bluuebunny/crossref_metadata_2025 huggingface dataset:
The Denial of Sustainable Energy as a Violation of Child Rights
Authors: Ifeakandu Ibe Okegbe
Published: April 2018

There is a general consensus across the world that children are entitled to a myriad of rights which government and other stakeholders must promote and protect. The rights to life, education, survival and development, sustainable and affordable medical care and prevention of communicable diseases, clean environment and water, amongst others are legally safeguarded in international and regional legal instruments as well as municipal laws of various countries. Under these instruments and laws, government is under obligation to adopt measures-legal, administrative, policy, and others to ensure the realization of rights by children. One way through which children can realize their rights is access to modern and affordable energy. With specific reference to Nigeria, Ghana, and Togo, this chapter examines the concept of sustainable energy and the need for improved access to modern energy services, in relation to its role in the fulfilment of rights that accrue to children.
Achieving Effective Law and Policy Frameworks for Access to Sustainable Energy in Africa— A Multidimensional Effort
Authors: Omorogbe Yinka , Ordor Ada Okoye
Published: April 2018

This chapter highlights some common themes which the editors see as significant research findings. The ubiquitous nature of energy is at once the most obvious and yet the most surprising realization. Not only are there clear linkages with water and renewable energy, but also with areas such as intellectual property and arbitration and, no doubt, the law in these areas can enhance or impede access. Access to energy so far falls short of the status of a realizable human right and this amounts to a denial of energy justice for affected persons. The lack of modern energy erodes and in some instances amounts to a denial of the rights of women, children, and the vulnerable. Electricity access has suffered, particularly in sub-Saharan Africa because of a combination of factors, chiefly the absence of legal provisions or failure to either reform or comply with legal provisions.
The Deepening of Global Governance
Authors: Zürn Michael
Published: April 2018

The contestation of inter- and transnational institutions does not necessarily lead to the decline of the global governance system. Against this backdrop, this chapter attempts to systematically demonstrate the possibility of substantial reform in the face of societal pressure. In doing so, it focuses on IOs that increasingly introduce provisions for the protection of human rights. Its goal is to examine the conditions under which the authority–legitimation link can deepen global governance in reactive sequences involving non-state actors and how this can play out in different pathways. The argument will be exemplified in the field of human rights protection. One more causal mechanism, “reinforcement via politicization” (CMALL 2), will be examined for this purpose. The method used in this chapter can be described as comparative process tracing.
Conclusion
Authors: Zürn Michael
Published: April 2018

This chapter summarizes the argument of the book. It recapitulates the global governance as a political system founded on normative principles and reflexive authorities in order to identify the legitimation problems built into it; it points to the explanation of the rise of societal politicization and counter-institutionalization via causal mechanisms highlighting the endogenous dynamics of that global governance system; and, it sums up the conditions under which the subsequent processes of legitimation and delegitimation lead to the system’s decline or to a deepening of it. In addition, the conclusion submits that the arguments put forward in this book are in line with a newly emerging paradigm in International Relations. A “global politics paradigm” is increasingly complementing the “cooperation under anarchy paradigm” which has been dominant for around five decades. The chapter finishes with suggestions of areas for further research.
Procedural Right to Life Obligations
Authors: Park Ian
Published: April 2018

A state’s procedural right to life obligations relate to the circumstances in which a state must conduct an investigation following a death. Procedural right to life obligations also extend to how and when the investigation is conducted, and by whom. This chapter explores these issues in detail and advances a hypothesis in respect of what amounts to a human rights law-compliant investigation that would satisfy a state’s procedural right to life obligations during armed conflict. It also considers the similarities and differences between the requirement to investigate a death pursuant to international humanitarian law and that pursuant to international human rights law.
Criminal Misconduct and the Constitution
Authors: Horder Jeremy
Published: April 2018

I provide reasons to regard to courts’ power to apply the misconduct offence to the conduct of Members of Parliament as a vital measure of last resort to deter and punish corruption at the highest level. In relation to matter of free speech in Parliament, we must place absolute trust in parliamentarians not to abuse parliamentary privilege; but when it comes to the avoidance of the use of public office for private gain, our trust in parliamentarians not to abuse this privilege should be only conditional. Parliamentarians should feel the full force of the criminal law when they participate in corrupt schemes to benefit themselves with public money, unprotected by parliamentary privilege.
UK Political Corruption and the Role of the Criminal Law
Authors: Horder Jeremy
Published: April 2018

My focus here is political corruption, as opposed to personal corruption, and my task is to explain that prosecution for a serious common law offence such as misconduct in a public office cannot be the sole, or even the main, way in which officials are held to account for corrupt conduct. So, I consider the most important—indeed, primary—remedy for corruption in politics, which I call ‘negation’: the setting back at naught of corrupt (potential) gains. I then go on to consider efforts to address risks of corruption through regulation (including regulatory offences), especially in relation to elections, but also in relation to the practice of ‘lobbying’. Discussion of lobbying provides an opportunity to discuss how ‘republican’ the UK constitution really is: how resistant it is to cheque-book influences or, more broadly, to the influence of repeat players amongst the wealthy and powerful.
Panda Nation
Authors: Songster E. Elena
Published: April 2018

Panda Nation links the emergence of the giant panda as a national symbol to the development of nature protection in the People’s Republic of China (PRC), 1949-present. The panda’s transformation into a national treasure exemplifies China’s efforts to distinguish itself as a nation through government-directed science and popular nationalism. Examining this process enhances our understanding of the intersection of policy, science, and the public. Tracing the panda’s iconic rise offers a striking reflection of China’s recent and dramatic ascent in global status. The significant role giant panda played in the advancement of nature protection policy during the PRC era reveals a striking tension between scientific inquiry and a nationalism particular to Chinese communist ideology. Sichuan’s initial response to the central government’s 1962 directive to protect precious species was to set aside land as reserves for the giant panda. This domestic initiative during a time of extreme isolation, following the Sino-Soviet schism and preceding China’s efforts to reestablish ties with western industrialized nations, forces us to acknowledge that nature played a more complex role in Chinese communist theory and history than is commonly recognized. An examination of the creation of the Wanglang Nature Reserve deepens our understanding of the ways that central government policies incorporated local concerns, Baima minority people, and environmental factors as they were implemented on the ground. This study of the ways that giant pandas have been portrayed and used with respect to national image and diplomacy deepens our understanding of China’s approach in its efforts to reengage with the international community during the 20th century and beyond.
Pandas Are Red
Authors: Songster E. Elena
Published: April 2018

Many advances gained in nature protection efforts during the early 1960s were brought to a screeching halt with the onset of China’s Cultural Revolution (1966-1976). The Wanglang Nature Reserve, however, hosted representatives from China’s top scientific institutes on the first species-specific giant panda survey in 1967. This event brings to light a narrative parallel to the well-known “decade of chaos”. During this era the government endorsed many scientific endeavors designed to highlight the glory of China’s nature and advertise its scientific prowess. In addition to being a scientific subject, the giant panda also became a popular expression of nationalism during this era. The giant panda was repeatedly reproduced as a politically safe image and demonstrated surprising durability against the ever-changing political winds of this decade.
Rescuing the Panda from a Reforming China
Authors: Songster E. Elena
Published: April 2018

The year 1976 was monumental for China with the loss of important state leaders, and a tragic earthquake. Amidst all of the government’s active response to a panda starvation scare demonstrates the importance of this animal to China. A repeat starvation scare in the mid-1980s creates an opportunity to trace the transformation of China from Mao Zedong era to the Deng Xiaoping era by juxtaposing the two panda-starvation scares. The responses to these two scares demonstrate a shift in the perception of nature from one of state ownership to one of popular ownership and illustrate the dramatic increase in international participation in the study of the panda and the efforts to preserve this national treasure.
Muslims in Delhi
Authors: Jamil Ghazala
Published: April 2018

Delhi is conceived as part of the global urban where the global processes are manifested in local. Simultaneously, the ‘local’ itself becomes mired in contradictory processes of urban governance and development—devaluing citizenship. As citizenship becomes a function of power for contestation and capacity for claim-making the governance mechanisms become more and more privy to elites and corporate lobbying, and the major task of the state becomes that of a manager of inequalities. In such a situation the Muslims find themselves to experiencing an acute deficit in citizenship. Because of their discursive subalternity they are rendered incapable of expressing any concerns that relate to their other identities such as being part of unorganized workforce in the country. This discussion is placed within the realm of state power and governmentality directing a closer examination of how these manifest in a segregated locality of Muslims.
Introduction
Authors: Das Chaity
Published: April 2018

Even with the birth of Pakistan after the Partition of 1947 cultural cohesion remained in an infantile stage. National self-defence became the obsession of the ruling establishment and there was a move towards administrative consolidation. Thus it is no surprise that the first general elections in Pakistan were held only in 1970. The Awami League of East Pakistan received an overwhelming verdict in the east and staked a claim to rule Pakistan. However, Yahya Khan’s government ordered a military crackdown on 25 March 1971 in East Pakistan. This work will revisit the war and pose questions about its place in memory and history. To understand the implications of the genocidal military crackdown by the army and the concomitant declaration of independence by East Pakistan and the aftermath of liberation, this book offers a close reading of memoirs, testimonies, and fiction that draw on memories of the war.
In Freedom’s Wake
Authors: Das Chaity
Published: April 2018

This chapter outlines the discourses emerging from 1971 and deals in a detailed manner with nationalist history and myth making relating to the foundational year in 1971. It examines the importance of the war as the second partition of the subcontinent. It also hints at the work to be done in the following chapters in closely analysing the strands of history, testimonial literature, and fiction to see how unbroken narratives of heroism and sacrifice are contested by memories of gratuitous violence and post-war humbling of those who believed that the golden age was on the horizon. The relevance of post-war developments in remembering 1971 and determining the ways in which the year is represented is also established in this chapter.
The Kothari Saga (1965–85)
Authors: Ayyar R.V. Vaidyanatha
Published: April 2018

This chapter outlines the exceptional composition of the landmark Kothari Commission, and its blend of idealism and realism. It offers a succinct account of the recommendations of the Kothari Commission, and the ferocious opposition to its recommendations regarding elementary and higher education, language policy, and the establishment of world class universities. It presents a candid critique of its recommendation that has become a hardy perennial of Indian educational discourse, namely that Government allocate at least 6 per cent of Gross Domestic Product (GDP) to education. It gives a crisp account of Independent India’s first National Policy on Education (1968). It also outlines the Constitutional Amendment of 1978 which made education a ‘concurrent subject’, and the educational initiatives of the short lived Janata Government (1976–8), India’s first non-Congress Party Central Government. It also outlines the key role played by J.P Naik in the Kothari Commission and Janata Government and evolution of his thinking.
Making of National Policy on Education, 1986
Authors: Ayyar R.V. Vaidyanatha
Published: April 2018

This chapter briefly narrates the great hopes aroused by Rajiv Gandhi’s accession to power and his dashing initiatives such as the reorganization of Central Government ministries and critiques the formation of the Ministry of Human Resource Development. It outlines other policy initiatives such as the establishment of Navodaya Vidyalayas and the Indira Gandhi National Open University, and describes the process followed for the formulation of the National Policy on Education (NPE), 1986, and its Programme of Action (POA). It narrates and critiques the key policy postulates of NPE, 1986, such as the a large and systemic programme of non-formal education being a pre-requisite for universalizing elementary education, and vesting the All India Council of Technical Education (AICTE) with statuary powers to regulate technical education. It highlights the fact that NPE, 1986, skirted burning issues of higher education as it not anchored in policy analysis. In the praxis of education policy, there is often no realistic assessment of the problem which needs to be addressed, no realistic identification of the various alternatives, no rigorous evaluation of alternatives, and no roadmap offered for realization of the policy objectives
Winds of Change Begin to Blow (Stints of Madhavrao Scindia and S.R. Bommai)
Authors: Ayyar R.V. Vaidyanatha
Published: April 2018

This chapter describes how the Indian education system began to undergo a systemic transformation from 1990s, how ‘international’ schools made their appearance, how private-unaided institutions (self-financing institutions) began to dominate professional education, how the idea of private universities begins to acquire traction, and how India began to be increasingly exposed to the ongoing globalization of education. It critiques the functioning of the AICTE and NCTE. It outlines the policy initiatives undertaken by Madhavrao Scindia and S.R. Bommai as Ministers, MHRD. It narrates the controversy aroused by the proposal to set up a world class National Science University. It describes the salient features of the Private Universities (Establishment and Regulation) Bill, 1995, introduced in the Rajya Sabha by Scindia, and the efforts made by Bommai to amend the Constitution so as to make elementary education a Fundamental Right.
The Lord Giveth and the Lord Taketh Away (Judicial Policymaking)
Authors: Ayyar R.V. Vaidyanatha
Published: April 2018

This chapter describes the personality and politics of Murli Manohar Joshi who was the Minister of Human Resource Development (MHRD) during the NDA Government (1998–2004), first truly non-Congress Party Government at the Centre with an idea of India which was starkly at variance with that of Nehru. It also describes the achievements of Joshi such as enacting the Constitutional Amendment to make Right to Elementary Education as Fundamental Right, and launch of Sarva Shiksha Abhiyan (SSA) as well as the controversies which enveloped the NCERT School History textbooks, the National Curricular Framework (NCF), 2000. It briefly outlines the competing schools of pedagogy, critiques NCF, 2000, and its proposal to incorporate education about religions in school curriculum. It also describes the growth of private universities as a result of the liberalization of regulations for deemed universities as well as permissive State Laws, the issue of UGC regulations on private university, and the landmark Supreme Court judgment in Yash Pal case which spawned a powerful New UGC that was a species different from that created by the UGC Act, 1956.
From Equity to Preferential Equity
Authors: Ayyar R.V. Vaidyanatha
Published: April 2018

This chapter describes at great length the extension of reservations (quotas) to Other Backward Classes (OBCs), by far the most important and most controversial initiative during Arjun Singh’s second stint as Minister, MHRD. It also describes the policy initiatives to advance the education of Muslims including a special focus on Muslims in programmes like SSA, constitution of a National Commission for Minority Educational Institutions with far reaching powers, of the Rajendra Sachar committee on the social economic and educational status of the Muslim, and the Ranganath Mishra Commission for Religious and Linguistic Minorities. In order to place these developments in a historical perspective the chapter offers an analysis of different dimensions of equity in education, the policies adopted from time to time advance equity in education, the distinction between equalization of opportunities and preferential equity, the seminal contribution of Ram Maonhar Lohia to the concretisation of the concept of preferential equity in the Indian context, and the sociological and political connotations of inclusion in education.
Reform Impulses in a Bipolar Government
Authors: Ayyar R.V. Vaidyanatha
Published: April 2018

This chapter describes the far reaching changes as a result of which the Indian education system ceased to be almost exclusively public funded and closed system, how these far reaching changes were not steered by any policy of the Government, and how the policy has to catch up to do. It describes how the early initiatives of the Manmohan Government aroused great hopes that higher education was poised for remarkable transformation, and how these hopes were dashed as the Prime Minister was only a minor centre of power and could not prevail upon Arjun Singh to accept the ambitious reform agenda drawn up by the National Knowledge Commission (NKC) he set up. It also describes the special focus on skill development and the new initiatives launched during the Eleventh Five Year Plan such as the expansion of Central Universities, IITs, IIMs and NITs, and the launch of Rashtriya Madhyamik Shiksha Abhiyan (RMSA). It compares and contrasts the philosophical underpinnings and recommendations of the NKC and Yash Pal Committee on the rejuvenation of Higher Education, and critques the recommendations of that Committee’s idea of university, and its proposal to constitute a National Commission on Higher Education and Research as an imperium imperio.
Fair Use and Fair Dealing
Authors: Balganesh Shyamkrishna , Nimmer David
Published: April 2018

Premised on realizing a balance between protection and access, ‘limitations and exceptions’ play an important role in the any copyright system. Jurisdictions around the world are generally thought to adopt one of two possible approaches to structuring limitations and exceptions: (a) the fair dealing approach, which delineates highly specific and carefully-worded exceptions with little room for judicial discretion, and (b) the fair use approach, which relies on more open-ended language and its contextual tailoring by courts. This chapter undertakes a comparative analysis of these two approaches using the Indian and US copyright systems as its focus. It shows that, although the two countries adopt different approaches as formal matter, in practice, they show far more convergence and similarity than might be predicted from the pure black letter of the law. In the process, the chapter casts doubt on the ubiquity and utility of the distinction in comparative copyright thinking.
Innovations in the Organization of Public Health Services for Rural and Remote Parts of India
Authors: Sundararaman T. , Ved Rajani
Published: April 2018

Facilitated by the National Rural Health Mission, the last decade has witnessed a number of innovations in the delivery of public health services in India. The pathways by which innovations happened are categorised into three groups: (a) identifying ‘best practices’ which are then scaled up; (b) the effort to build viable business models; and (c) driven by policy-level prioritization. Seventeen brief case studies are presented illustrating the variety of innovations and innovation pathways that exist, and an attempt is made to elucidate the general features of successful innovation. Innovations driven by critical problem-solving, dedicated innovators, and developments in technology with ability to manage its social interface do better. We also note that, despite much attention to transformational or disruptive innovations, it is home grown incremental innovations that have held sway.
Market-Based Solutions for Poverty Reduction in India
Authors: English Brian
Published: April 2018

The rapid increase in slum populations in India has far outpaced the impact of interventions to date. Market-based solutions have started gaining the attention of governments, international aid groups, NGOs and entrepreneurs as they look for new ways to scale up their impact and sustain their interventions. Thousands of new social enterprises that seek to provide social benefits, and sustain largely on business revenues, have sprung up in response. Their rapid proliferation has attracted the attention of impact investors looking to create the next microfinance industry. This chapter profiles two case studies of market-based solutions in India that provide some important lessons for others fostering similar initiatives.
Global Perspectives on Land-Grabbing
Authors: Suhail Peer Ghulam Nabi
Published: April 2018

While situating and contextualizing land-grabbing in Kashmir within the global land-grabbing debate, this chapter provides a detailed and critical account of the dominant assumptions about the current wave of land-grabbing—its features, impacts, and narratives. Existing literature on land-grabs lays emphasis on the quantification of land-grabs, and pays attention to the land-grabs in a special region—Africa. Moreover, it tells us about the role of different actors, especially the State, corporates, and other power houses—including institutions and elite in the land deals. However, most of this literatures fails to establish the link between the political structure and resistance. This chapter discusses these inter-linkages and the land- and water-grabbing literature in India.
Of Truth and Taxes
Authors: Ghosh Shrimoyee
Published: April 2018

The ‘stamp paper’ document, under the Indian Stamp Act, 1899 is a promiscuously present and iconic textual artifact that circulates through the worlds of Indian legality and bureaucracy. The stamp paper as a revenue instrument was imbricated in and constituted by the historical processes that standardized the forms and modes of revenue collection and instruments of evidence, credit, and credibility through the long nineteenth century. Elaborate protocols of writing, verification, identification, attestation and authorization performed by paper workers and truth functionaries produced its authority. Yet, stamp paper from its inception was viewed as notoriously suspect, stamp duties as being persistently evaded and truth-functionaries as scandalously corruptible. This chapter details the discussions and disputes that surrounded the materiality and visuality of stamp paper through the late eighteenth and nineteenth centuries. Through this account of the stamp paper’s material history, I explore colonial law’s contingency and contradictions, and the fraught relationships between commerce and corruption, authenticity and fraudulence, truth and evasion that the stamp paper both embodies and fails to contain.
Implicit Domain Restriction
Authors: Breckenridge Wylie
Published: April 2018

According to the proposal made in Chapter 4, we use ‘grey’ in ‘The patch looks grey to you’ to refer to a way of looking by quantifying over events. When we quantify it is very common for us to implicitly restrict the domain of things over which we do so. The author proposes that, as an instance of this general phenomenon, we employ implicit domain restriction when we use ‘grey’ to quantify over events in ‘The patch looks grey to you’. The author uses this to explain various phenomena to do with our use of ‘grey’ and other adjectives in ‘look’ sentences.
The N-pattern
Authors: Maiden Martin
Published: April 2018

The chapter presents the role of stress and stress-related vocalic differentiation in creating a pattern of root allomorphy (the N-pattern), which distinguishes the singular and third-person forms of the present indicative and subjunctive, and of the imperative, from the rest of the paradigm. It is shown how numerous innovatory patterns (including suppletion, defectiveness, heteroclisis, and periphrases) replicate this pattern in diachrony. The possible role of markedness or of residual phonological conditioning is critically considered. It is suggested that the verb meaning ‘go’ may have played a special role. The independence of the N-pattern from extramorphological conditioning is reaffirmed.
New morphomic patterns from old
Authors: Maiden Martin
Published: April 2018

This chapter considers ways in which morphomic patterns can themselves change, yet without ceasing to be morphomic. Overall, the trend does not appear to be towards paradigmatic distributions that make sense. Rather morphomic patterns may change, giving rise to new morphomic patterns because of overlap with other morphomic patterns, accidental effects of sound change (particularly ones that produce syncretisms), or independent morphological changes. The data suggest that the predictability of distribution is superordinate to making sense in extramorphological terms.
Origins, substance, and persistence of Romance morphomic patterns
Authors: Maiden Martin
Published: April 2018

This chapter reviews the evidence for the origins of morphomic patterns in the effects of defunct sound changes or extinct functional motivations and reflects on their substance and on the types of alternation involved, concluding that morphomic patterns exist independently of their phonological substance and that it is possible that any kind of formal difference (suppletion, defectiveness, heteroclisis, periphrastic structure, internal allomorphy) is liable to morphomic distribution. The chapter reasserts the crucial role of lexical identity in explaining morphomic structures in the face of formal difference. It invokes the principle of synonymy avoidance to explain speakers’ exploitation of morphomic patterns in the distribution of such differences. Finally, it considers the role of intraparadigmatic predictability in morphomic structure. Contrary to some current views, it argues that predictability is not an inherent property of morphomic patterns but an acquired property that favours the diachronic survival of morphomic patterns.
Two Visions of Lithuania
Authors: Balkelis Tomas
Published: April 2018

This chapter explores the initial conjunction and subsequent disentanglement of social and nationalist revolutions in Lithuania by focusing on the impact that war and various mobilizations had on the local population in 1918–19. Despite the explosion of social and nationalist unrest all over the country in late 1918, in a matter of several months the Bolsheviks lost their case. The key reasons for their failure were their military defeat by German, Lithuanian, and Polish troops, but also economic mismanagement, the refusal to distribute land to peasants, and an inability to present their revolution as “native.” Following the Leninist doctrine of “proletarian revolution” that relegated peasantry to a secondary position, the Bolsheviks failed to forge an alliance with the largest population group of Lithuanian society, which resulted in their downfall.
Bridging the Western and Eastern Traditions
Authors: Hu Henan
Published: April 2018

The encounter of the Western and Eastern world order has been a fundamental challenge to international law since the nineteenth century. Although China has been admitted into the modern States system originated in Europe and the principle of sovereignty has been applied to it, the legacy of ideological clash between the two civilizations remains. This chapter examines the issue of the compatibility between the Western and Eastern ideas of international order and aims to seek possible convergences between them. In this regard, it highlights the importance for both civilizations’ return to their original international theories that not only fit well into a State-centred system but also possess the essential characteristic of universalism.
USA–Iran, 2009–2010
Authors: Wheeler Nicholas J.
Published: April 2018

This chapter examines the attempts by the first Obama Administration to reach out to Iran in an effort to build trust. It traces the failure of Obama’s diplomatic efforts to secure any reciprocation from Iranian leaders. The lack of reciprocation shows the problem of accurate signal interpretation when there is no trust. It focuses on the negotiations in 2009–10 over limiting Iran’s supply of nuclear fuel in return for refuelling the Tehran Research Reactor. The chapter argues these negotiations failed because of the lack of trust. What makes this case so important is that there was no face-to-face interaction, which this book argues is critical to the development of interpersonal trust and accurate signal interpretation.
Trends in mental health outcomes and combat exposure among US marines returning from Iraq, Afghanistan or other deployments, 2004–13
Authors: Morgan Jessica Kelley , Levin-Rector Alison , Van Dorn Richard A , Trudeau James , Hourani Laurel L , Cartwright Joel K , Lattimore Pamela K
Published: April 2018

Background

As of 2015, more than 2.7 million US military Veterans have served in support of the Global War on Terror. The negative sequelae associated with deployment stressors and related traumas are well-documented. Although data on mental health issues are routinely collected from service members returning from deployment, these data have not been made publicly available, leaving researchers and clinicians to rely on convenience samples, outdated studies and small sample sizes.

Methods

Population-based data of US Marines returning from deployment between 2004 and 2013 were analyzed, using the Post-Deployment Health Assessment.

Results

Rates of Marines returning from Iraq who screened positive for depression ranged from 19.31 to 30.02%; suicidal ideation ranged from 0 to 1.44%. Marines screening positive for PTSD ranged from 3.00 to 12.41%; combat exposure ranged from 15.58 to 55.12%. Depression was indicated for between 12.54 and 30.04% of Marines returning from Afghanistan, while suicidal ideation ranged from 0 to 5.33%. PTSD percentages ranged from 6.64 to 18.18%; combat exposure ranged between 42.92 and 75%.

Conclusion

Our results support the heterogeneity of experiences and mental health sequelae of service members returning from deployments. Outcomes for Afghanistan and Iraq Veterans fluctuate with changes in OPTEMPO across theaters over time.
Assessment of Cartilage Growth After Biopsy of Osteochondral Loose Bodies in Adolescent Knees for Use in Autologous Chondrocyte Implantation
Authors: Robinson Sean , Kramer Jonathan , Shelton Trevor , Merriman Jarrad , Haus Brian
Published: April 2018

Background:

The goal of this study is to determine whether harvested cartilage from an osteochondral loose body maintains the same viability for implantation as cartilage harvested from the traditional locations within the adolescent knee for autologous chondrocyte implantation (ACI).

Methods:

A retrospective study was performed on all ACI procedures performed from 2014 to 2017 at a single institution. Biopsies were derived from 2 groups: osteochondral loose body verses the intercondylar notch. The viability, yield, identity, potency, and density were obtained from each sample in addition to basic demographics and concomitant injuries. A total of 12 patients with osteochondral loose bodies 14.6 (SD=2.9) and 20 patients 13.6 (SD=3.3) with intercondylar notch biopsies were evaluated for the study.

Results:

In the microscopic and histologic comparison, there was no significant difference in viability: 94% in the loose bodies and 93% in the intercondylar notch groups, identity: 7.4 d5L versus 6.3 d5L, or yield. Minimum yield is presented as different units in Carticel (1.2×107 cells/vial) and matrix-induced ACI (>8500 relative fluorescent units) products; however, there was no difference between groups and all samples were above the acceptable limit. Minimum identity value is recorded as d5L> −2.00 and all samples were above this limit. In addition, no sample had signs of contamination or endotoxin in either group.

Conclusion:

These results demonstrate an alternative method for obtaining cartilage biopsies in ACI procedures that may limit short-term and long-term donor site morbidity.

Level of Evidence:

Level III.
The Arrival of Robotics in Spine Surgery
Authors: Ghasem Alexander , Sharma Akhil , Greif Dylan N. , Alam Milad , Maaieh Motasem Al
Published: April 2018

Study Design.

Systematic review.

Objective.

The authors aim to review comparative outcome measures between robotic and free-hand spine surgical procedures including: accuracy of spinal instrumentation, radiation exposure, operative time, hospital stay, and complication rates.

Summary of Background Data.

Misplacement of pedicle screws in conventional open as well as minimally invasive surgical procedures has prompted the need for innovation and allowed the emergence of robotics in spine surgery. Before incorporation of robotic surgery in routine practice, demonstration of improved instrumentation accuracy, operative efficiency, and patient safety are required.

Methods.

A systematic search of the PubMed, OVID-MEDLINE, and Cochrane databases was performed for articles relevant to robotic assistance of pedicle screw placement. Inclusion criteria were constituted by English written randomized control trials, prospective and retrospective cohort studies involving robotic instrumentation in the spine. Following abstract, title, and full-text review, 32 articles were selected for study inclusion.

Results.

Intrapedicular accuracy in screw placement and subsequent complications were at least comparable if not superior in the robotic surgery cohort. There is evidence supporting that total operative time is prolonged in robot-assisted surgery compared to conventional free-hand. Radiation exposure appeared to be variable between studies; radiation time did decrease in the robot arm as the total number of robotic cases ascended, suggesting a learning curve effect. Multilevel procedures appeared to tend toward earlier discharge in patients undergoing robotic spine surgery.

Conclusion.

The implementation of robotic technology for pedicle screw placement yields an acceptable level of accuracy on a highly consistent basis. Surgeons should remain vigilant about confirmation of robotic-assisted screw trajectory, as drilling pathways have been shown to be altered by soft tissue pressures, forceful surgical application, and bony surface skiving. However, the effective consequence of robot-assistance on radiation exposure, length of stay, and operative time remains unclear and requires meticulous examination in future studies.

Level of Evidence: 4
Perioperative Use of Levosimendan Improves Clinical Outcomes in Patients After Cardiac Surgery: A Systematic Review and Meta-Analysis
Authors: Qiang Hua , Luo Xiu , Huo Jian-Hua , Wang Zhi-Quan
Published: April 2018

Severe postoperative complications can affect cardiac surgery patients. Levosimendan is a novel calcium sensitizer commonly administered after cardiac surgery. However, the patient benefits are controversial. PubMed, Embase, and the Cochrane library were systematically searched for randomized controlled trials comparing levosimendan with control in adult cardiac surgery patients. Twenty-five studies (3247 patients) were included. Pooled data indicated that levosimendan reduced mortality after cardiac surgery [odds ratio (OR) 0.63, 95% confidence interval (CI): 0.47–0.84, P = 0.001]. However, this reduction was restricted to patients with low (<50%) left ventricular ejection fraction (OR 0.49, 95% CI: 0.35–0.70, P = 0.0001). It significantly reduced the incidence of postoperative acute kidney injury (OR 0.55, 95% CI: 0.41–0.74, P < 0.0001) and renal replacement therapy use (OR 0.56, 95% CI: 0.39–0.80, P = 0.002). Moreover, levosimendan significantly shortened the duration of the intensive care unit stay (weighted mean differences −0.49 day, 95% CI: −0.75 to −0.24, P = 0.0002) and mechanical ventilation use (weighted mean differences −2.30 hours, 95% CI: −3.76 to −0.84, P = 0.002). In conclusion, levosimendan reduced the mortality in patients with low left ventricular ejection fraction and decreased the incidence of acute renal injury and renal replacement therapy use. In addition, it shortened the duration of the intensive care unit stay and mechanical ventilation use.
Recovery of Corneal Clarity After DMEK Followed by Rebubbling Versus Uneventful DMEK
Authors: Lazaridis Apostolos , Fydanaki Ourania , Giallouros Eleftherios , Georgalas Ilias , Kymionis George , Sekundo Walter , Droutsas Konstantinos
Published: April 2018

Purpose:

To evaluate the effect of a single rebubbling procedure after Descemet membrane endothelial keratoplasty (DMEK) on corneal backscatter and endothelial cell loss (ECL).

Methods:

Medical records of 130 consecutive DMEK cases (118 patients) were reviewed and 3 groups were formed: group 1 (n = 32), consisting of DMEK cases followed by 1 rebubbling; group 2a (n = 55), including uneventful DMEK cases with complete graft attachment; and group 2b (n = 25), including uneventful DMEK cases with minor peripheral detachment, not requiring rebubbling. Scheimpflug corneal densitometry (CD) of the central (0–2 mm), paracentral (2–6 mm), and mid-peripheral (6–10 mm) zones, endothelial cell density, central corneal thickness, and corneal volume were measured preoperatively and at 3, 6, 12, and 24 months.

Results:

Central CD in group 1 decreased from 32.3 ± 8.3 grayscale units preoperatively, to 21.2 ± 3.5 at 24 months. In group 2a, CD decreased from 37.0 ± 11.9 to 19.4 ± 3.0 and in group 2b from 32.5 ± 8.8 to 19.8 ± 3.1. No significant differences were observed among the 3 groups at any examination time point (P ≥ 0.12). At 3 months, paracentral CD of group 2a was significantly lower than that of group 1 (P = 0.047). Endothelial cell density at 3 months was higher in group 2a (1613 ± 503 cells/mm2) than in group 1 (1350 ± 557 cells/mm2; P = 0.033). ECL at 24 months was 56%, 43%, and 53% in groups 1, 2a, and 2b, respectively. Group 2a showed the lowest ECL, central corneal thickness, and corneal volume throughout the study period.

Conclusions:

A single rebubbling procedure does not increase the CD of the central cornea and but results in significantly higher ECL compared with uneventful DMEK with complete graft attachment.
Case of Primary Isolated Subconjunctival IgG4-Related Disease
Authors: Lee Hyo Seok , Choi Won , Kim Ga Eon , Yoon Kyung Chul
Published: April 2018

Purpose:

To report a case of isolated subconjunctival ocular adnexal IgG4-related disease that met the diagnostic criteria according to the Japanese Ministry of Health, Labour and Welfare's 2011 guidelines.

Methods:

We report a case of a 56-year-old woman with a left subconjunctival mass for 3 months. Excisional biopsy was performed. Postoperatively, the patient underwent systemic and radiologic evaluations for IgG4-related disease.

Results:

The clinicopathologic study revealed storiform fibrosis and lymphoplasmacytic infiltration, with increased IgG4-positive plasma cells and an IgG4/IgG-positive plasma cell ratio of 40%. Serum IgG4 and IgG levels were slightly elevated. Systemic involvement was not detected.

Conclusions:

IgG4-related disease is well known in the orbit and ocular adnexa, particularly the lacrimal gland. However, subconjunctival involvement should be recognized as a possible presentation for this entity.
Clinical Experience in Minimally Invasive Cardiac Surgery with Virtually Wall-Less Venous Cannulas
Authors: Ferrari Enrico , von Segesser Ludwig K. , Berdajs Denis , Müller Ludwig , Halbe Maximilian , Maisano Francesco
Published: April 2018

Objective

Inadequate peripheral venous drainage during minimally invasive cardiac surgery (MICS) is a challenge and cannot always be solved with increased vacuum or increased centrifugal pump speed. The present study was designed to assess the benefit of virtually wall-less transfemoral venous cannulas during MICS.

Methods

Transfemoral venous cannulation with virtually wall-less cannulas (3/8″ 24F 530–630-mm ST) was performed in 10 consecutive patients (59 ± 10 years, 8 males, 2 females) undergoing MICS for mitral (6), aortic (3), and other (4) procedures (combinations possible). Before transfemoral insertion of wall-less cannulas, a guidewire was positioned in the superior vena cava under echocardiographic control. The wall-less cannula was then fed over the wire and connected to a minimal extracorporeal system. Vacuum assist was used to reach a target flow of 2.4 l/min per m2 with augmented venous drainage at less than −80 mm Hg.

Results

Wall-less venous cannulas measuring either 630 mm (n = 8) in length or 530 mm (n = 2) were successfully implanted in all patients. For a body size of 173 ± 11 cm and a body weight of 78 ± 26 kg, the calculated body surface area was 1.94 ± 0.32 m2. As a result, the estimated target flow was 4.66 ± 0.78 l/min, whereas the achieved flow accounted for 4.98 ± 0.69 l/min (107% of target) at a vacuum level of 21.3 ± 16.4 mm Hg. Excellent exposure and “dry” intracardiac surgical field resulted.

Conclusions

The performance of virtually wall-less venous cannulas designed for augmented peripheral venous drainage was tested in MICS and provided excellent flows at minimal vacuum levels, confirming an increased performance over traditional thin wall cannulas. Superior results can be expected for routine use.
Pericardial Patch Exclusion Technique for Left Atrial Appendage Closure
Authors: Ginty Olivia K. , Khaliel Ferns H. , Adams Corey , Chu Michael W. A.
Published: April 2018

We describe a technique of left atrial appendage occlusion that consists of autologous pericardial patch closure of the left atrial appendage orifice from within the left atrium. This pericardial patch exclusion technique has little added risk of bleeding, can be performed through sternotomy or right minithoracotomy, and can be used in re-operative situations.
Transconjunctival Triamcinolone Injection for Upper Lid Retraction in Thyroid Eye Disease—A New Injection Method
Authors: Young Stephanie Ming , Kim Yoon-Duck , Lang Stephanie S. , Woo Kyung In
Published: April 2018

Purpose:

To evaluate the role of transconjunctival triamcinolone acetonide (TA) injection in the management of upper eyelid retraction in thyroid eye disease.

Methods:

Retrospective interventional review of all patients who underwent transconjunctival TA injection (40 mg/mL) for thyroid eye disease–related upper eyelid retraction from January 2010 to December 2016 in a single tertiary institution. The present study comprised 2 groups: Patients receiving only TA injection (group 1), and patients receiving both TA injection and other immunosuppressive therapy (group 2).

Results:

There were a total of 99 patients and 135 eyes. Group 1 comprised of 36 eyes (26.7%), while group 2 comprised 99 (73.3%). Normalization or improvement of margin reflex distance 1 was seen in 77.4% and 97.2% of group 1 patients at early and late review, respectively, and 77.6% and 87.8% of group 2, respectively. Absence or improvement in International Thyroid Eye Disease Society inflammatory index was seen in 83.9% and 86.1% of group 1 at early and late review, respectively, and 71.9% and 76.8% of group 2, respectively. Both active (73.7%) and inactive (79.3%) groups showed good early success for improvement in margin reflex distance 1, with increased late success and no significant difference between the groups. For International Thyroid Eye Disease Society inflammatory index, the active group had better early and late success than the inactive group, with the difference being significant (P = 0.002) for late success.

Conclusions:

Transconjunctival TA injection is an effective treatment option for thyroid eye disease–related upper eyelid retraction, as a primary and adjunctive treatment, in both active and inactive thyroid eye disease patients.
Perceptions of Missed Care Across Oncology Nursing Specialty Units
Authors: Villamin Colleen , Anderson Jacqueline , Fellman Bryan , Urbauer Diana , Brassil Kelly
Published: April 2018

Background:

An opportunity was identified to compare perceptions of the occurrence and types of missed care at a comprehensive cancer center.

Purpose:

The purpose was to evaluate the difference in perceived occurrence and types of missed care between medical, surgical, and hematologic oncology units in the context of a newly implemented patient care delivery system, Primary Team Nursing (PTN).

Methods:

A descriptive, repeated-measures design was used. The MISSCARE survey was distributed electronically to 580 staff members across 6 inpatient units.

Results:

Frequently perceived elements of missed nursing care were ambulation, turning every 2 hours, and care conference attendance. At the time of study implementation, surgical units reported 0.24 higher scores than medical units (P = .017); hematology units reported 0.26 lower scores than surgical units (P = .005). PTN status did not affect MISSCARE scores (P = .525).

Conclusions:

Study findings suggest that perceived missed care in a comprehensive cancer center is similar to that in other hospital settings.
Frequency of and Reasons for False-Positive Consults Generated by the Malnutrition Screening Tool
Authors: Sturgill Alison , Stanczyk Kathy , Crouch Lori , Byrd Karen
Published: April 2018

Background:

Nutrition screening on admission is one way to identify patients with malnutrition. The Malnutrition Screening Tool (MST) is a commonly used screening tool but has been found to generate false-positive consults.

Purpose:

The purpose of this research was two-fold: (1) to determine the percentage of nursing screens, using the MST, that generated a false-positive consult for a registered dietitian, and (2) to identify the reasons for these false-positive consults.

Methods:

During a 3-month period, registered dietitians documented the number of false-positive consults received from the MST and reasons they were received.

Results:

Of the registered dietitian consults generated, 5.5% were deemed false-positive. The most common reason for a false-positive consult was patient-reported weight loss that had resolved.

Conclusions:

As nurses are integral to completion of the MST, data generated can be used in ongoing education of nursing staff.