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PubMed2000

The 1999 Lauriston S. Taylor lecture--back to background: natural radiation and radioactivity exposed.

I am profoundly grateful for being chosen as the twenty-third presenter of the Lauriston S. Taylor Lecture, and I share this honor with a list of distinguished scientists, including my husband, who pay tribute to the premier leader in radiation protection. In 1938, Laurie was working for the National Bureau of Standards and chaired the Advisory Committee on X-ray and Radium Protection, a group of 8 persons, who set the pace for all forthcoming radiation standards. NBS had, since 1913, been standardizing essentially all of the radium offered for sale in the U.S., and the problem arose to revise the handbook on proper conditions for handling radium based on the then current knowledge. This resulted in Handbook 23 (1938) superseding the 1934 work. At the time Laurie was a scientist working in the measurements side of radiation and though he contributed much to that field, his name is inseparably linked with guidance in radiation protection. Today we pay tribute for his leadership that he carried out with intelligence, grace, and personal warmth. My talk today deals mostly with measured data for naturally occurring internal radiation emitters and how these data can be used for predictive purposes in estimating the dose and risk from internal body contamination. This stresses the "and Measurements" part of the Council's title. The topic of this year's NCRP Annual Meeting is "Radiation Protection in Medicine: Contemporary Issues." I believe that physicians and State and Federal agencies will have to cope with complaints following various exposure situations resulting from the cleanup of background radionuclides during closure at nuclear facilities, military use of radioactivity, and occurrences of high natural background in some locations. They will find comfort in the knowledge that existing background radiation data can be the basis for predictions of realistic dose and risk in most situations.

Background Radiation↗
PubMed2003

26th Lauriston S. Taylor Lecture: developing mechanistic data for incorporation into cancer and genetic risk assessments: old problems and new approaches.

The theme that runs through this 26th Taylor Lecture is the question of how can data on the mechanism of induction of genetic alterations by radiations and chemicals be used to support the development of risk estimates, particularly at low exposure levels. The premise is that chromosomal alterations are involved in the development of tumors and birth defects, and that data generated for genetic alterations can be interpreted in terms of these adverse health outcomes. The general conclusions are that chromosomal alterations can be induced by ionizing radiations by a single energy loss event in a target of the size of a DNA molecule and that aberrations generally result from misrepair or failure to repair the induced lesions (generally assumed to be double-strand breaks). Chromosomal alterations induced by chemicals are produced almost exclusively by replication errors on a damaged DNA template. Thus, cell cycle stage and DNA repair and replication fidelity will be influential on overall sensitivity to aberration induction. These same features are also important in considerations of genetic susceptibility-alterations in cell cycle control or DNA repair or replication fidelity can alter sensitivity. The differences in mechanism of induction of chromosomal aberrations by ionizing radiation and chemicals is most important when considering cells at risk and comparative sensitivities among species and cell types. Models of cancer induction have gradually evolved from initiation, promotion, and progression models to multistep genetic models to the most recent one of six acquired characteristics. This evolution has passed the level of concentration of research from single gene, single cell to multiple genes (pathways), and whole tissues. The latter areas of concentration are ideal for addressing with the new genomics, proteomics, and computational modeling approaches. The attention is still on the role of genetic alterations in cancer and hereditary effects and the mechanism of their formation--it is the approaches to address these that are changing.

Animals↗
PubMed1997

Expanding the specialty of occupational and environmental medicine: the role of the chief health officer. The Sappington Lecture.

Passage of the Occupational Safety and Health Act in 1971 represented a major milestone for occupational and environmental medicine. Creation of the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) flowed directly from the legislation, and the specialty of occupational medicine entered a new era. As the 25th anniversaries of OSHA and NIOSH are celebrated, consideration of the future of the specialty of occupational and environmental medicine seems timely. In this lecture, an expanded role for the specialty is proposed, based on an analysis of the forces shaping the practice of public health and the opportunities that these forces present. This analysis suggests considering the concept of a "Chief Health Officer" serving the broad health needs of the workplace.

Cost-Benefit Analysis↗
PubMed2001

The Leeuwenhoek Lecture 2001. Animal origins of human infectious disease.

Since time immemorial animals have been a major source of human infectious disease. Certain infections like rabies are recognized as zoonoses caused in each case by direct animal-to-human transmission. Others like measles became independently sustained with the human population so that the causative virus has diverged from its animal progenitor. Recent examples of direct zoonoses are variant Creutzfeldt-Jakob disease arising from bovine spongiform encephalopathy, and the H5N1 avian influenza outbreak in Hong Kong. Epidemics of recent animal origin are the 1918-1919 influenza pandemic, and acquired immune deficiency syndrome caused by human immunodeficiency virus (HIV). Some retroviruses jump into and out of the chromosomal DNA of the host germline, so that they oscillate between being inherited Mendelian traits or infectious agents in different species. Will new procedures like animal-to-human transplants unleash further infections? Do microbes become more virulent upon cross-species transfer? Are animal microbes a threat as biological weapons? Will the vast reservoir of immunodeficient hosts due to the HIV pandemic provide conditions permissive for sporadic zoonoses to take off as human-to-human transmissible diseases? Do human infections now pose a threat to endangered primates? These questions are addressed in this lecture.

Animals↗
PubMed2005

The Croonian Lecture 2004 risk: food, fact and fantasy.

We all take risks, but most of the time we do not notice them. We are generally bad at judging the risks we take, and in the end, for some of us, this will prove fatal. Eating, like everything else in life, is not risk free. Is that next mouthful pure pleasure, or will it give you food poisoning? Will it clog your arteries as well as filling your stomach? This lecture weaves together three strands-the public understanding of science, the perception of risk and the role of science in informing government policy-as it explains how food risks are assessed and managed by government and explores the boundaries between the responsibilities of the individual and the regulator. In doing so, it draws upon the science of risk assessment as well as our attitudes to risk in relation to issues such as bovine spongiform encephalopathy, dioxins in salmon and diet and obesity.

Animals↗
PubMed2001

Emanuel Miller lecture developmental risks (still) associated with early child care.

In the mid to late 1980s a major controversy erupted when Belsky's (1986, 1988. 1990) analysis of research produced the conclusion that early and extensive nonmaternal care carried risks in terms of increasing the probability of insecure infant-parent attachment relationships and promoting aggression and noncompliance during the toddler, preschool, and early primary school years. Widespread critiques of Belsky's analysis called attention to problems associated with the Strange Situation procedure for measuring attachment security in the case of day-care reared children and to the failure of much of the cited research to take into consideration child-care quality and control for background factors likely to make children with varying child-care experiences developmentally different in the first place. In this lecture, research concerning the developmental effects of child care and maternal employment initiated in the first year of life that has emerged since the controversy broke is reviewed. Evidence indicating that early, extensive, and continuous nonmaternal care is associated with less harmonious parent-child relations and elevated levels of aggression and noncompliance suggests that concerns raised about early and extensive child care 15 years ago remain valid and that alternative explanations of Belsky's originally controversial conclusion do not account for seemingly adverse effects of routine nonmaternal care that continue to be reported in the literature.

Aggression↗
PubMed2006

Gillies Lecture: ocular motility in a time of paradigm shift.

Abstract Recent progress in understanding of the structure and function of extraocular muscles, and our ability to image them clinically, allows prediction of revolutionary progress in diagnosis and treatment of strabismus in the coming decades. This perspective memorializes a lecture given in honour of Dr William Gillies, who has for decades been the paternal leader of strabismology in southern Australia.

Australia↗
PubMed2001

The Claude Bernard Distinguished Lecture. In pursuit of meaningful learning.

The Bernard Distinguished Lecturers are individuals who have a history of experience and expertise in teaching that impacts multiple levels of health science education. Dr. Joel Michael more than meets these criteria. Joel earned a BS in biology from CalTech and a PhD in physiology from MIT following which he vigorously pursued his fascination with the mammalian central nervous system under continuous National Institutes of Health funding for a 15-yr period. At the same time, he became increasingly involved in teaching physiology, with the computer being his bridge between laboratory science and classroom teaching. Soon after incorporating computers into his laboratory, he began developing computer-based learning resources for his students. Observing students using these resources to solve problems led to an interest in the learning process itself. This in turn led to a research and development program, funded by the Office of Naval Research (ONR), that applied artificial intelligence to develop smart computer tutors. The impact of problem solving on student learning became the defining theme of National Science Foundation (NSF)-supported research in health science education that gradually moved all of Dr. Michael's academic efforts from neurophysiology to physiology education by the early 1980's. More recently, Joel has been instrumental in developing and maintaining the Physiology Education Research Consortium, a group of physiology teachers from around the nation who collaborate on diverse projects designed to enhance learning of the life sciences. In addition to research in education and learning science, Dr. Michael has devoted much of his time to helping physiology teachers adopt modern approaches to helping students learn. He has organized and presented faculty development workshops at many national and international venues. The topics for these workshops have included computer-based education, active learning, problem-based learning, and the use of general models in teaching physiology.

Computer-Assisted Instruction↗
PubMed2003

Mineral exploration: search for the mechanism of vascular calcification and beyond: the 2003 Jeffrey M. Hoeg Award lecture.

Research in the area of vascular calcification has grown rapidly in the past decade, and there is a greater understanding of its active regulatory mechanisms. This brief review covers the ideas presented in the 2003 Jeffrey M. Hoeg Award lecture, including the concepts that bone tissue forms in the artery wall in patients with atherosclerosis, that vascular cells undergo osteoblastic differentiation, that bone morphogenetic protein and matrix GLA protein regulate vascular calcification in opposition, that inflammatory cytokines and lipids promote vascular cell calcification but inhibit osteoblastic cell differentiation, that these same factors promote differentiation of bone-resorbing osteoclasts, and that the artery wall may contain osteoclast-like cells with the potential to resorb calcium mineral. The review closes with a mention of therapeutic possibilities and an evolutionary paradigm to explain the reciprocal responses of vascular and bone mineralization to inflammation.

Animals↗
PubMedDate not supplied

1999 Jonathan E. Rhoads lecture. Isotopic metaprobes, nutrition, and the roads ahead.

The 1999 Jonathan E. Rhoads lecture, delivered by Vernon R. Young at the annual meeting of American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), San Diego, February 2, 1999, with the printed version coauthored with Alfred M. Ajami, is concerned with the application of isotopic probes and how, in particular, they may be used as diagnostic tools to enhance the role of nutrition in the comprehensive medical management of the patient. Following a brief review of the early uses of stable isotopes in metabolic research we consider the present and possible future application of stable isotope probes. The concept of a "gateway" enzyme in a discrete biochemical pathway and how the flow of substrate through this step might be assessed by giving a "metaprobe" is developed. The specific and desirable structural requirements of the metaprobe are considered. A number of examples are given that further exploit the concepts of "underground" metabolism and of metabolic "hijackers." It is our view that we are on the verge of a new era where, for the many pragmatic and exciting reasons discussed, stable isotope probes will find and increasing use in the practice of clinical medicine and in the preventive and public health areas.

Animals↗
PubMed2005

Daisy Ayris Lecture. The operating room: a personal history.

This is the first of two articles based on a presentation given at NATN Congress 2004. The presentation was given as the Daisy Ayris Memorial Lecture. In this article NATN archivist Nancy Cox describes her experiences working in the operating room beginning in the 1950s.

History, 20th Century↗
PubMed2005

Daisy Ayris Lecture. The history of NATN. 40 years and counting.

Nancy Cox joined NATN in 1970, becoming deputy secretary in 1972, and national secretary from 1985-1989. This article is the second part of the Daisy Ayris Memorial Lecture given at Congress 2004. Nancy gives us a fascinating insight into the early days of the organisation, and how it has become the association it is today.

Forecasting↗
PubMed2006

Daisy Ayris Lecture. Looking back, looking forward.

This was the second time that Mary Spinks, a former Chairman of NATN, has given the Daisy Ayris Lecture. This unprecedented move indicates the Association's respect for Mary's influence and commitment to patient care in her current role as Director of the Florence Nightingale Foundation. Her address, given below in full, covers key themes of education, reasoning and communication.

Forecasting↗
PubMed2005

Murray Kornfeld, American College Of Chest Physician, and sarcoidosis: a historical footnote: 2004 Murray Kornfeld Memorial Founders Lecture.

Murray Kornfeld was a successful New York businessman. His encounter with tuberculosis led him to the internationally famous Saranac Lake Sanatorium run by Dr. Edward Livingston Trudeau. At America's "magic mountain," Kornfeld decided to create an institution that would serve as the center of higher learning and research for diseases of the chest. Thus was born the American College of Chest Physicians and the famous journal that is now called CHEST. In this lecture, the story of Kornfeld's legacy is weaved with the growth of knowledge of sarcoidosis during the last 50 years.

History, 20th Century↗
PubMed2005

ADA Outstanding Scientific Achievement Lecture 2004. Thirty years of investigating the autoimmune basis for type 1 diabetes: why can't we prevent or reverse this disease?

Thirty years ago, a convergence of investigational observations lead to the now widely accepted notion that type 1 diabetes results from an autoimmune destruction of insulin-producing beta-cells in subjects genetically predisposed to the disease. Improvements in understanding of the natural history of type 1 diabetes, the biochemical identification of autoantigens, the discovery of spontaneous animal models for the disease, the availability of immune-modulating agents, and other important facets, including disease prediction, drove an early sense of optimism that the prevention of type 1 diabetes was possible and, in some research circles, that ability was thought to be within a not-to-distant reach. Unfortunately, those early expectations proved overly optimistic, and despite the aforementioned knowledge gains, the generation of improved investigational tools, the identification of methods to prevent the disease in animal models, and the formation of very large disease prevention trials, a means to prevent type 1 diabetes in humans continues to remain elusive. Believing in the concept of "informative failures" (a.k.a., wise people learn from their mistakes), this lecture reviews the knowledge base collected over this time period and, when combined with an analysis of those research experiences, sets forth a proposal for future investigations that will, hopefully, turn discoveries into a means for the prevention or reversal of type 1 diabetes.

Animals↗
PubMed1998

Stanley Paris Award Lecture. Reflections on the history and future of orthopaedic physical therapy.

Carolyn Wadsworth, MS, PT, CHT, OCS, deliver the 1998 Paris Distinguished Service Award Lecture at the Combined Sections Meeting in Boston in February. Wadsworth is the fifth recipient of the Paris Award, which is the Orthopaedic Section's highest honor given to commemorate a member's exceptional and enduring service. The Paris Distinguished Service Award was established in 1990 and is named after Stanley V. Paris, PhD, PT, founder and first president of the Orthopaedic Section. Born in Dunedin, New Zealand, Paris immigrated to the U.S. in 1966. He developed physical therapy practices in Boston, Hamilton, Bermuda, and Atlanta; established the Institute of Graduate Health Sciences in Atlanta, GA; and is currently president of the University of St. Augustine, St. Augustine, FL. Paris is a strong advocate of assertive professional practice, clinical specialization, and strengthening leadership in physical therapy. He also champions wellness, exemplified by his personal achievements in sailing the Atlantic Ocean, swimming the English Channel, and completing the Ironman Triathlon. Carolyn Wadsworth, recipient of the 1998 Paris Award, has served as secretary and president of the Orthopaedic Section and is currently editor of the Orthopaedic Section's Home Study Course. She owns a private practice, teaches nationally, and has written two books, Examination and Mobilization of the Spine and Extremities (1988) and Orthopedic Review for Physical Therapists (1998). Major components of the speech she presented at the Orthopaedic Section Awards Ceremony are highlighted in this article.

History, 20th Century↗
PubMed2003

Practice guidelines: pedantic pontification or pragmatic progress? 2003 Ryley-Jeffs Memorial Lecture.

Development and use of practice guidelines is one strategy to assist health professionals in translating research into practice. There has been a significant growth in the number of practice guidelines developed, with the increased focus on justifying health care costs and demonstrating outcomes. Quality and influence on established practice, however, has sometimes been lacking. Recognizing both the importance of practice guidelines and some of the controversies surrounding their quality and use, Dietitians of Canada convened a task group to make recommendations on future development. They reviewed the practice guideline programs of others and identified the key elements needed to ensure any dietetics-produced guidelines would be credible, feasible and applicable to clinical counselling, administration and community health promotion. In this memorial lecture, the chair of that task group briefly reviews the history of dietetic practice guidelines, new innovations in systematic review and consensus development methods, and specifically the Delphi process used to develop a new Dietetic Practice Guidelines Framework. The 34 elements of the framework direct overall management of the guideline development process, including topic nomination, systematic literature review, group judgment, and pilot testing.

Canada↗
PubMedDate not supplied

The 2000 Eleanor Clarke Slagle Lecture. Our mandate for the new millennium: evidence-based practice.

The health care environment of the past quarter century went through numerous evolutionary processes that affected how occupational therapy services were provided. The last iterations of these processes included requests for the evidence that supported what we were doing. This year's Eleanor Clarke Slagle Lecture (a) examines the strength of the evidence associated with occupational therapy interventions--what we do and how we do it--(b) raises dilemmas we face with our ethical principles when some of our practices are based on limited evidence, and (c) proposes a framework of continued competency to advance the evidence base of occupational therapy practice in the new millennium.

Adult↗