Vomiting and parotid enlargement.
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Biomedical subjects
Publications and source records attributed to A Kaufman.
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Students in the health professions are working with a variety of anxiety-provoking patients, such as victims of child abuse or sexual assault, suicidal and terminally ill patients. Faculty have a responsibility to assist these students in maximizing the growth potential of the experience. This study, involving 22 female and three male students at the University of New Mexico Colleges of Nursing and Medicine, examines the effects of such an experience. Each participant worked on a Sexual Assault Response Team at the Bernalillo County Medical Center for an average of 8.6 months; each saw an average of 16 rape victims for whom they provided counseling services and assisted in medical care and gathering evidence. All of the students reported heightened awareness of their own vulnerability. They began to develop cognitive and behavioral strategies to cope with the possibility of being raped. Approximately one third of the subjects developed symptoms similar to those experienced by rape victims. Those who did not develop symptoms attributed it to being able to work through their feelings at team meetings. Students became more aware of their attitudes toward rape victims, both positive and negative. Moreover, the most significant change they experienced was in their own perception of themselves as care givers; they felt more confident and competent, both in medical and counseling areas. Faculty are encouraged to meet weekly with students involved in such experiences.
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Fourteen male rape victims treated in a county hospital emergency room over a 30-month period are compared with 100 randomly selected female victims treated over the same period. The male victims as a group sustained more physical trauma, were more likely to have been a victim of multiple assaults from multiple assailants, and were more likely to have been held captive longer. They were more reluctant to reveal initially the genital component of their assault and were more likely to use denial and control their emotions in reaction to the assault. Proper diagnosis and treatment of male rape victims requires a high index of suspicion and sensititivty to the likelihood of major, hidden trauma.
The diagnosis of multiple endocrine neoplasia type II (MEN-II) was made in 18 patients from 1966 through 1978 at the University of Michigan Medical Center. Eight patients had adrenal medullary disease. Seven had bilateral adrenal pheocyromocytomas (two with concomitant medullary hyperplasia) and one had a unilateral pheochromocytoma with contralateral medullary hyperplasia. No malignant or extraadrenal pheochromocytomas were found. Pheochromocytomas in patients with MEN-II are multiple and involve both adrenal glands. Adrenal venography is advocated as the primary diagnostic tool for localization of adrenal medullary disease in MEN-II patients.
Current governmental policy regarding long-term care of the elderly relies heavily on a medical-model approach that stresses institutionalization. Because institutationalization has severe negative effects on older people, this policy must be redirected to encourage development of viable alternative programs and to support the traditional role of families in caring for their dependent aged members.
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Prison health has long been neglected as an area of serivice by organized medicine and a site for clinical education by health science centers. The University of New Mexico Health Science Center offers an elective, weekly clinical experience for preclinical medical students, senior nursing students, and senior pharmacy students at a prison facility in need of medical services. Students' reaction to the prison experience was strongly positive. Most developed empathy toward the inmates and a greater understanding of prison health problems. Inmates rated the student service highly and requested its continuation. This community health education experience has provided a noncontractual model of a university-prison health alliance.
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