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Management journals and business magazines are abuzz with discussions of how the changing makeup of the American workforce will affect business operations. Many health care executives are already making the transition to a workforce dominated by women, minorities, and immigrants. Managing the great American melting pot is a big challenge, according to executives, but with proper planning it can be done.
What consulting services are health care CEOs using? Hospitals magazine teamed up with the American Association of Healthcare Consultants to find out. The 723 CEOs who responded say legal assistance and strategic planning are today's top consulting areas. CEOs who were asked to comment on the survey results were not surprised that legal assistance topped the list. The trend toward hiring more outside attorneys "is a reflection of the multiplicity of issues hospitals face in the legal arena", says Ronald Aldrich, president and CEO of Franciscan Health System, Chadds Ford, PA. Why are CEOs placing so much emphasis on strategic planning? The answer is simple, say executives: Hospitals are trying to find ways to survive difficult times.
There are many professionals in multiple disciplines developing approaches for helping children with learning disabilities. Much of these data and reports are published in journals normally not read by physicians. On occasion, such publications are reported in newspapers or lay magazines. Thus, parents may know of ideas and suggestions before the professional. It is understandable that the parent of a handicapped child would continually seek out improved ways of helping his or her child. The treatment of choice is basically special education. Medication will minimize the hyperactivity and distractability; psychotherapy may minimize the emotional effects. However, special educational therapy for the underlying learning disabilities is essential. No one yet has a rapid or "guaranteed" cure. Parents are often caught in the middle. They turn to their physician for guidance. It is the purpose of this paper to review the significant literature in an effort to assist the family physician in providing this guidance.
Hospitals seeking to bolster their financial performance must improve their relationships with physicians, according to a panel of six hospital chief financial officers brought together by Hospitals magazine. CFOs are also concerned that Medicare's new method for reimbursing hospitals for capital expenses could further squeeze their resources.
Automated laboratory equipment, medical imaging equipment, and patient monitors top the list of hospitals' priorities for equipment acquisition during the next year. This is according to an exclusive survey sponsored by the Linc Group, Inc., Chicago, and Hospitals magazine. The new survey also found that equipment acquisitions are most often financed with internal funds and gifts; that equipment purchasing budgets are on the rise; and that executives believe that most equipment makes money for their hospitals. Find out what your peers have to say about anticipated trends in equipment acquisition and financing during the next year.
Hospitals are shifting their approach to physician recruiting as competition for qualified physician candidates heats up. Instead of recruiting physicians to establish solo practices, 85 percent of hospitals are now helping staff physicians expand their practices. So says an exclusive survey of physician recruiting habits conducted by the Atlanta-based recruiting firm Jackson & Coker and Hospitals magazine.
Self-administered anonymous questionnaires were included in the nationwide gay magazines "Pan" and "Cock" with the object of revealing the needs and possibilities of improved health educational effort in prevention of sexually transmitted HIV infection among homosexual and bisexual men. This was undertaken in March 1988 to illustrate the utilization and satisfaction of various sources of safe sex. The investigation reveals that campaigns about safe sex have been of great interest among the section of the target group which an investigation of this type could attract. In particular, the general efforts made by the Danish Health Board have attracted attention in a very broad section of men with homosexual contacts. Among those who employ the offers specifically made for the target gay group, considerable satisfaction is expressed. Compared with this, the employment of and satisfaction with medical help are considerably less. The significance of connections with a series of sociodemographic and subcultural subgroups are illustrated. Only where the gay-specific information is concerned was a significant association observed between receipt of information and the replier's reproduction of the given information about the risks involved in use of condoms. As regards the significance of single sources for sexual behaviour, a non-significant tendency was observed for persons who had received gay-specific written information to have a lower sex risk than those who had not received this information. It is recommended that the campaign hitherto initiated should be continued with intensification of AIDS prevention among the hidden homosexual men and men with sexual contacts with both sexes.
Neural tube defects are a heterogeneous group of malformations resulting from failure of neural tube closure during early embryogenesis. They range widely in severity from the lethal condition of anencephaly, to severely disabling meningomyeloceles, to completely surgically correctable meningoceles. Occurring in 1.4 to 1.6 per 1000 live births, neural tube defects rank second only to cardiac abnormalities as a cause of major congenital malformations in the United States. Technical developments over the past decade have enabled better detection of these conditions prenatally. Understanding of the etiology, neonatal treatment, and potential prevention of neural tube defects is increasing. Further, the ethical issues of treatment and screening are being widely discussed in both news magazines and the Congressional Record. Thus, it is timely to review this important area of prenatal counselling, diagnosis, and management.
Concepts of vitamin B6 megatherapy are classified in three categories: 1. megatherapy with well-known mechanism of action; 2. megatherapy with hypothetical or unknown, but nevertheless plausible mechanism of action; 3. megatherapy on the basis of pure speculation. Examples of all three categories are shown. The dosages applied extend from 100 mg up to several grams; the duration of treatment varies from weeks to several years. After long-term intake of high doses toxic effects can occur in the form of peripheral sensory neuropathy, in two reported cases combined with a subepidermal vesicular dermatosis. The threshold above which toxic effects can occur appears to be somewhat between 300 and 500 mg/day; however, systematic investigations in this dose range have never been performed. Furthermore, there appears to be an inverse relationship between the dose and the time up to the occurrence of toxic symptoms. The danger consists less in controlled application by a physician as far as he is aware of the clinical picture of sensory neuropathy. Doses in excess of 500 mg are rarely necessary in specific indications. Unlike this situation, self-medication by laymen on the basis of promises in obscure health magazines is much more risky because the dose is frequently raised more and more up to several grams per day when the expected effect does not occur.
70% of the pupils of public schools in the city of Bochum who were questioned in an opinion poll conducted by the Public Health Office were interested in knowing more about AIDS. More than 80% of the boys and girls approached during the questioning know the causative virus and how persons can get infected. It is also relatively well known how a person can protect himself or herself against HIV infection by meaningful measures. However, it is very surprising that only about 24% of all questioned pupils believe that anybody without exception can be involved. The school, TV and magazines or newspapers are named as principal sources of information. About 40% of all questioned persons are very afraid or afraid of AIDS. About 50% of the schoolgirls and schoolboys approached during the poll wanted to know how they should act when coming into contact with AIDS patients. Schoolgirls and schoolboys prefer to discuss problems of prevention and subjects like AIDS with their girlfriend or boyfriend or at the most with their mother. Almost 80% of all persons questioned believed that they could at least do something, albeit little, to prevent AIDS from spreading further by their own behaviour. The following column histograms show some of the exact percentage distributions.
An interview was carried out, using a standard questionnaire, with the parents of 103 children attending as new patients to a medical paediatric outpatient clinic. This interview was designed to determine the extent of deliberate additions and avoidances to their children's diets. Some specific alteration to the diet was seen in 48 children. There were 38 avoidances and 20 additions of some form of food or mineral substance. In 10 children there were both additions and avoidances. Avoidance of a foodstuff, most commonly food additives, was either for a particular illness or health belief. Dairy products and meats were the next most frequently avoided substances. Additions to the diet were predominantly vitamins and minerals. The sources of dietary advice were the media, mainly magazines and books, and family members. Medical influence on dietary alterations was small.
Mammography, although an effective screening tool, has generally been underutilized. Although many factors may contribute to low utilization rates, the degree to which fee structure influences women's decision to have mammography has not been determined. This study compared women having mammography at the regular fee with those women having mammography at a special reduced rate. The study group consisted of all women having mammography for eight consecutive months at a new mammography screening clinic. The clinic had specifically been established for self-referral. Women from both groups when compared to the general population in the surrounding area tended to be in a higher educational/socioeconomic level. Women in the regular fee group reported physician influence as being most important in their decision to have mammography while women in the reduced fee group reported the reduced fee of mammography itself as the most important factor. Books and magazines were the second most important factor for both the regular and reduced fee group with regard to their decision to have mammography.
Studies on the chemotaxonomy of obligate anaerobic bacteria have been made. The combination of gas chromatography and mass spectrometry with computer-assisted analysis, permitting the multicomponent analysis of all products of bacterial metabolism and bacterial cell components, has been shown to be a research method, quite suitable for such studies. The chromatographic profiles of the end products of metabolism in anaerobic cultures of different age have been found to differ not in the set and number of peaks indicating various metabolites, but only in the concentration of metabolites, increasing in the process of prolonged incubation. The authors believe that the national microbiological "library" of the chromatographic profiles of anaerobic organisms should be created and the album of typing chromatographic profiles should be published; besides, data on new profiles should regularly appear in magazines.
Twelve young and 12 old subscribers to an Italian magazine of riddles were invited by mail to form an anagram from a string of meaningful words consisting of 30 letters. Each of the participants was classified as either "overskilled" or "normal". All of the overskilled subjects, regardless of age, employed the 30 letters, whereas only the 50% of the remaining subjects did so. Even stronger differences were seen with regard to the number of complete anagrams. The overskilled elderly outscored the young adults, but the latter paid more attention to the quality of the anagrams. The article confirms previous results on the stability with age of anagram ability.
In recent years there has been increasing concern and involvement of Israeli adolescents with dieting. An increase in the incidence of obesity has been emphasized by the mass media. This has been marked by an increase in the number of questions on dieting sent anonymously by 12 to 14 year-olds to a column in a popular youth magazine about adolescent sexuality. These letters include requests for diets to prevent obesity in general and fatness of certain parts of the body in particular, such as the thighs or buttocks; questions as to side-effects of diets already started, particularly amenorrhea; and questions about the onset of bulimia and anorexia nervosa, expressing fear of the consequences. This study gives examples of the questions and the answers, and indicates the professions of those to whom the applicants were referred for further diagnosis and treatment. Newer techniques of health education with regard to adolescent dieting are urgently needed so that the health staff can promote insight and indicate the need for treatment at as early a stage as possible. The use of mass media in a suitable manner is critical, given the increase in diet-advertising.
Alternative foodstuffs restrict the usage of household sugar and instead recommend sweet honey or dried fruits; in popular informative magazines raisins and dried fruit are even described as "healthy snacks". In this study, with the help of sugar clearance and lactic acid measurements, the cariogenic potential of dried fruits is to be better estimated. The results clearly show that the alternative recommendations do not promote healthy teeth. The cariogenic potential of the named foodstuffs is comparable to sucrose containing products.
As part of the study on the prevention of oral malodour, people's attitudes and reactions towards oral malodour were investigated in this study. As a preliminary survey, investigation was made by questionnaire on a total of 179 students at three dental hygienics schools in November 1988. The findings are as follows: 1. Of the total number of the students questioned, 47% sometimes feel uneasy about their own oral malodour, while 35% have never thought about it. Only 6% have been told they had oral malodour. 2. Although 98% of the respondents felt sick when they became aware of another person's oral malodour, 53% of them told the other person of their discomfort when the person with oral malodour was a parent, brother, sister, or a very close friend. 3. About half (52%) of the students said, they practice the prevention of oral malodour by brushing their teeth, and 50% like to use mouthwashes. Of the total, 88% wished to know whether they had oral malodour or not. 4. Overwhelming majority knew of mouthwashes through TV commercials and advertisements in magazines, 80% of those could name any one of the tradenames of the mouthwashes. 5. These findings indicated that dental health education on oral malodour and mouthwashes would be important in future.
Two-stage, endosseous dental implants have become a clinically acceptable treatment modality for the restoration of function and esthetics in edentulous areas. One system (Biotes, Nobel-pharma) currently has full approval from the ADA for use in full edentulous cases, while several other systems have provisional approval. Several professional journals and lay magazines have published information about implants, and this has stimulated interest on the part of both the dentist and the patient. Many different brands of implant systems are now available for the clinician to utilize, and the manufacturers of these implants have established training programs designed to teach both the generalist and the specialist the correct placement and restoration of their particular implants. With an increase in the number of implants being placed, it is inevitable that the number of complications will likewise rise. While current implant literature is replete with information concerning the concept of osseointegration, success rates, and examples of restorative techniques, there is very little information available on guidelines for patient evaluation and selection, clinical maintenance homecare, or treatment considerations for system failure. It is conceivable that an implant that was correctly placed and exhibited all the criteria for success at the time of surgical exposure may develop problems subsequent to restoration. Since the investment for the patient is significant in terms of time, finances, and trust in the practitioner(s), the periodontist may be called upon to intervene in such cases to improve the prognosis. The purpose of this paper is to present four case reports that illustrate several treatment modalities for the clinical management of implant problems that developed at the time of, or following, exposure.