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Stereophotogrammetry was used to investigate the functional relations between the articular surface geometry, contact patterns, and kinematics of the glenohumeral joint. Nine normal shoulder specimens were elevated in the scapular plane by using simulated muscle forces in neutral rotation (NR) and starting rotation (SR). Motion was quantified by analyzing the translations of the geometric centers of the humeral head cartilage and bone surfaces relative to the glenoid surface. In both NR and SR, the ranges of translations of the center of the humeral head cartilage surface were greatest in the inferior-superior direction (NR 2.0 +/- 0.7 mm, SR 2.9 +/- 1.2 mm). Results of this study also show that joints with less congruence of the articular surfaces exhibit larger translations, and elevation in SR yields greater translations than in NR. Kinematic analyses with the humeral head bone surface data yielded larger values of translation than analyses that used the cartilage surface data, suggesting that similar overestimations may occur in radiographic motion studies. Results of this study demonstrate that small translations of the humeral head center occurred in both SR and NR. The proximity of the origin of the helical axes to the geometric center of the humeral head articular surface confirmed that glenohumeral elevation is mainly rotation about this geometric center with small translations.

A series of 15 patients with concomitant rotator cuff tears and infraclavicular brachial plexus injuries treated between 1 980 and 1 989 were reviewed. There were 6 men and 9 women with a mean age of 65 years. Seventeen nerve injuries were identified, including 12 axillary nerves, 4 suprascapular nerves, and 1 musculocutaneous nerve. One patient had an injury to all three nerves. Thirteen patients underwent operative repair of the torn rotator cuff, and 2 patients who refused surgery were treated conservatively. The average time from injury to surgery was 7.7 months. Follow-up averaged 5.5 years (range: 2-10 years). Clinical results were graded according to pain, range of motion, and strength. Postoperatively, mean active forward elevation was 1 37° and mean active external rotation was 40°. Clinically, 8 patients achieved complete nerve recovery and 7 had an incomplete recovery. Satisfactory pain relief was achieved in 87% of patients with 60% having excellent or good function. Overall, the results of rotator cuff repair with concurrent nerve injury are less favorable than those of isolated cuff repairs. Careful preoperative assessment of concomitant nerve injury should be performed to better predict outcome.

The effect of long-term exercise on canine knees was studied to determine whether an increased level of lifelong weightbearing exercise causes degeneration, or changes that may lead to degeneration, of articular cartilage. Eleven dogs were exercised on a treadmill at 3 km/hr for 75 minutes 5 days a week for 527 weeks while carrying jackets weighing 130% of their body weight. Ten control dogs were allowed unrestricted activity in cages for the 550 weeks. At the completion of the study all knee joints were inspected for evidence of joint injury and degeneration. Articular cartilage sur faces from the medial tibial plateau were examined by light microscopy, the cartilage thickness was meas ured, and the intrinsic material properties were deter mined by mechanical testing. No joints had ligament or meniscal injuries, cartilage erosions, or osteophytes. Light microscopy did not demonstrate cartilage fibrilla tion or differences in safranin O staining of the tibial articular cartilages between the two groups. Further more, the tibial articular cartilage thickness and me chanical properties did not differ between the two groups. These results show that a lifetime of regular weightbearing exercise in dogs with normal joints did not cause alterations in the structure and mechanical properties of articular cartilage that might lead to joint degeneration.

Despite the strong and growing interest in biography, few psychologists engage in such studies themselves or feel competent to supervise them. Yet biography is a naturalistic form of empirical research and a rich source of ideas about the development of the individual across the life span. I offer a set of five suggestions for the conduct of biographical research and illustrate its use with examples drawn from archival and biographical interviewing studies. Three of the five suggestions concern the selection, presentation, and interpretation of data, areas where the psychologist's concern about investigator bias and reliability of interpretation has been greatest.

The purpose of this study was to determine the position of the normal patella during routine magnetice resonance imaging (MRI). The literature indicates that the normal patella is positioned laterally relative to the trochlea when the knee is fully extended. As such, a laterally positioned patella on MRI is often interpreted as normal. Yet, in our experience, patients with a normal extensor mechanism show a patella that is centered over the trochlea on MRI, and we set out to formally study this. The MRIs of 60 patients without knee extensor pathology were analyzed. In 59 patients, the patella was centered over the underlying femur. The discrepancy between these results and those in the literature can probably be accounted for by the following: (1) Knees in general are somewhat flexed during MRI, and (2) relative to patients in other studies, patients in this study were subject to stricter criteria of normality. The results of this study strongly suggest that the normal patella is centered over the underlying trochlea during routine MRI. A laterally positioned patella, although possibly common, should not be automatically dismissed as a (medically) normal finding.

In this paper we, first, briefly review existing efforts to integrate adult development theory into psychodynamic psychotherapy. Next, we examine the concept of life structure and discuss its evolution across the eras and periods of the adult years. We explore the added concepts of the core self, the vital life structure, and life structure management skills. In so doing, we provide a context for proposing a new definition of the primary task of treatment: to help patients develop life structures that ensure a good fit between internal aspects of the self and the roles, relationships, and activities that comprise their lives. The creation of a life structure that is as fully expressive of the core self as reality permits increases patients' sense of vitality and well-being.

Between 1986 and 1989, 190 patients (214 hips) with the diagnosis of osteoarthritis or posttraumatic arthritis underwent cemented Charnley total hip replacement surgeries via the biplane or single plane transtrochanteric approach. The technique of surgery was identical in every aspect except for the technique of the trochanteric osteotomy and reattachment. The results indicate that there was no significant difference in union rates between the 2 groups. Six (6.4%) patients in the biplane group and 7 (6.2%) patients in the single plane group had obvious evidence of nonunion at the 1-year evaluation. This study suggests no significant difference in union rate between a group of patients with biplane osteotomy and a closely paired group of patients with single plane osteotomy. Other equally important factors also may influence the rate of union of the trochanter in total hip arthroplasty.

I offer some reminiscences occasioned by the death of Daniel Levinson, a modern pioneer in the study of the human life cycle. I clarify three controversial aspects of Levinson's theory—its universality, the role of critical life events, and the place of relationships—as well as briefly foreshadow findings from his forthcoming book on women. I show that relationships to people, enterprises, and social institutions are the stuff out of which the individual life structure—Levinson's central concept—is formed. Levinson's dream was of a society in which the developmental needs of adults were better understood and met so that they could more generatively fill their roles in the institutions upon which the young depend. He thought this essential to the evolution of a society that would be both more competent and more humane. In this dream, which was a product of his own difficult mid-life transition and a measure of the success he achieved in integrating its polarities, Levinson united a warm, scientific interest in others with an affectionate curiosity about nature.

We present findings from a videotape study of naturally occurring scapegoating incidents in a Tavistock Group Relations Training Conference. Videotape recordings of three successive sessions from each of four study groups revealed nine scapegoating incidents. We offer an empirical description of the incidents together with a sociopsychological theoretical analysis. Aspects of the tasks, social structure, and culture of the group-relations training conference as a temporary organization led to a reliance upon the projective identification of work difficulties into individuals who were then scapegoated. We identify the phenomenon of task displacement in which groups whose task performance is inherently hard to measure unwittingly shift their emphasis from achievement to conformity. This may be a general phenomenon in HEW-type organizations of which the group-relations training conference is one.

A life-span developmental theory of the evolution of the individual life structure through age-linked eras and periods2 is applied to the lives of faculty members. Two fictional cases of professors who do not wish to do academic work of any kind- one at the beginning of his career, the other near the end-are analyzed. It is argued that the meaning of the professor's work-his or her teaching, research, administration, and relations with students, younger faculty, peers, and superordinates- is a function of the developmental period the faculty member is in, as well as of the cumulative effects of previous -developmental success and failure in adulthood. To understand the demise of the motivation to work requires us to understand the professor's original career dream, his or her experiences, or lack of them, with mentors, as well as the current developmental tasks with which the professor struggles.

(1971). Abstinence as a Role Requirement in Psychotherapy. Psychiatry: Vol. 34, No. 4, pp. 391-400.

The attempt to reduce discrimination against women in work settings has received new strength from the re-emergent feminist movement. Women are now more often being considered for positions of genuine organizational authority. We present and analyze a case example-a woman manager and her staff within a mental health center-that illustrates some basic problems arising from such social change. Our approach to the exercise of authority is sociopsychological: We seek to interrelate organizational structure, leadership style, and staff group dynamics.