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Introduction: Patients who are candidates for a reverse total shoulder arthroplasty (rTSA) may have varying amounts and patterns of glenoid wear. The usual treatment of these deformities has been eccentric reaming or bone grafting. Eccentric reaming often removes a large amount of subchondral bone. Bone grafting is technically more difficult and introduces another mode of failure if the graft does not heal. The purpose of this study is to evaluate patients undergoing a rTSA with concomitant superior or posterior glenoid wear who were treated with a superior augmented baseplate (SAB) or posterior augmented baseplate (PAB) without eccentric reaming or bone grafting. Materials and Methods: Prospectively obtained data were queried from a multi-institutional IRB-approved database. Preoperative and postoperative data were analyzed from 39 patients who received a primary rTSA with either an 8° PAB or a 10° SAB and a minimum of 2 years follow-up. Twenty-four (10 females and 14 males, aged 72.3 ± 8.2 years) received a primary rTSA shoulder with a PAB. Fifteen patients (4 females and 11 males, aged 71.7 ± 9.2 years) received a primary rTSA shoulder with a SAB. Each patient was scored preoperatively and at latest follow-up using the SST, UCLA, ASES, Constant, and SPADI metrics. Active abduction, forward flexion, and active and passive external rotation with the arm at the side were also measured. The average follow-up for rTSA patients with a PAB was 25.6 ± 3.1 months, and the average follow-up for rTSA patients with a SAB was 32.5 ± 6.5 months. A Student's two-tailed, unpaired t-test was used to identify differences in preoperative and postoperative results, where p < 0.05 denoted a significant difference. Results: All patients in both groups demonstrated significant improvements in pain and function following treatment with the reverse shoulder arthroplasty. The PAB rTSA cohort had a scapular notching rate of 6.3%, whereas the SAB rTSA cohort had a scapular notching rate of 14.3%. The PAB outperformed the SAB with the ASES, Constant, and active forward elevation measures. Discussion: The PAB group outperformed the SAB group with the ASES and Constant outcome scores and forward flexion. The reason for this is unknown; however, it may be due to the posterior augment baseplate itself tensioning the remaining external rotators better than the superior augment, or it may be that the posterior augment group had a better posterior cuff. Both implant groups had no revisions or dislocations and had a low notching rate. It appears that a SAB for superior glenoid wear and a PAB for posterior glenoid wear are viable simple solutions in patients undergoing a rTSA, where each preserves glenoid bone and eliminates the need for glenoid bone grafting. [ABSTRACT FROM AUTHOR]

Introduction: Osteoarthritis of the shoulder often results in significant posterior glenoid wear. The options for treating this have been eccentric glenoid reaming and occasionally bone grafting. More recently reverse total shoulder arthroplasty (rTSA) with or without bone grafting and posterior augmented glenoids (PAGs) has been introduced. The PAG restores the native joint line while reaming a minimal amount of glenoid bone. The purpose of this study is to compare osteoarthritic shoulders with significant posterior glenoid wear treated with anatomic total shoulder arthroplasty (aTSA) using a PAG to shoulders without glenoid wear treated with aTSA using a standard all poly pegged glenoid. Methods: The patients' data in this study were retrospectively queried from prospectively acquired data in a multiinstitutional IRB approved database. The study population consisted of 24 patients with osteoarthritis and posterior glenoid wear who were treated with aTSA using a PAG with a minimum of two-year follow-up. This population was age, sex, and follow-up matched to patients treated with an all poly non-augmented pegged glenoid (NAG) for osteoarthritis. Seven females and 17 males with an average age of 65.8 ± 11.5 years received a posterior augmented glenoid. The control group consisted of 7 females and 17 males with an average age of 66.4 ± 9.1 years who underwent aTSA for osteoarthritis using an all poly standard glenoid. These age, gender, and follow-up matched patients were evaluated and scored preoperatively and at latest follow-up using the SST, UCLA, ASES, Constant, and SPADI scoring metrics; active abduction, elevation, and external rotation were also measured. A Grashey and axillary lateral radiograph was evaluated at two-year follow-up. The Shoulder Arthroplasty Subluxation Index was used to determine the degree of humeral component subluxation on the glenoid component. A Student's two-tailed, unpaired t-test was used to identify differences in preoperative and postoperative results, where p < 0.05 denoted a significant difference. Results: All patients demonstrated significant improvements in pain and function with the primary aTSA. Sixty percent of PAG shoulders had a radiolucent line with an average radiographic line score of 1.10, and 33.3% of NAG had a radiolucent line with an average radiographic line score of 0.438. One glenoid in the PAG group is radiographically but not clinically loose. In the PAG group, the Grashey view showed that 18/20 humeral heads were centered with the two remaining joints demonstrating superior subluxation. On the axillary lateral in the PAG group, 17/20 humeral heads were centered, and three were anteriorly subluxated; none were posteriorly subluxated. There were no differences in any of the measured postoperative clinical outcomes or any difference in improvement between the two groups. Discussion: At a minimum of two-year follow-up, there were no statistical clinical differences between the PAG and NAG groups despite the PAG group being disadvantaged with posterior worn glenoids. There were no revisions in either group. No humeral heads resubluxated posteriorly. The PAG group had a higher incidence of lucent lines. Based on this short-term follow-up, a posterior augmented glenoid is a viable option for the posterior worn osteoarthritic glenoid. [ABSTRACT FROM AUTHOR]

This paper documents and discusses a rheological and spectroscopic investigation of the oxidative aging in asphalt cements from a 2003 northern Ontario pavement trial. Seven asphalt cements were aged according to standard methodology (rolling thin film oven test (RTFOT) and pressure aging vessel test (PAV)), as thin films at temperatures of 45, 65, and 85 °C and standard pressure (thin film oven test (TFOT)), and under modified PAV conditions (extended time of 40 hours). It was found that the current RTFOT/PAV protocol provided insufficient aging for the poor performing asphalt cements. Infrared analysis of the TFOT-aged samples for the formation of carbonyl groups could largely explain the performance ranking in service. The only significant outlier was modified with polymer and waste engine oil residue. Rheological investigations of the recovered and the TFOT-aged residues were able to show that such materials likely suffer from early gel formation. These findings illustrate the need for improved asphalt cement aging protocols. A preliminary example is provided that shows how simply doubling the PAV aging time to 40 hours can produce materials that more closely replicate those aged for 5-6 years in a northern Ontario climate. It was further confirmed that both chemical and physical hardening tendencies are closely correlated, likely because they involve similar asphalt constituents. [ABSTRACT FROM AUTHOR]

Focuses on the impact of globalization on the defenses industry in China. Sale of several weapons to Africa; Impact of economic transformation on compliance with the global trade agreement; Demands of African states for small arms and other low-technology weaponry.

This article focuses on the field of clinical psychology. The history of clinical psychology, including its emergence during and immediately after World War II, is a familiar story. Diploma mills are not a new problem for psychology, but the number of such institutions continues to increase. Each of the major health professions in this country has undergone one major evaluation and upgrading during its lifetime. In medicine, this occurred between 1910 and 1920. Many psychologists fail to appreciate the negative repercussions of being the only profession in the health service arena that does not require graduation from an accredited training program for entry into practice.

The expanding professional interest in psychosomatic disorders, and in illness related psychopathology, is discussed. A variety of new checklists, constructed from reviews of the medical and psychological literature, are provided. These include: (a) a Psychosomatic Status Checklist, (b) a Children's Psychosomatic Problem Checklist, and (c) several checklists for specific problems such as suicide, multiple sclerosis, accidental poisoning, hemophelia, anorexia nervosa, and child abuse. Implications are drawn as they regard ethics, and future training for clinical child psychologists. [ABSTRACT FROM AUTHOR]

The scores of 40 hospitalized male coronary heart disease (CHD) patients for seven traditionally employed physical CHD risk factors, were subjected to a confirmatory factor analysis that employed a LISREL program. An attempt was made to confirm a two-factor solution that involved family attempt was made to confirm a two-factor solution that involved family history as one factor, and smoking, serum cholesterol level, blood pressure, physical exercise, diet, and weight control as the second. The obtained goodness-of-fit index (.84) suggests that the two-factor solution is a moderately valid one. These findings raise the question whether many of the physical risk factors for CHD simply may be manifestations of a single behavioral characteristic, perhaps best described as ‘lack of self-control.’ [ABSTRACT FROM AUTHOR]

This article argues that health psychology for children is not given proper attention in mainstream health psychology, which is primarily adult in orientation. It is believed that the U.S.'s children generally are neglected by psychologists concerned with health care. Although children certainly are not ignored totally within health psychology, the attention given them seems greatly disproportionate to the overall importance of their health problems. For example, the leading cause of death among adults is cardiovascular disease. Other high-incidence disorders for adults include cancer and automobile accidents. If the importance of childhood health-related behavior is judged merely by its potential effect on later adult health, then prevention of cardiovascular disease, cancer, and alcohol abuse become major foci health psychology efforts. Child abuse and neglect are other threats to health unique to children. Adult-oriented health psychology, however, reduces children and their immediate health care needs to the level of either a step-child or a stepping stone.

The article focuses on a study conducted to explore the personalities of battering parents of battered children by obtaining quantifiable data about them from standard personality measures. The 13 vallidity and clinical scales of Minnesota Multiphasic Personality Inventory (MMPI) measure overall level of psychopathology as well as to indicate specifics with regard to affect, character and other symptoms. Their most experimental parents appear significantly less are logically derived. The psychopathic character of battering parents, which is suggested here, irrespective of the severity of any accompanying disturbance, carries implications for those who deal with suspected child abusers.

Reports the development and initial psychometric refinement of a forced-choice version of the Way Of Life Scale (WOLS) which measures Type A behavior pattern, based on a study in the University of Oklahoma. Background of the study; Need to focus on the psychometric status of the WOLS.

Shostrom's SAV Scale was administered to 393 students at a large southwestern university. Items were factor analyzed according to a principle components solution. Nine factors were derived, which collectively accounted 57% of the total matrix variance. Five of the factors corresponded closely to components of Maslow's self-actualization theory upon which the scale was theoretically based. Two factors corresponded to a single Maslow component, and one appeared to be a combination of two of his categories. One derived factor seemed better explained by Freudian than Maslow theory. In general, the results supported Maslow's 15-component scheme for conceptualizing self-actualization. [ABSTRACT FROM PUBLISHER]

Discusses the treatment of children with psychogenic encopresis or fecal soiling of the clothes. Solution to the problem of poor toilet training; Psychologic factors contributing to fecal retention; Management program for encopresis.

The article reports that a child's refusal to emit appropriate consummatory responses can constitute an important medical-psychological problem. Such problems are extremely prevalent, and almost no family has been without the experience of having a child who refuses to accept oral medication, drink his walk, or eat his spinach. However, these problems can also be crucial or even lethal under certain circumstances. For instance, when prolonged and continuing media cation is necessary, the oral route is always preferable and sometimes essential.

Two 18- to 24-month-old girls who refused oral medication were subjected to a conditioning program designed to elicit their cooperation. Both patients had a disease which would be life threatening in the absence of medication. Their refusal to take medicine was further complicated by regurgitation of any substance placed in their stomachs by means of gavage. One patient responded promptly and completely to conditioning and thereafter accepted the necessary oral medication. The other child required the use of successive approximations or shaping, which resulted in her acceptance of the medicine when offered in candy. The conditioning techniques employed by the experimenters were successfully transferred to hospital staff and eventually to the parents in both cases. The techniques for conditioning and shaping are described. [ABSTRACT FROM AUTHOR]

The article presents a study on the performance standards among diverse classes of mentally retarded individuals in Oklahoma. The test was done through performing the manual crank test and indicate the prerest period of the subjects. The research has found that the investigation have motivated the nonretardates to perform well on prerest performance.

The article discusses the study showing the effects of therapeutic conditions in child therapy. Sixteen practicing child psychotherapists and 16 child patients were used as sample subjects in the study. Each children were evaluated early in therapy and four and a half months later by their respective therapists using the Current Adjustment Rating Scale. The effects of accurate empathy, warmth and genuineness in non-verbal communication of child therapy were also analyzed. Results show that the children receiving higher conditions improved significantly, while the parent's evaluations suggest that the children receiving low levels of empathy, warmth and genuineness showed actual deterioration.

Focuses on the success of electroshock in habitual vomiting. Discusses of two cases in children; Use of conditioning techniques or behavior modifications.

This article focuses on the application of psychological theory in management of behavior problems in children. Successful management by the physician of behavior problems of young children resides largely in discussions with the parents. These problems include those related to feeding difficulties, thumb-sucking, enuresis, tics, unhappiness, school and antisocial behavior. Several pediatricians have acquired a growing sensitivity to understanding and managing psychological difficulties. By using this knowledge and sensitivity, the pediatricians can explain the dynamics of child behavior to parents and advise alterations in parental response and actions to lessen behavior problems.