Ask the patients - they may want to know more than you think

What information do patients need about medicines? Partnership between health professionals and patients depends, in part, on the provision and exchange of accurate and reliable information about drugs, but who should provide it? We invited contributors to answer the question from the perspectives of patients, clinicians, and the pharmaceutical industry People's appetite for information about their treatment is often greater than doctors believe.1 Clearly, patients vary in the extent of their desire for partnership in making medical decisions. It follows that part of the duty of a health professional is to work out how much partnership a patient wants, and what information he or she needs to support that level of partnership

Cryogenic Hydrogen/helium Storage and Supply System, Phase 1

An existing cryogenic tank was refurbished, microspheres were installed in the tank annulus, and the thermal performance of the unit was tested. The performance data was compared with NRC-2 multilayer insulation and low emittance aluminized surfaces installed in tanks of the same basic design. The cryogenic tank modified during the program was originally designed for the Manned Orbiting Laboratory (MOL) Program, and subsequently modified by vacuum-depositing aluminum on all annulus surfaces and leaving out the NRC-2 multilayer insulation. It is concluded that the application of aluminized-microsphere insulation is not yet very predictable for tank design purposes, especially at LH2 temperature and in the presence of a vapor-cooled shield

African American Masculinity in the Wartime Diaries of Two Vietnam Soldiers

In her article African American Masculinity in the Wartime Diaries of Two Vietnam Soldiers Sharon D. Raynor discusses an unpublished diary (1967-68) written by her father, Louis Raynor with the diary (1965-66) of David Parks that was revised and published as a memoir. By contextualizing the traditions of African American autographical writing and wartime diaries, Raynor analyzes how African American masculinity permeates the autobiographical structure in the Raynor and Parks diaries as each soldier interweaves a collective experience with a unique personal experience in the Vietnam War. The Vietnam experience challenged their ideologies about racial politics, but affirmed their masculine identity in the face of violence. Raynor focuses on how in these wartime life writings, African American masculine identity is pervasive in the narratives and how it is performed and documented by Raynor and Parks differently

Second-chance punitivism and the contractual governance of crime and incivility: New Labour, old Hobbes

The growing application of mechanisms of contractual governance to behaviour that breaches social norms, rather than the criminal law, appears to represent an ethopolitical concern with delinquent self-reform through the activation of technologies of the self. In fact, there is little empirical evidence that the contractual governance of incivility leads to such self-reform. Beneath the ideology of contractual agreement to observe social norms lies what this paper calls a ‘second-chance punitivism’ which operates to crystallise behavioural elements of the Hobbesian social contract, after breach, into a more specific form. The responsibilising and individualising properties of this form of contractual governance set the moral-ideological platform for a retributive punitivism, when the rational agents it creates fail to live up to their image, and are taken to have wasted their ‘second chance’

Clinical Trial Results Summary for Laypersons: A User Testing Study

Objective: To apply “user testing” to maximize readability and acceptability of a Clinical Trial Results Laypersons Summary—a new European requirement. Methods: “User testing” (using questionnaire and semistructured interview) assessed whether people could find and understand key points. Findings were used to improve content and design, prior to retesting. Participants had a range of levels of health literacy and there was a higher education group. Participants accessed the summary on screen. In round 1 we tested 12 points of information. In round 2 a revised summary addressing round 1 findings was tested, leading to a third final version. Results: In round 1, 2 of 12 points of information did not reach the target and interviews raised further format and content issues (some distracting technical explanations and inability to find or understand the 2 main study purposes). These findings informed revisions for the version tested in round 2, with 2 different points not reaching the target (inclusion criteria relating to duration of seasonal allergies and how researchers found out about participants’ symptoms). Identified problems in both rounds were addressed and reflected in the final version. Despite improvements, participants did not consistently understand that summaries were intended for the public, or to only interpret results of single trials in the context of additional trials. All readers, including those with higher education, found the clear and straightforward language acceptable. Conclusions: Applying “user testing” resulted in a largely health-literate summary suitable for people across a range of backgrounds

Theresienstadt: A Geographical Picture of Transports, Demography, and Communicable Disease in a Jewish Camp-Ghetto, 1941–45

The Nazi ghetto system was one of the principal vehicles for the persecution of Jewish and other peoples in German-occupied Europe in World War II. Transport and confinement – twin pillars of the ghetto system – were intrinsically geographical matters that operated on scales from the international to the local and which shaped the demographic and epidemiological character of ghettos across Eastern Europe. This article uses geographical techniques of map-based visualisation and spatial analysis to portray the demographic and epidemic history of the Nazi ‘model’ camp-ghetto at Theresienstadt (Terezín) in the former German Protectorate of Bohemia and Moravia, 1941–45. Our study reconstructs the space-time pattern and demographic structure of transports of Jewish prisoners to the ghetto and their association with substantial outbreaks of communicable diseases in the ghetto. The study highlights the importance of a geographical approach to an understanding of the demographic and public health impacts of both the Holocaust and other genocidal events

Suzbijanje geografskog širenja zaraze: kuga u Italiji od 1347.-1851.

After the establishment of the first quarantine station in the Republic of Ragusa (modern-day Dubrovnik) in 1377, the states and principalities of Italy developed a sophisticated system of defensive quarantine in an attempt to protect themselves from the ravages of plague. Using largely unknown and unseen historical maps, this paper reconstructs the extent and operation of the system used. It is shown that a cordon sanitaire existed around the coast of Italy for several centuries, consisting of three elements: (i) an outer defensive ring of armed sailing boats in the Mediterranean and the Adriatic, (ii) a middle coastal ring of forts and observation towers, and (iii) an inner defensive ring of land-based cavalry. The principles established, although not especially successful at the time against a disease of (then) unknown aetiology, are still used today in attempts to control the spread of infections of animal and human populations.Nakon uspostave prvoga lazareta u Dubrovačkoj Republici 1377., talijanske državice i kneževine razradile su sustav karantena kako bi se zaštitile od razarajućega djelovanja kuge. Oslanjajući se mahom na dosad nepoznate povijesne karte, u ovome se članku rekonstruira kako je i u kojem razmjeru djelovao sustav zaštite. Duž talijanske obale stoljećima je postojao sanitarni kordon, a sastojao se od tri dijela: (i) vanjski pojas sastavljen od naoružanih jedrenjaka na Sredozemnom i Jadranskome moru, (ii) srednji obrambeni pojas sastavljen od utvrda i promatračnica te (iii) unutarnji obrambeni pojas na kopnu sastavljen od konjice. Premda ovaj sustav svojevremeno i nije bio pretjerano uspješan u zaštiti od bolesti (tada) nepoznate etiologije, njegova se načela još uvijek rabe za sprječavanje širenja bolesti među ljudima i životinjama