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Selected AbstractsRater and occasion impacts on the reliability of pre-admission assessmentsMEDICAL EDUCATION, Issue 12 2009Rick D Axelson Context, Some medical schools have recently replaced the medical school pre-admission interview (MSPI) with the multiple mini-interview (MMI), which utilises objective structured clinical examination (OSCE)-style measurement techniques. Their motivation for doing so stems from the superior reliabilities obtained with the OSCE-style measures. Other institutions, however, are hesitant to embrace the MMI format because of the time and costs involved in restructuring recruitment and admission procedures. Objectives, To shed light on the aetiology of the MMI's increased reliability and to explore the potential of an alternative, lower-cost interview format, this study examined the relative contributions of two facets (raters, occasions) to interview score reliability. Methods, Institutional review board approval was obtained to conduct a study of all students who completed one or more MSPIs at a large Midwestern medical college during 2003,2007. Within this dataset, we identified 168 applicants who were interviewed twice in consecutive years and thus provided the requisite data for generalisability (G) and decision (D) studies examining these issues. Results, Increasing the number of interview occasions contributed much more to score reliability than did increasing the number of raters. Conclusions, Replicating a number of interviews, each with one rater, is likely to be superior to the often recommended panel interview approach and may offer a practical, low-cost method for enhancing MSPI reliability. Whether such a method will ultimately enhance MSPI validity warrants further investigation. [source] Federal Repatriation Legislation and the Role of Physical Anthropology in RepatriationAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue S41 2005Stephen D. Ousley Abstract Two laws governing the disposition of Native American human remains in museums and institutions have had a profound impact on anthropology, and especially physical anthropology. In contrast to the perception of constant conflict between Native Americans and physical anthropologists, the repatriation process based on these laws has been in large part harmonious between institutions and Native peoples in the US. Despite misconceptions, the Native American Graves Protection and Repatriation Act (NAPGRA; 25 United States Code (U.S.C.) 3001-3013) was not intended to halt further research on Native American remains in museums. In fact, court decisions have affirmed that the documentation of human remains produces information no other methods can provide, and provides necessary evidence to be incorporated and weighed, along with other evidence, in evaluating "cultural affiliation," the legal term for the required connection from federally recognized Native American groups to their ancestors. The wide variety of osteological data collected at the National Museum of Natural History (NMNH), Smithsonian Institution, have proven indispensable when evaluating cultural affiliation, especially when other information sources are unhelpful or ambiguous, and provide an empirical basis for determining the ancestry of individuals whose remains will be discovered in the future. To date, the claim-driven process at the NMNH has resulted in the affiliation and repatriation of more Native American remains than any other institution in the country. Repatriation experiences at the NMNH demonstrate the changing relationships between museums and Native peoples, the continuing important contributions that physical anthropology makes to the repatriation process, and the importance of physical anthropology in understanding the recent and ancient history of North America. Yrbk Phys Anthropol 48:2,32, 2005. © 2005 Wiley-Liss, Inc. [source] Academic Research Training for a Nonacademic Workplace: a Case Study of Graduate Student Alumni Who Work in ConservationCONSERVATION BIOLOGY, Issue 6 2009MATTHEW J. MUIR educación en conservación; formación de graduados; habilidades para el trabajo; programas universitarios Abstract:,Graduate education in conservation biology has been assailed as ineffective and inadequate to train the professionals needed to solve conservation problems. To identify how graduate education might better fit the needs of the conservation workplace, we surveyed practitioners and academics about the importance of particular skills on the job and the perceived importance of teaching those same skills in graduate school. All survey participants (n = 189) were alumni from the University of California Davis Graduate Group in Ecology and received thesis-based degrees from 1973 to 2008. Academic and practitioner respondents clearly differed in workplace skills, although there was considerably more agreement in training recommendations. On the basis of participant responses, skill sets particularly at risk of underemphasis in graduate programs are decision making and implementation of policy, whereas research skills may be overemphasized. Practitioners in different job positions, however, require a variety of skill sets, and we suggest that ever-increasing calls to broaden training to fit this multitude of jobs will lead to a trade-off in the teaching of other skills. Some skills, such as program management, may be best developed in on-the-job training or collaborative projects. We argue that the problem of graduate education in conservation will not be solved by restructuring academia alone. Conservation employers need to communicate their specific needs to educators, universities need to be more flexible with their opportunities, and students need to be better consumers of the skills offered by universities and other institutions. Resumen:,La educación en biología de la conservación a nivel licenciatura ha sido calificada como ineficaz e inadecuada para formar a los profesionales que se requieren para resolver problemas de conservación. Para identificar cómo la educación a nivel licenciatura puede satisfacer las necesidades del ámbito laboral en conservación, sondeamos a profesionales y académicos sobre la importancia de habilidades particulares del trabajo y la percepción de la importancia de esas mismas habilidades en la universidad. Todos los participantes en el sondeo (n = 189) fueron alumnos del Grupo de Graduados en Ecología de la Universidad de California en Davis y obtuvieron el grado basado en tesis entre 1973 y 2008. Los académicos y profesionales encuestados difirieron claramente en sus habilidades, aunque hubo considerablemente mayor acuerdo en las recomendaciones de capacitación. Con base en las respuestas de los participantes, los conjuntos de habilidades en riesgo de no ser consideradas en los programas educativos son la toma de decisiones y la implementación de políticas, mientras que las habilidades de investigación tienden a ser sobre enfatizadas. Sin embargo, los profesionales en diferentes puestos de trabajo requieren una variedad de conjuntos de habilidades, y sugerimos que los constantes llamados a ampliar la capacitación para responder a esta multitud de labores conducirán a un desbalance en la enseñanza de otras habilidades. Algunas habilidades, como el manejo de programas, pueden desarrollarse en proyectos colaborativos o de capacitación en el trabajo. Argumentamos que el problema de la educación en biología de la conservación a nivel licenciatura no se resolverá solo con la reestructuración de la academia. Los empleadores deben comunicar sus requerimientos específicos a los educadores, las universidades deben ser más flexibles con sus oportunidades y los estudiantes necesitan ser mejores consumidores de las habilidades ofrecidas por las universidades y otras instituciones. [source] An Innovative Strategy for Conducting Clinical Research: The Academic Associate ProgramACADEMIC EMERGENCY MEDICINE, Issue 2 2002Judd E. Hollander MD Performance of high-quality clinical research usually requires procurement of substantial funding to support and sustain the research infrastructure. The authors have developed a program to support a research infrastructure that minimizes financial start-up costs and maximizes productivity of clinical-educator faculty with limited protected time. The program integrates clinical research with undergraduate education. The authors report the experience with the academic associate program at two academic institutions. They describe the program, provide measures of program success, and discuss potential methods for other institutions to initiate similar programs. Similar programs can be developed in a variety of outpatient and inpatient settings allowing the performance of high-quality clinical research in a time-efficient and cost-effective manner. [source] Definitive radiotherapy in the management of chemodectomas arising in the temporal bone, carotid body, and glomus vagaleHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 5 2001Russell W. Hinerman MD Abstract Purpose To evaluate the results of treatment for 71 patients with 80 chemodectomas of the temporal bone, carotid body, or glomus vagale who were treated with radiation therapy (RT) alone (72 tumors in 71 patients) or subtotal resection and RT (8 tumors) at the University of Florida between 1968 and 1998. Methods and Materials Sixty-six lesions were previously untreated, whereas 14 had undergone prior treatment (surgery, 11 lesions; RT, 1 lesion; or both, 2 lesions) and were treated for locally recurrent disease. All three patients who received prior RT had been treated at other institutions. Patients had minimum follow-up times as follows: 2 years, 66 patients (93%); 5 years, 53 patients (75%); 10 years, 37 patients (52%); 15 years, 29 patients (41%); 20 years, 18 patients (25%); 25 years, 12 patients (17%); and 30 years, 4 patients (6%). Results There were five local recurrences at 2.6 years, 4.6 years, 5.3 years, 8.3 years, and 18.8 years, respectively. Four were in glomus jugulare tumors and one was a carotid body tumor. Two of the four patients with glomus jugulare failures were salvaged, one with stereotactic radiosurgery and one with surgery and postoperative RT at another institution. Two of the five recurrences had been treated previously at other institutions with RT and/or surgery. Treatment for a third recurrence was discontinued, against medical advice, before receiving the prescribed dose. There were, therefore, only 2 failures in 65 previously untreated lesions receiving the prescribed course of RT. The overall crude local control rate for all 80 lesions was 94%, with an ultimate local control rate of 96% after salvage treatment. The incidence of treatment-related complications was low. Conclusions Irradiation offers a high probability of tumor control with relatively minimal risks for patients with chemodectomas of the temporal bone and neck. There were no severe treatment complications. © 2001 John Wiley & Sons, Inc. Head Neck 23: 363,371, 2001. [source] Why politics needs marketingINTERNATIONAL JOURNAL OF NONPROFIT & VOLUNTARY SECTOR MARKETING, Issue 2 2003Article first published online: 12 JUL 200, Roger Mortimore This paper examines the survey evidence for the low standing of politics, politicians and political institutions in the mind of the British public, and discusses its consequences. Present public opinion about political parties in Britain, and about politicians in general, is predominantly negative. Politicians are distrusted, to a considerably greater extent than can be explained solely by their bad press. Nor is the public very familiar with politicians or political institutions. Yet it can be shown that in general (and not only in the political field) ,familiarity breeds favourability, not contempt'. This may be feeding through into hostility towards the entire sector,not only the strictly ,political', but other institutions such as public services which the public associates with politics or government. Copyright © 2003 Henry Stewart Publications [source] The nature of technology-mediated interaction in globalized distance educationINTERNATIONAL JOURNAL OF TRAINING AND DEVELOPMENT, Issue 4 2003Charalambos Vrasidas The purpose of this paper is to discuss technology-mediated communication and interaction in globalized distance education. We will briefly present the context, methods, findings, and implications of a research and development program we have been running for the last five years at Western Illinois University in collaboration with other institutions in the US, Mexico, and Cyprus (Intercollege). The emphasis will be on discussing the differences between face-to-face (F2F) and technology-mediated interaction. Online interaction may be slower and ,lacking' in continuity, richness, and immediacy, when compared to F2F interaction; however, in some ways online interaction may be as good as or even superior to F2F interaction. We will use selected findings from our work to theorize the nature of interaction in online distance education in a globalized world. Our argument is that despite differences between F2F and online distance education, the latter should not be considered as second best, because there are significant qualities of online education that are often ignored. [source] Situation-dependant management of large parrots by manipulation of the social environmentINTERNATIONAL ZOO YEARBOOK, Issue 1 2000C. E. KING Further exploration of alternative methods of managing large parrots in captivity, that will allow natural behaviours to be expressed, is desirable. Examples of social behavioural management of large parrots at Rotterdam Zoo and other institutions are provided in this article. The topics discussed include group pair selection, group housing and breeding, leaving the young with the parents during successive breeding efforts, managing aggression, foster incubation and foster parenting. [source] Current Practice, Demographics, and Trends of Critical Care Trained Emergency Physicians in the United StatesACADEMIC EMERGENCY MEDICINE, Issue 3 2010Julie A. Mayglothling MD Abstract Objectives:, Critical care medicine (CCM) is of growing interest among emergency physicians (EPs), but the number of CCM-trained EPs and their postfellowship practice is unknown. This study's purpose was to conduct a descriptive census survey of EPs who have completed or are currently in a CCM fellowship. Methods:, The authors created a Web-based survey, and requests to participate were sent to EPs who have completed or are currently in a CCM fellowship. Responses were collected over a 12-month period. Physicians were located via multiple whom electronic mailing lists, including the Emergency Medicine Section of the Society of Critical Care Medicine, Critical Care Section of the American College of Emergency Physicians, and the Emergency Medicine Residents' Association. The authors also contacted CCM fellowship coordinators and used informal networking. Data were collected on emergency medicine (EM) and other residency training; discipline, duration, and year of CCM fellowship; current practice setting; and board certification status, including the European Diploma in Intensive Care (EDIC). Results:, A total of 104 physicians completed the survey (97% response rate), of whom 73 had completed fellowship at the time of participation, and 31 of whom were in fellowship training. Of those who completed fellowship, 36/73 (49%) practice both EM and CCM, and 45/73 (62%) practice in academic institutions. Multiple disciplines of fellowship were represented: multidisciplinary (39), surgical (28), internal medicine (16), anesthesia (14), and other (4). Together, the CCM fellowships at the University of Maryland R Adams Cowley Shock Trauma Center and the University of Pittsburgh have trained 42% of all EM-CCM physicians, with 38 other institutions training from one to four fellows each. The number of EPs completing CCM fellowships has risen: from 1974 to 1989, 12 EPs; from 1990 to 1999, 15 EPs; and from 2000 to 2007, 43 EPs. Conclusions:, Emergency physicians are entering CCM fellowships in increasing numbers. Almost half of these EPs practice both EM and CCM. ACADAEMIC EMERGENCY MEDICINE 2010; 17:325,329 © 2010 by the Society for Academic Emergency Medicine [source] Institutional discharges and subsequent shelter use among unaccompanied adults in New York CityJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 1 2010Stephen Metraux This study empirically examines the link between homelessness and discharges from other institutions. An administrative record match was undertaken to determine rates of discharge from institutional care for 9,247 unaccompanied adult shelter users in New York City. Cluster analysis and multinomial logistic regression analysis was then used to assess associations between different types of institutional discharges and the likelihood of persons subsequently experiencing extended shelter stays. Results show that 28% of the cohort was discharged from institutional care within the 90-day period preceding their initial shelter entry, with different types of institutional discharge associated with differences in subsequent patterns of shelter use. Based on these findings, transitions from institution to the community are potentially a key intervention point for reducing homelessness and shelter use. © 2009 Wiley Periodicals, Inc. [source] Assessment of the Joint Food Science Curriculum of Washington State University and the University of Idaho by Graduates and Their EmployersJOURNAL OF FOOD SCIENCE EDUCATION, Issue 1 2006Stephanie Clark ABSTRACT: Thirty-two recent graduates from the joint food science program of Washington State Univ. (WSU) and The Univ. of Idaho (UI) and 12 of their employers participated in a survey study to assess food science program outcomes. The objective of this study was to assess the joint curriculum in its ability to prepare undergraduate students for critical thinking, problem solving, and technical competence in the food industry. Two survey tools, 1 for graduates and 1 for their employers, were designed to assess job preparedness and the skill set attained by food science program graduates. Graduates of the joint food science program generally indicated satisfaction with their food science education and suggested that they were adequately prepared for their jobs. Both students and employers indicated that most of the identified Success Skills are used daily on the job, and that graduates were well prepared with Success Skills. Graduates and employers reported adequate preparation in Food Processing and Engineering competence. Some significant differences (P < 0.05) were found in perceived and assessed competence. Specifically, while student indicated that they were well prepared with Food Chemistry and Analysis, Food Safety and Microbiology, and Applied Food Science competence, employers indicated only adequate preparation in Food Chemistry and Analysis, and Applied Food Science competence, but poor preparation in Food Safety and Microbiology competence. The findings suggest that students should be given opportunities for self-evaluation in undergraduate courses. Because the survey models are based on Institute of Food Technologists requirements, it is expected that the surveys can be readily adopted by other institutions to assess student learning and program effectiveness. [source] Where are clinical trials going?JOURNAL OF INTERNAL MEDICINE, Issue 2 2004Society, clinical trials Abstract. Clinical trials now increasingly impinge on society at large. First there is growing emphasis from health organizations on the need for unbiased evidence about the effectiveness of promoted remedies. Second, as most novel treatments accrue increased costs to society, these need to be evaluated in terms of value for money. Third, there has been confusion and concern about the resolution of conflicting evidence, especially the role of advertising and commercial pressures from a powerful pharmaceutical industry motivated by profit. Fourth, there is concern about research fraud and the ethics of clinical trials. Fifth, there is increasing suspicion of political advice, which sometimes has sought to reassure an anxious public on the basis of complex and possibly inadequate scientific information. Some of these issues are addressed by truly independent and properly constituted data and safety monitoring committees, which are of particular importance when academic investigators or universities have a large financial conflict of interest. This is now more problematic with the current encouragement of investigator-led spin-off companies. These issues are best resolved by independent financial support (from government or other institutions) rather than relying on the commercial sponsor. [source] Leading change through an international faculty development programmeJOURNAL OF NURSING MANAGEMENT, Issue 8 2009LORA C. LACEY-HAUN PhD Aims, The purpose of the study was to evaluate the modification of an American model of academic leadership training for utilization in an African university and to pilot test the efficacy of the resulting model. Background, Traditionally many educators have moved into administrative positions without adequate training. Current world standards require leadership preparation for a wide array of persons. However, this opportunity did not yet exist in the study setting. Method, University leaders from the University of the Western Cape and the University of Missouri collaborated on revising and pilot testing a successful American academic leadership programme for use among African faculty. Cross-cultural adaptations, participant satisfaction and subsequent outcomes were assessed during the 2-year ,train-the-trainer' leadership development programme. Results, African faculty successfully modified the American training model, participated in training activities, and after 2 years, began to offer the service to other institutions in the region, which has increased the number of nurses in Africa who have had, and who will continue to have, the opportunity to move up the career ladder. Conclusion, The impact of the project extended further than originally expected, as the original plan to utilize the training materials at the University of the Western Cape (UWC) for the in-house faculty was expanded to allow UWC to utilize the modified materials to serve leadership development needs of faculty in other African universities. Implications for nursing management, Study findings will inform those interested in university policy and procedure on leadership training issues. The successful development of a self-sustaining leadership programme in which values of multiple cultures must be appropriately addressed has a significant impact for nursing administration. With the severe nursing shortage, health care institutions must develop cost effective yet quality development programmes to assure the succession of current staff into leadership positions. We no longer have the luxury of recruiting broadly and we must identify those talented nurses within our own institutions and prepare them for advanced leadership roles. This succession plan is especially important for the next generation of nurse leaders representing minority populations. In particular, nurse managers will find the overview of the literature for middle managers enlightening, and may find links to key resources that could be revised to be more culturally relevant for use in a wide array of settings. [source] Model-based measurement of latent risk in time series with applicationsJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 1 2008Frits Bijleveld Summary., Risk is at the centre of many policy decisions in companies, governments and other institutions. The risk of road fatalities concerns local governments in planning countermeasures, the risk and severity of counterparty default concerns bank risk managers daily and the risk of infection has actuarial and epidemiological consequences. However, risk cannot be observed directly and it usually varies over time. We introduce a general multivariate time series model for the analysis of risk based on latent processes for the exposure to an event, the risk of that event occurring and the severity of the event. Linear state space methods can be used for the statistical treatment of the model. The new framework is illustrated for time series of insurance claims, credit card purchases and road safety. It is shown that the general methodology can be effectively used in the assessment of risk. [source] Faculty-development activity to promote effective communication between instructors and studentsTHE CLINICAL TEACHER, Issue 2 2010Netta Notzer Summary Background:, Educators claim that conflicts and teacher,student miscommunications interfere in achieving optimal learning outcomes. Context:, Conflicts arise when clinical instructors communicate in a patronising fashion, expressing values that are not those of their medical students. This paper presents our approach of coping with such conflicts. It is based on the notion that language is comprised of developmental levels. The objective is to switch the instructor's lower level of language from an uncontrolled reaction to a high level of efficient communication. Innovation:, During our faculty-development workshops, we piloted sessions consisting of vignettes depicting instructor,student conflicts. The workshop participants were asked to react and discuss questions on their feelings in similar conflicts, and their immediate speech reaction to students. The workshop's facilitator pointed out that there was no one right solution. She singled out the reaction that takes into account the student's personality, avoiding imposing solutions. The feedback on these sessions was very favourable, indicating a high level of satisfaction. Implications:, The positive feedback is very encouraging. We believe that our workshops amplify the desired effective instructor,student communication, and suggest that the success of this intervention is partly achieved by selecting problematic issues of communication, and adjusting them to the current needs of our faculty members. In order to reproduce our approach, we suggest that other institutions should define their own values and communication code. We recommend them to use the same technique of intervention among a small group in an empowering atmosphere of discussion, using their own situations. [source] Banks' Advantage in Hedging Liquidity Risk: Theory and Evidence from the Commercial Paper MarketTHE JOURNAL OF FINANCE, Issue 2 2006EVAN GATEV ABSTRACT Banks have a unique ability to hedge against market-wide liquidity shocks. Deposit inflows provide funding for loan demand shocks that follow declines in market liquidity. Consequently, banks can insure firms against systematic declines in liquidity at lower cost than other institutions. We provide evidence that when liquidity dries up and commercial paper spreads widen, banks experience funding inflows. These flows allow banks to meet loan demand from borrowers drawing funds from commercial paper backup lines without running down their holdings of liquid assets. We also provide evidence that implicit government support for banks during crises explains these funding flows. [source] Reality monitoring and the mediaAPPLIED COGNITIVE PSYCHOLOGY, Issue 8 2007Marcia K. Johnson The study of reality monitoring is concerned with the factors and processes that influence the veridicality of memories and knowledge, and the reasonableness of beliefs. In thinking about the mass media and reality monitoring, there are intriguing and challenging issues at multiple levels of analysis. At the individual level, we can ask how the media influence individuals' memories, knowledge and beliefs, and what determines whether individuals are able to identify and mitigate or benefit from the media's effects. At the institutional level, we can ask about the factors that determine the veridicality of the information presented, for example, the institutional procedures and criteria used for assessing and controlling the quality of the products produced. At the inter-institutional level we can consider the role that the media play in monitoring the products and actions of other institutions (e.g. government) and, in turn, how other institutions monitor the media. Interaction across these levels is also important, for example, how does individuals' trust in, or cynicism about, the media's institutional reality monitoring mechanisms affect how individuals process the media and, in turn, how the media engages in intra- and inter-institutional reality monitoring. The media are interesting not only as an important source of individuals' cognitions and emotions, but for the key role the media play in a critical web of social/cultural reality monitoring mechanisms. Copyright © 2007 John Wiley & Sons, Ltd. [source] The early pregnancy assessment project: The effect of cooperative care in the emergency department for management of early pregnancy complicationsAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2009David O'ROURKE Background: Early pregnancy assessment clinics (EPAC) have been introduced and accepted as the gold standard for management of early pregnancy problems (EPP). However, EPAC are not universally available and management of EPP within the emergency department (ED) can result in prolonged waiting times, inappropriate use of resources and no clear treatment or follow-up plan being implemented. Aim: To assess the effect of an early pregnancy assessment protocol (EPAP) in the ED, designed to create a cultural change among doctors in relation to EPP in order to minimise use of resources, improve treatment times for patients and establish a clear management plan where dedicated EPAC services are not available. Methods: An intervention, the EPAP was introduced to the ED and retrospective and prospective audits of the patients were carried out to assess the effect. Results: Implementation of the EPAP decreased treatment time by 55%, representations by 48%, pathology blood tests by 56% and formal imaging services by 85%. Gynaecological consultation increased by 37% for each patient visit to the ED and by 9% for each EPP. Total direct cost saving was 63% per patient and no adverse outcomes were recorded. Conclusion: Introduction of the EPAP was successful in creating cultural change and delivering clinical and financial benefits to the hospital, patients and staff. Early gynaecological consultation and bedside ultrasound scanning within the ED were key factors. Similar benefits could be reproduced in other institutions and for other clinical scenarios where a need has been identified. [source] A portable bioinformatics course for upper-division undergraduate curriculum in sciencesBIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION, Issue 5 2008Wely B. Floriano Abstract This article discusses the challenges that bioinformatics education is facing and describes a bioinformatics course that is successfully taught at the California State Polytechnic University, Pomona, to the fourth year undergraduate students in biological sciences, chemistry, and computer science. Information on lecture and computer practice topics, free for academic use software and web links required for the laboratory exercises and student surveys for two instances of the course, is presented. This course emphasizes hands-on experience and focuses on developing practical skills while providing a solid knowledge base for critically applying these skills. It is designed in blocks of 1-hour lecture followed by 2 hours of computer laboratory exercises, both covering the same general topic, for a total of 30 hours of lecture and 60 hours of computer practice. The heavy computational aspect of this course was designed to use a single multiprocessor computer server running Linux, accessible from laptops through Virtual Network Computing sessions. The laptops can be either provided by the institution or owned by the individual students. This configuration avoids the need to install and maintain bioinformatics software on each laptop. Only a single installation is required for most bioinformatics software on the Linux server. The content of this course and its software/hardware configuration are well suited for institutions with no dedicated computer laboratory. This author believes that the same model can be successfully implemented in other institutions, especially those who do not have a strong instructional computer technology support such as community colleges and small universities. [source] Patterns of intraneural ganglion cyst descentCLINICAL ANATOMY, Issue 3 2008Robert J. Spinner Abstract On the basis of the principles of the unifying articular theory, predictable patterns of proximal ascent have been described for fibular (peroneal) and tibial intraneural ganglion cysts in the knee region. The mechanism underlying distal descent into the terminal braches of the fibular and tibial nerves has not been previously elucidated. The purpose of this study was to demonstrate if and when cyst descent distal to the articular branch-joint connection occurs in intraneural ganglion cysts to understand directionality of intraneural cyst propagation. In Part I, the clinical records and MRIs of 20 consecutive patients treated at our institution for intraneural ganglion cysts (18 fibular and two tibial) arising from the superior tibiofibular joint were retrospectively analyzed. These patients underwent cyst decompression and disconnection of the articular branch. Five of these patients developed symptomatic cyst recurrence after cyst decompression without articular branch disconnection which was done elsewhere prior to our intervention. In Part II, five additional patients with intraneural ganglion cysts (three fibular and two tibial) treated at other institutions without disconnection of the articular branch were compared. These patients in Parts I and II demonstrated ascent of intraneural cyst to differing degrees (12 had evidence of sciatic nerve cross-over). In addition, all of these patients demonstrated previously unrecognized MRI evidence of intraneural cyst extending distally below the level of the articular branch to the joint of origin: cyst within the proximal most portions of the deep fibular and superficial fibular branches in fibular intraneural ganglion cysts and descending tibial branches in tibial intraneural ganglion cysts. The patients in Part I had complete resolution of their cysts at follow-up MRI examination 1 year postoperatively. The patients in Part II had intraneural recurrences postoperatively within the articular branch, the parent nerve, and the terminal branches, although in three cases they were subclinical. The authors demonstrate that cyst descent distal to the take-off of the articular branch to the joint of origin occurs regularly in patients with fibular and tibial intraneural ganglion cysts. The authors believe that parent terminal branch descent follows ascent up the articular branch from an affected joint of origin. This mechanism for bidirectional flow explains cyst within terminal branches of the fibular and tibial nerves and is dependent on pressure fluxes and resistances. This new pattern is consistent with principles previously described in a unified (articular) theory, is generalizable to other intraneural ganglion cysts arising from joints, and has important implications for pathogenesis and treatment of these intraneural cysts. Clin. Anat. 21:233,245, 2008. © 2008 Wiley-Liss, Inc. [source] | ||||||||||||||||||||||