bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community-based participatory research remodelling occupational therapy to foster older adults’ social participation
Authors: Turcotte Pier-Luc , Carrier Annie , Levasseur Mélanie 
Published: March 2019

Background. Occupational therapists who provide community-based services are well positioned to foster older adults’ social participation. However, community occupational therapists rarely address social participation and require support to change their practice. Purpose. This study initiated a remodelling of community occupational therapy services by (a) selecting practices fostering older adults’ social participation and (b) identifying factors that could affect their integration. Method. A community-based participatory research study was conducted in a large Canadian city. Four focus group meetings and seven individual interviews were held with 28 key informants. Findings. A continuum of emerging practices was identified, including personalized, group-based, and community-based interventions. Potential enablers of these practices included clinical support, better communication, and user involvement. Organizational and systemic barriers were related to the institutional culture and performance indicators. Implications. These results point to innovative ways to foster older adults’ social participation and identify potential enablers and barriers affecting their integration.
Living With a Smoker and General and Central Adiposity in Middle-Aged and Older Women
Authors: Holahan Charles J. , Holahan Carole K. , Zhen Lichen , Powers Daniel A. 
Published: March 2019

Purpose: We hypothesized that living with a smoker would be positively associated with general and central adiposity among middle-aged and older women. Design: Prospective across up to 8 years. Setting: Women’s Health Initiative Observational Study. Sample: A total of 83 492 women (age 50-79 at baseline). Measures: The predictor was living with a smoker at baseline. Outcomes were clinic-assessed obesity and high waist circumference, examined cross-sectionally at baseline and prospectively at year 3 and (for self-reported obesity) year 8. Analysis: All analyses used logistic regression and controlled for sociodemographic factors and participants’ current smoking; prospective analyses also adjusted for baseline obesity or high waist circumference. Results: Living with a smoker was associated (1) cross-sectionally with obesity (n = 82 692, odds ratio [OR] = 1.38, P < .001) and a high waist circumference (n = 83 241, OR = 1.41, P < .001) and (2) prospectively with obesity (n = 68 753, OR = 1.22, P < .001) and a high waist circumference (n = 68 947, OR = 1.22, P < .001) 3 years later and obesity (n = 38 212, OR = 1.21, P < .001) 8 years later. Conclusion: These results document an essentially unrecognized health risk associated with living with a smoker. For practitioners, these findings underscore the need for innovative household-level interventions for families living with a smoker integrating established smoking and obesity prevention efforts.
Critical care transfer in an English critical care network: Analysis of 1124 transfers delivered by an ad-hoc system
Authors: Grier Scott , Brant Graham , Gould Timothy H , von Vopelius-Feldt Johannes , Thompson Julian 
Published: March 2019

Background Critical care transfers between hospitals are time critical high-risk episodes for unstable patients who often require urgent lifesaving intervention. This study aimed to establish the scale, nature and safety of current transfer practice in the South West Critical Care Network (SWCCN) in England. Methods The SWCCN database contains prospectively collected data in accordance with national guidelines. It was interrogated for all adult (>15 years of age) patients from January 2012 to November 2017. Results A total of 1124 inter-hospital transfers were recorded, with the majority (935, 83.2%) made for specialist treatment. The transferring team included a doctor in 998 (88.8%) and nurse in 935 (93.7%) transfers. In 204 (18.1%) transfers, delays occurred, with the commonest cause being availability of transport. Critical incidents occurred in 77 (6.9%). Conclusions This is the first published data on the transfer activity of a UK adult critical care network. It demonstrates that current ad-hoc provision is not meeting the longstanding expectations of national guidelines in terms of training, clinical experience and timeliness. The authors hope that this study may inform national conversation regarding the development of National Health Service commissioned inter-hospital transfer services for adult patients in England.
Determining the factors influencing the symptoms related to naviculo-medial cuneiform coalition
Authors: Choi Jun Young , Chun Kyung Ah , Lee Dong Joo , Cho Sung Tan , Suh Jin Soo 
Published: March 2019

Purpose: We aimed to determine the factors that influence the symptoms of naviculo-cuneiform (NC) coalition using radiography and computed tomography (CT). Methods: We retrospectively reviewed the radiographic and CT findings of 37 NC coalition cases. The existence of a large pit (depth >3 mm), irregular articular surface, joint space narrowing, dorsal bony spur, subchondral sclerosis, multiple subchondral bony cysts, and intra-articular loose body were evaluated on radiographs or CT. The size of the largest subchondral bony cyst was also measured using CT. All cases were divided into two subgroups according to the symptoms. Fisher’s exact test was used to distinguish the factors influencing the symptoms. Results: Twenty-three and fourteen feet were enrolled into the symptomatic and asymptomatic groups, respectively. The rates of the large pit on either radiograph (47.83 vs. 21.43%) or CT (65.22 vs. 28.57%) were significantly different between both groups ( p = 0.001). The mean size of the largest subchondral bony cyst on CT was also significantly greater in the symptomatic group (4.25 vs. 1.53 mm, p = 0.005). Conclusion: A large deep pit and huge subchondral bony cyst on the radiograph or CT can be related to symptoms for the patient with NC coalition. A CT is highly recommended for a more accurate evaluation in patients with NC coalition.
Pain, function, and patient satisfaction after arthroscopic treatment of elbow in a retrospective series with minimum of 5-year follow-up
Authors: Karelson Margit , Launonen Antti P , Jokihaara Jarkko , Havulinna Jouni , Mattila Ville M 
Published: March 2019

Background: The clinical indications for elbow arthroscopic procedures have expanded through last decades. The aim of the study was to assess the functional results and patient satisfaction after arthroscopic treatment of various elbow conditions after a minimum 5-year follow-up. Methods: We conducted a retrospective study of a consecutive patient cohort who had undergone unilateral elbow arthroscopy between 2008 and 2010. The main outcomes were Disabilities of the Arm, Shoulder and Hand (DASH) score and a specific patient-reported outcome measure questionnaire after a minimum 5-year follow-up. Results: In total, there were 93 patients in the cohort with different diagnoses. Majority of patients were suffering from elbow osteoarthrosis. After the average follow-up of 72 months (range 60–96 months), the response rate was 67%. Eighty two percent of patients were satisfied with the pain relief and locking of the elbow was relieved in 70% of patients. Elbow range of motion (ROM) improved in 80% of the 55 patients who had a limited ROM before the operation. The overall patient satisfaction after elbow arthroscopic treatment was good. There were no differences in median DASH score between patients with or without post-traumatic condition, but the median DASH score for patients who had severe (grade 3) osteoarthrosis before the operation was significantly worse. There were no major complications reported in this cohort. Conclusions: Arthroscopic treatment of various elbow conditions was associated with good patient satisfaction and reduced symptoms without major complications. Level of Evidence: Level IV, therapeutic case series.
Non-invasive massive growing prostheses reduce infection in paediatric cancer patients
Authors: Coathup Melanie Jean , Ahmad Samee , Maempel Julian F , Briggs Timothy WR , Aston William J , Skinner John A , Blunn Gordon W 
Published: March 2019

Purpose: In this study, we asked the question of whether non-invasive (NI) extendible bone tumour implants are as reliable and reduce infection when compared with patients who received a minimally invasive (MI) extendible implant. Methods: Forty-two NI extendible bone tumour implants were investigated at a mean follow-up of 22 months (range, 1–87 months) and 63 MI implants at a mean follow-up of 49 months (range, 1–156 months). Results: Kaplan–Meier analysis showed that the probability of MI implant survival was 58.8% compared with 78.6% in NI patients. No significant difference between these two patient groups was found. Infection was the main reason for failure in the MI implant group where nine (35%) implants were revised. However, only one (11%) NI implant was revised for infection ( p = 0.042). None of the NI implants failed due to aseptic loosening; however, six (23%) MI implants were revised for aseptic loosening of the intramedullary stem. Four (15%) of the failed MI implants were revised due to full extension and five (56%) of failed NI implants were replaced as the implant had been fully extended where the patient still required growth. Conclusion: Where possible, an NI massive prosthesis should be used in this patient group. Our results suggest that MI prostheses should be infrequently used due to the high incidence of infection. Lengthening of NI prostheses is painless, can be carried out in the clinic and is more cost-effective. However, further work is required to increase the amount of growth potential available in these implants.
Magnetic Resonance Imaging Grading System for Tears of the Latissimus Dorsi and Teres Major
Authors: Erickson Brandon J. , Chalmers Peter N. , Potter Hollis G. , Altchek David W. , Romeo Anthony A. 
Published: March 2019

Background: Recent awareness of latissimus dorsi/teres major (LD/TM) injuries has led to an increase in diagnoses. No magnetic resonance imaging (MRI) classification system specific to the LD/TM exists, nor has tear severity been correlated with ability to return to sport (RTS). Purpose/Hypothesis: The purpose of this study was to report a novel MRI classification system for LD/TM tears as well as to correlate tear grade with performance and RTS. We hypothesized that the new MRI classification system would have high intra- and interobserver reliabilities and that players with higher grade tears would require operative management. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: All patients with LD/TM tears diagnosed by MRI who were under the care of 2 orthopaedic surgeons were included. On 2 occasions 60 days apart, MRIs were reviewed and graded by 2 authors using a new classification system. Intra- and interobserver reliabilities were calculated. Timing from injury to RTS was recorded, and performance upon RTS was analyzed. Results: The proposed grading system had excellent intra- and interrater reliabilities (Cohen kappa >0.850). A total of 20 male patients (mean ± SD age, 26 ± 9.3 years) with LD/TM tears were included (80% were baseball pitchers). Of the 16 players treated operatively, 5 were initially treated nonoperatively by an outside physician but could not RTS (all professional baseball pitchers); 2 of these players had grade IIIA tears and 3 of the players had grade IVA tears. Regardless of initial treatment, ultimately 100% of the professional baseball players were able to RTS at a mean of 8.7 ± 3.3 months, although the initial nonoperative management failed for some of these players and they needed surgical intervention. No statistically significant differences were found between pre- versus postoperative performance in those professional players who were treated surgically. Conclusion: The proposed MRI-based grading system for LD/TM tears had excellent reliability. This system may allow physicians to better advise patients and all involved health care providers. Consideration should be given to acutely treat grade III and IV tears with operative repair.
Bodily Inertia and the Weaponization of the Sonoran Desert in US Boundary Enforcement: A GIS Modeling of Migration Routes through Arizona’s Altar Valley
Authors: Boyce Geoffrey Alan , Chambers Samuel N. , Launius Sarah 
Published: March 2019

Executive Summary This article conducts geographic information system (GIS) modeling of unauthorized migration routes in the Sonoran Desert in southern Arizona and finds an increase in the ruggedness of terrain crossed by pedestrian travelers throughout time. The modeling of ruggedness incorporates multiple variables that include slope, vegetation, “jaggedness,” and ground temperature, and provides an alternative to Euclidian distance as a way of measuring and conceptualizing borderlands space. The data that informs our analysis is derived from comprehensive activity logs maintained by the humanitarian organization No More Deaths from 2012 to 2015, including 4,847 unique entries documenting the use of 27,439 gallons of clean drinking water at 512 distinct geotagged cache sites located along known pedestrian migration routes. The shift in migration routes toward more difficult terrain within this one high-traffic corridor reveals the ongoing impacts of the US Border Patrol’s strategy of “Prevention Through Deterrence.” In short, the pressures of enforcement on migration routes combine with everyday interference with humanitarian relief (No More Deaths and Coalición de Derechos Humanos 2018) to maximize the physiological harm experienced by unauthorized migrants. Among other outcomes, this explains both the persistence of mortality of unauthorized migrants and an increase in the rate of mortality over time (Martínez et al. 2014). The article concludes with several policy recommendations for US Customs and Border Protection that include making interference and vandalism of humanitarian aid a fireable offense; the formation of a border-wide agency tasked with search-and-rescue and emergency medical response, whose mission and operations are restrained by a clear firewall between itself and those of law enforcement; and ending Prevention Through Deterrence as a nationwide strategy.
Evaluation of a simple tool to assess the results of Ponseti treatment for use by clubfoot therapists: a diagnostic accuracy study
Authors: Smythe Tracey , Mudariki Debra , Gova Maxman , Foster Allen , Lavy Christopher 
Published: March 2019

AbstractBackgroundWe aimed to develop and evaluate a tool for clubfoot therapists in low resource settings to assess the results of Ponseti treatment of congenital talipes equinovarus, or clubfoot, in children of walking age.MethodA literature review and a Delphi process based on the opinions of 35 Ponseti trainers in Africa were used to develop the Assessing Clubfoot Treatment (ACT) tool and score. We followed up children with clubfoot from a cohort treated between 2011 and 2013, in 2017. A full clinical assessment was conducted to decide if treatment was successful or if further treatment was required. The ACT score was then calculated for each child. Inter‐observer variation for the ACT tool was assessed. Sensitivity, specificity, positive and negative predictive values were calculated for the ACT score compared to full clinical assessment (gold standard). Predictors of a successful outcome were explored.ResultsThe follow up rate was 31.2% (68 children). The ACT tool consisted of 4 questions; each scored from 0 to 3, giving a total from 0 to 12 where 12 is the ideal result. The 4 questions included one physical assessment and three parent reported outcome measures. It took 5 min to administer and had excellent inter‐observer agreement.An ACT score of 8 or less demonstrated 79% sensitivity and 100% specificity in identifying children that required further intervention, with a positive predictive value of 100% and negative predictive value of 90%. Children who completed two or more years of bracing were four times more likely to achieve an ACT score of 9 or more compared to those who did not (OR: 4.08, 95% CI: 1.31–12.65, p = 0.02).ConclusionsThe ACT tool is simple to administer, had excellent observer agreement, and good sensitivity and specificity in identifying children who need further intervention. The score can be used to identify those children who definitely need referral and further treatment (score 8 or less) and those with a definite successful outcome (score 11 or more), however further discrimination is needed to decide how to manage children with a borderline ACT score of 9 or 10.Level of evidenceLevel II, Diagnostic Study.
Linking women experiencing incarceration to community-based HIV pre-exposure prophylaxis care: protocol of a pilot trial
Authors: Ramsey Susan E. , Ames Evan G. , Brinkley-Rubinstein Lauren , Teitelman Anne M. , Clarke Jennifer , Kaplan Clair 
Published: March 2019

AbstractBackgroundWomen experiencing incarceration (WEI) engage in high rates of sex- and drug-related behavior that places them at risk for HIV. Pre-exposure prophylaxis (PrEP) is an efficacious means of reducing HIV acquisition. There is a general lack of knowledge regarding PrEP among women at elevated risk, and only a small percentage of at-risk women are currently engaged in PrEP care. The period of incarceration represents an opportunity to identify at-risk women, initiate PrEP during incarceration, and establish linkage to community-based PrEP care upon release from incarceration. Further, post-release is a time period that is particularly risky, and there are numerous barriers, including substance use, that may impede linkage to community-based care in the absence of intervention. The current protocol describes plans for the development and pilot randomized controlled trial (RCT) of an intervention to promote PrEP uptake during incarceration and facilitate linkage to community-based PrEP care post-release.Methods/designThe motivational interviewing-navigation (MI-NAV) study intervention is being developed, refined, and tested over three phases within the framework of the social ecological model. All phases of the study are being conducted at a women’s correctional facility and community-based PrEP provider located in the Northeastern region of the United States. Phase 1 consists of individual qualitative interviews to be conducted with key stakeholders (n = 6–10) from the community-based PrEP care site and (n = 6–10) from the women’s correctional facility, as well as with (n = 18–30) WEI. Recruitment for Phase 1 was initiated in November 2017. In Phase 2, MI-NAV will be piloted with a small cohort (n = 8–12) of WEI and will be refined based upon participant feedback. During Phase 3, a pilot RCT of MI-NAV and a standard of care condition will be conducted with 80 WEI. RCT participants will complete baseline and follow-up assessments 1, 3, and 6 months post-release. The primary study outcome is linkage to community-based PrEP care, verified via medical records.DiscussionThis study will develop and evaluate a psychosocial intervention (MI-NAV) to promote PrEP uptake and facilitate linkage to community-based PrEP care among women at-risk for HIV. It is expected that, as a result of this project, the feasibility, acceptability, and preliminary efficacy of MI-NAV will be determined. If found to be efficacious, this intervention has the potential to reduce HIV acquisition in a high-need, underserved community.Clinical trial registrationNCT03281343
Comparison of administration of clopidogrel with aspirin versus aspirin alone in prevention of secondary stroke after transient ischemic attack
Authors: Khazaei Mojtaba , Ghasemian Fateme , Mazdeh Mehrdokht , Taheri Mohammad , Ghafouri‐Fard Soudeh 
Published: March 2019

AbstractBackgroundPatients with transient ischemic attack (TIA) or minor stroke are at risk of strokes. One of the precautionary measures to reduce risk of stroke in these patients is administration of antiplatelet drugs.MethodsThe aim of this study was comparison of clopidogrel with aspirin versus aspirin alone in prevention of stroke following TIA or acute minor stroke. This clinical trial study was carried out in Farshchian Hospital, Hamadan, Iran in 2018. Fifty‐four patients with TIA, isolated visual attacks, and minor stroke were randomly assigned to receive aspirin 80 mg/day or aspirin 80 mg/day and clopidogrel 75 mg/day for 3 months.ResultsAfter this period, patients were examined for occurrence of myocardial stroke, hemorrhagic/ischemic stroke and drug complications. Ischemic stroke or TIA occurred in 5 (18.5%) patients in clopidogrel–aspirin group and 10 patients (37.1%) in aspirin group (P = 0.12).ConclusionThe study suggests a trend toward superiority of administration of clopidogrel with aspirin versus aspirin alone in protection against secondary stroke. Studies in larger cohorts of patients are needed to verify these results.
How to Make a Queer: The Erotics of Begging; or, Down and Out in the Great Depression
Authors: Parker Robert Dale 
Published: March 2019

AbstractAcross the fiction and poetry of the Great Depression, when the focus turns to men on the down and out, unable to find work and not knowing where they will find their next meal or place to sleep, a series of representative scenes reappears from one now often-forgotten story, novel, and poem to another. Collectively such scenes, recurring across the literature of the 1930s, offer something like a cousinly alternative, on a far smaller scale, to the 1930s ascendency of documentary and the 1920s and 1930s movement for a proletarian literature. Stories of begging for money or food, for example, took a variety of forms, and they also took on erotic connotations. This article reads the erotics of begging in little-known literature from the Great Depression, especially Tom Kromer’s Waiting for Nothing (1935), and argues that when a man on the down and out “makes” a queer, in effect also queering himself, he queers as well the masses of down-and-out unemployed men whose unloosed gender stirred up a national anxiety about precarious masculinity.