Perceptions of medical errors by internal medicine residents: development and validation of a new scale

Efforts to identify the underlying structure of 40 survey items dealing with perceptions of medical errors are reported on the basis of responses from 195 medical residents. Factor analysis revealed that the medical errors perceptions were represented by a 10-factor solution. The external validity of these factors was examined relative to perceptions about the cost of medical errors, the cost of errors to health care, and the need for education and interventions to address errors. Results indicated that 13.9% of the variation in the perceived cost of medical errors and 17.1% of the variation in the perceived need for additional physician education was explained by the factor structure.     

The unmotivated patient syndrome: survey of therapeutic interventions.

The authors describe five groups of patients who have been found to respond poorly to psychiatric treatment--people from lower socioeconomic groups, juvenile delinquents, drug-addicted individuals, alcoholics and military psychiatric patients. Although these groups of patients represent different etiologies and symptom-specific pathologies, many of their members have in common a lack of motivation for change. The authors discuss the reasons for this lack of motivation, suggesting that focusing on this factor would promote a better understanding of the unmotivated patient syndrome and lead to the development of more effective psychotherapeutic efforts.     

The pineal and endocrine changes in heat exposed male hamsters

Summary Decreased testicular weight with damaged seminiferous tubules were observed in hamsters pinealectomized and exposed continuously to high ambient temperature. In hamsters with intact pineals, exposure to heat resulted in reduced testicular weight without recognizable histological damage. In both groups, serum testosterone levels were elevated, evidently through a compensatory mechanism in the interstitial cells, which did not appear to be damaged. Concomitantly with these findings, reduced serum LH, and pituitary LH and proclactin concentrations were encountered in the heat-exposed pinealectomized hamsters, compared to those of their heat-exposed sham-operated counterparts.These results in hamsters reaffirm a previous postulation of a moderating, protective role for the pineal, against adverse effects of prolonged exposure to heat, in rodents.     

Diurnal cortisol responses to dextroamphetamine in normal subjects

(1) Dextroamphetamine, in doses of 0.1 and 0.15 mg/kg, was administered intravenously morning and evening to normal young men and postmenopausal women, and plasma cortisol responses were assessed. (2) There were no differences in cortisol responses between the young men and older women at either dose. (3) The higher dose elicited a significant and reliable acute cortisol release, while the lower dose did not. (4) In the evening, 0.15 mg/kg amphetamine elicited a larger cortisol increase from baseline than the same dose in the morning. (5) Within morning or evening periods, baseline cortisol values were not significantly correlated with magnitude of cortisol responses, although trends for inverse correlations were observed. (6) It is suggested that these normal diurnal differences in the acute cortisol response to amphetamine may be related to a corresponding rhythm in the responsitivity to amphetamine of neuroendocrine neurotransmitters. (7) The previously reported abnormal cortisol response to amphetamine in a group of endogenous depressives probably is not primarily related to variables of age, sex or baseline cortisol level.     

Preparation of an infectious ribonucleic acid derived from mouse brains infected with Israel turkey meningo-encephalitis virus

Summary An infectious RNA preparation was obtained from mouse brains infected with the hitherto little known Israel turkey meningo-encephalitis virus isolated from diseased turkeys in 1958. The procedure adopted was based on the use of saturated aqueous phenol and bentonite. The infectiousness of the preparation was demonstrated in vivo and in vitro, and the identity of the virus derived thereof was proved by neutralization and fluorescent antibody techniques. The yields of infectivity was of a low order, approximately 0.001 per cent.     

Spatial structuring of Triatoma infestans (Hemiptera, Reduviidae) populations from northwestern Argentina using wing geometric morphometry

Wing geometric morphometry was used to study the spatial structuring of populations of Triatoma infestans from different villages, ecotopes, and sites within a village in northwestern Argentina. A total of 308 male and 197 female wings of T. infestans collected from peridomestic and domestic ecotopes in March 2000 was analyzed. On average, female bugs had a significantly larger wing size than males. Triatomines collected from domiciles or structures associated with chickens had larger wings than bugs collected from goat or pig corrals. The wing size of bugs did not differ significantly between villages. Discriminant analyses of wing shape showed significant divergence between villages, ecotopes, and individual collection sites. The study of metric variation of males between sites belonging to the same ecotope also revealed significant heterogeneity. Indeed, within the same section of the village the difference between two goat corrals was sometimes greater than that between neighboring goat and pig corrals. Thus, morphometric heterogeneity within villages may be the result not only of ecotope and host associations, but also of physical isolation between subunits. The strong structuring of T. infestans populations in the study area indicates that recolonization could be traced back to a small geographic source.