967 resultados para Copyright.


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Growth rods are commonly used for the treatment of scoliosis in the immature spine. Many variations have been proposed but breakage of implants is a common problem. Growth rod insertion commonly involves large exposures at initial insertion followed by multiple smaller procedures for lengthening. We present our early experiences using a percutaneous technique of insertion of a new titanium mobile bearing implant (Medtronic Inc). The implant allows some rotatory motion in the middle of the construct thus reducing construct stresses and thus possibly reducing rod breakage risk. Based on this small initial series with 12 months follow-up, percutaneous insertion of growth rods using the new implant is a safe and reliable technique although the infection rate in our sample was of note. This may be related to the titanium wear and inflammation seen in the soft tissues at time of operation and visualised on histology. No implants have required removal due to infection, and all infections were treated with debridement at next lengthening and suppressive antibiotics. Propionibacterium is one of the commonest infections seen with spinal implants and sometimes does not respond to simple antibiotic suppression. The technique allows preservation of the soft tissues until definitive fusion is needed and may lead to a decrease in hospital stay. The implant is low profile and seems to offer advantages over other systems on the market. Further follow up is needed to look at longer term outcomes with this new implant type.

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In studies of media industries, too much attention has been paid to providers and firms, too little to consumers and markets. But with user-created content, the question first posed more than a generation ago by the uses & gratifications method and taken up by semiotics and the active audience tradition (‘what do audiences do with media?’), has resurfaced with renewed force. What’s new is that where this question (of what the media industries and audiences did with each other) used to be individualist and functionalist, now, with the advent of social networks using Web 2.0 affordances, it can be re-posed at the level of systems and populations as well.

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The anatomy and microstructure of the spine and in particular the intervertebral disc are intimately linked to how they operate in vivo and how they distribute loads to the adjacent musculature and bony anatomy. The degeneration of the intervertebral discs may be characterised by a loss of hydration, loss of disc height, a granular texture and the presence of annular lesions. As such, degeneration of the intervertebral discs compromises the mechanical integrity of their components and results in adaption and modification in the mechanical means by which loads are distributed between adjacent spinal motion segments.

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I invented YouTube. Well, not YouTube exactly, but something close – something called YIRN; and not by myself exactly, but with a team. In 2003-5 I led a research project designed to link geographically dispersed young people, to allow them to post their own photos, videos and music, and to comment on the same from various points of view – peer to peer, author to public, or impresario to audience. We wanted to find a way to take the individual creative productivity that is associated with the Internet and combine it with the easy accessibility and openness to other people’s imagination that is associated with broadcasting; especially, in the context of young people, listening to the radio. So we called it the Youth Internet Radio Network, or YIRN.

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The primary aims of scoliosis surgery are to halt the progression of the deformity, and to reduce its severity (cosmesis). Currently, deformity correction is measured in terms of posterior parameters (Cobb angles and rib hump), even though the cosmetic concern for most patients is anterior chest wall deformity. In this study, we propose a new measure for assessing anterior chest wall deformity and examine the correlation between rib hump and the new measure. 22 sets of CT scans were retrieved from the QUT/Mater Paediatric Spinal Research Database. The Image J software (NIH) was used to manipulate formatted CT scans into 3-dimensional anterior chest wall reconstructions. A ‘chest wall angle’ was then measured in relation to the first sacral vertebral body. The chest wall angle was found to be a reliable tool in the analysis of chest wall deformity. No correlation was found between the new measure and rib hump angle. Since rib hump has been shown to correlate with vertebral rotation on CT, this suggests that there maybe no correlation between anterior and posterior deformity measures. While most surgical procedures will adequately address the coronal imbalance & posterior rib hump elements of scoliosis, they do not reliably alter the anterior chest wall shape. This implies that anterior chest wall deformity is to a large degree an intrinsic deformity, not directly related to vertebral rotation.

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The central cultural experience of modernity has been change, both the ‘creative destruction’ of existing structures, and the growth, often exponential, of new knowledge. During the twentieth century, the central cultural platform for the collective experience of modernising societies changed too, from page and stage to the screen – from publishing, the press and radio to cinema, television and latterly computer screens. Despite the successive dominance of new media, none has lasted long at the top. The pattern for each was to give way to a successor platform in popularity, but to continue as part of an increasingly crowded media menu. Modern media are supplemented not supplanted by their successors.

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Fusionless scoliosis surgery is an emerging treatment for idiopathic scoliosis as it offers theoretical advantages over current forms of treatment. Anterior vertebral stapling using a nitinol staple is one such treatment. Despite increasing interest in this technique, little is known about the effects on the spine following insertion, or the mechanism of action of the staple. The aims of this study were threefold; (1) to measure changes in the bending stiffness of a single motion segment following staple insertion, (2) to describe the forces that occur within the staple during spinal movement, and (3) to describe the anatomical changes that occur following staple insertion. Results suggest that staple insertion consistently decreased stiffness in all directions of motion. An explanation for the finding may be found in the outcomes of the strain gauge testing and micro-CT scan. The strain gauge testing showed that once inserted, the staple tips applied a baseline compressive force to the surrounding trabecular bone and vertebral end-plate. This finding would be consistent with the current belief that the clinical effect of the staples is via unilateral compression of the physis. Interestingly however, as each specimen progressed through the five cycles of each test, the baseline load on the staple tips gradually decreased, implying that the force at the staple tip-bone interface was decreasing. We believe that this was likely occurring as a result of structural damage to the trabecular bone and vertebral end-plate by the staple effectively causing ‘loosening’ of the staple. This hypothesis is further supported by the findings of the micro-CT scan. The pictures depict significant trabecular bone and physeal injury around the staple blades. These results suggest that the current hypothesis that stapling modulates growth through physeal compression may be incorrect, but rather the effect occurs through mechanical disruption of the vertebral growth plate.

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There are two aspects to the problem of digital scholarship and pedagogy. One is to do with scholarship; the other with pedagogy. In scholarship, the association of knowledge with its printed form remains dominant. In pedagogy, the desire to abandon print for ‘new’ media is urgent, at least in some parts of the academy. Film and media studies are thus at the intersection of opposing forces – pulling the field ‘back’ to print and ‘forward’ to digital media. These tensions may be especially painful in a field whose own object of study is another form of communication, neither print nor digital but broadcast. Although print has been overtaken in the popular marketplace by audio-visual forms, this was never achieved in the domain of scholarship. Even when it is digitally distributed, the output of research is still a ‘paper.’ But meanwhile, in the realm of teaching, production- and practice-based pedagogy has become firmly established. Nevertheless a disjunction remains, between high-end scholarship in research universities and vocational training in teaching institutions; but neither is well equipped to deal with the digital challenge.

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The measurement of Cobb angles from radiographs is routine practice in spinal clinics. The technique relies on the use and availability of specialist equipment such as a goniometer, cobbometer or protractor. The aim of this study was to validate the use of i-Phone (Apple Inc) combined with Tilt Meter Pro software as compared to a protractor in the measurement of Cobb angles. Between November 2008 and December 2008 20 patients were selected at random from the Paediatric Spine Research Groups Database. A power calculation was performed which indicated if n=240 measurements the study had a 96% chance of detecting a 5 degree difference between groups. All patients had idiopathic scoliosis with a range of curve types and severities. The study found the i-Phone combined with Tilt Meter Pro software offers a faster alternative to the traditional method of Cobb angle measurement. The use of i-Phone offers a more convenient way of measuring Cobb angles in the outpatient setting. The intra-observer repeatability of the iPhone is equivalent to the protractor in the measurement of Cobb angles.

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Adolescent Idiopathic Scoliosis (AIS) is the most common deformity of the spine, affecting 2-4% of the population. Previous studies have shown that the vertebrae in scoliotic spines undergo abnormal shape changes, however there has been little exploration of how AIS affects bone density distribution within the vertebrae. Existing pre-operative CT scans of 53 female idiopathic scoliosis patients with right-sided main thoracic curves were used to measure the lateral (right to left) bone density profile at mid-height through each vertebral body. This study demonstrated that AIS patients have a marked convex/concave asymmetry in bone density for vertebral levels at or near the apex of the scoliotic curve. To the best of our knowledge, the only previous studies of bone density distribution in AIS are those of Périé et al [1,2], who reported a coronal plane ‘mechanical migration’ of 0.54mm toward the concavity of the scoliotic curve in the lumbar apical vertebrae of 11 scoliosis patients. This is comparable to the value of 0.8mm (4%) in our study, especially since our patients had more severe scoliotic curves. From a bone adaptation perspective, these results suggest that the axial loading on the scoliotic spine is strongly asymmetric.

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This paper introduces the special issue “China: Internationalizing the Creative Industries”, describing the Australian Research Council funded “MATE” project which provides the conceptual background for the questions the issue explores. The MATE project began with the expectation that as China evolves from its status as a developing country with an emphasis on primary industries and manufacturing, to a mature, market-driven economy benefiting from high levels of international investment, it will become more actively engaged with the global “knowledge economy” and “information society”. In this context, developments in the “creative industries”, which are playing such an important role in developed economies, might reasonably be expected in China. Although China continues to be characterised by strong central-policy settings, as the domestic consumer market matures there is greater scope for consumer-led creative business development. The “MATE” project aimed to capture some of these changes as they began to gain momentum across a range of services: Media, Advertising, Tourism and Education. This special issue continues this theme with papers that explore the theoretical challenges, economic questions and implications, and practical instantiations of creative industries growth in China. All papers contained in this special issue have been peer-reviewed.

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There is increasing interest in the role the environment plays in shaping the dietary behavior of youth, particularly in the context of obesity prevention. An overview of environmental factors associated with obesity-related dietary behaviors among youth is needed to inform the development of interventions. A systematic review of observational studies on environmental correlates of energy, fat, fruit/ vegetable, snack/fast food and soft drink intakes in children (4–12 years) and adolescents (13–18 years) was conducted. The results were summarized using the analysis grid for environments linked to obesity. The 58 papers reviewed mostly focused on sociocultural and economical–environmental factors at the household level. The most consistent associations were found between parental intake and children’s fat, fruit/vegetable intakes, parent and sibling intake with adolescent’s energy and fat intakes and parental education with adolescent’s fruit/ vegetable intake. A less consistent but positive association was found for availability and accessibility on children’s fruit/vegetable intake. Environmental factors are predominantly studied at the household level and focus on sociocultural and economic aspects. Most consistent associations were found for parental influences (parental intake and education).More studies examining environmental factors using longitudinal study designs and validated measures are needed for solid evidence to inform interventions.

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Landscape beauty has long been a concern of geographers and other scholars, but relatively little work has been done on the aesthetic analysis of specific landscape features such as mountain peaks and waterfalls. In Australia, as in many other parts of the world, waterfalls are popular scenic attractions, and this paper attempts to explain the widespread appeal of these landforms by examining them in the light of theories of landscape aesthetics, from the Picturesque and Sublime to arousal and prospect-refuge. While no single theory offers a complete explanation of our experience of waterfalls, this paper suggests that by using several theoretical approaches to the subject we are more likely to gain a full understanding of the way we respond to these landscape features.

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While very few waterfalls may be regarded as tourism destinations, many are attractions. This paper discusses waterfalls within the theoretical frameworks developed by economists and geographers in the field of recreation and tourism. Examples are drawn from various parts of the world, including the United States, Canada, and the United Kingdom, with Jamaica examined as a case study. Here, as in many tourism areas, although visitors usually choose their destinations for reasons other than the appeal of waterfalls, these landscape features play important roles as attractions. Often associated with ecotourism, waterfalls help to diversify the tourism product and spread the benefits as well as some of the associated problems of tourism to less developed areas.

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There is increased recognition that determinants of health should be investigated in a life-course perspective. Retirement is a major transition in the life course and offers opportunities for changes in physical activity that may improve health in the aging population. The authors examined the effect of retirement on changes in physical activity in the GLOBE Study, a prospective cohort study known by the Dutch acronym for "Health and Living Conditions of the Population of Eindhoven and surroundings," 1991–2004. They followed respondents (n = 971) by postal questionnaire who were employed and aged 40–65 years in 1991 for 13 years, after which they were still employed (n = 287) or had retired (n = 684). Physical activity included 1) work-related transportation, 2) sports participation, and 3) nonsports leisure-time physical activity. Multinomial logistic regression analyses indicated that retirement was associated with a significantly higher odds for a decline in physical activity from work-related transportation (odds ratio (OR) = 3.03, 95% confidence interval (CI): 1.97, 4.65), adjusted for sex, age, marital status, chronic diseases, and education, compared with remaining employed. Retirement was not associated with an increase in sports participation (OR = 1.12, 95% CI: 0.71, 1.75) or nonsports leisure-time physical activity (OR = 0.80, 95% CI: 0.54, 1.19). In conclusion, retirement introduces a reduction in physical activity from work-related transportation that is not compensated for by an increase in sports participation or an increase in nonsports leisure-time physical activity.