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[Sichuan People's Government stresses planned parenthood].

A recent provincial conference on planned parenthood work convened by the Sichuan Provincial People's Government proposed: It is necessary to further strengthen party committee leadership, persistently grasp together the 2 kinds of production, and, while carrying out propaganda and education with great fanfare, adopt legal, administrative, and economic measures to fulfill this year's population plan and unswervingly do a good job of insuring that each couple has only 1 child. A new situation has appeared in the province's planned parenthood work since last year. Some 1,466,000 couples have insured that they will only have 1 child, accounting for 78.8% of the couples of childbearing age who presently have only 1 child. Although the province was facing a peak birth last year, the natural population growth rate actually fell to 6.7/1000. The population growth rate in Mianyang Prefecture has greatly decreased. The population growth rate has now fallen below 5/1000 in 62 counties, municipalities and districts. Mianyang is the largest prefecture in Sichuan. Last year its natural population growth rate fell to 3.5%. Its primary experience is that the leading cadres at all levels must personally and repeatedly grasp the work and grasp together the 2 kinds of production. It is worth noting that, to control the population, it is necessary to strengthen leadership over large and backward counties. If the population growth declines in these counties, it can also decline very fast in a whole prefecture and in the whole province. The conference demanded that the province step up propaganda work and patiently and meticulously carry out persuasive education. The emphasis should be on commendation and reward. It is necessary to take legal, administrative and economic measures against those who refuse to practice planned parenthood despite education and persuasion, in order to stimulate them to mend their ways. After discussion, the meeting put forward a number of views on amending the trial regulations on a number of issues in Sichuan's planned parenthood work. At its conclusion, the conference commended Mianyang, Wenjiang, Chongqing, and Jiangjin prefectures and municipalities and 81 other counties, municipalities, and districts including Shifang, Jiangjin and Guangyuan, and presented awards to them.

Asia↗

[High immunization rates--how can they be achieved at all?].

High rates of immunization are achieved not only by compulsory vaccination. Strict discipline is necessary as well as motivation of medical assistants and of patients in their social environment. All people have a natural instinct for protecting themselves against risks of life. This instinct can in fact be stimulated by repeated motivation and can be enforced by propaganda. The process of propaganda alone cannot stimulate urges. Strategy of immunization must be standardised in all districts of the Federal Republic. This means: immunisation schedule, information of patients, children and of their parents. This is part of discipline of vaccination, same as is the permanent training of medical staff. They should be sent to seminars and training workshops. Specialist opinions must be differentiated as to whether they are scientists or articulate their own and personal opinion or whether their attitude is conditioned by general medical considerations. Any legal claims arising from vaccination accidents would be decided 'in dubio pro aegroto'.

Child↗

[National socialist violent measures against psychiatric patients: ways of coping by family members].

In the cause of an historical study dealing with the closing of an ancient psychiatric hospital in Luebeck during the 2nd world war the infrafamilial structures of the deported patients were explored. Among 136 clinical reports 42 cases were found in which families succeeded to get into contact with deported patients, in three cases their efforts to have them discharged were successful. Stress was laid on the exploration of 12 relatives of deported or murdered psychiatric patients. The interviews were structured following the "oral history" concept and psychological interpretation was added. Focussing on infrafamiliar coping processes which were developed facing the NS-propaganda it was found that working-class people tended to see the victim in an idealized role. They showed a strong projective defence remembering Psychiatry as an integral part of nazi-system. Others saw their relatives as victims of war in general. Some of the relatives tried to repress the existence of surviving patients for a long time, a smaller group clinged to the idea of Euthanasia. Remarkable were the deep effects of eugenic nazi-propaganda on the following generation. The national socialistic violence concerning their fathers or mothers was often a total "tabu" and they nowadays still fear to get into contact with Psychiatry being aware of "suffering" from the same "bad blood" as their murdered relatives. Dealing with patients' resistance to therapeutic efforts in gerontopsychiatric wards their heritage of the nazi ear should be taken into account.

Adaptation, Psychological↗

[Health education. Power of information for purposes of public interest].

Just as publicity contributes to develop the economic activities, so must do social propaganda for the health field also. But the latter has its own particular constraints. Used along, information reaches rapidly its limits, as long as it is not backed up by changes in regulations, specific to each relevant theme. On the other hand, a deliberate policy involving both information and new regulations can yield the most rapid and spectacular results. As for any investment, it is needed to try to evaluate the efficiency of information campaigns; some indicators must be chosen in order to follow up adequately individual changes in terms of knowledges, opinions and behaviour regarding the topic presented; explorations, surveys and analyses of quantitative and qualitative data have to yield major results, to be integrated in a synopsis. As an example, an a priori study done by the author is presented dealing with the effectiveness of a national scale anti smoking campaign developped in France (in 1976), the effects of which having been consistent with the forcasting ones.

Adolescent↗

How Berlusconi keeps his face: a neuropsychological study in a case of semantic dementia.

A patient (V.Z.) is described as being affected by progressive bilateral atrophy of the mesial temporal lobes resulting in semantic dementia. Vis-a-vis virtually nil recognition of even the most familiar faces (including those of her closest relatives) as well as of objects and animals, V.Z. could nevertheless consistently recognize and name the face of Silvio Berlusconi, the mass media tycoon and current Italian Prime Minister. The experimental investigation led to the conclusion that Mr Berlusconi's face was seen as an icon rather than as a face. This telling effect of Mr Berlusconi's pervasive propaganda constitutes an unprecedented case in the neuropsychological literature.

Aged↗

FIOH-sponsored newsletter misrepresents asbestos hazards in Zimbabwe.

The Finnish Institute of Occupational Health (FIOH) has received support from the World Health Organization (WHO) and the International Labor Office (ILO) to publish the African Newsletter on Occupational Health and Safety. The African Newsletter on Occupational Health and Safety should not be a medium for industry propaganda, or the source of misinformation among the workers of Africa. Instead, FIOH should provide the same level of scientific information in Africa that it does in Finland and other developed countries.

Asbestos↗

Fake abortion clinics: the threat to reproductive self-determination.

The establishment of "fake abortion clinics" poses a great threat to women's ability to make free and informed procreative decisions. Such clinics intentionally deceive pregnant women into believing that they provide a full range of women's health services when, in reality, they provide only a pregnancy test, accompanied by intense anti-abortion propaganda. Because fake abortion clinics threaten women's interests in "privacy" and decisional autonomy, state attorneys general should challenge them under deceptive business practice statutes. Successful challenges can be brought without violating anti-abortion groups' First Amendment rights.

Abortion, Legal↗

[The history of biological warfare].

Selected events in the history of biological weapons are highlighted to increase the physician's awareness of this crucial threat. The deliberate use of biological substances originated in antiquity and has pervaded the history of human wars throughout time until the 21th century. The history of biological warfare is difficult to assess because of a number of confounding factors. These include the difficulty in verification of allegation, the use of the threat of this weapon for propaganda purposes, the lack of microbiological or epidemiological data, and the incidence of natural occurring endemic or epidemic diseases during hostilities. Although it may be problematic to verify at times, the use of such weapons has not been limited to national armies or militia. Frustrated civilians, terrorists and even physicians have used biological substances to promote their interests. Today, the biological threat has become more serious. It's potency, cost-effectiveness, and the ability to manufacture and deploy it with little sophistication, or under the semblance of legitimate commercial endeavors, will ensure that biological weapons remain a constant threat to human health.

Biological Warfare↗

Decision on family planning, 7 January 1987.

On 1 January 1987 the Gansu provincial party committee and government issued a Decision on family planning: "The Decision demands that the party committees and government at all levels assign family planning work an important place on their agenda and get a good and tight grasp of it. They must step up family planning propaganda. Beginning this year, the planning commissions and finance departments at all levels must list the task of capital construction for the family planning departments, and assign it a certain amount of investment. It is necessary to establish family planning committee organs, put them on a sound basis, and assign them good leadership groups, to ensure that all family planning work is carried out well. The decision demands that the public health, civil affair, pharmaceutical, and industry and commerce departments regard making a success of family planning work as their own important task and grasp it for a long time to come to ensure that Gansu's population will register proportional and planned growth."

Asia↗

Ophthalmology in Chile.

The practice of ophthalmology in Chile does not differ much from that in the United States. Basic ophthalmologic knowledge is the same, and common clinical problems are solved in the same way. The difference becomes evident in the more complex clinical problems. We have the knowledge and ability to perform the treatment but come up against the problem of high cost of technical instruments. Vitreous surgery, intraocular lens surgery, and laser treatments are performed, but we have to overcome the obstacles of obtaining the expensive and limited number of instruments. Perhaps, a US ophthalmologist will not understand this problem because, as I became aware during my stay as a fellow at The Wilmer Institute, Baltimore, and at other times when I have visited the United States, these difficulties do not arise. Lasers are bought, instruments are ordered by telephone, and manufacturers swamp the doctors with propaganda and offers of "call toll free for 30 days on trial." On the other hand, we know that, due to our efforts and using the means at our disposal, we have managed to keep the specialty at a high level, solving health problems and making the practice of ophthalmology pleasant in this beautiful country. Chilean ophthalmology has great prestige in South America. It has been the forerunner in the instruction of ophthalmologists, creating a method of teaching and of systematic specialization that has been unique in Latin America. It is an example to other branches of medicine in Chile. Although ophthalmologists are badly distributed in the country, considering our particular geographic and economic conditions, they fulfill their objectives in providing adequate visual health care for the population. This has come about through the combined effort of all Chilean ophthalmologists based on the example of their predecessors. Also, there has been a sense of solidarity among us, with responsibility and enthusiasm shown in practicing and in communicating ophthalmic precepts altruistically to the coming generations.

Chile↗

The case against laetrile: the fraudulent cancer remedy.

The evidence for the claims that laetrile (amygdalin) can prevent or control cancers has been reviewed. The beta-glucosidase content of cancer tissues is low compared to that of normal liver and small intestine. Cancer tissues contain the enzyme rhodanese in amounts comparable to that of liver and kidney and hence, cannot be attacked selectively by cyanide release through beta-glucosidase action on amygdalin. Amygdalin does not have the properties of a vitamin. Rats have been reared for several generations on diets devoid of cyanogenic glycosides, without developing neoplasms. Experiments with tumor-bearing rodents have demonstrated no curative properties by amygdalin administration. Amygdalin is not as non-toxic as claimed, particularly when ingested orally, and especially when taken with plant material high in beta-glucosidase. The claims for cure and control of cancers in humans have been refuted by distinguished physicians who specialize in the treatment of cancer patients. The writings of laetrile proponents are filled with erroneous and absurd statements. The propaganda for the doctrine of "freedom of choice in cancer treatment" deludes many individuals with treatable cancer to reject proven methods of treatment.

Amygdalin↗

Russia's imperial blood: was Rasputin not the healer of legend?

The only son of Russia's last Tsar, a great-grandson of Queen Victoria, continues to be used as the favorite example of the X-linked inheritance of hemophilia, in spite of the fact that this popular historical diathesis has never been confirmed by any form of modern medical laboratory testing. Certain to be controversial, a new study of the symptoms that were witnessed by those who were closest to the teenaged Russian heir now raises the possibility that his blood disorder might well have been something other than hemophilia. The key to discovering Tsarevich Alexei's true diagnosis is found in those now legendary allegations that the infamous "Mad Monk", Grigory Rasputin, had possessed a power of healing that was somehow responsible for the young boy's mysterious history of spontaneous recoveries. If we are to accept the popular diagnosis of history and call it a clotting factor deficiency, then the boy's now famous sudden recoveries will remain a complete mystery. The so-called "Mad Monk" Rasputin, as a direct result of the revolutionary propaganda of the time, is then overblown into a larger-than-life legend. If, however, we are to change the diagnosis and call it a platelet disorder, then the air is let out of the legend, and Rasputin is revealed to have been nothing more than a very ordinary middle-aged Siberian hippie who did not possess any healing powers at all.

Anemia, Hemolytic↗

Some aspects of social and working rehabilitation of patients with gastrointestinal tumors after radical operations.

The results of follow-up of 143 patients with malignant gastrointestinal tumors (stomach, 63 patients; colon, 13 patients; rectum, 67 patients) who have undergone radical operations are analyzed. The number of men and women among the examined patients was approximately equal, the age range was from 32 to 61 years, the length of follow-up was from three months to one and one-half years. The patients were regularly examined and questioned at the inpatient and outpatient departments by a surgeon and a psychiatrist. The analysis revealed marked psychogenic reactions, having different clinical forms, in patients of the oncological clinics in connection with a severe stress situation. In most of the cases these reactions were extremely extensive, and the patients were in need of specialized medical assistance (participation of a psychiatrist in their treatment). It is expedient to identify patients with marked psychogenic reactions for special treatment at the time of their acceptance to the clinic. The postoperative period of such patients was accompanied by complications in 58.5% of cases, in comparison with 12.5% in patients with mild psychogenic reactions. After discharge 31 of 62 patients found themselves in a conflict family situation, 24 patients were rather limited in their social contacts; the majority of these patients were not working after the operation. These findings indicate the need for psychotherapeutic support in oncology, plus psychopreventive measures and medical educational propaganda among the population as important components of rehabilitation programs.

Adult↗

Cardiovascular risk factors in the former communist countries. Analysis of 40 European MONICA populations.

MONICA Project findings provide a unique opportunity to compare cardiovascular disease (CVD) risk factor levels in a large number of populations living in different political systems. 15 European communist populations had significantly higher age-standardized mortality for age groups 35-64 years from all causes, from CVD and stroke than 25 democratic MONICA populations. The prevalence of systolic and diastolic hypertension in males and females, prevalence of smoking in males and prevalence of overweight in females were significantly higher in communist MONICA populations. In these populations there was tendency to lower prevalence of hypercholesterolemia. In simple and multiple regression analysis hypertension and smoking prevalence had the highest relation with CVD mortality in men; hypertension and overweight prevalence had the highest relation with CVD mortality in women. The combination of 'classical' CVD risk factors could explain only part of differences observed. In communist Europe there was high consumption of spirits, low consumption of fruits and extremely low intake of citrus fruits. Instead of exaggerated anti-cholesterol propaganda emphasis should be given to the prevention of antioxidant deficiencies by the increase of fruit and vegetable consumption and to the decrease in salt, spirit and cigarette consumption in former communist countries.

Adult↗

Self-evaluation of drivers' skill: a cross-cultural comparison.

In a study conducted in Sweden and the United States, subjects judged their own driving skills in relation to other drivers. The results showed that a majority of subjects regarded themselves as more skillful than the average driver. This result was compared with that obtained from similar studies on the population of Polish amateur and professional drivers. The outcomes of this comparison confirmed the existence of an optimistic tendency to overestimate one's own driving skill. This tendency was observed in various groups of drivers differing in cultural background. Finally, the influence of this tendency upon risk estimates of traffic accidents and inefficiency of safety propaganda are discussed.

Accidents, Traffic↗

Use and misuse of electroconvulsive treatment.

For the continued availability of electroconvulsive therapy (ECT) in clinical practice on equal footing with other treatments, and without judicial interference, the following points are essential: ECT should be used or not used on the basis of scientific evidence and not because of public opinion or antipsychiatric propaganda. There should be no hesitation to use ECT in conditions where its omission would mean prolonged suffering, risk of suicide, or death from other causes (deep melancholic syndromes, acute lethal catatonia, psychogenic confusion). ECT should not be used where the effect is short-lived or must be paid at the price of an organic syndrome (schizophrenia, paranoid states, organic confusions). Efficiency should be optimal (oxygen, superficial narcosis, absence of benzodiazepines, generalized tonic-clonic seizures of at least 30-sec duration, maintenance treatment with antidepressive drugs). Safety should be optimal, not only for life but also for cerebral functioning (anesthesiological management, unilateral nondominant stimulation, pulse wave stimuli, appropriate number of treatments, not too closely spaced). The mechanism of action should be the object of further investigation. Such research will open possibilities for finding drugs that can compete with ECT.

Bipolar Disorder↗

The phenomenon, the explanations and the responses: metaphors surrounding diabetes in urban Canadian Indians.

Type II Diabetes is a growing problem among Indian people in Canada. Ojibway and Cree leaders in Toronto collaborated with the University of Toronto, Faculty of Nursing, to develop the Native Diabetes Program. A key to the success of the program was seen by Natives to be the story 'Nanabush and the Pale Stranger', which seemed to put into perspective the nature of diabetes as a phenomenon. It provided explanations for it and answered numerous questions (non-biological) associated with the disease and indicated appropriate coping strategies. Yet formal methods of analyzing the story would not reveal its benefit as there is no explicit reference to many of the questions it implicitly answers. Metaphoric relationships are illuminated which may provide an underlying rationality to the narrative. Cultural expression is advocated as a source of making meaningful and tolerable that which is feared and avoided; of generating metaphors which make health information understandable and useful, by providing resolution to conflicting systems of belief. Information does not come in discreet ingestible particles of fact. All information is a sort of propaganda in that it is tied to deeper meaning structures. Clinicians are architects of meaning construction. Clinical research and practice requires a knowledge of the folk and professional construction of meaning around so-called factual information.

Alcoholism↗

Prostitutes, prostitution and STD/HIV transmission in mainland China.

China's opening to the world has enabled massive social and economic transformations and the liberalization of many policies, but also the rise of coincident social problems and diseases. A revival of wide-scale female prostitution since the 1980s has now accelerated to a nationwide dilemma. Prostitutes have long been considered to be reservoirs, if not 'vectors' for the transmission of sexual diseases. A well established STD epidemic in the last decade, plus the presence of growing HIV infections in China now, underscore the need to evaluate the prostitute's role in STD and HIV propagation. This report examines unobtrusive data on female prostitutes in the People's Republic of China through an analysis of prison records from eight sexually segregated prisons (six in Sichuan Province and two in Guizhou Province), two female re-education institutions, and arrest records for convicted prostitutes from four counties in Sichuan Province and Chengdu City (also in Sichuan). Collectively, these data represent 2057 female prostitution cases, and span the years 1988-1990. Demographics are examined to enable a profile of the prostitute as based on data reviewed, and this is contrasted to the stereotype of the prostitute as described in government propaganda against prostitution. STD prevalence rates in the samples are examined and contrasted to two other studies on STDs in nonprostitution populations made available to the authors. Prostitute arrest records reveal a majority had active STD infection[s] at the time of their apprehension, with gonorrhea being the most common bacterium; in many instances, prostitutes also had a history of other sexually transmitted diseases. Thus, data examined support the notion of prostitution as an agent in STD transmission. Presence of HIV infection in prostitutes could not be corroborated through sampled records, nor could prostitution itself be confirmed as an agent in HIV transmission at present. However, given the type of clients serviced by prostitutes in China, a prostitute's own risk of HIV infection is discussed. Control measures by the Chinese government to curb prostitution are examined at both national and provincial levels. Questions are raised as to the effectiveness of present tactics as adjunctive strategies in reducing STD infection and HIV risk in the prostitution population.

China↗