Beyond a shadow of a doubt? Experts, lay knowledge, and the role of radiography in the diagnosis of silicosis in Britain, c. 1919-1945

The history of silicosis provides an important chapter in the history of occupational and environmental health. Recent historical scholarship has drawn attention to the importance of patient attitudes, popular protests, and compensation claims in the formation of a "lay epidemiology" of such a disease, frequently challenging the scientific orthodoxies devised by large corporations and medical specialists. Surprisingly little research has been undertaken on the United Kingdom, which provided much of the early expertise and medical research in respiratory diseases among industrial workers. This article examines the introduction of a particular technique, x-radiography, and its use by radiologists and others in debates on the causes and consequences of silica inhalation by the laboring population in Britain during the early decades of the twentieth century. In contrast to some recent interpretations, and also to the narrative of progress that practitioner historians have developed since the 1940s, this article suggests that the use of this technology was contested for much of this period and the interpretation of X-rays remained disputed and uncertain into the 1950s. The article also questions recent accounts of lay epidemiology as an adequate model for understanding the progress of such innovations in medical history.     

Reliability of personality and values tests: The effects of “high stakes” selection conditions,and of four years in medical school

This study investigated if scores on tests of personal qualities are affected by whether they will determine selection decisions (“high stakes”) or not; and whether they are stable for individuals and groups across a four-year medical course. Two tests, one assessing values and one assessing components of personality, were administered either at the same time as a medical university entrance exam (first cohort; N?=?216), or after entry was confirmed (second cohort; N?=?142). Both cohorts took the tests again after four years of medical school. Analysis of variance was used to compare group mean scores and interactions, and correlation coefficients to measure temporal reliability. The high stakes cohort initially presented themselves in a significantly more positive light on the personality test. After four years of medical school scores on both tests changed significantly, towards more communitarian values and less empathic attitudes. Thus, personality scores were affected by both the conditions under which the initial tests were conducted and by the passage of time, but values only by the passage of time. Before and after scores were significantly correlated.     

Psychiatry,Sex, and Science: The Making of “Adolescent” Motherhood in Southern Brazil

ABSTRACT

Research linking teen motherhood to psychoneurodevelopmental causes and pathologies has proliferated in the past two decades. In Brazil, a psychodevelopmental project of teen motherhood has gained traction despite many experts’ long-standing commitment to psychodynamic psychiatry and social epidemiology, generating epistemic tension rather than substitution. Drawing on historical ethnography conducted in Southern Brazil, I explore how this project materialized through the co-production of epistemic struggles, remedial interventions, and ontological politics. In showing how this co-production became interwoven with incremental changes in young women’s emotions, sexualities, relationships, and bodies, I describe how one particular “kind” of teen motherhood emerged and became entangled with both psychiatric knowledge-production and the angst of working-class political agency. In giving women a contested psychiatric language with which to rework their social–moral worlds, I argue that science did more than conceptualize teen childbearing in pathological terms; it contributed to its troubled transformation.     

First do no harm? Female hysteria, trauma, and the (bio)logic of violence in Iraq

In Iraq, women are frequently rushed to the hospital in severe anxiety, diagnosed by medical professionals in local hospitals as "hysterical." The treatments proffered are often disturbingly violent in their own right, indicating the normalization of violence in the conflict zone and the rationalizing discourses of biomedicine to this end. Based on fieldwork in the northern Kurdish region, held to be a prosperous beacon of "postconflict" stability in an otherwise war-torn country, I consider the ways in which neoliberal interventionist agendas, medical technologies in the aftermath of war, and gendered narratives of the Kurdish nation coalesce to valorize particular forms of suffering while devaluing others as both inherently "feminine" and devoid of either agency or recuperative value. I argue that the violence of such biomedical beliefs forms a "natural" rationalized corollary of wider logics of violence in the war zone, and that both inscribe non-normative expressions of trauma in gendered terms.     

Can Clinical Empathy Survive? Distress,Burnout, and Malignant Duty in the Age of Covid‐19

The Covid‐19 crisis has accelerated a trend toward burnout in health care workers, making starkly clear that burnout is especially likely when providing health care is not only stressful and sad but emotionally alienating; in such situations, there is no mental space for clinicians to experience authentic clinical empathy. Engaged curiosity toward each patient is a source of meaning and connection for health care providers, and it protects against sympathetic distress and burnout. In a prolonged crisis like Covid‐19, clinicians provide care out of a sense of duty, especially the duty of nonabandonment. We argue that when duty alone is relied on too heavily, with fear and frustration continually suppressed, the risk of burnout is dramatically increased. Even before Covid‐19, clinicians often worked under dehumanizing and unjust conditions, and rates of burnout were 50 percent for physicians and 33 percent for nurses. The Covid‐19 intensification of burnout can serve as a wake‐up call that the structure of health care needs to be improved if we are to prevent the loss of a whole generation of empathic clinicians.     

Undergraduate medical students’ perspectives of skills,uses and preferences of information technology in medical education: A cross-sectional study in a Saudi Medical College

Abstract

Background: Information technology (IT) is widely used in medical education. However, there are not enough studies about IT uses and preferences among traditional and problem-based learning (PBL) medical students.

Aim: To compare IT skills, uses and preferences for education between traditional and PBL medical students’.

Method: A cross-sectional study; a modified Educause Center for Analysis and Research online survey was sent to traditional curriculum 5th and PBL 4th year medical students of King Saud University.

Results: Most of the responding 176 students prefer mobile devices and moderate amount of IT in education. Fourth and fifth year students perceived high academic value of Google (94.2 vs. 86.7%, p?=?0.34), YouTube (90.7 vs. 92.2%, p?=?0.83) and PubMed (83.7 vs. 86.7%, p?=?0.06). More 4th year than 5th year students rated themselves as skilled in learning management system (54.7 vs. 21.1%, p?=?0.0001) and Smartboard use (40.7 vs. 23.3%, p?=?0.04). Most students rated faculty IT skills as effective. Students agreed that technology helps working faster (95.5%) and make learning creative (85.9%).

Conclusions: More integration of information literacy and IT training in medical curricula is needed to enhance better utilization of full features of IT resources available for learning and problem solving. National multi-institutional studies are recommended.     

Lectures in problem-based learning--why, when and how? An example of interactive lecturing that stimulates meaningful learning

Even though opinions differ as to whether lecturing is compatible with problem-based learning (PBL) or not, lectures are still a common form of instruction in PBL curricula. This paper discusses the lecture in the framework of theories of learning in general and the medical problem-based learning tradition in particular. An example of how theories of learning can be implemented in the lecture hall is presented. Theories that underpin PBL as an educational philosophy rather than as a method of instruction are reviewed. A lecture form, organized in introductory, in depth and application lectures, that responds to important factors for stimulating deep processing of knowledge and meaningful learning is discussed. Examples of and practical points about how to renew and restructure lectures in a way that counteracts surface approaches to learning, teacher centering and student passivity are presented. We argue that, with proper awareness of possible drawbacks of the large format, lectures can be used as valuable tools for learning also in a PBL curriculum.     

Social representations of human papillomavirus in Bogotá, Colombia

Identifying DNA of Human papillomavirus (HPV) has been proposed as a new screening method for cervical cancer control. Conventionally, health education for screening programs is based on scientific information without considering any community cognitive processes. We examine HPV social representations of 124 men and women from diverse educational status living in Bogotá, Colombia. The social representation of HPV involves a series of figurative nuclei derived from meanings linked to scientific information. While women focused on symbols associated to contagion, men focused on its venereal character. Figurative nuclei also included long-term uncertainty, need or urgent treatment, and feelings of imminent death associated with cancer and chronic sexually transmitted infections. The social representation of HPV impeded many participants from clearly understanding written information about HPV transmission, clearance, and cancer risk; they are built into a framework of values, which must be deconstructed to allow women full participation in HPV screening programs.     

What is human in humans? Responses from biology, anthropology, and philosophy

Genomics has brought biology, medicine, agriculture, psychology, anthropology, and even philosophy to a new threshold. In this new context, the question about "what is human in humans" may end up being answered by geneticists, specialists of technoscience, and owners of biotech companies. The author defends, in this article, the idea that humanity is at risk in our age of genetic engineering, biotechnologies, and market-geared genetic research; he also argues that the values at the very core of our postgenomic era bring to its peak the science-based ideology that has developed since the time of Galileo, Newton, Descartes, and Harvey; finally, it shows that the bioindustry has invented a new genomythology that goes against the scientific evidence produced by the research in human sciences in which life is interpreted as a language.     

See one, do one, teach one--is this still how it works? A comparison of the medical and nursing professions in the teaching of practical procedures

A survey of 80 junior doctors and nurses was performed to compare the methods of teaching medical and nursing students in eight common practical procedures. Nurses were more likely to have received formal teaching and to be supervised when first performing a procedure. Some 42% percent of doctors felt inadequately trained to carry out a practical procedure safely when performing it alone for the first time compared with 7% of nurses. This study confirms that much of the training of doctors in practical procedures is still received on an informal basis, compared with that of nurses. It also reveals that many doctors view this training as insufficient.     

The art of presenting – Failures,fonts and the future

Many of you, like me, will have given countless presentations throughout your career and to wide and varied audiences. I too, like many of you, have never been formally taught how to present, if that is such a thing. So, I got to thinking: in any case, who are “expert presenter” teachers? Some people have it and some people do not – right? In this short piece, I explore what it is to present, how this evolves, and try to pin down the why rather than the how and give you a little insight into my haphazard journey along this process.     

The Pain and Pride of ‘Angel Mothers’: Disappointments and Desires Around Reproductive Loss in Romania

ABSTRACT

In this article, I highlight how Romanian women make sense of the losses of pregnancies and babies. Based on 15 months of fieldwork in a Transylvanian town, and on interviews with and observations among ‘angel mothers’ (women who have lost unborn or live-born children) in the Romanian capital Bucharest, I discuss the disappointments and desires that surface when reproduction goes awry. The criticisms of these ‘angel mothers’ throw into sharp relief wider disappointments with biomedical, political, and religious establishments, and continuing social struggles in postcommunist Romania. Although women’s personal predicaments are thus deeply connected to broader structural shortcomings, their coping strategies are highly intimate and nonpolitical. Women focus on creating a spiritual bond between themselves and their lost babies—one that transcends the hardships of earthly life and makes women proud to be the mothers of little angels.     

Beginning, formative power and intellect agent of Nicolò Leoniceno between the Arabic-Latin tradition and the rebirth of the Greek commentators

The treatise On Formative Power (Venice, 1506) of Ferrara's emblematic medical humanist, Nicolò Leoniceno (1428-1524), is the one of the first embryological monographs of the Renaissance. It shows, at the same time, the continuity of medieval Arabo-Latin tradition and the new elements brought by Renaissance medical humanism, namely through the use of the ancient Greek commentators of Aristotle like Simplicius. Thus this treatise stands at the crossroad of these two currents. The present study analyses the range of Leoniceno's philosophical discussion, determines its exact sources and brings to light premises for the early modern development of the concept of formative force, which will end up in the theory of "plastic nature" at the heart of the Scientific Revolution.     

Criticism of authority in the writings of Moses Maimonides and Fakhr Al-Dīn Al-Rāzī

Criticism of authority was a prominent feature of medieval philosophical writing. In this study the critiques of two contemporaneous scholars, Moses Maimonides and Fakhr al-Dīn al-Rāzī, are compared. Maimonides criticized Hellenistic authorities, mainly Aritotle. However, the starting point for his critique was Aristotle's admission of the limitations of his own inquiries. Maimonides admired Aristotle's questioning of his own conclusions, indeed, his own thought was characterized by constant selfdoubt. Al-Rāzī criticized an earlier Muslim scholar, Ibn Sinā (Avicenna), an intellectual giant whose imprint was strongly felt in philosophy and medicine. Al Rāzī used his commentaries on a number of Ibn Sīnā's books as a stage for criticizing the master and for arguing for his own, alternative viewpoints.