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Biomedical subjects

S Asch

Publications and source records attributed to S Asch.

24 records · Page 2Linked to original sources
PubMed1992

Proposal for an administrative curriculum in pediatric emergency medicine fellowship training.

Administrative tasks make up a significant component of the practice of pediatric emergency medicine (PEM) physicians. Our survey of 10 academic pediatric emergency departments revealed that PEM physicians who are primarily clinical spent an average of 15% of their time on administrative tasks, and PEM physicians whose positions are administrative as well as clinical spent 30 to 60% of their time on administrative tasks. Of the 101 programs responding to our survey of 220 pediatric residency programs, 80% did not address hospital administrative issues, and many that did address these issues allowed these topics only one hour of presentation time per year. It is clear that there is a discrepancy between the demands placed upon PEM physicians to perform administrative tasks and the sparse or nonexistent opportunities for learning about administrative issues during residency training. It is incumbent upon pediatric emergency fellowship programs to provide an inclusive and well-structured administrative curriculum for their trainees. This article suggests a framework for such a curriculum.

Curriculum↗
PubMed1991

Are insulin and hypertension independently related?

Hyperinsulinemia has been proposed as the common pathogenetic mechanism of obesity, non-insulin-dependent diabetes mellitus, and hypertension. We examined the cross-sectional relationship between fasting and postchallenge insulin levels and hypertensive status in a population-based study of 653 men and 784 women, aged 50 to 93 years, in Rancho Bernardo, California. Hypertensive subjects had slightly but not significantly higher fasting plasma insulin levels than did normotensive subjects, but significantly higher postchallenge insulin levels. After stratification for obesity and glucose intolerance, there was no significant difference between the mean age-adjusted fasting or postchallenge insulin levels of those with and those without hypertension in 12 possible subgroups. Analysis of variance of both fasting and postchallenge insulin levels also failed to reveal a significant relationship between insulin and hypertensive status after adjusting for age, sex, body mass index, and diabetes. The current study does not support the hypothesis that insulin is independently associated with hypertension.

Age Factors↗
PubMed1990

Occupational risk of human parvovirus B19 infection for school and day-care personnel during an outbreak of erythema infectiosum.

Human parvovirus B19, the cause of erythema infectiosum, has recently been associated with adverse fetal outcomes. During a large outbreak of erythema infectiosum in Connecticut, a survey was conducted on 571 (90%) of 634 school and day-care personnel to determine the risk of acquiring B19 infection. Serologic evidence of B19 infection was determined by using an enzyme-linked immunosorbent assay. Of the school and day-care personnel, 58% had evidence of previous B19 infection. The minimal rate of B19 infection in susceptible personnel during the outbreak was 19%. The risk was increased for teachers and day-care providers who had contact with younger children and with greater numbers of ill children. These results suggest that B19 infection is an occupational risk for school and day-care personnel.

Adult↗
PubMedDate not supplied

Potential impact of restricting STD/HIV care for immigrants in Los Angeles County.

Legislative restrictions in immigrants' access to health care and local governmental funding shortfalls in the US and Western Europe have raised fears that public clinic patients might delay care for communicable diseases. To help quantify the potential impact of both policies on public clinics providing sexually transmitted disease (STD) services, we surveyed 234 patients from five LA clinics regarding their alternative sources of health care. Of the 215 providing complete information (response rate = 91%), 52 (24%) reported they had no legal rights to reside in the US. Compared to the legal resident control group, illegal immigrants were more likely to indicate that they had no alternative access to medical care (27% vs 44%; P = 0.03). We conclude that for a substantial proportion of patients, particularly illegal immigrants, the STD clinics are indeed essential. Restricting access to these clinics may have unpredictable public health consequences.

Delivery of Health Care↗
PubMedDate not supplied

Beating fantasies: symbiosis and child battering.

A discussion of "The Psychodynamics of a Beating Fantasy," by Wayne Myers, M. D. Freud's concepts in "A Child is Being Beaten" (1919) require some revision. The fantasy may involve both parents, with the confusion of sexual identity as an additional significant element. Further, there are similarities between the phenomenon of child battering and the dynamics of Dr. Myer's patient. Also, a significant question is that while beating fantasies are probably universal among children, why do only a small number of adults have them occupy a central role in their psychosexual development and fantasy life?

Adult↗