bluuebunny/crossref_metadata_2025_split huggingface dataset:
Administrative elites and the crisis: what lies ahead for the senior civil service in Greece?
Authors: Spanou Calliope 
Published: September 2014

The nature of the relationship between the public administration and politics and the subsequent role of the administration appear to be incompatible with the emergence of an administrative elite. After analysing the reasons for this incompatibility, the article explores the impact of the measures taken in the wake of the economic crisis on the civil service and its reform, and also the prospects for the development of a senior civil service. The key, and also the challenge, to any change in this direction remains the rebalancing of the relationship between the public administration and politics. Points for practitioners What might interest practitioners is the issue of the conditions of effectiveness of civil service reform in times of economic crisis and significant pressure.
An evaluation of treatment integrity in a randomised controlled trial of memory rehabilitation for people with multiple sclerosis
Authors: Smale Kathryn J , Carr Sara E , Schwartz Annette F , das Nair Roshan , Lincoln Nadina B 
Published: September 2014

Objective: To assess the treatment integrity of a memory rehabilitation programme for people with multiple sclerosis. Subjects: Data were drawn from the intervention group of a randomised controlled trial of memory rehabilitation. This comprised 24 participants with multiple sclerosis. Measures: Four core session components were identified from the treatment manual: recap, activities, take-home activity and other. One video-recording of each of ten intervention sessions was transcribed and amount of time spent on components recorded. Results: There were no significant differences between early and late stages of the programme in time spent on the core components (recap Z= −0.87, P=0.49; activities Z = −0.29, P=0.89; take-home activity Z = −0.59, P=0.69; other Z = −0.58, P=0.69). Thus, adherence to the manual was good with no evidence of programme drift. Conclusions: Good adherence indicates the intervention was delivered as described in the manual and strengthens confidence in the findings of the randomised controlled trial.
A prospective study of the responsiveness of the original and the short form Berg Balance Scale in people with stroke
Authors: Chen Kuan-Lin , Chou Yei-Tai , Yu Wan-Hui , Chen Cheng-Te , Shih Ching-Lin , Hsieh Ching-Lin 
Published: September 2014

Objective: The study aim was to examine the responsiveness of the Berg Balance Scale (BBS) and that of its short form (SFBBS) at both the individual person level and the group level. Design: A repeated-measurements design. Setting: Hospital and home setting. Participants: Patients with stroke. Results: Totals of 226, 202, and 168 patients with stroke were assessed with the BBS at 14, 30, and 90 days after stroke, respectively. The SFBBS data were extracted from the patients’ responses on the BBS. At the group level, the BBS and the SFBBS had sufficient and similar responsiveness. For the Rasch scores, the effect sizes of the three change scores for the BBS and the SFBBS, respectively, had similar ranges between 0.38 and 0.88 and between 0.39 and 0.85, respectively. The standardized response means of the three change scores for the BBS and the SFBBS ranged from 0.74 to 1.33 and from 0.72 to 1.13, respectively. At the individual person level, the BBS detected significant balance improvement in about twice as many patients as the SFBBS detected. Conclusion: The responsiveness of the BBS at the individual person level was better than that of the SFBBS in patients with stroke. The BBS is recommended as an outcome measure to better detect changes in individual patients.
Developing a best practice model for partnership practice between specialist palliative care and intellectual disability services: A mixed methods study
Authors: McLaughlin Dorry , Barr Owen , McIlfatrick Sonja , McConkey Roy 
Published: September 2014

Background: The lack of access to good quality palliative care for people with intellectual disabilities is highlighted in the international literature. In response, more partnership practice in end-of-life care is proposed. Aim: This study aimed to develop a best practice model to guide and promote partnership practice between specialist palliative care and intellectual disability services. Design: A mixed methods research design involving two phases was used, underpinned by a conceptual model for partnership practice. Setting/participants: Phase 1 involved scoping end-of-life care to people with intellectual disability, based on self-completed questionnaires. In all, 47 of 66 (71.2%) services responded. In Phase 2, semi-structured interviews were undertaken with a purposive sample recruited of 30 health and social care professionals working in intellectual disability and palliative care services, who had provided palliative care to someone with intellectual disability. For both phases, data were collected from primary and secondary care in one region of the United Kingdom. Results: In Phase 1, examples of good practice were apparent. However, partnership practice was infrequent and unmet educational needs were identified. Four themes emerged from the interviews in Phase 2: challenges and issues in end-of-life care, sharing and learning, supporting and empowering and partnership in practice. Conclusion: Joint working and learning between intellectual disability and specialist palliative care were seen as key and fundamental. A framework for partnership practice between both services has been developed which could have international applicability and should be explored with other services in end-of-life care.
Patients’ perception of implantable cardioverter defibrillator deactivation at the end of life
Authors: Hill Loreena , McIlfatrick Sonja , Taylor Brian , Dixon Lana , Harbinson Mark , Fitzsimons Donna 
Published: September 2014

Background: Individualised care at the end of life requires professional understanding of the patient’s perception of implantable cardioverter defibrillator deactivation. Aim: The aim was to evaluate the evidence on patients’ perception of implantable cardioverter defibrillator deactivation at end of life. Design: Systematic narrative review of empirical studies was published during 2008–2014. Data Sources: Data were collected from six databases, citations from relevant articles and expert recommendations. Results: In all, 18 studies included with collective population of n = 5810. Concept mapping highlighted three themes: (1) Diverse preferences regarding discussion and deactivation. Deactivation was rarely discussed pre-implantation, with some studies demonstrating patients’ reluctance to discuss implantable cardioverter defibrillator deactivation at any stage. Two studies found the majority of patients valued such discussions. Diversity was reflected in patients’ willingness to deactivate, ranging from 12% (n = 9) in Irish cohort to 79% (n = 195) in Dutch study. (2) Ethical and legal considerations were predominant in Canadian and American literature as patients wanted to contribute but felt the decision should be a doctor’s responsibility. Advance directives were uncommon in Europe, and where they existed the implantable cardioverter defibrillator was not mentioned. (3) ‘Living in the now’ was evident as despite deteriorating symptoms many patients maintained a positive outlook and anticipated surviving more than 10 years. Several studies asserted living longer was more important than quality of life. Conclusion: Patients regard the implantable cardioverter defibrillator as a complex and solely beneficial device, with little insight regarding its potential impact on a peaceful death. This review confirms the need for professionals to discuss with patients and families implantable cardioverter defibrillator functionality and deactivation at appropriate opportunities.
Results of 10-year follow-up of the iliac donor site of graft patients
Authors: Qi Liqing , Liu Yueju , Li Han , Zhang Yingze 
Published: September 2014

Objectives To measure levels of pain and iliac regeneration at the iliac crest donor site during a 10-year follow-up of graft patients. Methods This prospective study used a visual analogue scale (VAS) to assess pain at the donor site at 1 month and 1, 3, 5 and 10 years postoperatively. Iliac regeneration status was recorded at 1, 3, 5, 7 and 10 years postoperatively by comparing plain radiographs. Results A total of 32 patients participated in the study. Mean VAS scores at 1 month, 1 year, 3, 5, and 10 years were 3.22, 3.39, 3.45, 2.02 and 1.38, respectively. There was no statistically significant difference between pain scores at 1 month and 1 year, but pairwise comparisons revealed significant differences between the other timepoints. The mean iliac regeneration rank scores at 1, 3, 5, 7 and 10 years were 1.36, 2.22, 2.97, 3.75 and 4.70, respectively; all pairwise comparisons were statistically significant. Conclusion The iliac donor site showed a declining trend in pain, which appeared to have started 3 years postoperatively. Long-term follow-up showed that the ilium is readily able to repair itself.
Biomechanical Evaluation of a Transtibial Pull-out Meniscal Root Repair
Authors: Cerminara Anthony J. , LaPrade Christopher M. , Smith Sean D. , Ellman Michael B. , Wijdicks Coen A. , LaPrade Robert F. 
Published: September 2014

Background: A common treatment for posterior meniscal root tears is transtibial pull-out repair, which has been biomechanically reported to restore tibiofemoral contact mechanics to those of the intact knee. Biomechanical data suggest that there is significant displacement of the repaired meniscal root with cyclic loading, which may be responsible for the poor healing and meniscal extrusion demonstrated in some clinical studies. Hypothesis/Purpose: The purpose of this study was to quantify the time-zero displacement of the posterior meniscal root in response to cyclic loading after transtibial pull-out repair and to quantify the individual contributions to displacement of the following: (1) suture elongation, (2) button-bone interface, and (3) meniscus-suture interface. The meniscus-suture interface was hypothesized to result in significantly more displacement than the button-bone interface or suture elongation. Study Design: Descriptive laboratory study. Methods: Transtibial pull-out repair of the posterior medial meniscal root was performed in 6 porcine knees, and cyclic displacement was measured using a loading protocol representative of postoperative rehabilitation. Displacement from (1) suture elongation, (2) the button-bone interface, and (3) the meniscus-suture interface was determined by cyclically loading 6 specimens for each construct using the same loading protocol to determine the contribution of each component to the overall displacement of the repair construct. Results: After 1000 cycles, the repair construct displaced by a mean of 3.28 mm (95% CI, 2.07-4.49). The meniscus-suture component (mean, 2.52 mm; 95% CI, 2.21-2.83) displaced significantly more than the button-bone component (mean, 0.90 mm; 95% CI, 0.64-1.15; P = .006) and suture elongation component (mean, 0.71 mm; 95% CI, 0.36-1.06; P = .006) after 1000 cycles. Displacement of the button-bone and suture elongation components was not significantly different after 1000 cycles ( P = .720). Conclusion: There was substantial displacement of the posterior medial meniscal root repaired with the transtibial pull-out technique under a cyclic loading protocol simulating postoperative rehabilitation. The meniscus-suture interface contributed to significantly more displacement than the button-bone interface and suture elongation in the transtibial pull-out repair construct. Clinical Relevance: The results provide a framework for optimizing the transtibial pull-out repair technique. Future studies should focus on improving suture fixation strength within the meniscus-suture interface.
Local Application of Strontium in a Calcium Phosphate Cement System Accelerates Healing of Soft Tissue Tendon Grafts in Anterior Cruciate Ligament Reconstruction
Authors: Kuang Guan-Ming , Yau W.P. , Lu William W. , Chiu K.Y. 
Published: September 2014

Background: Healing of soft tissue tendon grafts within the bone tunnel in anterior cruciate ligament (ACL) reconstruction is known to be slower than that of bone–patellar tendon–bone grafts. There are attempts to accelerate healing of the graft within the bone tunnel. One of the methods is the use of strontium-enriched calcium phosphate cement (Sr-CPC). Early results in animal studies have been encouraging, although it is not known whether the accelerated healing was solely caused by the effect of strontium within the cement or by the calcium phosphate cement (CPC) itself. Hypothesis: There would be differences between Sr-CPC and conventional CPC in terms of the effect on healing of soft tissue tendon grafts within the bone tunnels in ACL reconstruction. Study Design: Controlled laboratory study. Methods: A total of 30 single-bundle ACL reconstruction procedures were performed in 15 rabbits with the use of an Achilles tendon allograft. The graft on the left limb was coated with Sr-CPC, while that on the right limb was coated with CPC. Three animals each were sacrificed for histological and histomorphometric analyses at 3, 6, 9, 12, and 24 weeks after surgery. Results: In the Sr-CPC group, early formation of Sharpey fibers was present at 6 weeks after surgery, while early remodeling of a graft-fibrocartilage-bone junction was noted at 12 weeks. In the CPC group, early formation of Sharpey fibers was only found at 9 to 12 weeks after surgery. At 24 weeks, a direct enthesis was found in both groups. According to the histomorphometric score, graft healing in the Sr-CPC group took place 3 weeks faster than that in the CPC group at and before 12 weeks; however, there was no difference between the groups at 24 weeks. Conclusion: The local application of strontium in a CPC system leads to accelerated graft healing within the bone tunnels. Clinical Relevance: The use of Sr-CPC to enhance graft-bone healing may improve the clinical results of ACL reconstruction using soft tissue tendon grafts.
“Anatomic” Single-Bundle Anterior Cruciate Ligament Reconstruction Reduces Both Anterior Translation and Internal Rotation During the Pivot Shift
Authors: Porter Mark D. , Shadbolt Bruce 
Published: September 2014

Background: The ability of single-bundle anterior cruciate ligament (ACL) reconstruction to restore rotational control has been questioned by proponents of the double-bundle technique. The term anatomic positioning has become popularized in recognition of the incorrect positioning sometimes used in the past, which may have contributed to the lack of rotation control. The pivot-shift test remains the most clinically useful measure of ACL deficiency, and it is now possible to measure it both accurately and objectively using computer navigation. Hypothesis: Single-bundle ACL reconstruction will reduce anterior translation and internal rotation of the tibia during the pivot-shift test when compared with the contralateral uninjured knee. Study Design: Descriptive laboratory study. Methods: A total of 20 patients with an acute isolated ACL rupture underwent reconstruction with a single-bundle autologous hamstring graft. Computer navigation was used intraoperatively to plot the pivot shift before and after reconstruction. The opposite uninjured knee was used as a control. Statistical analysis was used to compare the pivot shifts before and after surgery. Results: Single-bundle ACL reconstruction produced a significant reduction in anterior translation, from a mean ± SD of 17.4 ± 3.80 mm to 6.4 ± 1.95 mm ( P < .001), as well as in internal rotation, from 22.9° ± 5.91° to 7.5° ± 2.96° ( P < .001). The anterior translation in the reconstructed knees was similar to the control knees, 6.4 ± 1.95 mm versus 5.6 ± 1.23 mm ( P < .148), while the internal rotation was significantly less in the reconstructed knees, 7.5° ± 2.96° versus 11.9° ± 3.36° ( P < .05). The values for the coupled movements were used to calculate the length of the radius of curvature, about which the tibia rotates relative to the femur, during the pivot shift. In the control knees, the mean value was 28.9 ± 8.21 mm, while there was extreme variability in the operated knee both before and after surgery. Conclusion: It is possible to reduce both anterior translation and internal rotation, which occur during the pivot-shift test in the ACL-deficient knee, using single-bundle ACL reconstruction, when measured at the time of surgery. However, normal motion is not fully restored.
Antiphospholipid (Hughes) syndrome: description of population and health-related quality of life (HRQoL) using the SF-36
Authors: Georgopoulou S , Efraimidou S , MacLennan S J , Ibrahim F , Cox T 
Published: September 2014

Objective Antiphospholipid (Hughes) syndrome (APS) affects mainly women 15 to 50 years of age and is responsible for approximately 20% of strokes in people <40 years. Little is known about the psychological burden of this long-term condition. We investigated HRQoL in APS. Methods We conducted a cross-sectional survey involving 270 members of the Hughes Syndrome Foundation worldwide. Data included HRQoL (SF-36), demographics, and APS-related self-reported major issues. Response rate was 60%. Results T-tests indicated significantly worse mean scores for seven of the eight domains of the SF-36 in secondary antiphospholipid syndrome (SAPS) compared to primary antiphospholipid syndrome (PAPS), e.g. bodily pain t(263) = 6.10 p < 0.001 except for mental health t(267) = 1.95 p = 0.053. PAPS appeared to be associated with poorer HRQoL in most mental health domains but overall better physical domains compared to systemic lupus erythematosus (SLE) alone. SAPS appeared to have a more adverse impact on HRQoL compared to PAPS and SLE. Major issues identified: pain and fatigue, lack of health care professional/public awareness, and medication unpredictability. Conclusion HRQoL in PAPS appears to be generally better than SLE and SAPS in physical domains, but poorer in mental domains. APS patients might need more social support in terms of information and awareness of the condition to improve their coping strategies.
Effect of Graft Shape in Lateral Column Lengthening on Tarsal Bone Position and Subtalar and Talonavicular Contact Pressure in a Cadaveric Flatfoot Model
Authors: Campbell Sean T. , Reese Keri A. , Ross Steven D. , McGarry Michelle H. , Leba Thu-Ba , Lee Thay Q. 
Published: September 2014

Background: Lateral column lengthening (LCL) has been used for correction of flatfoot deformity. The purpose of this study was to determine the effect of LCL graft shape on tarsal bone position and talonavicular and subtalar joint pressure. Methods: A flatfoot model was created in 6 cadaveric specimens. Corrective LCL was performed using a rectangular graft or a trapezoidal graft with the broad surface oriented dorsally, laterally, or plantarly. Bony surface markers were digitized to calculate angular parameters used in the evaluation of flatfoot deformity. Contact pressure and area in the subtalar and talonavicular joints were also recorded. All measurements were carried out under multiple axial loads in the intact and flatfoot conditions, and following LCL with each graft shape. Results: Flatfoot creation resulted in significant changes in arch collapse and forefoot abduction. LCL with a rectangular graft best corrected these parameters, while a laterally oriented trapezoidal graft provided some correction. Talonavicular contact pressure was unchanged after flatfoot creation, and was significantly less than intact after LCL. Subtalar contact pressure decreased in some conditions after flatfoot creation, and decreased further after LCL. Conclusion: LCL with a rectangular graft best restored tarsal bone orientation in a cadaveric flatfoot model. The decreases in talonavicular pressure likely represent redistribution of force from the medial to lateral foot. Clinical Relevance: When performing LCL for flatfoot deformity, increased bone graft volume medially better restores tarsal bone position. One way of achieving this is through the use of a rectangular graft as opposed to a trapezoidal graft.
Nilotinib Does Not Alter the Secretory Functions of Carotid Artery Endothelial Cells in a Prothrombotic or Antithrombotic Fashion
Authors: Katgı Abdullah , Sevindik Ömür Gökmen , Gökbulut Aysun Adan , Özsan Güner Hayri , Yüksel Faize , Solmaz Şerife Medeni , Alacacıoğlu İnci , Özcan Mehmet Ali , Demirkan Fatih , Baran Yusuf , Pişkin Özden 
Published: September 2014

Background: There have been concerns about the possible prothrombotic effects of nilotinib, especially in patients having cardiovascular risk factors. The potential mechanism behind the increased risk of thromboembolic events is still not clear. Objectives: In this study, we aimed to evaluate possible harmful effects of nilotinib on endothelial cells. To this aim, we examined proliferative capacity and secretory functions of healthy human carotid artery endothelial cells (HCtAECs) in response to nilotinib. Methods: 3-(4,5-Dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide (MTT) cell proliferation method was used to determine antiproliferative effects of nilotinib on HCtAECs. The HCtAECs were incubated with 5, 10, and 100 nmol/L doses of nilotinib for 72 hours. Then, in order to assess the endothelial function, levels of nitric oxide (NO), von Willebrand factor (vWF), tissue plasminogen activator, plasminogen activator inhibitor 1 (PAI-1), and endothelin 1 (ET-1) were evaluated using enzyme-linked immunosorbent assay from tissue culture supernatants. Results: There were slight but statistically significant decreases in cell proliferation in response to nilotinib. Nilotinib increased the secretion of t-PA, PAI-1, and vWF in a dose-dependent manner when compared with the untreated control group. The ET-1 secretion was lower in 5 nmol/L and higher in 10 and 100 nmol/L nilotinib-treated cells as compared to untreated cells. Regarding NO secretion, lower levels were observed in 5 and 10 nmol/L, and higher levels were detected in 100 nmol/L nilotinib-treated cells as compared to untreated control group cells. Conclusion: Considering the results obtained in our study, nilotinib does not affect the functions of endothelial cells either in a prothrombotic or an antithrombotic fashion, despite a dose-dependent decline in cell viability.