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COVID-19 has had a significant impact on the management of gynaecological malignancies globally. Despite the extensive work investigating the impact of the COVID-19 pandemic on gynaecological cancer care as a whole, little is known with regard to the specific management of endometrial cancer. The aim of this retrospective cohort study was to assess the impact of the COVID-19 pandemic on patients diagnosed with endometrial cancer in Northern Ireland (NI). All patients with endometrial cancer in NI between April 2019–March 2022 were included, divided into three cohorts: preCOVID, COVID-Year 1 and COVID-Year 2. The median was used to express data that was not normally distributed. Students t-test and Mann-Whitney U test were used to compare means with and without normal distribution respectively. Statistical analysis of count data included the chi-squared test. The p-value < 0.05 was considered statistically significant. 683 patients were included with a similar distribution of age, histology and length of stay. There was a 22% decrease in new endometrial cancer diagnoses in COVID-Year 1 (n = 195) compared to Pre-COVID (n = 249), with evidence of recovery by year 2 (n = 241). In COVID-Year 1 there was a 29% decrease in surgical resections. During COVID-Year 2 there was an increase in symptom duration of >6 months (21%) compared to Pre-COVID (11% (p = 0.03)). By COVID-Year 2 there was an increase in Stage III disease (19%) compared to Pre-COVID (12% (p = 0.02)). In COVIDYear 1 and 2 there was an increase in the use of adjuvant oncological treatment, with a significant increase in the use of chemoradiotherapy in COVID-Year 2. In conclusion, COVID-19 has significantly impacted the treatment pathways of endometrial cancer patients in NI. There was a significant increase in symptom duration and stage III disease requiring increased use of adjuvant oncological treatments. [ABSTRACT FROM AUTHOR]

Expert second opinions in surgery improve patient outcomes and influence surgical decision-making, allowing for peer review in peri-operative planning. The aim of this study is to assess the impact of "buddy operating" within gynaecological oncology on blood loss and length of stay (LOS) in hospital. A retrospective cohort study including all patients undergoing a hysterectomy (open and laparoscopic), for a gynaecological cancer, in 2004, 2014 and 2017. Data was collected using the hospital surgical ledger, Northern Ireland Electronic Care Record (NIECR) and online laboratory results. Data collected included the procedure performed, LOS, haemoglobin (Hb) levels pre- and post-operatively as a measure of blood loss, and number of consultants present. Only those for which insufficient data were available were excluded. Data was collected using Microsoft Excel and statistical analysis performed using JASPv0.16.1. The data followed a non-Gaussian distribution (Shapiro-Wilk p < 0.001). Analysis of Variance (ANOVA) was used to compare the frequency of procedures and overall Hb drop, The Wilcoxon-test was used to compare the mean Hb drop, and the Kruskal-Wallace test was used to compare the mean LOS. Statistical significance was defined as a p-value < 0.05. 630 patients were included. A 41.4% categorical reduction was shown in post-operative Hb drop between 2004 (22.7 g/L) and 2017 (13.3 g/L (p = 0.015)) for laparoscopic procedures following the implementation of buddy operating. There was no significant difference seen in the post-operative Hb drop for open procedures (p = 0.069). There was a 56% reduction in mean LOS from 2004 (12.1 days) to 2014 (6.1 days), which was significant for laparoscopic (p = 0.0025) and open procedures (p = 0.000033). In conlcusion, buddy operating is associated with a statistically significant reduction in blood loss for laparoscopic procedures and LOS for open and laparoscopic procedures. [ABSTRACT FROM AUTHOR]

Abstract Background Participants in trials evaluating preventive interventions such as screening are on average healthier than the general population. To decrease this 'healthy volunteer effect' (HVE) women were randomly invited from population registers to participate in the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) and not allowed to self refer. This report assesses the extent of the HVE still prevalent in UKCTOCS and considers how certain shortfalls in mortality and incidence can be related to differences in socioeconomic status. Methods Between 2001 and 2005, 202 638 postmenopausal women joined the trial out of 1 243 312 women randomly invited from local health authority registers. The cohort was flagged for deaths and cancer registrations and mean follow up at censoring was 5.55 years for mortality, and 2.58 years for cancer incidence. Overall and cause-specific Standardised Mortality Ratios (SMRs) and Standardised Incidence Ratios (SIRs) were calculated based on national mortality (2005) and cancer incidence (2006) statistics. The Index of Multiple Deprivation (IMD 2007) was used to assess the link between socioeconomic status and mortality/cancer incidence, and differences between the invited and recruited populations. Results The SMR for all trial participants was 37%. By subgroup, the SMRs were higher for: younger age groups, extremes of BMI distribution and with each increasing year in trial. There was a clear trend between lower socioeconomic status and increased mortality but less pronounced with incidence. While the invited population had higher mean IMD scores (more deprived) than the national average, those who joined the trial were less deprived. Conclusions Recruitment to screening trials through invitation from population registers does not prevent a pronounced HVE on mortality. The impact on cancer incidence is much smaller. Similar shortfalls can be expected in other screening RCTs and it maybe prudent to use the various mortality and incidence rates presented as guides for calculating event rates and power in RCTs involving women. Trial Registration This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN22488978. Medical Research Council (grant no. G990102), Cancer Research UK (grant no. C1479/A2884) and Department of Health

Debates the issue of whether generalists or specialists should teach art. Points out the strengths of each, maintaining the decision must consider educational philosophy, instructional approach, and teacher competence, as well as the permissible parameters of budgeting and staffing. Suggests that the two could team for success. (TRS)

Presents a study which examined nonspoken information that provides museums visitors with cues for perceiving, thinking about, and appreciating works of art through displays and labeled exhibitions. Discusses reasons museums operate as they do and considers what might be done to enhance visitors' satisfaction. Calls on museum educators to improve the educative-informative value of art museums. (GEA)

Explains the rationale for including art in the general education curriculum and expanding the studio orientation to include art criticism, art history, and aesthetics. Advocates a balanced, integrated curriculum that resembles artists' ways of confronting, experiencing, and producing art and meets students' multicultural needs. (MLH)

In light of the fact that young Americans spend hundreds of dollars each year on the arts yet have little training in developing critical skills, this writer outlines what must be done in school arts programs to educate culture consumers. (Author/JM)

Nathan Oliveira, a noted West Coast artist and professor of art at Stanford University, discusses his own training in art, his philosophy as an art educator, and his views on the student teacher relationship in art education. (SJL)

An interview with noted sculptor William McVey. (SJL)

San Francisco sculptor Ruth Asawa discusses her own artistic development and describes the Alvarado Arts Workshop, a community-based arts education program begun by herself, other parents, and community leaders in the San Francisco schools. (Author/SJL)

Bennett Tarleton is director of the Alliance for Arts Education, headquartered in Washington, D.C. At a time when the new federal Administration is discussing major budget cutbacks, the significance of alliance and cooperation among arts organizations is clearly underscored. (Editor)

The article presents the consensus statement of the British Gynaecological Cancer Society for endometrial, vulvar, and cervical cancers. Topics mentioned include recruitment of women to registered clinical trials when considering the sentinel lymph node technique in cervical cancer, the use of sentinel lymph node algorithms compared with systematic lymphadenectomy in cervical cancer, and the International Federation of Gynecology and Obstetrics stage 2009 classification system.

The objectives of this study were to investigate the accuracy of magnetic resonance imaging (MRI) in predicting the depth of myometrial invasion in the preoperative assessment of women with endometrial cancer and to quantify the impact of MRI as an adjunct to predicting patients requiring full surgical staging.This was a diagnostic accuracy study of prospective cases in conjunction with STARD guidelines using collected data from a tumor board within a cancer network. Consecutive series of all endometrial cancers in Northern Ireland over a 21-month period was discussed at the Gynaecological Oncology Multidisciplinary Team/tumor board meeting. This study concerns 183 women who met all the inclusion criteria. Main outcome measure was the correlation between the depth of myometrial invasion suggested by preoperative MRI study and the subsequent histopathological findings following examination of the hysterectomy specimen. Secondary end point was how MRI changed management of women who required surgery to be performed at a central cancer center.For the detection of outer-half myometrial invasion, overall sensitivity of MRI was 0.73 (95% confidence interval [CI], 0.59-0.83), and specificity was 0.83 (95% CI, 0.76-0.89). The positive predictive value was 0.63 (95% CI, 0.50-0.74), and negative predictive value was 0.89 (95% CI, 0.82-0.93). Positive likelihood ratio was 4.35 (95% CI, 2.87-6.61), and negative likelihood ratio was 0.33 (95% CI, 0.21-0.52). Magnetic resonance imaging improved the sensitivity and negative predictive value of endometrial biopsy alone in predicting women with endometrial cancer who require full surgical staging (0.73 vs 0.65 and 0.80 vs 0.78, respectively).Preoperative pelvic MRI is a moderately sensitive and specific method of identifying invasion to the outer half of myometrium in endometrial cancer. Addition of MRI to preoperative assessment leads to improved preoperative assessment, triage, and treatment. [ABSTRACT FROM AUTHOR]

Purpose Cancer screening strategies have commonly adopted single-biomarker thresholds to identify abnormality. We investigated the impact of serial biomarker change interpreted through a risk algorithm on cancer detection rates. Patients and Methods In the United Kingdom Collaborative Trial of Ovarian Cancer Screening, 46,237 women, age 50 years or older underwent incidence screening by using the multimodal strategy (MMS) in which annual serum cancer antigen 125 (CA-125) was interpreted with the risk of ovarian cancer algorithm (ROCA). Women were triaged by the ROCA: normal risk, returned to annual screening; intermediate risk, repeat CA-125; and elevated risk, repeat CA-125 and transvaginal ultrasound. Women with persistently increased risk were clinically evaluated. All participants were followed through national cancer and/or death registries. Performance characteristics of a single-threshold rule and the ROCA were compared by using receiver operating characteristic curves. Results: After 296,911 women-years of annual incidence screening, 640 women underwent surgery. Of those, 133 had primary invasive epithelial ovarian or tubal cancers (iEOCs). In all, 22 interval iEOCs occurred within 1 year of screening, of which one was detected by ROCA but was managed conservatively after clinical assessment. The sensitivity and specificity of MMS for detection of iEOCs were 85.8% (95% CI, 79.3% to 90.9%) and 99.8% (95% CI, 99.8% to 99.8%), respectively, with 4.8 surgeries per iEOC. ROCA alone detected 87.1% (135 of 155) of the iEOCs. Using fixed CA-125 cutoffs at the last annual screen of more than 35, more than 30, and more than 22 U/mL would have identified 41.3% (64 of 155), 48.4% (75 of 155), and 66.5% (103 of 155), respectively. The area under the curve for ROCA (0.915) was significantly (P = .0027) higher than that for a single-threshold rule (0.869). Conclusion: Screening by using ROCA doubled the number of screen-detected iEOCs compared with a fixed cutoff. In the context of cancer screening, reliance on predefined single-threshold rules may result in biomarkers of value being discarded.

The article focuses on the concept of silent pedagogy to appreciate and lessen the gap that exists between what viewers need in museums and what art museums provide. The author looks at what various museums do for the majority of their visitors who do not travel around the museum with literatures, read catalogues and attend lectures. It stresses the importance of bridges between the viewer and the viewed. Details on introduction and orientation, layout and installation of exhibitions and signage to deepen the perception of viewers on works of arts are discussed.

The author discusses the experience of New York City middle school students and their art teachers as delegates of the Asia Society of New York and the TDK Corp. in Japan. Titled "Japan Trail '83" the itinerary aims to promote goodwill through art in the country. He also discusses the participation of the delegates in the art classes at the Shitaya Junior High School in Tokyo. He describes the art facilities of Japanese schools and compared their art curriculum with that of the Americans. He also presents his observations on the emphasis given to aesthetics, ethics and cleanliness in Japanese life, and the incorporation of art in cultural activities such as flower arrangement (ikebana), paper folding (origami) and the sensory activity of the Tea Ceremony.

An interview with the deputy director of the Institute of Art Education of the Yevgeny Kvyatskovsky of the USSR Academy of Pedagogical Sciences is presented. When asked about the role of art in the curriculum of Soviet schools at various grade levels, he discussed how art was included in the curriculum from primary schools to senior grades. He explained how the art educators was trained. Kvyatskovsky also mentioned the contacts of Soviet art educators with teachers from other countries.

The article presents an interview with Ruth Asawa, the force behind the community-based arts education program Alvarado Arts Workshop. The program was started by parents and community leaders in the San Francisco schools. When asked about her unusual artistic training, she replied that when her entire family was interned into camps along with Japanese Americans during World War II, she managed to study art taught by professionals and artists.

The article presents an interview with William McVey, a fellow of the National Sculpture Society who has been teaching and making sculpture for more than a half-century. He talks about the person who has encouraged him towards art, the importance of working in stone on his teaching and art production, and his view on non-museum sculpture.

The article discusses the account of the San Francisco Art Institute as an epitome of all histories of American institutions of art located in San Francisco, California. According to the author, the institute symbolizes the forces that have made San Francisco a city of more than ordinary awareness of the arts in its civic and civil existence. The popularity of this institute led everyone to conclude that it faces a bright future and prospects for a continuing impact on the evolution of American art and art education.