51.   And lobbying by trial lawyers, the drug industry, insurers, physicians, hospitals and consumer groups work against fundamental change.

52.   And yet there are fundamental changes under way in Latin America, but these changes are producing complex, contentious and sometimes contradictory outcomes.

53.   And though he said the backlash against the current system is under way, Relman hedged when asked to predict when fundamental changes would occur.

54.   As elsewhere in Europe, a large part of the huge strain on welfare benefits is a direct result of fundamental demographic changes.

55.   As much as Speaker-to-be Gingrich talks of revolution, fundamental changes in American political history have always been more evolutionary than revolutionary.

56.   As noted, fundamental changes in how baseball does business could change the dynamic, but pigs have better odds of sprouting wings.

57.   At best it is a recipe for a short legislative agenda and narrow achievements, rather than for fundamental change in the ways of Washington.

58.   At the core of this clash of the weeklies is a perception of fundamental changes, particularly in Europe, in the last decade.

59.   At that time, fundamental change was occurring in the U.S. economy.

60.   At the same time, fundamental change was occurring in the U.S. economy.