Time and tides. Interview by Chris Serb.
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The symptom complex of urinary urgency, frequency, nocturia, and urge incontinence, also known as the "overactive bladder" syndrome, affects the lives of millions of American women. As the symptoms are nonspecific, several different etiologies may be responsible. In many women, however, no discernible source can be identified. If a basic evaluation, including history, physical examination, urinalysis, and postvoid residual determination, fails to identify a source for the complaints, empiric treatment with behavioral intervention or a trial of medication may be offered to control symptoms. Certain patients will require a more detailed evaluation, particularly if conservative measures fail to provide relief. The role of advanced diagnostic strategies and the emergence of new treatment modalities are discussed.
Despite efforts by groups as diverse as the federal and state governments, public health agencies, and various advocacy groups, tobacco use continued to increase among youth during the latter part of the 1990s. This article reviews the history of tobacco control in the latter part of the 20th century with special emphasis on policy development aimed at controlling use by children and adolescents. New trends in prevention and cessation are reviewed along with a discussion of tobacco control policies that will extend into this new century.
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As a result of hospital budget-cutting, the healthcare industry is losing many of its best security directors and managers, some experts warn. This loss is extending to the reduction of security officer complements, partially due to an "overdependence" on technology. And it's not only personnel who are being cut, but training programs as well. In this report, we'll give details on the current trend, its dangers to patient protection, and what changes can be made to operate more effectively in the current economic environment.
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The diversion of legitimate controlled substances to the black market is a major cause of medical emergencies, fatalities, and drug-related dependencies. The effects harm not only the illegal user, but also the legitimate patient who may be getting shorted on treatments and innocent medical providers who may be charged with false claim offenses or other professional failures because of diversions that take place during their watch. The dollar magnitude of this crime is estimated to rival the black markets for both crack cocaine and heroine combined. This article addresses the various ways prescription drugs are diverted to the black market, some monitoring programs employed by the states, and guidelines that doctors, pharmacists, and other providers can use to protect themselves against possible liabilities arising from the diversion of prescription drugs. We will also address some of the oppositions to monitoring programs that have been asserted and replies to these oppositions.
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