Seventy-five men undergoing vasectomy were tested by radial immunodiffusion assay prevasectomy and at 6 weeks and 3, 6, and 12 months postvasectomy for possible changes in serum immunoglobulin (Ig) levels. No significant changes occurred when the results were analyzed on a group basis per time period. However, when each individual's prevasectomy Ig level was considered as his norm, significant changes appeared to occur in serum IgG levels at 6 weeks, 6 months, and 12 months postvasectomy; in serum IgM levels at 6 weeks; but not, to date, in serum IgA levels. Seasonal, environmental, and infectious factors do not seem to be associated with the changes found. No significant seminal Ig changes have been demonstrated. Consideration of these findings and implications for possible immunopathology are briefly discussed.

Adult↗

PubMed1976

Looking at research.

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Attitude of Health Personnel↗

PubMed1976

Client-oriented medicine.

Both weak (Illich) and strong (Kerr White, Cochrane) cases have been made for radical changes in medical education and medical practice. The real needs of patients and of the community are considered to be incompletely served by the prevailing emphasis on acute hospital medicine, to the comparative neglect of primary care in the community and of the needs of particular 'client groups', e.g. the mentally and physically handicapped, and the elderly. Inherent in this approach are emphases on information systems related to morbidity rather than to mortality; on 'care' rather than on 'cure'; on quality control relating to 'outcomes' rather than to 'structure' or 'process' of practice; and on controlled trials of both new and accepted forms of treatment. Difficulties in this approach include the taxonomic incongruity of 'client-group' statistics and the 'disease-system' categories of biomedicine; the therapeutic expectations of the consciously ill; the intellectual interest and the immediacy of specialized clinical practice; and the necessary and profitable links between medical science and the general corpus of science. Nevertheless, and in the full recognition that what is socially desirable may not be scientifically feasible, there is a need in the research context to explore methods of assessing the 'health service priorities' to be attached to biomedical categories. However, these priorities are in themselves multiple, and their relative weighting involves value judgements which are not completely quantifiable.

Community Participation↗

PubMed1976

What happens to bereaved children?

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Attitude to Death↗

PubMed1976

Research and medical practice: their interaction. Introduction.

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Medicine↗

PubMed1976

The token economy in the National Health Service: possibilities and limitations.

The effects after 1 year of the introduction of a token economy system into a long-term male psychiatric ward of 45 mainly schizophrenic patients are described. The main objectives were (1) to define the limits of such programmes in "average" National Health Service conditions, where additional resources in staff, finance, and facilities are very limited and (2) to introduce the principles and techniques of behaviour modification to nursing staff. The programme succeeded in reducing social withdrawal and apathy and in increasing self-care skills and involvement in constructive activity. There was no change in the level of socially embarrassing behaviour. The major limitation affecting the maintenance of the programme was found to be the rapid turnover and unpredictable changes in nursing staff. It was concluded that such programmes are feasible with very little in the way of increased resources, and that such efforts will continue to be necessary in view of the existing large numbers of long-tern patients and the slow but significant accumulation of new patients.

Adult↗

PubMed1975