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Family Interventions in Health Care

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In this article the author discusses the background and present status of family interventions in health care. He notes the convergence of interest occurring in this area among several health care disciplines during the 1970s and 1980s. He also summarizes his and colleague Macaran Baird's model for primary care family interventions in health care, which distinguishes between primary care interventions and specialized family therapy interventions. The author then describes new work on delineating levels of professional involvement with families in health care, and discusses curriculum implications of these levels. Finally, he offers advice and warnings about collaboration among different professional groups in this emerging area.

Family interventions in health care can be defined as efforts by health care professionals to work systematically with the patient's family for the purposes of prevention, treatment, management, or rehabilitation of biopsychosocial problems. The focus of such interventions may be: (a) on the individual patient, with the family playing a supportive...

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Nocturnal Leg Cramps In Older People

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Cramps are episodes of pain, usually lasting up to a few minutes, caused by sudden, intense involuntary contractions of muscles or muscle groups. Residual discomfort and tenderness may persist for hours afterwards. Nocturnal leg cramps, usually involving the calf muscles or the small muscles of the foot, are common and troublesome in older people. In a general practice based study of 233 people aged 60 years or more, almost one third had had rest cramps during the previous two months, including one half of those aged 80 years or more.1 Furthermore, 40% of subjects had cramps more than three times a week, and 6% reported daily rest cramps. Another study of 350 elderly outpatients found that 50% had rest cramps, with 20% reporting symptoms for 10 years or more. Although cramps are generally a benign and transient problem, they can cause considerable distress for patients....

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Histamine and Antihistamines

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Abstract

Histamine is one of the most extensively studied biological amines in medicine. It stimulates smooth muscle contraction and gastric acid secretion, increases vascular permeability, functions as a neurotransmitter, and plays various roles in immunomodulation, allergy, inflammation, haematopoiesis and cell proliferation. Histamine exerts its effects through four receptors, designated H1–H4. H1 and H2 receptors are widely distributed, H3 receptors are mainly presynaptic, and H4 receptors are mainly haematopoietic. H1 antihistamines are classified as first- and second-generation compounds. First-generation compounds lack specificity and cross the blood–brain barrier causing sedation. Second-generation compounds are less sedating and highly specific. H1 antihistamines have well-documented anti-allergic and anti-inflammatory effects and are well established in the treatment of a variety of allergic disorders. First-generation antihistamines are also used in the treatment of vestibular disorders and can be used as sedatives, sleeping aids and anti-emetics. H2 antihistamines are widely used in the treatment of gastric acid-related disorders;...

See Also: Histamine and Antihistamines

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Unused Pharmaceuticals in the Health Care Industry:

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The Focus of EPA’s Study

EPA initiated the study of unused pharmaceutical disposal practices at health care facilities with the goals of understanding one way in which pharmaceuticals enter our waterways and also understanding what factors contribute to pharmaceuticals entering through water. While EPA understands that there are many factors influencing the handling and disposal of pharmaceuticals by the health care industry, the focus of EPA’s study is on disposal into water. EPA decided to study medical facilities because the Agency believes that these facilities dispose of a large quantity of unused pharmaceuticals. Thus far, EPA has only evaluated hospitals and long-term care facilities, so the information in this interim report pertains only to hospitals and long-term care facilities. Recently EPA decided to expand the scope of its study to include hospices and veterinary facilities and intends to issue a nationwide information collection request to gather better, representative data (see “Next Steps”). Hospitals include general and medical surgical hospitals, psychiatric and substance abuse hospitals, and specialty hospitals,...

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