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The radial forearm free flap (RFFF) is one option of many free-tissue flaps that is frequently selected to reconstruct defects of the head and neck. It is popular due to its relatively thin and pliable associated soft tissue, reliable supplying vasculature, and appropriate diameter and length of the supplying vessels to perform microvascular anastomosis. This case report describes the use of the RFFF to reconstruct an oral cavity defect following tumor resection in a patient who required adjustment of the typical RFFF design. This patient has a significant psychiatric history leading to self-induced forearm lacerations that resulted in substantial scarring of her bilateral forearms in the anatomical area typically included in the RFFF. Since the RFFF was the optimal reconstructive option for this patient, the design of the RFFF was able to be moved proximally up her forearm to avoid inclusion of the scars in the flap. Adequate blood flow of the ulnar artery was confirmed with an Allen0s test preoperatively to ensure the radial artery could be taken as part of the RFFF without causing ischemia of the hand. Following surgical resection of the patient0s tumor, the RFFF was harvested and inset to reconstruct the resulting oral cavity defect. The patient has had no complications following her resection and reconstruction to date. This report highlights the adaptability of the RFFF, allowing adjustments to typical flap design to optimize outcomes for each individualized patient. [ABSTRACT FROM AUTHOR]

The article presents a report on teaching methods and programmed instructions in the U.S. During the past few years, in the process of continuing search to discover means for increasing instructional efficiency and for developing new materials to cope with the rapidly expanding demands for additional education and training by a burgeoning number of learners, the experimentation and development of programed learning has received the attention of educators and training directors across the country. Programed instruction has found wide-spread usage in industry and in the armed forces in various aspects of training for specific assignments or tasks, in which predetermined performance levels or behavioral patterns had been established. In numerous situations in both education and industry, programed instruction has proved to be effective, and under some circumstances more so than conventional methods. However, at this time research findings, especially at the college level, are totally inadequate to serve as a basis for making decisions on the adoption of programed learning for use throughout any specific course or program.

The editor of Wildlife Society Bulletin asked me to respond to the Gates et al. (2006) article on The Wildlife Society's (TWS) economic growth policy statement. This was done with the concurrence of the authors of that article. I prepared a draft of this response, then ran it by Council, along with the Gates manuscript, the original proposed policy statement, and the policy statement approved by Council. In our reading of the Gates manuscript, the issues raised by the authors seem to be twofold: 1) the process by which this policy statement was adopted, and, 2) the content of the adopted policy, which varies significantly from that proposed by the TWS Working Group on Local Governance. I will address both issues. [ABSTRACT FROM AUTHOR]