Atypical Ductal Hyperplasia at the Margin of Lumpectomy Performed for Early Stage Breast Cancer: Is there Enough Evidence to Formulate Guidelines?

Background. Negative margins are associated with a reduced risk of ipsilateral breast tumor recurrence (IBTR) in women with early stage breast cancer treated with breast conserving surgery (BCS). Not infrequently, atypical ductal hyperplasia (ADH) is reported as involving the margin of a BCS specimen, and there is no consensus among surgeons or pathologists on how to approach this diagnosis resulting in varied reexcision practices among breast surgeons. The purpose of this paper is to establish a reasonable approach to guide the treatment of ADH involving the margin after BCS for early stage breast cancer. Methods. the published literature was reviewed using the PubMed site from the US National Library of Medicine. Conclusions. ADH at the margin of a BCS specimen performed for early stage breast cancer is a controversial pathological diagnosis subject to large interobserver variability. There is not enough data evaluating this diagnosis to change current practice patterns; however, it is reasonable to consider reexcision for ADH involving a surgical margin, especially if it coexists with low grade DCIS. Further studies with longer followup and closer attention to ADH at the margin are needed to formulate treatment guidelines

A War of Words: How Fundamentalist Rhetoric Threatens Reproductive Autonomy

This Comment argues that the recent use of the term adoption to define the decision of one couple to donate an unused embryo to a different couple for implantation is simply an attempt by those opposed to abortion to chip away at reproductive rights

Increasing Student Motivation In English Language Arts Through Student Choice

The purpose of this capstone project was to design and implement a digital website where resources are readily available for teachers and students in order to increase motivation in reading. This project sought to answer the question Can providing student choice improve student motivation in a middle school English Language Arts class? My love of reading happened early in my life and it has made me a lifelong reader, and this inspired me to instill that love in middle school students. The research conducted in this capstone indicates that increasing student engagement in reading is highly dependent upon building student motivation, including allowing student choice, presenting students with literature relevant to them, and student interest. This increase could in fact lead to an increase in student reading success. The website provides several ways to do this: literature circles, independent reading, and encouragement options (book brochures, book trailers, and first chapter Fridays). Therefore, this project was designed to provide sixth, seventh, and eight grade ELA teachers with digital resources that will allow students to grow as readers, improve student academic achievement, and save teachers prep-time. With the nation continuing to score below average in reading proficiency, it is imperative that educators increase student motivation in reading in order to increase their reading proficiency and this project will help with that goal

I am because WE are

Youth of today are given a bad name when relating to behavior and understanding of those behaviors. Many of those who are giving those bad reps do not spend relatable time with youth. Relatable time is when time spent with youth is not demanding but getting to know the youth as a person. During my time with youth, the best rapport I developed was when I had conversations that were accepting and understanding. So I started performing youth groups to see if the dynamics of the youth would change. IT did

Improving Access to Specialist Dental Services Using a Telehealth Platform in Victoria, Australia

Australians in rural and remote locations have worse health outcomes compared to that of their metropolitan counterparts and this is due in part to poor access to health services. Public specialist dental services in Victoria, Australia are predominantly offered in the capital city Melbourne. For rural patients this can mean considerable travel, out of pocket costs and delays due to long wait-times. In 2015 Dental Health Service Victoria (DHSV) embarked on a pilot project to enable access to rural clients by linking community dental clinics with the Royal Dental Hospital Melbourne using a Telehealth platform. Aim: The objectives of the pilot were to develop specialist care pathways and enable patient access, support community clinicians to work to full scope through a peer education approach and to identify the appropriate equipment and telehealth platform to support this model of care. Method: DHSV launched its pilot project June 2015 collaborating with four Community Dental sites. The specialties trialled during the pilot project were Oral Medicine, Oral Surgery, Endodontics and Orthodontics. An action based research framework was adopted so that improvements to the operational framework and clinical pathways could be made throughout the life of the pilot. Results: By the end of the pilot programme, DHSV was satisfied the program objectives had been met and the modality was accepted by specialists, community dentists, and patients as a satisfactory substitution for a traditional face-to-face referral and consult mode. Conclusion: Based on this outcome, the programme was endorsed and implemented across the state of Victoria in January 2018

QS-1000 vs. comment cards: A Study of measurement effectiveness

This study is a comparison of typical customer comment cards in comparison to the QS-1000 survey computer. Each of these instruments can be used to gather data from customers regarding their opinions on service. As compettion throughout the service industry increases, the need for businesses to obtain data from their customers is more significant. Service organizations must also find ways to gather this data at a relatively low cost to themselves. Each of the above survey tools will enable an organization to collect data from customers. The study details collection from two samples and concludes on which is more effective in the areas of readability of data, ease of use, and accuracy. The study went about collecting data by surveying two samples and cross referencing the data obtained. This enabled the survey manager an opportunity to discuss with customers their opinions of each method. It also allowed for some conclusions to be made as stated above. The QS-1000 was seen as the more effective method due to the ease of analysis as well as the ease of use to both the organization and its customers

An athletic approach to studying perception-action integration: Does sport-specific training, and the impact of injury, influence how individuals visually guide navigation?

The objective of this thesis was to investigate perception-action integration capabilities of individuals during a choice navigation task. This task assessed navigation strategies in open space while individuals avoided colliding with two vertical obstacles that created a body-scaled, horizontal gap, at three varying obstacle distances from the starting location (3m, 5m, 7m). The two studies completed in this thesis employed the same paradigm to assess the hypothesized group differences. Gaze behaviours and kinematics of navigation strategies were compared between: 1) athletes specifically trained in navigating in open space versus non-athletes; and 2) athletes with post-concussion syndrome (PCS) versus non-concussed, specifically trained athletes. Specifically trained athletes have been identified as demonstrating more successful perception-action integration in discrete motor tasks related to their sport (Mann et al., 2007; Vickers, 2007). However, whether these abilities translate to the continuous motor task of obstacle avoidance in open space was unknown. The purpose of Study 1 was to identify the influence of sport-specific training on navigating in open space (i.e. navigational strategies of large field sport athletes) compared to age-matched, non-athletes. It was hypothesized that specifically-trained athletes would demonstrate fewer, longer fixations, suggesting a more successful perception-action integration strategy (as defined by Mann et al., 2007), and would employ more sport-specific navigation strategies than non-athletes by maintaining their straight trajectory toward the goal (Fajen & Warren, 2003). Athletes were found to make fewer, longer fixations than non-athletes. However, no differences were observed between navigation strategies of the two groups, nor were any kinematic measures found to differ between groups. It can be concluded that athletes and non-athletes differentially obtain visual information to perform the same actions, suggesting that athletes and non-athletes differentially perform perception-action integration when navigating in open space. Future studies are required to identify sport-specific nuances of navigation (moving obstacles, running) to better identify athletic-related navigation strategies. Although athletic training can enhance perception-action integration strategies, sport-related injuries can hinder this process. Following a concussion, individuals experience deficits of perception-action integration that persist well beyond 30 days of recovery, post-concussion (Baker and Cinelli, 2014; Slobounov et al., 2006). These perception-action integration deficits may also exist in individual with postconcussion syndrome (PCS). The purpose of the Study 2 was to identify whether perception-action integration deficits persist with the persistent physical symptoms of concussion characteristic of PCS. The current study revealed that athletes with PCS did not differ from non-concussed athletes on any measure of visual fixation strategy, nor were they found to differ on any kinematic measure assessed. These findings suggest that in the context of the current paradigm, athletes with PCS have no perception-action integration deficit. In that, athletes with PCS may have adapted perception-action integration strategies to navigate with equal efficiency as a specifically-trained group of athletes or that the paradigm was not sensitive enough to identify these differences. Such findings suggest that more research is required to assess what, if any, perception-action integration deficits persist with persisting physical symptoms of PCS to better benefit rehabilitative procedures and outcomes for these individuals. Together, these studies add to what was previously known about perception-action integration, as it relates to navigation. Both studies assessed perception-action integration in unique populations that add to understanding of behavioural dynamics in the sport setting. Study 1 builds on a line of research assessing affordance theory and behavioural dynamics in sport (Fajen, Riley, & Turvey, 2008). The findings of this study suggest that although navigation strategies did not differ between specifically trained athletes and non-athletes, visual search strategies employed in task did. Such findings add to the understanding that sport-specific training influences perception-action integration, through our understanding of how athletes obtain visual information to perform actions. This thesis did not identify perception-action integration deficits in athletes with PCS. These findings suggest that the individuals in the present study likely adapted to their injury as they demonstrated equal ability in gaze and navigation strategies to specifically-trained athletes. As such, further research is required to assess the cognitive, motor, and sensory-motor deficits that may persist with the persisting physical symptoms of PCS. As individuals with PCS do not demonstrate similar visuomotor integration deficits as individuals with acute concussions (Baker & Cinelli, 2014), such individuals must be assessed and researched as a separate population

Comparison of Toxicological Models for Evaluation of Air Pollutants: Response of the Pulmonary Alveolar Macrophage to Hexavalent Chromium

This study was designed to accomplish two primary objectives: (1) to compare two test methods commonly used to evaluate toxicity of inhaled air pollutants, and (2) to observe the response as measured by each of the methods, of pulmonary alveolar macrophages exposed to 2μg hexavalent chromium. The first method evaluated featured use of intratracheal injections to simulate live inhalation exposures, and the second required exposure of macrophages cultured on petri plates. Pulmonary alveolar macrophages harvested from Long Evans rats were used. The two cell function parameters measured in the evaluations were chemiluminescence and oxygen consumption (which was determined for cells at rest and during phagocytosis). These two tests have been shown to be sensitive indicators of macrophage damage. Results of CL output and oxygen consumption revealed the two methods were significantly different. Evaluation of macrophages from live animals treated with CrO3 or CaCrO4showed no differences between their respective untreated controls as determined by measurement of their chemiluminescence production or of oxygen consumption rates. Alveolar macrophages that were cultured in media during treatment with the same two forms of hexavalent chromium showed statistically significant differences from untreated controls. These comparisons indicate that choices of investigative toxicological models influence interpretation of data recorded