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Medical Advances (medical + advance)
Selected AbstractsEvidence and the industrialization of medicineCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 4 2008J. L. Rees Summary Medicine is changing rapidly. In part, this is due to the accumulation of discoveries in biomedical science. However, this is not sufficient to explain the changes clinicians see. Whereas once medical advance concerned discoveries external to clinical practice (such as the identification of a causative microorganism or gene), medical practice itself is now a subject of study. What clinicians know, how they acquire knowledge, and how knowledge is distributed are all subjects of scrutiny. In short, medicine is being industrialized: we can see the twin changes of specialization, and the desire to codify practice such that those with different educational backgrounds can undertake a clinical role. Key to such change is the role played by evidence. Whereas once natural science was seen to determine clinical practice, this view is now known to be mistaken. How we can formally combine evidence from different traditions is, despite the claims of the evidence-based medicine movement, as yet unresolved. [source] Children's and young people's experiences of chronic renal disease: a review of the literature, methodological commentary and an alternative proposalJOURNAL OF CLINICAL NURSING, Issue 6 2006Philip Darbyshire MN Aim., The aims of this paper were to review and critique existing research literature on children's and young people's experiences of chronic renal disease and to propose alternative approaches that may be more fruitful in addressing existing research shortcomings. Background., Chronic renal disease, which results in approximately 1·6,4 new cases per year per million population in the 0,15 years age group, is a serious illness that causes severe and irreversible reduction in kidney function. Despite modern medical advances, its significance and implications for the lives of the children and young people concerned are profound. Method., Salient literature for this review was obtained using the major health and social science electronic databases such as Medline, CINAHL, Psyclit and Sociofile. Manual searching of relevant books, journals and ,grey literature', combined with the genealogy approach, extended and strengthened the search. Conclusions., Research in this area focuses mainly on two areas, namely psychological adjustment and adaptation to end-stage renal disease. This research is grounded within a framework of empirical psychology that values objectivity, measurement and quantification. This predominantly psychometric approach is critiqued for simplifying the complex experience of end-stage renal disease and for pathologizing children and young people with this disease. We identify a significant gap in the research literature, namely the lack of research that takes into account these children's and young peoples'own perspectives of their experiences. Relevance to clinical practice., Chronic renal disease has a significant impact on children's and young people's lives. Understanding the experiences of these children is important for the provision of effective healthcare. Conducting child-centred qualitative research in this area would allow us to explore vital questions of meaning, perception and understanding. If health and social care organizations claim to provide ,consumer-focused' services, it behoves us to develop first a clearer understanding of the lives and experiences of children and families who seek our help and to use this knowledge and understanding to plan and provide more grounded and responsive services. [source] Feasibility studies on a protein kinase assay when using radioisotope detection technique for developing a protein biochipJOURNAL OF LABELLED COMPOUNDS AND RADIOPHARMACEUTICALS, Issue 8 2007Sang Hyun Park Abstract Microarrays have recently become a precious research tool for proteomics and clinical investigation. Their applications to the diagnosis of a disease have emerged as a significant promise for medical advances. In this study, we report on an efficient strategy for the detection of phosphorylation of a substrate catalyzed by kinase, using the radioisotope (RI) detection technique for a protein biochip. This technique does not employ the use of the blocking step which is commonly used in conventional methods to prevent non-specific binding. It was found that the usage of a RI detection technique has the advantages of being highly sensitive and time saving when compared with other conventional methods. The results can be applied when using RI detection technique to develop biochips to determine the activity of a protein kinase. Further, it can be a useful tool for a high throughput screening and for studying protein,protein interactions. Copyright © 2007 John Wiley & Sons, Ltd. [source] Pitfalls in non-therapeutic research in childrenPEDIATRIC PULMONOLOGY, Issue 11 2006George B. Mallory Jr. Research has brought significant medical advances in modern times benefiting virtually all people. Children as a class should not be excluded from research studies. However, non-therapeutic research is potentially problematic in children because they must be afforded special protection from harm and exploitation by care-givers, researchers, and institutional review boards. An article in this month's journal provides an opportunity for a systematic analysis using the methodology provided by the United States Code of Federal Regulations. The research design of this particular study does not appear to stand up to the requirements of the Code. Pediatr Pulmonol. 2006, 41:1014,1016. © 2006 Wiley-Liss, Inc. [source] The challenges and opportunities for transitional care researchPEDIATRIC TRANSPLANTATION, Issue 6 2010J. E. McDonagh McDonagh JE, Kelly DA. The challenges and opportunities for transitional care research. Pediatr Transplantation 2010: 14:688,700. © 2010 John Wiley & Sons A/S. Abstract:, The provision of healthcare for young people with solid organ transplants as they move into adult-centered services has received increasing attention over recent years particularly as non-adherence and graft loss increase after transfer. Despite medical advances and that transitional care is now well established on national and international health agendas, progress in the research arena has unfortunately been slow. The aims of this paper are to consider why this is and discuss the particular challenges facing clinical researchers working within the area. [source] Longevity Among Hunter- Gatherers: A Cross-Cultural ExaminationPOPULATION AND DEVELOPMENT REVIEW, Issue 2 2007Michael Gurven Post-reproductive longevity is a robust feature of human life and not only a recent phenomenon caused by improvements in sanitation, public health, and medical advances. We argue for an adaptive life span of 68-78 years for modern Homo sapiens based on our analysis of mortality profiles obtained from small-scale hunter-gatherer and horticultural populations from around the world. We compare patterns of survivorship across the life span, rates of senescence, modal ages at adult death, and causes of death. We attempt to reconcile our results with those derived from paleodemographic studies that characterize prehistoric human lives as "nasty, brutish, and short," and with observations of recent acculturation among contemporary subsistence populations. We integrate information on age-specific dependency and resource production to help explain the adaptive utility of longevity in humans from an evolutionary perspective. [source] Pediatric Laryngotracheal Obstruction: Current Perspectives on StridorTHE LARYNGOSCOPE, Issue 7 2006John Bent MD Abstract Objectives/Hypothesis: To assess how medical advances have impacted the diagnosis, management, and outcomes of pediatric laryngotracheal obstruction, and to describe the advantages of audio-video documentation of stridorous children. Study Design and Methods: Retrospective. Methods and Materials: 268 patients were referred for suspected laryngotracheal obstruction during the 30 months between September 1, 1995 and March 1, 1998: 173 had 206 flexible fiberoptic laryngoscopies, and 160 had 273 direct laryngoscopies. One hundred and forty-one children were identified with laryngotracheal obstruction, yielding 40 different diagnoses that could be classified into 9 major categories. Thirty-six children (25.5%) had multiple sites of upper airway obstruction. Results: 138 children had follow-up >1 month. Twelve children died (8.7%), leaving 126 survivors (mean follow-up = 21.1 months). Outcomes were classified as resolved (44.2%), improved (37.0%), stable (9.4%), failed (0.7%), or death (8.7%). Better outcomes were seen in more readily treated diagnostic categories, such as tracheobronchial foreign body, chronic laryngitis, and suprastomal granulation tissue; laryngeal stenosis, tracheomalacia, and recurrent respiratory papillomatosis, had less favorable outcomes (P <.001). The former group also showed superior outcome compared to laryngomalacia (P <.001) and vocal cord mobility disorders (P = .004). Ninety-four patients (68.1%) had comorbidities complicating their management. Comorbid conditions were universal among deceased patients and least common in the resolved outcomes category (56.7%), supporting the premise that patients with poor outcomes are more likely to have comorbidities than patients with resolution of laryngotracheal symptoms (P = .034). Conclusions: Audio-video recording of pediatric laryngotracheal obstruction offers numerous advantages. Children classified into an array of diagnostic categories usually have favorable outcomes, but opportunities for continued advances exist, particularly regarding management of comorbidity and chronic obstruction. [source] Supporting pupils with special health needs in mainstream schools: policy and practiceCHILDREN & SOCIETY, Issue 2 2001Jane Lightfoot Education policy favouring ,inclusion', together with medical advances, mean that a growing number of pupils in mainstream schools may have health-related support needs in respect of a chronic illness or physical disability. Data from an empirical research study investigating these needs and carried out between 1996 and 1998 are used to reflect on the position of this group of pupils within policy guidance on special educational needs (SEN) and medical needs. Evidence of confusion and ambiguity, both in the guidance and its interpretation, suggests that the needs of this group remain somewhat hidden. More recent developments in special needs policy guidance are discussed in terms of the prospect for strengthening support for this group of pupils. Copyright © 2001 John Wiley & Sons, Ltd. [source] Translational Mini-Review Series on Vaccines: The Edward Jenner Museum and the history of vaccinationCLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 3 2007A. J. Morgan Summary Edward Jenner's discovery of vaccination must rank as one of the most important medical advances of all time and is a prominent example of the power of rational enquiry being brought to bear during the Age of Enlightenment in 18th century Europe. In the modern era many millions of lives are saved each year by vaccines that work essentially on the same principles that were established by Edward Jenner more than 200 years ago. His country home in Berkeley, Gloucestershire, is where he carried out his work and where he spent most of his life. The building is now a museum in which the life and times of Jenner are commemorated including not only the discovery of smallpox vaccination but also his other important scientific contributions to natural history and medicine. The trustees of the Edward Jenner museum are committed to promoting the museum as a real and "virtual" educational centre that is both entertaining and informative. [source] | |||||||||||||