Contemporary medicine involves a lot more than technologies that now permit effective medical intervention where none was possible before. Among other things, changes in technology have been accompanied by changes in social and cultural attitudes that are having major effects on health care and medical practice. This article provides a ...

Knowledge of the timing of, reasons for, and frequency of major medical-career changes of medical school graduates is useful in considering physician manpower needs. This study reports aspects of the medical-career changes made by a cohort of Alberta medical school graduates who graduated from 1973-1985. Of the 603 (81%) who ...

In the discourse of medical encounters, social problems arise frequently. Such problems typically derive from work and economic insecurity, family life and gender roles, aging, and conditions that foster substance use or other self-destructive behavior. The structure of medical discourse tends to marginalize the social issues that generate personal troubles ...

This rule sets forth changes in Medicare policy concerning payment for the direct graduate medical education costs of providers associated with approved residency programs in medicine, osteopathy, dentistry, and podiatry. These changes implement section 1886(h) of the Social Security Act, which was added by section 9202 of the Consolidated Omnibus ...

The challenge to medical education as we enter the last decade of the century and face the next millenium is how to utilize the new knowledge of human learning to train medical students in applying the fruits of rapidly advancing science and technology to the moral imperative of fulfilling social ...

The state of the art for insect allergy has undergone significant changes over the last two decades. Epinephrine, which is indispensable to treat all but the mildest reactions, is available in portable kits and can be used by the patient when medical help is not readily available. Venom immunotherapy has ...

The paper reviews sociological research on the medical school as a social organization from the 1950s to the present. Despite significant differences between societies in the organization of medical education, such research has been largely confined to the USA. Some reasons for this are suggested. Ways in which the climate ...

Expressive timing methods are described that map pianists' musical thoughts to sounded performance. In Experiment 1, 6 pianists performed the same musical excerpt on a computer-monitored keyboard. Each performance contained 3 expressive timing patterns: chord asynchronies, rubato patterns, and overlaps (staccato and legato). Each pattern was strongest in experienced pianists' ...

This paper is based on one which was prepared to support the World Conference of the World Federation for Medical Education in August 1988. It is designed to provide a broad perspective on the essential elements of an educational change process. The paper covers the stages in designing a change ...

Emerging public health problems, alterations in the nature of the medical profession and changes in individual student and practitioner needs are identified. The implications of these developments for modification of the content, organization, setting and instructional strategy of the medical education programme are discussed. A model for systematic consideration of ...

To study the physiological and psychophysical costs of symmetric and asymmetric manual materials handling, two tasks were performed by 30 industrial subjects. In both tasks, box weight and handle position were varied. The symmetric task, lifting and lowering between floor and conveyor, showed handles to be beneficial. The asymmetric task ...

To evaluate the effect of prolonged environmental extremes on common prehospital medications, four identical sets of 23 drugs were placed in a simulated environment for up to four weeks. Subsequently, the samples were analyzed by gas chromatography-mass spectrometry for evidence of degradation byproducts. Twenty-one of the 23 samples showed no ...

Medical students who had to undergo an important set of examinations were asked to fill out two questionnaires, the first early in the term, the second 1 or 2 wk before the exams. Students whose anxiety increased substantially between the two questionnaire administrations reported that their thoughts had become more ...

As part of a larger study aimed at surveying the clinical, histological and immunohistochemical features of filiform atrophy and geographic and fissured tongue, this work presents the clinical findings of three patient groups and controls. 200 individuals were examined; 18 (9%) had atrophic tongue, 15 (7.5%) geographic tongue and 53 ...

The following is an account of how indigenous social structure in Nepal shapes the organization and functioning of the country's allopathic medical profession. There is a division between doctors who are well placed socially and politically, who would like to maintain the traditional kinship based patron-client system of promotions and ...

Because it still is widely believed that one deadly disease after another is being eliminated, or diminished, largely because of medical interventions, there is little commitment to social change and even resistance to a reordering of national priorities. In this article we examine the contribution of medical measures to recent ...

During the 40 years of the NHS, photographic and graphic technology has undergone enormous change and progress. But has the medical illustrator kept up with these changes and is his status within the service, relative to other staff, as high as it was; or is he gradually sinking to become ...

A historical comparison of the careers of George Beard, medical doctor, and Lydia Pinkham, feminist and patent medicine maker, demonstrates the complex social nature of the experience of nerves among late 19th century women. Special attention is paid to the roles played by changing gender and class ideologies in Pinkham's ...

Defining a behavior as a medical problem can change both its moral and legal consequences. Responses to suicide were secularized in the late seventeenth and eighteenth centuries as coroners' juries increasingly adopted the medical explanation for self-destruction and excused suicides as innocent lunatics who were not criminally responsible for their ...

Medical schools in developing countries are constantly faced with the problem of adapting an inherited style of education to suit local needs and constraints. Often these needs have changed considerably since the curriculum was first established. Yet the difficulty of bringing about curricular changes, especially in conventional medical schools, is ...

This paper examines the results of the change of use of 44 out of a complement of 128 general medical beds to geriatric rehabilitation/assessment beds in a general hospital. The method is based on bed utilisation statistics and the results demonstrate that the reduced complement of medical beds functions more ...

The pharmacokinetic parameters of theophylline and its major metabolites were measured in two healthy volunteers, after the administration of theophylline alone and during co-medication with ofloxacin, 200 mg twice daily, or enoxacin, 200 mg twice daily. During enoxacin co-medication, elimination half-lives of theophylline increased from 8.7 h to 17.4 h ...

In patients with lupus nephropathy (LN), previous studies have shown that creatinine clearance (CCr) overestimates true glomerular filtration rate as measured by inulin clearance (CIn), and that among patients the degree of overestimation is highly variable. We sought to determine whether the discrepancy between CCr and CIn remains constant over ...

Five pelvises were photographed, roentgenographed, and sequentially sectioned or reamed to determine the location and appearance of the acetabular teardrop figure. The teardrop is located inferomedially in the acetabulum, just superior to the obturator foramen. The lateral lip is the exterior, and the medial lip is the interior of the ...

Perception follows logarithmic or power functions, rather than linear functions, of stimulus intensity. A small increment in stimulus strength can be sufficient to elicit discrimination between individuals of different phenotypes when the initial stimulus magnitude is near zero. This may confer an incipient advantage to the mutation that caused it. ...

Since 1945, the Japanese physique has changed a great deal. Physical examinations of medical students at Kyushu University have been carried out on an annual basis since 1939. We investigated changes in body proportions using data on 813 medical students examined from 1961 to 1986. During these 26 years, standing ...

Airway reactivity is known to increase in relation to the severity of asthma, and, in the community, hyperreactivity has been shown to be associated with respiratory symptoms such as wheezing and shortness of breath. However, the relation between change in airway reactivity and change in the severity of respiratory symptoms ...

Somatostatin-28 (SS-28) acted within the central nervous system (CNS) to produce a dose-dependent elevation of mean arterial pressure (MAP), a reduction of heart rate (HR), and an elevation of the plasma concentration of vasopressin. SS-28 given intravenously did not affect MAP or HR. Furthermore, these changes of cardiovascular functions were ...

Few experimentally rigorous studies have been conducted to determine the emotional impact of the infertility investigation on the infertile couple. In response to the deficit in rigorous experimental research, a longitudinal, exploratory study of 43 primary infertile couples was conducted. The study was conducted to determine if changes occurred in ...

In the last 5 years there has been an extraordinary increase in negligence actions against South Australian ophthalmologists. This paper considers the reasons, in particular those changes in the interpretation of the law which have made doctors vulnerable. Medical practice needs to be modified if doctors, especially surgeons, are to ...

Increasingly, patients with complicated medical problems are coming to dental offices for treatment. These patients report using a variety of medications to control one or more chronic conditions. Many of these medications produce changes in the mouth because of toxic overdoses, side effects, allergic reactions, or as a consequence of ...

Hair color changes result not only from alterations of melanin production but also from changes in the hair structure itself, altering its optical properties. A variety of genetic, metabolic, nutritional, and acquired disorders result in hair color changes. When the underlying defect can be corrected, hair color usually returns to ...

The Fontan circulation occasionally cannot be sustained by currently available medical treatment. In these circumstances, mechanical assistance to the Fontan circulation should be considered. We have experienced three cases where Fontan circulation was assisted by intra-aortic balloon pumping (IABP). The hemodynamic improvement and weaning from IABP were successfully achieved in ...

In the 20 years that have passed since I received my medical degree, some of the most evident, striking, and interesting changes in patterns of diseases have occurred among those due to transmissible agents. Among other changes are the recognition of new diseases, new clinical manifestations for old diseases, new ...

Once again, I find Mr. Cooper quote-worthy for his statement, "It is incumbent upon the trial bar not to support the status quo merely because it is in our economic interest. Change is in the wind, and our tort system will be blown away on the winds of change for ...

In 1986 in USSR medical investigations were continued in 125-day flight on "Salyut-7" and "Soyuz-T-15" orbital stations and on "Mir" basic block. Medical program consisted of medical control during active parts of flight and works in open space, profound medical examinations in rest and in function tests, metabolism and its ...

Changing times, as evidenced by the Health Care Quality Improvement Act of 1986 and the Joint Commission's "Agenda for Change," have made many committees as well as traditional quality assurance and peer review methods obsolete. The new hospital-wide accountability system consists of accurate and valid clinical data, provided in a ...

This study evaluated the relationship between brompheniramine maleate and changes in nasal reactivity. Ten subjects with moderate-to-severe perennial rhinitis took brompheniramine for seven days using either a standard formulation or sustained-release preparation. Nasal aerodynamics and response to histamine were assessed at the end of the week. Despite varying doses of ...

Technological advances in medicine have greatly enhanced the ability of physicians to treat disease and disability, but, at the same time, changes in the organization and management of health care services in the United States have imposed constraints on their autonomy. How have these changes--medical advancement and professional decline--affected the ...

Experiments on skin moisture, i.e. the hydration state of the outer epidermis, were undertaken using three different types of equipment, i.e. the Skicon-100 and Corneometer CM 420 hydrometers and the Servo Med EPI evaporimeter. The studies included 10 healthy volunteers. Water was applied to test sites on the forearm and ...

This community-based study of epilepsy in Rochester, Minnesota found that almost 60% of 127 adults aged 18-59 said they had altered their anticonvulsant medications in one of the following 3 ways: stopped taking them for at least 3 days, discontinued them completely, or changed the dosage for more than 2 ...

These rules amend the Medicare regulations that deal with supplementary medical insurance (SMI) premiums. These changes are necessary to conform our rules to changes made in the Medicare laws since the rules were last published. The purpose is to ensure that those who must apply our rules are not misled ...

During the past five years, the medical pharmacology course at the University of Arkansas College of Medicine has changed from a poorly attended course in which students depended on "canned notes" (from a note-taking and note-distribution system organized among themselves) and had bad rapport with faculty members to a course ...

"Change" is a critical dimension of contemporary experience. Library associations are not exempt, and they change in ways similar to other organizations. According to some authorities, four phases typify the process: diagnosis, design, implementation, and incorporation. Focusing on changes in the Medical Library Association's longstanding program of continuing education, the ...

The hydrophobic characteristics of Clostridium perfringens NCTC 8679 spores were demonstrated by adherence to toluene in a toluene-aqueous partition system. Spores and spore coat preparations were hydrophobic. Vegetative cells and spores extracted with a dithiothreitol-sodium dodecyl sulfate treatment known to remove spore coats were not hydrophobic. A heat activation treatment ...

Eighty-seven medicated essential hypertensives received either thermal biofeedback (TBF) or progressive muscle relaxation (PMR) training as a substitute for their second-stage antihypertensive medication. The psychological changes accompanying the treatments were obtained at pretreatment, at post-treatment and at the 3- and 6-month follow-up. Few psychological changes were noted, owing in part ...

To assess changes in disease on an internal medicine teaching service, the records of 292 patients admitted to University Hospital, Denver, Colorado, in the academic years 1961-1962 or 1981-1982 were reviewed. It was hypothesized that patients admitted more recently would be older, more chronically and catastrophically ill, and more likely ...

The purpose of this investigation was to study the influence of the flare at the lateral side of the heel of running shoes on: initial and total pronation; impact forces in heel-toe running; and to explain the results with a mechanical model. The experimental part of the study was performed ...

Regional migratory osteoporosis (RMO) is a well-defined clinical entity, consisting of migratory osteoporosis involving the lower extremities with associated radiographic changes. Idiopathic osteoporosis (IO) is considered to be a separate and distinct entity, occurring in young adults and consisting of axial osteoporosis and back pain. We describe a patient who ...

Qualitative and quantitative changes in the concentration of proteins, sialoglycoproteins and gangliosides and in the composition of gangliosides in the brains of the neotene and the thyroxine-induced metamorphic newt axolotl (Ambystoma mexicanum) were investigated. During metamorphosis two polar gangliosides (GT1b and GQ1b) decreased by about 5% each. On the contrary ...