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Notes: Objective  To quantify the amount of variation in caesarean section (CS) rates between maternity units explained by case mix differences.Design  Cross-sectional study.Setting  All 216 maternity units in England and Wales.Population  Women giving birth at these maternity units between May and July 2000.Methods  Logistic regression models were developed to investigate the relationship between case mix characteristics, and odds of (i) CS before labour, (ii) CS in labour. Using these results, overall CS rates standardised for case mix were calculated for each maternity unit. Random-effects meta-analysis was used to examine heterogeneity between maternity units.Main outcome measures  CS before labour and CS during labour.Results  Adjustment for case mix differences between maternity units explained 34% of the variance in CS rates. Odds of CS (before and in labour) increased with maternal age. Women from ethnic minority groups had lower odds of CS before labour, and increased odds of CS in labour. Women with a previous vaginal delivery had lower odds of CS, although the magnitude of this for CS before and in labour is markedly different.Conclusions  Case mix adjustment is important to enable understanding of the factors that influence the CS rate. These include organisational and staffing levels as well as women's preferences for childbirth and clinician's attitudes. An understanding of how these factors influence the CS rate is essential for evaluation of quality and appropriateness of obstetric care provided to women.

Notes: Library and Information Studies (LIS) remains an integral part of the newly chartered School of Information at the University of Michigan. Forging student, community-based, and foundation partnerships, LIS faculty are helping to re-define the role of information professionals in their research, teaching and services. Faculty are defining and practicing a new integrated discipline arising from the interactions among information, technology, and human systems. In collaboration with colleagues and students from disciplines including archives and records management, human computer interaction, public policy, psychology, computer science, and economics, LIS faculty are working to design a broad-based curriculum and a common set of foundations courses for all masters students in the program. In this article, Frost, an LIS faculty member who has been with the school for over 20 years, reflects on how teaching and research in cataloging and organization of information have been revitalized through project-based learning, collaboration with students and faculty from computer science and the arts, and community service to broaden the reach of cultural heritage materials.

Notes: Melanocytic naevi on the face and neck of 110 Brisbane secondary school students aged 16–17 years were mapped according to specified regions to investigate the dose-response relationship between ultraviolet (UV) radiation and melanocytic naevi. Highest naevus density occurred in regions receiving a mean UV dose of 0.2–0.4 relative to the vertex while densities were low in minimally and maximally exposed regions. This pattern of naevus distribution was unaffected by sex or phenotypic features such as skin colour or degree of freckling. These findings suggest that there is a narrow dose range over which UV radiation can effectively promote the proliferation of melanocytes. A comparison of the regional distribution of naevi on the face and neck with that of solar keratoses appearing over 1 year on the heads of residents of a neighbouring town has shown them to differ significantly. This study may shed some light on the unknown, yet expectedly complex, relation of UV radiation to melanocytic naevi.

Notes: Abstract  The relative importance of thermal diffusion versus new growth or recrystallization on U-Pb isotopic data from sphene is assessed through a study of amphibolites and granite gneisses within the contact aureole of the Red Mountain pluton, Laramie anorthosite complex, Wyoming. Samples were collected along a traverse approximately perpendicular to the margin of the intrusion over a distance of 0.13 to 2.65 km from the contact. The 207Pb/206Pb ages of sphene from amphibolite samples range between 1.43 Ga, the intrusive age of the Red Mountain pluton, to 1.78 Ga, the age of regional metamorphism. The 207Pb/206Pb ages of sphene in rocks metamorphosed above 700° C are within error of the intrusive age of the pluton, and appear to have resulted from diffusional resetting of preexisting sphene and the metamorphic growth of additional sphene at 1.43 Ga. At greater distance from the contact the 207Pb/206Pb ages range from 1.45 to 1.72 Ga. This 300 million year spread in ages is interpreted to result from two periods of sphene growth, one produced during regional metamorphism at 1.78 Ga and another generation of newly grown or recrystallized sphene that formed during contact metamorphism at 1.43 Ga. These two age populations may be identified on the basis of petrographic textures, the morphologies and color differences of grain separates as well as by the U-Pb systematics. In rocks metamorphosed to temperatures less than 700° C, sphene growth was the dominant process controlling the response of the U-Pb isotope system to contact metamorphism. Sphene grew well outside the zone of obvious contact metamorphism. The U-Pb sphene ages were reset by diffusion only at high temperatures, supporting the experimentally determined closure temperature estimates for the U-Pb system in sphene of around 650° C (Cherniak 1993). This study demonstrates that U-Pb ages of sphene can be used to date metamorphism not only in areas with a simple geologic history, such as igneous intrusion or single metamorphic or deformational events, but also to date multiple events so long as different generations of sphene can be identified and separated.