bluuebunny/crossref_metadata_2025 huggingface dataset:
The Familial Predisposition toward Tearing the Anterior Cruciate Ligament
Authors: Flynn R. Kevin , Pedersen Cheryl L. , Birmingham Trevor B. , Kirkley Alexandra , Jackowski Dianne , Fowler Peter J.
Published: December 2004

Purpose

A study of 171 surgical cases and 171 matched controls was conducted to investigate whether a familial predisposition toward tearing the anterior cruciate ligament of the knee exists.

Study Design

Case control study; Level of evidence, 3.

Methods

Patients who were diagnosed with an anterior cruciate ligament tear were matched by age (within 5 years), gender, and primary sport to subjects without an anterior cruciate ligament tear. All 342 subjects completed a questionnaire detailing their family history of anterior cruciate ligament tears.

Results

When controlling for subject age and number of relatives, participants with an anterior cruciate ligament tear were twice as likely to have a relative (first, second, or third degree) with an anterior cruciate ligament tear compared to participants without an anterior cruciate ligament tear (adjusted odds ratio = 2.00; 95% confidence interval, 1.19-3.33). When the analysis was limited to include only first-degree relatives, participants with an anterior cruciate ligament tear were slightly greater than twice as likely to have a first-degree relative with an anterior cruciate ligament tear compared to participants without an anterior cruciate ligament tear (adjusted odds ratio = 2.24; 95% confidence interval, 1.24-4.00).

Conclusions

Findings are consistent with a familial predisposition toward tearing the anterior cruciate ligament.

Clinical Relevance

Future research should concentrate on identifying the potentially modifiable risk factors that may be passed through families and developing strategies for the prevention of anterior cruciate ligament injuries.
Donor Site Morbidity and Return to the Preinjury Activity Level after Anterior Cruciate Ligament Reconstruction Using Ipsilateral and Contralateral Patellar Tendon Autograft
Authors: Mastrokalos Dimitrios S. , Springer Jan , Siebold Rainer , Paessler Hans H.
Published: December 2004

Aim

To compare the donor site morbidity after anterior cruciate ligament reconstruction using ipsilateral and contralateral bone–patellar tendon autograft.

Study Design

Cohort study; Level of evidence, 2

Patients and Method

Between 1997 and 1999, 100 patients underwent anterior cruciate ligament reconstruction with autologous bone–patellar tendon graft. The reconstructions were performed using ipsilateral bone–patellar tendon graft in 52 patients (group Ip) and contralateral bone–patellar tendon graft in 48 patients (group Co). Group Co consisted of 2 subgroups: group Co-D consisted of the donor knees (n = 48) and group Co-ACL consisted of the anterior cruciate ligament–reconstructed knees (n = 48). Mean follow-up was 39.2 months. Donor site morbidity was evaluated with a questionnaire, computerized historical data, KT-2000 arthrometer measurements, the Cincinnati score, and the Tegner score.

Results

KT-2000 arthrometer evaluation showed a mean side-to-side difference of 0.6 mm in both groups. There were no significant differences between the 2 groups concerning the Cincinnati and Tegner scores. With regard to local tenderness, a significantly higher rate was found in group Ip (59.6%) and group Co-D (58.3%) compared with group Co-ACL (6.3%). In groups Ip and Co-D, high statistically significant differences were also found according to kneeling pain (69.2% and 70.8%, respectively) and knee-walking pain (76.9% and 70.8%, respectively) compared with group Co-ACL (6.3% and 10.4%, respectively). With regard to numbness, there was no statistical significance between the rates of all 3 groups: group Ip = 75%, group Co-D = 85.4%, and group Co-ACL = 64.6%. There was one rupture of the patellar tendon and one patient with chronic patellar tendinitis, both in the donor knee of group Co-D.

Conclusion

The contralateral bone–patellar tendon graft appears to present no advantage over the ipsilateral graft, as all symptoms concerning donor site morbidity are shifted from the injured into the healthy knee, and return to activity is not more rapid.
Fixation of Osteochondritis Dissecans Lesions Using Poly(l-lactic Acid)/ Poly(glycolic Acid) Copolymer Bioabsorbable Screws
Authors: Larsen Mitchell W. , Pietrzak William S. , DeLee Jesse C.
Published: December 2004

Background

Many osteochondritis dissecans lesion fixation techniques are effective. A new absorbable copolymer screw maybe suitable for this application.

Purpose

To characterize the mechanical and in vitro absorption properties of a copolymer fixation screw and determine theclinical efficacy of using the screw to fix osteochondritis dissecans lesions.

Study Design

Case series and laboratory study; Level of evidence, 4.

Methods

Seven patients diagnosed with unstable, partially open osteochondritis dissecans lesions were treated withdebridement of the bed and fixation with 2.5-mm diameter screws made of Lacto Sorb copolymer; the patients were nonweightbearingfor 6 weeks. Clinical and radiographic follow-up was for 25 to 37 months. Biomechanical testing was performed in syntheticbone over a 12-week period on buffer-incubated specimens.

Results

Six of the 7 osteochondritis dissecans lesions healed clinically and radiographically; the osteochondritis dissecansfragment was removed from the seventh patient (unhealed). No symptoms indicative of an inflammatory reaction related to thepresence of the absorbable screws, including recurrent effusion, warmth, or erythema, were noted. In the in vitro testing, theinitial average peak pull-out and shear loads were 20.1 kg and 22.3 kg, respectively, with little strength remaining at 12 weeks.

Conclusions

In general, the 2.5-mm-diameter Lacto Sorb copolymer screws provided adequate stability for healing ofosteochondritis dissecans lesions and degraded without an inflammatory response by the body.
Intercondylar Notch Stenosis is not a Risk Factor for Anterior Cruciate Ligament Tears in Professional Male Basketball Players
Authors: Lombardo Stephen , Sethi Paul M. , Starkey Chad
Published: December 2004

Background

The value of femoral notch size and the notch width index in predicting anterior cruciate ligament injury has been debated. This study examined the relationship between the notch width index and anterior cruciate ligament injury in professional basketball players.

Hypothesis

No significant difference exists between the notch width index of anterior cruciate ligament–injured and noninjured professional basketball players.

Study Design

Case-control study; Level of evidence, 3.

Methods

Using a notch view radiograph, the authors prospectively measured the femoral notch and the condylar widths and then calculated the notch width index of 615 male athletes who participated in the National Basketball Association's combine workouts between 1992 and 1999. Players who participated in at least 1 professional game were included. After an 11-year follow-up period, the National Basketball Association's leaguewide injury database was reviewed to identify injured players. The players were then categorized into anterior cruciate ligament–injured or noninjured groups. Notch width, condylar width, and notch width index were compared between the 2 groups.

Results

A total of 305 players were followed for a period of up to 11 years. Anterior cruciate ligament trauma was suffered by 14 (4.6%) of the subjects. The average notch width index was 0.235 ± 0.031 for anterior cruciate ligament–injured players and 0.242 ± 0.041 for noninjured players (t305 –0.623, P=. 534). This difference was not significantly different. Two (3.9%) of the subjects with critical notch stenosis (notch width index 0.20) had noncontact anterior cruciate ligament injuries.

Conclusions

The notch width index did not predict the rate of anterior cruciate ligament injury. A level of critical notch stenosis was not detected. Anterior cruciate ligament injury could not be predicted by the absolute measurement of the femoral intercondylar notch. Use of a preparticipation notch view radiograph in male professional basketball players as a predictor of anterior cruciate ligament injury is not recommended.
The Influence of Supplementary Tibial Fixation on Laxity Measurements after Anterior Cruciate Ligament Reconstruction with Hamstring Tendons in Female Patients
Authors: Hill Peter F. , Russell Vivianne J. , Salmon Lucy J. , Pinczewski Leo A.
Published: December 2004

Background

Female patients undergoing arthroscopic anterior cruciate ligament reconstruction with a hamstring tendon graft developed increased postoperative laxity compared to male and female patients who had reconstruction using a patellar tendon graft. This difference may be due to graft slippage in less dense female tibial bone.

Hypothesis

Reinforcement of tibial fixation of the hamstring tendon graft in women by supplementary methods may reduce laxity.

Study Design

Randomized controlled clinical trial; Level of evidence, 2.

Methods

Fifty-six female patients divided into 2 groups (standard tibial fixation with 7 · 25–mm metal interference screw versus metal interference screw with supplementary staple fixation) were followed for 2 years.

Results

After 2 years, the mean side-to-side difference using KT-1000 arthrometer manual maximum measurements was 1.8 mm (standard group) and 1.1 mm (staple group) (P =. 05). The percentage of patients with a side-to-side difference of < 3 mm did not differ significantly between the 2 groups (P =. 66): 88.8% of the standard group versus 90.5% of the staple group. A grade 0 Lachman test result was present in 63% of the standard group and 86% of the staple group (P =. 04). Kneeling pain was experienced by 7% of the standard group and 29% of the staple group (P =. 05).

Conclusions

Supplementary tibial fixation in female patients undergoing anterior cruciate ligament reconstruction with hamstring tendon graft in addition to a single-size screw significantly improves laxity measurements and clinical stability assessment 2 years after surgery. However, this improvement is at the cost of increased kneeling pain.
Arthroscopic Anterior Shoulder Stabilization of Collision and Contact Athletes
Authors: Mazzocca Augustus D. , Brown Fred M. , Carreira Dominic S. , Hayden Jennifer , Romeo Anthony A.
Published: December 2004

Background

Repair of the anterior labrum (Bankart lesion) with tightening of the ligaments (capsulorrhaphy) is the recommended treatment for recurrent anterior glenohumeral dislocations. Current evidence suggests that arthroscopic anterior stabilization methods yield similar failure rates for resubluxation and redislocation when compared to open techniques.

Study Design

Case series; Level of evidence, 4

Purpose

To examine the results of arthroscopic anterior shoulder stabilization of high-demand collision and contact athletes.

Methods

Thirteen collision and 5 contact athletes were identified from the senior surgeon's case registry. Analysis was limited to patients younger than 20 years who were involved in collision (football) or contact (wrestling, soccer) athletics. Objective testing included preoperative and postoperative range of motion and stability. Outcome measures included the American Shoulder and Elbow Society shoulder score, Simple Shoulder Test, SF-36, and Rowe scores. The surgical procedure was performed in a consistent manner: suture anchor repair of the displaced labrum, capsulorrhaphy with suture placement supplemented with thermal treatment of the capsule when indicated, and occasional rotator interval closure. Average follow-up was 37 months (range, 24-66 months).

Results

Two of 18 contact and collision athletes (11%) experienced recurrent dislocations after the procedure; both were collision athletes. One returned to play 3 years of high school football but failed after diving into a pool. One patient failed in his second season after his stabilization (> 2 years) when making a tackle. None of the contact athletes experienced a recurrent dislocation, with all of them returning to high school or college athletics.

Conclusions

One hundred percent of all collision and contact athletes returned to organized high school or college sports. Fifteen percent of those collision athletes had a recurrence, which has not required treatment. Participation in collision and contact athletics is not a contraindication for arthroscopic anterior shoulder stabilization using suture anchors, proper suture placement, capsulorrhaphy, and occasional rotator interval plication.
Stabilization of the Clavicle after Distal Resection
Authors: Corteen Darren P. , Teitge Robert A.
Published: December 2004

Background

The potential destabilizing effect of distal clavicle resection has received limited attention.

Hypothesis

Suturing the coracoacromial ligament to the undersurface of the distal clavicle after resection could counter clavicle instability.

Study Design

Controlled laboratory study.

Methods

The effect of ligament augmentation on posterior translation of the clavicle after resection was evaluated using 12 fresh-frozen cadaveric shoulders. Posterior clavicular displacement was measured after the application of a 70-N load under 4 different conditions: (1) the intact joint, (2) after distal clavicle resection, (3) clavicle resection plus acromioclavicular capsular ligament repair, and (4) clavicle resection plus acromioclavicular capsular ligament repair plus coracoacromial ligament augmentation.

Results

Mean displacements for each of the test conditions were as follows: (1) 5.60 mm, (2) 7.38 mm, (3) 7.54 mm, and (4) 6.34 mm. A 32% increase in posterior translation was measured after resection compared to the intact specimen. No reduction in posterior displacement was noted after capsular repair; however, displacement decreased significantly when capsular repair was coupled with ligament augmentation.

Conclusions

Results suggest that the destabilizing effect of clavicle resection can be partially countered by the proposed ligament augmentation.

Clinical Relevance

That the destabilizing effect of clavicle resection can be partially countered by the proposed ligament augmentation may be particularly relevant in cases of resection for posttraumatic arthritis after acromioclavicular separation in which some degree of preexisting acromioclavicular capsular attenuation and consequently acromioclavicular joint laxity may be presumed.
Potential Risk of Rerupture in Primary Achilles Tendon Repair in Athletes Younger than 30 Years of Age
Authors: Rettig Arthur C. , Liotta Ferdinand J. , Klootwyk Thomas E. , Porter David A. , Mieling Paul
Published: December 2004

Background

Complete Achilles tendon ruptures are found more often in athletes who participate in sports involving explosive acceleration or maximal effort. In most studies, the consensus for athletes is surgery. This form of treatment has been shown to exhibit the best functional performance with a lower rerupture rate.

Hypothesis

Achilles tendon ruptures in a young population (<30 years) have a higher rerupture rate than similar injuries in an older age group (31-50 years), in which the injury is more common.

Study Design

Cohort study; Level of evidence, 4.

Methods

Retrospective study was carried out by chart review. Magnetic resonance images were obtained comparing appearance of repair in young and old patients at 8 to 12 weeks after operation.

Results

There were a total of 4 reruptures in the 89 Achilles tendon repairs. This was an overall rerupture rate of 4.5%, which was consistent with the literature. When the reruptures were critically analyzed, it was noted that the 4 reruptures of the repaired tendon occurred in a young population. Of the 89, there was a subgroup of athletes (n = 24) who were 30 years of age or younger at the time of injury. The incidence of rerupture for these individuals was 16.6%. In the remaining athletes (n = 65) older than 30 years, the incidence of rerupture was zero. There were no significant differences (P=. 05) in all parameters measured (average days in a boot, average days to active range of motion, average time to full weight-bearing, average days to bike or use a stair climbing machine, average return to sports) between age groups except in the time from injury to surgery (7.1 days, for athletes = 30 years vs 2.65 days for athletes >31 years).

Conclusions

The results of Achilles tendon repair with an early weightbearing and an early range of motion rehabilitation program are good. However, caution may need to be taken in the younger athlete (= 30 years) during rehabilitation.

Clinical Relevance

Although the authors recommend aggressive rehabilitation for Achilles tendon repairs, caution should be observed in the younger athlete.
Arthroscopic Findings in Chronic Lateral Ankle Instability
Authors: Okuda Ryuzo , Kinoshita Mitsuo , Morikawa Junichi , Yasuda Toshito , Abe Muneaki
Published: December 2004

Background

There are few studies that have assessed the influence of focal chondral lesions on the results of ligament reconstruction for chronic lateral ankle instability.

Hypothesis

Focal chondral lesions do not influence the results of ligament reconstruction.

Study Design

Case series; Level of evidence, 4.

Methods

Arthroscopic examination of the ankle was performed on 30 consecutive patients immediately before ligament reconstruction using the palmaris longus tendon. Clinical assessment was performed using the Karlsson scoring scale. A radiologic assessment was performed on stress radiographs of the ankle. Preoperative anteroposterior and lateral weightbearing radiographs of the ankle did not show any joint space narrowing in any ankle. The mean duration of follow-up was 38 months.

Results

On arthroscopy, focal chondral lesions were found in 19 ankles (63%). Chondral lesions were located on the medial side of the tibial plafond in 13 ankles (43%), on the lateral side in 2 ankles (7%), on the lateral side of the talar dome in 3 ankles (10%), and on the medial side in 9 ankles (30%). Postoperative mean Karlsson scores in patients without chondral lesions and in those with chondral lesions were 99.1 and 98.4 points, respectively. Postoperative mean talar tilt angles in patients without chondral lesions and in those with chondral lesions were 5.9° and 4.7°, respectively. There were no significant differences in the clinical and radiologic results between patients with chondral lesions and those without chondral lesions.

Conclusions

Reconstruction of the lateral ligament can be successful regardless of the presence of focal chondral lesions in patients with chronic lateral ankle instability when preoperative weightbearing radiographs of the ankle do not show any joint space narrowing.
Mechanisms of Organizational Sex Segregation
Authors: Bygren Magnus , Kumlin Johanna
Published: December 2004

This study examines the process underlying sex segregation at the organizational level by focusing on the process through which organizations renew their workforce. The authors used a sample of 1,460 Swedish workplaces that recruited 75,261 employees during the period 1991 to 1995. The results indicate that the most important factor in reproducing segregation at the organizational level is sex segregation in the occupations from which organizations recruit their personnel. Organizations’ sex composition is to a very high degree determined by the sex composition of the occupations they employ. In addition, large organizations and expanding organizations tend to make more sex-atypical recruitments compared with other organizations.
A Cornucopia of Research, Discussion, and Debate
Authors: Althauser Robert P.
Published: December 2004

This comprehensive handbook provides an overviewof the key developments in a variety of labor market contexts and in the analyses of these that have occurred during the two decades since the publication of the 1981 volume Sociological Perspectives on Labor Markets. Adistinguished roster of authors (sociologists as well as economists) examines the interplay between social institutions and markets in producing important outcomes for producers of goods and services, for their organizations’owners, and for their customers. For example, the authors investigate how social institutions such as unions, business organizations, and the government interact with labor, product, political, and capital markets to produce a variety of labor market outcomes, widening income inequality, career paths, and changing employment relationships.
Studying Race or Ethnic and Sex Segregation at the Establishment Level
Authors: Robinson Corre L. , Taylor Tiffany , Tomaskovic-Devey Donald , Zimmer Catherine , Irvin Matthew W.
Published: December 2004

Scholars of employment segregation now recognize that gender, race, and class processes are mutually constitutive. Coupled with new data-collection strategies, understanding of the organization of work and distribution of inequality will improve. The authors explore the strengths and weaknesses of longitudinal establishment data collected by the Equal Employment Opportunity Commission (EEOC), comparing these to other data used to study workplace status processes. Findings both confirm and dispute well-known occupation-based analyses of workplace segregation and lead to similar substantive conclusions. EEOC data are useful for discovering trends in segregation, for locating segregation in spatial, temporal, and industrial contexts, and for combining with organizational data to uncover mechanisms.
Control of Thermogelation Properties of Hydrophobically-Modified Methylcellulose
Authors: Lee Sang Cheon , Cho Yong Woo , Park Kinam
Published: December 2004

Aqueous solutions that undergo reversible thermosensitive gelation around body temperature were developed based on hydrophobically-modified methyl cellulose (HMMC). The approach involved HMMC as the main component of aqueous compositions to provide a system with fast gelling properties, which has not been accomplished with aqueous solutions of unmodified methyl cellulose (MC). MC was modified with the stearyl group as a hydrophobic modifier by controlling the degree of modification. The gelation rate of aqueous solutions containing identical amounts of HMMC and NaCl increased as the temperature increased. The HMMC solutions gelled at a fixed temperature and concentration range, while the unmodified MC solutions did not show sol-to-gel transition. In addition, HMMC solutions exhibited much faster gelation than MC solutions at given polymer and NaCl concentrations. The HMMC/NaCl solutions exhibited the reversible gel-to-sol transition upon cooling below 25°C. The rate of sol-to-gel transition at body temperature, and the reversible gel-to-sol transition at room temperature, were modulated by adjusting the concentration of HMMC and NaCl, respectively. The HMMC/NaCl compositions provided a simple system for accurate control of the thermogelling temperature and the thermogelation rates.
Biologically Active Polymers: Modification and Anti-microbial Activity of Chitosan Derivatives
Authors: Kenawy El-Refaie , Abdel-Hay F. Imam , El-Magd Ahmed Abou , Mahmoud Yehia
Published: December 2004

The principal derivative of chitin is chitosan, which is obtained by deacetylation of chitin. Chemical modification of synthetic and natural polymers is a convenient way to obtain materials with unique chemical and physical properties. Chitosan has an amino group at C-2 which is important because amino groups are nucleophilic and readily react with electrophilic reagents. Chitosan modified under mild conditions often results in regioselectivity for the C-2 amino group.

In the present work, this reactivity was exploited to attach biologically active moieties into the amino groups of chitosan to yield anti-microbial chitosans. Specifically, vanillin, p-hydroxybenzaldehyde, p-chlorobenzaldehyde, anisaldehyde, methyl 4-hydroxybenzoate, methyl 2,4-dihydroxybenzoate, propyl 3,4,5-trihydroxybenzoate and 2-hydroxymethylbenzoate were attached. The anti-microbial activity of these modified chitosans was explored against fungi such as Candida albicans SC5314, Aspergillus flavus and Fusarium oxysporium. Also, they were tested against bacteria such as Bacillus subtilis, Escherichia coli and Staphylococcus aureus. These modified chitosans were found to be highly active toward fungi species more than bacterial species.
Studies on PEGylated and Drug-Loaded PAMAM Dendrimers
Authors: Pan Gaofeng , Lemmouchi Yahia , Akala Emmanuel O. , Bakare Oladapo
Published: December 2004

Three methods were investigated for their suitability for the activation of poly(ethylene glycol) 2000 mono-methyl ether en route to conjugation with dendrimers, using 4-nitrophenylchloroformate as the activator. The use of acetonitrile as a solvent gave the best results. Poly(ethylene glycol) (PEG) grafted polyamidoamine (PAMAM) dendrimers were synthesized and characterized; the use of acetonitrile as a solvent gave the best result. A series of PEG conjugated PAMAM dendrimers with varying degrees of substitution of the dendrimer surface functional group by PEG were prepared. The encapsulation efficiency and the in vitro release characteristics of these PEG conjugated PAMAM dendrimers were studied. The percentage coverage of PAMAM dendrimer surface with PEG had little effect on the encapsulation efficiency but affected the release of methotrexate. IR spectra showed that many of the encapsulated methotrexate molecules were located within the cavity of the dendrimer.
Crosslinked Polyurethane Coating on Vascular Stents for Enhanced X-ray Contrast
Authors: Kondyurin Alexey , Romanova Valentina , Begishev Valery , Kondyurina Irina , Guenzel Reinhard , Maitz Manfred F.
Published: December 2004

A coating of polyurethaneurea was made from a solution on the surface of metal stents. The influence of cleaning, etching, chemical and ion beam modification (plasma immersion ion implantation) of the metal surface on the adhesion strength of the polyurethaneurea was analysed. Polyurethaneurea films imbedded with tantalum particles as a radiopaque filler maintained their strength and elasticity and produced clear X-ray contrast images of vascular stents.
A Fractional Derivative Viscoelastic Model for Hybrid Active-Passive Damping Treatments in Time Domain - Application to Sandwich Beams
Authors: Galucio A. C. , Deu J. F. , Ohayon R.
Published: December 2004

This work presents a finite element formulation for the dynamic transient analysis of a damped adaptive sandwich beam composed of a viscoelastic core and elastic-piezoelectric laminated faces. The latter are modeled using the classical laminate theory, which takes the electromechanical coupling into account by modifying the stiffness of the piezoelectric layers. For the core, a fractional derivative model is used to characterize its viscoelastic behavior. Equations of motion are solved using a direct time integration method based on the Newmark scheme in conjunction with the Grunwald approximation of fractional derivatives. Emphasis is given to the finite element implementation of the fractional derivative model and to the influence of the electromechanical coupling.
High-authority Piezoelectric Actuation System Synthesis through Mechanical Resonance and Electrical Tailoring
Authors: Kim Jun-Sik , Wang K. W. , Smith Edward C.
Published: December 2004

In this research, a new approach is proposed to enhance the effectiveness of piezoelectric actuators. Through mechanical tailoring, the resonant frequencies of the actuation system (this includes the piezoelectric actuator and the related mechanical and electrical elements for actuation) can be tuned to the required actuation frequencies. This obviously will increase the authority (both stroke and force) of the actuation system. However, the resonant actuation system can be hard to control and nonrobust, due to its narrow operating bandwidth. This issue can be resolved through electric circuit tailoring. With the aid of a network of inductance, resistance, and negative capacitance, the actuation resonant peak can be significantly broadened and flattened. In this case, one can achieve a high authority actuation system without the negative effects of resonant problems. The electrical networks can also achieve a fail-safe system due to its passive shunting character. The proposed concept is evaluated using a PZT tube actuator for trailing edge flap control of rotorcraft blades. Promising results are demonstrated, showing that the treatment can indeed create a high-authority and robust actuation system that satisfies the performance requirements of the example application. Also, the proposed concept is verified by experiments using an equivalent circuit model with a synthetic inductor and a negative impedance converter of capacitance.
Initial Thoughts on Weight Penalty Effects in Shape-adaptable Systems
Authors: Campanile L. F.
Published: December 2004

If a structural system has to be subjected to high loads and large geometry changes, according to the state of the art, articulated systems with discrete actuators are used, with the articulated systems consisting of stiff members connected by hinges. As an alternative, smart structures technologies can supply solutions based on the deliberate use of structural flexibility and on distributed actuation. In order to assess the advantages, which can be expected from such solutions, a thorough comparison must be made between the properties of compliant mechanisms and the conventional ones. A crucial aspect of this comparison, on which this contribution is focused, is the impact on the system’s structural weight.

The first part of the paper deals with the relevance of weight penalty effects in shape-adaptable systems, with a special focus on airfoil shape control. A quantitative analysis of weight penalty effects in pin-jointed articulated structures follows. The criterion on which this analysis is based allows a characterization of general validity, not restricted to a particular example, and can be applied to other mechanisms or hinge architectures, providing a sound way of assessing the lightweight potential of a given concept and allowing a consistent comparison between different design philosophies. An extension to weight penalty effects in compliant systems shows a higher degree of complexity and could not be addressed in the same detail in this study. Anyway, some peculiar aspects are discussed in the final part of the paper, which can serve as a basis for future developments in this sense. In particular, the dependence of weight penalty effects on the system’s range of motion as well as on the load-dependence of the mechanism’s kinematics is addressed.

Even if the presented results can be of direct significance to the designer of conventional articulated mechanisms, the primary relevance of this work is to be seen in the long term. Its main target is to provide a basis for the analysis of the potential offered by the compliant mechanisms and smart materials for the realization of light shape-adaptable structures and to give an impulse to research efforts aiming at developing suitable optimization procedures as well as formulating proper design rules for such kind of systems.
A Stress Gradient-enhanced Piezoelectric Actuator Composite (GEPAC) with Integrated Ultrasonic NDE Capability for Continuous Health Monitoring
Authors: Bechet Antoine , Berthelot Yves H. , Lynch Christopher S.
Published: December 2004

Stress gradient-enhanced piezoelectric actuator composites (GEPACs) are unimorph, curved actuators that can be used as low-frequency actuators embedded, for instance, within an aircraft skin. The actuator is made of a thin PZT ceramic layer bonded between two composite layers with different coefficients of thermal expansion. These curved actuators provide large bending motion. Actuators have been manufactured with segmented upper electrodes so that they can also be used at ultrasonic frequencies to monitor continuously the integrity of the actuator itself. It is shown that the actuator can be used to detect interfacial defects such as debonding between the piezoelectric layer and the outer layers. The input signal is a one-cycle burst at 1 MHz. The time domain signals recorded experimentally are compared with predictions from a finite element model. It is shown that the presence of a debonding defect can convert a symmetric pulse into a primarily antisymmetric wave. A simple correlation technique is used to estimate the size of the debonding region.
Community-Academic Research on Hard-to-Reach Populations: Benefits and Challenges
Authors: Benoit Cecilia , Jansson Mikael , Millar Alison , Phillips Rachel
Published: December 2004

In this article, the authors examine some of the benefits and challenges associated with conducting research on hard-to-reach/hidden populations: in this instance, sex workers. The population studied was female and male sex workers working in different sectors of the sex industry in a medium-size Canadian metropolitan area. The authors describe the need for close community-academic cooperation, given the hidden and highly stigmatized nature of the target population that was investigated and the local context in which the research project was embedded. The authors discuss the main benefits and challenges of the research collaboration for the various parties involved, including the community partner organization, indigenous research assistants, and academic research team. They conclude with a discussion of strategies to help overcome the main challenges faced during the research endeavor.
“Grab” and Good Science: Writing Up the Results of Qualitative Research
Authors: Gilgun Jane F.
Published: December 2004

Qualitative researchers have an array of choices in how to write up their research. Yet many write in distanced, third-person voices and give short shrift to the voices of informants, as if neither they nor their informants were part of the research. In doing so, they might believe that their writing style is scientific. Unfortunately, such styles of writing not only silence their informants and themselves, but many times they also contradict the philosophies of science on which many forms of qualitative research are based. If our philosophies of science are science, then how we write up our research, when it is consistent with our science, must logically be scientific. “Grab,” or writing that is both interesting and memorable, goes hand in hand with good science.
“Uncharted Waters”: The Experience of Parents of Young People With Mental Health Problems
Authors: Harden Jeni
Published: December 2004

In this article, the author discusses the experiences of parents of young people with mental health problems and their relations with health care professionals. She conducted qualitative interviews with 25 parents whose teenage child had a diagnosed psychiatric condition. She argues that the experiences of parent-carers can best be understood in the context of the particular relationships involved. The author contextualizes the meanings parents give to care received in wider understandings of parenting and the parental caregiving role. She argues that the parents were deskilled by the condition and by the medical profession. At the same time, parents engaged in a range of actions through which they were reskilled and their parental caregiving role was reestablished.
Sexuality and Sexual Risk Behavior in HIV-Positive Men Who Have Sex With Men
Authors: van Kesteren Nicole M. C. , Hospers Harm J. , Kok Gerjo , van Empelen Pepijn
Published: December 2004

The purpose of this study was to examine the psychological processes pertaining to sexuality and sexual risk behavior among HIV-positive men who have sex with men (MSM). The authors analyzed transcripts of 30 semistructured interviews. Findings suggest that sexual problems in HIV-positive MSM might be primarily caused by the perceived risk of transmitting HIV to others. Furthermore, safer sexual behavior seems to be related to feelings of personal responsibility for safer sex. This study illustrates that although some men might have a clear notion of personal responsibility for safer sex, contextual factors can influence whether behavior is consistent with their norms of personal responsibility. The implications of the study are discussed for the practice of HIV prevention for HIV-positive MSM.
Understanding Women’s Journey of Recovering From Anorexia Nervosa
Authors: Weaver Kathryn , Wuest Judith , Ciliska Donna
Published: December 2004

Previous studies of recovery from anorexia nervosa (AN) have concentrated on discrete behavioral responses of individual women. Little is understood about the subjective process of women’s recovery in the context of family, community, or society. In this feminist grounded theory study, the authors explored the perceptions of 12 women who considered themselves recovered or recovering from AN. They discovered a substantive theory of selfdevelopment that explains, within the current social context, women’s journey from the perilous self-soothing of devastating weight loss to the informed self-care of healthy eating and problem-solving practices. The findings provide an urgently needed explanatory framework to inform women, clinicians, and health policy makers in their prevention and recovery efforts.
Uncovering the Limits of Patient-Centeredness: Implementing a Self-Management Trial for Chronic Illness
Authors: Rogers Anne , Kennedy Anne , Nelson Elizabeth , Robinson Andrew
Published: December 2004

Research evaluating self-management of chronic conditions points to the effectiveness of interventions’ changing the health behavior of individuals. However, we know little about how self-management is negotiated within health services. The authors designed a qualitative investigation to illuminate the quantitative findings of a randomized controlled trial (RCT) of a self-management program for people with inflammatory bowel disease. They conducted in-depth interviews with physicians and patients, and qualitative analysis illuminated the nature of doctor-patient encounters and possible reasons for lack of change in patient satisfaction with the consultation. The findings suggest that factors inhibiting effective patient-centered consultations include failure of physicians to incorporate expressed need relevant to people’s self-management activities fully, interpretation of selfmanagement as compliance with medical instructions, and the organization of outpatients’ clinics. Giving attention to these barriers might maximize the opportunities for patient selfmanagement of chronic illness based on a therapeutic alliance with health care professionals.
AIDS-Related Stigma and Social Interaction: Puerto Ricans Living With HIV/AIDS
Authors: Varas-Díaz Nelson , Serrano-García Irma , Toro-Alfonso José
Published: December 2004

People living with HIV/AIDS are stigmatized. Although personal and social consequences of this stigmatization have been documented, research regarding its impact on social interactions is scarce. Latinos, and Puerto Ricans in particular, have voiced concern regarding AIDS stigma. The authors investigated the key role of social interaction in the process of stigmatization through in-depth, semistructured interviews in a sample of 30 Puerto Ricans living with HIV/AIDS. Participants reported instances in which AIDS stigma negatively influenced social interactions with family, friends, sexual partners, coworkers, and health professionals. Some of the consequences they described were loss of social support, persecution, isolation, job loss, and problems accessing health services. Findings support the need for interventions to address AIDS stigma and its consequences.
Sources of Political Distortions in Performance Appraisals
Authors: Curtis Ami B. , Harvey Richard D. , Ravden Daran
Published: December 2004

Although performance appraisal research has been ongoing for more than 50 years, the focus has largely been on the rater and the rating instruments. This study seeks to answer a more recent call by researchers to focus on contextual variables surrounding the performance appraisal process by analyzing two such variables: appraisal purpose and rater accountability. Results indicate that holding raters accountable for the accuracy of their ratings, especially when ratings are for administrative purposes, may be an effective strategy for reducing leniency error
Contextual and Rater Factors Affecting Rating Behavior
Authors: Tziner Aharon , Murphy Kevin R. , Cleveland Jeanette N.
Published: December 2004

Recent performance appraisal research has highlighted the important role played by contextual and individual factors in shaping rating behavior. This article reviews cumulated empirical data supporting the proposition that in factors and constraints present in the organization, contexts in which appraisal systems reside and rater attributes, such as personality factors or beliefs, systematically affect rating behavior. The effects of these context and rater factors are reflected in ratings accuracy, ratings discrimination among raters/dimensions, and rating elevation.
Managing to Overload?
Authors: Brown Michelle , Benson John
Published: December 2004

Performance appraisals are traditionally seen as tools that can promote employee productivity. This article examines whether performance appraisals stimulate employee efforts beyond levels that employees regard as manageable, as measured by feelings of work overload. Using data from 2,399 employees, the study finds that participation in setting performance objectives, difficult objectives, and higher performance ratings are associated with increased levels of work overload. Trust in the supervisor was associated with lower levels of work overload. These findings suggest that some of the features associated with a well-designed appraisal system may generate adverse outcomes for employees and, subsequently, for their organizations.
The Early Intervention Foster Care Program: Permanent Placement Outcomes From a Randomized Trial
Authors: Fisher Philip A. , Burraston Bert , Pears Katherine
Published: December 2004

Preschool-aged foster children face multiple risks for poor long-term outcomes. These risks appear to increase with the number of placement changes experienced. The Early Intervention Foster Care Program (EIFC) targets the spectrum of challenges that preschool-aged foster children face via a team approach delivered in home and community settings. In this article, we report on permanent placement outcomes from the EIFC randomized clinical trial. Children in EIFC had significantly fewer failed permanent placements than children in the regular foster care comparison condition. The number of prior placements was positively associated with the risk of failed permanent placements for children in the comparison condition but not for children in EIFC. Type of prior maltreatment did not predict permanent placement outcomes. These results provide the foundation of an evidence base for the EIFC program as a preventive intervention to improve permanent placement outcomes for preschool-aged foster children.
Comprehensive Services for Mothers of Drug-Exposed Infants: Relations Between Program Participation and Subsequent Child Protective Services Reports
Authors: Mullins Sharon M. , Bard David E. , Ondersma Steven J.
Published: December 2004

It is unclear whether intensive services for women using drugs during pregnancy can reduce child maltreatment. Within-subjects, dose-response analyses can be conducted using Child Protective Services (CPS) reports. Dose of services received can indicate either engagement or higher need for services. Using data from an intensive intervention program for mothers of drug-exposed infants, the authors examined associations between CPS reports and (a) dose of services received and (b) a termination status variable combining dose of services received with duration of service involvement and progress on treatment plan goals. Cox regression revealed no association between dose of services and follow-up CPS reports. The termination status variable was strongly related to follow-up CPS reports, such that higher ratings were associated with significantly lower risk of re-report, even after controlling for baseline motivation. Findings suggest that program effects may be detectable using a treatment process– based index that combines dose, duration, and quality of program involvement.
Extending the Metaphor: Notions of Jazz in Portraiture
Authors: Dixson Adrienne D.
Published: December 2004

Portraiture, as a qualitative research methodology, challenges how we define objectivity and rigor in the social science research tradition. More recently, and in this “seventh moment” of qualitative research, scholars have begun to explore the impact of “racialized discourses” and “ethnic epistemologies” on both the process and content of qualitative research, particularly within communities of color. In this article, the author offers jazz as a heuristic for thinking about research that is informed by and a reflection of “racialized discourses” and “ethnic epistemologies.”
Expressions of “Voice” in Portraiture
Authors: Chapman Thandeka K.
Published: December 2004

The various ways in which the researcher negotiates “voice are the focus of this article. The six aspects of “voice” as defined by portraiture are manifested through the researcher’s chosen methodology, research tools, observation and interview sites, and data analysis. The tensions in the research process and the choice to use portraiture for qualitative research are explicated through critical race theory. The author uses a case study of a White teacher in a racially diverse urban classroom to describe how matters of voice are situated within larger contextual issues, data analysis, theoretical frameworks, and personal and professional relationships between the participants and the researcher. While building a case for an alliance between critical race theory and portraiture, the author explores her various roles within the research, how these roles are constructed by historical and present-day contexts, and how intersections of race, class, and gender are manifested within the research process.
“City Girl”: A Portrait of a Successful White Urban Teacher
Authors: Harding Heather A.
Published: December 2004

Race is a salient part of American life, and the field of education is not exempt. Race and class shape the nationwide crisis in urban education and unfortunately, racism continues to affect the schooling of children of color in negative ways. Demographic trends suggest that much of the nation’s teaching is a cross-racial activity. White females made up more than 85% of the teaching force in 2000, whereas student populations grew increasingly racially and ethnically diverse, leading to a “cultural mismatch” between student and teacher that negatively affects classroom relationships. Using themethod of portraiture, this article explores how one White teacher, identified as successful by her principal, articulates her motivations and goals for teaching students of color as well as how her racial identity and her understanding of race inform her pedagogy and practice with students of color.
Learning to Teach in the Shadows of 9/11: A Portrait of Two Arab American Preservice Teachers
Authors: Newton Roberta M.
Published: December 2004

This qualitative case study of two Arab American preservice teachers living, studying, and learning to teach in post-9/11 New York City explores how arts-informed inquiry opens up a different space for conceptualizing the human condition. Poetry and collage allowed the researcher and participants to co-theorize in a way that rendered a portrait that reflects the tones, intensities, and various hues of their experiences during this historical time period. Poetry provided a space to talk with each other about the (re) presentation and (co)understandings of the experiences, whereas collage provided an alternative dimension to discuss the emotions and feelings involved with shifting selves and power struggles. This article argues that arts-informed inquiry provides the possibilities to paint “an authentic portrait” through engaging in evocative experiences that reveal the multidimensionality of our lived realities.