Management of the abnormal Papanicolaou smear

Since 1943, Papanicolaou (Pap) smears have been widely used to screen for cervical cancer. Over the past 25 years, new understanding of the natural history of cervical epithelial neoplasia has defined the existence and importance of dysplasia, also termed cervical intraepithelial neoplasia (CIN), and more recently, its probable link to human papilloma virus (HPV). Inflammatory atypia (IA) is a common cytological diagnosis whose significance is less understood. Current gynecological opinion strongly supports a practice of colposcopic evaluation for all women with cytology showing any degree of CIN. Data from studies in our health service and elsewhere establish that 15% to 30% of patients with IA will have CIN if evaluated by colposcopy. Although clinicians may choose to follow such patients with repeated Pap smears, there are strong arguments for offering colposcopic evaluation to patients with IA. Potential problems with false-positive cervical biopsy reports, however, may limit the utility of colposcopy in patients with IA cytology.     

Schooling,tracking, and inequality

Being poor does not only mean that a child has less money and fewer toys. Poverty is pervasive. It affects diet, nutrition, employment, housing, self-concept, and the entire educational experience. Ironically, Americans have always looked to education as a means of breaking the seemingly endless cycle of poverty. But rather than serve as a great ladder carrying all who climb with concerted effort to social and economic equality, current research suggests some educational structures may actually limit opportunities for certain children. This paper focuses on education in American society and how it may influence inequality . It addresses the question of why students from various social classes differ significantly in academic achievement and it critiques the major theoretical explanations for this difference. Finally, it supports the idea that specific educational structures perpetuate the cycle of poverty by determining educational outcomes and limiting the economic life chances of children. One such educational structure, tracking, or separation by ability, is the focus of this paper. Tracking is a reality in the American school system. Considerable research has revealed class, gender, and race biases with less-advantaged children more often placed in the lower tracks. This paper examines tracking on a national and international basis. It explores various processes within the tracks that limit a child's development and, in turn, have an impact on future economic opportunities. In sum, it examines how tracking may perpetuate the endless cycle of poverty.     

Teaching, tracking, and marketing our product

Many sociology departments have faced difficult times in the past decade. This article examines how this crisis confronted two universities in North Carolina and the strategies which they used to strengthen their departments. Major emphasis is given to how state associations can assist departments in developing applied curriculum, publicizing their successful endeavors, and recruiting students. The article also provides insights about dealing with outcomes assessment as well as administering internship programs. Jan Rienerth teaching interests are in women’s issues, applied sociology, and experimental learning. Her research has focused on women and the elderly in prison. Martin Shultz primary research area involves the long term changes in the American family, especially divorce. In the past ten years, he has developed additional interests in applied sociology with an internship program. Richard Caston interests include socio-economics, health, and applied research.     

Classification,Subjectivities, and Personal Visibility

This article proposes extending the empirical sociological debate regarding the complex ways social classifications construct scenarios of subjectivity. Based on the case study of the Boarding School for the Gifted Disadvantaged in Israel, the article describes how a new cultural order created a new scenario of subjectivity (“gifted disadvantaged”) that had not been known before. This scenario was shaped in relation both to the ethnic classification in Israel, as well as to two social categories that were well‐known in the educational field (“gifted” and “disadvantaged”). To understand the institutional dynamics involved in the construction of a new scenario of subjectivity, content analysis of the organizational documents that accompanied the founding of the school was carried out, and in‐depth interviews with graduates of the school were conducted in order to understand how those who populate the new scenario experience their subjectivity years after its construction. The findings indicate a specific connection between classifications, subjectivity, and personal visibility. Specifically, the study reveals a number of phenomenological aspects that enhance the experience of visibility: the cognitive identification of two types of self; the experience of cognitive liminality; and the consciousness of having a subjectivity deserving of special nurturance.     

The Classification,Intercorrelation, and Dynamic Nature of MSW Student Practice Preferences

Data was collected biannually (1992-98) from a complete population of students entering and exiting accredited graduate programs of social work in California (N=5,793). Findings suggest that practice interests and career aspirations of MSW students are more diverse and dynamic in nature than the debate in the literature on social work’s mission would lead readers to believe. Although the proportion of all students most interested in each of the seven practice areas studied does not change throughout graduate studies, there is tremendous movement among individual students with respect to practice preferences during the course of their education.     

Issue management and crisis management: An integrated,non-linear,relational construct

Despite extensive attempts to define and differentiate issue management and crisis management, the definitional approach – and linear life-cycle models which focus on the elements – fail to capture the full dynamics of the disciplines. Instead of a focus on definitions, this paper proposes a non-linear, relational construct which considers issue and crisis management in the context of interdependent activities and clusters of activity which must be managed at different stages. This includes the role of issue management in both the pre-crisis and post-crisis phases. The model addresses some of the limitations of linear approaches and helps analyze the outcomes and overlaps between activity clusters in order to optimize strategic relationships and enhance bottom-line effectiveness.     

Conflict,strategic management,and public relations

Public relations will be a viable contributor to strategic management if it has knowledge and experience in the mixed motive model of public relations to include contention, avoidance, compromise, accommodation, cooperation, being unconditionally constructive, win/win or no deal, principled, and mediated.Secondly, membership in top management also depends on the experience and ability of the practitioner to do strategic planning and solve problems for the organization. This assertion incorporates the long-term accumulation of expertise and a relationship with the dominant coalition built on sound judgment and trust.     

Methodology and Measurement in the Study of Multiracial aMericans: Identity,Classification, and Perceptions

This article lays out some of the methodological issues in doing research on multiracial people (those whose immediate and/or distant ancestors come from different racial or ethnic groups), including how they are counted, how they are perceived, how they identify themselves, what factors affect their self‐identifications, and how their identifications change over time.     

Education and the activation, course, and management of anger

Using data from the 1996 General Social Survey, I examine education's association with the activation, course, and management of anger. I argue that education--as a source of stratification (status) and as a personal resource (human capital)--organizes the conditions that influence anger-related processes. In analyses of anger activation, education is associated with lower odds of family-related anger. The well educated have fewer children and more income--factors associated with a lower risk of family anger. Conversely, education is associated with higher odds of work-related anger, but income and personal control account for that association. In analyses of the course of anger, I document a nonlinear association between education and anger duration. Adjustment for the sense of control--which is negatively associated with anger duration--sharpens that parabolic association. Education is positively associated with perceived appropriateness of anger and negatively associated with the display of anger. In both cases, adjustment for control accounts for education's effect. The sense of control also suppresses education's significant positive effect on anger processing. In analyses of anger management, education increases the odds of cognitive flexibility and problem solving, but its effect on communication depends on the sense of control. In sum, education organizes personal and social circumstances that influence anger-related processes.     

Business restructuring,management control,and corporate organization

Conclusions After half a century of growing dominance of the large corporation by non-owning managers, the 1980s were marked by a slowing or even reversing of their quiet revolution. Professional managers had come to control the corporation on the premise that they could more efficiently produce shareholder value than the original founder-owners. They turned shareholding into a passive investment on the same premise. As companies faced increasingly competitive pressures during the 1980s, however, the legitimacy of the rule of incumbent management came under challenge. No longer could government interference be blamed for many of the problems facing business; fingers pointed at management itself. As the criticism of corporate leadership gathered momentum, a leading diagnosis focused on one of managerial capitalism's crowning achievements: the autonomous power of professional management.The critique viewed the managerial autonomy as excessively permissive, the agency system as no longer effective. Professional managers had come to show too much concern for the social welfare of various stakeholder groups, including themselves, and too little concern for the financial welfare of the only stakeholder group that should really count — the shareholders. Many of the restructuring efforts were thus undertaken in the name of returning companies to the single-minded pursuit of ownership interests. What had stood in the way of such a pursuit was less a matter of government constraint and more a matter of inadequate stockholder vigilance by their appointed agents.Mindful of the critique, incumbent managements moved during the mid- to late-1980s to improve stockholder returns by paring the workforce and cutting other costs. Corporate acquisitions and leveraged buyouts brought new management teams to the fore where others had seemingly fallen short. The resulting restructuring reached a large proportion of the nation's major companies. Half or more of the largest companies had undergone a significant reduction in their workforce. And the dollar value of company resources changing ownership hands expanded considerably. The aggregate purchase price of mergers and acquisitions of publicly-traded firms in 1988 was nearly three times greater than in 1981. Even more striking was the sharp increase in the number of publicly-traded companies and divisions that were taken private. The aggregate dollar value of such buyouts in 1988 had increased almost 25 times over that in 1981. This opening of the market for corporate control among major U.S. firms brought a significant fraction of the nation's large corporations more directly under the immediate oversight of ownership interests.The reassertion of ownership control over large corporations was usually taken in the name of improving corporate earnings. Would be takeover groups generally promised more internal discipline and stronger financial performance. Whatever the actual financial impact of the intensification of ownership interests, available research suggests that it has had organizational impact. General company strategies may come to be more centrally guided while specific operating actions are devolved further down the organization.Ownership change and other restructuring steps have also ramified into corporate social and political action. That outreach is likely to be less vigorous and more divided. It is also being redirected. During the 1970s and early 1980s, corporate energies focused on reducing government regulation and improving community opinion. Those energies are now increasingly focused on facilitating or resisting restructuring. Companies have fought legislation that would limit the process of plant closings, but they have also sought legislation to protect themselves against hostile takeovers.The evidence also suggests that considerable managerial discretion remains in shaping company response to the restructuring pressures. Although market and organizational factors are sure to act as constraints, top management, whether a relatively autonomous non-owning management group or an owner-dominated management, retains an important independent capacity to exercise strategic choice. That choice is likely to receive special shaping by the long-term ascendance of financial managers and the decline of manufacturing personnel at the executive level.Yet corporate change must not be viewed as isolated managerial responses to changing market conditions. Companies and managements frequently look to one another for guidance in coping with ambiguous circumstances. DiMaggio and Powell's analysis of organizational isomorphism, for example, suggests that firms frequently adopt organizational practices not because they are dictated by the firm's market strategies, but rather because they are already used by other companies. Similarly, Granovetter's analysis of the social embeddedness of economic action indicates that company decisions are partially shaped by top management's contacts with their counterparts in other firms. Understanding company responses to restructuring pressures therefore requires a focus on inter-company flows of ideas and doctrines as well as purely internally generated responses specific to the company. Reactions to the restructuring pressures that are collectively developed and defined in the broader business community may prove to be as critical as individually fashioned solutions in guiding management approaches to restructuring during the years to come.

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城市轻轨交通的类型划分与技术特点分析

回顾了轻轨交通的发展,分析了目前城市轨道交通类型划分中存在的问题。从车辆、线路、轨道等方面论述了轻轨交通的技术特点和应注意的有关问题,并从优先发展我国轻轨快速交通和尽快制订轻轨交通标准两方面阐述了我国轻轨交通的发展策略。     

Ethnic Classification and Culture: The Case of the Tujia in Hubei,China

Specific cultural practices, or their absence, definitively mark many ethnic identities. Why then are cultural practices frequently at odds with ethnic categories? The case of the Tujia, an ethnic minority in China, demonstrates the disjuncture between officially assigned ethnic categories, culture and local identity. It also suggests a potential explanation for why such disjunctures occur. State officials apparently classified Tujia in terms of actual cultural practices that were not important locally. There may be a general pattern that outsiders classify others based on culture while locals classify themselves based on socio-political experience.     

Human resource management,employee engagement,and nonprofit hospital performance

Human resource management (HRM) has been shown to impact organizational performance, but more research is needed on particular human resource (HR) practices in nonprofits and their effect on performance. In this article, we explore one HRM practice argued to influence performance, employee engagement in decision‐making, examining whether involving staff at different levels of a nonprofit affects nonprofit organizational performance. Drawing on data from a 2011 study of nonprofit hospitals, we find employee engagement has a positive influence on managerial and stakeholder perceptions of organizational performance. Employee engagement in decision‐making is also related to objective nonprofit performance measures, although the effects are less consistent. We conclude by discussing the implications of these findings for nonprofit research and practice.     

SSRIs & the risk of abnormal bleeding

Considerable research is needed to fully understand the interactions of SSRIs and hematological functioning. Adequate studies of platelet function in patients taking SSRIs are lacking. The risk of bleeding with SSRI treatment appears to be low, and the occurrence of bleeding is usually minor when it does occur. However, the risk does exist and must be considered in any patient taking SSRIs who develops abnormal bleeding or bruising not otherwise explained by an appropriate assessment to determine the etiology. Routine monitoring of patients taking SSRIs should probably include questions about bruising or bleeding, particularly in patients with blood dyscrasias and in older patients taking medications that affect platelet function. Caution should be exercised before starting patients with preexisting bleeding risks on SSRIs, including patients taking NSAIDs, aspirin, or other drugs that may impair coagulation.