bluuebunny/crossref_metadata_2025 huggingface dataset:
Using the Clarion® Cochlear Implant in Cochlear Ossification
Authors: Bird Philip A. , Butts Stacy , Balkany Thomas J. , Gomez Orlando , Hodges Annelle V. , Lee David
Published: January 2017

This paper is a retrospective review of 5 patients with various degrees of cochlear ossification who were implanted with the CLARION® Multi-Strategy™ Cochlear Implant. Preoperative computed tomography scans, intraoperative findings, surgical technique, and hearing outcomes are discussed in a case report format. Full implantation was achieved in all cases by a systematic approach that included drill-through of proximal obstruction (2 cases), scala vestibuli insertion (2 cases), and complete drill-out (1 case). The only complication was delayed wound healing in a patient with sickle cell disease, chronic active hepatitis, and steroid dependency on antimetabolite therapy. Early results show that the 4 patients with at least 3 months of experience have a mean open-set sentence recognition score of 55% and a mean open-set word recognition score of 24%. The conclusion is that implantation of the Clarion device in ossified cochleas can be successful in all degrees of ossification and can provide significant hearing benefit.
Simultaneous Analog Stimulation (SAS)–Continuous Interleaved Sampler (CIS) Pilot Comparison Study in Europe
Authors: Battmer Rolf D. , Haake Philip , Zilberman Yitzak , Lenarz Thomas
Published: January 2017

The recent availability of the enhanced bipolar electrode array in the CLARION® Multi-Strategy™ Cochlear Implant has permitted clinicians to fit patients successfully with the Simultaneous Analog Stimulation (SAS) strategy by means of bipolar coupling. Out of 22 consecutively implanted subjects, 20 subjects could be fitted with both Continuous Interleaved Sampler (CIS) and SAS strategies. Their performance was evaluated up to 3 months postoperatively. Speech perception results, as well as the patient's preference for either CIS or SAS, were examined. It was found that half of the subjects selected SAS as their preferred strategy and that the use of a preferred strategy resulted in higher overall patient performance. Further analyses showed that those subjects preferring SAS had higher electrode impedance values and lower threshold and most comfortable loudness levels than subjects preferring CIS. We presume that these psychophysical findings are, in part, related to the position of the intracochlear electrode array. Specifically, SAS users may have a more modiolus-hugging electrode array position.
SAS-CIS Preference Study in Postlingually Deafened Adults Implanted with the Clarion® Cochlear Implant
Authors: Osberger Mary Joe , Fisher Laurel
Published: January 2017

This study examined the speech perception performance of 71 postlingually deafened adults implanted with the CLARION® Multi-Strategy™ Cochlear Implant. After 3 months of implant use, one third of the patients (n = 23) preferred to use the Simultaneous Analog Stimulation (SAS) strategy, and two thirds of them (n = 48) chose to use the Continuous Interleaved Sampler (CIS) strategy. The mean CID sentence scores were similar for the SAS and CIS user groups at the 3-month postoperative interval. In contrast, the mean CNC word score of the SAS users was significantly higher than the mean score of the CIS users after 3 months of implant experience. Patients who preferred to use SAS demonstrated significantly shorter duration of deafness at time of implantation than did the CIS users, whereas the CIS users demonstrated significantly higher preoperative sentence recognition scores than the SAS users. The results suggested that access to a preferred processing strategy improved the overall group performance of postlingually deafened adults in the present study compared to the results of previous studies in which only the CIS strategy was available to most patients with the Clarion.
The Effect of Long-Term Deafness on Speech Recognition in Postlingually Deafened Adult Clarion® Cochlear Implant Users
Authors: Geier Lisa , Fisher Laurel , Barker Mary , Opie Jane
Published: January 2017

Research suggests that duration of deafness prior to cochlear implantation affects postoperative speech recognition in adults. Duration of deafness usually is defined as the number of years between the onset of profound deafness and implantation. The purpose of this study was to examine the effects of duration of deafness — expressed as percentage of life with deafness — independent of age at implantation on postoperative speech recognition in adult postlingually deafened CLARION® Multi-Strategy™ Cochlear Implant users. Speech recognition tests (CID sentences and NU6 words) were administered to 202 consecutively implanted adults preoperatively and at 3 and 6 months after initial device fitting. Patients implanted at a younger age and those with smaller percentages of their lives with deafness achieved the highest levels of short-term postoperative speech recognition. Patients who had been deaf for ≥60% of their lives demonstrated a slower rate of speech recognition improvement than those with shorter durations of deafness, but still continued to improve with increased implant experience.
Implantation of Patients with Prelingual Long-Term Deafness
Authors: Waltzman Susan B. , Cohen Noel L.
Published: January 2017

The purpose of this paper is to provide performance data on long-term congenitally and prelingually deafened children and adults who are implanted with the CLARION® Multi-Strategy™ Cochlear Implant and who use the Continuous Interleaved Sampler (CIS) speech processing strategy. Open-set speech perception was assessed preoperatively and postoperatively with word and sentence recognition tests. Results indicate that a majority of subjects showed improvement from preoperative performance to the last available postoperative evaluation. These results represent a change from previously reported data on a similar population who used earlier speech processing strategies.
Speech Perception Results for Children Implanted with the Clarion® Cochlear Implant at the Medical University of Hannover
Authors: Illg Angelika , Lesinski-Schiedat Anka , von der Haar-Heise Sabine , Battmer Rolf D. , Goldring Jenny E. , Lenarz Thomas
Published: January 2017

The perception of speech of 167 children implanted with a CLARION® Multi-Strategy™ Cochlear Implant (1.2 device) was evaluated preimplantation and at 3, 6, 12, 18, and 24 months postimplantation. The children were between 15 months and 15 years of age. The test materials consisted of 8 tests involving syllable structure, single- and 2-syllable words, differentiation of word pairs, and sentences. Two difficulty levels were used, depending on developmental age (<7, and 7 to 15 years). There was an improvement in test scores over time for both age groups. The younger children (particularly those under age 4) improved steadily over the first 2 years, while the older children tended to plateau between 12 and 18 months after implantation. These findings demonstrate that deaf children up to 15 years old benefit from cochlear implants. Children under 4 years of age may even have the ability to compensate for delays in speech development before they reach school age.
Comparison of Speech Perception in Pediatric Clarion® Cochlear Implant and Hearing Aid Users
Authors: Svirsky Mario A. , Meyer Ted A.
Published: January 2017

Multichannel cochlear implants (CIs) allow many profoundly deaf children to achieve high levels of speech perception. In order to develop optimal criteria for implantation, it is crucial to test representative samples (or, if possible, full populations) of CI users and compare their results to those of hearing aid (HA) users of the same age and communication mode (oral or total communication) to determine which subgroups of HA users may obtain more perceptual benefit from a CI than from an HA. Word and phoneme identification skills of deaf children who use either HAs or CIs were evaluated and compared. The CI group included all of the prelingually deaf children in the United States who were implanted with the CLARION® Multi-Strategy™ Cochlear Implant during the clinical trial (as of January 1998). Before implantation, the mean scores on the PB-K test (scored phonemically) were lower for prospective CI users than for HA users. However, by 12 to 18 months postimplantation, the average scores for the CI users were higher than those of HA users with residual hearing in the 1010– to 110–dB hearing level (HL) range. The CI scores were similar to those of HA users with residual hearing in the 90– to 100–dB HL range.
Language Development in Children Implanted with the Clarion® Cochlear Implant
Authors: Robbins Amy McConkey , Bollard Priscilla M. , Green Janet
Published: January 2017

This study examined the development of language skills in 23 prelingually, profoundly deaf children following implantation with the CLARION® Multi-Strategy™ Cochlear Implant. Language skills were assessed with the Reynell Developmental Language Scales (RDLS) preoperatively with hearing aids, and compared to postoperative performance after 6 months of Clarion use. The RDLS was administered in each child's preferred mode of communication, either spoken English alone or simultaneous spoken and signed English. Significant improvements were observed in average age-equivalent scores over time, both for receptive and expressive skills, although the absolute language levels of the implanted children remained delayed relative to those of hearing peers of the same chronological age. The children's rate of language growth in the first 6 months of implant use also was calculated. The results from this analysis showed that the Clarion children, on average, progressed at a rate that exceeded that of normal-hearing children of the same language age. There was no significant difference between the language performance of children who used oral versus total communication.
Laser Surgery for Allergic and Hypertrophic Rhinitis
Authors: Inouye Tetsuzo , Tanabe Tetsuya , Nakanoboh Manabu , Ogura Masami
Published: January 2017

Laser surgery, which is one type of surgical treatment for allergic and hypertrophic rhinitis, was investigated basically and clinically. The basic investigation showed morphological changes in the nasal mucosa before and after laser surgery. Before laser surgery, hyperplasia of the mucous epithelium, thickening of the basement membrane, edema of the lamina propria mucosa, eosinophilic infiltration, and enlargement of the nasal glands were noted. After laser surgery, the nasal mucosa was covered with 1) epithelium that was squamatized or cuboidal and/or 2) columnar epithelium that was stratified. Granulation-like tissue or cicatricial tissue was found in the lamina propria mucosa. Clinically, we performed laser surgery in 204 cases. Regarding the short-term results, laser surgery was effective in 87%. In the long term, the short-term results persisted in 81% of cases treated for sneezing, 78% for nasal discharge, and 76% for nasal obstruction. From these results, we concluded that laser surgery was a useful surgical treatment for allergic and hypertrophic rhinitis.
Estimating the Mean and Variance of a Normal Distribution from Singly and Doubly Truncated Samples of Grouped Observations
Authors: Swamy P. S.
Published: January 2017

Summary

The maximum likehood estimating equations are derived to estimate the mean and variance of a normal distribution from singly and doubly truncated samples of grouped observations with known truncation points, when the number of unmeasured observations is (1) unknown for each “truncated tail”, (2) known separately for each “trucated tail”, (3) known jointly for the two “truncated tails”. The equations are seen to be easily solvable with the aid of Gjeddebaek's (1949) tables of Z1 and Z2 functions. Asymptotic variance‐covariance matrix of the estimates is obtained in each of the three cases, and an investigation is made into the loss of information due to truncation of the samples. The corresponding results for the singly truncated samples are obtained as special cases of (1) and (2). Practical application of the results has been illustrated by a numerical example.
On the Factorial Approach Multilateral Index Number System Satisfying base Invariance and Consistency
Authors: Banerjee K. S.
Published: January 2017

ABSTRACT:

The factorial approach multilateral index number system (FMS), as it is, is not base invariant and consistent. It is indicated in this paper how the FMS can be made to meet these requirements by way of a logarithmic transformation. The transformation leads to new multilateral index number formulae for price and quantity, which are found to be simple in form and which satisfy the basic axioms and the important tests. The new formulae are fully derived and illustrated, and the indices compared with those from some other systems.
Parameter Estimation in Nonlinear Regression
Authors: Bhattacharyya B. B. , Richardson G. D.
Published: January 2017

ABSTRACT:

A restriction generally imposed when proving consistency results in nonlinear regression is that the parameter space be compact. The authors relax this assumption; indeed, the parameter space includes all separable metric spaces. A nonlinear regression model having random regressors is studied.
Tests for Independence in Two-Way Contingency Tables Based on Canonical Analysis
Authors: Tsai Ming–Tan M. , Sen Pranab Kumar
Published: January 2017

ABSTRACT:

The canonical structure of a two‐way contingency table is emphasized to derive union‐intersection (Ul‐) tests for independence between two categorical variables. In this context, special attention has been paid to the so‐called step‐down procedure (which is a variant of the UI‐procedure Some properties of this procedure and computational algorithms are considered and a sequential way for identifying the adequate model is presented.
Improvement in Stein's Procedure using a Random Confidence Coefficient
Authors: Ghosh J. K. , Mukerjee Rahul
Published: January 2017

ABSTRACT:

With reference to Stein's two‐stage sampling, it is shown that with a suitably chosen random confidence coefficient, depending on second stage variation, one can be closer in the mean square sense to the indicator specifying whether a normal mean lies in a bounded length confidence interval, than the constant confidence coefficient 1‐α. The efficiency of the constant confidence coefficient 1‐α. as a predictor of this indicator, has also been investigated.
Multivariate Stable Distributions, a Natural Generalization of Cauchy Law and some Related Questions
Authors: Ghosh Pankaj
Published: January 2017

ABSTRACT:

A multivariate stable distribution is characterized in terms of the stability of the distributions of all linear compounds of the variables. The multivariate Cauchy law is seen to be stable as well as type 1 unimodal. Some questions on the possible decomposition of the same are raised.
Construction and Combinatorial Problems of Higher Associate Cyclic Pbib Designs
Authors: Adhikary Basudeb , Saha Tapas Kumar
Published: January 2017

ABSTRACT:

Properties of Higher Associate Cyclic (HAC) association scheme and its relation to Generalised Cyclic (GC' n) designs and some other similar designs have been studied, Following results have been established : (i) Associatiun schemes involved in GC/ n designs are HAC (ii) Any HAC scheme having Jess than the maximum possible number of -associate classes can be obtained only by amalgamating a number of associate classes. (iii) GC/1 designs wiih factorial structure (John 1973b) are isomorphic to GC/2 designs. (iv) Some well known association schemes have been shown to be particular cases of HAC association scheme. (v) A method of construction has been discussed.
On the Frequentist Proper Ties of Some Hierarchical Bayes Predictors in Finite Populattion Sampling
Authors: Datta Gouri Sankar , Ghosh Malay
Published: January 2017

ABSTRACT:

The paper shows that certain hierarchical Bayes (HB) predictors in general mixed linear models “universally” or “stochastically” dominate all linear unbiased predictors. Also, the HB predictors are the best within the class of all equivariant predictors under a certain group of transformations.

AMS 1980 Subject Classification: 62F15, 62F10.
Estimating a Finite Population Variance Under Some General Linear Models with Exchangeable Errors
Authors: Mukhopadhyay P. , Bhattacharyya S.
Published: January 2017

ABSTRACT:

Optimal estimation of a finite population variance has been considered under some exchangeable general linear models. The robustness of the optimal strategies under a class of alternative models has been examined. Sampling designs ensuring near unbiasedness have been investigated.
On the Construction of Some New Series of PBIB Designs and Some New Series of OA vs of Strength Two
Authors: Pal Satyabrata , Goswami Kalyan Kumar , Majumdar Anurup
Published: January 2017

ABSTRACT:

A method of construction of PBID designs with three and two associate classes respectively has been presented. The method provides a new class of rectangular designs and some new PBIB designs with two associate classes and is based on Q2–arrays. A general method of construction of orthogonal arrays of strength two with various symbols in rows through Q2 arrays has also been developed.
Multi‐Stage Estimation Procedures for the Mean OE A U‐Statistic and Some Associated Moderate Sample Size Comparisons
Authors: Mukhopadhyay Nitis , Moreno Mabel
Published: January 2017

ABSTRACT :

In this paper we estimate the mean of a U‐statistic when the distribution in the population from where the independent samples are taken is unspecified. We develop two‐stage and three‐stage minimum risk, with squared error loss plus linear cost, point estimation procedures which are both asymptotically risk efficient. These multistage procedures are also operationally much simpler than Sen and Ghosh's (1981)purely sequential scheme. The performances of these three procedures are then compared via computer simulation for mode rate sample sizes under a few specific types of population distributions.

1980 AMS Subject classifications: 62Ll2, 62G05.
A Stability Property of the Linear Growth Birth and Death Process Under Restricted Power Series Distributions
Authors: Roy Dilip
Published: January 2017

ABSTRACT :

Recently Ycart has investigated a type of stability property of the linear growth Birth and Death Process according to which if the initial distribution is binomial or Poisson then it remains the same at any subsequent point of time. We have generalised this stability property under the wider class of restricted power series distributions.
Lorenz Curve and Gini Index
Authors: Moothathu T. S. K.
Published: January 2017

ABSTRACT :

This is a review article on Lorenz Curve (LC) and Gini index (GI). The focus here is on those aspects of LC and GI which are not reviewed elsewhere. We present here both mathematical and statistical aspects of LC and GI, which include their relevance in economic theory and reliability, and bounds, approximations, extensions and various applications.
Beyond research literature: Occupational therapists’ perspectives on and uses of “evidence” in everyday practice
Authors: Dougherty Deborah A. , Toth-Cohen Susan E. , Tomlin George S.
Published: January 2017

Background.

Recent literature in evidence-based practice indicates that evidence is defined differently from practice and research perspectives. However, few published works address therapists’ perspectives of the nature and use of evidence in everyday practice.

Purpose.

This study describes the definition, types, and use of evidence from the perspective of six school-based occupational therapists.

Method.

Data were collected through focus groups and participant-submitted documentation and analyzed using qualitative and quantitative content analysis.

Findings.

Two categories of evidence emerged: internalized evidence and evidence gathered during the intervention process. Clinical reasoning, identified as a key skill in evidence-based practice, supported the synthesis of therapist internalized evidence with “in-the-moment” evidence gathered from activity, contextual, and occupational analyses of the client.

Implications.

The findings support current literature that has suggested expanding the definition of evidence (i.e., more than research findings alone). Further investigation of evidence building in practice may help in constructing a more inclusive professional culture of evidence-based practice.
Évaluation de l’écriture manuelle d’élèves franco-québécois au début du primaire
Authors: Couture Mélanie , Morin Marie-France , Coallier Mélissa , Lavigne Audrey , Archambault Patricia , Bolduc Émilie , Chartier Émilie , Liard Karolane , Jasmin Emmanuelle
Published: January 2017

Background.

Reasons for referring school-age children to occupational therapy mainly relate to handwriting problems. However, there are no validated tools or reference values for assessing handwriting in francophone children in Canada.

Purpose.

This study aimed to adapt and validate the writing tasks described in an English Canadian handwriting assessment protocol and to develop reference values for handwriting speed for francophone children.

Method.

Three writing tasks from the Handwriting Assessment Protocol–2nd Edition (near-point and far-point copying and dictation) were adapted for Québec French children and administered to 141 Grade 1 ( n = 73) and Grade 2 ( n = 68) students.

Findings.

Reference values for handwriting speed were obtained for near point and far point copying tasks.

Implications.

This adapted protocol and these reference values for speed will improve occupational therapy handwriting assessments for the target population.
Interrater reliability of Western University’s on-road assessment
Authors: Classen Sherrilene , Krasniuk Sarah , Knott Melissa , Alvarez Liliana , Monahan Miriam , Morrow Sarah , Danter Tim
Published: January 2017

Background.

Little empirical support exists for interrater reliability between evaluators from different backgrounds when assessing on-road outcomes of drivers.

Purpose.

We quantified interrater reliability of on-road outcomes between a certified driving school instructor (DI) and an occupational therapist and certified driver rehabilitation specialist (CDRS).

Method.

Both raters used the Global Rating Score (GRS) with two levels (pass, fail), the GRS with four levels (pass, pass with recommendations, fail remediable, fail), and the priority error rating score (PERS; most frequently occurring on-road errors in priority order) to assess 35 drivers (age, M = 48.31 years, SD = 9.76 years; 40% male; 86% with multiple sclerosis).

Findings.

The DI and occupational therapist CDRS had excellent agreement on the GRS with two levels (κ = .892, p < .0001), GRS with four levels (κ = .952, p < .0001), and the PERS (κ = .847–.902, p < .0001), indicating interrater reliability.

Implications.

This research contributes to empirical support for the on-road assessment.
The Performance of Two Tympanic Thermometers in a Pediatric Emergency Department
Authors: Terndrup Thomas E. , Milewski Anne
Published: January 2017

In a prospective, unblinded, controlled study, 303 children underwent comparison of rectal (RT) and right-sided tympanic membrane (TMT) temperatures. Digital electronic thermometers were used for RT, while two different infrared detection devices assessed TMT. The performance of TMT devices were compared using correlation with RT, fever detection, and ease of use. Correlation between RT and the two devices was good, r = 0.70 and r = 0.69, with little influence of patient age on performance. Using receiver operating characteristics curves to assess fever screening. Thermoscan@ performed somewhat better than First Temp@. Staff rated the Thermoscan® as significantly easier to use.
Comparison of a Tympanic Thermometer to Rectal and Oral Thermometers in a Pediatric Emergency Department
Authors: Chamberlain James M. , Grandner John , Rubinoff Jeffrey L. , Klein Bruce L. , Waisman Yeheskel , Huey Margaret
Published: January 2017

We performed a clinical trial of a new tympanic thermometer to test its accuracy in a pediatric emergency department. Tympanic temperature was compared to oral or rectal glass and electronic temperature, depending on the developmental age of the child. Results were controlled for age of the child, cooperation, quantity of cerumen, and the presence or absence of otitis media.

Our results suggest good correlation of tympanic with oral and rectal glass thermometry except in infants less than three months of age. Sensitivity and specificity, respectively, were 80% and 93% for detecting fever of 38°C and 80% and 95% for detecting fever of 38.5°C.
Tympanic Membrane Temperatures Compared to Rectal and Oral Temperatures
Authors: Talo Haitham , Macknin Michael L. , VanderBrug Medendorp Sharon
Published: January 2017

One hundred thirty-seven children at the Cleveland Clinic Foundation were enrolled in a study comparing the accuracy and acceptability of tympanic membrane temperatures taken with Thermoscan® to rectal or oral temperatures taken by IVAC® electronic thermometers.

The mean age of the rectal/ear group was 1.2 ± 0.86 years (range 0.08- 5.0 years) with 22 females and 21 males. The mean age of the oral and ear group was 9.0 ± 4.24 years (range 3 - 18 years) with 44 females and 50 males. Significantly large (p < 0.01) correlation coefficients were present between temperatures in the left ear and right ear (0.92), rectal and mean ear (0.77) and oral and mean ear (0.68). The temperature difference between mean ear and rectal measurements was -1.1° ± 0.51 °C and the temperature difference between the mean ear and oral measurements was -0.20° ± 0.59°C. A relative lack of correlation between ear and oral temperatures was noted with flat tympanograms, otoscopically diagnosed middle ear effusion, and with red-white or red tympanic membranes. However, small subgroup sizes (6-16) may have contributed to this lack of correlation.

Parents and physicians were impressed by the 2.5 second speed of the new technique. However, younger children were nearly as likely to resist and cry with ear as with rectal temperatures. Parents were comfortable with the ease, cleanliness and safety of ear temperatures. While these data indicate a strong correspondence of ear temperatures with oral and rectal temperatures, parents were not as confident of ear temperatures' accuracy. Further public education may be necessary to alleviate minor concerns about the accuracy of tympanic membrane temperature measurements.
lnfrared, Thermistor, and Glass-Mercury Thermometry for Measurement of Body Temperature in Children With Cancer
Authors: Shenep Jerry L. , Adair Janet R. , Hughes Walter T. , Roberson Paula K. , Flynn Patricia M. , Brodkey Terri O. , Fullen Glenda H. , Kennedy Wren T. , Oakes Linda L. , Marina Neyssa M.
Published: January 2017

Body temperature is often the sole determinant of whether or not the neutropenic cancer patient is admitted to the hospital for empiric antibiotic therapy. Recently developed infrared tympanic thermometers offer rapid readings, but their accuracy has not been established. We studied two infrared thermometers (FirstTemp@ and Thermoscan@) and a thermistor (IVAC®) in children with cancer. Mean infrared measurements did not differ significantly between right and left ear canals, and the mean IVAC® temperature did not differ significantly from the left to the right axilla (P > 0.05, paired t test). IVAC® predictive mode mean temperature was 0.2°C lower than monitor mode mean temperature in the axilla (P < 0.0001), but 0.1 °C higher than monitor mode orally (P < 0.0001). Aiming the infrared instrument at the tympanic membrane using an ear tug resulted in a 0.2°C higher mean temperature than casual placement in the ear canal (P < 0.0001). After compensation for the mean difference in reference oral glass-mercury versus test instrument temperatures, the FirstTemp®, Thermoscan®, and oral and axillary predictive mode IVAC® measurements yielded sensitivities for the detection of fever of 84%, 84%, 82%, and 86%; specificities of 100%, 99%, 100%, and 100%; positive predictive values of 100%, 93%, 100%, and 100%; and negative predictive values of 95%, 98%, 98%, and 98%, respectively. We conclude that each of these instruments detects fever with comparable reliability. Infrared instruments are especially attractive alternatives due to their time efficiency.
Effect of Otitis Media on Infrared Tympanic Thermometry
Authors: Kelly Barbara , Alexander David
Published: January 2017

This study was designed to determine if temperature readings using a new tympanic thermometer are affected by otitis media. These readings were also compared to a rectal or oral temperature. Eighty-four children with unilateral suppurative or non-suppurative otitis media diagnosed clinically by their pediatricians were enrolled in the study. Temperatures were measured in both ears using the Thermoscan PRO-1 Instant Thermometer and rectally or orally by a glass or electronic predictive thermometer.

For 67 children with unilateral suppurative otitis media the mean temperature in infected ears was 0.38 degrees Fahrenheit higher than in uninfected ears (p=.005). Neither temperatures measured in affected nor those from unaffected ears differed significantly from oral or rectal control readings. For 17 children with unilateral non-suppurative otitis media there was no statistically significant difference between temperatures in affected and unaffected ears or between the temperatures in either ear and the oral or rectal control.

Our data show that temperatures taken in ears with suppurative otitis media are slightly higher than those in normal ears. This difference is of minimal clinical significance and does not affect the accuracy when compared to oral or rectal control readings.
Responses of Children, Parents, and Nurses to Tympanic Thermometry in the Pediatric Office
Authors: Alexander David , Kelly Barbara
Published: January 2017

This study was designed to assess children's behavioral responses to tympanic thermometry. In addition, parents' and nurses' impressions of this new technology were evaluated. 224 patients were enrolled from three private pediatric practices. Patients were alternately assigned to have their temperature taken with either a tympanic thermometer or with a rectal or oral thermometer. Parents and nurses were then asked to fill out a short questionnaire to describe their observations of the child's behavior during temperature taking and to describe their own feelings about the temperature taking method used. Parents were also asked to assess their usual method of temperature taking at home and their child's usual behavioral response.

Tympanic thermometry was rated higher by both parents and nurses for speed, ease, cleanliness, and safety. Parents and nurses were more confident in the accuracy of traditional temperature taking methods. Children whose temperatures were taken rectally were more likely to be observed by both parents (p = .02) and nurses (p = .01) to have a negative behavioral reaction to the procedure than children whose temperatures were taken by tympanic thermometry. There was no difference observed between the behavioral responses of children who had temperatures taken orally and those who had tympanic thermometry.
Cost Effectiveness of Tympanic Thermometry in the Pediatric Office Setting
Authors: Alexander David , Kelly Barbara
Published: January 2017

This study was designed to see if tympanic thermometry might be more cost effective than cheaper more traditional methods of thermometry when office staff time saved is taken into account. There were 224 patients enrolled from three private pediatric practices. Patients were alternately assigned to have their temperature taken with either a tympanic thermometer or with a rectal or oral thermometer depending on the patient's age. For each child enrolled in the study a nurse was asked to time the temperature taking process. Items included in the cost analysis: a) thermometer costs; b) disposable supply costs; c) personnel costs; d) equipment service costs.

The mean duration of temperature taking was 35.2 seconds using tympanic thermometers, 73.4 seconds using electronic predictive thermometers, and 247.2 seconds using glass thermometers. In practices taking an average of 10 temperatures per day, tympanic thermometry saved $2,316/year when compared to glass thermometers and $442 /year when compared to electronic predictive thermometers.

The data presented in this study show that when nursing time is taken into account, tympanic thermometry is less expensive to perform than traditional methods of thermometry despite the initial higher cost of the thermometer.
The Impact of Moderate Ambient Temperature Variance on the Relationship Between Oral, Rectal, and Tympanic Membrane Temperatures
Authors: Zehner W. John , Terndrup Thomas E.
Published: January 2017

We examined the effect of moderate ambient temperature variance on the relationship between oral (OT), rectal (RT), and tympanic membrane (TMT) temperature in 21 healthy adults. Calibrated digital electronic thermometers were used to assess OT and RT, while TMT was measured using an infrared detection device and microprocessor. Recordings were made at baseline and after 15 and 20 minutes of exposure to either warm (35°C) or cool (18.3°C) environmental temperatures. Differences were examined for the three temperature sites and times using repeat measures analysis of variance. No significant differences in RT (37.7° ± 0.3°C; mean ± SD) were observed at any time. Both OT (+0.5°C) and TMT (+0.7°C) were significantly changed during warm, but not cool exposure, compared to baseline conditions. We conclude that OT and TMT have a predictable relationship to RT at normal ambient temperature. However, in warm examination areas, spuriously elevated OT and TMTs may occur.
Treatment with Oral Desmopressin in Adolescents with Primary Nocturnal Enuresis
Authors: Stenberg Arne , Läckgren Göran
Published: January 2017

Twenty-four adolescents, mean age 13.5 years, with primary nocturnal enuresis (PNE), were studied to evaluate the efficacy of long-term oral desmopressin use. Reduction in mean number of wet nights per week was the criterion for response. Results showed that during 12-week treatment Period I, 48% were full responders (≤1 wet night/wk); 22% were intermediate responders (2 to 3 wet nights/wk); and 30% were nonresponders (>3 wet nights/wk). During 12-week treatment Period II, 53% were full responders, 23.5% were intermediate responders, and 23.5% were nonresponders. Despite a high relapse rate (50% after Period I, 56% after Period II), 17 patients (71%) were completely dry 2 years posttreatment, suggesting a possible curative effect of oral desmopressin. It was concluded that oral desmopressin is comparable to the intranasal formulation, with a good, long-term therapeutic effect in adolescents with PNE.
Psychosocial Implications of Nocturnal Enuresis
Authors: Warzak William J.
Published: January 2017

Primary nocturnal enuresis (PNE), a biobehavioral problem affecting approximately 5,000,000 children in the United States, is among the most bothersome and frustrating disorders of childhood. Negative psychosocial consequences are common, secondary to the impact of enuresis on family members and others. The enuretic child may be at increased risk for emotional or even physical abuse from family members and may experience stress related to fear of detection by peers. These factors contribute to the loss of self-esteem that the enuretic child often experiences. Fortunately, a number of treatments — most commonly pharmacologic or behavioral intervention — are often effective in improving or correcting PNE. This disorder not only can be addressed but should be addressed because effective treatment benefits both the patient and the patient's family.
Negotiating with the LDCs: Situation and Context
Authors: Elgström Ole
Published: January 2017

In this article I introduce and analyze some characteristic features of bilateral foreign aid negotiations, as compared to other types of negotiations between states. A first typical trait is the apparent asymmetry of power between the negotiating actors. According to bargaining theory, this would predict also an asymmetry of outcome. Such a conclusion is challenged, however, by other distinguishing features of aid negotiations. The normative aspect, stating the existence of moral obligations, the repetitive nature of most aid negotiations, the existence of asymmetries of attention and resolve, and some tactical characteristics of such negotiations: all these aspects might be interpreted as creating more promising conditions for the weaker actor. To understand and explain foreign aid negotiations — their processes and outcomes — it is not enough, however, to study the negotiatory situation as such. An analysis of extra-negotiatory contextual factors is also needed. I distinguish between three categories: relations between the actors outside of the aid negotiations, relations between the actors and other actors, and the domestic contexts of both actors.
Nordic-SADCC Cooperation
Authors: Kiljunen Kimmo
Published: January 2017

The Nordic-SADCC cooperation initiative is potentially an innovative attempt to generate new forms of economic interaction between a well defined group of developed and developing countries. The partners concerned are internationally almost extreme cases as regards their level of socio-economic development. The extended cooperation framework between the two groups of countries is, however, well justified. Both groups are geographically concentrated and have a tradition of mutual development cooperation. Their policies as a whole have a similar emphasis on poverty alleviation and development as well as the consistent condemnation of the South African apartheid regime. Issues related to international politics rather than vested economic interests have offered the driving force in the emergence of this cooperation attempt. Never theless, the initiative is at this stage based on already existing measures and institutions and has not yet introduced qualitatively new patterns of mutual interaction.
What's Left for the MFA? Foreign Policy and the Management of External Relations in Norway
Authors: Underdal Arild
Published: January 2017

How and to what extent could the participation of "domestic" branches of government in the management of external relations affect the substance of foreign policy? Arguing that in order to answer this question we need to know not only how much but also more precisely what is now being handled by these agencies, the author attempts to map the participation of the Ministry of Foreign Affairs and "domestic" agencies in the management of Norway's external relations. The events data analysis reported in this article indicates that their roles are different in substantive profile: "Domestic" agencies are more narrowly specialized in terms of the kinds of problems they address, more "parochial" in their heavy concentration on relations to close neighbors, and relatively more preoccupied with issues affecting interests rather than values and some specific domestic subgroup(s) rather than the nation at large. "Sector" agencies seem to differ in several respects from those responsible for public goods or services and general regulation of society. In a concluding section the author argues that this particular pattern of differentiation implies a risk of "vertical disintegration" of foreign policy — threatening, in particular, bold or visionary policies with a perspective beyond immediate self-interest.
Iceland: Vulnerability in a Fish-based Economy
Authors: Kristinsson Gunnar Helgi
Published: January 2017

Fish — Iceland's main export product — accounts for three quarters of its exports. Although only a small proportion of the population is employed in fishing and fish processing, the economy is highly vulnerable to any fluctuations in the earnings from fish exports. This article discusses the Icelandic responses to vulnerability: an inwardly orientated emphasis on rapid adaptation to change, and an outwardly orientated qualified support for liberal trade policies. Also discussed is the possible impact of some of the changes in the foreign economic relations of the country in recent years, and the question of Iceland's relationship with the process of European integration.
Economy in Flux — Security Suspended. Foreign Economic Relations and Security Policy for Nordic NATO
Authors: Holm Hans-Henrik
Published: January 2017

Despite the spectacular economic changes in the international system and in Denmark, Norway and Iceland since 1945, the security policies of these countries have been remarkably constant. On the basis of a juxtapositioning of the conflicting trends of development in the international economic and political system, it is predicted that security policy in these three NATO countries to the North is up for change in the future. Three scenarios, based on present economic tendencies, are outlined: 1. International integration through renewed US dominance; 2. Split up into economic- political regions; 3. Collapse of the international economic system. The resulting changes in the security policy of each of these three states are indicated and discussed.
Of Lambs and Lions: Relations Between Great Powers and their Smaller Neighbors
Authors: Knudsen Olav F.
Published: January 2017

Knudsen, O. F. Of Lambs and Lions: Relations Between Great Powers and their Smaller Neighbors. Cooperation and Conflict, XXIII, 1988, 111-122.

The relations between great powers and their smaller neighbors are accentuated cases of great-power/small-state relations generally and thus potentially useful for exploring such asymmetries. The article presents a model to explain key features of asymmetric dyadic relationships, in particular the application of political pressure by a great power against its smaller neighbor(s). The model includes three causal variables: tension between the great powers; great-power neighbor's extroversion; the smaller neighbor's foreign policy orientation. The concept of "freedom of action" is critically scrutinized and rejected. It is replaced as dependent variable by "the great-power's propensity to apply pressure against the small state". The elements of the model are presented and discussed. The overall argument of the article is that relations between contiguous small and great powers tend to be unstable, due to (a) the fact that the neighbor's relations are largely shaped by factors outside the bilateral relationship, and (b) the asymmetric importance of the mutual relationship to the two parties.
The United States Defence Areas in Greenland
Authors: Archer Clive
Published: January 2017

Archer, C. The United States Defence Areas in Greenland. Cooperation and Conflict, XXIII, 1988, 123-144.

An examination of the US military presence in Greenland shows how it has developed in tandem with wider US strategy. After the Second World War bases were used by Strategic Air Command and later for early warning systems. The US presence has had consequences for the host nations, Denmark and Greenland, in its effect on the local populations, in its intrusion into host state politics and by the association with the defence policies of the USA. The 1980s have brought a questioning of the US defence areas in Greenland by Greenlandic and Danish politicians.
The Security Policies of Small NATO Countries: Factors of Change
Authors: Petersen Nikolaj
Published: January 2017

Petersen, N. The Security Policies of Small NATO Countries: Factors of Change. Cooperation and Conflict, XXIII, 1988, 145-162.

During the 1980s the traditional security policies of the smaller NATO countries in Northwest Europe have been under considerable stress. Policy changes have been most profound in Denmark, but similar trends have been evidenced in Norway, Holland and Belgium. Based on a simple analytical framework the article analyses the nature of these trends, mostly in the Danish case, and their background in domestic, transnational as well as systemic factors. Security policy values have changed, especially with respect to nuclear weapons; the policy process has become more complex and conflictual, and resulting policies have deviated from the old alliance loyalty of these countries. Among explanatory factors the article focuses on the breakdown of detente and increasing pressures on the European NATO members which were especially onerous for the small countries, changes in public opinion, transnational cooperation between political parties and social movements, and developments in Social Demo cratic perceptions. Even though some of these factors have been eclipsed by the present era of renewed detente, the adaptation of the small NATO countries to it is likely to be conditioned by the significant changes in perceptions, processes and policies which occurred in the 1980s.
Political Interpretations of International Legal Norms
Authors: Nilsson Ann-Sofie
Published: January 2017

Nilsson, A-S. Political Interpretations of International Legal Norms. Cooperation and Conflict, XXIII, 1988, 163-177.

International law is frequently accused of being irrelevant in the international system. In political language, it is supposed to play a basically manipulative role. This study examines the use of international legal norms in political language in an effort to determine whether actors actually, as critics argue, approach these norms in a homogeneous verbal way, regardless of the legal beliefs of the actors. Actors' verbal interpretations of legal norms ("say") are contrasted to the approach found in their legal models ("think") and in practical behavior ("do"). Traditional law is one of many possible legal models. The verbal, practical and theoretical interpretations of legal norms made by four intervening actors in the Spanish Civil War (France, Germany, Italy and the Soviet Union) are analyzed and compared. Although these are actors with a wide variance in legal beliefs (one is a status quo actor and three present different revolutionary models), their verbal approaches to legal norms proved to be very similar. Only rarely did political language reflect the legal beliefs/models and behavior of revolutionary actors. Instead, also revolutionary actors relied on traditional law in political language. The acceptance by the traditional legal system of such verbal manipulation of legal norms could, it is suggested here, both weaken and strengthen this system in the long run.
The New Era of Terrorism: Approaches and Typologies
Authors: Mozaffari Mehdi
Published: January 2017

Mozaffari, M. The New Era of Terrorism: Approaches and Typologies. Cooperation and Conflict, XXIII, 1988, 179-196.

Despite the fact that political terrorism has become an almost everyday phenomenon, and despite its unprecedented internationalization, little attention has been given to the typology of political terrorism. Terrorism has generally been considered a homogeneous phenomenon with no variations in either time or place. The aim of this article is first to proceed to a critical analysis of the contemporary terminologies and typologies of terrorism; and then to construct an alternative typology more operational for recognizing the specificities of the different types of terrorism, one that is more capable of predicting their respective plausible behaviour.