Academic literature on the topic 'Sports=2015-04-12'

Background As sports specialization continues to grow amongst youth, the prevalence of shoulder instability continues to increase. Bankart repair exists as a primary method to combat these issues, yet a third or more of patients experience recurrent instability following surgery. Currently most studies examining Bankart repair look at surgical technique (open vs arthroscopic) and the original treatment employed; however, there has been a lack of research examining whether demographic, injury history, and perioperative risk factors exist as well. The purpose of this prognostic study was to examine Bankart repair in the pediatric population and identify a wider range of risk factors associated with poor functional outcomes. Methods We conducted a retrospective review of all patients who received Bankart repair between 01/01/2010 and 12/31/2015 at the Children’s Hospital of Philadelphia. A range of demographic, injury history, clinical exam, operative, and perioperative variables were abstracted to identify risk factors associated with limited functional outcome as defined by inability to return to baseline sport or activity. Chi square analyses were used to find significant associations between dichotomous variables, and point-biserial analyses were used to find strength of correlations for continuous variables. Results 118 patients were included with an average age of 15.92 ±2.11 at the time of surgery. The mean OR time was 206.98 ±55.88 minutes. Point-biserial correlations for total OR time, BMI, and age with inability to return to baseline sport or activity were 0.32, .09, and .04 respectively. Chi square analyses found no significant associations for prior non-operative treatment, sulcus sign, and insurance type. For individuals who presented with prior instability, 92/119 (77.3%) with and 27/119 (22.7%) without, this was significantly associated with inability to return to baseline sport or activity (p = 0.04). For presence of a Hill Sachs Lesion 70/145 (48.2%) had a lesion, 75/145 (51.8%) did not, and this was significantly associated as well (p = 0.02). For injury type, 71/98 (72.4%) were contact, 27/98 (27.6%) were noncontact, and this was significantly associated as well (p = 0.01). Conclusion Many clinicians have informally found in practice that certain patient characteristics seem to be associated with poor outcomes after Bankart repair. Here we find that a history of prior instability, Hill Sachs lesion presence, and a contact injury mechanism are significantly associated with inability to return to baseline sport or activity post-operatively. The risk factors identified here can be categorized into injury history risk factors and perioperative risk factors. Clinicians can use these identified risk factors to better inform patients receiving Bankart repair of their likelihood of returning to baseline sport or activity.

Context:There is minimal patient-oriented evidence regarding the effectiveness of interventions targeted to reduce symptoms associated with chronic ankle instability (CAI). In addition, clinicians aiming to prioritize care by implementing only the most effective components of a rehabilitative program have very little evidence on comparative efficacy.Objective:To assess the comparative efficacy of 2 common ankle rehabilitation techniques (wobble-board [WB] balance training and ankle strengthening using resistance tubing [RT]) using patient-oriented outcomes.Design:Randomized controlled trial.Setting:Laboratory.Patients:40 patients with CAI randomized into 2 treatment groups: RT and WB. CAI inclusion criteria included a history of an ankle sprain, recurrent “giving way,” and a Cumberland Ankle Instability Tool (CAIT) score ≤25.Interventions:Participants completed 5 clinician-oriented tests (foot-lift test, time-in-balance, Star Excursion Balance Test, figure-of-8 hop, and side-hop) and 5 patient-oriented questionnaires (CAIT, Foot and Ankle Ability Measure [FAAM], Activities of Daily Living [ADL] and FAAM Sport scale, Short-Form 36 [SF-36], and Global Rating of Function [GRF]). After baseline testing, participants completed 12 sessions over 4 wk of graduated WB or RT exercise, then repeated baseline tests.Main Outcome Measures:For each patient- and clinician-oriented test, separate 2 × 2 RMANOVAs analyzed differences between groups over time (alpha set at P = .05).Results:There was a significant interaction between group and time for the FAAM-ADL (P = .04). Specifically, the WB group improved postintervention (P < .001) whereas the RT group remained the same (P = .29). There were no other significant interactions or significant differences between groups (all P > .05). There were significant improvements postintervention for the CAIT, FAAM-Sport, GRF, SF-36, and all 5 clinician-oriented tests (all P < .001).Conclusions:A single-exercise 4-wk intervention can improve patient- and clinician-oriented outcomes in individuals with CAI. Limited evidence indicates that WB training was more effective than RT.Level of Evidence:Therapy, level 1b.

Purpose: To determine whether heart-rate variability (HRV) was correlated with other training-load and training-tolerance markers for monitoring the effect of a training session on elite synchronized swimmers. Methods: The authors recorded the resting HRV of 12 elite swimmers (mean age = 21.5 [3.5] y) 3 times over 1 wk with a cadence of 48 h prior to the 2015 World Swimming Championships. They continuously monitored heart rate and obtained salivary cortisol (SC) samples before and after the last training session of the week. The authors measured capillary blood lactate (La) 2, 4, and 8 min after the last training session and monitored recovery HRV. They assessed rating of perceived exertion (RPE) over the entire session and tested the association between the highest La concentration (Lapeak), SC, and RPE and relative changes (Δ%) in the natural logarithm of the root-mean-square successive difference of intervals (LnRMSSD). The authors also calculated the smallest worthwhile change of the averaged pre and post LnRMSSD measurements. Results: There were periods of pronounced bradycardia (60.5 [16.7] beats/min) during training exercises corresponding to apneic exercise. The magnitude-based inferences showed nonclinically meaningful changes of LnRMSSD. Lapeak (6.8 [2.7] mmol/L) correlated positively with Δ%LnRMSSD and Δ%SC (r = .89, P = .001 and r = .61, P = .04, respectively). Conclusions: There was no change in LnRMSSD and Lapeak, Δ%SC, and RPE indicated reduced sympathetic activation and positive adaptation to the stress imposed by the session. Isolated HRV assessment may reveal a controversial interpretation of autonomic nervous system status or the training tolerance in elite synchronized swimming athletes due to the influence of the diving response.

Background: Distal radius fracture (DRF) is a common fracture of the upper extremity. The role of concurrent injuries in patients treated for DRFs is poorly elucidated. The authors sought to determine whether remote injuries were associated with worse outcomes after management of DRFs. Methods: A retrospective cohort study including all consecutively seen patients by a university hospital hand service between 2010 and 2015. Preoperative radiographs were analyzed, and patients were managed by surgeon preference and evaluated postoperatively using pain scores. Remote injury was defined as any other injury sustained at the time of fracture not localized to affected extremity. Univariate analysis was performed to identify factors associated with risk of complication. A multivariate logistic regression analysis was performed, controlling for confounding factors. Results: A total of 181 DRFs in 176 patients were treated over the 5-year period of the study. Forty-eight (26.5%) of the fractures were managed nonoperatively with casting, 12 (6.6%) with closed reduction and pinning, and 119 (65.7%) with open reduction and plating. The mean follow-up was 5.2 months. The complication rate was 18.2%. The most common complication was persistent pain in 5 patients, followed by median neuropathy, loss of reduction, arthritis, and distal radioulnar joint instability. After controlling for age, body mass index, hand surgeon, and other confounders, remote injury was associated with a significantly increased risk of complications ( P = .04, odds ratio: 6.03, 95% confidence interval: 1.05-34.70). Conclusions: Patients with remote injuries have a 6-fold increased risk of complications after DRF treatment. The additional risk in these patients should be considered during patient/family counseling and clinical decision-making in DRF management.

Objectives To evaluate baseline characteristics, describe pulmonary outcomes, and identify weaning predictors for people with acute traumatic spinal cord injury (SCI) who are dependent on mechanical ventilation at admission to acute inpatient rehabilitation (AIR). Methods The retrospective study was conducted at an AIR facility in the United States. It included 91 adults with acute traumatic SCI from 2015 to 2019 who were dependent on mechanical ventilation. Results People who successfully weaned (85%) had fewer days from time of SCI to AIR admission (22 vs. 30, p = .04), higher vital capacity at admission to AIR (12 vs. 3 mL/kg predicted body weight [PBW]; p < .001), and lower (caudal) neurological injury level (p < .001) compared to those who failed weaning. The risk of pneumonia was higher in people who failed weaning compared to those who were weaned successfully (risk ratio, 5.5; 95% confidence interval [95% CI], 2.3–13). Receiver operating characteristics (ROC) curves suggest a vital capacity cutoff of 5.8 mL/kg PBW could predict weaning. The vital capacity of ≥ 5.8 mL/kg PBW is associated with 109 times higher odds (95% CI, 11–1041; p < .001) of weaning than vital capacity below that threshold. Conclusion In this retrospective study, there was an increased risk of pneumonia in people with SCI who failed weaning at discharge from AIR. Vital capacity was a better predictor of weaning from mechanical ventilation compared to the neurological level of injury, with a cutoff of 5.8 mL/kg PBW predictive of weaning success. Further research is needed on this critical topic.

Background: There is a paucity of information in the literature on midterm outcomes from the arthroscopic treatment of femoroacetabular impingement syndrome (FAIS) with concomitant labral treatment in patients with mild osteoarthritis (OA) using modern surgical techniques. Purpose: To compare outcomes of hip arthroscopy for the treatment of FAIS between patients with mild OA (Tönnis grade 1) and patients without OA (Tönnis grade 0) at minimum 5-year follow-up. Study Design: Cohort study; Level of evidence, 3. Methods: Patients were identified who underwent primary hip arthroscopy for FAIS with routine capsular closure between January 2012 and December 2015. Patients with Tönnis grade 1 were matched 1:3 by age, sex, and body mass index to patients without OA. The Hip Outcome Score–Activities of Daily Living (HOS-ADL), HOS–Sports Subscale (HOS-SS), modified Harris Hip Score, and 12-item International Hip Outcome Tool were collected preoperatively and at 5 years postoperatively and compared between groups using an independent t test. Survivorship rate and percentage achievement of a Patient Acceptable Symptom State (PASS) or minimal clinically important difference (MCID) were compared using a Fisher exact test. Results: A total of 50 patients (54 hips) with Tönnis grade 1 were matched to 162 patients (162 hips) with Tönnis grade 0. The mean ± SD age and body mass index of the Tönnis grade 1 group were 44.5 ± 9.6 years and 28.5 ± 5.5, respectively. Patient-reported outcome (PRO) scores improved significantly for both groups from presurgery to 5 years postoperatively for all PROs ( P≤ .03). There were no significant differences in preoperative PROs between the groups. Patients with Tönnis grade 1 had significantly lower postoperative scores on the HOS-ADL (74.7 ± 22.6 vs 83.0 ± 20.1; P = .04) and HOS-SS (58.8 ± 33.7 vs 71.8 ± 29.3; P = .03) than patients with grade 0. Patients with Tönnis grade 1 also had significantly lower rates of achievement of the MCID (57.1% vs 80.2%; P < .01) and PASS (34.1% vs 53.4%; P = .03) for any PRO when compared with patients with Tönnis grade 0. Gross survivorship was significantly lower for Tönnis grade 1 versus grade 0 (77.8% vs 96.9%; P < .001). Conclusion: Patients with Tönnis grade 1 arthritis experienced significant improvement in PROs after hip arthroscopy for the treatment of FAIS. However, they had significantly lower postoperative HOS-ADL and HOS-SS scores with significantly lower rates of achievement on the MCID and PASS, with a significantly lower gross survivorship rate at a minimum 5 years postoperatively in comparison with those with Tönnis grade 0 changes.

Drawing upon popular magazines, newspapers, blogs, Web sites, and videos, this essay compares the media framing of six, “fat” political figures from around the world. Framing refers to the suggested interpretations that are imbedded in media reports (Entman; McCombs and Ghanem; Seo, Dillard and Shen). As Robert Entman explains, framing is the process of culling a few elements of perceived reality and assembling a narrative that highlights connections among them to promote a particular interpretation. Frames introduce or raise the salience of certain ideas. Fully developed frames typically perform several functions, such as problem definition and moral judgment. Framing is connected to the [covert] wielding of power as, for example, when a particular frame is intentionally applied to obscure other frames. This comparative international study is an inquiry into “what people and societies make of the reality of [human weight]” (Marilyn Wann as quoted in Rothblum 3), especially in the political arena. The cultural and historical dimensions of human weight are illustrated by the practice of force-feeding girls and young women in Mauritania, because “fat” women have higher status and are more sought after as brides (Frenkiel). The current study, however, focuses on “fat” politics. The research questions that guide the study are: [RQ1] which terms do commentators utilize to describe political figures as “fat”? [RQ2] Why is the term “fat” utilized in the political arena? [RQ3] To what extent can one detect gender, national, or other differences in the manner in which the term “fat” is used in the political arena? After a brief introduction to the current media obsession with fat, the analysis begins in 1908 with William Howard Taft, the 330 pound, twenty-seventh President of the United States. The other political figures are: Chris Christie (Governor of New Jersey), Bill Clinton (forty-second President of the United States), Michelle Obama (current First Lady of the United States), Carla Bruni (former First Lady of France), and Julia Gillard (former Prime Minister of Australia). The final section presents some conclusions that may help readers and viewers to take a more critical perspective on “fat politics.” All of the individuals selected for this study are powerful, rich, and privileged. What may be notable is that their experiences of fat shaming by the media are different. This study explores those differences, while suggesting that, in some cases, their weight and appearance are being attacked to undercut their legitimate and referent power (Gaski). Media Obsession with Fat “Fat,” or “obesity,” the more scientific term that reflects the medicalisation of “fat” (Sobal) and which seems to hold sway today, is a topic with which the media currently is obsessed, both in Asia and in the United States. A quick Google search using the word “obesity” reports over 73 million hits. Ambady Ramachandran and Chamukuttan Snehalatha report on “The Rising Burden of Obesity in Asia” in a journal article that emphasizes the term “burden.” The word “epidemic” is featured prominently in a 2013 medical news report. According to the latter, obesity among men was at 13.8 per cent in Mongolia and 19.3 per cent in Australia, while the overall obesity rate has increased 46 per cent in Japan and has quadrupled in China (“Rising Epidemic”). Both articles use the word “rising” in their titles, a fear-laden term that suggests a worsening condition. In the United States, obesity also is portrayed as an “epidemic.” While some progress is being made, the obesity rate nonetheless increased in sixteen states in 2013, with Louisiana at 34.7 per cent as the highest. “Extreme obesity” in the United States has grown dramatically over thirty years to 6.3 per cent. The framing of obesity as a health/medical issue has made obesity more likely to reinforce social stereotypes (Saguy and Riley). In addition, the “thematic framing” (Shugart) of obesity as a moral failure means that “obesity” is a useful tool for undermining political figures who are fat. While the media pay considerable attention to the psychological impact of obesity, such as in “fat shaming,” the media, ironically, participate in fat shaming. Shame is defined as an emotional “consequence of the evaluation of failure” and often is induced by critics who attack the person and not the behavior (Boudewyns, Turner and Paquin). However, in a backlash against fat shaming, “Who you callin' fat?” is now a popular byline in articles and in YouTube videos (Reagan). Nevertheless, the dynamics of fat are even more complicated than an attack-and-response model can capture. For example, in an odd instance of how women cannot win, Rachel Frederickson, the recent winner of the TV competition The Biggest Loser, was attacked for being “too thin” (Ceja and Valine). Framing fat, therefore, is a complex process. Fat shaming is only one way that the media frame fat. However, fat shaming does not appear to be a major factor in media coverage of William Howard Taft, the first person in this study. William Howard Taft William Howard Taft was elected the 27th President of the United States in 1908 and served 1909-1913. Whitehouse.com describes Taft as “Large, jovial, conscientious…” Indeed, comments on the happy way that he carried his “large” size (330 pounds) are the main focus here. This ‹happy fat› framing is much different than the media framing associated with ‹fat shaming›. His happy personality was often mentioned, as can be seen in his 1930 obituary in The New York Times: “Mr. Taft was often called the most human President who ever sat in the White House. The mantle of office did not hide his winning personality in any way” (“Taft Gained Peaks”). Notice how “large” and “jovial” are combined in the framing of Taft. Despite his size, Taft was known to be a good dancer (Bromley 129). Two other words associated with Taft are “rotund” (round, plump, chubby) and “pudgy.” These terms seem a bit old-fashioned in 2015. “Rotund” comes from the Latin for “round,” “circular,” “spherical.” “Pudgy,” a somewhat newer term, comes from the colloquial for “short and thick” (Etymology Online). Taft was comfortable with being called “pudgy.” A story about Taft’s portrait in the Smithsonian’s National Portrait Gallery in Washington, D.C. illustrates the point: Artist William Schevill was a longtime acquaintance of Taft and painted him several times between 1905 and 1910. Friendship did not keep Taft from criticizing the artist, and on one occasion he asked Schevill to rework a portrait. On one point, however, the rotund Taft never interfered. When someone said that he should not tolerate Schevill's making him look so pudgy in his likenesses, he simply answered, "But I am pudgy." (Kain) Taft’s self-acceptance, as seen in the portrait by Schevill (circa 1910), stands in contrast to the discomfort caused by media framing of other fat political figures in the era of more intense media scrutiny. Chris Christie Governor Christie has tried to be comfortable with his size (300+ pounds), but may have succumbed to the medicalisation of fat and the less than positive framing of his appearance. As Christie took the national stage in the aftermath of Hurricane Sandy (2012), and subsequently explored running for President, he may have felt pressure to look more “healthy” and “attractive.” Even while scoring political points for his leadership in the aftermath of Superstorm Sandy, Christie’s large size was apparent. Filmed in his blue Governor jacket during an ABC TV News report that can be accessed as a YouTube video, Christie obviously was much larger than the four other persons on the speakers’ platform (“Jersey Shore Devastated”). In the current media climate, being known for your weight may be a political liability. A 2015 Rutgers’ Eagleton Poll found that 53 percent of respondents said that Governor Christie did not have “the right look” to be President (Capehart). While fat traditionally has been associated with laziness, it now is associated with health issues, too. The media framing of fat as ‹morbidly obese› may have been one factor that led Christie to undergo weight loss surgery in 2013. After the surgery, he reportedly lost a significant amount of weight. Yet his new look was partially tarnished by media reports on the specifics of lap-band-surgery. One report in The New York Daily News stressed that the surgery is not for everyone, and that it still requires much work on the part of the patient before any long-term weight loss can be achieved (Engel). Bill Clinton Never as heavy as Governor Christie, Bill Clinton nonetheless received considerable media fat-attention of two sorts. First, he could be portrayed as a kind of ‹happy fat “Bubba”› who enjoyed eating high cholesterol fast food. Because of his charm and rhetorical ability (linked to the political necessity of appearing to understand the “average person”), Clinton could make political headway by emphasizing his Arkansas roots and eating a hamburger. This vision of Bill Clinton as a redneck, fast-food devouring “Bubba” was spoofed in a popular 1992 Saturday Night Live skit (“President-Elect Bill Clinton Stops by a McDonald's”). In 2004, after his quadruple bypass surgery, the media adopted another way to frame Bill Clinton. Clinton became the poster-child for coronary heart disease. Soon he would be framed as the ‹transformed Bubba›, who now consumed a healthier diet. ‹Bill Clinton-as-vegan› framing fit nicely with the national emphasis on nutrition, including the widespread advocacy for a largely plant-based diet (see film Forks over Knives). Michelle Obama Another political figure in the United States, whom the media has connected both to fast food and healthy nutrition, is Michelle Obama. Now in her second term as First Lady, Michelle Obama is associated with the national campaign for healthier school lunches. At the same time, critics call her “fat” and a “hypocrite.” A harsh diatribe against Obama was revealed by Media Matters for America in the personal attacks on Michelle Obama as “too fat” to be a credible source on nutrition. Dr. Keith Ablow, a FOX News medical adviser said, Michelle Obama needs to “drop a few” [pounds]. “Who is she to be giving nutrition advice?” Another biting attack on Obama can be seen in a mocking 2011 Breitbart cartoon that portrayed Michelle Obama devouring hamburgers while saying, “Please pass the bacon” (Hahn). Even though these attacks come from conservative media utterly opposed to the presidency of Barack Obama, they nonetheless reflect a more widespread political use of media framing. In the case of Michelle Obama, the media sometimes cannot decide if she is “statuesque” or “fat.” She is reported to be 5’11 tall, but her overall appearance has been described as “toned” (in her trademark sleeveless dresses) yet never as “thin.” The media’s ambivalence toward tall/large women is evident in the recent online arguments over whether Robyn Lawley, named one of the “rookies of the year” by the Sports Illustrated Swimsuit issue, has a “normal” body or a “plus-size” body (Blair). Therefore, we have two forms of media framing in the case of Michelle Obama. First, there is the ‹fat hypocrite› frame, an ad hominem framing that she should not be a spokesperson for nutrition. This first form of framing, perhaps, is linked to the traditional tendency to tear down political figures, to take them off their pedestals. The second form of media framing is a ‹large woman ambiguity› frame. If you are big and tall, are you “fat”? Carla Bruni Carla Bruni, a model and singer/songwriter, was married in 2008 to French President Nicolas Sarkozy (who served 2007 to 2012). In 2011, Bruni gave birth to a daughter, Giulia. After 2011, Bruni reports many attacks on her as being too “fat” (Kim; Strang). Her case is quite interesting, because it goes beyond ‹fat shaming› to illustrate two themes not previously discussed. First, the attacks on Bruni seem to connect age and fat. Specifically, Bruni’s narrative introduces the frame: ‹weight loss is difficult after giving birth›. Motherhood is taxing enough, but it becomes even more difficulty when the media are watching your waist line. It is implied that older mothers should receive more sympathy. The second frame represents an odd form of reverse fat shaming: ‹I am so sick and tired of skinny people saying they are fat›. As Bruni explains: “I’m kind of tall, with good-size shoulders, and when I am 40 pounds overweight, I don’t even look fat—I just look ugly” (Orth). Critics charge that celebs like Bruni not only do not look fat, they are not fat. Moreover, celebs are misguided in trying to cultivate sympathy that is needed by people who actually are fat. Several blogs echo this sentiment. The site Whisper displays a poster that states: “I am so sick and tired of skinny people saying they are fat.” According to Anarie in another blog, the comment, “I’m fat, too,” is misplaced but may be offered as a form of “sisterhood.” One of the best examples of the strong reaction to celebs’ fat claims is the case of actress Jennifer Lawrence. According The Gloss, Lawrence isn’t chubby. She isn’t ugly. She fits the very narrow parameters for what we consider beautiful, and has been rewarded significantly for it. There’s something a bit tone deaf in pretending not to have thin or attractive privilege when you’re one of the most successful actresses in Hollywood, consistently lauded for your looks. (Sonenshein) In sum, the attempt to make political gain out of “I’m fat” comments, may backfire and lead to a loss in political capital. Julia Gillard The final political figure in this study is Julia Eileen Gillard. She is described on Wikipedia as“…a former Australian politician who served as the 27th Prime Minister of Australia, and the Australian Labor Party leader from 2010 to 2013. She was the first woman to hold either position” (“Julia Gillard”). Gillard’s case provides a useful example of how the media can frame feminism and fat in almost opposite manners. The first version of framing, ‹woman inappropriately attacks fat men›, is set forth in a flashback video on YouTube. Political enemies of Gillard posted the video of Gillard attacking fat male politicians. The video clip includes the technique of having Gillard mouth and repeat over and over again the phrase, “fat men”…”fat men”…”fat men” (“Gillard Attacks”). The effect is to make Gillard look arrogant, insensitive, and shrill. The not-so-subtle message is that a woman should not call men fat, because a woman would not want men to call her fat. The second version of framing in the Gillard case, ironically, has a feminist leader calling Gillard “fat” on a popular Australian TV show. Australian-born Germaine Greer, iconic feminist activist and author of The Female Eunuch (1970 international best seller), commented that Gillard wore ill-fitting jackets and that “You’ve got a big arse, Julia” (“You’ve Got”). Greer’s remarks surprised and disappointed many commentators. The Melbourne Herald Sun offered the opinion that Greer has “big mouth” (“Germaine Greer’s”). The Gillard case seems to support the theory that female politicians may have a more difficult time navigating weight and appearance than male politicians. An experimental study by Beth Miller and Jennifer Lundgren suggests “weight bias exists for obese female political candidates, but that large body size may be an asset for male candidates” (p. 712). Conclusion This study has at least partially answered the original research questions. [RQ1] Which terms do commentators utilize to describe political figures as “fat”? The terms include: fat, fat arse, fat f***, large, heavy, obese, plus size, pudgy, and rotund. The media frames include: ‹happy fat›, ‹fat shaming›, ‹morbidly obese›, ‹happy fat “Bubba›, ‹transformed “Bubba›, ‹fat hypocrite›, ‹large woman ambiguity›, ‹weight gain women may experience after giving birth›, ‹I am so sick and tired of skinny people saying they are fat›, ‹woman inappropriately attacks fat men›, and ‹feminist inappropriately attacks fat woman›. [RQ2] Why is the term “fat” utilized in the political arena? Opponents in attack mode, to discredit a political figure, often use the term “fat”. It can imply that the person is “unhealthy” or has a character flaw. In the attack mode, critics can use “fat” as a tool to minimize a political figure’s legitimate and referent power. [RQ3] To what extent can one detect gender, national, or other differences in the manner in which the term “fat” is used in the political arena? In the United States, “obesity” is the dominant term, and is associated with the medicalisation of fat. Obesity is linked to health concerns, such as coronary heart disease. Weight bias and fat shaming seem to have a disproportionate impact on women. This study also has left many unanswered questions. Future research might fruitfully explore more of the international and intercultural differences in fat framing, as well as the differences between the fat shaming of elites and the fat shaming of so-called ordinary citizens.References Anarie. “Sick and Tired.” 7 July 2013. 17 May 2015 ‹http://www.sparkpeople.com/ma/sick-of--thin-people-saying-they-are-fat!/1/1/31404459›. Blair, Kevin. “Rookie Robyn Lawley Is the First Plus-Size Model to Be Featured in the Sports Illustrated Swimsuit Issue.” 6 Feb. 2015. 22 Apr. 2015 ‹http://www.starpulse.com/news/Kevin_Blair/2015/02/06/rookie-robin-lawley-is-the-first-pluss›. Boudewyns, Vanessa, Monique Turner, and Ryan Paquin. “Shame-Free Guilt Appeals.” Psychology & Marketing 23 July 2013. doi: 10.1002/mar.20647. Bromley, Michael L. William Howard Taft and the First Motoring Presidency. Jefferson, NC: McFarland & Company, 2007. 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PurposeServant leadership is primarily focused on the empowerment and moral development of followers (Burton et al., 2017). Within sports research, little is known about how servant leadership interacts with organizational culture in teams. Thus, the purpose of this study is to assess the servant leadership of one head baseball coach and examine the degree to which servant leadership affects the program's culture.Design/methodology/approachData were collected for this case study of an NCAA Division III head baseball coach throughout one academic year. Sources included 12 interviews (ranging from four minutes to 92 min), observation of practices and games, textual analysis of documents and websites, as well as the coach's reflection journal. Data were analyzed using a six-phase process of thematic analysis (Braun and Clarke, 2006).FindingsThe participant exhibited the following servant leadership behaviors: empowering, helping subordinates grow and succeed, behaving ethically, and conceptual skills (Liden et al., 2015, 2008). In addition, the program maintained a culture featuring a few distinct artifacts, very clear espoused values, and three deeply held basic assumptions. The findings suggest that the head coach used servant leadership not to create or change culture but instead to amplify the existing culture of the baseball program.Originality/valueThere is strong evidence of a link between servant leadership and team culture, which is context-bound. At the Division III level, servant leadership behaviors can be used to embody a program's culture. Furthermore, through this embodiment, servant leaders can perpetuate an effective, functioning team culture, particularly within intercollegiate athletics.

Background: Increased understanding of the acetabular labrum’s role in hip joint biomechanics has led to a greater focus on the conservation and restoration of normal labral anatomic characteristics; however, labral repair is often not possible in the setting of severe intrasubstance damage or deficiency. Purpose: To compare 5-year postoperative patient-reported outcomes between hips treated with primary complete arthroscopic labral reconstruction and those treated with primary labral repair. Study Design: Cohort study; Level of evidence, 3. Methods: All hips that underwent primary labral repair or reconstruction by the senior surgeon between January 2015 and December 2015 were included. Hips that had undergone a previous intra-articular procedure were excluded. Visual analog scales and patient-reported outcome (PRO) instruments were completed by patients within 1 week before surgery as a baseline measurement, between 22 and 26 months postoperatively for 2-year outcomes, and between 58 and 62 months for 5-year outcomes. PRO scores collected included the modified Harris Hip Score (mHHS), the 12-Item International Hip Outcome Tool, and the visual analog scale for pain and satisfaction. Pain and satisfaction were assessed using visual analog scales. Results: A total of 68 primary labral repairs and 62 primary complete labral reconstructions were included in the final analysis. Patients in the reconstruction cohort were older (38.3 vs 29.9 years; P < .001), had a higher incidence of severe labral tearing (62.90% vs 5.88%; P < .001), required a greater number of concomitant procedures ( P < .001), and were more likely to have Beck grade III or IV chondral damage (12.94% vs 1.47%; P < .001). Both groups demonstrated statistically significant increases in outcome scores at minimum 5-year follow-up. Patients who underwent labral reconstruction had a significantly greater increase in mHHS from the preoperative assessment to latest follow-up compared with patients undergoing labral repair (27.43 vs 17.13; P = .04). No statistically significant differences between the 2 cohorts were found in achievement of minimal clinically important difference, Patient Acceptable Symptom State, maximum outcome improvement, and substantial clinical benefit at latest follow-up ( P > .05). In total, 2 patients in the repair cohort and 3 patients in the reconstruction cohort required revision arthroscopy ( P = .574). Further, 1 patient from each group converted to arthroplasty ( P = .947). Conclusion: The results of this study suggest that primary complete labral reconstruction is a viable surgical option for hips with moderate to severe labral pathology. At minimum 5-year follow-up, labral reconstruction produced similar outcomes to labral repair despite less favorable preoperative patient characteristics in the reconstruction cohort.

Abstract Background A first-year interim analysis of this two-year study suggested that intra-articular injections of highly purified, natural-origin polynucleotides and hyaluronic acid (HA) as a fixed combination (PNHA) might improve knee function and joint pain more effectively than HA alone in patients with knee osteoarthritis (OA). The purpose of the second-year analysis herein described was to verify whether the first-year interim outcomes persist over the whole two-year period. Methods Randomised, double-blind, HA-controlled clinical trial in 100 knee OA patients (98 randomised, 79 completing the study) in a high-specialisation tertiary care setting. The hypothesised difference of efficacy between PNHA and HA for the original sample size estimate is 20%. Treatment cycle: three intra-articular knee injections of either PNHA or HA, at baseline and weekly for two weeks. Evaluations: Western Ontario and McMaster Universities (WOMAC) score and Knee Society Score (KSS) as, respectively, primary and secondary endpoints, evaluated at baseline and after 2, 6, 12, and 24 months; synovial fluid levels of mediators (at baseline and the end of the treatment cycle). Adverse effects investigated at each control visit. Statistical analysis: Kruskal-Wallis test for independent samples (nonparametric one-way analysis of variance) after correction of means for age, Body Mass Index and Kellgren-Lawrence grade. If significant, pairwise post-hoc Sidak multiple comparisons. Results KSS total score and KSS pain item: significant improvement in both groups, with significantly more pain improvement in patients treated with PNHA (2-point reduction) than HA (1-point reduction). Both groups experienced significant long-term reductions in WOMAC total scores: significantly stronger in PNHA-treated patients after 24 months with a steady difference of 16% favouring PNHA in WOMAC pain subscore. No clinically significant adverse events in either group. Conclusions The outcomes of the 2-year study confirmed that a short cycle of intra-articular treatment (3 weekly double-blind injections) with polynucleotides (long-acting viscosupplementation properties, chondrocyte activation, pain-relieving properties) in fixed combination with high molecular weight hyaluronic acid is more effective in improving knee function and pain in knee OA patients than HA alone. PNHA may be elective for viscosupplementation in knee OA patients with fastidious and resistant pain and worsening disease. Trial registration NCT02417610. Registration, 15/04/2015. ClinicalTrials.gov database link: