bluuebunny/crossref_metadata_2025 huggingface dataset:
Le rôle de la honte dans l’alcoolodépendance : une revue de la littérature
Authors: Roche Sophie
Published: April 2017

Les troubles liés à la consommation d’alcool représentent un enjeu prioritaire de santé publique, tant par leur fréquence que par la sévérité des dommages induits, qu’ils soient sanitaires ou sociaux, et qu’ils concernent le sujet ou son entourage. L’étude du rapport à l’alcool dans la population est généralement axée sur des facteurs sociaux, familiaux et environnementaux, mais peu de recherches en France envisagent l’émotionnalité comme facteur associé à cette consommation. L’objectif principal de ce travail consiste, au regard d’une revue de la littérature, à mettre en évidence l’importance des facteurs émotionnels que sont la honte et la culpabilité dans la consommation problématique d’alcool et de discuter la prise en charge en conséquence. Nous avons exploré le rôle des émotions dans l’alcoolodépendance. Les résultats mettent en avant la honte comme facteur de vulnérabilité et facteur aggravant dans l’alcoolodépendance. La honte est reconnue comme facteur dans l’apparition et le maintien de la consommation problématique d’alcool, tandis que la culpabilité apparaît comme un facteur protecteur. Une propension à ressentir de la honte serait caractéristique des individus ayant une addiction à l’alcool. Il est donc essentiel de prendre en compte la honte qui joue un rôle majeur dans la consommation problématique d’alcool, dans la prévention et la prise en charge de cette conduite. Une intervention axée sur l’amélioration de la capacité de l’individu à réguler ses émotions par le biais du développement de moyens d’adaptation pourrait être efficace pour la prévention ou le traitement de l’alcoolodépendance. Les individus sujets à la honte seraient alors moins enclins à utiliser la consommation d’alcool comme une stratégie d’adaptation.
Le lien familial dans la problématique alcoolique
Authors: Tamian Isabelle
Published: April 2017

Il s’agit ici d’envisager la dimension familiale de l’alcoolodépendance à travers des repères conceptuels émanant à la fois de travaux d’obédience psychanalytique et systémique. La théorie du lien en psychanalyse appliquée au groupe familial permettra de penser la problématique du sujet alcoolodépendant. Seront également définies la notion de codépendance mise au jour dans le dysfonctionnement familial alcoolique ainsi que différentes règles familiales dysfonctionnelles permettant de saisir la dynamique du système familial alcoolique. Une vignette clinique rendra compte du travail effectué avec les familles dans une institution de soins en addictologie.
Je t’aime, moi non plus
Authors: Denat Patricia
Published: April 2017

Le lien de fratrie, subi, apprivoisé, investi, au fur et à mesure du temps, de l’histoire de la famille, de la venue de l’enfant, à un moment donné, attendu ou pas, imaginé ou dénié, aimé ou repoussé, porteur des émotions, des rêves et des vécus de ceux qui l’accueillent dans un monde qu’il devra habiter, faire sien de sa force de vie. C’est dire s’il n’est pas évident, ce lien de fratrie, c’est dire s’il peut se trouver affecté par des histoires de vie… Et pourtant il est bien là, indéfectible, résistant aux tourmentes, pour un jour être réinvesti au détour du temps qui passe et des évènements…
La fratrie in utero
Authors: Farges François , Farges Nicole
Published: April 2017

La rencontre échographique entre les parents, l’échographiste et le fœtus est, dans certaines conditions, ouverture vers la vie « psychique » prénatale. La présence d’un « autre », le jumeau, proto-objet à demeure, nous donne à voir et à penser la naissance du lien fraternel in statu nascendi . La rêverie parentale fait exister ce lien en parlant à (et de) ces sujets en devenir. Notre regard et notre écoute se déplacent alors vers un « avant-coup » du côté des mythes originaires. La psychanalyse contemporaine recherche les conditions d’émergence de la vie psychique et s’intéresse à l’archaïque. Elle ne peut que s’enrichir de l’apport de cette nouvelle clinique autour de l’échographie, la seule qui permette de (re)franchir le col utérin…
La fratrie germaine dans la recomposition familiale : le point de vue de l’enfant
Authors: Djo Lou Charlotte , Zaouche-Gaudron Chantal
Published: April 2017

Notre objectif est d’analyser la représentation que l’enfant a de sa fratrie germaine dans la recompo-sition familiale. Dans le cadre de l’approche bioécosystémique de Bronfenbrenner (1996), des entretiens semi-directifs ont été réalisés auprès de 23 enfants. Il en ressort que les relations dans la fratrie germaine constituent, pour la moitié d’entre eux, une ressource pour l’enfant, de par la continuité et le soutien qu’elles apportent. D’autres types de relation, « neutre » ou « contrainte », peuvent aussi être déclinés étant à la fois continue et soutenante.
De l’exigence du bébé spectateur
Authors: Basset Virginie
Published: April 2017

Les bébés et jeunes enfants sont des spectateurs fabuleux : leur présence, leur regard, leur compréhension, leur attention, peuvent être intenses et entiers. Des qualités qui questionnent les adultes sur la manière de concevoir les propositions artistiques pour la toute petite enfance : quel accueil ? Quels accompagnements ? Quels temps ? Quand les subtilités du regard des jeunes enfants nous interrogent sur notre relation au spectacle vivant…
Deux regards d’écrivains sur le monde musulman en crise
Authors: Rivet Daniel
Published: April 2017

Le 13 Novembre a retenti sur ma pratique d’historien du Maghreb. Il m’a enjoint à parler de l’islam non à partir de la culture du djihad qui traverse l’histoire des sociétés du monde musulman, mais par rapport au régime de temporalité régissant les musulmans du temps présent. J’ai pris appui sur deux romans écrits à la fin du 20 e  siècle : Le Livre des Illuminations de l’Égyptien Gamal al Ghitany et L’Amour, la fantasia de l’Algérienne Assia Djebar. À travers ces deux ouvrages, émergent deux attitudes envers l’écoulement du temps : ou bien le saisir comme une réalité achronique, où passé et présent se confondent dans une perspective eschatologique (Gamal al Ghitany), ou bien restituer le cours de la durée pour agir sur le temps présent (Assia Djebar).
Les débuts difficiles de l’École nationale d’administration (1945-1958)
Authors: Prost Antoine
Published: April 2017

Envisagée depuis longtemps, la réforme du recrutement et de la formation des hauts fonctionnaires avait échoué. Le Front populaire n’était pas parvenu à créer une École nationale d’administration. Elle naît en 1945 dans le cadre d’une reconstruction d’ensemble de la haute fonction publique, l’une des grandes réformes de la Libération. Mais ce double caractère lui vaut d’une part une longue résistance des administrations qu’elle dérange, et d’autre part, durant les années 1950, l’hostilité des parlementaires de droite qui contestent sa pédagogie, tentent de l’épurer et lui infligent des brimades. Il faut attendre la Cinquième République pour qu’elle sorte de ces difficultés.
AlAs as a Bi blocking barrier in GaAsBi multi-quantum wells: Structural analysis
Authors: Butkutė Renata , Skapas Martynas , Selskis Algirdas , Bukauskas Virginijus , Stanionytė Sandra , Niaura Gediminas
Published: April 2017

Crystallographic properties of AlAs barriers in GaAsBi-based multi-quantum well structures grown on GaAs substrates by molecular beam epitaxy (MBE) and migration-enhanced epitaxy (MEE) were studied. The quantum wells were grown at temperatures ranging from 160 to 350 °C. The width of GaAsBi quantum wells varied from 4 to 20 nm. The optimization of technological parameters for the growth of high crystalline quality AlAs barriers at low temperatures was performed. To explore the impact of high temperature treatment on crystal quality, surface roughness and chemical composition stability, ex situ rapid thermal annealing was performed at 650–750 °C for 180 s in nitrogen ambiance. The structural quality of AlAs barriers, the morphology and sharpness of the interfaces between GaAsBi quantum wells and AlAs barriers were studied by high resolution X-ray diffraction, atomic force microscopy and high resolution transmission electron microscopy, respectively. In this study it was demonstrated that MEE allows one to achieve higher crystal quality of AlAs barriers at much lower temperatures in comparison to MBE. The blocking of Bi out-diffusion from the GaAsBi quantum wells toward the surface was shown for both MBE and MEE grown AlAs barriers.
Charge carrier transport properties in ternary Si-PCPDTBT:P3HT:PCBM solar cells
Authors: Važgėla Julius , Stephen Meera , Juška Gytis , Genevičius Kristijonas , Arlauskas Kęstutis
Published: April 2017

In this work we investigate ternary blends of an active layer in bulk heterojunction solar cells and estimate the influence of their composition on solar cell parameters such as efficiency, mobility and recombination. The studied ternary blends are composed of low bandgap polymer poly[2,6-(4,4-bis(2-ethylhexyl)dithieno[3,2-b:2,3-d]silole)-alt-4,7-(2,1,3 benzothiadiazole)] (Si-PCPDTBT), high bandgap polymer poly(3-hexylthiophene-2,5-diyl) (P3HT) and fullerene derivative [6,6]-phenyl-C61-butyric acid methyl ester (PCBM). The Langevin recombination reduction factor as well as charge carrier mobilities show an increasing trend with increasing Si-PCPDTBT content in the blends. The highest efficiencies have been achieved for the optimized blends of Si-PCPDTBT:P3HT:PCBM with ratios of 0.4:0.6:1, respectively.
generation of RBMK-1500 spent nuclear fuel one-group cross-section libraries and their evaluation against experimental data
Authors: Barkauskas Vytenis , Plukienė Rita , Plukis Artūras , Remeikis Vidmantas
Published: April 2017

Depletion of RBMK-1500 spent nuclear fuel (SNF) with and without an erbium burnable absorber was modelled, and one-group burn-up dependent cross-section libraries for Origen-ARP were created. Depletion calculations for the generation of cross-section libraries were performed using the SCALE 6.1 code package with the TRITON control module, which employs the NEWT deterministic 2D transport code with the 238-group energy library based on the ENDF-B VII library and the ORIGEN-S nuclide composition calculation code. Concentrations of the most important actinides for criticality safety were calculated using the created libraries and were compared with the available experimental data and the newest modelling results. Available experimental data of fission products (Nd and Cs isotopes) were also compared to the modelling results. Composition differences were evaluated for several fuel enrichments and water densities. The comparison shows an acceptable agreement between the values obtained using new one-group cross-section libraries and experimental data except for238Pu and241Am, as well as the causes of discrepancy are discussed. It has been found that the enrichment and presence of the burnable absorber play an important role in the SNF composition. At the highest evaluated burn-up (29 GWd/tU) isotopic composition differences between 2% enrichment fuel and 2.8% burn-up for actinides important to burn-up credit (BUC) applications varied from 11 to 52%.
Finite Volume Method for Analysis of Convective Longitudinal Fin with Temperature-Dependent Thermal Conductivity and Internal Heat Generation
Authors: Sobamowo Gbeminiyi M. , Ogunmola Bayo Y. , Nzebuka Gaius
Published: April 2017

In this study, heat transfer in a longitudinal rectangular fin with temperature-dependent thermal properties and internal heat generation has been analyzed using finite volume method. The numerical solution was validated with the exact solution for the linear problem. The developed heat transfer models were used to investigate the effects of thermo-geometric parameters, coefficient of heat transfer and thermal conductivity (non-linear) parameters on the temperature distribution, heat transfer and thermal performance of the longitudinal rectangular fin. From the results, it shows that the fin temperature distribution, the total heat transfer, and the fin efficiency are significantly affected by the thermo-geometric of the fin. Therefore, the results obtained in this analysis serve as basis for comparison of any other method of analysis of the problem and they also provide platform for improvement in the design of fin in heat transfer equipment.
Flow Assessment on the Effects of Water Droplets on Rotor Region of Wet Compression
Authors: Dayyabu Gambo Kofar Bai , Zhang Hai , Zheng Qun , Abdu Salman
Published: April 2017

Wet compression process has been widely accepted as a measure of increasing the performance of industrial gas turbine, in the present work, in-depth analysis on the principle aspects of wet compression, more specifically, the influence of injected water droplets diameter, surface temperature, and their effects on the behavior of axial flow transonic compressor and gas turbine performance were analyzed using computational fluid dynamic. Injected water droplets and gas flow phase change was most intense in the area adjacent to shockwaves and were the slip velocity of the droplet is highest. Water injection in to the compressor rotor is a little perturbation to the flow field due to the formation of flow separation, evaporation rate, increasing weber number, reduction in the inlet temperature, and velocity vortex pattern relatively different from that of the dry case. The effects of water droplets on the rotor region at injection rate of 1%, shows decrease in the inlet temperature of 11%, outlet temperature 5% and uplift the efficiency to 1.5%.
Thermodynamics Analysis of Unsteady MHD Mixed Convection with Slip and Thermal Radiation over a Permeable Surface
Authors: Muhammad Ahmad , Makinde Oluwole Daniel
Published: April 2017

This paper discusses the thermodynamics irreversibility in an unsteady hydromagnetic mixed convective flow of an electrically conducting optically dense fluid over a permeable vertical surface under the combined influence of thermal radiation, velocity slip, temperature jump, buoyancy force, viscous dissipation, Joule heating and magnetic field. The governing partial differential equations are reduced to ordinary differential equations by using similarity variable. A local similarity solution is obtained numerically using shooting technique coupled with Runge-Kutta Fehlberg integration method. The influence of various thermophysical parameters on velocity and temperature profiles, skin friction, Nusselt number, entropy generation rate and Bejan number are presented graphically and discussed quantitatively. It is found that velocity slip, surface injection and temperature jump can successfully reduce entropy generation rate in the presence of an applied magnetic field. A comparison of numerical solution is made with the exact solution under a special case scenario and excellent agreement is found.
Etiology and Laboratory Abnormalities in Bacterial Meningitis in Neonates and Young Infants
Authors: Kotzbauer David , Travers Curtis , Shapiro Craig , Charbonnet Margaux , Cooley Anthony , Andresen Deborah , Frank Gary
Published: April 2017

We conducted a retrospective review of electronic medical records of all cases of bacterial meningitis in neonates and young infants at our institution from 2004 to 2014. Fifty-six cases were identified. The most common causative organism was group B streptococcus, followed by Escherichia coli and then Listeria monocytogenes. Fortyfour of the 56 patients in the study had abnormalities of the blood white blood cell (WBC) count. The most common WBC count abnormalities were leukopenia and elevation of the immature to total (I:T) neutrophil ratio. Six patients in the case series lacked cerebrospinal fluid (CSF) pleocytosis. Overall, just 3 of the 56 patients had normal WBC count with differential, CSF WBC count, and urinalysis. Only 1 of the 56 patients was well appearing with all normal lab studies. Our study indicates that bacterial meningitis may occur without CSF pleocytosis but very infrequently occurs with all normal lab studies and well appearance.
Antifungal and insecticidal activities of Raphanus sativus mediated AgNPs against mango leafhopper, Amritodus brevistylus and its associated fungus, Aspergillus niger
Authors: Shanmugapriya R. , Nareshkumar A. , Meenambigai K. , Kokila R. , Shebriya A. , Chandhirasekar K. , Thendral Manikandan A. , Munusamy C.
Published: April 2017

Mangifera indica is an important commercial fruit of India and primary food source for the mango leafhopper, Amritodus brevistylus further leading to the development of its associated fungus, Aspergillus niger. The present study was done to assess the antifungal and insecticidal activity of biologically synthesized silver nanoparticles using peel extracts of Raphanus sativus (Brassicaceae). Raphanus sativus peel extract is effective in extracellular reduction of Ag ions and capping the synthesized nanoparticles avoiding further agglomeration. The synthesized AgNPs are characterized by UV-vis spectroscopy, X-ray diffraction analysis, fourier transform infrared spectroscopy, scanning electron microscopy and energy dispersive x-ray analysis. Biologically synthesized AgNPs exhibited significant toxicity (LC50 − 7.61 ppm/48h) over mango leafhopper, Amritodus brevistylus. Silver nanoparticles synthesized using Raphanus sativus is also effective against the fungal pathogen, Aspergillus niger (developed on the infestations of mango leafhopper, Amritodus brevistylus) showing very strong inhibitory zone (80 mm).
Effects of various sugar feeding choices on survival and tolerance of honey bee workers to low temperatures
Authors: Abou-Shaara H.F.
Published: April 2017

Beekeepers usually supply their colonies with alternatives to nectar (i.e. sugar feeding) during dearth periods of the year, especially cold times of winter. The objective of the study was to determine the best substances to feed bees to enhance the tolerance and survival of honey bees (Apis mellifera L.) to low temperatures. Seven feeding choices were compared under laboratory conditions. These feeding choices were: sugar syrup, liquid honey, creamed honey, honey candy, sugar candy, honey jelly, and honey/sugarcane juice jelly. The results showed that the number of bees attracted to each feeding choice was influenced significantly by feeding type. Worker bees were attracted to all feeding choices and showed a high preference to creamed honey, honey jelly or honey/juice jelly. The tolerance of honey bees to low temperature was enhanced when bees were fed on creamed honey, sugar syrup or honey candy. The mean time at which 50% of bees were able to survive ranged from 3 days (unfed bees) to 15.8 days (honey candy group). The survival rate of worker bees was highest when they fed on honey candy, creamed honey or sugar candy. In light of this study, creamed honey or honey candy can be considered the best feeding choices for bee colonies during winter to enhance their survival and tolerance to low temperatures.
Performance evaluation of tuberculosis smear microscopists working at rechecking laboratories in Ethiopia
Authors: Asrat Habtamu , Kebede Abebaw , Abebe Abnet , Meaza Abyot , Hailu Getinet , Desale Adinew , Gashu Andargachew , Kassa Wondwossen , Mekonnen Tesfaye , Abose Ebisea , Girmachew Feven , Yenealem Dereje , Mulugeta Achamyeleh , Ayana Gonfa , Desta Kassu
Published: April 2017

Background: Tuberculosis is an infectious disease caused by the bacillus Mycobacterium tuberculosis. According to the Ethiopian Federal Ministry of Health’s 2013–2014 report, the tuberculosis case detection rate was 53.7%, which was below the target of 81% set for that year.Objective: This study assessed the performance of tuberculosis smear microscopists at external quality assessment rechecking laboratories in Ethiopia.Methods: A cross-sectional study was conducted at 81 laboratories from April to July 2015. Panel slides were prepared and validated at the National Tuberculosis Reference Laboratory. The validated panel slides were used to evaluate the performance of microscopists at these laboratories compared with readers from the reference laboratory.Results: A total of 389 external quality assessment rechecking laboratory microscopists participated in the study, of which 268 (68.9%) worked at hospitals, 241 (62%) had more than five years of work experience, 201 (51.7%) held Bachelors degrees, and 319 (82%) reported tuberculosis smear microscopy training. Overall, 324 (83.3%) participants scored ≥ 80%. Sensitivity for detecting tuberculosis bacilli was 84.5% and specificity was 93.1%. The overall percent agreement between participants and reference readers was 87.1 (kappa=0.72). All 10 slides were correctly read (i.e., scored 100%) by 80 (20.6%) participants, 156 (40.1%) scored 90% – 95%, 88 (22.6%) scored 80% – 85% and 65 (16.7%) scored below 80%. There were 806 (20.7%) total errors, with 143 (3.7%) major and 663 (17%) minor errors.Conclusion: The overall performance of participants in reading the slides showed good agreement with the reference readers. Most errors were minor, and the ability to detect tuberculosis bacilli can be improved through building the capacity of professionals.
Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion Provides Sustained Improvements in Clinical and Radiological Outcomes up to 5 Years Postoperatively in Patients with Neurogenic Symptoms Secondary to Spondylolisthesis
Authors: Bin Abd Razak Hamid Rahmatullah , Dhoke Priyesh , Tay Kae-Sian , Yeo William , Yue Wai-Mun
Published: April 2017

Study Design

Retrospective review of prospective registry data.

Purpose

To determine 5-year clinical and radiological outcomes of single-level instrumented minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in patients with neurogenic symptoms secondary to spondylolisthesis.

Overview of Literature

MIS-TLIF and open approaches have been shown to yield comparable outcomes. This is the first study to assess MIS-TLIF outcomes using the minimal clinically important difference (MCID) criterion.

Methods

The outcomes of 56 patients treated by a single surgeon, including the Oswestry disability index (ODI), neurogenic symptom score, short-form 36 questionnaire (SF-36), and visual analog scale (VAS) scores for back pain (BP), and leg pain (LP), were collected prospectively for up to 5 years postoperatively. Radiological outcomes included adjacent segment degeneration, fusion, cage subsidence, and screw loosening rates.

Results

Our patients were predominantly female (71.4%) and had a mean age of 53.7±11.3 years and mean body mass index of 25.7±3.7 kg/m2. The mean operative time, blood loss, time to ambulation, and hospitalization were 167±49 minutes, 126±107 mL, 1.2±0.4 days, and 2.8±1.1 days, respectively. The mean fluoroscopic time was 58.4±33 seconds, and the mean postoperative intravenous morphine dose was 8±2 mg. Regarding outcomes, postoperative scores improved relative to preoperative scores, and this was sustained across various time points for up to 5 years (p<0.001). Improvements in ODI, SF-36, VAS-BP, and VAS-LP all met the MCID criterion. Notably, 5.4% of our patients developed clinically significant adjacent segment disease during follow-up, and 7 minor complications were reported.

Conclusions

Single-level instrumented MIS-TLIF is suitable for patients with neurogenic symptoms secondary to lumbar spondylolisthesis and is associated with an acceptable complication rate. Both clinical and radiological outcomes were sustained up to 5 years postoperatively, with many patients achieving an MCID.
Correlation between Topographic Parameters Obtained by Back Surface Topography Based on Structured Light and Radiographic Variables in the Assessment of Back Morphology in Young Patients with Idiopathic Scoliosis
Authors: Pino-Almero Laura , Mínguez-Rey María Fe , Cibrián-Ortiz de Anda Rosa María , Salvador-Palmer María Rosario , Sentamans-Segarra Salvador
Published: April 2017

Study Design

Optical cross-sectional study.

Purpose

To study the correlation between asymmetry of the back (measured by means of surface topography) and deformity of the spine (quantified by the Cobb angle).

Overview of Literature

The Cobb angle is considered the gold standard in diagnosis and follow-up of scoliosis but does not correctly characterize the three-dimensional deformity of scoliosis. Furthermore, the exposure to ionizing radiation may cause harmful effects particularly during the growth stage, including breast cancer and other tumors.

Methods

Patients aged 13.15±1.96 years (range, 7–17 years; n=88) with Cobb angle greater than 10° were evaluated with X-rays and our back surface topography method through three variables: axial plane (DHOPI), coronal plane (POTSI), and profile plane (PC). Pearson's correlation was applied to determine the correlation between topographic and radiographic variables. One-way analysis of variance and Bonferroni correction were used to compare groups with different grades of scoliosis. Significance was set at p<0.01 and, in some cases, at p<0.05.

Results

We detected a positive, statistically significant correlation between Cobb angle with DHOPI (r=0.810) and POTSI (r=0.629) and between PC variables with thoracic kyphosis angle (r=0.453) and lordosis lumbar angle (r=0.275). In addition, we found statistically significant differences for DHOPI and POTSI variables according to the grade of scoliosis.

Conclusions

Although the back surface topography method cannot substitute for radiographs in the diagnosis of scoliosis, correlations between radiographic and topographic parameters suggest that it offers additional quantitative data that may complement radiologic study.
An Iranian Version of the Fukushima Lumbar Spinal Stenosis Scale (FLS-25): A Validation Study
Authors: Azimi Parisa , Montazeri Ali
Published: April 2017

Study Design

Cross-sectional study.

Purpose

To translate and validate the Fukushima lumbar spinal stenosis (LSS) scale 25 (FLS-25) for use in Iran.

Overview of Literature

Tools measuring patient-reported outcomes should satisfy certain psychometric properties.

Methods

FLS-25 is a self-administered scale for evaluating symptoms of LSS. A forward-backward procedure was applied to translate the questionnaire from English into Persian. A sample of patients with LSS completed the questionnaire at two points in time: once before surgery and once 6 months after the surgery. The Neurogenic Claudication Outcome Score (NCOS) was also used for assessment. The psychometric properties of FLS-25 were evaluated for internal consistency, test-retest and interobserver reliabilities, responsiveness to change, known-group comparison, and convergent validity.

Results

In all, 131 patients were included in the study. The mean age of the patients was 61.4 (standard deviation, 11.1) years. The Cronbach's alpha coefficient for FLS-25 was 0.89. Test-retest reliability as carried out by the intraclass correlation coefficient was 0.94 (95% confidence interval, 0.95). Interobserver agreement as measured by the kappa statistics also was found to be acceptable (kappa value, 0.88), and validity was found to be satisfactory. The instrument was able to discriminate between the subgroups of patients who differed in symptom severity. The correlation between FLS-25 and NCOS scores was excellent, indicating good convergent validity (r=0.82, p<0.001). The results also indicated that the instrument was responsive to change (p<0.001).

Conclusions

The Iranian version of FLS-25 performed well, and the findings suggest that it is a valid measure of symptom severity in LSS patients.
Relationships among Disability, Quality of Life, and Physical Fitness in Lumbar Spinal Stenosis: An Investigation of Elderly Korean Women
Authors: Park Saejong , Han Ho Sung , Kim Gang-Un , Kang Sung Shik , Kim Ho-Joong , Lee Mihyun , Park Soo Hyun , Choi Kyu Hwan , Kim Sung-Ho , Yeom Jin S.
Published: April 2017

Study Design

A cross-sectional, case-control study.

Purpose

To investigate associations between physical fitness measures and disabilities related to back pain and quality of life (QOL) by the presence of symptomatic lumbar spinal stenosis (LSS) in elderly Korean women.

Overview of Literature

LSS leads to decreased functioning and reduced QOL. However, correlations among physical fitness, disability, and QOL have not been investigated in elderly women with LSS.

Methods

Participants included women aged 65 years and older (n=192), divided into a study group (n=38) and a control group (n=154) based on the presence/absence of LSS. All participants underwent physical function and fitness tests. Oswestry disability index (ODI) scores and EuroQol five-dimensional questionnaire (EQ-5D-5L) scores were used to assess disability and health-related QOL.

Results

The results for the handgrip strength, sit-and-reach, functional reach, and timed up and go (TUG) tests were significantly higher in the control group than the LSS group. ODI scores were significantly higher and EQ-5D-5L scores significantly lower in the LSS group. TUG and functional reach test scores were significantly correlated with ODI scores, and handgrip strength was strongly interrelated with ODI and EQ-5D-5L scores in the LSS group. No other physical fitness measures showed statistically significant relationships with ODI or EQ-5D-5L scores.

Conclusions

In elderly Korean women with LSS, back pain-related disability and QOL are significantly associated with some physical fitness parameters such as handgrip strength. Handgrip strength reflects general muscle strength, which is significantly interrelated with the level of disability and QOL. Our results suggest that enhancing generalized muscle strength helps to reduce disability due to back pain and improve QOL in patients with LSS.
Qualitative Grading as a Tool in the Management of Multilevel Lumbar Spine Stenosis
Authors: Soman Shardul Madhav , Chokshi Jimmy , Chhatrala Naitik , Tharadara Gulam Haider , Prabhakar Mukund
Published: April 2017

Study Design

This is a prospective study that was undertaken at a single centre and involved 80 consecutive patients diagnosed with lumbar spinal stenosis (LSS).

Purpose

The aim of the study was to assess the efficacy of a qualitative grading system as seen on magnetic resonance imaging (MRI) as a tool in the management of multilevel LSS.

Overview of Literature

LSS diagnosis is clinical but is usually radiologically supplemented. However, there are often multilevel radiological findings with non-specific or atypical clinical features. We used a qualitative grading system to help in the decision-making process of the management of patients with multilevel LSS.

Methods

80 patients with LSS were treated with decompression and prospectively followed-up for a minimum of 12 months. All had failed conservative treatment. Qualitative grading of LSS severity was based on the dural sac in T2 weighted axial MRI images at all disc levels and was done from L1–2 to L5–S1 (n=400). Functional outcome was assessed using the Oswestry disability index (ODI).

Results

The mean patient age was 56.6 years, with a gender ratio of 0.6:1. Forty patients had degenerative LSS and 40 had degenerative spondylolysthesis. A total of 178 levels were decompressed, the majority of which were L4–L5 (43.82%), followed by L5–S1 (41.57%). According to our qualitative grading system, grade D stenosis (53.93%) was decompressed most frequently, followed by grade C stenosis (41.57%). The average preoperative ODI score was 58.55%, which later reduced to 19.15%. Seventy percent of patients achieved excellent results, whereas 30% achieved good results.

Conclusions

Morphological grading is a useful tool in decision making in surgery for multilevel LSS. Grade C and D stenosis should be decompressed, whereas A and B should not be, unless clinically justified.
Clinical and Radiological Outcomes after Microscopic Bilateral Decompression via a Unilateral Approach for Degenerative Lumbar Disease: Minimum 5-Year Follow-Up
Authors: Dohzono Sho , Toyoda Hiromitsu , Matsumura Akira , Terai Hidetomi , Suzuki Akinobu , Nakamura Hiroaki
Published: April 2017

Study Design

A retrospective study.

Purpose

To assess postoperative bone regrowth at surgical sites after lumbar decompression with >5 years of follow-up. Postoperative preservation of facet joints and segmental spinal instability following surgery were also evaluated.

Overview of Literature

Previous reports have documented bone regrowth after conventional laminectomy or laminotomy and several factors associated with new bone formation.

Methods

Forty-nine patients who underwent microscopic bilateral decompression via a unilateral approach at L4–5 were reviewed. Primary outcomes included correlations among postoperative bone regrowth, preservation of facet joints, radiographic parameters, and clinical outcomes. Secondary outcomes included comparative analyses of radiographic parameters and clinical outcomes among preoperative diagnoses (lumbar spinal stenosis, degenerative spondylolisthesis, and degenerative lumbar scoliosis).

Results

The average value of bone regrowth at the latest follow-up was significantly higher on the dorsal side of the facet joint (3.4 mm) than on the ventral side (1.3 mm). Percent facet joint preservation was significantly smaller on the approach side (79.2%) than on the contralateral side (95.2%). Bone regrowth showed a significant inverse correlation with age, but no significant correlation was observed with facet joint preservation, gender, postoperative segmental spinal motion, or clinical outcomes. Subanalysis of these data revealed that bone regrowth at the latest follow-up was significantly greater in patients with degenerative lumbar scoliosis than in those with lumbar spinal stenosis. Postoperative segmental spinal motion at L4–L5 did not progress significantly in patients with degenerative spondylolisthesis or degenerative lumbar scoliosis compared with those with lumbar spinal stenosis.

Conclusions

Microscopic bilateral decompression via a unilateral approach prevents postoperative spinal instability because of satisfactory preservation of facet joints, which may be the primary reason for inadequate bone regrowth. Postoperative bone regrowth was not related to clinical outcomes and postoperative segmental spinal instability.
The Versatile Approach: A Novel Single Incision Combined with Anterior and Posterior Approaches for Decompression and Instrumented Fusion to Treat Tuberculosis of the Thoracic Spine
Authors: Srivastava Sudhir Kumar , Aggarwal Rishi Anil , Bhosale Sunil Krishna , Roy Kunal , Nemade Pradip Sharad
Published: April 2017

Study Design

Retrospective case series.

Purpose

To describe a novel single incision that combines anterior and posterior approaches for decompression and instrumented fusion to treat tuberculosis of the thoracic spine and study the neurological and radiological outcomes.

Overview of Literature

Tuberculosis of the spine remains a major health issue in many developing countries. The options for treating tuberculosis of the thoracic spine include the anterior, posterior, and combined approaches, each with its advantages and disadvantages.

Methods

Totally, 143 patients with tuberculosis of the thoracic spine were surgically treated using the “Versatile approach”. Posterior fixation was performed using sublaminar wires and a Hartshill rectangle in all patients. Anterior reconstruction was accomplished using bone graft harvested from autologous rib, iliac crest, or fibula.

Results

The study included 45 males and 98 females, with a mean age of 33.18±18.65 years (range, 3–82 years) and a mean follow-up of 60.23±24.56 months (range, 18–156 months). Kyphosis improved from a mean value of 24.02 preoperatively to 10.25 postoperatively. A preoperative neurological deficit was observed in 131 patients, with 130 patients regaining ambulatory power. No patient had deterioration of neurological status following surgery. Fusion was achieved in all cases. The visual analogscale score improved from an average score of 7.02 preoperatively to 1.51 at final follow-up. Eight patients had superficial macerations, which healed spontaneously. One patient had buckling of the anterior graft, and one patient had implant breakage following road traffic accident.

Conclusions

The “Versatile approach” is an effective, single-stage, single-incision method that combines anterior and posterior approaches for the surgically treating tuberculosis of the thoracic spine. It offers the advantage of direct visualization for decompression and reconstruction of the anterior and posterior vertebral columns, thus providing an excellent, long-lasting clinical outcome.
Atlantoaxial Stabilization Using C1 and C2 Laminar Screw Fixation
Authors: Tsuji Takashi , Chiba Kazuhiro , Horiuchi Yosuke , Urabe Tadahisa , Fujita Shota , Matsumoto Morio
Published: April 2017

We describe the use of a C1 laminar screw in combination with a C2 laminar screw as a salvage technique to treat two patients, one with persistent first intersegmental artery and the other with vertebral artery occlusion after cervical spine fracture. The combined use of C1 and C2 laminar screws allows for good fixation of the atlantoaxial joint with a lower risk of vertebral artery injury; therefore, it can be an alternative surgical procedure for patients with congenital or traumatic anomalous vertebral artery.
The arithmetic relations between total expenditure and the resulting current and financial account balances as determinants of the revenue-related need for means of payment in an economy
Authors: Stützel Wolfgang
Published: April 2017

Introductory note by the translators: In the following paragraphs, Stützel derives some balance mechanic relationships between revenue and expenditure surpluses, on the one hand, and the volume of credit necessary to finance these, on the other. He then moves on to consider the balance sheet of the banking sector and its relationships with the volume of credit. Insights from both exercises are subsequently used to synthesise the ‘orthodox’ and ‘modern’ theories of credit. The few parts of Stützel (1958 [1978]: 208–219) which were excluded from the translation are the ones in which Stützel directly refers to other parts of the book which are not translated here, as well as some footnotes referring to issues or publications which were topical at the time at which Stützel was writing but which are of very limited interest for our purposes. Furthermore, we omit a short passage in which Stützel briefly introduces the ‘straddle effect’, a concept which is important in his discussion of the quantity theory of money (ibid.: 229–255) but which does not feature any further in the section we are translating. For more on the quantity equation from a balance mechanics perspective, see Tarne (2016). The text below is a direct translation from Stützel without any changes or amendments, including Stützel's use of emphases and quotation marks.
Review of exchange-rate theories in four leading economics textbooks
Authors: Priewe Jan
Published: April 2017

In this paper, the parts of four leading economics textbooks that deal with exchange-rate theories are reviewed. The books are by Krugman/Obstfeld/Melitz, Blanchard/Johnson, Mankiw/Taylor and Samuelson/Nordhaus. The theoretical background for this exercise is the fact that exchange-rate theory is one of the weakest parts in ‘mainstream economics’, meaning the neoclassical and the New Keynesian stream of thought. It is now widely accepted that exchange-rate forecasts are no better than those arising from a random walk in the short and medium run. For the long run, most authors stick to the old purchasing-power-parity theory whose empirical validation is just as weak. Nonetheless the textbooks reviewed here only present exchange-rate theories that have little empirical support. Yet they differ considerably, even though they remain within the leading theoretical paradigm.
Development and use of a clinical decision support tool for behavioral health screening in primary care clinics
Authors: Burdick Timothy , Kessler Rodger
Published: April 2017

Objective: Screening, brief intervention, and referral for treatment (SBIRT) for behavioral health (BH) is a key clinical process. SBIRT tools in electronic health records (EHR) are infrequent and rarely studied. Our goals were 1) to design and implement SBIRT using clinical decision support (CDS) in a commercial EHR; and 2) to conduct a pragmatic evaluation of the impact of the tools on clinical outcomes.

Methods: A multidisciplinary team designed SBIRT workflows and CDS tools. We analyzed the outcomes using a retrospective descriptive convenience cohort with age-matched comparison group. Data extracted from the EHR were evaluated using descriptive statistics.

Results: There were 2 outcomes studied: 1) development and use of new BH screening tools and workflows; and 2) the results of use of those tools by a convenience sample of 866 encounters. The EHR tools developed included a flowsheet for documenting screens for 3 domains (depression, alcohol use, and prescription misuse); and 5 alerts with clinical recommendations based on screening; and reminders for annual screening. Positive screen rate was 21% (≥1 domain) with 60% of those positive for depression. Screening was rarely positive in 2 domains (11%), and never positive in 3 domains. Positive and negative screens led to higher rates of documentation of brief intervention (BI) compared with a matched sample who did not receive screening, including changes in psychotropic medications, updated BH terms on the problem list, or referral for BH intervention. Clinical process outcomes changed even when screening was negative.

Conclusions: Modified workflows for BH screening and CDS tools with clinical recommendations can be deployed in the EHR. Using SBIRT tools changed clinical process metrics even when screening was negative, perhaps due to conversations about BH not captured in the screening flowsheet. Although there are limitations to the study, results support ongoing investigation.

Citation: Burdick TE, Kessler RS. Development and use of a clinical decision support tool for behavioral health screening in primary care clinics. Appl Clin Inform 2017; 8: 412–429 https://doi.org/10.4338/ACI-2016-04-RA-0068
Mind the gap: Australian local government reform and councillors’ understandings of their roles
Authors: Tan Su Fei , Morris Alan , Grant Bligh
Published: April 2017

Over the last two decades a feature of local government reforms globally has been the introduction of New Public Management (NPM).  Under this broad approach to public administration there is an expectation that councillors play a greater strategic role and move away from involvement in day-to-day management.  This research, carried out in the state of Victoria, Australia, examines councillors’ understandings of their roles.  Based on 17 in-depth interviews and two focus groups, we found that despite the evolving legislative requirements framing councillors as policymakers not managers, most councillors continued to seek involvement in the day-to-day management of councils.  We argue that this gap may be linked to the diversity of views concerning the role of the councillor and the idea of representation and how both play out at the local level.  It may also signal a lack of awareness as to how the legislatively inscribed role for councillors has changed over time.
Australian local governments and the early national broadband network roll-out: an online survey
Authors: Alizadeh Tooran , Shearer Heather
Published: April 2017

A recent decision by the Australian Federal Government to reassess the scale of the National Broadband Network (NBN) will leave the country with a patchwork of different levels of access to the infrastructure. This intensifies the need to investigate and evaluate the implications of telecommunication at the local level. The paper opens a discussion on the different approaches taken by local government authorities towards the NBN in the early roll-out localities. Building upon the international literature, it analyses the empirical data collected from the Australian local governments involved with the early NBN roll-out using an online survey. The findings reveal an interesting diversity in the approaches taken at the local level, and show how decision-making at higher levels of government can impact local outcomes.
Assignment of functions to local authorities in Lesotho
Authors: Nyane Hoolo
Published: April 2017

In Lesotho the adoption of the new constitution in 1993 made provision for local development. These constitutional provisions were only operationalised in 1997 through an Act of parliament (Local Government Act 1997). The question of how functions are assigned between the central and local governments has always been an area of dispute. The Act attempted to demarcate the assignments through the Schedules to the Act which embody the functions of local authorities at various levels – community councils, urban councils and district councils. However, local development and service delivery continue by and large to be undertaken by central government despite the demarcation. The purpose of this paper, therefore, is to critically analyse the challenges of assignment of functions to local authorities in Lesotho. The paper contends that as the assignment of functions is integral to decentralisation in Lesotho, intergovernmental relations and assignment of functions should be incorporated into the country’s constitution.
Can organisation development principles in India's local governments improve governance?
Authors: Srivastava Sonali , Rajadhyaksha Madhavi
Published: April 2017

This paper examines the application of organisation development principles to rural local self-government bodies in Karnataka, India with the objective of developing their organisational capacity and improving their efficiency. The premise is that strong gram panchayats (village councils) can address issues hindering service delivery and governance at the grass roots.The paper illustrates the methodology used in the development of an innovative framework called Gram Panchayat Organisation Development (GPOD) and its implementation in action research mode in two village councils since 2011. It further explores the wider applicability of this framework, which has been extended to over 50 gram panchayats (GPs) since 2014. GPOD works towards strengthening the panchayat as an organisation in its entirety, rather than by tackling stand-alone components. It includes building a shared vision in the panchayat, mapping and re-engineering key processes, developing accountability and incentive structures, and supporting the village body in developing and implementing its annual plans. The approach has evolved to its present form based on real-time change management initiatives in GPs in which politically elected members participated in decision-making and implementation. We argue that by following the principles of organisation development and aligning the panchayat’s organisational components, marked improvements in local governance and service delivery were achieved. Impact is captured in terms of systemic outputs such as annual plans, accountability structures and activation of defunct committees, as well as improvements in services such as health, sanitation, drinking water, etc. The paper also includes a critique of the challenges faced as GPOD was scaled up to include new areas.
Review – Reclaiming Local Democracy: A progressive future for local government
Authors: Morris Gordon
Published: April 2017

This is a book that needed to be written. First published in 2014, Ines Newman takes a timely, refreshing, and broad look at local government.  Although it relates mainly to the UK, colleagues throughout the Commonwealth will find this book both interesting and relevant.  Her thoughtful approach has, I think, optimism at its heart.  The work is an effective counterpoint to the prevailing neoliberal orthodoxy that “austerity”, with its consequential public sector cuts, is unavoidable. As Newman makes clear, “austerity” is a political choice.