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In this paper we present the results of research among US graduate programs in Rehabilitation Counseling aimed at identifying and developing consensus among rehabilitation counselor educators about key readings in [...]

SINCE THE 1990 PUBLICATION of Thomas Laqueur's book Making Sex, his proposed 'one sex' model has served as the site of many spirited debates and discussions. (1) Joan Cadden was [...]

This paper explores how the ideal birth was constructed after World War Two, noting in particular the abstract enthusiasm on the part of physicians and government advocates for technological innovation accompanied by simultaneous silence regarding the specificities of labour and delivery in advice literature. The relationship of prescriptive mothering to the nascent medical ideology of prevention-oriented surveillance had a direct impact on the disembodying of women in the birthing process. Both vaginal and surgical childbirth were kept firmly within the realm of medical expertise, painting parturition as something that happened to women, rather than something they did themselves. Keywords. childbirth, prescription, advice literature Cet article analyse comment l'idee de la 'naissance parfaite' s'est construite apres la Deuxieme guerre mondiale. Il se penche en particulier sur ce que la documentation de conseil revele de l'enthousiasme ambiant des medecins et des representants du gouvernement a l'endroit de l'innovation technologique et, par contraste, de leur oubli commun des realites liees au travail et a l'accouchement. La rencontre entre l'obligation de maternite et l'ideologie medicale naissante auteur d'une surveillance orientee vers la prevention eut un impact direct sur la desincarnation du corps feminin dans le cadre de la naissance. L'accouchement vaginal comme chirurgical continuait alors de relever exclusivement du monde medical entrainant une caracterisation de ce processus comme un processus s'imposant a la femme non quelque chose a laquelle elle participait activement. Mots-cles. Naissance, normes, documentation de conseil, Since the public health movements of the early 20th century, maternal and infant health have been heavily discussed and debated in various contexts in Canada. As the health of Canada's [...]

The massive amount of expressed sequence tags (ESTs) gathered over recent years has triggered great interest in efficient applications for genomic research. In particular, EST functional relationships can be used to determine a possible gene network for biological processes of interest. In recent years, many researchers have tried to determine EST functional relationships by analyzing the biological literature. However, it has been challenging to find efficient prediction methods. Moreover, an annotated EST is usually associated with many functions, so successful methods must be able to distinguish between relevant and irrelevant functions based on user specifications. This paper proposes a method to discover functional relationships between ESTs of interest by analyzing literature from the Medical Literature Analysis and Retrieval System Online, with user-specified parameters for selecting keywords. This method performs better than the multiple kernel documents method in setting up a specific threshold for gathering materials. The method is also able to uncover known functional relationships, as shown by a comparison with the Kyoto Encyclopedia of Genes and Genomes database. The reliable EST relationships predicted by the proposed method can help to construct gene networks for specific biological functions of interest. Index Terms--Expressed sequence tags (ESTs), functional relationship, literature mining, Medical Literature Analysis and Retrieval System Online (MEDLINE).

Randomized controlled trials of public health interventions are often complex: practitioners may not deliver interventions as researchers intended, participants may not initiate interventions and may not behave as expected, and interventions and their effects may vary with environmental and social context. Reports of randomized controlled trials can be misleading when they omit information about the implementation of interventions, yet such data are frequently absent in trial reports, even in journals that endorse current reporting guidelines. Particularly for complex interventions, the Consolidated Standards of Reporting Trials (CONSORT) statement does not include all types of information needed to understand the results of randomized controlled trials. CONSORT should be expanded to include more information about the implementation of interventions in all trial arms. (doi:10.2105/AJPH.2006. 094169)

Introduction: Investigators aim to publish their work in top journals in an effort to achieve the greatest possible impact. One measure of impact is the number of times a paper [...]

The theme of death in childbirth was common in French works of fiction and in chronicles and memoirs of Early Modern France, and was also a subject regularly written about in French medical textbooks. The culture of death in fictional and historical writings is compared with the approaches in French medical treatises (1540-1630), arguing that literate audiences were increasingly conversant with obstetric knowledge and controversies with increased circulation of printed French medical works.

Objectives: This literature review briefly describes international programs, policies, and activities related to preconception care and resulting pregnancy outcomes. Methods: Electronic databases were searched and findings supplemented with secondary references cited in the original articles as well as textbook chapters, declarations, reports, and recommendations. Results: Forty-two articles, book chapters, declarations, and other published materials were reviewed. Policies, programs, and recommendations related to preconceptional health promotion exist worldwide and comprise a readily identifiable component of historic and modern initiatives pertaining to women's health, reproductive freedom, and child survival. Conclusions: The integration of preconception care services within a larger maternal and child health continuum of care is well aligned with a prevention-based approach to enhancing global health. Keywords Preconception care * Reproductive health * International health

Genre analysis is a means of examining the context of spoken and written language. It can, therefore, help practitioners to learn more about the language of health care. This article [...]

A demonstration project to create a second order of clinical peer review for journal articles to determine which articles are most relevant for specific clinical disciplines is illustrated. The conclusion of the project shows the feasibility and use of a post-publication clinical peer review system that differentiates published journal articles according to the interests of a broad range of clinical disciplines.

Dr. Charon makes an eloquent and convincing case for the importance of narrative competence in medical practice and medical training. My contribution to this discussion of storytelling and medicine is [...]

Introduction The 350 years after the European Black Death of 1347-1351 witnessed an enormous production of plague treatises as one of several responses--medical, religious, and social--to epidemic disease. Foremost among [...]

This article addresses in one specific respect the agenda for editing English medieval surgery sketched out by Linda Ehrsam Voigts in her pioneering study of such texts (Voigts, 'Editing'). It [...]

Terminally ill patients and their families are often referred to as being 'in denial' of impending death. This study uses the qualitative method of discourse analysis to investigate the usage of the term 'denial' in the contemporary hospice and palliative care literature. A Medline search (1970-2001) was performed combining the text words 'deny' and 'denial' with the subject headings 'terminal care', 'palliative care' and 'hospice care,' and restricted to English articles discussing death denial in adults. The 30 articles were analysed using a constant comparison technique and emerging themes regarding the meaning and usage of the words 'deny' and 'denial' identified. This paper focusses on the theme of denial as an individual psychological process. Three dominant subthemes were distinguished: denial as an unconscious 'defence mechanism', denial as 'healthy' and denial as temporary. The analysis focusses on the intertextuality of these themes with each other and with previous texts on the denial of death. Elements of the psychoanalytic definition of denial as an unconscious defence mechanism are retained in the literature but are interwoven with new themes on patient choice. The result is an overall discourse that is conflictual and at times selfcontradictory but overall consistent with the biomedical model of illness. I suggest that the representation of death denial elaborated in these articles may be related to a larger discourse on dying in contemporary Western society, which both invites patients to participate in the planning of their death and labels those who do not comply. Keywords: Terminal illness; Denial of death; Palliative care

Efficacy research is insufficient and ineffective in changing practice, despite a large supporting psychotherapy efficacy literature. Concurrently, demand for supporting data and the burden on everyday practice for generating these data is increasing. The disconnect between efficacy and effectiveness is due to a lack of conceptual and methodological tools for testing efficacious procedures in real-world settings, particularly medical contexts. This article articulates the position that effectiveness studies pose more complex questions that require an alteration of conceptual and methodological frames of reference in order to make behavioral services available to the broadest patient base.

ABBREVIATIONS. STM, scientific, technical, and medical; PLoS, Public Library of Science; AAP, American Academy of Pediatrics., Over the past few years there has been a growing concern within the world's scientific communities about access to scientific, technical, and medical (STM) literature. This concern has given rise [...]

Since before Hippocrates, case reports have provided a rich source for teaching and research. (1) Biochemistry, pathology and radiology, etc added objectivity to this knowledge in not only diagnosing the [...]

Duplicate publication is the publication of an article that overlaps substantially with an article published elsewhere. A comprehensive list of systematic reviews (1989 through August 15,2002) in anesthesia and analgesia that is accessible on the Internet were examined in this context.

Byline: Rolf Ahlzen (1,2) Keywords: ambiguity; clinical encounter; experience; literary text; perception; potential; understanding Abstract: Expectations are growing that literature may contribute to clinical skills. Narrative medicine is a quickly expanding area of research. However, many people remain sceptical to the idea of literature having a capacity to 'save the life of medicine'. It is therefore urgent to scrutinize both the arguments in favour of and those against the potential of literature for increasing medical understanding. This article attempts to do this. It does in fact support the assertion that literature is important, but it stresses precisely its character of potential. There is no simple connection between acquaintance with literary texts and understanding of the different aspects of medical work. Much more need to be known about the conditions which allow the experiences residing in texts to be transformed into lived personal knowledge. Author Affiliation: (1) Department of Humanistic Medicine, Karolinska Institute, Stockholm (2) Division of Environmental Sciences, University of Karlstad, S-65188, Karlstad, Sweden Article History: Registration Date: 09/10/2004 Article note: This revised version was published online in October 2005 with corrections to the Cover Date.

Chibnall, Jeral, and Cerullo argued that research on distant intercessory prayer assumes intervention by a supernatural being and does not meet the basic requirements for science of having explanatory relevance and being testable. They believed that this research will not be successful because it is "attempting to validate God through scientific methods." They also proposed that the weak effects in the existing studies may be due to multiple analyses in exploratory research. From a parapsychological perspective, attempts to investigate healing by God have similar methodological issues as attempts to investigate survival of death. The effects could be due to psi by the research participants. Distant healing studies are greatly complicated by the fact that there is a background prayer effort and motivation for paranormal healing for virtually all severely ill persons. This research implies that certain prayers are better than others and opens the door to ethical abuse by unscrupulous or misguided persons. At th e same time, the hypothesis of multiple exploratory analyses does not explain the results of the existing studies. Distant healing research appears to be subject to the same weak, unreliable effects and susceptibility to experimenter effects as other types of parapsychological studies., The article "Experiments on Distant Intercessory Prayer: God, Science, and the Lesson of Massah" by Chibnall, Jeral, and Cerullo (2001) may be a pivotal commentary in the medical literature that [...]

Numerous military servicemembers have sustained severe limb trauma as a result of the Global War on Terrorism. To date, the Army Medical Department has provided medical, surgical, and rehabilitative care [...]

Many clinical prediction rules do not meet proposed standards. Clinical prediction rules, which are also called clinical decision rules, are designed to help doctors make various decisions about patient care. Researchers analyzed 29 clinical prediction rules published in four general medical journals between 1991 and 1994. Many did not meet the standards proposed by one researcher in 1985. While 97% were clinically sensible, one-third were considered complicated. Additional standards for evaluating clinical prediction rules are discussed., Background.--Clinical prediction rules are decision-making tools for clinicians, containing variables from the history, physical examination, or simple diagnostic tests. Objective.--To review the quality of recently published clinical prediction rules and to suggest methodological standards for their development and evaluation. Data Sources.--Four general medical journals were manually searched for clinical prediction rules published from 1991 through 1994. Study Selection.--Four hundred sixty potentially eligible reports were identified, of which 30 were clinical prediction rules eligible for study. Most methodological standards could only be evaluated in 29 studies. Data Abstraction.--Two investigators independently evaluated the quality of each report using a standard data sheet. Disagreements were resolved by consensus. Data Synthesis.--The mathematical technique was used to develop the rule, and the results of the rule were described in 100% (29/29) of the reports. All the rules but 1 (97% [28/29]) were felt to be clinically sensible. The outcomes and predictive variables were clearly defined in 83% (24/29) and 59% (17/29) of the reports, respectively. Blind assessment of outcomes and predictive variables occurred in 41% (12/29) and 79% (23/29) of the reports, respectively, and the rules were prospectively validated in 79% (11/14). Reproducibility of predictive variables was assessed in only 3% (1/29) of the reports, and the effect of the rule on clinical use was prospectively measured in only 3% (1/30). Forty-one percent (12/29) of the rules were felt to be easy to use. Conclusions.--Although clinical prediction rules comply with some methodological criteria, for other criteria, better compliance is needed. JAMA. 1997;277:488-494

HIV disease has recently come to be defined as a chronic disease from both policy and clinical points of view. This paper investigates the meaning and some possible implications of the redefinition. The first section examines the features identifiable from medical texts used to define a disorder as either acute or chronic and explores some of the implications of the definition on patterns of care. In particular, different types of doctor--patient relationship are examined. The second section looks at the categorisation of HIV disease using these textbook definitions, finding that HIV is most appropriately labelled as chronic. The next section uses the clinical definitions to look at two conditions for comparison with HIV; testicular cancer and multiple sclerosis. In the fourth section the policy re-definition of HIV is investigated and one of the potential effects of a policy redefinition is discussed--a change in the extent to which services are centralised. The paper concludes that the policy and clinical communities confuse the picture of HIV disease as a chronic condition. There are strong parallels between care for people with HIV disease and care delivered for an acute condition. It therefore seems likely that the policy redefinition of the disease as chronic may not be entirely adequate to use as a current model for investigating or planning patterns of care in HIV disease.

Medical writers have advocated the use of plain language in medical literature in an attempt to provide ordinary writers the capacity to understand complex medical terms. However, such a practice was not effectively defined. Even some authors of medical literature have not actually used clear writing methods for ordinary readers, giving the plain language issue the flavor of just being a rhetorical convention.