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Lethbridge Herald, The (Newspaper) - May 3, 1973, Lethbridge, Alberta Thurtday, May 3, 1973 THE LETHiriDGI HIRAID 5 Doctors know too ittle about drugs By Max Wilde, London Observer commentator GENEVA The medical use of drugs is adding substantially to the total risk of daily life, according to Dr. H. Friebel, senior medical officer in charge of drug efficacy and safety in the World Health Organization. A surgeon, Dr. Friebel points has to undergo specific post- graduate training for several years, but comparable post- graduate training for physi- cians in the use of drugs does not exist. "The imbalance be- tween accessibility to potent drugs on the one hand, and pro- fessional trairfhg in the use of on the other, is one of the major problems of today." In a number of first-class hos- piWs consecutive medi- cal 'n-patients have been inten- sively monitored for drug ef- fects. Death due to drugs ad- ministered was recorded in 27 cases, 3.6 per cent of the total hospital deaths. Studies in other hospitals showed higher percentages of drug-related mortality; in one about a quarter of 67 deaths were the result of adverse drug reactions. "I'm looking for LIBERATION, far FULFILLMENT! And what do I a letter, Ms. Smith'." The prescribing physician is admittedly in a very difficult situation. In the United States in 1968, a prescribing physician had at his command a thera- peutic arsenal of some 1.200 generally available drugs and drug combinations. The rate of drug introduction and obsolescence is such that the markrt life of a product aver- ages about five years. As a con- sequence, of the drugs at pres- ent on the market 70 per cent were either unkown or unavail- able 15 years ago, when more than half of America's physicians were receiving their pharmaceutical t r r. i n i n g in medical school. The physician is thus forced constantly to ab- sorb new information on drugs in order to meet the standards of knowledge corresponding to his responsibilities. Dr. Friebel asks: "Can he satisfy his need for continuous information and education? Does he have access to unbias- ed information? Is he willing or able to spend time reading the literature regularly? Can he find a deputy for his practice and money to visit refresher In countries with an advanc- ed medical infrastructure there are opportunities for continuing education, but the poorer the country the more difficult it is for the physician to adapt him- self to the changing drug scene. At the same time, the tempta- tion to prescribe therapeutic novelties is the same in both cases "since the busy phar- maceutical industry is eager to export new products to even the remotest places." The con- clusion arrived at by Dr. Frie- bel is that "where the medical infrastructure is well developed, it may be possible though dif- ficult to close the informa- tional and educational gap in relation to the proper use of drugs, but where the conditions are inadequate the gap will continue to grow." Why have patients become in- creasingly ready to .demand drugs, and doctors increasingly reedy to prescribe drugs, tor trivial complaints? "Some blame the excessive use of drugs, especially new drugs, on the pharmaceutical industry, which by skilful promotion en- courages their use. Some doc- tors appear to be too easily per- suaded by drugs promotion. Some seem to wish to prove either to their patients or to themselves that they are up- to-date and modern by always using 'the latest drug'." In a number of countries, in- cluding France, the United Kingdom and the United States, doctors' and consum- ers' characteristics and motives in prescribing ana using certain drugs are being investigated. There is clearly no such thing as a completely safe drug. Even the minor analge- sics (painkillers) which are freely sold over the counter without prescription in most countries, and which are often combinations of aspirin, phen- acetin and caffeine, can give rise to fatal kidney disease. A recent investigation in Scot- land among people younger than 65, showed that there were ap- proximately five deaths per million from this cause. With other major categories 01 drugs, fatal cases per million prescrip- tions varied from 10 to 0.2, while non-fatal adverse ef- fects were 10 times higher. The World Health Organiza- tion, like the Food and Drug Administration of the U.S. re- gards effectiveness and safety as being intertwined, any con- sideration of safety involving DATSUN 1200 carries on the tradition of the classic 2-door coupe. The 2-door coupe has made automotive history. It's tough, it's quick. And traditionally, it looks a lot sportier than its bigger brothers When Datsun set out to design the best 2-door coupe around, we stuck to principles that made the coupe a classic. The '37 Ford Coupe (centre right) gave you maximum comfort in its day For its time, the '39 Packard Opera Coupe (.centre left) handled like a dream. Our own 1932 Drisun coupe (that's it in the background) was one of the toughest, most dependable cars built that year. 1 Books in brief "Tales From the Long- house" by the Indian Chil- dren of British Colombia. Gray's Publishing Ltd. 112 pages. While this book is written by children, the legends and the stories included therein are for everybody. The children, gathering the tales from their parents and grandparents, took six years to compile this intri- guing piece. The result of their work is an entertaining text in a superbly printed and bound book. The legends, with the occas- ional factual story included, show the deep kinship between the Indian and mother nature. Many of the tales delve into the origins of many animals and tribal customs, e.g.: a par- ticular tribe makes baskets; where the tribal name origin- ated; or why there's foam at the water's edge. A unique presentation c o n- cerning Indian folklore. GARRY ALLISON "Christie Malrv 's Own Double Entry" by B. S. John- son (Collins, 238 pages. I don't know whether B. S. Johnson has done it again this is the first Johnson book I've read but he won't do it to me again. Again, I don't know whether it's B. S. Johnson's most im- portant book to date because he will probably write another one. Once you get the knack, keep on going. Christie Malry takes a job as a junior bank clerk and then seeks to balance his account with society. You have to mine a lot of ore to get to the chuckles. No sus- pense and few surprises. Poets don't make good novelists. But then, we don't all laugh at the same things. More like Punch than Andy Capp. D'ARCY RICKARD In the Datsun 1200, we've simply updated these features with a large dollop of modern technology and the feel for good solid auto building that's been our trademark over the last 40 years So when you want tough, quick, sporty transportation, we think our Datsun 1200 is all you really need. And the man you need to see. FOREIGN CAR (LETHBRIDGE) LTD. 1102 3rd Avenue South Lethbridgt, Alberta Tel: 328-9651 G. S. SALES SERVICE LTD. 437 Victoria Street, Box 645 Blairmore, Alberta Tel: 562-2134 CARDSTON FARM SERVICE LTD. 124 Main Street, Bor 820 Corditon, A'berta Tel: 653-3346 There are more than 1300 Datsun. dealers across Canada and the United States. DATSUN DATSUN HENKER FARM EQUIPMENT LTD. 4419 lit Street Clareshotm, AlberlQ Tel: 235.3110 CHINOOK SERVICE (TABER) LTD. 5332 46th Avenue, Box 249 Taber, Alberta Tel: 223-3063 HARRY'S AUTO SERVICE LTD. 2111 Avenue, Box 270 Coaldale, Alberta Tel: 345-3390 "Prairie Storekeeper" by D. E. Macintyre (Peter Mar- tin Associates Ltd., MI pages, D. E. Macintyre has attempt- ed to give a glimpse of his life as a storekeeper in a rural Saskatchewan settlement of Tuxford, then only a cross- roads. Dissatisfied with read- ing about the suffering during the "Dirty Thirties1' he wants to show the happy boom years between 1904-1913 when droves of settlers flocked West with little money but of hope. His book is a series of inci- dents including local square dances, editorship of The Stan- dard, a paper lasting three issues, a tornado and an en- counter with Montana horse thieves. Included also a re sketchy impressions of people among whom he worked and lived. Although by no means an ex- citing hook it may be of some value to Canadian historians but especially to those who like to, reminisce. ELSIE MORRIS weighing the therapeutic value against the possible toxic ef- fects as well as against the risk and effectiveness of other avail- ab'e agents. Of pre-clinical testing of drugs, in the laboratory or on experimental animals, Dr. Friebel says that "scientists can disagree among themselves as much as lawyers do." These disagreements work both ways: some drugs which have caused adverse effects on animals or their offspring need not have such effects on human beings, while harmlessness to experi- mental animals is no guaran- tee of harmlessness to _man. As a result there is a great deal of confusion and inconsis- tency in the rules governing the distribution and application of drugs. For example, four substences prohibited in Austral- ia and some others restricted in the United States, are freely available over the counter in West Germany and Finland. Cyclamates were banned from all food and drug products in 1971 by the U.S. Food and Drug Administration, but sodium cyc- lamate may be offered as an al- ternative to sugar at the tab'e in some first-class Swiss rest- aurants. W.H.O. has set up a research centre for international drug monitoring which now collab- orates with national centres in 15 countries. At a recent sym- posium held in Heidelberg, sponsored by W.H.O. and the West German government, a recommendation was made that the basic cost of clinical pharmacology units should be borne by the government or community: "The pharmaceut- ical industry" it said "can make useful contributions in the form of grants, fellowships, payment for contract research, etc.. but it should not be allow- ed to determine policies and The bottle drive By Terence Morris, Fleetwood-Bowden School We had a school bottle drive recently. About 12 adults plus an uncertain number of children scoured the neighborhood for contributions. It was fascinating to see the children in action. They ran, trotted, skip- ped or jogged; but rarely walked. Their energy was limilless. It was exhausting to watch them. Is it any wonder that students get so restless in school? We all know the pattern too many students, each restricted to his own hard desk, and all jammed into one medium sized box. Pily the poor stu- dents as they try to contain the'r exuber- ant energy until the brief recess. Piy the poor teachers as they try to keep the stu- dents interested in quiet, meaningful work. Sursly we could find better ways to oc- cupy and organize studenls and teachers in school? Supporting the bottle hunters were the stoical adults. They drove cars, helped children, stored, and finally sold the bot- tles. Many hours of precious free time were willing'y donated to help bwst school funds. L's fantastic the amount of free help that is available to schools. There are parents who have lots of prac- tical experience in helping and loving chil- dren. There are parenfs who are recog- nized authorities in their own field of study but are not certificated pro'essional edu- cators (whatever that may Strange that with such talent available we are oPen reluctant to welcome parents and other cit- izens as partners in the school program. If that sounds too harsh then why are home and school associations almost de- funct? Why did school councils receive the thumbs down signal although school trust- ees gave their enthusiastic support? Whsn the bottles and cans were sold over was received. That's a lot of money. Were the parents who raised that money intending to keep it i'or their special pro- jects? No sir. II will be used to pay home and school affiliation fees and to support school projects. When it comes to giving a helping hind to the local school, how wonderfully gen- erous people are. Merchan's donate prizes and advertising money to school raffles or year books. The news media devote ex- pensive space and time to pub'ic educa- tion. Parents and interested citizens give time and money to support school func- tions. All this is in addition to the tax money earmarked for education by our governments. It is not surprising that peo- ple sometimes query, generally in a friendly way. if our school systems are as free of waste as they should be. Heaven protect us from the accountabil- ity fad that could turn our schoo's into sausage producing factories but are we doing the best possible JDb in our schools? Are we making the best possible use of our lavish resources? It's a simple question; school trustees in the province might find the answers interesting and informative. ANDY RUSSELL A desert in bloom WATERTON LAKES PARK We think of the desert as being a vast waste of sand, sun-blasted and dry, where the dis- tances fade into haze and mirages. Ordin- arily it is a place of limited life cactus, thorn brush; a few birds, lizards, snakes and rats with perhaps a scattering of bie- g3r animals living within reach of scanty springs and water holes. Men pass through journeying for places beyond leaving relatively few marks of their passing, compared to more fertile places in this wilderness of sand plains and mountains cut and rifted by gullies and canyons. At night it is usually cold but in daytime It can be as hot as a blast, furnace with heat waves dancing across the flats and the outlines of the mountains curling and shim- mering against the sky. It has its own special kind of beauty, but it is also stark, merciless and cruel, getting small comfort from nature and giving no quarter to any- thing that lives there. But always there is promise. In spite of harshness there is a certain magnificence. Even in the face of hopelessness there is hope. For the dessrt is the crucible of na- ture. Hidden everywhere among the grains of sand and rocks there are a host of ac- cumulated seeds lying inert, perfectly pre- served, waiting patiently, sometimes for decades until the rains come to allow them to germinate and grow. Last winter more rain and snow fell in the deserts of the southwest than has been seen for many years. East of the south rim of the Grand Canyon in the vast reaches of the Navajo reservation the win- ter was so severe that heavy losses were suffered among the Indian's livestock. Snow still lingered in some of thj sheltered places when my wife and I drove through this region in early April. When we came to the big Arizona desert country farther west and south the sun was dipping over the horizon and we drove in the dark for fifty miles until we came to a place to stay for the night. Early next morn- ing we woke to a completely nsw sight a desert was not a desert any more. It was transformed. The shimmering silver of water in the distance was not a mirage it was a lake that had been formed where no water had collected for over half a century- For the most part the sand was hidden by rich green growth and the colors of millions of flowers. As far as the could see, the flats, rolling hil'e arid mountains were painted with masses of bloom yellow, blue, or- ange and purple. When we walked out across it for twenty steps our boots and pants were yellow with pollen up to our knees. The abundance and diversity of subject material was a bonanza for a na- ture photographer. Here and there the fine sand between the plants was marked with a delicate lacework of small animal and reptile tracks. In one place along the rim of a wash I ssw the tracks of a foraging bobcat and in the distance the glasses picked up the heliographing flash of the rump patches of a small bunch of prong- horn antelope. In another place we saw the famed roadrunner, a peculiar bird of the arid desert regions, which lives on rep- tiles and small mammals and can run like a streak. People who live on and near the desert for a lifetime will tell you that they have never seen a roadrunner fly and some of them doubt if they can. But the one and only roadrunner we saw flew across a wash for us just to prove that he could navigate in the air, and did it very well. Accustomed to the plants of the plains and mountains of western and northern Canada, I was at a complete loss to name any of the flowering plants I photographed, although some of the general families were recognized. We were witnessing a botanical wonder for nothing like this display has been seen for 61 years. All day -west out of Arizona into California, we travelled through flowers. Then it was no ent. The Mnjave desert was splashed with thousands of acres of the brilliant orange of California poppies flowering so thick one could not step without crushing the blooms. It was a once-in-a-lifetime experience a proof of nature's promises being kept. The work ethic From The Wall Street Journal Not long ago the New York state con- troller reported widespread "under-uii'iza- tion of employee time" in other words, goofing-off at taxpayer expense. The report was denied of course, vet it obviously hit pretty close to home. It found, for example, that city water meter readers did one-half the work of employees performing similar jobs in pri- vate industry, that building inspectors gold- brick one-third of their time, that truck crews average only a half-day's actual work each day (or twice as much as road re- pair truck crews, performance-WES recently measured at about two hours daily by The New York But low productivity is not confined to the public sector. Private industry is simi- larly afflicted. Several months ago "Engineering News- McGraw Hill's construction weekly, published an extended analysis of the sort of restrictive labor union prac- tices and low production quotas that, ac- cording to the publication, waste from 15 per cent to 40 per cent of every construc- tion dollar. For example, one mrMer in accordance with a union requirement that he be paid for every hour that any man is working en the job (either one of his mechanics or an ou.side was more than one year in base salary and a whop- ping in overtime. Coffee bresks not uncommonly erode 15 per cent of a seven hour day. Jurisdictional disputes over things like which union is respons ble for holding the nozz'e on a fuel truck dur- ing fueling operations have caused hund- reds of stoppages and cist hundiecls of thousands of dollars in delavs In both the private r.nd public sector, the work ctliic the belief tn the d'gni'y of honest toil, the feeling of accomplishment at having helped produce something worth- while clearly has fallen on hard times. We worry that the greatest effect of this is on the character of a people. Work is mt always enjoyable, and certainly loafing has been known to all tjnes and ages. Yet work is necessary to progress, and we wonder how long a society can remain vi- able if too many people are content to get by without effort. ;