Characterization of Residential Pesticide Use and Chemical Formulations through Self-Report and Household Inventory: The Northern California Childhood Leukemia Study

Home and garden pesticide use has been linked to cancer and other health outcomes in numerous epidemiological studies. Exposure has generally been self-reported, so the assessment is potentially limited by recall bias and lack of information on specific chemicals.

Elimination Rates of Dioxin Congeners in Former Chlorophenol Workers from Midland, Michigan

Exposure reconstructions and risk assessments for 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and other dioxins rely on estimates of elimination rates. Limited data are available on elimination rates for congeners other than TCDD.

British Columbia: Improving Retention and Recruitment in Smaller Communities

This pilot project involved the application, in Canada, of the innovative 80/20 staffing model to a hospital in a small rural setting. The model provides the voluntary participants with 20% of their salaried time off from direct patient care in order to pursue various types of professional development activities. The project, overseen by a steering committee, lasted from June 2009 to February 2010 and involved 14 nurses on the pediatric unit of Royal Inland Hospital in Kamloops, British Columbia. It entailed a collaborative partnership of the British Columbia Nurses' Union, Interior Health Authority, Thompson Rivers University and the British Columbia Ministry of Health, and aimed to demonstrate how professional development opportunities can improve recruitment and retention of nurses, quality of work life and quality of patient care.

Childhood Obesity Prevention: Opportunities in Healthcare

Childhood obesity is a leading health problem in Canada and is associated with cardiometabolic disease, reduced quality of life and economic impacts. There is an emerging evidence base on obesity-prevention strategies in children that consider the determinants of obesity and that should be considered within the context of a child's family, school, neighbourhood, culture and society. This article reviews approaches to obesity prevention in children, with a focus on the healthcare setting, incorporating both primary and secondary preventions.

‘“Time Seemed Fiction”: Archaeological Encounters in Victorian Poetry’

For the Victorians, archaeology integrated a plethora of cultural remains from a range of times into the material landscape of their own culture. Containing objects from assorted pasts alongside objects from the present, that landscape became anachronic. Whether Roman, Middle Eastern or Early British, an artefact is a sign of the past from which it has emerged and the present in which it makes new meaning. Jean Baudrillard argues, “The antique object no longer has any practical application, its role being merely to signify” (74). This article examines three poets who considered the significance of archaeological objects. In particular, Thomas Hardy, Dante Gabriel Rossetti and Emmeline Fisher wrote about encounters with artefacts and took those encounters as occasions to re-imagine time. Victorian studies and history of science have paid little attention to archaeology, and poetry that engages with the rich symbolic field of archaeology has received even less notice. The poets considered here reveal that archaeology prompted not only reflection on the accomplishments and longevity of the British Empire but also reflection on the nature of time itself. An archaeological object is temporally and geographically removed from its original context and meaning. Indeed, this dislocation is part of what it comes to signify. What’s more, the artefact represents the very fact of anachronism and prompts those who encounter the object to cast away a linear notion of time. Writing of an object as a repository of cultural memories, Catherine Crawford asserts that while key moments in an object’s history can be pinpointed (i.e., when it was created, when it was sold, when it was defaced by an invading army, etc.), the artefact accumulates different meanings over time, and a palimpsest of significances is written (literally or figuratively) on its surface (14). Thus, the archaeological artefact does not represent a specific moment in time but rather a collection of moments and also time itself. The single object conflates an array of times, representing them at once. In this way, time ceases to appear as a line, stretched from them to now: the object reveals an alternate model in which multiple times co-exist. Using the phrase “tempo-object,” Paul Ricoeur emphasises this notion of an object that endures and continues to signify over time (26). For Ricoeur, as well as for Hardy, Rossetti and Fisher, an object’s origin is far less interesting than its endurance, and its accumulated significance, the palimpsest Crawford describes. Duration and the palimpsest may seem to be at odds, but archaeology and the Victorian poets who encountered archaeology put them together. Duration describes the experience of the object; it does not capture the experience of the archaeologist (or in the case of this article, the poet) who abruptly encounters the object in his present. He may immediately realise that the object has existed all these many years from the time of its creation to the present of its excavation, but that is the life of the object independent of any interpreter. More interesting is the experience of the person who comes upon the object and is probably not interested in what it has meant or done for all the years between its inception and the now. The poetic speakers who are the subjects here are interested in what the object means in the precise moment of encounter. Writing of an encounter between a fossilised trilobite and an imperilled character in his novel A Pair of Blue Eyes (1873),

Review of Catherine Belling’s “A Happy Doctor’s Escape from Narrative: Reflection in Saturday”

Osteoporosis in the community

To assess the sensitivity and specificity of self-reported osteoporosis compared with dual energy X-ray absorptiometry (DXA) defined osteoporosis, and to describe medication use among participants with the condition.

Routine on-table cholangiography during cholecystectomy: a systematic review

The aim of this review was to systemically analyse trials evaluating the efficacy of routine on-table cholangiography (R-OTC) versus no on-table cholangiography (N-OTC) in patients undergoing cholecystectomy.

Protein C Assay Performance

To determine the performance and frequency of protein C reagents currently used by clinical laboratories, we analyzed North American Specialized Coagulation Laboratory Association (NASCOLA) protein C proficiency testing data from 6 surveys conducted in 2009 and 2010 (2009-1 to 2009-3 and 2010-1 to 2010-3). Interlaboratory coefficients of variation (CV) for commonly used reagents on a survey with normal protein C ranged from 8% to 12% for antigenic assays, from 4% to 7% for chromogenic activity assays, and from 7% to 22% for clot-based activity assays. CVs for commonly used reagents on specimens with abnormal protein C ranged from 15% to 24% for antigenic, 4% to 11% for chromogenic, and 10% to 17% for clot-based assays (averaged across 3 surveys). Some reagents were used by relatively few laboratories and therefore additional study may be needed for those reagents. For all commonly used reagents, biases were usually small and often not statistically significant. All assessed reagents were clinically accurate, and were considered acceptable options for a specialized coagulation laboratory.

The Pathwork Tissue of Origin TestThe Authors’ Reply

To the Editor We read with interest the article by Dumur et al1 with respect to the use of the Pathwork Diagnostics Tissue of Origin (TOO) Test in the determination of the origin of tumors with unknown primary sites. While this study demonstrates the ability of the test to perform in some clinical settings, we believe that some of the statements and conclusions reached are overreaching and misguided.The authors state that the Pathwork TOO test showed 97% accuracy in determining the site of origin of a tumor, in contrast with immunohistochemical staining, which has a reported accuracy of 75% to 88%,2–4 suggesting that the TOO Test is a better discriminator of the site of origin of tumors. However, in our opinion, this is not a fair comparison. The case types studied are entirely different in these studies. Immunohistochemical panels reached more than 95% accuracy in the correct identification of sites of origin of lung, colon, breast, and prostate carcinoma for which relatively specific and sensitive markers are available. In fact, it would be reasonable to assume that these numbers have only been bettered by the introduction of newer markers, eg, napsin A (lung) and PAX8 (female genital tract). The failure of immunohistochemical staining is limited to relatively specific situations, eg, inability to conclusively identify the site of origin of related tumors such as gastric, pancreatic, and biliary carcinoma for which specific immunohistochemical markers are not available. These “difficult to nail” tumor types were not included in this study, and, as such, the percentages cited are not comparative. In fact, application of an appropriate immunohistochemical panel would have been discriminatory in all 6 cases in which the TOO Test’s performance was cited as being superior. Indeed, the authors concede as much by using immunohistochemical results as …