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Genetic counseling clinical chromosome analysis in 522 cases
142 counseling. As a geneticist’s view, the pathogenetic concept of diabetes presented here is mostly confuted to genetic mechanisms, leaving aside other influences on the development of diabetes such as hormones, viruses, nutrition, and drugs. Mendelian-inherited diabetic disorders are related to different pathogenetic principles where possible. These are speculative in some cases. 4) Genetic counseling clinical chromosome analysis in 522 cases LI, L., XIA, J., DAI, H., et al. Med. Genet. Lab., Hunan Med. Coll., Changsha, China Chin. Med. J. (Peking) 95(11), 793-804, 1982 Chromosome analysis in 522 cases at a genetic counseling clinic from April 1973 to December 1980 revealed 60 cases (11.5%) with numerical or structural abnormalities. The structural aberrations include 12 types involving chromosomes nos. 1, 2, 4, 5, 7, 9, 12, 13, X and Y. None of the karyotypes had been reported previously in China and nine types in 12 cases had not been reported in the world. These nine karyotypes include 46, XY, t(1; 4) (q43; q25); 46, XY, -13, +der (13), t(4; 13) (q25; q34); 46, XY, t(1; 17) (~36; q21’); 46, XX or XY, t(5; 7) (q22; ~13); 46, XY, or XX, inv(5) (p15.1; q33.1); 46, XX, 39, -9, +del (9), +del (9) (pteralphacen- > qll::q13> qter); 46, XX, inv(l2) (~1110; q1310); 46, XY/45, XY, t(13; 13) (~12; ~12) and 45, X/46, Xx/47, XX, +t(Y; Y) (Yqter> Ypl::Yql 1 - > Yqter). Typical cases with the new chromosome aberrations am described and the origin of chromosomal aberrations and their prevention are discussed. HEALTH
BELIEFS
AND PRACTICES
The outcome of efforts to influence patient behaviors depends ultimately upon the beliefs of the patients themselves. Research has linked selected health beliefs and practices of patients with nearly every health condition known. When health-care providers begin to “diagnose” their clients’ underlying health beliefs, they will begin to understand better the inner reasons affecting patient behaviors. 5) Beliefs and practices concerning measles in Gazankulu IJSSELMUIDEN, C.B. Elim Hosp., Gazankulu, Transvaal, South Africa S. Afr. Med. J. 63(10), 360-363, 1983 A survey was undertaken to isolate social factors that might be influencing the coverage of a measlesvaccination program which, after several years, showed no decrease in the measles admission rate at the area hospital. It was found not only that measles is still a
common disease, but also that it is considered essential for the normal development of a child. In the home treatment of measles, moreover, a variety of indigenous medications ate used, some of which ate potentially dangerous. Almost 80% of mothers will visit a clinic if their children have measles, but 64% combine this with traditional therapy. The majority, however, were in favor of a vaccination program. The content of any health-education program, therefore, must be carefully considered, to prevent adverse effects in the population. 6) Factors influencing initiation of breast-feeding EKWO, E.E., DUSDIEKER, L.B . , and BOOTH, B.M. Dept. Ped., Univ. Iowa Hosp., Iowa City, IA, U.S.A. Am. J. Dis. Child. 137(4), 375-377, 1983 The critical incidence method was used to study factors motivating 33 primigravidas and 39 multigravidas to initiate breast-feeding of their infants. The women studied chose breast-feeding because they believed it would protect the infant against infection, establish matemalinfant bonding, and provide better nutrition than cow ‘s-milk formula. They also viewed it as the natural way to feed infants and felt that it would be both convenient and emotionally satisfying. The decision to breast-feed was made well in advance of pregnancy by primigravidas and shortly before pregnancy by multigravidas. Friends who had successfully nursed infants were as influential as immediate family members in influencing our study subjects in their decision to breastfeed. Prenatal counseling, though important, may not be the optimal period for motivating women to breast-feed. HOSPITAL ROLES IN HEALTH EDUCATION/PATIENT EDUCATION The rising costs of health care have encouraged many hospitals to diversify into the broader fields of health promotion and health education. However, the new requirements of diagnostic related groups will increasingly force hospitals to examine their entire range of educational services and determine first and foremost how to provide the most effective patient education at the lowest cost. 7) Developing a strategy for reducing hospital expenditures BRINES, D.S. Vermont Hosp. Assoc., Blanchard Court, Montpelier, VT, U.S.A. Hosp. Health Serv. Adm. 27(5), 284, 1982 A number of courses of action are suggested to reduce increases in hospitals’ expenditures. They are: utilization of group-purchasing practices; reduction of staff;
PATlENT EDUCATION AND COUNSELING
BELIEFS
AND PRACTICES
The outcome of efforts to influence patient behaviors depends ultimately upon the beliefs of the patients themselves. Research has linked selected health beliefs and practices of patients with nearly every health condition known. When health-care providers begin to “diagnose” their clients’ underlying health beliefs, they will begin to understand better the inner reasons affecting patient behaviors. 5) Beliefs and practices concerning measles in Gazankulu IJSSELMUIDEN, C.B. Elim Hosp., Gazankulu, Transvaal, South Africa S. Afr. Med. J. 63(10), 360-363, 1983 A survey was undertaken to isolate social factors that might be influencing the coverage of a measlesvaccination program which, after several years, showed no decrease in the measles admission rate at the area hospital. It was found not only that measles is still a
common disease, but also that it is considered essential for the normal development of a child. In the home treatment of measles, moreover, a variety of indigenous medications ate used, some of which ate potentially dangerous. Almost 80% of mothers will visit a clinic if their children have measles, but 64% combine this with traditional therapy. The majority, however, were in favor of a vaccination program. The content of any health-education program, therefore, must be carefully considered, to prevent adverse effects in the population. 6) Factors influencing initiation of breast-feeding EKWO, E.E., DUSDIEKER, L.B . , and BOOTH, B.M. Dept. Ped., Univ. Iowa Hosp., Iowa City, IA, U.S.A. Am. J. Dis. Child. 137(4), 375-377, 1983 The critical incidence method was used to study factors motivating 33 primigravidas and 39 multigravidas to initiate breast-feeding of their infants. The women studied chose breast-feeding because they believed it would protect the infant against infection, establish matemalinfant bonding, and provide better nutrition than cow ‘s-milk formula. They also viewed it as the natural way to feed infants and felt that it would be both convenient and emotionally satisfying. The decision to breast-feed was made well in advance of pregnancy by primigravidas and shortly before pregnancy by multigravidas. Friends who had successfully nursed infants were as influential as immediate family members in influencing our study subjects in their decision to breastfeed. Prenatal counseling, though important, may not be the optimal period for motivating women to breast-feed. HOSPITAL ROLES IN HEALTH EDUCATION/PATIENT EDUCATION The rising costs of health care have encouraged many hospitals to diversify into the broader fields of health promotion and health education. However, the new requirements of diagnostic related groups will increasingly force hospitals to examine their entire range of educational services and determine first and foremost how to provide the most effective patient education at the lowest cost. 7) Developing a strategy for reducing hospital expenditures BRINES, D.S. Vermont Hosp. Assoc., Blanchard Court, Montpelier, VT, U.S.A. Hosp. Health Serv. Adm. 27(5), 284, 1982 A number of courses of action are suggested to reduce increases in hospitals’ expenditures. They are: utilization of group-purchasing practices; reduction of staff;
PATlENT EDUCATION AND COUNSELING