Creation Of Medical Knowledge Research Articles

Integration of Scientific Literacy Course into the Curriculum: Trakya University Medical School Experience

Aim: A good physician is expected to have competencies such as communicator, collaborator, leader, health advocate, professional and scholar besides clinical skills. A scholarrole of a physicianis associated with the application, dissemination, translation, and creation of medical knowledge and practices. The physician's ability to provide a good health service depends on having evidence-based practice and research awareness. Therefore, the medical education curriculum should have a structure that equips the physician with knowledge, skills and attitudes about scientific methods and principles.In this study, it is aimed to present the integration process of the Scientific Literacy Course, which is designed in relation to the physician's role as a scholar, into the undergraduate medical education curriculumof our faculty.Methods: In the process of restructuring a pre-graduate medical education program that meets national standards, a course called Scientific Literacy, which will enable our students to use their knowledge of science literacy, was added to the vertical corridor created in the curriculum of our faculty.The integration of the Scientific Literacy Course into the undergraduate medical education curriculum of Trakya University Faculty of Medicine was carried out in six steps using the Kern Program Development Model: "Problem Definition and General Needs Analysis", "Analysis of Participants Needs", "Goals and Objectives", "Training Strategies", "Implementation", "Evaluation and Feedback".Results: The change process that started with the Flexner Report in medical education has enabled the physician competencies to be redefined. Scholar is one of the competencies that a physician should have and provides a solid foundation for other competencies.A good physician is a physician who develops scientific knowledge and skills together with clinical practices.As a scholar, the physician must have enabling competencies such as lifelong learning, teaching, evidence-based decision making and research. In this context, it is important that the undergraduate medical education curriculum equips the physician with the knowledge, skills and attitude associated with these enabling competencies.Conclusions: The Scientific Literacy Course, which is added to the curriculum in order to support our students to develop their scientist competencies, is unique in that it is a five-year compact program that is integrated with the boards and has continuity in itself, and all faculty members serve as advisors. The extent to which the Scientific Literacy Course contributes to the development of our students' scientist competencies can be revealed through program evaluation processes.

Inquisitor as Physician: Friars, Inquisitors, Women, and Medical Knowledge in Early Colonial New Spain (1530–1650)

Abstract New Spain was the site not only of one of the largest-scale missionary enterprises in Christian history, but also of a prolonged encounter among diverse medical traditions of Mesoamerican, African, and European origin in which male missionaries were central. Given the paucity of licensed physicians in the colony, religious involvement in medical practice remained significant throughout the colonial period. This paper considers the confluence of religion and medicine in the encounters that friars and inquisitors had with women, arguing that in these encounters, missionaries and inquisitors participated in the translation, circulation, and creation of medical knowledge and positioned themselves as both theological and medical authorities, as proponents and translators of Galenic medical theory, and as “confessor-physicians” rather than “confessor-judges.” Women thus played a crucial interlocutory role in the articulation of a colonial religio-medical regime whose primary framers were not physicians, but clergymen.

Collective self-experimentation in patient-led research: How online health communities foster innovation

Researchers across academia, government, and private industry increasingly value patient-led research for its ability to produce quick results from large samples of the population. This study examines the role played by self-experimentation in the production of health data collected in these projects. We ask: How does the collaborative context of online health communities, with their ability to facilitate far-reaching collaborations over time and space, transform the practice and epistemological foundations of engaging in n = 1 experimentation? We draw from a digital ethnography of an online patient-led research movement, in which participants engage in self-experiments to develop a protocol for using psilocybe-containing mushrooms as a treatment for cluster headache, an excruciating neurological disease for which there is little medical research and huge unmet treatment need. We find that the collectivizing features of the internet have collectivized self-experimentation. Group dynamics shape everything in “collective self-experimentation,” from individual choices of intervention, reporting of outcomes, data analysis, determinations of efficacy, to embodiment. This study raises important questions about the role that individuals play in the creation of medical knowledge and the data that informs crowdsourced research.

Network Dynamics and Communities in Applied Biomedical Research

We investigate the emergence and structuration of the research on prion. Resorting to bibliometric data and tools from social network analysis, we look at the progressive appearance of a dense social network of researchers working on prion. We suggest that the relevant unit of analysis of medical knowledge creation is the community. We then detail how isolated communities emerge and connect to one another to produce a connected network. We then investigate the link creation dynamics to understand the collaboration patterns that the emergence of the observed macro-structures explains at a micro-level, showing that these micro-dynamics evolve over time as the field matures. JEL Codes: O31, O33, D8

Balint work and the creation of medical knowledge.

Michael Balint's pioneering work in primary care was not simply the application of psychodynamic theory to the complex problems and relationships encountered by clinicians. Rather, Balint's work was part of a wider conversation in Western epistemology that had already begun to break down the enlightenment rationalist agenda. Since the time of Descartes, we sought to find certain truth through decontextualizing and abstracting problems, and through separation of the observer from the thing observed, with a focus on finding universal timeless laws that could be generalized. By the mid-1950s, it was clear that this agenda was insufficient to answer important questions about what it means to be human and to live a healthy and happy life. Balint's experiment was a return to a method of knowledge creation that is case based, narrative, local, timely, particular, and especially considers specific contexts for finding solutions to problems. For current healthcare reform efforts to be effective, we must include Balint's focus on the context of the doctor, patient, and their relationship, as well as development of practical wisdom (i.e. Aristotelian phronesis) that we know in medicine as professional judgment. The case study method of the Balint group is one of the few and best formal methods to teach and practice this way of knowing.

Reconciliation of SNOMED CT and domain clinical model for interoperable medical knowledge creation.

Use of heterogeneous data models in hospital information systems (HIS), obstructs the integration of clinical decision support system (CDSS) with clinical workflows. The diverse concepts diminish the interoperability level among the CDSS knowledge bases and data models of HIS. Standard terminology utilization in knowledge acquisition and its reconciliation with HIS data models are the candidate solution to overcome the interoperability barrier. We propose a reconciliation model to map concepts of diverse domain clinical models (DCM) with the standard terminology. In the proposed model, the implicit and explicit semantics are complemented to the word set of the targeted DCM concepts. The inclusion of semantics, mapped the DCM concepts to the SNOMED CT concepts with high accuracy. The results showed that the system correctly mapped 95% of concepts of DCM with standard terminology SNOMED CT concepts.

A web-based knowledge management system integrating Western and Traditional Chinese Medicine for relational medical diagnosis.

This article presents the design of a web-based knowledge management system as a training and research tool for the exploration of key relationships between Western and Traditional Chinese Medicine, in order to facilitate relational medical diagnosis integrating these mainstream healing modalities. The main goal of this system is to facilitate decision-making processes, while developing skills and creating new medical knowledge. Traditional Chinese Medicine can be considered as an ancient relational knowledge-based approach, focusing on balancing interrelated human functions to reach a healthy state. Western Medicine focuses on specialties and body systems and has achieved advanced methods to evaluate the impact of a health disorder on the body functions. Identifying key relationships between Traditional Chinese and Western Medicine opens new approaches for health care practices and can increase the understanding of human medical conditions. Our knowledge management system was designed from initial datasets of symptoms, known diagnosis and treatments, collected from both medicines. The datasets were subjected to process-oriented analysis, hierarchical knowledge representation and relational database interconnection. Web technology was implemented to develop a user-friendly interface, for easy navigation, training and research. Our system was prototyped with a case study on chronic prostatitis. This trial presented the system's capability for users to learn the correlation approach, connecting knowledge in Western and Traditional Chinese Medicine by querying the database, mapping validated medical information, accessing complementary information from official sites, and creating new knowledge as part of the learning process. By addressing the challenging tasks of data acquisition and modeling, organization, storage and transfer, the proposed web-based knowledge management system is presented as a tool for users in medical training and research to explore, learn and update relational information for the practice of integrated medical diagnosis. This proposal in education has the potential to enable further creation of medical knowledge from both Traditional Chinese and Western Medicine for improved care providing. The presented system positively improves the information visualization, learning process and knowledge sharing, for training and development of new skills for diagnosis and treatment, and a better understanding of medical diseases.

Miners, silica and disability: The bi-national interplay between South Africa and the United Kingdom, c1900-1930s.

This paper investigates silicosis as a disabling disease in underground mining in the United Kingdom (UK) before Second World War, exploring the important connections between South Africa and the UK and examining some of the issues raised at the 1930 International Labour Office Conference on silicosis in Johannesburg in a British context. The evidence suggests there were significant paradoxes and much contestation in medical knowledge creation, advocacy, and policy-making relating to this occupational disease. It is argued here that whilst there was an international exchange of scientific knowledge on silicosis in the early decades of the twentieth century, it was insufficient to challenge the traditional defense adopted by the British government of proven beyond all scientific doubt before effective intervention in coal mining. This circumspect approach reflected dominant business interests and despite relatively robust trade union campaigning and eventual reform, the outcome was an accumulative legacy of respiratory disease and disability that blighted coalfield communities.

Another person's poison: a history of food allergy

To some, food allergies seem like fabricated cries for attention. For others, they pose a dangerous health threat. Food allergies are bound up with so many personal and ideological concerns that it is difficult to determine what is medical and what is myth. This book parses the political, economic, cultural, and genuine health factors of a phenomenon that now dominates our interactions with others and our understanding of ourselves. Surveying the history of food allergy from ancient times to the present, Another Person's Poison also gives readers a clear grasp of new medical findings on allergies and what they say about our environment, our immune system, and the nature of the food we consume. For most of the twentieth century, food allergies were considered a fad or junk science. While many physicians and clinicians argued that certain foods could cause a range of chronic problems, from asthma and eczema to migraines and hyperactivity, others believed that allergies were psychosomatic. Another Person's Poison traces the trajectory of this debate and its effect on public-health policy and the production, manufacture, and consumption of food. Are rising allergy rates purely the result of effective lobbying and a booming industry built on self-diagnosis and expensive remedies? Or should physicians become more flexible in their approach to food allergies and more careful in their diagnoses? Exploring the issue from scientific, political, economic, social, and patient-centered perspectives, this book is the first to engage fully with the history of what is now a major modern affliction, illuminating society's troubled relationship with food, disease, and the creation of medical knowledge.

Patient Data as Medical Facts: Social Media Practices as a Foundation for Medical Knowledge Creation

This paper investigates a web-based, medical research network that relies on patient self-reporting to collect and analyze data on the health status of patients, mostly suffering from severe conditions. The network organizes patient participation in ways that break with the strong expert culture of medical research. Patient data entry is largely unsupervised. It relies on a data architecture that encodes medical knowledge and medical categories, yet remains open to capturing details of patient life that have as a rule remained outside the purview of medical research. The network thus casts the pursuit of medical knowledge in a web-based context, marked by the pivotal importance of patient experience captured in the form of patient data. The originality of the network owes much to the innovative amalgamation of networking and computational functionalities built into a potent social media platform. The arrangements the network epitomizes could be seen as a harbinger of new models of organizing medical knowledge creation and medical work in the digital age, and a complement or alternative to established models of medical research.

An Audit of Emergency Department Accreditation Based on Joint Commission International Standards (JCI).

Despite thousands of years from creation of medical knowledge, it not much passes from founding the health care systems. Accreditation is an effective mechanism for performance evaluation, quality enhancement, and the safety of health care systems. This study was conducted to assess the results of emergency department (ED) accreditation in Shohadaye Tajrish Hospital, Tehran, Iran, 2013 in terms of domesticated standards of joint commission international (JCI) standards. This cohort study with a four-month follow up was conducted in the ED of Shohadaye Tajrish Hospital in 2013. The standard evaluation checklist of Iran hospitals (based on JCI standards) included 24 heading and 337 subheading was used for this purpose. The effective possible causes of weak spots were found and their solutions considered. After correction, assessment of accreditation were repeated again. Finally, the achieved results of two periods were analyzed using SPSS version 20. Quality improvement, admission in department and patient assessment, competency and capability test for staffs, collection and analysis of data, training of patients, and facilities had the score of below 50%. The mean of total score for accreditation in ED in the first period was 60.4±30.15 percent and in the second period 68.9±22.9 (p=0.005). Strategic plans, head of department, head nurse, resident physician, responsible nurse for the shift, and personnel file achieved the score of 100%. Of total headings below 50% in the first period just in two cases, collection and analysis of data with growth of 40% as well as competency and capability test for staffs with growth of 17%, were reached to more than 50%. Based on findings of the present study, the ED of Shohadaye Tajrish hospital reached the score of below 50% in six heading of quality improvement, admission in department and patient assessment, competency and capability test for staffs, collection and analysis of data, training of patients, and facilities. While, the given score in strategic plans, head of department, head nurse, resident physician, responsible nurse for the shifts, and personnel file was 100%.

Munchausen Syndrome by Proxy: problems of definition, diagnosis and treatment

Munchausen Syndrome by Proxy (MSbP) is a form of child abuse in which the abuser, usually the mother, fabricates or induces illness in another, usually a child, in order to present the child to the medical establishment for unnecessary examination. Since 1977, when the term was first used in Britain by Meadow, an extensive literature has evolved around the concept, describing cases, delineating indicators and perpetrators characteristics, and recommending strategies for management. While the technicalities of diagnosis have attracted some criticism, there has been much less debate about the validity of the concept itself. This paper raises certain problems associated with the conceptual validity of MSbP, outlines some concerns of current research and puts forward an alternative research programme in order that the concept be understood from the point of view of the suspected abuser and in the wider context of the creation of medical knowledge and sociocultural factors.

The creation of medical knowledge: Some problems in interpretation

The anthropologist's discourse on medicine depends on a satisfactory understanding of medical knowledge. This means recognizing that: (a) an actor does not know all of his medical facts in the same way; (b) his medical knowledge is recursive: and (c) this knowledge needs to be viewed in terms of the processes by which it is produced rather than in terms of its structure. When processual and structural views of medical knowledge are compared, the latter are found to either bracket out important emotional and ideological determinants, or to trivialize them. Scientific processes for producing medical knowledge can be distinguished from non-scientific ones. But in both cases medical facts are socially constructed. This view of medical science is at odds with empiricist versions. The latter ignore the social determinants of scientific knowledge and, as a consequence of this position, legitimize a technology-centered and theory-centered view of non-Western medicine.