The ligands, receptors and related signaling proteins of the insulin‐like growth factor family are involved in the regulation of breast‐cancer cell growth. We investigated the expression pattern of insulin‐like growth factor‐I receptor (IGF‐IR), insulin receptor (IR) and insulin receptor substrate‐1 (IRS‐1), a core downstream signaling protein, in 69 primary breast‐cancer specimens of different grades and in 21 control tissues by immunohistochemistry. In addition, cell proliferation (percentage of Ki67+ nuclei) and estrogen receptor (ER) expression were determined. IGF‐IR, IRS‐1 and IR were expressed mainly in epithelial cells. IRS‐1 and IGF‐IR were expressed at high levels in control tissues and in well and moderately differentiated carcinomas but at low levels in poorly differentiated breast cancers. IR expression did not show a significant correlation with the differentiation grade of the tissues investigated. Statistical analysis (ROC analysis for tumor grade) demonstrated that down‐regulation of IGF‐IR and IRS‐1 correlated better with tumor progression than reduction of ER expression or increase in cell proliferation, IGF‐IR showing the best correlation, followed by IRS‐1 and, less significant, ER and Ki67. Our findings clearly show that progression of breast cancer is accompanied by a reduction of IGF‐IR/IRS‐1 expression and that IGF‐IR/IRS‐1 expression inversely correlates with high proliferation rate in dedifferentiated breast cancers. The strong correlation of IGF‐IR and IRS‐1 down‐regulation with tumor progression suggests the use of IGF‐IR and IRS‐1 as a novel set of marker proteins for tumor grading. Int. J. Cancer 89:506–513, 2000. © 2000 Wiley‐Liss, Inc.

In the present study, we investigated how two team mental model properties (similarity vs. accuracy) and two forms of monitoring behavior (team vs. systems) interacted to predict team performance in anesthesia. In particular, we were interested in whether the relationship between monitoring behavior and team performance was moderated by team mental model properties. Thirty-one two-person teams consisting of anesthesia resident and anesthesia nurse were videotaped during a simulated anesthesia induction of general anesthesia. Team mental models were assessed with a newly developed measurement tool based on the concept-mapping technique. Monitoring behavior was coded by two organizational psychologists using a structured observation system. Team performance was rated by two expert anesthetists using a performance-checklist. Moderated multiple regression analysis revealed that team mental model similarity moderated the relationship between team monitoring and performance; a higher level of team monitoring in the absence of a similar team mental model had a negative effect on performance. Furthermore, team mental model similarity and accuracy interacted to predict team performance. Our findings provide new insights on factors influencing the relationship between team processes and team performance in health care. When investigating the effectiveness of a specific team coordination behavior, team cognition has to be taken into account. This represents a necessary and compelling extension of the popular process-outcome relationship on which previous teamwork research in health care has focused. Moreover, the current study adds further external validity to the concept of team mental models by highlighting its usefulness in health care.

This study provides valuable information for developing novel team training programs in health care that focus on adaptation to changing task requirements, for example, when faced with NREs.

This paper builds on and extends theory on team functioning in high-risk environments. We examined 2 implicit coordination behaviors that tend to emerge autochthonously within high-risk teams: team member monitoring and talking to the room. Focusing on nonrandom patterns of behavior, we examined sequential patterns of team member monitoring and talking to the room in higher- and lower-performing action teams working in a high-risk health care environment. Using behavior observation methods, we coded verbal and nonverbal behaviors of 27 anesthesia teams performing an induction of general anesthesia in a natural setting and assessed team performance with a Delphi-validated checklist-based performance measure. Lag sequential analyses revealed that higher-performing teams were characterized by patterns in which team member monitoring was followed by speaking up, providing assistance, and giving instructions and by patterns in which talking to the room was followed by further talking to the room and not followed by instructions. Higher- and lower-performing teams did not differ with respect to the frequency of team member monitoring and talking to the room occurrence. The results illustrate the importance of patterns of autochthonous coordination behaviors and demonstrate that the interaction patterns, as opposed to the behavior frequencies, discriminated higher- from lower-performing teams. Implications for future research and for team training are included. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

SummaryDespite growing public resistance to the practice of female genital cutting (FGC), documentation of its prevalence, social correlates or trends in practice are extremely limited, and most available data are based on self-reporting. In three antenatal and three family planning clinics in South-west Nigeria we studied the prevalence, social determinants, and validity of self-reporting for FGC among 1709 women. Women were interviewed on social and demographic history, and whether or not they had undergone FGC. Interviews were followed by clinical examination to af®rm the occurrence and extent of circumcision. In total, 45.9% had undergone some form of cutting. Based on WHO classi®cations by type, 32.6% had Type I cuts, 11.5% Type II, and 1.9% Type III or IV. Self-reported FGC status was valid in 79% of women; 14% were unsure of their status, and 7% reported their status incorrectly. Women are more likely to be unsure of their status if they were not cut, or come from social groups with a lower prevalence of cutting. Ethnicity was the most signi®cant social predictor of FGC, followed by age, religious af®liation and education. Prevalence of FGC was highest among the Bini and Urhobo, among those with the least education, and particularly high among adherents to Pentecostal churches; this was independent of related social factors. There is evidence of a steady and steep secular decline in the prevalence of FGC in this region over the past 25 years, with age-speci®c prevalence rates of 75.4% among women aged 45±49 years, 48.6% among 30±34-year olds, and 14.5% among girls aged 15±19. Despite wide disparities in FGC prevalence across ethnic, religious and educational groups, the secular decline is evident among all social subgroups.