Public health reports
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Public health reports · May 1986
Comparative StudyCommunity mental health care for the elderly--a look at the obstacles.
Despite the recent attention given to mental disorders in the aged and their higher risk for organic mental disorders, older people rarely receive specialized mental health treatment. This paper reviews recent research on some of the major obstacles to the use of treatment by the elderly. These include claims of "ageism" by health care professionals, the negative attitudes and behaviors of older persons toward mental disorders and their treatment, and the failure of general practice physicians to recognize or treat symptoms of mental disorders in their elderly patients or to refer these patients to geriatric mental health specialists. It is suggested that increased public education in geriatric mental health is urgently needed for potential patients, their families, and their general physicians.
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Public health reports · May 1985
Fatalities associated with farm tractor injuries: an epidemiologic study.
Death certificates were used as a source of information to characterize fatalities associated with farm tractor injuries in Georgia for the period 1971-81. In this period, 202 tractor-associated fatalities occurred among residents of Georgia; 198 of these persons were males. The annual tractor-associated fatality rate for males based on the population of male farm residents was 23.6 per 100,000; rates of fatal injury increased with age for this population. ⋯ Fatalities were attributed to crushed chest, exsanguination, strangulation or asphyxia, drowning, and other injuries. Current safety standards for the operation of farm tractors are limited; rollover protective canopies are not required for farm owners or their family members. Descriptive epidemiologic information obtained from death certificates can be used to define injury determinants and to suggest approaches for the further study and prevention of specific types of injuries.
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Public health reports · Jan 1985
Case ReportsSevere attacks by dogs: characteristics of the dogs, the victims, and the attack settings.
Sixteen incidents involving dog bites fitting the description "severe" were identified among 5,711 dog bite incidents reported to health departments in five South Carolina counties (population 750,912 in 1980) between July 1, 1979, and June 30, 1982. A "severe" attack was defined as one in which the dog "repeatedly bit or vigorously shook its victim, and the victim or the person intervening had extreme difficulty terminating the attack." Information from health department records was clarified by interviews with animal control officers, health and police officials, and persons with firsthand knowledge of the events. Investigation disclosed that the dogs involved in the 16 severe attacks were reproductively intact males. ⋯ The characteristics of these attacks, only one of which proved fatal, were similar in many respects to those that have been reported for other dog bite incidents that resulted in fatalities. On the basis of this study, the author estimates that a risk of 2 fatalities per 1,000 reported dog bites may exist nationwide. Suggestions made for the prevention of severe attacks focus on changing the behavior of both potential canine attackers and potential victims.
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The concept of primary care in the Kupat Holim Health Insurance Institution encompasses all the stages of health: the promotion of health, personal preventive care, curative care, and rehabilitation in the community. Primary care is, thus, the foundation of this nationwide comprehensive health insurance and health care delivery system; Kupat Holim covers 3.2 million people, close to 80 percent of Israel's total population in 1983. Primary care clinics in the community are the main focus of care and have undergone changes in the types of health care providers and functions as population characteristics change. ⋯ Current trends include the extension of services provided to the patient in his home as well as the clinic and greater emphasis on preventive care. The interrelationship between policy and planning for primary care is strengthened by the linkage between financer, provider, and consumer in Kupat Holim. The planning process must make optimal use of this linkage to guide those responsible for health policy in implementing effective change.