The Effect of Injury Definition and Surveillance Methodology on Measures of Injury Occurrence and Burden in Elite Volleyball

A time-loss injury definition continues to be the most widely used injury definition despite evidence that it fails to accurately capture overuse injuries. An overuse injury questionnaire, using an “all complaints” definition has been created to address the limitation of a time-loss definition. The main aim of this work was to determine the effect that injury definition and registration methodology has on the collection of knee injuries among elite level volleyball players. To reach this goal, seventy-two volleyball players were prospectively followed over 32-weeks. Time-loss injuries were captured using an individual injury report form (IIRF). Study participants completed an overuse injury questionnaire (mOIQ) via a weekly short message service (SMS). The IIRF captured 15 time-loss knee injuries in 72 study participants (20%). Based on the mOIQ, 84.7% of participants reported having a knee problem and 66.7% sustained a substantial knee problem. All IIRF knee injuries captured were also registered by the mOIQ. Agreement on the specific diagnosis occurred for 66.7% of injuries resulting in a moderate Kappa score of 0.51. In conclusion, an overuse injury questionnaire provided a greater understanding of the magnitude and burden of knee injuries in this population.

Patients’ preferences for the management of knee injuries: a discrete choice experiment

Objectives To elicit the preferences in two cohorts of patients with knee injuries who had been referred by their General Practitioner (GP) for Magnetic Resonance Imaging (MRI) or orthopaedic consultation; or were listed for an arthroscopy. Methods A discrete choice experiment using a postal questionnaire asked for patients’ preferences for, and trade-offs between, the attributes of waiting time for diagnosis, treatment time, change in knee problem and out of pocket expenses. Results Participants with knee injuries who responded to the questionnaire were: 148 of 218 (68%) in the GP cohort; and 95 of 121 (79%) in the arthroscopy cohort. Waiting time for diagnosis and treatment, as well as change in knee problem, were statistically significant important attributes. This applies less to out-of-pocket expenses although patients in the arthroscopy cohort were significantly more willing to pay extra for their treatment. There were no significant interactions between employment status and cost. For patient-related quality oflife, attributes for choosing a shorter time to diagnosis or treatment were statistically significant or borderline. Conclusion Patients with knee injuries find shorter waiting time for diagnosis and treatment to be important as well as improvements in their knee problem. Out-of-pocket expenses were less important, except for patients waiting for an arthroscopy who were willing to pay extra.

Objection Sustained: Revolutionary Pedagogical Praxis as an Occupying Force

On April 9, Condoleezza Rice delivered a talk in San Francisco. Or tried to. The former Secretary of State was interrupted repeatedly by cries from the audience of ‘war criminal’ and ‘torturer’. (For which we can thank our comrades in Code Pink and World Can't Wait.) As one of the protesters was being taken away by security guards, Rice made the kind of statement that has now become standard for high American officials under such circumstances: ‘Aren't you glad this lady lives in a democracy where she can express her opinion?’ She also threw in another line that's become de rigueur since the US overthrew Saddam Hussein, an argument that's used when all other arguments fail: ‘The children of Iraq are actually not living under Saddam Hussein, thank God.’ My response to such a line is this: If you went into surgery to correct a knee problem and the surgeon mistakenly amputated your entire leg, what would you think if someone then remarked to you how nice it was that ‘you actually no longer have a knee problem, thank God.’… The people of Iraq no longer have a Saddam problem. (Blum, 2011) Language is an invention that makes it possible for a person to deny what he is doing even as he does it. (Blum, 2012)

Assessment of In Vitro Patellar Laxity in the Native Knee

Patellar instability is a frequent knee problem and relates to anterior knee pain [1–3]. Patellofemoral (PF) joint laxity is a multifactor problem that depends on the active stabilization from the quadriceps muscles, the passive stabilization from the ligaments and retinacular tissue in the PF joint, and the static stabilization from the articular geometries of the distal femur and patella. The purpose of this study was to use a novel patellar laxity instrument to measure patellar laxity and to assess subject-to-subject variation in patellar laxity.

Superior Dislocation of the Patella Treated by Closed Reduction: A Rare Case Report and Review of the Literature

Superior dislocation of the patella is a rare condition. We report a 70-year-old gentleman with his patella lower pole osteophyte interlocked with the anterior femoral condyles after hyperextension. The patella was reduced successfully with proper reduction technique under sedation. The active range of movement ranged from full extension to 120-degree flexion a few minutes after reduction. He walked unaided afterwards. There was no knee problem in two years of follow-up. On reviewing the literature, only 20 cases were reported till year 2007 worldwide and 19 cases could be treated by closed reduction with or without sedation.

ENERGY SPECTRA AND MASS COMPOSITION OF COSMIC RAYS IN THE FRACTAL-LIKE GALACTIC MEDIUM

We consider the problem of the cosmic ray spectrum formation assuming that cosmic rays are produced by galactic sources. The fractional diffusion equation proposed in our recent papers is used to describe the cosmic rays propagation in interstellar medium. We show that in the framework of this approach it is possible to explain the locally observed basic features of the cosmic rays in the energy region 1010 ÷ 1020 eV : difference between spectral exponents of protons and other nuclei, mass composition variation, "knee" problem, flattening of the primary spectrum for E ≥ 1018 ÷ 1019 eV .

DOES THE "KNEE" IN PRIMARY COSMIC RAY SPECTRUM EXIST?

The problem of the knee in primary cosmic ray at energy about 3–5 PeV is the most exciting problem in cosmic ray physics. Since 1958, physicists have been trying to solve this problem. In our opinion, the problem could be solved from the experimental point of view, whereas the primary spectrum would follow a pure power law. A key to the "knee" problem lies in the hadronic structure of EAS and its propagation in the Earth's atmosphere. Neither exotic processes nor new physics are used. An explanation of the approach and some results of Monte Carlo simulations are given below.