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Cyber risks are a key issue for enterprises such as hospitals, insurance companies, and other medical organisations. Theft of patient data can pose a considerable threat to medical organisations. Risk management is a significant component of protecting patient and pharmaceutical information. There are serious shortcomings in the regulatory models if these medical organisations are exposed to cybersecurity risks. While most models describe cyber risks in a "one-size fits all" model, excluding calibrations specific to cyber risks most likely to occur in the organisation, using risk management, cyber risk modelling, a strong framework, and standards found in the NIST can strengthen cyber risk management and prevention of cybersecurity risks. In this paper, we first introduced the principles of risk management and approaches to cybersecurity, then discussed cybersecurity in a large medical centre setting, risk management approaches, cyber risk modelling, applying a framework to the cyber risk program, and standards necessary to prevent risks. [ABSTRACT FROM AUTHOR]

Big data analytics are gaining popularity in medical engineering and healthcare use cases. Stakeholders are finding big data analytics reduce medical costs and personalise medical services for each individual patient. Big data analytics can be used in large-scale genetics studies, public health, personalised and precision medicine, new drug development, etc. The introduction of the types, sources, and features of big data in healthcare as well as the applications and benefits of big data and big data analytics in healthcare is key to understanding healthcare big data and will be discussed in this article. Major methods, platforms and tools of big data analytics in medical engineering and healthcare are also presented. Advances and technology progress of big data analytics in healthcare are introduced, which includes artificial intelligence (AI) with big data, infrastructure and cloud computing, advanced computation and data processing, privacy and cybersecurity, health economic outcomes and technology management, and smart healthcare with sensing, wearable devices and Internet of things (IoT). Current challenges of dealing with big data and big data analytics in medical engineering and healthcare as well as future work are also presented. [ABSTRACT FROM AUTHOR]

Background: While human epidermal growth factor receptor 2 (HER2) overexpression is an adverse breast cancer prognostic factor, it is unclear whether there are differences in outcomes between types of local treatment in this population. This retrospective study examined locoregional recurrence and survival in women with node-negative, HER2+ breast cancer treated with breast-conserving therapy (BCT) versus mastectomy. Methods: Subjects were 748 patients with pT1-2, N0, M0 HER2+ breast cancer, treated with BCT ( n = 422) or mastectomy ( n = 326). Trastuzumab was used in 54 % of subjects. The 5-year Kaplan-Meier locoregional recurrence free survival (LRRFS), breast cancer specific survival (BCSS), and overall survival (OS) were compared between cohorts treated with BCT versus mastectomy. Subgroup analyses of LRR and survival were performed separately among patients treated with BCT or mastectomy to examine the effect of trastuzumab on outcomes in each group. Results: Median follow-up was 4.4 years. Patients treated with mastectomy had higher proportions of grade 3 histology (69 vs 60 %, p = 0.004) and lower rates of hormone therapy (51 vs 64 %, p < 0.001) and trastuzumab therapy (50 vs 57 %, p = 0.04). The 5-year outcomes in women treated with BCT compared with mastectomy were: LRRFS 98.0 versus 98.3 % ( p = 0.88), BCSS 97.2 versus 96.1 % ( p = 0.70), and OS 95.5 versus 93.4 % ( p = 0.19). Trastuzumab was associated with similar LRRFS and improved OS in both local treatment groups. Conclusions: BCT is safe in the population of women with pT1-2, N0, HER2+ breast cancer, providing high rates of locoregional control and survival equivalent to mastectomy. Trastuzumab was associated with improved survival in both groups. [ABSTRACT FROM AUTHOR]

Background. While human epidermal growth factor receptor 2 (HER2) overexpression is an adverse breast cancer prognostic factor, it is unclear whether there are differences in outcomes between types of local treatment in this population. This retrospective study examined locoregional recurrence and survival in women with nodenegative, HER2+ breast cancer treated with breast-conserving therapy (BCT) versus mastectomy. Methods. Subjects were 748 patients with pT1-2, N0, M0 HER2+ breast cancer, treated with BCT (n = 422) or mastectomy (n = 326). Trastuzumab was used in 54 % of subjects. The 5-year Kaplan-Meier locoregional recurrence free survival (LRRFS), breast cancer specific survival (BCSS), and overall survival (OS) were compared between cohorts treated with BCT versus mastectomy. Subgroup analyses of LRR and survival were performed separately among patients treated with BCT or mastectomy to examine the effect of trastuzumab on outcomes in each group. Results. Median follow-up was 4.4 years. Patients treated with mastectomy had higher proportions of grade 3 histology (69 vs 60 %, p = 0.004) and lower rates of hormone therapy (51 vs 64 %, p < 0.001) and trastuzumab therapy (50 vs 57 %, p = 0.04). The 5-year outcomes in women treated with BCT compared with mastectomy were: LRRFS 98.0 versus 98.3 % (p = 0.88), BCSS 97.2 versus 96.1 % (p = 0.70), and OS 95.5 versus 93.4 % (p = 0.19). Trastuzumab was associated with similar LRRFS and improved OS in both local treatment groups. Conclusions. BCT is safe in the population of women with pT1-2, N0, HER2+ breast cancer, providing high rates of locoregional control and survival equivalent to mastectomy. Trastuzumab was associated with improved survival in both groups. [ABSTRACT FROM AUTHOR]

Purpose: The prognosis of patients with breast cancer presenting with distant metastasis can vary depending on disease extent. This study evaluates a definition of limited M1 disease in association with survival in a cohort of women presenting with metastatic breast cancer. Methods: The study cohort comprised 692 women referred to the BC Cancer Agency between 1996 and 2005 with M1 breast cancer at presentation. Limited M1 disease was defined as <5 metastatic lesions confined to one anatomic subsite. Extensive M1 disease was defined as ≥5 lesions or disease in more than one subsite. Clinicopathologic and treatment characteristics and overall survival (OS) were compared between subjects with limited ( n = 233) versus extensive ( n = 459) M1 disease. Multivariable analysis was performed by Cox regression modeling. Results: Median follow-up time was 1.9 years. Five-year Kaplan-Meier OS was significantly higher in patients with limited compared to extensive M1 disease (29.7 vs. 13.1 %, p < 0.001). In the multivariable Cox regression analysis, limited M1 disease was significantly associated with OS (hazard ratio 0.51, 95 % confidence interval 0.40-0.66, p < 0.001). The only patient subsets with limited M1 disease with poor 5-year OS <15 % were patients with Eastern Cooperative Oncology Group performance status of ≥2 or estrogen receptor-negative status. Conclusions: Limited M1 disease, defined as <5 metastatic lesions confined to one anatomic subsite, is a relevant favorable prognostic factor in patients with stage IV breast cancer. This definition may be used in conjunction with other clinicopathologic factors to select patients for more aggressive systemic and locoregional treatments. [ABSTRACT FROM AUTHOR]

The article investigates the role of clinicopathologic characteristics of the recurrent tumor in determining survival in a cohort of patients with ipsilateral breast tumor recurrence (IBTR). Findings revealed that some of the prognostic factors for survival after IBTR include lyphovascular invasion positive status, high-grade histology, and close/positive margins in association with the recurrent tumor, among others. The researchers add that these factors can be used to prognosticate and guide clinical decisions after recurrence.

The article presents information on which described outcomes from whole breast boost radiotherapy (RT), with or without a boost, in women with pure ductal carcinoma in situ (DCIS) treated with breast-conserving surgery (BCS). A review of the related literature is presented. Data analysis was conducted between 1985 and 1999. Researchers employed the log-rank test to contrast ten-year Kaplan-Meier local control (LC), breast cancer specific survival (BCSS) and overall survival (OS). A discussion on the findings of the study is detailed.

Ipsilateral breast tumor recurrence (IBTR) is an increasingly common clinical challenge. IBTRs include True Recurrences (TR; persistent disease) and New Primaries (NP; de novo tumors), but discrimination between these is difficult. We assessed tumor infiltrating leukocytes (TIL) as biomarkers for distinguishing these types of IBTR using primary tumors and matched IBTRs from 24 breast cancer patients, half of which were identified as putative TRs and half as NPs using a previously reported clinical algorithm. Intratumoral lymphocyte populations (CD3, CD8, CD4, CD25, FOXP3, TIA1, CD20) and macrophages (CD68) were quantified by immunohistochemistry in each tumor. Compared to matched primaries, TRs showed significant trends towards increased CD++ and CD8+ TIL, while these populations were often diminished in NPs. Comparison of IBTRs showed that TRs had significantly higher levels of CD3+ (P = 0.0136), CD8+ (P = 0.0092), and CD25+ (P = 0.0159) TIL than NPs. We conclude that TIL may be a novel diagnostic biomarker to distinguish NP from TR IBTRs. [ABSTRACT FROM AUTHOR]

Background: To identify prognostic indicators of local recurrence (LR) in patients with ductal carcinoma in situ (DCIS) of the breast treated with breast conserving surgery (BCS) alone. Methods: A retrospective study was conducted of all women with pure DCIS, diagnosed 1985-1999, referred for tertiary oncologic opinion in British Columbia, treated with BCS without adjuvant radiotherapy. Kaplan-Meier local control (LC) and breast cancer specific survival (BCSS) estimates for the entire group were plotted. Stratified analyses identified subgroups with high Kaplan-Meier 10-year LR. Cox multivariate modeling was used to assess predictors of LR. Kaplan-Meier BCSS rates were compared between two cohorts: those who experienced LR and those who did not have LR. Results: A total of 460 women comprised the study cohort. Median follow-up was 9.4 years. The 15-year LC and BCSS rates were 82% and 97%, respectively. Stratified analyses of LR identified comedo histology, high nuclear grade, tumor size >4 cm or indeterminate size, and positive margins to be associated with significantly higher LR risk, with 10-year LR risks approximating 15-30%. The 10-year BCSS rates for the LR group were 94% compared with 99% for the NoLR group. On Cox regression modeling, high nuclear grade, the presence of comedocarcinoma, and positive margins were significant factors for higher risk of LR. Conclusions: Women with DCIS treated with BCS alone had higher LR risk, and those with a LR were more likely to die of breast cancer. Optimal local treatment is mandatory to minimize the risk of breast cancer death for women with this curable disease. [ABSTRACT FROM AUTHOR]

Building on social ecological research, this study considers whether neighborhood socioeconomic advantage modifies the relationship between parenting practices and sex initiation among young adolescents. Using data on a national sample of 2,559 middle school students, the authors examined two-way interactions between neighborhood socioeconomic status and parental involvement, decision making, and communication about sex. The parental decision-making measure was developed using latent class analysis. Greater parental involvement was related to a lower likelihood of sex initiation only when youth lived in socio-economically advantaged neighborhoods. Parental decision making centered on the child's activities within (e.g., television watching) and outside (e.g., hanging with peers) of the home was associated with a lower likelihood of sex initiation for adolescents in disadvantaged neighborhoods but to a greater likelihood of sex initiation for youth in advantaged neighbor- hoods. Results suggest that the neighborhood context must be considered in preventive interventions aimed at discouraging adolescent involvement in sexual intercourse. [ABSTRACT FROM AUTHOR]

Examines the relationship between cerebral hemisphere dominance and performance in the early screening project test. Description of the cognitive laterality battery neuropyschological test; Information on the indices of the Myers-Briggs Type Indicator personality inventory; Scores of subjects who practice mental disciplines such as yoga and transcendental meditation.

The objective of this study was to examine the association between adolescent exposure to and understanding of needle exchange programs (NEPs) and their perceptions of the impact of NEP on the decision to use illicit drugs. From November 1998 to February 1999, 9th and 10th grade students from 4 Baltimore City high schools completed surveys reporting perceptions of the effect of NEP and other factors on adolescents' decisions regarding illicit drug use. The perceived effect of NEP was compared to that of other factors, using the Wilcoxon signed rank test. The impact of seeing drug users attend NEPs on adolescents' decisions to use drugs was modeled using multiple linear regression. Among 1,110 students, 88% were African American, 58% were female, and the mean age was 15 years. The percentage of students who thought the specified factors promoted drug use follows: peer drug use, 49.9%; parents drug use, 43.5%; seeing drug users attend NEP, 11.1%; school drug education, 6.6%; and anti-drug TV advertisements, 6.1%. The percentage viewing these factors as having no influence on illicit drug use was 21.7, 19.1, 42.4, 36.9, and 29.8% respectively. Students of African American race, female gender, and those with medium/high knowledge about NEP were significantly less likely to consider NEP a promoter of drug use. These data suggest that the influence of NEPs on promoting illicit drug use among adolescents appears to be neutral compared to other factors known to be influential to this population group. [ABSTRACT FROM AUTHOR]

Objective To describe and understand variations in social influences on smoking behavior among African-American and white male and female adolescents in Baltimore City, USA . Design A qualitative study where adolescents, both smokers and non-smokers, were interviewed individually (n = 21) and participated in focus groups (n = 18 focus groups, 3-10 participants per group). Results Social contexts emerged as most relevant and salient themes related to smoking behavior. White females perceived the most permissive parental messages around smoking, while males, especially African-American males, reported receiving the strictest parental sanctions. Females' need to fit in with peers contrasted with males' being coerced to smoke. Possible reasons for African-Americans' non-use of cigarettes include a desire not to disrespect parents and being turned off by parental addiction to nicotine. All adolescents cited the school's lax anti-smoking policy as a reason teens smoke at school. Conclusion Interventions targeted at schools and families offer promise for reducing adolescent cigarette use. [ABSTRACT FROM AUTHOR]

This research examines the impact of teenage childbearing on secondary school completion, while focusing on the problem of causal ambiguity in the relationships among self-determined behaviours. Techniques for dealing with the teenage childbearing problem are discussed, and results from these methods are compared. Data from the High School and Beyond Study on young women (n = 5257) who were enrolled as sophomores in sample schools in February 1980 and who had not given birth before November 1980 are used. Results indicate that teen childbearing reduces the probability of completing high school by 8% to 10%. Some evidence suggests that programs that target reduction of teen childbearing in improving young women's education and subsequent economic and labor force outcomes. [ABSTRACT FROM AUTHOR]

Objectives. To study the social contexts and physiological consequences of an initial cigarette smoking experience among adolescents from four ethnic groups (African American, European American, Hispanic, Native American) who vary by gender and locale (e.g. urban vs rural). Method. A qualitative study using individual interviews and focus groups. Results. Results both amplify and reinforce conclusions about peer and family influences on adolescent smoking initiation reported in quantitative studies of teen smoking. Within the broader themes of peers and family, several important sub-themes emerged. The study findings suggest that peer influence can be characterized as social conformity or social acceptance. Males were more likely than females to describe experiences involving peers exerting strong messages to conform to smoking behaviors. Roles played by family members in the initiation process were complex and included those of initiator, prompter, accomplice, and inadvertent source of cigarettes. European American and Hispanic girls provided descriptions of parents/family members as instigators of their first smoking experience. Hispanic adolescents descripted instances in which family members prompted cigarette use at a young age by encouraging the young person to light the adult's cigarette. Finally, ethnic differences in the physiological responses to initial smoking suggest the need to further explore the role of brand preference and variations in inhaling among ethnically diverse adolescents. Conclusion. In order to design effective cigarette smoking prevention programs for adolescents, it is important to understand the meaning of smoking behaviors for adolescents from different ethnic and social backgrounds. [ABSTRACT FROM AUTHOR]

Objectives. The purpose of this study was to determine whether breast-feeding has a dose-related protective effect against illness and whether it confers special health benefits to poor infants. Methods. The association between breast-feeding dose and illnesses in the first 6 months of life was analyzed with generalized estimating equations regressions for 7092 infants from the National Maternal and Infant Health Survey. Breast-feeding dose (ration of breast-feedings to other feedings) was categorized as full, most, equal, less, or no breast-feeding. Results. Compared with no breast-feeding, full breast-feeding infants had lower odds ration of diarrhea, cough or wheeze, and vomiting and lower mean ratios of illness months and sick baby medical visits. Most breast-feeding infants had lower odds ratios of diarrhea and cough or wheeze, and equal breast-feeding infants had lower odds ration of cough or wheeze. Full, most, and equal breast-feeding infants without siblings had lower odds ratios or ear infections and certain other illnesses, but those with siblings did not. Less breast-feeding infants had no reduced odds ratios of illness. Findings did not vary by income. Conclusions. Full breast-feeding was associated with the lowest illness rates. Minimal (less) breast-feeding was not protective. Breast-feeding conferred similar health benefits in all economic groups. [ABSTRACT FROM AUTHOR]

The use of vignettes-systematically elaborated descriptions of concrete situations-is supported as a means of producing more valid and more reliable measures of respondent opinion than the "simpler" abstract questions more typical of opinion surveys. The fractional replication experimental design described here enables a wide range of situation characteristics to be included and varied in the presentations made to various respondents while minimizing the number of different vignette versions required for the research instrument. Results from a study of police and nurse reactions to crime victims are shown as an example of this technique. [ABSTRACT FROM AUTHOR]

We examined the relationship between drug use by young adolescents and two indicators of illness, frequency of illness and numbers of days absent from school owing to illness. Data were from a general health survey of all eighth grade students enrolled in public schools in two rural Maryland counties. A total of 745 students completed a self-administered questionnaire during school hours in January 1984. Information was obtained on a variety of sociodemographic characteristics and on the students' use of tobacco, alcohol, and marijuana. Correlational analyses were used to examine the relationships among cigarette smoking, beer or wine drinking, whiskey or hard liquor drinking, and marijuana use. Logistic regression was used to model the effects of drug use behaviors on the likelihood of being absent from school 3 or more days, adjusting for the student's age, sex, race, parents' education, illness frequency, and concerns about learning problems in school. We found substantial covariation among the use of cigarettes, alcohol, and marijuana. After adjusting for the background variables of illness, frequency, and learning problems, we found that students who are frequent cigarette smokers experienced a 2.6 risk of school absenteeism. Other drug use behaviors were not associated significantly with increased risk of missing school. Findings are discussed within the context of health-related consequences of drug use. [ABSTRACT FROM AUTHOR]

Are victims seen by nurses as being more responsible for the occurrence of a rape than for the occurrence of a violent nonsexual crime? If so, what are some of the determinants of victim blame? The present study considers how judgments made by hospital nurses (N = 312) regarding victim responsibility are influenced by the type of crime (i.e., rape or beating), the victim's marital status, her dress, her relationship with the assailant, evidence of her resistance, the extent of her injuries, and psychological attributes and sociodemographic characteristics of the nurse. Evaluations of victim responsibility were elicited through the use of vignettes. Findings suggest that although nurses make relatively similar assignments of blame to rape and beating victims, the assignment of blame differs significantly for those victims described as "respectable'' (married, wore print dress, was not acquainted with assailant, struggled with assailant, suffered serious injuries) and those described as "disrespectable" (divorced, wearing halter top and shorts, casual acquaintance of assailant, no struggle, minor scratches as a result of the crime). Psychological attributes of the nurse emerged as the strongest predictors of victim blaming. [ABSTRACT FROM AUTHOR]

Examines three issues relevant to adolescent self-reported sexual behavior. Extent to which adolescents rescind reports of sexual intercourse; Changes in reporting of lifetime sexual intercourse; Changes in reported age at first sexual intercourse.

In recent years, public interest and concern about the plight of the rape victim has increased. A recurrent theme in much of the popular literature about rape is that rape victims are blamed for their circumstances. The present study considers how judgments made by police (N = 368)and nurses (N = 312) regarding victim responsibility are influenced by the type of crime, the victim's marital status, her dress, her relationship with the assailant, evidence of her resistence, the extent of her injuries, and attitudinal and sociodemographic characteristics of the police and nurses. Evaluations of victim responsibility were elicited by vignettes. Findings suggest that, in general, victims are given very little responsibility for rape, and that police and nurses tend to make similar evaluations regarding the victim's participation in a crime. Two major occupa- tional differences are described. Non-white police officers tend t o blame victims of rape and beating somewhat more than white police officers. Nurses who see themselves as likely victims of a crime blame rape victims more than those who view their victimization as remote. Attitudinal and psychological characteristics of both nurses and police emerged as the strongest predictors of victim blaming. [ABSTRACT FROM PUBLISHER]

Presents information on a study that replicates the Psychophysical Research Laboratories ganzfeld extrasensory perception techniques. Aims of the study; Brief description of the autoganzfeld testing system; Methodology of the study; Discussion on the results in the study.

Data from a study of nursing turnover are used to compare findings based on two techniques for evaluating the reasons for resignations within the same population of hospital nurses during one year. The techniques are: (1) exit interviews, in which resigning nurses were asked to report in an open-ended format their major reasons for leaving their jobs; and (2) a prospective panel study, in which nurses who resigned are compared with nurses who remained, and actual turnover is predicted. Results show that due to the absence of a compari son group of remaining nurses and of baseline data, causal inferences based on exit interview data alone are overly simplistic and misleading for management purposes. Results of thepanel study are more inform ative, although implications for hospital management are more complex. Use of the prospective panel design is recommended for hospitals concerned with evaluating nursing job conditions during a period of high turnover and staff nurse shortages. [ABSTRACT FROM PUBLISHER]

Presents an abstract of the article `EEG and Spect Data of a Selected Subject During PSI Tasks: The Discovery of a Neurophysiological Correlate,' presented by Cheryl H. Alexander, Michael A. Persinger, et al at the annual convention of the Parapsychological Association held August 6-9, 1998 in Halifax, Nova Scotia.

The article offers information about ecological condition of lone wolf its ecological niche. Topics discussed include appearance of the wolf in Victoria, British Columbia (BC), Canada; talks about travelling and swimming distance of wolf to the island; and conflict created by domestic dogs, which were prohibited by Provincial and Songhees law.