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Liberal arts and the premedical curriculum.

Twenty-five leading physicians, medical educators, and humanists convened and affirmed the contributions of a liberal arts education to the study and practice of medicine. Participants agreed that overemphasizing technical expertise does have deleterious effects on premedical and medical education, which might be alleviated by encouraging a more broadly based undergraduate and medical curriculum. Admissions statistics show that approximately 50% of all applicants of medical school are admitted to some school and that there is no apparent bias against nonscience majors in the admissions process. Increased student awareness of these statistics should relieve anxieties and intense competitive pressures. A publication based on the conference recommendations will be made available to deans, advisors, and career counselors.

Congresses as Topic↗
PubMed1984

Toward the separation of memory and hope: applications of psychoanalysis to art in the writings of Martha Wolfenstein.

My aim in the foregoing article has been to demonstrate, by a brief study of Martha Wolfenstein's selected works, the value of applying clinically derived interpretative schema to the realm of art. It has not been possible here to recapitulate in all its intricacy the argument of each of Wolfenstein's papers under discussion; only a thorough reading of her papers themselves can provide that measure of detail. Beginning with an overview of Wolfenstein's theoretical contributions to the theme of parental loss in childhood, I have shown how her psychoanalytic understanding of this theme is brought to bear on the artistic products of both a poet and a painter who were themselves in childhood bereaved, as were the patients in Wolfenstein's clinical case studies. I hope in so doing to have conveyed a sense of the range and depth of Wolfenstein's work. I believe her work offers us a legacy not only substantive but paradigmatic, a legacy of humane concerns, passionate scholarship, remarkable ingenuity, and stunning leaps of insight.

Humans↗
PubMed1983

[Science and art in the supervision of a thesis for a degree].

The thesis required for the licenciature, master's degree and doctorate in any field of university education involves three components: the adviser, the student, and the research project that constitutes the subject matter of the thesis. In this paper the author examines in detail how each of these should be in the ideal situation and the defects they can have in real situations. Unfortunately, he observes, many institutions are neglecting--for a variety of reasons--the importance and significance of a well worked out thesis, and thus vitiating its original purpose in addition to depriving the student of an excellent opportunity for exercising his intelligence and imagination, and his adviser of one for imparting to him the cognitive, analytic and personal qualities needed to do good work. The article emphasizes that, particularly in medicine and biology, the research required for any thesis, done under a concerned and conscientious adviser, helps to produce a scientist who is truly able, studious, disciplined and, above all, humane. This, says the author, is how, from that combination of knowledge and behavior, of science and art, the student and his adviser unite to produce a thesis, a research project, the results of which can be of direct or indirect benefit to humanity.

Academic Dissertations as Topic↗
PubMed1983

Ethics in allied health education: state of the art.

This article addresses three aspects of the "state of the art" of ethics in allied health education. The first section reviews four types of concerns legitimately voiced by allied health educators as they try to ascertain the appropriate place of ethics in their curricula. The second part discusses the discipline of ethics itself, highlighting those areas of particular relevance to allied health professionals. In the last section three arguments are presented in favor of incorporating a substantial focus on ethics into the formal preparation of allied health students. The article emphasizes the clinical relevance of ethical decision making.

Allied Health Personnel↗
PubMed1982

[The present state of the art in diagnosis and therapy of cancer of the breast (author's transl)].

Opinions regarding the best possible treatment of cancer of the breast are more controversial than ever. This article analyses the present state of the art in diagnosis of the carcinoma of the breast on the basis of an extensive review of published literature. The methods are evaluated with regard to their value in early recognition and mass screening. The pros and cons brought forward in the discussion on the optimum treatment of this kind of tumour are described. Since no final judgment can be passed at the present moment, an attempt is made to explain the present state of therapy according to stages as seen from the radiologist's point of view.

Adult↗
PubMed1980

Physicians and lawyers: science, art, and conflict.

The relations between physicians and lawyers have deteriorated rapidly over the past several decades, most particulary since the early 70s when the perception that a medical malpractice crisis existed in America became widespread. Some believe that the factors dividing the two professions are linked (1) to professional jealousy, (2) to sometimes conflicting economic interests, or (3) to difficulties in communication, since both professions use many of the same words, or terms of art, but with different intended meanings. While the authors agree that these factors may have aggravated the problem, they believe that the conflict's real roots are in the very different ways in which physicians and lawyers are trained and in the different epistemologies that each profession has accepted, as a result of which each reasons and solves problems in a manner that not only diverges from but sometimes contradicts the other's. The authors conclude that only as the varying epistemologies begin to converge can physicians and lawyers begin to approach problems in more similar ways, and to discover the underlying compatibility of many of their interests and goals.

Attitude of Health Personnel↗
PubMed1995

Bonding to enamel and dentin: a brief history and state of the art, 1995.

The acid-etch technique for bonding composite resins to enamel has revolutionized the practice of restorative dentistry. The ability of clinicians to bond restorative materials to enamel has fundamentally changed such diverse areas as cavity preparation, caries prevention, and esthetic treatment options. Although bonding of resin to dentin has proved to be a difficult challenge, ongoing advances are improving the reliability and predictability of dentinal adhesion. The purpose of this article is to provide a brief history of enamel and dentinal bonding, as well as an overview of the current state of the art.

Acid Etching, Dental↗
PubMed1995

Analytic goals, concentration relationships, and the state of the art for clinical laboratory precision.

We analyzed the College of American Pathologists' Quality Assurance Service 1990 database of 1500 clinical laboratories to evaluate concentration relationships and the state of the art for the precision of 37 analytes. We compared these data to previously reported Quality Assurance Service precision performance data from 1974 through 1980. The general trend of decreasing average long-term, within-method, within-laboratory coefficients of variation continues. However, among 24 routine chemical and therapeutic drug monitoring tests observed for 11 to 16 years, 11 showed no evidence of continuous improvement in precision. The 1990 average coefficients of variation usually exceeded analytic goals modeled by clinical responses when these models assumed that variability in test results arises solely from the analytic performance of the method. In contrast, they usually did not meet goals that take into account the presence of biologic factors among the sources of test variation. Notable exceptions are the average coefficients of variation for cholesterol and triglycerides, which markedly decreased during the National Cholesterol Education Program initiatives of the 1980s. Continuous improvement of precision in disciplines dominated by relatively mature automated methods may not be the norm unless structure and direction are provided by appropriate and accepted analytic goals.

Humans↗
PubMed1994

DC-ART: what proportion of response constitutes a positive response?

In most clinical trials, patients' mean improvement scores are compared either for active against active treatment or active against placebo treatment. Testing drugs or strategies to qualify as disease controlling antirheumatic therapy will require treated patients to satisfy set criteria. But what proportion must fulfill the requirement if the therapy is to be classified as DC-ART? While the answer must address the problems of semantics, disease characteristics, and absolute levels of improvement, it may be easiest to begin by defining a significant degree of change in terms of a single disease activity index.

Antirheumatic Agents↗
PubMed1994

Art and literature in the anatomy of Charles Bell.

The artistic gifts of Sir Charles Bell (1774-1842) directed the course of his life's work. There is a fairly extensive literature on the discoveries of Bell in neurology and myology but comparatively poorly documented are the ways in which Bell exploited his aesthetic talents and erudition to communicate his findings to others. This study attempted to answer the question; how did Bell use art and literature to teach anatomy? The problem is all the more interesting because, in keeping with the spirit of education and improvement of the day, Charles Bell did not limit himself to addressing the medical profession but spoke to a wider public, dwelling on artists in particular. Bell's oil paintings and drawings, and the early editions of his written works, as well as their reviews in the contemporary press formed the main source material of this study.

Anatomy↗
PubMed1994

The art of cryosurgery.

Cryosurgery is an art as well as a science. Of course just as a sculptor or painter must learn about stone, wood, canvas, paper, chisels, rasps, paint brushes, and other materials, the cryosurgeon must understand the science underlying cryosurgery. He or she must learn the properties of the various cryogens, the apparatus for applying them, the three-dimensional extent of the lesions to be treated, and the tissue content of these lesions. He or she should also know the susceptibility of various portions of the target lesion and surrounding tissues to varying insults with cold.

Cryosurgery↗
PubMed1994

The art of getting what you want.

Whatever your position in health care, persuading others is part of your role. For an administrator, convincing others is actually a common place occurrence throughout the workday and is not just reserved for major change. This article describes techniques in the art of persuasion including use of a triad, enthusiasm, specific examples, information, involving key staff, asking for a trial, discussing rather than writing, pointing out the advantages to the employee, and indicating that the idea is coming from administration.

Interprofessional Relations↗
PubMed1994

[Backache: state-of-the-art from a biopsychosocial viewpoint].

The state-of-the-art in the diagnosis and therapy of low back pain is presented from a biopsychosocial point of view. Among low back pain patients, those dominate in whom psychosocial factors play an eminent role. The early comprehensive (biopsychosocial) integrative diagnosis is essential for further development of the illness. Conversion pain, psychoprosthetic pain and pain-proneness are the most important concepts for establishing a round diagnostic assessment and realistic therapeutic measures.

Combined Modality Therapy↗
PubMed1993

Hemoperfusion--state of art.

The authors make a general review of the state of art in HP with particular reference to the history, the main field of application, and the development of specific and selective sorbents. In this text, attention is paid to the application in the immunological field comparing the therapeutical removal of toxins with different sorbents. Next, the authors describe their experimental study with hemoperfusion using coated anion exchange resins for the treatment of acute respiratory insufficiency, the correction of metabolic alkalosis in pyloric stenosis, the removal of a high dosage of antiblastic agent in conjunction with the study of heparin subtraction by coated resins and finally the development of a particular type of resin for phosphates removal in uremia. These different fields of research recognize the necessity to look for a selective exchange by hemoperfusion because the concept of the "magic filter" that removes everything is not scientifically acceptable. Some explanations are given for the behaviour of the strong anion exchange resins regarding simple or complex ions and the influence of the chemical composition of the matrix. In conclusion, the authors underline that selective removal by HP is actually underutilized considering its potency.

Alkalosis↗
PubMed1994

My license is not on the line: the art of delegation.

Teaching staff and charge nurses how to skillfully delegate responsibility to assistive personnel can alleviate fears and mistrust. A workshop defining the art of delegation leaves nurses feeling more in control and less victimized. As a result, they begin to see delegation as a viable solution.

Humans↗
PubMed1993

[Effect of diacerhein (ART 50) on the matrix synthesis and collagenase secretion by cultured joint chondrocytes in rabbits].

Cultured rabbit joint chondrocytes were exposed to diacerhein (DAR : ART 50, Negma, 10(-6) to 10(-4) M), which has proved effective and safe when given for two months for the treatment of osteoarthritis. Experiments were performed with and without 500 pg/ml human recombinant interleukin-1 to determine whether diacerhein antagonizes the effects of this monokine. Glycosaminoglycan production was measured by 35S-sulfate incorporation followed by cetylpyridinium precipitation, collagen production by 3H-proline labeling and bacterial collagenase digestion, and collagenase production by determination of the amount of 3H-collagen that underwent degradation. Incubation of chondrocytes with diacerhein for 24 hours was not associated with substantial changes in glycosaminoglycan or collagen production but substantially antagonized interleukin-1-mediated enhancement of collagenase production. With longer incubation periods (6 days) with the 10(-6) M concentration of diacerhein, production of glycosaminoglycans and collagen increased. Incubation with both diacerhein and interleukin-1 for six days partly antagonized the cytokine's inhibitory effect on glycosaminoglycan and collagen production. During these experiments, the medium's ability to break down collagen was consistently reduced by diacerhein, even in the presence of interleukin-1. These data demonstrate that diacerhein can reduce or even abolish interleukin-1-mediated enhancement of collagenase production by joint chondrocytes. This effect may lead to less erosion of cartilage in degenerative joint diseases.

Animals↗
PubMed1993

Epidemiologic studies of occupational cancer as related to complex mixtures of trace elements in the art glass industry.

In the art glass industry workers run increased risks of dying from several types of cancer, cardiovascular diseases, and cerebrovascular diseases. This paper considers the diseases of glass workers in relation to exposure to particular elements, a high degree of correlation being found for some of them. Case-referent evaluations showed an association between stomach cancer and exposure to a mixture of elements, namely, arsenic, copper, nickel, and manganese, and to some extent also to lead and chromium. For colon cancer, a clearly increasing trend in risk was seen with increasing use of antimony, and to some extent also with increasing use of lead, the two elements being strongly correlated. For lung cancer no obvious correlation with any metal could be found. In addition, the risk for death from cardiovascular disease was fairly evenly distributed, although slightly more related to increasing consumption of the strongly correlated metals nickel and copper.

Glass↗