 40 and 60 years. [Although epidemiologic studies of tibial plateau fractures have been conducted, none have included geographically defined populations or a validated fracture classification based on computed tomography (CT). The goals of this study were to provide up-to-date information on the incidence and basic epidemiology of tibial plateau fractures in a large unselected patient population and to report the mechanisms of injury involved and the distribution of fractures according to a validated CT-based fracture classification. The authors conducted a population-based epidemiologic study of all patients treated for tibial plateau fracture over a 6-year period from 2005 to 2010. The study was based on an average background population of 576,364 citizens. A retrospective review of hospital records was performed. During this time, a total of 355 patients were treated for tibial plateau fracture. This group included 166 men and 189 women, and mean age was 52.6 years (SD, 18.3). The most common fracture type was AO type 41-B3, representing 35% of all tibial plateau fractures. The second most common fracture type was AO type 41-C3, representing 17% of all tibial plateau fractures. The incidence of tibial plateau fractures was 10.3 per 100,000 annually. Compared with women, men younger than 50 years had a higher incidence of fractures. The incidence of fractures increased markedly in women older than 50 years but decreased in men older than 50 years. In both sexes, the highest frequency was between the ages of 40 and 60 years. [ Orthopedics. 2015; 38(9):e780–e786.]

Incurable cancer significantly affects an individual's life, requiering comprehensive palliative care (PC). With early PC now recommended but poorly integrated, it is essential to address patients' experiences and concerns to ensure successful early PC integration. This study aims to investigate the experiences of life in the initial period following a diagnosis of incurable cancer to inform early PC integration. The study employed a phenomenological hermeneutical framework, drawing inspiration from interpretive descriptive methodology. Thirteen participants diagnosed with incurable cancer were purposively recruited. Data were generated through semi-structured, in-depth interviews exploring patients' experiences of lived life, their needs and wishes. Data analysis followed an iterative process of constant comparison and thematic development. One main theme was identified throughout the analysis: Standing still in the storm. Three sub-themes were identified reflecting varying manifestations innhow doing so, and navigating their challenging circumstances. peace: 1) The urge to take action, 2) Clarity and awakening in the face of reality, and 3) Changed self-perception. As their understanding of their illness deepened, the patients experienced a shift towards reconciliation. The experiences of patients living with incurable cancer reveal a complex interplay of psychological, emotional, and existential responses. It is essential that healthcare professionals address existential concerns within clinical care. By acknowledging and supporting patients' existential struggles, discussions about sensitive topics becomes more natural and better recieved by the patients. .

Background Patients with incurable cancer face complex physical, psychological, social, and existential challenges. Early integration of palliative care (PC) has proven essential to improve quality of life and well-being, yet implementation remains inconsistent and often delayed. To address this gap, we developed the Cross-PALL model, a cross-disciplinary approach to integrate PC across oncology and primary care. Methods Following the Medical Research Council’s framework for complex interventions, we used a participatory design approach to develop the model in collaboration with key stakeholders, including patients, their relatives, healthcare professionals from oncology, primary care, municipal services and representatives from voluntary organizations. Development involved iterative phases of evidence synthesis, needs assessment, field studies, collaborative workshops, and prototyping. For each of these phases, various methods and activities are applied to enhance genuine participation from all collaborators. Implementation determinants were continuously identified using the Consolidated Framework for Implementation Research, and a logic model was constructed to link determinants, implementation strategies, mechanisms, and outcomes. Results The Cross-PALL model is structured as a standardized care pathway designed to ensure systematic, person-centered, and coordinated PC. Key components include early initiation of PC at diagnosis, routine patient-reported outcome assessments, decision aids, navigation support, structured inter-sectoral communication, and integration of advance care planning. Conclusion The Cross-PALL model offers a feasible, scalable, evidence-informed approach to strengthen early PC integration in oncology. By combining implementation science with participatory design, the model aims to enhance relevance, sustainability, and continuity of care, ultimately supporting patients’ quality of life and well-being.

BackgroundShared care between oncology specialists and general practice regarding the delivery of palliative care (PC) is necessary to meet the demands for a cohesive PC. The primary objective of this study is to investigate models of cross-sectorial integration between primary care and oncology specialists that have been developed to promote early and basic PC and factors influencing the process.MethodA scoping review was conducted using publications dated up until April 2023. Searches were conducted in MEDLINE, CINAHL, Embase, Web of Science and ProQuest Dissertations and Theses. Complementary searches were performed via reference lists and grey literature. Explicit early PC models aimed at patients with cancer aged ≥18 years with healthcare professionals from primary care and oncology constituted the inclusion criteria. The screening of the papers was performed independently by two reviewers. The reporting adheres to the extension for scoping reviews of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.ResultsThe search provided 5630 articles of which six met the eligibility criteria, each describing a different model of early and cross-sectorial, integrated PC. 12 active components were identified. Education of staff as well as good communication and cooperation skills are essential factors to succeed with integrated, early PC.ConclusionIntegration of PC between general practice and oncology specialists has potential. The components of basic PC have been established. Factors known to influence the process are trust, communication and a common goal. Further research is required into strategies for approaching different levels of integration.

To explore the experiences of nurses and coordinators in the PRIMROSE childhood obesity prevention trial, and to understand the factors that might help to improve the outcome of future primary prevention of obesity. Using a qualitative approach, data were obtained by interviewing nine intervention nurses and three regional study coordinators. All participants were female. The interviews were transcribed and analysed using content analysis. Two themes emerged: The nurses experienced that it was rewarding to participate in the trial, but challenging to combine the intervention with regular work; and The study coordinators experienced that they were in a difficult position handling the conflicting needs of the research group and the nurses' commitment to usual child health care services. The importance of support, encouragement, briefer and simpler intervention, and adaptation of the training in motivational interviewing to the setting was emphasized. Stress and lack of time were major barriers to deliver the intervention as intended. Although the PRIMROSE intervention was developed in collaboration with representatives from the child health services, and additional research funding was provided to compensate for time spent working with the trial, nurses experienced stress and time constraints. .

Muscle strength is of importance for postsurgical rehabilitation. Myostatin is a growth factor that regulates the size of muscles and could thus influence muscle mass and function in the postsurgical period. The aim of the present study was to study the changes in myostatin levels during the postsurgical inflammatory period. Myostatin was analysed in serum samples from two elective surgery groups, orthopaedic surgery ( n  = 24) and coronary bypass patients ( n  = 21). The samples were collected prior to surgery and 4 and 30 days after surgery. In the orthopaedic group, the median myostatin levels decreased from 3582 ng/L prior to surgery to 774 ng/L at day 4 ( p  < 0.001) and to 2016 ng/L at day 30 ( p  < 0.001). Median CRP increased from 2.35 mg/L preoperatively to 117 mg/L at day 4 and decreased to 5.5 mg/L at day 30 in the same group. The coronary bypass group showed a similar pattern with a decrease in myostatin from 4212 ng/L to 2574 ng/L at day 4 ( p  < 0.001) and to 2808 ng/L at day 30 ( p  = 0.002). Median CRP increased from 1.80 mg/L preoperatively to 136 mg/L at day 4 and returned to 6.12 mg/L at day 30 in the coronary bypass group. There was a significant decrease in myostatin concentrations both in the early and late postsurgical period. The lowest myostatin concentration time point coincided with the highest CRP concentration time point.