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[Drug expenditures of pensioners in 1997-2000].

The general purpose of the study, carried out in the group of pensioners was to determine the relation between drug prices, household income and amounts of money spent on drugs in the years 1997-2000. The study was based on representative data gathered from annual household budgets review by Polish Statistical Office and data from pharmaceutical market published in 'Vitamina C++' magazine. The used method combined descriptive, comparative, table-descriptive analysis with graphical analysis. During studied period the real value of expenses on drugs in pensioners' households rose by 39.3% and available income decreased by 5.8%. Increased expenses on drugs caused the rise of the proportion of on spending on drugs in total household expenditure. It rose from 3.9% in 1997 to 5.2% in 2000. Throughout this time period the drug prices increased in real terms: the highest growth (approx. 49%) was noticed in patients' co-payment to reimbursed drugs. Despite rise in spending on drugs, due to the increase in drug retail prices and increasing patients co-payment, pensioners in comparison with 1997, could buy only approx. 93% units of reimbursed drugs in 2000. The possibility of buying drugs within OTC group increased by 18%.

Aged↗

Communications. Spreading the word.

A consumer-style magazine was aimed at young women, combining features with health information It was distributed both in health settings and through shops and local organisations Focus groups suggest it was a popular way to get messages to hard-to-reach groups.

Communication↗

[Teenagers' information about anticonceptive methods].

A transversal study was realized in order to identify information about anticonceptive methods in high school students. The sample included 816 adolescents of both genders from public schools in Aracaju, Sergipe. With respect to this information, demographic, pedagogical, behavioral and reproductive aspects were also analyzed. It was verified that 59.0% of the teenagers have an active sexual life and 57.7% affirmed that they do not receive information about anticonceptive methods in school. Magazines, books and newspapers obtained 28% as sources of information and the male condom (84.5%) was the best known method. The analysis made it possible to identify the need for further discussion in school and the insertion of the parents in this process.

Adolescent↗

[Relevance of the Di Bella case in the relationship between people and official medicine].

In this research, we suppose that the Di Bella case showed a separation, that is at the basis of the relation between people and the "official medicine", in an emblematic way: the separation between the reified universe--that is the scientific research with its necessary and universal rules, the medical practice, the medical and governmental institutions--and the consensual universe--the common sense, the emotions and the thoughts of people, of the patients and of their relatives. At the same time, these dynamics of the relationship between science and public opinion are framed in the context of the historical and political Italian situation of the Nineties to explain the origin and the development of the affair. Because of the priority role attributed to the mass-media in building the case, this research analyses all the articles on the Di Bella case published in Panorama and L'Espresso--two magazines chosen because they represent different cultural and political tendencies--by experimenting the integration of qualitative and quantitative methodologies. From our analysis, an ancient culture emerges, that is expressed by the stereotype of the no hope illness and by the repetition of consolidated common places: on one side the irrationality of the masses and the Italian character, on the other side the veneration for the science and the unquestionable trust in the guarantee provided by a foreign hospital or by a foreign research centre. At the same time, a positive role of the public opinion points out, which is able to get some negative sides of the reified universe and to give voice to the needs of the patients and of all common people who have to face with--or are afraid of facing with--the cancer, a prototypical illness which arouses fears and anxieties.

Humans↗

[Back to the future. Homage to the 25th year of nursing as part of the university].

This is a magnificent article by one of the most qualified nursing authors in our country. In order to celebrate the 25th anniversary of the incorporation of Nursing in Spanish universities, this author reviews the role the magazine ROL has played in this field, the milestones which have brought about changes in our health system, the current situation of university degrees in Nursing, and the our integration into the European studies system. This author finishes with a hopeful and combative vision of the future which awaits us.

Education, Nursing↗

[Maternal attitude to breast feeding and difficulties in the immediate puerperium].

OBJECTIVE: To investigate the attitudes of women who have just given birth towards breast feeding according to their social class and level of education, as well as the problems arising during their stay in hospital, and the possible repercussions the latter might have. DESIGN: Transversal descriptive study, based on random sampling. SITE. The Maternity Unit of the "Marqués de Valdecilla" University Hospital, Santander. PARTICIPANTS: 100 mothers of newborn babies chosen at random amongst those who had given birth vaginally to normal babies after a nine months pregnancy. RESULTS: The results from the questionnaire show that: 35% derived their information on breast feeding from magazines, 25% from the psychoprophylactic obstetrician (PPO), 28% had no information. 60% of the sample took the decision to breast-feed before pregnancy, 21% during the pregnancy, and 6% after the birth. 78% of the children were fully documented at the hospital on: first time at the breast, frequency of feeds, glucose solution supplement. 60% of the mothers evidenced problems with their breasts. On leaving hospital, 83% were breast feeding. CONCLUSIONS: To continue promoting breast feeding and helping mothers not to have so many problems at the beginning, we should use primary health attention, PPO courses and prenatal education as platforms for action, emphasising the importance of preventive care of the breast and breast-feeding technique. Hospitals should incorporate the international recommendations on initial lactation, with subsequent reinforcement during home visits and health centre appointments.

Adult↗

[Images of anti-luetic therapeutic systems and drugs].

This article offers a "flash" of images concerning the diffusion and advertising of specific anti-luetic therapeutic systems and drugs, since the beginning of XVI century to the discovery and the therapeutical use of penicillin. Advertisements in medical and scientific magazines and pictures of texts and articles of the Library of the History of Medicine (Università degli Studi di Roma "La Sapienza") have been used.

Advertising↗

The harder they fall.

The past decade may well be remembered as the era of the high-flying, aggressive leader. Corner-office titans like Kenneth Lay, Dennis Kozlowski, and Bernard Ebbers graced the covers of business magazines. They captured the public's fascination with their bold business moves and charismatic sound bites. Then scandal set in, and the stars fell to earth. In this article, social psychologist Roderick M. Kramer asks an important question: Why do so many leaders--not just in business, but also in politics, religion, and the media--display remarkable adeptness and ability while courting power, only to engage in even more remarkable bouts of folly once that power has been secured? Kramer, who has spent most of his career researching how leaders get to the top, says there is something about the process of becoming a leader that changes people in profound ways. The systems through which we select our leaders force executives to sacrifice the attitudes and behaviors that are essential to their survival once they have reached the top. Society has learned to consider risk taking and rule breaking as markers of good leadership. As a result, CEOs and other leaders lack the modesty and prudence needed to cope with the rewards and trappings of power. They come to believe that normal limits don't apply to them and that they are entitled to any spoils they can seize. The leaders who do remain grounded--who get to the top and stay there--exhibit five common psychological and behavioral habits: They simplify their lives, remaining humble and "awfully ordinary." They shine a light on their weaknesses instead of trying to cover them up. They float trial balloons to uncover the truth and prepare for the unexpected. They sweat the small stuff. And they reflect more, not less.

Administrative Personnel↗

Rupture of silicone gel breast implants and symptoms of pain and fatigue.

OBJECTIVE: To compare symptoms of women with silicone gel breast implants and women with chronic fatigue syndrome (CFS), and to study the effect of rupture of the silicone implant. METHODS: Five hundred readers of the Dutch silicone breast implant support group magazine were asked to respond if they had been informed by the surgeon about the silicone implant status at operation, and to answer questions about symptoms of CFS. Their complaints were compared with those of 100 female patients with CFS and 40 female controls. RESULTS: The questionnaires were returned by 319 women. Of these, 227 had symptoms of debilitating chronic fatigue. The patterns of symptoms differed from those in patients with CFS. An analysis of the relation between integrity of the implants and the symptoms could be carried out in 176 women, and 74% of these latter women reported ruptured implants. Significantly more women with ruptured implants than those with intact implants had debilitating chronic fatigue (75% vs 51%), postexertional malaise > 24 h (77% vs 51%), impaired short term memory (58% vs 38%), and multi-joint pain (77% vs 60%). CONCLUSION: Women with silicone breast implants often report severe pain and chronic fatigue. Rupture of the implant is associated with an increase in symptoms of pain and chronic fatigue.

Adult↗

Involvement of AMPA receptor GluR2 subunits in stimulus-reward learning: evidence from glutamate receptor gria2 knock-out mice.

Presence of the glutamate receptor 2 (GluR2) subunit prevents calcium influx through AMPA-receptor complexes; deletion of this subunit results in enhanced hippocampal long-term potentiation. We investigated whether mice lacking the GluR2 subunit [gria2 knock-out (KO) mice] displayed impairments in learning stimulus-reward associations, and the subsequent ability of reward-paired cues to control motivated behavior. Both gria2 KO and wild-type (WT) mice learned to associate a light/tone stimulus with food delivery, as evidenced by approach toward the food magazine after the presentation of the cues (pavlovian conditioning). Subsequently, the cues also served to reinforce an operant response in both KO and WT mice (conditioned reinforcement), although response rates were greater in gria2 KOs. Responding for conditioned reinforcement was enhanced after 0.5 mg/kg amphetamine administration in WT mice, but not in KO mice. The ability of the cues to elicit approach behavior (conditioned approach) and to enhance responding for the reward (pavlovian-to-instrumental transfer; PIT) were also impaired in gria2 KO mice. This pattern of behavior resembles that seen after lesions of the central nucleus of the amygdala (CeA), an area rich in GluR2-containing AMPA receptors. Immunostaining revealed reduced GluR1 expression within both the basolateral amygdala and the CeA, suggesting that the behavioral deficits observed were unlikely to be caused by compensatory changes in GluR1. These results suggest that GluR2-containing AMPA receptors, possibly within the CeA, are critical for the formation of stimulus-reward associations necessary for PIT and conditioned approach, but are not involved in the plastic processes underlying the attribution of motivational value to the conditioned stimulus (CS).

Acoustic Stimulation↗

Is there a need to involve doctors in management of health care in Saudi Arabia.

Recently, the role of doctors and managers in health care management has become a hot topic in the newspapers and public magazine in the Kingdom of Saudi Arabia. The aim of this paper is to contribute constructively and scientifically to this topical issue by emphasizing that commonality and interaction between medicine and management dictate more involvement of doctors in management. Although one may argue that doctors are usually not well trained in resources management, scientific evidence supports the need for more involvement of doctors in managing health care system. In addition, government needs to make a strategic shift towards high quality primary and preventive care to enable doctors in management role to maintain essential services and contain cost.

Attitude of Health Personnel↗

A snapshot of tobacco-related messages relayed in pediatric offices in Delaware.

OBJECTIVE: Much research exists demonstrating that pediatricians should counsel patients and families about tobacco. However, few data are available about tobacco-related messages relayed in pediatric offices. Since an anti-tobacco office environment can be a strong component of an active tobacco prevention program, we evaluated pediatric offices in Delaware to characterize tobacco-related messages. METHODS: A convenience sample of 32 of 63 (51%) pediatric offices in Delaware was directly evaluated for the presence of tobacco-related messages. Fifty-five of 63 (87%) pediatric practices in Delaware were contacted by telephone to inquire about the presence of a tobacco coordinator. RESULTS: The 32 practices represented 71 physicians, were located in all three counties throughout the state, and were urban and non-urban in setting. The same investigator evaluated practices in a single site visit. All were located in smoke-free buildings. At one office, people were seen smoking outside; however, the presence of discarded cigarettes was much more common. Thirteen practices (41%) employed smokers, most of whom smoked outside during work hours. Twenty-one of 28 practices (75%) had waiting room magazines containing tobacco advertisements. Fifteen practices (47%) offered anti-tobacco literature while six practices (19%) displayed visual media, none exclusively addressing tobacco. Nine practices (28%) use chart flags to identify smokers. None of 55 pediatric practices in Delaware contacted by telephone identified an office tobacco prevention coordinator. CONCLUSIONS: Our data indicate that, in Delaware, the pediatric offices we visited overall convey a limited message about tobacco and could strengthen tobacco prevention strategies. Research measuring the impact of office-based anti-tobacco messages is needed. If these messages are effective in preventing tobacco use, practitioners can supplement active counseling with indirect interventions that require minimal maintenance once established and that place no additional demands on their time.

Delaware↗

Interfering with RNA: kill the messenger.

A number of scientific papers were published in 2002 describing the discovery of a process called RNA interference, or RNAi. The newly discovered process, whereby small strands of RNA can block the development of new genetic material, was called the "breakthrough of the year" in 2002 by Science magazine. RNAi has excited AIDS researchers because it has both short- and long-term potential for significantly improving the treatment of HIV disease.

HIV Infections↗

System launches 3-level plan to cut ED crowding.

Improved communications and enlisting volunteers are key strategies. Targeted survey establishes a baseline of community attitudes. Emergency department magazine, videos help support patient education efforts.

Community-Institutional Relations↗

What do young people from Mostar, Bosnia and Herzegovina know about contraception and sexual health?

AIM: To determine the knowledge of adolescents living in Mostar, Bosnia and Herzegovina, about contraception and sexual health. METHODS: We used an anonymous questionnaire to survey a random sample of 120 high school students, 60 from two general high schools and 60 from a vocational school. There were 30 male and 30 female students aged 15-17 years from each type of school. The questionnaire consisted of 24 questions: 17 tested the students' knowledge on the menstrual cycle, contraception, emergency contraception, and sexually transmitted diseases (STDs), and six inquired how they obtained the information on these issues. Student t-test was used to test for score differences between male and female students, and between general high school and vocational school students in their general and specific knowledge. Pearson's r coefficient was used to test the correlation between average grades and knowledge. RESULTS: Female students had greater general knowledge (t=3.69, df=118, p<0.001), knowledge on contraception (t=3.66, df=118, p<0.001), and knowledge on STDs (t=2.71, df=118, p=0.008) than their male peers. General high school students also had greater general knowledge (t=2.44, df=118, p=0.016), and knowledge on contraception (t=2.18, df=118, p=0.031) or STDs (t=2.36, df=118, p=0.020) than their vocational school peers. Major sources of information were magazines (69%), TV/radio (50%), school (37%), and friends (36%). The most common reason that kept our examinees from obtaining information on these issues was shame (52%). The two most common contraception methods known to them were a condom (82%) and contraception pill (77%), whereas 17% of all students were unfamiliar with any contraception method. When asked what could be done to improve their knowledge on sexuality, contraception, and STDs, most students opted for the inclusion of sexual education into the school curricula. CONCLUSION: Female students knew more about contraception and sexual health than their male peers. Young people should be provided with more information on sexual health.

Adolescent↗

Maternal knowledge, attitude and practice of safety belt use during pregnancy at Srinagarind Hospital.

From January 2002 to July 2002, 260 pregnant women of more than 20 weeks gestation at the antenatal care unit of Srinagarind Hospital, who fulfilled the criteria and had signed consent forms, and had answered the structured questionnaires. This cross sectional study showed that 230 women (88.5%) had an acceptable level of knowledge. Only 85 pregnant women (32.7%) had received information about safety belt use during pregnancy and mostly from books or magazines. There were 97, 154, and 9 pregnant women (37.3%, 59.2%, and 3.5%) who had a good, fair and poor attitude about safety belt use during pregnancy. Prevalence of safety belt use during pregnancy was 93.5 per cent and 17 pregnant women (6.5%) never used it during pregnancy. The most frequent reason for not wearing safety belt was discomfort. Two hundred and twenty pregnant women (90.5%) identified the correct position of safety belt use.

Adolescent↗

Why not gold? Contemporary esthetics and restorative practice.

In today's dental world, there are many more options of materials and equipment than there was years ago. It can be very confusing for anyone to sift through the marketing and lectures and determine which of the new materials are best suited for our patients. Classic gold techniques have been around for over 100 years and have an obvious track record. Leinfelder (7) has stated, "Gold alloys are certainly the best materials by far in terms of maintaining a functional occlusion and longevity." Underutilized in the recent past, gold is undergoing a comeback in many areas. A major dental company recently introduced a new casting gold and recent advertisements for gold-related products have reappeared in dental magazines. It is incumbent upon the modern dental professional to be aware of all the restorative options available, learn how to perform them, and then choose the technique that will be the most appropriate for each situation. Longevity should always be a factor in the decision making process and gold is the answer in many applications.

Crowns↗

[Traditional medicine under Japanese rule after 1930s].

Japan, which occupied Korea from 1910 through the end of World War II, transformed traditional medicine. Japanese colonialists propagandized the "benefits of modern civilization such as western medicine" and rejected the advantages of traditional medicine. This bias against Korean traditional medicine mirrored the government's rejection of its own traditional medicine. So, Korean traditional medicine was marginalized in the national health care system: traditional doctors were excluded from public institutions and references to traditional medicine were purged from school textbooks and newspapers. The wars that Japan waged between 1931 and 1944 effected a favorable change toward traditional medicines, however. The wars created a severe shortage of drugs and medical personnel. Thus the colonial government was eager for Koreans to cultivate and gather herbal drugs; it also built a large research institute for herbalism at the Keijo Imperial University in 1938. The colonial government made pharmacopoeia for traditional herbal drugs including plant and animal drugs from 1937 to 1942, independently from Japan. Under these conditions, the prestige of traditional medicine was greatly improved. Influential newspapers and magazines covered the traditional medicine and public lectures on traditional medicine drew large audiences. The wartime government abandoned its opposition to traditional medicine, and appointed a traditional practitioner to the staff of the public hospital in 1934. Moreover, the government allowed the association of the traditional medical doctors in Seoul to train three hundred more practitioners between 1937 and 1942. Japanese colonial policy toward traditional medicine reflected the contradiction between modernizing ideology and the reality of poor colonial medical care. Japanese propaganda promised that the colonial regime would provide more advanced medicine to Korea, but the promise was an empty one. In this situation, traditional medical doctors and herbalists once again shouldered the main responsibility for the health of the Korean people.

Colonialism↗