Predicting mouth width from inter-canine width--a 75% rule

It has been suggested that inter-canine width plus 57% of the cumulative distance between the lateral aspect of the canines and the pupil centers can be used to estimate mouth width. Evidence also suggests that the distance between the medial irises approximates actual mouth width fairly well. However, these soft tissue prediction guidelines are limited because they rely on accurate medio-lateral positioning of the pupils within the orbits, for which no systematic empirical evidence appears to exist at this stage. It would, therefore, be more appropriate to use only known hard tissue landmarks in mouth width prediction. This study reports the results of using inter-canine width as a percentage of mouth width for its prediction. This method seems favorable in comparison to the other guidelines because it is as accurate, uses known hard tissue landmarks, and does not rely on assumptions concerning pupil location. Estimating mouth width by using the canines alone, therefore, seems the best guideline to use in facial approximation techniques, at least given knowledge existing at this stage.     

Hazards of mattresses, beds and bedding in deaths of infants

Of 52 infants who had died suddenly and were referred to autopsy, nine had lain on adult water beds for the first time; five had died as a result of accidents; two had died on water beds; two were in beds with widely spaced slats; and one had died as a result of strangulation. Three deaths were due to overlying. Three other infants had been placed on sheepskin rugs for the first time and were found dead shortly thereafter. These infants ranged in age from 2 to 9 months, except for a severely mentally retarded nine-year-old with spastic paraplegia. We believe that a general warning should be issued concerning water beds and that soft bedding should not be used for infants. Infants should not be placed unattended or left to sleep on water beds; only beds recommended for infants should be used. Overlying of a young infant is most likely to occur on a water bed, or if the parent is obese or has consumed alcohol.     

The reciprocal dynamics of organizing and sense‐making in the implementation of major public‐sector reforms

Abstract: Drawing on a longitudinal study from the early years of implementation of health‐care networks in Quebec, this article describes how public‐sector managers deal with complex challenges when both organizational structures and organizational strategies are radically transformed simultaneously. The new organizations studied had to completely re‐shuffle roles and responsibilities of their management teams while making sense of their new mandate of developing a population‐focused approach to health problems – all the time maintaining day‐to‐day operations. The four health‐care networks studied proceeded somewhat differently to meet these reciprocal challenges. The study reveals the importance of balancing organizing initiatives (focused on structures) with “sense‐making” initiatives (focused on strategies), of developing capacities for sense‐making through the creation of key “sense‐maker/sense‐giver” positions whose occupants are able to ensure that conceptual activities engage people working at different levels, even as organizational structures are in flux, and of mobilizing external constraints and influences as opportunities and resources in sense‐making and organizing. Sommaire : Se fondant sur une étude longitudinale des premières années de la mise en œuvre des réseaux de soins de santé au Québec, cet article décrit la manière dont les gestionnaires du secteur public font face à des défis complexes, alors que les structures et les stratégies organisationnelles sont radicalement transformées simultanément. Les nouveaux organismes étudiés ont dû complètement remanier les rôles et les responsabilités de leurs équipes de gestion et comprendre leur nouveau mandat d'élaborer une approche axée sur la population pour ce qui est des problèmes de santé, tout en maintenant leurs activités au jour le jour. Les quatre réseaux de soins de santéétudiés ont travailléà relever ces défis réciproques d'une manière assez différente. L'étude révèle l'importance de trouver un équilibre entre les initiatives consistant à organiser (axées sur les structures) et les initiatives consistant à interpréter les faits (axées sur les stratégies) ; de perfectionner les capacités à interpréter les faits grâce à la création de postes clés d'«interpréteurs de faits», dont les titulaires veilleraient à ce que des activités conceptuelles fassent intervenir les gens travaillant à différents niveaux même lorsque les structures organisationnelles fluctuent continuellement; et enfin de tirer parti des contraintes et influences externes comme autant d'occasions et de ressources pour interpréter et organiser les faits.     

Patterns and strategies of court administration in Canada and the United States

Abstract. This paper argues that patterns of court administration and the strategies pursued by judiciaries in Canada and the United States are quite different as a result of contrasting constitutional principles. Parliamentary supremacy in Canada has led to executive department administration of the courts, while the American separation of powers doctrine has encouraged judicial branch administration of the courts. Constitutional differences have also promoted more unified systems of court administration in Canada than in the United States. As a result of these differences, Canadian judiciaries have pursued an encapsulation strategy and have depended on the legal community to serve as their patron. On the other hand, American judiciaries have promoted organizational growth and sought empowerment — the development of a separate power base — rather than relying on powerful allies. Sommaire. D'après l'auteur de cet article, les scénarios de l'administration des tribunaux et les stratégies adoptés par les fonctionnaires judiciaires sont très différents au Canada et aux Etats-Unis, par suite de la divergence de leurs principes constitutionnels. La suprématie du parlement, au Canada, a conduit à l'exercice d'un contrǒle par l'exécutif sur l'administration des tribunaux alors que la doctrine américaine de la séparation des pouvoirs a encouragé l'exercice de ce contrǒle par le pouvoir judiciaire lui měme. Les différences constitution-nelles ont aussi contribuéà promouvoir des systèmes d'administration des tribunaux plus unifiés au Canada qu'aux Etats-Unis. A cause de ces différences, les fonctionnaires judiciaires canadiens ont adopté une stratégie de retranchement, comptant sur la communauté des juristes pour leur servir de protecteurs. Leurs homologues américains, par contre, ont cherché ce promouvoir la crois-sance de leur organisation et de ses pouvoirs en fait le devéloppement d'un pouvoir siparé-au lieu de se fies à des allies puissants extérieurs.