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At least 1,603 records · Page 89Linked to original sources
PubMed2000

Diffusion reconsidered: variation and transformation in biomedical practice, a case study from Mexico.

This paper focuses on biomedical transformations in an economically developing nation and poses the question, what are the variant and invariant aspects of biomedical practice, using empirical data from Mexico? I propose that when infectious disease predominated, biomedicine may have been uniformly practiced the world over, but with the ascent of chronic disease of unknown etiology, certain aspects of biomedical practice, especially diagnoses and causality, become reinterpreted culturally and idiosyncratically. The findings of the case study also illuminate current theories of globalization and earlier anthropological theories of diffusion as well as issues concerning the social constructivist perspective.

Anthropology, Cultural↗
PubMed2001

Making midwives: postmodern conditions and midwifery training in Saint Lucia.

Drawing on material from fieldwork conducted on the island of Saint Lucia, I examine how Saint Lucian nurse-midwives and student midwives negotiate multiple ways of understanding and evaluating their practices and roles in light of contradictory and powerful cultural, historical, and political forces. I argue that, although Saint Lucian nurse-midwives may not qualify as "postmodern" according to the criteria proposed by Davis-Floyd and Davis (1996), they are nonetheless struggling with postmodern conditions as they negotiate between competing healing ideologies. I illustrate the significance of these negotiations through analyzing: (1) the ways nurse-midwives understand and articulate the healing ideologies at play in Saint Lucia, (2) historical and ideological aspects of the Saint Lucian nurse-midwifery training program, and (3) a classroom discussion during which student reported on "bush-midwives."

Attitude of Health Personnel↗
PubMed2001

Midwifery across the generations: a modernizing midwife in Guatemala.

This article examines change and continuity in midwifery knowledge and practice by comparing a mother and daughter, both of whom are local midwives, or comadronas, on a Guatemalan plantation. The daughter apprenticed with the mother, who died in 1997. Like her mother, she received a government midwifery license after attending an official training course. I discuss the applicability of the concept of "postmodern midwifery" as I trace how both mother and daughter adapted to the pressures of medicalization and modernization. The daughter negotiates with biomedical personnel and copes with increasing government regulations, and she tends to accept biomedical authority more readily than did her mother. Unlike her mother, she sometimes uses this authority to enhance her own status. Nevertheless, her acceptance of the biomedical model is not complete, for she recognizes the practical constraints of poverty, under which both she and her clients live, and she also insists upon the superiority of such practices as massage. Furthermore, biomedicalization is countered by a process of sacralization, which, I suggest, enables midwives both to contest biomedical authority and to deliver meaningful care.

Attitude of Health Personnel↗
PubMed2001

Changing roles and identities of midwives in rural Costa Rica.

The roles and social identities of rural midwives in Costa Rica reflect the changing history of local birth practices vis-à-vis pragmatic local needs as well as the changing relation of the nation-state to the production of birth. This article explores how midwifery practices changed over time in relation to Costa Rican state policy and why prenatal massage (an important element of prenatal care historically) retains its importance despite the massive hospitalization of birth. Home birth's history as a heterogeneous, flexible model for care, combined with the pragmatic needs of women, make midwives and prenatal massage central in the production of hospital birth. Costa Rican midwives survive in the interstices of the biomedical model of care, providing interventions demanded by women (although demeaned by biomedicine) and serving as a safety net for pregnancy crises in hinterland communities. While acknowledging the potential for maternal or child death during pregnancy crises in isolated regions, midwives generate acute critiques of the biomedical model of birth and clearly articulate the practical need for (and continuing importance of) their practices in rural areas. This case study illustrates the obstacles to international awareness faced by midwives in so-called Third World countries like Costa Rica-midwives who must overcome not only geographic and socioeconomic marginalization, but also overwhelming opposition from the state and multilateral "reproductive development" policies.

Attitude of Health Personnel↗
PubMed2002

Development and characterisation of electromechanical muscles for driving trans-humeral myoelectric prostheses.

Recently, attempts have been made to construct actuators with similar behaviour to natural muscles. However the results have been inadequate for application to practical prostheses. For example, muscle wire, which has too low an efficiency to be powered by batteries and McKibben muscles which require two power supplies, one electric and one pneumatic. Electrochemical muscles are still in the development stage and cannot yet be used for prostheses. In this paper, a new electromechanical actuator is presented, which provides rectilinear movement and linear characteristics. This electromechanical actuator is based on a ball screw and rare earth magnet coreless motors. The system has been characterised and some of the most important results are that it produces a force of 167N while developing a velocity of 7x10(-3)m/s. The force developed is proportional to the current drained. Its efficiency is about 32%, its total mass 0.19kg and it is light and compact enough to be used in practical clinical prosthesis.

Artificial Limbs↗
PubMed2005

Does the private finance initiative promote innovation in health care? The case of the British National Health Service.

The Private Finance Initiative (PFI) is a specific example of health care privatization within the British National Health Service. In this essay, I critically assess the ways in which various Private Finance Initiatives have increased health care efficiency and effectiveness, as well as encouraged medical innovation. Indeed, as the analysis will demonstrate, significant empirical evidence supports the conclusion that Private Finance Initiatives are a driving force of innovation within the British Health Care System.

Biomedical Technology↗
PubMed2004

Evaluation of the continuing professional development scheme of the Institute of Biomedical Science.

As part of a review of the Continuing Professional Development (CPD) scheme of the Institute of Biomedical Science (IBMS), 10 years after it started, a survey was conducted. A questionnaire was distributed to all Institute members in July 2002. By the end of September, replies had been received from 777 biomedical scientists, representing a range of ages, grades and disciplines, and working for a variety of employers throughout the UK and overseas. The majority of respondents (n = 687) were current participants in the IBMS CPD scheme, but 74 replies were received from members who had not previously taken part. Half the respondents who were both scheme participants and Associate members of the IBMS and one-third of participating Fellows had yet to claim a diploma. The results showed that the IBMS CPD scheme was well respected among biomedical scientists, but many reported some difficulties in obtaining study leave and financial support to attend credited activities. Although respondents felt that an individual's own time should not be spent on CPD, activities that are performed when off duty (e.g., journal-based learning) are popular, especially among staff in younger age groups and among junior biomedical scientist grades. Respondents suggested that the scheme could be improved by provision of more resources at departmental level to allow regular participation for individual biomedical scientists. They also recommended inclusion of competency testing within CPD and a simplified diploma system. The IBMS scheme has been well received and has the potential to evolve into a good scheme to serve the profession's needs into the 21st century.

Adult↗
PubMedDate not supplied

The end of biomilitary realism? Rethinking biomedicine and international security.

Medicine and politics have a common aim, the welfare of people, and the ideas and language of one influence the other. There are parallels between medicine, particularly its more cutting-edge aspects, and international affairs; and the more aggressive forms of medicine, like the more aggressive forms of international relationships, seem to be about short-term gain, based on little evidence, with longer-term negative consequences as the full impact of the action becomes clear. Modem medicine has been very effective in curative methods, but the fundamentals of public health, which receive less kudos, have perhaps had more beneficial effects. The world of international affairs can learn much from a holistic and public health approach.

Biomedical Technology↗
PubMed2006

High maneuverability guidewire with functionally graded properties using new superelastic alloys.

Nitinol shape memory alloys (SMAs) are attracting considerable attention as core materials for medical guidewires because of their excellent flexibility and shape retention. However, since Nitinol guidewires possess low rigidity, the pushability and torquability of the guidewires are insufficient. On the other hand, although guidewires made of stainless steel have high pushability, plastic deformation occurs easily. We have developed a new class of superelastic guidewires with functionally graded properties from the tip to the end by using new SMA core materials such as Cu-Al-Mn-based or Ni-free Ti-Mo-Sn SMAs. The tip portion of the guidewire shows excellent superelasticity (SE), while the body portion possesses high rigidity. These functionally graded characteristics can be realized by microstructural control. These guidewires with functionally graded properties show excellent pushability and torquability and are considerably easier to handle than conventional guidewires with Nitinol or stainless steel cores. Moreover, a metallic catheter using a Ni-free Ti-based SMA with high biocompatibility is introduced.

Alloys↗
PubMedDate not supplied

Inhalation exposures to acrylamide in biomedical laboratories.

This study evaluated airborne acrylamide exposures experienced by laboratory personnel using either crystalline or commercially available solutions of acrylamide to make polyacrylamide gels. Exposures were monitored for a short-term (15-min) sampling period, during the weighing of the crystalline acrylamide or the removal of the acrylamide solution from its original container, and a long-term period, during which a sample was collected for as long as the subject was potentially exposed to acrylamide. Mean air concentrations for the 15-min exposures were 7.20 +/- 5.64 micrograms/m3 and 5.81 +/- 4.53 micrograms/m3 for the users of crystalline and solution acrylamide, respectively, although this difference was not statistically significant (p > 0.05). Mean concentrations for the long-term exposures were 12.77 +/- 24.20 micrograms/m3 for workers employing crystalline acrylamide and 4.22 +/- 7.05 micrograms/m3 for personnel using acrylamide solutions. This difference was also not statistically significant. Although the results indicate that the research laboratory personnel were generally exposed to measurable concentrations of acrylamide, with several subjects exposed to elevated levels, the calculated 8-hour time-weighted average exposures were below current occupational exposure limits. However, because the neurotoxic effects of acrylamide are cumulative and it is a suspected carcinogen, all exposures should be kept as low as reasonably achievable.

Acrylamide↗
PubMed2001

Local photorelease of caged thymosin beta4 in locomoting keratocytes causes cell turning.

The broad aim of this work was to explore the feasibility of using light-directed perturbation techniques to study cell locomotion. Specifically, a caged form of thymosin beta4 (Tbeta4) was photoactivated in a defined local region of locomoting fish scale keratocytes and the resulting perturbation of locomotion was studied. Purified Tbeta4 was produced in an inactive form by "caging" with ([n-nitroveratryl]oxy)chlorocarbamate. In vitro spectrophotofluorometric assays indicated that caged Tbeta4 did not change the normal actin polymerization kinetics, whereas photoactivated Tbeta4 significantly inhibited actin polymerization. With an a priori knowledge of the cytoplasmic diffusion coefficient of Tbeta4 as measured by fluorescence recovery after photobleaching experiments, the rapid sequestration of actin monomers by uncaged Tbeta4 and the consequent reduction in the diffusional spread of the Tbeta4-actin complex were predicted using Virtual Cell software (developed at the Center for Biomedical Imaging Technology, University of Connecticut Health Center). These simulations demonstrated that locally photoactivating Tbeta4 in keratocytes could potentially elicit a regional locomotory response. Indeed, when caged Tbeta4 was locally photoactivated at the wings of locomoting keratocytes, specific turning about the irradiated region was observed, whereas various controls were negative. Additionally, loading of exogenous Tbeta4 into both keratocytes and fibroblasts caused very rapid disassembly of actin filaments and reduction of cellular contractility. Based on these results, a mechanical model is proposed for the turning behavior of keratocytes in response to photoreleased Tbeta4.

3T3 Cells↗