Food shortages, stockpiling and panic buying ahead of Brexit as reported by the British media: a mixed methods content analysis.

BACKGROUND: On 23 June 2016, the United Kingdom voted to leave the European Union. From that date until the UK left the EU in January 2021, there were frequent warnings from industry and government sources of potential disruption to the food supply chain and possible food shortages. Over this period, the media had an important role in communicating on the potential impacts of Brexit. This study examines how food supply and demand, in the context of Brexit, was portrayed by the British media. METHODS: The study consisted of two components: (1) a quantitative analysis measuring frequency of reporting and information sources for articles on food supply and demand in the context of Brexit, in three daily newspapers, between January 2015 and January 2020; and (2) a content analysis exploring key themes and media framing of relevant issues in a subset of articles. RESULTS: Reports by the media about the impact of Brexit on the UK food system were largely absent in the six months before the UK voted to leave the EU in June 2016, increasing in frequency from mid-2018 onward, peaking in mid-2019 following the appointment of Boris Johnson as prime minister. Five themes were developed from included articles: food shortages/panic buying (appearing in 96% of articles); food chain disruption (86%); economic impacts (80%); preparation and stockpiling by the government/food sector (63%) and preparation and stockpiling by individuals (22%). CONCLUSION: Government messaging sought to reassure the public that even under a worst-case scenario there would be no food shortages. These messages, however, contradicted warnings in the media of disruption to the food supply chain and food shortages. The media further reinforced this narrative of potential food shortages by reporting on the experiences of those preparing for Brexit by stockpiling food. The media must consider the impact of their messaging on public behaviour, as even imagined food shortages can instigate stockpiling and panic buying behaviour, as observed during the COVID-19 pandemic.

Patient beliefs and perceptions play a crucial role in the decision-making process when managing a meniscal tear. A qualitative systematic review of the literature.

INTRODUCTION: There has been an increase in research on the effectiveness of treatment options for the management of meniscal tears. However, there is very little evidence about the patient experiences of meniscal tears. AIM: To summarise the available qualitative evidence on patients' experiences and expectations of meniscal tears. METHOD: A search of EMBASE, Medline, Sociofile and Web of Science up to November 2020 was performed to identify studies reporting patient experiences of meniscal tears. Studies were critically appraised using the CASP (Critical Appraisal Skills Program) checklist, and a meta-synthesis was performed to generate third-order constructs (new themes). RESULTS: Two studies reporting semi-structured interviews from 34 participants (24 male; 10 female) were included. The mean interview length ranged from 16 to 45 min. Five themes were generated: (1) the imaging (MRI) results are a key driver in the decision-making process, (2) surgery is perceived to be the definitive and quicker approach, (3) physiotherapy and exercise is a slower approach which brought success over time, (4) patient perceptions and preferences are important in the clinical decision-making process and, (5) the impact on patient lives is a huge driver in seeking care and treatment decisions. CONCLUSION: This is the first study to summarise the qualitative evidence on patient experiences with meniscal tears. The themes generated demonstrate the importance of patient perceptions of MRI findings and timing of treatment success as important factors in the decision-making process. This study demonstrates the need to strengthen our understanding of patients' experiences of meniscal tears.

Kinematic alignment of current TKA implants does not restore the native trochlear anatomy.

INTRODUCTION: Preserving constitutional patellofemoral anatomy, and thus producing physiological patellofemoral kinematics, could prevent patellofemoral complications and improve clinical outcomes after kinematically aligned TKA (KA TKA). Our study aims 1) to compare the native and prosthetic trochleae (planned or implanted), and 2) to estimate the safety of implanting a larger Persona® femoral component size matching the proximal lateral trochlea facet height (flange area) in order to reduce the native articular surfaces understuffing generated by the prosthetic KA trochlea. METHODS: Persona® femoral component 3D model was virtually kinematically aligned on 3D bone-cartilage models of healthy knees by using a conventional KA technique (group 1, 36models, planned KA TKA) or an alternative KA technique (AT KA TKA) aiming to match the proximal (flange area) lateral facet height (10 models, planned AT KA TKA). Also, 13postoperative bone-implant (KA Persona®) models were co-registered to the same coordinate geometry as their preoperative bone-cartilage models (group 2implanted KA TKA). In-house analysis software was used to compare native and prosthetic trochlea articular surfaces and medio-lateral implant overhangs for every group. RESULTS: The planned and performed prosthetic trochleae were similar and valgus oriented (6.1 and 8.5, respectively), substantially proximally understuffed compared to the native trochlea. The AT KA TKAs shows a high rate of native trochlea surface overstuffing (70%, 90%, and 100% for lateral facet, groove, medial facet) and mediolateral implant overhang (60%). There was no overstuffing with conventional KA TKAs having their anterior femoral cut flush. CONCLUSION: We found that with both the planned and implanted femoral components, the KA Persona® trochlea was more valgus oriented and understuffed compared to the native trochlear anatomy. In addition, restoring the lateral trochlea facet height by increasing the femoral component size generated a high rate of trochlea overstuffing and mediolateral implant overhang. While restoring a native trochlea with KA TKA is not possible, the clinical impact of this is low, especially on PF complications. In current practice it is better to undersize the implants even if it does not restore the native anatomy. Longer follow-up is needed for KA TKAs performed with current implant, and the debate of developing new, more anatomic, implants specifically designed for KA technique is now opened. LEVEL OF EVIDENCE: II, Laboratory controlled study.