bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of Regional Metastasis in Advanced Stage Cutaneous Squamous Cell Carcinoma of the Auricle
Authors: Peiffer Nicholas , Kutz J. Walter , Myers Larry L. , Isaacson Brandon , Sumer Baran D. , Truelson John M. , Ahn Chul , Roland Peter S.
Published: December 2010

Objective

To determine patterns of regional metastasis in patients with advanced stage cutaneous squamous cell carcinoma of the auricle.

Study Design

Case series with chart review.

Setting

University‐based tertiary care hospitals.

Subjects and Methods

We analyzed 41 patients with stage III and IV squamous cell carcinoma of the auricle.

Results

The mean age was 74.2 years (range, 20.6‐91.7 years). Thirty‐five patients (85.4%) were stage IV. Twenty‐nine patients (70.7%) had a prior history of nonauricular, nonmelanotic skin carcinoma. Twenty‐four patients (58.5%) had regional metastasis to either the cervical or parotid nodal basin. In patients with cervical metastasis, the involvement by level was 6.7% (n = 1), 80.0% (n = 12), 46.6% (n = 7), 13.3% (n = 2), and 40.0% (n = 6), respectively. Of the 6 patients with a level 5 metastasis, 3 had primaries in the preauricular region, 2 had primaries of the auricle, and 1 had a primary of the postauricular region. Occult disease was present in 2 patients (9.1%) with cervical metastasis and in 4 patients (18.2%) with periparotid lymph node metastasis. Perineural invasion was seen in 84.4% of the study population. The recurrence rate was 46.3% (n = 19). The median time to recurrence was 28.3 months.

Conclusion

Patients with advanced stage auricular cutaneous squamous cell carcinoma have a high rate of regional metastasis and recurrence. When planning neck dissections for these patients, level 5 should be included in the resection. Patients demonstrating locally advanced disease without clinical or radiographic evidence of metastasis to the parotid or cervical drainage basin should undergo a parotidectomy and comprehensive neck dissection.
Salvage Laryngectomy After Primary Radiotherapy
Authors: Aarts Mark C. J. , Rovers Maroeska M. , Grau Cai , Grolman Wilko , van der Heijden Geert J. M.
Published: December 2010

In this evidence based case report we addressed the clinical question: which factors predict the occurrence of a pharyngocutaneous fistula after total laryngectomy in patients that already were treated with radiotherapy for a squamous cell carcinoma of the larynx? We searched for relevant synonyms for the domain, being patients earlier treated with radiotherapy for a squamous cell carcinoma of the larynx and having a recurrence for which a salvage total laryngectomy is necessary, with the outcome being the development of a post‐operative pharyngocutaneous fistula. We searched for relevant publications in Embase, Pubmed and Web of Science using search terms in title and abstract fields. The search yielded 1764 records, of which three were relevant and valid for our clinical question. Our results show that the absolute risk of a pharyngocutaneous fistula after total laryngectomy in patients earlier treated with radiotherapy for a squamous cell carcinoma of the larynx mainly depends on characteristics and site of the primary tumor. In patients who have a primary glottic laryngeal T1 or T2 tumor the absolute risk of developing a fistula is 11% (95% CI 6; 15%), whereas the risk of developing a fistula in patients with a T3 or T4 extra laryngeal tumor is 35% (95% CI 25; 46%). Other patient and surgical characteristics can however not be ruled out as important prognostic factors since many of them have to date not been studied, e.g. diabetes mellitus, alcohol consumption, smoking, suture materials and surgical technique used.
Improving Temporal Bone Dissection Using Self‐Directed Virtual Reality Simulation
Authors: Zhao Yi Chen , Kennedy Gregor , Yukawa Kumiko , Pyman Brian , O’Leary Stephen
Published: December 2010

Objective

A significant benefit of virtual reality (VR) simulation is the ability to provide self‐direct learning for trainees. This study aims to determine whether there are any differences in performance of cadaver temporal bone dissections between novices who received traditional teaching methods and those who received unsupervised self‐directed learning in a VR temporal bone simulator.

Study Design

Randomized blinded control trial.

Setting

Royal Victorian Eye and Ear Hospital.

Subjects

Twenty novice trainees.

Methods

After receiving an hour lecture, participants were randomized into 2 groups to receive an additional 2 hours of training via traditional teaching methods or self‐directed learning using a VR simulator with automated guidance. The simulation environment presented participants with structured training tasks, which were accompanied by real‐time computer‐generated feedback as well as real operative videos and photos. After the training, trainees were asked to perform a cortical mastoidectomy on a cadaveric temporal bone. The dissection was videotaped and assessed by 3 otologists blinded to participants’ teaching group.

Results

The overall performance scores of the simulator‐based training group were significantly higher than those of the traditional training group (67% vs 29%; P <. 001), with an intraclass correlation coefficient of 0.93, indicating excellent interrater reliability. Using other assessments of performance, such as injury size, the VR simulator‐based training group also performed better than the traditional group.

Conclusions

This study indicates that self‐directed learning on VR simulators can be used to improve performance on cadaver dissection in novice trainees compared with traditional teaching methods alone.
Effects of Mother-Implemented Picture Exchange Communication System (PECS) Training on Independent Communicative Behaviors of Young Children With Autism Spectrum Disorders
Authors: Park Ju Hee , Alber-Morgan Sheila R. , Cannella-Malone Helen
Published: December 2010

This study examined the effects of mother-implemented Picture Exchange Communication System (PECS) training on the independent communication of three young children with autism spectrum disorders. Three mothers were trained to teach their child PECS Phases 1 through 3B, which they did with high integrity. Moreover, all three children successfully acquired independent picture exchanges that were generalized to a different communication partner and maintained for at least 1 month. Vocalizations across participants showed limited or no improvement. These findings systematically extend previous PECS research by training mothers to be the primary implementers of PECS training. In addition, this research provides practitioners with insight into the feasibility and necessity of parent-implemented PECS training.
Orthopaedic In-Training Examination
Authors: Osbahr Daryl C. , Cross Michael B. , Bedi Asheesh , Nguyen Joseph T. , Allen Answorth A. , Altchek David W. , Dines Joshua S.
Published: December 2010

Background: Since 1963, the Orthopaedic In-Training Examination (OITE) has been administered to orthopaedic residents to assess resident knowledge and measure the quality of teaching within individual programs. The OITE has evolved dramatically over the years and now maintains a standardized format consisting of 275 questions divided among 12 sections.

Purpose: To provide a detailed analysis of the OITE sports medicine section to identify patterns in question content, recommended references, and resident performance.

Study Design: Cross-sectional study.

Methods: All OITE sports medicine questions from 2005 to 2009 were analyzed, and the following data were recorded: resident performance scores, tested topics, type of imaging modalities, tested treatment modalities, taxonomy classification, and recommended references.

Results: From 2005 to 2009, the sports medicine section composed 7.8% of the OITE. Mean resident performance on the entire OITE as well as on the sports medicine section improved during each year of training. Imaging modalities typically involved questions on radiographs and magnetic resonance imaging and constituted 27.4% of the OITE sports medicine section. Treatment modalities involved 36.8% of the OITE sports medicine section questions, including most treatment questions relating to ligament reconstruction or rehabilitation. The authors’ assessment of taxonomy classification showed that recall-type questions were most common; however, mean resident performance was minimally affected by type of taxonomy question. Finally, there were trends noted in recommended references; namely, the American Journal of Sports Medicine and Orthopaedic Knowledge Update Sports Medicine were the most commonly and consistently cited journal and review book, respectively.

Conclusion: The current study provides some unique information relating to content, recommended references, and resident performance on the OITE sports medicine section. It is hoped this information will provide orthopaedic trainees, orthopaedic residency programs, and the American Academy of Orthopaedic Surgeons Evaluation Committee valuable information relating to improving resident knowledge and performance and optimizing sports medicine educational curricula.
Working Hard for More Money or Working Hard to Make a Difference? Efficiency Wages, Public Service Motivation, and Effort
Authors: Taylor Jeannette , Taylor Ranald
Published: December 2010

The issue of how much to pay government employees to ensure optimum effort level is a complex one. Government employees are generally reported to be less motivated by high wages than their private sector counterparts. There is substantial empirical evidence that many performance-based pay schemes are either meaningless or dysfunctional in the public sector. Yet, it is common knowledge that most people do not seek employment without expecting some sort of remuneration for their effort. Drawing on the efficiency wage theory and public service motivation (PSM) literature, this article constructs a model to examine the relationship of wages and PSM in determining the effort levels of the public sector workforce in 15 countries that include the United States, Great Britain, and Australia.
Organizational Goal Characteristics and Public Duty Motivation in U.S. Federal Agencies
Authors: Chan Su Jung  , Rainey Hal G.
Published: December 2010

Some authors have claimed that ambiguous goals frustrate public service motivation (PSM). This study uses data from the U.S. Office of Management and Budget’s Program Assessment Rating Tool (PART)1 to develop organizational goal ambiguity measures for U.S. federal agencies. These measures, from this very separate and independent source, are then significantly and negatively related to a variable measured by a questionnaire item on the U.S. Merit System Protection Board’s 2005 Merit Principles Survey. The item asks respondents about whether they are motivated to do a good job by their duty as a public employee. Responses on this item appear relevant to PSM, but because the question does not fully represent more elaborate measures of PSM, we call the variable as “public duty motivation.” Public duty motivation also relates significantly and positively to employees’ Merit Principles Survey responses about the specificity of their job goals and of their agency’s mission, and about job-goal importance and job-goal commitment.
Lame From Birth: Early Concepts of Cerebral Palsy
Authors: Obladen Michael
Published: December 2010

Deformations have been attributed to supernatural causes since antiquity. Cerebral palsy was associated with God’s wrath, witchcraft, the evil eye, or maternal imagination. Greek scholars recommended prevention by tight swaddling, a custom that persisted into modern times. In the Middle Ages, the midwife’s negligence was held responsible as was difficult teething. Morgagni described in 1769 that the neonatal brain can liquefy, and Bednar described leukomalacia in 1850 as a distinct disorder of the newborn. In 1861, Little associated cerebral palsies with difficult or protracted labor and neonatal asphyxia, but he was challenged by Freud, who in 1897 declared that most cases are prenatal in origin. In 1868, Virchow demonstrated inflammatory changes, a view recently confirmed by Leviton and Nelson. Although a causal relationship of cerebral palsy to the birth never has been established, the habit to put the blame for cerebral palsy on someone remained a frequent attitude.
Perspectives of Young Adults With Disabilities on Leadership
Authors: Carter Erik W. , Swedeen Beth , Walter Martha J. , Moss Colleen K. , Hsin Ching-Ting
Published: December 2010

Increasingly, researchers have linked greater self-determination capacities to improved postsecondary outcomes for youth with disabilities. Although leadership is one component of self-determination, little is known about how youth and young adults with disabilities define, develop, and demonstrate leadership. In this qualitative interview study, the authors examined the perspectives on youth leadership development of 34 young adults with disabilities. Participants identified key attitudes and skills possessed by leaders and addressed the influence these qualities have on others. They also communicated their own experiences of developing their capacities as leaders, emphasizing the importance of early involvement in school and community activities and their relationships with family members, teachers, mentors, and friends. The authors offer recommendations for fostering youth leadership during the transition period.
Perceived Career Barriers for Gay, Lesbian, and Bisexual Individuals
Authors: Parnell Martha Keeton , Lease Suzanne H. , Green Michael L.
Published: December 2010

This study examined career-related barriers that gay, lesbian, and bisexual (GLB) individuals had encountered in the past and anticipated in the future and the degree of hindrance associated with future barriers. Two hundred forty-one GLB participants (126 women and 115 men) completed the Career Barriers Inventory–Revised and 11 additional items developed to address sexual orientation–related career barriers. Sexual orientation barriers were the third most highly anticipated future barriers and the second most hindering. Lesbian and bisexual women had encountered significantly more barriers related to sex discrimination, career–child conflict, and choosing nontraditional careers. They also anticipated more gender-role–related future barriers and expected more hindrance from gender and multiple role career barriers. There were no gender differences on sexual orientation barriers. GLB individuals encountered and anticipated career barriers similar to those encountered by heterosexual individuals while also anticipating barriers unique to their sexual orientation.
The Reminiscence Bump Reconsidered
Authors: Bohn Annette , Berntsen Dorthe
Published: December 2010

The reminiscence bump—the reporting of more memories from young adulthood than from other stages of life—is considered a hallmark of autobiographical memory research. The most prevalent explanations for this effect assume that events in young adulthood are favored because of the way they are encoded and maintained in long-term memory. Here we show that a similar increase of events in early adulthood is found when children narrate their personal futures. In Study 1, children wrote their future life stories. The events in these life stories were mostly life-script events, and their distribution showed a clear bump in young adulthood. In Study 2, children were prompted by word cues to write down events from their future lives. The events generated consisted mostly of non-life-script events, and those events did not show a bump in young adulthood. Our findings challenge prevailing explanations of the reminiscence bump and suggest that the cultural life script forms an overarching organizational principle for autobiographical memories and future representations across the life span.
Science knowledge and biblical literalism
Authors: Zigerell L.J.
Published: December 2010

Biblical literalists are often described as scientific illiterates, but little if any empirical research has tested this claim. Analysis of a sixteen-item battery from the 2008 US General Social Survey revealed that literalists possess less science knowledge than those with other views of Scripture, but that much of this deficit can be attributed to demographic factors and unequal educational attainment. The marginal direct effect of biblical belief suggests that literalism is not incompatible with knowledge of science and, therefore, the best avenue for increasing science knowledge among literalists may be to foster interest in science and design science courses to attenuate any perceived conflict between science and religion.
The Existential Center of Small Groups: Member’s Conduct and Interaction
Authors: Bonito Joseph A. , Sanders Robert E.
Published: December 2010

In every society groups rather than individuals are given responsibility for producing results that individuals potentially could produce just as well, but without the benefits of group effort. Once a small discussion group is convened, the members can be counted on to interact, often at length and sometimes contentiously, incontrovertible evidence that their interaction accomplishes something over and above what comes about because of characteristics of the task, cognitive processing, and context. And in order for members to achieve the collaboration and interdependence that make them a group rather than co-present individuals, they must interact. Hence, it is essential for small group researchers to examine behavioral data (by which we mean interactional conduct) if we are to understand what gives small groups the distinct utilities with which they are credited. This position does not mean that individual motivation, cognition and information processing, and other related phenomena should be ignored. It means rather that these matters are secondary to and contingent on interactional conduct and processes.
An Exploration of Applying System Criminality to Arms Trafficking
Authors: Rothe Dawn L. , Collins Victoria
Published: December 2010

Small arms trafficking is multifaceted and involves a host of actors ranging from the individual rogue seller and buyer to intermediaries, transnational networks, states, corporate organizations, or with the complicity of third, fourth, even fifth parties that facilitate the movement of arms. It is a complex web of sellers, brokers, intermediaries, financiers, and shipping companies. Here, the authors draw from, revise, and expand upon what has been referred to as system criminality in an effort to illustrate that through the expansion of this term there is theoretical and juristic value in the broader effort to control arms trafficking. The authors also suggest that to conceptualize and analyze the levels of actor/actors involvement or in terms of legal liability and accountability at the international level, placing various actors and organizations actions along a continuum from the white market—gray market to black market is useful.
Emotional Intelligence as a Salient Predictor for Collegians’ Career Decision Making
Authors: Puffer Keith A.
Published: December 2010

Among the plethora of career theories and counseling practices, human emotion continues to be underrepresented. The paucity is evoking discontentment. For many career specialists, a distal role for emotionality has become untenable. This study demonstrated emotional intelligence (EI) associates with familiar constructs within the career decision-making journey. In particular, multiple regression analyses of 561 collegians revealed EI as a salient predictor of vocational personality (Holland’s Realistic, Investigative, Artistic, Social, Enterprising, and Conventional [RIASEC]), vocational identity, and career indecision. The findings also exposed important gender differences and distinguished which competency of EI is germane to what career construct and gender. Implications from the findings and practical applications for placing emotion in a more proximal role by career counselors are discussed.
Overcoming Barriers to Effective Environmental Aid: A Comparison between Japan, Germany, Denmark, and the World Bank
Authors: Mori Akihisa
Published: December 2010

When developed countries started providing environmental aid to developing countries, they faced three types of barriers that made such aid ineffective: Conflicting concerns, contracting problems, and lack of capacity. Donors have responded over time with changing policy contents and implementing strategies to convince recipient countries to change their own policies. However, they have taken such steps in different ways. This article examines the ways that bilateral and multilateral donors have adjusted their environmental aid and the results of such adjustments, taking Japan as the center of analysis and comparing it with Germany, Denmark, and the World Bank. The main findings are as follows. First, to overcome the barriers, donors changed their strategy for convincing recipients to make policy change and/or shifted their focus to lower income recipients to take advantage of asymmetric power relations, whereas making minor adjustments to initial policy contents and design within the same environmental discourse. Second, responses to the barriers varied among the donors, reflecting their policy orientation in the environmental discourse, their power relationship with the recipients, and their resource mobilization capacity. Third, sustainability and enforcement of the changed policy depends mainly on the policy contents rather than on the policy change strategy.
Persistent Illegal Logging in Costa Rica: The Role of Corruption Among Forestry Regulators
Authors: Miller Michael J.
Published: December 2010

Costa Rica is known for its environmental accomplishments. However, a high amount of illegal logging has continued to occur across the country, threatening to make wooded areas less viable for harboring biodiversity and supplying lumber. This article examines how corruption among forestry regulators is one important factor that leads them to allow people to log illicitly. Focusing on Limón Province, especially its Amistad-Caribe Conservation Area, this study examines regulators’ corrupt behaviors, how the latter contribute to specific forms of illegal logging, and why regulators act in this manner. Data was collected though in-depth and anonymous interviews with experts from a variety of stakeholder groups. This most detailed look yet at corruption in Costa Rica’s forestry sector provides new understandings. Most importantly, it indicates that a serious failure to satisfy regulators’ material needs, including salary, equipment, funds and staff, is the key issue causing them to fall into corruption. Costa Rica will have difficulty in better meeting regulators’ requirements since it has limited money for these purposes, and other developing countries are likely to face the same problem. As such, they will need to search for less expensive ways to assist regulators, such as having nongovernmental actors act as regulatory staff.
The Impact of Emotional Priming on MMPI-2 Scale Scores
Authors: Lee Tayla T. C. , Forbey Johnathan D. , Ritchey Kristin A.
Published: December 2010

The current study investigated potential emotional priming effects on Minnesota Multiphasic Personality Inventory—2 (MMPI-2) scale scores. Participants included 98 college students who completed a personal narrative intended to induce temporary mood states, the MMPI-2, and a mood rating inventory. Results of the mood manipulation indicated that the individuals who first wrote a negative personal narrative reported a less positive mood ( d = −.79). However, analysis of variance results indicated no statistically significant differences on MMPI-2 scale scores between groups (median η2 = .005). Limitations and future directions are discussed.
Examining the Construct Validity of the Elemental Psychopathy Assessment
Authors: Miller Joshua D. , Gaughan Eric T. , Maples Jessica , Gentile Brittany , Lynam Donald R. , Widiger Thomas A.
Published: December 2010

Lynam and colleagues recently developed a new self-report inventory for the assessment of psychopathy, the Elemental Psychopathy Assessment (EPA). Using a sample of undergraduates ( N = 227), the authors examined the construct validity of the EPA by examining its correlations with self and stranger ratings on the Five-Factor Model, as well as self-reported ratings of personality disorders, social cognition, and love styles. The EPA psychopathy scores manifested expected correlations with both self and stranger ratings of the Five-Factor Model, particularly with the domains of Agreeableness and Conscientiousness, and were significantly related to various forms of personality pathology such as narcissism and antisocial personality disorders. The EPA also manifested expected relations with aggressive social cognitions. Finally, the EPA psychopathy scores were correlated with romantic love styles indicative of game playing and infidelity. The current results provide further evidence of the construct validity of the EPA as it manifests relations consistent with the nomological network of psychopathy.
“Peace With My Maker”: Voices of Seriously Ill African American Elders Regarding Advance Care Planning
Authors: Parsons Emmett Catherine , Dobbs Debra , Williams Sharon , Daaleman Timothy P.
Published: December 2010

African Americans participate in advance care planning (ACP) less often and are more likely to opt for life sustaining treatment than non-Hispanic whites. Although prior quantitative and qualitative work has examined the perspectives and attitudes of African Americans, the voices of those who are most likely to confront situations requiring health care decision making—seriously ill African American elders—have not been well depicted. This study utilized literary representations, in the form of found data poetry, to further examine qualitative data from community dwelling, African American elders who were seriously ill. Found data poetry seeks to capture the participant’s voice intact, in an effort to better represent the individual. Reexamining the data yielded 9 found data poems that represented the voice of the participants and expressed strong feelings regarding ACP.
“All Googled Out on Suicide”: Making Collective Biographies Out of Silent Fragments With “The Unassuming Geeks”
Authors: Speedy Jane
Published: December 2010

This article reprises and extends previous work coauthored by a middle-aged, female scholar/ narrative therapist and a group of young men. Those young men, who described themselves collectively as the “Unassuming Geeks” had all spent some time in their lives seriously considering suicide. This article focuses on the moment 10 years later, when the same group met together to mourn the loss of one of their members. This text articulates the collective witnessing and writing practice the group used and employs devices borrowed from ancient Greek theatre, together with fictionalized accounts, in an attempt to cultivate a “poetics of insufficiency” and disrupt notions of authenticity within “voices.” In looking back to what was silent/silenced and unsaid in previous work, the edges between therapy, research, and writing are blurred and troubled. Ongoing mutuality and accountability is considered.
Mechanisms of Selection in Claiming Narrative Identities: A Model for Interpreting Narratives
Authors: Spector-Mersel Gabriela
Published: December 2010

Aiming at a tight correspondence between narrative epistemology and methodology, a model for interpreting narratives is proposed that derives from a theoretical conception of how identities are claimed via stories. The narrative production is conceived as consisting of six mechanisms of selection, through which biographical facts are chosen, filtered, and sorted, with the purpose of confirming an established end point. Accordingly, the analysis seeks to identify the expressions of these mechanisms in a given story, as a way to recognize the identity being claimed. A holistic interpretive strategy underlies the process, requiring that both life and story be considered, treating the narrative as a whole unit, regarding form and content, paying attention to contexts, and employing a multidimensional interdisciplinary lens. Following the presentation of the interpretive model and its underlying theoretical foundation, the analysis is demonstrated through life stories of retired senior officers from Israel’s founding generation.
Poststructural Writerly Representation: Screenplay as Creative Analytic Practice
Authors: Berbary Lisbeth A.
Published: December 2010

Based on the need to expand literature on sorority women and explore all women’s negotiations of gendered discourses, I conducted an ethnographic study of a southern sorority grounded in a priori notions of discourse, discipline, subjectivity, and performativity as theorized by Michel Foucault and Judith Butler. The findings of this study were represented through a creative analytic screenplay that illuminated the ways sorority women learned gendered expectations, were disciplined towards compliance, and sometimes resisted or reinterpreted expectations of the dominant discourse of “ladylike.” This manuscript explores the use of the ethnographic screenplay as data representation, specifically focusing on the methods of creating composite characters, content, settings, scenes, and director’s comments. Exploring the use of this creative analytic practice helps to challenge notions of “traditional research” and makes space for “doing representation differently.”
Shacking Up: An Autoethnographic Tale of Cohabitation
Authors: Jago Barbara J.
Published: December 2010

This autoethnography describes the author’s experience of cohabitation with her partner of seven years, Sam, and his two children, Mary and Michael. In particular, the author focuses on her troubled relationship with Mary. Using Rambo’s “layered account,” the author weaves together a multiplicity of scenes during the seven years she and Sam have been dating and then cohabiting to show how their relationships are constructed through daily interaction. The author moves back and forth through time and speak from a variety of perspectives and roles, including girlfriend, cohabiting partner, depressed person, professor, and autoethnographer. By intermingling these time periods and voices through autoethnography, the author endeavors to move beyond her personal experience and comment on the larger social, cultural, and political forces affecting cohabiting families. Finally, the author addresses the relational ethics of autoethnographic research.
The Sweetest Distraction
Authors: de Vries Peter
Published: December 2010

Two poems are the centerpiece of this article, the first exploring the meaning and role of music in the life of Irene, a 67-year-old. Irene is one of nine older Australians (aged 63-79) who were interviewed for multiple case studies examining the meaning and role of music in the lives of older Australians. As I analyzed the interview material to draw out central themes of each participant’s lived musical experience, I became acutely aware that Irene’s words were filled with lyricism, rhythm, and metaphor unlike the words coming from the other participants. This led me to writing a narrative poem using Irene’s words as the content of the poem. The rationale for using this particular type of poem to re-present empirical material will be discussed, along with an autoethnographic poem that presents my experience as a researcher with Irene, and subsequently as a musician with Irene. This poem begins to explore the blurring of my roles as researcher with Irene, musician with Irene, and being a friend to Irene.
More Statistical and Methodological Myths and Urban Legends
Authors: Lance Charles E.
Published: December 2010

The study of urban legends represents the application of concepts developed in the academic study of traditional folktales to stories circulating in the modern world. Vandenberg adapted the notion of ‘‘urban legends’’ into the area of organizational research methods and coined the term statistical and methodological myths and urban legends (SMMULs) to refer to the collection of various rules of thumb and other ‘‘received doctrines’’ that often guide researchers’ scientific behavior. Various SMMULs have been examined over 7 years in a number of symposia at scientific conferences, in a previous Feature Topic in Organizational Research Methods (2006), and in an edited book. This Feature Topic continues this tradition by presenting five new SMMULs.
Maternal communication style, problem-solving and dietary adherence in young children with type 1 diabetes
Authors: Chisholm Vivienne , Atkinson Leslie , Donaldson Caroline , Noyes Kathryn , Payne Anne , Kelnar Chris
Published: December 2010

The incidence of type 1 diabetes (T1D) in young children is increasing markedly however young children have been overlooked in paediatric adherence research despite the unique challenges their care presents. We investigated the relation between maternal communication style and adherence to the dietary regimen in 40 children with T1D, aged 2—8 years, and their mothers. Mothers completed measures of children’s sugar consumption, parent—child communication quality, and child psychological functioning. Mothers and children engaged in a videotaped problem-solving task related to the dietary regimen, with maternal utterances analysed for behavioural control style (e.g., commands versus suggestions) and cognitive complexity (e.g., provision of labels versus questions). Maternal communications which engaged children, behaviourally and cognitively, in the task were associated with better adherence, medical, communication quality, and child adjustment outcomes. We conclude that adherence and health (medical and psychological) are optimized when young children are given opportunities to participate in their care.
Feasibility of Voluntary Menu Labeling Among Locally Owned Restaurants
Authors: Britt John W. , Frandsen Kirsten , Leng Kirsten , Evans Diane , Pulos Elizabeth
Published: December 2010

In 2007, Tacoma-Pierce County Health Department launched a restaurant menu labeling project called SmartMenu. The objective was to recruit locally owned restaurants to voluntarily post basic nutrition information on their menus or menu boards. Participating restaurants submitted recipes to an independent contractor for nutritional analysis and agreed to post calorie, fat, carbohydrate, and sodium values on new menus within 90 days of receiving results. Vigorous recruitment efforts by the Health Department between June 2007 and September 2008 included free advertising, consultation with a Registered Dietitian, and free nutritional analysis. By the end of 2008, a total of 24 restaurants participated in the program. Significant barriers to participation included infrequent use of standardized recipes, perceived business risk of labeling, and low perceived customer demand for nutrition information. Key program elements, recruitment strategies, and costs are discussed. Results have important implications for future efforts to increase the adoption of menu labeling by locally owned and operated restaurants.
Single-Port Laparoscopic Cholecystectomy With the X-Cone: A Feasibility Study in 9 Pigs
Authors: Krajinovic Katica , Pelz Joerg , Germer Christoph-Thomas , Georg Kerscher Alexander
Published: December 2010

Objective: Virtually any port system for single-port laparoscopic surgery is for single usage only. The aim of this study was to trial the novel and completely reusable port X-Cone in order to perform a cholecystectomy by one infraumbilical incision. Methods: Single access cholecystectomies were performed in 9 anesthetized domestic pigs in nonsurvival studies. Only one infraumbilical incision was performed for placing the reusable, multichannel steel port system. A newly developed angulated forceps was used besides regularly used instruments in laparoscopic surgery. Results: The gallbladder was successfully removed in 9 pigs. At postmortem examination, the clips placed on the cystic duct and the cystic artery. No bile leakage was found at the operative field. Conclusion: Single-port cholecystectomy with the reusable X-Cone single-port system is safe and feasible. No additional incisions were needed. The system is ergonomically designed, easy to handle, and the learning curve for cholecystectomy is steep.
Salvage of Severe Ankle Varus Deformity With Soft Tissue and Bone Rebalancing
Authors: DeCarbo William T. , Granata Angela M. , Berlet Gregory C. , Hyer Christopher F. , Philbin Terrence M.
Published: December 2010

The etiology of ankle varus is multifactorial. Treatment recommendations after failed conservative care include hindfoot and ankle fusions or total ankle arthroplasty (TAA) with ligament rebalancing. The purpose of this study was to evaluate chronic varus ankle deformities through corrective calcaneal osteotomies and lateral soft tissue reconstruction.

All skeletally mature patients with at least 5 degrees of ankle varus were included in the study. Pre and postoperative radiographs were retrospectively reviewed measuring talar tilt. All patients had a lateral closing wedge (Dwyer) calcaneal osteotomy, joint debridement, and lateral ankle ligament reconstruction.

Eight feet were included in the study. The average follow-up time was 20.6 months. Six patients (six feet) were asymptomatic and did not have any additional surgery at their most recent follow-up. Two patients failed treatment, requiring surgical intervention for persistent pain and/or deformity. The average postoperative ankle varus correction overall was 4.9 degrees.

We found ankle varus on average of less than 10 degrees can be reliably corrected with a combination of lateral ligament reconstruction and calcaneal osteotomy. Approximately 50% of the deformity was corrected when comparing pre and postoperative talar tilt values. In patients with varus deformity greater than 10 degrees preoperatively, persistent varus may occur.
Arthroscopic Ultrasound Assessment of Articular Cartilage in the Human Knee Joint
Authors: Kaleva Erna , Virén Tuomas , Saarakkala Simo , Sahlman Janne , Sirola Joonas , Puhakka Jani , Paatela Teemu , Kröger Heikki , Kiviranta Ilkka , Jurvelin Jukka S. , Töyräs Juha
Published: December 2010

Objective:

We tested whether an intra-articular ultrasound (IAUS) method could be used to evaluate cartilage status arthroscopically in human knee joints in vivo.

Design:

Seven patients undergoing arthroscopic surgery of the knee were enrolled in this study. An ultrasonic examination was conducted using the same portals as in the arthroscopic surgery. A high-frequency (40-MHz) ultrasound transducer (diameter = 1 mm) was directed to the desired location on the articular surface under arthroscopic control. In addition to ultrasound data, an IAUS video and optical video through the arthroscope were recorded. Classification of cartilage injuries according to International Cartilage Repair Society, as conducted by the orthopedic surgeon, provided reference data for comparison with the IAUS.

Results:

The IAUS method was successful in imaging different characteristics of the articular surfaces (e.g., intact surface, surface fibrillation, and lesions of varying depth). In some cases, also the subchondral bone and abnormal internal cartilage structure were visible in the IAUS images. Specifically, using the IAUS, a local cartilage lesion of 1 patient was found to be deeper than estimated arthroscopically.

Conclusions:

The IAUS method provided a novel arthroscopic method for quantitative imaging of articular cartilage lesions. The IAUS provided quantitative information about the cartilage integrity and thickness, which are not available in conventional arthroscopy. The present equipment is already approved by the Food and Drug Administration for intravascular use and might be transferred to intra-articular use. The invasiveness of the IAUS method might restrict its wider clinical use but combined with arthroscopy, ultrasonic assessment may enlarge the diagnostic potential of arthroscopic surgery.
Penetrating Blast Injury to the Knee of a United States Soldier Treated with Allograft Mosaicplasty
Authors: Eichinger Maj. Josef K. , Bluman Eric M. , Arrington Col. Edward D.
Published: December 2010

Objective:

This is the first report of successful allograft mosaicplasty treatment of a large osteochondral lesion of the knee caused by a blast fragment sustained during combat operations. The patient was able to return to active duty following rehabilitation.

Methods:

An active-duty infantryman sustained an osteochondral lesion of the medial femoral condyle caused by a metallic fragment of an explosively formed projectile. Initial treatment consisted of removal of the foreign body and primary closure. The patient continued to experience pain, mechanical symptoms, and repeated effusions after initial nonoperative treatment. Allograft mosaicplasty of the lesion utilizing two 18-mm-diameter fresh allograft osteochondral plugs was performed at 6 months post-injury.

Results:

At 2-year follow-up, the patient remains on active duty with marked improvement in symptoms. Two years postoperatively, his outcome scores are 72 of 100 on the Western Ontario and McMaster University osteoarthritis scoring index (WOMAC) and 60 of 100 on the Knee Injury and Osteoarthritis Outcome Score (KOOS). His follow-up x-rays and MRI demonstrate intact articular cartilage and subchondral bone incorporation.

Conclusion:

Penetrating injuries to joints are commonplace in the battlefield environment. Combat injuries to the knee are frequently associated with articular cartilage injury. While numerous cartilage restoration techniques have been used with success for the treatment of osteochondral injuries to the femoral condyles, no published reports describe the use of allograft mosaicplasty in this location for open, penetrating injuries with focal cartilage loss. This is the first documented use of allograft mosaicplasty for a traumatic osteochondral defect of the medial femoral condyle caused by a metallic projectile. The patient was able to return to active duty following rehabilitation. We demonstrate a high level of functioning is possible following allograft mosaicplasty of a large osteochondral lesion caused by penetrating ballistic trauma.
Moving From Street to Home: Health Status of Entrants to a Housing First Program
Authors: Weinstein Lara Carson , Henwood Benjamin F. , Matejkowski Jason , Santana Abbie J.
Published: December 2010

Housing First (HF) is an evidence-based practice that ends chronic homelessness for individuals with serious mental illness by providing immediate access to permanent independent housing and team-based community supports. Little is known about the health status of homeless individuals entering HF programs. Through a cross-sectional analysis, this paper reports on the chronic physical disease burden of people entering a newly established HF program and examines whether these individuals recognize and request support for ongoing health-related issues. The authors’ evaluation confirmed significantly higher rates of chronic disease (60%) and fair/poor self-reported health status (47%) than the general urban population of Philadelphia. The majority of clients reported they wanted to address both medical (67%) and mental health (68%) problems, but a much lower percentage reported wanting to reduce substance use (23%) or take psychiatric medications (25%). The authors conclude that formerly homeless entrants to HF programs have a high burden of chronic disease with complex health-related needs. Additionally, these individuals look to the program for health-related assistance. As the HF model is disseminated throughout the United States to end chronic homelessness, these findings support the development of flexible, integrated, person-centered health services within the HF service delivery system as a potentially effective method to address complex health needs.
Postrelapse survival in childhood acute lymphoblastic leukemia is independent of initial treatment intensity: a report from the Children's Oncology Group
Authors: Freyer David R. , Devidas Meenakshi , La Mei , Carroll William L. , Gaynon Paul S. , Hunger Stephen P. , Seibel Nita L.
Published: December 2010

While intensification of therapy has improved event-free survival (EFS) and survival in newly diagnosed children with acute lymphoblastic leukemia (ALL), postrelapse outcomes remain poor. It might be expected that patients relapsing after inferior initial therapy would have a higher retrieval rate than after superior therapy. In the Children's Oncology Group Study CCG-1961, significantly superior EFS and survival were achieved with an augmented (stronger) versus standard intensity regimen of postinduction intensification (PII) for children with newly diagnosed high-risk ALL and rapid day 7 marrow response (EFS/survival 81.2%/88.7% vs 71.7%/83.4%, respectively). This provided an opportunity to evaluate postrelapse survival (PRS) in 272 relapsed patients who had received randomly allocated initial treatment with augmented or standard intensity PII. As expected, PRS was worse for early versus late relapse, marrow versus extramedullary site, adolescent versus younger age and T versus B lineage. However, no difference in 3-year PRS was detected for having received augmented versus standard intensity PII (36.4% ± 5.7% vs 39.2% ± 4.1%; log rank P = .72). Similar findings were noted within subanalyses by timing and site of relapse, age, and immunophenotype. These findings provide insight into mechanisms of relapse in ALL, and are consistent with emergence of a resistant subclone that has acquired spontaneous mutations largely independent of initial therapy. This study is registered at www.clinicaltrials.gov as NCT00002812.
Vocal cord dysfunction: what do we know?
Authors: Kenn K. , Balkissoon R.
Published: December 2010

Vocal cord dysfunction (VCD) is a disorder caused by episodic unintentional paradoxical adduction of the vocal cords, which may induce acute severe dyspnoea attacks not responsive to conventional asthma therapy. The aetiology of VCD is complex and often multifactorial. The essential pathophysiology is that of a hyperfunctional laryngeal reflex to protect the lower airway as a result of any combination of post-nasal drip, gastro-oesophageal reflux, laryngopharyngeal reflux and/or psychological conditions. Laryngoscopic demonstration of the paradoxical motion while wheezing or stridorous is considered the diagnostic gold standard. Speech therapy, including the use of special relaxed-throat breathing patterns is effective for VCD that is purely of the functional nature. Knowledge of the clinical features of VCD and identifying factors that may be contributing to the development of VCD can provide adequate clues to the correct diagnosis and management.