The realities and expectations of community involvement in COVID-19 research: a Consumer Reference Group perspective.

BACKGROUND: Older adults have been disproportionately impacted by the COVID-19 pandemic. COVID-19 restrictions such as stay at home orders and physical distancing measures have been implemented to reduce older adults' risk of infection, however, such measures can have negative effects on older adults' mental health and social wellbeing. In 2020, the research team received funding as part of an Australian COVID-19 research grants program to investigate how services can better meet the mental health and social support needs of older adults during COVID-19. A Consumer Reference Group (CRG) was established to provide a community perspective on all research activities. MAIN BODY: The CRG comprised of eight older adults aged 65 years and older living in Western Australia. Two members of the CRG were involved in the initial grant proposal, and one member worked for a not-for-profit organisation that provides support and advocacy for older adults. The CRGs role was to provide consumer and community perspectives on the research design, advise on study materials, facilitate links between consumers, the community, and researchers, and advocate on behalf of consumers and the community. The CRG was encouraged to reflect on the research project, their contributions, and the outcomes obtained. In this commentary, we document the CRGs contributions to the project, and record their reflections, including what went well, what were some challenges, the realities of conducting research during COVID-19, and lessons learnt. CONCLUSION: The CRG were active participants in the research process. They shared their perspectives and made important contributions to the project. Through collaboration with the CRG, we were able to reach four key messages, underpinned by consumers lived experiences, that were used to co-develop knowledge translation products. These were disseminated to service providers and older adults.

Since the start of the COVID-19 pandemic, health and social measures have been introduced to reduce the spread of the virus, including lockdowns, physical distancing, and mask mandates. Older adults (aged 60 years and older) are considered particularly vulnerable to COVID-19 and have therefore faced some of the greatest restrictions to reduce their risk of infection. These restrictions can have a negative effect on older adults social and emotional wellbeing. In 2020 the research team received funding to investigate how services could better meet the mental health and social support needs of older Australians during the pandemic. To enable a community perspective on all research activities, a Consumer Reference Group (CRG) of eight older adults living in Western Australia was established. Two of the eight CRG members were involved in the initial grant proposal. The CRG's role was to share their thoughts on the research design, study materials, and to provide links to and advocate for consumers and the community. This commentary reports reflections from the CRC on what went well, what some of the challenges were, the realities of conducting this research during COVID-19, and what lessons were learnt. Through collaboration with the CRG key messages for the research project were reached and used to inform infographics, which were then disseminated to inform service delivery providers and older adults of the research outcomes.

The use of 4D-CT in assessing wrist kinematics and pathology: a narrative view.

The wrist is a complex joint involving many small bones and complicated kinematics. It has, therefore, been traditionally difficult to image and ascertain information about kinematics when making a diagnosis. Although MRI and fluoroscopy have been used, they both have limitations. Recently, there has been interest in the use of 4D-CT in imaging the wrist. This review examines the literature regarding the use of 4D-CT in imaging the wrist to assess kinematics and its ability to diagnose pathology. Some questions remain about the description of normal ranges, the most appropriate method of measuring intercarpal stability, the accuracy compared with established standards, and the place of 4D-CT in postoperative assessment. Cite this article: Bone Joint J 2019;101-B:1325-1330.

The history of suture anchors in orthopaedic surgery.

The suture anchor allows secure fixation of soft tissue to bone and has become an invaluable tool for the orthopaedic surgeon. The original suture anchor was developed over 3 decades ago when a suture was bonded to a headless screw. Since then anchors have undergone a wide variety of design modifications to increase strength and allow for new applications based on biomechanical and clinical evidence. The suture anchor chain consists of the anchor to bone fixation, anchor suture interface, suture itself and suture to soft tissue interface. The early suture anchors failed most commonly from anchor pull out or breakage, with the strongest early design being a bone-screw-suture complex. Early concerns of metalwork complications saw the introduction of biodegradable suture anchors, originally lactic acid polymers and then osteoconductive bio-composites. Improvements in anchor design saw the suture become the main link of failure until the advent of novel suture materials made of ultrahigh molecular weight polyethylene. A form failure of suture at the anchor eyelet via cut-out led to redesign of the anchor suture interface with novel eyelet designs. Further innovations in the anchor suture interface have seen the advent of knotless anchors, especially useful in arthroscopic surgery. The newest products are all-suture anchors which show impressive strength whilst reducing the iatrogenic damage caused by insertion. The further biomechanical development of suture anchors is likely to produce new designs that continue to increase strength whilst managing size requirements for tailored clinical applications.