A psychiatrist in hospice

2003 ◽  
Vol 1 (1) ◽  
pp. 89-92 ◽  
Author(s):  
ALAN MORGENSTERN ◽  
HAROLD BOVERMAN ◽  
LINDA GANZINI
Keyword(s):  
United States Air Force ◽  
Medical Center ◽  
The United States ◽  
World Health ◽  
License Plate ◽  
Aerospace Medicine ◽  
Hospice Patient ◽  
Good Samaritan Hospital ◽  
Health Organization ◽  
Tremendous Impact

Dr. Alan Morgenstern joined the psychiatry faculty at Oregon Health and Science University (OHSU) in 1965. He also served as chairman of psychiatry at Good Samaritan Hospital and Medical Center in Portland, Oregon. His many accomplishments include his part in a World Health Organization Travel-Study Fellowship. He served as a senior examiner for the American Board of Psychiatry and Neurology and he published a critique of this process, which resulted in a humanization of the experience for examinees. While teaching at OHSU he had a tremendous impact on generations of students who were impressed by his humane approach to medicine. He received the OHSU Meritorious Achievement Award for Teaching. He also served as a captain in the United States Air Force School of Aerospace Medicine. His close friend, Harold Boverman, M.D., wrote, “He loved his family, his work, his patients, his friends, and his music; his license plate read ‘etude.’”Dr. Morgenstern contacted us regarding his hope that we would facilitate publishing this account of his experience as a hospice patient. This represents an edited version of his manuscript. L.G. and H.B.

scholarly journals Communications and Screening for 2019 Novel Coronavirus at a Tertiary-Care Medical Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s84-s84
Author(s):  
Lorinda Sheeler ◽  
Mary Kukla ◽  
Oluchi Abosi ◽  
Holly Meacham ◽  
Stephanie Holley ◽  
...  
Keyword(s):  
Screening Tool ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
The United States ◽  
World Health ◽  
Communication Campaign ◽  
Electronic Screening ◽  
Novel Coronavirus ◽  
The Impact

Background: In December of 2019, the World Health Organization reported a novel coronavirus (severe acute respiratory coronavirus virus 2 [SARS-CoV-2)]) causing severe respiratory illness originating in Wuhan, China. Since then, an increasing number of cases and the confirmation of human-to-human transmission has led to the need to develop a communication campaign at our institution. We describe the impact of the communication campaign on the number of calls received and describe patterns of calls during the early stages of our response to this emerging infection. Methods: The University of Iowa Hospitals & Clinics is an 811-bed academic medical center with >200 outpatient clinics. In response to the coronavirus disease 2019 (COVID-19) outbreak, we launched a communications campaign on January 17, 2020. Initial communications included email updates to staff and a dedicated COVID-19 webpage with up-to-date information. Subsequently, we developed an electronic screening tool to guide a risk assessment during patient check in. The screening tool identifies travel to China in the past 14 days and the presence of symptoms defined as fever >37.7°C plus cough or difficulty breathing. The screening tool was activated on January 24, 2020. In addition, university staff contacted each student whose primary residence record included Hubei Province, China. Students were provided with medical contact information, signs and symptoms to monitor for, and a thermometer. Results: During the first 5 days of the campaign, 3 calls were related to COVID-19. The number of calls increased to 18 in the 5 days following the implementation of the electronic screening tool. Of the 21 calls received to date, 8 calls (38%) were generated due to the electronic travel screen, 4 calls (19%) were due to a positive coronavirus result in a multiplex respiratory panel, 4 calls (19%) were related to provider assessment only (without an electronic screening trigger), and 2 calls (10%) sought additional information following the viewing of the web-based communication campaign. Moreover, 3 calls (14%) were for people without travel history but with respiratory symptoms and contact with a person with recent travel to China. Among those reporting symptoms after travel to China, mean time since arrival to the United States was 2.7 days (range, 0–11 days). Conclusion: The COVID-19 outbreak is evolving, and providing up to date information is challenging. Implementing an electronic screening tool helped providers assess patients and direct questions to infection prevention professionals. Analyzing the types of calls received helped tailor messaging to frontline staff.Funding: NoneDisclosures: None

scholarly journals Malaria continues to select for sickle cell trait in Central Africa

2015 ◽  
Vol 112 (22) ◽  
pp. 7051-7054 ◽  
Author(s):  
Eric Elguero ◽  
Lucrèce M. Délicat-Loembet ◽  
Virginie Rougeron ◽  
Céline Arnathau ◽  
Benjamin Roche ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Trait ◽  
Genetic Disorder ◽  
Central Africa ◽  
The United States ◽  
Malaria Prevalence ◽  
Current Data ◽  
World Health ◽  
Human Populations ◽  
Health Organization

Sickle cell disease (SCD) is a genetic disorder that poses a serious health threat in tropical Africa, which the World Health Organization has declared a public health priority. Its persistence in human populations has been attributed to the resistance it provides to Plasmodium falciparum malaria in its heterozygous state, called sickle cell trait (SCT). Because of migration, SCT is becoming common outside tropical countries: It is now the most important genetic disorder in France, affecting one birth for every 2,400, and one of the most common in the United States. We assess the strength of the association between SCT and malaria, using current data for both SCT and malaria infections. A total of 3,959 blood samples from 195 villages distributed over the entire Republic of Gabon were analyzed. Hemoglobin variants were identified by using HPLCy (HPLC). Infections by three species of Plasmodium were detected by PCR followed by sequencing of a 201-bp fragment of cytochrome b. An increase of 10% in P. falciparum malaria prevalence is associated with an increase by 4.3% of SCT carriers. An increase of 10 y of age is associated with an increase by 5.5% of SCT carriers. Sex is not associated with SCT. These strong associations show that malaria remains a selective factor in current human populations, despite the progress of medicine and the actions undertaken to fight this disease. Our results provide evidence that evolution is still present in humans, although this is sometimes questioned by scientific, political, or religious personalities.

PUBLIC HEALTH, NURSING AND MEDICAL SOCIAL WORK

PEDIATRICS ◽  
1951 ◽  
Vol 8 (4) ◽  
pp. 570-572
Keyword(s):  
Premature Infants ◽  
The United States ◽  
World Health ◽  
Multiple Birth ◽  
Expert Committee ◽  
Medical Social Work ◽  
Incidence And Mortality ◽  
Health Nursing ◽  
Health Organization ◽  
Intrinsic Variable

IN THE summary of the report of the Expert Committee on Prematurity of the World Health Organization, published in this column in February 1951, Dr. Ethel Dunham indicated the concern of the Expert Committee in regard to uniformity of information on the incidence and mortality of prematurity. The need for uniformity is particularly urgent in a field where there are so many intrinsic variable factors. It has been shown time and again that the ability of a premature infant to survive, under the best of care, is closely correlated with the birth weight, which in itself reflects the stage of maturity. In turn, the stage of maturity at a given weight is affected by sex, race, and whether the child is a single or one of a multiple birth. Uniformly, at a particular stage of maturity, male infants are larger than female, single births are larger than multiple births and, in the United States, white babies are larger than Negro babies. These considerations underline the danger of misinterpretation of so-called over-all rates for the incidence of prematurity and for the mortality of premature infants. For example, at any given weight, Negro premature infants are probably more mature and consequently have a better chance of surviving.

The Ethics of COVID-19 Vaccine Passports

2021 ◽  
Vol 46 (4) ◽  
pp. 1-2
Author(s):  
Joseph Meaney ◽  
Keyword(s):  
United States ◽  
World Health Organization ◽  
The United States ◽  
Scientific Data ◽  
World Health ◽  
Medical Decisions ◽  
The Poor ◽  
Divided Society ◽  
The World ◽  
Health Organization

COVID-19 vaccine passports run the risk of creating a divided society where social privileges or restrictions based on “fitness” lead to discrimination based on immunization status. Individuals have a strong right to be free of coercion to take a COVID-19 vaccine, and we should be very leery of further invasion of private medical decisions. These concerns are shared both internationally and in the United States, and the World Health Organization, the Biden administration, and many US governors oppose COVID-19 vaccine credentials. In addition, regulations for COVID-19 vaccine credentials face practical barriers, including lack of access globally, especially among the poor; and lack of scientific data on the efficacy of these vaccines.

Accounting for the Rising Caesarean Section Rate in Canada: What Are the Roles of Changing Needs, Practices, and Incentives?

2021 ◽  
Author(s):  
Michael Baker ◽  
Maripier Isabelle ◽  
Mark Stabile ◽  
Sara Allin
Keyword(s):  
Caesarean Section ◽  
Financial Incentives ◽  
Health Care Systems ◽  
Caesarean Section Rate ◽  
The United States ◽  
World Health ◽  
Strong Increase ◽  
Primary Determinant ◽  
Care Systems ◽  
Health Organization

In most high-income countries, including Canada, the share of births by Caesarean section (C‑section) has risen over the past decades to far exceed World Health Organization recommendations of the proportion justified on medical grounds (15 percent). Although unnecessary C-sections represent an important cost for health care systems, they are not associated with clear benefits for the mother and the child and can sometimes represent additional risks. Drawing on administrative records of nearly four million births in Canada, as well as macro data from the United States and Australia, we provide a comprehensive account of rising C-section rates. We explicitly consider the contributions of the main factors brought forward in the policy literature, including changing characteristics of mothers, births, and physicians as well as changing financial incentives for C-section deliveries. These factors account for at most one-half of the increase in C-section rates. The majority of the remaining increase in C-sections over the period 1994–2011 occurred in the early 2000s. We suggest that some event or shock in the early 2000s is likely the primary determinant of the recent strong increase in the C-section rate in Canada.

(Mis)Information on Digital Platforms: Lessons from Twitter and Sina Weibo in the COVID-19 Pandemic (Preprint)

2021 ◽  
Author(s):  
Sarah Kreps
Keyword(s):  
Public Health ◽  
World Health Organization ◽  
Public Discourse ◽  
The United States ◽  
World Health ◽  
Sina Weibo ◽  
Digital Platforms ◽  
The World ◽  
Health Organization ◽  
Relative Prevalence

BACKGROUND Misinformation about COVID-19 has presented challenges to public health authorities during pandemics. Understanding the prevalence and type of misinformation across contexts offers a way to understand the discourse around COVID-19 while informing potential countermeasures. OBJECTIVE The aim of the study was to study COVID-19 content on two prominent microblogging platform, Twitter, based in the United States, and Sina Weibo, based in China, and compare the content and relative prevalence of misinformation to better understand public discourse of public health issues across social media and cultural contexts. METHODS A total of 3,579,575 posts were scraped from both Weibo and Twitter, focusing on content from January 30th, 2020, when the World Health Organization (WHO) declared COVID-19 a “Public Health Emergency of International Concern” and February 6th, 2020. A 1% random sample of tweets that contained both the English keywords “coronavirus” and “covid-19” and the equivalent Chinese characters was extracted and analyzed based on changes in the frequencies of keywords and hashtags. Misinformation on each platform was compared by manually coding and comparing posts using the World Health Organization fact-check page to adjudicate accuracy of content. RESULTS Both platforms posted about the outbreak and transmission but posts on Sina Weibo were less likely to reference controversial topics such as the World Health Organization and death and more likely to cite themes of resisting, fighting, and cheering against the coronavirus. Misinformation constituted 1.1% of Twitter content and 0.3% of Weibo content. CONCLUSIONS Quantitative and qualitative analysis of content on both platforms points to cross-platform differences in public discourse surrounding the pandemic and informs potential countermeasures for online misinformation.

scholarly journals The Incidence of Bleeding and the Factors That Influence Its Development among Patients Admitted With Dengue Fever

2017 ◽  
Vol 9 (2) ◽  
pp. 23-28
Author(s):  
Krishna Bahadur Thapa ◽  
Namrata KC ◽  
T Koirala ◽  
A Bhatttarai
Keyword(s):  
Platelet Count ◽  
Dengue Fever ◽  
Medical Center ◽  
Adult Population ◽  
World Health ◽  
Chi Square ◽  
Factors Affecting ◽  
Female Sex ◽  
Unit Increase ◽  
Health Organization

Background: Dengue virus is now classified as a major global health threat by the World Health Organization. Bleeding is a common complication and is one of the most feared. There is an increase incidence in the adult population, hence, the focus of this study.Objectives: To determine the incidence of bleeding and the factors that influence its development among patients admitted with dengue fever at Fatima Medical Center, Phillipines from January 2009 to December 2011.Methods: This is a case control study using chart review. The incidence of bleeding is calculated using risk ratio. Factors affecting bleeding are determined using chi square for qualitative variables and T-test or ANOVA for quantitative variables. Simultaneous determination of factors association with bleeding will be analyzed using multiple logistic regression. Level of significance will be set at alpha = 0.05.Results: The female sex is significantly more prone to develop bleeding (p=0.044). There is no significant increase in bleeding in patients who have co-morbidities (p=0.447). In every one unit increase in WBC (1 x 109) the odds of bleeding decrease by 15%. For every one unit increase in hematocrit the odds of bleeding decreases by 6.8%. For every one unit increase in platelet count the odds of bleeding decreases by 3% that is every 10 unit increase in platelet count the odds of bleeding decrease by 22.9%.Conclusions: Female sex, a low initial WBC and platelet count will increase a patient’s propensity to develop bleeding.Journal of Gandaki Medical College Volume, 09, Number 2, July December  2016, page: 23-28

scholarly journals A comparative analysis of world health systems and Covid-19

2021 ◽  
Vol 38 (2) ◽  
pp. 115-120
Author(s):  
Ayşe İKİNCİ KELEŞ ◽  
Gökhan KELEŞ
Keyword(s):  
Health Systems ◽  
Social Life ◽  
Meta Analysis ◽  
Good Health ◽  
The United States ◽  
World Health ◽  
The Face ◽  
The Usa ◽  
Health Organization ◽  
Second Wave

Coronavirus disease 2019 (COVID-19), which causes severe airway problems, first emerged in the Chinese city of Wuhan. The virus led to a pandemic that affected the entire world. COVID-19 affects not only health, but also economic and social life. The emergence of this pandemic has led to health systems across the world being questioned. The aim of this study was to assess the adequacy of world health systems in the face of this pandemic. Twelve countries were selected and analyzed in the study. The choice of these countries was determined by the number of COVID-19 cases and deaths. Information concerning health systems and COVID-19 was obtained from Organization for Economic Co-operation and Development 2018, World Health Organization 2020 and Deep Knowledge Group data and was subjected to statistical analysis. According to the analysis, the country with the highest investment in health expenditures is the United States (10586 US dollars/capita), and Germany stands out as the best in health services. Another finding is the first and second wave of COVID-19 was identified as the USA with the highest case and death rate (First wave cases 1.942.363 and deaths 110.514; second wave cases at 7.419.230 and deaths 2.09.450). As a result of the meta-analysis, it is revealed that only socio-economic power is not enough, countries with good health systems are more successful in the pandemic. In addition, the analysis once again reveal how important health systems are in the face of such a pandemic.

scholarly journals High global consumption of potentially inappropriate fixed dose combination antibiotics: Analysis of data from 75 countries

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0241899
Author(s):  
Barbara Bortone ◽  
Charlotte Jackson ◽  
Yingfen Hsia ◽  
Julia Bielicki ◽  
Nicola Magrini ◽  
...  
Keyword(s):  
The United States ◽  
Antibiotic Consumption ◽  
Essential Medicines ◽  
World Health ◽  
Fixed Dose ◽  
Middle Income ◽  
Us Fda ◽  
Analysis System ◽  
Health Organization ◽  
Data Analysis System

Antibiotic fixed dose combinations (FDCs) can have clinical advantages such as improving effectiveness and adherence to therapy. However, high use of potentially inappropriate FDCs has been reported, with implications for antimicrobial resistance (AMR) and toxicity. We used a pharmaceutical database, IQVIA-Multinational Integrated Data Analysis System (IQVIA-MIDAS®), to estimate sales of antibiotic FDCs from 75 countries in 2015. Antibiotic consumption was estimated using standard units (SU), defined by IQVIA as a single tablet, capsule, ampoule, vial or 5ml oral suspension. For each FDC antibiotic, the approval status was assessed by either registration with the United States Food and Drug Administration (US FDA) or inclusion on the World Health Organization (WHO) Essential Medicines List (EML). A total of 119 antibiotic FDCs were identified, contributing 16.7 x 109 SU, equalling 22% of total antibiotic consumption in 2015. The most sold antibiotic FDCs were amoxicillin-clavulanic acid followed by trimethoprim/sulfamethoxazole and ampicillin/cloxacillin. The category with the highest consumption volume was aminopenicillin/β-lactamase inhibitor +/- other agents. The majority of antibiotic FDCs (92%; 110/119) were not approved by the US FDA. Of these, the most sold were ampicillin/cloxacillin, cefixime/ofloxacin and metronidazole/spiramycin. More than 80% (98/119) of FDC antibiotics were not compatible with the 2017 WHO EML. The countries with the highest numbers of FDC antibiotics were India (80/119), China (25/119) and Vietnam (19/119). There is high consumption of FDC antibiotics globally, particularly in middle-income countries. The majority of FDC antibiotic were not approved by either US FDA or WHO EML. International initiatives such as clear guidance from the WHO EML on which FDCs are not appropriate may help to regulate the manufacturing and sales of these antibiotics.

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