bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study to Assess Differences in Outcome Following Open Carpal Tunnel Decompressions Performed by Surgeons of Differing Grade
Authors: Akhtar S , Sinha S , Bradley MJ , Burke FD , Wilgis SEF , Dubin NH 
Published: January 2008

INTRODUCTION Carpal tunnel decompression is the most commonly performed surgical procedure within a hand unit. Although very effective, the complications following the procedure can be significant. In an attempt to identify the causes of such complications, we assessed whether seniority of the surgeon impacts on outcome for open carpal tunnel decompression. PATIENTS AND METHODS Data were jointly and prospectively gathered from two units from either side of the Atlantic – the Pulvertaft Hand Center, UK and the Curtis Hand Center, USA. The aim of the study was to assess outcome following carpal tunnel decompression. Completed data were gathered following open carpal tunnel decompression on 352 hands. Surgeons of a consultant grade had performed 123 of these procedures whilst surgical trainees had performed 229 of the procedures. Assessment was by Levine Katz questionnaire results, Semmes-Weinstein testing, grip strength and pinch grip strength testing performed both preoperatively and 6 months' postoperatively. Complications following the procedure were also recorded. RESULTS Mean results were found to be better in those patients where the surgeon was of a consultant grade. However, this was only found to be of statistical significance on Semmes-Weinstein testing. Complications following the procedure were also noted to be higher in the group of patients operated on by trainee grades. CONCLUSIONS Our results show the carpal tunnel decompression performed by a surgeon of consultant grade offers slightly better results in objective neurological testing when compared with those performed by a more junior grade.
Vascular Surgery is An Unattractive Career Option for Current Basic Surgical Trainees: A Regional Perspective
Authors: Currie S , Coughlin PA , Bhasker S , Hossain J , Irvine CD , Curley PJ 
Published: January 2008

INTRODUCTION The workload of vascular services will substantially increase in the foreseeable future with the recent changes in surgical training presenting a challenge to training and recruitment in vascular surgery. This study aimed to determine the current feelings towards vascular surgery as a career choice from basic surgical trainees (BSTs) within a single region. MATERIALS AND METHODS BSTs from a single region were questioned. Probable career specialty choice was ascertained, as were suggestions for changes to the career pathway of a vascular surgeon to make it a more attractive career choice. RESULTS Seventy-seven of 110 BSTs returned the questionnaire. Of the 77, 52 had previous experience of a vascular firm. Ten BSTs had been on a pure vascular firm as an SHO and 52 had been on a general surgical firm. No BST specified vascular surgery as their ultimate career choice. Career choices included general surgery (n = 30), orthopaedics (n = 17), plastic surgery (n = 9) and urology (n = 5). Thirty-three BSTs would not be tempted at all to a career in vascular surgery. Changes in the career structure that would result in BSTs contemplating a career in vascular surgery included the inclusion of endovascular surgery (n = 13), no compulsion to undertake a period of research (n = 5), pure vascular training (n = 2), more general surgical training (n = 2) and less onerous on-calls when older (n = 2). CONCLUSIONS The lack of trainees wishing to become vascular surgeons is of grave concern. Increasing the endovascular capabilities of vascular surgeons as well as altering the stance on research may have an increasingly positive role in recruitment.
Knowledge Transfer in Surgery: Skills, Process and Evaluation
Authors: Dawes Martin , Lens Marko 
Published: January 2008

INTRODUCTION Knowledge transfer is an essential element in the management of surgical health care. In a routine clinical practice, surgeons need to make changes to the health care they provide as new clinical evidence emerges. MATERIALS AND METHODS The information was derived from the authors' experience and research in evidence-based practice, searching of the literature, teaching and organisation of various national and international workshops on evidence-based medicine. DISCUSSION This manuscript discusses principles of knowledge transfer in surgery including evaluation of recommended changes that can improve quality of health care in routine surgical practice. Skills, process and evaluation are carefully described. Continuous information delivery is required to enable surgeons to improve knowledge transfer and to keep up to date their knowledge.
Oesophageal Replacement in Children
Authors: Arul GS , Parikh D 
Published: January 2008

INTRODUCTION The usual indications for oesophageal replacement in childhood are intractable corrosive strictures and long-gap oesophageal atresia. Generally, paediatric surgeons attempt to preserve the native oesophagus with repeat dilatations. However, when this is not successful, an appropriate conduit must be fashioned to replace the oesophagus. The neo-oesophagus should allow normal oral feeding, not have gastro-oesophageal reflux, and be able to function well for the life-time of the patient. PATIENTS AND METHODS A Medline search for oesophageal replacement, oesophageal atresia, gastric transposition, colon transposition, gastric tube, caustic stricture was conducted. The commonest conduits including whole stomach, gastric tube, colon and jejunum are all discussed. RESULTS No randomised controlled studies exist comparing the different types of conduits available for children. The techniques used tend to be based on personal preference and local experience rather than on any discernible objective data. The biggest series with long-term outcome are reported for gastric transposition and colon replacement. Comparison of a number of studies shows no significant difference in early or late complications. Early operative complications include graft necrosis, anastomotic leaks and sepsis. Late problems include strictures, poor feeding, gastro-oesophageal reflux, tortuosity of the graft and the development of Barrett's oesophagus. The biggest series, however, seem to have lower complications than small series probably reflecting the experience, built up over years, in their respective centres. CONCLUSIONS Long-term follow-up is recommended because of the risks of late strictures, excessive tortuosity of the neo-oesophagus and the development of Barrett's oesophagus.
Underestimation of Severity of Previous Whiplash Injuries
Authors: Naqui SZH , Lovell SJ , Lovell ME 
Published: January 2008

INTRODUCTION We noted a report that more significant symptoms may be expressed after second whiplash injuries by a suggested cumulative effect, including degeneration. We wondered if patients were underestimating the severity of their earlier injury. PATIENTS AND METHODS We studied recent medicolegal reports, to assess subjects with a second whiplash injury. They had been asked whether their earlier injury was worse, the same or lesser in severity. RESULTS From the study cohort, 101 patients (87%) felt that they had fully recovered from their first injury and 15 (13%) had not. Seventy-six subjects considered their first injury of lesser severity, 24 worse and 16 the same. Of the 24 that felt the violence of their first accident was worse, only 8 had worse symptoms, and 16 felt their symptoms were mainly the same or less than their symptoms from their second injury. Statistical analysis of the data revealed that the proportion of those claiming a difference who said the previous injury was lesser was 76% (95% CI 66–84%). The observed proportion with a lesser injury was considerably higher than the 50% anticipated. CONCLUSIONS We feel that subjects may underestimate the severity of an earlier injury and associated symptoms. Reasons for this may include secondary gain rather than any proposed cumulative effect.
Contemporary Practice of Percutaneous Nephrolithotomy: Review of Practice in a Single Region of the UK
Authors: Srirangam Shalom J , Darling Richard , Stopford Maureen , Neilson Donald 
Published: January 2008

INTRODUCTION Most series of percutaneous nephrolithotomy (PCNL) from single specialised centres represent optimum results achievable and may not reflect outcomes of everyday practice. We analysed the practice in our region. PATIENTS AND METHODS Medical records of 178 patients undergoing PCNL in 2002 in 12 participating hospital trusts were retrospectively analysed. RESULTS Even outside the tertiary referral centres, there was a 6-fold difference between trusts in the frequency of PCNL. In 28% of cases, another stone-removing modality had been tried first. Failed renal puncture was a major cause of abandoning surgery (9%). An indication of the difficulty in obtaining complete stone clearance is that only 107 (60%) operation notes recorded complete clearance, while 75 (42%) patients required a subsequent procedure (13% a secondary PCNL). Use of supra 12th rib punctures was small (6%) as was the rate of ‘tube-less’ PCNL (4%). Some 22% had simultaneous ureteric stent insertion. Approximately 8% of cases required a blood transfusion. Thirty-eight patients (23%) had a proven infection (UTI) pre-operatively (> 104 organisms; > 10 white blood cells) with almost all patients receiving antibiotics at anaesthesia induction. Postoperative sepsis rates (temperature > 38.5°C) were similar in those with and without a pre-operative UTI (18.4% versus 14.3%) and pre-operative antibiotics appeared to have little extra protective effect. Severe sepsis was rare with no patient requiring intensive care admission for this reason. Median length of stay postoperatively was 5 days. CONCLUSIONS These results present important figures to quote when counselling patients pre-operatively, albeit that the degree of difficulty (and hence the likelihood of problems) is identifiable from stone and anatomical configurations. In addition, the present data are a more accurate reflection of urinary stone surgery in non-tertiary, general urological practice.
What teacher factors influence their attributions for children's difficulties in learning?
Authors: Brady Katy , Woolfson Lisa 
Published: January 2008

Background Identifying the factors that influence teacher beliefs about teaching children with learning difficulties is important for the success of inclusive education. This study explores the relationship between teachers' role, self‐efficacy, attitudes towards disabled people, teaching experience and training, on teachers' attributions for children's difficulties in learning.Method One hundred and eighteen primary school teachers (44 general mainstream, 33 mainstream learning support, and 41 special education teachers) completed the short form of the Teachers' Sense of Efficacy Scale, the Interaction with Disabled Persons Scale (IDP), and a revised version of the Teacher Attribution Scale.Results Regression analysis found that teachers' role influenced stability and controllability attributions. However, for stability attributions the effect was not sustained when examined in the context of the other factors of teaching efficacy, experience, training, and attitudes towards disability. What emerged as important instead was strong feelings of sympathy towards disabled people which predicted stable attributions about learning difficulties. Experience of teaching children with additional support needs and teaching efficacy positively predicted external locus of causality attributions. Surprisingly, training was not found to have an impact on attributions. A mixed MANOVA found that mainstream teachers' controllability attributions were influenced by whether or not the child had identified learning support needs.Conclusions Teacher efficacy, experience of teaching students with support needs, attitudes towards disabled people, and teachers' role all impact on teacher attributions, but no relationship with training was found. Implications for teacher training and development, and for student achievement and student self‐perception are discussed.
Changing epistemological beliefs: The unexpected impact of a short‐term intervention
Authors: Kienhues Dorothe , Bromme Rainer , Stahl Elmar 
Published: January 2008

Background Previous research has shown that sophisticated epistemological beliefs exert a positive influence on students' learning strategies and learning outcomes. This gives a clear educational relevance to studies on the development of methods for promoting a change in epistemological beliefs and making them more sophisticated.Aims To investigate the potential for influencing domain‐specific epistemological beliefs through a short instructional intervention.Sample On the basis of their performance on a preliminary survey of epistemological beliefs, 58 students at a German university (87.7% females) with a mean age of 21.86 years (SD = 2.88) were selected. Half of them had more naive beliefs and the other half had more sophisticated ones.Methods Participants were randomly assigned to one of two groups: one whose epistemological beliefs were challenged through refutational epistemological instruction or another receiving non‐challenging informational instruction. The treatment effect was assessed by comparing pre‐ and post‐instructional scores on two instruments tapping different layers of epistemological beliefs (DEBQ and CAEB). Data were subjected to factor analyses and analyses of variance.Results According to the CAEB, the naive group receiving the refutational epistemological instruction changed towards a more sophisticated view, whereas the sophisticated students receiving the informational instruction changed towards an unintended, more naive standpoint. According to the DEBQ, all research groups except the naive refutational group revealed changes towards a more naive view.Conclusions This study indicates the possibility of changing domain‐specific epistemological beliefs through a short‐term intervention. However, it questions the stability and elaborateness of domain‐specific epistemological beliefs, particularly when domain knowledge is shallow.
Book Reviews
Authors: Gallucci Marcello 
Published: January 2008

New developments in categorical data analysis for the social and behavioural sciencesBy L. Andries van der Ark, Marcel A. Croon and Klass Sijtsma New Jersey, USA: Lawrence Erlbaum Associates, 2004, 240pp, £42.95, ISBN 978‐0‐8058‐4728‐4
Taking computerized CBT beyond primary care
Authors: Learmonth Despina. , Rai Sadik. 
Published: January 2008

ObjectivesThis study seeks to determine whether the effectiveness of Beating the Blues (BtB), an established computer‐based CBT (CCBT) programme, can extend beyond primary care.DesignBtB was delivered and evaluated in an NHS specialist CBT care centre as part of routine care.MethodA sample of 104 service users, typically displaying chronic levels of depression and/or anxiety received CCBT.ResultsCompleters' scores on the Clinical Outcomes in Routine Evaluation‐Outcome Measure (CORE‐OM), as well as on single‐item rating scales for anxiety and depression, improved significantly following the intervention. Statistically significant differences held during intention‐to‐treat analyses. Almost half of the completer sample achieved reliable and clinically significant change. The results were benchmarked against national data sets.ConclusionsThese preliminary findings suggest a potential role for CCBT within secondary care as a first step, self‐help treatment tool for anxiety and depression.
Implicit and explicit motor learning in children with and without Down's syndrome
Authors: Vinter Annie. , Detable Christelle. 
Published: January 2008

This paper reports a study investigating the degree of dissociation between performance shown by children with or without Down's syndrome (DS), matched on non‐verbal MA‐level, following an implicit or explicit learning procedure. Task‐specific factors were tightly controlled using the same task for both modes of learning. The implicit learning task was based on the manipulation of a graphic production principle. Our procedure trained participants to reverse the principle. In the explicit task, participants had to learn the two rules that account for this reversed principle. Whether they were trained implicitly or explicitly, participants then performed the same test in which the impact of their training was assessed.Children with DS performed as well as controls in the implicit learning condition. They benefited less from the explicit learning condition than controls. They appeared to be impaired in the ability to recollect explicit information about the implicit training situation in comparison with controls. These results are discussed in the light of the current literature on the implicit and explicit modes of learning, and hypotheses are formulated about specific information processes that may be impaired in individuals with DS.
Validity in judgments of high‐ and low‐accurate witnesses of own and other ethnic groups
Authors: Lindholm Torun 
Published: January 2008

Purpose. Research has shown that people often have difficulties estimating eyewitness accuracy correctly. In most previous studies examining validity in credibility judgments, participants have assessed the accuracy of witnesses who have been homogeneous in their memory performance. This study investigated validity in judgments of witnesses who varied widely in memory. A further purpose was to examine whether judgmental validity was moderated by the witnesses' ethnic in‐group/out‐group status.Methods. Participants (N = 120) rated the reliability of videotaped testimonies of high‐ and low‐accurate in‐group (Swedish, N = 4) and out‐group (immigrants, N = 4) witnesses who were genuinely trying to recall a criminal event.Results. Participants assigned more reliability to high‐ than to low‐accurate in‐group witnesses, while out‐group witnesses received low reliability ratings regardless of their actual memory performance. Path analyses demonstrated that the subjective confidence of in‐group, but not of out‐group, witnesses predicted participants' accuracy judgments.Conclusions. The results indicate that the validity in judgments of in‐group witnesses can be better than has previously been implied. Investigators may have difficulty distinguishing high‐ and low‐accurate witnesses from other ethnic groups, and they may also systematically underestimate the reliability of ethnic out‐group witnesses. Implications for legal practices are discussed.
Assessment of sexual interest using a choice reaction time task and priming: A feasibility study
Authors: Santtila Pekka , Mokros Andreas , Viljanen Klaus , Koivisto Mika , Sandnabba N. Kenneth , Zappalà Angelo , Osterheider Michael 
Published: January 2008

Purpose. We investigated the feasibility of assessing sexual interest in hetero‐ and homosexual men using two information‐processing methods, namely a choice reaction time task and priming. The participants were expected to have longer reaction times for sexually explicit when compared with non‐explicit pictures due to sexual content‐induced delay. In addition, the reaction times of the heterosexual (N=15) and homosexual (N=11) men for pictures corresponding with their sexual interest were compared to pictures not corresponding with their sexual interest. Heterosexual men were expected to have longer reaction times during the presentation of sexually explicit female as opposed to male pictures, whereas homosexual men were expected to have the opposite pattern.Method. The participants were presented either sexually explicit or non‐explicit male and female target pictures (and primes that preceded the targets in random combinations) while simultaneously performing a choice reaction time task in three phases each containing a total of 160 prime–target pairs.Results. Both expectations were confirmed in phase 1 of the study. In phase 2, the means differed in the expected way, but the effects were not significant. In phase 3, the expected effect was moderated by a complex priming effect.Conclusions. The results suggest that the choice reaction time task is a promising way of measuring sexual interest but that questions of habituation should be given more attention in future studies.
Psychosocial factors related to cardiovascular disease risk in UK South Asian men: A preliminary study
Authors: Williams Emily D. , Kooner Ishminder , Steptoe Andrew , Kooner Jaspal S. 
Published: January 2008

Objective. To compare the exposure to psychosocial factors associated with cardiovascular risk in UK South Asian and white European men.Design. Interview study of 63 healthy UK South Asian and 42 white European men aged 35–75 years, randomly selected from a larger study group in West London. Interviews were administered in Punjabi and English. Measures of psychosocial and cardiovascular risk factors were obtained.Setting. Ealing Hospital, West London.Results. The South Asian men had lived in the UK for an average of 27.9 (SD 11.6) years, and had higher educational attainment than the white Europeans. Compared with the white Europeans, the South Asian men lived in significantly more crowded homes, experienced lower job control, greater financial strain, lower neighbourhood social cohesion and more racial harassment. They received less emotional support, and were more depressed and less optimistic on standard questionnaires. These men also had higher waist/hip ratios and were more sedentary, but there were no significant ethnic differences in biological risk factors.Conclusions. South Asian men living in London showed a higher risk profile in psychosocial factors thought to contribute to cardiovascular disease risk. This preliminary investigation is consistent with the possibility that psychosocial adversity contributes to increased vulnerability to coronary heart disease in South Asians resident in the UK.
Does the easy–difficult item measure attitude or perceived behavioural control?
Authors: Gagné Camille , Godin Gaston 
Published: January 2008

Objective In order to determine if easy–difficult item measures attitude or perceived behavioural control (PBC), we used structural equation modelling of 10 cross‐sectional data sets.Design Cross‐sectional design was used.Method. Ten studies that examined health‐related behaviours and used the theory of planned behaviour as a theoretical framework were analysed. Samples totalling N = 4,552 participants were employed. All studies involved multi‐item measures of attitude (Aact) and PBC items derived from pilot testing.Results Confirmatory factor analysis confirmed the discriminant validity of Aact and PBC. Structural equation modelling of relevant path indicated that in three studies, easy–difficult item is an indicator of both Aact and PBC. In the other seven studies, easy–difficult item belongs to PBC. The indexes of meta‐analysis suggest that overall, easy–difficult item is an indicator of PBC.Conclusion. Findings from 10 studies converged toward the conclusion that the easy–difficult item is an indicator of perceived PBC. However, since the easy–difficult item is sometimes classified as both Aact and PBC, and only the perceived difficulty dimension of PBC captures a significant increment in the variance of intention, it appears important to develop and validate a set of items devoted to measure the perceived difficulty dimension adequately.