Observed ozone response to variations in solar ultraviolet radiation.

During the winter of 1979, the solar ultraviolet irradiance varied with a period of 13.5 days and an amplitude of 1 percent. The zonal mean ozone values in the tropics varied with the solar irradiance, with an amplitude of 0.25 to 0.60 percent. This observation agrees with earlier calculations, although the response may be overestimated. These results imply changes in ozone at an altitude of 48 kilometers of up to 12 percent over an 11-year solar cycle. Interpretation of ozone changes in the upper stratosphere will require measurements of solar ultraviolet radiation at wavelengths near 200 nanometers.

Congestive heart failure.

Congestive heart failure is important to the physician who treats elderly patients because of its incidence, prevalence, and high morbidity and mortality and because it often necessitates repeated hospitalizations. Presentation may be atypical and the condition may be precipitated by many of the ills that occur routinely in geriatric practice. Diastolic dysfunction may complicate diagnostic evaluation. Many of the symptoms respond gratifyingly to therapy. Congestive heart failure ranks among the most treatable of the geriatric syndromes. The physician who cares for older patients should be constantly alert for its presence and should keep abreast of the current therapies available and acquire experience in their use.

Some lessons learned in the care of the elderly.

This article is designed to acquaint physicians not trained in geriatrics with some precepts concerning the care of the elderly. It presents a summary of the experience in the care of over 2,000 outpatients over the age of 65 who were seen at a community hospital geriatric evaluation unit and resource center. The findings reaffirmed the importance of concentrating on the preservation and restoration of function in the care of the frail elderly. Although there are no clinical skills unique to geriatrics, but the approach to the gathering of clinical data in people with multiple and overlapping problems and disabilities must be structured differently. There is less emphasis on precise diagnosis, much less emphasis on the concept of cure, and more emphasis on structuring a medical/social response to the dominant problem or problems.

Tenure in medical schools in the 1980s.

Tenure in American medical schools is a personnel policy which exists in relation to institutional policies and realities. It is related to the functions of academic institutions and their capacity for carrying out these functions, and it arises from the needs of an open society to sustain critical and innovative roles for its universities, the necessity for universities to support and protect their faculties, the optimization of their capability to react to new opportunities, and the demands of ever shifting social circumstances. The relation between society and its universities and the balance among the various roles of the universities have not been stable in the past and will not be so in the future. Tenure policies will continue to be modified. The leadership of institutions needs to be aware of the fact that the modifications will occur and of what might be termed the plasticity of tenure.

The epidemiology and spectrum of surgical care in district hospitals of Pakistan.

On-site surveys of 19 district-level hospitals in Pakistan revealed that, in 1983, 23,839 procedures were performed. There were 98 different types of operations. Thirty-eight per cent were classified as General Surgery, 30 per cent Gynecology and Operative Obstetrics, 19 per cent Urology, and 13 per cent Orthopedics. In three regions, population-based data were obtained from the 12 hospitals which provided all surgical care to discrete populations. The overall rate of surgical operations per 100,000 population was 124, 1.5 per cent to 9 per cent of the rate in western countries. The ratio of surgeons per 100,000 population was 0.36, 1/80 the ratio in the United States. There were almost twice as many operations per surgeon as in the USA. These data indicate a severe shortage of surgeons in Pakistan's district hospitals. They also provide the spectrum and relative numbers of different operations performed at the district level. This information has been useful along with other factors in designing a surgical curriculum at the Aga Khan University in Karachi, Pakistan.

Departmental review in medical schools: focus and functions.

Approximately two-thirds of all U.S. and Canadian medical schools have provisions for the evaluation of their departments on a periodic or ad hoc basis. Most of these institutions have initiated the departmental review process since 1970. It appears that use of the practice is increasing and is becoming an important tool in providing guidance for departmental activities, programs, and leadership. Departmental review may be conducted in a variety of ways with varying levels of intensity, flexibility, and skill, depending on the environment, resources, dean, department chairmen, faculty, and attitudes of university administrators. Departmental review may be employed to identify, elaborate, document, and/or contribute to the resolution of current and potential organizational concerns. When carefully administered, the process can be a stabilizing rather than a disruptive force; however, by itself, it does not solve major institutional problems.