Proposal for the 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer in the era of intensity-modulated radiotherapy

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Delay in surgery increases rotational instability in patients suffering from anterior cruciate ligament deficiency

Concurrent Free Papers 5 - Sports: no. 5.3Conference Theme: Defying the Aging Spine: Our Mission ContinuesINTRODUCTION: Rotational stability of knee is contributed by both central (anterior cruciate ligament [ACL]) and peripheral structure. In chronic ACL deficiency, peripheral structures can be stretched out. It is hypothesised that delay in surgery can lead to increased rotational instability. The hypothesis was tested in an ACL reconstruction (ACLR) registry. METHODS: The results of 301 primary ACLR (209 single-bundle and 92 double-bundle) performed between 2007 and 2012 were analysed. The prospective data collected in this registry included …postprin

Associations between isolated bundle tear of anterior cruciate ligament, time from injury to surgery, and clinical tests

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‘From the soil we have come, to the soil we shall go and from the soil we want to live’: language, politics and identity in the Grande Révolte of 1907

During the summer of 1907, France experienced one of its largest social disturbances since the Revolution, as the winegrowers of the Languedoc-Roussillon led a mass protest movement that paralysed the region and challenged the state. Although the Grande Révolte evoked references to the Albigensian Crusade, and juxtaposed North and South, it never fully represented a moment of Occitan regionalist rising. The failure of the cultural organisation the Félibrige to fully engage with protesters led to a fissure between political and cultural expressions of Occitan identity that marked the movement thereafter. By combining linguistic anthropology and historical analysis, the authors are able to foreground a key aspect of national identity formation as it occurred in 1907. Considering the impact of the Grande Révolte on the identity and language of the Midi offers us an insight into the development of regionalism both within and beyond the borders of the French nation

How accurate is physical examination in diagnosing subacromial impingement?

Concurrent Free Papers 5 - Sports: no. 5.14Conference Theme: Defying the Aging Spine: Our Mission ContinuesINTRODUCTION: Primary subacromial impingement occurs when coracoacromial complex impinges the rotator cuff during movement of shoulder. The study aimed to investigate the accuracy of 5 described impingement signs in predicting a type III acromion found during shoulder arthroscopy. METHODS: A total of 103 shoulder arthroscopies performed by the senior author between July 2008 and June 2013 were recruited. Significant subacromial impingement was defined as a type III ...postprin

Why do battered women abuse their children? Explore and discussion

Congress Theme: New Directions in Child Protection and WellbeingOBJECTIVES: A strong association between the occurrences of imitate partner violence and child abuse is confirmed in studies. This study therefore aims to explore the associated factors of battered women being violent towards their children and its implication on the service development for the family at risk. The different characteristics among abused women without and with children at different ages will be examined. This study can enrich knowledge on child protection, especially in families with multiple types ...postprin

Anterior cruciate ligament tear in Hong Kong Chinese patients

Objective: To investigate the associations between patient sex, age, cause of injury, and frequency of meniscus and articular cartilage lesions seen at the time of the anterior cruciate ligament reconstruction. Design: Case series. Setting: University affiliated hospital, Hong Kong. Patients: Medical notes and operating records of 672 Chinese patients who had received anterior cruciate ligament reconstruction between January 1997 and December 2010 were reviewed. Data concerning all knee cartilage and meniscus injuries documented at the time of surgery were analysed. Results: Of the 593 patients, meniscus injuries were identified in 315 (53.1%). Patients older than 30 years were more likely to suffer from meniscal injury compared with those younger than 30 years (60% vs 51%, P=0.043). Longer surgical delay was observed in patients with meniscal lesions compared with those without (median, 12.3 months vs 9.1 months, P=0.021). Overall, 139 cartilage lesions were identified in 109 (18.4%) patients. Patients with cartilage lesions were significantly older than Introduction Anterior cruciate ligament (ACL) tear is one of the commonest sport injuries seen in clinical practice, and such injury is often associated with meniscal and chondral lesions. It is widely believed that early surgery can prevent such lesions in ACL-deficient patients, and probably help avoid the most dreadful complication of early osteoarthritis of the knee.1 Despite multiple studies conducted to evaluate the relationship between intra-articular injuries and ACL tear, such associations among Asians, especially Chinese, have not been extensively studied. Data show that females are more susceptible to ACL injury than their male counterparts,2-4 but lower risk of other intra-articular injuries in females was observed in some studies.5 Furthermore, a those without the lesions (mean, 27.6 years vs 25.1 years, P=0.034). Male patients were more likely to have chondral injuries than female patients (20.1% vs 10.9%, P=0.028). The risk of cartilage lesions was increased by nearly 3 times in the presence of meniscal tear (P<0.0001; odds ratio=2.7; 95% confidence interval, 1.7-4.2). Conclusions: Increased age and surgical delay increased the risk of meniscal tears in patients with anterior cruciate ligament tear. Increased age, male sex, and presence of meniscal tear were associated with an increased frequency of articular lesions after an anterior cruciate ligament tear.published_or_final_versio

Unraveling the In-law conflict and its association with intimate partner violence in Chinese culture: narrative accounts of Chinese battered women

This paper analyzes in-law conflict and disagreements experienced by Chinese battered women, and investigates their association with intimate partner violence (IPV). Conflict between a daughter- and mother-in-law seems to be a common phenomenon in Chinese families. Twenty-two Chinese women aged from 25 to 69 (M=41) who had experienced in-law conflict were interviewed in a refuge for battered women in Hong Kong. While most of the women experienced conflict with their mother-in-law, some interviewees were also abused by their sisters-in-law. Additionally, one case involved a daughter and father-in-law conflict and another case encompassed a son-and mother-in-law conflict. From their experiences, some important aspects of conflict and disagreement between parents- and children-in-law were identified, including disputes over financial matters, conflicting lifestyles, battles over children, differences in gender role expectations and being a scapegoat of the husband. Using the analysis of narrative accounts of Chinese battered women, the effects of perceived Chinese culture and family dynamics on in-law conflict are studied. Implications of the study for prevention of, and intervention in, domestic violence, as well as future studies of IPV, are addressed.postprin

Global Pattern of Nasopharyngeal Cancer: Correlation of Outcome With Access to Radiation Therapy

Purpose: This study aimed to estimate the treatment outcome of nasopharyngeal cancer (NPC) across the world and its correlation with access to radiation therapy (RT). Methods and Materials: The age-standardized mortality (ASM) and age-standardized incidence (ASI) rates of NPC from GLOBOCAN (2012) were summarized, and [1−(ASM/ASI)] was computed to give the proxy relative survival (RS). Data from the International Atomic Energy Agency (IAEA) and the World Bank were used to assess the availability of RT in surrogate terms: the number of RT equipment units and radiation oncologists per million population. Results: A total of 112 countries with complete valid data were analyzed, and the proxy RS varied widely from 0% to 83% (median, 50%). Countries were categorized into Good, Median, and Poor outcome groups on the basis of their proxy RS (55%). Eighty percent of new cases occurred in the Poor outcome group. Univariable linear regression showed a significant correlation between outcome and the availability of RT: proxy RS increased at 3.4% (P<.001) and 1.5% (P=.001) per unit increase in RT equipment and oncologist per million population, respectively. The median number of RT equipment units per million population increased significantly from 0.5 in the Poor, to 1.5 in the Median, to 4.6 in the Good outcome groups, and the corresponding number of oncologists increased from 1.1 to 3.3 to 7.1 (P<.001). Conclusions: Nasopharyngeal cancer is a highly treatable disease, but the outcome varies widely across the world. The current study shows a significant correlation between survival and access to RT based on available surrogate indicators. However, the possible reasons for poor outcome are likely to be multifactorial and complex. Concerted international efforts are needed not only to address the fundamental requirement for adequate RT access but also to obtain more comprehensive and accurate data for research to improve cancer outcome.postprin

Challenges in collecting clinical samples for research from pregnant women of South Asian origin: evidence from a UK study.

Objective: To recruit South Asian pregnant women, living in the UK, into a clinicoepidemiological study for the collection of lifestyle survey data and antenatal blood and to retain the women for the later collection of cord blood and meconium samples from their babies for biochemical analysis. Design: A longitudinal study recruiting pregnant women of South Asian and Caucasian origin living in the UK. Setting: Recruitment of the participants, collection of clinical samples and survey data took place at the 2 sites within a single UK Northern Hospital Trust. Participants: Pregnant women of South Asian origin (study group, n=98) and of Caucasian origin (comparison group, n=38) living in Leeds, UK. Results: Among the participants approached, 81% agreed to take part in the study while a ‘direct approach’ method was followed. The retention rate of the participants was a remarkable 93.4%. The main challenges in recruiting the ethnic minority participants were their cultural and religious conservativeness, language barrier, lack of interest and feeling of extra ‘stress’ in taking part in research. The chief investigator developed an innovative participant retention method, associated with the women’s cultural and religious practices. The method proved useful in retaining the participants for about 5 months and in enabling successful collection of clinical samples from the same mother–baby pairs. The collection of clinical samples and lifestyle data exceeded the calculated sample size required to give the study sufficient power. The numbers of samples obtained were: maternal blood (n=171), cord blood (n=38), meconium (n=176), lifestyle questionnaire data (n=136) and postnatal records (n=136). Conclusions: Recruitment and retention of participants, according to the calculated sample size, ensured sufficient power and success for a clinicoepidemiological study. Results suggest that development of trust and confidence between the participant and the researcher is the key to the success of a clinical and epidemiological study involving ethnic minorities