Overdiagnosis and overtreatment of breast cancer: Is overdiagnosis an issue for radiologists?

Overdiagnosis is diagnosis of cancers that would not present within the life of the patient and is one of the downsides of screening. This applies to low-grade ductal carcinoma in situ and some small grade 1 invasive cancers. Radiologists are responsible for cancer diagnosis, but at the time of diagnosis they cannot determine whether a particular low-grade diagnosis is one to which the definition of overdiagnosis applies. Overdiagnosis is likely to be driven by technological developments, including digital mammography, computer-aided detection and improved biopsy techniques. It is also driven by the patient's fear that cancer will be missed and the doctor's fear of litigation. It is therefore an issue of importance for radiologists, presenting them with difficult fine-tuned decisions in every assessment clinic that are ultimately counted later by those who evaluate their screening

Advanced life support (ALS) instructors experience of ALS education in Western Australia: A qualitative exploratory research study

Background: When cardiac arrest occurs, timely competent advanced life support (ALS) interventions by nursing staff can influence patient outcomes. Ongoing ALS education influences maintenance of competency and avoids skill decay. Objectives: To explore the methods of ALS education delivery for nurses in the workplace; describe the issues relating to maintaining ALS competency; explore ALS competency decay for nurses and develop recommendations for the provision of continuing ALS education. Design: A qualitative exploratory design was used to study ALS education provision in the workplace. Participants: Data were collected from ALS nurse experts in Western Australia by face-to-face and phone interviews. Methods: Semi-structured interviews were conducted and organised around a set of predetermined questions. Results: Two major themes were identified; the first theme Demand and Supply describes the increasing demand for ALS education for nurses and the challenges with providing timely cost effective traditional face-to-face ALS education. The second theme, Choosing The Best Education Options describes new ways to provide ALS education using emerging technologies. Conclusions: The study suggested that using e-learning methods would assist with educating the maximum amount of nurses in a timely manner and e-learning and teleconferencing offer opportunities to reach nurses in distant locations. Delivering ALS education more frequently than annually would increase skills maintenance and lessen skill decay. Further research is required to explore which blended e-learning model is best suited to ALS education

Beyond a neoclassical approach to household spending: Combination Modes theory

We use the ‘Combination Modes’ theory developed by Taplin (1989a), which claims that economic behaviour must be understood in terms of composite patterns of three ‘modes’: work, kinship, and ethnicity. We use data from a recent household survey in Bombay and Madras, to study spending on three types of time-saving food purchases: restaurant spending by husbands and by wives, and spending on ‘convenience’ foods. We find that a woman’s employment tends to increase her spending in restaurants, but not her household’s expenditure on convenience foods. We detect differences in spending patterns between nuclear and extended families. And we observe that descendants of immigrants from England, Portugal, and the Middle East appear to behave differently to the other residents of Bombay and Madras. We argue that these results offer support for the Combination Modes theory, and that this theory helps us to go beyond neoclassical economics, to give a more complete understanding of household behaviour. </jats:p

Achieving cooperation : hostages, trusts and contracts

Different societies use different mechanisms to assist people or organizations achieve cooperation. The purpose of this paper is to compare three different approaches to achieving cooperation. They are a contractual approach widely used in Anglo-Saxon societies, a trust approach more common in Asia, and a hostage approach widely used in the past and perhaps useful now in Eastern Europe or perhaps in some developing countries

Licensing for additional users and partner organizations: finding your way through the maze – a consortium perspective

Libraries are increasingly being called upon to extend access to their online resources to users beyond their core constituencies. Every institution has its own unique arrangements, but they all raise similar questions for the library: are these users included under our existing licences or are separate ones needed? Will we have to pay more and, if so, how much? Where can I go for advice? This article considers these questions and the related issues from the licensing perspective of an established UK higher education licensing consortium (Jisc Collections), and two individual UK university libraries (King’s College London and the University of Nottingham), using examples of licensing for additional users with partners who are from a different sector, and for students who are located in different countries

Understanding Labour Turnover in a Labour Intensive Industry: Evidence from the British Clothing Industry

The clothing industry is both a quintessential global industry and one that is inescapably labour intensive. Despite more and more production shifting to low wage economies in the past decades, there remains a significant amount of clothing manufacturing in high wage economies. This study examines the drivers of change that are forcing restructuring in one such country and the outcomes of such changes for the organization of production. Because the changes have involved treating workers as a resource to be developed rather than a cost, preventing labour turnover has become a crucial component of this strategic repositioning. In presenting the results of a national survey of UK clothing manufacturers we find that high labour turnover rates persist. We discuss the historical background to this phenomenon and current trends, and then explore the principal variables that might explain these trends. We conclude with a discussion of the outcomes facing firms in this industry and comment on why managers resist comprehensive changes in organizational routines and the effort bargain. Copyright Blackwell Publishing Ltd 2003.

What Do People Affected by Cancer Think About Electronic Health Information Exchange? Results From the 2010 LIVESTRONG Electronic Health Information Exchange Survey and the 2008 Health Information National Trends Survey

Responses to a 2010 survey by LIVESTRONG showed that, compared with the general population, persons affected by cancer had greater enthusiasm for electronic information exchange between patients and health care providers. Especially valued were security and privacy of communication