bluuebunny/crossref_metadata_2025 huggingface dataset:
Chapter 6. From integrative bioethics to integrative bioethics: European and American perspectives
Authors: Rinčić Iva , Sodeke Stephen Olufemi , Muzur Amir
Published: March 2017

Des questions concernant la bioéthique intégrative sont en train d’émerger et révèlent non seulement des différences de définition mais aussi de perspective et d’approche (Jurić, 2007; Schaefer-Rolffs, 2012; Bracanović, 2012; ten Have, 2012; Muzur, 2012). A partir de ces ambiguïtés conceptuelles, un nouveau moment dans l’histoire et la méthodologie de la bioéthique intégrative émerge aussi, ainsi donnant forme non seulement à une mais à deux approches de la bioéthique intégrative, l’une venant d’Europe (Croatie) et une autre des USA (Tuskegee, Alabama). Dans cet article, les auteurs essayeront d’analyser ces deux approches. Portant le même nom, mais différentes dans leurs racines, leur méthodologie et leurs objectifs, ces deux approches de la bioéthique intégrative serviront comme point de départ pour les auteurs qui tenteront de répondre à la question quant à savoir si les différences observées peuvent aussi servir d’éléments de liaison. Autrement dit, encore une fois, la bioéthique a été utilisée de façon créative comme un pont par-dessus la réalité tourmentée des activités de la vie.
Solaire et éolien chinois : stratégies et politiques d’internationalisation
Authors: Aurez Vincent , Desarnaud Gabrielle
Published: March 2017

La Chine a longuement soutenu l’internationalisation de son industrie pétrolière, dans une quête d’acquisition de ressources et de technologies qui a fait couler beaucoup d’encre. Désormais les fleurons de l’industrie renouvelable chinoise, en proie à la surcapacité locale et des concurrents étrangers qui mènent la course à l’innovation, se tournent également vers l’international et revoient leurs stratégies de développement. Soutenues par un discours politique qui met en avant les exploits chinois en matière d’investissements dans les énergies renouvelables, ces « entreprises émergentes stratégiques » commencent à changer le paysage énergétique international et le positionnement des acteurs du secteur.
Les récentes évolutions économiques, commerciales et politiques du Japon vues d’Europe
Authors: Donzé Pierre-Yves , Grialou Mathieu , Lechevalier Sébastien , Roux Didier , Veyrenc Thomas
Published: March 2017

Quatre évolutions récentes du Japon sont ici discutées : hiérarchies économiques et relations commerciales et de R&D ; crises économiques et réactions politiques ; structures économiques et rôle des puissances publiques nationales et transnationales ; la catastrophe de Fukushima et ses conséquences.
Tout change parce que rien ne change ? Politiques sociales et cycles de transformation économique et institutionnelle au Chili
Authors: Barozet Emmanuelle , Espinoza Vicente
Published: March 2017

Dans cet article, nous analysons les politiques sociales chiliennes au cours des trente dernières années, en particulier les options prises par les différents gouvernements, ainsi que le rejet qu’elles ont généré dans la dernière décennie. Sur la base d’une croissance économique soutenue, les politiques sociales mises en place ont permis de faire baisser de manière très importante le taux de pauvreté et d’améliorer les conditions de vie de la population, sans cependant remettre en cause les inégalités de revenus. La question centrale que nous abordons est comment un modèle qui assure une croissance économique soutenue et permet l’amélioration des conditions de vie de la population génère-t-il un rejet profond de la part d’une grande partie de la population ? La combinaison entre des politiques de croissance et sociales « pro-pauvres » et de ciblage sur les plus démunis, malgré ses succès, ne permet cependant pas de corriger les effets les plus ségrégatifs du système, en particulier dans le domaine de l’éducation, de la santé et des retraites. Nous montrons comment les limites de ce modèle, combiné avec une promesse non tenue d’égalité des chances, ouvre la voie depuis les années 2000 à un profond débat sur l’avenir du modèle économique et social. La partie finale de l’article aborde les dilemmes du gouvernement Bachelet dans le cadre des réformes sociales en cours et d’un profond ralentissement économique.
Référendum pour la paix en Colombie
Authors: Rodríguez Cuadros José Darío
Published: March 2017

Comment interpréter le résultat du référendum pour la paix en Colombie ? Quelles raisons peuvent expliquer la victoire du « Non » ? Quelle est l’importance, dans ce contexte, du prix Nobel de la Paix attribué au Président colombien Juan Manuel Santos ? Et, quelles possibilités subsistent pour obtenir un nouvel Accord qui mette fin aux cinq décennies de guerre avec les Farc ? Cet article tente de donner réponse à ces questions, à partir d’une analyse politique de ce nouveau contexte, marqué par l’incertitude, la polarisation de la société et la tension politique.
Assessing Nurses' Knowledge of Spiritual Care Practices Before and After an Educational Workshop
Authors: Murray Reinette P. , Dunn Karen S.
Published: March 2017

Background:

Although current research findings reflect that spiritual care is integral to the discipline of nursing, implementation of spiritual care still remains a neglected area of practice.

Method:

The purpose of this pretest–posttest study was to determine whether a spiritual care educational workshop would increase nurses' knowledge, self-awareness, and abilities regarding spiritual care practices. The Spirituality and Spiritual Care Rating Scale (SSCRS) was used to measure the nurses' knowledge, attitudes, and beliefs about spirituality and spiritual care practices.

Results:

Forty-nine nurses working at a satellite hospital within the midwestern United States attended the educational workshop. A statistically significant increase in nurses' knowledge, self-awareness, and abilities regarding spiritual care practices was observed after the educational workshop. The majority of nurses reported that their nursing education inadequately prepared them to provide spiritual care to their patients, and they were unable to meet the spiritual needs of their patients.

Conclusion:

Findings support the need for continued education regarding spiritual care practices among working nurses.

J Contin Educ Nurs.
2017;48(3):115–122.
Enhancing Transition to Practice Using a Valid and Reliable Evaluation Tool: Progressive Orientation Level Evaluation (POLE) Tool
Authors: Acuna Gail K. , Yoder Lina H. , Madrigal-Gonzalez Lizely , Yoder-Wise Patricia S.
Published: March 2017

Background:

Numerous evaluation tools are used to verify nursing competencies, job satisfaction, and leadership qualities separately. One comprehensive tool, the Progressive Orientation Level Evaluation (POLE) tool, measures the increasing complexity of competencies from novice through competent levels. The tool also measures employee satisfaction and engagement to identify potential challenges, stressors, or barriers to transition prior to completion of the post-hiring orientation (on-boarding) process.

Method:

A prospective cohort design was used to determine reliability of the POLE tool examining new graduate nurses' (NGNs) learning needs using objectives to individualize the length of training as needed. Cronbach's alpha was used to determine internal consistency.

Results:

The reliability of the instrument was established showing high internal consistency (Cronbach's alpha = .90 to .99).

Conclusion:

Using a valid and reliable tool provides NGNs and organizations with a way to evaluate the success of stated goals and outcomes from a residency program in a standardized and consistent manner.

J Contin Educ Nurs.
2017;48(3):123–128.
Activity Monitoring and Heart Rate Variability as Indicators of Fall Risk: Proof-of-Concept for Application of Wearable Sensors in the Acute Care Setting
Authors: Razjouyan Javad , Grewal Gurtej Singh , Rishel Cindy , Parthasarathy Sairam , Mohler Jane , Najafi Bijan
Published: March 2017

Growing concern for falls in acute care settings could be addressed with objective evaluation of fall risk. The current proof-of-concept study evaluated the feasibility of using a chest-worn sensor during hospitalization to determine fall risk. Physical activity and heart rate variability (HRV) of 31 volunteers admitted to a 29-bed adult inpatient unit were recorded using a single chest-worn sensor. Sensor data during the first 24-hour recording were analyzed. Participants were stratified using the Hendrich II fall risk assessment into high and low fall risk groups. Univariate analysis revealed age, daytime activity, nighttime side lying posture, and HRV were significantly different between groups. Results suggest feasibility of wearable technology to consciously monitor physical activity, sleep postures, and HRV as potential markers of fall risk in the acute care setting. Further study is warranted to confirm the results and examine the efficacy of the proposed wearable technology to manage falls in hospitals. [
Journal of Gerontological Nursing, 43
(7), 53–62.]
Enhancing Care for Hospitalized Patients With Parkinson's Disease: Development of a Formal Educational Program for Nursing Staff
Authors: DiBartolo Mary C.
Published: March 2017

Although not generally a primary admission diagnosis, Parkinson's disease (PD) can be a significant comorbidity during hospitalization. Hospitalized individuals with PD can experience a variety of complications, such as confusion, pneumonia, and urinary infections. More than 20% of patients experience deterioration in symptoms and hospital stays are extended by an average of 4 days. Late, omitted, or inappropriate medications are frequent culprits leading to serious consequences, including falls and aspiration. To address an identified gap in staff knowledge about PD, a formal educational program was developed to review its etiology, symptoms, treatments, and unique considerations in care and medication administration. This 2-hour intervention comprises a knowledge pre-test, PowerPoint® presentation, two concise handouts for reference, discussion of an unfolding case study, and review of the Aware in Care kit. Nurses can play a key role in educating staff to reduce avoidable hospital-related complications and enhance outcomes for this vulnerable group. [
Journal of Gerontological Nursing, 43
(5), 18–22.]
Culturally Responsive Pain Management for Black Older Adults
Authors: Robinson-Lane Sheria G. , Booker Staja Q.
Published: March 2017

The management of pain for Black older adults has received inadequate attention by health care professionals despite evidence of greater pain intensity, depressive symptoms, and functional disability compared with White American older adults. Pain management for this population may be significantly improved with more careful attention to the provision of culturally responsive care. As professionals concerned with the optimization of health and reduction of suffering throughout the lifespan, nurses have an ethical, moral, and professional responsibility to provide culturally responsive care to the populations they serve—particularly when clear disparities in health exist. By considering how culture affects important health beliefs, values, preferences, and customs, and integrating this understanding into practice, quality of life is likely to be improved. [
Journal of Gerontological Nursing, 43
(8), 33–41.]
Comparación del valor democrático de las discusiones de Facebook entre perfiles de candidatos políticos españoles a las elecciones generales de 2011
Authors: Valera Ordaz Lidia
Published: March 2017

El artículo examina el valor democrático de los comentarios ciudadanos en los perfiles de Facebook de tres candidatos políticos españoles durante la campaña de las Elecciones Generales 2011 a través de una operacionalización de la democracia deliberativa. Los resultados reflejan que las conversaciones no cumplen los criterios deliberativos, pero que aun así revisten beneficios democráticos, como la autoexpresión ciudadana, la socialización democrática y el refuerzo de la cohesión social entre activistas y simpatizantes. Además, reflejan que el valor democrático varía ligeramente en función del tamaño del partido donde se produce. La conversación en los muros de candidatos que pertenecen a partidos mayoritarios está orientada hacia la autoexpresión, pero también confronta a los hablantes esporádicamente con la diversidad. Por su parte, la discusión en el muro de la candidata de un partido minoritario es ideológicamente homogénea, pero incluye más interacción discursiva, permitiendo desarrollar argumentario y cultivar la cohesión social en condiciones discursivas favorables.
A natureza do urbano
Authors: Scarlato Francisco Capuano , Costa Everaldo Batista da
Published: March 2017

Percepção, essência e existência são categorias da fenomenologia potenciais ao entendimento da natureza do urbano, na história. Com o objetivo de contribuir no debate teórico da essência e da natureza do urbano, este artigo traz, metodologicamente, três questões estruturadas: i) reconhece a pertinência da fenomenologia existencialista e do materialismo histórico na interpretação desta natureza; ii) discute a natureza do urbano pela objetividade e subjetividade que envolvem as cidades, na história; iii) trata o centro histórico das cidades como memória na totalidade urbana e síntese dialética da natureza do urbano. Assim, a sociedade urbana é assumida como uma condição espacial advinda do construir e do habitar históricos e existenciais, em nome da dominação e da liberdade, o que antecede a industrialização moderna.
De frontier até pós-frontier: regiões pioneiras no Brasil dentro do processo de transformação espaço-temporal e sócio-ecológico
Authors: Coy Martin , Klingler Michael , Kohlhepp Gerd
Published: March 2017

Se existe uma região mundial na qual o frontier pertence às grandes narrativas espaço-temporais e assim às disciplinas importantes de pesquisa histórica, de ciências sociais e sobretudo de geografia, são sem dúvida as Américas. Até porque, a exploração através da colonização após a independência dos países da América Latina, sobretudo na Argentina, no Chile, no Paraguai e também no Brasil tornou-se o instrumento essencial da povoação, colonização, segurança geoestratégica e valorização econômica dos supostos espaços vazios de assentamentos e de população do hinterland. Enquanto que o foco regional do frontier agrário brasileiro concentrava-se no Sul até meados do séc. XX, as regiões pioneiras deslocaram-se em seguida e sucessivamente até as extensas periferias do Centro-Oeste e da Amazônia. Hoje está claro que o mito original das “historias bem sucedidas” do frontier não mais pode ser reproduzido sob as atuais condições gerais contraditórias de globalização e global change, de discursos de sustentabilidade e de desenvolvimento regional, entre lógicas de mercado e governança de meio ambiente. Neste contexto, os três estudos de caso deste trabalho representam fases diferentes de desenvolvimento de frontier e do processo de deslocamento das regiões pioneiras brasileiras. Condições gerais individuais e vias diferentes de desenvolvimentos marcam o seu processo espaço-temporal, deixando, no entanto, reconhecer ligações com a história migratória dos atores e suas redes interregionais, existentes até hoje. O objetivo é analisar as condições gerais dos frontiers no sentido do conceito do ciclo de vida e avaliar, sob perspectiva histórica, as possibilidades de mudanças do desenvolvimento regional.
O Mapa do Território Nacional de Misiones (1881) na conjuntura da disputa territorial entre Argentina e Brasil
Authors: Moraes Cristina de
Published: March 2017

O trabalho tem como objetivo um breve estudo do Mapa do Território Nacional de Misiones elaborado em 1881, na conjuntura da disputa territorial entre Argentina e Brasil, conhecida como Questão de Palmas. Este documento cartográfico que delimitava como território argentino parte do Brasil é um profícuo material para entender os mapas como produtos de uma dada sociedade, portanto, passível de visualizar através destes os interesses políticos que motivavam as apropriações espaciais. Deste modo num primeiro momento é esboçado o contexto histórico e posteriormente, efetuando algumas considerações.
A relação entre caipiras e o processo de urbanização na música sertaneja entre as décadas de 1920 e 1980
Authors: Leitão Jóyce Oliveira
Published: March 2017

Apesar da cultura caipira parecer estranha à sociedade capitalista, ela surge como resultado de uma histórica exclusão à propriedade da terra que atingiu as comunidades caipiras desde o Brasil colônia até as últimas décadas do século XX, levando à expulsão dos caipiras das áreas rurais e os compelindo à vida e ao trabalho nas cidades. A intensificação da expulsão destes trabalhadores das áreas rurais e a rápida urbanização estão ligados ao surgimento da Música Sertaneja e ao largo consumo de produtos atrelados a ela, tais como programas de rádio e discos. Procuramos identificar, através da trajetória da música sertaneja entre as décadas de 1920 e 1980, a relação existente entre esta produção musical e os processos migratórios que alteraram profundamente a relação entre o rural e o urbano neste período, buscando compreender de que forma o romantismo característico da música sertaneja é representativo de um posicionamento do caipira em relação aos processos de urbanização.
Recognizing Similarities and Differences Between Print and Digital Literacy in Education
Authors: Harvey Miles M.
Published: March 2017

This article focuses on recognizing similarities and differences between print and digital literacy in the field of education since the 1980's. The author found that many books and peer-reviewed articles agreed that both forms of literacy are social constructions of thought used to help humans read and write in the world. Literature suggests more work must be completed in the field of literacy studies and education in order to best understand the needs of digitally driven students in the United States. Differing definitions of print and digital literacy among articles were apparent, but those differences highlighted the importance of the meaning-making process. The evolution of recent advances in technology gives reason for researchers to question the future of literacy and its role in education. Literature for this review was limited to texts in English from the UNM Library databases: ERIC, WorldCat.org, ArticleFirst, Education Abstracts, Google Scholar, and Academic Search Complete.
A Fatal Case of Immune Hyperhemolysis with Bone Marrow Necrosis in a Patient with Sickle Cell Disease
Authors: Karafin Matthew S. , Singavi Arun , Johnson Susan T. , Field Joshua J.
Published: March 2017

In patients with sickle cell disease, hyperhemolysis is a rare but life-threatening complication of transfusion. In this case report, we describe a 61 year-old woman with hemoglobin sickle cell (SC) disease and history of alloimmunization who developed hyperhemolysis associated with a transfusion. She was found to have a warm and a clinically-significant cold autoantibody. Severe anemia (Hb 2.7 g/dL) with reticulocytopenia and thrombocytopenia prompted a bone marrow biopsy, which demonstrated extensive bone marrow necrosis. Despite treatment, the bone marrow failure did not improve and the patient died on hospital day 38. This case illustrates the potential risks of transfusion in a patient with sickle cell disease, especially one with previous hemolytic reactions. While uncommon, hyperhemolysis can cause death, in this case by extensive bone marrow necrosis. In patients with sickle cell disease, judicious use of red cell transfusions with phenotypically-matched units can diminish, but never completely abrogate, the risks associated with transfusion.
Successful Intrathecal Chemotherapy Combined with Radiotherapy Followed by Pomalidomide and Low-Dose Dexamethasone Maintenance Therapy for a Primary Plasma Cell Leukemia Patient
Authors: Yamashita Yusuke , Tamura Shinobu , Oiwa Takehiro , Kobata Hiroshi , Kuriyama Kodai , Mushino Toshiki , Murata Shogo , Hosoi Hiroki , Nishikawa Akinori , Hanaoka Nobuyoshi , Sonoki Takashi
Published: March 2017

Primary plasma cell leukemia (PPCL) is a rare aggressive variant of plasma cell disorder and frequently presents with extramedullary disease. Central nervous system (CNS) involvement with PPCL has an extremely poor prognosis. We describe a 46-year-old man with PPCL treated with a combination of lenalidomide, bortezomib, and dexamethasone as induction therapy following upfront allogeneic stem cell transplantation (allo-SCT). Despite achieving a very good partial response, the patient suffered from an isolated CNS relapse 12 months after allo-SCT. He was immediately started on concurrent intrathecal chemotherapy (IT) and cranial irradiation (RT). Subsequently, pomalidomide and low-dose dexamethasone (Pd) were given as maintenance therapy. He has been without CNS recurrence for more than 18 months. Our case suggests that concurrent IT and RT followed by Pd maintenance therapy may be an effective option to control CNS relapse of PPCL after allo-SCT.
Periodic lateralized epileptiform discharges can survive anesthesia and result in asymmetric drug-induced burst suppression
Authors: Mader Jr. Edward C. , Cannizzaro Louis A. , Williams Frank J. , Lalan Saurabh , Olejniczak Piotr W.
Published: March 2017

Drug-induced burst suppression (DIBS) is bihemispheric and bisymmetric in adults and older children. However, asymmetric DIBS may occur if a pathological process is affecting one hemisphere only or both hemispheres disproportionately. The usual suspect is a destructive lesion; an irritative or epileptogenic lesion is usually not invoked to explain DIBS asymmetry. We report the case of a 66-year-old woman with new-onset seizures who was found to have a hemorrhagic cavernoma and periodic lateralized epileptiform discharges (PLEDs) in the right temporal region. After levetiracetam and before anesthetic antiepileptic drugs (AEDs) were administered, the electroencephalogram (EEG) showed continuous PLEDs over the right hemisphere with maximum voltage in the posterior temporal region. Focal electrographic seizures also occurred occasionally in the same location. Propofol resulted in bihemispheric, but not in bisymmetric, DIBS. Remnants or fragments of PLEDs that survived anesthesia increased the amplitude and complexity of the bursts in the right hemisphere leading to asymmetric DIBS. Phenytoin, lacosamide, ketamine, midazolam, and topiramate were administered at various times in the course of EEG monitoring, resulting in suppression of seizures but not of PLEDs. Ketamine and midazolam reduced the rate, amplitude, and complexity of PLEDs but only after producing substantial attenuation of all burst components. When all anesthetics were discontinued, the EEG reverted to the original preanesthesia pattern with continuous non-fragmented PLEDs. The fact that PLEDs can survive anesthesia and affect DIBS symmetry is a testament to the robustness of the neurodynamic processes underlying PLEDs.
Increased QT Interval Variability in 3 Recently Concussed Athletes: An Exploratory Observation
Authors: La Fountaine Michael F. , Gossett James D. , De Meersman Ronald E. , Bauman William A.
Published: March 2017

Context: The QT interval variability index (QTVI) is a noninvasive measure of beat-to-beat fluctuations of the QT interval as seen from a single electrocardiographic lead. It represents the relationship between the respective variabilities of the QT and R-R intervals. Recently, the QTVI was demonstrated to be an index of vagal cardiac autonomic modulation in resting conditions.

Objective: To determine whether QTVI varied in athletes at 48 hours, 1 week, and 2 weeks after a concussive head injury.

Design: Case series.

Setting: Testing facility.

Patients or Other Participants: Three athletes with recent concussions and 3 uninjured athletes with similar demographic factors.

Main Outcome Measure(s): Continuous 3-lead electrocardiograms were obtained in a seated, resting position over 2 successive weeks. Separate, unpaired t tests were performed to determine whether group-visit differences were present in the QTVI at 48 hours, 1 week, or 2 weeks.

Results: No demographic differences were present between groups. At 48 hours, the QTVI was greater in the concussion group than in the matched controls. At weeks 1 and 2, the QTVI in the concussion group was lower than at 48 hours and not different from that of the control group.

Conclusions: Vagal cardiac autonomic modulation, as quantified by the QTVI, appeared to be negatively affected in concussed athletes within 48 hours of injury, resolved within 1 week, and remained at control group levels 2 weeks later. Serial assessments of QTVI may be of clinical utility in identifying suspected cases of acute concussion and may provide helpful information for determining when an athlete can return to play safely.
Persistent Motor System Abnormalities in Formerly Concussed Athletes
Authors: De Beaumont Louis , Mongeon David , Tremblay Sébastien , Messier Julie , Prince François , Leclerc Suzanne , Lassonde Maryse , Théoret Hugo
Published: March 2017

Context: The known detrimental effects of sport concussions on motor system function include balance problems, slowed motor execution, and abnormal motor cortex excitability.

Objective: To assess whether these concussion-related alterations of motor system function are still evident in collegiate football players who sustained concussions but returned to competition more than 9 months before testing.

Design: Case-control study.

Setting: University laboratory.

Patients or Other Participants: A group of 21 active, university-level football players who had experienced concussions was compared with 15 university football players who had not sustained concussions.

Intervention(s): A force platform was used to assess center-of-pressure (COP) displacement and COP oscillation regularity (approximate entropy) as measures of postural stability in the upright position. A rapid alternating-movement task was also used to assess motor execution speed. Transcranial magnetic stimulation over the motor cortex was used to measure long-interval intracortical inhibition and the cortical silent period, presumably reflecting γ-aminobutyric acid subtype B receptor-mediated intracortical inhibition.

Main Outcome Measure(s): COP displacement and oscillation regularity, motor execution speed, long-interval intracortical inhibition, cortical silent period.

Results: Relative to controls, previously concussed athletes showed persistently lower COP oscillation randomness, normal performance on a rapid alternating-movement task, and more M1 intracortical inhibition that was related to the number of previous concussions.

Conclusions: Sport concussions were associated with pervasive changes in postural control and more M1 intracortical inhibition, providing neurophysiologic and behavioral evidence of lasting, subclinical changes in motor system integrity in concussed athletes.
A Profile of Glenohumeral Internal and External Rotation Motion in the Uninjured High School Baseball Pitcher, Part II: Strength
Authors: Hurd Wendy J. , Kaplan Kevin M. , ElAttrache Neal S. , Jobe Frank W. , Morrey Bernard F. , Kaufman Kenton R.
Published: March 2017

Context: A database describing the range of normal rotator cuff strength values in uninjured high school pitchers has not been established. Chronologic factors that contribute to adaptations in strength also have not been established.

Objectives: To establish a normative profile of rotator cuff strength in uninjured high school baseball pitchers and to determine whether bilateral differences in rotator cuff strength are normal findings in this age group.

Design: Cohort study.

Setting: Baseball playing field.

Patients or Other Participants: A total of 165 uninjured male high school baseball pitchers (age = 16 ± 1 years, height = 1.8 ± 0.1 m, mass = 76.8 ± 10.1 kg, pitching experience = 7 ± 2 years).

Main Outcome Measure(s): Isometric rotator cuff strength was measured bilaterally with a handheld dynamometer. We calculated side-to-side differences in strength (external rotation [ER], internal rotation [IR], and the ratio of ER:IR at 90° of abduction), differences in strength by age, and the influence of chronologic factors (participant age, years of pitching experience) on limb strength.

Results: Side-to-side differences in strength were found for ER, IR, and ER:IR ratio at 90° of abduction. Age at the time of testing was a significant but weak predictor of both ER strength (R2 = 0.032, P = .02) and the ER:IR ratio (R2 = 0.051, P = .004) at 90° of abduction.

Conclusions: We established a normative profile of rotator cuff strength for the uninjured high school baseball pitcher that might be used to assist clinicians and researchers in the interpretation of muscle strength performance in this population. These data further suggested that dominant-limb adaptations in rotator cuff strength are a normal finding in this age group and did not demonstrate that these adaptations were a consequence of the age at the time of testing or the number of years of pitching experience.
Shoulder External Rotation Fatigue and Scapular Muscle Activation and Kinematics in Overhead Athletes
Authors: Joshi Mithun , Thigpen Charles A. , Bunn Kevin , Karas Spero G. , Padua Darin A.
Published: March 2017

Context: Glenohumeral external rotation (GH ER) muscle fatigue might contribute to shoulder injuries in overhead athletes. Few researchers have examined the effect of such fatigue on scapular kinematics and muscle activation during a functional movement pattern.

Objective: To examine the effects of GH ER muscle fatigue on upper trapezius, lower trapezius, serratus anterior, and infraspinatus muscle activation and to examine scapular kinematics during a diagonal movement task in overhead athletes.

Setting: Human performance research laboratory.

Design: Descriptive laboratory study.

Patients or Other Participants: Our study included 25 overhead athletes (15 men, 10 women; age = 20 ± 2 years, height = 180 ± 11 cm, mass = 80 ± 11 kg) without a history of shoulder pain on the dominant side.

Intervention(s): We tested the healthy, dominant shoulder through a diagonal movement task before and after a fatiguing exercise involving low-resistance, high-repetition, prone GH ER from 0° to 75° with the shoulder in 90° of abduction.

Main Outcome Measure(s): Surface electromyography was used to measure muscle activity for the upper trapezius, lower trapezius, serratus anterior, and infraspinatus. An electromyographic motion analysis system was used to assess 3-dimensional scapular kinematics. Repeated-measures analyses of variance (phase × condition) were used to test for differences.

Results: We found a decrease in ascending-phase and descending-phase lower trapezius activity (F1,25 = 5.098, P = .03) and an increase in descending-phase infraspinatus activity (F1,25 = 5.534, P = .03) after the fatigue protocol. We also found an increase in scapular upward rotation (F1,24 = 3.7, P = .04) postfatigue.

Conclusions: The GH ER muscle fatigue protocol used in this study caused decreased lower trapezius and increased infraspinatus activation concurrent with increased scapular upward rotation range of motion during the functional task. This highlights the interdependence of scapular and glenohumeral force couples. Fatigue-induced alterations in the lower trapezius might predispose the infraspinatus to injury through chronically increased activation.
Structure, Sex, and Strength and Knee and Hip Kinematics During Landing
Authors: Howard Jennifer S. , Fazio Melisa A. , Mattacola Carl G. , Uhl Timothy L. , Jacobs Cale A.
Published: March 2017

Context: Researchers have observed that medial knee collapse is a mechanism of knee injury. Lower extremity alignment, sex, and strength have been cited as contributing to landing mechanics.

Objective: To determine the relationship among measurements of asymmetry of unilateral hip rotation (AUHR); mobility of the foot, which we described as relative arch deformity (RAD); hip abduction–external rotation strength; sex; and me-dial collapse of the knee during a single-leg jump landing. We hypothesized that AUHR and RAD would be positively correlated with movements often associated with medial collapse of the knee, including hip adduction and internal rotation excursions and knee abduction and rotation excursions.

Design: Descriptive laboratory study.

Setting: Research laboratory.

Patients or Other Participants: Thirty women and 15 men (age = 21 ± 2 years, height = 171.7 ± 9.5 cm, mass = 68.4 ± 9.5 kg) who had no history of surgery or recent injury and who participated in regular physical activity volunteered.

Intervention(s): Participants performed 3 double-leg forward jumps with a single-leg landing. Three-dimensional kinematic data were sampled at 100 Hz using an electromagnetic tracking system. We evaluated AUHR and RAD on the preferred leg and evaluated isometric peak hip abductor–external rotation torque. We assessed AUHR by calculating the difference between internal and external hip rotation in the prone position (AUHR = internal rotation – external rotation). We evaluated RAD using the Arch Height Index Measurement System. Correlations and linear regression analyses were used to assess relationships among AUHR, RAD, sex, peak hip abduction–external rotation torque, and kinematic variables for 3-dimensional motion of the hip and knee.

Main Outcome Measure(s): The dependent variables were joint angles at contact and joint excursions between contact and peak knee flexion.

Results: We found that AUHR was correlated with hip adduction excursion (R = 0.36, P = .02). Asymmetry of unilateral hip rotation, sex, and peak hip abduction–external rotation torque were predictive of knee abduction excursion (adjusted R2 = 0.47, P < .001). Asymmetry of unilateral hip rotation and sex were predictive of knee external rotation excursion (adjusted R2 = 0.23, P = .001). The RAD was correlated with hip adduction at contact (R2 = 0.10, R = 0.32, P = .04) and knee flexion excursion (R2 = 0.11, R = −0.34, P = .03).

Conclusions: Asymmetry of unilateral hip rotation, sex, and hip strength were associated with kinematic components of medial knee collapse.
Comparison of Recovery Strategies on Maximal Force-Generating Capacity and Electromyographic Activity Level of the Knee Extensor Muscles
Authors: Zarrouk Nidhal , Rebai Haithem , Yahia Abdelmoneem , Souissi Nizar , Hug François , Dogui Mohamed
Published: March 2017

Context: With regard to intermittent training exercise, the effects of the mode of recovery on subsequent performance are equivocal.

Objective: To compare the effects of 3 types of recovery intervention on peak torque (PT) and electromyographic (EMG) activity of the knee extensor muscles after fatiguing isokinetic intermittent concentric exercise.

Design: Crossover study.

Setting: Research laboratory.

Patients or Other Participants: Eight elite judo players (age = 18.4 ± 1.4 years, height = 180 ± 3 cm, mass = 77.0 ± 4.2 kg).

Intervention(s): Participants completed 3 randomized sessions within 7 days. Each session consisted of 5 sets of 10 concentric knee extensions at 80% PT at 120°/s, with 3 minutes of recovery between sets. Recovery interventions were passive, active, and electromyostimulation. The PT and maximal EMG activity were recorded simultaneously while participants performed isokinetic dynamometer trials before and 3 minutes after the resistance exercise.

Main Outcome Measure(s): The PT and maximal EMG activity from the knee extensors were quantified at isokinetic velocities of 60°/s, 120°/s, and 180°/s, with 5 repetitions at each velocity.

Results: The reduction in PT observed after electromyo-stimulation was less than that seen after passive (P < .001) or active recovery (P < .001). The reduction in PT was less after passive recovery than after active recovery (P < .001). The maximal EMG activity level observed after electromyostimulation was higher than that seen after active recovery (P < .05).

Conclusions: Electromyostimulation was an effective recovery tool in decreasing neuromuscular fatigue after high-intensity, intermittent isokinetic concentric exercise for the knee extensor muscles. Also, active recovery induced the greatest amount of neuromuscular fatigue.
Comparison of Abdominal Muscle Activity During a Single-Legged Hold in the Hook-Lying Position on the Floor and on a Round Foam Roll
Authors: Kim Su-Jung , Kwon Oh-Yun , Yi Chung-Hwi , Jeon Hye-Seon , Oh Jae-Seop , Cynn Heon-Seock , Weon Jong-Hyuck
Published: March 2017

Context: To improve trunk stability or trunk muscle strength, many athletic trainers and physiotherapists use various types of unstable equipment for training. The round foam roll is one of those unstable pieces of equipment and may be useful for improving trunk stability.

Objective: To assess the effect of the supporting surface (floor versus round foam roll) on the activity of abdominal muscles during a single-legged hold exercise performed in the hook-lying position on the floor and on a round foam roll.

Design: Crossover study.

Setting: University research laboratory.

Patients or Other Participants: Nineteen healthy volunteers (11 men, 8 women) from a university population.

Intervention(s): The participants were instructed to perform a single-legged hold exercise while in the hook-lying position on the floor (stable surface) and on a round foam roll (unstable surface).

Main Outcome Measure(s): Surface electromyography (EMG) signals were recorded from the bilateral rectus abdominis, internal oblique, and external oblique muscles. Dependent variables were examined with a paired t test.

Results: The EMG activities in all abdominal muscles were greater during the single-legged hold exercise performed on the round foam roll than on the stable surface.

Conclusions: The single-legged hold exercise in the hook-lying position on an unstable supporting surface induced greater abdominal muscle EMG amplitude than the same exercise performed on a stable supporting surface. These results suggest that performing the single-legged hold exercise while in the hook-lying position on a round foam roll is useful for activating the abdominal muscles.
Prevalence of Eating Disorder Risk and Body Image Distortion Among National Collegiate Athletic Association Division I Varsity Equestrian Athletes
Authors: Torres-McGehee Toni M. , Monsma Eva V. , Gay Jennifer L. , Minton Dawn M. , Mady-Foster Ashley N.
Published: March 2017

Context: Participation in appearance-based sports, particularly at the collegiate level, may place additional pressures on female athletes to be thin, which may increase the likelihood of their resorting to drastic weight control measures, such as disordered eating behaviors.

Objectives: (1) To estimate the prevalence and sources of eating disorder risk classification by academic status (freshman, sophomore, junior, or senior) and riding discipline (English and Western), (2) to examine riding style and academic status variations in body mass index (BMI) and silhouette type, and (3) to examine these variations across eating disorder risk classification type (eg, body image disturbances).

Design: Cross-sectional study.

Setting: Seven universities throughout the United States.

Patients or Other Participants: A total of 138 participants volunteered (mean age = 19.88 ± 1.29 years). They represented 2 equestrian disciplines: English riding (n = 91) and Western riding (n = 47).

Main Outcome Measure(s): Participants self-reported menstrual cycle history, height, and weight. We screened for eating disorder risk behaviors with the Eating Attitudes Test and for body disturbance with sex-specific BMI silhouettes.

Results: Based on the Eating Attitudes Test, estimated eating disorder prevalence was 42.0% in the total sample, 38.5% among English riders, and 48.9% among Western riders. No BMI or silhouette differences were found across academic status or discipline in disordered eating risk. Overall, participants perceived their body images as significantly larger than their actual physical sizes (self-reported BMI) and wanted to be significantly smaller in both normal clothing and competitive uniforms.

Conclusions: Disordered eating risk prevalence among equestrian athletes was similar to that reported in other aesthetic sports and lower than that in nonaesthetic sports. Athletic trainers working with these athletes should be sensitive to these risks and refer athletes as needed to clinicians knowledgeable about disordered eating. Professionals working with this population should avoid making negative comments about physical size and appearance.
Hip Kinematics During a Stop-Jump Task in Patients With Chronic Ankle Instability
Authors: Brown Cathleen N. , Padua Darin A. , Marshall Stephen W. , Guskiewicz Kevin M.
Published: March 2017

Context: Chronic ankle instability (CAI) commonly develops after lateral ankle sprain. Movement pattern differences at proximal joints may play a role in instability.

Objective: To determine whether people with mechanical ankle instability (MAI) or functional ankle instability (FAI) exhibited different hip kinematics and kinetics during a stop-jump task compared with “copers.”

Design: Cross-sectional study.

Setting: Sports medicine research laboratory.

Patients or Other Participants: Sixty-three recreational athletes, 21 (11 men, 10 women) per group, matched for sex, age, height, mass, and limb dominance. All participants reported a history of a moderate to severe ankle sprain. The participants with MAI and FAI reported 2 or more episodes of giving way at the ankle in the last year and decreased functional ability; copers did not. The MAI group demonstrated clinically positive anterior drawer and talar tilt tests, whereas the FAI group and copers did not.

Intervention(s): Participants performed a maximum-speed approach run and a 2-legged stop jump followed by a maximum vertical jump.

Main Outcome Measure(s): An electromagnetic tracking device synchronized with a force plate collected data during the stance phase of a 2-legged stop jump. Hip motion was measured from initial contact to takeoff into the vertical jump. Group differences in hip kinematics and kinetics were assessed.

Results: The MAI group demonstrated greater hip flexion at initial contact and at maximum (P = .029 and P = .017, respectively) and greater hip external rotation at maximum (P = .035) than the coper group. The MAI group also demonstrated greater hip flexion displacement than both the FAI (P = .050) and coper groups (P = .006). No differences were noted between the FAI and coper groups in hip kinematic variables or among any of the groups in ground reaction force variables.

Conclusions: The MAI group demonstrated different hip kinematics than the FAI and coper groups. Proximal joint motion may be affected by ankle joint function and laxity, and clinicians may need to assess proximal joints after repeated ankle sprains.
Knee Separation Distance and Lower Extremity Kinematics During a Drop Land: Implications for Clinical Screening
Authors: Sigward Susan M. , Havens Kathryn L. , Powers Christopher M.
Published: March 2017

Context: Excessive knee valgus during dynamic tasks is thought to contribute to lower extremity overuse and traumatic injuries. Clinically, assessments of frontal-plane knee motion typically include measures of the distance between the knees during landing. However, it is not clear how this clinical assessment relates to knee-abduction angle or how it is influenced by the position of the lower extremities in the transverse and frontal planes.

Objective: To determine whether normalized knee separation distance (NKSD) is a predictor of knee-abduction angles and to assess the influence of lower extremity transverse-plane and frontal-plane angles on NKSD during a drop land.

Design: Cross-sectional study.

Setting: Motion analysis laboratory.

Patients or Other Participants: Twenty-five healthy female athletes.

Intervention(s): The frontal-plane distance between the 2- dimensional coordinates of markers over the greater trochanters (intertrochanteric distance), lateral femoral epicondyles (knee separation distance), and lateral malleoli (stance width) bilaterally was calculated during a drop land. The knee separation distance was normalized by intertrochanteric distance (NKSD). Concurrently, 3-dimensional lower extremity transverse-plane and frontal-plane kinematics were obtained.

Main Outcome Measure(s): We assessed NKSD, stance width, and bilateral average knee and hip transverse plane and frontal-plane angles and ankle frontal-plane angles. Linear regression was used to determine the association between NKSD and bilateral average knee frontal-plane angles. Stepwise multiple regression was used to identify the best predictors of NKSD during the drop land.

Results: After we controlled for stance width, NKSD explained 52% of the variance in the knee frontal-plane angle. When we took lower extremity kinematics into account, after controlling for stance width, the average hip frontal-plane angle was the best predictor of NKSD, explaining 97% of the variance.

Conclusions: Although NKSD is a predictor of knee- abduction angle, frontal-plane hip angle and stance width are strongly related to NKSD. Caution must be taken when interpreting NKSD as knee abduction.
Self-Paced Exercise Performance in the Heat After Pre-Exercise Cold-Fluid Ingestion
Authors: Byrne Christopher , Owen Craig , Cosnefroy Aurélien , Lee Jason Kai Wei
Published: March 2017

Context: Precooling is the pre-exercise reduction of body temperature and is an effective method of improving physiologic function and exercise performance in environmental heat. A practical and effective method of precooling suitable for application at athletic venues has not been demonstrated.

Objective: To confirm the effectiveness of pre-exercise ingestion of cold fluid without fluid ingestion during exercise on pre-exercise core temperature and to determine whether pre-exercise ingestion of cold fluid alone without continued provision of cold fluid during exercise can improve exercise performance in the heat.

Design: Randomized controlled clinical trial.

Setting: Environmental chamber at an exercise physiology laboratory that was maintained at 32°C, 60% relative humidity, and 3.2 m/s facing air velocity.

Patients or Other Participants: Seven male recreational cyclists (age = 21 ± 1.5 years, height = 1.81 ± 0.07 m, mass = 78.4 ± 9.2 kg) participated.

Intervention(s): Participants ingested 900 mL of cold (2°C) or control (37°C) flavored water in 3 300-mL aliquots over 35 minutes of pre-exercise rest.

Main Outcome Measure(s): Rectal temperature and thermal comfort before exercise and distance cycled, power output, pacing, rectal temperature, mean skin temperature, heart rate, blood lactate, thermal comfort, perceived exertion, and sweat loss during exercise.

Results: During rest, a greater decrease in rectal temperature was observed with ingestion of the cold fluid (0.41 ± 0.16°C) than the control fluid (0.17 ± 0.17°C) over 35 to 5 minutes before exercise (t6 = −3.47, P = .01). During exercise, rectal temperature was lower after ingestion of the cold fluid at 5 to 25 minutes (t6 range, 2.53–3.38, P ≤ .05). Distance cycled was greater after ingestion of the cold fluid (19.26 ± 2.91 km) than after ingestion of the control fluid (18.72 ± 2.59 km; t6 = −2.80, P = .03). Mean power output also was greater after ingestion of the cold fluid (275 ± 27 W) than the control fluid (261 ± 22 W; t6 = −2.13, P = .05). No differences were observed for pacing, mean skin temperature, heart rate, blood lactate, thermal comfort, perceived exertion, and sweat loss (P > .05).

Conclusions: We demonstrated that pre-exercise ingestion of cold fluid is a simple, effective precooling method suitable for field-based application.