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[Who wants to go in early retirement? A multivariate analysis of civil servants' intention to retire early or not].

Despite the popularity of early retirement schemes in the Netherlands, little attention has been paid to the factors underlying this phenomenon. In this article an initial step is taken towards a multivariate modelling of plans for taking voluntary early retirement of older employees. Data for this have been obtained from a survey conducted among civil servants eligible for early retirement. This analysis includes various aspects which could be related to retirement. It appears that the attitude towards work, health, expectations regarding the consequences of retirement with respect to the loss of income, self-esteem, the perceived (positive or negative) attitude of the partner are the main reasons for civil servants to retire early or not. In the last model, containing all independent variables, 25 percent of the variance can be explained.

Age Factors↗

New legislation on civil commitment in Hungary.

In Hungary the legal provisions concerning civil commitment of mentally ill patients recently changed. The new act became effective in February 1995. The main reason for the amendment was to fulfil the duty concerning harmonization of the legal system with the European Convention on the Protection of Human Rights and Liberties, which was ratified by Hungary in 1992. Both the substantive criteria and the procedural rules changed: The need for treatment no longer justifies civil commitment, the role of the court has become more important, and more emphasis is laid on the protection of the rights of patients in commitment proceeding. In spite of these advantageous changes some important provisions remained unchanged: a regulation on the rights of committed patients is absent, and informed consent issues are not addressed in the new act.

Commitment of Persons with Psychiatric Disorders↗

[Eponyms and epilepsy (history of Eastern civilizations)].

The history of eponyms for epilepsy in the lands of the Eastern globe present the portrait of the attitudes of both the laymen and skilled people towards the disease and patient, as well as to the Nature itself. As opposed to the West which during the Middle ages changed its concepts of epilepsy as the organic brain disease for the sublime 'alchemic' position, the people of the East were more prone to consider from the beginning of their civilization till the XIX century that epilepsy is the consequence of the evanescent spiritual and extracorporal forces which by themselves were out of their reach. As compared to the western civilization, the historical resources are, often as a consequence of a linguistic barriers, more scarce-as consequently is the number of eponyms, but are nevertheless picturesque. The medical science from Babylonian period presumed that epileptic manifestations are the consequence of the demonic or ill spiritual actions. There existed an attitude that at the beginning of an epileptic attack the patient was possessed by a demon (the Akkadic, i.e., Babylonian verb "sibtu" denoting epilepsy, had the meaning "to seize" or "to be obsessed"); at the end of the clonic phase the demon departed from the body. Different demons were responsible for different forms of epilepsy such as nocturnal and children epilepsy, absence epilepsy and pure convulsions, simple and complex automatisms, and gelastic epilepsy. Thus, the doctors from the period of Babylon aside from making primordial classification of epilepsies, knew about their clinical picture (prodromal symptoms and aura, Jackson's epilepsy. Todd's paralysis), postictal phenomena and intericatl emotional instability; provocative factors were also known (sleep deprivation, emotions, as well as alcohol, albeit in a negative sense-as a cure for epilepsy). There is no doubt than in the period of Babylon the clinical picture of serial fits and its progress to status epilepticus were clearly recognized and considered as life threatening events. Persian history of epilepsy, except from the 6th century Zoroastrian "Avesta" document, lacks the written or spoken medical heritage untill the 7th century A.D. and the Arabic conquest of the entire Moslem world. On the other hand, Islamic medicine should be freed from the simple prejudice that the Moslem authors were only the translators of Greek medicine; contrary to such a view, their work contains a high degree of individuality. Although Mohammed introduced a lot of novelty into medicine, Khoran and the Sayings do not explicitly refer to epilepsy. Of importance is to notice that Moslem medicine did not have demons in the "repertoire" of direct causes of epilepsy. The causes and the cures of epilepsy were more magic-mystical and occult in nature, which is reminiscent of the European, as well as Serbian Middle age attitudes. Avicenna recognized difference between children and adult epilepsy. He considered insomnia and afternoon siesta as well as intensive sounds and light to be a provocative factors, whereby we see that at least empirically he knew of sleep (deprivation), startle and reflex epilepsy. The XIII century invasion of Mongols brought about the recession in Moslem Medicine; it recovered only in the XVIII century under the strong influence of European medicine handed over to us through Jewish doctors of various nationalities. The story of the China history of epilepsy has its debut approximately in the 8th century B. C. Medical texts from this period name epilepsy "Dian" and "Xian" which meant "the falling sickness" and "convulsions", respectively. Chinese medical terminology often interchangeably used the words "mania", "madness" and "psychosis" for "epilepsy" which, aside from a prominent language barrier, brings additional confusion. Although Chinese documents gave the first description of the grand mal epileptic attack already in the 8th century B. C. (ABSTRACT TRUNCATED)

China↗

Passenger doctors in civil airliners--obligations, duties and standards of care.

Airlines frequently rely on passenger doctors to assist with in-flight medical emergencies, but the legal implications of such actions vary between nations. While no examples of actions taken against treating physicians for alleged negligence in such emergencies were found, examples of recourse to litigation against individual airlines where the advice of passenger doctors was deemed to be incorrect are cited. Legislation regarding the obligation to treat patients involved in in-flight medical emergencies, the duty and standard of care once treatment, including any history-taking and examination, has commenced, and the requirement for consent to any examination or treatment that may be required is discussed. Particular emphasis is placed on comparing and contrasting the approach of the law in the United Kingdom and United States with the law in countries using Civil Law systems. The paper concludes with a hypothetical example of the kind of difficulties that may practically be encountered and a list of recommendations for physicians attending medical emergencies in civil airliners.

Aerospace Medicine↗

[Illness-induced early retirement of municipal civil servants].

The present study can't be but an impulse to initiate further investigations on officials' health and it's effects on employment. There are two reasons to do so: 1. The public frequently considers the system of civil servants to be unprofitable--clear facts can only be obtained by precise analysis in comparison with different employees. 2. Up to now, civil servants in Germany have been dealt with as stepchildren of occupational medicine; before including them into regular preventive medical check-ups, it would be efficient to realise relevant requirements.

Adult↗

Extended civil commitment for dangerous psychiatric patients.

Mental health clinicians are increasingly held civilly liable for the dangerous acts of their psychiatric patients. One area of liability is the negligent release of involuntarily committed patients who engage in dangerous acts after their hospital discharge. All states have provisions for extended involuntary commitment for mentally ill dangerous patients. We examined extended civil commitment petitions in Los Angeles County, California, and found that the great majority were rejected. While the standard for extended civil commitment in California includes verbal threats of substantial physical harm, deputy district attorneys tended to reject petitions initiated by clinicians when verbal threats were the sole criterion of dangerousness. This tendency by deputy district attorneys can be quite confusing for clinicians. Mental health professionals' liability has sensitized them to the legal implications of patients' verbal threats of harm; attorneys do not incur the same legal liability and are not so sensitized.

Adult↗

[Radiotherapy of cancer of the anal canal. 15 years experience at the Lyon civil hospices and brief review of the literature].

AIM: Retrospective analysis of a series of 287 anal canal carcinomas seen during a 15-year period in the Department of Radiotherapy Oncology of Hospices Civils de Lyon. MATERIAL AND METHOD: Between 1980 and 1995, 287 patients were managed in the radiotherapy department of Hospices Civils de Lyon. In 25 cases, the patients were referred for recurrence. Post or preoperative irradiation was performed in 12 and 23 cases. Palliative treatment was given to 15 cases and simple follow-up in 7 cases. Radiotherapy was given to 205 patients. In 71 cases irradiation alone and in 134 concomitant radiochemotherapy was given. RESULTS: The 5-year overall survival of the group treated by radiotherapy (205 patients) was 71.5% and the 10 year-overall survival was 60.8%. The specific survival at 5 and 10 years was 81.9% and 74.7% respectively. At 5 years the overall survival was 78% for the group treated by concomitant radiochemotherapy and 60% for the group treated by irradiation alone. CONCLUSION: Radiotherapy is the standard treatment for anal canal carcinoma. Radiochemotherapy seems to improve results in advanced cases. The best irradiation of technique has yet to be defined.

Adult↗

[PHOLY: a pilot study of drug utilization in civil hospitals in Lyon. Results].

As shown in many studies, up-to-date knowledge is not reflected in prescribing behaviours. The aim of pilot study PHOLY (Prescription aux Hospices civils de LYon) was to study methodological and technical conditions of a drug utilization study in a large university medical centre and to evaluate the discrepancy between drug prescribing and up-to-date knowledge. Data of 1115 in-patients of Hospices Civils de Lyon were collected. We have shown the feasibility of such a study in spite of many difficulties (52.15 per cent of questionnaires received, missing data...). Reference treatments such as ACE inhibitors in heart failure treatment or betablockers for high blood pressure represent respectively only 14.6 per cent and 6.7 per cent of the prescriptions in these indications. Within the framework of quality of care improvement, the study of the appropriateness of the treatments enables identification of domains where better therapeutic information is necessary.

Adrenergic beta-Antagonists↗

Policing, collective action and social movement theory: the case of the Northern Ireland civil rights campaign.

In this paper we examine the relationship between social movements and the police through an analysis of the Civil Rights Movement (CRM) which emerged in the late 1960s in Northern Ireland. Following della Porta (1995) and Melucci (1996) we argue that the way in which episodes of collective action are policed can affect profoundly both levels of mobilization and the orientation of social movements. We also submit that the symbolic and representational dimensions of policing can be a significant trigger in the stimulation of identification processes and collective action. The paper concludes by questioning some of the assumptions contained within social movement theory, and their applicability to divided societies such as Northern Ireland.

Catholicism↗

Addressing racial inequities in health care: civil rights monitoring and report cards.

Large racial inequities in health care use continue to be reported, raising concerns about discrimination. Historically, the health system, with its professionally dominated, autonomous, voluntary organizational structure, has presented special challenges to civil rights efforts. De jure racial segregation in the United States gave way to a period of aggressive litigation and enforcement from 1954 until 1968 and then to the current period of relative inactivity. A combination of factors--declining federal resources and organizational capacity to address more subtle forms of discriminatory practices in health care settings, increasingly restrictive interpretations by the courts, and the lack of any systematic mechanisms for the statistical monitoring of providers--offers little assurance that discrimination does not continue to play a role in accounting for discrepancies in use. The current rapid transformation of health care into integrated delivery systems driven by risk-based financing presents both new opportunities and new threats. Adequate regulation, markets, and management for such systems impose new requirements for comparative systematic statistical assessment of performance. My conclusion illustrates ways that current "report card" approaches to monitoring performance of such systems could be used to monitor, correct, and build trust in equitable treatment.

Adolescent↗

Civil rights in a changing health care system.

Title VI of the 1964 Civil Rights Act prohibits discriminatory conduct by recipients of federal financial assistance. The law has been used in the past to challenge discrimination in health care. The evolution of the health care system from fee-for-service to managed care holds much promise for minority persons, who historically have faced serious, extensively documented barriers to health care access. However, managed care providers, like their fee-for-service counterparts, may perpetuate past discriminatory practices in new ways. Understanding new forms of discrimination is important at this stage of the development of managed care, when program design and policy action can most effectively prevent the occurrence of such practices.

Civil Rights↗

Hospitals and Civil Rights, 1945-1963: the case of Simkins v Moses H. Cone Memorial Hospital.

In the 1960s, the legacy of discrimination against black persons still existed in all areas of medicine. This historical analysis investigates the strategies that were used by lawyers alongside physicians, dentists, and patients in elevating health care for black persons. Primary resources include oral histories, government documents, hospital records, archival and personal manuscripts, and professional and hospital periodicals. After World War II, leaders in the black community were determined to improve health care for black persons by ending discrimination in hospital policies and practices. Leaders of professional organizations developed a collaborative strategy that involved the court system, federal legislation, and research and education of the public and health professionals to integrate the hospital system rather than to expand the existing separate-but-equal system. Efforts culminated in the case of Simkins v Moses H. Cone Memorial Hospital; this case became the landmark decision by the U.S. Supreme Court and led to the elimination of segregated health care. Three months after the case, President Johnson ratified the Civil Rights Act of 1964, which included Title VI, thus extending the policy of equality to all federal programs. Laying a foundation for universal access to health care in the United States depended on a victory in the courts, in national health legislation, and in public opinion. All were achieved through strategic efforts to amass widespread support for the elimination of discrimination in medicine.

Civil Rights↗

Procedural justice in the context of civil commitment: an analogue study.

Procedural justice theory posits that the process by which disputes are resolved influences perceptions of fairness and satisfaction with outcomes, even if the outcomes are unfavorable. Within the context of civil commitment, Tyler (1992) has suggested that enhancing respondents' perceptions of procedural justice (i.e., participation, dignity, and trust) during commitment proceedings might facilitate accommodation to an adverse judicial determination (i.e., commitment) and subsequently enhance therapeutic outcomes. The study reported here used videotapes of mock commitment hearings to examine whether patients committed for involuntary treatment are sensitive to procedural justice manipulations. Results suggest that patients are sensitive to procedural justice manipulations and, further, that such manipulations are likely to influence the patients' attitude toward psychiatric care. These findings suggest that the development of strategies to enhance patients' perceptions of procedural justice in commitment hearings may indeed have positive therapeutic implications and warrants further investigation.

Adolescent↗

Plaintiff life-taking: the effect of mock juror attitudes toward suicide on assignment of negligence and damages in a civil suit.

Social scientific and legal scholars have examined the potential of a variety of case-relevant biases to distort juror decision-making (inter alia, death penalty attitudes, attitudes toward corporations, attitudes toward physicians, etc.). However, previous research has yet to address empirically the impact of attitudes toward suicide on juror decision-making. This study sought to examine the impact of mock juror's attitudes toward, and experiences with, suicide on assignment of negligence and damages in a civil suit. While results suggest that mock juror attitudes toward suicide do not directly affect a juror's assignment of negligence or damage awards, they do suggest that jurors may be susceptible to a reactance effect. As a result, attorneys should exercise caution when considering whether to directly address issues of possible plaintiff suicide.

Adult↗

Passing on our culture: how older Australians from diverse cultural backgrounds contribute to civil society.

Australia is a culturally diverse country, with one in five older Australians born overseas in non-English speaking countries, as well as others who are part of the Indigenous population of Aboriginal and Torres Strait Islanders. Little is known about how these individuals age productively and contribute to society. Survey data show that they are less likely to volunteer for an organisation than other older people, yet it may be that they contribute to civil society in alternate ways that are generally unrecognised and unacknowledged. In the absence of a general lack of understanding of how older Australians from diverse cultural backgrounds contribute to community, the aim of the present paper is to explore this topic using qualitative data from a larger study of the lived experiences of older Australians. Findings suggest that respondents are very active within their families and communities in ways that differ from mainstream older Australians. Generally, they have an important role in maintaining or promoting their culture; and providing support across their communities based on common experience. In particular, respondents describe a special relationship with the young within their communities. This includes being a grandparent or elderly advisor, as well as the role that many Indigenous elders play in encouraging and supporting troubled young people. Although further and more representative studies of older Australians are now needed, this paper, nevertheless, begins to explore what has been a neglected area of ageing policy and research.

Aged↗

The "army itch:" a dermatological mystery of the American Civil War.

The army itch was a chronic, severely pruritic dermatosis which first appeared among soldiers and some civilians early in the American Civil War (1861-1865). As the war progressed, so did army itch, becoming epidemic in the Potomac Valley of Maryland in 1862 and in Virginia in 1864. Immediately after the war, civilian cases traceable to contact with returning soldiers focused attention on the disorder, but the postwar outbreaks were short-lived and the army itch disappeared by the end of 1867. The origin of army itch eluded medical observers of the time, though many considered epidemic scabies to be the cause. Many cases of army itch were successfully treated with scabicides, but the disease had a well-deserved reputation for intractability. After a review of the chronology of army itch and excerpts from the writings of physicians who saw and treated the disease, it is possible to conclude that army itch was epidemic scabies, though the clinical picture was frequently confounded by coexisting pediculosis, prurigo, and other pruritic dermatoses.

American Civil War↗