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This randomized trial investigated the influence of the width of the margin of the surgical excision (1 cm or 3 cm) on the risk of recurrence and death in patients with high-risk cutaneous melanoma (as defined by a tumor thickness of 2 mm or more). A 1-cm margin was associated with a higher risk of locoregional recurrence than was a 3-cm margin, but three years after surgical treatment, overall survival was similar in the two groups. This randomized trial assessed the margin of the surgical excision (1cm or 3 cm) and the risk of recurrence. The risk of death from cutaneous melanoma is determined mainly by the thickness of the tumor, as described by Breslow, 1 the presence or absence of tumor ulceration and microdeposits of melanoma in sentinel lymph nodes, 2 , 3 the site of the tumor, and the patient's sex. 4 Spread occurs by lymphatic and hematogenous routes. Micrometastases from primary tumors migrate through cutaneous lymphatics to the regional lymph nodes. Traditionally, wide margins of excision have been used to prevent lymphatic spread, but over the past decade, margins have become smaller because previous trials have suggested that narrower margins are safe. 5 – 7 The issue remains . . .

This stimulating text presents a concise and accessible introduction to feminist theory today. Covering all the major variants of feminist political thought, it offers a unique examination of the archive of modern feminist theory from the publication of The Feminine Mystique in 1963 to current postmodernist and legal feminist texts. It provides both an intellectual history and a political critique of contemporary feminism in the United States and in the United Kingdom. Judith Evans focuses on the divergence within, as well as between, feminist schools, and on protests from women marginalized by `the movement′ - including those who are lesbian and those who are black. Feminist Theory Today contends that the ear.

Background: Overweight and obesity prevalence is increasing in Canadian children. In the Capital Health region of Alberta, there is a need to examine this public health issue and implement strategies to overcome it. Two growth references, one provided by the US Centers for Disease Control and Prevention (CDC), and the other by the International Obesity Task Force (IOTF), are available to assess individuals and screen populations for overweight and obesity. The prevalence can vary as a function of the reference used. The primary objective of this study is to determine prevalence estimates of overweight and obesity in 4-6 year olds in the Capital Health region. The secondary objective is to explore differences in estimates using both classification systems. Methods: Anthropométrie measurements were incorporated into regular preschool immunization visits. Body Mass Index (BMI), defined as the bodyweight in kilograms divided by height in metres squared was calculated for each record and percentiles for age and sex were determined using cut-offs from the IOTF and CDC. The prevalence estimates of overweight and obesity using both classification systems were determined and compared. Results: Out of 7,369 children, 13.8% were overweight and 11.4% were obese according to the CDC reference. The IOTF reference classified 11.5% as overweight and 6.8% as obese. The two reference systems had moderate agreement (kappa 0.69, p<0.01). Conclusion: The results indicate a lower prevalence estimate of overweight and obesity among young children in the Capital Health region compared to other parts of Canada. The IOTF reference provides more conservative estimates than the CDC reference, accounted for more by the difference in estimates of obesity than by the difference in estimates for overweight. Contexte : La prévalence de l'embonpoint et de l'obésité est en hausse chez les enfants canadiens. Dans la région sanitaire d'Edmonton (Alberta), il a été jugé nécessaire d'examiner ce problème de santé publique et de mettre en oeuvre des stratégies pour le surmonter. Deux graphiques de croissance sont disponibles pour analyser l'embonpoint et l'obésité individuellement et à l'échelle d'une population : celui des Centers for Disease Control and Prevention des États-Unis (CDC) et celui du groupe de travail international sur l'obésité (IOTF). La prévalence peut varier en fonction du graphique utilisé. L'objectif principal de notre étude était de calculer la prévalence estimative de l'embonpoint et de l'obésité chez les enfants de 4 à 6 ans dans la région sanitaire d'Edmonton. Le deuxième objectif était d'analyser les différences dans les estimations produits par les deux systèmes de classification. Méthode : Des mesures anthropométriques ont été intégrées dans les visites de vaccination systématique au préscolaire. Nous avons calculé l'indice de masse corporelle (IMC) de chaque enfant (le poids corporel en kilogrammes divisé par la taille en mètres carrés) et déterminé les centiles d'âge et de sexe en utilisant les seuils de l'IOTF et des CDC. Nous avons ensuite déterminé et comparé les estimations de la prévalence de l'embonpoint et de l'obésité selon les deux systèmes de classification. Résultats : Sur 7 369 enfants, 13,8 % faisaient de l'embonpoint et 11,4 % étaient obèses selon le graphique des CDC. Selon celui de l'IOTF, 11,5 % faisaient de l'embonpoint et 6,8 % étaient obèses. Les deux systèmes de classification affichaient un degré de concordance moyen (coefficient Kappa de 0,69, p<,01). Conclusion : Les résultats indiquent que la prévalence estimative de l'embonpoint et de l'obésité chez les jeunes enfants de la région sanitaire d'Edmonton est plus faible qu'ailleurs au Canada. Les estimations obtenues selon le graphique de l'IOTF sont plus prudentes que celles obtenues avec le graphique des CDC, ce qui s'explique davantage par les écarts dans les estimations de l'obésité que de l'embonpoint.

In 2006, the University of Melbourne awarded several nursing Research Fellowships under the auspice of Primary Health Care Research and Development (PHCRED) and the Department of General Practice. This opportunity has enabled the research fellows to work within a 'research rich' academic general practice environment. From here they have learnt the value of research skills, the process of developing and answering a research question, fostering an ongoing interest in research. (non- author abstract)

* Send a letter to all patients who fit this criteria advising of the planned program. Invite patients to make an appointment in the allocated flu clinic period. The letter should include an explanation about the need for immunisation and any out-of-pocket costs.

Dick Gregory 1932-2017 Dick Gregory, who has died aged 84, was the first, and greatest, black American satirist of the modern age, and an inspiration to younger comedians such as Richard Pryor, Eddie ...