Psychologists and nuclear war: A survey.

Surveyed 290 members (187 males and 103 females) of the American Psychological Association about their attitudes toward nuclear war. Findings show that the Council of Representatives' resolution calling for a Soviet-American nuclear weapons freeze was supported by a majority. Females were more supportive of the resolution. Less than one-fourth of Ss responded that the nuclear war issue had entered into their personal decision making. Ss supported public involvement in the issue. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Epidemiology of anorexia nervosa

Large number of military and civilian physicians took part in war on the territory of former Yugoslavia during 1991/1992, managing the medical service or in medical units of Yugoslav Peoples' Army and civilian health institutions. Their vast war experiences were presented in their reports and numerous papers published in proceedings of congresses and meetings, held in the period from 1992 till today. This is an attempt to systematize those experiences and to draw out some conclusions significant for the further development of doctrinaire approach to the organization and functioning of the medical service of the Army of Yugoslavia at war.     

Diagnostic dilemmas and cultural diversity in emergency rooms

Language and cultural beliefs play an extremely important role in the interaction between patients from diverse cultural groups and physicians. Especially in emergency rooms, there are many dangers in missed communications. A patient from a foreign culture, especially one who does not speak English, often expresses symptoms in ways that are unfamiliar to many American physicians. Specific areas of cultural vulnerability can be identified for the major ethnic groups in the United States as they interact with the scientific medical system. A short review of folk medical beliefs and recommendations for improving diagnostic accuracy and treatment may assist emergency room staffs in offering care that is culturally acceptable to patients of diverse ethnic backgrounds.     

Helicobacter pylori infection decreases gastric alcohol dehydrogenase activity and first-pass metabolism of ethanol in man

Current world stockpiles of nuclear weapons and the status of treaties for nuclear disarmament and the ultimate elimination of nuclear weapons are summarised. The need for including stockpiles of civil plutonium in a programme for ending production and disposing of fissile materials is emphasized, and the ultimate difficulty of disposing of the last few nuclear weapons discussed.     

After the missiles: Sociopsychological effects of nuclear war.

Discusses the physical and medical effects of nuclear war, including the effects of radiation and the possibility of a "nuclear winter," and speculates on the sociopsychological effects on persons in urban and rural areas. Issues considered include the occurrence of survival guilt and deindividuation, the forseeable breakdown in the social and economic order, and resulting violence. The uncertainties of nuclear war and the disastrous effects of even a limited nuclear exchange are emphasized. (59 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

PET in breast cancer

In mid-summer 1997, just as the United States National Cancer Institute was acknowledging that the nuclear bomb tests at the Nevada Test Site may ultimately cause up to 75,000 cases of thyroid cancer in people who were living in the USA in the 1950s and 1960s, the Australian authorities were mooting the possibility that the Maralinga test sites in South Australia should become a tourist attraction. Some Aboriginal tribal leaders welcomed this proposed use when the 20 million Pounds 'clean-up' being paid for by the United Kingdom government as some compensation for using the area for its weapons tests in the 1950s and 1960s is completed. This paper surveys the attempts to clean up the site of UK nuclear weapons tests in the 1950s, not least by attempting to vitrify vast tracts of desert.     

Eye injuries in twentieth century warfare: a historical perspective

With successive wars in the twentieth century, there has been a relative increase in injuries to the eye compared to injuries of other parts of the body. The main causes of eye injury have changed with advances in techniques and weaponry of warfare, with blast fragmentation injuries accounting for 50-80% of cases. Penetrating and perforating injuries are most common, and injuries associated with intraocular foreign bodies pose special diagnostic and management problems. Injuries are bilateral in 15-25% of cases. Injuries associated with chemical, nuclear, and laser weapons have distinct characteristics and epidemiology. Enucleation was commonly performed at the turn of the century, but incidence has declined with better understanding of the pathophysiology of ocular trauma, improved surgical techniques and sepsis control with antibiotics. Sympathetic ophthalmia appears to be uncommon and earlier fears of this complication seem to have been exaggerated. Timely evacuation to a surgical facility is important for a good visual prognosis and preservation of the globe. However, prevention of injuries with eye armor is ultimately the best management, and the need for a comprehensive eye protection program in the military cannot be overemphasized, especially since eye injuries pose important socioeconomic, as well as medical, problems.     

Computed tomography of cholesterinic granulomas in the choroid plexus of horses

Selected events in the history of biological weapons are highlighted to increase physicians' awareness of the threat of biological weapons. The hostile use of biological substances originated in antiquity and pervades the history of human conflict. Although difficult to verify at times, the use of such weaponry has not been limited to national militaries. Disgruntled civilians and even physicians have used biological weapons to promote their interests. Their potency, cost-effectiveness, and the ability to manufacture and deploy them with little sophistication, or under the semblance of legitimate commercial endeavors, will ensure that biological weapons remain a constant threat to public health.     

Primary health care in Ethiopia under three political systems: community participation in a war-torn society

This paper examines primary health care (PHC) development with an emphasis on community participation in Ethiopia under the feudal regime of emperor Haile Sellassie, the socialist/military rule of Mengistu Haile Mariam and the sprouting democracy and free market economy of Meles Zenawi. In spite of the rapid expansion of primary care under Mengistu, community participation was hampered by the protracted war and centralized, urban-based, bureaucratic approaches and attitudes that failed to promote an enabling environment for community participation. The socialist government, although implementing various community programs and expanding the rural health services, did not succeed in revolutionizing the health services. A comparative examination of the democratized rebel health services of the Eritrean People's Liberation Front (EPLF) and the Tigray People's Liberation Front (TPLF) illustrates the inconsistencies between stated policies of the Ethiopian government and actual strategies, and identifies factors promoting and impeding participatory health care development in a war environment. Achievements, opportunities and potential dangers to PHC and community participation in the post-war era characterized by economic progress, democratization, decentralization, lingering ethnic conflict and private initiatives are briefly described.     

Toward a policy-relevant psychology of avoiding nuclear war: Lessons for psychologists from the Cuban missile crisis.

A virtually paradigmatic psychological response to the risk of nuclear war has begun to emerge: nuclear depth psychology. The goal of nuclear depth psychologists is to reverse the arms race by healing what they take to be a deeply pathological superpower relationship. This approach is criticized as implausible historically, because even the most opportune moment for fundamental change in the relationship between the United States and Soviet Union (immediately following the Cuban missile crisis) failed to produce such a change. It is also argued that this and subsequent failures to fundamentally alter the superpower relationship are due to the persistence of conflicting values and of pervasive ambiguities faced by policymakers charged with managing nuclear risks. It is apparent, therefore, that a policy-relevant psychology of avoiding nuclear war must begin where nuclear policymakers begin: by focusing on (salient psychological aspects of) the prevention and management of nuclear crises. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Challenges and opportunities in occupational medicine

Recent position papers of the American College of Physicians and the Institute of Medicine have emphasized the role of primary care physicians in occupational medicine. Although opportunities for physicians to become certified in occupational medicine have expanded, shortages in the specialty are likely to persist throughout the 1990s. To help acquaint osteopathic physicians with some of the challenges facing the specialty of occupational medicine, this article addresses the extent of occupational illnesses, health-related policies in the workplace, the delivery of occupational medical services, and graduate medical education.     

Oncocytic hepatocellular carcinoma with numerous globular hyaline bodies

The current approach to the management of physician resources in Canada needs to be re-examined by all concerned. Canada is about to enter a phase of accelerating depletion of physicians as the result of two separate and evolving circumstances. Because of the unusually large number of physicians who graduated from Canadian medical schools in the late 1960s and early 1970s, a significantly larger than usual number of practising physicians will reach their normal retirement age in the decade ahead. In addition, if the recent surge in the emigration of Canadian physicians continues, the loss of so many physicians will exaggerate the impact of the expected increase in retirements. Therefore, the decision to cut medical school class sizes in the 1990s would have been more suitable in the early 1980s. Existing physician work force policies may be leading to unexpected or undeclared consequences for health care across Canada. On the basis of current trends, the author concludes that policy makers now should reconsider current physician workforce policies in anticipation of a possible shortfall of physicians beginning in the early decades of the next century.     

Sperm and HIV

Screening and prevention are two major weapons in the fight against AIDS. Procreation of couples where the spouse is seropositive poses a serious ethical social and epidemiological problem. We have consequently established a list of the current biological data concerning HIV in the sperm at the level of non germinal cells, seminal plasma and spermatozoa and of the clinical data on the transmission of the virus during sexual intercourse and insemination. Finally, we have presented the results of the research on predictable factors of the infectiousness of sperm. After this analysis, we consider the possibilities open to the medical corps: dissuasion, ovulation monitoring, insemination with the husband sperm, IVF and insemination with hope to be able to participate in the debate which must lead to a clear concerted and coherent position on the part of the medical corps, at least on a national level.     

Endoscopic bile duct stent placement as a predictor of outcome following endoscopic sphincterotomy in patients with suspected sphincter of Oddi dysfunction

The long way toward the Mexican Independence developed in various stages, each one characterized by the temperament of the leaders, the theater of war actions and the social instances. At the beginning of the movement, of popular and radical types, we find few physicians perhaps due to the small number of them in the cities and to their absence in the villages. The middle period shows a larger number of national and foreign physicians. They are present in a more important number during the last stage, of bourgeois and reformist characteristics. The comportment of these worthy members of the medical class, during the different stages of the national independence movement, is a clear example of the patriotism and honesty of the Mexican physicians.     

Specialty differences in cardiovascular disease prevention practices

OBJECTIVES: The aim of this study was to examine physician specialty differences in cardiovascular disease prevention practices. BACKGROUND: Despite the importance of cardiovascular disease prevention, little is known about current national practices, particularly physician specialty differences. METHODS: Using a national survey of office visits, we evaluated differences in the propensity of physicians of different specialties to provide prevention services. We analyzed 30,929 adult visits to 1,521 physicians selected by stratified random sampling in the 1995 National Ambulatory Medical Care Survey. Standard and ordinal multiple logistic regression models were employed to estimate the independent effects of physician and patient characteristics. RESULTS: A variety of cardiovascular disease prevention services were provided during an estimated 547 million adult office visits to US physicians in 1995, including blood pressure measurement (50% of visits), cholesterol testing (5%) and counseling for exercise (12%), weight (6%), cholesterol (4%) and smoking (3%). In addition, medication management was reflected by the report of antihypertensives in 12% of visits and lipid-lowering medications in 2%. Across these eight services, propensity to provide services varied consistently with specialty. Controlling for patient and visit characteristics and compared to general internists, the likelihood of providing services was higher for cardiologists (adjusted odds ratio 1.65, 95% confidence interval 1.44 to 1.89) but lower for obstetrician/gynecologists (0.75, 0.68 to 0.82), family physicians (0.69, 0.64 to 0.74), general practitioners (0.58, 0.53 to 0.63), other medical specialists (0.65, 0.59 to 0.72) and surgeons (0.06, 0.05 to 0.06). CONCLUSIONS: Cardiologists have the greatest propensity to provide cardiovascular disease prevention services, while primary care physicians vary substantially in their practices. These findings suggest a need to address variations in cardiovascular disease prevention.     

Near drowning. Rescuing patients through education as well as treatment

Optimal prehospital care of near-drowning victims requires bystanders and emergency-response personnel who are knowledgeable in CPR and proper rescue techniques. Primary care physicians can play an important role when asked to teach CPR, first-responder, or emergency-care classes or to serve as medical director for a local ambulance group. Rapid response and appropriate ventilation and airway protection by prehospitalization providers can improve the condition of near-drowning victims on arrival in the emergency department and their chances for neurologically intact survival. With knowledge of the local risks of drowning, proper emergency treatment, appropriate referral, and conscientious efforts at prevention conducted in the office and the community, primary care physicians can have maximum impact on this summer-time killer.     

Patient-reported medical outcomes according to physician type and region

The purpose of the present study was to determine whether patients with common foot disorders have different medical outcomes depending on whether podiatrists, orthopedic surgeons, or other physicians provided their medical care in rural or urban areas. A validated medical effectiveness score was formulated using indirect standardization of risk-adjusted morbidity, based on patient reports from a national random household interview survey of 3,270 subjects. Patients in rural and urban areas did not differ significantly in medical outcomes across provider types, but there was a trend for patients in rural areas to have poorer outcomes. The medical effectiveness score of podiatrists was 3.9 times higher (indicating more beneficial outcomes) than that of orthopedic surgeons or other physicians (p < 0.01). Patients that visited podiatrists for common foot problems reported significantly more beneficial outcomes than those who visited other types of health care providers.     

Medical Records for Building Health Management

Medical records provide essential information for evaluating a patient’s health. Without them, it would be difficult for doctors to make accurate diagnoses. Similar to diagnoses in medical science, building health management also requires building medical records for making accurate diagnoses. At later stages of a building’s life cycle, when the budget is limited, organizations responsible for building repairs and maintenance are unable to digitalize building health diagnoses and keep complete medical records of buildings; as a result, maintenance crews usually cannot fully understand buildings’ overall health conditions and their medical histories, which may result in erroneous diagnoses directly or public safety dangers indirectly. Using the problem-oriented medical record adopted for the medical diagnosis of human diseases, this paper designs a building medical record (BMR), which allows simple electronic archiving, and evaluates its practicability with a case study of school buildings. The purpose of a BMR is to enable maintenance engineers (building doctors), building managers, and contractors of school buildings to have low-cost access to required information for making complete evaluations and maintenance suggestions for buildings.     

Nutrient Intake Report: a coordination of patient dietary assessment between physicians and registered dietitians

The Nutrient Intake Report (NIR) is based on a 7-day dietary recall questionnaire used previously in research for dietary assessment and adapted for clinical use. Used to provide information and counseling as part of total patient care, the NIR acts as a cornerstone for dietary education and interaction between physician, registered dietitian, and patient. The NIR is ordered by physicians or registered dietitians, scanned and assessed by a registered dietitian, and incorporated into the laboratory section of the medical record. It documents the patient's dietary intake in the context of his or her diagnosis and general health status. The NIR also opens a dialogue between physicians and registered dietitians. Incorporation of the NIR into the medical record makes the work of the registered dietitian available to other health practitioners, which is welcome in an era when licensing and reimbursement are contingent on systematic documentation of dietary assessment and its role in patient care.