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The professional socialisation of midwives: balancing art and science.

Mastery of esoteric knowledge is one of the central features assigned by sociologists to fully professionalised service occupations, together with an orientation towards public service. There are, nevertheless, different views about the best way in which this education and socialisation can be provided for new recruits for practitioner roles. Some maintain that the university provides an ideal training ground. Critics of this view, however, call for a rejection of "university diploma mills' and a return to the type of apprenticeship socialisation common during the premodern era. This paper tests the usefulness of these perspectives in understanding the occupational socialisation of Newfoundland and Labrador midwives. Three major styles of training - traditional apprenticeship, vocational schooling and university education - can be discerned. In comparison to both apprenticeship and academic styles of occupational socialisation, only vocational training nicely blended the art and science of midwifery to produce competent and committed professionals.

Clinical Competence↗

Hairstyles in the arts of Greek and Roman antiquity.

Styling one's hair seems to be an innate desire of humans to emphasize their beauty and power. As reviewed here, hairstyles were influenced by preceding cultures, by religion, by those depicted for gods and emperors on sculptures and coins. In addition, they were determined by aspects of lifestyle such as sports, wealth, and the desire to display inner feelings. The historical changes in fashions can be exemplarily followed by a visitor to an art collection of Graeco-Roman antiquity. The study of hairstyles permits an insight into very basic aspects of the self-conception of individuals and of the respective societies.

Greek World↗

Hemophilia: state of the art of hematologic care 1988.

Since 1982, when the World Federation of Hemophilia first published a document on the state of the art of hemophilia diagnosis and care, there have been lights and shadows in this field. Although the widespread infection of hemophiliacs with the human immunodeficiency virus (HIV) contaminating clotting factor concentrates is still a threatening and formidable shadow, the gloomy picture brought about by the AIDS epidemic is partially lightened by spectacular improvements in therapy and diagnosis. Carrier detection and first-trimester prenatal diagnosis can now be performed accurately in most kindreds by analysis of DNA of the factor VIII or IX genes. An important step forward towards the elimination of the risk of blood-borne infections transmitted by plasma products was recently made through the application of virucidal methods to clotting factor concentrates. Since HIV appears more vulnerable to such methods than the hepatitis viruses, currently available concentrates can be considered substantially free from the risk of transmitting HIV infection. Even though transmission of hepatitis is much reduced but not totally abolished, virucidal methods are continuously being improved, so that it can be foreseen that concentrates will become safer and safer. Finally, factor VIII produced by recombinant DNA technology is undergoing the first clinical trials in hemophiliacs. Hopefully, it will free from the risk of transmitting infections and will be available in sufficiently large amounts to meet the need of hemophiliacs worldwide. In 1982, the World Federation of Hemophilia published a message on the status of diagnosis and treatment of hemophilia. Since then, hemophilia care has been complicated by widespread infection of hemophiliacs with human immunodeficiency virus (HIV).(ABSTRACT TRUNCATED AT 250 WORDS)

Hematology↗

The spirit of nursing and its healing art: a Jungian perspective.

Timely change is in the air as interest grows in the riches of nursing literature and other creative arts of nursing. Using Jungian and sociological concepts, this article takes a personal look at the literature's contribution to the profession. As the image of contemporary nursing is redefined, the power of the creative is evident, both in its grounding effect on individual practice and its unifying and strengthening potential for a changing profession.

Humans↗

Radiology in pleural disease: state of the art.

Diseases of the pleura and pleural space are common and present a significant contribution to the workload of the chest radiologist. The radiology department plays a crucial role in the imaging and management of pleural disease. This review aims to describe and illustrate the appearances of common pleural pathologies on various radiological modalities including plain film, ultrasound, CT, magnetic resonance imaging and positron emission tomography. The review will also address the state-of-the-art techniques used to image pleural disease and discuss image-guided intervention in the management of pleural disease.

Empyema, Pleural↗

Intracoronary beta radiation: state of the art.

This state-of-the-art review is intended to explore the development of beta radiation including catheter delivered and permanent implants from its inception to current practice. Specific focus will be given to the isotopes currently available, radiation physics of beta emitters, preclinical studies, clinical trials, beta radiation delivery systems, and implications for future practice. The encouraging results from the clinical trials have established vascular brachytherapy as a standard of care for patients with in-stent restenosis. Vascular brachytherapy requires additional "fine-tuning" to achieve full optimization.

Beta Particles↗

State of the art: therapeutic controversies in severe acute asthma.

This is a transcript of the 1999 SAEM State-of-the-Art session on "Therapeutic Controversies in Severe Acute Asthma," presented at the 1999 SAEM annual meeting in Boston. The aim of this session was to address some of the current controversies in the management of acute asthma exacerbations, a major issue in emergency medicine. Despite many recent advances in asthma management, morbidity and mortality remain high. While many of us have strong feelings on how asthma patients should be treated, many of our assertions are not based on good science, and there are numerous areas of controversy. This discussion focuses on the controversy over beta agonist treatment for acute asthma, the physiology of corticosteroids in asthma, and the emergency use of leukotriene-modifying agents.

Administration, Inhalation↗

Molecular approach to the characterisation of fungal communities: methods for DNA extraction, PCR amplification and DGGE analysis of painted art objects.

A protocol for efficient extraction of fungal DNA from micromycetes colonising painted art objects was developed. Polymerase chain reaction (PCR) inhibitors were successfully removed by a combined application of a Chelex-100 adsorption resin and a Geneclean Kit for Ancient DNA. Universal fungal primers for PCR amplification of 28S rDNA (U1 and U2) were tested for their applicability in denaturing gradient gel electrophoresis (DGGE) analysis of fungal communities. Artificially produced mortar samples inoculated with fungal pure cultures isolated from mural paintings were used as model objects for DNA extractions and DGGE analysis. Good resolution in DGGE was achieved using 260-bp rDNA fragments amplified with U1/DGGE and U2 primers directly from model communities.

Biofilms↗

Hyposensitization to urushiol among Japanese lacquer craftsmen: results of patch tests on students learning the art of lacquerware.

8 subjects learning the art of lacquerware were patch tested to urushiol before and after contact with lacquer, in order to document whether hyposensitization to urushiol occurred among Japanese lacquer craftsmen. Simultaneously, we performed patch tests on 2 urushiol-sensitized controls who had no contact with lacquer during the investigation. Lacquer is made from the sap of the Japanese lacquer tree and raw lacquer is composed of 60-65% urushiol and its oligomer. 5 of the 8 subjects showed positive reactions to urushiol 1 month after their first contact. They became negative or less positive after prolonged (9 or 10 months) exposure to lacquer. As reactions to urushiol decreased, dermatitis became less severe. Controls showed consistently high reactions. However, 1 subject showed persistently strong reactions to urushiol. Unlike the other 7 subjects, he was previously sensitized to urushiol before the first contact with lacquer. The remaining 2 subjects showed no reaction throughout our investigation. These results strongly suggest that hyposensitization to urushiol does occur among Japanese lacquer craftsmen.

Adult↗

Nutrition messages in language arts and mathematics textbooks used in English elementary schools in Montreal.

This analysis examined references to foods mentioned in elementary school textbooks used in Montreal English schools. A study of 58 language arts and mathematics textbooks used in grades one-six revealed 4,391 references to foods in words and pictures. A large proportion of the references were to sugar-rich foods. Eating with peers was depicted more frequently than eating with family, while a surprising number of children were depicted consuming their food alone in texts used in grades one-three. Results suggest that, because unintended information may influence children's nutritional habits, more attention should be directed at concomitant messages in elementary school textbooks.

Child↗

Canine cemented total hip replacements: state of the art.

Total hip replacements in the dog have become well established over the past 20 years as an effective method for treating disabling hip conditions. A fixed head prosthesis has been the mainstay during most of this period. Return to normal function with this prosthesis has been reported at 95 per cent. Although patient selection, pre- and post surgical care, the surgical technique and the treatment or prevention of complications has been continually improved, it was not until recently that the prosthesis and its instrumentation were improved. Now a modular prosthesis with improved instrumentation gives the veterinary surgeon state of the art' implants and instruments. The prosthesis is easier to implant, the surgeon has greater flexibility in surgery and improved results are expected. Total hip replacement continues to be an effective way to give dogs a pain-free, mechanically sound hip joint.

Animals↗

From the art of filling teeth to the science of dental caries prevention: a personal review.

The journey from the art of filling teeth to the science of prevention is reviewed. First, a private winding road is described that produced some new methods of value in risk assessment, treatment of the causes of dental caries, and prevention of the disease. The description illustrates the importance of monitoring the effects of different measures. Next, the new knowledge and methods that form the primary basis of prevention on a large scale are reviewed. They represent a golden era in caries research and form a solid ground for the prevention of dental caries and for the treatment of the causes of disease. The prevalence and incidence of dental caries has fallen not only among schoolchildren, but also among adults in developed countries. Improvement in dental health is due to the successful application of new knowledge-it has not happened by chance. New or improved opportunities for prevention could lead to a further reduction in dental caries. The problem is to find ways to stimulate both dentists and patients to use them. Finally, the next part of the journey is discussed. In some countries the journey probably will be an uphill struggle; in others, it could be fairly undulating, eventually leading to further declines in dental caries.

Adult↗

In vivo neutron activation analysis: state of the art and future prospects.

From the inauspicious beginning arising in the aftermath of a reactor accident in 1957, in vivo analysis of body elements by neutron activation has become an important tool in medical research. In particular, it provides a much needed means to make quantitative assessments of body composition of human beings in vivo. The data are useful both for basic physiological understanding and for diagnosis and management of a variety of diseases and disorders. The paper traces the development of the in vivo neutron activation technique in the past quarter of a century from basic systems to the present state of the art facilities, and discusses the advantages and disadvantages of the various systems. A scan of some of the numerous clinical applications that have been made of this technique reveals the broad potentialities of in vivo neutron activation. The paper also considers alternative routes of future development and raises some of the questions now faced in making the techniques more widely available to both medical practitioners and medical investigators.

Activation Analysis↗

Evaluation of stage acoustics in Seoul Arts Center Concert Hall by measuring stage support.

Stage acoustics is an important characteristic for concert halls, both for the acoustic quality on stage and for the audience. However, relatively little research has been conducted into the question. This study was based on the investigation of an actual concert hall stage, that of the Seoul Arts Center Concert Hall in Korea. The stage acoustics was evaluated in the actual hall, and with two models: a 1:25 scale model and a computer model. The study was based on the stage support parameter ST1 proposed by Gade as a measure of support for individual performers [Acustica 65, 193-203 (1989)]. The variation of support was measured on the empty stage of the actual hall and in the two models. The effect of musicians on stage, the effect of moving the orchestra, the effect of ceiling height and of stage-wall profile were also investigated. Conclusions are drawn both relating to the Seoul Concert Hall stage and stages in general.

Acoustics↗

The art and science of anti-aging therapies.

A meeting entitled "The Art and Science of Anti-Aging Therapies: Convergence of Theory and Practice" took place on 18 and 19 March 2005 at the University of Pennsylvania School of Medicine. The symposium was held for health care professionals, researchers, and consumers to provide them with information about current trends in anti-aging therapies. The program, which combined medical, surgical, and nonpharmacological approaches to healthy successful aging, gave attendees the opportunity to make sense of the issues at hand and to sort out safe treatments from perilous quick fixes.

Aged↗

Avian endogenous retrovirus EAV-HP shares regions of identity with avian leukosis virus subgroup J and the avian retrotransposon ART-CH.

The existence of novel endogenous retrovirus elements in the chicken genome, designated EAV-HP, with close sequence identity to the env gene of avian leukosis virus (ALV) subgroup J has been reported (L. M. Smith, A. A. Toye, K. Howes, N. Bumstead, L. N. Payne, and K. Venugopal, J. Gen. Virol. 80:261-268, 1999). To resolve the genome structure of these retroviral elements, we have determined the complete sequence of two proviral clones of EAV-HP from a line N chicken genomic DNA yeast artificial chromosome library and from a meat-type chicken line 21 lambda library. The EAV-HP sequences from the two lines were 98% identical and had a typical provirus structure. The two EAV-HP clones showed identical large deletions spanning part of the gag, the entire pol, and part of the env genes. The env region of the EAV-HP clones was 97% identical to the env sequence of HPRS-103, the prototype subgroup J ALV. The 5' region of EAV-HP comprising the R and U5 regions of the long terminal repeat (LTR), the untranslated leader, and the 5' end of the putative gag region were 97% identical to the avian retrotransposon sequence, ART-CH. The remaining gag sequence shared less than 60% identity with other ALV sequences. The U3 region of the LTR was distinct from those of other retroviruses but contained some of the conserved motifs required for functioning as a promoter. To examine the ability of this endogenous retroviral LTR to function as a transcriptional promoter, the EAV-HP and HPRS-103 LTR U3 regions were compared in a luciferase reporter gene assay. The low luciferase activity detected with the EAV-HP LTR U3 constructs, at levels close to those observed for a control vector lacking the promoter or enhancer elements, suggested that these elements function as a weak promoter, possibly accounting for their low expression levels in chicken embryos.

5' Untranslated Regions↗

The acupuncture randomised trial (ART) for tension-type headache--details of the treatment.

OBJECTIVE: The goal of this paper is to describe the characteristics of physicians and their interventions in a large, multicentre randomised trial of acupuncture for tension-type headache known as ART TTH, in order to enable acupuncturists to assess the study interventions. METHODS: Participating physicians were recruited whose qualifications met or surpassed those of physicians currently accredited for providing acupuncture by state health funding agencies in Germany. Semi-standardised treatment strategies for acupuncture and minimal acupuncture were developed in a consensus process with acupuncture experts. A total of 270 patients suffering from episodic or chronic tension-type headache were randomised to 12 sessions of semi-standardised acupuncture (three predefined 'basic' points, recommendations for additional points given, but individual choice of additional points possible), standardised minimal acupuncture (superficial needling of at least 5 of 10 predefined, bilateral, distant non-acupuncture points) or a waiting list. Forty two physicians, trained and experienced in acupuncture, from 28 centres in Germany participated in the trial. RESULTS: The median duration of acupuncture training of trial physicians was 500 hours (range 140 to 1350 hours). Physicians had 10 (< 1 to 25) years acupuncture experience. The three 'basic' points (GB20, GB21 and LR3) were treated in 96%, 82% and 97% of sessions, respectively. Frequently treated optional points included LI4 (67%), SP6 (50%) and ST36 (46%). Ten of the 42 physicians stated that they would have treated patients differently outside the trial. The trial found a significant effect of acupuncture over waiting list but not over minimal acupuncture. CONCLUSIONS: In general, trial physicians complied well with the predefined interventions. A relevant minority of participating trial physicians stated that they would have treated patients differently outside the trial.

Acupuncture↗

Background for studies on the treatment of male osteoporosis: state of the art.

Male osteoporosis represents an important, although long underestimated, public health problem. Both in men and in women aging is accompanied by continuous bone loss and by an exponential increase in the incidence of osteoporotic fracture, with a female to male incidence ratio of about 2 to 3 to 1 in the elderly for hip and vertebral fractures. Morbidity after osteoporotic fractures appears to be more serious and mortality more common in men than in women. To date, no single treatment has been proved to be effective and safe in published prospective studies. The present report, based on a systematic search of the literature on male osteoporosis, summarises the state of the art on the clinical consequences of male osteoporosis and its risk factors, in relation to the present state of knowledge about female osteoporosis. This constitutes the background for the design of rational clinical development strategies for therapeutic interventions in male osteoporosis. From this review of the literature it is apparent that notwithstanding the existing sex differences in pathophysiology of osteoporosis and the difference in age-specific incidence of osteoporotic fractures, there are also important similarities between osteoporosis in women and men. The higher incidence of fracture in women than in men results from quantitative differences in risk factors rather than from different risk factors. Even though there are sex differences in bone geometry, incidence of fracture seems to be similar in men and women for a same absolute areal bone mineral density. However, the lack of data on the changes in fracture rates in men resulting from pharmacological intervention, leading to changes in bone mineral density or bone turnover, remains the main limitation for extrapolation of established treatment outcomes from women to men.

Age Factors↗