The development of model curricula for Health Informatics.

We have developed model Health Informatics (HI) curricula for the education of three categories of professionals: Applied Health Informaticians, the professionals that deploy information technologies, Research and Development Health Informaticians those that develop new concepts, techniques, and solutions, and what we have called Clinician Health Informaticians, providers who use HI capabilities to support their professional work. The curricula specify the competencies that each type of professional must acquire.

Is there an association among low untreated serum lipid levels, anger, and hazardous driving?

Anger and hazardous driving were explored in two studies for their possible explanatory role in the low cholesterol-violent mortality association. In Study 1, we obtained fasting blood samples and indices of anger and driving habits from 102 healthy young adults. Among men (but not women), lower low-density lipoprotein (LDL) cholesterol levels were associated with significantly higher anger (r = 41, p < .01) and unsafe driving habits (r = -.30, p < .05), and although total cholesterol levels were correlated in the predicted direction, these were not significant. In Study 2, 78 healthy young men completed the same measures, and this time, both lower total and LDL-cholesterol were significantly related to increased anger and dangerous driving. Implications of these findings are discussed as are possible avenues for future research. Further scrutiny of the components of serum cholesterol and their relation to psychological factors may aid us in better understanding the reasons why men are at increased risk for hazardous behavior and violent death.

Increases in depression after cholesterol-lowering drug treatment.

To investigate the possibility that increases in depressive symptoms might occur in patients who have undergone cholesterol-lowering interventions, the authors administered the Center for Epidemiological Studies-Depression scale before and after cholesterol lowering to 6 men who were referred to a lipid clinic. All of the patients' cholesterol levels were reduced after the 6-week intervention, and 4 of the patients' depression scores increased; scores of 2 of the 4 met the criteria for mild clinical depression. Further study of possible links among low cholesterol, depressive symptoms, and serotonergic activity is needed.

Cardiopulmonary resuscitation. Not for all terminally ill patients.

Where there are clear clinical indications that a patient suffering from a terminal illness would not benefit from cardiopulmonary resuscitation, there is no legal or ethical requirement that CPR be discussed with the patient as a treatment option or that CPR be administered if the patient stops breathing or suffers cardiac arrest.

The Lottes nail in the closed treatment of tibia fractures.

The effectiveness of the Lottes nail was evaluated in 63 consecutive cases of tibia fractures treated by closed intramedullary fixation with image intensification. The procedure was offered to all adults except those with Gustillo and Anderson Type III open wounds and with fractures less than 10 cm from the knee or 5 cm from the ankle. The operations were generally performed within a few days in closed fractures and somewhat later in open fractures. Patellar-tendon-bearing casts were applied five to ten days after operation, and weight-bearing to tolerance was emphasized. All fractures united. Bridging callus was generally seen by seven or eight weeks. Complications not necessarily peculiar to the procedure included one each of delayed wound infection, peroneal neurapraxia, compartment syndrome, heel decubitus, and shortening of more than 2 cm. Technical failures included malunion of fracture, loss of fixation by the nail, backing out of the nail, and penetration into the ankle joint. Most of the complications and technical failures could be remedied and did not influence the ultimate result. The authors recommended the Lottes nail and closed intramedullary nail fixation as the preferred method of treatment of diaphyseal fractures of the tibia in adults.

Sex education for patients.

Sex education evokes a wide variety of responses in the community and from teachers. Consequently, physicians have a responsibility to present sex education material in a factual, objective way. Many people are misinformed about sexual behavior. Physicians can help patients and the community by being aware of appropriate sex education for each age group. A curriculum for sex education, and opportunities to provide sex information for patients of different ages and stages in the lifecycle, are described.

Roller skating accidents and injuries.

A consecutive series of 65 fractures, dislocations, and ligament tears produced by roller skating accidents treated by the Orthopaedic Department of the Mt. Sinai Services at City Hospital Center of Elmhurst, New York, is reviewed. It was learned that the injuries resulting from collisions occurring in a skating rink were more serious than those resulting from street accidents. Data indicated that lack of expertise is a prominent factor in the production of serious injury. However, the sport has inherent risk which is not eliminated by expertise. It was concluded that roller skating can and does produce disabling injuries. In order to reduce the number of injuries it will be required to reduce crowding in rinks, designate separate beginners' areas, use training wheels or clampon-type of skates when learning, encourage lessons, and separate beginners in the rinks.