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C B Mueller

Publications and source records attributed to C B Mueller.

13 recordsLinked to original sources

Topical neomycin.

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Administration, Topical

Some effects of health insurance in Canada--from private enterprise toward public accountability.

Ten years after the introduction of national medical insurance in Canada, it is possible to view the effect of a comprehensive health-insurance program on the relations among physicians, society and government. With costs of health care paid from the public rather than the private purse, provincial efforts to control the cost of hospital and physician services are increasing, and various methods for cost containment are now visible. Since the budget for these expenses is publicly debated it competes for support against other publicly funded programs. The federal/provincial insurance system is evolving as an instrument of reform in the organization of health services and has led to the introduction of legislation that is changing the health-delivery system. A gradual shift in power between various health agencies, physicians, professional organizations and government is occurring.

Canada

Arousal, personality, and assortative mating in marriage: generalizability and cross-cultural factors.

The significant assortative mating for the sensation-seeking motive in (married) American students reported by Farley and Davis was significantly cross validated on American (N = 160) and German (N = 160) samples randomly selected from two comparable cities in the Federal German Republic and the United States. A control condition of age-matched unmarried pairs was included. Spouses were found to have 19% and 29% of sensation-seeking variance in common in the American and German samples, respectively. The later figure is exceptionally high for the literature on assortative mating (exceeding or approximating some of the relationships found for intellectual measures). No significant variance was in common for the unmarried pairs. When a simple and easily measured construct with such wide implications as the sensation-seeking motive can be shown to be so significantly involved in marital partner similarity, then its consequences for successful and unsuccessful marriage should be pursued with vigor. Such a program in research and therapy is recommended and a theoretical model suggested.

Adolescent

Breast cancer in 3,558 women: age as a significant determinant in the rate of dying and causes of death.

The forces of mortality created by cancer of the breast have been examined utilizing data collected during the past 19 years by the Syracuse, N. Y., Upstate Medical Center Cancer Registry on 3,558 women. Except for 15 lost to follow-up, all have been contacted annually through 1974 or until death. Time and cause were recorded for all deaths. In April, 1975, 1,883 remain alive and in the registry and 1,660 women have died. Using life-table analyses and considering deaths due only to breast cancer, mortality rates were calculated for three age groups--21 to 50 years, 51 to 70 years, and 71 to 100 years. Breast cancer expresses its lethality most vigorously in the oldest group. The half-death time (50% mortality rate) for the youngest group was 13 years, for the middle group 8 years, and for the oldest group 5 years. The rate of dying was a function of both age and stage at diagnosis. At 16 to 18 years after diagnosis, deaths due to breast cancer begin to disappear. Eighty-eight percent of the women who died following a diagnosis of cancer of the breast have died of their breast cancer. Age as well as stage at diagnosis are significant determinants on the length of survival and cause of death.

Adult

Bilateral carcinoma of the breast: frequency and mortality.

Of 3558 women with cancer of the breast, 129 were found to have bilateral primary cancers. In approximately one quarter (33) of these women the two cancers developed synchronously; in the remainder (96) the second cancer developed metachronously, more than 6 months after the appearance of the first primary tumour. In two thirds (64) of the women in the latter group the second cancer made its appearance within 4 years after the first was detected. The 15-year survival curve for the 129 patients shows a 50% mortality at approximately 10 years, slightly better than that for the total group of 3558. At the time of our study (April 1975) 70 were alive and 59 were dead; 53 died as a result of their breast cancer and 6 from other causes. Only 3 of the 48 women in whom the first cancer developed before the age of 70 years died of causes other than breast cancer, giving a mortality due to breast cancer of 90%. The clinical stage, the recorded histopathology, the type of operation and the duration of time at risk after the first diagnosis did not differ significantly between those who lived and those who died. The authors conclude that age, stage or type of growth, operative therapy or time at risk do not determine the time of death or alter the 90% certainty that death will be due to carcinoma of the breast.

Adult

Cancer of the breast: Its outcome as measured by the rate of dying and causes of death.

Mortality forces in women with cancer of the breast were measured by calculating the rate of dying and determining the cause of death in women who develop breast cancer. In the Syracuse-Upstate Medical Center Cancer Registry, 1,513 patients were followed for 15 years. The death curve of this group assumed a major slope characteristic of a single exponential curve, with a half life of 5.9 years. The cause of death was examined in a randomly selected group of patients from the Ontario Cancer Foundation, Hamilton, Ontario, and a group from the Syracuse Registry dying after 10 years. In these 136 patients, 130 died of breast cancer. From the National Cancer Institute Cooperative Studies of 3,225 women undergoing treatment for primary breast cancer, 914 died during the study---705 of cancer of the breast and 209 of competing risks. These data suggest that 80-85% of all women who die after developing cancer of the breast die of their breast cancer. Modification of the time of dying (rate of dying) or cause of death should be used as objectives of management rather than 5-year survival figures.

Age Factors