A photographic test for attitude measurement: a cultural examination of peasant attitudes to agricultural change in Campeche, Mexico

A photographic test for attitude measurement, abbreviated PHOTAM, has been developed and applied in a case study of attitudes to agricultural change in peasant groups currently undergoing transformation from traditional to modern. The aim of this research was to develop a structured cultural method for combining the holistic intuitive insight of anthropological and cultural geographical inquiry with the rigour of objective behavioural assessment techniques. This method involves the use of a test based on the projective principle, which bridges the gap between cultural and behavioural approaches by establishing a common data source for subjective and objective interpretations set in the overall cultural and regional context. PHOTAM involves 10 steps: (1) preliminary cultural geographic reconnaissance to provide an holistic empathetic overview of the study area and peasant life-way; (2) selection of attitude categories critical for understanding the given problem; (3) assembly of a series of photographs depicting various aspects of the attitudes selected and for use in testing internal consistency of responses; (4) selection of sample subjects in representative groups; (5) standardized administration of the test photographic set to each subject; (6) translation of tape recorded responses into English and transcription of selected responses in the original language; (7) coding of protocols using a binary decision tree involving an attitude scale and other desired attitude dimensions such as activeness, change - orientation and modernity; (8) subjective and objective interpretation of attitude profiles; (9) testing for reliability and conceptual validity of postulated attitude structure; (10) (optional) cross-cultural testing and comparison of obtained attitude pro files. A sample of 68 subjects in five peasant groups possessing experience with modern irrigation and mechanized agricultural projects ranging from none up to two years, was selected from the Mayan Camino Real and Los Chenes regions of northern Campeche, Mexico, where a government sponsored, internationally financed small irrigation programme has recently been initiated. A set of 21 photographs was employed representing easily recognizable culturally appropriate situations within the realm of experience of the typical Mexican oam-pesino. The subjects were requested to invent a story about each photograph in turn which fully describe d its content and context. The resulting protocols yielded data concerning 17 attitudes which were processed in 60 coding categories; more than 40,000 binary measurements (seven for each attitude identified) were taken on the responses. Subjective evaluation of the protocols revealed that most of the typical characteristics of peasantry encountered in the academic literature do not apply to the study groups in Campeche, and suggests that these general conceptions of the peasant sub-culture are outdated, at least as far as modernizing peasants are concerned. Thus, it seems probable that attitudinal inconsistencies and discontinuities are more prevalent amongst contemporary peasant societies than the traditional, stable, clearly-defined patterns. If these out-moded stereotypes are not discarded, costly development programming errors may result. Objective evaluation indicated that the initial attitudes selected for examination had acceptable conceptual validity, high interrater reliability (with two judges) and reasonable internal consistency. It is also clear that the PHOTAM protocols are amenable to objective coding into a-priori attitude categories which distinguish effectively within and between groups. Attitudinal differences were most pronounced between the groups of peasants having the longest development project membership compared with the inexperienced groups. The results indicate that PHOTAM is a reliable diagnostic measurement device, capable of penetrating beyond superficial opinions into the realm of deeply-felt attitudes. Thus, PHOTAM should prove useful as a tool for cultural geographic research, and in development planning applications where attitudes are often the critical factor in determining project outcomes. The richness of the response stories confirms the advantages of projective instruments especially involving the use of photographs, for breaking down barriers to deep communication with illiterate peoples. In addition, there is evidently considerable potential for cross-cultural investigation of peasant attitudes.Arts, Faculty ofGeography, Department ofGraduat

Current Evidence Regarding the Treatment of Pediatric Lumbar Spondylolisthesis: A Report From the Scoliosis Research Society Evidence Based Medicine Committee.

© 2017 Scoliosis Research Society Study Design Structured literature review. Objectives The Scoliosis Research Society requested an assessment of the current state of peer-reviewed evidence regarding pediatric lumbar spondylolisthesis to identify what is known and what research remains essential to further understanding. Summary of Background Data Pediatric lumbar spondylolisthesis is common, yet no formal synthesis of the published literature regarding treatment has been previously performed. Methods A comprehensive literature search was performed. From 6600 initial citations with abstract, 663 articles underwent full-text review. The best available evidence regarding surgical and medical/interventional treatment was provided by 51 studies. None of the studies were graded Level I or II evidence. Eighteen of the studies were Level III, representing the current best available evidence. Thirty-three of the studies were Level IV. Results Although studies suggest a benign course for “low grade” (\u3c50% slip) isthmic spondylolisthesis, extensive literature suggests that a substantial number of patients present for treatment with pain and activity limitations. Pain resolution and return to activity is common with both medical/interventional and operative treatment. The role of medical/interventional bracing is not well established. Uninstrumented posterolateral fusion has been reported to produce good clinical results, but concerns regarding nonunion exist. Risk of slip progression is a specific concern in the “high grade” or dysplastic type. Although medical/interventional observation has been reported to be reasonable in a small series of asymptomatic high-grade slip patients, surgical treatment is commonly recommended to prevent progression. There is Level III evidence that instrumentation and reduction lowers the risk of nonunion, and that circumferential fusion is superior to posterior-only or anterior-only fusion. There is Level III evidence that patients with a higher slip angle are more likely to fail medical/interventional treatment of high-grade spondylolisthesis. Conclusions The current “best available” evidence to guide the treatment of pediatric spondylolisthesis is presented. Level of Evidence Level III; review of Level III studies

Current Evidence Regarding the Treatment of Pediatric Lumbar Spondylolisthesis: A Report From the Scoliosis Research Society Evidence Based Medicine Committee

© 2017 Scoliosis Research Society Study Design Structured literature review. Objectives The Scoliosis Research Society requested an assessment of the current state of peer-reviewed evidence regarding pediatric lumbar spondylolisthesis to identify what is known and what research remains essential to further understanding. Summary of Background Data Pediatric lumbar spondylolisthesis is common, yet no formal synthesis of the published literature regarding treatment has been previously performed. Methods A comprehensive literature search was performed. From 6600 initial citations with abstract, 663 articles underwent full-text review. The best available evidence regarding surgical and medical/interventional treatment was provided by 51 studies. None of the studies were graded Level I or II evidence. Eighteen of the studies were Level III, representing the current best available evidence. Thirty-three of the studies were Level IV. Results Although studies suggest a benign course for “low grade” (\u3c50% slip) isthmic spondylolisthesis, extensive literature suggests that a substantial number of patients present for treatment with pain and activity limitations. Pain resolution and return to activity is common with both medical/interventional and operative treatment. The role of medical/interventional bracing is not well established. Uninstrumented posterolateral fusion has been reported to produce good clinical results, but concerns regarding nonunion exist. Risk of slip progression is a specific concern in the “high grade” or dysplastic type. Although medical/interventional observation has been reported to be reasonable in a small series of asymptomatic high-grade slip patients, surgical treatment is commonly recommended to prevent progression. There is Level III evidence that instrumentation and reduction lowers the risk of nonunion, and that circumferential fusion is superior to posterior-only or anterior-only fusion. There is Level III evidence that patients with a higher slip angle are more likely to fail medical/interventional treatment of high-grade spondylolisthesis. Conclusions The current “best available” evidence to guide the treatment of pediatric spondylolisthesis is presented. Level of Evidence Level III; review of Level III studies