This longitudinal study analyses self-reported perfectionism, eating disorders and psychiatric symptoms during recovery from anorexia nervosa (AN). With a recovered design, a group of 68 previous patients with AN was studied in two follow-up studies, 8 and 16 years after 1st admission to Child and Adolescent Psychiatry (CAP). Levels of perfectionism stayed the same while eating disorder symptoms and psychiatric symptoms decreased during recovery. Levels of perfectionism were inversely related to duration of remission so that individuals that had short illness duration had lower levels of perfectionism at both follow-ups. Patients with initial high levels of perfectionism may be at risk for a long illness duration which we recommend clinicians to acknowledge.

The aim of this qualitative study was to describe the patients' perspective of the recovery process from anorexia nervosa. On average 16 years after initial assessment at child and adolescent psychiatric clinics, 68 women were interviewed about what they attributed as important factors in the recovery process of their adolescent onset anorexia nervosa. The answers were coded using content analysis. Those having recovered (n = 58) were able to describe clear turning points in their history and mentioned as most important aspects in their recovery: friends, own decisions, activities, treatment, family of origin, and own family.

Summary1. The size of an individual is an important determinant of its trophic position and the type of interactions it engages in with other heterospecific and conspecific individuals. Consequently an individual's ecological role in a community changes with its body size over ontogeny, leading to that trophic interactions between individuals are a size-dependent and ontogenetically variable mixture of competition and predation. 2. Because differently sized individuals thus experience different biotic environments, invasion success may be determined by the body size of the invaders. Invasion outcome may also depend on the productivity of the system as productivity influences the biotic environment. 3. In a laboratory experiment with two poeciliid fishes the body size of the invading individuals and the daily amount of food supplied were manipulated. 4. Large invaders established persistent populations and drove the resident population to extinction in 10 out of 12 cases, while small invaders failed in 10 out of 12 trials. Stable coexistence was virtually absent. Invasion outcome was independent of productivity. 5. Further analyses suggest that small invaders experienced a competitive recruitment bottleneck imposed on them by the resident population. In contrast, large invaders preyed on the juveniles of the resident population. This predation allowed the large invaders to establish successfully by decreasing the resident population densities and thus breaking the bottleneck. 6. The results strongly suggest that the size distribution of invaders affects their ability to invade, an implication so far neglected in life-history omnivory systems. The findings are further in agreement with predictions of life-history omnivory theory, that size-structured interactions demote coexistence along a productivity gradient.

To evaluate different modes of cementless fixation of hemispherical cups, we operated on 87 hips in 81 patients using 4 different means of cup fixation. The hips were randomly assigned to fixation with press-fit technique only (PF), or with augmentation with screws (S), pegs (P), or hydroxyapatite (HA) coating. The patients were evaluated with radiostereometric analysis (RSA) for cup migration and wear, conventional radiography for osteolysis, and Harris Hip Score for clinical outcome over 5 years. The fixation of the cups did not differ between the groups, but HA showed a tendency to decrease proximal migration. HA-coated cups displayed the best interface with hardly any signs of radiolucent lines, indicating a superior sealing effect of the HA coating. Cups with screws or pegs had more radiolucent lines and osteolytic lesions than the other groups. Radiolucent lines were correlated to higher proximal migration, young age, and female gender (r2=.2). The wear rate of the ethylene oxide-sterilized polyethylene liner was high (0.2 mm/y) but did not differ between the groups. Two cups with a perioperative fracture of the acetabular rim showed large initial migration but stabilized thereafter.

Background and purpose Highly cross-linked polyethylenes (PEs) all appear to reduce wear dramatically in laboratory studies, although there is substantial variation in this respect between manufacturers. Nonremelted cross-linked PE is almost as tough as unirradiated PE, but is not completely stable and can oxidize in vivo, as has been shown in recent retrievals studies.We had reported low wear and good clinical performance after 2 years for 10 non-remelted highly crosslinked PE cups compared to 16 conventional PE cups sterilized by gamma-in-air.Method Because of possible degradation by free radicals, we followed up both cohorts for 5 years (conventional PE) and 6 years (highly cross-linked PE).Result Mean (CI) proximal head penetration over the observation time was linear and measured 0.08 (0.02-0.13) mm for cross-linked PE and 0.42 (0.23-0.62) mm for conventional PE, and total penetration was 0.23 (0.1-0.35) mm and 0.75 (0.05-1.4) mm respectively. After subtracting creep, the annual wear for non-remelted highly cross-linked PE was below 6 µm. The cups had equally low migration and few radiolucencies.Interpretation The theoretical possibility of oxidation in non-remelted highly cross-linked PE may not show clinically. However, it may be that cemented cups with their thicker PE are more forgiving than metal-backed cups with thin PE moving in the locking mechanism. So far, we can conclude that the Crossfire highly crosslinked polyethylene cups performed very well clinically, with extremely low wear even after almost 6 years. This is reassuring, but care should be taken in extrapolating

Objective: This study examines the long-term outcome of adolescent onset anorexia nervosa, 8 and 16 years after first admission to child and adolescent psychiatric (CAP) treatment in northern Sweden. Method: Two follow-ups (1991 and 1999) were made of 68 women who were first admitted to CAP between 1980 and 1985. The follow-ups included interviews and self-report inventories. Eating disorders and GAF were evaluated according to DSM-III-R. Results: Recovery increased from 46 (68%) to 58 (85%). EDNOS (eating disorder not otherwise specified) decreased from 16 (24%) to seven (10%). The numbers for anorexia nervosa (AN) were the same, two (3%) in both follow-ups. Bulimia nervosa (BN) decreased from four (6%) in the first follow-up to one (1.5%) in the second follow-up. The mortality rate was one (1%). Selfevaluation of mental health indicated that 15% had problems with depression, anxiety or compulsive symptoms. Somatic problems and paediatric inpatient care during the first treatment period could predict long-term outcome. Most former patients had a satisfactory family and work situation. Conclusion: Recovery from eating disorders continued during the follow-ups.

Background and purposeMaximal total point motion (MTPM) measured by radiostereometry (RSA) is widely used as a predictor of total knee arthroplasty (TKA) loosening. We compared the ability of different RSA measurements at different time points to predict loosening of tibial TKA components in the long term.Patients and methods116 TKAs in 116 patients were included in our analysis. 16 (14.8–17.4) years after surgery, 5 tibial components had been revised due to aseptic loosening. Receiver operating characteristic curves were calculated in order to investigate the specificity and sensitivity of different RSA parameters at different thresholds.ResultsRotation around the transverse (x-) axis measured 2 years postoperatively had the best predictive value of all parameters, with an area under the curve (AUC) of 80%. Using a threshold of 0.8 degrees, a specificity of 85% and a sensitivity of 50% were reached. The AUC for tibial component distal translation was 79% and it was 77% for proximal translation, whereas it was only 68% for MTPM.InterpretationRotation of the cemented tibial component around the transverse axis, proximal translation, and distal translation are slightly better at predicting aseptic loosening than MTPM, and tibial component migration measured after 2 years gives a good prediction of aseptic loosening up to 15 years.

This qualitative study describes the perspectives of former anorexia nervosa (AN) patients with respect to why they believed they developed AN. Previous patients with initial treatment in child and adolescent psychiatric clinics in northern Sweden were interviewed 8 and 16 years after initial assessment. The question, "What do you think today about the reasons why you got AN?" was asked at both interviews. Content analyze was used to categorize the answers. Causes were attributed to self, family, and socio-cultural stressors outside of the family. Most common were high own demands and perfectionism. At the second follow-up there were more answers in the family categories. The results agreed with results from risk-factor research.