Explore the vast range of titles available.

Breast carcinogenesis is a multistep process accompanied by widespread molecular and genomic alterations, both in tumor and in surrounding microenvironment. It is known that tumors have altered metabolism, but the metabolic changes in normal or cancer-adjacent, nonmalignant normal tissues and how these changes relate to alterations in gene expression and histological composition are not well understood. Normal or cancer-adjacent normal breast tissues from 99 women of the Normal Breast Study (NBS) were evaluated. Data of metabolomics, gene expression and histological composition was collected by mass spectrometry, whole genome microarray, and digital image, respectively. Unsupervised clustering analysis determined metabolomics-derived subtypes. Their association with genomic and histological features, as well as other breast cancer risk factors, genomic and histological features were evaluated using logistic regression. Unsupervised clustering of metabolites resulted in two main clusters. The metabolite differences between the two clusters suggested enrichment of pathways involved in lipid metabolism, cell growth and proliferation, and migration. Compared with Cluster 1, subjects in Cluster 2 were more likely to be obese (body mass index ≥30 kg/m2, p<0.05), have increased adipose proportion (p<0.01) and associated with a previously defined Active genomic subtype (p<0.01). By the integrated analyses of histological, metabolomics and transcriptional data, we characterized two distinct subtypes of non-malignant breast tissue. Further research is needed to validate our findings, and understand the potential role of these alternations in breast cancer initiation, progression and recurrence.

The field of administration is dominated by certain principles or proverbs. For each principle, there is a set of circumstances which can undermine or serverely constrain the application of the principle. Two of the proverbs are: 1. Administrative efficiency depends on unity of command. 2. Greater efficiency is achieved with a more limited span of control.An amazing number of proverbs find their way into conventional wisdom with little to recommend them beyond a surface plausibility. The experience of the US Community Services Administration (CSA) provides an example. Three proverbs that apply to this situation involve experimental design, program manager involvement, and decision making. Each pair of evaluation proverbs in this case reflects both a sound academic orientation and operational realities. Proverbs in contrasting pairs allows for examination at both the academic and practitioner levels.

The present decade has witnessed a shift from planning to emphasis on program performance and accountability. However, program evaluation must contend with many different policy preferences articulated by groups and institutions involved with social programs. In particular, the entity commissioning an evaluation expects some policy \"mileage\" from the undertaking. Evaluation intended as an aid to decisionmaking cannot afford to separate the program under study from its organizational and political context. Federal categorical social programs like Head Start fill many needs for many groups. Evaluation preoccupied with experimental rigor often underestimates the need to adapt to political and administrative realities. At the other extreme, excessive accommodation to program ideology and organizational self-interest undermines the credibility of the evaluative process. Its limitations notwithstanding, program evaluation does yield informed policy alternatives. It invites rational public discussion of social programs and adds substance to the process of political bargaining.

The United States Constitution requires that an enumeration (or census) of the population be conducted every 10 years to apportion seats in the House of Representatives. Census information is also used to allocate funds and to plan and manage programs. Census 2000 occurs on April 1, 2000, when one-sixth of all American households will be mailed the \"long form,\" containing disability, demographic, economic, and housing questions. Although no short set of commonly accepted questions on disability existed, one was developed for Census 2000 by a collaborative, federal interagency work group on disability, convened by the Office of Management and Budget. The work group consisted of staff from the Social Security Administration (SSA), the Department of Health and Human Services, the U.S. Census Bureau, and other agencies. They reviewed questions initially proposed by the Census Bureau, developed an alternative proposal, tested both versions in the Census Bureau's cognitive questionnaire lab, and on the basis of testing, derived a consensus version for Census 2000. In many ways, the six questions now contained on Census 2000 are an improvement over previous efforts. Disability is ascertained for children as well as for adults, and information will be collected separately for several domains of disability (for example, sensory, mental, physical). The need for a brief set of disability measures goes beyond Census 2000. If such data were collected regularly on national surveys, critical policy and program concerns across agencies could be addressed because better information could be gathered on changes in disability prevalence and on the characteristics of persons with disabilities. Other similar efforts include the former Disability Evaluation Study, now known as the National Study of Health and Activity--a national sample survey on working-age disability to be conducted by SSA--and the President's Task Force on the Employment of Adults with Disabilities (Executive Order 13078).

IN 1969 THE OFFICE OF ECONOMIC OPPORTUNITY REGION IV, WHICH COVERS EIGHT SOUTHEASTERN STATES, UNDERTOOK A PRELIMINARY STUDY OF LOW INCOME HOUSING COMDITIONS. NONE OF THE RECOMMENDATIONS OF THE EVALUATION TEAM FOUND THEIR WAY INTO OFFICIAL POLICY STATEMENTS OR THE PATTERN OF GRANT AWARDS IN REGION IV.

Recognizing that a frequently recommended use for evaluation research (ER) findings is to exert an influence on budget decisions, the impracticality of such recommendations are outlined. Examining the time frame of the budgetary cycle & the time needed to produce a good evaluation study, it becomes apparent that the budget cycle & the evaluation cycle are incompatible. A four-year time frame would be required for the ER to optimally affect the basic budget decisions for a fiscal year; by that time, the evaluation data may be outdated & questionable. It is concluded that ER may be better suited to influencing new legislative initiatives, regulatory reforms, or management practices than annual budget decisions. 3 Tables. Modified HA.

At a time when many employers are being forced to contemplate how, and even whether, they can continue to offer retiree health care benefits in the face of skyrocketing costs, it is increasingly apparent that employers need to equip employees with the tools and skills to gauge the impact of healthcare spending on their retirement plans. The convergence of retiree health care and retiree wealth-building benefits, such as 401(k)s, is the inevitable product of trends that have been emerging in the world of employee benefits over the past few years. These trends have implications for employers. The emergence of health savings accounts is a significant step in the direction of convergence of health and wealth management tools that combine tax benefits with portability and investment options, enabling employees to take the lead in determining how much to save and how to invest it while also permitting them to take their savings to their next job.

Given the increase in job mobility and the decrease in employee tenure at many companies, how can employers ensure that their workforce will reap the financial rewards of retirement? Under cash balance plans, according to Carol Quick of Employee Benefit Research Institute, employees who change jobs in mid-career have an earned retirement benefit that is in proportion to the number of years they have been at that job. Advantages and disadvantages of cash balance plans are discussed.