P.W. MACFARLANE and T.D.V. LAWRIE
This paper briefly describes the technical aspects of ECG interpretation by computer, and thereafter discusses in detail the considerations involved in introducing the method into…
Abstract
This paper briefly describes the technical aspects of ECG interpretation by computer, and thereafter discusses in detail the considerations involved in introducing the method into a large hospital. One of the most important of these is that of educating physicians to accept 3‐lead ECG interpretations. Technical problems are discussed together with the question of staffing, and it is emphasized that the introduction of automation does not normally lead to any staff redundancy. The various shortcomings of existing methods are described but the benefits accruing from automation are discussed. The conclusion drawn is that the technique will prove to be of value in the near future when regional centres are established to cope with the ever increasing demand for ECG interpretations.
Neale R. Chumbler, Ashley Foster, James W. Grimm and Philip Williams
The objective of this chapter was to advance the medical sociology theoretical literature on health lifestyle behaviors. This study investigated the influence of mid-life adult…
Abstract
The objective of this chapter was to advance the medical sociology theoretical literature on health lifestyle behaviors. This study investigated the influence of mid-life adult statuses (gender, marital status, parenthood, presence of children in the home, and employment status) and functional health status (general physical health, general mental health, vitality, and social functioning) on selected health-related behaviors. These behaviors included preventive medicine behaviors (routine physical exams, cholesterol checks, and blood pressure checks), risk-taking behaviors (driving above the speed limit, smoking, and consuming alcohol), health promoting behaviors (exercising, sleeping well, and relaxing), and medication usage (using prescribed medicines, over-the-counter medicines, and herbal supplements). The data were gathered through the Warren County Health Survey, a telephone survey of a randomly selected sample of residents from a county in Kentucky. Logistic regression was used to analyze the data. Results indicated that having children at home, being married, being fifty years old or older, and possessing better mental health and social functioning statuses were associated with a greater likelihood of practicing better health-related behaviors. In contrast, being both male and aged 49 and younger were correlated with a greater likelihood of engaging in poorer health-related behaviors. Based on these results, the authors offered several testable, theoretical propositions for future research to test the relationships between mid-life adult health statuses, functional health statuses, and health-related behaviors in other community-based samples.
D. Dutta and B. Ogunnaike
There is strong evidence for the use of HMG Co‐A reductase inhibitors (statins) for secondary prevention after myocardial infarction. Previous surveys suggest sub‐optimal use of…
Abstract
There is strong evidence for the use of HMG Co‐A reductase inhibitors (statins) for secondary prevention after myocardial infarction. Previous surveys suggest sub‐optimal use of such secondary prevention measures. The national service framework (NSF) for coronary heart disease (CHD) has now set new standards for preventing and treating CHD. In our audit of 182 survivors of myocardial infarction in 1999, 86.2 per cent had cholesterols measured on admission, but only 39 per cent had statins prescribed on discharge. Our data provide information about base‐line practice for the year immediately preceding the publication of the NSF and indicate that the average district general hospital may have a long way to go to meet the target set by the NSF.
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J. Mark F. Temple and D.L. Fone
Standing Medical Advisory Committee (SMAC) guidance for prevention of coronary heart disease (CHD) and the National Service Framework – Coronary Heart Disease both require the…
Abstract
Standing Medical Advisory Committee (SMAC) guidance for prevention of coronary heart disease (CHD) and the National Service Framework – Coronary Heart Disease both require the identification of patients at high risk of CHD for targeted treatment with statins. Since the best method of identifying these patients is unknown, we compared population screening with opportunistic case finding in a discrete event computer simulation model of the population aged 45‐64 in one local health group in Wales. The main outcome measures were numbers of CHD and all‐cause deaths and extra patient‐years of drug treatment. Screening and case finding were of similar effectiveness in identifying high risk individuals to prevent CHD and all‐cause mortality during the five years simulated. The extra patient‐years of drug treatment required by a population screening programme suggests that screening would not be cost effective. Concludes that opportunistic case finding is the method of choice in primary care.
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Aarhus Kommunes Biblioteker (Teknisk Bibliotek), Ingerslevs Plads 7, Aarhus, Denmark. Representative: V. NEDERGAARD PEDERSEN (Librarian).
Ulla Eriksson-Zetterquist and Kerstin Sahlin
Collegiality is often discussed and analyzed as a challenged form of governance, a form of working that used to function well in universities prior to the emergence of…
Abstract
Collegiality is often discussed and analyzed as a challenged form of governance, a form of working that used to function well in universities prior to the emergence of contemporary and modern forms of governance. This seems to suggest that collegiality used to dominate, while other forms of governance are now taking over. The papers in volume 86 of this special issue support the notion of challenged collegiality, but also show that for the most part, nostalgic notions of “the good old days” are neither true nor helpful if we are to revitalize academic collegiality. After examining whether a golden age of collegiality ever existed, we discuss why collegiality matters. Exploring what are often described as limitations or “dark sides” of collegiality, we address four such “dark sides” related to slow decision-making, conflicts, parochialism, and diversity. This is followed by a discussion of how these limitations may be handled and what measures must be taken to maintain and develop collegiality. With a brief summary of the remaining papers under two headings, “Maintaining collegiality” and “Revitalizing collegiality,” we preview the rest of this volume.