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Scale score measures are ubiquitous in the psychological literature and can be used as both dependent and independent variables in data analysis. Poor reliability of scale score measures leads to inflated standard errors and/or biased estimates, particularly in multivariate analysis. Reliability estimation is usually an integral step to assess data quality in the analysis of scale score data. Cronbach's [alpha] is a widely used indicator of reliability but, due to its rather strong assumptions, can be a poor estimator (L. J. Cronbach, 1951). For longitudinal data, an alternative approach is the simplex method; however, it too requires assumptions that may not hold in practice. One effective approach is an alternative estimator of reliability that relaxes the assumptions of both Cronbach's [alpha] and the simplex estimator and thus generalizes both estimators. Using data from a large-scale panel survey, the benefits of the statistical properties of this estimator are investigated, and its use is illustrated and compared with the more traditional estimators of reliability. (Contains 4 footnotes, 4 tables and 4 figures.)

Efforts to improve the public welfare and child welfare system sparked an unprecedented amount of federal legislation in the 1990s, including the Adoption and Safe Families Act of 1997 (ASFA), the Multiethnic Placement Act of 1994 and Interethnic Adoption Provisions of 1996 (MEPA-IEP), and welfare reform. Such reforms allow an unprecedented degree of flexibility, but little is known about their implementation. Researchers administered the Local Agency Survey to the first national probability sample of public child welfare agencies from 1999 to 2000. Findings indicate that ASFA has had the most effect on child welfare service delivery. Welfare reform has had less effect, and MEPA-IEP seems to have had little effect at all.

The federal government's move away from affirmative action combined with a growing national indifference to civil rights has resulted in major setbacks in the education of American Indians. Tribalism can be part of a solution with programs that reinforce a student's connection to parents, community, and tribe. (MLW)

Leydig cell tumors are rare sex cord-stromal tumors that account for less than 1% of all testicular tumors. Less than 10% of these tumors show metastatic malignant behavior. Herein we present a case of metastatic malignant Leydig cell tumor in an iliac lymph node diagnosed on fine-needle aspiration (FNA) in a 70-year-old man. The patient was referred from an outside institution with lymphadenopathy and had a past medical history of lymphoplasmacytic lymphoma/Waldenström's macroglobulinemia and past surgical history of orchiectomy. An iliac lymph node FNA was performed demonstrating large discohesive plasmacytoid cells with indistinct cell borders; abundant and finely granular cytoplasm; round, eccentric nuclei with evenly distributed chromatin; and prominent nucleoli. The tumor cells were positive for inhibin and negative for calretinin and keratin leading to the diagnosis of metastatic malignant Leydig cell tumor. Review of the patient's history and of previous pathologic material, careful evaluation of cytomorphologic features, and the judicious use of immunohistochemistry can allow an accurate diagnosis of metastatic Leydig cell tumor. [ABSTRACT FROM AUTHOR]

Describes a computer program which will randomly select questions and change the arrangement of answers each time the program is run, providing realistic practice for standardized test-taking. A listing of the program is provided in AppleSoft BASIC, and modifications for the IBM-PC are included. (LP)

Two models of in-service education programs for secondary school teachers are described--the on-site model and the teacher center model. (MM)

Summary: This study explores the quality of life in 118 patients following severe and major hand injury with a Hand Injury Severity Score >50. Each patient answered five different validated outcome measures (DASH (Disability of the Arm, Shoulder, and Hand), FLZM (‘Fragen zur Lebenszufriedenheit’), HADS (Hospital Anxiety and Depression Score), BDDE-SR (Body Dysmorphic Disorder Examination-Self Report) and FBeK (‘Fragebogen zur Beurteilung des eigenen Körpers’), which were incorporated into a single questionnaire. Each of these questionnaires covered one or more of the established quality-of-life domains. Patients with pain and pressure sensations were significantly less satisfied in life, showed lower levels of health satisfaction, had higher levels of anxiety and depression and showed higher body dysmorphic disorder levels (all p < 0.001). General life satisfaction in this hand-injury study group is highly dependent on the patients` satisfaction with their health and appearance as well as self-confidence. The quality-of-life outcomes improve with time, and despite evidence of continued impairment in the injured hand, the majority of patients had a normal quality of life. [ABSTRACT FROM AUTHOR]

Summary: Background: Changes in breast-morphology occur after all types of breast surgery, but a systematic and objective surgical result assessment is currently lacking. Three-dimensional (3-D) surface imaging offers the ability to quantitatively evaluate breast contour, shape, surface and volume changes after surgery. This study evaluates 3-D breast contour and volume changes after breast augmentation over time. Methods: 3-D surface imaging of 14 subpectoral breast-augmentation patients (n = 28 breasts) were accomplished over six time periods (preoperative (OP), post-OP 1: 2–3 days; post-OP 2: 1 week; post-OP 3: 1 month; post-OP 4: 3 months; and post-OP 5: 6 months after surgery) and linear-distance measurement, breast volume and surface changes were analysed. 3-D breast-contour- and volume variations are expressed in percentage changes over time. Results: All breast measurements changed significantly between pre-OP and post-OP 1 (Friedmann test, p = 0.001–0.025). First significant postoperative changes over time compared with post-OP 1 for breast volume, surface, sternal notch to nipple and nipple to inframammary-fold-distance measurements are quantifiable after 1 month (post hoc Wilcoxon test, p = 0.001 for all) with further relevant breast volume (post hoc Wilcoxon test, p = 0.041) and surface changes (post hoc Wilcoxon test, p = 0.037) between months 1 and 3 after surgery. The inframammary fold dropped by 1.4 cm after 6 months and final breast volume ± 0.5% is reached between months 1 and 3 after surgery. Valuable reductions in breast contour and volume by nearly 85% are also reached after 1 month (Wilcoxon test, p = 0.001) and changed to 98% after 3 months and 100% after 6 months. Conclusions: Breast morphological changes following subpectoral breast augmentation are completed after 3 months. 3-D surface imaging may play a part in comparing different breast-augmentation techniques. [Copyright &y& Elsevier]

Abstract: In response to palmitate, the antidiabetic sulfonylurea drug glimepiride, phosphoinositoglycans, or H2O2, the release of the glycosylphosphatidylinositol-anchored and cyclic adenosine monophosphate–degrading phosphodiesterase Gce1 from adipocytes into small vesicles (adiposomes) and its translocation from adiposomes to cytoplasmic lipid droplets (LD) of adipocytes have been reported. Here the role of Gce1-harboring adiposomes in coordinating lipolysis between differently sized adipocytes was studied. Separate or mixed populations of isolated epididymal rat adipocytes of small and large size and native adipose tissue pieces from young and old rats were incubated with exogenous adiposomes or depleted of endogenous adiposomes and then analyzed for translocation of Gce1 and lipolysis in response to above antilipolytic stimuli. Large compared with small adipocytes are more efficient in releasing Gce1 into adiposomes but less efficient in translocating Gce1 from adiposomes to LDs. Maximal lipolysis inhibition by above antilipolytic stimuli, but not by insulin, was observed with mixed populations of small and large adipocytes (1:1 to 1:2) rather than with separate populations. In mixed adipocyte populations and adipose tissue pieces from young, but not old, rats, lipolysis inhibition by above antilipolytic stimuli, but not by insulin, was dependent on the function of Gce1-harboring adiposomes. Inhibition of lipolysis in rat adipose tissue in response to palmitate, glimepiride, and H2O2 is coordinated via the release of adiposome-associated and glycosylphosphatidylinositol-anchored Gce1 from large “donor” adipocytes and their subsequent translocation to the LDs of small “acceptor” adipocytes. This transfer of antilipolytic information may be of pathophysiologic relevance. [Copyright &y& Elsevier]

Summary: Background: The angiogenic potential of vascular endothelial growth factor (VEGF) and its oxygen pressure-dependent regulation suggest a strong connection between this growth factor and the ‘delay phenomenon’. In this study we focused on the chronological changes in VEGF concentration and flap perfusion in order to optimise the duration of surgical delay. Methods: The VEGF concentration in skin and underlying muscle was measured in oversized, random-pattern flaps on 38 male Sprague-Dawley rats after 3, 5 or 7 days of surgical delay. Additionally, flaps were raised 5 or 7 days past preconditioning. The effect on flap perfusion was measured using indocyanine green fluoroscopy and the size of surviving and necrotic areas of the flaps were analysed. Microvessel density was assessed using a monoclonal CD31 antibody, and vessel diameter and morphometry were appraised by means of corrosion casting. Results: VEGF expression in the distal half of the flaps was significantly increased 3 days after preconditioning and perfusion was significantly enhanced after day 5. An interval of 5 days between preconditioning and flap transposition resulted in a significantly reduced average necrosis rate. Microvessel density was significantly increased and vessel diameters were enlarged (P <0.05). Conclusions: We illustrated the chronology of events from the ischaemic procedure to the rise in VEGF concentration and changes in flap perfusion, and demonstrated vasodilatation and the formation of new vessels. Most significantly, we were able to further specify the optimal length of surgical delay based on alterations on a molecular level as well as changes in vascularisation and perfusion. [Copyright &y& Elsevier]

Summary: Facial hemi atrophy is seen after trauma, Parry-Romberg syndrome and on other rare occasions. Since the aesthetic deficit is very obvious and irritating, facial reconstruction is often requested by these patients. In most cases the only option for sufficient reconstruction is free flap reconstruction, which represents the standard treatment. Recently in plastic surgery, various new techniques have been developed with the potential for multiple applications. Lipofilling has been presented primarily for the correction of cosmetic lesions or the reconstruction of minor soft tissue defects, but even reconstruction of larger soft tissue deficits is possible. The concept of using 3-D technology in facial reconstruction has multiple advantages. Primarily, the ideal final aesthetic outcome can be simulated by virtual reconstruction. Mathematic calculations deliver exact numbers in volume deficits, enabling precise planning of soft tissue substitution especially in lipofilling, ideally avoiding unnecessary corrections. Since autologous soft tissue reconstruction represents a dynamic process with periods of swelling as well as atrophy, quality control is required for achieving optimal results. Use of 3-D scanning has the advantage of reliable visualisation in soft tissue reconstruction without the limitations of harmful side effects. We present the history of a female suffering from the posttraumatic consequences of head injuries related to a car accident and the successful correction of her hemi facial atrophy by autologous lipofilling. Technical details and the potential of 3-D scanning in plastic surgery are discussed. [Copyright &y& Elsevier]

Summary: Background: The objective of this study was the prospective evaluation of quality of life in patients undergoing aesthetic plastic surgery procedures. We examined pre- and postoperative changes in quality of life, and performed a comparison of our data with a representative random sample. Method: 228 patients agreed to participate in the present study. Measurements were taken preoperatively as well as 3 and 6 months postoperatively. One hundred and thirty two patients completed the three months postoperative evaluation (T1), 82 answered the 6 months follow-up evaluation (T2). The testing instrument included a standardised self-assessment test on satisfaction and quality of life (FLZM), consisting of three modules: satisfaction with general life, health and appearance. Further, a postoperative complication questionnaire was used in order to evaluate the satisfaction with the surgical outcome and to estimate postoperative complications and side effects. Results: Significantly increasing values in two aspects of quality of life were found: health and appearance. Whereas the positive influence on health is persistent, there is a diminishing influence of appearance 6 months postoperatively. Although higher values for some of the individual items of the FLZM modules of the norm data were found in comparison to our study group, a general preoperative lower level of quality of life of the aesthetic surgery patients could not be confirmed. Over 84% were satisfied or very satisfied with the aesthetic result. 85% would undergo the same treatment again and 94% of the patients would further recommend their operation. More than half of the study group did not report a decrease in physical fitness or reduced social contacts in the direct postoperative period. Conclusion: Our study reveals that aesthetic plastic surgery increases most aspects of quality of life, especially regarding body satisfaction and health. It is very well tolerated by the patients and is therefore a recommended option. [Copyright &y& Elsevier]

Summary: Quantification of the complex breast region can be helpful in breast surgery, which is shaped by subjective influences. However, there is no generally recognized method for breast volume calculation. Three-dimensional (3D) body surface imaging represents a new alternative for breast volume computation. The aim of this work was to compare breast volume calculation with 3D scanning and three classic methods, focusing on relative advantages, disadvantages, and reproducibility. Repeated breast volume calculations of both breasts in six patients (n=12) were performed using a 3D laser scanner, nuclear magnetic resonance imaging (MRI), thermoplastic castings, and anthropomorphic measurements. Mean volumes (cc) and mean measurement deviations were calculated, and regression analyses were performed. MRI showed the highest measurement precision, with a mean deviation (expressed as a percentage of mean breast volume) of 1.56±0.52% compared with 2.27±0.99% for the 3D scanner, 7.97±3.53% for thermoplastic castings, and 6.26±1.56% for the anthropomorphic measurements. Breast volume calculations using MRI showed the best agreement with 3D scanning measurement (r=0.990), followed by anthropomorphic measurement (r=0.947), and thermoplastic castings (r=0.727). Compared with three classical methods of breast volume calculation, 3D scanning provides acceptable accuracy for breast volume measurements, better spatial interpretation of the anatomical area to be operated on (due to lack of chest deformation), non-invasiveness, and good patient tolerance. After this preliminary study and further development, we believe that 3D body surface scanning could provide better preoperative planning and postoperative control in everyday clinical practice. [Copyright &y& Elsevier]

Harold Herber's self-paced, self-teaching book, "Teaching Reading in the Content Area," can be used by social studies teachers to develop lessons that help students read, write, and think. A sample U.S. history lesson which uses techniques from Herber's book to help students learn about the Declaration of Independence is presented. (RM)

The teacher education standards presented here provide criteria by which to assess both preservice and inservice programs that seek to improve the quality of social studies education at the elementary and secondary levels.

Summary: Three-dimensional recording of the surface of the human body or of certain anatomical areas has gained an ever increasing importance in recent years. When recording living surfaces, such as the human face, not only has a varying degree of surface complexity to be accounted for, but also a variety of other factors, such as motion artefacts. It is of importance to establish standards for the recording procedure, which will optimise results and allow for better comparison and validation. In the study presented here, the faces of five male test persons were scanned in different experimental settings using non-contact 3D digitisers, type Minolta Vivid 910®. Among others, the influence of the number of scanners used, the angle of recording, the head position of the test person, the impact of the examiner and of examination time on accuracy and precision of the virtual face models generated from the scanner data with specialised software were investigated. Computed data derived from the virtual models were compared to corresponding reference measurements carried out manually between defined landmarks on the test persons'' faces. We describe experimental conditions that were of benefit in optimising the quality of scanner recording and the reliability of three-dimensional surface imaging. However, almost 50% of distances between landmarks derived from the virtual models deviated more than 2mm from the reference of manual measurements on the volunteers'' faces. [Copyright &y& Elsevier]

Summary: Aim: To develop a 3D CT cephalometric analysis for maxillary growth evaluation of sheep fetuses operated in utero, and to evaluate the reliability of this analysis by comparing it with a direct cephalometric analysis on dry skulls. Material and methods: Five skulls of operated sheep fetuses were used, which after preparation were CT scanned and a 3D reconstruction was performed. A cephalometric analysis was performed directly on the dry skulls as well as on the reconstructed 3D CT images. In total, 56 linear distances were measured. In order to access the error of the method, the procedure was repeated after a 2 week interval. Results: The comparison between the direct cephalometric and the 3D CT analysis revealed that only 5 variables were significantly different. The evaluation of the error of method revealed that 7 variables of the direct cephalometric analysis and none of the 3D CT analysis differed significantly. Conclusions: According to the results of this study, it can be concluded that a cephalometric analysis on 3D CT reconstructed images of the skulls includes fewer identification errors and seems to be an accurate and reliable method that could be regarded at least as equivalent to conventional cephalometry. [Copyright &y& Elsevier]

The objective of this study was to calculate, prepare and evaluate the Protein Efficiency Ratio (P.E.R.) and Net Protein Utilization (N.P.U.) of two infant formulas made with amaranth ( Amaranthus cruentus). Both formulas were formulated to match a previously developed and tested soy-oats infant formula. No significant differences were found between the three formulas with respect to corrected Protein Efficiency Ratio (P.E.R.) and Net Protein Utilization (N.P.U.) values. Only the product made with the 1-R fraction of amaranth was found to have a significantly lower P.E.R. than casein. [ABSTRACT FROM AUTHOR]

Direct estimates of response bias for self-reports of drug use in surveys require that essentially error free determinations of drug use be obtained for a subsample of survey respondents. The difficulty of obtaining determinations which are accurate enough for estimating validity is well-documented in the literature. Methods such as specimen (e.g., hair, urine) analysis, proxy reports, and the use of highly private and anonymous modes of interview all have to contend with error rates which may only be marginally lower than those of the parent survey. Thus, any methodology for direct validity estimation must rely to some extent on approximations and questionable assumptions. In this chapter, the authors consider a number of methods that rely solely on repeated measures data to assess response bias. Since the assumptions associated with these approaches do not require highly accurate second determinations they may be more easily satisfied in practice. One such method for bias estimation for dichotomous variables that is considered in some detail provides estimates of misclassification probabilities in the initial measurement without requiring that the second measure be accurate or even better than the first. This methodology does require, however, that two subpopulations exist which have different rates of prevalence but whose probabilities of false positive and false negative error are the same. The applicability of these methods for self-reported drug use are described and illustrated using data from the National Household Survey on Drug Abuse. In the discussion of the results, the importance of these methods for assessing the validity of self-reported drug use are examined.

"The [U.S.] Current Population Survey (CPS) reinterview sample consists of two subsamples: (a) a sample of CPS households is reinterviewed and the discrepancies between the reinterview responses and the original interview responses are reconciled for the purpose of obtaining more accurate responses..., and (b) a sample of CPS households, nonoverlapping with sample (a), is reinterviewed 'independently' of the original interview for the purpose of estimating simple response variance (SRV). In this article a model and estimation procedure are proposed for obtaining estimates of SRV from subsample (a) as well as the customary estimates of SRV from subsample (b).... Data from the CPS reinterview program for both subsamples (a) and (b) are analyzed both (1) to illustrate the methodology and (2) to check the validity of the CPS reinterview data. Our results indicate that data from subsample (a) are not consistent with the data from subsample (b) and provide convincing evidence that errors in subsample (a) are the source of the inconsistency.", (excerpt)