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Hypertext and hypermedia are important new methods of learning and instruction for the health sciences. Articles cited in this bibliography deal with the creation, development, and implementation of hypertext/hypermedia programs in both academic and clinical environments.
When a lizard loses its tail, a new caudal appendage soon grows to replace the one that is missing. But when a human loses a kidney, severs a peripheral nerve or worse, the spinal cord, that organ is lost forever. Such at least is conventional thinking. But imagine that the victim of an industrial accident with a paralyzed hand could achieve new levels of function by inducing axonal regrowth through a synthetic nerve guidance channel; or that a Parkinsonian patient's symptoms could be relieved by implanting in his brain neural tissue encased in a selectively permeable polymer envelope; or that the inexorable progression of the vascular complications of juvenile diabetes could be stopped, even reversed, by a membrane-protected xenograft of insulin-producing tissue. This is the dream of bionic organ science. It is predicated on two lines of technological achievement: the availability of ultra-thin, biocompatible, selectively permeable polymer membranes which can protect a transplant against immune rejection while allowing solute exchange between the graft and its environment; and the synthesis of novel materials, some biostable, some bioresorbable, which can serve as scaffolding or anchor for tissue regrowth in the geometrically and chemically controlled environment of an implant. The fabrication, growth and survival of composites of living tissues with synthetic polymers, often enhanced by the incorporation of specific cell growth factors or inhibitors, has been demonstrated at the tissue culture level, and extended in vivo to experimental models of human endocrine deficiency or neurological defects. The key to progress with bioartificial organs is the confluence of knowledge ranging from materials science to cell and molecular biology to experimental surgery. Obstacles to clinical implementation of this new therapeutic concept include: large scale procurement of specific tissue structures or isolated postmitotic cells from animal sources; demonstration of safety and efficacy of spontaneously occurring, bioactive tumor cell lines; verification of long-term stability and bio-acceptance of polymer implants; and industrialization of the fabrication process to meet quality control, shelf-life and commercial distribution requirements.(ABSTRACT TRUNCATED AT 400 WORDS)
The professional training of the medical illustration student has been a subject of controvery for the last few years. Curricula of the schools accredited by the Association of Medical Illustrators have, to varying degrees, undergone change due to new demands on the practicing illustrator. The curriculum in Biomedical Illustration at The University of Texas Health Science Center at Dallas attempts to balance time-proven courses with contemporary problem-solving approaches to the training of the medical illustrator. This paper reflects the history, philosophy and methods of implementation of the course of study leading to the M.A. degree in Biomedical Communication at the University of Texas Health Science Center at Dallas.
A description of an open system, distributed computing environment for the Biological Sciences is presented. This system utilizes a transparent interface in a computer network using NCS to implement an application system for molecular biologists to perform various processing activities from their local workstation. This system accepts requests for the services of a remote database server, located across the network, to perform all of the database searches needed to support the activities of the user. This database access is totally transparent to the user of the system and it appears, to the user, that all activities are being carried out on the local workstation. This system is a prototype for a much more extensive system being built to support the research efforts in the Biological Sciences at UMC.
The design and implementation of an experimental MEDLINE module at Case Western Reserve University School of Library Science is described. The module places MEDLINE within the context of multiple data bases and networking operations andis embedded in a course in health science communications. The module consists of eight weeks of lectures, demonstrations, videotapes, and exercises on terminals.
Although the quality circle (QC) process has been used in health care, there is a conspicuous gap in the literature about its use in community health nursing. The purpose of this service/education project was to implement QCs in the public health nursing sector throughout a southern central state. The major objective was to provide QC training to approximately 250 supervisors and staff nurses so that this participative group problem-solving approach might be used as a systematic method of dealing with concerns related to quality of care. Evaluation tools, such as the Science Research Associates' attitude scale and the quality management maturity index, were used to determine whether or not the implementation of the QC program influenced the level of morale and quality management maturity. The data obtained reflected positive changes and favorable supervisory responses.
This program can be implemented as either a preventative program or a rehabilitative program for the upper extremity in the throwing athlete or in nonthrowing athletes involved in overhead activities. The authors have found this program to be easily employed in a university setting. The keystone to its effectiveness is the participating individual. For optimal results, it should be performed as specifically outlined. The likelihood that shoulder symptomatology will develop is higher now that more people are participating in recreational and team sports for cardiovascular fitness. It is, therefore, imperative that a preventative program be developed in both the recreational and professional athletic population.
Accurate estimation of the Post-Mortem Interval (PMI) and Post-Mortem Submersion Interval (PMSI) remains a persistent challenge in forensic science, especially when traditional morphological and entomological methods fail due to advanced decomposition or in aquatic environments. Proteomic profiling of bone tissues has recently emerged as a promising approach, leveraging the predictable degradation patterns of bone proteins to estimate time since death more reliably. This systematic review, conducted in accordance with PRISMA guidelines, analyzed 24 peer-reviewed studies focusing on the application of proteomic techniques to bone tissue for PMI and PMSI estimation. The included studies were evaluated based on sample type, analytical techniques used, identified biomarkers, environmental conditions assessed, and the overall reliability and reproducibility of the findings. The review found that specific bone proteins, particularly collagen, osteocalcin, fetuin-A, etc. exhibited consistent degradation patterns that correlated strongly with elapsed post-mortem time. Cortical bone was identified as a more stable and informative matrix compared to trabecular bone. Mass spectrometry, especially LC-MS/MS, emerged as the predominant analytical technique due to its high sensitivity and accuracy in detecting low-abundance proteins over extended PMIs and PMSIs. However, protein degradation rates were significantly influenced by environmental variables such as temperature, humidity, soil pH, and microbial activity. This review also emphasizes the transformative role of bone proteomics in advancing forensic science while identifying key gaps that must be addressed to achieve global standardization and practical implementation in diverse forensic contexts. The integration of proteomics with other emerging technologies, such as machine learning algorithms and computational modeling, may further enhance the precision of PMI and PMSI estimation in future applications.
This article has examined the role of the nurse in clinical trials, particularly the clinical, administrative, and research roles. Components of each role and characteristics essential for the implementation of each role have been examined. The nursing role in clinical trials research is undergoing major transformation from the perception of the nurse as a data collector for medical research to the recognition of the nurse as an essential member of the research team with a multifaceted role. Miaskowski identifies two factors influencing the development of oncology nursing practice; scientific and technological advances and societal factors relating to the perception of cancer as a disease and changes in the nursing profession. Certainly it is recognized that progress in basic science research will lead to an increase in the complexity and number of clinical trials. Nurses have clearly implemented the roles necessary to be vital participants and have contributed to answering questions leading to improved treatments for the patients with cancer.
Major health care problems such as patient dissatisfaction, inequity of access to care, and spiraling costs no longer seem amenable to traditional biomedical solutions. Concepts derived from anthropologic and cross-cultural research may provide an alternative framework for identifying issues that require resolution. A limited set of such concepts is described as illustrated, including a fundamental distinction between disease and illness, and the notion of the cultural construction of clinical reality. These social science concepts can be developed into clinical strategies with direct application in practice and teaching. One such strategy is outlined as an example of a clinical social science capable of translating concepts from cultural anthropology into clinical language for practical application. The implementation of this approach in medical teaching and practice requires more support, both curricular and financial.
In order to focus attention on education, the University of Texas Medical Branch at Galveston adopted a system of internal review. The process was initially conducted for courses in the basic sciences by an ad hoc dean's committee consisting of representatives from the teaching faculty, administration, and student body as well as experts in medical education. As a consequence of the experience with the review of the basic science courses, the internal review process was applied to the clinical science courses and the elective programs at UTMB. The activities of the internal review process have resulted in improvements in instructional procedures and structural changes in the medical school's approach to educational planning, implementation, and evaluation.
This paper presents four aspects of health professions education at McMaster University: (1) a review of the key elements of the history and distinctive approach of the Doctor of Medicine (M.D.) program; (2) a description of the process and substance of curriculum change over the past decade, focusing on a major revision of the M.D. program that began in 1983; (3) a summary of the findings of follow-up studies of McMaster M.D. program graduates; and (4) an analysis of the current context within which the Faculty of Health Sciences (of which the M.D. program is a part) is operating and a description of strategies for renewal that are being implemented. The evidence and experience to date support the assertion that satisfactory--and in some ways special--physicians can be prepared using the "McMaster approach" to medical education, but that continuous review and periodic major revisions of the educational program are both necessary and possible; they must occur in concert with developments in other sectors of Faculty of Health Sciences activities.
An Image Management and Communications System for digital dentomaxillofacial radiology is under development at the Department of Dental Diagnostic Science at the University of Texas Health Science Center at San Antonio, Texas, USA. In its final stage, the system will provide a method of integrating different direct digital image acquisition modalities such as intraoral, panoramic and extraoral radiography. A review of the design criteria necessary for establishing such a system for clinical dentistry is discussed and the first phase of its implementation described.
This paper describes the conceptualization, development, planning, and implementation of a new professional preparation course entitled "AIDS/HIV Education: Issues and Strategies." The 15-week, campuswide course was offered through the Dept. of Health Science Education at the University of Florida during spring semester 1990. Though universities have been identified as providers of preservice education for future teachers and health professionals, current activities often have been deemed inadequate to meet the needs of those charged with providing AIDS/HIV education. This course was implemented to address an array of issues related to HIV education, ranging from epidemiological and biomedical information and educational strategies to examination of personal and ethical issues surrounding the disease. Delivery of a successful course and student reaction are discussed, along with recommendations for programs considering similar educational efforts. A detailed planned information packet is available from the authors.
The development of behavioral science in a family practice residency has first to be structured around a statement of purpose and adequate goals. These goals can only be implemented when the purely custodial function of the medical profession is rejected and the ethical responsiblity of the physician to society is allowed to direct the role innovations that must be incorporated. It is the person of the physician as a diagnostic and therapeutic tool that must be cultivated. The curriculum presented has included behavioral science conferences, a one-month behavioral science rotation, a two-month orientation program, behavioral science clinical attendings, and a personal counseling program for each resident throughout the three years of training. To be complete, such a program requires the further refinement of behavioral objectives that allow reliable evaluation and redefinition by residents and faculty.
Behavioral scientists on the faculty of the Johns Hopkins University Health Associate Program work in teams with medical preceptors in the clinical education and supervision of students during their first year of training. The rationale, objectives, and methods of implementation for this aspect of the program are discussed. This approach answers current concerns that relevant behavioral science content must be integrated into clinical training, and it appears to be useful at all levels of medical education.
The experience from the first four years of a longitudinal study on interrelations between nutrition, parasitic infections, immunity and environmental factors in a rural community, Kikwawila village (southeastern Tanzania) is reviewed. Two elements supported the implementation of the project. Firstly, the multidisciplinary approach with surveys across a range of biomedical and agricultural science disciplines has enabled the elucidation of part of the complexity of the mutually reinforcing, changing interrelations which can affect child health. Secondly, the primary health care component based on village health workers which paralleled the research project has facilitated the longitudinal character of the study and has triggered some community participation. The studies also indicated that the indigenous perceptions of disease, signs and symptoms may be used as an integrative tool to monitor health care programmes. Already during an initial stage of a project, the indigenous health perspectives could become indicators for community participation and could help to determine the strategy of applied research and control measures within primary health care.
Under the auspices of the Council for International Organizations of Medical Sciences, a working group composed of representatives of seven multinational pharmaceutical manufacturers and six regulatory authorities developed and implemented a standardized method for reporting post-approval adverse drug reactions (ADR). The method is based on a set of uniform definitions and procedures and a single reporting form, and has been demonstrated to be feasible and effective. Regulators and manufacturers, in establishing requirements and systems for reporting of adverse drug reactions, should consider adopting this method.