Social science & medicine
-
Social science & medicine · Jan 1991
Historical ArticleDiffusion and physiological responses to the influenza pandemic of 1918-19 in Nigeria.
Although virologists are not in agreement on the origins of the 1918-19 influenza pandemic, it has long been associated with the virulent type A virus. At least 21 million people died from the disease over a 12-month period, becoming one of the world's worst short-term demographic disasters. The disease was introduced into Nigeria by passengers and crews who arrived via ship from overseas. ⋯ The over-crowded urban centers were the hardest hit and, even though pandemic declined almost as suddenly as it began, morbidity, mortality, and panic adversely affected the productive capacity of the country. Since the 1930s, virologists have gained much knowledge about the agents responsible for influenza diffusion, but the disease remains one of the few plagues to be eradicated. This is partly because of the exceptional adaptability of influenza viruses, and partly because artificially and naturally-acquired immunity to influenza are temporary in duration, making reinfection possible even by the same type or subtype of influenza.
-
Puerperal mastitis is a potentially serious illness among lactating women which traditionally has been thought to be associated with primiparity, stress, improper nursing technique, and incomplete emptying of the breast. However, none of these putative associations has been examined analytically in recent years. ⋯ This incidence was associated with professional, technical, or managerial occupation in both parents (rate ratio = 12.29; 95% CI: 1.62, 93.43) and with giving birth in the hospital delivery room, rather than the labor room (rate ratio = 4.05; 95% CI: 0.92, 17.83). Parity was not associated with risk of mastitis in this sample.
-
Research comparing hospice and conventional programs of care for the terminally ill has identified few measurable differences in the care provided to patients and their families. Nonetheless, hospice recipients frequently express a higher level of satisfaction with their program of care. This study compared the ability of hospice and conventional care settings to meet the basic emotional needs of families during a member's dying and death from cancer. ⋯ As predicted, overall satisfaction with care was consistent across hospice groups. However, home hospice care provided the highest quality of basic needs satisfaction and the highest level of satisfaction with the nurse. Significant Pearson correlations supported the hypothesis that overall satisfaction is negatively related to unmet basic needs (r = -0.69) and positively related to the psycho-social support received from nurses (r = 0.73).(ABSTRACT TRUNCATED AT 250 WORDS)
-
Social science & medicine · Jan 1991
The patient's right to information in Japan--legal rules and doctor's opinions.
A questionnaire survey concerning informed consent was administered among Japanese physicians in Yamaguchi prefecture. The survey results showed that even though these Japanese physicians are willing to give their patients sufficient information to obtain informed consent, the discretion of the physician to provide information is still prevalent. The survey also revealed that Japanese physicians believe that information regarding the treatment to be administrated should be fully disclosed both in case when the treatment is still experimental and when it is established among specialists. ⋯ It was found that when Japanese physicians were faced with special cases such as prior to administering high-risk diagnostic procedures, prior to disclosing the presence of cancer in their patients, or when faced with patients unwilling to receive treatment, the involvement of the patient's family members in the decision-making process was preferred so as not to aggravate the patient's emotional anxiety. With respect to cancer patients, the survey suggested that many Japanese physicians believe that cancer operations performed without informed consent from the patient should be legal. Finally, the survey concluded that, although the concept of individualized informed consent has been generally accepted among physicians, the involvement of family members in the decision-making process and a conservative attitude toward disclosure of information are still prevalent in Japan.
-
Social science & medicine · Jan 1991
Charging for health care: evidence on the utilisation of NHS prescribed drugs.
The effects of regular and frequent increases in charges for health care on patient utilisation are analysed using monthly data on National Health Service (NHS) prescribed drugs in England for the period 1979-1985. Using a partial adjustment model a utilisation equation of prescribed drugs is estimated for the adult non-elderly population that is subject to the NHS prescription charge. ⋯ The short-run price elasticity of utilisation is -0.109 and the long-run elasticity is -0.09, while exempt utilisation is unaffected. Although the policy has generated a reduction in the central Government expenditure for prescribed drugs, on the basis of these estimates around 66% of these savings arise from the reduction in service use as opposed to the increased revenue per item of drugs.