Developing and implementing interprofessional learning in a Faculty of Health Professions

Although medial displacement calcaneal osteotomy has been advocated for treatment of acquired pes planus, no studies have determined the biomechanical consequences at the ankle of such a procedure. The present investigation examined the alteration in ankle motion that resulted from a medial sliding calcaneal osteotomy. In dorsiflexion, the ankle specimens were found to have altered internal rotation and varus alignment. At maximal dorsiflexion, there was a 76% increase in internal rotation (4.4 degrees +/- 2.5 degrees versus 2.5 degrees +/- 1.7 degrees for intact ankles, P < 0.0004) and an increase of 425% in varus (0.42 degrees +/- 0.56 degrees versus 0.08 degrees +/- 0.34 degrees for intact ankles, P < 0.003). There were no significant differences seen in plantar flexion. Based on these results, caution is advised in the indiscriminate use of medial sliding osteotomies, because this procedure may predispose the patient to premature ankle arthritis as a consequence of the altered ankle motions.     

Background and prospects of the Community Health Act

Japan was defeated in World War II and almost all of the nation was demoralized by the destruction and damage to much of the nation. The medical and health care system during and before World War II needed to be reformed radically and fundamentally since almost all medical and health institutes were destroyed. On the other hand, many health personnel came back from overseas after the war. Japanese modern medicine had developed on the basis of German medicine; however, many aspects of American medicine, including public health and democracy, were rapidly introduced following the end of World War II. The American type of health center was established and many laws concerning medical and health care were enacted in 1947-1948. One of them was "The Health Center Law." The National Health Insurance Act was enacted in 1958 and the total population has been covered by health insurance plans since 1961. Many physicians quit the health centers and they have worked as clinicians under the National Health Insurance scheme, because health centers were introduced before adequate education and research existed in the field of public health. On the other hand, the health insurance scheme was in its golden age during the high economic growth period of the 1960s. Japan has succeeded in all forms of modern technology and economy for the past 30 years and is now one of the top nations in the field of medical and health care, such as the numbers of clinics and hospitals and beds, the frequency of consulting with a doctor, length of hospital stay, examinee rates in mass health examinations in the community and workplace and so on. Health conditions have changed drastically from the 1950s to the present. Therefore, health centers do not fit current health needs. For example, mortality from tuberculosis, acute infections diseases and also stomach and uterus cancers and apoplexy have decreased rapidly while mortality from chronic diseases, especially lung, breast and rectal cancers, and myocardial infarction have increased gradually. Changes of life style resulting from rapid economic growth are suspected to be important causes of the change in the prevalence of these diseases. Mass health examination was important and effective as a preventive measure against tuberculosis, especially as a means of early detection and early treatment. However, it is not now effective against chronic diseases. The screening examination has resulted in identifying many patients suspected of being ill. Every examiner must be able to distinguish pathologic findings from physiologic changes of aging. Every patient must, therefore, understand his/her individuality and evaluate the result of his/her efforts to improve life style by receiving a health examination. Accordingly, the aim of health examination has changed from early detection to health support for the examinee. During the decades when life expectancy was less than 50 years of age, it was not necessary for people to plan for retirement. Moreover, there was little burden on younger generations to provide care for the aged people because there were few old people more than 70 years of age and the birth rate was high. Nowadays, elderly people face many years of life after retirement and there are too many aged people in relation to the number of younger persons. As for medical care services, many new medical needs have emerged in recent years, including "quality of life," "palliative medicine in terminal care," "establishment of a primary care system" and "comprehensive care connecting health and medical care with welfare" etc. Improved living standards resulting from economic growth, called the "economic miracle" internationally, have helped to bring about a rapid and wide range of change in daily lifestyle, such as eating habits, working conditions and environment. The Ministry of Health and Welfare has made every effort to revise the laws in relation to health and medical care systems, in order to adjust to recent     

A discussion of problems in interpretation of the Mental Health Act

On the basis of their experience as psychiatrists, and observations of Mental Health Act influence on mutual relationships between psychiatrists, their patients and patients family members, the authors analyze situations in which strict, appliance of the law may be harmful, or, for other reasons, ethically doubtful. They suggest that the Mental Health Act is too meticulous in regulating the procedures regarding mentally disturbed persons. According to the law indications, motives for treatment without consent are more often social or behavioral rather than strictly medical. It limits the ability to help a lot of people who really require psychiatric care. Authors indirectly suggest that it is impossible to replace ethics and doctors' conscience by the law.     

Health planning, part 2; The National Health Planning and Resources Development Act of 1974

The National Health Planning and Resources Development Act of 1974 is discussed, with particular reference to national guidelines, Health Sytems Agencies, state planning and development, technical assistance from HEW, and the purpose, plan and state approval of Health Resources Development.     

Initial psychological research related to the Occupational Safety and Health Act of 1970.

Describes 5 classifications of research supported by the National Institute for Occupational Safety and Health, a U.S. Public Health Service agency. The categories are: (a) behavioral and neurophysiological disturbances resulting from exposure to chemical or physical conditions; (b) use of behavioral methods to detect occupational hazards; (c) individual differences affecting worker safety and health; (d) job stress and worker health, and (e) psychological strategies for improving safety and health practices. Specific studies being conducted in each area are reviewed briefly. (19 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Health Insurance Portability and Accountability Act of 1996: understanding the anti-kickback laws

This double-blind placebo-controlled study specifically tested the efficacy of fluvoxamine, at a dose of 100 mg a day, in reducing the risk of new episodes of depression. Out of 436 patients treated openly with fluvoxamine 283 patients fulfilled stringent criteria to define responders at 6 weeks. A total of 204 patients maintained their remission throughout a continuation treatment period of 18 weeks and then entered the prophylactic study. They were randomly assigned to receive either fluvoxamine 100 mg a day or placebo for 1 year. There were significantly fewer recurrences of new episodes of depression in the fluvoxamine group compared with the placebo group (p < 0.001). The significant advantage for fluvoxamine was also seen in the Kaplan-Meier analysis of time to recurrence (p < 0.001). The clear-cut efficacy of 100 mg of fluvoxamine and the good tolerability and side-effect profile demonstrated in this study support the view that fluvoxamine is particularly suitable for maintenance or prophylactic treatment.     

大学生心理健康教育

我国大学生心理健康状况不容乐观,自杀现象时有发生,这已引起党和政府高度重视。目前大多数高校都已成立大学生心理健康教育中心,而要想心理健康教育中心正常、高效运作,更好地服务于广大师生,必须做到思想认识到位、制度保障到位、教育措施到位。     

Societal Factors in Health Education.

Comments on T. J. Stachnik's original article (see record 1980-10503-001) which examined priorities for psychology in medical education and health care delivery. It is argued that psychologists must bring their expertise to bear on assisting Americans to alter current habits most likely related to preventable health problems. Additionally, this item comments on A. McAlister et al's original article (see record 1980-12690-001) which examined mass communication and community organization for public health education. The current author states that both articles are thought provoking, but wishes, however, that they had spotlighted the societal factors involved in health education--for example, the persistent and consistent propaganda of business establishments to get people to indulge in smoking or eat unhealthy foods in order to promote their own sales and profits. The current author asserts that however much one educates the community, certain industries have far greater access to mass media and make very effective use of them by clever advertisements, thereby neutralizing the effect of health education for a large number of people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Analysis of the Truth and Responsibility in Mental Health Practices Act and similar proposals.

A version of the so-called Truth and Responsibility in Mental Health Practices Act was introduced in New Hampshire's Legislature in 1995. The American Psychological Association (APA) Practice Directorate analyzed the legislation with the assistance of the law firm of Hogan and Hartson and, convinced of its potentially harmful impact on the public and the profession, assisted New Hampshire and other states in combating such misleading and harmful legislation. Anticipating that such legislation will continue to be introduced, the authors include analyses that will assist readers in understanding and dealing with the problems such legislation poses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

1998/1999 Award Winners: Distinguished Contributions to Education and Training.

Announces that Gregory Adams Kimble is the winner of the 1998/1999 Award for Distinguished Career Contributions to Education and Training, and that Nadine M. Lambert is the winner of the 1998/1999 Award for Distinguished Contributions of Applications of Psychology to Education and Training. Presented here are a citation, biography, and selected bibliography of each winner's works. Also included are the award addresses that they presented at APA's annual meeting in 1999. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health and substance abuse benefits in carve-out plans and the Mental Health Parity Act of 1996

Legislation passed in the fall of 1996 required employers and insurers offering mental health benefits to raise dollar coverage limits on mental health services to the level of medical services. We analyze the benefit designs of 4,000 current behavioral health carve-out plans and contrast them to medical benefits. We find that almost 90 percent of all plans are inconsistent with the current legislation and need to be rewritten in the coming year. The restructuring of designs required by the Parity Act provides a unique opportunity because plans often are inconsistent and unnecessarily complex, a legacy of past attempts by employers to contain costs and control adverse selection and moral hazard in an unmanaged fee-for-service environment. Under managed care, the need for deductibles, limits, or other demand-side cost-sharing mechanisms may have diminished and restructuring outdated designs could benefit both enrollees and employers.     

Conditions for women in in-patient psychiatric units: the Mental Health Act Commission 1996 national visit

All NHS services are expected to make in-patient wards single-sex. However, as LESLEY WARNER and RICHARD FORD report, women in psychiatric hospitals still have to share sleeping accommodation with men, and still experience sexual harassment, violence, threat and abuse. Some units are unable even to guarantee 24-hour access to a female member of staff.     

Health effects of microwave exposures: a review of the recent (1995-1998) literature

The microbial aetiology of large joint sepsis is changing now that joint replacement therapy is becoming common place. The clinical history and examination may give important clues about the likelihood of infection and the possible involvement of unusual organisms. Newly introduced technology to improve the sensitivity of tests for the presence of micro-organisms in synovial fluid has not yet made a significant contribution to routine management. New imaging techniques such as magnetic resonance imaging are likely to improve patient management, but their utility is still under assessment. Arthroscopic biopsy to obtain material for culture and histology is particularly important in suspected chronic septic arthritis. Prosthetic joint infections present a particular challenge to microbiologists since the organisms involved are often found in small numbers and are common skin contaminants. Optimal microbiological management involves the taking of multiple (> or = 5) samples, careful processing to resuscitate organisms whilst avoiding contamination, and careful interpretation of results in the light of the clinical and histological picture.