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Background: Fear of reinjury and lack of confidence influence return-to-sport outcomes after anterior cruciate ligament (ACL)reconstruction. The physical, psychosocial, and functional recovery of patients reporting fear of reinjury or lack of confidenceas their primary barrier to resuming sports participation is unknown.Purpose: To compare physical impairment, functional, and psychosocial measures between subgroups based on return-to-sportstatus and fear of reinjury/lack of confidence in the return-to-sport stage and to determine the association of physical impairmentand psychosocial measures with function for each subgroup at 6 months and 1 year after surgery.Study Design: Case-control study; Level of evidence, 3.Methods: Physical impairment (quadriceps index [QI], quadriceps strength/body weight [QSBW], hamstring:quadriceps strengthratio [HQ ratio], pain intensity), self-report of function (International Knee Documentation Committee [IKDC]), and psychosocial(Tampa Scale for Kinesiophobia–shortened form [TSK-11]) measures were collected at 6 months and 1 year after surgery in73 patients with ACL reconstruction. At 1 year, subjects were divided into ‘‘return-to-sport'' (YRTS) or ‘‘not return-to-sport''(NRTS) subgroups based on their self-reported return to preinjury sport status. Patients in the NRTS subgroup were subcategorizedas NRTS-Fear/Confidence if fear of reinjury/lack of confidence was the primary reason for not returning to sports, and allothers were categorized as NRTS-Other.Results: A total of 46 subjects were assigned to YRTS, 13 to NRTS-Other, and 14 to NRTS-Fear/Confidence. Compared with theYRTS subgroup, the NRTS-Fear/Confidence subgroup was older and had lower QSBW, lower IKDC score, and higher TSK-11score at 6 months and 1 year; however, they had similar pain levels. In the NRTS-Fear/Confidence subgroup, the IKDC scorewas associated with QSBW and pain at 6 months and QSBW, QI, pain, and TSK-11 scores at 1 year.Conclusion: Elevated pain-related fear of movement/reinjury, quadriceps weakness, and reduced IKDC score distinguishpatients who are unable to return to preinjury sports participation because of fear of reinjury/lack of confidence. Despite low averagepain ratings, fear of pain may influence function in this subgroup. Assessment of fear of reinjury, quadriceps strength, andself-reported function at 6 months may help identify patients at risk for not returning to sports at 1 year and should be consideredfor inclusion in return-to-sport guidelines. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to compare the improvement in symptoms and quality of life achieved when using two treatments which include inner sole and medical compression stockings. It states that the study was initiated to 24 patients with a symptomatic chronic venous disease associated with foot static disorders. It is inferred that a number of leg symptoms happening in varicose veins patients are not likely to have a venous origin.

The article discusses the use of Social Judgment Theory method for occupational therapy in Great Britain, Australia and New Zealand. It highlights the importance of automobile driving as an instrumental activity of daily living for community mobility of many individuals. It cites the integration of occupational therapy to the drivers with acquired illness or disability that deteriorate health condition.

The article discusses the impact of stroke to the visual perception of a driver wherein stroke can lead to a homonymous visual field loss in Great Britain. It states that people with homonymous visual field loss are banned from driving to avoid accident. It examines the prevalence of visual field loss among stroke survivors which depends on the population factors and the presence of a visual field defect.

The article presents a study on graft extrusion in sagittal and coronal planes after medial and lateral meniscus allograft transplantation (MAT). Topics covered include anterior cartilage meniscus distance (ACMD), posterior cartilage meniscus distance (PCMD) horns, and magnetic resonance imaging (MRI) after MAT.

The article presents a study on medical comorbidities and age as risk factors for short-term adverse events and readmission following arthroscopic meniscectomy. Topics covered include studies that questioned the efficacy of meniscectomy in older patients, the use of multivariate logistic regression analyses, and complications.

We employed item response theory (IRT), specifically using Rasch modeling, to determine the measurement precision of the Fitness-to-Drive Screening Measure (FTDS), a tool that can be used by caregivers and occupational therapists to help detect at-risk drivers. We examined unidimensionality through the factor structure (how items contribute to the central construct of fitness to drive), rating scale (use of the categories of the rating scale), item/person-level separation (distinguishing between items with different difficulty levels or persons with different ability levels) and reliability, item hierarchy (easier driving items advancing to more difficult driving items), rater reliability, rater effects (severity vs. leniency of a rater), and criterion validity of the FTDS to an on-road assessment, via three rater groups (n = 200 older drivers; n = 200 caregivers; n = 2 evaluators). The FTDS is unidimensional, the rating scale performed well, has good person (>3.07) and item (>5.43) separation, good person (>0.90) and item reliability (>0.97), with <10% misfitting items for two rater groups (caregivers and drivers). The intraclass correlation (ICC) coefficient among the three rater groups was significant (.253, p < .001) and the evaluators were the most severe raters. When comparing the caregivers’ FTDS rating with the drivers’ on-road assessment, the areas under the curve (index of discriminability; caregivers .726, p < .001) suggested concurrent validity between the FTDS and the on-road assessment. Despite limitations, the FTDS is a reliable and accurate screening measure for caregivers to help identify at-risk older drivers and for occupational therapy practitioners to start conversations about driving. [ABSTRACT FROM PUBLISHER]

Aim: In the 1990s, several studies noted a large gap in life expectancy between Western and Eastern European countries. It was speculated that this could be explained by environmental pollution, socioeconomic factors, lifestyle and psychosocial stress. A weakness in addressing the issue has been the lack of prospective studies with mortality as end point. Methods: We used the national population registries (between 1996 and 1998) to screen a cohort of 269 55-year-old subjects in Sweden and Estonia. We assessed conventional risk factors, lifestyle and socio-economic factors. A 13-year follow-up regarding all-cause and cardiovascular mortality was done. Results: Smoking and, to a lesser extent, plasma levels of interleukin-6 were significant predictors for CVD and non-CVD mortality in men, but none of the other conventional risk factors reached statistical significance. During the follow-up period, 22 of the 52 male smokers died compared to 8 of the 85 male non-smokers (p<0.01). Ten of the smokers died of CVD compared to three of the non-smokers (p<0.002). In total, only two women died. Conclusions: These data emphasize that smoking prevention is extremely important in preventing premature death. Although smoking prevalence is diminishing, it is still the most important risk factor to treat. [ABSTRACT FROM PUBLISHER]

In 1994 the Government of Delhi (India) implemented an essential medicines policy in public health facilities (HF) to improve the availability and rational use of medicines (RUM). An essential medicines list (EML) was made. Training programmes in RUM were initiated. After 13 years the outcome of the policy on RUM within public HF was evaluated. Policy implementation improved the availability of medicines to 91.4 per cent. Prescribing of medicines from EML increased (94.6 per cent) and antimicrobials declined (51.7 per cent). The number of patients with complete knowledge of how to take prescribed medicines improved (53.4 per cent). However, the use of generic medicines declined (18.1 per cent) and prescriptions were mostly incomplete (79.6 percent). Majority of prescribers lacked awareness about the Drug Policy, including not having undergone training sessions on RUM. There were no Drugs and Therapeutic Committees within HF, and only a few doctors had information about medicines available within the HF. The most common sources of information for medicines were commercial published sources and medical representatives of pharmaceutical companies. The regulatory intervention of enforcing an EML in public HF has been successful in increasing the use of medicines from the EML and improving some prescribing indicators. However, educational interventions have been inadequate and need to be combined and strengthened to improve the policy outcomes in RUM. [ABSTRACT FROM PUBLISHER]

We assessed endothelial dysfunction (ED) in patients with Behcet disease (BD; n = 40) and healthy controls (n = 20). Serum lipid, homocysteine, asymmetric dimethylarginine (ADMA) and high-sensitivity C-reactive protein (hsCRP) levels, erythrocyte sedimentation rates (ESRs), and ultrasonographic flow-mediated dilatation (FMD) were measured. Mean hsCRP, ESR, homocysteine, and ADMA were significantly higher in the BD group (P < .001 for all). Patients with active BD had higher serum levels of hsCRP, homocysteine, and ESR compared with those in remission (P < .001, P < .001, and P = .005, respectively). Flow-mediated dilatation was significantly lower in patients with BD than in controls (P = .001). Flow-mediated dilatation correlated negatively with BD duration and serum ADMA levels (P < .001, r = −.745 and P < .001, r = −.682); a positive correlation was seen between serum ADMA levels and BD duration (P < .001, r = .552). Only stepwise multivariate regression analysis revealed BD duration to have a significant effect on FMD. Flow-mediated dilatation, in conjunction with markers of inflammation, may evaluate ED in patients with BD. [ABSTRACT FROM PUBLISHER]

We investigated whether serum concentrations of apolipoprotein (apo) B and apoA-I and the apoB/apoA-I ratio provided predictive information on myocardial infarction (MI) and ischemic stroke during 13 years of follow-up in a group of initially clinically healthy 58-year-old men, free from previous cardiovascular disease, diabetes, other established disease, or treatment with cardiovascular drugs. Multivariate logistic regression analysis showed that the apoB/apoA-I ratio and apoB were significant and independent determinants of MI (exponentiation of the B coefficient [Exp(β)] 3.1, 95% confidence interval [CI] 1.6-6.3, P = .001, Exp(β) 2.8, 95% CI 1.1-7.7, P = .045, respectively). The area under the receiver–operating characteristics curve as a relative measure of test efficiency was highest and significant for both apoB/apoA-I ratio and apoB (area under the curve = 0.75, P < .001). In conclusion, the apoB/apoA-I ratio and apoB are independent risk factors for MI and has the highest efficiencies for predicting MI in initially healthy middle-aged men. [ABSTRACT FROM PUBLISHER]

The article presents research which examined the risk factors for anterior glenohumeral instability. Topics covered include the prevalence of this condition in young athletes as well as lack of studies about the injury. Also mentioned is the measurement of the condition by examining glenoid height, glenoid version, glenoid depth as well as rotator interval height.

The article presents research which discussed the rate and risk factors for patients who underwent revision anterior cruciate ligament reconstruction in Ontario. Topics covered include the number of participants who have been readmitted after the surgery as well as survival rate among those who had re-revision of the approach. Also mentioned is the rarity of patients who had total knee arthroplasty.

The article presents research which looked at the association of preoperative subchondral bone edema with graft and pain outcomes in patients who underwent matrix-induced autologous chondrocyte implantation. Topics covered include the use of the implantation approach to repair knee chondral defects as well as the use of Pain and Symptoms subscales to examine the degree of bone marrow edema. Also mentioned is the application of linear regression method in the study.

The article presents research which examined poor lumbopelvic control as a risk factor for baseball pitchers with injuries. Topics covered include the association of lumbopelvic control with players' loading, kinematics and pitching performance. Also provided are the number of days missed by injured player for the entire season as quantified by the team's medical staff.

Objective: Bevacizumab, the first FDA-approved anti-angiogenesis agent, has been used for metastatic colorectal cancer since 2004. This study evaluated the utilization of bevacizumab among elderly metastatic colorectal cancer patients in the United States. Methods: Using Surveillance and Epidemiology and End Results (SEER)-Medicare data, this retrospective cohort study consisted of individuals aged 65 years or older with a colorectal cancer diagnosis between 2005 and 2009, who received chemotherapy any time through 2010. This included patients with newly diagnosed metastatic colorectal cancer and patients who progressed from initially diagnosed earlier-stage disease. We ascertained comorbid conditions using ICD-9 codes and conducted logistic regression to identify patients’ characteristics associated with bevacizumab use. Results: A total of 8645 patients were identified (mean age 74 years; 52% male); 57% of patients received bevacizumab with initially diagnosed metastatic colorectal cancer and 44% of patients with treated progressive or recurrent disease. After adjusting for other covariates, we found that patients aged ≥80 years were less likely to receive bevacizumab compared with those aged 65–69 years (odds ratio (OR), 0.64 (95% confidence interval (CI): 0.57–0.73)), or if they had evidence of comorbid cardiomyopathy/congestive heart failure (OR, 0.82 (CI: 0.70–0.95)) or arrhythmic disorder (OR, 0.85 (CI: 0.75–0.96)). Adoption of bevacizumab into practice was rapid following its approval, and the use increased from 36% to 40% from 2005 to 2010 (p = 0.013). There were significant regional variations in bevacizumab use. Conclusions: Despite rapid uptake since its original approval, there appears to be low use of bevacizumab in elderly metastatic colorectal cancer patients in the United States. Regional variations and the strong effects of age and comorbidity suggest lack of consensus among oncologists regarding benefits and risks of bevacizumab in elderly patients. [ABSTRACT FROM AUTHOR]

Objective. Intervention to reduce nonurgent pediatric emergency department (PED) visits over a 12-month follow-up. Methods. Prospective, randomized, controlled trial enrolled children seen in the PED for nonurgent concerns. Intervention subjects received a structured session/handout specific to their primary care provider (PCP), which outlined ways to obtain medical advice. Visitation to the PED and PCP were followed over 12 months. Results. A total of 164 patients were assigned to the intervention and 168 patients to the control. At 12-month follow-up, the intervention group had a lower rate of nonurgent PED utilization compared with the control group (70 [43%] patients in the intervention compared with 91 [54%] in the control; P = .047). At 12 months, there was an increase in the rate of sick visits to PCP in the intervention group when compared with the control (P = .036). Conclusions. Intervention designed in cooperation with pediatricians was able to decrease nonurgent PED utilization and redirect patients to their PCP for future sick visits over a 12-month period. [ABSTRACT FROM PUBLISHER]

The article presents research which examined the relation between the baseline performance and testing environment in the concussion analysis among pediatric patients. Topics covered include the disparities in the cognitive performance of children and adolescents as well as application of standardized test administration procedures to analyze concussion rate among patients. Also mentioned is the participation of 939 patients in the study.

The article presents a study which investigates the primary caregivers' attitudes toward hospice/palliative care (HPC) utilization in South Korea. Topics discussed include the management of terminal cancer patients, the availability of health-care resources, and the importance of promoting awareness of prognosis and improved communication between doctors and families for facilitating the use of HPC.

Objective: To assess the status of pulse oximetry screening and barriers to implementing screening programs. Methods: This was a prospective pre-post intervention survey of nurse managers and medical directors of hospital-based birthing centers in Oregon, Idaho, and Southern Washington. The intervention was a 7-minute video demonstrating and discussing pulse oximetry screening for critical congenital heart disease. Results: Analysis of matched pairs showed a significant increase in the use of pulse oximetry screening during the study period from 52% to 73% (P < .0001). Following implementation of the video, the perception of all queried potential barriers decreased significantly among individuals from hospitals self-identified as nonscreening at baseline. Viewing the educational video was associated with an increase in the percentage of individuals from nonscreening hospitals that rated screening as “very beneficial” (45% vs 90%, P = .0001). Conclusions: An educational video was associated with improved opinions of pulse oximetry screening among hospitals not currently screening. [ABSTRACT FROM PUBLISHER]

The article presents research which focused on the use of acromioplasty in the arthroscopic repair of full-thickness rotator cuff injuries. Topics covered include the popularity of this medical technique as well as the debate concerning its effectiveness on athletes. Also mentioned is the participation of 114 patients in the study.

The article presents research which examined the occurrence of childhood trauma in children with bipolar disorder. Topics covered include the impact of stress on the treatment course for the children and the rate of childhood trauma in patients with the condition. Also mentioned is the use of the Childhood Trauma Questionnaire in the study.

Objective: To examine the association between 6-min walk test (6 MWT) performance and all-cause mortality, coronary heart disease mortality, and incident coronary heart disease in older adults. Method: We conducted a time-to-event analysis of 1,665 Cardiovascular Health Study participants without prevalent cardiovascular disease with a 6 MWT. Results: During a mean follow-up of 8 years, there were 305 incident coronary heart disease events, and 504 deaths of which 100 were coronary heart disease–related deaths. The 6 MWT performance in the shortest two distance quintiles was associated with increased risk of all-cause mortality (290-338 m: hazard ratio [HR] = 1.7; 95% confidence interval [CI] = [1.2, 2.5]; <290 m: HR = 2.1; 95% CI = [1.4, 3.0]). The adjusted risk of coronary heart disease mortality incident events among those with a 6 MWT < 290 m was not significant. Discussion: Performance on the 6 MWT is independently associated with all-cause mortality and is of prognostic utility in community-dwelling older adults. [ABSTRACT FROM PUBLISHER]

To explore the different developmental trajectories of social-communicative skills in children with autism and typically developing infants, two longitudinal studies were conducted. In Study 1, we examined the developmental sequence of social-communicative skills in 26 typically developing infants when they were 9 months old and reexamined them when they were 12 and 15 months old. The results indicated a reliable developmental sequence of social-communicative skills in infants with typical development. In Study 2, we explored the emergence sequence of social-communicative skills of 23 children with autism and 23 children with developmental delay between the ages of 2 and 4 years. The results demonstrated that the developmental sequence of social-communicative skills in young children with autism and children with developmental delays was different. [ABSTRACT FROM PUBLISHER]

The aim of this study was to identify child characteristics, family demographics, and parent cognitions that may affect access to early intervention, special education, and related services. The sample included 70 families of young children with autism spectrum disorders. All parents were enrolled in a short education program, providing them with basic information and resources on advocating for a young child with autism spectrum disorders (Parent Advocacy Coaching). Longitudinal change in children’s intervention program in the community was evaluated over a period of about 27 months, starting 12 months prior to enrollment in Parent Advocacy Coaching. Results revealed large individual differences in the intensity of children’s individual and school-based services. Despite this variability, only two child characteristics (age, gender) emerged as independent predictors. In contrast, the intensity of children’s intervention programs was independently predicted by a broad range of demographic characteristics, including parental education, child ethnicity and race, and family composition. Finally, even after child characteristics and family demographics were statistically controlled, results revealed associations between specific parental cognitions (parenting efficacy, understanding of child development) and the subsequent rate of change in the intensity of children’s intervention programs. Implications for improving educational programs that aim to enhance parent advocacy are discussed. [ABSTRACT FROM PUBLISHER]

The article discusses a study that investigated the risk factors for lower extremity injuries in elite female soccer players. Players in the Norwegian elite female soccer league were included in the baseline screening tests before the 2009 competitive soccer season. A total of 173 players had complete screening tests and registration of injuries and exposure during the season. It is said that a greater body mass index was associated with lower extremity injuries in elite female soccer players.

Objective To determine if infrared laser acupuncture (LA) may have a specific effect in reducing pain and disability in treatment of chronic low back pain (LBP). Methods This was a double-blind sham laser controlled trial performed in general practices in Perth, Western Australia. The participants were 144 adults with chronic non-specific LBP. They were randomised to receive eight once-weekly treatments. Laser machines (20 mW, 840 nm diode, power density 0.1 W/cm2) stimulated points in three treatment groups: sham (0 joules/ point), low dose (0.2 J/point) and high dose (0.8 joules/point). Participants were followed-up at 1 and 6 weeks, and 6 and 12 months post treatment. Primary outcomes were pain (Numerical Pain Rating Scale (NPRS)) and disability (Oswestry Disability Inventory (ODI)) at 6 weeks post treatment. Secondary outcomes included numerical rating scale for limitation of activity, global assessment of improvement, analgesic usage and adverse effects after treatment. Results The analysis showed no difference between sham and the laser groups at 6 weeks for pain or disability. There was a significant reduction in mean pain and disability in all groups at 6 weeks (p<0.005); NPRS: sham (-1.5 (95% CI -2.1 to - 0.8)), low dose (-1.3 (-2.0 to -0.8)), high dose (-1.1 (-1.7 to -0.5)). ODI: sham (-4.0 (-7.1 to -1.0)), low dose (-4.1, (-6.7 to -1.5)), high dose (-2.6 (-5.7 to 0.5)). All secondary outcomes also showed clinical improvement over time but with no differences between groups. Conclusions LA using energy density range (0-4 J/cm2) for the treatment of chronic nonspecific LBP resulted in clinical improvement unrelated to laser stimulation. [ABSTRACT FROM AUTHOR]

The article presents a cohort study which examined if patellar and trochlear defects of the knee actually represent various clinical conditions with different healing potentials following cartilage treatment. In the study, 49 patients with full-thickness patellofemoral chondral lesions of the knee were treated with matrix-assisted autologous chondrocyte transplantation (MACT). The results were analyzed using such methods as International Knee Documentation Committee (IKDC) subjective.

The article presents a study that explores end-of-life transitions of older old people across the cognitive spectrum. The study used mortality records linked to 283 Cambridge City over-75s Cohort participants' cognitive assessments less than one year before dying aged 85 years or more. One finding suggests that 55% their usual address on death registration was not their place of death.

Introduction: This study examined the relationship between interest, current participation, and desire for future participation in each activity listed in the Japanese Interest Checklist for the Elderly. Method: Data were collected from 375 community-dwelling older Japanese people through individual interviews using the revised Japanese Interest Checklist for the Elderly, which contains 25 activities. Responses in interest, current participation, and desire for future participation were analysed across activity and gender. Findings: Interest, current participation, and desire for future participation in activities correlated significantly and positively for both genders. Three different situations were identified: (1) participants could not currently participate in activities despite showing interest; (2) they were not currently engaged in activities but wished to participate them in the future; and (3) they preferred not to participate in the specific activities in the future, despite currently showing interest. Conclusion: There is a need for occupational therapists, therefore, to understand these findings in considering appropriate therapeutic options. Moreover, occupational therapists need to determine whether the person prefers not to participate in some activities, despite showing interest and/or participation in interests more generally. [ABSTRACT FROM AUTHOR]

The article discusses a study which calculated the incidence density rate (IDR) of primary anterior shoulder dislocation requiring closed reduction in the general population and demographic subgroups in Ontario. Results showed that young male patients have the highest incidence of primary anterior shoulder dislocation requiring CR and the greatest risk of repeat shoulder CR. The study also found that patient, provider, and injury factors all influence repeat shoulder CR risk.

Background: Parental concerns persist that immunization increases the risk of autism spectrum disorder, resulting in the potential for reduced uptake by parents of younger siblings of children with autism spectrum disorder (“younger sibs”). Objective: To compare immunization uptake by parents for their younger child relative to their older child with autism spectrum disorder (“proband”) and controls. Design: Immunization status was obtained for 98 “younger sibs,” 98 “probands,” and 65 controls. Results: A significant group difference emerged for overall immunization status (Fisher’s exact test = 62.70, p < .001). One or more immunizations in 59/98 younger sibs were delayed (47/98; 48%) or declined (12/98; 12.2%); immunizations were delayed in 16/98 probands (16.3%) and declined in only one. All controls were fully immunized, with only 6 (9.2%) delayed. Within the “younger sibs” group, 25/98 received an autism spectrum disorder diagnosis; 7 of whom (28%) were fully immunized. The rates of autism spectrum disorder diagnosis did not differ between immunized and nonimmunized younger sib groups, although small sample size limits interpretability of this result. Conclusion: Parents who already have one child with autism spectrum disorder may delay or decline immunization for their younger children, potentially placing them at increased risk of preventable infectious diseases. [ABSTRACT FROM AUTHOR]

The article presents a study that evaluates whether early loading of the tendon and range of motion training could improve patient-reported outcome and function after a total acute Achilles tendon rupture. The study focuses on 100 patients with an acute total Achilles tendon rupture who were randomized to surgical and nonsurgical treatment. It reveals no significant differences between the groups in terms of symptoms, physical activity level, or quality of life.

Context--Catecholamines and inflammatory mediators, with elevated levels after brain death, are associated with reduced function and survival of transplanted organs. Enteral nutrition reduces tissue damage and may benefit organs. Objective--To evaluate the effects of immunomodulating enteral nutrition in organ donors. Design--Prospective, randomized, open-label study. Setting--Intensive care unit. Patients--Thirty-six brain-dead organ donors. Interventions--Donors were randomized to receive enteral nutrition containing omega-3 polyunsaturated fatty acid, antioxidants, and glutamine or standard care (fasting). Donors received hormonal replacement therapy of corticosteroid, levothyroxine, dextrose, and insulin. Main Outcome Measures--Gastrointestinal assimilation (measured by 13carbon-labeled uracil breath analysis), quantity of organs recovered, resting energy expenditure, urine level of urea nitrogen, and serum levels of albumin, prealbumin, interleukin 6, tumor necrosis factor-α, and C-reactive protein were evaluated. Results--Thirteen patients (36%) assimilated 13C-labeled uracil. Resting energy expenditure was significantly higher than predicted between 10 and 14 hours after baseline in 33 donors (P= .007). Other measures were not conclusively different between fed and fasting groups. No adverse events occurred that were related to the enteral feeding. Conclusions--About 30% of donors metabolized 13C-labeled uracil, although no difference in oxidation rate was found between fasting and fed donors. Corticosteroid administration lowers plasma levels of interleukin 6 and most likely contributes to greater than predicted resting energy expenditure. Thus energy needs may not be met during fasting if hormones are given. Consequences of this possible energy deficit warrant further study. [ABSTRACT FROM AUTHOR]

Intimate partner violence often begins during the courtship stage of romantic relationships. Although some relationships dissolve as a result of aggression, other relationships remain intact, increasing the risk for escalated violence. The present study identified factors predictive of individual differences in emerging adults’ commitment to physically aggressive or sexually coercive dating relationships. Specifically, Rusbult’s Investment Model of romantic relationships (e.g., investment, satisfaction, quality of alternatives, and commitment) was applied to a longitudinal sample of 148 young adult women who reported experiencing aggression or coercion from their current partners. To further explain commitment within aggressive or coercive dating relationships, rejection sensitivity and anxious and avoidant romantic relational styles were included as predictors of the Investment Model variables. A more avoidant romantic style indirectly predicted commitment through relationship satisfaction and investment. Both commitment and rejection sensitivity significantly predicted continuing an aggressive or coercive relationship 6 months later. The present study improves our understanding of the processes involved in relationship commitment. Continuing to understand these processes will inform interventions that seek to help women who have decided to end aggressive or coercive dating relationships. [ABSTRACT FROM PUBLISHER]

Background:While posterior glenohumeral instability is becoming increasingly common among young athletes, little is known of the risk factors for injury.Purpose:To determine the modifiable and nonmodifiable risk factors for posterior shoulder instability in a high-risk cohort.Study Design:Case-control study (prognosis); Level of evidence, 2.Methods:A prospective cohort study in which 714 young athletes were followed from June 2006 through May 2010 was conducted. Baseline testing included a subjective history of instability, instability testing by a sports medicine fellowship–trained orthopaedic surgeon, range of motion, strength measurement with a handheld dynamometer, and bilateral noncontrast magnetic resonance imaging of the shoulder. A musculoskeletal radiologist measured glenoid version, height, depth, rotator interval (RI) height, RI width, RI area, and RI index. Participants were followed to document all acute posterior shoulder instability events during the 4-year follow-up period. The time to the posterior shoulder instability event during the follow-up period was the primary outcome of interest. Univariate and multivariable Cox proportional hazards regression models were used to analyze the data.Results:Complete data on 714 participants were obtained. During the 4-year surveillance period, 46 shoulders sustained documented glenohumeral instability events, of which only 7 were posterior in direction. The baseline factors that were associated with subsequent posterior instability during follow-up were increased glenoid retroversion (P < .0001), increased external rotation strength in adduction (P = .029) and at 45° of abduction (P = .015), and increased internal rotation strength in adduction (P = .038).Conclusion:This is the largest known prospective study to follow healthy participants in the development of posterior shoulder instability. Posterior instability represents 10% of all instability events. The most significant risk factor was increased glenoid retroversion. While increased internal/external strength was also associated with subsequent instability, it is unclear whether these strength differences are causative or reactive to the difference in glenoid anatomy. This work confirms that increased glenoid retroversion is a significant prospective risk factor for posterior instability. [ABSTRACT FROM AUTHOR]

Background:Benefits of graft harvest from the side contralateral to the anterior cruciate ligament (ACL)–deficient leg have been identified when using bone–patellar tendon–bone autografts in ACL reconstruction (ACLR). As hamstring tendon autografts are becoming more commonly used, a study examining the effect of contralateral graft harvest of semitendinosus gracilis (STG) tendons on patient quality of life was conducted.Purpose:To evaluate if ACLR using a hamstring tendon autograft results in better patient quality of life if the graft is harvested from the leg contralateral to the ACL rupture compared with the ipsilateral leg.Study Design:Randomized controlled trial; Level of evidence, 1.Methods:A total of 100 participants between 16 and 50 years of age with a complete ACL tear were randomly assigned to undergo ACLR using either the ipsilateral or contralateral leg as the STG graft donor. Primary outcome measures were the ACL Quality of Life questionnaire (ACL-QOL), concentric knee flexion and extension strength at 60 and 240 deg/s, International Knee Documentation Committee (IKDC) knee assessment form, early postoperative pain and diary of analgesic use, and rate of reruptures. Outcome measures were evaluated before surgery and at 3, 6, 12, and 24 months after surgery.Results:The ACL-QOL score improved over time for both groups (P < .001), and there were no significant differences between groups at any time point (P = .528). Significant differences in knee flexion and extension strength were found at 3 months after surgery. There were no differences between groups in IKDC knee assessment scores or rerupture rates.Conclusion:There does not appear to be any measurable benefit or drawback in quality of life to the use of an STG graft from the unaffected limb. In light of this finding, further research to examine other possible effects on agility and balance as well as time and ability to return to sport should be conducted. Longer term follow-up beyond 2 years would allow for a more thorough evaluation of the risk of reruptures or contralateral reruptures using this novel approach. [ABSTRACT FROM AUTHOR]

Investigating manual actions when infants' upper limbs are heavier can provide information on whether mechanical forces can infl uence the early ability of exploring grasped objects. This study assessed whether additional weight load aff ected typical infants' manual non-exploratory and exploratory behaviors. Ten healthy full-term infants were evaluated longitudinally at 5, 6, and 7 months of age. They were tested consecutively without weight and with a weight of 20% of the total upper limb mass ( M = 74.7–85.3 g) attached to their wrists while seated in a baby chair. During each condition, a malleable rubber object was presented at the infant's midline to elicit reaching, grasping, and object exploration for 2 min. Reactions were recorded using three digital cameras. Behaviors were coded as non-exploratory (dropping) and manual exploratory behaviors (waving, banging, rotating, alternating and mouthing) and were computed by frequencies of their occurrence. The analyses indicated that the frequency of dropping increased in the weight condition independent of age. This indicates that the non-exploratory behavior was aff ected by the load disturbance imposed by the additional weight. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to determine the efficiency of a rehabilitation programme over standard physiotherapy practices in the improvement of function in metal-on-metal hip resurfacing arthroplasty patients. It says that the participants completed other measures such as the Hip disability and Osteoarthritis Outcome Score (HOOS), quality of life, and the EuroQol (EQ-5D-3L). It concludes that a tailored physiotherapy approach improves functional outcomes in the patients.

Many countries throughout the world are facing a serious nursing shortage, and retention of nurses also is a challenge. The aim of this study was to compare the predictive contribution of a broad spectrum of psychosocial work factors, including job strain, effort-reward imbalance, and alternative employment opportunity, to the probability of intention to leave the nursing profession. A total of 7,990 registered female nurses working in hospitals in eight countries (Germany, Italy, France, the Netherlands, Belgium, Poland, Slovakia, and China) were included in the one-year prospective study. A standardized questionnaire on job strain, effort-reward imbalance, employment opportunity, and intention to leave the nursing profession was used in the survey. Multilevel logistic regression modeling was used to analyze the data. Results showed that an imbalance between high effort and low reward (in particular, poor promotion prospects) and good employment opportunity at baseline were independently associated with a new intention to leave the nursing profession at follow-up. However, job strain appeared to have relatively less explanatory power. Findings suggest that interventions to improve the psychosocial work environment, especially the reciprocity experienced between effort and reward, may be effective in improving retention of nurses and tackling the international nursing shortage. [ABSTRACT FROM AUTHOR]

Context—Daytime sleepiness in kidney transplant recipients has emerged as a potential predictor of impaired adherence to the immunosuppressive medication regimen. Thus there is a need to assess daytime sleepiness in clinical practice and transplant registries. Objective—To evaluate the validity of a single-item measure of daytime sleepiness integrated in the Swiss Transplant Cohort Study (STCS), using the American Educational Research Association framework. Methods—Using a cross-sectional design, we enrolled a convenience sample of 926 home-dwelling kidney transplant recipients (median age, 59.69 years; 25%-75% quartile [Q25-Q75], 50.27-59.69), 63% men; median time since transplant 9.42 years (Q25-Q75, 4.93-15.85). Daytime sleepiness was assessed by using a single item from the STCS and the 8 items of the validated Epworth Sleepiness Scale. Receiver operating characteristic curve analysis was used to determine the cutoff for the STCS daytime sleepiness item against the Epworth Sleepiness Scale score. Results—Based on the receiver operating characteristic curve analysis, a score greater than 4 on the STCS daytime sleepiness item is recommended to detect daytime sleepiness. Content validity was high as all expert reviews were unanimous. Concurrent validity was moderate (Spearman ρ, 0.531; P< .001) and convergent validity with depression and poor sleep quality although low, was significant (ρ, 0.235; P<.001 and ρ, 0.318, P=.002, respectively). For the group difference validity: kidney transplant recipients with moderate, severe, and extremely severe depressive symptom scores had 3.4, 4.3, and 5.9 times higher odds of having daytime sleepiness, respectively, as compared with recipients without depressive symptoms. Conclusion—The accumulated evidence provided evidence for the validity of the STCS daytime sleepiness item as a simple screening scale for daytime sleepiness. [ABSTRACT FROM AUTHOR]

The article focuses on a cohort study undertaken to determine the factor which can help in deducing the recovery from bone stress injuries in field and track athletes. A total of 211 male and female athletes were part of the study. The multi regression models showed that the bone mineral density (BMD) was low and magnetic imaging resonance (MRI) grading was high. The results indicate that low BMD and high MRI grading knowledge can determine recovery time.