To err is human: An Institute of Medicine report.

In November 1999, the Institute of Medicine (IOM) Committee on Quality of Health Care in America released its report To Err Is Human; Building a Safer Health System. The IOM committee had found that between 44,000 and 98,000 Americans die each year as a direct result of medical errors committed in hospitals, The lower estimate made this the eighth leading cause of death, exceeding traffic accidents, breast cancer, and AIDS. Medication errors alone, occurring either in or out of hospitals, account for 7,000 deaths annually, more than the number of deaths from workplace injuries. The economic cost of preventable adverse events (medical errors resulting in injury) approximates $17-$29 billion. The committee recommended a four-tiered approach: (1) establish a national focus to create Leadership, research, tools, and protocols to enhance the knowledge base about safety; (2) identify and learn from errors through mandatory reporting; (3) raise standards and expectations for improvements in safety through the actions of oversight organizations, group purchasers, and professional groups; and (4) create safety systems inside health care organizations to implement safe practices at the delivery level. The committee called for the establishment of a Center for Patient Safety within the recently renamed Agency for Healthcare Research and Quality (AHRQ). The committee's rationale was thus: Health care in the United States is a decade or more behind other high-risk industries in its attention to ensuring basic safety. The report repeatedly called for establishing a "culture of safety," in which providers are encouraged to identify and prevent errors. In this regard, health care providers can learn from other industries, such as from aviation and occupational health, which have made systematic efforts to uncover and learn from past accidents and mistakes. To encourage prevention of errors, both facilities and practitioners must be held to objective performance standards and expectations (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Institute of Medicine report on prevention of mental disorders: Summary and commentary.

A comprehensive report mandated by the US Congress on the state of the science of prevention recommends a stricter definition of the term prevention; summarizes specific preventive intervention research programs across the life span; and specifies funding, personnel, and coordination priorities to build a national prevention research infrastructure. A major conceptual recommendation is a focus on reducing risk for mental disorders, which has been a fruitful strategy in the prevention of physical illness. The report argues that the prevention field should also draw from advances in mental disorder treatment research and from the major contributions to the knowledge base occurring in the behavioral and biological core sciences. Relevant advances in neuroscience, genetics, epidemiology, and developmental psychopathology are examined in detail. Five major disorders are chosen to illustrate possible approaches to prevention: conduct disorder, depressive disorders, alcohol abuse and dependence, schizophrenia, and Alzheimer's disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Murder of the mother by the daughter--family dynamics and mythology

The comprehensive casuistry, which is based on the forensic examination by the author illustrates a family-drama, in which a 19-year-old girl killed her alcohol and tablet dependent mother in multiple ways and later, with the help of the three years younger sister plastered the body in a sarcophagus inside the apartment. The paper will delineate the life-circumstances, the family- and the psychodynamic of the criminal act. Beside a review of the literature concerning matricide by the daughter, the dynamic aspect of the matricide will be discussed on the basis of the greek tragedies Elektra (Sophokles) and Medea (Euripides). The victim is compared with the part of Medea, the fate of the daughter with the fate of Elektra.     

Building sound and regular teeth. The National Institute of Dental Research celebrates its golden anniversary

BACKGROUND: Peripheral nociceptive barrage after tissue injury results in acute pain and a variety of physiologic responses, including pituitary secretion of beta-endorphin. This study evaluated whether administration of the pharmacologically active S(+)-isomer of ibuprofen suppresses acute pain and plasma beta-endorphin levels in the oral surgery model of acute pain. METHODS: Subjects in a single-dose, double-blind, parallel-group study received either 200 mg S(+)-ibuprofen, 400 mg S(+)-ibuprofen, 400 mg racemic ibuprofen, or placebo. Both doses of S(+)-ibuprofen resulted in significantly greater analgesia over the first 60 minutes in comparison to racemic ibuprofen and placebo; the 400 mg dose of S(+)-ibuprofen also produced greater analgesia at 2 and 3 hours. Plasma levels of immunoreactive beta-endorphin decreased over time coincident with the onset of analgesia in all groups but were significantly less than placebo after both doses of S(+)-ibuprofen from 30 to 120 minutes. CONCLUSIONS: These findings show that, compared with racemic ibuprofen, administration of the S(+)-isomer of ibuprofen results in faster analgesic onset, greater peak analgesia, similar duration of action, and a low incidence of adverse effects, while suppressing nociceptive activation of the pituitary-adrenal axis.     

A report on Indiana PANDA. Prevention of Abuse and Neglect through Dental Awareness

Since originally surveying Indiana dentists' knowledge of child abuse and neglect in 1990, numerous efforts have been made to help dental professionals improve their ability to identify and report instances of abuse. This article explains the purpose for the 1995 follow-up survey and why dental professionals' assistance is needed to complete the surveys. A second survey is scheduled for distribution six months after the Prevention of Abuse and Neglect through Dental Awareness (PANDA) efforts have been implemented to determine if those efforts are far having an effect throughout Indiana.     

Dental human resource distribution in Ontario: a report for 1997

Clinicomorphological diagnosis of uterine endometriosis based on distinguishing forms of the disease different by their activity is considered. Quantitative morphological methods used for the first time allowed to define reliable mathematical criteria of morphofunctional activity of endometriosis. The differential diagnosis is clinically perspective.     

Current problems of aviation medicine (the 60th anniversary of the State Research Institute of Aviation and Space Medicine)

The paper provides a brief review of topical problems of aviation medicine as an ingredient of occupational medicine. It considers the most important guidelines and concepts which ensure efficiency and reliability of skilled performance of specialists and shows the significance of research and practical advances of aviation medicine for human health promotion in our country.     

Commentary on the treatise "Radiation protection and quality assurance in dental radiography". Scientific Commission of the Society of Dental Medicine

Five cases of schistosomiasis have been recorded in the Belfast City Hospital Histopathology Laboratory over the last three years. The sites of infection have included the colon, bladder, uterus and seminal vesicles. All the infected individuals had visited Africa. Three of them were health care workers. The clinician must maintain a high index of suspicion when treating those with a history of travel and risk of exposure to this infection. Diagnosis is made even more critical as the condition is treatable, and serological markers can identify those with occult infection.     

Dental treatment and the alcoholic

Practising dentists must include in their diagnostic skills the ability to identify the patient with a high intake of alcohol. Dental status can often reflect the patient's perception of health and disease. The development of an appropriate treatment plan for these patients needs to take into account their generally unreliable nature. Appointments are often not kept; there is poor compliance with general health-care information, and compliance with preventive advice on dental care is achieved with difficulty. Symptomatic presentation is common with the alcoholic patient. The dentist should avoid "rushing in" to treat the presenting acute problem without appropriate investigation of the medical history. This should include consultation with the patient's medical advisor and other involved health professionals. A careful review of the oral mucosa for pre-cancerous or cancerous changes should be systematically included in the examination of any patient. Patients with a high intake of alcohol, and especially those who smoke, need to be carefully screened.     

Case report. Dental Class I and skeletal Class III with unilateral right crossbite

Different forms of bone grafting materials are alluded to in this paper. Autogenous graft is superior to other bone grafting materials but is many times not available or the patient is not willing to utilize cranial or iliac crest bone. Allografts, Xenografts and bone substitute materials are the most widely used today in dentistry and especially those patients wishing to use dental implants as abutment support. The technique discussed utilizing surgical tissue design, tissue closure over the graft material and the tissue barrier can be used to produce a successful final result using a graft material of choice. It is quite certain that in the near future, the use of bone graft enhancement materials (bone morphogenic protein-like substances) will be used to enhance a quicker result. It is anticipated that growth factors, stimulating factors, bone morphogenetic proteins, and osteogenetic proteins will cause a bone graft to vascularize, solidify, incorporate, and function optimally in a shorter period of time. These materials will reduce the disability time and enhance the outcome of bone grafting in the dental profession. It is also anticipated that advanced tissue surgical techniques will give better vascularization to the new graft. The described technique is predictable and should give the operator the desired result.