DIGESTIVE ENDOSCOPY, Issue 2 2010
Tatsuya Fujimoto
Aim:, To assess long-term outcome of endoscopic papillotomy alone without subsequent cholecystectomy in patients with choledocholithiasis and cholecystolithiasis. Methods:, Retrospective review of clinical records of patients treated for choledocholithiasis and cholecystolithiasis from 1976 to 2006. Of 564 patients subjected to endoscopic papillotomy and endoscopic stone extraction, 522 patients (279 men, 243 women; mean age 66.2 years) were followed up and predisposing risk factors for late complications were analyzed. Results:, The mean duration of follow up was 5.6 years. Cholecystitis and recurrent choledocholithiasis occurred in 39 (7.5%) and 60 (11.5%) patients, respectively. Cholecystitis, including one severe case, resolved with conservative treatment. Recurrent choledocholithiasis was successfully treated endoscopically except in one case. Pneumobilia was found to be a significant risk factor for cholecystitis (P = 0.019) and recurrent choledocholithiasis (P = 0.013). Biliary tract cancer occurred in 16 patients; gallbladder cancer in 13 and bile duct cancer in three. Gallbladder cancer developed within 2 years after endoscopic papillotomy in seven of the 13 patients (53.8%). Conclusion:, Pneumobilia was the only significant risk factor for cholecystitis and recurrent choledocholithiasis in our study population. As for the long-term outcome, it was unclear whether endoscopic papillotomy contributed to the occurrence of biliary tract cancer. [source]

INFLUENCE OF MENSTRUAL CYCLE PHASE ON SMOKING CESSATION TREATMENT OUTCOME: A HYPOTHESIS REGARDING THE DISCORDANT FINDINGS IN THE LITERATURE

ADDICTION, Issue 11 2009
TERESA R. FRANKLIN
No abstract is available for this article. [source]

HAPLODIPLOIDY AS AN OUTCOME OF COEVOLUTION BETWEEN MALE-KILLING CYTOPLASMIC ELEMENTS AND THEIR HOSTS

EVOLUTION, Issue 4 2004
Benjamin B. Normark
Abstract Haplodiploidy (encompassing both arrhenotoky and paternal genome elimination) could have originated from coevolution between male-killing endosymbiotic bacteria and their hosts. In insects, haplodiploidy tends to arise in lineages that rely on maternally transmitted bacteria for nutrition and that have gregarious broods in which competition between siblings may occur. When siblings compete, there is strong selection on maternally transmitted elements to kill males. I consider a hypothetical bacterial phenotype that renders male zygotes effectively haploid by preventing chromosome decondensation in male-determining sperm nuclei. By causing high male mortality, such a phenotype can be advantageous to the bacterial lineage. By eliminating paternal genes, it can also be advantageous to the host female. A simple model shows that the host female will benefit under a wide range of values for the efficiency of resource re-allocation, the efficiency of transmission, and the viability of haploid males. This hypothesis helps to explain the ecological correlates of the origins of haplodiploidy, as well as such otherwise puzzling phenomena as obligate cannibalism by male Micromalthus beetles, reversion to diploidy by aposymbiotic male stictococcid scale insects, and the bizarre genomic constitution of scale insect bacteriomes. [source]

PLASMA LEVELS OF INFLAMMATORY C-REACTIVE PROTEIN AND INTERLEUKIN-6 PREDICT OUTCOME IN ELDERLY PATIENTS WITH STROKE

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2004
Antonello Silvestri MD
No abstract is available for this article. [source]

PREDICTORS OF SUBSTANCE USE AND FAMILY THERAPY OUTCOME AMONG PHYSICALLY AND SEXUALLY ABUSED RUNAWAY ADOLESCENTS

JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 3 2006
Natasha Slesnick
There is a dearth of research that examines the impact of family systems therapy on problems among sexually and/or physically abused youth. Given this void, differential outcome and predictors of substance use change were evaluated for abused, as compared with nonabused, runaway adolescents who were randomly assigned to family therapy or treatment as usual. Abused adolescents reported lower family cohesion at baseline, although both abused and nonabused adolescents showed similar substance use reductions. Utilizing hierarchical linear modeling, we found that substance use changed with change in cohesion over time. These findings link change in family functioning to change in adolescent substance use, supporting family systems theory. Findings suggest that a potent target of intervention involves focus on increasing positive communication interactions. [source]

THE THERAPEUTIC ALLIANCE IN HOME-BASED FAMILY THERAPY: IS IT PREDICTIVE OF OUTCOME?

JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 1 2002
Lee N. Johnson
This study examined the association between the therapeutic alliance in family therapy and changes in symptom distress, interpersonal relationships, and family coping. The participants (N = 81) were members of low socioeconomic status families referred to a university clinic for in-home family therapy. Participants completed the Outcome Questionnaire, Family Crisis Oriented Personal Evaluation, and the Family Therapy Alliance questionnaires. Regression analyses revealed that the therapeutic alliance explained 19% of the variance in symptom distress changes for mother, 55% for fathers, and 39% for adolescents. The implications of these findings for practicing and researching family therapy are presented. [source]

COUPLES THERAPY FOR WOMEN SURVIVORS OF CHILD SEXUAL ABUSE WHO ARE IN ADDICTIONS RECOVERY: A COMPARATIVE CASE STUDY OF TREATMENT PROCESS AND OUTCOME

JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 1 2001
Barry Trute
Treatment for women who are survivors of child sexual abuse and who have a history of substance abuse has largely involved gender-specific interventions. This study examines the use of conjoint couple therapy with a cohort of women who were survivors of child sexual abuse and who are in addiction recovery and with their partners. A comparative case study analysis incorporated standardized clinical measures with client and therapist interviews. Brief conjoint therapy was found to assist couples in the specific relationship skill areas of communication and mutual problem solving. Further, substantive gains were found in the realm of affective relations. The women reported an increase in support from their male partners, and the men reported a decrease in negative emotional atmosphere in the relationship. [source]

THE EFFECTS OF RENAL TRANSPLANT HISTOLOGY AT 3 MONTHS ON LONG-TERM GRAFT OUTCOME

NEPHROLOGY, Issue 3 2000
Fenton-Lee C
[source]

MANAGEMENT AND HOSPITAL OUTCOME OF THE SEVERELY HEAD INJURED ELDERLY PATIENT

ANZ JOURNAL OF SURGERY, Issue 7 2008
Biswadev Mitra
Introduction: Severe traumatic head injury in the elderly has been associated with poor outcomes. However, there is currently no consensus to direct management in these patients. This study outlines the demographics, injury characteristics, management and outcome of the elderly trauma patients with severe head injury across a defined population. Materials and Methods: A retrospective review of all elderly patients (age >64 years) with a Glasgow Coma Scale (GCS) score of 8 or less, and confirmed intracranial pathology or fractured skull, was undertaken over a period of 40 months from July 2001 to September 2005. Data on patient demographics, injury cause, presenting clinical features and interventions were collected. In-hospital mortality was used as the primary outcome. Results: There were 96 patients who met the inclusion criteria. One-third of the patients were managed palliatively, one-third supportively without surgery and another third underwent surgery. Overall mortality was 70.8% (n = 68). Older age and brainstem injuries were identified as independent predictors of mortality. Mortality was reported in all patients aged 85 years or older. Conclusions: Although overall outcomes were poor, careful consideration should be given to active treatment as favourable outcomes were possible even in the presence of extremely low GCS scores. Prediction of outcome on the basis of age and anatomical diagnoses may help in this decision-making. [source]

TREATMENT FOR DUCTAL CARCINOMA IN SITU IN AN ASIAN POPULATION: OUTCOME AND PROGNOSTIC FACTORS

ANZ JOURNAL OF SURGERY, Issue 1-2 2008
Esther W. L. Chuwa
Background: Breast cancer is the most common cancer among Singapore women and ductal carcinoma in situ (DCIS) is believed to be the precursor of most invasive breast cancers. The incidence of DCIS has increased dramatically with mammographic screening, but its treatment remains controversial. Further, results of treatment for DCIS in Asians, and in particular Singapore women, are lacking. We review our institution's results treating a predominantly Chinese population with DCIS of the breast before the introduction of mammographic screening and aim to determine treatment outcomes and identify prognostic factors for disease recurrence. Methods: Between January 1994 and December 2000, 170 consecutive patients with DCIS were treated at our institution. One hundred and three (60.5%) were managed with breast conservation (17 with local wide excision alone and 86 with adjuvant irradiation following wide excision) whereas 67 (39.4%) underwent mastectomy. Of those who underwent wide local excision, 56 (54.3%) underwent re-excision for margin clearance. Overall, the axilla was surgically staged in 47 (27.6%) and no nodal involvement was found in all cases. Pathological specimens were reviewed by one of the authors. Median follow up was 86 months (range 4,151 months). Results: Sixty-two patients (36%) were asymptomatic at presentation whereas most (64%) presented with clinical symptoms; out of these more than half (54%) presented with a palpable lump. The median size of tumours was 13 mm (range 1.5,90 mm). Patients who underwent breast conservation surgery had oncologically more favourable lesions , with a significantly higher incidence of smaller and non-palpable lesions and lesions of lower nuclear grade. However, there was also a significantly higher incidence of local recurrence in this group. At the end of follow up, there were 12 patients (7.1%) who developed local recurrence and 8 patients (4.7%) developed contralateral disease. The crude incidence of all breast events (including both local failure and contralateral events) at 5 years was 5.6%. Median time to the development of any breast event (local recurrence or contralateral disease) was 60 months (range 12,120 months). The cumulative 5-year recurrence-free survival for patients who underwent breast conservation surgery was 94%. Factors influencing local recurrence rate were close or involved margins (,1 mm) and lack of adjuvant radiotherapy. There were no cancer-specific deaths during the period of follow up. Conclusion: Our results indicate that rates of cancer-specific survival were similar after mastectomy and breast conserving surgery. However, a close or involved margin (,1mm) and lack of adjuvant radiotherapy were associated with local recurrence, with margin status being the independent predictor for local recurrence. Our results reinforce that optimizing local therapy is crucial to improve local control rates in women treated with DCIS in our population. [source]

USE OF PORCINE SMALL INTESTINAL SUBMUCOSA IN BLADDER AUGMENTATION IN RABBIT: LONG-TERM HISTOLOGICAL OUTCOME

ANZ JOURNAL OF SURGERY, Issue 1-2 2008
Ali Ayyildiz
Aim: To investigate long-term histological features of bladder augmentation using porcine small intestine submucosa (SIS) in a rabbit model. Materials and method: Sixteen New Zealand rabbits were used. Porcine SIS was provided by a manufactured formation derived from the pig. After partial cystectomy was carried out on the bladder, a single layer of SIS (Cook® -SIS Technology, Cook Biotech Incorporated, West Lafayette, IN, USA) (2 × 5 cm) was sewn to bladder with continuous 5/0 vicryl suture material in a watertight manner. Urinary diversion was not used. The rabbits were killed 12 months later and perivesical fat was removed together with bladder. The 5-,m preparations taken from the samples were stained with haematoxylin,eosin and Mason's trichrome dye. S-100 and F8 stains were also used for immunohistochemical investigations. Results: The macroscopic view of bladder was normal. SIS was indistinguishable from normal bladder wall, but the region of the graft had a slight white coloration. Microscopic observations showed the continuity of transitional epithelium of host bladder tissue on SIS material. Detrusor and serosal layers were formed and these layers were indistinguishable from host bladder. Fibroblasts were scattered among the collagen fibrils. New vessel formations were present without lymphatic proliferation. Nerve regeneration was excellent. No inflammation was observed in normal and regenerated bladder wall. Conclusion: At the end of 12 months, the long-term histological features of bladder augmentation with porcine SIS in a rabbit model, such as presence of new vessel formations, nerve regeneration, collagen and smooth muscle regenerations, which were indistinguishable from original bladder, and the absence of inflammation, showed that SIS seems to be a viable alternative to the use of intestine in bladder augmentation. [source]

SURGICAL OUTCOME OF SUPERFICIAL AND DEEP CASTLEMAN DISEASE

ANZ JOURNAL OF SURGERY, Issue 5 2007
Chih-Hao Chen
Background: Castleman disease is a rare lymphoproliferative disease of low malignant potential occurring in two forms, unicentric and multicentric. Surgery, chemotherapy, immunotherapy and radiation therapy have all been used to manage the disease. In this study, we evaluate whether the site of the lesions, that is, superficial or deep, influences the surgical outcome. Methods: We retrospectively reviewed the records of 20 patients operated on for Castleman disease from 1994 to 2003, of whom 11 patients had superficial disease and 9 had deep lesions. The end-points of this study were survival and recurrence. Results: Of the 20 patients, 19 had unicentric (cervical in 8, mediastinal in 5, retroperitoneal in 2, axillary in 2, hepatic in 1, and mesenteric in 1) and 1 had multicentric Castleman disease. Among 19 patients who had complete resection (18 with unicentric and 1 with multicentric disease), there has been no evidence of recurrence. Conclusion: Whether Castleman disease is superficial or deep has no effect on surgical outcome as long as resection is complete. [source]

GS13P OUTCOME OF TRANS-ANAL EXCISION FOR RECTAL CANCER

ANZ JOURNAL OF SURGERY, Issue 2007
S. Banerjee
Aims The aim of this study is to assess the outcome of trans-anal excision of rectal cancer in a single Surgeon's practice and determine possible selection criteria for this procedure. Methods Retrospective review of hospital records, specimen histopathology and imaging of consecutive patients with rectal cancer undergoing trans-anal excision as the primary treatment. Results 25 patients had trans-anal excision of rectal cancer including 3 cases of carcinoid tumour and 1 case of gastro-intestinal stromal tumour (GIST). 5/25 proceeded to radical rectal resection because of the presence of adverse features including lympho-vascular and peri-neural invasion and poorly differentiated cell type; residual tumour was present in 4/5 cases, nodal metastases in 3/5 patients each of whom received pre-operative chemotherapy and radiotherapy. 2/25 patients developed recurrence at 12 and 48 months from excision. One of these patients had distant recurrence at 12 months having proceeded to radical rectal resection and the other patient (aged 99), managed with trans-anal excision alone, recurred locally at 48 months. Both cases of recurrence were T3 tumours. Overall, 19/20 cases managed with trans-anal excision alone had no recurrence with a follow-up period of 12,48 months. 16 of these patients had T1 malignancy. Conclusion T1 tumours may be treated with trans-excision alone in the absence of adverse pathological features. It is unclear from our study whether T2 should be managed in this way due to their small number in this study and T3 tumours are clearly at high risk of recurrence with this treatment alone. [source]

MARGINS AND OUTCOME OF SCREEN-DETECTED BREAST CANCER WITH EXTENSIVE IN SITU COMPONENT

ANZ JOURNAL OF SURGERY, Issue 7 2006
Paul R. B. Kitchen
Background: In situ disease surrounding invasive tumours is an important consideration in the management of patients with early breast cancer. This study of screen-detected breast cancers assessed the influence of in situ disease including an extensive in situ component (defined as ductal carcinoma in situ involving more than 25% of the area within the invasive tumour) on surgical management, local recurrence and survival of a group of patients. Methods: A total of 595 cases of invasive breast cancer detected at St Vincent's BreastScreen were retrospectively reviewed to determine presence and extent of in situ disease, the surgical procedure and adequacy of excision. Outcome was examined in a cohort of 126 cases. Results: A total of 438 (74%) patients had in situ foci in or around the invasive tumour and 107 (18%) were defined as extensive in situ component (EIC)-positive. The initial procedure was mastectomy in 20% of the cases and breast-conserving surgery in 80% including 18% who underwent further surgery. Re-excision (P = 0.02) or mastectomy (P = 0.01) was more often required in patients with EIC. After definitive local excision, margins were close or involved with invasive disease in 3% but the patients with EIC were more likely to have margins close or involved with in situ disease (16 vs 2%; P = 0.001). There were seven deaths and one local invasive recurrence in the follow-up group and none of the deaths were in patients who were EIC-positive. Conclusions: EIC predicts for a higher rate of re-excision and/or mastectomy. For patients with EIC, there is an acceptably low risk of local recurrence if margins are clear. [source]

EFFECT OF RESECTION AND OUTCOME IN PATIENTS WITH RETROPERITONEAL SARCOMA

ANZ JOURNAL OF SURGERY, Issue 6 2006
Antonio Chiappa
Background: A consecutive series of 47 patients with retroperitoneal sarcoma (RPS) were resected and prospectively followed. Method: Between July 1994 and March 2005, 47 patients (24 men, 23 women; mean age, 56 years; range, 17,82 years) were evaluated. Results: A total of 23 patients had primary RPS and 24 patients had recurrent RPS. A total of 30 out of 47 patients (64%) underwent removal of contiguous intra-abdominal organs. The peroperative mortality was nil and significant preoperative complications occurred in eight cases only (17%). High tumour grade and incomplete resection were significant variables for a worse survival in all 47 patients, both in the univariate and multivariate analyses (P = 0.008 and P = 0.016, respectively). Among 28 radically resected patients, only histological grade affected overall survival (90% 5-year survival for low-grade tumour vs 26% 5-year survival for high-grade tumour; P = 0.006) with a similar effect noted for disease-free survival. Conclusions: Histological grade was the only factor that affected overall and disease-free survival for RPS tumours. An aggressive surgical approach in both primary and recurrent RPS is associated with long-term survival. [source]

ANTERIOR TONGUE CANCER: AGE IS NOT A PREDICTOR OF OUTCOME AND SHOULD NOT ALTER TREATMENT

ANZ JOURNAL OF SURGERY, Issue 11 2003
Michael J. Veness
Background: Mucosal head and neck cancers usually occur in older males after years of smoking and alcohol abuse. Despite this, approximately 5% of cases occur in young adults. The aetiology remains unclear and the anterior tongue is a prevalent site. Prognosis has been reported as worse in young patients and some have proposed a more aggressive treatment approach. Methods: Patients diagnosed with previously untreated anterior tongue squamous cell carcinoma and treated with curative intent were identified. Retrospective and prospective data were collected. Univariate and multivariate analyses were undertaken using Cox regression analysis. The outcome of patients treated with anterior tongue cancer using a cut-off age of 40 years was compared. Results: Between 1980 and 2000, 106 males and 58 females with anterior tongue squamous cell carcinoma were treated at Westmead Hospital. Median follow up was 47 months (6,210 months). Twenty-two patients (13.4%) were aged ,40 years. Other than age, patient demographics, TNM stage and treatment approach were similar between the two groups. Eighty-one per cent had either a T1 or T2 primary. In total, 139 patients (84.8%) had surgery or surgery and radiotherapy. A total of 56 (34%) patients experienced a recurrent event, with nodal recurrence occurring most often as the first site (n = 33, 59%). Young patients had a higher recurrence rate (45.5% vs 32.4%; P = 0.23). Relapse-free survival at 5 years was 62% versus 81% (P = 0.27). Overall survival at 5 years was 65% versus 67% (P = 0.74). Conclusions: In keeping with recently published evidence, young age at diagnosis with anterior tongue cancer did not portend worse outcome. There is therefore currently no strong evidence to support a different treatment approach in young patients. [source]

OUTCOME AFTER CYTOREDUCTIVE NEPHRECTOMY FOR METASTATIC RENAL CELL CARCINOMA IS PREDICTED BY FRACTIONAL PERCENTAGE OF TUMOUR VOLUME REMOVED

BJU INTERNATIONAL, Issue 7 2008
Magdi Kirollos
No abstract is available for this article. [source]

PALLIATIVE TRANSURETHRAL RESECTION OF THE PROSTATE: FUNCTIONAL OUTCOME AND IMPACT ON SURVIVAL

BJU INTERNATIONAL, Issue 4 2007
Makarand Khochikar
No abstract is available for this article. [source]

THE EFFECTS OF FISCAL AND MONETARY DISCIPLINE ON BUDGETARY OUTCOMES

CONTEMPORARY ECONOMIC POLICY, Issue 2 2007
BILIN NEYAPTI
This article extends the model of Von Hagen and Harden that analyzed the impact of fiscal discipline on budgetary outcomes. We modify the model by adding monetary discipline to interact with fiscal discipline in order to analyze the effects of both on budgetary outcomes. The model predicts that while both inflation and budget deficits are negatively associated with fiscal discipline, they may be positively associated with monetary discipline, proxied by central bank independence. This result obtains due to optimizing agents internalizing the burden of spending: inflation. Although not conclusive due to data limitations, empirical findings also support these predictions. (JEL D73, E58, H61, H72) [source]

PUNISHING THE "MODEL MINORITY": ASIAN-AMERICAN CRIMINAL SENTENCING OUTCOMES IN FEDERAL DISTRICT COURTS,

CRIMINOLOGY, Issue 4 2009
BRIAN D. JOHNSON
Research on racial and ethnic disparities in criminal punishment is expansive but remains focused almost exclusively on the treatment of black and Hispanic offenders. The current study extends contemporary research on the racial patterning of punishments by incorporating Asian-American offenders. Using data from the United States Sentencing Commission (USSC) for FY1997,FY2000, we examine sentencing disparities in federal district courts for several outcomes. The results of this study indicate that Asian Americans are punished more similarly to white offenders compared with black and Hispanic offenders. These findings raise questions for traditional racial conflict perspectives and lend support to more recent theoretical perspectives grounded in attribution processes of the courtroom workgroup. The article concludes with a discussion of future directions for research on understudied racial and ethnic minority groups. [source]

RESISTING CRIME: THE EFFECTS OF VICTIM ACTION ON THE OUTCOMES OF CRIMES

CRIMINOLOGY, Issue 4 2004
JONGYEON TARK
This study assessed the impact of sixteen types of victim self protection (SP) actions on three types of outcomes of criminal incidents: first, whether the incident resulted in property loss, second, whether it resulted in injury to the victim, and, third, whether it resulted in serious injury. Data on 27, 595 personal contact crime incidents recorded in the National Crime Victimization Survey for the 1992 to 2001 decade were used to estimate multivariate models of crime outcomes with logistic regression. Results indicated that self-protection in general, both forceful and nonforceful, reduced the likelihood of property loss and injury, compared to nonresistance. A variety of mostly forceful tactics, including resistance with a gun, appeared to have the strongest effects in reducing the risk of injury, though some of the findings were unstable due to the small numbers of sample cases. The appearance, in past research, of resistance contributing to injury was found to be largely attributable to confusion concerning the sequence of SP actions and injury. In crimes where both occurred, injury followed SP in only 10 percent of the incidents. Combined with the fact that injuries following resistance are almost always relatively minor, victim resistance appears to be generally a wise course of action. [source]

OUTCOMES AND EXPERIENCE: NEW PRIORITIES FOR MUSEUMS

CURATOR THE MUSEUM JOURNAL, Issue 1 2001
Judith C. Siegel
First page of article [source]

P-25 DOES THE PRESENCE OF KOILOCYTES IN A BNA SMEAR AFFECT CLINICAL OUTCOMES?

CYTOPATHOLOGY, Issue 2006
L. Alexander
Introduction:, There is ongoing debate about the terminology used in the classification of dyskaryosis, including whether BNA smears should be classified according to whether koilocytes are present or not. We explored the effect of koilocytosis in the management experiences and clinical outcomes of women with a single BNA smear. Methods:, This study includes 410 women aged 20,59 years, resident in Tayside who had an ,baseline' BNA smear between 31/10/1999 and 31/10/2002 who were eligible for the TOMBOLA trial but who did not participate. Recommended follow-up for these women was a repeat smear in six months. Up to three-years follow-up data was collected on subsequent cytological smears, colposcopy examinations and any related histology. The baseline smear was re-read for the presence or absence of koilocytes. Women were classified according to their clinical outcomes during their three years. Results:, 47% (192/410) of women were classified as having koilocytosis at baseline. The mean age was lower among these women (25 years) compared to those without koilocytosis (35 years). 55% (105/192) of women with koilocytosis at baseline had one or more negative smears and no further abnormal smears, compared to 63% (137/218) of those without koilocytosis, the difference was not statistically significant. 28% (53/192) of women with koilocytosis at baseline were referred to colposcopy after subsequent low-grade or high-grade smears compared to 19% (42/218) of those without koilocytosis; the difference was statistically significant. 14% (27/192) of women with koilocytosis at baseline were diagnosed with CIN2/3 or worse during follow-up compared to 10% (21/218) of women without koilocytosis; the difference was not statistically significant. Discussion:, Our results suggest that the presence or absence of koilocytosis has little impact on the clinical outcomes of women with a BNA smear. [source]

CULTURAL DIVERSITY, DISCRIMINATION, AND ECONOMIC OUTCOMES: AN EXPERIMENTAL ANALYSIS

ECONOMIC INQUIRY, Issue 2 2007
PAUL J. FERRARO
Does cultural diversity affect economic outcomes? We develop an experimental framework that complements ongoing research on this question. We vary the ethnic mix of bargaining sessions to study intercultural interactions among members of U.S. Hispanic and Navajo cultures. We control for demographic differences in our subject pools and elicit beliefs directly in order to differentiate between statistical discrimination and preference-based discrimination. Hispanic and Navajo subjects behave differently, and their behavior is affected by the ethnic composition of the experimental session. Our experimental framework can shed light on economic behavior and outcomes in societies of mixed ethnicity, race, and religion. (JEL C78, C90, Z10) [source]

MEASUREMENT AND CLASSIFICATION OF PRENATAL ALCOHOL EXPOSURE AND CHILD OUTCOMES: TIME FOR IMPROVEMENT

ADDICTION, Issue 8 2009
COLLEEN M. O'LEARY
No abstract is available for this article. [source]

MORBIDITY AND OUTCOMES OF UROGYNECOLOGICAL SURGERY IN ELDERLY WOMEN

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2010
Patrick F. Vetere MD
No abstract is available for this article. [source]

Guidelines Abstracted from the Department of Veterans Affairs/Department of Defense Clinical Practice Guideline for the Management of Stroke Rehabilitation

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2006
Miriam Rodin MD
OBJECTIVES: To assist facilities in identifying those evidence-based processes of poststroke care that enhance measurable patient outcomes. The guideline(s) should be used by facilities (hospitals, subacute-care units and providers of long-term care) to implement a structured approach to improve rehabilitative practices and by clinicians to determine best interventions to achieve improved patient outcomes. OPTIONS: The guideline considers five elements of poststroke rehabilitation care: interdisciplinary teams; use of standardized assessments; intensity, timing, and duration of therapy; involvement of patients' families and caregivers in decision-making; and educational interventions for patients, families, and caregivers. Evidence, benefits, harms, and recommendations for each of the five designated elements and specific annotated recommendations for poststroke managements are presented separately. OUTCOMES: The overall guideline considers improvement in functional status measures as the primary outcome. Achieving community-dwelling status and preventing complications, death, and rehospitalization are also important outcomes. Costs are not specifically addressed. PARTICIPANTS: The Department of Veterans Affairs/Department of Defense (VA/DoD) Stroke Rehabilitation Working Group consisted of 28, largely VA and military hospital, representatives of medical and allied professions concerned with stroke diagnosis, management, and rehabilitation. Nine additional members with similar credentials served as the editorial committee. Technical consultation was contracted from ACS Federal Health Care, Inc., and the Center for Evidence-Based Practice, State University of New York,Upstate Medical University, Department of Family Medicine conducted evidence appraisal. Consensus was achieved over several years of facilitated group discussion and iterative evaluation of draft documents and supporting evidence. SPONSOR: The guideline was prepared under the auspices of the VA/DoD. No other source of support was identified in the document, or supporting documents. [source]

SUPPLY MANAGEMENT, SUPPLY FLEXIBILITY AND PERFORMANCE OUTCOMES: AN EMPIRICAL INVESTIGATION OF MANUFACTURING FIRMS

JOURNAL OF SUPPLY CHAIN MANAGEMENT, Issue 3 2010
YING LIAO
Increasingly, the global market environment is becoming more turbulent, complex and uncertain. Literature has explored the importance of supply management and its direct impact on performance. However, the nature of strategic supply management and its impact on supply flexibility needs further clarification in the context of the use of supplier resources and supplier network coordination. This research presents a model of supply management, supply flexibility and supply chain performance. In this study, we examine the relationships between supply management and supply flexibility, and extend the concept of supply flexibility in terms of supplier flexibility and supply network flexibility on relevant supply chain performance measures. Data for the study were collected from 201 manufacturing firms, and the measurement scales of supply flexibility were tested and validated using structural equation modeling. The results indicate strong, positive and direct relationships between supply management practices and supply flexibility, and between supply flexibility and supply chain performance. Concluding theoretical and managerial implications are discussed. [source]

EMBEDDED CONTRASTS IN RACE, MUNICIPAL FRAGMENTATION, AND PLANNING: DIVERGENT OUTCOMES IN THE DETROIT AND GREATER TORONTO,HAMILTON REGIONS 1990,2000

JOURNAL OF URBAN AFFAIRS, Issue 2 2009
A. J. JACOBS
ABSTRACT:,Since the early 1980s, scholars have debated whether or not the converging forces of globalization have disembedded city-regions from their national contexts. This study explored this question through a comparison of post-1990 growth trends in the Detroit and Greater Toronto Area,Hamilton regions (GTAH), two urban areas within the same natural region and closely linked by industrial production flows, yet politically situated within two separate Federalist states. Guided by Nested City Theory, it reveals how their dissimilar contexts for race, local autonomy, and multilocal planning have helped foster divergent spatial patterns in the two regions. In particular, provincial controls governing municipal fragmentation, Ontario's Planning Act, and subregional/microregional planning have been key embedded structures helping to limit population decline and disinvestment in GTAH core cities. In the process, this article shows how urban trajectories have remained nested within multilevel spatial and institutional configurations. Its findings also call for greater consideration of nested state/provincial factors in cross-national comparisons of cities within Federal states. Finally, its conclusion offers a starting point toward a more nuanced specific version of Nested Theory to be called the Contextualized Model of Urban,Regional Development. [source]

INDETERMINATE RESULTS IN CORE BIOPSIES OF BREAST FROM MAMMOGRAPHICALLY DETECTED LESIONS: OUTCOMES OF EXCISION BIOPSY

PATHOLOGY INTERNATIONAL, Issue 12 2001
Harvey J
INTRODUCTION: Protocols for excision of mammographically detected lesions following core biopsy include all diagnoses of atypical ductal hyperplasia (ADH) or intraductal atypia of uncertain significance (AUS). The aims of this study were to look at: i) the prevalence of reporting ADH and AUS, ii) the proportion of cases where excision revealed breast carcinoma, iii) whether any cases could be downgraded to hyperplasia on review. METHODS: Breast core biopsy reports from the SCGH Breast Centre for the years 1999,2000 were retrieved. The results of excision biopsy were obtained and slides reviewed. RESULTS: There were 1048 core biopsies from 911 women. Breast carcinoma was diagnosed in 197 samples (18.8%) including 88 with invasive carcinoma (8.4%), 109 with ductal carcinoma in situ (10.4%) and 3 samples (2.9%) suspicious of invasive carcinoma. The suspicious cases all proved to be invasive carcinomas. There were 53 samples (5.1%) with a diagnosis of ADH or AUS. 46 were excised, showing 7 invasive carcinomas 15 DCIS, 11 ADH, 2 lobular carcinoma in situ (LCIS), 1 mucocoele-like lesion, 1 fibroadenoma and 9 fibrocystic change (FCC). The 22 malignancies represented 47.8% of the excised lesions. At review, 8 of the 53 original diagnoses were downgraded to benign hyperplasia; 5 underwent excision; 2 showed ,incidental' invasive carcinomas, 1 ,incidental' LCIS, 1 ADH and 1 FCC. CONCLUSIONS: There was a low prevalence of reporting of ADH and AUS in core biopsies (5.1%) and a high rate of carcinoma (47.8%) in subsequent excision biopsies. Very few diagnoses of ADH/AUS were downgraded at review. Current protocols for excision of lesions with a core biopsy diagnosis of ADH/AUS appear to be justified. [source]