Explore the vast range of titles available.

For most people in the United States, going almost anywhere begins with reaching for the car keys. This is true, Christopher Wells argues, because the United States is Car Country a nation dominated by landscapes that are difficult, inconvenient, and often unsafe to navigate by those who are not sitting behind the wheel of a car. The prevalence of car-dependent landscapes seems perfectly natural to us today, but it is, in fact, a relatively new historical development. In Car Country, Wells rejects the idea that the nation's automotive status quo can be explained as a simple byproduct of an ardent love affair with the automobile. Instead, he takes readers on a tour of the evolving American landscape, charting the ways that transportation policies and land-use practices have combined to reshape nearly every element of the built environment around the easy movement of automobiles. Wells untangles the complicated relationships between automobiles and the environment, allowing readers to see the everyday world in a completely new way. The result is a history that is essential for understanding American transportation and land-use issues today. Watch the book trailer: http://www.youtube.com/watch?v=48LTKOxxrXQ

Anemia commonly complicates inflammatory bowel disease (IBD). In patients with chronic renal failure, the treatment of anemia with iron ± erythropoietin improves both quality of life (QOL) and cognitive function (CF). The same drugs are effective in treating severe anemia in IBD, but there is no evidence to direct the treatment of mild anemia. Concern exists that the use of iron may exacerbate inflammation in patients with IBD. The present study examined the association between changes in hemoglobin (Hb) in a population of IBD patients and changes in QOL and CF independent of change in disease activity (DA). Subsidiary aims were to assess whether the use of iron was associated with worsening DA.MethodsA cohort of 50 patients with IBD (29 Crohn's disease and 21 ulcerative colitis) took part. Iron replacement was given to 21 patients with low Hb. Measures of QOL, CF, DA, and Hb were recorded at baseline and at 6 months.ResultsThe iron-treated group had lower Hb and higher DA scores compared with the non-iron-treated group at baseline. In a hierarchical regression model, changes in DA accounted for 13% (P = 0.17) and changes in Hb accounted for 18% (P = 0.005) of the variance in change in SF-36 and 12% (P = 0.23) and 17% (P = 0.009) in the Inflammatory Bowel Disease Questionnaire. In this pilot study, although no associations were identified between changes in Hb or DA and CF, increases in Hb improved QOL scores in IBD patients independent of changes in DA. We found no similar effect with CF, but again, the sample size was small. We found no evidence that iron therapy causes worsening of DA.ConclusionsTreatment of IBD-associated anemia with iron may lead to improvement in patients' QOL.

Background The treatment of end-stage hip disease in very young patients is controversial, with advocates for nonoperative treatment, hip arthrodesis and replacement procedures. The functional improvements in this group of patients are not well documented and whether the condition for which the surgery is performed influences function. Questions/purposes We determined whether (1) modern THA provides major functional improvements; (2) disease-specific factors impact the magnitude of improvement; (3) these procedures are associated with early failures and complications; and (4) radiographically secure implant fixation is achieved with contemporary implants. Methods We retrospectively reviewed 88 patients (102 hips) who had THA and were 25 years or younger at surgery. The most common diagnoses were osteonecrosis (44%) and secondary osteoarthritis (41%). All patients received a cementless socket of varying designs and all except five a cementless stem. Demographic data, Harris hip score, and Charnley classification were recorded. Radiographic evaluation was used to determine implant fixation. We identified complications and failure mechanisms. The minimum followup was 2 years (median, 4.2 years; range, 2–16 years). Results The 95 nonrevised hips were followed clinically an average of 61 months. The mean Harris hip scores improved from 42 preoperatively to 83 postoperatively. Lower Harris hip scores were associated with systemic disease (Charnley Class C). Seven hips (7%) underwent revision. There were nine (9%) major complications. One hundred percent of femoral stems and 98% of acetabular components were well-fixed at last followup. Conclusion Contemporary total hip arthroplasty in patients 25 years of age and younger is associated with improved hip function, and secure fixation of cementless implants at early followup. Level of Evidence Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Background Most long-term followup studies of younger patients who underwent TKA include a relatively high percentage of rheumatoid patients, whose function and implant durability may differ from those with osteoarthritis (OA). Questions/purposes The purpose of this study was to evaluate the minimum 10 year followup of TKA performed in more active patients with OA, using modular tibial components, to determine the durability of that construct. Specifically, we determined (1) survivorship; (2) revision rates; (3) functional scores; and (4) rates of radiographic failure at a minimum 10 year followup. Methods We retrospectively reviewed 59 patients (67 knees) with OA who underwent primary total knee arthroplasty with posterior cruciate retaining (27%) or posterior cruciate substituting (73%) components which had modular tibial trays. Patients were evaluated clinically for need of revision and Knee Society, SF-36 and WOMAC scores as well as UCLA and Tegner activity scores. Radiographs were evaluated for loosening and osteolysis. The minimum followup of living patients was 10 years (mean, 12.4 years; range, 10 to 18.4 years). Ten patients (11 knees) died; two patients (2 knees) were lost to followup. Results Ten patients (11 knees; 16%) had revisions for aseptic loosening and/or osteolysis. Thirty-one patients (65%) were still performing moderate labor or sports activities. The average UCLA score was 5.5 (range, 2–9). No nonrevised knee demonstrated radiographic loosening. Conclusion Most patients in this active patient population continued to have acceptable function although 16% underwent revision for wear and/or osteolysis. Isolated tibial insert exchange alone was performed in four of the 11 (36%) revised knees. These data should provide comparison for total knee arthroplasties performed in younger patients with newer designs and newer bearing materials. Level of Evidence Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

When the US Congress created an inviolate Highway Trust Fund in 1956--into which federal gas-tax revenue flowed, obligated entirely for interstate highway bills--it greatly expanded the system by elevating it to the federal level. Indeed, beginning in the interwar period, state and federal gas-tax policies, coupled with new highway-planning techniques, reconfigured the American environment by funding the growth of a vast automotive infrastructure that was designed explicitly to stimulate near-constant growth in American demand for gasoline. Here, Wells tackles gas taxes, federal linkage and highway infrastructure in the US.

Wells discusses the significance of Ford's Model T design which has created a new type of motor vehicle and transformed the US market from one of disagreement and division into a broad mass market focused largely on a single technology. The Model T's design allowed it to bridge the technological and social chasm that divided mobility and horse-minded motorists a signal accomplishment.

Purpose: The purpose of this paper is to discuss the practical realities of using a college seminar to fulfill the carbon audit requirement for signatories to the American College and University Presidents Climate Commitment (ACUPCC) and presents evidence of this approach's advantages as an educational and practical tool. Design/methodology/approach: The paper reviews the course structure and presents research findings, based on student questionnaires on student learning outcomes. Findings: Structuring a course around a campus carbon audit has unique educational advantages for students and practical advantages for ACUPCC signatory campuses. Originality/value: This paper enumerates the concrete advantages to using a college class to conduct a greenhouse gas emissions inventory and provides evidence of valuable learning outcomes for students in such a class. (Contains 3 figures.)