Media violence

American media are the most violent in the world, and American society is now paying a high price in terms of real life violence. Research has confirmed that mass media violence contributes to aggressive behavior, fear, and desensitization of violence. Television, movies, music videos, computer/video games are pervasive media and represent important influences on children and adolescents. Portraying rewards and punishments and showing the consequences of violence are probably the two most essential contextual factors for viewers as they interpret the meaning of what they are viewing on television. Public health efforts have emphasized public education, media literacy campaign for children and parents, and an increased use of technology to prevent access to certain harmful medial materials.

The prostatic imperative and the social relations of medical technology

A sociological approach to medical technology assessment is outlined in this paper, first in general and then with specific reference to controversies surrounding the use of prostate-specific antigen (PSA) testing to population screening for prostate cancer.

Managing the doctor-nurse game: a nursing and social science analysis

In the struggle to achieve professional status and develop a body of knowledge, nursing has embraced a number of 'sciences' and 'disciplines'. These have included sociology and feminist perspectives. This paper explores the difficulties of drawing on these disciplines independently of everyday nursing practice. Using a case study approach, we illustrate the way in which some nurses draw on sociological and feminist 'definitions of the situation' in the 'doctor-nurse game', while others draw directly on nursing practice. The nursing practice in this case is concerned with pain management. We conclude that 'shared care' requires a collaboration with medicine that draws on nursing practice to demonstrate an integrated nursing knowledge in a way that acknowledges, challenges and asserts issues of power and status.

Health technology assessment in Australia: the role of AHTAC. Australian Health Technology Advisory Committee

This paper outlines and discusses the field of medical technology assessment and the role of the Australian Health Technology Advisory Committee (AHTAC) in that process. Developments in medical technologies have altered the way in which health care is practised and delivered. The policy task is a complex one; attempting to balance the need for cost containment whilst at the same time ensuring that the processes of innovation into Australia, and diffusion occur in a manner which maximises the benefit and minimises any harm to the Australian community.

Childhood immunizations: position on the enhanced inactivated poliovirus vaccine and live attenuated oral poliovirus vaccine dilemma

Recent review of the polio vaccines (live attenuated oral poliovirus vaccine [OPV] and enhanced inactivated poliovirus vaccine [eIPV]) for children has generated much debate between infectious disease experts and public health officials. Poliomyelitis was a common medical condition in the 1940s and 1950s, and the success of OPV in eradicating poliomyelitis from the United States and even the Western hemisphere cannot be disputed. However, the adverse condition of vaccine-associated paralytic poliomyelitis (VAPP) has been reported in eight to nine cases per year as a result of exclusively using OPV in the United States. The dilemma has been how to continue the elimination of wild-type poliovirus paralytic poliomyelitis in the United States and worldwide while minimizing the occurrence of VAPP. Clinical trials have supported that eIPV and OPV provide similar protection for humoral immunity. However, OPV provides superior gastrointestinal immunity, which is a public health benefit for vulnerable populations. Recommendations among experts have concluded that the sequential eIPV/OPV is the preferred schedule, with eIPV only or OPV only as alternative equally acceptable schedules. Therefore, factors such as cost, compliance, and access to health care must be considered by parents and providers when selecting a polio vaccine regimen, especially among underserved populations.

Chiropractic and the politics of health care

Musculoskeletal disorders remain a common disability suffered by Australians, but the question of who should treat them remains a contentious issue as the first centenary of the original chiropractic adjustment approaches. This paper, part of a longitudinal study of the role of chiropractic in the Australian health system, analyses this ongoing debate. Recent events are analysed here in this commentary on the politics of health care in this field. These include meta-analysis to evaluate the effectiveness of spinal manipulation for the treatment of lower back pain, recent legal action in the United States, and the recent epistle against Australian chiropractors published by the Australian Medical Association.

Anatomical urinary stress incontinence in women with rheumatoid arthritis: its frequency and coping strategies

OBJECTIVE

The objectives of this study were to develop a valid screening tool for anatomical urinary stress incontinence (AUSI), to use it to determine the frequency of AUSI in women with RA, and to identify the cognitive, behavioral, and psychological coping strategies used by these women to deal with incontinence.

METHODS

A screening tool concerning AUSI was validated by comparing self-reported incidences of AUSI with clinical evaluation. Questionnaires regarding presence of AUSI and cognitive, behavioral, and psychological coping strategies were sent to 750 women clinically diagnosed with RA.

RESULTS

Of the 262 respondents (35% response rate), 21% had characteristics of AUSI, a rate similar to general population studies. Coping strategies varied depending on whether the women were at home or away from home and whether the women were alone or with others.

CONCLUSIONS

There is a need for women with incontinence and the health care workers who serve them to be educated about AUSI and its treatments.

Nurses and independent fee-for-service practice: a critical view

A contemporary development in nursing in Australia is the move to independent private practice. This move is made in support of autonomy for the individual nurse practitioner and in the interests of improved patient care. This paper examines this development using the literature as data and critical theory as the framework of analysis. Critical theory argues that much human knowledge is bound by 'ideological' interests in either the technical or interpretative. Emancipatory knowledge attempts to peel off the various ideological layers in search of truth. Using work to examine the 'technical interest' and professionalism to examine the 'interpretative interest', it is argued that in the contemporary Australian health care system the nurse's claim to autonomy through independent practice calls for continuing debate and reflection.

Chiropractic in Australia

This paper analyzes the emergence of professional chiropractic in Australia. Drawing on the concept of legitimation, it aims to provide a sociological analysis of the evolution of chiropractic.

Occupational stress and RANs

This paper explores nurses' self-reported stress during a time of policy changes in the Northern Territory Health Department. It is argued that current research tends to associate nurses' stress with their personality or type of work, offering a psychological or occupational explanation. Little consideration is given to the complex structural subordination and ambivalence remote area nurses experience on Aboriginal settlements vis a vis their immediate superiors and clients. It is proposed that the nurses' self-reported stress can be partly accounted for by their marginal position between these two groups. The sociological concept of marginality can explain this.

Efficacy of concomitant early summer treatment with fenbendazole and clorsulon against Fasciola hepatica and gastrointestinal nematodes in calves in Louisiana

The efficacy, safety, and compatibility of fenbendazole (FBZ) and clorsulon (CLN) were tested after oral administration of label recommended and of higher (5x) dosage rates to calves naturally infected with gastrointestinal nematodes and Fasciola hepatica. Results for 42 calves allotted to 4 treatment groups indicated a similar efficacy against mature F hepatica by FBZ (5 mg/kg of body weight) and CLN (7 mg/kg) in a combined oral suspension, compared with CLN (7 mg/kg) alone (100 vs 99% reduction). A lesser efficacy was observed against immature flukes (88.6 and 84.9% reduction, respectively). Calves given 25 mg of FBZ/kg and 35 mg of CLN/kg had nearly complete reduction of both mature (99.6%) and immature flukes (99.1%). Fasciola egg counts were reduced by greater than 99.5% in all treated groups. Against Ostertagia ostertagi, the percentage of efficacy of the combined FBZ (5 mg/kg) and CLN (7 mg/kg) treatment was 94.3% against adults and 81.3% against inhibited larvae. Efficacy against all other nematodes was 100%, except against Cooperia spp adults (98.3%) and immature Oesaphagostomum radiatum (88.0%). At 5 x dosage rates for FBZ and CLN, percentage of removal of adults and inhibited larvae of O ostertagi was 99.3 and 99.0%, respectively, and 99 to 100% for other nematodes. Results indicate that FBZ and CLN are compatible when mixed together and administered as an oral suspension to cattle and that the efficacy is similar to that of the drugs individually. On the basis of further results, we suggest that summer treatment may be superior in preventive value for gastrointestinal nematodes and F hepatica, compared with spring treatment, because of seasonal infection dynamics of the major cattle parasites in Louisiana.

Technological innovation and the labour process in health care

The process of technological innovation in health care is explored in this paper using labour process theory. Taking the specific case study of diagnostic imaging technology it argues for the utility of labour process theory for analysing the professional labour process as a means of delineating the social contexts in which technological innovation provides a means of empowering workers.

Chlamydia and the adolescent girl. The enzyme immunoassay as a screening tool

To evaluate the enzyme immunoassay for Chlamydia detection in a population of sexually active urban adolescent girls, 100 endocervical screens using both immunoassay and tissue cell culture were performed. Prevalence of Chlamydia trachomatis was 35%, with more than two thirds of infected adolescents being asymptomatic. When compared with cell culture, the immunoassay was determined to have a sensitivity of 74%, a specificity of 98%, and positive and negative predictive values of 96% and 88%, respectively. Adolescents with false-negative immunoassay test results were more likely to lack evidence of cervical inflammation on examination and have lower-titer infections than their peers with positive results. When the immunoassay was matched against culture for test of cure after therapy, a 10% false-positive rate was found. We conclude that the immunoassay is a useful screening technique for detection of Chlamydia in high-risk adolescent populations; however, its limitations with respect to decreased sensitivity in asymptomatic girls and poor positive predictive value in the context of tests of cure must be appreciated.

A disinfectant delivery system for control of micro-organisms in urine collection bags

We developed a formaldehyde delivery system for urine collection bags and evaluated its effectiveness in suppressing the growth of bacteria in simulated human urine. The system was composed of paraformaldehyde in a polymeric carrier. We determined that inoculation of small numbers of Escherichia coli and Pseudomonas aeruginosa in urinary bags with a continuous flow of synthetic urine (40-80 ml h-1) quickly gives rise to high levels of contamination. This single tablet delivery system, however, proved bacteriostatic or bactericidal for both organisms over the 10-day lifespan. The formaldehyde concentration in the synthetic urine was c. 90 micrograms ml-1 or more during tests.

Ultraviolet light stability of composite resins

The ultraviolet light color stability of seven commercial composite resins was evaluated after 1, 8, and 15 days of exposure. Color differences between exposed and unexposed specimens stored for identical time periods were determined. Samples exposed to ultraviolet light showed large changes in Munsell Hue and Chroma, with smaller but significant changes in Value. Unexposed samples showed small changes in the Munsell components in some cases opposite those observed for the exposed samples. Statistical analysis showed that although significant color changes were observed, brands of composite resins could not be distinguished by length of storage in the dark. Time of exposure was a significant variable at 24 hours and 8 days. At 15 days a number of composite resins did not undergo additional significant color change. Scanning electron microscope showed a significant roughening of the surface of exposed composites with resin breakdown and exposure of the composite filler.

Iatrogenic risks and financial costs of hospitalizing febrile infants

We identified, by diagnostic categories, the iatrogenic and financial costs that arise from hospitalizing febrile infants 60 days of age or younger. Thirty-seven (19.5%) of all admissions resulted in 48 separate complications. Twenty-nine (60.4%) of these complications were preventable, and six complications (12.5%) occurred in infants who probably did not require hospitalization for therapy. Twenty-four (50%) of all complications resulted from intravenous therapy. In addition to the complications, 26 diagnostic misadventures were identified. The average length of hospitalization for all infants was 7.0 days, with a range of two to 28 days. The average cost of hospitalization in 1979-80 dollars was $2,130 per infant, with a range from $6,345 for those infants with bacterial meningitis to $1,480 for those infants with aseptic meningitis. On the average, 25.6% of the bill was for diagnostic studies and 8.3% for physician fees.

Hospitalization v outpatient treatment of young, febrile infants

Our medical center has an unwritten policy of admitting all febrile infants younger than 2 months of age. We studied this practice during a three-year period to determine what proportion of the febrile infants who came to the outpatient department were admitted. The characteristics of the infants who were not admitted were compared with those who were. The timing of and the infant's status at a subsequent visit for those not admitted were also identified. One hundred six (35%) of 303 encounters with young, febrile infants did not result in admissions. An infant was more likely to be admitted if he was male, younger than 30 days of age, and febrile (greater than 38.5 degrees C). None of the infants who were followed up as outpatients suffered morbidity that could be directly related to their not having been hospitalized.