Tobramycin-impregnated bone cement is frequently used in revision procedures of infected total hip and knee arthroplasties. Aminoglycoside-impregnated cement is typically fashioned into beads or block spacers, which are temporarily placed in infected joint spaces. The use of aminoglycoside-impregnated bone cement has allowed the local concentration to exceed the minimum inhibitory concentration breakpoint of susceptible organisms while serum concentrations after 48 hours were usually not detected. Nephrotoxic complications are rarely encountered with this type of antibiotic delivery method. However, we report the case of an 85-year-old man with a history of renal insufficiency who experienced acute renal failure after undergoing revision treatment of an infected knee arthroplasty with the combined use of tobramycin-cefazolin bone cement and a block spacer. Clinicians should be aware of the potential for aminoglycoside-induced nephrotoxicity from the use of this combination.
Applying Ajzen's (1991) theory of planned behaviour to inform a persuasive communication intervention involves a number of phases of field research. While the initial belief elicitation phase is theoretically necessary to inform all subsequent phases, it is often undervalued due to its formative nature. To assess the importance of the elicitation phase, research was undertaken at two national parks to identify the beliefs underlying visitor use of alternative transportations systems (ATS) that have been introduced to reduce the pressures created by growing vehicle numbers. Results indicate that although visitors at the two parks share some beliefs, others are site-specific. Persuasive communication aimed at encouraging visitor use of ATS at the two parks would therefore need to potentially target different beliefs. The research demonstrates that the elicitation phase was a critical first step in the context of this study, as beliefs cannot be intuited or assumed to be transferable among different populations and behavioural domains. The paper adds to a growing body of literature informing the use of theory-driven approaches to influence the leisure behaviour of national park visitors.
Plastic pollution is a critical global sustainability challenge, but the social norms associated with single-use plastics are changing. These new norms could be encouraging consumer behaviour change by highlighting which behaviours are common and acceptable. This paper explores the role of social norms in predicting plastic avoidance, using the theory of normative social behaviour (TNSB). A representative survey (n = 1,001) was conducted measuring consumer behaviour in relation to four singleuse plastic items (bags, straws, coffee cups, and takeaway containers). Descriptive norms were found to be the strongest predictor of plastic avoidance and most of the remaining variables moderated the norm-behaviour relationship. However, the relative importance of each variable differed depending on the specific item and behaviour. These findings indicate that there is an opportunity to use social norm messaging to close the perception-action gap among consumers in order to address a global sustainability problem. Social norms are the unwritten rules, which guide individual behaviour based on what others are doing (descriptive norms) and what others approve and disapprove of (injunctive norms) (Cialdini, Kallgren, &
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