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The article reports on a decline in incidence rates for female breast cancer in the U.S. over the period 1999-2003. An analysis by the U.S. Centers for Disease Control & Prevention indicated that age-adjusted incidence rates for invasive breast cancer declined each year during the period, with the greatest decrease occurring from 2002-2003. From 2002 to 2003, all racial/ethnic groups other than American Indians/Alaska Natives experienced a significant decrease in incidence rates.

Iron status affects both microbial growth and immune function. Mammalian iron homeostasis is maintained primarily by regulating the absorption of the micronutrient in the proximal small intestine. The iron concentration of the enterocyte can fluctuate widely in response to both dietary and whole body iron status, as well as in response to infections. The possibility that an enterocyte with an elevated iron concentration is more susceptible to invasion by enteric pathogens is not known. Therefore, we examined the impact of enterocyte iron status on the invasion and survival of an enteric pathogen, as well as on the levels of several cytokine and chemokine mRNAs by the host cell. The enterocyte-like Caco-2 human intestinal cell line and Salmonella enteritidis served as the models to examine the effect of iron on the host-parasite interaction. Iron status of Caco-2 cells was altered by incubation in serum-free medium supplemented with varying levels of iron. Elevated iron status of Caco-2 cells increased the efficiency of the invasion and the number of bacteria surviving in the intracellular environment. Caco-2 cells constitutively expressed transforming growth factor-beta1, interleukin-8, monocyte chemotactic protein-1, tumor necrosis factor-alpha and interleukin-1beta, and infection with S. enteritidis increased the relative quantities of all cytokine/chemokine mRNAs except interleukin-1beta. Elevated iron status of Caco-2 cells decreased the levels of cytokine/chemokine mRNAs by 25-45% in uninfected cells. In contrast, bacterial infection was associated with a 21-95% increase in cytokine/chemokine mRNAs levels in Caco-2 cells with higher iron concentration compared with infected cells with lower iron concentration. These data support the hypothesis that elevated enterocyte iron status increases susceptibility to infection and exacerbates the mucosal inflammatory response initiated by microbial invasion by increasing cytokine/chemokine expression. [ABSTRACT FROM AUTHOR]

Managed care organizations are excellent environments for pharmaceutical care programs to demonstrate their impact on patient care outcomes and to decrease costs. Patient consultation is the cornerstone in implementing pharmaceutical care because it increases patient contact with the pharmacists while improving patient compliance with drug therapy (adherence). Implementation of a patient consultation program that verifies patients' understanding of their disease and therapy gives the pharmacist information necessary to monitor drug therapy. Use of strategic planning to overcome barriers, followed by the development of local standards of practice, will refocus the practice philosophy to one of improving patient outcomes. Pharmacy managers must demonstrate and document the value that patient consultation brings to the patient and the healthcare system. Then, they must integrate their counseling effort with other health education efforts of the managed care system. Pharmacists will gain the support of other disciplines by reinforcing their efforts. Together they can work to decrease the problems that are inherent with drug therapy. These goals can be accomplished with minimal expense and have the potential to produce significant savings in healthcare costs.

Recent interest in children's social competence has been prompted by findings of correlational and retrospective studies that indicate a positive relationship between early social adjustment problems of children and their adjustment later in life. To date, the assessment methodology in the area has pursued two directions: (1) sociometric measures (peer nomination and peer rating scales), which have provided the major means of identifying the socially competent child, and (2) direct observation, principally employed in the specification of socially competent behaviors. The current uses and the inherent assets and limitations of both strategies are discussed along with suggestions for enhancing current data collection methods. Issues concerning the definition of social competence, generalizability of current findings, and social norms are also examined.