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PubMed1993

A cephalometric comparison of medieval skulls with a modern population.

Thirty-one medieval skulls, mostly dating from the Black Death in 1348, were compared with 32 modern, untreated adults. The medieval population was unusual because the skulls could be so closely dated. Lateral skull radiographs were used for the comparison, based on the method of Seddon (1984). A method error study indicated that the measurements could be treated with reasonable confidence, although possible difficulties with the material are discussed. The findings suggest that the modern group have the longer face and longer palate. The medieval group were found to have more retroclined upper incisors and more proclined lower incisors as well as reduced overbites. The results also suggest changes in mandibular shape over time together with cranial base changes: the modern mandible has a more obtuse gonial angle and is generally longer and thinner. It was not possible to reach a firm conclusion regarding chin prominence. The cranial base saddle angle has become more acute since the medieval period, and the length S-N is greater in the modern group. Depending on interpretation, the skull material could be said to have a more prominent maxilla. Possible reasons for the differences are discussed.

Adolescent↗
PubMed1982

Indirect modernization and the status of the elderly in a rural Third World setting.

Currently the majority of the world's elderly reside in less developed countries and their proportion is increasing. This paper presents evidence that the process of modernization can have a negative impact on the elderly in even the most remote rural Third World settings, even though those settings are not modernized or in the process of modernization in any of the normal uses of that concept. Fieldwork was conducted in Helambu, Nepal on a sample of 37 persons over the age of 50 that included 86% of population aged 60 and over. Despite high levels of activity, health, social and economic status, the elderly were greatly dissatisfied with their situation. The paper demonstrates the manner in which modernization in India has profoundly changed household/family organization in Helambu and produced this situation.

Aged↗
PubMed2005

Quality of care of modern health services as perceived by users and non-users in Burkina Faso.

OBJECTIVE: Only one-fifth of the population in rural Burkina Faso uses modern health services. This article aims to identify barriers to increased use, which may help decision makers to develop policies to remove them. DESIGN: This article compares perceived quality of care of 853 pairs of users and non-users of modern health services. Non-users were matched to users on age, sex, occupation of the head of the household and distance to health post. Questions were structured according to four dimensions of quality of care. SETTING: Nouna health care district, Burkina Faso. RESULTS: Both users and non-users were relatively favourable about health personnel practices and conduct (77% versus 70% of the maximum attainable score), and about health care delivery (77% versus 74%). They were less favourable about adequacy of resources and services (51% versus 46%), and financial and physical accessibility of care (57% versus 51%). Both groups were very negative regarding the availability of drugs (33% versus 27%). Users were more favourable than non-users overall (66% versus 61%), and especially regarding payment arrangements (51% versus 43%) and costs (50% versus 40%). Observed differences were generally significant. CONCLUSION: To remove barriers to increase utilization, policy makers may do good to target their attention to improve financial accessibility of modern health services and improve drugs availability. These factors seem most persistent in decisions of ill people to stay with home-based care and/or traditional medicine, or go to consult modern health services.

Adolescent↗
PubMedDate not supplied

Modern African ape populations as genetic and demographic models of the last common ancestor of humans, chimpanzees, and gorillas.

In order to fully understand human evolutionary history through the use of molecular data, it is essential to include our closest relatives as a comparison. We provide here estimates of nucleotide diversity and effective population size of modern African ape species using data from several independent noncoding nuclear loci, and use these estimates to make predictions about the nature of the ancestral population that eventually gave rise to the living species of African apes, including humans. Chimpanzees, bonobos, and gorillas possess two to three times more nucleotide diversity than modern humans. We hypothesize that the last common ancestor (LCA) of these species had an effective population size more similar to modern apes than modern humans. In addition, estimated dates for the divergence of the Homo, Pan, and Gorilla lineages suggest that the LCA may have had stronger geographic structuring to its mtDNA than its nuclear DNA, perhaps indicative of strong female philopatry or a dispersal system analogous to gorillas, where females disperse only short distances from their natal group. Synthesizing different classes of data, and the inferences drawn from them, allows us to predict some of the genetic and demographic properties of the LCA of humans, chimpanzees, and gorillas.

Africa↗
PubMed1983

Modern psychotherapy and Halakhic values: an approach toward consensus in values and practice.

In this paper, I have examined in some detail a number of examples of actual and potential consensus between Jewish ethics and the practice of modern psychotherapy, psychology, and psychiatry. Moreover, I have posited specific halakhic models which represent analogies to modern psychotherapeutic principles and practices, which through analogy lend specific halakhic guidelines to modern practice. The unitary halakhic approach presented here is thus both heuristic--in that it seeks to demonstrate the ways in which psychotherapeutic processes are essentially halakhic ones--as well as practical. Through this approach, psychological theory and practice have been brought into intimate contact with the ethical requirements of the halakhically committed mental health practitioner and his or her patient, filling an inexcusable void in halakhic application to modern technology, and setting a direction for future work in this area.

Ethics, Medical↗
PubMed1992

The evolution of the mitochondrial D-loop region and the origin of modern man.

The origin of modern man is a highly debated issue that has recently been tackled by using mitochondrial DNA sequences. The limited genetic variability of human mtDNA has been explained in terms of a recent common genetic ancestry, thus implying that all modern-population mtDNAs originated from a single woman who lived in Africa less than 0.2 Mya. This divergence time is based on both the estimation of the rate of mtDNA change and its calibration date. Because different estimates of the rate of mtDNA evolution can completely change the scenario of the origin of modern man, we have reanalyzed the available mitochondrial sequence data by using an improved version of the statistical model, the "Markov clock," devised in our laboratory. Our analysis supports the African origin of modern man, but we found that the ancestral female from which all extant human mtDNAs originated lived in a time span of 0.3-0.8 Mya. Pushing back the date of the deepest root of the human implies that the earliest divergence would have been in the Homo erectus population.

Animals↗
PubMed1997

Modernity, postmodernity and disability in developing countries.

This paper examines the implications of two theoretical perspectives, modernity and postmodernity, for provision of community-based disability services in developing countries. The author argues that modernity's embrace of the 'wonders' of science and technology have significantly affected our understanding of what community is. Modernity, in fact, leads us to view communities in one of two major ways: as inferior, or as ideal. Both views are deeply flawed. Postmodernity's profound scepticism of truth claims and authority provides a useful critique of community conceived in modern terms. The critique is helpful to the extent that it reveals the power of language in constructing our ideas of community. It also highlights a new way of thinking about participation, individualism and choice in community disability initiatives.

Developing Countries↗
PubMed2005

Management of urinary tract infections: historical perspective and current strategies: Part 2--Modern management.

PURPOSE: An understanding of the microbial origin of infectious diseases and the introduction of antimicrobial therapy stimulated more advances in the management of urinary tract infections (UTIs) in the 20th century than had occurred in the previous 5 centuries. MATERIALS AND METHODS: Numerous resources were used to collect the information described in this review. Medical texts from the 19th and 20th century contain information regarding the traditional contemporary treatment of UTI during those eras. Early volumes of the Journal of Urology from the beginning of the 20th century describe the first attempts at chemotherapy for UTI. MEDLINE searches were used to collect appropriate information after 1969. Modern medical journals and modern medical texts were used to collect information on antimicrobial therapy since the late 1960s through today. RESULTS: Numerous advances in the diagnosis and management of UTI were made during the 20th century. Advances in microbiological and chemical assays have facilitated the development of historical uroscopy into modern day urinalysis and culture techniques, which are the cornerstone of UTI diagnosis. Imaging technologies, including x-ray, ultrasound, nuclear imaging, magnetic resonance and computerized tomography, have been particularly helpful in the diagnosis of complicated or recurrent UTIs. Major innovations in nonpharmacological therapy include noninvasive shock wave lithotripsy and percutaneous drainage of kidney abscesses. The most profound advance in UTI management during the 20th century was the discovery of antimicrobial agents. Nitrofurantoin was the first truly effective and safe antimicrobial therapy for UTI but its spectrum of activity is limited. Broad use of amoxicillin (and other beta-lactams) after its introduction in the 1970s led to the development of resistance to this antimicrobial, prompting a gradual change to trimethoprim/sulfamethoxazole (TMP/SMX) as first line therapy for UTI. However, wide use of TMP/SMX also resulted in the progressive emergence of resistance, limiting the clinical usefulness of this therapy in the modern management of UTI. Fluoroquinolones offer an attractive alternative to TMP/SMX, and American and European guidelines recommend their empirical use in areas where TMP/SMX resistance is 10% or higher. CONCLUSIONS: The development of antimicrobial therapy was the defining moment of 20th century medicine and one of the key innovations in medical history. While the initial promise of antimicrobials has been validated in clinical practice, overuse of certain agents has led to the emergence of resistance, illustrating the importance of using evidence based strategies to select therapy.

Anti-Infective Agents, Urinary↗
PubMed2002

Complete mitochondrial DNA genome sequences show that modern birds are not descended from transitional shorebirds.

To test the hypothesis put forward by Feduccia of the origin of modern birds from transitional birds, we sequenced the first two complete mitochondrial genomes of shorebirds (ruddy turnstone and blackish oystercatcher) and compared their sequences with those of already published avian genomes. When corrected for rate heterogeneity across sites and non-homogeneous nucleotide compositions among lineages in maximum likelihood (ML), the optimal tree places palaeognath birds as sister to the neognaths including shorebirds. This optimal topology is a re-rooting of recently published ordinal-level avian trees derived from mitochondrial sequences. Using a penalized likelihood (PL) rate-smoothing process in conjunction with dates estimated from fossils, we show that the basal splits in the bird tree are much older than the Cretaceous-Tertiary (K-T) boundary, reinforcing previous molecular studies that rejected the derivation of modern birds from transitional shorebirds. Our mean estimate for the origin of modern birds at about 123 million years ago (Myr ago) is quite close to recent estimates using both nuclear and mitochondrial genes, and supports theories of continental break-up as a driving force in avian diversification. Not only did many modern orders of birds originate well before the K-T boundary, but the radiation of major clades occurred over an extended period of at least 40 Myr ago, thus also falsifying Feduccia's rapid radiation scenario following a K-T bottleneck.

Animals↗
PubMed2005

Recovering the geographic origin of early modern humans by realistic and spatially explicit simulations.

Most genetic and archeological evidence argue in favor of a recent and unique origin of modern humans in sub-Saharan Africa, but no attempt has ever been made at quantifying the likelihood of this model, relative to alternative hypotheses of human evolution. In this paper, we investigate the possibility of using multilocus genetic data to correctly infer the geographic origin of humans, and to distinguish between a unique origin (UO) and a multiregional evolution (ME) model. We introduce here an approach based on realistic simulations of the genetic diversity expected after an expansion process of modern humans into the Old World from different possible areas and their comparison to observed data. We find that the geographic origin of the expansion can be correctly recovered provided that a large number of independent markers are used, and that precise information on past demography and potential places of origins is available. In that case, it is also possible to unambiguously distinguish between a unique origin and a multiregional model of human evolution. Application to a real human data set of 377 STR markers tested in 22 populations points toward a unique but surprising North African origin of modern humans. We show that this result could be due to ascertainment bias in favor of markers selected to be polymorphic in Europeans. A new estimation modeling this bias explicitly reveals that East Africa is the most likely place of origin for modern humans.

Africa↗
PubMed2000

Development and validation of Swedish classical and modern sexism scales.

In two studies we develop and validate a Classical--overt or direct--and a Modern--covert or subtle--Sexism Scale concerning attitudes toward women, for a Swedish (Scandinavian) context. Further, we examine whether these two forms of prejudice are distinguishable. Confirmatory factor analyses showed that, although highly correlated, classical and modern sexism are distinguishable. The construct validations showed that men had higher means on modern and classical sexism scores than women, and that our scales were related to other constructs as expected. In a third study, we analyzed the knowledge and the content of cultural stereotypes about women. There were no differences in the knowledge of cultural stereotypes between men and women or between high- and low-sexist individuals. The findings are discussed in relation to previous international studies that examine people's modern and/or classical sexism.

Adult↗
PubMed2004

The role of load-carrying in the evolution of modern body proportions.

The first unquestionably bipedal early human ancestors, the species Australopithecus afarensis, were markedly different to ourselves in body proportions, having a long trunk and short legs. Some have argued that 'chimpanzee-like' features such as these suggest a 'bent-hip, bent-knee' (BHBK) posture would have been adopted during gait. Computer modelling studies, however, indicate that this early human ancestor could have walked in a reasonably efficient upright posture, whereas BHBK posture would have nearly doubled the mechanical energy cost of locomotion, as it does the physiological cost of locomotion in ourselves. More modern body proportions first appear at around 1.8-1.5 Ma, with Homo ergaster (early African Homo erectus), represented by the Nariokotome skeleton KNM-WT 15000, in which the legs were considerably longer in relation to the trunk than they are in human adults, although this skeleton represents an adolescent. Several authors have suggested that this morphology would have allowed faster, more endurant walking. But during the same period, the archaeological record indicates a sharp rise in distances over which stone tools or raw materials are transported. Is this coincidental, or can load-carrying also be implicated in selection for a more modern morphology? Computer simulations of loaded walking, verified against kinetic data for humans, show that BHBK gait is even more ineffective while load-carrying. However, walking erect, the Nariokotome individual could have carried loads of 10-15% body mass for less cost, relative to body size, than AL 288-1 walking erect but unloaded. In fact, to the extent that our sample of humans is typical, KNM-WT 15000 would have had better mechanical effectiveness in bearing light loads on the back than modern human adults. Thus, selection for effectiveness in load-carrying, as well as in endurant walking, is indeed likely to have been implicated in the evolution of modern body proportions.

Animals↗
PubMed2004

Practice development and health care governance: a recipe for modernization.

The terms practice development (PD) and health care governance (HG) have become synonymous with quality and modernization. However, limited activity has been devoted to deciphering why this is the case and what the potential benefits of PD and HG are in supporting the National Health Service modernization agenda. The paper attempts to demystify this issue by providing an insight into the drivers for modernization and through outlining the emerging debates associated with how and why PD and HG may provide the recipe for modernization.

Clinical Competence↗
PubMed1995

Foucault and modern medicine.

Modernity as a concept or ideal, resulting from the age of Enlightenment and the French Revolution gave hope of a better future and new possibilities. To be modern means an 'enlightened' individual and society, welcoming change and development. In this paper, I will discuss Foucault's analysis (1973) of problematics in medicine in eighteenth century France. Three themes prominent in the text are: 'the birth of the clinic', 'the clinical gaze' and the power-knowledge relationship. Three problematics identified in modern medicine by Foucault and which are particularly relevant to twentieth century medicine are: (i) the extension of the clinical gaze from the individual body to the wider population; (ii) the increasing medical intervention and use of technology in fundamental life processes; and (iii) the relationship between society and medicine. I will argue that Foucault's analysis is fraught with ambiguities. It is useful, however, for establishing an explanation for medicine today and for presenting a particular interpretation of modernity.

Clinical Medicine↗
PubMed2001

Modern human ancestry at the peripheries: a test of the replacement theory.

The replacement theory of modern human origins stipulates that populations outside of Africa were replaced by a new African species of modern humans. Here we test the replacement theory in two peripheral areas far from Africa by examining the ancestry of early modern Australians and Central Europeans. Analysis of pairwise differences was used to determine if dual ancestry in local archaic populations and earlier modern populations from the Levant and/or Africa could be rejected. The data imply that both have a dual ancestry. The diversity of recent humans cannot result exclusively from a single Late Pleistocene dispersal.

Africa↗
PubMed1982

Critical care at Tianjin's First Central Hospital and the fourth modernization.

This case study of the Critical Care Unit at Tianjin's First Central Hospital, its physician-director, and one of its patients provides a portrait of how the policy of the four modernizations is being applied to the field of medicine in the People's Republic of China. On this unit of an urban hospital the "fourth modernization," science and technology, is systematically brought to bear on the problems of critically ill patients. The Chinese dualities and dilemmas that this "scaling the heights" policy entails are continually played out on the Critical Care Unit. An intricate balancing is involved between modern Western and traditional Chinese medicine, and between rural public health programs and primary and tertiary care services, within a medical morality framework that combines present-day political ideology with age-old ethical precepts. At this juncture the overall balance seems to be moving in the direction of modern, city-based, curative medicine.

Adolescent↗
PubMed1995

Determinants of modern health care use by families after a childhood burn in Ghana.

OBJECTIVES: This study examined determinants of modern health care use by families after their child aged 0-5 years sustained a burn injury in the Ashanti Region of Ghana. METHODS: A community based survey of children aged 0-5 years was conducted in 50 enumeration areas in the region. Mothers of all children with scars as evidence of a burn were selected for a follow up interview using a standard questionnaire two to three months later. Determinants of health care use were investigated through a multivariate logistic regression using interview responses from mothers of 617 children for whom report on some treatment was given. RESULTS: Overall, 48% of the burned children were taken to a modern health facility for treatment. Of those taken to a modern health facility, 68% were sent within 24 hours of the burn event. Factors with large adjusted odds ratios for modern health care use included wound infection, burns covering 6% or more of the body surface, and third degree burns. Compared with scalds, children with contact and flame burns were less likely to be taken to a health facility, as were burns to rural children, and those given first aid treatment at home. CONCLUSIONS: It is concluded that families, particularly rural residents, should be educated about appropriate health care seeking practices after a burn.

Adult↗
PubMed2003

[Movement and its significance: natural healing physiotherapy and modern pharmacological therapy of osteoporosis in the semantic differential. A quantitative study of a self-help group and two comparison groups].

BACKGROUND: Physiotherapy is a frequently applied concomitant therapy for patients with osteoporosis. Compared to modern pharmacological therapy physiotherapy appears to receive sustained high regard, which should be further examined in view of the attribution pattern of the patients. OBJECTIVE: Elements of physiotherapy and Kneipp therapy were quantitatively examined in terms of their semantic content in a three-dimensional space of meaning. This was done in comparison with elements of modern pharmacological therapy. The questions regarding possible patterns of the attributions and a possible hierarchy of the therapy forms were analyzed by a survey of a self-help group for osteoporosis patients and two control groups. MATERIAL AND METHODS: According to the methods of semantic differentials, a self-help group for osteoporosis patients and two control groups (high-school female pupils, breast carcinoma patients) were queried about the individual elements of physiotherapy and modern pharmacological therapy in a polar profile of a questionnaire. The results were arranged onto a numerical matrix and by means of factor analysis, a location in a three-dimensional space of meaning was calculated for each element questioned. For purpose of illustration, the results were transferred to a succession of diagrams so that the assessments for the three axes of meaning became more distinct. The results are discussed on the background of a current neurolinguistic theory of meaning: Sensomotoric experience generates meaning in form of 'primary metaphors'; if reactivated e.g. by physiotherapy, these metaphors can give fundaments for an emergent and salutogenic system of meaning, which helps to reconstruct the patient's 'subjective anatomy' and helps to create new values of living one's life. HYPOTHESES: If sensomotoric experience has a central function in generating meaning, the axis of 'motion' and therapies stressing on sensomotoric experience (e.g. exercise group) will show a corresponding profile of evaluation throughout the three groups. RESULTS: For the axis 'motion' the interventions examined in all three groups show a harmonious profile. The most stable position for all three axes is reflected by 'exercise group', followed by 'whole-body pack'. This stability concerning the axis 'motion' as well as 'exercise group' is discussed in terms of a neurolinguistic theory of meaning, giving sensomotoric experiences the central function for generating meaning. CONCLUSIONS: The results allow conclusions concerning the concrete 'meaning-oriented' combination of physiotherapy with modern pharmacotherapy. Moreover, sensomotoric experiences in physiotherapy are possible reasons for an emergent system of meaning reconstructing the patient's 'subjective anatomy' from basic 'primary metaphors' of bodily experiences up to a whole salutogenetic system of meaning.

Adolescent↗