Suchergebnisse

Robert Gildea, Marianne in Chains – In Search of the German Occupation, 1940–1945 (Henry Holt: New York, 2002) 524 pp., £20.00 (hb), ISBN 0-33-378230-5.Michael Curtis, Verdict on Vichy: Power and Prejudice in the Vichy France Regime (Arcade Publishing: New York, 2003) 419 pp., $27.95 (hb), ISBN: 1-55-970689-9.Julian Jackson, France: The Dark Years, 1940–1944 (Oxford: Oxford University Press, 2003), 690 pp., £12.99 (pb), ISBN 0-19-925457-5.Andrew Shennan, The Fall of France, 1940 (Harlow: Longman, 2000), 181 pp., $22.99 (pb), ISBN 0-582-29081-3.Henry Rousso, The Haunting Past. History, Memory, and Justice in Contemporary France (Philadelphia: University of Pennsylvania Press, 2002), 136 pp., $29.95 (hb), ISBN 0-8122-3645-9.

During the Second World War, the black market was an integral part of daily life in all parts of wartime Europe – occupied, collaborationist, neutral – and beyond, in the United Kingdom, Canada, the United States and elsewhere. Wherever nations had shifted to a controlled economy, in which supply and distribution were regulated by the government through rationing and quota systems and demand exceeded the regulated supply, the black market flourished. It was the free market at its most brutal. Prices were determined by the laws of supply and demand, adjusted to recognise and reward the enormous risks taken by suppliers in trading on the black market. It was no different in northern France.

ABSTRACTThis study was conducted to understand perceptions that may influence oral self‐care behaviors among elderly African American adults living in an urban community. Four focus groups at two senior centers were recruited, involving a total of 25 participants. Content analysis and ethnographic summaries were used to identify themes, common concepts and language. The results indicated that although the participants recognized the advantages of routine brushing, the importance of keeping teeth clean to prevent gum disease was not widely acknowledged. On the basis of these focus groups, the authors suggest that health promotion approaches for adults who are elderly should be linked to the audience's cultural norms and perceptions regarding the benefits of oral hygiene practices.

Abstract Background Rheumatoid arthritis (RA) has been associated with an increased risk of cardiovascular morbidity and mortality but this has not translated to optimal management of traditional cardiovascular risk factors such as hyperlipidemia. The objectives of this study were to 1) determine the prevalence of screening for hyperlipidemia in patients with RA followed by primary care practitioners (PCP); 2) examine initiation of lipid-lowering therapy in patients with an indication, and 3) assess whether proposed modifications to cardiovascular risk calculations change the percentage of RA patients with an indication for therapy. Methods We performed a retrospective cohort study using an academic medical center-based medical record database in the United States. Patients with RA defined by the presence of at least one ICD-9 code between 2005–2010 and followed by a PCP within the health care system were included. The positive predictive value of ICD-9 codes for accurately identifying patients with RA was 96.7 %. Descriptive statistics were used to report the prevalence of screening and use of lipid-lowering therapy among those with an indication. Factors associated with not receiving lipid screening were examined using logistic regression models. Indication for and receipt of therapy were then assessed before and after the application of the European Union League Against Rheumatism (EULAR) recommended multiplier to the Framingham risk score. Results Among 1,056 patients with RA followed by PCPs and eligible for lipid screening, lipid screening was ordered for 539 (51 %) within the 3-year follow-up period. Patients with diabetes, hypertension, chronic kidney disease, obesity or age >50 were more likely to be screened. Of those with lipid results ( N = 290), 25 (9 %) patients had an indication for lipid-lowering therapy based on Adult Treatment Panel III guidelines. Ten (40 %) patients with an indication for lipid-lowering therapy received therapy did not receive therapy. Applying the EULAR multiplier only changed the indication for lipid-lowering therapy in two patients. Conclusions Screening and management of traditional cardiovascular risk factors, including hyperlipidemia, need to be optimized.

IMPORTANCE: The combined 28 years of data of medical aid in dying (MAID) between Oregon (OR) and Washington (WA) are the most comprehensive in North America. No reports to date have compared MAID use in different US states. OBJECTIVE: To evaluate and compare patterns of MAID use between the states with the longest-running US death with dignity programs. DESIGN, SETTING, AND PARTICIPANTS: A retrospective observational cohort study of OR and WA patients with terminal illness who received prescriptions as part of their states' legislation allowing MAID. All published annual reports, from 1998 to 2017 in OR and from 2009 to 2017 in WA, were reviewed. A total of 3368 prescriptions were included. MAIN OUTCOMES AND MEASURES: Number of deaths from self-administration of lethal medication vs number of prescriptions written. RESULTS: A combined 3368 prescriptions were written in OR and WA, with 2558 patient deaths from lethal ingestion (76.0%). Of the 2558 patients, most were male (1311 [51.3%]), older than 65 years (1851 [72.4%]), and non-Hispanic white (2426 [94.8%]). The most common underlying illnesses were cancer (1955 [76.4%]), neurologic illness (261 [10.2%]), lung disease (144 [5.6%]), and heart disease (117 [4.6%]). Loss of autonomy (2235 [87.4%]), impaired quality of life (2203 [86.1%]), and loss of dignity (1755 [68.6%]) were the most common reasons for pursuing MAID. Time between drug intake to coma ranged from 1 to 660 minutes and time from drug intake to death ranged from 1 to 6240 minutes. In the 1557 patients for whom rates of complications were reported, 1494 (96.0%) did not experience a complication (592 of 626 [94.6%] in OR and 902 of 931 [96.8%] in WA). Eight patients (<0.5%) regained consciousness after drug ingestion in OR. Annual rates per year for percentage of patients who received a prescription ingesting the prescribed medication ranged from 48% to 87%, with no significant time trend in OR (adjusted odds ratio per year, 1.01; 95% CI, 0.99-1.02; P = .59) but with an increase over time in WA ...