MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Perspectives in Biology and Medicine' source. Thu, 29 Dec 2011 13:47:16 +0100 http://www.medworm.com/index.php?rid=5360137&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22019532%26dopt%3DAbstract Authors: Grob GN Abstract Abstract:At the beginning of the 21st century, fibromyalgia syndrome (FM) has become a diagnostic category that includes extremely large numbers of people, predominantly women. Yet only a few decades ago, FM (and its predecessor fibrositis) was of little interest or concern to either physicians or the general public. What, then, were the origins of the FM diagnosis, and why did its boundaries expand so rapidly during and after the 1980s? The answers to such questions are complex. Broad social and intellectual currents, internal developments within medicine, the appearance of a self-conscious women's movement, and the rise of an increasingly important pharmaceutical industry all converged to elevate the importance of FM. Yet the diagnosi... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5360137 Mon, 31 Oct 2011 00:40:05 +0100 5360137 http://www.medworm.com/index.php?rid=5360136&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22019533%26dopt%3DAbstract This article develops this idea further, suggesting that placebo response represents a nervous-system response aimed at countering the dysphoric effects attributable to chronic stress, and that it is dependent on developmental attachment dynamics. A range of behaviors by caregivers that mimic those achieved during secure attachment are suggested to promote placebo responses. PMID: 22019533 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5360136 Mon, 31 Oct 2011 00:40:05 +0100 5360136 http://www.medworm.com/index.php?rid=5360135&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22019534%26dopt%3DAbstract Authors: Reid L Abstract Abstract:Conceptions of professionalism in medicine draw on social contract theory; its strengths and weaknesses play out in how we reason about professionalism. The social contract metaphor may be a heuristic device prompting reflection on social responsibility, and as such is appealing: it encourages reasoning about privilege and responsibility, the broader context and consequences of action, and diverse perspectives on medical practice. However, when this metaphor is elevated to the status of a theory, it has well-known limits: the assumed subject position of contractors engenders blind spots about privilege, not critical reflection; its tendency to dress up the status quo in the trappings of a theoretical agreement may limit social ... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5360135 Mon, 31 Oct 2011 00:40:05 +0100 5360135 http://www.medworm.com/index.php?rid=5360134&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22019535%26dopt%3DAbstract Authors: Gans H Abstract Abstract:One would expect that the first to arrive at a new observation, discovery, or concept would be properly acknowledged as such. Unfortunately, it is not unusual that someone else receives the credit. This is not just unfair and unethical, but it also distorts the history of science. In addition, the victims of misattribution are deeply affected by losing not only the recognition of being first, but also the credit, kudos, and other benefits that derive from their contribution. This issue deserves far more attention than it currently receives. It continues to cause much mischief in the most unexpected places and under circumstances that should not be tolerated. This article looks at the consequences of some instances of misattribut... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5360134 Mon, 31 Oct 2011 00:40:05 +0100 5360134 http://www.medworm.com/index.php?rid=5360133&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22019536%26dopt%3DAbstract Authors: Buchanan A, Weiss EB Abstract Abstract:The Victorian poet Elizabeth Barrett Browning suffered for most of her life from an illness that her physicians were never able to diagnose, and that Barrett Browning scholars and others have tried to diagnose since her death in 1861. Many suggestions have been offered, but none has been convincing. By happenstance, my daughter was reading the correspondence of Elizabeth and Robert Browning not long ago, and she recognized the symptoms described as those of the rare muscle-weakening disorder she herself has, hypokalemic periodic paralysis (HKPP). The evidence from Barrett Browning's letters and the diary she kept when she was 25 strongly suggest she too had HKPP. PMID: 22019536 [PubMed - in process] (Source: Pers... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5360133 Mon, 31 Oct 2011 00:40:05 +0100 5360133 http://www.medworm.com/index.php?rid=5360132&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22019537%26dopt%3DAbstract Richard doll and alice stewart: reputation and the shaping of scientific "truth". Perspect Biol Med. 2011;54(4):504-31 Authors: Greene G Abstract Abstract:As the world watched the Fukushima reactors release radionuclides into the ocean and atmosphere, the warnings of Dr. Alice Stewart about radiation risk and the reassurances of Sir Richard Doll assumed renewed relevance. Doll and Stewart, pioneer cancer epidemiologists who made major contributions in the 1950s-he by demonstrating the link between lung cancer and smoking, she by discovering that fetal X-rays double the chance of a childhood cancer-were locked into opposition about low-dose radiation risk. When she went public with the discovery that radiation at a fraction of the dose "known" to be dangero... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5360132 Mon, 31 Oct 2011 00:40:05 +0100 5360132 http://www.medworm.com/index.php?rid=5360131&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22019538%26dopt%3DAbstract This article brings his accomplishments to the attention of the contemporary medical public. PMID: 22019538 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5360131 Mon, 31 Oct 2011 00:40:05 +0100 5360131 http://www.medworm.com/index.php?rid=5360130&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22019539%26dopt%3DAbstract Authors: Rinčić I, Muzur A Abstract Abstract:Since the discovery of his work in 1997, Fritz Jahr (1895-1953) has slowly become recognized as the author of the term and concept of bioethics. Jahr's ideas on bioethics were partly different from those shaped by Van Rensselaer Potter in the 1970s and, therefore, might be helpful for the further reform and broadening of modern bioethics. In this article, the authors elucidate ideas from lesser-known works by Jahr, especially those considering animal protection and teaching. PMID: 22019539 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5360130 Mon, 31 Oct 2011 00:40:05 +0100 5360130 http://www.medworm.com/index.php?rid=5360129&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22019540%26dopt%3DAbstract This article reviews the cultural history of man's relationship with tobacco and the steps in the discovery of tobacco addiction. Nicotine dependence (ND) or nicotine addiction (NA), among other forms of drug addiction, continues to be a significant public health problem in the world, as it is associated with major severe diseases such as cardiovascular disease and cancer. Evidence for a genetic influence on smoking behavior and ND has prompted a search for susceptibility genes. Proof has recently accumulated that single nucleotide polymorphisms (SNPs) in the genetic region encoding the nicotinic acetylcholine receptor (nAChR) subunits α5, α3, and β4 are associated with smoking and ND. In this review, we consider tobacco as the archetype of substance addiction and ... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5360129 Mon, 31 Oct 2011 00:40:05 +0100 5360129 http://www.medworm.com/index.php?rid=5360128&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22019541%26dopt%3DAbstract This article presents a recent disconcerting event that took place at a rehabilitative nursing home in Tel Aviv in light of Israel's Dying Patient Law, which came into effect in 2005. It probes the double effect doctrine as it is relevant to the case at hand and the role of the medical profession and of the family in making decisions at the end of life, and it argues that patients who express a wish to die should receive a comprehensive care assessment that addresses their physical and mental condition before rushing to provide lethal medication. The article concludes by offering some guidelines to help practitioners address the intricate questions they face when patients ask to die. PMID: 22019541 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5360128 Mon, 31 Oct 2011 00:40:05 +0100 5360128 http://www.medworm.com/index.php?rid=5152657&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21857122%26dopt%3DAbstract Authors: Hirsch J Abstract The year 2010 marked the centennial of the Rockefeller University Hospital, one of the great philanthropic achievements of 20th-century science. For 100 years, the Hospital played a central role in the development and growth of medical science by enabling physician-scientists to make intensive study of human biology and disease. With ingenuity and devotion, they greatly enriched clinical medicine as well as basic biological science. This account emphasizes the founding and first half-century of the Hospital as it became a germinal center for clinical investigation. The second half of the century saw rapid change in medicine and health care with vexing problems, many yet unsolved. This history should serve as a call to arms for maintaining the linkage of s... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5152657 Wed, 24 Aug 2011 23:28:02 +0100 5152657 http://www.medworm.com/index.php?rid=5152643&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21857123%26dopt%3DAbstract Authors: Buhles WC Abstract This history chronicles the unusual development of the antiviral drug ganciclovir. The first compound with activity against human cytomegalovirus (CMV), ganciclovir was so clearly efficacious that a placebo-controlled clinical trial could not ethically be done, and the FDA rejected the first application to market the drug. Used to treat a blinding eye infection in patients with AIDS, the story of ganciclovir paralleled the spread of the AIDS epidemic. Both ganciclovir and AIDS caught the federal government off guard. Caught in a Catch-22 situation, the pharmaceutical company developing ganciclovir gave the drug away free for five years under compassionate use guidelines. The problems encountered in the development of ganciclovir provide guidance on how f... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5152643 Wed, 24 Aug 2011 23:28:02 +0100 5152643 http://www.medworm.com/index.php?rid=5152635&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21857124%26dopt%3DAbstract This article considers the rise and fall of gene therapy for CF and suggests that CF may provide a particularly compelling case study of a failed genomic technology, perhaps even of a medical "canary." The story of CF might be a kind of warning to us that genetic medicine may create as many problems as it solves, and that moving forward constructively with these techniques and practices requires many kinds of right information, not just about biology, but also about values, priorities, market forces, uncertainty, and consumer choice. PMID: 21857124 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5152635 Wed, 24 Aug 2011 23:28:02 +0100 5152635 http://www.medworm.com/index.php?rid=5152628&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21857125%26dopt%3DAbstract This article presents some of the more striking examples of atavisms, discusses some of the currently controversial issues like human quadrupedalism, and reviews the progress made in explaining some of the mechanisms that can lead to atavistic features. PMID: 21857125 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5152628 Wed, 24 Aug 2011 23:28:02 +0100 5152628 http://www.medworm.com/index.php?rid=5152619&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21857126%26dopt%3DAbstract This article tracks the transformations in the history of legislative response in Australia to the anxieties provoked by the use of reproductive and regenerative human material over the last 40 years, in order to examine how embryos have come to adopt such a special position in the community's psyche. "The embryo" is at once a biological, scientific, social, cultural, and political object, fixed by the legislative processes that seek to define it, and subject to definitions that change over time. Understanding the history of where our ideas about the embryo have come from can help us to negotiate the continuing debate about the use of human embryos in research. PMID: 21857126 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5152619 Wed, 24 Aug 2011 23:28:02 +0100 5152619 http://www.medworm.com/index.php?rid=5152607&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21857127%26dopt%3DAbstract This article explores the biological background and discusses the neuroscientific evidence for shared brain pathways for aesthetics and morals. PMID: 21857127 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5152607 Wed, 24 Aug 2011 23:28:02 +0100 5152607 http://www.medworm.com/index.php?rid=5152602&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21857128%26dopt%3DAbstract "Wonders unconceived": reflections on the birth of medical entomology. Perspect Biol Med. 2011;54(3):381-98 Authors: Cirillo VJ Abstract Prior to Patrick Manson's discovery in 1877 that the mosquito Culex fatigans was the intermediate host of filariasis, the association of insects with disease and the nature of disease transmission was almost entirely speculation. Manson's work was incomplete, however, because it showed the manner in which the mosquito acquired the infection from humans, but failed to show the way in which the mosquito passed the infection to humans. That pathogens were transmitted by the bite of an infected female mosquito was later proven experimentally with bird malaria by Manson's protégé, Ronald Ross. In 1898 Ross demonstrated that the infective stag... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5152602 Wed, 24 Aug 2011 23:28:02 +0100 5152602 http://www.medworm.com/index.php?rid=5152601&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21857129%26dopt%3DAbstract This article examines the broader structural constraints that provide incentives, erect barriers, or otherwise shape the potential for interdisciplinary research and practice, with particular attention to work involving the life sciences. It argues that in order to understand the nature and scope of the problems facing interdisciplinary work, we must focus on the institutional constraints that shape how individuals frame questions, pursue investigations, develop careers, and collaborate. PMID: 21857129 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5152601 Wed, 24 Aug 2011 23:28:02 +0100 5152601 http://www.medworm.com/index.php?rid=5152600&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21857130%26dopt%3DAbstract This article focuses on a different way in which organ transplantation shapes recipient identity: the idea of becoming whole. We present the case studies of two women separated by a century (one in 1902 and the other in 2004) who sought ovarian transplantation, and examine how ovarian transplantation can engender a sense of wholeness on the individual, the familial, and the cultural levels, due to its ability to enable a recipient to naturally conceive and experience pregnancy. PMID: 21857130 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=5152600 Wed, 24 Aug 2011 23:28:02 +0100 5152600 http://www.medworm.com/index.php?rid=4802122&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21532128%26dopt%3DAbstract This study, carried out in prisoners and patients with schizophrenia in 1941-42, largely disappeared from public discourse for a number of years. It has received occasional attention subsequently and been considered controversial. Recently discovered records, including extensive written and photographic data from the studies, shed new light on the methods and motives of the research team. We describe here this new information and its implications for the scientific and ethical assessment of the study. PMID: 21532128 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4802122 Tue, 10 May 2011 02:45:02 +0100 4802122 http://www.medworm.com/index.php?rid=4802121&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21532129%26dopt%3DAbstract This article proposes a reformulation of the social brain theory of schizophrenia. Contrary to those who consider schizophrenia to be an inherently human condition, we suggest that it is a relatively recent phenomenon, and that the vulnerability to it remained hidden among our hunter-gatherer ancestors. Hence, we contend that schizophrenia is the result of a mismatch between the post-Neolithic human social environment and the design of the social brain. We review the evidence from human evolutionary history of the importance of the distinction between ingroup and out-group membership that lies at the heart of intergroup conflict, violence, and xenophobia. We then review the evidence for the disparities in schizophrenia incidence around the world and for the higher risk of this condition am... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4802121 Tue, 10 May 2011 02:45:02 +0100 4802121 http://www.medworm.com/index.php?rid=4802120&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21532130%26dopt%3DAbstract Authors: Ghiselin MT Abstract:The organism, like the molecule, the cell, and the species, is one of the fundamental levels in our hierarchical classification of life and its components. The units ranked at these levels, being concrete, particular things, are individuals in the broadest philosophical sense. But in a much narrower and more familiar sense, individual means an individual organism. Like species, the term individual is hard to define, but in most biological discourse it has meant the unit of philosophical autonomy. Some authors have attempted to revise this terminology, restricting individual to organisms, and redefining organism to include families and other units. Such semantic surgery is unnecessary if the goal is merely to justify selection at more than one level. Analog... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4802120 Tue, 10 May 2011 02:45:02 +0100 4802120 http://www.medworm.com/index.php?rid=4802119&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21532131%26dopt%3DAbstract Authors: Chisolm MS Abstract:Psychotherapy has long been an integral treatment modality for patients with psychiatric conditions, but recent evidence suggests that the practice of psychotherapy by psychiatrists has greatly diminished. Between 1996 and 2005, the percentage of psychiatry office visits involving psychotherapy decreased from about 44% to 29%, a 35% reduction in less than 10 years. Although the increasing availability of medications to treat psychiatric disorders has played a role in this decline, it is not the only factor. This essay reviews the multiple forces effecting this shift and highlights the limited knowledge base regarding the impact of this change on patients. The essay concludes with a call for research to prevent unintended and potentially harmful consequences... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4802119 Tue, 10 May 2011 02:45:02 +0100 4802119 http://www.medworm.com/index.php?rid=4802118&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21532132%26dopt%3DAbstract This article utilizes type-1 diabetes to explore the issues surrounding medical progress with respect to defining medical cure, especially in terms of distinguishing it from managing a patient's illness. PMID: 21532132 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4802118 Tue, 10 May 2011 02:45:02 +0100 4802118 http://www.medworm.com/index.php?rid=4802117&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21532133%26dopt%3DAbstract This article explores the aims of classification, their embodiment in medical diagnosis, and the historical traditions of medical classification. It provides a brief overview of the aims and principles of classification and their relevance to contemporary medicine. It also demonstrates how classifications operate as social framing devices that enable and disable communication, assert and refute authority, and are important items for sociological study. PMID: 21532133 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4802117 Tue, 10 May 2011 02:45:02 +0100 4802117 http://www.medworm.com/index.php?rid=4802116&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21532134%26dopt%3DAbstract "A gentle and humane temper": humility in medicine. Perspect Biol Med. 2011;54(2):206-16 Authors: Coulehan J Abstract:Humility is the medical virtue most difficult to understand and practice. This is especially true in contemporary medicine, which has developed a culture more characterized by arrogance and entitlement than by self-effacement and moderation. In such a culture, humility suggests weakness, indecisiveness, or even deception, as in false modesty. Nonetheless, an operational definition of medical humility includes four distinct but closely related personal characteristics that are central to good doctoring: unpretentious openness, honest self-disclosure, avoidance of arrogance, and modulation of self-interest. Humility, like other virtues, is best taught by means of ... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4802116 Tue, 10 May 2011 02:45:02 +0100 4802116 http://www.medworm.com/index.php?rid=4802115&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21532135%26dopt%3DAbstract This article explores the role of genomics in the elaboration of a more ecocentric view of ourselves with the help of two examples, namely the renaissance of Paleolithic diets and of Pleistocene parks. It argues that an understanding of the world in ecocentric terms requires new partnerships and mutually beneficial forms of collaboration and convergence between life sciences, social sciences, and the humanities. PMID: 21532135 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4802115 Tue, 10 May 2011 02:45:02 +0100 4802115 http://www.medworm.com/index.php?rid=4802114&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21532136%26dopt%3DAbstract This article examines distinctive aspects of medical care experienced by a 55-year-old hospitalized for quintuple coronary artery bypass surgery who was also a senior physician-administrator (chief of gastroenterology) at the same hospital. The article describes eight distinctive aspects of administrator-physicians as patients, including special patient treatment; exalted patient expectations by hospital personnel; patient suppression of emotions; patient denial; self-doctoring; job stress contributing to disease; self-sacrifice to achieve better health; and rational medical decisions when not under stress. Health-care workers should recognize how these distinctive aspects of medical care and behavior affect administrator-physicians as patients, in order to mitigate their negative effects,... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4802114 Tue, 10 May 2011 02:45:02 +0100 4802114 http://www.medworm.com/index.php?rid=4802113&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21532137%26dopt%3DAbstract Authors: Ho VK Abstract:The current guidelines of evidence-based medicine (EBM) presuppose that clinical research and clinical practice should advance from rigorous scientific tests as they generate reliable, value-free knowledge. Under this presupposition, hypotheses postulated by doctors and patients in the process of their decision making are preferably tested in randomized clinical trials (RCTs), and in systematic reviews and meta-analyses summarizing outcomes from multiple RCTs. Since testing under this scheme is predominantly focused on the criteria of generality and precision achieved through methodological rigor, at the cost of the criterion of realism, translating test results to clinical practice is often problematic. Choices concerning which methodological criteria should ha... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4802113 Tue, 10 May 2011 02:45:02 +0100 4802113 http://www.medworm.com/index.php?rid=4802112&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21532138%26dopt%3DAbstract Authors: Davis AM Abstract:The passage of the 2010 Affordable Care Act has not ended bitter debates around the policies and practice patterns required to appropriately balance access, quality, and cost in the U.S. health-care system. While many physicians have asked simply "to be left alone" to continue practicing as they see fit, this is an increasingly untenable position, given the notably high costs and very mixed clinical outcomes in the United States relative to other developed nations. A new multi-author text on Medical Quality Management stresses physician involvement in health-care quality, safety, and efficiency and lays out key concepts to help readers better understand many of the national challenges and opportunities that lie ahead. This essay extends lessons from this book... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4802112 Tue, 10 May 2011 02:45:02 +0100 4802112 http://www.medworm.com/index.php?rid=4637672&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21399376%26dopt%3DAbstract Authors: Perlman RL PMID: 21399376 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4637672 Sun, 27 Mar 2011 14:30:04 +0100 4637672 http://www.medworm.com/index.php?rid=4637671&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21399377%26dopt%3DAbstract Authors: Chambers DA PMID: 21399377 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4637671 Sun, 27 Mar 2011 14:30:04 +0100 4637671 http://www.medworm.com/index.php?rid=4637670&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21399378%26dopt%3DAbstract Authors: Ludmerer KM Abstract:The Flexner Report had its roots in the recognition in the mid-19th century that medical knowledge is not something fixed but something that grows and evolves. This new view of medical knowledge led to a recasting of the goal of medical education as that of instilling the proper techniques of acquiring and evaluating information rather than merely inculcating facts through rote memorization. Abraham Flexner, a brilliant educator, had the background to understand and popularize the meaning of this new view of education, and he took the unprecedented step of relating the developments in medical education to the ideas of John Dewey and the progressive education movement. Although the Flexner Report is typically viewed as a historical document-due to an unders... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4637670 Sun, 27 Mar 2011 14:30:04 +0100 4637670 http://www.medworm.com/index.php?rid=4637669&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21399379%26dopt%3DAbstract This article reviews the history of premedical education, describes some recent critiques of premedical education, discusses a newer program for premedical education evolving at the University of Illinois at Chicago, and offers some suggestions for the future. PMID: 21399379 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4637669 Sun, 27 Mar 2011 14:30:04 +0100 4637669 http://www.medworm.com/index.php?rid=4637668&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21399380%26dopt%3DAbstract Authors: Fleming KA Abstract:Of all the principles set out by Flexner in 1910, the most fundamental, that of academic and scientific excellence, is more relevant to medical education in the United Kingdom today than ever before. To realize this, undergraduate medical education (UGME) at Oxford has evolved to incorporate the tutorial method of teaching to promote independent and critical thought. Coupled with the usual didactic experiences, each medical student is also required to complete a 26-week research experience before going on to clinical study. Outcome measures reveal that Oxford graduates have consistently achieved highest marks in the U.K. equivalent of the United States Medical Licensing Examination. In contrast to UGME in the United Kingdom, postgraduate medical education (... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4637668 Sun, 27 Mar 2011 14:30:04 +0100 4637668 http://www.medworm.com/index.php?rid=4637667&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21399381%26dopt%3DAbstract Authors: Alpern RJ, Belitsky R, Long S Abstract:One hundred years ago, Flexner emphasized the importance of science in medicine and medical education. Over the subsequent years, science education in the premedical and medical curricula has changed little, in spite of the vast changes in the biomedical sciences. The National Research Council, in their report Bio 2010, noted that the premedical curriculum caused many students to lose interest in medicine and in the biological sciences in general. Many medical students and physicians have come to view the premedical curriculum as of limited relevance to medicine and designed more as a screening mechanism for medical school admission. To address this, the Association of American Medical Colleges and the Howard Hughes Medical Institute form... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4637667 Sun, 27 Mar 2011 14:30:04 +0100 4637667 http://www.medworm.com/index.php?rid=4637666&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21399382%26dopt%3DAbstract Authors: Dienstag JL Abstract:In 1985, Harvard Medical School adopted a "New Pathway" curriculum, based on active, adult learning through problem-based, faculty-facilitated small-group tutorials designed to promote lifelong skills of self-directed learning. Despite the successful integration of clinically relevant material in basic science courses, the New Pathway goals were confined primarily to the preclinical years. In addition, the shifting balance in the delivery of health care from inpatient to ambulatory settings limited the richness of clinical education in clinical clerkships, creating obstacles for faculty in their traditional roles as teachers. In 2006, Harvard Medical School adopted a more integrated curriculum based on four principles that emerged after half a decade of se... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4637666 Sun, 27 Mar 2011 14:30:04 +0100 4637666 http://www.medworm.com/index.php?rid=4637665&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21399383%26dopt%3DAbstract Authors: Nachman RL, Marzuk PM Abstract:Medical education in the 20th century has been vastly influenced by the Carnegie Foundation Flexner Report. The basic tenets of the modern four-year medical curriculum and the dominant role of the associated university teaching hospital were cemented into place and have remained the paradigm of the present-day medical educational process. The Flexner Report contributed importantly to the development of the modern health-care system. Despite enormous success, a number of current problems have been identified in today's medical educational curricula and have catalyzed the generation of a new Carnegie Foundation report that emphasizes the building of strong bridges across the artificial divide that separates the basic science and clinical years and ... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4637665 Sun, 27 Mar 2011 14:30:04 +0100 4637665 http://www.medworm.com/index.php?rid=4637664&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21399384%26dopt%3DAbstract Authors: Cohen JJ Abstract:Medical educators are facing a challenge today that is quite analogous to that addressed by Abraham Flexner, namely how to transform a legacy system of education that is no longer preparing future physicians adequately to meet contemporary expectations and responsibilities. In facing up this challenge, however, today's educators not only must equip students to deal effectively with the rapidly changing paradigms in health care and medical practice, they also must adapt their curricula and pedagogical methods to the demanding new paradigms of medical education. Their success in addressing these dual imperatives will determine whether the educational transformations currently underway will have as momentous an effect on the public's health as did those stimulat... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4637664 Sun, 27 Mar 2011 14:30:04 +0100 4637664 http://www.medworm.com/index.php?rid=4637663&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21399385%26dopt%3DAbstract This article suggests three roles for medical decision making in medical education. First, basic decision science would be a valuable prerequisite to medical training. Second, several decision-related competencies would be important outcomes of medical education; these include the physician's own decision skills, the ability to guide patients in shared decisions, and knowledge of health policy decisions at the societal level. Finally, decision making could serve as a unifying principle in the design of the medical curriculum, integrating other curricular content around the need to create physicians who are competent and caring decision makers. PMID: 21399385 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4637663 Sun, 27 Mar 2011 14:30:04 +0100 4637663 http://www.medworm.com/index.php?rid=4637662&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21399386%26dopt%3DAbstract Authors: Perlman RL Abstract:Evolutionary biology was a poorly developed discipline at the time of the Flexner Report and was not included in Flexner's recommendations for premedical or medical education. Since that time, however, the value of an evolutionary approach to medicine has become increasingly recognized. There are several ways in which an evolutionary perspective can enrich medical education and improve medical practice. Evolutionary considerations rationalize our continued susceptibility or vulnerability to disease; they call attention to the idea that the signs and symptoms of disease may be adaptations that prevent or limit the severity of disease; they help us understand the ways in which our interventions may affect the evolution of microbial pathogens and of cancer cel... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4637662 Sun, 27 Mar 2011 14:30:04 +0100 4637662 http://www.medworm.com/index.php?rid=4637661&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21399387%26dopt%3DAbstract Authors: Boudreau JD, Cruess SR, Cruess RL Abstract:Although he did not write extensively about professionalism, Abraham Flexner clearly understood its critical role in medical practice. In discerning the basics of medical education he characterized scientific methodology as the instrumental minimum. He left open to future generations the task of defining its necessary complement, the "noble behaviors and fine feelings" required of the medical practitioner. Situated within the current professionalism movement, and informed by previous commentary on the enduring attributes of medicine, a curriculum based on "Physicianship"-the physician as healer and professional-can serve as a logical post-Flexnerian curriculum. The conceptual armature of Physicianship and the attributes necessary for ... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4637661 Sun, 27 Mar 2011 14:30:04 +0100 4637661 http://www.medworm.com/index.php?rid=4637660&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21399388%26dopt%3DAbstract "A Sudden Lift of Wings": Poetry and Prose about Alzheimer's Disease. Perspect Biol Med. 2011;54(1):106-14 Authors: Coe FL Abstract:The editor has collected poems from people who have cared for loved ones with Alzheimer's disease. The writers range from prize-winning poets to amateurs, but all share in common a passion, an experience that evokes from them emotions they long to rest in the crystal of poetry. Their poems illuminate the dark terrors of this most disabling and dehumanizing disease, and, perhaps surprisingly, reveal an ancient truth: that love is stronger than death. PMID: 21399388 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4637660 Sun, 27 Mar 2011 14:30:04 +0100 4637660 http://www.medworm.com/index.php?rid=4138477&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037402%26dopt%3DAbstract Authors: PMID: 21037402 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138477 Sat, 06 Nov 2010 04:35:03 +0100 4138477 http://www.medworm.com/index.php?rid=4138476&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037403%26dopt%3DAbstract Authors: Marino TA Abstract:Recent consensus is that individuals with atypical male or female phenotype are to be considered to have a "disorder of sexual development." The goal is to eliminate previous terminology that included the terms intersex, hermaphrodite, or pseudohermaphrodite. However, the teaching of embryology, and particularly teaching about the development of the reproductive system, still has not made the change to the new terminology. If those who teach embryology to health-care professionals remain unaware of the controversies associated with the old terminology and continue to use it, they will perpetuate a nomenclature that can be destructive. Any terminology must be used carefully to avoid dehumanizing the individual to a disease or a medical state. We should be abl... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138476 Sat, 06 Nov 2010 04:35:03 +0100 4138476 http://www.medworm.com/index.php?rid=4138474&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037404%26dopt%3DAbstract Authors: Blumenthal S Abstract:In 1941, Gellhorn reported that administration of human blood to hypophysectomized/adrenodemedullated rats caused a fall in blood sugar. This was among the early demonstrations that human blood possesses glucose-lowering or insulin-like activity (ILA). Gellhorn assumed he had detected only insulin. During the 1960s, however, it became evident that plasma ILA contained at least two components: one, suppressible ILA (SILA), was inactivated by anti-insulin antibody and was therefore considered to be indistinguishable from pancreatic insulin; the other, nonsuppressible ILA (NSILA), was unaffected by anti-insulin antibody. Subsequent work resolved NSILA into insulin-like growth factors I and II (IGF-I and IGF-II), two 7.5 kilodalton peptides with potent mitoge... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138474 Sat, 06 Nov 2010 04:35:03 +0100 4138474 http://www.medworm.com/index.php?rid=4138473&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037405%26dopt%3DAbstract Authors: Miller FG, Colloca L Abstract:Despite substantial progress in elucidating its neurobiological mechanisms, theoretical understanding of the placebo effect is poorly developed. Application of the semiotic theory developed by the American philosopher Charles Peirce offers a promising account of placebo effects as involving the apprehension and response to signs. The semiotic approach dovetails with the various psychological mechanisms invoked to account for placebo effects, such as conditioning and expectation, and bridges the biological and cultural dimensions of this fascinating phenomenon. PMID: 21037405 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138473 Sat, 06 Nov 2010 04:35:03 +0100 4138473 http://www.medworm.com/index.php?rid=4138472&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037406%26dopt%3DAbstract This article synthesizes theory from clinical ethics, operational design, and philosophy to provide a bioethical framework for the health policy of translational research. PMID: 21037406 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138472 Sat, 06 Nov 2010 04:35:03 +0100 4138472 http://www.medworm.com/index.php?rid=4138471&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037407%26dopt%3DAbstract Authors: Austad K, Brendel DH, Brendel RW Abstract:Despite their potential benefits, relationships linking medical school faculty and the pharmaceutical and device industries may also challenge the professional value of primacy of patient welfare, a point highlighted in a recent Institute of Medicine report. Academic medical centers and professors have the added professional obligation to ensure the unbiased, evidence-based education of future doctors. This essay argues that faculty financial conflicts of interest may threaten this obligation by propagating the bias introduced by these relationships to students. This could occur directly through the process of curriculum determination and delivery, and also indirectly through the "hidden curriculum," which deserves particular attention... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138471 Sat, 06 Nov 2010 04:35:03 +0100 4138471 http://www.medworm.com/index.php?rid=4138470&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037408%26dopt%3DAbstract This article outlines the conceptual framework of the "mind-body problem" as formulated in contemporary analytical philosophy and argues that this philosophical debate has potentially far-reaching implications for psychiatry as a clinical-scientific discipline, especially for its own autonomy and its relationship to neurology/neuroscience. This point is illustrated by a conceptual analysis of the five principles formulated in Kandel's 1998 article "A New Intellectual Framework for Psychiatry." Kandel's position in the philosophical mind-body debate is ambiguous, ranging from reductive physicalism (psychophysical identity theory) to non-reductive physicalism (in which the mental "supervenes" on the physical) to epiphenomenalist dualism or even emergent dualism. We illustrate how these diver... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138470 Sat, 06 Nov 2010 04:35:03 +0100 4138470 http://www.medworm.com/index.php?rid=4138469&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037409%26dopt%3DAbstract Authors: Portugal F Abstract:In 1944, Oswald T. Avery and his associates reported that DNA was the chemical substance acting to genetically transform species of pneumococcal bacteria. Many believe that Avery warranted the Nobel Prize for this discovery. Avery's work is evaluated here in light of the Nobel archives, which have made public the names of those who nominated Avery for this award and the basis for each of the nominations. Based on the archival record, it seems that key biological chemists "were not convinced by Avery's claim that DNA was the basis of heredity, that no geneticists nominated Avery, and that most nominators overlooked Avery's work on DNA in favor of his work on the immunogenicity of the bacterial capsule. Three critical scientific factors that adversely affecte... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138469 Sat, 06 Nov 2010 04:35:03 +0100 4138469 http://www.medworm.com/index.php?rid=4138462&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037410%26dopt%3DAbstract Authors: Piatigorsky J Abstract:After almost 50 years in science, I believe that there is an acceptable, often advantageous chasm between open-ended basic research-free exploration without a practical destination and in which the original ideas may fade into new concepts-and translational research or clinical research. My basic research on crystalline (proteins conferring the optical properties of the eye lens) led me down paths I never would have considered if I were conducting translational research. My investigations ranged from jellyfish to mice and resulted in the gene-sharing concept, which showed that the same protein can have distinct molecular functions depending upon its expression pattern and, conversely, that different proteins can serve similar functional roles. This essay... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138462 Sat, 06 Nov 2010 04:35:03 +0100 4138462 http://www.medworm.com/index.php?rid=4138455&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037411%26dopt%3DAbstract This article comments on the problems raised by the conventional anatomo-clinic paradigm and reviews three areas in which the influence of nonlinear dynamics and fractal geometry can be especially prominent: disease as a loss of complexity, the idea of homeostasis, and fractals in pathology. PMID: 21037411 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138455 Sat, 06 Nov 2010 04:35:03 +0100 4138455 http://www.medworm.com/index.php?rid=4138454&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037412%26dopt%3DAbstract This article addresses the influence of literature on Freud's psychoanalytical theory, specifically the role that modern detective fiction played in shaping Freudian theory. Edgar Allan Poe gave Freud the literary precedent; Sir Arthur Conan Doyle's creation Sherlock Holmes gave him the analytical model. In turn, the world of crime story-telling embedded Freudian theories in subsequent forms, spinning the tales of crime into a journey into the human mind. As these tales were popularized on the silver screen in the early 20th century, psychoanalytical ideas moved from the lecture halls into the cultural mainstream. PMID: 21037412 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138454 Sat, 06 Nov 2010 04:35:03 +0100 4138454 http://www.medworm.com/index.php?rid=4138453&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037413%26dopt%3DAbstract Authors: Fleagle JG Abstract:The early primate fossil that forms the type specimen of Darwinius masillae, known informally as Ida, was first announced in a spectacular media blitz in May 2009, including a publication in the journal PLoS ONE, a public unveiling at the American Museum of Natural History, massive coverage by television and newspapers, a documentary program on the History Channel, and a book. However, reaction to the fossil by other scientists was largely critical of its purported significance, and later publications have reached very different conclusions than those promoted in the original announcements. Moreover, there are inconsistencies in the information provided by the scientific paper, the book, and the public announcements. What is the source of these discrepancie... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138453 Sat, 06 Nov 2010 04:35:03 +0100 4138453 http://www.medworm.com/index.php?rid=4138452&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037414%26dopt%3DAbstract This article responds to some of the issues raised by a new volume of essays about pediatric bioethics. It puts these issues into historical context by examining the implications of Saul Krugman's famous studies on the etiology and prevention of hepatitis at New York's Willowbrook State School. PMID: 21037414 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138452 Sat, 06 Nov 2010 04:35:03 +0100 4138452 http://www.medworm.com/index.php?rid=4138451&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037415%26dopt%3DAbstract Authors: Sachs B Abstract:Over the last few decades, scientists have been busy debunking the myth that nonhuman animals relate to each other in a primarily competitive, aggressive way. What they have found is that many species of animal, including many of those most closely related to humans, display a remarkable range of cooperative, "prosocial" behavior. In fact, it appears that some animal societies adhere to a moral code. What is preventing us, then, from saying that the members of these societies are moral beings? Nothing important, according to a recent book. Probing further into this question, I suggest that in fact quite a lot is at risk in making this move. To integrate nonhuman animals fully into the moral domain, we may have to adapt our conception of morality in some very t... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138451 Sat, 06 Nov 2010 04:35:03 +0100 4138451 http://www.medworm.com/index.php?rid=4138450&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21037416%26dopt%3DAbstract Authors: Sargis RM, Brady MJ Abstract:The burgeoning obesity and metabolic disease epidemics in the developed world are exerting a terrible toll on society, yet the precise mechanisms responsible for the emergence of these dramatic trends over a relatively short period of time remain poorly understood. Philip A.Wood's book How Fat Works provides important insights into cellular lipid metabolism, as well as discussing some of the important external contributors to the development of human obesity. The foundation provided by this book allows for the exploration of how body fat has gone from hero during the millennia when starvation was the paramount nutritional risk to its current role as villain in our period of caloric excess. With the incredible personal and societal costs brought abo... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=4138450 Sat, 06 Nov 2010 04:35:03 +0100 4138450 http://www.medworm.com/index.php?rid=3777311&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20639602%26dopt%3DAbstract This article discusses these issues and makes suggestions for enhancing the validity and reliability of the findings. PMID: 20639602 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3777311 Thu, 22 Jul 2010 19:09:03 +0100 3777311 http://www.medworm.com/index.php?rid=3777310&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20639603%26dopt%3DAbstract This article offers a new definition of life as a "self-contained, self-regulating, self-organizing, self-reproducing, interconnected, open thermodynamic network of component parts which performs work, existing in a complex regime which combines stability and adaptability in the phase transition between order and chaos, as a plant, animal, fungus, or microbe." Open thermodynamic networks, which create and maintain order and are used by all organisms to perform work, import energy from and export entropy into the environment. Intra- and extracellular interconnected networks also confer order. Although life obeys the laws of physics and chemistry, the design of living organisms is not determined by these laws, but by Darwinian selection of the fittest designs. Over a short range of normalize... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3777310 Thu, 22 Jul 2010 19:09:03 +0100 3777310 http://www.medworm.com/index.php?rid=3777309&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20639604%26dopt%3DAbstract Authors: Sturmberg JP, Martin CM, Moes MM Contemporary views hold that health and disease can be defined as objective states and thus should determine the design and delivery of health services. Yet health concepts are elusive and contestable. Health is neither an individual construction, a reflection of societal expectations, nor only the absence of pathologies. Based on philosophical and sociological theory, empirical evidence, and clinical experience, we argue that health has simultaneously objective and subjective features that converge into a dynamic complex-adaptive health model. Health (or its dysfunction, illness) is a dynamic state representing complex patterns of adaptation to body, mind, social, and environmental challenges, resulting in bodily homeostasis and personal inter... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3777309 Thu, 22 Jul 2010 19:09:03 +0100 3777309 http://www.medworm.com/index.php?rid=3777308&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20639605%26dopt%3DAbstract This article addresses the question of whether race is a biological category and whether it is permissible to use it in biomedicine. I suggest that instrumentalism, a view that race is a problem-solving tool rather than a concept with an objective referent in nature, may be more consistent with the available scientific evidence. I argue that, to be morally permissible, the instrumentalist use of race in research and medicine requires stringent guidelines. I then provide four normative rules to guide race research in the biomedical sciences. The paper gathers evidence from philosophy of science, genomics, legal history, and normative ethics in order to ground the biomedical use of race in a converging ethical and epistemic framework. PMID: 20639605 [PubMed - in process] (Source: Perspec... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3777308 Thu, 22 Jul 2010 19:09:03 +0100 3777308 http://www.medworm.com/index.php?rid=3777307&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20639606%26dopt%3DAbstract Authors: Wayne K, Glass KC Medical research is frequently regarded as not only laudable, but even obligatory. However, the moral foundation for such an obligation is far from clear. Lively debate concerning the viability of an obligation to conduct and support medical research is transpiring among a small number of scholars speaking from a variety of backgrounds, yet the current discussion is predominantly situated within several discrete academic and professional circles, allowing only sporadic engagement within and between scholarly disciplines and the medical realm. We aim to lay the groundwork for a focused critique of the "research imperative" by examining (1) its commitments within ideologies of science, medicine, and progress: and (2) its normative theoretical underpinnings. Our... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3777307 Thu, 22 Jul 2010 19:09:03 +0100 3777307 http://www.medworm.com/index.php?rid=3777306&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20639607%26dopt%3DAbstract Dr. Alexander garden, a linnaean in colonial america, and the saga of five "electric eels". Perspect Biol Med. 2010;53(3):388-406 Authors: Finger S Alexander Garden (1730-1791) was born in Scotland, where he trained in medicine before settling in South Carolina in 1752. With a passion for collecting and a love of nature, he sent specimens to Linnaeus and his associates in Europe. In 1774, Garden observed and conducted electrical experiments on some "eels" that had survived the trip from Surinam to Charleston. His detailed observations and reasons for believing they emit electricity were read before the Royal Society of London and subsequently published. He also advised the sea captain who owned the eels on how to preserve them and where to deliver their bodies if they died en r... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3777306 Thu, 22 Jul 2010 19:09:03 +0100 3777306 http://www.medworm.com/index.php?rid=3777305&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20639608%26dopt%3DAbstract Authors: Kaufman SR Life-extending interventions for older persons are changing medical knowledge and societal expectations about longevity. Today's consciousness about growing older is partly shaped by a new form of ethics, constituted by and enabled through the routines and institutions that comprise ordinary clinical care. Unlike bioethics, whose emphasis is on clinical decision-making in individual situations, this new form of ethics is exceptionally diffuse and can be characterized as an ethical field. It is located in and shaped by health-care policies, standard technologies, and clinical evidence, and it emerges in what patients and families come to need and want. Three developments illustrate this ethical field at work: the changing nature of disease, especially the ascent of r... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3777305 Thu, 22 Jul 2010 19:09:03 +0100 3777305 http://www.medworm.com/index.php?rid=3777304&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20639609%26dopt%3DAbstract This article examines the social and cultural roots of the stigma of chronic pain in American society. I document the long history of illness stigma in Western societies as a way of illustrating the power of this meaning-making construct, and I use the Book of Job as a framework for understanding the deep link between sin and suffering in the context of illness and chronic pain in the United States. Unfortunately, while illness stigma can be ameliorated, there is little evidence of such progress in the undertreatment and stigmatization of chronic pain sufferers, and I explain some of the reasons why the best evidence does not demonstrate much improvement. I conclude by sketching some recommendations for diminishing the stigmatization of the chronic pain sufferer, and warn that the focus on... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3777304 Thu, 22 Jul 2010 19:09:03 +0100 3777304 http://www.medworm.com/index.php?rid=3777303&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20639610%26dopt%3DAbstract Authors: Belling C Popular fiction responds to, and may exacerbate, public anxieties in ways that more highbrow literary texts may not. Robin Cook's 1977 novel Coma exemplifies the ways in which medical thrillers participate in the public discourse about health care. Written shortly after the medical establishment promoted "irreversible coma," or brain death, as a new definition of dying, and at a time when the debate over the removal of Karen Ann Quinlan from life support was the subject of popular attention, Coma crystallized public fears over the uses of medical technology. While Cook hoped that Coma would encourage public participation in health-care decision-making, the book may have fueled public concerns about medicine in ways that he did not anticipate. The public engagement th... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3777303 Thu, 22 Jul 2010 19:09:03 +0100 3777303 http://www.medworm.com/index.php?rid=3777302&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20639611%26dopt%3DAbstract Authors: Ross LF Two discrete conceptions of bioethics emerged in the 1970s: a holistic model that would "embrace within its scope long-range environmental concerns" versus a notion of bioethics that "would deal with concrete medical dilemmas." Although the latter has been the dominant perspective, Irina Pollard's new book Bioscience Ethics reintroduces a more global perspective of bioethics. This essay provides a cursory review of the different conceptions of bioethics and where Pollard's book fits in the controversy. It concludes by considering how some progress has been made to find a middle path that interprets bioethics more broadly as "the ethics of the life sciences and health care." PMID: 20639611 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3777302 Thu, 22 Jul 2010 19:09:03 +0100 3777302 http://www.medworm.com/index.php?rid=3777301&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20639612%26dopt%3DAbstract Authors: Vantassel SM Andrew Linzey contends that our treatment of children should act as a model for our treatment of animals: just as we use our power to prevent the suffering of children, so should we restrict our behavior to protect animals from human-originated suffering. While not ignoring the role theology and emotion play in his ethical view, Linzey endeavors to provide a rational argument for the moral consideration of animals. In addition, Linzey explains how humans have created institutions to help them justify the continuance of animal suffering, followed by a plan to replace those institutions with animal-friendly ones. Linzey then applies his thinking to three contemporary institutions he believes cause animal suffering in an unjustifiable manner, namely hunting with dogs... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3777301 Thu, 22 Jul 2010 19:09:03 +0100 3777301 http://www.medworm.com/index.php?rid=3777300&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20639613%26dopt%3DAbstract <i>Sciences from Below: Feminisms, Postcolonialities, and Modernities</i> (review). Perspect Biol Med. 2010;53(3):471-9 Authors: Weaver H Sandra Harding's newest book, Sciences from Below: Feminisms, Postcolonialities, and Modernities, continues her work in feminist standpoint theory and science and technologies studies, asking how we might judge "good" science. Attentive to race, class, gender, and imperialism, Harding critically examines Northern and Southern sciences and technologies by adopting the perspective of those who see from below. This vision from the peripheries lets Harding question stories of modern scientific progress, revealing a multiplicity of "ethnosciences" and critiquing modernity itself. However, while Harding aims to produce knowledge for the... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3777300 Thu, 22 Jul 2010 19:09:03 +0100 3777300 http://www.medworm.com/index.php?rid=3599871&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20495255%26dopt%3DAbstract This article discusses the connection between clinical equipoise and pragmatic trials, contrasts explanatory with pragmatic trials, points to the differences in the ways in which trial data are analyzed and interpreted, and discusses the power of replication, one of the defining hallmarks of the scientific method. Viewing clinical equipoise through a consequentialist lens reveals a number of problems, many of which are attributable to equipoise's insistence on a pragmatic approach to trial architecture. PMID: 20495255 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3599871 Wed, 26 May 2010 17:48:03 +0100 3599871 http://www.medworm.com/index.php?rid=3599870&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20495256%26dopt%3DAbstract Authors: Turoldo F Abstract:Caring for patients from different cultural or religious backgrounds may create difficult ethical dilemmas for physicians. The article reviews four case histories, involving patients from the Navajo culture or the Christian Science Church, that highlight some of these ethical problems. It then discusses an "ethics of responsibility," which is based on and encompasses a variety of meanings of responsibility, including responsibility as recognition, as taking charge, as the ability to assess the consequences of one's actions, and as making a commitment. An ethics of responsibility provides a novel perspective for resolving ethical problems in medicine. PMID: 20495256 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3599870 Wed, 26 May 2010 17:48:03 +0100 3599870 http://www.medworm.com/index.php?rid=3599869&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20495257%26dopt%3DAbstract This article examines the influence of Erasmus Darwin on Charles's evolutionary thought and shows how, in many ways, Erasmus anticipated his much better-known grandson. It discusses the similarity in the mindsets of the two Darwins, asks how far the younger Darwin was exposed to the elder's evolutionary thought, examines the similarities and differences in their theories of evolution, and ends by showing the surprising similarity between their theories of inheritance. Erasmus's influence on Charles is greater than customarily acknowledged, and now is an opportune time to bring the grandfather out from behind the glare of his stellar grandson. PMID: 20495257 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3599869 Wed, 26 May 2010 17:48:03 +0100 3599869 http://www.medworm.com/index.php?rid=3599868&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20495258%26dopt%3DAbstract Authors: Webb JR, Thomas JW, Valasek MA Abstract:Medical school and residency can be stressful times, involving years of intensive academic study and pressure to earn high grades. Students and residents must learn to care for the sick, a task requiring long work hours and sleep deprivation. In such an environment, it is important to monitor the mental health of trainees and the factors that influence it. This essay examines a relatively unexplored facet of physician mental health: the use of pharmacological stimulants by students and residents to study better, earn higher grades, stay awake longer, and take better care of patients. Practical and ethical considerations of stimulant use in the medical profession, along with future directions for medical student mental health, are discuss... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3599868 Wed, 26 May 2010 17:48:03 +0100 3599868 http://www.medworm.com/index.php?rid=3599867&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20495259%26dopt%3DAbstract This article explores the specific form of confessional writing offered by physicians during the past half century, writing that often exposes medical error or negative feelings towards patients. A history of confessional practices as a legal tool, as religious practice, and as literary genre is offered, followed by analyses of selected confessional writings by physicians, many of them found in clinical journals such as Journal of the American Medical Association, Annals of Internal Medicine, and the Lancet. The authors of the narratives described here are engaged in several or all elements of the confessional sequence, which may offer them some resolution through the exposure and acknowledgment of their shared humanity with their patients and their expression of regret for any harm done. ... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3599867 Wed, 26 May 2010 17:48:03 +0100 3599867 http://www.medworm.com/index.php?rid=3599866&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20495260%26dopt%3DAbstract This article provides an overview of the retail DNA industry, addressing a few questions ripe for misinterpretation and confusion. It argues that the challenges posed by the retail DNA industry are both intelligible and manageable; optimally, multidisciplinary individuals would guide the way, steering the courts, legislature, laboratories, and clinics toward an adequate balance of consumer protection, autonomy, and understanding. PMID: 20495260 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3599866 Wed, 26 May 2010 17:48:03 +0100 3599866 http://www.medworm.com/index.php?rid=3599865&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20495261%26dopt%3DAbstract Authors: Demas A, Kindermann D, Pimentel D Abstract:In light of the rise in childhood obesity rates and the influence of the food system on fossil fuel use, this article analyzes current school meals in Baltimore and makes suggestions for school meal reform based on both childhood nutrition and environmental resource use. The nutrient content and estimated energy costs of a typical school lunch are compared with a proposed alternate meal. The study indicates that healthier meals can significantly limit fossil fuel energy inputs for harvesting, production, processing, packaging, and transportation. The authors also provide strategies for developing menus that are both more nutritious and more energy efficient. PMID: 20495261 [PubMed - in process] (Source: Perspectives in Biology and... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3599865 Wed, 26 May 2010 17:48:03 +0100 3599865 http://www.medworm.com/index.php?rid=3599864&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20495262%26dopt%3DAbstract Authors: Tauber AI Abstract:Gilbert and Epel present a new approach to developmental biology: embryogenesis must be understood within the full context of the organism's environment. Instead of an insular embryo following a genetic blueprint, this revised program maintains that embryogenesis is subject to inputs from the environment that generate novel genetic variation with dynamic consequences for development. Beyond allelic variation of structural genes and of regulatory loci, plasticity-derived epigenetic variation completes the triad of the major types of variation required for evolution. Developmental biology and ecology, disciplines that have previously been regarded as distinct, are presented here as fully integrated under the rubric of "eco-devo," and from this perspective, whi... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3599864 Wed, 26 May 2010 17:48:03 +0100 3599864 http://www.medworm.com/index.php?rid=3599863&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20495263%26dopt%3DAbstract Authors: Nutton V Abstract:From the fifth century BCE onwards, Greek doctors and philosophers debated the ways in which the will could be translated into physical action. Aristotle and his followers believed that the heart was the controlling organ, working through sinews. Later anatomists, first in Alexandria in Egypt and later in the Roman world, continued to speculate for several centuries. Galen (129-ca. 216) established a new medical paradigm, insisting on the primacy of the brain mediating largely through nerves. The Aristotelian and Galenic theories continued to be debated in the Greek and Islamic worlds, and, in new Latin translations, in the later Western medieval universities. These debates were largely conducted without recourse to experiment. Even after Mondino de' Liuzzi h... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3599863 Wed, 26 May 2010 17:48:03 +0100 3599863 http://www.medworm.com/index.php?rid=3599862&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20495264%26dopt%3DAbstract This article examines Richards's case for clearing Haeckel's name, as well as the subsequent (slanderous) charge from Daniel Gasman that Richards is guilty of whitewashing the Haeckelian roots of the Holocaust. PMID: 20495264 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3599862 Wed, 26 May 2010 17:48:03 +0100 3599862 http://www.medworm.com/index.php?rid=3599861&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20495265%26dopt%3DAbstract On First Looking into Kutcher's "Contested Medicine": Ethical Tensions in Clinical Research. Perspect Biol Med. 2010;53(2):304-14 Authors: Hellman S Abstract:Contested Medicine examines the experiments done at the University of Cincinnati by Eugene Saenger and his colleagues during the 1960s, a time of great fear that the Cold War between the United States and the Soviet Union would become a hot war using nuclear weapons. These studies were to provide the Department of Defense information relevant to the consequences of exposure of military personnel to ionizing radiation in such circumstances. Kutcher, a radiation physicist turned historian of science, is especially well prepared to put these studies into the context of the evolving bioethics of the time. He reviews the essent... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=3599861 Wed, 26 May 2010 17:48:03 +0100 3599861 http://www.medworm.com/index.php?rid=2935513&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19855120%26dopt%3DAbstract Authors: Abstract:Biologists use models in two distinct ways that have not been clearly articulated. A model may be used either as an exemplar of a larger group, or as a surrogate for a specific target. Zebrafish serve as an exemplary model of vertebrates in developmental biology; rodents are both exemplary vertebrates and specific surrogates for humans in biomedical research. The distinction between exemplary and surrogate models is important, because the criteria for and implications of model choice diverge in significant ways, depending on which role the model is to serve. So, too, do the kinds of conclusions we can legitimately draw from model-based research. The divergence derives in part from the use of the two sorts of models to answer different kinds of questions: exemplary mo... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2935513 Thu, 29 Oct 2009 02:36:02 +0100 2935513 http://www.medworm.com/index.php?rid=2935512&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19855121%26dopt%3DAbstract Authors: Abstract:There is a growing perception that modern medicine is approaching a state of crisis characterized by creative inertia, non-innovation, and non-productivity. Compared to the remarkable progress during the first 30 years after World War II, the last 30 years have been characterized by a self-congratulatory illusion of progress, the fruits of which have failed to reach our patients. The problem may lie with the fact that the (often lone) clinical innovator of the past who made all the difference to the spectacular progress of medicine during the golden age has been marginalized to the extent that he is now an endangered species. The two definable forces that have led to his alienation are the hegemony of molecular science and the primacy accorded to the randomized clini... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2935512 Thu, 29 Oct 2009 02:36:02 +0100 2935512 http://www.medworm.com/index.php?rid=2935511&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19855122%26dopt%3DAbstract Authors: Abstract:The placebo effect has been a source of fascination, irritation, and confusion within biomedicine over the past 60 years. Although scientific investigation has accelerated in the past decade, with particular attention to neurobiological mechanisms, there has been a dearth of attention to developing a general theory of the placebo effect. In this article, we attempt to address this gap. To set the stage, we review evidence relating to the reality and clinical significance of the placebo effect. Next we investigate the scope and limits of the placebo effect by examining the hypothesis that the placebo effect operates predominantly by modifying the experience and perceptions of illness symptoms, such as pain, anxiety, and fatigue, rather than by modifying the pathophysi... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2935511 Thu, 29 Oct 2009 02:36:02 +0100 2935511 http://www.medworm.com/index.php?rid=2935510&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19855123%26dopt%3DAbstract This article examines definitions of cause in the epidemiological literature. Those definitions describe causes as factors that make a difference to the distribution of disease or to individual health status. In philosophical terms, they are "difference-makers." I argue that those definitions are underpinned by an epistemology and a methodology that hinge upon the notion of variation, contra the dominant Humean paradigm according to which we infer causality from regularity. Furthermore, despite the fact that causes are defined in terms of difference-making, this doesn't fix the causal metaphysics but rather reflects the "variational" epistemology and methodology of epidemiology. I suggest that causality in epidemiology ought to be interpreted according to Williamson's epistemic theory. In ... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2935510 Thu, 29 Oct 2009 02:36:02 +0100 2935510 http://www.medworm.com/index.php?rid=2935509&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19855124%26dopt%3DAbstract This article examines the use of lobotomy as a treatment for chronic intractable pain and reconstructs then-common perceptions of pain and of the patients who suffered from it. It delineates the social expectations and judgments implicit in physicians' descriptions of the patients, analyzing what was expected from such patients and how the medical establishment responded to non-normative expressions of suffering. I argue that the medicalized response to an expectation for normativity demonstrates the convergence between psychiatric and palliative interventions. Based on a historically informed perspective of psychiatric interventions in the field of pain medicine, I examine the use of psychiatric medications for pain syndromes today and evaluate the interface between depression, chronic pa... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2935509 Thu, 29 Oct 2009 02:36:02 +0100 2935509 http://www.medworm.com/index.php?rid=2935508&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19855125%26dopt%3DAbstract Authors: Abstract:During the years 1714 to 1721, Richard Bradley, who was later to become the first Professor of Botany at Cambridge University, proposed a unified, unique, living agent theory of the cause of infectious diseases of plants and animals and the plague of humans. Bradley's agents included microscopic organisms, revealed by the studies of Robert Hooke and Antony van Leeuwenhoek. His theory derived from his experimental studies of plants and their diseases and from microscopic observation of animalcules in different naturally occurring and artificial environments. He concluded that there was a microscopic world of "insects" that lived and reproduced under the appropriate conditions, and that infectious diseases of plants were caused by such "insects." Since there are struct... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2935508 Thu, 29 Oct 2009 02:36:02 +0100 2935508 http://www.medworm.com/index.php?rid=2935507&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19855126%26dopt%3DAbstract Authors: Abstract:During the past century, several biologists have studied the mental processes involved in creativity. In recent years psychologists have approached the subject experimentally. In one such study (), creativity has been shown to originate in the subconscious mind and to be transmitted to the conscious mind as a result of a decrease in latent inhibition, an ordinarily strong cognitive barrier between the conscious mind and the subconscious. In my scientific work I have found evidence for creativity in the design of experiments, in which the addition of apparently superfluous controls has led to important discoveries. PMID: 19855126 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2935507 Thu, 29 Oct 2009 02:36:02 +0100 2935507 http://www.medworm.com/index.php?rid=2935506&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19855127%26dopt%3DAbstract Authors: Abstract:Suffering is the experience of distress or disharmony caused by the loss, or threatened loss, of what we most cherish. Such losses may strip away the beliefs by which we construct a meaningful narrative of human life in general and our own in particular. The vocation of physicians and other health professionals is to relieve suffering caused by illness, trauma, and bodily degeneration. However, since suffering is an existential state that does not necessarily parallel physical or emotional states, physicians cannot rely solely on knowledge and skills that address physiological dysfunction. Rather, they must learn to engage the patient at an existential level. Unfortunately, however, medical pedagogy encourages "detached concern," which devalues subjectivity, emotion,... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2935506 Thu, 29 Oct 2009 02:36:02 +0100 2935506 http://www.medworm.com/index.php?rid=2935505&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19855128%26dopt%3DAbstract Authors: Abstract:An old man, I am convinced that aging is no disease, but a normal part of living, just like childhood. Society should provide for our inevitable decline rather than support research to postpone our dying. Retirement, now so arbitrary, defines when men and women are old, and so discards contributions from the elderly who want to work. As a physician, I am sure that many of us over 65 could help to assist the caregivers who have so little time. Ageism is part of the problem: medical students learn ageism in their early training, and that ageism is reinforced by later contact with the frail sick elderly who come to them for care. Aging-and death-have grown invisible to the young. But now that we elderly are so many and, thanks to good luck or the Creator's grace, so hea... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2935505 Thu, 29 Oct 2009 02:36:02 +0100 2935505 http://www.medworm.com/index.php?rid=2725353&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19694072%26dopt%3DAbstract Authors: Hughes JC PMID: 19694072 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2725353 Sun, 23 Aug 2009 15:44:03 +0100 2725353 http://www.medworm.com/index.php?rid=2725352&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19694073%26dopt%3DAbstract Authors: Brain RM, Whitmer KJ PMID: 19694073 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2725352 Sun, 23 Aug 2009 15:44:03 +0100 2725352 http://www.medworm.com/index.php?rid=2725351&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19694074%26dopt%3DAbstract Authors: Brudney D PMID: 19694074 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2725351 Sun, 23 Aug 2009 15:44:03 +0100 2725351 http://www.medworm.com/index.php?rid=2713214&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19684369%26dopt%3DAbstract Authors: In 1960 Berson and Yalow published a method for the radioimmunoassay (RIA) of plasma insulin based on the concept that the extent to which unlabeled insulin displaces labeled insulin from anti-insulin antibody is proportional to the concentration of unlabeled insulin. The RIA for insulin has greatly increased knowledge of the physiology of glucose homeostasis and of the diverse causes of diabetes mellitus. Beyond this, the insight on which the RIA-or, more broadly, the competitive protein-binding assay-is based has provided the means to measure nanomolar or picomolar concentrations of a vast array of compounds in plasma and tissues. Directly or indirectly, the RIA has profoundly affected every branch of medicine. This essay reviews the ideas that were current in the medical r... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2713214 Wed, 19 Aug 2009 23:36:03 +0100 2713214 http://www.medworm.com/index.php?rid=2713213&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19684370%26dopt%3DAbstract This article recommends a collaboration between basic scientists and geriatricians in order to develop a curriculum that would identify how new knowledge derived from basic aging research bears on the inception of aging-related conditions and diseases that emerge over time. This information could be used to create new approaches to reducing or postponing diseases in later life. Health providers participating in this curriculum would gain new insights about aging, health maintenance, risk factors for disease inception, and appropriate interventions over the life course of their adult patients, helping them to achieve a healthier longevity. PMID: 19684370 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2713213 Wed, 19 Aug 2009 23:36:03 +0100 2713213 http://www.medworm.com/index.php?rid=2713212&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19684371%26dopt%3DAbstract Authors: The response of groups to pressing medical problems cannot be predicted on theoretical grounds. An example is the program for the control of beta-thalassemia in Iran, a country with a tradition of inbreeding and a conservative religious culture, and in which thalassemia is common. Thalassemia is largely treatable, but the treatment is lifelong and onerous and creates a serious economic burden for the individual family and for the national health budget. The genetics are simple, and inexpensive screening tests are available to identify carriers. An Iranian program requiring mandatory premarital screening was started in 1997, and between 1998 and 2005 the laws of the country were modified to permit abortion of affected fetuses. The story of this effort indicates how a country w... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2713212 Wed, 19 Aug 2009 23:36:03 +0100 2713212 http://www.medworm.com/index.php?rid=2713211&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19684372%26dopt%3DAbstract Authors: Van Rensselaer Potter is usually credited with coining the term bioethics and with founding this field. However, the rediscovery of the article "Bioethics: A Panorama of the Human Being's Ethical Relations with Animals and Plants," published in 1927 by Fritz Jahr in the German magazine Kosmos, necessitates a revision of this history of the foundation of bioethics. While Potter made significant contributions to this field, the importance of Jahr to the founding of bioethics should be recognized. PMID: 19684372 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2713211 Wed, 19 Aug 2009 23:36:03 +0100 2713211 http://www.medworm.com/index.php?rid=2713210&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19684373%26dopt%3DAbstract Authors: Suffering is frequent among patients, and it is common for physicians to attempt to avoid contact with individuals who are dying, debilitated, or in pain. Both patients and physicians are harmed when this happens: patients feel abandoned, resulting in unnecessary suffering, and physicians miss moments of meaning and renewal through direct connection. Ernest Gaines's novel A Lesson Before Dying is not a medical story, yet one character, Grant Wiggins, behaves like a physician when he tries to avoid direct, personal contact with Miss Emma, a community member who is suffering. This novel illuminates the tendency of human beings (including physicians) to try to avoid suffering, and the realization of this tendency can provide opportunities for ongoing medical education to help st... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2713210 Wed, 19 Aug 2009 23:36:03 +0100 2713210 http://www.medworm.com/index.php?rid=2713209&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19684374%26dopt%3DAbstract Authors: Microorganisms were first observed by Robert Hooke and Antoni van Leeuwenhoek between 1665 and 1678. In 1665, Hooke published Micrographia, which depicted the details of 60 objects as seen in the microscope. One chapter was devoted to the microfungus Mucor, the first microbe observed by the human eye. Leeuwenhoek, despite having no scientific training, became the first to observe protozoa, red blood cells, the sperm cells of animals, and bacteria, which he described in numerous letters to the Royal Society of London. In 1677, Hooke became Secretary of the Royal Society and, in the same year, confirmed some of Leeuwenhoek's discoveries. The discovery in 2006 of more than 650 pages of Hooke's missing records (the "Hooke Folio") allows us to verify the proceedings of Royal Socie... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2713209 Wed, 19 Aug 2009 23:36:03 +0100 2713209 http://www.medworm.com/index.php?rid=2713208&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19684375%26dopt%3DAbstract "More fatal than powder and shot": dysentery in the u.s. Army during the mexican war, 1846-48. Perspect Biol Med. 2009;52(3):400-13 Authors: In terms of deaths due to disease, the Mexican War (1846-48) was the deadliest of all American wars. Nearly 13% of the entire U.S. force perished from disease. Of the total 12,535 war deaths, 10,986 (88%) were due to infectious diseases (overwhelmingly dysentery, both bacterial and amoebic); seven men died from disease for every man killed by Mexican musket balls. Camp pollution was the greatest error committed by U.S. troops in the Mexican War. The indifference of line officers and recruits to the need for proper sanitation and military hygiene fueled the dysentery outbreaks, and the poor conditions in military hospitals contributed furt... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2713208 Wed, 19 Aug 2009 23:36:03 +0100 2713208 http://www.medworm.com/index.php?rid=2713207&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19684376%26dopt%3DAbstract Henry James's "The Ambassadors": The Promise to Lonely Adolescents that There Will Be a Future. Perspect Biol Med. 2009;52(3):414-23 Authors: Adolescence is a lonely time for all of us, as we shift our emotional attachment from our parents to our own autonomous selves and to those people outside our families who will be essential to our emotional growth. Perhaps because Henry James's novel The Ambassadors (1903) deals so masterfully with this subject, it promised the author that there would be a future beyond her senior year in college. The novel has two protagonists: a young American who has arrived at his maturity in Paris, and a middle-aged man who lives in a gray, ungratifying world because he has missed the opportunity to complete his unfolding into an independent sexual ... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2713207 Wed, 19 Aug 2009 23:36:03 +0100 2713207 http://www.medworm.com/index.php?rid=2713206&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19684377%26dopt%3DAbstract Authors: This essay is a "prespective"-the musings of a soon-to-be MD/PhD student on various aspects of the practice of medicine, written just before he began his training in the fall of 2008. It discusses some of the issues-genomic medicine, healthcare reform, and evidence-based medicine-that will likely impact medicine and medical care during his career. These thoughts are interwoven with the personal story of his grandfather's fight against disease and the complications of diagnosis and treatment. PMID: 19684377 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2713206 Wed, 19 Aug 2009 23:36:03 +0100 2713206 http://www.medworm.com/index.php?rid=2713205&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19684378%26dopt%3DAbstract Authors: The need to ensure the maximal safety of patients participating in clinical research has led to a number of regulations and oversight measures. None of these has had a more profound effect on the way such research is carried out in the United States than the establishment of the Institutional Review Board (IRB) system. While the individual rights of patients must be respected and confidentiality assured, such official scrutiny may actually inhibit the ability of physicians to initiate and conduct clinical research, thus defeating, at times, the very purpose of this research: the ultimate improvement in patient care. The experiences of one physician attempting to operate under this system and later taking part in administering it as an IRB member may offer some insights into b... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2713205 Wed, 19 Aug 2009 23:36:03 +0100 2713205 http://www.medworm.com/index.php?rid=2472755&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395816%26dopt%3DAbstract Authors: Schechter AN, Perlman RL PMID: 19395816 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472755 Sat, 13 Jun 2009 04:00:13 +0100 2472755 http://www.medworm.com/index.php?rid=2472738&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395817%26dopt%3DAbstract Authors: Goldenberg MJ, Borgerson K, Bluhm R PMID: 19395817 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472738 Sat, 13 Jun 2009 04:00:12 +0100 2472738 http://www.medworm.com/index.php?rid=2472720&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395818%26dopt%3DAbstract This article redirects critical attention toward EBM's rigid hierarchy of evidence as the culprit of its objectionable epistemic practices. It reframes the EBM discourse in light of a distinction between objectivist and pragmatic epistemology, which allows for a more nuanced analysis of EBM than previously offered: one that is not either/or in its evaluation of the decision-making technology as either iconoclastic or creedal. PMID: 19395818 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472720 Sat, 13 Jun 2009 04:00:12 +0100 2472720 http://www.medworm.com/index.php?rid=2472702&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395819%26dopt%3DAbstract This article examines flaws in the current processes of research production and the implications of these for justice and for vulnerable patients, and explores possible solutions. PMID: 19395819 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472702 Sat, 13 Jun 2009 04:00:12 +0100 2472702 http://www.medworm.com/index.php?rid=2472683&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395820%26dopt%3DAbstract This article discusses how the withholding of clinical trial information by pharmaceutical companies and academic researchers affects the reliability of clinical guidelines. It first offers a case study analysis of the U.K. drug regulator's failure to prosecute GlaxoSmithKline, manufacturer of the bestselling antidepressant Seroxat (manufactured as Paxil in North America), for withholding information on the safety of Seroxat from regulators. It next examines the idea of a "Sarbanes- Oxley for Science," a recent proposal that seeks to introduce legislation forcing companies to disclose clinical trials that have indeterminate or negative results. Legislation such as Sarbanes-Oxley for Science would solve some problems with the withholding of data, but not all. Until practitioners and policym... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472683 Sat, 13 Jun 2009 04:00:12 +0100 2472683 http://www.medworm.com/index.php?rid=2472662&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395821%26dopt%3DAbstract This article argues that two familiar justifications offered for the EBM hierarchy of evidence-that the hierarchy provides special access to causes, and that evidence derived from research methods ranked higher on the hierarchy is less biased than evidence ranked lower-both fail, and that this indicates that we are not epistemically justified in using the EBM hierarchy of evidence as a guide to medical research and practice. Following this critique, the article considers the extent to which biases influence medical research and whether meta-analyses might rescue research from the influence of bias. The article concludes with a discussion of the nature and role of biases in medical research and suggests that medical researchers should pay closer attention to social mechanisms for managing p... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472662 Sat, 13 Jun 2009 04:00:11 +0100 2472662 http://www.medworm.com/index.php?rid=2472640&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395822%26dopt%3DAbstract Authors: Giacomini M The evidence-based medicine (EBM) movement was established to combat capricious reasoning in clinical care, particularly arguments from authority. Critique of authority and appraisal of evidence remain EBM's core values and should be revisited in this era of EBM's maturity and influence. We are now faced with a new form of under-questioned authority: evidence from well-designed and methodologically appraised randomized controlled trials (RCTs). RCT evidence is now prized even when it is incapable of providing meaningful information-in particular, when underlying causal theory is inscrutable. Experimental trial evidence of the effectiveness of remote intercessory prayer provides an illustrative case that highlights systematic scientific blind spots in the institutio... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472640 Sat, 13 Jun 2009 04:00:11 +0100 2472640 http://www.medworm.com/index.php?rid=2472617&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395823%26dopt%3DAbstract This article argues that what matters is whether the treatment and control groups are similar with respect to potential confounding factors, not whether they got that way through randomization. Moreover, nonrandomized studies tend to have other characteristics that make them useful sources of evidence, in that they tend to last longer and to enroll more patients than do randomized trials. Replacing the sharp dichotomy between randomized and nonrandomized studies with a continuum from "clean" studies (which have high internal validity but whose results do not readily generalize to clinical practice) to pragmatic studies (which are designed to more closely reflect clinical practice) would also make a place for outcomes research and research using clinical databases, which are not included in... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472617 Sat, 13 Jun 2009 04:00:11 +0100 2472617 http://www.medworm.com/index.php?rid=2472595&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395824%26dopt%3DAbstract Authors: Upshur R Despite evidence-based medicine's (EBM's) significant evolution and maturation from its revolutionary origins to its current form as the preeminent means of practicing medicine, there are still good reasons to be unsatisfied with EBM. This essay explores two important new developments in EBM: recently articulated accounts of the scientific basis of EBM, and the related writings of the GRADE Working Group to create standards for interpretation of the medical literature and evaluation of recommendations. A review of Karanicolas, Kunz, and Guyatt's (2008) three-step articulation of EBM's scientific basis demonstrates that the supposed soundness of each principle is not attributable to its scientific status; instead, the normative language of each principle highlights EBM... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472595 Sat, 13 Jun 2009 04:00:11 +0100 2472595 http://www.medworm.com/index.php?rid=2472557&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395825%26dopt%3DAbstract This article provides an overview of some of the main ethical issues within psychiatry and examines three interrelated questions: (1) to which ethical values is EBM committed? (2) which ethical theory is reflected in these values? and (3) can these values and theories resolve existing ethical issues in psychiatry? EBM strives for the "greatest good for the greatest number," where good is defined as improved health. This utilitarian orientation cannot, however, address critical areas of moral importance for psychiatry, such as how its practitioners differentiate normal from abnormal, how they determine which forms of suffering should be alleviated through psychiatric means, and when involuntary intervention is ethically justified. The ethical principles implicit in EBM are too limited to se... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472557 Sat, 13 Jun 2009 04:00:11 +0100 2472557 http://www.medworm.com/index.php?rid=2472537&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395826%26dopt%3DAbstract This article outlines CAM's position between evidence and absurdity. It discusses misconceptions that often mislead the public and shows how CAM can and should be submitted to the principles of evidence- based medicine (EBM). Employing the example of acupuncture, the evidence as it currently stands is described. But there are numerous obstacles to applying EBM to CAM. EBM is defenseless against absurdity. We should, therefore, demarcate the absurd in order to avoid wasting time and resources. The new fad of "integrated" medicine has been proposed as a potential replacement for EBM. PMID: 19395826 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472537 Sat, 13 Jun 2009 04:00:10 +0100 2472537 http://www.medworm.com/index.php?rid=2472516&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395827%26dopt%3DAbstract This article draws from this debate in order to inform the discussions over the appropriateness of evidence- based policymaking and the related question of what is the nature of policymaking. The positivist, empiricist worldview that underpins the theory and practice of evidence-based medicine (EBM) fails to address key elements of the policymaking process. In particular, a narrowly "evidence-based" framing of policymaking is inherently unable to explore the complex, context-dependent, and value-laden way in which competing options are negotiated by individuals and interest groups. Sociolinguistic tools such as argumentation theory offer opportunities for developing richer theories about how policymaking happens. Such tools also have potential practical application in the policymaking proc... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472516 Sat, 13 Jun 2009 04:00:10 +0100 2472516 http://www.medworm.com/index.php?rid=2472496&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395828%26dopt%3DAbstract Authors: Tonelli MR Despite being the central concept to evidence-based medicine (EBM), evidence remains an elusive and controversial notion. Ongoing debates regarding evidence primarily serve to confuse and obfuscate. Examination of the nature of medical decision making without any appeal to evidence reveals a more complete understanding of the optimal practice of clinical medicine. An "evidence-free medicine" allows for the incorporation of a variety of facts and warrants, reasons and reasoning, into clinical decisions. The relative weighting of potentially conflicting warrants for a medical decision comprises the critical process of clinical judgment. Forgoing evidence allows clinical medicine to once again be a personal and prudential undertaking, arising from and focused on the in... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472496 Sat, 13 Jun 2009 04:00:10 +0100 2472496 http://www.medworm.com/index.php?rid=2472476&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19395829%26dopt%3DAbstract Authors: Landau WM PMID: 19395829 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472476 Sat, 13 Jun 2009 04:00:09 +0100 2472476 http://www.medworm.com/index.php?rid=2472453&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19496291%26dopt%3DAbstract Authors: Hughes AL The advent of nucleotide sequence data has created e new era in evolutionary biology. With theoretical underpinnings derived the work of the late Motoo Kimura, evolutionary concepts have played role in the development of the field of bioinformatics. However, the maturation of modern evolutionary biology has been hindered by a conception of natural selection as an all-powerful force shaping every aspect of phenotypic evolution. In new books, Joram Piatigorsky and Michael Lynch provide a corrective to some outdated views and thus provide a glimpse of what the evolutionary biology of the 21th century may look like. PMID: 19496291 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2472453 Sat, 13 Jun 2009 04:00:09 +0100 2472453 http://www.medworm.com/index.php?rid=2259013&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19271348%26dopt%3DAbstract Authors: McCormick JB, Scott CT Stem-cell research is still a prominent part of the political, scientific, and public discourse. Scientific advances are being made at a rapid rate, while debates on the moral status of the embryo continue. In the United States, President George W. Bush has twice vetoed legislation that some maintain would be an improvement over the current funding environment; others argue the solution is not optimal for thoroughly exploiting the potential of this exciting new area of research. In addition, we face a number of additional policy and legal challenges, including such issues as intellectual property, oocyte procurement, and informed consent of egg donors. We review Russell Korobkin's Stem Cell Century in the context of recent additions to the literature on ... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2259013 Fri, 13 Mar 2009 17:41:22 +0100 2259013 http://www.medworm.com/index.php?rid=2259012&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19271349%26dopt%3DAbstract Authors: Pigliucci M Biologists are increasingly reexamining the conceptual structure of evolutionary theory, which dates back to the so-called Modern Synthesis of the 1930s and 1940s. Calls for an Extended Evolutionary Synthesis (EES) cite a number of empirical and theoretical advances that need to be accounted for, including evolvability, evolutionary novelties, capacitors of phenotypic evolution, developmental plasticity, and phenotypic attractors. In Biological Emergences, however, Robert Reid outlines a theory of evolution in which natural selection plays no role or-worse-actually impedes evolution by what Reid calls "natural experimentation." For Reid, biological complexity emerges because of intrinsic mechanisms that work in opposition to natural selection, a view that would reo... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2259012 Fri, 13 Mar 2009 17:41:22 +0100 2259012 http://www.medworm.com/index.php?rid=2259011&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19271350%26dopt%3DAbstract Authors: Schweber SS During the 1970s, something deeply consequential happened in the cultural, economic, and social relationships between science and technology. Paul Forman has proposed that the abrupt reversal of the culturally ascribed primacy in the science-technology relationship circa 1980 be taken as a demarcation of postmodernity from modernity. Modernity's most basic cultural presuppositions-the superiority of theory to practice, the elevation of the public over the private and that of the disinterested over the interested, and the belief that the means sanctify the ends-were ascribed to science. In postmodernity, science is subsumed under technology, and the status of technology relative to science reflects our pragmatic-utilitarian subordination of means to ends. These cult... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2259011 Fri, 13 Mar 2009 17:41:22 +0100 2259011 http://www.medworm.com/index.php?rid=2259010&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19271351%26dopt%3DAbstract Authors: Ecks S For many scholars, the Cartesian mind/body split is one of the fundamental mistakes of the Western scientific tradition. Anthropologists who study notions of the body in cultures around the world regularly take Descartes as their point of departure. Many also suggest that breaking free from Descartes is politically liberating: if the mindful body could be rediscovered, society could move away from its materialist, positivist, and commodity-fetishizing ways. Beyond the Body Proper is anthropology's best and most comprehensive anti-Cartesian manifesto to date. This volume brings together some of the finest studies on the cultural and historical diversity of bodies and minds. Yet anthropologists' blanket rejection of the mind/body dualism seems politically self-defeating. ... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2259010 Fri, 13 Mar 2009 17:41:22 +0100 2259010 http://www.medworm.com/index.php?rid=2138604&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19168940%26dopt%3DAbstract This article outlines a Darwinian approach to sports that takes into account its profoundly cultural character and thereby overcomes the traditional nature-culture dichotomies in the sociology of sport. We argue that there are good reasons to view sports as culturally evolved signaling systems that serve a function similar to (biological) courtship rituals in other animals. Our approach combines the insights of evolutionary psychology, which states that biological adaptations determine the boundaries for the types of sport that are possible, and pure cultural theories, which describe the mechanism of cultural evolution without referring to sport's biological bases. Several biological and cultural factors may moderate the direct effect that signaling value has on a sport's viability or popu... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2138604 Wed, 28 Jan 2009 12:44:49 +0100 2138604 http://www.medworm.com/index.php?rid=2138603&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19168941%26dopt%3DAbstract This article addresses the question of whether the increased diagnosis of KD in India represents the emerging recognition of an illness that had been previously obscured by misdiagnosis, or whether KD is new to India and is increasing in incidence.Whichever answer turns out to be correct, the burden of KD is likely to pose a significant challenge to the health-care system in India in the coming years, due to the high cost of treatment and the potential for lifelong cardiovascular sequelae.Moreover, elucidating the factors that have contributed to the increased recognition of KD in India may provide useful insights for the continuing search for the etiology of KD worldwide. PMID: 19168941 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2138603 Wed, 28 Jan 2009 12:44:49 +0100 2138603 http://www.medworm.com/index.php?rid=2138602&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19168942%26dopt%3DAbstract This article examines the issue of expanding rights of conscience for health-care professionals to include rights grounded in claims of complicity. Our concerns relate to the nature of professional expertise, on the one hand, and an individual's right to live by his or her values, on the other. The fact that a patient is dependent on a physician's counseling about treatment options requires limiting conscience-based refusal to provide information, since allowing refusal would deprive patients of even knowing the options that exist for them. Sanctioning such claims of conscience not only would supplant one person's moral judgment with another's, it would also allow professional standing to be used as a justification for imposing one person's moral views on another. PMID: 19168942 [PubMe... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2138602 Wed, 28 Jan 2009 12:44:49 +0100 2138602 http://www.medworm.com/index.php?rid=2138601&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19168943%26dopt%3DAbstract This article focuses on collaborations between philosophers and biomedical scientists in order to discuss how interdisciplinary collaborations may address ethical, social, and environmental concerns in ways that lead to improvements in people's health and quality of life. The article concludes with a consideration of some of the challenges that such collaborations face. PMID: 19168943 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2138601 Wed, 28 Jan 2009 12:44:49 +0100 2138601 http://www.medworm.com/index.php?rid=2138600&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19168944%26dopt%3DAbstract Who Is Dürer's "Syphilitic Man"? Perspect Biol Med. 2009;52(1):48-60 Authors: Eisler CT Among Albrecht Dürer's first known woodcuts is one showing a syphilitic man. The Nuremberg artist's image is the earliest known depiction of an individual suffering from this illness. Syphilis was probably brought by Conquistadores from the New World to Naples in the later 1490s and was then transmitted throughout Western Europe by Northern mercenaries (Landsknechten) returning from Italy to their native Germany and Switzerland. The attire worn by Dürer's Syphilitic Man is exactly that of the Landsknecht. This makes the image important not only as a very early work by the artist and the earliest image of a syphilitic, but also as a depiction of the agent of the disease. The yo... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2138600 Wed, 28 Jan 2009 12:44:49 +0100 2138600 http://www.medworm.com/index.php?rid=2138599&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19168945%26dopt%3DAbstract Edward Bancroft's "Torporific Eels". Perspect Biol Med. 2009;52(1):61-79 Authors: Finger S Edward Bancroft was a medical apprentice in Connecticut before running off to Guiana in 1763. While in South America, he practiced medicine and collected material for a lengthy book on the region, which he published after he settled in London. Bancroft's Essay (1769) contains a description of the "torporific eels" found in the warm rivers of Guiana, along with a series of experiments suggesting that the eel's powers are electrical. It also calls for studies to determine whether saltwater torpedo rays might demonstrate the same properties, which Bancroft expected would be the case. Today, Bancroft is best remembered for serving Benjamin Franklin and the American delegation in France during... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2138599 Wed, 28 Jan 2009 12:44:49 +0100 2138599 http://www.medworm.com/index.php?rid=2138598&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19168946%26dopt%3DAbstract We present an English version of Cajal's essay, which may be of interest to both humanists and biologists, and which further denotes the celebrated neuroanatomist's attempt at understanding the mystery of the human mind. PMID: 19168946 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2138598 Wed, 28 Jan 2009 12:44:49 +0100 2138598 http://www.medworm.com/index.php?rid=2138597&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19168947%26dopt%3DAbstract This article examines the intellectual origins and hidden assumptions of this concept and argues that it is an inadequate, and even harmful, concept to use as a guiding motif for professional education. The competency model-which tends to be top-down and prescriptive-does not provide the framework for objective educational assessment that it claims to provide. The alternative apprenticeship model is more appropriate for professional education and is more consistent with what psychological research has shown about the acquisition of expertise. PMID: 19168947 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2138597 Wed, 28 Jan 2009 12:44:49 +0100 2138597 http://www.medworm.com/index.php?rid=2138596&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19168948%26dopt%3DAbstract Authors: Callahan D A number of changes can be observed in the way people are coming to think about death, mourning, and medical progress. The palliative care movement was initiated some 30 years ago to respond to widespread ignorance or neglect of pain relief for the dying, which was then coming to public attention and becoming a key part of the nascent hospice movement. Yet if an important feature of the latter movement was acceptance of the reality of death, in recent years there has emerged a blending of clinical treatment and hospice care, a kind of compromise with the idea of death as an inevitability. Meanwhile, the combination of real progress in forestalling death and the matching medical and media hype about past and coming victories over mortality mean that death itself is c... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2138596 Wed, 28 Jan 2009 12:44:49 +0100 2138596 http://www.medworm.com/index.php?rid=2138595&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19168949%26dopt%3DAbstract Authors: Epstein RJ, Zhao Y The end of the human race is not imminent, but it is both inevitable and important. Judging by the scarcity of relevant publications, however, there seems little public or professional concern about this prospect. We submit that this striking disinterest reflects a combination of ignorance and denial that is putting the long-term interests of society in jeopardy. With the pace of change now outstripping that of adaptation, it is no longer alarmist for academics to raise awareness about the approach of human extinction and to design strategies by which time to extinction might be prolonged. By making complacent and anthropocentric thinking less politically correct than it is at present, such awareness could motivate the world community to reformulate social n... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=2138595 Wed, 28 Jan 2009 12:44:49 +0100 2138595 http://www.medworm.com/index.php?rid=1976567&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19013852%26dopt%3DAbstract Authors: Mahowald MB Advances in reproductive technology and genetic interventions raise questions about the possibility of using these procedures to promote the birth of children with socially advantageous conditions. In Babies by Design, Ronald M. Green supports this goal and accuses its opponents of a "status quo bias." Unfortunately, some of Green's own arguments also show a status quo bias. Moreover, although he attempts to avoid the thorny issue of the moral status of human embryos, he implicitly takes a stand on it by endorsing prenatal interventions that inevitably entail the creation and loss of some human embryos. This essay identifies these and other flaws in Green's account. PMID: 19013852 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1976567 Fri, 21 Nov 2008 13:53:04 +0100 1976567 http://www.medworm.com/index.php?rid=1976566&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19013853%26dopt%3DAbstract Authors: Lamm E, Jablonka E This volume joins a growing list of books, monographs, and proceedings from scientific meetings that attempt to consolidate the wide spectrum of approaches emphasizing the role of development in evolution into a coherent and productive synthesis, often called evo-devo. Evo-devo is seen as a replacement or amendment of the modern synthesis that has dominated the field of evolution since the 1940s and which, as even its architects confessed, was fundamentally incomplete because development remained outside its theoretical framework (Mayr and Provine 1980). As the volume attests, there is now a strong feeling that the time is ripe for the consolidation of evo-devo, and that the field is mature enough so that mapping the theoretical terrain and experimental appr... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1976566 Fri, 21 Nov 2008 13:53:04 +0100 1976566 http://www.medworm.com/index.php?rid=1953023&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18997350%26dopt%3DAbstract Authors: PMID: 18997350 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1953023 Wed, 12 Nov 2008 18:06:41 +0100 1953023 http://www.medworm.com/index.php?rid=1953022&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18997351%26dopt%3DAbstract Authors: Humphrey HJ PMID: 18997351 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1953022 Wed, 12 Nov 2008 18:06:41 +0100 1953022 http://www.medworm.com/index.php?rid=1953021&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18997352%26dopt%3DAbstract Authors: Stern DT, Cohen JJ, Bruder A, Packer B, Sole A As the "passion that animates authentic professionalism," humanism must be infused into medical education and clinical care as a central feature of medicine's professionalism movement. In this article, we discuss a current definition of humanism in medicine. We will also provide detailed descriptions of educational programs intended to promote humanism at a number of medical schools in the United States (and beyond) and identify the key factors that make these programs effective. Common elements of programs that effectively teach humanism include: (1) opportunities for students to gain perspective in the lives of patients; (2) structured time for reflection on those experiences; and (3) focused mentoring to ensure that these event... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1953021 Wed, 12 Nov 2008 18:06:41 +0100 1953021 http://www.medworm.com/index.php?rid=1953020&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18997353%26dopt%3DAbstract We present the medical students' perspective on the hotly contested topic of professionalism in medical education and explore why students are often hostile to education in professionalism. We then suggest ways to improve professionalism education in the medical curriculum. PMID: 18997353 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1953020 Wed, 12 Nov 2008 18:06:41 +0100 1953020 http://www.medworm.com/index.php?rid=1953019&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18997354%26dopt%3DAbstract We present a case vignette with subsequent discussion to highlight the complexities of ensuring medical professionalism in the digital age. PMID: 18997354 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1953019 Wed, 12 Nov 2008 18:06:41 +0100 1953019 http://www.medworm.com/index.php?rid=1953018&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18997355%26dopt%3DAbstract Authors: Woodruff JN, Angelos P, Valaitis S A number of medical specialties have recently developed their own specialty-specific charters. This proliferation of charters is representative of an unease about medical professionalism that has arisen not just from increasing medical specialization, but also from evolving needs as physicians progress through their careers. The development of such specialty-specific definitions of professionalism is undesirable: all specialties should adhere to the same basic principles. These charters and "definitions" should be incorporated into a formal developmental model, derived from needs assessments from the level of medical school through the level of specialization. Such a model would provide physicians with more concrete guidance regarding profess... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1953018 Wed, 12 Nov 2008 18:06:41 +0100 1953018 http://www.medworm.com/index.php?rid=1953017&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18997356%26dopt%3DAbstract This article compares professionalism education from the vantage points of three different disciplines: medicine, law, and business. In particular, it asks how each of these professions conceives of "professionalism," and how these different conceptions affect what is taught to graduate students. The object of professionalism education differs among these three disciplines, as do the specific challenges to professionalism and professionalism education. The article offers examples of how professionalism is taught in medicine, law, and business, and what each profession might learn from the others in developing their professionalism education and pedagogy. PMID: 18997356 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1953017 Wed, 12 Nov 2008 18:06:41 +0100 1953017 http://www.medworm.com/index.php?rid=1953016&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18997357%26dopt%3DAbstract Authors: Dugdale LS, Siegler M, Rubin DT The practice of medicine increasingly poses obstacles to the cultivation of strong relationships between physicians and their patients. The current discussion of medical professionalism aims to identify some of these obstacles and to improve both the doctor-patient relationship and the quality of medical care. In this essay, we explore professionalism within the context of the relationship between physician and patient and examine the concrete actions, behaviors, and qualities that medical professionalism requires of physicians in today's challenging environment. PMID: 18997357 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1953016 Wed, 12 Nov 2008 18:06:41 +0100 1953016 http://www.medworm.com/index.php?rid=1953015&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18997358%26dopt%3DAbstract Authors: Walsh C, Abelson HT A comprehensive discussion of professionalism in medicine must include its impact on successive generations of physicians. Fifty years ago, doctors acting professionally emphasized medicine as a calling and an ability to act as the authority for patients in crisis at home and in hospitals. Therapeutic options were limited relative to the modern era, and the laying on of hands was practiced as science and art. Today, doctors balance increasing demands on time and efficiency with the sense of primacy of patient care. Technological innovation and patients' increasing access to medical knowledge through varying media of inconsistent quality challenge physicians in novel ways. Fifty years in the future, doctors will have access to vast amounts of information thr... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1953015 Wed, 12 Nov 2008 18:06:41 +0100 1953015 http://www.medworm.com/index.php?rid=1953014&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18997359%26dopt%3DAbstract Authors: Wynia MK The profession of medicine is based on a shared set of tacit and explicit agreements about what patients, doctors, and society at large should be able to expect from each other, a social contract that defines the profession. Historically, the development of this set of agreements depended upon the creation of social organizations that could speak for the entire profession. Over the last several decades, however, the perceived need for these organizations, and especially the umbrella organization for the profession, the American Medical Association, has waned. The reasons for this are complex, but the consequences are significant: an eroding social contract, fragmentation, lack of cohesion and integrity, and loss of the public's confidence. The present social contract ... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1953014 Wed, 12 Nov 2008 18:06:41 +0100 1953014 http://www.medworm.com/index.php?rid=1953013&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18997360%26dopt%3DAbstract Authors: Cruess RL, Cruess SR As health care has become of great importance to both individual citizens and to society, it has become more important to understand medicine's relationship to the society it serves in order to have a basis for meaningful dialogue. During the past decade, individuals in the medical, legal, social sciences, and health policy fields have suggested that professionalism serves as the basis of medicine's relationship with society, and many have termed this relationship a social contract. However, the concept of medicine's social contract remains vague, and the implications of its existence have not been fully explored. This paper endorses the use of the term social contract, examines the origin of the concept and its relationship to professionalism, traces its ... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1953013 Wed, 12 Nov 2008 18:06:41 +0100 1953013 http://www.medworm.com/index.php?rid=1953012&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18997361%26dopt%3DAbstract Authors: Hafferty FW, Levinson D Modern-day discourse on medical professionalism has largely been dominated by a "nostalgic" view, emphasizing individual motives and behaviors. Shaped by a defining conflict between commercialism and professionalism, this discourse has unfolded through a series of waves, the first four of which are discovery, definition, assessment, and institutionalization. They have unfolded in a series of highly interactive and overlapping sequences that extend into the present. The fifth wave-linking structure and agency-which is nascent, proposes to shift our focus on professionalism from changing individuals to modifying the underlying structural and environmental forces that shape social actors and actions. The sixth wave-complexity science-is more incubatory in ... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1953012 Wed, 12 Nov 2008 18:06:41 +0100 1953012 http://www.medworm.com/index.php?rid=1953011&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18997362%26dopt%3DAbstract Authors: Barondess JA Chronic disease is now hyper-endemic in the United States and is the central problem to be addressed in efforts to enhance the health of the American population. Efforts to reduce the prevalence of chronic disease through diminished exposure to risk factors have achieved significant success in recent decades, but most have been expressions of secondary or tertiary prevention. Current knowledge suggests it would be more effective to extend efforts directed at reduction of risk to earlier phases in the biology of chronic diseases, and to maintain them over the life course. This approach lends itself to a health preservation perspective-in other words, to an orientation around protection of the future health of the individual across the lifespan, from preconception t... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1953011 Wed, 12 Nov 2008 18:06:41 +0100 1953011 http://www.medworm.com/index.php?rid=1743150&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18723936%26dopt%3DAbstract The Third Gospel in <i>Finnegans Wake</i>. Perspect Biol Med. 2008;51(3):102-15 Authors: Abstract:This paper examines the role of the Gospel of Luke in Finnegans Wake. While the identities of all four evangelists are usually obscured by Joyce's composite figure Mamalujo, here I attempt to show how unique characteristics of Luke also influenced the Wake. Some of those characteristics are Luke's classical style, his skill as a story-teller, and his role as an editor and arranger. Luke's universalizing mission also left its trace on the figure of "Here Comes Everybody." Joyce incorporated Luke's parables concerning redemption of "that which was lost" and Luke's "Jubilee theme," which signaled a canceling of debts. In contrast to the secretive gospel of Mark, Luke is c... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1743150 Sat, 30 Aug 2008 13:03:44 +0100 1743150 http://www.medworm.com/index.php?rid=1743149&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18723937%26dopt%3DAbstract Authors: Tauber AI PMID: 18723937 [PubMed - in process] (Source: Perspectives in Biology and Medicine) Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1743149 Sat, 30 Aug 2008 13:03:44 +0100 1743149 http://www.medworm.com/index.php?rid=1743148&cid=s_37067_74_f&fid=37067&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18723938%26dopt%3DAbstract Authors: Schwartz PH The way that diseases such as high blood pressure (hypertension), high cholesterol, and diabetes are defined is closely tied to ideas about modifiable risk. In particular, the threshold for diagnosing each of these conditions is set at the level where future risk of disease can be reduced by lowering the relevant parameter (of blood pressure, low-density lipoprotein, or blood glucose, respectively). In this article, I make the case that these criteria, and those for diagnosing and treating other "risk-based diseases," reflect an unfortunate trend towards reclassifying risk as disease. I closely examine stage 1 hypertension and high cholesterol and argue that many patients diagnosed with these "diseases" do not actually have a pathological condition. In addition, th... Perspectives in Biology and Medicine journals http://www.medworm.com/rss/comments.php?id=1743148 Sat, 30 Aug 2008 13:03:44 +0100 1743148