Studying addicts over time: methodology and preliminary findings.
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Biomedical subjects
Publications and source records attributed to M Lerner.
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Traditional oriental thinking attracts the growing scientific interest of occidental practitioners. Dr. Pierre Etévenon, head of the Department of Neuro-Psycho-Pharmacology at the French Institute for Health and Medical Research (INSERM), held several conversations and scientific exchanges with the author, and kindly provided copies of some of his works. They are at the basis of the present paper. M. A. Descamps (Paris) found that asanas--yoga postures-- are generators of dynamic action when there is an extension of the spinal column, whilst they lead to quiet states when there is a flexion of it. Claeys and Gones (Belgium) proved that overall global relaxation, as well as differential relaxation were far more effective and deep when obtained by yogis than those attempted by University students majoring in Physical Education. Lonsdorfer and Nussbaum (France) studied several parameters concerning hatha-yoga and concluded that it provides a regular functioning of the main bodily functions fostering thus a psycho-physical balance. Wallace and Benson (U.S.A.) proved that transcendental meditation increases aerobic metabolism, counteracting anaerobic metabolism which is related to mental distress. Etévenon (Paris) investigated neurophysiological effects of yoga in connection to ancient Indian concepts (Upanishads) on sleeping, meditation and degree of consciousness. Dr. Etévenon has studied the phylogenetic evolution of waking-sleeping cycles, focusing on phylogenetic and ontongenetic appearances of REM cycles (activated sleep). A correlation has been made with EEG studies during states of concentration (yoga, transcendental meditation, Zen). These states have been found to be specific brain activities, and different from deep sleep, in spite of certain similarities in the EEG. Several hypothesis are set forth to explain brain activities underlying sites of concentration. The possibilities of developing a conscious mastering of dreams are also under research, and special attention is paid to the works of Saint Denys (1867), and hindu tradition. This paper discusses also the psychological, therapeutic and anthropological implications of recent discoveries in the field.
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Physicians generally know how patients pay for their medical care. At the Marshfield Clinic, however, a group practice in Marshfield, Wis., physicians did not know the source of payment for the vast majority of their patients (79.3 percent). Also, even for the approximately one-fifth of the patients whose payment status they reported knowing, the information was incorrect for a small proportion. The patient's age and sex, length of time the physician had provided care, patient's place of employment, reason for patient's visit, and whether the physician was in the medical or surgical department apparently affected the physician's knowledge of the patient's payment status. Twenty-five of the 49 physicians studied reported they knew the payment status of none of their patients about whom they were asked; 24 knew the status of at least one patient. Only one physician in seven, however, reported having this knowledge about all the patients about whom he was asked. Physicians in medicine were more likely than those in surgical sub-specialties to know the patient's payment status. About one physician in five said such knowledge would be helpful for at least one patient; about one in seven said it would be helpful for all patients about whom they were asked. The Marshfield Clinic physicians, who receive salaries, emphasize comprehensive care and increased access to care, rather than maximization of income. The clinic offers medical care to patients in a prepayment health plan while continuing to serve other patients on a fee-for-service basis. Arrangements like this may help ease the transition to repayment if health-maintenance organizations become predominant in the delivery of health services in the United States.
The authors present a case report of pyoderma gangrenosum. Antibiotics may be indicated, but are not curative. A review of the literature is also presented.