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Tourism is one of the most important sectors for many countries and is also one of the most vulnerable to the impact of disasters. However, while tourism has proved resilient to localized or regional crisis, COVID-19 has had a universal impact on tourists, with pervasive, profound, and enduring implications. Our main objective is to explore and elucidate how such recent changes to tourism, triggered by the pandemic, affected the future travel intentions of tourists. Our exploration of these issues through in-depth interviews, finds that tourists were emotionally and psychologically affected by the sudden curb to their lives and that these emotions broadly equate to stages of grief. Furthermore, we uncover not only a general reduction in trust, but, concomitantly, an elevation in distrust towards destinations, manifest at the level of government, healthcare and tourist institutions, activities, and risk mitigation practices. Finally, we offer a discussion of the contributions and implications of our study in terms of tourism and hospitality research and practice.

During the COVID-19 pandemic, universities were among the first institutions to shift to an online model. As they did so, nascent collegiate esports program lost access to campus spaces and in-person connections, potentially destabilizing this rising industry. Conversely, universities also worked to provide students remote access to resources, and many components of esports already occur online. Therefore, collegiate esports may have adjusted to distancing measures, potentially strengthening their footholds on US campuses. This paper draws on in-depth interviews with collegiate esports players, student employees, program directors, and administrators to address different programs’ reactions to the pandemic, specifically the challenges and opportunities they faced. Overall, interviews reveal how COVID-19 shifted the understandings of and practices around gaming and esports, highlighted the intermittent relationship of online and offline spheres, and presented various possibilities and challenges for different stakeholders during the global pandemic.

Background: Malreduction after syndesmotic stabilization occurs in as many as 52% of cases and has been shown to detrimentally affect clinical outcomes. We propose that the modified Glide Path technique reduces the occurrence of syndesmotic malreduction. Methods: This study is a prospective series comparing 16 patients reduced with the modified Glide Path technique with a retrospectively reviewed series of 25 patients reduced with a traditional technique using fluoroscopy and a clamp. The modified Glide Path technique consists of manual reduction of the fibula and placement of a Kirschner wire through the fibula and tibia along the transmalleolar axis. The syndesmosis can then be reduced along the glide path created by the Kirschner wire to prevent posterior or anterior malreduction. Computed tomographic scans of the repaired and contralateral ankles were obtained postoperatively to assess reduction. Results: We found a statistically significant decrease of syndesmotic malreductions using the modified Glide Path technique when compared with technique that did not use a glide path. In our study, 2 of 16 patients (12.5%) had syndesmotic malreductions using the modified Glide Path technique, compared with 11 of 25 patients (44%) with syndesmotic malreductions in the historical cohort. Conclusion: The modified Glide Path technique is a simple method for ankle syndesmotic reduction. The technique has lower rates of malreduction compared with historical methods and may be useful for most operative syndesmotic injuries. Level of Evidence: Level II, prospective cohort study.

Over the past few decades, marriage rates in the United States among African Americans continue to decline, yet African American women continue to express a desire to be married. Using a grounded theory qualitative approach with semi-structured interviews ( N = 23), we explored marital attitudes among never married African American women. Participants identified both negative and positive exposures to marriage during childhood and messaging from family and faith communities as major sources influencing their desire to marry. Other themes, such as respectability and child behavioral benefits emerged that influenced women’s attitudes toward marriage. We present a discussion of the findings, limitations of this study, and next steps in the research.

Supportive community contexts are critical to positive youth development. Out-of-school time (OST) programs serve as supportive community contexts, and participation in OST programs is associated with a host of positive outcomes for youth. Cultural centers, such as museums, have been identified as potentially supportive community contexts for youth. Still, museums have been mostly absent in the broader research discussion of the role of community-based OST programs in promoting positive youth development. The current article presents a qualitative, single-case study of 37 youth between the ages of 13 and 18, the majority of whom identified with racial/ethnic identity groups traditionally underrepresented in OST program participation, in which we examined youths’ perspectives of the features of a museum-based, science-focused, youth development program that they found to be particularly supportive. Five themes emerged, including (a) the program structure, (b) meaningful opportunities and experiences offered by the program, (c) relationships with staff, (d) a positive peer culture, and (e) sense of belonging. The results provide detailed insight into how cultural centers, such as museums, can serve as supportive community contexts for youth development.

Background: Although lengthening of the lateral column through a calcaneal neck osteotomy is an integral component of flatfoot reconstruction in younger patients with flexible planovalgus deformities, concern exists as to the effect of this intra-articular osteotomy on subtalar motion. The purpose of this study was to quantify the alterations in subtalar motion following lateral column lengthening (LCL). Methods: The subtalar motion of 14 fresh-frozen cadaveric feet was assessed using a 3-dimensional motion capture system and materials testing system (MTS). Following potting of the tibia and calcaneus, optic markers were placed into the tibia, calcaneus, and talus. The MTS was used to apply a rotational force across the subtalar joint to a torque of 5 Nm. Abduction/adduction, supination/pronation, and plantarflexion/dorsiflexion about the talus were recorded. Specimens then underwent LCL via a calcaneal neck osteotomy, which was maintained with a 12-mm porous titanium wedge. Repeat subtalar motion analysis was performed and compared to pre-LCL motion using a paired t test. Results: No statistically significant differences in subtalar abduction/adduction (10.9 vs 11.8 degrees, P = .48), supination/pronation (3.5 vs 2.7 degrees, P = .31), or plantarflexion/dorsiflexion (1.6 vs 1.0 degrees, P = .10) were identified following LCL. Conclusion: No significant changes in subtalar motion were observed following lateral column lengthening in this biomechanical cadaveric study. Clinical Relevance: Although these findings do not obviate concerns of clinical subtalar stiffness following lateral column lengthening for planovalgus deformity correction, they suggest that diminished postoperative subtalar motion, when it occurs, may be due to soft tissue scarring rather than alterations of joint anatomy.

‘Crunch’ – a period of unpaid overtime meant to speed up lagging projects – is a common labor practice in the video game industry and persists despite many costs to developers. To understand why, we conducted a critical discourse analysis of Game Developer magazine (2000–2010) to explore how industry members perceive and discuss gamework (1) in a publication for developers, by developers and (2) during the first decade in which serious conversations about labor emerge in the games industry. Our analysis found that many gameworkers treat crunch as ‘inevitable’ due to three specific themes: games as an unmanageable creative industry, an anti-corporate ethos, and a stereotypical developer identity based on passion and perfectionism. These constructions – combined with the industry’s project-based nature and cultures of passion and secrecy – build crunch into the habitus of gamework, helping reproduce exploitative labor practices. However, habitus can and does change over time, providing interested employees, companies, and labor organizers a means to intercede in existing work practices. We suggest a multipronged intervention that could build a healthier, more sustainable habitus of gamework.

Studies of service delivery often assume that any deviance from service protocols when interacting with customers is largely due to service worker ineptitude or incompetence; this is particularly the case with customer deception or manipulation. This contrasts with studies which report that service workers frequently act in deviant ways. In tourist settings, service quality is paramount, and any attempts to deceive or manipulate customers is tantamount to service failure. This study explores service worker deception and manipulation on cruise ships through a series of in-depth interviews ( n = 50) via the lens of “Deviant Leisure.” This study finds that manipulation is a quotidian practice on cruise ships, including the manipulation by cruise ship frontline employees (including the manipulation of customers, co-workers, subordinates, and superordinates), and the manipulation of cruise ship frontline employees (including manipulation by customers, co-workers, and managers). The paper concludes with a discussion of contributions to theory and practice.

Nonprofits are key in local community development and often work in tandem with or against municipal governments in neighborhood planning. We focus on a unique case of a local government that largely contracts neighborhood planning processes to a nonprofit in Oklahoma City. Using thirty-nine interviews with municipal staff, nonprofit employees, and stakeholders, we examine the benefits and consequences of this contracting relationship on participatory processes. The findings reveal that the nonprofit excels at grassroots resident engagement but also faces constraints due to contract benchmarks. The findings offer implications on co-creating subcontractor goals and disparate neighborhood planning service outcomes.

Category: Ankle; Trauma Introduction/Purpose: Syndesmotic screw fixation is frequently required in rotational ankle injuries. Fibular malreduction after syndesmotic screw fixation occurs in as many as 52% of cases, which has been shown to detrimentally affect subjective outcomes and increase the probability of developing arthritis. The glidepath technique has been proposed as a useful technique to prevent malreduction. We hypothesize that the glidepath technique reduces the occurrence of fibular malreduction and results in improved outcomes compared to clamping. Methods: A retrospective cohort study comparing 25 patients reduced with a clamp compared to 18 patient using the glidepath technique. The glidepath technique, described by Needleman, the fibula is manually reduced and a Kirschner wire is placed through the fibula and tibia along the transmalleolar axis, parallel to the superior border of the ankle mortise. CT scans of the injured and contralateral ankles were obtained postoperatively to assess reduction. Malreduction is defined as >2mm difference between the anterior or posterior incisura-fibular distance of the injured ankle compared to the contralateral side. Prospective outcomes were assessed using the AOFAS and VR-12 scores at preoperative, 3 month, 6 month and 1 year followup of the glidepath cohort only. Results: We found a statistically significant reduction in malreduced syndesmoses using the glidepath technique when compared with the clamping technique. In our study, 17% (3/18) were malreduced using the glidepath technique, compared with 48% (12/25 patients) with clamping (p=0.005). The three malreductions seen in our study were anterior, we had no posterior malreductions. Compared with the clamping cohort that had 10/25 posterior malreductions and 2/25 anterior malreductions. Mean outcomes at 3,6 and 1 year scores were AOFAS 76, 86,86; VR-12 46,53,50/ 42,44,47 (physical/mental) respectively. Conclusion: Historically, malreduction for syndesmotic fixation is as high as 52%. The glidepath technique is a viable reduction maneuver that has lower rates of malreduction compared to clamping in our study. This is the first ever CT confirmed study measuring syndesmosis reduction utilizing manual reduction. The value of this technique is that is does not require an open reduction, arthroscopic visualization/reduction or CT guidance to achieve syndesmotic reduction.

The ReninAAV db/db uNx model of diabetic kidney disease (DKD) exhibits hallmarks of advanced human disease, including progressive elevations in albuminuria and serum creatinine, loss of glomerular filtration rate, and pathological changes. Microarray analysis of renal transcriptome changes were more similar to human DKD when compared to db/db eNOS−/− model. The model responds to treatment with arterial pressure lowering (lisinopril) or glycemic control (rosiglitazone) at early stages of disease. We hypothesized the ReninAAV db/db uNx model with advanced disease would have residual disease after treatment with lisinopril, rosiglitazone, or combination of both. To test this, ReninAAV db/db uNx mice with advanced disease were treated with lisinopril, rosiglitazone, or combination of both for 10 weeks. All treatment groups showed significant lowering of urinary albumin to creatinine ratio compared to baseline; however, only combination group exhibited lowering of serum creatinine. Treatment improved renal pathological scores compared to baseline values with residual disease evident in all treatment groups when compared to db/m controls. Gene expression analysis by TaqMan supported pathological changes with increased fibrotic and inflammatory markers. The results further validate this model of DKD in which residual disease is present when treated with agents to lower arterial pressure and glycemic control.

Purpose Acute radiologic emergencies, primarily severe contrast reactions, are rare but life-threatening events. Given a generalized paucity of formalized or mandated training, studies have shown that radiologists and trainees perform poorly when acutely managing such events. Moreover, skill base, knowledge, and comfort levels precipitously decline over time given the infrequent occurrence of these events during one's daily practice. The primary aim of this study was to assess radiologists' preparedness for managing acute radiologic emergencies and to determine the efficacy of a high-fidelity simulation based training model in an effort to provide a rationale for similar programs to be implemented on a provincial or national level. Methods This was a prospective, observational study of radiology residents and attending radiologists throughout the province who were recruited to attend a full-day simulation-based course presenting various cases of acute radiologic emergencies. Participant demographics were collected at the time of commencement of the workshop. Course materials were disseminated 4 weeks prior to the workshop, and a 17-question knowledge quiz was administered before and after the workshop. Likert-type questionnaires were also distributed to survey comfort levels and equipment familiarity. The knowledge quiz and questionnaire were redistributed at 3- and 6-month intervals for acquisition of follow-up data. Results A total of 14 attending radiologists and 7 residents attended the workshop, with all participants completing the preworkshop questionnaire and 90.5% (19 of 21) completing the post-workshop questionnaire. Participants' principle locations of practice were as follows: academic institutions (50%), community hospitals (36.9%), and private clinics (13.1%). A significant increase in knowledge was demonstrated, with average scores of 10 out of 17 (59%) and 14.5 out of 17 (85%) ( P < .001) before and after the workshop, respectively. A significant increase in participants' comfort levels in recognizing acute anaphylactic reactions (3.5; 4.7, P < .001), commencing initial management for acute radiologic emergencies (3.3; 5.0, P < .001), and administering the correct dose for anaphylactic reactions (2.5; 4.8, P < .001) was also demonstrated. Moreover, participants became increasingly familiar with the contents and equipment found within contrast reaction kits (2.8; 3.8, P < .01). Repeat evaluations at 3 and 6 months found an average knowledge test score of 13.8 out of 17 (81%) and 10.8 out of 17 (64%), respectively. Comfort levels were also reassessed in recognizing acute anaphylactic reactions (4.5; 4.1), commencing initial management (4.0; 3.9) and administering the correct dose of medication (4.0; 3.7) at 3- and 6-month intervals. Conclusions Acute radiologic emergencies are rare but life-threatening events that require rapid diagnosis and treatment to mitigate associated morbidity and mortality. Simulation-based workshops are a highly efficacious training model to increase knowledge, comfort levels, and equipment familiarity for radiologists and trainees alike; however, retraining at regular intervals is required.

Peer review for radiologists plays an important role in identifying contributing factors that can lead to diagnostic errors and patient harm. It is essential that all radiologists be aware of the multifactorial causes of diagnostic error in radiology and the methods available to reduce it. This pictorial review provides readers with an overview of common errors that occur in abdominal radiology and strategies to reduce them. This review aims to make readers more aware of pitfalls in abdominal imaging so that these errors can be avoided in the future. This essay also provides a systematic approach to classifying abdominal imaging errors that will be of value to all radiologists participating in peer review.

It has been 50 years since magnet schools were first used to address segregation in public schools. The context of magnet schools has changed dramatically during this time, raising questions about the role of magnet schools in a modern context. This study utilized data from a large urban district with more than 100 magnet schools to assess integration from magnet schools in a modern context. The results point to integration in magnet schools, but this integration comes at the cost of segregating the traditional public schools in the district. Interdistrict transfers could improve the integrative capacity of magnet schools.

Patient race/ethnicity affects health care utilization, provider trust, and treatment choice. It is uncertain how these influences affect pediatric care. We performed a systematic review (PubMed, Scopus, Web of Science, PsycINFO, Cochrane, and Embase) for articles examining race/ethnicity and parental treatment decision-making, adhering to PRISMA methodology. A total of 9200 studies were identified, and 17 met inclusion criteria. Studies focused on treatment decisions concerning end-of-life care, human papillomavirus vaccination, urological surgery, medication regimens, and dental care. Findings were not uniform between studies; however, pooled results showed (1) racial/ethnic minorities tended to prefer more aggressive end-of-life care; (2) familial tradition of neonatal circumcision influenced the decision to circumcise; and (3) non-Hispanic Whites were less likely to pursue human papillomavirus vaccination but more likely to complete the vaccine series if initiated. The paucity of studies precluded overarching findings regarding the influence of race/ethnicity on parental treatment decisions. Further investigation may improve family-centered communication, parent engagement, and shared decision-making.

Burkitt's lymphoma is a highly aggressive non-Hodgkin's B-cell lymphoma, which often presents with intra-abdominal involvement. The purpose of this pictorial review is to illustrate the various intra-abdominal imaging findings of Burkitt's lymphoma. Extranodal disease at presentation is common, including involvement of the bowel, stomach, pancreas, spleen, and mesentery.

Much attention has been paid to administrators and teachers in turnaround schools; however, little focus, if any, is given to school counselors and the vital role that they play in improving student outcomes. In turnaround schools, it is critical that all school personnel are involved in improving school outcomes, such as academic achievement and graduation rates, in the lowest performing high schools in the United States. The authors highlight the critical role that school counselors play in turnaround schools and offer specific recommendations on how they may collaborate with other stakeholders to improve student achievement in such school settings.

Background: Optimal timing of anterior cruciate ligament (ACL) reconstruction has been a topic of controversy. Reconstruction has historically been delayed for at least 3 weeks, given previous studies reporting a high risk of postoperative arthrofibrosis and suboptimal clinical results. Purpose: To prospectively evaluate postoperative range of motion following acutely reconstructed ACLs with patellar tendon autograft. Study Design: Case series; Level of evidence, 4. Methods: Patients (age >18 years) who had ACL reconstruction as soon as possible after injury, regardless of the condition or preoperative range of motion of the injured knee, underwent reconstruction with patellar tendon autograft. An identical standard surgical technique and postoperative rehabilitation were employed for all patients. Postoperative assessment included active range of motion measurements with a goniometer. Subjective outcomes were assessed with the Knee injury and Osteoarthritis Outcome Score (KOOS). Results: A total of 25 consecutive patients who met the inclusion criteria were enrolled. The mean age was 27.9 years (range, 20-48 years), and 19 were men. The time from injury to surgery was a mean 4.5 days (range, 1-9 days). The mean objective follow-up was 10.9 months (range, 3 days–19.4 months), and range of motion was regained at a mean 4.4 months (range, 1-9 months). Three meniscal repairs and 3 microfractures were performed concomitantly. There was 1 graft failure at 3 years postoperatively, noted at 50 months of subjective follow-up. There was no loss of extension >3° as compared with the contralateral knee in any patient. There was no loss of flexion >5° as compared with the contralateral knee in any patient who completed objective follow-up. The mean KOOS at final subjective follow-up was 82.8 (range, 57.7-98.8) at a mean 56.6 months postoperative (n = 14/24; range, 48-58 months). Conclusion: Excellent clinical results can be achieved following ACL reconstruction performed ≤9 days after injury with patellar tendon autograft. The authors found that early ACL reconstructions do not result in loss of motion or suboptimal clinical results as long as a rehabilitation protocol emphasizing extension and early range of motion is employed.

The sense of urgency for addressing the concerns of males of color cannot be overstated. The reality of racial discrimination and trauma is present for males of color in urban, suburban, and rural settings and regardless of their socioeconomic status. Such oppressive conditions in education, criminal justice, health, and employment, for example, wreak havoc on their overall well-being and advancement in society. Until the systems constraining the progress of males of color are addressed through substantive policy and practice, the social, economic, and educational struggles will persist. This special issue presents 19 theoretical, qualitative, and quantitative articles focusing specifically on the experiences of males of color in educational settings and the importance of school counselors in helping them to thrive.

This qualitative study explores the perspectives and experiences of Black male student-athletes with particular focus on their interactions with school counselors. It draws on nine participants selected through purposive and snowball sampling techniques. The Black male participants were current or former student-athletes at the high school and Division I levels. We developed and analyzed the semistructured interview questions through the lens of critical race theory. Using deductive data analysis techniques, we identified key factors that appear to shape interactions between Black male student-athletes and school counselors, including the perception of the school counselor role, a village of support, and prior experiences with school counselors. The results of this study have implications for school counselor practice, policy, and research.

Enterococcal spondylitis (ES) is a disease of commercial broiler chickens, with a worldwide distribution. Symmetrical hind limb paralysis typical of ES results from infection of the free thoracic vertebra (FTV) by pathogenic strains of Enterococcus cecorum . To determine the pathogenesis of ES, birds with natural and experimental ES were studied over time. In natural disease, case birds (n = 150) from an affected farm and control birds (n = 100) from an unaffected farm were evaluated at weeks 1–6. In control birds, intestinal colonization by E. cecorum began at week 3. In case birds, E. cecorum was detected in intestine and spleen at week 1, followed by infection of the FTV beginning at week 3. E. cecorum isolates recovered from intestine, spleen, and FTV of case birds had matching genotypes, confirming that intestinal colonization with pathogenic strains precedes bacteremia and infection of the FTV. Clinical intestinal disease was not required for E. cecorum bacteremia. In 1- to 3-week-old case birds, pathogenic E. cecorum was observed within osteochondrosis dissecans (OCD) lesions in the FTV. To determine whether OCD of the FTV was a risk factor for ES, 214 birds were orally infected with E. cecorum, and the FTV was evaluated histologically at weeks 1–7. Birds without cartilage clefts of OCD in the FTV did not develop ES; while birds with OCD scores ≥3 were susceptible to lesion development. These findings suggest that intestinal colonization, bacteremia, and OCD of the FTV in early life are crucial to the pathogenesis of ES.

The characterization and management of focal liver lesions is a commonly encountered problem in radiology. While the imaging findings will often be diagnostic, in equivocal cases the decision of how to proceed may be challenging. The primary modalities for liver lesion characterization are multiphase contrast-enhanced computed tomography and magnetic resonance imaging. Most lesions have typical imaging features, and when taken in conjunction with patient demographics and biochemistry the diagnosis can usually be made. Ancillary imaging modalities such as contrast-enhanced ultrasound and hepatobiliary specific contrast agents are also useful. Cirrhotic livers present a challenge due to the spectrum of benign, dysplastic, and malignant nodules that can occur. The report should include information necessary for accurate staging, and published standardized reporting guidelines should be taken into consideration. A decision to proceed to biopsy should be made only after multidisciplinary review of the case. If biopsy is required, fine needle aspiration is usually sufficient, though core needle biopsy may be required in certain circumstances.

Category: Midfoot/Forefoot; Other Introduction/Purpose: While lengthening of the lateral column through a calcaneal neck osteotomy is an integral component of flatfoot reconstruction in younger patients with flexible planovalgus deformities, the procedure has been implicated in iatrogenic calcaneocuboid (CC) subluxation and subsequent degenerative changes at the CC articulation. The purpose of this study is to characterize alterations at the CC joint following lateral column lengthening (LCL) as well as to determine if Steinman pin stabilization of the CC joint prior to distraction maintains a normal CC relationship. Methods: Seven matched pairs of fresh frozen cadaveric feet underwent pre-procedure plain radiography and cross-sectional computed tomography (CT) imaging. LCL via a calcaneal neck osteotomy was then performed. One foot of each matched pair had a single smooth Steinman pin placed centrally across the CC joint prior to osteotomy distraction. Distraction across each osteotomy was then performed and maintained with a 12mm porous titanium wedge. Repeat imaging was obtained and compared to pre-procedure studies to quantify sagittal and rotational differences at the CC articulation Results: Following LCL, plain radiography demonstrated statistically significant increases in the percentage of the calcaneal articular surface dorsal to the superior aspect of the cuboid in both the pinned (8.2% vs 17.6%, p=0.02) and unpinned (12.5% vs 16.3%, p=0.04) specimens. No difference in the percentage of subluxation was found between the two groups following LCL. CT imaging demonstrated statistically significant increases in rotation between the calcaneus and cuboid following LCL in both the pinned (7.6O +- 5.6O, p=0.01) and unpinned (17O +- 12.3O, p=0.01) specimens. Though a greater degree of rotation was present in the unpinned specimens following LCL, this difference was not statistically significant (p=0.28). Conclusion: Both sagittal and rotatory subluxation seem to occur at the CC joint following LCL regardless of pin stabilization. As a single pin would be expected to limit pure translation while having little effect on rotation, it is possible that the rotational changes identified on three-dimensional imaging are interpreted as dorsal translation when viewed two dimensionally using plain radiography. Consideration should therefore be given to CC stabilization with two pins during LCL to prevent this rotatory subluxation.

Category: Hindfoot; Other Introduction/Purpose: While lengthening of the lateral column through a calcaneal neck osteotomy is an integral component of flatfoot reconstruction in younger patients with flexible planovalgus deformities, concern exists as to the effect of this intra- articular osteotomy on subtalar motion. The purpose of this study is to quantify the alterations in subtalar motion following lateral column lengthening (LCL). Methods: The subtalar motion of 14 fresh frozen cadaveric feet was assessed using a three-dimensional motion capture system and materials testing system (MTS). Following potting of the tibia and calcaneus, optic markers were placed into the tibia, calcaneus and talus. The MTS was used to apply a rotational force across the subtalar joint to a torque of 5Nm. Abduction/adduction, supination/pronation, and plantarflexion/dorsiflexion about the talus was recorded. Specimens then underwent LCL via a calcaneal neck osteotomy which was maintained with a 12mm porous titanium wedge. Repeat subtalar motion analysis was performed and compared to pre-LCL motion using a paired t-test. Results:: No statistically significant differences in subtalar abduction/adduction (10.9O vs. 11.8O degrees, p=.48), supination/pronation (3.5O vs. 2.7O, p=.31), or plantarflexion/dorsiflexion (1.6O vs 1.0O, p=.10) were identified following LCL. Conclusion:: No significant changes in subtalar motion were observed following lateral column lengthening in this biomechanical cadaveric study. While these findings do not obviate concerns of clinical subtalar stiffness following planovalgus deformity correction, they suggest that diminished postoperative subtalar motion may be due to soft tissue scarring rather than alterations of joint anatomy.

Recent contributions on the discrimination of black and minority ethnic (BME) groups in organizations have suggested that overt forms of discrimination are now ‘old-fashioned’ and researchers are urged to focus on identifying different, ‘modern’ forms of discrimination. These are, however, set against studies that continue to report evidence of overt racism in organizations. This article argues that it may be premature and potentially counterproductive to celebrate the demise of overt discrimination in that such binary classification (‘old-fashioned’ and ‘modern’) may discourage efforts to investigate the full gamut of experiences of BME groups. The article contends that additional insights will be gained by concurrently studying not only the victims and the perpetrators of discrimination but also the organizational context in which discrimination occurs. Through the theoretical lens of gatekeeping, the article presents evidence of shopfloor discrimination against BME groups that is neither fully overt nor entirely covert.

Criminal (drug and prostitution) charges, employment levels (weekly hours), recent substance use in the past 6 months, and primary sources of income were examined among a sample ( n = 106) of women ex-offenders who had opioid use disorders with and without methadone histories. A general linear model was tested to examine differences in relation to methadone use history. Results from a one-way MANCOVA found that those with methadone histories reported significantly higher levels of drug and prostitution charges than those without any methadone history, but no significant differences in terms of weekly hours of employment or recent substance use were observed between groups. Women ex-offenders with methadone histories reported various sources of income beyond employment, and proportionally, more of these women reported prostitution as a primary source of income. Findings suggest that methadone maintenance treatments are not sufficient in meeting the needs of women ex-offenders.

Autoimmune pancreatitis (AIP) accounts for approximately 5% of chronic pancreatitis cases and is an important consideration in the differential diagnosis of pancreatic pathologies. The underlying pathophysiology of AIP is thought to involve lymphocyte infiltration and associated sclerosis. Although AIP is a benign condition that is treatable with corticosteroids, it can have imaging and clinical findings indistinguishable from pancreatic cancer. As such, the radiologist plays an important management role in distinguishing AIP from more sinister conditions. In addition, there are several extrapancreatic imaging findings in the context of AIP that have been recently described. This pictorial review outlines both the pancreatic and extrapancreatic imaging features in AIP and the response to steroid therapy. Important imaging features that allow AIP to be differentiated from other pancreatic pathology, including adenocarcinoma, lymphoma, and acute pancreatitis will be discussed.

Purpose The objective of the study was to determine the efficacy of contrast-enhanced ultrasound (CEUS) using ultrasound (US)-specific microbubbles in guiding radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC). Methods A retrospective analysis of 50 patients with HCC treated with CEUS guided RFA using perflutren at our institution was performed. CEUS images were first compared to B-mode US images performed at the same RFA session to determine the ability of CEUS to increase the conspicuity of lesions. A qualitative score (1 = poor, 2 = fair, 3 = excellent) was used to grade the ability to visualize the lesions. The preprocedure CEUS images were then evaluated using the most recent prior contrast enhanced computed tomography (CT) or magnetic resonance imaging (MRI). The efficacy of the treatment was evaluated with short-term follow-up imaging (median 1 month) for presence of residual or recurrent disease. Results CEUS allows at least fair visualization (score ≥2) in 78% (reader 1) and 80% (reader 2) of the lesions not visualized by B-mode US, and 50% (reader 1) and 42% (reader 2) of the lesions poorly visualized by B-mode US. Lesion appearances on CEUS are largely concordant with those on CT or MRI: 88% for reader 1, 96% for reader 2. With CEUS-guided RFA, complete response was achieved in the vast majority of the lesions at short-term follow-up: 82% for reader 1, 94% for reader 2. Conclusions CEUS increases the conspicuity and provides better characterization of hypervascular HCC that are either not seen or poorly seen on B-mode US, and CEUS provides real-time guidance of RFA with good short-term treatment responses.

While “knowledge learning” about the outgroup has been regarded as one of the key mechanisms for the contact–prejudice relation since the contact hypothesis’ first inception (Pettigrew & Tropp, 2008), “learning,” more broadly, has rarely been used as an explanatory framework to investigate the consequences of intergroup contact. In this article, we lay the foundation of a learning model of anxiety and stress in ingroup–outgroup interactions. We distinguish between episodic and chronic anxiety responses to the outgroup and recommend investigations on the complexities of their dynamic interplay, as individuals accumulate and dynamically integrate their experiences with the outgroup over time. Through a review of established and emerging psychophysiological and behavioral research of anxiety during ingroup–outgroup interactions, we identify evidence consistent with this dynamic outlook of intergroup contact effects. In this context, we also advance novel and untested predictions for future investigations onto the temporal integration of contact effects during an individual’s lifespan.

Hepatocellular carcinoma (HCC) is the most common primary tumour of the liver, responsible for significant morbidity and mortality worldwide. In the Western world, it primarily affects patients with cirrhosis, secondary to hepatitis C virus and alcoholism. In the rest of the world, HCC is closely associated with hepatitis B virus infections. Radiologists play a key role in accurately staging HCC, which has important implications for treatment planning. This pictorial review aims to describe the routes of HCC spread and the most frequent sites of metastases, to recognize extrahepatic HCC findings on computed tomography and magnetic resonance imaging, and to understand the implications of HCC staging on treatment planning.

The purpose of this pictorial review is to illustrate the various imaging findings of extrapulmonary tuberculosis. Manifestations of cardiac, central nervous system, head and neck, musculoskeletal, abdominal, genitourinary, and breast tuberculosis will be discussed. Extrapulmonary tuberculosis presents a difficult diagnostic challenge for the radiologist and requires a high index of suspicion, particularly in high-risk populations.

Fatigue is an important factor in aviation accidents, and effective fatigue management requires understanding the relationship between working conditions and fatigue. Two studies were conducted to clarify the relationship between working conditions and fatigue. In the first study, 59 airline pilots completed a workload questionnaire and the Profile of Mood States (POMS) in the morning and at the completion of their final flight of the day. In the second study, 133 pilots completed a revised questionnaire and the POMS. In both samples, fatigue increased and vigor levels decreased. Regression of fatigue increase upon working conditions indicated that the number of takeoffs and landings during the day were related to fatigue development. Correlation of incident level with both weather and airport difficulty suggest that incident level is a function of weather conditions and airport difficulty. These results argue that fatigue management should be founded upon the demands of working conditions, not merely the simplistic assessment of hours of work.

The psychological states and cognitive performance capacities of military participants were assessed prior to and following 1 week of field training at a Navy Survival, Evasion, Resistance, and Escape (SERE) School. The effect of this exposure resulted in significant cognitive performance deterioration and an increase in reported levels of subjective discomfort. Simple Reaction Time increased, and the capacity to perform information manipulation tasks such as Spatial Processing and Code Substitution deteriorated. Logical Reasoning proved the most susceptible of all tasks to the effects of the weeklong stressful exposure. These various effects were evident only in interaction with time on task. In the testing session following the stressful field exposure, participants’ immediate response was at a level similar to their pretraining baseline. However, unlike their preexposure session, performance in the later condition declined as the session progressed. This pattern suggests that immediately following the stress exposure, participants are able to sustain their normal performance but only for a limited period of time. Because the duration of any one single task, each being less than 1 min, was very brief, the results indicated that this time-based degradation was fairly rapid. Overall results indicate, therefore, that for stress assessment, Simple Reaction Time task may be usefully and pragmatically diagnostic of stress-induced deterioration. Our results further indicate that cognitive performance decrements are associated with subjective report of decreased vigor and increased difficulty in concentrating. In addressing the issue of sustained performance capacity and resilience following extended stress exposure, we seek to facilitate one goal—a modern objective force that is responsive to rapid changes in mission profile and operations. These findings indicate that crucial informationprocessing response measures help to achieve this aim.

The purpose of this study is to explore the direct, indirect, and total effects of high school sports participation on educational attainment for Black males using the Educational Longitudinal Study (2002/2006), a large, nationally representative, database. A path analysis procedure for determining underlying causal relationships between variables is presented. Although the implications of the results of this study are relevant for all who work with this population, school counselors are specifically highlighted.

This study examines how a community-based organization, the Balm in Gilead, has created social marketing campaigns targeted at the Black Church to promote AIDS awareness and education. This research examines how these social marketing campaigns were carefully framed within a religious and moral narrative so that it resonated with the values of the Black Church. Data consist of participant observation, in-depth interviews, and content analysis. Findings reveal that the Balm in Gilead marketed AIDS awareness to the Black Church's Christian obligation and duty to care for the sick and suffering. The Balm in Gilead created social marketing campaigns targeted at four key themes found within the tenets of the Black Church: responsibility to care for others, love, acceptance, and forgiveness. Discussions on possible policy implications along with the limitations of this study are also provided.

This study focused on patients' accounts of perceptions and experience of preoperative home-based interventions to increase health professionals' understanding of what is important or not when supporting patients preparing for hip replacements. Method: A phenomenological approach helped to develop insights into what patients found useful or not about preoperative interventions, thus developing an understanding of the value of the service from patients' perspectives. Data were gathered from 10 participants, using semi-structured interviews. Analysis used a seven-step framework for phenomenological data analysis. Findings: Five main themes emerged: preoperative equipment use increases independence, progress and confidence; individual needs are better met through timely visits; competent therapist home intervention offers reassurance regarding surgery; knowing one's home environment is suitable increases confidence in planning hospital discharge after surgery; and levels of social support require preoperative assessment. The participants identified preoperative home visits as valuable in helping to prepare for surgery. Home visits can alleviate preoperative anxiety and may contribute to more streamlined discharge planning. Visits may help to cut the costs of erroneous equipment provision or last-minute equipment deliveries and decrease length of stay. Conclusion: This research offers clinicians and managers relevant insight into patients' perceptions of home-based services and could work alongside quantitative research findings to inform best practice within National Health Service resource restrictions.

The aim of this paper is to update the reader on the subject of dental neglect in children. Recent national guidelines produced by the National Institute for Health and Clinical Excellence and the British Society of Paediatric Dentistry have raised the profile of this condition by providing specific, evidence-based recommendations for recognition and response to dental neglect. Dental neglect may be a sign of general neglect or may be considered maltreatment in itself. The specific dental and non-dental features are described and actions secondary to a diagnosis of dental neglect are discussed. Three types of intervention are described: preventive dental team management, preventive multi-agency management, and referral to child protection services. With increasing awareness of this condition and through access to the expertise of other specialist agencies in this field, the primary care practitioner can play a key role in safeguarding the welfare of children.

This article presents a mixed methods procedure for evaluating information processing and the role of social influences in deliberative public involvement groups. Specifically, it describes an interpretive, qualitative coding scheme for analyzing group discussions to quantitatively assess how group differences in information processing and social influences affect decision judgments. To substantiate the need for this new approach, the contributions of social psychology for better understanding persuasive influences in groups and individual information processing are described in relation to participatory public involvement contexts. The approach is then described using examples from a deliberative public involvement process. The article concludes with a discussion of the challenges associated with the proposed technique and suggestions for research to advance the technique and assess its contribution to mixed methods research.

Tissue microarray (TMA) is a new high-throughput method that enables simultaneous analysis of the profiles of protein expression in multiple tissue samples. TMA technology has not previously been adapted for physiological and pathophysiological studies of rodent kidneys. We have evaluated the validity and reliability of using TMA to assess protein expression in mouse and rat kidneys. A representative TMA block that we have produced included: (1) mouse and rat kidney cortex, outer medulla, and inner medulla fixed with different fixatives; (2) rat kidneys at different stages of development fixed with different fixatives; (3) mouse and rat kidneys with different physiological or pathophysiological treatments; and (4) built-in controls. As examples of the utility, immunostaining for cyclooxygenase-2, renin, Tamm Horsfall protein, aquaporin-2, connective tissue growth factor, and synaptopodin was carried out with kidney TMA slides. Quantitative analysis of cyclooxygense-2 expression in kidneys confirms that individual cores provide meaningful representations comparable to whole-kidney sections. These studies show that kidney TMA technique is a promising and useful tool for investigating the expression profiles of proteins of interest in rodent kidneys under different physiological and pathophysiological conditions. (J Histochem Cytochem 58:413–420, 2010)

Studies have argued that misbehaviour by customers is becoming increasingly prevalent in certain sectors. However, online consumer misbehaviour is comparatively under-researched. The focus of the current study is peer-to-peer activities, including copying music, movies, software or video games: a phenomenon which affects the entertainment sector as a whole and costs the industry billions of pounds each year. Neutralization theory provides a potentially fruitful perspective from which to explore consumer justifications and rationalizations for their online misbehaviour. The aim of this paper is to explore the extent to which peer-to-peer users employ techniques of neutralization to justify prior-to behaviour or rationalize their activities post behaviour. First, a review of online customer misbehaviour is provided, followed by an overview of existing research into the techniques of neutralization. Following a discussion of the research methods employed, findings regarding the peer-to-peer online misbehaviours and neutralization techniques are presented. Data analysis reveals that peer-to-peer file-sharers employ (often multiple) techniques of neutralization in order to pre-justify or post-event rationalize their activities, including: denial of victim; denial of injury; denial of responsibility; claim of normality; claim of relative acceptability; justification by comparison; and appeal to higher loyalties. The paper concludes with a series of implications for both theory and practice.

This commentary adopts a cross-disciplinary framework to discuss possible influences of both family and ethnicity on business performance in the marketplace. Both family and ethnicity are viewed as “upstream factors” that may help a business gain a favorable identity with potential stakeholders. Family businesses that have an ethnic background in common with customers, employees, and suppliers may receive preferential treatment. Communities may patronize a business simply because of an associated group identity. Thus, ethnic collectivism may alter some assumptions about family businesses and how they compete.

Researchers have argued that consumers frequently view marketing efforts as intrusive and that they fail to exhibit either trust or commitment. However, studies have found that some customers develop strong emotional relationships with firms, often independently of firm-driven relationship-building efforts. These confusing findings indicate that there is a need for additional research to explore the dynamics underlying service firm—customer relationships. The aim of this study is to elucidate customers' conception and manifestation of their relationships with service firms. Therefore, the objectives are to uncover the extent to which various types of customers exhibit relational links with service firms and to generate insights into the manner in which such identification is manifested. After a review of recent studies into relationship marketing, the authors present and explain the research design and method. Then, the authors present the findings that emerged during the focus groups and in-depth interviews with soccer supporters.

The assessment of dynamic cognitive abilities during actual field operations by professional personnel represents a significant challenge to the behavioral scientist. Here, we present a short-duration, portable cognitive assessment instrument which seeks to address such issues. Any such instrument with poor face validity is unlikely to receive the required attention and cooperation of operational personnel. Also, if supervisors see little relationship between the assessment procedure and the actual operational tasks they are unlikely to use outcome results anyway. This work summarizes our customization of an established cognitive assessment battery, which is composed of operationally relevant tasks for field assessment. Our present results suggest equivalent user acceptance and comparable assessment capacity as the longer duration, currently established battery.

Background: The quality of a school's teaching force has a significant effect on student learning. One potential lever for increasing teacher quality is through selecting and rewarding teachers with desired characteristics. Purpose: To analyze differences and similarities in the salary determinants of Michigan's charter and traditional public schools. Participants: The representative sample included 723 full-time traditional public school teachers and 468 full-time charter school teachers in Michigan during the 1999-2000 school year. Research Design: This is a multivariate analysis of quantitative data. A secondary analysis of survey data was performed, allowing for greater generalizability across the population of interest. Data Collection and Analysis: The 1999-2000 Schools and Staffing Survey was the data source. This NCES survey provides comprehensive data on school and staff characteristics that are representative at the state level. Findings: The average Michigan charter school teacher earns more than $15, 000 less than the average Michigantraditionalpublic school teacher. Two thirds of this salary difference is because charter school teachers often have lower endowments of valued characteristics, such as experience and certification. Conclusions: Charter school administrators appear to be selecting and rewarding teachers in innovative ways thatcouldhavea positive impactonteacher quality. They are hampered in these efforts by the depressed salaries offered in many charter schools.

This article explores and analyses the dynamics of workplace relationships in an organization characterized by a highly ethnically diverse workforce. The specific objectives are: 1) to understand the factors that are contributing to high levels of ethnic diversity; 2) to uncover the ways in which such diversity is manifested in an organizational setting; and 3) to explore the ramifications that this diversity and its manifestations may have for individuals and groups of employees on the one hand and for relations between management and groups of employees on the other. The article concludes by discussing the implications that such ethnic diversity may have for extant research and conceptualization of ethnic minorities in the workplace.

Female nudity in advertising varies greatly across Europe and the world. However, in studying extant literature regarding female nudity in advertising a number of limitations emerge. In particular, existing research into consumer attitudes fails to recognize sexuality and cultural differences. The aim of this research is to explore and describe consumer attitudes to the depiction of female nudity in advertising in the UK; a previously overlooked context. In addition, in order to overcome omissions in existing empirical research, a secondary aim is to explore such issues from a variety of perspectives by noting and incorporating into the analysis participant sexuality. The literature review concentrates on the key areas of sex roles in advertising, sex appeal and arousal in advertising, female nudity in advertising and the application of literary, feminist and art theory to advertising research. Thereafter follows a discussion and justification of focus groups as the chosen method that incorporates a detailed description of the informants (including details of informant sexuality and sex) as well as a breakdown of the choice of advertising material. Following from this are the results and discussion that focus on six key themes: sex and sex approval; the gaze; sexual and non-sexual use of nudity; femininity and androgyny; congruence; and authorial intent and reader response. The article concludes with a discussion of the main implications of the study and with the forwarding of suggestions for further research.