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PubMed1997

[Present state of countermeasure to AIDS in the world today].

UNLABELLED: 1. INTRODUCTION: Only about 10 years have passed since HIV was discovered but WHO presumes that there will be 30 to 40 million infected cases by the year 2,000. This then possesses the possibility of more frequent contact with such persons and thus means we must look for how to protect ourselves. I would like to discuss the present state of AIDS, particularly in eastern European countries such as Bulgaria, Hungary, Romania and Russia, based on recent data I have compiled. 2. AIDS-related laws at present in various countries. (1) Comparison of major laws (17 countries) including 1) patient (17 countries) and infected person (13 countries) notification, 2) protection of privacy (9 countries), 3) prohibiting infected person discrimination (3 countries) and 4) other matters including restraint on behavior to spread infection (6 countries). (2) Entry laws from foreign country (10 countries) applicable to patient and infected person for 1) entry (3 countries) and 2) long period of stay (8 countries). 3. Present countermeasures to AIDS. (1) Data for 8 countries including Japan, U.S.A. U.K., France, Germany and three eastern European countries with regard to 1) budgets, 2) examinations, 3) medical care, 4) consultation and guidance and 5) education. I shall also discuss the following 2 countermeasures in Japan. I have proposed to the Diet: 1) Examination to detect HIV-antibodies in donated blood. This measure is present in effect since Nov. 1st, 1986, as a result of my proposal made to the Diet on March 14th, 1986. 2) For person infected by transfusion of the blood products without heat treatment, I proposed that expenses should be defrayed according to the CD4 level at either CD4 < or = 200 or CD4 < or = 500. (2) Present situation in eastern European countries. Common features are as follows: 1) Infected person and patient are quarantined if they request, since they know their condition which was disclosed based on data from past mass screening test under communism. 2) At present infected persons are few in number. 3) This number will rapidly increase with greater active interchange with western countries following elimination of the Berlin Wall. 4) AIDS countermeasures such as blood and blood products examinations are inadequate due to insufficient funds. In Bulgaria, the government has conducted AIDS tests on more than half the population and in Romania, there is the tragic situation. (3) Guidelines for WHO-ILO countermeasures to AIDS at work places. 4. Present situation in research. The development of effective medicines and vaccines is the primary objective of AIDS research. Research programs may be enumerated as follows; 1) In the U.S.A., NIH and CDC are major organizations which lead research around the world. The major objective is synthetic medicine. 2) In U.K., the development of vaccines for monkey and cat is being sought. 3) In China, herb medicine is administrated to patients in Un-nan-sho where AIDS patients are quite numerous. 4) In Japan, a recombinant vaccine is being sought through use of BCG, vaccinia viruses and the like. 5. Topics related to AIDS include 1) informed consent to be treated by a AIDS-infected doctor, 2) suits against doctors who fail to make infected person known infection and 3) government control laws for AIDS in Russia.

AIDS Vaccines↗
PubMed2002

Responding to the challenge of communicable disease in Europe.

In the 1960s and 1970s, communicable disease seemed a minor threat, but since then the emergence of new infections and the reemergence of old diseases has provoked a renewed focus on European communicable disease surveillance and control. A "network approach" among European countries has been successful in detecting some international outbreaks, but management and funding aspects remain unresolved. Surveillance outside the European Union has faced new challenges as a result of economic and political change following the collapse of communism. Subsequently, innovative international surveillance schemes are currently being implemented in the countries of Central and Eastern Europe and the former Soviet Union. The challenge for surveillance in Europe is to ensure that it has the capacity to meet both the needs of today and the diseases of the future.

Communicable Disease Control↗
PubMed1997

Political changes and trends in cardiovascular risk factors in the Czech Republic, 1985-92.

BACKGROUND: Mortality from cardiovascular diseases is substantially higher in central and eastern Europe than in the west. After the fall of communism, these countries have undergone radical changes in their political, social, and economic environments but little is known about the impact of these changes on health behaviours or risk factors. Data from the Czech Republic, a country whose mortality rates from cardiovascular diseases are among the highest, were analysed in this report. OBJECTIVES: To examine the trends in cardiovascular risk factors in Czech population over the last decade during which a major and sudden change of the political and social system occurred in 1989, and whether the trends differed in relation to age and educational group. DESIGN AND SETTING: Data from three cross sectional surveys conducted in 1985, 1988, and 1992 as a part of the MONICA project were analysed. The surveys examined random samples of men and women aged 25-64 in six Czech districts and measured the following risk factors: smoking, blood pressure, body mass index (BMI), and total and high density lipoprotein (HDL) cholesterol. RESULTS: The numbers of subjects (response rate) examined were 2573 (84%) in 1985, 2769 (87%) in 1988, and 2353 (73%) in 1992. Total cholesterol and body mass index increased between 1985 and 1988 and decreased between 1988 and 1992. The prevalence of smoking was declining slightly in men between 1985 and 1992 but remained stable in women. There were only small changes in blood pressure. The decline in cholesterol and BMI in 1988-92 may be related to changes in foods consumption after the price deregulation in 1991. An improvement in risk profile was more pronounced in younger age groups, and the declines in cholesterol and obesity were substantially larger in men and women with higher education. By contrast, there was an increase in smoking in women educated only to primary level. CONCLUSION: Substantial changes in cholesterol, obesity, and women's smoking occurred in the Czech population after the political changes in 1989. Although a causal association cannot be claimed, national trends in foods consumption are consistent with changes in blood lipids and obesity. Further monitoring of trends is required to confirm these trends.

Adult↗
PubMed1997

Homosexuality and totalitarianism.

Since the dissolution of Communism left the Right with no unifying enemy, some conservatives may be turning to the gay world as the new "evil empire." This article explores the ideology that underpins the recent upsurge of gay-baiting. Its central thesis is that in identifying the homosexual as the demonic "other" the cultural Right is offering us another form of ersatz Christianity masquerading as tradition but actually infected with the virus of modernity. The paper classifies homophobia as an essentially secular phenomenon, reminiscent of other ideologies which have arisen as a substitute for religion.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Working through a psychotherapy group's political cultures.

Macropolitical evolution, starting with authoritarian monarchism, has moved through anarchistic transitions either to the totalitarianism of fascism and communism or to liberal and social democracy. We posit analogous micropolitical development in process-oriented therapy groups: "dependence" and "counterdependence" corresponding to monarchism and anarchism; and "independence" and "interdependence" to liberal and social democracy, respectively. Transition from counterdependence to independence and interdependence may be: (1) facilitated through group members' cooperative experience of rebellion, or (2) blocked by collective identification, the internalization of dystopian or utopian fantasies that coalesce as "group-self" perceptions. We explore how group therapists work clinically with and through these several "political cultures" in the service of group and self transformation.

Defense Mechanisms↗
PubMed2003

The Russian health care system today: can American-Russian CME programs help?

The health of the Russian people has deteriorated dramatically since the fall of communism, due particularly to cardiovascular disease. The Eurasian Medical Education Program was developed in response to provide continuing medical education for Russian physicians. Programs are directed mainly toward primary care physicians and focus on outpatient management of diseases that cause high rates of mortality and morbidity. This experience provides an opportunity to assess the structure and functioning of the Russian health care system and emphasizes the importance of general internal medicine training in detection, management, and prevention of disease complications.

Delivery of Health Care↗
PubMed1991

Next move for Hungary.

After 40 years of communism, Hungary is a tired nation. But now an enormous task faces its government; bringing its antiquated healthcare system into line with those of western Europe. Annabelle May reports from a conference in Budapest.

Hospitals, Public↗
PubMed1992

Capitalism ex cathedra. Sources of hope in tough economic times.

Pope John Paul II's encyclical Centesimus Annus--written in honor of the centennial anniversary of Rerum Novarum, the first papal social encyclical--examines the present world socioeconomic situation in light of traditional Catholic social teaching. The pope warns the West not to be too quick to celebrate the demise of communism as a victory for capitalism. Capitalism has some good points, the pope acknowledges, but by themselves, market mechanisms do not ensure the just distribution of food and other goods that fulfill essential human needs. When capitalism relies on market forces alone, it creates a culture of consumerism that promotes selfishness and greed. Capitalism has been in flux for decades. After World War II, developed Western societies began moving toward "Keynesian capitalism," which subjects the mechanisms of the free market to public control. After Keynesian capitalism's apparent failure in the United States in the 1970s came the "monetarist" theory and a return to an earlier, liberal form of capitalism in which society relies on market mechanisms alone to revitalize the economy and regulate the production and distribution of goods. The monetarist policies of the 1980s turned out to be part of a global plan to reorganize the economy around the giant multinational corporations. This forced individual countries to compete for capital investment and led to unemployment and neglect of low-income people. Structural adjustment policies have been adopted by governments all over the world, in poor countries as well as developed. All are moving toward the form of capitalism that is repudiated by Catholic social teaching in general and Centesimus Annus in particular.

Catholicism↗
PubMed1996

From Solferino to Sarajevo.

Behind an apparent consensus on humanitarianism among politicians, soldiers, diplomats, intellectuals, and artists, and while public aid has become an important element of the Western response to contemporary tragedies, numerous voices are questioning the role of humanitarian aid in conflict situations. This article provides a historical perspective of humanitarianism, from the emergence of basic concepts in the eighteenth century to modern times. The post-World War II era witnessed intellectual critiques of humanitarian action, and, in the 1980s humanitarian aid became, consciously or not, an important instrument of the antitotalitarian struggle. The end of Soviet communism and the evolution of international relations have profoundly changed the work of humanitarian organizations. Today, the gap is immense between proclaimed humanitarian principles and values, and the actions undertaken to defend them. This article examines how humanitarian action has attempted to keep humanitarian aid from contributing to aggravation of the victim's fate rather than to their relief.

Journal Article↗
PubMed1996

Social work services in Army medical treatment facilities: are they reorganizing?

The end of the Cold War and the fall of Communism in Europe resulted in profound changes in U.S. defense policy. Those changes led to dramatic reductions in personnel and programs within the Army. The Army Medical Department (AMEDD) is also being reduced in size and reorganized. At the same time, the AMEDD is facing escalating health care costs associated with demand and access to medical care. Social work services in Army medical treatment facilities are being directly affected by these system changes. Therefore, the question is raised whether changes in the organization and delivery of social work services are being initiated or anticipated. To what extent are social work chiefs of service involved in these decisions at the medical treatment facility level, and what are the positive and negative effects of reorganization on social work staff and the clients they serve?

Attitude of Health Personnel↗
PubMed1995

[The Polish Paderewski Hospital in Edinburgh].

On 22 March 1941 the Polish School of Medicine was established at the University of Edinburgh for soldier students in the Polish Forces. Six months later the Polish Paderewski Hospital was opened at the Western General Hospital in a building offered by the Edinburgh City Council. It was meant for Polish soldiers and civilians for the time of war. The moving force behind these events was Professor Jurasz, the organiser and dean of the Polish School of Medicine. He was made the superintendant of the Paderewski Hospital. The hospital was also a teaching hospital for the Polish students. The Hospital was very well equipped thanks to the financial aid coming from the Paderewski Fund in New York. The peak activity of the hospital was in 1944/45 with the invasion of Europe and still more after the end of the war when tens of thousands of Polish soldiers arrived from Italy and the Middle East to Gr. Britain for demobilisation. The hospital was closed down at the end of 1947. It had been planned that a new Medical School would be set up in Poland after the war, based on the Polish School of Medicine in Edinburgh and the Paderewski Hospital. The post-war political changes in Eastern Europe with enforced communism in Poland prevented the realisation of these plans.

History, 20th Century↗
PubMed2002

Acute poisoning with psychoactive substances in the 1990-2000 period of socioeconomic transition and crisis in Plovdiv region, Bulgaria.

The "opening" of the post-totalitarian societies of Eastern Europe increased the illegal spread of psychoactive substances (PAS) in the past decade. We studied psychoactive substance acute poisoning (PAS AP)--types of toxic agents involved, incidence rates, and their changes--as indirect indicators of the characteristics, magnitude and development of the problem in Bulgaria during the 1990-2000 period of socioeconomic transition and crisis after collapse of communism. The study analyzed retrospectively the caseload of all 571 PAS acute poisonings that occurred in the territory: 417 men (73%) and 154 women (27%); mean age 24.07y (range 10-75). The number of all AP and PAS AP showed a marked increase during the last 3years of the studied period, especially in 2000. The average PAS AP incidence rate for 1998-2000 (13.50/100,000) compared to the mean value for the preceding period 1990-1997 (5.76/100,000) showed a 2.34 fold increase. Acute alcohol intoxication was 62.7%, of all PASAP; the opioid 15.2% (heroin 11.0%, other opioids 4.2%); prescribed and over the counter drugs 12.6%; inhalants 1.1%; cannabis 1.1%; and cocaine 0.7%. Amphetamine (or amphetamine-like), hallucinogens and phencyclidine (or phencyclidine-like) AP were not encountered. The average percentage of alcohol AP for 1998-2000 compared to the preceding 1990-1997 dropped from 78.12% to 44.72% (1.75 fold), while that of opioids rose from 6.59% to 26.47% (4.02 fold), and that of the other drugs group from 12.22% to 21.78% (1.78 fold increase). The new non-alcoholic PAS AP (heroin, cocaine, inhalants and cannabis AP, as indirect indicators of narcotic exposure) showed a rapid increase. The data showed they are expanding and catching up with alcohol as a new cause of substance-related problems, thus becoming one of the important health and social problems of post-totalitarian society.

Acute Disease↗
PubMedDate not supplied

Muslim refugees in Southeast Asia, the Malaysian response.

This article surveys the arrivals of Muslim refugees from countries in Southeast Asia who have not only come to Malaysia for political refuge, but who have also stayed on, in many instances integrating into the local Muslim community. The author concludes that Burmese, Thai, and Filipino Muslim refugee-cum-migrants, and the estimated 500,000 illegal Indonesian migrant workers in East and Peninsular Malaysia make the presence of economic migrants in Malaysia's towns and rural sectors a far more pressing concern to Malaysians than that posed by the arrival of genuine political refugees. Only the Indonesians present in Malaysia are consistently termed by all parties as illegal migrants and some of them have been subjected to well-publicized deportation by the Malaysian immigration authorities. Sympathy for fellow-Muslims in distress explains Malaysia's open-door policy to Muslim refugees. The Koran specifically enjoins Muslims to assist Muslim refugees who have been persecuted by others. However, the necessity to maintain regional political and military alliances, principally as a bulwark against Communism, and the Malay--Non-Malay, Muslim--Non-Muslim dichotomy in Malaysia which almost evenly divides Malaysia's 16 million population into mutually antagonistic halves, results in any overt public policy in favor of Malays and Muslims to be immediately denounced by the other half of the population as a move against the Non-Malays and Non-Muslims. Without political and media attention, the refugees live wherever they can find work, as do hundreds of thousands of mainly Indonesian illegal migrant workers. They surreptitiously get their children admitted to public schools, and through bribery, can even get Malaysian identification papers. Malaysia is a relatively tranquil haven for Malaysia's Muslim refugees compared to their homelands, but their continued stay remains dependent on the ever-present struggle for more equitable sharing of political and economic power between the different ethnic groups in Malaysia. At present, it is deemed inopportune to discuss publicly the issue of Muslim refugees in Malaysia. To do so would be to invite strong emotional responses from Malaysian Muslim groups objecting to refugee repatriation to what they see as continued persecution in Southeast Asia's non-Muslim countries, and from non-Muslim Malaysians who see in their continued presence a possible long-term demographic threat. Furthermore, the presence of Muslim evacuees granted refugee status brings painful memories as to why non-Muslim refugees principally from Indochina were denied such a similar privilege.

Asia↗
PubMed2003

[Relations of German anesthesiology to east European societies of anesthesiology].

On the occasion of the 50th anniversary of the foundation of the "German Society of Anaesthesiology" (DGA)--later called "German Society of Anaesthesiology and Intensive Care Medicine" (DGAI)--which was founded on 10 April 1953, and in memory of the foundation of the "Section of Anaesthesiology", which was founded in East-Berlin ten years later on 25 October 1963 and later called "Society of Anaesthesiology and Intensive Therapy of the GDR" (GAIT), the development of relations between German anaesthetists and anaesthesiological societies in East Europe are described. The limited economic base of the medical-technical and pharmaceutical industries, a chronic lack of hard currencies and economic and political restrictions on travel activities by East German and East European anaesthetists to West European countries resulted in improved contacts between East German and East European anaesthesiological societies. This, in turn, led to the holding of "International Anaesthesiological Congresses" of the so-called socialist countries and "Bilateral Symposia of the Anaesthesiological Societies of Czechoslovakia and the GDR" and also bilateral meetings of nurses of anaesthesiology and intensive therapy from both countries. These congresses and in particular the "3rd European Congress of Anaesthesiology", which was hosted by the "Czechoslovak Society of Anaesthesiology and Resuscitation" in Prague in 1970, were of high value for the further development of anaesthesiology in these countries. Furthermore, congresses held in East Europe but outside the GDR, were especially important for meetings between East German anaesthetists and their West German colleagues, who regularly took part in these congresses as invited speakers, because West German anaesthetists were not allowed to participate in East German anaesthesia congresses, on the one hand, and East Germans were not allowed to attend West German anaesthesia congresses, on the other. There were also regular meetings of the boards of East European anaesthesia societies in order to discuss the further development of anaesthesiology as an independent new academic field of medicine. Both East and West German anaesthetists were very often invited as guest lecturers by various East European societies and anaesthesiological departments. They were always deeply impressed by the tremendous hospitality of their hosts. During the "Cold War", many anaesthetists from East European countries were also invited as guests by anaesthesia departments of East and West Germany. Most of the East European anaesthetists preferred West German departments because they were better equipped and some of them used these trips to the West also to escape from communism. Shortly before and mainly after the political changes in 1989 and the dissolving of the "Society of Anaesthesiology and Intensive Therapy of the GDR" in 1990, the "German Society of Anaesthesiology and Intensive Care Medicine" improved its contacts to the East European anaesthesiological societies. The "Bavarian Section" of the "German Society of Anaesthesiology and Intensive Care Medicine" organized joint meetings with the Romanian, Bulgarian, Latvian and Russian societies of anaesthesiology in Bucharest (1987), Riga (1989), Moscow (1989) and Sofia (1991). In 1996, an "Association of German and Russian Anaesthetists" (ADRA) was founded in Moscow, which now has both a German (Prof. Dr. Dr. h.c. Joachim Nadstawek/Bonn) and a Russian (Prof. Dr. Armen Buniatian/Moscow) President. The German members of this association, in particular its Secretary-General, Prof. Dr. Reinhard Purschke/Dortmund, organize postgraduate courses including theoretical lectures and practical work not only in Russia but also in Armenia and Usbekistan.

Anesthesiology↗
PubMed2006

[Richard Koch's life in national socialism and in Soviet emigration].

The Jewish historian and theorist of medicine, Richard Koch, teaching in Frankfurt/Main, fled in 1936 from National Socialist Germany to the USSR where he lived in the Caucasian spa Essentuki until his death in 1949. Here he worked as a doctor and continued his scientific work, especially on the foundations of medicine in natural philosophy. None of his works of this time were published. Koch was a scientific outsider in the USSR, and he was aware of this. However, he tried to make his views compatible with official doctrines. In 1947 he lost his employment at the medical clinic of Essentuki, and his material situation grew worse. It is still an open question whether this development was related to an increasingly anti-Jewish atmosphere in the USSR that was linked with the Stalinist "purges", as Koch himself appeared to believe. Before his flight from Germany Koch did not show any tendency towards communism or the political left at all. His attitude towards Soviet society and Stalin was mixed: cautious criticism was accompanied by strong expressions of commitment to Stalin and Koch's new Socialist home. The question to what extent Koch's comments showed his true convictions must remain without a definite answer. At least in part they can be understood as precautions in threatening circumstances. The opportunity of a remigration to Germany after 1945, however, was turned down by Koch.

Ethics, Medical↗
PubMed1979

[Inside the labyrinth of feminine delirium.].

In order to understand the problem of the relationship between woman and madness, it is important to take history into account. Mental illness consists in the difficulty to express one's sexual difference in a wide sense (economic, political, ideological, imaginary and symbolical), this is where history comes into consideration. Woman, relegated in the far recess of history, deprived of the possibility to express herself, is today searching for her true expression. As far as the man's confusion of ideas is concerned, because of his denial of woman, all he had left was to differentiate himself from himself and therefore creates symbolic social classes ; this thesis is not an idealistic one - it goes without saying that this symbolical evolution develops itself in interrelation with economic and material development of society. The masculine confusion of ideas (délire) is historical while the feminine one is hysterical. This view of mental illness has political and ideological consequences. The annihilation of the roots of mental illness will come about only through the elimination of social classes and the real liberation of woman. This does not mean the rejection of therapeutic work, revolutions never cured anybody, but the extension of the clinical world to politics, the breaking down of established practices and interdisciplinarity. In short term, we have to deal with individuals who feel in themselves the after effects of an aged social structure, therefore not strictly individual but collective behaviors. In the long term, only a profound social transformation can limit the number of victims of the situation. One day maybe every one will be able to express and achieve themselves in a fully realised communism. This text wanted to be a locus of information on the historical and political basis of mental illness and the interconnected role played by the feminine 'délire' (madness).

English Abstract↗
PubMed1991

Ludwik Rajchman, international health leader.

Ludwik Rajchman was a man caught up in the whirlwind of international politics. He suffered from the conquest of his country, Poland, by both Nazism and Communism yet managed to rise to eminence as a leader of the Health Organisation of the League of Nations and then of UNICEF.

History, 20th Century↗
PubMed1995

[Blind alleys and misconceptions in public health].

The concept of hygiene was created in the 19th century although Hippocrates had already conceived an influence of atmosphere, soil and water on human health. The concept of a public health organisation, however, is a fairly recent one. Environmental and social hygiene were the two poles of the new discipline that focussed on public health. However, the ideologies of capitalism, communism and socialism as well as of social darwinism and "survival of the elite" discredited social hygiene. The decline of totalitarianism was associated with a "loss of face" of state-controlled medicine, including social hygiene. Both the post-World War II German constitution and the previous German statutory health insurance ordinance had blocked it, and hence, no Federal bill on public health was carried. The consequences of this disregard of public health are poor protection by vaccination, a gap in compulsory notification and in epidemics control and high rates of nosocomial infections. Absolutely no development of the science of epidemiology was possible whereas that of medical microbiology is choked by the system now in existence. There is a great misconception within individual hygiene by identifying it merely with cleanliness. Hygiene became a synonym for cleanliness, although that had evolved during a long cultural sociological process centuries before hygiene was established. The modern evolution of the science of hygiene shows the danger that emphasis on healthy lifestyles or on environmental protection may result in regulations and finally in a tyranny that may threaten the liberty of human rights. The so-called "principle of concern" is an example of such irrationality because there is no sensible proportion between risk and expense.

Attitude to Health↗