Abstinence is not the only answer

Familial inheritance of congenital diaphragmatic hernia is uncommon. We report two siblings with identical bilateral diaphragmatic defects.     

Looking beyond the walls

Once a risk management process limited to hospitals, the practice of practitioner credentialing has expanded to include many other health care organizations, including insurers, health maintenance organizations, preferred provider organizations, management services organizations, medical groups, and independent practice associations. Standards set by recognized accreditation bodies, including the Joint Commission on Accreditation of Healthcare Organizations (Joint Commission), National Committee for Quality Assurance (NCQA), and American Accreditation Health Care Commission/Utilization Review Accreditation Committee mandate a substantial effort to properly evaluate the credentials of health care practitioners. A sector of commerce called the credentials verification organization (CVO) industry has undertaken the mission to make the process of practitioner credentialing more consistent and efficient, faster, and less expensive.     

Looking beyond the presenting problem

General practitioners tend to manage disease within the context of the patient's total life. They also have to deal with illness in its various forms when no overt 'disease' is evident. Looking at the interplay of these two facets of ill health gives a deeper understanding of what general practice is about and how general practitioners deal with the problems of their practice. Two cases are presented from the author's personal practice which display how general practitioners deal with the whole person rather than isolated problems. Analysis reveals that the ability to listen to the patient and the willingness to take adequate time is crucial to successful general practice.     

Looking back

Fractures of the first rib are extremely rare and are more commonly associated with either multiple rib fractures or life-threatening injuries. First rib fractures are commonly caused by direct trauma, violent muscular contraction or by chronic stress. We present a case of isolated bilateral rib fracture in an elderly patient, in the absence of multiple trauma, where the mechanism of injury appears to be a whiplash injury.     

Medicare's search for effective obesity treatments: Diets are not the answer.

The prevalence of obesity and its associated health problems have increased sharply in the past 2 decades. New revisions to Medicare policy will allow funding for obesity treatments of proven efficacy. The authors review studies of the long-term outcomes of calorie-restricting diets to assess whether dieting is an effective treatment for obesity. These studies show that one third to two thirds of dieters regain more weight than they lost on their diets, and these studies likely underestimate the extent to which dieting is counterproductive because of several methodological problems, all of which bias the studies toward showing successful weight loss maintenance. In addition, the studies do not provide consistent evidence that dieting results in significant health improvements, regardless of weight change. In sum, there is little support for the notion that diets lead to lasting weight loss or health benefits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Looking for Skinner and finding Freud.

Sigmund Freud and B. F. Skinner are often seen as psychology's polar opposites. It seems this view is fallacious. Indeed, Freud and Skinner had many things in common, including basic assumptions shaped by positivism and determinism. More important, Skinner took a clear interest in psychoanalysis and wanted to be analyzed but was turned down. His views were influenced by Freud in many areas, such as dream symbolism, metaphor use, and defense mechanisms. Skinner drew direct parallels to Freud in his analyses of conscious versus unconscious control of behavior and of selection by consequences. He agreed with Freud regarding aspects of methodology and analyses of civilization. In his writings on human behavior, Skinner cited Freud more than any other author, and there is much clear evidence of Freud's impact on Skinner's thinking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

电渣冶金的回顾与展望

制备超纯优质金属材料的精细冶金不断地向前发展,近期电渣冶金的进展令人瞩目。高压电渣重熔（ＰＥＳＲ） ,真空电渣重熔（ＶａｒＥＳＲ） 使重熔金属质量达到高纯水平。电渣热封顶（ＥＳＨＴ） 生产巨型钢锭具有技术与经济上的潜在优势