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The Supreme Court’s Shelby County v. Holder ruling invalidating Section 4(b) of the Voting Rights Act of 1965 is in part a product of efforts to resist further transformations to the traditional American institutional arrangements that have conferred advantages on whites, especially disproportionate political power. Those efforts in resistance are not likely to succeed in the long run. But they may embroil American elections and American governance in paralyzing conflicts for years to come.

Spirituality refers to that which gives us hope, meaning and purpose. It is naturally part of the holistic nature of the care provided by nurses to people going through life's challenges: health-related accident, serious and incurable illness, chronic disease, end of life, etc. A British advanced practice nurse, who has enriched her training with a doctorate in spirituality in the context of health care, enlightens this dimension, which is less formalized in France than in the United Kingdom, and suggests resources for progressing personally and professionally., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

The incidence of ovarian cysts in the general population is difficult to estimate. Certain cysts are functional and generally not operated, except in case of complications. Others are organic cysts which are usually, but not always operated. Data is available only from surgical series or pathology reports. An analysis of the literature shows that for operated cysts, approximately 75% are organic, 25% are function and 1 to 4% of the supposed benign cysts are found to be malignant. In France, the PMSI database on public and private institutions is available on the net (www.le-pmsi.fr). The number of hospital stays for benign ovarian tumors or ovarian cysts was to the order of 45,000 in 1998 and 1999. Twenty-one percent of these patients were discharged without surgery. Most had a functional cyst of the ovary. This leaves 32,000 women who underwent surgery annually for an ovarian cyst. Nearly 7000 women were hospitalized for follicular or yellow body cysts, i.e. 15%, with an incidence of 29/100,000 women over the age of 15 years. The abstention rate for hospitalized women with a follicular cyst or a yellow body cyst was 30 to 40%. For endometrioma, there were 5218 hospitalizations in 1999 (2137 in the public hospitals and 3081 in private clinics) (11% of the hospitalizations). The rate of abstention was 11% (15% in the public hospitals and 8% in private clinics). Approximately 4100 women thus underwent surgery, including 13% for ovarian cysts. According to data in the literature, serous and mucinous cysts account for 20 to 30% of the operated cysts and dermoid cysts for 10 to 20%. The type of cyst cannot be identified with the international WHO classification used in the PMSI.