Accurate assessment of bowel length: the method of measurement matters.

PURPOSE: Small intestinal length has prognostic significance for patients with short bowel syndrome, and accurate measurement of Roux-en-Y limbs is considered important. The flexible elasticity of bowel makes its measurement highly subjective, yet a recommended method for intestinal measurement allowing accurate comparisons between surgeons remains undefined. Measurement of intestinal length has been described, but no comparison of the fidelity of measurement technique has been made. We hypothesized that silk suture and umbilical tape would yield the most consistent measurements. METHODS: This institutional review board-approved prospective trial enrolled 12 volunteer surgeons and two Institutional Animal Care and Use Committee-donated rabbits. Participants were asked to measure short, medium, and long segments of small intestine in a euthanized rabbit using common operating room tools: 18-in silk suture, 75-cm umbilical tape, 15-cm straight ruler, laparoscopic Dorsey bowel graspers. Data were analyzed by analysis of variance repeated measures model. RESULTS: Over short segments, intestinal measurements by grasper were significantly shorter than those by tape (P = 0.002) and ruler (P = 0.039). Over medium lengths of bowel, measurements by grasper were significantly shorter than those by suture (P = 0.032) and tape (P = 0.046), and measurements by ruler also were significantly shorter than those by suture (P = 0.008). Over the long intestinal segment, measurements by ruler resulted in the greatest variability, and comparison of variance across all possible pairs of groups found significant difference by method of measurement (P = 0.049). There was a significant difference in measurements taken along the mesenteric border compared with those taken along the antimesenteric border (P = 0.001). CONCLUSIONS: Measurement technique along short segments matters less; however, rigid tools underestimate length, and smaller variances in measurement by silk suture and umbilical tape suggest that these methods are more reliable across longer distances.

Understanding antigay bias from a cognitive-affective-behavioral perspective.

In general, United States citizens have become increasingly more accepting of lesbians and gay men over the past few decades. Despite this shift in public attitudes, antigay bias remains openly tolerated, accepted, practiced, and even defended by a substantial portion of the population. This article reviews why and how antigay bias persists using a cognitive-affective-behavioral perspective that touches on sociocognitive factors such as prejudice and stereotyping, as well as features unique to antigay bias, such as its concealable nature. The article concludes with a discussion of how understanding modern antigay bias through a cognitive-affective-behavioral lens can be applied to reduce discrimination against gays and lesbians.

The effects of parental depressive symptoms, appraisals, and physical punishment on later child externalizing behavior.

Examined a cognitive-behavioral pathway by which depressive symptoms in mothers and fathers increase risk for later child externalizing problem behavior via parents' appraisals of child behavior and physical discipline. Participants were 245 children (118 girls) at risk for school-age conduct problems, and their parents and teachers. Children were approximately 3 years old at Time 1 (T1) and 5 ½ years old at Time 2 (T2). At T1, mothers and fathers reported their depressive symptoms, perceptions of their child's reciprocal affection and responsiveness, frequency of physical punishment, and child externalizing problems. Mothers, fathers, and teachers provided ratings of externalizing behavior at T2. Structural equation modeling revealed that parents' negative attributions mediated positive relations between their depressive symptoms and frequency of physical punishment for both fathers and mothers. More frequent physical punishment, in turn, predicted increased child externalizing behavior at T2. In future research, transactional mechanisms underlying effects of clinical depression on child conduct problems should be explored at multiple stages of development. For parents showing depressive symptoms, restructuring distorted perceptions about their children's behavior may be an important component of intervention programs.

Assessment of cheating behavior in young school-age children: distinguishing normative behaviors from risk markers of externalizing psychopathology.

The central goal of this longitudinal study was to develop a laboratory-based index of children's covert cheating behavior that distinguished normative rule violations from those that signal risk for antisocial behavior. Participants (N = 215 children) were drawn from a community population and oversampled for externalizing behavior problems (EXT). Cheating behavior was measured using two resistance-to-temptation tasks and coded for extent of cheating, latency to cheat, and inappropriate positive affect. Mothers rated internalized conduct and three forms of self-regulation: inhibitory control, impulsivity, and affective distress. Mothers and teachers reported EXT concurrently (T1) and 4 years later, when children averaged 10 years of age (T2). Children categorized as severe cheaters manifested lower inhibitory control, greater impulsivity, and lower levels of internalized conduct at T1. Children in this group also manifested higher levels of EXT in home and school settings at T1 and more EXT in the school setting at T2, even after accounting for T1 ratings.