Although screening for cervical cancer has been shown to be effective in reducing the morbidity and mortality associated with this disease, and despite many attempts to encourage the development of provincial programs, as of 1995 no province had a comprehensive screening program for cervical cancer. Participants at the Interchange '95 workshop, held in Ottawa in November 1995, reviewed the recommendations of the 1989 National Workshop on Screening for Cancer of the Cervix and identified factors that have impeded their implementation. Participants discussed the need for comprehensive information systems, quality control and strategies to increase recruitment of unscreened and underscreened women. They concluded that the formation of a Cervical Cancer Prevention Network involving key stakeholders will facilitate the development and implementation of provincial programs to ensure optimal screening. They agreed that, in the interim, recommendations for practising physicians should remain as they were following the 1989 workshop.
Cites: Can Med Assoc J. 1980 Feb 23;122(4):417-237370844
In light of current debates on global climate change it has become important to know more on how large, roaming species have responded to environmental change in the past. Using the highly variable mitochondrial control region, we revisit theories of Rangifer colonization and propose that the High Arctic archipelagos of Svalbard, Franz Josef Land, and Novaia Zemlia were colonized by reindeer from the Eurasian mainland after the last glacial maximum. Comparing mtDNA control region sequences from the three Arctic archipelagos showed a strong genetic connection between the populations, supporting a common origin in the past. A genetic connection between the three archipelagos and two Russian mainland populations was also found, suggesting colonization of the Eurasian high Arctic archipelagos from the Eurasian mainland. The age of the Franz Josef Land material (>2000 years before present) implies that Arctic indigenous reindeer colonized the Eurasian Arctic archipelagos through natural dispersal, before humans approached this region.
We present the chain of mechanisms linking free radical catalytic loss of stratospheric ozone, specifically over the central United States in summer, to increased climate forcing by CO2 and CH4 from fossil fuel use. This case directly engages detailed knowledge, emerging from in situ aircraft observations over the polar regions in winter, defining the temperature and water vapor dependence of the kinetics of heterogeneous catalytic conversion of inorganic chlorine (HCl and ClONO2) to free radical form (ClO). Analysis is placed in the context of irreversible changes to specific subsystems of the climate, most notably coupled feedbacks that link rapid changes in the Arctic with the discovery that convective storms over the central US in summer both suppress temperatures and inject water vapor deep into the stratosphere. This places the lower stratosphere over the US in summer within the same photochemical catalytic domain as the lower stratosphere of the Arctic in winter engaging the risk of amplifying the rate limiting step in the ClO dimer catalytic mechanism by some six orders of magnitude. This transitions the catalytic loss rate of ozone in lower stratosphere over the United States in summer from HOx radical control to ClOx radical control, increasing the overall ozone loss rate by some two orders of magnitude over that of the unperturbed state. Thus we address, through a combination of observations and modeling, the mechanistic foundation defining why stratospheric ozone, vulnerable to increased climate forcing, is one of the most delicate aspects of habitability on the planet.
High abundances of iodine monoxide (IO) are known to exist and to participate in local photochemistry of the marine boundary layer. Of particular interest are the roles IO plays in the formation of new particles in coastal marine environments and in depletion episodes of ozone and mercury in the Arctic polar spring. This paper describes a ground-based instrument that measures IO at mixing ratios less than one part in 10(12). The IO radical is measured by detecting laser-induced fluorescence at wavelengths longer that 500 nm. Tunable visible light is used to pump the A(2)?3/2 (v(') = 2) ? X(2)?3/2 (v(?) = 0) transition of IO near 445 nm. The laser light is produced by a solid-state, Nd:YAG-pumped Ti:Sapphire laser at 5 kHz repetition rate. The laser-induced fluorescence instrument performs reliably with very high signal-to-noise ratios (>10) achieved in short integration times (
The purpose of the study was to identify dissociative experiences and disorders among women who are survivors of sexual abuse. Fifty-one women from two different centers who identified themselves as abuse survivors participated in the research interviews. The Dissociative Experiences Scale (DES) and the Dissociative Disorders Interview Schedule (DDIS) were used to collect data. The results indicated that 88.2% of the 51 women had a dissociative disorder of some type. Twenty-eight (54.9%) of the women had a DDIS diagnosis of multiple personality disorder (MPD). The women had high DES scores, a high number of secondary features of MPD, high rates of depression, borderline personality, substance abuse, somatic symptoms, Schneiderian symptoms, ESP/supernatural experiences, suicide attempts, and conversion symptoms. The vast majority of sexual abuse survivors in this sample have extensive dissociative symptomatology and related features. Therapists working with adult sexual abuse survivors should be knowledgeable about dissociation, should thoroughly assess a client's dissociative abilities, and should incorporate these findings into the therapy process.
Using data from a comprehensive prescription drug benefit program in British Columbia, we studied the distribution of prescription drug expenditures and exposures in the community-dwelling elderly over a 1-year period. Overall, 84% of the population was exposed to at least one prescription drug. The 11% of individuals with the highest level of use accounted for 50% of total drug expenditures. Individuals 65 to 74 years of age were exposed to a median of 2.2 different drugs during the year compared to a median of 3.8 for those 75 years of age and over. Twenty-four percent of the 65- to 74-year-old population were exposed to six or more different drugs during a 1-year period compared to 37% of the 75 years and over population. Central nervous system and cardiovascular drugs were most commonly responsible for multiple drug exposures. Forty-eight percent of the individuals exposed to six or more different drugs received prescriptions from three or more different physicians. In British Columbia, 98% of the elderly receiving six or more different drugs received at least one prescription from a general practitioner or a family practitioner.
BACKGROUND: The inclusion of large, heterogeneous groups of patients for coronary bypass grafting (CABG) surgery has resulted in a more mixed treatment outcome. Thus it becomes important to identify patients who are less likely to benefit from surgery or who may require additional support to improve treatment outcome. The aim of the present study was to examine whether psychological status measured before CABG can contribute to prediction of short- and long-term outcomes of the surgery. METHODS AND RESULTS: One hundred seventy-one consecutive patients from two large university hospitals in Stockholm completed a psychosocial questionnaire before being scheduled for surgery. One year after CABG, patients again completed the questionnaire. Follow-up of medical charts was conducted during the first 3 years after surgery. All major cardiac events (cardiac death, definite myocardial infarction, revascularization, and unstable angina verified by angiography or myocardial scintigraphy) were recorded. Although the overall effect of surgery was excellent in the majority of cases, the patients exhibiting a high degree of distress (anxiety, depression, and tiredness) before surgery assessed their status as being much worse both before the operation and at the 1-year follow-up. Equally important was the fact that patients considered distressed before surgery had significantly higher rates of cardiac events (16%) in the 3-year follow-up period compared with nondistressed patients (5%) (chi-square=5.11, degrees of freedom=1, p
Ongoing acidification of the ocean through uptake of anthropogenic CO2 is known to affect marine biota and ecosystems with largely unknown consequences for marine food webs. Changes in food web structure have the potential to alter trophic transfer, partitioning, and biogeochemical cycling of elements in the ocean. Here we investigated the impact of realistic end-of-the-century CO2 concentrations on the development and partitioning of the carbon, nitrogen, phosphorus, and silica pools in a coastal pelagic ecosystem (Gullmar Fjord, Sweden). We covered the entire winter-to-summer plankton succession (100 days) in two sets of five pelagic mesocosms, with one set being CO2 enriched (~760 µatm pCO2) and the other one left at ambient CO2 concentrations. Elemental mass balances were calculated and we highlight important challenges and uncertainties we have faced in the closed mesocosm system. Our key observations under high CO2 were: (1) A significantly amplified transfer of carbon, nitrogen, and phosphorus from primary producers to higher trophic levels, during times of regenerated primary production. (2) A prolonged retention of all three elements in the pelagic food web that significantly reduced nitrogen and phosphorus sedimentation by about 11 and 9%, respectively. (3) A positive trend in carbon fixation (relative to nitrogen) that appeared in the particulate matter pool as well as the downward particle flux. This excess carbon counteracted a potential reduction in carbon sedimentation that could have been expected from patterns of nitrogen and phosphorus fluxes. Our findings highlight the potential for ocean acidification to alter partitioning and cycling of carbon and nutrients in the surface ocean but also show that impacts are temporarily variable and likely depending upon the structure of the plankton food web.