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Objective: To evaluate declarative memory outcomes in medically refractory epilepsy patients who underwent either a highly selective laser ablation of the amygdalohippocampal complex or a conventional open temporal lobe resection. Methods: Post-operative change scores were examined for verbal memory outcome in epilepsy patients who underwent stereotactic laser amygdalohippocampotomy (SLAH: n = 40) or open resection procedures (n = 40) using both reliable change index (RCI) scores and a 1-SD change metric. Results: Using RCI scores, patients undergoing open resection (12/40, 30.0%) were more likely to decline on verbal memory than those undergoing SLAH (2/40 [5.0%], p = 0.0064, Fisher's exact test). Patients with language dominant procedures were much more likely to experience a significant verbal memory decline following open resection (9/19 [47.4%]) compared to laser ablation (2/19 [10.5%], p = 0.0293, Fisher's exact test). 1 SD verbal memory decline frequently occurred in the open resection sample of language dominant temporal lobe patients with mesial temporal sclerosis (8/10 [80.0%]), although it rarely occurred in such patients after SLAH (2/14, 14.3%) (p = 0.0027, Fisher's exact test). Memory improvement occurred significantly more frequently following SLAH than after open resection. Interpretation: These findings suggest that while verbal memory function can decline after laser ablation of the amygdalohippocampal complex, it is better preserved when compared to open temporal lobe resection. Our findings also highlight that the dominant hippocampus is not uniquely responsible for verbal memory. While this is at odds with our simple and common heuristic of the hippocampus in memory, it supports the findings of non-human primate studies showing that memory depends on broader medial and lateral TL regions.

ObjectiveTo determine whether a less-invasive approach to surgery for medically refractory temporal lobe epilepsy is associated with lower health care costs and costs of lost productivity over time, compared to open surgery.MethodsWe compared direct medical costs and indirect productivity costs associated with treatment with stereotactic radiosurgery (SRS) or anterior temporal lobectomy (ATL) in the ROSE (Radiosurgery or Open Surgery for Epilepsy) trial. Health care use was abstracted from hospital bills, the study database, and diaries in which participants recorded health care use and time lost from work while seeking care. Costs of use were calculated using a Medicare costing approach used in a prior study of the costs of ATL. The power of many analyses was limited by the sample size and data skewing.ResultsCombined treatment and follow-up costs (in thousands of US dollars) did not differ between SRS (n = 20, mean = $76.6, 95% confidence interval [CI] = 50.7-115.6) and ATL (n = 18, mean = $79.0, 95% CI = 60.09-103.8). Indirect costs also did not differ. More ATL than SRS participants were free of consciousness-impairing seizures in each year of follow-up (all P

PurposeStereotactic radiosurgery (SRS) may be an alternative to anterior temporal lobectomy (ATL) for mesial temporal lobe epilepsy (MTLE). Visual field defects (VFD) occur in 9-100% of patients following open surgery for MTLE. Postoperative VFD after minimally invasive versus open surgery may differ.MethodsThis prospective trial randomized patients with unilateral hippocampal sclerosis and concordant video-EEG findings to SRS versus ATL. Humphries perimetry was obtained at 24 m after surgery. VFD ratios (VFDR = proportion of missing homonymous hemifield with 0 = no VFD, 0.5 = complete superior quadrantanopsia) quantified VFD. Regressions of VFDR were evaluated against treatment arm and covariates. MRI evaluated effects of volume changes on VFDR. The relationships of VFDR with seizure remission and driving status 3 years after surgery were evaluated.ResultsNo patients reported visual changes or had abnormal bedside examinations, but 49 of 54 (91%) of patients experienced VFD on formal perimetry. Neither incidence nor severity of VFDR differed significantly by treatment arm. VFDR severity was not associated with seizure remission or driving status.ConclusionThe nature of VFD was consistent with lesions of the optic radiations. Effective surgery (defined by seizure remission) of the mesial temporal lobe results in about a 90% incidence of typical VFD regardless of method.

Racial attitudes can be shaped by personal attributes and social network properties. Literature on White social work students' racial attitudes remains scarce. The purposes of this study are to explore racial attitudes among social work students and identify personal and social network correlates of such attitudes. One hundred and sixty-three White social work students in a major Midwest public university were recruited via social work electronic mailing list to complete an anonymous online survey measuring personal-level characteristics (e.g., demographic information and racial attitudes as measured by the color-blind racial attitude scale) and social network composition (e.g., information regarding network diversity). Descriptive analysis and linear regression models were conducted for the study. Social work students demonstrated moderately low levels of color-blind racial attitudes. Age was positively associated with unawareness of institutional and blatant racism. Identifying as politically liberal was associated with lower unawareness of racial privilege, institutional racism, and blatant racism. Having more social network members to talk to about topics related to race and ethnicity was associated with lower unawareness of blatant racism. Being familiar with a campus antidiscrimination protest was negatively associated with unawareness of racial privilege and blatant racism. Implications for social work educators are discussed.

The current study addresses certain limitations in prior analyses of teachers' perceptions of parents' involvement in education. In our analyses, we draw on teachers' responses to the School Community Survey (SCS) as well as information on school characteristics to address two limitations in prior studies. The SCS is a descriptive tool that describes the school community from the view-point of parents, students, teachers, and principals. Prior studies have relied on responses to the SCS collected from communities in a limited number of areas. In the current study we assess the generalizability of measures of teachers' perceptions developed within the SCS. Specifically, we assess the internal consistency of nine subscales as well as a complete index of teachers' perceptions developed in prior analyses. In addition, we explore the association between the demographic characteristics of teachers, institutional (i.e., school) characteristics, and teachers' perceptions. Our findings suggest that measures included in the SCS consistently gauge teachers' perceptions and that multiple measures can be combined to form summary measures of distinct elements of overall perceptions. In addition, our linear regression analyses using robust clustered standard errors suggests there are important variations in both the individual and institutional level correlates of elements of teacher perceptions.

Retention and graduation rates of an entire cohort of 1,913 first-time full-time college students are analyzed. The effects of participation in a first year experience (FYE) course and of entry level academic preparation (ELAP) on retention and graduation are examined, both descriptively and with discrete-time survival analyses. Although descriptive results support the efficacy of the FYE, survival analyses calls into question whether any unique variability beyond ELAP is attributable to FYE. Alternative hypotheses to explain the results and plans of new research for further exploration are presented.