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Biomedical subjects

A M Brandt

Publications and source records attributed to A M Brandt.

At least 19 recordsLinked to original sources
PubMed2000

Antagonism and accommodation: interpreting the relationship between public health and medicine in the United States during the 20th century.

Throughout the course of the 20th century, many observers have noted important tensions and antipathies between public health and medicine. At the same time, reformers have often called for better engagement and collaboration between the 2 fields. This article examines the history of the relationship between medicine and public health to examine how they developed as separate and often conflicting professions. The historical character of this relationship can be understood only in the context of institutional developments in professional education, the rise of the biomedical model of disease, and the epidemiologic transition from infectious disease to the predominance of systemic chronic diseases. Many problems in the contemporary burden of disease pose opportunities for effective collaborations between population-based and clinical interventions. A stronger alliance between public health and medicine through accommodation to a reductionist biomedicine, however, threatens to subvert public health's historical commitment to understanding and addressing the social roots of disease.

Agonistic Behavior↗
PubMed1998

Electronic patient-physician communication: problems and promise.

A critical mass of Internet users will soon enable wide diffusion of electronic communication within medical practice. E-mail between physicians and patients offers important opportunities for better communication. Linking patients and physicians through e-mail may increase the involvement of patients in supervising and documenting their own health care, processes that may activate patients and contribute to improved health. These new linkages may have profound implications for the patient-physician relationship. Although the federal government proposes regulation of telemedicine technologies and medical software, communications technologies are evolving under less scrutiny. Unless these technologies are implemented with substantial forethought, they may disturb delicate balances in the patient-physician relationship, widen social disparities in health outcomes, and create barriers to access to health care. This paper seeks to identify the promise and pitfalls of electronic patient-physician communication before such technology becomes widely distributed. A research agenda is proposed that would provide data that are useful for careful shaping of the communications infrastructure. The paper addresses the need to 1) define appropriate use of the various modes of patient-physician communication, 2) ensure the security and confidentiality of patient information, 3) create user interfaces that guide patients in effective use of the technology, 4) proactively assess medicolegal liability, and 5) ensure access to the technology by a multicultural, multilingual population with varying degrees of literacy.

Communication↗
PubMed1997

FDA regulation of tobacco advertising and youth smoking. Historical, social, and constitutional perspectives.

Perspectives on tobacco control in American society have shifted markedly. As the view that smoking as a voluntarily assumed health risk has declined, the social and political environment has become more conducive to industry regulation. This transformation can be traced to the mounting evidence of the health risks of secondary smoke; the addictive quality of nicotine; the vulnerability and exploitation of young people; and industry knowledge of the harmful effects of tobacco. Regulation of tobacco advertising and promotions by the Food and Drug Administration (FDA) raises serious concerns about constitutional protection for commercial speech. However, the minimal informational value of tobacco advertising suggests that it should be afforded a low level of constitutional protection. The FDA regulations impose reasonable "time, place, and manner" restrictions, leave open alternative channels of communication, restrict messages that are harmful to the public health, do not restrict political speech, prevent misleading messages, and help deter the unlawful sale of tobacco products to minors. The regulations meet the traditional criteria for regulating commercial speech, in that the government's asserted interest is strong, the agency's regulations directly advance that interest, and the regulations are no more extensive than necessary. Thus, the judiciary should defend the FDA's historical social and legislative mission to protect the public health.

Adolescent↗
PubMed1994

Detection of relapses in alcohol dependent patients using serum carbohydrate deficient transferrin: improvement with individualized reference levels.

Alcohol dependent male outpatients were monitored for a period of six months. Indicators of alcohol consumption were compared using clinical information three times per week, serum levels of carbohydrate deficient transferrin (CDT) weekly and urine samples of 5-hydroxytryptophol daily. Individualized reference values of CDT were calculated by using an increase of three times the lowest coefficient of variation in the group, which meant that an increase of < or = 30% from the lowest value of each individual was considered a significant increase, and therefore an indication of alcohol consumption. By this approach, it was possible to improve the ability to detect relapses in alcohol dependent patients using serum CDT once a week compared to CDT using reference values recommended by the manufacturer.

Alcohol Drinking↗
PubMed1991

Emerging themes in the history of medicine.

The critical themes that have emerged in medical history over the last 25 years reflect the development of a "new social history of medicine." The earlier focus on the evolution of medical knowledge has been replaced by work that emphasizes the nature of the social responses to disease, their sociocultural meanings and historical epidemiology. Because medical historiography reflects debates and questions in contemporary medical culture, the AIDS epidemic is likely to have an important impact on the study of medical history in the immediate future.

Acquired Immunodeficiency Syndrome↗
PubMed1988

The syphilis epidemic and its relation to AIDS.

This article presents an overview of the history of medical and public health responses to syphilis in the 20th-century United States and briefly evaluates the relevance and significance of these approaches for the AIDS epidemic. The parallels are numerous: they relate to science, public health, civil liberties, and social attitudes concerning sexually transmitted infection. The strengths and limits of past approaches to controlling sexually transmitted diseases are explored as a possible guide for AIDS policy.

Acquired Immunodeficiency Syndrome↗