NLM and the Internet (National Library of Medicine, 1994)
This short video chronicles the National Library of Medicine #39;s introduction to, and use of, the internet via Gopher, MOSAIC, and other early internet-driven resources for information search...
By: NLMNIH
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NLM and the Internet (National Library of Medicine, 1994) - Video
Medicine and Mistrust Grandville
The world of my parents, and that of their children, dramatically improved in the latter half of the twentieth century as modern medicine introduced an array of effective vaccines and antibiotics, writes Jerome Groopman, reviewing On Immunity by Eula Biss in the March 5, 2015, issue of The New York Review of Books. When the Salk vaccine against the polio virus became available I was inoculated, along with my siblings. The idea of preventing or curing dreaded infectious diseases naturally, relying on the body alone, hardly entered our minds.
Eula Biss is one of many parents for whom the decision to inoculate a child, in 2015, is not so simple. We fear that vaccination will invite autism or any one of the diseases of immune dysfunction that now plague industrialized countriesdiabetes, asthma, and allergies, she writes. We fear that the hepatitis B vaccine will cause multiple sclerosis, or that the diphtheria-tetanus-pertussis vaccine will cause sudden infant death. We fear that the combination of several vaccines at once will tax the immune system, and that the total number of vaccines will overwhelm it.
In the era between Jerome Groopmans vaccination and Eula Bisss indecision, The New York Review has published many articles on what Groopman, considering the origin of Bisss anxieties, calls our culture of suspicion, the widespread unease with expertise and mistrust of authority that complicates relations between doctors and patients. A selection of these articles is presented below.
Richard Horton, editor of The Lancet and the author of Health Wars: On the Global Front Lines of Modern Medicine, examines the shortcomings of institutionalized medicine in two essays, one on compromised medical research, and another on The Doctors Plague, the biography of a Viennese doctor whose discovery that colleagues were unwittingly spreading infection saved the lives of patients, but alienated him from the medical establishment.
In his review of The Creative Destruction of Medicine by Eric Topol, Arnold Relman questions whether advances in medical technology will produce better healthcare, or a wealth of useless information and wealthier technology executives.
Among several articles written for The New York Review on the practices of the pharmaceutical industry, Marcia Angell has advocated for reforms to curb corporate influence on the US Food and Drug Administration, in her review of Reputation and Power by Daniel Carpenter, and investigated the insidious influence of money on academic expertise and the integrity of practitioners, in an omnibus review of books on the subject.
Many of the contributions to The New York Review by Richard C. Lewontin have adopted a perspective skeptical of scientific claims to absolute truth and unbiased objective knowledge. In two such reviews, Lewontin writes on the political context of scientific progress, and the conflicted role of science in a world of believers.
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IMAGE:Michael Mullen, M.D., is an assistant professor of Neurology at the Perelman School of Medicine at the University of Pennsylvania and director of Penn's Comprehensive Stroke Center. view more
Credit: Penn Medicine
PHILADELPHIA- Stroke is one of the leading causes of death and disability in the United States, but access to rapid EMS care and appropriate stroke care centers with the ability to deliver acute stroke therapies can drastically mitigate the debilitating effects of a stroke. A population-based approach to health planning would prevent disparities in access to specialized stroke care, says new Penn Medicine research. Their evaluation of access to stroke centers in the U.S. found that even under the most optimal conditions, a large proportion of the United States population would be unable to access a comprehensive stroke center within 60 minutes. The study is published in the current issue of Neurology.
In 2003, a system of designation of stroke care centers was initiated by The Joint Commission. The tiered approach designated acute stroke-ready hospitals, primary stroke centers (PSC) and comprehensive stroke centers (CSC) in order of increasing resources and capabilities. While certification of PSCs began in 2003, certification of CSCs did not commence until 2012, and were not yet in place at the time of this research.
"We sought to demonstrate how mathematical modeling can inform the strategic development of the U.S. network of stroke centers by stimulating the conversion of PSCs into CSCs," says lead author, Michael Mullen, MD, assistant professor of Neurology at the Perelman School of Medicine at the University of Pennsylvania and director of Penn's Comprehensive Stroke Center.
Mullen and his team obtained population counts and geographic data from the 2010 Neilson-Claritas Census Estimations. Access to hospitals was calculated by ground and air transportation with the hospital that would contribute the maximal population access selected as the first CSC. Using the team's proprietary algorithm, CSCs were added in an iterative matter that would offer the greatest ground and air access for the surrounding population to a maximum of 20 CSCs.
As of December 31, 2010, there were 811 PSC-designated hospitals to which 66 percent of the U.S. population had 60 minute ground access. The team's analysis found that after the addition of up to 20 CSCs per state, 63.1% of the U.S. population would have 60 minute ground access to a CSC. And, averaging across states, the median population with 60-minute ground access to a CSC was 55.7%, but there was significant variability across states. Incorporating air ambulance transport into the model showed that median population with 60-minute ground or air access to a CSC was 85.3%, but variability across states persisted.
Their analysis also found that median ground access in the stroke belt states, including Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, and Tennessee, was worse, with a median of 32 percent of the population with 60-minute ground access versus 59 percent in non-stroke belt states.
Even with the most optimally located CSCs throughout the country, the team found that roughly one-third (37 percent) of the US population, 114 million people, would be unable to access a CSC by ground transportation within 60 minutes. Allowing for air transportation improved access, researchers report, but in one-quarter of the U.S., less than 60 percent of the population had ground OR air access to a CSC.
"Our results highlight the need for population-based planning for developing systems of care," says Mullen. "Given finite resources, it is critically important to locate CSCs in a way that maximizes population access."
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Penn Medicine analysis: One-third of Americans do not have access to stroke center within 1 hour
MEDICINE HAT, Alta. - A curfew remains in place for a southern Alberta woman convicted of murdering her parents and younger brother when she was 12.
The woman's defence lawyer asked a judge at a hearing in Medicine Hat on Tuesday to release her client from the restriction that is in effect between 11:30 p.m. and 6:00 a.m. Mondays through Thursdays.
But Justice Scott Brooker ruled to hold off on any change.
Defence council Katherin Beyak said outside court that the curfew is to be re-examined Aug. 20 once the woman has been living on her own for a few months.
"Right now there is still some supervision in the placement that she's in and she'll be moving to a situation where there won't be any supervision at all," Beyak said.
Chief Crown prosecutor Ramona Robins said the woman's case workers agree with the judge that it would be helpful to keep the curfew in place for a while longer.
"She's being moved to a more independent setting and he thought ... the curfew would assist ... to make sure that she was still complying and responsible."
Progress reports suggest the woman is at the lowest possible risk to reoffend, Robins added.
The woman can't be named under the Youth Criminal Justice Act. She was convicted as a teen along with her then-23-year-old boyfriend Jeremy Steinke of first-degree murder in the stabbing deaths of her family in their Medicine Hat home in 2006.
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Medicine Hat Woman Who Killed Family Has To Remain Under Curfew: Court
(March 5, 2015) - Gender equality has not yet been achieved in science, medicine, and engineering, but The New York Stem Cell Foundation (NYSCF), through its Initiative on Women in Science and Engineering, is committed to making sure progress is made. NYSCF convened the Inaugural Meeting of its Initiative on Women in Science and Engineering (IWISE) Working Group in February 2014, where the group put forward seven actionable strategies for advancing women in science, medicine, and engineering, and reconvened in February 2015 to further develop the strategies.
NYSCF began this initiative after an analysis of its own programs. "We found that the ratio of men and women in our own programs was OK but it could certainly be improved," said Susan L. Solomon, CEO and Co-Founder, of NYSCF. "We wanted to take action and actually make tangible progress, so we brought together many of the leading men and women who have already committed time, energy, and resources towards this problem."
Today, the recommendations were published in Cell Stem Cell. They were divided into three categories: direct financial support strategies, psychological and cultural strategies, and major collaborative and international initiatives. The group chose to highlight the most high-impact and implementable strategies from a larger list developed during the meeting. They also sought to promote promising, long-term initiatives that will require significant collaboration among multiple stakeholders with the aim of connecting potential partners.
"Advancing women in science and medicine is of critical importance to the academic and research enterprise in our country," said Dr. Marc Tessier-Lavigne, President of Rockefeller University. "This paper is important as it not only brings attention to this key issue but also outlines creative strategies that can help break down barriers to gender equality in science."
Changing financing structures, embedded cultural norms, and tying funding to gender balance to enact real change are the pillars underlying the seven strategies recommended by the Working Group.
"The brain power provided by women in science is essential to sustaining a thriving US society and economy. It is time to move beyond just lamenting its loss and embrace the actions called for in this timely report," Dr. Claire Pomeroy, President, the Lasker Foundation and a member of the IWISE Working Group.
The seven strategies include:
1) Implement flexible family care spending 2) Provide "extra hands" awards 3) Recruit gender-balanced external review committees and speaker selection committees 4) Incorporate implicit bias statements 5) Focus on education as a tool 6) Create an institutional report card for gender equality 7) Partner to expand upon existing searchable databases of women in science, medicine, and engineering
The IWISE Working Group reconvened in February 2015 to continue to work on the Institutional Report Card for Gender Equality. The paper published today includes the proposed Phase 1 Institutional Report Card, and the group plans to release the Phase 2 report card once finalized.
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Achieving gender equality in science, engineering and medicine
The most complete and trusted visual compendium of emergency medicine with 1500 full-color illustrations looks great on iPad, iPhone, and iPod Touch. No internet connection needed to view the full app. It is all ready for quick image and information retrieval. This app is easy to navigate, allowing you to browse the contents, find topics in an alphabetical index, or even search the entire app for words in the text or image captions. You also have the ability to bookmark and add notes to any chapter or image. You can also change the text size for easier reading.The Atlas of Emergency Medicine is the ultimate visual guide to the diagnosis and treatment of common and uncommon conditions encountered in the Emergency Department. Filled with 1500 crisp, clear full-color images, this essential clinical companion is logically organized by organ system and then by problem, making it a practical quick reference for medical students, residents in training, new graduates preparing for their certification exam, the practicing physician, and instructors. The Atlas of Emergency Medicine features a streamlined presentation with clear, concise text and an unmatched collection of diagnoses-speeding images. The images are accompanied by brief, high-yield descriptions of clinical problems.4 STAR DOODY'S REVIEW of the book on which this app is based:"This is an excellent study aid, especially for visual learners....This atlas is perhaps the most comprehensive source of high quality emergency medicine images available....This book is outstanding. I used it just before my in-service exam and found it a delightful way to solidify the information with images, which greatly increases the chance of recall."--Doody's Review ServiceCheck out http://www.usatinemedia.com to learn more and watch a video demo of this app narrated by Dr. Richard P. Usatine.This interactive app is based on the full content of The Atlas of Emergency Medicine, 3rd Edition by McGraw-Hill.Authors:Kevin J. Knoop. MD, MS, Director, Professional Education, Naval Medical Center, Portsmouth, VA; Assistant Professor of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MDLawrence B. Stack, MDAlan B. Storrow, MDR. Jason Thurman, MDDisclaimer: This app is intended for educational reference only. If you find yourself in an emergency situation, contact a physician.Developed by Usatine Media, LLCRichard P. Usatine, MD, Co-President, Professor of Family Medicine, Professor of Dermatology, University of Texas Health Science Center at San AntonioPeter Erickson, Co-President, Lead Software Developer
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"I'm launching a new Precision Medicine Initiative to bring us closer to curing diseases like cancer and diabetesand to give all of us access to the personalized information we need to keep ourselves and our families healthier.We can do this," said President Obamaduring the 2015 State of the Union Address.
On Friday, President Obama is expected to elaborateonthePrecision Medicine Initiative, which he first introduced during last week'sState of the Union Address. Obama will ask Congress for $215 million to help get the projectoff the ground.
Theassociate director for science at the White House Office of Science and Technology Policyexplained, "Precision medicine is about moving beyond [the] one-size-fits-all approach to medicine and, instead, taking into account people's genes, their microbiomes, their environments and their lifestyles."
If the budget is approved, right off the bat it will mainly focus on cancer research and treatment. There are four major players in the initiative which would receive that $215 million.
First, the National Institutes of Health would get the lion's share $130 millionto help create a database totrackdata of about 1 million volunteer donors.
"Now, that will of course include genomic sequencing. But it will also include things like lifestyle, things from their medical records, use of personal health devices, all sorts of things. So it's a really comprehensive project," explained a reporterfor CNBC.
$70 million would go to the National Cancer Instituteto help discover if there aregenetic factors that lead to cancer.
The Food and Drug Administration would receive $10 million to create structures to better deal with personalized medicine and fast-track breakthroughs.
Lastly, $5 million is expected to go tothe Office of the National Coordinatorfor Health Information Technology tocreate a better technological systemfor the new incentive.
At least four large pharmaceutical companies including Illumina, which heavily focuses ongenetic sequencing are expected to attend a White House event Friday where more information willbe released.
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Medical School Pathology, Chapter 8f
By: Muhammad Muammar
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Washington State University has offered written assurances to state lawmakers that training at its proposed medical school wont be limitedby partnerships with religiously affiliated hospitals.
Such concerns, raised by Rep. Gerry Pollet, D-Seattle, had briefly delayed a committee vote on a bill authorizing the medical school. Pollet said he worried WSUs proposed school model,which will rely heavily on trainingstudents inSpokane hospitals, could limit training on womens reproductive health and end-of-life care.
Rep. Gerry Pollet, D-Seattle (THE SEATTLE TIMES)
WSU has sought to put those fears to rest. In a brief letter to Rep. Marcus Riccelli, D-Spokane, the chief sponsor of the medical school bill, WSU lobbyist Chris Mulick wrote that WSU is firmly committed to ensuring its students receive the full range of training. The letter noted such training would be required in any case for the medical school to achieve accreditation.
While it is certainly possible that certain services will not be performed at certain training sites, WSU would make use of many training sites in order to ensure our students gain the required education and experience required for graduation, the letter said.
The public assurance satisfied Pollet on the point, as he dropped an amendment to insert the training assurance language in bill authorizing the new WSU medical school. Its what I wanted, Pollet said.
Nevertheless, Pollet still opposed the bill, casting the lone dissentTuesday as the House Higher Education Committee passed approved the proposal on a 12-1 vote.Pollet, whos an instructor at the UW, argued the state should delay the WSU proposal while conducting a comprehensivestudy of how to best meet the need for better access to health care across the state.
A companion bill also cleared the Senate Higher Ed. Committee Tuesday.
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WSU to lawmakers: medical school won't face religious limits
He acknowledged that having a conversation about end-of-life measures such as cardiopulmonary resuscitation, and the consequences of not receiving it, does not come easily to many people.
"I think it's difficult for families because they don't know what might happen" to a loved one in the future, he said.
But waiting to discuss those issues until they actually need to be decided can make things worse.
"I think it's extremely difficult for families, because families are often forced into this position at the worst time," Volandes said. "And I blame doctors."
Volandes doesn't exempt himself from this finger-pointing. Doctors often know the treatment and procedures they are administering to terminally ill patients are ultimately futile, costly and the source of pain and stress.
Dr. David Goodman, a Dartmouth Medical School professor, in 2013 co-authored a study published in the Journal of American Medical Association that found that while there had been an increase in the use of hospice services over the prior decade, there also had been an increase in the use of intensive care units. The study found that while more people were going to hospice, many were going there just for a few days after being in the ICU.
Goodman has cited the case of his colon cancer-stricken sister, who died while undergoing a medical procedure just a day before she was supposed to enter hospice and spend her final days there.
"Poor communication leading to unwanted care is epidemic in many health systems," Goodman said at the time the JAMA report was issued. "The patterns of care observed in this study reflect needlessly painful experiences suffered by many patients, including my sister, and other friends and family members of the research team,"
Early in Volandes' book, he writes about being a young resident and treating a 78-year-old, terminally ill lung cancer patient, a mine worker and immigrant from Ukraine whose condition left him "too confused to have a lucid conversation," and who "lacked family members to guide his decision-making."
"So his medical plan was the default for all patients: Do everything possible to keep him alive," Volandes wrote.
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A school bus carrying 11 children swerved along a central Minnesota highway and in and out of the ditch Wednesday while its driver suffered a medical condition.
The bus, traveling northbound on Hwy. 47 at 35 to 40 miles per hour, wove in and out of the right lane of the two-lane undivided highway for more than 10 minutes around 4 p.m. as an Aitkin County sheriffs deputy followed, according to a news release from the Aitkin County Sheriffs Office. None of the students, who attend school in Isle, Minn., was injured.
The deputy, who followed the bus for about 14 minutes, drove into the oncoming traffic lane a few times with her emergency lights on to warn approaching drivers, the release said. Dashcam video from the deputys car shows one motorist, who was driving toward the oncoming bus, throwing the car into reverse and then backing up into a driveway to avoid a collision. At one point, a student on the bus dialed 911 and said the driver, Scott Gilbertson, 68, of Isle, appeared to be having a medical emergency, the release said.
Students never took control of the bus, said Sheriff Scott Turner. At one point, the bus slowed down almost to a stop and its rear door opened, the release said, but then the bus drove on.
Another time, the bus careened across the southbound lane into a ditch on the left side of the road, pitched to the left at an alarming angle, and then swerved back onto the highway.
A state trooper deployed a tire deflation device just south of the town of Glen to stop the bus, according to the release. The bus slowly drove into a shallow ditch and stopped.
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The older kids comforted the younger kids and called for help, said Isle School District Superintendent Dean Kapsner. Im very proud of our students. Everything came together in a positive way that day.
Kapsner said the driver was treated and released from the hospital. The school has not yet decided if he will return to driving buses.
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School bus with 11 kids swerves along Minnesota highway as driver suffers medical condition
Liberty Suppressors H.A.T.E. Ring
This device will allow for a multitude of weapons to be mounted to the Mystic X silencer. Options are always a good thing.
By: libertycansdotnet
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Liberty Pep Band Fox28 news cast
By: krojas322
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Haciendo zeritos con mi jeep liberty en la nieve
Aprovechando la tormenta de nieve de 3-6-15.
By: Freddy Rodriguez
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2002 Jeep Liberty Used Cars St. Paul MN
http://www.crosstownauto.net This 2002 Jeep Liberty is available from Crosstown Auto. For details, call us at 651-645-7715.
By: CrosstownAuto
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Julie Goodnight: How to attach the neck rope for liberty work and bridleless riding
Want more videos from Julie Goodnight and Horse Master? Please visit the entire video and article library at http://tv.juliegoodnight.com --watch full horse training videos there and check...
By: Julie Goodnight
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Julie Goodnight: How to attach the neck rope for liberty work and bridleless riding - Video
Metal Gear Solid 2: Sons of Liberty - Part 15: Unfortunate
Spin the wheel of Fortune! This video is part of a series. Click on the following link to go to the series playlist: http://www.youtube.com/playlist?list=PLGhBhkxFasrtru2VugLBZop7w0G-o0_kA...
By: hairybones1997
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Metal Gear Solid 2: Sons of Liberty - Part 15: Unfortunate - Video
TIME GOES BY | Presentable Liberty Episode 2
You have been imprisoned without being told why. All you can hear day in day out is the faint ticking of a clock in your cell. That is, until the first of 5 fateful days begins.
By: Doodle Six
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IMG 1165 - Max Liberty
Megan Jordan Clinic - March 6, 2015.
By: Sue Evans
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