bluuebunny/crossref_metadata_2025 huggingface dataset:
The Porcine Model for Intratemporal Facial Nerve Trauma Studies
Authors: Barrs David M. , Trahan Creighton J. , Casey Kenneth , Brooks Daniel
Published: November 2015

Facial nerve anatomy was compared in the rat, rabbit, cat, and pig in an effort to develop a model for facial nerve trauma within the temporal bone. The porcine model was found to have the most suitable anatomy. Landmarks for the nerve were excellent. The pig had a definite facial nerve mastoid segment that was vertical, as in the human, and long enough to allow for performance of sequential procedures on the nerve. It was also large enough for grafting and electrical testing. A detailed description of the advantages of the pig model and the anatomy of the surgical approach to the facial nerve in the porcine model is presented.
Comparison of Plain Radiographs, Coronal CT, and Intraoperative Findings in Children with Chronic Sinusitis
Authors: Lazar Rande H. , Younis Ramzi T. , Parvey Louis S.
Published: November 2015

Evaluating the extent of chronic sinusitis in children is critical in management of the disease and determination of the need for surgery. High‐resolution computed tomography can demonstrate disease that is not shown on routine x‐ray films. It can also delineate pathologic variations and demonstrate inaccessible anatomic structures. We compared plain radiographs, CT scans, and intraoperative findings for 300 pediatric patients with chronic or recurrent sinusitis. Despite an imperfect record in demonstration of sinus disease in all of our patients, computed tomography was unquestionably better than plain radiography in diagnosis of chronic sinusitis and evaluation of the need for surgery. Despite its superior performance, CT should not be used exclusively to diagnose disease or propose surgery. These determinations must be made on the basis of a combination of the patient's symptoms, physical examination findings, and CT results.
Nasal Patency, Aerobic Capacity, and Athletic Performance
Authors: Benninger Michael S. , Sarpa J. R. , Ansari Tariq , Ward Joseph
Published: November 2015

The patency of the nasal airway may directly affect pulmonary ventilation, with obstruction and increased nasal resistance resulting in increased pulmonary resistance, hypoxia, and hypercapnea. Nine aerobic athletes were evaluated to assess the role of the nasal airway on aerobic capacity and athletic performance. A step‐ladder graded maximal aerobic capacity test was performed under three test conditions: obstructed, decongested with oxymetazoline hydrochloride, and saline control. No differences in maximum VO2, work load, oxygen saturation, maximal blood pressure, heart rate, or respiratory rate were noted between test conditions. Pre‐exercise nasal resistance was lower in the decongested compared to control conditions, but no differences were found after exercise. Athletic performance was not influenced by nasal patency in this model.
Kanamycin Inhibits Cochlear‐Renal ODC in Neonatal Rats
Authors: Lyos Andrew T. , Winter William E. , Henley Charles M.
Published: November 2015

Ornithine decarboxylase (ODC), a key enzyme in polyamine biosynthesis, is important in development and regeneration. We hypothesize that aminoglycoside inhibition of ODC mediates developmental hypersensitivity to aminoglycoside ototoxicity. Kanamycin effects on ODC activity (decarboxylation of ornithine) in vitro were determined in the postmitochondriai fraction of cochlear and renal homogenates from 11‐day‐old rats. Kanamycin inhibited cochlear and renal ODC by an uncompetitive mechanism. For the cochlear enzyme, the inhibitor constant (Ki) for kanamycin was 99 ± 25 (μmol/L; for the renal enzyme, the Ki = 1.5 ± 0.1 mmol/L. In vivo effects of kanamycin on cochlear, renal, brain ODC activity were determined in rats treated with kanamycin (400 mg/kg/day, intramuscularly) or saline during postnatal days 11 through 20, the hypersensitive period for ototoxicity. Rats were killed on postnatal days 12,14,16, and 20 and ODC was assayed. Kanamycin significantly inhibited ODC in the lateral wall‐organ of Corti and kidney (ANOVA α = 0.05), but had no effect on cochlear nerve and no consistent inhibitory effect in the brain. These results suggest that ODC is a potential target of kanamycin in susceptible tissues and may be a contributing factor in developmental sensitivity to the drug by inhibiting repair and developmental processes mediated by ODC.
The Synergistic Effects of Rhodamine‐123 and Merocyanine‐540 Laser Dyes on Human Tumor Cell Lines: A New Approach to Laser Phototherapy
Authors: Castro Dan J. , Saxton Romaine E. , Haghighat Sherry , Reisler Emil , Plant David , Soudant Jacques
Published: November 2015

Many new photosensitizers and laser wavelengths are being tested to improve photodynamic therapy by enhancing specific tumor uptake and/or retention, lowering systemic toxicity, and increasing laser tissue penetration. In this study the potential synergistic effects of rhodamine‐123 (Rh‐123) and merocyanine‐540 (MC‐540) sensitization of human tumor cell lines after laser exposure were explored. In a first series of experiments, the kinetics of uptake of Rh‐123 and M‐540 were tested on three human leukemia cell lines (K562, RAJI, 729HF2), P3 squamous carcinoma, and M26 melanoma. Our results demonstrate a clear difference in the rate and amount of uptake of MC‐540 (K562 > P3 > RAJI > 729HF2 > M26) and Rh‐123 (P3 > RAJI > 729HF2 > K562 > M26) by these cell lines. In a second series of experiments, M26 tumor cells were sensitized with either Rh‐123 (1 μg/ml) or with MC‐540 (20 μg/ml) alone or with a combination of the two dyes for 60 minutes, then exposed to the argon (514.5 nm) laser at nonthermal energy levels. Our results demonstrate a significant enhancement of the tumoricidal effects of the laser on M26 carcinoma cells after sensitization with both dyes together (MC‐540 and Rh‐123) when compared to each dye alone. As with combination antibiotherapy, the synergistic effects of two laser dyes that have different intracellular targeting sites appear to enhance tumoricidal effects significantly after exposure to a matching laser wavelength. The data provide evidence for effective laser phtototherapy by dye synergy.
Kawasaki Disease: Early Presentation to the Otolaryngologist
Authors: Seicshnaydre Michael A. , Frable Mary Ann
Published: November 2015

Kawasaki disease is an acute febrile illness of unknown etiology that occurs primarily in childhood. Early diagnosis and treatment can reduce the risk of cardiac complications of Kawasaki disease, which carries a 1% to 2% mortality for cardiovascular events. Clinical features include: (1) fever (2) conjunctival injection (3) oral cavity changes (4) changes in the peripheral extremities (5) erythematous rash and (6) cervical adenopathy without suppuration. We describe three cases in detail and survey a series of 42 patients at our institution. Otolaryngologic manifestations were found to occur in the early stages of Kawasaki disease. The otolaryngologist may see these patients early in the disease and should be alert to the signs and symptoms for appropriate diagnosis and treatment. Characteristics of Kawasaki disease, difficulties in diagnosis during the initial febrile stage, and the importance of early diagnosis by the otolaryngologist is stressed.
Eye Banking: Techniques for Eye Preservation in Selected Neoplasms Encroaching on the Globe
Authors: Quatela Vtto C. , Futran Neal D. , Boynton James R.
Published: November 2015

Removal of the globe and associated structures has been advocated for tumors Invading the periorbital bone and periosteum, orbital fat, or extraocular muscles. In some patients with cancerous tumors encroaching on the globe, however, it may be possible to remove the tumor and save the eye. Tenon's fascia is a firm fibrous sheath surrounding the entire globe except the cornea. If the neoplasm spreads along fascial planes rather than through them, and If this layer remains free of tumor Involvement, preservation of the globe can be considered. Oculoplastic reconstructive techniques may limit exposure and diplopia, allowing the eye to be “banked” in vivo, and saved as a spare for the future. Six patients with malignant tumors encroaching on the globe have had definitive surgical extirpation with preservation of the eye. Three patients have had the globe uncovered successfully. Five of six patients remain disease‐free, with followup from 6 months to 6 years. No globes have been removed. These techniques appear to be therapeutically sound, preserve function and appearance, and Improve patient morale. The indications and limitations of this approach to certain cases of periorbital cancer are discussed.
Temporal bone pathology in scuba diving deaths
Authors: Antonelli Patrick J. , Parell G. Joseph , Becker Gary D. , Paparella Michael M.
Published: November 2015

Scuba diving has long been associated with otologic injuries; however, little is known about temporal bone pathology in diving‐related deaths. We examined 18 temporal bones from 11 divers who died, primarily from complications of rapid ascent. Bleeding into the middle ear and mastoid air cells was nearly universal. Inner ear damage included hemorrhage around Reissner's membrane and the round window membrane and rupture of the utricle and saccule. Most of the observed inner ear damage was not surgically treatable. (OTOLARYNGOL HEAD NECK SURG 1993;109:514‐21.)
A revised speech intelligibility rating (rsir) test: Listeners with normal hearing
Authors: Speaks Charles , Trine Timothy D. , Crain Thomas R. , Niccum Nancy
Published: November 2015

Two experiments were conducted to examine the intelligibility of 72 passages of connected discourse prepared by Cox and McDaniel1,2 in their development of the Speech Intelligibility Rating (SIR) test. Intelligibility was assessed with a method‐of‐adjustment (MOA) procedure in which listeners adjusted the level of a multi‐talker babble until they could just understand 50% of a passage; the measure of intelligibility was the signal‐to‐babble ratio, dB S/B. The objective was to develop a Revised Speech Intelligibility Rating (RSIR) test that would comprise a large number of equivalent passages that produce reliable intelligibility measures. In experiment 1, the S/B ratio was based on the overall root‐mean‐square (rms) levels of speech and babble, as represented by the average level of frequent peaks observed on a VU meter. Across all 72 passages, mean intelligibility was −1.43 dB S/B, and the measure of intelligibility for 42 passages was within ±0.5 dB of the overall mean for all 72 passages. In experiment 2, the S/B ratio was based on long‐term rms levels of speech and babble measured in 16 one‐third‐octave bands, with center frequencies from 160 to 5000 Hz. In an effort to achieve greater equivalence in intelligibility among passages, the overall rms level of each passage was attenuated by the difference between SB16‐band for an individual passage and S/B16‐band for a reference passage. Mean intelligibility across all 72 passages was — 8.06 dB, and the measure of intelligibility was within ±0.5 dB of the overall mean for 64 of the 72 passages. For those 64 passages, the 95% critical difference for five MOAs was 0.72 dB, which corresponds to an estimated percentage critical difference Of 10.8%.
A Holistic Behavioural Economic Approach to Environmental Problems?
Authors: Wagner-Tsukamoto Sigmund
Published: November 2015

Bioeconomics, Biological Economics. Interdisciplinary Study of Economics and Educationby Mansour Mohammadian, Edición Personal, Spain, 2000 (ISBN 84-607-1556-6)
The Asian Bookshelf
Authors: Kingston Jeff
Published: November 2015

EXPLOITING PATENT RIGHTS AND A NEW CLIMATE FOR INNOVATION IN JAPAN, edited by Ruth Taplin. London: Intellectual Property Institute, 2003, 124 pp., £35 (paper).
Restorative Justice for Victims of Crime: A Victim-Oriented Approach to Restorative Justice
Authors: Wemmers Jo-Anne
Published: November 2015

The topic of restorative justice has become increasingly popular. However, there is some debate as to whether restorative justice programs adequately address victims' needs. To this end a review of the literature on victims' experiences with, and their expectations and perceptions of, restorative justice, was conducted. The available research shows that while restorative justice has advantages for victims, there is a risk of secondary victimization. There is, however, a demand for restorative justice programs among victims. The question is therefore not whether restorative justice programs should be offered to victims, but how they should be offered. This paper addresses the research on victims' needs and closes with recommendations for victim-oriented restorative justice programs.
Human Agency Revisited: The Paradoxical Experiences of Victims of Crime
Authors: Kenney J. Scott
Published: November 2015

Victims of violent crime often complain of feeling powerless. In some respects this represents a psychological aftereffect of the crime — an experience in which something was done to them against their will that they were powerless either to prevent or to stop. However, focusing attention on the psychological aftereffects of such experiences often overshadows other important considerations. For example, there is the possibility that an accumulation of subsequent social and institutional interactions may serve to minimize their ability actively to cope with their experiences.

This paper seeks to address these issues head on by reframing victimization in terms of the interplay between victims' social and institutional interactions, on the one hand, and their agency to cope on the other.1 Following a brief review of the critical literature on victims' problematic institutional positions and a discussion of agency, data will be presented from a qualitative study of individuals who have suffered the murder of a loved one.2 As will be seen, the differing experiences of these individuals in a variety of social contexts have much to teach us about institutional influences, therapeutic ideologies, and human agency.
A Comparison of Canine Giant Cell Tumor and Giant Cell Reparative Granuloma of Bone
Authors: Trigo F. J. , Leathers C. W. , Brobst D. F.
Published: November 2015

The clinical, radiographic, and pathologic features of a canine giant cell tumor of bone are compared with those of a giant cell reparative granuloma of bone. The giant cell bone tumor usually emerges from the epiphysis of long bones as a rapidly developing lytic bone lesion without periosteal new bone formation. The giant cell reparative bone granuloma originates preferentially in flat bones on the skull and mandible as a result of trauma-associated intraosseous hemorrhage, with new bone formation and sclerosis. Histologically, the neoplastic giant cells are scattered diffusely throughout the tissue, in contrast to the inflammatory giant cells that accumulate at the periphery of hemorrhages or around bone spicules. This peripheral accumulation is accompanied by a prominent collagenous and reticulum stroma. The morphologic and histochemical features of the giant cells can not be used as reliable tools to differentiate these two conditions.
The Twilight of Certitudes: Secularism, Hindu Nationalism, and other Masks of Deculturation
Authors: Nandy Ashis
Published: November 2015

What follows is basically a series of propositions. It is not meant for academics grappling with the issue of ethnic and religious violence as a cognitive puzzle but for concerned intellectuals and grassroots activists trying, in the language of Gustavo Esteva, to “regenerate people's space.” The aim of the article is threefold: (1) To systematize some available insights into the problem of ethnic and communal violence in South Asia, particularly India, from the point of view of those who do not see communalism and secularism as sworn enemies but as the disowned doubles of each other; (2) To acknowledge, as part of the same exercise, that Hindu nationalism, like other such ethnonationalisms, is not an “extreme” form of Hinduism but a modernist creed that seeks to retool Hinduism, on behalf of the global nation-state system, into a national ideology and the Hindus into a “proper” nationality; (3) To hint at an approach to religious tolerance in a democratic polity that is not dismissive toward the ways of life, idioms, and modes of informal social and political analyses of the citizens, even when they happen to be unacquainted with—or inhospitable to—the ideology of secularism.
Biblical versus Israelite Images of the Heavenly Realm
Authors: Wright J. Edward
Published: November 2015

The biblical editors did not create a record of the entire spectrum of ancient Israel's religious beliefs and practices. Theirs was by necessity a selective and biased account. It is left to modern scholarship to sift through all the evidence to create a more complete picture of ancient Israelite piety. This paper explores the available artifactual, inscriptional, literary and iconographic evidence in order to reconstruct what ancient Israelites and Judaeans believed about the heavenly realm, and not simply what the editors of the Hebrew Bible wanted people to believe or what they deemed appropriate to record.
Micah's Debate with Isaiah
Authors: Sweeney Marvin A.
Published: November 2015

This article observes the interrelationship between Isa. 2.2–4, 5 and Mic. 4.1–5, but it eschews previous attempts to reconstruct the original or common form of the composition. Based upon an analysis of the unique formulations of these passages in relation to their respective literary contexts in Isaiah and Micah, it argues that each serves a unique religio-political agenda. Whereas Isa. 2.2–4 looks forward to an idyllic period of world peace in which Israel/Judah will join the nations in acknowledging Yhwh's sovereignty as part of the larger Persian empire, Mic. 4.1–5 looks forward to an era of world peace in which a righteous Davidic monarch will arise to punish the nations prior to acknowledgement of Yhwh's sovereignty. The different agendas in these texts point to a debate within earlier Persian-period Judah concerning the character of the restoration and Judah's relationship to the Persian empire.
Passover in Biblical Narratives
Authors: Prosic Tamara
Published: November 2015

This article attempts to reveal the function of the pre-Yahwistic Passover. Rather then applying the usual methods of analysing the biblical text, the author applies the method of structural anthropology in an attempt to penetrate beyond the conspicuous plane of the stories. The aim of this study is to establish the symbolic function of mentioning Passover observances in the retellings of biblical events.
The Vågå Study: An Outline of the Design
Authors: Sjaastad O , Bårnes J , Haugen S
Published: November 2015

We carried out an epidemiological study of headache in a rural parish in the mountainous region of southern Norway. During a 2-year period from October 1995, 1838 parishioners in the age range 18–65 (or 88.6% of the target group) were examined in a structured interview based on a questionnaire. The questionnaires were validated in two ways: 100 records were re-checked, with a consistency of 98%, and a re-check of 41 parishioners was carried out >2 months after the 1st examination. The details of the latter control study will be reported later. Only one result of the study is given: namely, idiopathic stabbing headache (“jabs and jolts syndrome”) was present in >30% of parishioners.
Sleep Hygiene and Migraine in Children and Adolescents
Authors: Bruni O , Galli F , Guidetti V
Published: November 2015

Although sleep problems are a common complaint in migraine patients, the role of sleep habits and hygiene as triggering factors of head pain attacks has been poorly analyzed. The aim of this study was to evaluate the effect of modifying bad sleep habits across several headache parameters. Based on our previous study, we selected 70/164 migraineurs (42.7%) with poor sleep hygiene and randomly assigned them to two groups: group A migraineurs, who were instructed to follow directions to improve sleep hygiene; and group B migraineurs who were not given instructions on improving sleep hygiene. Mean duration and frequency of migraine attacks were significantly reduced at follow-up in group A, while group B showed only an insignificant initial reduction. No differences were found in the severity of migraine attacks that seemed related to a higher prevalence of nocturnal symptoms such as bedtime struggles, hypnic jerks, nightmares, and restless sleep. Our study is an alternative approach to the treatment of migraine, i.e. treatment through a simple modification of sleep behavior without recurring to pharmacological treatment.
“And You're Telling Me Not to Stress?” a Grounded Theory Study of Postpartum Depression Symptoms among Low-Income Mothers
Authors: Abrams Laura S. , Curran Laura
Published: November 2015

Low-income mothers in the U.S. are more likely to experience postpartum depression (PPD) and less likely to seek treatment than their middle-class counterparts. Despite this knowledge, prior research has not provided an in-depth understanding of PPD symptoms as they are experienced by low-income mothers. Through in-depth interviews, this study investigated low-income mothers' ( n = 19) experiences and explanatory frameworks for their PPD symptoms. Grounded theory analysis uncovered five main categories that linked the participants' PPD symptoms to their lived experiences of mothering in poverty, including: (1) ambivalence, (2) caregiving overload, (3) juggling, (4) mothering alone, and (5) real-life worry. The analysis further located the core experience of PPD for low-income mothers as “feeling overwhelmed” due to mothering in materially and socially stressful conditions. These findings challenge the prevailing biomedical discourse surrounding PPD and situate mothers' symptoms in the context of the material hardships associated with living in poverty.
Cognitive Processing Deficits and Students with Specific Learning Disabilities: A Selective Meta-Analysis of the Literature
Authors: Johnson Evelyn S. , Humphrey Michael , Mellard Daryl F. , Woods Kari , Swanson H. Lee
Published: November 2015

Many practitioners and state education agency staff would likely agree that the accuracy and consistency of specific learning disability (SLD) eligibility decisions is in need of improvement. One component of the SLD definition particularly controversial in the identification procedures is the evaluation of cognitive processes, primarily due to a lack of information about the role they might play in informing an SLD diagnosis and eligibility for special education services. A meta-analysis of 32 studies was conducted to examine the cognitive processing differences between students with SLD and typically achieving peers. The analysis found moderately large to large effect sizes in cognitive processing differences between groups of students with SLD and typically achieving students. These differences are of sufficient magnitude to justify including measures of cognitive processing ability in the evaluation and identification of SLD.
Strategic Note-Taking for Middle-School Students with Learning Disabilities in Science Classes
Authors: Boyle Joseph R.
Published: November 2015

While today's teachers use a variety of teaching methods in middle-school science classes, lectures and note-taking still comprise a major portion of students' class time. To be successful in these classes, middle-school students need effective listening and note-taking skills. Students with learning disabilities (LD) are poor note-takers, which negatively impacts their academic performance. This investigation sought to examine the effects of strategic note-taking on the recall and comprehension of middle-school students with LD. Forty students with LD were randomly assigned to either an experimental or a control group. Using strategic note-taking, students in the experimental group were taught to record notes independently while viewing a videotaped science lecture. Students who were taught strategic note-taking scored significantly higher on measures of immediate free recall, long-term free recall, comprehension, and number of lecture points and words recorded in their notes than students in a control group who used conventional note-taking. The limitations of the research and implications of this technique for classroom application are discussed.
The Effects of a Computerized Professional Development Program on Teachers and Students with and without Disabilities in Secondary General Education Classes
Authors: Schumaker Jean B. , Fisher Joseph B. , Walsh Lisa D.
Published: November 2015

Effects of a computerized professional development (PD) program were investigated in two studies. For each, teachers were randomly assigned to either a Virtual Workshop (VW) group that used a computerized program for PD or to an Actual Workshop (AW) group that participated in a live PD session. In Study 1, the teachers' knowledge about and planning for use of a concept comparison routine significantly improved after completing either workshop. Further, Knowledge Scores earned by the VW group were significantly higher than those of the AW group. In Study 2, both groups of teachers' knowledge about the routine, planning for the routine, and implementation of the routine in classrooms significantly improved, as did the concept acquisition of their students with and without learning disabilities. Implementation scores earned by the VW teachers were significantly higher than those of the AW teachers. Students were satisfied with the instruction provided by both teacher groups. All teacher groups in both studies were satisfied. Implications are discussed.
Predicting Kindergarteners' End-Of-Year Spelling Ability Based on Their Reading, Alphabetic, Vocabulary, and Phonological Awareness Skills, as Well as Prior Literacy Experiences
Authors: Otaiba Stephanie Al , Puranik Cynthia S. , Rouby D. Aaron , Greulich Luana , Sidler Jessica F. , Lee Julia
Published: November 2015

This study examined the role of home literacy, parental education, and demographic factors in addition to conventional literacy skills at the beginning and end of kindergarten in predicting end-of-kindergarten spelling achievement. The study involved 9 schools and 29 classrooms serving an economically and ethnically diverse population ( N = 288). Students spelled three types of words: Sight words, decodable real words, and decodable pseudowords; spellings were scored to allow partial credit for invented spelling. Results from a three-step hierarchical regression indicated the variables accounted for 66% of the variance in spelling scores, with the single strongest spring predictor being a 1-minute letter-sound fluency test. Implications for instruction and for identifying students at risk for spelling and reading difficulties are discussed.
A Comprehensive Approach to RTI: Embedding Universal Design for Learning and Technology
Authors: Basham James D. , Israel Maya , Graden Janet , Poth Rita , Winston Markay
Published: November 2015

Response to intervention (RtI) provides tiered levels of supports to all students and allows for increasingly more intensive and individualized instruction. Similarly, universal design for learning (UDL) addresses needs of students by proactively planning for instructional, environmental, and technology supports to allow all students to effectively access and engage in instruction. Although these two frameworks are widely accepted as structures for supporting students with diverse learning needs, the relationship between them has not been adequately developed. This article describes how an ecological RtI framework that integrates scientifically based instructional strategies, proactive instructional design, and purposeful technology use can provide a more seamless support system for all students.
Response to Intervention and Evidence-Based Practices: Where Does Technology Fit?
Authors: Smith Sean J. , Okolo Cynthia
Published: November 2015

Advancements in technology-based solutions for students with learning disabilities (LD) offer tremendous opportunities to enhance learning as well as meaningful access to the general education curriculum for this group of students. This article examines technology integration within the context of response to intervention (RTI). At the forefront of special education reform, RTI is reshaping special education practice. This article seeks to connect RTI components (e.g., evidence-based practice) with technology-based solutions in order to further ways in which technology tools can be incorporated into the lives of students with LD. Three effective practices (graphic organizers, written instruction, explicit instruction) are examined. For each area, we briefly describe the approach, examine the evidence behind the approach, and discuss technology-based tools that embed these effective features.
The Effects of Tier 2 Literacy Instruction in Sixth Grade: Toward the Development of a Response-To-Intervention Model in Middle School
Authors: Graves Anne W. , Brandon Regina , Duesbery Luke , McIntosh Angela , Pyle Nicole B.
Published: November 2015

The purpose of this quasi-experimental study was to (a) compare Tier 2 evidence-based intensive reading instruction to business-as-usual instruction for sixth graders with and without learning disabilities who were “far below” or “below” basic level in literacy and (b) explore the development of a response-to-intervention model in middle school. The study took place in a large inner-city urban setting, where 100% of students received free or reduced-price lunch and 90% of the students were considered English learners at some point in their school history. Intervention students received intensive small-group instruction for 30 hours across 10 weeks. Credential candidates in special education provided the small-group instruction in the treatment condition. Results on oral reading fluency, less so for Maze reading comprehension measures, indicated greater improvements for treatment students, and students with learning disabilities benefited as much or more than the other struggling sixth graders. Educational implications and recommendations for future research are discussed.
Politics and Merit: Can They Meet in a Public Service Model?
Authors: Ingraham Patricia W. , Ban Carolyn
Published: November 2015

This analysis examines existing models of career bureaucrat and political appointee relationships and asks: to what extent is the broader purpose of public service for both politicals and careerists considered? Because most current models focus on career responsibilities, but exclude the special public responsibilities of political managers, a new “Public Service Model” is proposed. The new-model proposes a joint political-career commitment to serving the public interest and a heightened recognition of the value of both sets of public executives. Both have a critical role to play in democratic policy processes; joint action and cooperation are essential to effective governance.
Implications of Salary Structure and Merit Pay in the Fifty American States
Authors: Lawther Wendell C. , Bernardin H. John , Traynham Earle , Jennings Kenneth
Published: November 2015

The burgeoning literature concerning merit pay in the public sector primarily focuses on themes such as its ability to improve performance, implementation problems in merit pay system maintenance, and a much more limited review of how merit pay should be integrated with salary structure. There are no studies of merit pay and salary structure, however, that compare experiences across local, state and federal government. Compensation specialists from all 50 states were surveyed to determine current practices in the area of pay structure and merit pay systems. Results indicate that many states are having difficulty in effectively integrating structure and merit pay.
Selection's Uniform Guidelines: Help, Hindrance, or Irrelevancy?
Authors: Daniel Christopher
Published: November 2015

Personnel directors from 76 Texas cities assessed the Uniform Guidelines’ impact and described their jurisdictions’ procedures for selecting police officers. Sixty percent felt that the Guidelines had little or no effect on their cities’ procedures while 37 percent said their city now uses more valid, varied, or standardized selection information because of federal requirements. Only three percent said the Guidelines had caused their city to abandon good selection instruments or be less willing to innovate their standardize procedures.
Maturity and Leadership in the Planning Academy
Authors: Burns Elizabeth K. , Prosperi David C.
Published: November 2015

This paper begins to formalize a conception of maturity and leadership in the planning academy. Building on a pair of seminal papers by Krueckeberg (1984, 1985) and recent literature on academic unit leadership, this paper presents a descriptive and analytic overview of the planning academy and compares and contrasts leadership in planning education units against a situational model of academic leadership. The paper concludes with an agenda of possible research and programmatic directions designed to advance the intellectual field of planning thereby enhancing its institutional maturity.
Measurement and Calculation of the Extracorporeal Elimination of Vancomycin During Continuous Venovenous Hemodiafiltration and Continuous Venovenous Hemofiltration in Critically Ill Patients
Authors: Muhl Elke , Bundesen Jens , Iven Heiko , Bruch Hans-Peter
Published: November 2015

Six surgical intensive care patients with continuous renal replacement therapy and therapy with vancomycin entered the prospective clinical study. The first day the patients were treated with continuous venovenous hemodiafiltration (CVVHDF) and the second day with continuous venovenous hemofiltration (CVVH). Three patients received 500 mg and three patients received 1000 mg of vancomycin every 12 hours. Monoclonal fluorescence polarization immunoassay (AxSYM) of vancomycin levels was performed from serum and dialysate/ultrafiltrate (during CVVHDF) or ultrafiltrate (during CVVH). Blood flow was 90 ml/hr, substitution 1 L/hr predilution, dialysate flow 1 L/hr (CVVHDF). The extracorporeal elimination of vancomycin during CVVHDF and CVVH is nearly linear but shows wide interindividual variation. The extracorporeal clearance of vancomycin was 24.2 ± 3.1 ml/min during CVVHDF (total clearance 60.4 ±18.1 ml/min) and 14.5 ± 2.4 ml/min during CVVH (total clearance 50.2 ± 14.9 ml/min). Intraindividual comparison revealed a significantly higher elimination of vancomycin by CVVHDF (p < 0.028). Peak serum vancomycin levels in patients receiving vancomycin 1g/day were 24.7 ± 5.3 μg/ml (CVVH) and 23.1 ± 5.2 μg/ml (CVVHDF), and with 2 g/day were 33.5 ± 2.7 μg/ml (CVVH) and 27.3 ±4.1 μg/ml (CVVHDF). The daily excreted amount of vancomycin during CVVHDF (r2 = 0.950, p = 0.01) and CVVH (r2 = 0.947, p = 0.01) can be calculated from a vancomycin level in the ultrafiltrate/dialysate outlet (CVVHDF) or the ultrafiltrate (CVVH) 8 hours after dosing. The 8-hour concentration of vancomycin in the ultrafiltrate from CVVH (or ultrafiltrate/dialysate from CVVHDF) during continuous renal replacement therapy serves as a basis for predicting extracorporeal elimination within 24 hours for the individual patient. Since critically ill patients show wide interindividual and intraindividual differences in the volume of distribution, clearance, and elimination half-life of vancomycin during therapy, the estimation of serum levels remains a necessity.
Correlation of Venous and Arterial Blood Gas Values Following Cardiothoracic Surgery in Infants and Children
Authors: McBride Mary E. , Berkenbosch John W. , Tobias Joseph D.
Published: November 2015

The authors retrospectively compared the correlation of pH and pCO2 from venous and arterial blood gases following cardiothoracic surgery in neonates, infants, and children. The cohort for the study included 14 infants and children undergoing cardiovascular surgery procedures for correction of congenital heart disease. The patients ranged in age from neonates to 48 months (6.2 ± 12.3 months) and in weight from 2.9 to 16.1 kg (5.0 ± 3.2 kg). A total of 95 simultaneous samples of arterial and venous blood were obtained for blood gas analysis. The mean venous pCO2 value was 45 ± 9 mmHg, with a mean arterial pCO2 value of 37 ± 7.4 mmHg. The overall difference between the venous and arterial CO2 values was 8 ± 4 mmHg. The venous to arterial CO2 gradient was greater than 5 mmHg in 78 of 95 samples. There was a significantly greater discrepancy between the arterial and venous pCO2 values when the central venous oxygen saturation was less than 70% compared to when the central venous saturation was ≥70% (p < 0.01). Linear regression analysis of venous versus arterial pCO2 revealed a slope of 0.62, r = 0.76, and r2 = 0.58. The mean venous pH value was 7.42 ± 0.07 and the mean arterial pH value was 7.46 ± 0.07. The overall difference between the venous and arterial pH values was 0.04 ± 0.02. Chi-squared analysis showed that with a central venous oxygen saturation of ≥70%, there were a significantly greater number of values with a venous to arterial pH difference of 0.05 or less compared to samples with a central venous oxygen saturation of less than 70% (p = 0.002). Linear regression analysis of venous versus arterial pH revealed a slope of 0.84, r = 0.88, and r2 = 0.77. Venous blood gas values do not provide a clinically useful estimate of arterial blood gas values following cardiothoracic surgery in children.
Current Concepts in the Pathophysiology and Management of Near-Drowning
Authors: Smyrnios Nicholas A. , Irwin Richard S.
Published: November 2015

Approximately 6,500 people drown in the United States each year. Nearly 50,000 of the estimated 500,000 annual near-drowning victims seek medical attention. Near-drowning is most common among children, young adults, blacks, males, and in the southern states. Risk factors for near-drowning include ethanol use, drugs, seizures, boating accidents, water sports, inadequate supervision of children, and voluntary hyperventilation. Alcohol use alone is associated with 37 to 47% of these cases. Although anoxia and hypothermia produce the major pathological changes associated with the morbidity of near-drowning, hypothermia may paradoxically exert a protective effect in some cases and is associated with most of the spectacular long term survivals. There is almost no difference in the clinical presentation of freshwater and saltwater near-drowning. Both situations often involve hypothermia, anoxic injury due to cardiac arrest, and the frequent progression to the adult respiratory distress syndrome. Basic principles of management include the immediate institution of cardiopulmonary resuscitation; aggressive rewarming, preferably with cardiopulmonary bypass; continuation of cardiopulmonary resuscitation at least until the patient has been effectively rewarmed; and appropriate supportive care if the patient develops the adult respiratory distress syndrome. Cerebral salvage techniques have not been proved to be beneficial in these patients.
Evaluation of the Protected Brush Catheter and Bronchoalveolar Lavage in the Diagnosis of Nosocomial Pneumonia
Authors: Cook D. J. , Fitzgerald J. M. , Guyatt G. H. , Walter S.
Published: November 2015

We assess the sensitivity and specificity of the protected brush catheter (PBC) and bronchoalveolar lavage (BAL) in diagnosing nosocomial pneumonia in nonimmuno-compromised critically ill patients. Computerized bibliographic literature searches of MEDLINE were performed, and the reference list of each article selected was reviewed. Of 496 citations, there were 19 articles (describing 18 studies) that proved relevant. Study quality was assessed, and descriptive information concerning study populations, interventions, and clinically relevant outcome measurements was extracted. The sensitivity and specificity of PBC were high (pooled estimates, 89.9 and 94.5%, respectively). Criteria for a positive BAL have varied between studies, and sensitivity ranged from 53.3 to 100%, whereas specificity was 98.6%. Most studies did not report whether antibiotics were withheld on the basis of negative test results. In those that did, the incidence of adverse outcomes consequent on withholding antibiotics was low. BAL and PBC, combined with the use of quantitative cultures, appear to increase accuracy in diagnosing pneumonia. The strength of inference is hampered, however, by the absence of a “gold standard” for the diagnosis of pneumonia. Moreover, the generalizability of these findings is limited by the fact that there are so few methodologically sound studies from so few centers. A randomized trial of PBC is needed.
Disseminated Intravascular Coagulation: Pathogenesis and Management
Authors: Schmaier Alvin H.
Published: November 2015

Disseminated intravascular coagulation (DIC) is a clini-copathological syndrome secondary to an underlying disease. Characteristic laboratory abnormalities of DIC should suggest, much like the recognition of fever, anemia, or congestive heart failure, that an inciting disease process must be searched for. The clinical and laboratory consequences of DIC can be ascribed to the unregulated and unbalanced formation of thrombin, the main clot-forming enzyme, and plasmin, the main clot-lysing enzyme. If too much plasmin is formed in relation to thrombin, a hemorrhagic state, which appears in 60 to 75% of patients with deep vein thrombosis, will occur. Alternatively, if too much thrombin is formed in relation to the degree of secondary fibrinolysis, a thrombotic condition, which appears in 25 to 40% of patients with DIC, will become manifest. The diagnosis of DIC is dependent on the presence of an appropriate clinical situation with concurrent laboratory evidence of thrombin and plasmin formation. Thrombin formation, plasmin formation, or both, can be assessed by detection of fibrin monomer, fibrin/fibrinogen degradation products, and D-dimer or E fragment, respectively. Treatment of DIC should initially be addressed to treatment of the primary, underlying condition inciting the disorder. If treatment for DIC is specifically needed, blood product replacement is the first order of therapy. This replacement should be tailored to each patient's specific needs (i.e., platelets, fibrinogen, or plasma proteins). Heparin has a definite but limited use in conditions associated with acral cyanosis and dermal ischemia. Other specific therapies for DIC may be of use in individualized situations.
The Immunosuppressive Aspects of Blood Transfusion
Authors: Mickler Thomas A. , Longnecker David E.
Published: November 2015

Blood transfusion is associated with immunosuppression, although the exact etiology of the immunosuppressive effect is not fully understood. The clinical significance of the immunosuppressive effect of blood transfusion has been examined in three situations: (1) studies of renal allograft survival after renal transplantation, (2) outcome studies in patients who have had surgical resection of solid cancer tumors, and (3) studies of infection rates in postoperative patients. In each scenario, the data support the conclusion that transfusion is associated with immunosuppression as manifested by increased renal allograft survival, increased recurrence and mortality rates in patients with cancer, and increased infection rates in postoperative patients who are transfused. Not all studies demonstrate an immunosuppressive effect of transfusion. There are several possible explanations for these discrepancies. First, prognostic variables other than transfusion itself account for the outcome results in these retrospective studies. Second, the extent of immunosuppression may be influenced by the type of blood product transfused, the amount transfused, and the timing of the transfusion; these factors have not been considered in all studies. For example, whole blood has been implicated as having a greater immunosuppressive effect than packed red blood cells, and many studies have shown that more than three units of packed red blood cells are necessary to affect outcome. Controlled animal studies have tested the hypothesis that transfusions increase solid tumor growth or the risk for infection. These studies have yielded conflicting results. Nevertheless, evidence that blood transfusion influences clinical outcome mitigates that a decision to transfuse must consider both risks and benefits of a transfusion; the possible consequences of immunosuppression must be included among the risks. Use of autologous blood, erythropoietin, and, in the future, synthetic hemoglobin may lead to improved outcome in patients with certain disease processes.
Indications, Technique, and Complications of Balloon Tamponade for Variceal Gastrointestinal Bleeding
Authors: Cook Deborah , Laine Loren
Published: November 2015

Timely treatment of bleeding esophageal varices with balloon tamponade effectively achieves initial hemostasis. However, therapeutic endoscopy and sclerotherapy in patients with acute upper gastrointestinal hemorrhage is associated with better short- and long-term follow-up. We describe the technique of esophagogastric balloon insertion, as well as principles of monitoring and maintenance. The different types of balloons for tamponade are described, as well as potential complications.
Noninvasive Evaluation of Newborns with Congenital Heart Disease
Authors: Ramaciotti Claudio , Chin Alvin J.
Published: November 2015

Over the last decade, diagnosis and management of neonates with congenital heart disease have been greatly influenced by the constant expansion of noninvasive methods. We classify the most common congenital defects presenting in the first 2 weeks of like, based on clinical presentation and hemodynamic characteristics, followed by a discussion of echocardiographic findings in the most common congenital heart lesions and how ultrasound techniques can help solve problems frequently encountered during the early postoperative period.
Septic Encephalopathy
Authors: Maher John , Young G. Bryan
Published: November 2015

Septic encephalopathy occurs easily in many septic persons. Manifestations are largely similar to those seen in other metabolic brain diseases. It can be detected most sensitivily, but not specifically, with electroencephalography. Diagnosis is based on excluding other causes of encephalopathy, such as a central nervous system infection or exposure to drugs or toxins. The pathogenesis is unknown but is likely diverse. Its severity correlates with mortality. Early recognition of septic encephalopathy is essential becuase early: diagnosis and treatment of sepsis markedly reduces mortality.
Serious Infections Caused by Pseudomonas Aeruginosa
Authors: Artenstein Andrew W. , Cross Alan S.
Published: November 2015

Over the last 3 decades, Pseudomonas aeruginosa has become a leading cause of infectious morbidity and mortality in certain predisposed patient populations. It primarily affects those with impaired host defenses, and its prevalence in the hospital environment makes it an important nosocomial pathogen. Infection with this organism may result in a broad spectrum of clinical manifestations, many of which may be seen in the intensive care setting. This review focuses on epidemiology, clinical presentations, nad treatment of serious Pseudomonas infections.