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Library and information management (LIM) organisations are on an almost continual path of change driven by changes in technology, service models, staffing structures, and financial allocations. The way in which LIM organisations approach change varies, as does the success rate of change management procedures undertaken. One particular approach to change management is Appreciative Inquiry (AI). AI has been gaining in popularity since its inception over two decades ago. This technique seeks to identify what works with individuals, teams, or whole organisations and then build on those elements, a digression from the common approach of looking for a problem that needs to be fixed. This paper explores the Al technique and its potential for application by LIM organisations. [ABSTRACT FROM AUTHOR]

: BackgroundRecent studies report the incidence of axillary metastases in patients with ductal carcinoma in-situ (DCIS) approaches 13%. The purpose of this study was to define the incidence of axillary micrometastases in patients with pure DCIS before and after the introduction of sentinel lymph node biopsy.: MethodsPatients with a final diagnosis of DCIS form the basis of this study. Data were entered prospectively into an Institutional Review Board approved Oracle database from January 1997 through July 2002.: ResultsOne hundred and thirty-four patients had lymph nodes evaluated. Ninety-eight percent of patients had no evidence of metastatic disease and 2% were found to have micrometastases. This was consistent in those who had level I or II lymph node sampling or both and those who had lymphatic mapping and a sentinel lymph node biopsy procedure.: ConclusionsThese data do not support axillary lymph node removal of any type in patients with pure DCIS. [Copyright &y& Elsevier]

Libraries and other information agencies have highly developed systems, skills, and techniques for delivering information to users. There is, nevertheless, a need to improve the delivery systems and discusses the means by which web-based systems in particular can be evaluated. The authors review systems evaluation in recent LIS literature and identify some of the common measures and methodologies employed. [ABSTRACT FROM AUTHOR]

Introduction: Personal, community, and environmental factors can influence the attraction and retention of regional, rural, and remote health workers. However, the concept of place attachment needs further attention as a factor affecting the sustainability of the rural health workforce. Objective: The purpose of this rapid review was to explore the influence of a sense of place in attracting and retaining health professionals in rural and remote areas. Design: A systematic rapid review was conducted based on an empirical model using four dimensions: place dependence, place identity, social bonding and nature bonding. English‐language publications between 2011 and 2021 were sought from academic databases, including studies relevant to Australian health professionals. Findings: A total of 348 articles were screened and 52 included in the review. Place attachment factors varied across disciplines and included (a) intrinsic place‐based personal factors; (b) learning experiences enhancing self‐efficacy and rural health work interest; (c) relational, social and community integration; and (d) connection to place with lifestyle aspirations. Discussion: This rapid review provides insight into the role of relational connections in building a health workforce and suggests that community factors are important in building attachment through social bonding and place identity. Results indicate that future health workforce research should focus on career decision‐making and psychological appraisals including place attachment. Conclusion: An attachment to place might develop through placement experiences or from a strong rural upbringing. The importance of the relational interactions within a work community and the broader community is seen as an important factor in attracting, recruiting, and sustaining a rural health workforce. [ABSTRACT FROM AUTHOR]

The techniques for intraoperative evaluation of sentinel lymph nodes (SLNs) vary. The most common methods include frozen section, imprint cytology/touch preparation cytology, and scrape cytology (SC). The purpose of this study was to evaluate whether there is concordance between the intraoperative SC and the final pathology of SLNs in patients with breast cancer. From October 2001 to June 2005, sentinel lymph node biopsies were attempted in 181 patients with breast cancer using a combination of blue dye and radioisotope. A lymph node was considered an SLN when it was stained with blue dye, had a blue lymphatic afferent, had increased radioactivity, or was abnormal by palpation. SLNs were successfully identified in 180 patients, for an identification rate of 99.4%. Forty-five patients had positive SLNs. In 16 (35%) of those patients, the SLNs were negative intraoperatively by SC. All of the false negatives occurred in SLNs with micrometastases. Thus, SC is an excellent method for identifying macrometastases intraoperatively, but less successful for micrometastases. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the sensitivity and specificity of breast-specific gamma imaging (BSGI) using a high-resolution breast-specific gamma camera and magnetic resonance imaging (MRI) in patients with indeterminate breast findings. Twenty-three women with an indeterminate breast finding that required BSGI and MRI as deemed necessary by the interpreting radiologist or referring physician were included. MRI was performed on a GE 1.5T scanner and BSGI was performed on a Dilon high-resolution breast-specific gamma camera. All imaging findings were correlated with pathologic diagnosis. Thirty-three indeterminate lesions were evaluated in the study. There were a total of nine pathologically confirmed cancers. There was no statistically significant difference in sensitivity of cancer detection between BSGI and MRI. BSGI demonstrated a greater specificity than MRI, 71% and 25%, respectively. BSGI has equal sensitivity and greater specificity than MRI for the detection of breast cancer. [ABSTRACT FROM AUTHOR]

The purpose of this study was to critically evaluate the added benefit of intraoperative mammary ductoscopy on margin assessment and identification of occult intraductal pathology in patients undergoing therapeutic partial mastectomy for in-situ and invasive breast carcinoma.Eligible patients underwent intraoperative mammary ductoscopy before partial mastectomy. In patients where an intraductal abnormality was identified and the mammary ductoscope was not within the partial mastectomy cavity, an additional ductoscopy-directed margin of tissue was analyzed.Nineteen of 30 (63%) patients yielded nipple aspirate fluid and were able to undergo mammary ductoscopy; an intraductal abnormality was identified in 15 of 19 (79%) patients. Only 1 patient had an occult infiltrating carcinoma, which was outside of the resection cavity and identified by ductoscopy.Although mammary ductoscopy can identify intraductal abnormalities during partial mastectomy in a significant number of patients, many of these findings may be either benign or within the standard field of resection, thus adding no benefit to the patient. [Copyright &y& Elsevier]

Background: Numerous studies have evaluated the benefit of performing lymphoscintigraphy for the sentinel lymph node procedure in breast cancer patients. The purpose of this study is to determine if lymphoscintigraphy accurately predicts the number of radioactive sentinel lymph nodes (SLNs) identified during surgery for breast cancer patients. Methods: From October 2001 to June 2004, SLN biopsy was attempted in 112 patients with breast cancer using a combination of blue dye and radioisotope. Lymphoscintigraphy was performed in 98 of the patients. A lymph node was considered an SLN when it was stained with blue dye, had a blue lymphatic afferent, had increased radioactivity, or was abnormal by palpation. Results: Lymphoscintigraphy accurately predicted the number of radioactive SLN identified intraoperatively in 47 patients. In 44 of the patients who did not have concordance, there were more SLN identified intraoperatively than were seen on lymphoscintigraphy. In the other 8 patients, there were fewer SLN identified intraoperatively than seen on lymphoscintigraphy. Conclusions: Lymphoscintigraphy accurately predicted the number of SLN identified intraoperatively in only 47% of the patients in this study. In a majority of the patients in whom the lymphoscintigraphy was not concordant, the number of SLN identified intraoperatively was underestimated. Thus, although lymphoscintigraphy is beneficial in showing that at least 1 radioactive SLN will be identified intraoperatively, it does not accurately predict the number. [ABSTRACT FROM AUTHOR]