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Biomedical subjects

D Goldberg

Publications and source records attributed to D Goldberg.

At least 19 recordsLinked to original sources

A classification of psychological distress for use in primary care settings.

This paper contrasts three ways of conceptualizing emotional distress in general medical settings: high scorers on screening tests, 'cases' according to the doctor seeing them, and standardized research diagnoses. It is shown that distress as measured by screening test is very much more prevalent than research diagnosis, and yet doctors working in general medical settings need to be able to conceptualize disorders using a classification that is helpful for them. The proposed classification is based upon the patient's need for intervention, and it distinguishes the few who need to be thought of as having a formal mental disorder from the many who do not. It takes account of what is known about 'labelling' and compliance, and it is linked to the skills needed by primary care workers. The largest group consists of those whose emotional distress needs recognition and discussion; the next group also needs social interventions; while the final group benefits from recognition of a mental disorder which necessitates a medical or psychological treatment.

Depressive Disorder

The value of feedback in teaching interviewing skills to medical students.

Forty-eight medical students took part in a study to assess the value of giving students some feedback about their interviewing skills. During the study they all received training from their clinical firms. In addition, 36 of the students received 1 of 3 types of feedback training. This was given by tutors who used television replays, audiotape replays or ratings of practice interviews conducted by the students. As in previous studies there was little improvement in the interviewing skills of those students who only received training from their clinical firms. In contrast, all 3 feedback groups improved their ability to elicit accurate and relevant information. However, only the television and audiotape groups also showed gains in techniques. While the differences between these 2 groups were not significant, they all favoured the television group.

Clinical Competence

High levels of microbial contamination of vegetables irrigated with wastewater by the drip method.

The public health aspects of the use of wastewater in agriculture and the effects of the drip irrigation method on the contamination of vegetables were studied. The method used was to simulate enteric microorganisms' dissemination by contaminated irrigation water in the field. The vegetables were irrigated with an effluent inoculated with a high titer of traceable microorganisms: poliovirus vaccine and a drug-resistant Escherichia coli. The dissemination of the marker organisms in the field was followed, and the effects of certain manipulations of the drip irrigation method on the contamination of the crops by the effluent were examined. It was shown that drip irrigation under plastic sheet cover with the drip lines placed either on the soil surface or buried at a depth of 10 cm significantly reduced crop contamination from inoculated irrigation water even when massive doses of bacteria and viruses were used. The microbial contamination was found to persist in the irrigation pipes and in the soil for at least 8 and 18 days, respectively. The data indicate that the recovery of the marker organisms was affected by soil texture and environmental conditions.

Agriculture

Nurse therapists.

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Attitude of Health Personnel

Evaluation of the expanded newborn screening program in New York City.

Since September 1974, New York State public health law has mandated that all newborn infants be tested for phenylketonuria, maple syrup urine disease, homocystinuria, histidinemia, galactosemia, adenosine deaminase deficiency, and sickle cell anemia in accordance with regulations of the state commissioner of health. During the period from May 1, 1975, to April 30, 1976, a total of 110,180 babies born in New York City were tested for these seven conditions. One year's experience with the screening program demonstrated a paucity of technological problems, low observed rate of both false-negatives and -positives, and the expected incidence of the conditions of highest prevalence, incidentally found during screening: i.e., sickle cell traits, AS and AC. What is equally apparent in reviewing this first year's experience is the extent to which the New York State law, its structure, and implementation have fallen short of the ultimate objective. The major reason for this failure is lack of funds and facilities in the areas of education, case retrieval, continuing medical care, and counseling. This report is presented with the hope that it will benefit all involved in genetic screening and especially those concerned with establishing similar programs.

Adenosine Deaminase

Cost-benefit analysis and the evaluation of psychiatric services.

The paper sets out a method for evaluating changes in psychiatric services in a cost-benefit framework. The first section of the paper analyses some of the problems which arise with those elements which can be measured in monetary terms--the 'hard' costs and benefits. The second section looks at a method of presenting the less tangible effects--the 'soft' costs and benefits. Finally, it is suggested how these can be brought together to aid rational decision-making.

Community Mental Health Services

The role of social anxiety in social interaction difficulties.

Social anxiety was found to be the most common complaint in a sample of psychiatric patients reporting social interaction difficulties. High social anxiety was shown to be associated with impairments to social behaviour in socially anxious psychiatric patients and non-psychiatric volunteers. A comparison was made of systematic desensitization and a form of social skills training in the treatment of social interaction difficulties associated with high social anxiety. This indicated that while both therapies were effective in the reduction of social anxiety, the training programme was the more effective in reducing problem behaviour, but desensitization appeared to lead to a wider generalization of improvement as indicated by increases in social participation.

Adolescent