F. Marian Bishop

EPIDEMIOLOGY IN PUBLIC HEALTH PLANNING FOR NATURAL DISASTERS.

EPIDEMIOLOGY has proved useful in the study and prevention of accidents of various types as well as epidemics of communicable diseases. Disasters may be defined arbitrarily a,s epidemics of accidents in which 25 or more people are seriously injured or killed. Therefore it seems reasonable to believe that when the epidemiology of various kinds of natural disasters is known many of them can also be predicted and prevented or at least controlled (1). Moreover an epidemiologic analysis of the disaster provides a sound basis for public health program planning. The word epidemiology, derived from the Greek epi (on or upon) and demos (the people) implies something inflicted upon the people. Natural disasters, such as earthquakes, as well as diseases, fit this definition. At 10:51 p.m. on September 1, 1962, an earthquake devastated part of the Central Plateau of Iran, a country which suffered motre than 115 major earthquakes from 1904 to 1961. A detailed report of this catastrophe by Saidi (2) is used in this paper as a basis for examination of the epidemiologic approach to public health planning for a natural disaster. It should be made clear that we did not have firsthand observation of the Iranian earthquake. This earthquake was merely used as a conceptual model to illustrate the epidemiology of a natural disaster. Epidemiologists conveniently classify three major types of factors which influence the incidence of a disease-agent factors, host factors, and environmental factors. In natural disasters, the agent would be the factor producing the actual injury or disease; the hosts would be human beings and to a lesser extent animals; and environmental factors, the physical, chemical, biological, and social climates in which a disaster occurs. The epidemiologist initially takes three steps in investigating an epidemic: (a) He confirms the diagnosis. Was there an earthquake and if so, was it a major or a minor one? (b) He determines if there is an epidemic. Was there a disaster killing or seriously injuring 25 or more people? (c) The epidemiologist next characterizes the epidemic as to time, place, and the victims. When did the earthquake take place, how large an area was affected, how much damage was done, approximately how many people were injured, dead, or missing, and what are the immediate needs of the survivors? This type of community diagnosis is essential for intelligent public health program planning and is needed as soon as possible. Like diseases, disasters have definite patterns, so that a knowledge about their usual characteristics may prove valuable. For example, in earthquakes fractures and crushing wounds are the usual types of injuries if seicondary fires have not caused burns and tidal waves have not caused people to drown. Information on the occurrence, duration, direction, and intensity of an earthquake can be obtained through seismograph reports as well as by telephone, radio, and wireless. In the Dr. Parrish is associate professor, Dr. Baker is assistant professor, and Dr. Bishop is associate professor in the department of community health and medical practice, University of Missouri School of Medicine, Columbia.

A Method for Guiding Professional Socialization in Medical Education

A planned curriculum designed to develop professional behaviour can be facilitated by situation simulation with recording and review. Socialization is the process by which an individual learns socially relevant behaviour at various stages in the life cycle. Although the term has been used in relation to children, the process is a general one and is applicable also to adults. A person may, at any age, be introduced to new groups and acquire their values, norms, and behavioural expectations. Professional behaviour is behaviour learned through socialization.

Functional Role Activities of the Private Practitioner: A Method of Investigating Office Practice and Time Study of the Typical Day of 25 Physicians

routine tasks which fall within the competence of their training. With time a vital commodity of modern living and with demands upon their limited manpower increasing steadily, physicians are asking such questions as: How much time do I spend in patient care? How is my time distributed between diagnosis, treatment, administration, counseling and other activities? Can I improve my method of providing health information? Can I save much time with the newer diagnostic and therapeutic aids? Can I arrange my functionalrole activities more expediently and release more time for additional patient care? Can ancillary personnel perform some medical activities? Can the efficiency of may current office