Forecast Hesitancy:Why are People Reluctant to Believe,Accept,or Respond to Various Weather,Water,and Climate Hazard-Related Forecasts?

Current discussions of the social phenomenon of"vaccine hesitancy"with regard to Covid-19 provide an opportunity to use hesitancy as a means to shift thinking a...     

Urgent endoscopic retrograde cholangio-pancreatography: to whom, when and how to perform?

Although the effectivity of an urgent endoscopic retrograde cholangio-pancreatography was documented, some aspects relating to this method are still debated. Timing of this procedure has not been established yet. Indications for urgent endoscopic retrograde cholangio-pancreatography with stone extraction from the common bile duct in patients with biliary pancreatitis remains controversial. Biliary decompression and drainage is the cornerstone of acute cholangitis treatment. The timing of endoscopic retrograde cholangio-pancreatography should be based on the grade of the severity of the disease. Using endoscopic retrograde cholangio-pancreatography, the accurate diagnosis and treatment of bile leaks in a timely manner is imperative to limit associated morbidity and mortality. Difficulty in cannulating the common bile duct is one of the main risk factors for pancreatitis occurring after the procedure. Alternative techniques to facilitate difficult cannulation are discussed. Organized training and introduction of objective measures of the investigator's competence are emphasized to improve the performance of the procedure in Hungary.     

What can technology do to, and for, family medicine?

Medical technology can be divided into information technology, diagnostic technology, and therapeutic technology. These technologies can enhance the care of patients in a family practice; they also have the potential to diminish or fragment family practice when the technologies can only be provided by specialists. While some family physicians have an aversion to technological advances, we believe it is imperative that family physicians participate in the development of technologies that enhance family practice and improve patient outcomes in primary care practice. These include electronic medical records, decision support systems, tools for managing medical information, and others. Criteria are presented to help determine when these new technologies should be adopted into practice.     

Chronic,Inhalation Exposure of Rats,Rabbits , and Monkeys to 1 , 2 , 4–Trichlorobenzene

Three groups composed of rats, rabbits, and monkeys were exposed for 26 weeks to 1,2,4-trichlorobenzene (-TCB), and one group of each species was used as a control group. TTie nominal exposure concentrations of 1,2,4-TCB were 25.0, 50.0, and 100.0 ppm. Pulmonary function and operant behavior tests in monkeys, ophthalmoscopic examinations in rabbits and monkeys, and measurement of body weights and hematologic and serum biochemical determinations in all species were conducted before and during the exposure period. At termination of 1, 3, and 6 months of exposure, microscopic examination of selected rat tissues was performed. Microscopic changes were seen in the parenchymal cells of livers and kidneys from all groups of rats exposed to 1,2,4-TCB when sacrificed after 4 and 13 weeks of exposure, but no exposure-related abnormalities or other effects were seen after 26 weeks of exposure in any species.     

Community-based Organizations’ Capacity to Plan, Implement, and Evaluate Success

Community-based organizations (CBOs) have the potential to promote and sustain health, prevent disease, and address health disparities, but many lack the capacity to do so. An assessment of the 20 CBOs receiving supplemental grant funding from the Pfizer Foundation Southern HIV/AIDS Prevention Initiative indicated a high level of knowledge for developing goals and objectives (mean score=3.08 on a scale of 0 (none) to 4 (extensive)) and high self-assessed abilities to conduct six of 20 specific intervention activities, including the development of community relationships and coalitions. Lower knowledge and skill levels were observed for intervention evaluation. While CBOs of this Initiative have established prerequisite abilities, they have self-acknowledged needs for technical assistance to maximize HIV/AIDS prevention capacity.     

Memorial Tribute to Vince L. Hutchins,MD, MPH, 1928–2001

Maternal and Child Health Journal -     

The influence of autonomy on personal support workers’ job satisfaction,capacity to care,and intention to stay

Using survey data collected in Ontario, Canada, we explore the impacts of autonomy on community-based Personal Support Workers’ intrinsic job satisfaction, capacity to care for and about clients, and intention to continue working in home care. Autonomy was measured as “freedom to decide how to do your job” and “working on your own.” Findings show that freedom to do your job and working on your own are both positively associated with job satisfaction and capacity to care, and indirectly increase intention to stay through their relationships with job satisfaction and capacity to care. We suggest that policies should allow personal support workers to make decisions about how to do their job within the care plans provided, to facilitate retention of this highly needed workforce.