Dysphoria and impaired mentation in young physicians

A syndrome of dysphoria and impaired mentation afflicting young physicians is described. Complaints involve a perceived inability to remember recently read medical literature and a perceived lack of ability and "memory lapses" in the clinical care of patients. This syndrome occurs at a time when the young physicians' professional role is in transition and when he has just assumed increased clinical responsibilities. Resolution of the syndrome may be facilitated by a suggested protocol.     

Unnecessary medical interventions. A questionnaire study among physicians and laymen

The aim of the study was to survey attitudes among medical doctors and lay people to unsolicited medical intervention. The design of the study was an anonymous questionnaire study including three scenarios implying ethical considerations. A total of 445 medical doctors working within different areas received the questionnaire, as did 75 medical students and 600 lay people. The results showed a response rate of 67%, highest among medical doctors and students. The lay people had significantly higher expectations concerning the medical intervention in two out of three scenarios compared to medical doctors and students. The participants were offered the opportunity to comment on the questionnaire. The conclusion of the Danish survey is that there is a significantly different approach to unsolicited medical intervention among lay people compared to medical doctors and students. Medical doctors are less disposed to perform unsolicited intervention compared with the wishes/expectations of the lay people. More open attitudes and information as well as better communication is recommended.     

Continuing medical education in Maritime Canada: the methods physicians use, would prefer and find most effective

A cluster epidemic of 13 Morganella morganii infections involving 11 patients occurred over a 3-month period in 1977. This epidemic was unusual in that it involved four services and five hospital floors. The outbreak was effectively terminated when strict asceptic techniques were reinforced.     

Early defibrillation by emergency physicians or emergency medical technicians? A controlled, prospective multi-centre study

In a controlled, prospective multi-centre study, defibrillation by emergency medical technicians (EMTs) was compared with the current standard of care in Germany--defibrillation by emergency physicians (EPs)-in order to answer the following questions: can EMTs in a two-tiered emergency medical services (EMS) system with physicians in the field defibrillate earlier than, and as safely as EPs? Does defibrillation by EMTs (study group) affect survival rate and long-term prognosis of patients in ventricular fibrillation (VF), as compared with the current national standards in resuscitation (basic cardiopulmonary resuscitation (CPR) by EMTs, and defibrillation by physicians: control group? METHODS: Prior to the onset of the study, all EMTs completed retraining in basic life support (BLS). Randomly assessed EMTs were then trained to use semi-automatic defibrillators. With the help of on-line tape recordings, the complete resuscitation sequence was evaluated. Follow-up of the patients was carried out with the help of the Glasgow Coma Scale as well as Pittsburgh Cerebral and Overall Performance Categories. RESULTS: A total of 159 patients with VF were included in the study. In 121 cases, collapse was witnessed. Of the patients receiving defibrillation by EMTs 25% were discharged from hospital alive, compared to 24% of the patients defibrillated by EPs. Of the study patients 67% were defibrillated within 12 min, while the percentage of control patients was 46%. Study patients were defibrillated earlier (P < 0.01), the return of spontaneous circulation (ROSC) was achieved earlier (P < 0.05), and the rate of patients requiring no adrenalin during resuscitation was higher in the study group (P < 0.05). The total amount of adrenalin administered in the study group was lower (P < 0.05). No statistically significant differences were found concerning the neurologic long-term prognosis. CONCLUSIONS: In our study, EMT defibrillation was equally effective as defibrillation by EPs, but failed to improve survival rates or long-term outcome of patients in VF significantly, compared to EP defibrillation. Due to a reduction in the time intervals from collapse to defibrillation and to ROSC, as well as in adrenalin doses, by EMT-defibrillation, EMTs in Germany should defibrillate if they reach a patient prior to an EP, provided they have received continuous medical training and supervision.     

Professional courtesy--ethics and the law in the medical treatment of physicians and their families

Children's toothpastes with fluoride help to prevent decay, but parents should ask their dentist before giving fluoride supplements to children. Overdosage is harmful. Sugars eaten as part of a meal do less harm to teeth than those eaten frequently as snacks. Sugar-free infant drinks and children's confectionery are now on the market and are more "tooth friendly". Look out for the "happy tooth" symbol. Babies can be registered with NHS dentists as soon as the first teeth start to come through, and should be taken regularly to the dentist throughout childhood. Under the NHS scheme, dentists are paid a capitation fee to provide continuing preventive care and treatment for children free of charge.     

Postoperative complications of elective surgeries in dogs and cats determined by examining electronic and paper medical records

Postoperative complications (POC) that developed in dogs and cats that underwent elective ovariohysterectomy, castration, and declaw at a veterinary teaching hospital were determined by examining the computerized abstracts of the medical records and by examining a random sample of the paper medical records. When the computerized abstracts were examined, POC were found to have occurred in 62 (6.1%) of 1,016 dogs. One dog died and 6 others developed major complications. Postoperative complications were found to have occurred in 38 (2.6%) of 1,459 cats. Two cats died and 1 was euthanatized. Four other cats developed major complications. Complete paper medical records for 218 dogs and cats were examined. When the paper medical records were examined, the proportions of dogs and cats with POC were 19.4% and 12.2%, respectively. These proportions were 4 to 7 times higher than when the computerized abstracts were the data source. Results of this study indicate that the frequency of clinically relevant POC of elective surgeries in dogs and cats is substantial. Examination of the computerized abstracts of medical records at this hospital allowed us to rapidly identify cases that could be included in the study but the frequency of POC would be significantly underestimated if paper records were not also assessed.     

Global physician budgets as common-property resources: some implications for physicians and medical associations

Since 1990 payment for physician services in the fee-for-service sector has shifted from an open-ended system to fixed global budgets. This shift has created a new economic context for practising medicine in Canada. A global cap creates a conflict between physicians' individual economic self-interest and their collective interest in constraining total billings within the capped budget. These types of incentive problems occur in managing what are known in economics as "common-property resources." Analysts studying common-property resources have documented several management principles associated with successful, long-run use of such resources in the face of these conflicting incentives. These management principles include early defining the boundaries of the common-property resource, explicitly specifying rules for using the resource, developing collective decision-making arrangements and monitoring mechanisms, and creating low-cost conflict-resolution mechanisms. The authors argue that global physician budgets can usefully be viewed as common-property-resources. They describe some of the key management principles and note some implications for physicians and the provincial and territorial medical associations as they adapt to global budgets.     

Officers, boards, committees, and representatives of the American Psychological Association.

Item lists the officers, boards and members, committees and members, and representatives of the American Psychological Association for 1968-1969. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Officers, boards, committees, and representatives of the American Psychological Association.

Provides a list of Officers, Boards, Committees and Representatives of the American Psychological Association. Affiliation and contact information is provided for selected individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Officers, boards, committees, and representatives of the American Psychological Association.

Lists the officers, boards, committees, and representatives of the American Psychological Association for 1958-1959. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Minor head injury in children: current management practices of pediatricians, emergency physicians, and family physicians

OBJECTIVE: To describe variation in the clinical management of minor head trauma in children among primary care and emergency physicians. DESIGN: A survey of pediatricians, family physicians, and emergency physicians drawn from a random sample of members of the American Academy of Pediatrics, the American Academy of Family Physicians, and the appropriate American Medical Association specialty listings, respectively. Physicians were given clinical vignettes describing children presenting with normal physical examination results after minor head trauma. Different clinical scenarios (brief loss of consciousness or seizures) were also presented. Information was gathered on initial and subsequent management steps most commonly used by the physician. RESULTS: Surveys were returned by 765 (51%) of 1500 physicians. Of these, 303 (40%) were pediatricians, 269 (35%) family practitioners, and 193 (25%) emergency physicians. For minor head trauma without complications, observation at home was the most common initial physician management choice (n = 547, 72%). Observation in office or hospital was chosen by 81 physicians (11%). Head computed tomographic (CT) scan was chosen by 7 physicians (1%) and skull x-ray by 24 physicians (3%) as the first management option. Most physicians (n = 445, 80%) who initially chose observation at home would obtain a CT scan if the patient showed clinical deterioration. In the original scenario, if the patient had also sustained a loss of consciousness, 383 physicians (58%) altered management. Of these, 120 (18%) chose CT, 13 (2%) chose skull x-ray, 1 (1%) chose magnetic resonance imaging, 141 (21%) chose inpatient observation, and 125 (19%) chose a combination of CT scanning and observation. With seizures, 595 (90%) altered management, with 176 physicians (27%) choosing CT scan, 5 (1%) skull x-ray, 60 (9%) inpatient observation, and 299 (45%) a combination of radiological evaluation and observation. CONCLUSIONS: Most physicians surveyed chose clinic or home observation for initial management of minor pediatric head trauma. Clinical management was more varied when patients had sustained either loss of consciousness or seizures. Further study of the appropriate management of minor head trauma in children is needed to guide physicians in their care.     

Officers, boards, committees, and representatives of the American Psychological Association, 2002.

Lists members of the Council of Representatives, officers, boards, committees, and representatives of the American Psychological Association, 2002. Other organizations of interest to APA members are also included. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Officers, boards, committees, and representatives of the American Psychological Association, 2008.

Lists the officers, board members, committee members, and representatives of the American Psychological Association in 2008. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Officers, boards, committees, and representatives of the American Psychological Association, 2009.

Presents a list of the American Psychological Association's officers, boards, committees, and representatives for the year 2009. This list includes the Council of Representatives; Boards and Committees Reporting Directly to the Council of Representatives; Standing Boards and Committees; Continuing Committees; Ad Hoc Committees and Task Forces; Other Organizations of Interest to APA Members; Officers of Divisions; Affiliated Regional Associations; and APA-Affiliated State, Provincial, and Territorial Psychological Associations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Officers, boards, committees, and representatives of the American Psychological Association, 1999.

Reports the names of the officers, boards, committees, and representatives of the American Psychological Association (APA). The lists of members presented include the Council of Representatives, the Board of Directors, Policy and Planning Board, Committee on Structure and Function of Council, Standing Boards and Committees, Continuing Committees, and Ad Hoc Committees and Task Forces. In addition, a list of organizations that may be of interest to APA members, the list of the officers of APA divisions, as well as lists of affiliated associations are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)