MR safety: past, present, and future from a historical perspective

This article focuses on both static field effects and oscillating magnetic fields associated with MR imaging and spectroscopy. Contemporary experiments and theories on health effects demonstrate that currently MR imaging is practiced in a safe manner. Technological capabilities and medical science objectives, however, will lead to procedures that will challenge the thresholds of physiological effects. Thus progress in this field will require continual surveillance and better definitions of guidelines which at present are considered prudent but too restrictive.     

Asbestos: past, present and future

Owing to its particular properties asbestos has been widely used for the production of insulating material, for fire proofing, and for strengthening to other materials such as cements and plastics, and thus the story of this mineral was one of progressive commercial success until the middle of this century. However, serious health hazards were realized early: around the turn of the century a progressive form of diffuse fibrosis (asbestosis) in asbestos workers was observed and in 1950 an excess risk of lung cancer, while in 1960 the causal relationship between asbestos and mesothelioma were confirmed. In view of the known potential risks of asbestos and its widespread use in the building industry, more recently asbestos has caused considerable public concern and anxiety. Based on numerous experimental and epidemiological observations, present knowledge of the pathogenic effects of asbestos is sufficient for a number of broad conclusions to be drawn. (1) The amphibole types of asbestos are too dangerous for use as industrial material, and should be banned. (2) Chrysotile can probably be used safely if there is strict control of the workers' dust exposure. (3) It is very unlikely that the general public is at any measurable risk from asbestos in buildings. Exceptions are people working regularly on maintenance tasks involving removing or cutting of asbestos in buildings; such people are properly classified as asbestos workers and should be protected accordingly.(ABSTRACT TRUNCATED AT 250 WORDS)     

Hydroxychloroquine: past, present, future

OBJECTIVE: To examine the trends in motor vehicle exhaust gas suicides since 1970 and to investigate the impact of catalytic converters. DESIGN: Australia-wide database analyses and a retrospective stratified series of 100 Victorian cases. DATA SOURCES: Australian Bureau of Statistics, 1970-1995; Australian Institute of Health and Welfare, National Injury Surveillance Unit, 1991/92-1995/96; Victorian Coroner's files, 1994-1996. RESULTS: There were 509 motor vehicle exhaust gas suicides in Australia in 1995, representing 22% of total suicides. Since the 1986 requirements for reduced carbon monoxide emissions from new vehicles (and thus the use of catalytic converters), the absolute numbers and rates of such suicides have increased, and they have come to represent a larger percentage of total suicides. Of 75 Victorian victims' vehicles traced, 36% were manufactured during or after 1986, showing that exhaust gas suicides have occurred in vehicles with catalytic converters. Blood carboxyhaemoglobin levels did not differ between victims using vehicles with or without catalytic converters. Between 1976 and 1991 exhaust gas suicides increased at a faster rate than motor vehicle registrations. Australian hospital admissions for exhaust gas suicide attempts have increased substantially since 1991-1992. CONCLUSION: Catalytic converters and the associated lower CO emission limits of 9.3 g/km had not, by 1995, resulted in a reduction in numbers, rates or percentages of exhaust gas suicides in Australia.     

Psychoneuroimmunology: Past, present, and future.

Provides a brief overview of the history and current status of behavioral immunology research as well as speculation on the likely future directions. It is suggested that field may have broad implications for basic biological sciences and medicine. The field of psychoneuroimmunology has clear relevance for health psychology; its relevance to actual health outcomes, however, is not yet known. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pain: Past, present and future.

The gate control theory of pain proposes that a mechanism in the dorsal horns of the spinal cord acts like a gate that inhibits or facilitates transmission from the body to the brain on the basis of the diameters of the active peripheral fibers as well as the dynamic action of brain processes. As a result, psychological variables such as past experience, attention, and other cognitive activities have been integrated into current research and theory on pain processes. The gate control theory, however, is not able to explain some chronic pain problems which require a greater understanding of brain mechanisms. A new theory of brain function that proposes a new conceptual nervous system is described. One of the system's components is a body-self neuromatrix whose portions (or neuromodules) subserve major psychological dimensions (or qualities) of experience. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pubovaginal slings: past, present and future

Renewed interest in the pubovaginal sling procedure for stress urinary incontinence has occurred in response to recent reports of poor durability and inconsistent efficacy associated with simple cystourethropexy. Many of the failures are felt to represent patients with an unrecognized component of intrinsic sphincteric deficiency. Historically slings have a favourable cure rate, but have been perceived as having unacceptably high rates of prolonged urinary retention and secondary detrusor instability. This article reviews the preoperative evaluation and indications for pubovaginal slings, describes the evolution of the current techniques, and discusses choice of sling material, surgical approach, results and complications. It is hoped that this review will stimulate interest in this versatile but technically challenging procedure.     

Cancer prevention: past, present, future

There are many examples of different types of cancers that have been prevented by appropriate measures in the past. Most of them were related to occupational, iatrogenic or accidental factors, often as the outcome of heavy exposure of humans to specific carcinogenic agents. Cancer is a disease of DNA, and is generally associated with multiple genetic alterations, these being produced in the typical case by exposure to various carcinogens, each of which exists at minute concentrations. Thus, the impact of carcinogenic factors, xenobiotics and autobiotics, is due to their actions in concert. However, a single mutation yielding genomic instability exerts a disproportionately large influence by resulting in a large number of secondary mutational events. Epigenetic changes can also not be disregarded especially from the view point of prevention of neoplasia. The occurrence of multiple primary cancers among survivors of initial primaries, and the presence of hereditary groups with a high risk of cancer development provide a strong stimulus for establishment of effective approach for cancer prevention, which should be, in principle, multi-faceted. Therefore, a holistic approach is essential with improvement in life style including choosing a balanced diet and avoidance of cigarette smoking and other sources of carcinogens, as integral elements.     

船舶用钢标准现状分析与展望

对我国船舶用钢标准的演变、取得的成绩、存在的问题以及下一步的工作等内容进行了全面地介绍和对比分析,对更好地了解船舶用钢标准具有一定的参考价值和现实意义。     

Workers' compensation past, present, and future: a model for reform

The author describes the volatile and highly complex nature of workers' compensation programs and details the successful evolution of Kentucky's system.     

Cognitive development: Past, present, and future.

Summarizes what developmentalists have come to believe about human cognitive development after over a century of study. Topics briefly considered include the child as constructive thinker; invention of new research methods; the diagnosis problem; recent changes in estimates of children's competence; the question of general stages vs domain-specific developments; the effects of expertise; natural domains and constraints; cognitive development as theory development; synchronisms, sequences, and qualitative changes; mechanisms of development; sociocultural influences; individual differences; practical applications; and suggestions about what develops. This article concludes with some guesses about future directions for the field. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cost offset: Past, present, and future.

The health of the U.S. health care system is precarious. Calls for reform in areas such as cost, quality, and equal access to health care are widespread and growing louder each day. Action is required on each of these issues, yet the lack of progress is cause for serious concern. A central problem is the reluctance to acknowledge the roles that the mind and behavior play in health and illness. One solution is the integration of psychological health care into the general health care system. A major vehicle for advancing the integration of health care is the "cost-offset" effect, a concept that involves paying systematic attention to psychological factors in order to reduce overuse of medical services and thereby decrease costs. Despite data demonstrating that the cost-offset hypothesis is quite robust, little has been done to implement integrated health care. This article reviews the literature on cost offset, discusses the policy implications, and considers its application to the public sector. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medicare managed care: past, present, and future

Medicare managed care enrollment has mushroomed in the past few years, tripling from 1993 to 1997. The payment rates have allowed plans to offer valuable extra benefits to beneficiaries at little or no additional cost; employers have provided inducements for their retirees to enroll; and many of the new Medicare beneficiaries are already in managed care plans when they enter the program. The Balanced Budget Act of 1997 and other factors could cause enrollment trends to change in either direction. More kinds of plans, including physician service organizations and preferred provider organizations, may be more attractive; new educational efforts may make more beneficiaries aware of managed care plans; and employers may continue to move their retirees into managed care. On the other hand, lower than expected Medicare payment rates to the plans may reduce the additional benefits they offer; consumer dissatisfaction with managed care is growing; and employers are dropping retiree benefits altogether. The future of Medicare managed care is hard to predict.     

Jury instructions: Past, present, and future.

This introduction provides an overview of the relevant issues addressed in this special theme issue of Psychology, Public Policy, and Law, which is devoted to the topic of jury instructions. It begins with a brief history of jury instruction research. This is followed by a summary of the articles represented in this issue. Next, the strengths and weaknesses of the typical methodology used in jury instruction research are considered. Finally, the specific goals of this special issue are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Instructional psychology: Past, present, and future.

Traces the history of instructional psychology from the early part of this century to recent developments. Currently, instructional psychology, with the methods and concepts of cognitive psychology, focuses on the acquisition of intellectual competence. Researchers are examining such areas as the knowledge and cognitive processes required in advanced levels of reading and text comprehension, the computational and problem-solving skills needed in mathematics, the skills of learning assessed by aptitude tests, and the effects on school achievement of the interaction between initial ability and classroom variables. The emerging field of instructional psychology can be described in terms of 4 major components: the nature of the competence to be attained, the initial state of the learner, the transition processes between these 2 stages, and ways of assessing and monitoring performance changes in the acquisition of competence. Principles that should guide the development of a psychology of instruction are discussed. (110 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental retardation: Past, present, and future.

The history of the education of the retarded, the development and subsequent overuse of institutional programs, and the current emphasis on deinstitutionalization are discussed in relation to social-political movements occurring in the same time periods. The contributions of E. Seguin, A. Binet, H. Goddard, and L. Terman are discussed, moving from an emphasis on education and early development to identification and classification with the use of tests. Genetic differences appeared to be confirmed by early cross-sectional studies, and the concept of the "fixed IQ" influenced attitudes toward retardation and care-giving institutions. The beginning of current emphasis on the modifiability of mental development, deinstitutionalization, and social and medical prevention was signaled by the 1962 report of the President's panel on mental retardation. It is stressed that future programs for the retarded will be influenced by the availability of resources and the presence of innovative, well-trained people dedicated to work with the retarded. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive therapy: Past, present, and future.

Proponents of cognitive therapy have striven to establish this approach as a mature system of psychotherapy for over 3 decades. The theoretical formulations have been enriched by clinical extrapolations from the neopsychoanalysts and experimental findings from cognitive psychology. The therapeutic strategies and techniques have been refined as a result of interaction with behavior therapy, which also influenced the emphasis on empirical testing of the theoretical formulations and the therapeutic applications. Outcome trials have demonstrated efficacy in a number of common disorders. New emphasis on the crucial importance of specific formulations (especially dysfunctional beliefs) has provided important clues to the treatment of a large number of other disorders. It is concluded that cognitive therapy has fulfilled the criteria of a system of psychotherapy by providing a coherent, testable theory of personality, psychopathology, and therapeutic change; a teachable, testable set of therapeutic principles, strategies, and techniques that articulate with the theory; and a body of clinical and empirical data that support the theory and the efficacy of the theory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Defining epileptogenic foci: past, present, future

There is a direct relationship between the geometry (location, area, and orientation) of cortex-generating epileptiform discharges and resultant spike or seizure voltage fields at the scalp. Epileptogenic foci have been localized traditionally with EEG by identifying the negative field maximum (e.g., a phase reversal between adjacent bipolar channels). However, it is the shape of the entire voltage field over the head, including both negative and positive maxima, which provides information necessary to characterize the focus properly. Source location and orientation can be inferred from spike or seizure voltage topography, however, three-dimensional visualization can be obtained from mathematical source models, such as an equivalent dipole. Recent investigations have shown that dipole models can identify the location of epileptogenic foci with sub-lobar precision. Accuracy is enhanced by using additional electrodes, particularly on the lower half of the head, and by measuring their location. Realistic head models obtained from three-dimensional reconstructions of MR images can overcome errors introduced by simple spherical models of the cranium. Co-registering EEG voltage topography and source models with a patient's own cerebral anatomy will make EEG an unparalleled functional imaging technique for defining epileptogenic foci.     

Psoriasis: a review of present and future management

Psoriasis is a chronic skin condition prevalent in a significant minority of the population. Its cause is unknown and effective treatments are elusive. In this article, the authors examine the impact of the disease on patients' lives and describe how unproven treatments make skilled nursing essential for people with such a challenging and disabling disease.