bluuebunny/crossref_metadata_2025 huggingface dataset:
Property rules: State fragmentation, industry heterogeneity and property rights in the Russian oil industry, 1992—2006
Authors: Suhomlinova Olga
Published: October 2007

The study examines the interdependence between the state and organizations and develops a proposition that the fragmentation of state structure and industry heterogeneity (defined as the number of organizations and organizational forms) are mutually conducive. The investigation focuses on property rights as an important arena of state—organization interaction and explores how, through the development of rules regarding obJect, subJect, use, enforcement and transfer of property, the state and the industry shape each other. Case study analysis of the Russian oil industry in 1992—2006 shows how the property rights relations between the state and the oil industry affected the U-shaped traJectories of change both in the state structure (from increasing to decreasing fragmentation on spatial and functional dimensions) and in the industry structure (from increasing to decreasing heterogeneity).
Persistent unemployment and passive policies: Politics and institutional change in post-communist Poland
Authors: Brown Dana L.
Published: October 2007

This article explains Poland's approach to unemployment in the postcommunist era as a case of path dependency, driven by institutionalized practices and cultures in key domestic policy-making organizations. The roots of Poland's passive and benefits-based unemployment policy are traced to the period immediately following regime change, which is defined as a critical juncture in social and economic policy-making. Policy choices in this period reflected the predominant reliance on market mechanisms to improve welfare. These choices have been reproduced over time despite widespread agreement that unemployment policies in Poland are failing both in terms of efficiency and effectiveness.
Exploitation and exploration learning and the development of organizational capabilities: A cross-case analysis of the Russian oil industry
Authors: Dixon Sarah E.A. , Meyer Klaus E. , Day Marc
Published: October 2007

We use a cross-case analysis of four Russian oil majors to develop a framework explaining the relationship between exploitation and exploration learning, and the development of organizational capabilities in transition economies. Our research explains how the changing top management style influences organizational learning over time. In the first stage of organizational transformation an authoritarian management style initiates a break with the administrative heritage of the organization to facilitate exploitation learning and the development of operational capabilities. These are required for survival in the new conditions of a market economy. In the second stage a more participatory management style fosters exploration learning and the development of strategic flexibility, required for sustainable competitive advantage. We demonstrate that exploitation and exploration learning do not coexist in the initial stages of transformation but are sequential. We found that the western-derived constructs of organizational learning add to our understanding of the process of organizational transformation in a transition context. Our study of the Russian oil industry also provides new ways to think about the processes of organizational learning in western companies, particularly large bureaucratic ones, anchored in their administrative heritage and needing to undergo organizational transformation.
Transition and organizational dissonance in Serbia
Authors: Hollinshead Graham , Maclean Mairi
Published: October 2007

This study reveals and analyses contradictory narrative voices within a local enterprise in the troubled Balkan region, recently acquired by a multinational enterprise. We employ case study research methods informed by semi-structured interviews with management and worker representatives to expose underlying and conflicting rationalities relating to the upgrading of technological and work systems, as a management-led response to growing market pressures. Recognition of the post-socialist enterprise as a site of political contestation and social fragmentation serves to frustrate broader aspirations of policy-makers towards early transitional closure, and limits the potential applicability of linear western conceptions of organizational change to transitional realities. The Serbian case presents an extreme variant of other, post-socialist contexts, institutionally volatile and politically charged. In an increasingly unbounded, indeterministic world, however, it emerges as potentially archetypal, thus enhancing our understanding of organizations and their management in the new global era.
Looking into the Future of Air Transportation Modeling and Simulation: A Grand Challenge
Authors: Wieland Frederick , Pritchett Amy
Published: October 2007

The future of air transportation modeling and simulation represents a grand challenge for both the air transportation and the modeling and simulation communities. In addition to its size and scope, air transportation has many technical, operational, organizational, policy, security and legal aspects contributing to its complexity, yet must ensure an un-rivaled level of safety throughout any transition to next generation systems. Thus, modeling and simulation must address not only technical challenges in representing a system of this complexity, but also institutional realities that prevent full data and model sharing between the many entities involved in air transportation. We outline the attributes of a shared repository of data, models and computational tools required to meet this challenge, including the coordination and administrative processes required to manage it, and provide an example of its potential application.
Educational Experiences of Children in Foster Care
Authors: Scherr Tracey G.
Published: October 2007

The educational achievements of children in foster care have been determined to be below average in individual studies. In the present investigation, 31 studies were examined via four meta-analyses to answer questions regarding the educational status of children in out-of-home placements in multiple countries. Data analysis encompassed the following variables: special education eligibility rates, grade retention rates and disciplinary rates. Exploratory meta-analyses uncovered conclusive results in this project, illuminating common educational challenges faced by children living in foster care across countries. Students living in out-of-home care are disproportionately represented in special education. They are prevented from moving to advanced grade levels at alarming rates. In addition, these students are disciplined frequently in the school setting. Implications for serving fostered youth include promoting pre-referral interventions and positive behavioural supports.
Challenging the Assumptions About the Frequency and Coexistence of Learning Disability Types
Authors: Dickerson Mayes Susan , Calhoun Susan L.
Published: October 2007

A popular but unsubstantiated belief is that a reading disability is the most prevalent type of learning disability (LD), that LD in mathematics is rare, and that LD in written expression is very rare. In 485 clinical children administered the WISC-III and WIAT, 65 percent had LD. The most common was LD in written expression (92 percent), either alone (50 percent) or in combination with LD in reading and/or mathematics (42 percent). Only 4 percent of the children had LD in reading alone, and 4 percent had LD in mathematics alone. Total LD percentages for reading and mathematics were similar (33 percent and 32 percent). Children with writing problems had far greater difficulty with compositional skills than with spelling.
Improving Creative Problem-Solving in a Sample of Third Culture Kids
Authors: Ju Lee Young , Bain Sherry K. , McCallum R. Steve
Published: October 2007

We investigated the effects of divergent thinking training (with explicit instruction) on problem-solving tasks in a sample of Third Culture Kids (Useem and Downie, 1976). We were specifically interested in whether the children's originality and fluency in responding increased following instruction, not only on classroom-based worksheets and the Torrance Tests of Creative Thinking (TTCT; Torrance, 1990), but also on activities related to real-world dilemmas. Our treatment group of 15 children exhibited gains over 10 weeks of instruction whereas our comparison group of 15 children did not improve in performance. The respective effects of explicit instructions to improve originality or fluency were evident on classroom-based worksheets, on the TTCT and on Realistic Story Telling Problems [adapted from Real World Problems based on Okuda et al. (1991), Runco and Okuda (1988)]. Our results, albeit from a small sample, imply that relatively simple, explicit instructions focusing on originality or fluency can aid third culture children in adopting effective problem-solving stances as they construct their new cultural environment.
Responding to Bullying
Authors: Craig Wendy , Pepler Debra , Blais Julie
Published: October 2007

Children who are bullied are often told to `solve the problems themselves'; however, when bullying is repeated over time, it becomes increasingly difficult for victimized children to stop the torment because of their relative lack of power. We examine the ways in which children respond to bullying and their evaluations of the effectiveness of various strategies in reducing their bullying problems. One thousand eight hundred and fifty-two Canadian children and youth, ranging in age from 4- to 19-years-old (mean 12.6, SD 2.4) responded to a web-based questionnaire. Few respondents indicated that they were motivated by public education campaigns or information about bullying. Participants indicated they were motivated to do something to stop bullying by their own need to exert control and be assertive and by their emotional reactions to bullying. A significant group of youth responded that they did nothing to stop bullying. Finally, the longer the bullying had been ongoing, the less effective students perceived their own strategies. The results highlight the importance of adults supporting students. Similarly, it is important to provide children and youth with strategies that are effective, as they are most likely to implement strategies that are only going to increase the victimization over time.
Bullying and Victimization Among Taiwanese 7th Graders: A Multi-Method Assessment
Authors: Wei Hsi-sheng , Jonson-Reid Melissa , Tsao Hui-ling
Published: October 2007

The present study investigated the magnitude of school bullying problems among Taiwanese adolescents and collected detailed information about the locations, perpetrators and offence types of peer victimization. Gender differences were also explored. Unlike many previous surveys, the present study utilized multiple measures and provided a more comprehensive picture of the problem. Two hundred and thirty-eight Taiwanese seventh graders were assessed via self- and peer-report measures. The results showed that a considerable number of the respondents had already experienced peer victimization in their first semester of middle school. Victimization by classmates was more prevalent then victimization by people outside class. Verbal and physical aggression were the most common types of victimization. Peer-rated measures showed that most students had bullied others. Boys were more likely to engage in physical and verbal bullying than girls. Implications for research and policy are discussed.
Effects of Teacher Avoidance of School Policies on Student Victimization
Authors: Marachi Roxana , Avi Astor Ron , Benbenishty Rami
Published: October 2007

The present study examines relations between school policy, teacher responses to violence and students' victimization outcomes as reported by teachers in a nationally representative sample of schools in Israel. Data were analysed using Structural Equations Modeling for the full sample of teachers, as well as group comparisons by school level, gender and ethnic groups. Across all models, violence prevention as a school priority was significantly related to less staff/ teacher avoidance of dealing with violence. In turn, teacher avoidance of student violence related strongly to elevated rates of reported student victimization. The findings indicate that School Violence Prevention (as a policy on its own), does not necessarily translate to less student victimization. It is through the indirect impact on staff/teacher response that student victimization was less likely. This study highlights the importance of school policy in its relation to teachers' actions and student behaviour.
Organs of Process: Rethinking Human Organization
Authors: Cooper Robert
Published: October 2007

Human organization is discussed as a social body or collection of organs and senses that create and re-create the forms and objects that constitute the human world. Organs represent process as the continuous making and remaking of passages between the body and its environment. Organs express a pre-human, impersonal force that transmits itself through the human body and its products in a generic act of making as opposed to the making of specific forms and objects. Process is discussed as the ceaseless work of alternation between the making of presence and the unmaking of absence. The work of process is illustrated through the work of three examples of human organization: the supermarket, the art gallery and the Church.
Strategy Practice and Strategy Process: Family Differences and the Sociological Eye
Authors: Whittington Richard
Published: October 2007

This Essai argues for the distinctive position of Strategy-as-Practice research outside the immediate family of Strategy Process. Strategy-as-Practice's fascination with the phenomenon of strategy itself takes it beyond traditional Process perspectives. Relying on the `sociological eye', Strategy-as-Practice treats strategy like any other practice in society, capable of being studied from many different angles. Under the four themes of praxis, practices, practitioners and the profession of strategy as an institutional field, the Essai demonstrates the potential range of research topics, performance notions and methodologies within Strategy-as-Practice. It concludes by proposing five implications of the sociological eye for the conduct of Strategy-as-Practice research, highlighting particularly social connections and relationships, embeddedness, irony, problematized notions of performance and a respect for continuity.
Interactional style, elicitation strategies and language production in professional language intervention
Authors: Bruce Barbro , Hansson Kristina , Nettelbladt Ulrika
Published: October 2007

This paper explores language intervention for children with specific language impairment in Sweden. The elicitation strategies, style of interaction and language production used by speech and language pathologists (SLPs) were analyzed in two conditions, free conversation and training of grammar. In training, the grammatical targets were used significantly more often by the SLPs, but not by the children. In the free conversations the children talked more and had significantly higher mean length of utterance in words and the SLPs linked significantly more to the child's focus. The two conditions represent different, but complementary approaches to language intervention.
Enhancing the phonological awareness and language skills of socially disadvantaged preschoolers: An interdisciplinary programme
Authors: McIntosh Beth , Crosbie Sharon , Holm Alison , Dodd Barbara , Thomas Sian
Published: October 2007

The research reported investigated the efficacy of intervention, developed by a speech-language therapist and implemented by a teacher, for the language and phonological awareness (PA) abilities of pre-school, socially disadvantaged children. One study established that children from low socio-economic (SES) backgrounds had poorer skills on both measures compared to children of average SES. Half of the low SES group received language and PA intervention programmes and their progress was compared to untreated SES matched controls. Both programmes were highly effective with post-intervention performance not only exceeding that of SES controls but also equalling the performance of controls of average SES.
Clinical implications of the effects of lexical aspect and phonology on children's production of the regular past tense
Authors: Johnson Bonnie W. , Morris Sherrill R.
Published: October 2007

This study examined the effect of lexical aspect and phonology on regular past-tense production. Data are presented from a group of 31 children, mean age 33 months, with typical language development. A case study of a 50-month-old child with Specific Language Impairment (SLI) is also presented. Children imitated sentence pairs that included an endpoint (accomplishments, e.g. she crawled into a box) or did not (activity, e.g. she crawled around in circles). Verbs ended in obstruents (e.g. walk) or nonobstruents (e.g. roll). The regular past tense was produced with the lowest accuracy in activities ending in obstruents (e.g., she walked in circles). Assessment and treatment suggestions for children with SLI are provided.
Using an observational framework to investigate adult language input to young children in a naturalistic environment
Authors: Andersen Claire Elizabeth , Marinac Julie V.
Published: October 2007

The correlation between the communicative intent of parents, in terms of their expectation of a response and the response patterns of young children aged 23—25 months during parent—child interactions, was investigated. An Observational Framework was used to code these parameters in interactions between 36 children and their mothers. The children were assigned by cluster analysis to `advanced', `typical' and `delayed' language groups and their responses were coded with respect to the degree of correctness or appropriateness within the interaction. Differences in both the parental response expectations and the children's response patterns across the three clusters are discussed.
A method for assessing the use of first person verb forms by preschool-aged children with SLI
Authors: Polite Elgustus J. , Leonard Laurence B.
Published: October 2007

Children with specific language impairment (SLI) often have extraordinary difficulty in the use of tense and agreement morphemes. Because spontaneous speech samples may not provide a sufficient number of obligatory contexts for these morphemes, structured probe items are often employed. However, these usually emphasize actions that can be readily illustrated through drawings, which tend to have third person subjects. In this paper we describe a method that has been successful in creating obligatory contexts for a first person morpheme — auxiliary am — that until now has been assessed exclusively through spontaneous speech samples. Participants were 32 mainstream American English-speaking children comprising three diagnostic subgroups: children with SLI, typically developing age-matched peers, and younger typically developing peers matched for mean length of utterance (MLU). The children participated in a task in which they described their actions for an audience; these descriptions required the use of auxiliary am . The results revealed that the children with SLI used auxiliary am with significantly smaller percentages than both groups of typically developing children, a finding that is consistent with findings that employ other tense and agreement morphemes. Clinical applications of this method are discussed.
Terminal delirium: families' experience
Authors: Namba Miki , Morita Tatsuya , Imura Chizuru , Kiyohara Emi , Ishikawa Sayuri , Hirai Kei
Published: October 2007

Background: Although delirium is a common complication in terminally ill cancer patients and can cause considerable distress to family members, little is known about the actual experience of family members. The primary aims of this study were thus to explore: (1) what the family members of terminally ill cancer patients with delirium actually experienced, (2) how they felt, (3) how they perceived delirium and (4) what support they desired from medical staff. Methods: A single-center in-depth qualitative study on 20 bereaved family members of cancer patents who developed delirium during the last two weeks before death. Content analysis of transcribed text was performed. Results: Families experienced various events including other than psychiatric symptoms, such as `patients talked about events that actually occurred in the past', `patients were distressed as they noticed that they were talking strangely,' `patients talked about uncompleted life tasks', and `patients expressed physiologic desires such as excretion and thirst'. Family emotions were positive, neutral, or negative (eg, distress, guilt, anxiety and worry, difficulty coping with delirium, helplessness, exhaustion and feeling a burden on others). Families perceived the delirium to have different meanings, including positive meanings (eg, relief from real suffering), a part of the dying process, and misunderstanding of the causes of delirium (effects of drugs, mental weakness and pain). Families recommended several support measures specifically for delirium, in addition to information and general support: `respect the patients' subjective world', `treating patients as the same person as before', `facilitating preparations for the patients' death', and `relieving family's physical and psychological burden'. Conclusions: From the results of this study, we generated a potentially useful care strategy for terminal delirium: respect the patients' subjective world, treat patients as the same persons as before, explore unmet physiological needs behind delirium symptoms, consider ambivalent emotions when using psychotropics, coordinate care to achieve meaningful communication according to changes in consciousness levels during the day, facilitate preparations for the patients' death, alleviate the feelings of being a burden on others, relieve family's physical and psychological burden and information support. Pallative Medicine 2007; 21 : 587—594
Use of the clock-drawing test in a hospice population
Authors: Henderson M. , Scott S. , Hotopf M.
Published: October 2007

Background : Cognitive impairment is common in patients with advanced disease and has significant implications for the patient, their carers and hospice staff. The effectiveness of screening tools is limited by a number of factors. The clock-drawing test (CDT) has performed well in other settings but has rarely been studied in the hospice setting. Aim : To assess the performance of the CDT in a hospice population. Methods : Consecutive admissions to a large hospice over three months were assessed using the CDT, the abbreviated mental test score and brief tests of attention and memory function. Results : One-hundred and nine eligible patients were admitted and 77% took part. Thirty per cent were cognitively impaired. The CDT had a sensitivity of 0.92, a specificity of 0.73 and a negative predictive value of 0.95. No patient refused to complete it. Conclusions : The CDT performs well as a screening tool for cognitive impairment in a hospice population. Palliative Medicine 2007; 21: 559—565
Change in what matters to palliative patients: eliciting information about adaptation with SEIQoL-DW
Authors: Westerman Marjan J. , Hak Tony , Echteld Michael A. , Groen Harry J.M. , van der Wal Gerrit
Published: October 2007

This study was carried out to investigate the usefulness of the SEIQoL-DW to elicit information about response shifts in palliative patients. The instrument measures individual quality of life and allows respondents to choose, rate and weight important areas of life (cues). We explored patients' reconceptualizations (ie, change in cues) and their value change (ie, change of cues weights). Results of 21 patients showed what mattered to these patients and how they had adjusted to deteriorating health. There is a risk that repeated measurements do not provide all the information that is potentially present and relevant to explore response shifts. But clear instructions to interviewers, such as careful listening, probing self-evident cues such as health and family, and accurate recording of cues on the forms may overcome this risk. Future research is recommended to explore the possibilities of regular assessments to facilitate better adjustment of patients. Palliative Medicine 2007; 21 : 581—586
Attitudes toward euthanasia among Swedish medical students
Authors: Karlsson Marit , Strang Peter , Milberg Anna
Published: October 2007

Attitudes toward euthanasia differ between individuals and populations, and in many studies the medical profession is more reluctant than the general public. Our goal was to explore medical students' attitude toward euthanasia. A questionnaire containing open-ended questions was answered anonymously by 165 first- and fifth-year medical students. Data were analysed using qualitative content analysis with no predetermined categories. The students' arguments opposing euthanasia were based on opinions of 1. euthanasia being morally wrong, 2. fear of possible negative effects on society, 3. euthanasia causing strain on physicians and 4. doubts about the true meaning of requests of euthanasia from patients. Arguments supporting euthanasia were based on 1. patients' autonomy and 2. the relief of suffering, which could be caused by severe illnesses, reduced integrity, hopelessness, social factors and old age. There are several contradictions in the students' arguments and the results indicate a possible need for education focusing on the possibility of symptom control in palliative care and patients' perceived quality of life. Palliative Medicine 2007; 21 : 615—622
Out-of-hours prescribing: a survey of current practice in the UK
Authors: Gregory Amanda , Todd Jennifer , Wanklyn Steven
Published: October 2007

This postal survey was developed to establish the current practice for out-of-hours (OOH) prescribing accepted in palliative care units throughout the UK. Around 144 palliative care units were sent a questionnaire and 94 units responded (65.3%). All of the responding units had non-resident medical on call cover. Although verbal orders currently appear to be the most popular communication method for OOH prescribing (84.1%), there was a wide range of other communication systems in use including email, fax and BlackBerry®. There appears to be a lack of specific guidance and clarity relating to the use of remote prescribing. It seems that guidance has not kept up with changes in working patterns and technology, and in time this will hopefully change. In the meantime, all staff groups should be involved in the development of local procedures and policies appropriate to local circumstances, which pay due regard to the relevant legislation and clinical governance standards available at the time. Palliative Medicine 2007; 21 : 575—580
Impact of euthanasia on primary care physicians in the Netherlands
Authors: van Marwijk Harm , Haverkate Ilinka , van Royen Paul , The Anne-Mei
Published: October 2007

Background : There is only limited knowledge about the emotional impact that performing euthanasia has on primary care physicians (PCPs) in the Netherlands. Objective : To obtain more insight into the emotional impact on PCPs of performing euthanasia or assisted suicide, and to tailor the educational needs of vocational PCP trainees accordingly. Methods : Qualitative research, consisting of four focus group studies. The setting was primary care in the Netherlands; 22 PCPs participated, in four groups (older males, older females, younger males and a group with interest with regard to euthanasia). Results : Various phases with different emotions were distinguished: before (tension), during (loss) and after (relief) the event. Although it is a very rare occurrence, euthanasia has a major impact on PCPs. Their relationship with the patient, their loneliness, the role of the family, and pressure from society are the main issues that emerged. Making sufficient emotional space and time available to take leave adequately from a patient is important for PCPs. Conclusions : Many PCPs stressed that young physicians should form their own opinions about euthanasia and other end-of-life decisions early on in their career. We recommend that these issues are officially included in the vocational training programme for general practice. Palliative Medicine 2007; 21 : 609—614
Review article: Financial stress and strain associated with terminal cancer—a review of the evidence
Authors: Hanratty Barbara , Holland Paula , Jacoby Ann , Whitehead Margaret
Published: October 2007

Financial circumstances are a significant influence on the quality of life for older people and may be important to health and wellbeing at the end of life. The aim of this study is to review the evidence for the existence and consequences of financial stress and strain at the end of life for people dying with cancer. We conducted a systematic search of four electronic databases for studies, providing data on illness-related financial burden (stress), or perception of financial hardship (strain), from patients with terminal cancer or their caregivers. Twenty-four papers were identified from 21 studies published in English between 1980 and 2006, the majority (14) of cross-sectional design. Financial stress was reported in all 13 studies from the USA (median 33%, range 10—66%), but only four sought measures of financial strain. In the USA, specific social consequences, such as moving house or change in employment to cope with caregiving, were reported in four of these studies; one of these also noted changes in treatment choices and avoidance of care for other family members. In studies from outside the USA, there is a dearth of data on financial stresses and the consequences of this for the household, despite widespread reporting of financial strain. To fill a gap in our understanding and improve holistic palliative care, researchers need to ask the questions about the consequences of financial stresses and strain for the health and wellbeing of the household. Palliative Medicine 2007; 21 : 595—607
The evidence base of palliative medicine: is inpatient palliative medicine evidence-based?
Authors: Keeley Paul W. , Waterhouse Esther T. , Noble Simon I.R.
Published: October 2007

Background: In 2001, Good and Stafford published a study attempting to show that inpatient palliative medicine is evidence-based. Aim: To critically examine the papers cited in support of the claim that palliative medicine is evidence-based. Method: All the papers cited were re-examined by at least two reviewers. The papers were graded using a tool used in the production of 22 evidence-based national clinical guidelines over the past three years. Differences of opinion about quality were resolved by discussion or independent arbitration. Results: The 41 papers cited by Good and Stafford included 25 randomized controlled trials (RCT), six other controlled studies and 10 uncontrolled studies. Sample size. Mean sample size was 160 (range 9—1404). The median sample size was 56; 19/41(46%) had <50 subjects; 30/41 (73%) had <100. Power calculations. 16/25 (64%) of RCTs, had no power calculations, making it difficult to draw conclusions about true differences between groups. Quality rating and grade of evidence: Of the RCTs 15/25 (60%) had a high risk of bias; of the other controlled studies 5/6 (83%) had a high risk of bias. Applicability. The studies were generally applicable to a population with advanced disease: 30/41 (73%) related with populations with advanced disease. Conclusions: This study demonstrates that studies cited in support of palliative medicine as an evidence-based specialty are of variable, and at times poor quality. This study seems to show that the claim that inpatient palliative medicine is evidence-based is at best tenuous and at worst misleading. Palliative Medicine 2007; 21 : 623—627
Indigenous ethnic minorities and palliative care: exploring the views of Irish Travellers and palliative care staff
Authors: McQuillan Regina , Van Doorslaer Onja
Published: October 2007

Indigenous people are among the ethnic minorities who encounter palliative care services. This research shows that Irish Travellers have little experience of specialist palliative care and that specialist palliative care providers have little knowledge or experience of Irish Travellers. Characteristics of Irish Travellers culture including the importance of hope, avoidance of open acknowledgment of death, the importance of family and the avoidance of the place of death (including moving away or burning caravans where death has occurred) challenge the provision of specialist palliative care. Individualisation of patient care, a feature of specialist palliative care can help staff provide appropriate care. Palliative Medicine 2007; 21 : 635—641
Injustifiable use of gastroprotection in advanced cancer patients
Authors: Mercadante Sebastiano , David Fabrizio , Riina Salvatore , Girelli Davide
Published: October 2007

The aim of this survey was to prospectively collect data about gastroprotector prescription at admission of an acute pain relief and palliative care unit. An observational survey was performed on three-hundred consecutive patients. Reasons for admission, concomitant treatment and use of drugs were recorded at admission. About 60.6% patients had been prescribed proton pump inhibitors or anti-H2 receptors agents. Of these patients, possible risk factors were nonsteroidal anti-inflammatory drugs (41, 22.5%), corticosteroids (43, 23.6%), age > 75 years (27, 14.8%). In only 25 admissions (13.7%) prescription corresponded to Italian drug agency recommendations with an odds ratio of an off-label prescription of 7.28. In a relatively high percentage of admissions (55%), patients receiving gastroprotectors were on chemotherapy, with an odds ratio of 1.42.

This survey showed that gastroprotectors are often prescribed regardless of Health Care System regulations, as only a minority of patients satisfied the requirements of an appropriate and refundable prescription. The attitudes of oncologists who prescribe gastroprotectors for a putative protective effects are not supported by evidence. Health Care Service in Italy should be aware of these problems to improve the strategies of budgeting the drug expense in a better way or providing further guidelines based on studies able to demonstrate the real cost-benefit ratio of this class of drugs. Palliative Medicine 2007; 21 : 631—633
No Effect of a Graded Training Program on the Number of Running-Related Injuries in Novice Runners
Authors: Buist Ida , Bredeweg Steef W. , van Mechelen Willem , Lemmink Koen A. P. M. , Pepping Gert-Jan , Diercks Ron L.
Published: October 2007

Background

Although running has positive effects on health and fitness, the incidence of a running-related injury (RRI) is high. Research on prevention of RRI is scarce; to date, no studies have involved novice runners.

Hypothesis

A graded training program for novice runners will lead to a decrease in the absolute number of RRIs compared with a standard training program.

Study Design

Randomized controlled trial; Level of evidence, 1.

Methods

GRONORUN (Groningen Novice Running) is a 2-armed randomized controlled trial comparing a standard 8-week training program (control group) and an adapted, graded, 13-week training program (intervention group), on the risk of sustaining an RRI. Participants were novice runners (N = 532) preparing for a recreational 4-mile (6.7-km) running event. The graded 13-week training program was based on the 10% training rule. Both groups registered information on running characteristics and RRI using an Internet-based running log. The primary outcome measure was RRIs per 100 participants. An RRI was defined as any musculoskeletal complaint of the lower extremity or back causing a restriction of running for at least 1 week.

Results

The graded training program was not preventive for sustaining an RRI (χ 2 = 0.016, df = 1, P = .90). The incidence of RRI was 20.8% in the graded training program group and 20.3% in the standard training program group.

Conclusions

This randomized controlled trial showed no effect of a graded training program (13 weeks) in novice runners, applying the 10% rule, on the incidence of RRI compared with a standard 8-week training program.
A Comprehensive Rehabilitation Program with Quadriceps Strengthening in Closed versus Open Kinetic Chain Exercise in Patients with Anterior Cruciate Ligament Deficiency
Authors: Tagesson Sofi , Öberg Birgitta , Good Lars , Kvist Joanna
Published: October 2007

Background

There is no consensus regarding the optimal rehabilitation regimen for increasing quadriceps strength after anterior cruciate ligament (ACL) injury.

Hypothesis

A comprehensive rehabilitation program supplemented with quadriceps strengthening in open kinetic chain (OKC) exercise will increase quadriceps strength and improve knee function without increasing static or dynamic sagittal tibial translation, compared with the same comprehensive rehabilitation program supplemented with quadriceps strengthening in closed kinetic chain (CKC) exercise, in patients with acute ACL deficiency.

Study Design

Randomized controlled trial; Level of evidence, 1.

Methods

Forty-two patients were tested a mean of 43 days (range, 20–96 days) after an ACL injury. Patients were randomized to rehabilitation with CKC quadriceps strengthening (11 men and 9 women) or OKC quadriceps strengthening (13 men and 9 women). Aside from these quadriceps exercises, the 2 rehabilitation programs were identical. Patients were assessed after 4 months of rehabilitation. Sagittal static translation and dynamic tibial translation were evaluated with a CA-4000 electrogoniometer. Muscle strength, jump performance, and muscle activation were also assessed. Functional outcome was evaluated by determining the Lysholm score and the Knee Injury and Osteoarthritis Outcome Score.

Results

There were no group differences in static or dynamic translation after rehabilitation. The OKC group had significantly greater isokinetic quadriceps strength after rehabilitation ( P = .009). The hamstring strength, performance on the 1-repetition-maximum squat test, muscle activation, jump performance, and functional outcome did not differ between groups.

Conclusions

Rehabilitation with OKC quadriceps exercise led to significantly greater quadriceps strength compared with rehabilitation with CKC quadriceps exercise. Hamstring strength, static and dynamic translation, and functional outcome were similar between groups. Patients with ACL deficiency may need OKC quadriceps strengthening to regain good muscle torque.
A 10-Year Prospective Trial of a Patient Management Algorithm and Screening Examination for Highly Active Individuals with Anterior Cruciate Ligament Injury
Authors: Hurd Wendy J. , Axe Michael J. , Snyder-Mackler Lynn
Published: October 2007

Background

A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture.

Objective

To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care.

Methods

Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care.

Results

A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up.

Conclusion

The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.
No Advantages in Repairing a Type II Superior Labrum Anterior and Posterior (SLAP) Lesion When Associated with Rotator Cuff Repair in Patients over Age 50
Authors: Franceschi Francesco , Longo Umile Giuseppe , Ruzzini Laura , Rizzello Giacomo , Maffulli Nicola , Denaro Vincenzo
Published: October 2007

Background

Arthroscopic management has been recommended for some superior labrum anterior and posterior (SLAP) lesions, but no studies have focused on patients over 50 years of age with rotator cuff tear and a type II SLAP lesion.

Hypothesis

In patients over 50 years of age with an arthroscopically confirmed lesion of the rotator cuff and a type II SLAP lesion, there is no difference between (1) repair of both lesions and (2) repair of the rotator cuff tear without repair of the SLAP II lesion but with a tenotomy of the long head of the biceps.

Study Design

Randomized controlled clinical trial; Level of evidence, 1.

Methods

We recruited 63 patients. In 31 patients, we repaired the rotator cuff and the type II SLAP lesion (group 1). In the other 32 patients, we repaired the rotator cuff and tenotomized the long head of the biceps (group 2). Seven patients (2 in group 1 and 5 in group 2) were lost to final follow-up.

Results

At a minimum 2.9 years’ follow-up, statistically significant differences were seen with respect to the University of California, Los Angeles (UCLA) score and range of motion values. In group 1 (SLAP repair and rotator cuff repair), the UCLA showed a statistically significant improvement from a preoperative average rating of 10.4 (range, 6–14) to an average of 27.9 (range, 24–35) postoperatively ( P < .001). In group 2 (biceps tenotomy and rotator cuff repair), the UCLA showed a statistically significant improvement from a preoperative average rating of 10.1 (range, 5–14) to an average of 32.1 (range, 30–35) postoperatively ( P < .001) There was a statistically significant difference in total postoperative UCLA scores and range of motion when comparing the 2 groups postoperatively ( P < .05).

Conclusions

There are no advantages in repairing a type II SLAP lesion when associated with a rotator cuff tear in patients over 50 years of age. The association of rotator cuff repair and biceps tenotomy provides better clinical outcome compared with repair of the type II SLAP lesion and the rotator cuff.
Double-Bundle Anterior Cruciate Ligament Reconstruction Using Hamstring Autografts and Bioabsorbable Interference Screw Fixation
Authors: Järvelä Timo , Moisala Anna-Stina , Sihvonen Raine , Järvelä Sally , Kannus Pekka , Järvinen Markku
Published: October 2007

Background

Conventional anterior cruciate ligament reconstruction techniques have focused on restoration of the anterome-dial bundle only, which, however, may be insufficient in restoring the rotational stability of the knee.

Hypothesis

Rotational stability of the knee is better when using a double-bundle technique instead of a single-bundle technique for anterior cruciate ligament reconstruction.

Study Design

Randomized controlled clinical trial; Level of evidence, 1.

Methods

Seventy-seven patients were randomized into 3 different groups for anterior cruciate ligament reconstruction with hamstring tendons: double-bundle with bioabsorbable screw fixation (n = 25), single-bundle with bioabsorbable screw fixation (n = 27), and single-bundle with metallic screw fixation (n = 25). The evaluation methods were clinical examination, KT-1000 arthrometric measurement, and the International Knee Documentation Committee and Lysholm knee scores.

Results

There were no differences between the study groups preoperatively. Seventy-three patients (95%) were available at a minimum 2-year follow-up (range, 24–35 mo). The rotational stability of the knee, as evaluated by the pivot-shift test, was the best in the patients in the double-bundle group. In addition, the patients in the single-bundle groups had more graft failures than those in the double-bundle group. Concerning the anterior stability of the knee as measured with the KT-1000 arthrometer, the group differences were not statistically significant. No significant differences were found between the groups in knee scores.

Conclusion

Rotational stability of the knee is better when using the double-bundle technique instead of the single-bundle technique in anterior cruciate ligament reconstruction.
A Proactive Strategy for the Aging Population That Capitalizes on the Talents of Older Adults in China
Authors: Cheng Joseph Y. S. , Zhang Mujin  , Wei Zhiyuan
Published: October 2007

A proactive strategy for the aging population was first proposed by the World Health Organization in 2002. Chinese authorities and experts in gerontology welcome the strategy, and they have already emphasized the need to safeguard the dignity of the elderly population and utilize their talents. There currently exists a shortage of expertise concerning the positive utilization of older persons, and attempts to implement such utilization must be monitored closely and may require preventive intervention. China's experts in gerontology therefore advocate new socioeconomic ideals regarding the elderly community, proposing refinement of statutes and policies to protect the rights of elderly people. Furthermore, the success of this proactive strategy demands social support, the mobilization of public opinion, and allocation of resources. It appears that the Chinese leadership has already laid a good foundation for this process.
Prescription Drug Abuse Among Older Adults: A Family Ecological Case Study
Authors: Morgan Martha , Brosi Whitney A.
Published: October 2007

The issue of prescription drug abuse among the elderly population is multifaceted. Such abuse has implications for the individual's health and his or her family relationships, and has other ecological dimensions. In this in-depth, qualitative case study, one family's experience with prescription drug abuse is examined using human ecological theory as a guiding framework. Findings include the powerful role played by the medical community, influence of societal biases, and family conflict. Implications for training physicians, developing clinical assessments, family treatment, and future research are discussed.
Are Pets a Source of Support or Added Burden for Married Couples Facing Dementia?
Authors: Connell Cathleen M , Janevic Mary R. , Solway Erica , McLaughlin Sara J.
Published: October 2007

In studies that have explored pet ownership in families affected by dementia, reported benefits have ranged from improvements in patient behavior to reduction in caregiver blood pressure. In this exploratory study, the impact of dementia on relationships among pets, caregivers, and care recipients was examined using content analysis of open-ended questions included in a telephone survey. Female spouse caregivers who owned pets were asked how their (and their husband's) relationship with their pets changed since they started caring for their husband. Most caregivers reported that they felt closer and more attached to their pets than previously. However, some caregivers reported that their pets created an additional burden and that they and their spouse had less time to care for the pets since the onset of illness. Findings highlight the need for further research to explore the unique benefits and burdens of owning a pet for families affected by dementia.