Search

Objectives: Incidents of discrimination against Asian Americans have increased in the United States during the COVID-19 pandemic. The aims of this study are to (a) examine the overall psychological impact of incidents of discrimination on Asian Americans adults, (b) identify whether East Asians experience worse psychological outcomes following experiences of discrimination compared to other Asian Americans, and (c) identify culturally relevant factors that moderate the relationship between incidents of discrimination and psychological outcomes., Method: Two hundred eighty-nine participants who identified racially as Asian American ( M age = 33.1 years, ±10.5 SD , 57.1% male, and 54.3% East Asian) completed an online survey including measures of demographics, psychological outcomes, culturally relevant factors (e.g., acculturative stress, collective self-esteem), and racial discrimination., Results: We found that, overall, experiencing increased frequency of discrimination related to more depressive symptoms and alcohol use ( p s < .05). When comparing Asian subgroups (East Asian vs. other Asian), there were no significantly different relationships between discrimination frequency and attribution to race on psychological outcomes ( p s > .098). Collective self-esteem ( p = .041) weakened, while acculturative stress strengthened ( p < .001) the relationship between discrimination frequency and alcohol use; collective self-esteem weakened the relationship between attribution to race and social anxiety ( p = .021); and internalized racism weakened the relationship between discrimination frequency and depression ( p = .038)., Conclusions: We identified moderators of the relationship between experiences of discrimination and psychological outcomes in Asian Americans. Because the moderators held for all Asian groups under study, they are strong candidates for points of intervention to mitigate the harmful effects of discrimination for Asian Americans. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The American Revolution was a gruesome war that resulted in the independence of the United States of America from the British crown and countless casualties to both belligerents. However, from these desperate times, the treatment of traumatic head injury was elucidated, as were the origins of American neurosurgery in the 18th century. During the war, the surgical manual used by military field surgeons was titled Plain Concise Practical Remarks on the Treatment of Wounds and Fractures, by Dr. John Jones. This manual explains the different types of cranial injuries understood at that time as well as the relevant surgical treatment. This article seeks to review the surgical treatment of head injury in the Revolutionary War as outlined by Dr. Jones's manual.

The American Revolution was a gruesome warthat resulted in the independence of the United States of America from the British crown and countless casualties to both belligerents. However, from these desperate times, the treatment of traumatic head injury was elucidated, as were the origins of American neurosurgery in the 18th century. During the war, the surgical manual used by military field surgeons was titled Plain Concise Practical Remarks on the Treatment of Wounds and Fractures, by Dr. John Jones. This manual explains the different types of cranial injuries understood at that time as well as the relevant surgical treatment. This article seeks to review the surgical treatment of head injury in the Revolutionary War as outlined by Dr. Jones's manual.

Objective: Most professional organizations now provide patient information material, and not all of this material is appropriate for the average American adult to comprehend. The National Institutes of Health (NIH) and the United States Department of Health and Human Services recommend that patient education materials be written at the sixth-grade level. Our aim was to assess the readability of neurosurgery-related patient education material and compare it with The American Medical Association, NIH, and United States Department of Health and Human Services recommendations., Methods: Materials provided by the American Association of Neurologic Surgeons (AANS) and the U.S. National Library of Medicine (NLM) and National Institutes of Health were assessed with the Flesch-Kincaid grade level and Flesch Reading Ease score with Microsoft Office Word software., Results: None of the articles had Flesch-Kincaid grade levels at or below the sixth-grade level. All articles on the AANS Conditions and Treatments section were written at or above the ninth-grade level; three of the AANS Camera-Ready Fact Sheets and four of the NIH/NLM articles were written between the seventh- and eighth-grade levels., Conclusions: Current patient education material provided by the AANS is written well above the recommended level. Material from the NLM and NIH performed better, but was still above the recommended sixth-grade level. Education materials should contain information relevant to patients' conditions, be accurate in the information they present, and be written with the average patient in mind., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Object: Forty-two states and the District of Columbia have passed legislation based on the Lystedt law of Washington state, enacted in 2009 to protect young athletes who have sustained a concussion. The aim of this study was to note the several similarities and differences among the various laws., Methods: Concussion legislation was compared for 50 states and the District of Columbia. Evaluation parameters of this study included stipulations of concussion education, criteria for removal from play, requirements for evaluation and return to play after concussion, and individuals required to assess young athletes. Other parameters that were not consistent across states were also noted., Results: Forty-three states and the District of Columbia have passed concussion legislation, and an additional 4 states have pending legislation. All states with existing legislation support concussion education for coaches; however, only 48% require coaches to undergo formal education. Athletes must be educated on concussion in 86% of states and parents in 88.7%. Suspicion of concussion is a criterion for removal from play in 75% of states; signs and symptoms of concussion are criteria for removal from play in 16% of states. The individuals allowed to evaluate and clear an athlete for return to play differ greatly among states., Conclusions: Injury prevention legislation holds historical precedent, and given the increasing attention to long-term sequelae of repeated head trauma and concussion, concussion legislation has been rapidly passed in 43 states and the District of Columbia. Although the exact stipulations of these laws vary among states, the overall theme is to increase recognition of concussion in young athletes and ensure that they are appropriately cleared for return to play after concussion.

Military explorations of the practical role of simulators have served as a driving force for much of the virtual reality technology that we have today. The evolution of 3-dimensional and virtual environments from the early flight simulators used during World War II to the sophisticated training simulators in the modern military followed a path that virtual surgical and neurosurgical devices have already begun to parallel. By understanding the evolution of military simulators as well as comparing and contrasting that evolution with current and future surgical simulators, it may be possible to expedite the development of appropriate devices and establish their validity as effective training tools. As such, this article presents a historical perspective examining the progression of neurosurgical simulators, the establishment of effective and appropriate curricula for using them, and the contributions that the military has made during the ongoing maturation of this exciting treatment and training modality., (Copyright © 2012. Published by Elsevier Inc.)

The Advanced Trauma Life Support (ATLS) protocol is a successful course offered by the American College of Surgeons. Once based on didactic lectures and seminars taught by experts in the field, trauma training has evolved to become a set of standardized assessment and treatment protocols based on evidence rather than expert opinion. As the ATLS expands, indices to predict outcome, morbidity, and mortality have evolved to guide management and treatment based on retrospective data. This historical, perspective article attempts to tell the story of ATLS from its inception to its evolution as an international standard for the initial assessment and management of trauma patients., (Copyright 2012, SLACK Incorporated.)

The history of aneurysm therapy is rich in parallelisms that exist between the once-fledgling field of aneurysm surgery and the now-growing field of endovascular aneurysm treatment. The treatment of aneurysms has had a cyclic progression. The indirect and safest approach to the treatment of aneurysms was seen in the development and use of Hunterian ligation in the 19th century. During the past few decades, nascent technology and a better understanding of the pathophysiology of aneurysms resulted in a more direct intracranial, extravascular approach to aneurysm therapy, with the focal point being the use of the aneurysm clip to secure an aneurysm at its neck. Interestingly, alternative and, arguably, even more direct approaches to aneurysm therapy developed in the surgical suites. These techniques became the seeds for the birth of direct endovascular aneurysm treatment in particular and endovascular surgery in general. As endovascular technology continues to develop, somewhat more sophisticated, indirect approaches to aneurysm therapy (the use of stents to modify flow, for example) are being investigated. The treatment of intracranial aneurysms has a rich history. First thought to be inoperable lesions, aneurysms have challenged neurosurgeons and their colleagues since they were first recognized in the 18th century. Treatment for these lesions did not begin until the 19th century with the use of Hunterian ligation. This review describes the many milestones in the field of aneurysm surgery and endovascular surgery, tracing the many parallelisms contained within the birth and growth of each field and their respective significance.

Objective: Although some data regarding the use of thrombolysis are available from community-based studies, national estimates of the use of thrombolysis for ischemic stroke are not available. We performed this study to determine the frequency of thrombolysis for ischemic stroke in the United States and associated in-hospital outcomes., Methods: National estimates of thrombolysis, associated in-hospital outcomes, and mortality were obtained from National Hospital Discharge Survey data from 1999 to 2001. Patient numbers and frequency distributions were calculated for a nationally representative sample of patients hospitalized with a primary diagnosis of ischemic stroke. Thrombolysis was further stratified into thrombolysis with (intra-arterial) or without (intravenous) cerebral angiography., Results: There were 1,796,513 admissions for ischemic stroke between 1999 and 2001. Of these admitted patients, 1,314 (0.07%) underwent intra-arterial thrombolysis and 11,283 (0.6%) underwent intravenous thrombolysis. The days of hospitalization (mean +/- standard deviation) were significantly higher for patients admitted with ischemic stroke treated with intra-arterial thrombolysis (10.7 +/- 4.8) or intravenous thrombolysis (7.1 +/- 3.6) compared with non-thrombolytic admissions (5.4 +/- 5.7). We observed a trend toward a higher frequency of use of intravenous and intra-arterial thrombolysis and hospitals with greater number of beds (P < 0.01). The mortality rates for hospitalizations were not significantly different for admissions with ischemic stroke treated with intra-arterial or intravenous thrombolysis compared with other ischemic strokes. The rates of discharge to home after hospitalizations were significantly lower for patients treated with intravenous thrombolysis (19.8%) compared with those not treated with thrombolysis (53.1%)., Conclusion: The present study provides national estimates of patients undergoing thrombolysis for ischemic stroke. Further efforts need to be made to increase the proportion of patients with ischemic stroke who receive thrombolysis in the United States.

Background and Purpose: Conventional spinal angiography, although useful in providing angioarchitectural details of spinal vascular disease, has limitations. The advent of 3D angiography has provided a better comprehension of angioarchitectural detail when evaluating the intracranial circulation. The purpose of this study was to evaluate the usefulness of 3D angiography in the diagnosis and treatment of vascular malformations of the spine., Methods: This retrospective analysis included 17 3D spinal angiograms acquired in 14 consecutive patients examined at our institution for a spinal vascular lesion, which included nine spinal cord arteriovenous malformations (AVMs), one perimedullary arteriovenous fistula (AVF), three spinal dural AVFs, and one nerve root AVM. 3D angiography was obtained with apnea under general anesthesia by using a 14-second acquisition and 200 degrees rotation of the gantry during injection of 300 mg I/mL nonionic contrast material at a rate of 0.5-3.5 mL/s. Multiple reconstructed images were obtained with or without opacification of the surrounding structures. These images were then evaluated by the interventionalists at the time of the procedure and compared with findings obtained by conventional subtraction angiography., Results: 3D angiography was useful in differentiating intramedullary lesions from perimedullary surface lesions; detecting arterial, nidal, or venous aneurysms; and evaluating the 3D structure of the lesion as well as the relationship between the malformation and its draining veins or surrounding bony structures. In specific situations, it obviated the need for contrast-enhanced conventional or 3D CT, as well as for lateral or oblique angiographic views, which are sometimes difficult to obtain with good quality. No 3D angiography-related complications were experienced. Some limitations in the definition of small vessel anatomy in the reconstructed images were noted., Conclusion: In this small series of patients, 3D angiography was safe and useful for evaluation of the 3D vascular anatomy of spinal vascular malformations.