bluuebunny/crossref_metadata_2025 huggingface dataset:
La théologie/philosophie féministe de Mary Daly et le socialisme religieux de Paul Tillich
Authors: Dion Michel
Published: January 2017

Dans le socialisme religieux de Paul Tillich, nous retrouvons le principe de libération (principe socialiste) et le principe de salut (attente socialiste). Dans cet article, il sera question des points de convergence entre ces deux principes tillichiens et la théologie féministe de Mary Daly qui a, par ailleurs, subi l'influence des écrits de la période américaine de Paul Tillich. Quant au principe socialiste chez Tillich, Mary Daly en exprime une version féministe, pour le moins transformée en parlant de l'intégrité originelle des femmes, de la race originelle des femmes (pouvoir de l'origine) les attitudes antiidéologique, anti-idolâtrique et anti-démonique, si importantes dans le socialisme religieux de Tillich se retrouvent également dans la théologie féministe de Daly, tout comme d'ailleurs le rejet de la croyance bourgeoise en l'harmonie automatique, mais avec des contenus passablement différents et directement orientés vers la libération des femmes. Aussi, le concept de sororité vient ajouter des dimensions absentes dans celui d'attente socialiste chez Tillich.
God and Christ in Kierkegaard's Journals: Tools for large texts
Authors: McKinnon Alastair
Published: January 2017

This article describes five computer tools or methods intended to help scholars master the many texts which continue to appear in electronic form and at the same time to raise the general level of literary scholarship. It illustrates these tools by summarizing the results of some of my own recent studies of the figures of God and Christ in Kierkegaard's Dagbøger.
Kierkegaard as Fire Chief in post-1848 Denmark: What says the chief in Judge for Yourselves!?
Authors: Khan Abrahim H.
Published: January 2017

Kierkegaard uses the metaphor of a fire chief in his attack literature of 1854-55. With that metaphor in mind, a word list for the Danish text Judge for Yourselves! is examined statistically to find the answers to two questions: (1) Is the text a transition piece between the Postscript and the attack literature of 1854-55? (2) Does the lexical evidence support the text's description of the dominant socio-historical realities in the post-1848 climate of Denmark, namely, the obliteration of the frontiers between the religious and political spheres? The results provide another perspective on the situation that precipitated Kierkegaard's scathing attack against Christendom and the clarification of his view of genuine Christianity.
Paulo Freire and the crisis of modernity
Authors: Vasquez Manuel A.
Published: January 2017

Brazilian educator Paulo Freire played an influential role in the development of grass-roots religious movements throughout the Third World from the 1960s to 1980s. Partaking of the Enlightenment affirmation of critical thinking as the key emancipatory tool, Freire's pedagogical method has empowered hitherto marginalized subjects. Toward the end of the 1980s, however, postmodernist critiques of Enlightenment rationality as domination have raised some troublesome doubts about the viability of modernist emancipatory projects, including Freire's method. In this article, I reformulate Freire's method to respond to the challenges of postmodernist critiques. I argue that despite some serious shortcomings, the emancipatory impulse behind Freire's pedagogy is worth preserving. Further, I see a revised Freirean approach as a salutary counterpoint to postmodernism's excessive localism and elective affinity with neoliberal capitalism.
Issues of naturalism and supranaturalism in Tillich's correlation of religious with psychological healing
Authors: Dourley John P.
Published: January 2017

This article shows that Tillich's understanding of the relation of religious to psychological healing rests on the theological anthropology which informs his method of correlation and his understanding of the relation of essence to existence. Through these categories Tillich understands religious healing as essentialization and psychological healing as removing pathological responses to ontologically inescapable existential anxiety. The article summarizes the three locations in his work where Tillich establishes the above positions, argues that they are too clearly drawn and contends that the correlation of his own thought with contemporary psychologies of the self would effect a happier understanding of the relation of religious to psychological healing.
Measuring Communist Priorities
Authors: Bahry Donna
Published: January 2017

Research on communist systems has in the past decade come increasingly to focus on the making and impact of public policy, and to rely on fiscal data as one of the most abundant sources of information about communist priorities. Yet although government budgets and investments offer the advantages of quantification, and permit comparisons both within and across nations, they can be inconsistent and ambiguous measures of communist priorities. Labels for various items are consistent, but their meaning may vary from one country, one region, and one year to another, because of complex fiscal arrangements that are frequently recast. The data thus require careful analysis and in many cases adjustment in order to provide equivalent measurement of the policy choices that communist systems make. This article offers an analysis of the equivalence problem, reanalyzing the results of other studies to illustrate that communist fiscal arrangements and reforms can have a significant impact on the conclusions we draw about communist policy.
Ethnic Social, Political, and Economic Progress
Authors: Grove D. John
Published: January 2017

This article examines the thesis that a reduction in occupational and educational differentials across cross-cutting lines of differentiation, and a more representative government, will have a redistributive effect on ethnic income distribution. This thesis emerges out of the liberal theory of development which implicitly assumes that equalizing opportunity structures across cultural divisions, and increasing political participation, will eventually affect income disparities between groups. The extent to which ethnic income redistribution is a function of educational reform and a broader political participation is a question that has not been systematically examined cross-culturally. In fact, we know very little about the relative progress of ethnic groups in different parts of the world.
The Cognitive Dynamics of Swedish Security Elites: Beliefs about Swedish National Security and How They Change
Authors: Hart Thomas G.
Published: January 2017

This article is based on a full-length study of the cognitive behavior of highly-influential elites who deal professionally with the analysis of international politics with respect to Swedish national security. It attempts to relate findings in the field of cognitive psychology to the actual behavior of Swedish observers in the examination and interpretation of international events. Especial emphasis is given to processes of conceptualization, threat perceptions and changes in beliefs that have occurred. The derivation of ‘cognitive archetypes’ is discussed and these are related to the relative openness vs. constraint exhibited by elites in accommodating new information about the international environment.
Danish Elite Attitudes towards European Integration
Authors: Sørensen Carsten Lehmann
Published: January 2017

During the months preceding the Danish EC referendum in 1972, 90 persons constituting the very top of the political elite were interviewed. Categorized in four sub-elites – the parliamentary, administrative, organization and communications elites – this highest layer of the Danish political system is portrayed with respect to social background and other potentially important characteristics. Elite attitudes towards EC membership and European integration in general showed a pro-European consensus motivated by economic considerations. Social and political integration were also viewed with sympathy, provided the extent of social integration remained limited, and provided political integration excluded security policy. Only elite attitudes towards the supranational EC institutions revealed cleavages and ambiguity. More than anything else, Danish elite attitudes seemed to be determined by a small state's overall dependence on the surrounding European system both in an economic and political sense.
The Physiological Cost of Carrying Loads in Temperate and Hot Environments
Authors: Kamon Eliezer , Belding Harwood S.
Published: January 2017

Cartons weighing 10, 15, and 20 kg. were carried by the hands in front of the body at speeds of 4 and 5 km/hr on level and at 4% grade at dry ambient temperatures of 20, 35 and 45°C. Three pretrained subjects were used. Each test involved three 5-min. periods of carrying the load, walking without the load and sitting, repeated three times. At each speed, step rate increased with increase in the weight of the load, although the increase (but not total cost) was less when carrying uphill. Metabolic cost per total weight of body and load also increased with increase in the load; thus work efficiency decreased. The metabolic cost for each kilogram of load carried was 1.3 to 2.3 times greater than the cost per kilogram of body weight without load. No significant differences in metabolic cost were observed under the three thermal conditions, but heart rate increased about 7 to 10 beats/min for each 10°C-rise in air temperature. Heart rate increased progressively from first to third cycle when 20 kg. were carried at 20° and 35° C; this was more obvious for uphill carrying. Such progressive rise in heart rate was most conspicuous when the subject was carrying 15 and 20 kg. at 45° C.

Based on considerations of metabolic and cardiac cost, fatigue and need for rest pauses, 15-kg. packages were determined to be preferable to 10- and 20-kg. packages when large amounts of material must be moved by hand.
Time-Estimation Skill Assessment: A Demonstration of Adaptive Assessment Techniques
Authors: Michael J. Wargo
Published: January 2017

The general applicability of adaptive measurement techniques to human skill and capability assessment is demonstrated in terms of the adaptive assessment of a representative cognitive (judgmental) skill. Adaptive assessment techniques are defined, and an adaptive time-estimation assessment system that automatically adjusts task difficulty on the basis of operator performance is described. Data are presented to demonstrate the sensitivity and economy of adaptive assessment systems. The advantages of adaptive assessment systems are detailed and guidelines for the development of such systems are suggested.
Sudden Death during Restraint: A Study to Measure the Effect of Restraint Positions on the Rate of Recovery from Exercise
Authors: Parkes John
Published: January 2017

A small number of mental health patients have died suddenly following violent behaviour and restraint by staff. The safety of certain restraint positions has been questioned. This study evaluates two control and restraint (C & R) positions commonly used by health service staff. A repeated measures design was used to study rate of recovery from exercise in volunteer staff, measured by pulse oximetry, comparing the restraint positions with a seated (control) position.

It was found that the recovery time for pulse rate of subjects restrained in a face-down position was significantly longer than for subjects restrained in a face-up position. No significant findings were made in terms of comparison between the control position and the restraint positions, and no significant changes in oxygen saturation were noted during restraint. It is concluded that restraint position may be a factor in death during restraint, but only where other factors contribute to the overall situation.
Sudden Unexplained Death Syndrome
Authors: Elfawal MA
Published: January 2017

A retrospective investigation of 51 cases of sudden unexplained death syndrome (SUDS) reported to the Medico-Legal Centre in Dammam during the period January 1995 to June 1997 was carried out. The vast majority of SUDS victims were Indians (43%). The study reports SUDS in non-East Asian subjects, including indigenous Saudis, for the first time. Autopsy examination was carried out on 22 subjects and did not reveal any significant pathological lesions which could fully explain the sudden death. However, seven cases showed mild to moderate cardiac hypertrophy (of whom two had mild to moderate coronary stenosis), and another four showed a similar degree of coronary narrowing without any evidence of myocardial hypertrophy. Severe pulmonary congestion and alveolar haemorrhage were noticed in 18 of the autopsied cases. Microbiological tests were performed on different specimens from 27 subjects and showed significant bacterial growth in seven cases. This paper reviews different hypotheses explaining SUDS and suggests areas of further study in such deaths.
Forensic Medicine in the Rivers State of Nigeria: Experience in Four Rural General Hospitals
Authors: Amakiri C N T
Published: January 2017

A retrospective study of 375 consecutive medicolegal cases seen in four peripheral general hospitals in the Rivers State of Nigeria over a five-year period (March 1984 to February 1989) was undertaken. The most common indications for forensic medical consultation were assaults (78.6%) using clubs, sticks, fists and machetes as weapons, road traffic accidents (9.1%) and sexual offences (7.7%). The proportions of accidental deaths (4.3%), homicidal deaths (2.9%), sudden natural deaths (0.5%), maternal deaths (0.5%) and suicidal deaths (0.3%) were much lower.

The male-to-female ratio was 1.4 to 1. The patients' ages ranged from 10 months to 75 years, with a mean of 31.6 years. Twenty-three cases (6.1%) were children, while the remaining 352 cases (93.9%) were adults.

The study showed that for those cases which do come to the pathologist's attention, forensic personnel and laboratory services are inadequate in the peripheral parts of Nigeria. The study also highlighted the possible range of medicolegal problems of which the medical practitioner should be aware, even if he is practising in the rural non-urbanized areas of Nigeria. The study shows that not all deaths are registered in Nigeria.
Motives for Arson (Fire Raising)
Authors: Prins H. , Tennent G. , Trick K.
Published: January 2017

Using a sample of imprisoned arsonists, an attempt is made to present a more refined classification of motivation than has been offered in the past. The need for psychiatric opinion on all arsonists is stressed.
Differences in Forensic Pathology Practice between Scotland and England
Authors: Davison A M , McFarlane J H , Clark J C
Published: January 2017

Scotland and England are part of the United Kingdom but have separate legal systems. These legal differences have a substantial effect on forensic pathology practice, and are probably best appreciated by those pathologists who have worked on both sides of the border.

This paper seeks to highlight the differences in forensic pathology practice between Scotland and England, discussing the investigation of death in both countries. It concludes that a knowledge of the Scottish procurator fiscal system of death investigation may be beneficial to those contemplating changes to the coroner system. All three authors have practised forensic pathology in Scotland and England or Wales.
What is an ‘Intact’ Hymen? A Critique of the Literature
Authors: Goodyear-Smith Felicity A , Laidlaw Tannis M
Published: January 2017

The purpose of this study was to establish medicolegal guidelines based upon medical findings which support or refute allegations of sexual penetration, taking into account non-sexual explanations for positive physical findings. A review of the literature was undertaken to examine what has been determined about the range of usual findings which can be expected if the hymen has been penetrated. While a large body of literature is available on the topic, some findings are ambiguous, and further research is required to advance and clarify our knowledge base in these areas.

In only a minority of non-acute cases can definitive statements be made as to whether an alleged molestation has occurred. A non-scarred hymen that will not admit a finger is ‘intact’; a hymenal opening accommodating two fingers or a vaginal speculum, with evidence of a deficit or scarring at the lower pole, indicates past sexual or, possibly, non-sexual penetration. Other findings are not definitive and, at best, can estimate only relative probability of occurrence of penetration. Findings within the normal range should be presented as ‘neither confirm nor deny abuse’, not ‘consistent with abuse’. Often, it is impossible to establish whether a hymen is ‘intact’ in regard to past sexual intercourse.
The Evolution of the Role of the Police with Special Reference to Social Support and the Mental Health Statutes
Authors: Andoh Benjamin
Published: January 2017

The role of the police at their formation centred around law enforcement (crime detection and apprehension of criminals) and crime prevention in order to maintain the peace. That role has been changing to keep pace with socio-economic developments. Thus, it has expanded to include the provision of social support. However, law enforcement, crime prevention and provision of social support often overlap. Also, though some studies have shown that much police time is spent on non-crime-fighting activities, other studies have found that lower-rank officers in general see their main role as fighting crime. That apart, the police have always had a role to play under the various mental health statutes: referring mentally disordered people to hospital, retaking absconders from mental hospitals, escorting patients from hospital or prison to court and vice versa, which are all tasks classifiable as provision of social support. Because of the complexity of his work today, the policeman may be described as an ‘all-purpose public servant’.
Skin Cancer Referrals-Could Prioritisation Be a Reasonable Approach in the New Millennium?
Authors: McGregor J. C.
Published: January 2017

With the increasing and ageing population and concomitant increased referral of skin lesions and skin cancer in particular, problems with regard to waiting times to be seen as well as waiting lists currently face us. While several other specialties including radiotherapists, dermatologists, general surgeons, general practitioners may perform surgical and other treatments, there may be some confusion as well as some inefficiencies in the services provided. With a better understanding of the different grades and types of skin cancer, it should be possible to provide a more efficient and fairer service even without a major increase in resources. The question is whether or not the general practitioners and their patients are ready for prioritisatio?
Results of a Survey of Cardiovascular Risk Factor Prevalence Amongst Health Care Workers
Authors: McEwan S.R. , Dewhurst N.G. , Daly F. , Forbes C.D. , Belch J.J.F.
Published: January 2017

Summary analyses of screening data were used to ascertain the cardiovascular risk profile in a sample of health care workers in Scotland. A sample of NHS staff (298 women and 78 men) were screened during visits to Perth Royal Infirmary (PRI) in 1996 and 1997. Comparisons were made within subsets and with previous screening studies. Health care workers have been a neglected component of the workforce for receiving education about risk factors. The high prevalence of smokers found in this sample should be a cause for concern.
Evaluation of Immediate Discharge Documents — Room for Improvement?
Authors: Foster D. S. , Paterson C. , Fairfield G.
Published: January 2017

Background: The Immediate Discharge Document is a tool used to communicate patient discharge information between hospitals and general practitioners. The standard of information provided may be variable, and sometimes delayed in arriving at the GP practice. Typed communication from the hospital can also be slow. This can result in difficulty managing patients in the community following their discharge. Our aim was to assess the quantity of information provided on Immediate Discharge Documents, and to assess the time scale taken for GPs to receive written communications from hospitals regarding patient discharges.

An audit was initiated using a tool devised from Scottish Intercollegiate Guidelines Network Publication no 5 and involving four general practices within City of Perth, Scotland. Data was collected over a 28-day period in June/July 2001, by examining Immediate Discharge Documents relevant to each practice population received during this period, and by noting the time of arrival of a final typed summary. Data was analysed by Tayside Audit Resource for Primary Care. A total of 244 Documents were audited. Most significant results include basic administrative detail lacking in up to 30%. Of total documents, 13% failed to record a main condition or diagnosis; 93% recorded drug information, but only in 28% were follow up plans clear; 60% were received within five days of discharge, whilst final typed summaries were received from the hospitals within four weeks only in 51%.

Conclusion: These results show there to be room for improvement with regard communication of patient discharge information, in regard to both the content of information provided and the time it takes to arrive. We require to raise awareness of this problem amongst hospital colleagues involving clinical governance and audit staff, with the objective to improve the quality and timescale of information transfer.

Where this piece fits It is known that effective information transfer between health professionals is vital to optimise patient care. This work gives further impetus to improve the current standard of communication, and confirms a significant time delay that it takes information to reach GPs from the hospital setting.
Job Satisfaction, Work-Related Stress and Intentions to Quit of Scottish GPS
Authors: Simoens S. , Scott A. , Sibbald B.
Published: January 2017

Job satisfaction and work-related stress influence physician retention, turnover, and patient satisfaction. This study purports to elicit the views of Scottish GPs on job satisfaction, stress, intentions to quit, and to examine any patterns by demographic, job, and practice characteristics.

A descriptive, cross-sectional study was undertaken by postal questionnaire on a random sample of 1,000 GP principals, 359 GP non-principals, and 62 PMS GPs. The response rate was 56%. GPs were most satisfied with their colleagues, variety in the job, and amount of responsibility given. The most frequently mentioned sources of job stress were increasing workloads, paperwork, insufficient time to do justice to the job, increased and inappropriate demands from patients. White, female, young (under 40 years) and old (55 years and over) GP non-principals and PMS GPs who work less than 50 hours per week as a GP were more likely to be satisfied with their job and reported lower levels of stress.

Conclusions: GP participation in the workforce could be promoted by introducing more flexible working patterns (e.g. part-time work), by expanding the scope of contractual arrangements, and by making patient expectations more realistic by clearly communicating what the role of a GP actually encompasses.
Human Subcutaneous Dirofilariasis: A Report of Three Cases Manifesting as Breast or Axillary Nodules
Authors: Maltezos E. S. , Sivridis E. L. , Giatromanolaki A. N. , Simopoulos C. E.
Published: January 2017

Human subcutaneous dirofilariasis is a rare infection caused by filarial worms of the genus Dirofilaria. The parasites are transmitted to man by zooanthropophilic bloodsucking insects and the infection is manifested as subcutaneous nodules. Excisional biopsy is both diagnostic and therapeutic. We herein report three cases of human subcutaneous dirofilariasis diagnosed, over a period of ten years (1991-2000), in North East Greece. The patients, two women and one man, were all adults between 32 and 67 years of age. In two cases the infection was manifested as breast nodules, while in the third case as a painful nodule in the axillary region. The excisional biopsy showed the presence of an adult Dirofilaria, identified as Dirofilaria (Nochtiella) repens. It is emphasised that both clinicians and pathologists should have an increased awareness of this clinicopathologic entity and include dirofilariasis in the differential diagnosis in patients presenting with breast or subcutaneous nodules.
Erectile Dysfunction: A Significant Health Need in Patients with Coronary Heart Disease
Authors: Hood S , Robertson I
Published: January 2017

Background and Aims: Erectile dysfunction (ED) is a common condition, which negatively affects quality of life, and shares similar risk factors with Coronary Heart Disease (CHD). Studies from the pre—sildenafil era confirm a higher risk of ED in patients with cardiovascular disease. The high profile and success of sildenafil therapy has made it easier for some men to discuss erectile difficulties with healthcare professionals. Our aim therefore was to estimate the prevalence of ED in our cardiac rehabilitation patients. Methods and Results: We surveyed 150 random male cardiac rehabilitation patients using the International Index of Erectile Function (IIEF) questionnaire. 61% of all respondents had erectile difficulties, rising to 75% in the over 55 age group. 48% of respondents indicated their wish to discuss erectile problems with the healthcare team. Conclusion. ED and CHD commonly co-exist. A large proportion of our respondents wished further discussion of erectile insufficiency. We recommend that cardiac rehabilitation programmes should adopt a proactive approach to detection and treatment of ED.
Case of a Late Presentation of Cor Triatriatum in a Woman Born with an Imperforate Anus
Authors: Leslie S J , Jilaihawi H , Ruddell W , Hargreaves A D
Published: January 2017

Cor triatriatum and imperforate anus are rare. We describe, for the first time, the coexistence of these conditions in a 43 year old woman.
Fatal Calcific Uraemic Arteriolopathy (CUA): A Case Report and Review of the Literature
Authors: Lang N , Davie R , Whitworth C , Winney R , Hughes J
Published: January 2017

Calciphylaxis, now better known as Calcific uraemic arteriolopathy (CUA), is an uncommon condition characterised by small vessel calcification and occlusion with resultant painful violaceous skin lesions that typically ulcerate to form non-healing gangrenous ulcers. The syndrome is usually found in patients with renal failure. In this report we describe a 61 year old lady who developed lower limb ulceration secondary to calciphylaxis and discuss the current treatment options for this serious condition.
Hans Christian Andersen's Visit to James Young Simpson
Authors: Baillie T W
Published: January 2017

Preparations are currently under way in Denmark for the celebration in 2005 of the 200th anniversary of the birth of that country's illustrious son Hans Christian Andersen. The renowned author of fairy tales had a passion for travel and recorded in his diary and in the several editions of his autobiography his encounters with the dignitaries and celebrities of his day. On this anniversary we recall the little-known occasion on which Hans Andersen was entertained to dinner and to a demonstration of the effects of inhalation of ether at the home of James Y. Simpson.
Gender Inequalities in the Management of Angina Pectoris: Cross-Sectional Survey in Primary Care
Authors: Crilly M A , Bundred P E
Published: January 2017

Background and Aims: To determine the extent of gender differences in the routine clinical care of patients with angina pectoris in primary care. Methods: A cross-sectional survey of general practitioner (GP) medical records undertaken by trained data managers in 6 GP practices. 925 adults (489 men) with a clinical diagnosis of angina (prevalence= 2.4%, 95%CI 2.3–2.6). Data extracted included: level of care; risk factor recording; prescribed medication; exercise ECG and coronary revascularisation. Adjusted male-to-female odds ratios (AOR) adjusted for age, angina duration, and previous myocardial infarction, (MI). Results: Women with angina were older than men (71 v 65 years) with a lower prevalence of MI (30% v 43%), but a longer duration of angina (5 v 4 years). Men were more likely to receive once daily aspirin (AOR = 2.07, 95% CI 1.56–2.74) and be prescribed triple anti-anginal therapy (1.58, 95% CI 1.03–2.42). Men were also significantly more likely to undergo exercise ECG (1.56, 95% CI 1.14–2.15) and surgical revascularisation (1.71, 95% CI 1.03–2.85). Women tended to receive GP care alone (AOR = 0.64, 95% CI 0.46–0.89), whilst men received specialist cardiac care (1.47, 95% CI 1.09–2.00). Beta-blocker use following MI was similar (0.99, 95% CI 0.59–1.69). Conclusion: Differences in the management of men and women are unaccounted for by differences in age, previous MI or duration of angina. Gender differences in management of CHD reported from secondary care may also exist in primary care.
Conservative Management, Percutaneous or Open Repair of Acute Achilles Tendon Rupture: A Retrospective Study
Authors: Miller D , Waterston S , Reaper J , Barrass V , Maffulli N
Published: January 2017

Background and Aims: To ascertain the differences in patients' perceived outcomes between conservative, percutaneous or open repair of Achilles tendon ruptures. Methods: We studied 111 patients who had been managed for a unilateral closed Achilles tendon rupture. We excluded patients with open Achilles tendon lesions, patients whose tear had occurred more than seven days from operation, patients with diabetes, inflammatory disease, systemic corticosteroids or fluoroquinolones. Patients were contacted by telephone and asked to answer a questionnaire. Results: There was no difference in effects on working life, patient satisfaction, sports performance, muscle strength, swelling and fear of re-rupture. Pain on weight bearing and cramps were significantly more frequent in the patients managed conservatively. Re-rupture and complication rates were comparable to published rates. Conclusion: Treatment should be individualised according to the demands and health of the patient.
Prescribing a Website
Authors: Jariwala A C , Paterson C R , Cochrane L , Abboud R J , Wigderowitz C A
Published: January 2017

Aim: To assess the value of directing the attention of patients to sources of medical information on the internet. Design: Prospective qualitative study in an orthopaedic outpatient clinic. Participants: 253 patients agreed to complete electronic questionnaires before and after reviewing information relevant to their conditions on the internet. Patients were allocated randomly into two groups; one group was given indications of general sites and the other recommended specific non-commercial sites. Completed questionnaires were received from 44 patients. Results: 95% of the patients found the internet information easy to understand and 84% said that it was helpful for coping. 86% of the patients were satisfied that their current treatment was appropriate in the light of what they had learned from the internet. Ten patients out of the 36 who expressed a view thought that the internet information contradicted that provided by the doctor. Despite these results most patients still said that the doctor represented the best source of patient education. Conclusions: Increasing numbers of patients are familiar with the internet. Most of our patients felt that the internet was, on balance, helpful in providing information. The main difficulties with the internet are the sheer volume of information, the potential for misleading and the danger of misunderstanding. We feel that there is a real place for the specific prescription of an internet site by a clinician who has personally reviewed it to a patient thought to be able to benefit from it.
Cryoprecipitate Therapy in Haemophilia
Authors: Forbes C. D. , Hunter J. , Barr R. D. , Davidson J. F. , Short D. W. , McDonald G. A. , McNicol G. P. , Wallace J. , Douglas A. S.
Published: January 2017

This paper describes experience over an 18-month period of a new preparation of factor VIII, cryoprecipitate, prepared by the Regional Blood Transfusion Service from human plasma. This relatively simple and inexpensive method selectively extracts the factor VIII leaving behind the other blood products for use in other ways.

Replacement therapy in the treatment of haemophilia has been generally regarded as inadequate due to the difficulty in obtaining potent antihaemophilic globulin in sufficient amounts, and cryoprecipitate represents a useful advance.

Bleeding episodes in 25 patients with factor VIII deficiency have been treated with cryoprecipitate on 41 occasions and an assessment of the haemostatic effect of this material has been made in treating haemarthrosis, muscle haematomata and the management of major and minor surgical operations. Routine follow-up over a 6 month period was undertaken to determine the incidence of side effects. Two cases of hepatitis were found, possibly resulting from cryoprecipitate therapy. However, both patients had also received blood or fresh frozen plasma and the source of the hepatitis virus must remain in doubt. No factor VIII inhibitors were found despite repeated courses of therapy in several patients.

The advantages and disadvantages of cryoprecipitate are set out and its encouraging place in the management of haemophilic bleeding assessed.
Coliform Bacteraemia in Infants
Authors: Conn Nancy K.
Published: January 2017

The incidence of patients with positive blood cultures from which a single species of coliform bacillus was isolated is given for the years 1962 to 67. There has been an increase during these years particularly in neonatal infants: 91 cases were recorded in babies under 6 months of age, and the bacteriological and clinical findings have been related in 85. Children born either prematurely or as a multiple birth and those with congenital malformations showed a predisposition to this form of infection. Many of the remaining cases had an associated localised infection.

Some aspects of the cause of the increase in coliform bacteraemia in babies are discussed and the severity and possible implications of the infection are emphasised.
Further Thoughts on the South-Eastern Regional Hospital Board Survey of Junior Hospital Medical Staff 1968/69
Authors: Petrie P. W. R.
Published: January 2017

The main reasons for undertaking the survey of junior hospital medical staff are recalled. The emphasis given to off-duty and study time is considered. The implications of postgraduate training for the staffing posts already available in hospitals up to and including registrar level are examined. It is suggested that three training aims need to be kept in mind, viz. the training of hospital staff, the training of general practitioners and the training of doctors for overseas. Further consideration is directed towards the last two of these.
Ischaemic Carotid Strokes Angiographic Investigation of 523 Patients
Authors: Angel F. , Cross J. N. , Tedeschi G. M. , Jennett W. B. , Steven J. L. , Grossart K. W.
Published: January 2017

Carotid angiography showed a lesion in more than two-thirds of this series of ischaemic carotid strokes; two-thirds of the lesions shown were in the neck vessels.

Carotid narrowing (incomplete occlusion) in the neck was much commoner after the age of 50 years and was frequently associated wth a temporary stroke.

Complete carotid occlusion in the neck did not become commoner with increasing age as did carotid narrowing; nor was it associated with previous temporary strokes (as was carotid narrowing). It is therefore doubtful whether complete occlusion is usually the end-result of narrowing.

Persisting strokes were frequently preceded by one or more temporary strokes; these ‘warning strokes’ were more frequent in patients with carotid narrowing.

Middle cerebral artery lesions accounted for two-thirds of all intracranial lesions; they were particularly common in association with pregnancy and rarely caused temporary strokes.
The Natural History of Bacterial Colonization of the Newborn in a Maternity Hospital (Part I)
Authors: McAllister T. A. , Givan J. , Black A. , Turner M. J. , Kerr M. M. , Hutchison J. H.
Published: January 2017

Bacteriological examinations were performed on 1103 infants to determine the ages at which the newborn are colonized at different sites by bacteria, and with which organisms. On the day of birth, specimens for culture included aspirated gastric contents, and swabs from nose, throat, groin and rectum; on Day 3 the umbilical cord clamp with a section of the cord, swabs from nose, throat, groin and rectum; on days 5 and 1, and weekly thereafter, swabs from the same 4 sites. These examinations included identification of the individual bacterial species. The mass of information so obtained was analysed by computer.

The high level of bacterial colonization by day 3 was striking and, indeed, large numbers of potential pathogens were grown from infants within one hour of birth. Staphylococcus aureus was found only in very small numbers of infants, e.g. only 2.6 per cent of infants' umbilical cords on day 3, and 4 per cent of infants' noses on day 7. If the levels of colonization reflect the risks of infection, Pseudomonas aeruginosa ranks close to Staph. aureus in the newborn nursery of the modern maternity hospital. Forty two different species of bacteria were isolated from these infants of which 24 were potential pathogens and of the latter, gram-negative organisms greatly outnumbered the gram-positive. This high incidence of gram-negative colonization in a large series of hospitalized neonates may be a normal phenomenon but it suggests that the risk of infection is today greater with gram-negative than with gram-positive bacteria. The figures for carriage of pathogenic staphylococci in the present investigation contrast markedly with the figures reported by many workers between 1950 and 1960.
Advances in the Management of Parkinsons Disease
Authors: Marsden C. D.
Published: January 2017

The treatment of Parkinson's disease today is complex, time-consuming, but rewarding. The introduction of levodopa has not cured the disease, but has provided the most powerful therapy available yet. Its use is limited by side effects and careful titration to optimum dosage, often in combination with other drugs, is required. Despite best therapy, some patients never respond, and others begin to lose benefit after some years of therapy. New problems, such as the ‘on-off’ effect have appeared with long-term treatment, and require careful adjustment of dosage. As with any replacement therapy, a balance between sub-optimal benefit and side effects has to be discovered and maintained by careful and frequent review. New approaches to treatment may offer further improvement in the near future.
The Therapeutic Uses of Calcitonin
Authors: Martin T. J.
Published: January 2017

Calcitonin is a potent hormonal inhibitor of bone resorption. Its major therapeutic effect is in the treatment of Paget's Disease of bone, in which it has been shown to reduce bone pain, lead to radiological and histological improvement in bone, and to restore abnormal biochemistry towards normal. Some patients are resistant to treatment, and in others resistance may develop during treatment. Although antibodies to pig or to salmon calcitonin develop in almost 50 per cent of treated patients it is only very rarely that resistance may be ascribed to antibodies. There are a number of other clinical states of increased resorption in which the value of calcitonin therapy has yet to be established.
Priapism as a Complication of Long-Term Intravenous Nutrition
Authors: Chapuis P. H. , Splatt A. J.
Published: January 2017

A case of priapism following prolonged intravenous nutrition is reported. The small amounts of heparin as received by our patient would tend to minimise a risk of hypercoagulability. However, the administration of intravenous feeding agents and the concomitant metabolic acidosis may have enhanced this risk.
Advantages of Treatment of Hypertension with Minoxidil
Authors: Isles C. , Strachan R. W.
Published: January 2017

A detailed study has been made of the five hypertensive patients who received Minoxidil in Dumfries; four have been observed for over a year. Minoxidil was found to be highly effective, free from commonly encountered side effects and capable of achieving excellent control of blood pressure when given once daily. Its use led to simpler drug regimens, improved compliance and significant reduction in the length, or even need, of admission to hospital. A prolonged and clinically useful delay in the recurrence of hypertension following withdrawal of the drug was also observed.
Mycoplasma Pneumonia: Failure of Erythromycin Therapy
Authors: Ford M. J. , Brunton W. A. Telfer , Millar J. , Stewart C. , Critchley J. A. J. H.
Published: January 2017

Two cases of mycoplasma pneumonia are described which failed to respond to prolonged treatment with erythromycin. The substitution of oxytetracycline therapy resulted in rapid clinical and radiological resolution.
Clinical Examination as a Screening Method for Breast Cancer
Authors: McLatchie Greg , McArdle Colin , Menzies Thomas
Published: January 2017

A five-year experience of a breast cancer screening clinic in a Scottish urban area is reported. During this period 28 per cent of the female population aged 25 to 70 years was screened by clinical examination alone. The pick-up rate for cancers was 7.8 per 1,000 ‘well’ women examined, and 21 per cent of all patients with cancer were under 40 years old.

Clinical examination is an effective and economical method of screening for breast cancer. The establishment of similar clinics to detect breast disease in women of all age groups is recommended.
The Pre-Operative Electrocardiogram: An Assessment
Authors: Paterson K. R. , Caskie June P. , Galloway D. J. , McArthur K. , McWhinnie D. L.
Published: January 2017

Electrocardiography is of limited value in pre-operative screening for cardiac disease. A short questionnaire has been shown to be helpful in assessing cardiac status and could permit a 30% reduction in the number of pre-operative ECGs performed.
The Localisation of Parathyroid Tumours—A Comparison of Computed Tomography with Cervical Vein Hormone Assay
Authors: McMillan N. C. , Smith Linda , McKellar N. J. , Beastall G. H. , Fogelman I. , Duncan J. G. , Boyle I. T.
Published: January 2017

Computed tomography has been employed for the localisation of parathyroid tissue in 26 patients with primary hyperparathyroidism. In 14 of these selective venous catheter studies with parathyroid hormone assay were also undertaken. Computed tomography proved unreliable, identifying only 39 per cent whereas the cervical venous hormone assay studies localised 69 per cent of lesions correctly—a figure which is in agreement with several other groups. On balance our results suggest that neither technique should be routinely employed pre-operatively but that, following unsuccessful parathyroid surgery, the most useful localisation technique remains venous hormone assay.
Coxsackie B Infection in a General Medical Unit
Authors: Bell E. J. , Irvine K.G. , Gardiner A. J. S. , Rodger J. C.
Published: January 2017

From January 1979 until December 1980, neutralizing antibody titres to Coxsackie B1-6 viruses were measured in sera from 220 patients presenting to a general medical unit, the majority of whom had chest pain. No four-fold or greater rises in antibody titre were detected in these hospital patients. However, 49 per cent had titres of ⪖256 to one or more Coxsackie B virus types compared with 10 per cent of the 950 persons studied during a ‘normal population’ survey in the West of Scotland. When a more rigorous threshold was adopted, titres ⪖512 were found in 33 per cent and 4 per cent respectively. We conclude that Coxsackie B infections are not uncommon in the practice of a general medical unit and that they may account for more cases of both acute and subacute left chest pain than is usually realised.
Echo Virus Type 30 Meningitis in Edinburgh
Authors: Todd W. T. A. , MacMillan Moira J. , Gray J. A.
Published: January 2017

Fifty-five patients with ECHO virus type 30 meningitis were admitted to the Infectious Diseases Unit, Edinburgh City Hospital between August and December 1980. There was a preponderance of males and patients aged 10–15 years. The peak admission rate was about two weeks earlier than that recorded for Scotland as a whole. Helpful diagnostic findings were headache, fever, photophobia, vomiting and nuchal rigidity but not Kernig's sign. Only one patient had a rash. The majority of patients were admitted within 48 hours of the onset of symptoms. The CSF pleiocytosis was high and tended to be polymorphonuclear in type. CSF glucose concentrations were all normal. There were no serious sequelae. The considerable morbidity reported after leaving hospital emphasises the importance of adequate convalescence.
Group Meetings for Parents in a Children's Burns Unit
Authors: Mollison Helen , Abrams Helen , Barrett Emily , Hamilton Jane , Maas Eva , Azmy A. , Raine P.
Published: January 2017

Thermal injuries in childhood occur mainly in the first three years of life and often lead to hospital admission: most are due to scalds in the home. The distress and anxiety of parents bears on the management of the young sick child in hospital, on his subsequent recovery at home and on the welfare of the whole family. To help parents, a weekly meeting was held with a small group of staff in the Burns Unit at which there was free and open discussion of all problems and worries connected with the child's accident. This paper describes the working of the group and the contribution it made to the care of 149 children admitted with burns and scalds during one year.
Total Body Potassium in Patients Receiving Chlorthalidone and Metoprolol for Hypertension
Authors: Gray J. M. B. , Lawson D. H. , Boddy K. , East W.
Published: January 2017

Measurements of potassium status were reviewed in 23 hypertensive patients receiving metoprolol either alone or in combination with chlorthalidone or chlorthalidone plus potassium over an average period of nine months. There was no statistically significant change in plasma potassium, total blood cell or total body groups developed hypokalaemia (serum potassium <3.0mmol/l) in the absence of significant falls in total blood cell or total body potassium. Thus the use of chlorthalidone plus potassium did not provide adequate prophylaxis against hypokalaemia even in metoprolol recipients. The study confirms that monitoring parameters of potassium handling is still necessary in β-blocker recipients who also receive diuretics alone or in a fixed-dose combination with potassium.
A Family Study of Vitiligo Patterns
Authors: Goudie B. M. , Wilkieson Carol , Goudie R. B.
Published: January 2017

The anatomical distribution of vitiligo has been studied in families with evidence of organ-specific autoimmune disease. No examples of similar pattern inheritance were found in first degree relatives in contrast to published reports of similar vitiligo patterns in identical twins. The genetic predisposition to develop vitiligo apparently allows for a diversity of anatomical pattern. A similar mechanism may be responsible for the occurrence of different organ-specific autoimmune diseases in members of the same family.
Effect of a Blood Transfusion Protocol and Low Dose Steroid Regime on Renal Transplant Survival
Authors: Notghi A. , Anderton J.L. , Chisholm G.D. , Hamer-Hodges D. , Wilkinson S. , Smith G. , Galloway N.T.M. , Yap P.L. , Winney R.J.
Published: January 2017

The effects of introduction of a low dose steroid regime and pre-transplant blood transfusion were evaluated. The kidney and patient survival rates for the period before such a policy was adopted were compared with the period after this policy. There has been a highly significant rise in patient survival rates to the present level of 95 per cent at three years. There was a similar rise in three year graft survival rates from less than 40 per cent to 66 per cent.