bluuebunny/crossref_metadata_2025 huggingface dataset:
Washington et les régimes militaires sud-américains (1964-1989)
Authors: Vagnoux Isabelle
Published: May 2010

Résumé De l’avènement des dictatures brésilienne (1964) et chilienne (1973) à la désintégration des régimes militaires sud-américains dans les années 1980, cet article se propose d’analyser les ressorts de leurs alliances stratégiques avec Washington, avec un accent tout particulier sur les trois grands pays d’Amérique du Sud : l’Argentine, le Brésil et le Chili. Nous nous attachons également à souligner la pluralité et la complexité des positions américaines sur la question, notamment en montrant les dissensions internes à Washington, entre la Maison Blanche et le Congrès, mais aussi au sein de l’exécutif.
Laboratoires de la mondialisation économique
Authors: Boisard Stéphane , Heredia Mariana
Published: May 2010

Résumé Partant d’une étude comparée des politiques économiques des dictatures argentine (1976-1983) et chilienne (1973-1990), cet article questionne l’existence d’un « modèle économique » propre aux dictatures dites de sécurité nationale, en mettant l’accent sur l’influence des approches théorico-idéologiques importées des États-Unis, notamment en ce qui concerne l’inflation. Certains aspects montrent des points de convergence entre les deux expériences tels que les effets sociaux régressifs ou encore les conflits dans la mise en œuvre des politiques économiques entre civils (économistes) et militaires d’une part et entre corps d’armée d’autre part. D’autres aspects en revanche mettent en évidence de profondes divergences. En cela la « cohérence » de la politique économique chilienne s’oppose au caractère hybride du cas argentin.
Les Églises et le pouvoir dans le Brésil des militaires (1964-1985)
Authors: Marin Richard
Published: May 2010

Résumé À partir milieu des années 1950, certains évangéliques et des secteurs de l’Église catholique amorcent un mouvement de rénovation et s’ouvrent aux problèmes de la réalité brésilienne. Pourtant, en avril 1964, toutes les Églises chrétiennes adhérent au nouvel ordre, issu du coup d’État militaire avant de diverger fortement par la suite. Alors que la Conférence des évêques brésiliens en vient à incarner la résistance de la société tout entière au régime autoritaire puis dictatorial, les évangéliques continuent à le soutenir. Plus que dans une différence de nature entre les deux cultures religieuses, c’est dans l’histoire et dans les rapports de force au sein du champ religieux qu’il convient de rechercher les raisons d’évolutions aussi antagoniques.
Associations de victimes, terrorisme d'État et politique dans l'Argentine de 1973 à 1987
Authors: Tahir Nadia , Franco Marina
Published: May 2010

Résumé Between 1976 and 1983, Argentina was governed by a military dictatorship that instituted a repressive system. It was particularly unusual because of its violence and economic, political, social and cultural effects on the long term on Argentine society. This article goes through this historical process again, but with a broader perspective to explain the human rights movement that emerged as the principal, and almost only, opposition to the authoritarian regime. The point of view chosen considers a political process in the long term, including the years before the coup of 1976, and a brief period of time after democracy was re-established in 1983. It makes it possible not only to understand some fundamental characteristics of the humanitarian movement of these years – protagonist of the Argentine public sphere until today, but also to reflect on important historical problems and the way research touches the subject.
Advocacy, une recouvrance
Authors: Dutoit Martine , Deutsch Claude
Published: May 2010

Résumé La réappropriation de la dignité doit partir de la considération de ce que les gens sont vraiment et de ce qu’ils peuvent faire eux-mêmes et pour eux-mêmes. La pratique d’Advocacy, à travers le soutien individualisé dans les vécus de préjudice et l’action collective dans les espaces conviviaux citoyens permet l’accès à la pleine citoyenneté à travers l’ empowerment .
Le travail social vu à distance
Authors: Richard Christophe
Published: May 2010

Résumé J’ai rencontré Christophe Richard dans un train, au retour des Entretiens du travail social de Saint-Étienne, qui ont eu lieu du 1 er au 3 décembre et auxquels nous avions participé tous les deux. Nous ne nous connaissions pas. Après un pot pris ensemble à la gare de Lyon, nous avons dû nous quitter, chacun devant prendre sa direction. Je me suis senti rempli des questions que nous venions d’aborder ensemble pendant les trois jours, plein aussi de nos interrogations communes. Il y avait trop de choses qui remuaient là-dedans, sur le travail social, sur la vie des quartiers, l’incompréhension entre les bénévoles et les professionnels, les politiques et les habitants du quartier, sa propre trajectoire, celle de quelqu’un qui fait « cause commune », qui ne veut pas trahir, et qui se trouve démuni et un peu seul devant la détresse du monde. J’ai demandé à Richard de mettre par écrit son histoire de vie et son parcours, enfin, ce qu’il pourrait en dire aujourd’hui. Après un mois de silence, j’ai reçu le texte ci-dessous. Peut-être amènera-t-il un utile dialogue dans la brèche ouverte par l’auteur qui raconte sa vie avec exactitude et modestie. Vous pourrez lui répondre. Jean-François Gomez
Sartre et Fanon
Authors: Mornet Joseph
Published: May 2010

Résumé La préface de Jean-Paul Sartre au livre de Frantz Fanon est à elle-même un petit essai qui ne compte pas moins de cinquante pages. Elle oblige à nous replonger dans les événements de cette année 1961, de ce que l’histoire a appelé la « guerre d’Algérie ».
Les CEMÉA et Frantz Fanon
Authors: Ebion Roger
Published: May 2010

Résumé C’est le thème du séminaire organisé par les ceméa de Martinique les 21, 22 et 23 avril 2005. Par ce séminaire sur Frantz Fanon, les ceméa célébraient leurs 50 ans d’existence à la Martinique.
Approche clinique du sujet
Authors: Douville Olivier
Published: May 2010

Résumé Comment la pratique clinique peut-elle recevoir un éclairage de patients dont l’histoire, la leur ou celle de leurs ascendants, est marquée par des violences massives de meurtre de l’humanité brisant les fils des générations qui la constituent ?
Fanon et le psychotraumatisme
Authors: Ridouh Bachir , Chakali Mohammed
Published: May 2010

Résumé Les événements que connaît notre pays depuis plus de dix ans aujourd’hui ont contraint les professionnels de la santé mentale à une lecture de tout ce qui s’est écrit sur les souffrances qui découlent des situations de conflits sociaux majeurs et de guerre, autrement dit, sur le psychotraumatisme.
Mission impossible ?
Authors: Koscinski T.
Published: May 2010

Résumé Cet article a été rédigé dans le cadre d’un master de « stratégies de direction ». La démarche d’écriture a été « utilitaire » dans le sens où l’expérience vécue devait pouvoir être utilisable par la plupart. Il ne s’agissait donc pas de se raconter de façon personnelle mais de tenter d’extraire ce qui pourrait être utile. L’autocensure a donc occulté les périodes de souffrance et de dépression individuelles et/ou collectives, mais aussi celles des plaisirs et réussites.
Loi Perben II
Authors: Puech Laurent , Samson Emmanuel
Published: May 2010

Résumé Ce texte est extrait de La revue française de service social publiée par l’ anas (n? 219, février 2006). Les professionnels tenus au secret professionnel 1 savent qu’il existe des situations où la loi autorise à sa levée sans jamais l’y obliger 2 et un cas où sa levée est obligatoire 3 . La loi du 9 mars 2004, dite Loi Perben II, en élargissant les possibilités d’accès aux informations détenues par les services sociaux, ajoute une nouvelle forme d’atteinte au secret professionnel. Afin que les assistants de service social et l’ensemble des travailleurs sociaux soumis au secret professionnel puissent se positionner 4 , nous proposons ici un guide qui a pour ambition d’éclairer votre pratique.
La formation est une clinique de l'expérience
Authors: Lumeau Françoise
Published: May 2010

Résumé Le centre de formation aux métiers du social de l’association erasme , membre associé des Ceméa, prépare aux métiers d’éducateurs. S’il s’inscrit dans les nouveaux référentiels et les nouvelles conceptions du métier et de la formation, il ne veut pas pour autant abandonner ses axes de réflexion fondateurs qui ont la prétention de donner aux étudiants une identité professionnelle solide. Cet écrit sur la construction de l’expérience dans le parcours de formation est le fruit d’un travail collectif.
Une crise en centre de formation
Authors: Chauvière Michel
Published: May 2010

Résumé Il y a un an l’ irts de Paris traversait une grave crise financière et institutionnelle. vst ne prendra pas ici position dans les arguments développés par les acteurs de ce conflit car, si les responsabilités lourdes de l’institution gestionnaire sont évidentes, il nous apparaît également que des positions professionnelles extrêmes n’ont pas permis de trouver une issue positive. Michel Chauvière avait alors pris position dans le débat. vst a souhaité que son texte figure dans ce dossier sur la formation non pas pour réactiver le conflit passé, mais pour l’analyse globale et l’ouverture de réflexion qu’il propose. vst
Le chat
Authors: Perraud Étienne
Published: May 2010

Résumé Ce texte a été écrit à l’occasion d’une formation sur le concept de « référent » dans un service de psychothérapie institutionnelle, formation organisée par les Ceméa, en réponse à un appel d’offre dans un « projet de service ». Cette formation regroupait trente professionnels du même service, tous statuts confondus.
Qu'auriez-vous fait à leur place ?
Authors: Le Roy Pierre
Published: May 2010

Résumé Ce « témoignage-fiction » construit de toutes pièces reflète une situation tout à fait plausible qui a pu arriver hier, qui peut se dérouler aujourd’hui et pourrait se produire demain. Cette situation pose des problèmes de droit mais aussi d’éthique pour tous les acteurs concernés.
Santé mentale de l'enfant
Authors: Tubiana Maurice
Published: May 2010

Résumé À la demande de la mission dirigée par le Dr Philippe Most, qui avait été chargée par les ministères de l’Éducation nationale et de la Santé d’un rapport sur la santé des jeunes en milieu scolaire, le conseil d’administration de l’Académie de médecine a créé deux groupes de travail sur la santé mentale des jeunes de 0 à 4 ans et de 5 à 12 ans, qui ont été coordonnés par Maurice Tubiana et Michel Arthuis 1 . Ces groupes ont travaillé en liaison avec la mission Most et ont pris note du rapport préliminaire de cette mission et des observations et recommandations qui y sont faites. Leur rapport commun donné ci-dessous 2 , rédigé sous l’égide de l’Académie de médecine, s’inscrit dans le cadre de cette mission. Plusieurs experts ont été auditionnés 3 .
Computerized Bioterrorism Education and Training for Nurses on Bioterrorism Attack Agents
Authors: Nyamathi Adeline M. , Casillas Adrian , King Major L. , Gresham Louise , Pierce Elaine , Farb Daniel , Weichmann Carrie
Published: May 2010

Background:

Biological agents have the ability to cause large-scale mass casualties. For this reason, their likely use in future terrorist attacks is a concern for national security. Recent studies show that nurses are ill prepared to deal with agents used in biological warfare. Achieving a goal for bioterrorism preparedness is directly linked to comprehensive education and training that enables first-line responders such as nurses to diagnose infectious agents rapidly.

Methods:

The study evaluated participants’ responses to biological agents using a computerized bioterrorism education and training program versus a standard bioterrorism education and training program.

Results:

Both programs improved participants’ ability to complete and solve case studies involving the identification of specific biological agents.

Conclusion:

Participants in the computerized bioterrorism education and training program were more likely to solve the cases critically without reliance on expert consultants. However, participants in the standard bioterrorism education and training program reduced the use of unnecessary diagnostic tests.
Nurse Educator Orientation: Professional Development that Promotes Retention
Authors: Baker Sandra L.
Published: May 2010

Formalized orientation can prepare and socialize nurse educators for academic roles, increasing job satisfaction and retention. This article describes a community college nursing faculty orientation program that includes goals, pre- and post-assessment, a group-determined instructional plan, support and mentoring, and outcomes evaluation. Posttest scores showed that at program completion, perceived teaching competency was either the same or greater in all identified skill areas (increase of 40% to 60% above the original group baseline). Nurse educator participants reported that the program contributed to their overall perception of support and satisfaction with academia, with open group discussion times rated highest. At the end of 3 years, 91% of novice faculty (
n
= 11) were retained.
Clinical Ladder Program Evolution: Journey from Novice to Expert to Enhancing Outcomes
Authors: Burket Tamara L. , Felmlee Margaret , Greider Penelope J. , Hippensteel Dawn M. , Rohrer Elizabeth A. , Shay M. Lynn
Published: May 2010

The clinical ladder program has evolved with the ever-changing environment of nursing at one academic medical center. The process has developed over time while adhering to the foundational tenets of recognizing and rewarding excellent bedside nursing practice. Nurses on the clinical ladder at this institution represent the ideal performance of mentoring and motivating other nurses and interdisciplinary team members. This article describes how the program has evolved over the last two decades, the challenges that have been met, and the successful outcomes that endure.
Contact Sports for Young Athletes: Keys to Safety
Authors: Halstead Mark E.
Published: May 2010

CME EDUCATIONAL OBJECTIVES

1.

Identify specific sporting activities that are considered contact or collision sports by the American Academy of Pediatrics (AAP).

2.

Discuss common injuries associated with contact sports with high injury rates.

3.

Update information related to new guidelines and safety devices designed to reduce injuries in contact sports.
Non-contact Sports: Running, Swimming, and Dance — Identifying Common Injuries
Authors: Kelly Amanda Weiss
Published: May 2010

CME EDUCATIONAL OBJECTIVES

1.

Identify the common injuries associated with non-contact sports participation in children and adolescents.

2.

Identify and discuss the assessment of commonly associated injuries in children and adolescents who participate in non-contact sports.

3.

Determine the best rehabilitation program for each of the identified injuries discussed.
Sports Nutrition for Young Athletes
Authors: Bonci Leslie
Published: May 2010

CME EDUCATIONAL OBJECTIVES

1.

Identify an effective means to assess the nutritional status of a young athlete during the office visit.

2.

Review the most common performance detractors associated with nutritional inadequacies in children and adolescents.

3.

Discuss specific nutritional guidelines for the young athlete and how best to motivate the affected child to improve their overall nutritional health.
Factors Affecting Health-Promoting Behaviors of Community-Dwelling Korean Older Women
Authors: Lim Young Mi , Sung Mi Hae , Joo Kyung Sook
Published: May 2010

The purpose of the study was to examine a staged theoretical causal model on health-promoting behavior of community-dwelling Korean older women (N= 438). Sixty-two percent of the variance in the health-promoting behaviors of the sample was explained by the direct effect of social support (β = 0.53), self-efficacy (β = 0.18), perceived health status (β = 0.16), education (β = 0.12), and presence of a spouse (β = 0.10). Twenty-nine percent of the variance in social support was explained by the direct effect of self-efficacy (β = 0.31), personal control (β = 0.10), perceived health status (β = 0.16), age (β = −0.31), and religion (β = 0.15). The results indicate that self-efficacy, personal control, and perceived health status had an indirect influence on health-promoting behavior through social support. The findings of this study suggest that social support is a mediating variable on health-promoting behavior of community-dwelling older women, and further refinement of the underlying model is warranted.
The Influence of Postoperative Acromial and Scapular Spine Fractures on the Results of Reverse Shoulder Arthroplasty
Authors: Hattrup Steven J.
Published: May 2010

Fractures of the acromion or scapular spine are recognized complications of reverse arthroplasty. This study reviewed the outcome of reverse arthroplasties with such fractures and compared the results to arthroplasties without the fractures. A consecutive series of 125 reverse arthroplasties were reviewed for the development of a postoperative acromial or scapular spine fracture. Nine cases were identified, all treated nonoperatively. Five fractures occurred from falls, and the remainder were fatigue fractures. These results were compared to 67 patients with similar diagnoses in the series without such fractures. No significant differences existed between the 2 groups in terms of age, sex, side of surgery, or diagnosis.

Preoperatively, both groups had substantial pain, limitation of motion, and poor American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) outcome scores. No significant differences existed between the 2 groups. At minimum 1-year follow-up, results in the shoulders with fractures were improved. Mean visual analog score (VAS) was 4.0, flexion was 89.3°, ASES score was 47.9, and SST score was 5.6. Nevertheless, these results were inferior to those in shoulders without a fracture, whose mean VAS was 0.7, flexion was 152.1°, ASES score was 87.7, and SST score was 10.2.

Nonoperative management was chosen in these cases due to a concern that stable fixation would not be obtained with surgery. Although the final outcome was diminished, these patients improved their preoperative state. A decision for surgical treatment will need to weigh the challenges of internal fixation with the incremental improvement that may occur with improved fracture healing.
Plain Radiographs Have Limited Sensitivity for Glenohumeral Cartilage Lesions
Authors: Kappe Thomas , Elsharkawi Mohammed , Flören Markus , Reichel Heiko , Cakir Balkan
Published: May 2010

Glenohumeral cartilage lesions are frequently encountered during shoulder arthroscopy, but are not always represented on radiographs. We intended to define the diagnostic value of plain shoulder radiographs in detecting glenohumeral cartilage lesions. The radiographs of 167 patients undergoing shoulder arthroscopy were analyzed for signs of degenerative joint disease. Formal criteria indicating osteoarthritis (osteophytes, joint space narrowing, and sclerosis) were registered and correlated to cartilage lesions diagnosed during shoulder arthroscopy. The intrarater reliabilities were .920 (T.K.) and .953 (M.E.) and the interrater reliabilities were .802 (T.K. 1, M.E. 1), .909 (T.K. 2, M.E. 1), .922 (T.K. 1, M.E. 2), and .953 (T.K. 2, M.E. 2), indicating excellent agreement. There were 35 correct positive, 91 correct negative, 34 false negative, and 7 false positive radiographs. The sensitivity and specificity for any degree of cartilage lesion were 50.7% and 92.9%, respectively, and the positive and negative predictive values were 83.3% and 72.8%, respectively. For third- and fourth-grade cartilage lesions, the sensitivity was 76.0% and the positive and negative predictive values were 73.1% and 93.8%, respectively. While plain radiographs can often detect severe cartilage lesions, the sensitivity and negative predictive value are too low to reliably exclude cartilage lesions overall. In case of doubt, we recommend further radiological workup.
Primary Musculoskeletal Sarcoidosis
Authors: Anakwenze Okechukwu A. , Kancherla Vamsi , Hatch Michael , Brooks John S. , Ogilvie Christian M.
Published: May 2010

Sarcoidosis is a well-described clinical entity with several types of presentation among different organ systems. However, primary musculoskeletal manifestation is a rare and seldom-described manifestation. A retrospective review of patients seen at our institution from 1999 to 2009 was performed to identify patients with such presentation.

Eleven patients with musculoskeletal sarcoidosis were identified. Seven patients presented with solitary lesions, while 4 presented with multiple foci of disease. Histologically, all lesions revealed granulomatous inflammation consistent with sarcoidosis. Cultures and gram stain were negative in all patients. One patient was found to have evidence of pulmonary sarcoidosis after diagnosis of musculoskeletal sarcoidosis. Eight patients had primarily soft tissue involvement with visible masses, while 3 patients had primarily osseous involvement with no mass. Pain was reported by 9 of 11 patients. On magnetic resonance imaging, all lesions were dark on T1, bright on T2, and poorly marginated. Magnetic resonance imaging was noted to be more accurate in revealing the pathology than radiographic imaging. Four patients underwent complete excision and 1 received a steroid injection. The remaining patients required no further treatment after diagnosis.

Musculoskeletal sarcoidosis is rare and can present as single or multiple lesions. Definitive diagnosis is made by biopsy. The decision to operate should be based on symptoms, issues with cosmesis, impending fractures, growth, and/or involvement of neurovascular structures. Patients should be evaluated for pulmonary involvement.
Infraspinatus Muscle Atrophy as a Function of the Sagittal Extent of Rotator Cuff Tears
Authors: Matsuki Keisuke , Sugaya Hiroyuki , Watanabe Atsuya , Toyone Tomoaki , Moriishi Joji , Mochizuki Tomoyuki , Akita Keiichi , Wada Yuichi
Published: May 2010

Infraspinatus muscle atrophy is sometimes observed in rotator cuff tears that appear to involve only the supraspinatus tendon. The goal of this study was to evaluate infraspinatus muscle atrophy as a function of the sagittal extent of tears, using magnetic resonance imaging. Forty-three patients (45 shoulders) were enrolled, including 23 men and 20 women with a mean age of 60 years. Patients were divided into 4 groups reflecting the sagittal extent of their tears: 16 shoulders with intact cuff (group A), 8 tears localized to the anterior half of the superior facet (group B), 10 tears extending to the posterior half of the superior facet (group C), and 11 tears extending to the middle facet (group D). The infraspinatus muscle was divided into 4 compartments using proximal muscular slices in oblique sagittal images; muscle atrophy in each compartment was graded on a scale of I to IV. Within each compartment, differences in degree of atrophy between the 4 groups were statistically tested. No shoulders in groups A and B had more than grade II atrophy in all compartments. However, grade III and IV atrophy was observed in group C in the anterosuperior compartment and in group D in all compartments. Considering the new anatomical finding that the infraspinatus inserts into the posterior portion of the superior facet as well as the middle facet, infraspinatus muscle atrophy in group C patients may have resulted from infraspinatus tendon involvement in this type of tear.
Comparison of Posterior Dynamic and Posterior Rigid Transpedicular Stabilization With Fusion to Treat Degenerative Spondylolisthesis
Authors: Kaner Tuncay , Dalbayrak Sedat , Oktenoglu Tunc , Sasani Mehdi , Aydin Ahmet Levent , Ozer Ali Fahir
Published: May 2010

This article describes the clinical and radiological outcomes of a comparison of posterior dynamic transpedicular stabilization and posterior rigid transpedicular stabilization with fusion after decompression in the treatment of degenerative spondylolisthesis. This prospective clinical and radiologic study was conducted between 2004 and 2007 and included 46 patients, of whom 33 were women (71.7%) and 13 were men (28.3%). Mean patient age was 61.67±10.80 years (range, 45–89 years). Twenty-six patients who underwent lumbar decompression and posterior dynamic transpedicular stabilization were followed for a mean of 38 months (range, 24–55 months). In the fusion group, 20 patients who underwent lumbar decompression and rigid stabilization with fusion were followed for a mean of 44 months (range, 26–64 months).

The intervertebral space measurements of the dynamic group at the preoperative examination and at 12 and 24 months postoperatively were statistically significantly higher than the intervertebral space measurements of the fusion group (
P
<.05). In the dynamic group, complications occurred in 2 patients; the first was a screw malposition, which was improved with revision surgery within 1 month of the initial surgery, and the second was a fusion performed in the second year in 1 patient because the patient reported continued pain. In the fusion group, adjacent segment disease was observed in 1 patient, with subsequent reoperation. Lumbar decompression and posterior dynamic transpedicular stabilization yield satisfactory results in the treatment of degenerative lumbar spondylolisthesis and can be considered a valid alternative to fusion.
The External Rotation Test in the Diagnosis of Adhesive Capsulitis
Authors: Wolf Eugene M. , Cox Wesley K.
Published: May 2010

This article evaluates the effectiveness of the external rotation test in diagnosing capsulitis. The test is performed with the upper arm in a neutral position at the patient's side and the elbow in 90° of flexion. The test is positive when pain is produced with this maneuver. All patients (379) evaluated for atraumatic shoulder pain during 1 calendar year were studied. The patients were divided into external rotation positive (91 patients) and external rotation negative (311 patients) groups. Patients with atraumatic shoulder pain with a positive external rotation test were presumed to have adhesive capsulitis in the absence of glenohumeral arthritis. Patients diagnosed with adhesive capsulitis received an intraarticular steroid injection and a home therapy program. Patients were contacted 10 to 19 months following treatment to determine their status and need for any further care.

A diagnosis of adhesive capsulitis was made in 75% of external rotation positive patients (68 patients). Glenohumeral arthritis evidenced by radiographs was the only other diagnosis that produced a positive external rotation test (23 patients) in this group of atraumatic shoulders. Only 1 of 68 patients (1.4%) with a diagnosis of adhesive capsulitis (external rotation positive) had surgery during the follow-up period. However, 86 of 311 (27.7%) patients in the external rotation negative group underwent surgery (
P
<.0001). In the external rotation positive group, 3 patients (5%) sought second opinions, while 95% (55/58) sought no further care.

Our data suggest that patients with a history of atraumatic shoulder pain and a positive external rotation test on examination should be considered for adhesive capsulitis in the absence of glenohumeral arthritis.
Implant Removal Following Surgical Stabilization of Patella Fracture
Authors: Kumar Gunasekaran , Mereddy Praveen K. , Hakkalamani Santhosh , Donnachie Nigel J.
Published: May 2010

Patella fractures are relatively common injuries. Tension band wiring is commonly used to treat displaced patella fractures. The goal of this study was to assess the outcome and implant removal rate following surgical stabilization of patella fracture. A consecutive series of 67 patients over a 6-year period was reviewed. Minimum follow-up to fracture healing (3 months) was available in 63 patients.

Forty-three men and 24 women with a mean age of 49 years (range, 14–90 years) underwent surgical stabilization of patella fracture. Three open fractures and associated injuries were noted in 22 patients. Surgical treatment methods used were: tension band wiring in 44, tension band wiring with cerclage wire in 13, tension band wiring with screws in 4, and screw fixation in 6. All fractures united. Two superficial infections responded to oral antibiotics. One patient had revision surgery at 6 weeks. Twenty-two patients required implant removal for implant-related symptoms. Mean follow-up in asymptomatic patients was 8 months (range, 3–18 months) and in patients with implant-related problems was 17 months (range, 10–36 months). Four patients were lost to follow-up.

Surgical stabilization of patella fractures by current techniques demonstrated satisfactory fracture union. However, 1 in 3 required surgery for implant-related symptoms. In the younger than 60 years group, the implant removal rate was 40%. This high rate of implant removal must be discussed with the patient prior to surgery. Newer techniques to avoid skin irritation should be considered.
P53 Expression as a Prognostic Marker in Giant Cell Tumor of Bone: A Pilot Study
Authors: Papanastassiou Ioannis , Ioannou Markos , Papagelopoulos Panayiotis J. , Arealis George , Mihas Constantinos , Iakovidou Ioanna , Demertzis Nikolaos
Published: May 2010

P53 is the best known tumor suppressor gene. If p53 is mutated, the ability of the cell to sense and repair DNA defects is lost. Failure of this mechanism increases the risk of malignant transformation and tumorigenesis. P53 overexpression is implicated in many carcinomas. P53 alterations appear to be frequent in bone and soft tissue sarcoma and have a strong negative impact on survival in various subtypes of sarcoma like Ewing's sarcoma, synovial sarcoma, and myxoid liposarcoma. There is also evidence in the literature that p53 may be implicated in bone giant cell tumor behavior.

The goal of this pilot retrospective study was to detect p53 mutation in giant cell tumor of bone and correlate it with clinical outcome. We analyzed the presence of p53 mutation in 39 patients with giant cell tumor of bone by means of immunohistochemical staining; 8 tumors expressed mutated p53 protein. Seven of them recurred locally (
P
<.001) and 2 metastasized to the lung (
P
<.05). In multivariate analysis/subgroup analysis, local recurrence was still strongly correlated, while metastasis had a weaker correlation. Our findings suggest that p53 mutation in giant cell tumor of bone can be useful in predicting tumor behavior, especially in regard to local recurrence.

Limitations of this study include the retrospective data collection, the limited number of patients, and the multifactorial nature of the disease; tumor grade, surgical margins, use of adjuvant therapy, and thoroughness of excision may influence the therapeutic outcome. Despite these limitations, this correlation should be further investigated with larger clinical studies. P53 may be used as a marker for the biologic behavior of giant cell tumor of bone.
Research Update and Recent Developments in the Management of Scoliosis in Neurofibromatosis Type 1
Authors: Wang Zhenyu , Liu Yi
Published: May 2010

Neurofibromatosis type 1 (NF-1) is an autosomal dominant hereditary disease characterized by an abnormal proliferation of cells from the neural crest. Neurofibromatosis type 1 is often associated with orthopedic disorders, especially scoliosis, which is the most common skeletal manifestation of NF-1. The effects of treatment of scoliosis in NF-1 are less satisfactory than other scoliotic types due to the particular pathogenesis and clinical characteristics. Early diagnosis and treatment may be the best way to improve outcomes. This article summarizes the recent genetic and clinical developments of scoliosis in NF-1.
Femoroacetabular Impingement and Acetabular Labral Tears
Authors: Rylander Lucas , Froelich John M. , Novicoff Wendy , Saleh Khaled
Published: May 2010

Educational Objectives

As a result of reading this article, physicians should be able to:

1.

Describe the pathoanatomy and clinical presentation of femoroacetabular impingement and acetabular labral tears.

2.

Compare the different radiographic findings associated with cam and pincer impingement.

3.

Discuss potential treatment options for femoroacetabular impingement and acetabular labral tears.

4.

Review and summarize the current outcome studies for the differing treatment options of femoroacetabular impingement and acetabular labral tears.
Absent Optic Chiasm Presenting With Horizontal Nystagmus
Authors: Salchow Daniel J. , Kohlhase Jürgen , Miller Marijean , Kadom Nadja , FitzGibbon Edmond J. , Caruso Rafael C. , Brooks Brian P.
Published: May 2010

A female infant with horizontal nystagmus and normal ophthalmic examination had isolated absence of the optic chiasm on magnetic resonance imaging. Eye movements were recorded on video and reviewed. Horizontal nystagmus without see-saw nystagmus was observed. Visual evoked potential showed inter-hemispheric asymmetry compatible with the absence of crossing chiasmal fibers. Systemic abnormalities in this patient included cleft lip, preauricular skin tags, broad thumbs, and an anteriorly positioned anus, suggestive of Townes–Brock syndrome.
[J Pediatr Ophthalmol Strabismus 2010;47:187–191.]
Vitrectomy in Cases of Nonaccidental Injury
Authors: Rahman Waheeda , Osbourne Sarah , Bhan Anna , Orr Gavin M. , Gregson Richard
Published: May 2010

Nonaccidental head injuries may present in several ways, requiring prompt recognition and management because of the risk of death or permanent neurologic and visual impairment. Dense amblyopia and high anisometropic myopia induced by prolonged occlusion of the macula by hemorrhage is a concern in these infants, although the prognosis also depends on the extent of associated brain injury. There are few reports of the visual and general outcome of children with a diagnosis of nonaccidental injury who have undergone vitrectomy. This report describes the outcome in six eyes of four patients diagnosed as having nonaccidental injury who underwent vitrectomy. The results are more favorable than in previous reports.
[J Pediatr Ophthalmol Strabismus 2010;47:163–167.]
Traumatic Rupture of the Superior Oblique Muscle Tendon Resulting in Acquired Brown's Syndrome
Authors: Warrier Sunil , Wells Jane , Prabhakaran Venkatesh C. , Selva Dinesh
Published: May 2010

Traumatic rupture of the superior oblique tendon is a rare cause of acquired Brown's syndrome. This report describes a case of traumatic rupture of the superior oblique tendon, distal to the trochlea, after injury with a plant hook. The ruptured tendon was reapproximated. Postoperatively, asymptomatic Brown's syndrome developed, although residual function of the superior oblique muscle was retained. Full-thickness upper eyelid lacerations, especially those caused by a hook, must be explored carefully to exclude superior oblique tendon rupture. Careful reapproximation of the tendon can result in residual muscle function.
[J Pediatr Ophthalmol Strabismus 2010;47:168–170.]
Central Corneal Thickness in Children and Adolescents with Pediatric Glaucoma and Eye Disorders at Risk of Developing Glaucoma
Authors: Lopez Juan P. , Freedman Sharon F. , Muir Kelly , Duncan Lois , Stephens Derek , Atenafu Eshetu , Levin Alex V.
Published: May 2010

Background:

To investigate central corneal thickness (CCT) in children with glaucoma and at risk for glaucoma.

Methods:

The study included 139 children with glaucoma: 66 at risk for glaucoma (ie, aphakia, aniridia, or uveitis) and 66 normal children. CCT was measured by ultrasound pachymetry and intraocular pressure (IOP) by applanation. Analysis of variance was used to compare CCT between groups. Correlation analysis assessed associations between CCT and ocular factors including spherical equivalent, cup-to-disc ratio, glaucoma medications, and number of intraocular surgeries.

Results:

CCT was significantly higher for 141 eyes with glaucoma (mean: 0.598 mm,
P
< .001) and 76 eyes at risk for glaucoma (mean: 0.604 mm,
P
= .001) than for 66 normal eyes (mean: 0.558 mm). No significant difference was observed between at-risk (
P
= .989) and glaucoma eyes. Eyes with aphakia (0.653 mm) and aniridia (0.639 mm) had the thickest CCT values. Thinnest CCT was found in anterior segment dysgenesis and uveitis (mean: 0.541 mm). A significant positive correlation between CCT and spherical equivalent was found for glaucoma (r = 0.413;
P
< .001) and at-risk (r = 0.412;
P
< .0003) eyes, and between CCT and intraocular surgery for at-risk eyes (
P
= .0066). A significant negative correlation was found between CCT and cup-to-disc ratio for glaucoma eyes (r = −0.223;
P
= .01).

Conclusion:

This is the largest series of CCT in pediatric glaucoma and related disorders. The data suggest caution in application of standard formulas for IOP-to-CCT correction when evaluating children with glaucoma because their mean CCT values extend far beyond values reported for normal eyes.
Horizontal Misalignment in Patients with Unilateral Superior Oblique Palsy
Authors: Telander David G. , Egeland Brent M. , Christiansen Stephen P.
Published: May 2010

Purpose:

To determine the frequency and distribution of horizontal misalignment in patients with unilateral superior oblique palsy (SOP) and to determine the indications for combining horizontal with vertical strabismus surgery.

Methods:

Patients included in the study had a vertical heterophoria or tropia that fit Parks three-step test for SOP and had no previous strabismus surgery or other ocular motility disturbance. Ocular motility and alignment were recorded. Outcomes between patients who had vertical surgery alone and those who had combined vertical and horizontal surgery were compared using the Student’s
t
test.

Results:

Of 205 patients, 121 (59.0%) had a horizontal misalignment in addition to vertical strabismus. Ninety-six patients (46.8%) required strabismus surgery. Of these, 29 had 8 prism diopters (PD) or more horizontal deviation. Twenty-two had vertical combined with horizontal surgery (V+H group). Although their initial deviation was greater, these patients had better surgical outcomes than patients who had vertical surgery alone (V group). The V+H group had a final mean horizontal deviation of 2.18 PD compared with 6.85 PD in the V group (
P
< .01). Postoperative vertical alignment in the V+H group was also superior with a final mean vertical deviation of 3.7 versus 6.8 PD for the V group (
P
= .12).

Conclusion:

These results indicate that horizontal misalignment is common in patients with SOP. Patients with 8 PD or more horizontal deviation benefited from surgical correction of the horizontal deviation in addition to the vertical surgery.
Practical Aspects and Efficacy of Intraoperative Adjustment in Concomitant Horizontal Strabismus Surgery
Authors: Yi Jeong Ho , Chung Seung Ah , Chang Yoon Hee , Lee Jong Bok
Published: May 2010

Purpose:

To analyze the practical aspects and advantages of one-stage adjustable surgery under topical anesthesia in concomitant horizontal strabismus.

Methods:

A retrospective review of 363 patients was completed to assess (1) the frequency of need to perform adjustment, (2) the amount and pattern of adjustment, and (3) the final alignment at least 6 months after surgery. Intraoperative adjustment was performed strictly toward the aim of orthophoria or slight overcorrection (heterophoria < 6 prism diopters [PD]) while avoiding diplopia.

Results:

Of the 363 patients, 261 (72%) required intraoperative adjustment. Of these, 85% of exotropes underwent a decreased amount of surgery compared with the standard amount, whereas 58% of esotropes underwent an increased amount of surgery. Forty-two patients underwent a one-muscle surgery instead of the scheduled two-muscle surgery, and all had less than 35 PD preoperative angle of deviation. Success rates were 83% in all patients with one-stage adjustable sutures and 87% in patients who underwent adjustment. In 42 patients with one-muscle surgery instead of two-muscle surgery, 32 (76%) obtained successful results.

Conclusion:

Intraoperative adjustment was effective in concomitant horizontal strabismus surgery and can provide the opportunity to avoid a large overcorrection, especially in cases with moderate angle horizontal muscle surgery.
Psychiatric Nursing Practice & the Recovery Model of Care
Authors: Caldwell Barbara A. , Sclafani Michael , Swarbrick Margaret , Piren Karen
Published: May 2010

This article provides an overview of the national actions by key groups on recovery from psychiatric disability and how a shift is needed to transform health care service delivery in mental health. Fundamental components of recovery are outlined, and examples are provided from the literature in nursing and related disciplines that reflect similar research and evidence-based practice interventions. It is recommended that professional nursing include consumers as active participants in the design of evidence-based practices in all settings.
Culture Is Treatment
Authors: Green Brenda L.
Published: May 2010

This article presents an overview of culture is treatment, by recognizing the impact that culture has on treatment along with the specific rituals, customs, and meanings related to healing. Attention must be given to the Aboriginal heritage, including various concepts of metaphysics, spirituality, medicines, government, oral history, and language. A pedagogical underpinning of illness and healing is better cared for through cultural messaging and learning that is related to the complex historical legacy of Aboriginal societies, and therefore, culture provides important diverse contributions to current treatment and wellness programs.
Clinical Results With the Light Adjustable Intraocular Lens After Cataract Surgery
Authors: von Mohrenfels Christoph Winkler , Salgado Josefina , Khoramnia Ramin , Maier Mathias , Lohmann Chris P.
Published: May 2010

PURPOSE:

The accuracy of intraocular lens (IOL) calculation is limited by the variation of the measurement of corneal power, axial length, anterior chamber depth, and effective postoperative lens position. Therefore, IOL predictability is limited. The aim of this study was to evaluate the performance of the novel light adjustable lens (LAL, Calhoun Vision).

METHODS:

Ten eyes with cataracts (seven patients) were included. After standard phacoemulsification, the LAL was implanted. Two to 3 weeks after surgery, all IOL adjustments had been completed. Preoperatively, pre-adjustment, pre-lock-in, and 1 month post-lock-in, a full ophthalmic examination including objective (autorefraction) and subjective refraction (ie, manifest uncorrected visual acuity [UCVA] and manifest best spectacle-corrected visual acuity [BSCVA]) and topography were performed.

RESULTS:

All cataract surgeries were performed with no complications. Two weeks after surgery, the mean refraction was +0.78±0.79 diopters (D). After adjustment and lock-in, the refraction was −0.07±0.21 D. In 4 of 10 eyes, second adjustments were necessary. One month after surgery, all patients were within ±0.50 D of the intended refraction. Preoperatively, the cylinder was 0.88±0.77 D, but was reduced after adjustments to 0.15±0.20 D. Mean UCVA was 1.02, and all eyes gained at least two lines on the Snellen visual acuity test (ie, BSCVA) after surgery.

CONCLUSIONS:

The LAL is a new IOL with the ability to correct up to 2.00 D of sphere and cylinder after implantation. Our first clinical results are promising and indicate effective safety and stability. [
J Refract Surg
. 2010;26:314–320.]
Practitioners' Use of Interpersonal Modes within the Therapeutic Relationship: Results from a Nationwide Study
Authors: Taylor Renee R. , Lee Sun Wook , Kielhofner Gary
Published: May 2010

Although occupational therapy literature emphasizes the importance of therapeutic use of self, there have been few studies of the interpersonal strategies used in response to different client needs. This study sought to explore therapists' use of self according to the Intentional Relationship Model by examining the use of different modes of interacting with clients. A questionnaire was mailed to a random sample of 1,000 practicing occupational therapists. Sixty-four percent responded and 563 met inclusion criteria. Modes used most to least often were: encouraging, collaborating, problem-solving, instructing, and empathizing. Mode use did not differ according to client population. Therapists who experienced more difficult behaviors and emotions reported higher levels of using all modes. Therapists facing difficult behavior in general were more likely to report use of the instructing and problem-solving modes. Therapists with anxious clients reported greater use of the problem-solving mode, whereas therapists with depressed clients reported increased use of problem-solving, collaborating, and empathizing modes. Implications for occupational therapy practice and education are discussed.
Evaluation of Anterior Lenticonus in Alport Syndrome Using Tracey Wavefront Aberrometry and Transmission Electron Microscopy
Authors: Kim Kwan Soo , Kim Mo Sae , Kim Joon Mo , Choi Chul Young
Published: May 2010

BACKGROUND AND OBJECTIVE:

To evaluate the efficacy of Tracey wavefront aberrometry (Tracey Technologies, Houston, TX) and transmission electron microscopy for the detection of anterior lenticonus in Alport syndrome.

PATIENTS AND METHODS:

Tracey wavefront aberrometry was used to treat a patient with bilateral anterior lenticonus who had a history of Alport syndrome. For transmission electron microscopic examination, anterior lens capsules were obtained during clear lens phacoemulsification and intraocular lens implantation.

RESULTS:

Spherical aberrations were the predominant higher-order aberrations in the internal optics of both eyes. The Tracey wavefront aberrometer showed that most of the irregular astigmatism originated from the lenticular portion. Transmission electron microscopy of the specimens showed anterior lens capsules with decreased thickness and multiple dehiscences.

CONCLUSION:

Tracey wavefront aberrometry and transmission electron microscopy are effective tools for evaluation of anterior lenticonus in Alport syndrome.

[Ophthalmic Surg Lasers Imaging 2010;41:330–336.]
Moderate-Angle Exotropia: A Comparison of Unilateral and Bilateral Rectus Muscle Recession
Authors: Spierer Oriel , Spierer Abraham , Glovinsky Joseph , Ben-Simon Guy J.
Published: May 2010

BACKGROUND AND OBJECTIVE:

To compare the surgical outcome of unilateral lateral rectus recession and bilateral lateral rectus recession in moderate-angle exotropia (⩽ 30 prism diopters [PD]).

PATIENTS AND METHODS:

The charts of all patients with moderate-angle exotropia (30 PD) who were operated on during the years 1993 to 2005 were retrospectively reviewed. Twenty-nine patients underwent unilateral lateral rectus recession (group 1) and 27 patients underwent bilateral lateral rectus recession (group 2).

RESULTS:

Exotropia improved an average of 9.4 ± 7.1 PD in group 1 and 15.5 ± 10.6 PD in group 2 (
P
< .05, independent samples Student's
t
test). The success rate, defined as deviation of 10 PD or less, was achieved in 69% of patients in group 1 and 74% of patients in group 2 (
P
= .67, chi-square). No postoperative complications occurred in either group.

CONCLUSION:

Similar postoperative success rates were achieved with unilateral lateral rectus recession and bilateral lateral rectus recession.

[Ophthalmic Surg Lasers Imaging 2010;41:355–359.]