Disparity Of Opinion Research Articles

Assessing Medical Ethics Knowledge and Practice Among Healthcare Professionals in Al Majma'ah, Saudi Arabia.

Background The healthcare system is increasingly confronted with ethical challenges, necessitating a thorough exploration of healthcare providers' ethical knowledge and attitudes. This study aims to evaluate the ethical awareness and attitudes of healthcare providers in the Al Majma'ah region of the Kingdom of Saudi Arabia (KSA). Aim This research focuses on assessing the level of knowledge and practice regarding medical ethics among healthcare providers in a community hospital in Majmaah, KSA. Methods A comprehensive cross-sectional study was undertaken in the Majmaah governorate of Saudi Arabia. Data collection involved distributing a meticulously designed questionnaire to healthcare providers and faculty members affiliated with the College of Medicine. Subsequently, the acquired dataset underwent analysis utilizing SPSS software. Results A total of 183 participants were included in the study. The findings revealed that only 77 respondents (42.1%) considered ethical issues in their profession as extremely important. Moreover, 104 participants (56.8%) were aware of the existence of an ethics committee in their institution. A total of 113 respondents (61.7%) disagreed with the notion that ethical conduct is primarily important to avoid legal consequences, and 120 participants (65.6%) believed in the significance of in-service training on medical ethics for doctors. The study also highlighted that 100 participants (54.6%) believed that healthcare providers' opinions supersede patient preferences. However, a majority, 163 participants (89.1%), agreed that patients should be informed of any wrongdoing, contrasting with only 20 (10.9%) who disagreed. When asked about adhering to patients' wishes despite doctors' opinions, 112 (61.2%) responded affirmatively, while 71 (38.3%) disagreed. There was also a disparity in opinions regarding the necessity of obtaining consent, with 81 (44.3%) agreeing that consent is required not only for surgical procedures but also for medications or investigations. Furthermore, 137 participants (74.9%) recognized the importance of discussing ethical, social, and legal issues during clinical rounds alongside clinical aspects of patient care, while 46 (25.1%) disagreed. Conclusion Although medical ethics were introduced into the Saudi healthcare system more than a decade ago, this study underscores the ethical necessity of obtaining comprehensive informed consent prior to invasive and other medical procedures. It also highlights the significance of engaging patients in the decision-making process regarding their treatment. Well-informed patients typically exhibit higher satisfaction levels and are less inclined to pursue legal action.

Survey of antimicrobial and probiotic use practices in wildlife rehabilitation in the United States.

Antimicrobial resistance is a global health concern. As such, there have been increased efforts to monitor and standardize antimicrobial prescribing practices in humans and domestic animals. In contrast, there is relatively little known about specific prescribing practices in wild animals despite the wide use of antimicrobials and other microbial interventions, such as probiotics to treat captive wildlife. Therefore, the goal of this study was to examine current antimicrobial and probiotic use from a cross-section of wildlife rehabilitation facilities in the United States. An anonymous electronic survey was sent to 105 United States permitted wildlife facilities to collect information about admissions, current antimicrobial and probiotic use practices, and current staff knowledge and attitudes surrounding antimicrobial resistance and probiotic effectiveness. Respondents from over 50% of facilities participated in the survey (54/105), including 45 facilities that treated birds. All facilities reported using antimicrobials, including some from groups considered critically important for human medicine, for a wide range of medical conditions and prophylaxis. Among antibiotics, enrofloxacin and amoxicillin-clavulanic acid were the most commonly used. Antifungals were not as widespread, but itraconazole was the most commonly used. Over 75% of respondents said that their facilities would benefit from having standardized antimicrobial guidelines in place. Probiotics were also used in more than 50% of facilities, but there was notable disparity in opinions regarding their efficacy. The results of this survey are a first step towards understanding antimicrobial and probiotic use practices in the treatment of captive wildlife and developing an antimicrobial stewardship program for wildlife rehabilitation.

Asymptomatic Hyperuricemia as an Independent Risk Factor for Myocardial Infarction in Adult Population: A Four-Year Follow-Up Study.

Introduction A condition in which uric acid levels are elevated but there are no accompanying symptoms is known as asymptomatic hyperuricemia. As a result of the disparity in opinions and findings between the studies, the guidelines regarding whether or not asymptomatic hyperuricemia should be treated are unclear. Material and methods Between the months of January 2017 and June 2022, this research was carried out in the community in collaboration with the internal medicine unit and the public health unit of Liaquat University of Medical and Health Sciences. After obtaining informed consent from each participant, the researchers enrolled 1,500 patients in the study who had uric acid levels that were greater than 7.0 mg/dL. These patients ranged in age from 40 to 70 years old and were of either gender. As a control group, 1,500 patients were recruited who did not have abnormally high levels of uric acid. Patients were monitored for a total of 48 months or until the occurrence of a major cardiovascular event (MACCE) or death from all causes, whichever occurred first. Death, cardiovascular mortality, non-fatal myocardial infarction, and non-fatal stroke were the four categories that made up the primary outcome, also known as MACCEs. Results In the hyperuricemic group, the incidence of myocardial infarction that did not result in death was significantly higher than in the non-hyperuricemic group (1.6% vs. 0.7%; p-value, 0.04). However, the result was not significant for deaths from all causes, deaths from cardiovascular disease, or strokes that did not result in death. Conclusion Asymptomatic hyperuricemia is a potential threat to one's health that can lead to cardiovascular diseases and may go undiagnosed in some cases. It is important to remember that hyperuricemia can lead to delirious complications, so efforts should be made to perform routine monitoring and management of the condition.

Assessing the Acceptability of Home Blood Monitoring for Patients With Cancer Who Are Receiving Systemic Anticancer Therapy From a Patient, Caregiver, and Clinician Perspective: Focus Group and Interview Study.

Regular blood testing is an integral part of systemic anticancer therapy delivery. Blood tests are required before every administration of treatment to ensure that a patient is sufficiently well to receive it. Blood testing is burdensome for patients as they require either an extra visit within 48 hours of planned administration of treatment or a significantly long visit if performed on the day of treatment. The additional time for appointments can have a significant impact on the quality of life of someone who is living with cancer. In the United Kingdom, the COVID-19 pandemic created unprecedented disruption to the delivery of cancer care. Face-to-face hospital visits were reduced, resulting in the need to develop more innovative ways of working to minimize treatment interruptions. This led to significant uptake of digital technologies, with new models of care rapidly deployed across the UK health service to meet these challenges. This study aimed to explore the acceptability of a point-of-care home blood monitoring device for people with cancer who are receiving systemic anticancer therapy, which is being developed in response to the increased need for remote care for patients with cancer. Qualitative focus groups and semistructured interviews were conducted with patients (23/47, 49%), caregivers (6/47, 13%), and health care professionals (18/47, 38%) over a 19-month time frame from May 2019 to December 2020. Data were analyzed using framework analysis guided by the Unified Theory of Acceptance and Use of Technology model. Analysis identified 4 overarching themes: performance expectancy, effort expectancy, social influence, and facilitating conditions. This study found that patients with cancer, their caregivers, and health care professionals had positive perceptions about home blood monitoring. Although they are often considered synonymously, self-testing and self-management are not mutually exclusive, and this study illustrated some disparity in opinions regarding patient self-management. Home blood monitoring has the potential to provide patients with cancer with a convenient option for blood monitoring. It would minimize hospital attendances, decrease late treatment deferrals, and provide prompt recognition of cancer treatment toxicities, thus enhancing the existing nurse-led protocols and clinical pathways. Home blood monitoring would create a long-term sustainable transformation for the delivery of cancer care, using digital health to act as a facilitator to address a pertinent issue regarding improving the efficiency of hospital resources and increasing the delivery of personalized patient care. Further studies are needed to determine how and where home blood monitoring would fit within clinical pathways, in a way that is robust and equitable.

Perceptions of US Medical Students on Artificial Intelligence in Medicine: Mixed Methods Survey Study.

Given the rapidity with which artificial intelligence is gaining momentum in clinical medicine, current physician leaders have called for more incorporation of artificial intelligence topics into undergraduate medical education. This is to prepare future physicians to better work together with artificial intelligence technology. However, the first step in curriculum development is to survey the needs of end users. There has not been a study to determine which media and which topics are most preferred by US medical students to learn about the topic of artificial intelligence in medicine. We aimed to survey US medical students on the need to incorporate artificial intelligence in undergraduate medical education and their preferred means to do so to assist with future education initiatives. A mixed methods survey comprising both specific questions and a write-in response section was sent through Qualtrics to US medical students in May 2021. Likert scale questions were used to first assess various perceptions of artificial intelligence in medicine. Specific questions were posed regarding learning format and topics in artificial intelligence. We surveyed 390 US medical students with an average age of 26 (SD 3) years from 17 different medical programs (the estimated response rate was 3.5%). A majority (355/388, 91.5%) of respondents agreed that training in artificial intelligence concepts during medical school would be useful for their future. While 79.4% (308/388) were excited to use artificial intelligence technologies, 91.2% (353/387) either reported that their medical schools did not offer resources or were unsure if they did so. Short lectures (264/378, 69.8%), formal electives (180/378, 47.6%), and Q and A panels (167/378, 44.2%) were identified as preferred formats, while fundamental concepts of artificial intelligence (247/379, 65.2%), when to use artificial intelligence in medicine (227/379, 59.9%), and pros and cons of using artificial intelligence (224/379, 59.1%) were the most preferred topics for enhancing their training. The results of this study indicate that current US medical students recognize the importance of artificial intelligence in medicine and acknowledge that current formal education and resources to study artificial intelligence-related topics are limited in most US medical schools. Respondents also indicated that a hybrid formal/flexible format would be most appropriate for incorporating artificial intelligence as a topic in US medical schools. Based on these data, we conclude that there is a definitive knowledge gap in artificial intelligence education within current medical education in the US. Further, the results suggest there is a disparity in opinions on the specific format and topics to be introduced.

The Dangerous Discourse of “Us” vs. “Them:” Spain's VOX Discursive Practices

Abstract Since the entry of the far-right party VOX into the Spanish government administrations in 2018, Spain's political scene has gone through a deep transformation. The disparity in opinions among the different parties concerning migration seems to tear the country's democratic foundation apart. This paper is a study of the language and discursive strategies used by VOX's leader, Santiago Abascal, articulating the party's populist propaganda for a united country to “make Spain great again.” The analysis was grounded on the theoretical underpinnings of Wodak's (2001) discursive strategies and Van Dijk's (1993) “Us” vs. “Them” framework. The data were based on Abascal's closing political campaign speech during the Madridlenian elections, which was televised in May 2021. The 30-minute video recording was transcribed, annotated, coded, and analyzed. The findings suggest a pattern of discursive practices aimed at diminishing other political parties and their representatives, vilify immigrants, and impugn government measures that were against VOX's authoritarian conservatism and nationalism. There was a predominant use of predication strategies to positively present VOX while denigrating its political rivals. Referential/nomination strategies were also used to divide the society between in-groups and out-groups. Strongly embedded in these strategies were perlocutionary acts used to incite hate toward the out-groups and evoke fear and anxiety toward the in-group, strategically employed as tools to gain votes in the elections.

Saving Sexuality From Stigma: A Perception Study On LGBT Bullying In Korean International Schools

Teens who identify as lesbian, gay, bisexual, or transgender (LGBT) often experience bullying and are at increased risk of suffering from mental health issues. Research, especially in the West, has shown that such bullying can decline if schools actively implement programs that raise awareness and educate students to promote a safer and more tolerant environment. However, in South Korea, schools currently either lack such programs or have ineffective programs. On the other hand, International Schools in Korea (ISK), which enroll more diverse students and teach western curricula, seem more liberal about LGBT issues, and tolerant towards such individuals. However, the fact that many ISK are affiliated with Christianity, and that Christian tenets are not entirely amicable towards LGBT individuals, raises an intriguing question: Despite Christian beliefs about LGBT individuals and the conservative attitude of Korea, have ISK actually created a culture that reflect the schools’ stated policies of tolerance and inclusivity, or is there a disparity of opinions between LGBT students and staff that needs to be addressed? In order to find an answer, I conducted anonymous surveys and interviews with both students and staff from six different ISK. The results show that the opinions of the LGBT students differ in both experience and perception from those of the staff and non-LGBT students, but are similar to those of non–LGBT students. Ultimately, by analyzing data from my study, I determined perceptions on LGBT in ISK and proposed necessary plans of action to increase support of LGBT in these communities.

Религиозный прозелитизм как ресурс государственной политики: прошлый и актуальный опыт россии и сша

This article seeks to understand the use of religious proselytizing in the Statecraft of the United States and Russia. The different perspectives on this activity is first assessed historically. The experiences that both countries had (or did not have, in the case of the US), provide insights into the disparity of opinion and practice between the two countries today. This historical view reveals how politically important and influential such activity was for Russia. Good relations with religious leaders and their religious movements helped to ensure stability in far flung regions of its territory, and active attempts to convert other people, i.e. proselytizing, was seen as politically aggressive and socially disruptive. The second part of this article looks at the contemporary implications of statecraft and proselytization. One sees a continuity between the imperial, Soviet and contemporary periods regarding proselytism, despite the political diversity of the periods. Domestically, Russia has clamped down on religious organizations with ties to the US and whose practices included active proselytizing. In this way, one can see how it believes religion, and proselytizing in particular, can be politicized or weaponized and used in foreign policy. Beyond its borders, Russia has employed the Russian Orthodox Church (ROC) in proselytizing or quasi-proselytizing activities to help carry out its political agendas. For the US, religious conversions were traditionally never part of the national or political discourse, and so there is still a tendency to view such activity as innocuous, individual experiences. Meanwhile, Russia continues its crackdown on religions which promote an aggressive proselytizing agenda, and especially US-based ones, such as the Jehovah’s Witnesses, whose members are often treated as enemies of the state.

Current practice and registration patterns among United Kingdom Haemophilia Centre Doctors’ Organisation centers for patients with unclassified bleeding disorders

BackgroundBleeding of unknown cause (BUC) and unclassified bleeding disorders (UBD) are increasingly recognized. There is no guidance on diagnosis and management. ObjectivesTo examine UK haemophilia centre registration patterns and current practice for UBD patients. MethodsIn a two‐step process, the UK National Haemophilia Database (NHD) was reviewed for registration patterns of UBD patients and a survey of UK haemophilia centers was conducted (January/February 2021) to capture current practice for diagnosis and management of patients with UBD. Results/discussionOverall, registrations with the NHD for UBD patients has sharply risen from 2012 to 2020 and in 2019 accounted for 2.65% of registered patients. For the survey, the response rate was 52/67 (78%). Practice was widely variable; 35/52 (67%) centers register UBD; among these 35 centers, terminology included UBD (28 centers), undiagnosed bleeding disorder (four centers), and BUC (three centers); 34/52 (65%) centers use a formal bleeding assessment tool. For management of dental extraction and high bleeding risk surgery in a fictional UBD patient we found that tranexamic acid was widely used; however, beyond this a variety of hemostatic products were advised including blood products, recombinant factor VIIa/prothrombin complex concentrate, and desmopressin. There was general consensus (≈90%) on avoiding regional anesthesia in pregnancy, but no agreement on the need for fetal precautions to avoid bleeding at delivery (50% would advise these). There was a disparity of opinion on chemical thromboprophylaxis, and management of patients without prior hemostatic challenges and offspring of these patients. ConclusionThis study provides a snapshot of current practice and real‐world data in this area. Future studies need to address the gaps in evidence.

Humanitarian resistance in the context of digitalisation of education

Introduction.In the context of a pandemic, significant transformations in education have occurred: the urgent shift to new forms of learning and digitalisation of the learning process have become a challenge to the traditional understanding of education as a public good, based on humanistic grounds. In the media and social networks, there was a public debate over the prospects of the education for several months. The disparity in opinions and not always accurate determination of the positions of the authors of numerous publications highlight the need for analysing the situation in modern education from the standpoint of axiology and cultural studies.Aim.The present publication isaimedto consider the current changes in education in the conditions of digitalisation and to identify the potential of humanistic pedagogy.Methodology and research methods.The study is based on an interdisciplinary methodology, which integrates the achievements of the humanities and social sciences. The method of cluster analysis, content analysis in the mass media and social media, supplemented by group identification analysis, were employed.Research results.According to the findings of the present study, it was concluded that the contemporary processes in Russian education can be described from the point of view of trauma theory. The author introduces the concept of “humanitarian resistance”, which is referred to the forms of symbolic protest, based on the values of humanism, national and cultural traditions, and non-violence. Furthermore, the author proposes a primary classification of the forms of humanitarian resistance in Russian education, including worldview, axiological, socio-psychological and pedagogical aspects. In the current article, the essence of each aspect is disclosed on specific examples.Scientific noveltyof the conducted research lies in the theoretical justification of the analysis of current educational practices from a philosophical and cultural point of view. The introduction of new categories into scientific circulation allows for an adequate description of the current processes in education. The article is debatable, involving the discussion on the problems of education as a public good and the teacher as a bearer of the humanistic tradition in terms of digitalisation.Practical significanceof the research consists in the possibility of using its results to determine the prospects of educational policy in the digital society, as well as to develop the strategies and to select teacher training routes in new conditions.

Vestidos-objeto de Olly Reinheimer: a veiculação na mídia impressa sobre a exposição realizada no MAM-RJ em 1969

Este artigo visa analisar e comparar as distintas críticas artísticas e veiculações sobre a exposição Vestidos-objeto ocorrida no MAM-RJ, em 1969, e a disparidade das opi-niões na leitura do evento. A mostra de Olly Reinheimer produz uma contradição entre os espectadores, críticos de arte e jornalistas, que irão publicar conteúdos diferenciados para cada segmento de público (artes, feminino ou entretenimento) na mídia impressa da época. A análise dos discursos e imagens publicados é realizada nos periódicos O Dia (RJ), Correio da Manhã (RJ), Jornal do Brasil (RJ), Última Hora (RJ) e Jornal do Commercio (RJ), a partir do embasamento teórico-artístico de Argan (1994; 2005; 2006) e também dos pressupostos teóricos sobre cultura visual e material de Ulpiano Toledo Bezerra de Meneses (2003).

La perspectiva de los tutores académicos de Prácticum en Educación Primaria

El prácticum es una oportunidad de aprendizaje, no solo para estudiantes, sino también para tutores/as académicos y tutores/as externos. En este estudio se muestran las percepciones de cuatro tutores/as académicos del Grado en Educación Primaria de la Universidad de Vigo sobre la formación previa de los estudiantes, la metodología de trabajo empleada, el contacto con las instituciones escolares y los apoyos y obstáculos que se encuentran en la tutorización. Los resultados ponen de manifiesto la disparidad en las opiniones sobre la formación previa, una metodología de trabajo reflexiva, las diferencias en el contacto con los centros, la implicación de los estudiantes como apoyo a la tutorización y la falta de ciertas habilidades reflexivas y críticas en los estudiantes como barrera a la tutorización. Asimismo, las tecnologías juegan un papel imprescindible en el proceso. Las conclusiones extraídas concuerdan con el estado del arte de la cuestión.

Nerve Sparing Radical Hysterectomy: Short-Term Oncologic, Surgical, and Functional Outcomes.

There is an obvious prevalence of disparity in opinions concerning the technique of nerve-sparing radical hysterectomy and its application, despite agreement on the need to spare the pelvic autonomic nerve system during such a radical operation. Understanding the precise three-dimensional anatomy of paracolpium and its close anatomical relationship to the components of the pelvic autonomic nervous system is the key in performing the nerve-sparing radical hysterectomy. A total of 42 consecutive patients with primary cervical cancers, who were operated upon in our institution between January 2017 and June 2019, were analyzed, concerning surgical, urinary functional, and short-term oncologic outcomes. Two thirds of the patients had locally advanced tumors (T > 40 mm or pT ≥ IIA2) with a median tumor size of 44.1 mm. The nerve-sparing radical hysterectomy was combined with the complete recovery of bladder function in 90% of patients directly after surgery and in 97% of patients in the first 2 weeks. The recurrence rate in a median follow-up time of 18 months was 9.5%. The nerve-sparing radical hysterectomy approach, which depends on the comprehensive understanding of the precise entire anatomy of paracolpium, was found to be feasible and applicable, even in locally advanced tumors, with good functional results and convincing short-term oncologic outcomes.

Intergeneric Hybridization of a Vagrant Common Black Hawk and a Red-Shouldered Hawk

Natural intergeneric hybridization occurs rarely in raptors. In 2012, L. Hug observed a juvenile hawk interacting with a banded adult Common Black Hawk (Buteogallus anthracinus) in Sonoma County, California, USA, and reported that the juvenile was a Common Black Hawk × Red-shouldered Hawk (Buteo lineatus) hybrid (Hug 2016; Western Birds 47:325–326). A disparity of opinions concerning the parentage of the juvenile prompted us to document the nesting efforts of this Common Black Hawk in 2013 and 2014. The 2013 nesting attempt failed during incubation before the identity of the mate could be confirmed. In 2014 the adult female Common Black Hawk bred with an adult male Red-shouldered Hawk (B. l. elegans), and this pair fledged one hybrid offspring. Evidence of this hybridization included observations of the pair engaged in courtship flights (n = 3), copulations (n = 2), and simultaneous nest attendance (n = 2), and the offspring's intermediate physical characters and vocalizations. Although the hybrid offspring's juvenile plumage more closely resembled a juvenile Common Black Hawk overall, the hybrid also exhibited some intermediate plumage, morphological, and vocal characteristics. This hybridization event appears to be an example of the desperation hypothesis, in which a rare vagrant, unable to secure a conspecific mate, settled on a species of raptor abundant in western California. Dietary overlap of the two parental species (e.g., crayfish, amphibians) and strong associations with aquatic habitats may also have facilitated this pairing and hybridization event.

Document Length Variation in the Vector Space Clustering of News in Arabic: A Comparison of Methods

This article is concerned with addressing the effect of document length variation on measuring the semantic similarity in the text clustering of news in Arabic. Despite the development of different approaches for addressing the issue, there is no one strong conclusion recommending one approach. Furthermore, many of these have not been tested for the clustering of news in Arabic. The problem is that different length normalization methods can yield different analyses of the same data set, and that there is no obvious way of selecting the best one. The choice of an inappropriate method, however, has negative impacts on the accuracy and thus the reliability of clustering performance. Given the lack of agreement and disparity of opinions, we set out to comprehensively evaluate the existing normalization techniques to prove empirically which one is the best for the normalization of text length to improve the text clustering performance of news in Arabic. For this purpose, a corpus of 693 stories representing different categories and of different lengths is designed. Data is analyzed using different document length normalization methods along with vector space clustering (VSC), and then the analysis on which the clustering structure agrees most closely with the bibliographic information of the news stories is selected. The analysis of the data indicates that the clustering structure based on the byte length normalization method is the most accurate one. One main problem, however, with this method is that the lexical variables within the data set are not ranked which makes it difficult for retaining only the most distinctive lexical features for generating clustering structures based on semantic similarity. As thus, the study proposes the integration of TF-IDF for ranking the words within all the documents so that only those with the highest TF-IDF values are retained. It can be finally concluded that the proposed model proved effective in improving the function of the byte normalization method and thus on the performance and reliability of news clustering in Arabic. The findings of the study can also be extended to IR applications in Arabic. The proposed model can be usefully used in supporting the performance of the retrieval systems of Arabic in finding the most relevant documents for a given query based on semantic similarity, not document length.

Muddied Waters: Perceptions and Attitudes towards Mangroves and Their Removal in New Zealand

Seaward expansion of New Zealand’s mangrove Avicennia marina (subsp.) australasica in estuaries has led to disparity in opinion over their social-ecological value. This study investigated existing stakeholders and interested parties’ perceptions and attitudes towards mangroves, focusing on four sites in Auckland. A mixed methods design was used consisting of semi-structured interviews, ratings of importance of mangrove ecosystem services and issues and Q-sorts on mangrove social-ecological statements. 29 participants were interviewed in person. Results revealed a disparity in perceptions and attitudes towards mangroves. Community Groups displayed strongly negative opinions towards mangrove preservation and Conservation Organisations expressed a strongly positive stance. The occupation of participants was a significant factor in the ratings. Overall, sediment and nutrient retention were rated as the most important ecosystem services. The desire for reversion of estuaries to a “pre-mangrove” state is the greatest issue affecting mangroves. Q-analysis revealed loading of participants onto two factors representing (1) a pro-preservation attitude towards mangrove and (2) a neutral view. Managing sediment loads and nutrient run-off in the wider catchment were highlighted as ways to reduce mangrove expansion. Improving water quality and the health of the harbour was of utmost priority to kaitiaki (Māori guardians of the environment). This study provides critical insights into the management of mangroves as social-ecological systems.

Current Trends in Management of Nonsyndromic Unilateral Coronal Craniosynostosis: A Cross-sectional Survey.

Background:Although the natural history of nonsyndromic unilateral coronal craniosynostosis has been extensively described, optimal management remains controversial due to lack of Level 1 evidence. This study aims to assess the current state of practice among craniofacial surgeons.Methods:Ninety-four craniofacial surgeons were approached to complete a survey consisting of 15 questions. Data were collected assessing surgeons’ primary surgical indication, timing of intervention, preoperative imaging, and choice of technique for patients presenting with nonsyndromic unilateral coronal craniosynostosis. Choice of technique and timing of intervention in case of recurrence were also investigated.Results:After 5 mailings, the response rate was 61%. The combination of both appearance and raised intracranial pressure was the primary indication for treatment for 73.2% of surgeons. Preoperative CT scan of the skull was “always” performed by 70.1% of respondents. Open surgical management was most commonly performed at 8–10 months of age (38.6%). Bilateral frontal craniectomy with remodeling of the supraorbital bandeau and frontal bone was the most common choice of procedure (84.2%). In case of mild to moderate and moderate to severe recurrences at 1 year of age, 89.5% and 47.4% of surgeons opted for conservative management, respectively. Optimal timing for repeat cranioplasty was after 4 years of age (65.5%). Overall, 43.4% quoted lack of evidence as the greatest obstacle to clinical decision-making when dealing with unilateral synostosis.Conclusion:This survey exposes the lack of consensus and the disparity of opinion among craniofacial surgeons regarding the management of nonsyndromic coronal synostosis, particularly in the setting of recurrence.

Disparity in opinions on lip protrusiveness in contemporary African American faces.

ObjectiveIn accordance with the changing demographics in the United States, orthodontists working on various ethnic populations should be more conscious when using the standardized profile analyses for the African American patient. The objective of this study was to examine whether the perception of lip protrusiveness in modern African American faces has changed. For this purpose, we investigated the most favorable African American lip profile using the opinions of 10 experienced and 10 newly trained younger orthodontists.MethodsAttractiveness was converted to a number on visualized analog scales. Comparative ranks on 16 African American profiles, with focus on lip protrusiveness and thickness, were made among the groups. Mixed-effects linear regression models were fit and group differences were estimated.ResultsYounger orthodontists favored a more protrusive lip profile, and the variance in their perceptions was narrower than those of older orthodontists. Measurements related to upper lip protrusion showed the strongest correlation to attractiveness (r = −0.82). The association with attractiveness decreased linearly as the protrusiveness of the upper lip increased. Steiner's E-line was the most influential reference for determining the level of attractiveness for the older orthodontists, whereas upper lip protrusion was the most influential factor for the young orthodontists.ConclusionsAn adequate level of lip protrusiveness and thickness should be essential for maintaining attractive esthetics in African American patients. Yet, a new set of standards for prominent lips in this population is necessary to reflect the current trend in the concept of a beautiful face in the modern world.

Examining the temporo-mandibular joint from a biotensegrity perspective: A change in thinking

The temporo-mandibular joint is a characteristic feature of mammalian development, and essential to mastication and speech, yet it causes more problems than any other joint in the body and remains the least understood. While it is generally accepted that the normal joint is loaded under compression, the problems and controversies surrounding this view remain unresolved and the disparity in opinion over its treatment continues. Although difficulties in the acquisition of reliable information have undoubtedly contributed to this situation, it is now considered that deficits in neural control and shortcomings in the underlying biomechanical theory and analysis have also played a part, and that a re-assessment from a different perspective could resolve these.Biotensegrity considers the TMJ from this position, where the mandible is suspended within a tensioned network that extends over a much wider anatomical field than is generally recognized and significant motion control is contained within the structure itself. It is an evolutionary-conserved arrangement that enables the system to rapidly respond to changing functional demands and provides a more complete model of joint physiology that can be used to guide further research.

Fewer specialists support using medical marijuana and CBD in treating epilepsy patients compared with other medical professionals and patients: result of Epilepsia's survey.

From May 20 to September 1 2014, Epilepsia conducted an online survey seeking opinions about the use of medical marijuana and cannabidiol (CBD) for people with epilepsy. This study reports the findings of that poll. The survey consisted of eight questions. Four questions asked if there were sufficient safety and efficacy data, whether responders would advise trying medical marijuana in cases of severe refractory epilepsy, and if pharmacologic grade compounds containing CBD should be available. Four questions addressed occupation, geographic region of residence, if responders had read the paper, and if they were International League Against Epilepsy/International Bureau for Epilepsy (ILAE/IBE) members. Of 776 who started or completed the survey, 58% were patients from North America, and 22% were epileptologists and general neurologists from Europe and North America. A minority of epileptologists and general neurologists said that there were sufficient safety (34%) and efficacy (28%) data, and 48% would advise using medical marijuana in severe cases of epilepsy. By comparison, nearly all patients and the public said there were sufficient safety (96%) and efficacy (95%) data, and 98% would recommend medical marijuana in cases of severe epilepsy. General physicians, basic researchers, nurses, and allied health professions sided more with patients, saying that there were sufficient safety (70%) and efficacy (71%) data, and 83% would advise using marijuana in severe cases. A majority (78%) said there should be pharmacologic grade compounds containing CBD, and there were no differences between specialists, general medical personal, and patients and the public. This survey indicates that there is a wide disparity in opinion on the use of medical marijuana and CBD in the treatment of people with epilepsy, which varied substantially, with fewer medical specialists supporting its use compared with general medical personal, and patients and the public.