Computerised morphometrical analysis in endometrial hyperplasia for the prediction of cancer development. A long term retrospective study from northern Norway

Aims—To evaluate and compare the long term prognostic value of the WHO classification and the computerised multivariate morphometrical D score in endometrial hyperplasia. To test the reproducibility of the D score in two different centres. Methods—Histopathological WHO classification and computerised morphometrical analysis using the D score (< 0, high risk; > 1, low risk; 0–1, uncertain) in a population based study from northern Norway of archival dilatation and curettage material from 68 women with 10–20 years of follow up. Results—Of the 68 patients included in the study, 18 developed cancer. The sensitivity and specificity of the D score (< 0 v > 1) were 100% and 78%, respectively, which was better than the WHO classification (89% and 60%, respectively). The negative and positive predictive values for the D score were 100% and 58% and of the WHO classification 94% and 44%, respectively. This study found a slightly higher specificity for the D score than former retrospective studies, but otherwise the results were comparable. The D score results were reproducible between the two centres (R = 0.91; slope = 0.98; intercept = 0.3). Conclusions—D score assessment is a reproducible and more accurate predictor of outcome of endometrial hyperplasia than the WHO classification assessed by an experienced gynaecological pathologist. Routine application of the D score might reduce over and undertreatment of endometrial hyperplasia. Key Words: endometrial hyperplasia • cancer • image analysis • prognostic classification rul

Seasonal Production and Biomass of the Seagrass, Halodule wrightii Aschers. (Shoal Grass), in a Subtropical Texas Lagoon

A study of Halodule wrightii in a shallow subtropical Texas lagoon was performed to obtain seasonal data on its physiological ecology. Leaf production and biomass dynamics of H. wrightii were intensively monitored along with the underwater light environment at a 1.2-m depth study site over a 21-month period from June 1995 to February 1997. The annual photosynthetically active radiation (PAR) flux of 6,764 mol m−2 year−1 was more than twice as high as 2,400 mol m−2 year−1, the minimum annual PAR required for maintenance of growth. As light intensity declined, blade chlorophyll a/b ratios increased suggesting that the plants were photo-adapting. Seasonal trends were evident in shoot growth and biomass. Compared to other Halodule populations in Texas, H. wrightii in LLM displayed slow growth and low biomass, high leaf tissue N content, and low C/N ratio but high N/P ratio of 38 suggesting that the plants were phosphorus-limited

Thinking disability orientation : practicing affirmation

Introduction: Occupational therapy’s theoretical base is informed by beliefs in empowerment, partnership, choice and hope — all key components in client-centred practice (Sumsion and Law 2006). In order to be client-centred, it is important to appreciate an individual’s perception of their own disability, known as their disability orientation. Disability orientation, as described by Darling and Heckert (2010), includes three aspects: disability identity; adherence to a particular model of disability, and involvement in disability rights activism. Each type of disability orientation will affect the disabled person’s beliefs and feelings about themselves, their impaired bodies and their disabled lives. This, in turn, is likely to influence their expectations of and satisfaction with occupational therapy services. Therefore, occupational therapists aiming to work within a client-centred approach should be cognisant of this concept and consider its possible impact on their therapeutic approach. This seminar will: – Explore the concept of disability orientation and discuss examples of different orientations; – Examine the affirmative disability orientation as it relates to occupational therapy; – Enable participants to analyse and understand their clients’ disability orientation; – Discuss strategies to provide intervention informed by a client’s disability orientation. Case studies will be used to promote discussion and explore practical ways to ascertain an individual’s disability orientation. The affirmative disability orientation will be discussed in particular. Impact on service users: Understanding disability orientation could lead to enhanced client-centred and culturally sensitive practice. Implications for occupational therapy: Contribution to the improvement of practice through the development of culturally sensitive therapeutic strategies