Viability and recovery of peripheral blood mononuclear cells cryopreserved for up to 12 years in a multicenter study

Polish physicians-philosophers tried to find a compromise between medicine as a science and medicine as a healing art. They stated that clinical practice should be transformed into science, bearing in mind that there would be no medicine without the existence of the sick. A perfect physician is a good and wise person and not exclusively a proficient expert. Polish physicians exercised a science that they called philosophy of medicine. It included logic, psychology, and medical ethics. The Polish school claimed that the history of medicine and philosophy of medicine are necessary for future doctors. The historical and philosophical approach makes it possible to recognize the subject of medicine (health, disease, and the sick) and its aim (treatment, restoration of health or just alleviation of suffering). The ethics teaches what values are pursued by medicine, what moral duties a doctor has, and what role model to follow to become a good physician. Placing the sick in the focus of medical interest, the Polish school taught future physicians to see in them suffering fellow men who should be embraced with care, compassion, and Christian charity. Such an approach to the ethical aspect of medical philosophy became incorporated into an education towards humane values, responsibility for ones' life and health in the spirit of the ethics of care.     

Human values in medical education

Attitudes and values in medicine vary with the nature of the individual, his education and training, and the circumstances of his professional life. Comparisons are drawn between medical education in Britain 40 years ago and today. Though education has changed, British students are still mainly motivated by a desire to care for sick people. The impact of personal medicine on a country that has long accepted the need for some kind of national health service is described. It is postulated that as government and public become increasingly involved in health care, it is of paramount importance that medical education should provide a clear understanding of what a profession is and inculcate a determination to maintain true professional status. New responsibilities of the profession, to the public at large and to society, are suggested. The ability of medical education to exert a good influence on concern for human values in medicine depends in the final analysis on the ability to show excellence to medical students.     

Smooth muscle cells isolated from the neointima after vascular injury exhibit altered responses to platelet-derived growth factor and other stimuli

Health promotion is gaining widespread recognition throughout the world as the most efficacious practice in achieving health for all. In Canada, the philosophy of health promotion is driving both federal and provincial health initiatives. Such a philosophy is derived from a human science paradigm and is in direct opposition to the natural science paradigm from which the biomedical approach to health care emerged. There now exists a tension between these contrasting paradigms as health care shifts to embrace a health-promotion perspective. The nursing process is based in the natural science paradigm and on a biomedical approach to health care. In order for nurses to embrace health promotion fully, they must move away from the philosophy of the natural sciences and adopt a human science perspective. Such a shift requires a radical transformation in nursing practice as nurses move away from the 'top-down' approach of the nursing process and adopt a 'bottom-up' approach to health-promoting nursing practice. The purpose of this paper is to compare and contrast the nursing process with the principles of health promotion, and to challenge our use of the nursing process in current nursing practice. In particular, a framework for health-promoting nursing practice will be provided.     

Medical research at Norwegian universities

This study shows that Norwegian medical research suffers from lack of both public funds and recruitment, as well as being affected by the following major factors. Norway uses less of its GNP on R&D than other Western countries and less than the OECD average. Medical research in particular receives less financial support than in any of the other Nordic countries. Norwegian medical researchers publish less material and are cited less often than their colleagues in comparable countries. More than half of the medically trained scientific staff in Norway's four medical faculties will retire during the next decade and today there are many vacant positions in academic medicine because there are not enough competent applicants to fill them. The percentage of M.D.s among professors and lecturers has fallen, and a continued decline in preclinical and laboratory medicine and in public health is predicted. This percentage has also decreased among Ph.D. students, while the age at which medical doctors dissertate has increased and is higher than for other Ph.D.s. The number of medical students doing research has fallen in recent years, and the number of doctoral theses has not increased as much in medicine as in other fields. There are significant differences between the salaries paid in medical science and those paid in clinical medicine. Lack of resources and low salaries keep doctors from pursuing a career in academic medicine. In conclusion, if Norway is to be visible in the field of international medical science, this negative trend must be reversed and medical research and academic medicine revitalised.     

Hamartoma of the urinary bladder: case report and review of the literature

In this first article for the feature Humanism and Medicine, Rita Charon introduces an excerpt from Richard Selzer's introduction to his latest book, The Doctor Stories. In her introductory and concluding comments, Charon contemplates the role of stories in medicine and how both truth and healing can be found in both listening to and telling stories. In the excerpt presented, surgeon and writer Selzer muses on his twin crafts. As a writer, Selzer can fully appreciate that which he witnesses in his life as a doctor. His ruminations on his own dual citizenship suggests that all doctors, perhaps, can deepen their commitment to medicine, to their patients, and to themselves by strengthening their capacity to behold their patients and to grasp their predicaments. Selzer also traces his origins and, by implication, projects his future. As practicing physicians and medical educators, readers of Academic medicine might be inspired to do the same.     

Developing curricula in spirituality and medicine

In recent years patients and some members of the medical community have expressed the concern that doctors have forgotten about compassion and too often ignore their patients' spiritual concerns. Patients can and should expect their physicians to respect their beliefs and be able to talk with them about spiritual concerns in a respectful and caring manner. Medical schools must teach their students how to meet these expectations, and health care systems need to provide practice environments that foster compassionate caregiving. Medical educators are recognizing the need to bring the art of compassionate caregiving back into the medical school curriculum. This paper focuses on one approach to achieving this goal, the study of spirituality and medicine. The authors discuss the relationship of spirituality and healing, and describe studies that have shown patients' desire to have spiritual issues addressed by their physicians and the potential health benefits of spiritual beliefs. Finally, they describe common elements of the spirituality courses offered by approximately 50 U.S. medical schools, including 19 schools that have been awarded grants from the National Institute for Healthcare Research for the development of curricula in spirituality and medicine.     

Medical Records for Building Health Management

Medical records provide essential information for evaluating a patient’s health. Without them, it would be difficult for doctors to make accurate diagnoses. Similar to diagnoses in medical science, building health management also requires building medical records for making accurate diagnoses. At later stages of a building’s life cycle, when the budget is limited, organizations responsible for building repairs and maintenance are unable to digitalize building health diagnoses and keep complete medical records of buildings; as a result, maintenance crews usually cannot fully understand buildings’ overall health conditions and their medical histories, which may result in erroneous diagnoses directly or public safety dangers indirectly. Using the problem-oriented medical record adopted for the medical diagnosis of human diseases, this paper designs a building medical record (BMR), which allows simple electronic archiving, and evaluates its practicability with a case study of school buildings. The purpose of a BMR is to enable maintenance engineers (building doctors), building managers, and contractors of school buildings to have low-cost access to required information for making complete evaluations and maintenance suggestions for buildings.     

The influence of acid on astringency of alum and phenolic compounds

For any physician, sympathetic interaction with his/her patients should remain a central concern. It is his/her task to understand the patient's hopes, fears, anxieties and social situation, as well as to understand himself and his own motives and attitudes, which can often be identified as helplessness. Continually advancing technology, rationalization, time, and the pressure for success leave less and less room for such considerations in medical practice. While patients often consider their medical care as very good, they, however, complain that the emotional support is often insufficient. Thus, for the benefit of both the doctor and the patient, every physician has to assure compassion in his relationship with the patients. Medical doctors taking care of cancer patients do not need only thorough medical training but also additional training in psychosomatic medicine.     

Rehabilitation psychology in primary care: Preparing for a changing health care environment.

Restructuring of health care delivery systems has deemphasized tertiary and specialty services with a resultant increase in primary medical care. These reform efforts are anticipated to continue, highlighting the need for rehabilitation psychologists to expand beyond tertiary care settings to sustain the growth and prosperity of their profession. New models of service delivery and training are needed to help them transition into the new health care environment. A recently developed model for integrating behavioral medicine into primary care may serve as a guide. In this paper we discuss a model for integrating behavioral science into the medical management of primary care patients. The model is applicable to the functions and philosophy of rehabilitation psychologists. A discussion of the new model and its relation to rehabilitation psychology is provided along with implications for predoctoral training and strategies for overcoming barriers to primary care integration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some unresolved challenges facing psychology's entrance into the health care field.

Psychology has recently attempted to broaden service, research, and training opportunities. However, major differences between psychology and medicine over paradigms, training approaches, and organizational and professional practice issues may impede psychology's growth in the health science field. The hospital setting for physicians and for university and community training environments for psychologists foster the development of different analytic abilities and attitudes regarding disciplinary primacy and approaches to patient care. As such, total medical authority over all health-related professions is sought. This medical dominance is inimical to the emergence of psychology as an independent health-related discipline. These differences are further magnified at a professional level, as psychology expands the scope of its practice and threatens the economic and organizational control that medicine exerts over health care. Concern is expressed over the ability of psychology to establish itself as a major force in a field that is structurally dominated by the medical profession, which would probably resist any change that is not in its own best interest. (42 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Involvement of lipid peroxidation in free fatty acid-induced isolated rat pancreatic acinar cell injury

Ophthalmologists play a relatively peripheral role in medical student and resident education. A review of the evolution, funding, and administration of medical education in the United States lends insight into why this is so. The author reviews the current status of education in ophthalmology for medical students and residents; the development of an ophthalmology curriculum; alternatives to the traditional medical school curriculum and how these have been incorporated into ophthalmic education; and the effect of new trends in medical education and pressures created by health care reform on the education of medical students and residents. The role of ophthalmologists in the general practice of medicine and in teaching doctors about the eye is discussed. Finally, the opportunity that the current climate presents for ophthalmologists to define their role in health care through education is considered.     

The standardization of medical care and the training of medical personnel

The medical specialist training at all levels (medical orderly, doctor's assistant, general practitioner, doctors) should be based on the medical care standards. Preliminary studies in the field of military medicine standards have demonstrated that the medical service of the Armed Forces of Russia needs medical resources' standards, structure and organization standards, technology standards. Military medical service resources' standards should reflect the requisitions for: all medical specialists' qualification, equipment and material for medical set-ups, field medical systems, drugs, etc. Standards for structures and organization should include requisitions for: command and control systems in military formations' and task forces' medical services and their information support; health-care and evacuation functions, sanitary control and anti-epidemic measures and personnel health protection. Technology standards development could improve and regulate the health care procedures in the process of evacuation. Standards' development will help to solve the problem of the data-base for the military medicine education system and medical research.     

Health psychology at the crossroads.

Reviews the books, Handbook of psychology and health, volume I: Clinical psychology and behavioral medicine: Overlapping disciplines, edited by R. J. Gatchel, A. Baum, and J. E. Singer (see record 1985-97683-000); Handbook of psychology and health, volume II: Issues in child health and adolescent health, edited by A. Baum and J. E. Singer (1982); and Introduction to medical psychology by J. C. Norton (1982). The conflict between the traditional medical model and the biopsychosocial model threatens to prevent the establishment of health psychology's principles and identity. This conflict clearly characterizes the volumes presently under review. James C. Norton's Introduction to medical psychology aims to introduce mental health professionals to medicine, to teach behavioral treatments for disease, and to address issues of health promotion. The Handbook of psychology and health is a much more ambitious attempt to meet the same goals. The volumes are "intended for investigators, clinicians, teachers, and both graduate and undergraduate students." Given tradition, simplicity, inertia, and existing status structures, the traditional medical model has an almost overwhelming allure. Unfortunately, the traditional medical model also is inadequate, and its deficiencies cannot be remedied by forcing psychological and behavioral problems into its mechanistic clutches. By carefully reviewing and evaluating complex issues in health psychology while simultaneously endeavoring to prescribe clinical and medical treatments, the volumes under review delineate the dilemma facing health psychology; but they do little to resolve it. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lipids from Mycobacterium leprae cell wall suppress T-cell activation in vivo and in vitro

The need for an ethics of medical justice in Latin America is asserted in the context of a review of concepts of justice throughout history and of changing governmental perspectives on provision of health care in the US and other developed countries. The current view that individuals are primarily human resources is at odds with a long tradition asserting the intrinsic dignity of human beings. English-speaking bioethicists began in the 1960s to stress the principal of autonomy of patients, recognizing their right to make decisions on their own lives and medical care equally with the physician. At the same time, the US has approved no legislation establishing a right to health care, which is rather regarded as a private good. Governments are increasingly inclined to renounce their role as direct providers of health care. The liberal democratic state until recently understood that it fulfilled its ethical commitment to promoting social justice through provision of health care. Nevertheless, societies that stress the importance of the individual in decision-making and that conceive of health as a private good are confronted with the contradiction of apparently irreconcilable visions. With infinite demand for health services and limited health resources, the discourse of autonomy has slowly been replaced by a discourse of distributive justice. The most appropriate version of distributive justice for Latin America is probably that which affirms the duty of assisting those most in need. The prevalence of malnutrition, misery, and premature death in the world is a clear sign of imbalance. If the essential dignity of all human beings and not just of the elite is to be affirmed, medical justice must become the most urgent priority of Latin America.     

Psychologists as change agents in chronic pain management practice: Cultural competence in the health care system.

Psychologists bring great value to health care systems, but our ethnocentrism regarding the medical community often limits our effectiveness as agents of change. Based on experience in developing pain management services within the Department of Veterans Affairs health care system, we discuss cultural issues as central to effective systems change and provide specific recommendations for psychologists aspiring to change organized health care systems, such as the Department of Veterans Affairs. Consideration is given to the misfit of the biomedical model to chronic pain, “physics envy” affecting the authority accorded psychology, and societal stigmatization of psychopathology. A process-based definition of cultural competence is recommended as improving on psychology's intrinsic group-based notion of culture in engaging the medical community. The systems thinking literature is sampled in summarizing practical recommendations that include identifying features of local medical culture and power dynamics between psychology and medicine that can be modified by engaging stakeholders in an interpersonally effective manner. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The drive for professionalization in acupuncture: a preliminary view from the San Francisco Bay area

Although various biomedical physicians and chiropractors now employ acupuncture, generally as an adjunct therapy to their practices, acupuncture is quickly evolving into a professionalized heterodox medical system in various areas of the United States. This process has overlapped considerably with the rise of the holistic health movement. Acupuncture particularly obtained public recognition and political legitimation in California, where about one half of all the licensed acupuncturists in the U.S. presently practice. In part drawing upon case studies that various students conducted in a course titled "Medical Pluralism in North America and Europe" that one of the authors taught at Berkeley in the spring of 1994, this paper examines several aspects of the drive for professionalization within acupuncture in the San Francisco Bay area, one of the major centers of acupuncture in the U.S. Other major centers of the holistic health movement include New York, Boston, Washington, DC, Houston, Seattle, and Santa Fe. It considers two dimensions involved in the professionalization of acupuncture: (1) the creation of schools of traditional Chinese medicine and acupressure and (2) accommodation to the biomedical model. The essay also explores the health policy implications of the emergence of acupuncture as a professionalized heterodox medical system that views itself as an alternative or complementary form of primary health care.     

Folk medicine and health culture in contemporary society

Folk medicine comprises "unofficial health beliefs and practices" which rely heavily (but not exclusively) on oral transmission. It is one form of alternative medicine, and a major source for many other forms such as phytotherapy and mind/body medicine. While many folk medicine ideas and practices are associated with particular ethnic groups, many others are widely distributed throughout American society. Folk medicine is not dying out in the modern world. Because it has both medical benefits and risks, effective medical care with folk medicine requires awareness and discussion of its influence.     

Lorrin A. Riggs.

Presents the biography and lists the scientific publications of Lorrin A. Riggs, a recipient of the award for Distinguished Scientific Contribution in 1974. For his many basic and incisive studies of human vision. His ingenious contact lens electrode made possible the first reliable quantitative correlations of a subject's electroretinogram with his psychophysical responses. By another adaptation of the contact lens, he obtained highly precise and quantitative measures of both voluntary and involuntary eye movements, the latter proving to be essential for the maintenance of vision. His further electrophysiological studies of human peripheral color receptors and their concurrent evoked cortical responses laid the groundwork for his most recent studies of the color and form "channels" of the human perceptual system. All this bespeaks a mastery of visual science, its physiology and psychology in the grand tradition of Helmholtz. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

125th anniversary of Revista Médica de Chile

The first issue of Revista Médica de Chile was printed in July, 1872. Since then, it has been published monthly, interrupted only for a few months during a Chilean civil war (1891). This medical journal has been devoted mainly to clinical topics in internal medicine, but currently it includes an increasing proportion of research papers in other biomedical and preclinical subjects. This journal is included in the most important international indexes of biomedical publications. Most issues cover also medical education, public health, the ethics of clinical and experimental research, medical administration and the history of medicine. The evolution of medicine in Chile along 125 years is clearly reflected in the contents of this journal. Revista Médica de Chile is one of the oldest medical journals in the world, particularly among those published in Spanish, and a top ranking biomedical publication in Chile.