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Tests 53 fourth- and fifth-grade children on postdivorce adjustment immediately before and six months after participation in an eight-week preventive interventive program. Method; Results; Discussion.

A finite difference method is proposed for solving the transport of intensity equation. Simulation results show that although slower than fast Fourier transform (FFT)-based methods, finite difference methods are able to reconstruct the phase with better accuracy due to relaxed assumptions for solving the transport of intensity equation relative to FFT methods. Finite difference methods are also more flexible than FFT methods in dealing with different boundary conditions.

Unlabelled: The measurement of volatile organic compound (VOC) emissions from building products and materials by manufacturers and testing laboratories, and the use of the test results for labeling programs, continue to expand. One issue that hinders wide acceptance for chamber product testing is the lack of a reference material to validate test chamber performance. To meet this need, the National Institute of Standards and Technology (NIST) and Virginia Tech (VT) have developed a prototype reference material that emits a single VOC similar to the emissions of a diffusion-controlled building product source with a dynamic emissions profile. The prototype material has undergone extensive testing at NIST and a pilot interlaboratory study (ILS) with four laboratories. The next development step is an evaluation of the prototype source in multiple-sized chambers of 14 laboratories in seven countries. Each laboratory was provided duplicate specimens and a test protocol. Study results identified significant issues related to the need to store the source at a subzero Celsius temperature until tested and possible inconsistencies in large chambers. For laboratories using a small chamber and meeting all the test method criteria, the results were very encouraging with relative standard deviations ranging from 5% to 10% across the laboratories., Implications: Currently, the chamber performance of laboratories conducting product VOC emissions testing is assessed through interlaboratory studies (ILS) using a source with an unknown emission rate. As a result, laboratory proficiency can only be based on the mean and standard deviation of emission rates measured by the participating ILS laboratories. A reference material with a known emission rate has the potential to provide an independent assessment of laboratory performance as well as improve the quality of interlaboratory studies. Several international laboratories with different chamber testing systems demonstrated the ability to measure the emission rate of such a reference material within an acceptable measurement uncertainty.

Objective: To compare the effects of ultraviolet-C (UVC) with placebo-UVC on pressure ulcer healing in individuals with spinal cord injury (SCI)., Design: Double-blind randomized trial with stratification for ulcer location to buttock or lower extremity. Subjects were followed up for 1 year postintervention., Setting: Rehabilitation institution., Participants: Adult inpatients and outpatients (N=43) with SCI and stage 2 to 4 pressure ulcers (n=58)., Interventions: Ulcers and periwound skin were irradiated 3 times per week using UVC or placebo-UVC. The endpoint was wound closure or hospital discharge without closure., Main Outcome Measures: Primary outcome was weekly percent area relative to baseline. Secondary outcomes were mean percent area change between consecutive weeks, surface appearance, weeks to closure, and impact on quality of life and wound status postintervention., Results: Groups were similar at baseline for all demographic characteristics except ulcer duration (P=.02). Groups were similar when healing was compared overall. Subgroup analysis showed that the percent area relative to baseline for stage 2 buttock ulcers was significantly smaller in the group receiving UVC compared with placebo at weeks 3, 5, and 7. During weeks 1 through 8, these ulcers were 26% to 76% of baseline area using UVC versus 111% to 180% for placebo (achieved significant level [ASL], .03-.08; effect size, 0.5-0.8). Groups were similar in the percent area relative to baseline for stage 2 lower extremity ulcers. Group mean percent area change between consecutive weeks for all stage 2 ulcers was 36.6% with the use of UVC and 5.8% for placebo (ASL=.09). There were no group differences in the percent area relative to baseline and the mean percent area change between consecutive weeks for stage 3 to 4 ulcers. Groups were similar for all other secondary outcomes., Conclusions: UVC is beneficial for stage 2 buttock ulcers. Further studies are warranted using a larger sample size, carefully considered exclusion criteria, and strategies to ensure homogeneity of the groups that are being compared., (Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Most cleft surgeons require children to wear postoperative arm restraints although the literature suggests that there is no difference in early complications. The aim of this study was to determine if the use of postoperative arm restraints was effective in preventing early postoperative complications., Methods: We reviewed 120 consecutive primary cleft surgeries in which 1 surgeon used arm restraints in all patients and the other surgeon did not. Demographic information was obtained and complications were reviewed. We compared infection, fistula, and dehiscence between the 2 groups., Results: In 120 primary cleft surgeries, there was no difference in early complications in patients who were required to wear arm restraints versus those who were not (P<0.05)., Discussion: Arm restraints are unnecessary and may cause distress in both patients and their families. Eliminating arm restraints from cleft care would save the health care system an estimated $234,000 annually.

Mutations in breast and ovarian cancer susceptibility genes BRCA1 and BRCA2 predispose women to a high risk of these cancers. Here, we show that lymphoblasts of women with BRCA1 mutations who had been diagnosed with breast cancer are deficient in the repair of some products of oxidative DNA damage, namely, 8-hydroxy-2'-deoxyguanosine and 8,5'-cyclopurine-2'-deoxynucleosides. Cultured lymphoblasts from 10 individuals with BRCA1 mutations and those from 5 control individuals were exposed to 5 Gy of ionizing radiation to induce oxidative DNA damage and then allowed to repair this damage. DNA samples isolated from these cells were analyzed by liquid chromatography/mass spectrometry and gas chromatography/mass spectrometry to measure 8-hydroxy-2'-deoxyguanosine, (5'-S)-8,5'-cyclo-2'-deoxyadenosine, (5'-R)-8,5'-cyclo-2'-deoxyguanosine, and (5'-S)-8,5'-cyclo-2'-deoxyguanosine. After irradiation and a subsequent period of repair, no significant accumulation of these lesions was observed in the DNA from control cells. In contrast, cells with BRCA1 mutations accumulated statistically significant levels of these lesions in their DNA, providing evidence of a deficiency in DNA repair. In addition, a commonly used breast tumor cell line exhibited the same effect when compared to a relevant control cell line. The data suggest that BRCA1 plays a role in cellular repair of oxidatively induced DNA lesions. The failure of cells with BRCA1 mutations to repair 8,5'-cyclopurine-2'-deoxynucleosides indicates the involvement of BRCA1 in nucleotide-excision repair of oxidative DNA damage. This work suggest that accumulation of these lesions may lead to a high rate of mutations and to deleterious changes in gene expression, increasing breast cancer risk and contributing to breast carcinogenesis.

The incidence of operative procedures in a group of 374 cleft lip and palate patients was determined by a chart review. These patients were part of a long term study funded by the National Institute of Dental Research at the Lancaster Cleft Palate Clinic. The chart review provided a breakdown of the primary and secondary procedures performed on the patients. Although the secondary procedures carried out were underestimated in this study, it is clear that these operations comprise a major component of the successful treatment of these patients. The results of the study and the implications in today's managed care environment are discussed.

This study examined the processing of supportive interactions by dysphoric and nondysphoric preteens and early adolescents. Seventy-two youngsters between the ages of 10 and 13 evaluated the supportiveness and helpfulness of standardized, videotaped interactions between a distressed preadolescent and a maternal figure. The tape presentations varied in terms of the level of depicted maternal support and instructional condition (degree of self-reference). The results indicated that dysphoric youngsters evaluated both the supportiveness and helpfulness of interactions less positively than nondysphoric agemates. Group differences in support evaluations were most pronounced in the self-referenced condition. The level of depicted support did not affect processing differences. Dysphoric subjects reported lower levels of emotional support in prior relationships and a greater tendency to view supportive behavior as ingenuine than nondysphoric peers. Variation in prior support experiences accounted for group differences in the evaluation of the supportiveness of new interactions.

Perceptions of marital interactions were gathered from a representative sample of urban newlywed couples (199 Black and 174 White). A factor analysis of the reports found 6 factors common to husbands and wives: Disclosing Communication, Affective Affirmation, Negative Sexual Interaction, Traditional Role Regulation, Destructive Conflict, and Constructive Conflict. Avoiding Conflict was specific to men and Positive Coorientation was specific to women. Wives reported fewer constructive and more destructive conflict behaviors. Compared with Whites, Blacks reported more disclosure, more positive sexual interactions, and fewer topics of disagreement. They also more often reported leaving the scene of conflict and talking with others more easily than with the spouse. As hypothesized, perceptions that marital interactions affirm one's sense of identity strongly predicted marital well-being. Although regression analyses predicting marital happiness yielded few interactions with race or gender, those that are significant, coupled with race and gender differences in perceiving interaction, suggest taking a contextual orientation to the meaning of marital interaction.

Purpose: The response of malignant gliomas to radiation was examined retrospectively in 71 patients with newly diagnosed supratentorial malignant gliomas. Questions asked included frequency, timing and clinical significance of response., Methods and Materials: After surgery, all were treated with whole brain plus boost radiotherapy followed 8 weeks later by chemotherapy. The rate, degree, and timing of response to radiation were determined by comparing postoperative, end of radiation, and prechemotherapy CT scans on each patient., Results: Postoperative residual tumor was evident on 63/71 postoperative scans. Twenty-two of 63 tumors (35%) had a partial or complete response to radiation. Twenty (32%) had responded by the end of radiation; 17 maximally. Six to 8 weeks later, three responding tumors had responded further and two previously stable ones had begun to respond. Only three tumors (5%) responded completely. A greater proportion of anaplastic gliomas than glioblastomas responded to radiation (52% vs. 26%). Protracted or delayed responses were only observed in patients with anaplastic glioma. Patients who responded to radiation did not live significantly longer than non-responders. However, tumor progression prior to chemotherapy was associated with significantly shorter survival., Conclusion: This CT scan-based analysis demonstrates that malignant gliomas are only moderately radioresponsive tumors and also demonstrates that response to radiation, if it is going to occur, is usually evident by the end of treatment.

Pre- and postoperative computerized tomography scans, simulator films, and computerized tomography scans documenting tumor recurrence were analyzed on 70 patients with supratentorial malignant glioma treated with whole brain plus boost radiation therapy to determine sites of recurrence in relation to the boost. The boost was planned using the postoperative computerized tomography scan. Tumor recurred in 53 patients--within the boost in 38 (72%), partly outside the boost in 12 (23%), outside the boost but within the brain in one (2%), in the boost and in the spinal cord in one (2%), and in the spinal cord only in one (2%). All recurrences confined to the brain were found within 4 cm of the enhancing tumor as defined by the preoperative computerized tomography scan. Recurrences outside the boost were more common with inadequate boost margins, small boost volumes, temporal lobe tumors, and homolateral wedge pair technique. Survival was not adversely affected by recurrence outside the boost. We recommend that patients with malignant glioma be treated by parallel opposed fields with a margin that is 4 cm beyond the edge of the preoperative enhancing tumor, as seen on computerized tomography scan.

Urine samples of 120 heroin-addicted probands who had to take part in urinanalysis tests were analysed during a 26 months' period. Up to 7 substances (morphine/diamorphie, codeine, cocain, LSD, cannabinoides, barbiturates and amphetamines) were tested. The results were compared to the results of a group of 177 cannabies-smokers. The purpose of this study was to find out in how far urinanalysis tests can change drug-consuming behaviour. More than 80% of the cannabis-smokers showed evidently a decrease of THC-positive urine samples at the end of the investigation period. Only about 13% had positive samples during the whole period. 12 out of 120 heroin-addicted probands (= 10%) had morphine-positive urine samples at the beginning of investigations. For 104 out of 1423 tested samples (46 probands) an unmistakable distinction between morphine/diamorphine- or codeine-intake was not possible because the concentrations found were too low. About 20% of the samples indicated a shift to a substitutional used drug like codeine. Further more a slightly significant increase of cannabis-intake was to be observed.

Urine samples of 31 probands who had come in conflict with the Dangerous Drugs act and therefore had to take part in urinalysis tests where analysed during a period of 34 months. The purpose of this study was to find out whether urinalysis testing can reduce drug abuse. The urine samples were tested on morphine/codeine, cannabis and barbiturates. 28 out of 31 persons were to be tested on morphine, 13 on cannabis and 26 on barbiturates. 32% of the persons tested on morphine showed no positive results during the whole period of investigation. 3% had continuous relapses (greater than 30% positive results) during this time. A significant (x2 = 28.98) decrease of positive samples at the end of the investigation period was found. The tests on barbiturates showed no significant (x2 = 0) influence of the urinalysis on the frequency of positive results. Tests on cannabis showed a slightly significant (x2 = 4.26) increase of positive results at the end of the investigation period. Most of the test persons showed an obvious improvement of their social and family conditions during this period.

The functional and cosmetic results of this modified radical mastectomy are superior to those achieved by standard radical mastectomy. The incidence of lymphedema of the ipsilateral arm, which is one of the feared complications from a standard radical mastectomy, appears to be decidedly less.

A method for surgical correction of entropion in the elderly has been described, utilizing a medially-based muscle flap of the orbicularis oculi muscle. The flap is sutured to the periosteum over the lateral orbital rim, thus holding the tarsus and lower lid in a correct position against the globe. The repair is supported further by excising the excess lower lid skin and anchoring the remaining skin to the lateral canthal ligament. The key to this procedure is the ease and accuracy with which the correction can be accomplished.