Human speech and blood pressure.

The recent development of a noninvasive automated blood pressure device has revealed a strong relationship between human conversation and blood pressure. Conventional techniques of pressure measurement such as the stethoscope and manometer, which require silence during the measurement, tended to obscure this important relationship. Findings from this study indicate that interpersonal communications surrounding the measurement of blood pressure can rapidly alter systolic and diastolic pressures. In certain situations, changes greater than 20 per cent in systolic and diastolic blood pressure and heart rate can occur within 30 seconds after the initiation of human speech. Such variance can be of critical significance in making clinical judgments concerning hypertension. These findings are discussed in the context of recent nonpharmacological treatment approaches being developed to help control hypertension.

HMO development for primary care team teaching of medical and nursing students.

This article describes a three-year effort to facilitate the development of a university health maintenance organization (HMO) into an effective clinical teaching site for the team practice of primary care. Project staff initiated several activities to promote team development in the HMO. These included review and development of algorithms to guide physician/nurse teams in the care of patients with common problems, workshops on communication and role negotiating skills, and preceptor training. A variety of objective and subjective methods were employed to assess HMO team development and the effectiveness of the HMO as a primary care teaching site. Initial resistance to both team practice and teaching have been overcome. Students who were trained in the project not only acquired good clinical skills but also, perhaps more importantly, developed skills in professional role negotiation and communication as well.

Attempted prevention of diarrheal disease in Apache children with a non-absorbable broad-spectrum antimicrobial.

A double-blind study was conducted to test the prophylactic effect of a non-absorbable broad-spectrum antimicrobial (oral colistin sulfate) against acute diarrhea in Apache children. Children 1 to 6 months old had over twice the morbidity from diarrhea if assigned to the antimicrobial group as compared to placebo, while the toddler group (7-30 months) taking the antimicrobial had somewhat less diarrhea. Enteropathogenic E. coli were significantly more often isolated from the antimicrobial group (but only in well children). No special effect on the children's growth by the antimicrobial was discerned.