Sterilising a woman while performing an unplanned caesarean section is usually frowned on. But in countries such as Zimbabwe, some women are more likely to die of their next pregnancy than regret having an emergency tubal ligation. Among higher parity women who were offered sterilisation under such circumstances, 90% said they were happy with the outcome. Of those not offered sterilisation, 64% said they regretted not having had one, and urgent decision making didn't result in more regret than decisions made at leisure. Stressful working conditions have been linked to depressive symptoms, and personality traits could be relevant too. A three year follow up of over 1000 people working at the French National Electricity and Gas Company found that personality traits such as hostility and low self esteem were independent predictors of an increase in depressive symptoms.
But highly demanding jobs and low social support at work also brought on more depression, regardless of personality. Volunteers injected with what's become known as the “fullness” hormone (PYY3-36) found that they helped themselves to a third less food from a free buffet than did controls and ate less for up to 12 hours. The hormone is released from cells that line the bowel, and blood levels rise after eating and stay high between meals. Scientists believe that PYY3-36 may act on the hypothalamus, shutting down the nerves that trigger eating. Mild head trauma accounts for 90% of all traumatic brain injuries, with a huge loss of long term productivity resulting from post-traumatic complaints.
106021,PONCE PLAZA NURSING & REHABILITATION CENTER,335 SW 12. RD,NILES,OH,522053,Trumbull 365674,ARBORS AT MINERVA. DRIVE,LAKE RIDGE,VA,439017,Prince William 495282,LOUISA. Minerva Article (PDF Available) in BMJ Clinical Research 335(7624) October 2007 with 29 Reads DOI: 10.1136/bmj.60.BD Source: PubMed Central.
Some doctors advocate bed rest immediately after such injury to prevent post-traumatic problems. A randomised trial of bed rest versus no bed rest after mild head trauma found no difference in recovery rate between the two groups at six months, except for a trend to experience less dizziness in those who went to bed ( Journal of Neurology, Neurosurgery and Psychiatry 2002;73:167-72). In older women the most common presenting complaint at a genitourinary clinic was symptoms of vulval soreness and irritation.
Of 124 women seen, 40% had atrophic vulvovaginitis (AVV) and 23% had thrush ( Journal of Family Planning and Reproductive Health Care 2002;28:135-6). Contrary perhaps to expectation, there was no link between AVV and the use or otherwise of systemic hormone replacement therapy, but the symptoms respond well to local oestrogen therapy. Most people in Ghana are taken to hospital by commercial vehicles (including buses and taxis), but half of severely injured people die before arrival. To try to improve this situation, 335 commercial drivers were offered a basic first aid course.
Ten months later, 61% of those interviewed had given first aid, and there had been vast improvements in the provision of prehospital crash scene management, airway management, and control of external bleeding ( Journal of Trauma, Injury, Infection and Critical Care 2002;53:90-7). The debate continues about how best to manage ear infections. Specimens taken from 2240 diseased ears in the United States identified Pseudomonas aeruginosa as the commonest bacterial isolate in otitis externa, although 201 other species were also identified.
With such a surprisingly wide diversity of bugs implicated, the authors suggest choosing the most potent broad spectrum topical treatment available. Medical students in the United States usually take premedical courses as undergraduates.
Some then drop the premedical curriculum to pursue other careers, but why? According to one survey, being in debt long term and the perception that medical careers are incompatible with family life are common preoccupations. Apprehension about the years of being a junior doctor and the need to be on call, and the realisation that other attractive career options are available, are other influential factors.
Risky sexual behaviour among gay men significantly increases the risk of secondary HIV transmission. In a cohort study that followed men who had become newly infected with the virus in London, more than half of the men reported having had unprotected anal intercourse during the period of seroconversion with partners who were seronegative for HIV or of unknown serological status. The men's risk taking behaviour tended to reduce after receiving a positive HIV test, but a substantial proportion continued to practise unsafe sex in the 12 months after seroconversion. Minerva is quite partial to green tea and was interested to read that the anticarcinogenic effects of green tea polyphenols make it potentially protective against stomach cancer. But further analysis of a huge Japanese cancer risk study suggests that early favourable reports were premature. Epidemiologists found no inverse relationship between green tea consumption and death from stomach cancer ( British Journal of Cancer 2002,87:309-13).
Another food substance that has good health potential is fish oil. A dizzy array of statistical techniques has revealed that a high intake of fish oil may lower blood pressure, especially in older and hypertensive individuals. The effect of lower doses, however, remains unclear, and before anyone rushes to eat more fish, the authors say that the blood pressure effect of fish oil from capsules may well differ from that found in fatty fish. A teenage boy was admitted to our hospital with depressed consciousness. A carefully taken history, full examination, initial blood tests, lumbar puncture, and computed tomography revealed no cause. However, the nursing staff noticed “glitter” in his urine, which was later identified as crystals of primidone (a barbiturate).
It became apparent that this must have been due to ingestion of the family dog's anticonvulsant drug. He made a good recovery. While less interesting than blood, cerebrospinal fluid, or radiological investigations, simple inspection of urine and ward tests can prove invaluable. S Birch, locum consultant, L Kidman, senior house officer, B McManus, senior house officer, J Legg, locum consultant, department of child health, V Walker, consultant chemical pathology, Southampton General Hospital.
What does it mean for a Police Department to be accredited? Accredited Police Departments have gone through the accrediting process of the Commission on Accreditation for Law Enforcement Agencies (CALEA). CALEA is a non-profit professional organization that assesses the policies and procedures of law enforcement agencies. Accredited Police Departments are considered to have implemented best practices in law enforcement. What is Community Policing? Community Policing is an approach to public safety that involves building relationships between the Police and individuals and groups in a community to help solve problems and prevent crime.
Community Policing is intended to be proactive in nature by addressing social disorder and other causes of crime. What kinds of special purpose districts have Police Departments?
In addition to state, county, and local Police forces, states often confer police powers to other government agencies and entities. Special purpose Police Departments are commonly found at universities and colleges, transit authorities, port authorities, airports, and conservation agencies.