bluuebunny/crossref_metadata_2025 huggingface dataset:
The Nexus Between Health Literacy and Empowerment
Authors: Crondahl Kristine , Eklund Karlsson Leena
Published: May 2016

The aim of this article was to explore what is known about the assumed connection between health literacy and empowerment and how this connection is portrayed in the scientific literature. If empowerment is an outcome of health literacy, what are the mechanisms behind this process? A literature search conducted in 2013 yielded 216 hits, of which five met the inclusion criteria, and thus were read in depth and analyzed through a narrative-review approach. The findings indicate that health literacy might be regarded as a tool for empowerment but does not automatically lead to empowerment. Health literacy might be increased by health education. Crucial for empowerment is to achieve the critical level of health literacy including an ability to question and reflect on the prevailing power relations and societal conditions; increased senses of power, self-esteem, and self-efficacy; and an ability to utilize these resources to engage in social and political action for change. This article suggests that for health literacy to be critical to empowerment, there must be a focus on social health determinants and individuals’ subjective perceptions of health and health needs. The article proposes functional and interactive health literacy as a form of capacity building for health and empowerment and critical health literacy as a way to describe empowerment. This scoping review indicates a research gap and a need for future research examining the relationship between health literacy and empowerment.
Expecting Immediate Grades
Authors: Zhao Qin , Redifer Jenni
Published: May 2016

Two experiments were conducted to investigate the effects of expecting immediate grades on numerical and verbal reasoning performance and the moderating role of achievement goals. Anticipated grade proximity (immediate vs. 1 week later) and goal orientation (approach vs. avoidance) were manipulated with instructions. Experiment 1 showed that expecting immediate grades yielded lower numerical performance than expecting delayed feedback, regardless of participants’ goal orientation. Neither grade proximity nor goal orientation impacted verbal performance. In Experiment 2, we used a stronger goal manipulation and included measures of motivation. Expecting immediate grades increased task anxiety, lowered task involvement, and lowered task effort among participants with avoidance goals, compared with expecting delayed grades. The effects on performance were not replicated in Experiment 2, however. The findings demonstrate that expecting immediate grades may have negative consequences under certain conditions, including demotivation and performance impairment.
Reshaping Bengal’s Health Care: Exploring Its Prospects and Challenges
Authors: Gomes Shubhro Michael , Pareek Sushil Kumar
Published: May 2016

Tourism is one of the basic desires of every human being for experience, education, and entertainment. It is also one of the important areas in the tertiary sector of India. Health care is a subsector under tourism. Health care tourism sector has gained enormous response throughout the world and in India, especially during this post-globalization phase. It is so primarily because of its association with the inflow of foreign exchange through foreign tourist arrival, and foreign direct investment and its impact on the economy—sociocultural, economic, politico-legal, etc. The contribution of domestic tourist also cannot be ignored.

The article is aimed to create awareness among various stakeholders of health care tourism in West Bengal and at the same time create more enthusiasm toward the subsector. The article also puts forward some specific recommendations to make the West Bengal health care sector more viable, vibrant, and sustainable.
Book Review: Sushil Chaudhury, Companies, Commerce and Merchants: Bengal in the Pre-colonial Era
Authors: Habib Irfan
Published: May 2016

Sushil Chaudhury, Companies, Commerce and Merchants: Bengal in the Pre-colonial Era (New Delhi: Monohar), 2015, pp. 433, ₹1495 (Hardback).
AVO inversion in exploration — Key learnings from a Norwegian Sea prospect
Authors: Avseth Per , Janke Andre , Horn Frederik
Published: May 2016

AVO inversion of prestack seismic data, constrained by geologic knowledge and rock-physics modeling, is an essential technology that can greatly reduce interpretation risk during exploration. However, in spite of its great potentials, this technology suffers from a wide range of pitfalls and many uncertainties. In this study, we demonstrate the use of simultaneous AVO inversion in an area of the Norwegian Sea where several proven discoveries with strong AVO anomalies are present, all of which are structural traps. The inversion successfully delineated these discoveries, and a pure blind test of a prospect on a structural high correctly predicted the presence of hydrocarbons. The AVO inversion also gave support for a stratigraphic trap in a graben setting between the prolific structural highs. However, this prospect turned out to be a failure, as the observed AVO anomaly was false. Postdrill analysis showed that a thin, very hard, calcareous event right above the target had created a refraction that interfered with the target horizon below, creating a false AVO class II to III anomaly. The target interval was predominantly a very soft, thick, and immature organic-rich shale, which normally should show a class IV AVO anomaly. Moreover, the low-frequency model used in the inversion was derived from wells on structural highs combined with interval velocities and turned out to not be representative in the graben areas. The key learnings from this study are not to use angle ranges exceeding about 40° during AVO inversion in this area and, in general, to be careful extrapolating the low-frequency model away from well control, even when interval velocities are used, especially in areas with complex geology. More integration between geology and geophysics is necessary during all steps of the AVO inversion to avoid such pitfalls.
Practising evidence-based medicine in an era of high placebo
response: number needed to treat reconsidered
Authors: Roose Steven P. , Rutherford Bret R. , Wall Melanie M. , Thase Michael E.
Published: May 2016

The number needed to treat (NNT) statistic was developed to facilitate the
practice of evidence-based medicine. Placebo was assumed to be
therapeutically inert when the NNT was originally conceived, but more recent
data for conditions such as major depressive disorder (MDD) suggest that the
placebo control condition can have considerable therapeutic effects.
Complications arise because the NNT calculated from randomised controlled
trials (RCTs) reflects a comparison between medication plus clinical
management and placebo plus clinical management, whereas, in the clinical
setting, physicians choose between prescribing open medication, observing a
patient over time with a supportive approach, and doing nothing. Thus, NNTs
derived from clinical trials are not directly relevant to clinical
decision-making, because they are based on control conditions that do not
exist in standard practice. Additional difficulties may arise when using
NNTs to compare alternative treatments for MDD, such as medication and
psychotherapy, since these comparisons require the control conditions upon
which the respective NNTs are based to be similar. Whereas pill placebo
conditions include intensive clinical management and elicit expectations of
improvement, attention control conditions for psychotherapy research are
less well developed. Often the effects of psychotherapy are gauged against a
wait-list control condition, which has substantially fewer therapeutic
components than a pill placebo control condition. To improve the clinical
utility of NNTs for the treatment of MDD, we advocate effectiveness studies
that include treatment conditions resembling actual clinical practice,
rather than using placebo-controlled RCTs for this purpose. Until such
studies are performed, the effect of bias in comparing NNTs across
treatments can be controlled by ensuring that the RCT control conditions
upon which the NNTs are based are comparable.
Asialoglycoprotein receptor 1 is a specific cell-surface marker for isolating hepatocytes derived from human pluripotent stem cells
Authors: Peters Derek T. , Henderson Christopher A. , Warren Curtis R. , Friesen Max , Xia Fang , Becker Caroline E. , Musunuru Kiran , Cowan Chad A.
Published: May 2016

Hepatocyte-like cells (HLCs) are derived from human pluripotent stem cells (hPSCs) in vitro, but differentiation protocols commonly give rise to a heterogeneous mixture of cells. This variability confounds the evaluation of in vitro functional assays performed using HLCs. Increased differentiation efficiency and more accurate approximation of the in vivo hepatocyte gene expression profile would improve the utility of hPSCs. Towards this goal, we demonstrate the purification of a subpopulation of functional HLCs using the hepatocyte surface marker asialoglycoprotein receptor 1 (ASGR1). We analyzed the expression profile of ASGR1-positive cells by microarray, and tested their ability to perform mature hepatocyte functions (albumin and urea secretion, cytochrome activity). By these measures, ASGR1-positive HLCs are enriched for the gene expression profile and functional characteristics of primary hepatocytes compared with unsorted HLCs. We have demonstrated that ASGR1-positive sorting isolates a functional subpopulation of HLCs from among the heterogeneous cellular population produced by directed differentiation.
Heartbreak hotel: a convergence in cardiac regeneration
Authors: Schneider Michael D.
Published: May 2016

In February 2016, The Company of Biologists hosted an intimate gathering of leading international researchers at the forefront of experimental cardiovascular regeneration, with its emphasis on ‘Transdifferentiation and Tissue Plasticity in Cardiovascular Rejuvenation’. As I review here, participants at the workshop revealed how understanding cardiac growth and lineage decisions at their most fundamental level has transformed the strategies in hand that presently energize the prospects for human heart repair.
Visualizing Asymmetric Competition Among More Than 1,000 Products Using Big Search Data
Authors: Ringel Daniel M. , Skiera Bernd
Published: May 2016

In large markets comprising hundreds of products, comprehensive visualization of competitive market structures can be cumbersome and complex. Yet, as we show empirically, reduction of the analysis to smaller representative product sets can obscure important information. Herein we use big search data from a product- and price-comparison site to derive consideration sets of consumers that reflect competition between products. We integrate these data into a new modeling and two-dimensional mapping approach that enables the user to visualize asymmetric competition in large markets (>1,000 products) and to identify distinct submarkets. An empirical application to the LED-TV market, comprising 1,124 products and 56 brands, leads to valid and useful insights and shows that our method outperforms traditional models such as multidimensional scaling. Likewise, we demonstrate that big search data from product- and price-comparison sites provide higher external validity than search data from Google and Amazon.

Data, as supplemental material, are available at http://dx.doi.org/10.1287/mksc.2015.0950 .
Monetizing Ratings Data for Product Research
Authors: Hardt Nino , Varbanov Alex , Allenby Greg M.
Published: May 2016

Features involving the taste, smell, touch, and sight of products, as well as attributes such as safety and confidence, are not easily measured in product research without respondents actually experiencing them. Moreover, product researchers often evaluate a large number of these attributes (e.g., >50) in applied studies, making standard valuation techniques such as conjoint analysis difficult to implement. Product researchers instead rely on ratings data to assess features for which the respondent has had actual experience. In this paper we develop a method of monetizing rating data to standardize product evaluations among respondents. The adjusted data are shown to increase the accuracy of purchase predictions by about 20% relative to existing methods of scale adjustment, leading to better inference in models using ratings data. We demonstrate our method using data from a large scale product use study by a packaged goods manufacturer.

Data, as supplemental material, are available at http://dx.doi.org/10.1287/mksc.2016.0980 .
Experimental Designs and Estimation for Online Display Advertising Attribution in Marketplaces
Authors: Barajas Joel , Akella Ram , Holtan Marius , Flores Aaron
Published: May 2016

Online Display Advertising’s importance as a marketing channel is partially due to its ability to attribute conversions to campaigns. Current industry practice to measure ad effectiveness is to run randomized experiments using placebo ads, assuming external validity for future exposures. We identify two different effects, i.e., a strategic effect of the campaign presence in marketplaces, and a selection effect due to user targeting; these are confounded in current practices. We propose two novel randomized designs to: (1) estimate the overall campaign attribution without placebo ads, (2) disaggregate the campaign presence and ad effects. Using the Potential Outcomes Causal Model, we address the selection effect by estimating the probability of selecting influenceable users. We show the ex-ante value of continuing evaluation to enhance the user selection for ad exposure mid-flight. We analyze two performance-based (CPA) and one Cost-Per-Impression (CPM) campaigns with 20 million users each. We estimate a negative CPM campaign presence effect due to cross product spillovers. Experimental evidence suggests that CPA campaigns incentivize selection of converting users regardless of the ad, up to 96% more than CPM campaigns, thus challenging the standard practice of targeting most likely converting users.

Data, as supplemental material, are available at http://dx.doi.org/10.1287/mksc.2016.0982 .
Student midwives' perspectives on efficacy of feedback after objective structured clinical examination
Authors: Killingley Jo , Dyson Sue
Published: May 2016

Students' experience of feedback is considered an indicator of the efficacy of the assessment process. Negative experiences of feedback are unproductive in terms of the likelihood that students will act on and learn from assessment. To understand the impact of feedback on learning, this study explored the experiences of student midwives after receiving feedback following objective structured clinical examination (OSCE). Data were collected from second-year undergraduate student midwives who had recently completed OSCE, via a focus group. Students reported raised stress levels, concerns around legitimacy of feedback, and inconsistencies in the manner in which feedback was articulated. Assessment feedback in higher education should be used to empower students to become self-regulated learners. This is important for student midwives, for whom a considerable amount of learning is spent in practice. The study has implications for midwifery academics concerned with modes of assessment and quality of assessment feedback in midwifery education.
Clinicians in the classroom: The consultant anaesthetist
Authors: Power Alison , Gupta Kalpna
Published: May 2016

In 2013–14, 166 081 babies born in England—accounting for 26.2% of all births in the country—were born by caesarean section ( Health and Social Care Information Centre (HSCIC), 2015 ). Epidural or caudal anaesthesia was required in 16.4% of births, while spinal anaesthetics were used in 15.1% of births ( HSCIC, 2015 ). Support from obstetric anaesthesia services is also required in obstetric emergencies such as postpartum haemorrhage and eclampsia. Modern maternity services require a multi-professional approach to providing high-quality care, and it is therefore important that pre-registration midwifery education prepares student midwives to work in such an environment. This is the fourth in a series of articles exploring the value of expert clinicians' participation in teaching pre-registration midwifery students in the classroom setting. This article will consider sessions at the University of Northampton facilitated by Dr Kalpna Gupta, consultant anaesthetist at Northampton General Hospital NHS Trust.
Eosinophilic granuloma complex in the cat
Authors: Paterson Sue
Published: May 2016

Eosinophilic granuloma complex (EGC) is a common feline dermatological reaction pattern that includes eosinophilic plaques, eosinophilic granulomas and indolent ulcers. Most cases are associated with allergy. Flea bite hypersensitivity is the most common trigger, followed by cutaneous adverse food reaction and atopic dermatitis. Investigations should include a thorough elimination of ectoparasites and the institution of a strict dietary exclusion trial before in vitro or in vivo allergy testing to identify environmental allergens. The most commonly used treatment options include antihistamines, glucocorticoids and ciclosporine. Allergen specific immunotherapy can be used in cats where EGC is caused by atopic dermatitis.
Parvoviruses in individuals and shelters
Authors: Stavisky Jenny
Published: May 2016

Parvoviruses cause common infectious diseases of dogs and cats. Challenging in individual patients, these diseases may be devastating in the shelter situation, due to the possibility of outbreaks occurring and the impact on shelter function. This article reviews the pathogenesis, treatment, prevention and management of canine parvovirus infection and feline panleukopenia in dogs and cats, with emphasis on the challenges of these infections in the shelter environment. Vaccination protocols are discussed with particular reference to shelters and other potentially high-challenge environments, and recommendations are provided for adaptations of traditional vaccination schedules according to patient risk.
Feline injection site sarcoma: current paradigms and future directions
Authors: Davidson Catherine , Lawrence Jessica
Published: May 2016

Feline injection site sarcoma (FISS) is an uncommon but important tumour in cats due to its locally aggressive biologic behaviour, poor prognosis and link to routinely-administered vaccinations, which raises ethical questions regarding vaccine practices. Post-vaccinal granulomas commonly occur in cats, therefore client education is vital and careful monitoring should be adopted. Incisional biopsy is recommended to confirm diagnosis of FISS, and full staging is recommended prior to determination of a treatment strategy. Tumour palpation has been shown to vastly underestimate the extent of tumour infiltration, therefore prospective treatment planning with advanced imaging is highly recommended. Although further studies are required to determine the most effective combination of treatment modalities for definitive treatment, a multi-modal approach is often required, based on expeditious and aggressive surgery in combination with radiotherapy ×/− chemotherapy. Importantly, early detection by careful post-vaccination monitoring as well as a shift in vaccination practices is key to improving the outcome of FISS.
Fatal pulmonary embolism following elective total hip arthroplasty
Authors: Bayley E. , Brown S. , Bhamber N. S. , Howard P. W.
Published: May 2016

Aims

The place of thromboprophylaxis in arthroplasty surgery remains controversial, with a challenging requirement to balance prevention of potentially fatal venous thrombo-embolism with minimising wound-related complications leading to deep infection. We compared the incidence of fatal pulmonary embolism in patients undergoing elective primary total hip arthroplasty (THA) between those receiving aspirin, warfarin and low molecular weight heparin (LMWH) for the chemical component of a multi-modal thromboprophylaxis regime.

Patients and Methods

A prospective audit database was used to identify patients who had died within 42 and 90 days of surgery respectively between April 2000 and December 2012. A case note review was performed to ascertain the causes of death.

Results

During this period 7983 THAs were performed. The rate of mortality was 0.43% and 0.58% at 42 and 90 days respectively. The groups comprised 1571 patients (19.7%) on warfarin, 1838 (23.0%) on LMWH and 4574 (57.3%) on aspirin. The 90-day mortality for these three groups was 0.38%, 1.09% and 0.43% respectively. The higher mortality rate for LMWH was significant (p < 0.05). There were six fatal pulmonary emboli (PEs) (0.08%). A total of three occurred within 42 days, all in the LMWH group. A total of three occurred between 42 and 90 days; one on warfarin, two on LMWH. The leading causes of death in all three groups were lower respiratory tract infections and myocardial infarction.

Conclusion

We confirmed that fatal PE following elective THA with a multi-modal prophylaxis regime is rare. We further found that LMWH conferred no benefit over aspirin in this context, and is associated with a higher all-cause rate of mortality. Take home message: This study proposes that aspirin may be an appropriate thromboprophylaxis agent when used as part of a multi-modal regimen, suggesting current guidelines should be reviewed. Cite this article: Bone Joint J 2016;98-B:585–8.
Closed intramedullary nailing with percutaneous cement augmentation for long bone metastases
Authors: Kim Y-i. , Kang H. G. , Kim J. H. , Kim S-k. , Lin P. P. , Kim H. S.
Published: May 2016

Aims

The purpose of the study was to investigate whether closed intramedullary (IM) nailing with percutaneous cement augmentation is better than conventional closed nailing at relieving pain and suppressing tumours in patients with metastases of the femur and humerus.

Patients and Methods

A total of 43 patients (27 men, 16 women, mean age 63.7 years, standard deviation (sd) 12.2; 21 to 84) underwent closed IM nailing with cement augmentation for long bone metastases. A further 27 patients, who underwent conventional closed IM nailing, served as controls. Pain was assessed using a visual analogue scale (VAS) score pre-operatively (pre-operative VAS), one week post-operatively (immediate post-operative VAS), and at six weeks post-operatively (follow-up post-operative VAS). Progression of the tumour was evaluated in subgroups of patients using F-18-fludeoxyglucose (F-18-FDG) positron emission tomography (PET)/computed tomography (CT) and/or bone scintigraphy (BS), at a mean of 8.8 and 7.2 months post-operatively, respectively.

Results

The mean pain scores of patients who underwent closed nailing with cement augmentation were significantly lower than those of the control patients post-operatively (immediate post-operative VAS: 3.8, sd 0.9 versus 6.0, sd 0.9; follow-up post-operative VAS: 3.3, sd 2.5 versus 6.6, sd 2.2; all p < 0.001). The progression of the metastasis was suppressed in 50% (10/20) of patients who underwent closed nailing with augmentation, but in only 8% (1/13) of those in the control group.

Conclusion

Percutaneous cement augmentation of closed IM nailing improves the relief of pain and limits the progression of the tumour in patients with metastases to the long bones. Take home message: Percutaneous cement augmentation while performing closed IM nailing has some advantages for long bone metastases. Cite this article: Bone Joint J 2016;98-B:703–9.
Corrosion at the head-neck interface of current designs of modular femoral components
Authors: Osman K. , Panagiotidou A. P. , Khan M. , Blunn G. , Haddad F. S.
Published: May 2016

There is increasing global awareness of adverse reactions to metal debris and elevated serum metal ion concentrations following the use of second generation metal-on-metal total hip arthroplasties. The high incidence of these complications can be largely attributed to corrosion at the head-neck interface. Severe corrosion of the taper is identified most commonly in association with larger diameter femoral heads. However, there is emerging evidence of varying levels of corrosion observed in retrieved components with smaller diameter femoral heads. This same mechanism of galvanic and mechanically-assisted crevice corrosion has been observed in metal-on-polyethylene and ceramic components, suggesting an inherent biomechanical problem with current designs of the head-neck interface.

We provide a review of the fundamental questions and answers clinicians and researchers must understand regarding corrosion of the taper, and its relevance to current orthopaedic practice.

Cite this article: Bone Joint J 2016;98-B:579–84.
Factors predictive of patient outcome following total wrist arthrodesis
Authors: Owen D. H. , Agius P. A. , Nair A. , Perriman D. M. , Smith P. N. , Roberts C. J.
Published: May 2016

Aims

Total wrist arthrodesis (TWA) produces a spectrum of outcomes. We investigated this by reviewing 77 consecutive TWA performed for inflammatory and post-traumatic arthropathies, wrist instability and as a salvage procedure.

Patients and Methods

All operations were performed by a single surgeon using a specifically designed pre-contoured dorsally applied non-locking wrist arthrodesis plate at a single centre.

Results

Median post-operative Buck-Gramcko Lohman (BGL), Disabilities of the Arm, Shoulder and Hand and Patient Rated Wrist Evaluation scores at six years (interquartile range (IQR) 3 to 11) were 9 (IQR = 6 to 10), 19 (IQR = 7 to 45) and 13 (IQR = 1 to 31) respectively. Polyarticular inflammatory arthritis and female gender were associated with poorer patient-reported outcomes, although the effect of gender was partly explained by higher rates of inflammatory disease among women. Return to work was negatively influenced by workers’ compensation and non-inflammatory wrist pathology. There was no difference in complication rates for inflammatory and non-inflammatory indications. Take home message: Polyarticular inflammatory arthritis is a risk factor for adverse patient-reported outcomes in TWA. Furthermore, when compared with patients without inflammatory arthritis, dorsally applied pre-contoured plates can be used for wrist arthrodesis in patients with inflammatory arthritis without an increased risk of complications. Cite this article: Bone Joint J 2016;98-B:647–53.
Vertebral column decancellation
Authors: Zhang X. , Zhang Z. , Wang J. , Lu M. , Hu W. , Wang Y. , Wang Y.
Published: May 2016

Aims

The aim of this study is to introduce and investigate the efficacy and feasibility of a new vertebral osteotomy technique, vertebral column decancellation (VCD), for rigid thoracolumbar kyphotic deformity (TLKD) secondary to ankylosing spondylitis (AS).

Patients and Methods

We took 39 patients from between January 2009 and January 2013 (26 male, 13 female, mean age 37.4 years, 28 to 54) with AS and a TLKD who underwent VCD (VCD group) and compared their outcome with 45 patients (31 male, 14 female, mean age 34.8 years, 23 to 47) with AS and TLKD, who underwent pedicle subtraction osteotomy (PSO group), according to the same selection criteria. The technique of VCD was performed at single vertebral level in the thoracolumbar region of AS patients according to classification of AS kyphotic deformity. Pre- and post-operative chin-brow vertical angle (CBVA), sagittal vertical axis (SVA) and sagittal Cobb angle in the thoracolumbar region were reviewed in the VCD and PSO groups. Intra- , post-operative and general complications were analysed in both group.

Results

lf patients could lie on their backs and walk with horizontal vision and sagittal profile, radiographic parameters improved significantly post-operatively in both groups. No major acute complications such as death or complete paralysis occurred in either group. In the VCD group, five patients (12.8%) experienced complications such as severe CSF leak (n = 4), deep wound infection (n = 1) and in one patient a transient neurological deficit occurred. In the PSO group, eight patients (17.8%) suffered conditions such as severe CSF leak (n = 5), infections (n = 2) and sagittal translation at osteotomy site (n = 1). Scoliosis Research Society outcomes instrument (SRS-22) improved significantly in both groups. All patients achieved solid fusion at latest follow-up and no implant failures were noted in either group. Take home message: The VCD technique is a new, safe and effective strategy for correction of rigid TLKD in AS patients. The main advantage of the new correction mechanism is that it achieved a satisfactory correction by controlled anterior column opening and posterior column closing, avoiding the occurrence of sagittal translation. Cite this article: Bone Joint J 2016;98-B:672–8.
Quantitative analysis of a spinal surgeon’s learning curve for scoliosis surgery
Authors: Ryu K. J. , Suh S. W. , Kim H. W. , Lee D. H. , Yoon Y. , Hwang J. H.
Published: May 2016

Aims

The aim of this study was a quantitative analysis of a surgeon’s learning curve for scoliosis surgery and the relationship between the surgeon’s experience and post-operative outcomes, which has not been previously well described.

Patients and Methods

We have investigated the operating time as a function of the number of patients to determine a specific pattern; we analysed factors affecting the operating time and compared intra- and post-operative outcomes. We analysed 47 consecutive patients undergoing scoliosis surgery performed by a single, non-trained scoliosis surgeon. Operating time was recorded for each of the four parts of the procedures: dissection, placement of pedicle screws, reduction of the deformity and wound closure.

Results

The median operating time was 310 minutes (interquartile range 277.5 to 432.5). The pattern showed a continuous decreasing trend in operating time until the patient number reached 23 to 25, after which it stabilised with fewer patient-dependent changes. The operating time was more affected by the patient number (r =- 0.75) than the number of levels fused (r = 0.59). Blood loss (p = 0.016) and length of stay in hospital (p = 0.012) were significantly less after the operating time stabilised. Post-operative functional outcome scores and the rate of complications showed no significant differences. Take home message: We describe a detailed learning curve for scoliosis surgery based on a single surgeon’s practise, providing useful information for novice scoliosis surgeons and for those responsible for training in spinal surgery. Cite this article: Bone Joint J 2016;98-B:679–85.
The use of continuous negative pressure after open debridement for septic arthritis of the shoulder
Authors: Jung H. J. , Song J. H. , Kekatpure A. L. , Adikrishna A. , Hong H. P. , Lee W. J. , Chun J. M. , Jeon I. H.
Published: May 2016

Aims

The treatment of septic arthritis of the shoulder is challenging. The infection frequently recurs and the clinical outcome can be very poor. We aimed to review the outcomes following the use of continuous negative pressure after open debridement with a large diameter drain in patients with septic arthritis of the shoulder.

Patients and Methods

A total of 68 consecutive patients with septic arthritis of the shoulder underwent arthrotomy, irrigation and debridement. A small diameter suction drain was placed in the glenohumeral joint and a large diameter drain was placed in the subacromial space with continuous negative pressure of 15 cm H2O. All patients received a standardised protocol of antibiotics for a mean of 5.1 weeks (two to 11.1).

Results

Negative pressure was maintained for a mean of 24 days (14 to 32). A total of 67 patients (98.5%) were cured without further treatment being required. At a mean follow-up of 14 months (three to 72), the mean forward flexion was 123° (80° to 140°) and the mean external rotation was 28°(10° to 40°) in those with a rotator cuff tear, and 125° (85° to 145°) and 35° (15° to 45°) in those without a rotator cuff tear.

Conclusion

Continuous negative pressure, following open arthrotomy, irrigation and debridement, was effective in treating septic arthritis of the shoulder. The rate of recurrence was significantly lower than with conventional treatment involving arthroscopic or open debridement reported in the literature. Functional outcomes, even in patients with rotator cuff tears, were excellent. Take home message: Continuous negative pressure is effective in treating septic arthritis of the shoulder. Cite this article: Bone Joint J 2016;98-B:660–5.
The epidemiology of fractures of the scaphoid
Authors: Garala K. , Taub N. A. , Dias J. J.
Published: May 2016

Aims

This study explores the epidemiology of patients with a fracture of the scaphoid presenting to a regional teaching hospital.

Patients and Methods

All patients with a confirmed fracture of the scaphoid over a retrospective period between January 2010 and May 2013 were included. Their demographics, deprivation status and when the fracture occurred was noted and assessed. There were 415 fractures in 365 males and 50 females.

Results

The incidence of fracture of the scaphoid was 12.4 in 100 000 each year in the general population. The mean age of the patients was 22 years (nine to 35); the highest incidence was in males aged between 15 and 19 years. We calculate the annual incidence in the United Kingdom to be 7265 each year. Patients with the lowest socioeconomic status had an incidence of 18.57 in 100 000 whereas the least deprived patients had an incidence of 9.98 (p < 0.001). There was evidence of a seasonal trend (p = 0.022) with the highest monthly rate found in June (16.96 in 100 000 each year) and the lowest was in December (7.61 in 100 000 each year). There were significantly fewer presentations of fracture at the weekend (p <  0.001), and the highest incidence was on Mondays. Most fractures occurred at the waist (64%) and tubercle (18.1%). Take home message: In this large-scale epidemiological study, we confirmed that young men are most at risk of sustaining a fracture of the scaphoid, and report new factors in relation to social deprivation and seasonality that influence scaphoid fractures. Cite this article: Bone Joint J 2016;98-B:654–9.
Efficiency and safety of ondansetron in preventing postanaesthesia shivering
Authors: He k , Zhao H , Zhou HC
Published: May 2016

Introduction

Shivering is one of the most frequent complications of operation during the postanaesthesia period. Ondansetron has been proved to be valid in preventing postanaesthesia shivering (PAS) in several studies. However, its efficiency and safety are still disputable. We therefore performed an updated meta-analysis of randomised controlled trials (RCTs) for evaluation and to clarify this issue.

Methods

A literature search using the PubMed, Embase™ and Cochrane Library databases was performed (from inception to January 2015). RCTs that evaluated the efficiency and safety of ondansetron in the prevention of PAS were included in the meta-analysis. The primary outcome measure was incidence of PAS, and secondary outcomes included subgroup analysis and the side effects of ondansetron.

Results

A total of 8 RCTs containing 905 subjects were identified as suitable for this review. Compared with placebo, ondansetron was associated with a significant reduction of PAS (relative risk [RR]: 0.33, 95% confidence interval [CI]: 0.19–0.58, p=0.0001) while no difference was detected between ondansetron and pethidine (RR: 0.89, 95% CI: 0.41–1.94, p=0.78). There was no significant difference between ondansetron and placebo or pethidine in terms of risk of bradycardia but ondansetron was associated with a lower risk of hypotension (RR: 0.26, 95% CI: 0.08–0.79, p=0.020) than placebo. There was no difference in hypotension when ondansetron was compared with pethidine.

Conclusions

Ondansetron can prevent PAS effectively and reduce the risk of hypotension.
First-line tracheal resection and primary anastomosis for postintubation tracheal stenosis
Authors: Elsayed H , Mostafa AM , Soliman S , Shoukry T , El-Nori AA , El-Bawab HY
Published: May 2016

Introduction

Tracheal stenosis following intubation is the most common indication for tracheal resection and reconstruction. Endoscopic dilation is almost always associated with recurrence. This study investigated first-line surgical resection and anastomosis performed in fit patients presenting with postintubation tracheal stenosis.

Methods

Between February 2011 and November 2014, a prospective study was performed involving patients who underwent first-line tracheal resection and primary anastomosis after presenting with postintubation tracheal stenosis.

Results

A total of 30 patients (20 male) were operated on. The median age was 23.5 years (range: 13–77 years). Seventeen patients (56.7%) had had previous endoscopic tracheal dilation, four (13.3%) had had tracheal stents inserted prior to surgery and one (3.3%) had undergone previous tracheal resection. Nineteen patients (63.3%) had had a tracheostomy. Eight patients (26.7%) had had no previous tracheal interventions. The median time of intubation in those developing tracheal stenosis was 20.5 days (range: 0–45 days). The median length of hospital stay was 10.5 days (range: 7–21 days). The success rate for anastomoses was 96.7% (29/30). One patient needed a permanent tracheostomy. The in-hospital mortality rate was 3.3%: 1 patient died from a chest infection 21 days after surgery. There was no mortality or morbidity in the group undergoing first-line surgery for de novo tracheal lesions.

Conclusions

First-line tracheal resection with primary anastomosis is a safe option for the treatment of tracheal stenosis following intubation and obviates the need for repeated dilations. Endoscopic dilation should be reserved for those patients with significant co-morbidities or as a temporary measure in non-equipped centres.
The impact of The Royal College of Surgeons of England research fellowship scheme
Authors: Shalhoub J , Cromwell D , Coomer M , Alderson D
Published: May 2016

Introduction

The research fellowship scheme for surgeons in training run by The Royal College of Surgeons of England (RCS) had its 20th anniversary in 2013. A survey was undertaken to assess outcomes of the scheme during those 20 years.

Methods

Fellowship recipients were invited to complete an online 20-item questionnaire about their fellowship research and research activities since its completion. The questionnaire covered type of research undertaken, higher research degree enrolment, publications resulting from the fellowship research and subsequent research career.

Results

Of the 502 RCS fellowship recipients, 361 responded (72%). Their research covered a broad array of topics, Almost two-thirds (62%) undertook laboratory-based research and most of the remainder conducted patient-based clinical research. The vast majority (96%) of respondents had enrolled for a higher degree, with a high completion rate: 91% of fellowship recipients in the first 15 years of the scheme obtained their degree. Of the fellowships from the first 15 years of the scheme, between a fifth and a third of recipients subsequently held an academic position. The median number of peer reviewed articles and presentations per recipient was 3 and 6 respectively. Almost two-thirds (60%) of respondents had obtained funding for further research, with over half of these receiving grants from national research funding bodies.

Conclusions

The RCS research fellowship scheme has helped trainee surgeons to undertake research towards the start of their career. Most trainees used RCS fellowships as part of their funding towards a higher degree and this was regularly achieved, along with a number of peer reviewed publications. A significant proportion of fellowship recipients progressed into academic positions in surgery.
Creating aesthetic, institutional and symbolic boundaries in fashion photo shoots
Authors: Van Der Laan Elise , Kuipers Giselinde
Published: May 2016

This study proposes a ‘bottom-up’, micro-sociological analysis of cultural production. Drawing on detailed observations of fashion photo shoots and interviews with fashion professionals in the Netherlands, we analyse how the division between ‘high’ (editorial) and ‘low’ (commercial) culture is produced in the fashion field. Our ethnographic analysis complements structuralist or institutionalist approaches like Bourdieu’s field theory, that assume an almost mechanical reproduction of field structure. Combining insights from existing ethnographies of fashion photography, with interaction ritual theory, and symbolic interactionism, we looked at a unique instance of cultural co-creation – the fashion photo shoot – to investigate how field structure and social practice come together in ‘doing aesthetics’. A step-by-step analysis of the ‘ingredients’ of a photo shoot, from finance, props and set to the model’s poses and the photographer’s style shows how the symbolically charged boundary between high and low fashion is made in concrete, embodied interactions, where it manifests itself simultaneously as institutional divide, aesthetic system and symbolic boundary. People producing fashion images experience structures and institutions as practical, aesthetic or institutional constraints and routines that provide both a conceptual framework and room for negotiation. Thus, during aesthetic interactions, people reproduce and produce boundaries, standards and conventions.
Performative fashion discourse: Vogue Paris and Elsa Schiaparelli
Authors: Papalas Marylaura
Published: May 2016

What happens when fashion design is converted into language? Roland Barthes’s thought-provoking question, from his 1967 influential book on the significance of language in fashion magazines, entitled Système de la Mode, frames this inquiry. Looking at the representations of Schiaparelli designs in Vogue Paris between 1936 and 1938, when the designer collaborated most with surrealist artists, this study traces the process whereby the French magazine appropriates Surrealism in order to present a restrained vision of experimental design. Contrary to the revolutionary message of Schiaparelli’s original creations, Vogue’s renditions of them are familiar and glamorous, generating a narrow ideological discourse that redefines Surrealism as a consumable product.
Long live the (im)material: Concept and materiality in Viktor&Rolf’s fashion
Authors: Bruggeman Danielle , Van de Peer Aurélie
Published: May 2016

This article seeks to challenge the way in which journalistic and academic discourses on the conceptual fashion of Dutch designers Viktor&Rolf privilege ideas over the materiality of fashion. Whereas Viktor&Rolf have been considered predominantly as late-twentieth-century conceptual designers, we aim to offer an alternative reading of Viktor&Rolf’s fashion practices. Through a detailed visual analysis of renowned Viktor&Rolf collections, Russian Doll (Autumn/Winter 1999–2000) and Glamour Factory (Autumn/Winter 2010–11), and a discourse analysis of the reception of these collections in the international fashion press, we propose to rethink their conceptual approach through a material lens. Reflecting on the dominant discourse of the conceptual in the field of fashion studies, we develop an argument on the inextricable entanglement of concept and materiality in terms of a material-discursive ‘intra-action’ (Barad 1996, 2003; Parkins 2008). Instead of viewing the materiality of fashion as a blank slate awaiting signification, we offer a reconceptualization of how the meanings, signs, values, concepts and ideas of fashion objects, and their material expression, are mutually constituted. By doing so, we provide a fresh perspective on the ways in which Viktor&Rolf’s work can be understood as an intimate encounter between concept and materiality.
One Tool Amongst Many: Considering the Political Potential of Neighbourhood Planning for the Greater Carpenters Neighbourhood, London
Authors: Sagoe Cecil
Published: May 2016

Currently within English planning literature there are polarizing debates about whether neighbourhood planning represents a politically useful tool for communities to utilize to challenge and shape top-down government development plans for their neighbourhood. One side of the debate optimistically presents neighbourhood planning as a radical and exciting opportunity for communities who wish to shape development plans for their locality. On the other side of the debate neighbourhood planning is denounced as a post-political governance technology which does not enable communities to meaningfully challenge and shape government development plans for their neighbourhood. This paper will engage with these competing perspectives whilst exploring how the Greater Carpenters Neighbourhood Forum (GCNF) are using neighbourhood planning to try and protect housing on the Carpenters Estate, a council estate in Stratford, east London.

This paper begins by providing a brief introduction to community participation in planning in England. Subsequently, this paper discusses benefits and challenges communities face engaging with formal planning mechanisms before specifically exploring perspectives on the challenges of using neighbourhood planning to realize their development aspirations for their neighbourhood. Drawing from interviews, planning document analysis, and ethnographic research carried out over the last year this paper then reflects on how neighbourhood planning is being deployed by the GCNF within a wider repertoire of community activities aimed at ensuring the protection and refurbishment of housing on the Carpenters Estate. Throughout this paper there will be reflection on whether participation in state planning processes represents a politically effective way for communities to shape development plans and outcomes for their neighbourhood. It will be argued that the political potential of neighbourhood planning for communities may be unlocked when it is pursued strategically in concert with a range of other actions aimed at challenging and shaping state development plans for a community’s neighbourhood.
Pattern of occlusal contacts in intercuspal position of natural teeth
Authors: Imran Tanzeela , Ahmed Naseer , Nazeer Bushra
Published: May 2016

The purpose of this study was to determine the patterns of occlusal contacts and location in intercuspal position of natural teeth.A cross-sectional study was conducted with a sample size of around seventy patients within a span of seven months, complete mouth impressions were made of each patient with hydrocolloid material and the impressions were poured in dental stone. The contact areas of the teeth in the maximum intercuspation position were determined by wax. Three distinct types of indentations were noted on the wax interocclusal record. Then similarly the centric occlusion contacts of the teeth on the cast were determined by interposing a new piece of wax, approximating the casts in the maximum intercuspation position by hand, and applying pressure. The oral and cast wax recordings were then compared. The occlusal relation for each individual tooth was then classified and recorded in a Performa.Following wax interocclusal record of natural teeth in intercuspation an ideal occlusion was absent, a difference in morphology of anterior and posterior teeth was also evident that inevitably affects the nature of occlusal contacts.The ideal occlusion was not found in any of the patientâ€™s investigation.