bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing a microwave tomographic system for multiphase flow imaging: advances and challenges
Authors: Wu Zhipeng
Published: September 2014

Since the 1980s, electrical tomographic imaging techniques based on low-frequency capacitance and resistance measurements have been developed for the monitoring of industrial processes and in some cases multiphase flows. Research on microwave tomography for oil and gas multiphase flow imaging began in the mid-1990s, even though the basic principle of microwave tomography was reported a decade earlier for biomedical imaging. In this paper, the development of a microwave tomographic imaging system for such an application since then is overviewed. It is shown by several examples that microwave tomography can effectively reconstruct the images of dielectric objects, moisture distribution inside processed food and oil–gas two-phase flows. It is also shown that the use of higher microwave frequencies would effectively lead to images of higher spatial resolution. Since real-time microwave tomography systems are currently available and ready for industrial applications, the challenges in developing a practical system with higher temporal resolutions suitable for the imaging of high speed multiphase flows in oil industry are highlighted and discussed in both hardware and image reconstruction aspects.
Simultaneous multi-stage anti-windup synthesis for open-loop stable plants
Authors: Ran Maopeng , Wang Qing , Dong Chaoyang , Ni Maolin
Published: September 2014

In this paper, we present a synthesis method for global stability and performance of input constrained linear plants. We consider the multi-stage anti-windup scheme that uses two sets of static anti-windup gains. Unlike traditional two-step anti-windup design procedures, our method synthesizes all controller parameters simultaneously. This simultaneous design also provides an opportunity to guarantee different levels of performance based on the magnitude of the controller output. The synthesis results are cast as an optimization over linear matrix inequalities. The benefits of the proposed method are illustrated with a well-known example.
A new attribute control chart using multiple dependent state sampling
Authors: Aslam Muhammad , Nazir Amna , Jun Chi-Hyuck
Published: September 2014

This paper proposes a new np control chart by utilizing the information on the past subgroups through the idea of multiple dependent state sampling. The proposed control chart has two pairs of control limits and their parameters are determined by considering the target in-control average run length (ARL). To check the efficiency of the proposed control chart, the out-of-control ARLs are evaluated for different process shift. The efficiency of the proposed chart is compared with the traditional Shewhart np control chart and the results show that our proposed control chart has a better performance than the traditional np control chart.
Tutorial on Health Economics and Outcomes Research in Nutrition
Authors: Philipson Tomas , Linthicum Mark T. , Snider Julia Thornton
Published: September 2014

As healthcare costs climb around the world, public and private payers alike are demanding evidence of a treatment's value to support approval and reimbursement decisions. Health economics and outcomes research, or HEOR, offers tools to answer questions about a treatment's value, as well as its real‐world effects and cost‐effectiveness. Given that nutrition interventions have to compete for space in budgets along with biopharmaceutical products and devices, nutrition is now increasingly coming to be evaluated through HEOR. This tutorial introduces the discipline of HEOR and motivates its relevance for nutrition. We first define HEOR and explain its role and relevance in relation to randomized controlled trials. Common HEOR study types—including burden of illness, effectiveness studies, cost‐effectiveness analysis, and valuation studies—are presented, with applications to nutrition. Tips for critically reading HEOR studies are provided, along with suggestions on how to use HEOR to improve patient care. Directions for future research are discussed.
Impact of Drug Shortages on Patients Receiving Parenteral Nutrition After Laparotomy
Authors: Bible Jaimee R. , Evans David C. , Payne Brett , Mostafavifar Lisa
Published: September 2014

Background: Drug shortages, including parenteral nutrition (PN) product shortages, continue to increase and have a significant impact on healthcare. The extent to which product shortages affect bowel recovery and outcomes in patients receiving PN is unknown. The objective of this study is to examine the impact of extensive PN product shortages on patients receiving PN after laparotomy for bowel obstruction. Methods: A retrospective review was conducted for patients who underwent a laparotomy for small bowel obstruction and received PN postoperatively. Periods of limited and extensive PN product shortages at our institution were defined. PN therapy duration and composition, daily laboratory values, electrolyte supplementation, length of stay, and cost of hospitalization were recorded. Analyses using χ2, Wilcoxon rank sum, log‐rank, and t tests as appropriate were performed using SAS/STAT 9.2. Results: Patients had longer hospital length of stays (20.0 vs 15.2 days; P = .04), trends toward longer PN therapy courses (8.8 vs 6.6 days; P = .13), and a 51% higher hospital cost during the extensive PN drug shortage period. Mean serum electrolyte concentrations were similar while the need for supplemental magnesium replacements increased during the extensive shortage period (75% vs 35%; P = .01). Supplemented patients also required higher doses of magnesium (2.7 vs 1.0 g; P < .01) and more laboratory draws during the extensive shortage period (59% vs 21% required ≥2 draws daily; P = .04). Fewer lipid calories were delivered during the extensive shortage period (2.4 vs 4.8 kcal/kg/d; P < .01). Conclusion: PN drug shortages have a negative impact on patient outcomes and require aggressive management strategies.
Customer Mistreatment, Employee Health, and Job Performance
Authors: Baranik Lisa E. , Wang Mo , Gong Yaping , Shi Junqi
Published: September 2014

The current study examined employee outcomes associated with customer mistreatment, conceptualizing customer mistreatment as signaling failure regarding employees’ pursuit of task and social goals at work. We argue that employees make internal attributions when experiencing customer mistreatment and are likely to engage in rumination because of this perceived goal failure. The goal of this article was to test this conceptualization and examine the outcomes of customer mistreatment–induced rumination as well as emotional labor strategies as potential protective mechanisms against customer mistreatment. Findings from time-lagged data collected from 737 call-center customer representatives indicated that cognitive rumination mediated the relationship between customer mistreatment and supervisor-rated job performance, customer-directed sabotage, employee well-being, and emotional exhaustion. The second mediator, social sharing of negative events, mediated the relationship between customer mistreatment and emotional exhaustion only. As expected, cognitive rumination was positively related to customer sabotage and emotional exhaustion and negatively related to job performance and well-being. Social sharing of negative events was positively related to both well-being and emotional exhaustion. Finally, we found that deep acting, but not surface acting, buffered the effects of customer mistreatment on cognitive rumination and social sharing. Limitations, future research directions, and managerial implications are discussed.
Fiscal Implications of City-City Consolidations
Authors: Gaffney Michael , Marlowe Justin
Published: September 2014

There is a rich literature on the fiscal implications of municipal consolidations. Almost all of it is focused on city–county consolidations. City–city consolidations, although rare, are an even better setting to test the claim that municipal consolidation reduces local government taxing and spending. We examine this claim with data from six city–city consolidations since 1985. We find that, in fact, most city–city consolidations result in higher taxing and higher spending on core operations and salaries. Consolidation produced lower overall spending in three of the six jurisdictions, but mostly because it was accompanied by lower intergovernmental revenues and changes in debt management. All this suggests the economic theory of consolidation would be more salient if it considered a broader array of benefits and costs that are not directly reflected in tax and spending rates.
Strategic Alignment for the New Normal
Authors: Abels Michael
Published: September 2014

Local government is assuming a new and transformational leadership role in this era of the “new normal,” which is highlighted by structural resource scarcity and the assumption of new missions in our federal structure. These new missions mandate regional governance, both in planning and in service delivery. Planning in the twenty-first century must be strategic, regionally based, and founded on the principles of community sustainability. Service delivery, while maintaining its traditional emphasis on public safety and service, must move into areas that address the growing social and economic needs of our citizens. The foundation for mission success will see regionalism, deliberative democracy, and strategic sustainability as foundation for local governance.
The augmented newsbeat: spatial structuring in a Twitterized news ecosystem
Authors: Revers Matthias
Published: September 2014

This article deals with the intertwining of digital and nondigital spaces of news reporting. It focuses specifically on how Twitter affects spatial and temporal orderings of news ecosystems. At the New York state government, actors within the space permeate informational barriers through Twitter while enabling others to follow and engage in events from remote locations. The always-on mentality of tweeters not only blurs boundaries between work life and private life but also helps correspondents to get access to and pass on information instantly, as well as to better anticipate events. The proliferation of digital spaces enhances awareness of nondigital spaces but requires coordination between the two. This paper is based on over two years of field research, involving observation, interviews, digital ethnography of the state house twitterverse and content analysis of journalists’ tweets during the same-sex marriage debate.
Back in the USSR: Introducing Recursive Contingency Into Institutional Theory
Authors: Deroy Xavier , Clegg Stewart
Published: September 2014

Institutional theory’s understanding of unplanned change in fragmented and complex environments has made the connection between institutional work at the micro level and institutional logics at the macro level a central issue. Change that is not planned is contingent on events. In practice an event, as a single occurrence of an unexpected, unanticipated or unacknowledged process, connects these levels, as the event is selected for attention, enacted in meaning, and organizationally coded. Not all events are selected, enacted and coded, of course. The recognition, attributes and potential of events depend on selections made from and meaning given to past events and those conceived as coming into being in the future perfect. The concept of recursive contingency describes how unique occurrences become connected in an evolving process over time; in doing so, it stresses the important role of the unexpected in regard to institutional change. Using a theoretical framework derived from Luhmann’s work, in which institutions are seen as relatively autonomous self-closed subsystems generating contingency, we define an event as such by the fact that what it means and what is to be done with it cannot be decided by the application of a rule: choice is demanded that requires coding it as a specific type of event. A recursive view of contingency can be connected to an institutional theory of change in which the central role of institutional codes and networks of communication is stressed, producing a new theoretical approach to the explanation of institutional change. To illustrate the argument we make reference to one of the most significant counterfactual cases for questioning the solidity of institutions: the collapse of the key organization of the Soviet Union, the Communist Party.
Supervisor’s Interactive Model of Organizational Relationships
Authors: O’Reilly Frances L. , Matt John , McCaw William P.
Published: September 2014

The Supervisor’s Interactive Model of Organizational Relationships (SIMOR) integrates two models addressed in the leadership literature and then highlights the importance of relationships. The Supervisor’s Interactive Model of Organizational Relationships combines the modified Hersey and Blanchard model of situational leadership, the Glickman Developmental Supervision Model, and considers relationships within the organization to form a more comprehensive picture of the supervisee’s supportive and supervisory needs. This model provides supervisors with a more realistic and useful framework to guide their supportive interactions with supervisees.
Infected Lives
Authors: Peltzer Jill N. , Domian Elaine W. , Teel Cynthia S.
Published: September 2014

This hermeneutic phenomenological study explored the lived experiences of young African American HIV-infected women. Eleven women between the ages of 21 and 35 participated. One pattern, Infected Lives, and three themes—Living Alone With HIV, Living With Unresolved Conflicts, and Living With Multiple Layers of Betrayal—emerged. The pattern and themes portray the very complex and challenging experiences faced by these young women living with HIV infection. They have experienced isolation, abandonment, betrayal, and discrimination in their interpersonal and social systems. They often dealt with conflicts of hope and anguish in the relationships with their children, and portraying strength, while feeling fragile. These complexities negatively influence the ability to fully engage in self-care activities. Implications for future research include further investigation about the experiences of psychological distress experienced post-diagnosis, development and evaluation of holistic nursing interventions, and evaluative research on mass media educational campaigns to reduce HIV-related stigma.
Rights, responsibilities and refusals: Homelessness policy and the exclusion of single homeless people with complex needs
Authors: Dwyer Peter , Bowpitt Graham , Sundin Eva , Weinstein Mark
Published: September 2014

Since 1977 homelessness legislation in England has offered limited statutory accommodation rights to unintentionally homeless people who are judged to be in priority need and able to demonstrate a local connection. Using data generated in interviews with homeless people and staff working to support them, this paper considers the impact of current homelessness policy and practice and explores how decisions about intentionality, priority need and local connection serve to exacerbate the social exclusion experienced by single homeless people with multiple support needs. It is concluded that a more genuinely inclusive welfare state will only emerge when, and if, policymakers and wider society are able to abandon their current fixation with using welfare policy to punish ‘irresponsible’ behaviour and refocus instead on providing services to adequately meet the basic needs of marginalised people.
The Subtlety of Sound
Authors: Dehghani Morteza , Khooshabeh Peter , Nazarian Angela , Gratch Jonathan
Published: September 2014

Aspects of language, such as accent, play a crucial role in the formation and categorization of one’s cultural identity. Recent work on accent emphasizes the role of accent in person perception and social categorization, demonstrating that accent also serves as a meaningful indicator of an ethnic category. In this article, we investigate whether the accent of an interaction partner, as a marker for culture, can induce cultural frame-shifts in biculturals. We report the results of three experiments, performed among bicultural and monocultural individuals, in which we test the above hypothesis. Our results demonstrate that accent alone can affect people’s cognition.
Assembling capabilities for innovation: Evidence from New Zealand SMEs
Authors: Whittaker D Hugh , Fath Benjamin P , Fiedler Antje
Published: September 2014

This article draws upon survey data from New Zealand small- and medium-sized enterprises (SMEs) to explore the relationship between training, collaboration and innovation performance. Based on the perspective that SME owner–managers attempt to marshal both internal and external capabilities to improve innovation outcomes, it shows that strategies which focus on internal capabilities (training) only have no tangible effect. SMEs benefit from different capability strategies depending on their age. For younger firms, accessing external resources (collaboration) has a positive effect, while older SMEs benefit from a combined strategy (collaboration and training). Training effects are context (e.g. industry or sector) dependent and contingent on a broader approach to innovation. Our findings also suggest that demographic characteristics of the owner–manager influence the capability assembling strategy and are therefore, an important contingency for the innovation performance of SMEs.
Records management models in the public sector in South Africa
Authors: Ngoepe Mpho
Published: September 2014

Records management models play a significant role in the provision of records management services in organizations. However, many governmental bodies design records management programmes without taking into consideration the models appropriate for implementation. This study investigated records management models adopted by the public sector in South Africa, with a view to developing a model that can be customized by governmental bodies in the implementation of records management. Quantitative data was collected through questionnaires distributed electronically to records management practitioners in governmental bodies. The study revealed that governmental bodies in South Africa apply general records management principles without customizing them or addressing the challenges they are facing. It is argued that, because each organization is unique in its make-up, culture, goals and management style, effective records management cannot be obtained by copying other organizations’ records management programmes. The study proposes a model that governmental bodies can customize in the implementation of records management.
Veno-venous extracorporeal membrane oxygenation using a double-lumen bi-caval cannula for severe respiratory failure post total artificial heart implantation
Authors: Miessau J , Yang Q , Unai S , Entwistle JWC , Cavarocchi NC , Hirose H
Published: September 2014

We report a unique utilization of a double-lumen, bi-caval Avalon cannula for veno-venous (VV) extracorporeal membrane oxygenation (ECMO) during placement of a total artificial heart (TAH, SynCardia, Tucson, AZ). A 22-year-old female with post-partum cardiomyopathy was rescued on veno-arterial (VA) ECMO because of cardiogenic shock. The inability to wean ECMO necessitated implantation of the TAH as a bridge to transplant. In addition, the patient continued to have respiratory failure and concomitant VV ECMO was planned with the implant. During TAH implantation, the Avalon cannula was placed percutaneously from the right internal jugular vein into the inferior vena cava (IVC) under direct vision while the right atrium was open. During VV ECMO support, adequate flows on both ECMO and TAH were maintained without adverse events. VV ECMO was discontinued, without reopening the chest, once the patient’s respiratory failure improved. However, the patient subsequently developed a profound respiratory acidosis and required VV ECMO for CO2 removal. The Avalon cannula was placed in the femoral vein to avoid accessing the internal jugular vein and risking damage to the TAH. The patient’s oxygenation eventually improved and the cannula was removed at the bedside. The patient was supported for 22 days on VV ECMO and successfully weaned from the ventilator prior to her orthotropic heart transplantation.
Degrees of frame alignment: Comparing organisers’ and participants’ frames in 29 demonstrations in three countries
Authors: Ketelaars Pauline , Walgrave Stefaan , Wouters Ruud
Published: September 2014

The frame alignment approach is one of the most influential mobilisation theories. This theory holds that frame alignment is a necessary condition for movement participation. The present study challenges this premise. Instead of treating frame alignment as a precondition for participation, the authors address it as something that should be empirically examined. And rather than distinguishing between either aligned or non-aligned protesters, they study frame alignment as a matter of degree. They do so drawing on protest surveys collected during 29 demonstrations in Belgium, the Netherlands and the United Kingdom. The authors answer the following research questions: To what extent are the frames of protest organisers and participants aligned? And are there differences in degrees of alignment across framing tasks, countries and issues? The findings show that many participants are only partially aligned. The highest levels of alignment are found for the diagnostic framing task. The article finds few differences across countries and issues for general alignment levels, but sub-aspects do tend to differ.
The dominant rationality of local stakeholder networks: The case of a southern Italian province
Authors: Pino Giovanni , Prete M Irene , Guido Gianluigi
Published: September 2014

This study examines the level of interconnectedness and the relational power of stakeholders operating in four local territorial systems (LTSs) localized in a southern Italian province. Such an analysis allows for the determination of the dominant rationality of each LTS, i.e. the pattern of distribution of decision-making power among its stakeholders and hence the extent to which each of them is capable of influencing local governance processes. In all four LTS, public institutions are revealed to be endowed with higher relational power than the other stakeholders. The dominant rationality of each LTS and policy implications deriving from results are discussed.
Motives for starting up a side activity in rural areas in the Netherlands
Authors: Markantoni Marianna , Strijker Dirk , Koster Sierdjan
Published: September 2014

This paper explores the side activities of non-farmers in rural areas in the Netherlands and more specifically their start up motives. A side activity is a small-scale home-based activity, which provides a supplementary income to the household. Side activities may have the potential to diversify the economic base of rural areas and to contribute to the quality of life and the social well-being in rural communities. Yet, little is known about their role for the development of rural areas. Furthermore, to date, rural policies have largely neglected non-farmers’ side activities in their rural development strategies partly because of their small size and partly because of the lack of available data in business registers. This study, by exploring the side activity motives, brings to light the specific needs and aspirations of the owners and is based on the results of 260 interviews by side-activity owners. The results highlight that the owners are mainly oriented towards non-economic benefits corresponding to the individuals’ needs, dreams and desires, while financial betterment falls into a secondary place. People are in search of a different type of pay-off than economic rewards, namely the opportunity for a better quality lifestyle. This is relevant for policy makers because of the potential contribution of side activities to providing services, diversifying rural activities and adding to the resilience of rural communities.
An evaluation of treatment integrity in a randomised controlled trial of memory rehabilitation for people with multiple sclerosis
Authors: Smale Kathryn J , Carr Sara E , Schwartz Annette F , das Nair Roshan , Lincoln Nadina B
Published: September 2014

Objective:

To assess the treatment integrity of a memory rehabilitation programme for people with multiple sclerosis.

Subjects:

Data were drawn from the intervention group of a randomised controlled trial of memory rehabilitation. This comprised 24 participants with multiple sclerosis.

Measures:

Four core session components were identified from the treatment manual: recap, activities, take-home activity and other. One video-recording of each of ten intervention sessions was transcribed and amount of time spent on components recorded.

Results:

There were no significant differences between early and late stages of the programme in time spent on the core components (recap Z= −0.87, P=0.49; activities Z = −0.29, P=0.89; take-home activity Z = −0.59, P=0.69; other Z = −0.58, P=0.69). Thus, adherence to the manual was good with no evidence of programme drift.

Conclusions:

Good adherence indicates the intervention was delivered as described in the manual and strengthens confidence in the findings of the randomised controlled trial.
A prospective study of the responsiveness of the original and the short form Berg Balance Scale in people with stroke
Authors: Chen Kuan-Lin , Chou Yei-Tai , Yu Wan-Hui , Chen Cheng-Te , Shih Ching-Lin , Hsieh Ching-Lin
Published: September 2014

Objective:

The study aim was to examine the responsiveness of the Berg Balance Scale (BBS) and that of its short form (SFBBS) at both the individual person level and the group level.

Design:

A repeated-measurements design.

Setting:

Hospital and home setting.

Participants:

Patients with stroke.

Results:

Totals of 226, 202, and 168 patients with stroke were assessed with the BBS at 14, 30, and 90 days after stroke, respectively. The SFBBS data were extracted from the patients’ responses on the BBS. At the group level, the BBS and the SFBBS had sufficient and similar responsiveness. For the Rasch scores, the effect sizes of the three change scores for the BBS and the SFBBS, respectively, had similar ranges between 0.38 and 0.88 and between 0.39 and 0.85, respectively. The standardized response means of the three change scores for the BBS and the SFBBS ranged from 0.74 to 1.33 and from 0.72 to 1.13, respectively. At the individual person level, the BBS detected significant balance improvement in about twice as many patients as the SFBBS detected.

Conclusion:

The responsiveness of the BBS at the individual person level was better than that of the SFBBS in patients with stroke. The BBS is recommended as an outcome measure to better detect changes in individual patients.
Developing a best practice model for partnership practice between specialist palliative care and intellectual disability services: A mixed methods study
Authors: McLaughlin Dorry , Barr Owen , McIlfatrick Sonja , McConkey Roy
Published: September 2014

Background:

The lack of access to good quality palliative care for people with intellectual disabilities is highlighted in the international literature. In response, more partnership practice in end-of-life care is proposed.

Aim:

This study aimed to develop a best practice model to guide and promote partnership practice between specialist palliative care and intellectual disability services.

Design:

A mixed methods research design involving two phases was used, underpinned by a conceptual model for partnership practice.

Setting/participants:

Phase 1 involved scoping end-of-life care to people with intellectual disability, based on self-completed questionnaires. In all, 47 of 66 (71.2%) services responded. In Phase 2, semi-structured interviews were undertaken with a purposive sample recruited of 30 health and social care professionals working in intellectual disability and palliative care services, who had provided palliative care to someone with intellectual disability. For both phases, data were collected from primary and secondary care in one region of the United Kingdom.

Results:

In Phase 1, examples of good practice were apparent. However, partnership practice was infrequent and unmet educational needs were identified. Four themes emerged from the interviews in Phase 2: challenges and issues in end-of-life care, sharing and learning, supporting and empowering and partnership in practice.

Conclusion:

Joint working and learning between intellectual disability and specialist palliative care were seen as key and fundamental. A framework for partnership practice between both services has been developed which could have international applicability and should be explored with other services in end-of-life care.
Patients’ perception of implantable cardioverter defibrillator deactivation at the end of life
Authors: Hill Loreena , McIlfatrick Sonja , Taylor Brian , Dixon Lana , Harbinson Mark , Fitzsimons Donna
Published: September 2014

Background:

Individualised care at the end of life requires professional understanding of the patient’s perception of implantable cardioverter defibrillator deactivation.

Aim:

The aim was to evaluate the evidence on patients’ perception of implantable cardioverter defibrillator deactivation at end of life.

Design:

Systematic narrative review of empirical studies was published during 2008–2014.

Data Sources:

Data were collected from six databases, citations from relevant articles and expert recommendations.

Results:

In all, 18 studies included with collective population of n = 5810. Concept mapping highlighted three themes: (1) Diverse preferences regarding discussion and deactivation. Deactivation was rarely discussed pre-implantation, with some studies demonstrating patients’ reluctance to discuss implantable cardioverter defibrillator deactivation at any stage. Two studies found the majority of patients valued such discussions. Diversity was reflected in patients’ willingness to deactivate, ranging from 12% (n = 9) in Irish cohort to 79% (n = 195) in Dutch study. (2) Ethical and legal considerations were predominant in Canadian and American literature as patients wanted to contribute but felt the decision should be a doctor’s responsibility. Advance directives were uncommon in Europe, and where they existed the implantable cardioverter defibrillator was not mentioned. (3) ‘Living in the now’ was evident as despite deteriorating symptoms many patients maintained a positive outlook and anticipated surviving more than 10 years. Several studies asserted living longer was more important than quality of life.

Conclusion:

Patients regard the implantable cardioverter defibrillator as a complex and solely beneficial device, with little insight regarding its potential impact on a peaceful death. This review confirms the need for professionals to discuss with patients and families implantable cardioverter defibrillator functionality and deactivation at appropriate opportunities.
Results of 10-year follow-up of the iliac donor site of graft patients
Authors: Qi Liqing , Liu Yueju , Li Han , Zhang Yingze
Published: September 2014

Objectives

To measure levels of pain and iliac regeneration at the iliac crest donor site during a 10-year follow-up of graft patients.

Methods

This prospective study used a visual analogue scale (VAS) to assess pain at the donor site at 1 month and 1, 3, 5 and 10 years postoperatively. Iliac regeneration status was recorded at 1, 3, 5, 7 and 10 years postoperatively by comparing plain radiographs.

Results

A total of 32 patients participated in the study. Mean VAS scores at 1 month, 1 year, 3, 5, and 10 years were 3.22, 3.39, 3.45, 2.02 and 1.38, respectively. There was no statistically significant difference between pain scores at 1 month and 1 year, but pairwise comparisons revealed significant differences between the other timepoints. The mean iliac regeneration rank scores at 1, 3, 5, 7 and 10 years were 1.36, 2.22, 2.97, 3.75 and 4.70, respectively; all pairwise comparisons were statistically significant.

Conclusion

The iliac donor site showed a declining trend in pain, which appeared to have started 3 years postoperatively. Long-term follow-up showed that the ilium is readily able to repair itself.
Biomechanical Evaluation of a Transtibial Pull-out Meniscal Root Repair
Authors: Cerminara Anthony J. , LaPrade Christopher M. , Smith Sean D. , Ellman Michael B. , Wijdicks Coen A. , LaPrade Robert F.
Published: September 2014

Background:

A common treatment for posterior meniscal root tears is transtibial pull-out repair, which has been biomechanically reported to restore tibiofemoral contact mechanics to those of the intact knee. Biomechanical data suggest that there is significant displacement of the repaired meniscal root with cyclic loading, which may be responsible for the poor healing and meniscal extrusion demonstrated in some clinical studies.

Hypothesis/Purpose:

The purpose of this study was to quantify the time-zero displacement of the posterior meniscal root in response to cyclic loading after transtibial pull-out repair and to quantify the individual contributions to displacement of the following: (1) suture elongation, (2) button-bone interface, and (3) meniscus-suture interface. The meniscus-suture interface was hypothesized to result in significantly more displacement than the button-bone interface or suture elongation.

Study Design:

Descriptive laboratory study.

Methods:

Transtibial pull-out repair of the posterior medial meniscal root was performed in 6 porcine knees, and cyclic displacement was measured using a loading protocol representative of postoperative rehabilitation. Displacement from (1) suture elongation, (2) the button-bone interface, and (3) the meniscus-suture interface was determined by cyclically loading 6 specimens for each construct using the same loading protocol to determine the contribution of each component to the overall displacement of the repair construct.

Results:

After 1000 cycles, the repair construct displaced by a mean of 3.28 mm (95% CI, 2.07-4.49). The meniscus-suture component (mean, 2.52 mm; 95% CI, 2.21-2.83) displaced significantly more than the button-bone component (mean, 0.90 mm; 95% CI, 0.64-1.15; P = .006) and suture elongation component (mean, 0.71 mm; 95% CI, 0.36-1.06; P = .006) after 1000 cycles. Displacement of the button-bone and suture elongation components was not significantly different after 1000 cycles ( P = .720).

Conclusion:

There was substantial displacement of the posterior medial meniscal root repaired with the transtibial pull-out technique under a cyclic loading protocol simulating postoperative rehabilitation. The meniscus-suture interface contributed to significantly more displacement than the button-bone interface and suture elongation in the transtibial pull-out repair construct.

Clinical Relevance:

The results provide a framework for optimizing the transtibial pull-out repair technique. Future studies should focus on improving suture fixation strength within the meniscus-suture interface.
Local Application of Strontium in a Calcium Phosphate Cement System Accelerates Healing of Soft Tissue Tendon Grafts in Anterior Cruciate Ligament Reconstruction
Authors: Kuang Guan-Ming , Yau W.P. , Lu William W. , Chiu K.Y.
Published: September 2014

Background:

Healing of soft tissue tendon grafts within the bone tunnel in anterior cruciate ligament (ACL) reconstruction is known to be slower than that of bone–patellar tendon–bone grafts. There are attempts to accelerate healing of the graft within the bone tunnel. One of the methods is the use of strontium-enriched calcium phosphate cement (Sr-CPC). Early results in animal studies have been encouraging, although it is not known whether the accelerated healing was solely caused by the effect of strontium within the cement or by the calcium phosphate cement (CPC) itself.

Hypothesis:

There would be differences between Sr-CPC and conventional CPC in terms of the effect on healing of soft tissue tendon grafts within the bone tunnels in ACL reconstruction.

Study Design:

Controlled laboratory study.

Methods:

A total of 30 single-bundle ACL reconstruction procedures were performed in 15 rabbits with the use of an Achilles tendon allograft. The graft on the left limb was coated with Sr-CPC, while that on the right limb was coated with CPC. Three animals each were sacrificed for histological and histomorphometric analyses at 3, 6, 9, 12, and 24 weeks after surgery.

Results:

In the Sr-CPC group, early formation of Sharpey fibers was present at 6 weeks after surgery, while early remodeling of a graft-fibrocartilage-bone junction was noted at 12 weeks. In the CPC group, early formation of Sharpey fibers was only found at 9 to 12 weeks after surgery. At 24 weeks, a direct enthesis was found in both groups. According to the histomorphometric score, graft healing in the Sr-CPC group took place 3 weeks faster than that in the CPC group at and before 12 weeks; however, there was no difference between the groups at 24 weeks.

Conclusion:

The local application of strontium in a CPC system leads to accelerated graft healing within the bone tunnels.

Clinical Relevance:

The use of Sr-CPC to enhance graft-bone healing may improve the clinical results of ACL reconstruction using soft tissue tendon grafts.
“Anatomic” Single-Bundle Anterior Cruciate Ligament Reconstruction Reduces Both Anterior Translation and Internal Rotation During the Pivot Shift
Authors: Porter Mark D. , Shadbolt Bruce
Published: September 2014

Background:

The ability of single-bundle anterior cruciate ligament (ACL) reconstruction to restore rotational control has been questioned by proponents of the double-bundle technique. The term anatomic positioning has become popularized in recognition of the incorrect positioning sometimes used in the past, which may have contributed to the lack of rotation control. The pivot-shift test remains the most clinically useful measure of ACL deficiency, and it is now possible to measure it both accurately and objectively using computer navigation.

Hypothesis:

Single-bundle ACL reconstruction will reduce anterior translation and internal rotation of the tibia during the pivot-shift test when compared with the contralateral uninjured knee.

Study Design:

Descriptive laboratory study.

Methods:

A total of 20 patients with an acute isolated ACL rupture underwent reconstruction with a single-bundle autologous hamstring graft. Computer navigation was used intraoperatively to plot the pivot shift before and after reconstruction. The opposite uninjured knee was used as a control. Statistical analysis was used to compare the pivot shifts before and after surgery.

Results:

Single-bundle ACL reconstruction produced a significant reduction in anterior translation, from a mean ± SD of 17.4 ± 3.80 mm to 6.4 ± 1.95 mm ( P < .001), as well as in internal rotation, from 22.9° ± 5.91° to 7.5° ± 2.96° ( P < .001). The anterior translation in the reconstructed knees was similar to the control knees, 6.4 ± 1.95 mm versus 5.6 ± 1.23 mm ( P < .148), while the internal rotation was significantly less in the reconstructed knees, 7.5° ± 2.96° versus 11.9° ± 3.36° ( P < .05). The values for the coupled movements were used to calculate the length of the radius of curvature, about which the tibia rotates relative to the femur, during the pivot shift. In the control knees, the mean value was 28.9 ± 8.21 mm, while there was extreme variability in the operated knee both before and after surgery.

Conclusion:

It is possible to reduce both anterior translation and internal rotation, which occur during the pivot-shift test in the ACL-deficient knee, using single-bundle ACL reconstruction, when measured at the time of surgery. However, normal motion is not fully restored.
Using Virtual Manipulative Instruction to Teach the Concepts of Area and Perimeter to Secondary Students With Learning Disabilities
Authors: Satsangi Rajiv , Bouck Emily C.
Published: September 2014

Secondary students with a learning disability in mathematics often struggle with the academic demands presented in advanced mathematics courses, such as algebra and geometry. With greater emphasis placed on problem solving and higher level thinking skills in these subject areas, students with a learning disability in mathematics often fail to keep pace with their general education peers. This study sought to address the lack of existing empirical research targeting viable interventions for learning the concepts of area and perimeter for secondary students with a learning disability in mathematics. Through the use of a multiple baseline design across three participants, virtual manipulatives were found to be an effective tool to acquire, maintain, and generalize the concepts of area and perimeter. Results from this study provide new evidence showing virtual manipulatives to be a viable and accessible technology to teach students with learning disabilities advanced mathematical concepts.
Black Feminisms
Authors: Jones Lani V.
Published: September 2014

Issues in mental health treatment for black women are multiplicative, significant, and often controversial. As black women increasingly seek professional mental health services, it is imperative that social work practitioners utilize strategies that are based on culturally congruent mental health paradigms that illuminate their strengths and recognize the deficits in the environment. Black feminist therapy has been identified as one such method. Black feminist therapy can mark a beacon in mental health practice, theory, and inform a political movement in the combating of their complex and multiplicative oppressions. This column serves as a call to action to the profession.
The Effect of Cognitive Speed of Processing Training on the Development of Additional IADL Difficulties and the Reduction of Depressive Symptoms
Authors: Wolinsky Fredric D. , Vander Weg Mark W. , Howren M. Bryant , Jones Michael P. , Dotson Megan M.
Published: September 2014

Objective: We evaluated the effects of cognitive speed of processing training (SOPT) on the development of additional Instrumental Activities of Daily Living (IADL) difficulties and the reduction of depressive symptoms in the Iowa Healthy and Active Minds Study (IHAMS). Method: Six hundred eighty-one patients were randomized to 4 groups: 10 hr of on-site SOPT, 10 hr of on-site SOPT plus 4 hr of boosters, 10 hr of at-home SOPT, or 10 hr of on-site attention-control (crossword puzzles). Developing additional difficulties with IADLs and reductions in depressive symptoms 1 year later were evaluated using multiple logistic regression. Results: The on-site SOPT with boosters group had reduced odds of developing additional difficulties with IADLs (adjusted odds ratio [AOR] = 0.45, p = .044) compared with attention-controls. The on-site SOPT with boosters group also had increased odds of reduced depressive symptom levels (AOR = 2.93, p = .003) compared with attention-controls. Discussion: These findings provide evidence that SOPT transfers beyond the cognitive skills trained to meaningful downstream improvements in the lives of middle-aged and older adults.
Memory Banking
Authors: Zanjani Faika , Downer Brian G. , Hosier Amy F. , Watkins John D.
Published: September 2014

Objective: The aim of this study is to examine the feasibility of Memory Banking (MB), a life story development intervention within the context of aging preparation. Individuals participate in MB to strategically document and share their life story, including mapping out future dreams, aspirations, plans, and decisions. Method: Data (2010-2012) from eight MB workshops were examined to determine the impact of the intervention on mental health, social support, and quality of life. Results: Recruitment efforts resulted in n = 72 participants, primarily female (72%), White/Caucasian (93%), average age of 70 years. Data indicated intervention effects showing improvements in depression ( p = .041), mood disturbance ( p = .0067), and cognitive performance ( p = .0045). Discussion: MB outcomes indicate that the intervention is promising and supports continued investigation and development in the area of life story development for aging preparation and improving late life mental health distress in a community setting. Future research is needed to examine the versatility and long-term effects of the MB intervention.
Antiphospholipid (Hughes) syndrome: description of population and health-related quality of life (HRQoL) using the SF-36
Authors: Georgopoulou S , Efraimidou S , MacLennan S J , Ibrahim F , Cox T
Published: September 2014

Objective

Antiphospholipid (Hughes) syndrome (APS) affects mainly women 15 to 50 years of age and is responsible for approximately 20% of strokes in people <40 years. Little is known about the psychological burden of this long-term condition. We investigated HRQoL in APS.

Methods

We conducted a cross-sectional survey involving 270 members of the Hughes Syndrome Foundation worldwide. Data included HRQoL (SF-36), demographics, and APS-related self-reported major issues. Response rate was 60%.

Results

T-tests indicated significantly worse mean scores for seven of the eight domains of the SF-36 in secondary antiphospholipid syndrome (SAPS) compared to primary antiphospholipid syndrome (PAPS), e.g. bodily pain t(263) = 6.10 p < 0.001 except for mental health t(267) = 1.95 p = 0.053. PAPS appeared to be associated with poorer HRQoL in most mental health domains but overall better physical domains compared to systemic lupus erythematosus (SLE) alone. SAPS appeared to have a more adverse impact on HRQoL compared to PAPS and SLE. Major issues identified: pain and fatigue, lack of health care professional/public awareness, and medication unpredictability.

Conclusion

HRQoL in PAPS appears to be generally better than SLE and SAPS in physical domains, but poorer in mental domains. APS patients might need more social support in terms of information and awareness of the condition to improve their coping strategies.
Belonging to Law
Authors: Berger Benjamin L
Published: September 2014

This article examines the appeal to law as the basis for civic identity and political belonging under conditions of religious diversity. Beginning by assessing the descriptive utility of the concept of ‘secularism’, the article argues that secularism is best approached as a repertoire of moves available in negotiating the relationship between religion and political authority, focusing then on one such move evident in the contemporary project of liberal secularism: the assertion, in the face of the challenges posed by religious diversity, that to belong to the political community means, above all else, to belong to law. This shift of ‘obedience to the law’ to the diagnostic center of civic belonging is explored by turning to two case studies drawn from the legal encounter with Islam in Canada: the debate over official recognition of Sharia law and controversies surrounding the niqab. Having assessed the implications that this move has for the understanding and management of religious difference, the article explains the attractiveness of this symbolic appeal to law – whereby law begins to stand as a kind of synecdoche for the secular state – and assesses the effect of this alignment of law and belonging on the politics of religious diversity.