Selection based on merit versus demography: implications across race and gender lines.

In a replication and extension of the study by M. E. Heilman, M. C. Simon, and D. P. Repper (1987), 201 undergraduates participated in a simulation in which they experienced differing selection procedures and outcome feedback. Selection procedures did not have the deleterious effects on women that were found previously. Instead, race interacted with gender to moderate this relationship, and outcome played a significant role in participant self-evaluations. Black participants rated their leadership ability highest when both chosen preferentially and given negative outcome feedback, apparently because of a desire to maintain positive self-esteem. The latter explanation was supported in a follow-up study in which undergraduates (n = 80) worked in groups and received negative outcome feedback from either a racially similar or racially different experimenter. Theoretical and practical implications relating to diversity and self-appraisal management are discussed.

Microscopically controlled excision of skin cancer.

OBJECTIVE: To describe the technique of microscopically controlled excision of skin cancer (Moh's surgery) and to review the early experience of the use of this technique at Royal Prince Alfred Hospital. DESIGN: A review of 170 clinical records of patients with 198 skin malignancies treated by microscopically controlled excision from 1981 to 1983. PATIENTS: Long term follow-up of 148 patients with 170 lesions was possible. An analysis of these patients' sex and age, and the site, size and histopathological diagnosis of their lesions was carried out. INTERVENTIONS: All patients underwent microscopically controlled excision of their skin cancer. Analysis of the operative procedure revealed an average of 2.1 excision stages and 14.8 blocks examined by frozen section for each tumour. RESULTS: The overall cure rate was 97.1% for this group of patients. This rate is comparable with that of other centres performing this procedure. CONCLUSIONS: Microscopically controlled excision offers an excellent cure rate for skin cancers, especially recurrent, difficult basal cell carcinomas in areas known to be at high risk for recurrence, for example, central areas on the face. The application of this technique to selected patients and tumours offers a higher cure rate than conventional treatment methods.

Harvey-ras oncogene restriction fragment alleles in familial melanoma kindreds.

Unique and uncommon BamHI allelic restriction fragments of the Ha-ras locus have been reported in the genomes of patients with cancer and of three affected members of a familial melanoma kindred (Krontiris et al., 1986). Analysis of the BamHI and Msp/HpaII restriction fragments of peripheral blood leucocyte DNA from the members of two families with hereditary melanoma (HM)/familial dysplastic naevus syndrome (DNS) revealed that the only Ha-ras allele common to four affected members of one kindred and two from a second kindred, was the 6.7kb allele which is found in 66% of the normal population. This allele was found equally in affected and non-affected family members, and in one affected case was inherited from an unaffected homozygous parent. It was absent in two affected sisters in a third kindred. In the first kindred the karyotype of all three melanoma sufferers was 46XX 9qh+, while six unaffected members had a normal karyotype. BamHI polymorphism of the Ha-ras gene does not identify the affected members in the HM/DNS families studied.

Patient satisfaction with outpatient primary health care in a metropolitan medical center.

This paper presents rates and correlates of patient satisfaction with primary care in a New York medical center. Over an eight-week period, we studied only first-time, "workup" encounters. Patient satisfaction was measured with three scales and one single-item measure. The highest rates of satisfaction were registered in relation to (1) the encounter in general, followed by (2) doctor conduct and (3) convenience. Four sets of independent variables were studied: sociodemographic variables, social psychological antecedent variables, other patient characteristics, and physician characteristics. Age was found to be the most important sociodemographic characteristic of patients affecting their satisfaction with the encounter; having positive expectations of the encounter had more effect on subsequent satisfaction ratings than other social psychological variables studied here. When each of the satisfaction measures was regressed on the sets of independent variables, the proportion of variance explained changed, as did the relative contribution of the different independent variables. We discuss the importance of studying patient satisfaction with specific medical encounters, along with the findings of our study.

Population density of tropical forest frogs: relation to retreat sites.

The forest frog Eleutherodactylus coqui defends specific sites for retreats and nests in the Luquillo Forest, Puerto Rico. The hypothesis that shortages of nest and retreat sites limit population size was tested by placing 100 bamboo frog houses in plots measuring 100 square meters in areas of high frog density. These new sites were readily adopted by adult frogs. After one year, experimental plots had significantly more nests and frogs of all sizes than did control plots.

Internal fertilization in an oviparous frog.

Eleutherodactylus coqui, an oviparous frog, undergoes internal fertilization. If this mode of fertilization occurs in other species of anurans, interpretations of anuran reproductive strategies based on the assumption of external fertilization must be reviewed.

A conceptual framework for emergency care planning.

The experience of functional program planning, in addition to facilitating the planning process for a new emergency unit, has had additional benefits. It has given the staff a common conceptual framework for analyzing patient care as provided and for identifying areas where improvements can be made. Also, a new approach has been developed for communicating with other departments and with hospital administration about day-to-day operating problems which may be useful for addressing other resource allocating and operating room time schedules. By developing a planning framework, it is possible to integrate the expertise of various services, while retaining an integrated overall orientation within which the efficacy of different proposals can be judged. This approach is critically important in helping to avoid the adverse effects of fragmented planning.