Carcinomas in the Bay of Plenty: incomplete excision rates.
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Basal Cell Carcinoma↗
Biomedical subjects
Paul Salmon
Publications and source records attributed to Paul Salmon.
Alar anaesthesia: A kinder method.
SUMMARY Local infiltration of anaesthetic in the ala of the nose is very uncomfortable for most patients. This is an area frequently operated on by dermatosurgeons under local anaesthesia as it is a common site for non-melanoma cutaneous malignancies. A simple method is described of providing more pleasant local anaesthesia for patients undergoing alar surgery by using nerve blocks prior to local infiltration.
Anesthesia, Local↗
Childhood trauma and diurnal cortisol disruption in fibromyalgia syndrome.
Adults with fibromyalgia syndrome report high rates of childhood trauma. Neuroendocrine abnormalities have also been noted in this population. Exploratory analyses tested relationships between retrospective reports of childhood trauma and diurnal salivary cortisol patterns among 85 women with fibromyalgia. Subjects with fibromyalgia completed self-reports of childhood physical, sexual and emotional abuse, as well as emotional and physical neglect. Recent major life events, current perceptions of stress, and depressive symptoms were also assessed. Salivary cortisol was collected six times per day for two consecutive days to assess diurnal rhythm, awakening response and mean cortisol levels. Hierarchical regression analyses were performed, controlling for age, relevant medications, life events, perceived stress, and depressive symptoms. Childhood physical abuse predicted flattened diurnal cortisol rhythms as well as greater cortisol responses to awakening. Sexual abuse was a second predictor of increased awakening cortisol responses. Patients with a history of trauma had markedly low levels of cortisol at the time of first awakening, partly explaining the results. These findings suggest that severe traumatic experiences in childhood may be a factor of adult neuroendocrine dysregulation among fibromyalgia sufferers. Trauma history should be evaluated and psychosocial intervention may be indicated as a component of treatment for fibromyalgia.
Adaptation, Psychological↗
Situation awareness measurement: a review of applicability for C4i environments.
The construct of situation awareness (SA) has become a core theme within the human factors (HF) research community. Consequently, there have been numerous attempts to develop reliable and valid measures of SA but there is a lack of techniques developed specifically for the assessment of SA in command, control, communication, computers and intelligence (C4i) environments. During the design, development and evaluation of novel systems, technology and procedures, valid and reliable situation awareness measurement techniques are required for the assessment of individual and team SA, in order to determine the improvements (or in some cases decrements) resulting from proposed design and technological interventions. The paper presents a review of existing situation awareness measurement techniques for their suitability for use in the assessment of SA in C4i environments. Seventeen SA measures were evaluated against a set of HF methods criteria. It was concluded that current SA measurement techniques are inadequate by themselves for use in the assessment of SA in C4i environments, and a multiple-measure approach utilising different approaches is recommended.
Awareness↗
Nasalis flap and graft repair provides reliable closure for denuded defects of the nose.
BACKGROUND: Skin cancer surgery involving the nasal tip and dorsum sometimes results in exposure of underlying bone or cartilage. We describe a simple method of providing a vascular bed for the defect using the superficial nasalis musculoaponeurotic system (SNAS) of the nose, which allows full-thickness skin graft reconstruction of the defect and an acceptable cosmetic outcome. OBJECTIVE: The utility of nasalis flaps to provide a vascular bed for grafting has not been specifically addressed in the dermatology literature. Our experience with 26 SNAS flaps is outlined to demonstrate the utility of this closure in the appropriate situations. METHODS: A discussion of the relevant anatomy is followed by an outline of the surgical technique. RESULTS: SNAS flaps provide a reliable vascular bed and contour for defects of the bridge and distal nose. Complications have been few. CONCLUSIONS: The SNAS flap and graft are simple to perform and provide a reliable alternative to interpolated nasolabial or forehead flaps when the defect exposes significant bare cartilage or bone.
Basal Cell Carcinoma↗
Biological and psychological factors associated with memory function in fibromyalgia syndrome.
Fibromyalgia is a stress-related disorder characterized by chronic pain, memory impairment, and neuroendocrine aberrations. With the hypothesis that biological and psychological symptoms may underlie the cognitive problems, the relative influences of neuroendocrine function and psychological factors on declarative memory were examined among 50 women with fibromyalgia. This within-group analysis controlled for age, education, pain, and relevant medications. Neuroendocrine function and depression had significant independent associations with memory function. Higher log-transformed mean salivary cortisol levels were associated with better performance on both immediate and delayed visual recall and with delayed verbal recall. Depressive symptoms were negatively associated with verbal recall. These findings suggest that a basic disorder of endocrine stress responses may contribute to the cognitive symptoms experienced by fibromyalgia patients.
Adult↗
Development and initial testing of a multimedia program for computer-assisted cognitive therapy.
A multimedia program for computer-assisted psychotherapy has been developed to help patients learn cognitive therapy skills. The program is designed to provide psychoeducation, teach self-help methods, and give information to clinicians on the patient's progress in using the software. Multimedia technology is utilized to engage users in the learning process and to make the program accessible for persons who do not have computer or keyboard skills. A preliminary study with 96 subjects who used the software along with treatment as usual found that 75 (78.1%) completed the entire program. Users indicated a high rate of acceptance of this form of computer-assisted therapy, and mean scores on a measure of cognitive therapy knowledge were significantly improved.
Adult↗
Event Analysis of Systemic Teamwork (EAST): a novel integration of ergonomics methods to analyse C4i activity.
C4i is defined as the management infrastructure needed for the execution of a common goal supported by multiple agents in multiple locations and technology. In order to extract data from complex and diverse C4i scenarios a descriptive methodology called Event Analysis for Systemic Teamwork (EAST) has been developed. With over 90 existing ergonomics methodologies already available, the approach taken was to integrate a hierarchical task analysis, a coordination demand analysis, a communications usage diagram, a social network analysis, and the critical decision method. The outputs of these methods provide two summary representations in the form of an enhanced operation sequence diagram and a propositional network. These offer multiple overlapping perspectives on key descriptive constructs including who the agents are in a scenario, when tasks occur, where agents are located, how agents collaborate and communicate, what information is used, and what knowledge is shared. The application of these methods to live data drawn from the UK rail industry demonstrates how alternative scenarios can be compared on key metrics, how multiple perspectives on the same data can be taken, and what further detailed insights can be extracted. The ultimate aim of EAST is, by applying it across a number of scenarios in different civil and military domains, to provide data to develop generic models of C4i activity and to improve the design of systems aimed at enhancing this management infrastructure.
Communication↗
Command and control in emergency services operations: a social network analysis.
There is increasing interest in the use of social network analysis as a tool to study the performance of teams and organizations. In this paper, processes of command and control in the emergency services are explored from the perspective of social network theory. We report a set of network analyses (comprising visualization, a selection of mathematical metrics, and a discussion of procedures) based on the observation of six emergency service incidents: three fire service operations involving the treatment of hazardous chemicals, and three police operations involving immediate response to emergency calls. The findings are discussed in terms of our attempts to categorize the network structures against a set of extant command and control network archetypes and the relationship between those structures; comments on the qualities the networks display are put into the contexts of the incidents reported. We suggest that social network analysis may have a valuable part to play in the general study of command and control.
Efficiency, Organizational↗