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The use of life story books with people with moderate to severe dementia in continuing care and day hospital settings is examined. The approach involved activity-based carer and relative training and support. A collaborative approach has developed and shifts in staff attitudes are discussed. Consideration is given to generalisation to other aspects of patient care.
Adherents to American lay healer Samuel Thomson's system of medicine have been viewed in Canada primarily as antagonists of mainstream medicine. Their publishing activities, however, reveal a wide reform impulse. As this discussion illustrates by considering publishers, printers, editors, and compilers of Thomsonian books in Upper Canada, most had links--real and temperamental--to Reform politics and to dissenting Protestant beliefs, especially Methodism. Their publications may thus be viewed as vehicles for social change in a British colony having a strong Tory alliance between church and state.
A new technique is reported for preparation of the recipient graft bed for posterolateral intertransverse process fusion of the lumbar spine. The dorsal surface of each transverse process is reflected open like the pages of a book. This increases the surface area of cancellous bone in the recipient bed, thereby promoting better contact with the grafted bone. This maneuver also preserves much of the periosteal blood supply to the dorsal aspect of the transverse process and much of the cortical bone that would normally be drilled away during decortication. The technical details are described.
OBJECTIVE: To study the preconceptional preparedness of women attending two antenatal clinics. DESIGN: Cross-sectional descriptive study done in August and September 2001. SUBJECTS AND SETTING: Pregnant women attending the antenatal clinics De Soysa Maternity Hospital and Castle Street Hospital for Women for their booking visit. MATERIAL AND METHODS: Pregnant women were randomly selected. Before collecting data the purpose of the study was explained and those who consented were recruited for the study. Data were collected on the basis of an interviewer administered questionnaire. Ethical approval was obtained from the Ethical Review Committee of the Faculty of Medicine, University of Colombo. RESULTS: 225 pregnant women were recruited. 55% of them were between the ages of 18 and 30 years. 96% had achieved an educational level of above year five. 55% were in their first pregnancy and 2.75 were grand-multipara. 186 (82.7%) were housewives. 81% had a planned pregnancy. Only 21% had received pre-pregnancy counselling, 52% of them from a specialist obstetrician, and 21% and 19% from a general practitioner and public health midwife. Only 15 (6.6%) had taken preconceptional folic acid supplementation, and all of them had a level of education of GCE (A/L) or above. 11 of those who took preconceptional folic acid were primipara. 159 (70.6%) had received rubella vaccination. Of those who did not take the vaccine, 44% knew about it but did not know its importance, and 38% did not know about its availability. 18% did not take it because of various myths that they believed in. Preconceptional health knowledge regarding pregnancy was assessed by asking 10 questions and expressing it as a score out of 10. This score showed a positive correlation to the level of education of the woman. A majority received information from the print (81.7%) and electronic (72.4%) media. 50% received information from a public health midwife, and 36% from doctors. CONCLUSIONS: Preconceptional preparedness among our women is poor. However, rubella vaccination is relatively successful compared to other aspects of preconceptional preparedness.
BACKGROUND: Anaemia in pregnancy is a significant cause of direct and indirect morbidity and mortality to both the pregnant mother and her fetus. The prevalence however remains undetermined in many parts of Africa. The study aims at determining the prevalence of anaemia and sociodemographic characteristics of anaemic pregnant women in a Nigerian tertiary obstetric care centre. METHODS: A cross-sectional study involving all pregnant women that registered for ante-natal care between 1st January 2001 and 30th of June 2001 in Wesley Guild Hospital Unit of Obafemi Awolowo University Teaching Hospitals Complex, Ile-lfe. RESULTS: Prevalence of anaemia among the pregnant women during the period of study was 62.2%. Two percent of the women had severe anaemia. Parity and gestational age at booking significantly influenced the prevalence of anaemia. CONCLUSION: Prevalence of anaemia among pregnant women in developing world is still unacceptably high, and it calls for improvement in standard of living for our pregnant women.
PC Coloring Book, a software program for the personal microcomputers, is a helpful treatment modality in cognitive rehabilitation and also for upper extremity motor control refinement. In addition to the case described this program has been initiated with several other patients, including two adults with cerebral palsy who have had additional brain trauma and one 5-year-old who is developmentally delayed. We cannot yet assess the results because these patients have not used the program for a sufficient period of time. However, we have noted that with all patients the increase in motivation was greater with this program than with more conventional treatment modalities. We expect additional patient trials to provide more applications for this program and to support the increased use of personal computers and software for improving cognitive cells.
Managed-care plans have become the nation's whipping boys, under attack from consumers, policymakers and some physicians alarmed by charges of treatment information being withheld and life-threatening denials of medical care. The issue of drive-through deliveries became a lightning rod for politicians who rushed to pass legislation requiring minimum stays for new mothers and their babies. Reports of forced outpatient treatments for mastectomy patients has reignited criticism. A new book by Wall Street Journal reporter George Anders promises to be a pivotal publication in the debate.
Most health policy experts see the hospital as the enemy of the people or, at best, as a body repair shop. Rosemary Steven's new book, In Sickness and in Wealth, provides a solid, factual, historical basis for such negative perceptions of the hospital's future role. But in a final brief chapter, she suggests that the voluntary hospital may emerge as an instrument of social policy. Stevens believes that this expanded role is "justified by the historical record--and in the absence of any better alternative." She outlines a three-point program for hospitals to meet the current challenges: "lobbying by consumer groups, hospitals, employers and others for public policy designed to improve individual insurance coverage; mobilization at the local level to define and meet community needs; pressures within the system to bring the major players together to work for common goals." Then hospitals, she continues, "may expand into multi-faceted health-care complexes as the basic notion of the 'hospital' extends beyond the walls of the institution," and "the hospital becomes, in effect, the health-care system."
This final rule responds to the comments we received on a final rule that we published December 30, 1982, that set forth criteria and procedures concerning the Department's access to books, documents and records of a contractor of a Medicare provider. In addition, we have made a few procedural revisions and technical corrections to the final rule.
Eye movement patterns and reading performance were evaluated in 38 4th and 5th grade male students who were at least 1 year behind in their reading levels. Half of the subjects (Group I) demonstrated a need for convex lenses at near by a book retinoscopy criterion. The remaining subjects (Group II) showed no need for convex lenses at near by the same criterion. The subject's eye movements during reading were recorded by a commercial device called Eye-Trac. These recordings were made with 2 lens applications, plano and +0.50 D, respectively. The number of fixations, regressions, rate of reading, and relative efficiency for each condition (plano and +0.50 D) were calculated. In Group I, 3 of 5 measures showed significant improvement with plus lenses. These subjects showed fewer regressions, increased reading speed, and higher relative efficiency with plus than without. In Group II, 3 of 5 measures showed decrement with plus lenses, while 1 (comprehension) showed improvement. These subjects showed more fixations and regressions and lower relative efficiency with plus than without. It is therefore concluded that convex lenses of low power can have considerable immediate effect on children's reading skills, sometimes helpful and sometimes detrimental, and that proper pretesting with both retinoscopy will aid in the prediction of this effect.
Seventeen eminent and experienced people have contributed to this most valuable review of NICE and CHI and their potential impact on clinical practice in the UK. There is essentially 100% agreement that the basic concept is a good one; we all want to have the highest possible quality of clinical practice and improvements in health care. This is all motherhood and apple-pie stuff which goes without question but the problem is how it is put into effect. The contributors are also in agreement and fear that central desire for control will outweigh the benefits. The most recent NICE action, which was leaked to the media as a 'preliminary opinion', concerned the use of beta-interferon for the treatment of multiple sclerosis (MS). The opinion seems to be that beta-interferon is very expensive, that, yes, it does help some sufferers but, no, it does not help others and because it costs more than the NHS can afford no one can have it. This seems to me to be a most unsatisfactory outcome. Surely what clinical excellence demands is the refinement of diagnostic capabilities so that those who will benefit may be distinguished from those who will not. In the meantime we do the best we can even if it does mean that the NHS has to pay for some patients who do not respond. This is the inevitable consequence of the belief that a 'free' and comprehensive health service can be provided out of general taxation. Beta-interferon for the treatment of MS is an example of the observable fact that medical science is advancing at a rate considerably in excess of possible increases in funding. Possibly the most important problem identified in this book is the absence of a relevant, high quality data source for the preparation of the numerous guidelines that NICE is expected to produce each year. In a fully grown science a starting point for a quantitative procedure is the establishment of a baseline and, having done that, the scientist's next step is to produce a standard curve for use in the measurement of further investigations. I have said previously that medicine is not a fully grown science (which is one of the problems) but that does not mean that basic scientific method can be abandoned. What is the baseline for the evaluation of clinical practice? The best would be records of the progression of a disease-state in untreated patients. That, for obvious reasons, is clearly not possible so a compromise is unavoidable. Unfortunately we do not even have that compromise baseline so how do we know what is better and what is worse? In simple, single disease states and within the limits of RCTs that is sometimes possible but in a population composed of many elderly people with multiple pathology it is greatly more difficult. If NICE is to produce authoritative guidelines then its first task is to define a (compromise) baseline. For the readers of this journal the absence of safety as one of the measures of clinical excellence must be a matter of concern. All clinical interventions may be casually related to adverse reactions which may, on occasion, be serious or even fatal. Perhaps excluding safety was a conscious decision by those who created NICE. At the time of market approval information on safety is almost always limited to events occurring more frequently than 1 in 1000 exposures which is far below the desirable level of precision. If NICE is to provide advice at the time of market authorization or shortly after then it will never be in a position to include an acceptable evaluation of safety. So why give a hostage to fortune by mentioning it in NICE's remit? Time alone will tell whether NICE and CHI achieve health improvement or whether they prove to be no more than a political gesture.
The goal of the Funen Health Care Network is to ensure a fast correct communication between the Health Care professionals. Since 1993 electronic links have been established from all clinical hospital departments, radiology departments, laboratories, the clinical microbiology department and the pathology department to the general practitioners. Recently, the electronic referral and a confirmation of the booking has been implemented, and this will be followed by structured clinical e-mail service. Due to directed organisational changes, the introduction of electronic referral has resulted in a faster and more logical workflow in the hospitals when dealing with referrals. The primary sector is kept updated on the patient throughout the period of care.
The data have been sorted and calculated by statistics for personages' life-span according to surname and Yin-Yang type and disease according to the cause of pattern over 793 personage from the biography of emperor families' and official in feudal times and subjects of the feudal ruler in History Book of Song Dynasty. (1) For there are some genetic diseases causing their earlier death in surname Zhao's, the average value of life-span is shorter than the other surname of Wang, Li, Zhang, Liu and Chen's. Because the average value among those five surnames are not different each other, the character of the distribution of every one's tally with neuter alleles. (2) The average value in a population on a type of mild Yin and Yang is higher than the type of Yang only, P < 0.05. (3) Disease and bad environment are the limiting factors for life. Besides, to rise the resistance ability is an important path way for increasing our life-span. The attribute of a genetic system in Yin or Yang is an objective existence. Influence on life by genetics may vary with various disease and environment, but different disease is controlled genetically. A bad environment may affect life, but neuter environment would be affected the life through attribute of a genetic system in Yin or Yang type indirectly.
In early 20th century some Urdu scholars tried to enrich urdu literature with medical history. They started compiling and publishing the biographies of the contemporary physicians along with their achievements. One of such works "Rumoozul Atibba" a rare book compiled by Hakim Fairozuddin in Urdu, published by 'Darul Kutub Rafiqul Atibba' and printed in 'Rifah-e-Aam Press' at Lahore in the year 1913 A.D. has been taken here. It contains about 150 short biographies of Ayurvedic and Unani physicians, out of which all the twenty biographies of Ayurvedic physicians given in it, have been presented in this article.
This article reviews additions to 3 ways of visually enriching verbal accounts of the history of psychology: illustrated books, slides, and videos. Although each approach has its limitations and its merits, taken together they constitute a significant addition to the printed word. As such, they broaden the toolkits of both the learners and the teachers of the history of psychology. Reference is also made to 3 earlier publications.
It is claimed that this Annotations on Synopsis of Jade Book of Golden Chamber written by the Japanese Kitamura Tadahiro may possibly recover, to a great extent, the original face of Jingui (Synopsis of Golden Chamber) through textual research. This is supported by the author's own study. It is also held that Kitamura's expounding on Jingui's theory is unique, based on his rich medical practice. This is of significant reference value to both clinical practice and textual research.
The book, "L'Art Dentaire en Medecine Legale" by Dr. Oscar Amoedo was published in Paris in 1898. Before having passed two years from its edition, it was well spread in the main countries of Europe and America through the scientific press. A Japanese translation arriving at the dental school of Tokyo in 1900 influenced, later on, on the creation of the first Forensic Dental Institute, held in that country in 1964. This information was given by the History Professor at that institution, Dr. Kazuo Suzuki, during the Fourth International Meeting of Forensic Medicine, in Copenhagen, 1966.
Historically significant books relating to the specialty of ophthalmic photography are listed and described.