The MRRC at the University of California (UCLA), Los Angeles, CA.
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The MRRC at Children's Hospital/Harvard Medical School is focused on research in genetics and neuroscience. Both clinical and basic science approaches are abundant. Major interdisciplinary programs, particularly in the areas of neonatal brain injury, human cerebral cortical malformations, and human neuromuscular disorders, interdigitate basic and clinical research in cohesive research programs. The core research support facilities serve as the nidus for this large research effort, encompassing 65 externally funded clinical and basic scientists.
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It is important that educators in the intensive care unit (ICU) provide physicians in training with the guidance and experience requisite in developing foundational skills in value-based medical practice. This article discusses the underlying philosophy of ethically based medical decision making and describes the components of an educational program in medical humanities for the ICU. In particular, the authors focus on the central role of a relationship between the patient and the caregiver.
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In 2005, an unprecedented number of recalls were issued on pacemakers and implantable cardioverter defibrillators. While recalls in the cardiac rhythm device industry are not new, the sheer magnitude of potentially affected patients in 2005 led to a great deal of concern, frustration, and even anger. Physicians have, in many instances, been uncertain when (or if) to recommend device replacement in an environment where the magnitude of the risk and the potential consequences of device failure have not been well defined in a timely way. Doctors and patients are now calling for reform of postmarket analysis and reporting mechanisms. The present article provides a uniquely Canadian perspective on this international issue. Potential solutions include the development of a set of realistic and common expectations, a restoration of confidence in postmarket analysis and reporting mechanisms, increased data transparency, and an increased role for patient and physician groups.
Current conceptualizations of knowledge transfer reinforce the notion of a linear process between researchers and clinicians, who are seen as operating separately with different agenda. This paper uses a case study to illustrate a dynamic model of knowledge integration involving integrated and interdependent relationships among researchers, clinicians, and decision-makers. We believe the principles of this model are more likely to lead to effective use of research evidence in clinical practice.
This article describes the Preceptor & Mentor Initiative for Health Sciences in BC, a provincial strategy to facilitate preceptoring and mentoring. A web site was developed with a comprehensive preceptor/mentor framework and resources, based on best practices and applicable to all health sciences. Informal feedback indicates this Initiative is effective in supporting health sciences preceptoring and mentoring in BC. A formal evaluation will be conducted by March 2003 and reported in a future FORUM article.
With advances in medical technology, difficult questions of "What should be done?" and "Who should decide?" are a daily occurrence in hospitals. This paper reports the results of a survey of Canadian chaplains with respect to their involvement in bioethical decision-making. The survey suggests that chaplains make a significant contribution to discussion and resolution of bioethical dilemmas. Using a case study, the paper elaborates on the chaplain's role in bioethical decision-making, and indicates how such participation can influence both cost containment and risk management.
Animal abuse has long been recognized as a sign of family violence and a warning sign of future aggression in children and adolescents. As leaders in youth violence prevention, pediatric nurse practitioners need to be aware of the prevalence and types of juvenile animal cruelty and its relationship to human violence. In doing so, they can champion for health care and related policies for this disturbing problem, described by Ascione as an underreported and understudied issue that may add to the understanding and prevention of youth violence."[One of the most dangerous things that can happen to a child] is when the child who kills or tortures [an animal] is not caught, or if caught is not punished." -Anthropologist Margaret Mead
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Three kinds of ethics committees should be distinguished, the mandatory local hospital or clinic-based committee, the statutory national committee set up to issue licences, or survey issues highlighted by local committees, or in the national press, reporting to Parliament, and publishing annual reports; and the committee established either temporarily or on a permanent basis to examine outstanding and general problems in the morals of medical practice and research, and to advise Ministers as to possible changes in the law. At all levels, such committees will be concerned with moral problems, and can never, therefore, be expected to come up with uniquely 'correct' solutions. Nevertheless they are essential both to reassure the public and to give guidance to the medical profession, both in clinical practice and research. Such committees should, at all levels, have a non-medical chairman, and a high proportion of 'lay' members. They must have regard to common moral sentiments, and to what will be morally acceptable in the country as a whole (though they can never hope for total agreement with their conclusions). Their recommendations, being in the sphere of public rather than private morality will be as far as possible the outcome of consensus, without which legislation is not possible.
With the advance of genome projects the search for the order of cellular processes has become a realistic goal. Yet this order is hidden behind a screen of data, which obscures the actual connectivity of genes and proteins. In order to expose the true nature of these networks it becomes necessary to apply in silico analysis based on certain parallels between biological and complex technical systems. These efforts far exceed current notions of computational biology.
Astrobiology is rapidly gaining the worldwide attention of scientists, engineers and the public. Astrobiology's captivation is due to its inherently interesting focus on life, its origins and distribution in the Universe. Because of its remarkable breadth as a scientific field, astrobiology touches on virtually all disciplines in the physical, biological and social sciences as well as engineering. The multidisciplinary nature and the appeal of its subject matter make astrobiology ideal for integrating the teaching of science at all levels in educational curricula. The rationale for implementing novel educational programs in astrobiology is presented along with specific research and educational policy recommendations.
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