INTRODUCTION THE CHEMICAL THREAT AND ENEMY CAPABILITY THE STATUS OF CHEMICAL PROLIFERATION Chemical Warfare Capabilities of Nations International Agreements and Verification Terrorism MILITARY CHEMICAL AGENTS TACTICAL AND STRATEGIC USE OF CHEMICAL WEAPONS Chemical Agent Delivery Systems Physical Properties of Chemical Agents Strategic Concerns in the Use of Toxins Choice of Agent and Delivery S...

The quality of service which could be delivered by the U.S. healthcare system is in contrast with the customer’s perceived expectations and reported levels of satisfaction. Due to the uncertainty about stakeholder views and the anomaly of the third-party payment system, healthcare service providers are accused of not relating to their patients. This article examines how—by using an analytical f...

BACKGROUND External supervision of Rwandan primary healthcare facilities unfolds as an interaction between supervisors and healthcare providers. Their relationship has not been thoroughly studied in Rwanda, and rarely in Africa. AIM To explore perceived characteristics and effects of the relationship between providers in public primary healthcare facilities and their external supervisors in R...

Childhood obesity in Hawai‘i is a signifi cant problem; in some of our rural and low-income communities more than 40% of children entering kindergarten are overweight or obese.1 Studies in this issue of the Hawai‘i Medical Journal Supplement highlight other concerns related to the development of obesity in childhood. The current problems refl ect the complex and rapid changes in our society ove...

Exposure to high altitude imposes significant strain on cardiopulmonary system and the brain. As a consequence, sojourners to high altitude frequently experience sleep disturbances, often reporting restless and sleepless nights. At altitudes above 3,000 meters (9,800 ft) almost all healthy subjects develop periodic breathing especially during NREM sleep. Sleep architecture gradually improves wi...

OBJECTIVES The objective of this study was to determine if Spanish language preference was significantly associated with barriers to healthcare services among a nationally representative sample of Hispanic persons in the United States. DESIGN Cross-sectional analysis of secondary data. Differences in outcomes between those responding in Spanish and those responding in English were tested usin...

People living near environmental hazards may develop symptoms and health conditions that require specialized monitoring and treatment by healthcare providers. One emerging environmental hazard is coal ash. Coal ash is comprised of small particles containing heavy metals, polycyclic aromatic hydrocarbons, and radioactive elements. The overall purpose of this study was to explore whether healthca...

BACKGROUND The rapid global adoption of mobile health (mHealth) smartphone apps by healthcare providers presents challenges and opportunities in medicine. Challenges include ensuring the delivery of high-quality, up-to-date and optimised information. Opportunities include the ability to study global practice patterns, access to medical and surgical care and continuing medical education needs. ...

OBJECTIVES To determine whether patients can understand and use the vaginal pH device in the diagnosis of vaginitis. To compare whether vaginal pH readings determined by patients and healthcare providers are similar. To determine whether vaginal pH can reduce inappropriate over-the-counter (OTC) antifungal medication use and improve the correct diagnosis of vaginitis. METHODS One hundred and ...

The 21st century promises to usher in an era of Internet based healthcare services--Tele-Healthcare. Such services augur well with the on-going paradigm shift in healthcare delivery patterns, i.e. patient centred services as opposed to provider centred services and wellness maintenance as opposed to illness management. This paper presents a Tele-Healthcare info-structure TIDE--an 'intelligent' ...