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Biomedical subjects

Anthony R Mawson

Publications and source records attributed to Anthony R Mawson.

8 recordsLinked to original sources

Understanding mass panic and other collective responses to threat and disaster.

While mass panic (and/or violence) and self-preservation are often assumed to be the natural response to physical danger and perceived entrapment, the literature indicates that expressions of mutual aid are common and often predominate, and collective flight may be so delayed that survival is threatened. In fact, the typical response to a variety of threats and disasters is not to flee but to seek the proximity of familiar persons and places; moreover, separation from attachment figures is a greater stressor than physical danger. Such observations can be explained by an alternative "social attachment" model that recognizes the fundamentally gregarious nature of human beings and the primacy of attachments. In the relatively rare instances where flight occurs, the latter can be understood as one aspect of a more general affiliative response that involves escaping from certain situations and moving toward other situations that are perceived as familiar but which may not necessarily be objectively safe. The occurrence of flight-and-affiliation depends mainly on the social context and especially the whereabouts of familiar persons (i.e., attachment figures); their physical presence has a calming effect and reduces the probability of flight-and-affiliation, while their absence has the opposite effect. Combining the factors of perceived physical danger and the location of attachment figures results in a four-fold typology that encompasses a wide spectrum of collective responses to threat and disaster. Implications of the model for predicting community responses to terrorist attacks and/or use of weapons of mass destruction are briefly discussed.

Disasters↗

On not taking the world as you find it-epidemiology in its place.

Modern epidemiology has been criticized as being fragmented and reductionist, lacking coherent theories, and contributing little to the understanding of disease. These criticisms assume that epidemiology is a system of knowledge about health and disease, based on observation. In fact, consensus on the definition of the field is surprisingly elusive. A more practice-based approach would be to consider epidemiology as a field concerned with the methods for determining the causes of disease and for evaluating health services and treatments. The value of epidemiology is that it provides the tools for doing well-crafted research once the substantive hypothesis has been formulated. The focus of the discipline is thus methodological rather than conceptual. The major implication for the practitioner is that he or she must necessarily be more than an epidemiologist. Theoretical understanding must come from conceptual developments in the substantive fields of medicine, sociology, or biology and, more fundamentally, from fresh visions that transcend traditional categories of exposure and disease and accepted views of causation.

Epidemiology↗

Preventing lethal violence in schools: the case for entry-based weapons screening.

Violence-related behavior in schools has declined in recent years, but the perception of risk remains high. Disturbingly high percentages of students and teachers report staying home out of fear, and many students bring weapons to school for protection. Current proposals for preventing school violence include punishing the violence-prone, expulsion for weapon carriers, and creating a culture of nonviolence through various behavioral methods like conflict resolution. None of these proposals address the issue of lethal violence and hence personal safety. The risk of lethal violence in schools (related mainly to firearms) could be substantially reduced by creating an effective barrier between firearms and people. This could be achieved by using entry-based weapons detection systems similar to those now used in airports and courts. Decreasing the risk and fear of violence by converting schools into weapons-free zones would also be expected to increase attendance and improve scholastic performance. Randomized, controlled studies should be undertaken to evaluate the efficacy and cost-effectiveness of entry-based weapons detection systems for achieving these outcomes.

Adolescent↗

Reducing cesarean delivery rates in managed care organizations.

BACKGROUND: A national consensus has emerged that cesarean delivery (CD) rates are excessive. OBJECTIVES: To review the subject of CD delivery and to discuss options for reducing CD delivery rates in managed care organizations (MCOs) from the current rate of approximately 22% to a rate of 10% to 15% in 5 years, as proposed by the World Health Organization. STUDY DESIGN AND METHODS: Literature review. RESULTS: Contracted physicians could be provided with evidence-based clinical practice guidelines for CD as well as data on acuity-adjusted physician-specific CD rates within the MCO and could be offered supplementary fees for performing vaginal deliveries after a previous CD. Administrators and physician leaders of contracted hospitals could also be asked to adopt written criteria for lack of progress in labor, to review all indications for CD for all cases, to encourage use of vaginal delivery after a previous CD, and to require a second opinion for performing all except emergency CDs. Members of MCOs who become pregnant could be mailed an educational pamphlet that encourages vaginal delivery rather than CD. CONCLUSIONS: To facilitate dissemination of information, MCOs should report their experience in implementing, monitoring, and evaluating the effectiveness and outcomes of programs to reduce CD delivery rates. The MCO objective would be to lower CD rates without alienating physicians or attempting to impose a regimented approach that would offend and be counterproductive for consumers.

Cesarean Section↗

Onchocerciasis-associated morbidity: hypothesis.

Tissue concentrations of vitamin A in Onchocerca volvulus are about 8 times higher than those of the host. About 100,000 microfilariae (mf) die every day in heavily infected persons. Onchocerciasis-associated morbidity may be due in part to the release of retinoids from dying mf and their gradual accumulation to toxic concentrations in affected tissues.

Animals↗