bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anterolateral Ligament Reconstruction Protects the Repaired Medial Meniscus: A Comparative Study of 383 Anterior Cruciate Ligament Reconstructions From the SANTI Study Group With a Minimum Follow-up of 2 Years
Authors: Sonnery-Cottet Bertrand , Saithna Adnan , Blakeney William G. , Ouanezar Herve , Borade Amrut , Daggett Matt , Thaunat Mathieu , Fayard Jean-Marie , Delaloye Jean-Romain 
Published: May 2018

Background: The prevalence of osteoarthritis after successful meniscal repair is significantly less than that after failed meniscal repair. Purpose: To determine whether the addition of anterolateral ligament reconstruction (ALLR) confers a protective effect on medial meniscal repair performed at the time of anterior cruciate ligament reconstruction (ACLR). Study Design: Cohort study; Level of evidence, 3. Methods: Retrospective analysis of prospectively collected data was performed to include all patients who had undergone primary ACLR with concomitant posterior horn medial meniscal repair through a posteromedial portal between January 2013 and August 2015. ACLR autograft choice was bone–patellar tendon–bone, hamstring tendons (or quadrupled hamstring tendons), or quadrupled semitendinosus tendon graft with or without ALLR. At the end of the study period, all patients were contacted to determine if they had undergone reoperation. A Kaplan-Meier survival curve was plotted, and a Cox proportional hazards regression model was used to perform multivariate analysis. Results: A total of 383 patients (mean ± SD age, 27.4 ± 9.2 years) were included with a mean follow-up of 37.4 months (range, 24-54.9 months): 194 patients underwent an isolated ACLR, and 189 underwent a combined ACLR + ALLR. At final follow-up, there was no significant difference between groups in postoperative side-to-side laxity (isolated ACLR group, 0.9 ± 0.9 mm [min to max, –1 to 3]; ACLR + ALLR group, 0.8 ± 1.0 mm [min to max, –2 to 3]; P = .2120) or Lysholm score (isolated ACLR group, 93.0 [95% CI, 91.3-94.7]; ACLR + ALLR group, 93.7 [95% CI, 92.3-95.1]; P = .556). Forty-three patients (11.2%) underwent reoperation for failure of the medial meniscal repair or a new tear. The survival rates of meniscal repair at 36 months were 91.2% (95% CI, 85.4%-94.8) in the ACLR + ALLR group and 83.8% (95% CI, 77.1%-88.7%; P = .033) in the ACLR group. The probability of failure of medial meniscal repair was >2 times lower in patients with ACLR + ALLR as compared with patients with isolated ACLR (hazard ratio, 0.443; 95% CI, 0.218-0.866). No other prognosticators of meniscal repair failure were identified. Conclusion: Combined ACLR and ALLR is associated with a significantly lower rate of failure of medial meniscal repairs when compared with those performed at the time of isolated ACLR.
Long-term Comparison of Semitendinosus and Gracilis Tendon Versus Patellar Tendon Autografts for Anterior Cruciate Ligament Reconstruction: A 17-Year Follow-up of a Randomized Controlled Trial
Authors: Sajovic Matjaz , Stropnik Domen , Skaza Katja 
Published: May 2018

Background: Short-term and mid-term differences between hamstring and patellar tendon autografts for anterior cruciate ligament (ACL) reconstruction are well documented. Systematic reviews highlight the lack of long-term results between the two grafts. Hypothesis: Seventeen years after ACL reconstruction, no difference will be found in functional outcome, quality of life, and graft failure between patients with patellar tendon (PT) or semitendinosus and gracilis tendon (STG) autografts; however, a significant difference will be seen in the prevalence of osteoarthritis. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Sixty-four patients were included in this prospective study (32 in each group). A single surgeon performed primary ACL reconstruction in alternating sequence. Forty-eight patients (24 in each group) were evaluated 17 years after ACL reconstruction: A clinical assessment was made based on the International Knee Documentation Committee (IKDC) form, instrumented laxity was measured with KT-1000 arthrometer, and radiography of the operated knee was conducted and assessed for degenerative disease. The Lysholm questionnaire and the Short Form–36 version 2 questionnaire were filled out by the patients. Results: At the 17-year follow-up, no statistically significant differences were seen with respect to graft failure (2 reruptures in the semitendinosus and gracilis tendon [STG] group [6.3%] and 3 reruptures in the PT group [9.4%]) and functional outcome. Increased instrumented laxity (>3 mm) measured with KT-1000 arthrometer was seen in significantly more patients in the STG group (8 in the STG group compared with 2 in the PT group; P = .03) with a mean side-to-side difference of 2.17 ± 1.86 mm in the STG group compared with 1.33 ± 1.93 mm in the PT group. A significant difference was found in frequency of knee osteoarthritis (OA)—100% in the PT group compared with 71% in the STG group ( P = .004). Patients in the PT group tended to have higher grade OA according to the IKDC grading system, with an average grade of 1.46 in the PT group compared with 1 in the STG group ( P = .055). The degenerative changes in the PT group were more common in the medial and patellofemoral compartments ( P = .003 and P = .04, respectively). Conclusion: Both autografts provided good to excellent subjective outcomes. No significant differences were noted in graft failure and clinical instability. However, significantly more patients in the STG group had increased instrumented anteroposterior translation measured with KT-1000 arthrometer, and there was a greater prevalence of knee OA at 17 years after surgery in the PT group.
Effects of Proud Large Osteochondral Plugs on Contact Forces and Knee Kinematics: A Robotic Study
Authors: Du Peter Z. , Markolf Keith L. , Boguszewski Daniel V. , Yamaguchi Kent T. , Lama Christopher J. , McAllister David R. , Jones Kristofer J. 
Published: May 2018

Background: Osteochondral allograft (OCA) transplantation is used to treat large focal femoral condylar articular cartilage defects. A proud plug could affect graft survival by altering contact forces (CFs) and knee kinematics. Hypothesis: A proud OCA plug will significantly increase CF and significantly alter knee kinematics throughout controlled knee flexion. Study Design: Controlled laboratory study. Methods: Human cadaver knees had miniature load cells, each with a 20-mm-diameter cylinder of native bone/cartilage attached at its exact anatomic position, installed in both femoral condyles at standardized locations representative of clinical defects. Spacers were inserted to create proud plug conditions of +0.5, +1.0, and +1.5 mm. CFs and knee kinematics were recorded as a robot flexed the knee continuously from 0° to 50° under 1000 N of tibiofemoral compression. Results: CFs were increased significantly (vs flush) for all proudness conditions between 0° and 45° of flexion (medial) and 0° to 50° of flexion (lateral). At 20°, the average increases in medial CF for +0.5-mm, +1-mm, and +1.5-mm proudness were +80 N (+36%), +155 N (+70%), and +193 N (+87%), respectively. Corresponding increases with proud lateral plugs were +44 N (+14%), +90 N (+29%), and +118 N (+38%). CF increases for medial plugs at 20° of flexion were significantly greater than those for lateral plugs at all proudness conditions. At 50°, a 1-mm proud lateral plug significantly decreased internal tibial rotation by 15.4° and decreased valgus rotation by 2.5°. Conclusion: A proud medial or lateral plug significantly increased CF between 0° and 45° of flexion. Our results suggest that a medial plug at 20° may be more sensitive to graft incongruity than a lateral plug. The changes in rotational kinematics with proud lateral plugs were attributed to earlier contact between the proud plug’s surface and the lateral meniscus, leading to rim impingement with decreased tibial rotation. Clinical Relevance: Increased CF and altered knee kinematics from a proud femoral plug could affect graft viability. Plug proudness of only 0.5 mm produced significant changes in CF and knee kinematics, and the clinically accepted 1-mm tolerance may need to be reexamined in view of our findings.
Can Social Case Work be Interpreted to a Community as a Basic Approach to Human Problems?
Authors: Reynolds Bertha C. 
Published: May 2018

The Milford Conference whose report on Generic Social Case Work was published by the A.A.S.W. in 1929 has reconvened this winter to study and discuss some of the matters of immediate importance to the field of social case work. At its sessions on December 9–11, 1932, the Conference appointed two committees: one to consider the interpretation of social case work skills as a basic approach to human needs; the other to consider the integration of social case work services in the total community program so that they may fulfil their purposes both effectively and economically. It was suggested to both committees that they think in terms of social case work as a whole rather than of functional responsibilities of agencies. The report of the first committee was presented for discussion at the meeting of the Conference on January 13, 1933. We are privileged to present the report herewith as expressing the thinking of the committee and as a preliminary statement of discussions which will, it is hoped, later be incorporated in a report which will carry some of the implications of this discussion into the practical field of agency planning and equipment.—Editor's Note.
The Philosophy of Personnel Practices
Authors: Hill Ruth , White Helen C. 
Published: May 2018

[There is probably no subject more vitally important to the field of social case work at the present time than that of building up and maintaining a staff of professionally and personally equipped case workers. On this depends the whole future of social case work, a method which most of us believe has been forged from the raw material of human misery and of human helpfulness in the furnace of social change. The Committee on Personnel of the Family Welfare Association of America has therefore taken its assignment very seriously. Rightly considered, each question of personnel policy involves our whole philosophy of social case work organization and its place in modern society. The question of salaries and vacation, for example, depends in a final analysis on the extent to which the board and the community believe in trained service as against mere kindly and economical relief of suffering, and this in turn depends upon the social philosophy of its members. Fascinating as the pursuit of such a line of thought is, however, the Committee on Personnel decided that, in view of the pressing nature of the problems confronting boards of directors, executives, staff members, and clients–who are inevitably vitally affected–it should spend its available time in considering aspects of personnel policies and practices which might be of immediate assistance to those in the field who are struggling to uphold fundamental principles. It plans to present, therefore, in successive articles (The Family and the commitments of the Committee members willing) the results of its deliberations while they are still in the tentative stage. The Committee hopes that in this way it may be of more immediate assistance to the field on the one hand, and on the other that it may have the benefit of the criticisms and suggestions of staff and board groups– which will in turn stimulate further thinking on the part of the Committee and will be incorporated in its final report. Four of the subjects considered by the divisions of the Committee are: philosophy, agency policies, participation, and evaluation of workers. The Committee has met and faced the objection that situations are changing with such rapidity in these days that anything it may say may be out of date by the time it gets into print. On the other hand it expresses its firm belief that principles which are basic are worth stating, even though they may need re-interpretation or re-application within a very short space of time. The worst criticism that could possibly be made of any group's thinking in 1934 is that it considers it to be final. But only slightly less damning is the suggestion that because of the present uncertainties it is impossible or not worth while to think at all or, while thinking, to present the results to others. Mary S. Brisley, Chairman, Committee on Personnel.]
The Widened Base in Public Assistance
Authors: Berman Jules H. 
Published: May 2018

The 1950 amendments are substantial in scope and, when taken together with the changes made to the old-age and survivors insurance program, should have a profound effect on the state-federal assistance programs. State and federal assistance agencies will need time to work with these amendments before their exact effect can be assayed and future trends determined and changes planned. Several respects in which the state-federal assistance programs are deficient and in need of improvement are now well known. Assistance programs financed from state and federal funds still fall short of the objective of being available to any needy person. The new program for the permanently and totally disabled will meet some of the needs of persons previously not covered by a state-federal program. There are many disabled persons, however, who are equally in need but who are not permanently and totally disabled and who will not be aided under the new program. These individuals will be dependent upon state and local general assistance programs. In a number of states these programs are far from adequate and in some areas nonexistent. We also know that the direct payments for medical care, potentially, can be an important part of the assistance program. This plan cannot achieve its potential, however, without some additional money from the federal government either in the form of a separate provision in the formula governing the federal share for medical expenditures, or in the form of an increased average maximum on the assistance payments. Without such provisions, the usefulness of the new amendment to make direct payments for medical care will be limited. To the extent that states divert money from supplying maintenance needs to paying for medical care, the new amendment might actually reduce the amount of money available for meeting maintenance needs. With additional money, the medical care amendment can do a great deal to meet medical costs not now met by other programs such as health or rehabilitation. In this statement, I have attempted to analyze the new amendments and to evaluate their effect on the public assistance programs. Although the new amendments leave some deficiencies uncorrected, they have advanced the programs considerably and should result in a considerably improved state-federal plan for meeting the assistance needs of people.
Educational Process in Supervision
Authors: Hester Mary C. 
Published: May 2018

Supervision in social casework is an educational process and teaching, therefore, is the primary function of the supervisor. According to this view, all the aspects of supervision—administering, teaching-consulting, and evaluation—are parts of this total process since each of them involves learning content that contributes to the attainment of the supervisory aim of helping in the development of professional workers who are self-directing, self-disciplined, and increasingly skilful in giving service to clients. The effectiveness of supervisory methods in achieving this aim can be measured by the extent to which these methods facilitate the learning process. The importance of the relationship between the supervisor and the worker has been stressed, since this relationship is the medium through which learning takes place and through which purpose and goals are achieved. Recognition has been given to the fact that the worker's emotional involvement is sometimes the cause of problems in practice. On the premise that self-awareness is a necessary part of the knowledge that the worker must acquire, it is the supervisor's responsibility to help him realize the need for it, if feeling reactions are interfering with performance. There are, however, ways to help the worker achieve this self-knowledge other than by focusing directly on his personality. Also, difficulties that frequently are attributed to the personal problems of the worker may be the result of lack of knowledge, or due to the anxiety that arises when the worker's emotional balance is threatened by his lack of knowledge. Teaching is therefore the first choice of the methods available to the supervisor. An educational approach based on a diagnosis of the worker's learning needs helps in assuring that he will have the knowledge he requires to arrive at a full and emotional understanding of the client and his situation, to formulate the long-range casework goals, and to plan the steps he will take in the process of helping the client attain these goals.
“Aggressive” Approach in Preventive Casework with Children's Problems
Authors: Lane Lionel C. 
Published: May 2018

The one factor that is characteristic of these case illustrations is our acceptance of greater responsibility. It is quite clear that in our practice we have to begin to move out more firmly to certain clients. We accept the parent's right to make his own decision, but we question the wisdom of having him base it solely on his impulse to resist help and not include his wish to help his child. The community gives authority to the family agency. This is not the authority of the court or the protective agency, but the more subtle one that goes with professional skill and knowledge of the dynamics of human behavior. We are still, often, too hesitant about accepting a role that is essentially a preventive one. The limits imposed on us by the client's right to make his own decision about using help is a valid and essential part of the process. One could, however, pursue this idea to its ultimate end and maintain that a family has a right to pursue its own path to self-destruction. But when the lives of young children are affected, we cannot limit ourselves to such a passive role. To do so would mean that the problems of children are not our concern until the point of crisis and emergency has been reached, a development that we have encouraged by our passivity. There is a need for more concerted and aggressive efforts on our part so that we are more truly offering a preventive service to the community. A client's decision to use help will be influenced, we believe, by the degree of firmness and persistence with which we approach him. Furthermore, we need not fear that we shall force our help on the client too much, since this is a manifest impossibility anyway. A lack of conviction in offering service, as evidenced by our willingness to withdraw at the first rebuff, can only leave the parent more comfortable in continuing in an unhealthy situation. We need to be more aggressive in our approach, so that if we finally have to accept a client's refusal of our help, we are sure we have used, to the fullest extent, every available means to demonstrate our ability and desire to be of help to him.
The Use of Case Records in Research
Authors: Hochwald Hilde Landenberger 
Published: May 2018

It can be stated that case records probably will be more useful for research if the research objectives are conceived within the same frame of reference as that used by the worker in writing the records for purposes of treatment. The research objectives may deal with characteristics of persons or of situations revealed in treatment, or with the dynamics of treatment itself. The adequacy, validity, and representativeness of case records need to be appraised in relation to specific research objectives, through study of function, policies, and procedures of the agency in which they originate. The analysis of the problems and processes involved in the use of case records of social agencies for research purposes leads to the conclusion that this type of research requires a combination of skills in research and the professional practice of social work.
Evaluating the Time to Palliative Care Referrals in Patients With Small-Cell Lung Cancer: A Single-Centre Retrospective Review
Authors: Watson Geoffrey Alan , Saunders Jean , Coate Linda 
Published: May 2018

Introduction: Lung cancer is a leading cause of morbidity and mortality worldwide. Patients with lung cancer may experience a plethora of symptoms, which can be debilitating and affect their quality of life. Palliative care input to manage their physical and psychological well-being is a crucial component of their oncological care. The benefit of early palliative care input has been shown in patients with non-small cell lung cancer; however, data pertaining to patients with small-cell lung cancer are scarce. Nevertheless, early palliative care input is recommended by several national and international guidelines. Thus, we aimed to assess the time to palliative care referrals in patients diagnosed with small-cell lung cancer in an Irish tertiary hospital and to determine what impact this had on overall survival. Methods: We performed a retrospective, single-center audit of all patients diagnosed with extensive stage small-cell lung cancer over a 6-year period in an Irish tertiary hospital. Results: Overall, 91 patients were identified. Median age at diagnosis was 66 years (range: 38-83 years). The median Eastern Cooperative Oncology Group Performance Status at diagnosis was 1 (range: 0-3); 24 (26%) patients had multiple sites of distant metastasis at diagnosis; 45 (49.5%) patients were alive at 6 months, and 15 (16.5%) patients were alive at 12 months. One hundred percent of patients received palliative care input in our center over the course of their care. In the patients alive at 6 months after diagnosis, there was no survival advantage in those receiving palliative care within 1 month ( P = .002, odd ratio: 0.23, 95% confidence interval: 0.09-0.59). Conclusion: Palliative care treatment is a critical aspect in the oncological treatment of all patients diagnosed with advanced cancer, and this study highlights good compliance with existing national guidelines. Further research focusing on quality-of-life issues with the use of questionnaires to assess physical and psychological symptoms should be performed to further understand the impact of palliative care in these patients.