Is medicine a spiritual practice?

Spirituality and medicine have a long history in common. For much of that history for many persons and cultures today, the rupture between medicine and spirituality that characterizes Western medicine at the brink of the 21st century is a distinct anomaly. Spirituality is defined by a person's relationship with the transcendent. Only persons are capable of such relationships. The transcendent can be experienced in and through the practice of medicine, which essentially involves personal relationships with patients and always raises transcendent questions for patients and practitioners. Physicians who wish to deepen their own spiritual lives can begin to do so by intensifying their personal commitments to their own spiritual beliefs and practices, and by beginning to talk with each other about spiritual issues that arise in the practice of medicine. This will better prepare them to meet the spiritual needs of their patients.     

Can elderly people take their medicine?

This study used performance tests to assess the cognitive, visual and physical abilities related to taking medicines in the elderly population. The study population consisted of the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD II), a nationally representative interview survey. SWEOLD II is a random sample of all community-based and institutionalized persons aged 77+ in Sweden. Five tests related to medication management were administered in the direct interviews (n=492): hand function (opening bottle), vision (reading label), and medication competence (comprehension and calculation). Results showed that 9.4% could not read instructions on a medicine container and 14.6% had difficulty opening a plastic flip-top medicine bottle. The three cognitive tests related to taking medicine resulted in 30.7, 47.4 and 20.1% errors. Combining all the tests revealed that 66.3% of the sample had at least one limitation of capacity related to taking medicine. There were no significant gender differences. Among those people who did not pass all the tests, 31.8% lived alone with no home-help. Taking medicines is a complex task and a large proportion of the Swedish elderly population has cognitive, visual or physical limitations that may hinder their ability to take medicines accurately. Awareness of these limitations is essential to concordance.     

Is Lamarckian evolution relevant to medicine?

Background  

200 years have now passed since Darwin was born and scientists around the world are celebrating this important anniversary of the birth of an evolutionary visionary. However, the theories of his colleague Lamarck are treated with considerably less acclaim. These theories centre on the tendency for complexity to increase in organisms over time and the direct transmission of phenotypic traits from parents to offspring.     

Academic medicine: dream or nightmare?

Academic medicine seems under pressure. The revolutionary changes in the practice of medicine of the last decades, the continuing demands for educational reform, decreased appreciation of the medical profession, budgetary constraints, and a variety of medical ethical issues have shaken up academic medicine and interest in an academic career seems to be waning. In this paper these issues are discussed from the viewpoint of a pathologist. The present situation can also be perceived as a challenge, which offers new opportunities. Better appreciation of educational efforts, more emphasis on the intellectual rather than the technological challenges of modern medicine, reconsideration of the strong tendency for super-specialization, recognition of originality and dedication over academic hierarchy and rethinking of strategies for development of patient-oriented research are briefly discussed.     

Temptation of academic medicine: second alma mater and "shared employment' concepts as possible way out?

Apparently, in developing and in well-developed societies we are confronted with a crisis of academic medicine in all aspects: health care, teaching, and research. Health care providers in teaching hospitals are under pressure to generate revenues, academic research is pressed to keep pace with institutions devoted solely to research, and teaching is often understood not as privilege and honor but as burden and nuisance. The key problem and the principal cause of the crisis are low interest of the best young graduates to follow an academic career in a world where the benefits and values of the private sector are prevailing. Confronted with these circumstances and the continuous perils of permanent brain-drain, we developed an innovative concept of "shared employment' where two academic institutions (one in a developed and one in a developing country) will collaborate in development and support of fresh talents, building elite academic staff. Most academic exchange programs developed so far have proved to be ineffective and of poor vitality, in spite of loud exclamations, high expectations, and a huge amount of good will involved. In contrast, the suggested cooperation will be based exclusively on mutual interest and clearly defined benefits for all involved parties.