Basal cell carcinoma is generally an indolent form of skin cancer. Morpheaform, infiltrative, and sclerosing types are more aggressive tumors. The incidence of perineural invasion in aggressive types of basal cell carcinoma has not been previously described. We studied aggressive basal cell carcinomas for the presence of perineural invasion. Between 1995 and 1998, the histopathologic diagnosis of basal cell carcinoma was made on 5,097 specimens at Dartmouth-Hitchcock Medical Center. Of this total, 507 were classified as sclerosing, infiltrative, or morpheaform. Perineural invasion was found in 15 of the 507 cases. Of these 15 cases, 12 were from the face, and 3 from the back; 13 were recurrent, and 2 were primary lesions. The mean age of patients at diagnosis was 71 years. We found 9.9% of all basal cell carcinomas at our institution to be aggressive types. We found an incidence of perineural invasion of 3% in the aggressive basal cell carcinoma types. This incidence approaches that reported by others for cutaneous squamous cell carcinomas.

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Sexual minority persons (e.g., lesbian, gay, bisexual, and queer) are likely to encounter minority stress, such as discrimination, concealment, expectation of rejection, and internalized heterosexism. Minority stress occurs alongside one's lifespan and has considerable implications in the context of the career lifespan trajectory. Using the approach of developmental contextualism as a framework to embed minority stress, this article reviews the existing literature regarding facets of minority stress across the career lifespan trajectory and provides a conceptualization on how to incorporate minority stress into affirmative career appraisal, intervention, and research practices.The minority stress framework postulates that tensions emerge when the values of sexual minority persons (e.g., lesbian, gay, bisexual, and queer [LGBQ]) are in a state of conflict with the values of the dominant heteronormative culture, leading to significant life strains and burdens (Meyer, 1995(Meyer, , 2003. Minority stress has been demonstrated to impact sexual minority persons across the lifespan trajectory (Chen, Androsiglio, & Ng, 2010), and it is plausible that minority stress could also influence the career-lifespan development trajectory. Vocational scholars have selectively attended to various facets of minority stress in the workplace (refer to Velez, Moradi, & Brewster, 2013) but have yet to fully conceptualize the entire career-lifespan trajectory from a minority stress framework.According to Meyer (2003), the underlying assumptions of minority stress include (a) unique and additive adaptations beyond general stressors and coping resources; (b) stressors that are experienced as chronic in a given social space or setting; and (c) stressors that are related to social processes, institutions, and situations. Experiences of discrimination (or distal related stressors) are one particular manifestation of minority stress. Violations of heterosexual normality may lead to direct violence (e.g., physical or sexual assault) against sexual minority persons or experiences of harassment and prejudice due to a deviation from heterosexuality (Herek, 2007). An extension of violence and discrimination includes sexual orientation microaggressions, brief, and everyday ignominies that indicate

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A modern rhetoric has developed concerning itself with considerably more dimensions of speech than was the case with traditional rhetoric's concentration on persuasion and public address. Indeed, this modern rhetoric has expanded its domain to include the whole range of types of oral communication. But while this very basic kind of evolution has been taking place, it appears that a corresponding ethic ( a n interpersonal one) has not emerged. The authors make bold to try to stimulate that study.The interpersonal ethic proposed in the article can be stated as follows: A's communication is ethical to the extent that it accepts B's responses; it is unethical to the extent to which it develops hostility toward B's responses, or in some way tries to subjugate B. The ethic can be observed best, the authors believe, when A discovers that B rejects the message A is sending.Such an ethic springs from the following assumptions: (1) By virtue of the very nature of the communicative act, the two parties to a communication exercise control over each other. Both the listener and the speaker are, in part, at the other's mercy.( 2 ) One of the highest values in a democratic culture is that conditions be created and maintained in which the potential of the individual is best realized. ( 3) The individual will be able to realize his potential to the extent that psychological freedom can be increased for him.An interpersonal ethic, the article suggests, may have more to do with the attitude of the speaker and listener toward each other than with elements of the message (as in the more traditional rhetoric). It may concern itself more with loyalty to the person with whom one is in communication than to rationality or cosmic truth.