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IN THE LATE 1990s, LINCOLN ELECTRIC Co. ENTERED a joint venture with Taiwan's Kuang Tai Metal Industrial Co., one of East Asia's largest producers of welding wire. By January 2000, […]

The Plain Dealer in Cleveland, OH, has developed a series of informal seminars for newspaper distributors. The Growth and Profits series was created in 1994 to encourage distributors to learn the fundamentals of record keeping, sales and marketing. Nearly 500 independent distributors enrolled in the seminars in Mar 1994 and Nov 1995. The newspaper has also developed Growth and Profits II to supplement the original seminar series., It's never easy, but operating a small business is especially difficult for people with little or no business education or experience. That's why the Plain Dealer, Cleveland, Ohio, initiated Growth [...]

In this column, Mark Gottlieb, a freelance journalist for 25 years, gives the IW audience his take on the state of manufacturing across the globe. He delves into the social, […]

With rents going through the roof in many areas of this country, it is more important than ever to find ways to increase gross margins while maximizing sales potential from [...]

The Plain Dealer in Cleveland, OH, is using a state-of-the-art system to process deposits from its newspaper distributors. Securomatic, which was developed by Diebold Inc., uses specially-designed automated teller machines to increase the efficiency and reliability of the collection process. Distributors are reportedly pleased with the convenience of the system., If Automated Teller machines (ATMs) speed up banking for individuals, could they also speed up transactions for independent newspaper distributors? Alex Machaskee, president and publisher of the Plain Dealer in [...]

The article informs about European émigré Chaim Grade in the pantheon of great Yiddish writers of the twentieth century with a decades-long rivalry between the eponymous Hersh, a traditional Jewish scholar cultural accommodation. Topics include version tradition's triumph occurs in social-scientic and evolutionary terms; and Orthodoxy is celebrated broad life for its adherents Mere Judaism without rabbinic reasoning, theological demonstration, or standard apologetics.

• Health care workers, particularly surgeons, understand the importance of preventing contamination from blood of patients infected with deadly viruses. One of the most common areas of contamination is the hands and fingers due to the failure of glove protection. There are varying opinions regarding the frequency of glove failure, the necessity of wearing two gloves for added protection, and the ability to operate when wearing two gloves. We performed a prospective, randomized, trial of 143 procedures involving 284 persons to answer these questions for surgeons and first assistants. Overall, the glove failure rate (blood contamination of the fingers) was 51% when one glove was worn and 7% when two gloves were worn. Acceptability was 88% in the group who agreed to wear two gloves, and 88% of these did not perceive that tactile sense was significantly impaired. We believe that double gloving should be, and can be, used routinely during major surgical procedures to protect surgeons from blood contamination.(Arch Surg. 1992;127:213-217)

Whereas fractures related to osteoporosis have become a pressing public health concern, relatively few epidemiologic studies have focused on vertebral fractures. To shed further light on the occurrence of this injury, we collected data from the Health Care Financing Administration on 151,986 discharges listing a diagnosis of vertebral fracture over a 4-year period. After adjusting for age, white women experienced the highest rates of discharge, at 17.1 per 10,000 per year, followed by white men (9.9 per 10,000), black women (3.7 per 10,000), and black men (2.5 per 10,000). Among white women, discharge rates rose exponentially from 5.3 discharges per 10,000 population at age 65 to nearly 47.8 per 10,000 at age 90. White men, black women, and black men experienced less dramatic age-related increases in discharge rates. The similarity of these patterns to discharge rates for hip fracture suggests that the race-sex differences in vertebral fracture discharge rates may be due to differences in the incidence of vertebral fracture. (Epidemiology 1992;3515–518)

Substantial geographic and hospital-based variations have been documented in the use of breast-conserving surgery (BCS) in 1986. The authors studied the patterns of adoption of this procedure from 1986 to 1990. National Medicare inpatient claims were used to study women aged 65 to 79 who underwent an operation for local or regional breast cancer in 1986 (38,679 patients) or 1990 (43,083 patients). Breast-conserving surgery was used for 5,509 (14.1%) of the Medicare patients in 1986 and 6,476 (15.0%) in 1990. The only region with an increase in BCS use from 1986 to 1990 was New England. Many hospitals had low volumes of operations, with a median of six to seven patients annually. Ten percent of the hospitals performed 55% of the conservative operations. Large hospitals, urban hospitals, and those with higher patient volumes or a cancer center were somewhat more likely to have increased use of BCS by 1990. Despite the substantial evidence supporting BCS as an alternative to mastectomy, the overall use of BCS in Medicare inpatients increased minimally from 1986 to 1990. Many patients are treated in hospitals with little experience with BCS. Hospitals using more BCS in 1986 were somewhat more likely to increase the use of BCS by 1990.

To determine which characteristics of hospitals may be related to a higher quality of care, the association of hospital characteristics with the outcomes of medical record review by state Peer Review Organizations (PROs) was studied. The two data sources were 1) the AHA 1986 Annual Survey of Hospitals and 2) reviews completed between July 1987 through June 1988 from six large PROs. For each hospital the percentage of cases that failed physician review (the confirmed problem rate) was computed. Hospital characteristics evaluated included financial status, ownership, medical training, technological sophistication, and size. The following characteristics were significantly associated with a lower confirmed problem rate a higher occupancy rate, greater payroll expenses per bed, a higher proportion of physicians who were board-certified specialists, greater technological sophistication, a higher number of beds, a higher proportion of nurses who were registered, and membership in the Council of Teaching Hospitals. Public hospitals had higher problems rates than private not-for-profit hospitals. All characteristics significantly related to higher confirmed problem rates were also related to higher adjusted mortality rates in a previous study of 3,100 U.S. hospitals. The results suggest that hospital resources, including financial status, training of medical personnel, and availability of sophisticated equipment, are related to the quality of care provided by the hospital.

Nasal accessory sinus disease is a very common finding in patients suffering with bronchial asthma. Because of this occurrence, many thoughtful investigators have suggested that there is an etiologic relation between disease in the paranasal sinuses and this baffling malady. There are four conceivable ways by which the symptom complex called asthma may be produced through nasal disease. Mucopurulent material may drip into the pharynx from an infected sinus and the infection gradually involve the mucous membrane of the trachea and bronchi. Mucopurulent material may be retained in a sinus and the toxic products be absorbed through the blood stream or lymphatics or both and produce allergic phenomena that may manifest themselves in asthma. The nose may be obstructed by polypi and enlarged turbinates, and the patient is compelled to breathe constantly through the mouth, and the effect of cold and dry inspired air, combined with the presence of infected

The treatment of bronchial asthma is so much dependent on its etiology and a differentiation from other conditions which have similar symptoms, that it is mandatory that a short sketch of these necessary facts be presented before I enter on the main subject of this paper.Bronchial asthma may be due to anaphylactic or reflex phenomena. It must be distinguished from asthmatic bronchitis, dyspnea due to cardiac decompensation, uremia, and obstructive dyspnea from inflammatory tissue, tumors or enlarged glands or organs in the lumen of the tracheobronchial tree or pressing on the outside of it. A proper physical examination, roentgenoscopy, urine and blood investigation and endoscopy will definitely exclude all the conditions mentioned except asthmatic bronchitis. The last can be excluded by the fact that it is not dependent on anaphylaxis for its symptoms but on definite pathologic changes in the bronchial and peribronchial tissues, which may or may not

ETIOLOGY1In 1925, Drury2 showed that in cases in which anatomic defects or concrete pathologic changes could be eliminated the level of aural acuity as measured by audiometric devices was an index of the nutritional level of the individual. Little attention was paid to this statement. It was again brought to my attention in "Vital Function Studies," by Rowe and Drury.3 This is the most important generalization relative to deafness of constitutional origin that has yet been uttered. Taking due cognizance of the importance of this dictum, the related data in the literature and the accumulated material at hand, the etiology of this condition may be set forth as follows:Predisposing CausesExciting CausesHeredityHepaticEnvironmentHepatic and PancreaticEndocrinePREDISPOSING CAUSESHeredity.—Practically all of the literature on the subject of heredity is based on the assumption that the cases with which the authors dealt

According to the understanding herein implied, progressive deafness is a condition in which the organ of hearing gradually becomes more deficient in its capacity to perceive and to convey sounds to the brain. It is caused by some constitutional abnormality and therefore may also be termed "constitutional" deafness. It occurs more frequently in women than in men. It may begin at any age, but it more commonly has its onset during late adolescence or early adult life. Its onset is insidious, the patient not experiencing its presence until a fairly large portion of the hearing ability has been incapacitated. One of the first symptoms is tinnitus, which is annoying. Dizziness may be an early or late symptom, but it is not common. Paracusis is a frequent experience.Those who have no inflammation of the middle ear have normal drums and patent eustachian tubes. At times, a pink zone is seen