Frequency and citations of published authors in two community psychology journals

The current study examined the development of community psychology through publications in the main journals of the field, the American Journal of Community Psychology (AJCP) and Journal of Community Psychology (JCP). The investigation assessed which individuals played a major role in shaping the field through their publications by recording information from every citation in AJCP and JCP since the journals started in 1973 through 2004. Each author and the year of publication were documented. In addition, the number of times each article was cited by other researchers was also documented as an approximation of the impact of the article. To document trends over time, three periods (1973–1983; 1984–1994; 1995–2004) were assessed. The relative contribution of authors to the field's literature is presented by rank orders of productivity and influence. Historical trends are discussed. © 2009 Wiley Periodicals, Inc.     

Plantar pressure analysis after percutaneous repair of displaced intra-articular calcaneal fractures

BACKGROUND: Clinical results for the treatment of displaced intra-articular calcaneal fractures are mainly expressed using disease-specific outcome scores, physical examination and radiographs. We hypothesized that plantar pressure and foot position analysis is a valuable tool in assessing foot function in patients with a unilateral displaced intra-articular calcaneal fracture treated percutaneously. MATERIALS AND METHODS: With a followup of at least one year, 21 patients with a unilateral displaced intra-articular calcaneal fracture treated percutaneously participated in the study. The pedobarographic measurements in the injured foot were compared with the contralateral control foot. Correlations between the ratios (injured/control) of plantar pressure and foot position variables and outcome scores, the physical exam items ratios, the fracture classification, and the radiological parameters were calculated. RESULTS: Statistically significant differences between the injured and the control foot were found for the weight distribution (p = 0.002), total contact time (p < 0.001), and the maximum pressure under the first metatarsal (p = 0.02) after a median followup of 18 months. Of all correlations calculated, only the heel time ratio correlated significantly with the heel width ratio (p = 0.004). CONCLUSION: Significant differences in plantar pressure distribution between the injured and uninjured foot were found, indicating that plantar pressure analysis and foot position analysis is an objective test to assess deviations in foot function. Plantar pressure data revealed limited correlation with outcome scores. Therefore, plantar pressure analysis should not be used instead of but in addition to established outcome scores.     

Cost-effectiveness of the treatment of traumatic thoracolumbar spine fractures: Nonsurgical or surgical therapy?

Background:

Spinal fractures can be an important cause for disabling back pain. Therefore, in judging the cost-effectiveness of nonsurgical or surgical therapy, not only direct costs but also the indirect costs should be calculated. In this prospective randomized study, the costs incurred by nonsurgically and surgically treated patients with a traumatic thoracolumbar spine fracture without neurological involvement were analysed.

Materials and Methods:

32 patients with a traumatic thoracolumbar spine fracture were prospectively randomized for operative or nonsurgical treatment. Patients were sent a questionnaire every three months to inquire about work-status, additional health costs and doctor visits. The patients who have minimum followup of two years were included.

Results:

Of thirty-two patients, 30 met the criterion of the followup period of at least two years. Fourteen patients received nonsurgical therapy, while 16 received surgical treatment. Direct costs of the treatment of nonsurgically treated patients were €10,608 ($12,730). For the operatively treated group, these costs were €18,769 ($22,523). Indirect costs resulted in a total of €219,187 ($263,025) per nonoperatively treated patient. In the operatively treated group, these costs were €66,004 ($79,206).

Conclusion:

In the treatment of traumatic thoracolumbar spine fractures, the indirect costs exceed the direct costs by far and make up 95.4% of the total costs for treatment in nonsurgically treated patients and 71.6% of the total costs in the operative group. In view of cost-effectiveness, the operative therapy of traumatic thoracolumbar spine fractures is to be preferred.     

Radiographic evaluation of calcaneal fractures: to measure or not to measure

Objective The aim of this study was to correlate the functional outcome after treatment for displaced intra-articular calcaneal fracture with plain radiography. Design The design was a prognostic study of a retrospective cohort with concurrent follow-up. Patients A total of 33 patients with a unilateral calcaneal fracture and a minimum follow-up of 13 months participated. Patients filled in three disease-specific questionnaires, graded their satisfaction and the indication for an arthrodesis was noted. Standardised radiographs were made of the previously injured side and the normal (control) side. Different angles and distances were measured on these radiographs and compared with values described in the literature. The differences in values in angles and distances between the injured and uninjured (control) foot were correlated with the outcome of the questionnaires, and the indication for an arthrodesis. Results None of the angles correlated with the disease-specific outcome scores. Of the angles only the tibiotalar angle correlated with the VAS (r = 0.35, p = 0.045) and only the absolute foot height correlated with the indication for an arthrodesis (odds = 0.70, CI = 0.50–0.99). Conclusion In this study the radiographic evaluation correlated poorly with the final outcome. Measurements on plain radiographs seem not to be useful in determining outcome after intra-articular calcaneal fractures.     

Willingness to Pay for Lives Saved by Helicopter Emergency Medical Services

Introduction. Currently, policy makers in the Netherlands are discussing the possibility to expand the availability of Helicopter Emergency Medical Services (HEMS) from 12 hours to 24 hours per day. For this, the preferences of the general public towards both the positive effects and negative consequences of HEMS should be taken into account. Therefore, the willingness to pay (WTP) for lives saved by HEMS was calculated. Methods. A discrete choice experiment (DCE) was performed in order to explore the preferences of respondents towards (expansion of) HEMS availability. The attributes: costs (for HEMS) per household number of additional lives saved (by HEMS), number of noise disturbances (caused by HEMS) during day time or night time were used. A written questionnaire was presented to 150 individuals by convenience sampling. Result. One hundred and thirty-six (91%) of the 150 individuals completed the DCE questionnaire. The marginal WTP for one additional life saved (in a month) was 3.43 (95% CI; 2.96–3.90) per month per household. Overall, the WTP for expansion to a 24-hour availability of HEMS can therefore be estimated at 12.29 (～ US$ 17.50) per household per month. Conclusion. The WTP derived from this study is by far exceeding the 1–1.5 Million-euro necessary per HEMS per year for the expansion from a daytime HEMS to a 24-h availability in the Netherlands. Respondents are willing to pay for lives saved by HEMS in spite of increases in flights and concurrent noise disturbances. These results may be helpful for the decision-making process, and may provide a positive argument for the expansion of HEMS availability.     

Percutaneous Reduction and Fixation of Intraarticular Calcaneal Fractures

OBJECTIVE: Percutaneous reduction by distraction and subsequent percutaneous screw fixation to restore calcaneal and posterior talocalcaneal facet anatomy. The aim of this technique is to improve functional outcome and to diminish the rate of secondary posttraumatic arthrosis compared to conservative treatment and, secondly, to reduce infectious complications compared to open reduction and internal fixation (ORIF). INDICATIONS: Sanders type II-IV displaced intraarticular calcaneal fractures. CONTRAINDICATIONS: Isolated centrally depressed fragment. Patients who are expected to be noncompliant. SURGICAL TECHNIQUE: Four distractors (Synthes) are positioned, two on each side of the foot, between the tuberosity of the calcaneus and talus and between the tuberosity and cuboid. A distracting force is given over all four distractors. A blunt drifter is then introduced from the plantar side to unlock and push up any remaining depressed parts of the subtalar joint surface of the calcaneus. The reduction is fixated with two or three screws inserted percutaneously. POSTOPERATIVE MANAGEMENT: Directly postoperatively, full active range of motion exercises of the ankle joint can start, with the foot elevated in the 1st postoperative week. Stitches are removed after 14 days. Implant removal is necessary in 50-60% of patients. RESULTS: Between 1999 and 2004, 59 patients with 71 fractures were treated by percutaneous skeletal triangular distraction and percutaneous fixation. A total of 50 patients with 61 fractures and a minimum follow-up of 1 year were available for follow-up. According to the American Orthopaedic Foot and Ankle Society Hindfoot Score, 72% had a good to excellent result. A secondary subtalar arthrodesis was performed in five patients and planned in four (total 15%). B?hler's angle increased by about 20 degrees postoperatively. Sagittal motion was 90% and subtalar motion 70% compared to the healthy foot.     

In vitro bactericidal activity of piperacillin,gentamicin, and metronidazole in a mixed model containing Escherichia coli,Enterococcus faecalis,and Bacteroides fragilis

An anaerobic, mixed model assay was used to study the bactericidal activities of piperacillin, gentamicin, and metronidazole, alone and in double- and triple-antibiotic combinations against a polymicrobial suspension of E. coli, E. faecalis, and B. fragilis. Only slight differences were noted with the agents when tested against single (10(5) cfu/mL inoculum) versus polymicrobic suspensions (10(6) cfu/mL final inoculum) of susceptible and resistant organisms. Contrary to previous reports in the literature, metronidazole was not active against E. coli in an anaerobic environment (even in the presence of B. fragilis) nor was the activity of metronidazole reduced against B. fragilis in the presence of E. faecalis. Gentamicin demonstrated excellent activity against E. coli when tested in a Bactron anaerobic chamber (5% hydrogen, 5% CO(2,) 90% nitrogen). The pH of the media was only reduced to 6.3-6.7, considerably higher than the pH range of 5-6 needed to significantly reduce the activity of aminoglycosides.