Year Period Of Time Research Articles

Seasonal Variation of Childhood Acute Lymphoblastic Leukaemia is Different Between Girls and Boys

The aim of this study was to investigate seasonal trends in the incidence of acute lymphoblastic leukaemia (ALL) around the times of birth and diagnosis in children aged 0-4 years and also to examine gender specific effects. Children born in South Hungary during 1981-1997 were analysed. Registrations of first malignancies for children, diagnosed under age 5 years before the end of 2002 were obtained from the Hungarian Paediatric Oncology Group providing a representative sample of Hungarian children over a 17 year period of time. Data were available on the corresponding numbers of births for each month of the study period were obtained. Statistical analyses were performed using logistic regression with harmonic components. The study analysed 121 cases of children, aged under 5 years, who were diagnosed with ALL. We found no seasonal effect related to date of diagnosis. However, there was seasonal variability for ALL related to date of birth. Maximal rates were seen in children born in February and August in the simple harmonic regression model for all children diagnosed with ALL. Analysis by gender found evidence of seasonality related to month of birth with peaks in February and August in boys, but different seasonal effects were seen for girls (peak in November, nadir in May). Our study provides some evidence that male specific immune responses to infections around the time of birth could explain the male predominance in the incidence of ALL.

Submandibular gland excision: a 16 year clinicopathological review of cases in a Nigerian Teaching Hospital

AbstractAim: This study presents a review of the clinicopathological features of excised submandibular glands over a 16 year period of time at the Lagos University Teaching Hospital, Nigeria.Materials and methods: A retrospective review of excised submandibular glands over a period of 16 years (January 1990 to December 2005) was conducted. Parameters studied included: age and gender of patients, symptoms and duration of symptoms and histologic diagnosis.Results: A total of 47 patients had their submandibular gland excised during the period of the study. There were 28 men and 19 women (men : women ratio of 1.5:1). Mean age [standard deviation (SD)] of patients at presentation was 40.5 ± 18.1 years (range, 13–84 years). There were 34 (72%) histologically diagnosed neoplasms and 13 (28%) non‐neoplastic pathologies. Patients with neoplastic pathologies were significantly older than those with non‐neoplastic pathologies (P = 0.004). The most common neoplasm was pleomorphic adenoma (35%), followed by adenocystic carcinoma (12%) and anaplastic carcinoma (12%). Chronic sialadenitis with or without sialolithiasis (85%) was the most common non‐neoplastic pathology.Conclusion: The most common submandibular salivary gland pathology that necessitated surgical excision, in our institution, was neoplasia, predominately pleomorphic adenomas. The most common non‐neoplastic pathology was chronic sialadenitis with or without sialolithiasis.

Newborn hearing screening in a South African private health care hospital

Early Hearing Detection and Intervention (EHDI) programs are being established as part of the public health systems in increasing numbers of countries. In developing countries, however, little progress has been made towards implementing NHS programs and South Africa's public and private health care sectors is no exception. The current study presents the first report on a hospital-based UNHS program conducted in the South African private health care sector to provide preliminary results towards advocating for and guiding future programs. A retrospective study of a UNHS program at a private hospital in urban Gauteng, South Africa over a 4 year period of time was performed. Screening was conducted with Transient Evoked Otoacoustic Emissions (TEOAE) with a rescreen recommended within 6 weeks if referred. Diagnostic audiological assessments were performed on those infants referring the rescreen. The discharge screening costs were subsidized through the hospital birthing package for the first 22 months of the program. Six thousand two hundred and forty-one newborns were screened from 13,799 hospital births during the first 4 years. Ninety-four percent of these infants were from the well-baby nurseries. During the initial 22 months, whilst the service was subsidized as part of the hospital birthing package, coverage of 75% was attained compared to 20% during the subsequent 26 months. The overall referral rate for the screening program across the 4 years was 11.1% but referral rates decreased by between 2 and 4% for each year of program existence with a 5% rate in year 4. Only 32% of the rescreens were completed at the hospital and no data was available for the remaining infants because parents were provided a choice of follow up centers. Referral for a diagnostic assessment after the rescreens at the hospital was predictive of sensorineural hearing loss in one-third of cases and the estimated prevalence was 3 in every 1000. Screening coverage in the current study was not adequately high and can be attributed to insufficient parental knowledge to make an informed decision. Improvements in program efficiency over time also suggest that pilot programs must be monitored over sufficiently long periods of time to allow observations of optimal efficiency. Initial referral rates and prevalence data indicate a large hearing loss burden and the capacity to implement increasingly efficient programs in South Africa.

The Evolution of the Concept of the 'Executive' from the 20th Century Manager to the 21st Century Global Leader

The purpose of this paper is to take an in-depth look at the profiles of executive skills and competencies drawn across the expanse of seventy-five years framed in the backdrop of management philosophy changes. In the early 1900's, Chester Barnard outlined the competencies he felt the executive of the future would need in the 20th Century. At the beginning of the 21st Century, Morgan McCall and George Hollenbeck interviewed over 100 expatriates and reported a list of needed competencies for the global executive of the 21st Century. This paper chronicles the changes in the management arena over that 70 plus year period of time to frame the backdrop of these two executive skill profiles. The journey is interesting and the outcome is surprising at times. Just as organizations are a product of their past, so to is the executive of today. He/she is an anthology of all the things that an executive needed in early 1900's, with a couple dynamic dimensions thrown in to maintain their sustainable competitive advantage in the new millennium global marketplace. Key Words: leadership, executive development, global management, 20th Century management training/development, 21st Century global managers, differences between traditional managers and global leaders

Our Reflections on Writing for Publication

The outgoing editorial team of Language Arts reflect on their insights about writing a manuscript for submission to a journal. They focused on patterns in the suggestions of reviewers and in their editorial letters over a five year period of time. They discuss the range of decisions to consider related to planning and writing a draft and then revisiting and reshaping that draft before submitting it to a journal for review. Examples from articles published during their editorship are used to discuss the range of alternatives for each decision.

Vertebral artery dissections after chiropractic neck manipulation in Germany over three years

Vertebral artery dissection (VAD) has been observed in association with chirotherapy of the neck. However, most publications describe only single case reports or a small number of cases. We analyzed data from neurological departments at university hospitals in Germany over a three year period of time of subjects with vertebral artery dissections associated with chiropractic neck manipulation. We conducted a country-wide survey at neurological departments of all medical schools to identify patients with VAD after chirotherapy followed by a standardized questionnaire for each patient. 36 patients (mean age 40 + 11 years) with VAD were identified in 13 neurological departments. Clinical symptoms consistent with VAD started in 55% of patients within 12 hours after neck manipulation. Diagnosis of VAD was established in most cases using digital subtraction angiography (DSA), magnetic resonance angiography (MRA) or duplex sonography. 90% of patients admitted to hospital showed focal neurological deficits and among these 11 % had a reduced level of consciousness. 50% of subjects were discharged after 20 +/- 14 hospital days with focal neurological deficits, 1 patient died and 1 was in a persistent vegetative state. Risk factors associated with artery dissections (e. g. fibromuscular dysplasia) were present in only 25% of subjects. In summary, we describe the clinical pattern of 36 patients with vertebral artery dissections and prior chiropractic neck manipulation.

Robotic minimally invasive mitral valve reconstruction yields less blood product transfusion and shorter length of stay

Introduction: Robotically-assisted minimally invasive mitral valve reconstruction has recently gained popularity. Initial reports suggest that this approach can be utilized with relative safety and efficacy. Direct comparisons with a traditional sternotomy approach have not yet been extensively explored. Methods: All mitral valve procedures performed by a single surgeon during a three year period of time were analyzed. (n=142) Patients requiring concomitant coronary artery bypass grafting or aortic valve surgery were subsequently excluded from analysis, as all of these patients were obligatorily approached via sternotomy (n=71). Six patients underwent right thoracotomy mitral valve procedures without robotic assistance and one patient in cardiogenic shock underwent emergent mitral valve reconstruction via sternotomy. Of the remaining 64 patients theoretically eligible for sternotomy or robotically-assisted minimally invasive surgery, 39 underwent sternotomy and 25 underwent right chest minimally invasive robotically-assisted surgery. Randomization between these two approaches would be almost impossible in the United States. The primary determinant for choice of approach was request of the referring physician or patient. Multiple perioperative outcomes were then compared. Results: Sternotomy and robotic patients exhibited equivalent preoperative characteristics. Robotic and sternotomy patients experienced equivalent degree of correction of mitral regurgitation in repairs and in need for replacement. Complex mitral valve repairs entailing leaflet resection and reapproximation, annular plication, sliding annuloplasty, chordal transfer, and GoreTex neochordal construction were successfully accomplished with the robotic system. Cross-clamp and bypass times were longer in minimally invasive patients (110 vs 151min p=0.0015, 162 vs 239min p<0.001). Far greater robotic patients avoided any blood product transfusion 38% vs 15% and mean PRBC transfusion trended to a significantly lower amount among robotic patients (2.9 vs 4.8units p=0.06). Robotic patients experienced shorter mean length of postoperative hospitalization (7.1 vs 10.6 days p=0.039). There was one mortality among the sternotomy patients and no mortalities among the robotic patients. Conclusions: Patients can undergo mitral valve reconstruction with minimally invasive robotic assistance, avoid a sternotomy, require less blood product transfusion, and experience shorter hospitalization.

The Association Between Uterine Septum and Infertility

The association between uterine septum and recurrent pregnancy loss (rpl) is well established. However, the relationship between uterine septum and infertility remained unclear. Whenever assisted reproductive technology (ART) is considered, the female patient is scrutinized for uterine factors in order to enhance pregnancy outcome. However, subtle uterine factors may be missed or ignored in infertile patients who are not undergoing ART. The purpose of this study is to report the incidence of short uterine septum in infertility patients based on hysteroscopic findings as well as to report the pregnancy outcome after assisted conception. A historical cohort study. The study included 1011 patients who underwent laparoscopic and hysteroscopic surgery for treatment of infertility over a 12 year period of time ending February 2005. Group 1 included 661 patients who were found to have endometriosis; Group 2 included 350 patients who had no endometriosis. All patients underwent both a diagnostic hysteroscopy and laparoscopy. Surgical correction was done if any pathology was found. The majority of surgeries were performed by the same surgeon. If a uterine septum was detected, the type was determined (short <2cm or long >2cm), and hysteroscopic division was performed. The incidence of uterine septum in both groups was determined. Following surgery 33 patients underwent ART, while 35 patients underwent intrauterine insemination (IUI) after controlled ovarian hyperstimulation (COH). Pregnancy outcome was calculated. The mean age and duration of infertility of the women with uterine septum was 31.0± 5.1 and 3.6± 3.4 years respectively while 51.7% had primary infertility. Uterine septum was found in 117 patients (17.7%) in Group1 and in 61 patients (17.4%) in Group 2. The majority of septa were of the short type, 15.6% in Group1 and 14.3% in Group 2. Of 178 patients who were found to have uterine septum, 117 (65.7%) had endometriosis and 61 patients (34.3%) had no endometriosis. Of those patients who attempted ART, 81.8% conceived while the pregnancy rate per cycle was 51.9%. Of those patients who attempted IUI, 68.6% conceived while the pregnancy rate per cycle was 38.1%. Seven patients who had initially undergone IUI and did not conceive, had ART, 6 of the 7 conceived. Our data suggest that the incidence of short uterine septum in infertile patients is much higher than what has previously been reported. After hysteroscopic surgical correction, high pregnancy rates can be achieved after assisted conception. Thorough evaluation of the endometrial cavity to detect subtle uterine anomalies should be advocated for all infertility patients. If a uterine septum is found in infertile patients, the possibility of endometriosis should be considered.

Maintenance of Community Change: Enforcing Youth Access to Tobacco Laws

Youth access to tobacco remains a significant problem for this nation. Methods have been developed to reduce youth access to commercial outlets and these involve enforcement efforts of monitoring and fining merchant offenders. In the present study, over a three year period of time, readiness to participate in these types of enforcement programs were assessed in 11 communities. Several years after the research study was completed, enforcement activities were re-assessed. Findings indicated that those communities that had made the largest changes in community readiness to enforce youth access laws during the three year intervention were the ones most likely to continue enforcement activities into the follow-up period. There is a need to better understand how youth access to tobacco community-based interventions can be maintained.

Suicide prevalence in chemical dependency programs: preliminary data from a national sample, and an examination of risk factors.

Completed suicides over a one year period of time were reported from a nationwide survey of Department of Veteran Affairs medical centers. Of a total of 248 completed suicides, 11 occurred in outpatient substance abuse programs, and an additional 5 occurred among patients receiving combined outpatient substance abuse and psychiatric treatment. There were no inpatient suicides. During this time, there were 7 suicide attempts on inpatient units and 37 suicide attempts in outpatient chemical dependency treatment. The majority of suicides were committed by males who had a primary alcohol addiction (63%). Thirty-eight percent of the sample had a comorbid mood disorder and 38% had a comorbid personality disorder. Risk factors relating to the potential for suicide in chemical dependency programs are discussed.

Survival Models of Community Tenure and Length of Hospital Stay for the Seriously Mentally Ill: A 10-year Perspective

Objective: To examine the effects of personal and community characteristics, specifically race and rurality, on lengths of state psychiatric hospital and community stays using maximum likelihood survival analysis with a special emphasis on change over a ten year period of time. Data Sources: We used the administrative data of the Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services (DMHMRSAS) from 1982–1991 and the Area Resources File (ARF). Given these two sources, we constructed a history file for each individual who entered the state psychiatric system over the ten year period. Histories included demographic, treatment, and community characteristics. Study Design: We used a longitudinal, population-based design with maximum likelihood estimation of survival models. We presented a random effects model with unobserved heterogeneity that was independent of observed covariates. The key dependent variables were lengths of inpatient stay and subsequent length of community stay. Explanatory variables measured personal, diagnostic, and community characteristics, as well as controls for calendar time. Data Collection: This study used secondary, administrative, and health planning data. Principal Findings: African-American clients leave the community more quickly than whites. After controlling for other characteristics, however, race does not affect hospital length of stay. Rurality does not affect length of community stays once other personal and community characteristics are controlled for. However, people from rural areas have longer hospital stays even after controlling for personal and community characteristics. The effects of time are significantly smaller than expected. Diagnostic composition effects and a decrease in the rate of first inpatient admissions explain part of this reduced impact of time. We also find strong evidence for the existence of unobserved heterogeneity in both types of stays and adjust for this in our final models. Conclusions: Our results show that information on client characteristics available from inpatient stay records is useful in predicting not only the length of inpatient stay but also the length of the subsequent community stay. This information can be used to target increased discharge planning for those at risk of more rapid readmission to inpatient care. Correlation across observed and unobserved factors affecting length of stay has significant effects on the measurement of relationships between individual factors and lengths of stay. Thus, it is important to control for both observed and unobserved factors in estimation.

Ten–Year Incidence of Dental Caries in Adult and Elderly Chinese

Only very few longitudinal studies on dental caries are available in adults and elderly. Therefore, the aim of the present study was to describe the patterns of lesion progression in a group of adult and elderly Chinese followed over a 10–year period of time. In 1984, 587 persons aged 20–80 years were examined and by 1994, 440 of these were still available and re–examined by the same two examiners. All restorations, periodontal conditions and dental caries were recorded for all teeth and surfaces. Only caries data are reported here. Dental caries on coronal surfaces was classified as sound, non–cavitated, cavitated without or with pulp involvement or filled. On root surfaces, lesions were classified as sound, active caries or restored. Prior to analysis of the data, a series of drop–out analyses was carried out showing that most of the drop–outs were above 60 years of age at baseline, and death of participants was the major drop–out reason. A total of 2,114 teeth were lost, 36% of which had a deep dentin lesion at baseline. The distribution of persons according to number of new lesions/restorations over 10 years was highly skewed in all age groups, the prevalence increasing with age. Molars had the highest risk of becoming carious/restored over the 10–year period, and a remarkably low proportion of teeth had the same caries diagnosis after 10 years, indicative of lesion progression. When comparing the 1984 DFT/DMFT with the figures for 1994, there were no statistically significant differences indicating that the period and cohort effects cancel out each other. There was a significant increase with age of the number of new DFT. It can be concluded that dental caries is a major health problem in contemporary adult and elderly Chinese populations, and that caries incidence increases with old age.

A Longitudinal Examination of Wants-Out-of-Life Among Mid-Life Adults

Abstract The purpose of this study was to examine change and stability in values among mid-life adults over time. Using longitudinal data from A Study of Leisure During Adulthood, values were measured using Kahle's List of Values. Data collected enabled researchers to examine mid-life adult values, or wants-out-of-life, without interruption for a ten year period of time. Findings revealed that wants-out-of-life remained relatively stable over time. Self-respect, self-fulfillment, and a sense of accomplishment received the highest overall mean ratings.

Sluggish giants, sticky cultures, and dynamic capability transformation

Using a theoretical framework derived from contemporary literature this paper investigates whether large and culturally dominant firms can transform their capabilities over time. Strategic capabilities, as articulated in theory, include resource accumulation and resource configuration. To these is added the capability of resource utilization which comes about because of tacit and inimitable intra-firm coordination skills and is a key performance measurement metric. This article evaluates whether large firms in the U.S. telecommunications industry have been able to effect a transformation in their strategic performance over a 16 year period of time: 1975 to 1990. Since the late 1960s and early 1970s many measures have been undertaken to restructure the industry environment, and these culminated in the 1984 divestiture by AT&T of this 22 Bell Operating Companies (BOCs) to seven Regional Holding companies (RHCs). Simultaneously a series of steps opened competition in many markets for not only the RHCs but for the other local operating companies, of which there are approximately 25 large ones, which in many cases are bigger than some of the companies belonging to the RHC fold. The local operating companies have faced a major transformation in their environment in the last 10 years. Once protected monopolies, they now face increasing competition in many market segments, which were once their profit sanctuaries enabling them to cross-subsidize many unprofitable operations. For the larger operating companies once owned by AT&T there was the shock of divestiture and re-birth, providing them an opportunity to engage in entrepreneurially oriented behavior. Thus, the U.S. telecommunications industry provides a useful laboratory within which to analyze performance and capability transformation. Additionally, one of the key issues that the literature is concerned with is the transformation in the performance of existing organizations. This article provides evidence on the key issue of corporate performance transformation for the principal firms that comprise one of the most important industries of contemporary times. It is a transformation that continues at an even faster pace today. The results show that in a dynamic setting size no longer materially influences negative performance. Inertia arguments about the ability of large firms to effect change are not validated in the context of a dynamic U.S. telecommunications industry. With a larger variety and pool of resources available, larger firms can undergo transformation through a process of dynamic learning as effectively as smaller firms. The relative transformation of the erstwhile Bell Operating Companies is a testimony to this assertion. The results have some implications for downsizing. Received wisdom means that less is better and smaller is swifter. Downsizing means dispersal of assets and resources, particularly human resources which embody firm-specific skills and knowledge. Which types of resources are lost in this process is critical to the eventual success of such endeavors. With downsizing, the ability of large firms to transform themselves via internal learning may be lost. Dynamic learning implies information scale economy exploitation, and to the extent that critical mass is reduced through downsizing there is lesser diffusion of information and knowledge. As a qualitatively important part of this human capital mass is reduced, there is less impact of future learning as firm-specific knowledge, which could be combined with emergent information to create new capabilities disappears. In such circumstances whether large firms can transform themselves successfully is a salient issue that ought to be further evaluated.

Randomized Controlled Trial of Ipratropium Bromide and FrequentLow Doses of Salbutamol in the Management of Mild and Moderate AcutePediatric Asthma

Ducharme FM, Davis GMJ Pediatr.1331998479485Previous studies have demonstrated the benefit of inhaled ipratropium as an adjunct to inhaled β2 bronchodilators in the treatment of acute severe asthma in children. The purpose of this study was to observe children with mild to moderate exacerbations of asthma, comparing the efficacy, safety, and possible synergy of inhaled salbutamol with or without inhaled ipratropium.Two hundred ninety-eight events in 275 patients were analyzed. The children were 3 to 17 years of age and presented to a single emergency room facility with mild to moderate exacerbations of asthma over a 2½-year period of time. To qualify they also had to be able to reproducibly perform forced oscillometry (a noneffort dependent, quiet breathing/tidal volume measurement of airway resistance) and they required more than one salbutamol treatment.The study was blinded, randomized, and placebo-controlled for the ipratropium. Patients were excluded if they had a severe asthma exacerbation, or significant comorbidity such as heart disease or cyctic fibrosis. Eligible patients were randomized to one of four treatment groups: high-dose salbutamol (0.15 mg/kg q 60 minutes; maximum dose 5 mg) with or without 250 μg ipratropium; frequent low-dose salbutamol (0.075 mg/kg q 30 minutes) with or without ipratropium. Ipratropium or placebo were given only once 30 minutes after the first salbutamol treatment. The primary endpoint was the change from baseline in respiratory resistance as measured by forced oscillometry. Values were ascertained at the time of the peak effect of both drugs; 30 minutes after salbutamol and 60 minutes after ipratropium. Secondary endpoints were oxygen saturation, the need for oral corticosteroids as a discharge medication, hospital admission, and relapse within 10 days. Prior home treatment and maintenance medications were cofactored into the analysis.The use of forced oscillometry allowed 69% of the children to participate who would have otherwise been excluded by the inability to reproducibly perform standard spirometry. All treatment groups improved significantly from baseline to 90 minutes (P < .001). There were no differences in the acute management at home nor the physician assessment of severity among the four treatment groups. No group differences were observed in the magnitude of improvement or in the number of patients who required an additional hour of treatment. In a subgroup of children in whom cough and rhonchi were prominent features, the anticholinergic effects of ipratropium did not provide additional benefit beyond salbutamol alone. There were no group differences in the need for corticosteroids, oxygen saturation, hospitalization rates, or relapse rates. The frequent, low-dose regimen of salbutamol was associated with a greater incidence of vomiting than hourly, high-dose salbutamol. There were no group differences in the incidence of other side effects.In children with a mild to moderate exacerbation of asthma neither frequent low-dose salbutamol nor the addition of inhaled ipratropium provided additional beneficial effect compared with hourly high-dose salbutamol alone.This is the largest study of its kind and unique in its ability to objectively evaluate changes in lung function in young children who represent a significant population of pediatric asthma patients presenting for acute care for mild to moderate exacerbations. Previous studies have demonstrated the benefit of frequent low-dose albuterol and the synergistic effect of inhaled ipratropium in children with severe exacerbations. This study suggests that these intense strategies may not be necessary for children with mild to moderate exacerbations, economizing on provider time and materials without sacrificing patient outcomes. However, it is possible that higher or more frequent doses of ipratropium may have shown a greater improvement in lung function as suggested in recent studies (Querishi FA, et al. Ann Emerg Med. 1997;29:205–211 and Schuh S, et al. J Pediatr. 1995;126:639–645).

Effect of Nebulized Ipratropium on the Hospitalization Rates ofChildren With Asthma

1. Qureshi F, 2. Pestian J, 3. Davis P, 4. et al. (1998) N Engl J Med. 339:1030–1035. [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] #### Purpose β-agonists have been identified as primary therapy for acute asthma and adjunctive therapy with anticholinergic agents has yielded variable results. This study evaluates the addition of ipratropium to β-agonist in the treatment of acute asthma. ##### Study Population A double-blind study of 434 children (2–18 years) … [1]: {openurl}?query=rft.jtitle%253DNew%2BEngland%2BJournal%2Bof%2BMedicine%26rft.stitle%253DNEJM%26rft.issn%253D0028-4793%26rft.aulast%253DQureshi%26rft.auinit1%253DF.%26rft.volume%253D339%26rft.issue%253D15%26rft.spage%253D1030%26rft.epage%253D1035%26rft.atitle%253DEffect%2Bof%2BNebulized%2BIpratropium%2Bon%2Bthe%2BHospitalization%2BRates%2Bof%2BChildren%2Bwith%2BAsthma%26rft_id%253Dinfo%253Adoi%252F10.1056%252FNEJM199810083391503%26rft_id%253Dinfo%253Apmid%252F9761804%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1056/NEJM199810083391503&link_type=DOI [3]: /lookup/external-ref?access_num=9761804&link_type=MED&atom=%2Fpediatrics%2F104%2FSupplement_2%2F394.2.atom [4]: /lookup/external-ref?access_num=000076294800003&link_type=ISI

Breast Cancer in Mass Circulating Magazines in the U.S.A. and Canada, 1974–1995

ABSTRACT This paper presents the results of a study of the images of breast cancer in the highest circulating periodicals in the USA and Canada over a twenty year period of time. Both manifest and latent themes are noted and described. The emphasis in the manifest themes is on the medical aspects of the treatment and early detection of breast cancer. The latent themes emphasize the contrast in the ways that women with the disease, as compared to their doctors, are described. Notably, women are portrayed as being 'worried about their health' and, in particular, the most feared of 'their' diseases, breast cancer. Breast cancer is said to be caused by everything, especially women's own traitorous bodies. Women are described as isolates, as emotional and preoccupied with their sexual attractiveness. Doctors are described in contrasting ways, as moral truth-seekers, infused with rationality and intelligence. The ubiquitous causes of breast cancer are also noted. The paper concludes with a discussion of the possible implications of the gendered character of the reporting about breast cancer.

An Analysis of Nurses' Communications in a Shelter Setting

The purpose of this study was to analyze written communications among nurses providing care to battered women and their children in a community shelter setting over a 1 -year period of time. Interviews were conducted with the nurses to study the perceived effectiveness of the manual used to update daily shelter health operations, clients of concern, follow-up recommendations, or other ongoing issues. The unit of analysis was each entry recorded in the manual. The Communications Process Model guided the study (Budd, Thorp, & Donohew, 1967). Communications were transcribed and analyzed for categories of meaning from the data utilizing the Ethnograph software (Seidel & Clark, 1983). When content analysis was applied, 10 distinct categories emerged: (a) injury assessment, (b) acute condition assessment, (c) chronic condition assessment, (d) pregnancy assessment, (e) emergency assessment, (0 nursing care and procedures, (g) teaching and counseling, (h) community referrals and resources, (i) housekeeping, and Cj) health program issues. From the categories, 3 primary themes were identified: nursing assessments, nursing interventions, and health program operations. The nurses were positive about using the manual for various communications. Nurses who consider working in shelter settings may find descriptions of the realities of practice and application of a working tool for communications useful. Shelter administrators and board members need to recognize the importance of having nurses on staff to address inevitable injuries and health concerns of battered women and their children. Researchers are encouraged to develop models that relate to care of clients and caregivers in this challenging practice setting.

Object-Oriented Education: Trends in Information Systems and Computer Science Curricula

The use of object-oriented (OO) technology in industry continues to grow. Unfortunately, re-training of existing developers has proven to be a slow and difficult process. Thus, industry must look to computer science (CS) and information systems (IS) programs to provide many of the needed OO developers. This study investigates the extent of OO in CS and IS curricula over a four year period of time (1992 to 1996). Results indicate that the extent of OO in CS and IS programs is growing, although IS lags CS programs in both the percentage of programs offering OO and the number of courses offered per program. OO is being integrated with existing courses, such as Analysis and Design, and new courses, such as OO Programming, are being added to the curriculum. Overall, the growth of OO in higher education and the information taught in the courses is keeping pace with industry expectations.

Surgical treatment of primary cutaneous B-cell lymphoma of the head and neck

Cutaneous B-cell lymphoma with CD30, CD20 antigenic phenotype are a distinct group of cutaneous lymphomas with a favorable prognosis after treatment. Three patients are presented seen over a three year period of time, they were all excised. A good response to this therapy was observed with a satisfactory overall prognosis on long-term follow-up. This may prevent patients from having unnecessarily aggressive treatment.