Safety vs. reputation: risk controversies in emerging policy networks regarding school safety in the Netherlands

This article deals with risk controversies in emerging policy networks regarding school safety in the Netherlands. It offers a grounded account of the interpretations of school risks and safety measures by the various stakeholders of the policy network, in particular, schools, local government and the police. Theoretically, policy networks are conceived as mediating between the structural conditions of the risk-society and the culture of fear on the one hand and the institution of safety standards on the organizational level of schools on the other hand. It is argued that in the low-risk context of schools, it is particularly important to take into account the soft, cultural side of safety next to the hard, material side of safety. This distinction also accounts for the ambiguities and controversies over school risks. A further conclusion is that in this network a lack of local leadership seems to hinder the development of firm safety measures. Overall, this article highlights the paradox between a concern for safety and a concern for a schools reputation. © 2012 Taylor & Francis

Report of the international conference on manufacturing and testing of pluripotent stem cells

Personalised Therapeutic

Axillary recurrence after a tumor-positive sentinel lymph node biopsy without axillary treatment: a review of the literature

Item does not contain fulltextBACKGROUND: Sentinel lymph node biopsy (SLNB) has become standard of care as a staging procedure in patients with invasive breast cancer. A positive SLNB allows completion axillary lymph node dissection (cALND) to be performed. The axillary recurrence rate (ARR) after cALND in patients with positive SLNB is low. Recently, several studies have reported a similar low ARR when cALND is not performed. This review aims to determine the ARR when cALND is omitted in SLNB-positive patients. METHODS: A literature search was performed in the PubMed database with the search terms "breast cancer," "sentinel lymph node biopsy," "axillary" and "recurrence." Articles with data regarding follow-up of patients with SLNB-positive breast cancer were identified. To be eligible, patients should not have received cALND and ARR should be reported. RESULTS: Thirty articles were analyzed. This resulted in 7,151 patients with SLNB-positive breast cancer in whom a cALND was omitted (median follow-up of 45 months, range 1-142 months). Overall, 41 patients developed an axillary recurrence. 27 studies described 3,468 patients with micrometastases in the SLNB, of whom 10 (0.3 %) developed an axillary recurrence. ARR varied between 0 and 3.7 %. Sixteen studies described 3,268 patients with macrometastases, 24 (0.7 %) axillary recurrences were seen. ARR varied between 0 and 7.1 %. Details regarding type of surgery and adjuvant treatment were lacking in the majority of studies. CONCLUSIONS: ARR appears to be low in SLNB-positive patients even when a cALND is not performed. Withholding cALND may be safe in breast cancer selected patients such as those with isolated tumor cells or micrometastatic disease