[EMAIL PROTECTED] > Dot's Information Service Hotline > "Unbossed and unbought news and information you can use" > Visit The DISH online at www.thedish.org > Vol. 8 No 34...Dedicated to the Dialogue on Race... 08-26-05 > ******************************************************** > > Table of Contents > > 1. Bit of History...Hippocrates (c.460 BC-380 BC) > 2. Politics Y2K5...Worldwide Medical Errors > 3. Hood Notes...Disparities in Medical Services > 4. Three-Fifths Compromise Healthcare...By John Burl Smith > 5. Disgruntled > 6. Venue for an Artist...Hippocratic Oath...By Louis Lasagna > 7. News You Use...Healthy People 2010 > > *************************************** > > Bit of History > Hippocrates (c. 460 BC- 380 BC) > > > There are in fact two things, science and opinion; the former begets > knowledge, the latter ignorance...Prayer indeed is good, but while calling > on the gods a man should himself lend a hand. > > Ancient Greek physician, Hippocrates was born in 460 BC on the island of > Cos, Greece. Well-educated, Hippocrates acquired immense knowledge of > natural sciences including chemistry, physics and biology. Armed with this > knowledge, he played a key role in efforts to rid ancient Greece of the > notion that illnesses were caused by evil spirits or demonic possessions. > Medicine based on religious beliefs of the time reduced physicians to roles > of sorcerers and exorcists. > > Hippocrates believed illness had a physical and rational explanation. Basing > his medical practice on observations and study of the human body, > Hippocrates recommended that physicians record their findings and methods > for future doctors. Likely written by many, but attributed to him, Corpus > hippocraticum or "Hippocratic writings," some 60 or 70 books on all aspects > of ancient medicine, laid the foundations of medicine as a branch of > science. Primum non nocere (first, do no harm) is one of the famous rules > ascribed to Hippocrates. > > In following this rule, Hippocrates treated the body as a whole, rather than > as a series of parts. He accurately described disease symptoms and noted > individual differences in coping with disease and illness. Believing in the > natural healing process, Hippocrates recommended rest, a good diet, fresh > air and cleanliness. He was the first physician to attribute thoughts, > ideas, and feelings to the brain as opposed to the heart. > > Hippocrates traveled throughout Greece practicing his medicine. He founded a > medical school on the island of Cos, recruited and trained new entrants into > the medical field. Probably sworn to by these new entrants, the best known > of the Hippocratic writings is the Hippocratic Oath, which detailed > responsibilities the physician had to the patient. It is regarded as the > most valuable statement of medical ethics and good practice. He died in 377 > BC. Today, Hippocrates is generally considered "the Father of Medicine." > (Sources: www.quotationspage.com, > www.allsands.com/Science/hippocratesbiog_rtb_gn.htm, > http://en.wikipedia.org/wiki/Hippocrates and > http://www2.sjsu.edu/depts/Museum/hippoc.html) > > > > Politics Y2K5 > Worldwide Medical Errors > > According to the World Health Organization (WHO), health care errors > seriously harm one in every 10 patients. Nearly a million patients in the US > alone die or incur serious injury as a result of medical errors each year. > > WHO, the Joint Commission International and the Joint Commission on > Accreditation of Healthcare Organizations, which accredits US Hospitals, are > creating a collaborating center to focus worldwide attention on best > practices to reduce safety risks to patients. Dedicated solely to patient > safety, the WHO Collaborating Center will provide for better information > sharing and coordination, which will allow everyone to learn from the > mistakes and best practices of others. > > Liam Donaldson, chairman of WHO's World Health Alliance for Patient Safety, > acknowledged, "Human error is inevitable. We can never eliminate it. We can > eliminate problems in the system that make it more likely to happen." > > The safety measures experts will focus on in eliminating problems in the > system include ways to avoid mixing up drugs, procedures to safely place > tubes threaded through the nose and stomach to feed patients or remove > poisons and procedures to prevent performing surgery on the wrong body part > or even the wrong patient. > > > Hood Notes > Disparities in Medicare Services > > In 1998, the average life expectancy for African American males was 7 years > less than white males, and African American females lived 5 years less than > white females. Gornick et al. replicated other studies that documented wide > disparities between blacks and whites in Medicare services. They studied the > effects of race and income on mortality and use of services. They linked > 1990 census data with 1993 Medicare data for 26.3 million beneficiaries age > 65 or older (24.2 million whites and 2.1 million blacks). > > For mortality, the black/white ratios were 1.19 and 1.16 for men women, > respectively. For hospital discharges, the ratio was 1.14, and for visits to > physicians for ambulatory care, it was 0.89. The black/white rate ratio for > bilateral orchiectomy was 2.45 and 3.64 for amputations of all or part of > the lower limb. For every 1000 beneficiaries, there were 515 influenza > immunizations among whites and 313 among blacks. Comparing rates in the most > affluent with the least affluent group, the rates were 26 percent lower > among whites and 39 percent lower among blacks. > > Gornick et al. concluded race and income have substantial effects on > mortality and use of services among Medicare beneficiaries. Consequently, > just providing health insurance will not guarantee that all beneficiaries > effectively and equitably utilize the program. (Source: > www.ncbi.nlm.nih.gov) > > > Emergency Room Disparities > > Despite changes in medical technology and health care advances, minorities > have continued to suffer higher mortality for a number of common health > conditions. Many disparities in medical care occur in emergency care (EC). > Functioning as the sole provider for the uninsured, the inadequately > insured, and those who have difficulty navigating the primary care system, > EC is their health care safety net. Excessive mortality/morbidity persisted > even after adjusting for socioeconomic status for both non-preventable as > well as preventable causes of death. > > When considering poverty and access to care, EC should be a mitigating > factor for the poor. In that regard, access is a life and death issue for > poor uninsured patients; poverty rates among African Americans, Hispanics > and Native Americans are more than twice that of whites. Lack of access may > be a key to greater disease severity, thereby accounting for higher rates of > mortality and morbidity in minorities for diseases such as asthma, > congestive heart failure and diabetes. For example, Gornick and colleagues > found that despite lower rates of other preventive care measures and > interventional procedures such as angioplasty, African American Medicare > recipients have significantly higher rates of limb amputations. This is a > procedure directly linked to complications from diabetes. However, rates > reported in Gornick's study far exceeded the differentials in diabetes > prevalence between African Americans and whites. > > Differences in primary care access, disease severity and coverage may > address some differences in poor health outcomes; it does not completely > explain disparities that persist once minority patients are actually within > the health care system. Differences in delivery of care that persist even in > the face of similar levels of disease severity have been found in recent > studies. Data showed that nonwhites with acute cardiac ischemia were two > times more likely to be sent home from the EC unit, and nonwhites with > myocardial infarctions were over four times more likely. In Todd et al. > significant disparities were found in administering something as simple as > pain medication in EC. Ethnicity affected the administration of pain > medication to patients with long-bone extremity fractures. They found that > 55% of Hispanic patients failed to receive appropriate analgesics compared > to 26% of non-Hispanic whites. African American patients also were > significantly less likely than white patients to receive EC analgesics. > (Source: www.aemj.org) > > > Sex and Race Bias in Science > > Women and blacks are under-represented in the sciences. Only twelve percent > of all science doctoral degrees awarded in the United States in 2003 went to > minorities, according to the National Science Foundation, which funds about > 20 percent of all federally supported basic research conducted by US > colleges and universities. > > According to research published in the journal Science, women in science > faced overt and covert bias. Researchers found "no convincing evidence that > women's representation in science is limited by innate ability," a reference > to statements to that effect made by Harvard University President Lawrence > Summers. > > The lack of diversity in the science professions is clearly not explained by > biological differences. > > > > Three Fifth Compromise Healthcare > By John Burl Smith > > Last week (8-18-05) a report in the New England Journal of Medicine > re-ignited the debate about disparities between blacks and whites in > healthcare. At the heart of this controversy is the history of slavery in > the US. Racism, discrimination and other forms of disparate treatment > traditionally accorded blacks were codified in the 3/5 Compromise of Article > I Section 2 of the US Constitution by the founding fathers. Although, > segregation was state law only in the South, all of America's socioeconomic > and political institutions discriminated against blacks. The medical > profession was no different. Doctors were educated in the same segregated > schools as lawyers, judges, businessmen and politicians. They were trained > to treat blacks differently to protect white privilege. National efforts to > reduce the discriminatory affects of the 3/5 Compromise became known as > "affirmative action" in the 1960s. > > Patterns of disparate treatment for blacks hold true throughout US society. > Denying blacks opportunities reduce competition for resources. All whites > benefited from not having to compete with blacks; this is the glue that > holds the white lie of not discriminating against blacks together. The > majority of whites support this lie when it comes to denying blacks access > to medical school. Even though volumes of research continue to show unabated > disparities in every facet of American life, whites continue to pretend that > the gap is due to something other than race. > > The collaborative study between Emory, Yale, and other U.S. institutions > that re-ignited this debate looked at the records of 598,911 white and black > patients treated for heart attacks between 1994 and 2002 in 658 hospitals. > Their findings were consistent with other studies that found significant > disparities in treatment. > > However, as Dr. Ashish Jha of the Harvard School of Public Health, said > "When we started our study two years ago, we hoped we would find a few > procedures where the gap was narrowing, or a few regions around the country > where the gap truly got eliminated. We couldn't find any place in the > country where the gap narrowed." > > The relationship between improving minority health and affirmative action > may not be obvious to most whites. Inextricably linked, discrimination is > the root of both. Whites discriminate against blacks because they want to > continue controlling society's resources. Blacks suffer far higher rates of > heart disease, cancer, stroke and infant mortality than whites for the same > reason slaves wore rags and ate scraps, while whites dressed in fine > fashions and ate ham, and for the same reason blacks are denied access to > medical school-- whites control them. Healthcare for blacks has not improved > because the 3/5 Compromise and the discrimination it permits benefit whites. > It is the basis of white privilege and superiority. > > > Disgruntled feels: Unimpressed! In response to his all-time low poll > numbers, George W. Bush's advisers decided he should take time from his busy > vacation to travel to some safe "red states" to publicly reiterate his > determination to stay the course in Iraq. Based on his public relations > image, Bush is a man of conviction. Without exception, according to his > carefully crafted public persona, once he decides on a course of action, > Bush never waivers. Flip-flops are for lesser men. Given such intransigence, > which in any other mortal would be labeled ignorance, Bush must always be > right, even though he is not known for due diligence. After all, he was a > mediocre student and remains a reluctant reader. On more than one occasion, > members of his administration have assured us that poll numbers do not drive > Bush policies and actions. Yet, here he is campaigning to convince Americans > that he was right to invade Iraq, although all the reasons cited for that > act have since been proven to be lies. Even he takes a different tact; > instead of weapons of mass destruction, he uses words like democracy to > justify staying the course. Since neither of his offspring is on his > front-line in the war on terror, staying the course is easy. However, > falling poll numbers show a majority of parents are too unimpressed with his > act to serve their kids up as cannon fodder. > > Disgruntled says: A real right-wing Christian, Reverend Pat Robertson > suggested the US should just kill Venezuelan president Hugo Chavez. > According to his rather public tirade, Chavez should be wasted because, > among other things, his huge oil holding could "hurt us very badly." The > assumption is, the US could send commandos down there, decapitate the > nation's leader and install a puppet regime. Obviously, Robertson remembers > when the US engaged in covert assassinations all over South America. Now, > only Israel openly engages in targeted assassinations. After a firestorm of > criticism and no public support from fellow fundamentalists, Robertson > retracted his terrorist suggestion. > > Disgruntled wants to know: The day of reckoning is fast approaching. Prices > of all the necessities of life from food to fuel are steadily rising. > Question is, will the bust come before or after Alan Greenspan, father of > the dot.com and housing bubbles, retire? > > > > Venue for an Artist > Hippocratic Oath -- Modern Version > By Louis Lasagna > > I swear to fulfill, to the best of my ability and judgment, this covenant: I > will respect the hard-won scientific gains of those physicians in whose > steps I walk, and gladly share such knowledge as is mine with those who are > to follow. I will apply, for the benefit of the sick, all measures which are > required, avoiding those twin traps of over-treatment and therapeutic > nihilism. > > I will remember that there is art to medicine as well as science, and that > warmth, sympathy, and understanding may outweigh the surgeon's knife or the > chemist's drug. I will not be ashamed to say "I know not," nor will I fail > to call in my colleagues when the skills of another are needed for a > patient's recovery. > > I will respect the privacy of my patients, for their problems are not > disclosed to me that the world may know. Most especially must I tread with > care in matters of life and death. If it is given me to save a life, all > thanks. But it may also be within my power to take a life; this awesome > responsibility must be faced with great humbleness and awareness of my own > frailty. Above all, I must not play at God. > > I will remember that I do not treat a fever chart, a cancerous growth, but a > sick human being, whose illness may affect the person's family and economic > stability. My responsibility includes these related problems, if I am to > care adequately for the sick. > > I will prevent disease whenever I can, for prevention is preferable to cure. > I will remember that I remain a member of society, with special obligations > to all my fellow human beings, those sound of mind and body as well as the > infirm. > > If I do not violate this oath, may I enjoy life and art, respected while I > live and remembered with affection thereafter. May I always act so as to > preserve the finest traditions of my calling and may I long experience the > joy of healing those who seek my help. > > About Me: This modern version of the Hippocratic Oath was written in 1964 by > Louis Lasagna, Academic Dean of the School of Medicine at Tufts University. > Very similar to the original oath ascribed to Hippocrates, it is used in > many medical schools today. For a translation of the original by Francis > Adams, log on to http://classics.mit.edu/Hippocrates/hippooath.html. ) > > > > > News You Use > Healthy People 2010 > > The 1979 Surgeon General's Report, Healthy People, and Healthy People 2000: > National Health Promotion and Disease Prevention Objectives established > national health objectives. These reports served as the basis for the > development of state and community public health plans. Healthy People 2010, > which builds on these earlier initiatives, is the national set of health > objectives for the first decade of the 21st century. Healthy People 2010 > serves as a model for national and international disease prevention and > health promotion plans. > > The two overarching goals of Healthy People 2010 are: (1) to help > individuals of all ages increase life expectancy and improve their quality > of life and (2) to eliminate health disparities among different segments of > the population. Reflecting the major health concerns in the United States at > the start of the new century, Healthy People 2010 employs ten (10) leading > health indicators, i.e., Physical Activity, Overweight and Obesity, Tobacco > Use, Substance Abuse, Responsible Sexual Behavior, Mental Health, Injury and > Violence, Environmental Quality, Immunization and Access to Health Care, to > measure national health. Each indicator has one or more objectives. Under > these ten indicators, there are 28 focus areas with more than four hundred > specific objectives. > > Built on the best scientific knowledge available and designed to measure > programs over time, Healthy People 2010, like its predecessors, was > developed through a consultation process. To ensure it remains current, > accurate and relevant, the U.S. Department of Health and Human Services, > Federal agencies and other experts assess data trends during the first half > of the decade, consider new science and available data, and make changes > that reflect this new information. > > As part of this mid-course review, the public is invited to comment on > proposed changes. The public comment period extends from 9:00 A.M. August 15 > through 5:00 P.M., Eastern Daylight Time, September 15, 2005. The public can > read more about Healthy People 2010, view proposed changes to its objectives > and register to submit comments at www.healthypeople.gov. > > > ********************************************* > For comments or to unsubscribe, email [EMAIL PROTECTED] > ********************************************* > > > >
------------------------ Yahoo! Groups Sponsor --------------------~--> Life without art & music? Keep the arts alive today at Network for Good! http://us.click.yahoo.com/FXrMlA/dnQLAA/Zx0JAA/LRMolB/TM --------------------------------------------------------------------~-> Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/scifinoir2/ <*> To unsubscribe from this group, send an email to: [EMAIL PROTECTED] <*> Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/
