Self-Concept in Children of Alcoholics

The progressive deterioration of an alcohol abuser is well documented. As the alcoholic continues to sink into a deeper dependency on alcohol, he experiences devastating physical and emotional repercussions. Not the least of the repercussions is the gradual breakdown of his family system. As the alcoholic moves toward the bottle, his family moves away from him, with the result that alcoholism ranks as one of the leading causes of broken homes. Alcoholism is double-edged; it affects not only the primary victim but it exerts a heavy toll on the spouse and children as well. Only recently has stress in research been placed on the children of alcoholics. The following study was an attempt to provide some of the empirical base for a more complete understanding of the personality and developmental problems of children of alcoholics. The general purpose of the study was to test whether the children of alcoholics have poorer self-concepts in comparison to children with non-alcoholic parents. Self-concept was measured both through an established self- concept assessment procedure, the Piers-Harris Children’s Self-Concept Scale, and also through an examination of the child\u27s self-evaluation system. A total of 149 children, 40 of them children of alcoholics, ranging in age from 9 to 12, were examined with the aid of an alcoholic treatment program and the public schools of a northern Minnesota community. The Piers-Karris Self-Concept Scale was administered to all of the 149 subjects. In addition, a behavioral self-evaluation task was administered to the 40 children of alcoholics as well as to a like number of control children matched according to a number of socioeconomic indicators. The data were then analyzed in three ways. A multiple regression analysis of the self-concept scores of the 149 children was done to determine the extent to which being a child of an alcoholic is predictive of low self-concept. Following that, the scores on both the self-concept and self-reinforcement tasks were analyzed using a dependent tytest, to determine if the children of alcoholics would score significantly different than their matched group. Finally, regression analyses were done on the data obtained from the 40 children of alcoholics to test the effects of a number of variables on both self-concept and self-evaluation. These independent variables included age, sex, number of siblings and birth order, as well as six variables particularly pertinent to the children of alcoholics: number of parents in the home, years of separation from the alcoholic parent, membership in Ala-Teen, years of child\u27s life the parent was alcoholic, total years of recent sobriety, and number of treatment programs attended by the alcoholic parent. The principal hypothesis of the study, that children of alcoholics register lower self-concept scores than children of nonalcoholics, was supported. The regression analysis showed evidence that parental alcoholism is predictive of low self-concept in children. A matched sample comparison gave more conclusive evidence. Regression analysis on the children of alcoholics confirmed the hypothesis that years of separation from the alcoholic parent had favorable effects on self-concept, as did larger number of siblings. There was some evidence that membership in Ala-Teen was predictive of higher self-concept. The hypothesis that number of treatment programs attended by the alcoholic parent and total years of parental alcoholism would be deliterious to children\u27s self-concept was not substantiated, nor was the hypothesis that total years of recent sobriety would have a favorable effect on self-concept. This analysis of sub-groups was marked by an uneven distribution of the sample, and the need for further research based on a more evenly distributed sample was discussed. No significant results were found regarding the self-evaluation task. It did not prove to be a discriminating measure within the sample of children of alcoholics, nor did it discriminate the experimental and matched groups. A number of possible explanations for this lack of significant findings were offered. Further research is warranted to correlate actual behavior with established trait-state dimensions

Vibrational microscopy and imaging of skin: from single cells to intact tissue

Vibrational microscopy and imaging offer several advantages for a variety of dermatological applications, ranging from studies of isolated single cells (corneocytes) to characterization of endogenous components in intact tissue. Two applications are described to illustrate the power of these techniques for skin research. First, the feasibility of tracking structural alterations in the components of individual corneocytes is demonstrated. Two solvents, DMSO and chloroform/methanol, commonly used in dermatological research, are shown to induce large reversible alterations (α-helix to β-sheet) in the secondary structure of keratin in isolated corneocytes. Second, factor analysis of image planes acquired with confocal Raman microscopy to a depth of 70 μm in intact pigskin, demonstrates the delineation of specific skin regions. Two particular components that are difficult to identify by other means were observed in the epidermis. One small region was formed from a conformationally ordered lipid phase containing cholesterol. In addition, the presence of nucleated cells in the tissue (most likely keratinocytes) was revealed by the spectral signatures of the phosphodiester and cytosine moieties of cellular DNA

In situ chemical analysis of biological tissue--vibrational Raman spectroscopy of human atheroschlerosis

Thesis (Ph. D.)--Massachusetts Institute of Technology, Whitaker College of Health Sciences and Technology, 1992.Includes bibliographical references (leaves 209-223).by Joseph John Baraga.Ph.D

US National Practice Patterns in Ambulatory Operative Management of Lateral Epicondylitis

Lateral epicondylitis is a common cause of elbow pain, frequently responsive to nonoperative management. There are multiple operative techniques for persistently symptomatic patients who have exhausted conservative therapies. Little is known regarding US national trends in operative management of lateral epicondylitis. We conducted a study to investigate changes in use of ambulatory procedures for lateral epicondylitis. Cases of lateral epicondylitis were identified using the National Survey of Ambulatory Surgery and were analyzed for trends in demographics and use of ambulatory surgery. Between 1994 and 2006, the population-adjusted rate of ambulatory surgical procedures increased from 7.29 to 10.44 per 100,000 capita. The sex-adjusted rate of surgery for lateral epicondylitis increased by 85% among females and decreased by 31% among males. Most patients were between ages 40 and 49 years, and the largest percentage increase in age-adjusted rates was found among patients older than 50 years (275%) between 1994 and 2006. Use of regional anesthesia increased from 17% in 1994 to 30% in 2006. Private insurance remained the most common payer. Awareness of the increasing use of ambulatory surgery for lateral epicondylitis may lead to changes in health care policies and positively affect patient care

Supplemental Fixation of Inner Graft Limbs in All-Inside, Quadrupled, Single-Tendon Anterior Cruciate Ligament Reconstruction Graft Construct Yields Improved Biomechanical Properties

To compare the time-zero load to failure of a quadrupled, single-tendon, all-inside anterior cruciate ligament (ACL) reconstruction graft construct with (supplemented) and without the incorporation of inner-limb whipstitch sutures (control) into a tibial suspensory fixation button. Eight matched pairs of peroneus longus tendons were prepared according to a quadrupled, all-inside ACL soft-tissue graft technique with 1 side serving as a control and the contralateral side supplemented. The constructs were biomechanically tested for strain in the inner and outer limbs during a preconditioning protocol, single-cycle load to failure, and elongation of the whole construct. Ultimate load to failure was significantly higher in the supplemented group: 797.5 ± 49.6 N (95% confidence interval [CI], 763.13-831.87 N) versus 719.6 ± 69.6 N (95% CI, 671.38-767.82 N; P = .044). Less graft elongation at failure was observed in the supplemented group (3.1 ± 1.5 mm; 95% CI, 2.07-4.17 mm) versus the control group (21.0 ± 21.2 mm; 95% CI, 6.31-35.69 mm; P = .052). The number of grafts undergoing a 5-mm or greater change in length at failure was 1 of 8 in the supplemented group versus 5 of 8 in the control group (P = .038). Inner-limb supplemental tibial fixation results in higher time-zero load to failure and decreased graft elongation in a quadrupled, single-tendon, all-inside ACL reconstruction graft construct. The weak point of a single-tendon, quadrupled, all-inside ACL graft construct is the tendon-to-tendon suturing to secure the inner limbs of the graft. Adding supplemental fixation by incorporating the sutures from the inner limb to the tibial suspensory fixation button leads to a higher time-zero load to failure and decreased graft elongation

Rehabilitation Protocols for Superior Capsular Reconstruction Are Variable: A Systematic Review

To screen manuscripts that discuss rehabilitation protocols for patients who underwent superior capsular reconstruction (SCR) to elucidate whether a standard rehabilitation algorithm exists for SCR. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses (i.e., PRISMA) guidelines. PubMed (MEDLINE) and Embase were searched using pertinent Boolean operation terms “superior capsular reconstruction” and “rotator cuff repair rehabilitation,” and articles that included rehabilitation protocols following superior capsular reconstruction surgery were reviewed. Two independent reviewers performed the search and quality assessment. A total of 549 articles were yielded after our database search. Fourteen studies fulfilled our inclusion criteria and were included in the review. Study designs included 9 editorials, 3 case series, and 2 case reports. Each study included in this review used a unique rehabilitation algorithm that posed significant variability between the protocols. Four phases were identified to summarize each protocol and were used as a basis of discussion—sling versus brace time (3-6 weeks for comfort/removal vs complete immobilization), passive range of motion (immediately after surgery to initiation at 6 weeks), active range of motion (4-8 weeks), and strengthening/return to full activity (12-52 weeks). Initiation of rehabilitation, length of time spent in each phase, types of exercises, and overarching goals for return to function were significantly variable and were decided upon by the surgeon based on current massive rotator cuff repair protocols. Presently, there is no standard rehabilitation protocol for SCR. SCR is a relatively new procedure that is gaining rapid popularity with promising outcomes. Based on our review, there is no standard rehabilitation protocol in place; thus, it is not possible to recommend an evidence-based rehabilitation protocol following SCR at this time. Level V, systematic review of Level IV and V studies

A Comparison of Two-Year ACL Reconstruction Clinical Outcomes Using All-Soft Tissue Quadriceps Tendon Autograft With Femoral/Tibial Cortical Suspensory Fixation Versus Tibial Interference Screw Fixation

To contribute to future quadriceps tendon harvest and fixation guidelines in the setting of anterior cruciate ligament reconstruction by comparing 2-year patient-reported subjective knee outcome scores and incidence of graft-related complications between the shorter harvest all-inside tibial-femoral suspensory fixation (TFSF) approach versus the longer harvest standard tibial interference screw fixation technique. Patients who underwent primary anterior cruciate ligament reconstruction with all soft tissue quadriceps tendon autograft from January 2017 to May 2019 were identified for inclusion. Patients were matched into 2 cohorts of 62 based on reconstruction technique. All patients completed baseline and minimum 2-year International Knee Documentation Committee, Tegner Activity Level, and Lysholm questionnaires and were queried regarding subsequent procedures and complications to the operative knee. Average graft length for the all-inside TFSF was 69.55 (95% confidence interval 68.99-70.19) mm versus 79.27 (95% confidence interval 77.21-81.34) mm in the tibial screw fixation cohort (P = .00001). Two-year Lysholm scores were greater in the TFSF cohort (P = .04) but were not clinically significant. There was no difference in 2-year International Knee Documentation Committee (P = .09) or Tegner (P = .69) scores between cohorts, but more patients in the TFSF cohort returned to or exceeded their baseline activity level compared with the tibial screw fixation cohort (73% vs 61%, P = .25). Seven patients in the TFSF cohort versus 13 in the tibial screw fixation cohort reported anterior knee pain or kneeling difficulty (P = .22). There were no differences in reported complications. All-inside soft-tissue quadriceps tendon autograft with TFSF resulted in clinically comparable subjective outcome scores at 2 years to tibial screw fixation. There were also no differences in complications or reports of anterior knee pain or kneeling difficulty. All-inside TFSF can be a viable alternative to tibial screw fixation for all-soft tissue quadriceps autograft. III, comparative therapeutic trial