bluuebunny/crossref_metadata_2025 huggingface dataset:
Health-promoting skills for children: Evaluating the influence of a media literacy and food marketing intervention
Authors: Truman Emily , Elliott Charlene
Published: November 2019

Background:

Media literacy skills are needed to navigate high levels of food marketing promoting the consumption of unhealthy foods. Health-promoting media literacy education encourages children to use analytical skills to critically examine media messages in order to make informed health choices.

Objective:

To evaluate the influence of media literacy lesson plans for children focusing on critical knowledge around food marketing.

Design:

Evidence-based Media Literacy & Food Marketing lesson plans, designed for grades 3 to 6 (ages 8–11) and 6 to 9 (ages 11–14), were developed to fill the knowledge gaps children demonstrated with respect to assessing of the healthfulness of packaged foods.

Setting:

Two public schools in Calgary, Alberta, Canada.

Methods:

An educational intervention with pre-test/post-test design. The lesson plans were used by teachers in the classroom, and a questionnaire was created to assess children’s pre- and post-lesson levels of critical knowledge about food marketing.

Results:

In total, 71 students from grades 5, 7, 8 and 9 participated. Qualitative analysis of responses showed increased analysis and evaluation skills when it came to understanding of food marketing appeals, and increased ability to assess the nutritional content of packaged foods.

Conclusion:

This study is novel in its use of media literacy as a framework for understanding food packaging appeals. It highlights the importance of examining procedural and interpretive knowledge in the evaluation of critical media literacy skills around food. This allows researchers, educators and health practitioners to better gauge how children are able to apply nutrition information in different contexts to make informed food choices.
Influence of post-migration living difficulties on post-traumatic symptoms in Chinese asylum seekers resettled in Italy
Authors: Aragona Massimiliano , Castaldo Miriam , Cristina Tumiati Maria , Schillirò Cristina , Dal Secco Alessandra , Agrò Francesca , Forese Angela , Tosi Marco , Baglio Giovanni , Mirisola Concetta
Published: November 2019

Background:

Little is known about mental health and resettlement difficulties of Chinese asylum seekers fleeing China due to religious persecutions.

Aim:

This study explores main post-migration living difficulties (PMLD) in this population, with a focus on their role in post-traumatic stress disorder (PTSD).

Methods:

A total of 67 patients (95.52% women, mean age 34.75 ± 7.63) were included in the study. The Harvard Trauma Questionnaire (HTQ) was used to assess PTSD, the List of Migration Experiences (LiMEs) was used for pre-migration and post-migration experiences (potentially traumatic events as well as living difficulties). The t-test was used to examine the differences in pre-migration and post-migration mean scores. Logistic regression was used to test the effect of pre-migration traumatic experiences (PMTE) and most frequent PMLD on having a PTSD.

Results:

A total of 49 patients scored above the HTQ cut-off score for PTSD. As expected, traumatic experiences were concentrated in the pre-migration phase, while living difficulties were present in both phases but more frequently in the post-migration period. PMTE were significantly related to PTSD (OR 1.29, p = .01). However, three PMLD (‘Feeling that you do not know where you will lend up tomorrow’, ‘Loneliness and boredom’ and ‘Not being able to find work’) showed a significant interaction with PMTE, suggesting that their presence in the post-migration phase has a modulation effect by increasing the likelihood of PTSD.

Conclusion:

This study extends to Chinese asylum seekers the previous evidence that PMLD have a significant role in the likelihood to have a PTSD after landing in the host country.
Linked Lives in Double Jeopardy: Child Incarceration and Maternal Health at Midlife
Authors: Goldman Alyssa W.
Published: November 2019

Parents’ relationships with their adult children play an important role in shaping mid and later life health. While these relationships are often sources of support, stressors in the lives of children can compromise parents’ health as they age. I consider that a child’s incarceration is also a stressor that could imperil parents’ health through social, emotional, and economic strains that parents may experience as a result. Using data on 3,159 mothers from the National Longitudinal Survey of Youth 1979 in a series of lagged dependent variable regression models, I find that a child’s incarceration is associated with declines in maternal health between ages 40 and 50. These associations are largest for mothers who had grandchildren by their child at the time of the child’s incarceration. I close by discussing the implications of child incarceration for intergenerational ties and other social determinants of midlife health.
Transcutaneous electrical nerve stimulation of acupuncture points enhances therapeutic effects of oral lactulose solution on opioid-induced constipation
Authors: Cai Hu , Zhou Qinfei , Bao Guanai , Kong Xiangming , Gong Li-Yan
Published: November 2019

Objective

The aim of this study was to evaluate the therapeutic effects of transcutaneous electrical nerve stimulation (TENS) on opioid-induced constipation (OIC) and patient quality of life.

Methods

A total of 251 patients were randomly allocated to a treatment group, who received TENS and oral lactulose solution (n = 124), and a control group, who received only oral lactulose solution (n = 127). Constipation and quality of life after treatment were measured by comparing semiquantitative scores based on subjective symptoms.

Results

The defecation difficulty, incomplete defecation feeling, and overall defecation satisfaction scores of the treatment group were significantly different from those of the control group ( P = 0.018). Bowel Function Index and quality of life scores of the treatment group were significantly greater than those of the control group. The effective rates of control and treatment groups were 85.8% and 91.9%, respectively.

Conclusion

TENS of relevant acupuncture points significantly relieved the clinical symptoms of constipation of patients with OIC and improved their quality of life.
Pernicious placenta previa/placenta percreta complicating active systemic lupus erythematosus resulting in postoperative artery thrombosis
Authors: Liu Jiahuang , Liu Chao , Zuo Xiaohang , Teng Yue
Published: November 2019

Systemic lupus erythematosus (SLE) increases the risk of adverse pregnancy outcomes and fetal complications. Placenta percreta, involving placental attachment to another organ, is a rare but severe placental abnormality. We report a 26-year-old woman, G2P1, with a 6-year history of SLE with coexisting pernicious placenta previa and placenta percreta detected by second trimester ultrasound. She discontinued prednisone 5 months before admission, without consultation, and active SLE was diagnosed on admission. Because of her progressive condition, the patient underwent infrarenal abdominal aorta balloon occlusion and double J ureteral catheter placement, followed by elective cesarean at 27+6 weeks gestation. Despite aggressive management, she experienced severe bleeding requiring internal iliac artery ligation and peripartum hysterectomy. The placenta had penetrated the uterus walls and attached to the bladder apex, necessitating bladder repair. Thrombosis was detected in the common iliac artery and common femoral artery in the right leg 1 day postoperatively. Conservative antithrombotic therapy had little effect, and embolectomy by arteriotomy was performed on the 6th post-cesarean day, and an arterial thrombus was removed. Infrarenal abdominal aorta balloon occlusion may increase the risk of postoperative thrombosis in pregnant women with active SLE and coagulation disorders. These patients therefore require close monitoring and timely anticoagulation.
Comprehensive treatment of diabetic hallux gangrene with lower extremity vascular disease: A case report
Authors: Gao Lei , Li Tianbo , Wang Shuo , Wang Jiangning
Published: November 2019

Diabetic foot is a serious complication in patients with diabetes. It is caused by diabetes combined with lower extremity vascular lesions and neuropathy so that a wound does not heal for a long time. In severe cases, it may lead to bone marrow infection and bone destruction, with a high disability and fatality rate. This report describes the case of a patient with diabetic hallux gangrene with lower extremity vascular disease, which was treated by surgical debridement, ozone therapy, and vascular interventional surgery. Using this treatment, the diabetic foot can be cured better and faster, and a satisfactory effect can be achieved.
Environmental Conditions in TT 209, Luxor. The Case of a Theban Tomb Subject to Periodic Flooding
Authors: Ángel Molinero Polo Miguel , Soler Javaloyes Vicente
Published: November 2019

TT 209 was built in a wadi, a location that means it has been affected by flash floods since ancient times. The team in charge of its study and conservation has initiated a systematic programme of environmental data collection (temperature and relative humidity) in order to understand the natural conditions of the tomb and any transformations caused by archaeological work in its underground chambers, as well as to inform future conservation. These statistics can also be useful for excavation and conservation programmes in nearby tombs whose architectonic structure is similar and have also suffered from exposure to water damage.
Prediction of the skin sensitization potential of polyhexamethylene guanidine phosphate, oligo(2-(2-ethoxy)ethoxyethyl) guanidinium chloride, triclosan, and mixtures of these compounds with the excipient propylene glycol through the local lymph node assay: BrdU-FCM
Authors: Joo Su-Jeong , Gautam Ravi , Lee JaeHee , Kim HyeonJi , Yang SuJeong , Jo JiHun , Acharya Manju , Maharjan Anju , Kim YeonGyeong , Lim Yeon-Mi , Kim ChangYul , Kim HyoungAh , Heo Yong
Published: November 2019

The guanidine family of antimicrobial agents, which includes polyhexamethylene guanidine phosphate (PHMG) and oligo(2-(2-ethoxy)ethoxyethyl) guanidinium chloride (PGH), and chlorophenol biocidal chemicals such as 2,4,4′-trichloro-2′-hydroxydiphenyl ether (triclosan) are used in various occupational and environmental biocidal applications. The excipient propylene glycol (PG) is used to dissolve the active ingredients. The skin sensitization (SS) potential of these substances has not been systemically investigated and is still debated. Moreover, mixtures of PHMG, PGH, or triclosan with PG have not been evaluated for SS potency. An in vivo assay known as the local lymph node assay: 5-bromo-2-deoxyuridine-flow cytometry method (LLNA: BrdU-FCM) was recently adopted as an alternative testing method and was used to address these issues. Via the LLNA: BrdU-FCM, PHMG, PGH, and triclosan were predicted to be sensitizers, while PG was predicted to be a nonsensitizer. In addition, d-limonene, which is used as a flavoring in various consumer products, was also predicted to be a sensitizer, although no unanimous conclusion has been reached regarding its SS potential. Mixtures of PHMG, PGH, triclosan, or d-limonene with PG at ratios of 9:1, 4:1, and 1:4 (w/w) were all positive in terms of SS potential, indicating that the PG excipient does not influence the SS predictions of these chemicals. Since humans can be occupationally and environmentally exposed to mixtures of excipients with active ingredients, the present study may give insight into further investigations of the SS potentials of various chemical mixtures.
Gamma radiation preparation of chitosan nanoparticles for controlled delivery of memantine
Authors: Radwan Rasha R , Abdel Ghaffar Ashraf M , Ali Hussein E
Published: November 2019

The purpose of the current study is to prepare chitosan nanoparticles by gamma radiation as a new brain delivery system for memantine to improve its therapeutic efficiency. Fourier-transform infrared analysis of chitosan nanoparticles showed the characteristic peaks of chitosan and the reduction of particle size induced by irradiation at doses 10, 20 and 30 kGy. The solubility of chitosan nanoparticles was tested using different solvents and exhibited good solubility in both water and 1% acetic acid than other tested solvents at 80°C. Different formulations containing memantine -loaded chitosan nanoparticles were evaluated for brain targeting on aluminum-induced Alzheimer’s disease in rats. Memory deficit was evaluated using the Morris water maze test. The levels of amyloid-β peptide, tumour necrosis factor alpha, interleukin-1β and interleukin-6 in brain tissues as well as the serum level of brain-derived neurotrophic factor were assayed. Data demonstrated that memantine -loaded chitosan nanoparticles 1:1 transported memantine effectively into the brain compared to free memantine as evidenced by better behaviour performance and biochemical amelioration and confirmed by histopathological examination in Alzheimer’s disease rats. Interestingly, the therapeutic effect of memantine -loaded chitosan nanoparticles 1:1 was superior to memantine -loaded chitosan nanoparticles 1:2 and memantine -loaded chitosan nanoparticles 2:1. Based on these findings, it is reasonable to suggest that memantine -loaded chitosan nanoparticles 1:1 could be a promising approach for Alzheimer’s disease.
He Said, She Said: Comparing Men’s and Women’s Descriptions of Men’s Partner Violence
Authors: Rodriguez Jasmine , Burge Sandra K. , Becho Johanna , Katerndahl David A. , Wood Robert C. , Ferrer Robert L.
Published: November 2019

More than one in three women and one in four men in the United States report victimization by intimate partner violence. Women and men often disagree about the frequency or severity of violent acts, and researchers have proposed various reasons for discordant reports. Using daily surveys and qualitative interviews, we compared men’s and women’s reports about men’s partner aggression and examined language they used to describe their experiences. Fifteen heterosexual couples in violent relationships completed an 8-week study that involved daily telephone surveys about violent behaviors and household environment; baseline and end-of-study surveys addressing predictors and outcomes of violence; and qualitative end-of-study interviews to provide perspective about their relationships. Most participants were Latinos with low income. Relationship length was 5.5 years, median. In daily surveys, both partners reported similar frequencies of men’s physical violence (4% of days), but men reported more physical violence by women than women did (8% vs. 3% of days). The qualitative analysts compared men’s and women’s accounts of male-to-female violence and observed gender-specific variations in style of reporting. Men used indirect language to describe their violent behavior, implied definitions of abuse, and justified their aggression. These findings have implications for clinical guidelines to screen and intervene with victims and perpetrators of intimate partner violence in primary care and emergency settings. Future research should focus on perpetrators of violence and examine effective ways for health care providers to identify and manage their care.
Healthy Aging in Older Chinese Americans: Associations With Immigrant Experiences
Authors: Li Lydia W. , McLaughlin Sara J. , Zhang Jiaan
Published: November 2019

Objectives: We examined the associations of aspects of the immigrant experience—acculturation, neighborhood belonging, and perceived discrimination—with healthy aging in older Chinese Americans and explored whether the associations vary by age and gender. Method: The sample included 3,056 older Chinese Americans. Healthy aging was defined as no disability, no cognitive impairment, and high physical functioning, coded dichotomously (1 = meets all criteria, 0 = otherwise). Acculturation, neighborhood belonging, and perceived discrimination were measured using standardized scales. Results: About 31% of the sample experienced healthy aging. Acculturation was positively associated with healthy aging, with stronger associations in older age and women. A greater sense of neighborhood belonging was associated with higher odds of healthy aging; experiences of discrimination were associated with lower odds. Discussion: Interventions to promote healthy aging in Chinese Americans are needed. Programs that support immigrants with low acculturation levels, strengthen immigrants’ connectedness to their neighbors, and promote inclusiveness may improve population health.
Inpatient Antibiotic Stewardship Interventions in the Adult Oncology and Hematopoietic Stem Cell Transplant Population: A Review of the Literature
Authors: Pillinger Kelly E. , Bouchard Jeannette , Withers Sarah T. , Mediwala Krutika , McGee Edoabasi U. , Gibson Geneen M. , Bland Christopher M. , Bookstaver P. Brandon
Published: November 2019

Objective: To review the use of antibiotic stewardship interventions in the adult oncology and hematopoietic cell transplantation (HCT) populations. Data Sources: A literature search of PubMed was performed from inception to October 31, 2019. The general search terms used were oncology, cancer, hematologic malignancy, antimicrobial stewardship, antibiotic stewardship, febrile neutropenia, neutropenic fever, de-escalation, discontinuation, prophylaxis, practice guidelines, clinical pathway, rapid diagnostics, Filmarray, Verigene, MALDI-TOF, antibiotic allergy, and antimicrobial resistance. Study Selection and Data Extraction: Relevant English-language studies describing interventions supported by the Infectious Diseases Society of America guidelines on “Implementing an Antibiotic Stewardship Program” were included. Data Synthesis: Antibiotic stewardship publications in the oncology population have increased in recent years. Studies have described the impact of stewardship interventions, including preauthorization, prospective audit and feedback, implementation of clinical pathways, de-escalation of empirical antibiotics for febrile neutropenia (FN) prior to neutrophil recovery, allergy assessments, and use of rapid diagnostic testing. Many of these interventions have been shown to decrease antibiotic use without increased negative consequences, such as affecting length of stay or mortality. Relevance to Patient Care and Clinical Practice: This review synthesizes available evidence for implementing antibiotic stewardship interventions, particularly de-escalation of antibiotics for FN and implementation of clinical pathways for FN and sepsis, in oncology patients and HCT recipients. Summary tables highlight studies and specific research needs for clinicians. Conclusions: Immunocompromised populations, including oncology patients, have often been excluded from stewardship studies. Antibiotic stewardship is effective in reducing antibiotic consumption and improving outcomes in this patient population, although more quality data are needed.
Correlation Between Digital and Manual Determinations of Ki-67/MIB-1 Proliferative Indices in Human Meningiomas
Authors: Pham Duc-Tien , Skaland Ivar , Winther Theo L. , Salvesen Øyvind , Torp Sverre H.
Published: November 2019

Objective. Proliferative activity in tumor tissues is assessed as the percentage of Ki-67/MIB-1-positive cells, or the proliferative index (PI). The PI is routinely assessed manually. However, the subjectivity of manual assessments might result in poor reproducibility. We hypothesized that digital assessments might reduce the error. Method. In our study, we assessed Ki-67/MIB-1 PIs, both manually and digitally, with tissue microarrays constructed from 141 human meningioma samples. Spearman-rank correlation and κ statistics were applied for correlation and agreement analyses, respectively. Mann-Whitney U tests were used to compare MIB-1 PIs between groups. Prognostic ability was assessed with Kaplan-Meier and Cox regression analyses. Results. We found a significant, high correlation (Spearman ρ = 0.832, P < .01) and moderate agreement (κ coefficient = 0.617, observed agreement = 80.9%) between the 2 methods. Both methods found significantly different Ki-67/MIB-1 PIs for different World Health Organization grades ( P < .05). Neither method showed significant prognostic value. Conclusion. Digital determinations of Ki-67/MIB-1 PIs in human meningiomas are feasible for the daily routine.
Characteristics and Prognostic Factors of Patients With Osteosarcoma Older Than 60 Years From the SEER Database
Authors: Pan Yue , Chen Daqi , Hu Taobo , Lv Guohua , Dai Zhehao
Published: November 2019

Osteosarcoma is predominant in the adolescent and the elderly population, but few studies have described the characteristics and prognostic factors of patients older than 60 years. In this study, the Surveillance, Epidemiology, and End Results registry database was used to identify all patients diagnosed with primary osteosarcoma from 1973 to 2014. We utilized Cox proportional hazards regression analysis to evaluate the association between patient overall survival and relevant characteristics, including gender, race, disease stage, treatment methods, primary tumor site, differentiation grade, and histologic subtype. In the data set, a total of 1139 patients with osteosarcoma older than 60 years old were identified. The overall rate of distant metastatic cases was 28.6%. Osteosarcoma occurred equally in men and women (49.5% vs 50.5%). Of all, 41.3% of tumors were located in axial location (pelvis, spine, and ribs), 34.1% of tumors were located in extremity (long or short bones of the upper or lower extremity), and 24.6% in other location (mandible, skull, and other atypical locations). Male (hazard ratio [HR] = 1.201; 95% confidence interval [CI]: 1.056-1.366), axial location (HR = 1.342; 95% CI: 1.157-1.556), distant metastasis (HR = 2.369; 95% CI: 2.015-2.785), non-surgery perform (HR = 2.108; 95% CI: 1.814-2.451) were independent risk factors for 5-year overall survival. This study revealed distinct clinicopathological features of patients with osteosarcoma older than 60 years. Male gender, tumor in axial site, nonsurgery perform, and distant metastasis indicated worse prognosis survival. Performing surgery is still an effective and reliable treatment method for patients older than 60 years.
Without land we are lost: traditional knowledge, digital technology and power relations
Authors: Kuoljok Kajsa
Published: November 2019

This study examines use of digital transferred knowledge within husbandry based on interviews and literature studies. Traditional knowledge is the base of husbandry. In husbandry today, this knowledge is combined with the digitally transferred knowledge through the use of the global positioning system collar. Husbandry never operates in isolation from other actors but interacts and is affected by multiple stakeholders and by regulatory practices regulations. The digital data can, besides being used in everyday practice, also be incorporated in reindeer husbandry plans. Reindeer husbandry plans is a tool for obtaining information of land use in husbandry in communication with other land users, but it is also a tool for operational reindeer management for the communities. The reindeer use of grazing land can through the data from the global positioning system collar create “hard facts” used for aspirations of power in discussions over land use.
Agricultural cooperatives remaining competitive in a globalised food system: At what cost to members, the cooperative movement and food sustainability?
Authors: Ajates Raquel
Published: November 2019

There are more than 40,000 agricultural cooperatives in Europe with 9 million farmer members and over 600,000 workers. Due to the democratic nature of the cooperative form, it is assumed agricultural cooperatives empower their members and allow small farmers to have a stronger voice in the supply chain. However, much of the academic literature on agricultural cooperatives focuses on the economic analysis of their performance, while hardly any research has been done on analysing the impact that policy, long supply chains and the internationalisation of the food system have on members and labour dimensions. This article contributes to covering this gap by analysing how agricultural cooperatives are being shaped and misshaped by European farming policy and the architecture of global food systems. Following Schneiberg’s thesis on social movements being a condition for processes of diffusion and mutualism, this article reflects on critical issues in organisational studies related to agricultural cooperatives, the cooperative movement and sustainable food systems. Case studies from Spain and United Kingdom are used to illustrate the Northern and Southern European perspective. The concept of deviant mainstreaming is applied to discuss how agricultural cooperatives are being co-opted and losing their transformative potential as a result of pressures to remain competitive, with effects on members, social justice and the environment. The findings suggest policy changes at the European level, and the increasing internationalisation of the food system is fuelling the amalgamation of agricultural cooperatives, which is threatening their local embeddedness and creating organisational tensions between the local, co-operative space and the global, capitalist space.
‘Should it fit? Yes. Does it fit? No’: Exploring the organisational processes of introducing a recovery-oriented approach to mental health in Australian private health care
Authors: Dawson Lisa , River Jo , McCloughen Andrea , Buus Niels
Published: November 2019

This article explores the implementation of an innovative approach to mental health care in a private health setting. Open Dialogue is a recovery-oriented approach to mental health that emerged in Finland, which emphasises family involvement, interdisciplinary collaboration and a flexible, needs-adapted approach. Early research is promising; however, little research has explored Open Dialogue outside Finland. This study aimed to explore the introduction of this approach at a private, inpatient young-adult mental health unit in Australia. Drawing on data from a long-term ethnographic field study that included 190 hours of observation and qualitative interviews, the findings show that despite staff members being inspired by and supportive of Open Dialogue, the existing ideology and organisational structures of the unit conflicted with the integration of Open Dialogue principles. Dialogical ways of working were challenged by medical dominance and emphasis on economic efficiencies. This study emphasises the importance of a ‘good’ fit between organisational cultures and innovations. It also highlights the challenges of moving towards recovery-oriented and family-focused models of care in the Australian neoliberal health care context. There is a need for organisational and ideological change in health services that is receptive to, and meaningfully supports, efforts to implement recovery-oriented care.
Media, civilization and the international order
Authors: Athique Adrian
Published: November 2019

This article is intended to provoke debate around the assumed relationships between media, culture and civilization. To begin with, it considers how the concept of civilization has been framed, and periodically re-framed, in media theory by shifts in the international order of communication. In parallel with this historiography, the article revisits a body of research that explored the evolution of television audiences in alignment with the cultural geography of the world. Taking account of this transition from national media institutions to supra-national markets, and the apparent dissolution of the worldwide web into geolinguistic networks more recently, this article argues that media systems and audiences are subject to the primacy of civilizational mass in the world system. Consequently, this article draws attention to persistent anxieties around a purported crisis of civilization, and the political imperatives for cultural studies scholarship to engage with both the concept and scale of civilization.
Towards an integrative sociological theory of empathy
Authors: McCaffree Kevin
Published: November 2019

Sociological theories of morality have grown in prevalence over the last decade and a half. These theories often focus on developing single concepts such as identity, reputation or emotion, or they provide sweeping historical accounts. Such theories often also take the construct of empathy for granted, as an inevitable consequence of morality. Here, I present a mechanistic theory of empathy which operates at multiple levels of analysis. The approach offered can help frame particular topics in the sociology of morality, though it is also robust enough to analyse historical change. Specifically, the theory presented here is composed of sets of situational, structural and societal mechanisms. Each set is discussed, as well as their relation to one another, before turning to an explication of how the present theory relates to a selective sampling of prominent theories in the contemporary sociology of morality.
A comparative study of how social workers’ voice and silence strategies relate to organisational resources, attitudes and well-being at work
Authors: Astvik Wanja , Welander Jonas , Hellgren Johnny
Published: November 2019

This study sets out to investigate the potential differences between social workers using voice- or silence strategies in their experience of organisational resources, attitudes and health, and whether social workers moving between strategies (voice or silence) over time have a different experience of the same outcomes than those who stay with the same strategy group. The participating social workers (n = 1356) responded to two web-based questionnaires over a one-year period.

Findings

The results show that voice strategies are related to the experience of more positive organisational resources, more positive attitudes (greater job satisfaction and organisational commitment, but lower intention to exit) and more positive health (greater recovery, but less emotional exhaustion and stress symptoms) than those using silence strategies. The results also show that moving from silence to voice is related to the experience of increased organisational resources, more positive attitudes and more positive health at T2, while those moving from voice to silence reported the opposite.

Applications

The longitudinal approach applied in this study adds empirical evidence of the relationship between voice/silence and work-related attitudes, as well as health and well-being. The close relationship between organisational resources, employee voice behaviour and related individual outcomes regarding attitudes and health imply that Human Resources (HR) management has a lot to gain by developing and securing a voice-friendly and considerate climate in their organisations.
Local Government Reform: Compromise Through Cross-Cutting Cleavages
Authors: Klausen Jan Erling , Askim Jostein , Christensen Tom
Published: November 2019

Public sector reforms often take place in heterogeneous reform environments. Key political, administrative and societal actors often advocate different definitions of problems and solutions. A major leadership challenge is to choose a reform strategy that ensures the requisite level of support, even when the initial conflict structure is highly complex. Using cleavage theory, we develop assumptions about how the reform leader’s assessment of the initial conflict affects the leader’s choice between three distinct reform strategies. These assumptions are applied to a case study of a complex and contested public sector reform, Norway’s national local government reform. We show how the government’s choice of a reform strategy can be understood in light of cleavage theory and discuss the implications of these findings for further theory development.
Initial Experience With a New Robotic Surgical System for Cholecystectomy
Authors: Aggarwal Ravi , Winter Beatty Jasmine , Kinross James , von Roon Alexander , Darzi Ara , Purkayastha Sanjay
Published: November 2019

Background. Laparoscopic cholecystectomy has been the gold standard treatment for symptomatic cholelithiasis for more than 3 decades. Robotic techniques are gaining traction in surgery, and recently, the Senhance™ robotic system was introduced. The system offers advantages over other robotic systems such as improved ergonomics, haptic feedback, eye tracking, and usability of standard laparoscopic trocars and reusable instruments. The Senhance was evaluated to understand the feasibility, benefits, and drawbacks of its use in cholecystectomy. Study Design. A prospectively maintained database of the first 20 patients undergoing cholecystectomy with the Senhance was reviewed at a single hospital. Data including operative time, console time, set up time, and adverse events were collected, with clinical outcome and operative time as primary outcome measures. A cohort of 20 patients having laparoscopic cholecystectomy performed by the same surgeon was used as a comparator group. Results. The 2 groups had comparable demographic data (age, sex, and body mass index). In the Senhance group, 19 of the 20 procedures (95%) were completed robotically. The median (interquartile range) total operating, docking, and console times were 86.5 (60.5-106.5), 11.5 (9-13), and 30.8 (23.5-35) minutes, respectively. In the laparoscopic group, the median (interquartile range) operating time was 31.5 (26-41) minutes. Postoperatively, only one patient had a surgical complication, namely a wound infection treated with antibiotics. Conclusion. Our results suggest that Senhance-assisted cholecystectomy is safe, feasible, and effective, but currently has longer operative times. Further prospective and randomized trials are required to determine whether this approach can offer any other benefits over other minimally invasive surgical techniques.
Autophagy and pulmonary disease
Authors: Liao Shi-xia , Sun Peng-peng , Gu Yan-hui , Rao Xi-min , Zhang Lan-ying , Ou-Yang Yao
Published: November 2019

Autophagy is a process of cell self-renewal that is dependent on the degradation of the cytoplasmic proteins or organelles of lysosomes. Many diseases, such as metabolic diseases, cancer, neurodegenerative diseases, and lung diseases, have been confirmed to be associated with elevated or impaired levels of autophagy. At present, studies have found that autophagy participates in the regulation of chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis, pulmonary hypertension, acute lung injury, lung cancer, and other pulmonary diseases. Using recent literature on the signal transduction mechanisms of autophagy and the effects of autophagy signalling on lung diseases, this review intends to clarify the mechanisms of lung disease to guide the treatment of related diseases.

The reviews of this paper are available via the supplemental material section.
Down’s syndrome
Authors: MacLennan Sarah
Published: November 2019

Down’s syndrome is caused by trisomy of chromosome 21; it is one of the best known chromosomal disorders in humans. It has effects on most body systems, giving rise to a variety of characteristic clinical features including intellectual impairment, short stature, flat face, flat nasal bridge, prominent epicanthic folds, up slanting palpebral fissures and protruding tongue. Down’s syndrome is also associated with an increased risk of other medical conditions. All patients with Down’s syndrome have a degree of intellectual impairment ranging from mild to severe. This article considers the epidemiology, genetics, associated risks, antenatal screening and potential ethico-legal issues relating to the disorder before discussing clinical features, complications and monitoring requirements. Finally, Down’s syndrome management, prognosis, and future diagnostic tests are outlined.
Bone Tendon Interface: A New Perspective on Rotator Cuff Healing
Authors: Sun Yucheng , Kholinne Erica , Jeon In-Ho
Published: November 2019

During rotator cuff repair surgery, fixation and incorporation of ruptured rotator cuff tendon into the bone is a major concern. Many studies have report the limitations in the healing potential of the bone-tendon interface. The structure and composition of the native direct bone-tendon interface cannot be restored after primary repair, resulting in a poor mechanical and structural interface and leading to a high rate of re-tear (95%) especially after in larger or massive tear (Figure 1). If the native bone-tendon junction cannot be regenerated after primary repair, a bone-tendon composite graft, which preserves the native bone-tendon junction, can be a valuable option. Thus, we have adopted the concept of bone to bone and tendon to tendon healing by using autogenous bone-tendon composite graft. The Achilles-calcaneus composite autograft group showed significantly better biomechanical characteristics at 3 and 6 weeks in terms of maximum load, maximum stress, stiffness, and Young’s modulus. Tissue histology demonstrated an organized extracellular matrix, a clear tide mark, and distinct fibrocartilage layers in the composite graft group, similar to those of the native bone-tendon interface (Figure 2). Additionally, clear bone to bone healing and tendon to tendon healing were observed. By contrast, the conventional primary repair could not regenerate the structure of the native bone-tendon interface, although bone-tendon interface healing progressed. Bone-tendon autograft for chronic rotator cuff reconstruction is superior to the primary repair regarding biomechanical property and histological structure.

[Figure: see text][Figure: see text]
Subtalar Arthroscopy
Authors: Ahn Jae Hoon
Published: November 2019

The subtalar joint plays an important role in the movement of the ankle and foot. The complex anatomy of the subtalar joint makes it difficult for surgeons to evaluate the entire joint even with extensile approach. The arthroscopy of posterior subtalar joint was first described by Parisien in 1985. The development of good quality small-diameter arthroscopes and refined arthroscopic techniques has contributed to the improvement of the subtalar arthroscopy. The reported advantages of the subtalar arthroscopy include faster postoperative recovery and decreased postoperative pain.

The subtalar arthroscopy can be applied as a diagnostic and therapeutic tool. The diagnostic indications are persistent pain, swelling, stiffness, or locking of the subtalar area resistant to conservative treatment. Therapeutic indications include debridement of sinus tarsi syndrome and chondromalacia, excision of subtalar impingement lesions and osteophytes, lysis of adhesions with post-traumatic arthrofibrosis, synovectomy, removal of loose bodies, removal of a symptomatic os trigonum, calcaneal fracture assessment and reduction, and arthroscopic arthrodesis of the subtalar joint.

The subtalar arthroscopy can be done in supine position using thigh holder or in lateral decubitus position. The arthroscope generally used is a 2.7-mm 30 degrees short arthroscope. Noninvasive distraction with a strap around the hindfoot can be helpful. Usually anterolateral, middle, and posterolateral portals are utilized for inspection and instrumentation within the subtalar joint. After insertion of the arthroscope, thorough inspection of the joint can be done using 13-point examination techniques. Two-portal posterior subtalar arthroscopy in prone position can be performed as well with 4.0-mm 30 degrees arthroscope, depending on the type and location of the subtalar pathology. The joint capsule and the adjacent fatty tissue should be partially resected for better visualization.

The subtalar arthroscopy is a technically demanding procedure, which requires proper instrumentation and careful operative technique. Possible complications after subtalar arthroscopy are nerve damage and persistent wound drainage.

In conclusion, the ankle arthroscopy is a safe adjunctive procedure for the treatment of ankle fractures. It can be performed as well for the evaluation and management of syndesmotic injury, and for persistent pain following the definitive treatment of ankle fractures.
Superior Capsular Reconstruction with Mesh Augmentation: a Perspective from Bench to Bedside
Authors: Kholinne Erica , Jeon In-Ho
Published: November 2019

Objectives:

Superior capsular reconstruction (SCR) is an alternative to treat massive chronic rotator cuff tear with the premise to provide static restraint avoiding upward migration of the humeral head. However, graft tears and their impact on clinical function outcomes following SCR is still in contentious. We aimed to compare clinical and radiologic outcomes following arthroscopic SCR using fascia lata graft with or without mesh augmentation in massive chronic rotator cuff tear.

Methods:

There were 63 patients underwent SCR with fascia lata from 2014 to 2017. From 2013 to 2016, only fascia lata tendon was used, categorized as fascia lata only group (F). From 2016 to 2018, a mesh is added in the reconstructed capsule, categorized as mesh group (M). Mesh was fashioned inside the folded fascia lata graft for the purpose of structural augmentation. The final study population included 34 and 24 shoulders in group F and M, respectively. All patients were followed for a minimum of 3 months, with mean total follow-ups of 31.3 ± 8.2 and 11.45 ± 11.6 months in Group F and M, respectively. Average ages were 64.9 ± 8.7 and 65.1 ± 6.1 years in Group F and M, respectively. Assessment of both clinical and radiological outcome was conducted at the final follow up. The clinical outcome included ASES (American Shoulder Elbow Society) score and VAS (Visual Analogue Scale) score. The radiological outcome included the re-tear rate and AHD (Acromio-humeral distance).

Results:

Overall, all scores in ASES (40.8 to 78.4), VAS (6.2 to 3.0) and AHD were improved. Both groups showed improvement of clinical and radiological outcome. ASES score was improved from 54.43 ± 17.27 to 73.7 ± 13.8 for group F, and 48.13 ± 13.2 to 77.42 ± 12.04 for group M. VAS score was improved from 6 ± 1.13 to 2.5 ± 0.87 for group F, and 5.72 ± 1.07 to 2.4 ± 0.84. AHD was significantly superior in group M (9.08 ± 2.43 mm) compared to group F (6.36 ± 1.80 mm) at the final follow up. The re-tear rate was found higher at group F for 41.1% compared to group M for 16.6% (Table 2). There was no significant difference for both groups regarding demographic data (age, sex, preoperative VAS score, ASES score, ROM).

Conclusion:

The early graft tear rate for SCR was 41.4%. Mesh augmentation can reduce for more than half of the graft tear rate from 41.4% to 16.6% by providing structural support. In conclusion, SCR with mesh augmentation for massive rotator cuff tear showed better clinical outcome with a lower re-tear rate compared to conventional SCR with fascia lata only.
Arthroscopic Excision of an Intraarticular Osteochondroma of Knee: A Rare Case Report
Authors: Mahardika I Made Yudi , Suhendra Henry , Wonggokusuma Erick
Published: November 2019

Background:

Osteochondroma is the most common benign bone tumor. Osteochondroma usually grows away from the joint and its presence in the joint is very rare and is often misdiagnosed. The presenting symptoms are generally pain, swelling, reduced range of motion and bursitis. It is rarely known to cause pressure symptoms compromising the nerves and vasculature.

Case presentation:

A 27 years old male patient presented with pain and clicking sounds in the left knee two months prior to consultations with progressively worsening symptoms. There was no history of trauma, high-intensity sports, twisting of the knee or any previous surgery of the knee. A click was felt at the flexion of the knee. There was no restriction in the range of motion of the knee joint, but mild pain with over 900 to 1100 flexion of the knee. Knee Scoring of the patient measured by the International Knee Documentation Committee (IKDC), The WOMAC and The Lysholm Score was approximately 80. Plain radiography was normal. Magnetic resonance imaging (MRI) showed bony prominence at the medial aspect of the lateral condyle of the femoral bone, with impingement of the anterior cruciate ligament (ACL). Arthroscopy showed an abnormal bony growth in the intercondylar notch impinging on the ACL. The tumor was excised and histopathology findings revealed osteochondroma.

Discussion:

A combination of clinical signs, plain radiography, and MRI can be used to make a clear diagnosis of osteochondroma. Plain radiography alone is usually insufficient in portraying the extent of clinical disease. MRI is much more useful in comparison when compared to plain radiography in the determination of an accurate diagnosis. The most accurate approach is through arthroscopy and histopathology examination. Early accurate diagnosis is important to determine the prognosis of the patient. If our case was not clearly diagnosed, the ACL would have a higher chance of rupture in this patient.

Conclusion:

Intraarticular osteochondroma of the knee can be considered a rare cause of pain and in young patients. Arthroscopy excision is accompanied with less pain, minimal infection and results in a faster recovery with Knee Scores of 100 postoperatively.
A Simple and Inexpensive Management for Peroneus Longus Dislocation
Authors: Winata Fahroni Cahyono
Published: November 2019

Introduction:

Peroneal longus dislocation is an uncommon sports injury and commonly misdiagnosed. Imaging measure includes plain radiography, ultrasonography, and MRI examination. Treatment strategies include controversial nonoperative treatment with a significant failure rate and several surgical procedures were reported. We reporting a chronic peroneal longus dislocation case in our hospital.

Material and methods:

Twenty-two years old male presented with a painful snapping lateral ankle suffered 3-month prior surgery. He played futsal and suddenly he felt popped on his ankle followed by pain and swelling. Dynamic ultrasound examination shows dislocation of peroneal longus tendon and convex shape of the retromalleolar groove. A five-centimeter long incision is made posterior to the lateral malleolus and during exploration we confirmed the ultrasound findings. We perform retromalleolar groove deepening by making bone flap medially, curette the cancellous bone and tamper back the bone flap, followed by superior peroneal retinaculum (SPR) reconstruction to the medial aspect of lateral cortex of the lateral malleolus to provide smooth gliding surface. We immobilize the ankle with a cast for six weeks for soft tissue healing.

Result:

After six weeks he can perform the almost full range of motion of the ankle without pain. Followed by further physiotherapy to regain full range of motion of the ankle. He returns to sport six months after surgery. Ultrasound examination shows the stability of the peroneal longus tendon.

Conclusion:

Dynamic ultrasound examination and retromalleolar groove deepening with SPR reconstruction are simple and inexpensive management for peroneal longus dislocation