Sample records for pathologist clarence lushbaugh

  1. Human radiation studies: Remembering the early years: Oral history of pathologist Clarence Lushbaugh, M.D., conducted October 5, 1994

    International Nuclear Information System (INIS)


    This report provides a transcript of an interview with Dr. Clarance Lushbaugh by representatives of the DOE Office of Human Radiation Experiments. Dr. Lushbaugh was chosen for this interview because of his research involving experimental use of irradiation with human beings at Los Alamos and at the Oak Ridge Institute of Nuclear Science (ORINS). After a brief biographical sketch Dr. Lushbaugh and his assistant Mrs. Ann Swipe defend their use of total body irradiation using the LETBI (Low Exposure Total Body Irradiation) and the LETBI (Medium Energy Total Body Irradiator). Dr. Lushbaugh also discusses his earlier experiments involving use of nitrogen mustards in chemotherapy application, his early interest in the LD50 for man, his early impressions of low-level spray radiation as introduced by Heubline, anedotal information for his duties a pathologist for Los Alamos, and his developing interest in establishing safer radiation limits for human exposure

  2. Clarence Batan: Giving a voice to Filipino Youth | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)


    Sep 29, 2014 ... Find out more about Clarence Batan's research: Read Batan's ethnography of the people of Talim Island: An Ethnographic Account of ... As the world observed International Youth Day (August 12), IDRC asked researchers:.

  3. Student Rights, Clarence Thomas, and the Revolutionary Vision of Education (United States)

    Warnick, Bryan R.; Rowe, Bradley; Kim, Sang Hyun


    In his concurring opinion to the 2007 U.S. Supreme Court decision, "Morse v. Frederick," Justice Clarence Thomas argues that the "Tinker" decision, which granted students constitutional rights in public schools, should be overturned on originalist grounds. In this essay, Bryan Warnick, Bradley Rowe, and Sang Hyun Kim make the case that Thomas's…

  4. Improving Pathologists' Communication Skills. (United States)

    Dintzis, Suzanne


    The 2015 Institute of Medicine report on diagnostic error has placed a national spotlight on the importance of improving communication among clinicians and between clinicians and patients [1]. The report emphasizes the critical role that communication plays in patient safety and outlines ways that pathologists can support this process. Despite recognition of communication as an essential element in patient care, pathologists currently undergo limited (if any) formal training in communication skills. To address this gap, we at the University of Washington Medical Center developed communication training with the goal of establishing best practice procedures for effective pathology communication. The course includes lectures, role playing, and simulated clinician-pathologist interactions for training and evaluation of pathology communication performance. Providing communication training can help create reliable communication pathways that anticipate and address potential barriers and errors before they happen. © 2016 American Medical Association. All Rights Reserved.

  5. Benchmarking Academic Anatomic Pathologists

    Directory of Open Access Journals (Sweden)

    Barbara S. Ducatman MD


    Full Text Available The most common benchmarks for faculty productivity are derived from Medical Group Management Association (MGMA or Vizient-AAMC Faculty Practice Solutions Center ® (FPSC databases. The Association of Pathology Chairs has also collected similar survey data for several years. We examined the Association of Pathology Chairs annual faculty productivity data and compared it with MGMA and FPSC data to understand the value, inherent flaws, and limitations of benchmarking data. We hypothesized that the variability in calculated faculty productivity is due to the type of practice model and clinical effort allocation. Data from the Association of Pathology Chairs survey on 629 surgical pathologists and/or anatomic pathologists from 51 programs were analyzed. From review of service assignments, we were able to assign each pathologist to a specific practice model: general anatomic pathologists/surgical pathologists, 1 or more subspecialties, or a hybrid of the 2 models. There were statistically significant differences among academic ranks and practice types. When we analyzed our data using each organization’s methods, the median results for the anatomic pathologists/surgical pathologists general practice model compared to MGMA and FPSC results for anatomic and/or surgical pathology were quite close. Both MGMA and FPSC data exclude a significant proportion of academic pathologists with clinical duties. We used the more inclusive FPSC definition of clinical “full-time faculty” (0.60 clinical full-time equivalent and above. The correlation between clinical full-time equivalent effort allocation, annual days on service, and annual work relative value unit productivity was poor. This study demonstrates that effort allocations are variable across academic departments of pathology and do not correlate well with either work relative value unit effort or reported days on service. Although the Association of Pathology Chairs–reported median work relative

  6. The Pathologist Pipeline

    Directory of Open Access Journals (Sweden)

    Wesley Y. Naritoku MD, PhD


    Full Text Available A shortage of physicians in the United States has been long projected. Because of predictions of retirement among the aging pathology workforce, there is an anticipated shortage of pathologist as well. To address the pathology workforce shortage among pathologists, the Association of Pathology Chairs assembled a subcommittee of the Association of Pathology Chairs Advocacy Committee to explore ways to identify the strengths, weaknesses, opportunities, and threats to the pathology workforce. One opportunity to encourage strong candidates to pursue pathology as a career is to explore possibility to revisit advanced credit for the post-sophomore fellowship. A survey that was designed to understand the post-sophomore fellowship training better was distributed on the listserv of the Program Directors Section of the Association of Pathology Chairs. A review of the literature on post-sophomore fellowship programs is presented in light of the findings from this survey. Many post-sophomore fellowship programs are run similar to a first-year resident experience, although programs show great diversity in curriculum, including some programs that focus on research. Post-sophomore fellowships attract medical students to the area of pathology and tend to end up in academic and research positions. A second survey of program directors served as an opinion poll of challenging issues that affect residency training. From the second opinion poll, most program directors feel that residents can use additional training to improve the outcome of our future pathologists.

  7. ‘Beware of Elites Bearing Theories’: Clarence Thomas on Race and Education

    NARCIS (Netherlands)

    New, W.; Merry, M.S.


    No matter one's political loyalties, it seems worthwhile to take seriously Clarence Thomas’s ideas about education because over the past twenty-five years most have acquired the force of law. This article explains Thomas’ views on the legitimacy and efficacy of affirmative action as a remedy to

  8. From Typology to Topography in Clarence King's "Mountaineering in the Sierra Nevada." (United States)

    Hoekzema, Loren

    The book "Mountaineering in the Sierra Nevada" by Clarence King, a late-ninteenth-century American geologist, writer, art critic, and romantic, is discussed in this paper. In the writing and revision of this book, King was attempting a metamorphosis of landscape description into popular reading as he moved from being a symbolic writer to…

  9. Mid-late Holocene paleoseismicity of the eastern Clarence Fault, Marlborough, New Zealand

    International Nuclear Information System (INIS)

    Van Dissen, R.J.; Nicol, A.


    The middle Clarence valley, or eastern, section of the active Clarence Fault bounds the steep southeast flank of the Inland Kaikoura Range, Marlborough, New Zealand. This section of the fault extends c. 45 km northeastwards from its junction with the Elliott Fault to Mead Stream, where the active trace of the fault appears to abruptly end. Along the active trace, 41 separate right-lateral offsets of c. 3-40 m were recorded with uncertainties of 10-50% (mean 25%) using tape measurement of displaced topographic features (e.g., gully walls, landslide margins, and ridge crests). Single-event right-lateral displacements of 7 ± 2 m are inferred and indicate earthquake magnitudes of Mw 7.2-7.9. Probable rupture lengths have been in excess of 45 km, which suggests that rupture of the middle Clarence valley (eastern) section of the fault extended to the west onto the central Clarence and/or Elliott faults. Stream incision through the uphill-facing fault scarp at Ravine Stream and Dead Horse Gully has exposed progressively faulted peat and charcoal horizons. Elsewhere, there are several exposures of unfaulted sediments. Twelve radiocarbon samples dated from these horizons constrain the timing of the four most recent surface-rupture earthquakes on the Clarence Fault in the study area. The most recent surface rupture took place at c. 1700-1900 cal. yr BP (rounded to the nearest hundred years), with two surface ruptures since c. 3400 cal. yr BP, three since 6700 cal. yr BP, and most likely a fourth surface rupture at c. 6600-6900 cal. yr BP. These data suggest a recurrence interval for surface-rupture earthquakes of c. 1700 yr, and imply a lateral slip rate of c. 4 mm/yr (i.e., c. 7 m of slip every c. 1700 yr). (author). 45 refs., 9 figs., 3 tabs.

  10. Glacial and postglacial geology near Lake Tennyson, Clarence River, New Zealand

    International Nuclear Information System (INIS)

    McCalpin, J.P.


    Otiran valley glaciers extended 15 km down the upper Clarence Valley in central Marlborough, South Island, New Zealand. A massive Otiran terminal moraine complex, composed of moraines of three glacial advances, impounds Lake Tennyson. The moraines are early and middle Otiran, and possibly late Otiran-early Aranuian in age, based on relative position and differences in moraine morphology, weathering rinds, and soils. Radiocarbon ages from a tributary (Serpentine Creek) suggest the latest major episode of aggradation in the Clarence Valley was in progress by 11.3 ka, and had ended by 9.2 ka. Postglacial history was dominated by incision of glacial outwash, deposition of small alluvial fans, and landsliding near the trace of the Awatere Fault. Fault scarps of the Awatere Fault and of unnamed parallel splays displace early Otiran moraines up to 19 m and early Holocene terraces up to 2.6 m. (author). 25 refs., 10 figs., 3 tabs

  11. Fluorescence confocal microscopy for pathologists. (United States)

    Ragazzi, Moira; Piana, Simonetta; Longo, Caterina; Castagnetti, Fabio; Foroni, Monica; Ferrari, Guglielmo; Gardini, Giorgio; Pellacani, Giovanni


    surgical specimens other than the skin and to evaluate the diagnostic capability of this technology from pathologists' viewpoint.

  12. Twenty-First Century Pathologists' Advocacy. (United States)

    Allen, Timothy Craig


    Pathologists' advocacy plays a central role in the establishment of continuously improving patient care quality and patient safety, and in the maintenance and progress of pathology as a profession. Pathology advocacy's primary goal is the betterment of patient safety and quality medical care; however, payment is a necessary and appropriate component to both, and has a central role in advocacy. Now is the time to become involved in pathology advocacy; the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act of 2015 (MACRA) and the Protecting Access to Medicare Act of 2014 (PAMA) are 2 of the most consequential pieces of legislation impacting the pathology and laboratory industry in the last 20 years. Another current issue of far-reaching impact for pathologists is balance billing, and yet many pathologists have little or no understanding of balance billing. Pathologists at all stages of their careers, and in every professional setting, need to participate. Academic pathologists have a special obligation to, if not become directly involved in advocacy, at least have a broad and current understanding of those issues, as well as the need and responsibility of pathologists to actively engage in advocacy efforts to address them, in order to teach residents the place of advocacy, and its value, as an inseparable and indispensable component of their professional responsibilities.

  13. Definition, age, and correlation of the Clarence Series stages in New Zealand (late Early to early Late Cretaceous)

    International Nuclear Information System (INIS)

    Crampton, J.S.; Tulloch, A.J.; Wilson, G.J.; Ramezani, J.; Speden, I.G.


    The New Zealand local Clarence Series spans the Lower/Upper Cretaceous boundary and includes three stages, in ascending order, the Urutawan, Motuan, and Ngaterian. All three were defined originally from a type section at Motu Falls, Raukumara Peninsula. To address problems with their original definitions and to improve correlations between the New Zealand time-scale and Global Chronostratigraphic Scale, four key sections have been re-studied: the Motu Falls and adjacent Te Waka sections, and the Coverham and Seymour sections in the Clarence valley, Marlborough. The sections contain locally abundant macrofossils and have been sampled at a reconnaissance level for dinoflagellates. In addition, a middle Motuan tuff bed in the Motu Falls section has yielded a zircon U-Pb age of 101.6 ± 0.2 Ma, and an upper Ngaterian basalt flow in the Seymour section has yielded a plagioclase Ar/Ar age of 96.1 ± 0.6 Ma. The older of these dates allows, for the first time, direct age correlation of Clarence Series stages that are based on marine strata in eastern New Zealand, with non-marine rocks in the west. Thus, the Stitts Tuff, at the base of the Pororari Group in the western South Island, is shown to be middle Motuan. Based on the new data, we emend the definitions of the Clarence Series stages. The base of the Urutawan is defined using the lowest occurrence of the inoceramid bivalve Mytiloides ipuanus in the Motu Falls section. The base of the Motuan is defined using the lowest occurrence of the bivalve Aucellina euglypha in the same section. The base of the Ngaterian is defined using the lowest occurrence of the inoceramid 'I.' tawhanus in the Te Waka section. In all three cases, the placements of the lowest occurrence datums are subject to uncertainties that can only be resolved by further biostratigraphic and/or taxonomic study. Based on biostratigraphic data and the new radiometric dates, the following international correlations are proposed: Urutawan Stage = lower

  14. [Pathology and pathologists in fiction revisited]. (United States)

    Nizze, H


    Pathology and pathologists are rarely the subjects of works of fiction. In the existing sources, the kind of representation naturally depends on the occupations and attitudes of the respective authors. The surgeon and gynecologist Carl Ludwig Schleich recollected Rudolf Virchow's free and easy handling of an autopsy assistant and his simultaneous understanding for a mourning husband. The dermatologist Gottfried Benn processed his disturbing impressions of pathology as an expressionistic dialogue between professor and students, with a violent ending. The writer and dramatic adviser Günther Weisenborn recalled unpleasant details about the autopsy course in his earlier medical studies, which he linked with individual views about the life of a deceased young woman. Praise, so to speak, to the dissecting pathologist have been sensitively written by the lawyer Maxence van der Meersch and by the surgeon Peter Bamm. Finally, the bestselling novelist Arthur Hailey gives an excellent fictional portrayal of the microscopic pathologist in The Final Diagnosis.

  15. The Moundville Expeditions of Clarence Bloomfield Moors, edited and with an Introduction by Vernon James Knight Jr. University of Alabama Press, Tuscaloosa, 1996

    Directory of Open Access Journals (Sweden)

    Douglas R. Givens


    Full Text Available The University of Alabama Press has done a valuable service to the Americanist archaeological community by reprinting certain parts of Clarence B. Moore's Moundville's work. As part of their series "Classics in Southeastern Archaeology", this volume provides the historian of Americanist archaeology yet another glimpse into the Moore's classic work at Moundville.

  16. Electronic medical devices: a primer for pathologists. (United States)

    Weitzman, James B


    Electronic medical devices (EMDs) with downloadable memories, such as implantable cardiac pacemakers, defibrillators, drug pumps, insulin pumps, and glucose monitors, are now an integral part of routine medical practice in the United States, and functional organ replacements, such as the artificial heart, pancreas, and retina, will most likely become commonplace in the near future. Often, EMDs end up in the hands of the pathologist as a surgical specimen or at autopsy. No established guidelines for systematic examination and reporting or comprehensive reviews of EMDs currently exist for the pathologist. To provide pathologists with a general overview of EMDs, including a brief history; epidemiology; essential technical aspects, indications, contraindications, and complications of selected devices; potential applications in pathology; relevant government regulations; and suggested examination and reporting guidelines. Articles indexed on PubMed of the National Library of Medicine, various medical and history of medicine textbooks, US Food and Drug Administration publications and product information, and specifications provided by device manufacturers. Studies were selected on the basis of relevance to the study objectives. Descriptive data were selected by the author. Suggested examination and reporting guidelines for EMDs received as surgical specimens and retrieved at autopsy. Electronic medical devices received as surgical specimens and retrieved at autopsy are increasing in number and level of sophistication. They should be systematically examined and reported, should have electronic memories downloaded when indicated, will help pathologists answer more questions with greater certainty, and should become an integral part of the formal knowledge base, research focus, training, and practice of pathology.

  17. Evaluating Nonclinical Performance of the Academic Pathologist

    Directory of Open Access Journals (Sweden)

    Austin Blackburn Wiles MD


    Full Text Available Academic pathologists perform clinical duties, as well as valuable nonclinical activities. Nonclinical activities may consist of research, teaching, and administrative management among many other important tasks. While clinical duties have many clear metrics to measure productivity, like the relative value units of Medicare reimbursement, nonclinical performance is often difficult to measure. Despite the difficulty of evaluating nonclinical activities, nonclinical productivity is used to determine promotion, funding, and inform professional evaluations of performance. In order to better evaluate the important nonclinical performance of academic pathologists, we present an evaluation system for leadership use. This system uses a Microsoft Excel workbook to provide academic pathologist respondents and reviewing leadership a transparent, easy-to-complete system that is both flexible and scalable. This system provides real-time feedback to academic pathologist respondents and a clear executive summary that allows for focused guidance of the respondent. This system may be adapted to fit practices of varying size, measure performance differently based on years of experience, and can work with many different institutional values.

  18. "Ask The Pathologist": An Internet Forum Facilitating Communication Between Cancer Registrars and Pathologists. (United States)

    Strickland-Marmol, Leah B; Muro-Cacho, Carlos A; Washington, Kay; Foulis, Philip R


    - Cancer registrars should work closely with pathologists to ensure compliance with reporting standards. Many registrars, however, have little contact with pathologists, resulting in a lack of "real-time" interaction that is essential for their professional activities and development. - To facilitate registrars' case management, as cancer biology becomes more complex, we developed the ATP (Ask the Pathologist) forum as a place to ask pathology-related questions about neoplasms, such as terminology, biology, histologic classification, extent of disease, molecular markers, and prognostic factors. - Questions posted are reviewed by the ATP multidisciplinary oversight committee, which consists of 3 pathologists, 4 cancer registrars, 1 internal medicine physician, the pathology resident member of the College of American Pathologists Cancer Committee, and 2 medical technologists. The oversight committee may answer the question. Alternatively, the committee may forward the question to a content expert pathologist, determine that the question is better suited for another reference Web site, or both. - Since September 2013, when the ATP forum became available, users have posted 284 questions, of which 48 (17%) related to gastrointestinal tumors, 43 (15%) to breast tumors, and 37 (13%) to general pathology. The average turnaround time, from question posted to response, is 11.1 days. - The ATP forum has had a positive impact in the daily activities of cancer registrars. Of 440 registrars surveyed, more than 90% considered that questions were answered satisfactorily, and one-third reported that ATP answers affected how they managed a given case.

  19. Paleoenvironmental changes across the Cretaceous/Tertiary boundary in the northern Clarence valley, southeastern Marlborough, New Zealand

    International Nuclear Information System (INIS)

    Hollis, C.J.; Rodgers, K.A.; Strong, C.P.; Field, B.D.; Rogers, K.M.


    Strata outcropping in Mead and Branch Streams, northern Clarence valley, provide important records of pelagic-hemipelagic sedimentation through the Cretaceous-Paleocene transition in a southern high-latitude, upwelling system flanking a carbonate platform. The two stream sections, 13 C) indicate that high biological productivity continued across the K/T boundary and through the biosiliceous episode. Siliceous plankton thrived in the Marlborough upwelling zone during the Early Paleocene. Fluctuations in abundance and lithofacies can be related to significant changes in sea level, which may be the result of local tectonic or global climate changes. The delayed recovery of calcareous plankton after mass extinction at the K/T boundary, in both outer neritic and bathyal settings, indicates a relatively cool oceanic regime for the first 1.5 m.y. of the Paleocene. (author). 68 refs., 11 figs., 6 tabs

  20. Response of groundwater level and surface-water/groundwater interaction to climate variability: Clarence-Moreton Basin, Australia (United States)

    Cui, Tao; Raiber, Matthias; Pagendam, Dan; Gilfedder, Mat; Rassam, David


    Understanding the response of groundwater levels in alluvial and sedimentary basin aquifers to climatic variability and human water-resource developments is a key step in many hydrogeological investigations. This study presents an analysis of groundwater response to climate variability from 2000 to 2012 in the Queensland part of the sedimentary Clarence-Moreton Basin, Australia. It contributes to the baseline hydrogeological understanding by identifying the primary groundwater flow pattern, water-level response to climate extremes, and the resulting dynamics of surface-water/groundwater interaction. Groundwater-level measurements from thousands of bores over several decades were analysed using Kriging and nonparametric trend analysis, together with a newly developed three-dimensional geological model. Groundwater-level contours suggest that groundwater flow in the shallow aquifers shows local variations in the close vicinity of streams, notwithstanding general conformance with topographic relief. The trend analysis reveals that climate variability can be quickly reflected in the shallow aquifers of the Clarence-Moreton Basin although the alluvial aquifers have a quicker rainfall response than the sedimentary bedrock formations. The Lockyer Valley alluvium represents the most sensitively responding alluvium in the area, with the highest declining (-0.7 m/year) and ascending (2.1 m/year) Sen's slope rates during and after the drought period, respectively. Different surface-water/groundwater interaction characteristics were observed in different catchments by studying groundwater-level fluctuations along hydrogeologic cross-sections. The findings of this study lay a foundation for future water-resource management in the study area.

  1. Professor Witold Nowicki - a greatly spirited pathologist. (United States)

    Wincewicz, A; Szepietowska, A; Sulkowski, S


    This paper presents a complete overview of the scientific, professional and social activity of a great Polish pathologist, Witold Nowicki (1878-1941), from mainly Polish-written, original sources with a major impact on mostly his own publications. The biographical commemoration of this eminent professor is not only due to the fact that he provided a profound microscopic characterization of pneumatosis cystoides in 1909 and 1924. Nowicki greatly influenced the development of anatomical pathology in Poland, having authored over 82 publications, with special reference to tuberculosis, lung cancer, sarcomatous carcinomas, scleroma and others. However, the first of all his merits for the readership of Polish pathologists was his textbook titled Anatomical Pathology, which was a basic pathology manual in pre-war Poland. Witold Nowicki - as the head of the academic pathological anatomy department and former dean of the medical faculty - was shot with other professors by Nazi Germans in the Wuleckie hills in Lvov during World War Two. Professor Nowicki was described as being "small in size but great in spirit" by one of his associates, and remains an outstanding example of a meticulous pathologist, a patient tutor and a great social activist to follow.

  2. Biostratigraphy and carbon isotope stratigraphy of uppermost Cretaceous-lower Cenozoic Muzzle Group in middle Clarence valley, New Zealand

    International Nuclear Information System (INIS)

    Hollis, C.J.; Field, B.D.; Jones, C.M.; Strong, C.P.; Wilson, G.J.; Dickens, G.R.


    Muzzle Group strata exposed along southeast-flowing tributaries of the Clarence River valley, Marlborough, record hemipelagic-pelagic sedimentation across a high latitude (c. 55 degrees S), terrigenous sediment-starved, continental margin from latest Cretaceous to middle Eocene times. Studies of dinoflagellates, foraminifera, calcareous nannofossils, and radiolarians have been integrated with bulk carbonate δ 13 C profiles to establish the chronostratigraphy for two stratigraphic sections along Bluff and Muzzle Streams, middle Clarence valley. The two sections comprise similar successions. Uppermost Cretaceous (upper Haumurian) micritic limestone of Mead Hill Formation is overlain unconformably by Teredo Limestone, a c. 0.25 m thick bed of highly glauconitic, calcareous sandstone. This unit, the basal member of Amuri Limestone, is overlain conformably by c. 15 m thick Lower Limestone, micritic limestone that is glauconitic at base and progressively more marl-rich in its upper part. Lower Limestone grades up into Lower Marl, a poorly exposed, 40-70 m thick unit of alternating marl and micritic limestone beds. Biostratigraphy indicates that the base of Amuri Limestone is younger at Bluff Stream (earliest Eocene, early Waipawan) than at Muzzle Stream (late Paleocene, late Teurian). In the condensed (12 m) upper Paleocene-lower Eocene Amuri Limestone sequence at Muzzle Stream, a trend in δ 13 C from high (≥2.4 permille) to low (≤1 permille) values is consistent with global records across three major climate or carbon cycle perturbations: the late Paleocene carbon isotope maximum (PCIM, 59-56 Ma), the initial Eocene thermal maximum (IETM, 55.5 Ma), and the early Eocene climatic optimum (EECO, 53-50 Ma). Probably only the upper PCIM is preserved in the 4 m thick siliceous limestone interval overlying Teredo Limestone. The IETM is well-defined by a 1 permille negative δ 13 C excursion at the base of a 0.8 m thick marl-rich unit (Dee Marl), 5 m above the base of

  3. Practical Stereology Applications for the Pathologist. (United States)

    Brown, Danielle L


    Qualitative histopathology is the gold standard for routine examination of morphological tissue changes in the regulatory or academic environment. The human eye is exceptional for pattern recognition but often cannot detect small changes in quantity. In cases where detection of subtle quantitative changes is critical, more sensitive methods are required. Two-dimensional histomorphometry can provide additional quantitative information and is quite useful in many cases. However, the provided data may not be referent to the entire tissue and, as such, it makes several assumptions, which are sources of bias. In contrast, stereology is design based rather than assumption based and uses stringent sampling methods to obtain accurate and precise 3-dimensional information using geometrical and statistical principles. Recent advances in technology have made stereology more approachable and practical for the pathologist in both regulatory and academic environments. This review introduces pathologists to the basic principles of stereology and walks the reader through some real-world examples for the application of these principles in the workplace.

  4. A Case Study of a Collaborative Speech-Language Pathologist (United States)

    Ritzman, Mitzi J.; Sanger, Dixie; Coufal, Kathy L.


    This study explored how a school-based speech-language pathologist implemented a classroom-based service delivery model that focused on collaborative practices in classroom settings. The study used ethnographic observations and interviews with 1 speech-language pathologist to provide insights into how she implemented collaborative consultation and…

  5. Benchmarking Academic Anatomic Pathologists: The Association of Pathology Chairs Survey. (United States)

    Ducatman, Barbara S; Parslow, Tristram


    The most common benchmarks for faculty productivity are derived from Medical Group Management Association (MGMA) or Vizient-AAMC Faculty Practice Solutions Center ® (FPSC) databases. The Association of Pathology Chairs has also collected similar survey data for several years. We examined the Association of Pathology Chairs annual faculty productivity data and compared it with MGMA and FPSC data to understand the value, inherent flaws, and limitations of benchmarking data. We hypothesized that the variability in calculated faculty productivity is due to the type of practice model and clinical effort allocation. Data from the Association of Pathology Chairs survey on 629 surgical pathologists and/or anatomic pathologists from 51 programs were analyzed. From review of service assignments, we were able to assign each pathologist to a specific practice model: general anatomic pathologists/surgical pathologists, 1 or more subspecialties, or a hybrid of the 2 models. There were statistically significant differences among academic ranks and practice types. When we analyzed our data using each organization's methods, the median results for the anatomic pathologists/surgical pathologists general practice model compared to MGMA and FPSC results for anatomic and/or surgical pathology were quite close. Both MGMA and FPSC data exclude a significant proportion of academic pathologists with clinical duties. We used the more inclusive FPSC definition of clinical "full-time faculty" (0.60 clinical full-time equivalent and above). The correlation between clinical full-time equivalent effort allocation, annual days on service, and annual work relative value unit productivity was poor. This study demonstrates that effort allocations are variable across academic departments of pathology and do not correlate well with either work relative value unit effort or reported days on service. Although the Association of Pathology Chairs-reported median work relative value unit productivity

  6. Pathologists and the judicial process: how to avoid it. (United States)

    Epstein, J I


    This review article covers the full range of issues concerning malpractice as it relates to pathologists. Following a brief summary as to the incidence and general statistics on the outcome of lawsuits as well as common pathology misdiagnoses resulting in lawsuits, the definition of malpractice is discussed. These include duty, breech of standard of care, proximal cause, and damage. Details are provided as to what a pathologist should do from the initial threat of a lawsuit, to the initial lawsuit, and through the initial physician/lawyer meeting. An in-depth analysis as to how pathologists should handle themselves through the discovery process and, in particular, deposition is provided. Plaintiff attorneys' goals at deposition are covered in depth. These goals include: 1) education about the pathologist's case and strategies; 2) impeachment of the pathologist's credibility; and 3) judgment as to how effective a witness the pathologist will be at trial. Various types of plaintiff's attorney at deposition are summarized. Also discussed is the post-deposition meeting with the legal representative, whether to settle, and specific issues relating to trial. Finally, general tips on how to avoid a lawsuit in pathology are reviewed.

  7. Mitotic Figure Recognition: Agreement among Pathologists and Computerized Detector

    Directory of Open Access Journals (Sweden)

    Christopher Malon


    Full Text Available Despite the prognostic importance of mitotic count as one of the components of the Bloom – Richardson grade [3], several studies ([2, 9, 10] have found that pathologists’ agreement on the mitotic grade is fairly modest. Collecting a set of more than 4,200 candidate mitotic figures, we evaluate pathologists' agreement on individual figures, and train a computerized system for mitosis detection, comparing its performance to the classifications of three pathologists. The system’s and the pathologists’ classifications are based on evaluation of digital micrographs of hematoxylin and eosin stained breast tissue. On figures where the majority of pathologists agree on a classification, we compare the performance of the trained system to that of the individual pathologists. We find that the level of agreement of the pathologists ranges from slight to moderate, with strong biases, and that the system performs competitively in rating the ground truth set. This study is a step towards automatic mitosis count to accelerate a pathologist's work and improve reproducibility.

  8. The virtuous pathologist. An ethical basis for laboratory medicine. (United States)

    Stempsey, W E


    The profession of pathology is a practice in the technical sense used by many philosophers. Such practices have internal goods, which, it is hoped, lead to the attainment of a certain end. The ultimate end of the practice of pathology must be the good of the patient in terms of restoring health. Key internal goods in pathology are technical competence, the proper pathologist-patient relationship, and the proper pathologist-clinician relationship. Virtues are predispositions to act so as to attain the end of the practice and further the internal goods. Technical growth in the practice of pathology must be accompanied by continued attempts to articulate the goals and internal goods of the practice. Only if pathologists are predisposed to act in accordance with proper goals will an ethical practice be assured.

  9. Resourcing speech-language pathologists to work with multilingual children. (United States)

    McLeod, Sharynne


    Speech-language pathologists play important roles in supporting people to be competent communicators in the languages of their communities. However, with over 7000 languages spoken throughout the world and the majority of the global population being multilingual, there is often a mismatch between the languages spoken by children and families and their speech-language pathologists. This paper provides insights into service provision for multilingual children within an English-dominant country by viewing Australia's multilingual population as a microcosm of ethnolinguistic minorities. Recent population studies of Australian pre-school children show that their most common languages other than English are: Arabic, Cantonese, Vietnamese, Italian, Mandarin, Spanish, and Greek. Although 20.2% of services by Speech Pathology Australia members are offered in languages other than English, there is a mismatch between the language of the services and the languages of children within similar geographical communities. Australian speech-language pathologists typically use informal or English-based assessments and intervention tools with multilingual children. Thus, there is a need for accessible culturally and linguistically appropriate resources for working with multilingual children. Recent international collaborations have resulted in practical strategies to support speech-language pathologists during assessment, intervention, and collaboration with families, communities, and other professionals. The International Expert Panel on Multilingual Children's Speech was assembled to prepare a position paper to address issues faced by speech-language pathologists when working with multilingual populations. The Multilingual Children's Speech website ( ) addresses one of the aims of the position paper by providing free resources and information for speech-language pathologists about more than 45 languages. These international

  10. Cytologic diagnosis: expression of probability by clinical pathologists. (United States)

    Christopher, Mary M; Hotz, Christine S


    Clinical pathologists use descriptive terms or modifiers to express the probability or likelihood of a cytologic diagnosis. Words are imprecise in meaning, however, and may be used and interpreted differently by pathologists and clinicians. The goals of this study were to 1) assess the frequency of use of 18 modifiers, 2) determine the probability of a positive diagnosis implied by the modifiers, 3) identify preferred modifiers for different levels of probability, 4) ascertain the importance of factors that affect expression of diagnostic certainty, and 5) evaluate differences based on gender, employment, and experience. We surveyed 202 clinical pathologists who were board-certified by the American College of Veterinary Pathologists (Clinical Pathology). Surveys were distributed in October 2001 and returned by e-mail, fax, or surface mail over a 2-month period. Results were analyzed by parametric and nonparametric tests. Survey response rate was 47.5% (n = 96) and primarily included clinical pathologists at veterinary schools (n = 58) and diagnostic laboratories (n = 31). Eleven of 18 terms were used "often" or "sometimes" by >/= 50% of respondents. Broad variability was found in the probability assigned to each term, especially those with median values of 75 to 90%. Preferred modifiers for 7 numerical probabilities ranging from 0 to 100% included 68 unique terms; however, a set of 10 terms was used by >/= 50% of respondents. Cellularity and quality of the sample, experience of the pathologist, and implications of the diagnosis were the most important factors affecting the expression of probability. Because of wide discrepancy in the implied likelihood of a diagnosis using words, defined terminology and controlled vocabulary may be useful in improving communication and the quality of data in cytology reporting.

  11. Adhesion molecules in breast carcinoma: a challenge to the pathologist

    Directory of Open Access Journals (Sweden)

    Claudia Rossetti


    Full Text Available The role of adhesion molecules is very important both in the activation of carcinogenesis and in the differentiation of subtypes of breast carcinoma, aiding in diagnosis, prognosis and therapeutic choice in these tumors. Therefore, understanding the functions and interrelationships among these molecules is crucial to the pathologist, who often uses these factors as a resource to differentiate tumors and further classify them according to a molecular point of view. Our goal is to describe the applicability and the difficulties encountered by the pathologist in the diagnosis of breast carcinoma, discussing the most commonly used markers of adhesion in routine analyses.

  12. Annual congress of the South African Society of Pathologists

    International Nuclear Information System (INIS)


    The joint annual congress of the South African Society of Pathologists, International Academy of Pathology, South African Association of Clinical Biochemists and the Southern African Microbiology Society, was held from 13 to 15 July 1981 in Bloemfontein. This congress covered facets of clinical biochemistry, anatomical pathology, virology, microbiology, immunology and molecular biology

  13. Activity-based differentiation of pathologists' workload in surgical pathology

    NARCIS (Netherlands)

    Meijer, G.A.; Oudejans, J.J.; Koevoets, J.J.M.; Meijer, C.J.L.M.


    Adequate budget control in pathology practice requires accurate allocation of resources. Any changes in types and numbers of specimens handled or protocols used will directly affect the pathologists' workload and consequently the allocation of resources. The aim of the present study was to develop a

  14. Activity-based differentiation of pathologists' workload in surgical pathology. (United States)

    Meijer, G A; Oudejans, J J; Koevoets, J J M; Meijer, C J L M


    Adequate budget control in pathology practice requires accurate allocation of resources. Any changes in types and numbers of specimens handled or protocols used will directly affect the pathologists' workload and consequently the allocation of resources. The aim of the present study was to develop a model for measuring the pathologists' workload that can take into account the changes mentioned above. The diagnostic process was analyzed and broken up into separate activities. The time needed to perform these activities was measured. Based on linear regression analysis, for each activity, the time needed was calculated as a function of the number of slides or blocks involved. The total pathologists' time required for a range of specimens was calculated based on standard protocols and validated by comparing to actually measured workload. Cutting up, microscopic procedures and dictating turned out to be highly correlated to number of blocks and/or slides per specimen. Calculated workload per type of specimen was significantly correlated to the actually measured workload. Modeling pathologists' workload based on formulas that calculate workload per type of specimen as a function of the number of blocks and slides provides a basis for a comprehensive, yet flexible, activity-based costing system for pathology.

  15. Non-Small Cell Carcinoma Biomarker Testing: The Pathologist's Perspective.

    Directory of Open Access Journals (Sweden)

    Elisa eBrega


    Full Text Available Biomarker testing has become standard of care for patients diagnosed with non-small cell lung cancer. Although it can be successfully performed in circulating tu-mor cells, at present, the vast majority of investigations are carried out using di-rect tumor sampling, either through aspiration methods, which render most often isolated cells, or tissue sampling, that could range from minute biopsies to large resections. Consequently, pathologists play a central role in this process. Recent evidence suggests that refining NSCLC diagnosis might be clinically signifi-cant, particularly in cases of lung adenocarcinomas (ADC, which in turn, has prompted a new proposal for the histologic classification of such pulmonary neo-plasms. These changes, in conjunction with the mandatory incorporation of biomarker testing in routine NSCLC tissue processing, have directly affected the pathologist’s role in lung cancer work-up. This new role pathologists must play is complex and demanding, and requires a close interaction with surgeons, oncologists, radiologists and molecular pathologists. Pathologists often find themselves as the central figure in the coordination of a process, that involves assuring that the tumor samples are properly fixed, but without disruption of the DNA structure, obtaining the proper diagnosis with a minimum of tissue waste, providing pre-analytical evaluation of tumor samples selected for biomarker testing, which includes assessment of the proportion of tumor to normal tissues, as well as cell viability, and assuring that this entire pro-cess happens in a timely fashion. Therefore, it is part of the pathologist’s respon-sibilities to assure that the samples received in their laboratories, be processed in a manner that allows for optimal biomarker testing. This article goal is to discuss the essential role pathologists must play NSCLC bi-omarker testing, as well as to provide a summarized review of the main NSCLC bi-omarkers of

  16. The role of the speech-language pathologist in home care. (United States)

    Giles, Melanie; Barker, Mary; Hayes, Amanda


    Speech language pathologists play an important role in the care of patients with speech, language, or swallowing difficulties that can result from a variety of medical conditions. This article describes how speech language pathologists assess and treat these conditions and the red flags that suggest a referral to a speech language pathologist is indicated.

  17. New Zealand pathologists: a case study in occupational control. (United States)

    France, N; Lawrence, S; Smith, J F


    This paper examines the progressive exertion of external managerial control over New Zealand pathologists as the country's New Public Management health reforms were implemented during the 1990s. Perspectives on professionalism, and its role in the effective use of resources, are discussed as part of the examination of this shift in decision-making power from pathologists to external management. Our analysis, based on a range of archived and interview data collected over the period 1997-2000, suggests that publicly unacceptable compromises in pathology service quality were risked by the pursuit of tight bureaucratic and free market controls over pathology practice. The paper concludes with suggestions for a health professional control model facilitative of maximal health gain.

  18. Aldred scott warthin: Pathologist and teacher par excellence

    Directory of Open Access Journals (Sweden)

    Vineeth G Nair


    Full Text Available Born in 1866, Aldred Scott Warthin was a pathologist and teacher of great repute. Even though many know him from his eponyms, the true value of his achievements, and how far he was ahead of his peers, is known to but a few modern day medical students. It was in fact, based on his work, that Henry Lynch came up with his theories on the genetic nature of cancer. He died in 1931 leaving a lot of work unfinished.

  19. Discharge experiences of speech-language pathologists working in Cyprus and Greece. (United States)

    Kambanaros, Maria


    Post-termination relationships are complex because the client may need additional services and it may be difficult to determine when the speech-language pathologist-client relationship is truly terminated. In my contribution to this scientific forum, discharge experiences from speech-language pathologists working in Cyprus and Greece will be explored in search of commonalities and differences in the way in which pathologists end therapy from different cultural perspectives. Within this context the personal impact on speech-language pathologists of the discharge process will be highlighted. Inherent in this process is how speech-language pathologists learn to hold their feelings, anxieties and reactions when communicating discharge to clients. Overall speech-language pathologists working in Cyprus and Greece experience similar emotional responses to positive and negative therapy endings as speech-language pathologists working in Australia. The major difference is that Cypriot and Greek therapists face serious limitations in moving their clients on after therapy has ended.

  20. Occupational health risks of pathologists - results from a nationwide online questionnaire in Switzerland

    Directory of Open Access Journals (Sweden)

    Fritzsche Florian Rudolf


    Full Text Available Abstract Background Pathologists are highly trained medical professionals who play an essential part in the diagnosis and therapy planning of malignancies and inflammatory diseases. Their work is associated with potential health hazards including injuries involving infectious human tissue, chemicals which are assumed to be carcinogenic or long periods of microscope and computer work. This study aimed to provide the first comprehensive assessment of the health situation of pathologists in Switzerland. Methods Pathologists in Switzerland were contacted via the Swiss Society of Pathologists and asked to answer an ethically approved, online anonymous questionnaire comprising 48 questions on occupational health problems, workplace characteristics and health behaviour. Results 163 pathologists participated in the study. Forty percent of pathologists reported musculoskeletal problems in the previous month. The overall prevalence was 76%. Almost 90% of pathologists had visual refraction errors, mainly myopia. 83% of pathologists had experienced occupational injuries, mostly cutting injuries, in their professional career; more than one fifth of participants reported cutting injuries in the last year. However, long lasting injuries and infectious diseases were rare. Depression and burnout affected every eighth pathologist. The prevalence of smoking was substantially below that of the general Swiss population. Conclusions The results of this study suggest that more care should be taken in technical and personal protective measures, ergonomic workplace optimisation and reduction of work overload and work inefficiencies. Despite the described health risks, Swiss pathologists were optimistic about their future and their working situation. The high rate of ametropia and psychological problems warrants further study.

  1. Ulrike Freitag: Indian Ocean, Migrants and State Formation in Hadhramaut. Reforming the Homeland. Ulrike Freitag & William Clarence-Smith : Hadhrami Traders, Scholars and Statesmen in the Indian Ocean, 1750s-1960s.

    Directory of Open Access Journals (Sweden)

    Jean Lambert


    Full Text Available Ulrike Freitag Indian Ocean, Migrants and State Formation in Hadhramaut. Reforming the Homeland Leyde / Boston, Brill, 2003 Ulrike Freitag & William Clarence-Smith (directeurs Hadhrami Traders, Scholars and Statesmen in the Indian Ocean, 1750s-1960s Leyde / New-York / Cologne, Brill, 1997 Le livre Indian Ocean, Migrants and State Formation in Hadhramaut nous présente l'histoire moderne du Hadramaout, du début du xixe siècle à la fin de la période britannique (1967, en parallèle avec...

  2. The role of the speech language pathologist in acute stroke

    Directory of Open Access Journals (Sweden)

    Dilworth Cindy


    Full Text Available Dysphagia and communication impairment are common consequences of stroke. Stroke survivors with either or both of these impairments are likely to have poorer long-term outcomes than those who do not have them. Speech-language pathologists (SLP play a significant role in the screening, formal assessment, management, and rehabilitation of stroke survivors who present with dysphagia and/or communication impairment. Early diagnosis and referral is critical, as is intensive intervention as soon as the patient is able to participate. The SLP is also responsible for educating carers and staff in strategies that can support the patient and for making appropriate environmental modifications (e.g. altering diet consistencies or providing information in an aphasia-friendly format to optimize the stroke survivor′s participation, initially, in the rehabilitation program and, subsequently, within the community.

  3. Classroom listening assessment: strategies for speech-language pathologists. (United States)

    Johnson, Cheryl DeConde


    Emphasis on classroom listening has gained importance for all children and especially for those with hearing loss and special listening needs. The rationale can be supported from trends in educational placements, the Response to Intervention initiative, student performance and accountability, the role of audition in reading, and improvement in hearing technologies. Speech-language pathologists have an instrumental role advocating for the accommodations that are necessary for effective listening for these children in school. To identify individual listening needs and make relevant recommendations for accommodations, a classroom listening assessment is suggested. Components of the classroom listening assessment include observation, behavioral assessment, self-assessment, and classroom acoustics measurements. Together, with a strong rationale, the results can be used to implement a plan that results in effective classroom listening for these children. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Juvenile Toxicology: Relevance and Challenges for Toxicologists and Pathologists (United States)

    Remick, Amera K.; Catlin, Natasha R.; Quist, Erin M.; Steinbach, Thomas J.; Dixon, Darlene


    The Society of Toxicologic Pathology (STP) Education Committee and the STP Reproductive Special Interest Group held a North Carolina regional meeting entitled, “Juvenile Toxicology: Relevance and Challenges for Toxicologists and Pathologists” on March 13, 2015, at the National Institute of Environmental Health Sciences/National Toxicology Program in Research Triangle Park, North Carolina. The purpose of this regional meeting was to familiarize attendees with the topic of juvenile toxicity testing and discuss its relevance to clinical pediatric medicine, regulatory perspectives, challenges of appropriate study design confronted by toxicologists, and challenges of histopathologic examination and interpretation of juvenile tissues faced by pathologists. The 1-day meeting was a success with over 60 attendees representing industry, government, research organizations, and academia. PMID:26220944

  5. Advances in Merkel cell carcinoma from a pathologist's perspective. (United States)

    Barksdale, Sarah Kay


    Merkel cell carcinoma (MCC) is a rarely made but potentially devastating diagnosis. While local disease might be cured by surgery and radiotherapy, advanced disease is usually rapidly progressive and fatal. Until very recently, the only approach to metastatic MCC was cytotoxic chemotherapy with results so disappointing that current treatment guidelines discourage its use and recommend clinical trial as a more viable treatment option. Fortunately, recent advances in the understanding of the molecular pathogenesis of this tumour have produced a wide variety of experimental treatments for MCC, some of which are quite promising. The most current information regarding the diagnosis, staging, management of this tumour is briefly presented as well as new insights into the molecular basis of MCC and therapeutic approaches to MCC. Copyright © 2017 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.

  6. [Work quota setting and man-hour productivity estimation in pathologists]. (United States)

    Svistunov, V V; Makarov, S V; Makarova, A E

    The paper considers the development and current state of the regulation of work quota setting and remuneration in pathologists. Reasoning from the current staff standards for morbid anatomy departments (units), the authors present a method to calculate the load of pathologists. The essence of the proposed method is demonstrated using a specific example.

  7. Comparison of specimen adequacy in fine-needle aspiration biopsies performed by surgeons and pathologists

    International Nuclear Information System (INIS)

    Al-Marzooq, Yusef M.; Chopra, Rajan; Al-Bahrani, Ahmed T.; Younis, Mohammad; Al-Mulhim, Abdulrahman S.; Al-Mommatten, Mohammed I.


    Fine-needle aspiration biopsy (FNAB) may yield different results depending on its operator. We compared the proportions of unsatisfactory aspirates obtained by pathologists vs. surgeons. In a retrospective review, all FNAB reports and slides performed between March 2002 and February 2003 were grouped by organ/site and according to whether they were done by pathologist or a surgeon. The proportions of unsatisfactory aspirates for pathologists and surgeons were compared. Of 692 FNAB's, 390 were performed by pathologists at the FNAC clinic and the remainder by surgeons. Overall, 15.5% of aspirates obtained were unsatisfactory (n=107). Of aspirates obtained by surgeons, 29.5% were unsatisfactory, compared to 4.6% of those obtained by pathologists (P<0.001). Pathologists had significantly lower proportions of unsatisfactory aspirates in all sites. A 33% reduction in the number of lymph node excisional biopsies has been reported subsequent to establishment of the FNAC clinic. The advantages of a pathologist performing FNAB are that a rapid evaluation can be rendered regarding specimen adequacy and the need for repeating the procedure. In addition, pathologists can direct the distribution of aspirated material for other tests such as culture study, flow cytometry and electron microscopy, as indicated by preliminary evaluation of the smears. These factors significantly lower the proportions of unsatisfactory specimens and improve the diagnstic accuracy of FNAB technique. (author)

  8. Enhancing and Customizing Laboratory Information Systems to Improve/Enhance Pathologist Workflow. (United States)

    Hartman, Douglas J


    Optimizing pathologist workflow can be difficult because it is affected by many variables. Surgical pathologists must complete many tasks that culminate in a final pathology report. Several software systems can be used to enhance/improve pathologist workflow. These include voice recognition software, pre-sign-out quality assurance, image utilization, and computerized provider order entry. Recent changes in the diagnostic coding and the more prominent role of centralized electronic health records represent potential areas for increased ways to enhance/improve the workflow for surgical pathologists. Additional unforeseen changes to the pathologist workflow may accompany the introduction of whole-slide imaging technology to the routine diagnostic work. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Employer Expectations for Newly Trained Pathologists: Report of a Survey From the Graduate Medical Education Committee of the College of American Pathologists. (United States)

    Post, Miriam D; Johnson, Kristen; Brissette, Mark D; Conran, Richard Michael; Domen, Ronald E; Hoffman, Robert D; McCloskey, Cindy B; Raciti, Patricia M; Roberts, Cory Anthony; Rojiani, Amyn M; Tucker, J Allan; Powell, Suzanne Z


    -Multiple sources have identified challenges that training programs face in preparing graduates for the "real world" practice of pathology, and many training programs have sought to decrease the gap between skills acquired during training and those required in practice. However, there exists the possibility that some of the difficulty experienced by newly trained pathologists and employers might arise from differences between employer expectations of new hires and what applicants expect from their first job. -To define the constellation of skills and attributes employers prioritize when hiring newly trained pathologists. -A survey of fellows of the College of American Pathologists in practice for 5 or more years in the United States was administered and the results were analyzed. -A total of 630 pathologists who were responsible for hiring a new-in-practice pathologist completed the survey. Regardless of practice setting, certain skills and attributes were rated critically important in new hires, including ethics/integrity, work ethic, and professionalism. Seventy-one percent reported having some difficulty hiring entry-level pathologists and cited inadequate training/experience during residency, and applicants having unrealistic expectations regarding work load/hours as the most common reasons. -Prospective employers not only expect well-developed diagnostic skills in their job applicants, but also require evidence of a strong work ethic and outstanding professionalism. Successful applicants must display willingness to assume responsibilities and flexibility regarding existing and new responsibilities. A secondary but important finding of this survey was that most jobs are garnered through word-of-mouth recommendations; therefore, it is crucial for pathologists-in-training to hone their networking skills.

  10. Auditory processing disorders: an update for speech-language pathologists. (United States)

    DeBonis, David A; Moncrieff, Deborah


    Unanswered questions regarding the nature of auditory processing disorders (APDs), how best to identify at-risk students, how best to diagnose and differentiate APDs from other disorders, and concerns about the lack of valid treatments have resulted in ongoing confusion and skepticism about the diagnostic validity of this label. This poses challenges for speech-language pathologists (SLPs) who are working with school-age children and whose scope of practice includes APD screening and intervention. The purpose of this article is to address some of the questions commonly asked by SLPs regarding APDs in school-age children. This article is also intended to serve as a resource for SLPs to be used in deciding what role they will or will not play with respect to APDs in school-age children. The methodology used in this article included a computerized database review of the latest published information on APD, with an emphasis on the work of established researchers and expert panels, including articles from the American Speech-Language-Hearing Association and the American Academy of Audiology. The article concludes with the authors' recommendations for continued research and their views on the appropriate role of the SLP in performing careful screening, making referrals, and supporting intervention.

  11. From Access to Collaboration: Four African Pathologists Profile Their Use of the Internet and Social Media. (United States)

    Royall, Julia; Isyagi, Micongwe Moses; Iliyasu, Yawale; Lukande, Robert; Vuhahula, Edda


    The shared practice of pathology via the Internet holds great potential for pathologists in sub-Saharan Africa (SSA) and their global partners. Application of the Internet is constrained by issues of bandwidth, cost, and power. The penetration of mobile telephony and the arrival of smartphones have changed the use of Internet and social media in Africa and therefore the work of the 4 African pathologists featured in this article. As pathology in SSA struggles for visibility and usefulness, the Internet and its electronic applications provide a critical infrastructure as well as a podium for pathologists across the continent. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Balancing habitat delivery for breeding marsh birds and nonbreeding waterfowl: An integrated waterbird management and monitoring approach at Clarence Cannon National Wildlife Refuge, Missouri (United States)

    Loges, Brian W.; Lyons, James E.; Tavernia, Brian G.


    The Clarence Cannon National Wildlife Refuge (CCNWR) in the Mississippi River flood plain of eastern Missouri provides high quality emergent marsh and moist-soil habitat benefitting both nesting marsh birds and migrating waterfowl. Staff of CCNWR manipulate water levels and vegetation in the 17 units of the CCNWR to provide conditions favorable to these two important guilds. Although both guilds include focal species at multiple planning levels and complement objectives to provide a diversity of wetland community types and water regimes, additional decision support is needed for choosing how much emergent marsh and moist-soil habitat should be provided through annual management actions.To develop decision guidance for balanced delivery of high-energy waterfowl habitat and breeding marsh bird habitat, two measureable management objectives were identified: nonbreeding Anas Linnaeus (dabbling duck) use-days and Rallus elegans (king rail) occupancy of managed units. Three different composite management actions were identified to achieve these objectives. Each composite management action is a unique combination of growing season water regime and soil disturbance. The three composite management actions are intense moist-soil management (moist-soil), intermediate moist-soil (intermediate), and perennial management, which idles soils disturbance (perennial). The two management objectives and three management options were used in a multi-criteria decision analysis to indicate resource allocations and inform annual decision making. Outcomes of the composite management actions were predicted in two ways and multi-criteria decision analysis was used with each set of predictions. First, outcomes were predicted using expert-elicitation techniques and a panel of subject matter experts. Second, empirical data from the Integrated Waterbird Management and Monitoring Initiative collected between 2010 and 2013 were used; where data were lacking, expert judgment was used. Also, a

  13. 22nd Annual congress of the South African Society of Pathologists

    International Nuclear Information System (INIS)


    This publication only contains the abstracts of papers delivered on the 22nd annual congress of the South African Society of Pathologists on 5-7 July 1987. The topics covered, include anatomical pathology, haematology, biochemistry microbiology, and immunology

  14. The pathologist's mean grade is constant and individualizes the prognostic value of bladder cancer grading. (United States)

    van Rhijn, Bas W G; van Leenders, Geert J L H; Ooms, Bert C M; Kirkels, Wim J; Zlotta, Alexandre R; Boevé, Egbert R; Jöbsis, Adriaan C; van der Kwast, Theo H


    A new grading system for bladder cancer (BCa) was adopted in 2004 to reduce observer variability and provide better prognostic information. We compared the World Health Organization (WHO) 1973 and 2004 systems for observer variability and prognosis. Slides of 173 primary non-muscle-invasive BCa were reviewed two times by four pathologists. Intra- and interobserver variability were assessed using κ statistics. We determined the mean grade (eg, G1/low malignant potential is 1 grade point, G2/low grade is 2 grade points) of the pathologists per grading cycle. Kaplan-Meier analyses were applied for prediction of recurrence and progression. For WHO 2004 and 1973 grading, the agreement between the pathologists was 39-74% (κ: 0.14-0.58) and 39-64% (κ: 0.15-0.41), respectively. The intraobserver agreement varied from 71% to 88% (κ: 0.55-0.81). The mean grade of a pathologist was constant (difference below 0.1 grade point) irrespective of the grading system. Conversely, mean-grade differences among the pathologists were high, up to 0.7 grade point. The mean grades for the WHO 2004 system were 0.3-0.5 grade point higher than those of WHO 1973. Mean grade distinguished low and high graders among the pathologists and was strongly linked with risk of progression in each grade category. The variation in mean grade among individual pathologists exceeded the grade shift caused by WHO 2004 grading. Knowledge of the pathologist's mean grade allows a better assessment of the prognostic value of grading. Mean grade has the potential to become a tool for quality assurance in pathology. Copyright © 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  15. Characteristics associated with requests by pathologists for second opinions on breast biopsies. (United States)

    Geller, Berta M; Nelson, Heidi D; Weaver, Donald L; Frederick, Paul D; Allison, Kimberly H; Onega, Tracy; Carney, Patricia A; Tosteson, Anna N A; Elmore, Joann G


    Second opinions in pathology improve patient safety by reducing diagnostic errors, leading to more appropriate clinical treatment decisions. Little objective data are available regarding the factors triggering a request for second opinion despite second opinion consultations being part of the diagnostic system of pathology. Therefore we sought to assess breast biopsy cases and interpreting pathologists characteristics associated with second opinion requests. Collected pathologist surveys and their interpretations of 60 test set cases were used to explore the relationships between case characteristics, pathologist characteristics and case perceptions, and requests for second opinions. Data were evaluated by logistic regression and generalised estimating equations. 115 pathologists provided 6900 assessments; pathologists requested second opinions on 70% (4827/6900) of their assessments 36% (1731/4827) of these would not have been required by policy. All associations between case characteristics and requesting second opinions were statistically significant, including diagnostic category, breast density, biopsy type, and number of diagnoses noted per case. Exclusive of institutional policies, pathologists wanted second opinions most frequently for atypia (66%) and least frequently for invasive cancer (20%). Second opinion rates were higher when the pathologist had lower assessment confidence, in cases with higher perceived difficulty, and cases with borderline diagnoses. Pathologists request second opinions for challenging cases, particularly those with atypia, high breast density, core needle biopsies, or many co-existing diagnoses. Further studies should evaluate whether the case characteristics identified in this study could be used as clinical criteria to prompt system-level strategies for mandating second opinions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  16. Speech language pathologists' opinions of constraint-induced language therapy. (United States)

    Page, Stephen J; Wallace, Sarah E


    Constraint-induced language therapy (CILT) has received recent attention as a possible intervention to improve expressive language in people with nonfluent aphasia. Difficulties have been reported with the practical implementation of constraint-induced movement therapy due to its intensive treatment parameters. It remains unknown whether similar challenges may exist with CILT. To determine the opinions of speech-language pathologists (SLPs) about CILT for people with nonfluent aphasia. One hundred sixty-seven SLPs completed an electronic survey assessing their opinions of various aspects of CILT. Over 60% of participants felt that people with aphasia would be very unlikely or somewhat unlikely to adhere to CILT. The majority felt that people with aphasia would hold high or moderate concerns with the number of hours spent in therapy (high, 41.8%; moderate, 31.4%), the number of days spent in therapy (high, 44.4%; moderate, 24.8%), likelihood for managed care reimbursement (high, 74.8%; moderate, 15.2%), and other logistical issues (high, 39.2%; moderate, 30.7%). With respect to providing CILT, participants cited the number of hours of therapy (high, 37.3%; moderate, 21.6%) and the number of consecutive days of therapy (high, 29.4%; moderate, 20.3%) as concerns. There were 70.6% who indicated that their facilities lacked resources to provide CILT, and 90.9% felt that most facilitates do not have the resources to provide CILT. Some SLPs hold significant concerns with the administration of CILT, particularly related to its dosing and reimbursement parameters. Additional work is needed to investigate the issues that were identified in this survey using qualitative methods with SLPs and people with aphasia and to examine modified CILT protocols.

  17. Commentary: Roles for Pathologists in a High-throughput Image Analysis Team. (United States)

    Aeffner, Famke; Wilson, Kristin; Bolon, Brad; Kanaly, Suzanne; Mahrt, Charles R; Rudmann, Dan; Charles, Elaine; Young, G David


    Historically, pathologists perform manual evaluation of H&E- or immunohistochemically-stained slides, which can be subjective, inconsistent, and, at best, semiquantitative. As the complexity of staining and demand for increased precision of manual evaluation increase, the pathologist's assessment will include automated analyses (i.e., "digital pathology") to increase the accuracy, efficiency, and speed of diagnosis and hypothesis testing and as an important biomedical research and diagnostic tool. This commentary introduces the many roles for pathologists in designing and conducting high-throughput digital image analysis. Pathology review is central to the entire course of a digital pathology study, including experimental design, sample quality verification, specimen annotation, analytical algorithm development, and report preparation. The pathologist performs these roles by reviewing work undertaken by technicians and scientists with training and expertise in image analysis instruments and software. These roles require regular, face-to-face interactions between team members and the lead pathologist. Traditional pathology training is suitable preparation for entry-level participation on image analysis teams. The future of pathology is very exciting, with the expanding utilization of digital image analysis set to expand pathology roles in research and drug development with increasing and new career opportunities for pathologists. © 2016 by The Author(s) 2016.

  18. "Apologies" from pathologists: why, when, and how to say "sorry" after committing a medical error. (United States)

    Dewar, Rajan; Parkash, Vinita; Forrow, Lachlan; Truog, Robert D


    How pathologists communicate an error is complicated by the absence of a direct physician-patient relationship. Using 2 examples, we elaborate on how other physician colleagues routinely play an intermediary role in our day-to-day transactions and in the communication of a pathologist error to the patient. The concept of a "dual-hybrid" mind-set in the intermediary physician and its role in representing the pathologists' viewpoint adequately is considered. In a dual-hybrid mind-set, the intermediary physician can align with the patients' philosophy and like the patient, consider the smallest deviation from norm to be an error. Alternatively, they might embrace the traditional physician philosophy and communicate only those errors that resulted in a clinically inappropriate outcome. Neither may effectively reflect the pathologists' interests. We propose that pathologists develop strategies to communicate errors that include considerations of meeting with the patients directly. Such interactions promote healing for the patient and are relieving to the well-intentioned pathologist.

  19. Speech pathologists' current practice with cognitive-communication assessment during post-traumatic amnesia: a survey. (United States)

    Steel, Joanne; Ferguson, Alison; Spencer, Elizabeth; Togher, Leanne


    To investigate speech pathologists' current practice with adults who are in post-traumatic amnesia (PTA). Speech pathologists with experience of adults in PTA were invited to take part in an online survey through Australian professional email/internet-based interest groups. Forty-five speech pathologists responded to the online survey. The majority of respondents (78%) reported using informal, observational assessment methods commencing at initial contact with people in PTA or when patients' level of alertness allowed and initiating formal assessment on emergence from PTA. Seven respondents (19%) reported undertaking no assessment during PTA. Clinicians described using a range of techniques to monitor cognitive-communication during PTA, including static, dynamic, functional and impairment-based methods. The study confirmed that speech pathologists have a key role in the multidisciplinary team caring for the person in PTA, especially with family education and facilitating interactions with the rehabilitation team and family. Decision-making around timing and means of assessment of cognitive-communication during PTA appeared primarily reliant on speech pathologists' professional experience and the culture of their workplace. The findings support the need for further research into the nature of cognitive-communication disorder and resolution over this period.

  20. Pathologist workforce in the United States: I. Development of a predictive model to examine factors influencing supply. (United States)

    Robboy, Stanley J; Weintraub, Sally; Horvath, Andrew E; Jensen, Bradden W; Alexander, C Bruce; Fody, Edward P; Crawford, James M; Clark, Jimmy R; Cantor-Weinberg, Julie; Joshi, Megha G; Cohen, Michael B; Prystowsky, Michael B; Bean, Sarah M; Gupta, Saurabh; Powell, Suzanne Z; Speights, V O; Gross, David J; Black-Schaffer, W Stephen


    Results of prior pathology workforce surveys have varied between a state of equilibrium and predictions of shortage. To assess the current and future supply of pathologists, and apply a dynamic modeling tool for assessing the effects of changing market forces and emerging technologies on the supply of pathologists' services through 2030. Data came from various sources, including the literature, College of American Pathologists' internal data, and primary research through custom-developed surveys for the membership and for pathology practice managers Through 2010, there were approximately 18 000 actively practicing pathologists in the United States (5.7 per 100 000 population), approximately 93% of whom were board certified. Our model projects that the absolute and per capita numbers of practicing pathologists will decrease to approximately 14 000 full-time equivalent (FTE) pathologists or 3.7 per 100 000 in the coming 2 decades. This projection reflects that beginning in 2015, the numbers of pathologists retiring will increase precipitously, and is anticipated to peak by 2021. Including all types of separation, the net pathologist strength will begin falling by year 2015. Unless workforce entry or exit rates change, this trend will continue at least through 2030. These changes reflect the closure of many training programs 2 to 4 decades ago and the substantially decreased number of graduating residents. This comprehensive analysis predicts that pathologist numbers will decline steadily beginning in 2015. Anticipated population growth in general and increases in disease incidence owing to the aging population, to be presented in a companion article on demand, will lead to a net deficit in excess of more than 5700 FTE pathologists. To reach the projected need in pathologist numbers of nearly 20 000 FTE by 2030 will require an increase from today of approximately 8.1% more residency positions. We believe a pathologist shortage will negatively impact both

  1. The use of oral and maxillofacial pathology services by general pathologists and their attitude towards it in Saudi Arabia. (United States)

    Binmadi, Nada O; Almazrooa, Soulafa A


    To investigate the awareness and usage of oral and maxillofacial pathology (OMFP)  subspecialty services among pathologists in Saudi Arabia. Methods: In this cross-sectional study, we conducted an electronic questionnaire survey of pathologists in all regions of Saudi Arabia. The study was conducted between July 2015 and August 2016.  The questionnaire comprised 19 questions to evaluate the knowledge of pathologists regarding microscopic OMFP and their perceptions towards this subspecialty. Results: Most of the pathologists surveyed (94.6%) were aware of the OMFP subspecialty and its scope of practice. Although most of the pathologists recognized the importance and need of this subspecialty, 70% of them never referred or consulted an oral pathologist as they either diagnosed the cases themselves or  did not know any oral pathologist (57.7%). The pathologists had the greatest difficulty in identifying and diagnosing odontogenic tumors, salivary gland tumors, and odontogenic cysts.  Conclusion: Pathologists are aware of the OMFP subspecialty, but their utilization of the services offered by OMFP specialists in Saudi Arabia is quite low despite the strong demand for OMFP services.

  2. [Web-ring of sites for pathologists in the internet: a computer-mediated communication environment]. (United States)

    Khramtsov, A I; Isianov, N N; Khorzhevskiĭ, V A


    The recently developed Web-ring of pathology-related Web-sites has transformed computer-mediated communications for Russian-speaking pathologists. Though the pathologists may be geographically dispersed, the network provides a complex of asynchronous and synchronous conferences for the purposes of diagnosis, consultations, education, communication, and collaboration in the field of pathology. This paper describes approaches to be used by participants of the pathology-related Web-ring. The approaches are analogous to the tools employed in telepathology and digital microscopy. One of the novel methodologies is the use of Web-based conferencing systems, in which the whole slide digital images of tissue microarrays were jointly reviewed online by pathologists at distant locations. By using ImageScope (Aperio Technologies) and WebEx connect desktop management technology, they shared presentations and images and communicated in realtime. In this manner, the Web-based forums and conferences will be a powerful addition to a telepathology.

  3. Exploring Australian speech-language pathologists' use and perceptions ofnon-speech oral motor exercises. (United States)

    Rumbach, Anna F; Rose, Tanya A; Cheah, Mynn


    To explore Australian speech-language pathologists' use of non-speech oral motor exercises, and rationales for using/not using non-speech oral motor exercises in clinical practice. A total of 124 speech-language pathologists practising in Australia, working with paediatric and/or adult clients with speech sound difficulties, completed an online survey. The majority of speech-language pathologists reported that they did not use non-speech oral motor exercises when working with paediatric or adult clients with speech sound difficulties. However, more than half of the speech-language pathologists working with adult clients who have dysarthria reported using non-speech oral motor exercises with this population. The most frequently reported rationale for using non-speech oral motor exercises in speech sound difficulty management was to improve awareness/placement of articulators. The majority of speech-language pathologists agreed there is no clear clinical or research evidence base to support non-speech oral motor exercise use with clients who have speech sound difficulties. This study provides an overview of Australian speech-language pathologists' reported use and perceptions of non-speech oral motor exercises' applicability and efficacy in treating paediatric and adult clients who have speech sound difficulties. The research findings provide speech-language pathologists with insight into how and why non-speech oral motor exercises are currently used, and adds to the knowledge base regarding Australian speech-language pathology practice of non-speech oral motor exercises in the treatment of speech sound difficulties. Implications for Rehabilitation Non-speech oral motor exercises refer to oral motor activities which do not involve speech, but involve the manipulation or stimulation of oral structures including the lips, tongue, jaw, and soft palate. Non-speech oral motor exercises are intended to improve the function (e.g., movement, strength) of oral structures. The

  4. Legal decision-making by people with aphasia: critical incidents for speech pathologists. (United States)

    Ferguson, Alison; Duffield, Gemma; Worrall, Linda


    The assessment and management of a person with aphasia for whom decision-making capacity is queried represents a highly complex clinical issue. In addition, there are few published guidelines and even fewer published accounts of empirical research to assist. The research presented in this paper aimed to identify the main issues for speech pathologists when decision-making capacity for legal and related matters arose for their clients with aphasia, and to describe qualitatively the nature of these issues and the practices of the speech pathologists in these situations. The methodology was informed by the qualitative research paradigm and made use of the semi-structured interview methods developed for the Critical Incident Technique. Nine speech pathologists, with a range of clinical experience between three and 27 years, were interviewed by telephone, with verbatim notes being taken on-line by the interviewer. The speech pathologists described a total of 21 clients (15 male, six female) with acquired neurological communication disorders (including cerebral vascular accident, traumatic brain injury, and tumour) whose care had raised critical incidents for the speech pathologist in relation to legal and related matters. These verbatim notes were qualitatively analysed using NVivo qualitative analysis software. The main incidents related to legal decisions (for example, power of attorney, will-making), as well as decisions involving consent for medical treatment, discharge, accommodation, and business/financial decisions. In all but one of the incidents recounted, the issues centred on a situation of conflict between the person with aphasia and their family, friends or with the multidisciplinary team. The roles taken by the speech pathologists ranged from those expected within a speech pathology scope of practice, such as that of assessor and consultant, to those which arguably present dilemmas and conflict of interest, for example, interpreter, advocate. The

  5. Ethical Perspective on Quality of Care: The Nature of Ethical Dilemmas Identified by New Graduate and Experienced Speech Pathologists (United States)

    Kenny, Belinda J.; Lincoln, Michelle; Blyth, Katrina; Balandin, Susan


    Background: Speech pathologists are confronted by ethical issues when they need to make decisions about client care, address team conflict, and fulfil the range of duties and responsibilities required of health professionals. However, there has been little research into the specific nature of ethical dilemmas experienced by speech pathologists and…

  6. Dysphagia Management: A Survey of School-Based Speech-Language Pathologists in Vermont (United States)

    Hutchins, Tiffany L.; Gerety, Katherine W.; Mulligan, Moira


    Purpose: This study (a) gathered information about the kinds of dysphagia management services school-based speech-language pathologists (SLPs) provide, (b) examined the attitudes of SLPs related to dysphagia management, (c) compared the responses of SLPs on the basis of their experience working in a medical setting, and (d) investigated the…

  7. Automated Detection of Heuristics and Biases among Pathologists in a Computer-Based System (United States)

    Crowley, Rebecca S.; Legowski, Elizabeth; Medvedeva, Olga; Reitmeyer, Kayse; Tseytlin, Eugene; Castine, Melissa; Jukic, Drazen; Mello-Thoms, Claudia


    The purpose of this study is threefold: (1) to develop an automated, computer-based method to detect heuristics and biases as pathologists examine virtual slide cases, (2) to measure the frequency and distribution of heuristics and errors across three levels of training, and (3) to examine relationships of heuristics to biases, and biases to…

  8. Korean Speech-Language Pathologists' Attitudes toward Stuttering According to Clinical Experiences (United States)

    Lee, Kyungjae


    Background: Negative attitudes toward stuttering and people who stutter (PWS) are found in various groups of people in many regions. However the results of previous studies examining the influence of fluency coursework and clinical certification on the attitudes of speech-language pathologists (SLPs) toward PWS are equivocal. Furthermore, there…

  9. Experienced Speech-Language Pathologists' Responses to Ethical Dilemmas: An Integrated Approach to Ethical Reasoning (United States)

    Kenny, Belinda; Lincoln, Michelle; Balandin, Susan


    Purpose: To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas. Method: Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual…

  10. Speech-Language Pathologists' Preparation, Practices, and Perspectives on Serving Culturally and Linguistically Diverse Children (United States)

    Guiberson, Mark; Atkins, Jenny


    This study describes the backgrounds, diversity training, and professional perspectives reported by 154 Colorado speech-language pathologists in serving children from culturally and linguistically diverse (CLD) backgrounds. The authors compare the results of the current survey to those of a similar survey collected in 1996. Respondents reported…

  11. Speech-Language Pathologists' and Teachers' Perceptions of Classroom-Based Interventions. (United States)

    Beck, Ann R.; Dennis, Marcia


    Speech-language pathologists (N=21) and teachers (N=54) were surveyed regarding their perceptions of classroom-based interventions. The two groups agreed about the primary advantages and disadvantages of most interventions, the primary areas of difference being classroom management and ease of data collection. Other findings indicated few…

  12. Recent Advances in Pancreatic Cancer Surgery of Relevance to the Practicing Pathologist

    NARCIS (Netherlands)

    van Rijssen, Lennart B.; Rombouts, Steffi J. E.; Walma, Marieke S.; Vogel, Jantien A.; Tol, Johanna A.; Molenaar, Isaac Q.; van Eijck, Casper H. J.; Verheij, Joanne; van de Vijver, Marc J.; Busch, Olivier R. C.; Besselink, Marc G. H.


    Recent advances in pancreatic surgery have the potential to improve outcomes for patients with pancreatic cancer. We address 3 new, trending topics in pancreatic surgery that are of relevance to the pathologist. First, increasing awareness of the prognostic impact of intraoperatively detected

  13. Evaluating Nonclinical Performance of the Academic Pathologist: A Comprehensive, Scalable, and Flexible System for Leadership Use. (United States)

    Wiles, Austin Blackburn; Idowu, Michael O; Clevenger, Charles V; Powers, Celeste N


    Academic pathologists perform clinical duties, as well as valuable nonclinical activities. Nonclinical activities may consist of research, teaching, and administrative management among many other important tasks. While clinical duties have many clear metrics to measure productivity, like the relative value units of Medicare reimbursement, nonclinical performance is often difficult to measure. Despite the difficulty of evaluating nonclinical activities, nonclinical productivity is used to determine promotion, funding, and inform professional evaluations of performance. In order to better evaluate the important nonclinical performance of academic pathologists, we present an evaluation system for leadership use. This system uses a Microsoft Excel workbook to provide academic pathologist respondents and reviewing leadership a transparent, easy-to-complete system that is both flexible and scalable. This system provides real-time feedback to academic pathologist respondents and a clear executive summary that allows for focused guidance of the respondent. This system may be adapted to fit practices of varying size, measure performance differently based on years of experience, and can work with many different institutional values.

  14. Identifying Culturally Competent Clinical Skills in Speech-Language Pathologists in the Central Valley of California (United States)

    Maul, Christine A.


    The purpose of this research was to identify specific clinical skills in speech-language pathologists (SLPs) that may constitute cultural competency, a term which currently lacks operational definition. Through qualitative interview methods, the following research questions were addressed: (1) What dominant themes, if any, can be found in SLPs'…

  15. The role of clinical pathologists in the management of male infertility ...

    African Journals Online (AJOL)

    Male infertility is receiving increasing attention in Africa as up to 50% of cases of infertility are ascribed to it. In the management of this condition, the clinical laboratory plays a crucial role especially in the proper identification of causes of infertility. The role of the pathologists in this respect stems from the choice of laboratory ...

  16. Facilitating Emergent Literacy: Efficacy of a Model that Partners Speech-Language Pathologists and Educators (United States)

    Girolametto, Luigi; Weitzman, Elaine; Greenberg, Janice


    Purpose: This study examined the efficacy of a professional development program for early childhood educators that facilitated emergent literacy skills in preschoolers. The program, led by a speech-language pathologist, focused on teaching alphabet knowledge, print concepts, sound awareness, and decontextualized oral language within naturally…

  17. Perceptions of pathology informatics by non-informaticist pathologists and trainees

    Directory of Open Access Journals (Sweden)

    Addie Walker


    Full Text Available Background: Although pathology informatics (PI is essential to modern pathology practice, the field is often poorly understood. Pathologists who have received little to no exposure to informatics, either in training or in practice, may not recognize the roles that informatics serves in pathology. The purpose of this study was to characterize perceptions of PI by noninformatics-oriented pathologists and to do so at two large centers with differing informatics environments. Methods: Pathology trainees and staff at Cleveland Clinic (CC and Massachusetts General Hospital (MGH were surveyed. At MGH, pathology department leadership has promoted a pervasive informatics presence through practice, training, and research. At CC, PI efforts focus on production systems that serve a multi-site integrated health system and a reference laboratory, and on the development of applications oriented to department operations. The survey assessed perceived definition of PI, interest in PI, and perceived utility of PI. Results: The survey was completed by 107 noninformatics-oriented pathologists and trainees. A majority viewed informatics positively. Except among MGH trainees, confusion of PI with information technology (IT and help desk services was prominent, even in those who indicated they understood informatics. Attendings and trainees indicated desire to learn more about PI. While most acknowledged that having some level of PI knowledge would be professionally useful and advantageous, only a minority plan to utilize it. Conclusions: Informatics is viewed positively by the majority of noninformatics pathologists at two large centers with differing informatics orientations. Differences in departmental informatics culture can be attributed to the varying perceptions of PI by different individuals. Incorrect perceptions exist, such as conflating PI with IT and help desk services, even among those who claim to understand PI. Further efforts by the PI community could

  18. The international criminal tribunal for the former Yugoslavia (ICTY) and the forensic pathologist: ethical considerations (United States)

    Lorin De La Grandmaison, Geoffroy; Durigon, Michel; Moutel, Grégoire; Hervé, Christian


    War crimes in the former Yugoslavia since 1991 have been subjected to several international medico-legal investigations of mass graves within the framework of inquiries led by the ICTY. Forensic pathologists involved in the ICTY missions could be subjected to ethical tensions due to the difficulties of the missions, the emergent conflicts between forensic scientists of the teams and the original nature of the ICTY proceedings. In order to study the nature of such ethical tensions, we sent a questionnaire to 65 forensic pathologists who have been involved in the ICTY missions. The rate of answer was 38%. The majority of the forensic pathologists questioned (n=18) did not know how the medico-legal data were exploited by the ICTY. Three of them have been subjected to pressures. Three of them were aware of mass grave sites wittingly not investigated by the ICTY. Fifteen considered that the ICTY respected the elementary rules of the law and four of them questioned the impartiality of the justice led by the ICTY. Two conflicting types of ethics can be drawn from these results: a conviction ethics which is shared by most of the forensic pathologists questioned and a responsibility ethics. In the first, the forensic pathologist completely agrees with the need for an international war crime tribunal even if such justice can be challenged regarding the respect of human rights and impartiality. In the second, he or she needs to conduct himself in ways that do not infringe impartiality. As medical deontology duty requires an impartiality ethics, discursive ethics are needed to ease ethical tensions and to suggest ethical guidelines. Alternatives to international justice through a truth and reconciliation commission and by the way of humanitarian mission of victims’ identification combined with forensic investigations for historical purposes could be considered. PMID:16909642

  19. Speech pathologists' experiences with stroke clinical practice guidelines and the barriers and facilitators influencing their use: a national descriptive study. (United States)

    Hadely, Kathleen A; Power, Emma; O'Halloran, Robyn


    Communication and swallowing disorders are a common consequence of stroke. Clinical practice guidelines (CPGs) have been created to assist health professionals to put research evidence into clinical practice and can improve stroke care outcomes. However, CPGs are often not successfully implemented in clinical practice and research is needed to explore the factors that influence speech pathologists' implementation of stroke CPGs. This study aimed to describe speech pathologists' experiences and current use of guidelines, and to identify what factors influence speech pathologists' implementation of stroke CPGs. Speech pathologists working in stroke rehabilitation who had used a stroke CPG were invited to complete a 39-item online survey. Content analysis and descriptive and inferential statistics were used to analyse the data. 320 participants from all states and territories of Australia were surveyed. Almost all speech pathologists had used a stroke CPG and had found the guideline "somewhat useful" or "very useful". Factors that speech pathologists perceived influenced CPG implementation included the: (a) guideline itself, (b) work environment, (c) aspects related to the speech pathologist themselves, (d) patient characteristics, and (e) types of implementation strategies provided. There are many different factors that can influence speech pathologists' implementation of CPGs. The factors that influenced the implementation of CPGs can be understood in terms of knowledge creation and implementation frameworks. Speech pathologists should continue to adapt the stroke CPG to their local work environment and evaluate their use. To enhance guideline implementation, they may benefit from a combination of educational meetings and resources, outreach visits, support from senior colleagues, and audit and feedback strategies.

  20. Impact of Pathologist Involvement in Sarcoma and Rare Tumor Patient Support Groups on Facebook: A Survey of 542 Patients and Family Members. (United States)

    Haller, Jasmine; David, Marjorie Parker; Lee, Nathan E; Shalin, Sara C; Gardner, Jerad M


    - Patients with rare tumors have difficulty finding reliable information about their disease. Facebook patient support groups allow patients to educate one another. - To investigate how these patients perceive the value of pathologists, both in Facebook groups and real-world patient care. - Survey links were posted in 12 Facebook patient groups: 6 with an active pathologist member (angiosarcoma, epithelioid hemangioendothelioma, epithelioid sarcoma, dermatofibrosarcoma protuberans [×2], and desmoid fibromatosis), and 6 without "active" pathologist involvement (aggressive angiomyxoma, chondrosarcoma, Ewing sarcoma, leiomyosarcoma, liposarcoma, and osteosarcoma). - A total of 542 people responded (403 were patients): 264 from groups with a pathologist, and 278 from groups without active pathologist involvement. Of groups with an active pathologist, respondents agreed the pathologist's posts helped them better understand their disease (107 of 119; 90%) and relieved some of their disease-related anxiety (92 of 119; 77%). And for these groups 98% (117 of 119) of respondents agreed that having a pathologist in their group was a good thing; 83% (192 of 232) wanted more pathologists involved. More respondents from groups with an active pathologist (219 of 236; 93%) than without one (215 of 252; 85%) agreed: "pathologists are an important part of the patient care team for patients with cancer and other rare tumors" ( P = .008). - This study is the first to evaluate the impact of pathologist interaction with Facebook patient support groups and to assess perceptions about the specialty of pathology from a large group of patients with rare tumors. Pathologist involvement in Facebook patient groups appears to positively influence patient perception of the importance of pathologists. We hope these data will encourage more pathologists to participate in Facebook patient support groups.

  1. General pathologist-helper: The new medical app about general pathology

    Directory of Open Access Journals (Sweden)

    Iván Fernandez-Vega


    Full Text Available Introduction: Smartphone applications (apps have become increasingly prevalent in medicine. Due to most pathologists, pathology trainees, technicians, and medical students use smartphones; apps can be a different way for general pathology education. “General pathologist-helper (GP-HELPER” is a novel app developed as a reference tool in general pathology and especially for general pathologists, developed for Android and iOS platforms. Materials and Methods: “GP-HELPER,” was created using Mobincube website platform. This tool also integrates “FORUM GP-HELPER,” an external website created using Miarroba website ( and “COMMUNITY GP-HELPER” a multichannel chat created using Chatango website platform. Results: The application was released in July 2015, and it is been periodically updated since then. The app has permanent information (offline data about different pathology protocols (TNM latest edition, protocols regarding management of tumors of unknown primary origin, and flowcharts for some of the most difficult tumors to diagnose and a database with more than 5000 immunohistochemistry results from different tumors. Online data have links to more than 1100 reference pathology video lectures, 250 antibodies information, more than 70 pathology association websites, 46 pathology providers, and 78 outstanding pathology journal websites. Besides this information, the app has two interactive places such as “FORUM GP-HELPER” and “COMMUNITY GP-HELPER” that let users to stay in touch everywhere and every time. Expert consult section is also available. Conclusions: “GP-HELPER” pretends to integrate offline and online data about pathology with two interactive external places in order to represent a reference tool for general pathologists and associate members.

  2. General pathologist-helper: The new medical app about general pathology. (United States)

    Fernández-Vega, Iván


    Smartphone applications (apps) have become increasingly prevalent in medicine. Due to most pathologists, pathology trainees, technicians, and medical students use smartphones; apps can be a different way for general pathology education. "General pathologist-helper (GP-HELPER)" is a novel app developed as a reference tool in general pathology and especially for general pathologists, developed for Android and iOS platforms. "GP-HELPER," was created using Mobincube website platform. This tool also integrates "FORUM GP-HELPER," an external website created using Miarroba website ( and "COMMUNITY GP-HELPER" a multichannel chat created using Chatango website platform. The application was released in July 2015, and it is been periodically updated since then. The app has permanent information (offline data) about different pathology protocols (TNM latest edition, protocols regarding management of tumors of unknown primary origin, and flowcharts for some of the most difficult tumors to diagnose) and a database with more than 5000 immunohistochemistry results from different tumors. Online data have links to more than 1100 reference pathology video lectures, 250 antibodies information, more than 70 pathology association websites, 46 pathology providers, and 78 outstanding pathology journal websites. Besides this information, the app has two interactive places such as "FORUM GP-HELPER" and "COMMUNITY GP-HELPER" that let users to stay in touch everywhere and every time. Expert consult section is also available. "GP-HELPER" pretends to integrate offline and online data about pathology with two interactive external places in order to represent a reference tool for general pathologists and associate members.

  3. Techniques for Maximizing the Performance of Molecular Pathology Testing: Responsibilities of All Pathologists

    Directory of Open Access Journals (Sweden)

    Evren UZUN


    Full Text Available Molecular pathological analysis has an expanding role in patient diagnosis and management. The performance of these techniques relies on excellent laboratory procedures. However, the crucial step is obtaining the best samples for molecular analysis. Archiving and selection of these are the responsibilities of all pathologists even if they are not working at a center with molecular pathological facilities. This review focuses on the features of different types of materials for molecular pathological analysis. Many steps that might affect the results, including communication between the pathologist and the oncology team, features of different types of materials (cytological, tissue blocks, biopsy, circulating tumor cells (CTCs and cell-free circulating nucleic acids, effects of tissue processing, methods for selecting the best material, and tissue saving and tumor enrichment methods are discussed. The procedures for referral to a center for molecular pathological analysis are also mentioned. Awareness of the importance of the cytopathological and histopathological material of the patients for future molecular pathological analysis by pathologists is of the utmost importance.

  4. Microarray-Based Gene Expression Analysis for Veterinary Pathologists: A Review. (United States)

    Raddatz, Barbara B; Spitzbarth, Ingo; Matheis, Katja A; Kalkuhl, Arno; Deschl, Ulrich; Baumgärtner, Wolfgang; Ulrich, Reiner


    High-throughput, genome-wide transcriptome analysis is now commonly used in all fields of life science research and is on the cusp of medical and veterinary diagnostic application. Transcriptomic methods such as microarrays and next-generation sequencing generate enormous amounts of data. The pathogenetic expertise acquired from understanding of general pathology provides veterinary pathologists with a profound background, which is essential in translating transcriptomic data into meaningful biological knowledge, thereby leading to a better understanding of underlying disease mechanisms. The scientific literature concerning high-throughput data-mining techniques usually addresses mathematicians or computer scientists as the target audience. In contrast, the present review provides the reader with a clear and systematic basis from a veterinary pathologist's perspective. Therefore, the aims are (1) to introduce the reader to the necessary methodological background; (2) to introduce the sequential steps commonly performed in a microarray analysis including quality control, annotation, normalization, selection of differentially expressed genes, clustering, gene ontology and pathway analysis, analysis of manually selected genes, and biomarker discovery; and (3) to provide references to publically available and user-friendly software suites. In summary, the data analysis methods presented within this review will enable veterinary pathologists to analyze high-throughput transcriptome data obtained from their own experiments, supplemental data that accompany scientific publications, or public repositories in order to obtain a more in-depth insight into underlying disease mechanisms.

  5. Eye movements as an index of pathologist visual expertise: a pilot study.

    Directory of Open Access Journals (Sweden)

    Tad T Brunyé

    Full Text Available A pilot study examined the extent to which eye movements occurring during interpretation of digitized breast biopsy whole slide images (WSI can distinguish novice interpreters from experts, informing assessments of competency progression during training and across the physician-learning continuum. A pathologist with fellowship training in breast pathology interpreted digital WSI of breast tissue and marked the region of highest diagnostic relevance (dROI. These same images were then evaluated using computer vision techniques to identify visually salient regions of interest (vROI without diagnostic relevance. A non-invasive eye tracking system recorded pathologists' (N = 7 visual behavior during image interpretation, and we measured differential viewing of vROIs versus dROIs according to their level of expertise. Pathologists with relatively low expertise in interpreting breast pathology were more likely to fixate on, and subsequently return to, diagnostically irrelevant vROIs relative to experts. Repeatedly fixating on the distracting vROI showed limited value in predicting diagnostic failure. These preliminary results suggest that eye movements occurring during digital slide interpretation can characterize expertise development by demonstrating differential attraction to diagnostically relevant versus visually distracting image regions. These results carry both theoretical implications and potential for monitoring and evaluating student progress and providing automated feedback and scanning guidance in educational settings.

  6. Surgical pathology report defects: a College of American Pathologists Q-Probes study of 73 institutions. (United States)

    Volmar, Keith E; Idowu, Michael O; Hunt, Jennifer L; Souers, Rhona J; Meier, Frederick A; Nakhleh, Raouf E


    The rate of surgical pathology report defects is an indicator of quality and it affects clinician satisfaction. To establish benchmarks for defect rates and defect fractions through a large, multi-institutional prospective application of standard taxonomy. Participants in a 2011 Q-Probes study of the College of American Pathologists prospectively reviewed all surgical pathology reports that underwent changes to correct defects and reported details regarding the defects. Seventy-three institutions reported 1688 report defects discovered in 360,218 accessioned cases, for an aggregate defect rate of 4.7 per 1000 cases. Median institutional defect rate was 5.7 per 1000 (10th to 90th percentile range, 13.5-0.9). Defect rates were higher in institutions with a pathology training program (8.5 versus 5.0 per 1000, P = .01) and when a set percentage of cases were reviewed after sign-out (median, 6.7 versus 3.8 per 1000, P = .10). Defect types were as follows: 14.6% misinterpretations, 13.3% misidentifications, 13.7% specimen defects, and 58.4% other report defects. Overall, defects were most often detected by pathologists (47.4%), followed by clinicians (22.0%). Misinterpretations and specimen defects were most often detected by pathologists (73.5% and 82.7% respectively, P benchmarking data on report defects and defect fractions using standardized taxonomy.

  7. “Dig, What Makes Your Mouth So Big?”: Off-Modern Nostalgia, Symbolic Cannibalism, and Crossing the Border of the Universal Language in Clarence Major’s “The Slave Trade: View from the Middle Passage”

    Directory of Open Access Journals (Sweden)

    Kamionowski Jerzy


    Full Text Available African American literature on the Middle Passage has always challenged white supremacy’s language with its power to define and control. This article demonstrates how the border of such a “Universal Language” is challenged and trespassed in Clarence Major’s ekphrastic poem “The Slave Trade: View from the Middle Passage” in order to communicate – through the implementation of the voice of a disembodied water spirit Mfu – the black perspective on understanding the slave trade and effectively resist the symbolic cannibalism of Western Culture. The trope of antropophagy often appears in Middle Passage poems in the context of (miscommunication (which results in the production of controlling, racist images of blacks and stands as a sign of Euro-American power to create the historical, hierarchical, racial reality of the Atlantic slave trade in its economic and symbolic dimensions. The strategy implemented by Major in his poetic confrontation with representation of historical slave trade in European and American Fine arts may be classified as “off-modern” (to use Svetlana Boym’s (2001 nomenclature, which immediately places his poem in a “tradition of critical reflection on the modern condition that incorporates nostalgia” as a means of a critical analysis of the heritage and limitations of a given culture. My claim is that the poem’s “off-modern nostalgia” perspective is a version of textualist strategy which Henry Louis Gates (1988 identifies as Signifyin(g. Major/Mfu successfully perforates and destabilizes the assumed objectivity and neutrality of the images of blacks and blackness created and circulated within the realm of the visual arts of the dominant Western Culture. In “The Slave Trade: View from the Middle Passage” Signifyin(g takes the form of what could be called an ekphrastic (reinterpretation of actual works of art and joins in the critique of essentialist views often associated with understanding of

  8. Fault lines in forensic medical toxicology in Ireland exposed through replies of pathologists and coroners to anonymous questionnaires. (United States)

    Tormey, William P; Borovickova, Ingrid; Moore, Tara M


    The attitudes and experiences of pathologists and coroners to the provision of biochemical forensic toxicology in the Republic of Ireland were determined using separate questionnaires to each group anonymously. Replies were received from 36/88 (41%) of pathologists and 19/71 (27%) of coroners. 37% of coroners considered that histopathologists give an adequate opinion in forensic toxicology yet 58% of pathologists reported that they did not have adequate access to expert medical interpretative toxicological opinion. For drug-drug interactions and metabolic diseases, 69% of pathologists were unhappy with the processes and 68% of coroner replies did not know if vitreous samples were used appropriately. There is a clear requirement for retraining of coroners and for the appointment of medical toxicology expertise to improve the quality of service for coroners.

  9. "Score the Core" Web-based pathologist training tool improves the accuracy of breast cancer IHC4 scoring. (United States)

    Engelberg, Jesse A; Retallack, Hanna; Balassanian, Ronald; Dowsett, Mitchell; Zabaglo, Lila; Ram, Arishneel A; Apple, Sophia K; Bishop, John W; Borowsky, Alexander D; Carpenter, Philip M; Chen, Yunn-Yi; Datnow, Brian; Elson, Sarah; Hasteh, Farnaz; Lin, Fritz; Moatamed, Neda A; Zhang, Yanhong; Cardiff, Robert D


    Hormone receptor status is an integral component of decision-making in breast cancer management. IHC4 score is an algorithm that combines hormone receptor, HER2, and Ki-67 status to provide a semiquantitative prognostic score for breast cancer. High accuracy and low interobserver variance are important to ensure the score is accurately calculated; however, few previous efforts have been made to measure or decrease interobserver variance. We developed a Web-based training tool, called "Score the Core" (STC) using tissue microarrays to train pathologists to visually score estrogen receptor (using the 300-point H score), progesterone receptor (percent positive), and Ki-67 (percent positive). STC used a reference score calculated from a reproducible manual counting method. Pathologists in the Athena Breast Health Network and pathology residents at associated institutions completed the exercise. By using STC, pathologists improved their estrogen receptor H score and progesterone receptor and Ki-67 proportion assessment and demonstrated a good correlation between pathologist and reference scores. In addition, we collected information about pathologist performance that allowed us to compare individual pathologists and measures of agreement. Pathologists' assessment of the proportion of positive cells was closer to the reference than their assessment of the relative intensity of positive cells. Careful training and assessment should be used to ensure the accuracy of breast biomarkers. This is particularly important as breast cancer diagnostics become increasingly quantitative and reproducible. Our training tool is a novel approach for pathologist training that can serve as an important component of ongoing quality assessment and can improve the accuracy of breast cancer prognostic biomarkers. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. A Career on Both Sides of the Atlantic: Memoirs of a Molecular Plant Pathologist. (United States)

    Panopoulos, Nickolas J


    This article recounts the experiences that shaped my career as a molecular plant pathologist. It focuses primarily on technical and conceptual developments in molecular phytobacteriology, shares some personal highlights and untold stories that impacted my professional development, and describes the early years of agricultural biotechnology. Writing this article required reflection on events occurring over several decades that were punctuated by a mid-career relocation across the Atlantic. I hope it will still be useful, informative, and enjoyable to read. An extended version of the abstract is provided in the Supplemental Materials , available online.

  11. Accreditation of Individualized Quality Control Plans by the College of American Pathologists. (United States)

    Hoeltge, Gerald A


    The Laboratory Accreditation Program of the College of American Pathologists (CAP) began in 2015 to allow accredited laboratories to devise their own strategies for quality control of laboratory testing. Participants now have the option to implement individualized quality control plans (IQCPs). Only nonwaived testing that features an internal control (built-in, electronic, or procedural) is eligible for IQCP accreditation. The accreditation checklists that detail the requirements have been peer-reviewed by content experts on CAP's scientific resource committees and by a panel of accreditation participants. Training and communication have been key to the successful introduction of the new IQCP requirements. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. [The key role of the pathologist in the diagnosis of syphilis: A case report]. (United States)

    Picard, Cécile; Fontaine, Juliette; Chouvet, Brigitte; Balme, Brigitte; Traverse-Glehen, Alexandra


    Syphilis is a resurging sexually transmitted infection linked to Treponema Pallidum. Syphilitic lymphadenitis can be present during the 3 stages of the disease. Its histological diagnosis remains challenging for the pathologist given its possible misleading aspect and its ability to mimic as well as reactional as tumoral conditions. We report the case of an HIV-infected young patient referred for suspicion of an aggressive lymphoma. Histological and immunohistochemical analysis of cervical lymphadenopathy revealed secondary syphilis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. Medicolegal aspects of the Thai Airbus crash near Kathmandu, Nepal: findings of the investigating pathologists. (United States)

    Fernando, R; Vanezis, P


    A Thai Airbus, carrying 99 passengers and 14 crew members, traveling from Bangkok to Kathmandu, hit a mountain and crashed several minutes before landing. There were no survivors. Recovered human remains, none of which was easily identifiable, varied in size from a small piece of muscle to mutilated bodies. Of the 97 fragments, only 15 were sufficiently intact (albeit, only partially) to be designated as "bodies." Of the fragments and "bodies," only 11 were positively identified. Causes of death, although all traumatic, could not be stated accurately due to the degree of disintegration. Identification of human remains in these circumstances is a major problem for the pathologist.

  14. The forensic entomologist in the context of the forensic pathologist's role. (United States)

    Campobasso, C P; Introna, F


    An adequate death investigation requires the combined efforts and cooperation of experts in different disciplines: crime scene technicians, death investigators, forensic pathologists, anthropologists, entomologists, other medical and non-medical professionals. These front-line experts play a crucial role in every death investigation process. The forensic pathologist normally has the legal authority to take charge of the dead body at a death scene and his primary functions are the exterior and interior examination of the cadaver by analyzing the extent of antemortem injuries and the postmortem changes and the recovery of physical evidence. He is responsible for determining how, when and why of any death which is the result of violence, suspicious or unexplained circumstances or a death which is sudden or unattended, defending and explaining the reasons for making these diagnoses in a courtroom. The forensic entomologist can provide invaluable aid in death cases where human remains are colonized by insects and in the overall investigation. His principal role is to identify the arthropods associated with such cases and to analyze entomological data for interpreting insect evidence. He is responsible for determining the period of insect activity according to all the variables affecting insect invasion of remains and their development. The major goal of medico-criminal entomology is to contribute to the determination of the time, cause, manner and place of the investigated death (especially on badly decomposed corpses or skeletonized human remains) with the support of all the elements which can be inferred from the study of insects found on the cadaver or nearby. The application of techniques devised recently in forensic entomology can allow experts in the field to collect strong entomological evidence and provide useful information not only in a death investigation including movement or storage of the remains following death, time of dismemberment, postmortem artifacts

  15. [Close teamwork between pathologist and surgeon can improve results in colorectal cancer treatment]. (United States)

    West, Nicholas P; Quirke, Philip; Hagemann-Madsen, Rikke Hjarnø


    Colorectal cancer is common in the Western world and is a leading cause of cancer related mortality. The introduction of multidisciplinary teams and focus on quality control has led to improved outcomes in which pathologists play a central role through feedback to surgeons, radiologists, and oncologists. This review focuses on the importance of pathological examination of the resection specimen and subsequent feedback to the surgical team regarding quality. Specific markers of oncological quality including grading the plane of surgery, tissue morphometry and lymph node yields are discussed.

  16. Annual congress of the South African Society of Pathologists: congress brochure

    International Nuclear Information System (INIS)


    The 1980 annual congress of the South African Society of Pathologists was held in cooperation with the Southern African Society for Haematology, International Academy of Pathology, South African Association of Clinical Biochemistry and the Southern African Microbiology Society on the 7-9th July at the South African Institute for Medical Research. The subjects covered in this abstracts include virology, microbiology, histopathology, immunology, and chemical pathology. It seems that the use of isotopes as tracers is very popular in pathology and relative fields

  17. Issues related to diagnosing oral lichen planus among oral pathologists in South India: A pilot survey. (United States)

    Sanketh, D Sharathkumar; Srinivasan, Samuel Raj; Patil, Shankargouda; Ranganathan, Kannan


    In the present study, we simulated clinical scenarios by explicitly describing the history and clinical and histological features of hypothetical patients presenting with oral lichen planus (OLP), oral lichenoid lesion, and epithelial dysplasia in a self-designed questionnaire. By doing so, we aimed to elicit a diagnosis from oral pathologists and trainees, analyze their responses, appraise issues, and propose solutions regarding the diagnosis of OLP. The questionnaire was distributed to 100 oral pathologists and trainees in South India. Six questions were designed to assess awareness of the diagnostic aspects of OLP. Ten questions were hypothetical clinical scenarios (HCS) devised to evaluate respondents' knowledge of diagnostic guidelines and the criteria used by the respondents to render a diagnosis. There were 60 of 100 responses to the questionnaire. More than half the respondents were aware of the World Health Organization and modified guidelines of OLP. We observed considerable variations in diagnoses for the HCS. Our study illustrates the ambiguity in rendering an accurate diagnosis, despite adequate guidelines. Based on the responses for the HCS, we hypothesized that changes in the distribution (unilateral or bilateral) and clinical characteristic of OLP, and habits of patients, have a significant bearing on the clinical and final diagnoses of the lesion. © 2016 John Wiley & Sons Australia, Ltd.

  18. Molecular Diagnostics in Pathology: Time for a Next-Generation Pathologist? (United States)

    Fassan, Matteo


    - Comprehensive molecular investigations of mainstream carcinogenic processes have led to the use of effective molecular targeted agents in most cases of solid tumors in clinical settings. - To update readers regarding the evolving role of the pathologist in the therapeutic decision-making process and the introduction of next-generation technologies into pathology practice. - Current literature on the topic, primarily sourced from the PubMed (National Center for Biotechnology Information, Bethesda, Maryland) database, were reviewed. - Adequate evaluation of cytologic-based and tissue-based predictive diagnostic biomarkers largely depends on both proper pathologic characterization and customized processing of biospecimens. Moreover, increased requests for molecular testing have paralleled the recent, sharp decrease in tumor material to be analyzed-material that currently comprises cytology specimens or, at minimum, small biopsies in most cases of metastatic/advanced disease. Traditional diagnostic pathology has been completely revolutionized by the introduction of next-generation technologies, which provide multigene, targeted mutational profiling, even in the most complex of clinical cases. Combining traditional and molecular knowledge, pathologists integrate the morphological, clinical, and molecular dimensions of a disease, leading to a proper diagnosis and, therefore, the most-appropriate tailored therapy.

  19. Perinatal pathology in the context of a clinical trial: attitudes of neonatologists and pathologists. (United States)

    Snowdon, C; Elbourne, D R; Garcia, J


    To describe the attitudes of neonatologists to trial related perinatal postmortem examinations (PMs), in the light of declining perinatal PM rates and poor levels of participation in pathology studies. A qualitative study was carried out, using semistructured interviews. Twenty six neonatologists from five UK neonatal units were interviewed; five UK perinatal pathologists also contributed to the study. The professionals involved were all linked to one or both of two neonatal trials. Pathologists expressed concern over the difficulties experienced in UK perinatal pathology and the impact on research of inadequate levels of samples. The interviews with neonatologists reveal discomfort over approaching bereaved parents for PMs, and a widespread concern that parents should not be further distressed or feel under pressure to consent. Although there was support for neonatal trials, the study highlights a view that PMs may be unnecessary if the cause of death seems apparent or when a baby was born prematurely, and a devaluation of PMs among some younger staff. Poor rates of participation in pathology studies may be accounted for by a notable sense of disconnection between trial interventions and pathology studies. Neonatologists were concerned to protect vulnerable parents and varied in whether they saw this as compatible with inclusion in trial related pathology studies. Dedicated research is needed to document and gain an understanding of the consent process and should examine the usefulness and impact of consent forms. It should assess whether professionals might benefit from training, to help parents to come to their decisions.

  20. Attitudes of a group of South African speech-language pathologists towards stutterers and stuttering therapy. (United States)

    Baker, B; Ross, E; Girson, J


    The present study aimed to examine the attitudes of a group of South African speech-language pathologists towards stuttering and stuttering therapy. Further aims were to investigate whether a stereotype of stutterers was found among these speech-language pathologists, and to determine whether there was any relationship between the attitudes held about stutterers, and the therapists' training and experience. A random probability sample of respondents was selected from the population of speech therapists registered with the Interim Medical and Dental Council of South Africa (I.M.D.C.S.A.). A self-administered mailed questionnaire was employed to realise the aims of the study. The main result of this investigation indicated that almost 50% of the sample of qualified clinicians surveyed, viewed stutterers as a group characterised by specific personality traits and psychological problems. This belief held true irrespective of the number of years of experience working in the field, the time of graduation, the frequency of treating stutterers, or the training emphasis. Implications of these results are considered with respect to student training, continuing education of qualified practitioners and future research.

  1. Interobserver Variability by Pathologists in the Distinction Between Cellular Fibroadenomas and Phyllodes Tumors (United States)

    Lawton, Thomas J.; Acs, Geza; Argani, Pedram; Farshid, Gelareh; Gilcrease, Michael; Goldstein, Neal; Koerner, Frederick; Rowe, J. Jordi; Sanders, Melinda; Shah, Sejal S.; Reynolds, Carol


    Fibroepithelial lesions with cellular stroma are frequently termed cellular fibroadenomas although criteria for distinguishing them from a phyllodes tumor are vague and subjective. However, the clinical implications and surgical management for these 2 lesions may be different. We randomly selected 21 cases of fibroepithelial lesions sent in consultation to the senior author that were challenging to classify as cellular fibroadenoma or phyllodes tumor. One to 2 representative slides of each case along with patient age were sent to 10 pathologists who specialize in breast pathology. The World Health Organization criteria for phyllodes tumors and a diagnosis form were included with the study set. For the purposes of data reporting, fibroadenoma and cellular fibroadenoma are considered together. In only 2 cases was there uniform agreement as to whether the tumor represented a fibroadenoma or phyllodes tumor. Of the remaining 19 cases, if the diagnoses of fibroadenoma and benign phyllodes tumor were combined and separated from borderline and malignant phyllodes tumors, there was 100% agreement in 53% of cases and 90% agreement in 79% of cases. This study highlights the difficulty that exists in distinguishing some cellular fibroadenomas from phyllodes tumors even for pathologists who specialize in breast pathology. However, there appears to be considerable agreement when cellular fibroadenomas and benign phyllodes tumors are distinguished from borderline and malignant phyllodes tumors. Further studies are needed to determine if there is a clinically significant difference between cellular fibroadenomas and benign phyllodes tumors and how to better distinguish them from borderline and malignant phyllodes tumors. PMID:25161205

  2. The Pathologist 2.0: An Update on Digital Pathology in Veterinary Medicine. (United States)

    Bertram, Christof A; Klopfleisch, Robert


    Using light microscopy to describe the microarchitecture of normal and diseased tissues has changed very little since the middle of the 19th century. While the premise of histologic analysis remains intact, our relationship with the microscope is changing dramatically. Digital pathology offers new forms of visualization, and delivery of images is facilitated in unprecedented ways. This new technology can untether us entirely from our light microscopes, with many pathologists already performing their jobs using virtual microscopy. Several veterinary colleges have integrated virtual microscopy in their curriculum, and some diagnostic histopathology labs are switching to virtual microscopy as their main tool for the assessment of histologic specimens. Considering recent technical advancements of slide scanner and viewing software, digital pathology should now be considered a serious alternative to traditional light microscopy. This review therefore intends to give an overview of the current digital pathology technologies and their potential in all fields of veterinary pathology (ie, research, diagnostic service, and education). A future integration of digital pathology in the veterinary pathologist's workflow seems to be inevitable, and therefore it is proposed that trainees should be taught in digital pathology to keep up with the unavoidable digitization of the profession.

  3. The assessment of pathologists/laboratory medicine physicians through a multisource feedback tool. (United States)

    Lockyer, Jocelyn M; Violato, Claudio; Fidler, Herta; Alakija, Pauline


    There is increasing interest in ensuring that physicians demonstrate the full range of Accreditation Council for Graduate Medical Education competencies. To determine whether it is possible to develop a feasible and reliable multisource feedback instrument for pathologists and laboratory medicine physicians. Surveys with 39, 30, and 22 items were developed to assess individual physicians by 8 peers, 8 referring physicians, and 8 coworkers (eg, technologists, secretaries), respectively, using 5-point scales and an unable-to-assess category. Physicians completed a self-assessment survey. Items addressed key competencies related to clinical competence, collaboration, professionalism, and communication. Data from 101 pathologists and laboratory medicine physicians were analyzed. The mean number of respondents per physician was 7.6, 7.4, and 7.6 for peers, referring physicians, and coworkers, respectively. The reliability of the internal consistency, measured by Cronbach alpha, was > or = .95 for the full scale of all instruments. Analysis indicated that the medical peer, referring physician, and coworker instruments achieved a generalizability coefficient of .78, .81, and .81, respectively. Factor analysis showed 4 factors on the peer questionnaire accounted for 68.8% of the total variance: reports and clinical competency, collaboration, educational leadership, and professional behavior. For the referring physician survey, 3 factors accounted for 66.9% of the variance: professionalism, reports, and clinical competency. Two factors on the coworker questionnaire accounted for 59.9% of the total variance: communication and professionalism. It is feasible to assess this group of physicians using multisource feedback with instruments that are reliable.

  4. Evidence-based practice among speech-language pathologists: attitudes, utilization, and barriers. (United States)

    Zipoli, Richard P; Kennedy, Marianne


    A total of 240 speech-language pathologists responded to a questionnaire examining attitudes toward and use of research and evidence-based practice (EBP). Perceived barriers to EBP were also explored. Positive attitudes toward research and EBP were reported. Attitudes were predicted by exposure to research and EBP practice during graduate training and the clinical fellowship year (CFY). Clinical experience and opinions of colleagues were used to guide decision making more frequently than research studies or clinical practice guidelines. Only exposure to research and EBP during the CFY predicted use of evidence-based resources. Respondents reported a decline in exposure to research and EBP as they moved from graduate training into the CFY. A lack of time was perceived as a barrier to EBP.

  5. Examining the Echolalia Literature: Where Do Speech-Language Pathologists Stand? (United States)

    Stiegler, Lillian N


    Echolalia is a common element in the communication of individuals with autism spectrum disorders. Recent contributions to the literature reflect significant disagreement regarding how echolalia should be defined, understood, and managed. The purpose of this review article is to give speech-language pathologists and others a comprehensive view of the available perspectives on echolalia. Published literature from the disciplines of behavioral intervention, linguistics, and speech-language intervention is discussed. Special areas of focus include operational definitions, rationales associated with various approaches, specific procedures used to treat or study echolalic behavior, and reported conclusions. Dissimilarities in the definition and understanding of echolalia have led to vastly different approaches to management. Evidence-based practice protocols are available to guide speech-language interventionists in their work with individuals with autism spectrum disorders.

  6. Perspectives of speech-language pathologists on the use of telepractice in schools: the qualitative view. (United States)

    Tucker, Janice K


    Telepractice in speech-language pathology shows the potential to mitigate the current shortage of speech-language pathologists (SLPs) available to serve a growing number of persons with communication disorders. Since a majority of American Speech-Language-Hearing Association (ASHA) certified SLPs work in schools and the population of communicatively impaired clients in schools continues to grow, research into the use of telepractice in the educational setting is warranted. This article reports upon the perspectives of SLPs regarding the use of telepractice in school settings. In-depth qualitative interviews were conducted with five SLPs experienced in the delivery of telepractice. Four major themes emerged: barriers, benefits, reasons for acceptance and use of telepractice, and suggestions to resolve telepractice professional issues.

  7. Perspectives of Speech-Language Pathologists on the Use of Telepractice in Schools: Quantitative Survey Results

    Directory of Open Access Journals (Sweden)

    Janice K. Tucker


    Full Text Available This research surveyed 170 school-based speech-language pathologists (SLPs in one northeastern state, with only 1.8% reporting telepractice use in school-settings. These results were consistent with two ASHA surveys (2002; 2011 that reported limited use of telepractice for school-based speech-language pathology. In the present study, willingness to use telepractice was inversely related to age, perhaps because younger members of the profession are more accustomed to using technology.  Overall, respondents were concerned about the validity of assessments administered via telepractice; whether clinicians can adequately establish rapport with clients via telepractice; and if therapy conducted via telepractice can be as effective as in-person speech-language therapy. Most respondents indicated the need to establish procedures and guidelines for school-based telepractice programs.

  8. Specific pathologist responses for Standard for Exchange of Nonclinical Data (SEND). (United States)

    Watanabe, Atsushi; Kusuoka, Osamu; Sato, Norihiro; Nakazono, Osamu; Wasko, Michael; Potenta, Daniel; Nakae, Dai; Hatakeyama, Hirofumi; Iwata, Hijiri; Naota, Misaki; Anzai, Takayuki


    The Standard for Exchange of Nonclinical Data (SEND), introduced by the US Food and Drug Administration (FDA), is a scheme for the computerization, electronic application, and screening of preclinical data. Since its establishment, related organizations have been working together to implement SEND. However, it is difficult for individual pharmaceutical companies that often outsource to achieve complete compliance with SEND; hence, the cooperation of contract research organizations (CROs) and SEND Registered Solution Providers (RSPs) is indispensable. In SEND, most data, including those on pathology findings, are converted into controlled terminology (CT), but it is not a simple process to convert findings or levels of severity in the field of pathology, which is a descriptive science. The authors have successfully completed an FDA trial submission for a toxicology test conducted at a CRO and in doing so acquired important knowledge. This article presents a clear picture of such important knowledge from a pathologist's viewpoint.

  9. Telepathology and continuous education: important tools for pathologists of developing countries

    Directory of Open Access Journals (Sweden)

    Barcelo Héctor A


    Full Text Available Abstract Education shows that active participation allows the best development of skills to acquire, and the results are better when the information is well documented. Now, with digital images and the Internet, in the case of the Static Telepathology (ST, it is easy to share macroscopic and microscopic photographs. The progress of the technologies enabled a form of Dynamic Telepathology (DT named "virtual slides", with navigation tools, and can be moved around changing powers as desired, making any personal computer into a digital microscope. The use of these tools in continuous education leads to optimal development of knowledge. We reported the experience of a Latin-American Pathologist from La Rioja, a small Province of Argentina, and we also mentioned the electronic publications in Virtual Hispano-American Congresses of Pathology (VHACP since 1997(18 reports in the case of ST and in two Virtual Slide Congress (VSC. In the 1st (2005 and 2nd (2007 Internet VSCs two of our cases were digitized in Spain (case 1 and 3 respectively. In these Virtual Slides, the microscopic images can be moved remotely from any computer connected to the Internet, we should recognize that it will become a valuable continuing Medical Education tool in microscopy, probably related to the phrase "a picture is worth more than a thousand words", then we might add; "what about thousands of images?" Similarly, the autoevaluation test is very important. ST and DT, in support of Virtual Congresses allows learning, teaching and sharing of diseases in scientific presentations and the exchange of views in the forums, these are the optimum material for distance education. In addition we received CDs or DVDs and certificates as authors, recognized by European Institutions. The active participation and the autoevaluation test are the best tools for continuous medical education in telepathology, not only for pathologists in developing countries but for the entire world.

  10. Pocket pathologist: A mobile application for rapid diagnostic surgical pathology consultation

    Directory of Open Access Journals (Sweden)

    Douglas J Hartman


    Full Text Available Introduction: Telepathology allows the digital transmission of images for rapid access to pathology experts. Recent technologic advances in smartphones have allowed them to be used to acquire and transmit digital images of the glass slide, representing cost savings and efficiency gains over traditional forms of telepathology. We report our experience with developing an iPhone application (App - Pocket Pathologist to facilitate rapid diagnostic pathology teleconsultation utilizing a smartphone. Materials and Methods: A secure, web-based portal ( was created to facilitate remote transmission of digital images for teleconsultation. The App augments functionality of the web-based portal and allows the user to quickly and easily upload digital images for teleconsultation. Image quality of smartphone cameras was evaluated by capturing images using different adapters that directly attach phones to a microscope ocular lens. Results: The App was launched in August 2013. The App facilitated easy submission of cases for teleconsultation by limiting the number of data entry fields for users and enabling uploading of images from their smartphone′s gallery wirelessly. Smartphone cameras properly attached to a microscope create static digital images of similar quality to a commercial digital microscope camera. Conclusion: Smartphones have great potential to support telepathology because they are portable, provide ubiquitous internet connectivity, contain excellent digital cameras, and can be easily attached to a microscope. The Pocket Pathologist App represents a significant reduction in the cost of creating digital images and submitting them for teleconsultation. The iPhone App provides an easy solution for global users to submit digital pathology images to pathology experts for consultation.

  11. Revaluation of breast cytology with pathologist on-site of lesions with suspicious sonographic features

    Energy Technology Data Exchange (ETDEWEB)

    Capalbo, Emanuela, E-mail: [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Sajadidehkordi, Farideh, E-mail: [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Colombi, Claudio; Ticha, Vladimira; Moretti, Angela, E-mail: [Dipartimento di Scienze Diagnostiche, UOC di Radiologia Diagnostica ed Interventistica, A.O San Carlo Borromeo. Via Pio II, 3, 20153 Milano (Italy); Peli, Michela, E-mail: [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Cosentino, Maria, E-mail: [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Lovisatti, Maria, E-mail: [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Berti, Elisabetta, E-mail: [Dipartimento di Scienze Diagnostiche, UOC di Anatomia Patologica, A.O San Carlo Borromeo. Via Pio II, 3, Milano 20153 (Italy); Cariati, Maurizio, E-mail: [Dipartimento di Scienze Diagnostiche, UOC di Radiologia Diagnostica ed Interventistica, A.O San Carlo Borromeo. Via Pio II, 3, 20153 Milano (Italy)


    Objective: Evaluating correlation estimation between diagnostic ultrasound (U.S.) of breast lesions and fine needle aspiration cytology (FNAC), and the correlation between cytology and histology (I) of these lesions undergo surgery. Materials and methods: In 2010 we performed 1589 ultrasound breast. We identified 210 suspicious lesions to be subjected to FNAC, which was performed with pathologist on site, and extemporaneous analysis of the sample to assess their appropriateness. We classified the lesions in 5 ultrasound (U) classes according to the criteria defined by Echographic BIRADS Lexicon. The results of cytology were classified in 5 classes (C) according to the guidelines of F.O.N.Ca.M. Then we evaluated the diagnostic correlation between U.S. and FNAC, and between FNAC and Histology. Results: The distribution of lesions in U classes was: 57U2, 55U3, 36U4 and 62U5. The diagnostic concordance between U and FNAC was 96.7%, with a sensitivity of 98%, specificity 93%, negative and positive predictive value respectively of 94.9% and 97.3%, and diagnostic accuracy of 96.6%. The 98 patients with C4-C5 lesions were subjected to surgery and the histology confirmed high-grade malignancy of lesions with a concordance of 99.7%. Conclusions: Having achieved high diagnostic concordance between U and FNAC, and then between FNAC and histology, we may say that the FNAC, less invasive and traumatic for the patient than needle biopsy (CB), may be still a valid method when performed with pathologist on-site to assess the adequacy of the sample taken.

  12. A narrative analysis of a speech pathologist's work with Indigenous Australians with acquired communication disorders. (United States)

    Hersh, Deborah; Armstrong, Elizabeth; Bourke, Noni


    To explore in detail the narrative of a speech pathologist (SP) working with Indigenous Australian clients with acquired communication disorders following stroke or brain injury. There is some evidence that Indigenous clients do not find speech pathology rehabilitation to be culturally appropriate but, currently, there is very little published on the nature of this service or the experiences of SPs who provide this rehabilitation. This research uses both thematic and structural narrative analysis of data from a semi-structured, in-depth interview with a SP to examine the adaptations that she made to address the needs of her adult neurological caseload of (mainly) Indigenous Australians from both urban and remote regions. The thematic analysis resulted in a core theme of flexibility and four other sub-themes: awareness of cultural context, client focus/person-centredness, being practical and working ethically. The structural narrative analysis allowed insight into the nature of clinical reasoning in a context lacking predictability and where previous clinical certainties required adaptation. Individual, detailed narratives are useful in exposing the challenges and clinical reasoning behind culturally sensitive practice. Implications for Rehabilitation Speech pathologists (SPs) can learn from hearing the clinical stories of colleagues with experience of providing rehabilitation in culturally diverse contexts, as well as from ongoing training in culturally competent and safe practices. Such stories help bridge understanding from the general to the particular. SPs working with Indigenous Australians with acquired communication disorders post-stroke and brain injury may find it helpful to consider how the themes, drawn from an interview with the clinician in this study - flexibility, awareness of cultural context, person-centredness, being practical and working ethically - might apply to their practice. Narratives may be helpful in staff training and form an important

  13. Clinical implementation of KRAS testing in metastatic colorectal carcinoma: the pathologist's perspective. (United States)

    Ross, Jeffrey S


    Mutation status of the KRAS gene identifies a distinct disease subtype of metastatic colorectal carcinoma that does not respond to antibody therapeutics targeting the epidermal growth factor receptor. This is currently the only validated marker in metastatic colorectal carcinoma with a clear implication in treatment selection. KRAS testing is widely accepted in clinical practice to guide metastatic colorectal carcinoma therapeutic decisions, and there are many commercially available platforms to perform the test. To evaluate the critical role of pathologists in the full implementation of KRAS testing by optimizing tumor tissue collection and fixation procedures and by choosing testing technologies and reliable Clinical Laboratory Improvement Amendments of 1988-certified laboratories to perform the tests. Prospective clinical trials, retrospective studies, and quality assessment and survey reports were identified in the following databases: PubMed, American Society of Clinical Oncology Proceedings (American Society of Clinical Oncology Annual Meeting and Gastrointestinal Cancer Symposium) and European Society for Medical Oncology Proceedings (Annals of Oncology European Society for Medical Oncology Congress and Annals of Oncology World Congress on Gastrointestinal Cancers). More bona fide standards are needed to address the variety of available test methods, which have different performance characteristics including speed, sensitivity to detect rare mutations, and technical requirements. Refined standards addressing timing of KRAS testing, laboratory performance and accuracy, quality assurance and control, proper tissue collection, and appropriate result reporting would also be greatly beneficial. Pathologists should be aware that the amount of information they need to manage will increase, because future trends and technological advances will enhance the predictive power of diagnostic tests or the scope of the biomarker panels tested routinely across tumor types.

  14. The Pathologist Workforce in the United States: II. An Interactive Modeling Tool for Analyzing Future Qualitative and Quantitative Staffing Demands for Services. (United States)

    Robboy, Stanley J; Gupta, Saurabh; Crawford, James M; Cohen, Michael B; Karcher, Donald S; Leonard, Debra G B; Magnani, Barbarajean; Novis, David A; Prystowsky, Michael B; Powell, Suzanne Z; Gross, David J; Black-Schaffer, W Stephen


    Pathologists are physicians who make diagnoses based on interpretation of tissue and cellular specimens (surgical/cytopathology, molecular/genomic pathology, autopsy), provide medical leadership and consultation for laboratory medicine, and are integral members of their institutions' interdisciplinary patient care teams. To develop a dynamic modeling tool to examine how individual factors and practice variables can forecast demand for pathologist services. Build and test a computer-based software model populated with data from surveys and best estimates about current and new pathologist efforts. Most pathologists' efforts focus on anatomic (52%), laboratory (14%), and other direct services (8%) for individual patients. Population-focused services (12%) (eg, laboratory medical direction) and other professional responsibilities (14%) (eg, teaching, research, and hospital committees) consume the rest of their time. Modeling scenarios were used to assess the need to increase or decrease efforts related globally to the Affordable Care Act, and specifically, to genomic medicine, laboratory consolidation, laboratory medical direction, and new areas where pathologists' expertise can add value. Our modeling tool allows pathologists, educators, and policy experts to assess how various factors may affect demand for pathologists' services. These factors include an aging population, advances in biomedical technology, and changing roles in capitated, value-based, and team-based medical care systems. In the future, pathologists will likely have to assume new roles, develop new expertise, and become more efficient in practicing medicine to accommodate new value-based delivery models.

  15. Principals' Opinions on the Role of Speech-Language Pathologists Serving Students with Communication Disorders Involved in Violence (United States)

    Ritzman, Mitzi J.; Sanger, Dixie


    Purpose: The purpose of this study was to survey the opinions of principals concerning the role of speech-language pathologists (SLPs) serving students with communication disorders who have been involved in violence. Method: A mixed methods design involving 678 questionnaires was mailed to elementary, middle, and high school principals in a…

  16. Speech-Language Pathologists' Knowledge of Genetics: Perceived Confidence, Attitudes, Knowledge Acquisition and Practice-Based Variables (United States)

    Tramontana, G. Michael; Blood, Ingrid M.; Blood, Gordon W.


    The purpose of this study was to determine (a) the general knowledge bases demonstrated by school-based speech-language pathologists (SLPs) in the area of genetics, (b) the confidence levels of SLPs in providing services to children and their families with genetic disorders/syndromes, (c) the attitudes of SLPs regarding genetics and communication…

  17. Psychological distress in newly diagnosed colorectal cancer patients following microsatellite instability testing for Lynch syndrome on the pathologist's initiative.

    NARCIS (Netherlands)

    Landsbergen, K.M.; Prins, J.B.; Brunner, H.G.; Duijvendijk, P. van; Nagengast, F.M.; Krieken, J.H.J.M. van; Ligtenberg, M.J.; Hoogerbrugge-van der Linden, N.


    According to the Dutch Guideline on Hereditary Colorectal Cancer published in 2008, patients with recently diagnosed colorectal cancer (CRC) should undergo microsatellite instability (MSI) testing by a pathologist immediately after tumour resection if they are younger than 50 years, or if a second

  18. 23rd Annual congress of the South African Society of Pathologists, Pretoria, 4-6 July 1983

    International Nuclear Information System (INIS)


    The proceedings of the twenty third annual congress of the South African Society of Pathologists are presented. Papers on the following topics were presented: anatomical pathology, virology, microbiology, chemical biochemistry, and haematology. Separate abstracts were prepared for thirteen of the papers presented. The remaining papers were considered out of scope for INIS

  19. Potentials for mutually beneficial collaboration between FIA specialists and IEG-40 pathologists and geneticists working on fusiform rust (United States)

    Ellis Cowling; KaDonna Randolph


    The purpose of this article is to encourage development of an enduring mutually beneficial collaboration between data and information analysts in the US Forest Service’s "Enhanced Forest Inventory and Analysis (FIA) Program" and forest pathologists and geneticists in the information exchange group (IEG) titled "Genetics and Breeding of Southern Forest...

  20. Characteristics of Children Who Struggle with Reading: Teachers and Speech-Language Pathologists Collaborate to Support Young Learners (United States)

    Squires, Katie E.; Gillam, Sandra L.; Reutzel, D. Ray


    Speech language pathologists (SLPs) have developed specialized knowledge about oral language and its relationship to early literacy development that can be particularly useful to early childhood educators. The purpose of this article is to highlight ways in which an SLP can support early childhood teachers in a Response to Intervention role by…

  1. Nazareth College: Specialty Preparation for Speech-Language Pathologists to Work with Children Who Are Deaf and Hard of Hearing (United States)

    Brown, Paula M.; Quenin, Cathy


    The specialty preparation program within the speech-language pathology master's degree program at Nazareth College in Rochester, New York, was designed to train speech-language pathologists to work with children who are deaf and hard of hearing, ages 0 to 21. The program is offered in collaboration with the Rochester Institute of Technology,…

  2. Addressing Phonological Memory in Language Therapy with Clients Who Have Down Syndrome: Perspectives of Speech-Language Pathologists (United States)

    Faught, Gayle G.; Conners, Frances A.; Barber, Angela B.; Price, Hannah R.


    Background: Phonological memory (PM) plays a significant role in language development but is impaired in individuals with Down syndrome (DS). Without formal recommendations on how to address PM limitations in clients with DS, it is possible speech-language pathologists (SLPs) find ways to do so in their practices. Aims: This study asked if and how…

  3. Day as a Pathologist: Utilization of Technology to Guide Students in Exploring Careers in Breast Cancer Pathology (United States)

    Adler, Jacob J.; Judd, Mariah V.; Bringman, Lauren R.; Wells, Clark D.; Marrs, Kathleen A.


    We developed an interactive laboratory that allows students to identify and grade tissue samples from human breast biopsies, using techniques similar to those used by actual pathologists. This unique lab develops a practical and intellectual understanding of basic tissue structures that make up living systems, utilizing technology to bring…

  4. Understanding Why Speech-Language Pathologists Rarely Pursue a PhD in Communication Sciences and Disorders (United States)

    Myotte, Theodore; Hutchins, Tiffany L.; Cannizzaro, Michael S.; Belin, Gayle


    Masters-level speech-language pathologists in communication sciences and disorders (n = 122) completed a survey soliciting their reasons for not pursuing doctoral study. Factor analysis revealed a four-factor solution including one reflecting a lack of interest in doctoral study (Factor 2) and one reflecting practical financial concerns (Factor…

  5. The microbe, creator of the pathologist: an inter-related history of pathology, microbiology, and infectious disease. (United States)

    Rosati, L A


    This brief historical review of pathology stresses the impact of microbial discovery on the development of pathology as a medical specialty. If, as it has been said, the microscope invented the pathologist, it was the microbe, especially the pathogenic bacterium, that gave him his name and made him clinically relevant.

  6. Speech-language pathologists' contribution to the assessment of decision-making capacity in aphasia: a survey of common practices. (United States)

    Aldous, Kerryn; Tolmie, Rhiannon; Worrall, Linda; Ferguson, Alison


    Speech-language pathologists' scope of practice is currently unclear in relation to their contribution to the multi-disciplinary assessment of decision-making capacity for clients with aphasia and related neurogenic communication disorders. The primary aim of the current research study was to investigate the common practices of speech-language pathologists involved in assessments of decision-making capacity. The study was completed through the use of an online survey. There were 51 of 59 respondents who indicated involvement in evaluations of decision-making. Involvement in this kind of assessment was most commonly reported by speech-language pathologists working in inpatient acute and rehabilitation settings. Respondents reported using a variety of formal and informal assessment methods in their contributions to capacity assessment. Discussion with multidisciplinary team members was reported to have the greatest influence on their recommendations. Speech-language pathologists reported that they were dissatisfied with current protocols for capacity assessments in their workplace and indicated they would benefit from further education and training in this area. The findings of this study are discussed in light of their implications for speech-language pathology practice.

  7. Reliability of an Automated High-Resolution Manometry Analysis Program across Expert Users, Novice Users, and Speech-Language Pathologists (United States)

    Jones, Corinne A.; Hoffman, Matthew R.; Geng, Zhixian; Abdelhalim, Suzan M.; Jiang, Jack J.; McCulloch, Timothy M.


    Purpose: The purpose of this study was to investigate inter- and intrarater reliability among expert users, novice users, and speech-language pathologists with a semiautomated high-resolution manometry analysis program. We hypothesized that all users would have high intrarater reliability and high interrater reliability. Method: Three expert…

  8. Prevalence of Vocal Problems: Speech-Language Pathologists' Evaluation of Music and Non-Music Teacher Recordings (United States)

    Hackworth, Rhonda S.


    The current study, a preliminary examination of whether music teachers are more susceptible to vocal problems than teachers of other subjects, asked for expert evaluation of audio recordings from licensed speech-language pathologists. Participants (N = 41) taught music (n = 23) or another subject (n = 18) in either elementary (n = 21), middle (n =…

  9. 'That doesn't translate': the role of evidence-based practice in disempowering speech pathologists in acute aphasia management. (United States)

    Foster, Abby; Worrall, Linda; Rose, Miranda; O'Halloran, Robyn


    An evidence-practice gap has been identified in current acute aphasia management practice, with the provision of services to people with aphasia in the acute hospital widely considered in the literature to be inconsistent with best-practice recommendations. The reasons for this evidence-practice gap are unclear; however, speech pathologists practising in this setting have articulated a sense of dissonance regarding their limited service provision to this population. A clearer understanding of why this evidence-practice gap exists is essential in order to support and promote evidence-based approaches to the care of people with aphasia in acute care settings. To provide an understanding of speech pathologists' conceptualization of evidence-based practice for acute post-stroke aphasia, and its implementation. This study adopted a phenomenological approach, underpinned by a social constructivist paradigm. In-depth interviews were conducted with 14 Australian speech pathologists, recruited using a purposive sampling technique. An inductive thematic analysis of the data was undertaken. A single, overarching theme emerged from the data. Speech pathologists demonstrated a sense of disempowerment as a result of their relationship with evidence-based practice for acute aphasia management. Three subthemes contributed to this theme. The first described a restricted conceptualization of evidence-based practice. The second revealed speech pathologists' strained relationships with the research literature. The third elucidated a sense of professional unease over their perceived inability to enact evidence-based clinical recommendations, despite their desire to do so. Speech pathologists identified a current knowledge-practice gap in their management of aphasia in acute hospital settings. Speech pathologists place significant emphasis on the research evidence; however, their engagement with the research is limited, in part because it is perceived to lack clinical utility. A sense

  10. Acute kidney injury in the newborn: the role of the perinatal pathologist

    Directory of Open Access Journals (Sweden)

    Daniela Fanni


    Full Text Available Neonatal acute kidney injury (AKI, that becomes acute renal failure (when renal replacement is needed, represents a common clinical problem in critically ill infants admitted to neonatal intensive care unit (NICU centers. This article is aimed at reviewing the most important histological renal changes generally considered typical of AKI, useful to confirm, at morphological level, the structural and cell lesions responsible for the clinical picture. In the first part a simple schematic approach to the elementary lesions of the developing kidney will be proposed, aimed to decipher the renal lesions. In the second part, the typical lesions of AKI in the neonate will be presented and discussed. In the final part, we’ll prospect the necessity for a more accurate microscopic analysis of the kidney in every neonate undergoing asphyxia or sepsis, in order to reveal subtle renal changes that might allow a pathological diagnosis of AKI even in newborns in which the clinical and laboratory pictures were not representative of a severe kidney damage. Finally, the role of the clinical-pathological discussion between the pathologist and the neonatologist will be underlined, in order to reach a final diagnosis, based on the clinical history, the laboratory findings, and the histological lesions. In this article, the role of the pathologist in the evaluation of a neonatal kidney in a newborn with the clinical diagnosis of AKI is described, with particular attention to the differences existing between the preterm and the at term kidney, focusing on the differentiation between developmental changes occurring in the kidney in the perinatal period and the histological lesions induced by pathological events occurring around birth. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological

  11. Laboratory compliance with the American Society of Clinical Oncology/college of American Pathologists guidelines for human epidermal growth factor receptor 2 testing: a College of American Pathologists survey of 757 laboratories. (United States)

    Nakhleh, Raouf E; Grimm, Erin E; Idowu, Michael O; Souers, Rhona J; Fitzgibbons, Patrick L


    To ensure quality human epidermal growth receptor 2 (HER2) testing in breast cancer, the American Society of Clinical Oncology/College of American Pathologists guidelines were introduced with expected compliance by 2008. To assess the effect these guidelines have had on pathology laboratories and their ability to address key components. In late 2008, a survey was distributed with the HER2 immunohistochemistry (IHC) proficiency testing program. It included questions regarding pathology practice characteristics and assay validation using fluorescence in situ hybridization or another IHC laboratory assay and assessed pathologist HER2 scoring competency. Of the 907 surveys sent, 757 (83.5%) were returned. The median laboratory accessioned 15 000 cases and performed 190 HER2 tests annually. Quantitative computer image analysis was used by 33% of laboratories. In-house fluorescence in situ hybridization was performed in 23% of laboratories, and 60% of laboratories addressed the 6- to 48-hour tissue fixation requirement by embedding tissue on the weekend. HER2 testing was performed on the initial biopsy in 40%, on the resection specimen in 6%, and on either in 56% of laboratories. Testing was validated with only fluorescence in situ hybridization in 47% of laboratories, whereas 10% of laboratories used another IHC assay only; 13% used both assays, and 12% and 15% of laboratories had not validated their assays or chose "not applicable" on the survey question, respectively. The 90% concordance rate with fluorescence in situ hybridization results was achieved by 88% of laboratories for IHC-negative findings and by 81% of laboratories for IHC-positive cases. The 90% concordance rate for laboratories using another IHC assay was achieved by 80% for negative findings and 75% for positive cases. About 91% of laboratories had a pathologist competency assessment program. This survey demonstrates the extent and characteristics of HER2 testing. Although some American Society of

  12. Speech-Language Pathologists' Knowledge and Attitudes Regarding Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Populations. (United States)

    Hancock, Adrienne; Haskin, Gregory


    The cultures and service needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) minority groups are relevant to speech-language pathologists (SLPs). In particular, transgender individuals seeking communication services from SLPs in order to improve quality of life require culturally and clinically competent clinicians. Knowledge and attitudes regarding a population are foundational stages toward cultural competency (Turner, Wilson, & Shirah, 2006). The purpose of this research is to assess LGBTQ knowledge and attitudes among aspiring and practicing SLPs. An online survey was completed by 279 SLPs from 4 countries. Mean accuracy scores on LGBTQ culture questions were near 50%. Self-ratings indicated more comfort than knowledge, with generally positive feelings toward LGBTQ subgroups. Transgender communication is within SLPs' scope of practice, yet 47% indicated such services were not addressed in their master's curriculum, and 51% did not know how to describe transgender communication therapy. When respondents were asked to indicate priority of 10 LGBTQ topics for a continuing education seminar, communication masculinization/feminization best practice and case examples had the highest mean priority scores. There is a need to promote LGBTQ cultural competence within speech-language pathology. This study provides direction for improving LGBTQ cultural competence among SLPs.

  13. Review of Medical Advisory Services by the Korean Society of Pathologists from 2003 to 2014

    Directory of Open Access Journals (Sweden)

    Min Hye Jang


    Full Text Available Background: Since 2003, the Korean Society of Pathologists (KSP has been officially providing medical advisory services (MAS. We reviewed the cases submitted to the KSP between 2003 and 2014. Methods: In total, 1,950 cases were submitted, most by private health insurance companies. The main purposes of the consultations were to clarify the initial diagnoses and to assign a proper disease classification code. We comprehensively reviewed 1,803 consultation cases with detailed information. Results: In spite of some fluctuations, the number of submitted cases has been significantly increasing over the 12 study years. The colon and rectum (40.3%, urinary bladder (14.2%, and stomach (6.9% were the three most common tissues of origin. The most common diagnoses for each of the three tissues of origin were neuroendocrine tumor (50.7%, non-invasive papillary urothelial carcinoma (70.7%, and adenocarcinoma (36.2%. Regardless of the tissue of origin, neuroendocrine tumor of the digestive system was the most common diagnosis (419 of 1,803. Conclusions: In the current study, we found that pathologic consultations associated with private health insurance accounted for a large proportion of the MAS. Coding of the biologic behavior of diseases was the main issue of the consultations. In spite of the effort of the KSP to set proper guidelines for coding and classification of tumors, this review revealed that problems still exist and will continue to be an important issue.

  14. Korean speech-language pathologists' attitudes toward stuttering according to clinical experiences. (United States)

    Lee, Kyungjae


    Negative attitudes toward stuttering and people who stutter (PWS) are found in various groups of people in many regions. However the results of previous studies examining the influence of fluency coursework and clinical certification on the attitudes of speech-language pathologists (SLPs) toward PWS are equivocal. Furthermore, there have been few empirical studies on the attitudes of Korean SLPs toward stuttering. To determine whether the attitudes of Korean SLPs and speech-language pathology students toward stuttering would be different according to the status of clinical certification, stuttering coursework completion and clinical practicum in stuttering. Survey data from 37 certified Korean SLPs and 70 undergraduate students majoring in speech-language pathology were analysed. All the participants completed the modified Clinician Attitudes Toward Stuttering (CATS) Inventory. Results showed that the diagnosogenic view was still accepted by many participants. Significant differences were found in seven out of 46 CATS Inventory items according to the certification status. In addition significant differences were also found in three items and one item according to stuttering coursework completion and clinical practicum experience in stuttering, respectively. Clinical and educational experience appears to have mixed influences on SLPs' and students' attitudes toward stuttering. While SLPs and students may demonstrate more appropriate understanding and knowledge in certain areas of stuttering, they may feel difficulty in their clinical experience, possibly resulting in low self-efficacy. © 2014 Royal College of Speech and Language Therapists.

  15. Automated detection of heuristics and biases among pathologists in a computer-based system. (United States)

    Crowley, Rebecca S; Legowski, Elizabeth; Medvedeva, Olga; Reitmeyer, Kayse; Tseytlin, Eugene; Castine, Melissa; Jukic, Drazen; Mello-Thoms, Claudia


    The purpose of this study is threefold: (1) to develop an automated, computer-based method to detect heuristics and biases as pathologists examine virtual slide cases, (2) to measure the frequency and distribution of heuristics and errors across three levels of training, and (3) to examine relationships of heuristics to biases, and biases to diagnostic errors. The authors conducted the study using a computer-based system to view and diagnose virtual slide cases. The software recorded participant responses throughout the diagnostic process, and automatically classified participant actions based on definitions of eight common heuristics and/or biases. The authors measured frequency of heuristic use and bias across three levels of training. Biases studied were detected at varying frequencies, with availability and search satisficing observed most frequently. There were few significant differences by level of training. For representativeness and anchoring, the heuristic was used appropriately as often or more often than it was used in biased judgment. Approximately half of the diagnostic errors were associated with one or more biases. We conclude that heuristic use and biases were observed among physicians at all levels of training using the virtual slide system, although their frequencies varied. The system can be employed to detect heuristic use and to test methods for decreasing diagnostic errors resulting from cognitive biases.

  16. Delivering Bad News: Attitudes, Feelings, and Practice Characteristics Among Speech-Language Pathologists. (United States)

    Gold, Rinat; Gold, Azgad


    The purpose of this study was to examine the attitudes, feelings, and practice characteristics of speech-language pathologists (SLPs) in Israel regarding the subject of delivering bad news. One hundred and seventy-three Israeli SLPs answered an online survey. Respondents represented SLPs in Israel in all stages of vocational experience, with varying academic degrees, from a variety of employment settings. The survey addressed emotions involved in the process of delivering bad news, training on this subject, and background information of the respondents. Frequency distributions of the responses of the participants were determined, and Pearson correlations were computed to determine the relation between years of occupational experience and the following variables: frequency of delivering bad news, opinions regarding training, and emotions experienced during the process of bad news delivery. Our survey showed that bad news delivery is a task that most participants are confronted with from the very beginning of their careers. Participants regarded training in the subject of delivering bad news as important but, at the same time, reported receiving relatively little training on this subject. In addition, our survey showed that negative emotions are involved in the process of delivering bad news. Training SLPs on specific techniques is required for successfully delivering bad news. The emotional burden associated with breaking bad news in the field of speech-language pathology should be noticed and addressed.

  17. Experienced speech-language pathologists' responses to ethical dilemmas: an integrated approach to ethical reasoning. (United States)

    Kenny, Belinda; Lincoln, Michelle; Balandin, Susan


    To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas. Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual narrative transcriptions were analyzed by using the participant's words to develop an ethical story that described and interpreted their responses to dilemmas. Key concepts from individual stories were then coded into group themes to reflect participants' reasoning processes. Five major themes reflected participants' approaches to ethical reasoning: (a) focusing on the well-being of the client, (b) fulfilling professional roles and responsibilities, (c) attending to professional relationships, (d) managing resources, and (e) integrating personal and professional values. SLPs demonstrated a range of ethical reasoning processes: applying bioethical principles, casuistry, and narrative reasoning when managing ethical dilemmas in the workplace. The results indicate that experienced SLPs adopted an integrated approach to ethical reasoning. They supported clients' rights to make health care choices. Bioethical principles, casuistry, and narrative reasoning provided useful frameworks for facilitating health professionals' application of codes of ethics to complex professional practice issues.

  18. The management of vocal fold nodules in children: a national survey of speech-language pathologists. (United States)

    Signorelli, Monique E; Madill, Catherine J; McCabe, Patricia


    The purpose of this study was to determine the management options and voice therapy techniques currently being used by practicing speech-language pathologists (SLPs) to treat vocal fold nodules (VFNs) in children. The sources used by SLPs to inform and guide their clinical decisions when managing VFNs in children were also explored. Sixty-two SLPs completed a 23-item web-based survey. Data was analysed using frequency counts, content analyses, and supplementary analyses. SLPs reported using a range of management options and voice therapy techniques to treat VFNs in children. Voice therapy was reportedly the most frequently used management option across all respondents, with the majority of SLPs using a combination of indirect and direct voice therapy techniques. When selecting voice therapy techniques, the majority of SLPs reported that they did not use the limited external evidence available to guide their clinical decisions. Additionally, the majority of SLPs reported that they frequently relied on lower levels of evidence or non-evidence-based sources to guide clinical practice both in the presence and absence of higher quality evidence. Further research needs to investigate strategies to remove the barriers that impede SLPs use of external evidence when managing VFNs in children.

  19. Histology of microscopic colitis-review with a practical approach for pathologists. (United States)

    Langner, Cord; Aust, Daniela; Ensari, Arzu; Villanacci, Vincenzo; Becheanu, Gabriel; Miehlke, Stephan; Geboes, Karel; Münch, Andreas


    Microscopic colitis has emerged as a major cause of chronic watery non-bloody diarrhoea, particularly in elderly females. The term is used as an umbrella term to categorize a subgroup of colitides with distinct clinicopathological phenotypes and no significant endoscopic abnormalities. Lymphocytic colitis is defined by an increased number of surface intraepithelial lymphocytes, and collagenous colitis by a thickened collagen band underneath the surface epithelium. There is increased inflammation in the lamina propria, but only little or no crypt architectural distortion. Incomplete and variant forms showing less characteristic features have been reported under different names. The differential diagnosis mainly includes resolving infectious colitis and changes related to the intake of drugs such as non-steroidal anti-inflammatory drugs. Substantial clinical and histological overlap between lymphocytic and collagenous colitis has been described, raising the suspicion that the conditions are two histological manifestations of the same entity, possibly representing different manifestations during the disease course or different stages of disease development. In this review, we provide a practical approach for pathologists, with a focus on diagnostic criteria and differential diagnosis, and discuss recent insights into the pathogenesis of disease and the relationship with classic chronic inflammatory bowel disease, i.e. Crohn's disease and ulcerative colitis. © 2014 John Wiley & Sons Ltd.

  20. Unique Contributors to the Curriculum: From Research to Practice for Speech-Language Pathologists in Schools. (United States)

    Powell, Rachel K


    This lead article of the Clinical Forum focuses on the research that supports why speech-language pathologists (SLPs) are an integral part of the overarching curriculum for all students in schools. Focus on education has shifted to student performance in our global world, specifically in college and career readiness standards. This article reviews recommendations on best practice from the American Speech-Language-Hearing Association on SLPs' roles in schools, as well as data on school-based services. Implementation of these practices as it is applicable to school initiatives will be explored. Methods of interventions available in schools, from general education to special education, will be discussed based on national guidelines for a Response to Intervention and Multi-Tiered System of Support. Research regarding teacher knowledge of the linguistic principles of reading instruction will be explored, as well as correlation between teacher knowledge and student performance. The implications for how SLPs as the linguistic experts offer unique roles in curriculum and the evidence available to support this role will be explored. Implications for future research needs will be discussed. The demands of a highly rigorous curriculum allow SLPs a unique opportunity to apply their knowledge in linguistic principles to increase student performance and achievement. With the increased focus on student achievement, growth outcome measures, and value-added incentives, it is critical that SLPs become contributors to the curriculum for all students and that data to support this role are gathered through focused research initiatives.

  1. Speech-language pathologist job satisfaction in school versus medical settings. (United States)

    Kalkhoff, Nicole L; Collins, Dana R


    The goal of this study was to determine if job satisfaction differs between speech-language pathologists (SLPs) working in school settings and SLPs working in medical settings. The Job Satisfaction Survey (JSS) by Spector (1997) was sent via electronic mail to 250 SLPs in each of the 2 settings. Job satisfaction scores were computed from subscale category ratings and were compared between the 2 settings. Subscale category ratings for pay, promotion, supervision, benefits, contingent rewards, operating conditions, coworkers, nature of work, and communication were analyzed for differences between and within settings. Age, caseload size, and years-at-position were analyzed by linear regression to determine whether these factors might predict SLPs' job satisfaction. The survey had a response rate of 19.6% (N = 98 participants). Although SLPs in both settings were generally satisfied with their jobs, SLPs in medical settings had significantly higher total job satisfaction scores. Respondents from both settings had similar satisfaction ratings for subscale categories, with nature of work receiving the highest rating and operating conditions and promotion the lowest. Results of the linear regression analysis for age, caseload size, and years-at-position were not significant. Further research should evaluate important aspects of job satisfaction in both settings, especially nature of work operating conditions, and promotion.

  2. Application of whole slide image markup and annotation for pathologist knowledge capture. (United States)

    Campbell, Walter S; Foster, Kirk W; Hinrichs, Steven H


    The ability to transfer image markup and annotation data from one scanned image of a slide to a newly acquired image of the same slide within a single vendor platform was investigated. The goal was to study the ability to use image markup and annotation data files as a mechanism to capture and retain pathologist knowledge without retaining the entire whole slide image (WSI) file. Accepted mathematical principles were investigated as a method to overcome variations in scans of the same glass slide and to accurately associate image markup and annotation data across different WSI of the same glass slide. Trilateration was used to link fixed points within the image and slide to the placement of markups and annotations of the image in a metadata file. Variation in markup and annotation placement between WSI of the same glass slide was reduced from over 80 μ to less than 4 μ in the x-axis and from 17 μ to 6 μ in the y-axis (P < 0.025). This methodology allows for the creation of a highly reproducible image library of histopathology images and interpretations for educational and research use.

  3. Beyond lip service: Towards human rights-driven guidelines for South African speech-language pathologists. (United States)

    Pascoe, Michelle; Klop, Daleen; Mdlalo, Thandeka; Ndhambi, Mikateko


    Developed with a strong awareness of past injustices, South Africa's progressive constitution emphasises a full spectrum of human rights. While the constitution celebrates many languages and cultures, speech-language pathologists (SLPs) face challenges in translating these values into practice with a diverse clientele. Similarly, Article 19 of the Universal Declaration of Human Rights focuses on freedom of expression in one's language of choice, but is often perceived as a "Cinderella" right (i.e. one that is frequently neglected). This paper presents a literature review undertaken in association with the Health Professions Council of South Africa to produce guidelines to support SLPs in their practice with diverse linguistic and cultural groups. The aim was to identify key points for inclusion in a set of human rights-driven guidelines. Specific objectives were to critique: (1) current guidelines for SLPs working with diverse cultural and linguistic groups; and (2) equivalent guidelines for related professions. Content analysis of the datasets revealed key themes which formed the basis of an initial skeleton, to be further developed through a consultative process and discussion, ultimately aiming to provide supportive, practical guidelines to better equip South African SLPs to serve all the people of the country.

  4. Communication as a human right: Citizenship, politics and the role of the speech-language pathologist. (United States)

    Murphy, Declan; Lyons, Rena; Carroll, Clare; Caulfield, Mari; De Paor, Gráinne


    According to Article 19 of the Universal Declaration on Human Rights "Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers." The purpose of this paper is to elucidate communication as a human right in the life of a young man called Declan who has Down syndrome. This commentary paper is co-written by Declan, his sister who is a speech-language pathologist (SLP) with an advocacy role, his SLP, and academics. Declan discusses, in his own words, what makes communication hard, what helps communication, his experiences of speech-language pathology, and what he knows about human rights. He also discusses his passion for politics, his right to be an active citizen and participate in the political process. This paper also focuses on the role of speech-language pathology in supporting and partnering with people with communication disabilities to have their voices heard and exercise their human rights.

  5. Entrustable Professional Activities for Pathology: Recommendations From the College of American Pathologists Graduate Medical Education Committee. (United States)

    McCloskey, Cindy B; Domen, Ronald E; Conran, Richard M; Hoffman, Robert D; Post, Miriam D; Brissette, Mark D; Gratzinger, Dita A; Raciti, Patricia M; Cohen, David A; Roberts, Cory A; Rojiani, Amyn M; Kong, Christina S; Peterson, Jo Elle G; Johnson, Kristen; Plath, Sue; Powell, Suzanne Zein-Eldin


    Competency-based medical education has evolved over the past decades to include the Accreditation Council for Graduate Medical Education Accreditation System of resident evaluation based on the Milestones project. Entrustable professional activities represent another means to determine learner proficiency and evaluate educational outcomes in the workplace and training environment. The objective of this project was to develop entrustable professional activities for pathology graduate medical education encompassing primary anatomic and clinical pathology residency training. The Graduate Medical Education Committee of the College of American Pathologists met over the course of 2 years to identify and define entrustable professional activities for pathology graduate medical education. Nineteen entrustable professional activities were developed, including 7 for anatomic pathology, 4 for clinical pathology, and 8 that apply to both disciplines with 5 of these concerning laboratory management. The content defined for each entrustable professional activity includes the entrustable professional activity title, a description of the knowledge and skills required for competent performance, mapping to relevant Accreditation Council for Graduate Medical Education Milestone subcompetencies, and general assessment methods. Many critical activities that define the practice of pathology fit well within the entrustable professional activity model. The entrustable professional activities outlined by the Graduate Medical Education Committee are meant to provide an initial framework for the development of entrustable professional activity-related assessment and curricular tools for pathology residency training.

  6. [Histological diagnosis of bone tumors: Guidelines of the French committee of bone pathologists reference network on bone tumors (RESOS)]. (United States)

    Galant, Christine; Bouvier, Corinne; Larousserie, Frédérique; Aubert, Sébastien; Audard, Virginie; Brouchet, Anne; Marie, Béatrice; Guinebretière, Jean-Marc; de Pinieux du Bouexic, Gonzague


    The management of patients having a bone lesion requires in many cases the realization of a histological sample in order to obtain a diagnosis. However, with the technological evolution, CT-guided biopsies are performed more frequently, often in outpatient clinics. Interpretation of these biopsies constitutes new challenges for the pathologists within the wide spectrum of bone entities. The purpose of the document is to propose guidelines based on the experience of the French committee of bone pathologists of the reference network on bone tumors (RESOS) regarding the indications and limitations of the diagnosis on restricted material. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  7. Demystifying the Courtroom: Everything the Veterinary Pathologist Needs to Know About Testifying in an Animal Cruelty Case. (United States)

    Frederickson, Reese


    When veterinary pathologists testify as expert witnesses in animal cruelty trials, they may find themselves in an intimidating and unfamiliar environment. The legal rules are clouded in mystery, the lawyers dwell on mundane details, and the witness's words are extracted with precision by a verbal scalpel. An unprepared expert witness can feel ungrounded and stripped of confidence. The goal of this article is to lift the veil of mystery and give the veterinary pathologist the tools to be a knowledgeable and confident expert witness before and during testimony. This article discusses the types of expert witnesses, disclosure requirements and the importance of a good report, the legal basics of expert testimony, and how to be an effective expert witness. The article references Minnesota law; however, the laws are similar in most jurisdictions and based on the same constitutional requirements, and the concepts presented are applicable in nearly every courtroom.(1). © The Author(s) 2016.

  8. Guidelines from the Canadian Association of Pathologists for establishing a telepathology service for anatomic pathology using whole-slide imaging

    Directory of Open Access Journals (Sweden)

    Chantal Bernard


    Full Text Available The use of telepathology for clinical applications in Canada has steadily become more attractive over the last 10 years, driven largely by its potential to provide rapid pathology consulting services throughout the country regardless of the location of a particular institution. Based on this trend, the president of the Canadian Association of Pathologists asked a working group consisting of pathologists, technologists, and healthcare administrators from across Canada to oversee the development of guidelines to provide Canadian pathologists with basic information on how to implement and use this technology. The guidelines were systematically developed, based on available medical literature and the clinical experience of early adopters of telepathology in Canada. While there are many different modalities and applications of telepathology, this document focuses specifically on whole-slide imaging as applied to intraoperative pathology consultation (frozen section, primary diagnosis, expert or second opinions and quality assurance activities. Applications such as hematopathology, microbiology, tumour boards, education, research and technical and/or standard-related issues are not covered.

  9. College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference on good laboratory practices in gynecologic cytology: background, rationale, and organization. (United States)

    Tworek, Joseph A; Henry, Michael R; Blond, Barbara; Jones, Bruce Allen


    Gynecologic cytopathology is a heavily regulated field, with Clinical Laboratory Improvement Amendments of 1988 mandating the collection of many quality metrics. There is a lack of consensus regarding methods to collect, monitor, and benchmark these data and how these data should be used in a quality assurance program. Furthermore, the introduction of human papilloma virus testing and proficiency testing has provided more data to monitor. To determine good laboratory practices in quality assurance of gynecologic cytopathology. Data were collected through a written survey consisting of 98 questions submitted to 1245 Clinical Laboratory Improvement Amendments-licensed or Department of Defense laboratories. There were 541 usable responses. Additional input was sought through a Web posting of results and questions on the College of American Pathologists Web site. Four senior authors who authored the survey and 28 cytopathologists and cytotechnologists were assigned to 5 working groups to analyze data and present statements on good laboratory practices in gynecologic cytopathology at the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference. Ninety-eight attendees at the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference discussed and voted on good laboratory practice statements to obtain consensus. This paper describes the rationale, background, process, and strengths and limitations of a series of papers that summarize good laboratory practice statements in quality assurance in gynecologic cytopathology.

  10. How important is embeddedness in predicting Australian speech-language pathologists' intentions to leave their jobs and the profession? (United States)

    Heritage, Brody; Quail, Michelle; Cocks, Naomi


    This study explored the predictors of the outcomes of turnover and occupation attrition intentions for speech-language pathologists. The researchers examined the mediating effects of job satisfaction and strain on the relationship between stress and the latter outcomes. Additionally, the researchers examined the importance of embeddedness in predicting turnover intentions after accounting for stress, strain and job satisfaction. An online questionnaire was used to explore turnover and attrition intentions in 293 Australian speech-language pathologists. Job satisfaction contributed to a significant indirect effect on the stress and turnover intention relationship, however strain did not. There was a significant direct effect between stress and turnover intention after accounting for covariates. Embeddedness and the perceived availability of alternative jobs were also found to be significant predictors of turnover intentions. The mediating model used to predict turnover intentions also predicted occupation attrition intentions. The effect of stress on occupation attrition intentions was indirect in nature, the direct effect negated by mediating variables. Qualitative data provided complementary evidence to the quantitative model. The findings indicate that the proposed parsimonious model adequately captures predictors of speech-language pathologists' turnover and occupation attrition intentions. Workplaces and the profession may wish to consider these retention factors.

  11. Strategies for laboratory cost containment and for pathologist shortage: centralised pathology laboratories with microwave-stimulated histoprocessing and telepathology. (United States)

    Leong, Anthony S Y; Leong, F Joel W M


    The imposition of laboratory cost containment, often from external forces, dictates the necessity to develop strategies to meet laboratory cost savings. In addition, the national and worldwide shortage of anatomical pathologists makes it imperative to examine our current practice and laboratory set-ups. Some of the strategies employed in other areas of pathology and laboratory medicine include improvements in staff productivity and the adoption of technological developments that reduce manual intervention. However, such opportunities in anatomical pathology are few and far between. Centralisation has been an effective approach in bringing economies of scale, the adoption of 'best practices' and the consolidation of pathologists, but this has not been possible in anatomical pathology because conventional histoprocessing takes a minimum of 14 hours and clinical turnaround time requirements necessitate that the laboratory and pathologist be in proximity and on site. While centralisation of laboratories for clinical chemistry, haematology and even microbiology has been successful in Australia and other countries, the essential requirements for anatomical pathology laboratories are different. In addition to efficient synchronised courier networks, a method of ultra-rapid tissue processing and some expedient system of returning the prepared tissue sections to the remote laboratory are essential to maintain the turnaround times mandatory for optimal clinical management. The advent of microwave-stimulated tissue processing that can be completed in 30-60 minutes and the immediate availability of compressed digital images of entire tissue sections via telepathology completes the final components of the equation necessary for making centralised anatomical pathology laboratories a reality.

  12. Familiarity breeds support: speech-language pathologists' perceptions of bullying of students with autism spectrum disorders. (United States)

    Blood, Gordon W; Blood, Ingrid M; Coniglio, Amy D; Finke, Erinn H; Boyle, Michael P


    Children with autism spectrum disorders (ASD) are primary targets for bullies and victimization. Research shows school personnel may be uneducated about bullying and ways to intervene. Speech-language pathologists (SLPs) in schools often work with children with ASD and may have victims of bullying on their caseloads. These victims may feel most comfortable turning to SLPs for help during one-to-one treatment sessions to discuss these types of experiences. A nationwide survey mailed to 1000 school-based SLPs, using a vignette design technique, determined perceptions about intervention for bullying and use of specific strategies. Results revealed a majority of the SLPs (89%) responses were in "likely" or "very likely" to intervene categories for all types of bullying (physical, verbal, relational and cyber), regardless of whether the episode was observed or not. A factor analysis was conducted on a 14 item strategy scale for dealing with bullying for children with ASD. Three factors emerged, labeled "Report/Consult", "Educate the Victim", and Reassure the Victim". SLPs providing no services to children with ASD on their caseloads demonstrated significantly lower mean scores for the likelihood of intervention and using select strategies. SLPs may play an important role in reducing and/or eliminating bullying episodes in children with ASD. Readers will be able to (a) explain four different types of bullying, (b) describe the important role of school personnel in reducing and eliminating bullying, (c) describe the perceptions and strategies selected by SLPs to deal with bullying episodes for students with ASD, and (d) outline the potential role of SLPs in assisting students with ASD who are victimized. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Sex Differences in Workplace Satisfaction and Engagement of Academic Pathologists: Opportunities to Enhance Faculty Diversity. (United States)

    Howell, Lydia Pleotis; Lyons, Mary Lipscomb; Thor, Ann; Dandar, Valerie


    There is attrition of women across professorial ranks in academic pathology. Women are underrepresented as leaders; 15.4% of academic pathology departments are chaired by women, according to the Association of American Medical Colleges (AAMC). To identify areas for targeted interventions that can advance academic and leadership development of women faculty by examining (1) sex differences in career satisfaction in US medical school pathology departments participating in the AAMC's Faculty Forward Engagement Survey, and (2) findings from a survey of the Association of Pathology Chairs (APC). The AAMC Faculty Forward Engagement Survey data are from 14 US medical schools participating in the 2011-2012 survey. Pathologists' response rate was 66% (461 of 697). To investigate sex differences, t tests and χ(2) analyses were used. The APC survey, administered to academic department chairs, had a 55% response rate (104 of 189). According to the Faculty Forward Engagement Survey, women report more time in patient care and less time in research. Women consider formal mentorship, feedback, and career advancement more important than men do and are less satisfied with communication and governance. The APC survey shows that 20% to 40% of nonchair department leaders are women. More than half of chairs report satisfaction with the sex diversity of their departmental leaders. Opportunities exist for department chairs and professional organizations to create targeted interventions to support career satisfaction, recruitment, retention, and career and leadership development for women in academic pathology. Although chairs report satisfaction with diversity within department leadership, responses of women faculty indicate there is work to be done to grow more women leaders.

  14. "Meaningful use" of electronic health records and its relevance to laboratories and pathologists

    Directory of Open Access Journals (Sweden)

    Walter H Henricks


    Full Text Available Electronic health records (EHRs have emerged as a major topic in health care and are central to the federal government′s strategy for transforming healthcare delivery in the United States. Recent federal actions that aim to promote the use of EHRs promise to have significant implications for laboratories and for pathology practices. Under the HITECH (Health Information Technology Economic and Clinical Health Act, an EHR incentive program has been established through which individual physicians and hospitals can qualify to receive incentive payments if they achieve "meaningful use" of "certified" EHR technology. The rule also establishes payment penalties in future years for eligible providers who have not met the requirements for meaningful use of EHRs. Meaningful use must be achieved using EHR technology that has been certified in accordance with functional and technical criteria that are set forth a regulation that parallels the meaningful use criteria in the incentive program. These actions and regulations are important to laboratories and pathologists for a number of reasons. Several of the criteria and requirements in the meaningful use rules and EHR certification criteria relate directly or indirectly to laboratory testing and laboratory information management, and future stage requirements are expected to impact the laboratory as well. Furthermore, as EHR uptake expands, there will be greater expectations for electronic interchange of laboratory information and laboratory information system (LIS-EHR interfaces. Laboratories will need to be aware of the technical, operational, and business challenges that they may face as expectations for LIS-EHR increase. This paper reviews the important recent federal efforts aimed at accelerating EHR use, including the incentive program for EHR meaningful use, provider eligibility, and EHR certification criteria, from a perspective of their relevance for laboratories and pathology practices.

  15. Informatics for practicing anatomical pathologists: marking a new era in pathology practice. (United States)

    Gabril, Manal Y; Yousef, George M


    Informatics can be defined as using highly advanced technologies to improve patient diagnosis or management. Pathology informatics had evolved as a response to the overwhelming amount of information that was available, in an attempt to better use and maintain them. The most commonly used tools of informatics can be classified into digital imaging, telepathology, as well as Internet and electronic data mining. Digital imaging is the storage of anatomical pathology information, either gross pictures or microscopic slides, in an electronic format. These images can be used for education, archival, diagnosis, and consultation. Virtual microscopy is the more advanced form of digital imaging with enhanced efficiency and accessibility. Telepathology is now increasingly becoming a useful tool in anatomical pathology practice. Different types of telepathology communications are available for both diagnostic and consultation services. The spectrum of applications of informatics in the field of anatomical pathology is broad and encompasses medical education, clinical services, and pathology research. Informatics is now settling on solid ground as an important tool for pathology teaching, with digital teaching becoming the standard tool in many institutions. After a slow start, we now witness the transition of informatics from the research bench to bedside. As we are moving into a new era of extensive pathology informatics utilization, several challenges have to be addressed, including the cost of the new technology, legal issues, and resistance of pathologists. It is clear from the current evidence that pathology informatics will continue to grow and have a major role in the future of our specialty. However, it is also clear that it is not going to fully replace the human factor or the regular microscope.

  16. Immune checkpoint inhibitor-induced gastrointestinal and hepatic injury: pathologists' perspective. (United States)

    Karamchandani, Dipti M; Chetty, Runjan


    Immune checkpoint inhibitors (CPIs) are a relatively new class of 'miracle' dugs that have revolutionised the treatment and prognosis of some advanced-stage malignancies, and have increased the survival rates significantly. This class of drugs includes cytotoxic T lymphocyte antigen-4 inhibitors such as ipilimumab; programmed cell death protein-1 inhibitors such as nivolumab, pembrolizumab and avelumab; and programmed cell death protein ligand-1 inhibitors such as atezolizumab. These drugs stimulate the immune system by blocking the coinhibitory receptors on the T cells and lead to antitumoural response. However, a flip side of these novel drugs is immune-related adverse events (irAEs), secondary to immune-mediated process due to disrupted self-tolerance. The irAEs in the gastrointestinal (GI) tract/liver may result in diarrhoea, colitis or hepatitis. An accurate diagnosis of CPI-induced colitis and/or hepatitis is essential for optimal patient management. As we anticipate greater use of these drugs in the future given the significant clinical response, pathologists need to be aware of the spectrum of histological findings that may be encountered in GI and/or liver biopsies received from these patients, as well as differentiate them from its histopathological mimics. This present review discusses the clinical features, detailed histopathological features, management and the differential diagnosis of the luminal GI and hepatic irAEs that may be encountered secondary to CPI therapy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Speech-language pathologists' assessment and intervention practices with multilingual children. (United States)

    Williams, Corinne J; McLeod, Sharynne


    Within predominantly English-speaking countries such as the US, UK, Canada, New Zealand, and Australia, there are a significant number of people who speak languages other than English. This study aimed to examine Australian speech-language pathologists' (SLPs) perspectives and experiences of multilingualism, including their assessment and intervention practices, and service delivery methods when working with children who speak languages other than English. A questionnaire was completed by 128 SLPs who attended an SLP seminar about cultural and linguistic diversity. Approximately one half of the SLPs (48.4%) reported that they had at least minimal competence in a language(s) other than English; but only 12 (9.4%) reported that they were proficient in another language. The SLPs spoke a total of 28 languages other than English, the most common being French, Italian, German, Spanish, Mandarin, and Auslan (Australian sign language). Participants reported that they had, in the past 12 months, worked with a mean of 59.2 (range 1-100) children from multilingual backgrounds. These children were reported to speak between two and five languages each; the most common being: Vietnamese, Arabic, Cantonese, Mandarin, Australian Indigenous languages, Tagalog, Greek, and other Chinese languages. There was limited overlap between the languages spoken by the SLPs and the children on the SLPs' caseloads. Many of the SLPs assessed children's speech (50.5%) and/or language (34.2%) without assistance from others (including interpreters). English was the primary language used during assessments and intervention. The majority of SLPs always used informal speech (76.7%) and language (78.2%) assessments and, if standardized tests were used, typically they were in English. The SLPs sought additional information about the children's languages and cultural backgrounds, but indicated that they had limited resources to discriminate between speech and language difference vs disorder.

  18. Multiple organ failure in the newborn: the point of view of the pathologist

    Directory of Open Access Journals (Sweden)

    Clara Gerosa


    Full Text Available One of the most severe events occurring in critically ill patients admitted to a neonatal intensive care unit (NICU center is represented by the multiple organ failure (MOF, a systemic inflammatory response leading to a progressive organ dysfunction and mortality in newborns. MOF may occur in newborns primarily affected by multiple single organ diseases, including respiratory distress syndrome neonatal sepsis with acute kidney injury, post-asphyxial hypoxic-ischemic encephalopathy and pandemic influenza A (H1N1 infection. In a previous article from our group, based on the histological examination of all organs at autopsy of newborns affected by MOF, all organs studied did not escape to be damaged, including thymus and pancreas normally not mentioned in the literature of MOF. The aim of this article is to review the most important pathological changes pathologists should look for in every case of MOF occurring in the perinatal period, with particular attention to systemic endothelial changes occurring in blood vessels in all organs and sytems. On the basis of our experience, matching data during the last phases of the clinicopathological diagnosis represents a useful method, much more productive as compared to the method based on giving pathological answers to the clinical questions prospected before autopsy. As for the pathological features observed in neonatal MOF, one of them deserves a particular attention: the vascular lesions, and in particular the multiple changes occurring during MOF development in endothelial cells, ending with the loss of the endothelial barrier, probably the most relevant histological lesion followed by the insurgence of interstitial edema and disseminated intravascular coagulation. Small vessels should be observed at high power, with particular attention to the size and shape of endothelial nuclei, in order to evidence endothelial swelling, probably the initial modification of the endothelial cells leading to their

  19. 'Why don't they ever call?' Expectations of clinicians and pathologists regarding the communication of critical diagnoses in dermatopathology. (United States)

    Korbl, Jasmin Dvorah; Wood, Benjamin Andrew; Harvey, Nathan Tobias


    Certain diagnoses in dermatopathology have significant implications for patient management and on occasion appropriate clinical care may be facilitated by a phone call from the reporting dermatopathologist to the referring doctor. Whether this is appropriate depends on a number of factors. The concept of 'critical diagnoses' is now well established in surgical pathology, having evolved from critical value policies in clinical pathology and haematology. However, only limited attempts have been made to assess perceptions among different clinical groups. We designed a survey to assess the attitudes of pathologists, dermatologists, surgeons and general practitioners as to what circumstances warrant telephone contact in addition to a standard written report, as well as their approaches to routine histology follow-up. The survey was distributed Australia-wide via a combination of specialist colleges, medical forums and collegiate contacts. A total of 262 responses were received, encompassing representations from all of the targeted specialties. Approximately 20% of respondents were aware of adverse outcomes or 'near misses' which they felt had been due in some part to inadequate communication of histopathology results. While most practitioners have formal systems in place to review histopathology reports, this practice is not universal. There were a number clinical situations where there was a discrepancy between the expectations of clinicians and those of pathologists, in particular with regard to a diagnosis of cutaneous melanoma as well as cutaneous lesions which might be associated with inherited cancer syndromes. It is our hope that the results of this study will facilitate discussion between pathologists and referring clinicians at a local level to minimise the potential for miscommunication. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

  20. International aspirations for speech-language pathologists' practice with multilingual children with speech sound disorders: development of a position paper. (United States)

    McLeod, Sharynne; Verdon, Sarah; Bowen, Caroline


    A major challenge for the speech-language pathology profession in many cultures is to address the mismatch between the "linguistic homogeneity of the speech-language pathology profession and the linguistic diversity of its clientele" (Caesar & Kohler, 2007, p. 198). This paper outlines the development of the Multilingual Children with Speech Sound Disorders: Position Paper created to guide speech-language pathologists' (SLPs') facilitation of multilingual children's speech. An international expert panel was assembled comprising 57 researchers (SLPs, linguists, phoneticians, and speech scientists) with knowledge about multilingual children's speech, or children with speech sound disorders. Combined, they had worked in 33 countries and used 26 languages in professional practice. Fourteen panel members met for a one-day workshop to identify key points for inclusion in the position paper. Subsequently, 42 additional panel members participated online to contribute to drafts of the position paper. A thematic analysis was undertaken of the major areas of discussion using two data sources: (a) face-to-face workshop transcript (133 pages) and (b) online discussion artifacts (104 pages). Finally, a moderator with international expertise in working with children with speech sound disorders facilitated the incorporation of the panel's recommendations. The following themes were identified: definitions, scope, framework, evidence, challenges, practices, and consideration of a multilingual audience. The resulting position paper contains guidelines for providing services to multilingual children with speech sound disorders ( The paper is structured using the International Classification of Functioning, Disability and Health: Children and Youth Version (World Health Organization, 2007) and incorporates recommendations for (a) children and families, (b) SLPs' assessment and intervention, (c) SLPs' professional

  1. The Royal College of Pathologists of Australasia Quality Assurance Program: Immunohistochemistry Breast Marker Audit Overview 2005-2015. (United States)

    Haffajee, Zenobia Ayesha Mohamed; Kumar, Beena; Francis, Glenn; Peck, Martyn; Badrick, Tony


    The Royal College of Pathologists of Australasia Quality Assurance Program (RCPAQAP) Anatomical Pathology provides a comprehensive External Quality Assurance (EQA) exercise to review the reporting of immunohistochemistry (IHC) and in-situ hybridization (ISH) breast markers through an audit of clinical results. The aim of this exercise was to provide information regarding the quality of breast marker testing within clinical laboratories from 2005 to 2015. This comprehensive audit included estrogen, progesterone, and HER2 marker reporting. This was an important quality assurance activity established in response to ongoing difficulties experienced in laboratories in this area of testing.

  2. S. Burt Wolbach, Rocky Mountain spotted fever, and blood-sucking arthropods: triumph of an early investigative pathologist. (United States)

    Musser, James M


    In a series of four articles published between 1916 and 1919 in The Journal of Medical Research, precursor to The American Journal of Pathology, the investigative pathologist S. Burt Wolbach unambiguously showed that Rocky Mountain spotted fever has a tick-borne mode of transmission, the causative agent replicates intracellularly, and the disease is fundamentally a vasculitis. Although underappreciated, Wolbach's tour-de-force work epitomized investigative pathology. These four articles should be mandatory reading for young investigators and are recommended also to seasoned investigators who seek reinvigoration in the beauty in their craft. Copyright © 2013 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  3. The role of the speech-language pathologist in identifying and treating children with auditory processing disorder. (United States)

    Richard, Gail J


    A summary of issues regarding auditory processing disorder (APD) is presented, including some of the remaining questions and challenges raised by the articles included in the clinical forum. Evolution of APD as a diagnostic entity within audiology and speech-language pathology is reviewed. A summary of treatment efficacy results and issues is provided, as well as the continuing dilemma for speech-language pathologists (SLPs) charged with providing treatment for referred APD clients. The role of the SLP in diagnosing and treating APD remains under discussion, despite lack of efficacy data supporting auditory intervention and questions regarding the clinical relevance and validity of APD.

  4. Overview of the Common Core State Standard initiative and educational reform movement from the vantage of speech-language pathologists. (United States)

    Staskowski, Maureen


    Educational reform is sweeping the country. The adoption and the implementation of the Common Core State Standards in almost every state are meant to transform education. It is intended to update the way schools educate, the way students learn, and to ultimately prepare the nation's next generation for the global workplace. This article will describe the Common Core State Standard initiative and the underlying concerns about the quality of education in the United States as well as the opportunities this reform initiative affords speech-language pathologists. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. Artificial Intelligence for Pathologists Is Not Near--It Is Here: Description of a Prototype That Can Transform How We Practice Pathology Tomorrow. (United States)

    Ye, Jay J


    Pathologists' daily tasks consist of both the professional interpretation of slides and the secretarial tasks of translating these interpretations into final pathology reports, the latter of which is a time-consuming endeavor for most pathologists. To describe an artificial intelligence that performs secretarial tasks, designated as Secretary-Mimicking Artificial Intelligence (SMILE). The underling implementation of SMILE is a collection of computer programs that work in concert to "listen to" the voice commands and to "watch for" the changes of windows caused by slide bar code scanning; SMILE responds to these inputs by acting upon PowerPath Client windows (Sunquest Information Systems, Tucson, Arizona) and its Microsoft Word (Microsoft, Redmond, Washington) Add-In window, eventuating in the reports being typed and finalized. Secretary-Mimicking Artificial Intelligence also communicates relevant information to the pathologist via the computer speakers and message box on the screen. Secretary-Mimicking Artificial Intelligence performs many secretarial tasks intelligently and semiautonomously, with rapidity and consistency, thus enabling pathologists to focus on slide interpretation, which results in a marked increase in productivity, decrease in errors, and reduction of stress in daily practice. Secretary-Mimicking Artificial Intelligence undergoes encounter-based learning continually, resulting in a continuous improvement in its knowledge-based intelligence. Artificial intelligence for pathologists is both feasible and powerful. The future widespread use of artificial intelligence in our profession is certainly going to transform how we practice pathology.

  6. Using the computer to optimize human performance in health care delivery. The pathologist as medical information specialist. (United States)

    Korpman, R A


    The demands for information retrieval, processing, and synthesis placed on all providers of health care have increased dramatically in the last several decades. Although systems have been developed to capture charge-related data in support of cost reimbursement, there has been a conspicuous lack of attention paid to information tools to directly enhance the delivery of patient care. The termination of cost reimbursement, together with an increasing recognition of the problems inherent in current manual record-keeping systems, is creating a significant new focus on medical information. This change in focus requires a shift in systems orientation away from financial and departmentally centered systems and toward patient-centered approaches. There is thus increasing recognition of the need for a physician-level medical information specialist to serve as an institution's chief information officer, assuming responsibility for the collection, manipulation, and availability of all patient care-related data. By virtue of training, typical experience, hospital presence, and a noncompetitive position with the hospital's medical staff, the pathologist is uniquely suited for this position. To effectively perform this role, a variety of new specialized data management tools are becoming available. Integrated information systems, patient care management by exception, decision support tools, and, in the future, "artificial intelligence" assists can all be expected to become staples of pathology practice, especially impacting those pathologists who choose to be responsive to the new practice milieu of medical information science.

  7. "… Trial and error …": Speech-language pathologists' perspectives of working with Indigenous Australian adults with acquired communication disorders. (United States)

    Cochrane, Frances Clare; Brown, Louise; Siyambalapitiya, Samantha; Plant, Christopher


    This study explored speech-language pathologists' (SLPs) perspectives about factors that influence clinical management of Aboriginal and Torres Strait Islander adults with acquired communication disorders (e.g. aphasia, motor speech disorders). Using a qualitative phenomenological approach, seven SLPs working in North Queensland, Australia with experience working with this population participated in semi-structured in-depth interviews. Qualitative content analysis was used to identify categories and overarching themes within the data. Four categories, in relation to barriers and facilitators, were identified from participants' responses: (1) The Practice Context; (2) Working Together; (3) Client Factors; and (4) Speech-Language Pathologist Factors. Three overarching themes were also found to influence effective speech pathology services: (1) Aboriginal and Torres Strait Islander Cultural Practices; (2) Information and Communication; and (3) Time. This study identified many complex and inter-related factors which influenced SLPs' effective clinical management of this caseload. The findings suggest that SLPs should employ a flexible, holistic and collaborative approach in order to facilitate effective clinical management with Aboriginal and Torres Strait Islander people with acquired communication disorders.

  8. Pathology of pulmonary tuberculosis and non-tuberculous mycobacterial lung disease: Facts, misconceptions, and practical tips for pathologists. (United States)

    Jain, Deepali; Ghosh, Subha; Teixeira, Lucileia; Mukhopadhyay, Sanjay


    Most pathologists are familiar with the microscopic features of tuberculosis and the need to examine special stains for acid-fast bacteria (AFB) in cases of granulomatous lung disease. However, misconceptions do exist, including the concept that finding AFB in "caseating granulomas" confirms the diagnosis of tuberculosis. This dogma is attributable to the high prevalence of tuberculosis in many countries, as well as unfamiliarity with the microscopic spectrum of non-tuberculous mycobacterial lung disease. This review aims to provide surgical pathologists with practical tips to identify AFB, illustrate the histologic overlap between pulmonary tuberculosis and non-tuberculous mycobacterial lung disease, and highlight the importance of cultures in this setting. M. tuberculosis and non-tuberculous mycobacteria cannot be reliably differentiated either on the basis of the tissue reaction or by bacterial morphology on acid-fast stains. Although a presumptive clinical diagnosis of tuberculosis can be made without culture-confirmation, the only definitive means to determine the true identity of AFB is by cultures or molecular methods. Making this distinction is most critical when AFB are found in incidentally detected lung nodules in geographic locations where the incidence of tuberculosis is low, because in such settings AFB in necrotizing granulomas of the lung are more likely to be non-tuberculous mycobacteria than M. tuberculosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. International Society of Gynecological Pathologists (ISGyP) Endometrial Cancer Project: Guidelines From the Special Techniques and Ancillary Studies Group. (United States)

    Cho, Kathleen R; Cooper, Kumarasen; Croce, Sabrina; Djordevic, Bojana; Herrington, Simon; Howitt, Brooke; Hui, Pei; Ip, Philip; Koebel, Martin; Lax, Sigurd; Quade, Bradley J; Shaw, Patricia; Vidal, August; Yemelyanova, Anna; Clarke, Blaise; Hedrick Ellenson, Lora; Longacre, Teri A; Shih, Ie-Ming; McCluggage, W Glenn; Malpica, Anais; Oliva, Esther; Parkash, Vinita; Matias-Guiu, Xavier


    The aim of this article is to propose guidelines and recommendations in problematic areas in pathologic reporting of endometrial carcinoma (EC) regarding special techniques and ancillary studies. An organizing committee designed a comprehensive survey with different questions related to pathologic features, diagnosis, and prognosis of EC that was sent to all members of the International Society of Gynecological Pathologists. The special techniques/ancillary studies group received 4 different questions to be addressed. Five members of the group reviewed the literature and came up with recommendations and an accompanying text which were discussed and agreed upon by all members of the group. Twelve different recommendations are made. They address the value of immunohistochemistry, ploidy, and molecular analysis for assessing prognosis in EC, the value of steroid hormone receptor analysis to predict response to hormone therapy, and parameters regarding applying immunohistochemistry and molecular tests for assessing mismatch deficiency in EC.

  10. Related Services Research for Students With Low-Incidence Disabilities: Implications for Speech-Language Pathologists in Inclusive Classrooms. (United States)

    Giangreco, Michael F


    When speech-language pathologists provide educationally related services for students with lowincidence disabilities who are placed in inclusive classrooms, they are asked to work with a variety of other adults. The ways in which these adults make decisions about individualizing a student's educational program, determine related services, and coordinate their activities have an impact on educational outcomes for students as well as on interprofessional interactions. This article summarizes a team process for making related services decisions called VISTA (Vermont Interdependent Services Team Approach) and a series of nine research studies pertaining to the use and impact of VISTA. It also addresses related topics, such as team size, consumer perspectives, and paraprofessional supports. Five major implications from these studies are offered concerning (a) developing a disposition of being an ongoing learner, (b) developing a shared framework among team members, (c) having a research-based process to build consensus, (d) clarifying roles, and (e) increasing involvement of families and general education teachers.

  11. Immunohistochemistry practices of cytopathology laboratories: a survey of participants in the College of American Pathologists Nongynecologic Cytopathology Education Program. (United States)

    Fischer, Andrew H; Schwartz, Mary R; Moriarty, Ann T; Wilbur, David C; Souers, Rhona; Fatheree, Lisa; Booth, Christine N; Clayton, Amy C; Kurtyz, Daniel F I; Padmanabhan, Vijayalakshmi; Crothers, Barbara A


    Immunohistochemistry (IHC) is important for cytology but poses special challenges because preanalytic conditions may differ from the conditions of IHC-positive controls. To broadly survey cytology laboratories to quantify preanalytic platforms for cytology IHC and identify problems with particular platforms or antigens. To discover how validation guidelines for HER2 testing have affected cytology. A voluntary survey of cytology IHC practices was sent to 1899 cytology laboratories participating in the College of American Pathologists Nongynecologic Cytopathology Education Program in the fall of 2009. A total of 818 laboratories (43%) responded to the survey by April 2010. Three hundred fourty-five of 791 respondents (44%) performed IHC on cytology specimens. Seventeen different fixation and processing platforms prior to antibody reaction were reported. A total of 59.2% of laboratories reported differences between the platforms for cytology specimens and positive controls, but most (155 of 184; 84%) did not alter antibody dilutions or antigen retrieval for cytology IHC. When asked to name 2 antibodies for which staining conditions differed between cytology and surgical samples, there were 18 responses listing 14 antibodies. A total of 30.6% of laboratories performing IHC offered HER2 testing before publication of the 2007 College of American Pathologists/American Society of Clinical Oncologists guidelines, compared with 33.6% afterward, with increased performance of testing by reference laboratories. Three laboratories validated a nonformalin HER2 platform. The platforms for cytology IHC and positive controls differ for most laboratories, yet conditions are uncommonly adjusted for cytology specimens. Except for the unsuitability of air-dried smears for HER2 testing, the survey did not reveal evidence of systematic problems with any antibody or platform.

  12. Histologic processing artifacts and inter-pathologist variation in measurement of inked margins of canine mast cell tumors. (United States)

    Kiser, Patti K; Löhr, Christiane V; Meritet, Danielle; Spagnoli, Sean T; Milovancev, Milan; Russell, Duncan S


    Although quantitative assessment of margins is recommended for describing excision of cutaneous malignancies, there is poor understanding of limitations associated with this technique. We described and quantified histologic artifacts in inked margins and determined the association between artifacts and variance in histologic tumor-free margin (HTFM) measurements based on a novel grading scheme applied to 50 sections of normal canine skin and 56 radial margins taken from 15 different canine mast cell tumors (MCTs). Three broad categories of artifact were 1) tissue deformation at inked edges, 2) ink-associated artifacts, and 3) sectioning-associated artifacts. The most common artifacts in MCT margins were ink-associated artifacts, specifically ink absent from an edge (mean prevalence: 50%) and inappropriate ink coloring (mean: 45%). The prevalence of other artifacts in MCT skin was 4-50%. In MCT margins, frequency-adjusted kappa statistics found fair or better inter-rater reliability for 9 of 10 artifacts; intra-rater reliability was moderate or better in 9 of 10 artifacts. Digital HTFM measurements by 5 blinded pathologists had a median standard deviation (SD) of 1.9 mm (interquartile range: 0.8-3.6 mm; range: 0-6.2 mm). Intraclass correlation coefficients demonstrated good inter-pathologist reliability in HTFM measurement (κ = 0.81). Spearman rank correlation coefficients found negligible correlation between artifacts and HTFM SDs ( r ≤ 0.3). These data confirm that although histologic artifacts commonly occur in inked margin specimens, artifacts are not meaningfully associated with variation in HTFM measurements. Investigators can use the grading scheme presented herein to identify artifacts associated with tissue processing.

  13. Teaching Active Listening Skills to Pre-Service Speech-Language Pathologists: A First Step in Supporting Collaboration with Parents of Young Children Who Require AAC (United States)

    Thistle, Jennifer J.; McNaughton, David


    Purpose: This study examined the effect of instruction in an active listening strategy on the communication skills of pre-service speech-language pathologists (SLPs). Method: Twenty-three pre-service SLPs in their 2nd year of graduate study received a brief strategy instruction in active listening skills. Participants were videotaped during a…

  14. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer

    NARCIS (Netherlands)

    Wolff, Antonio C.; Hammond, M. Elizabeth H.; Schwartz, Jared N.; Hagerty, Karen L.; Allred, D. Craig; Cote, Richard J.; Dowsett, Mitchell; Fitzgibbons, Patrick L.; Hanna, Wedad M.; Langer, Amy; McShane, Lisa M.; Paik, Soonmyung; Pegram, Mark D.; Perez, Edith A.; Press, Michael F.; Rhodes, Anthony; Sturgeon, Catharine; Taube, Sheila E.; Tubbs, Raymond; Vance, Gail H.; van de Vijver, Marc; Wheeler, Thomas M.; Hayes, Daniel F.


    PURPOSE: To develop a guideline to improve the accuracy of human epidermal growth factor receptor 2 (HER2) testing in invasive breast cancer and its utility as a predictive marker. METHODS: The American Society of Clinical Oncology and the College of American Pathologists convened an expert panel,

  15. Current Training and Continuing Education Needs of Preschool and School-Based Speech-Language Pathologists regarding Children with Cleft Lip/Palate (United States)

    Bedwinek, Anne P.; Kummer, Ann W.; Rice, Gale B.; Grames, Lynn Marty


    Purpose: The purpose of this study was to obtain information regarding the education and experience of preschool and school-based speech-language pathologists (SLPs) regarding the assessment and treatment of children born with cleft lip and/or palate and to determine their continuing education needs in this area. Method: A 16-item mixed-methods…

  16. Speech-Language Pathologists' Perceptions of the Importance and Ability to Use Assistive Technology in the Kingdom of Saudi Arabia (United States)

    Al-Dawaideh, Ahmad Mousa


    Speech-language pathologists (SLPs) frequently work with people with severe communication disorders who require assistive technology (AT) for communication. The purpose of this study was to investigate the SLPs perceptions of the importance of and ability level required for using AT, and the relationship of AT with gender, level of education,…

  17. Questions You May Want to Ask Your Child's Speech-Language Pathologist = Preguntas que usted le podria hacer al patologo del habla y el lenguaje de su hijo (United States)

    Centers for Disease Control and Prevention, 2007


    This accordion style pamphlet, dual sided with English and Spanish text, suggests questions for parents to ask their Speech-Language Pathologist and speech and language therapy services for their children. Sample questions include: How will I participate in my child's therapy sessions? How do you decide how much time my child will spend on speech…

  18. The Psychologist, Audiologist, and Speech Pathologist and the Deaf-Blind Child: Proceedings (San Jose, California, November 5-7, 1975). (United States)

    Southwestern Region Deaf-Blind Center, Sacramento, CA.

    The booklet offers five presentations from a 1975 special conference on the role of the psychologist, audiologist, and speech pathologist in working with the deaf-blind child. The first paper, "Meeting the Needs of the Severely Handicapped" by L. Hall, addresses the needs of special education, the role of administration in special education, and…

  19. Inter-observer reproducibility before and after web-based education in the Gleason grading of the prostate adenocarcinoma among the Iranian pathologists.

    Directory of Open Access Journals (Sweden)

    Alireza Abdollahi


    Full Text Available This study was aimed at determining intra and inter-observer concordance rates in the Gleason scoring of prostatic adenocarcinoma, before and after a web-based educational course. In this self-controlled study, 150 tissue samples of prostatic adenocarcinoma are re-examined to be scored according to the Gleason scoring system. Then all pathologists attend a free web-based course. Afterwards, the same 150 samples [with different codes compared to the previous ones] are distributed differently among the pathologists to be assigned Gleason scores. After gathering the data, the concordance rate in the first and second reports of pathologists is determined. In the pre web-education, the mean kappa value of Interobserver agreement was 0.25 [fair agreement]. Post web-education significantly improved with the mean kappa value of 0.52 [moderate agreement]. Using weighted kappa values, significant improvement was observed in inter-observer agreement in higher scores of Gleason grade; Score 10 was achieved for the mean kappa value in post web-education was 0.68 [substantial agreement] compared to 0.25 (fair agreement in pre web-education. Web-based training courses are attractive to pathologists as they do not need to spend much time and money. Therefore, such training courses are strongly recommended for significant pathological issues including the grading of the prostate adenocarcinoma. Through web-based education, pathologists can exchange views and contribute to the rise in the level of reproducibility. Such programs need to be included in post-graduation programs.

  20. Expanding the "ports of entry" for speech-language pathologists: a relational and reflective model for clinical practice. (United States)

    Geller, Elaine; Foley, Gilbert M


    To outline an expanded framework for clinical practice in speech-language pathology. This framework broadens the focus on discipline-specific knowledge and infuses mental health constructs within the study of communication sciences and disorders, with the objective of expanding the potential "ports or points of entry" (D. Stern, 1995) for clinical intervention with young children who are language impaired. Specific mental health constructs are highlighted in this article. These include relationship-based learning, attachment theory, working dyadically (the client is the child and parent), reflective practice, transference-countertransference, and the use of self. Each construct is explored as to the way it has been applied in traditional and contemporary models of clinical practice. The underlying premise in this framework is that working from a relationally based and reflective perspective augments change and growth in both client and parent(s). The challenge is for speech-language pathologists to embed mental health constructs within their discipline-specific expertise. This leads to paying attention to both observable aspects of clients' behaviors as well as their internal affective states.

  1. Gendered health care labour markets? A case study of anatomical pathologists and haematologists in KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Suveera Singh


    Full Text Available This study qualitatively explored the role of gender and related factors that influence medical doctors’ decisions in selecting a specialisation within medical laboratory medicine. This study is novel in that it disaggregates doctors by specialisation. It further focuses on non-clinical medical specialists who have been ignored in the global human resources for health literature. Hakim’s preference theory as well as socialisation theory is adapted to explain some of the reasons female doctors make certain career choices regarding specialisation within the medical field. The study focused on laboratory doctors in the public and private sector in KwaZulu- Natal. A qualitative approach was adopted given the small population size and the need for an interpretive approach to the data. The research design was an exploratory case study and thematic analysis was used to discover the relevant themes. The non-probability purposeful sample comprised a total of 20 participants, of which 11 were anatomical pathologists and 9 were haematologists, all based in KwaZulu-Natal, South Africa. Data collection was performed via in-depth interviews. Trustworthiness of the data was ensured through methods of credibility and triangulation. The key finding is that although gender is a significant factor in career choice (for specific disciplines, it is one of many factors that determine self-selection into a specific medical laboratory specialisation. The conclusions, although not generalisable, have implications for human resources for health policies targeted at achieving higher levels of recruitment in laboratory medicine as a profession.

  2. Maximising health literacy and client recall of clinical information: An exploratory study of clients and speech-language pathologists

    Directory of Open Access Journals (Sweden)

    Friderike Schmidt von Wûhlisch


    Full Text Available Limited research has been carried out in the field of speech-language pathology with regard to ways of maximising health literacy and client recall. However, speech-language pathologists (SLPs frequently provide vast amounts of information that clients need to understand, apply and review in order to manage their (or their child’s health. This exploratory study aimed to contribute information about ways in which SLPs can overcome low health literacy and poor client recall so that treatment effectiveness is improved. A case-study design was used with specific focus on four clients receiving treatment for dysphagia, voice disorders (including laryngectomies and cleft lip and/or palate management in Cape Town. Strategies which may be able to maximise health literacy and client recall of clinical information were trialled and evaluated by clients and their SLPs, using semi-structured interviews. The researchers proposed a combination of high-tech strategies which assisted in all the cases. No single solution or universal tool was found that would be appropriate for all. There is a need to evaluate the long-term effectiveness of the combined strategies across a wider population, at different stages of rehabilitation and in diverse contexts. Implications and suggestions for future related research are presented.

  3. Gerhart Panning (1900-1944): a German forensic pathologist and his involvement in Nazi crimes during Second World War. (United States)

    Preuss, Johanna; Madea, Burkhard


    Twenty years after the Second World War the public were made aware of War Crimes committed by the German forensic pathologist, Gerhart Panning (1900-1944). From 1942 till 1944, Panning was professor at the Institute of Forensic Medicine at the University of Bonn. Panning died of tuberculosis on 22 March 1944. After the Second World War, Panning's widow tried to obtain denazification for her husband. There were no particularly serious doubts. In 1965, Konrad Graf von Moltke, the son of Helmuth James Graf von Moltke (1907-1944), presented to the court a private letter from his father to his mother. In this letter, written in 1941, Panning's experiments on Soviet prisoners are described. In the so-called Callsen trial in the court of Darmstadt from 1960 to 1968, the experiments were confirmed by witnesses. In 1941, Panning performed experiments in cooperation with the Sicherheitsstaffel (Nazi special police) in the Ukraine to prove that captured ammunition of the soviet infantry violated international law. For this purpose, different parts of the bodies of living Soviets were used as firing targets. He published the results of these experiments in a scientific journal without any evidence of the origin of these observations. In this article, Panning's life and crimes have been described.

  4. Communication-based services for persons with severe disabilities in schools: a survey of speech-language pathologists. (United States)

    Siegel, Ellin B; Maddox, Laura L; Ogletree, Billy T; Westling, David L


    Speech-language pathologists in school settings were surveyed with an instrument created from the National Joint Committee for the Communication Needs of Persons with Severe Disabilities' quality indicators self-assessment tool. Participants valued practice indicators of quality communication assessment and intervention to a higher degree than their actual practice. These findings appear to suggest that SLPs may not provide best practice services to individuals with severe disabilities. Suggestions for enhancing inservice training and intervention practices of SLPs and team members who work with individuals with severe disabilities are provided. The reader will be able to; (1) understand the value of using the NJC quality indicators to guide SLP practices with individuals with severe disabilities in schools; (2) recognize that research indicates that SLPs working with individuals with severe disabilities in schools may not provide best practice services to the extent that they value these practices; (3) discuss possible strategies to increase the quality of services provided to individuals with severe disabilities in schools.

  5. Distinguishing between casual talk and academic talk beginning in the preschool years: an important consideration for speech-language pathologists. (United States)

    van Kleeck, Anne


    The need for speech-language pathologists (SLPs) to consider an academic talk (AT) register in addition to an everyday casual talk (CT) register of oral language with children beginning in the preschool years is presented, the AT and CT registers are distinguished in a comprehensive manner, ideas regarding AT language assessment are proposed, and suggestions for fostering children's skills with the AT register are offered. Extant research and scholarship from a wide variety of disciplines are integrated and organized. The author discusses the role of the SLP in supporting AT skills beginning in the preschool years and the added risk of difficulties with the AT register for children with language impairment who are from diverse backgrounds. Two broad categories-social-interactive and cognitive-that give rise to linguistic features that differentiate between the CT and AT registers are deduced from extant scholarship. SLPs should consider children's competence with the AT register as they work to prepare preschoolers and older children for the language demands of school.

  6. Issues in Identification and Assessment of Children with Autism and a Proposed Resource Toolkit for Speech-Language Pathologists. (United States)

    Hus, Yvette


    The prevalence of autism spectrum disorder (ASD) has increased significantly in the last decade as have treatment choices. Nonetheless, the vastly diverse autism topic includes issues related to naming, description, iden-tification, assessment, and differentiation from other neu-rodevelopmental conditions. ASD issues directly impact speech-language pathologists (SLPs) who often see these children as the second contact, after pediatric medical practitioners. Because of shared symptomology, differentiation among neurodevelopmental disorders is crucial as it impacts treatment, educational choices, and the performance trajectory of affected children. To highlight issues in: identification and differentiation of ASD from other communication and language challenges, the prevalence differences between ASD gender phenotypes, and the insufficient consideration of cultural factors in evaluating ASD in children. A second objective was to propose a tool to assist SLPs in the management of autism in children. A universal resource toolkit development project for SLP communities at large is proposed. The resource is comprised of research-based observation and screening tools for caregivers and educators, as well as parent questionnaires for portraying the children's function in the family, cultural com-munity, and educational setting. © 2017 S. Karger AG, Basel.

  7. A study on task-analysis of clinical pathologists as medical consultants in Nihon University Hospital--a Japanese perspective by comparison with current status in the USA. (United States)

    Kumasaka, K; Yanai, M; Hosokawa, N; Iwasaki, Y; Hoshino, T; Arashima, Y; Hayashi, K; Murakami, J; Tsuchiya, T; Kawano, K


    To identify our role and the customers' satisfaction, the on-call consultation service records of the Department of Clinical Pathology, Nihon University School of Medicine, Itabashi Hospital (NUIH), were analyzed. Between 1995 and 1998, 1,789 consultation services were recorded, and approximately 40% were from physicians, and 50% were from medical technologists. During office hours, many physicians made contact with us at the office of clinical pathology, the clinical laboratory and other places in the hospital by various means. They asked us to interpret multidisciplinary laboratory data, and to provide the specific information that might affect clinical management. Medical technologists asked for clinical information of patients with extreme measured values and requested that we contact with physicians. In contrast, on weekends/holidays or after routine working hours, physicians sometimes requested non-automated laboratory tests such as peripheral blood smears/bone marrow smears or Gram stains. The major contents of our responses to medical technologists were concerned with blood banking and handling of instruments not to be operated in routine work. These results reconfirm that we are still required to have clinical competence for common laboratory procedures and to have the capability of interpretation of multidisciplinary laboratory data in the university hospital. Traditionally, most Japanese clinical pathologists have been focused their attention on bench work in research laboratories. However, the present study shows that the clinical pathologists need to bridge the real gap between laboratory technology and patient care. Our on-call service system can enhance the education of clinical pathologists, and improve not only laboratory quality assurance but also patient care. In addition, in response to a need for customer access to this service with a shortage of clinical pathologists, a more effective method would be to set up a proactive systemic approach in

  8. Diagnostic reproducibility of hydatidiform moles: ancillary techniques (p57 immunohistochemistry and molecular genotyping) improve morphologic diagnosis for both recently trained and experienced gynecologic pathologists. (United States)

    Gupta, Mamta; Vang, Russell; Yemelyanova, Anna V; Kurman, Robert J; Li, Fanghong Rose; Maambo, Emily C; Murphy, Kathleen M; DeScipio, Cheryl; Thompson, Carol B; Ronnett, Brigitte M


    Distinction of hydatidiform moles from nonmolar specimens (NMs) and subclassification of hydatidiform moles as complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM) are important for clinical practice and investigational studies; however, diagnosis based solely on morphology is affected by interobserver variability. Molecular genotyping can distinguish these entities by discerning androgenetic diploidy, diandric triploidy, and biparental diploidy to diagnose CHMs, PHMs, and NMs, respectively. Eighty genotyped cases (27 CHMs, 27 PHMs, 26 NMs) were selected from a series of 200 potentially molar specimens previously diagnosed using p57 immunohistochemistry and genotyping. Cases were classified by 6 pathologists (3 faculty level gynecologic pathologists and 3 fellows) on the basis of morphology, masked to p57 immunostaining and genotyping results, into 1 of 3 categories (CHM, PHM, or NM) during 2 diagnostic rounds; a third round incorporating p57 immunostaining results was also conducted. Consensus diagnoses (those rendered by 2 of 3 pathologists in each group) were also determined. Performance of experienced gynecologic pathologists versus fellow pathologists was compared, using genotyping results as the gold standard. Correct classification of CHMs ranged from 59% to 100%; there were no statistically significant differences in performance of faculty versus fellows in any round (P-values of 0.13, 0.67, and 0.54 for rounds 1 to 3, respectively). Correct classification of PHMs ranged from 26% to 93%, with statistically significantly better performance of faculty versus fellows in each round (P-values of 0.04, <0.01, and <0.01 for rounds 1 to 3, respectively). Correct classification of NMs ranged from 31% to 92%, with statistically significantly better performance of faculty only in round 2 (P-values of 1.0, <0.01, and 0.61 for rounds 1 to 3, respectively). Correct classification of all cases combined ranged from 51% to 75% by morphology and 70% to 80

  9. Speech-language pathologists' knowledge of genetics: perceived confidence, attitudes, knowledge acquisition and practice-based variables. (United States)

    Tramontana, G Michael; Blood, Ingrid M; Blood, Gordon W


    The purpose of this study was to determine (a) the general knowledge bases demonstrated by school-based speech-language pathologists (SLPs) in the area of genetics, (b) the confidence levels of SLPs in providing services to children and their families with genetic disorders/syndromes, (c) the attitudes of SLPs regarding genetics and communication disorders, (d) the primary sources used by SLPs to learn about genetic disorders/syndromes, and (e) the association between general knowledge, confidence, attitudes, the number of years of experience working as an SLP, and the number of children currently provided services with genetic disorders/syndromes on SLPs' caseloads. Survey data from a nationwide sample of 533 SLPs was analyzed. Results showed SLPs earned a median knowledge score about genetics of 66% correct responses. Their mean confidence and attitude ratings were in the "unsure" categories while they reported they learned about genetics from three main sources, (a) self-study via web and internet-based searches, (b) on-the-job training and (c) popular press magazines and newspapers. Analyses revealed that Confidence summary scores, Attitude Summary scores, the number of children with genetic disorders/syndromes on SLPs' caseloads are positively associated with the ratings of participants with the highest Knowledge scores. Readers will be able to (a) explain the important links between developmental and communication disabilities and genetics, (b) describe the associations between knowledge about genetics and confidence, attitudes, and the number of children with genetic disorders/syndromes on their caseloads, and (c) outline the clinical and theoretical implications of the results from this study. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Psychological distress in newly diagnosed colorectal cancer patients following microsatellite instability testing for Lynch syndrome on the pathologist's initiative. (United States)

    Landsbergen, K M; Prins, J B; Brunner, H G; van Duijvendijk, P; Nagengast, F M; van Krieken, J H; Ligtenberg, M; Hoogerbrugge, N


    According to the Dutch Guideline on Hereditary Colorectal Cancer published in 2008, patients with recently diagnosed colorectal cancer (CRC) should undergo microsatellite instability (MSI) testing by a pathologist immediately after tumour resection if they are younger than 50 years, or if a second CRC has been diagnosed before the age of 70 years, owing to the high risk of Lynch syndrome (MIPA). The aim of the present MIPAPS study was to investigate general distress and cancer-specific distress following MSI testing. From March 2007 to September 2009, 400 patients who had been tested for MSI after newly diagnosed CRC were recruited from 30 Dutch hospitals. Levels of general distress (SCL-90) and cancer-specific distress (IES) were assessed immediately after MSI result disclosure (T1) and 6 months later (T2). Response rates were 23/77 (30%) in the MSI-positive patients and 58/323 (18%) in the MSI-negative patients. Levels of general distress and cancer-specific distress were moderate. In the MSI-positive group, 27% of the patients had high general distress at T1 versus 18% at T2 (p = 0.5), whereas in the MSI-negative group, these percentage were 14 and 18% (p = 0.6), respectively. At T1 and T2, cancer-specific distress rates in the MSI-positive group and MSI-negative group were 39 versus 27% (p = 0.3) and 38 versus 36% (p = 1.0), respectively. High levels of general distress were correlated with female gender, low social support and high perceived cancer risk. Moderate levels of distress were observed after MSI testing, similar to those found in other patients diagnosed with CRC. Immediately after result disclosure, high cancer-specific distress was observed in 40% of the MSI-positive patients.

  11. Speech-language pathologists' practices regarding assessment, analysis, target selection, intervention, and service delivery for children with speech sound disorders. (United States)

    Mcleod, Sharynne; Baker, Elise


    A survey of 231 Australian speech-language pathologists (SLPs) was undertaken to describe practices regarding assessment, analysis, target selection, intervention, and service delivery for children with speech sound disorders (SSD). The participants typically worked in private practice, education, or community health settings and 67.6% had a waiting list for services. For each child, most of the SLPs spent 10-40 min in pre-assessment activities, 30-60 min undertaking face-to-face assessments, and 30-60 min completing paperwork after assessments. During an assessment SLPs typically conducted a parent interview, single-word speech sampling, collected a connected speech sample, and used informal tests. They also determined children's stimulability and estimated intelligibility. With multilingual children, informal assessment procedures and English-only tests were commonly used and SLPs relied on family members or interpreters to assist. Common analysis techniques included determination of phonological processes, substitutions-omissions-distortions-additions (SODA), and phonetic inventory. Participants placed high priority on selecting target sounds that were stimulable, early developing, and in error across all word positions and 60.3% felt very confident or confident selecting an appropriate intervention approach. Eight intervention approaches were frequently used: auditory discrimination, minimal pairs, cued articulation, phonological awareness, traditional articulation therapy, auditory bombardment, Nuffield Centre Dyspraxia Programme, and core vocabulary. Children typically received individual therapy with an SLP in a clinic setting. Parents often observed and participated in sessions and SLPs typically included siblings and grandparents in intervention sessions. Parent training and home programs were more frequently used than the group therapy. Two-thirds kept up-to-date by reading journal articles monthly or every 6 months. There were many similarities with

  12. Collaboration and conquest: MTD as viewed by voice teacher (singing voice specialist) and speech-language pathologist. (United States)

    Goffi-Fynn, Jeanne C; Carroll, Linda M


    This study was designed as a qualitative case study to demonstrate the process of diagnosis and treatment between a voice team to manage a singer diagnosed with muscular tension dysphonia (MTD). Traditionally, literature suggests that MTD is challenging to treat and little in the literature directly addresses singers with MTD. Data collected included initial medical screening with laryngologist, referral to speech-language pathologist (SLP) specializing in voice disorders among singers, and adjunctive voice training with voice teacher trained in vocology (singing voice specialist or SVS). Initial target goals with SLP included reducing extrinsic laryngeal tension, using a relaxed laryngeal posture, and effective abdominal-diaphragmatic support for all phonation events. Balance of respiratory forces, laryngeal coordination, and use of optimum filtering of the source signal through resonance and articulatory awareness was emphasized. Further work with SVS included three main goals including a lowered breathing pattern to aid in decreasing subglottic air pressure, vertical laryngeal position to lower to allow for a relaxed laryngeal position, and a top-down singing approach to encourage an easier, more balanced registration, and better resonance. Initial results also emphasize the retraining of subject toward a sensory rather than auditory mode of monitoring. Other areas of consideration include singers' training and vocal use, the psychological effects of MTD, the personalities potentially associated with it, and its relationship with stress. Finally, the results emphasize that a positive rapport with the subject and collaboration between all professionals involved in a singer's care are essential for recovery. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  13. Performance in Measurement of Serum Cystatin C by Laboratories Participating in the College of American Pathologists 2014 CYS Survey. (United States)

    Eckfeldt, John H; Karger, Amy B; Miller, W Greg; Rynders, Gregory P; Inker, Lesley A


    Cystatin C is becoming an increasingly popular biomarker for estimating glomerular filtration rate, and accurate measurements of cystatin C concentrations are necessary for accurate estimates of glomerular filtration rate. To assess the accuracy of cystatin C concentration measurements in laboratories participating in the College of American Pathologists CYS Survey. Two fresh frozen serum pools, the first from apparently healthy donors and the second from patients with chronic kidney disease, were prepared and distributed to laboratories participating in the CYS Survey along with the 2 usual processed human plasma samples. Target values were established for each pool by using 2 immunoassays and ERM DA471/IFCC international reference material. For the normal fresh frozen pool (ERM-DA471/IFCC-traceable target of 0.960 mg/L), the all-method mean (SD, % coefficient of variation [CV]) reported by all of the 123 reporting laboratories was 0.894 mg/L (0.128 mg/L, 14.3%). For the chronic kidney disease pool (ERM-DA471/IFCC-traceable target of 2.37 mg/L), the all-method mean (SD, %CV) was 2.258 mg/L (0.288 mg/L, 12.8%). There were substantial method-specific biases (mean milligram per liter reported for the normal pool was 0.780 for Siemens, 0.870 for Gentian, 0.967 for Roche, 1.061 for Diazyme, and 0.970 for other/not specified reagents; and mean milligram per liter reported for the chronic kidney disease pool was 2.052 for Siemens, 2.312 for Gentian, 2.247 for Roche, 2.909 for Diazyme, and 2.413 for other/not specified reagents). Manufacturers need to improve the accuracy of cystatin C measurement procedures if cystatin C is to achieve its full potential as a biomarker for estimating glomerular filtration rate.

  14. Productivity of Veterans Health Administration laboratories: a College of American Pathologists Laboratory Management Index Program (LMIP) study. (United States)

    Valenstein, Paul N; Wang, Edward; O'Donohue, Tom


    The Veterans Health Administration (VA) operates the largest integrated laboratory network in the United States. To assess whether the unique characteristics of VA laboratories impact efficiency of operations, we compared the productivity of VA and non-VA facilities. Financial and activity data were prospectively collected from 124 VA and 131 non-VA laboratories enrolled in the College of American Pathologists Laboratory Management Index Program (LMIP) during 2002. In addition, secular trends in 5 productivity ratios were calculated for VA and non-VA laboratories enrolled in LMIP from 1997 through 2002. Veterans Health Administration and non-VA facilities did not differ significantly in size. Inpatients accounted for a lower percentage of testing at VA facilities than non-VA facilities (21.7% vs 37.3%; P benefits; P depreciation, and maintenance than their non-VA counterparts (all P <.001), resulting in lower overall cost per on-site test result (2.64 dollars vs 3.40 dollars; P <.001). Cost per referred (sent-out) test did not differ significantly between the 2 groups. Analysis of 6-year trends showed significant increases in both VA (P <.001) and non-VA (P =.02) labor productivity (on-site tests/total FTE). Expenses at VA laboratories for labor per test, consumables per test, overall expense per test, and overall laboratory expense per discharge decreased significantly during the 6-year period (P <.001), while in non-VA facilities the corresponding ratios showed no significant change. Overall productivity of VA laboratories is superior to that of non-VA facilities enrolled in LMIP. The principal advantages enjoyed by the VA are higher-than-average labor productivity (tests/FTE) and lower-than-average consumable expenses.

  15. The Pathologist as Poet. (United States)

    Domen, Ronald E


    The role of the humanities (eg, philosophy, bioethics, literature, music, theater, religion, anthropology) in medical education has been argued long and hard for decades. It is argued that the study of subjects included in the humanities can enhance critical thinking skills, foster a deeper level of learning and understanding, and help to enhance one's level of compassion, empathy, and moral/ethical reasoning. It is the author's contention that writing and reading poetry (as an example of a personal pursuit in the humanities) can help achieve these goals not only in our contact with patients but also in our contact with other humans and cultures in the world at large.

  16. Autoimmune gastritis: Pathologist's viewpoint. (United States)

    Coati, Irene; Fassan, Matteo; Farinati, Fabio; Graham, David Y; Genta, Robert M; Rugge, Massimo


    Western countries are seeing a constant decline in the incidence of Helicobacter pylori-associated gastritis, coupled with a rising epidemiological and clinical impact of autoimmune gastritis. This latter gastropathy is due to autoimmune aggression targeting parietal cells through a complex interaction of auto-antibodies against the parietal cell proton pump and intrinsic factor, and sensitized T cells. Given the specific target of this aggression, autoimmune gastritis is typically restricted to the gastric corpus-fundus mucosa. In advanced cases, the oxyntic epithelia are replaced by atrophic (and metaplastic) mucosa, creating the phenotypic background in which both gastric neuroendocrine tumors and (intestinal-type) adenocarcinomas may develop. Despite improvements in our understanding of the phenotypic changes or cascades occurring in this autoimmune setting, no reliable biomarkers are available for identifying patients at higher risk of developing a gastric neoplasm. The standardization of autoimmune gastritis histology reports and classifications in diagnostic practice is a prerequisite for implementing definitive secondary prevention strategies based on multidisciplinary diagnostic approaches integrating endoscopy, serology, histology and molecular profiling.

  17. The Pathologist as Poet

    Directory of Open Access Journals (Sweden)

    Ronald E. Domen MD


    Full Text Available The role of the humanities (eg, philosophy, bioethics, literature, music, theater, religion, anthropology in medical education has been argued long and hard for decades. It is argued that the study of subjects included in the humanities can enhance critical thinking skills, foster a deeper level of learning and understanding, and help to enhance one’s level of compassion, empathy, and moral/ethical reasoning. It is the author’s contention that writing and reading poetry (as an example of a personal pursuit in the humanities can help achieve these goals not only in our contact with patients but also in our contact with other humans and cultures in the world at large.

  18. Understanding perceptions of stuttering among school-based speech-language pathologists: an application of attribution theory. (United States)

    Boyle, Michael P


    The purpose of this study was to investigate whether attribution theory could explain speech-language pathologists (SLPs) perceptions of children with communication disorders such as stuttering. Specifically, it was determined whether perceptions of onset and offset controllability, as well as biological and non-biological attributions for communication disorders were related to willingness to help, sympathy, and anger toward children with these disorders. It was also of interest to determine if blame for stuttering was related to perceived controllability of stuttering and negative attitudes toward people who stutter (PWS). A survey was developed to measure perceived onset and offset controllability, biological and non-biological attributions, willingness to help, sympathy, and anger toward middle school children with developmental stuttering, functional articulation disorders, and cerebral palsy. In addition, a scale was developed to measure blame and negative attitudes toward PWS in general. Surveys were mailed to 1000 school-based SLPs. Data from 330 participants were analyzed. Supporting the hypotheses of attribution theory, higher perceived onset and offset controllability of the disorder was linked to less willingness to help, lower sympathy, and more anger across conditions. Increased biological attributions were associated with more reported sympathy. Increased blame for stuttering was linked to higher perceived controllability of stuttering, more dislike of PWS, and more agreement with negative stereotypes about PWS. Educating SLPs about the variable loss of control inherent in stuttering could improve attitudes and increase understanding of PWS. Reductions in blame may facilitate feelings of sympathy and empathy for PWS and reduce environmental barriers for clients. Learning outcomes Readers should be able to: (1) identify the main principles of Weiner's attribution theory (2) identify common negative perceptions of people who stutter (3) describe how

  19. Interactive case vignettes utilizing simulated pathologist-clinician encounters with whole slide imaging and video tutorials of whole slide scans improves student understanding of disease processes

    Directory of Open Access Journals (Sweden)

    Adam J Horn


    Full Text Available Background: One of the drawbacks of studying pathology in the second year of medical school in a classroom setting is the relatively limited exposure to patient encounters/clinical rotations, making it difficult to understand and fully appreciate the significance of the course material, specifically the molecular and tissue aspects of disease. In this study, we determined if case vignettes incorporating pathologist-clinician encounters with whole slide imaging (WSI and narrated/annotated videos of whole slide (WS scans in addition to clinical data improved student understanding of pathologic disease processes. Materials and Methods: Case vignettes were created for several genitourinary disease processes that utilized clinical data including narratives of pathologist-clinician encounters, WSI, and annotated video tutorials of WS scans (designed to simulate "double-heading". The students were encouraged to view the virtual slide first, with the video tutorials being provided to offer additional assistance. The case vignettes were created to be interactive with a detailed explanation of each correct and incorrect question choice. The cases were made available to all second year medical students via a website and could be viewed only after completing a 10 question pre-test. A post-test could be completed after viewing all cases followed by a brief satisfaction survey. Results: Ninety-six students completed the pre-test with an average score of 7.7/10. Fifty-seven students completed the post-test with an average score of 9.4/10. Thirty-six students completed the satisfaction survey. 94% agreed or strongly agreed that this was a useful exercise and 91% felt that it helped them better understand the topics. Conclusion: The development of interactive case vignettes incorporating simulated pathologist-clinician encounters with WSI and video tutorials of WS scans helps to improve student enthusiasm to learn and grasp pathologic aspects of disease

  20. Customer satisfaction in anatomic pathology. A College of American Pathologists Q-Probes study of 3065 physician surveys from 94 laboratories. (United States)

    Zarbo, Richard J; Nakhleh, Raouf E; Walsh, Molly


    Measurement of physicians' and patients' satisfaction with laboratory services has recently become a requirement of health care accreditation agencies in the United States. To our knowledge, this is the first customer satisfaction survey of anatomic pathology services to provide a standardized tool and benchmarks for subsequent measures of satisfaction. This Q-Probes study assessed physician satisfaction with anatomic pathology laboratory services and sought to determine characteristics that correlate with a high level of physician satisfaction. In January 2001, each laboratory used standardized survey forms to assess physician customer satisfaction with 10 specific elements of service in anatomic pathology and an overall satisfaction rating based on a scale of rankings from a 5 for excellent to a 1 for poor. Data from up to 50 surveys returned per laboratory were compiled and analyzed by the College of American Pathologists. A general questionnaire collected information about types of services offered and each laboratory's quality assurance initiatives to determine characteristics that correlate with a high level of physician satisfaction. Hospital-based laboratories in the United States (95.8%), as well as others from Canada and Australia. Ninety-four voluntary subscriber laboratories in the College of American Pathologists Q-Probes quality improvement program participated in this survey. Roughly 70% of respondents were from hospitals with occupied bedsizes of 300 or less, 65% were private nonprofit institutions, just over half were located in cities, one third were teaching hospitals, and 19% had pathology residency training programs. Overall physician satisfaction with anatomic pathology and 10 selected aspects of the laboratory service (professional interaction, diagnostic accuracy, pathologist responsiveness to problems, pathologist accessibility for frozen section, tumor board presentations, courtesy of secretarial and technical staff, communication of

  1. Living successfully with aphasia: a qualitative meta-analysis of the perspectives of individuals with aphasia, family members, and speech-language pathologists. (United States)

    Brown, Kyla; Worrall, Linda E; Davidson, Bronwyn; Howe, Tami


    The concept of living successfully with aphasia has recently emerged as an alternative to more traditional "deficit" models in aphasiology, encouraging a focus on positive rather than negative outcomes. This research aimed to integrate findings from studies exploring the perspectives of three participant groups (individuals with aphasia, speech-language pathologists, and family members) about living successfully with aphasia. Qualitative meta-analysis of three studies conducted by the authors was used to integrate perspectives across the participant groups. Steps in the qualitative meta-analysis were based on those described in the process of "meta-ethnography" by Noblit and Hare (1988) . Analysis was an inductive process, in which data from each study were re-analysed and translated into each other in order to identify higher-level overarching themes that accounted for similarities and discrepancies across the original studies. A total of seven overarching themes related to living successfully with aphasia were identified. These were: participation, meaningful relationships, support, communication, positivity, independence and autonomy, and living successfully with aphasia as a journey over time. Findings indicate the need for a holistic, client-centred approach that considers communication in the broader context of an individual's daily life. The overarching themes may act as guides for areas of importance to be addressed in clinical practice, as well as in future research. By working in partnership with individuals with aphasia and their families, speech-language pathologists are challenged to continue to improve services and assist clients on their journey of living successfully with aphasia.

  2. Intervention Techniques Used With Autism Spectrum Disorder by Speech-Language Pathologists in the United States and Taiwan: A Descriptive Analysis of Practice in Clinical Settings. (United States)

    Hsieh, Ming-Yeh; Lynch, Georgina; Madison, Charles


    This study examined intervention techniques used with children with autism spectrum disorder (ASD) by speech-language pathologists (SLPs) in the United States and Taiwan working in clinic/hospital settings. The research questions addressed intervention techniques used with children with ASD, intervention techniques used with different age groups (under and above 8 years old), and training received before using the intervention techniques. The survey was distributed through the American Speech-Language-Hearing Association to selected SLPs across the United States. In Taiwan, the survey (Chinese version) was distributed through the Taiwan Speech-Language Pathologist Union, 2018, to certified SLPs. Results revealed that SLPs in the United States and Taiwan used 4 common intervention techniques: Social Skill Training, Augmentative and Alternative Communication, Picture Exchange Communication System, and Social Stories. Taiwanese SLPs reported SLP preparation program training across these common intervention strategies. In the United States, SLPs reported training via SLP preparation programs, peer therapists, and self-taught. Most SLPs reported using established or emerging evidence-based practices as defined by the National Professional Development Center (2014) and the National Standards Report (2015). Future research should address comparison of SLP preparation programs to examine the impact of preprofessional training on use of evidence-based practices to treat ASD.

  3. The Recent Pathology Residency Graduate Job Search Experience: A Synthesis of 5 Years of College of American Pathologists Job Market Surveys. (United States)

    Gratzinger, Dita; Johnson, Kristen A; Brissette, Mark D; Cohen, David; Rojiani, Amyn M; Conran, Richard M; Hoffman, Robert D; Post, Miriam D; McCloskey, Cindy B; Roberts, Cory A; Domen, Ronald E; Talbert, Michael L; Powell, Suzanne Z


    - Pathology residents and fellows tailor their training and job search strategies to an actively evolving specialty in the setting of scientific and technical advances and simultaneous changes in health care economics. - To assess the experience and outcome of the job search process of pathologists searching for their first non-fellowship position. - The College of American Pathologists (CAP) Graduate Medical Education Committee has during the past 5 years sent an annual job search survey each June to CAP junior members and fellows in practice 3 years or less who have actively searched for a non-fellowship position. - Job market indicators including job interviews, job offers, positions accepted, and job satisfaction have remained stable during the 5 years of the survey. Most survey respondents who had applied for at least 1 position had accepted a position at the time of the survey, and most applicants who had accepted a position were satisfied or very satisfied. However, most attested that finding a non-fellowship position was difficult. Despite a perceived push toward subspecialization in surgical pathology, the reported number of fellowships completed was stable. Respondent demographics were not associated with job search success with 1 significant exception: international medical school graduate respondents reported greater perceived difficulty in finding a position, and indeed, fewer reported having accepted a position. - Pathology residents and fellows seeking their first position have faced a relatively stable job market during the last 5 years, with most accepting positions with which they were satisfied.

  4. Evaluation of the correlation between KRAS mutated allele frequency and pathologist tumorous nuclei percentage assessment in colorectal cancer suggests a role for zygosity status. (United States)

    Libbrecht, Louis; Baldin, Pamela; Dekairelle, Anne-France; Jouret-Mourin, Anne


    Evaluation of molecular tumour heterogeneity relies on the tumorous nuclei percentage (TNP) assessment by a pathologist, which has been criticised for being inaccurate and suffering from interobserver variability. Based on the 'Big Bang theory' which states that KRAS mutation in colorectal cancer is mostly homogeneous, we investigated this issue by performing a critical analysis of the correlation of the KRAS mutant allele fraction with the TNP in 99 colorectal tumour samples with a positive KRAS mutation status as determined by next-generation sequencing. Our results yield indirect evidence that the KRAS zygosity status influences the correlation between these parameters and we show that a well-trained pathologist is indeed capable of accurately assessing TNP. Our findings indicate that tumour zygosity, a feature which has largely been neglected until now, should be taken into account in future studies on (colorectal) molecular tumour heterogeneity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. HER2 testing of gastro-oesophageal adenocarcinoma: a commentary and guidance document from the Association of Clinical Pathologists Molecular Pathology and Diagnostics Committee. (United States)

    Wong, Newton A C S; Amary, Fernanda; Butler, Rachel; Byers, Richard; Gonzalez, David; Haynes, Harry R; Ilyas, Mohammad; Salto-Tellez, Manuel; Taniere, Philippe


    The use of biologics targeted to the human epidermal growth factor receptor 2 (HER2) protein is the latest addition to the armamentarium used to fight advanced gastric or gastro-oesophageal junction adenocarcinoma. The decision to treat with the biologic trastuzumab is completely dependent on HER2 testing of tumour tissue. In 2017, the College of American Pathologists, American Society for Clinical Pathology and the American Society of Clinical Oncology jointly published guidelines for HER2 testing and clinical decision making in gastro-oesophageal adenocarcinoma. The Association of Clinical Pathologists Molecular Pathology and Diagnostics Committee has issued the following document as a commentary of these guidelines and, in parallel, to provide guidance on HER2 testing in National Health Service pathology departments within the UK. This guidance covers issues related to case selection, preanalytical aspects, analysis and interpretation of such HER2 testing. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Synoptic tool for reporting of hematological and lymphoid neoplasms based on World Health Organization classification and College of American Pathologists checklist

    Directory of Open Access Journals (Sweden)

    Winters Sharon B


    Full Text Available Abstract Background Synoptic reporting, either as part of the pathology report or replacing some free text component incorporates standardized data elements in the form of checklists for pathology reporting. This ensures the pathologists make note of these findings in their reports, thereby improving the quality and uniformity of information in the pathology reports. Methods The purpose of this project is to develop the entire set of elements in the synoptic templates or "worksheets" for hematologic and lymphoid neoplasms using the World Health Organization (WHO Classification and the College of American Pathologists (CAP Cancer Checklists. The CAP checklists' content was supplemented with the most updated classification scheme (WHO classification, specimen details, staging as well as information on various ancillary techniques such as cytochemical studies, immunophenotyping, cytogenetics including Fluorescent In-situ Hybridization (FISH studies and genotyping. We have used a digital synoptic reporting system as part of an existing laboratory information system (LIS, CoPathPlus, from Cerner DHT, Inc. The synoptic elements are presented as discrete data points, so that a data element such as tumor type is assigned from the synoptic value dictionary under the value of tumor type, allowing the user to search for just those cases that have that value point populated. Results These synoptic worksheets are implemented for use in our LIS. The data is stored as discrete data elements appear as an accession summary within the final pathology report. In addition, the synoptic data can be exported to research databases for linking pathological details on banked tissues. Conclusion Synoptic reporting provides a structured method for entering the diagnostic as well as prognostic information for a particular pathology specimen or sample, thereby reducing transcription services and reducing specimen turnaround time. Furthermore, it provides accurate and

  7. Simultaneous natural speech and AAC interventions for children with childhood apraxia of speech: lessons from a speech-language pathologist focus group. (United States)

    Oommen, Elizabeth R; McCarthy, John W


    In childhood apraxia of speech (CAS), children exhibit varying levels of speech intelligibility depending on the nature of errors in articulation and prosody. Augmentative and alternative communication (AAC) strategies are beneficial, and commonly adopted with children with CAS. This study focused on the decision-making process and strategies adopted by speech-language pathologists (SLPs) when simultaneously implementing interventions that focused on natural speech and AAC. Eight SLPs, with significant clinical experience in CAS and AAC interventions, participated in an online focus group. Thematic analysis revealed eight themes: key decision-making factors; treatment history and rationale; benefits; challenges; therapy strategies and activities; collaboration with team members; recommendations; and other comments. Results are discussed along with clinical implications and directions for future research.

  8. Family-centered services for children with complex communication needs: the practices and beliefs of school-based speech-language pathologists. (United States)

    Mandak, Kelsey; Light, Janice


    This study used an online focus group to examine the beliefs and practices of school-based speech-language pathologists (SLPs) who served children with complex communication needs regarding their provision of family-centered services. Participants revealed that despite their desire for family involvement and reported beliefs in the importance of family-centered services, there were barriers in place that often limited family-centered service provision. Across the SLPs, many were dissatisfied with their current provision of family-centered services. The SLPs varied in their reported practices, with some reporting family-centered services and others, professional-centered services. Future research is recommended in order to investigate which factors contribute to the variation among SLPs and how the variation impacts children who require augmentative and alternative communication (AAC) and their families. Potential clinical implications for in-service and pre-service SLPs are discussed to improve future family-centered AAC services.

  9. Designing augmentative and alternative communication applications: the results of focus groups with speech-language pathologists and parents of children with autism spectrum disorder. (United States)

    Boster, Jamie B; McCarthy, John W


    The purpose of this study was to gain insight from speech-language pathologists (SLPs) and parents of children with autism spectrum disorder (ASD) regarding appealing features of augmentative and alternative communication (AAC) applications. Two separate 1-hour focus groups were conducted with 8 SLPs and 5 parents of children with ASD to identify appealing design features of AAC Apps, their benefits and potential concerns. Participants were shown novel interface designs for communication mode, play mode and incentive systems. Participants responded to poll questions and provided benefits and drawbacks of the features as part of structured discussion. SLPs and parents identified a range of appealing features in communication mode (customization, animation and colour-coding) as well as in play mode (games and videos). SLPs preferred interfaces that supported motor planning and instruction while parents preferred those features such as character assistants that would appeal to their child. Overall SLPs and parents agreed on features for future AAC Apps. SLPs and parents have valuable input in regards to future AAC app design informed by their experiences with children with ASD. Both groups are key stakeholders in the design process and should be included in future design and research endeavors. Implications for Rehabilitation AAC applications for the iPad are often designed based on previous devices without consideration of new features. Ensuring the design of new interfaces are appealing and beneficial for children with ASD can potentially further support their communication. This study demonstrates how key stakeholders in AAC including speech language pathologists and parents can provide information to support the development of future AAC interface designs. Key stakeholders may be an untapped resource in the development of future AAC interfaces for children with ASD.

  10. Appeals in gynecologic cytology proficiency testing: review and analysis of data from the 2006 College of American Pathologists gynecologic cytology proficiency testing program. (United States)

    Crothers, Barbara A; Moriarty, Ann T; Fatheree, Lisa A; Booth, Christine N; Tench, William D; Wilbur, David C


    In 2006, 9643 participants took the initial College of American Pathologists (CAP) Proficiency Test (PT). Failing participants may appeal results on specific test slides. Appeals are granted if 3 referee pathologists do not unanimously agree on the initial reference diagnosis in a masked review process. To investigate causes of PT failures, subsequent appeals, and appeal successes in 2006. Appeals were examined, including patient demographic information, Centers for Medicare and Medicaid Services category (A, B, C, or D), exact reference diagnosis, examinees per appeal, examinee's Centers for Medicare and Medicaid Services category, referee's Centers for Medicare and Medicaid Services category, slide preparation type, and slide field validation rate. There was a 94% passing rate for 2006. One hundred fifty-five examinees (1.6%) appealed 86 slides of all preparation types. Forty-five appeals (29%) were granted on 21 slides; 110 appeals (72%) were denied on 65 slides. Reference category D and B slides were most often appealed. The highest percentage of granted appeals occurred in category D (35% slides; 42% of participants) and the lowest occurred in category B (9% slides; 8% of participants). The field validation rate of all appealed slides was greater than 90%. Despite rigorous field validation of slides, 6% of participants failed. Thirty percent of failing participants appealed; most appeals involved misinterpretation of category D as category B. Referees were never unanimous in their agreement with the participant. The participants and referees struggled with the reliability and reproducibility of finding rare cells, "overdiagnosis" of benign changes, and assigning the morphologically dynamic biologic changes of squamous intraepithelial lesions to static categories.

  11. Tutorial: Speech Assessment for Multilingual Children Who Do Not Speak the Same Language(s) as the Speech-Language Pathologist. (United States)

    McLeod, Sharynne; Verdon, Sarah


    The aim of this tutorial is to support speech-language pathologists (SLPs) undertaking assessments of multilingual children with suspected speech sound disorders, particularly children who speak languages that are not shared with their SLP. The tutorial was written by the International Expert Panel on Multilingual Children's Speech, which comprises 46 researchers (SLPs, linguists, phoneticians, and speech scientists) who have worked in 43 countries and used 27 languages in professional practice. Seventeen panel members met for a 1-day workshop to identify key points for inclusion in the tutorial, 26 panel members contributed to writing this tutorial, and 34 members contributed to revising this tutorial online (some members contributed to more than 1 task). This tutorial draws on international research evidence and professional expertise to provide a comprehensive overview of working with multilingual children with suspected speech sound disorders. This overview addresses referral, case history, assessment, analysis, diagnosis, and goal setting and the SLP's cultural competence and preparation for working with interpreters and multicultural support workers and dealing with organizational and government barriers to and facilitators of culturally competent practice. The issues raised in this tutorial are applied in a hypothetical case study of an English-speaking SLP's assessment of a multilingual Cantonese- and English-speaking 4-year-old boy. Resources are listed throughout the tutorial.

  12. A comparison of rural speech-language pathologists' and residents' access to and attitudes towards the use of technology for speech-language pathology service delivery. (United States)

    Dunkley, Carolyn; Pattie, Lydelle; Wilson, Linda; McAllister, Lindy


    This paper reports results and implications of two related studies which investigated (a) access of residents and speech-language pathologists (SLPs) of rural Australia to information and communication technologies (ICT) and (b) their attitudes towards the use of ICT for delivery of speech-language pathology services. Both studies used mail out questionnaires, followed by interviews with a subset of those who completed the questionnaires. Data were obtained from 43 questionnaires from rural residents and 10 interviews with a subset of those residents, and from questionnaires returned by 49 SLPs and 4 interviews with a subset of those SLPs. Results show a mismatch between rural residents' and SLPs' access to and attitudes towards use of ICT for speech-language pathology service delivery. Rural residents had better access and more positive attitudes to the use of ICT for speech-language pathology service delivery than expected by SLPs. The results of this study have important implications for education and professional development of SLPs and for research into the use of ICT for telespeech-language pathology.

  13. External quality assurance of fibrinogen assays using normal plasma: results of the 2008 College of American Pathologists proficiency testing program in coagulation. (United States)

    Cunningham, Mark T; Olson, John D; Chandler, Wayne L; Van Cott, Elizabeth M; Eby, Charles S; Teruya, Jun; Hollensead, Sandra C; Adcock, Dorothy M; Allison, Paul M; Kottke-Marchant, Kandice K; Smith, Marc D


    Proper diagnosis and therapy of fibrinogen deficiency requires high-quality fibrinogen assays. To assess the interlaboratory bias, precision, and grading of fibrinogen assays used by laboratories participating in the United States College of American Pathologists proficiency testing program in coagulation. Two identical vials of normal plasma were sent to more than 3500 laboratories. Participants measured fibrinogen levels using local methods. Fifty different fibrinogen methods were evaluated. All-method bias was 8.3% (range of method-specific biases, 0.0%-27.0%) and all-method coefficient of variation was 7.7% (range of method-specific coefficients of variation, 0.7%-25.8%). After controlling for reagent/instrument type, mean fibrinogen levels were 11.6% higher for prothrombin time-based reagents compared to Clauss (P graded as pass or fail using a target range of ±20% from the method mean (total pass rate, 98.8%). Total fail rate was 3.0-fold lower for mechanical instruments compared to photo-optical (0.5% versus 1.5%, P  =  .001). Nonetheless many photo-optical methods had very high precision and very low fail rates. Fibrinogen assays showed highly variable methodology and performance characteristics. Bias, precision, and grading were affected by the type of reagent or instrument used.

  14. Fine-needle aspiration biopsy of lymphoproliferative disorders--interpretations based on morphologic criteria alone: results from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology. (United States)

    Young, Nancy A; Moriarty, Ann T; Haja, Jennifer C; Wilbur, David C


    Diagnosis of lymphoproliferative disorders is one of the most challenging tasks faced by the cytologist. The initial cytomorphologic evaluation of lymphoproliferative lesions directs the choice of ancillary studies that ultimately lead to a diagnosis based on the World Health Organization classification system using a composite of clinical, morphologic, immunophenotypic, and molecular features. To evaluate the ability of participating laboratories in the College of American Pathologists Interlaboratory Comparison Program in Non-Gynecologic Cytopathology to appropriately categorize lymphoproliferative lesions based solely on cytomorphologic criteria. Laboratory responses for lymph node aspirates were examined. All responses were based on review of glass slides without ancillary immunologic or molecular data available. The benchmarking data provided for each specific diagnosis were analyzed, with a focus on the performance for evaluation of lymphoproliferative lesions. Based on morphology alone, responses for lymph node aspirates in the Non-Gynecologic Cytopathology program were correct to the exact reference diagnosis for 87.1% of Hodgkin lymphoma. Non-Hodgkin lymphoma was identified in 69.5% of the large cell non-Hodgkin lymphoma cases, of which 66.8% were correctly classified as large cell type. Non-Hodgkin lymphoma was identified in 68.1% of non-Hodgkin lymphoma, other than large cell cases, and of these, 94.7% were identified as other than large cell type. The spectrum of specific responses was consistent for lymphoproliferative lesions, with a reasonable differential diagnosis based on cytomorphology alone, which, in practice, facilitates the appropriate choice of immunophenotypic markers and other ancillary studies.

  15. Primary pulmonary non-small cell carcinomas: the College of American Pathologists Interlaboratory Comparison Program confirms a significant trend toward subcategorization based upon fine-needle aspiration cytomorphology alone. (United States)

    Yildiz-Aktas, Isil Z; Sturgis, Charles D; Barkan, Guliz A; Souers, Rhona J; Fraig, Mostafa M; Laucirica, Rodolfo; Khalbuss, Walid E; Moriarty, Ann T


    Context.-Subtyping of non-small cell lung carcinomas (NSCLCs) is necessary for optimal patient management with specific diagnoses triggering specific molecular tests and affecting therapy. Objective.-To assess the accuracy of the participants of the College of American Pathologists Interlaboratory Comparison Program in diagnosing and subtyping NSCLC fine-needle aspiration (FNA) slides, based on morphology alone, considering preparation and participant type and trends over time. Design.-The performance of program participants was reviewed for the 5-year period spanning 2007-2011. Lung FNA challenges with reference diagnoses of adenocarcinoma and squamous cell carcinoma (SCC) were evaluated for diagnostic concordance by using a nonlinear mixed model analysis. Results.-There were 10 493 pathologist and 6378 cytotechnologist responses with concordance rates of 97.4% and 97.9% for malignancy, respectively. Overall concordance rates for subcategorization were 54.6% for adenocarcinoma and 74.9% for SCC. For the exact reference diagnoses, pathologists performed better for adenocarcinoma and cytotechnologists performed better for SCC. Accurate subcategorization of adenocarcinomas significantly increased over time with 31.5% of adenocarcinomas classified as NSCLC in 2007 and 25.5% of adenocarcinomas classified as NSCLC in 2011 (P alone. During the study period, a statistically significant trend was confirmed toward greater accuracy of subcategorization of adenocarcinomas, suggesting that participants are cognizant of the impact that more specific cytomorphologic interpretations have in directing molecular triage and therapy.

  16. Enhancement of Pathologist's Routine Practice: Reuse of DNA Extracted from Immunostained Formalin-fixed Paraffin-embedded (FFPE) Slides in Downstream Molecular Analysis of Cancer. (United States)

    Al-Attas, Asmaa; Assidi, Mourad; Al-Maghrabi, Jaudah; Dallol, Ashraf; Schulten, Hans-Juergen; Abu-Elmagd, Muhammad; Chaudhary, Adeel; Abuzenadah, Adel; Budowle, Bruce; Buhmeida, Abdelbaset; Al-Qahtani, Mohammed

    To date, the conventional formalin-fixed, paraffin-embedded (FFPE) technique is the gold-standard for preserving histomorphology. Once FFPE tissues are stained, slides are routinely archived along with their blocks at biobanks/hospitals. However, the reuse of fixed and stained biospecimens as DNA source is not a common routine practice worldwide and, thus, indicates the need of studies to investigate the feasibility of extracting DNA from already immunohistochemistry (IHC) FFPE-stained slides and its possible reuse in subsequent downstream molecular analyses. FFPE IHC slides from colorectal cancer (CRC) patients were prepared and stored in the CEGMR Biobank. The workflow consists of digitalization of IHC stained slide's image, removing the slide cover-slip, crude dissection and DNA extraction. Following DNA quality assessment, mutation analysis of CTNNB1 and methylation profile of CDH1 were performed. High-quality DNA was obtained allowing 60% concordance between CDH1 methylation and membranous E-cadherin expression pattern. Clean CTNNB1 DNA chromatograms with evenly-spaced peaks were observed. This study is a proof of concept to recycle and reuse DNA from IHC stained slides with suitable concentration and integrity for further downstream molecular applications. These findings will enhance the pathologists' knowledge, attitudes and practices (KAP) towards the use of these biospecimens and support the implementation of this approach in clinical pathology practice. Therefore, the scientific community will benefit from the largest comprehensive database of human fully annotated FFPE biospecimens already available at their disposal in order to demystify the complexity and the heterogeneity of many challenging diseases and foster the transition towards precision medicine. Copyright© 2016, International Institute of Anticancer Research (Dr. John G. Delinasios), All rights reserved.

  17. [Aggressive B‑cell lymphomas : Recommendations from the German Panel of Reference Pathologists in the Competence Network on Malignant Lymphomas on diagnostic procedures according to the current WHO classification, update 2017]. (United States)

    Klapper, W; Fend, F; Feller, A; Hansmann, M L; Möller, P; Stein, H; Rosenwald, A; Ott, G


    The update of the 4th edition of the WHO classification for hematopoietic neoplasms introduces changes in the field of mature aggressive B‑cell lymphomas that are relevant to diagnostic pathologists. In daily practice, the question arises of which analysis should be performed when diagnosing the most common lymphoma entity, diffuse large B‑cell lymphoma. We discuss the importance of the cell of origin, the analysis of MYC translocations, and the delineation of the new WHO entities of high-grade B‑cell lymphomas.

  18. Importância do fonoaudiólogo no acompanhamento de indivíduos com hipotireoidismo congênito Speech and language pathologist importance in the attendance of individuals with congenital hypothyroidism

    Directory of Open Access Journals (Sweden)

    Mariana Germano Gejão


    the children thataccomplish the treatment can present development disturbances. The National Neonatal Screening Program, instituted by Health Ministry, foresees the individuals' longitudinal attendance with multidisciplinary team. However, the Speech and Language Pathologist is not included in this team. This way, considering the occurrence of communication disturbances in these individuals, a bibliographical assessment was carried out in Lilacs, MedLine and PubMed databases, in the period from 1987 to 2007, regarding the disturbances in development abilities arising from congenital hypothyroidism. PURPOSE: to check, in the scientific literature, for the presence of development alterations in individuals with congenital hypothyroidism and contemplate the importance of the speech and language pathologist performance, together with a multidisciplinary team specialized in their attendance. CONCLUSION: the literature reports disturbances in development abilities (motor, cognitive, linguistics and self-care and stresses out that children with congenital hypothyroidism are under risk for disturbances in the linguistic development and, therefore, they need the longitudinal attendance of the communicative development. The importance of the speech and language pathologist performance in credential Neonatal Screening Programs by the Health Ministry becomes evident. It still fits to emphasize the need for investigations regarding the other metabolic alterations meditated in these programs, in which the speech and language pathologist can act in such a way to prevent, enable and rehabilitate the communication disturbances, contributing to the work in team, promoting health in this population.

  19. Cytologic anaplasia is a prognostic factor in osteosarcoma biopsies, but mitotic rate or extent of spontaneous tumor necrosis are not: a critique of the College of American Pathologists Bone Biopsy template. (United States)

    Cates, Justin Mm; Dupont, William D


    The current College of American Pathologists cancer template for reporting biopsies of bone tumors recommends including information that is of unproven prognostic significance for osteosarcoma, such as the presence of spontaneous tumor necrosis and mitotic rate. Conversely, the degree of cytologic anaplasia (degree of differentiation) is not reported in this template. This retrospective cohort study of 125 patients with high-grade osteosarcoma was performed to evaluate the prognostic impact of these factors in diagnostic biopsy specimens in predicting the clinical outcome and response to neoadjuvant chemotherapy. Multivariate Cox regression was performed to adjust survival analyses for well-established prognostic factors. Multivariate logistic regression was used to determine odds ratios for good chemotherapy response (≥90% tumor necrosis). Osteosarcomas with severe anaplasia were independently associated with increased overall and disease-free survival, but mitotic rate and spontaneous necrosis had no prognostic impact after controlling for other confounding factors. Mitotic rate showed a trend towards increased odds of a good histologic response, but this effect was diminished after controlling for other predictive factors. Neither spontaneous necrosis nor the degree of cytologic anaplasia observed in biopsy specimens was predictive of a good response to chemotherapy. Mitotic rate and spontaneous tumor necrosis observed in pretreatment biopsy specimens of high-grade osteosarcoma are not strong independent prognostic factors for clinical outcome or predictors of response to neoadjuvant chemotherapy. Therefore, reporting these parameters for osteosarcoma, as recommended in the College of American Pathologists Bone Biopsy template, does not appear to have clinical utility. In contrast, histologic grading schemes for osteosarcoma based on the degree of cytologic anaplasia may have independent prognostic value and should continue to be evaluated.

  20. John Dewey's Pragmatic Ethics and "Manipulation": A Response to Walter Feinberg and Clarence Karier. (United States)

    Pyong, Gap Min


    Dewey's emphasis on the individual as the determiner for moral judgments and his consideration of the general welfare as the standard is the focus for argument against the interpretation that his ethical theory supports the possibility of the manipulation of the masses by liberal reformers. (JN)

  1. The onset of the Early Eocene Climatic Optimum at Branch Stream, Clarence River valley, New Zealand

    International Nuclear Information System (INIS)

    Slotnick, B.S.; Dickens, G.R.; Hollis, C.J.; Crampton, J.S.; Strong, C.P.; Phillips, A.


    We present new lithologic, biostratigraphic and carbon isotope records for a calcareous-rich ∼84m thick, early Eocene, upper continental slope section now exposed along Branch Stream, Marlborough. Decimetre-scale limestone-marl couplets comprise the section. Several marl-rich intervals correspond to carbon isotope excursions (CIEs) representing increased 13 C -depleted carbon fluxes to the ocean. These records are similar to those at nearby Mead Stream, except marl-rich intervals at Branch Stream are thicker with a wider δ 13 C range. Comparison to other sites indicates the section spans ∼53.4-51.6 Ma, the onset of the Early Eocene Climatic Optimum (EECO). The most prominent CIE is correlated with the K/X event (52.9 Ma). Prominent marl-rich intervals resulted from increased fluxes of terrigenous material and associated carbonate dilution. We find multiple warming events marked lowermost EECO, each probably signaling enhanced seasonal precipitation. Branch Stream bulk isotopic records suggest 'differential diagenesis' impacted the sequence during sediment burial. (author).

  2. 76 FR 3011 - Establishment of Class E Airspace; Port Clarence, AK (United States)


    ...: Federal Aviation Administration (FAA), DOT. ACTION: Final rule; delay of effective date, correction... Products office stated that more time was needed to chart the airspace. Therefore, this action will delay...; (2) is not a ``significant rule'' under DOT Regulatory Policies and Procedures (44 FR 11034; February...

  3. H11274: NOS Hydrographic Survey , Port Clarence, Alaska, 2005-08-20 (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  4. Clarence Batan met en lumière le sort des jeunes Philippins | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Research Committee on Sociology of Youth, le RC 34) à l'occasion du Congrès mondial de sociologie de l'Association internationale de sociologie (ISA), et il est maintenant l'un des deux vice-présidents pour l'Asie de ce comité.

  5. Conhecimento, crença e uso de medicina alternativa e complementar por fonoaudiólogas Knowledge, beliefs and practices toward alternative and complementary therapies among speech-language pathologists

    Directory of Open Access Journals (Sweden)

    Thaise Manzini


    Full Text Available O objetivo do presente estudo é entender o conhecimento, as crenças e o uso das medicinas alternativas e complementares entre fonoaudiólogas que atuam no setor público de saúde. O estudo foi realizado em um hospital terciário de Ribeirão Preto, SP. Um questionário desenvolvido para os propósitos do estudo foi administrado em uma casuística de 40 fonoaudiólogas. Os itens do questionário foram criados conforme uma revisão da literatura. A aceitação de medicinas alternativas e complementares, como acupuntura e homeopatia, é expressiva entre as profissionais entrevistadas. Os resultados do presente estudo sugerem que o uso e a prática destas medicinas são feitos de forma racional, com certa prudência. As entrevistadas admitem que um tratamento complementar deve ser submetido a testes científicos antes de sua aceitação, e que é desaconselhável a um paciente buscar um tratamento alternativo ou complementar sem antes consultar o médico.The purpose of this study is to understand the knowledge, beliefs, concerns and practices toward alternative and complementary therapies among speech-language pathologists in a Brazilian public hospital. The current study was conducted in a large tertiary hospital in Ribeirão Preto, Southeastern Brazil. A questionnaire developed to measure knowledge, beliefs and practices on alternative and complementary therapies was answered by forty speech-language pathologists. The questionnaire items were created via literature review. Alternative and complementary therapies as acupuncture and homeopathy have high acceptance among the interviewed professionals. The results of the present study suggest that the use and practice of these techniques are made in a rational manner, with some prudence. The interviewed professionals admit that complementary treatment must be submitted to scientific tests before its acceptance, and that it is inadvisable for the patient to try treatment with alternative and

  6. Variability among pathologists in the histological diagnosis of helicobacter pylori infection: is it a subjective diagnosis? Variabilidad entre patólogos en el diagnóstico histológico de la infección por Helicobacter pylori: ¿un diagnóstico subjetivo?

    Directory of Open Access Journals (Sweden)

    Luis Fernando Arias Restrepo


    Full Text Available Histopathologic diagnosis of Helicobacter pylori (Hp infection is not necessarily easy, and reproducibility is not perfect. Our aim was to determine differences in the frequency of Hp infection according to the pathologists interpreting gastric biopsies in Medellín (Colombia. Materials and methods: All gastric biopsy reports of eight pathologists during one year were reviewed. We excluded cases with intestinal metaplasia, atrophy, dysplasia or carcinoma. We registered patient age, positivity or negativity for H. pylori, and pathologist. We determined the percentage with H. pylori infection and the percentage of each pathologist in order to determine differences. Results: 2.023 cases were included. Each pathologist evaluated a mean of 252.9 ± 154.9 cases (range: 102-445. Patients were 43.5 ± 15.1 years-old (range: 12-90. H. pylori was diagnosed in 1.034 cases (51.1%. The range of positivity according to the pathologist was 38.8-71.1%; mean 51.1% ± 8.7% (p < 0,001. Conclusion: Among pathologists, there is a significant variability in the frequency of diagnosis of H. pylori infection. This result suggests the need to achieve greater homogeneity of concepts and criteria for the diagnosis of this infection, and of its severity. El diagnóstico histológico de la infección por Helicobacter pylori (Hp puede ser difícil, principalmente en casos con pocos microorganismos. Nuestro objetivo fue determinar si hay diferencias significativas en la frecuencia del diagnóstico de la infección por Hp entre patólogos que laboran en Medellín. Materiales y métodos: revisamos todos los informes de biopsias gástricas de ocho patólogos durante un año. Excluimos las biopsias con metaplasia, atrofia, displasia o carcinoma. Registramos la edad del paciente, la presencia o ausencia de Hp y el patólogo que estudió la biopsia. Calculamos el porcentaje de casos con la infección y el porcentaje por patólogo. Finalmente, comparamos estos porcentajes para

  7. Interactive storage and retrieval of pathologist's observations

    International Nuclear Information System (INIS)

    Trauger, G.M.; Dagle, G.E.; Watson, C.R.; McIntyre, J.M.


    A system was developed for interactive storage and retrieval of pathologic observations. Data are entered on a CRT terminal using modified SNOP (Systematized Nomenclature of Pathology) codes. They are then stored and processed in a PDP 11/70 computer, and are retrieved on demand, utilizing DATATRIEVE and a variety of reports convenient for statistical analysis

  8. A Qualitative Study Comparing the Assay Performance Characteristics Between the 2007 and the 2013 American Society for Clinical Oncology and College of American Pathologists HER2 Scoring Methods in Mucinous Epithelial Ovarian Cancer (United States)

    Chen, Chi-Kuan; Lee, Ming-Yung; Lin, Wea-Lung; Wang, Yu-Ting; Han, Chih-Ping; Yu, Cheng-Ping; Chao, Wan-Ru


    Abstract The remarkable success of trastuzumab and other newly developed anti-HER2 (human epidermal growth factor receptor 2) therapies in breast, gastric, or gastroesophageal junction cancer patients has supported us to investigate the HER2 status and its possible therapeutic implication in mucinous epithelial ovarian cancer (EOC). However, there is currently no standardization of HER2 scoring criteria in mucinous EOC. In this study, we aimed to compare both the assay performance characteristics of the 2007 and the 2013 American Society for Clinical Oncology and College of American Pathologists scoring methods. Forty-nine tissue microarray samples of mucinous EOC from Asian women were analyzed by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) tests using the 2007 and the 2013 criteria, respectively. The overall concordance between IHC and FISH by the 2007 criteria was 97.92 % (kappa = 0.921), and that by the 2013 criteria was 100% (kappa = 1.000). The percentage of Her2 FISH-amplified cases showed an increasing trend significantly through their corresponding HER2 IHC ordinals by the 2007 and the 2013 criteria, respectively (P < 0.001, P < 0.001). After excluding equivocal cases, the specificity (100%) and positive predictive value (100%) were unchanged under either the 2007 or the 2013 criteria. The sensitivity (100%), negative predictive value (NPV) (100%), and accuracy (100%) of HER2 IHC were higher under the 2013 criteria than those (sensitivity 87.5%, NPV 97.6%, and accuracy 97.9%) under the 2007 criteria. Of the total 49 cases, the number (n = 4) of HER2 IHC equivocal results under the 2013 criteria was 4-fold higher than that (n = 1) under the 2007 criteria (8.16% vs 2.04%). Conclusively, if first tested by IHC, the 2013 criteria caused more equivocal HER2 IHC cases to be referred to Her2 FISH testing than the 2007 criteria. That decreased the false-negative rate of HER2 status and increased the detection

  9. HER2 Gene Amplification Testing by Fluorescent In Situ Hybridization (FISH): Comparison of the ASCO-College of American Pathologists Guidelines With FISH Scores Used for Enrollment in Breast Cancer International Research Group Clinical Trials. (United States)

    Press, Michael F; Sauter, Guido; Buyse, Marc; Fourmanoir, Hélène; Quinaux, Emmanuel; Tsao-Wei, Denice D; Eiermann, Wolfgang; Robert, Nicholas; Pienkowski, Tadeusz; Crown, John; Martin, Miguel; Valero, Vicente; Mackey, John R; Bee, Valerie; Ma, Yanling; Villalobos, Ivonne; Campeau, Anaamika; Mirlacher, Martina; Lindsay, Mary-Ann; Slamon, Dennis J


    Purpose ASCO and the College of American Pathologists (ASCO-CAP) recently recommended further changes to the evaluation of human epidermal growth factor receptor 2 gene (HER2) amplification by fluorescent in situ hybridization (FISH). We retrospectively assessed the impact of these new guidelines by using annotated Breast Cancer International Research Group (BCIRG) -005, BCIRG-006, and BCIRG-007 clinical trials data for which we have detailed outcomes. Patients and Methods The HER2 FISH status of BCIRG-005/006/007 patients with breast cancers was re-evaluated according to current ASCO-CAP guidelines, which designates five different groups according to HER2 FISH ratio and average HER2 gene copy number per tumor cell: group 1 (in situ hybridization [ISH]-positive): HER2-to-chromosome 17 centromere ratio ≥ 2.0, average HER2 copies ≥ 4.0; group 2 (ISH-positive): ratio ≥ 2.0, copies < 4.0; group 3 (ISH-positive): ratio < 2.0, copies ≥ 6.0; group 4 (ISH-equivocal): ratio < 2.0, copies ≥ 4.0 and < 6.0; and group 5 (ISH-negative): ratio < 2.0, copies < 4.0. We assessed correlations with HER2 protein, clinical outcomes by disease-free survival (DFS) and overall survival (OS) and benefit from trastuzumab therapy (hazard ratio [HR]). Results Among 10,468 patients with breast cancers who were successfully screened for trial entry, 40.8% were in ASCO-CAP ISH group 1, 0.7% in group 2; 0.5% in group 3, 4.1% in group 4, and 53.9% in group 5. Distributions were similar in screened compared with accrued subpopulations. Among accrued patients, FISH group 1 breast cancers were strongly correlated with immunohistochemistry 3+ status (P < .0001), whereas groups 2, 3, 4, and 5 were not; however, groups 2, 4 and, 5 were strongly correlated with immunohistochemistry 0/1+ status (all P < .0001), whereas group 3 was not. Among patients accrued to BCIRG-005, group 4 was not associated with significantly worse DFS or OS compared with group 5. Among patients accrued to BCIRG-006, only

  10. Laboratory compliance with the American Society of Clinical Oncology/College of American Pathologists human epidermal growth factor receptor 2 testing guidelines: a 3-year comparison of validation procedures. (United States)

    Dyhdalo, Kathryn S; Fitzgibbons, Patrick L; Goldsmith, Jeffery D; Souers, Rhona J; Nakhleh, Raouf E


    The American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) published guidelines in 2007 regarding testing accuracy, interpretation, and reporting of results for HER2 studies. A 2008 survey identified areas needing improved compliance. To reassess laboratory response to those guidelines following a full accreditation cycle for an updated snapshot of laboratory practices regarding ASCO/CAP guidelines. In 2011, a survey was distributed with the HER2 immunohistochemistry (IHC) proficiency testing program identical to the 2008 survey. Of the 1150 surveys sent, 977 (85.0%) were returned, comparable to the original survey response in 2008 (757 of 907; 83.5%). New participants submitted 124 of 977 (12.7%) surveys. The median laboratory accession rate was 14,788 cases with 211 HER2 tests performed annually. Testing was validated with fluorescence in situ hybridization in 49.1% (443 of 902) of the laboratories; 26.3% (224 of 853) of the laboratories used another IHC assay. The median number of cases to validate fluorescence in situ hybridization (n = 40) and IHC (n = 27) was similar to those in 2008. Ninety-five percent concordance with fluorescence in situ hybridization was achieved by 76.5% (254 of 332) of laboratories for IHC(-) findings and 70.4% (233 of 331) for IHC(+) cases. Ninety-five percent concordance with another IHC assay was achieved by 71.1% (118 of 168) of the laboratories for negative findings and 69.6% (112 of 161) of the laboratories for positive cases. The proportion of laboratories interpreting HER2 IHC using ASCO/CAP guidelines (86.6% [798 of 921] in 2011; 83.8% [605 of 722] in 2008) remains similar. Although fixation time improvements have been made, assay validation deficiencies still exist. The results of this survey were shared within the CAP, including the Laboratory Accreditation Program and the ASCO/CAP panel revising the HER2 guidelines published in October 2013. The Laboratory Accreditation Program checklist was

  11. Apoio respiratório na voz cantada: perspectiva de professores de canto e fonoaudiólogos Support and singing voice: perspective of singing teachers and speech language pathologists

    Directory of Open Access Journals (Sweden)

    Wilson Gava Júnior


    Full Text Available OBJETIVO: analisar a definição de apoio respiratório, assim como as estratégias de trabalho e benefícios de sua aplicação, segundo a perspectiva de professores de canto e fonoaudiólogos. MÉTODOS: seis profissionais com experiência em voz cantada foram entrevistados sobre questões relacionadas ao apoio respiratório no canto. As respostas foram submetidas à análise de conteúdo e definidas quatro categorias: definição de apoio respiratório, tipo de apoio, estratégias e benefícios. RESULTADOS: os aspectos mais mencionados pelos entrevistados foram: a definição de apoio está relacionada com a participação do músculo diafragma e dos intercostais; o tipo de apoio mais adequado é o intercostal e diafragmático; dentre as estratégias de trabalho, utilizadas para a adequação do apoio respiratório, as mais citadas foram propriocepção corporal, conscientização da musculatura envolvida, equilíbrio do fluxo aéreo, alívio de tensões e correção da postura. Há discrepâncias com relação à utilização da contração abdominal, do uso de objetos de apoio, de imagens mentais e realização de vocalizes. Para os entrevistados, o maior benefício do apoio respiratório está no alívio das tensões laríngeas e melhoria na coordenação pneumofonoarticulatória. Houve pouca concordância sobre a ação benéfica do apoio, principalmente quanto à sua melhoria na emissão cantada. CONCLUSÃO: os resultados apontam para uma convergência da maioria dos entrevistados quanto à definição, estratégias de trabalho e benefícios do apoio respiratório, porém ainda sem consenso.PURPOSE: to analyze the definition of breath support, as well as the strategies used to achieve it and their benefits according to both singing teachers and Speech Language Pathologists (SLP. METHODS: six professionals experienced in singing voice answered an interview on issues pertaining to singing breath support. The answers were submitted to

  12. Immune Reconstitution Inflammatory Syndrome (IRIS): What pathologists should know. (United States)

    Nelson, Ann Marie; Manabe, Yukari C; Lucas, Sebastian B


    Antiretroviral therapy has significantly improved the quality and length of life for those patients able to access effective and sustained treatment. The resulting restoration of the immune response is associated with a change in the clinical presentation of opportunistic infections, and the histologic reaction to pathogens. A complex combination of alterations in host response across the stages of HIV infection has been documented over the past 3 decades. The defects are seen in both acute and chronic phases of inflammation and involve innate and adaptive immunity. In advanced stages of HIV infection, the marked disruption of lymphoid tissue and loss of follicular dendritic cells limits the host's ability to process antigen and mount specific responses to pathogens. There are qualitative and quantitative defects in CD4 T cells due to HIV infection. The resulting indirect effects include loss of cytokine production, dysregulation of B-cell function, loss of cellular mediated immunity and "holes" in the immunologic repertoire that may not be restored with the use of antiretroviral therapy. Immune reconstitution allows the host to respond to and control infection, but a significant number of patients will have atypical inflammatory syndromes during the recovery period. We briefly discuss the impact of HIV infection on the immune system and give an overview of the spectrum of conditions attributed to the Immune Reconstitution Inflammatory syndrome (IRIS). Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Peripheral nervous system neuroimmunology seen by a neuro-pathologist. (United States)

    Vallat, J-M


    In most dysimmune neuropathies, historically the microscopical lesions were described prior to immunological studies. The latter along with neuropathological studies have found some immune, albeit incomplete, explanations of the mechanisms of these lesions which we will describe in two main syndromes: the primitive auto-immune inflammatory peripheral polyneuropathies (GBS and CIDP) and polyneuropathies induced by a monoclonal dysglobulinemia. In some patients who have to be discussed case by case pathology (nerve biopsy) will confirm the diagnosis, may help to delineate the molecular anomalies and identify lesional mechanisms. We will review the high variability of nerve lesions which is characteristic of dysimmune neuropathies. Pathological studies confirm that both humoral and cellular immune reactions against Schwann cell and/or axonal antigens are implicated in primitive dysimmune neuropathies due to a dysfunction or failure of immune tolerance mechanisms. In case of a polyneuropathy associated to a monoclonal dysglobulinemia, pathological and immunological studies have shown that in many patients, the dysglobulinemia did harm the peripheral nerve; knowledge of the pathological lesions and their mechanisms is of major interest for orienting specific treatments. Copyright © 2014. Published by Elsevier Masson SAS.

  14. Helen Hart, remarkable plant pathologist (1900-1971). (United States)

    Wilcoxson, R D


    Helen Hart was a Professor of Plant Pathology at the University of Minnesota from 1924 until retirement in 1966. Born in Janeville, Wisconsin, she died at Grants Pass, Oregon. Her scholarly research concentrated on wheat stem rust to understand host pathogen relationships and to develop rust-resistant cultivars. She did not teach formal courses but was heavily involved in making seminars a vital part of instruction, in teaching languages needed for graduate studies, and as an informal advisor for most rust research theses. She had common sense, excellent scientific judgment, and sound instincts on personnel matters that served the department well. A talented science writer, Hart served as editor of hundreds of theses and departmental manuscripts for publication. Her writing and editing skills were used as associate editor of Phytopathology for two years and as editor-in-chief from 1944-1951. A strong advocate of The American Phytopathological Society, Helen Hart served on Council for 12 years and as President in 1956. Helen Hart was a great professional scientist who had a far-reaching impact on plant pathology during the twentieth century.

  15. Bipolar Disorder in Children: Implications for Speech-Language Pathologists (United States)

    Quattlebaum, Patricia D.; Grier, Betsy C.; Klubnik, Cynthia


    In the United States, bipolar disorder is an increasingly common diagnosis in children, and these children can present with severe behavior problems and emotionality. Many studies have documented the frequent coexistence of behavior disorders and speech-language disorders. Like other children with behavior disorders, children with bipolar disorder…

  16. Autopsy practice in Ghana – reflections of a pathologist | Anim ...

    African Journals Online (AJOL)

    Autopsy practice in Ghana can be said to be far from satisfactory. Most Ghanaians do not know that there are different categories of death, which categories of death require an autopsy and who is required to perform the autopsy. The problems have further been complicated by the fact that, unlike other countries where ...

  17. Disciplinary Literacy from a Speech-Language Pathologist's Perspective (United States)

    Ehren, Barbara J.; Murza, Kimberly A.; Malani, Melissa D.


    Disciplinary literacy is an increasingly popular focal area in adolescent literacy. In disciplinary literacy, the discourse features of specific knowledge domains (e.g., literature, history, science, and math) assume major importance in understanding and constructing meaning in each discipline. Because language plays a significant role in…

  18. [Professor Kazimierz Jaegermann--forensic pathologist--scientist--thinker]. (United States)

    Nasiłowski, Władysław


    Professor Kazimierz Jaegermann, a founder of the theory of medico-legal opinionating, passed away 20 years ago. Numerous specialists in forensic medicine and an ever increasing number of lawyers substantiate the importance and value of the creative thought and the entire research work of Professor Jaegermann that have been an inspiration of progress in forensic medicine and in the science of applied law. His unique ability to perform a scientific synthesis leading to recognizing forensic medicine as an applied bridging knowledge points to the eminently creative role played by Professor Jaegermann in development of forensic medicine. There is an urgent need to recall his research activities and to publish a complete collection of his articles and publications. With this idea in mind, I present below an article based on the text published in No. 1 of the Zeszyty Naukowe Katedry Medycyny Sadowej Slaskiej Akademii Medycznej in 1995.

  19. Speech-Language Pathologists: Vital Listening and Spoken Language Professionals (United States)

    Houston, K. Todd; Perigoe, Christina B.


    Determining the most effective methods and techniques to facilitate the spoken language development of individuals with hearing loss has been a focus of practitioners for centuries. Due to modern advances in hearing technology, earlier identification of hearing loss, and immediate enrollment in early intervention, children with hearing loss are…

  20. Vibrotactile Stimulation: A Future Clinical Tool for Speech Pathologists (United States)

    Telage, Kal; Fucci, Donald


    Presented is a rationale for using vibrotactile stimulation (vibration applied to oral structures) as a diagnostic instrument to assess oral-sensory deficits which may contribute to defective speech patterns. (Author/LS)

  1. Reflexões acerca do papel do fonoaudiólogo junto à família de uma criança com Transtorno Global do Desenvolvimento: estudo de caso Considerations about the role of a speech-language pathologist with the family of a child with Pervasive Development Disorder: case report

    Directory of Open Access Journals (Sweden)

    Marta Cecília Rabinovitsch Gertel


    Full Text Available O objetivo deste artigo foi refletir e discutir o papel do fonoaudiólogo na condução das estratégias terapêuticas junto à família de uma criança com Transtorno Global do Desenvolvimento. Esta pesquisa foi desenvolvida por meio de estudo de caso de uma criança com Transtorno Global do Desenvolvimento atendida de julho/2002 a novembro/2004. Os recortes do material clínico retratam o percurso seguido ao longo do eixo da história do paciente enfatizando os momentos significativos que geraram desenvolvimento do processo terapêutico fonoaudiológico no que se refere à comunicação oral e integração social no ambiente familiar. O enfoque das estratégias clínicas foi direcionado para propiciar um ambiente físico e emocional capaz de promover experiências constitutivas que respeitem a singularidade de cada paciente levando em conta a realidade da família e da comunidade onde se encontra inserido aquele núcleo social. Portanto, em nosso entender, a atuação fonoaudiológica pode ser direcionada para a criação de situações que favoreçam o processo [de cada paciente] de inclusão na vida cotidiana, com o respeito que todas as pessoas merecem.The aim of this study was to reflect about and discuss the role of a speech-language pathologist with the family of a child with Pervasive Development Disorder. This case study reported the case of a child with Pervasive Development Disorder that attended speech-language therapy from July/2002 to November/2004. The excerpts of clinical material depict the course of the patient's history, emphasizing the significant moments that generated development of the therapeutical process related to oral communication and social interaction within his familiar setting. Clinical strategies focused a favorable physical and emotional environment, promoting constitutive experiences that respect the singularity of each patient, considering the realities of the family and the community it is part of

  2. Percepções do fonoaudiólogo recém-formado quanto a sua formação, intenção profissional e atualização de conhecimentos Perceptions of newly graduated Speech and Language Pathologists regarding their academic formation, professional goals and knowledge update

    Directory of Open Access Journals (Sweden)

    Denise Guapyassú Meirelles da Silva


    Full Text Available OBJETIVO: Investigar as percepções do fonoaudiólogo recém-formado do estado do Rio de Janeiro quanto a sua formação, intenção profissional e busca por atualização de conhecimento. MÉTODOS: Participaram fonoaudiólogos graduados em cursos de formação no estado do Rio de Janeiro, nos anos 2005 e 2006. Foi aplicado um questionário constituído por dez perguntas fechadas, elaboradas para esta pesquisa e previamente verificadas por projeto piloto. Os dados foram submetidos a análise estatística com cruzamento de variáveis. RESULTADOS: Observou-se que a maioria dos fonoaudiólogos considerou-se atendida em suas expectativas e segura dos conhecimentos adquiridos (pPURPOSE: To investigate the perceptions of newly graduated Speech and Language Pathologists (SLP from the state of Rio de Janeiro regarding their academic formation, professional goals and search for knowledge updates. METHODS: SLPs graduated from universities located at the state of Rio de Janeiro during the years of 2005 and 2006 participated in the study. A questionnaire with ten closed questions, developed for the present study and validated through a pilot study, was applied. Data were statistically analyzed comparing different variables. RESULTS: It was observed that the majority of the SLPs interviewed considered that their expectations were met and felt safe about the knowledge acquired (p<0.001. These professionals wish to act mostly in clinics (89%, and intend to continue their studies through lato sensu programs (70%. Language was considered the area in which they received the best support during their training (68%, while Public Health was the area in which they considered to have received less support (72%, and this difference was statistically significant. Industry was considered the most difficult workplace to be accessed by SLPs (p<0,05. CONCLUSION: Newly graduated SLPs from the state of Rio de Janeiro considered to have met their expectations regarding their

  3. Eficácia de duas técnicas fonoaudiológicas da estética facial no músculo orbicular dos olhos: estudo piloto Efficacy of two techniques of speech-language pathologists of facial esthetic in the orbicular oculi muscle: a pilot study

    Directory of Open Access Journals (Sweden)

    Nayara Lana e Silva


    Full Text Available OBJETIVO: comparar a eficácia de duas técnicas fonoaudiológicas utilizadas no músculo orbicular dos olhos. MÉTODOS: foi realizado um estudo piloto com quatro pacientes, com idades entre 40 e 51 anos. As mesmas foram submetidas a um exercício miofuncional na hemiface esquerda e à massagem na hemiface direita, por um período de 20 dias. A coleta de dados foi realizada por meio de protocolos de anamnese, avaliação e reavaliação aplicados por uma dermatologista e por um cirurgião plástico, e pela avaliação de fotos realizada por 10 fonoaudiólogas especializandas em Motricidade Orofacial. RESULTADOS: foi constatado que não houve diferença nos resultados em relação às técnicas utilizadas no tratamento. Para a dermatologista e o cirurgião plástico todas as pacientes obtiveram melhora, sendo esta mais evidente na paciente 2 para a dermatologista e na paciente 4 para o cirurgião plástico. De acordo com as fonoaudiólogas houve melhora em todas as pacientes, sendo que a paciente 1 apresentou melhor resultado na hemiface esquerda e as demais mantiveram equilíbrio entre as hemifaces. CONCLUSÃO: com a realização deste estudo constatou-se que, na amostra avaliada, houve melhora nas rugas de expressão do músculo orbicular dos olhos sem diferenças entre as técnicas estudadas.PURPOSE: to compare the efficacy of two techniques speech-language pathologists used in the orbicular oculi muscle. METHODS: we conducted a pilot study with four patients, aged between 40 and 51 years. They were submitted to a myofunctional exercise in the left hemiface and to a massage in the right hemiface for a period of 20 days. Data collection was performed followed by historical protocols, then evaluation and review applied by dermatologist and plastic surgeon and by photos evaluation made by 10 speech therapist specializing in orofacial myology. RESULTS: it revealed that there were no differences on the results related to the techniques used during

  4. A Natural Language Intelligent Tutoring System for Training Pathologists - Implementation and Evaluation (United States)

    El Saadawi, Gilan M.; Tseytlin, Eugene; Legowski, Elizabeth; Jukic, Drazen; Castine, Melissa; Fine, Jeffrey; Gormley, Robert; Crowley, Rebecca S.


    Introduction We developed and evaluated a Natural Language Interface (NLI) for an Intelligent Tutoring System (ITS) in Diagnostic Pathology. The system teaches residents to examine pathologic slides and write accurate pathology reports while providing immediate feedback on errors they make in their slide review and diagnostic reports. Residents can ask for help at any point in the case, and will receive context-specific feedback. Research Questions We evaluated (1) the performance of our natural language system, (2) the effect of the system on learning (3) the effect of feedback timing on learning gains and (4) the effect of ReportTutor on performance to self-assessment correlations. Methods The study uses a crossover 2×2 factorial design. We recruited 20 subjects from 4 academic programs. Subjects were randomly assigned to one of the four conditions - two conditions for the immediate interface, and two for the delayed interface. An expert dermatopathologist created a reference standard and 2 board certified AP/CP pathology fellows manually coded the residents' assessment reports. Subjects were given the opportunity to self grade their performance and we used a survey to determine student response to both interfaces. Results Our results show a highly significant improvement in report writing after one tutoring session with 4-fold increase in the learning gains with both interfaces but no effect of feedback timing on performance gains. Residents who used the immediate feedback interface first experienced a feature learning gain that is correlated with the number of cases they viewed. There was no correlation between performance and self-assessment in either condition. PMID:17934789

  5. A retrospective of an unconventionally trained plant pathologist: plant diseases to molecular plant pathology. (United States)

    Ouchi, Seiji


    Plant pathology evolved from its mycology-oriented origins into a science dealing with biochemical mechanisms of diseases, along with enhanced crop production through disease control. This retrospective describes first my personal experience from my introduction to plant pathology, to the establishment of the concept of accessibility as a model pertaining to genetically defined basic compatibility induced by pathogens. I then refer to the development of molecular plant pathology from physiological and biochemical plant pathology fostered by the growth in recombinant technology in the second half of the past century. This progress was best reflected by the U.S.-Japan Seminar Series held at 4-5-year intervals from 1966 to 2003 and documented by publications in major journals of our discipline. These seminars emphasized that progress in science has always been supported by the invention of novel techniques and that knowledge integrated from modern genomics and subsequent proteomics should contribute to the progress of basic life sciences and, more importantly, to the elaboration of rational measures for disease control.

  6. Mindfulness Training in Stuttering Therapy: A Tutorial for Speech-Language Pathologists (United States)

    Boyle, Michael P.


    The use of mindfulness training for increasing psychological well-being in a variety of clinical and nonclinical populations has exploded over the last decade. In the area of stuttering, it has been widely recognized that effective long-term management often necessitates treatment of cognitive and affective dimensions of the disorder in addition…

  7. Conceptual Framework for Speech Language Pathologists to Work with Migrants: A Focus on Malta (United States)

    Grech, Helen; Cheng, Li Rong Lilly


    The goal of this paper is to describe the current state, needs and values of migrants with a focus on relevant global issues and Malta as a case study. It also aims to review services offered to these migrants, identify aspects that require attention and draw up a framework that could be applied to enhance services to the culturally diverse…

  8. The European Network of Uropathology: a novel mechanism for communication between pathologists

    NARCIS (Netherlands)

    Egevad, Lars; Algaba, Ferran; Berney, Dan M.; Boccon-Gibod, Liliane; Griffiths, David F.; Lopez-Beltran, Antonio; Mikuz, Gregor; Varma, Murali; Montironi, Rodolfo; Asboth, F.; Haitel, A.; Hudler, H.; Langner, C.; Mazal, P.; Mikuz, G.; Neuhold, N.; Richter, B.; Susani, M.; Aguilar, S. F.; Cappelle, L.; Cosyns, I. P.; Dalle, I.; de Leval, L.; Delvaux, S.; Garbar, C.; Lerut, E.; Martinez, M. D. Martin; Nollevaux, M. C.; Op de Beeck, L.; Rorive, S.; Steenkiste, E.; Thienpont, L.; van Dijck, H.; van Dorpe, J.; van Huysse, J.; van Marck, V.; Vanneste, A.; Dige, U.; Horn, T.; Johansen, M.; Kiaer, H.; Korsgaard, N.; Jacobsen, G. Krag; Ludwigsen, E.; Jepsen, F. Løve; Marcussen, N.; Nürnberg, B. Meinecke; Moll, M.; Ottosen, P.; Petersen, A.; Svanholm, H.; Vainer, B.; Alanen, K.; Hirvikoski, P.; Kuopio, T.; Kärjä, V.; Malinen, H.; Martikainen, P.; Paloneva, T.; Salo, K.; Sankila, A.; Allory, Y.; Audry-Gouget, I.; Aymard, B.; Bedgedjian, I.; Beschet, I.; Boccon-Gibod, L.; Boidart, F.; Bottero, N.; Camparo, P.; Champigneulle, J.; Chanoz, J.; Chapeau, M. C.; Choudat, L.; Cochand-Priollet, B.; Compérat, E.; Decaussin-Petrucci, M.; Devouassoux-Shisheboran, M.; Dupré, F.; Eslimani-Sahla, M.; Fromont, G.; Grossin, M.; Kemeny, J. L.; Leroux, A.; Leroy, X.; Lesourd, A.; Lhermitte, B.; Lindner, V.; Martin, L.; Mazerolles, C.; Mège-LeChevallier, F.; Michiels, J. F.; Moreau, A.; Myriam, M.; Paraf, F.; Petit, J.; Pluot, M.; Renaudin, K.; Rioux-Leclercq, N.; Sabatier, P.; Satgé, D.; Sibony, M.; Talisse, A.; Lacombe, M. J. Terrier; Triau, S.; Vieillefond, A.; Andrejewski, A.; Arnold, G.; Autschbach, F.; Biermann, K.; Bittmann, I.; Bonkhoff, H.; Braun, S.; Burkhardt, M.; Dockhorn-Dworniczak, B.; Donhuijsen, K.; Dworak, O.; Ebel, T.; Falk, S.; Fayyazi, A.; Fleige, B.; Fries, J. W. U.; Gassel, A. M.; Gerharz, C. D.; Grobholz, R.; Günther, M.; Haedicke, W.; Hartmann, A.; Heisig, T.; Helpap, B.; Henke, R. P.; Hinze, R.; Härle, M.; Kasper, H. U.; Kellner, U.; Krause, U.; Kristiansen, G.; Krüger, S.; Leuschner, I.; Loy, V.; Oehler, U.; Permanetter, W.; Pfiester, P.; Philippou, S.; Raute-Kreinsen, U.; Remberger, K.; Rumpelt, H. J.; Sarbia, M.; Schmid, K. W.; Schweyer, S.; Seitz, G.; Stömmer, P.; Venzke, T.; Crotty, T.; Farrell, D.; Fitzgibbon, J.; Kay, E.; Leader, M.; Loftus, B.; Barresi, G.; Bellomi, A.; Betri, E.; Betta, P. G.; Bittesini, L.; Bollito, E.; Bonucci, M.; Bussani, R.; Canzonieri, V.; Carbone, A.; Carpino, F.; Colecchia, M.; Corti, D.; Cossu-Rocca, P.; Dalla Palma, P.; Di Cristofano, C.; Discepoli, S.; Vigl, E. Egarter; Faraggiana, T.; Ferrari, A. M.; Flora, F.; Galia, A.; Gallo, P.; Ghimenton, C.; Giannini, A.; Guanella, S.; Incensati, R. M.; Inchingolo, C.; Lanzanova, G.; Lastilla, G.; Martignoni, G.; Monga, G.; Montironi, R.; Nappi, O.; Nesi, G.; Pacchioni, D.; Patriarca, C.; Pece, A.; Pennelli, N.; Raspollini, M. R.; Ruggeri, C.; Salvadore, M.; Sindici, G.; Sironi, M.; Taraglio, S.; Toncini, C.; Trabucco, S.; Visonà, A.; Zini, E.; Zolfanelli, F.; Zucchini, N.; Baldewijns, M.; Beerman, H.; Berends, D.; de Bruine, A.; Demeyere, T. B. J.; Hoedemaeker, R.; Hulsbergen-van de Kaa, C. A.; Jonges, T.; Koot, R. A. C.; Kuiper, S.; Kwee, W. S.; Lambert, I.; Nap, M.; Nieken, J.; Peters, H. M.; Prins, E.; Riemersma, S. A.; Schaafsma, H. E.; Smedts, F.; Smit, V. T. H. B. M.; ten Kate, F. J. W.; van de Wiel, B.; van den Heuvel, M. C.; van Dijk, M. A. A. M.; van Leenders, G. J. L. H.; Veselic-Charvat, M.; Willig, A. P.; Vink, R.; Vreuls, W.; Aaberg, T.; Bie, R. Bruun; Gundersen, L.; Halvorsen, O. J.; Hanssen, T. A.; Laurini, R.; Lie, A. K.; Kvelstad, I. Lien; Isfoss, B. L.; Beck, B. Lomholt; Majak, B. M.; Nesbakken, A. J.; Refsum, S. B.; Snersrud, G.; Sund, S.; Svindland, A.; Westre, B.; Viset, T.; Vlatkovic, L.; Cabrera, R.; Couceiro, A.; Dias, M.; Henrique, R.; Brito, M. José; Lopes, J. M.; Maya, M.; Oliveira, P.; Pereira, H.; e Castro, L. Prado; de Carvalho, P. Roquette Ferreira; Salazar, A.; Lopes, C. A. Silva; da Cunha, M. F. Xavier; Algaba, F.; Blanco, J.; Dorronsoro, G.; Zarza, B. Eizaguirre; Severin, C. Escudero; Flores, T.; García, H.; Lemberg, P.; Lopez, J. I.; Beltran, A. Lopez; Luque, R. J.; Manzarbeitia, F.; Matilla, A.; Nieto, S.; Rey, J. A. Ortiz; Ortega, M. Paz; Soler, D. Ramos; Ramos, M. Sánchez; Santonja, C.; Trias, I.; Usera, G.; Val-Bernal, J. F.; Bergh, A.; Busch, C.; Chebil, G.; Dahl, F.; Egevad, L.; Ehrnström, R.; Eriksson, S.; Gestblom, C.; Gorecki, T.; Holm, E.; Jacobsson, B.; Johansson, S.; Karolyi, P.; Krenz, R.; Lannes, P.; Lipponen, P.; Lundberg, L. M.; Olling, S.; Olsson, H.; Pihl, C. G.; Sadeghi, M.; Sandberg, P. O.; Seidal, T.; Tolf, A.; Tot, T.; Toth, B.; Wahlin, T.; Bubendorf, L.; Cerncic, P.; Diebold, J.; Diener, P. A.; Flury, R.; Guillou, L.; Hailemariam, S.; Moch, H.; Moll, C.; Pelte, M. F.; Pfofe, D.; Rössle, M.; Singer, G.; Wagner, B.; Went, P.; Aachi, V.; Adams, S.; Al-Jafari, M.; Astall, E.; Bailey, D. M.; Barnetson, R.; Berney, D. M.; Bhattarai, S.; Butterworth, D.; Chandra, A.; Coup, A.; Cross, S.; Dabbagh, V.; Deshmukh, N.; Gertenbach, M.; Goepel, J. R.; Grigor, K.; Hamid, B.; Harris, M.; Khan, Z.; Knox, F.; Kothari, A.; Lawton, H.; Lishman, S.; Ludeman, L.; Maheswaran, P. R.; Mansour, P.; Nagarajan, S.; Naidoo, P.; Nairn, R.; O'Rourke, D.; Oxley, J.; Radojkovic, M.; Reeve, N.; Seywright, M.; Shanks, J. H.; St John, A.; Theaker, J.; Thomas, H.; Tungekar, F.; Turner, G.; Varma, M.; Warren, A. Y.; Verghese, A.; Verma, S.; Wong, J.; Zakhour, H.


    In pathology there is a need to rapidly disseminate professional information to the appropriate target groups. This is a surprisingly difficult task on an international level. Therefore, the European Network of Uropathology (ENUP) was recently organized by the Uropathology Working Group of the

  9. Accent and television journalism: evidence for the practice of speech language pathologists and audiologists. (United States)

    Lopes, Leonardo Wanderley; Lima, Ivonaldo Leidson Barbosa; Silva, Eveline Gonçalves; Almeida, Larissa Nadjara Alves de; Almeida, Anna Alice Figueiredo de


    To analyze the preferences and attitudes of listeners in relation to regional (RA) and softened accents (SA) in television journalism. Three television news presenters recorded carrier phrases and a standard text using RA and SA. The recordings were presented to 105 judges who listened to the word pairs and answered whether they perceived differences between the RA and SA, and the type of pronunciation that they preferred in the speech of television news presenters. Afterwards, they listened to the sentences and judged seven attributes in the contexts of RA and SA using a semantic differential scale. The listeners perceived the difference between the regional and softened pronunciation (pstudied (pstudied (pstudied.

  10. A leitmotif of contemporary mycology has challenges and benefits for plant pathologists (United States)

    Multiple traditional species names for plant pathogenic fungi have been supplemented with new names that delimit formerly cryptic species. In other instances, isolates within a species are clearly differentiated by both phylogeny and distinctive pathogenic traits and are assigned sub-specific design...

  11. Fatal air embolism during endoscopic retrograde cholangiopancreatography (ERCP): An 'impossible' diagnosis for the forensic pathologist. (United States)

    Marchesi, Matteo; Battistini, Alessio; Pellegrinelli, Moira; Gentile, Guendalina; Zoja, Riccardo


    Fatal air embolism related to endoscopic retrograde cholangiopancreatography is a very rare phenomenon. The authors describe the case of a 51-year-old female patient who developed this mortal complication; a computed tomography (CT) examination was performed in articulo mortis by the physicians. Autopsy was unreliable because of bizarre post-mortem changes (reabsorption of intra-cardiac gas vs. conservation of intra-cranial gas) and a lack of strong diagnostic value of histological findings. The right diagnosis was possible thanks only to the CT examination that permitted the assumption of this possible cause of death before the autopsy and to prepare the necessary procedures to recognise and probe air embolism. This case exemplifies how early post-mortem imaging can be crucial to avoid a wrong diagnosis. © The Author(s) 2015.

  12. Diagnostic problems in the subtyping of renal tumors encountered by five pathologists

    DEFF Research Database (Denmark)

    Kümmerlin, Intan; ten Kate, Fiebo; Smedts, Frank


    was reached for all 28 cases after examination of more slides from different tumor areas and IHC-stained sections. An accurate histologic distinction between benign and malignant renal tumors is possible on one HE-stained section. Correct assignment of the subtype is difficult on one slide alone and relies...

  13. The effect of threat of litigation on forensic pathologist diagnostic decision making. (United States)

    Oliver, William Russell


    Recent litigation involving medical examiners has caused concern over certifying deaths. We administered a survey of 716 medical examiners regarding the effects of the threat of litigation. Two hundred twenty-two medical examiners responded (31%). Of those who responded, approximately 13.5% admitted to having modified their diagnostic findings due to threat of litigation, and approximately 32.5% stated these considerations would affect their decisions in the future. Physicians who indicated they had or would modify their diagnoses expressed more concern over the possibility of litigation. Chiefs of services were less likely than staff members to indicate changing diagnoses. Practitioners whose jurisdictions included rural areas were significantly more likely to indicate that litigation considerations would affect their diagnoses in the future, although this was not true with those who had already modified their diagnoses. No correlation was found with elected versus appointed positions, accreditation status, sex, race, geographic location, or board certification. Although very few medical examiners have actually been sued because of their diagnoses, a demonstrated threat of litigation has a substantial effect on diagnostic decision making.

  14. HER2 aberrations and heterogeneity in cancers of the digestive system: Implications for pathologists and gastroenterologists. (United States)

    Fusco, Nicola; Bosari, Silvano


    Management of cancers of the digestive system has progressed rapidly into the molecular era. Despite the significant recent achievements in the diagnosis and treatment of these patients, the number of deaths for these tumors has currently plateaued. Many investigations have assessed the role of HER2 in tumors of the digestive system in both prognostic and therapeutic settings, with heterogeneous results. Novel testing and treatment guidelines are emerging, in particular in gastric and colorectal cancers. However, further advances are needed. In this review we provide a comprehensive overview of the current state-of-knowledge of HER2 alterations in the most common tumors of the digestive system and discuss the operational implications of HER2 testing.

  15. An Inquiry into the Development of Future Speech-Language Pathologists: A Mixed Methods Study (United States)

    Plotts, Kimberly P.


    Upon graduating college, many students seek employment within the degree area in which they obtained. Employers are seeking skills in individuals that encompass interpersonal, technical, analytical, personal, and professional abilities. As with many careers, the allied health field requires content specific knowledge and specialized skills, which…

  16. Teamwork: a study of Australian and US student speech-language pathologists. (United States)

    Morrison, Susan C; Lincoln, Michelle A; Reed, Vicki A


    In the discipline of speech-language pathology little is known about the explicit and implicit team skills taught within university curricula. This study surveyed 281 speech-language pathology students to determine a baseline of their perceived ability to participate in interprofessional teams. The students were enrolled in programs in Australia and the USA and were surveyed about their perceptions of their attitudes, knowledge and skills in teamwork. MANCOVA analysis for main effects of age, university program and clinical experience showed that age was not significant, negating the perception that life experiences improve perceived team skills. Clinical experience was significant in that students with more clinical experience rated themselves more highly on their team abilities. Post Hoc analysis revealed that Australian students rated themselves higher than their US counterparts on their knowledge about working on teams, but lower on attitudes to teams; all students perceived that they had the skills to work on teams. These results provide insight about teamwork training components in current speech-language pathology curricula. Implications are discussed with reference to enhancing university training programs.

  17. The Role of Speech Pathologist in Inclusive Education of Children with Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Tsyrulnikova E.L.,


    Full Text Available This paper outlines the author’s practical experience in inclusion of children with autism spectrum disorder in a general educational setting, that is, in a group of normally developing peers participating in group lessons aimed at forming basic mathematical concepts. The author hopes that this material might be useful to teachers of kindergartens and schools who are providing education to children with ASD and including them in regular groups and classes.

  18. Education of speech-language pathologists around the world: The Scandinavian experience. (United States)

    Söderpalm, Ewa


    The object of this paper is to give an overview of the education and training programmes in logopedics offered in the Scandinavian/Nordic countries and to provide some information about the development of the programmes in Scandinavia since their foundation in the 1920s. In order to collect information about the various programmes, a questionnaire comprising 12 questions was sent to representatives for education programmes and national societies affiliated to the IALP. In the past all the countries used to provide possibilities for teachers to continue their education with courses in logopedics to become 'special teachers'. These programmes no longer exist except in Norway. Degree programmes at bachelor's and/or master's level are now offered in all the Nordic countries. It can be concluded that the education and training in logopedics have developed into university degree programmes, with few exceptions, in the Nordic countries. Copyright (c) 2006 S. Karger AG, Basel.

  19. Time for change: a new training programme for morpho-molecular pathologists? (United States)

    Moore, David A; Oien, Karin A; Lee, Jessica L; Jones, J Louise; Salto-Tellez, Manuel


    The evolution of cellular pathology as a specialty has always been driven by technological developments and the clinical relevance of incorporating novel investigations into diagnostic practice. In recent years, the molecular characterisation of cancer has become of crucial relevance in patient treatment both for predictive testing and subclassification of certain tumours. Much of this has become possible due to the availability of next-generation sequencing technologies and the whole-genome sequencing of tumours is now being rolled out into clinical practice in England via the 100 000 Genome Project. The effective integration of cellular pathology reporting and genomic characterisation is crucial to ensure the morphological and genomic data are interpreted in the relevant context, though despite this, in many UK centres molecular testing is entirely detached from cellular pathology departments. The CM-Path initiative recognises there is a genomics knowledge and skills gap within cellular pathology that needs to be bridged through an upskilling of the current workforce and a redesign of pathology training. Bridging this gap will allow the development of an integrated ‘morphomolecular pathology’ specialty, which can maintain the relevance of cellular pathology at the centre of cancer patient management and allow the pathology community to continue to be a major influence in cancer discovery as well as playing a driving role in the delivery of precision medicine approaches. Here, several alternative models of pathology training, designed to address this challenge, are presented and appraised. PMID:29113995

  20. "That Doesn't Translate": The Role of Evidence-Based Practice in Disempowering Speech Pathologists in Acute Aphasia Management (United States)

    Foster, Abby; Worrall, Linda; Rose, Miranda; O'Halloran, Robyn


    Background: An evidence-practice gap has been identified in current acute aphasia management practice, with the provision of services to people with aphasia in the acute hospital widely considered in the literature to be inconsistent with best-practice recommendations. The reasons for this evidence-practice gap are unclear; however, speech…

  1. Broadening the "ports of entry" for speech-language pathologists: a relational and reflective model for clinical supervision. (United States)

    Geller, Elaine; Foley, Gilbert M


    To offer a framework for clinical supervision in speech-language pathology that embeds a mental health perspective within the study of communication sciences and disorders. Key mental health constructs are examined as to how they are applied in traditional versus relational and reflective supervision models. Comparisons between traditional and relational and reflective approaches are outlined, with reference to each mental health construct and the developmental level of the supervisee. Three stages of supervisee development are proposed based on research from various disciplines, including nursing, psychology, speech-language pathology, social work, and education. Each developmental stage is characterized by shifts or changes in the supervisee's underlying assumptions, beliefs, and patterns of behavior. This article makes the case that both the cognitive and affective dimensions of the supervisor-supervisee relationship need to be addressed without minimizing the necessary development of discipline-specific expertise. The developmental stages outlined in this paradigm can be used to understand supervisees' patterns of change and growth over time, as well as to create optimal learning environments that match their developmental level and knowledge base.

  2. Qualitative analysis of decision making by speech-language pathologists in the design of aided visual displays. (United States)

    McFadd, Emily; Wilkinson, Krista


    For children with complex communication needs, augmentative and alternative communication (AAC) devices offer a functional way to communicate thoughts and feelings. Despite many significant advances in the field, effective and efficient aided communication can remain a challenge for some clients and their partners. One critical element of aided AAC intervention is systematic attention to the design of the communication display itself. A well-designed display will foster communication outcomes; a poorly designed one might have the opposite effect. Surprisingly, to our knowledge there are no studies of the strategies that clinicians actually employ when putting together a display. In this research note, we examine, on a case-by-case basis, the strategies six clinicians used when constructing display pages, as a means of highlighting potential areas that might warrant systematic research on display design.

  3. Physician Satisfaction With Clinical Laboratory Services: A College of American Pathologists Q-Probes Study of 81 Institutions. (United States)

    McCall, Shannon J; Souers, Rhona J; Blond, Barbara; Massie, Larry


    -Assessment of customer satisfaction is a vital component of the laboratory quality improvement program. -To survey the level of physician satisfaction with hospital clinical laboratory services. -Participating institutions provided demographic information and survey results of physician satisfaction, with specific features of clinical laboratory services individually rated on a scale of 5 (excellent) to 1 (poor). -Eighty-one institutions submitted 2425 surveys. The median overall satisfaction score was 4.2 (10th percentile, 3.6; 90th percentile, 4.6). Of the 16 surveyed areas receiving the highest percentage of excellent/good ratings (combined scores of 4 and 5), quality of results was highest along with test menu adequacy, staff courtesy, and overall satisfaction. Of the 4 categories receiving the lowest percentage values of excellent/good ratings, 3 were related to turnaround time for inpatient "STAT" (tests performed immediately), outpatient STAT, and esoteric tests. The fourth was a new category presented in this survey: ease of electronic order entry. Here, 11.4% (241 of 2121) of physicians assigned below-average (2) or poor (1) scores. The 5 categories deemed most important to physicians included quality of results, turnaround times for inpatient STAT, routine, and outpatient STAT tests, and clinical report format. Overall satisfaction as measured by physician willingness to recommend their laboratory to another physician remains high at 94.5% (2160 of 2286 respondents). -There is a continued trend of high physician satisfaction and loyalty with clinical laboratory services. Physician dissatisfaction with ease of electronic order entry represents a new challenge. Test turnaround times are persistent areas of dissatisfaction, representing areas for improvement.

  4. Physician satisfaction with clinical laboratory services: a College of American Pathologists Q-probes study of 138 institutions. (United States)

    Jones, Bruce A; Bekeris, Leonas G; Nakhleh, Raouf E; Walsh, Molly K; Valenstein, Paul N


    Monitoring customer satisfaction is a valuable component of a laboratory quality improvement program. To survey the level of physician satisfaction with hospital clinical laboratory services. Participating institutions provided demographic and practice information and survey results of physician satisfaction with defined aspects of clinical laboratory services, rated on a scale of 1 (poor) to 5 (excellent). One hundred thirty-eight institutions participated in this study and submitted a total of 4329 physician surveys. The overall satisfaction score for all institutions ranged from 2.9 to 5.0. The median overall score for all participants was 4.1 (10th percentile, 3.6; 90th percentile, 4.5). Physicians were most satisfied with the quality/reliability of results and staff courtesy, with median values of excellent or good ratings of 89.9%. Of the 5 service categories that received the lowest percentage values of excellent/good ratings (combined scores of 4 and 5), 4 were related to turnaround time for inpatient stat, outpatient stat, routine, and esoteric tests. Surveys from half of the participating laboratories reported that 96% to 100% of physicians would recommend the laboratory to other physicians. The category most frequently selected as the most important category of laboratory services was quality/reliability of results (31.7%). There continues to be a high level of physician satisfaction and loyalty with clinical laboratory services. Test turnaround times are persistent categories of dissatisfaction and present opportunities for improvement.

  5. Edward Rhodes Stitt Award Lecture. Will a computer (with artificial vision) replace the surgical pathologist (or other health professionals)? (United States)

    Heffner, D K


    Many jobs require vision for most of the tasks performed and the discussion focuses on the nature of human visual perception. Arguments are given to support the claim that visual perception is a very complicated function of the brain. To attempt to answer whether or not artificial intelligence (AI) will ever be able to essentially do what the brain does, the history and current state of AI research is examined, with special attention to neural net research.

  6. Factors that enhance English-speaking speech-language pathologists' transcription of Cantonese-speaking children's consonants. (United States)

    Lockart, Rebekah; McLeod, Sharynne


    To investigate speech-language pathology students' ability to identify errors and transcribe typical and atypical speech in Cantonese, a nonnative language. Thirty-three English-speaking speech-language pathology students completed 3 tasks in an experimental within-subjects design. Task 1 (baseline) involved transcribing English words. In Task 2, students transcribed 25 words spoken by a Cantonese adult. An average of 59.1% consonants was transcribed correctly (72.9% when Cantonese-English transfer patterns were allowed). There was higher accuracy on shared English and Cantonese syllable-initial consonants /m,n,f,s,h,j,w,l/ and syllable-final consonants. In Task 3, students identified consonant errors and transcribed 100 words spoken by Cantonese-speaking children under 4 additive conditions: (1) baseline, (2) +adult model, (3) +information about Cantonese phonology, and (4) all variables (2 and 3 were counterbalanced). There was a significant improvement in the students' identification and transcription scores for conditions 2, 3, and 4, with a moderate effect size. Increased skill was not based on listeners' proficiency in speaking another language, perceived transcription skill, musicality, or confidence with multilingual clients. Speech-language pathology students, with no exposure to or specific training in Cantonese, have some skills to identify errors and transcribe Cantonese. Provision of a Cantonese-adult model and information about Cantonese phonology increased students' accuracy in transcribing Cantonese speech.

  7. Formaldehyde and tobacco smoke as alkylating agents: the formation of N-methylenvaline in pathologists and in plastic laminate workers. (United States)

    Bono, Roberto; Romanazzi, Valeria; Pirro, Valentina; Degan, Raffaella; Pignata, Cristina; Suppo, Elisa; Pazzi, Marco; Vincenti, Marco


    Aim of this study was to investigate the relationships between the concentration of formaldehyde in air and the alkylation of hemoglobin to form a terminal N-methylenvaline residue in three occupationally exposed groups: a) technicians of pathology wards, b) workers of the plastic laminates industry, and c) a control group. All subjects recruited in this study were also tested on their smoking habits. Formaldehyde adsorbed on passive air samplers was quantified by HPLC with UV detection (360 nm), cotinine was quantified by GC-MS. Terminal hemoglobin N-methylenvaline was determined by treating globine under reducing conditions with pentafluorophenyl isothiocyanate to yield a derivative, subsequently detected by GC-MS. One-way analysis of variance was performed to compare among the three groups the biomarkers considered in this study. For air-FA and N-methylenvaline a difference between the three groups was detected (p alkylation to form N-methylenvaline molecular adduct in two occupationally exposed groups of subjects considered in the present study. In comparison with occupational exposition, tobacco smoke proved to have a minor impact on the formation of N-methylenvaline molecular adduct. Copyright © 2011 Elsevier B.V. All rights reserved.

  8. Role of the speech-language pathologist: augmentative and alternative communication for acute care patients with severe communication impairments. (United States)

    Vento-Wilson, Margaret T; McGuire, Anthony; Ostergren, Jennifer A


    Severe communication deficits occur frequently in acute care. Augmentative and alternative communication (AAC) may improve patient-nurse communication, yet it remains underutilized. The objective of this study was to assess the impact of training student nurses (SNs) in acute and critical care on the use of AAC with regard to confidence levels and likelihood of implementation of AAC by SNs in acute care. Training in AAC techniques was provided to SNs. A pretraining and posttraining assessment was completed along with follow-up surveys conducted after the SNs had an opportunity to use AAC. A 6-fold increase in confidence (P the SNs after AAC training, as was an approximately 3-fold increase in likelihood of use (P The reliable yes/no was the most reported AAC technique (34.7% of the students). Providing SNs with AAC tools accompanied by brief training increases their confidence in the use of AAC and the likelihood that they will use them. Inclusion of AAC education in nursing curricula and nursing orientations could be an important step in risk reduction among patients with severe communication disorders. Further study is needed of the relationship between training student nurses in the use of AAC as a way to change practice and improve communication outcomes.

  9. The Role of the Speech-Language Pathologist in Creating a Model for Interprofessional Practice in an Ambulatory Care Clinic. (United States)

    Robinson, Tommie L; Anderson, Debra; Long, Sahira


    There is a need to better coordinate services for children in urban settings who are at risk for communication disorders. This article addresses the barriers to obtaining services and discusses the process for creating a model for interprofessional practice to better serve patients from lower socioeconomic backgrounds. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Schoolwide Collaboration to Prevent and Address Reading Difficulties: Opportunities for School Psychologists and Speech-Language Pathologists (United States)

    Nellis, Leah M.; Sickman, Linda Sue; Newman, Daniel S.; Harman, Deborah R.


    With the increase in schoolwide practices to improve reading instruction for all students and provide supplemental interventions for struggling readers, the need for collaboration among education professionals has become increasingly important. This article focuses on the expanding opportunities for collaboration between school psychologists and…

  11. Family-Centered Services for Children with ASD and Limited Speech: The Experiences of Parents and Speech-Language Pathologists (United States)

    Mandak, Kelsey; Light, Janice


    Although family-centered services have long been discussed as essential in providing successful services to families of children with autism spectrum disorder (ASD), ideal implementation is often lacking. This study aimed to increase understanding of how families with children with ASD and limited speech receive services from speech-language…

  12. An online readability analysis of pathology-related patient education articles: an opportunity for pathologists to educate patients. (United States)

    Prabhu, Arpan V; Kim, Christopher; Crihalmeanu, Tudor; Hansberry, David R; Agarwal, Nitin; DeFrances, Marie C; Trejo Bittar, Humberto E


    Information for patients regarding their clinical conditions and treatment options is widely available online. The American Medical Association and National Institutes of Health recommend that online patient-oriented materials be written at no higher than a seventh-grade reading level to ensure full comprehension by the average American. This study sought to determine whether online patient-oriented materials explaining common pathology procedures are written at appropriate reading levels. Ten pathology procedures that patients would likely research were queried into Google search, and plain text from the first 10 Web sites containing patient education materials for each procedure was analyzed using 10 validated readability scales. We determined mean reading levels of materials grouped by readability scale, procedure, and Web site domain, the overall average reading level of all resources, and popular Web site domains. One hundred Web sites were accessed; one was omitted for short length (pathology-related patient education materials exceeded those recommended by national health literacy guidelines. These patient education materials should be revised to help patients fully understand them. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Speech-language pathologists as determiners of the human right to diversity in communication for school children in the US. (United States)

    Farrugia-Bernard, Audrey M


    Article 19 of the Universal Declaration of Human Rights states that everyone has the right to freedom of opinion and expression - the right to communication. Communication is at the core of the speech-language pathology (SLP) profession. Yet, while we celebrate the 70th anniversary of the Universal Declaration of Human Rights some of our most vulnerable youth are being placed in special education at disproportional rates. School-based SLPs in the United States may be unwittingly contributing to this phenomenon, obstructing the human right to communication because of biased assessment procedures. However, increasing cultural competence, diversifying the profession, and utilising additional assessment measures are actions that can be taken to promote equity in assessment for all children.

  14. A Speech-Language Pathologist's Guide to Creating a Support Group for Caregivers of Persons with Dementia (United States)

    Morrow-Odom, K. Leigh; Robbins, Sarah M.


    The purpose of this article is to provide basic guidelines to successfully establish a support group for caregivers of persons with dementia. Support groups should provide its members with a community of support, as well as coping and management strategies to improve daily function of loved ones. This should improve the care provided, and the…

  15. Relativism, regulation and the dangers of indifferent science: the Sir Roy Cameron lecture of the Royal College of Pathologists. (United States)

    Berry, Colin L


    The evaluation of data obtained from scientific investigations is not easy and the process often seems counterintuitive to the uninformed. Some commentators hold the conviction that ideological motives colour all deliberations-this makes it easy to suggest that in any scientific debate an opponent's reason for holding a particular viewpoint or belief depends on his or her motives, rather than their knowledge base. This position may be useful in providing the grounds on which to mount a polemic against any perceived threat (drugs in modern medicine, pesticides in intensive agriculture or genetically modified organisms). However, its existence is not a reason to ignore the fact that the data obtained by use of the scientific method may be of a different kind from that which depends on opinions, honed by prejudices. Here I use prejudice to mean a bias that may be favourable or unfavourable to a particular viewpoint, rather than to a willful disregard of fact or an unreasoning predilection to arrive at a particular answer--the Precautionary Principle is a good example of only considering results that fit a preconceived viewpoint. The conviction that opinions cannot be based on independent thought has led to a disregard of professionalism and the development of the view that who pays you determines your opinion--not your science. This is relativism, which embodies the assertion that knowledge is relative and that ethical truths depend on the individuals and groups holding them-there are no absolutes. This compounds the problems of regulatory toxicology which is always beset by unavoidable uncertainties and suffers from being based on the use of the results of testing procedures many decades old which have themselves failed to incorporate new knowledge about the processes we investigate (see Hartung, 2009). A more vigorous assertion of the particular values of the scientific viewpoint and a willingness to incorporate new knowledge into regulatory decision making is necessary. 2009 Elsevier Ireland Ltd. All rights reserved.

  16. Investing in a new generation of knowledge leaders | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Investing in a new generation of knowledge leaders. 27 avril 2015. Image. IDRC Communications. Where are they now? Awatef Ketiti · Clarence Batan · Deirdre Anne McKay · Henry Juarez. Awatef Ketiti Linking ICTs, gender, and societies across the Mediterranean Sea. Clarence Batan Giving a voice to Filipino Youth.

  17. Economics | Page 12 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The book is a bona fide crystal ball. It will be a must read for the next decade. David Bloom, Clarence James Gamble Professor of Economics and Demography and ... of Global Health and Population, Harvard School of Public Health, USA.

  18. Employment and Growth | Page 72 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    David Bloom, Clarence James Gamble Professor of Economics and Demography ... of Global Health and Population, Harvard School of Public Health, USA ... This book explores the place of poor people within a rich variety of value chains, ...

  19. 76 FR 3531 - Final Flood Elevation Determinations (United States)


    ... proof Flood Insurance Study and FIRM available at the address cited below for each community. The BFEs... (All Jurisdictions) Docket No.: FEMA-B-1085 Duck Lake Entire shoreline within +930 Township of Clarence...

  20. 75 FR 9478 - Qualification of Drivers; Exemption Applications; Vision (United States)


    ... and devices showing standard red, green, and amber (49 CFR 391.41(b)(10)). FMCSA recognizes that some..., Donald D. Overton, Willie L. Parks, Derrick A. Robinson, Clarence Robinshaw, Jr., Norman J. Watson and...

  1. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... benefits Become a member DermCare Team Professionalism and ethics My account Member directory Publications JAAD JAAD Case ... Meeting Travel Grant Lila and Murray Gruber Cancer Research Award and Lectureship Clarence S. Livingood Award and Lectureship ...

  2. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... benefits Become a member DermCare Team Professionalism and ethics My account Member directory Publications JAAD JAAD Case ... Meeting Travel Grant Lila and Murray Gruber Cancer Research Award and Lectureship Clarence S. Livingood Award and Lectureship ...

  3. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... benefits Become a member DermCare Team Professionalism and ethics My account Member directory Publications JAAD JAAD Case ... Meeting Travel Grant Lila and Murray Gruber Cancer Research Award and Lectureship Clarence S. Livingood Award and Lectureship ...

  4. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... Society Meeting Travel Grant Lila and Murray Gruber Cancer Research Award and Lectureship Clarence S. Livingood Award and ... Services Resident Rotation Shade Structure Program SPOTme® Skin Cancer Screening Program Volunteer Recognition Program Leadership Institute Programs ...

  5. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... Society Meeting Travel Grant Lila and Murray Gruber Cancer Research Award and Lectureship Clarence S. Livingood Award and ... Services Resident Rotation Shade Structure Program SPOTme® Skin Cancer Screening Program Volunteer Recognition Program Leadership Institute Programs ...

  6. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... Society Meeting Travel Grant Lila and Murray Gruber Cancer Research Award and Lectureship Clarence S. Livingood Award and ... Services Resident Rotation Shade Structure Program SPOTme® Skin Cancer Screening Program Volunteer Recognition Program Leadership Institute Programs ...

  7. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... and Lectureship Clarence S. Livingood Award and Lectureship Marion B. Sulzberger Award and Lectureship Master Dermatologist Award Members ... care Nail care Nail biting "); (function () { var a = "", b = [ "adid=aad-aad-1", "site=ehs.con.aad. ...

  8. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... and Lectureship Clarence S. Livingood Award and Lectureship Marion B. Sulzberger Award and Lectureship Master Dermatologist Award Members ... skin Bug bites and stings "); (function () { var a = "", b = [ "adid=aad-aad-1", "site=ehs.con.aad. ...

  9. Publications | Page 73 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    , the Philippines has the highest unemployment rate in the ASEAN region — more than 7%. Particularly hard hit are youth, who account for more than half of the close to 3 million unemployed. As sociologist Clarence ...

  10. The Use of the Bethesda System for Reporting Thyroid Cytopathology in Korea: A Nationwide Multicenter Survey by the Korean Society of Endocrine Pathologists

    Directory of Open Access Journals (Sweden)

    Mimi Kim


    Full Text Available Background The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC has standardized the reporting of thyroid cytology specimens. The objective of the current study was to evaluate the nationwide usage of TBSRTC and assess the malignancy rates in each category of TBSRTC in Korea. Methods Questionnaire surveys were used for data collection on the fine needle aspiration (FNA of thyroid nodules at 74 institutes in 2012. The incidences and follow-up malignancy rates of each category diagnosed from January to December, 2011, in each institute were also collected and analyzed. Results Sixty out of 74 institutes answering the surveys reported the results of thyroid FNA in accordance with TBSRTC. The average malignancy rates for resected cases in 15 institutes were as follows: nondiagnostic, 45.6%; benign, 16.5%; atypical of undetermined significance, 68.8%; suspicious for follicular neoplasm (SFN, 30.2%; suspicious for malignancy, 97.5%; malignancy, 99.7%. Conclusions More than 80% of Korean institutes were using TBSRTC as of 2012. All malignancy rates other than the SFN and malignancy categories were higher than those reported by other countries. Therefore, the guidelines for treating patients with thyroid nodules in Korea should be revisited based on the malignancy rates reported in this study.

  11. O arranjo em matriz de amostras teciduais (tissue microarray: larga escala e baixo custo ao alcance do patologista Tissue microarrays: high throughput and low cost avaiable for pathologists

    Directory of Open Access Journals (Sweden)

    Victor Piana de Andrade


    Full Text Available O arranjo em matriz de amostras teciduais, ou tissue microarray (TMA, é uma técnica descrita em 1998 por Kononen et al. com ampla aceitação pela literatura mundial. Com um conceito extremamente simples, trata-se de agrupar um grande número de amostras teciduais em um único bloco de parafina, permitindo o estudo de expressão de marcadores moleculares em larga escala com grande aproveitamento do material arquivado, do tempo e dos custos. Discutimos as vantagens e limitações do método, as estratégias e técnica de construção, as aplicações e dificuldades encontradas para a patologia investigativa nos últimos cinco anos de uso no Hospital do Câncer A. C. Camargo.Tissue microarrays (TMA is a worldwide well accepted technique described in 1998 by Kononen et al. It uses an extremely simple concept of ordering hundreds of samples in just one paraffin block to evaluate protein expression in large cohorts with great advantages on costs, time and sample saving. We discuss the technique, its advantages and limitations, strategies to construct the receptor block, its usefulness and difficulties experienced in the last five years at Hospital do Cancer A.C. Camargo.

  12. Prevalence, distribution and risk of sessile serrated adenomas/polyps at a center with a high adenoma detection rate and experienced pathologists

    NARCIS (Netherlands)

    IJspeert, Joep E. G.; de Wit, Koos; van der Vlugt, Manon; Bastiaansen, Barbara A. J.; Fockens, Paul; Dekker, Evelien


    Sessile serrated adenomas/polyps (SSA/Ps) are the precursors of 15 % - 30 % of colorectal cancers (CRC). We aimed to determine the prevalence and distribution of SSA/Ps and to evaluate the association between SSA/Ps and the risk of synchronous advanced neoplasia at a high quality colonoscopy center.

  13. A Comparison of Inter-Professional Education Programs in Preparing Prospective Teachers and Speech and Language Pathologists for Collaborative Language-Literacy Instruction (United States)

    Wilson, Leanne; McNeill, Brigid; Gillon, Gail T.


    Ensuring teacher and speech and language pathology graduates are prepared to work collaboratively together to meet the diverse language literacy learning needs of children is an important goal. This study investigated the efficacy of a 3-h inter-professional education program focused on explicit instruction in the language skills that underpin…

  14. [Skin biopsy in diagnosis of chronic graft-versus-host disease in patients after allogeneic haematopoietic stem cell transplantation: pathologist's point of view on quantitative scoring system]. (United States)

    Grzanka, Dariusz; Styczyński, Jan; Debski, Robert; Krenska, Anna; Pacholska, Małgorzata; Prokurat, Andrzej I; Wysocki, Mariusz; Marszałek, Andrzej


    Pathology diagnosis of chronic graft-versus-host-disease (GVHD) after allogeneic haematopoietic stem cell transplantation (allo-HSCT) is an important issue in clinical follow-up, in spite of frequent difficulties in interpretation., related to dynamic changes occurring in the skin during the disease, as well as to sequelae of basic disease and immunosuppressive therapy. Recently presented Consensus NIH (National Health Institute, Bethesda, USA) of histopathologic (HP) analysis is still complex and intrinsically divergent, thus clinically difficult to implement. Analysis of clinical value of histological evaluation results of skin biopsy in children after allo-HSCT and its correlation with clinical status. Ten skin biopsies were taken from 7 patients (4 boys, 3 girls, age 3-15 years) after allo-HSCT (6 MFD, 1 MMUD) and analyzed after hematoxylin/eosine and immunohistochemical (CD3, CD45T, CD20) staining. Pathology analysis was based on commonly accepted criteria enabling simple and unambiguous interpretation. Results were compared with clinical data and indications for immunosuppressive therapy. It was found that reliable and coherent interpretation can be made when following parameters were taken into account: 1. in epithelium: the presence of apoptosis, archetypical changes and vacuolar degeneration in the basilar layer, presence of CD3/CD45 in the epidermis; 2. in the dermis: the extent of collagenization, presence of melanophages and lymphocyte infiltrations; 3. in the eccrine glands epithelium: eccrine glands atrophy and presence of lymphocytes. A new scoring system of skin biopsy analysis in patients with chronic GVHD based on the modified NIH Consensus was proposed. The preliminary clinical value of histological results was assessed. Skin biopsy evaluation based on limited qualitative and quantitative analysis of lymphocyte infiltrates together with studies on intensity of apoptosis, collagenization and archetypical changes is a valuable diagnostic method complementary to clinical records, enabling easier undertaking of therapeutic decisions.

  15. Addressing education of speech-language pathologists in the World Report on Disability: development of a speech-language pathology program in Malaysia. (United States)

    Ahmad, Kartini; Ibrahim, Hasherah; Othman, Basyariatul Fathi; Vong, Etain


    The current paper is a response to the Wiley, McAllister, Davidson, and Marshall lead article regarding the application of the World Report on Disability (WRD) to people with communication disorders. The current paper directly addresses recommendation 5 (improvement of human resource capacity) and indirectly addresses recommendations 7, 8, and 9 (related to improving local knowledge and data on communicative disabilities) indirectly. The paper describes Malaysia's initiatives in the early 1990s, in developing its local professional capacity to provide services for people with communication disorders (PWCD). It charts the history of development of a local undergraduate entry-level degree program for speech-language pathology (SLP) from the point of conceptualization to full execution. The article provides glimpses to the processes and challenges faced by Universiti Kebangsaan Malaysia as the pioneer university in the South East Asia region to undertake the training and education of the SLP profession and highlights relevant issues faced by newly introduced professions in a country where resources and practice traditions were previously unavailable. It underscores the important role played by government institutions and an international professional network in driving forward-looking policies to implement and sustain the program.

  16. American Society of Clinical Oncology/College Of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer.

    NARCIS (Netherlands)

    Hammond, M.E.; Hayes, D.F.; Dowsett, M.; Allred, D.C.; Hagerty, K.L.; Badve, S.; Fitzgibbons, P.L.; Francis, G.; Goldstein, N.S.; Hayes, M.; Hicks, D.G.; Lester, S.; Love, R.; Mangu, P.B.; McShane, L.; Miller, K.; Osborne, C.K.; Paik, S.; Perlmutter, J.; Rhodes, A.; Sasano, H.; Schwartz, J.N.; Sweep, F.C.; Taube, S.; Torlakovic, E.E.; Valenstein, P.; Viale, G.; Visscher, D.; Wheeler, T.; Williams, R.B.; Wittliff, J.L.; Wolff, A.C.


    PURPOSE: To develop a guideline to improve the accuracy of immunohistochemical (IHC) estrogen receptor (ER) and progesterone receptor (PgR) testing in breast cancer and the utility of these receptors as predictive markers. METHODS: The American Society of Clinical Oncology and the College of

  17. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer.

    NARCIS (Netherlands)

    Hammond, M.E.; Hayes, D.F.; Dowsett, M.; Allred, D.C.; Hagerty, K.L.; Badve, S.; Fitzgibbons, P.L.; Francis, G.; Goldstein, N.S.; Hayes, M.; Hicks, D.G.; Lester, S.; Love, R.; Mangu, P.B.; McShane, L.; Miller, K.; Osborne, C.K.; Paik, S.; Perlmutter, J.; Rhodes, A.; Sasano, H.; Schwartz, J.N.; Sweep, F.C.; Taube, S.; Torlakovic, E.E.; Valenstein, P.; Viale, G.; Visscher, D.; Wheeler, T.; Williams, R.B.; Wittliff, J.L.; Wolff, A.C.


    PURPOSE: To develop a guideline to improve the accuracy of immunohistochemical (IHC) estrogen receptor (ER) and progesterone receptor (PgR) testing in breast cancer and the utility of these receptors as predictive markers. METHODS: The American Society of Clinical Oncology and the College of

  18. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer (unabridged version).

    NARCIS (Netherlands)

    Hammond, M.E.; Hayes, D.F.; Dowsett, M.; Allred, D.C.; Hagerty, K.L.; Badve, S.; Fitzgibbons, P.L.; Francis, G.; Goldstein, N.S.; Hayes, M.; Hicks, D.G.; Lester, S.; Love, R.; Mangu, P.B.; McShane, L.; Miller, K.; Osborne, C.K.; Paik, S.; Perlmutter, J.; Rhodes, A.; Sasano, H.; Schwartz, J.N.; Sweep, F.C.; Taube, S.; Torlakovic, E.E.; Valenstein, P.; Viale, G.; Visscher, D.; Wheeler, T.; Williams, R.B.; Wittliff, J.L.; Wolff, A.C.


    PURPOSE: To develop a guideline to improve the accuracy of immunohistochemical (IHC) estrogen receptor (ER) and progesterone receptor (PgR) testing in breast cancer and the utility of these receptors as predictive markers. METHODS: The American Society of Clinical Oncology and the College of

  19. Vasily shervinsky – Russian Doctor, scientist, therapeutist and pathologist, Honored scientist of the RSFSR and the founder of the Russian Endocrinology school


    Ivanova, N.


    Шервинский Василий Дмитриевич ? русский врач, ученый, терапевт и патолог, заслуженный деятель науки РСФСР и основоположник русской эндокринологии.

  20. Assessing Clinical Laboratory Quality: A College of American Pathologists Q-Probes Study of Prothrombin Time INR Structures, Processes, and Outcomes in 98 Laboratories. (United States)

    Howanitz, Peter J; Darcy, Theresa P; Meier, Frederick A; Bashleben, Christine P


    The anticoagulant warfarin has been identified as the second most frequent drug responsible for serious, disabling, and fatal adverse drug events in the United States, and its effect on blood coagulation is monitored by the laboratory test called international normalized ratio (INR). To determine the presence of INR policies and procedures, INR practices, and completeness and timeliness of reporting critical INR results in participants' clinical laboratories. Participants reviewed their INR policies and procedure requirements, identified their practices by using a questionnaire, and studied completeness of documentation and timeliness of reporting critical value INR results for outpatients and emergency department patients. In 98 participating institutions, the 5 required policies and procedures were in place in 93% to 99% of clinical laboratories. Fifteen options for the allowable variations among duplicate results from different analyzers, 12 different timeliness goals for reporting critical values, and 18 unique critical value limits were used by participants. All required documentation elements were present in 94.8% of 192 reviewed INR validation reports. Critical value INR results were reported within the time frame established by the laboratory for 93.4% of 2604 results, but 1.0% of results were not reported. Although the median laboratories successfully communicated all critical results within their established time frames and had all the required validation elements based in their 2 most recent INR calculations, those participants at the lowest 10th percentile were successful in 80.0% and 85.7% of these requirements, respectively. Significant opportunities exist for adherence to INR procedural requirements and for practice patterns and timeliness goals for INR critical results' reporting.

  1. The Impact of Speech Impairment in Early Childhood: Investigating Parents' and Speech-Language Pathologists' Perspectives Using the ICF-CY (United States)

    McCormack, Jane; McLeod, Sharynne; Harrison, Linda J.; McAllister, Lindy


    Purpose: To explore the application of the Activities and Participation component of the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY, World Health Organization, 2007) as a framework for investigating the perceived impact of speech impairment in childhood. Method: A 32-item questionnaire based on…

  2. Interdisciplinary evaluation of consecutive patients with unilateral cleft lip and palate at age 6, 15, and 25 years: a concurrent standardized procedure and documentation by plastic surgeon; speech and language pathologist; ear, nose, and throat specialist; and orthodontist. (United States)

    Tindlund, Rolf S; Holmefjord, Anders; Eriksson, Jens-Christian Haug; Johnson, Gunnar E; Vindenes, Hallvard


    To evaluate surgical results, speech, hearing, and craniofacial morphology after primary cleft repair performed from 1973 to 1979. During the years 1972 to 1985, all primary cleft surgeries were performed by 1 plastic surgeon, using Tennison lip closure combined with a periosteoplasty on the clefted alveolus at age 3 months. By mobilizing mucoperiosteal flaps, bony bridges were induced in the alveolar process in approximately 60% of the cases. All patients had the soft palate closed at age 24 months by a pushback technique. All children with complete unilateral clefts without soft tissue bands (unilateral cleft lip and palate) primary operated on 1973 to 1979 were included in the material, except 3 patients with a syndrome and 2 patients of foreign ethnicity. The material involved 30 consecutive patients with unilateral cleft lip and palate (20 boys and 10 girls; 16 left-sided and 14 right-sided clefts) who were operated on. Standardized records including photos, radiographs, lateral cephalograms, plaster model, and recording of speech and hearing were collected according to the treatment protocol at age 6, 15, and approximately 25 years. Evaluation included craniofacial descriptive cephalometric analysis, dentoalveolar morphology, dentofacial aesthetics, speech concerning articulation and nasality, and hearing status. Number of surgical interventions after primary surgery was recorded. Secondary revisions and candidates for orthognathic surgery are reported. Ten consecutive patients (case nos. 11-20) are demonstrated as clinical reports. : This longitudinal study shows how a multidisciplinary evaluation adequate for intercenter comparison can be performed when standardized procedures, registrations, and documentations are available.

  3. Automated Quantitative Analysis of p53, Cyclin D1, Ki67 and pERK Expression in Breast Carcinoma Does Not Differ from Expert Pathologist Scoring and Correlates with Clinico-Pathological Characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Cass, Jamaica D. [Division of Cancer Biology and Genetics, Cancer Research Institute, Queen’s University, Kingston K7L 3N6 (Canada); Varma, Sonal [Department of Pathology and Molecular Medicine, Queen’s University, Kingston K7L 3N6 (Canada); Day, Andrew G. [Kingston General Hospital, Kingston K7L 2V7 (Canada); Sangrar, Waheed [Division of Cancer Biology and Genetics, Cancer Research Institute, Queen’s University, Kingston K7L 3N6 (Canada); Rajput, Ashish B. [Department of Pathology and Molecular Medicine, Queen’s University, Kingston K7L 3N6 (Canada); Raptis, Leda H.; Squire, Jeremy [Division of Cancer Biology and Genetics, Cancer Research Institute, Queen’s University, Kingston K7L 3N6 (Canada); Madarnas, Yolanda [Department of Oncology, Queen’s University, Kingston K7L 3N6 (Canada); SenGupta, Sandip K. [Department of Pathology and Molecular Medicine, Queen’s University, Kingston K7L 3N6 (Canada); Elliott, Bruce E., E-mail: [Division of Cancer Biology and Genetics, Cancer Research Institute, Queen’s University, Kingston K7L 3N6 (Canada); Department of Pathology and Molecular Medicine, Queen’s University, Kingston K7L 3N6 (Canada)


    There is critical need for improved biomarker assessment platforms which integrate traditional pathological parameters (TNM stage, grade and ER/PR/HER2 status) with molecular profiling, to better define prognostic subgroups or systemic treatment response. One roadblock is the lack of semi-quantitative methods which reliably measure biomarker expression. Our study assesses reliability of automated immunohistochemistry (IHC) scoring compared to manual scoring of five selected biomarkers in a tissue microarray (TMA) of 63 human breast cancer cases, and correlates these markers with clinico-pathological data. TMA slides were scanned into an Ariol Imaging System, and histologic (H) scores (% positive tumor area x staining intensity 0–3) were calculated using trained algorithms. H scores for all five biomarkers concurred with pathologists’ scores, based on Pearson correlation coefficients (0.80–0.90) for continuous data and Kappa statistics (0.55–0.92) for positive vs. negative stain. Using continuous data, significant association of pERK expression with absence of LVI (p = 0.005) and lymph node negativity (p = 0.002) was observed. p53 over-expression, characteristic of dysfunctional p53 in cancer, and Ki67 were associated with high grade (p = 0.032 and 0.0007, respectively). Cyclin D1 correlated inversely with ER/PR/HER2-ve (triple negative) tumors (p = 0.0002). Thus automated quantitation of immunostaining concurs with pathologists’ scoring, and provides meaningful associations with clinico-pathological data.

  4. Fonoaudiólogo e agente comunitário de saúde: uma experiência educativa Speech-language and hearing pathologist and community health agent: an educative experience

    Directory of Open Access Journals (Sweden)

    Liara Saldanha Brites


    Full Text Available OBJETIVOS: Analisar a eficácia de um processo de formação sobre a Fonoaudiologia, desenvolvido com Agentes Comunitários de Saúde, embasado na concepção teórica da educação radical em saúde. MÉTODOS: Inicialmente, uma equipe, composta por cinco agentes comunitários de uma Unidade de Programa de Saúde da Família, foi submetida a uma entrevista coletiva semi-estruturada. Posteriormente, por meio da técnica de grupo focal, foi realizado um processo de educação radical em saúde, perfazendo um total de oito encontros de aproximadamente uma hora e meia cada. Na fase final, o grupo recebeu um exemplar de material informativo escrito sobre Fonoaudiologia, comunicação humana, seus distúrbios e formas de intervenção. RESULTADOS: Durante a entrevista inicial, o grupo demonstrou uma visão predominantemente relacionada a práticas clínicas, de modo especial, em distúrbios da fala e escrita/aprendizagem, surdez e acamados. O processo educativo teve início com a representação do modelo tradicional de educação em saúde e, ao longo dos encontros, com a ampliação do diálogo, assumiu a proposta de modelo radical em saúde, apesar da centralização no modelo de prevenção em saúde. Apenas um agente leu o material escrito. CONCLUSÃO: O processo educativo apresentou-se eficiente para tratar os temas propostos pelo grupo e permitiu o empoderamento no nível individual.PURPOSE: To analyze the efficacy of a formation process regarding Speech-Language and Hearing Sciences developed with Community Health Agents, based on the theoretical concept of radical education in health. METHODS: Initially, a group of five community agents from a Family Health Program Unit was submitted to a semi-structured collective interview. Then, through the focal group technique, a process of radical education in health was carried out, totalizing eight sessions of approximately 90 minutes each. In the final phase, the group received an informative written material regarding Speech-Language and Hearing Sciences, human communication, its disorders and ways of prevention. RESULTS: During the initial interview, the group showed knowledge predominantly related to clinical practice, especially on speech, writing and learning disorders, deafness and bedridden patients. The educative process began with the representation of the traditional model of health education and, throughout the sessions, with the dialogue development, it assumed the radical model in health, besides the centralization in the model of health prevention. Only one health agent read the written material. CONCLUSION: The educational process was effective to treat the subjects proposed by the group and allowed the individual empowerment.

  5. O que fonoaudiólogos e estudantes de fonoaudiologia entendem por fluência e disfluência What speech-language pathologists and students of speech-pathology understand as fluency and disfluency

    Directory of Open Access Journals (Sweden)

    Ana Maria do Carmo Carvalho de Oliveira


    Full Text Available OBJETIVO: verificar a compreensão dos estudantes de 3º e 4º anos e dos profissionais de Fonoaudiologia em relação aos conceitos de fluência e disfluência, aos componentes e influenciadores da fluência e aos tipos de disfluências. MÉTODOS: foram aplicados 107 questionários a uma amostra de 57 profissionais e 50 estudantes. Foi realizada análise qualitativo-quantitativa das questões abertas e quantitativa das questões fechadas. RESULTADOS: a análise descritiva identificou mais de 20 fatores para as perguntas abertas (conceito de fluência e de disfluência e componentes da fluência, mas nenhum fator citado pela maioria dos sujeitos. O componente da fluência mais listado relaciona-se à taxa de elocução. Fatores psicológicos como ansiedade e introversão-extroversão estão entre os fatores mais citados como influenciadores do grau de fluência. Os tipos de disfluências mais categorizadas como gaguejadas foram bloqueios, prolongamentos iniciais e comportamentos de defesa. Não houve diferença estatisticamente significante entre profissionais e estudantes quanto ao perfil de respostas. O aumento dos anos de atuação modificou algumas respostas. CONCLUSÃO: os participantes: 1 apresentaram conceito idealizado de fluência ("fala livre de rupturas", 2 consideraram disfluência como sinal de alteração e não como um fenômeno intrínseco da fala, 3 consideraram a taxa de elocução, e não as disfluências, como o componente que mais afeta o grau de fluência, 4 consideraram os fatores afetivos, principalmente a ansiedade, como os que mais influenciam o grau de fluência, atribuindo uma influência secundária a fatores lingüísticos, cognitivos e genéticos e 5 classificaram os tipos de disfluências de maneira alinhada com a literatura.PURPOSE: to check the understanding of current students (those who are in 3rd and 4th year and Speech-Language Pathology professionals about the concepts of fluency and dysfluency, the components and aspects that affect fluency and the sorts of speech dysfluency. METHODS: 107 questionnaires were applied in a sample of 57 professionals and 50 students of Speech-Language Pathology. Qualitative and quantitative analyses were applied to open questions and quantitative analysis was applied to multiple-choice questions. RESULTS: more than 20 analytic factors were identified for each open answer, but no factor was mentioned by the great majority of subjects. Most cited fluency component was speech rate. Psychological factors such as anxiety and introversion-extraversion are among the more quoted factors that affect fluency level. The three sorts of dysfluency which were more categorized as stuttered were blocks, initial prolongations and defense behaviors. There were not significant statistical differences between students' and professionals' answers. Increase in professional practice has changed some answers. CONCLUSION: the subjects: 1 have revealed an ideal concept of fluency ("speech free from disruptions", 2 have considered dysfluency as some kind of disorder and not as a speech inherent event, 3 have considered speech rate, not dysfluency, as fluency's most important component, 4 have considered psychological factors, mainly anxiety, as the factors that have the major impact on fluency level (language, cognitive and genetic factors would have a secondary importance and 5 have classified dysfluency according to scientific literature.

  6. Detecting and preventing the occurrence of errors in the practices of laboratory medicine and anatomic pathology: 15 years' experience with the College of American Pathologists' Q-PROBES and Q-TRACKS programs. (United States)

    Novis, David A


    This review extracts those studies from the CAP Q-PROBES and Q-TRACKS programs that have benchmarked and monitored the occurrence of errors in the practices of laboratory medicine and anatomic pathology. The outcomes of these studies represent in aggregate the analysis of millions of data points collected in thousands of hospitals throughout the United States. Also presented in this review are hospital and laboratory practices associated with improved performance (ie, fewer errors). Only those associations that were shown to be statistically significant are presented. They represent only a small fraction of the practices examined in these studies. The reader is encouraged to peruse the Q-PROBES studies cited in the reference list to learn about the wide range of practices investigated. The institution of some of these practices for which the associated error reductions were not statistically significant might nonetheless improve performance in some environments. There is no way of knowing whether some better-performing institutions compensated for not employing presumably beneficial practices by applying other practices about which the studies' authors neglected to inquire. Nor is there any way of knowing whether institutions in which performance was poor employed presumably beneficial practices, but possessed operational flaws about which the studies' authors neglected to inquire. Certainly, hospitals operating in the bottom 10% of benchmarked performances would do well to investigate the possibility that some of these practices might reduce the incidence of errors in their institutions. From the results of these studies, there emerge two complementary strategies that appear to be associated with reduction of errors. Obviously, the first strategy involves doing what is necessary to prevent the occurrence of errors in the first place. Several tactics may accomplish this goal. Healthcare workers responsible for specific tasks must be properly educated and motivated to perform those tasks with as few errors as possible. There must be written policies and protocols detailing responsibilities and providing contingencies when those responsibilities are not met. The successful completion of required tasks must be documented, especially those tasks that are performed as requisite to others. In other words, it should be impossible to move on to subsequent operations in testing processes before documenting the successful completion of previous requisite operations. Finally, the opportunities for making errors must be reduced. Specifically, the number of steps in which specimens are delivered to laboratories, tests are performed, and results are disseminated to those who use them must be reduced as much as possible. The second strategy involves the assumption that despite our best efforts to prevent them, errors will occur. No matter how smart we are, no matter how careful we try to be, we will make mistakes. It is essential that systems designed to eliminate errors include elements of redundancy to catch those mistakes. Work must be checked and verified before therapeutic decisions are finalized. This is especially true when those decisions are irrevocable and the potential damage caused by errors cannot be undone. Ideally, systems that use redundancy should include provisions to shut down the testing process altogether when the successful execution of previous steps cannot be verified. Once error detection systems are established, service providers can gauge their performance by employing tools of continuous monitoring to assess the degree to which health care workers comply with required procedures, and with which services achieve their intended outcomes.

  7. Automated Quantitative Analysis of p53, Cyclin D1, Ki67 and pERK Expression in Breast Carcinoma Does Not Differ from Expert Pathologist Scoring and Correlates with Clinico-Pathological Characteristics

    International Nuclear Information System (INIS)

    Cass, Jamaica D.; Varma, Sonal; Day, Andrew G.; Sangrar, Waheed; Rajput, Ashish B.; Raptis, Leda H.; Squire, Jeremy; Madarnas, Yolanda; SenGupta, Sandip K.; Elliott, Bruce E.


    There is critical need for improved biomarker assessment platforms which integrate traditional pathological parameters (TNM stage, grade and ER/PR/HER2 status) with molecular profiling, to better define prognostic subgroups or systemic treatment response. One roadblock is the lack of semi-quantitative methods which reliably measure biomarker expression. Our study assesses reliability of automated immunohistochemistry (IHC) scoring compared to manual scoring of five selected biomarkers in a tissue microarray (TMA) of 63 human breast cancer cases, and correlates these markers with clinico-pathological data. TMA slides were scanned into an Ariol Imaging System, and histologic (H) scores (% positive tumor area x staining intensity 0–3) were calculated using trained algorithms. H scores for all five biomarkers concurred with pathologists’ scores, based on Pearson correlation coefficients (0.80–0.90) for continuous data and Kappa statistics (0.55–0.92) for positive vs. negative stain. Using continuous data, significant association of pERK expression with absence of LVI (p = 0.005) and lymph node negativity (p = 0.002) was observed. p53 over-expression, characteristic of dysfunctional p53 in cancer, and Ki67 were associated with high grade (p = 0.032 and 0.0007, respectively). Cyclin D1 correlated inversely with ER/PR/HER2-ve (triple negative) tumors (p = 0.0002). Thus automated quantitation of immunostaining concurs with pathologists’ scoring, and provides meaningful associations with clinico-pathological data

  8. Ernst von Glasersfeld's Radical Constructivism and Truth as Disclosure (United States)

    Joldersma, Clarence W.


    In this essay Clarence Joldersma explores radical constructivism through the work of its most well-known advocate, Ernst von Glasersfeld, who combines a sophisticated philosophical discussion of knowledge and truth with educational practices. Joldersma uses Joseph Rouse's work in philosophy of science to criticize the antirealism inherent in…

  9. Population Aging and the Generational Economy: A Global ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    31 oct. 2011 ... The book is a bona fide crystal ball. It will be a must read for the next decade. David Bloom, Clarence James Gamble Professor of Economics and ... of Global Health and Population, Harvard School of Public Health, USA.

  10. 75 FR 52021 - Notice of Inventory Completion: New York University College of Dentistry, New York, NY (United States)


    ... University College of Dentistry, New York, NY AGENCY: National Park Service, Interior. ACTION: Notice. Notice... University College of Dentistry, New York, NY. The human remains were removed from Port Clarence, Nome County... the human remains was made by New York University College of Dentistry professional staff in...

  11. On Students' Rights, an "Originalist" Stands Firm (United States)

    Walsh, Mark


    The author reports on how U.S. Supreme Court Justice Clarence Thomas' opinions in youths'-rights cases reflect his "originalist" thinking. Justice Thomas, 63, marks two decades on the court Oct. 23, and a hallmark of his tenure is his willingness to carve out a solitary stance on certain issues. Particularly in cases involving schools…

  12. An Unreasonable Argument against Student Free Speech (United States)

    Blacker, David


    The U.S. Supreme Court's recent opinion in "Morse v. Frederick" (2007), perhaps better known as the "Bong Hits 4 Jesus" case, contains a widely reported concurrence by Justice Clarence Thomas. Challenging well-established precedent, Thomas argues that students should have no constitutional rights in school. In this essay David Blacker argues that,…

  13. 75 FR 3488 - Notice of Public Meetings for the National Park Service Alaska Region's Subsistence Resource... (United States)


    ... held on Saturday, February 20, 2010, from 7 p.m. to 8:30 p.m. and Sunday, February 21, 2010, from 9 a.m... Clarence Summers, Subsistence Manager, Tel. (907) 644-3603. The proposed meeting agenda for each meeting... Agenda. 6. Status of SRC Membership. 7. SRC Member Reports. 8. Park Subsistence Manager's Report. 9. Park...

  14. [Pearl Harbor. (United States)

    Johnson, Jennifer, Ed.


    This issue of "Loblolly Magazine" was written in observance of the 50th anniversary of the U.S. entrance into World War II. The publication features interviews conducted by East Texas high school students with Clarence Otterman, one of the few survivors of the crew of the USS Arizona, which was bombed during the attack on Pearl Harbor,…

  15. Notoriety Yields Tragedy in Iowa Sexual-Harassment Cases (United States)

    Wilson, Robin


    Sexual harassment broke into the national consciousness in 1991, when Anita Hill accused Clarence Thomas--then a nominee to the U.S. Supreme Court--of having made sexually inappropriate comments to her. The controversy spawned a flood of charges nationwide, including on college campuses. Since then colleges have tried to stem harassment with…

  16. 76 FR 70711 - Senior Executive Service; Performance Review Board (United States)



  17. 75 FR 69061 - Senior Executive Service; Performance Review Board (United States)


    ..., Linda C Burrows, Charles W Buttress, Larry D Buzzard, Christine M Cadieux, Gena E Callahan, Samuel N... Bekkedahl, Larry N Bell, Melody C Berkowitz, Barry E Bieniawski, Andrew J Bishop, Clarence T Bishop, Tracey..., Douglas E Kane, Michael C Kaplan, Stan M Kearney, James H Kelly, Henry C Kelly, Larry C Kenchington, Henry...

  18. Final Environmental Assessment for the Bridge Replacement and Scour Protection Measures at Avon Park Air Force Range, Florida (United States)


    stipulated in the permit. Potential indigo snake refugia: gopher tortoise burrows , active or inactive, other holes, ground cavities, and root hollows...holes, cavities, and snake refugia other than gopher tortoise burrows will be inspected each morning before planned site manipulation of a particular...University 1999 Years Experience: 12 Larry McLain Operational Transportation Manager and Range Maintenance Manager Clarence Morgan Rangeland

  19. 77 FR 24217 - Alaska Native Claims Selection (United States)


    ... within the Clarence Rhode National Wildlife Range in existence on the date ANCSA was enacted, December 18... contact the BLM during normal business hours. In addition, the FIRS is available 24 hours a day, 7 days a week, to leave a message or question with the BLM. The BLM will reply during normal business hours...

  20. 78 FR 22596 - Qualification of Drivers; Exemption Applications; Vision (United States)


    ...) Wesley J. Jenkins (IL) Francisco J. Jimenez (TX) Christopher J. Kane (VT) Kenneth C. Keil (CA) Melvin A. Kleman (OH) Michael Lafferty (ID) Roosevelt Lawson (AL) Eugene R. Lydick (VA) Emanuel N. Malone (VA.... Riendeau (ND) James A. Smith (WA) Clarence L. Swann, Jr. (AL) Michael G. Trueblood (IL) Donald A. Uplinger...

  1. Browse Title Index

    African Journals Online (AJOL)

    Items 351 - 400 of 633 ... Vol 27, No 6 (2017), Nurturing the continuum of HIV testing, treatment and prevention matrix cascade in reducing HIV transmission, Abstract PDF. Clarence S. Yah. Vol 27, No 2 (2017), Nutritional status and effect of maternal employment among children aged 6–59 months in Wolayta Sodo Town, ...

  2. Family Incomes: Will Your Children Be as Well Off as Your? = Les revenue familiaux: vos enfants s'en tireront-ils aussi bien que vous? (United States)

    Theilheimer, Ish, Ed.


    Against the background of recent radical changes in the Canadian economy, this issue of the Canadian journal "Transition" examines the question of parents' concerns for their children's economic futures. "Changes in Family Incomes and Labour Market Participation in Post-War Canada" (David Ross and Clarence Lochhead) charts…

  3. histopathological evaluation of h. pylori associated gastric lesions in ...

    African Journals Online (AJOL)


    Dec 12, 2012 ... HISTOPATHOLOGICAL EVALUATION OF H. PYLORI ASSOCIATED GASTRIC LESIONS IN BENIN CITY,. NIGERIA. M. O. Udoh, MBBS, FMCPath, Consultant Pathologist, Department of Pathology, D. E. Obaseki, MBBS, FMCPath,. Consultant Pathologist, Department of Pathology, University of Benin ...

  4. Neurogenic Stuttering (United States)

    ... Teachers Speech-Language Pathologists Physicians Employers Tweet Neurogenic Stuttering Parents of Preschoolers Parents of School-Age Children ... Pathologists Physicians Employers Download brochure What is neurogenic stuttering? Neurogenic stuttering is a type of fluency disorder ...

  5. Specialty Board on Fluency Disorders (United States)

    ... or large groups of speech-language pathologists. Speech-language pathologists who are Board Certified Specialists in Fluency may be found on this website by searching name, city(location) or zip code. ...

  6. Efficient nucleus detector in histopathology images.

    NARCIS (Netherlands)

    Vink, J.P.; Leeuwen, van M.B.; Deurzen, van C.H.M.; Haan, de G.


    In traditional cancer diagnosis, (histo)pathological images of biopsy samples are visually analysed by pathologists. However, this judgment is subjective and leads to variability among pathologists. Digital scanners may enable automated objective assessment, improved quality and reduced throughput

  7. Modeling Red Blood Cell and Iron Dynamics in Patients with Chronic Kidney Disease (United States)


    level in the body. Most patients with CKD have elevated levels of inflammation due to CKD and the presence of other medical issues (e.g., diabetes ...Blood, 37 (1971), 725–732. [11] Chung-Che Chang, Yayan Chen, Kapil Modi , Omar Awar, Clarence P. Alfrey, and Lawrence Rice, Changes of red blood cell...National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2008. [43] M. M. Udden, T. B. Driscoll, M

  8. Some doctors of medicine who published optometry books and played significant roles in early twentieth century optometric education. (United States)

    Goss, David A


    This paper provides brief profiles of four doctors of medicine who wrote books for optometrists and who were faculty members in, and/or directors of, optometry schools in the early twentieth century. Those studied were Thomas G. Atkinson (1870-1946), Marshall B. Ketchum (1856-1937), Joseph I. Pascal (1890-1955), and Clarence W. Talbot (1883-1958). The content of the books they wrote is also discussed.

  9. Investigating a self-scoring interview simulation for learning and assessment in the medical consultation


    Bruen, Catherine; Kreiter, Clarence; Wade, Vincent; Pawlikowska, Teresa


    Catherine Bruen,1 Clarence Kreiter,2 Vincent Wade,3 Teresa Pawlikowska1 1Health Professions Education Centre, Faculty of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland; 2Department of Family Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA; 3School of Computer Science and Statistics, Faculty of Engineering, Mathematics and Science, Trinity College Dublin, Dublin, Ireland Abstract: Experience with simulated patients supports un...

  10. Blue Marsh Lake, Bernville Protective Works. Design Memorandum Number 13 Schuylkill River basin. Tulpehocken Creek, Pennsylvania (United States)


    Aetna Telephone and Telegraph Company Z60 E. Washington Avenue Meyerstown, PA 19602 Mr. James Vallosio, Supervisor Engineering Department Heidelberg...line: (1) Miscellaneous Book Volume 311, page 456, Berks County Records - Clarence W. Mengel and Lillian W. Mengel, his wife and Henry L. Kalbach and...Marion B. Kalbach , his wife - agreement ) and right of way to Bernville Borough Authority. (2) Mi ’ ellaneous Book Volume 311, Page 509, Berks County

  11. The Chinese Air Force: Evolving Concepts, Roles, and Capabilities (United States)


    improvements were for the most part cosmetic (the lengthening of a fuselage, relocation of components, etc.) and though Chinese writings are...Security Developments Involving the PRC, 62. 10 Chris Pocock with Clarence Fu, The Black Bats: CIA Spy Flights over China from Taiwan (Atglen, PA...development, 276 to avoid R&D investments, 277 RF–100A, 74 RF–84F, 74 RF–86A/F, 74 Rice , Donald, 19 Right Sizing the People’s Liberation Army: Exploring the

  12. Annotated Bibliography for Lake Erie. Volume II. Chemical, (United States)


    ural forces tending to restore equilibrium. Bieber , Glen F. - See: Frank J. Little, Jr., et al, No. 212. 37. Bird, John. 1966. Our dying waters...research should indicate more definite trends. 207. Leonard, Justin W. 1962. Environmental requirements of Ephemeroptera. In: Clarence M. Tarzwell (Ed... Bieber , Thomas J. Horst and Danley F. Brown. 1973. Possible accelerated eutrophication thresholds in the Great Lakes rela- tive to human population

  13. 82D Airborne Division in Sicily and Italy (United States)


    34L.1 ranki, wou1d1 refrain from flashUing his tc;rch inrsiLd4e the caro Neithbler T1’ayloEcr no<->r 3-ar di ror f el+- : nyXr real chill o- f fea -r... Mendez , Louis G, Myers, Joseph F, Muzynski, TWalter J, Nau, Charles E, Ostberg, EJe Parris, Harold L; Polette, Lloyd L, Prager, Clarence’ Prager, Leonard A

  14. Identifying the Flow Physics and Modeling Transient Forces on Two-Dimensional Wings (United States)


    pushrods actuated by Copley servo tubes, allowing for pitching motion to be commanded. For the results presented here, only the rear pushrod was actuated...JHU Press , 2012. [54] M. Goman and A. Khrabrov. State-space representation of aerodynamic characteristics of an aircraft at high angles of attack...Berkooz, and Clarence W. Rowley. Turbulence, coherent structures, dynamical systems and symmetry. Cambridge University Press , 2012. [67] Simon J

  15. Test Excavations at the Cedar Grove Site (3LA97): A Late Caddo Farmstead on the Red River. (United States)


    trees around Maya Lake, just eastward of the Cedar Grove site (Figure 3). There appears to be some lcorrelation in this region between floodplain prairies...Press, New York. Davis, E. Mott 1970 Archaeological and historical assessment of the Red River Basin in Texas. In Archeological and historical... Archaeological Conference, Atlanta. 113 4 -- - - - - .. .. .- .. - . . . Webb, Clarence B. 1945 A second historic Caddo site at Natchitoches, Louisiana

  16. ‘Historical narratives and historical desires: re-evaluating American art criticism of the mid-nineteenth century’: Karen Georgi, Critical Shift: Rereading Jarves, Cook, Stillman, and the Narratives of Nineteenth-Century American Art, The Pennsylvania State University Press, 2013


    Emily Gephart


    Striving to distinguish their authority as and demonstrate their professionalism, art critics James Jackson Jarves, Clarence Cook, and William James Stillman wrote exhibition reviews, essays, and increasingly self-conscious histories of American art and artists in the mid-nineteenth century. Whereas their writing has often been employed to establish a model of opposed pre- and post-war periodization in American art, Karen Georgi challenges this view, re-evaluating the rhetorical structures t...

  17. Evaluation and Analysis of a Multi-Band Transceiver for Next Generation Telemetry Applications (United States)


    UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Morgan State University (INC) 1700 E Cold Spring LN, Baltimore MD 21251-0002 8...Eng., Samuel Berhanu, and Willie L. Thompson II, D.Eng Morgan State University , The Clarence M. Mitchell Jr. School of Engineering Center of... DDC ) BAND SELECTION Kintex FPGA DIGITAL RADIO RECEIVER DIGITAL RADIO TRANSMITTER ADC Fs < 225 MSPS Fs = 400 MHz RF BW = 36 MHz FREQ TRANSLATION VIA

  18. Fifteenth LAMPF users group meeting

    International Nuclear Information System (INIS)

    Cochran, D.R.F.


    The Fifteenth LAMPF Users Group Meeting was held November 2-3, 1981 at the Clinton P. Anderson Meson Physical Facility. The program of papers scheduled to be presented was amended to include a Report from Washington by Clarence R. Richardson, US Department of Energy. The general meeting ended with a round-table working group discussion concerning the Planning for a Kaon Factory. Individual items from the meeting were prepared separately for the data base

  19. Validation of a Cytotechnologist Manual Counting Service for the Ki67 Index in Neuroendocrine Tumors of the Pancreas and Gastrointestinal Tract. (United States)

    Cottenden, Jennielee; Filter, Emily R; Cottreau, Jon; Moore, David; Bullock, Martin; Huang, Weei-Yuarn; Arnason, Thomas


    - Pathologists routinely assess Ki67 immunohistochemistry to grade gastrointestinal and pancreatic neuroendocrine tumors. Unfortunately, manual counts of the Ki67 index are very time consuming and eyeball estimation has been criticized as unreliable. Manual Ki67 counts performed by cytotechnologists could potentially save pathologist time and improve accuracy. - To assess the concordance between manual Ki67 index counts performed by cytotechnologists versus eyeball estimates and manual Ki67 counts by pathologists. - One Ki67 immunohistochemical stain was retrieved from each of 18 archived gastrointestinal or pancreatic neuroendocrine tumor resections. We compared pathologists' Ki67 eyeball estimates on glass slides and printed color images with manual counts performed by 3 cytotechnologists and gold standard manual Ki67 index counts by 3 pathologists. - Tumor grade agreement between pathologist image eyeball estimate and gold standard pathologist manual count was fair (κ = 0.31; 95% CI, 0.030-0.60). In 9 of 20 cases (45%), the mean pathologist eyeball estimate was 1 grade higher than the mean pathologist manual count. There was almost perfect agreement in classifying tumor grade between the mean cytotechnologist manual count and the mean pathologist manual count (κ = 0.910; 95% CI, 0.697-1.00). In 20 cases, there was only 1 grade disagreement between the 2 methods. Eyeball estimation by pathologists required less than 1 minute, whereas manual counts by pathologists required a mean of 17 minutes per case. - Eyeball estimation of the Ki67 index has a high rate of tumor grade misclassification compared with manual counting. Cytotechnologist manual counts are accurate and save pathologist time.

  20. Career advancement opportunities and the ACVP/STP Coalition. (United States)

    Cockerell, Gary


    A new service to facilitate career advancement opportunities has been implemented by the American College of Veterinary Pathologists (ACVP)/Society of Toxicologic Pathology (STP) Coalition for Veterinary Pathology Fellows. This service will allow rapid communication of these opportunities between veterinary pathologists in academia, industry, and government, and will be useful to trainees as well as established pathologists. © 2014 by The Author(s).

  1. Biosensors and environmental health

    National Research Council Canada - National Science Library

    Preedy, Victor R; Patel, Vinood B


    .... Contributors are leading authorities and the book is essential reading for environmental scientists, toxicologists, medical doctors, health care professionals, pathologists, biologists, biochemists...

  2. Research

    African Journals Online (AJOL)



    May 30, 2012 ... cleft care supporting teams, especially speech language pathologists, orthodontists, and audiologists. ... social workers, speech therapists, dental technologists, and medical students. .... autonomy of local professionals.

  3. A Source Term for Wave Attenuation by Sea Ice in WAVEWATCH III (registered trademark): IC4 (United States)


    blue and 4 locations in the ice: 1, 2, 5, and 10 km. Notice the steepening of the high frequency face and the shift of the peak to slightly lower...Term for Wave Attenuation by Sea Ice in WAVEWATCH III®: IC4 ClarenCe O. COllins iii W. eriCk rOgers Ocean Dynamics and Prediction Branch Oceanography...Wave model Sea ice Ocean surface waves Arctic Ocean WAVEWATCH III Spectral wave modeling Source terms Wave hindcasting 73-N2K2-07-5 Naval Research

  4. Thermodynamic and hydrochemical controls on CH4 in a coal seam gas and overlying alluvial aquifer: new insights into CH4 origins


    Owen, D. Des. R.; Shouakar-Stash, O.; Morgenstern, U.; Aravena, R.


    Using a comprehensive data set (dissolved CH4, ?13C-CH4, ?2H-CH4, ?13C-DIC, ?37Cl, ?2H-H2O, ?18O-H2O, Na, K, Ca, Mg, HCO3, Cl, Br, SO4, NO3 and DO), in combination with a novel application of isometric log ratios, this study describes hydrochemical and thermodynamic controls on dissolved CH4 from a coal seam gas reservoir and an alluvial aquifer in the Condamine catchment, eastern Surat/north-western Clarence-Moreton basins, Australia. ?13C-CH4 data in the gas reservoir (?58? to ?49?) and sha...

  5. Climate and Human History of Nature

    DEFF Research Database (Denmark)

    Frølund, Sune


    The paper investigates the ideas that have prevented environmental knowledge from developing into action and change. According to Clarence J. Glacken throughout European history design ideas about the relation between man and nature have prevented the many local observations of the negative...... expose some ecological ideas – that nature itself is a perpetual equilibrium and that man lived in harmony with nature until the emergence of modernity (industrialisation, capitalism, and technology) – as illusions. Such ‘new’ ecological ideas can be seen as disguised versions of the old design idea...

  6. Formalin treatments pass new tests. Additional notes on the control of ecto-parasitic protozoa (United States)


    After the completion of the eхреriments reported recently, in which the efficacy of formalin in controlling infections of Gostia mecatrix was demonstrated, the author was afforded an opportunity to test the value of formalin solutions in combatting established mixed infections of (Gyrodactylus, Tricbodina, Cyclochaeta) and a stalked protozoan on rainbow trout fingerlings. This opportunity was provided through the courtesy and cooperation of Clarence F. Pautzke, Chief Biologist for the Washington State Game Department, and Lee Walters, Superintendent of the Washington State Hatchery at Seward Park, Seattle.

  7. High Frontier, The Journal for Space & Missile Professionals. Volume 4, Number 4 (United States)


    the Hidden Story of America’s Space Espionage (New York, NY: Simon & Schuster, 2003), 364. 2 Dwayne A. Day, John M. Logsdon, and Brian Latell, lengthy but includes folks like Lt Gen Mike Hamel, Lt Gen Tom Sheridan, Maj Gen Jimmy Morrell, Maj Gen Jim Armour , Maj Gen Mitch Mitchell, Brig...Security: Security was very tight. For example, shortly af- ter I was appointed DDNRO I was visited by Clarence “Kel- ly” Johnson , with whom I had worked

  8. Capturing a Luxurious Commons through State Intervention

    Directory of Open Access Journals (Sweden)

    Dan Moscovici


    Full Text Available Seaview Resort is nestled on 270 hectares of New Jersey USA coast. Seaview is adjacent to the Pinelands National Reserve (an almost 500,000 hectare protected area and is a historical landmark for the region. Founded in 1914 by Clarence H. Geist as a retreat for the wealthy, it brought some famous and powerful people to the Pinelands and the NJ Shore during its private ownership. Notables include Bing Crosby, Ben Hogan, Grace Kelly, The Rolling Stones, Bob Dylan and Presidents Eisenhower, Harding, Nixon, and Hoover.

  9. Clinical Characterization of Aerosolized Francisella tularensis Infection in Cynomolgus macaques (United States)


    All airflows, environmental monitoring, and system balancing were configured, controlled, and recorded through the institute standard automated...were used as a baseline to fit an autoregressive integrated moving average (ARIMA) model. Temperature elevations exceeding three standard deviations...supervision of a pathologist board certified by the American College of Veterinary Pathologist in a biosafety level (BSL) 3 necropsy facility. Tissues

  10. Fund af lymfeknuder ved kolorektal cancer

    DEFF Research Database (Denmark)

    Schmidt, Mads Bo; Engel, Ulla; Mogensen, Anne Mellon


    that may influence the detection of LNs, including patient- as well as surgeon- and pathologist-related issues. The pathologist-related variable most probably shapes the yield the most. Introduction of guidelines focusing on the most appropriate technique may secure better and more consistent results...

  11. Current laboratory diagnosis of hepatitis b virus infection including 8 ...

    African Journals Online (AJOL)

    patient management. ... into visually palatable information using the myriad of available bioinformatics tools. J G M SIM, BSc, MB ... Clinical Pathologist, Drs Martin & Sim Inc., Clinical Pathologists, Toga Laboratories, Johannesburg ... system. Therefore, this phase is sometimes called the immune escape phase although it.

  12. Involving Parents in Teaching Social Communication Skills to Young Children (United States)

    Weiss, Amy L.; Theadore, Geraldine


    This article focuses on why and how speech-language pathologists and other professionals can encourage the involvement of parents in teaching social communication skills to their young children. Four main topics are explored: (1) the evidence that many of the children with special needs served by speech-language pathologists and other…

  13. Prognostic Value of the Circumferential Resection Margin in Esophageal Cancer Patients After Neoadjuvant Chemoradiotherapy

    NARCIS (Netherlands)

    Hulshoff, J. B.; Faiz, Z.; Karrenbeld, A.; Kats-Ugurlu, G.; Burgerhof, J. G. M.; Smit, J. K.; Plukker, J. Th. M.


    Background. Circumferential resection margins (CRM) for esophageal cancer (EC), defined by the College of American Pathologists (CAP; >0 mm) or the Royal College of Pathologists (RCP; >1 mm) as tumor-free (R0), are based on a surgery-alone approach. We evaluated the usefulness of both definitions in

  14. Preservation of food by cold chains. Part 4. Brief history of the industrial food preservation; Conservering van voedingsmiddelen door koudeketens. Deel 4. Korte historie van de industriele voedingsmiddelenconservering

    Energy Technology Data Exchange (ETDEWEB)

    Van den Berg, C.; Berends, E.


    This is the fourth article in the series on cold chain food preservation, which describes the use of refrigeration in the food industry. Milestones were the building of cold chains for food distribution and new processes such as margarine and lager beer, and the scaling up of existing processes (e.g. for dairy, meat and fish products). By quick freezing, introduced by Clarence Birdseye in 1925, refrigeration can also be used for long term preservation of food products, as a powerful alternative for canning food. [Dutch] Dit vierde artikel in de reeks 'voedingsmiddelenconservering door koudeketens' completeert de beknopte historie van de voedingsmiddelenindustrie met een overzicht van het in gebruik nemen van de koelmachine. Mijlpalen zijn het ontstaan van koudeketens voor voedseldistributie en de nu mogelijk geworden nieuwe processen, de bereiding van pilsbier en margarine, de opschaling van bereidingsprocessen en het lange-afstandtransport van bederfelijke producten zoals zuivelproducten, vlees en vis. Door diepvriezen als methode aan te wenden, uitgevonden door Clarence Birdseye in 1925, kan koude ook worden gebruikt om voedingsmiddelen lang houdbaar te maken, een superieur alternatief voor inblikken van voedsel.

  15. Visual memory effects on intraoperator study design: determining a minimum time gap between case reviews to reduce recall bias. (United States)

    Campbell, W Scott; Talmon, Geoffrey A; Foster, Kirk W; Baker, John J; Smith, Lynette M; Hinrichs, Steven H


    The objective of this research was to determine test intervals between intraoperator case reviews to minimize the impact of recall. Three pathologists were presented with a group of 120 slides and subsequently challenged with a study set of 120 slides after 2-week and 4-week intervals. The challenge set consisted of 60 slides seen during the initial review and 60 slides previously unseen within the study. Pathologists rendered a diagnosis for each slide and indicated whether they recalled seeing the slide previously (yes/no). Two weeks after having been shown 60 cases from a challenge set of 120 cases, the pathologists correctly remembered 26, 22, and 24 cases or 40% overall. After 4 weeks, the pathologists correctly recalled 31% of cases previously seen. Pathologists were capable of recalling from memory cases seen previously at 2 and 4 weeks. Recall rates may be sufficiently high to affect intraobserver study design. Copyright© by the American Society for Clinical Pathology.

  16. Automated quantification of renal interstitial fibrosis for computer-aided diagnosis: A comprehensive tissue structure segmentation method. (United States)

    Tey, Wei Keat; Kuang, Ye Chow; Ooi, Melanie Po-Leen; Khoo, Joon Joon


    Interstitial fibrosis in renal biopsy samples is a scarring tissue structure that may be visually quantified by pathologists as an indicator to the presence and extent of chronic kidney disease. The standard method of quantification by visual evaluation presents reproducibility issues in the diagnoses. This study proposes an automated quantification system for measuring the amount of interstitial fibrosis in renal biopsy images as a consistent basis of comparison among pathologists. The system extracts and segments the renal tissue structures based on colour information and structural assumptions of the tissue structures. The regions in the biopsy representing the interstitial fibrosis are deduced through the elimination of non-interstitial fibrosis structures from the biopsy area and quantified as a percentage of the total area of the biopsy sample. A ground truth image dataset has been manually prepared by consulting an experienced pathologist for the validation of the segmentation algorithms. The results from experiments involving experienced pathologists have demonstrated a good correlation in quantification result between the automated system and the pathologists' visual evaluation. Experiments investigating the variability in pathologists also proved the automated quantification error rate to be on par with the average intra-observer variability in pathologists' quantification. Interstitial fibrosis in renal biopsy samples is a scarring tissue structure that may be visually quantified by pathologists as an indicator to the presence and extent of chronic kidney disease. The standard method of quantification by visual evaluation presents reproducibility issues in the diagnoses due to the uncertainties in human judgement. An automated quantification system for accurately measuring the amount of interstitial fibrosis in renal biopsy images is presented as a consistent basis of comparison among pathologists. The system identifies the renal tissue structures

  17. Remote Controlling and Monitoring of Microscopic Slides

    International Nuclear Information System (INIS)

    Mustafa, G.; Qadri, M.T.; Daraz, U.


    Remotely controlled microscopic slide was designed using especial Graphical User Interface (GUI) which interfaces the user at remote location with the real microscope using site and the user can easily view and control the slide present on the microscope's stage. Precise motors have been used to allow the movement in all the three dimensions required by a pathologist. The pathologist can easily access these slides from any remote location and so the physical presence of the pathologist is now made easy. This invention would increase the health care efficiency by reducing the time and cost of diagnosis, making it very easy to get the expert's opinion and supporting the pathologist to relocate himself for his work. The microscope is controlled with computer with an attractive Graphical User Interface (GUI), through which a pathologist can easily monitor, control and record the image of the slide. The pathologist can now do his work regardless of his location, time, cost and physically presence of lab equipment. The technology will help the specialist in viewing the patients slide from any location in the world. He would be able to monitor and control the stage. This will also help the pathological laboratories in getting opinion from senior pathologist who are present at any far location in the world. This system also reduces the life risks of the patients. (author)

  18. Health Information Systems. (United States)

    Sirintrapun, S Joseph; Artz, David R


    This article provides surgical pathologists an overview of health information systems (HISs): what they are, what they do, and how such systems relate to the practice of surgical pathology. Much of this article is dedicated to the electronic medical record. Information, in how it is captured, transmitted, and conveyed, drives the effectiveness of such electronic medical record functionalities. So critical is information from pathology in integrated clinical care that surgical pathologists are becoming gatekeepers of not only tissue but also information. Better understanding of HISs can empower surgical pathologists to become stakeholders who have an impact on the future direction of quality integrated clinical care. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Observer variability in the histologic assessment of oral premalignant lesions

    DEFF Research Database (Denmark)

    Karabulut, A.; Reibel, Jesper; Therkildsen, Marianne Hamilton


    Histopathologic examination of oral leukoplakias has a major impact on the assessment of prognosis and treatment planning. We investigated the extent of agreement in grading epithelial dysplasia between pathologists with the same or different educational backgrounds. Two general pathologists...... and two oral pathologists were each given 100 sections of oral leukoplakia to grade from no dysplasia to carcinoma in-situ. The interobserver agreement rates were in the range of 49% to 69%. The calculated kappa values were in the range of 27% to 45%, showing poor to moderate agreement between...

  20. 78 FR 75515 - Veterinary Feed Directive (United States)


    ... professionals, such as poultry pathologists and fish health biologists. The need for greater flexibility in a... fed ``top dressed'' on (added on top of usual ration) or offered ``free-choice'' (e.g., supplement) in...

  1. From professional monopoly to corporate oligopoly:the clinical laboratory industry in transition. (United States)

    Bailey, R M


    Until the mid-1960s the nonhospital clinical laboratory industry was dominated by pathologists. The ethics of medical professionalism protected the pathologists' market from price competition and from any serious threat from new entrants into the market. Immune from the competitive pressures of the marketplace, pathologists exerted monopoly control in local markets. That power was eroded by laboratories operated by technologists and bioanalysts and was finally overcome by the entry of large corporations into the industry. The market power of the largest corporate laboratories is now growing to a point where competition may again be thwarted. The professional ethics of pathologists allowed high prices, but there was little push toward higher volume. The commercial ethics of the corporate entrants brought lower prices but resulted in strong pressure for greater test quantities. In either case, the power wielded by the dominant producer would seem to go against the consumer's interests.

  2. Some reminiscences, some reflections

    International Nuclear Information System (INIS)

    Ganatra, R.D.


    Radioiodine therapy is considered to be one of the safest therapeutic procedures. Treatment of thyroid cancer is a multidisciplinary problem, where a surgeon, pathologist, nuclear medicine specialist, a health physicist and imaging experts come together to solve common clinical problems

  3. Hoarseness (United States)

    ... too low) when speaking Not using amplification when public speaking (microphone, megaphone) Benign Vocal Cord Lesions: Prolonged hoarseness ... language pathologists, and teachers of singing, acting, and public speaking. Vocal nodules, polyps, and cysts are typically treated ...

  4. 34 CFR 300.308 - Additional group members. (United States)


    ... examinations of children, such as a school psychologist, speech-language pathologist, or remedial reading... of his or her age; or (3) For a child of less than school age, an individual qualified by the SEA to...

  5. Etiology and Treatment of Developmental Stammering

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available The etiology and treatment of developmental stammering in childhood (DS, also called idiopathic stammering or stuttering are reviewed by a speech pathologist and psychologist at the University of Reading, UK.

  6. Aphasia vs. Apraxia (United States)

    ... After Stroke Inspirational Stories Stroke Heroes Among Us Aphasia vs. Apraxia Updated:Oct 24,2016 Excerpted from " ... treated by a speech-language pathologist. Read more Aphasia articles: Talking Tech: How technology helps survivors with ...

  7. Research and Theory

    African Journals Online (AJOL)


    work, and so limited receptivity to the idea of costing as an additional duty for administrators, ... and pathologists) at the conceptual and operational levels was facilitated by a nursing ..... for greater fiscal discipline has exacerbated this problem.

  8. Gland segmentation in colon histology images : The glas challenge contest

    NARCIS (Netherlands)

    Sirinukunwattana, Korsuk; Pluim, J.P.W.; Chen, Hao; Qi, Xiaojuan; Heng, Pheng Ann; Guo, Yun Bo; Wang, Li Yang; Matuszewski, Bogdan J.; Bruni, Elia; Sanchez, Urko; Böhm, Anton; Ronneberger, Olaf; Cheikh, Bassem Ben; Racoceanu, Daniel; Kainz, Philipp; Pfeiffer, Michael; Urschler, Martin; Snead, David R.J.; Rajpoot, Nasir M.


    Colorectal adenocarcinoma originating in intestinal glandular structures is the most common form of colon cancer. In clinical practice, the morphology of intestinal glands, including architectural appearance and glandular formation, is used by pathologists to inform prognosis and plan the treatment

  9. Stuttering and Tourette's Syndrome (United States)

    ... Adults Teachers Speech-Language Pathologists Physicians Employers Tweet Stuttering and Tourette's Syndrome Parents of Preschoolers Parents of ... to 3 people in 1000. Just as in stuttering, TS is more common in males than females ( ...

  10. The diagnostic value of immunohistochemically detected methylthioadenosine phosphorylase deficiency in malignant pleural mesotheliomas

    DEFF Research Database (Denmark)

    Zimling, Zarah Glad; Jørgensen, Anne; Santoni-Rugiu, Eric


      Malignant pleural mesothelioma (MPM) often causes diagnostic difficulties for pathologists. We assessed whether loss of methylthioadenosine phosphorylase (MTAP), a key enzyme in the intracellular recycling of adenosine triphosphate (ATP) often deleted in MPM, could be detected with immunohistoc...

  11. Evaluation of the Ramazzini Foundation Study of Methanol in Rats (United States)

    Evaluation of the Ramazzini Foundation Study of Methanol in Rats: A Comparison of Diagnoses by the RF Study Pathologist and a Recent NTP Review Team, summarized by George Cruzan and submitted to the Methanol Institute

  12. Sir James Paget: Paget's disease of the nipple, Paget's disease of bone. (United States)

    Ellis, Harold


    Sir James Paget was one of the 'great' Victorians. Eminent as a surgeon, pathologist and teacher, his nobility of character and application to his work made him a leader in his profession in that age of great men.

  13. Research

    African Journals Online (AJOL)



    Mar 11, 2011 ... The prevalence and pattern of HPV-16 immunostaining in uterine cervical carcinomas .... irregular vaginal bleeding or post coital bleeding. .... Dr MR and Dr AB equally contributed to the study, both are pathologists. Dr. AB ...

  14. Index of Glossary Terms (United States)

    ... analysis of blood cells (hematology), identification of microorganisms (microbiology), and the collection, preparation and use of blood for transfusion (transfusion medicine). Clinical pathologists direct the laboratories that perform these tests and provide consultation to other doctors on the ...

  15. Mitosis counting in breast cancer : object-level interobserver agreement and comparison to an automatic method

    NARCIS (Netherlands)

    Veta, M.; van Diest, P.J.; Jiwa, M.; Al-Janabi, S.; Pluim, J.P.W.


    BACKGROUND: Tumor proliferation speed, most commonly assessed by counting of mitotic figures in histological slide preparations, is an important biomarker for breast cancer. Although mitosis counting is routinely performed by pathologists, it is a tedious and subjective task with poor

  16. Mitosis Counting in Breast Cancer : Object-Level Interobserver Agreement and Comparison to an Automatic Method

    NARCIS (Netherlands)

    Veta, Mitko; van Diest, Paul J; Jiwa, Mehdi; Al-Janabi, Shaimaa; Pluim, JPW


    BACKGROUND: Tumor proliferation speed, most commonly assessed by counting of mitotic figures in histological slide preparations, is an important biomarker for breast cancer. Although mitosis counting is routinely performed by pathologists, it is a tedious and subjective task with poor

  17. Communicating and Collaborating for the Right Lab Test and Diagnosis

    Centers for Disease Control (CDC) Podcasts

    This podcast is a scenario-based skit between a clinical pathologist and primary care physician around the challenges in ordering clinical laboratory tests and offers solutions to optimizing the use of laboratory services for quality patient care.

  18. A “Pathology Explanation Clinic (PEC” for Patient-Centered Laboratory Medicine Test Results

    Directory of Open Access Journals (Sweden)

    Blake Gibson MD


    Full Text Available This concept paper addresses communication issues arising between physicians and their patients. To facilitate the communication of essential diagnostic pathology information to patients, and address their questions and concerns, we propose that “Pathology Explanation Clinics” be created. The Pathology Explanation Clinics would provide a channel for direct communications between pathologists and patients. Pathologists would receive special training as “Certified Pathologist Navigators” in preparation for this role. The goal of Pathology Explanation Clinics would be to help fill gaps in communication of information contained in laboratory reports to patients, further explain its relevance, and improve patient understanding of the meaning of such information and its impact on their health and health-care choices. Effort would be made to ensure that Certified Pathologist Navigators work within the overall coordination of care by the health-care team.

  19. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (EGPA) Consensus Task Force recommendations for evaluation and management

    NARCIS (Netherlands)

    Groh, Matthieu; Pagnoux, Christian; Baldini, Chiara; Bel, Elisabeth; Bottero, Paolo; Cottin, Vincent; Dalhoff, Klaus; Dunogué, Bertrand; Gross, Wolfgang; Holle, Julia; Humbert, Marc; Jayne, David; Jennette, J. Charles; Lazor, Romain; Mahr, Alfred; Merkel, Peter A.; Mouthon, Luc; Sinico, Renato Alberto; Specks, Ulrich; Vaglio, Augusto; Wechsler, Michael E.; Cordier, Jean-François; Guillevin, Loïc


    To develop disease-specific recommendations for the diagnosis and management of eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) (EGPA). The EGPA Consensus Task Force experts comprised 8 pulmonologists, 6 internists, 4 rheumatologists, 3 nephrologists, 1 pathologist and 1

  20. The use, publication and future directions of immunocytochemistry in veterinary medicine: a consensus of the Oncology-Pathology Working Group. (United States)

    Priest, H L; Hume, K R; Killick, D; Kozicki, A; Rizzo, V L; Seelig, D; Snyder, L A; Springer, N L; Wright, Z M; Robat, C


    One of the primary objectives of the Oncology Pathology Working Group (OPWG), a joint initiative of the Veterinary Cancer Society and the American College of Veterinary Pathologists, is for oncologists and pathologists to collaboratively generate consensus documents to standardize aspects of and provide guidelines for oncologic pathology. Consensus is established through review of relevant peer-reviewed literature relative to a subgroup's particular focus. In this document, the authors provide descriptions of the literature reviewed, the review process, and a summary of the information gathered on immunocytochemistry. The intent of this publication is to help educate practitioners and pathologists on the process of immunocytochemistry and to provide a guide for the use of this technique in veterinary medicine. This document represents the opinions of the working group and the authors and does not constitute a formal endorsement by the American College of Veterinary Pathologists or the Veterinary Cancer Society. © 2016 John Wiley & Sons Ltd.

  1. Reproducibility of current classifications of endometrial endometrioid glandular proliferations : further evidence supporting a simplified classification

    NARCIS (Netherlands)

    Ordi, Jaume; Bergeron, Christine; Hardisson, David; McCluggage, W. Glenn; Hollema, Harry; Felix, Ana; Soslow, Robert A.; Oliva, Esther; Tavassoli, Fattaneh A.; Alvarado-Cabrero, Isabel; Wells, Michael; Nogales, Francisco F.

    AimsTo compare the reproducibility of the current (2003) World Health Organization (WHO), endometrial intraepithelial neoplasia (EIN) and European Working Group (EWG) classifications of endometrial endometrioid proliferations. Methods and resultsNine expert gynaecological pathologists from Europe

  2. Pathology data integration with eXtensible Markup Language. (United States)

    Berman, Jules J


    It is impossible to overstate the importance of XML (eXtensible Markup Language) as a data organization tool. With XML, pathologists can annotate all of their data (clinical and anatomic) in a format that can transform every pathology report into a database, without compromising narrative structure. The purpose of this manuscript is to provide an overview of XML for pathologists. Examples will demonstrate how pathologists can use XML to annotate individual data elements and to structure reports in a common format that can be merged with other XML files or queried using standard XML tools. This manuscript gives pathologists a glimpse into how XML allows pathology data to be linked to other types of biomedical data and reduces our dependence on centralized proprietary databases.

  3. Use of a high resolution melt real-time polymerase chain reaction (PCR) assay for the environmental monitoring of Vibrio cholerae

    CSIR Research Space (South Africa)

    Le Rouw, Wouter J


    Full Text Available ATCC 9207 Shigella sonnei ATCC 9290 Enterococcus faecium ATCC 6569 Enterobacter aerogenes ATCC 13048 Klebsiella pneumoniae Vermaak and Partners Pathologists, S.A. Pseudomonas aeruginosa ATCC 27853 Staphylococcus aureus ATCC 25923 Proteus...

  4. Central Auditory Processing through the Looking Glass: A Critical Look at Diagnosis and Management. (United States)

    Young, Maxine L.


    The article examines the contributions of both audiologists and speech-language pathologists to the diagnosis and management of students with central auditory processing disorders and language impairments. (CL)

  5. Research and Evaluation in the Public Schools. (United States)

    Laney, Mary D.


    The article examines reasons for the lack of research being conducted by speech-language pathologists and audiologists in the public schools and points out advantages of that setting as a research site. (Author)

  6. Dr. Omalu Talks Childhood, Concussions, and CTE | Poster (United States)

    Dr. Bennet Omalu, the famed forensic pathologist who discovered Chronic Traumatic Encephalopathy (CTE), recently spoke at NCI at Frederick about his upbringing as well as the trials he faced while working to educate the NFL about CTE.

  7. Lynch syndrome-associated neoplasms

    DEFF Research Database (Denmark)

    Shia, Jinru; Holck, Susanne; Depetris, Giovanni


    It was a century ago that Warthin, a pathologist, first described the clinical condition now known as Lynch syndrome. One hundred years later, our understanding of this syndrome has advanced significantly. Much of the progress took place over the last 25 years and was marked by a series...... of interacting developments from the disciplines of clinical oncology, pathology, and molecular genetics, with each development serving to guide or enhance the next. The advancement of our understanding about the pathology of Lynch syndrome associated tumors exemplifies such intimate interplay among disciplines....... Today, accumulative knowledge has enabled surgical pathologists to detect tumors that are likely to be associated with Lynch syndrome, and the pathologist is playing an increasingly more important role in the care of these patients. The pathologist's ability is afforded primarily by information gained...

  8. Your Starting Guide To Childhood Apraxia of Speech (United States)

    ... To Help Ways to Give Be the Voice Corporate Sponsorship Shop to Help Events Calendar Educational Events ... including evaluation, speech therapy, research and other childhood communication topics. Invaluable for parents, speech language pathologists, teachers ...

  9. Nervous system (United States)

    Histopathology and immunohistochemistry are two analytic methods used in veterinary medicine for diagnosis and control of animal diseases. This book chapter provides specialized information for the veterinary pathologist and poultry veterinarians on the histopathological changes associated with dise...

  10. Exploring avenues for best use of cytotechnologists in non-gynaecological cytology: Double screening or independent sign-out. (United States)

    Fischer, G; Haddad, M; Cormier, K


    Cytotechnologist (CT) screening workload has been decreasing due to the falling number of Papanicolaou tests. This continuing trend has prompted exploration of ways to best employ the CT skillset. One potential way of more effective use is by having two CTs double screen non-gynaecological (NGC) cases to assess whether this improves screening quality and concordance with pathologists. Another is evaluating the CT's performance on low-complexity negative NGC cases for a potential independent CT sign-out without pathologist review. In total, 1119 NGC cases were reviewed; 577 screened by two CTs and 542 screened by one CT. All cases were signed out by a pathologist and all CT interpretations were compared to the pathologist final diagnoses. The disagreements were classified based on degree of discrepancy. The extra workload by adding the second screener was assessed. The agreement rate between the CT's screening interpretation and pathologist's interpretation did not improve by adding a second CT compared to a single screener (91.5% vs 92.9%, respectively). CT to pathologist concordance was very high on low complexity NGC cases (voided urine, fluid, sputum) whether screened and interpreted as negative by one CT (97.3%) or two CTs (99.3%). Double screening of NGC cases by two cytotechnologists prior to pathologist sign-out does not improve screening quality and is not cost-effective. The high concordance between the CTs and pathologists in this limited group of low complexity negative cases suggests that such cases could be signed out independently by cytotechnologists. © 2017 John Wiley & Sons Ltd.

  11. Being at the right place, at the right time, for the right reasons--plant pathology. (United States)

    Webster, Robert K


    This article relates some personal history and influences leading to becoming a plant pathologist. Next a summary of my research experiences on rice and barley diseases and the effect of regulatory changes on efforts to manage rice diseases in California. I conclude with an invitation to consider the opportunities and obligations of plant pathologists to return to the field and for individual introspection regarding attitudes and behavior toward colleagues and factors affecting our profession.

  12. Uppföljning av logopedisk behandling för patienter med träningsinducerad vocal cord dysfunction


    Hamberg, Lena; Karlsson, Sanna


    Abstract. Several treatment options are described for patients with vocal cord dysfunction. At Karolinska University hospital, these patients are offered treatment by speech and language pathologists. The current study describes traits and treatment effects for 148 people diagnosed with exercise-induced vocal cord dysfunction at Karolinska University hospital who received treatment by speech and language pathologists in 2005-2012. Data were collected from medical records and through a questi...

  13. Observer reliability in assessing placental maturity by histology.


    Khong, T Y; Staples, A; Bendon, R W; Chambers, H M; Gould, S J; Knowles, S; Shen-Schwarz, S


    AIMS--To evaluate the ability of five experienced perinatal pathologists to assess placental maturity reliably by histology. METHODS--Twenty four haematoxylin and eosin slides, six each from placentas of 27, 31, 35, and 39 weeks' gestation, were circulated to five pathologists on three separate occasions. The slides were labelled with the correct or incorrect gestational ages. RESULTS--The mean absolute error over all 360 readings was 2.72 weeks. Only 54% of the slides were assessed within tw...

  14. Gleason grading challenges in the diagnosis of prostate adenocarcinoma: experience of a single institution. (United States)

    Chen, Sonja D; Fava, Joseph L; Amin, Ali


    Gleason score (GS) is an important factor in determining management and outcome of prostate adenocarcinoma. A standard GS scheme was introduced by ISUP 2005 consensus conference, but there is still significant discordance in grading prostate adenocarcinomas among pathologists, especially between genitourinary-trained (GU) and non-GU pathologists. All biopsies from outside institutions referred for definitive treatment in our hospital are reviewed by a GU pathologist for confirmation and quality assurance. From 2011 to 2013, 117 consecutive prostate consults were retrieved and compared with the initial outside reports as well as final radical prostatectomy (RP) results. Follow-up prostate specific antigen (PSA) was assessed pre- and post-RP, and the results were analyzed. The overall initial GS was higher for all specimens (p = 0.007) especially for the RP cases (p = 0.002). Overall, the modal GS on initial diagnosis was GS7(4 + 3) that was downgraded to the modal GS6(3 + 3) upon review. Despite an overall substantial agreement between the non-GU and GU pathologists [ICC = 0.66], GS by GU pathologist had higher correlation with the final GS in the RP specimen [ICC = 0.62] than non-GU pathologist [ICC = 0.48]. GS on all reviewed cases were found to correlate significantly with the pre-operative PSA (p = 0.002) but the same was not true for the initial report. A non-GU pathologist is more likely to assign a higher GS than a GU pathologist, with a trend to overcall Gleason pattern 4. Considering the implications on treatment, close attention must be paid to the ISUP 2005 consensus conference recommendations.

  15. New Technologies: Real-time Telepathology Systems-Novel Cost-effective Tools for Real-time Consultation and Data Sharing. (United States)

    Siegel, Gabriel; Regelman, Dan; Maronpot, Robert; Rosenstock, Moti; Nyska, Abraham


    Real-time telepathology for use in investigative and regulated preclinical toxicology studies is now feasible. Newly developed microscope-integrated telepathology systems enable geographically remote stakeholders to view the live histopathology slide as seen by the study pathologist within the microscope. Simultaneous online viewing and dialog between study pathologist and remote colleagues is an efficient and cost-effective means for consultation, pathology working groups, and peer review, facilitating good science and economic benefits by enabling more timely and informed clinical decisions.

  16. Portable telepathology: methods and tools


    Alfaro, Luis; Roca, Ma José


    Abstract Telepathology is becoming easier to implement in most pathology departments. In fact e-mail image transmit can be done from almost any pathologist as a simplistic telepathology system. We tried to develop a way to improve capabilities of communication among pathologists with the idea that the system should be affordable for everybody. We took the premise that any pathology department would have microscopes and computers with Internet connection, and selected a few elements to convert...

  17. Stimulation of Central A1 Adenosine Receptors Suppresses Seizure and Neuropathology in a Soman Nerve Agent Seizure Rat Model (United States)


    implantation site, Nissl stained , and then analyzed by a trained pathologist to verify the accuracy of cannulae placement and evaluate toxicity. The second...transcardial perfusion and fixation, the brains were sectioned and stained with Nissl . A trained pathologist then analyzed the sections and verified that CPA...proto- col was used for assessing neuropathology in the subsequent soman seizure experiments. Those brains were serial sec- tioned at 5 mm, stained

  18. A "Network" and a "Dictum"

    DEFF Research Database (Denmark)

    Harder, Henrik


    safety and accessibility problems in the urban areas created by the car. The strong ideal shared by the people within the "network" were based on the dictum "forms follow function" about mans behaviour, the car and the structure of the urban areas and was based on very little empirical research. The use...... of the urban planning thoughts expressed as road planning principles indicated and supported a changing perception of the urban areas, although people in the "network" (Le Corbusier, F. and Clarence S. Stein, US) had very different ideas about how the urban ideal itself should be expressed. Basically......, the recommendation concerning traffic and specifically the car was the same, segregation. This shift in perception had spatial implications: Firstly through the recommendation of turning the individual urban (residential) areas inwards or upwards i.e. away from the car traffic on the streets. Secondly...

  19. Gambling on the Protestants: the Pathfinder Fund and birth control in Peru, 1958-1965. (United States)

    López, L Necochea


    Among the agencies involved in population control activities in the mid-twentieth century, none scored as many early victories in Latin America as did the Pathfinder Fund, founded by Procter & Gamble scion Clarence Gamble. This article analyzes a style in the delivery of family planning assistance in the developing world through the work of the Pathfinder Fund in Peru, the organization's hub in South America, and shows how Pathfinder personnel collaborated with local Protestant institutions. Its Protestant allies helped Pathfinder set up and manage rapid interventions such as the production of pamphlets, the smuggling of contraceptives, and the enrollment of physicians as advocates of the use of intrauterine devices. Although these rapid interventions helped quickly disseminate information and certain technologies among a fortunate few, they also weakened legitimate state agencies, neglected the monitoring of the safety of the drugs supplied, and alienated allies with their high-handed boldness.

  20. Helping to expand scientific knowledge

    International Nuclear Information System (INIS)


    Nuclear research has spread rapidly across practically all of the established sciences. It has been a dynamic and creative process in which the Agency has been able to play a constructive role. One of the methods has been the programme of research contracts. This has provided financial support for research involving some form of nuclear technology to physicists, chemists, medical doctors, hydrologists, entomologists, geneticists and scientists in many other disciplines. It is a system almost unique within the United Nations family, though the World Health Organization (WHO) also supports medical research under contract. An examination of the programme and its catalysing and co-ordinating effects in the expansion of scientific knowledge is made here by Clarence O'Neal, of the Division of Research and Laboratories. (author)

  1. Special Issue: Aspects of Game Theory and Institutional Economics

    Directory of Open Access Journals (Sweden)

    Wolfram Elsner


    Full Text Available Classical economists from Adam Smith to Thomas Malthus and to Karl Marx have considered the importance of direct interdependence and direct interactions for the economy. This was even more the case for original institutionalist thinkers such as Thorstein Veblen, John Commons, and Clarence Ayres. In their writings, direct interdependence, interactions (or transactions among agents, with all beneficial and with all problematic consequences, took center stage in economic analysis. Why, for instance, do people adhere to a particular new fashion or trend? Because others do, after eminent people, wealthy people, the “leisure class” (T. Veblen, have made it a symbol for status. The new fashion, however, ceases to serve as such a symbol once too many people follow it. The constant effort put into following trends and adopting fashion turns out to be a social dilemma, driven by Veblenian instincts, such as invidious distinction in predatory societies, conspicuous consumption and emulation. [...

  2. Environmental history

    DEFF Research Database (Denmark)

    Pawson, Eric; Christensen, Andreas Aagaard


    Environmental history is an interdisciplinary pursuit that has developed as a form of conscience to counter an increasingly powerful, forward-looking liberal theory of the environment. It deals with the relations between environmental ideas and materialities, from the work of the geographers George...... Perkins Marsh, Carl Sauer, and Clarence Glacken, to more recent global-scale assessments of the impact of the “great acceleration” since 1950. Today’s “runaway world” paradoxically embraces risk management in an attempt to determine its own future whilst generating a whole new category of “manufactured...... risks”. These are exposed by environmental history’s focus on long-run analysis and its narrative form that identifies the stories that we tell ourselves about nature. How a better understanding of past environmental transformations helps to analyse society and agency, and what this can mean...

  3. Digital pathology for the primary diagnosis of breast histopathological specimens: an innovative validation and concordance study on digital pathology validation and training. (United States)

    Williams, Bethany Jill; Hanby, Andrew; Millican-Slater, Rebecca; Nijhawan, Anju; Verghese, Eldo; Treanor, Darren


    To train and individually validate a group of breast pathologists in specialty-specific digital primary diagnosis by using a novel protocol endorsed by the Royal College of Pathologists' new guideline for digital pathology. The protocol allows early exposure to live digital reporting, in a risk-mitigated environment, and focuses on patient safety and professional development. Three specialty breast pathologists completed training in the use of a digital microscopy system, and were exposed to a training set of 20 challenging cases, designed to help them identify personal digital diagnostic pitfalls. Following this, the three pathologists viewed a total of 694 live, entire breast cases. All primary diagnoses were made on digital slides, with immediate glass slide review and reconciliation before final case sign-out. There was complete clinical concordance between the glass and digital impression of the case in 98.8% of cases. Only 1.2% of cases had a clinically significant difference in diagnosis/prognosis on glass and digital slide reads. All pathologists elected to continue using the digital microscope as the standard for breast histopathology specimens, with deferral to glass for a limited number of clinical/histological scenarios as a safety net. Individual training and validation for digital primary diagnosis allows pathologists to develop competence and confidence in their digital diagnostic skills, and aids safe and responsible transition from the light microscope to the digital microscope. © 2017 John Wiley & Sons Ltd.

  4. Image selection in static telepathology through the Internet. (United States)

    Della Mea, V; Cataldi, P; Boi, S; Finato, N; Della Palma, P; Beltrami, C A


    A telepathology study was carried out to examine the differences occurring when the images were selected by an experienced pathologist, a junior pathologist and a first-year resident. One hundred and fifty-five consecutive frozen-section pathology cases were collected and sent for consultation to a remote experienced pathologist using multimedia email. Local diagnoses (as reported in the files of the Institute, not from the image selector) and remote diagnoses (based on the images) were compared with those performed on paraffin-embedded sections. Acquisition time and number of selected images were recorded for each case and used to compare the different behaviour of the three local pathologists. Of the 155 cases sent by telepathology, four were considered insufficient for a diagnosis by the remote pathologist and thus the diagnosis was postponed. In the remaining 151 cases, the overall diagnostic agreement between remote and definitive diagnosis was 96.7%. The results indicate that in the routine diagnostic work of a frozen-section service, an inexperienced pathologist can select images which are sufficiently informative for a remote diagnosis, in a sufficiently short time.

  5. Current Australian speech-language pathology practice in addressing psychological well-being in people with aphasia after stroke. (United States)

    Sekhon, Jasvinder K; Douglas, Jacinta; Rose, Miranda L


    Psychological well-being is essential to overall health; however, there is a paucity of research on how to address psychological well-being in stroke survivors with aphasia. This study describes the current beliefs, attitudes and practices of Australian speech-language pathologists in addressing psychological well-being in people with aphasia after stroke. A 26-item web-based survey consisting of open and closed questions was distributed to Australian speech-language pathologists through four electronic databases. Australian speech-language pathologists (n = 111) utilized counselling and clinical approaches to address psychological well-being in people with post-stroke aphasia. The majority of speech-language pathologists did not feel comfortable with addressing psychological well-being in people with aphasia and sought support from other health professionals in this practice. Self-perception of being under-skilled was the main barrier identified to adequate practice in this domain, followed by inadequate time, inadequate staffing and people with aphasia declining referral to counselling. The main facilitators reported by speech-language pathologists to address psychological well-being included personal interest, personal and professional experience and availability of counselling health professionals for people with aphasia. There were small-to-medium statistically significant correlations between speech-language pathologists reporting additional training in counselling and perceived knowledge of, confidence in and satisfaction with managing psychological well-being in people with aphasia. This study identifies factors requiring attention in order to enable speech-language pathologists to facilitate improved psychological well-being in people with aphasia.

  6. Added value, decreased cost: the evolving role of the cytotechnologist for preliminary screening and triage of thyroid aspirates. (United States)

    Wotruba, Angelean L; Stewart, Jimmie; Scheberl, Thomas; Selvaggi, Suzanne M


    Immediate adequacy assessment for thyroid fine-needle aspirations (FNAs) is standard practice in many cytopathology laboratories. A pathologist is usually present for these time consuming assessments. The purpose of this 5 month study (January 2008-May 2008) was to show that cytotechnologists can accurately provide the majority of immediate adequacy assessments for thyroid FNAs, saving both time and money for pathologists, clinicians, and patients. The study consisted of 167 thyroid nodule FNAs performed in twice weekly thyroid FNA clinics. A comparison was made of the immediate assessments by five participating cytotechnologists and the preliminary and final diagnoses by three pathologists. The cytotechnologist prepared the slides, assessed the air-dried Hema-Diff™ stained slides for adequacy, and the pathologist viewed the slides remotely via real-time video streaming. Results were recorded in an Excel spreadsheet. There was a discordance rate of 1.2% when comparing the cytotechnologist's adequacy interpretation and the pathologist's preliminary diagnosis; both clinically insignificant. By cytotechnologist assessment, 79.0% of the cases were benign and 6.6% were nondiagnostic. 14.4% of the cases were assessed as cellular nodule or neoplastic lesion; all requiring pathologist's preliminary diagnosis. Utilizing a cytotechnologist to provide adequacy, instead of a pathologist, saved $464.10/case (2.38 passes/case) based on current gross technical and professional charges. On the basis of our findings, cytotechnologists can accurately provide immediate onsite adequacy assessments for thyroid nodule FNAs. Affording cytotechnologists the opportunity to preliminarily assess FNAs for adequacy also creates a new role in the laboratory. Furthermore, cost-savings are realized for patients and the health care system. Copyright © 2010 Wiley Periodicals, Inc.

  7. Residency choices by graduating medical students: why not pathology? (United States)

    Hung, Tawny; Jarvis-Selinger, Sandra; Ford, Jason C


    Pathology is an unpopular residency choice for medical students worldwide. In some countries, this has contributed to a crisis in pathologist human resources that has affected the quality of clinical laboratories. Several previous studies have used information from junior medical students and from residents to suggest ways of improving pathology recruitment. There are, however, no published studies of pathology residency choice that focus on the senior medical students who must be recruited. This study uses focus groups of senior medical students to explore both general and pathology-specific influences on residency choice. Several general influences are identified, including students' expectations for their future clinical practices, their own clinical rotation experiences, influences from other people including mentors, and their choice to reject certain fields. Several specific antipathology influences are also revealed, including negative stereotypes about pathologists, a perceived incompatibility of personality between most medical students (extroverted) and pathologists (introverted), and perceptions of pathologists as being in some ways nonmedical. The most important antipathology influence was that, from the students' perspective, pathology was utterly invisible in clinical practice. Most students did not consider and then reject a pathology residency: instead, pathology was completely ignored. Given the importance of clerkship electives in influencing medical student career choice, promoting clerkship experiences in pathology may improve recruitment. However, departments of pathology must first make pathology visible to students and teach them how pathologists contribute to clinical care. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. The flowering of pathology as a medical discipline in Boston, 1892-c.1950: W.T. Councilman, FB Mallory, JH Wright, SB Wolbach and their descendants. (United States)

    Louis, David N; O'Brien, Michael J; Young, Robert H


    During most of the nineteenth century, the discipline of pathology in Boston made substantial strides as a result of physicians and surgeons who practiced pathology on a part-time basis. The present essay tells the subsequent story, beginning in 1892, when full-time pathologists begin to staff the medical schools and hospitals of Boston. Three individuals from this era deserve special mention: William T Councilman, Frank Burr Mallory and James Homer Wright, with Councilman remembered primarily as a visionary and teacher, Mallory as a trainer of many pathologists, and Wright as a scientist. Together with S Burt Wolbach in the early-to-mid-twentieth century, these pathologists went on to train the next generation of pathologists-a generation that then populated the various hospitals that were developed in Boston in the early 1900s. This group of seminal pathologists in turn formed the diagnostically strong, academically productive, pathology departments that grew in Boston over the remainder of the twentieth century.

  9. Relevance of deep learning to facilitate the diagnosis of HER2 status in breast cancer (United States)

    Vandenberghe, Michel E.; Scott, Marietta L. J.; Scorer, Paul W.; Söderberg, Magnus; Balcerzak, Denis; Barker, Craig


    Tissue biomarker scoring by pathologists is central to defining the appropriate therapy for patients with cancer. Yet, inter-pathologist variability in the interpretation of ambiguous cases can affect diagnostic accuracy. Modern artificial intelligence methods such as deep learning have the potential to supplement pathologist expertise to ensure constant diagnostic accuracy. We developed a computational approach based on deep learning that automatically scores HER2, a biomarker that defines patient eligibility for anti-HER2 targeted therapies in breast cancer. In a cohort of 71 breast tumour resection samples, automated scoring showed a concordance of 83% with a pathologist. The twelve discordant cases were then independently reviewed, leading to a modification of diagnosis from initial pathologist assessment for eight cases. Diagnostic discordance was found to be largely caused by perceptual differences in assessing HER2 expression due to high HER2 staining heterogeneity. This study provides evidence that deep learning aided diagnosis can facilitate clinical decision making in breast cancer by identifying cases at high risk of misdiagnosis.

  10. An approach to peer review in forensic pathology. (United States)

    Sims, D Noel; Langlois, Neil E I; Byard, Roger W


    Peer review in forensic pathology has been a long time in evolution but may provide a very useful mechanism to check for, and to correct, errors, in addition to establishing an important educative vehicle for pathologists. A process is reported that has been established at our institution that involves both informal peer review in the mortuary and formal auditing of a set number of cases. Every autopsy case is discussed at a daily meeting of pathologists before a provisional cause of death is released. In addition, one in ten cases including all homicides, deaths in custody, suspicious and paediatric cases, and randomly selected additional cases undergo formal auditing by a second pathologist. Finally, administrative staff check the completed report. This formalized process, in a jurisdiction where autopsies are usually performed by only one pathologist, has been extremely useful in standardizing autopsy reports and in enabling pathologists to discuss cases and associated issues on a regular basis. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  11. The Prince Edward Island-Mayo Clinic connection: Malcolm B. Dockerty and Lewis B. Woolner. (United States)

    Wright, James R


    Malcolm B. Dockerty and Lewis B. Woolner, 2 preeminent mid-20th-century surgical pathologists, spent their entire careers at the Mayo Clinic. Both were raised in poverty on potato farms only 49 miles apart in Canada's smallest province (Prince Edward Island); both were educated in 1-room schools and graduated as gold medalists from Prince Edward Island's only college and then from Maritime Canada's only medical school; both then trained at the Mayo Clinic. To explore the lives and accomplishments of these 2 important surgical pathologists. Standard historiographic methods were used to explore primary and secondary historical sources. Both became world-renowned general surgical pathologists, one developing subspecialty expertise in gynecologic pathology and the other in cytopathology, pulmonary pathology, and thyroid/parathyroid pathology. Both were prolific authors with h-indices higher than 40, and between them, they published more than 750 peer-reviewed papers and book chapters. As educators, they trained hundreds of pathology and surgery residents/fellows who disseminated their knowledge around the world. Both were fascinated by poetry from childhood and could quote the classics from memory. One wrote poetry throughout his entire life and even used it to teach pathology and serve as his memoir; the other strongly preferred the classics and in jest called his colleague "a (minor) poet." Both received postretirement honorary doctorates from their alma maters. Dockerty died in 1987; Woolner celebrates his 100th birthday on November 17, 2013. Every pathologist should know of these 2 pioneering surgical pathologists.

  12. Pathology and medical malpractice. Academic and trainee empirical review of cases by State of Texas physicians. (United States)

    Allen, Timothy Craig; Stafford, Mehary; Liang, Bryan A


    This study examines whether the assumptions that pathologists understand the medical malpractice negligence rule and have a clear single standard of care are reasonable. Two hundred eighty-one Texas academic pathologists and trainees were presented 10 actual pathology malpractice cases from publicly available sources, representing the tort system's signal. Of the respondents, 55.52% were trainees, and 44.48% were pathology faculty. Only in two cases did more than 50% of respondents correctly identify the behavior of pathologists as defined by legal outcomes. In only half of the cases did more than 50% of pathologists concur with the jury verdict. This study provides further evidence that physicians do not understand the legal rule of negligence. Pathologists have a poor understanding of negligence and cannot accurately predict a jury verdict. There is significant divergence from the single standard of care assumption. Alternative methods to provide appropriate compensation and to establish physician accountability should be explored. Additional education about medical negligence is needed.

  13. Expectations and essentials for the community practice of pathology. (United States)

    Horowitz, Richard E


    In 3 surveys during the past 10 years, community hospital pathologists were asked what they want, need, or look for when employing a pathologist and, more specifically, what skills and knowledge a newly minted pathologist should have to be successful in the community practice of pathology. The most recent survey, done in spring of 2005, cited surgical pathology diagnosis, frozen section diagnosis, gross dissection, cytology, and fine-needle aspiration as essentials in anatomic pathology. For clinical pathology, knowledge of clinical medicine and test strategies that use the laboratory for clinical problem solving was paramount. New expectations in the latest survey were knowledge of molecular pathology and experience in quality assurance procedures. New pathologists generally meet the expectations of the community hospital workplace; however, there were some deficiencies: they were not proficient in gross pathology or autopsy pathology, they were slow, and many lack the clinical knowledge and experience to be effective consultants. The principal attribute that determines success in the practice of pathology, however, is skill in communication and interpersonal relations, and this remains the major deficiency of the fledgling pathologist.

  14. Incorporating pathology in the practice of infectious disease: myths and reality. (United States)

    Guarner, Jeannette


    The role pathology plays in establishing or excluding infectious diseases has been established. However, as the practice of pathology has become subspecialized, there is not enough infectious disease specimen volume to have a pathologist dedicated full time to this crosscutting subspecialty. So, what are the myths and realities of a practicing infectious disease pathologist in the hospital setting? Infectious disease clinicians tend to consult pathologists when there are questions regarding terminology used in pathology reports; when there is the need to perform additional studies on formalin-fixed, paraffin-embedded tissues; and when there is an interest in seeing biopsies or resections obtained from patients and in obtaining photographs for presentations. Pathologists consult infectious disease pathologists when there is a need to review diverse inflammatory reactions; for identification of fungi, parasites, or unknown structures; to define the need to use special stains and other techniques in order to identify organisms in tissues that have been formalin fixed; and to help with terminology to be used in reports. This review explores in more detail why and how these consultations occur. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:

  15. One foot in the furrow: implications to one's career in plant pathology. (United States)

    Mathre, D E


    Most of us want to be successful in what we do-either financially or programmatically. For me, being a good, well-respected plant pathologist is what motivated me throughout my professional career. After being trained as a plant pathologist at the University of California-Davis, an institution that prides itself in solving problems, I spent the majority of my career in population-sparse Montana-"the last best place." And best place it has been for me as I became involved in researching a number of plant disease problems and solving a few. J.C. Walker's philosophy of keeping "one foot in the furrow" has stood by me, and I encourage young plant pathologists to adopt it as well to ensure a productive and satisfying life in agricultural science.

  16. Interpretation of coagulation test results using a web-based reporting system. (United States)

    Quesada, Andres E; Jabcuga, Christine E; Nguyen, Alex; Wahed, Amer; Nedelcu, Elena; Nguyen, Andy N D


    Web-based synoptic reporting has been successfully integrated into diverse fields of pathology, improving efficiency and reducing typographic errors. Coagulation is a challenging field for practicing pathologists and pathologists-in-training alike. To develop a Web-based program that can expedite the generation of a individualized interpretive report for a variety of coagulation tests. We developed a Web-based synoptic reporting system composed of 119 coagulation report templates and 38 thromboelastography (TEG) report templates covering a wide range of findings. Our institution implemented this reporting system in July 2011; it is currently used by pathology residents and attending pathologists. Feedback from the users of these reports have been overwhelmingly positive. Surveys note the time saved and reduced errors. Our easily accessible, user-friendly, Web-based synoptic reporting system for coagulation is a valuable asset to our laboratory services. Copyright© by the American Society for Clinical Pathology (ASCP).

  17. Pathology Image-Sharing on Social Media: Recommendations for Protecting Privacy While Motivating Education. (United States)

    Crane, Genevieve M; Gardner, Jerad M


    There is a rising interest in the use of social media by pathologists. However, the use of pathology images on social media has been debated, particularly gross examination, autopsy, and dermatologic condition photographs. The immediacy of the interactions, increased interest from patients and patient groups, and fewer barriers to public discussion raise additional considerations to ensure patient privacy is protected. Yet these very features all add to the power of social media for educating other physicians and the nonmedical public about disease and for creating better understanding of the important role of pathologists in patient care. The professional and societal benefits are overwhelmingly positive, and we believe the potential for harm is minimal provided common sense and routine patient privacy principles are utilized. We lay out ethical and practical guidelines for pathologists who use social media professionally. © 2016 American Medical Association. All Rights Reserved.

  18. [Perception of health and safety risks among workers pathology laboratories]. (United States)

    Alvarado-Cabrero, Isabel; Valencia-Cedillo, Raquel


    Health care workers are experiencing increasing numbers of occupational illnesses. Safety practices in anatomical pathology laboratories (APL) are crucial to prevent unnecessary exposures to both chemical and biological agents. The main goal of this study was to determine if pathologists perceptions and actual practice mirror regulatory guidelines. Current available recommendations for APL were reviewed and used to construct an online survey distributed to pathologists. The survey was completed by 121 participants. Eighty-seven (72 %) of respondents reported receiving inadequate safety training. Most pathologists (82 %) were not well-informed about biosafety practices. Sixty-three (52 %) participants felt that the risks of chemical and infectious disease exposures in the APL were low. Most respondents reported having a needle stick or cut (71 %). Eighty-six (71 %) of participants reported musculo skeletal problems. This study indicated that there is a need for improving training in anatomical pathology safety practices in Mexican laboratories as daily practices do not reflected current guidelines.

  19. Cytological Punctures in the Diagnosis of Renal Tumours: A Study on Accuracy and Reproducibility

    DEFF Research Database (Denmark)

    Kümmerlin, Intan P E D; Smedts, Frank; ten Kate, Fiebo J W


    BACKGROUND: Fine needle aspiration (FNA) cytology is under consideration as an auxiliary preoperative diagnostic technique in the diagnosis of renal masses. However, reports for FNA are contradictory with regard to diagnostic accuracy and applicability. OBJECTIVE: To evaluate the diagnostic...... accuracy and reproducibility of FNA from renal masses. DESIGN: FNAs performed in-bench (hematoxylin and eosin [H&E] stains) from 66 consecutive renal tumours (58 malignant and 8 benign tumours) were presented twice with a 6-mo interval to five pathologists with little experience in renal cytology...... benignity. CONCLUSION: Despite the lack of experience in renal cytology, all pathologists showed a high diagnostic yield and good overall accuracy in distinguishing between malignant and benign tumours. Concordance in subtyping varied widely among pathologists and was reliable only for clear cell renal cell...

  20. Interobserver variability in the evaluation of mismatch repair protein immunostaining

    DEFF Research Database (Denmark)

    Klarskov, Louise Laurberg; Ladelund, Steen; Holck, Susanne


    Immunohistochemical staining for mismatch repair proteins has during recent years been established as a routine analysis in many pathology laboratories with the aim to identify tumors linked to the hereditary nonpolyposis colorectal cancer syndrome. Despite widespread application, data on reliabi......Immunohistochemical staining for mismatch repair proteins has during recent years been established as a routine analysis in many pathology laboratories with the aim to identify tumors linked to the hereditary nonpolyposis colorectal cancer syndrome. Despite widespread application, data...... on reliability are lacking. We therefore evaluated interobserver variability among 6 pathologists, 3 experienced gastrointestinal pathologists and 3 residents. In total, 225 immunohistochemically stained colorectal cancers were evaluated as having normal, weak, loss of, or nonevaluable mismatch repair protein...... variability was considerable, though experienced pathologists and residents reached the same level of consensus. Because results from immunohistochemical mismatch repair protein stainings are used for decisions on mutation analysis and as an aid in the interpretation of gene variants of unknown significance...

  1. Animal Abuse and Interpersonal Violence: The Cruelty Connection and Its Implications for Veterinary Pathology. (United States)

    Lockwood, R; Arkow, P


    The role of the veterinary forensic pathologist in the investigation of animal abuse or neglect can go beyond documenting the condition of animals presented as evidence. Although animal cruelty is a moral concern and a crime in itself, law enforcement response to such crimes is often enhanced by the recognition that crimes against animals can be both indicators of other ongoing crimes against people and predictors of the potential for interpersonal violence. An understanding of common motives underlying animal cruelty can aid the pathologist in asking appropriate questions. The authors review the forms of pathology evidence commonly seen in various presentations of animal cruelty. Understanding these forms of evidence can help the pathologist describe findings that can be significant for assessing the potential risks the alleged perpetrator may pose to other animals and humans. © The Author(s) 2016.

  2. The current and ideal state of anatomic pathology patient safety. (United States)

    Raab, Stephen Spencer


    An anatomic pathology diagnostic error may be secondary to a number of active and latent technical and/or cognitive components, which may occur anywhere along the total testing process in clinical and/or laboratory domains. For the pathologist interpretive steps of diagnosis, we examine Kahneman's framework of slow and fast thinking to explain different causes of error in precision (agreement) and in accuracy (truth). The pathologist cognitive diagnostic process involves image pattern recognition and a slow thinking error may be caused by the application of different rationally-constructed mental maps of image criteria/patterns by different pathologists. This type of error is partly related to a system failure in standardizing the application of these maps. A fast thinking error involves the flawed leap from image pattern to incorrect diagnosis. In the ideal state, anatomic pathology systems would target these cognitive error causes as well as the technical latent factors that lead to error.

  3. Developing and fostering a dynamic program for training in veterinary pathology and clinical pathology: veterinary students to post-graduate education. (United States)

    Lairmore, Michael D; Oglesbee, Michael; Weisbrode, Steve E; Wellman, Maxey; Rosol, Thomas; Stromberg, Paul


    Recent reports project a deficiency of veterinary pathologists, indicating a need to train highly qualified veterinary pathologists, particularly in academic veterinary medicine. The need to provide high-quality research training for veterinary pathologists has been recognized by the veterinary pathology training program of the Ohio State University (OSU) since its inception. The OSU program incorporates elements of both residency training and graduate education into a unified program. This review illustrates the components and structure of the training program and reflects on future challenges in training veterinary pathologists. Key elements of the OSU program include an experienced faculty, dedicated staff, and high-quality students who have a sense of common mission. The program is supported through cultural and infrastructure support. Financial compensation, limited research funding, and attractive work environments, including work-life balance, will undoubtedly continue to be forces in the marketplace for veterinary pathologists. To remain competitive and to expand the ability to train veterinary pathologists with research skills, programs must support strong faculty members, provide appropriate infrastructure support, and seek active partnerships with private industry to expand program opportunities. Shortages of trained faculty may be partially resolved by regional cooperation to share faculty expertise or through the use of communications technology to bridge distances between programs. To foster continued interest in academic careers, training programs will need to continue to evolve and respond to trainees' needs while maintaining strong allegiances to high-quality pathology training. Work-life balance, collegial environments that foster a culture of respect for veterinary pathology, and continued efforts to reach out to veterinary students to provide opportunities to learn about the diverse careers offered in veterinary pathology will pay long

  4. Validation of full-field optical coherence tomography in distinguishing malignant and benign tissue in resected pancreatic cancer specimens.

    Directory of Open Access Journals (Sweden)

    Labrinus van Manen

    Full Text Available Pancreatic cancer is the fourth leading cause of cancer-related mortality in the United States. The minority of patients can undergo curative-intended surgical therapy due to progressive disease stage at time of diagnosis. Nonetheless, tumor involvement of surgical margins is seen in up to 70% of resections, being a strong negative prognostic factor. Real-time intraoperative imaging modalities may aid surgeons to obtain tumor-free resection margins. Full-field optical coherence tomography (FF-OCT is a promising diagnostic tool using high-resolution white-light interference microscopy without tissue processing. Therefore, we composed an atlas of FF-OCT images of malignant and benign pancreatic tissue, and investigated the accuracy with which the pathologists could distinguish these.One hundred FF-OCT images were collected from specimens of 29 patients who underwent pancreatic resection for various indications between 2014 and 2016. One experienced gastrointestinal pathologist and one pathologist in training scored independently the FF-OCT images as malignant or benign blinded to the final pathology conclusion. Results were compared to those obtained with standard hematoxylin and eosin (H&E slides.Overall, combined test characteristics of both pathologists showed a sensitivity of 72%, specificity of 74%, positive predictive value of 69%, negative predictive value of 79% and an overall accuracy of 73%. In the subset of pancreatic ductal adenocarcinoma patients, 97% of the FF-OCT images (n = 35 were interpreted as tumor by at least one pathologist. Moreover, normal pancreatic tissue was recognised in all cases by at least one pathologist. However, atrophy and fibrosis, serous cystadenoma and neuroendocrine tumors were more often wrongly scored, in 63%, 100% and 25% respectively.FF-OCT could distinguish normal pancreatic tissue from pathologic pancreatic tissue in both processed as non-processed specimens using architectural features. The accuracy in

  5. The "demise" of diagnostic and research ocular pathology: temporary or forever? (United States)

    Apple, David J; Werner, Liliana; Mamalis, Nick; Olson, Randall J


    Several authorities have documented a significant decrease in support for modern eye pathology/pathology research laboratories. Indeed, many laboratories have closed or suffered marked cutbacks. The purpose of this report is to ask why this is so and to seek a possible means for reversing this trend. Observations from the senior author's experience and a case from author's facility are analyzed. There are several reasons for ocular pathologists' difficulties, such as financial problems, lack of vision, personality conflicts, and problems with the departmental administration. Until recently, most research and development in several subspecialty fields of ophthalmology, including biodevices research, has been done primarily by engineers and in-house workers in industry. This precludes proper independent, nonbiased control and guidance from academia. Most ocular pathologists have not participated in this relatively new and wide-open field. We suggest a new realm of activity for today's newly trained ocular pathologists. Based on personal experience of two decades of fruitful collaboration with industry, we believe that ocular pathologists are uniquely trained to apply their expertise to various new fields of research that most pathologists today have not utilized. An important example is research on clinicopathological aspects of implantable biodevices. In addition, support and oversight should be provided by the major ophthalmic societies, such as the American Academy of Ophthalmology, in order to retain (even regain) control over this field. This is mandatory in order to control the safety and efficacy of new drugs and devices being introduced almost daily. Only then can clear differentiation between profit and patient welfare be achieved as potentially dangerous devices and techniques are let loose on the market. The field of "routine, descriptive" eye pathology is severely wounded and will return only in an attenuated fashion. In general, full-time support for

  6. Automatic detection of mycobacterium tuberculosis using artificial intelligence (United States)

    Xiong, Yan; Ba, Xiaojun; Hou, Ao; Zhang, Kaiwen; Chen, Longsen


    Background Tuberculosis (TB) is a global issue that seriously endangers public health. Pathology is one of the most important means for diagnosing TB in clinical practice. To confirm TB as the diagnosis, finding specially stained TB bacilli under a microscope is critical. Because of the very small size and number of bacilli, it is a time-consuming and strenuous work even for experienced pathologists, and this strenuosity often leads to low detection rate and false diagnoses. We investigated the clinical efficacy of an artificial intelligence (AI)-assisted detection method for acid-fast stained TB bacillus. Methods We built a convolutional neural networks (CNN) model, named tuberculosis AI (TB-AI), specifically to recognize TB bacillus. The training set contains 45 samples, including 30 positive cases and 15 negative cases, where bacilli are labeled by human pathologists. Upon training the neural network model, 201 samples (108 positive cases and 93 negative cases) were collected as test set and used to examine TB-AI. We compared the diagnosis of TB-AI to the ground truth result provided by human pathologists, analyzed inconsistencies between AI and human, and adjusted the protocol accordingly. Trained TB-AI were run on the test data twice. Results Examined against the double confirmed diagnosis by pathologists both via microscopes and digital slides, TB-AI achieved 97.94% sensitivity and 83.65% specificity. Conclusions TB-AI can be a promising support system to detect stained TB bacilli and help make clinical decisions. It holds the potential to relieve the heavy workload of pathologists and decrease chances of missed diagnosis. Samples labeled as positive by TB-AI must be confirmed by pathologists, and those labeled as negative should be reviewed to make sure that the digital slides are qualified. PMID:29707349

  7. How does it feel to be a pathology resident? Results of a survey on experiences and job satisfaction during pathology residency. (United States)

    Pehlivanoglu, Burcin; Hassoy, Hur; Calle, Catarina; Dendooven, Amelie; Nalbantoglu, ILKe; Reshchikova, Lidiya; Gul, Gulen; Doganavsargil, Basak


    Residents' career choices and professional motivation can be affected from perception of their role and recognition within a medical team as well as their educational and workplace experiences. To evaluate pathology trainees' perceptions of their pathology residency, we conducted a 42-item survey via a web-based link questioning respondents' personal and institutional background, workplace, training conditions, and job satisfaction level. For the 208 residents from different European countries who responded, personal expectations in terms of quality of life (53%) and scientific excitement (52%) were the most common reasons why they chose and enjoy pathology. Sixty-six percent were satisfied about their relationship with other people working in their department, although excessive time spent on gross examination appeared less satisfactory. A set residency training program (core curriculum), a set annual scientific curriculum, and a residency program director existed in the program of 58, 60, and 69% respondents, respectively. Most respondents (76%) considered that pathologists have a direct and high impact on patient management, but only 32% agreed that pathologists cooperate with clinicians/surgeons adequately. Most (95%) found that patients barely know what pathologists do. Only 22% considered pathology and pathologists to be adequately positioned in their country's health care system. Almost 84% were happy to have chosen pathology, describing it as "puzzle solving," "a different fascinating world," and "challenging while being crucial for patient management." More than two thirds (72%) considered pathology and pathologists to face a bright future. However, a noticeable number of respondents commented on the need for better physical working conditions, a better organized training program, more interaction with experienced pathologists, and deeper knowledge on molecular pathology.

  8. Central pathology review with two-stage quality assurance for pathological response after neoadjuvant chemotherapy in the ARTemis Trial. (United States)

    Thomas, Jeremy St John; Provenzano, Elena; Hiller, Louise; Dunn, Janet; Blenkinsop, Clare; Grybowicz, Louise; Vallier, Anne-Laure; Gounaris, Ioannis; Abraham, Jean; Hughes-Davies, Luke; McAdam, Karen; Chan, Stephen; Ahmad, Rizvana; Hickish, Tamas; Houston, Stephen; Rea, Daniel; Caldas, Carlos; Bartlett, John Ms; Cameron, David Allan; Hayward, Richard Laurence; Earl, Helena Margaret


    The ARTemis Trial tested standard neoadjuvant chemotherapy±bevacizumab in the treatment of HER2-negative early breast cancer. We compare data from central pathology review with report review and also the reporting behavior of the two central pathologists. Eight hundred women with HER2-negative early invasive breast cancer were recruited. Response to chemotherapy was assessed from local pathology reports for pathological complete response in breast and axillary lymph nodes. Sections from the original core biopsy and surgical excision were centrally reviewed by one of two trial pathologists blinded to the local pathology reports. Pathologists recorded response to chemotherapy descriptively and also calculated residual cancer burden. 10% of cases were double-reported to compare the central pathologists' reporting behavior. Full sample retrieval was obtained for 681 of the 781 patients (87%) who underwent surgery within the trial and were evaluable for pathological complete response. Four hundred and eighty-three (71%) were assessed by JSJT, and 198 (29%) were assessed by EP. Residual cancer burden calculations were possible in 587/681 (86%) of the centrally reviewed patients, as 94/681 (14%) had positive sentinel nodes removed before neoadjuvant chemotherapy invalidating residual cancer burden scoring. Good concordance was found between the two pathologists for residual cancer burden classes within the 65-patient quality assurance exercise (kappa 0.63 (95% CI: 0.57-0.69)). Similar results were obtained for the between-treatment arm comparison both from the report review and the central pathology review. For pathological complete response, report review was as good as central pathology review but for minimal residual disease, report review overestimated the extent of residual disease. In the ARTemis Trial central pathology review added little in the determination of pathological complete response but had a role in evaluating low levels of residual disease. Calculation

  9. Automatic detection of mycobacterium tuberculosis using artificial intelligence. (United States)

    Xiong, Yan; Ba, Xiaojun; Hou, Ao; Zhang, Kaiwen; Chen, Longsen; Li, Ting


    Tuberculosis (TB) is a global issue that seriously endangers public health. Pathology is one of the most important means for diagnosing TB in clinical practice. To confirm TB as the diagnosis, finding specially stained TB bacilli under a microscope is critical. Because of the very small size and number of bacilli, it is a time-consuming and strenuous work even for experienced pathologists, and this strenuosity often leads to low detection rate and false diagnoses. We investigated the clinical efficacy of an artificial intelligence (AI)-assisted detection method for acid-fast stained TB bacillus. We built a convolutional neural networks (CNN) model, named tuberculosis AI (TB-AI), specifically to recognize TB bacillus. The training set contains 45 samples, including 30 positive cases and 15 negative cases, where bacilli are labeled by human pathologists. Upon training the neural network model, 201 samples (108 positive cases and 93 negative cases) were collected as test set and used to examine TB-AI. We compared the diagnosis of TB-AI to the ground truth result provided by human pathologists, analyzed inconsistencies between AI and human, and adjusted the protocol accordingly. Trained TB-AI were run on the test data twice. Examined against the double confirmed diagnosis by pathologists both via microscopes and digital slides, TB-AI achieved 97.94% sensitivity and 83.65% specificity. TB-AI can be a promising support system to detect stained TB bacilli and help make clinical decisions. It holds the potential to relieve the heavy workload of pathologists and decrease chances of missed diagnosis. Samples labeled as positive by TB-AI must be confirmed by pathologists, and those labeled as negative should be reviewed to make sure that the digital slides are qualified.

  10. Interobserver Variability in Scoring Liver Biopsies with a Diagnosis of Alcoholic Hepatitis. (United States)

    Horvath, Bela; Allende, Daniela; Xie, Hao; Guirguis, John; Jeung, Jennifer; Lapinski, James; Patil, Deepa; McCullough, Arthur J; Dasarathy, Srinivasan; Liu, Xiuli


    Alcoholic hepatitis (AH) is one of the most severe forms of alcoholic liver disease. Recently, a histologic scoring system for predicting prognosis in this patient cohort was proposed as Alcoholic Hepatitis Histologic Score (AHHS). We aimed to assess interobserver variability in recognizing histologic features of AH and the effect of this variability on the proposed AHHS categories. Hematoxylin-eosin- and trichrome-stained slides from 32 patients diagnosed with AH with liver biopsies within 1 month of presentation (2000 to 2015) were reviewed by 5 pathologists including 3 liver pathologists and 2 gastrointestinal (GI) pathologists masked to the clinical findings or outcome. Histologic features of AH were assessed, the AHHS was calculated, and an AHHS category (mild, moderate, severe) was assigned. The Fleiss' kappa coefficient (κ) analysis was performed to determine the interobserver agreement. A slight-to-moderate level of interobserver agreement existed among 5 reviewers on histopathologic features of AH with κ value ranging from 0.20 (95% confidence interval (CI): 0.03 to 0.46, megamitochondria) to 0.52 [95% CI: 0.40 to 0.68, polymorphonuclear leukocyte (PMN) infiltration]. There was only a fair level of agreement in assigning AHHS category (κ = 0.33, 95% CI: 0.20 to 0.51). While overall fibrosis and neutrophilic inflammation were comparably evaluated by 3 liver pathologists and 2 GI pathologists, bilirubinostasis and megamitochondria were more consistently diagnosed by liver pathologists. Overall, 18 of 32 (56%) were uniformly assigned to an AHHS category by all liver pathologists with a κ value of 0.40 (95% CI: 0.22 to 0.60). In general, features of AH can be recognized with a slight-to-moderate level of interobserver agreement and there was fair interobserver agreement on assigning an AHHS category. Significant interobserver variability among pathologists revealed by the current study can limit its usefulness in everyday clinical practice. Copyright

  11. Data Representation, Coding, and Communication Standards. (United States)

    Amin, Milon; Dhir, Rajiv


    The immense volume of cases signed out by surgical pathologists on a daily basis gives little time to think about exactly how data are stored. An understanding of the basics of data representation has implications that affect a pathologist's daily practice. This article covers the basics of data representation and its importance in the design of electronic medical record systems. Coding in surgical pathology is also discussed. Finally, a summary of communication standards in surgical pathology is presented, including suggested resources that establish standards for select aspects of pathology reporting. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. The World Report on Disability as a blueprint for international, national, and local aphasia services. (United States)

    Worrall, Linda E; Howe, Tami; O'Callaghan, Anna; Hill, Anne J; Rose, Miranda; Wallace, Sarah J; Rose, Tanya; Brown, Kyla; Power, Emma; O'Halloran, Robyn; Rohde, Alexia


    This commentary aims to extend the debate of the lead article authors (Wylie, McAllister, Davidson, and Marshall, 2013) by translating the nine recommendations of the World Report on Disability into a plan of action for the aphasia community. Solutions for the advancement of aphasia science and services are presented at international (macro), national (meso), and local (micro) levels. Implications for speech-language pathologists and aphasia service delivery are discussed. An overarching call to action is the need for speech-language pathologists to support a strong and vibrant aphasia community at all levels, so that the voices of people with aphasia can be heard.

  13. Diagnostic reproducibility of hydatidiform moles: ancillary techniques (p57 immunohistochemistry and molecular genotyping) improve morphologic diagnosis. (United States)

    Vang, Russell; Gupta, Mamta; Wu, Lee-Shu-Fune; Yemelyanova, Anna V; Kurman, Robert J; Murphy, Kathleen M; Descipio, Cheryl; Ronnett, Brigitte M


    Distinction of hydatidiform moles (HMs) from nonmolar specimens (NMs) and subclassification of HMs as complete hydatidiform moles (CHMs) and partial hydatidiform moles (PHMs) are important for clinical practice and investigational studies; yet, diagnosis based solely on morphology is affected by interobserver variability. Molecular genotyping can distinguish these entities by discerning androgenetic diploidy, diandric triploidy, and biparental diploidy to diagnose CHMs, PHMs, and NMs, respectively. Eighty genotyped cases (27 CHMs, 27 PHMs, and 26 NMs) were selected from a series of 200 potentially molar specimens previously diagnosed using p57 immunostaining and genotyping. Cases were classified by 3 gynecologic pathologists on the basis of H&E slides (masked to p57 immunostaining and genotyping results) into 1 of 3 categories (CHM, PHM, or NM) during 2 diagnostic rounds; a third round incorporating p57 immunostaining results was also conducted. Consensus diagnoses (those rendered by 2 of 3 pathologists) were determined. Genotyping results were used as the gold standard for assessing diagnostic performance. Sensitivity of a diagnosis of CHM ranged from 59% to 100% for individual pathologists and from 70% to 81% by consensus; specificity ranged from 91% to 96% for individuals and from 94% to 98% by consensus. Sensitivity of a diagnosis of PHM ranged from 56% to 93% for individual pathologists and from 70% to 78% by consensus; specificity ranged from 58% to 92% for individuals and from 74% to 85% by consensus. The percentage of correct classification of all cases by morphology ranged from 55% to 75% for individual pathologists and from 70% to 75% by consensus. The κ values for interobserver agreement ranged from 0.59 to 0.73 (moderate to good) for a diagnosis of CHM, from 0.15 to 0.43 (poor to moderate) for PHM, and from 0.13 to 0.42 (poor to moderate) for NM. The κ values for intraobserver agreement ranged from 0.44 to 0.67 (moderate to good). Addition of the p57

  14. Alternative careers in the laboratory re-engineering paradigm. (United States)

    Balis, U J


    The expanding and diverse opportunities offered by the information technology and biotechnology fields provides for many obvious and perhaps more not-so-obvious compelling opportunities for pathologists and clinical laboratorians. It can be reasonably expected that individuals who choose to pursue such careers outside the conventional opportunities sought out by most pathologists will be rewarded with the satisfaction that comes with the application of established science in new and challenging ways. The realization of the power of the multidisciplinary approach, both within academia and industry, will only serve to further foster opportunities and success stories for those who choose to sail off the edge of the known pathology world.

  15. Interobserver agreement of the injury diagnoses obtained by postmortem computed tomography of traffic fatality victims and a comparison with autopsy results

    DEFF Research Database (Denmark)

    Leth, Peter Mygind; Struckmann, Henrik; Lauritsen, Jens


    The present study investigated the interobserver variation between a radiologist and a forensic pathologist in 994 injury diagnoses obtained by postmortem computed tomography (CT) of 67 traffic fatality victims, and the results were compared with diagnoses obtained by autopsy. The injuries were...... system, but the pathologist diagnosed more organ injuries. We recommend the use of a radiologist as a consultant for the evaluation of postmortem CT images. Training in radiology should be included in forensic medicine postgraduate training. CT was superior to autopsy in detecting abnormal air...

  16. Vulva Fibroadenoma Associated with Lactating Adenoma in a 26-Year-Old Nigerian Female

    Directory of Open Access Journals (Sweden)

    C. C. Anunobi


    Full Text Available Background. Vulva lactating adenoma is rare and may be misdiagnosed as adenocarcinoma in frozen section and aspiration cytology if breast tissue is not anticipated. Objective. To raise the awareness of lactating vulva ectopic breast lesion among clinicians and pathologists. Case Report. We present a case of vulva fibroadenoma associated with lactating adenoma in a 26-year-old Nigerian female. Conclusion. The rarity of vulva ectopic breast tissue can present a diagnostic challenge for both the clinician and the anatomical pathologist. Once excisional biopsy is done and the lesion confirmed histologically, the anxious patient can be reassured.

  17. Diagnostic Assessment of Deep Learning Algorithms for Detection of Lymph Node Metastases in Women With Breast Cancer. (United States)

    Ehteshami Bejnordi, Babak; Veta, Mitko; Johannes van Diest, Paul; van Ginneken, Bram; Karssemeijer, Nico; Litjens, Geert; van der Laak, Jeroen A W M; Hermsen, Meyke; Manson, Quirine F; Balkenhol, Maschenka; Geessink, Oscar; Stathonikos, Nikolaos; van Dijk, Marcory Crf; Bult, Peter; Beca, Francisco; Beck, Andrew H; Wang, Dayong; Khosla, Aditya; Gargeya, Rishab; Irshad, Humayun; Zhong, Aoxiao; Dou, Qi; Li, Quanzheng; Chen, Hao; Lin, Huang-Jing; Heng, Pheng-Ann; Haß, Christian; Bruni, Elia; Wong, Quincy; Halici, Ugur; Öner, Mustafa Ümit; Cetin-Atalay, Rengul; Berseth, Matt; Khvatkov, Vitali; Vylegzhanin, Alexei; Kraus, Oren; Shaban, Muhammad; Rajpoot, Nasir; Awan, Ruqayya; Sirinukunwattana, Korsuk; Qaiser, Talha; Tsang, Yee-Wah; Tellez, David; Annuscheit, Jonas; Hufnagl, Peter; Valkonen, Mira; Kartasalo, Kimmo; Latonen, Leena; Ruusuvuori, Pekka; Liimatainen, Kaisa; Albarqouni, Shadi; Mungal, Bharti; George, Ami; Demirci, Stefanie; Navab, Nassir; Watanabe, Seiryo; Seno, Shigeto; Takenaka, Yoichi; Matsuda, Hideo; Ahmady Phoulady, Hady; Kovalev, Vassili; Kalinovsky, Alexander; Liauchuk, Vitali; Bueno, Gloria; Fernandez-Carrobles, M Milagro; Serrano, Ismael; Deniz, Oscar; Racoceanu, Daniel; Venâncio, Rui


    Application of deep learning algorithms to whole-slide pathology images can potentially improve diagnostic accuracy and efficiency. Assess the performance of automated deep learning algorithms at detecting metastases in hematoxylin and eosin-stained tissue sections of lymph nodes of women with breast cancer and compare it with pathologists' diagnoses in a diagnostic setting. Researcher challenge competition (CAMELYON16) to develop automated solutions for detecting lymph node metastases (November 2015-November 2016). A training data set of whole-slide images from 2 centers in the Netherlands with (n = 110) and without (n = 160) nodal metastases verified by immunohistochemical staining were provided to challenge participants to build algorithms. Algorithm performance was evaluated in an independent test set of 129 whole-slide images (49 with and 80 without metastases). The same test set of corresponding glass slides was also evaluated by a panel of 11 pathologists with time constraint (WTC) from the Netherlands to ascertain likelihood of nodal metastases for each slide in a flexible 2-hour session, simulating routine pathology workflow, and by 1 pathologist without time constraint (WOTC). Deep learning algorithms submitted as part of a challenge competition or pathologist interpretation. The presence of specific metastatic foci and the absence vs presence of lymph node metastasis in a slide or image using receiver operating characteristic curve analysis. The 11 pathologists participating in the simulation exercise rated their diagnostic confidence as definitely normal, probably normal, equivocal, probably tumor, or definitely tumor. The area under the receiver operating characteristic curve (AUC) for the algorithms ranged from 0.556 to 0.994. The top-performing algorithm achieved a lesion-level, true-positive fraction comparable with that of the pathologist WOTC (72.4% [95% CI, 64.3%-80.4%]) at a mean of 0.0125 false-positives per normal whole-slide image

  18. Rehabilitation of a patient with complete mandibulectomy and partial glossectomy

    International Nuclear Information System (INIS)

    Meyerson, M.D.; Johnson, B.H.; Weitzman, R.S.


    Following a number of radiologic and surgical procedures for the treatment of oral cancer, a patient with severe facial difigurement and alteration of the vocal tract acquired acceptable speech. Consultation among referring physicians and speech pathologists can aid such a patient by facilitating the rehabilitative process through improvement of communicative skills

  19. Daugiakalbių vaikų kalbos sutrikimų idetifikavimas ir logopedinės pagalbos būdai


    Cigaitė, Eglė; Ivoškuvienė, Regina; Makauskienė, Vilma


    The most important multilingualism cause is the increasing migration of the population. Multilingual children's primary language (mother's tongue), second, and foreign languages learning features, speech disorders, their recognition and overcoming methods activate researchers’, speech language pathologist practitioner’s attention. Psycholinguistic researches affirm that multilingualism is one of the most fundamental factors that positively impacts child’s language development and expands the ...

  20. Cartilaginous Choristoma of the Tonsil: Three Case Reports

    Directory of Open Access Journals (Sweden)

    Recep Bedir


    Conclusion:  Choristomas may cause difficulty in the differential diagnosis of true neoplasms, since they are rare and may grow. Therefore pathologists should be considered in the differential diagnosis of cartilaginous lesions, because cartilaginous choristomas of the tonsil are a rare entity.

  1. Integrating Family Capacity-Building and Child Outcomes to Support Social Communication Development in Young Children with Autism Spectrum Disorder (United States)

    Woods, Juliann J.; Brown, Jennifer A.


    The focus of this article is on the transactional relationship of research and practice for speech-language pathologists serving infants and toddlers with and at risk for autism spectrum disorder in Individuals with Disabilities Education Act supported early intervention. Specifically, information is provided on (a) the relationship between…

  2. Embryology, normal anatomy, and imaging techniques of the hyoid and larynx with respect to forensic purposes: a review article

    NARCIS (Netherlands)

    Soerdjbalie-Maikoe, Vidija; van Rijn, Rick R.


    Experiences with pre- and postmortem imaging in a forensic setting create more and more interest. If autopsy is permitted, forensic pathologists perform careful examination of the neck structures, which plays an important role as this is decisive in the diagnostics of compressive neck injury.

  3. Wood decay and the cleanup crew (United States)

    Kevin T. Smith; Jessie A. Glaeser


    Arborists are encouraged to recognize the wood-decay process as an important factor in tree health and public safety. Technical experts who develop training materials to recognize wood-decay processes in living trees are frequently forest pathologists. Much of the history of forest pathology was to support production of sound, high-quality timber. That heritage is...

  4. Use of Language Sample Analysis by School-Based SLPs: Results of a Nationwide Survey (United States)

    Pavelko, Stacey L.; Owens, Robert E., Jr.; Ireland, Marie; Hahs-Vaughn, Debbie L.


    Purpose: This article examines use of language sample analysis (LSA) by school-based speech-language pathologists (SLPs), including characteristics of language samples, methods of transcription and analysis, barriers to LSA use, and factors affecting LSA use, such as American Speech-Language-Hearing Association certification, number of years'…

  5. Tutorial: Assessment and Analysis of Polysyllables in Young Children (United States)

    Masso, Sarah; McLeod, Sharynne; Baker, Elise


    Purpose: Polysyllables, words of 3 or more syllables, represent almost 30% of words used in American English. The purpose of this tutorial is to support speech-language pathologists' (SLPs') assessment and analysis of polysyllables, extending the focus of published assessment tools that focus on sampling and analyzing children's segmental accuracy…

  6. A Procedure for the Computerized Analysis of Cleft Palate Speech Transcription (United States)

    Fitzsimons, David A.; Jones, David L.; Barton, Belinda; North, Kathryn N.


    The phonetic symbols used by speech-language pathologists to transcribe speech contain underlying hexadecimal values used by computers to correctly display and process transcription data. This study aimed to develop a procedure to utilise these values as the basis for subsequent computerized analysis of cleft palate speech. A computer keyboard…

  7. The untapped potential of digital pathology in prostate cancer ...

    African Journals Online (AJOL)

    Discussion: Digital pathology platforms could offer new solutions to the diagnostic and educational challenges facing pathologists practicing in Africa. For prostate cancer, they could provide several advantages including the assessment of biopsy cores, measurement of tumor volumes and second opinion consultation of ...

  8. Finding regions of interest in pathological images: an attentional model approach (United States)

    Gómez, Francisco; Villalón, Julio; Gutierrez, Ricardo; Romero, Eduardo


    This paper introduces an automated method for finding diagnostic regions-of-interest (RoIs) in histopathological images. This method is based on the cognitive process of visual selective attention that arises during a pathologist's image examination. Specifically, it emulates the first examination phase, which consists in a coarse search for tissue structures at a "low zoom" to separate the image into relevant regions.1 The pathologist's cognitive performance depends on inherent image visual cues - bottom-up information - and on acquired clinical medicine knowledge - top-down mechanisms -. Our pathologist's visual attention model integrates the latter two components. The selected bottom-up information includes local low level features such as intensity, color, orientation and texture information. Top-down information is related to the anatomical and pathological structures known by the expert. A coarse approximation to these structures is achieved by an oversegmentation algorithm, inspired by psychological grouping theories. The algorithm parameters are learned from an expert pathologist's segmentation. Top-down and bottom-up integration is achieved by calculating a unique index for each of the low level characteristics inside the region. Relevancy is estimated as a simple average of these indexes. Finally, a binary decision rule defines whether or not a region is interesting. The method was evaluated on a set of 49 images using a perceptually-weighted evaluation criterion, finding a quality gain of 3dB when comparing to a classical bottom-up model of attention.

  9. The Top 10 fungal pathogens in molecular plant pathology

    NARCIS (Netherlands)

    Dean, R.; Kan, van J.A.L.; Pretorius, Z.A.; Hammond-Kosack, K.E.; Pietro, Di A.; Spanu, P.D.; Rudd, J.J.; Dickman, M.; Kahmann, R.; Ellis, J.; Foster, G.D.


    The aim of this review was to survey all fungal pathologists with an association with the journal Molecular Plant Pathology and ask them to nominate which fungal pathogens they would place in a ‘Top 10’ based on scientific/economic importance. The survey generated 495 votes from the international

  10. Mining the gap: Assessing leadership needs to improve 21st century plant pathology (United States)

    Scientists and plant pathologists are trained in scientific knowledge and critical thinking as part of their career preparation process. However, the extensive training in science-related skills comes at a cost to “soft skills”, the competencies needed for interpersonal skills, communication, manage...

  11. Extension plant pathology: strengthening resources to continue serving the public interest. (United States)

    Everts, K L; Osborne, L; Gevens, A J; Vasquez, S J; Gugino, B K; Ivors, K; Harmon, C


    Extension plant pathologists deliver science-based information that protects the economic value of agricultural and horticultural crops in the United States by educating growers and the general public about plant diseases. Extension plant pathologists diagnose plant diseases and disorders, provide advice, and conduct applied research on local and regional plant disease problems. During the last century, extension plant pathology programs have adjusted to demographic shifts in the U.S. population and to changes in program funding. Extension programs are now more collaborative and more specialized in response to a highly educated clientele. Changes in federal and state budgets and policies have also reduced funding and shifted the source of funding of extension plant pathologists from formula funds towards specialized competitive grants. These competitive grants often favor national over local and regional plant disease issues and typically require a long lead time to secure funding. These changes coupled with a reduction in personnel pose a threat to extension plant pathology programs. Increasing demand for high-quality, unbiased information and the continued reduction in local, state, and federal funds is unsustainable and, if not abated, will lead to a delay in response to emerging diseases, reduce crop yields, increase economic losses, and place U.S. agriculture at a global competitive disadvantage. In this letter, we outline four recommendations to strengthen the role and resources of extension plant pathologists as they guide our nation's food, feed, fuel, fiber, and ornamental producers into an era of increasing technological complexity and global competitiveness.

  12. AECVP and SCVP 2009 recommendations for training in cardiovascular pathology

    NARCIS (Netherlands)

    Thiene, Gaetano; Veinot, John P.; Angelini, Annalisa; Baandrup, Ulrik T.; Basso, Cristina; Bruneval, Patrick; Buja, L. Maximilian; Butany, Jagdish; d'Amati, Giulia; de Gouveia, Rosa H.; Fallon, John T.; Fishbein, Michael C.; Gallagher, Patrick J.; Kholova, Ivana; Leone, Ornella; McManus, Bruce; Rodriguez, E. René; Schoen, Frederick J.; Sheppard, Mary N.; Stone, James R.; van der Wal, Allard C.; Winters, Gayle L.


    Cardiovascular disease is of continuing importance as the result of a growing burden of risk factors in both developing and developed countries and the increasing number of elderly people worldwide. The recruitment and training of a new generation of Cardiovascular Pathologists is crucial to

  13. An Investigation of the Efficacy of Direct and Indirect AAC Service Provision via Telepractice (United States)

    Hall, Nerissa C.


    There is a growing population of individuals using Augmentative and Alternative Communication (AAC) in need of evidence-based intervention from highly qualified personnel. However, not all speech pathology programs offer AAC coursework and/or practicum opportunities, and practicing speech-language pathologists (SLPs) report low levels of…

  14. Counseling and Aphasia Treatment: Missed Opportunities (United States)

    Simmons-Mackie, Nina; Damico, Jack S.


    During clinical interactions between speech-language pathologists and adults with aphasia, a variety of emotional issues arise. The literature suggests that while counseling is within the scope of practice, SLPs tend to avoid emotional issues in therapy (A. Holland, 2007a). The precise mechanisms employed for circumventing emotional issues in…

  15. What is current practice in soft tissue sarcoma grading?

    International Nuclear Information System (INIS)

    Golouh, R.; Bracko, M.


    Purpose. Most published grading systems of soft tissue sarcomas (STS) are somewhat subjective and it seems that there is no definite consensus among experts which of them is the most effective. The aim of this study was to collect data from practicing pathologists and to get some insight in the practice of STS grading. Subjects. A questionnaire was sent to 135 pathologists chosen randomly. Results. There were 88 responders from 30 countries from 5 continents. Most responders (85%) grade STS, more frequently in Europe than in non-European countries. Three-grade system is preferred by both European and non-European pathologists, who use it in almost 77% and 67%, respectively. They apply the criteria set by FNCLCC in 37.3%, by NCI in 24%, by Broders in 12% and by Markhede in 1.4%. In Europe, FNCLCC system is the most widely used. Beside classical histological criteria, other modern methods are applied by more than one half of the responders. Immunohistochemical evaluation of proliferation markers is the method most widely used, followed by molecular markers and DNA flow cytometry. Conclusion. The results of our study indicate that most pathologists consider histologic grade of STS as a valuable, however not completely satisfactory predictor of a patient's survival. (author)

  16. Vulvar mucinous adenocarcinoma with neuroendocrine differentiation: A case report and review of the literature

    NARCIS (Netherlands)

    Rosmalen, M.H. Van; Reijnen, C.; Boll, D.; Pijnenborg, J.M.A.; Wurff, A.A. van der; Piek, J.M.


    BACKGROUND: There are limited cases in literature of patients with mucinous adenocarcinoma of the vulva with neuroendocrine differentiation have. With this new case, we aim to provide an overview of the existing literature and present a tool with relevant markers for the pathologist in the

  17. Multidisciplinary management of hypohydrotic ectodermal dysplasia – a case report (United States)

    Joseph, Suja; Cherackal, George J; Jacob, Jose; Varghese, Alex K


    Key Clinical Message Hypohydrotic ectodermal dysplasia is a hereditary disorder, which affects ectodermal derivatives. It manifests several abnormalities of the teeth, and is commonly inherited through female carriers. This case report presents a patient with compromised esthetics and function. A multidisciplinary approach was planned involving an oral pathologist, endodontist, orthodontist and a prosthodontist. PMID:25984305

  18. Integrating Speech-Language Pathology Services in Palliative End-of-Life Care (United States)

    Pollens, Robin D.


    Clinical speech-language pathologists (SLPs) may receive referrals to consult with teams serving patients who have a severe and/or terminal disease. Palliative care focuses on the prevention or relief of suffering to maximize quality of life for these patients and their families. This article describes how the role of the SLP in palliative care…

  19. Cutting out the middleman: measuring nuclear area in histopathology slides without segmentation

    NARCIS (Netherlands)

    Veta, M.; van Diest, P.J.; Pluim, J.P.W.


    The size of nuclei in histological preparations from excised breast tumors is predictive of patient outcome (large nuclei indicate poor outcome). Pathologists take into account nuclear size when performing breast cancer grading. In addition,the mean nuclear area (MNA) has been shown to have

  20. Cutting out the middleman : Measuring nuclear area in histopathology slides without segmentation

    NARCIS (Netherlands)

    Veta, Mitko; Van Diest, Paul J.; Pluim, Josien P W


    The size of nuclei in histological preparations from excised breast tumors is predictive of patient outcome (large nuclei indicate poor outcome). Pathologists take into account nuclear size when performing breast cancer grading. In addition,the mean nuclear area (MNA) has been shown to have

  1. Exudative lesions of Reinke's space : a terminology proposal

    NARCIS (Netherlands)

    Hantzakos, A.; Remacle, M.; Dikkers, F. G.; Degols, J. -C.; Delos, M.; Friedrich, G.; Giovanni, A.; Rasmussen, N.

    There has been an ongoing confusion among pathologists in their attempt to accurately identify lesions of Reinke's space. Nodules, polyps and Reinke's edema fall in the same basket and differentiation between them relies largely on the clinical description of the pathologic specimen by the operating

  2. 42 CFR 431.54 - Exceptions to certain State plan requirements. (United States)


    ... 1915(g) of the Act provides that a State may provide, as medical assistance, targeted case management... requirement by the College of American Pathologists. (Hospital and physician laboratories may participate in... reasonable period of time to obtain Medicaid services from designated providers only. The agency may impose...

  3. Parent Perceptions of the Impact of Stuttering on Their Preschoolers and Themselves (United States)

    Langevin, Marilyn; Packman, Ann; Onslow, Mark


    Speech-language pathologists (SLPs) are advised to consider the distress of preschoolers and parents along with the social consequences of the child's stuttering when deciding whether to begin or delay treatment. Seventy-seven parents completed a survey that yielded quantitative and qualitative data that reflected their perceptions of the impact…

  4. Safety Behaviors and Stuttering (United States)

    Lowe, Robyn; Helgadottir, Fjola; Menzies, Ross; Heard, Rob; O'Brian, Sue; Packman, Ann; Onslow, Mark


    Purpose: Those who are socially anxious may use safety behaviors during feared social interactions to prevent negative outcomes. Safety behaviors are associated with anxiety maintenance and poorer treatment outcomes because they prevent fear extinction. Social anxiety disorder is often comorbid with stuttering. Speech pathologists reported in a…

  5. Characteristics of Young Children Close to the Onset of Stuttering (United States)

    Cavenagh, Penny; Costelloe, Sarah; Davis, Steve; Howell, Peter


    Five factors (gender, handedness, some aspects of general health, family history, and intelligence) that could assist speech-language pathologists in identification of children who stutter (CWS) in 42 CWS and 34 fluent control children (children who do not stutter [CWNS]) were investigated. The data reported here were obtained from assessments…

  6. A Diagnostic Approach for Rodent Progressive Cardiomyopathy and Like Lesions in Toxicology Studies up to 28 Days in the Sprague Dawley Rat (Part 2 of 2). (United States)

    Hailey, James R; Maleeff, Beverly E; Thomas, Heath C; Pearse, Gail; Klapwijk, Jan C; Cristofori, Patrizia G; Berridge, Brian; Kimbrough, Carie L; Parker, George A; Morton, Daniel; Elmore, Susan; Hardisty, Jerry F; Dybdal, Noel O; Rehagen, David A; Fikes, James D; Lamb, Martin; Biddle, Kathleen; Buetow, Bernard S; Carreira, Vinicius; Nyska, Abraham; Tripathi, Niraj K; Workman, Heather C; Bienvenu, Jean-Guy; Brees, Ingrid; Turk, James R; Adler, Rick R


    To test the diagnostic approach described in part 1 of this article, 2 exercises were completed by pathologists from multiple companies/agencies. Pathologist's examination of whole slide image (WSI) heart sections from rats using personal diagnostic approaches (exercise #1) corroborated conclusions from study #1. Using the diagnostic approach described in part 1, these pathologists examined the same WSI heart sections (exercise #2) to determine whether that approach increased consistency of diagnosis of rodent progressive cardiomyopathy (PCM) lesions. In exercise #2, there was improved consistency of categorization of small borderline morphologies and mild lesions, but a decrement in consistency of categorizing minimal lesions. Exercises 1 and 2 suggest the described diagnostic approach is representative of that in use by the majority of toxicologic pathologists across companies/agencies and that application by all may improve diagnostic consistency of PCM/like lesions. Additionally, a criterion of approximately 5% heart section involvement is suggested for separating mild from moderate or greater severity. While evidence is not absolute, until further investigation shows otherwise, microscopic changes resembling PCM, but located in the epicardial and subepicardial region of the right ventricle, may be considered as part of the spectrum of PCM.

  7. A Conceptual Framework for Responsive Global Engagement in Communication Sciences and Disorders (United States)

    Hyter, Yvette D.


    The field of speech-language pathology needs a conceptual framework to guide the provision of services in a globalized world. Proposed in this article is a conceptual framework designed to facilitate responsive global engagement for professionals such as speech-language pathologists, who are increasingly serving diverse populations around the…

  8. The Teaching of Reading, Writing and Language in a Clinical Speech and Language Setting: A Blended Therapy Intervention Approach (United States)

    Ammons, Kerrie Allen


    With a growing body of research that supports a link between language and literacy, governing bodies in the field of speech and language pathology have recognized the need to reconsider the role of speech-language pathologists in addressing the emergent literacy needs of preschoolers who struggle with literacy and language concepts. This study…

  9. The Sociolinguistic Model in Speech and Language Pathology. (United States)

    Wolfram, Walt

    A discussion of the role of sociolinguistics in the treatment of communication disorders focuses on issues related to dialect and language variation. It begins with an examination of linguistic diversity and dynamic description of language, reporting on a study of speech and language pathologists' judgments of sentences in African American…

  10. Clinical Linguistics--Retrospect and Prospect. (United States)

    Grunwell, Pamela

    In the past 20 years, linguistics has gained a prominent position in speech and language pathology in Britain, evolving into a new field, clinical linguistics. It includes three related areas of activity: training of speech pathologists/therapists; professional practice; and research. Linguistics and speech/language pathology have developed as…

  11. 'I do the best I can': an in-depth exploration of the aphasia management pathway in the acute hospital setting. (United States)

    Foster, Abby M; Worrall, Linda E; Rose, Miranda L; O'Halloran, Robyn


    While research has begun to explore the management of aphasia across the continuum of care, to date there is little in-depth, context specific knowledge relating to the speech pathology aphasia management pathway. This research aimed to provide an in-depth understanding of the current aphasia management pathway in the acute hospital setting, from the perspective of speech pathologists. Underpinned by a social constructivist paradigm, the researchers implemented an interpretive phenomenological method when conducting in-depth interviews with 14 Australian speech pathologists working in the acute hospital setting. Interview transcripts and interviewer field notes were subjected to a qualitative content analysis. Analysis identified a single guiding construct and five main categories to describe the management of aphasia in the acute hospital setting. The guiding construct, First contact with the profession, informed the entire management pathway. Five additional main categories were identified: Referral processes; Screening and assessment; Therapeutic intervention; Educational and affective counselling; and Advocacy. Findings suggest significant diversity in the pathways of care for people with aphasia and their families in the acute hospital setting. Additional support mechanisms are required in order to support speech pathologists to minimise the evidence-practice gap. Implications for Rehabilitation Significant diversity exists in the current aphasia management pathway for people with acute post-stroke aphasia and their families in the acute hospital setting. Mechanisms that support speech pathologists to minimise the evidence-practice gap, and consequently reduce their sense of professional dissonance, are required.

  12. A Survey of Speech and Language Pathology Services for Down's Syndrome: State of the Art. (United States)

    Kumin, Libby


    This article summarizes current trends in speech and language pathology services to individuals with Down's syndrome. Speech and language pathologists (N=112) responded to a survey identifying widely used assessment instruments, therapy materials, sources of information, and needs in relation to services at five age levels. (Author/DB)

  13. Therapy Talk: Analyzing Therapeutic Discourse (United States)

    Leahy, Margaret M.


    Therapeutic discourse is the talk-in-interaction that represents the social practice between clinician and client. This article invites speech-language pathologists to apply their knowledge of language to analyzing therapy talk and to learn how talking practices shape clinical roles and identities. A range of qualitative research approaches,…

  14. How to read a pathology report of a bone tumor

    International Nuclear Information System (INIS)

    Guinebretière, Jean-Marc; Kreshak, Jennifer; Suciu, Voichita; Maulmont, Charles De; Mascard, Eric; Missenard, Gilles; Larousserie, Frederique; Vanel, Daniel


    The interpretation of a biopsy specimen involving bone is one of the most challenging feats for a pathologist, as it is often difficult to distinguish between benign or reactive lesions and malignant tumors on microscopic analysis. Therefore, correlation with the clinical data and imaging is essential and sometimes it is only the evolution of certain characteristics over time or information garnered from molecular analysis that can provide an accurate diagnosis. The pathology report is critical in that it will define subsequent patient management; its wording must precisely reflect those elements that are known with certainty and those that are diagnostic hypotheses. It must be systematic, thorough, and complete and should not be limited to a simple conclusion. The pathologist must first ensure the completeness and correct transcription of the information provided with the specimen, then describe and analyze the histology as well as the quality and representative nature of the sample (as they relate to the radiographic findings and preliminary/final diagnoses), and finally, compare what is seen under the microscope with the assessment made by the radiologist and/or surgeon. This analysis helps to identify difficult cases requiring further consultation between the radiologist and pathologist. There are multiple reasons for misinterpretation of a pathology report. An important and largely underestimated reason is varied interpretations of terms used by the pathologist. Standardized pathology reports with concise phrases as well as multidisciplinary meetings may limit errors and should be encouraged for optimal diagnostic accuracy

  15. Renal replacement lipomatosis and xanthogranulomatous pyelonephritis: differential diagnosis

    International Nuclear Information System (INIS)

    Romero, Frederico R.; Pilati, Roberto; Brenny Filho, Thadeu; Caboclo, Maria Fernanda Sales Ferreira; Silva, Antonio de Padua Gomes; Cravo, Marco Aurelio


    Renal replacement lipomatosis (RRL) is a relatively uncommon entity, although misdiagnosis - mainly with xanthogranulomatous pyelonephritis (XGP) - due to lack of awareness by urologists, radiologists, and pathologists may be responsible for underreporting. We illustrate a case of RRL that was initially misdiagnosed as XGP, and compare it with a classic case of XGP, underscoring the similarities and the differences between them. (author)

  16. Renal replacement lipomatosis and xanthogranulomatous pyelonephritis: differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Romero, Frederico R. [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil); Pilati, Roberto; Brenny Filho, Thadeu; Caboclo, Maria Fernanda Sales Ferreira [Hospital Sao Vicente de Curitiba, PR (Brazil); Silva, Antonio de Padua Gomes [Centro de Citopatologia Parana Ltda. (Citopar), Curitiba, PR (Brazil); Cravo, Marco Aurelio [Laboratorio de Patologia e Citologia (Consulpat), Curitiba, PR (Brazil)


    Renal replacement lipomatosis (RRL) is a relatively uncommon entity, although misdiagnosis - mainly with xanthogranulomatous pyelonephritis (XGP) - due to lack of awareness by urologists, radiologists, and pathologists may be responsible for underreporting. We illustrate a case of RRL that was initially misdiagnosed as XGP, and compare it with a classic case of XGP, underscoring the similarities and the differences between them. (author)

  17. The Use of Direct Spelling Instruction for Children with Language Impairment (United States)

    Good, Joy E.; Lance, Dee M.; Rainey, Jacquie


    Children with language impairment frequently struggle with written language skills such as spelling. With their expertise in language, speech-language pathologists are in the position to promote the development of such skills. One way to do this is through the use of direct spelling instruction which has been shown to facilitate growth in a number…

  18. Automated Speech Rate Measurement in Dysarthria (United States)

    Martens, Heidi; Dekens, Tomas; Van Nuffelen, Gwen; Latacz, Lukas; Verhelst, Werner; De Bodt, Marc


    Purpose: In this study, a new algorithm for automated determination of speech rate (SR) in dysarthric speech is evaluated. We investigated how reliably the algorithm calculates the SR of dysarthric speech samples when compared with calculation performed by speech-language pathologists. Method: The new algorithm was trained and tested using Dutch…

  19. Aspects of ecological radiation endocrinology and occupational pathology

    International Nuclear Information System (INIS)

    Ajtbembetov, B.M.


    The collection consists of works on radiation endocrinology and occupational pathology in different branches of industry - petroleum, mining, cotton, non-ferrous metallurgy as well as agriculture. Collection is intended for endocrinologists and occupational pathologists, for specialists of labour protection and occupational safety, for doctors examining of industrial and agricultural workers (author)

  20. Forest nursery pests (United States)

    Michelle M. Cram; Michelle S. Frank; Katy M. Mallams


    This edition of Forest Nursery Pests, Agriculture Handbook No. 680, was made possible by the work of many people from around the country. Contributing authors include U.S. Department of Agriculture, Forest Service and Agricultural Research Service entomologists and pathologists, university professors and researchers, State extension specialists, consultants, and plant...

  1. Language Assessment of Latino English Learning Children: A Records Abstraction Study (United States)

    Kraemer, Robert; Fabiano-Smith, Leah


    The researchers examined how speech-language pathologists (SLPs) in a small northern California school district assessed Spanish speaking English learning (EL) Latino children suspected of language impairments. Specifically we sought to (1) determine whether SLPs adhered to federal, state, and professional guidelines during initial assessments and…

  2. Sequence Text Structure Intervention during Interactive Book Reading of Expository Picture Books with Preschool Children with Language Impairment (United States)

    Breit-Smith, Allison; Olszewski, Arnold; Swoboda, Christopher; Guo, Ying; Prendeville, Jo-Anne


    This study explores the outcomes of an interactive book reading intervention featuring expository picture books. This small-group intervention was delivered by four practitioners (two early childhood special education teachers and two speech-language pathologists) three times per week for 8 weeks to 6 preschool-age children (3 years 1 month to 4…

  3. Communicating and Collaborating for the Right Lab Test and Diagnosis

    Centers for Disease Control (CDC) Podcasts


    This podcast is a scenario-based skit between a clinical pathologist and primary care physician around the challenges in ordering clinical laboratory tests and offers solutions to optimizing the use of laboratory services for quality patient care.  Created: 10/13/2016 by Center for Surveillance, Epidemiology, and Laboratory Services (CSELS).   Date Released: 10/13/2016.

  4. Liver biopsy — the current view?

    African Journals Online (AJOL)

    needles, or the more recent cutting-core automated or semi-automated needles. These may be single units, or part of gun-type system with disposable needles. The pathologist's requirements of the specimen depend on whether diffuse disease or focal lesions are biopsied. The ideal tissue core for diffuse disease should be ...

  5. XP11.2 Translocation renal cell carcinoma: Clinical experience of Taipei Veterans General Hospital

    Directory of Open Access Journals (Sweden)

    Chia-Chen Hung


    Conclusion: Although RT-PCR and DNA sequencing are the final diagnoses of the molecular identity of Xp11.2 translocation RCC, experienced pathologists could confirm the histologic diagnosis based on the distinctive morphologic features with positive TFE3 immunochemical nuclear stain. Surgical resection is the only treatment. The role of systemic therapy for local recurrence and metastasis remains to be determined.

  6. Relational Aggression, Victimization, and Language Development: Implications for Practice (United States)

    Ostrov, Jamie M.; Godleski, Stephanie A.


    This review explores the development of relational aggression and relational victimization among peers, with specific emphasis on clinical implications for speech-language pathologists. Developmental manifestations of relational aggression and victimization are reviewed from early childhood through emerging adulthood. The concurrent and…

  7. Some new, simple and efficient stereological methods and their use in pathological research and diagnosis

    DEFF Research Database (Denmark)

    Gundersen, H J; Bendtsen, T F; Korbo, L


    Stereology is a set of simple and efficient methods for quantitation of three-dimensional microscopic structures which is specifically tuned to provide reliable data from sections. Within the last few years, a number of new methods has been developed which are of special interest to pathologists...... are invariably simple and easy....

  8. Chromophobe hepatocellular carcinoma with abrupt anaplasia: a proposal for a new subtype of hepatocellular carcinoma with unique morphological and molecular features


    Wood, Laura D; Heaphy, Christopher M; Daniel, Hubert Darius-J; Naini, Bita V; Lassman, Charles R; Arroyo, May R; Kamel, Ihab R; Cosgrove, David P; Boitnott, John K; Meeker, Alan K; Torbenson, Michael S


    Hepatocellular carcinomas exhibit heterogeneous morphologies by routine light microscopy. Although some morphologies represent insignificant variations in growth patterns, others may represent unrecognized subtypes of hepatocellular carcinoma. Identification of these subtypes could lead to separation of hepatocellular carcinomas into discrete groups with unique underlying genetic changes, prognosis, or therapeutic responses. In order to identify potential subtypes, two pathologists independen...

  9. A study of the role and functions of inspectors of anatomy in South ...

    African Journals Online (AJOL)


    Dec 1, 2017 ... anatomy, with the fundamental role of regulating human tissue. As a result, the .... requirement or order of an inspector of anatomy' or health officer.[22]. As seen from .... chief forensic pathologist; and (iv) a nursing education/occupational .... bodies of the poor and families experiencing financial constraints).


    African Journals Online (AJOL)

    and dental practitioners of the crucial role of dentist in victim's identification and ... role of forensic dental personnel in human identification following ... matrimonial, or financial reasons6. The first and .... chief physician during the systematic extermination of the Jews at ... of police officers with forensic pathologist and forensic.

  11. Exudative lesions of Reinke's space: a terminology proposal

    DEFF Research Database (Denmark)

    Hantzakos, A; Remacle, M; Dikkers, F G


    There has been an ongoing confusion among pathologists in their attempt to accurately identify lesions of Reinke's space. Nodules, polyps and Reinke's edema fall in the same basket and differentiation between them relies largely on the clinical description of the pathologic specimen by the operat...

  12. Selective Mutism in Elementary School: Multidisciplinary Interventions. (United States)

    Giddan, Jane J.; And Others


    Presents the symptoms of selective mutism and historical background for treatment. It provides a case study which illustrates successful multidisciplinary treatment outcomes for a child who was selectively mute. Issues relevant to speech-language pathologists working with elementary school children are discussed and treatment guidelines provided.…

  13. In situ hybridization for the detection of rust fungi in paraffin embedded plant tissue sections (United States)

    Rust fungi infect a wide range of plant species making them of particular interest to plant pathologists. In order to study the interactions between these important pathogenic fungi and their host plants it is useful to be able to differentiate fungal tissue from plant tissue. This can be accomplish...

  14. Determining customer satisfaction in anatomic pathology. (United States)

    Zarbo, Richard J


    Measurement of physicians' and patients' satisfaction with laboratory services has become a standard practice in the United States, prompted by national accreditation requirements. Unlike other surveys of hospital-, outpatient care-, or physician-related activities, no ongoing, comprehensive customer satisfaction survey of anatomic pathology services is available for subscription that would allow continual benchmarking against peer laboratories. Pathologists, therefore, must often design their own local assessment tools to determine physician satisfaction in anatomic pathology. To describe satisfaction survey design that would elicit specific information from physician customers about key elements of anatomic pathology services. The author shares his experience in biannually assessing customer satisfaction in anatomic pathology with survey tools designed at the Henry Ford Hospital, Detroit, Mich. Benchmarks for physician satisfaction, opportunities for improvement, and characteristics that correlated with a high level of physician satisfaction were identified nationally from a standardized survey tool used by 94 laboratories in the 2001 College of American Pathologists Q-Probes quality improvement program. In general, physicians are most satisfied with professional diagnostic services and least satisfied with pathology services related to poor communication. A well-designed and conducted customer satisfaction survey is an opportunity for pathologists to periodically educate physician customers about services offered, manage unrealistic expectations, and understand the evolving needs of the physician customer. Armed with current information from physician customers, the pathologist is better able to strategically plan for resources that facilitate performance improvements in anatomic pathology laboratory services that align with evolving clinical needs in health care delivery.

  15. HIV and the histopathologist | Nel | Southern African Journal of HIV ...

    African Journals Online (AJOL)

    The practicing histopathologist is often a forgotten link in the management of HIV patients. This article aims to highlight the unique challenges faced by anatomical pathologists as well as focusing on the valuable contribution they can make to ensure prompt and accurate diagnoses that will ultimately benefit the patient.

  16. From Interdisciplinary to Integrated Care of the Child with Autism: The Essential Role for a Code of Ethics (United States)

    Cox, David J.


    To address the developmental deficits of children with autism, several disciplines have come to the forefront within intervention programs. These are speech-pathologists, psychologists/counselors, occupational-therapists/physical-therapists, special-education consultants, behavior analysts, and physicians/medical personnel. As the field of autism…

  17. Pleomorphic adenoma of the parotid gland 1985-2010

    DEFF Research Database (Denmark)

    Andreasen, Simon; Therkildsen, Marianne H; Bjørndal, Kristine


    -up on these topics. METHODS: The Danish Pathology Data Bank was searched for parotid pleomorphic adenoma and Ca-ex-PA in the period 1985 to 2010 and all pathology descriptions were reviewed. Ca-ex-PA specimens were reviewed by a pathologist. RESULTS: A total of 5.497 patients were identified and 2.86% had at least...

  18. SEM-EDX

    African Journals Online (AJOL)



    Mar 11, 2015 ... Chun-Yen Liu1, Chao-Jen Wang1, Wen-Chuan Chung2, Chien Chu3, Wan-Yu Lin1 and ..... We sincerely thank Dr. C. J. Chang, Plant Pathologist, .... Wasser SP, Didukh MY, de A. Amazonas MAL, Nevo E, Stamets P, da.

  19. Postoperative Adhesive Intestinal Obstruction from Gossypiboma ...

    African Journals Online (AJOL)

    We report a case of 41.year.old female admitted with features of intestinal obstruction and had a previous history of hysterectomy performed 2 months back at another hospital. Pathologists must be aware of this entity and its proper reporting as the cases are liable to go to court. Surgeons must recognize the risk factors that ...

  20. Effective Oral Language Development Strategies for Elementary Teachers (United States)

    Kohler, Karen L.


    This action research study explored first and second grade classroom teachers' knowledge of oral language development and interventions for students at-risk of an oral language delay. This was accomplished through collaboration between a speech-language pathologist and classroom teachers. The data was aligned with assessments, the Response to…