Smallpox and the Native American

With the arrival of Europeans in the Western Hemisphere, Native American populations were exposed to new infectious diseases, diseases for which they lacked immunity. These communicable diseases, including smallpox and measles, devastated entire native populations. In this article, we focus on the effect of smallpox on the Native Americans from the 15th through the 19th centuries. Among the "new" infectious diseases brought by the Europeans, smallpox was one of the most feared because of the high mortality rates in infected Native Americans. This fear may have been well-founded, because the Native Americans were victims of what was probably one of the earliest episodes of biological warfare. Fortunately, they were also major beneficiaries of early vaccination programs. Thus, the arrival of smallpox and the decline of the Native American populations are inexorably linked, as the history summarized here illustrates.     

Preventing cancer, cardiovascular disease, and diabetes: a common agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association

Collectively, cardiovascular disease (including stroke), cancer, and diabetes account for approximately two thirds of all deaths in the United States and about 700 billion dollars in direct and indirect economic costs each year. Current approaches to health promotion and prevention of cardiovascular disease, cancer, and diabetes do not approach the potential of the existing state of knowledge. A concerted effort to increase application of public health and clinical interventions of known efficacy to reduce prevalence of tobacco use, poor diet, and insufficient physical activity-the major risk factors for these diseases-and to increase utilization of screening tests for their early detection could substantially reduce the human and economic cost of these diseases. In this article, the ACS, ADA, and AHA review strategies for the prevention and early detection of cancer, cardiovascular disease, and diabetes, as the beginning of a new collaboration among the three organizations. The goal of this joint venture is to stimulate substantial improvements in primary prevention and early detection through collaboration between key organizations, greater public awareness about healthy lifestyles, legislative action that results in more funding for and access to primary prevention programs and research, and reconsideration of the concept of the periodic medical checkup as an effective platform for prevention, early detection, and treatment.     

Attachment styles in older European American and African American adults

OBJECTIVES: Differential attachment styles have been linked to differential emotion regulation and ability to cope with stress in samples of young adults. There are few data on attachment styles in older adults despite the fact that attachment relationships are said to play a significant role in psychological well-being throughout the life span. The goal of the study was to examine attachment patterns in older adults. METHODS: Participants were 800 community-dwelling older European Americans and African Americans (M = 74 years) living in a large urban community. Attachment measures included the family and friend intimacy subscales from the Network Analysis Profile and the Relationship Scales Questionnaire. RESULTS: In contrast to findings with younger individuals, where the majority of respondents have been found to be secure (i.e., comfortable with closeness and dependency), the majority of the present sample were found to be dismissing/avoidant (i.e., uncomfortable with closeness, compulsively self-reliant). European Americans scored higher than African Americans on attachment security, whereas African Americans scored higher than European Americans on dismissing attachment. However, the assessment of relatedness based on the Network Analysis Profile, where respondents named their closest kin, indicated that African Americans had higher scores than European Americans, though their networks were smaller. DISCUSSION: Age and ethnicity differences appear to reflect cohort effects related to the impact of economic hardship on families earlier this century and racial prejudice. The high rates of dismissing attachment and low rates of secure attachment in this large urban population suggest that these individuals may be at risk for social isolation and poor health as they become older and more frail.     

Use of animals in biomedical research. Historical role of the American Medical Association and the American physician

From the introduction of the "Gallinger-DC" bill in 1896 to the passage of the Laboratory Animal Welfare Act in 1966, organized medicine and the American physician have been active in promoting the humane and appropriate use of research animals and explaining to the public and legislators the importance of research using animals to medical progress. The role of organized medicine and science in events leading to passage of federal legislation is discussed. Past efforts of the American Medical Association and the American physician have been critical in numerous successful efforts at the local, state, and national level to prevent the passage of laws which restricted animal use for health research and impeded medical progress. This article demonstrates that current initiatives by physicians to preserve biomedical research are a reaffirmation of their traditional role.     

The American public and the Terri Schiavo case

An important question for physicians in the aftermath of the Terri Schiavo case is whether the effort of elected officials to intervene was a one-time anomaly or signals a future trend of elected officials being involved in cases where patients are in a vegetative or long-term comatose state. To try to answer this question, we used results from 12 national opinion surveys conducted in March and April 2005, when the Schiavo case was being debated. A review of these survey results showed that efforts by elected politicians to intervene in the Schiavo case were opposed by the majority of Americans. However, the public was more divided on the question of whether Schiavo's feeding tube should be removed. Opposition to removing Schiavo's feeding tube was associated with opposition to abortion. The results suggest that issues involved in cases like Schiavo's are not likely to disappear from the political agenda.     

Investment analysts and the American Society of Hematology

Investment analysts are a growing presence at the Annual Meeting of the American Society of Hematology (ASH), and financial professionals frequently contact ASH members for information and perspective on drugs, devices, and scientific developments. Recent incidents have raised concerns about consulting relationships between physicians and the investment industry; the appropriate role of medical societies in influencing these relationships is unclear. In this essay, I summarize the current situation, discuss potential risks and benefits from interactions between physicians and investment analysts, and outline issues that all individuals involved in investment industry consulting should consider. I also propose changes in ASH policy that may help safeguard public trust as well as preserve the access of clinicians and scientists to clinically relevant data presented at the Annual Meeting.