PubMed · 249028
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C Kurz. 1978-04-20. [Facing reality, refusing myths].. https://pubmed.ncbi.nlm.nih.gov/249028/
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Modern treatment has increased the survival rate for children with brain tumour, but treatment with radiation may lead to late adverse neuropsychologic effects. Also, peer problems may follow long periods away from school, and painful treatment and anxiety about the disease may mobilize emotional stress reactions. 16 brain tumour children with a mean age of 11 years (range 6-16 years), all of them treated with radiation, were tested with WISC-R. The mean time between diagnosis and study was five years (range 2-11 years). Parents and teachers completed the Achenbach check lists CBCL and TRF. Children below age four years at diagnosis achieved the lowest WISC-R IQs, the highest problem scores and the lowest social adaptive scores on CBCL and TRF. More problems were reported among the youth group aged 12-16 years than among the child group aged 6-11 years. Hypoactivity and low psychomotor speed seemed to have an adverse effect on both intellectual and psychosocial functioning. An almost normal communicative and reasoning ability was a resource for most of the children.
OBJECTIVE: To assess the effect of anticipating job change or non-employment on self reported health status in a group of middle aged male and female white collar civil servants. DESIGN: Longitudinal cohort study (Whitehall II study). Questionnaire data on self reported health status and health behaviour were obtained at initial screening and four years later, during the period when employees of the department facing privatisation were anticipating job change or job loss. SETTING: London based office staff in 20 civil service departments. SUBJECTS: 666 members of one department threatened with early privatisation were compared with members of the 19 other departments. MAIN OUTCOME MEASURES: Self reported health status measures and health related behaviours, before and during anticipation of privatisation. RESULTS: In comparison to the remainder of the cohort, the profile of health related behaviours of cohort members who faced privatisation was more favourable, both before and during anticipation of privatisation. There were no significant differences in the changes in health behaviours between cohort members moving into a period of job insecurity and the remainder of the cohort. Self reported health status, however, tended to deteriorate among employees anticipating privatisation when compared with that of the rest of the cohort. CONCLUSIONS: The application of a longitudinal design, allowing the same individuals to be followed from job security into anticipation, provides more robust evidence than has previously been available that anticipation of job loss affects health even before employment status has changed.
In spite of prohibitions against the sexual involvement of physicians with their patients, erotic feelings sometimes arise in physician-patient relationships. The authors suggest that physicians can protect themselves and their patients from the harm that results from sexual involvement by establishing behavioural limits for their professional relationships, responding to patients' sexual overtures in a firm but nonjudgemental manner, examining their own sexual feelings rationally, seeking consultation if necessary and terminating the relationship if sexual feelings are compromising patient care. The challenge for physicians is to acknowledge that sexual feelings can arise and to manage such feelings for the sake of their own and their patients' well-being.