Surgical wound infections: a 63-month survey in a developmental institution.

Michener Centre, a developmental institution of 1200 residents, instituted a nosocomial infection control program in October 1983, which included surgical wound monitoring. Of the 336 clean and clean-contaminated operations performed in the next 63 months, there were 15 wound infections attributable to the surgeon; another 7 occurred which were directly attributable to the patient's postoperative behaviour. Six of the seven occurred in severely retarded patients. The wound infection rate dropped during the surveillance period from 23% to 4.1% or less. Careful preselection of patients for elective surgery and studious attention to postoperative nursing care are necessary to achieve these rates or to reduce them further, particularly amongst severely retarded patients.

Availability of marriage partners in England and Wales: a comparison of three measures.

Measures of partner availability introduced by Goldman, Westoff & Hammerslough (1984) and by Veevers (1988) are described and a new measure of partner availability, the Iterated Availability Ratio, is introduced. The three measures are applied to 1981 Census data for England and Wales and their abilities to predict regional variations in age-specific marriage rates are compared.

PIP: The aim of this theoretical study is to adequately describe a measure of partner availability for use in predicting marriage rates. Reference is made to the formulations of Goldman, Westoff, and Hammerslough for the US and Veevers for Canada for determining partner availability. Comparisons are made between Goldman's Availability Ratio (AR), the Iterated Availability Ratio (IAR) (a new measure which overcomes the inadequacies of Goldman's AR by summing the IARs of all unmarried women and mankind this equal to the total number of unmarried men) and Veevers Availability Index (AI). Measures of availability were calculated from ages in combination at marriage and the usually resident population (age at marital status by sex) from England and Wales for 1981. A test of predictability of marriage rates from availability data was conducted; methods were evaluated to determine the best predictor of marriage rates. Analysis suggests that the IAr is superior to Goldman et al's Ar and inferior to Veever's AI and to straightforward sex ratios, which was established by Fossett and Kiecolt. The best predictors of marriage rates are measures that capture the availability of partners belonging to the age groups that are preferred. The IAR is a conceptual improvement over Goldman et al's AR in adequately measuring partner availability, but a better measure of availability is the age specific sex ratio in the context of predicting marriage rates. Goldman et al's measures, when constructed, were an improvement over the existing crude population sex ratios, but did not differentiate between marrieds and unmarrieds. Another limitation was that the empirical data do not reflect the demand from individuals for a particular partner type, but do reflect the supply. The notion was advanced that potential competition for a possible partner must be taken into account, and that other relevant factors such as education and social class were important to consider. Veever's AI is based on the notions that eligible potential partners appear within a specified age range and that competition for potential partners must be taken into account. The age range was determined to be one where 80% of all marriages for persons of a given age occur; "fair share" is also determined.

Repartnering: the relevance of parenthood and gender to cohabitation and remarriage among the formerly married.

This paper is an exploratory analysis of the impact of current and anticipated parenthood on cohabitation and remarriage among those formerly living in marriage-type relationships. The focus on children is embedded within a broader analysis of repartnering which takes account of other factors, including gender. Quantitative and qualitative analyses are used, with a multivariate analysis of repartnering patterns, using data from the General Household Survey, being complemented by in-depth interview data examining the attitudes of the formerly married to future relationships. The paper demonstrates that parenthood has a statistically significant effect on the likelihood of formerly married women repartnering, with a higher number of children being associated with a lower probability of repartnering. The presence of children can work against repartnering in a variety of ways. Children place demands on their parents and can deter or object to potential partners. Parents may see their parental role as more important than, and a barrier to, new relationships. However, mothers are typically looking for partners for themselves rather than fathers for their children. Among formerly married people without children, the desire to become a parent encourages repartnering. The paper concludes that parenthood should be a key consideration in analyses of repartnering.

The Ram's Horn: the commonplace book of Dr. Earle Parkhill Scarlett.

Dr. Earle Scarlett (1896-1982) was "a man for all sasons:" he was a flourishing internist in Calgary, Alta., and a proud, self-confessed "medical truant." One of his greatest accomplishments was his written work; he published over 500 articles in several journals. His passion for books and reading gave rise to his commonplace book, The Ram's Horn. He used this collection of poems, prose, quotations, thoughts, and ideas as a source for his articles, most of which focused on historical and philosophical matters, and were rich in references to literary figures, mythology, and the Bible. The Ram's Horn contains writings that he deemed to be worthwhile and enjoyed reading over again. This book gives insight into the writings and interests of Scarlett, and in his words. "sound[s] a full-blooded compliment to [his] life."

Computed tomography of the upper cervical spine in Down syndrome.

Axial CT of the upper cervical spine was performed on 25 Down syndrome patients. Measurements of the degree of atlantoaxial displacement, the sagittal diameters of the spinal canal and spinal cord, thickness of the transverse ligament, and the ratio of sagittal diameter of spinal cord to canal were made. Thirty-six percent of the group showed evidence of cord compression. These patients demonstrated a significant decrease in the anteroposterior diameter of the spinal canal and the cord with an increase in the degree of subluxation and the cord:canal ratio when compared with the remainder.

Changes at the base of skull and cervical spine in Down syndrome.

Lateral films of the skull base and upper cervical spine in flexion, extension, and neutral positions in 165 patients with Down syndrome, ranging in age from 16 to 60 years, were analyzed. There is a 20% incidence of atlantoaxial subluxation with a marked preponderance in men (24% incidence compared to 15% in women). In addition, there is a high incidence of degenerative changes at the C2-3 and C3-4 cervical interspaces, especially in patients over 37 years of age; these are unusual sites when compared to the normal population in which the degenerative changes are most often at the C5-6 and C6-7 levels. Four patients demonstrated subluxation at cervical interspaces other than C1-2 and six had congenital fusion of either vertebral bodies or facets in the cervical region. Several patients also had flattening of cervical vertebrae; 20% of patients had nonaeration of the sphenoid sinus and 46% had partial aeration.