bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Proximal Fifth Metatarsal Fractures and Refractures With Plantar Plating in Elite Athletes
Authors: Bernstein Derek T. , Mitchell Ronald J. , McCulloch Patrick C. , Harris Joshua D. , Varner Kevin E.
Published: August 2018

Background:

Fractures of the proximal fifth metatarsal are relatively common foot injuries in elite athletes. Acute fixation with intramedullary screws is the most common operative treatment. However, the rate of nonunion and refracture after this procedure remains a concern. The purpose of this study was to determine rates of clinical and radiographic fracture healing, return to sport, and patient-reported clinical outcomes of elite athletes with proximal fifth metatarsal fracture or refracture treated with plantar plating.

Methods:

An institutional review board–approved retrospective single-surgeon case series investigation assessed athletes (competing at college, Olympic, or professional levels) with proximal fifth metatarsal fracture or refracture, treated with open reduction internal fixation and calcaneal autogenous bone grafting using a plantar plate with a minimum 2-year follow-up. Demographic data, radiographic evaluation, and the time until return to unrestricted sporting competition were collected and analyzed. Means with standard deviations were calculated for continuous data, and frequencies of categorical data were calculated in percentages.

Results:

Four refractures and 4 primary fractures were treated in 8 male athletes with a mean age of 21.9 ± 1.9 years at a mean follow-up of 3.2 ± 0.4 years. Two patients experienced temporary neuropraxia of the sural nerve that resolved within 6 weeks. There were no incisional complications, delayed unions or nonunions, refractures, hardware loosening, or complaints of hardware prominence. Clinically asymptomatic radiographic union was observed in 100% of the athletes at 6.5 ± 1.1 weeks and full release given at 12.3 ± 1.9 weeks. All athletes returned to sport at the same level of competition.

Conclusion:

With minimum 2-year follow-up, plantar plating of proximal fifth metatarsal fractures was an effective and safe technique that was used in both primary and revision settings.

Level of Evidence:

Level IV, case series.
Alcohol Use, Mental Health Disability, and Violence Victimization in College Women: Exploring Connections
Authors: Bonomi Amy , Nichols Emily , Kammes Rebecca , Chugani Carla D. , De Genna Natacha M. , Jones Kelley , Miller Elizabeth
Published: August 2018

The present study is an analysis of in-depth interviews with college women reporting a mental health disability and at least one experience of intimate partner violence (IPV) or sexual violence (SV) to elucidate how alcohol use is associated with both violence victimization and mental health symptoms. Our findings underscore salient alcohol-related themes in college women with histories of IPV/SV and mental health disability: alcohol use in their family of origin and/or with intimate partners, partying and heavy drinking as a normal college social context, abusive partners and SV perpetrators using alcohol as a mechanism for control and targeted rape, and worsening mental health symptoms after violence exposure, which prompted alcohol use to cope and was associated with vulnerability to more violence.
Men Who Sexually Assault Drinking Women: Similarities and Differences With Men Who Sexually Assault Sober Women and Nonperpetrators
Authors: Pegram Sheri E. , Abbey Antonia , Helmers Breanne R. , Benbouriche Massil , Jilani Zunaira , Woerner Jacqueline
Published: August 2018

Little is known about the attributes of men who sexually assault drinking women as compared with men who sexually assault sober women and nonperpetrators. Findings from a cross-sectional survey of 548 men and a laboratory computer-simulated date completed by a subset ( n = 87) support the hypothesis that both groups of perpetrators would share some common risk factors and differ regarding alcohol beliefs and consumption. Men who had previously assaulted a drinking woman gave their simulated date more alcohol to drink and perceived her as being more disinhibited. These findings demonstrate the power of alcohol expectancies and stereotypes about drinking women.
Patient monitoring programs in oncology pharmacy practice: A survey of oncology pharmacists in Atlantic Canada
Authors: Edwards Scott , Abbott Rick , Dranitsaris George
Published: August 2018

Background

There has been a dramatic increase in new drug approvals in oncology, consisting of both small molecule inhibitors and monoclonal antibodies. However, Health Canada approval for many of the new agents was based on single randomized trials consisting of only a few hundred patients. As more patients get treated with these newer agents, there is the potential for new and discrete toxicities. Pharmacists are in an ideal position to identify, monitor, manage, and even preempt future events, given their close proximity to the patient. However, the extent of pharmacists’ involvement in formal patient programs is unknown. To address this knowledge gap, a survey of oncology pharmacists practicing in Atlantic Canada was conducted.

Methods

A structured mailing strategy was adopted as recommended by Dillman (1978). Standardized data collection forms were electronically mailed to 60 oncology pharmacists. Survey items consisted of respondent demographic information, practice setting, the existence of a formal patient monitoring program managed, and if patients are contacted by telephone following the completion of their anticancer cycle.

Results

Overall, 31 completed surveys were received, for an overall response rate of 50%. Respondents had a median age of 42 and a median of 18 years’ (range 1 to 25) professional experience as a pharmacist. Only 18 of the 31 (58%) respondents indicated that there was a formal monitoring and call back program managed by pharmacy available at their institution. For those without such programs, the main reasons were due to staffing issues and lack of adequately trained clinical personnel. Overall, 100% of respondents would favor the development of a formal monitoring program in hospitals with a high volume of anticancer drug prescribing.

Conclusions

Even though the number of new anticancer drugs being introduced into clinical pharmacy practice is increasing, formal patient monitoring and patient call back programs are not universal in Atlantic Canada hospitals.
The Fallacy of Sham-Controlled Neurofeedback Trials: A Reply to Thibault and Colleagues (2018)
Authors: Pigott H. Edmund , Cannon Rex , Trullinger Mark
Published: August 2018

Background: Sham-controlled neurofeedback (NFB) trials consistently find no separation on ADHD outcome measures leading many to conclude that NFB’s beneficial effects are due to placebo. Method: We deconstruct the NFB training methodology and findings of six sham-controlled trials that assessed for evidence of learning. Results: All six studies found no evidence NFB subjects learned to self-modulate the targeted electroencephalogram (EEG). Careful analyses revealed these studies’ training methodologies were antithetical to the established science of operant conditioning thereby preventing subjects from learning to self-modulate. These findings are in marked contrast to NFB studies whose methodology mirror the best practices of operant conditioning. Conclusion: The premise that NFB’s beneficial effects are due to placebo phenomenon is unproven as these studies compared two forms of false-feedback, not operant conditioning of the EEG. Because these studies are highly cited and considered the gold standard in scientific rigor, a reappraisal of the evidence is urgently needed.
A Large Randomized Trial: Effects of Mindfulness-Based Stress Reduction (MBSR) for Breast Cancer (BC) Survivors on Salivary Cortisol and IL-6
Authors: Lengacher Cecile A. , Reich Richard R. , Paterson Carly L. , Shelton Melissa , Shivers Steve , Ramesar Sophia , Pleasant Michelle L. , Budhrani-Shani Pinky , Groer Maureen , Post-White Janice , Johnson-Mallard Versie , Kane Bradley , Cousin Lakeshia , Moscoso Manolete S. , Romershausen Tiffany A. , Park Jong Y.
Published: August 2018

Breast cancer survivors (BCS) often experience psychological and physiological symptoms after cancer treatment. Mindfulness-based stress reduction (MBSR), a complementary and alternative therapy, has reduced subjective measures of stress, anxiety, and fatigue among BCS. Little is known, however, about how MBSR affects objective markers of stress, specifically the stress hormone cortisol and the pro-inflammatory cytokine interleukin-6 (IL-6). In the present study, BCS ( N = 322) were randomly assigned to a 6-week MBSR program for BC or usual-care control. Measurements of cortisol, IL-6, symptoms, and quality of life were obtained at orientation and 6 weeks. Cortisol and IL-6 were also measured prior to and after the MBSR(BC) class Weeks 1 and 6. The mean age of participants was 56.6 years and 69.4% were White non-Hispanic. Most had Stage I (33.8%) or II (35.7%) BC, and 35.7% had received chemotherapy and radiation. Cortisol levels were reduced immediately following MBSR(BC) class compared to before the class Weeks 1 and 6 (Wilcoxon-signed rank test; p < .01, d = .52–.56). IL-6 was significantly reduced from pre- to postclass at Week 6 (Wilcoxon-signed rank test; p < .01, d = .21). No differences were observed between the MBSR(BC) and control groups from baseline to Week 6 using linear mixed models. Significant relationships with small effect sizes were observed between IL-6 and both symptoms and quality of life in both groups. Results support the use of MBSR(BC) to reduce salivary cortisol and IL-6 levels in the short term in BCS.
Creative work, self-organizing and autonomist potentiality: Snapshots taken from Amsterdam’s art factories
Authors: Cnossen Boukje
Published: August 2018

This article argues that while creative spaces are believed to instigate creative production, their strongest value is in producing new possibilities for self-organizing. By zooming in on short snapshots of resistance against gentrification in creative spaces in Amsterdam, I investigate whether small-scale and grass-roots forms of resistance and self-organizing between independent workers in the creative industries can be understood as examples of the autonomist notions of ‘the common’ and ‘the multitude’. By placing observations of creative workers’ self-organizing practices alongside autonomist theory, I suggest that autonomist thought is a promising philosophy for a politicized view of creative production, because it celebrates multiplicity and uniqueness. This is a timely topic in a society with growing numbers of freelancers and increasing flexibilization of labour. This article contributes to research on self-organizing among creative workers and to the literature on work conditions in the creative industries.
Educational inequalities in midlife risk factors for non-communicable diseases in two Norwegian counties 1974–2002
Authors: Graff-Iversen Sidsel , Ariansen Inger , Næss Øyvind , Selmer Randi M. , Strand Bjørn Heine
Published: August 2018

Background: The absolute educational differences in the mortality of Norwegian women and men increased during 1960–2000 and thereafter levelled off in men, but continued to widen in women. Which of the risk factors for non-communicable diseases (NCDs) might explain these trends? Aim: The aim of this study was to investigate trends in gender-specific, absolute educational differences in established risk factors during 1974–2002. Methods: We used cross-sectional data from 40–45-year-old women and men who participated in one of three health surveys in two counties, from the years 1974–1978, 1985–1988 and 2001–2002. To account for increasing educational attainment through the period we used a regression-based index of inequality (Slope Index of Inequality) to assess the educational gradients over time. Results: From 1974 to 2002, the mean levels of serum total cholesterol and blood pressure decreased and body mass index (BMI) increased in all subgroups by education in both sexes. In men, the educational gradient tended to diminish toward the null for serum total cholesterol and narrowed for systolic blood pressure, but increased for BMI. In women, the educational gradient increased to the double for smoking and increased for triglycerides. Conclusions: In two Norwegian counties, the NCD risk factors showed dynamic patterns during 1974–2002. For blood pressure and serum total cholesterol, the levels showed consistent beneficial changes in all educational subgroups, with a narrowing tendency for educational gradients in men. In women, the educational gradient for smoking increased markedly. Knowledge on midlife trends in the educational gradients of risk factors may help to explain recent and future NCD mortality.
Social media platforms as a photo-elicitation tool in research on alcohol intoxication and gender
Authors: Laws Ryan , Hunt Geoffrey , Antin Tamar M. J.
Published: August 2018

Aim:

This methodological article aims to describe the use of comparative social media platforms within a photo-elicitation (PE) activity as part of a multi-method interview-based study on the gendered meanings of alcohol intoxication among young adults (aged 18–25 years, n = 200).

Method:

Early interviews revealed social media as a particularly engaging topic for participants, and discussions of social media exposed relevant issues that often were not discussed in other sections of the interview guide. By embedding photos of young people drinking within three social media platforms with photo-sharing capabilities – Instagram, SnapChat and Facebook – we elicited narrative data revealing important aspects of the meanings of intoxication and providing information on how participants manage and judge drinking behaviours shared through online social networking systems (SNS).

Conclusions:

Given that social media use and photo-sharing are so common, familiar, and endemic among young people, to ignore this feature of contemporary social interaction would have limited our exploration of meanings of intoxication. We suggest that embedding existing methods, such as photo-elicitation, into social media contexts that are salient for youth may be a valuable strategy for providing a more comprehensive approach for investigating contemporary social issues.
Governance of substance use as a by-product of policing in Norway
Authors: Johansen Kenneth Arctander , Debaere Virginie , Vandevelde Stijn , Vandenbroeck Michel
Published: August 2018

Aim:

The aim of this article was to study governance of drug use in Norway through a historical account.

Method:

A genealogy was conducted through the study of documentation and legal texts from the 1600s until contemporary times.

Findings:

Based on legal texts addressing people using substances (both drugs and alcohol) various strategies for governance of drug use appears. The first section describes the emergence of institutions where people with alcohol problems were confined in a system originating the Dutch discipline houses. The second section describes the poor laws of the 1800s and the practice of the local poorhouses. The third section takes a look at the Vagrancy Act of 1900 and the state-owned labour camp at Opstad. The fourth section discusses the establishment of the sobriety boards and their role in confining alcoholics at cure homes. The fifth section describes developments in post-world-war Norway, with increased attention to illicit substances.

Conclusions:

The terminology justifying interventions is increasingly medicalised. Descriptions of the “drunkard” that appeared in 18th-century legal texts as immoral and free are contrasted by a positioning of this character as being a slave to his drinking in 20th-century political discourses, or as substance-dependent patients in the 21st century, alongside concerted efforts to dissolve open drug scenes.
Students’ perceptions of their preparedness for transition to work after graduation
Authors: García-Aracil Adela , Monteiro Sílvia , Almeida Leandro S
Published: August 2018

This study explores the factors that contribute to students’ perceptions of their preparedness for transition from university to work, taking a multidimensional perspective on their academic experience. To that end, a questionnaire was designed and administered to students enrolled in the final year of their master’s degree programme. Students were asked to self-assess their preparedness for the transition to the world of work and also self-assess their academic experience by exploring their academic engagement and the knowledge and competencies they developed during their study. Regarding academic engagement, we find that they consider that participation in lectures and the quality in developing collective work have a positive influence on their preparedness for work, while regular attendance at lectures appears to be negatively associated with their perceptions of their preparedness. The results also show that the practical and theoretical content, together with methodological and employability competencies, have a positive impact on students’ perceptions of their preparedness for transition to work. Thus, the promotion of learning experiences fostering methodological and practical competencies, together with more collective career-related experience and employability skills, may better help prepare graduates for the transition to work.
Vital mobilities: circulating blood via fictionalized vignettes
Authors: Sodero Stephanie
Published: August 2018

How do we move things when it really matters? Drawn from research encounters, this article traces the journey of blood from donor to recipient through nine fictionalized vignettes interwoven throughout the article. This article makes two key contributions. First, by using blood as both exemplar and metaphor, this article experiments with fictionalized vignettes to illustrate the ‘non-visible . . . non-obvious . . . non-verbal’ vein-to-vein journey entailed in blood donation as a vital mobility. Blood supply chains rely upon and constitute complex and geographically expansive infrastructure circuits. Blood has a societal circulation and can be described as hemosocial. Second, it introduces and theorizes the concept of vital mobilities, extending Adey’s work on emergency mobilities. I distinguish vital mobilities in two ways: they are non-optional material and/or energetic movements that safeguard life, and they constitute ongoing circuits of care that can be ramped up in case of wide-spread crisis, and are also required in everyday contexts. Overall, this article contributes to cultural geography by demonstrating how non-traditional qualitative methods can effectively be used to represent and communicate dynamic temporalities, spatialities and rhythms of vital mobilities such as blood.
Be Your Own Superhero: A Case of a Young Boy With Selective Mutism and Complex Comorbidities
Authors: Khan Maria , Renk Kimberly
Published: August 2018

This case study outlines the treatment of a 5-year-old Caucasian male who presented with symptoms of selective mutism (SM) along with significant impairment related to comorbid anxiety and speech difficulties. To address these symptoms, Integrated Behavior Therapy for Selective Mutism (IBTSM) was utilized for the treatment of this young boy’s SM and comorbid anxiety. An attachment focus was incorporated as a framework for conceptualizing his SM symptoms. As the treatment of this young boy’s symptoms proceeded, it became clear that his underlying speech difficulties needed to be addressed as well, as these difficulties were preventing expected progress to occur. Thus, this young boy’s treatment was individualized to fit his unique difficulties. In shifting the treatment focus to “being brave like a superhero,” significant decreases were achieved in this young boy’s overall internalizing and Diagnostic and Statistical Manual of Mental Disorders ( DSM)-related anxiety symptoms, facilitating a successful transition to speech and language therapy. This case study is distinctive in its description of the complexities that may come along with treating symptoms that appear consistent with SM along with other comorbid conditions and nuanced circumstances.
The “Chauffeur Fracture”: Historical Origins of an Often-Forgotten Eponym
Authors: Andreotti Mattia , Tonon Francesco , Caruso Gaetano , Massari Leo , Riva Michele A.
Published: August 2018

This article describes the origin of the term “chauffeur fracture” used to indicate an oblique fracture of the radial styloid process with extension into the wrist joint. This kind of fracture was originally described by the British surgeon Jonathan Hutchinson in 1866. The invention of the automobile increased the incidence of this fracture among chauffeurs and cabdrivers. Indeed, at the beginning of the 20th century, motor vehicles were started by means of a crank-handle connected to the engine, which needed to be turned vigorously clockwise by hand. If the motor started unexpectedly, the crank-handle could jerk back violently and thereby cause a wrist injury due to sudden hyperextension. We retrospectively reviewed the literature and historical articles to better define the historical origins of an often-forgotten eponym. In 1904, the French surgeon Just Lucas-Championnière first evidenced the occupational origin of this fracture, so introducing the term “chauffeur fracture” to identify this injury.
Investigation of axial thrust deviation between the theory and experiment for high-speed mine submersible pump
Authors: Xia Bin , Kong Fanyu , Zhang Hui , Yang Lei , Qian Wanghuan
Published: August 2018

In this article, three types of high-speed mine submersible pumps were designed and experimented. During the reliability performance test, the axial thrust balancing device of GFQ150-700 was overloaded and damaged due to an unsuitable designed value of axial thrust. The designed hydraulic axial thrust with the actual value is compared in this article, and the reason for axial thrust deviation is discussed. Results show that axial thrust of the theoretical calculation is close to the numerical simulation value at a certain extent. GFQ100-1000 obtains the maximum theoretical axial thrust, while the maximum simulated value is produced in GFQ150-700, and that is corroborated by experiments. The axial blade force is related to the pump stage and area differences between the blade suction and pressure surface. Due to the increasing stage in GFQ100-1000, the axial blade force increases to a remarkable value in an opposite direction with respect to GFQ150-700. The opposite blade force offsetting other hydraulic forces in GFQ100-1000 is responsible for the maximum hydraulic axial thrust emerges in GFQ150-700 instead of GFQ100-1000.
A tilt compensation system for translation micromirror
Authors: Xue Yuan , He Siyuan
Published: August 2018

A tilt compensation system is presented in this article to compensate the tilt in the translation micromirror used in miniaturized Fourier transform infrared spectrometers. This compensation system can not only be used for the micromirror tested in this article but also be applicable to any translation micromirror with undesired tilt about one fixed axis. The compensation system consists of only a compensation micromirror and a reflecting mirror. The compensation micromirror rotates an angle of the same magnitude and same direction as the translation micromirror’s tilt. The compensation micromirror has its rotation axis parallel to the tilting axis of the translation micromirror, which is identified using a position sensing detector–based setup introduced in the article. Experimental results show the tilt of the translation micromirror can be compensated to 0.026° from the original tilt of 0.24°.
A new kind of career
Authors: Newbegin Claudia , Shrewsbury Duncan
Published: August 2018

General practice is an essential component of the UK’s health economy, ensuring the sustainability of the National Health Service, as well as promoting wellness and managing ill health in the communities we serve. The role of the GP has evolved over time, and will continue to do so. What has remained constant over the years is the position of the family doctor as a local champion of the health of patients, with the GP acting as an early warning system for problems seen in the consulting room. GPs are not only clinicians, but also social entrepreneurs, able to draw on transferrable skills to adapt and influence the communities in which their patients live.
The unicortical sternoclavicular joint reconstruction using synthetic graft
Authors: Imam Mohamed A , Javed Saqib , Trail Ian , Monga Puneet
Published: August 2018

Sternoclavicular joint injuries represent 5% of all injuries to the shoulder complex. We report a safe and reproducible technique for reconstruction of anterior sternoclavicular joint dislocations, employing a synthetic graft using a unicortical technique with minimal dissection anterior to the joint.
Progression-free survival as a surrogate endpoint for overall survival in modern ovarian cancer trials: a meta-analysis
Authors: Sjoquist Katrin M. , Lord Sarah J. , Friedlander Michael L. , John Simes Robert , Marschner Ian C. , Lee Chee Khoon
Published: August 2018

Background:

Progression-free survival (PFS) has been adopted as the primary endpoint in many randomized controlled trials, and can be determined much earlier than overall survival (OS). We investigated whether PFS is a good surrogate endpoint for OS in trials of first-line treatment for epithelial ovarian cancer (EOC), and whether this relationship has changed with the introduction of new treatment types.

Methods:

In a meta-analysis, we identified summary data [hazard ratio (HR) and median time] from published randomized controlled trials. Linear regression was used to assess the association between treatment effects on PFS and OS overall, and for subgroups defined by treatment type, postprogression survival (PPS) and established prognostic factors.

Results:

Correlation between HRs for PFS and OS, in 26 trials with 30 treatment comparisons comprising 24,870 patients, was modest ( r2 = 0.52, weighted by trial sample size). The correlation diminished with recency: preplatinum/paclitaxel era, r2 = 0.66; platinum/paclitaxel, r2 = 0.44; triplet combinations, r2 = 0.22; biologicals, r2 = 0.30. The median PPS increased over time for the experimental ( Ptrend = 0.03) and control arms ( Ptrend = 0.003). The difference in median PPS between treatment arms strongly correlated with the difference in median OS ( r2 = 0.83). In trials where the control therapy had median PPS of less than 18 months, correlation between PFS and OS was stronger ( r2 = 0.64) than where the median PPS was longer ( r2 = 0.48).

Conclusions:

In EOC, correlation in the relative treatment effect between PFS and OS in first-line platinum-based chemotherapy randomized controlled trials is moderate and has weakened with increasing availability of effective salvage therapies.
Punk primers and reggae readers: Music and politics in British children’s literature
Authors: Sands-O’Connor Karen
Published: August 2018

In the late 1970s and early 1980s, British punk and reggae artists united to fight racism throughout society. Young people embraced the ideology of these musical forms, and many wrote about and published their experiences with racism and the police, and their desire to change society. Children’s and young adults’ highly politicized writing contrasted with that of adults who wrote about punk and reggae during the 1970s and 1980s. Adult authors divorced the music from its political meaning by focusing solely on punk and reggae style, yet left the threat of police oppression to thoroughly remove any appeal to young readers. The rejection of punk and reggae ideology by mainstream adult authority was so successful that later incarnations of punk and reggae children’s books either allied the music with the authorities or turned it into commodified nostalgia.
Don’t Shoot the Messenger! Embedded Direct Speech Conveyed by a Messenger in 2 Samuel 11 and Numbers 22
Authors: de Regt Lénart J.
Published: August 2018

In 2 Sam 11 and Num 22, the direct speech of the first speaker (Joab and Balak, respectively) is passed on and quoted by others. However, the messenger does not convey the message exactly as it had been formulated by the first speaker but instead adapts it to his own point of view. In this short contribution I show that the differences in the Hebrew text between the original message (the first speaker’s direct speech) and the message as conveyed (the embedded direct speech within the messenger’s own direct speech) have a specific function in the narrative. We should respect these differences when we translate. They should therefore not be treated as text-critical problems and be harmonized on the basis of variant readings from ancient versions, as has been done from time to time.
Implicit and Explicit Information in Translation
Authors: Mundhenk Norm
Published: August 2018

Different languages allow different kinds of information to be left implicit and require different kinds of information to be made explicit. So when translating from one language to another, the way we handle implicit and explicit information is a major issue. This article illustrates the treatment of such information in translating directionals, pronouns, verbal tense, word meanings, chains of reference, and passives.
A Discourse Structural Overview of the Prophecy of Micah
Authors: Wendland Ernst R.
Published: August 2018

After a short introduction, the methodology underlying this study is explained in terms of the so-called breaks, bonds, bounds, and bumps of discourse organization, as revealed by five principal literary-structural markers: aperture, closure, bonding, juncture, and peak. These diagnostic features are then applied to present a sequential summary of the compositional arrangement (cycles, stanzas, strophes) of the entire prophetic book of Micah. The significance of this type of detailed discourse analysis for both understanding the biblical text and translating it is briefly pointed out and illustrated.
At What Level Does Translation Occur?
Authors: Porter Stanley E.
Published: August 2018

In this paper, I ask the question, not what level (word, clause, discourse) a particular theory of translation addresses, but at what level translation occurs. I problematize the notion of levels of translation and explore, even if only briefly, how translation is an endeavor that spans the rank scale from word group to discourse and beyond.
Career choices for nephrology and factors influencing them: surveys of UK medical graduates
Authors: Barat Atena , Goldacre Michael J , Lambert Trevor W
Published: August 2018

Objectives

To study early and eventual career choices for nephrology among UK medical graduates and investigate factors which influenced career preferences.

Design

Self-completed survey questionnaires mailed to medical graduates 1, 3, 5 and 10 years after graduation.

Setting

United Kingdom.

Participants

UK medical graduates in 15 year-of-qualification cohorts between 1974 and 2015.

Main outcome measures

Early career specialty choices, career specialty destinations at 10 years and ratings of factors affecting career choices.

Results

Around 0.4%–1.1% of these junior doctors expressed a career preference for nephrology, varying by year of qualification and years after qualification. Among all graduates of 1993–2002 combined, 0.4% expressed a career preference for nephrology 1 year after qualification rising to 1.0% in year 5. Among graduates of 2005–2008, the corresponding figures were 1.0% in year 1 falling to 0.7% in year 5. Only 18% of doctors who chose nephrology in year 1 eventually became nephrologists. Of doctors who were practising as nephrologists for 10 years and more after qualification, 74% of the women and 56% of the men had decided to pursue a career in nephrology by year 5 after qualification. ‘Enthusiasm/commitment’ had a great deal of influence on those who chose nephrology, for all cohorts and all years studied.

Conclusions

The most recent data suggest that the proportion of young doctors who sustain an interest in nephrology through the early postgraduate training years may be lower than among their predecessors. Efforts are needed to reverse the declining trend and increase interest in nephrology.
The Singaporean Paralympics and Its Media Portrayal: Real Sport? Men-Only?
Authors: Brooke Mark
Published: August 2018

This article explores the discursive representations of Paralympians in South East Asia, particlarly in Singapore. One goal is to look at the extent and nature of media coverage of the Paralympics. Another goal of the research is to examine whether female Paralympians are exposed to the dual burden of sexist and ablest ideology in the media. Over 2 years, data from 100 articles were collected from three local Singaporean and Asian media sources; additionally, interviews and a survey were conducted with both Paralympians and citizens from the disabled community as well as a cohort of nondisabled Singaporean citizens. Findings suggest that coverage of Paralympic sport is significantly low, and that patriotism is more starkly linked to the Paralympics than the Olympics. Findings also suggest that othering (presenting the disabled as passive as well as challenged), or the supercrip narrative is apparent. Disabled women athletes tend to be overrepresented in passive poses out of the sport field. Finally, and more positively, the study finds that there are many images of Paralympian women as sophisticated and attractive without being sexually provocative. Therefore, evidence of sexual objectification or presentation of asexual disabled women tends not to be as present, as other similar studies have found.
Simultaneous Bilateral Spontaneous Pneumothorax in an Adult Patient With Pulmonary Langerhans Cell Histiocytosis: A Case Report
Authors: Karamouzos Vasileios , Prokakis Christos , Kosmopoulou Fotini , Karanikolas Evangelos , Kalogeropoulou Christina , Aretha Diamanto , Panagiotopoulos Nikolaos , Koletsis Efstratios , Velissaris Dimitrios
Published: August 2018

We report a case of a young female with known history of pulmonary Langerhans cell histiocytosis who was initially presented in the emergency department of a university hospital with respiratory distress. Clinical assessment and diagnostic workup revealed left hemithorax subcutaneous emphysema, bilateral pneumothorax, and atelectasis in both lower lung lobes. The patient was treated with bilateral staged thoracoscopic bullectomy and mechanical abrasion of the parietal pleura combined with chemical pleurodesis with talc. A new occurrence of right-sided pneumothorax was noticed 3 days after surgery, which was treated with chest tube insertion and chemical pleurodesis. The aforementioned surgical approach resulted in complete lung expansion and the patient’s full recovery. A review of pulmonary Langerhans cell histiocytosis and treatment options in cases of pneumothorax due to lung histiocytosis is also presented in this report.
Patient- and Procedure-Specific Variables Driving Total Direct Costs of Outpatient Anterior Cruciate Ligament Reconstruction
Authors: Karns Michael R. , Jones Daniel L. , Todd Dane C. , Maak Travis G. , Aoki Stephen K. , Burks Robert T. , Yoo Minkyoung , Nelson Richard E. , Greis Patrick E.
Published: August 2018

Background:

Few studies have investigated the influence of patient-specific variables or procedure-specific factors on the overall cost of anterior cruciate ligament reconstruction (ACLR) in an ambulatory surgery setting.

Purpose:

To determine patient- and procedure-specific factors influencing the overall direct cost of outpatient arthroscopic ACLR utilizing a unique value-driven outcomes (VDO) tool.

Study Design:

Cohort study (economic and decision analysis); Level of evidence, 3.

Methods:

All ACLRs performed by 4 surgeons over 2 years were retrospectively reviewed. Cost data were derived from the VDO tool. Patient-specific variables included age, body mass index, comorbidities, American Society of Anesthesiologists (ASA) classification, smoking status, preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Computerized Adaptive Testing (PF-CAT) score, and preoperative Single Assessment Numeric Evaluation (SANE) score. Procedure-specific variables included graft type, revision status, associated injuries and procedures, time from injury to ACLR, surgeon, and operating room (OR) time. Multivariate analysis determined patient- and procedure-related predictors of total direct costs.

Results:

There were 293 autograft reconstructions, 110 allograft reconstructions, and 31 hybrid reconstructions analyzed. Patient-specific factors did not significantly influence the ACLR cost. The mean OR time was shorter for allograft reconstruction ( P < .001). Predictors of an increased direct cost included the use of an allograft or hybrid graft (44.5% and 33.1% increase, respectively; P < .001), increased OR time (0.3% increase per minute; P < .001), surgeon 3 or 4 (9.1% or 5.9% increase, respectively; P < .001 or P = .001, respectively), and concomitant meniscus repair (24.4% increase; P < .001). Within the meniscus repair cohort, all-inside, root, and combined repairs correlated with a 15.5%, 31.4%, and 53.2% increased mean direct cost, respectively, compared with inside-out repairs ( P < .001).

Conclusion:

This study failed to identify modifiable patient-specific factors influencing direct costs of ACLR. Allografts and hybrid grafts were associated with an increased total direct cost. Meniscus repair independently predicted an increased direct cost, with all-inside, root, and combined repairs being costlier than inside-out repairs. The time-saving potential of all-inside meniscus repair was not realized in this study, making implant use a significant factor in the overall cost of ACLR with meniscus repair.
Myroides odoratimimus urinary tract infection in an immunocompromised patient: an emerging multidrug-resistant micro-organism
Authors: Lorenzin Giovanni , Piccinelli Giorgio , Carlassara Lucrezia , Scolari Francesco , Caccuri Francesca , Caruso Arnaldo , De Francesco Maria Antonia
Published: August 2018

Background

Myroides spp. are common environmental organisms and they can be isolated predominantly in water, soil, food and in sewage treatment plants. In the last two decades, an increasing number of infections such as urinary tract infections and skin and soft tissue infections, caused by these microorganisms has been reported. Selection of appropriate antibiotic therapy to treat the infections caused by Myroides spp. is difficult due to the production of a biofilm and the organism’s intrinsic resistance to many antibiotic classes.

Case presentation

We report the case of a 69-year-old immunocompromised patient who presented with repeated episodes of macroscopic haematuria, from Northern Italy.

A midstream urine sample cultured a Gram negative rod in significant amounts (> 105 colony-forming units (cfu)/mL), which was identified as Myroides odoratimimus. The patient was successfully treated with trimethoprim/sulfamethoxazole after antibiotic susceptibility testing confirmed its activity.

Conclusion

This case underlines the emergence of multidrug resistant Myroides spp. which are ubiquitous in the environment and it demands that clinicians should be more mindful about the role played by atypical pathogens, which may harbour or express multidrug resistant characteristics, in immunocompromised patients or where there is a failure of empiric antimicrobial therapy.
The Diagnostic Specificity of Negative Symptoms and their Psychopathological Context
Authors: Mundt Ch. , Kasper S. , Huerkamp M.
Published: August 2018

Rating scales for negative symptoms, basic symptoms and other comparable psychopathological syndromes were not originally constructed in order to make psychiatric diagnoses. Moreover, these scales were intended to be applied principally to schizophrenic patients. From the point of view of psychological testing their application to non-schizophrenic patients could be rejected on methodological grounds. Nevertheless there are some considerations which may justify such an investigation.
Three Syndromes in Chronic Schizophrenia
Authors: Liddle P.F. , Barnes Thomas R.E. , Morris D. , Haque S.
Published: August 2018

In recent years, exploration of the distinction between positive and negative symptoms of schizophrenia has provided a fruitful basis for attempts to relate the clinical features of schizophrenia to the accumulating evidence of brain abnormalities in schizophrenic patients. By 1982, there was an extensive body of evidence supporting the hypothesis that negative schizophrenic symptoms, such as poverty of speech and flatness of affect, were associated with substantial brain abnormalities, such as increased ventricular to brain ratio, and extensive cognitive impairment (Crow, 1980; Andreasen & Olsen, 1982). However, at that stage there were several fundamental unanswered questions about the nature of negative symptoms, and their relationship to indices of brain abnormality. This paper presents some findings of a series of studies initiated in 1982 to seek answers to some of these questions.
Editorial Preface
Authors: Abou-Saleh M. T.
Published: August 2018

The introduction of neuroimaging techniques for the study of brain structure and function has revolutionised the endeavour to elucidate the pathology of psychiatric disorder, the Holy Grail in psychiatry (Krishnan, 1990). Emil Kraepelin discovered the two major mental disorders, dementia praecox and manic-depression, and conceived their aetiology in brain pathology. It was Alois Alzheimer, however, his most successful student, who discovered the neuropathology of Alzheimer's disease. Sigmund Freud, who started his inquiries in brain science, lost faith and shifted to the study of the mind. Brain science and mind ‘science’ rapidly became odd bed fellows and parted company. The breakdown in communication fostered a mistrust in both parties, aborting endeavours of reconciliation. The evidence for the neuropathology of the ‘functional’ psychoses has, however, been inconclusive. It was the advent of brain-imaging techniques that rejuvenated brain sciences and modern neurosciences. The introduction of neuroimaging techniques, such as the electroencephalogram (EEG) in the 1920s and the whole-brain blood-flow techniques (Berger, 1929; Kety & Schmidt, 1948), antedated the discovery of psychotropic drugs. Pneumoencephalography was also applied to study brain structure in schizophrenia (Storey, 1966). The true methodological leap, however, was the introduction of computerised methods to construct three-dimensional images from two-dimensional data, enabling the development of computerised tomography (CT), magnetic resonance imaging (MRI), positron-emission tomography (PET) and single-photon emission computerised tomography (SPECT).
Computerised Tomography in Schizophrenia 15 Years On
Authors: Lewis Shôn W.
Published: August 2018

X-ray computerised tomography (CT) has revolutionised diagnostic radiology, particularly neuroradiology, since its inception (Houndsfield, 1973). It has been used widely in the systematic examination of brain structure in schizophrenia since the first study, 15 years ago, by Johnstone et al (1976). Several good reviews of the findings appeared in the mid-1980s (e.g. Reveley, 1985a; Shelton & Weinberger, 1986). Since then, although the spate of published studies has slowed, the quality of more recent published studies has in general been higher than the earlier ones, and it is time to look at the field again. This review examines the methodological pitfalls in CT research in schizophrenia and then attempts to draw some conclusions in the light of these.
Positron Emission Tomography in the Study of Brain Metabolism in Psychiatric and Neuropsychiatric Disorders
Authors: Bench C. J. , Dolan R. J. , Friston K. J. , Frackowiak R. S. J.
Published: August 2018

Positron emission tomography (PET) differs fundamentally from computerised tomography (CT) and magnetic resonance imaging (MRI) in that it is a method for measuring function as opposed to structure. It is the most powerful tool available for the measurement of in-vivo brain function. This review describes the basic principles of the technique and its application to the study of brain metabolism in neurological and psychiatric disorder. The development of resting-state metabolic studies by the application of specific activation paradigms, a major current focus of the technique, is discussed.
Editors' Preface
Authors: Abou-Saleh M. T. , Filip V.
Published: August 2018

Psychopharmacology has revolutionised the practice of psychiatry and continues to evolve with developments in psychiatric nosology. It has provided the bridge for elucidating the biology of psychiatric disorders and has refined diagnostic distinctions with the introduction of highly specific agents such as lithium. Prediction in psychopharmacology has enhanced the clinical validity of psychiatric syndromes and has contributed to the delineation of meaningful subgroups, with implications for clinical practice.
Early Neuroleptic Intervention in Schizophrenia: Are Prodromal Symptoms Valid Predictors of Relapse?
Authors: Gaebel W. , Frick U. , Köpcke W. , Linden M. , Müller P. , Müller-Spahn F. , Pietzcker A. , Tegeler J.
Published: August 2018

All recently completed controlled two-year studies on intermittent, early neuroleptic intervention treatment have failed to compare favourably with studies on maintenance treatment concerning relapse prevention. The reason for this failure is still unclear. Therefore the implicit, but as yet unproven, hypothesis that a relapse can be predicted from prodromal symptoms was tested from the perspective of our German multicentre study. Results demonstrate that this is not the case. Possible reasons for and clinical implications of this negative finding are discussed.
The Challenge of Predicting Response to Stabilising Lithium Treatment
Authors: Grof P. , Alda M. , Grof E. , Fox D. , Cameron P.
Published: August 2018

Lithium treatment, an approach with well documented efficacy, has recently been losing its treatment value. Lithium continues working, however, for those patients for whom it was proven efficacious; that is, most patients with primary episodic affective disorders. Such responders to lithium prophylaxis can be reliably identified beforehand by a comprehensive clinical assessment. The explanation for the paradox of lithium's lost efficacy lies mostly in the educational bias against a comprehensive patient assessment, and in the shift in diagnostic fashion favouring affective disorders and the treatment methods associated with them in the clinicians' minds.
The TAPS Project. 22: A Five-Year Follow-Up of Long-Stay Psychiatric Patients Discharged to the Community
Authors: Leff Julian , Thornicroft Graham , Coxhead Neil , Crawford Colin
Published: August 2018

A group of 114 long-stay patients in Friern and Claybury Hospitals was assessed while in hospital, and then again one year and five years after discharge to community placements. Neurotic symptoms, verbal and non-verbal behaviour and, most notably, negative symptoms all improved between the two community follow-up interviews. Patients were living under much less restrictive conditions in the community, and their appreciation of this freedom continued to grow over the years. Their social networks were enriched by an increase in the number of friends in the first year after discharge and in the number of confidants in the subsequent four years. There were no adverse outcomes, but these conclusions cannot yet be said to apply to all long-stay residents of mental hospitals.