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He had to build up the ortho- his real greatness was as a leader and a colleague buy diclofenac gel pills in toronto arthritis medication reviews. He was on his own in those if he was displeased by its quality order diclofenac gel us arthritis care, he was pre- days and his duties held him to his work. This criticism, always being just About 1967, seeing his wife Sheila put up some and fair, increased the respect of those concerned net curtains on curtain springs, he decided to and made them more determined than ever to adapt springs to surgery and had them made in rectify matters and achieve the improvement stainless steel. In a very short time he had bosacral fusion, for which, to those who use this become internationally famous for his work on method, there is no better way of achieving early arthroplasty, particularly of the knee. Soon the springs constant demand for lectures, both at home and became used for the stabilization of other condi- overseas, and his company was sought after by all tions, such as the fractured olecranon, to give only who knew him. An example of courage is an edification to us In 1970 Christopher moved to Hastings and all, and so when Christopher Attenborough died was at once at home, both clinically and mechan- on June 13, 1979, at the age of 56 after a long ically. He made excellent use of the orthopedic illness, he left behind a great sense of achieve- workshop, wherein he designed his knee prosthe- ment and an uplifting respect. It was not only the illness he made a determined recovery; against knee that attracted his attention, for he was inter- all difficulties he returned to his clinical duties ested in replacement of other joints and his elbow and to operating, including his total knee re- prosthesis was under trial; he was working on placements. This epitomizes Christopher’s life, finger, wrist and ankle prostheses up to the time because no problem or difficulty was too great to of his death. He had evolved the very important overcome; throughout his career he was a stead- concept of a stabilized and gliding joint replace- fast courageous surgeon on whom others could ment and was applying this to the other joints lean for advice, encouragement and strength. It is a tragedy that many patients will be denied the better prostheses that his inventive- ness would have undoubtedly produced in the future. Christopher described his interests as being in orthopedics and family life. The former was divided into the surgery of arthritis, congenital deformities and cerebral palsy. It is not surpris- ing, therefore, that in 1975 he was appointed Hunterian Professor and gave a most erudite and sensible appreciation of the problems of the arthritic knee and its prosthetic replacement fol- lowed by an elegant description of his own, equally elegant, technique of doing his now world-famous knee replacement. He 16 Who’s Who in Orthopedics Georg AXHAUSEN José Luis BADO 1877–1960 1903–1977 Georg Axhausen graduated from the Military Thinker, philosopher, doctor, surgeon, orthope- Medical Academy of Berlin, remained in the dist, Bado placed a really brilliant mind at the German army for some years and started his aca- service of his ideals. After several him with the divine gift of a powerful intelli- more years with the army, he returned to Berlin gence, which was strengthened and enriched by as instructor in the surgical division of the information acquired through study and medita- Zahn-ärztlichen Institute. He was one of the tion, through the capacity to think clearly, and pioneers in studies of bone graft and necrosis. Phemister’s work on the pupils are to be found not only in his native same subject followed and recognized country, but all over Latin America. In transmit- Axhausen’s contribution, and Phemister’s famous ting his knowledge, he did not just teach the prin- phrase “creeping replacement” is well described ciples and goals of a medical discipline; he taught in Axhausen’s work.

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Inman buy diclofenac gel 20 gm tramadol in dogs with arthritis, MD cheap diclofenac gel online master card x rays of arthritis in fingers, PhD, the scientist, prob- and provided him an education at its university ably did more than any individual before him to campuses in Berkeley and San Francisco. The exact- Department of Orthopedic Surgery from 1957 to ness of his measurements established demanding 1970. His remarkable and respected for his erudite investigative studies, ability to simplify concepts and formulate princi- those who knew him closely remember him as a ples enabled him to see clearly what others often light-hearted, congenial, informal individual who saw dimly. On gradua- greeting for secretaries, nurses, students, profes- tion from college in 1928, he initiated his master’s sors, cooks, and administrators was always on a program as a medical student, and filed his thesis first-name basis. After phone by a consultative call from Washington, graduation from medical school in 1932, he D. All of the visitors to his laboratory human fetal cranium and appendicular skeleton in 157 Who’s Who in Orthopedics relation to sitting height was published in 1934. Howard Naffziger, was completed during his residency and published in 1938. From that time forward a continuous stream of substantive reports was added to the medical literature. Shortly after his classic report, “Observations on the Function of the Shoulder Joint,” appeared in The Journal of Bone and Joint Surgery in 1944, Dr. Inman was approached by the Committee on Prosthetic Devices of the National Research Council and urged to accept a federal grant for the purpose of improving artificial limbs. Howard Eberhart, Professor of Engineering, and they accepted the challenge. Thus began the lower-extremity prosthetic devices research project in the School of Engi- neering, Berkeley, and the subsequent devel- John N. INSALL opment of the Biomechanics Laboratory in the Department of Orthopedic Surgery, San 1930–2000 Francisco. Inman’s interest in biomechanics and consumed John Insall was born in 1930 in Bournemouth, most of his creative energies for a period of nearly England, by the sea. He was educated at the Uni- 30 years, during which nearly 40 major reports versity of Cambridge and at London Hospital were published. He received He lived the final decade of his life at a more his training at St. He and Irene found more time to and at the Royal Free Hospital in London. He then spend at the family farm in the Santa Clara Valley, served as a resident in general surgery and ortho- where Dr. Inman cultivated unusual plants and pedic surgery at the Royal Victoria Hospital and fruit trees. At the university he wound down his at Shriners Hospital for Crippled Children in research activities and completed a monograph, Montreal. In 1961, he was awarded a fellowship The Joints of the Ankle, which was published in in orthopedic surgery at the Hospital for Special 1976.

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Model for directly assessing and Portfolio improving competence and performance in revalidation of clinicians order diclofenac gel mastercard arthritis pain prescriptions. The assessment of clinical skills/competence/ How portfolios are compiled performance order generic diclofenac gel online arthritis knee leg swelling. The photograph of a surgical team is from Philippe Plailly/Eurelios/SPL; x Cunningham JPW, Hanna E, Turnbull J, Kaigas T, Norman GR. What makes one learning context unpleasant • Curriculum style supervisors, facilitators and another pleasant? This is affected by their motivation assessment environment and perception of relevance. These, in turn, can be affected by • Support mechanisms • Role modelling learners’ previous experiences and preferred learning styles and by the context and environment in which the learning is taking place. In adult learning theories, teaching is as much about Educational environment setting the context or climate for learning as it is about imparting knowledge or sharing expertise. Student • Motivation • Previous experience • Perceived relevance • Learning style • Perception of task Motivation Motivation can be intrinsic (from the student) and extrinsic (from external factors). Assessments are usually a strong Learning extrinsic motivator for learners. Individual learners’ intrinsic motivation can be affected by previous experiences, by their desire to achieve, and the relevance of the learning to their future. Many factors influence learning A teacher’s role in motivation should not be underestimated. Enthusiasm for the subject, interest in the students’ experiences, and clear direction (among other things) all help to keep students’ attention and improve assimilation of information and understanding. Even with good intrinsic motivation, however, external factors can demotivate and disillusion. Distractions, unhelpful attitudes of teachers, and physical discomfort will prompt learners to disengage. Maslow described a model to illustrate Self actualisation the building blocks of motivation. Each layer needs to be in Self esteem place before the pinnacle of “self actualisation” is reached. Belonging Safety Physiological needs Physiological needs Although the need to be fed, watered, and comfortable seems trite, many teachers will have experienced, for example, the difficulties of running sessions in cold or overheated rooms, in long sessions without refreshments, in noisy rooms, in facilities with uncomfortable seating. Motivation and Personality, New York: Harper and Row, 1954 Physical factors can make it difficult for learners and teachers to relax and pay attention. Ensuring adequate breaks and being mindful of the physical environment are part of the teacher’s role. Safety Case history: safe environment A teacher should aim to provide an environment in which Dr Holden claims to use interactive teaching techniques. She learners feel safe to experiment, voice their concerns, identify introduces the topic then points to a student in the audience and says, their lack of knowledge, and stretch their limits.