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Sample records for defense medical human

  1. Defense Human Resources Activity > PERSEREC

    Science.gov (United States)

    Skip to main content (Press Enter). Toggle navigation Defense Human Resources Activity Search Search Defense Human Resources Activity: Search Search Defense Human Resources Activity: Search Defense Human Resources Activity U.S. Department of Defense Defense Human Resources Activity Overview

  2. DMHRSwhy? The Value of the Defense Medical Human Resource System-Internet (DMHRSi) to the Military Health System (MHS)

    Science.gov (United States)

    2015-02-01

    ABSTRACT The Military Health System (MHS) uses a variety of systems and processes to manage its most important asset ???its people. Chief among the...Health System (MHS) uses a variety of systems and processes to manage its most important asset …its people. Chief among the systems employed to do...enhanced multi-service market FTE full-time equivalent HRM human -resource management LCA labor cost assignment MEPRS Medical Expense

  3. EDUCATIONAL NETWORKING: HUMAN VIEW TO CYBER DEFENSE

    OpenAIRE

    Oleksandr Yu. Burov

    2016-01-01

    Networks play more and more important role for human life and activity, both in critical occupations (aviation, power industry, military missions etc.), and in everyday life (home computers, education, leisure). Interaction between human and other elements of human-machine system have changed, because they coincide in the information habitat. Human-system integration has reached new level of defense needs. The paper will introduce features of information society in respect of a human and corr...

  4. Rethinking medical humanities.

    Science.gov (United States)

    Chiapperino, Luca; Boniolo, Giovanni

    2014-12-01

    This paper questions different conceptions of Medical Humanities in order to provide a clearer understanding of what they are and why they matter. Building upon former attempts, we defend a conception of Medical Humanities as a humanistic problem-based approach to medicine aiming at influencing its nature and practice. In particular, we discuss three main conceptual issues regarding the overall nature of this discipline: (i) a problem-driven approach to Medical Humanities; (ii) the need for an integration of Medical Humanities into medicine; (iii) the methodological requirements that could render Medical Humanities an effective framework for medical decision-making.

  5. Journal of Medical Chemical, Biological and Radiological Defense

    International Nuclear Information System (INIS)

    Price, B.

    2007-01-01

    The Journal of Medical Chemical, Biological, and Radiological Defense is a free, on-line journal dedicated to providing an international, peer-reviewed journal of original scientific research and clinical and doctrinal knowledge in the area of medical treatment and countermeasures for chemical, biological and radiological defense; and to developing and maintaining an archive of current research and development information on training, doctrine, and professional discussions of problems related to chemical, biological and radiological casualties. The Journal, www.JMedCBR.org, now in its fifth year, is sponsored by the US Defense Threat Reduction Agency. Areas of interest include, but are not limited to: Neuroprotectants; Bioscavengers for Nerve Agents; Medical Diagnostic Systems and Technologies; Medical Effects of Low Level Exposures; Toxicology and Biological Effects of TICs and TIMs; Broad Spectrum Medical Countermeasures; Treatments and Therapeutics for Bacterial, Viral and Toxin Agents; Radiological Medical Countermeasures; Clinical Treatment of Chemical, Biological or Radiological Casualties; Toxins Structures and Treatments. The Journal is supported by an editorial advisory board of distinguished scientists and researchers in the fields of CBR defense and medical treatment and countermeasures in eleven countries.(author)

  6. EDUCATIONAL NETWORKING: HUMAN VIEW TO CYBER DEFENSE

    Directory of Open Access Journals (Sweden)

    Oleksandr Yu. Burov

    2016-05-01

    Full Text Available Networks play more and more important role for human life and activity, both in critical occupations (aviation, power industry, military missions etc., and in everyday life (home computers, education, leisure. Interaction between human and other elements of human-machine system have changed, because they coincide in the information habitat. Human-system integration has reached new level of defense needs. The paper will introduce features of information society in respect of a human and corresponding changes in HF/E: (1 information becomes a tool, goal, mean and environment of a human activity, (2 it becomes a part of the human nature and this makes him/her unprotected, (3 human psycho-physiological status becomes not only a basis of effective performance, but an object of control and support, and means of a human security and safety should be a part of information habitat, (4 networking environment becomes an independent actor in a human activity. Accompanying cyber-security challenges and tasks are discussed, as well as types of networking threats and Human View regarding the cyber security challenges.

  7. Medical humanities in the undergraduate medical curriculum.

    Science.gov (United States)

    Supe, Avinash

    2012-01-01

    The medical humanities have been introduced in medical curricula over the past 30 years in the western world. Having medical humanities in a medical school curriculum can nurture positive attitudes in the regular work of a clinician and contribute equally to personality development. Though substantial evidence in favour of a medical humanities curriculum may be lacking, the feedback is positive. It is recommended that medical humanities be introduced into the curriculum of every medical school with the purpose of improving the quality of healthcare, and the attitudes of medical graduates.

  8. Improving Defense Health Program Medical Research Processes

    Science.gov (United States)

    2017-08-08

    research , including a Business Cell; 87 Research Development, 88 Research Oversight, 89 and Research Compliance offices;90 and the Center...needed for DHP medical research , such as the Army’s Clinical and Translational Research Program Office, 38 the Navy’s Research Methods Training Program... research stated, “key infrastructure for a learning health system will encompass three core elements: data networks, methods , and workforce.” 221

  9. Nanorobot Hardware Architecture for Medical Defense

    Directory of Open Access Journals (Sweden)

    Luiz C. Kretly

    2008-05-01

    Full Text Available This work presents a new approach with details on the integrated platform and hardware architecture for nanorobots application in epidemic control, which should enable real time in vivo prognosis of biohazard infection. The recent developments in the field of nanoelectronics, with transducers progressively shrinking down to smaller sizes through nanotechnology and carbon nanotubes, are expected to result in innovative biomedical instrumentation possibilities, with new therapies and efficient diagnosis methodologies. The use of integrated systems, smart biosensors, and programmable nanodevices are advancing nanoelectronics, enabling the progressive research and development of molecular machines. It should provide high precision pervasive biomedical monitoring with real time data transmission. The use of nanobioelectronics as embedded systems is the natural pathway towards manufacturing methodology to achieve nanorobot applications out of laboratories sooner as possible. To demonstrate the practical application of medical nanorobotics, a 3D simulation based on clinical data addresses how to integrate communication with nanorobots using RFID, mobile phones, and satellites, applied to long distance ubiquitous surveillance and health monitoring for troops in conflict zones. Therefore, the current model can also be used to prevent and save a population against the case of some targeted epidemic disease.

  10. Evasion of host immune defenses by human papillomavirus.

    Science.gov (United States)

    Westrich, Joseph A; Warren, Cody J; Pyeon, Dohun

    2017-03-02

    A majority of human papillomavirus (HPV) infections are asymptomatic and self-resolving in the absence of medical interventions. Various innate and adaptive immune responses, as well as physical barriers, have been implicated in controlling early HPV infections. However, if HPV overcomes these host immune defenses and establishes persistence in basal keratinocytes, it becomes very difficult for the host to eliminate the infection. The HPV oncoproteins E5, E6, and E7 are important in regulating host immune responses. These oncoproteins dysregulate gene expression, protein-protein interactions, posttranslational modifications, and cellular trafficking of critical host immune modulators. In addition to the HPV oncoproteins, sequence variation and dinucleotide depletion in papillomavirus genomes has been suggested as an alternative strategy for evasion of host immune defenses. Since anti-HPV host immune responses are also considered to be important for antitumor immunity, immune dysregulation by HPV during virus persistence may contribute to immune suppression essential for HPV-associated cancer progression. Here, we discuss cellular pathways dysregulated by HPV that allow the virus to evade various host immune defenses. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  11. In Defense of Pharmaceutically Enhancing Human Morality.

    Science.gov (United States)

    Protopapadakis, Evangelos D

    2017-01-01

    I will discuss the prospect of pharmaceutically enhancing human morality and decision making in such a way as to eliminate morally unjustifiable choices and promote desirable ones. Our species in the relatively short period since it has emerged has enormously advanced in knowledge, science, and technical progress. When it comes to moral development, the distance it has covered is almost negligible. What if we could medically accelerate our moral development? What if we could once and for all render our species totally immune to certain vices? I will examine whether pharmaceutically intervening in human morality would compromise the autonomy of moral agents. I will argue that the argument from the autonomy of the moral agent is neither stable nor convincing. In the light of Kantian ethics we might consider moral enhancement by pharmaceutical means to be a perfect duty for moral agents.

  12. The Society's Involvement in the Defense of Human Rights

    Science.gov (United States)

    Gerjuoy, Edward

    2015-04-01

    The history of the Society's involvement in the defense of human rights, a history of which the Society can be proud, will be summarized; the summary will include illustrative specific APS human rights defense actions in illustrative specific cases. As will be emphasized, the aforesaid involvement has been primarily through the activities of the APS Committee on International Freedom of Scientists (CIFS). It is noteworthy-and one of the reasons the Society can be proud-that CIFS is charged with ``monitoring concerns regarding human rights for scientists,'' not solely for physicists, and that CIFS indeed has sought to protect the human rights of nonphysicists.

  13. Human biomonitoring in civil defense; Humanbiomonitoring im Bevoelkerungsschutz

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Michael; Schmiechen, Katharina [Universitaetsmedizin Goettingen (Germany). Arbeits-, Sozial- und Umweltmedizin

    2012-07-01

    The booklet on human biomonitoring (HBM) in civil defense covers the following issues within two sections: (1) general part: definition and importance of human biomonitoring; application in civil defense; practice in a CBRN (chemical, biological, radiation, nuclear) scenario; sampling following a CBRN assignment; HBM for antidote administration; peculiarities of sampling in case of biological agents; microbiological detection procedure; human biomonitoring of radioactive metal isotopes. (2) Special part: substance profiles; list of HBM laboratories; list of poison information centers; questionnaire for exposure assessment in case of dangerous substance accidents; agreement for human biomonitoring examination.

  14. Ego defense mechanisms in Pakistani medical students: a cross sectional analysis

    Directory of Open Access Journals (Sweden)

    Khalid Roha

    2010-01-01

    Full Text Available Abstract Background Ego defense mechanisms (or factors, defined by Freud as unconscious resources used by the ego to reduce conflict between the id and superego, are a reflection of how an individual deals with conflict and stress. This study assesses the prevalence of various ego defense mechanisms employed by medical students of Karachi, which is a group with higher stress levels than the general population. Methods A questionnaire based cross-sectional study was conducted on 682 students from five major medical colleges of Karachi over 4 weeks in November 2006. Ego defense mechanisms were assessed using the Defense Style Questionnaire (DSQ-40 individually and as grouped under Mature, Immature, and Neurotic factors. Results Lower mean scores of Immature defense mechanisms (4.78 were identified than those for Neurotic (5.62 and Mature (5.60 mechanisms among medical students of Karachi. Immature mechanisms were more commonly employed by males whereas females employed more Neurotic mechanisms than males. Neurotic and Immature defenses were significantly more prevalent in first and second year students. Mature mechanisms were significantly higher in students enrolled in Government colleges than Private institutions (p Conclusions Immature defense mechanisms were less commonly employed than Neurotic and Mature mechanisms among medical students of Karachi. The greater employment of Neurotic defenses may reflect greater stress levels than the general population. Employment of these mechanisms was associated with female gender, enrollment in a private medical college, and students enrolled in the first 2 years of medical school.

  15. Medical humanities' challenge to medicine.

    Science.gov (United States)

    Macnaughton, Jane

    2011-10-01

    Medicine is predicated on a view of human nature that is highly positivist and atomistic. This is apparent in the way in which its students are taught, clinical consultations are structured and medical evidence is generated. The field of medical humanities originally emerged as a challenge to this overly narrow view, but it has rarely progressed beyond tinkering around the edges of medical education. This is partly because its practitioners have largely been working from within a pervasive medical culture from which it is difficult to break free, and partly because the field has been insufficiently armed with scholarly thinking from the humanities. This is beginning to change and there is a sign that research in medical humanities has the potential to mount a persuasive challenge to medicine's ways of teaching, working and finding out. This article problematizes medicine's narrow viewpoint, grounding its critique in philosophical ideas from phenomenology and pragmatism. I will reflect upon the historical context within which medical humanities has emerged and briefly examine specific examples of how its interdisciplinary approach, involving humanities scholars with clinicians and medical scientists, may develop new research directions in medicine. © 2011 Blackwell Publishing Ltd.

  16. Boundaries of Humanities: Writing Medical Humanities

    Science.gov (United States)

    Bolton, Gillie

    2008-01-01

    Literature and medicine is a discipline within medical humanities, which challenges medicine to reconfigure its scientific model to become interdisciplinary, and be disciplined by arts and humanities as well as science. The psychological, emotional, spiritual and physical are inextricably linked in people, inevitably entailing provisionality,…

  17. Insights from human studies into the host defense against candidiasis.

    Science.gov (United States)

    Filler, Scott G

    2012-04-01

    Candida spp. are the most common cause of mucosal and disseminated fungal infections in humans. Studies using mutant strains of mice have provided initial information about the roles of dectin-1, CARD9, and Th17 cytokines in the host defense against candidiasis. Recent technological advances have resulted in the identification of mutations in specific genes that predispose humans to develop candidal infection. The analysis of individuals with these mutations demonstrates that dectin-1 is critical for the host defense against vulvovaginal candidiasis and candidal colonization of the gastrointestinal tract. They also indicate that CARD9 is important for preventing both mucosal and disseminated candidiasis, whereas the Th17 response is necessary for the defense against mucocutaneous candidiasis. This article reviews the recent studies of genetic defects in humans that result in an increased susceptibility to candidiasis and discusses how these studies provide new insight into the host defense against different types of candidal infections. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Rejecting medical humanism: medical humanities and the metaphysics of medicine.

    Science.gov (United States)

    Bishop, Jeffrey P

    2008-03-01

    The call for a narrative medicine has been touted as the cure-all for an increasingly mechanical medicine. It has been claimed that the humanities might create more empathic, reflective, professional and trustworthy doctors. In other words, we can once again humanise medicine through the addition of humanities. In this essay, I explore how the humanities, particularly narrative medicine, appeals to the metaphysical commitments of the medical institution in order to find its justification, and in so doing, perpetuates a dualism of humanity that would have humanism as the counterpoint to the biopsychosociologisms of our day.

  19. Human Factors and Medical Devices

    International Nuclear Information System (INIS)

    Dick Sawyer

    1998-01-01

    Medical device hardware- and software-driven user interfaces should be designed to minimize the likelihood of use-related errors and their consequences. The role of design-induced errors in medical device incidents is attracting widespread attention. The U.S. Food and Drug Administration (FDA) is fully cognizant that human factors engineering is critical to the design of safe medical devices, and user interface design is receiving substantial attention by the agency. Companies are paying more attention to the impact of device design, including user instructions, upon the performance of those health professionals and lay users who operate medical devices. Concurrently, the FDA is monitoring human factors issues in its site inspections, premarket device approvals, and postmarket incident evaluations. Overall, the outlook for improved designs and safer device operation is bright

  20. Medical devices and human engineering

    CERN Document Server

    Bronzino, Joseph D

    2014-01-01

    Known as the bible of biomedical engineering, The Biomedical Engineering Handbook, Fourth Edition, sets the standard against which all other references of this nature are measured. As such, it has served as a major resource for both skilled professionals and novices to biomedical engineering.Medical Devices and Human Engineering, the second volume of the handbook, presents material from respected scientists with diverse backgrounds in biomedical sensors, medical instrumentation and devices, human performance engineering, rehabilitation engineering, and clinical engineering.More than three doze

  1. The Department of Defense's Civilian Human Capital Strategic Plan Does Not Meet Most Statutory Requirements

    National Research Council Canada - National Science Library

    Farrell, Brenda S

    2008-01-01

    To examine the extent to which DOD's civilian human capital strategic plan addresses congressional reporting requirements, we obtained and analyzed the "Department of Defense Civilian Human Capital...

  2. Medical Humanities in Nepal: Present Scenario.

    Science.gov (United States)

    Dhakal, Ajaya Kumar; Shankar, P Ravi; Dhakal, Sanjaya; Shrestha, Devendra; Piryani, Rano Mal

    2014-01-01

    Humanities have an essential role in medical education. The current gap between the humanities and medicine has to be bridged and there should be continuous and vigorous debate about the theory and practice of medical humanities. Medical humanities is a relatively new concept even in developed countries, and is at infancy stage in developing countries. In Nepal, modules on medical humanities have been initiated in certain medical schools by enthusiastic faculties and it requires further debates for inclusion in curriculum.

  3. Human Milk Hyaluronan Enhances Innate Defense of the Intestinal Epithelium*

    Science.gov (United States)

    Hill, David R.; Rho, Hyunjin K.; Kessler, Sean P.; Amin, Ripal; Homer, Craig R.; McDonald, Christine; Cowman, Mary K.; de la Motte, Carol A.

    2013-01-01

    Breast-feeding is associated with enhanced protection from gastrointestinal disease in infants, mediated in part by an array of bioactive glycan components in milk that act through molecular mechanisms to inhibit enteric pathogen infection. Human milk contains hyaluronan (HA), a glycosaminoglycan polymer found in virtually all mammalian tissues. We have shown that synthetic HA of a specific size range promotes expression of antimicrobial peptides in intestinal epithelium. We hypothesize that hyaluronan from human milk also enhances innate antimicrobial defense. Here we define the concentration of HA in human milk during the first 6 months postpartum. Importantly, HA isolated from milk has a biological function. Treatment of HT-29 colonic epithelial cells with human milk HA at physiologic concentrations results in time- and dose-dependent induction of the antimicrobial peptide human β-defensin 2 and is abrogated by digestion of milk HA with a specific hyaluronidase. Milk HA induction of human β-defensin 2 expression is also reduced in the presence of a CD44-blocking antibody and is associated with a specific increase in ERK1/2 phosphorylation, suggesting a role for the HA receptor CD44. Furthermore, oral administration of human milk-derived HA to adult, wild-type mice results in induction of the murine Hβ D2 ortholog in intestinal mucosa and is dependent upon both TLR4 and CD44 in vivo. Finally, treatment of cultured colonic epithelial cells with human milk HA enhances resistance to infection by the enteric pathogen Salmonella typhimurium. Together, our observations suggest that maternally provided HA stimulates protective antimicrobial defense in the newborn. PMID:23950179

  4. Charges Assessed the Army by the Defense Logistics Agency for Deployable Medical Systems

    National Research Council Canada - National Science Library

    1995-01-01

    .... Deployable medical systems are standardized modular field hospitals that can be prepositioned in the event of a contingency, national emergency, or war operations. In FY 1994, the Defense Personnel Support Center billed the Army $25 million for acquiring and assembling deployable medical systems.

  5. Unified Medical Command and Control in the Department of Defense

    Science.gov (United States)

    2012-03-22

    This is the Joint Task Force – Capital Medical (JTF CAPMED ) model, in which organizations, resources, and personnel are aligned under a single...This was demonstrated in the formation of the JTF- CAPMED , designed as a 3-star level command controlling military medical activities in the National...used ground vehicles, helicopters and fixed wing aircraft for strategic casualty evacuation (CASEVAC). Enroute care is standard and critical in

  6. Archives: Egyptian Journal of Medical Human Genetics

    African Journals Online (AJOL)

    Items 1 - 34 of 34 ... Archives: Egyptian Journal of Medical Human Genetics. Journal Home > Archives: Egyptian Journal of Medical Human Genetics. Log in or Register to get access to full text downloads.

  7. The journal of medical chemical, biological and radiological defense, an update

    International Nuclear Information System (INIS)

    Price, B. B. S.; Peitersen, L.E.

    2009-01-01

    The Journal of Medical Chemical, Biological, and Radiological Defense (www.JMedCBR.org) is a peer-reviewed scientific online journal focusing on the biology, chemistry, physiology, toxicology and treatment of exposure to threat agents. JMedCBR provides a central international forum for the publication of current research and development information on medical chemical, biological and radiological defense, as well as training, doctrine, and problems related to chemical, biological and radiological casualties. JMedCBR is sponsored by the US Defense Threat Reduction Agency (DTRA) Chem-Bio Technologies Directorate as part of its scientific outreach program in chemical and biological defense solutions for the Department of Defense. In addition to scientific and medical research, JMedCBR hosts an archive of related papers from authors in the field. Although organized into annual issues, articles are published on the web continuously. The complete JMedCBR is published electronically and is made available to the scientific community free of charge. JMedCBR is committed to providing its readers with quality scientific information and critical analyses. All submissions are peer-reviewed by an editorial board of recognized and respected international scientists who represent expertise in different aspects of medical chemical, biological and radiological defense. Contributions to JMedCBR must be original works of the author(s) and must not have been previously published or simultaneously submitted to other publications. The author(s) transfer the copyright of articles published in JMedCBR to the journal. A copyright transfer form must accompany each manuscript submission. For more information on submitting to JMedCBR, see the Authors' Guide, available at http://www.jmedcbr.org/authorGuide.html.(author)

  8. The defendant in a medical malpractice suit: an integral part of the defense team

    International Nuclear Information System (INIS)

    Petrek, F.R. Jr.; Slovis, M.R.

    1998-01-01

    This article explains the litigation process of a medical malpractice suit and offers suggestions to help pediatric radiologists cope with the stress of being sued. It provides tangible ways in which the pediatric radiologist can become an important part of the defense team. Our goal is to enable the pediatric radiologist to place the lawsuit in a proper perspective and demonstrate the importance of providing medical insight to aid in forming legal strategy. (orig.)

  9. Advancing the defensive explanation for anxiety disorders: lorazepam effects on human defense are systematically modulated by personality and threat-type

    NARCIS (Netherlands)

    Perkins, A. M.; Ettinger, U.; Weaver, K.; Schmechtig, A.; Schrantee, A.; Morrison, P. D.; Sapara, A.; Kumari, V.; Williams, S. C. R.; Corr, P. J.

    2013-01-01

    Clinically effective drugs against human anxiety and fear systematically alter the innate defensive behavior of rodents, suggesting that in humans these emotions reflect defensive adaptations. Compelling experimental human evidence for this theory is yet to be obtained. We report the clearest test

  10. Emphasizing humanities in medical education: Promoting the integration of medical scientific spirit and medical humanistic spirit.

    Science.gov (United States)

    Song, Peipei; Tang, Wei

    2017-05-23

    In the era of the biological-psychological-social medicine model, an ideal of modern medicine is to enhance the humanities in medical education, to foster medical talents with humanistic spirit, and to promote the integration of scientific spirit and humanistic spirit in medicine. Throughout the United States (US), United Kingdom (UK), other Western countries, and some Asian countries like Japan, many medical universities have already integrated the learning of medical humanities in their curricula and recognized their value. While in China, although medical education reform over the past decade has emphasized the topic of medical humanities to increase the professionalism of future physicians, the integration of medical humanity courses in medical universities has lagged behind the pace in Western countries. In addition, current courses in medical humanities were arbitrarily established due to a lack of organizational independence. For various reasons like a shortage of instructors, medical universities have failed to pay sufficient attention to medical humanities education given the urgent needs of society. The medical problems in contemporary Chinese society are not solely the purview of biomedical technology; what matters more is enhancing the humanities in medical education and fostering medical talents with humanistic spirit. Emphasizing the humanities in medical education and promoting the integration of medical scientific spirit and medical humanistic spirit have become one of the most pressing issues China must address. Greater attention should be paid to reasonable integration of humanities into the medical curriculum, creation of medical courses related to humanities and optimization of the curriculum, and actively allocating abundant teaching resources and exploring better methods of instruction.

  11. 'The medical' and 'health' in a critical medical humanities.

    Science.gov (United States)

    Atkinson, Sarah; Evans, Bethan; Woods, Angela; Kearns, Robin

    2015-03-01

    As befits an emerging field of enquiry, there is on-going discussion about the scope, role and future of the medical humanities. One relatively recent contribution to this debate proposes a differentiation of the field into two distinct terrains, 'medical humanities' and 'health humanities,' and calls for a supersession of the former by the latter. In this paper, we revisit the conceptual underpinnings for a distinction between 'the medical' and 'health' by looking at the history of an analogous debate between 'medical geography' and 'the geographies of health' that has, over the last few years, witnessed a re-blurring of the distinction. Highlighting the value of this debate within the social sciences for the future development of the medical humanities, we call for scholars to take seriously the challenges of critical and cultural theory, community-based arts and health, and the counter-cultural creative practices and strategies of activist movements in order to meet the new research challenges and fulfill the radical potential of a critical medical humanities.

  12. Medical humanities: lineage, excursionary sketch and rationale.

    Science.gov (United States)

    Hurwitz, Brian

    2013-11-01

    Medical Humanities the journal started life in 2000 as a special edition of the JME. However, the intellectual taproots of the medical humanities as a field of enquiry can be traced to two developments: calls made in the 1920s for the development of multidisciplinary perspectives on the sciences that shed historical light on their assumptions, methods and practices; refusals to assimilate all medical phenomena to a biomedical worldview. Medical humanities the term stems from a desire to situate the significance of medicine as a product of culture. But despite growing usage over half a century the term defies a unifying encapsulation and continues to conjure up a multitude of discourse communities, including scholars working at the interfaces of health and humanities, arts and health, and medical education and bioethics. The field is intellectually capacious and polymorphous, forming and reforming around critical new research questions and teaching tasks spanning disciplines.

  13. Medical humanities: a resident doctor's perspective.

    Science.gov (United States)

    Pauranik, Anvita

    2012-01-01

    The barrage of competitive examinations, overwork, sleep deprivation, and the pressure of expectations all combine to destroy the dreams that resident doctors have when they start medical school. The empathy they had before entering this field fades away, and they eventually become insensitive to their patients. Medical humanities may be the means to halt this trend. Sensitising young minds, using the arts, literature, history and lessons on social issues, may bring about a paradigm shift in these doctors' outlook towards their patients. However, for the humanities to be integrated into medical education, the current curriculum must be modified and made more clinically and socially relevant. Further, the humanities cannot be taught in lecture halls; they need to be integrated into all aspects of medical school. For this, the medical school faculty should be sensitised to, and trained in, humanities education.

  14. Perspective: Medical education in medical ethics and humanities as the foundation for developing medical professionalism.

    Science.gov (United States)

    Doukas, David J; McCullough, Laurence B; Wear, Stephen

    2012-03-01

    Medical education accreditation organizations require medical ethics and humanities education to develop professionalism in medical learners, yet there has never been a comprehensive critical appraisal of medical education in ethics and humanities. The Project to Rebalance and Integrate Medical Education (PRIME) I Workshop, convened in May 2010, undertook the first critical appraisal of the definitions, goals, and objectives of medical ethics and humanities teaching. The authors describe assembling a national expert panel of educators representing the disciplines of ethics, history, literature, and the visual arts. This panel was tasked with describing the major pedagogical goals of art, ethics, history, and literature in medical education, how these disciplines should be integrated with one another in medical education, and how they could be best integrated into undergraduate and graduate medical education. The authors present the recommendations resulting from the PRIME I discussion, centered on three main themes. The major goal of medical education in ethics and humanities is to promote humanistic skills and professional conduct in physicians. Patient-centered skills enable learners to become medical professionals, whereas critical thinking skills assist learners to critically appraise the concept and implementation of medical professionalism. Implementation of a comprehensive medical ethics and humanities curriculum in medical school and residency requires clear direction and academic support and should be based on clear goals and objectives that can be reliably assessed. The PRIME expert panel concurred that medical ethics and humanities education is essential for professional development in medicine.

  15. Host defense, dendritic cells and the human lung

    NARCIS (Netherlands)

    J.M.W. van Haarst (Jan Maarten)

    1995-01-01

    textabstractHost defense mechanisms protect the body against microorganisms and other foreign structures. These mechanisms can be divided in nonspecific, or innate, and specific, or acquired, immunity. In both branches of immunity the several types of leukocytes (white blood cells) play a dominant

  16. Medical Humanities: The Rx for Uncertainty?

    Science.gov (United States)

    Ofri, Danielle

    2017-12-01

    While medical students often fear the avalanche of knowledge they are required to learn during training, it is learning to translate that knowledge into wisdom that is the greatest challenge of becoming a doctor. Part of that challenge is learning to tolerate ambiguity and uncertainty, a difficult feat for doctors who are taught to question anything that is not evidence based or peer reviewed. The medical humanities specialize in this ambiguity and uncertainty, which are hallmarks of actual clinical practice but rarely addressed in medical education. The humanities also force reflection and contemplation-skills that are crucial to thoughtful decision making and to personal wellness. Beyond that, the humanities add a dose of joy and beauty to a training process that is notoriously frugal in these departments. Well integrated, the humanities can be the key to transforming medical knowledge into clinical wisdom.

  17. Association of Ego Defense Mechanisms with Academic Performance, Anxiety and Depression in Medical Students: A Mixed Methods Study.

    Science.gov (United States)

    Waqas, Ahmed; Rehman, Abdul; Malik, Aamenah; Muhammad, Umer; Khan, Sarah; Mahmood, Nadia

    2015-09-30

     Ego defense mechanisms are unconscious psychological processes that help an individual to prevent anxiety when exposed to a stressful situation. These mechanisms are important in psychiatric practice to assess an individual's personality dynamics, psychopathologies, and modes of coping with stressful situations, and hence, to design appropriate individualized treatment. Our study delineates the relationship of ego defense mechanisms with anxiety, depression, and academic performance of Pakistani medical students.  This cross-sectional study was done at CMH Lahore Medical College and Fatima Memorial Hospital Medical and Dental College, both in Lahore, Pakistan, from December 1, 2014 to January 15, 2015. Convenience sampling was used and only students who agreed to take part in this study were included. The questionnaire consisted of three sections: 1) Demographics, documenting demographic data and academic scores on participants' most recent exams; 2) Hospital Anxiety and Depression Scale (HADS); and 3) Defense Style Questionnaire-40 (DSQ-40). The data were analyzed with SPSS v. 20. Mean scores and frequencies were calculated for demographic variables and ego defense mechanisms. Bivariate correlations, one-way ANOVA, and multiple linear regression were used to identify associations between academic scores, demographics, ego defense mechanisms, anxiety, and depression.  A total of 409 medical students participated, of whom 286 (70%) were females and 123 (30%) were males. Mean percentage score on the most recent exams was 75.6% in medical students. Bivariate correlation revealed a direct association between mature and neurotic ego defense mechanisms and academic performance, and an indirect association between immature mechanisms and academic performance. One-way ANOVA showed that moderate levels of anxiety (P academic performance.  There was a significant association between academic performance and ego defense mechanisms, anxiety, and depression levels in our

  18. Violence toward health workers in Bahrain Defense Force Royal Medical Services’ emergency department

    Directory of Open Access Journals (Sweden)

    Rafeea F

    2017-11-01

    Full Text Available Faisal Rafeea,1 Ahmed Al Ansari,2–4 Ehab M Abbas,1 Khalifa Elmusharaf,5 Mohamed S Abu Zeid1 1Emergency Department, Bahrain Defense Force Hospital, Riffa, Bahrain; 2Training and Education Department, Bahrain Defense Force Hospital, Riffa, Bahrain; 3Department of General Surgery, College of Medicine and Medical Science, Arabian Gulf University, Manama, Bahrain; 4Medical Education Department, Royal College of Surgeons in Ireland - Medical University of Bahrain, Busaiteen, Bahrain; 5Graduate Entry Medical School, University of Limerick, Ireland Background: Employees working in emergency departments (EDs in hospital settings are disproportionately affected by workplace violence as compared to those working in other departments. Such violence results in minor or major injury to these workers. In other cases, it leads to physical disability, reduced job performance, and eventually a nonconducive working environment for these workers. Materials and methods: A cross-sectional exploratory questionnaire was used to collect data used for the examination of the incidents of violence in the workplace. This study was carried out at the ED of the Bahrain Defense Force (BDF Hospital. Participants for the study were drawn from nurses, support staff, and emergency physicians. Both male and female workers were surveyed.Results: The study included responses from 100 staff in the ED of the BDF Hospital in Bahrain (doctors, nurses, and support personnel. The most experienced type of violence in the workers in the past 12 months in this study was verbal abuse, which was experienced by 78% of the participants, which was followed by physical abuse (11% and then sexual abuse (3%. Many cases of violence against ED workers occurred during night shifts (53%, while physical abuse was reported to occur during all the shifts; 40% of the staff in the ED of the hospital were not aware of the policies against workplace violence, and 26% of the staff considered leaving their jobs

  19. Meningitis and Meningoencephalitis among Israel Defense Force Soldiers: 20 Years Experience at the Hadassah Medical Centers.

    Science.gov (United States)

    Pikkel, Yoav Y; Ben-Hur, Tamir; Eliahou, Ruth; Honig, Asaf

    2015-11-01

    Meningitis and meningoencephalitis pose major risks of morbidity and mortality. To describe 20 years of experience treating infections of the central nervous system in Israel Defense Force (IDF) soldiers, including the common presentations, pathogens and sequelae, and to identify risk groups among soldiers. All soldiers who were admitted to the Hadassah University Medical Center (both campuses: Ein Kerem and Mt. Scopus) due to meningitis and meningoencephalitis from January 1993 to January 2014 were included in this retrospective study. Clinical, laboratory and radiologic data were reviewed from their hospital and army medical corps files. Attention was given to patients' military job description, i.e., combat vs. non-combat soldier, soldiers in training, and medical personnel. We identified 97 cases of suspected meningitis or meningoencephalitis. Six were mistakenly filed and these patients were found to have other disorders. Four soldiers were diagnosed with epidural abscess and five with meningitis due to non-infectious in flammatory diseases. Eighty-two soldiers in active and reserve duty had infectious meningitis or meningoencephalitis. Of these, 46 (56.1%) were combat soldiers and 31 (37.8%) non-combat; 20 (29.2%) were soldiers in training, 10 (12.2%) were training staff and 8 (9.8%) were medical staff. The main pathogens were enteroviruses, Epstein-Barr virus an d Neisseria meningitidis. In our series, soldiers in training, combat soldiers and medical personnel had meningitis and meningoencephalitis more than other soldiers. Enteroviruses are highly infectious pathogens and can cause outbreaks. N. meningitidis among IDF soldiers is still a concern. Early and aggressive treatment with steroids should be considered especially in robust meningoencephalitis cases.

  20. Medical humanities as expressive of Western culture.

    Science.gov (United States)

    Hooker, Claire; Noonan, Estelle

    2011-12-01

    In this paper we articulate a growing awareness within the field of the ways in which medical humanities could be deemed expressive of Western cultural values. The authors suggest that medical humanities is culturally limited by a pedagogical and scholarly emphasis on Western cultural artefacts, as well as a tendency to enact an uncritical reliance upon foundational concepts (such as 'patient' and 'experience') within Western medicine. Both these tendencies within the field, we suggest, are underpinned by a humanistic emphasis on appreciative or receptive encounters with 'difference' among patients that may unwittingly contribute to the marginalisation of some patients and healthcare workers. While cultural difference should be acknowledged as a central preoccupation of medical humanities, we argue that the discipline must continue to expand its scholarly and critical engagements with processes of Othering in biomedicine. We suggest that such improvements are necessary in order to reflect the cultural diversification of medical humanities students, and the geographical expansion of the discipline within non-Western and/or non-Anglophone locations.

  1. Protection of human cultured cells against oxidative stress by Rhodiola rosea without activation of antioxidant defenses.

    Science.gov (United States)

    Schriner, Samuel E; Avanesian, Agnesa; Liu, Yanxia; Luesch, Hendrik; Jafari, Mahtab

    2009-09-01

    Rhodiola rosea root has been long used in traditional medical systems in Europe and Asia as an adaptogen to increase an organism's resistance to physical stress. Recent research has demonstrated its ability to improve mental and physical stamina, to improve mood, and to help alleviate high-altitude sickness. We have also recently found that R. rosea is able to extend the life span of Drosophila melanogaster. The mode of action of R. rosea is currently unknown; it has been suggested by some to act as an antioxidant, whereas others have argued that it may actually be a pro-oxidant and act through a hormetic mechanism. We found that R. rosea supplementation could protect cultured cells against ultraviolet light, paraquat, and H(2)O(2). However, it did not alter the levels of the major antioxidant defenses nor did it markedly activate the antioxidant response element or modulate heme-oxygenase-1 expression levels at relevant concentrations. In addition, R. rosea extract was not able to significantly degrade H(2)O(2) in vitro. These results suggest that in human cultured cells R. rosea does not act as an antioxidant and that its mode of action cannot be sufficiently explained through a pro-oxidant hormetic mechanism.

  2. [Humanities in medical education: between reduction and integration].

    Science.gov (United States)

    Han, Taehee

    2015-09-01

    Reductive logic has been a major reasoning style in development of modern biomedical sciences. However, when "medical humanities" is developed by reductive reasoning, integrative and holistic values of humanities tend to be weakened. In that sense, identity and significance of "medical humanities" continue to be controversial despite of its literal clarity. Humanities in medical education should be established by strengthening humanistic and socialistic aspects of regular medical curriculum as well as developing individual "medical humanities" programs.

  3. Critical medical humanities: embracing entanglement, taking risks.

    Science.gov (United States)

    Viney, William; Callard, Felicity; Woods, Angela

    2015-06-01

    What can the medical humanities achieve? This paper does not seek to define what is meant by the medical humanities, nor to adjudicate the exact disciplinary or interdisciplinary knowledges it should offer, but rather to consider what it might be capable of doing. Exploring the many valences of the word 'critical', we argue here for a critical medical humanities characterised by: (i) a widening of the sites and scales of 'the medical' beyond the primal scene of the clinical encounter; (ii) greater attention not simply to the context and experience of health and illness, but to their constitution at multiple levels; (iii) closer engagement with critical theory, queer and disability studies, activist politics and other allied fields; (iv) recognition that the arts, humanities and social sciences are best viewed not as in service or in opposition to the clinical and life sciences, but as productively entangled with a 'biomedical culture'; and, following on from this, (v) robust commitment to new forms of interdisciplinary and cross-sector collaboration. We go on to introduce the five other articles published in this special issue of the journal, reflecting on the ways in which collaboration and critique are articulated in their analyses of immunology, critical neuroscience, toxicity, global clinical labour, and psychological coercion and workfare. As these articles demonstrate, embracing the complex role of critical collaborator--one based on notions of entanglement, rather than servility or antagonism--will, we suggest, develop the imaginative and creative heterodox qualities and practices which have long been recognised as core strengths of the medical humanities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. In defense of the dignity of being human.

    Science.gov (United States)

    Gaylin, W

    1984-08-01

    The concept of human dignity is examined in terms of the religious belief that man is created in God's image and from the Kantian viewpoint that man's autonomy gives special value to our species. The theory of psychic determinism and the prospect of genetic engineering of humans are seen as attacks on self determination. Five additional attributes that make humans "special" are explored: conceptual thought, the capacity for technology, our range of emotions, "Lamarckian" environmental genetics, and the freedom to change and modify ourselves.

  5. Medical humanities and medical alterity in fiction and in life

    Science.gov (United States)

    Hurwitz, Brian

    2016-01-01

    A widely accepted component of any answer to the question ‘What is it to do good medical ethics?’ is the commitment to benefit people’s health, in principlist terminology, ‘beneficence’. This paper addresses deliberate maleficence and the cultural otherness with which it is associated, focusing on the activities of the serial killer Dr Harold Shipman. It finds an uncanny ‘fit’ between the normal operation of healthcare services and this sort of alterity which has attracted little attention from bioethicists but has been addressed by novelists. To the extent that the medical humanities offers useful insights into hard moral problems, its capacities rest on taking account of both the fictional and the real. PMID:25516938

  6. Preliminary thoughts on research in medical humanities.

    Science.gov (United States)

    Yun, Xiaojing; Guo, Jiawei; Qian, Haihong

    2017-05-23

    Medical humanities (MH) is an interdisciplinary field of medicine which includes the humanities (literature, philosophy, ethics, history, and religion), social sciences (anthropology, cultural studies, psychology, sociology, and health geography), and the arts (literature, theater, film, and visual arts) and their application to medical education and practice. Studies of MH should not be limited to theoretical discussions. Research results must be translated into use of methodologies to formulate medical policies, guide clinical practices, and help resolve physical or mental problems. MH has a critical role in addressing medicine-related issues, such as human cloning legislation and the treatment of Ebola virus infection. Recently, MH has also been included in the "Healthy China 2030" project, indicating that MH has garnered more attention in China. Medical colleges, research institutes, and non-profit organizations are focusing on MH studies. Over the past few years, financial support for MH studies has also increased. Although the development of MH currently lags behind medicine and health sciences, MH has promise.

  7. Medical education and human trafficking: using simulation.

    Science.gov (United States)

    Stoklosa, Hanni; Lyman, Michelle; Bohnert, Carrie; Mittel, Olivia

    2017-01-01

    Healthcare providers have the potential to play a crucial role in human trafficking prevention, identification, and intervention. However, trafficked patients are often unidentified due to lack of education and preparation available to healthcare professionals at all levels of training and practice. To increase victim identification in healthcare settings, providers need to be educated about the issue of trafficking and its clinical presentations in an interactive format that maximizes learning and ultimately patient-centered outcomes. In 2014, University of Louisville School of Medicine created a simulation-based medical education (SBME) curriculum to prepare students to recognize victims and intervene on their behalf. The authors share the factors that influenced the session's development and incorporation into an already full third year medical curriculum and outline the development process. The process included a needs assessment for the education intervention, development of objectives and corresponding assessment, implementation of the curriculum, and finally the next steps of the module as it develops further. Additional alternatives are provided for other medical educators seeking to implement similar modules at their home institution. It is our hope that the description of this process will help others to create similar interactive educational programs and ultimately help trafficking survivors receive the care they need. HCP: Healthcare professional; M-SIGHT: Medical student instruction in global human trafficking; SBME: Simulation-based medical education; SP: Standardized patient; TIC: Trauma-informed care.

  8. Medical humanities: a closer look at learning.

    Science.gov (United States)

    Patterson, A; Sharek, D; Hennessy, M; Phillips, M; Schofield, S

    2016-06-01

    The inclusion of medical humanities with medical curricula is a question that has been the focus of attention for many within the evolving field. This study addressed the question from a medical education perspective and aimed to investigate what students at Trinity College Dublin learned from participating in a short medical humanities student-selected module in their first year of an undergraduate medical programme. A total of 156 students provided a written reflection on a memorable event that occurred during their student-selected module. The reflections were analysed using the Reflection Evaluation for Learners' Enhanced Competencies Tool (REFLECT) and through qualitative thematic analysis of the written reflections. Evidence of learning from the REFLECT quantitative analysis showed that 50% of students displayed higher levels of reflection when describing their experience. The reflection content analysis supported the heterogeneous nature of learning outcome for students, with evidence to support the idea that the module provided opportunities for students to explore their beliefs, ideas and feelings regarding a range of areas outside their current experience or world view, to consider the views of others that they may have not previously been aware of, to reflect on their current views, and to consider their future professional practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Medical education and human trafficking: using simulation

    Science.gov (United States)

    Stoklosa, Hanni; Lyman, Michelle; Bohnert, Carrie; Mittel, Olivia

    2017-01-01

    ABSTRACT Healthcare providers have the potential to play a crucial role in human trafficking prevention, identification, and intervention. However, trafficked patients are often unidentified due to lack of education and preparation available to healthcare professionals at all levels of training and practice. To increase victim identification in healthcare settings, providers need to be educated about the issue of trafficking and its clinical presentations in an interactive format that maximizes learning and ultimately patient-centered outcomes. In 2014, University of Louisville School of Medicine created a simulation-based medical education (SBME) curriculum to prepare students to recognize victims and intervene on their behalf. The authors share the factors that influenced the session’s development and incorporation into an already full third year medical curriculum and outline the development process. The process included a needs assessment for the education intervention, development of objectives and corresponding assessment, implementation of the curriculum, and finally the next steps of the module as it develops further. Additional alternatives are provided for other medical educators seeking to implement similar modules at their home institution. It is our hope that the description of this process will help others to create similar interactive educational programs and ultimately help trafficking survivors receive the care they need. Abbreviations: HCP: Healthcare professional; M-SIGHT: Medical student instruction in global human trafficking; SBME: Simulation-based medical education; SP: Standardized patient; TIC: Trauma-informed care PMID:29228882

  10. Confronting actual influence of radiation on human bodies and biological defense mechanism

    International Nuclear Information System (INIS)

    Matsubara, Junko

    2012-01-01

    After the accident at Fukushima Daiichi Nuclear Power Plant of Tokyo Electric Power Company, social, economical, psychological pressures on local residents and fears of radiation among the general public have not been resolved. Based on the assumption that the negligence of specialists to clearly explain the influence of radiation on human bodies to the general public is the factor for above mentioned pressures and fears, the influence of radiation from a realistic view was discussed. The topics covered are: (1) understanding the meaning of radiation regulation, (2) radiation and threshold values, (3) actual influence of low-dose radiation, (4) chemical and biological defense in defense mechanism against radiation, (5) problems raised by Fukushima Daiichi nuclear accident. Furthermore, the article explains the principles and the applications of biological defense function activation, and suggested that self-help efforts to fight against stress are from now on. (S.K.)

  11. The medical humanities and the perils of curricular integration.

    Science.gov (United States)

    Chiavaroli, Neville; Ellwood, Constance

    2012-12-01

    The advent of integration as a feature of contemporary medical curricula can be seen as an advantage for the medical humanities in that it provides a clear implementation strategy for the inclusion of medical humanities content and/or perspectives, while also making its relevance to medical education more apparent. This paper discusses an example of integration of humanities content into a graduate medical course, raises questions about the desirability of an exclusively integrated approach, and argues for the value of retaining a discrete and coherent disciplinary presence for the medical humanities in medical curricula.

  12. Science fiction and the medical humanities.

    Science.gov (United States)

    Miller, Gavin; McFarlane, Anna

    2016-12-01

    Research on science fiction within the medical humanities should articulate interpretative frameworks that do justice to medical themes within the genre. This means challenging modes of reading that encourage unduly narrow accounts of science fiction. Admittedly, science studies has moved away from reading science fiction as a variety of scientific popularisation and instead understands science fiction as an intervention in the technoscientific imaginary that calls for investment in particular scientific enterprises, including various biomedical technologies. However, this mode of reading neglects science fiction's critical relationship to the construction of 'the future' in the present: the ways in which science fiction proposes concrete alternatives to hegemonic narratives of medical progress and fosters critical self-awareness of the contingent activity which gives 'the future' substance in the here-and-now. Moreover, the future orientation of science fiction should not distract from the function of medical science fiction as 'cognitive estrangement': the technological innovations that dominate science-fiction narratives are less concrete predictions and more generic devices that explain in historical time the origins of a marvellous world bearing provocative correspondences to our own, everyday reality. The editorial concludes with a series of introductions to the articles comprising the special issue, covering the print edition and a special online-only section. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Medical humanities in nursing: thought provoking?

    Science.gov (United States)

    Robb, A J; Murray, R

    1992-10-01

    Medical humanities is an innovative way of learning. Discussing literary texts of nursing practice has been used to help students analyse attitudes, values and ethics; it has also been used to help practitioners review and reflect on their own experience and philosophy of nursing. In nursing education, it has been used to explore difficult issues in a safe environment. The value of this approach in nursing education and practice is that it can encourage reflection, promote self-awareness and stimulate debate on difficult issues: for example, death and dying, power and institutionalization (of patients and staff) and pain. This paper gives a detailed worked example of how a literary text can be used in this way, the aim being to provide a resource which readers can then use with a group of students or colleagues. Finally, the authors explore the question of where medical humanities might have a place in the curriculum: as a lecture/tutorial in a course (e.g. Ethics), as a module in the curriculum, as a method of teaching nursing subjects (e.g. communication skills), as a discussion group (outside the curriculum), as a study guide, using literary texts alongside nursing text books. Any of these strategies can be a powerful vehicle for preserving the 'human factor' in both nursing education and continuing professional development.

  14. Design, fiction and the medical humanities.

    Science.gov (United States)

    Strachan, Christopher Gordon

    2016-12-01

    This paper sets out to explore the similarities between the developing discipline of speculative and critical design (SCD) and science fiction, and their relevance to the medical humanities. SCD looks beyond 'commercial design' to consider what sort of things we should, or should not, be designing in order to create preferable futures. It does so by extrapolating from current social, economic, political and scientific knowledge, designing artefacts, experiences and scenarios which communicate futures and alternative realities in tangible ways. By first outlying the relevance of SCD to the medical humanities, through its ability to imagine and visualise preferable healthcare futures, the paper will then discuss several recent design projects which focus on current and future ethical issues raised by emerging biotechnology. Through these projects, the paper will look at SCD's ability to provoke, engage and critique science and society, while also critically reflecting on the limitations of the evolving design discipline. Through the paper it is hoped that there can be an increased understanding of SCD and its ambitions, as well as its limitations, in order for SCD to better approach issues relating to health and wellbeing, along with other difficult and challenging issues which will affect all us today and into the (sci-fi) future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Medical futility decisions and physicians' legal defensiveness: the impact of anticipated conflict on thresholds for end-of-life treatment.

    Science.gov (United States)

    Swanson, J W; McCrary, S V

    1996-01-01

    Does legal defensiveness significantly influence physicians' assessments of medical futility, in ways that may adversely affect the rights of patients and their family members to make their own health care decisions at the end of life? This exploratory study addresses that question with attitudinal data from a survey of 301 physicians practicing in academic medical centers in Texas. The majority of respondents indicated that the probability of success defining futile treatment should hypothetically be lower for patients with potential to benefit more from life-sustaining medical intervention (e.g. typically patients who are sentient), and higher for patients with less potential to benefit (e.g. patients in a persistent vegetative state). That is to say, physicians normally perceive longer odds to be worth pursuing for greater potential gain - a position that seems logically consonant with patients' rational self-interest. However, physicians with an attitude of extreme legal defensiveness did not fit this pattern. Rather, they tended to define futility in a manner that would maximize the physician's latitude to justifiably oppose patient preferences for end-of-life treatment abatement. These findings suggest that some physicians assume an adversarial position in their consideration of medical futility issues - an attitude that anticipates conflict with terminally-ill patients or their surrogates. The analysis presented here is not definitive, but at least raises the question of whether some physicians may inappropriately use their prerogative over medical futility as a means to guard their professional autonomy against perceived threats.

  16. A CBO Study: Growth in Medical Spending by the Department of Defense

    National Research Council Canada - National Science Library

    Percy, Allison

    2003-01-01

    The Department of Defense (DoD) faces a growing burden in providing peacetime health care for military personnel, retirees, and their dependents and survivors-who all together number over 8 million...

  17. Systemwide Deployment of Medical Team Training: Lessons Learned in the Department of Defense

    National Research Council Canada - National Science Library

    King, Heidi B; Kohsin, Beth; Salisbury, Mary

    2005-01-01

    .... Lessons learned within the U.S. Department of Defense indicate that for teamwork initiatives to be effective, they must possess a clear blueprint defining the solid steps for building the desired culture...

  18. Medical humanities and their discontents: definitions, critiques, and implications.

    Science.gov (United States)

    Shapiro, Johanna; Coulehan, Jack; Wear, Delese; Montello, Martha

    2009-02-01

    The humanities offer great potential for enhancing professional and humanistic development in medical education. Yet, although many students report benefit from exposure to the humanities in their medical education, they also offer consistent complaints and skepticism. The authors offer a pedagogical definition of the medical humanities, linking it to medicine as a practice profession. They then explore three student critiques of medical humanities curricula: (1) the content critique, examining issues of perceived relevance and intellectual bait-and-switch, (2) the teaching critique, which examines instructor trustworthiness and perceived personal intrusiveness, and (3) the structural/placement critique, or how and when medical humanities appear in the curriculum. Next, ways are suggested to tailor medical humanities to better acknowledge and reframe the needs of medical students. These include ongoing cross-disciplinary reflective practices in which intellectual tools of the humanities are incorporated into educational activities to help students examine and, at times, contest the process, values, and goals of medical practice. This systematic, pervasive reflection will organically lead to meaningful contributions from the medical humanities in three specific areas of great interest to medical educators: professionalism, "narrativity," and educational competencies. Regarding pedagogy, the implications of this approach are an integrated required curriculum and innovative concepts such as "applied humanities scholars." In turn, systematic integration of humanities perspectives and ways of thinking into clinical training will usefully expand the range of metaphors and narratives available to reflect on medical practice and offer possibilities for deepening and strengthening professional education.

  19. A Theoretical Framework for Human and Veterinary Medical Ethics Education

    Science.gov (United States)

    Magalhães-Sant'Ana, Manuel

    2016-01-01

    In their practice, physicians and veterinarians need to resort to an array of ethical competences. As a teaching topic, however, there is no accepted gold standard for human medical ethics, and veterinary medical ethics is not yet well established. This paper provides a reflection on the underlying aims of human and veterinary medical ethics…

  20. NASA Medical Response to Human Spacecraft Accidents

    Science.gov (United States)

    Patlach, Robert

    2011-01-01

    This slide presentation reviews NASA's role in the response to spacecraft accidents that involve human fatalities or injuries. Particular attention is given to the work of the Mishap Investigation Team (MIT), the first response to the accidents and the interface to the accident investigation board. The MIT does not investigate the accident, but the objective of the MIT is to gather, guard, preserve and document the evidence. The primary medical objectives of the MIT is to receive, analyze, identify, and transport human remains, provide assistance in the recovery effort, and to provide family Casualty Coordinators with latest recovery information. The MIT while it does not determine the cause of the accident, it acts as the fact gathering arm of the Mishap Investigation Board (MIB), which when it is activated may chose to continue to use the MIT as its field investigation resource. The MIT membership and the specific responsibilities and tasks of the flight surgeon is reviewed. The current law establishing the process is also reviewed.

  1. Humanities in undergraduate medical education: a literature review.

    Science.gov (United States)

    Ousager, Jakob; Johannessen, Helle

    2010-06-01

    Humanities form an integral part of undergraduate medical curricula at numerous medical schools all over the world, and medical journals publish a considerable quantity of articles in this field. The aim of this study was to determine the extent to which the literature on humanities in undergraduate medical education seeks to provide evidence of a long-term impact of this integration of humanities in undergraduate medical education. Medline was searched for publications concerning the humanities in undergraduate medical education appearing from January 2000 to December 2008. All articles were manually sorted by the authors. Two hundred forty-five articles were included in the study. Following a qualitative analysis, the references included were categorized as "pleading the case," "course descriptions and evaluations," "seeking evidence of long-term impact," or "holding the horses." Two hundred twenty-four articles out of 245 either praised the (potential) effects of humanities on medical education or described existing or planned courses without offering substantial evidence of any long-term impact of these curricular activities on medical proficiency. Only 9 articles provided evidence of attempts to document long-term impacts using diverse test tools, and 10 articles presented relatively reserved attitudes toward humanities in undergraduate medical education. Evidence on the positive long-term impacts of integrating humanities into undergraduate medical education is sparse. This may pose a threat to the continued development of humanities-related activities in undergraduate medical education in the context of current demands for evidence to demonstrate educational effectiveness.

  2. Robotic Missions to Small Bodies and Their Potential Contributions to Human Exploration and Planetary Defense

    Science.gov (United States)

    Abell, Paul A.; Rivkin, Andrew S.

    2015-01-01

    Introduction: Robotic missions to small bodies will directly address aspects of NASA's Asteroid Initiative and will contribute to future human exploration and planetary defense. The NASA Asteroid Initiative is comprised of two major components: the Grand Challenge and the Asteroid Mission. The first component, the Grand Challenge, focuses on protecting Earth's population from asteroid impacts by detecting potentially hazardous objects with enough warning time to either prevent them from impacting the planet, or to implement civil defense procedures. The Asteroid Mission involves sending astronauts to study and sample a near-Earth asteroid (NEA) prior to conducting exploration missions of the Martian system, which includes Phobos and Deimos. The science and technical data obtained from robotic precursor missions that investigate the surface and interior physical characteristics of an object will help identify the pertinent physical properties that will maximize operational efficiency and reduce mission risk for both robotic assets and crew operating in close proximity to, or at the surface of, a small body. These data will help fill crucial strategic knowledge gaps (SKGs) concerning asteroid physical characteristics that are relevant for human exploration considerations at similar small body destinations. These data can also be applied for gaining an understanding of pertinent small body physical characteristics that would also be beneficial for formulating future impact mitigation procedures. Small Body Strategic Knowledge Gaps: For the past several years NASA has been interested in identifying the key SKGs related to future human destinations. These SKGs highlight the various unknowns and/or data gaps of targets that the science and engineering communities would like to have filled in prior to committing crews to explore the Solar System. An action team from the Small Bodies Assessment Group (SBAG) was formed specifically to identify the small body SKGs under the

  3. A compelling practice: empowering future leaders in the medical humanities.

    Science.gov (United States)

    Runyan, Aliye; Ellington, Katherine; Wershof Schwartz, Andrea

    2013-12-01

    Medical students and faculty explore the medical humanities for diverse reasons: as a medium for self-reflection, a means to cultivate professionalism and humanism, and a way to gain an appreciation for the broader contexts in which illness and health occur. One important area for development is increasing the exposure of learners and clinicians of various levels of training to the medical humanities and to role models in the field. Student-led programs in the medical humanities at the American Medical Student Association (AMSA) address these needs by offering unique opportunities for learning and sharing experiences. AMSA programs connect physicians-in-training using technology to create virtual communication and learning opportunities. These include monthly book discussion webinars, the Writers' Institute and the Medical Humanities Scholars Program (MHSP).

  4. MedWatch Safety Alerts for Human Medical Products

    Data.gov (United States)

    U.S. Department of Health & Human Services — MedWatch alerts provide timely new safety information on human drugs, medical devices, vaccines and other biologics, dietary supplements, and cosmetics. The alerts...

  5. [Medical Humanities--the Historical Significance and Mission in Medical Education].

    Science.gov (United States)

    Fujino, Akihiro

    2015-12-01

    In this paper we consider the significance and mission of medical humanities in medical education from the following six viewpoints: (1) misunderstanding of the medical humanities; (2) its historical development; (3) the criteria for the ideal physician; (4) the contents of current Medical Humanities education; (5) the basic philosophy; and (6) its relation to medical professionalism. Medical humanities consists of the three academic components of bioethics, clinical ethics and medical anthropology, and it is a philosophy and an art which penetrate to the fundamental essence of medicine. The purpose of medical humanities is to develop one's own humanity and spirituality through medical practice and contemplation by empathizing with patients' illness narratives through spiritual self-awakening and by understanding the mutual healing powers of human relations by way of the realization of primordial life. The basic philosophy is "the coincidence of contraries". The ultimate mission of medical humanities is to cultivate physicians to educate themselves and have a life-long philosophy of devotion to understanding, through experience, the coincidence of contraries.

  6. Standardizing Medication Error Event Reporting in the U.S. Department of Defense

    National Research Council Canada - National Science Library

    Nosek, Ronald A., Jr; McMeekin, Judy; Rake, Geoffrey W

    2005-01-01

    ...) began an aggressive examination of medical errors and the strategies for minimizing them. A primary goal was the creation of a standardized medication event reporting system, including a central registry for the compilation of reported data...

  7. How Human Amygdala and Bed Nucleus of the Stria Terminalis May Drive Distinct Defensive Responses.

    Science.gov (United States)

    Klumpers, Floris; Kroes, Marijn C W; Baas, Johanna M P; Fernández, Guillén

    2017-10-04

    The ability to adaptively regulate responses to the proximity of potential danger is critical to survival and imbalance in this system may contribute to psychopathology. The bed nucleus of the stria terminalis (BNST) is implicated in defensive responding during uncertain threat anticipation whereas the amygdala may drive responding upon more acute danger. This functional dissociation between the BNST and amygdala is however controversial, and human evidence scarce. Here we used data from two independent functional magnetic resonance imaging studies [ n = 108 males and n = 70 (45 females)] to probe how coordination between the BNST and amygdala may regulate responses during shock anticipation and actual shock confrontation. In a subset of participants from Sample 2 ( n = 48) we demonstrate that anticipation and confrontation evoke bradycardic and tachycardic responses, respectively. Further, we show that in each sample when going from shock anticipation to the moment of shock confrontation neural activity shifted from a region anatomically consistent with the BNST toward the amygdala. Comparisons of functional connectivity during threat processing showed overlapping yet also consistently divergent functional connectivity profiles for the BNST and amygdala. Finally, childhood maltreatment levels predicted amygdala, but not BNST, hyperactivity during shock anticipation. Our results support an evolutionary conserved, defensive distance-dependent dynamic balance between BNST and amygdala activity. Shifts in this balance may enable shifts in defensive reactions via the demonstrated differential functional connectivity. Our results indicate that early life stress may tip the neural balance toward acute threat responding and via that route predispose for affective disorder. SIGNIFICANCE STATEMENT Previously proposed differential contributions of the BNST and amygdala to fear and anxiety have been recently debated. Despite the significance of understanding their

  8. Toward "harder" medical humanities: moving beyond the "two cultures" dichotomy.

    Science.gov (United States)

    Polianski, Igor J; Fangerau, Heiner

    2012-01-01

    Using the current international debate surrounding the incorporation of medical humanities into medical curricula as a starting point, the authors address both the legitimacy and didactics of teaching medical humanities to medical students. They highlight the paradox of the increasing prevalence of medical humanities in medical curricula and the often critical reception humanities courses receive. The alleged lack of empirical evidence linking such courses with improved patient care cannot alone explain the criticism they engender. After a short overview of the debate surrounding medical humanities and their inclusion in outcomes-based education, the authors outline the medical humanities block, "The History, Theory, and Ethics of Medicine," which is part of the German medical curriculum. A model developed at Ulm University exemplifies the integrated inclusion of the heterogeneous aspects of medical culture into medical education. This model emphasizes a reflexive approach (i.e., understanding how the humanities are manifested in medicine) as an alternative to the currently dominant narrative approach (i.e., liberal arts, moral development, and/or mental retreat), which has gradually been limited to a quasi-"secular religion" for doctors. This model uses established concepts from science and cultural studies as the "instruments" for seminars and courses; paradigms, discourses, social systems, and cosmologies constitute the tools for teaching and learning about the historical, theoretical, and ethical dimensions of medicine. The authors argue that this approach both precludes the need to justify the medical humanities and overcomes the dichotomy that has heretofore existed between the two cultures of science and the humanities in medicine.

  9. Language Functions and Medical Communication: The Human Body as Text

    Science.gov (United States)

    Kantz, Deirdre; Marenzi, Ivana

    2016-01-01

    This article presents the findings of a field experiment in medical English with first-year medical students at the University of Pavia, Northern Italy. Working in groups of 8-10, the students were asked to produce a corpus of medical texts in English demonstrating how the human body is itself a meaningful text (Baldry and Thibault 2006: Ch. 1).…

  10. Cigarette smoke modulates expression of human rhinovirus-induced airway epithelial host defense genes.

    Directory of Open Access Journals (Sweden)

    David Proud

    Full Text Available Human rhinovirus (HRV infections trigger acute exacerbations of chronic obstructive pulmonary disease (COPD and asthma. The human airway epithelial cell is the primary site of HRV infection and responds to infection with altered expression of multiple genes, the products of which could regulate the outcome to infection. Cigarette smoking aggravates asthma symptoms, and is also the predominant risk factor for the development and progression of COPD. We, therefore, examined whether cigarette smoke extract (CSE modulates viral responses by altering HRV-induced epithelial gene expression. Primary cultures of human bronchial epithelial cells were exposed to medium alone, CSE alone, purified HRV-16 alone or to HRV-16+ CSE. After 24 h, supernatants were collected and total cellular RNA was isolated. Gene array analysis was performed to examine mRNA expression. Additional experiments, using real-time RT-PCR, ELISA and/or western blotting, validated altered expression of selected gene products. CSE and HRV-16 each induced groups of genes that were largely independent of each other. When compared to gene expression in response to CSE alone, cells treated with HRV+CSE showed no obvious differences in CSE-induced gene expression. By contrast, compared to gene induction in response to HRV-16 alone, cells exposed to HRV+CSE showed marked suppression of expression of a number of HRV-induced genes associated with various functions, including antiviral defenses, inflammation, viral signaling and airway remodeling. These changes were not associated with altered expression of type I or type III interferons. Thus, CSE alters epithelial responses to HRV infection in a manner that may negatively impact antiviral and host defense outcomes.

  11. Library Collaboration with Medical Humanities in an American Medical College in Qatar

    Directory of Open Access Journals (Sweden)

    Sally Birch

    2013-11-01

    Full Text Available The medical humanities, a cross-disciplinary field of practice and research that includes medicine, literature, art, history, philosophy, and sociology, is being increasingly incorporated into medical school curricula internationally. Medical humanities courses in Writing, Literature, Medical Ethics and History can teach physicians-in-training communication skills, doctor-patient relations, and medical ethics, as well as empathy and cross-cultural understanding. In addition to providing educational breadth and variety, the medical humanities can also play a practical role in teaching critical/analytical skills. These skills are utilized in differential diagnosis and problem-based learning, as well as in developing written and oral communications. Communication skills are a required medical competency for passing medical board exams in the U.S., Canada, the UK and elsewhere. The medical library is an integral part of medical humanities training efforts. This contribution provides a case study of the Distributed eLibrary at the Weill Cornell Medical College in Qatar in Doha, and its collaboration with the Writing Program in the Premedical Program to teach and develop the medical humanities. Programs and initiatives of the DeLib library include: developing an information literacy course, course guides for specific courses, the 100 Classic Books Project, collection development of ‘doctors’ stories’ related to the practice of medicine (including medically-oriented movies and TV programs, and workshops to teach the analytical and critical thinking skills that form the basis of humanistic approaches to knowledge. This paper outlines a ‘best practices’ approach to developing the medical humanities in collaboration among the medical library, faculty and administrative stakeholders.

  12. Library collaboration with medical humanities in an american medical college in qatar.

    Science.gov (United States)

    Birch, Sally; Magid, Amani; Weber, Alan

    2013-11-01

    The medical humanities, a cross-disciplinary field of practice and research that includes medicine, literature, art, history, philosophy, and sociology, is being increasingly incorporated into medical school curricula internationally. Medical humanities courses in Writing, Literature, Medical Ethics and History can teach physicians-in-training communication skills, doctor-patient relations, and medical ethics, as well as empathy and cross-cultural understanding. In addition to providing educational breadth and variety, the medical humanities can also play a practical role in teaching critical/analytical skills. These skills are utilized in differential diagnosis and problem-based learning, as well as in developing written and oral communications. Communication skills are a required medical competency for passing medical board exams in the U.S., Canada, the UK and elsewhere. The medical library is an integral part of medical humanities training efforts. This contribution provides a case study of the Distributed eLibrary at the Weill Cornell Medical College in Qatar in Doha, and its collaboration with the Writing Program in the Premedical Program to teach and develop the medical humanities. Programs and initiatives of the DeLib library include: developing an information literacy course, course guides for specific courses, the 100 Classic Books Project, collection development of 'doctors' stories' related to the practice of medicine (including medically-oriented movies and TV programs), and workshops to teach the analytical and critical thinking skills that form the basis of humanistic approaches to knowledge. This paper outlines a 'best practices' approach to developing the medical humanities in collaboration among the medical library, faculty and administrative stakeholders.

  13. Anatomy, Medical Education, and Human Ancestral Variation

    Science.gov (United States)

    Strkalj, Goran; Spocter, Muhammad A.; Wilkinson, A. Tracey

    2011-01-01

    It is argued in this article that the human body both in health and disease cannot be fully understood without adequately accounting for the different levels of human variation. The article focuses on variation due to ancestry, arguing that the inclusion of information pertaining to ancestry in human anatomy teaching materials and courses should…

  14. Cooperation between National Defense Medical College and Fukushima Medical University in thyroid ultrasound examination after the Fukushima Daiichi nuclear power plant disaster

    International Nuclear Information System (INIS)

    Yamamoto, Yoritsuna; Fujita, Masanori; Tachibana, Shoich; Morita, Koji; Hamano, Kunihisa; Hamada, Koji; Uchida, Kosuke; Tanaka, Yuji

    2013-01-01

    Fukushima Daiichi Nuclear Power Plant was utterly destroyed by The Great East Japan Earthquake which happened on March 11, 2011, and followed by radioactive contamination to the surrounding areas. Based on the known radioactive iodine ("1"3"1I) which led to thyroid cancer in children after the Chernobyl nuclear power plant disaster in 1986, children living in Fukushima should be carefully observed for the development of thyroid cancer. Fukushima Prefecture and Fukushima Medical University started ''Fukushima Health Management Survey'' in May 2011, which includes screening for thyroid cancer by ultrasonography (Thyroid Ultrasound Examination). Thyroid Ultrasound Examination would cover roughly 360,000 residents aged 0 to 18 years of age at the time of the nuclear disaster. The initial screening is to be performed within the first three years after the accident, followed by complete thyroid examinations from 2014 onwards, and the residents will be monitored regularly thereafter. As Thyroid Ultrasound Examination is being mainly performed by medical staff at Fukushima Medical University, there is insufficient manpower to handle the large number of potential examinees. Thus, specialists of thyroid diseases from all over Japan have begun to support this examination. Six endocrinologists including the authors belonging to the National Defense Medical College are cooperating in part of this examination. This paper briefly reports the outline of Thyroid Ultrasound Examination and our cooperation. (author)

  15. Nuclear weapons and civil defense. The influence of the medical profession in 1955 and 1983

    International Nuclear Information System (INIS)

    Kornfeld, H.

    1983-01-01

    The issue of nuclear war and its medical consequences is discussed from a historical perspective. The Federal Emergency Management Agency has proposed a multi-billion dollar program designed to relocate the population over a period of several days to help residents find protection from lethal fallout. The American Medical Association is called on to make a clear statement to the government that adequate preparation for a nuclear holocaust is impossible and that the medical problems would be awesome and without precedent. Forty-seven references are included

  16. Introducing medical humanities in the medical curriculum in Saudi Arabia: A pedagogical experiment

    Directory of Open Access Journals (Sweden)

    Rabie E Abdel-Halim

    2012-01-01

    Full Text Available In a marked shift from the modern positivist materialist philosophy that influenced medical education for more than a century, Western medical educators are now beginning to realize the significance of the spiritual element of human nature. Consensus is currently building up in Europe and North America on the need to give more emphasis to the study of humanities disciplines such as history of medicine, ethics, religion, philosophy, medically related poetry, literature, arts and medical sociology in medical colleges with the aim of allowing graduates to reach to the heart of human learning about meaning of life and death and to become kinder, more reflective practitioners. The medicine taught and practiced during the Islamic civilization era was a vivid example of the unity of the two components of medical knowledge: natural sciences and humanities. It was also a brilliant illustration of medical ethics driven by a divine moral code. This historical fact formed the foundation for the three medical humanities courses presented in this article reporting a pedagogical experiment in preparation for starting a humanities program in Alfaisal University Medical College in Riyadh. In a series of lectures alternating with interactive sessions, active learning strategies were employed in teaching a course on history of medicine during the Islamic era and another on Islamic medical ethics. Furthermore, a third course on medically relevant Arabic poetry was designed and prepared in a similar way. The end-of-the-course feedback comments reflected effectiveness of the courses and highlighted the importance of employing student-centered learning techniques in order to motivate medical students to become critical thinkers, problem solvers, life-long learners and self-learners.

  17. Innate Defense against Influenza A Virus: Activity of Human Neutrophil Defensins and Interactions of Defensins with Surfactant Protein D

    DEFF Research Database (Denmark)

    Hartshorn, Kevan L.; White, Mitchell R.; Tecle, Tesfaldet

    2006-01-01

    Surfactant protein D (SP-D) plays important roles in innate host defense against influenza A virus (IAV) infection, in part by modifying interactions with neutrophils. Human neutrophil defensins (HNPs) inhibit infectivity of enveloped viruses, including IAV. Our goal in this study...

  18. Medical Humanities Teaching in North American Allopathic and Osteopathic Medical Schools.

    Science.gov (United States)

    Klugman, Craig M

    2017-11-07

    Although the AAMC requires annual reporting of medical humanities teaching, most literature is based on single-school case reports and studies using information reported on schools' websites. This study sought to discover what medical humanities is offered in North American allopathic and osteopathic undergraduate medical schools. An 18-question, semi-structured survey was distributed to all 146 (as of June 2016) member schools of the American Association of Medical Colleges and the American Association of Colleges of Osteopathic Medicine. The survey sought information on required and elective humanities content, hours of humanities instruction, types of disciplines, participation rates, and humanities administrative structure. The survey was completed by 134 schools (145 AAMC; 31 AACOM). 70.8% of schools offered required and 80.6% offered electives in humanities. Global health and writing were the most common disciplines. Schools required 43.9 mean (MD 45.4; DO 37.1) and 30 (MD 29; DO 37.5) median hours in humanities. In the first two years, most humanities are integrated into other course work; most electives are offered as stand-alone classes. 50.0% of schools report only 0-25% of students participating in humanities electives. Presence of a certificate, concentration or arts journal increased likelihood of humanities content but decreased mean hours. Schools with a medical humanities MA had a higher number of required humanities hours. Medical humanities content in undergraduate curriculum is lower than is indicated in the AAMC annual report. Schools with a formal structure have a greater humanities presence in the curriculum and are taken by more students.

  19. Medical negligence: Coverage of the profession, duties, ethics, case law, and enlightened defense - A legal perspective

    Directory of Open Access Journals (Sweden)

    M S Pandit

    2009-01-01

    Full Text Available A patient approaching a doctor expects medical treatment with all the knowledge and skill that the doctor possesses to bring relief to his medical problem. The relationship takes the shape of a contract retaining the essential elements of tort. A doctor owes certain duties to his patient and a breach of any of these duties gives a cause of action for negligence against the doctor. The doctor has a duty to obtain prior informed consent from the patient before carrying out diagnostic tests and therapeutic management. The services of the doctors are covered under the provisions of the Consumer Protection Act, 1986 and a patient can seek redressal of grievances from the Consumer Courts. Case laws are an important source of law in adjudicating various issues of negligence arising out of medical treatment.

  20. Educational Corner | Salem | Egyptian Journal of Medical Human ...

    African Journals Online (AJOL)

    Egyptian Journal of Medical Human Genetics. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 13, No 1 (2012) >. Log in or Register to get access to full text downloads.

  1. The 'medical humanities' in health sciences education in South Africa.

    Science.gov (United States)

    Reid, S

    2014-02-01

    A new masters-level course, 'Medicine and the Arts" will be offered in 2014 at the University of Cape Town, setting a precedent for interdisciplinary education in the field of medical humanities in South Africa. The humanities and social sciences have always been an implicit part of undergraduate and postgraduate education in the health sciences, but increasingly they are becoming an explicit and essential component of the curriculum, as the importance of graduate attributes and outcomes in the workplace is acknowledged. Traditionally, the medical humanities have included medical ethics, history, literature and anthropology. Less prominent in the literature has been the engagement with medicine of the disciplines of sociology, politics, philosophy, linguistics, education, and law, as well as the creative and expressive arts. The development of the medical humanities in education and research in South Africa is set to expand over the next few years, and it looks as if it will be an exciting inter-disciplinary journey.

  2. The introduction of medical humanities in the undergraduate curriculum of Greek medical schools: challenge and necessity.

    Science.gov (United States)

    Batistatou, A; Doulis, E A; Tiniakos, D; Anogiannaki, A; Charalabopoulos, K

    2010-10-01

    Medical humanities is a multidisciplinary field, consisting of humanities (theory of literature and arts, philosophy, ethics, history and theology), social sciences (anthropology, psychology and sociology) and arts (literature, theater, cinema, music and visual arts), integrated in the undergraduate curriculum of Medical schools. The aim of the present study is to discuss medical humanities and support the necessity of introduction of a medical humanities course in the curriculum of Greek medical schools. Through the relevant Pub-Med search as well as taking into account various curricula of medical schools, it is evident that medical education today is characterized by acquisition of knowledge and skills and development of medical values and attitudes. Clinical observation with the recognition of key data and patterns in the collected information, is crucial in the final medical decision, i.e. in the complex process, through which doctors accumulate data, reach conclusions and decide on therapy. All sciences included in medical humanities are important for the high quality education of future doctors. The practice of Medicine is in large an image-related science. The history of anatomy and art are closely related, already from the Renaissance time. Studies have shown that attendance of courses on art critics improves the observational skills of medical students. Literature is the source of information about the nature and source of human emotions and behavior and of narratives of illness, and increases imagination. Philosophy aids in the development of analytical and synthetical thinking. Teaching of history of medicine develops humility and aids in avoiding the repetition of mistakes of the past, and quite often raises research and therapeutic skepticism. The comprehension of medical ethics and professional deontology guides the patient-doctor relationship, as well as the relations between physicians and their colleagues. The Medical Humanities course, which is

  3. Structure-activity studies and therapeutic potential of host defense peptides of human thrombin.

    Science.gov (United States)

    Kasetty, Gopinath; Papareddy, Praveen; Kalle, Martina; Rydengård, Victoria; Mörgelin, Matthias; Albiger, Barbara; Malmsten, Martin; Schmidtchen, Artur

    2011-06-01

    Peptides of the C-terminal region of human thrombin are released upon proteolysis and identified in human wounds. In this study, we wanted to investigate minimal determinants, as well as structural features, governing the antimicrobial and immunomodulating activity of this peptide region. Sequential amino acid deletions of the peptide GKYGFYTHVFRLKKWIQKVIDQFGE (GKY25), as well as substitutions at strategic and structurally relevant positions, were followed by analyses of antimicrobial activity against the Gram-negative bacteria Escherichia coli and Pseudomonas aeruginosa, the Gram-positive bacterium Staphylococcus aureus, and the fungus Candida albicans. Furthermore, peptide effects on lipopolysaccharide (LPS)-, lipoteichoic acid-, or zymosan-induced macrophage activation were studied. The thrombin-derived peptides displayed length- and sequence-dependent antimicrobial as well as immunomodulating effects. A peptide length of at least 20 amino acids was required for effective anti-inflammatory effects in macrophage models, as well as optimal antimicrobial activity as judged by MIC assays. However, shorter (>12 amino acids) variants also displayed significant antimicrobial effects. A central K14 residue was important for optimal antimicrobial activity. Finally, one peptide variant, GKYGFYTHVFRLKKWIQKVI (GKY20) exhibiting improved selectivity, i.e., low toxicity and a preserved antimicrobial as well as anti-inflammatory effect, showed efficiency in mouse models of LPS shock and P. aeruginosa sepsis. The work defines structure-activity relationships of C-terminal host defense peptides of thrombin and delineates a strategy for selecting peptide epitopes of therapeutic interest.

  4. Medical modification of human acute radiation injury

    International Nuclear Information System (INIS)

    Wald, N.; Watson, J.A.

    1977-01-01

    In weighing the benefits and risks of utilizing nuclear energy, there must be a continuing reassessment as nuclear technology develops and changes. The health effects of radiation accidents, as most important part of the risk, must also be reevaluated as our medical ability grows to modify and ameliorate the consequences. The therapeutic efforts were classified as minimal, supportive or heroic. Supportive treatment included reverse isolation, detailed clinical laboratory measurements copious antibiotics, and transfusions of various blood cells, electrolytes and nutrients. Heroic treatment added bone marrow transplantation, while minimal treatment included none of these. It was concluded that while the LD 50 for man is about 340 rads with only minimal treatment, it could be increased to 510 rads with supportive therapy and to over 1,000 rads with heroic treatment. Hematopoietic injury predominated in this exposure range. Finally an estimate of the medical facilities available in the United States to meet these potential clinical needs was made. The relationship of the medical care resources to the likely needs following a serious nuclear power plant accident will be discussed

  5. To fail is human: remediating remediation in medical education.

    Science.gov (United States)

    Kalet, Adina; Chou, Calvin L; Ellaway, Rachel H

    2017-12-01

    Remediating failing medical learners has traditionally been a craft activity responding to individual learner and remediator circumstances. Although there have been moves towards more systematic approaches to remediation (at least at the institutional level), these changes have tended to focus on due process and defensibility rather than on educational principles. As remediation practice evolves, there is a growing need for common theoretical and systems-based perspectives to guide this work. This paper steps back from the practicalities of remediation practice to take a critical systems perspective on remediation in contemporary medical education. In doing so, the authors acknowledge the complex interactions between institutional, professional, and societal forces that are both facilitators of and barriers to effective remediation practices. The authors propose a model that situates remediation within the contexts of society as a whole, the medical profession, and medical education institutions. They also outline a number of recommendations to constructively align remediation principles and practices, support a continuum of remediation practices, destigmatize remediation, and develop institutional communities of practice in remediation. Medical educators must embrace a responsible and accountable systems-level approach to remediation if they are to meet their obligations to provide a safe and effective physician workforce.

  6. Harnessing Full Value from the DoD Serum Repository and the Defense Medical Surveillance System

    Science.gov (United States)

    2010-01-01

    research laboratories are located in Egypt, Indo- nesia, Kenya, Peru , and Thailand and serve as collaborative centers with host nation research...wide range of medical topics, including infec- tious diseases, cancers, diabetes , multiple sclerosis, and schizophrenia. Civilian and military...test for diabetes . Whole blood is required for some hematology tests such as complete blood counts, and it can also be used for a variety of

  7. NATO Handbook on the Medical Aspects of NBC Defensive Operations AMedP-6(B)

    Science.gov (United States)

    1996-02-01

    1979. Alter, W. A., and Conklin, J. J. "Radiation Casualties" in: Handbook of Disaster Medicine . Medical Examination Publishing Co., 1983. Berdjis...disturbance produced in indoles (such as LSD) or the cannabinols (such as marihuana extracts) is not really delirium, because the casualties remain... medicinal properties similar to those of inorganic arsenic to which it is partially reduced in the body. However, no reduction to trivalent arsenic

  8. Violence toward health workers in Bahrain Defense Force Royal Medical Services’ emergency department

    Science.gov (United States)

    Rafeea, Faisal; Al Ansari, Ahmed; Abbas, Ehab M; Elmusharaf, Khalifa; Abu Zeid, Mohamed S

    2017-01-01

    Background Employees working in emergency departments (EDs) in hospital settings are disproportionately affected by workplace violence as compared to those working in other departments. Such violence results in minor or major injury to these workers. In other cases, it leads to physical disability, reduced job performance, and eventually a nonconducive working environment for these workers. Materials and methods A cross-sectional exploratory questionnaire was used to collect data used for the examination of the incidents of violence in the workplace. This study was carried out at the ED of the Bahrain Defense Force (BDF) Hospital. Participants for the study were drawn from nurses, support staff, and emergency physicians. Both male and female workers were surveyed. Results The study included responses from 100 staff in the ED of the BDF Hospital in Bahrain (doctors, nurses, and support personnel). The most experienced type of violence in the workers in the past 12 months in this study was verbal abuse, which was experienced by 78% of the participants, which was followed by physical abuse (11%) and then sexual abuse (3%). Many cases of violence against ED workers occurred during night shifts (53%), while physical abuse was reported to occur during all the shifts; 40% of the staff in the ED of the hospital were not aware of the policies against workplace violence, and 26% of the staff considered leaving their jobs at the hospital. Conclusion This study reported multiple findings on the number of workplace violence incidents, as well as the characteristics and factors associated with violence exposure in ED staff in Bahrain. The results clearly demonstrate the importance of addressing the issue of workplace violence in EDs in Bahrain and can be used to demonstrate the strong need for interventions. PMID:29184452

  9. Human rights reasoning and medical law: a sceptical essay.

    Science.gov (United States)

    Wall, Jesse

    2015-03-01

    I am sceptical as to the contribution that human rights can make to our evaluation of medical law. I will argue here that viewing medical law through a human rights framework provides no greater clarity, insight or focus. If anything, human rights reasoning clouds any bioethical or evaluative analysis. In Section 1 of this article, I outline the general structure of human rights reasoning. I will describe human rights reasoning as (a) reasoning from rights that each person has 'by virtue of their humanity', (b) reasoning from rights that provide 'hard to defeat' reasons for action and (c) reasoning from abstract norms to specified duties. I will then argue in Section 2 that, unless we (a) re-conceive of human rights as narrow categories of liberties, it becomes (b) necessary for our human rights reasoning to gauge the normative force of each claim or liberty. When we apply this approach to disputes in medical law, we (in the best case scenario) end up (c) 'looking straight through' the human right to the (disagreement about) values and features that each person has by virtue of their humanity. © 2014 John Wiley & Sons Ltd.

  10. Evasion of Human Neutrophil-Mediated Host Defense during Toxoplasma gondii Infection.

    Science.gov (United States)

    Lima, Tatiane S; Gov, Lanny; Lodoen, Melissa B

    2018-02-13

    Neutrophils are a major player in host immunity to infection; however, the mechanisms by which human neutrophils respond to the intracellular protozoan parasite Toxoplasma gondii are still poorly understood. In the current study, we found that, whereas primary human monocytes produced interleukin-1beta (IL-1β) in response to T. gondii infection, human neutrophils from the same blood donors did not. Moreover, T. gondii inhibited lipopolysaccharide (LPS)-induced IL-1β synthesis in human peripheral blood neutrophils. IL-1β suppression required active parasite invasion, since heat-killed or mycalolide B-treated parasites did not inhibit IL-1β release. By investigating the mechanisms involved in this process, we found that T. gondii infection of neutrophils treated with LPS resulted in reduced transcript levels of IL-1β and NLRP3 and reduced protein levels of pro-IL-1β, mature IL-1β, and the inflammasome sensor NLRP3. In T. gondii -infected neutrophils stimulated with LPS, the levels of MyD88, TRAF6, IKKα, IKKβ, and phosphorylated IKKα/β were not affected. However, LPS-induced IκBα degradation and p65 phosphorylation were reduced in T. gondii- infected neutrophils, and degradation of IκBα was reversed by treatment with the proteasome inhibitor MG-132. Finally, we observed that T. gondii inhibited the cleavage and activity of caspase-1 in human neutrophils. These results indicate that T. gondii suppression of IL-1β involves a two-pronged strategy whereby T. gondii inhibits both NF-κB signaling and activation of the NLRP3 inflammasome. These findings represent a novel mechanism of T. gondii evasion of human neutrophil-mediated host defense by targeting the production of IL-1β. IMPORTANCE Toxoplasma gondii is an obligate intracellular parasite that infects approximately one-third of humans worldwide and can invade virtually any nucleated cell in the human body. Although it is well documented that neutrophils infiltrate the site of acute T

  11. Convergence of emerging science and technology trends for defense, security, and human performance

    International Nuclear Information System (INIS)

    Vaseashta, Ashok

    2010-01-01

    Full text: Recent technological innovations have changed the landscape of traditional scientific research. Advances in the nano- and bio-sciences, and materials and information processing are driving innovations at a phenomenal rate, resulting in greater interest yet uncertainty in the chemical-biological threat environment, research and development and other fields of policy, and overall preparedness. Conversely, the synergy arising from the convergence of nanotechnology, biotechnology, information processing and cognitive sciences (NBIC) offers great potential for transformational, revolutionary opportunities with many technological applications. Employing a new initiative termed 'Technology Foresight, Assessment, and Road-Mapping' (Tech-FARM TM ) - a multi dimensional futures-oriented approach for identification and management of emerging and/or disruptive science and technology. In literature similar initiative termed as GRAIN and BANG appear with similarity to NBIC - however Tech-FARM is comprehensive and an exhaustive method. Trans-disciplinary principles underlying NBIC convergence facilitates the development of visions and projections of future possible scientific and technological advances, environments, and productive collaborations for integrated, novel and/or unconventional solutions for 21 st century chem. -bio defense challenges. Incorporation of cognitive sciences refers to human performance enhancement in battlefield theatre. The dynamic relationship between contextual influence (socio-economical factors) and technological development is of critical consideration for S and T futures analyses. The Tech-FARM approach comprises three over-lapping practices of futures studies, including: foresight, the identification of future S and T development and their interaction with society and environment with the purpose of guiding actions to produce a more favorable future; assessment, which is concerned with the unintended, indirect, and delayed impacts of

  12. Humanization of medical education: Need of the hour

    Directory of Open Access Journals (Sweden)

    K. A. Kumar

    2014-01-01

    Full Text Available Though the importance of psychological factors in maintenance of health, as well as etiology and prognosis of diseases have been recognized in ancient medicine by discerning and thoughtful clinicians in all ages, for the large majority of the practitioners such a perception has not been there. A cross-sectional, organ-based, and symptom-centered clinical approach was largely prevalent in day-to-day medicine. Medical training also followed more or less the same path. The positive psychological and behavioral qualities needed in the physician are left to the individual student to develop on his own during studies or to the physician afterwards. Some do, many do not. The importance of communication, doctor-patient relationship, empathy and psychological sensitivity in the making of a physician started getting identified in advanced medical universities in western countries by the middle of the last century. Since then behavioral science and medical humanities have been incorporated as important modules in the graduate medical training curriculum not only in advanced western medical universities, but also in good universities elsewhere. The situation in India, till now has been quite unsatisfactory. The undergraduate medical students had only 2 weeks of clinical posting and few hours of lectures, allotted for psychiatry: Even these were not actually carried out in many institutions properly. Responding to repeated representations from mental health experts in the country and abroad, medical universities and educationists, the Medical Council of India in 2012 has made 2 weeks of Residential Internship in Psychiatry (CRRI mandatory, and also recommended incorporation of medical humanities in the MBBS curriculum. The paper presents a brief outline of how a Clinical Behavioral Sciences Training Program l incorporating medical humanities can be developed and carried out as a mainstream component for the undergraduate medical training in the country. The

  13. Incapacity of the Mind Secondary to Medication Misuse as a Not Criminally Responsible Defense.

    Science.gov (United States)

    Prat, Sebastien S; Losier, Bruno J; Moulden, Heather M; Chaimowitz, Gary A

    2017-01-01

    The manifestations of disorders of the mind may play a role in the occurrence of criminal behavior. In the majority of the cases, the presence of a psychiatric disorder is cited as the reason that an individual was not fully aware of his behavior. However, other conditions, such as seizure disorders or hypoglycemia, have also been linked to an inability to understand the nature and consequences of one's actions. On occasion, these situations can be explained by a state of automatism that may be described as insane or noninsane. In this article, we describe the case of a 77-year-old man, suffering from Parkinson's disease, where the issue of criminal responsibility associated with incapacity of the mind secondary to medication misuse was raised. We elaborate on the thinking behind this opinion and the implications according to Canadian law. Although the legal outcome of this case is specific to our jurisdiction, the clinical implication may be common to any patient suffering from a similar condition and may inform physicians, families, and lawyers. © 2016 American Academy of Forensic Sciences.

  14. Integrating medical humanities into a pharmaceutical care seminar on dementia.

    Science.gov (United States)

    Zimmermann, Martina

    2013-02-12

    Objective. To design, integrate, and assess the effectiveness of a medical humanities teaching module that focuses on pharmaceutical care for dementia patients.Design. Visual and textual dementia narratives were presented using a combination of teacher and learner-centered approaches with the aim being to highlight patients' and caregivers' needs for empathy and counselling.Assessment. As gauged from pre- and post-experience questionnaires, students highly rated this approach to teaching medical humanities. In-class presentations demonstrated students' increased sensitivity to patient and caregiver needs, while objective learning outcomes demonstrated students' increased knowledge and awareness.Conclusions. Pharmacy students were open to and successfully learned from reading and discussing patient and caregiver narratives, which furthers the discussion on the value of integrating the medical humanities into the curricula of pharmacy and other health sciences.

  15. Medical humanities and philosophy: is the universe expanding or contracting?

    Science.gov (United States)

    Stempsey, William E

    2007-12-01

    The question of whether the universe is expanding or contracting serves as a model for current questions facing the medical humanities. The medical humanities might aptly be described as a metamedical multiverse encompassing many separate universes of discourse, the most prominent of which is probably bioethics. Bioethics, however, is increasingly developing into a new interdisciplinary discipline, and threatens to engulf the other medical humanities, robbing them of their own distinctive contributions to metamedicine. The philosophy of medicine considered as a distinct field of study has suffered as a result. Indeed, consensus on whether the philosophy of medicine even constitutes a legitimate field of study is lacking. This paper presents an argument for the importance of a broad conception of the philosophy of medicine and the central role it should play in organizing and interpreting the various fields of study that make up the metamedical multiverse.

  16. Human-machine analytics for closed-loop sense-making in time-dominant cyber defense problems

    Science.gov (United States)

    Henry, Matthew H.

    2017-05-01

    Many defense problems are time-dominant: attacks progress at speeds that outpace human-centric systems designed for monitoring and response. Despite this shortcoming, these well-honed and ostensibly reliable systems pervade most domains, including cyberspace. The argument that often prevails when considering the automation of defense is that while technological systems are suitable for simple, well-defined tasks, only humans possess sufficiently nuanced understanding of problems to act appropriately under complicated circumstances. While this perspective is founded in verifiable truths, it does not account for a middle ground in which human-managed technological capabilities extend well into the territory of complex reasoning, thereby automating more nuanced sense-making and dramatically increasing the speed at which it can be applied. Snort1 and platforms like it enable humans to build, refine, and deploy sense-making tools for network defense. Shortcomings of these platforms include a reliance on rule-based logic, which confounds analyst knowledge of how bad actors behave with the means by which bad behaviors can be detected, and a lack of feedback-informed automation of sensor deployment. We propose an approach in which human-specified computational models hypothesize bad behaviors independent of indicators and then allocate sensors to estimate and forecast the state of an intrusion. State estimates and forecasts inform the proactive deployment of additional sensors and detection logic, thereby closing the sense-making loop. All the while, humans are on the loop, rather than in it, permitting nuanced management of fast-acting automated measurement, detection, and inference engines. This paper motivates and conceptualizes analytics to facilitate this human-machine partnership.

  17. Use of the CRISPR/Cas9 system as an intracellular defense against HIV-1 infection in human cells.

    Science.gov (United States)

    Liao, Hsin-Kai; Gu, Ying; Diaz, Arturo; Marlett, John; Takahashi, Yuta; Li, Mo; Suzuki, Keiichiro; Xu, Ruo; Hishida, Tomoaki; Chang, Chan-Jung; Esteban, Concepcion Rodriguez; Young, John; Izpisua Belmonte, Juan Carlos

    2015-03-10

    To combat hostile viruses, bacteria and archaea have evolved a unique antiviral defense system composed of clustered regularly interspaced short palindromic repeats (CRISPRs), together with CRISPR-associated genes (Cas). The CRISPR/Cas9 system develops an adaptive immune resistance to foreign plasmids and viruses by creating site-specific DNA double-stranded breaks (DSBs). Here we adapt the CRISPR/Cas9 system to human cells for intracellular defense against foreign DNA and viruses. Using HIV-1 infection as a model, our results demonstrate that the CRISPR/Cas9 system disrupts latently integrated viral genome and provides long-term adaptive defense against new viral infection, expression and replication in human cells. We show that engineered human-induced pluripotent stem cells stably expressing HIV-targeted CRISPR/Cas9 can be efficiently differentiated into HIV reservoir cell types and maintain their resistance to HIV-1 challenge. These results unveil the potential of the CRISPR/Cas9 system as a new therapeutic strategy against viral infections.

  18. The Limits of Narrative: Provocations for the Medical Humanities

    Science.gov (United States)

    Woods, Angela

    2014-01-01

    This paper aims to (re)ignite debate about the role of narrative in the medical humanities. It begins with a critical review of the ways in which narrative has been mobilised by humanities and social science scholars to understand the experience of health and illness. I highlight seven dangers or blind spots in the dominant medical humanities approach to narrative, including the frequently unexamined assumption that all human beings are “naturally narrative.” I then explore this assumption further through an analysis of philosopher Galen Strawson’s influential article “Against Narrativity.” Strawson rejects the descriptive claim that “human beings typically see or live or experience their lives as a narrative” and the normative claim that “a richly Narrative outlook is essential to a well-lived life, to true or full personhood.” His work has been taken up across a range of disciplines but its implications in the context of health and illness have not yet been sufficiently discussed. This article argues that “Against Narrativity” can and should stimulate robust debate within the medical humanities regarding the limits of narrative, and concludes by discussing a range of possibilities for venturing “beyond narrative.” PMID:22038696

  19. The limits of narrative: provocations for the medical humanities.

    Science.gov (United States)

    Woods, Angela

    2011-12-01

    This paper aims to (re)ignite debate about the role of narrative in the medical humanities. It begins with a critical review of the ways in which narrative has been mobilised by humanities and social science scholars to understand the experience of health and illness. I highlight seven dangers or blind spots in the dominant medical humanities approach to narrative, including the frequently unexamined assumption that all human beings are 'naturally narrative'. I then explore this assumption further through an analysis of philosopher Galen Strawson's influential article 'Against Narrativity'. Strawson rejects the descriptive claim that "human beings typically see or live or experience their lives as a narrative" and the normative claim that "a richly Narrative outlook is essential to a well-lived life, to true or full personhood". His work has been taken up across a range of disciplines, but its implications in the context of health and illness have not yet been sufficiently discussed. This article argues that 'Against Narrativity' can and should stimulate robust debate within the medical humanities regarding the limits of narrative, and concludes by discussing a range of possibilities for venturing 'beyond narrative'.

  20. Community-oriented Curriculum Design for Medical Humanities

    Directory of Open Access Journals (Sweden)

    Duu-Jian Tsai

    2008-07-01

    Full Text Available Various recent surveys in Taiwan show physicians' decreasing satisfaction and increasing frustration with their working environment. Their major complaints are stress, long hours, salary, management's disrespect, and lack of trust from patients and society. To move towards restoration of social trust, this paper proposes incorporating the concept of “doctor as mediator in the changing relationship with patients” into the medical curriculum, as will be described in detail. This paper argues that structured community service for medical students facilitates self-learning, and will not only motivate them to develop good clinical and communication skills, but will also lead them to realize that the essence of medicine must be social trust. These effects have been seen after several years of an experimental curriculum involving more than 800 students. A program using methodology for community empowerment has been realized in a two-stage curriculum design. Students' self-assessment of achievements in these courses included further improvement in communication skills, courage to express own position, appropriate planning in advance, management of human resources, ability to deal with limited space and time, and experience of a profoundly moving learning process. In conclusion, community-based curriculum designs that facilitate self-learning for medical students should be the key element of reformed humanities education in Taiwan medical schools. Moreover, medical humanities continues to be a key element contributing to ongoing intellectual movements in Taiwan for building civil society and rooting democracy in the community.

  1. The human genome project and the future of medical practice ...

    African Journals Online (AJOL)

    Contrary to the scepticism that characterised the planning stages of the human genome project, the technology and sequence data resulting from the project are set to revolutionise medical practice for good. The expected benefits include: enhanced discovery of disease genes, which will lead to improved knowledge on the ...

  2. Human Factors in Training: Space Medical Proficiency Training

    Science.gov (United States)

    Byrne, Vicky E.; Barshi, I.; Arsintescu, L.; Connell, E.

    2010-01-01

    The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and the International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to the ISS, medical equipment will be located on the ISS, and carried into CEV in the event of an emergency. Flight surgeons (FS) on the ground in Mission Control will be expected to direct the crew medical officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). This is a joint project consisting of human factors team from the Ames Research Center (ARC) with Immanuel Barshi as Principal Investigator and the Johnson Space Center (JSC). Human factors researchers at JSC have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. Work on medical training has been conducted in collaboration with the Medical Training Group at the Johnson Space Center (JSC) and with Wyle Laboratories that provides medical training to crew members, biomedical engineers (BMEs), and to flight surgeons under the Bioastronautics contract. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. A second area of research involves FS performance support tools. Information needed by the FS during the ISS mission

  3. Innovative taught MSc in Medical Visualisation and Human Anatomy.

    Science.gov (United States)

    Clunie, Lauren; Livingstone, Daniel; Rea, Paul M

    2015-06-01

    A relatively new, fully accredited MSc in Medical Visualisation and Human Anatomy, is now offered through a joint collaboration with the Laboratory of Human Anatomy, University of Glasgow and the Digital Design Studio, Glasgow School of Art. This degree combines training in digital technologies and intensive human anatomy training as a result of a long-standing successful partnership between these two esteemed institutes. The student also has to complete a research dissertation which encompasses both the digital perspective and a related medical, dental, surgical, veterinary (comparative anatomy) or life science specialty to enhance development in the digital field for a variety of specialties. This article discusses the background in development of this degree, the course structure and the career prospects and destinations for graduates of this unique degree programme.

  4. Use of human cadavers in teaching of human anatomy in brazilian medical faculties

    Directory of Open Access Journals (Sweden)

    Isabela de Sousa Leal Lopes

    2017-05-01

    Full Text Available The Human Anatomy is the study of human body structure and it has been related to the use of cadavers through the history. The aim of this research was to investigate the use of human cadavers in practical classes of human anatomy in Brazilian medical schools, and it was also made the identification of alternative methodologies and new technologies applied to the teaching of Anatomy. The research was conducted at the Faculdade Integral Diferencial from January to December of 2015. The population studied was composed by professors responsible for the Human Anatomy sector of the Brazilian medical faculties. It was addressed all the 242 medical colleges of the Brazil. It was obtained 81 answers. 96% of respondents reported make use of human corpses in its practical lessons of anatomy. It can be observed that 42% of the surveyed medical schools make use of only formaldehyde. 81% of faculties reported to face some difficulties to acquire human cadavers. 84% of medical schools make use of artificial models. 46% of faculties make use of diagnostic images. It can be concluded that human bodies, artificial models and new technologies are widely used in practical classes of anatomy in Brazil, since there is a difficulty to obtain cadavers.

  5. Human rights and the requirement for international medical aid.

    Science.gov (United States)

    Tolchin, Benjamin

    2008-08-01

    Every year approximately 18 million people die prematurely from treatable medical conditions including infectious diseases and nutritional deficiencies. The deaths occur primarily amongst the poorest citizens of poor developing nations. Various groups and individuals have advanced plans for major international medical aid to avert many of these unnecessary deaths. For example, the World Health Organization's Commission on Macroeconomics and Health estimated that eight million premature deaths could be prevented annually by interventions costing roughly US$57 bn per year. This essay advances an argument that human rights require high-income nations to provide such aid. The essay briefly examines John Rawls' obligations of justice and the reasons that their applicability to cases of international medical aid remains controversial. Regardless, the essay argues that purely humanitarian obligations bind the governments and citizens of high-income liberal democracies at a minimum to provide major medical aid to avert premature deaths in poor nations. In refusing to undertake such medical relief efforts, developed nations fail to adequately protect a fundamental human right to life.

  6. Music and health. Phenomenological investigation of a medical humanity.

    Science.gov (United States)

    McLellan, Lucy; McLachlan, Emma; Perkins, Laurence; Dornan, Tim

    2013-05-01

    In response to the tendency for music to be under-represented in the discourse of medical humanities, we framed the question 'how can music heal?' We answered it by exploring the lived experiences of musicians with lay or professional interests in health. Two medical students and a medically qualified educationalist, all musicians, conducted a co-operative inquiry with a professional musician interested in health. All researchers and six respondents kept audio or written diaries. Three respondents were interviewed in depth. A medical school head (and experienced musician) critiqued the phenomenological analysis of respondents' accounts of music, health, and its relationship with undergraduate medical education. Respondents experienced music as promoting health, even in seriously diseased people. Music affected people's identity and emotions. Through the medium of structure and harmony, it provided a means of self-expression that adapted to whatever condition people were in. Music was a communication medium, which could make people feel less isolated. Immersion in music could change negative states of mind to more positive ones. A transport metaphor was commonly used; music 'taking people to better places'. Exercising control by becoming physically involved in music enhanced diseased people's self-esteem. Music was able to bring the spiritual, mental, and physical elements of their lives into balance, to the benefit of their wellbeing. Music could help medical students appreciate holistically that the state of health of people who are either well or diseased can be enhanced by a 'non-technical' intervention.

  7. Real time medical learning using the WhatsApp cellular network: a cross sectional study following the experience of a division's medical officers in the Israel Defense Forces.

    Science.gov (United States)

    Blumenfeld, Ofer; Brand, Ronen

    2016-01-01

    Primary care medical officers (MOs) are expected to maintain self-education while serving in their units in order to maintain professional standards. With the rise of smartphone use in the Israel Defense Forces (IDF), the WhatsApp application can facilitate medical learning. To date, there has been no description of the use of this tool by MOs in a military setting. This paper aims to describe the pattern of use of a WhatsApp application group by IDF's MOs. We collected all the information (textual and visual) uploaded to a WhatsApp group called "The Division's Physicians", originally established two years earlier, during a randomly selected sample month. We analyzed the pattern of its use and explored the association between the number of questions and responses uploaded to the group and the duration of service of their senders. In December 2014, the "The Division's Physicians" WhatsApp group had 41 participants. We identified 478 messages classified as questions and 531 messages classified as responses. The number of questions asked by MOs in their first 2 months of service in the battalion (median = 14.5) and the number of questions asked by MOs with more than one year of their first assignment (median = 10.5) were significantly higher than the number of questions (median = 1.0) asked by MOs in their second assignment or later ( p values for comparisons were 0.008 and 0.012 respectively). We also found that both the number of responses provided by MOs with more than one year of service in the battalion (median = 21) and the number of responses provided by MOs in their second assignment or later (median = 5) were significantly higher than the number of responses (median = 1) provided by MOs within their first 2 months of service in the battalion ( p value for comparisons were 0.024 and 0.039 respectively). We conclude from our preliminary study that a WhatsApp group can facilitate the transfer of knowledge from more experienced MOs to those with

  8. Fluoridation: a violation of medical ethics and human rights.

    Science.gov (United States)

    Cross, Douglas W; Carton, Robert J

    2003-01-01

    Silicofluorides, widely used in water fluoridation, are unlicensed medicinal substances, administered to large populations without informed consent or supervision by a qualified medical practitioner. Fluoridation fails the test of reliability and specificity, and, lacking toxicity testing of silicofluorides, constitutes unlawful medical research. It is banned in most of Europe; European Union human rights legislation makes it illegal. Silicofluorides have never been submitted to the U.S. FDA for approval as medicines. The ethical validity of fluoridation policy does not stand up to scrutiny relative to the Nuremberg Code and other codes of medical ethics, including the Council of Europe's Biomedical Convention of 1999. The police power of the State has been used in the United States to override health concerns, with the support of the courts, which have given deference to health authorities.

  9. The C-terminal sequence of several human serine proteases encodes host defense functions.

    Science.gov (United States)

    Kasetty, Gopinath; Papareddy, Praveen; Kalle, Martina; Rydengård, Victoria; Walse, Björn; Svensson, Bo; Mörgelin, Matthias; Malmsten, Martin; Schmidtchen, Artur

    2011-01-01

    Serine proteases of the S1 family have maintained a common structure over an evolutionary span of more than one billion years, and evolved a variety of substrate specificities and diverse biological roles, involving digestion and degradation, blood clotting, fibrinolysis and epithelial homeostasis. We here show that a wide range of C-terminal peptide sequences of serine proteases, particularly from the coagulation and kallikrein systems, share characteristics common with classical antimicrobial peptides of innate immunity. Under physiological conditions, these peptides exert antimicrobial effects as well as immunomodulatory functions by inhibiting macrophage responses to bacterial lipopolysaccharide. In mice, selected peptides are protective against lipopolysaccharide-induced shock. Moreover, these S1-derived host defense peptides exhibit helical structures upon binding to lipopolysaccharide and also permeabilize liposomes. The results uncover new and fundamental aspects on host defense functions of serine proteases present particularly in blood and epithelia, and provide tools for the identification of host defense molecules of therapeutic interest. Copyright © 2011 S. Karger AG, Basel.

  10. Effects of 60Co gamma radiation on defense function of human polymorphonuclear leukocytes

    International Nuclear Information System (INIS)

    Sasagawa, Sumiko; Suzuki, Kazuo; Sakatani, Tatsuichiro; Brooks, G.T.; Fujikura, Toshio.

    1986-06-01

    The effects of radiation on defense function of polymorphonuclear leukocytes (PMN) were studied following irradiation with 60 Co γ radiation (30 - 3,000 rad) using PMN separated from the peripheral blood of healthy volunteers. The migration distances for all three measures of chemotaxis to fMet-Leu-Phe (10 -8 M), chemokinesis induced by fMet-Leu-Phe, and random migration tended to decrease with increasing dose, showing 0.0054 μm/rad (p -5 M) in conjunction with cytochalasin B (CB, 5 μg/ml) there was a significant dose trend, showing the dose effects of decreasing 0.0022 % release/rad for BGL and 0.0030 % release/rad for LYZ with increasing dose. In superoxide anion (O 2 - ) production, a slight and marginally significant linear dose trend was found. These results suggest that the defense function of PMN is not so resistant to radiation as predicted from the fact that PMN in the peripheral blood are differentiated and mature. It is thought that radiation inflicts substantially harmful effects on the defense function of peripheral PMN. (author)

  11. Cultural crossings of care: An appeal to the medical humanities.

    Science.gov (United States)

    Kristeva, Julia; Moro, Marie Rose; Ødemark, John; Engebretsen, Eivind

    2018-03-01

    Modern medicine is confronted with cultural crossings in various forms. In facing these challenges, it is not enough to simply increase our insight into the cultural dimensions of health and well-being. We must, more radically, question the conventional distinction between the 'objectivity of science' and the 'subjectivity of culture'. This obligation creates an urgent call for the medical humanities but also for a fundamental rethinking of their grounding assumptions.Julia Kristeva (JK) has problematised the biomedical concept of health through her reading of the anthropogony of Cura (Care), who according to the Roman myth created man out of a piece of clay. JK uses this fable as an allegory for the cultural distinction between health construed as a 'definitive state', which belongs to biological life ( bios ), and healing as a durative 'process with twists and turns in time' that characterises human living ( zoe ). A consequence of this demarcation is that biomedicine is in constant need of 'repairing' and bridging the gap between bios and zoe, nature and culture. Even in radical versions, the medical humanities are mostly reduced to such an instrument of repairment, seeing them as what we refer to as a soft, 'subjective' and cultural supplement to a stable body of 'objective', biomedical and scientific knowledge. In this article, we present a prolegomenon to a more radical programme for the medical humanities, which calls the conventional distinctions between the humanities and the natural sciences into question, acknowledges the pathological and healing powers of culture, and sees the body as a complex biocultural fact. A key element in such a project is the rethinking of the concept of 'evidence' in healthcare. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Medical students as human subjects in educational research

    Directory of Open Access Journals (Sweden)

    Adina L. Kalet

    2013-02-01

    Full Text Available Introduction: Special concerns often arise when medical students are themselves the subjects of education research. A recently completed large, multi-center randomized controlled trial of computer-assisted learning modules for surgical clerks provided the opportunity to explore the perceived level of risk of studies where medical students serve as human subjects by reporting on: 1 the response of Institutional Review Boards (IRBs at seven institutions to the same study protocol; and 2 the thoughts and feelings of students across study sites about being research subjects. Methods: From July 2009 to August 2010, all third-year medical students at seven collaborating institutions were eligible to participate. Patterns of IRB review of the same protocol were compared. Participation burden was calculated in terms of the time spent interacting with the modules. Focus groups were conducted with medical students at each site. Transcripts were coded by three independent reviewers and analyzed using Atlas.ti. Results: The IRBs at the seven participating institutions granted full (n=1, expedited (n=4, or exempt (n=2 review of the WISE Trial protocol. 995 (73% of those eligible consented to participate, and 207 (20% of these students completed all outcome measures. The average time to complete the computer modules and associated measures was 175 min. Common themes in focus groups with participant students included the desire to contribute to medical education research, the absence of coercion to consent, and the low-risk nature of the research. Discussion: Our findings demonstrate that risk assessment and the extent of review utilized for medical education research vary among IRBs. Despite variability in the perception of risk implied by differing IRB requirements, students themselves felt education research was low risk and did not consider themselves to be vulnerable. The vast majority of eligible medical students were willing to participate as research

  13. Innate Defense against Influenza A Virus: Activity of Human Neutrophil Defensins and Interactions of Defensins with Surfactant Protein D

    DEFF Research Database (Denmark)

    Hartshorn, Kevan L.; White, Mitchell R.; Tecle, Tesfaldet

    2006-01-01

    Surfactant protein D (SP-D) plays important roles in innate host defense against influenza A virus (IAV) infection, in part by modifying interactions with neutrophils. Human neutrophil defensins (HNPs) inhibit infectivity of enveloped viruses, including IAV. Our goal in this study was to characte......Surfactant protein D (SP-D) plays important roles in innate host defense against influenza A virus (IAV) infection, in part by modifying interactions with neutrophils. Human neutrophil defensins (HNPs) inhibit infectivity of enveloped viruses, including IAV. Our goal in this study...... was to characterize antiviral interactions between SP-D and HNPs. Recombinant and/or natural forms of SP-D and related collectins and HNPs were tested for antiviral activity against two different strains of IAV. HNPs 1 and 2 did not inhibit viral hemagglutination activity, but they interfered...... with the hemagglutination-inhibiting activity of SP-D. HNPs had significant viral neutralizing activity against divergent IAV strains. However, the HNPs generally had competitive effects when combined with SP-D in assays using an SP-D-sensitive IAV strain. In contrast, cooperative antiviral effects were noted in some...

  14. Defense of the Human Rights in opposition to the regressive dictatorships: A comparison between the Argentinian and the Uruguayian cases

    Directory of Open Access Journals (Sweden)

    Luciano ALONSO

    2011-05-01

    Full Text Available The article presents a tentative comparison between the social movements in defense of fundamental human rights, against the dictatorships of Uruguay (1973-1985 and Argentina (1976-1983. Variations among both movements are systematically identified. The temporalities, the problems relative to his endogenous or exogenous origins as the differentiations that they registered during both dictatorships and in the transitions to the constitutional governments are analyzed. The text relativizes the conception of the Uruguayan movement like later and weaker than the Argentinean, and suggests some provisional explanations of the differences. The main points of comparison are: a The political inscription of the social actors and the mode in which were organized the majority of the syndical and political groups, b The rate of violence applied by both dictatorships, c The different types of activism in defense of fundamental human rights, d The modalities of the transition, e The ways of government (governmentality, and f The scale and geographical and demographic characteristics.

  15. Nonadherence with pediatric human immunodeficiency virus therapy as medical neglect.

    Science.gov (United States)

    Roberts, Gretchen M; Wheeler, J Gary; Tucker, Nancy C; Hackler, Chris; Young, Karen; Maples, Holly D; Darville, Toni

    2004-09-01

    To examine the results of an interventionist approach applied to human immunodeficiency virus (HIV)-infected children for whom caregiver nonadherence was suspected as the cause of treatment failure. The medical records of a cohort of 16 perinatally HIV-infected children whose care was managed at the Arkansas Children's Hospital Pediatric HIV Clinic for an uninterrupted period of >or=3 years were reviewed through July 2003. Data collected included date of birth, dates of and explanations for clinic visits and hospitalizations, dates of laboratory evaluations, CD4(+) T cell percentages, plasma HIV-1 RNA levels, antiretroviral medications, viral resistance tests (eg, phenotype and genotype), and physician-initiated interventions to enhance adherence to the medication regimen. A stepwise interventionist approach was undertaken when patients continued to demonstrate high viral loads, despite documented viral sensitivity to the medication regimen and caregivers' insistence that medications were being administered regularly. Step 1 was prescribing a home health nurse referral, step 2 was administering directly observed therapy (DOT) while the patient was hospitalized for 4 days, and step 3 was submitting a physician-initiated medical neglect report to the Arkansas Department of Human Services. The results for 6 patients for whom this stepwise approach was initiated are reported. Home health nurse referrals failed to result in sustained improvements in adherence in all 6 cases. Viral load assays performed before and after DOT provided an objective measure of the effect of adherence, with 12 hospitalizations resulting in a mean +/- SD decrease in HIV RNA levels of 1.09 +/- 0.5 log(10) copies per mL, with a range of 0.6 to 2.1 log(10) copies per mL. Four families responded to DOT hospitalization, and sustained decreases in the respective patients' viral loads were noted. In 2 cases, medical neglect reports were submitted when DOT did not result in improved adherence. These

  16. Medical Sequencing at the extremes of Human Body Mass

    Energy Technology Data Exchange (ETDEWEB)

    Ahituv, Nadav; Kavaslar, Nihan; Schackwitz, Wendy; Ustaszewski,Anna; Martin, Joes; Hebert, Sybil; Doelle, Heather; Ersoy, Baran; Kryukov, Gregory; Schmidt, Steffen; Yosef, Nir; Ruppin, Eytan; Sharan,Roded; Vaisse, Christian; Sunyaev, Shamil; Dent, Robert; Cohen, Jonathan; McPherson, Ruth; Pennacchio, Len A.

    2006-09-01

    Body weight is a quantitative trait with significantheritability in humans. To identify potential genetic contributors tothis phenotype, we resequenced the coding exons and splice junctions of58 genes in 379 obese and 378 lean individuals. Our 96Mb survey included21 genes associated with monogenic forms of obesity in humans or mice, aswell as 37 genes that function in body weight-related pathways. We foundthat the monogenic obesity-associated gene group was enriched for rarenonsynonymous variants unique to the obese (n=46) versus lean (n=26)populations. Computational analysis further predicted a significantlygreater fraction of deleterious variants within the obese cohort.Consistent with the complex inheritance of body weight, we did notobserve obvious familial segregation in the majority of the 28 availablekindreds. Taken together, these data suggest that multiple rare alleleswith variable penetrance contribute to obesity in the population andprovide a deep medical sequencing based approach to detectthem.

  17. Human Parasites in Medieval Europe: Lifestyle, Sanitation and Medical Treatment.

    Science.gov (United States)

    Mitchell, Piers D

    2015-01-01

    Parasites have been infecting humans throughout our evolution. However, not all people suffered with the same species or to the same intensity throughout this time. Our changing way of life has altered the suitability of humans to infection by each type of parasite. This analysis focuses upon the evidence for parasites from archaeological excavations at medieval sites across Europe. Comparison between the patterns of infection in the medieval period allows us to see how changes in sanitation, herding animals, growing and fertilizing crops, the fishing industry, food preparation and migration all affected human susceptibility to different parasites. We go on to explore how ectoparasites may have spread infectious bacterial diseases, and also consider what medieval medical practitioners thought of parasites and how they tried to treat them. While modern research has shown the use of a toilet decreases the risk of contracting certain intestinal parasites, the evidence for past societies presented here suggests that the invention of latrines had no observable beneficial effects upon intestinal health. This may be because toilets were not sufficiently ubiquitous until the last century, or that the use of fresh human faeces for manuring crops still ensured those parasite species were easily able to reinfect the population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Teaching history of medicine in the perspective of "medical humanities".

    Science.gov (United States)

    von Engelhardt, D

    1999-03-01

    The current interest in philosophical questions and ethical aspects of medicine turns attention towards the past and obtains suggestions and perspectives from previous descriptions and interpretations of sickness, therapy, and the relation between the patient and physician. Culture as therapy and therapy as culture are fundamental challenges for the present; physician, patient, and society, i.e., humans and humane medicine, need this dialogue, which should also be constitutive for teaching history of medicine. Through the separation of the natural sciences and the humanities, modern progress of medicine has produced many benefits but has, at the same time, raised many problems. Negative consequences of this development exist not only for the patient, but also for his personal environment and for the physician. In the course of modern history, there have been several reactions aimed at overcoming these one-sided tendencies: in the Renaissance, in the epoch of Romanticism and Idealism, and at the beginning and the end of the 19th century. This article outlines, with historical examples and contemporary reflections, the concept of teaching history of medicine in the perspective of "medical humanities".

  19. Medical humanities in healthcare education in Italy: a literature review

    Directory of Open Access Journals (Sweden)

    Laura Fieschi

    2013-03-01

    Full Text Available OBJECTIVE. The introduction of medical humanities (MH in undergraduate medical education in Italy has been an issue of debate since the 90's and few years later it was extended to other healthcare degrees. The aims of this Italian literature review, after considering the international scene, are: to evaluate the extent to which the interest in this subject has gradually developed throughout the country; which professional groups have contributed to the debate; to identify which theoretical constructs led to the introduction of MH in undergraduate medical education; to identify whether a clear and shared definition of MH exists in Italian literature; to verify what kinds of MH experiences have been accomplished in Italy. MATERIALS AND METHODS. A comprehensive literature search was conducted, including electronic databases, bibliographies, manual sorting of articles in paper format, congress proceedings. RESULTS. The analysis of the chosen articles underlines that, however limited, Italian literature does not present a very different picture from the international scene. It emerges that teaching MH is believed to be an important feature in undergraduate education of healthcare professionals who intend to propose a bio-psychological-social approach to care, in spite of the difficulty to measure its short and long term effectiveness. The lack of a multidisciplinary, multi-professional approach is also evident. CONCLUSION. Further research aiming to implement the quantity and quality of MH studies in the curricula of undergraduate healthcare education is desirable.

  20. "Making strange": a role for the humanities in medical education.

    Science.gov (United States)

    Kumagai, Arno K; Wear, Delese

    2014-07-01

    Stories, film, drama, and art have been used in medical education to enhance empathy, perspective-taking, and openness to "otherness," and to stimulate reflection on self, others, and the world. Yet another, equally important function of the humanities and arts in the education of physicians is that of "making strange"-that is, portraying daily events, habits, practices, and people through literature and the arts in a way that disturbs and disrupts one's assumptions, perspectives, and ways of acting so that one sees the self, others, and the world anew. Tracing the development of this concept from Viktor Shklovsky's "enstrangement" (ostranenie) through Bertolt Brecht's "alienation effect," this essay describes the use of this technique to disrupt the "automaticity of thinking" in order to discover new ways of perceiving and being in the world.Enstrangement may be used in medical education in order to stimulate critical reflection and dialogue on assumptions, biases, and taken-for-granted societal conditions that may hinder the realization of a truly humanistic clinical practice. In addition to its ability to enhance one's critical understanding of medicine, the technique of "making strange" does something else: By disrupting fixed beliefs, this approach may allow a reexamination of patient-physician relationships in terms of human interactions and provide health care professionals an opportunity-an "open space"-to bear witness and engage with other individuals during challenging times.

  1. Thinking regionally: narrative, the medical humanities and region.

    Science.gov (United States)

    Waddington, Keir

    2015-06-01

    Drawing on multiple literatures from history, geography, anthropology, sociology and literature, this essay asks questions about what we mean by region and why narratives of region should matter to the medical humanities. The essay surveys how region can be used as a lens of analysis, exploring the various academic approaches to region and their limitations. It argues that regions are dynamic but also unstable as a category of analysis and are often used uncritically by scholars. In encouraging scholars working in the medical humanities to be aware that regions are not simple objective or analytical boxes, the essay shows how an awareness of region helps challenge metropolitan whiggism and ideas of core and periphery to give a more prominent place to hinterlands, market towns and rural environments. Furthermore, the essay considers how incorporating region into our understanding of illness can offer new insights. It demonstrates the need for scholars to be attuned to the narratives constructed around regions, suggesting that regions can be viewed as discursive formations that provide a frame for understanding both collective and personal ideas of, and responses to, health and illness, disease and healing, to create what Megan Davies calls a more nuanced 'intellectual cartography'. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Host-pathogen interactions between the human innate immune system and Candida albicans - Understanding and modeling defense and evasion strategies

    Directory of Open Access Journals (Sweden)

    Sybille eDühring

    2015-06-01

    Full Text Available The diploid, polymorphic yeast Candida albicans is one of the most important humanpathogenic fungi. C. albicans can grow, proliferate and coexist as a commensal on or within thehuman host for a long time. Alterations in the host environment, however, can render C. albicansvirulent. In this review, we describe the immunological cross-talk between C. albicans and thehuman innate immune system. We give an overview in form of pairs of human defense strategiesincluding immunological mechanisms as well as general stressors such as nutrient limitation,pH, fever etc. and the corresponding fungal response and evasion mechanisms. FurthermoreComputational Systems Biology approaches to model and investigate these complex interactionare highlighted with a special focus on game-theoretical methods and agent-based models. Anoutlook on interesting questions to be tackled by Systems Biology regarding entangled defenseand evasion mechanisms is given.

  3. A defense of peace as a human right | Hayden | South African ...

    African Journals Online (AJOL)

    Recent years have seen increased debate about the contributions that human rights make to the creation of conditions of peace. However, less attention has been paid to the claim that peace itself is a genuine human right. Whereas some critics argue that a focus on rights results in an overly formal juridical account of ...

  4. Friends or Foes? Host defense (antimicrobial) peptides and proteins in human skin diseases.

    Science.gov (United States)

    Niyonsaba, François; Kiatsurayanon, Chanisa; Chieosilapatham, Panjit; Ogawa, Hideoki

    2017-11-01

    Host defense peptides/proteins (HDPs), also known as antimicrobial peptides/proteins (AMPs), are key molecules in the cutaneous innate immune system. AMPs/HDPs historically exhibit broad-spectrum killing activity against bacteria, enveloped viruses, fungi and several parasites. Recently, AMPs/HDPs were shown to have important biological functions, including inducing cell proliferation, migration and differentiation; regulating inflammatory responses; controlling the production of various cytokines/chemokines; promoting wound healing; and improving skin barrier function. Despite the fact that AMPs/HDPs protect our body, several studies have hypothesized that these molecules actively contribute to the pathogenesis of various skin diseases. For example, AMPs/HDPs play crucial roles in the pathological processes of psoriasis, atopic dermatitis, rosacea, acne vulgaris, systemic lupus erythematosus and systemic sclerosis. Thus, AMPs/HDPs may be a double-edged sword, promoting cutaneous immunity while simultaneously initiating the pathogenesis of some skin disorders. This review will describe the most common skin-derived AMPs/HDPs (defensins, cathelicidins, S100 proteins, ribonucleases and dermcidin) and discuss the biology and both the positive and negative aspects of these AMPs/HDPs in skin inflammatory/infectious diseases. Understanding the regulation, functions and mechanisms of AMPs/HDPs may offer new therapeutic opportunities in the treatment of various skin disorders. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Factors affecting defensive strike behavior in Brown Treesnakes (Boiga irregularis) provoked by humans

    Science.gov (United States)

    Spencer, McKayka M.; Lardner, Bjorn; Mazurek, M.J.; Reed, Robert N.

    2015-01-01

    Striking is a typical antipredator defense exhibited by many species of snakes. While trapping Brown Treesnakes (Boiga irregularis) on Guam, we observed that snakes most frequently struck at an approaching person at a site where snakes had been trapped, marked, and handled in the past. Using a combination of between-sites and within-site comparisons, we assessed if the propensity to strike was correlated with capture histories (both recent and long-term), snake size, body condition (a proxy to nutritional stress), sex, or tail condition (broken or intact), while controlling for confounding variables. We confirmed that propensity to strike was higher at the site where we had been conducting capture-mark-recapture for several years. However, we were unable to demonstrate a correlation between striking tendencies and individual recent or long-term capture histories. The only morphological covariate that had an effect on strike propensity was sex, with females striking more often than males. After removing the site effect from our model, we found that snakes missing parts of their tails were more likely to strike than snakes with intact tails. We have yet to identify the factor(s) that cause the pronounced difference across sites in snake propensity to strike, and data from additional sites might help elucidate any geographical patterns.

  6. Defense Health Care. Reimbursement of Hospitals Not Meeting CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) Copayment Requirements.

    Science.gov (United States)

    1988-06-01

    8217JntedState* General AccouýLg Office __ Rteport to Congmesoa Commitee A,""FILE COPYAD-A197 876 DF7-EANSE HEF.ALTHl L’W Reimbur emen--t Of I...Secretary of Defense grant a waiver from CHAMPUS copayment requirements and be approved, tuader certain criteria, to be reimbursed for care to...that a provider waives patient copayments, it denies the provider’s claim for reimbursement . . In fiscal year 1987, cHAmpus payments to civilian

  7. Human exposure to ionizing radiation for medical reasons

    International Nuclear Information System (INIS)

    Thomas, R.H.; Busick, D.D.

    1977-01-01

    The central issue in this debate is not whether there is a threshold dose below which deleterious effects in humans occur nor whether the dose-effect relationship is linear or curvilinear. The central issue is whether there is merit in a continuing effort to reduce radiation exposures to patients no matter at what level. This should be determined by a careful balancing of potential risks against expected benefits. It is this element of risk-benefit analysis that is absent in Morgan's philosophy. A good example of the changing nature on the risk-benefit balance is that of the use of mass radiography programs to diagnose tuberculosis. Before the Second World War this disease was a terrible scourge of the poor who could ill-afford adequate medical care. The use of mass radiography programs have played a large part in the elimination of this disease

  8. Transforming Defense

    National Research Council Canada - National Science Library

    Lamb, Christopher J; Bunn, M. E; Lutes, Charles; Cavoli, Christopher

    2005-01-01

    .... Despite the resources and attention consumed by the war on terror, and recent decisions by the White House to curtail the growth of defense spending, the senior leadership of the Department of Defense (DoD...

  9. Host-pathogen interactions between the human innate immune system and Candida albicans—understanding and modeling defense and evasion strategies

    Science.gov (United States)

    Dühring, Sybille; Germerodt, Sebastian; Skerka, Christine; Zipfel, Peter F.; Dandekar, Thomas; Schuster, Stefan

    2015-01-01

    The diploid, polymorphic yeast Candida albicans is one of the most important human pathogenic fungi. C. albicans can grow, proliferate and coexist as a commensal on or within the human host for a long time. However, alterations in the host environment can render C. albicans virulent. In this review, we describe the immunological cross-talk between C. albicans and the human innate immune system. We give an overview in form of pairs of human defense strategies including immunological mechanisms as well as general stressors such as nutrient limitation, pH, fever etc. and the corresponding fungal response and evasion mechanisms. Furthermore, Computational Systems Biology approaches to model and investigate these complex interactions are highlighted with a special focus on game-theoretical methods and agent-based models. An outlook on interesting questions to be tackled by Systems Biology regarding entangled defense and evasion mechanisms is given. PMID:26175718

  10. The (human) science of medical virtual learning environments.

    Science.gov (United States)

    Stone, Robert J

    2011-01-27

    The uptake of virtual simulation technologies in both military and civilian surgical contexts has been both slow and patchy. The failure of the virtual reality community in the 1990s and early 2000s to deliver affordable and accessible training systems stems not only from an obsessive quest to develop the 'ultimate' in so-called 'immersive' hardware solutions, from head-mounted displays to large-scale projection theatres, but also from a comprehensive lack of attention to the needs of the end users. While many still perceive the science of simulation to be defined by technological advances, such as computing power, specialized graphics hardware, advanced interactive controllers, displays and so on, the true science underpinning simulation--the science that helps to guarantee the transfer of skills from the simulated to the real--is that of human factors, a well-established discipline that focuses on the abilities and limitations of the end user when designing interactive systems, as opposed to the more commercially explicit components of technology. Based on three surgical simulation case studies, the importance of a human factors approach to the design of appropriate simulation content and interactive hardware for medical simulation is illustrated. The studies demonstrate that it is unnecessary to pursue real-world fidelity in all instances in order to achieve psychological fidelity--the degree to which the simulated tasks reproduce and foster knowledge, skills and behaviours that can be reliably transferred to real-world training applications.

  11. Friction of Human Skin against Different Fabrics for Medical Use

    Directory of Open Access Journals (Sweden)

    Luís Vilhena

    2016-03-01

    Full Text Available Knowledge of the tribology of human skin is essential to improve and optimize surfaces and materials in contact with the skin. Besides that, friction between the human skin and textiles is a critical factor in the formation of skin injuries, which are caused if the loads and shear forces are high enough and/or over long periods of time. This factor is of particular importance in bedridden patients, since they are not moving about or are confined to wheelchairs. Decubitus ulcers are one of the most frequently-reported iatrogenic injuries in developed countries. The risk of developing decubitus ulcers can be predicted by using the “Braden Scale for Predicting Pressure Ulcer Risk” that was developed in 1987 and contains six areas of risk (cognitive-perceptual, immobility, inactivity, moisture, nutrition, friction/shear, although there are limitations to the use of such tools. The coefficient of friction of textiles against skin is mainly influenced by: the nature of the textile, skin moisture content and ambient humidity. This study will investigate how skin friction (different anatomical regions varies, rubbing against different types of contacting materials (i.e., fabrics for medical use under different contact conditions and their relationship in the formation and prevention of decubitus ulcers.

  12. Can the science of communication inform the art of the medical humanities?

    Science.gov (United States)

    Bleakley, Alan; Marshall, Robert

    2013-02-01

    There is increasing interest in establishing the medical humanities as core integrated provision in undergraduate medicine curricula, but sceptics point to the lack of evidence for their impact upon patient care. Further, the medical humanities culture has often failed to provide a convincing theoretical rationale for the inclusion of the arts and humanities in medical education. Poor communication with colleagues and patients is the main factor in creating the conditions for medical error; this is grounded in a historically determined refusal of democracy within medical work. The medical humanities may play a critical role in educating for democracy in medical culture generally, and in improving communication in medical students specifically, as both demand high levels of empathy. Studies in the science of communication can provide a valuable evidence base justifying the inclusion of the medical humanities in the core curriculum. A case is made for the potential of the medical humanities--as a form of 'adult play'--to educate for collaboration and tolerance of ambiguity or uncertainty, providing a key element of the longer-term democratising force necessary to change medical culture and promote safer practice. The arts and humanities can provide important contextual media through which the lessons learned from the science of communication in medicine can be translated and promoted as forms of medical education. © Blackwell Publishing Ltd 2013.

  13. The cGAS/STING Pathway Detects Streptococcus pneumoniae but Appears Dispensable for Antipneumococcal Defense in Mice and Humans.

    Science.gov (United States)

    Ruiz-Moreno, Juan Sebastian; Hamann, Lutz; Jin, Lei; Sander, Leif E; Puzianowska-Kuznicka, Monika; Cambier, John; Witzenrath, Martin; Schumann, Ralf R; Suttorp, Norbert; Opitz, Bastian

    2018-03-01

    Streptococcus pneumoniae is a frequent colonizer of the upper respiratory tract and a leading cause of bacterial pneumonia. The innate immune system senses pneumococcal cell wall components, toxin, and nucleic acids, which leads to production of inflammatory mediators to initiate and control antibacterial defense. Here, we show that the cGAS (cyclic GMP-AMP [cGAMP] synthase)-STING pathway mediates detection of pneumococcal DNA in mouse macrophages to primarily stimulate type I interferon (IFN) responses. Cells of human individuals carrying HAQ TMEM173 , which encodes a common hypomorphic variant of STING, were largely or partly defective in inducing type I IFNs and proinflammatory cytokines upon infection. Subsequent analyses, however, revealed that STING was dispensable for restricting S. pneumoniae during acute pneumonia in mice. Moreover, explorative analyses did not find differences in the allele frequency of HAQ TMEM173 in nonvaccinated pneumococcal pneumonia patients and healthy controls or an association of HAQ TMEM173 carriage with disease severity. Together, our results indicate that the cGAS/STING pathway senses S. pneumoniae but plays no major role in antipneumococcal immunity in mice and humans. Copyright © 2018 American Society for Microbiology.

  14. Using films and television shows with a medical theme as a medium to accelerate the spread of medical humanities.

    Science.gov (United States)

    Chen, Wenting; Qian, Haihong

    2017-05-23

    People have more visual experiences than ever before, and the same is true for situations in medicine. More mature films and television shows with a medical theme have been available over the past 20 years. In mainland China, the TV series "Angel Heart" has generated a wave of universal concern since it truly depicts the work of health care workers and it reflects the sharp distinction between doctors and patients to a certain extent. Riding this wave, many medical documentaries like The Human World have also been launched in China and have garnered sizable audiences. Such films and television shows with a medical theme strive to depict the lives of ordinary people. When watching these medical documentaries, audiences are able to better comprehend the work of health care workers in light of their life experiences and feelings towards current society. Audiences can gain a profound understanding of the medical humanities through films and television shows with a medical theme. We look forward to more such films and television shows with a medical theme that depict "hospitals-the realest place" on camera. Films and television shows with a medical theme can serve as a storytelling medium to accelerate the spread of medical humanities and to promote harmony among doctors, patients, and the public.

  15. An open-ended future: In defense of a new humanism

    Science.gov (United States)

    Vonputtkamer, J.

    1984-01-01

    The edge between technology and humanism is discussed. Advances in biology, in medicine, energy technology, tools and weapons, communications, psychology, problem solving and information storage, transportation, and other fields are presented. Ecology in self-transcendence and space travel as a survival tool are considered.

  16. Privacy Impact Assessment for the Medical and Research Study Records of Human Volunteers

    Science.gov (United States)

    The Medical & Research Study Records of Human Volunteers System collects demographic and medical information on subjects who participate in research. Learn how this data is collected, used, access to the data, and the purpose of data collection.

  17. Biological Defense: DOD Has Strengthened Coordination on Medical Countermeasures but Can Improve Its Process for Threat Prioritization

    Science.gov (United States)

    2014-05-01

    diseases such as equine encephalitis and Ebola have contributed to concerns about the nation’s vulnerability to biological attacks and naturally occurring...private sector and incorporates the cost associated with failed attempts to develop a medical countermeasure. DOD officials told us they face similar...biodefense medical countermeasure innovators (including those from the private sector ) that can use emerging platform technologies to enhance the

  18. Innate immune defense in the inner ear - mucines are expressed by the human endolymphatic sac

    DEFF Research Database (Denmark)

    Møller, Martin N; Kirkeby, Svend; Cayé-Thomasen, Per

    2017-01-01

    The human endolymphatic sac has been shown recently to have immunological capacities and has thus been proposed as the main entity protecting the inner ear from pathogen invasion, equivalent to mucosa-associated lymphoid tissue (MALT). Although the sac expresses molecules of the innate immune...... system, the potential expression of members of the important mucin family has not been detailed. Thus, this paper explores endolymphatic sac expression of a number of mucins and mucin precursors. Twelve fresh tissue samples from the human endolymphatic sac were obtained during translabyrinthine surgery...... immunological tissue structure of the inner ear, equivalent to MALT in other organs. The mucins may also play a role in the formation and continuous homeostasis of the inner ear fluids, as well as the pathogenesis of Meniere's disease....

  19. Applications of Human Performance Models to System Design: Defense Research Series. Volume 2

    Science.gov (United States)

    1989-01-01

    Animation of Human Figures ... ........... .. 375 Norman I. Badler SAFEWORK: Software to Analyse and Design Workplaces ... .......... .389 Robert Gilbert...workload estimation is generally associated with Senders’ research on monitoring tasks (e.g., Senders, Elkind, Grignetti, & Smallwood , 1966; Senders...controller’s workload, IEEE Transactions on Systems, Man, and Cybernetics, SMC-8(6) :492-493. Senders, J. W., Elkind, J. I., Grignetti, M. C., and Smallwood , R

  20. Department of Defense Report on Search for Human Radiation Experiment Records, 1944 - 1994, Volume 2

    Science.gov (United States)

    1997-06-01

    subsequent survival of patients in stage IV hepatic coma Abstract: This study did not involve human exposure to ionizing radiation. Start Date...renal function; (2) euthyroid subjects with renal disease; (3) hyperthyroid patients; and (4) myxedema patients. Simultaneous determinations of the...30 October 1953 Number Title ACIR54000-B Renal function and 131-1 clearance in hyperthyroidism and myxedema From a presently undetermined date

  1. Human Expeditions to Near-Earth Asteroids: Implications for Exploration, Resource Utilization, Science, and Planetary Defense

    Science.gov (United States)

    Abell, Paul; Mazanek, Dan; Barbee, Brent; Landis, Rob; Johnson, Lindley; Yeomans, Don; Friedensen, Victoria

    2013-01-01

    Over the past several years, much attention has been focused on human exploration of near-Earth asteroids (NEAs) and planetary defence. Two independent NASA studies examined the feasibility of sending piloted missions to NEAs, and in 2009, the Augustine Commission identified NEAs as high profile destinations for human exploration missions beyond the Earth-Moon system as part of the Flexible Path. More recently the current U.S. presidential administration directed NASA to include NEAs as destinations for future human exploration with the goal of sending astronauts to a NEA in the mid to late 2020s. This directive became part of the official National Space Policy of the United States of America as of June 28, 2010. With respect to planetary defence, in 2005 the U.S. Congress directed NASA to implement a survey program to detect, track, and characterize NEAs equal or greater than 140 m in diameter in order to access the threat from such objects to the Earth. The current goal of this survey is to achieve 90% completion of objects equal or greater than 140 m in diameter by 2020.

  2. Recruiting "Friends of Medical Progress": Evolving Tactics in the Defense of Animal Experimentation, 1910s and 1920s.

    Science.gov (United States)

    Ross, Karen D

    2015-07-01

    In 1923, Thomas Barbour of Harvard announced the creation of a national lay organization, the Society of Friends of Medical Progress (FMP), to defend animal research in the United States against a resurgent antivivisection movement. After decades of successful behind-the-scenes lobbying and avoiding the public spotlight, medical scientists significantly altered their tactics and sought public engagement, at least by proxy. Although the authority of scientific medicine was rising, women's suffrage, the advent of the ballot initiative, and a growing alliance of antivivisectionists and other groups in opposition to allopathic medicine so altered the political landscape that medical scientists reconsidered formerly rejected ideas such partnering with laymen. Medical scientists, Walter B. Cannon and Simon Flexner chief among them, hoped that the FMP would relieve the scientists of a time-consuming burden and defend against government regulation of medical institutions without the charge of material self-interest. However, financial problems and the frequent conflicts that arose between the lay leadership and Flexner eventually undermined the FMP's value as a defender of animal experimentation and reveal the distrust of reformers like Flexner who did not believe that laymen could speak for scientific medicine. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. The Impact of Baccalaureate Medical Humanities on Subsequent Medical Training and Practice: A Physician-Educator's Perspective.

    Science.gov (United States)

    Barron, Lauren

    2017-12-01

    This reflective essay is an attempt to organize trends in feedback I have observed during ten years of coursework, conversations, and correspondence with former students associated with the Medical Humanities Program at Baylor University. Over the years, recurrent themes arise when speaking with alumni about whether and how their medical humanities experience intersects with their current training. I have identified five particular domains in which baccalaureate medical humanities training affects students' subsequent healthcare professions training and practice: context and complementarity, clinical relevance, reflective practice, professional preparedness and vocational calling. I created an instrument of open-ended questions for each of these categories and posted it to social media with an invitation for alumni to respond. This informal survey was conceived as an exploratory exercise with the intent to help generate a foundation for more formal qualitative research in these five domains. In this essay, I offer my own reflections together with those of former students on the impact of baccalaureate-level medical humanities training in order to illustrate the benefits in each domain for subsequent healthcare training and practice. The need for qualitative research that explores the impact of baccalaureate medical humanities merits collaboration between multiple centers of investigation across many disciplines, and across the divide between premedical and medical educators.

  4. Human-centered design of the human-system interfaces of medical equipment: thyroid uptake system

    International Nuclear Information System (INIS)

    Monteiro, Jonathan K.R.; Farias, Marcos S.; Santos, Isaac J.A. Luquetti; Monteiro, Beany G.

    2013-01-01

    Technology plays an important role in modern medical centers, making healthcare increasingly complex, relying on complex technical equipment. This technical complexity is particularly noticeable in the nuclear medicine. Poorly design human-system interfaces can increase the risks for human error. The human-centered approach emphasizes the development of the equipment with a deep understanding of the users activities, current work practices, needs and abilities of the users. An important concept of human-centered design is that the ease-of-use of the equipment can be ensured only if users are actively incorporated in all phases of the life cycle of design process. Representative groups of users are exposed to the equipment at various stages in development, in a variety of testing, evaluation and interviewing situations. The users feedback obtained is then used to refine the design, with the result serving as input to the next interaction of design process. The limits of the approach are that the users cannot address any particular future needs without prior experience or knowledge about the equipment operation. The aim of this paper is to present a methodological framework that contributes to the design of the human-system interfaces, through an approach related to the users and their activities. A case study is described in which the methodological framework is being applied in development of new human-system interfaces of the thyroid uptake system. (author)

  5. Rethinking research in the medical humanities: a scoping review and narrative synthesis of quantitative outcome studies.

    Science.gov (United States)

    Dennhardt, Silke; Apramian, Tavis; Lingard, Lorelei; Torabi, Nazi; Arntfield, Shannon

    2016-03-01

    The rise of medical humanities teaching in medical education has introduced pressure to prove efficacy and utility. Review articles on the available evidence have been criticised for poor methodology and unwarranted conclusions. To support a more nuanced discussion of how the medical humanities work, we conducted a scoping review of quantitative studies of medical humanities teaching. Using a search strategy involving MEDLINE, EMBASE and ERIC, and hand searching, our scoping review located 11 045 articles that referred to the use of medical humanities teaching in medical education. Of these, 62 studies using quantitative evaluation methods were selected for review. Three iterations of analysis were performed: descriptive, conceptual, and discursive. Descriptive analysis revealed that the medical humanities as a whole cannot be easily systematised based on simple descriptive categories. Conceptual analysis supported the development of a conceptual framework in which the foci of the arts and humanities in medical education can be mapped alongside their related epistemic functions for teaching and learning. Within the framework, art functioned as expertise, as dialogue or as a means of expression and transformation. In the discursive analysis, we found three main ways in which the relationship between the arts and humanities and medicine was constructed as, respectively, intrinsic, additive and curative. This review offers a nuanced framework of how different types of medical humanities work. The epistemological assumptions and discursive positioning of medical humanities teaching frame the forms of outcomes research that are considered relevant to curriculum decision making, and shed light on why dominant review methodologies make some functions of medical humanities teaching visible and render others invisible. We recommend the use of this framework to improve the rigor and relevance of future explorations of the efficacy and utility of medical humanities teaching

  6. Development of a medical humanities and ethics certificate program in Texas.

    Science.gov (United States)

    Erwin, Cheryl J

    2014-12-01

    Education in the medical humanities and ethics is an integral part of the formation of future physicians. This article reports on an innovative approach to incorporating the medical humanities and ethics into the four-year curriculum in a Certificate Program spanning all four years of the medical school experience. The faculty of the McGovern Center for Humanities and Ethics at the University of Texas Medical School at Houston conceived and implemented this program to teach medical students a range of scholarly topics in the medical humanities and to engage the full human experience into the process of becoming a physician. This study follows six years of experience, and we report student experiences and learning in their own words.

  7. 75 FR 24754 - Cost of Hospital and Medical Care Treatment Furnished by the Department of Defense Military...

    Science.gov (United States)

    2010-05-05

    ... OFFICE OF MANAGEMENT AND BUDGET Cost of Hospital and Medical Care Treatment Furnished by the... Third Persons AGENCY: Office of Management and Budget, Executive Office of the President. ACTION: Notice.... 593; 42 U.S.C. 2652), and delegated to the Director of the Office of Management and Budget by the...

  8. Safety, identity and consent: a limited defense of reproductive human cloning.

    Science.gov (United States)

    Lane, Robert

    2006-06-01

    Some opponents of reproductive human cloning have argued that, because of its experimental nature, any attempt to create a child by way of cloning would risk serious birth defects or genetic abnormalities and would therefore be immoral. Some versions of this argument appeal to the consent of the person to be conceived in this way. In particular, they assume that if an experimental reproductive technology has not yet been shown to be safe, then, before we use it, we are morally obligated to get either the actual consent or the presumed consent of the person to be conceived. In this article, I attempt to explain the appeal of such consent-based arguments as deriving from a mistaken view of personal identity. I then argue that since this view is false, such arguments are unsound. Finally, I argue that even if reproductive cloning is unsafe, it may still be morally permissible in some circumstances.

  9. Friendliness to humans and defensive aggression in cats: the influence of handling and paternity.

    Science.gov (United States)

    Reisner, I R; Houpt, K A; Erb, H N; Quimby, F W

    1994-06-01

    This study was undertaken to examine and reduce the stress and aggressiveness associated with fear of handling in laboratory cats (Felis sylvestris catus). Thirteen litters of kittens from a specific pathogen-free breeding colony were divided into three treatment groups: two were early weaned, removed from the colony and caged individually with or without handling up to 8 weeks of age, and the third served as a control group, removed from the colony just before testing. Behavior tests measuring degree of friendliness to humans and response to physical restraint were performed at ages 8, 12, 16, and 20 weeks. Serum cortisol concentrations were measured after each test. Results indicate that litter and sire influenced tractability but that handling or individual caging of kittens did not. Posttest serum cortisol concentrations were below normal adult levels in most kittens, including those reacting fearfully during testing and aggressively during restraint, and, therefore, are not a reliable indicator of stress in juvenile cats.

  10. Martha C. Nussbaum – Another Approach for the Defense of the Human Being and the Human Rights of Women

    Directory of Open Access Journals (Sweden)

    Cristina Monereo Atienza

    2015-06-01

    Full Text Available This paper confronts the advantagesand disadvantages of Nussbaum´s theory inseeking equality for women. Nussbaum under-stands that people in general and women in par-ticular have a number of common capabilitiesbecause they are ends in themselves. You cannot treat another person as a mere object, andthis deserves a cross-cultural consensus on whatis the human being. The universal concept ofthe subject that she offers, based on a minimumcommon to all, open to dialogue and politicalconsensus, is very interesting. However, we cannot forget other approaches like the discourse ofrights.

  11. Urea uptake enhances barrier function and antimicrobial defense in humans by regulating epidermal gene expression

    Science.gov (United States)

    Grether-Beck, Susanne; Felsner, Ingo; Brenden, Heidi; Kohne, Zippora; Majora, Marc; Marini, Alessandra; Jaenicke, Thomas; Rodriguez-Martin, Marina; Trullas, Carles; Hupe, Melanie; Elias, Peter M.; Krutmann, Jean

    2012-01-01

    Urea is an endogenous metabolite, known to enhance stratum corneum hydration. Yet, topical urea anecdotally also improves permeability barrier function, and it appears to exhibit antimicrobial activity. Hence, we hypothesized that urea is not merely a passive metabolite, but a small-molecule regulator of epidermal structure and function. In 21 human volunteers, topical urea improved barrier function in parallel with enhanced antimicrobial peptide (LL-37 and β-defensin-2) expression. Urea both stimulates expression of, and is transported into keratinocytes by two urea transporters, UT-A1 and UT-A2, and by aquaporin 3, 7 and 9. Inhibitors of these urea transporters block the downstream biological effects of urea, which include increased mRNA and protein levels for: (i) transglutaminase-1, involucrin, loricrin and filaggrin; (ii) epidermal lipid synthetic enzymes, and (iii) cathelicidin/LL-37 and β-defensin-2. Finally, we explored the potential clinical utility of urea, showing that topical urea applications normalized both barrier function and antimicrobial peptide expression in a murine model of atopic dermatitis (AD). Together, these results show that urea is a small-molecule regulator of epidermal permeability barrier function and antimicrobial peptide expression after transporter uptake, followed by gene regulatory activity in normal epidermis, with potential therapeutic applications in diseased skin. PMID:22418868

  12. Human trafficking: an evaluation of Canadian medical students' awareness and attitudes.

    Science.gov (United States)

    Wong, Janice C; Hong, Jonathan; Leung, Pearl; Yin, Penny; Stewart, Donna E

    2011-04-01

    Human trafficking is a human rights violation prevalent globally. Current guidelines highlight healthcare professionals' key role in responding to human trafficking, emphasizing the importance of medical education in raising awareness of trafficking. To assess pre-clerkship medical students' awareness of human trafficking and attitudes towards learning about trafficking in the medical curriculum at Canada's largest medical school. An anonymous, classroom-based questionnaire was designed, piloted and administered to first- and second-year medical students at one large Canadian medical school with a diverse student population. The questionnaire sought demographic data and information on students' self-perceived awareness of human trafficking and interest in learning about trafficking and other community health issues. 262 medical students completed the questionnaire (70.0% response). Most participants reported that they were not knowledgeable (48.5%) or only somewhat knowledgeable (45.4%) about human trafficking. 88.9% of participants were not familiar with signs and symptoms of trafficked persons. While students' responses indicated that they prioritized other social issues, a majority of participants (76.0%) thought that trafficking was important to learn about in medical school, especially identifying trafficked persons and their health needs. These medical students of one Canadian medical school demonstrated limited familiarity with the issue of human trafficking but largely felt that they should be taught more about this issue during their medical education. This assessment of early medical students' awareness of human trafficking is relevant to medical educators and the organizations that could develop the required educational curricula and resources.

  13. Constitutive and inducible expression of SKALP/elafin provides anti-elastase defense in human epithelia.

    Science.gov (United States)

    Pfundt, R; van Ruissen, F; van Vlijmen-Willems, I M; Alkemade, H A; Zeeuwen, P L; Jap, P H; Dijkman, H; Fransen, J; Croes, H; van Erp, P E; Schalkwijk, J

    1996-01-01

    Skin-derived antileukoproteinase (SKALP), also known as elafin, is a serine proteinase inhibitor first discovered in keratinocytes from hyperproliferative human epidermis. In addition to the proteinase inhibiting domain which is directed against polymorphonuclear leukocyte (PMN) derived enzymes such as elastase and proteinase 3, SKALP contains multiple transglutaminase (TGase) substrate domains which enable crosslinking to extracellular and cell envelope proteins. Here we show that SKALP is constitutively expressed in several epithelia that are continuously subjected to inflammatory stimuli, such as the oral cavity and the vagina where it co-localizes with type 1 TGase. All epithelia from sterile body cavities are negative for SKALP. In general, stratified squamous epithelia are positive, whereas pseudostratified epithelia, simple/glandular epithelia and normal epidermis are negative. SKALP was found in fetal tissues of the oral cavity from 17 wk gestation onwards where it continued to be expressed up to adult life. Remarkably, in fetal epidermis SKALP was found from week 28 onwards, but was downregulated to undetectable levels in neonatal skin within three months, suggesting a role during pregnancy in feto-maternal interactions or in the early maturation phase of the epidermis. Immunoelectron microscopy revealed the presence of SKALP in secretory vesicles including the lamellar granules. In culture models for epidermal keratinocytes we found that expression of the endogenous SKALP gene provided protection against cell detachment caused by purified elastase or activated PMNs. Addition of exogenous recombinant SKALP fully protected the keratinocytes against PMN-dependent detachment whereas superoxide dismutase and catalase were only marginally effective. These findings strongly suggest that the constitutive expression of SKALP in squamous epithelia, and the inducible expression in epidermis participate in the control of epithelial integrity, by inhibiting PMN

  14. Divergent Fates of the Medical Humanities in Psychiatry and Internal Medicine: Should Psychiatry Be Rehumanized?

    Science.gov (United States)

    Rutherford, Bret R.; Hellerstein, David J.

    2008-01-01

    Objective: To determine the degree to which the medical humanities have been integrated into the fields of internal medicine and psychiatry, the authors assessed the presence of medical humanities articles in selected psychiatry and internal medicine journals from 1950 to 2000. Methods: The journals searched were the three highest-ranking…

  15. Transforming educational accountability in medical ethics and humanities education toward professionalism.

    Science.gov (United States)

    Doukas, David J; Kirch, Darrell G; Brigham, Timothy P; Barzansky, Barbara M; Wear, Stephen; Carrese, Joseph A; Fins, Joseph J; Lederer, Susan E

    2015-06-01

    Effectively developing professionalism requires a programmatic view on how medical ethics and humanities should be incorporated into an educational continuum that begins in premedical studies, stretches across medical school and residency, and is sustained throughout one's practice. The Project to Rebalance and Integrate Medical Education National Conference on Medical Ethics and Humanities in Medical Education (May 2012) invited representatives from the three major medical education and accreditation organizations to engage with an expert panel of nationally known medical educators in ethics, history, literature, and the visual arts. This article, based on the views of these representatives and their respondents, offers a future-tense account of how professionalism can be incorporated into medical education.The themes that are emphasized herein include the need to respond to four issues. The first theme highlights how ethics and humanities can provide a response to the dissonance that occurs in current health care delivery. The second theme focuses on how to facilitate preprofessional readiness for applicants through reform of the medical school admission process. The third theme emphasizes the importance of integrating ethics and humanities into the medical school administrative structure. The fourth theme underscores how outcomes-based assessment should reflect developmental milestones for professional attributes and conduct. The participants emphasized that ethics and humanities-based knowledge, skills, and conduct that promote professionalism should be taught with accountability, flexibility, and the premise that all these traits are essential to the formation of a modern professional physician.

  16. Teaching medical humanities in the digital world: affordances of technology-enhanced learning.

    Science.gov (United States)

    Kemp, Sandra Joy; Day, Giskin

    2014-12-01

    Medical humanities courses are typically taught in face-to-face teaching environments, but now medical humanities educators, alongside educators from other disciplines, are facing shifts in higher education towards online (and sometimes open) courses. For the medical humanities educator, there is limited guidance regarding how technology-enhanced learning design can support the learning outcomes associated with medical humanities. This article aims to provide useful direction for such educators on how digital technologies can be used through learner-focused pedagogies. Specific examples are provided as to how the affordances of Web 2.0 and other tools can be realised in innovative ways to help achieve skills development within the medical humanities. The guidance, alongside the practical suggestions for implementation, can provide important conceptual background for medical humanities educators who wish to embrace technology-enhanced learning, and reconceptualise or redesign medical humanities for an online or blended teaching environment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Machine medical ethics when a human is delusive but the android has its wits about him

    NARCIS (Netherlands)

    Hoorn, J.F.; van Rysewyk, S.P.; Pontier, M.A.

    2015-01-01

    When androids take care of delusive patients, ethic-epistemic concerns crop up about an agency’s good intent and why we would follow its advice. Robots are not human but may deliver correct medical information, whereas Alzheimer patients are human but may be mistaken. If humanness is not the

  18. New trends in medical and service robots human centered analysis, control and design

    CERN Document Server

    Chevallereau, Christine; Pisla, Doina; Bleuler, Hannes; Rodić, Aleksandar

    2016-01-01

    Medical and service robotics integrates several disciplines and technologies such as mechanisms, mechatronics, biomechanics, humanoid robotics, exoskeletons, and anthropomorphic hands. This book presents the most recent advances in medical and service robotics, with a stress on human aspects. It collects the selected peer-reviewed papers of the Fourth International Workshop on Medical and Service Robots, held in Nantes, France in 2015, covering topics on: exoskeletons, anthropomorphic hands, therapeutic robots and rehabilitation, cognitive robots, humanoid and service robots, assistive robots and elderly assistance, surgical robots, human-robot interfaces, BMI and BCI, haptic devices and design for medical and assistive robotics. This book offers a valuable addition to existing literature.

  19. The challenge of promoting professionalism through medical ethics and humanities education.

    Science.gov (United States)

    Doukas, David J; McCullough, Laurence B; Wear, Stephen; Lehmann, Lisa S; Nixon, Lois LaCivita; Carrese, Joseph A; Shapiro, Johanna F; Green, Michael J; Kirch, Darrell G

    2013-11-01

    Given recent emphasis on professionalism training in medical schools by accrediting organizations, medical ethics and humanities educators need to develop a comprehensive understanding of this emphasis. To achieve this, the Project to Rebalance and Integrate Medical Education (PRIME) II Workshop (May 2011) enlisted representatives of the three major accreditation organizations to join with a national expert panel of medical educators in ethics, history, literature, and the visual arts. PRIME II faculty engaged in a dialogue on the future of professionalism in medical education. The authors present three overarching themes that resulted from the PRIME II discussions: transformation, question everything, and unity of vision and purpose.The first theme highlights that education toward professionalism requires transformational change, whereby medical ethics and humanities educators would make explicit the centrality of professionalism to the formation of physicians. The second theme emphasizes that the flourishing of professionalism must be based on first addressing the dysfunctional aspects of the current system of health care delivery and financing that undermine the goals of medical education. The third theme focuses on how ethics and humanities educators must have unity of vision and purpose in order to collaborate and identify how their disciplines advance professionalism. These themes should help shape discussions of the future of medical ethics and humanities teaching.The authors argue that improvement of the ethics and humanities-based knowledge, skills, and conduct that fosters professionalism should enhance patient care and be evaluated for its distinctive contributions to educational processes aimed at producing this outcome.

  20. German medical students' interest in and knowledge about human sexuality in 1972 and 2012.

    Science.gov (United States)

    Turner, Daniel; Jopt, Konstantin; Nieder, Timo O; Briken, Peer

    2014-08-01

    During the 1970s, a growing number of medical schools began to recognize the importance of medical education concerning human sexuality. Currently, most medical schools provide at least some instruction in human sexuality. In light of this development, the present study aimed to compare the interest in and knowledge about human sexuality of medical students from two different time periods. The answers to a self-constructed questionnaire of 236 students in 1972 were compared with those of 259 students in 2012. Students were asked whether they were interested in education regarding human sexuality and which specific topics they felt should be included in the medical curriculum. The students' knowledge in the following domains was assessed: sexual development, sexual behavior, sexual physiology and psychology, and sexual medicine. The two cohorts were compared with regard to those specific sexuality-related topics in which the students were most and least interested in. Furthermore, the number of correct responses to the knowledge questions was compared. While in 1972, 99.2% of the students were interested in medical education about human sexuality, in 2012, 80.3% showed an interest. The connection of disorders from different medical disciplines with sexuality was rated as most interesting by both the students from 1972 and 2012. Medical students from 2012 gave 50.3% correct answers to the knowledge questions, whereas students from 1972 correctly answered 46.3% of the questions. Although interest in education concerning human sexuality has decreased, the majority of students view it as an important topic. Nevertheless, medical students still lack knowledge about important aspects of human sexuality (e.g., psychosexual development and relative safety of different contraceptives). Therefore, more time should be dedicated to education concerning human sexuality and its cultural, societal, and health aspects in particular. © 2014 International Society for Sexual Medicine.

  1. Early-life medical care and human capital accumulation

    DEFF Research Database (Denmark)

    Daysal, N. Meltem

    2015-01-01

    that both types of interventions may benefit not only child health but also long-term educational outcomes. In addition, early-life medical interventions may improve the educational outcomes of siblings. These findings can be used to design policies that improve long-term outcomes and reduce economic......Ample empirical evidence links adverse conditions during early childhood (the period from conception to age five) to worse health outcomes and lower academic achievement in adulthood. Can early-life medical care and public health interventions ameliorate these effects? Recent research suggests...

  2. Planetary Defense

    Science.gov (United States)

    2016-05-01

    4 Abstract Planetary defense against asteroids should be a major concern for every government in the world . Millions of asteroids and...helps make Planetary Defense viable because defending the Earth against asteroids benefits from all the above technologies. So if our planet security...information about their physical characteristics so we can employ the right strategies. It is a crucial difference if asteroids are made up of metal

  3. Human resource management practices in a medical complex in the ...

    African Journals Online (AJOL)

    staff, accountability, general HR efficiency, occupation-specific dispensation adjustments and performance management and development system efficiency, and availability of HR staff. All these characteristics were judged to be poor. Conclusion. HRM practices in this Eastern Cape medical complex were inadequate and a ...

  4. Human Cryptosporidiosis: A Review | Ayuo | East African Medical ...

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 86, No 2 (2009) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  5. Instrumentation for Evaluating Medical School Courses in Human Sexuality.

    Science.gov (United States)

    Wiggers, T. Thorne; And Others

    A Sex Content Scale was developed to evaluate a series of simulated interviews conducted with 24 second year medical students and an actress who was carefully coached to reveal a specific sexual problem as she felt comfortable with the student and as he/she asked her appropriate questions. A patient response form was also developed to quantify the…

  6. Egyptian Journal of Medical Human Genetics - Vol 14, No 3 (2013)

    African Journals Online (AJOL)

    Egyptian Journal of Medical Human Genetics - Vol 14, No 3 (2013) ... Comparative study: Parameters of gait in Down syndrome versus matched obese and ... episodes in a Japanese child: Clinical, radiological and molecular genetic analysis ...

  7. Egyptian Journal of Medical Human Genetics - Vol 11, No 1 (2010)

    African Journals Online (AJOL)

    Egyptian Journal of Medical Human Genetics - Vol 11, No 1 (2010) ... Gene polymorphisms of TNF-α and IL-10 related to rheumatic heart disease · EMAIL ... with familial Mediterranean fever · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  8. Egyptian Journal of Medical Human Genetics - Vol 13, No 2 (2012)

    African Journals Online (AJOL)

    Egyptian Journal of Medical Human Genetics - Vol 13, No 2 (2012) ... as independent indicators for B-CLL: Correlation to response to treatment and disease ... Profile of disorders of sexual differentiation in the Northeast region of Cairo, Egypt ...

  9. Religious morality (and secular humanism) in Western civilization as precursors to medical ethics: A historic perspective

    OpenAIRE

    Miguel A Faria

    2015-01-01

    In discussing bioethics and the formulation of neuroethics, the question has arisen as to whether secular humanism should be the sole philosophical guiding light, to the exclusion of any discussion (or even mention) of religious morality, in professional medical ethics. In addition, the question has arisen as to whether freedom or censorship should be part of medical (and neuroscience) journalism. Should independent medical journals abstain from discussing certain issues, or should only the m...

  10. Human engineering design in medical x-ray system

    International Nuclear Information System (INIS)

    Mori, Sadayoshi

    1981-01-01

    The dimension of control desk, design of controller and indicator are studied in relation with human body dimension of radiological technologist. First, in the design of apparatus, it is reasonable to adopt the cumulative distribution in stead of mean values of human body dimension because the mean values would be cause of inadequacy to the majority of operator. Second, I reported about the fundamental items e.g. the display of controller and indicator recommended from the point of view of human engineering. Up to now the radiological technologists were intended to take a serious view of performance of X-ray apparatus only, but hereafter, we think, it is also important to induce the thought of human engineering in the design of X-ray apparatus. (J.P.N.)

  11. Ethics in action: Approving and improving medical research with human subjects

    NARCIS (Netherlands)

    de Jong, J.P.

    2013-01-01

    In this thesis, Jean Philippe de Jong presents a new understanding of ethical oversight on medical research with human subjects and proposes that two philosophies for ethical oversight exist: '(dis)approving' and 'improving'. Systems for ethical oversight on medical research have been in place for

  12. ER-16 regulation. Requirements for granting the permit exceptional use of medical devices in humans

    International Nuclear Information System (INIS)

    2015-01-01

    The purpose of this regulation is to establish requirements for applying for a permit exceptional use of medical equipment in Human Beings, the procedures for the evaluation process and bestowal. This regulation is aimed at researchers and designers of medical equipment, related to or associated with National Health Service's priority programs of interest to health.

  13. [Medical science and the human image--on the theory of medical tasks].

    Science.gov (United States)

    Jenny, S

    1993-06-22

    Our science-determined medicine interprets the non-individual partial aspects of disease that are approachable by causal analytical thought; therefore, it becomes only then an art of healing when it is complemented by medical craftsmanship and philosophic reflection. Naturopathy perceives the individual as an open self-regulatory system whose innumerable mechanisms and strategies for maintenance of integrity have to be supported. In medical practise both concepts have always to be available concomitantly and and in equal rights, not only for repair of lesions but also for real healing.

  14. Medical Photography: Documentation, Art, and the Expression of Human Emotions.

    Science.gov (United States)

    Aberer, Elisabeth; Stieber, Werner; Homayoon, Donja; Fink-Puches, Regina; Lichen, Roland; Salmhofer, Wolfgang; Gruber-Wackernagel, Alexandra; Aberer, Werner

    2016-01-01

    Medical photography is the state of the art for the documentation of dermatological disease. Experienced photographers take pictures of the most typical skin lesions in order to assist the clinician in assessing disease morphology and activity. In this study, we present 6 individuals with a variety of dermatoses and the expression of the patients' emotions. The patients were asked to show their diseased skin and to present typically involved areas in the respective disease. The feelings expressed by their body movements and positions are viewed and interpreted. The patients' history will be reported retrospectively. The aim of the report is to show that the art of medical photography does not only document skin lesions but also the disease burden and the associated impairment of quality of life. Moreover, dermatologic photography is a sensitive intervention for patients viewed in the light of teaching and patient care.

  15. Human engineering design of medical x-ray system

    International Nuclear Information System (INIS)

    Tohma, Hideo

    1981-01-01

    There have been remarkable progress in the area of X-ray diagnosis technology in recent years. However, there have been some cases of accident. Such accidents included those due to defective apparatus such as defects in apparatus and poor safety system, those caused by incorrect handling of apparatus by radiologic technologist, and those originating in a poor surrounding condition or bad management of apparatus. In this report, the following subjects are statistically studied: 1. Analysis of radiographic error. 2. Analysis of failure in medical X-ray systems. (author)

  16. Metallothionein-mediated antioxidant defense system and its response to exercise training are impaired in human type 2 diabetes

    DEFF Research Database (Denmark)

    Scheede-Bergdahl, Celena; Penkowa, Milena; Hidalgo, Juan

    2005-01-01

    lower levels of MT-I+II were also detected in the plasma of type 2 diabetic subjects compared with control subjects. These results suggest that, in control subjects, the MT-I+II defense system is active and inducible within skeletal muscle tissue and plasma. In type 2 diabetes, reduced levels of MT......Oxidative stress is implicated in diabetes complications, during which endogenous antioxidant defenses have important pathophysiological consequences. To date, the significance of endogenous antioxidants such as metallothioneins I and II (MT-I+II) in type 2 diabetes remains unclear. To examine....... Immunohistochemical analysis revealed reduced MT-I+II levels in the skeletal muscle of type 2 diabetic subjects compared with control subjects. Control subjects produced a robust increase of MT-I+II in response to training; however, in type 2 diabetes, MT-I+II levels remained essentially unchanged. Significantly...

  17. Tryptophan Biochemistry: Structural, Nutritional, Metabolic, and Medical Aspects in Humans.

    Science.gov (United States)

    Palego, Lionella; Betti, Laura; Rossi, Alessandra; Giannaccini, Gino

    2016-01-01

    L-Tryptophan is the unique protein amino acid (AA) bearing an indole ring: its biotransformation in living organisms contributes either to keeping this chemical group in cells and tissues or to breaking it, by generating in both cases a variety of bioactive molecules. Investigations on the biology of Trp highlight the pleiotropic effects of its small derivatives on homeostasis processes. In addition to protein turn-over, in humans the pathways of Trp indole derivatives cover the synthesis of the neurotransmitter/hormone serotonin (5-HT), the pineal gland melatonin (MLT), and the trace amine tryptamine. The breakdown of the Trp indole ring defines instead the "kynurenine shunt" which produces cell-response adapters as L-kynurenine, kynurenic and quinolinic acids, or the coenzyme nicotinamide adenine dinucleotide (NAD(+)). This review aims therefore at tracing a "map" of the main molecular effectors in human tryptophan (Trp) research, starting from the chemistry of this AA, dealing then with its biosphere distribution and nutritional value for humans, also focusing on some proteins responsible for its tissue-dependent uptake and biotransformation. We will thus underscore the role of Trp biochemistry in the pathogenesis of human complex diseases/syndromes primarily involving the gut, neuroimmunoendocrine/stress responses, and the CNS, supporting the use of -Omics approaches in this field.

  18. Human Cryptosporidiosis: A Review | Ayuo | East African Medical ...

    African Journals Online (AJOL)

    Objective: To provide an overview of risk factors, presentation and management of human cryptosporidium infection. Data sources: Literature review was obtained through PubMed search. Data selection: Published articles on the taxonomy of Cryptosporidium and the epidemiology, clinical presentation and management of ...

  19. Medical and technology requirements for human solar system exploration missions

    Science.gov (United States)

    Nicogossian, Arnauld; Harris, Leonard; Couch, Lana; Sulzman, Frank; Gaiser, Karen

    1989-01-01

    Measures that need to be taken to cope with the health problems posed by zero gravity and radiation in manned solar system exploration missions are discussed. The particular systems that will be used aboard Space Station Freedom are addressed, and relevant human factors problems are examined. The development of a controlled ecological life support system is addressed.

  20. Defense Business Board

    Science.gov (United States)

    Skip to main content (Press Enter). Toggle navigation Defense Business Board Search Search Defense Business Board: Search Search Defense Business Board: Search Defense Business Board Business Excellence in Defense of the Nation Defense Business Board Home Charter Members Meetings Studies Contact Us The Defense

  1. Epidemiological studies on radiation carcinogenesis in human populations following acute exposure: nuclear explosions and medical radiation

    International Nuclear Information System (INIS)

    Fabrikant, J.I.

    1981-05-01

    The current knowledge of the carcinogenic effect of radiation in man is considered. The discussion is restricted to dose-incidence data in humans, particularly to certain of those epidemiological studies of human populations that are used most frequently for risk estimation for low-dose radiation carcinogenesis in man. Emphasis is placed solely on those surveys concerned with nuclear explosions and medical exposures

  2. Image processing for medical diagnosis of human organs

    International Nuclear Information System (INIS)

    Tamura, Shin-ichi

    1989-01-01

    The report first describes expectations and needs for diagnostic imaging in the field of clinical medicine, radiation medicine in particular, viewed by the author as an image processing expert working at a medical institute. Then, medical image processing techniques are discussed in relation to advanced information processing techniques that are currently drawing much attention in the field of engineering. Finally, discussion is also made of practical applications of image processing techniques to diagnosis. In the field of clinical diagnosis, advanced equipment such as PACS (picture archiving and communication system) has come into wider use, and efforts have been made to shift from visual examination to more quantitative and objective diagnosis by means of such advanced systems. In clinical medicine, practical, robust systems are more useful than sophisticated ones. It is difficult, though important, to develop completely automatized diagnostic systems. The urgent, realistic goal, therefore, is to develop effective diagnosis support systems. In particular, operation support systems equipped with three-dimensional displays will be very useful. (N.K.)

  3. MEDICAL AND LEGAL ISSUES OF THE DECISIONS RENDERED BY THE EUROPEAN COURT OF HUMAN RIGHTS.

    Science.gov (United States)

    Chakhvadze, B; Chakhvadze, G

    2017-01-01

    The European Convention on Human rights is a document that protects human rights and fundamental freedoms of individuals, and the European Court of Human Rights and its case-law makes a convention a powerful instrument to meet the new challenges of modernity and protect the principles of rule of law and democracy. This is important, particularly for young democracies, including Georgia. The more that Georgia is a party to this convention. Article 3 of the convention deals with torture, inhuman and degrading treatment, while article 8 deals with private life, home and correspondence. At the same time, the international practice of the European court of human rights shows that these articles are often used with regard to medical rights. The paper highlights the most recent and interesting cases from the case-law of the ECHR, in which the courts conclusions are based solely on the European Convention on Human Rights. In most instances, the European Court of Human Rights uses the principle of democracy with regard to medical rights. The European court of human rights considers medical rights as moral underpinning rights. Particularly in every occasion, the European Court of Human Rights acknowledges an ethical dimension of these rights. In most instances, it does not matter whether a plaintiff is a free person or prisoner, the European court of human rights make decisions based on fundamental human rights and freedoms of individuals.

  4. COP21: defense stakes

    International Nuclear Information System (INIS)

    Coldefy, Alain; Hulot, Nicolas; Aichi, Leila; Tertrais, Bruno; Paillard, Christophe-Alexandre; Piodi, Jerome; Regnier, Serge; Volpi, Jean-Luc; Descleves, Emmanuel; Garcin, Thierry; Granholm, Niklas; Wedin, Lars; Pouvreau, Ana; Henninger, Laurent

    2015-01-01

    The 21. Conference of the Parties (COP21) from the UN Framework Convention took place in Paris between November 30 and December 11, 2015. The challenge is to reach a universal agreement of fight against global warming and to control the carbon footprint of human activities. This topic is in the core of the Defense Ministry preoccupations. This special dossier takes stock of the question of defense issues linked with global warming. The dossier comprises 13 papers dealing with: 1 - COP21: defense stakes (Coldefy, A.); 2 - Warfare climate, a chance for peace (Hulot, N.); 3 - COP21 and defense (Aichi, L.); 4 - A war climate? (Tertrais, B.); 5 - Challenges the World has to face in the 21. century (Paillard, C.A.); 6 - Desertification: a time bomb in the heart of Sahel (Piodi, J.); 7 - The infrastructure department of defense in the fight against climate disturbance (Regnier, S.); 8 - Fight against global warming, a chance for the forces? (Volpi, J.L.); 9 - Sea and sustainable development (Descleves, E.); 10 - Rationales of Arctic's surrounding powers (Garcin, T.); 11 - Arctic: strategic stake (Granholm, N.; Wedin, L.); 12 - Strategic impact of Turkey's new energy choices (Pouvreau, A.); 13 - Climate and war: a brief historical outlook (Henninger, L.)

  5. Administration of ionizing radiation to human subjects in medical research

    International Nuclear Information System (INIS)

    1985-01-01

    Any administration of ionizing radiation to human subjects for the purposes of diagnostic or therapeutic research involving either irradiation or the administration of radionuclides, should be undertaken only after approval by an institutional ethics committee. The ethics committee should obtain advice from a person experienced in radiation protection before granting approval. The research proposal must conform to regulatory requirements relating to the use of ionizing radiation

  6. Plucked Human Hair Shafts and Biomolecular Medical Research

    Directory of Open Access Journals (Sweden)

    Kevin Schembri

    2013-01-01

    Full Text Available The hair follicle is a skin integument at the boundary between an organism and its immediate environment. The biological role of the human hair follicle has lost some of its ancestral importance. However, an indepth investigation of this miniorgan reveals hidden complexity with huge research potential. An essential consideration when dealing with human research is the awareness of potential harm and thus the absolute need not to harm—a rule aptly qualified by the Latin term “primum non nocere” (first do no harm. The plucked hair shaft offers such advantages. The use of stem cells found in hair follicles cells is gaining momentum in the field of regenerative medicine. Furthermore, current diagnostic and clinical applications of plucked hair follicles include their use as autologous and/or three-dimensional epidermal equivalents, together with their utilization as surrogate tissue in pharmacokinetic and pharmacodynamics studies. Consequently, the use of noninvasive diagnostic procedures on hair follicle shafts, posing as a surrogate molecular model for internal organs in the individual patient for a spectrum of human disease conditions, can possibly become a reality in the near future.

  7. United States Department of Health and Human Services Biodosimetry and radiological/nuclear medical countermeasure programs

    International Nuclear Information System (INIS)

    Homer, Mary J.; Raulli, Robert; Esker, John; Moyer, Brian; Wathen, Lynne; DiCarlo-Cohen, Andrea L.; Maidment, Bert W.; Rios, Carmen; Macchiarini, Francesca; Hrdina, Chad; Prasanna, Pataje G.

    2016-01-01

    The United States Department of Health and Human Services (HHS) is fully committed to the development of medical countermeasures to address national security threats from chemical, biological, radiological, and nuclear agents. Through the Public Health Emergency Medical Countermeasures Enterprise, HHS has launched and managed a multi-agency, comprehensive effort to develop and operationalize medical countermeasures. Within HHS, development of medical countermeasures includes the National Institutes of Health (NIH), (led by the National Institute of Allergy and Infectious Diseases), the Office of the Assistant Secretary of Preparedness and Response/Biomedical Advanced Research and Development Authority (BARDA); with the Division of Medical Countermeasure Strategy and Requirements, the Centers for Disease Control and Prevention, and the Food and Drug Administration as primary partners in this endeavor. This paper describes various programs and coordinating efforts of BARDA and NIH for the development of medical countermeasures for radiological and nuclear threats. (authors)

  8. The Almost Right Word: The Move From Medical to Health Humanities.

    Science.gov (United States)

    Jones, Therese; Blackie, Michael; Garden, Rebecca; Wear, Delese

    2017-07-01

    Since the emergence of the field in the 1970s, several trends have begun to challenge the original assumptions, claims, and practices of what became known as the medical humanities. In this article, the authors make the case for the health humanities as a more encompassing label because it captures recent theoretical and pedagogical developments in higher education such as the shift from rigid disciplinary boundaries to multi- and interdisciplinary inquiry, which has transformed humanities curricula in health professions. Calling the area of study health humanities also underscores the crucial distinction between medicine and health. Following a brief history of the field and the rationales that brought humanities disciplines to medical education in the first place-the "why" of the medical humanities-the authors turn to the "why" of the health humanities, using disability studies to illuminate those methodologies and materials that represent the distinction between the two. In addition, the authors make note of how humanities inquiry has now expanded across the landscape of other health professions curricula; how there is both awareness and evidence that medicine is only a minor determinant of health in human populations alongside social and cultural factors; and finally, how the current movement in health professions education is towards interdisciplinary and interprofessional learning experiences for students.

  9. Biological and medical effects of UV radiation on human health

    International Nuclear Information System (INIS)

    Piazena, H.

    1994-01-01

    Effecsts of UV radiation on human health are discussed. UV radiation is taken up through the skin and eyes. In the case of the eyes, the only known effects are damaging ones (e.g. cataracts). Irradiation of the skin, on the other hand, may either have a prophylactic and therapeutic effect or cause health problems if the exposure is too frequent and/or the dose too high. Positive effects are: Stimulation of the vitamin-D-3 synthesis and the autoimmune system, economisation of blood circulation, higher fitness, and the development of a UV protection system in the skin. Negative effects are: UV erythema, disturbances of the unspecific resistance and the immune system, and photocarcinogenesis. (orig.) [de

  10. Teratogenicity of recently introduced medications in human pregnancy.

    Science.gov (United States)

    Lo, W Y; Friedman, J M

    2002-09-01

    To determine how long it takes after a new drug is marketed to establish whether or not its use by pregnant women is likely to pose a substantial teratogenic risk. We used standard clinical teratology resources to assess the teratogenic risks in human pregnancy of therapeutic treatment with 468 drugs approved by the US Food and Drug Administration between 1980 and 2000. The teratogenic risk of each treatment was classified using the current online version of TERIS into one of three categories: 1) no risk, minimal risk, or unlikely to produce an increased risk; 2) associated with a small, moderate, or high risk; or 3) risk undetermined. We found that the teratogenic risk in human pregnancy was still undetermined for 91.2% of drug treatments approved in the United States between 1980 and 2000. The proportion of treatments classified as having an "undetermined" teratogenic risk was more than 80% for drugs approved for marketing 0-4, 5-9, 10-14, or 15-20 years ago, but the highest proportion of drugs with an "undetermined" teratogenic risk was found among those approved 15-20 years ago. The agreement between TERIS risk ratings and Food and Drug Administration Use-in-Pregnancy Categories for 163 drugs that had been assessed by both systems was poor (kappa +/- standard error = 0.082 +/- 0.042). We conclude that inadequate information is available for pregnant women and their physicians to determine whether the benefits exceed the teratogenic risks for most drug treatments introduced in the past 20 years.

  11. Writing, self-reflection, and medical school performance: the Human Context of Health Care.

    Science.gov (United States)

    Stephens, Mark B; Reamy, Brian V; Anderson, Denise; Olsen, Cara; Hemmer, Paul A; Durning, Steven J; Auster, Simon

    2012-09-01

    Finding ways to improve communication and self-reflection skills is an important element of medical education and continuing professional development. This study examines the relationship between self-reflection and educational outcomes. We correlate performance in a preclinical course that focuses on self-reflection as it relates to contextual elements of patient care (Human Context of Health Care), with educational measures such as overall grade point average, clinical clerkship scores, and Medical College Admission Test (MCAT) scores. Student performance in Human Context of Health Care correlated with MCAT-Verbal scores, MCAT-writing sample scores, clerkship grades, and overall medical school grade point average (R = 0.3; p self-reflection skills are often neglected in undergraduate medical curricula. Our findings suggest that these skills are important and correlate with recognized long-term educational outcomes.

  12. Organizing of medical ensurance of human population under extreme conditions. Summaries of reports of scientific-practical conference

    International Nuclear Information System (INIS)

    1994-01-01

    Summary of reports are presented of Scientific-Practical conference on the organizing of medical ensurance of human population under extreme conditions including radiation accidents. The conference held in Moscow in October, 1994. It covered problems of organizing medical ensurance of population, medical surveillance problems, sanitary-hygienic and epidemiological problems (including radiation protection), and medical provision problems under extreme conditions

  13. Playing to our human strengths to prepare medical students for the future

    OpenAIRE

    Julie Chen

    2017-01-01

    We are living in an age where artificial intelligence and astounding technological advances are bringing truly remarkable change to healthcare. Medical knowledge and skills which form the core responsibility of doctors such as making diagnoses may increasingly be delivered by robots. Machines are gradually acquiring human abilities such as deep learning and empathy. What, then is the role of doctors in future healthcare? And what direction should medical schools be taking to prepare their gra...

  14. Salmonella Typhi Colonization Provokes Extensive Transcriptional Changes Aimed at Evading Host Mucosal Immune Defense During Early Infection of Human Intestinal Tissue

    Directory of Open Access Journals (Sweden)

    K.P. Nickerson

    2018-05-01

    Full Text Available Commensal microorganisms influence a variety of host functions in the gut, including immune response, glucose homeostasis, metabolic pathways and oxidative stress, among others. This study describes how Salmonella Typhi, the pathogen responsible for typhoid fever, uses similar strategies to escape immune defense responses and survive within its human host. To elucidate the early mechanisms of typhoid fever, we performed studies using healthy human intestinal tissue samples and “mini-guts,” organoids grown from intestinal tissue taken from biopsy specimens. We analyzed gene expression changes in human intestinal specimens and bacterial cells both separately and after colonization. Our results showed mechanistic strategies that S. Typhi uses to rearrange the cellular machinery of the host cytoskeleton to successfully invade the intestinal epithelium, promote polarized cytokine release and evade immune system activation by downregulating genes involved in antigen sampling and presentation during infection. This work adds novel information regarding S. Typhi infection pathogenesis in humans, by replicating work shown in traditional cell models, and providing new data that can be applied to future vaccine development strategies. Keywords: Typhoid fever, Salmonella, Snapwell™ system, Human tissue, Terminal ileum, Immune system, Innate immunity, Immune evasion, Host-pathogen interaction, Vaccine development, Intestinal organoids, Organoid monolayer

  15. Innovation Through Tradition: Rediscovering the “Humanist” in the Medical Humanities

    Science.gov (United States)

    Osipov, Rimma; Childress, Andrew

    2018-01-01

    Throughout its fifty-year history, the role of the medical humanist and even the name “medical humanities” has remained raw, dynamic and contested. What do we mean when we call ourselves “humanists” and our practice “medical humanities?” To address these questions, we turn to the concept of origin narratives. After explaining the value of these stories, we focus on one particularly rich origin narrative of the medical humanities by telling the story of how a group of educators, ethicists, and scholars struggling to define their relatively new field rediscovered the studia humanitatis, a Renaissance curriculum for learning and teaching. Our origin narrative is composed of two intertwined stories—the history of the studia humanitatis itself and the story of the scholars who rediscovered it. We argue that as an origin narrative the studia humanitatis grounds the medical humanities as both an engaged moral practice and pedagogical project. In the latter part of the paper, we use this origin narrative to show how medical humanists working in translational science can use their understanding of their historical roots to do meaningful work in the world. PMID:26561349

  16. Providing context for a medical school basic science curriculum: The importance of the humanities.

    Science.gov (United States)

    Thompson, Britta M; Vannatta, Jerry B; Scobey, Laura E; Fergeson, Mark; Humanities Research Group; Crow, Sheila M

    2016-01-01

    To increase students' understanding of what it means to be a physician and engage in the everyday practice of medicine, a humanities program was implemented into the preclinical curriculum of the medical school curriculum. The purpose of our study was to determine how medical students' views of being a doctor evolved after participating in a required humanities course. Medical students completing a 16-clock hour humanities course from 10 courses were asked to respond to an open-ended reflection question regarding changes, if any, of their views of being a doctor. The constant comparative method was used for coding; triangulation and a variety of techniques were used to provide evidence of validity of the analysis. A majority of first- and second-year medical students (rr = 70%) replied, resulting in 100 pages of text. A meta-theme of Contextualizing the Purpose of Medicine and three subthemes: the importance of Treating Patients Rather than a Disease, Understanding Observation Skills are Important, and Recognizing that Doctors are Fallible emerged from the data. Results suggest that requiring humanities as part of the required preclinical curriculum can have a positive influence on medical students and act as a bridge to contextualize the purpose of medicine.

  17. [Historical and epistemological notes and considerations on Medical Humanities] [Article in Italian] • Note e riflessioni storico-epistemologiche sulle Medical Humanities

    Directory of Open Access Journals (Sweden)

    Giancarlo Nonnoi

    2012-10-01

    Full Text Available In the field of health care, recovery, and pain management, more and more interest is being shown in the development of a patient-centred medicine able to overcome several of the obvious limitations of the predominant medical conception of the ars medendi. Over the last few decades, professionals and health agencies have refocused their attention on the original humanistic vocation of Western medicine, making use of the analysis tools of the Medical Humanities, as well as the actual results of their use in clinical practice. Drawing on the ongoing debate of the last few decades in English-speaking countries, the paper deals with two main issues. In view of a treatment strategy and more effective shared caring, the first part underlines the need for healthcare personnel to increase their propensity to listen empathetically and appreciate the patient’s story of his/her suffering. This will be followed by an in-depth examination of, on the one hand, the main structures involved in the illness experience and on the other, the ontological metamorphosis and the new order and set of values that such an experience generates. The paper ends with reference to the polymorphic and polycentric nature of the Medical Humanities and the holistic epistemology that characterizes them.

  18. The Virome and Its Major Component, Anellovirus, a Convoluted System Molding Human Immune Defenses and Possibly Affecting the Development of Asthma and Respiratory Diseases in Childhood

    Directory of Open Access Journals (Sweden)

    Giulia Freer

    2018-04-01

    Full Text Available The microbiome, a thriving and complex microbial community colonizing the human body, has a broad impact on human health. Colonization is a continuous process that starts very early in life and occurs thanks to shrewd strategies microbes have evolved to tackle a convoluted array of anatomical, physiological, and functional barriers of the human body. Cumulative evidence shows that viruses are part of the microbiome. This part, called virome, has a dynamic composition that reflects what we eat, how and where we live, what we do, our genetic background, and other unpredictable variables. Thus, the virome plays a chief role in shaping innate and adaptive host immune defenses. Imbalance of normal microbial flora is thought to trigger or exacerbate many acute and chronic disorders. A compelling example can be found in the respiratory apparatus, where early-life viral infections are major determinants for the development of allergic diseases, like asthma, and other non-transmissible diseases. In this review, we focus on the virome and, particularly, on Anelloviridae, a recently discovered virus family. Anelloviruses are major components of the virome, present in most, if not all, human beings, where they are acquired early in life and replicate persistently without causing apparent disease. We will discuss how modulation of innate and adaptive immune systems by Anelloviruses can influence the development of respiratory diseases in childhood and provide evidence for the use of Anelloviruses as useful and practical molecular markers to monitor inflammatory processes and immune system competence.

  19. Is the decline of human anatomy hazardous to medical education/profession?--A review.

    Science.gov (United States)

    Singh, Rajani; Shane Tubbs, R; Gupta, Kavita; Singh, Man; Jones, D Gareth; Kumar, Raj

    2015-12-01

    The continuous decrease in teaching time, the artificially created scarcity of competent anatomical faculties and a reduced allocation of resources have brought about the decline of anatomy in medical education. As a result of this, anatomical knowledge and the standard of medical education have fallen with consequences including safety in clinical practice. The aim of the present study is to analyze this declining phase of anatomy and its impact on medical education and to consider corrective measures. This article expresses comparative viewpoints based on a review of the literature. Anatomy enables doctors to master the language of medical science so they can communicate with patients, the public and fellow doctors and diagnose and treat diseases successfully in all medical fields. No medical specialist or expert can master their field without adequate knowledge of human anatomy. The shrinkage of anatomical schedules, inadequate faculties and declining allocation of resources is therefore unfortunate. These factors produce stress in both student and faculty creating gaps in anatomical knowledge that means insufficient skill is developed to practice medicine safely. This decline is hazardous not only to the medical profession but also to society. Reforms consisting of balanced rescheduling of medical curricula and optimum resource allocation have been proposed to improve the standard of education of doctors.

  20. A Study of Core Humanistic Competency for Developing Humanism Education for Medical Students.

    Science.gov (United States)

    Jung, Hee-Yeon; Kim, Jae-Won; Lee, Seunghee; Yoo, Seong Ho; Jeon, Ju-Hong; Kim, Tae-Woo; Park, Joong Shin; Jeong, Seung-Yong; Oh, Seo Jin; Kim, Eun Jung; Shin, Min-Sup

    2016-06-01

    The authors conducted a survey on essential humanistic competency that medical students should have, and on teaching methods that will effectively develop such attributes. The participants consisted of 154 medical school professors, 589 medical students at Seoul National University College of Medicine, 228 parents, and 161 medical school and university hospital staff. They answered nine questions that the authors created. According to the results, all groups chose "morality and a sense of ethics," a "sense of accountability," "communication skills," and "empathic ability" were selected as essential qualities. According to the evaluation on the extent to which students possess each quality, participants believed students had a high "sense of accountability" and "morality," whereas they thought students had low "empathic ability," "communicate," or "collaborate with others". In terms of effective teaching methods, all sub-groups preferred extracurricular activities including small group activities, debates, and volunteer services. With regard to the speculated effect of humanism education and the awareness of the need for colleges to offer it, all sub-groups had a positive response. However the professors and students expressed a relatively passive stance on introducing humanism education as a credited course. Most participants responded that they preferred a grading method based on their rate of participation, not a relative evaluation. In order to reap more comprehensive and lasting effects of humanism education courses in medical school, it is necessary to conduct faculty training, and continuously strive to develop new teaching methods.

  1. Effects of diets based on foods from conventional versus organic production on intake and excretion of flavonoids and markers of antioxidative defense in humans

    DEFF Research Database (Denmark)

    Grinder-Pedersen, Lisbeth; Rasmussen, Salka E.; Bügel, Susanne

    2003-01-01

    selection of more resistant varieties is of central importance to organic farming, it cannot be excluded that the observed effects originate from these differences. The food production method affected the content of the major flavonoid, quercetin, in foods and also affected urinary flavonoids and markers......Different food production methods may result in differences in the content of secondary metabolites such as polyphenolic compounds. The present study compared conventionally (CPD) and organically produced (OPD) diets in a human crossover intervention study (n = 16) with respect to the intake...... both interventions. Most markers of antioxidative defense did not differ between the diets, but intake of OPD resulted in an increased protein oxidation and a decreased total plasma antioxidant capacity compared to baseline (P

  2. Designing medical technology for resilience : integrating health economics and human factors approaches

    NARCIS (Netherlands)

    Borsci, Simone; Uchegbu, Ijeoma; Buckle, Peter; Ni, Zhifang; Walne, Simon; Hanna, George B.

    2018-01-01

    Introduction: The slow adoption of innovation into healthcare calls into question the manner of evidence generation for medical technology. This paper identifies potential reasons for this including a lack of attention to human factors, poor evaluation of economic benefits, lack of understanding of

  3. Toward Improved Collections in Medical Humanities: Fiction in Academic Health Sciences Libraries

    Science.gov (United States)

    Dali, Keren; Dilevko, Juris

    2006-01-01

    Although fiction plays a prominent role in the interdisciplinary field of medical humanities (MH), it is physically and intellectually isolated from non-fiction in academic health sciences libraries. Using the Literature, Arts, and Medicine Database (LAMD) as a tool for selection and subject analysis, we suggest a method of integrating fiction…

  4. Egyptian Journal of Medical Human Genetics - Vol 12, No 2 (2011)

    African Journals Online (AJOL)

    Egyptian Journal of Medical Human Genetics - Vol 12, No 2 (2011) ... Serum interferon-alpha level in first degree relatives of systemic lupus erythematosus patients: Correlation with autoantibodies titers · EMAIL FREE FULL TEXT EMAIL FREE FULL ... LB Salah, CB Salem, F B'Chir, K Bouraoui, F Broly, S Saguem, 183-186.

  5. Chekhov’s Ethical Heritage in the Contemporary American Medical Humanities

    Directory of Open Access Journals (Sweden)

    Eugenyia M. Butenina

    2017-12-01

    Full Text Available The paper discusses Chekhovian ethical discourse in American fiction and non-fiction that forms part of an emerging literary canon of medical humanities in the USA. Besides Chekhov’s “medical” stories, special attention is given to his book Sakhalin Island seen as an object of “moral cartography.” The analysis of contemporary medical humanities in the USA shows that Chekhov’s ethical heritage has entered this field at several levels. One is teaching “medical” stories and Sakhalin Island as part of the future doctors’ ethical education. The other is expanding the literary-medical context by including these texts in comparative studies and anthologies. Finally, there is the overall level of developing the method of literary “diagnostic” bearing on Chekhov’s ethical heritage that is important for the study of both fiction and non-fiction authored by doctors-writers.

  6. Equality in Distribution of Human Resources: the Case of Iran's Ministry of Health and Medical Education.

    Science.gov (United States)

    Mobaraki, H; Hassani, A; Kashkalani, T; Khalilnejad, R; Chimeh, E Ehsani

    2013-01-01

    Equity in access to and utilization of health services is a common goal of policy-makers in most countries. The fair allocation of human resources is one of the dimensions of equity, which was evaluated in this study. We evaluated the equity of human resources' distribution among Iran's medical science universities between 2005 and 2009 by inequality measures including Lorenze curve, Gini coefficient and Rabin hood indexes. In the distribution 60403 recruitment licenses among medical universities with 72456140 covered populations, Gini coefficient was 0.167 and Robin Hood Index 0.11. Calculations indicated Recruitment licenses are equitably distributed in MOH&ME of Iran. However a portion of recruitment licenses should redistributed for achieving perfect equal distribution among all public medical universities of Iran.

  7. Towards cultural materialism in the medical humanities: the case of blood rejuvenation

    Science.gov (United States)

    2018-01-01

    This paper argues for an approach within the medical humanities that draws on the theoretical legacy of cultural materialism as a framework for reading cultural practices and their relationship to the social and economic order. It revisits the origins and development of cultural materialism in cultural studies and literary studies between the 1970s and 1990s and considers how, with adaptation, this methodology might facilitate ideological criticism focused on material formations of health, disease and the human body. I outline three key characteristics of a medicocultural materialist approach along these lines: (a) interdisciplinary work on a broad range of medical and cultural sources, including those drawn from ‘popular’ forms of culture; (b) the combination of historicist analysis with scrutiny of present-day contexts; (c) analyses that engage with political economy perspectives and/or the work of medical sociology in this area. The subsequent sections of the paper employ a medicocultural materialist approach to examine conjectural understandings of, and empirical investigations into, the capacity of transfused human blood to rejuvenate the ageing body. I trace textual faultlines that expose the structures of power which inform the movement of blood between bodies in ‘medical gothic’ fictions from the 19th-century fin de siècle, including Mary Elizabeth Braddon's ‘Good Lady Ducayne’ (1896) and Bram Stoker's Dracula (1897). I conclude with a critique of biomedical innovations in blood rejuvenation in the era of medical neoliberalism, before considering the potential applications of medicocultural materialism to other topics within the field of the medical humanities. PMID:28495908

  8. Towards cultural materialism in the medical humanities: the case of blood rejuvenation.

    Science.gov (United States)

    Oakley, Catherine

    2018-03-01

    This paper argues for an approach within the medical humanities that draws on the theoretical legacy of cultural materialism as a framework for reading cultural practices and their relationship to the social and economic order. It revisits the origins and development of cultural materialism in cultural studies and literary studies between the 1970s and 1990s and considers how, with adaptation, this methodology might facilitate ideological criticism focused on material formations of health, disease and the human body. I outline three key characteristics of a medicocultural materialist approach along these lines: (a) interdisciplinary work on a broad range of medical and cultural sources, including those drawn from 'popular' forms of culture; (b) the combination of historicist analysis with scrutiny of present-day contexts; (c) analyses that engage with political economy perspectives and/or the work of medical sociology in this area. The subsequent sections of the paper employ a medicocultural materialist approach to examine conjectural understandings of, and empirical investigations into, the capacity of transfused human blood to rejuvenate the ageing body. I trace textual faultlines that expose the structures of power which inform the movement of blood between bodies in 'medical gothic' fictions from the 19th-century fin de siècle, including Mary Elizabeth Braddon's 'Good Lady Ducayne' (1896) and Bram Stoker's Dracula (1897). I conclude with a critique of biomedical innovations in blood rejuvenation in the era of medical neoliberalism, before considering the potential applications of medicocultural materialism to other topics within the field of the medical humanities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Identification and Evaluation of Human Errors in the Medication Process Using the Extended CREAM Technique

    Directory of Open Access Journals (Sweden)

    Iraj Mohammadfam

    2017-10-01

    Full Text Available Background Medication process is a powerful instrument for curing patients. Obeying the commands of this process has an important role in the treatment and provision of care to patients. Medication error, as a complicated process, can occur in any stage of this process, and to avoid it, appropriate decision-making, cognition, and performance of the hospital staff are needed. Objectives The present study aimed at identifying and evaluating the nature and reasons of human errors in the medication process in a hospital using the extended CREAM method. Methods This was a qualitative and cross-sectional study conducted in a hospital in Hamadan. In this study, first, the medication process was selected as a critical issue based on the opinions of experts, specialists, and experienced individuals in the nursing and medical departments. Then, the process was analyzed into relative steps and substeps using the method of HTA and was evaluated using extended CREAM technique considering the probability of human errors. Results Based on the findings achieved through the basic CREAM method, the highest CFPt was in the step of medicine administration to patients (0.056. Moreover, the results revealed that the highest CFPt was in the substeps of calculating the dose of medicine and determining the method of prescription and identifying the patient (0.0796 and 0.0785, respectively. Also, the least CFPt was related to transcribing the prescribed medicine from file to worksheet of medicine (0.0106. Conclusions Considering the critical consequences of human errors in the medication process, holding pharmacological retraining classes, using the principles of executing pharmaceutical orders, increasing medical personnel, reducing working overtime, organizing work shifts, and using error reporting systems are of paramount importance.

  10. Playing to our human strengths to prepare medical students for the future

    Directory of Open Access Journals (Sweden)

    Julie Chen

    2017-09-01

    Full Text Available We are living in an age where artificial intelligence and astounding technological advances are bringing truly remarkable change to healthcare. Medical knowledge and skills which form the core responsibility of doctors such as making diagnoses may increasingly be delivered by robots. Machines are gradually acquiring human abilities such as deep learning and empathy. What, then is the role of doctors in future healthcare? And what direction should medical schools be taking to prepare their graduates? This article will give an overview of the evolving technological landscape of healthcare and examine the issues undergraduate medical education may have to address. The experience at The University of Hong Kong will serve as a case study featuring several curricular innovations that aim to empower medical graduates with the capabilities to thrive in the future.

  11. Playing to our human strengths to prepare medical students for the future.

    Science.gov (United States)

    Chen, Julie

    2017-09-01

    We are living in an age where artificial intelligence and astounding technological advances are bringing truly remarkable change to healthcare. Medical knowledge and skills which form the core responsibility of doctors such as making diagnoses may increasingly be delivered by robots. Machines are gradually acquiring human abilities such as deep learning and empathy. What, then is the role of doctors in future healthcare? And what direction should medical schools be taking to prepare their graduates? This article will give an overview of the evolving technological landscape of healthcare and examine the issues undergraduate medical education may have to address. The experience at The University of Hong Kong will serve as a case study featuring several curricular innovations that aim to empower medical graduates with the capabilities to thrive in the future.

  12. Anxieties of communication: the limits of narrative in the medical humanities.

    Science.gov (United States)

    McKechnie, Claire Charlotte

    2014-12-01

    This paper aims to provide an initial response to Angela Woods's endeavour to '(re)ignite critical debates around this topic' in her recent essay 'The limits of narrative: provocations for the medical humanities' (Medical Humanities 2011). Woods's essay challenges the validity of the notion of the narrative self through her discussion and use of Galen Strawson's seminal 'Against narrativity' (2004). To some extent in dialogue with Woods, this article will examine three exploratory concepts connected with the topic. First, it will explore ways in which we might seek to re-place narrative at the centre of the philosophy of good medicine and medical practice by reassessing the role of the narratee in the narrative process. Second, it will reconsider the three alternative forms of expression Woods puts forward as non-narrative--metaphor, phenomenology and photography--as narrative. Finally, and connected to the first two areas of discussion, it will reflect on ways in which narrative might be used to interpret illness and suffering in medical humanities contexts. What I hope to show, in relation to Woods's work on this subject, is that in order to be interpreted (indeed interpretable) the types of non-narrative representation and communication she discusses in fact require a narrative response. We employ narratology to engage with illness experience because narrative is so fundamental to meaning-making that it is not just required, it is an inherent human response to creative outputs we encounter. This is a quite different approach to the question of narrativity in the medical humanities, and it is therefore related to, but not entirely hinged upon, the work that Woods has done, but it is intended to spark further discussion across the emergent discipline. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Development of a Medical Humanities Program at Dalhousie University Faculty of Medicine, Nova Scotia, Canada, 1992-2003.

    Science.gov (United States)

    Murray, Jock

    2003-10-01

    The Medical Humanities Program at Dalhousie University Faculty of Medicine in Nova Scotia, Canada, was initiated in 1992 to incorporate the medical humanities into the learning and experiences of medical students. The goal of the program was to gain acceptance as an integral part of the medical school. The program assumed a broad concept of the medical humanities that includes medical history, literature, music, art, multiculturalism, philosophy, epistemology, theology, anthropology, professionalism, history of alternative therapies, writing, storytelling, health law, international medicine, and ethics. Phase I of the program has provided the same elective and research opportunities in the medical humanities that are available to the students in clinical and basic sciences, and has encouraged and legitimized the involvement of the humanities in the life and learning of the medical student through a wide array of programs and activities. Phase II will focus on further incorporation of the humanities into the curriculum. Phase III will be the development of a graduate program in medical humanities to train more faculty who will incorporate the humanities into their teaching and into the development of education programs.

  14. Beyond "Dr. Feel-Good": A Role for the Humanities in Medical Education.

    Science.gov (United States)

    Kumagai, Arno K

    2017-12-01

    Although educators embrace the values that are nominally included in the idea of "the art and science of medicine," the arts and humanities have remained at the edges of medical education. One reason for this exile is the overwhelming emphasis in the curriculum on biomedical science over the social sciences and humanities. Other causes are self-inflicted-a frequent lack of theoretical rigor in the design of educational offerings and, more important, no clear answer to the question of how the humanities can make better physicians. A common justification for including the arts and humanities in medical education-that spending time with literature, music, and the visual arts contributes to student and faculty reflection and well-being-is compelling; however, it risks further marginalizing the field as a soft, feel-good supplement to training.In this Invited Commentary, the author proposes several unique ways in which the arts and humanities contribute to the development of physicians who practice with excellence, compassion, and justice.These ways include disrupting taken-for-granted beliefs and assumptions; introducing a pause in perceiving, thinking, and acting; encouraging engagement with complexity and ambiguity; seeing past the surface to historical and societal influences and causes; and encouraging an awareness of the multiple, unique voices and perspectives of patients. Ultimately, the humanities prompt awareness of the space in which physicians care for human beings in their moments of greatest need and bear witness to fundamental changes in their patients and in themselves.

  15. Graduate medical education in humanism and professionalism: a needs assessment survey of pediatric gastroenterology fellows.

    Science.gov (United States)

    Garvey, Katharine C; Kesselheim, Jennifer C; Herrick, Daniel B; Woolf, Alan D; Leichtner, Alan M

    2014-01-01

    The deterioration of humanism and professionalism during graduate medical training is an acknowledged concern, and programs are required to provide professionalism education for pediatric fellows. We conducted a needs assessment survey in a national sample of 138 first- and second-year gastroenterology fellows (82% response rate). Most believed that present humanism and professionalism education met their needs, but this education was largely informal (eg, role modeling). Areas for formal education desired by >70% included competing demands of clinical practice versus research, difficult doctor-patient relationships, depression/burnout, angry parents, medical errors, work-life balance, and the patient illness experience. These results may guide curricula to formalize humanism and professionalism education in pediatric gastroenterology fellowships.

  16. ASTM lights the way for tissue engineered medical products standards: jump start for combination medical products that restore biological function of human tissues.

    Science.gov (United States)

    Picciolo, G L; Stocum, D L

    2001-01-01

    Everybody hopes for better health and restoration of impaired bodily function, and now that hope is illuminated by the promise of powerful biological tools that make human cells grow and replace human tissue. ASTM Committee F04 on Medical and Surgical Materials and Devices is taking the lead by defining some of those tools as standards that can be used for the development, production, testing, and regulatory approval of medical products.

  17. Medications

    Science.gov (United States)

    ... Red Dress ® , and Red Dress ® are registered trademarks of U.S. Department of Health and Human Services. National Wear Red Day ® is a registered trademark of the U.S. Department of Health and Human ...

  18. The medicalization of love and narrow and broad conceptions of human well-being.

    Science.gov (United States)

    Nyholm, Sven

    2015-07-01

    Would a "medicalization" of love be a "good" or "bad" form of medicalization? In discussing this question, Earp, Sandberg, and Savulescu primarily focus on the potential positive and negative consequences of turning love into a medical issue. But it can also be asked whether there is something intrinsically regrettable about medicalizing love. It is argued here that the medicalization of love can be seen as an "evaluative category mistake": it treats a core human value (love) as if it were mainly a means to other ends (viz. physical health and hedonic well-being). It is also argued that Earp et al's closing argument (that a scientific perspective on love actually adds more value to love) can be seen as involving another evaluative category mistake: it treats an object of desire and practical interest (namely, love) as if it mainly were an object of scientific contemplation and theoretical interest. It is concluded that, to relate love to health and well-being in a more satisfying way, we should construe the latter two in broader ways, whereby love is itself a component or element of human flourishing.

  19. Religious morality (and secular humanism) in Western civilization as precursors to medical ethics: A historic perspective

    Science.gov (United States)

    Faria, Miguel A.

    2015-01-01

    In discussing bioethics and the formulation of neuroethics, the question has arisen as to whether secular humanism should be the sole philosophical guiding light, to the exclusion of any discussion (or even mention) of religious morality, in professional medical ethics. In addition, the question has arisen as to whether freedom or censorship should be part of medical (and neuroscience) journalism. Should independent medical journals abstain from discussing certain issues, or should only the major medical journals — i.e., the New England Journal of Medicine (NEJM), the Journal of the American Medical Association (JAMA) or Lancet — be heard, speaking with one “consensual,” authoritative voice? This issue is particularly important in controversial topics impacting medical politics — e.g., public health policy, socio-economics, bioethics, and the so-called redistributive justice in health care. Should all sides be heard when those controversial topics are discussed or only a consensual (monolithic) side? This historical review article discusses those issues and opts for freedom in medical and surgical practice as well as freedom in medical journalism, particularly in opinion pieces such as editorials, commentaries, or letters to the editor, as long as they relate to medicine and, in our special case, to neuroscience and neurosurgery. After answering those questions, and in response to a critical letter to the editor, this review article then expounds comprehensively on the historical and philosophical origins of ethics and religious morality. Necessarily, we discuss the Graeco-Roman legacy and the Judeo-Christian inheritance in the development of ethics and religious morality in Western civilization and their impact on moral conduct in general and on medical and neuroscience ethics in particular. PMID:26110085

  20. The suggestion of common cause of disease, characteristics of human body, and medical treatment

    Directory of Open Access Journals (Sweden)

    Byung-Jun Cho

    2011-06-01

    Full Text Available Objectives & Methods: This suggestion was attempted to be elevated the recognition of common characteristics in disease. So, we performed to analyze the correlation of common cause of disease, characteristics of human body, and medical treatment. And the results are as follows. Results: 1. The cause of disease is consist of genetic factor, aging, habit, food of not good in health, weather, environment, deficit of the physical activity, stress and so on. 2. Generally, human has common and individual weakness. Individual weakness is appeared similar to the occurrence of volcano and lapse. 3. The correlation of disease and medical treatments is possible to explain using the quotation of the law of motion made by Isaac Newton, the great physicist. 4. When the process of the medical treatment was not progressed, the prognosis is determined by the correlation of the homeostasis(H' in human body and the homeostasis(H of disease. 5. The prognosis of disease is determined by the relationship between the energy of disease(F and medical treatment(F'. 6. The exact diagnosis is possible to predict the treatment sequence, and the facts that homeostasis in human body and disease, relationship between the energy of disease(F and medical treatment(F', action and reaction are important to determine the prognosis. 7. The careful observation of improving response and worsening action of disease becomes available for exact prognosis. Conclusion: The above described contents may be useful in clinical studies, and the concrete clinical reports about this will be made afterward.

  1. An Interactive Method for Teaching Anatomy of the Human Eye for Medical Students in Ophthalmology Clinical Rotations

    Science.gov (United States)

    Kivell, Tracy L.; Doyle, Sara K.; Madden, Richard H.; Mitchell, Terry L.; Sims, Ershela L.

    2009-01-01

    Much research has shown the benefits of additional anatomical learning and dissection beyond the first year of medical school human gross anatomy, all the way through postgraduate medical training. We have developed an interactive method for teaching eye and orbit anatomy to medical students in their ophthalmology rotation at Duke University…

  2. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module II. Human Systems and Patient Assessment.

    Science.gov (United States)

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This instructor's lesson plan guide on human systems and patient assessment is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Four units are presented: (1) medical terminology, which covers some common prefixes and suffixes and the use of the medical dictionary; (2) an overview of the…

  3. Training medical students in human rights: a fifteen-year experience in Geneva

    Directory of Open Access Journals (Sweden)

    Philippe Chastonay

    2012-09-01

    Full Text Available Background: Training health professionals in the field of human rights has long been advocated by the United Nations. Over the past decade some medical schools have introduced health and human rights courses, yet by far not all. This paper describes the objectives and the content of the Health and Human Rights program developed at the Faculty of Medicine, University of Geneva. Methods: The health and human rights program was developed through the identification of the course objectives, contents, and educational modalities using consensus techniques, and through a step by step implementation procedure integrating multiple evaluation processes. Results: Defined objectives included the familiarization with the concepts, instruments and mechanisms of human rights, the links between health and human rights, and the role of health professionals in promoting human rights. The content ultimately adopted focused on the typology of human rights, their mechanisms of protection, their instruments, as well as social inequalities and vulnerable groups of the population. The implementation proceeded through a step by step approach. Evaluation showed high satisfaction of students, good achievement of learning objectives, and some academic and community impact. Conclusions: High interest of students for a human rights course is encouraging. Furthermore, the community projects initiated and implemented by students may contribute to the social responsibility of the academic institution.

  4. Enhancement, ethics and society: towards an empirical research agenda for the medical humanities and social sciences.

    Science.gov (United States)

    Pickersgill, Martyn; Hogle, Linda

    2015-12-01

    For some time now, bioethicists have paid close attention to issues associated with 'enhancement'; specifically, the appropriate use and regulation of substances and artefacts understood by some to improve the functioning of human bodies beyond that associated with 'normal' function. Medical humanities scholars (aside from philosophers and lawyers) and social scientists have not been frequent participants in debates around enhancement, but could shine a bright light on the range of dilemmas and opportunities techniques of enhancement are purported to introduce. In this paper, we argue that empirical research into the notion and practice of enhancement is necessary and timely. Such work could fruitfully engage with-and further develop-existing conceptual repertoires within the medical humanities and social sciences in ways that would afford benefit to scholars in those disciplines. We maintain that empirical engagements could also provide important resources to bioethicists seeking to regulate new enhancements in ways that are sensitive to societal context and cultural difference. To this end, we outline an empirical agenda for the medical humanities and social sciences around enhancement, emphasising especially how science and technology studies could bring benefits to-and be benefitted by-research in this area. We also use the example of (pharmaceutical) cognitive enhancement to show how empirical studies of actual and likely enhancement practices can nuance resonant bioethical debates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. A call to include medical humanities in the curriculum of colleges of osteopathic medicine and in applicant selection.

    Science.gov (United States)

    Hoff, Gary; Hirsch, Norma J; Means, J Jeffrey; Streyffeler, Lisa

    2014-10-01

    Medicine stands at a crossroad. Disruptive physician behavior has increased, and patient satisfaction has decreased. A growing body of knowledge demonstrates that the medical humanities assist in the creation of compassionate, resilient physicians. Incorporating medical humanities into the medical school curriculum promotes the development of compassionate, culturally sensitive physicians, and also encourages the development of resilience in health care professionals at a time when internal and external pressures on physicians are increasing. © 2014 The American Osteopathic Association.

  6. A Study to Develop the Optimal Military Inter-Institutional Patient Referral Systems Model for DoD (Department of Defense) Military Medical Region III

    Science.gov (United States)

    1988-05-01

    I rerr syttemn an do wlon t P ontimal military inter-instittiuonal patient referral systems model for DOD Military Medical Region III. A convenience...Dactin- on the Armed Services Medical Regulating Office and Patient Airlift "lc rcsusl.s of :his study indicated that the single largest breakdown...and the requirement to regulate to the closest medical facility with capability to care for the patient . L! / I Ii I i A STUDY TO DEVELOP THE OPTIMAL

  7. Human and Animal Isolates of Yersinia enterocolitica Show Significant Serotype-Specific Colonization and Host-Specific Immune Defense Properties

    Science.gov (United States)

    Schaake, Julia; Kronshage, Malte; Uliczka, Frank; Rohde, Manfred; Knuuti, Tobias; Strauch, Eckhard; Fruth, Angelika; Wos-Oxley, Melissa

    2013-01-01

    Yersinia enterocolitica is a human pathogen that is ubiquitous in livestock, especially pigs. The bacteria are able to colonize the intestinal tract of a variety of mammalian hosts, but the severity of induced gut-associated diseases (yersiniosis) differs significantly between hosts. To gain more information about the individual virulence determinants that contribute to colonization and induction of immune responses in different hosts, we analyzed and compared the interactions of different human- and animal-derived isolates of serotypes O:3, O:5,27, O:8, and O:9 with murine, porcine, and human intestinal cells and macrophages. The examined strains exhibited significant serotype-specific cell binding and entry characteristics, but adhesion and uptake into different host cells were not host specific and were independent of the source of the isolate. In contrast, survival and replication within macrophages and the induced proinflammatory response differed between murine, porcine, and human macrophages, suggesting a host-specific immune response. In fact, similar levels of the proinflammatory cytokine macrophage inflammatory protein 2 (MIP-2) were secreted by murine bone marrow-derived macrophages with all tested isolates, but the equivalent interleukin-8 (IL-8) response of porcine bone marrow-derived macrophages was strongly serotype specific and considerably lower in O:3 than in O:8 strains. In addition, all tested Y. enterocolitica strains caused a considerably higher level of secretion of the anti-inflammatory cytokine IL-10 by porcine than by murine macrophages. This could contribute to limiting the severity of the infection (in particular of serotype O:3 strains) in pigs, which are the primary reservoir of Y. enterocolitica strains pathogenic to humans. PMID:23959720

  8. Study of an investigation on factors influencing human resources productivity in Shiraz University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Zahra Ghasemi

    2016-01-01

    Full Text Available Introduction: Human resources development is one of the most important components of any organization and detecting important factors influencing human resources management plays an essential role in the success of the firms. In this study, we investigated different factors influencing human resources productivity of Shiraz University of Medical Sciences staff. Method: The present research was a cross-sectional study. Sample size was calculated 208 individuals. To access information about the human resource productivity, a valid and reliable questionnaire was used. The data were analyzed using SPSS software. Pearson correlation was used for statistical analysis of the data (p=0.05. Results:The results showed that there was a statistically significant relationship (p-value<0.001 between human resources productivity and factors affecting the productivity of human resources (motivational factors, leadership style, creativity and innovation, general and applied education, and competitive spirit. Motivational factors (r =0.89 and general education (r =0.65 had the most and the least effects on human resources productivity. Conclusion: Considering the fact that motivational factors were the most effective factors on human resource productivity, we recommend that managers should care more than before about this factor; also, in order to motivate the employees, they should consider the staff’s individual differences.

  9. Integration of human factors and ergonomics during medical device design and development: it's all about communication.

    Science.gov (United States)

    Vincent, Christopher James; Li, Yunqiu; Blandford, Ann

    2014-05-01

    Manufacturers of interactive medical devices, such as infusion pumps, need to ensure that devices minimise the risk of unintended harm during use. However, development teams face challenges in incorporating Human Factors. The aim of the research reported here was to better understand the constraints under which medical device design and development take place. We report the results of a qualitative study based on 19 semi-structured interviews with professionals involved in the design, development and deployment of interactive medical devices. A thematic analysis was conducted. Multiple barriers to designing for safety and usability were identified. In particular, we identified barriers to communication both between the development organisation and the intended users and between different teams within the development organisation. We propose the use of mediating representations. Artefacts such as personas and scenarios, known to provide integration across multiple perspectives, are an essential component of designing for safety and usability. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  10. Body of evidence: integrating Eduard Pernkopf's Atlas into a librarian-led medical humanities seminar.

    Science.gov (United States)

    Mages, Keith C; Lohr, Linda A

    2017-04-01

    Anatomical subjects depicted in Eduard Pernkopf's richly illustrated Topographische Anatomie des Menschen may be victims of the Nazi regime. Special collections librarians in the history of medicine can use this primary resource to initiate dialogs about ethics with medical students. Reported here is the authors' use of Pernkopf's Atlas in an interactive medical humanities seminar designed for third-year medical students. Topical articles, illustrations, and interviews introduced students to Pernkopf, his Atlas , and the surrounding controversies. We aimed to illustrate how this controversial historical publication can successfully foster student discussion and ethical reflection. Pernkopf's Atlas and our mix of contextual resources facilitated thoughtful discussions about history and ethics amongst the group. Anonymous course evaluations showed student interest in the subject matter, relevance to their studies, and appreciation of our special collection's space and contents.

  11. Medical and psychological examination of women seeking asylum: documentation of human rights abuses.

    Science.gov (United States)

    Laws, A; Patsalides, B

    1997-01-01

    Human rights abuses of women are ubiquitous throughout the world. Those perpetrated by governments entitle women to seek political asylum, and many women refugees do so in the United States. The asylum process often requires medical or psychological evaluations to corroborate women's reports of torture or other abuses. This article provides an overview of how to conduct such examinations and how to document findings for the asylum process.

  12. A review of human factors principles for the design and implementation of medication safety alerts in clinical information systems

    OpenAIRE

    Phansalkar, Shobha; Edworthy, Judy; Hellier, Elizabeth; Seger, Diane L; Schedlbauer, Angela; Avery, Anthony J; Bates, David W

    2010-01-01

    The objective of this review is to describe the implementation of human factors principles for the design of alerts in clinical information systems. First, we conduct a review of alarm systems to identify human factors principles that are employed in the design and implementation of alerts. Second, we review the medical informatics literature to provide examples of the implementation of human factors principles in current clinical information systems using alerts to provide medication decisio...

  13. Exploring Barriers to Medication Safety in an Ethiopian Hospital Emergency Department: A Human Factors Engineering Approach

    Directory of Open Access Journals (Sweden)

    Ephrem Abebe

    2018-02-01

    Full Text Available Objective: To describe challenges associated with the medication use process and potential medication safety hazards in an Ethiopian hospital emergency department using a human factors approach. Methods: We conducted a qualitative study employing observations and semi-structured interviews guided by the Systems Engineering Initiative for Patient Safety model of work system as an analytical framework. The study was conducted in the emergency department of a teaching hospital in Ethiopia. Study participants included resident doctors, nurses, and pharmacists. We performed content analysis of the qualitative data using accepted procedures. Results: Organizational barriers included communication failures, limited supervision and support for junior staff contributing to role ambiguity and conflict. Compliance with documentation policy was minimal. Task related barriers included frequent interruptions and work-related stress resulting from job requirements to continuously prioritize the needs of large numbers of patients and family members. Person related barriers included limited training and work experience. Work-related fatigue due to long working hours interfered with staff’s ability to document and review medication orders. Equipment breakdowns were common as were non-calibrated or poorly maintained medical devices contributing to erroneous readings. Key environment related barriers included overcrowding and frequent interruption of staff’s work. Cluttering of the work space compounded the problem by impeding efforts to locate medications, medical supplies or medical charts. Conclusions: Applying a systems based approach allows a context specific understanding of medication safety hazards in EDs from low-income countries. When developing interventions to improve medication and overall patient safety, health leaders should consider the interactions of the different factors. Conflict of Interest We declare no conflicts of interest or

  14. Designing medical technology for resilience: integrating health economics and human factors approaches.

    Science.gov (United States)

    Borsci, Simone; Uchegbu, Ijeoma; Buckle, Peter; Ni, Zhifang; Walne, Simon; Hanna, George B

    2018-01-01

    The slow adoption of innovation into healthcare calls into question the manner of evidence generation for medical technology. This paper identifies potential reasons for this including a lack of attention to human factors, poor evaluation of economic benefits, lack of understanding of the existing healthcare system and a failure to recognise the need to generate resilient products. Areas covered: Recognising a cross-disciplinary need to enhance evidence generation early in a technology's life cycle, the present paper proposes a new approach that integrates human factors and health economic evaluation as part of a wider systems approach to the design of technology. This approach (Human and Economic Resilience Design for Medical Technology or HERD MedTech) supports early stages of product development and is based on the recent experiences of the National Institute for Health Research London Diagnostic Evidence Co-operative in the UK. Expert commentary: HERD MedTech i) proposes a shift from design for usability to design for resilience, ii) aspires to reduce the need for service adaptation to technological constraints iii) ensures value of innovation at the time of product development, and iv) aims to stimulate discussion around the integration of pre- and post-market methods of assessment of medical technology.

  15. Medical implications of obesity in horses--lessons for human obesity.

    Science.gov (United States)

    Johnson, Philip J; Wiedmeyer, Charles E; Messer, Nat T; Ganjam, Venkataseshu K

    2009-01-01

    There is growing recognition that obesity is common and represents a significant detriment to the health of companion animals in a manner similar to that by which it is affecting the human population. As is the case for other species, obesity appears to promote insulin resistance in horses and it is through this pathophysiological process that many of the adverse medical consequences of obesity are being characterized. Equine medical conditions that have been described in the context of obesity and insulin resistance differ from those in humans. Chronic human conditions that have been attributed to obesity and insulin resistance, such as atherosclerosis and diabetes mellitus, are rarely described in obese horses. Significant current interest is centered on the recognition that insulin resistance plays a role in the pathogenesis of laminitis, a potentially severe and debilitating cause of lameness in the equine species. Other equine medical conditions that are more likely in obese, insulin-resistant individuals include hyperlipemia (hepatic lipidosis) and developmental orthopedic disease (osteochondrosis). Pituitary pars intermedia dysfunction (equine Cushing's syndrome) represents another common endocrinopathic condition of older horses associated with insulin resistance. This review presents an introductory overview of the present understanding of obesity and insulin resistance and how these conditions may be associated with disease conditions in horses. © Diabetes Technology Society

  16. Medical Implications of Obesity in Horses—Lessons for Human Obesity

    Science.gov (United States)

    Johnson, Philip J.; Wiedmeyer, Charles E.; Messer, Nat T.; Ganjam, Venkataseshu K.

    2009-01-01

    There is growing recognition that obesity is common and represents a significant detriment to the health of companion animals in a manner similar to that by which it is affecting the human population. As is the case for other species, obesity appears to promote insulin resistance in horses and it is through this pathophysiological process that many of the adverse medical consequences of obesity are being characterized. Equine medical conditions that have been described in the context of obesity and insulin resistance differ from those in humans. Chronic human conditions that have been attributed to obesity and insulin resistance, such as atherosclerosis and diabetes mellitus, are rarely described in obese horses. Significant current interest is centered on the recognition that insulin resistance plays a role in the pathogenesis of laminitis, a potentially severe and debilitating cause of lameness in the equine species. Other equine medical conditions that are more likely in obese, insulin-resistant individuals include hyperlipemia (hepatic lipidosis) and developmental orthopedic disease (osteochondrosis). Pituitary pars intermedia dysfunction (equine Cushing's syndrome) represents another common endocrinopathic condition of older horses associated with insulin resistance. This review presents an introductory overview of the present understanding of obesity and insulin resistance and how these conditions may be associated with disease conditions in horses. PMID:20046661

  17. 75 FR 43944 - Membership of the Defense Logistics Agency (DLA) Senior Executive Service (SES) Performance...

    Science.gov (United States)

    2010-07-27

    ... CONTACT: Ms. Lisa Novajosky, SES Program Manager, DLA Human Resources (J-14), Defense Logistics Agency... DEPARTMENT OF DEFENSE Defense Logistics Agency Membership of the Defense Logistics Agency (DLA... management of the SES cadre. DATES: Effective Date: September 16, 2010. ADDRESSES: Defense Logistics Agency...

  18. An approach to human-centered design of nuclear medical equipment: the system of caption of the thyroid

    International Nuclear Information System (INIS)

    Santos, Isaac J.A. Luquetti; Silva, Carlos Borges da; Santana, Marcos; Carvalho, Paulo Victor R.; Oliveira, Mauro Vitor de; Mol, Antonio Carlos Mol; Grecco, Claudio Henrique; Augusto, Silas Cordeiro

    2005-01-01

    Technology plays an important role in modern medical centers, making health care increasingly complex, relying on complex technical equipment. This technical complexity is particularly noticeable in the nuclear medicine and can increase the risks for human error. Human error has many causes such as performance shaping factors, organizational factors and user interface design. Poorly design human system interfaces of nuclear medical equipment can increase the risks for human error. If all nuclear medical equipment had been designed with good user interfaces, incidents and accidents could be reduced as well as he time required to learn how to use the equipment. Although some manufacturers of nuclear medical equipment have already integrate human factors principles in their products, there is still a need to steer the development of nuclear medical technology toward more human-centered approach. The aim of this paper is to propose a methodology that contributes to the design, development and evaluation of nuclear medical equipment and human system interface, towards a human-centered approach. This methodology includes the ergonomic approach, based on the operator activity analysis, together with human factors standards and guidelines, questionnaires and user based testing. We describe a case study in which this methodology is being applied in evaluation of the thyroid uptake system, getting essential information and data, that ill be used in development of a new system. (author)

  19. Medical humanitarianism, human rights and political advocacy: the case of the Israeli Open Clinic.

    Science.gov (United States)

    Gottlieb, Nora; Filc, Dani; Davidovitch, Nadav

    2012-03-01

    In the context of neo-liberal retrenchments humanitarian NGOs have become alternative healthcare providers that partially fill the vacuum left by the welfare state's withdrawal from the provision of services to migrants and other marginalized populations. In many cases they thus help to build legitimacy for the state's retreat from social responsibilities. Human rights organizations play an important role in advocating for migrants' rights, but in many cases they represent a legalistic and individualized conceptualization of the right to health that limits their claims for social justice. This paper analyzes the interactions and tensions between the discourses of medical humanitarianism, human rights and political advocacy using the example of an "Open Clinic" run by an Israeli human rights organization as a case-study: In 2007 dramatically increasing patient numbers provoked an intense internal debate concerning the proposal to temporarily close the "Open Clinic" in order to press the government to take action. Based on protocols from internal meetings and parliamentary hearings and in-depth interviews, we have analyzed divergent contextualizations of the Clinic's closure. These reflect conflicting notions regarding the Clinic's variegated spectrum of roles--humanitarian, political, legitimizing, symbolic, empowering and organizational--and underlying conceptualizations of migrants' "deservingness". Our case-study thus helps to illuminate NGOs' role in the realm of migrant healthcare and points out options for a possible fruitful relationship between the divergent paradigms of medical humanitarianism, human rights and political advocacy. Copyright © 2011. Published by Elsevier Ltd.

  20. Developing and Evaluating Medical Humanities Problem-Based Learning Classes Facilitated by the Teaching Assistants Majored in the Liberal Arts

    Science.gov (United States)

    Tseng, Fen-Yu; Shieh, Jeng-Yi; Kao, Tze-Wah; Wu, Chau-Chung; Chu, Tzong-Shinn; Chen, Yen-Yuan

    2016-01-01

    Abstract Although medical humanities courses taught by teachers from nonmedical backgrounds are not unusual now, few studies have compared the outcome of medical humanities courses facilitated by physicians to that by teaching assistants majored in the liberal arts. The objectives of this study were to (1) analyze the satisfaction of medical students with medical humanities problem-based learning (PBL) classes facilitated by nonmedical teaching assistants (TAF) majored in the liberal arts, and those facilitated by the attending physicians (APF) and (2) examine the satisfaction of medical students with clinical medicine-related and clinical medicine-unrelated medical humanities PBL classes. A total of 123 medical students, randomly assigned to 16 groups, participated in this study. There were 16 classes in the course: 8 of them were TAF classes; and the others were APF classes. Each week, each group rotated from 1 subject of the 16 subjects of PBL to another subject. All of the 16 groups went through all the 16 subjects in the 2013 spring semester. We examined the medical students’ satisfaction with each class, based on a rating score collected after each class was completed, using a scale from 0 (the lowest satisfaction) to 100 (the highest satisfaction). We also conducted multivariate linear regression analysis to examine the association between the independent variables and the students’ satisfaction. Medical students were more satisfied with the TAF (91.35 ± 7.75) medical humanities PBL classes than APF (90.40 ± 8.42) medical humanities PBL classes (P = 0.01). Moreover, medical students were more satisfied with the clinical medicine-unrelated topics (92.00 ± 7.10) than the clinical medicine-related topics (90.36 ± 7.99) in the medical humanities PBL course (P = 0.01). This medical humanities PBL course, including nonmedical subjects and topics, and nonmedical teaching assistants from the liberal arts as class facilitators, was

  1. Epidemiological studies on radiation carcinogenesis in human populations following acute exposure: nuclear explosions and medical radiation

    International Nuclear Information System (INIS)

    Fabrikant, J.I.

    1981-01-01

    The present review provides an understanding of our current knowledge of the carcinogenic effect of low-dose radiation in man, and surveys the epidemiological studies of human populations exposed to nuclear explosions and medical radiation. Discussion centers on the contributions of quantitative epidemiology to present knowledge, the reliability of the dose-incidence data, and those relevant epidemiological studies that provide the most useful information for risk estimation of cancer induction in man. Reference is made to dose-incidence relationships from laboratory animal experiments where they may obtain, for problems and difficulties in extrapolation from data obtained at high doses to low doses, and from animal data to the human situation. The paper describes the methods of application of such epidemiological data for estimation of excess risk of radiation-induced cancer in exposed human populations and discusses the strengths and limitations of epidemiology in guiding radiation protection philosophy and public health policy

  2. Home - Defense Technology Security Administration

    Science.gov (United States)

    by @dtsamil Defense Technology Security Administration Mission, Culture, and History Executive Official seal of Defense Technology Security Administration Official seal of Defense Technology Security Administration OFFICE of the SECRETARY of DEFENSE Defense Technology Security Administration

  3. Defense Health Program Financial Reporting of General Property, Plant, and Equipment

    National Research Council Canada - National Science Library

    Lane, F

    2000-01-01

    .... The Defense Health Program funds the operations of the Military Departments' medical treatment facilities, the development of DoD medical systems software, and congressionally directed research...

  4. Study of the Levels of Human-Human and Human-Animal Empathy in Veterinary Medical Students from Chile.

    Science.gov (United States)

    Calderón-Amor, Javiera; Luna-Fernández, Daniela; Tadich, Tamara

    Social relationships are based on our ability to put ourselves in the place of others, and from there to react appropriately and logically. This empathic ability can be extended to other species, based on the human ability to develop techniques to understand and communicate with animals. In education, the benefits of training professionals with ethical and empathic tools are known. Gender, diet, past experiences, and other factors can modify a person's levels of empathy toward humans and animals, and a relationship exists between both types of empathy. The aims of this study were to investigate some determinants of the level of empathy and to gain insight into the possible correlation between human-animal and human-human empathy. For this, the Animal Empathy Scale and the Interpersonal Reactivity Index by Davis were applied through an electronic survey system to freshmen and final-year students (n=452) from five schools of veterinary medicine in Chile. The correlation between the empathy scores of both instruments and their association with individual factors were studied using Spearman's correlation, the Wilcoxon signed-rank test, and the Kruskal-Wallis test. The results suggest that both instruments correlate significantly, and that gender, year of study, diet, and area of interest have a significant association with the score for empathy toward animals. This research shows that individual characteristics and changes that occur during veterinary training can affect students' attitudes toward animals.

  5. Ballistic missile defense effectiveness

    Science.gov (United States)

    Lewis, George N.

    2017-11-01

    The potential effectiveness of ballistic missile defenses today remains a subject of debate. After a brief discussion of terminal and boost phase defenses, this chapter will focus on long-range midcourse defenses. The problems posed by potential countermeasures to such midcourse defenses are discussed as are the sensor capabilities a defense might have available to attempt to discriminate the actual missile warhead in a countermeasures environment. The role of flight testing in assessing ballistic missile defense effectiveness is discussed. Arguments made about effectiveness by missile defense supporters and critics are summarized.

  6. Investigating Therapeutic Potential of Trigonella foenum-graecum L. as Our Defense Mechanism against Several Human Diseases

    Directory of Open Access Journals (Sweden)

    Shivangi Goyal

    2016-01-01

    Full Text Available Current lifestyle, stress, and pollution have dramatically enhanced the progression of several diseases in human. Globally, scientists are looking for therapeutic agents that can either cure or delay the onset of diseases. Medicinal plants from time immemorial have been used frequently in therapeutics. Of many such plants, fenugreek is one of the oldest herbs which have been identified as an important medicinal plant by the researchers around the world. It is potentially beneficial in a number of diseases such as diabetes, hypercholesterolemia, and inflammation and probably in several kinds of cancers. It has industrial applications such as synthesis of steroidal hormones. Its medicinal properties and their role in clinical domain can be attributed to its chemical constituents. The 3 major chemical constituents which have been identified as responsible for principle health effects are galactomannan, 4-OH isoleucine, and steroidal saponin. Numerous experiments have been carried out in vivo and in vitro for beneficial effects of both the crude chemical and of its active constituent. Due to its role in health care, the functional food industry has referred to it as a potential nutraceutical. This paper is about various medicinal benefits of fenugreek and its potential application as therapeutic agent against several diseases.

  7. Ribonuclease 7, an antimicrobial peptide up-regulated during infection, contributes to microbial defense of the human urinary tract

    Science.gov (United States)

    Spencer, John David; Schwaderer, Andrew L.; Wang, Huanyu; Bartz, Julianne; Kline, Jennifer; Eichler, Tad; DeSouza, Kristin R.; Sims-Lucas, Sunder; Baker, Peter; Hains, David S.

    2012-01-01

    The mechanisms that maintain sterility in the urinary tract are incompletely understood; however, recent studies stress the importance of antimicrobial peptides in protecting the urinary tract from infection. Ribonuclease 7 (RNase 7), a potent antimicrobial peptide contributing to urinary tract sterility, is expressed by intercalated cells in the renal collecting tubules and is present in the urine at levels sufficient to kill bacteria at baseline. Here, we characterize the expression and function of RNase 7 in the human urinary tract during infection. Both quantitative real-time PCR and ELISA assays demonstrated increases in RNASE7 expression in the kidney along with kidney and urinary RNase 7 peptide concentrations with infection. While immunostaining localized RNase 7 production to the intercalated cells of the collecting tubule during sterility, its expression during pyelonephritis was found to increase throughout the nephron but not in glomeruli or the interstitium. Recombinant RNase 7 exhibited antimicrobial activity against uropathogens at low micromolar concentrations by disrupting the microbial membrane as determined by atomic force microscopy. Thus, RNase 7 expression is increased in the urinary tract with infection, and has antibacterial activity against uropathogens at micromolar concentrations. PMID:23302724

  8. Optimizing Active Cyber Defense

    OpenAIRE

    Lu, Wenlian; Xu, Shouhuai; Yi, Xinlei

    2016-01-01

    Active cyber defense is one important defensive method for combating cyber attacks. Unlike traditional defensive methods such as firewall-based filtering and anti-malware tools, active cyber defense is based on spreading "white" or "benign" worms to combat against the attackers' malwares (i.e., malicious worms) that also spread over the network. In this paper, we initiate the study of {\\em optimal} active cyber defense in the setting of strategic attackers and/or strategic defenders. Specific...

  9. Effect of Probiotic Bacteria on Microbial Host Defense, Growth, and Immune Function in Human Immunodeficiency Virus Type-1 Infection

    Directory of Open Access Journals (Sweden)

    Stig Bengmark

    2011-12-01

    Full Text Available The hypothesis that probiotic administration protects the gut surface and could delay progression of Human Immunodeficiency Virus type1 (HIV-1 infection to the Acquired Immunodeficiency Syndrome (AIDS was proposed in 1995. Over the last five years, new studies have clarified the significance of HIV-1 infection of the gut associated lymphoid tissue (GALT for subsequent alterations in the microflora and breakdown of the gut mucosal barrier leading to pathogenesis and development of AIDS. Current studies show that loss of gut CD4+ Th17 cells, which differentiate in response to normal microflora, occurs early in HIV-1 disease. Microbial translocation and suppression of the T regulatory (Treg cell response is associated with chronic immune activation and inflammation. Combinations of probiotic bacteria which upregulate Treg activation have shown promise in suppressing pro inflammatory immune response in models of autoimmunity including inflammatory bowel disease and provide a rationale for use of probiotics in HIV-1/AIDS. Disturbance of the microbiota early in HIV-1 infection leads to greater dominance of potential pathogens, reducing levels of bifidobacteria and lactobacillus species and increasing mucosal inflammation. The interaction of chronic or recurrent infections, and immune activation contributes to nutritional deficiencies that have lasting consequences especially in the HIV-1 infected child. While effective anti-retroviral therapy (ART has enhanced survival, wasting is still an independent predictor of survival and a major presenting symptom. Congenital exposure to HIV-1 is a risk factor for growth delay in both infected and non-infected infants. Nutritional intervention after 6 months of age appears to be largely ineffective. A meta analysis of randomized, controlled clinical trials of infant formulae supplemented with Bifidobacterium lactis showed that weight gain was significantly greater in infants who received B. lactis compared to

  10. Assessing Changes in Medical Student Attitudes toward Non-Traditional Human Sexual Behaviors Using a Confidential Audience Response System

    Science.gov (United States)

    Tucker, Phebe; Candler, Chris; Hamm, Robert M.; Smith, E. Michael; Hudson, Joseph C.

    2010-01-01

    Medical students encountering patients with unfamiliar, unconventional sexual practices may have attitudes that can affect open communication during sexual history-taking. We measured changes in first-year US medical student attitudes toward 22 non-traditional sexual behaviors before and after exposure to human sexuality instruction. An…

  11. A review of human factors principles for the design and implementation of medication safety alerts in clinical information systems.

    Science.gov (United States)

    Phansalkar, Shobha; Edworthy, Judy; Hellier, Elizabeth; Seger, Diane L; Schedlbauer, Angela; Avery, Anthony J; Bates, David W

    2010-01-01

    The objective of this review is to describe the implementation of human factors principles for the design of alerts in clinical information systems. First, we conduct a review of alarm systems to identify human factors principles that are employed in the design and implementation of alerts. Second, we review the medical informatics literature to provide examples of the implementation of human factors principles in current clinical information systems using alerts to provide medication decision support. Last, we suggest actionable recommendations for delivering effective clinical decision support using alerts. A review of studies from the medical informatics literature suggests that many basic human factors principles are not followed, possibly contributing to the lack of acceptance of alerts in clinical information systems. We evaluate the limitations of current alerting philosophies and provide recommendations for improving acceptance of alerts by incorporating human factors principles in their design.

  12. Human-simulation-based learning to prevent medication error: A systematic review.

    Science.gov (United States)

    Sarfati, Laura; Ranchon, Florence; Vantard, Nicolas; Schwiertz, Vérane; Larbre, Virginie; Parat, Stéphanie; Faudel, Amélie; Rioufol, Catherine

    2018-01-31

    In the past 2 decades, there has been an increasing interest in simulation-based learning programs to prevent medication error (ME). To improve knowledge, skills, and attitudes in prescribers, nurses, and pharmaceutical staff, these methods enable training without directly involving patients. However, best practices for simulation for healthcare providers are as yet undefined. By analysing the current state of experience in the field, the present review aims to assess whether human simulation in healthcare helps to reduce ME. A systematic review was conducted on Medline from 2000 to June 2015, associating the terms "Patient Simulation," "Medication Errors," and "Simulation Healthcare." Reports of technology-based simulation were excluded, to focus exclusively on human simulation in nontechnical skills learning. Twenty-one studies assessing simulation-based learning programs were selected, focusing on pharmacy, medicine or nursing students, or concerning programs aimed at reducing administration or preparation errors, managing crises, or learning communication skills for healthcare professionals. The studies varied in design, methodology, and assessment criteria. Few demonstrated that simulation was more effective than didactic learning in reducing ME. This review highlights a lack of long-term assessment and real-life extrapolation, with limited scenarios and participant samples. These various experiences, however, help in identifying the key elements required for an effective human simulation-based learning program for ME prevention: ie, scenario design, debriefing, and perception assessment. The performance of these programs depends on their ability to reflect reality and on professional guidance. Properly regulated simulation is a good way to train staff in events that happen only exceptionally, as well as in standard daily activities. By integrating human factors, simulation seems to be effective in preventing iatrogenic risk related to ME, if the program is

  13. An Independent Human Factors Analysis and Evaluation of the Emergency Medical Protocol Checklist for the International Space Station

    Science.gov (United States)

    Marshburn, Thomas; Whitmore, Mihriban; Ortiz, Rosie; Segal, Michele; Smart, Kieran; Hughes, Catherine

    2003-01-01

    Emergency medical capabilities aboard the ISS include a Crew Medical Officer (CMO) (not necessarily a physician), and back-up, resuscitation equipment, and a medical checklist. It is essential that CMOs have reliable, usable and informative medical protocols that can be carried out independently in flight. The study evaluates the existing ISS Medical Checklist layout against a checklist updated to reflect a human factors approach to structure and organization. Method: The ISS Medical checklist was divided into non-emergency and emergency sections, and re-organized based on alphabetical and a body systems approach. A desk-top evaluation examined the ability of subjects to navigate to specific medical problems identified as representative of likely non-emergency events. A second evaluation aims to focus on the emergency section of the Medical Checklist, based on the preliminary findings of the first. The final evaluation will use Astronaut CMOs as subjects comparing the original checklist against the updated layout in the task of caring for a "downed crewmember" using a Human Patient Simulator [Medical Education Technologies, Inc.]. Results: Initial results have demonstrated a clear improvement of the re-organized sections to determine the solution to the medical problems. There was no distinct advantage for either alternative, although subjects stated having a preference for the body systems approach. In the second evaluation, subjects will be asked to identify emergency medical conditions, with measures including correct diagnosis, time to completion and solution strategy. The third evaluation will compare the original and fully updated checklists in clinical situations. Conclusions: Initial findings indicate that the ISS Medical Checklist will benefit from a reorganization. The present structure of the checklist has evolved over recent years without systematic testing of crewmember ability to diagnose medical problems. The improvements are expected to enable ISS

  14. Human-machine interface for a VR-based medical imaging environment

    Science.gov (United States)

    Krapichler, Christian; Haubner, Michael; Loesch, Andreas; Lang, Manfred K.; Englmeier, Karl-Hans

    1997-05-01

    Modern 3D scanning techniques like magnetic resonance imaging (MRI) or computed tomography (CT) produce high- quality images of the human anatomy. Virtual environments open new ways to display and to analyze those tomograms. Compared with today's inspection of 2D image sequences, physicians are empowered to recognize spatial coherencies and examine pathological regions more facile, diagnosis and therapy planning can be accelerated. For that purpose a powerful human-machine interface is required, which offers a variety of tools and features to enable both exploration and manipulation of the 3D data. Man-machine communication has to be intuitive and efficacious to avoid long accustoming times and to enhance familiarity with and acceptance of the interface. Hence, interaction capabilities in virtual worlds should be comparable to those in the real work to allow utilization of our natural experiences. In this paper the integration of hand gestures and visual focus, two important aspects in modern human-computer interaction, into a medical imaging environment is shown. With the presented human- machine interface, including virtual reality displaying and interaction techniques, radiologists can be supported in their work. Further, virtual environments can even alleviate communication between specialists from different fields or in educational and training applications.

  15. Understanding the impacts of medical tourism on health human resources in Barbados: a prospective, qualitative study of stakeholder perceptions

    Science.gov (United States)

    2013-01-01

    Background Medical tourism is a global health practice where patients travel internationally with the intention of receiving medical services. A range of low, middle, and high income countries are encouraging investment in the medical tourism sector, including countries in the Caribbean targeting patients in North America and Europe. While medical tourism has the potential to provide economic and employment opportunities in destination countries, there are concerns that it could encourage the movement of health workers from the public to private health sector. Methods We present findings from 19 semi-structured interviews with stakeholders across the public health care, private health care, government, allied business, and civil society sectors. These interviews were conducted in-person in Barbados and via phone. The interview transcripts were coded and a thematic analysis developed. Results Three themes were identified: 1) Stakeholder perceptions of the patterns and plans for health human resource usage by current and planned medical tourism facilities in Barbados. We found that while health human resource usage in the medical tourism sector has been limited, it is likely to grow in the future; 2) Anticipated positive impacts of medical tourism on health human resources and access to care in the public system. These benefits included improved quality control, training opportunities, and health worker retention; and 3) Anticipated negative impacts of medical tourism on health human resources and access to care in the public system. These impacts included longer wait times for care and a shift in planning priorities driven by the medical tourism sector. Conclusions Stakeholders interviewed who were connected to medical tourism expansion or the tourism sector took a generally positive view of the likely impacts of medical tourism on health human resources in Barbados. However, stakeholders associated with the public health system and health equity expressed concern

  16. Understanding the impacts of medical tourism on health human resources in Barbados: a prospective, qualitative study of stakeholder perceptions.

    Science.gov (United States)

    Snyder, Jeremy; Crooks, Valorie A; Turner, Leigh; Johnston, Rory

    2013-01-05

    Medical tourism is a global health practice where patients travel internationally with the intention of receiving medical services. A range of low, middle, and high income countries are encouraging investment in the medical tourism sector, including countries in the Caribbean targeting patients in North America and Europe. While medical tourism has the potential to provide economic and employment opportunities in destination countries, there are concerns that it could encourage the movement of health workers from the public to private health sector. We present findings from 19 semi-structured interviews with stakeholders across the public health care, private health care, government, allied business, and civil society sectors. These interviews were conducted in-person in Barbados and via phone. The interview transcripts were coded and a thematic analysis developed. Three themes were identified: 1) Stakeholder perceptions of the patterns and plans for health human resource usage by current and planned medical tourism facilities in Barbados. We found that while health human resource usage in the medical tourism sector has been limited, it is likely to grow in the future; 2) Anticipated positive impacts of medical tourism on health human resources and access to care in the public system. These benefits included improved quality control, training opportunities, and health worker retention; and 3) Anticipated negative impacts of medical tourism on health human resources and access to care in the public system. These impacts included longer wait times for care and a shift in planning priorities driven by the medical tourism sector. Stakeholders interviewed who were connected to medical tourism expansion or the tourism sector took a generally positive view of the likely impacts of medical tourism on health human resources in Barbados. However, stakeholders associated with the public health system and health equity expressed concern that medical tourism may spread

  17. The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Human Space Flight Missions

    Science.gov (United States)

    Kerstman, Eric L.; Minard, Charles; FreiredeCarvalho, Mary H.; Walton, Marlei E.; Myers, Jerry G., Jr.; Saile, Lynn G.; Lopez, Vilma; Butler, Douglas J.; Johnson-Throop, Kathy A.

    2011-01-01

    This slide presentation reviews the Integrated Medical Model (IMM) and its use as a risk assessment and decision support tool for human space flight missions. The IMM is an integrated, quantified, evidence-based decision support tool useful to NASA crew health and mission planners. It is intended to assist in optimizing crew health, safety and mission success within the constraints of the space flight environment for in-flight operations. It uses ISS data to assist in planning for the Exploration Program and it is not intended to assist in post flight research. The IMM was used to update Probability Risk Assessment (PRA) for the purpose of updating forecasts for the conditions requiring evacuation (EVAC) or Loss of Crew Life (LOC) for the ISS. The IMM validation approach includes comparison with actual events and involves both qualitative and quantitaive approaches. The results of these comparisons are reviewed. Another use of the IMM is to optimize the medical kits taking into consideration the specific mission and the crew profile. An example of the use of the IMM to optimize the medical kits is reviewed.

  18. Teaching medical students to discern ethical problems in human clinical research studies.

    Science.gov (United States)

    Roberts, Laura Weiss; Warner, Teddy D; Green Hammond, Katherine A; Brody, Janet L; Kaminsky, Alexis; Roberts, Brian B

    2005-10-01

    Investigators and institutional review boards are entrusted with ensuring the conduct of ethically sound human studies. Assessing ethical aspects of research protocols is a key skill in fulfilling this duty, yet no empirically validated method exists for preparing professionals to attain this skill. The authors performed a randomized controlled educational intervention, comparing a criteria-based learning method, a clinical-research- and experience-based learning method, and a control group. All 300 medical students enrolled at the University of New Mexico School of Medicine in 2001 were invited to participate. After a single half-hour educational session, a written posttest of ability to detect ethical problems in hypothetical protocol vignettes was administered. The authors analyzed responses to ten protocol vignettes that had been evaluated independently by experts. For each vignette, a global assessment of the perceived significance of ethical problems and the identification of specific ethical problems were evaluated. Eighty-three medical students (27%) volunteered: 50 (60%) were women and 55 (66%) were first- and second-year students. On global assessments, the criteria-focused group perceived ethical problems as more significant than did the other two groups (p evaluation skills. This work supports the potential value of empirically derived methods for preparing professionals to discern ethical aspects of human studies.

  19. The Shared Goals and Distinct Strengths of the Medical Humanities: Can the Sum of the Parts Be Greater Than the Whole?

    Science.gov (United States)

    Greene, Jeremy A; Jones, David S

    2017-12-01

    Since the 1960s, faculty from diverse fields have banded together under the banner of the medical humanities, a term which unites art, literature, history, anthropology, religious studies, philosophy, and other disciplines. Arguments for the relevance of medical humanities often emphasize contributions that any of these disciplines can make to medical education, whether those involve empathy, professionalism, critical reasoning, or tolerating ambiguity. The authors argue that the constituent disciplines of the medical humanities are not interchangeable parts, but represent different perspectives and methodologies that offer their own distinct contributions to medical training. Efforts to define a role for medical humanities in medical education should pursue two strategies in parallel. On the one hand, advocates of the medical humanities should continue to make the case for the shared contributions that all of the disciplines can make to medical education. But advocates for the medical humanities should also emphasize the valuable contributions of each specific discipline, in terms that medical educators can understand. The authors illustrate this point by delineating contributions of their own discipline, medical history. Historical analysis contributes essential insights to the understanding of disease, therapeutics, and institutions-things that all physicians must know in order to be effective as clinicians, just as they must learn anatomy or pathophysiology. Analogous but different arguments can be made for literature, philosophy, and the other disciplines that constitute the medical humanities. The field of medical humanities will be most successful if it builds on both the shared and the distinct contributions of its disciplines.

  20. Human rights from the Nuremberg Doctors Trial to the Geneva Declaration. Persons and institutions in medical ethics and history.

    Science.gov (United States)

    Frewer, Andreas

    2010-08-01

    The "Universal Declaration of Human Rights" and the "Geneva Declaration" by the World Medical Association, both in 1948, were preceded by the foundation of the United Nations in New York (1945), the World Medical Association in London (1946) and the World Health Organization in Geneva (1948). After the end of World War II the community of nations strove to achieve and sustain their primary goals of peace and security, as well as their basic premise, namely the health of human beings. All these associations were well aware of the crimes by medicine, in particular by the accused Nazi physicians at the Nuremberg Doctors Trial (1946/47, sentence: August 1947). During the first conference of the World Medical Association (September 1947) issues of medical ethics played a major role: and a new document was drafted concerning the values of the medical profession. After the catastrophe of the War and the criminal activities of scientists, the late 1940s saw increased scrutiny paid to fundamental questions of human rights and medical ethics, which are still highly relevant for today's medicine and morality. The article focuses on the development of medical ethics and human rights reflected in the statement of important persons, codes and institutions in the field.

  1. Assessment of the Department of Defense Prisoner of War/Missing in Action Accounting Community

    Science.gov (United States)

    2014-10-17

    the regulations prescribed by the Secretary of Defense, the Armed Forces Medical Examiner may conduct a forensic pathology investigation to determine...I – Notable Initiatives 8 │ DODIG-2015-001 that forensic testing of human remains buried as unknowns will produce probative information that will...practitioner of an appropriate forensic science; or (C) credible evidence exists to support another determination of the person’s status. However

  2. [Medical human resources planning in Europe: A literature review of the forecasting models].

    Science.gov (United States)

    Benahmed, N; Deliège, D; De Wever, A; Pirson, M

    2018-02-01

    Healthcare is a labor-intensive sector in which half of the expenses are dedicated to human resources. Therefore, policy makers, at national and internal levels, attend to the number of practicing professionals and the skill mix. This paper aims to analyze the European forecasting model for supply and demand of physicians. To describe the forecasting tools used for physician planning in Europe, a grey literature search was done in the OECD, WHO, and European Union libraries. Electronic databases such as Pubmed, Medine, Embase and Econlit were also searched. Quantitative methods for forecasting medical supply rely mainly on stock-and-flow simulations and less often on systemic dynamics. Parameters included in forecasting models exhibit wide variability for data availability and quality. The forecasting of physician needs is limited to healthcare consumption and rarely considers overall needs and service targets. Besides quantitative methods, horizon scanning enables an evaluation of the changes in supply and demand in an uncertain future based on qualitative techniques such as semi-structured interviews, Delphi Panels, or focus groups. Finally, supply and demand forecasting models should be regularly updated. Moreover, post-hoc analyze is also needed but too rarely implemented. Medical human resource planning in Europe is inconsistent. Political implementation of the results of forecasting projections is essential to insure efficient planning. However, crucial elements such as mobility data between Member States are poorly understood, impairing medical supply regulation policies. These policies are commonly limited to training regulations, while horizontal and vertical substitution is less frequently taken into consideration. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Anatomy and Humanity: Examining the Effects of a Short Documentary Film and First Anatomy Laboratory Experience on Medical Students

    Science.gov (United States)

    Dosani, Farah; Neuberger, Lindsay

    2016-01-01

    Medical students begin their education inside a laboratory dissecting cadavers to learn human gross anatomy. Many schools use the course experience as a way to instill empathy and some have begun integrating video and recorded interviews with body donors to humanize the experience, but their impact has yet to be measured. This study examines the…

  4. Human Papilloma Virus and HPV vaccine knowledge among Mustafa Kemal University Medical Students

    Directory of Open Access Journals (Sweden)

    Raziye Keskin Kurt

    2014-02-01

    Full Text Available Background: Human papilloma virus (HPV is regarded as the main cause in the etiology of cervical cancer. The purpose of our study is to assess the knowledge of medical students about HPV vaccine and to evaluate their opinion on this subject.   Material and Method: The study population consisted of 488 medical students. The survey was composed of questions intended   to obtain information about transmission route of HPV, types of HPV, role of HPV in cervical cancer, whether HPV is treatable or not, which types of HPV the HPV vaccine prevents, the age groups HPV vaccine is administered, the opinions on HPV vaccine and sufficiency of public health, whether female students have underwent vaccination and if not what their drawbacks are.   Results: Mean age of the students participating in the study was 21±4 and 58 % of the patients were female. Out of 448 medical students, 60% of them did not know that HPV was a sexually transmitted disease. Only 55% students knew about the association of HPV with cervical cancer and 52% participants stated that HPV vaccine could not be preventive against cervical cancer. None of female students had been immunized and 67% of female students did not consider getting immunized. Among those who did not consider getting immunized, 70% said they had worries about the safety of the vaccine. Conclusion: Our study results revealed that the knowledge of medical students about HPV is satisfactory, however their knowledge about HPV vaccine, immunization status and desire to be immunized were little.

  5. Strategic Defense Initiative Overview

    National Research Council Canada - National Science Library

    1990-01-01

    ... to Third World and other nations. I will then discuss the scope of the SDI effort, the evolving strategic defense system architectures and theater defense, our compliancy with the ABM Treaty, technology spinoffs resulting from SDI...

  6. Rethinking Defensive Information Warfare

    National Research Council Canada - National Science Library

    French, Geoffrey S

    2004-01-01

    .... This paper examines defensive tactics and strategies from the German defense in depth that emerged from World War I to the American Active Defense that developed in the Cold War and proposes a new mindset for DIW that draws on these operational concepts from military history.

  7. Recognizing Plant Defense Priming

    NARCIS (Netherlands)

    Martinez-Medina, Ainhoa; Flors, Victor; Heil, Martin; Mauch-Mani, Brigitte; Pieterse, Corné M J|info:eu-repo/dai/nl/113115113; Pozo, Maria J; Ton, Jurriaan; van Dam, Nicole M; Conrath, Uwe

    2016-01-01

    Defense priming conditions diverse plant species for the superinduction of defense, often resulting in enhanced pest and disease resistance and abiotic stress tolerance. Here, we propose a guideline that might assist the plant research community in a consistent assessment of defense priming in

  8. Recognizing Plant Defense Priming.

    Science.gov (United States)

    Martinez-Medina, Ainhoa; Flors, Victor; Heil, Martin; Mauch-Mani, Brigitte; Pieterse, Corné M J; Pozo, Maria J; Ton, Jurriaan; van Dam, Nicole M; Conrath, Uwe

    2016-10-01

    Defense priming conditions diverse plant species for the superinduction of defense, often resulting in enhanced pest and disease resistance and abiotic stress tolerance. Here, we propose a guideline that might assist the plant research community in a consistent assessment of defense priming in plants. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Recognizing plant defense priming

    NARCIS (Netherlands)

    Martinez-Medina, A.; Flors, V.; Heil, M.; Mauch-Mani, B.; Pieterse, C.M.J.; Pozo, M.J.; Ton, J.; Van Dam, N.M.; Conrath, U.

    2016-01-01

    Defense priming conditions diverse plant species for the superinduction of defense, often resulting in enhanced pest and disease resistance and abiotic stress tolerance. Here, we propose a guideline that might assist the plant research community in a consistent assessment of defense priming in

  10. Defensive medicine: No wonder policymakers are confused.

    Science.gov (United States)

    Kapp, Marshall B

    2016-01-01

    Discussions regarding defensive medical practice often result in proposals for public policy actions. Such proposals generally are premised on assumptions about defensive medicine, namely, that it (a) is driven by physicians' legal anxieties, (b) constitutes bad medical practice, (c) drives up health care costs, (d) varies depending on a jurisdiction's particular tort law climate, (e) depends on medical specialty and a physician's own prior experience as a malpractice defendant, and (f) is a rational response to actual legal risks confronting physicians. This article examines a sample of recent literature focusing on defensive medicine and finds that the messages conveyed vary widely, helping to explain the confusion experienced by many policymakers trying to improve the quality and affordability of health care.

  11. Initiating Hehe [see text] medical system of traditional Chinese medicine and biomedicine to realize health cycle of human beings.

    Science.gov (United States)

    Wang, Jie-Hua

    2011-12-01

    This paper suggests a novel approach concerning the medical treatment of human beings, which appears to be economically and practically superior to either biomedicine or traditional medicine. A brand new medical system-Hehe [see text] medicine, has been proposed based on a preventive-biomedical-psycho-social treatment model. This is characterized by a dual approach in which life nurturing is consistently practised and medical treatment is applied when necessary in order to maintain a healthy life. Its core value would facilitate the self-restoration to health and self-adaptation to nature through health cultivation and medical means. Medical services would be firstly provided to the prevention of potential disease germinating in the human body, and clinical medical treatment would be the last resort of systematic medical practice. This paper discusses not only this new concept but also the advantages of traditional Chinese medicine and biomedicine, especially how both medical systems compare in cognitive style, on a cultural level, and on a technical level.

  12. What is nature capable of? Evidence, ontology and speculative medical humanities.

    Science.gov (United States)

    Savransky, Martin; Rosengarten, Marsha

    2016-09-01

    Expanding on the recent call for a 'critical medical humanities' to intervene in questions of the ontology of health, this article develops a what we call a 'speculative' orientation to such interventions in relation to some of the ontological commitments on which contemporary biomedical cultures rest. We argue that crucial to this task is an approach to ontology that treats it not as a question of first principles, but as a matter of the consequences of the images of nature that contemporary biomedical research practices espouse when they make claims to evidence, as well as the possible consequences of imagining different worlds in which health and disease processes partake. By attending to the implicit ontological assumptions involved in the method par excellence of biomedical research, namely the randomised controlled trial (RCT), we argue that the mechanistic ontology that tacitly informs evidence-based biomedical research simultaneously authorises a series of problematic consequences for understanding and intervening practically in the concrete realities of health. As a response, we develop an alternative ontological proposition that regards processes of health and disease as always situated achievements. We show that, without disqualifying RCT-based evidence, such a situated ontology enables one to resist the reduction of the realities of health and disease to biomedicine's current forms of explanation. In so doing, we call for medical humanities scholars to actively engage in the speculative question of what nature may be capable of. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Dental and Medical Students' Use and Perceptions of Learning Resources in a Human Physiology Course.

    Science.gov (United States)

    Tain, Monica; Schwartzstein, Richard; Friedland, Bernard; Park, Sang E

    2017-09-01

    The aim of this study was to determine the use and perceived utility of various learning resources available during the first-year Integrated Human Physiology course at the dental and medical schools at Harvard University. Dental and medical students of the Class of 2018 were surveyed anonymously online in 2015 regarding their use of 29 learning resources in this combined course. The learning resources had been grouped into four categories to discern frequency of use and perceived usefulness among the categories. The survey was distributed to 169 students, and 73 responded for a response rate of 43.2%. There was no significant difference among the learning resource categories in frequency of use; however, there was a statistically significant difference among categories in students' perceptions of usefulness. No correlation was found between frequency of use and perceived usefulness of each category. Students seemingly were not choosing the most useful resources for them. These results suggest that, in the current educational environment, where new technologies and self-directed learning are highly sought after, there remains a need for instructor-guided learning.

  14. Human Research Program (HRP) Exploration Medical Capability (ExMC) Standing Review Panel (SRP)

    Science.gov (United States)

    Cintron, Nitza; Dutson, Eric; Friedl, Karl; Hyman, William; Jemison, Mae; Klonoff, David

    2009-01-01

    The SRP believes strongly that regularly performed in-flight crew assessments are needed in order to identify a change in health status before a medical condition becomes clinically apparent. It is this early recognition in change that constitutes the foundation of the "occupational health model" expounded in the HRP Requirements Document as a key component of the HRP risk mitigation strategy that will enable its objective of "prevention and mitigation of human health and performance risks". A regular crew status examination of physiological and clinical performance is needed. This can be accomplished through instrumented monitoring of routine embedded tasks. The SRP recommends addition of a new gap to address this action under Category 3.0 Mitigate the Risk. This new gap is closely associated with Task 4.19 which addresses the lack of adequate biomedical monitoring capabilities for performing periodic clinical status evaluations and contingency medical monitoring. A corollary to these gaps is the critical emphasis on preventive medicine, not only during pre- and post-flight phases of a mission as is the current practice, but continued into the in-flight phases of exploration class missions.

  15. The Joint Military Medical Executive Skills initiative: an impressive response to changing human resource management rules of engagement.

    Science.gov (United States)

    Kerr, Bernard J

    2007-01-01

    Confronted with a sudden and substantial change in the rules regarding who could command a military medical treatment facility (MTF), the Military Health System (MHS) responded to the challenge with an impressive human resource management solution-the Joint Medical Executive Skills Program. The history, emergence, and continuing role of this initiative exemplifies the MHS's capacity to fulfill the spirit and intent of an arduous Congressional mandate while enhancing professional development and sustaining the career opportunities of medical officers. The MHS response to the Congressional requirement that candidates for MTF command demonstrate professional administrative skills was decisive, creative, and consistent with the basic principles of human resource management. The Joint Medical Executive Skills Program is a management success story that demonstrates how strategic planning, well-defined skills requirements, and structured training can assure a ready supply of qualified commanders for the military's MTFs.

  16. Undergraduate Training in Human Sexuality?Evaluation of the Impact on Medical Doctors' Practice Ten Years After Graduation

    OpenAIRE

    Clegg, Mary; Pye, Joanne; Wylie, Kevan R.

    2016-01-01

    Introduction: It has been suggested that an indicator of a doctor's ability to assess patients' sexual function relates to the level of earlier training. The amount and quality of training the doctor receives at the undergraduate level and beyond could contribute to the doctor's confidence and competence. Aims: To evaluate whether doctors found that the teaching in human sexuality received at medical school was sufficient for their future practice and whether their chosen medical specialty...

  17. Human Trafficking Identification and Service Provision in the Medical and Social Service Sectors.

    Science.gov (United States)

    Schwarz, Corinne; Unruh, Erik; Cronin, Katie; Evans-Simpson, Sarah; Britton, Hannah; Ramaswamy, Megha

    2016-06-01

    The medical sector presents a unique opportunity for identification and service to victims of human trafficking. In this article, we describe local and site-specific efforts to develop an intervention tool to be used in an urban hospital's emergency department in the midwestern United States. In the development of our tool, we focused on both identification and intervention to assist trafficked persons, through a largely collaborative process in which we engaged local stakeholders for developing site-specific points of intervention. In the process of developing our intervention, we highlight the importance of using existing resources and services in a specific community to address critical gaps in coverage for trafficked persons. For example, we focus on those who are victims of labor trafficking, in addition to those who are victims of sex trafficking. We offer a framework informed by rights-based approaches to anti-trafficking efforts that addresses the practical challenges of human trafficking victim identification while simultaneously working to provide resources and disseminate services to those victims.

  18. HIV/AIDS in the visual arts: applying discipline-based art education (DBAE) to medical humanities.

    Science.gov (United States)

    Tapajos, Ricardo

    2003-06-01

    Health professions educators have been systematically attempting to insert the humanities into health professions curricula for over 4 decades, with various degrees of success. Among the several medical humanities, the visual arts seem particularly adequate for the teaching/learning of crucial aspects of medicine. Educational efforts in the arts require, however, a sound pedagogical philosophy of art education. Health professions educators need therefore to be aware of educational frameworks in the arts. Discipline-based art education (DBAE) is a recognised contemporary educational framework for the teaching/learning of the arts, which may be adapted to medical humanities. It is the ultimate objective of this essay to share the experience of applying this educational framework to a course in a medical curriculum. The author describes a course on the representations of HIV/AIDS in the visual arts, with explicit reference to its objectives, content, instructional features and student assessment in the light of DBAE, whose principles and characteristics are described in detail. Discipline-based art education may be applied to medical humanities courses in a medical curriculum. This essay throws light on how this structure may be particularly useful for designing other pedagogically sound art courses in health professions curricula.

  19. The relation between flexibility of human resources and performance indexes of selected hospitals of Tehran Medical Sciences University

    Directory of Open Access Journals (Sweden)

    Noushin Alibakhshi

    2016-12-01

    Full Text Available Today, flexibility has turned to one of important issues in management theories and policies and most current discussions about flexibility patterns focus on management policies, so that these patterns are one of important aspects of human resources strategic management. This study was performed with the aim of assessing the flexibility rate of human resources and performance indexes of Tehran Medical Sciences University hospitals and determining the possible relation between these variables. The present study is descriptive – analytical which was conducted in cross-sectional form in 2015. The statistical population was selected by stratifies random sampling method as 317 persons from nursing, administrative and financial personnel of 5 hospitals of Tehran Medical Sciences University. Data collecting toll was hospitals performance indexes form and Wright & Snell flexibility questionnaire of human resources. Data analysis was performed using SPSS 18 software and with the aid of descriptive statistical indexes and linear regression analysis. The results showed that personnel ( human resources had high flexibility = 4.16.\tthere was a significant relation between total flexibility and the index of bed circulation so that by one unit increase in bed circulation space, normally, the average of total flexibility decreased 0.64 units ( p-value<0.05. The results showed that human resources of Tehran Medical Sciences University hospitals have high flexibility, so authorities and policy makers are suggested to adopt policies of human resources management for creating flexibility in human resources and improving hospitals performance and amending hospitals status.

  20. Learning to walk before we run: what can medical education learn from the human body about integrated care?

    Directory of Open Access Journals (Sweden)

    Eron G. Manusov

    2013-05-01

    Full Text Available True integration requires a shift in all levels of medical and allied health education; one that emphasizes team learning, practicing, and evaluating from the beginning of each students' educational experience whether that is as physician, nurse, psychologist, or any other health profession.  Integration of healthcare services will not occur until medical education focuses, like the human body, on each system working inter-dependently and cohesively to maintain balance through continual change and adaptation.  The human body develops and maintains homeostasis by a process of communication: true integrated care relies on learned interprofessionality and ensures shared responsibility and practice.

  1. Learning to walk before we run: what can medical education learn from the human body about integrated care.

    Science.gov (United States)

    Manusov, Eron G; Marlowe, Daniel P; Teasley, Deborah J

    2013-04-01

    True integration requires a shift in all levels of medical and allied health education; one that emphasizes team learning, practicing, and evaluating from the beginning of each students' educational experience whether that is as physician, nurse, psychologist, or any other health profession. Integration of healthcare services will not occur until medical education focuses, like the human body, on each system working inter-dependently and cohesively to maintain balance through continual change and adaptation. The human body develops and maintains homeostasis by a process of communication: true integrated care relies on learned interprofessionality and ensures shared responsibility and practice.

  2. Humanities mini-course curricula for midcareer health professionals at the Penn State Milton S. Hershey Medical Center.

    Science.gov (United States)

    Myers, Kimberly R; George, Daniel R

    2012-08-01

    The field of medical humanities has traditionally focused on medical students and, more recently, on premedical undergraduates. Comparatively little formal humanities pedagogy has been dedicated to midcareer health professionals. To address this lack, the Department of Humanities at the Pennsylvania State University College of Medicine and the Milton S. Hershey Medical Center designed eight annual humanities mini-courses for faculty and staff throughout the college and medical center.These mini-courses fell into four categories: reading, reflection, and discussion; creative expression; technology; and ethics. They were geared toward midcareer health professionals who were seeking new intellectual and creative stimulation and variety in daily routine. They also provided humanities faculty the opportunity to devote attention to topics that capitalize on their professional training and that interest them personally.Participants indicated a high degree of satisfaction with the mini-courses for four principal reasons: (1) learning the tools and methodologies of a new discipline or domain other than biomedicine, (2) using their minds and training in uncustomary ways, (3) forming new alliances with colleagues (which served to lessen the sense of professional isolation), and (4) enjoying a respite from the stressful flow of the workday. Humanities faculty facilitators provided more mixed responses but agreed that conducting the mini-courses had been a positive overall experience.Although this article provides a foundational framework for the development of a humanities mini-course series, the authors encourage others to replicate these curricula in other medical settings as an important step toward a robust pedagogy designed for midcareer health care professionals.

  3. Testing knowledge of human gross anatomy in medical school: an applied contextual-learning theory method.

    Science.gov (United States)

    Clough, R W; Lehr, R P

    1996-01-01

    The traditional gross anatomy laboratory experience, with modifications in evaluations that we outline later, meets the criteria of contextual-learning theory, expands the repertoire of core objectives we identify for our students, and may increase the likelihood of cognitive permanence of anatomical data. Our subjects included approximately 54 first-year medical students from each of three sequential class years (1996, 1997, 1998). As an alternative to more typical written and practical exams, examinations in a major portion of our gross anatomy program consist of two approximately 30 minute oral expositions by each student to his or her peers and a faculty member. Students demonstrate specific detail on cadaver, x-ray, cross sections, or a model. Clinical applications, spatial relationships, nomenclature, and functions are strongly emphasized. The results of this teaching approach to the utilization of anatomical knowledge in clinical situations requires further assessment: however, new attributes have been afforded our students with implementation of the present program: First, students learn anatomical detail equally well as the students of the more traditional system (based on board exam results). Second, students who completed the program indicate that this approach provides a useful simulation of what is expected later in their training. Third, students gradually gain confidence in verbal presentation, they demonstrate cognitive synthesis of separate conceptual issues, they retain information, and they are quite visibly more enthusiastic about anatomy and its importance in medicine. Our program demonstrates that the learning of applicable human anatomy is facilitated in a contextual-learning environment. Moreover, by learning anatomy in this way, other equally beneficial attributes are afforded the medical student, including, but not limited to, increases in communication skills, confidence in verbal presentation, synthesis of anatomical concepts

  4. Genome sequencing of idiopathic pulmonary fibrosis in conjunction with a medical school human anatomy course.

    Science.gov (United States)

    Kumar, Akash; Dougherty, Max; Findlay, Gregory M; Geisheker, Madeleine; Klein, Jason; Lazar, John; Machkovech, Heather; Resnick, Jesse; Resnick, Rebecca; Salter, Alexander I; Talebi-Liasi, Faezeh; Arakawa, Christopher; Baudin, Jacob; Bogaard, Andrew; Salesky, Rebecca; Zhou, Qian; Smith, Kelly; Clark, John I; Shendure, Jay; Horwitz, Marshall S

    2014-01-01

    Even in cases where there is no obvious family history of disease, genome sequencing may contribute to clinical diagnosis and management. Clinical application of the genome has not yet become routine, however, in part because physicians are still learning how best to utilize such information. As an educational research exercise performed in conjunction with our medical school human anatomy course, we explored the potential utility of determining the whole genome sequence of a patient who had died following a clinical diagnosis of idiopathic pulmonary fibrosis (IPF). Medical students performed dissection and whole genome sequencing of the cadaver. Gross and microscopic findings were more consistent with the fibrosing variant of nonspecific interstitial pneumonia (NSIP), as opposed to IPF per se. Variants in genes causing Mendelian disorders predisposing to IPF were not detected. However, whole genome sequencing identified several common variants associated with IPF, including a single nucleotide polymorphism (SNP), rs35705950, located in the promoter region of the gene encoding mucin glycoprotein MUC5B. The MUC5B promoter polymorphism was recently found to markedly elevate risk for IPF, though a particular association with NSIP has not been previously reported, nor has its contribution to disease risk previously been evaluated in the genome-wide context of all genetic variants. We did not identify additional predicted functional variants in a region of linkage disequilibrium (LD) adjacent to MUC5B, nor did we discover other likely risk-contributing variants elsewhere in the genome. Whole genome sequencing thus corroborates the association of rs35705950 with MUC5B dysregulation and interstitial lung disease. This novel exercise additionally served a unique mission in bridging clinical and basic science education.

  5. Genome sequencing of idiopathic pulmonary fibrosis in conjunction with a medical school human anatomy course.

    Directory of Open Access Journals (Sweden)

    Akash Kumar

    Full Text Available Even in cases where there is no obvious family history of disease, genome sequencing may contribute to clinical diagnosis and management. Clinical application of the genome has not yet become routine, however, in part because physicians are still learning how best to utilize such information. As an educational research exercise performed in conjunction with our medical school human anatomy course, we explored the potential utility of determining the whole genome sequence of a patient who had died following a clinical diagnosis of idiopathic pulmonary fibrosis (IPF. Medical students performed dissection and whole genome sequencing of the cadaver. Gross and microscopic findings were more consistent with the fibrosing variant of nonspecific interstitial pneumonia (NSIP, as opposed to IPF per se. Variants in genes causing Mendelian disorders predisposing to IPF were not detected. However, whole genome sequencing identified several common variants associated with IPF, including a single nucleotide polymorphism (SNP, rs35705950, located in the promoter region of the gene encoding mucin glycoprotein MUC5B. The MUC5B promoter polymorphism was recently found to markedly elevate risk for IPF, though a particular association with NSIP has not been previously reported, nor has its contribution to disease risk previously been evaluated in the genome-wide context of all genetic variants. We did not identify additional predicted functional variants in a region of linkage disequilibrium (LD adjacent to MUC5B, nor did we discover other likely risk-contributing variants elsewhere in the genome. Whole genome sequencing thus corroborates the association of rs35705950 with MUC5B dysregulation and interstitial lung disease. This novel exercise additionally served a unique mission in bridging clinical and basic science education.

  6. [Investigation of human brucellosis diagnosis and report quality in medical institutions in key areas of Shanxi province].

    Science.gov (United States)

    Zeng, L J; Yang, W W; Tie, P; Liu, X R; Gao, X R; Li, Z Y; Hou, P; Zhi, Y; Bai, Y F; Geng, M J; Chen, Q L; Cui, B Y; Li, Z J; Wang, L P

    2017-11-10

    Objective: To evaluate the accuracy of human brucellosis diagnosis and reporting in medical institutions in Shanxi province, and understand the performance of clinical doctors to diagnose human brucellosis according to diagnostic criteria. Methods: Field investigation was conducted in 6 medical institutions in the key areas of human brucellosis in Shanxi province. The diagnosis data of the reported brucellosis cases in 2015 were collected and reviewed retrospectively for the evaluation of the diagnosis accuracy with systematic sampling method. The database was established with Excel 2010 and the descriptive analysis and statistical test were conducted with software R 3.3.2. Results: The diagnosis consistent rate of the 377 brucellosis cases reviewed was 70.8% (267/377), the diagnosis consistent rates in medical institutions at city-level and country-level were 77.0% (127/165) and 66.0% (140/212) respectively, the differences had significance ( χ (2)=5.4, P =0.02). Among the reviewed cases, the diagnosis consistent rate of laboratory diagnosis and clinical diagnosis were 87.1% (256/294) and 13.3% (11/83) respectively, and the differences had significance ( χ (2)=170.7, P brucellosis cases within 24 hours after diagnosis. Conclusion: The accuracy of human brucellosis diagnosis in key areas of human brucellosis in Shanxi was low, and the performance of the clinical doctors to diagnose human brucellosis according to diagnostic and case classification criteria was unsatisfied.

  7. Technologies for distributed defense

    Science.gov (United States)

    Seiders, Barbara; Rybka, Anthony

    2002-07-01

    For Americans, the nature of warfare changed on September 11, 2001. Our national security henceforth will require distributed defense. One extreme of distributed defense is represented by fully deployed military troops responding to a threat from a hostile nation state. At the other extreme is a country of 'citizen soldiers', with families and communities securing their common defense through heightened awareness, engagement as good neighbors, and local support of and cooperation with local law enforcement, emergency and health care providers. Technologies - for information exploitation, biological agent detection, health care surveillance, and security - will be critical to ensuring success in distributed defense.

  8. Dynamic defense workshop :

    Energy Technology Data Exchange (ETDEWEB)

    Crosby, Sean Michael; Doak, Justin E.; Haas, Jason Juedes.; Helinski, Ryan; Lamb, Christopher C.

    2013-02-01

    On September 5th and 6th, 2012, the Dynamic Defense Workshop: From Research to Practice brought together researchers from academia, industry, and Sandia with the goals of increasing collaboration between Sandia National Laboratories and external organizations, de ning and un- derstanding dynamic, or moving target, defense concepts and directions, and gaining a greater understanding of the state of the art for dynamic defense. Through the workshop, we broadened and re ned our de nition and understanding, identi ed new approaches to inherent challenges, and de ned principles of dynamic defense. Half of the workshop was devoted to presentations of current state-of-the-art work. Presentation topics included areas such as the failure of current defenses, threats, techniques, goals of dynamic defense, theory, foundations of dynamic defense, future directions and open research questions related to dynamic defense. The remainder of the workshop was discussion, which was broken down into sessions on de ning challenges, applications to host or mobile environments, applications to enterprise network environments, exploring research and operational taxonomies, and determining how to apply scienti c rigor to and investigating the eld of dynamic defense.

  9. Awareness and attitude towards human papillomavirus (HPV vaccine among medical students in a premier medical school in India.

    Directory of Open Access Journals (Sweden)

    Deeksha Pandey

    Full Text Available BACKGROUND: As preventing cancer with the help of a vaccine is a comparatively new concept, awareness and education about it will have important implication in the implementation of this strategy. MATERIALS AND METHODS: Present explorative questionnaire based survey included 618 MBBS students for final analysis. RESULTS: Majority of participants (89.6% were well aware of the preventable nature of cervical cancer. Most of them (89.2% knew that necessary factor responsible for cervical cancer is infection with high risk HPV. Awareness regarding the availability of vaccine against cervical cancer was 75.6%. Females had a better awareness regarding availability of vaccine, target population for vaccination and about the catch up program. Overall acceptance of HPV vaccine among the population studied was 67.8%. Medical teaching had a definitive impact on the understanding of this important public health issue. Females seemed to be more ready to accept the vaccine and recommend it to others. For our study population the most common source of information was medical school teaching. Majority of participants agreed that the most important obstacle in implementation of HPV vaccination program in our country is inadequate information and 86.2% wanted to be educated by experts in this regard. CONCLUSION: HPV vaccine for primary prevention of cervical cancer is a relatively new concept. Health professional will be able to play a pivotal role in popularizing this strategy.

  10. The Medical Humanities Effect: a Pilot Study of Pre-Health Professions Students at the University of Rochester.

    Science.gov (United States)

    Baker, Clayton J; Shaw, Margie Hodges; Mooney, Christopher J; Daiss, Susan Dodge-Peters; Clark, Stephanie Brown

    2017-12-01

    Qualitative and quantitative research on the impact of medical and health humanities teaching in baccalaureate education is sparse. This paper reviews recent studies of the impact of medical and health humanities coursework in pre-health professions education and describes a pilot study of baccalaureate students who completed semester-long medical humanities courses in the Division of Medical Humanities & Bioethics at the University of Rochester. The study format was an email survey. All participants were current or former baccalaureate students who had taken one or more courses in literature and narrative in medicine, bioethics, history of medicine, and/or visual arts and healthcare during the past four years. The survey gathered numerical data in several areas: demographic information, career plans, self-reported influence of coursework on educational and career plans, and self-reported influence of coursework on intellectual skills and abilities. It also gathered narrative commentary that elaborated on students' responses to the numerically-based questions. Notable findings from preliminary analysis of the data include higher scores of self-reported impact of the coursework on specific habits of mind and on preparedness for intended career rather than on gaining admission to future educational programs. Discussion of the results focuses on several potential future directions this type of study might take, including multi-center, longitudinal, and sequential approaches.

  11. The medicalization of love and narrow and broad conceptions of human well-being

    NARCIS (Netherlands)

    Nyholm, S.R.

    2015-01-01

    Would a "medicalization" of love be a "good" or "bad" form of medicalization? In discussing this question, Earp, Sandberg, and Savulescu primarily focus on the potential positive and negative consequences of turning love into a medical issue. But it can also be asked whether there is something

  12. The medicalization of society: on the transformation of human conditions into treatable disorders

    National Research Council Canada - National Science Library

    Conrad, Peter

    2007-01-01

    ... 197This page intentionally left blank PrefacePreface I have been interested in the medicalization of society for a long time. My Ph.D. dissertation was a participant observation study of the medicalization of hyperactivity in children (Conrad, 1976). This was followed by a more historical account of the medicalization of deviance, coau...

  13. Defense Mechanisms: A Bibliography.

    Science.gov (United States)

    Pedrini, D. T.; Pedrini, Bonnie C.

    This bibliography includes studies of defense mechanisms, in general, and studies of multiple mechanisms. Defense mechanisms, briefly and simply defined, are the unconscious ego defendants against unpleasure, threat, or anxiety. Sigmund Freud deserves the clinical credit for studying many mechanisms and introducing them in professional literature.…

  14. Defense Business Transformation

    Science.gov (United States)

    2009-12-01

    Defense Business Transformation by Jacques S. Gansler and William Lucyshyn The Center for Technology and National...REPORT TYPE 3. DATES COVERED 00-00-2009 to 00-00-2009 4. TITLE AND SUBTITLE Defense Business Transformation 5a. CONTRACT NUMBER 5b. GRANT NUMBER...vii Part One: DoD Business Transformation

  15. Thinking about thinking and emotion: the metacognitive approach to the medical humanities that integrates the humanities with the basic and clinical sciences.

    Science.gov (United States)

    Eichbaum, Quentin G

    2014-01-01

    Medical knowledge in recent decades has grown prodigiously and has outstripped the capacity of the human brain to absorb and understand it all. This burgeoning of knowledge has created a dilemma for medical educators. We can no longer expect students to continue memorizing this large body of increasingly complex knowledge. Instead, our efforts should be redirected at developing in students a competency as flexible thinkers and agile learners so they can adeptly deal with new knowledge, complexity, and uncertainty in a rapidly changing world. Such a competency would entail not only cognitive but also emotional skills essential for the holistic development of their professional identity. This article will argue that metacognition--“thinking about thinking (and emotion)”--offers the most viable path toward developing this competency. The overwhelming volume of medical knowledge has driven some medical schools to reduce the time allocated in their curricula to the “soft-option” humanities as they tend to consider them an expendable “luxury.” Vanderbilt University School of Medicine, Nashville, TN, has moved away from the traditional conception of the medical humanities as “the arts,” composed of art, music, and literature, toward an approach that integrates the humanities with the basic and clinical sciences, based on metacognition. This metacognitive approach to the humanities, described in this article, has three goals: 1) to develop students as flexible thinkers and agile learners and to provide them with essential cognitive and emotional skills for navigating medical complexity and uncertainty; 2) to elicit in students empathy and tolerance by making them aware of the immense diversity in human cognition (and emotion); and 3) to integrate the humanities with the basic and clinical sciences. Through this metacognitive approach, students come to understand their patterns of cognition and emotions, and in the group setting, they learn to mindfully

  16. Unfolding Green Defense

    DEFF Research Database (Denmark)

    Larsen, Kristian Knus

    2015-01-01

    In recent years, many states have developed and implemented green solutions for defense. Building on these initiatives NATO formulated the NATO Green Defence Framework in 2014. The framework provides a broad basis for cooperation within the Alliance on green solutions for defense. This report aims...... to inform and support the further development of green solutions by unfolding how green technologies and green strategies have been developed and used to handle current security challenges. The report, initially, focuses on the security challenges that are being linked to green defense, namely fuel...... consumption in military operations, defense expenditure, energy security, and global climate change. The report then proceeds to introduce the NATO Green Defence Framework before exploring specific current uses of green technologies and green strategies for defense. The report concludes that a number...

  17. Medical evidence of human rights violations against non-Arabic-speaking civilians in Darfur: a cross-sectional study.

    Science.gov (United States)

    Tsai, Alexander C; Eisa, Mohammed A; Crosby, Sondra S; Sirkin, Susannah; Heisler, Michele; Leaning, Jennifer; Iacopino, Vincent

    2012-01-01

    Ongoing conflict in the Darfur region of Sudan has resulted in a severe humanitarian crisis. We sought to characterize the nature and geographic scope of allegations of human rights violations perpetrated against civilians in Darfur and to evaluate their consistency with medical examinations documented in patients' medical records. This was a retrospective review and analysis of medical records from all 325 patients seen for treatment from September 28, 2004, through December 31, 2006, at the Nyala-based Amel Centre for Treatment and Rehabilitation of Victims of Torture, the only dedicated local provider of free clinical and legal services to civilian victims of torture and other human rights violations in Darfur during this time period. Among 325 medical records identified and examined, 292 (89.8%) patients from 12 different non-Arabic-speaking tribes disclosed in the medical notes that they had been attacked by Government of Sudan (GoS) and/or Janjaweed forces. Attacks were reported in 23 different rural council areas throughout Darfur. Nearly all attacks (321 [98.8%]) were described as having occurred in the absence of active armed conflict between Janjaweed/GoS forces and rebel groups. The most common alleged abuses were beatings (161 [49.5%]), gunshot wounds (140 [43.1%]), destruction or theft of property (121 [37.2%]), involuntary detainment (97 [29.9%]), and being bound (64 [19.7%]). Approximately one-half (36 [49.3%]) of all women disclosed that they had been sexually assaulted, and one-half of sexual assaults were described as having occurred in close proximity to a camp for internally displaced persons. Among the 198 (60.9%) medical records that contained sufficient detail to enable the forensic medical reviewers to render an informed judgment, the signs and symptoms in all of the medical records were assessed to be consistent with, highly consistent with, or virtually diagnostic of the alleged abuses. Allegations of widespread and sustained torture and

  18. Medical evidence of human rights violations against non-Arabic-speaking civilians in Darfur: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Alexander C Tsai

    Full Text Available BACKGROUND: Ongoing conflict in the Darfur region of Sudan has resulted in a severe humanitarian crisis. We sought to characterize the nature and geographic scope of allegations of human rights violations perpetrated against civilians in Darfur and to evaluate their consistency with medical examinations documented in patients' medical records. METHODS AND FINDINGS: This was a retrospective review and analysis of medical records from all 325 patients seen for treatment from September 28, 2004, through December 31, 2006, at the Nyala-based Amel Centre for Treatment and Rehabilitation of Victims of Torture, the only dedicated local provider of free clinical and legal services to civilian victims of torture and other human rights violations in Darfur during this time period. Among 325 medical records identified and examined, 292 (89.8% patients from 12 different non-Arabic-speaking tribes disclosed in the medical notes that they had been attacked by Government of Sudan (GoS and/or Janjaweed forces. Attacks were reported in 23 different rural council areas throughout Darfur. Nearly all attacks (321 [98.8%] were described as having occurred in the absence of active armed conflict between Janjaweed/GoS forces and rebel groups. The most common alleged abuses were beatings (161 [49.5%], gunshot wounds (140 [43.1%], destruction or theft of property (121 [37.2%], involuntary detainment (97 [29.9%], and being bound (64 [19.7%]. Approximately one-half (36 [49.3%] of all women disclosed that they had been sexually assaulted, and one-half of sexual assaults were described as having occurred in close proximity to a camp for internally displaced persons. Among the 198 (60.9% medical records that contained sufficient detail to enable the forensic medical reviewers to render an informed judgment, the signs and symptoms in all of the medical records were assessed to be consistent with, highly consistent with, or virtually diagnostic of the alleged abuses

  19. Digital medical imaging

    International Nuclear Information System (INIS)

    Goeringer, F.; Mun, S.K.; Kerlin, B.D.

    1989-01-01

    In formulating an implementation strategy for digital medical imaging, three interrelated thrusts have emerged for the defense medical establishment. These thrusts: totally filmless medical imaging on the battlefield, teleradiology, and DIN/PACS for peacetime military health care are discussed. They have implications in their fully developed form as resource savers and quality improvers for the unique aspects of military health care

  20. UK medical education on human trafficking: assessing uptake of the opportunity to shape awareness, safeguarding and referral in the curriculum.

    Science.gov (United States)

    Arulrajah, Poojani; Steele, Sarah

    2018-06-13

    Human trafficking is a serious violation of human rights, with numerous consequences for health and wellbeing. Recent law and policy reforms mean that clinicians now hold a crucial role in national strategies. 2015 research, however, indicates a serious shortfall in knowledge and confidence among healthcare professionals in the UK, leading potentially to failures in safeguarding and appropriate referral. Medical education is a central point for trafficking training. We ascertain the extent of such training in UK Medical Schools, and current curricular design. We sent Freedom of Information requests to the 34 public UK medical schools, which included a preliminary question on education provision, supplemented with follow-up questions exploring the nature, delivery and format of any education, as well as future curriculum development. There was a response rate of 97%. A majority (72%) of the schools did not provide trafficking education. 13% of these did, however, offer opportunities outside the formal curriculum. 70% had no plans to implement any education opportunities. Among the 28% of schools providing teaching, 56% integrated this within the core curriculum. 56% only delivered this within a single year of the degree. 67% provided some form of teaching in-person, while 78% used a combination of methods. Medical education on trafficking in the UK is variable and often absent. To produce future clinicians who are competent and capable, there is a need for expanded education on trafficking and research into optimal curriculum design. The UK's new Independent Anti-Slavery Commissioner should work with medical schools to develop an educational strategy urgently to fulfil the UK Government's plans and commitments. Both in the UK and around the world, human trafficking education presents a critical opportunity to address human rights and safeguarding to a generation of new doctors.

  1. The Development of 1Balance: A Connected Medical Device for Measuring Human Balance

    Directory of Open Access Journals (Sweden)

    Heikki Sjöman

    2018-05-01

    Full Text Available Prototyping (iterative loops of design–build–test is a proven method of efficiently developing new products. Developing products not only quickly, but that are also fit for purpose, implies engaging the end users and iterating the technology at hand. However, there is currently little research on how engineering design can approach developing connected devices. The purpose of this paper is to distinguish and discuss design approaches that are suitable for connected devices. Internet of Things devices consist of both the physical products themselves and the data that is coming out of the products, which we define as the external and internal data, respectively. They both can be prototyped separately, but since the data acquired can influence the design of the device and vice versa, we propose to link these two together in the product development process. This issue becomes more apparent when designing networks of sensors, e.g., for complex artificial intelligence (AI databases. We explain the principle by describing the development of 1Balance through six different prototypes for human balance measurement. Technologically quantifying balance is an underused approach for objectively evaluating the state of a human’s performance. The authors have developed a mobile application for monitoring balance as a physiological signal (amount of sway via a compact wireless inertial measurement unit (IMU sensor strapped to the body of the subject for the duration of the measurement. We describe the design process for developing this connected medical device, as well as how the acquired data was used to improve the design of the product. In conclusion, we propose conceptually connecting the external and internal data prototyping loops.

  2. Improvement of debate competence: an outcome of an introductory course for medical humanities

    Directory of Open Access Journals (Sweden)

    Kyung Hee Chun

    2016-03-01

    Full Text Available Purpose: Academic debate is an effective method to enhance the competences of critical thinking, problem solving, communication skills and cooperation skills. The present study examined the improvement of debate competence which is an outcome of debate-based flipped learning. Methods: A questionnaire was administrated to second-year premedical school students at Yeungnam University. In total 45 students participated in the survey. The survey questionnaire was composed of 60 items of eight subfactors on debate competence. To investigate the homogeneous of low and high achievement groups, 18 items on empathy and 75 items on critical thinking scales were used. To compare the pretest with posttest scores, data was analyzed using paired sample t-test. Results: There were no significant differences between low and high achievement groups by average grade at the beginning of the semester. There was a significant improvement in high achievers on the logical argumentation (p<0.001, proficiency in inquiry (p<0.01, active participation (p<0.001, ability to investigate and analyze (p<0.001, observance of debate rules (p<0.05, and acceptability (p<0.05. Even in low achievers, active participation (p<0.05 and ability to investigate and analyze (p<0.01 were significantly improved. Conclusion: Results showed that students could improve their debate competence by the debate-based flipped learning. A prospective and comparative study on the communication and teamwork competences needs to be conducted in the future. It is suggested that in-depth discussion for the curriculum design and teaching will be needed in terms of the effectiveness and the outcomes of the medical humanities.

  3. Review of the Book “Defense Mechanisms. Coping Strategies. Self-Regulation”

    Directory of Open Access Journals (Sweden)

    Stoil Mavrodiev

    2012-10-01

    Full Text Available This book deals with coping strategies and defense mechanisms as two kinds of self-regulation of human behaviour. The defense mechanisms are described with some examples of fiction books.

  4. Ciencias Sociales y Humanísticas en la formación médica Social Sciences and Humanities within undergraduate medical education

    Directory of Open Access Journals (Sweden)

    María Elena Macías Llanes

    2011-04-01

    Full Text Available El papel de las Humanidades Médicas en la formación del profesional de la salud ha sido entendido de diversas maneras. Se propone como objetivo ofrecer una valoración del significado de las Humanidades en los procesos formativos de la profesión médica. En primer lugar, se brindará una panorámica de este desarrollo y de sus diversas interpretaciones. En segundo lugar, se reflexionará sobre el encargo de las Ciencias Sociales y Humanísticas en la producción de conocimientos en Salud; en el contexto socio-político, económico y cultural actual latinoamericano. Por último, se analizará la contribución de este campo en los procesos formativos a través de la actividad del Centro de Desarrollo de las Ciencias Sociales y Humanísticas en Salud a lo largo de una década.The Medical Humanities have been understood in different ways. This paper deals with their importance for undergraduate medical education. Firstly, it analyzes their development and various readings. Secondly, it reflects on the role of the Social Sciences and Humanities in the production of health knowledge, within the political socioeconomic cultural Latin-American context. Finally, it considers their contribution to the educational processes, by way of the Center for the Development of Social Sciences and Humanities.

  5. Department of Defense perspective

    International Nuclear Information System (INIS)

    Devine, R.

    1985-01-01

    This paper examines radiation instrumentation from the Department of Defense perspective. Radiation survey instruments and calibration, or RADIAC, as it is called in the services, while administratively falling under the Assistant Secretary of Defense for Atomic Energy, has generally been managed at a lower level. The Naval Electronics Systems Command and Army Signal Corp are the two principles in the Department of Defense for RADIAC. The actions of the services are coordinated through the tri-service RADIAC working group, which meets about every year and a half. Several points from this organization are highlighted

  6. Cyber defense and situational awareness

    CERN Document Server

    Kott, Alexander; Erbacher, Robert F

    2015-01-01

    This book is the first publication to give a comprehensive, structured treatment to the important topic of situational awareness in cyber defense. It presents the subject in a logical, consistent, continuous discourse, covering key topics such as formation of cyber situational awareness, visualization and human factors, automated learning and inference, use of ontologies and metrics, predicting and assessing impact of cyber attacks, and achieving resilience of cyber and physical mission. Chapters include case studies, recent research results and practical insights described specifically for th

  7. Cruise Missile Defense

    National Research Council Canada - National Science Library

    Hichkad, Ravi R; Bolkcom, Christopher

    2005-01-01

    Congress has expressed interest in cruise missile defense for years. Cruise missiles (CMs) are essentially unmanned attack aircraft -- vehicles composed of an airframe, propulsion system, guidance system, and weapons payload...

  8. Cruise Missile Defense

    National Research Council Canada - National Science Library

    Hichkad, Ravi R; Bolkcom, Christopher

    2004-01-01

    Congress has expressed interest in cruise missile defense for years. Cruise missiles (CMs) are essentially unmanned attack aircraft -- vehicles composed of an airframe, propulsion system, guidance system, and weapons payload...

  9. Defense Transportation; The Army

    National Research Council Canada - National Science Library

    1998-01-01

    .... The statement of managers in the conference report on the Department of Defense Appropriations Act, 1997, directed us to validate the results and savings achieved from this and any other personal property pilot program...

  10. Insisting on the Healer's Art: The Implications of Required Participation in a Medical School Course on Values and Humanism.

    Science.gov (United States)

    Rabow, Michael W; Lapedis, Marissa; Feingold, Anat; Thomas, Mark; Remen, Rachel N

    2016-01-01

    Elective courses, by definition, allow medical students to self-select for participation in the class. In a small-group learning setting, students uninterested or not ready for a particular learning topic might change the educational experience ("poison the well") for those students most interested in the topic. It is not known how medical students required to take a course in humanism (that they otherwise would not have elected to take) might be impacted by the course or how their presence might affect students originally interested in the course. Medical students in a required course on humanism and values in medicine will have different experiences based on whether a particular student might have or not have elected to enroll in the course. Students uninterested in taking a course in humanism and values, but required to enroll, will limit the benefit of the course for those students originally interested in participating. In 2012, all 1st-year students at a U.S. medical school were required to take the Healer's Art, an elective on professional values and humanism offered at more than 90 other schools in the United States and internationally. Students completed pre/postcourse surveys assessing emotional exhaustion, work engagement, positive emotions, and cynicism. We analyzed differences between those who would have elected to take the course (Elective students) and those who would not have elected to take it (Required students). Elective students did not differ from Required students in baseline demographic characteristics, emotional exhaustion, work engagement, or positive emotions. At baseline, Elective students did report feeling safer to talk openly, a greater sense of community, and higher levels of cynicism. Over time, there were no differences in course evaluations or outcomes between Elective and Required students. Required students do not differ greatly from those who would have elected to take Healer's Art, and all students appear to have similar

  11. Defense Primer: DOD Contractors

    Science.gov (United States)

    2017-02-10

    functions, from intelligence analysis or software development to landscaping or food service. Why does DOD use individual contractors? Going back to...that provide professional services, from research to management support. The bulk of contractors—more than 70%—provide products, and these include...10 U.S.C. Part IV: Service, Supply, and Procurement. CRS Products CRS In Focus IF10548, Defense Primer: U.S. Defense Industrial Base, by Daniel

  12. Ballistic Missile Defense

    OpenAIRE

    Mayer, Michael

    2011-01-01

    At the 2010 NATO summit in Lisbon, the alliance decided to move forward on the development of a territorial ballistic missile defense (BMD) system and explore avenues for cooperation with Russia in this endeavor. Substantial progress on BMD has been made over the past decade, but some questions remain regarding the ultimate strategic utility of such a system and whether its benefi ts outweigh the possible opportunity costs. Missile defense has been a point of contention between the US and its...

  13. Using Complementary Learning Clusters in Studying Literature to Enhance Students' Medical Humanities Literacy, Critical Thinking, and English Proficiency.

    Science.gov (United States)

    Liao, Hung-Chang; Wang, Ya-Huei

    2016-04-01

    This study examined whether students studying literature in complementary learning clusters would show more improvement in medical humanities literacy, critical thinking skills, and English proficiency compared to those in conventional learning clusters. Ninety-three students participated in the study (M age = 18.2 years, SD = 0.4; 36 men, 57 women). A quasi-experimental design was used over 16 weeks, with the control group (n = 47) working in conventional learning clusters and the experimental group (n = 46) working in complementary learning clusters. Complementary learning clusters were those in which individuals had complementary strengths enabling them to learn from and offer assistance to other cluster members, hypothetically facilitating the learning process. Measures included the Medical Humanities Literacy Scale, Critical Thinking Disposition Assessment, English proficiency tests, and Analytic Critical Thinking Scoring Rubric. The results showed that complementary learning clusters have the potential to improve students' medical humanities literacy, critical thinking skills, and English proficiency. © The Author(s) 2016.

  14. 76 FR 72391 - Defense Logistics Agency Revised Regulation 1000.22, Environmental Considerations in Defense...

    Science.gov (United States)

    2011-11-23

    ... DEPARTMENT OF DEFENSE Office of the Secretary [Docket ID DOD-2011-OS-0055] Defense Logistics Agency Revised Regulation 1000.22, Environmental Considerations in Defense Logistics Agency Actions AGENCY: Defense Logistics Agency, Department of Defense. ACTION: Revised Defense Logistics Agency...

  15. 75 FR 76423 - Defense Intelligence Agency National Defense Intelligence College Board of Visitors Closed Meeting

    Science.gov (United States)

    2010-12-08

    ... DEPARTMENT OF DEFENSE Office of the Secretary Defense Intelligence Agency National Defense Intelligence College Board of Visitors Closed Meeting AGENCY: National Defense Intelligence College, Defense Intelligence Agency, Department of Defense. ACTION: Notice of Closed Meeting. SUMMARY: Pursuant to the...

  16. 76 FR 28960 - Defense Intelligence Agency National Defense Intelligence College Board of Visitors Closed Meeting

    Science.gov (United States)

    2011-05-19

    ... DEPARTMENT OF DEFENSE Office of the Secretary Defense Intelligence Agency National Defense Intelligence College Board of Visitors Closed Meeting AGENCY: National Defense Intelligence College, Defense Intelligence Agency, Department of Defense. ACTION: Notice of Closed Meeting. SUMMARY: Pursuant to the...

  17. Defensive medicine among obstetricians and gynecologists in tertiary hospitals.

    Directory of Open Access Journals (Sweden)

    Elad Asher

    Full Text Available OBJECTIVE: To describe the daily work practice under the threat of defensive medicine among obstetricians and gynecologists. STUDY DESIGN: A prospective cross-sectional survey of obstetricians and gynecologists working at tertiary medical centers in Israel. RESULTS: Among the 117 obstetricians and gynecologists who participated in the survey, representing 10% of the obstetricians and gynecologists registered by the Israel Medical Association, 113 (97% felt that their daily work practice is influenced by concern about being sued for medical negligence and not only by genuine medical considerations. As a result, 102 (87% physicians are more likely to offer the cesarean section option, even in the absence of a clear medical indication, 70 (60% follow court rulings concerning medical practices, and 85 (73% physicians mentioned that discussions about medical negligence court rulings are included in their departments' meetings. CONCLUSIONS: Defensive medicine is a well-embedded phenomenon affecting the medical decision process of obstetricians and gynecologists.

  18. Developing and Evaluating Medical Humanities Problem-Based Learning Classes Facilitated by the Teaching Assistants Majored in the Liberal Arts: A Longitudinal Crossover Study.

    Science.gov (United States)

    Tseng, Fen-Yu; Shieh, Jeng-Yi; Kao, Tze-Wah; Wu, Chau-Chung; Chu, Tzong-Shinn; Chen, Yen-Yuan

    2016-02-01

    Although medical humanities courses taught by teachers from nonmedical backgrounds are not unusual now, few studies have compared the outcome of medical humanities courses facilitated by physicians to that by teaching assistants majored in the liberal arts. The objectives of this study were to (1) analyze the satisfaction of medical students with medical humanities problem-based learning (PBL) classes facilitated by nonmedical teaching assistants (TAF) majored in the liberal arts, and those facilitated by the attending physicians (APF) and (2) examine the satisfaction of medical students with clinical medicine-related and clinical medicine-unrelated medical humanities PBL classes.A total of 123 medical students, randomly assigned to 16 groups, participated in this study. There were 16 classes in the course: 8 of them were TAF classes; and the others were APF classes. Each week, each group rotated from 1 subject of the 16 subjects of PBL to another subject. All of the 16 groups went through all the 16 subjects in the 2013 spring semester. We examined the medical students' satisfaction with each class, based on a rating score collected after each class was completed, using a scale from 0 (the lowest satisfaction) to 100 (the highest satisfaction). We also conducted multivariate linear regression analysis to examine the association between the independent variables and the students' satisfaction.Medical students were more satisfied with the TAF (91.35 ± 7.75) medical humanities PBL classes than APF (90.40 ± 8.42) medical humanities PBL classes (P = 0.01). Moreover, medical students were more satisfied with the clinical medicine-unrelated topics (92.00 ± 7.10) than the clinical medicine-related topics (90.36 ± 7.99) in the medical humanities PBL course (P = 0.01).This medical humanities PBL course, including nonmedical subjects and topics, and nonmedical teaching assistants from the liberal arts as class facilitators, was satisfactory. This

  19. Undergraduate Training in Human Sexuality-Evaluation of the Impact on Medical Doctors' Practice Ten Years After Graduation.

    Science.gov (United States)

    Clegg, Mary; Pye, Joanne; Wylie, Kevan R

    2016-09-01

    It has been suggested that an indicator of a doctor's ability to assess patients' sexual function relates to the level of earlier training. The amount and quality of training the doctor receives at the undergraduate level and beyond could contribute to the doctor's confidence and competence. To evaluate whether doctors found that the teaching in human sexuality received at medical school was sufficient for their future practice and whether their chosen medical specialty and exposure to issues related to sexual health affected this opinion. One hundred seventy doctors maintaining contact with the University of Sheffield Medical School Alumni Office after qualifying in 2004 were sent self-completion postal questionnaires. Space was allocated for supplementary comments to their answers. Self-completion postal questionnaire. Although the response rate was low, there appeared to be an impact of the teaching of human sexuality on the clinical practice of doctors. More than two-thirds of respondents rated the teaching as useful and more than 70% felt more confident in diagnosing and managing male and female sexual issues. The results show a link between the undergraduate teaching of sexual medicine and education and a subsequent proactive approach to sexuality issues; unfortunately, the study does not provide any information about the level of skills or ability in this field of medicine. We have confirmed that the Sheffield model might be suitable for teaching sexual medicine issues in the United Kingdom but cannot confirm that the current format is suitable for international undergraduate audiences. Future study could include other medical schools and a comparison of sexual medicine practice among physicians who received undergraduate medical education and overall numbers could be increased to compare current practice with the number of hours of sexual medicine education as a key parameter. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  20. Coronal leakage of four intracanal medications after exposure to human saliva in the presence of a temporary filling material.

    Science.gov (United States)

    Verissimo, Rebeca Dibe; Gurgel-Filho, Eduardo Diogo; De-Deus, Gustavo; Coutinho-Filho, Tauby; de Souza-Filho, Francisco Jose

    2010-01-01

    To determine the time required for the recontamination of root canals medicated with four different materials. A total of 60 intact, caries-free, human single-rooted teeth with straight roots were selected for this study. After chemo-mechanical preparation they must be changed in the specimens into seven groups: 10 teeth medicated with calcium hydroxide (Ca(OH) 2) + Camphorated paramonochlorophanol (CPMC) (G.1); 10 medicated with 2.5% Sodium hypochlorite (NaOCL) (G.2); 10 medicated with 2% Chlorhexidine gluconate (CHX) in gel (G.3); 10 medicated with 2% CHX in gel + Ca(OH) 2 (G.4); 10 without intracanal medicament and sealed with a coronal temporary filling (G.5). Five teeth were without intracanal medicament and coronally unsealed, used as the positive control group (PC) (G.6) and 5 teeth with intact crowns used as the negative control group (NC) (G.7). Glass vials with rubber stoppers were adjusted for use. The medicaments were prepared and injected into the root canals using sterile plastic syringes. An apparatus was used to evaluate for 30 days leakage. The chamber was filled with 3 ml of human saliva and Brain Heart Infusion (BHI) broth, incubated at 37 degrees C and checked daily for the appearance of turbidity in the BHI broth. Recontamination was detected after an average time of 2.6 days in group 2, 15.9 days in group 3, 30 days in group 1, 27.6 days in group 4, 2.9 days in group 5, 1 day in the positive control, and there was no contamination in the negative control group. The NaOCl group showed the highest worst average of recontamination; on the other hand, high averages were also shown by Ca(OH) 2 + CPMC and Ca(OH) 2 + 2% CHX in gel.

  1. Will they lead by example? Assessment of vaccination rates and attitudes to human papilloma virus in millennial medical students.

    Science.gov (United States)

    Afonso, Nelia M; Kavanagh, Maurice J; Swanberg, Stephanie M; Schulte, Jeanne M; Wunderlich, Tracy; Lucia, Victoria C

    2017-01-06

    Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. It is also well established that HPV viruses are responsible for a variety of cancers. Little is known about the prevailing knowledge and attitudes toward the HPV vaccine in our future healthcare providers, a majority of whom were among the first in the target age group to receive the vaccine; the same vaccine that they will in turn be expected to recommend to their patients. The aims of this pilot study were to examine the HPV vaccination rate among medical students and determine their knowledge about HPV and attitudes toward vaccination. To aid in the development of an HPV educational intervention, a needs assessment survey was administered to discover medical students' knowledge and attitudes toward the HPV vaccine. All medical students at a Midwestern US medical school were invited to complete the survey. Two hundred fourteen of 390 medical students completed the survey with 44% having been previously vaccinated. Although 82% of all respondents believed they would recommend the vaccine to family and friends, only 40% felt knowledgeable about the vaccine and 40% felt comfortable counseling patients. More positive attitudes and better knowledge scores were found in fully vaccinated students compared to non-vaccinated students. Provider recommendation was strongly associated with HPV vaccination status. This study revealed the unique perspectives of U.S. millennial medical students as the first group of future healthcare providers to have personally encountered the HPV vaccine. Overall, students' knowledge as well as their comfort level in counseling patients was lacking. This assessment has guided the development of targeted educational interventions to address knowledge gaps and prepare students to appropriately discuss the vaccine with patients and parents and help protect young people from life threatening cancers.

  2. Will they lead by example? Assessment of vaccination rates and attitudes to human papilloma virus in millennial medical students

    Directory of Open Access Journals (Sweden)

    Nelia M. Afonso

    2017-01-01

    Full Text Available Abstract Background Human papillomavirus (HPV is the most common sexually transmitted infection in the United States. It is also well established that HPV viruses are responsible for a variety of cancers. Little is known about the prevailing knowledge and attitudes toward the HPV vaccine in our future healthcare providers, a majority of whom were among the first in the target age group to receive the vaccine; the same vaccine that they will in turn be expected to recommend to their patients. The aims of this pilot study were to examine the HPV vaccination rate among medical students and determine their knowledge about HPV and attitudes toward vaccination. Methods To aid in the development of an HPV educational intervention, a needs assessment survey was administered to discover medical students’ knowledge and attitudes toward the HPV vaccine. All medical students at a Midwestern US medical school were invited to complete the survey. Results Two hundred fourteen of 390 medical students completed the survey with 44% having been previously vaccinated. Although 82% of all respondents believed they would recommend the vaccine to family and friends, only 40% felt knowledgeable about the vaccine and 40% felt comfortable counseling patients. More positive attitudes and better knowledge scores were found in fully vaccinated students compared to non-vaccinated students. Provider recommendation was strongly associated with HPV vaccination status. Conclusions This study revealed the unique perspectives of U.S. millennial medical students as the first group of future healthcare providers to have personally encountered the HPV vaccine. Overall, students’ knowledge as well as their comfort level in counseling patients was lacking. This assessment has guided the development of targeted educational interventions to address knowledge gaps and prepare students to appropriately discuss the vaccine with patients and parents and help protect young people from

  3. Use of social media in graduate-level medical humanities education: two pilot studies from Penn State College of Medicine.

    Science.gov (United States)

    George, Daniel R; Dellasega, Cheryl

    2011-01-01

    Social media strategies in education have gained attention for undergraduate students, but there has been relatively little application with graduate populations in medicine. To use and evaluate the integration of new social media tools into the curricula of two graduate-level medical humanities electives offered to 4th-year students at Penn State College of Medicine. Instructors selected five social media tools--Twitter, YouTube, Flickr, blogging and Skype--to promote student learning. At the conclusion of each course, students provided quantitative and qualitative course evaluation. Students gave high favourability ratings to both courses, and expressed that the integration of social media into coursework augmented learning and collaboration. Others identified challenges including: demands on time, concerns about privacy and lack of facility with technology. Integrating social media tools into class activities appeared to offer manifold benefits over traditional classroom methods, including real-time communication outside of the classroom, connecting with medical experts, collaborative opportunities and enhanced creativity. Social media can augment learning opportunities within humanities curriculum in medical schools, and help students acquire tools and skill-sets for problem solving, networking, and collaboration. Command of technologies will be increasingly important to the practice of medicine in the twenty-first century.

  4. Human Rights, Humanitarianism, and State Violence: Medical Documentation of Torture in Turkey.

    Science.gov (United States)

    Can, Başak

    2016-09-01

    State authorities invested in developing official expert discourses and practices to deny torture in post-1980 coup d'état Turkey. Documentation of torture was therefore crucial for the incipient human rights movement there in the 1980s. Human rights physicians used their expertise not only to treat torture victims but also to document torture and eventually found the Human Rights Foundation of Turkey (HRFT) in 1990. Drawing on an ethnographic and archival research at the HRFT, this article examines the genealogy of anti-torture struggles in Turkey and argues that locally mediated intimacies and/or hostilities between victims of state violence, human rights physicians, and official forensics reveal the limitations of certain universal humanitarian and human rights principles. It also shows that locally mediated long-term humanitarian encounters around the question of political violence challenge forensic denial of violence and remake the legitimate levels of state violence. © 2015 by the American Anthropological Association.

  5. Department of Defense Timely & Effective Care Data – military hospitals

    Data.gov (United States)

    U.S. Department of Health & Human Services — This file contains U.S. military hospital data for timely & effective care (process of care) measures collected by the Department of Defense (DoD). DoD collects...

  6. Defense waste management plan

    International Nuclear Information System (INIS)

    1983-06-01

    Defense high-level waste (HLW) and defense transuranic (TRU) waste are in interim storage at three sites, namely: at the Savannah River Plant, in South Carolina; at the Hanford Reservation, in Washington; and at the Idaho National Engineering Laboratory, in Idaho. Defense TRU waste is also in interim storage at the Oak Ridge National Laboratory, in Tennessee; at the Los Alamos National Laboratory, in New Mexico; and at the Nevada Test Site, in Nevada. (Figure E-2). This document describes a workable approach for the permanent disposal of high-level and transuranic waste from atomic energy defense activities. The plan does not address the disposal of suspect waste which has been conservatively considered to be high-level or transuranic waste but which can be shown to be low-level waste. This material will be processed and disposed of in accordance with low-level waste practices. The primary goal of this program is to utilize or dispose of high-level and transuranic waste routinely, safely, and effectively. This goal will include the disposal of the backlog of stored defense waste. A Reference Plan for each of the sites describes the sequence of steps leading to permanent disposal. No technological breakthroughs are required to implement the reference plan. Not all final decisions concerning the activities described in this document have been made. These decisions will depend on: completion of the National Environmental Policy Act process, authorization and appropriation of funds, agreements with states as appropriate, and in some cases, the results of pilot plant experiments and operational experience. The major elements of the reference plan for permanent disposal of defense high-level and transuranic waste are summarized

  7. Evaluation of Small-Group Teaching in Human Gross Anatomy in a Caribbean Medical School

    Science.gov (United States)

    Chan, Lap Ki; Ganguly, Pallab K.

    2008-01-01

    Although there are a number of medical schools in the Caribbean islands, very few reports have come out so far in the literature regarding the efficacy of small-group teaching in them. The introduction of small-group teaching in the gross anatomy laboratory one and a half years ago at St. Matthew's University (SMU) on Grand Cayman appears to have…

  8. Online Dissection Audio-Visual Resources for Human Anatomy: Undergraduate Medical Students' Usage and Learning Outcomes

    Science.gov (United States)

    Choi-Lundberg, Derek L.; Cuellar, William A.; Williams, Anne-Marie M.

    2016-01-01

    In an attempt to improve undergraduate medical student preparation for and learning from dissection sessions, dissection audio-visual resources (DAVR) were developed. Data from e-learning management systems indicated DAVR were accessed by 28% ± 10 (mean ± SD for nine DAVR across three years) of students prior to the corresponding dissection…

  9. 3D visualization of medical images for personalized learning of human anatomy

    NARCIS (Netherlands)

    Laurence Alpay; Jelle Scheurleer; Harmen Bijwaard

    2015-01-01

    to be held in Lisbon/Portugal on October 15-17, 2015 Medical imaging nowadays often yields high definition 3D images (from CT, PET, MRI, etc.). Usually these images need to be evaluated on 2D monitors. In the transition from 3D to 2D the image becomes more difficult to interpret as a whole. To aid

  10. Salt, chloride, bleach, and innate host defense

    Science.gov (United States)

    Wang, Guoshun; Nauseef, William M.

    2015-01-01

    Salt provides 2 life-essential elements: sodium and chlorine. Chloride, the ionic form of chlorine, derived exclusively from dietary absorption and constituting the most abundant anion in the human body, plays critical roles in many vital physiologic functions, from fluid retention and secretion to osmotic maintenance and pH balance. However, an often overlooked role of chloride is its function in innate host defense against infection. Chloride serves as a substrate for the generation of the potent microbicide chlorine bleach by stimulated neutrophils and also contributes to regulation of ionic homeostasis for optimal antimicrobial activity within phagosomes. An inadequate supply of chloride to phagocytes and their phagosomes, such as in CF disease and other chloride channel disorders, severely compromises host defense against infection. We provide an overview of the roles that chloride plays in normal innate immunity, highlighting specific links between defective chloride channel function and failures in host defense. PMID:26048979

  11. Salt, chloride, bleach, and innate host defense.

    Science.gov (United States)

    Wang, Guoshun; Nauseef, William M

    2015-08-01

    Salt provides 2 life-essential elements: sodium and chlorine. Chloride, the ionic form of chlorine, derived exclusively from dietary absorption and constituting the most abundant anion in the human body, plays critical roles in many vital physiologic functions, from fluid retention and secretion to osmotic maintenance and pH balance. However, an often overlooked role of chloride is its function in innate host defense against infection. Chloride serves as a substrate for the generation of the potent microbicide chlorine bleach by stimulated neutrophils and also contributes to regulation of ionic homeostasis for optimal antimicrobial activity within phagosomes. An inadequate supply of chloride to phagocytes and their phagosomes, such as in CF disease and other chloride channel disorders, severely compromises host defense against infection. We provide an overview of the roles that chloride plays in normal innate immunity, highlighting specific links between defective chloride channel function and failures in host defense. © Society for Leukocyte Biology.

  12. Defensive Federal Litigation

    Science.gov (United States)

    1998-08-20

    requires that all affirmative defenses be pleaded in the answer. The rule lists 19 specific affirmative defenses, such as estoppel , laches, res judicata...Brown, 22 F.3d 516 (2d Cir. 1994); Poole v. Rourke, 779 F. Supp. 1546 (E.D. Cal. 1991). 3-40 potential collateral estoppel .4. effect of the district...the back pay claim, which was over $10,000, to the Court of Claims. The court of appeals found that ൸Collateral estoppel prohibits relitigation of

  13. Human cloning and embryo research: the 2003 John J. Conley Lecture on medical ethics.

    Science.gov (United States)

    George, Robert P

    2004-01-01

    The author, a member of the U.S. President's Council on Bioethics, discusses ethical issues raised by human cloning, whether for purposes of bringing babies to birth or for research purposes. He first argues that every cloned human embryo is a new, distinct, and enduring organism, belonging to the species Homo sapiens, and directing its own development toward maturity. He then distinguishes between two types of capacities belonging to individual organisms belonging to this species, an immediately exerciseable capacity and a basic natural capacity that develops over time. He argues that it is the second type of capacity that is the ground for full moral respect, and that this capacity (and its concomitant degree of respect) belongs to cloned human embryos no less than to adult human beings. He then considers and rejects counter-arguments to his position, including the suggestion that the capacity of embryos is equivalent to the capacity of somatic cells, that full human rights are afforded only to human organisms with functioning brains, that the possibility of twinning diminishes the moral status of embryos, that the fact that people do not typically mourn the loss of early embryos implies that they have a diminished moral status, that the fact that early spontaneous abortions occur frequently diminishes the moral status of embryos, and that his arguments depend upon a concept of ensoulment. He concludes that if the moral status of cloned human embryos is equivalent to that of adults, then public policy should be based upon this assumption.

  14. The Frequency of Reporting Ethical Issues in Human Subject Articles Published in Iranian Medical Journals: 2009-2013.

    Science.gov (United States)

    Astaneh, Behrooz; Khani, Parisa

    2017-11-10

    Researchers should strictly consider the participants' rights. They are required to document such protections as an ethical approval of the study proposal, the obtaining "informed consent", the authors' "conflict of interests", and the source of "financial support" in the published articles. The purpose of this study was to assess the frequency of reporting ethical issues in human subject articles published in Iranian medical journals during 2009-2013. In this cross-sectional study, we randomly reviewed 1460 human subject articles published in Iranian medical journals during 2009-2013 in two Persian and English language groups. Data collection was carried out by assessing articles, focusing on the documentation "ethics committee approval", patients' "informed consent", "financial support", "confidentiality", and "conflict of interest". Of 1460 evaluated articles, 443 (30.3%) reported "ethics committee approval", 686 (47.0%) reported "informed consent", 594 (40.7%) reported "financial support", and 341 (23.4%) reported "conflict of interest". 13% of the articles referred to patients' confidentiality in their text. There was a significant association between these ethical documentations and the year of publication. Articles published in English language journals reported "ethics committee approval", "financial support", and "conflict of interest" significantly more than Persian language journals, but the frequency of "informed consent" was similar. Ethical documentation rate in Iranian medical journals is not up to the expected standards of reputable journals which might be related to a lack of awareness and the education of the authors and the journal's editors. Precise reporting of ethical considerations in medical articles by authors are recommended. It is suggested journals and policymakers pay more attention to reporting this issue while providing standard guidelines in this regard.

  15. Personnel of human anatomy department of Saratov State Medical University n.a. V. I. Razumovsky as the participants of the Great Patriotic War

    Directory of Open Access Journals (Sweden)

    Aleshkina O.Yu.

    2015-03-01

    Full Text Available The article provides evidence on participation of assistants who worked at the Department of Human Anatomy of Saratov State Medical University n.a. V. I. Razumovsky and took part in the Great Patriotic War.

  16. Effect of fraxetin on antioxidant defense and stress proteins in human neuroblastoma cell model of rotenone neurotoxicity. Comparative study with myricetin and N-acetylcysteine

    International Nuclear Information System (INIS)

    Molina-Jimenez, Maria Francisca; Sanchez-Reus, Maria Isabel; Cascales, Maria; Andres, David; Benedi, Juana

    2005-01-01

    Mitochondrial complex I inhibitor rotenone induces apoptosis through enhancing mitochondrial reactive oxygen species production. Recently, it has been shown that fraxetin (coumarin) and myricetin (flavonoid) have significant neuroprotective effects against apoptosis induced by rotenone, increase the total glutathione levels in vitro, and inhibit lipid peroxidation. Thus, these considerations prompted us to investigate the way in which fraxetin and myricetin affect the endogenous antioxidant defense system, such as Mn and CuZn superoxide dismutase (MnSOD, CuZnSOD), catalase, glutathione reductase (GR), and glutathione peroxidase (GPx) on rotenone neurotoxicity in neuroblastoma cells. N-acetylcysteine (NAC), a potent antioxidant, was employed as a comparative agent. Also, the expression and protein levels of HSP70 by Northern and Western blot analysis were assayed in SH-SY5Y cells. After incubation for 16 h, rotenone significantly increased the expression and activity of MnSOD, GPx, and catalase. When cells were preincubated with fraxetin, there was a decrease in the protein levels and activity of both MnSOD and catalase, in comparison with the rotenone treatment. The myricetin effect was less pronounced. Activity and expression of GPx were increased by rotenone and pre-treatment with fraxetin did not modify significantly these levels. The significant enhancement in HSP70 expression at mRNA and protein levels induced by fraxetin was observed by pre-treatment of cells 0.5 h before rotenone insult. These data suggest that major features of rotenone-induced neurotoxicity are partially mediated by free radical formation and oxidative stress, and that fraxetin partially protects against rotenone toxicity affecting the main protection system of the cells against oxidative injury

  17. The Humanities in Medical Education: Ways of Knowing, Doing and Being.

    Science.gov (United States)

    Boudreau, J Donald; Fuks, Abraham

    2015-12-01

    The personhood of the physician is a crucial element in accomplishing the goals of medicine. We review claims made on behalf of the humanities in guiding professional identity formation. We explore the dichotomy that has evolved, since the Renaissance, between the humanities and the natural sciences. The result of this evolution is an historic misconstrual, preoccupying educators and diverting them from the moral development of physicians. We propose a curricular framework based on the recovery of Aristotelian concepts that bridge identity and activity. The humanities and the natural sciences, jointly and severally, can fulfill developmental, characterological and instrumental purposes.

  18. Human Rights, Privacy and Medical Research; Analysing UK Policy on Tissue and Data

    OpenAIRE

    Gillott, John

    2006-01-01

    This report is one outcome of a study into privacy and human genetics initiated by John Gillott and staff and trustees of the Genetic Interest Group. \\ud \\ud The initial focus was on genetics and human rights, with an emphasis on legal aspects and policy decisions informed by law and rights ideology. Article 8 of the Human Rights Act 1998, the right to respect for private and family life,1 is of most relevance to this study, though other Articles are considered.\\ud \\ud The study as a whole co...

  19. Defense styles of pedophilic offenders.

    Science.gov (United States)

    Drapeau, Martin; Beretta, Véronique; de Roten, Yves; Koerner, Annett; Despland, Jean-Nicolas

    2008-04-01

    This pilot study investigated the defense styles of pedophile sexual offenders. Interviews with 20 pedophiles and 20 controls were scored using the Defense Mechanisms Rating Scales. Results showed that pedophiles had a significantly lower overall defensive functioning score than the controls. Pedophiles used significantly fewer obsessional-level defenses but more major image-distorting and action-level defenses. Results also suggested differences in the prevalence of individual defenses where pedophiles used more dissociation, displacement, denial, autistic fantasy, splitting of object, projective identification, acting out, and passive aggressive behavior but less intellectualization and rationalization.

  20. Strategic Framework for the Defense Acquisition System Understanding Defense Consolidation

    National Research Council Canada - National Science Library

    Potts, Anthony W

    2007-01-01

    The 1993 policy to promote the consolidation of the United States defense industry began a series of acquisitions and mergers that went beyond the intent of the policy and left the Department of Defense (DoD...

  1. Strategic Framework for the Defense Acquisition System Understanding Defense Consolidation

    National Research Council Canada - National Science Library

    Potts, Anthony W

    2007-01-01

    ...% of defense product sales annually. Defense consolidation has diminished the flexibility required for surge capacity, diminished competitive innovations in products, and reduced competitive pricing based on multiple sources for products...

  2. Developing a pilot curriculum to foster humanism among graduate medical trainees

    Directory of Open Access Journals (Sweden)

    Sarah K Dotters-Katz

    2018-01-01

    Conclusion: A pilot humanism curriculum for residents was well-received. Participants showed decreased burnout and trended to improved compassion scores. Development and evaluation of an expanded curriculum would further explore feasibility and effectiveness of the intervention.

  3. De Novo Human Cardiac Myocytes for Medical Research: Promises and Challenges

    Directory of Open Access Journals (Sweden)

    Veronique Hamel

    2017-01-01

    Full Text Available The advent of cellular reprogramming technology has revolutionized biomedical research. De novo human cardiac myocytes can now be obtained from direct reprogramming of somatic cells (such as fibroblasts, from induced pluripotent stem cells (iPSCs, which are reprogrammed from somatic cells, and from human embryonic stem cells (hESCs. Such de novo human cardiac myocytes hold great promise for in vitro disease modeling and drug screening and in vivo cell therapy of heart disease. Here, we review the technique advancements for generating de novo human cardiac myocytes. We also discuss several challenges for the use of such cells in research and regenerative medicine, such as the immature phenotype and heterogeneity of de novo cardiac myocytes obtained with existing protocols. We focus on the recent advancements in addressing such challenges.

  4. COGME 1995 Physician Workforce Funding Recommendations for Department of Health and Human Services' Programs. Council on Graduate Medical Education, 7th Report.

    Science.gov (United States)

    Council on Graduate Medical Education.

    This report presents specific recommendations to the Department of Health and Human Services and Congress from the Council on Graduate Medical Education that address Medicare's direct and indirect graduate medical education (GME) payments and the monies allocated by the Public Health Service that is targeted toward physician education and primary…

  5. Academic training of radiation protection human resources in the X-ray medical diagnostic

    International Nuclear Information System (INIS)

    Gaona, E.

    2008-12-01

    The current regulation, established by NOM-229-SSA1-2002 standard, T echnical requirements for facilities, health responsibilities, technical specifications for equipment and facilities for radiation protection in medical diagnosis with X-rays, t hat should be credited refresher courses, and training in radiation safety in accordance with current regulations, however, has been observed that the assistance and accreditation of courses is basically to cover administrative and regulatory requirements and therefore does not necessarily cover needs of the patient to radiation protection in the use of old and new technologies. David Brenner and Eric Hall claim that between 1.5 and 2% of all cancers in the USA may be attributable to exposure to X-ray computerized tomography techniques, given the intensive use of these techniques and the patient dose ranges in which incurred. While this is not debatable, if it is, the alternative does not seem to be abandoning the use of computerized tomography, because it gives them undoubted benefits with respect to invasive procedures. Deserves mention concerns the use of computerized tomography in children using scanning protocols designed for adults, in which case it incurs in 5 times higher dose. An additional warning about unwarranted use of computerized tomography is a procedure of this technique in abdomen resulting in an equivalent dose to 298 times that of a mammogram. Additional aspects such as biological effects (including deterministic) of both medical staff and patients of interventional procedures further reinforces the idea that there are education programs in radiation protection. Attention must put in the new generations, including in the curricula of medical residencies in radiology, endoscopy, cardiology and orthopedic, the education (no emerging courses) in radiation protection, radiobiology, radiology physics, and other topics, but previously must have medical physicists in radiology available to train new

  6. METHOD OF PHYSIOTHERAPY MEDICAL PROCEDURES FOR THERMAL IMPACT ON SELECTED AREAS WITH HUMAN HANDS THERMOELECTRIC DEVICES

    Directory of Open Access Journals (Sweden)

    A. B. Sulin

    2015-01-01

    Full Text Available The device for thermal impact on separate zones of a hand of the person executed on the basis of thermoelectric converters of energy is considered. The advantages consisting in high environmental friendliness, noiselessness, reliability, functionality, universality are noted it. The technique of carrying out medical (preventive physiotherapeutic procedures, the hands of the person consisting in contrast thermal impact on a site with various level of heating and cooling, and also lasting expositions is described.

  7. Flagellated Magnetotactic Bacteria as Controlled MRI-trackable Propulsion and Steering Systems for Medical Nanorobots Operating in the Human Microvasculature.

    Science.gov (United States)

    Martel, Sylvain; Mohammadi, Mahmood; Felfoul, Ouajdi; Lu, Zhao; Pouponneau, Pierre

    2009-04-01

    Although nanorobots may play critical roles for many applications in the human body such as targeting tumoral lesions for therapeutic purposes, miniaturization of the power source with an effective onboard controllable propulsion and steering system have prevented the implementation of such mobile robots. Here, we show that the flagellated nanomotors combined with the nanometer-sized magnetosomes of a single Magnetotactic Bacterium (MTB) can be used as an effective integrated propulsion and steering system for devices such as nanorobots designed for targeting locations only accessible through the smallest capillaries in humans while being visible for tracking and monitoring purposes using modern medical imaging modalities such as Magnetic Resonance Imaging (MRI). Through directional and magnetic field intensities, the displacement speeds, directions, and behaviors of swarms of these bacterial actuators can be controlled from an external computer.

  8. Defensive Passivity in Adolescence

    Science.gov (United States)

    Rosenheim, Eliyahu; Gaoni, Bracha

    1977-01-01

    There are potentially healthy adolescents who display excessive reluctance to move toward independent decision and action. This research presents a clinical description of this "syndrome", conceptualizes it as a defensive maneuver against mourning over cherished childhood dreams and offers steps for therapeutic intervention. (Editor/RK)

  9. Defense radioactive waste management

    International Nuclear Information System (INIS)

    Hindman, T.B. Jr.

    1988-01-01

    The Office of Defense Programs (DP), U.S. Department of Energy, is responsible for the production of nuclear weapons and materials for national defense. Pursuant to this mission, DP operates a large industrial complex that employs over 60,000 people at various installations across the country. As a byproduct of their activities, these installations generate radioactive, hazardous, or mixed wastes that must be managed in a safe and cost-effective manner in compliance with all applicable Federal and STate environmental requirements. At the Federal level such requirements derive primarily from the Atomic Energy Act, the Resource Conservation and Recovery Act (RCRA), the comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) and the Superfund Amendments and Reauthorization Act (SARA). Responsibility for DP activities in connection with the disposal of defense wastes is consolidated within the Office of Defense Waste and Transportation Management (DWTM). This paper discusses these activities which consist of five principal elements: the environmental restoration of inactive DP facilities and sites, the processing storage and disposal of wastes associated with ongoing operations at active DP facilities, research and development directed toward the long-term disposal of radioactive, hazardous, mixed wastes, technology development directly supporting regulatory compliance, and the development of policies, procedures, and technologies for assuring the safe transportation of radioactive and hazardous materials

  10. Auxins in defense strategies

    Czech Academy of Sciences Publication Activity Database

    Čarná, Mária; Repka, V.; Skůpa, Petr; Šturdík, E.

    2014-01-01

    Roč. 69, č. 10 (2014), s. 1255-1263 ISSN 0006-3088 R&D Projects: GA TA ČR TA01011802 Institutional support: RVO:61389030 Keywords : auxin * defense responses * JA Subject RIV: GF - Plant Pathology, Vermin, Weed, Plant Protection Impact factor: 0.827, year: 2014

  11. Hanford defense waste studies

    International Nuclear Information System (INIS)

    Napier, B.A.; Zimmerman, M.G.; Soldat, J.K.

    1981-01-01

    PNL is assisting Rockwell Hanford Operations to prepare a programmatic environmental impact statement for the management of Hanford defense nuclear waste. The Ecological Sciences Department is leading the task of calculation of public radiation doses from a large matrix of potential routine and accidental releases of radionuclides to the environment

  12. Rethinking Defensive Information Warfare

    Science.gov (United States)

    2004-06-01

    Countless studies, however, have demonstrated the weakness in this system.15 The tension between easily remembered passwords and suffi...vulnerabilities Undiscovered flaws The patch model for Internet security has failed spectacularly. Caida , 2004 Signature-Based Defense Anti virus, intrusion

  13. Overview of Accelerator Applications for Security and Defense

    Science.gov (United States)

    Antolak, Arlyn J.

    Particle accelerators play a key role in a broad set of defense and security applications, including war-fighter and asset protection, cargo inspection, nonproliferation, materials characterization, and stockpile stewardship. Accelerators can replace the high activity radioactive sources that pose a security threat to developing a radiological dispersal device, and, can be used to produce isotopes for medical, industrial, and research purposes. An overview of current and emerging accelerator technologies relevant to addressing the needs of defense and security is presented.

  14. Alfred Russel Wallace's medical libertarianism: state medicine, human progress, and evolutionary purpose.

    Science.gov (United States)

    Flannery, Michael A

    2015-01-01

    Alfred Russel Wallace (1823-1913), naturalist and explorer of South America and the Malay Archipelago, secured his place in history by independently discovering the theory of natural selection. His letter outlining the theory was sent from Ternate in eastern Indonesia and received at Down House, according to Charles Darwin (1809-82), on June 18, 1858, prompting the now-famed evolutionist to rush his languishing manuscript to press. Wallace's contributions to evolutionary biology, biogeography, and anthropology are well known, but his medical views have received far less attention. Within the context of a strident populist antivaccination movement and an ominous elitist eugenics campaign, Wallace took his stand, which revealed itself in a libertarianism that defended traditional socialist constituencies (the working poor, the lumpenproletariat, and feminist reformers) against state-mandated medical interventions. Rather than viewing Wallace as a heterodox contrarian, this article argues that his positions were logical outgrowths of his medical libertarianism and evolutionary and social theories. © The Author 2013. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. The innate defense antimicrobial peptides hBD3 and RNase7 are induced in human umbilical vein endothelial cells by classical inflammatory cytokines but not Th17 cytokines.

    Science.gov (United States)

    Burgey, Christine; Kern, Winfried V; Römer, Winfried; Sakinc, Türkan; Rieg, Siegbert

    2015-05-01

    Antimicrobial peptides are multifunctional effector molecules of innate immunity. In this study we investigated whether endothelial cells actively contribute to innate defense mechanisms by expression of antimicrobial peptides. We therefore stimulated human umbilical vein endothelial cells (HUVEC) with inflammatory cytokines, Th17 cytokines, heat-inactivated bacteria, bacterial conditioned medium (BCM) of Staphylococcus aureus and Streptococcus sanguinis, and lipoteichoic acid (LTA). Stimulation with single cytokines induced discrete expression of human β-defensin 3 (hBD3) by IFN-γ or IL-1β and of ribonuclease 7 (RNase7) by TNF-α without any effects on LL-37 gene expression. Stronger hBD3 and RNase7 induction was observed after combined stimulation with IL-1β, TNF-α and IFN-γ and was confirmed by high hBD3 and RNase7 peptide levels in cell culture supernatants. In contrast, Th17 cytokines or stimulation with LTA did not result in AMP production. Moreover, only BCM of an invasive S. aureus bacteremia isolate induced hBD3 in HUVEC. We conclude that endothelial cells actively contribute to prevent dissemination of pathogens at the blood-tissue-barrier by production of AMPs that exhibit microbicidal and immunomodulatory functions. Further investigations should focus on tissue-specific AMP induction in different endothelial cell types, on pathogen-specific induction patterns and potentially involved pattern-recognition receptors of endothelial cells. Copyright © 2015 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

  16. Defense Logistics Agency Revenue Eliminations

    National Research Council Canada - National Science Library

    1996-01-01

    The issue of revenue eliminations was identified during our work on the Defense Logistics Agency portion of the Audit of Revenue Accounts in the FY 1996 Financial Statements of the Defense Business Operations Fund...

  17. Medical and biological progress and the European Convention on Human Rights.

    Science.gov (United States)

    Byk, C

    1992-01-01

    The advances made in life sciences are one of the most significant features of the 20th century scientific revolution and human rights obviously enjoy prominence among the legal issues affected by the development of medicine. The case law of the organs of the European Convention on Human Rights arising from developments in the biomedical sciences is reviewed. The approach of especially the European Commission on Human Rights to the consequences of advances in the life sciences on the protection of the individual's physical integrity and the protection of freedom of thought and private and family life is analysed. 'Contrary to what we are led to believe, it is not from the starting-point of biology that a particular idea of man can be formed; on the contrary, it is from the starting-point of a particular idea of man that biology can be used to serve him': F Gros, F Jacob & P Royer Life Sciences and Society (1979) 288.

  18. Human dissection: an approach to interweaving the traditional and humanistic goals of medical education.

    Science.gov (United States)

    Rizzolo, Lawrence J

    2002-12-15

    Anatomy remains one of the core courses of medical school, but the time devoted to it is decreasing. To accommodate the explosion of medical knowledge, educators search to streamline the curriculum. Because it is time-consuming, dissection comes under increased scrutiny. Even in the face of these pressures to reduce course hours, I would like to propose broadening, not reducing, the responsibilities of the anatomy instructor. Anatomy instructors can play a crucial role in helping medical schools meet the critical need to cultivate humanistic values, especially in the arena of end-of-life care. Anatomy can--and should--play an important role in a curriculum-wide effort to address this issue. Just as dissection remains an essential technique to teach three-dimensional concepts, the cadaver dissection lab is an ideal place to introduce concepts of humanistic care. The lab evokes the students' memories, speculations, and fears about serious illness in themselves, their families, and loved ones. Some programs address these reactions with supplemental activities, such as journaling, essay writing, and small group discussion. Valuable as these activities may be, anatomy instructors can achieve more by recognizing their role as a mentor, who can integrate humanistic values into traditional course objectives in a way that adds little time to the curriculum. The attitude of the instructor in ministering to the students' needs as they undertake the emotionally charged task of dissection can provide a model for how the students will respond, in turn, to the hopes and fears of their patients-and to their own reactions to dying. This approach will allow students to implement and practice humanistic values immediately, laying a foundation for their clinical training. Copyright 2002 Wiley-Liss, Inc.

  19. Mechanical stretch up-regulates the B-type natriuretic peptide system in human cardiac fibroblasts: a possible defense against transforming growth factor-ß mediated fibrosis

    LENUS (Irish Health Repository)

    Watson, Chris J

    2012-07-07

    AbstractBackgroundMechanical overload of the heart is associated with excessive deposition of extracellular matrix proteins and the development of cardiac fibrosis. This can result in reduced ventricular compliance, diastolic dysfunction, and heart failure. Extracellular matrix synthesis is regulated primarily by cardiac fibroblasts, more specifically, the active myofibroblast. The influence of mechanical stretch on human cardiac fibroblasts’ response to pro-fibrotic stimuli, such as transforming growth factor beta (TGFβ), is unknown as is the impact of stretch on B-type natriuretic peptide (BNP) and natriuretic peptide receptor A (NPRA) expression. BNP, acting via NPRA, has been shown to play a role in modulation of cardiac fibrosis.Methods and resultsThe effect of cyclical mechanical stretch on TGFβ induction of myofibroblast differentiation in primary human cardiac fibroblasts and whether differences in response to stretch were associated with changes in the natriuretic peptide system were investigated. Cyclical mechanical stretch attenuated the effectiveness of TGFβ in inducing myofibroblast differentiation. This finding was associated with a novel observation that mechanical stretch can increase BNP and NPRA expression in human cardiac fibroblasts, which could have important implications in modulating myocardial fibrosis. Exogenous BNP treatment further reduced the potency of TGFβ on mechanically stretched fibroblasts.ConclusionWe postulate that stretch induced up-regulation of the natriuretic peptide system may contribute to the observed reduction in myofibroblast differentiation.

  20. Psychological Stress In First Year Medical Students In Response To The Dissection Of A Human Corpse

    Science.gov (United States)

    Bernhardt, Veronika; Rothkötter, Hermann Josef; Kasten, Erich

    2012-01-01

    Objectives: Gross anatomy is one of the most important and time consuming subjects in the first preclinical part of medical school in Germany. In October 2007 186 students started the dissection course at Otto-von-Guericke-University Magdeburg. The objective of this study is to analyze the emotional aspect relating to the gross anatomy course. In order to address this issue, we investigated how medical students experience the first confrontation and the following exposure to the dead bodies and whether there are any differences between various groups (age, gender, experience) of students. Methods: The study was carried out with a group of 155 first year medical students (112 female, 43 male, 21.4±2.9 years). Self-composed questionnaires were used to distinguish between concerns related to dissection and individual experiences and anxiety because of deceasing or death. In order to detect the changes of attitudes towards the dissection course, one questionnaire was answered by participants in the beginning of the course and one in the end (n=94, 66 female, 28 male). Additionally, personality traits of the students were analyzed using two scales of the “Freiburger Persönlichkeitsinventar (FPI-R)”. Results: The self-composed questionnaires showed high reliability. For some students dissection was emotional stress; about 50% became anxious when coping the first confrontation, however, only 12% to large extent. Concerning the anxiety of dissection of individual body parts it was less for limbs, internal organs and skin and increased for head and genitals. Although hypothesized before, the correlation between age, extraversion, emotionality and the extent of anxiety were small. Almost 90% of the students approve the early beginning of the gross anatomy course. The follow-up study showed a marked decline of anxiety. Conclusion: Our results show that about 50% of the students started the course with emotional stress and about one-tenth of them were very worried about

  1. Nurturing professionalism and humanism in the 21st century medical professional

    Directory of Open Access Journals (Sweden)

    Vijay Rajput, MD

    2014-12-01

    Full Text Available There is a need to redefine physician excellence through promoting professionalism with humanism to meet the needs of a diverse generational and cultural society. My goal is to bring together and advance concepts that cultivate emotional and social intelligence to complement the clinical skills required for the effective practice of medicine in the complex milieu of the 21st century

  2. The Human Rights Context for Ethical Requirements for Involving People with Intellectual Disability in Medical Research

    Science.gov (United States)

    Iacono, T.; Carling-Jenkins, R.

    2012-01-01

    Background: The history of ethical guidelines addresses protection of human rights in the face of violations. Examples of such violations in research involving people with intellectual disabilities (ID) abound. We explore this history in an effort to understand the apparently stringent criteria for the inclusion of people with ID in research, and…

  3. 78 FR 12664 - Human Subject Protection; Acceptance of Data From Clinical Studies for Medical Devices

    Science.gov (United States)

    2013-02-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Parts 807, 812, and... this document) identifying ethical and other principles that provide assurance of the quality and... communities as ``a standard for the design, conduct, performance, monitoring, auditing, recording, analyses...

  4. The Human Volunteer in Military Biomedical Research (Military Medical Ethics. Volume 2, Chapter 19)

    Science.gov (United States)

    2002-10-01

    justice have long been associated with social practices such as punishment, taxation and political The Human Volunteer in Military Biomedical Research...suspension of eligibility to receive research funding, to use investigational interventions, or to practise medicine. Unless there are persuasive reasons to do

  5. Egyptian Journal of Medical Human Genetics - Vol 10, No 1 (2009)

    African Journals Online (AJOL)

    EEG changes and neuroimaging abnormalities in relevance to severity of autism · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT ... Detection of human telomerase reverse transcriptase messenger RNA in urine of high risk patients as a non invasive molecular diagnostic tool for urinary bladder cancer in Egyptians ...

  6. Differences in Moral Judgment on Animal and Human Ethics Issues between University Students in Animal-Related, Human Medical and Arts Programs.

    Science.gov (United States)

    Verrinder, Joy M; Ostini, Remo; Phillips, Clive J C

    2016-01-01

    Moral judgment in relation to animal ethics issues has rarely been investigated. Among the research that has been conducted, studies of veterinary students have shown greater use of reasoning based on universal principles for animal than human ethics issues. This study aimed to identify if this was unique to students of veterinary and other animal-related professions. The moral reasoning of first year students of veterinary medicine, veterinary technology, and production animal science was compared with that of students in non-animal related disciplines of human medicine and arts. All students (n = 531) completed a moral reasoning test, the VetDIT, with animal and human scenarios. When compared with reasoning on human ethics issues, the combined group of students evaluating animal ethics issues showed higher levels of Universal Principles reasoning, lower levels of Personal Interest reasoning and similar levels of Maintaining Norms reasoning. Arts students showed more personal interest reasoning than students in most animal-related programs on both animal and human ethics issues, and less norms-based reasoning on animal ethics issues. Medical students showed more norms-based reasoning on animal ethics issues than all of the animal-related groups. There were no differences in principled reasoning on animal ethics issues between program groups. This has implications for animal-related professions and education programs showing that students' preference for principled reasoning on animal ethics issues is not unique to animal-related disciplines, and highlighting the need to develop student (and professional) capacity to apply principled reasoning to address ethics issues in animal industries to reduce the risk of moral distress.

  7. Differences in Moral Judgment on Animal and Human Ethics Issues between University Students in Animal-Related, Human Medical and Arts Programs

    Science.gov (United States)

    Verrinder, Joy M.; Ostini, Remo; Phillips, Clive J. C.

    2016-01-01

    Moral judgment in relation to animal ethics issues has rarely been investigated. Among the research that has been conducted, studies of veterinary students have shown greater use of reasoning based on universal principles for animal than human ethics issues. This study aimed to identify if this was unique to students of veterinary and other animal-related professions. The moral reasoning of first year students of veterinary medicine, veterinary technology, and production animal science was compared with that of students in non-animal related disciplines of human medicine and arts. All students (n = 531) completed a moral reasoning test, the VetDIT, with animal and human scenarios. When compared with reasoning on human ethics issues, the combined group of students evaluating animal ethics issues showed higher levels of Universal Principles reasoning, lower levels of Personal Interest reasoning and similar levels of Maintaining Norms reasoning. Arts students showed more personal interest reasoning than students in most animal-related programs on both animal and human ethics issues, and less norms-based reasoning on animal ethics issues. Medical students showed more norms-based reasoning on animal ethics issues than all of the animal-related groups. There were no differences in principled reasoning on animal ethics issues between program groups. This has implications for animal-related professions and education programs showing that students’ preference for principled reasoning on animal ethics issues is not unique to animal-related disciplines, and highlighting the need to develop student (and professional) capacity to apply principled reasoning to address ethics issues in animal industries to reduce the risk of moral distress. PMID:26934582

  8. Civil defense should be mandatory

    International Nuclear Information System (INIS)

    Kearney, C.H.

    1985-01-01

    In this paper, the author exposes myths about the effects of nuclear weapons so that the U.S. can begin the necessary task of a mandatory civil defense program. An all-out nuclear war between Russia and the United States would be the worst catastrophe in history, a tragedy so huge it is difficult to comprehend. Even so, it would be far from the end of human life on earth. The dangers from nuclear weapons have been distorted and exaggerated for varied reasons. These exaggerations have become demoralizing myths, believed by millions of Americans. The author has found that many people see no sense in talking about details of survival skills. Only after they have begun to question the truth of these myths do they become interested, under normal peacetime conditions, in acquiring nuclear war survival skills. The author examines the most harmful of the myths about nuclear war dangers, along with some of the grim facts

  9. IMASIS computer-based medical record project: dealing with the human factor.

    Science.gov (United States)

    Martín-Baranera, M; Planas, I; Palau, J; Sanz, F

    1995-01-01

    The Institut Municipal d'Assistència Sanitària (IMAS) is a health care organization in Barcelona, comprising two general hospitals, a psychiatric hospital, a surgical clinic, a geriatric center, some primary care clinics, and a research institute. Since 1984, IMAS has been engaged in creating a multicenter integrated hospital information system (IMASIS). Currently, IMASIS offers the possibility to manage administrative data, laboratory results, pathology and cytology reports, radiology reports, and pharmacy inpatient orders; it also shares this information on-line among IMAS centers. IMASIS users may also work with a word processor, a spreadsheet, a database, or a statistical package and have access to MEDLINE. A second phase of IMASIS development began in December 1993 focused on clinical information management. The goal was to move towards an integrated multimedia medical record [1]. As a first step, the implementation experiences of the most advanced hospital information systems around the world were studied. Some of these experiences detected behavioral, cultural, and organizational factors [2] as the main sources of delay, or even failure, in HIS projects. A preliminary analysis to define such factors, assess their potential impact, and introduce adequate measures to deal with them seemed unavoidable before structuring of the project. In our approach to physician attitudes analysis, two survey techniques were applied. First, every hospital service head was contacted to schedule an interview, with either a service representative or a group of staff physicians and residents. The aim was to provide detailed information about project objectives and collect personal opinions, problems encountered in the current HIS, and specific needs of every medical and surgical specialty (including imaging needs). Every service head was asked to distribute a questionnaire among all clinicians, which assessed frequency of use of IMASIS current applications, user's satisfaction

  10. Department of Defense Joint Chemical and Biological Defense Program 2009 Annual Report to Congress

    Science.gov (United States)

    2009-03-27

    private sector all partner with the DoD CBDP to fulfill its mission to provide CBRN defense capabilities in support of the National Military Strategies...Venezuelan, and Eastern Equine Encephalitis) delivered by electroporation which showed high efficacy in non-human primates. Developed five technology

  11. Developing a pilot curriculum to foster humanism among graduate medical trainees.

    Science.gov (United States)

    Dotters-Katz, Sarah K; Chuang, Alice; Weil, Amy; Howell, Jennifer O

    2018-01-01

    Humanism is a central tenant of professionalism, a required competency for all residency programs. Yet, few residencies have formal curriculum for teaching this critical aspect of medicine. Instead, professionalism and humanism are often taught informally through role-modeling. With increased burnout, faculty professionalism may suffer and may compromise resident role-modeling. The objective of this study was to design a pilot curriculum to foster humanism in among residents and assess its ability to do so. Two-phase exploratory sequential mixed methods study. Phase 1: a qualitative analysis of residents' narratives regarding challenges to humanistic behavior, and identified themes of compassion, fatigue, communication challenges, and work-life balance. Themes used as needs assessment to build curriculum. Phase 2: three sessions with themes taken from faculty development course. Participants and controls completed baseline and 60-day follow-up questionnaires assessing burnout, compassion, satisfaction, and ability to practice psychological medicine. Phase one included Obstetrics/Gynecology and internal medicine residents. Phase two included residents from the above programs, who attended at least 2/3 interactive sessions designed to address the themes identified above. Twelve participants began and ten completed curriculum (83%). The curriculum met course objectives and was well-received (4.8/5). Burnout decreased (-3.1 vs. 2.5, P = 0.048). A trend toward improved compassion (4.4 vs.-0.6, P = 0.096) for participants compared to controls was noted. A pilot humanism curriculum for residents was well-received. Participants showed decreased burnout and trended to improved compassion scores. Development and evaluation of an expanded curriculum would further explore feasibility and effectiveness of the intervention.

  12. From Collective Adaptive Systems to Human Centric Computation and Back: Spatial Model Checking for Medical Imaging

    Directory of Open Access Journals (Sweden)

    Gina Belmonte

    2016-07-01

    Full Text Available Recent research on formal verification for Collective Adaptive Systems (CAS pushed advancements in spatial and spatio-temporal model checking, and as a side result provided novel image analysis methodologies, rooted in logical methods for topological spaces. Medical Imaging (MI is a field where such technologies show potential for ground-breaking innovation. In this position paper, we present a preliminary investigation centred on applications of spatial model checking to MI. The focus is shifted from pure logics to a mixture of logical, statistical and algorithmic approaches, driven by the logical nature intrinsic to the specification of the properties of interest in the field. As a result, novel operators are introduced, that could as well be brought back to the setting of CAS.

  13. Motivating Human Resources for Health at Govt Medical Colleges: The leaders' Way

    Directory of Open Access Journals (Sweden)

    Ravinder Nath Bansal

    2016-10-01

    Full Text Available Public sector organisations have limited scope for incentives, performance based pay and promotions. Leaders can influence public service motivation through several mechanisms including engaging employees existing values, infusing jobs with meaning and highlighting and rewarding public service values. Current research was aimed to study the impact of leader behaviour aspects on motivation levels of different types of personnel working at a non-profit making teaching medical college. Results suggested that impact of leaders behaviour must be studied separately for different professional groups. Approach to motivating different category of professionals needs to be different. Not all leader behaviour aspects have similar impact on motivation of different professional groups and organsiations. Government sector organisations having limited scope for external motivation and must look at creating provisions for contingent rewards. Nursing professionals need immediate management focus for better patient care.

  14. Defense Primer: Procurement

    Science.gov (United States)

    2017-02-10

    Usually, incremental funding is used to mitigate peaks and valleys in annual budgets caused by the cost of one item significantly changing the...base defense budget . DOD uses these funds to buy several different types of materiel, including  new items easily recognizable as military...pursues a policy of full funding for procurement, meaning that the total estimated cost of each unit must be funded in the year it is budgeted . In a

  15. Quadrennial Defense Review Report

    Science.gov (United States)

    2010-02-01

    medicine , and computer network operations. While we continue to employ a mix of programs and incentives to recruit quality personnel, we are also...Lithuania* Singapore Australia Finland Luxembourg* Slovakia* Austria France* Macedonia Slovenia* Azerbaijan Georgia Montenegro Spain* Belgium...20,000 positions by 2015. We will continue to significantly enhance Secretary of Defense Robert M. Gates meets with plant workers during a tour of an

  16. Whither Ballistic Missile Defense?

    Science.gov (United States)

    1992-11-30

    important that technology today is placing enormous power in the many camps-not only information that enables timely decision-making, but also the...WHITHER BALLISTIC MISSILE DEFENSE? BY AMBASSADOR HENRY F. COOPER NOVEMBER 30,1992 TECHNICAL MARKETING SOCIETY OF AMERICA WASHINGTON, DC...Conference on Technical Marketing 2000: Opportunities and Strategies for a Changing World) I intend to discuss the prospects for SDI in a changing

  17. Plant defense against insect herbivores

    DEFF Research Database (Denmark)

    Fürstenberg-Hägg, Joel; Zagrobelny, Mika; Bak, Søren

    2013-01-01

    , defense compounds. These bioactive specialized plant defense compounds may repel or intoxicate insects, while defense proteins often interfere with their digestion. Volatiles are released upon herbivory to repel herbivores, attract predators or for communication between leaves or plants, and to induce......Plants have been interacting with insects for several hundred million years, leading to complex defense approaches against various insect feeding strategies. Some defenses are constitutive while others are induced, although the insecticidal defense compound or protein classes are often similar...... defense responses. Plants also apply morphological features like waxes, trichomes and latices to make the feeding more difficult for the insects. Extrafloral nectar, food bodies and nesting or refuge sites are produced to accommodate and feed the predators of the herbivores. Meanwhile, herbivorous insects...

  18. Human Thiel-Embalmed Cadaveric Aortic Model with Perfusion for Endovascular Intervention Training and Medical Device Evaluation.

    Science.gov (United States)

    McLeod, Helen; Cox, Ben F; Robertson, James; Duncan, Robyn; Matthew, Shona; Bhat, Raj; Barclay, Avril; Anwar, J; Wilkinson, Tracey; Melzer, Andreas; Houston, J Graeme

    2017-09-01

    The purpose of this investigation was to evaluate human Thiel-embalmed cadavers with the addition of extracorporeal driven ante-grade pulsatile flow in the aorta as a model for simulation training in interventional techniques and endovascular device testing. Three human cadavers embalmed according to the method of Thiel were selected. Extracorporeal pulsatile ante-grade flow of 2.5 L per min was delivered directly into the aorta of the cadavers via a surgically placed connection. During perfusion, aortic pressure and temperature were recorded and optimized for physiologically similar parameters. Pre- and post-procedure CT imaging was conducted to plan and follow up thoracic and abdominal endovascular aortic repair as it would be in a clinical scenario. Thoracic endovascular aortic repair (TEVAR) and endovascular abdominal repair (EVAR) procedures were conducted in simulation of a clinical case, under fluoroscopic guidance with a multidisciplinary team present. The Thiel cadaveric aortic perfusion model provided pulsatile ante-grade flow, with pressure and temperature, sufficient to conduct a realistic simulation of TEVAR and EVAR procedures. Fluoroscopic imaging provided guidance during the intervention. Pre- and post-procedure CT imaging facilitated planning and follow-up evaluation of the procedure. The human Thiel-embalmed cadavers with the addition of extracorporeal flow within the aorta offer an anatomically appropriate, physiologically similar robust model to simulate aortic endovascular procedures, with potential applications in interventional radiology training and medical device testing as a pre-clinical model.

  19. Example of a Human Factors Engineering approach to a medication administration work system: potential impact on patient safety.

    Science.gov (United States)

    Beuscart-Zéphir, Marie-Catherine; Pelayo, Sylvia; Bernonville, Stéphanie

    2010-04-01

    The objectives of this paper are: In this approach, the implementation of such a complex IT solution is considered a major redesign of the work system. The paper describes the Human Factor (HF) tasks embedded in the project lifecycle: (1) analysis and modelling of the current work system and usability assessment of the medication CPOE solution; (2) HF recommendations for work re-design and usability recommendations for IT system re-engineering both aiming at a safer and more efficient work situation. Standard ethnographic methods were used to support the analysis of the current work system and work situations, coupled with cognitive task analysis methods and documents review. Usability inspection (heuristic evaluation) and both in-lab (simulated tasks) and on-site (real tasks) usability tests were performed for the evaluation of the CPOE candidate. Adapted software engineering models were used in combination with usual textual descriptions, tasks models and mock-ups to support the recommendations for work and product re-design. The analysis of the work situations identified different work organisations and procedures across the hospital's departments. The most important differences concerned the doctor-nurse communications and cooperation modes and the procedures for preparing and administering the medications. The assessment of the medication CPOE functions uncovered a number of usability problems including severe ones leading to impossible to detect or to catch errors. Models of the actual and possible distribution of tasks and roles were used to support decision making in the work design process. The results of the usability assessment were translated into requirements to support the necessary re-engineering of the IT application. The HFE approach to medication CPOE efficiently identifies and distinguishes currently unsafe or uncomfortable work situations that could obviously benefit from an IT solution from other work situations incorporating efficient work

  20. The effects of IL-20 subfamily cytokines on reconstituted human epidermis suggest potential roles in cutaneous innate defense and pathogenic adaptive immunity in psoriasis.

    Science.gov (United States)

    Sa, Susan M; Valdez, Patricia A; Wu, Jianfeng; Jung, Kenneth; Zhong, Fiona; Hall, Linda; Kasman, Ian; Winer, Jane; Modrusan, Zora; Danilenko, Dimitry M; Ouyang, Wenjun

    2007-02-15

    IL-19, IL-20, IL-22, IL-24, and IL-26 are members of the IL-10 family of cytokines that have been shown to be up-regulated in psoriatic skin. Contrary to IL-10, these cytokines signal using receptor complex R1 subunits that are preferentially expressed on cells of epithelial origin; thus, we henceforth refer to them as the IL-20 subfamily cytokines. In this study, we show that primary human keratinocytes (KCs) express receptors for these cytokines and that IL-19, IL-20, IL-22, and IL-24 induce acanthosis in reconstituted human epidermis (RHE) in a dose-dependent manner. These cytokines also induce expression of the psoriasis-associated protein S100A7 and keratin 16 in RHE and cause persistent activation of Stat3 with nuclear localization. IL-22 had the most pronounced effects on KC proliferation and on the differentiation of KCs in RHE, inducing a decrease in the granular cell layer (hypogranulosis). Furthermore, gene expression analysis performed on cultured RHE treated with these cytokines showed that IL-19, IL-20, IL-22, and IL-24 regulate many of these same genes to variable degrees, inducing a gene expression profile consistent with inflammatory responses, wound healing re-epithelialization, and altered differentiation. Many of these genes have also been found to be up-regulated in psoriatic skin, including several chemokines, beta-defensins, S100 family proteins, and kallikreins. These results confirm that IL-20 subfamily cytokines are important regulators of epidermal KC biology with potentially pivotal roles in the immunopathology of psoriasis.

  1. Integration of genomic and medical data into a 3D atlas of human anatomy.

    Science.gov (United States)

    Turinsky, Andrei L; Fanea, Elena; Trinh, Quang; Dong, Xiaoli; Stromer, Julie N; Shu, Xueling; Wat, Stephen; Hallgrímsson, Benedikt; Hill, Jonathan W; Edwards, Carol; Grosenick, Brenda; Yajima, Masumi; Sensen, Christoph W

    2008-01-01

    We have developed a framework for the visual integration and exploration of multi-scale biomedical data, which includes anatomical and molecular components. We have also created a Java-based software system that integrates molecular information, such as gene expression data, into a three-dimensional digital atlas of the male adult human anatomy. Our atlas is structured according to the Terminologia Anatomica. The underlying data-indexing mechanism uses open standards and semantic ontology-processing tools to establish the associations between heterogeneous data types. The software system makes an extensive use of virtual reality visualization.

  2. Medical Hydrogeology of Asian Deltas: Status of Groundwater Toxicants and Nutrients, and Implications for Human Health

    Directory of Open Access Journals (Sweden)

    Mohammad A. Hoque

    2015-12-01

    Full Text Available Drinking water, a fluid primarily for human hydration, is also a source of mineral nutrients. Groundwater, a drinking water source for more than 70% of inhabitants living in Asian deltas, has received much attention because of its naturally occurring arsenic, but the linkage of arsenic toxicity with other water constituents has not been studied. In addition, although nutrients are generally provided by food, in under developed rural settings, where people subsist on low nutrient diets, drinking-water-nutrients may supply quantities critical to human health thereby preventing diseases. Here, we show, using augmented datasets from three Asian deltas (Bengal, Mekong, and Red River, that the chemical content of groundwater is so substantial that in some areas individuals obtain up to 50% or more of the recommended daily intake (RDI of some nutrients (e.g., calcium, magnesium, iron from just two litres of drinking water. We also show some indications of a spatial association of groundwater nutrients and health outcome using demographic health data from Bangladesh. We therefore suggest that an understanding of the association of non-communicable disease and poor nutrition cannot be developed, particularly in areas with high levels of dissolved solids in water sources, without considering the contribution of drinking water to nutrient and mineral supply.

  3. Medical Hydrogeology of Asian Deltas: Status of Groundwater Toxicants and Nutrients, and Implications for Human Health.

    Science.gov (United States)

    Hoque, Mohammad A; Butler, Adrian P

    2015-12-26

    Drinking water, a fluid primarily for human hydration, is also a source of mineral nutrients. Groundwater, a drinking water source for more than 70% of inhabitants living in Asian deltas, has received much attention because of its naturally occurring arsenic, but the linkage of arsenic toxicity with other water constituents has not been studied. In addition, although nutrients are generally provided by food, in under developed rural settings, where people subsist on low nutrient diets, drinking-water-nutrients may supply quantities critical to human health thereby preventing diseases. Here, we show, using augmented datasets from three Asian deltas (Bengal, Mekong, and Red River), that the chemical content of groundwater is so substantial that in some areas individuals obtain up to 50% or more of the recommended daily intake (RDI) of some nutrients (e.g., calcium, magnesium, iron) from just two litres of drinking water. We also show some indications of a spatial association of groundwater nutrients and health outcome using demographic health data from Bangladesh. We therefore suggest that an understanding of the association of non-communicable disease and poor nutrition cannot be developed, particularly in areas with high levels of dissolved solids in water sources, without considering the contribution of drinking water to nutrient and mineral supply.

  4. Online dissection audio-visual resources for human anatomy: Undergraduate medical students' usage and learning outcomes.

    Science.gov (United States)

    Choi-Lundberg, Derek L; Cuellar, William A; Williams, Anne-Marie M

    2016-11-01

    In an attempt to improve undergraduate medical student preparation for and learning from dissection sessions, dissection audio-visual resources (DAVR) were developed. Data from e-learning management systems indicated DAVR were accessed by 28% ± 10 (mean ± SD for nine DAVR across three years) of students prior to the corresponding dissection sessions, representing at most 58% ± 20 of assigned dissectors. Approximately 50% of students accessed all available DAVR by the end of semester, while 10% accessed none. Ninety percent of survey respondents (response rate 58%) generally agreed that DAVR improved their preparation for and learning from dissection when used. Of several learning resources, only DAVR usage had a significant positive correlation (P = 0.002) with feeling prepared for dissection. Results on cadaveric anatomy practical examination questions in year 2 (Y2) and year 3 (Y3) cohorts were 3.9% (P learning outcomes of more students. Anat Sci Educ 9: 545-554. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  5. Human Albumin Use in Adults in U.S. Academic Medical Centers.

    Science.gov (United States)

    Suarez, Jose I; Martin, Renee H; Hohmann, Samuel F; Calvillo, Eusebia; Bershad, Eric M; Venkatasubba Rao, Chethan P; Georgiadis, Alexandros; Flower, Oliver; Zygun, David; Finfer, Simon

    2017-01-01

    To determine rates and predictors of albumin administration, and estimated costs in hospitalized adults in the United States. Cohort study of adult patients from the University HealthSystem Consortium database from 2009 to 2013. One hundred twenty academic medical centers and 299 affiliated hospitals. A total of 12,366,264 hospitalization records. Analysis of rates and predictors of albumin administration, and estimated costs. Overall the proportion of admissions during which albumin was administered increased from 6.2% in 2009 to 7.5% in 2013; absolute difference 1.3% (95% CI, 1.30-1.40%; p Albumin use varied geographically being lowest with no increase in hospitals in the North Eastern United States (4.9% in 2009 and 5.3% in 2013) and was more common in bigger (> 750 beds; 5.2% in 2009 and 7.3% in 2013) compared to smaller hospitals (albumin use were appropriate indication for albumin use (odds ratio, 65.220; 95% CI, 62.459-68.103); surgical admission (odds ratio, 7.942; 95% CI, 7.889-7.995); and high severity of illness (odds ratio, 8.933; 95% CI, 8.825-9.042). Total estimated albumin cost significantly increased from $325 million in 2009 to $468 million in 2013; (absolute increase of $233 million), p value less than 0.0001. The proportion of hospitalized adults in the United States receiving albumin has increased, with marked, and currently unexplained, geographic variability and variability by hospital size.

  6. [Community inclusion as a human right and medical necessity for individuals with serious mental illnesses].

    Science.gov (United States)

    Salzer, Mark S

    2017-09-01

    Community inclusion refers to equal opportunities for people to participate in the community and willingness to welcome and active community attitude. The opportunity to participate in the community is both a medical necessity and a rights issue. This concept provides a novel theoretical framework for the advancement of mental health policies, programs, and global practices that enable the development of the well-being and health of people with mental disorders. Eleven fundamentals for promoting community inclusion of individuals with serious mental illnesses that are supported by key conceptual, theoretical, and research evidence. These fundamentals reflect beliefs and schemas that need to be present to truly prioritize and facilitate inclusion, intervention strategies and achieve the most impactful objectives that were expected. The greater inclusion, greater community participation, which includes work, education, religion and spiritual participation, and other domains associated with having a life that makes sense, all of which generates physical, cognitive and mental benefts for anyone, disregarding the presence or absence of a mental disorder. The concept of community inclusion offers a transformative next step in the delivery of mental health services that clearly articulates community participation in meaningful areas as the target for promoting full health and wellness.

  7. Exploring the effects of telehealth on medical human resources supply: a qualitative case study in remote regions

    Directory of Open Access Journals (Sweden)

    Duplantie Julie

    2007-01-01

    Full Text Available Abstract Background The availability of medical human resource supply is a growing concern for rural and remote communities in many countries. In the last decade, various telehealth experiences in Canada have highlighted the potential impact of this technology on professional practice. The purpose of this study was to explore physicians' and managers' perceptions regarding the potential of telehealth to support recruitment and retention of physicians in remote and rural regions. Methods A case study in Eastern Quebec was performed to explore this complex phenomenon. The analytical framework was based on two literature reviews and a Delphi study. Data were collected from semi-structured interviews with 41 physicians and 22 managers. Transcripts were produced and interview content was coded independently by two judges and validated by an expert panel. Results Interviews have highlighted the potential impact of telehealth on several factors influencing the recruitment and retention of physicians in rural and remote regions. The potential effects of telehealth on physicians' choice of practice location could be seen at the professional, organizational, educational and individual levels. For instance, telehealth could improve work satisfaction by allowing a regional on-call duty system and a better follow-up of patients. However, there are also certain limits related to telehealth, such as the fear that it would eventually replace all continuing medical education activities and onsite specialists in remoteregions. Conclusion Telehealth is likely to have an impact on several factors related to medical workforce supply in remote and rural regions. However, the expected benefits will materialize if and only if this technology is properly integrated into organizations as a support to professional practice.

  8. [Human myoblast culture as muscle stem cells in medical and biological studies].

    Science.gov (United States)

    Terekhov, S M; Krokhina, T B; Shishkin, S S; Krakhmaleva, I N; Zakharov, S F; Ershova, E S

    2001-01-01

    The method for obtaining human myoblast culture has been modified to consider the specific histological localization of the satellite cells as well as their growth properties; the cultivation conditions have been selected to grow up to 150000 cells/cm2. At high densities, the cells remain mononuclear and preserve their typical myoblast morphology as well as the capacity for fusion and the formation of myotubes. By contrast to fibroblasts, up to 80% of the cells in the myoblast culture were positive in the acid phosphatase test, which indicates their stem nature. The obtained myoblast cultures were used in the clinical tests of cell-mediated gene therapy of Duchenne's muscular dystrophy as well as in the bioassay for the effects of biologically active compounds.

  9. Enhancing human-animal relationships through veterinary medical instruction in animal-assisted therapy and animal-assisted activities.

    Science.gov (United States)

    Schaffer, Caroline Brunsman

    2008-01-01

    Instruction in animal-assisted therapy (AAT) and animal-assisted activities (AAAs) teaches veterinary medical students to confidently and assertively maximize the benefits and minimize the risks of this union of animals and people. Instruction in AAT/AAA also addresses requirements by the American Veterinary Medical Association Council on Education that accredited schools/colleges of veterinary medicine include in their standard curriculum the topics of the human-animal bond, behavior, and the contributions of the veterinarian to the overall public and professional health care teams. Entry-level veterinarians should be prepared to: (1) assure that animals who provide AAT/AAA are healthy enough to visit nursing homes, hospitals, or other institutions; (2) promote behavior testing that selects animals who will feel safe, comfortable, and connected; (3) advise facilities regarding infection control and ways to provide a safe environment where the animals, their handlers, and the people being visited will not be injured or become ill; and (4) advocate for their patients and show compassion for their clients when animals are determined to be inappropriate participants in AAT/AAA programs. This article presents AAT/AAA terminology, ways in which veterinarians can advocate for AAT/AAA, the advantages of being involved in AAT/AAA, a model AAT/AAA practicum from Tuskegee University's School of Veterinary Medicine (TUSVM), and examples of co-curricular activities in AAT/AAA by TUSVM's student volunteers.

  10. Coating of human decay accelerating factor (hDAF) onto medical devices to improve biocompatibility.

    Science.gov (United States)

    Watkins, N J; Braidley, P; Bray, C J; Savill, C M; White, D J

    1997-12-01

    In passing blood through an artificial circulatory system, the blood is exposed to surfaces that result in activation of the complement system. The consequences of the activation of complement can be extremely serious for the patient ranging from mild discomfort to respiratory distress and even anaphylaxis. An entirely novel approach was to express recombinant GPI anchored human decay accelerating factor (hDAF) using the baculovirus system and then coat the recombinant protein onto the surfaces of these materials to reduce complement activation. Expression of hDAF in Sf9 cells was shown by ELISA, FACS analysis, and Western blot. Functional activity was tested by CH50 assay. For the coating experiments a small scale model of a cardiovascular bypass circuit constructed from COBE tubing was used. hDAF was either coated onto the circuit using adsorption or covalently linked via the photoreactive crosslinker, p-azidobenzoyl hydrazide. After coating, heparinised human blood was pumped around the circuit and samples were collected into EDTA collection tubes at different time points. Complement activation was measured using a Quidel C3a-des-arg EIA. The photolinked circuits gave a reduction in C3a production of 20-50%, compared to 10-20% seen with an absorbed hDAF circuit. Furthermore, the inhibition of complement was seen over the whole time scale of the photolinked circuit, 60-90 min, whilst in the adsorbed circuit inhibition was not seen to a significant degree after 60 min. The time scale of a standard cardiac bypass is 45-90 min, therefore, the photolinked circuit results are encouraging, as significant inhibition of complement activation is seen within this time frame.

  11. DEFENSE PROGRAMS RISK MANAGEMENT FRAMEWORK

    Directory of Open Access Journals (Sweden)

    Constantin PREDA

    2012-01-01

    Full Text Available For the past years defense programs have faced delays in delivering defense capabilities and budget overruns. Stakeholders are looking for ways to improve program management and the decision making process given the very fluid and uncertain economic and political environment. Consequently, they have increasingly resorted to risk management as the main management tool for achieving defense programs objectives and for delivering the defense capabilities strongly needed for the soldiers on the ground on time and within limited defense budgets. Following a risk management based decision-making approach the stakeholders are expected not only to protect program objectives against a wide range of risks but, at the same time, to take advantage of the opportunities to increase the likelihood of program success. The prerequisite for making risk management the main tool for achieving defense programs objectives is the design and implementation of a strong risk management framework as a foundation providing an efficient and effective application of the best risk management practices. The aim of this paper is to examine the risk management framework for defense programs based on the ISO 31000:2009 standard, best risk management practices and the defense programs’ needs and particularities. For the purposes of this article, the term of defense programs refers to joint defense programs.

  12. Proteasome inhibitors activate autophagy involving inhibition of PI3K-Akt-mTOR pathway as an anti-oxidation defense in human RPE cells.

    Directory of Open Access Journals (Sweden)

    Bingrong Tang

    Full Text Available The two major intracellular protein degradation systems, the ubiquitin-proteasome system (UPS and autophagy, work collaboratively in many biological processes including development, apoptosis, aging, and countering oxidative injuries. We report here that, in human retinal pigment epithelial cells (RPE, ARPE-19 cells, proteasome inhibitors, clasto-lactacystinβ-lactone (LA or epoxomicin (Epo, at non-lethal doses, increased the protein levels of autophagy-specific genes Atg5 and Atg7 and enhanced the conversion of microtubule-associated protein light chain (LC3 from LC3-I to its lipidative form, LC3-II, which was enhanced by co-addition of the saturated concentration of Bafilomycin A1 (Baf. Detection of co-localization for LC3 staining and labeled-lysosome further confirmed autophagic flux induced by LA or Epo. LA or Epo reduced the phosphorylation of the protein kinase B (Akt, a downstream target of phosphatidylinositol-3-kinases (PI3K, and mammalian target of rapamycin (mTOR in ARPE-19 cells; by contrast, the induced changes of autophagy substrate, p62, showed biphasic pattern. The autophagy inhibitor, Baf, attenuated the reduction in oxidative injury conferred by treatment with low doses of LA and Epo in ARPE-19 cells exposed to menadione (VK3 or 4-hydroxynonenal (4-HNE. Knockdown of Atg7 with siRNA in ARPE-19 cells reduced the protective effects of LA or Epo against VK3. Overall, our results suggest that treatment with low levels of proteasome inhibitors confers resistance to oxidative injury by a pathway involving inhibition of the PI3K-Akt-mTOR pathway and activation of autophagy.

  13. Defense Forensic Enterprise: Assessment and Status Report Personnel Accounting Extract

    Science.gov (United States)

    2013-12-01

    pathology , forensic anthropology, forensic toxicology, and DNA analysis to iden- tify human remains. Per DOD Directive 5205.15E, the stakeholders fall...Defense Forensic Enterprise Assessment and Status Report Personnel Accounting Extract Christine A. Hughes • Jeffrey E. Chilton John J. Clifford • C...community-related sections from a CNA report titled, “Defense Forensic Enterprise Assessment and Status Report” [1]. The first sec- tion within this

  14. Malpractice liability and defensive medicine: a national survey of neurosurgeons.

    Directory of Open Access Journals (Sweden)

    Brian V Nahed

    Full Text Available BACKGROUND: Concern over rising healthcare expenditures has led to increased scrutiny of medical practices. As medical liability and malpractice risk rise to crisis levels, the medical-legal environment has contributed to the practice of defensive medicine as practitioners attempt to mitigate liability risk. High-risk specialties, such as neurosurgery, are particularly affected and neurosurgeons have altered their practices to lessen medical-legal risk. We present the first national survey of American neurosurgeons' perceptions of malpractice liability and defensive medicine practices. METHODS: A validated, 51-question online-survey was sent to 3344 practicing U.S. neurosurgeon members of the American Association of Neurological Surgeons, which represents 76% of neurosurgeons in academic and private practices. RESULTS: A total of 1028 surveys were completed (31% response rate by neurosurgeons representing diverse sub-specialty practices. Respondents engaged in defensive medicine practices by ordering additional imaging studies (72%, laboratory tests (67%, referring patients to consultants (66%, or prescribing medications (40%. Malpractice premiums were considered a "major or extreme" burden by 64% of respondents which resulted in 45% of respondents eliminating high-risk procedures from their practice due to liability concerns. CONCLUSIONS: Concerns and perceptions about medical liability lead practitioners to practice defensive medicine. As a result, diagnostic testing, consultations and imaging studies are ordered to satisfy a perceived legal risk, resulting in higher healthcare expenditures. To minimize malpractice risk, some neurosurgeons have eliminated high-risk procedures. Left unchecked, concerns over medical liability will further defensive medicine practices, limit patient access to care, and increase the cost of healthcare delivery in the United States.

  15. Malpractice liability and defensive medicine: a national survey of neurosurgeons.

    Science.gov (United States)

    Nahed, Brian V; Babu, Maya A; Smith, Timothy R; Heary, Robert F

    2012-01-01

    Concern over rising healthcare expenditures has led to increased scrutiny of medical practices. As medical liability and malpractice risk rise to crisis levels, the medical-legal environment has contributed to the practice of defensive medicine as practitioners attempt to mitigate liability risk. High-risk specialties, such as neurosurgery, are particularly affected and neurosurgeons have altered their practices to lessen medical-legal risk. We present the first national survey of American neurosurgeons' perceptions of malpractice liability and defensive medicine practices. A validated, 51-question online-survey was sent to 3344 practicing U.S. neurosurgeon members of the American Association of Neurological Surgeons, which represents 76% of neurosurgeons in academic and private practices. A total of 1028 surveys were completed (31% response rate) by neurosurgeons representing diverse sub-specialty practices. Respondents engaged in defensive medicine practices by ordering additional imaging studies (72%), laboratory tests (67%), referring patients to consultants (66%), or prescribing medications (40%). Malpractice premiums were considered a "major or extreme" burden by 64% of respondents which resulted in 45% of respondents eliminating high-risk procedures from their practice due to liability concerns. Concerns and perceptions about medical liability lead practitioners to practice defensive medicine. As a result, diagnostic testing, consultations and imaging studies are ordered to satisfy a perceived legal risk, resulting in higher healthcare expenditures. To minimize malpractice risk, some neurosurgeons have eliminated high-risk procedures. Left unchecked, concerns over medical liability will further defensive medicine practices, limit patient access to care, and increase the cost of healthcare delivery in the United States.

  16. External dose estimation of the human associated with companion animals under veterinary nuclear medical diagnosis

    International Nuclear Information System (INIS)

    Ito, Nobuhiko; Hanawa, Asumi; Suzuki, Kanan

    2004-01-01

    This study was performed in order to make a safety guideline for veterinary nuclear medicine in Japan. Well often used radionuclides ( 18 F and 99 mTc) were employed for evaluating the external radiation exposures of veterinarians, animal owners, and the public. The human external radiation exposure from radiation sources in phantom likened to animal was considered by comparing the results of computer simulation and the actually measured exposure. The computer simulation was performed by using macro program of Microsoft Visual Basic for Applications (VBA). In this simulation calculation process, radiation absorption and buildup were taken into consideration with the gamma ray emitted from radioactive materials in the body of the animal. Both corresponded well though the simulation result tended to be overvalued from the actual measurement value. Therefore, it is thought that this system can be applied to the estimation of human's external exposure. When the calculation was done on the condition that the radioactive substance exists only in internal organs (heart, liver, kidneys, and bladder), the unequal distribution of the dose rate was found near the animal body. External radiation exposure estimation to the veterinarian, the animal owner and the public was performed under consideration of the actual working condition, the distance from the source, and the time of exposure. In the calculation, the radiation dose of the animal owner and the public did not exceed the dose limit (5 mSv/yr for the animal owner, and 1 mSv/yr for the general public: International Commission of Radiological Protection (ICRP) 1990) in the release after 24 hours of the radiopharmaceutical administering. The calculation condition used in this study was actually more excessive. So the authors consider these exposures would cause no significant issue by starting the veterinary nuclear medicine in Japan. Moreover, since injected radiopharmaceutical is excreted out of the body actually, the

  17. Human Capital Overview

    National Research Council Canada - National Science Library

    McCarthy, Ellen E

    2007-01-01

    ...: To provide an agile, adaptive, integrated, and innovative defense intelligence workforce through a deliberate process identifying, implementing, and directing human capital organizational, doctrinal...

  18. Nanomaterials for Defense Applications

    Science.gov (United States)

    Turaga, Uday; Singh, Vinitkumar; Lalagiri, Muralidhar; Kiekens, Paul; Ramkumar, Seshadri S.

    Nanotechnology has found a number of applications in electronics and healthcare. Within the textile field, applications of nanotechnology have been limited to filters, protective liners for chemical and biological clothing and nanocoatings. This chapter presents an overview of the applications of nanomaterials such as nanofibers and nanoparticles that are of use to military and industrial sectors. An effort has been made to categorize nanofibers based on the method of production. This chapter particularly focuses on a few latest developments that have taken place with regard to the application of nanomaterials such as metal oxides in the defense arena.

  19. Phenomenon of Psychological Defense

    Directory of Open Access Journals (Sweden)

    Elena T. Sokolova

    2011-01-01

    Full Text Available The author discusses the controversial issues of formation and functioning of psy¬chological defense mechanisms in ontogenesis and in personality disorders as they are represented in classical and contemporary psychoanalysis, in cognitivism and communication theory. The paper emphasizes the role of cognitive organi¬zation (style, sign-symbolic mediation, representative system of object relations and attachments in individual typological variability of the level organization of ciency of personal and social adaptation, in maturity and mental health of personality

  20. Tripolar mitosis in human cells and embryos: occurrence, pathophysiology and medical implications.

    Science.gov (United States)

    Kalatova, Beata; Jesenska, Renata; Hlinka, Daniel; Dudas, Marek

    2015-01-01

    Tripolar mitosis is a specific case of cell division driven by typical molecular mechanisms of mitosis, but resulting in three daughter cells instead of the usual count of two. Other variants of multipolar mitosis show even more mitotic poles and are relatively rare. In nature, this phenomenon was frequently observed or suspected in multiple common cancers, infected cells, the placenta, and in early human embryos with impaired pregnancy-yielding potential. Artificial causes include radiation and various toxins. Here we combine several pieces of the most recent evidence for the existence of different types of multipolar mitosis in preimplantation embryos together with a detailed review of the literature. The related molecular and cellular mechanisms are discussed, including the regulation of centriole duplication, mitotic spindle biology, centromere functions, cell cycle checkpoints, mitotic autocorrection mechanisms, and the related complicating factors in healthy and affected cells, including post-mitotic cell-cell fusion often associated with multipolar cell division. Clinical relevance for oncology and embryo selection in assisted reproduction is also briefly discussed in this context. Copyright © 2014 Elsevier GmbH. All rights reserved.

  1. Quantitative Circulatory Physiology: an integrative mathematical model of human physiology for medical education.

    Science.gov (United States)

    Abram, Sean R; Hodnett, Benjamin L; Summers, Richard L; Coleman, Thomas G; Hester, Robert L

    2007-06-01

    We have developed Quantitative Circulatory Physiology (QCP), a mathematical model of integrative human physiology containing over 4,000 variables of biological interactions. This model provides a teaching environment that mimics clinical problems encountered in the practice of medicine. The model structure is based on documented physiological responses within peer-reviewed literature and serves as a dynamic compendium of physiological knowledge. The model is solved using a desktop, Windows-based program, allowing students to calculate time-dependent solutions and interactively alter over 750 parameters that modify physiological function. The model can be used to understand proposed mechanisms of physiological function and the interactions among physiological variables that may not be otherwise intuitively evident. In addition to open-ended or unstructured simulations, we have developed 30 physiological simulations, including heart failure, anemia, diabetes, and hemorrhage. Additional stimulations include 29 patients in which students are challenged to diagnose the pathophysiology based on their understanding of integrative physiology. In summary, QCP allows students to examine, integrate, and understand a host of physiological factors without causing harm to patients. This model is available as a free download for Windows computers at http://physiology.umc.edu/themodelingworkshop.

  2. Just another reproductive technology? The ethics of human reproductive cloning as an experimental medical procedure.

    Science.gov (United States)

    Elsner, D

    2006-10-01

    Human reproductive cloning (HRC) has not yet resulted in any live births. There has been widespread condemnation of the practice in both the scientific world and the public sphere, and many countries explicitly outlaw the practice. Concerns about the procedure range from uncertainties about its physical safety to questions about the psychological well-being of clones. Yet, key aspects such as the philosophical implications of harm to future entities and a comparison with established reproductive technologies such as in vitro fertilisation (IVF) are often overlooked in discussions about HRC. Furthermore, there are people who are willing to use the technology. Several scientists have been outspoken in their intent to pursue HRC. The importance of concerns about the physical safety of children created by HRC and comparisons with concerns about the safety of IVF are discussed. A model to be used to determine when it is acceptable to use HRC and other new assisted reproductive technologies, balancing reproductive freedom and safety concerns, is proposed. Justifications underpinning potential applications of HRC are discussed, and it is determined that these are highly analogous to rationalisations used to justify IVF treatment. It is concluded that people wishing to conceive using HRC should have a prima facie negative right to do so.

  3. Feature Selection for Nonstationary Data: Application to Human Recognition Using Medical Biometrics.

    Science.gov (United States)

    Komeili, Majid; Louis, Wael; Armanfard, Narges; Hatzinakos, Dimitrios

    2018-05-01

    Electrocardiogram (ECG) and transient evoked otoacoustic emission (TEOAE) are among the physiological signals that have attracted significant interest in biometric community due to their inherent robustness to replay and falsification attacks. However, they are time-dependent signals and this makes them hard to deal with in across-session human recognition scenario where only one session is available for enrollment. This paper presents a novel feature selection method to address this issue. It is based on an auxiliary dataset with multiple sessions where it selects a subset of features that are more persistent across different sessions. It uses local information in terms of sample margins while enforcing an across-session measure. This makes it a perfect fit for aforementioned biometric recognition problem. Comprehensive experiments on ECG and TEOAE variability due to time lapse and body posture are done. Performance of the proposed method is compared against seven state-of-the-art feature selection algorithms as well as another six approaches in the area of ECG and TEOAE biometric recognition. Experimental results demonstrate that the proposed method performs noticeably better than other algorithms.

  4. Medical Imaging and the Human Brain: Being Warped is Not Always a Bad Thing

    International Nuclear Information System (INIS)

    Patterson, James C. II

    2005-01-01

    The capacity to look inside the living human brain and image its function has been present since the early 1980s. There are some clinicians who use functional brain imaging for diagnostic or prognostic purposes, but much of the work done still relates to research evaluation of brain function. There is a striking dichotomy in the use of functional brain imaging between these two fields. Clinical evaluation of a brain PET or SPECT scan is subjective; that is, a Nuclear Medicine physician examines the brain image, and states whether the brain image looks normal or abnormal. On the other hand, modern research evaluation of functional brain images is almost always objective. Brain images are processed and analyzed with advanced software tools, and a mathematical result that relates to regional changes in brain activity is provided. The potential for this research methodology to provide a more accurate and reliable answer to clinical questions about brain function and pathology are immense, but there are still obstacles to overcome. Foremost in this regard is the use of a standardized normal control database for comparison of patient scan data. The tools and methods used in objective analysis of functional imaging data, as well as potential clinical applications will be the focus of my presentation

  5. Defense Treaty Inspection Readiness Program

    International Nuclear Information System (INIS)

    Cronin, J.J.; Kohen, M.D.; Rivers, J.D.

    1996-01-01

    The Defense Treaty Inspection Readiness Program (DTIRP) was established by the Department of Defense in 1990 to assist defense facilities in preparing for treaty verification activities. Led by the On-Site Inspection Agency (OSIA), an element of the Department of Defense, DTIRP''s membership includes representatives from other Department of Defense agencies, the Department of Energy (DOE), the Central Intelligence Agency, the Federal Bureau of Investigation, the Department of Commerce, and others. The Office of Safeguards and Security has a significant interest in this program, due to the number of national defense facilities within its purview that are candidates for future inspections. As a result, the Office of Safeguards and Security has taken a very active role in DTIRP. This paper discusses the Office of Safeguards and Security''s increasing involvement in various elements of the DTIRP, ranging from facility assessments to training development and implementation

  6. Ballistic Missile Defense in Europe

    OpenAIRE

    Sarihan, Ali; Bush, Amy; Summers, Lawrence; Thompson, Brent; Tomasszewski, Steven

    2009-01-01

    This paper will build on ballistic missile defense in Europe. In the first part, a brief historical overview will place the current public management issue into light. This is followed by a discussion of the main actors in the international debate, the problems that arise and the available options and recommendations to address missile defense. In the second part, differences between George W. Bush and Barack H. Obama will analyze under the title “Ballistic Missile Defense in Europe: Evolving...

  7. Implementation of "social and communicative competencies" in medical education. The importance of curriculum, organisational and human resource development.

    Science.gov (United States)

    Pruskil, Susanne; Deis, Nicole; Druener, Susanne; Kiessling, Claudia; Philipp, Swetlana; Rockenbauch, Katrin

    2015-01-01

    With this article we want to support teachers and curriculum planners to be aware of and apply knowledge and recommendations of organisational (OD), curriculums (CD) and human resource development (HRD) ideas already in the planning phase of a project. Taking these into account can influence the process of change successfully and controlled during the introduction and establishment of curricula in the field of communication and social skills in medical education. In the context of a multi-stage developmental process, a recommendation on CD for "Communicative and social competencies" was developed. The basis for it was made during two workshops of the GMA-committee "Communicative and social competencies" and supplemented by the available literature and the experience of communication experts. The "Undeloher Recommendation" (see attachment ) includes a compilation of recommendations and guiding questions, which is geared to the various phases of CD. Additionally, general approaches and recommendations of organisational and human resource development were integrated, which turned out to be particularly relevant in the process of CD. Thus, the "Undeloher recommendation" includes an orientation for each phase of the curriculum development process, the organisation and the staff in order to successfully implement a longitudinal curriculum. In addition to theoretical models the long-term discussion process and the personal experiences of a variety of curriculum planners and teachers have been integrated. The "Undeloher recommendation" can support the implementation processes of curricula in communication and social skills during development and realisation. Its application was reviewed in the context of workshops based on concrete examples. The participating teachers and curriculum planners assessed it to be very helpful. The recommendation goes beyond of what has been described in terms of content models in the CD so fare. In particular, the organisational and human

  8. Defense Programs and Budget Risk

    National Research Council Canada - National Science Library

    Troutman, Mark D

    2006-01-01

    .... Therefore the Defense Department has set before itself a requirement to modernize a large conventional force structure engaged in ongoing combat operations while simultaneously developing deeper...

  9. Integrated Cyber Defenses: Towards Cyber Defense Doctrine

    Science.gov (United States)

    2007-12-01

    and spam filters, mail relays, antivirus /antimalware software , router Access Control Lists (ACLs), cryptography and encryption, user access... Cisco ), network protocols (like TCP/IP [Transmission Control Protocol/Internet Protocol]), programs, programming languages (like C++, Java, ActiveX...rules were built into them. Since these are human-made rules, they can be changed by replacing or updating hardware and/or software . Unlike the

  10. Defense.gov Special Report: Defense Officials Release Operational Energy

    Science.gov (United States)

    , DOD Operational Energy Strategy DOD's Operational Energy Strategy will guide the Defense Department to operations are among the goals of the Defense Department's operational energy strategy, a senior Pentagon operational energy footprint, experts in solar power, microgrids and "smart" generators recently

  11. Induction of defensive enzymes (isozymes) during defense against ...

    African Journals Online (AJOL)

    user

    2012-09-06

    Sep 6, 2012 ... defense against two different fungal pathogens in pear calli ... study the biochemical changes in relation to plant defense ... relatively easy to manipulate by empirical means, allowing for a ... earlier phase, and the degree of rot was significantly ..... resistance of fruit, and they play an important role in the.

  12. 32 CFR 564.37 - Medical care.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Medical care. 564.37 Section 564.37 National... REGULATIONS Medical Attendance and Burial § 564.37 Medical care. (a) General. The definitions of medical care; policies outlining the manner, conditions, procedures, and eligibility for care; and the sources from which...

  13. Infection and cellular defense dynamics in a novel 17β-estradiol murine model of chronic human group B streptococcus genital tract colonization reveal a role for hemolysin in persistence and neutrophil accumulation.

    Science.gov (United States)

    Carey, Alison J; Tan, Chee Keong; Mirza, Shaper; Irving-Rodgers, Helen; Webb, Richard I; Lam, Alfred; Ulett, Glen C

    2014-02-15

    Genital tract carriage of group B streptococcus (GBS) is prevalent among adult women; however, the dynamics of chronic GBS genital tract carriage, including how GBS persists in this immunologically active host niche long term, are not well defined. To our knowledge, in this study, we report the first animal model of chronic GBS genital tract colonization using female mice synchronized into estrus by delivery of 17β-estradiol prior to intravaginal challenge with wild-type GBS 874391. Cervicovaginal swabs, which were used to measure bacterial persistence, showed that GBS colonized the vaginal mucosa of mice at high numbers (10(6)-10(7) CFU/swab) for at least 90 d. Cellular and histological analyses showed that chronic GBS colonization of the murine genital tract caused significant lymphocyte and PMN cell infiltrates, which were localized to the vaginal mucosal surface. Long-term colonization was independent of regular hormone cycling. Immunological analyses of 23 soluble proteins related to chemotaxis and inflammation showed that the host response to GBS in the genital tract comprised markers of innate immune activation including cytokines such as GM-CSF and TNF-α. A nonhemolytic isogenic mutant of GBS 874391, Δcyle9, was impaired for colonization and was associated with amplified local PMN responses. Induction of DNA neutrophil extracellular traps, which was observed in GBS-infected human PMNs in vitro in a hemolysin-dependent manner, appeared to be part of this response. Overall, this study defines key infection dynamics in a novel murine model of chronic GBS genital tract colonization and establishes previously unknown cellular and soluble defense responses to GBS in the female genital tract.

  14. Human capital strategy: talent management.

    Science.gov (United States)

    Nagra, Michael

    2011-01-01

    Large organizations, including the US Army Medical Department and the Army Nurse Corps, are people-based organizations. Consequently, effective and efficient management of the human capital within these organizations is a strategic goal for the leadership. Over time, the Department of Defense has used many different systems and strategies to manage people throughout their service life-cycle. The current system in use is called Human Capital Management. In the near future, the Army's human capital will be managed based on skills, knowledge, and behaviors through various measurement tools. This article elaborates the human capital management strategy within the Army Nurse Corps, which identifies, develops, and implements key talent management strategies under the umbrella of the Corps' human capital goals. The talent management strategy solutions are aligned under the Nurse Corps business strategy captured by the 2008 Army Nurse Corps Campaign Plan, and are implemented within the context of the culture and core values of the organization.

  15. Antipredator defenses predict diversification rates

    Science.gov (United States)

    Arbuckle, Kevin; Speed, Michael P.

    2015-01-01

    The “escape-and-radiate” hypothesis predicts that antipredator defenses facilitate adaptive radiations by enabling escape from constraints of predation, diversified habitat use, and subsequently speciation. Animals have evolved diverse strategies to reduce the direct costs of predation, including cryptic coloration and behavior, chemical defenses, mimicry, and advertisement of unprofitability (conspicuous warning coloration). Whereas the survival consequences of these alternative defenses for individuals are well-studied, little attention has been given to the macroevolutionary consequences of alternative forms of defense. Here we show, using amphibians as the first, to our knowledge, large-scale empirical test in animals, that there are important macroevolutionary consequences of alternative defenses. However, the escape-and-radiate hypothesis does not adequately describe them, due to its exclusive focus on speciation. We examined how rates of speciation and extinction vary across defensive traits throughout amphibians. Lineages that use chemical defenses show higher rates of speciation as predicted by escape-and-radiate but also show higher rates of extinction compared with those without chemical defense. The effect of chemical defense is a net reduction in diversification compared with lineages without chemical defense. In contrast, acquisition of conspicuous coloration (often used as warning signals or in mimicry) is associated with heightened speciation rates but unchanged extinction rates. We conclude that predictions based on the escape-and-radiate hypothesis must incorporate the effect of traits on both speciation and extinction, which is rarely considered in such studies. Our results also suggest that knowledge of defensive traits could have a bearing on the predictability of extinction, perhaps especially important in globally threatened taxa such as amphibians. PMID:26483488

  16. Medical Students' Exposure to the Humanities Correlates with Positive Personal Qualities and Reduced Burnout: A Multi-Institutional U.S. Survey.

    Science.gov (United States)

    Mangione, Salvatore; Chakraborti, Chayan; Staltari, Giuseppe; Harrison, Rebecca; Tunkel, Allan R; Liou, Kevin T; Cerceo, Elizabeth; Voeller, Megan; Bedwell, Wendy L; Fletcher, Keaton; Kahn, Marc J

    2018-05-01

    Literature, music, theater, and visual arts play an uncertain and limited role in medical education. One of the arguments often advanced in favor of teaching the humanities refers to their capacity to foster traits that not only improve practice, but might also reduce physician burnout-an increasing scourge in today's medicine. Yet, research remains limited. To test the hypothesis that medical students with higher exposure to the humanities would report higher levels of positive physician qualities (e.g., wisdom, empathy, self-efficacy, emotional appraisal, spatial skills), while reporting lower levels of negative qualities that are detrimental to physician well-being (e.g., intolerance of ambiguity, physical fatigue, emotional exhaustion, and cognitive weariness). An online survey. All students enrolled at five U.S. medical schools during the 2014-2015 academic year were invited by email to take part in our online survey. Students reported their exposure to the humanities (e.g., music, literature, theater, visual arts) and completed rating scales measuring selected personal qualities. In all, 739/3107 medical students completed the survey (23.8%). Regression analyses revealed that exposure to the humanities was significantly correlated with positive personal qualities, including empathy (p humanities and both a higher level of students' positive qualities and a lower level of adverse traits. These findings may carry implications for medical school recruitment and curriculum design. "[Science and humanities are] twin berries on one stem, grievous damage has been done to both in regarding [them]... in any other light than complemental." (William Osler, Br Med J. 1919;2:1-7).

  17. 32 CFR 724.406 - Commander, Naval Medical Command.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Commander, Naval Medical Command. 724.406 Section 724.406 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NAVAL DISCHARGE REVIEW BOARD Principal Elements of the Navy Department Discharge Review System § 724.406 Commander...

  18. A Medical Research and Evaluation Facility (MREF) and Studies Supporting the Medical Chemical Defense Program. Evaluation of the Passive Protection Against Five Serotypes of Botulinum Toxin Provided by Botulinum Human Immune Globulin in an Animal Model

    National Research Council Canada - National Science Library

    Olson, Carl

    1998-01-01

    Pentavalent (ABCDE) botulinum toxoid vaccine is intended for use as a prophylactic measure to protect combat troops against the lethal effects of botulinum toxins A-E, a group of toxins considered to be a serious biological warfare threat...

  19. Effects of Gain/Loss Framing in Cyber Defense Decision-Making

    Energy Technology Data Exchange (ETDEWEB)

    Bos, Nathan; Paul, Celeste; Gersh, John; Greenberg, Ariel; Piatko, Christine; Sperling, Scott; Spitaletta, Jason; Arendt, Dustin L.; Burtner, Edwin R.

    2016-10-24

    Cyber defense requires decision making under uncertainty. Yet this critical area has not been a strong focus of research in judgment and decision-making. Future defense systems, which will rely on software-defined networks and may employ ‘moving target’ defenses, will increasingly automate lower level detection and analysis, but will still require humans in the loop for higher level judgment. We studied the decision making process and outcomes of 17 experienced network defense professionals who worked through a set of realistic network defense scenarios. We manipulated gain versus loss framing in a cyber defense scenario, and found significant effects in one of two focal problems. Defenders that began with a network already in quarantine (gain framing) used a quarantine system more than those that did not (loss framing). We also found some difference in perceived workload and efficacy. Alternate explanations of these findings and implications for network defense are discussed.

  20. Defense Reutilization and Marketing Manual

    Science.gov (United States)

    1990-03-01

    H -3 E Responsibilities of Defense Reutilization and Marketing Regions (D R M s...at Defense electronic products which produce radiation Reutilization and Marketing Offices, para- when energized. Among the principal radi- graph F... Sporting Equipment 7820 Games , Toys, and Wheeled Goods 7830 Recreational and Gymnastic Equipment 7910 Floor Polishers and Vacuum Cleaning Equipment

  1. Defense Acquisitions Acronyms and Terms

    Science.gov (United States)

    2012-12-01

    DR Decision Review DRMO Defense Reutilization Marketing Office DRPM Direct Reporting Program Manager DSAA Defense Security Assistance Agency...STE Special Test Equipment STEP Simulation, Test, and Evaluation Process STLDD Software Top Level Design Document STP Software Test Plan STPR...established catalog or market prices for specific tasks under standard commercial terms and conditions; this does not include services sold based

  2. Discovering Innovation at the Intersection of Undergraduate Medical Education, Human Factors, and Collaboration: The Development of a Nasogastric Tube Safety Pack.

    Science.gov (United States)

    Taylor, Natalie; Bamford, Thomas; Haindl, Cornelia; Cracknell, Alison

    2016-04-01

    Significant deficiencies exist in the knowledge and skills of medical students and residents around health care quality and safety. The theory and practice of quality and safety should be embedded into undergraduate medical practice so that health care professionals are capable of developing interventions and innovations to effectively anticipate and mitigate errors. Since 2011, Leeds Medical School in the United Kingdom has used case study examples of nasogastric (NG) tube patient safety incidents within the undergraduate patient safety curriculum. In 2012, a medical undergraduate student approached a clinician with an innovative idea after undertaking an NG tubes root cause analysis case study. Simultaneously, a separate local project demonstrated low compliance (11.6%) with the United Kingdom's National Patient Safety Agency NG tubes guideline for use of the correct method to check tube position. These separate endeavors led to interdisciplinary collaboration between a medical student, health care professionals, researchers, and industry to develop the Initial Placement Nasogastric Tube Safety Pack. Human factors engineering was used to inform pack design to allow guideline recommendations to be accessible and easy to follow. A timeline of product development, mapped against key human factors and medical device design principles used throughout the process, is presented. The safety pack has since been launched in five UK National Health Service (NHS) hospitals, and the pack has been introduced into health care professional staff training for NG tubes. A mixed-methods evaluation is currently under way in five NHS organizations.

  3. Addressing Human Factors Gaps in Cyber Defense

    Science.gov (United States)

    2016-09-23

    awareness (Endsley, 1995), and thus stands a good chance of benefiting from similar study. It should be noted that cyber situation awareness as a...models of the environment, divided across multiple types of cyber operations (Tyworth, Giacobe, Mancuso, McNeese, & Hall, 2013). Given the... Attention Switching in Cyber Security Dr. Christopher Wickens Colorado State University Cyber-security analysts at whatever level they serve

  4. Evaluation of the Defense Contract Audit Agency Audit Coverage of Tricare Contracts

    National Research Council Canada - National Science Library

    Brannin, Patricia

    2000-01-01

    Our objective was to evaluate the adequacy of the Defense Contract Audit Agency (DCAA) audit coverage of contracts for health care provided under TRICARE and the former Civilian Health Care and Medical Program of the Uniformed Services...

  5. Today´s medical self and the other: Challenges and evolving solutions for enhanced humanization and quality of care.

    Directory of Open Access Journals (Sweden)

    Perla Sueiras

    Full Text Available Recent scientific developments, along with growing awareness of cultural and social diversity, have led to a continuously growing range of available treatment options; however, such developments occasionally lead to an undesirable imbalance between science, technology and humanism in clinical practice. This study explores the understanding and practice of values and value clusters in real-life clinical settings, as well as their role in the humanization of medicine and its institutions. The research focuses on the values of clinical practice as a means of finding ways to enhance the pairing of Evidence-Based Medicine (EBM with Values-based Medicine (VBM in daily practice.The views and representations of clinical practice in 15 pre-CME and 15 post-CME interviews were obtained from a random sampling of active healthcare professionals. These views were then identified and qualitatively analyzed using a three-step hermeneutical approach. A clinical values space was identified in which ethical and epistemic values emerge, grow and develop within the biomedical, ethical, and socio-economic dimensions of everyday health care. Three main values-as well as the dynamic clusters and networks that they tend to form-were recognized: healthcare personnel-patient relationships, empathy, and respect. An examination of the interviews suggested that an adequate conceptualization of values leads to the formation of a wider axiological system. The role of clinician-as-consociate emerged as an ideal for achieving medical excellence.By showing the intricate clusters and networks into which values are interwoven, our analysis suggests methods for fine-tuning educational interventions so they can lead to demonstrable changes in attitudes and practices.

  6. Coronal leakage of provisional restorative materials used in endodontics with and without intracanal medication after exposure to human saliva

    Directory of Open Access Journals (Sweden)

    P Udayakumar

    2016-01-01

    Full Text Available Aim: To determine the coronal leakage of various provisional restorations with and without intracanal medication over time after being exposed to human saliva. Materials and Methods: This study investigated Coltosol F, Cavit, Ketac Molar, and IRM as provisional restorative material. Calcium hydroxide and chlorhexidine were used as an intracanal medicament. Ninety-eight single rooted teeth were randomly selected and then mounted in an apparatus that isolated the crown portion of the tooth. Provisional restorative materials were placed in the access cavity following manufacturer guidelines after placement of intracanal medicament. Human saliva and brain heart infusion broth in 3:1 ratio were applied to the samples, incubated at 37°C, and results were tabulated over the course of 4 weeks by the appearance of turbidity in the lower part of the apparatus. Statistical Analysis: The data were statistically analyzed using proportional Z-test. The level of significance was set at 0.05. Results: Coltosol F and Cavit could significantly prevent the bacterial leakage up to a period of 7 days with a P value of 0.01 and 0.005, respectively. Bacterial recontamination was relatively less in the samples treated with intracanal medicaments up to 14 days. After 14 days, however, all materials leaked in over half of the samples. Conclusion: No provisional restorative material can be considered superior in providing a reliable seal after 14 days. Inter-appointments schedule should not extend beyond 2 weeks and after endodontic therapy final restoration should be completed within 1 week.

  7. Evaluation of the medical devices benchmark materials in the controlled human patch testing and in the RhE in vitro skin irritation protocol.

    NARCIS (Netherlands)

    Kandárová, Helena; Bendova, Hana; Letasiova, Silvia; Coleman, Kelly P; De Jong, Wim H; Jírova, Dagmar

    2018-01-01

    Several irritants were used in the in vitro irritation medical device round robin. The objective of this study was to verify their irritation potential using the human patch test (HPT), an in vitro assay, and in vivo data. The irritants were lactic acid (LA), heptanoic acid (HA), sodium dodecyl

  8. Medical students' cognitive load in volumetric image interpretation : Insights from human-computer interaction and eye movements

    NARCIS (Netherlands)

    Stuijfzand, Bobby G.; Van Der Schaaf, Marieke F.; Kirschner, Femke C.; Ravesloot, Cécile J.; Van Der Gijp, Anouk; Vincken, Koen L.

    2016-01-01

    Medical image interpretation is moving from using 2D- to volumetric images, thereby changing the cognitive and perceptual processes involved. This is expected to affect medical students' experienced cognitive load, while learning image interpretation skills. With two studies this explorative

  9. Collaborative-group testing improves learning and knowledge retention of human physiology topics in second-year medical students.

    Science.gov (United States)

    Vázquez-García, Mario

    2018-06-01

    The present study examined the relationship between second-year medical students' group performance and individual performance in a collaborative-learning environment. In recent decades, university professors in the scientific and humanistic disciplines have successfully put into practice different modalities of collaborative approaches to teaching. Essentially, collaborative approach refers to a variety of techniques that involves the joint intellectual effort of a small group of students, which encourages interaction and discussion among students and professors. The present results show the efficacy of collaborative learning, which, furthermore, allowed students to participate actively in the physiology class. Average student's grades were significantly higher when they engaged in single-best-response, multiple-choice tests as a student team, compared with taking the same examinations individually. The method improved notably knowledge retention, as learning is more effective when performed in the context of collaborative partnership. A selected subset of questions answered wrongly in an initial test, both individually and collectively, was used on a second test to examine student retention of studied material. Grade averages were significantly improved, both individually and groupwise, when students responded to the subset of questions a second time, 1, 2, or 3 wk after the first attempt. These results suggest that the collaborative approach to teaching allowed a more effective understanding of course content, which meant an improved capacity for retention of human physiology knowledge.

  10. Procurement of Human Tissues for Research Banking in the Surgical Pathology Laboratory: Prioritization Practices at Washington University Medical Center

    Science.gov (United States)

    Chernock, Rebecca D.; Leach, Tracey A.; Kahn, Ajaz A.; Yip, James H.; Rossi, Joan; Pfeifer, John D.

    2011-01-01

    Academic hospitals and medical schools with research tissue repositories often derive many of their internal human specimen acquisitions from their site's surgical pathology service. Typically, such acquisitions come from appropriately consented tissue discards sampled from surgical resections. Because the practice of surgical pathology has patient care as its primary mission, competing needs for tissue inevitably arise, with the requirement to preserve adequate tissue for clinical diagnosis being paramount. A set of best-practice gross pathology guidelines are summarized here, focused on the decision for tissue banking at the time specimens are macroscopically evaluated. These reflect our collective experience at Washington University School of Medicine, and are written from the point of view of our site biorepository. The involvement of trained pathology personnel in such procurements is very important. These guidelines reflect both good surgical pathology practice (including the pathologic features characteristic of various anatomic sites) and the typical objectives of research biorepositories. The guidelines should be helpful to tissue bank directors, and others charged with the procurement of tissues for general research purposes. We believe that appreciation of these principles will facilitate the partnership between surgical pathologists and biorepository directors, and promote both good patient care and strategic, value-added banking procurements. PMID:23386925

  11. Oxygen in human health from life to death – An approach to teaching redox biology and signaling to graduate and medical students

    Directory of Open Access Journals (Sweden)

    Margaret M. Briehl

    2015-08-01

    Full Text Available In the absence of oxygen human life is measured in minutes. In the presence of oxygen, normal metabolism generates reactive species (ROS that have the potential to cause cell injury contributing to human aging and disease. Between these extremes, organisms have developed means for sensing oxygen and ROS and regulating their cellular processes in response. Redox signaling contributes to the control of cell proliferation and death. Aberrant redox signaling underlies many human diseases. The attributes acquired by altered redox homeostasis in cancer cells illustrate this particularly well. This teaching review and the accompanying illustrations provide an introduction to redox biology and signaling aimed at instructors of graduate and medical students.

  12. Machine medical ethics

    CERN Document Server

    Pontier, Matthijs

    2015-01-01

    The essays in this book, written by researchers from both humanities and sciences, describe various theoretical and experimental approaches to adding medical ethics to a machine in medical settings. Medical machines are in close proximity with human beings, and getting closer: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. In such contexts, machines are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for e...

  13. The Evaluation of The Knowledge Levels and Attitudes of Medical Students Who Have Accomplished Obstetric and Gynaecological Diseases Internship in a Medical School About Human Papilloma Virus Vaccine

    Directory of Open Access Journals (Sweden)

    M. Fatih Onsuz

    2011-10-01

    Full Text Available Aim: Aim of the study was to determine medical school students’ knowledge levels and attitudes who accomplished Obstetric and Gynecology clerkship in a medical school about HPV vaccination and intention to suggest HPV vaccine to their patients. Method: This descriptive study was carried out in a medical school among 166 medical students accomplishing their internship in the Obstetrics and Gynaecological Diseases Department. Study data had been collected by questionnaire which had three part and 30 question. The data were evaluated by descriptive statistics. Results: Fifty five point four of the students stated that they felt informed about HPV vaccine, 72.9% of them stated that HPV was more serious for women. 95.8% of the participants thought they would suggest HPV vaccine to their patients and the most proposed group was adolescent girls (51.6%. 80.5% of students stated their possibility to suggest the vaccine would increase in case the vaccine would be free. The most important drawback points of the students in suggesting the vaccine to their patients were thinking high priced and not cost effectiveness of the vaccine (51.6% and inducing unprotected, risky sexual intercourses (45.9%. Conclusion: In this study we determine the professional acception of HPV vaccine between students. Also we determine the most important factor in suggesting the HPV vaccine is the cost effectiveness of it. [TAF Prev Med Bull 2011; 10(5.000: 557-564

  14. [Unravelling medical leadership].

    Science.gov (United States)

    Voogt, Judith J; van Rensen, Elizabeth L J; Noordegraaf, Mirko; Schneider, Margriet M E

    2015-01-01

    Medical leadership is a popular topic in the Netherlands, and several interest groups now incorporate medical leadership into postgraduate medical education. However, there is no consensus on what this concept entails. By conducting a discourse analysis, a qualitative method which uses language and text to reveal existing viewpoints, this article reveals three perspectives on medical leadership: administrative leadership, leadership within organisations and leadership within each doctor's daily practice. Text analysis shows that the first two perspectives refer to medical leadership mainly in a defensive manner: by demonstrating medical leadership doctors could 'take the lead' once again; patient care only seems to play a small part in the process. These perspectives are not free of consequences, they will determine how the medical profession is constructed. For this reason, it is argued that there should be more emphasis on the third perspective, in which the quality of care for patients is of primary importance.

  15. Knowledge of primary health care and career choice at primary health care settings among final year medical students - challenges to human resources for health in Vietnam.

    Science.gov (United States)

    Giang, Kim Bao; Minh, Hoang Van; Hien, Nguyen Van; Ngoc, Nguyen Minh; Hinh, Nguyen Duc

    2015-01-01

    There is a shortage of medical doctors in primary health care (PHC) settings in Vietnam. Evidence about the knowledge medical students have about PHC and their career decision-making is important for making policy in human resources for health. The objective of this study was to analyse knowledge and attitudes about PHC among medical students in their final year and their choice to work in PHC after graduation. A cross-sectional study was conducted among 400 final year general medical students from Hanoi Medical University. Self-administered interviews were conducted. Key variables were knowledge, awareness of the importance of PHC and PHC career choices. Descriptive and analytic statistics were performed. Students had essential knowledge of the concept and elements of PHC and were well aware of its importance. However, only one-third to one half of them valued PHC with regard to their professional development or management opportunities. Less than 1% of students would work at commune or district health facilities after graduation. This study evidences challenges related to increasing the number of medical doctors working in PHC settings. Immediate and effective interventions are needed to make PHC settings more attractive and to encourage medical graduates to start and continue a career in PHC.

  16. Humanize the medical profession

    Directory of Open Access Journals (Sweden)

    Frank Lizaraso Caparó

    2016-04-01

    Full Text Available The doctor should keep in mind that the dialogue Is one of the most important tools that it has and through it you can get a Creative interaction in which emotions and thoughts emerge that allow a relationship and empathy between Doctor and patient that influences transcendentally on the state of health.

  17. Organization of educational process at the department of human anatomy of Saratov State Medical University n.a. V. I. Razumovsky

    Directory of Open Access Journals (Sweden)

    Bugaeva I0

    2017-06-01

    Full Text Available Human anatomy is one of the basic disciplines in the system of medical education. Knowledge in this area is necessary for the development of related theoretical subjects and constitutes a basis for studying clinical disciplines. Therefore the priority task of department of human anatomy is qualitative training of students at the modern level using classical and innovative pedagogical and computer technologies, being based on competence-based approach to training. In the article the features of organization of educational process at department of Human Anatomy of Saratov State Medical University n.a. V. I. Razumovsky, within the Federal state educational standard of the 3rd generation which key differences are considered: acquisition by students of cultural and professional competences.

  18. Defense Agencies Cash Management in the Defense Business Operations Fund

    National Research Council Canada - National Science Library

    Lane, F

    1997-01-01

    The primary audit objective was to determine whether the Fund Balance With Treasury Account on the Consolidated Financial Statements of the Defense Business Operations Fund for FY 1996 was presented...

  19. [The concept of the organ, as a hierarchal unit of human body, and its place in teaching histology at the medical university and medical college].

    Science.gov (United States)

    Miadelets, O D; Miadelets, N Ia; Miadelets, V O

    2011-01-01

    This paper deals with the methodological aspects of teaching histology at the medical university and medical college. The authors raise the issue of the necessity of teaching of the topic "Introduction to Special Histology" and the inclusion of the appropriate chapter into the textbooks. This is important for the students, as the formation of the general concepts of organ structure and function, components, and classification will aid in the further study of specific organs during the course of Special Histology. The authors describe their own experience in teaching of the section, dedicated to the general regularities of organ structure, present some definitions and classifications that are used by them for a number of years.

  20. Defenses to malpractice: what every emergency physician should know.

    Science.gov (United States)

    Hudson, Michael Jason; Moore, Gregory P

    2011-12-01

    Emergency medicine is a high-risk specialty that carries a constant risk of malpractice litigation. Fear of malpractice litigation can lead to less-than-optimal patient care as well as impairments in physician quality of life. Although malpractice fear can be ubiquitous among emergency physicians, most receive little to no education on malpractice. Medical malpractice requires that 1) The physician had a duty, 2) The physician breached the duty, 3) There was harm to the patient, and 4) The harm was caused by the physician's breach of duty. Even if all four medical malpractice conditions are met, there are still special legal defenses that have been and can be used in court to exonerate the physician. These defenses include assumption of the risk, Good Samaritan, contributory negligence, comparative fault, sudden emergency, respectable minority, two schools of thought, and clinical innovation. These legal defenses are illustrated and explained using defining precedent cases as well as hypothetical examples that are directly applicable to emergency medical practice. Knowledge of these special legal defenses can help emergency physicians minimize their risk of litigation when caring for patients. Published by Elsevier Inc.

  1. Review of "Handbook of Human Factors in Medical Device Design", edited by Matthew B. Weinger, Michael E. Wiklund and Daryle J. Gardner-Bonneau, Assistant Editor Loir M. Kelly

    Directory of Open Access Journals (Sweden)

    Gaev Jonathan A

    2011-06-01

    Full Text Available Abstract Human factors is the study of the relationship between people and devices or systems. The goal of considering human factors in the design of medical devices is to create devices that take into consideration the way people use technology and process information to create a man-machine interface that leads to the best possible performance. This text describes the significant aspects of human factors issues related to medical device design. It is well written and is useful for medical device designers and for others who use or evaluate medical equipment.

  2. Knowledge of Human Papillomavirus Infection, Cervical Cancer and Willingness to pay for Cervical Cancer Vaccination among Ethnically Diverse Medical Students in Malaysia.

    Science.gov (United States)

    Maharajan, Mari Kannan; Rajiah, Kingston; Num, Kelly Sze Fang; Yong, Ng Jin

    2015-01-01

    The primary objective of this study was to assess the knowledge of medical students and determine variation between different cultural groups. A secondary aim was to find out the willingness to pay for cervical cancer vaccination and the relationships between knowledge and attitudes towards Human Papillomavirus vaccination. A cross-sectional survey was conducted in a private medical university between June 2014 and November 2014 using a convenient sampling method. A total of 305 respondents were recruited and interviewed with standard questionnaires for assessment of knowledge, attitudes and practice towards human papilloma virus and their willingness to pay for HPV vaccination. Knowledge regarding human papilloma virus, human papilloma virus vaccination, cervical cancer screening and cervical cancer risk factors was good. Across the sample, a majority (90%) of the pupils demonstrated a high degree of knowledge about cervical cancer and its vaccination. There were no significant differences between ethnicity and the participants' overall knowledge of HPV infection, Pap smear and cervical cancer vaccination. Some 88% of participants answered that HPV vaccine can prevent cervical cancer, while 81.5% of medical students said they would recommend HPV vaccination to the public although fewer expressed an intention to receive vaccination for themselves.

  3. Counseling Received by Adolescents Undergoing Voluntary Medical Male Circumcision: Moving Toward Age-Equitable Comprehensive Human Immunodeficiency Virus Prevention Measures.

    Science.gov (United States)

    Kaufman, Michelle R; Patel, Eshan U; Dam, Kim H; Packman, Zoe R; Van Lith, Lynn M; Hatzold, Karin; Marcell, Arik V; Mavhu, Webster; Kahabuka, Catherine; Mahlasela, Lusanda; Njeuhmeli, Emmanuel; Seifert Ahanda, Kim; Ncube, Getrude; Lija, Gissenge; Bonnecwe, Collen; Tobian, Aaron A R

    2018-04-03

    The minimum package of voluntary medical male circumcision (VMMC) services, as defined by the World Health Organization, includes human immunodeficiency virus (HIV) testing, HIV prevention counseling, screening/treatment for sexually transmitted infections, condom promotion, and the VMMC procedure. The current study aimed to assess whether adolescents received these key elements. Quantitative surveys were conducted among male adolescents aged 10-19 years (n = 1293) seeking VMMC in South Africa, Tanzania, and Zimbabwe. We used a summative index score of 8 self-reported binary items to measure receipt of important elements of the World Health Organization-recommended HIV minimum package and the US President's Emergency Plan for AIDS Relief VMMC recommendations. Counseling sessions were observed for a subset of adolescents (n = 44). To evaluate factors associated with counseling content, we used Poisson regression models with generalized estimating equations and robust variance estimation. Although counseling included VMMC benefits, little attention was paid to risks, including how to identify complications, what to do if they arise, and why avoiding sex and masturbation could prevent complications. Overall, older adolescents (aged 15-19 years) reported receiving more items in the recommended minimum package than younger adolescents (aged 10-14 years; adjusted β, 0.17; 95% confidence interval [CI], .12-.21; P benefits or uptake of HIV testing. These self-reported findings were confirmed during counseling observations. Moving toward age-equitable HIV prevention services during adolescent VMMC likely requires standardizing counseling content, as there are significant age differences in HIV prevention content received by adolescents.

  4. Development of a translational model to screen medications for cocaine use disorder II: Choice between intravenous cocaine and money in humans

    Science.gov (United States)

    Lile, Joshua A.; Stoops, William W.; Rush, Craig R.; Negus, S. Stevens; Glaser, Paul E. A.; Hatton, Kevin W.; Hays, Lon R.

    2016-01-01

    Background A medication for treating cocaine use disorder has yet to be approved. Laboratory-based evaluation of candidate medications in animals and humans is a valuable means to demonstrate safety, tolerability and initial efficacy of potential medications. However, animal-to-human translation has been hampered by a lack of coordination. Therefore, we designed homologous cocaine self-administration studies in rhesus monkeys (see companion article) and human subjects in an attempt to develop linked, functionally equivalent procedures for research on candidate medications for cocaine use disorder. Methods Eight (N=8) subjects with cocaine use disorder completed 12 experimental sessions in which they responded to receive money ($0.01, $1.00 and $3.00) or intravenous cocaine (0, 3, 10 and 30 mg/70 kg) under independent, concurrent progressive-ratio schedules. Prior to the completion of 9 choice trials, subjects sampled the cocaine dose available during that session and were informed of the monetary alternative value. Results The allocation of behavior varied systematically as a function of cocaine dose and money value. Moreover, a similar pattern of cocaine choice was demonstrated in rhesus monkeys and humans across different cocaine doses and magnitudes of the species-specific alternative reinforcers. The subjective and cardiovascular responses to IV cocaine were an orderly function of dose, although heart rate and blood pressure remained within safe limits. Conclusions These coordinated studies successfully established drug vs. non-drug choice procedures in humans and rhesus monkeys that yielded similar cocaine choice behavior across species. This translational research platform will be used in future research to enhance the efficiency of developing interventions to reduce cocaine use. PMID:27269368

  5. Japan and Ballistic Missile Defense

    National Research Council Canada - National Science Library

    Swaine, Michael

    2001-01-01

    Spurred by a perceived growing ballistic missile threat from within the Asia-Pacific region and requests from the United States to support research and development on components of a missile defense...

  6. Proactive Self Defense in Cyberspace

    National Research Council Canada - National Science Library

    Caulkins, Bruce D

    2009-01-01

    ... and standards to properly secure and defend the Global Information Grid (GIG) from cyber attacks. This paper will discuss the strategic requirements for enacting a proactive self-defense mechanism in cyberspace...

  7. Defense Meteorological Satellite Program (DMSP)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Defense Meteorological Satellite Program (DMSP) satellites collect visible and infrared cloud imagery as well as monitoring the atmospheric, oceanographic,...

  8. Improving the human readability of Arden Syntax medical logic modules using a concept-oriented terminology and object-oriented programming expressions.

    Science.gov (United States)

    Choi, Jeeyae; Bakken, Suzanne; Lussier, Yves A; Mendonça, Eneida A

    2006-01-01

    Medical logic modules are a procedural representation for sharing task-specific knowledge for decision support systems. Based on the premise that clinicians may perceive object-oriented expressions as easier to read than procedural rules in Arden Syntax-based medical logic modules, we developed a method for improving the readability of medical logic modules. Two approaches were applied: exploiting the concept-oriented features of the Medical Entities Dictionary and building an executable Java program to replace Arden Syntax procedural expressions. The usability evaluation showed that 66% of participants successfully mapped all Arden Syntax rules to Java methods. These findings suggest that these approaches can play an essential role in the creation of human readable medical logic modules and can potentially increase the number of clinical experts who are able to participate in the creation of medical logic modules. Although our approaches are broadly applicable, we specifically discuss the relevance to concept-oriented nursing terminologies and automated processing of task-specific nursing knowledge.

  9. Strategic Missile Defense & Nuclear Deterrence

    Science.gov (United States)

    Grego, Laura

    The United States has pursued defenses against nuclear-armed long-range ballistic missiles since at least the 1950s. At the same time, concerns that missile defenses could undermine nuclear deterrence and potentially spark an arms race led the United States and Soviet Union to negotiate limits on these systems. The 1972 Anti-Ballistic Missile Treaty constrained strategic missile defenses for thirty years. After abandoning the treaty in 2002, President George W. Bush began fielding the Ground-based Midcourse Defense (GMD) homeland missile defense system on an extremely aggressive schedule, nominally to respond to threats from North Korea and Iran. Today, nearly fifteen years after its initial deployment, the potential and the limits of this homeland missile defense are apparent. Its test record is poor and it has no demonstrated ability to stop an incoming missile under real-world conditions. No credible strategy is in place to solve the issue of discriminating countermeasures. Insufficient oversight has not only exacerbated the GMD system's problems, but has obscured their full extent, which could encourage politicians and military leaders to make decisions that actually increase the risk of a missile attack against the United States. These are not the only costs. Both Russia and China have repeatedly expressed concerns that U.S. missile defenses adversely affect their own strategic capabilities and interests, particularly taken in light of the substantial US nuclear forces. This in turn affects these countries' nuclear modernization priorities. This talk will provide a technical overview of the US strategic missile defense system, and how it relates to deterrence against non-peer adversaries as well as how it affects deterrence with Russia and China and the long-term prospects for nuclear reductions

  10. Tactile defensiveness and stereotyped behaviors.

    Science.gov (United States)

    Baranek, G T; Foster, L G; Berkson, G

    1997-02-01

    This study explores the constructs of stereotyped behaviors (e.g., repetitive motor patterns, object manipulations, behavioral rigidities) and tactile defensiveness as relevant to occupational therapy theory and practice and attempts to test their purported relationships in children with developmental disabilities. Twenty-eight children with developmental disabilities and autism were assessed on eight factors of stereotyped behavior via a questionnaire and by four measures of tactile defensiveness. The subjects' scores from the questionnaire were correlated with their scores on the tactile defensiveness measures to see what, if any, relationship among these behaviors exists. Significant relationships emerged from the data, indicating that subjects with higher levels of tactile defensiveness were also more likely to evidence rigid or inflexible behaviors, repetitive verbalizations, visual stereotypes, and abnormal focused affections that are often associated with autism. No significant association was found between motor and object stereotypes and tactile defensiveness. These relationships could not be explained solely by maturational factors. The results suggest that clinicians should include observations of stereotyped behaviors, particularly behavioral rigidities, in conjunction with assessments of sensory defensiveness because these are related phenomena that may pose unique challenges for children with developmental disabilities and autism. Further study is needed to determine the causal mechanisms responsible for these relationships.

  11. Psychological Defenses against Death Anxiety: Integrating Terror Management Theory and Firestone's Separation Theory

    Science.gov (United States)

    Bassett, Jonathan F.

    2007-01-01

    The author attempts to integrate Terror Management Theory (TMT) and R. W. Firestone's Separation Theory (1984, 1994). Both theories emphasize defense against death anxiety as a key human motive. Whereas TMT focuses extensively on self-esteem and cultural worldview, Firestone posited additional defenses such as gene survival, self-nourishing…

  12. Team-Based Learning Module for Undergraduate Medical Education: a Module Focused on the Human Papilloma Virus to Increase Willingness to Vaccinate.

    Science.gov (United States)

    Wiley, Rachel; Shelal, Zeena; Bernard, Carolyn; Urbauer, Diana; Toy, Eugene; Ramondetta, Lois

    2017-12-26

    Human papilloma virus (HPV) vaccination rates lag behind other vaccines, primarily because of weak provider recommendations, and are associated with nearly 30,000 new cancer diagnoses a year. Educating medical students about HPV using active, team-centered learning may increase assimilation of information and may increase vaccination rates. A team-based learning (TBL) module focused on HPV for first-year medical students about HPV will better increase knowledge and likeliness to vaccinate than traditional education methods. Baseline HPV knowledge in medical students across Texas was assessed by surveying all 4-year undergraduate medical schools. Students at one medical school then participated in a week-long TBL focused on basic and clinical concepts relating to HPV, and then were re-surveyed upon completion of the course module. At baseline assessment, first-year student at the intervention site performed at the same level as first-year medical students across the state of Texas on knowledge and satisfaction with their HPV-related medical school education. After the TBL implementation, students performed significantly better than similar-year students and equal to graduating seniors, on knowledge of HPV- and HPV-related cancers, and report significantly higher satisfaction with education measures. Students at the intervention site were significantly more likely to recommend the HPV vaccination in future practice. Short-term knowledge and willingness to recommend vaccination are improved with a targeted HPV TBL early in medical education, which may provide a basis of knowledge that could translate into improved vaccination rates.

  13. Acquisition Planning at the Defense Communications Agency.

    Science.gov (United States)

    1984-04-01

    guidelines for interaction are developed under the leadership of DCA agencywide integrators with the participation of personnel from DCA, the Services...Communications System DCSO - Defense Communications System Organizatin . DDN - Defense Data Network DEC - Decision Making DG - Defense Guidance DIA - Defense

  14. Inflation in DoD Medical Care

    National Research Council Canada - National Science Library

    Goldberg, Matthew

    1997-01-01

    The Defense Health Program (DHP) is appropriated funds to provide medical care to active-duty military personnel and their family members, military retirees and their family members, and other eligible beneficiaries...

  15. Cometary Defense with Directed Energy

    Science.gov (United States)

    Zhang, Q.; Lubin, P. M.; Hughes, G. B.

    2016-12-01

    Cometary impacts pose a long-term hazard to humans on Earth. Due to their comparative rarity, most planetary defense schemes neglect the comet threat, choosing instead to focus exclusively on mitigating asteroid impacts. Methods like kinetic impactors may be suitable for deflecting near-Earth asteroids (NEAs) and Jupiter-family comets (JFCs), both of which are characterized by low inclination orbits and short orbital periods which favor early detection—characteristics ideal for an interception mission. In contrast, Halley-type comets (HTCs) and long-period comets (LPCs) are often found in high inclination orbits rarely more than 2 yr prior to reaching Earth's orbit. Unless discovered and identified in a prior apparition—often centuries or millennia earlier, if ever—timely interception of a threatening HTC or LPC is improbable even with preparation, with missions demanding delta-v budgets often in excess of 30 km/s. Active comets, however, are already naturally perturbed from purely gravitational trajectories through solar-driven sublimation of volatiles. Further deflection may be achieved by supplementing the solar radiation with an artificial directed energy source such as by one or more laser arrays positioned on or near Earth. Simulations were developed with models derived from the known solar nongravitational perturbations of typical comets. Results suggest that a diffraction-limited 500 m array operating at 10 GW for 10 min/day may be sufficient to divert a typical active 500 m comet from an impact given 1 yr. A larger 1 km array operating at 100 GW for 100 s/day is similarly effective. Care must be taken to ensure the target remains intact throughout the deflection period due to comets' low compressive strength and resulting propensity for disintegration at high incident flux.

  16. Report of the Defense Science Board/Defense Policy Board Task Force On Theater Missile Defense

    National Research Council Canada - National Science Library

    1996-01-01

    ... also tackled the controversial subject of the ABM Treaty and its effect on theater missile defenses Subsequent to its interim report, which expressed strong concerns about the demarcation path the US...

  17. 76 FR 28757 - Defense Logistics Agency Revised Regulation 1000.22, Environmental Considerations in Defense...

    Science.gov (United States)

    2011-05-18

    ... DEPARTMENT OF DEFENSE Office of the Secretary [DOCKET ID DOD-2011-OS-0055] Defense Logistics Agency Revised Regulation 1000.22, Environmental Considerations in Defense Logistics Agency Actions AGENCY: Defense Logistics Agency, Department of Defense. ACTION: Notice of Availability (NOA) of Revised...

  18. 76 FR 53119 - Defense Logistics Agency Revised Regulation 1000.22, Environmental Considerations in Defense...

    Science.gov (United States)

    2011-08-25

    ... DEPARTMENT OF DEFENSE Office of the Secretary [Docket ID: DOD-2011-OS-0055] Defense Logistics Agency Revised Regulation 1000.22, Environmental Considerations in Defense Logistics Agency Actions AGENCY: Defense Logistics Agency, Department of Defense. ACTION: Comment Addressed on Notice of...

  19. 75 FR 52732 - Renewal of Department of Defense Federal Advisory Committee; Missile Defense Advisory Committee

    Science.gov (United States)

    2010-08-27

    ... Committee; Missile Defense Advisory Committee AGENCY: Department of Defense (DoD). ACTION: Renewal of..., the Department of Defense gives notice that it is renewing the charter for the Missile Defense... Director, Missile Defense Agency, independent advice and recommendations on all matters relating to missile...

  20. Near-peer role modeling: Can fourth-year medical students, recognized for their humanism, enhance reflection among second-year students in a physical diagnosis course?

    Directory of Open Access Journals (Sweden)

    Mimi McEvoy

    2016-09-01

    Full Text Available Introduction: Humanism is cultivated through reflection and self-awareness. We aimed to employ fourth-year medical students, recognized for their humanism, to facilitate reflective sessions for second-year medical students with the intention of positively influencing reflective process toward humanistic development. Methods/Analysis: A total of 186 students were randomly assigned to one of three comparison arms: eight groups of eight students (64 students were facilitated by a fourth-year student who was a Gold Humanism Honor Society member (GHHS; eight groups (64 students by a volunteer non-GHHS student; and seven groups (58 students were non-facilitated. Before sessions, second-year students set learning goals concerning interactions with patients; fourth-year students received training materials on facilitation. Groups met twice during their 10 clinical site visits. At the last session, students completed a reflective assignment on their goal progress. Comparative mixed method analyses were conducted among the three comparison arms on reflection (reflective score on in-session assignment and session satisfaction (survey in addition to a thematic analysis of responses on the in-session assignment. Results: We found significant differences among all three comparison arms on students’ reflective scores (p=0.0003 and satisfaction (p=0.0001. T-tests comparing GHHS- and non-GHHS-facilitated groups showed significantly higher mean reflective scores for GHHS-facilitated groups (p=0.033; there were no differences on session satisfaction. Thematic analysis of students’ reflections showed attempts at self-examination, but lacked depth in addressing emotions. There was a common focus on achieving comfort and confidence in clinical skills performance. Discussion/Conclusions: Near peers, recognized for their humanism, demonstrated significant influence in deepening medical students’ reflections surrounding patient interactions or humanistic

  1. Technical Soddi Defenses: The Trojan Horse Defense Revisited

    Directory of Open Access Journals (Sweden)

    Chad Steel

    2014-12-01

    Full Text Available In 2004, the Trojan horse defense was at a crossroads, with two child pornography cases where it was successfully employed in the United Kingdom, resulting in acquittals.  The original Trojan horse defense has now become part of the more general “technical SODDI” defense, which includes the possibility of unknown actors using unsecured Wi-Fi connections or having physical access to a computer to perform criminal acts.  In the past ten years, it has failed to be effective in the United States for criminal cases, with no published acquittals in cases where it was the primary defense.  In the criminal cases where it has been used as leverage in plea negotiations, there has been either poor forensics performed by the prosecution or political pressure to resolve a matter.  On the civil side, however, the defense has been wildly successful, effectively shutting down large John Doe copyright infringement litigation against non-commercial violators.  

  2. Defensive medicine among neurosurgeons in the Netherlands: a national survey.

    Science.gov (United States)

    Yan, Sandra C; Hulsbergen, Alexander F C; Muskens, Ivo S; van Dam, Marjel; Gormley, William B; Broekman, Marike L D; Smith, Timothy R

    2017-12-01

    In defensive medicine, practice is motivated by legal rather than medical reasons. Previous studies have analyzed the correlation between perceived medico-legal risk and defensive behavior among neurosurgeons in the United States, Canada, and South Africa, but not yet in Europe. The aim of this study is to explore perceived liability burdens and self-reported defensive behaviors among neurosurgeons in the Netherlands and compare their practices with their non-European counterparts. A survey was sent to 136 neurosurgeons. The survey included questions from several domains: surgeon characteristics, patient demographics, type of practice, surgeon liability profile, policy coverage, defensive practices, and perception of the liability environment. Survey responses were analyzed and summarized. Forty-five neurosurgeons filled out the questionnaire (response rate of 33.1%). Almost half (n = 20) reported paying less than 5% of their income to annual malpractice premiums. Nearly all respondents view their insurance premiums as a minor or no burden (n = 42) and are confident that in their coverage is sufficient (n = 41). Most neurosurgeons (n = 38) do not see patients as "potential lawsuits". Relative to their American peers, Dutch neurosurgeons view their insurance premiums as less burdensome, their patients as a smaller legal threat, and their practice as less risky in general. They are sued less often and engage in fewer defensive behaviors than their non-European counterparts. The medico-legal climate in the Netherlands may contribute to this difference.

  3. Differential activity of innate defense antimicrobial peptides against Nocardia species.

    Science.gov (United States)

    Rieg, Siegbert; Meier, Benjamin; Fähnrich, Eva; Huth, Anja; Wagner, Dirk; Kern, Winfried V; Kalbacher, Hubert

    2010-02-23

    Members of the genus Nocardia are ubiquitous environmental saprophytes capable to cause human pulmonary, disseminated and cutaneous nocardiosis or bovine mastitis. Innate immunity appears to play an important role in early defense against Nocardia species. To elucidate the contribution of antimicrobial peptides (AMPs) in innate defense against Nocardia, the activity of human alpha-defensins human neutrophil peptides (HNPs) 1-3, human beta-defensin (hBD)-3 and cathelicidin LL-37 as well as bovine beta-defensins lingual and tracheal antimicrobial peptides (LAP, TAP) and bovine neutrophil-derived indolicidin against four important Nocardia species was investigated. Whereas N. farcinica ATCC 3318 and N. nova ATCC 33726 were found to be susceptible to all investigated human and bovine AMPs, N. asteroides ATCC 19247 was killed exclusively by neutrophil-derived human alpha-defensins HNP 1-3 and bovine indolicidin. N. brasiliensis ATCC 19296 was found to exhibit complete resistance to investigated human AMPs and to be susceptible only to bovine indolicidin. Selected AMPs are capable to contribute to the first line of defense against Nocardia, yet, susceptibility appears to vary across different Nocardia species. Obtained results of neutrophil-derived AMPs to possess the broadest antinocardial spectrum are remarkable, since nocardiosis is characterized by a neutrophil-rich infiltrate in vivo.

  4. Differential activity of innate defense antimicrobial peptides against Nocardia species

    Directory of Open Access Journals (Sweden)

    Wagner Dirk

    2010-02-01

    Full Text Available Abstract Background Members of the genus Nocardia are ubiquitous environmental saprophytes capable to cause human pulmonary, disseminated and cutaneous nocardiosis or bovine mastitis. Innate immunity appears to play an important role in early defense against Nocardia species. To elucidate the contribution of antimicrobial peptides (AMPs in innate defense against Nocardia, the activity of human α-defensins human neutrophil peptides (HNPs 1-3, human β-defensin (hBD-3 and cathelicidin LL-37 as well as bovine β-defensins lingual and tracheal antimicrobial peptides (LAP, TAP and bovine neutrophil-derived indolicidin against four important Nocardia species was investigated. Results Whereas N. farcinica ATCC 3318 and N. nova ATCC 33726 were found to be susceptible to all investigated human and bovine AMPs, N. asteroides ATCC 19247 was killed exclusively by neutrophil-derived human α-defensins HNP 1-3 and bovine indolicidin. N. brasiliensis ATCC 19296 was found to exhibit complete resistance to investigated human AMPs and to be susceptible only to bovine indolicidin. Conclusion Selected AMPs are capable to contribute to the first line of defense against Nocardia, yet, susceptibility appears to vary across different Nocardia species. Obtained results of neutrophil-derived AMPs to possess the broadest antinocardial spectrum are remarkable, since nocardiosis is characterized by a neutrophil-rich infiltrate in vivo.

  5. Effects of benzalkonium chloride- or polyquad-preserved fixed combination glaucoma medications on human trabecular meshwork cells.

    Science.gov (United States)

    Ammar, David A; Kahook, Malik Y

    2011-01-01

    We investigated the potential short and long-term effects in cultured human trabecular meshwork (TM) cells of various topical glaucoma formulations containing different preservatives. We tested the fixed combination medications 0.004% travoprost plus 0.5% timolol preserved with either 0.015% benzalkonium chloride (BAK; DuoTrav®), or with 0.001% polyquad (PQ; DuoTrav(®) BAK-free); and 0.005% latanoprost plus 0.5% timolol preserved with 0.020% BAK (Xalacom(®)). Also tested was a range of BAK concentrations (0.001%-0.020%) in balanced salt solution (BSS). Cells were treated for 25 min at 37 °C with solutions diluted 1:10 and 1:100 to mimic the reduced penetration of topical preparations to the anterior chamber. The percentage of live cells was determined immediately after treatment through the uptake of the fluorescent vital dye calcein-AM. To determine any long-term effects, we assayed release of matrix metalloproteinase 9 (MMP-9) and apoptosis 24 h after treatments. BAK demonstrated a dose-dependent reduction in TM cell viability, ranging from 71±5% live cells at 0.001% BAK (diluted 1:10) to 33±3% live cells at 0.020% BAK (diluted 1:10). Travoprost (0.004%) plus 0.5% timolol preserved with 0.015% BAK had statistically fewer live TM cells (79±7%) than the same preparation preserved with 0.001% polyquad® (PQ; 93±1%; p<0.001). Latanoprost plus timolol preserved with 0.020% BAK (29±9% live cells) was similar to the 0.020% BAK (33±3%) treatment. However, travoprost plus timolol preserved in 0.015% BAK had significantly more live cells (83±12%) than the 1:10 dilution of 0.015% BAK (49±10%). We also found 0.020% BAK (diluted 1:100) resulted in elevated levels of extracellular MMP-9 at 24 h. These results demonstrate that the substitution of the preservative BAK from topical ophthalmic drugs results in greater in vitro viability of TM cells. Travoprost with timolol, but not latanoprost with timolol, countered some of the toxic BAK effects. BAK treatment

  6. The defense counsel's perspective.

    Science.gov (United States)

    Hoffman, Peter J; Plump, Joan D; Courtney, Marcie A

    2005-04-01

    In all likelihood, most orthopedic surgeons today will be the subject of a lawsuit related to the care and treatment of a patient. This article is designed to provide physicians with pertinent material to help prepare for what seems to have become the inevitable--the medical malpractice lawsuit. There are a number of things that can be done to minimize the chance that a surgeon will be sued. Keeping informed about recent developments in orthopaedics, developing a good relationship with patients, and maintaining good documentation are just a few of the ways to help reduce the chances of being named in a potential lawsuit. Additionally, we offer physicians who have been sued assistance in getting through the litigation process, which at times can be daunting. Logical suggestions, such as not discussing a case with anyone other than a spouse and/or an attorney and not altering the medical records and larger concepts, including the importance of developing a relationship with an attorney, understanding the attorney-client privilege, and adequately preparing for the deposition and trial are discussed at length. Although it is not possible to be completely prepared for the day one gets sued, this article should provide insight and information necessary to enable surgeons to face each element of the lawsuit with some knowledge and control.

  7. A critical commentary on Derek Morgan's unpublished manuscript: 'coming Back to Life: The Normal Chaos of Medical Law' and how to deal with property in human cells.

    Science.gov (United States)

    Capps, Benjamin J

    2014-01-01

    This article is an analysis of Derek Morgan's manuscript-'Coming Back to Life: The Normal Chaos of Medical Law', which remained unpublished at his death in 2011. Morgan made two claims in the manuscript: (1) medical practitioners and patients approach health from the different perspectives of 'reason' and 'emotion' respectively, while medical law treads the line between these ultimately resulting in 'normal chaos'. (2) In this respect, medical law ought to be coaxed 'back to life' so that it can address broader principles and values in respect to practical resolution; however, it has, in the face of this chaos, become dull in its ambitions. In this article, I first analyse these two claims in detail, before, second, illustrating the 'normal chaos' of medical law using the debate over ownership of human cells and tissues. I draw my own conclusions as to whether Morgan's final thesis was successful. © The Author [2014]. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Human resources issues and Australian Disaster Medical Assistance Teams: results of a national survey of team members.

    Science.gov (United States)

    Aitken, Peter; Leggat, Peter; Harley, Hazel; Speare, Richard; Leclercq, Muriel

    2012-01-01

    Calls for disaster medical assistance teams (DMATs) are likely to continue in response to international disasters. As part of a national survey, this study was designed to evaluate Australian DMAT experience in relation to the human resources issues associated with deployment. Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 South East Asian Tsunami disaster. The response rate for this survey was 50% (59/118). Most personnel had deployed to the Asian Tsunami affected areas with DMAT members having significant clinical and international experience. While all except one respondent stated they received a full orientation prior to deployment, only 34% of respondents (20/59) felt their role was clearly defined pre deployment. Approximately 56% (33/59) felt their actual role matched their intended role and that their clinical background was well suited to their tasks. Most respondents were prepared to be available for deployment for 1 month (34%, 20/59). The most common period of notice needed to deploy was 6-12 hours for 29% (17/59) followed by 12-24 hours for 24% (14/59). The preferred period of overseas deployment was 14-21 days (46%, 27/59) followed by 1 month (25%, 15/59) and the optimum shift period was felt to be 12 hours by 66% (39/59). The majority felt that there was both adequate pay (71%, 42/59) and adequate indemnity (66%, 39/59). Almost half (49%, 29/59) stated it was better to work with people from the same hospital and, while most felt their deployment could be easily covered by staff from their workplace (56%, 33/59) and caused an inconvenience to their colleagues (51%, 30/59), it was less likely to interrupt service delivery in their workplace (10%, 6/59) or cause an inconvenience to patients (9%, 5/59). Deployment was felt to benefit the affected community by nearly all

  9. Artificial Intelligence and the Future of Defense

    DEFF Research Database (Denmark)

    De Spiegeleire, Stephan; Maas, Matthijs Michiel; Sweijs, Tim

    Artificial intelligence (AI) is on everybody’s minds these days. Most of the world’s leading companies are making massive investments in it. Governments are scrambling to catch up. Every single one of us who uses Google Search or any of the new digital assistants on our smartphones has witnessed...... suggests that the advent of artificial super-intelligence (i.e. AI that is superior across the board to human intelligence), which many experts now put firmly within the longer-term planning horizons of our DSOs, presents us with unprecedented risks but also opportunities that we have to start to explore....... The report contains an overview of the role that ‘intelligence’ - the computational part of the ability to achieve goals in the world - has played in defense and security throughout human history; a primer on AI (what it is, where it comes from and where it stands today - in both civilian and military...

  10. Human genome and philosophy: what ethical challenge will human genome studies bring to the medical practices in the 21st century?

    Science.gov (United States)

    Renzong, Q

    2001-12-01

    A human being or person cannot be reduced to a set of human genes, or human genome. Genetic essentialism is wrong, because as a person the entity should have self-conscious and social interaction capacity which is grown in an interpersonal relationship. Genetic determinism is wrong too, the relationship between a gene and a trait is not a linear model of causation, but rather a non-linear one. Human genome is a complexity system and functions in a complexity system of human body and a complexity of systems of natural/social environment. Genetic determinism also caused the issue of how much responsibility an agent should take for her/his action, and how much degrees of freedom will a human being have. Human genome research caused several conceptual issues. Can we call a gene 'good' or 'bad', 'superior' of 'inferior'? Is a boy who is detected to have the gene of Huntington's chorea or Alzheimer disease a patient? What should the term 'eugenics' mean? What do the terms such as 'gene therapy', 'treatment' and 'enhancement' and 'human cloning' mean etc.? The research of human genome and its application caused and will cause ethical issues. Can human genome research and its application be used for eugenics, or only for the treatment and prevention of diseases? Must the principle of informed consent/choice be insisted in human genome research and its application? How to protecting gene privacy and combating the discrimination on the basis of genes? How to promote the quality between persons, harmony between ethnic groups and peace between countries? How to establish a fair, just, equal and equitable relationship between developing and developed countries in regarding to human genome research and its application?

  11. Defensive Medicine in U.S. Spine Neurosurgery.

    Science.gov (United States)

    Din, Ryan S; Yan, Sandra C; Cote, David J; Acosta, Michael A; Smith, Timothy R

    2017-02-01

    Observational cross-sectional survey. To compare defensive practices of U.S. spine and nonspine neurosurgeons in the context of state medical liability risk. Defensive medicine is a commonly reported and costly phenomenon in neurosurgery. Although state liability risk is thought to contribute greatly to defensive practice, variation within neurosurgical specialties has not been well explored. A validated, online survey was sent via email to 3344 members of the American Board of Neurological Surgeons. The instrument contained eight question domains: surgeon characteristics, patient characteristics, practice type, insurance type, surgeon liability profile, basic surgeon reimbursement, surgeon perceptions of medical legal environment, and the practice of defensive medicine. The overall response rate was 30.6% (n = 1026), including 499 neurosurgeons performing mainly spine procedures (48.6%). Spine neurosurgeons had a similar average practice duration as nonspine neurosurgeons (16.6 vs 16.9 years, P = 0.64) and comparable lifetime case volume (4767 vs 4,703, P = 0.71). The average annual malpractice premium for spine neurosurgeons was similar to nonspine neurosurgeons ($104,480.52 vs $101,721.76, P = 0.60). On average, spine neurosurgeons had a significantly higher rate of ordering labs, medications, referrals, procedures, and imaging solely for liability concerns compared with nonspine neurosurgeons (89.2% vs 84.6%, P = 0.031). Multivariate analysis revealed that spine neurosurgeons were roughly 3 times more likely to practice defensively compared with nonspine neurosurgeons (odds ratio, OR = 2.9, P = 0.001) when controlling for high-risk procedures (OR = 7.8, P < 0.001), annual malpractice premium (OR = 3.3, P = 0.01), percentage of patients publicly insured (OR = 1.1, P = 0.80), malpractice claims in the last 3 years (OR = 1.13, P = 0.71), and state medical-legal environment (OR = 1.3, P = 0

  12. Department of Defense TRICARE Inpatient Satisfaction Survey (TRISS) Data– military hospitals

    Data.gov (United States)

    U.S. Department of Health & Human Services — This file contains U.S. military hospital data from the TRICARE Inpatient Satisfaction Survey (TRISS) administered by the Department of Defense (DoD). TRISS data do...

  13. Identification and Assessment of Human Errors in Postgraduate Endodontic Students of Kerman University of Medical Sciences by Using the SHERPA Method

    Directory of Open Access Journals (Sweden)

    Saman Dastaran

    2016-03-01

    Full Text Available Introduction: Human errors are the cause of many accidents, including industrial and medical, therefore finding out an approach for identifying and reducing them is very important. Since no study has been done about human errors in the dental field, this study aimed to identify and assess human errors in postgraduate endodontic students of Kerman University of Medical Sciences by using the SHERPA Method. Methods: This cross-sectional study was performed during year 2014. Data was collected using task observation and interviewing postgraduate endodontic students. Overall, 10 critical tasks, which were most likely to cause harm to patients were determined. Next, Hierarchical Task Analysis (HTA was conducted and human errors in each task were identified by the Systematic Human Error Reduction Prediction Approach (SHERPA technique worksheets. Results: After analyzing the SHERPA worksheets, 90 human errors were identified including (67.7% action errors, (13.3% checking errors, (8.8% selection errors, (5.5% retrieval errors and (4.4% communication errors. As a result, most of them were action errors and less of them were communication errors. Conclusions: The results of the study showed that the highest percentage of errors and the highest level of risk were associated with action errors, therefore, to reduce the occurrence of such errors and limit their consequences, control measures including periodical training of work procedures, providing work check-lists, development of guidelines and establishment of a systematic and standardized reporting system, should be put in place. Regarding the results of this study, the control of recovery errors with the highest percentage of undesirable risk and action errors with the highest frequency of errors should be in the priority of control

  14. A HUMAN RELIABILITY-CENTERED APPROACH TO THE DEVELOPMENT OF JOB AIDS FOR REVIEWERS OF MEDICAL DEVICES THAT USE RADIOLOGICAL BYPRODUCT MATERIALS.

    Energy Technology Data Exchange (ETDEWEB)

    COOPER, S.E.; BROWN, W.S.; WREATHALL, J.

    2005-02-02

    The U.S. Nuclear Regulatory Commission (NRC) is engaged in an initiative to risk-inform the regulation of byproduct materials. Operating experience indicates that human actions play a dominant role in most of the activities involving byproduct materials, which are radioactive materials other than those used in nuclear power plants or in weapons production, primarily for medical or industrial purposes. The overall risk of these activities is strongly influenced by human performance. Hence, an improved understanding of human error, its causes and contexts, and human reliability analysis (HRA) is important in risk-informing the regulation of these activities. The development of the human performance job aids was undertaken by stages, with frequent interaction with the prospective users. First, potentially risk significant human actions were identified based on reviews of available risk studies for byproduct material applications and of descriptions of events for byproduct materials applications that involved potentially significant human actions. Applications from the medical and the industrial domains were sampled. Next, the specific needs of the expected users of the human performance-related capabilities were determined. To do this, NRC headquarters and region staff were interviewed to identify the types of activities (e.g., license reviews, inspections, event assessments) that need HRA support and the form in which such support might best be offered. Because the range of byproduct uses regulated by NRC is so broad, it was decided that initial development of knowledge and tools would be undertaken in the context of a specific use of byproduct material, which was selected in consultation with NRC staff. Based on needs of NRC staff and the human performance related characteristics of the context chosen, knowledge resources were then compiled to support consideration of human performance issues related to the regulation of byproduct materials. Finally, with

  15. A HUMAN RELIABILITY-CENTERED APPROACH TO THE DEVELOPMENT OF JOB AIDS FOR REVIEWERS OF MEDICAL DEVICES THAT USE RADIOLOGICAL BYPRODUCT MATERIALS

    International Nuclear Information System (INIS)

    COOPER, S.E.; BROWN, W.S.; WREATHALL, J.

    2005-01-01

    The U.S. Nuclear Regulatory Commission (NRC) is engaged in an initiative to risk-inform the regulation of byproduct materials. Operating experience indicates that human actions play a dominant role in most of the activities involving byproduct materials, which are radioactive materials other than those used in nuclear power plants or in weapons production, primarily for medical or industrial purposes. The overall risk of these activities is strongly influenced by human performance. Hence, an improved understanding of human error, its causes and contexts, and human reliability analysis (HRA) is important in risk-informing the regulation of these activities. The development of the human performance job aids was undertaken by stages, with frequent interaction with the prospective users. First, potentially risk significant human actions were identified based on reviews of available risk studies for byproduct material applications and of descriptions of events for byproduct materials applications that involved potentially significant human actions. Applications from the medical and the industrial domains were sampled. Next, the specific needs of the expected users of the human performance-related capabilities were determined. To do this, NRC headquarters and region staff were interviewed to identify the types of activities (e.g., license reviews, inspections, event assessments) that need HRA support and the form in which such support might best be offered. Because the range of byproduct uses regulated by NRC is so broad, it was decided that initial development of knowledge and tools would be undertaken in the context of a specific use of byproduct material, which was selected in consultation with NRC staff. Based on needs of NRC staff and the human performance related characteristics of the context chosen, knowledge resources were then compiled to support consideration of human performance issues related to the regulation of byproduct materials. Finally, with

  16. Organizing Defense Logistics: What Strategic Structures Should Exist for the Defense Supply Chain

    National Research Council Canada - National Science Library

    Maddox, Edward D

    2005-01-01

    .... The primary research question of this study was: What strategic organizational structures should exist within the Department of Defense to facilitate further integration of the defense supply chain...

  17. CXCR1 regulates pulmonary anti-Pseudomonas host defense

    Science.gov (United States)

    Carevic, M.; Öz, H.; Fuchs, K.; Laval, J.; Schroth, C.; Frey, N.; Hector, A.; Bilich, T.; Haug, M.; Schmidt, A.; Autenrieth, S. E.; Bucher, K.; Beer-Hammer, S.; Gaggar, A.; Kneilling, M.; Benarafa, C.; Gao, J.; Murphy, P.; Schwarz, S.; Moepps, B.; Hartl, D.

    2016-01-01

    Pseudomonas aeruginosa is a key opportunistic pathogen causing disease in cystic fibrosis (CF) and other lung diseases such as chronic obstructive pulmonary disease (COPD). However, the pulmonary host defense mechanisms regulating anti-Pseudomonas aeruginosa immunity remain incompletely understood. Here we demonstrate, by studying an airway Pseudomonas aeruginosa infection model, in vivo bioluminescence imaging, neutrophil effector responses and human airway samples, that the chemokine receptor CXCR1 regulates pulmonary host defense against Pseudomonas aeruginosa. Mechanistically, CXCR1 regulated anti-Pseudomonas neutrophil responses through modulation of reactive oxygen species and interference with toll-like receptor 5 expression. These studies define CXCR1 as a novel non-canonical chemokine receptor that regulates pulmonary anti-Pseudomonas host defense with broad implications for CF, COPD and other infectious lung diseases. PMID:26950764

  18. National Defense Center of Excellence for Research in Ocean Sciences

    Science.gov (United States)

    1999-09-01

    aureas , vancomycin-resistant Enterococcus and other bacteria in in vitro tests. ATI contacted Tripler Army Medical Hospital in Honolulu and Walter...an HP 712/60 workstation and is mostly written in C+ except for the radar cross- section model, which is written in FORTRAN. The output of the model...Congressional Record, contained a section entitled Research, Development, Test, and Evaluation, Defense Agencies and provided for ".. .an additional amount

  19. The Inflammasome in Host Defense

    Directory of Open Access Journals (Sweden)

    Gang Chen

    2009-12-01

    Full Text Available Nod-like receptors have emerged as an important family of sensors in host defense. These receptors are expressed in macrophages, dendritic cells and monocytes and play an important role in microbial immunity. Some Nod-like receptors form the inflammasome, a protein complex that activates caspase-1 in response to several stimuli. Caspase-1 activation leads to processing and secretion of pro-inflammatory cytokines such as interleukin (IL-1β and IL-18. Here, we discuss recent advances in the inflammasome field with an emphasis on host defense. We also compare differential requirements for inflammasome activation in dendritic cells, macrophages and monocytes.

  20. On Three Defenses of Sentimentalism

    OpenAIRE

    Iwasa, Noriaki

    2013-01-01

    This essay shows that a moral sense or moral sentiments alone cannot identify appropriate morals. To this end, the essay analyzes three defenses of Francis Hutcheson’s, David Hume’s, and Adam Smith’s moral sense theories against the relativism charge that a moral sense or moral sentiments vary across people, societies, cultures, or times. The first defense is the claim that there is a universal moral sense or universal moral sentiments. However, even if they exist, a moral sense or moral sent...

  1. Defense Primer: The National Defense Budget Function (050)

    Science.gov (United States)

    2017-03-17

    individual policy activities. Subfunctions are assigned a numeric identifier (ending in a single digit ) related to the function to which they belong...operations, equipment repair, and maintenance of defense facilities, healthcare costs, and administration. 24% Military Personnel (MILPERS) Pay and

  2. Report on Defense Business Operations to the Congressional Defense Committees

    Science.gov (United States)

    2009-03-15

    Department’s strategic framework for planning and decision-making, and acknowledged the need to establish clear, actionable strategic goals and...Business Operations Department of Defense Business Transformation 5 2. Business Enterprise Priorities Six Business Enterprise Priorities ( BEPs ... framework products that facilitate the interoperability and integration of the operational activities, processes, data, information exchanges

  3. A Medical Research and Evaluation Facility (MREF) and Studies Supporting the Medical Chemical Defense Program: Task 95-39: Methods Development and Validation of Two Mouse Bioassays for Use in Quantifying Botulinum Toxins (A, B, C, D and E) and Toxin Antibody Titers

    National Research Council Canada - National Science Library

    Olson, Carl

    1997-01-01

    Ths task was conducted for the U.S. Army Medical Materiel Development Activity (USAMMDA) to validate two mouse bioassays for quantify botulinum toxin potency and neutralizing antibodies to botulimun toxins...

  4. Civil defense is futile

    International Nuclear Information System (INIS)

    Schell, J.

    1985-01-01

    In this paper, the author argues that the effects of a nuclear war would be so total and so horrible that plans to survive are a vain hope. The author says with overwhelming immediate local effects striking the vast majority of the population, and with one-week doses of radiation then rising into the tens of thousands of rems, evacuation and shelters are a vain hope. In these circumstances, evacuation before an attack would exercise in transporting people from one death to another. In a full-scale nuclear attack, there would be in all likelihood no surviving communities to help afflicted communities. in the second place, everyone who failed to seal himself off from the outside environment for as long as several months would soon die of radiation sickness. The natural environment would also be dying. If anyone survived the attack, the generations that would be trying to rebuild a human life would be sick and possibly deform generations. The human race as it is known would cease to be

  5. Financial Reporting Procedures for Defense Distribution Depots - Defense Logistics Agency Business Area of the Defense Business Operations Fund

    National Research Council Canada - National Science Library

    Young, Shelton

    1994-01-01

    In our audit of the FY 1993 Financial Statements for the Distribution Depots--Defense Logistics Agency Business Mea of the Defense Business Operations Fund, we evaluated procedures and controls used...

  6. An in vitro method for detecting chemical sensitization using human reconstructed skin models and its applicability to cosmetic, pharmaceutical, and medical device safety testing.

    Science.gov (United States)

    McKim, James M; Keller, Donald J; Gorski, Joel R

    2012-12-01

    Chemical sensitization is a serious condition caused by small reactive molecules and is characterized by a delayed type hypersensitivity known as allergic contact dermatitis (ACD). Contact with these molecules via dermal exposure represent a significant concern for chemical manufacturers. Recent legislation in the EU has created the need to develop non-animal alternative methods for many routine safety studies including sensitization. Although most of the alternative research has focused on pure chemicals that possess reasonable solubility properties, it is important for any successful in vitro method to have the ability to test compounds with low aqueous solubility. This is especially true for the medical device industry where device extracts must be prepared in both polar and non-polar vehicles in order to evaluate chemical sensitization. The aim of this research was to demonstrate the functionality and applicability of the human reconstituted skin models (MatTek Epiderm(®) and SkinEthic RHE) as a test system for the evaluation of chemical sensitization and its potential use for medical device testing. In addition, the development of the human 3D skin model should allow the in vitro sensitization assay to be used for finished product testing in the personal care, cosmetics, and pharmaceutical industries. This approach combines solubility, chemical reactivity, cytotoxicity, and activation of the Nrf2/ARE expression pathway to identify and categorize chemical sensitizers. Known chemical sensitizers representing extreme/strong-, moderate-, weak-, and non-sensitizing potency categories were first evaluated in the skin models at six exposure concentrations ranging from 0.1 to 2500 µM for 24 h. The expression of eight Nrf2/ARE, one AhR/XRE and two Nrf1/MRE controlled gene were measured by qRT-PCR. The fold-induction at each exposure concentration was combined with reactivity and cytotoxicity data to determine the sensitization potential. The results demonstrated that

  7. Influence of surface polysaccharides of Escherichia coli O157:H7 on plant defense response and survival of the human enteric pathogen on Arabidopsis thaliana and lettuce (Lactuca sativa).

    Science.gov (United States)

    Jang, Hyein; Matthews, Karl R

    2018-04-01

    This study aimed to determine the influence of bacterial surface polysaccharides (cellulose, colanic acid, and lipopolysaccharide; LPS) on the colonization or survival of Escherichia coli O157:H7 on plants and the plant defense response. Survival of E. coli O157:H7 were evaluated on Arabidopsis thaliana and romaine lettuce as a model plant and an edible crop (leafy vegetable), respectively. The population of the wild-type strain of E. coli O157:H7 on Arabidopsis plants and lettuce was significantly (P lettuce regardless of day post-inoculation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Soviet debate on missile defense

    Energy Technology Data Exchange (ETDEWEB)

    Parrott, B.

    1987-04-01

    Although the Strategic Defense Initiative (SDI) is meant to cope with the danger of a Soviet nuclear attack, the recent US debate over SDI has paid surprisingly little attention to Soviet views of ballistic missile defense. Despite the existence of a substantial body of pertinent scholarship, the debate has failed to take adequate account of major changes in Soviet ballistic missile defense policy since the mid-1960s. It has also neglected the links between current Soviet military policy and broader Soviet political and economic choices. The Soviets regard SDI not as a novel undertaking to reduce the risks of nuclear war but as an extension of the geopolitical competition between the superpowers. This competition has been dominated in the 1980s, in the Soviet view, by sharply increased US assertiveness and the decline of detente. Viewing SDI as a manifestation of these general trends, Soviet decision makers find the prospect of an unregulated race in ballistic missile defenses and military space technologies deeply unsettling. The deterioration of superpower relations has raised serious doubts in Moscow about the wisdom of Soviet external policy during the 1970s and has provoked sharp internal differences over policy toward the US. Already highly suspicious of the Reagan administration, the elite is united by a general conviction that SDI is an American gambit that may ultimately undercut past Soviet strategic gains and pose a grave new threat to Soviet security. 14 references.

  9. Using the computer to optimize human performance in health care delivery. The pathologist as medical information specialist.

    Science.gov (United States)

    Korpman, R A

    1987-07-01

    The demands for information retrieval, processing, and synthesis placed on all providers of health care have increased dramatically in the last several decades. Although systems have been developed to capture charge-related data in support of cost reimbursement, there has been a conspicuous lack of attention paid to information tools to directly enhance the delivery of patient care. The termination of cost reimbursement, together with an increasing recognition of the problems inherent in current manual record-keeping systems, is creating a significant new focus on medical information. This change in focus requires a shift in systems orientation away from financial and departmentally centered systems and toward patient-centered approaches. There is thus increasing recognition of the need for a physician-level medical information specialist to serve as an institution's chief information officer, assuming responsibility for the collection, manipulation, and availability of all patient care-related data. By virtue of training, typical experience, hospital presence, and a noncompetitive position with the hospital's medical staff, the pathologist is uniquely suited for this position. To effectively perform this role, a variety of new specialized data management tools are becoming available. Integrated information systems, patient care management by exception, decision support tools, and, in the future, "artificial intelligence" assists can all be expected to become staples of pathology practice, especially impacting those pathologists who choose to be responsive to the new practice milieu of medical information science.

  10. Collaborative-Group Testing Improves Learning and Knowledge Retention of Human Physiology Topics in Second-Year Medical Students

    Science.gov (United States)

    Vázquez-García, Mario

    2018-01-01

    The present study examined the relationship between second-year medical students' group performance and individual performance in a collaborative-learning environment. In recent decades, university professors in the scientific and humanistic disciplines have successfully put into practice different modalities of collaborative approaches to…

  11. Ukraine - USA partnership for peace. AEMS project on development and improving of 'Defense' automated emergency management system of the Civil Defense Department of Ukraine

    International Nuclear Information System (INIS)

    1998-01-01

    AEMS project is destined for the development and improving of 'Defense' system of the Civil Defense Department of Ukraine. 'Defense' system is destined for prevention and operation prognosis of emergencies of technological and natural character on the territory of Ukraine as well as for the elaboration of the solutions on protection and rescue of the population and national economy resources. The data are processed at national, regional, district and town levels. By the results of task solutions possible losses of human and material resources as well as necessary forces and means for removal of these consequences are defined. (R.P.)

  12. Managing Quadrennial Defense Review Integration: An Overview

    National Research Council Canada - National Science Library

    Schrader, John

    2001-01-01

    ...). The lessons learned from the 1997 Quadrennial Defense Review (QDR 1997) included the need for leadership guidance and integration of analytic activities to sort through the myriad issues that are always confronting the Department of Defense...

  13. Department of Defense PERSEREC (DOD PERSEREC)

    Data.gov (United States)

    Social Security Administration — The purpose of this agreement is for SSA to verify SSN information for Defense Manpower Data Center (DMDC) of the Department of Defense. DMDC will use the SSA data...

  14. The Art and Science of Defense Logistics

    Science.gov (United States)

    1995-04-01

    The Art And Science Of Defense Logistics CSC 1995 SUBJECT AREA - Logistics THE ART AND SCIENCE OF DEFENSE LOGISTICS...Government EXECUTIVE SUMMARY Title: The Art and Science of Defense Logistics Author: Major S. I. Schuler, USMC Research Questions: 1...00-1995 4. TITLE AND SUBTITLE The Art And Science Of Defense Logistics 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6

  15. Missile defense in the United States

    OpenAIRE

    Heurlin, Bertil

    2004-01-01

    The basic arguments of this paper are, first, that the current US-missile defense, being operative from fall 2004, is based upon the former experiences with missile defense, second, that missile defense closely associated with weapons of mass destruction has gained the highest priority in American national security policy due to the 9.11 attacks, and third, that the superior argument for establishing an American missile defense is to maintain global, long term political-strategic superiority....

  16. [Forensic medical evaluation of a burn injury from combustion of flammable fluids on the human body based on morphological changes in internal organs].

    Science.gov (United States)

    Khushkadamov, Z K

    2009-01-01

    The author describes morphological features of splanchnic organs in the patients that suffered an injury from combustion of flammable fluids at the body surface. The burn injury is a specific form of trauma originating from a combination of several injurious factors including thermoinhalation and intoxication with combustion products in the absence of oxygen in the centre of the hot spot. A rather specific combination of morphological changes in internal organs along with results of laboratory studies provides the most reliable criterion for forensic medical diagnosis of burn injuries from combustion of flammable fluids on the human body.

  17. Mood States Associated with Induced Defensiveness.

    Science.gov (United States)

    Jaderlund, Natasha Slesnick; Waldron, Holly Barrett

    1994-01-01

    Compared effects of neutral and defensive mood induction in 70 students reporting conflicted versus nonconflicted families for presence of hostility, aggression, fear, anxiety, and sadness. Found that defensive students from high-conflict families reported stronger negative emotions than did neutral high-conflict and defensive low-conflict…

  18. 22 CFR 120.6 - Defense article.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Defense article. 120.6 Section 120.6 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS PURPOSE AND DEFINITIONS § 120.6 Defense article. Defense article means any item or technical data designated in § 121.1 of this subchapter...

  19. 22 CFR 120.9 - Defense service.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Defense service. 120.9 Section 120.9 Foreign... Defense service. (a) Defense service means: (1) The furnishing of assistance (including training) to..., educational, or information publications and media of all kinds, training aid, orientation, training exercise...

  20. 75 FR 65462 - Renewal of Department of Defense Federal Advisory Committee; Department of Defense Military...

    Science.gov (United States)

    2010-10-25

    ... Committee; Department of Defense Military Family Readiness Council AGENCY: Department of Defense (DoD... renewing the charter for the Department of Defense Military Family Readiness Council (hereafter referred to... requirements for the support of military family readiness by the Department of Defense; and (c) evaluate and...