Journals at the University of Arizona
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SURGICAL TREATMENT OF SCROTAL LYMPHEDEMA: MODIFIED SURGICAL TECHNIQUE
No full textLymphedema is a chronic disease in which lymph accumulates under the subcutaneous tissue. The condition may be due to either congenital or acquired lymphatic system abnormalities. Genital lymphedema (scrotal lymphedema) has a high psychological and functional impact, and many surgical techniques have been tried in an attempt to improve function and cosmetic appearance. The aim of this study is to present our experience in treatment of a series of patients with scrotal lymphedema. Twenty patients suffering from moderate to severe scrotal lymphedema underwent treatment by using three flaps technique (2 inguinoscrotal flap and one perineoscrotal flap). The technique showed improvement in cosmetic, sexual, and voiding function with low incidence of recurrence up to 23 months of followup
LYMPHATIC TRACT RECONSTRUCTION USING A PEDICLED DEEP INFERIOR EPIGASTRIC PERFORATOR FLAP
No full textWe encountered a case in which we used a pedicled deep inferior epigastric perforator (DIEP) flap to repair a lymphatic leak. This case shows that such repairs can lead to the reconstruction of the lymphatic tract and prevent lymphatic leak recurrences. The present report describes a 45-year-old woman with ovarian cancer who underwent hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, para-aortic lymphadenectomy, and omentectomy. She presented with a pelvic lymphocele with lower-extremity swelling. Lymphovenous anastomosis was performed and swelling of the lower extremity abated. However, because of the occurrence of deep vein thrombosis and the recurrence of swelling, we used a 6-cm-long and 14-cm-wide DIEP flap after lymphocele fenestration. The flap was de-epithelialized and fixed into the peritoneum, with the cutis side facing the leakage point. The postoperative course was uneventful, and no recurrence was observed. We obtained good results by providing abundant blood flow to abundant lymph tissue at the fenestration point. It is known that lymphatic vessels can spontaneously connect with each other. We hypothesize that the DIEP flap improved the edema in this case by regenerating the lymphatic network and improving flow into the bridging flap
IS LYMPHATIC RECONSTITUTION POSSIBLE AFTER MESHED SKIN GRAFTING?
No full textRestorative potential of lymph transport after skin graft has rarely been discussed. We report a case of lymphatic reconstitution across meshed, split-thickness skin graft performed for a patient with necrotizing fasciitis. The patient underwent extensive circumferential soft tissue debridement of the lower leg and resurfacing of the skin defect with meshed split-thickness skin graft. Indocyanine green fluorescence lymphography was performed 3 years after surgery and demonstrated that injected dye in the foot traveled across the skin graft and reached to the adjacent native skin in the proximal region. Our observation revealed that transferred split-thickness skin graft possessed some potential to allow for transport of lymph fluid possibly owing to the retention of lymphatic capillaries
Technology Use in Collegiate Foreign Language Programs
No full textAlthough technology use to support learning in Foreign Language (FL) courses is no longer in question and has substantially increased in the last decade, the ways in which collegiate FL programs approach and train instructors for its use have not been addressed as directly (Allen Negueruela-Azarola, 2010; Angus, 2017; Lord, 2014; Pfeiffer, 2008). According to the ACTFL and the Partnership for 21st Century Skills (2011), using technology is a must “in order to function in a knowledge economy” (p. 16). As called for by the MLA AD Hoc Committee on Foreign Languages (2007), “graduate studies should provide substantive training in language teaching and in the use of new technologies” (p. 241). While this statement is supported by many in the field of SLA (Lord, 2014; Melin, 2000; Muyskens, 1997), gaps persist in understanding how language program directors (LPDs) and graduate teaching assistants (TAs) view and approach the use of technology in their classrooms. This paper aims at filling these gaps by raising two questions: 1) How and for what purposes is technology used in collegiate level FL classrooms? and 2) What type of technology training is offered for TAs in FL programs? Two online surveys were administered in the current study to answer these questions. We collected data from TAs and LPDs in various collegiate foreign language departments around the United States about their current technology use in their classrooms and programs, as well as the training they have offered or received. Our findings reveal several discrepancies between LPDs and TAs in views surrounding the purpose of technology and the role of professional development. In particular, our findings show a great lack of technology training that discusses pedagogical frameworks on digital literacies and promotes professional collaboration among LPDs and TAs, such as in selecting and reflecting on teaching methods and approaches, and developing and carrying out research related to technology use in FL classrooms. Responding to these findings, we provide several suggestions to address shortcomings in training and technology use identified by participants in the current study and the review of the literature
Political ecology of asymmetric ecological knowledges: diverging views on the eucalyptus-water nexus in the Taita Hills, Kenya
No full textEnvironmental resource management policies worldwide have long insisted on the need to involve local communities and their diverse ecological knowledges in management planning and decision-making. In SubSaharan post-colonial countries, however, formal resource management is still largely dominated by bureaucratic governance regimes that date back to colonial power structures and that rely mainly on professional or formal knowledge. In this study, we use a political ecology approach to analyze disputes over eucalyptus plantations in the Taita Hills, Kenya. The approach recognizes the plurality of socially constructed and powerladen perceptions of environmental resources. We found that local people regard eucalyptus plantations not only as a threat to local water resources but they also highlight historical injustices and the loss of control over, and cultural relationships to their land. Bureaucratic resource management institutions, however, support the planting of eucalyptus to meet national demands for commercial forestry. Management officials also plead a lack of "valid" evidence for the negative impacts of eucalyptus on local water resources, diverting attention away from the formal environmental governance system which has unequal sharing of benefits, unclear policies, and internal incoherence. Recognition of historically rooted asymmetries of knowledge and power provides a step towards social transformation, ending a long-standing reproduction of subalternity, and promoting environmental justice and pluralism in decision-making.Keywords: bureaucratic knowledge; environmental justice; eucalyptus; Kenya; knowledge asymmetries; local ecological knowledge; political ecology; resource managemen
Political ecologies of biopower: diversity, debates, and new frontiers of inquiry
No full textThis article reviews recent literature on the political ecologies of conservation and environmental change mitigation, highlighting the biopolitical stakes of many writings in this field. Although a large and apparently growing number of political ecologists engage the concept of biopower directly – in its Foucauldian, Agambenian, and various other formulations – recent writings across the humanities and social sciences by scholars utilizing an explicitly biopolitical lens provide us with an array of concepts and research questions that may further enrich writings within political ecology. Seeking to extend dialogue between scholars of biopolitics, of political ecology, and of both, then, this article surveys both new and shifting contours of the various ways in which contemporary political ecologies increasingly compel us to bring the very lives of various human and nonhuman populations, as Foucault once put it, "into the realm of explicit calculations." In doing so, 'new frontiers' of biopolitical inquiry are examined related to: i) species, varieties, or 'multiple modes' of governmentality and biopower; ii) critical (ecosystem) infrastructure, risk, and 'reflexive' biopolitics; iii) environmental history, colonialism, and the genealogies of biopower, and iv) the proliferation of related neologisms, such as ontopower and geontopower
Representing environment and development – tracing links between drivers, representations and power dynamics in cocoa sustainability and beyond
No full textHow much do misleading representations matter? This article examines carefully constructed narratives of engagement in 'sustainable' cocoa production initiatives, which fail to mention one of the actual key drivers: the need to shore up production in the long term in an embattled sector. Consequently, representations also downplay the need for systemic change, reproducing the power asymmetries they claim to change. The research seeks to establish to what degree public-facing communication differs from underlying priorities in terms of forefronting altruism over necessity, and whether this is problematic for the initiatives' overall outcome. Through semi-structured interviews, focus-group discussions, documentary analysis and participant observation in Latin America and Europe, it reviews relations in two cocoa sustainability initiatives with environmental foci. Crucially, the research establishes a link between representations, underlying priorities and the degree to which they (re)produce pre-existing power asymmetries between global North and global South, private sector and other stakeholders in the industry, speaking to a variety of political ecology questions. It argues that public-facing, altruism-focused communication distracts from the sector's underlying systemic issues: the emphasis on altruism works to reduce pressure to transform power asymmetries and omnipresent inequalities