Developing and maintaining intergenerational relationships in an economically vulnerable community: findings from the Flint women's study

Few studies describe how community disadvantage impacts intergenerational relationships. Using interviews with women and service providers (n = 100), we explored benefits and challenges of intergenerational relationships in Flint, Michigan, an economically vulnerable community. Women valued relationships that increased social connections and generativity; however, few community resources promoted such relationships. Intergenerational relationships were important for leaving a social legacy in lieu of a meaningful economic legacy. Some middle-aged women are overwhelmed by caregiving, balancing employment while caring for multiple generations. Women desired intergenerational activities that include children and younger adult women. Further, caregiving programs should attend to the needs of middle-aged caregivers.

Intersectionality, special populations, needs and suggestions: the Flint Women's study

BACKGROUND

Equitable access to services that promote health and wellbeing is an important component of social justice. A community-engaged participatory qualitative study was conducted in Flint, Michigan, USA, to understand the needs of special populations (young women, perinatal women and new mothers, older women, women with disabilities, and LGBTQIA women) and elicit their ideas about solutions.

METHODS

In-depth interviews (n = 100) were conducted. Participants were either women living in the Flint area, human service providers in the area, or both. A team of community and academic coders analyzed the data using an a priori framework.

RESULTS

Participants identified needs of different groups of women and suggested ways to address them. Access to healthy food, reducing healthcare costs, and improving transportation, job opportunities and affordable quality housing were crosscutting themes across all groups of women. Mentoring support was said to protect vulnerable young women from the risk of human trafficking. Older women were said to gain a sense of purpose, build their social support and reduce their loneliness by engaging in mentoring younger women. Women with disabilities were reported to benefit from infrastructure accessibility and authentic inclusion in all areas of life. Providing help that considers their dignity, pride and self-worth were suggested. LGBTQIA women were reported to have housing needs due to discrimination; mostly turned down as renters and can be rejected from faith-based homeless shelters. LGBTQIA women would also benefit from increased sensitivity among healthcare providers. For all groups of women, streamlining access to social services and other resources, building social support networks and increasing awareness about existing resources were recommended.

CONCLUSION

Efforts directed towards improving women's health and wellbeing should include perspectives and suggestions of diverse groups of women from the community. Acting on suggestions that emanate from the community's lived experiences may reduce inequalities in health and wellbeing.

Long-term results of total knee arthroplasty in class 3 and 4 rheumatoid arthritis

One hundred four total knee arthroplasties in 67 patients with class 3 and 4 rheumatoid arthritis were reviewed clinically and radiographically at an average of 12.7 years. The Hospital for Special Surgery knee scores were good to excellent in 84 knees (81%). Seventeen knees (16%) were rated as fair, and three knees (3%) as poor. The average range of motion at follow-up examination was 95 degrees. Six knees failed due to delayed sepsis (4.1%), and two failed due to aseptic loosening. At a follow-up period of 15 years, the survivorship analysis suggests a 91% probability of the arthroplasty remaining functional in situ. Cemented total condylar knee arthroplasties in severe rheumatoid arthritis provide durable pain relief and restoration of function.

An intermeniscal fibrous band in a recreational runner

An intermeniscal fibrous band was found to produce anterior knee pain in a recreational runner. Arthroscopic resection of the band eliminated the symptoms of pain with running. A literature review found no prior reports of this entity. The differential of plica syndrome and Hoffa's disease was reviewed.

Long-term results of the total condylar knee arthroplasty. A 15-year survivorship study

This study reports the 15-year survivorship of 112 consecutive Total Condylar knee arthroplasties that have been followed since 1974. Two endpoints were chosen for survivorship: (1) Revision attributable to septic or aseptic loosening or malalignment. (2) Revision or roentgenographic evidence of component loosening. Life table analysis reveals a 94.1% clinical survivorship at 15 years, with an 90.9% survivorship when roentgenographic failures are included. There were five revisions: one for infection, one for instability, and three for tibial loosening. In addition, two tibiae and one patella were considered roentgenographically loose, but were not symptomatic. As of May 1992, 34 patients with 48 knees are known deceased, 15 knees are lost to follow-up evaluation, and 49 knees are available for clinical evaluation. Follow-up data was available on 62 knees for greater than 11 years. Ninety-two percent had good or excellent results, with 1.6% fair and 6.5% poor. Average range of motion was 99 degrees. The average Hospital for Special Surgery knee score was 85. Roentgenographic study revealed lucencies around 72% of tibiae, but only two components were loose. There was a correlation between body weight and the presence of radiolucencies, and patients who weighed more than 80 kg had the lowest survivorship at 15 years: 89.2% clinical survival and 70.6% clinical plus roentgenographic survival. Total Condylar knee arthroplasty has a 94.6% clinical survival at 15 years, with predictably good clinical results.