bluuebunny/crossref_metadata_2025 huggingface dataset:
Simulated parents: Developing paediatric trainees’ skills in giving bad news
Authors: Gough Jenny K , Frydenberg Alexis R , Donath Susan K , Marks Michael M
Published: March 2009

Aim:  In curriculum documents for medicine in undergraduate, post‐graduate and continuing professional development, there is now a focus on communication skills. The challenges are to place communication skills in the crowded curriculum and then to construct and sustain a programme that uses an evidence‐based approach to the teaching and learning of communication skills. For 6 years, we have conducted a programme that involves simulated parents supporting junior medical staff to refine their skills in communication, particularly in giving parents bad news. The aim of our study was to obtain a better understanding of the trainees' experiences of the programme.

Methods:  Nine junior residents individually worked through two scenarios and received feedback from the simulated parent. They gave bad news to a simulated parent/actor who then gave feedback. A recording of the simulation was provided for discussion with a designated colleague at an arranged time. The tapes were then separately appraised by two independent raters – another actor and a paediatrician. Brief written reports and conducted semi‐structured interviews provided more insights into the trainees’ experience of the simulation. Other participating medical/medical education staff were interviewed about the simulation programme.

Results:  Five themes emerged from the qualitative data: timeliness, emotional safety, the complexity of communication, practical usefulness and the challenge of effecting change. In addition, the ratings of the videos helped to clarify those ‘parent‐centred’ communication skills that trainees may neglect in difficult conversations: ‘ask about support’, ‘encourage the parent to ask questions’ and ‘repeat key messages’.

Conclusion:  The evaluation highlighted the value of an early‐career experiential programme to highlight the importance of communication skills in post‐graduate paediatrics practice.
Reduced exhaled breath condensate pH in asthmatic smokers using inhaled corticosteroids
Authors: KANE Binita , BORRILL Zoe , SOUTHWORTH Thomas , WOODCOCK Ashley , SINGH Dave
Published: March 2009

Background and objectives:  Exhaled breath condensate (EBC) pH has been proposed as a biomarker of airway inflammation and oxidative stress in asthma. Cigarette smoking reduces EBC pH in mild asthma. The effects of smoking on EBC pH in more symptomatic asthmatic patients using inhaled corticosteroids (ICS) are unknown. We aimed to compare EBC pH in asthmatic smokers (AS) and non‐smokers (ANS) with moderate to severe disease, who were taking ICS. We also investigated the relationship between EBC pH and biomarkers of airway inflammation and oxidative stress.

Methods:  AS (n = 18) and ANS (n = 17), who were using ICS, were recruited and EBC pH, sputum inflammatory cell counts and sputum supernatant 8‐isoprostane concentrations were measured. Full lung function testing was performed.

Results:  EBC pH was significantly lower in AS than in ANS (6.91 vs 7.41). In AS there was a significant inverse correlation between EBC pH and 8‐isoprostane levels (r = −0.54, P = 0.03). There was no correlation between EBC pH and sputum neutrophil counts.

Conclusions:  EBC pH appears to be a biomarker of the level of oxidative stress in smokers with moderate to severe asthma. EBC pH may have applications for the longitudinal monitoring of the effects of smoking on the airways of asthmatic patients.
Observations on environmental asbestos exposure in a high risk area
Authors: SAHIN Unal , OZTURK Onder , SONGUR Necla , BIRCAN Ahmet , AKKAYA Ahmet
Published: March 2009

Background and objective:  Environmental asbestos exposure is causally associated with various pulmonary pathologies. In Turkey, one of the most important sources of asbestos exposure is dust originating from the walls of homes whitewashed with white stucco. The main asbestos types implicated are tremolite and, to a lesser extent, chrysotile. This study investigated the presence and effect of environmental asbestos exposure in a small village in Isparta, Turkey.

Methods:  Samples of asbestos mine ore, whitewashed plaster from the interior walls of the houses and whitesoil from the outside walls of the houses were analysed. Chest radiographs of 132 villagers aged 30 years and over and living in the village during the study were obtained. Verbal histories from the relatives of people who had died from lung cancer or mesothelioma and hospital records contributed 13 cases to the study population, giving a total of 145 cases under study.

Results:  Chrysotile fibres were found in the old asbestos mine sample, and zeolite in the whitesoil sample from the outside walls. Abnormal CXR were found in 19 subjects (14. 4%), the most common being pleural calcifications and/or pleural plaques (n = 14, 10.6%). A further five subjects with pleural calcifications and/or pleural plaques were identified from verbal autopsy and hospital records. Malignant pleural mesothelioma was present in one living subject and four of the deaths. A possible familial clustering of lung cancer and malignant mesothelioma was noted.

Conclusion:  While tremolite asbestos is the asbestos found in most white soil in Turkey, in this village chrysotile asbestos was found in the white soil. Familial clustering may indicate genetic susceptibility or increased environmental exposure in some families.
Clinicopathological features and epidermal growth factor receptor mutations associated with epithelial–mesenchymal transition in non‐small cell lung cancer
Authors: DENG Qin‐Fang , ZHOU Cai‐Cun , SU Chun‐Xia
Published: March 2009

Background and objective:  Small molecular inhibitors of the epidermal growth factor receptor (EGFR) have been extensively studied in non‐small cell lung cancer (NSCLC) patients. The discovery of molecular biomarkers that identify the subgroups of NSCLC patients benefiting from EGFR tyrosine kinase inhibitor (TKI) has become an important area of investigation. Recent studies have suggested that epithelial–mesenchymal transition (EMT) in tumours decreases the cellular requirements for EGFR signalling pathway, and this may provide a molecular signature to define those NSCLC patients most likely to respond to treatment with targeted EGFR TKI. This research explored the clinicopathological features and EGFR mutations associated with EMT in NSCLC.

Methods:  The EMT status in surgically resected specimens from 62 patients with NSCLC was tested by immunohistochemical staining. The frequency of tumour epithelial phenotype was calculated and the strength of the association with clinicopathological features and EGFR genotype was determined by logistic regression.

Results:  The overall frequency of the epithelial phenotype was 35.48% (22 of 62). Based on univariate analyses, the frequency of the epithelial phenotype (E‐cadherin‐positive) was greater for EGFR mutants versus wild types (77.78% vs 18.18%; P < 0.0001) and women versus men (54.55% vs 25%; P = 0.02). Multivariate logistic analysis showed that only the EGFR genotype (odds ratio, 0.063; 95% CI: 0.013–0.3; P = 0.0005) was significantly associated with the epithelial phenotype.

Conclusion:  In patients with NSCLC, there is a higher frequency of epithelial markers in patients with EGFR mutation.
Natural stent in the management of post‐intubation tracheal stenosis
Authors: PARK Hye Yun , KIM Hojoong , KOH Won‐Jung , SUH Gee Young , CHUNG Man Pyo , KWON O Jung
Published: March 2009

Background and objective:  The treatment choice for post‐intubation tracheal stenosis (PITS) in patients for whom surgery is not initially feasible is bronchoscopic silicone stenting. A new silicone stent, called the Natural stent (N stent), was investigated for its clinical efficacy and safety in patients with PITS.

Methods:  A retrospective review was conducted of 32 patients with PITS who underwent N stenting between November 2001 and December 2006 and were followed for at least 12 months.

Results:  Airway dilatation with combined modalities such as Nd : YAG laser, ballooning or bougienage was followed by N stent insertion. After intervention, all patients had symptomatic and spirometric improvement without immediate complications. Removal of the stent without re‐stenosis was successful in 38% of the patients at a median time of 7 months after insertion. The stent could not be removed or needed reinsertion in 31% of patients, and 16% of patients underwent surgery after initial stabilization by stenting. Late complications were stent migration (34%), mucostasis (31%), granulation tissue formation (38%) and re‐stenosis (40%). All patients tolerated the management of complications during a median follow up of 22 months.

Conclusions:  Bronchoscopic N stenting is an effective treatment for patients with PITS in whom surgery is not feasible on initial presentation. Further stent development is necessary to reduce the late complication rate.
Acute effects of hyperoxia on resting pattern of ventilation and dyspnoea in COPD
Authors: MOORE Rosemary , BERLOWITZ David , PRETTO Jeffrey , BRAZZALE Danny , DENEHY Linda , JACKSON Bruce , MCDONALD Christine
Published: March 2009

Background and objective:  Hyperoxia has been shown to reduce resting ventilation, hyperinflation and dyspnoea in patients with severely hypoxaemic COPD. This study assessed the effects of hyperoxia on these resting measures in patients with COPD of varying disease severity and characterized those patients who responded.

Methods:  Measurements of dyspnoea (Borg score), oxyhaemoglobin saturation (SpO2), inspiratory capacity (IC), minute ventilation, tidal volume, breathing and cardiac frequency were performed at rest in 51 patients with COPD while they breathed air and 44% oxygen, in a randomized double‐blinded fashion.

Results:  Hyperoxia induced significant reductions in cardiac frequency and dyspnoea and a significant increase in SpO2. No significant change was noted in IC for the group overall, and there was substantial inter‐subject variation in this measurement. No significant changes were found in ventilation, and there was no correlation between change in dyspnoea and change in IC. In patients with moderate to severe airflow obstruction (FEV1 < 70% predicted), a significant association was found between the degree of airflow obstruction and change in IC induced by hyperoxia.

Conclusions:  Hyperoxia improved dyspnoea but did not significantly alter resting pulmonary hyperinflation in a group of patients with COPD of varying severity. However, in a subset patients with moderate to severe airflow obstruction a relationship existed between the severity of airflow obstruction and volume response to hyperoxia.
Cerebral blood flow monitoring using a novel laser Doppler flowmeter in asphyxiated infants
Authors: Ohashi Atsushi , Kuroyanagi Yuichi , Kitamura Naoyuki , Kinoshita Yo , Kaneko Kazunari , Yabuta Keijiro
Published: March 2009

Background:  The aim of the present study was to investigate the role of early changes in cerebral blood flow (CBF) predicting the severity of neurological outcome in asphyxiated infants.

Method:  Serial monitoring of CBF was performed using a newly developed laser Doppler flowmeter (LDF) in parallel with conventional hemodynamic monitoring, such as mean arterial blood pressure (mABP) or heart rate (HR) in 11 asphyxiated infants (five infants with neurological sequelae and six infants without sequelae) during the first 4 days of life. Psychomotor development was followed up to 20 months.

Results:  No differences in average CBF, mABP, average HR, or Apgar scores were found between infants with neurological sequelae and those without (P > 0.1). Significant difference was found only in average stability index during the first 48 h of life (SI48), defined as a coefficient of variation of CBF during the corresponding period (P= 0.04). An SI48 ≥ 0.24 had positive predictive value of 100% for neurological sequelae while that <0.24 had a negative predictive value of 66.7%.

Conclusion:  SI48, an average stability index of CBF during the first 48 h of life, can be a useful index to predict neurological outcome in asphyxiated infants.
Polymorphism of cytochrome P450 2B6 and prostate cancer risk: A significant association in a Japanese population
Authors: Kurosaki Takayuki , Suzuki Motofumi , Enomoto Yutaka , Arai Tomio , Sawabe Motoji , Hosoi Takayuki , Homma Yukio , Kitamura Tadaichi
Published: March 2009

Objectives:  To explore whether Lys262Arg polymorphism of the Cytochrome P450 2B6 (CYP2B6) gene could act as a genetic marker for prostate cancer risk among Japanese men.

Methods:  A total of 350 patients with sporadic prostate cancer and 328 controls were examined. A single nucleotide polymorphism with non‐synonymous amino acid change located at Lys262Arg of the CYP2B6 gene was genotyped using a TaqMan assay.

Results:  The frequency of the Arg/Arg genotype among prostate cancer patients was significantly higher than that among the controls (P = 0.027). The frequency of the G allele of the Lys262Arg polymorphism was also significantly higher in prostate cancer patients than in the controls (30.4% vs 24.8%, P = 0.025). Patients with the Lys/Arg plus Arg/Arg genotypes carried a low Gleason score more frequently than those with the Lys/Lys genotype (P = 0.042). The frequency of the G allele of the Lys262Arg polymorphism was significantly higher in the low Gleason score group than that in the high Gleason score group (34.3% vs 26.8%, P = 0.038).

Conclusions:  Lys262Arg polymorphism of the CYP2B6 gene may be a genetic marker for evaluating the risk of sporadic prostate cancer in native Japanese men.
Laparoscopic versus open radical prostatectomy: Urodynamic evaluation of vesicourethral function
Authors: Matsukawa Yoshihisa , Hattori Ryohei , Yoshikawa Yoko , Ono Yoshinari , Gotoh Momokazu
Published: March 2009

Objectives:  To assess the impact of laparoscopic radical prostatectomy on vesicourethral function and compare it to that of open radical prostatectomy.

Methods:  Sixty‐three patients undergoing laparoscopic radical prostatectomy for localized prostate cancer were included in this retrospective analysis. Urodynamic parameters, including maximum urethral closing pressure (MUCP), functional profile length (FPL), bladder compliance, maximum cystometric capacity (MCC) and detrusor overactivity, were considered. Continence status and changes in urodynamic findings before and after surgery were evaluated. In addition, postoperative urodynamic findings were compared with those in 58 patients undergoing open radical prostatectomy.

Results:  After laparoscopic radical prostatectomy, MUCP and FPL showed a significant postoperative decrease. Continence rates after surgery were 82% in the laparoscopic and 78% in the open group. Comparison of postoperative data between continent and incontinent patients in both surgical groups showed significantly lower MUCP, shorter FPL, lower bladder compliance and higher incidence of detrusor overactivity in incontinent patients. Although there was no significant difference in postoperative MUCP and FPL between the two groups, bladder compliance was significantly lower and incidence of detrusor overactivity was significantly higher in the open prostatectomy group.

Conclusions:  Laparoscopic radical prostatectomy has a negative impact on storage function by impairing function of the urethral sphincter and decreasing bladder compliance. There is no difference in postoperative urethral function between open and laparoscopic radical prostatectomy. Laparoscopic surgery might be associated with less impairment of bladder function than open surgery.
Training tomorrow’s surgeons: what are we looking for and how can we achieve it?
Authors: Grantcharov Teodor P. , Reznick Richard K.
Published: March 2009

The aim of a surgical residency program is to produce competent professionals in a safe and pedagogically efficient environment. For many years, there has been an overemphasis on technical attributes as the fundamental competencies of a trained surgeon. With the advent of new frameworks for defining the outcomes of surgical training, such as CanMeds from the Royal College of Physicians and Surgeons of Canada and the six competencies outlined by the Accreditation Council for Graduate Medical Education in USA, there has been a broadening of the focus of surgical training. Although technical proficiency is definitely an important prerequisite for a successful outcome, other qualities such as intellectual abilities, personality and communication skills, and a commitment to practice are important elements in the profile of a competent surgeon. Recently, there is a growing appreciation for the heterogeneity in achievement of technical competence among our trainees, with some residents able to quickly master technical skill in contrast to others who may never achieve mastery in the technical domain. The questions of how to select, teach and grant privileges for independent practice requires an understanding of the components of surgical competence and implementation of evidence based tools for training and assessment of these competencies.
Training in the private sector: what works and how do we increase opportunities?
Authors: Watters David A. K. , D’Souza B. , Guest G. , Wardill D. , Levy S. , O’Keefe M. , Crowley S.
Published: March 2009

In Australia 61% of elective surgery takes place in private hospitals where current opportunities for surgical education and training (SET) are limited. The situation will shortly be compounded because of the large increase in local medical graduates, many of whom will aspire to be surgeons. How and where to train these extra surgeons to meet the expanding needs of the community must be addressed. Two models of private sector training are reviewed both of which involved combined training in both private and public sectors. Two second‐year (SET 2) positions were created from one public hospital SET position by using the private sector for 3.5 days per week for 3 months of a 6‐month rotation. The second model was applicable to post‐fellowship training with a fairly even split between public and private sector responsibilities. In the first year, four registrars shared the two 6‐month rotations for the SET 2 position. Trainees did the required minimum procedures (range 109–139) with primary operating targets of 20–25% (range 21–32%). The post‐fellowship position in colorectal surgery was greatly enhanced by the private sector involvement with regard to operating experience as well as meeting part of the remuneration of the trainee. Successful models for training within the private sector in Australia can be found. To expand training in the private sector there will need to be a cultural shift in the perceptions of surgeons, patients, administrators, and trainees. Funding for posts may be available to those private hospitals that can meet the Royal Australasian College of Surgeons’ accreditation standards for posts and hospitals.
Experience matters: comparing novice and expert ratings of non‐technical skills using the NOTSS system
Authors: Yule Steven , Rowley David , Flin Rhona , Maran Nikki , Youngson George , Duncan John , Paterson‐Brown Simon
Published: March 2009

There is growing evidence that non‐technical skills (NTS) are related to surgical outcomes and patient safety. The aim of this study was to further evaluate a behaviour rating system (NOTSS: Non‐Technical Skills for Surgeons) which can be used for workplace assessment of the cognitive and social skills which are essential components of NTS. A novice group composed of consultant surgeons (n = 44) from five Scottish hospitals attended one of six experimental sessions and were trained to use the NOTSS system. They then used NOTSS to rate surgeons’ behaviors in six simulated scenarios filmed in the operating room. The behaviours demonstrated in each scenario were compared to expert ratings to determine accuracy. The mode rating from the novice group (who received a short training session in behaviour assessment) was the same as the expert group in 50% of ratings. Where there was disagreement, novice raters tended to provide lower ratings than the experts. Novice raters require significant training in this emerging area of competence in order to accurately rate non‐technical skills.
Evolution of the OSCA–OSCE–Clinical Examination of the Royal Australasian College of Surgeons
Authors: Serpell Jonathan W.
Published: March 2009

The Objective Structured Clinical Assessment (OSCA) was introduced by the Royal Australasian College of Surgeons in 1990. Over the last 5 years important changes have been made to the format of the examination to improve the processes of the examination overall and its reliability and validity. Competency scores have been introduced to comprise 25% of the score for each station to allow an additional judgement by the examiner of clinical competence beyond the structure objective marking scale. The examination has changed to a purely clinical examination with an increase in stations from 12 to 16 and deletion of the written component. The name has progressively changed from OSCA to Objective Structured Clinical Examination to Clinical Examination. The roles of the clinical committee have been refined and a database of station questions has been developed. This enables a blueprint matrix of clinical skills and specialty classifications to ensure a broad representation of stations on each examination. The database also allows information to be collected about the performance of stations and statistical analysis has shown the current clinical exam to have an overall reliability of approximately 0.7, which is a good level of reliability. Progressively stations with low correlation are being reduced and reproducibility across multiple centres is being assessed. In the 18 years since this examination was introduced multiple changes have refined the processes, reliability and validity of the examination.
Evolution of the final fellowship examination
Authors: Panting Allan , Black Robert
Published: March 2009

The Royal Australasian College of Surgeons Final Fellowship or exit examination, common to nine surgical specialties, has undergone substantial change since the beginning of formal assessment in 1934. These changes reflect the altered requirements of the different specialties and developments in examination techniques and technology. Although there is now some variation between specialties in the format of each segment of the examination, consistency remains with seven segments of the examination being common to all specialties – two written papers, two clinical segments and three vivas. Approval for Fellowship, indicating success in the examination, is the responsibility of the full Court of Examiners although guided by each Specialty Court. During the past decade the examination has become more structured and objective and all candidates experience similar assessment. Considerable work has been undertaken to ensure that the examination process is appropriate and fair. A review of examination outcomes 2001–2007 shows some variation between specialties. Although the basis for this is multifactorial, some differences between Specialty Courts of Examiners in the structure of the examination and the assessment process may be small contributory factors. With an increased emphasis on competence‐based assessment during training the form of this exit examination will continue to evolve.
Guide to the Assessment of Competence and Performance in Practising Surgeons
Authors: Dickinson Ian , Watters David , Graham Ian , Montgomery Pam , Collins John
Published: March 2009

Surgical performance is increasingly under public scrutiny and non‐technical behavioural issues are more frequently the focus of complaints. Currently, there is a lack of a suitable framework or template to assist surgeons in the assessment of their own performance or that of their colleagues. A Royal Australasian College of Surgeons (RACS) Working Party considered the methods currently available to define and assess surgical performance. The scope included assessment tools, resources available, and support for surgeons. The Non‐Technical Skills for Surgeons (NOTSS) programme developed by the Royal College of Surgeons, Edinburgh and the School of Psychology, University of Aberdeen was of particular interest. This programme was reviewed, adapted and expanded. The nine RACS competencies were used as the foundation for developing a set of three behavioural patterns within each competency domain. Each behavioural pattern was then described by a set of eight behavioural markers – describing four good and four poor behaviours. A variety of resources were identified to assist surgeons, including College and other similar courses and guidelines, publications covering professionalism‐and health issues and support through various agencies. It was recognized that the College has a role to support its Fellows and to ensure any review of performance is conducted impartially, competently and confidentially. The resulting guide was approved by College Council in June 2008 and later distributed to Fellows and hospitals throughout Australia and New Zealand. It is intended to be used for self‐reflection and self‐assessment, although it could equally be used as a template for the review of an individual surgeon’s performance by a clinical director of surgery or other agency. Considerable progress has been made in the assessment of performance of practising surgeons. This guide has been published to address performance issues across all RACS competencies. It also outlines a variety of assessment methods and strategies to support surgeons.
Five‐year longitudinal effect of radical perineal prostatectomy on health‐related quality of life in Japanese men, using general and disease‐specific measures
Authors: Inoue Shogo , Shiina Hiroaki , Hiraoka Takeo , Wake Koji , Sumura Masahiro , Honda Satoshi , Urakami Shinji , Igawa Mikio , Usui Tsuguru
Published: March 2009

OBJECTIVE

To investigate the longitudinal alteration of health‐related quality of life (HRQL) up to 5 years after radical perineal prostatectomy (RPP) among Japanese patients with localized prostate cancer.

PATIENTS AND METHODS

In all, 194 patients who had RPP were included in this longitudinal survey. The validated RAND 36‐Item Health Survey (SF‐36) and the University of California, Los Angeles Prostate Cancer Index (UCLA‐PCI) were used to evaluate the HRQL.

RESULTS

Among the UCLA‐PCI urinary domains, urinary function scores decreased at 3 months after RPP, but they increased 6 months after RPP. Likewise, urinary bother showed a transient decrease at 3 months, but had returned to the baseline level 6 months after RPP. Sexual function (SF) was drastically decreased at 3 months after RPP, but had slightly increased 1 year after RPP. Patients who had a nerve‐sparing (NS) RPP showed better SF‐related HRQL than those who did not at 6 months after RPP. This favourable alteration involving SF‐related HRQL was closely associated with the NS procedure, but not with the patient age. Multivariate analysis showed that later recovery of SF was essentially related to the use of NS RPP, while early recovery of sexual bother was closely related to the patient age.

CONCLUSIONS

Our results confirmed the positive effect of RPP on the long‐term HRQL in Japanese patients. Although NS surgery conferred the benefit of the recovery of SF, older Japanese patients were not greatly concerned about their decreased SF‐related HRQL. The current results provide primary evidence for predicting the alteration of HRQL and understanding the effect of patient age and NS surgery on HRQL after RPP.
Microbiological tined‐lead examination: does prolonged sacral neuromodulation testing induce infection?
Authors: Huwyler Mirjam , Kiss Gustav , Burkhard Fiona C. , Madersbacher Helmut , Kessler Thomas M.
Published: March 2009

OBJECTIVE

To investigate whether prolonged sacral neuromodulation (SNM) testing induces a substantial risk of infection because of the percutaneous passage of the extension wire.

PATIENTS AND METHODS

A consecutive series of 20 patients with negative prolonged SNM testing for ≥14 days who underwent tined‐lead explantation were prospectively evaluated. The explanted tined leads were sent for microbiological examination. The tined lead, gluteal, and extension wire incision sites were investigated for clinical signs of infection according to the Centers for Disease Control and Prevention classification system.

RESULTS

In all, 17 patients had bilateral and three unilateral implanted tined leads. The median (range) test period was 30 (21–62 days). Bacterial growth (Staphylococcus species) was detected in four of 20 (20%) patients on seven of 37 (19%) explanted tined leads. There were clinical signs of infection in one of 20 (5%) patients at none of 37 tined lead, one of 20 (5%) gluteal, and none of 20 extension wire incision sites. There were no clinical signs of infection in the remaining three of four patients with bacterial growth.

CONCLUSIONS

After prolonged tined‐lead testing, we found an infection rate comparable to that reported with the usual short test period. In addition, most patients with bacterial growth on tined leads showed no clinical signs of infection. Thus, prolonged tined‐lead testing does not seem to induce clinically relevant infection, warranting randomized trials.
The 7‐year outcome of the tension‐free vaginal tape procedure for treating female stress urinary incontinence
Authors: Song Phil Hyun , Kim Young Don , Kim Hyun Tae , Lim Hwa Su , Hyun Chang Ho , Seo Joon Hyung , Yoo Eun Sang , Park Choal Hee , Jung Hee Chang
Published: March 2009

OBJECTIVE

To evaluate the long‐term results and predictive risk factors for efficacy after the tension‐free vaginal tape (TVT) procedure for treating female stress urinary incontinence (SUI).

PATIENTS AND METHODS

Inall, 306 women (mean age 50.7 years, sd 8.7) who had a TVT procedure for SUI were selected and followed ≥7 years (mean 92.3 months, range 84–110) after surgery. We analysed the long‐term results, the variables predictive of cure rates, and patient satisfaction.

RESULTS

The overall 7‐year cure rate was 84.6%, with a satisfaction rate of 69.3%. The cure rates were lower in patients with high‐grade SUI (50% in grade III, 82.8% in grade II and 90.7% in grade I; P < 0.001). On multivariate analysis, there were no independent risk factors related to cure rate, and urgency was the only factor independently associated with patient satisfaction (P = 0.008; odds ratio 2.47). Seventy‐one patients (23.2%) had complications at the 1‐month follow‐up after surgery, but only eight (2.6%) had complications at the 7‐year follow‐up, including mesh exposure in six and de novo urgency in two.

CONCLUSION

The absence of long‐term adverse events associated with the TVT procedure, and high subjective and objective 7‐year success rates with no independent predictive factors affecting the long‐term cure rate, make the TVT procedure a recommendable surgical treatment for female SUI.
On the Development of Harmonious and Obsessive Passion: The Role of Autonomy Support, Activity Specialization, and Identification With the Activity
Authors: Mageau Geneviève A. , Vallerand Robert J. , Charest Julie , Salvy Sarah‐Jeanne , Lacaille Nathalie , Bouffard Thérèse , Koestner Richard
Published: March 2009

ABSTRACT
Recent research (Vallerand et al., 2003) has supported the existence of two types of passion for activities: a harmonious and an obsessive passion. The purpose of this investigation was to study the processes likely to lead to the development of passion. Three studies using correlational and short‐term longitudinal designs with varied populations ranging from beginners to experts reveal that identification with the activity, activity specialization, parents' activity valuation, and autonomy support predict the development of passion. Furthermore, results show that children and teenagers whose environment supports their autonomy are more likely to develop a harmonious passion than an obsessive one. Conversely, children and teenagers who highly value activity specialization, who rely heavily on their activity for self‐definition, and whose parents highly value the activity are more likely to develop an obsessive passion.
Early Personality Traits as Predictors of Mortality Risk Following Conjugal Bereavement
Authors: Taga Keiko A. , Friedman Howard S. , Martin Leslie R.
Published: March 2009

ABSTRACT
This study explored pre‐bereavement personality traits and gender as predictors of post‐widowhood mortality risk, using newly derived life span data for participants originally recruited for Lewis Terman's classic study of the gifted. Personality traits measured in 1940 were used to predict mortality risk from 1940 through 2004 for married participants who were either widowed between 1940 and 1986 or who remained married. Results indicated that widowhood predicted a decrease in mortality risk for these (intelligent) individuals (relative hazard [rh]=0.68, N=843, p<.001) and neuroticism significantly moderated this effect. Specifically, neuroticism in young adulthood was significantly associated with decreased mortality risk among men who were later widowed (rh=0.50, N=66, p<.02) but not among women or consistently married men. Conclusions reveal the importance of personality–situation interactions and the adoption of a long‐term perspective.
Friend or Foe? Differential Use of the Self‐Based Heuristic as a Function of Relationship Satisfaction
Authors: Weller Joshua , Watson David
Published: March 2009

ABSTRACT
We report two studies investigating whether relationship satisfaction differentially influences the use of the “self‐based heuristic” (SBH) or the degree to which an individual's own characteristics contribute to ratings of another's personality. Individuals rated themselves, a friend, and a person with whom they have experienced significant conflict (a “foe”); ratings were made on measures of the Big Five and trait affectivity. Replicating previous research, judges made greater use of the SBH when rating trait affectivity than when rating the Big Five. In addition, individuals were more likely to utilize the SBH when rating friends than when rating foes. Further, relationship satisfaction made significant independent contributions in accounting for the variance in trait ratings of others. These findings extend our understanding of the mechanisms involved with person perception beyond observable trait‐related information.
Political Market Power Reflected in Milk Pricing Regulations
Authors: Ahn Byeong‐Il , Sumner Daniel A.
Published: March 2009

We investigate revealed political market power reflected in the pattern of price discrimination by end use that is the hallmark of U.S. milk marketing orders. We show that the pattern of prices that would maximize producer profits, if producers operated a cartel with monopoly power in a regional market, is far above actual government‐set price differentials between milk used for fluid products and that used for manufactured products. The pattern of actual price differentials is consistent with political welfare weights for producers relative to consumers that are small compared to the weights that would yield maximum producer profits.
Aid, Volatility, and Growth Again: When Aid Volatility Matters and When it Does Not
Authors: Chauvet Lisa , Guillaumont Patrick
Published: March 2009

In previous papers the authors have argued that aid is likely to mitigate the negative effects of external shocks on economic growth (i.e. that aid is more effective in countries which are more vulnerable to external shocks). Recently an important debate has emerged about the possible negative effects of aid volatility itself. However, the cushioning effect of aid may involve some volatility in aid flows, which then is not necessarily negative for growth. In this paper the authors examine to what extent the time profile of aid disbursements may contribute to an increase or a decrease of aid effectiveness. They first show that aid, even if volatile, is not clearly as pro‐cyclical as is often argued, and, even if pro‐cyclical, is not necessarily destabilizing. They measure aid volatility by several methods and assess pro‐cyclicality of aid with respect to exports, thus departing from previous literature, which usually assess pro‐cyclicality of aid with respect to national income or fiscal receipts. The stabilizing/destabilizing nature of aid is measured by the difference in the volatility of exports and the volatility of the aid plus export flows. Then, in order to take into account the diversity of shocks to which aid can respond, they consider the effect of aid on income volatility and again find that aid is making growth more stable, while its volatility reduces this effect. They finally show through growth regressions that the higher effectiveness of aid in vulnerable countries is to a large extent due to its stabilizing effect.
New Model‐assisted Estimators for the Distribution Function Using the Pseudo Empirical Likelihood Method
Authors: Rueda M. , Muñoz J.F.
Published: March 2009

This paper proposes using a model‐assisted approach based on the pseudo empirical likelihood method to construct estimators for the finite population distribution function. It shows that the proposed sample‐based estimators are genuine distribution functions that exhibit several attractive features, such as the fact that they do not depend on unknown parameters, and good performance at any argument is expected to be obtained. Consequently, estimation of other measures, such as quantiles, is a problem that is efficiently addressed by the proposed methodology and applications in various areas are therefore derived. Simulation studies based upon real and artificial populations show that the proposed estimators perform better than the existing ones. A practical situation in which the proposed estimators can be applied is also described.
Infrastructure Investment and Maintenance Expenditure: Optimal Allocation Rules in a Growing Economy
Authors: AGÉNOR PIERRE‐RICHARD
Published: March 2009

This paper studies the allocation of public expenditure between infrastructure investment and maintenance in an endogenous growth framework. In the basic model, maintenance spending affects both the durability and efficiency of public capital. The balanced growth path is derived and transitional dynamics associated with a revenue‐neutral increase in expenditure on maintenance are analyzed. The model is then extended to account for the possibility that public spending on maintenance affects also the durability of private capital. The growth‐maximizing tax rate and share of infrastructure investment are calculated in both cases. First‐ and second‐best welfare‐maximizing solutions are also discussed.
The developmental nature of meta‐cognition and the relationship between knowledge and control over time
Authors: Schmitt Maribeth Cassidy , Sha Shuying
Published: March 2009

This study explored the development of meta‐cognitive knowledge and control, the relationship between the two constructs, the types of strategy knowledge Chinese students consider valuable and comparisons with US children's knowledge of strategies at the third‐grade level. One hundred and twenty students were randomly sampled from third‐, fifth‐ and seventh‐grade classes in China. Control was operationalised as comprehension monitoring and measured with CLOZE and Error Detection tasks, while awareness comprised declarative knowledge of strategies and was measured using an interview and a questionnaire. The findings indicated that knowledge of strategies and meta‐cognitive control develop over time, but knowledge develops at a faster rate in comparison. The evaluation of the relationships between the constructs suggested that the measurement format affected the students' accessibility of the declarative knowledge. The Chinese students demonstrated similarities in their knowledge of useful strategies, with previewing and activating background knowledge as the most valued strategies.
Gender differences in reading ability and attitudes: examining where these differences lie
Authors: Logan Sarah , Johnston Rhona
Published: March 2009

The aim of this study was to investigate gender differences in the relationship between reading ability, frequency of reading and attitudes and beliefs relating to reading and school. Two hundred and thirty‐two 10‐year‐old children (117 male) completed a reading comprehension test and a questionnaire exploring the following areas: frequency of reading, attitude to reading, attitude to school, competency beliefs and perceived academic support (from peers and teacher). Overall, girls had better reading comprehension, read more frequently and had a more positive attitude to reading and school. However, smaller gender differences were found in reading ability than in attitudes and frequency of reading. Indeed, effect sizes for gender differences in reading were found to be small in this and other studies. Reading ability correlated with both boys' and girls' reading frequency and competency beliefs; however, only boys' reading ability was associated with their attitude to reading and school. Notably, gender differences were found predominantly in the relationship between factors, rather than solely in the factors themselves. Previous research has neglected to study these relationships, and has focused instead on the gender differences found in individual factors. Conclusions are made regarding the applicability of these findings to the school situation.
Learning to read in Russian: effects of orthographic complexity
Authors: Kerek Eugenia , Niemi Pekka
Published: March 2009

Much attention has been paid to the delay in writing acquisition caused by irregularities of Russian orthography, but little is known about their effect on reading acquisition. Results of the present longitudinal reading acquisition study of Russian first graders suggest that phonological recoding is the dominant strategy in the initial phase of reading development in Russian, while there is evidence of gradual shift towards orthographic processing in reading high‐frequency regular words. The study confirms that Russian readers encounter difficulties in reading orthographically complex words, where phonological recoding does not completely succeed. These findings are compared with results of reading acquisition studies in other orthographies, and their relevance for models of reading acquisition in different types of orthographies is discussed.
Preschool cognitive and language skills predicting Kindergarten and Grade 1 reading and spelling: a cross‐linguistic comparison
Authors: Furnes Bjarte , Samuelsson Stefan
Published: March 2009

The importance of cognitive and language skills on reading and spelling development were investigated in a cross‐linguistic longitudinal study of 737 English‐speaking children (US/Australia) and 169 Scandinavian children (Norway/Sweden) from preschool to Kindergarten and Grade 1. The results revealed that phonological awareness and print knowledge were the strongest predictors of early reading and spelling across orthographies. The contribution from rapid naming to literacy development was low in Kindergarten, but similar to that of phonological awareness and print knowledge in Grade 1. The present study identified a significant difference across orthographies in the effects of print knowledge and general verbal ability on spelling in Kindergarten. However, this pattern was explained by cultural rather than orthographic differences. The results indicate that cognitive and language skills underlying early reading and spelling development are similar across alphabetic orthographies.
House Guest of the AEC: Dorothy Hutchinson, the 1958 Fast at the Atomic Energy Commission, and the Domestication of Protest
Authors: Hostetter David
Published: March 2009

Quaker peace activist Dorothy Hutchinson joined a fast against nuclear weapons testing at the Atomic Energy Commission (AEC) headquarters during Mother's Day weekend in 1958. Supporting the crew of the Golden Rule, then in jail in Honolulu for sailing into a nuclear testing zone, the fasters demanded a meeting with AEC chairman Lewis Strauss. The protest helped the Golden Rule's message resonate with the political culture of the day. Hutchinson's activism combined successfully the pragmatic peace activism of the years between the world wars with the direct action protest born from the existential angst of the nuclear age.
Re‐imaging War: The Voice of Women, the Canadian Aid for Vietnam Civilians, and the Knitting Project for Vietnamese Children, 1966–1976
Authors: Early Frances
Published: March 2009

This essay focuses on a humanitarian knitting project to make dark camouflaged clothing for Vietnamese children residing in combat zones that was sponsored by the most significant Canadian peace association of the Vietnam War era, the Voice of Women/La Voix des Femmes (VOW). VOW members were inspired by an influential Canadian humanitarian group and aided by other North American women's peace groups—notably Women Strike for Peace and the Women's International League for Peace and Freedom. I will argue that the members of VOW sought to disrupt and contest the stereotypic Western image of the compliant and uncritical woman war worker by challenging an essentialized image of a girl or woman knitting for “her boys” during wartime. By placing the implicitly motherly female knitter in the service of the victimized Other (Vietnamese children), VOW women and their like‐minded sister peace activists in the United States helped to recast in critical fashion the hegemonic male‐privileged discourse of war in a manner unique to their gender and time.
Cindy Sheehan and the Rhetoric of Motherhood: A Textual Analysis
Authors: Knudson Laura
Published: March 2009

Through her peace work, Cindy Sheehan helped bolster the U.S. antiwar movement. Relying on her identity as the mother of a soldier who was slain during active duty in Iraq, Sheehan captured the media spotlight through increasingly outspoken and public ways that include the sit‐ins she staged outside of President George W. Bush's ranch in Crawford, Texas, and the “Open Letter to George Bush” she published in November 2004. In this essay, I examine the rhetoric surrounding Sheehan's peace activism and attend to the ways in which the rhetoric hinges on conflicting views about war, motherhood, and activism. Maternal activism is certainly not a new phenomenon. However, media coverage of Sheehan provides ample evidence of the constantly shifting nature of definitions of “good” and “bad” mothering in early twenty‐first‐century America. Through an examination of Sheehan's own book, Peace Mom, and a book written to counter it, American Mourning by Catherine Moy and Melanie Morgan, I demonstrate the central role that discourses of motherhood play in Sheehan's ability to craft a maternal politics of peace.
Like Agamemnon and Clytemnestra: Ilse Langner's Gendered Perspective on the Politics of War and the Prospects for Peace
Authors: Kutch Lynn Marie
Published: March 2009

In her politically influenced plays and essays, German author Ilse Langner (1899–1987) rigorously analyzes her own gendered theories concerning war, peace, and guilt. This article views Langner's drama Klytämnestra (1947) along with the author's subsequent essays on peace theory as a framework for investigating her observations on the evolving relationship between German politics and gender roles. The belligerent atmosphere of Germany in the 1930s and 1940s forced Langner to recalibrate her previously rigid and traditional paradigms of male and female war involvement. After allegorically treating a temporary interruption marked by female aggressiveness with Klytämnestra, Langner returns to the notion of the enduring female role of maternal peacemaker in her theoretical writings (1946–1948). The assertion that women have the inherent ability and responsibility to administer peace in the postwar era directs Langner's work into ongoing gendered debates surrounding women's accountability for wartime violence.