T2 mapping in the knee after microfracture at 3.0 T: correlation of global T2 values and clinical outcome - preliminary results

OBJECTIVE: The aim of our study was to correlate global T2 values of microfracture repair tissue (RT) with clinical outcome in the knee joint. METHODS: We assessed 24 patients treated with microfracture in the knee joint. Magnetic resonance (MR) examinations were performed on a 3T MR unit, T2 relaxation times were obtained with a multi-echo spin-echo technique. T2 maps were obtained using a pixel wise, mono-exponential non-negative least squares fit analysis. Slices covering the cartilage RT were selected and region of interest analysis was done. An individual T2 index was calculated with global mean T2 of the RT and global mean T2 of normal, hyaline cartilage. The Lysholm score and the International Knee Documentation Committee (IKDC) knee evaluation forms were used for the assessment of clinical outcome. Bivariate correlation analysis and a paired, two tailed t test were used for statistics. RESULTS: Global T2 values of the RT [mean 49.8ms, standards deviation (SD) 7.5] differed significantly (P<0.001) from global T2 values of normal, hyaline cartilage (mean 58.5ms, SD 7.0). The T2 index ranged from 61.3 to 101.5. We found the T2 index to correlate with outcome of the Lysholm score (r(s)=0.641, P<0.001) and the IKDC subjective knee evaluation form (r(s)=0.549, P=0.005), whereas there was no correlation with the IKDC knee form (r(s)=-0.284, P=0.179). CONCLUSION: These findings indicate that T2 mapping is sensitive to assess RT function and provides additional information to morphologic MRI in the monitoring of microfracture.

Nongovernmental organization staff views of global water privatization

More than 1 billion people lack access to clean water and proper sanitation. As part of efforts to solve this problem, there is a growing shift from public to private water management led by The World Bank and the International Monetary Fund (IMF). This shift has inspired much related research. Researchers have assessed water privatization related perceptions of consumers, government officials, and multinational company agents. This thesis presents results of a study of nongovernmental (NGO) staff perceptions of water privatization. Although NGOs are important actors in sustainable water related development through water provision, we have little understanding of their perceptions of water privatization and how it impacts their activities. My goal was to fill this gap. I sampled international and national development NGOs with water, sanitation, and hygiene (WASH) foci. I conducted 28 interviews between January and June of 2011 with staff in key positions including water policy analysts, program officers, and project coordinators. Their perceptions of water privatization were mixed. I also found that local water privatization in most cases does not influence NGO decisions to conduct projects in a region. I found that development NGO staff base their beliefs about water privatization on a mix of personal experience and media coverage. My findings have important implications for the WASH sector as we work to solve the worsening global water access crisis.