Faculty Bibliography

Network therapy (NT) employs family members and/or friends to support compliance with an addiction treatment carried out in office practice. This study was designed to ascertain whether NT is a useful psychosocial adjunct, relative to a control treatment, for achieving diminished illicit heroin use for patients on buprenorphine maintenance. Patients agreeing to randomization to either NT (N = 33) or medication management (MM, N = 33) were inducted onto short-term buprenorphine maintenance and then tapered to zero dose. NT resulted in significantly more urine toxicologies negative for opioids than MM (65% vs. 45%) and more NT than MM patients (50% vs. 23%) experienced a positive outcome relative to secondary heroin use by the end of treatment. The use of NT in office practice may therefore improve the effectiveness of eliminating secondary heroin use during buprenorphine maintenance. It may also be useful in enhancing compliance with an addiction treatment regimen in other contexts

Medical educators have a responsibility to teach students to communicate effectively, yet ways to accomplish this are not well-defined. Sixty-five percent of medical schools teach communication skills, usually in the preclinical years; however, communication skills learned in the preclinical years may decline by graduation. To address these problems the New York University School of Medicine, Case Western Reserve University School of Medicine, and the University of Massachusetts Medical School collaborated to develop, establish, and evaluate a comprehensive communication skills curriculum. This work was funded by the Josiah P. Macy, Jr. Foundation and is therefore referred to as the Macy Initiative in Health Communication. The three schools use a variety of methods to teach third-year students in each school a set of effective clinical communication skills. In a controlled trial this cross-institutional curriculum project proved effective in improving communication skills of third-year students as measured by a comprehensive, multistation, objective structured clinical examination. In this paper the authors describe the development of this unique, collaborative initiative. Grounded in a three-school consensus on the core skills and critical components of a communication skills curriculum, this article illustrates how each school tailored the curriculum to its own needs. In addition, the authors discuss the lessons learned from conducting this collaborative project, which may provide guidance to others seeking to establish effective cross-disciplinary skills curricula

Ibrahim Shekarau, the Kano state governor whose eight-month moratorium on polio vaccinations has been blamed for the spread of polio widely across Africa, said in an interview on Tuesday that he was ready to resume immunizations. Dr. David L. Heymann, director of W.H.O.'s polio program, said Wednesday that his agency ''welcomes any decision to resume polio vaccinations in [Kano].'' After a formal decision is announced, he said, W.H.O. and its partners, Rotary International and the United Nations children's fund, Unicef, would help conduct a large-scale program from June to August to immunize all children 5 years and younger in Nigeria. A Nigerian child receives a dose of the polio vaccine. The governor of the northern Nigerian state of Kano had opted out of a polio immunization drive, prompted by claims of a link between the vaccine and infertility. (Photo by European Pressphoto Agency)

When the SARS epidemic ended last July, experts were concerned that it would come back from wherever it hid in nature. But officials of the World Health Organization were just as worried about a new epidemic emerging from a SARS sample that escaped from one of the many laboratories working with it. The outbreak began March 25 after a graduate student became infected in China's main SARS laboratory in Beijing. Her case led to two more waves of transmission involving seven people including her mother, who died before her illness was recognized as SARS, or severe acute respiratory syndrome, on April 22. One problem is what happens when you have BL3 and BL4 laboratories in old buildings in developing countries, he went on, adding: What struck me as quite bizarre is, here is a student working in a laboratory that handles SARS, and when she gets a respiratory disease and pneumonia, it takes three weeks before they even tested for SARS. That is a long period of time. In that period, for example, she could have infected fellow passengers on trains

If Plan B ever does go over the counter, doctors will lose the ability to keep track of side effects such as nausea, vomiting, headache and bleeding. Perhaps more importantly, patients might be steered into leaving their doctors out of important medical decisions. When a patient asks me to prescribe a routine birth- control pill (which may contain lower doses of the same progesterone, levonorgestrel, that Plan B contains), she often uses it as an opportunity to discuss not only her fear of pregnancy but also sexually transmitted diseases or other issues. The FDA's track record is mixed. Last December, it bravely banned ephedra because of an acknowledged inability to regulate the dosage or effects of the potent over-the-counter herb. But cold medications, Tylenol and aspirin have shown the potential to damage livers and kidneys after they were already over the counter and beyond the FDA's ability to regulate them. Where should the FDA draw the line? Consider that Plan B is a hormone at least three times as powerful as the progestin found in many prescription-only birth-control pills. Why prescription-only? Because birth-control pills have the potential to cause blood clots and strokes along with other serious complications that increase if the medicine isn't used properly

Merck, Bristol-Myers Squibb and Gilead Sciences said in a joint statement that they were in discussions to develop a one-pill combination of three antiretroviral drugs. The single pill would include two Gilead drugs tenofovir, which the company sells under the brand name Viread, and emtricitabine, which it sells under the brand name Emtriva and a third drug, efavirenz. Bristol-Myers Squibb markets efavirenz under the brand name Sustiva in the United States, Canada and some European countries; Merck sells efavirenz as Stocrin elsewhere. The [Bush] administration had been expected to be the target of heavy criticism at the weeklong meeting for its previous reluctance to approve inexpensive combinations of patented antiretroviral AIDS drugs. AIDS advocacy groups had accused the Bush administration of bowing to pressure from the U.S. pharmaceutical industry by delaying approval of less costly generic copies to promote sales of the more expensive patented originals. It was unclear what had contributed to the administration's change of policy, but international health officials welcomed the announcement. It's a pretty radical change in U.S. policy, if applied, Dr. Peter Piot, the director of the United Nations AIDS program, said in a telephone interview. It will help AIDS treatment programs everywhere

When the SARS epidemic ended last July, experts were concerned that it would come back from wherever it hid in nature. But officials of the World Health Organization were just as worried about a new epidemic emerging from a SARS sample that escaped from one of the many laboratories working with it. 'One problem is what happens when you have BL3 and BL4 laboratories in old buildings in developing countries,' he went on, adding: 'What struck me as quite bizarre is, here is a student working in a laboratory that handles SARS, and when she gets a respiratory disease and pneumonia, it takes three weeks before they even tested for SARS. That is a long period of time.' In that period, for example, she could have infected fellow passengers on trains. Black & White Photo: Peter Dasilva, The New York Times / The World Health Organization recommends that work on SARS be performed in a laboratory classified as Biosafety Level 3, the second-most biologically secure ranking. But according to at least one worried virologist, the world still needs a common definition of what a BL3 lab is.; Black & White Photo: Marilynn K. Yee, The New York Times / A researcher, wearing protective gear and taking in filtered air, works with cells infected with the SARS virus at Columbia University

When the SARS epidemic ended last July, experts were concerned that it would come back from wherever it hid in nature. But officials of the World Health Organization were just as worried about a new epidemic emerging from a SARS sample that escaped from one of the many laboratories working with it. The outbreak began March 25 after a graduate student became infected in China's main SARS laboratory in Beijing. Her case led to two more waves of transmission involving seven people -- including her mother, who died -- before her illness was recognized as severe acute respiratory syndrome on April 22. ''One problem is what happens when you have B.L. 3 and B.L. 4 laboratories in old buildings in developing countries,'' he went on, adding: ''What struck me as quite bizarre is, here is a student working in a laboratory that handles SARS, and when she gets a respiratory disease and pneumonia, it takes three weeks before they even tested for SARS. That is a long period of time.'' In that period, for example, she could have infected fellow passengers on trains