title: Posterior sloping angle as a predictor of contralateral slip in slipped capital femoral epiphysis

authors: Phillips, Paul M.

subjects: Polynesian

abstract: Background: Slipped capital femoral epiphysis is a condition with potentially severe complications. Controversy remains as to when to undertake prophylactic pinning. We aimed to assess the utility of the posterior sloping angle as a predictor for contralateral slip in a large, multi-ethnic cohort including Polynesian children with a high incidence of slipped capital femoral epiphysis.
Methods: All patients presenting to our hospital between 2000 and 2009 were identified and records were reviewed to determine demographic data and determine whether they subsequently developed a contralateral slip. The presenting radiographs were reviewed and the posterior sloping angle was measured. Patients with bilateral slips at presentation and those without initial radiographs were excluded.
Results: Records and radiographs of 132 patients were analyzed for the posterior sloping angle in the unaffected hip. Forty-two patients who had subsequently developed a contralateral slip had a mean posterior sloping angle (and standard deviation) of 17.2 degrees +/- 5.6 degrees, which was significantly higher (p < 0.001) than that of 10.8 degrees +/- 4.2 degrees for the ninety patients who had had a unilateral slip. Children who had developed a subsequent contralateral slip were significantly younger (11.1 years) than those who had developed a unilateral slip (12.2 years) (p < 0.001). If a posterior sloping angle of 14 degrees were used as an indication for prophylactic fixation in this population, thirty-five (83.3%) of forty-two contralateral slips would have been prevented, and nineteen (21.1%) of ninety hips would have been pinned unnecessarily. The number needed to treat to prevent one subsequent contralateral slip is 1.79.
Conclusions: To our knowledge, this is the largest study to date that confirms that the posterior sloping angle is a reliable predictor of contralateral slip and can be used to guide prophylactic pinning. The posterior sloping angle is applicable in the high-risk Polynesian population and could be useful in preventing future slips in populations that are difficult to follow up.

text: Posterior sloping angle as a predictor of contralateral slip in slipped capital femoral epiphysis Background: Slipped capital femoral epiphysis is a condition with potentially severe complications. Controversy remains as to when to undertake prophylactic pinning. We aimed to assess the utility of the posterior sloping angle as a predictor for contralateral slip in a large, multi-ethnic cohort including Polynesian children with a high incidence of slipped capital femoral epiphysis.
Methods: All patients presenting to our hospital between 2000 and 2009 were identified and records were reviewed to determine demographic data and determine whether they subsequently developed a contralateral slip. The presenting radiographs were reviewed and the posterior sloping angle was measured. Patients with bilateral slips at presentation and those without initial radiographs were excluded.
Results: Records and radiographs of 132 patients were analyzed for the posterior sloping angle in the unaffected hip. Forty-two patients who had subsequently developed a contralateral slip had a mean posterior sloping angle (and standard deviation) of 17.2 degrees +/- 5.6 degrees, which was significantly higher (p < 0.001) than that of 10.8 degrees +/- 4.2 degrees for the ninety patients who had had a unilateral slip. Children who had developed a subsequent contralateral slip were significantly younger (11.1 years) than those who had developed a unilateral slip (12.2 years) (p < 0.001). If a posterior sloping angle of 14 degrees were used as an indication for prophylactic fixation in this population, thirty-five (83.3%) of forty-two contralateral slips would have been prevented, and nineteen (21.1%) of ninety hips would have been pinned unnecessarily. The number needed to treat to prevent one subsequent contralateral slip is 1.79.
Conclusions: To our knowledge, this is the largest study to date that confirms that the posterior sloping angle is a reliable predictor of contralateral slip and can be used to guide prophylactic pinning. The posterior sloping angle is applicable in the high-risk Polynesian population and could be useful in preventing future slips in populations that are difficult to follow up.

year: 2013

title: Does a video speed task predict risky speeding behaviour in young and inexperienced drivers?

authors: Cantwell, Stephen James

subjects: Young drivers

abstract: Vehicle crashes account for the highest number of fatalities for persons aged between 17 and 25 years of age in New Zealand. Despite a myriad of factors precipitating vehicle crashes, excess or inappropriate vehicle speed has been identified as the greatest predictor of crash likelihood and severity. Excess or inappropriate speed reduces a driver’s control over the vehicle, while exaggerating both collision force and the distances required in stopping or safely manoeuvring. One of the major differences identified between young and inexperienced and older more experienced drivers is the ability to adapt driving behaviour to road conditions. Young drivers are more prone to speeding through both a lack of awareness of risks and a desire to seek out novel and stimulating experiences. Recent developments in cognitive models of risk taking propose that older more experienced drivers may adapt their speed by “feeling out” the road conditions, where as young drivers may depend more upon posted limits to determine their speed. A video speed task was developed to measure speed preferences on a selection of road conditions (or ‘environments’) commonly confronting New Zealand motorists. Analyses of speed preferences revealed that young and inexperienced drivers preferred speeds close to the road-limit irrespective of conditions, whereas older and more experienced drivers preferred speeds clearly below the road limit, and demonstrated greater variation in speed preferences on different road environments. This suggests that young and inexperienced drivers both prefer faster speeds and may use the road limit as a target in determining an appropriate speed. Older and more experienced drivers prefer slower speeds, and adapt driving to changing road conditions. Faster preferred speeds were found to be related to a riskier attitudes towards driving in general, and more lenient attitudes toward speeding in particular. In addition, faster preferred speeds were found to be related to a heightened enjoyment of risk taking, as well as the number of speeding convictions issued in the previous 12 months. The used video speed task provided a convenient measure of speeding behaviour in natural driving scenarios, and appeared to be sensitive to differences in the way drivers adjust their behaviour across changing driving conditions. The video speed task might be useful in determining differences in speed choice between day and night time driving scenarios, as well as expanding the road conditions to including wet or foggy driving situations. This may be particularly useful in determining the pre- and post-effectiveness of driver training programs.

text: Does a video speed task predict risky speeding behaviour in young and inexperienced drivers? Vehicle crashes account for the highest number of fatalities for persons aged between 17 and 25 years of age in New Zealand. Despite a myriad of factors precipitating vehicle crashes, excess or inappropriate vehicle speed has been identified as the greatest predictor of crash likelihood and severity. Excess or inappropriate speed reduces a driver’s control over the vehicle, while exaggerating both collision force and the distances required in stopping or safely manoeuvring. One of the major differences identified between young and inexperienced and older more experienced drivers is the ability to adapt driving behaviour to road conditions. Young drivers are more prone to speeding through both a lack of awareness of risks and a desire to seek out novel and stimulating experiences. Recent developments in cognitive models of risk taking propose that older more experienced drivers may adapt their speed by “feeling out” the road conditions, where as young drivers may depend more upon posted limits to determine their speed. A video speed task was developed to measure speed preferences on a selection of road conditions (or ‘environments’) commonly confronting New Zealand motorists. Analyses of speed preferences revealed that young and inexperienced drivers preferred speeds close to the road-limit irrespective of conditions, whereas older and more experienced drivers preferred speeds clearly below the road limit, and demonstrated greater variation in speed preferences on different road environments. This suggests that young and inexperienced drivers both prefer faster speeds and may use the road limit as a target in determining an appropriate speed. Older and more experienced drivers prefer slower speeds, and adapt driving to changing road conditions. Faster preferred speeds were found to be related to a riskier attitudes towards driving in general, and more lenient attitudes toward speeding in particular. In addition, faster preferred speeds were found to be related to a heightened enjoyment of risk taking, as well as the number of speeding convictions issued in the previous 12 months. The used video speed task provided a convenient measure of speeding behaviour in natural driving scenarios, and appeared to be sensitive to differences in the way drivers adjust their behaviour across changing driving conditions. The video speed task might be useful in determining differences in speed choice between day and night time driving scenarios, as well as expanding the road conditions to including wet or foggy driving situations. This may be particularly useful in determining the pre- and post-effectiveness of driver training programs.

year: 2010

title: Constructing strategies for sustainable development the communitarian way

authors: Arunachalam, Murugesh

subjects: communities

abstract: Purpose – The paper aims to draw on recommendations of Agenda 21 and communitarian theory to examine collaboration between local district community and local authorities to formulate strategies for the sustainable development of the Taupo district. 
Design/methodology/approach – The paper adopts an interpretative methodology based on philosophical hermeneutic to understand collaboration between local community and local authorities in the Taupo district. Empirical data for this interpretive study comprise public documents, interview transcripts and minutes of meetings attended by the researchers. The paper begins interpretation of empirical data with pre-understanding of communitarian theory and Agenda 21. 
Findings – The findings indicate that historical and political factors and diversity of interests in the community affect processes and outcomes of collaboration. Local authorities play a crucial role in bringing together various groups in the Taupo community which are segregated by diversity of interests, especially between Maori and non-Maori community groups. Without local authority facilitation, the Taupo community may remain segregated; inhibited by lack of information; and not having the opportunity to participate in sustainable development. Community participation in the Taupo district is at an infancy stage and collaboration intended to empower communities may result in local authorities recentralising their positions. 
Originality/value – The paper integrates theory and practice and provides valuable insights for statutory agencies seeking to implement the recommendations of Agenda 21 regarding community participation in sustainable development.

text: Constructing strategies for sustainable development the communitarian way Purpose – The paper aims to draw on recommendations of Agenda 21 and communitarian theory to examine collaboration between local district community and local authorities to formulate strategies for the sustainable development of the Taupo district. 
Design/methodology/approach – The paper adopts an interpretative methodology based on philosophical hermeneutic to understand collaboration between local community and local authorities in the Taupo district. Empirical data for this interpretive study comprise public documents, interview transcripts and minutes of meetings attended by the researchers. The paper begins interpretation of empirical data with pre-understanding of communitarian theory and Agenda 21. 
Findings – The findings indicate that historical and political factors and diversity of interests in the community affect processes and outcomes of collaboration. Local authorities play a crucial role in bringing together various groups in the Taupo community which are segregated by diversity of interests, especially between Maori and non-Maori community groups. Without local authority facilitation, the Taupo community may remain segregated; inhibited by lack of information; and not having the opportunity to participate in sustainable development. Community participation in the Taupo district is at an infancy stage and collaboration intended to empower communities may result in local authorities recentralising their positions. 
Originality/value – The paper integrates theory and practice and provides valuable insights for statutory agencies seeking to implement the recommendations of Agenda 21 regarding community participation in sustainable development.

year: 2010