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Abstract Artificial intelligence (AI) is rapidly moving from an experimental phase to an implementation phase in many fields, including medicine. The combination of improved availability of large datasets, increasing computing power, and advances in learning algorithms has created major performance breakthroughs in the development of AI applications. In the last 5 years, AI techniques known as deep learning have delivered rapidly improving performance in image recognition, caption generation, and speech recognition. Radiology, in particular, is a prime candidate for early adoption of these techniques. It is anticipated that the implementation of AI in radiology over the next decade will significantly improve the quality, value, and depth of radiology's contribution to patient care and population health, and will revolutionize radiologists' workflows. The Canadian Association of Radiologists (CAR) is the national voice of radiology committed to promoting the highest standards in patient-centered imaging, lifelong learning, and research. The CAR has created an AI working group with the mandate to discuss and deliberate on practice, policy, and patient care issues related to the introduction and implementation of AI in imaging. This white paper provides recommendations for the CAR derived from deliberations between members of the AI working group. This white paper on AI in radiology will inform CAR members and policymakers on key terminology, educational needs of members, research and development, partnerships, potential clinical applications, implementation, structure and governance, role of radiologists, and potential impact of AI on radiology in Canada. [ABSTRACT FROM AUTHOR]

Surface properties have been found to be one of the key parameters which cause degradation and of thrombogenicity in all polymers used in biomedical devices, thus signifying the importance and the necessity for quantitative and accurate characterization of the polymer surface itself as used in the construction of the device. The characterization techniques employed generally involve thermal and spectroscopic measurements, in which class the electrochemical investigations and scanning probe microscopies can also be included. Current hypotheses on the correlations that exist between surface parameters and hemocompatibility and degradation of polymers are examined herein, but concentrating on the field of clinically utilized polymeric materials as used within medical devices themselves. Furthermore, this review provides a brief but complete synopsis of these techniques and other emerging ones, which have proven useful in the analysis of the surface properties of polymeric materials as used in the construction of cardiovascular devices. Statements and examples are given as to how specific information can be acquired from these differing methodologies and how it aids in the design and development of new polymers for usage in biomedical device construction. [ABSTRACT FROM AUTHOR]

This paper has been substantially revised by the Canadian Psychiatric Association's Research Committee and approved for republication by the CPA's Board of Directors on May 3, 2017. The original policy paper1 was developed by the Scientific and Research Affairs Standing Committee and approved by the Board of Directors on November 10, 2008. [ABSTRACT FROM AUTHOR]

As previous research has observed, medical students and physicians alike confront vast amounts of knowledge in their education and practice, such that no one clinician can know everything there is to know about biomedicine. Even before clerkships, medical students learn to cope with this impossibility by prioritizing certain information based on its perceived utility for exams and clinical practice. Many factors can shape this process, including teamwork, wherein individual medical students rely on one another to address gaps in knowledge at the level of the group. This paper will draw on qualitative data from two allopathic medical schools in the American Midwest to demonstrate that peer-to-peer learning, a widely utilized pedagogical modality in North American medical schools, is amongst the earliest places where future physicians learn how to rely on their peers in the profession as they make choices about what to know and what not to know about biomedicine: cultivating a culture of "intraprofessionalism" between students with different knowledges and values, as they prepare to enter the same profession. The paper will also consider how differences in the student populations at two field sites impact intraprofessional development. Drawing on scholarship of peer-based learning strategies and the sociology and anthropology of medical education, the authors argue that peer-to-peer learning is a key site in the professional socialization of medical students toward the effective management of medical knowledge. [ABSTRACT FROM AUTHOR]

Papers presented at the three Successes and Failures in Telehealth conferences have made a helpful contribution to what is known about the practicalities of implementing and using telehealth. Ten of the 89 papers covered general concepts, 40 described primary studies and 26 discussed telehealth programmes or networks. Common themes that emerged on determinants of success and failure included the reliability of equipment, the reliability of vendors, political and budgetary issues, the perceived need for telehealth, the involvement of stakeholders, health professionals' opinions, the stability of management structures, the turnover of personnel and cooperation between organizations. Limitations in some papers included an absence of data, weak study designs, short-term perspectives and lack of information on health outcomes. Despite these limitations, the papers have made a valuable contribution to our knowledge of what has worked and what has failed in the field of telehealth. [ABSTRACT FROM AUTHOR]

Abstracts of papers presented at the 73rd National Scientific Congress of the Australian Society of Anaesthetists in October 2014, including Protective Lung Strategy During Bronchoscopic Laser Resection of Tracheo-bronchial Tumours: A Case Series" and "The Impact of Indigenous Status on Perioperative Complications and Length of Hospital Stay After Cholecystectomy."

Journaling has been around for many centuries but continues to be a vital modality in the realm of complementary alternative medicine. This modality is discussed relative to the technique, outcomes, and benefits derived from regularly using journaling for expression and relaxation. The response to journaling by different individuals and application techniques are an integral part of this article. The key considerations—patience, practice, and consistency—are presented as they relate to the successful development of regular journaling. [ABSTRACT FROM AUTHOR]

Healing of chronic lower extremity wounds is a global problem, especially in the developing world where it is often only folk and traditional medicine that can be afforded. In the structured health services of the developed world, there are usually a wider range of possible therapies. In India, traditional medicines flourish in parallel with Western systems, and those who treat wounds may use the expertise of more than one system. Ayurveda is a traditional system that has evolved in India over centuries using especially native plant sources as remedies. Like many Asian systems, its theoretical basis concerns balance and energy in the individual. In this perspective paper, the author advocates awareness of plant products available for wound healing and a study of the extent of their utilization. They must be developed for safe use and their efficacy reviewed, taking into account cure well-being and patient satisfaction as well as cost. Developing a list of products and classifying them appropriately is a beginning for such studies. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical topics including blood pressure measurements taken in anaesthetic pre-admission clinic with ambulatory measurements, research on problems with transitioning from regional to systemic analgesia, and transthoracic echocardiography in preadmission clinic.

The author reflects on the three research papers regarding medical marketing. He states that the first paper is relevant to markets, such as pharmaceutical and related markets, in which consumer acceptance of new products is very important. He adds that the second paper is directly relevant to medical markets because it deals with the question of how doctors search for information when considering prescribing.

The article highlights separate modes or languages in ascribing meaning to an illness. Medical, material or molecular involves the suggestion of philosopher René Descartes that the body should be seen as a system of mechanisms. Connection between several diseases like hiatus hernia and the low-fiber content of the diet is included in cultural, social and political mode.

The article presents the author's views on the Cartesian notion of mankind as a composite dualism in medicine. This literature demonstrates how this mechanistic view of mankind has influenced medical practice and how, by adopting a more contemporary philosophical approach, medical professionals can obtain a better understanding of what is, after all, their subject matter.

The article discuses on the combination medicines over to single products and over multiple drug regimes in Great Britain. The alleged disadvantages of the products are mostly of theoretical or doctrinal. Nearly all medicines are formulated mixture of several chemicals and a single active ingredients may be metabolized to a variety of substances with different therapeutic and toxic effects. Discrimination against combination medicine is on pharmacological grounds is questionable.

The article discusses the application of modern science in medicine and correlates it with reference of modern science in detective novel. Many medical students are often told that diagnosis is as exciting as the action in a detective novel. Doctor-scientists have unraveled many facts related to medicine, including human physiology, agents of disease, the defenses of the immunological system and others. These achievements have encouraged the role of science in medicine.

The article discusses the use of artificial intelligence in medicine. One of the definitions of artificial intelligence is the use of computer programs and programming techniques to cast light on the principles of intelligence. Simulation model PARRY is considered to be important to cognitive emulation and to psychiatry.

The article discusses the theoretical objectives of liaison psychiatry. Information on the each style of liaison psychiatry, advantages and disadvantages is also presented. Liaison style provides wider psychiatric service and care tailored to patients' individual needs. In consultation style, patients are scattered through different medical wards and their psychological needs are left to busy nurses with no psychiatric knowledge.

The article examines the role of research in the rapprochement between conventional medicine and complementary therapies. It mentions that the absence of quality controls and ethical constraints drive the need for research on the therapies. The modern concept of imbalance of homeostasis as a cause of illness was anticipated by Greek physician Hippocrates in his theory of imbalance of blood, phlegm, black bile and yellow bile.

Acoustic rhinometry is a new technique which evaluates nasal obstruction by analysing reflections of a sound pulse introduced via the nostrils. The technique is rapid, reproducible, non-invasive and requires minimal cooperation from the subject. Unlike rhinomanometry it does not require airflow. A graph of nasal cross-sectional area as a function of distance from the nostril is produced, from which several area and volume estimates of the nasal cavity can be derived. The reliability of the method is greatest in the anterior nasal cavity, which is the site of the nasal valve. We have applied the technique to the study of normal nasal physiology in adults and children and to a range of pathological conditions. The role of acoustic rhinometry in diagnosis is somewhat limited compared to nasal endoscopy, but it is useful for nasal challenge and for quantifying nasal obstruction. Monitoring of medical and surgical therapy is a more promising application. In future, acoustic rhinometry is likely to be of particular help in evaluating childhood nasal obstruction, as it is well tolerated by children as young as 3 years old - a group of patients to whom objective tests have hitherto been difficult to apply. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We, therefore, aim to conduct a systematic review to assess the academic potential of ChatGPT-3.5, along with its strengths and limitations when giving medical exams. METHOD: Following PRISMA guidelines, a systemic search of the literature was performed using electronic databases PUBMED/MEDLINE, Google Scholar, and Cochrane. Articles from their inception till April 4, 2023, were queried. A formal narrative analysis was conducted by systematically arranging similarities and differences between individual findings together. RESULTS: After rigorous screening, 12 articles underwent this review. All the selected papers assessed the academic performance of ChatGPT-3.5. One study compared the performance of ChatGPT-3.5 with the performance of ChatGPT-4 when giving a medical exam. Overall, ChatGPT performed well in 4 tests, averaged in 4 tests, and performed badly in 4 tests. ChatGPT's performance was directly proportional to the level of the questions' difficulty but was unremarkable on whether the questions were binary, descriptive, or MCQ-based. ChatGPT's explanation, reasoning, memory, and accuracy were remarkably good, whereas it failed to understand image-based questions, and lacked insight and critical thinking. CONCLUSION: ChatGPT-3.5 performed satisfactorily in the exams it took as an examinee. However, there is a need for future related studies to fully explore the potential of ChatGPT in medical education. [ABSTRACT FROM AUTHOR]

The Scottish doctor Robert Erskine (1677–1718) became Chief Doctor of Russia and personal physician to Tsar Peter the Great. Extensive archival material documents his remarkable career. From schooling in the village of Alva and apprenticeship to an Edinburgh apothecary, he went on to study medicine in Paris and Utrecht and was admitted to the Royal Society in London. Recruited into the service of the Tsar, to whom he became a trusted friend and counsellor, Erskine played a central role in the modernisation of Russian medicine, pharmacy and natural science in the early 18th century. His untimely death at age 41 was marked with a state funeral in St Petersburg. Some historians in Russia assert that in their country, the development of medicine and the natural sciences took place without the transitional stages of iatrochemistry and iatrophysics which characterised the shift in scientific thinking throughout Europe in the early modern period. This study of archival records shows that Erskine held iatrophysical and iatrochemical views in common with his European contemporaries. His influence ensured that Russia was thoroughly involved in European developments in science and medicine in the 18th century. [ABSTRACT FROM AUTHOR]

The article reports on the number of papers submitted for publication during 2004 for the periodical "Journal of Telemedicine and Telecare." The rapid growth of publications in telemedicine observed in the 1990s seems to have slowed or stopped. 34 weeks was the median time from submission of papers to their publication.

This cross-sectional study evaluates the knowledge, attitudes, experiences, and behavior of final year medical students, PhD students, and supervisors at the School of Medicine of the University of Zagreb in relation to research misconduct, questionable research practices, and the research environment. The overall response rate was 36.4% (68%–100% for the paper survey and 8%–15% for the online surveys). The analysis reveals statistically significant differences in attitude scores between PhD students and supervisors, the latter having attitudes more in concordance with accepted norms. The results overall show a nonnegligible incidence of self-reported misconduct and questionable research practices, as well as some problematic attitudes towards misconduct and questionable research practices. The incidence of problematic authorship practices was particularly high. The research environment was evaluated as being mostly supportive of research integrity. [ABSTRACT FROM AUTHOR]

This article explores the prominent medical theories in Western Europe, paying attention to how these theoretical frameworks changed perceptions of consuming food. It discusses the idea of moderation of food and drink and how it connected to the practice of Protestantism in the household. Finally, the article explores Scottish domestic papers dating from the seventeenth and eighteenth centuries, focusing on recipe books. Through these sources, this article will highlight the historical ties between food and medicine and how it was understood in the upper-class Scottish households. [ABSTRACT FROM AUTHOR]

The workforce of the medical specialty of Rehabilitation Medicine (RM) in the UK is 10 times less than the European average for the specialty of Physical and Rehabilitation Medicine (PRM). This can be explained partly by the difference in the scope of practice within the specialty between the UK and other European countries and USA. This opinion paper aims to compare the rehabilitation needs in chronic medical conditions and compare the scope of practice between countries within Europe and other regions of the world. The potential advantages of a broader remit specialty to improve rehabilitation care for patients by involving rehabilitation physicians in various medical conditions is explored. Recommendations have been put forward in the Rehabilitation Medicine Expansion Proposal (RMEP), which is likely to make the medical specialty of RM/ PRM more satisfying for the doctors working in the specialty and a more attractive career choice for those entering training in the specialty. There is a need for an international universal framework for the scope of the specialty to have a greater impact on improving the lives of those with chronic medical conditions. [ABSTRACT FROM AUTHOR]

Several studies have summarized the biomedical publications in Arab countries. However, the quantity of health-related article publications from universities in recent years in Saudi Arabia is unknown. Therefore, this study aimed to perform a bibliometric analysis that showcases the quantitative health-related article publications output from universities in Saudi Arabia between 2008 and 2017. An extensive literature search was conducted using the PubMed database. The search was limited to original research articles, systematic reviews, and meta-analyses published in the English language reporting on humans from medicine and health sciences colleges by researchers affiliated with any university in Saudi Arabia between January 2008 and December 2017. A total of 3172 articles were found published between January 2008 and December 2017. The number of publication output increased significantly (p = 0.0027) from 73 (2.3%) in 2008 to 721 (22.7%) in 2017. The highest quantity of publications came from the Riyadh region (n = 2257), specifically King Saud University (n = 1538). Of specific journals, the BioMed Central journals published the most articles by Saudi Arabian researchers (n = 112). The total number of publications increased from 2% to 24.8% by region. However, approximately 80% of the papers were published in journals with an impact factor (IF) <3. Around 3.8% of the papers were published in journals that had an IF ≥6 and has increased significantly (p = 0.030) from 0% to 1.2% in the past decade. The journal with the highest IF that published a high quantity of articles was the American Journal of Human Genetics. This study has identified a continuous significant increase in the publication of health-related articles from universities in Saudi Arabia. This study extended our knowledge of the quantity of scientific productivity in the field of medicine and health sciences over a recent decade. [ABSTRACT FROM AUTHOR]

This paper historicises the criticisms and backlash from within medicine against new computer technologies in the clinic. Physicians' reactions to proposals for the implementation of algorithmic technologies in the clinic ranged from enthusiastic to cautionary to critical from as early as the 1960s. Clinicians were suspicious of these technologies as they threatened their professional expertise. I argue that these discontent reactions from doctors demonstrate an implicit struggle for authority over clinical spaces and with regards to medicine's place within society more generally. Drawing on Foucault's concept of discursive rules and their function within a closed community, I recover the forgotten debate to include or reject AI and its predecessor technologies of expert systems and neural networks. This paper explains how and why justifications for and against the applicability of AI to the clinic are underpinned by questions of medical authority. I conclude with an inquiry into the transformative possibilities of partisanship. [ABSTRACT FROM AUTHOR]

The article discusses the biomedical and biochemical principles behind the sudden seizure that led to the death of Lot's wife in the Old Testament. According to the author, it is possible to apply modern medical knowledge to the recountings of a Biblical episode and gain clearer insights into the sequence of events described. This paper shows how modern science serves to corroborate and clarify medical events described in the Bible.

Background: There has been an increasing need to address end of life (EOL) care and palliative care in an era when measures to extend life for terminal illnesses are often initiated without consideration of quality of life. Addressing the barriers for resident physicians to initiate EOL conversations with patients is an important step towards eliminating the disconnect between patient wishes and provider goals. Objective: To assess resident physician perspectives on initiating palliative care conversations with terminally ill patients at an urban teaching hospital. Methods: This paper solicited the experiences of pediatric, general surgery, and internal medicine residents through an anonymous survey to assess exposure to palliative care during training, comfort with providing palliative care, and barriers to implementing effective palliative care. Results: 45% of residents reported exposure to palliative care prior to medical training. Ninety-three percent of these residents reported being formally introduced to palliative care during medical training through formal lecture, although the majority reported also being exposed through either small group discussions or informal teaching sessions. Time constraints and lack of knowledge on how to initiate and continue conversations surrounding EOL care were the greatest barriers to effectively caring for patients with terminal illnesses. Residents concurred that either attending physicians or hospital-designated palliative care providers should initiate palliative care discussions, with care managed by an interdisciplinary palliative care team; this consensus demonstrates a potential assumption that another provider will initiate EOL discussions. Conclusions: This study evaluated the current state of physician training in EOL care and provided support for the use of experience-based training as an important adjunct to traditional didactic lectures in physician education. [ABSTRACT FROM AUTHOR]

The author describes several potential formal and informal logic-based fallacies that could occur in anesthesia practice or in the appraisal of anesthesia research. Formal fallacies are defined as those referring to arguments having an invalid structure while informal fallacies are said to have incorrect or irrelevant premises. Examples are given of formal fallacies such as "affirming the consequent" and "denying the antecedent," and of informal fallacies such as "truth by authority" and "appeal to emotion."

A literature review was conducted to identify the 'trigger factors' associated with a need for increased levels of care and support for elderly people. An expert panel then prioritized the trigger factors into one of five bands of importance. The literature review produced 2037 hits. Of these, 1768 were excluded after reading the abstract and 111 after reading the full paper, leaving 158 papers for inclusion in the review. From these papers, 102 unique factors that triggered a need for greater care and support among elderly people were identified. The expert panel ranked 36 of the trigger factors into the top three bands of importance. Subsequent analysis suggested that telecare could be used to assist, prevent or minimise the impact of some 66% of these 36 trigger factors and 75% of the top 12 factors. This suggests that telecare has a significant role to play in the support of elderly people and should be a major consideration when re-designing services. [ABSTRACT FROM AUTHOR]

We carried out a systematic review of recent telemedicine assessments to identify scientifically credible studies that included comparison with a non-telemedicine alternative and that reported administrative changes, patient outcomes or the results of an economic assessment. From 605 publications identified in the literature search, 44 papers met the selection criteria and were included in the review. Four other publications were identified through references cited in one of the retrieved papers and from a separate project to give a total of 48 papers for consideration, which referred to 42 telemedicine programmes and 46 studies. Some kind of economic analysis was included in 25 (52%) of the papers. In considering the studies, we used a quality appraisal approach that took account of both study design and study performance. For those studies that included an economic analysis, a further quality-scoring approach was applied to indicate how well the economic aspects had been addressed. Twenty-four of the studies were judged to be of high or good quality and 11 of fair to good quality but with some limitations. Seven studies were regarded as having limited validity and a further four as being unacceptable for decision makers. New evidence on the efficacy and effectiveness of telemedicine was given by studies on geriatric care, intensive care and some of those on home care. For a number of other applications, reports of clinical or economic benefits essentially confirmed previous findings. Although further useful clinical and economic outcomes data have been obtained for some telemedicine applications, good-quality studies are still scarce. [ABSTRACT FROM AUTHOR]

The lack of radio navigational aids in early Royal Flying Doctor Service aircraft in Australia occasionally resulted in aircraft being stranded at a remote site with a critically injured patient due to weather and other conditions. For a brief period in the 1950s, at least one Royal Flying Doctor Service pilot was trained to administer anaesthesia to critically ill patients who could not be immediately evacuated. The aim of this paper is to describe the circumstances in which this arose and how it worked in practice. This is based largely on the recollections of pilot anaesthetist Captain Keith Galloway, who shared his recollections during interviews with the authors. [ABSTRACT FROM AUTHOR]

Physician spending has substantially increased over the last few years in Canada to reach $27.4 billion in 2010. Total clinical payment to physicians has grown at an average annual rate of 7.6% from 2004 to 2010. The key policy question is whether or not this additional money has bought more physician services. So, the purpose of this study is to understand if we are paying more for the same amount of medical services in Canada or we are getting more bangs for our buck. At the same time, the paper attempts to find out whether or not there is a productivity difference between family physician services and surgical procedures. Using the Baumol theory and data from the National Physician Database for the period 2004-2010, the paper breaks down growth in physician remuneration into growth in unit cost and number of services, both from the physician and the payer perspectives. After removing general inflation and population growth from the 7.6% growth in total clinical payment, we found that real payment per service and volume of services per capita grew at an average annual rate of 3.2% and 1.4% respectively, suggesting that payment per service was the main cost driver of physician remuneration at the national level. Taking the payer perspective, it was found that, for the fee-for-service (FFS) scheme, volume of services per physician decreased at an average annual rate of -0.6%, which is a crude indicator that labour productivity of physicians on FFS has fallen during the period. However, the situation differs for the surgical procedures. Results also vary by province. Overall, our finding is consistent with the Baumol theory, which hypothesizes higher productivity growth in technology-driven sectors. [ABSTRACT FROM AUTHOR]

Based on ethnographic research within refugee-serving institutions in Philadelphia, Pennsylvania (USA), this paper examines the relationship between physicians and the knowledge they produce and consume about caring for refugees from around the world. I explore the "seething presence" of race in refugee medicine, a domain of medical practice whose entanglement with racial ideology and practice has been underexamined. I consider how knowledge about refugees from different groups—whether racially laden designations like "Asian" or "African" or national markers like Congolese or Burmese—circulates in clinical spaces as health-care teams diagnose and treat refugees using standards of "evidence-based" medicine. Assessing the primary literatures that refugee health-care providers use to justify varying care plans, I argue that race, while often unmentioned, structures the practice of refugee medicine. Additionally, the implicit use of race as an analytic, not racism or economic injustice, often disguises the impact of structural racism and inequality in refugee health disparities. I end with some reflections on how we might conduct a more just practice of refugee health care—and by extension, health care more generally—by shifting our gaze from the particularities of seemingly obvious cultural difference to social structure. [ABSTRACT FROM AUTHOR]

Epigenetic processes, and the investigative practices that take these as their focus, are of increasing interest to a range of professionals beyond biomedicine. This has been piqued by, especially, the belief that bioscientific research is demonstrating new molecular mechanisms through which the social and physical environment impact upon the bodies of humans and other animals. Beyond the laboratory, epigenetic notions are entangled with wider ideas about the malleability of the soma (e.g., relating to neuroscience). In many contexts (including, to an extent, education), this intertwinement has contributed to producing and valourising a conception of a particularly plastic body. In this paper, I draw on a range of biomedical and education-related texts in order to outline and reflect upon the notions of 'education' and 'epigenetics' that are supported through and propelled by an array of writings that, to greater or lesser extents, bring these spheres of praxis into conversation. Discussions of epigenetics and stress, for instance, are framing certain kinds of educational work (e.g., with new parents) as a means of intervening in soma and society. In so doing, they implicitly extend ideas about what education is and what it can do. On the other hand, writings from educational researchers, for example, are enrolling epigenetic findings and ideas to support various positions or approaches. Many education researchers will be sceptical of some of the more hyperbolic assertations made about the significance of epigenetics. However, the fact that a nascent discourse connecting education and epigenetics is emerging is suggestive of a need for reciprocal, thoughtful, and critical exchange with bioscientists who seek to address educational issues, or whose work is being enrolled by others to do so. [ABSTRACT FROM AUTHOR]

This paper analyses the historical and epistemological work of the French psychiatrist Georges Lantéri-Laura (1930–2004) within the context of the French ‘tradition’ of history and philosophy of sciences, with special reference to Georges Canguilhem and Michel Foucault. After an introduction devoted to a critical survey of the most recent works on the history and historiography of psychiatry in French, the paper outlines Lantéri-Laura’s approach by focusing especially on the role played by the methodological concept of ‘semiology’ as regards the relation between medicine and psychiatry. The last part of the paper draws attention to the relation between the history and philosophy of psychiatry in light of Lantéri-Laura’s ‘critical epistemology’. [ABSTRACT FROM AUTHOR]

Already emerging as an original thinker in the field of classical philology and history of medicine, German scholar Ludwig Edelstein became one of many scholars who lost his academic position when the National Socialists came to power in early 1933. This paper details his life before and after his difficult transition from Europe to North America, while reviewing the lasting significance of his translation and commentary on the Hippocratic Oath. [ABSTRACT FROM AUTHOR]

We have developed a telemedicine elective for fourth-year medical students to learn about the delivery of primary care telemedicine. The goals were to expose medical students to telemedicine as a method for delivery of primary care and to reinforce the importance of doctor-patient communication during the health-care encounter. The elective lasted four weeks. It had three components: two online introductory courses to telemedicine; site visits to near and distant telemedicine sites; and a reflective writing paper. In the first year, seven medical students out of a class of 230 chose the telemedicine elective from a list of 188 alternatives. Evaluation ratings and the students' written comments, along with end-of-course discussions, indicated that the telemedicine elective was a valuable experience. An elective in the medical school curriculum may be a useful way of providing future physicians with an understanding of telemedicine. [ABSTRACT FROM AUTHOR]

Every Christmas season children's hospitals in the United States are flooded with gift donations. Businesses, service organizations, and the public deliver carloads of new toys, puzzles, games, books, electronics, sports equipment, art supplies, cosmetics, blankets, and clothing for sick children. The practice is so common and widespread that donors rarely ask whether they may donate, what types of donations are welcome, and when and where they should deliver their donations. Based on ethnographic observations of holiday gifting at University Children's Hospital, a nationally ranked pediatric hospital on the West Coast, the purpose of this paper is to investigate the implicit cultural beliefs that guide holiday gifting practices. Eschewing the popular rhetoric of American hyper-consumption and hedonism, I use a Durkheimian framework to argue that holiday gifting in children's hospital is a sacred ritual. The data presented describe the wide-ranging variety of donors—from Boy Scouts to nightclub strippers—who journey to the hospital bearing gifts. Drawing on sacred conceptualizations of childhood and gifting in American culture, I argue that children's hospitals are more than medico-scientific institutions. They represent sacred unifying spaces and the heart of their local communities where individuals and organizations come to privately and publicly reaffirm their moral commitments to society through holiday gifting. [ABSTRACT FROM AUTHOR]

The aim of this paper is to analyse the relationship between reference prices (RPs), generic medicines and generic substitution at pharmacy level. In particular, the focus is on generic reference pricing. RPs in general aim to control reimbursement prices to reduce public pharmaceutical expenditure. In addition, generic reference pricing also aims to increase the use of generic medicines. The link between generic reference pricing and generic medicines is that the RP is usually set as a function of generic prices. Generic RPs are also linked with generic substitution because, without the possibility of substitution at pharmacy level, the potential cost savings from reference pricing will be reduced. RPs in general have been relatively successful in reducing prices, but less successful at controlling pharmaceutical expenditure. Moreover, generic reference pricing has not necessarily led to significant increases in generic drug use in those countries where such a system has been implemented. This paper analyses the reasons for these results, and discusses further issues that need to be considered when considering an RP system, concentrating in particular on generic reference pricing. [ABSTRACT FROM AUTHOR]

This paper reviews the author's experience in becoming a medical sociologist before the field had become formalized. The contributions to medical sociology of sociologist Selden D. Bacon and physician and medical educator William R. Willard are described. The relationship of medical sociology to medical behavioral science, as experienced at the University of Kentucky, is discussed. Finally, the thesis of the author's 1957 paper on the nature and status of medical sociology is re-examined. [ABSTRACT FROM AUTHOR]

This paper examines the logic of evaluation of health care services, calling into question the possibility of assessing the extent to which medicine and health care systems are 'rational' or 'irrational'. The paper analyses and rejects claims to rationality made in discourses on evaluation and in particular economic evaluation, by recourse to Weber's distinction between formal and substantive rationalities. The rationality claimed by evaluation is a value-laden and therefore substantive rationality. Similarly, the claims of the rational actor model are seen to over-simplify the ways actors interact in the market. [ABSTRACT FROM AUTHOR]

The introduction to this special issue of the Journal expands the scope of research on "the sociology of medical education" to include studies of the institutions in which physicians are trained as well as studies of the socialization of the physician throughout the life cycle. Research since the 1960s is reviewed briefly and the papers in this issue are discussed. Studies of the macropolitics and micropolitics of academic medicine are called for as well as comparative analyses of the settings in which physicians are trained and research on the relative effects on physicians' attitudes and behavior of different sets of experiences, professional and nonprofessional, over the course of their life cycle-all in the context of massive changes in the organization of health care. [ABSTRACT FROM AUTHOR]