bluuebunny/crossref_metadata_2025_split huggingface dataset:
L’intégration des élèves syriens dans les écoles libanaises : trois témoignages
Authors: Compain Delphine , Grappe Isabelle , Salamé Feyrouz 
Published: March 2015

Cet article présente trois témoignages d’actions en cours depuis 2013. Ceux-ci montrent comment les actions de formations pour l’intégration des élèves réfugiés syriens dans les établissements scolaires libanais ont transformé la résistance à l’accueil de ces enfants en une prise de conscience des problèmes des élèves libanais. L’approche sociolinguistique couplée à une approche globale ainsi adoptée a permis de prendre en compte le profil linguistique et socioculturel des élèves et a renforcé les techniques des enseignants et des encadrants. Ceci a contribué à faire émerger une conscience des Droits à l’Education et des Droits des Enfants.
La réponse humanitaire à la crise syrienne : et si une autre action, citoyenne et engagée, était possible ?
Authors: Mohanna Kamel 
Published: March 2015

Le Liban accueille aujourd’hui environ un million et demi de réfugiés syriens, soit l’équivalent d’un tiers de sa population. Dans cette situation, l’absence de solidarité des pays du nord est criante. Mais surtout, le glissement de l’humanitaire solidaire vers le « charity business », et la marginalisation des acteurs locaux qui en découle, traduisent une forme de néo-colonialisme insupportable. Les sommes astronomiques consacrées à la coordination, aux frais de gestion, à la communication, représentent un gaspillage scandaleux, inversement proportionnel à l’efficacité de l’action. L’expérience de l’association Amel, association libanaise créée en 1979, pendant la guerre civile, offre un exemple à contre-courant de cette logique en s’appuyant sur la société civile locale et en ciblant son action en direction de tous les démunis.
Adaptations of the Shoulder to Overhead Throwing in Youth Athletes
Authors: Astolfi Matthew Michael , Struminger Aaron H. , Royer Todd D. , Kaminski Thomas W. , Swanik, Charles B. 
Published: March 2015

Context
The high number of repetitions and high forces associated with overhead throwing lead to anatomical adaptations, such as humeral retrotorsion and posterior-capsule thickness, in elite and professional baseball athletes. However, little is known about the origin and progression of these changes that may account for the increasing trend of chronic shoulder injuries in youth baseball and precipitate subsequent pathologic conditions throughout a young athlete's lifetime.

Objective
To investigate the relationship of age and upper extremity dominance on humeral retrotorsion, posterior-capsule thickness, and glenohumeral range of motion.

Design
Cross-sectional study.

Setting
Research laboratory, local baseball fields, and training facilities.

Patients or Other Participants
Thirty-six boys (mean age = 10.94 ± 1.34 years, height = 151.31 ± 12.17 cm, mass = 42.51 ± 10.32 kg) ranging in age from 8 to 12 years and involved in organized youth baseball.

Main Outcome Measure(s)
Diagnostic ultrasound was used to determine humeral retrotorsion and posterior-capsule thickness. Glenohumeral internal rotation and external rotation were measured using a handheld inclinometer. We used 2 × 2 mixed-model analyses of variance to compare the influence of limb dominance and age on the dependent variables of humeral retrotorsion, posterior-capsule thickness, internal rotation, and external rotation.

Results
The dominant shoulders of youth throwers exhibited less glenohumeral internal rotation but greater humeral retrotorsion, posterior-capsule thickness, and glenohumeral external rotation than the nondominant shoulders. Dominant internal rotation was greater in the 8- to 10-year-old group than in the 11- to 12-year-old group, and results trended toward a difference (F1,33 = 4.12, P = .05). Correlations existed between humeral retrotorsion and range of motion (P &lt; .05).

Conclusions
The structural adaptations in the dominant shoulders of younger baseball players were similar to adaptations observed in older baseball athletes, indicating that more examination is needed in younger athletes. We are the first to demonstrate greater posterior-capsule thickness in the dominant shoulders of youth baseball athletes.
Five Key Leadership Actions Needed to Redesign Family Medicine Residencies
Authors: Kozakowski Stanley M. , Eiff M. Patrice , Green Larry A. , Pugno Perry A. , Waller Elaine , Jones Samuel M. , Fetter Gerald , Carney Patricia A. 
Published: March 2015

Abstract

Background
New skills are needed to properly prepare the next generation of physicians and health professionals to practice in medical homes. Transforming residency training to address these new skills requires strong leadership.

Objective
We sought to increase the understanding of leadership skills useful in residency programs that plan to undertake meaningful change.

Methods
The Preparing the Personal Physician for Practice (P4) project (2007–2014) was a comparative case study of 14 family medicine residencies that engaged in innovative training redesign, including altering the scope, content, sequence, length, and location of training to align resident education with requirements of the patient-centered medical home. In 2012, each P4 residency team submitted a final summary report of innovations implemented, overall insights, and dissemination activities during the study. Six investigators conducted independent narrative analyses of these reports. A consensus meeting held in September 2012 was used to identify key leadership actions associated with successful educational redesign.

Results
Five leadership actions were associated with successful implementation of innovations and residency transformation: (1) manage change; (2) develop financial acumen; (3) adapt best evidence educational strategies to the local environment; (4) create and sustain a vision that engages stakeholders; and (5) demonstrate courage and resilience.

Conclusions
Residency programs are expected to change to better prepare their graduates for a changing delivery system. Insights about effective leadership skills can provide guidance for faculty to develop the skills needed to face practical realities while guiding transformation.
Use of Emergency Medicine Milestones as Items on End-of-Shift Evaluations Results in Overestimates of Residents' Proficiency Level
Authors: Dehon Erin , Jones Jonathan , Puskarich Michael , Sandifer John Petty , Sikes Kristina 
Published: March 2015

Abstract

Background
The emergency medicine milestones were developed to provide more objective resident assessment than current methods. However, little is known about the best practices for applying the milestones in resident assessment.

Objective
We examined the utility of end-of-shift evaluations (ESEs) constructed using the milestones in resident assessment.

Methods
We developed 14 daily ESEs, each of which included 9 or 10 emergency medicine milestones. Postgraduate year (PGY)-1 and PGY-2 residents were assessed on milestone levels 1 through 3; PGY-3 and PGY-4 residents were assessed on levels 3 through 5. Each milestone was rated on a nominal scale (yes, no, or not applicable). The Clinical Competency Committee combined the ESE data with data from other assessments to determine each resident's proficiency level for the emergency medicine subcompetencies. We used descriptive statistics to summarize resident ESEs and milestone levels. We analyzed differences in ESE score across PGY levels using t tests and analyses of variance.

Results
Faculty completed 763 ESEs on 33 residents with a range of 2 to 54 (median = 22) ESEs per resident. Faculty rarely (8%, 372 of 4633) rated a resident as not achieving a milestone on the ESEs. Analyses of variance revealed that ESE scores on level 3 milestones did not differ significantly by PGY level. There was poor agreement between ESE scores and Clinical Competency Committee ratings.

Conclusions
The ESEs constructed using the milestones resulted in grade or milestone inflation. Our results do not support using milestones as a stand-alone assessment tool.
Barriers and Facilitators to Effective Feedback: A Qualitative Analysis of Data From Multispecialty Resident Focus Groups
Authors: Reddy Shalini T. , Zegarek Matthew H. , Fromme H. Barrett , Ryan Michael S. , Schumann Sarah-Anne , Harris Ilene B. 
Published: March 2015

AbstractBackgroundDespite the importance of feedback, the literature suggests that there is inadequate feedback in graduate medical education.ObjectiveWe explored barriers and facilitators that residents in anesthesiology, emergency medicine, obstetrics and gynecology, and surgery experience with giving and receiving feedback during their clinical training.MethodsResidents from 3 geographically diverse teaching institutions were recruited to participate in focus groups in 2012. Open-ended questions prompted residents to describe their experiences with giving and receiving feedback, and discuss facilitators and barriers. Data were transcribed and analyzed using the constant comparative method associated with a grounded theory approach.ResultsA total of 19 residents participated in 1 of 3 focus groups. Five major themes related to feedback were identified: teacher factors, learner factors, feedback process, feedback content, and educational context. Unapproachable attendings, time pressures due to clinical work, and discomfort with giving negative feedback were cited as major barriers in the feedback process. Learner engagement in the process was a major facilitator in the feedback process.ConclusionsResidents provided insights for improving the feedback process based on their dual roles as teachers and learners. Time pressures in the learning environment may be mitigated by efforts to improve the quality of teacher-learner relationships. Forms for collecting written feedback should be augmented by faculty development to ensure meaningful use. Efforts to improve residents' comfort with giving feedback and encouraging learners to engage in the feedback process may foster an environment conducive to increasing feedback.
Incidence of Lymphatic Metastasis to Neck Nodes Level IIb in Neck Dissection for Head and Neck Cancers: A Retrospective Study
Authors: Zahrani Faisal Al , Al-Qahtani Khalid , Alshahrani Mohammed , Almufargi Khamis , Alkhudhayri Abdullah , Obad Labeb , Islam Tahera 
Published: March 2015

ABSTRACTIntroductionSelective neck dissection (SND) is performed to prevent head and neck cancers metastasis. We tried to determine the incidence of level IIb lymph nodes metastasis and it is associations in head and neck cancers for selection of patients requiring SND.Materials and methodsA retrospective study was conducted on 57 patients who underwent surgical removal of the head and neck tumor by 84 neck dissections. Fisher exact test was used to measure the association between positive IIb nodes and the other variables.ResultsNine (15.8%) of 57 patients showed level IIb lymph nodes metastasis comprising 10.71% of the 84 neck dissections. Six (66.66%) were associated with oral cavity cancers, 8 (88.9%) with squamous cell carcinoma (SCC), 6 (66.66%) with T4 tumor. Five (55.6%) were N2b, and 7 (77.8%) were found in N+ necks. All (100%) positive IIb nodes were associated with metastatic level IIa. Significant associations were found betweenpositive IIbnodesand N2b (p= 0.005), clinically N+ necks (p = 0.005) and IIa (p < 0.01).ConclusionThe incidence of level IIb nodes metastasis is high so they should be removed in any oral tumor, SCC, advanced staging, N+ necks or positive IIa lymph nodes metastasis.How to cite this articleAl zahrani F, Al-Qahtani K, Alshahrani m, Almufargi K, Alkhudhayri A, Obad l, Islam T. Incidence of lymphatic metastasis to Neck Nodes level IIb in Neck Dissection for Head and Neck Cancers: A Retrospective Study. Int J Head Neck Surg 2014;5(3):99-103.
Acute Formic Acid Poisoning: A Case Series Analysis with Current Management Protocols and Review of Literature
Authors: Naik Sudhir M , Goutham MK , Bhat Ravishankar S , Bhat CR , Appaji Mohan , Chidananda KV , Devi Nongthomban Pinky , Joseph Sherry , Nayak Pooja 
Published: March 2015

ABSTRACT

Background
Formic acid (FA) being pungent, odorless, easily available and consumed for suicidal purposes and the dilute form being colorless and odorless is consumed accidentally. Accidental ingestion is rare and deliberate self-harm is very painful and violent which has been a rare modality of committing suicide but for these areas where it is easily available.

Materials and methods
This a retrospective case series analysis study 14 patients with acute formic acid poisoning. There were 14 patients, with 3 females and 11 males. The average age was 35.5 years, with the average in males being 34.9 and 37.6 in females. Thirty milliliter were considered as cutoff range as diluted/undiluted FA below 30 ml were managed in our institution and 30 ml+ were referred to higher toxicology speciality care.

Results
Act of deliberate self-harm was seen in 11 cases (78.5%) and accidental ingestion in three cases (21.5%). All had orofacial burns, 4 had mild hematemesis and 3 severe hematemesis with impending renal complications. All the stabilized and referred cases were no further evaluated for follow-up. Facial burns and contracture needing cosmetic correction was seen in three cases, while corneal and lid scarring seen in two cases while a case of esophageal stricture with lower GIT and renal complications were seen in one case.

Conclusion
Formic acid poisoning is uncommon, and limited literature review is available with fewer protocols laid. So, immediate management of this corrosive poisoning with supportive measures reduces the mortality drastically. Serial upper gastrointestinal imaging diagnose stricture earlier and cosmetic reconstruction helps in facial scarring and contractures.

How to cite this article
Bhat RS, Naik SM, Goutham MK, Bhat CR, Appaji M, Chidananda KV, Devi NP, Joseph S, Nayak P. Acute Formic Acid Poisoning: A Case Series Analysis with Current management Protocols and Review of Literature. Int J head Neck Surg 2014;5(3):104-107.
Physiotherapy on the Complications of Head and Neck Cancer: Retrospective Study
Authors: Tacani Rogerio Eduardo , Machado Aline Fernanda Perez , Goes João Carlos G Sampaio , Marx Angela Gonçalvez , Franceschini Juliana Pereira , Tacani Pascale Mutti 
Published: March 2015

ABSTRACT

Introduction
Physiotherapy has an important role in cancer rehabilitation, particularly with the head and neck cancer patients, in an attempt to minimize the morbidities caused by the disease and its treatment.

Objective
To determine the role of physiotherapy treatment in morbidities of head and neck cancer, in a retrospective investigation, at one oncologic hospital.

Materials and methods
Retrospective study based on the analysis of medical records of 32 patients treated at the outpatient Physiotherapy department at the Brazilian Institute of Cancer Control (IBCC), from August 2008 to July 2010.

Results
Twenty-nine medical records were evaluated, 86.2% were males with cancer in the oral cavity (41.4%) that had radical neck dissection (69%) and radiotherapy (86.2%), evolving with lymphedema (89.7%), pain (82.8%), normotrophic scar (65.5%), tissue adherence (27.6%) and hypoesthesia (51.7%). The physiotherapeutic treatment included: manual lymphatic drainage (89.7%), transcutaneous electrical nerve stimulation (TENS; 51.7%), mechanical massage therapy (37.9%), stretching exercises (79.3%) and patient education (100%). The results showed a reduction of pain and lymphedema, increased normotrophic scars and normoesthesia, with an average of 19.3 ± 14.5 sessions and treatment discharge of 65.5%.

Conclusion
Physical therapy in morbidities of head and neck cancer was effective in reducing pain and lymphedema, combining manual lymphatic drainage, transcutaneous electrical nerve stimulation (TENS), mechanical massage therapy, stretching exercises and patient education, with an average of 19 sessions and discharge after treatment.

How to cite this article
Tacani RE, Machado AFP, Goes JCGS, Marx AG, Franceschini JP, Tacani PM. Physiotherapy on the Complications of Head and Neck Cancer: Retrospective Study. Int J Head Neck Surg 2014;5(3):112-118.
Paradigm Shift of Carotid Body Paraganglioma Surgical Technique from Caudocranial to Craniocaudal Dissection: Analysis of Recent Literature
Authors: Naik Sudhir , Halkud Rajshekar , Nanjundappa A , Biswas Siddharth , Shenoy Ashok M , Chavan Purshottam , Sidappa KT , Madhu SD 
Published: March 2015

ABSTRACT

Background
The classical Shamblin's classification predicts only vascular morbidity without remarking on the neurological morbidity, while the neurological damage increase with vessel ligation and reconstruction. A modified Shamblin's classification described by Luna-ortiz with incorporation of the Hallett's zones of injury has been studied here.

Materials and methods
We present a case series analysis of carotid body paraganglioma managed in our institute. The study included 17 patients, 14 females and three males with a mean duration of presentation of 6.82 months. All were imaged with multislicer computed tomography angiography (CTA) and magnetic resonance angiography (MRA) for preoperative assessment and operated in the craniocaudal technique. The tumors were graded according to the modified Shamblin's criteria: grades I (2), II (13), IIIa (2), IIIb (0).

Results
All the preoperative assessment of grading matched with the intraoperative findings. External carotid artery (ECA) ligation was done in two cases, no internal carotid artery (ICA) ligation and reconstruction were done. Two cases of permanent damage to the 12th nerve, two vagal nerve weakness was seen. No stroke or mortality recorded. The tumor was confirmed on immunohistochemistry. The patients were followed up for 6 months to 5 years with a mean follow-up of 2.5 years.

Conclusion
Preoperative imaging assessment using multislicer computed tomography angiography (MSCTA) and MRA helps to measuring the circumferential vessel involvement in grade III tumors. So, a craniocaudal dissection with assessment of all the zones of injury reduced blood loss and minimized neurovascular complications.

How to cite this article
Halkud R, Shenoy AM, Nanjundappa A, Chavan P, Sidappa KT, Madhu SD, Biswas S, Naik SM. Paradigm Shift of Carotid Body Paraganglioma Surgical Technique from Caudocranial to Craniocaudal Dissection: Analysis of Recent Literature. Int J Head Neck Surg 2014;5(3):119-125.
Rosai-Dorfman Disease: A Rare Cause of Cervical Lymphadenopathy
Authors: Anand Adharsh , Lanjewar Kanchan , Ekhar Vipin Ram , Shelkar Ritesh N , Rane Sachin , Jain Suresh Kumar Tarachand 
Published: March 2015

ABSTRACT
Rosai-Dorfman disease is also known as sinus histiocytosis with massive lymphadenopathy (SHML) is a rare clinico-pathological condition. It is a benign condition which causes significant cervical lymphadenopathy in children and young adults. The clinical presentation varies from isolated nodal involvement to significant extranodal manifestations. The clinical features are usually mild, but rarely life-threatening complications can occur in some individuals depending on the site of involvement. Here, we present two cases of Rosai-Dorfman disease, both diagnosed on fine needle aspiration cytology (FNAC) and histopathology and responded well to steroids. One of the patients had extranodal site involvement in the form of bilateral nasal mass which is very rare.

How to cite this article
Ekhar VR, Shelkar RN, Rane S, Anand A, Lanjewar K, Jain SKT. Rosai-Dorfman Disease: A Rare Cause of Cervical Lymphadenopathy. Int J Head Neck Surg 2014;5(3): 152-154.
Novel Approach to Rhinosporidiosis
Authors: Aroor Rajeshwary , Gowda Madhukar Muniswamy , Bhat Vadisha Srinivas , Bhandary Satheesh Kumar 
Published: March 2015

ABSTRACTRhinosporidiosis is a chronic enigmatic disease affecting mainly the upper aerodigestive tract and is notorious for frequent recurrences as high as 70%. Higher incidences of recurrence are mainly due to nonendoscopic excision with resultant residual disease leading to seedling of the disease.ObjectivesThe aim of this study is to highlight the factors responsible for recurrence and to follow the clinical course to ensure against recurrence of rhinosporidiosis. External surgery in rhinosporidiosis should be avoided for the fear of implantation. With the advent of endoscopes and Lasers allow the surgeon to complete excision of the lesion with cauterization of the base.Materials and methodsA retrospective study of thirty two cases of rhinosporidiosis presented to us over a period of 10 years from 2002 to 2012. Out of which 14 cases presented to us for the first time and 18 cases were recurrent cases. The commonest age group of presentation was between 20 and 30 years in patients presenting for the first time and in recurrent cases the commonest age of presentation was between 50 and 60 years of age. Majority of patients were males with male to female ratio of 9:1. All patients underwent endoscopic excision, electro cautery was used in 30 patients and Laser was used in 2 patients.ResultsFourteen cases did not have any recurrence and in the 18 cases of recurrent cases three of them again had a recurrence where electro cautery was used to cauterize the base.ConclusionEndoscopic excision of rhinosporidiosis has a better result over nonendoscopic approaches with lesser recurrence rate. Our results show that use of endoscopes in patients who presented for the first time have a better results as the mucosa of recurrence patients have already been insulted due to previous surgeries.How to cite this articleAroor R, Gowda MM, Bhat VS, Bhandary SK. Novel Approach to Rhinosporidiosis. Int J Otorhinolaryngol Clin 2014;6(2):55-57.
Preauricular Sinus as Recurrent Postaural Abscess: A Rare Presentation
Authors: Malipatil Sharanabasappa Rudragouda 
Published: March 2015

ABSTRACTPreauricular sinus (PAS) is not uncommon congenital anomaly. It is usually asymptomatic and does not require any treatment. Patient presenting with discharge, recurrent infections and preauricular abscess will require management with antibiotics and surgical extirpation of the sinus tract. Here, it is a rare case report of PAS presenting as a recurrent postaural abscess.How to cite this articleMalipatil SR. Preauricular Sinus as Recurrent Postaural Abscess: A Rare Presentation. Int J Otorhinolaryngol Clin 2014;6(2):84-86.