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Article #1 Acute knee injuries
Article #2 Lived experience
Article #3 Child safety seat
Article #4 Coronary Heart Disease
Article #5 Colorectal Adenomas
Article #6 Social support in rehabilitation

The articles with citation and abstract:
1. Yawn, Barbara P. MD, MSc. Amadio, Peter MD. Harmsen, W. Scott MS. Hill, Jeannie RN. Ilstrup, Duane MS. Gabriel,
Sherine MD, MSc. Isolated Acute Knee Injuries in the General Population. Journal of Trauma-Injury Infection & Critical
Care. 48(4):716-723, April 2000.
Abstract
Objective: Knee injuries are common in the general population, yet most studies have concentrated on special populations. The purpose of this study was to describe the types of injuries, injury events, age, and sex distributions in a community population.
Methods: The medical records of all residents of Olmsted County, Minnesota, 17 years of age or older who had a first visit for an isolated acute knee (acute was defined as occurring within 60 days of the physician visit) injury between January 1, 1993, and January 1, 1996, were abstracted.  Results: A total of 664 patients (4/1,000 community adults, 46% women and 54% men) presented to a physician for evaluation and treatment of an isolated acute knee injury. Injured men were on average younger than women and more likely to have an injury during a sports activity, whereas women's injuries were more likely to be the result of non-sports-related falls. Knee sprain or strain was the most common final diagnosis (36%). Approximately half (49%) of the patients had a single visit. The likelihood of orthopedic surgeon's care (37%overall) increased with injury severity and age of the patient. Overall, 12% of subjects had surgical treatment recommended.  Conclusion: Knee injuries are common, often result in a single visit, seldom receive surgical intervention, and the majority are cared for entirely by generalist physicians.

2. Leenerts, Mary Hobbs RN, PhD; Magilvy, Joan K. RN, PhD, FAAN.  Investing in Self-Care: A Midrange Theory of Self-Care Grounded in the Lived Experience of Low-Income HIV-Positive White Women [Healing And Caring] Advances in Nursing Science Volume 22(3) March 2000 pp 58-75
Abstract
Little is known about the types of interventions that invite low-income women into partnerships that motivate self-care practices when living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). The increasing incidence of HIV infection in low-income women with histories of inattention to self-care calls for nursing theories that address self-care practices. The purpose of this article is to describe a midrange theory developed from grounded theory research and to discuss implications of theoretical construction for future knowledge development. For the 12 women in this study, self-care practices developed over time and through four categories: focusing self, fitting resources, feeling emotions, and finding meaning. The core category, investing in self-care, linked the categories and carried explanatory power for developing midrange theory. Implications for nursing knowledge development through partnerships with low-income women are discussed.

3. Kohn, Melvin MD, MPH. Chausmer, Kerry ACSW, MPH. Flood, M. Holly MPH. Anticipatory Guidance About Child
Safety Seat Misuse: Lessons From Safety Seat "Checkups". Archives of Pediatrics & Adolescent Medicine. 154(6):606-609, June 2000.
Abstract
Objectives: To quantify the frequency of improper child safety seat use and to identify the most common mistakes in safety seat use, so that priorities for anticipatory guidance about misuse can be identified.  Design: Descriptive survey of types and frequency of safety seat misuse.  Setting: Eleven safety seat "checkups" sponsored by the Louisiana SAFE KIDS Coalition in southeastern Louisiana in 1998.
Participants: Convenience sample of parents recruited for checkups through local media and sponsoring businesses. Three hundred seventeen child safety seats were checked.
Results: Of the 266 forward- and rear-facing seats checked, 250 (94%) were installed incorrectly. Sixty-one (23%) of the seats had minor misuse or were correctly used, 107 (40%) were partially misused, and 98 (37%) were extensively misused. The 3 most frequently found problems were seat not belted into vehicle tightly (142 [88%] of forward-facing seats and 84 [81%] of rear-facing seats), safety seat harness straps not snug (70 [43%] of forward-facing seats and 49 [47%] of rear-facing seats), and harness retainer clip not at armpit level (55 [34%] of forward-facing seats and 38 [37%] of rear-facing seats).
Conclusions: As part of the routine anticipatory guidance offered during well-child visits, health care providers (ie, physician, nurse, or nurse practitioner) should counsel parents specifically about these 3 frequent errors in child safety seat use.

4. Iribarren, Carlos MD, MPH, PhD. Sidney, Stephen MD, MPH. Sternfeld, Barbara PhD. Browner, Warren S. MD, MPH.
Calcification of the Aortic Arch: Risk Factors and Association With Coronary Heart Disease, Stroke, and Peripheral Vascular Disease. JAMA. 283(21):2810-2815, June 7, 2000.
Abstract
Context: Psychosocial factors, including personality and character traits, may play a role in the development and expression of coronary artery disease.  Objective: To evaluate whether hostility, a previously reported predictor of clinical coronary artery disease, is associated with coronary calcification, which is a marker of subclinical atherosclerosis.
Design: Prospective cohort study.
Setting and Participants: Volunteer subsample from Chicago, Ill, and Oakland, Calif, consisting of 374 white and black men and women, aged 18 to 30 years at baseline, who participated in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Cook-Medley hostility assessment data were collected at baseline from 1985 to 1986 and at year 5 examinations from 1990 to 1992. After the 10-year examinations in the 1995-1996 year, electron-beam computed tomographic scans were performed.
Main Outcome Measures: Presence of any detectable coronary artery calcification (coronary calcium score >0), and coronary artery calcium scores of 20 or higher.
Results: In logistic regression analysis adjusting for age, sex, race, and field center comparing those with hostility scores above and below the median of the distribution of the present sample, the odds ratio of having any coronary calcification was 2.57 (95% confidence interval, 1.31-5.22), and the odds ratio of having a calcium score of 20 or higher was 9.56 (95% confidence interval, 2.29-65.9) for calcium scores of 20 or higher. The associations with any coronary artery calcification persisted after adjusting for demographic, lifestyle, and physiological variables. Results using a cynical distrust subscale were somewhat weaker than for those using the global hostility score. Power was inadequate to perform sex- or race-specific analyses.
Conclusion: These results suggest that a high hostility level may predispose young adults to coronary artery calcification.

5. Alberts, David S.. Martinez, Maria Elena. Roe, Denise J.. Guillen-Rodriguez, Jose M.. Marshall, James R.. van Leeuwen,
J. Barbara. Reid, Mary E.. Ritenbaugh, Cheryl. Vargas, Perla A.. Bhattacharyya, A.B.. Earnest, David L.. Sampliner, Richard E. Parish, Dianne. Koonce, Kris. Fales, Lianne. Lack of Effect of a High-Fiber Cereal Supplement on the Recurrence of Colorectal Adenomas. New England Journal of Medicine. 342(16):1156-1162, April 20, 2000.
Abstract
Background: The risks of colorectal cancer and adenoma, the precursor lesion, are believed to be influenced by dietary factors. Epidemiologic evidence that cereal fiber protects against colorectal cancer is equivocal. We conducted a randomized trial to determine whether dietary supplementation with wheat-bran fiber reduces the rate of recurrence of colorectal adenomas.  Methods: We randomly assigned 1429 men and women who were 40 to 80 years of age and who had had one or more histologically confirmed colorectal adenomas removed within three months before recruitment to a supervised program of dietary supplementation with either high amounts (13.5 g per day) or low amounts (2 g per day) of wheat-bran fiber. The primary end point was the presence or absence of new adenomas at the time of follow-up colonoscopy.  Subjects and physicians, including colonoscopists, were unaware of the group assignments.
Results: Of the 1303 subjects who completed the study, 719 had been randomly assigned to the high-fiber group and 584 to the low-fiber group. The median times from randomization to the last follow-up colonoscopy were 34 months in the high-fiber group and 36 months in the low-fiber group. By the time of the last follow-up colonoscopy, at least one adenoma had been identified in 338 subjects in the high-fiber group (47.0 percent) and in 299 subjects in the low-fiber group (51.2 percent). The multivariate adjusted odds ratio for recurrent adenoma in the high-fiber group, as compared with the low-fiber group, was 0.88 (95 percent confidence interval, 0.70 to 1.11; P=0.28), and the relative risk of recurrence according to the number of adenomas, in the high-fiber group as compared with the low-fiber group, was 0.99 (95 percent confidence interval, 0.71 to 1.36; P=0.93).
Conclusions: As used in this study, a dietary supplement of wheat-bran fiber does not protect against recurrent colorectal adenomas.

6. Natterlund, Birgitta OT. Ahlstrom, Gerd RN PhD. Experience of social support in rehabilitation: a phenomenological
study. Journal of Advanced Nursing. 30(6):1332-1340, December 1999.
Abstract
The progressive muscular weakness brought on by muscular dystrophy causes the sufferer many problems in everyday life. Earlier studies in Sweden have shown that adults with hereditary muscular dystrophy often have difficulty in gaining access to rehabilitation. For this reason a special rehabilitation programme was drawn up and carried out, extending over a period of 18 months.  The purpose of the study is to describe the participants' experience of social support in connection with the programme. Thirty-seven participants (21 women and 16 men) were interviewed. The analytical method was phenomenological, incorporating validation by independent judges. Nine overall themes emerged from the interviews: psychosocial support, meeting other people with muscular dystrophy, knowledge and learning, adjustment in daily life, coping with illness-related problems, adjustment at work, management of physical disability, medical examination and treatment, and involvement of relatives. The results indicate that the participants encountered staff with a sense of commitment and felt themselves to be 'seen and confirmed'. From the discussions and the contact with others in the same situation there arises a sense of affinity and a better understanding of one's own situation. There was appreciation of the education about the disease, its hereditary aspect, technical aids, grants and physical training.  Hardly any of the participants spoke of knowing such things before. In conclusion there was approval of the received support, and recognition that persons with muscular dystrophy should be given access to recurrent rehabilitation.