Randomized trial of breast self-examination in Shanghai: methodology and preliminary results

BACKGROUND: The efficacy of breast self-examination in helping to reduce mortality from breast cancer has not been rigorously demonstrated. PURPOSE: To assess efficacy, a large, randomized trial was initiated in Shanghai, China. METHODS: From October 1989 to October 1991, 267040 current and retired female employees associated with 520 factories in the Shanghai Textile Industry Bureau were randomly assigned on the basis of factory to either a self-examination instruction group (133375 women) or a control group (133665 women). The women were born within the period from 1925 through 1958. Women in the instruction group were given intensive training in breast self-examination, including the use of silicone breast models and personalized instruction, plus two subsequent reinforcement sessions and multiple reminders to practice the technique. Women in the control group were asked to attend training sessions on the prevention of low back pain. All women have been followed for the development of breast diseases and for death from breast cancer. RESULTS: A high level of participation during the first 4-5 years of the trial was documented among women in the instruction group. Randomly sampled women in this group demonstrated greater proficiency in detecting lumps in breast models than did randomly sampled women in the control group. Approximately equal numbers of breast cancers were detected in the two groups (331 in the instruction group and 322 in the control group) through 1994, which is the last year for which case-finding efforts have been completed. The breast cancers detected in the instruction group were not diagnosed at an appreciably earlier stage or smaller size than those in the control group. More benign breast lesions were detected in the instruction group than in the control group (1457 versus 623, respectively), suggesting a higher index of suspicion for women who received training. Cumulative breast cancer mortality rates through 5 years from entry into the study were nearly equivalent for the two groups. CONCLUSIONS: Breast self-examination has not led to a reduction in mortality from breast cancer in this study cohort in the first several years since the trial began. A shift toward the diagnosis of disease at a less advanced stage in women given instruction has also not been demonstrated. Longer follow-up of participants in this trial is required before final assessment can be made of the efficacy of breast self-examination. IMPLICATIONS: At this time, there is insufficient evidence to recommend for or against the teaching of breast self-examination.     

Modified oil agglomeration process for coal beneficiation. III. Grinding and agglomeration using different szego mill designs

The simultaneous grinding/agglormeration process has been used to beneficiate Minto coal. Experiments with the Szego Mill, a planetary ring-roller mill with grooved rollers, have given good results. Different roller ridge/groove sizes have been tested and favourable oil-coal-water ratios established. Ash removal is closely related to grinding performance. Very short mill residence times, of the order of 10 seconds, are sufficient for microagglomerate formation. Considerable equipment and operating cost savings are possible with the modified process.     

Perceived equity, motivation, and final-offer arbitration in major league baseball.

Final-offer salary arbitration in major league baseball offers a unique institutional arrangement that creates a naturally occurring, non-equivalent-groups, repeated measures research design. The structural arrangements allow for examination of anticipatory expectancy effects and assessment of behavioral responses consistent with equity theory predictions. In addition, equity theory can be tested without the methodological problems inherent in defining the referent other. Performance and mobility were examined for major league baseball position players who won and lost their arbitration hearings. Prearbitration performance significantly predicted arbitration outcome. A significant relationship was noted between losing arbitration and postarbitration performance decline. Losers were significantly more likely to change teams and leave major league baseball. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discriminating age-associated memory impairment from Alzheimer's disease.

The authors attempt to provide a better understanding of the differences between the normal memory decline characteristic of age-associated memory impairment (AAMI) and the pathological decline typical of mild Alzheimer's disease (AD). Batteries of traditional memory tests and computer-simulated everyday-memory tests discriminated between the 2 groups, which were matched on age, gender, and education, with reasonable degrees of accuracy (87.5% and 88.4%, respectively). False positives were the most frequent classification errors when using either battery. These results indicate that it is possible to use ecologically valid memory assessment paradigms without sacrificing discriminant validity. The clinical significance of discriminating mild AD from AAMI is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuroanatomy in Rett syndrome: cerebral cortex and posterior fossa

Rett syndrome (RS), a neurodevelopmental disorder of unknown etiology occurring almost exclusively in females, is characterized by autistic-like behavior, motor dysfunction, loss of language skills, dementia, and microcephaly. This study is a follow-up and extension of a previously reported neuroimaging study of patients with RS. We replicated previously reported findings with a larger patient population, and the volumetric MRI analysis was extended to include an analysis of neuroanatomy of the posterior fossa. Twenty girls with RS were compared with individually age- and gender-matched normal controls. Patients with RS showed global reduction in gray- and white-matter volumes. The prefrontal, posterior-frontal, and anterior-temporal regions showed the largest bilateral decrease in gray-matter volume, whereas white-matter volume was uniformly reduced throughout the brain. We found confirmation for the preferential reduction in caudate nucleus volume. However, we observed no preferential reduction in midbrain volume despite a preferential reduction in the midsagittal area of this region. We also present an individual case comparison between monozygotic twins discordant for RS.     

Genetic influences on job satisfaction: A reply to Cropanzano and James.

Responds to the points made by R. Cropanzano and K. James (see record 1991-00462-001) concerning the article by R. D. Arvey et al (1989). The authors acknowledge that the Arvey et al study is based on a single design, makes use of a small and special sample, and, as such, is vulnerable to threats of internal and external validity. Nevertheless, after providing a more comprehensive conceptual and empirical context for the study, and after reviewing a number of the issues raised by Cropanzano and James, the authors conclude that it is not premature to accept the idea that work attitudes are partially genetically influenced. Indeed, the authors use behavioral genetic theory, together with data gathered in the Arvey et al study, to make specific point predictions regarding the outcomes of an array of studies that easily can be undertaken. Finally, the authors acknowledge that the comments and issues raised by Cropanzano and James, along with the interchange, can offer directions for future research in this important area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sociodemographic factors and the variation in syphilis rates among US counties, 1984 through 1993: an ecological analysis

OBJECTIVES: Syphilis in the United States is focally distributed, with high incidence rates in the South and in metropolitan areas nationwide. In this study an ecological analysis, using the county as the unit of analysis, was performed to generate hypotheses about community-level determinants of syphilis rates. METHODS: Bivariate rank correlations and multivariate, backward stepwise elimination linear regressions were performed. Mean annual incidence of primary- and secondary-stage syphilis in a county was the dependent variable, and county sociodemographic characteristics (from census data) were the independent variables. RESULTS: In the multivariate regression model, sociodemographic characteristics accounted for 71% of the variation in syphilis rates among counties. With other factors accounted for, the most highly correlated characteristics were percentage non-Hispanic Black population, county location in the South, percentage of the population that was urban, percentage Hispanic population, and percentage of births to women younger than 20 years. CONCLUSIONS: Most of the variation in syphilis rates among counties is accounted for by sociodemographic characteristics. Identification and remediation of modifiable health determinants for which these factors are markers are needed to improve the health status of these populations.     

Order acceptance with weighted tardiness

Over the past decade the strategic importance of order acceptance has been widely recognized in practice as well as academic research. This paper examines order acceptance decisions when capacity is limited, customers receive a discount for late delivery, but early delivery is neither penalized nor rewarded. We model a manufacturing facility that considers a pool of orders, and chooses for processing the subset that results in the highest profit. We present several solution methods, beginning with a straightforward application of an approach which separates sequencing and job acceptance. We then develop an optimal branch-and-bound procedure that uses a linear (integer) relaxation for bounding and performs the sequencing and job acceptance decisions jointly. We develop a variety of fast and high-quality heuristics based on this approach. For small problems, beam search runs almost 20 times faster than the benchmark, with a high degree of accuracy, and a branch-and-bound heuristic using Vogel's method for bounding is over 100 times faster with very high accuracy. For larger problems, a myopic heuristic based on the relaxation runs 2000 times faster than the beam-search benchmark, with comparable accuracy.