Social Aspects Of Medicine Research Articles

Come Roll with Me: Integrating Disability Awareness and Interprofessional Learning into a Medical Musculoskeletal Course

One in four Americans are affected by a disability making people with disabilities (PWD) the largest minority group in the United States. PWD experience a variety of social, economic and structural barriers that limit access to medical care and create significant health care disparities. While PWD visit health care providers at a higher frequency than those without disabilities, half of U.S. medical schools lack a disability awareness program, and 58% of medical school deans reported that a curriculum for patients with disabilities was not a high priority. These factors have led to a sense of unpreparedness amongst medical students in providing care for this population. In order to address these deficiencies, a new educational activity, Come Roll with Me (CRWM), was integrated into the Musculoskeletal & Skin course within a Southeastern allopathic medical school in 2021. Authors hypothesized that CRWM would increase disability awareness amongst medical students and enhance attitudes towards interprofessional practice. Come Roll with Me paired PWD, specifically power and manual wheelchair users, with small groups of second‐year medical and Doctor of Physical Therapy (DPT) students for a two‐hour session. Groups rotated through four stations including (1) a self‐propelled wheelchair course within the students’ educational building, (2) a discussion about accessible parking and transportation at the wheelchair users’ vehicles, (3) a skill‐development session on transfers taught by DPT students, and (4) an open dialog regarding barriers to healthcare experienced by PWD. Come Roll with Me was assessed via course evaluations and student reflection essays. Additionally, students were invited to complete the Interprofessional Attitudes Scale (IPAS) before and after the course. The study was approved by the UAB Institutional Review Board. CRWM was the highest rated instructional session in the Musculoskeletal and Skin course with a mean Likert‐scale score of 4.59/5.0 (N=109). Thematic analysis of reflection essays revealed newfound awareness of difficulties navigating a building in a wheelchair and lack of accessibility in doors, bathrooms, etc. Students expressed increased comfort in engaging with PWD and a desire for advocacy on their part. Medical students’ attitudes towards interprofessional collaborative practice improved with significant increases in the mean Teamwork, Roles, Responsibilities (39.3 vs. 42.0) and Interprofessional Biases (8.5 vs. 8.9) IPAS subscales (p<0.01). Come Roll with Me represents a novel interprofessional and patient‐centered method of embedding disability awareness and health care disparities within the preclinical medical curriculum. Integration of the basic sciences with patient encounters and social aspects of medicine are essential in the training of physicians who are competent to care for a diverse patient population.

Pathological laughing and psychotic disorder: the medical evaluation of the Joker

In the psychological thriller film Joker, released in 2019 and starring Joaquin Phoenix in the first role, another possible origin story for this iconic character is reported. Above all, it brings us medical elements for the understanding of the development of this complex character. Contrary to other interpretations, we discover a lonely, timid and uncharismatic man (Arthur Fleck). He seems to be suffering from psychobehavioral disorders and seems depressed. There is a strangeness in his behavior along with social withdrawal. He suffers from fits of laughter that occur at socially inappropriate times. He also suffers from psychotic symptoms with visual delusions. We learn through the film that he was a beaten child, psychologically and physically abused with severe traumatic brain injury (TBI). The uncontrollable outbursts of laughter, behavioral and psychotic disorders followed these elements. As a neurologist, I was intrigued by these symptoms. I have explored the neuropsychiatric symptoms complicating TBI from which he seems to suffer and which have been reported in the literature. We can assume that the Joker is suffering from neuropsychiatric sequelae related to childhood TBI involving the frontotemporal regions and, in particular, the lateral aspect of the left frontal lobe. The movie Joker has medical significance and covers social aspects of medicine and health care. First, it allows us to discuss whether psychotic disorder due to TBI should be considered a neurobiological syndrome. More broadly, albeit fictitious, it asks us about the management of patients with neuropsychiatric illness, which is a public health problem. It also reminds us that semiological descriptions of patients with neuropsychiatric disorders have served as inspiration for many authors.

Akira Takeshita, MD, PhD

Akira Takeshita, MD, PhD, 69, Professor Emeritus of Cardiovascular Medicine and Director Emeritus of the Institute of Angiocardiology, Kyushu University Graduate School of Medicine, Japan, died on March 15, 2009 after a long illness. Dr Takeshita was an internationally recognized leader in cardiovascular medicine. His research focused on neural regulation and vascular biology. Dr Takeshita was born on January 24, 1940. He earned his MD degree from Kyushu University School of Medicine in 1965. His unique and international career started immediately after his graduation when, unlike many other Japanese physicians, especially at that time, he moved to the Tachikawa U.S. Air Force Hospital near Tokyo, where he was an intern and resident. He met Makiko, who was performing her externship in anesthesiology at the Hospital, and they married in 1968. They helped each other as the best partners in life and also as medical professionals, for 41 years until his death. In 1967, Dr Takeshita returned to Kyushu University where he trained in the Department of Cardiovascular Medicine. He then moved to Mount Sinai Hospital, Cleveland, in …

La historiografía de la medicina árabe ante los retos del siglo XXI

This is a critical review of the work and methods of past and present Western historians of Arabic medicine. It points out traditional errors, prejudices and limitations, and proposes to modernize the way we approach this field of research. Up to now, many Western scholars have deemed that Arabic medicine could be understood by knowing the important theoretical treatises (even in unreliable translations) and by reading the frequently outdated secondary literature. Modern research must turn to the texts that reflect the actual medical practices, focus on social aspects of medicine or reflect the actual medical practices, focus on social aspects of medicine or the interaction of learned and folkloric medicine, and must even try to find out the truth about the questionable statements we read in our textbooks. The field urgently needs interdisciplinary and international cooperation and wider diffusion of the recent bibliography.

Shedding Light on the Human and Social Aspects of Medicine Through Research

General MedicineVolume 9, Issue 2 p. 45-46 EditorialOpen Access Shedding Light on the Human and Social Aspects of Medicine Through Research Seiji Bito MD, MSHS, Corresponding Author Seiji Bito MD, MSHS Editor, General Medicine bitoseiji@kankakuki.go.jp Author for correspondence: Seiji Bito, MD, MSHS National Hospital Organization Higashigaoka 2–5–21, Meguro-city, Tokyo 152–8621 E-mail: bitoseiji@kankakuki.go.jpSearch for more papers by this author Seiji Bito MD, MSHS, Corresponding Author Seiji Bito MD, MSHS Editor, General Medicine bitoseiji@kankakuki.go.jp Author for correspondence: Seiji Bito, MD, MSHS National Hospital Organization Higashigaoka 2–5–21, Meguro-city, Tokyo 152–8621 E-mail: bitoseiji@kankakuki.go.jpSearch for more papers by this author First published: 14 April 2009 https://doi.org/10.14442/general.9.45AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References 1Whitehead WE, Wald A, Norton NJ. Priorities for treatment research from different professional perspectives. Gastroenterology. 2004; 126(1 Supp 1): S180– 5 2Miller D, Shindell S. Narrowing the evidence-practice gap: strengthening the link between research and clinical practice. Neurology. 1998; 50: 319– 21. 3Asai A, Itai K, Izumi S, et al. Qualitative research on clinical ethics consultation in Japan: The voices of medical practitioners. General Medicine. 2008; 9: 47– 55. 4Horinouchi H, Tokuda Y, Nishimura N, Fukui T, et al. Influence of residents' workload, mental state and job satisfaction on procedural error: a prospective daily questionnaire-based study. General Medicine. 2008; 9: 57– 64. Volume9, Issue2December 2008Pages 45-46 ReferencesRelatedInformation

Ida Cannon, Ethel Cohen, and Early Medical Social Work in Boston: The Foundations of a Model of Culturally Competent Social Service

Early medical social workers Ida Cannon and Ethel Cohen formulated innovative models of hospital social service in Boston. As directors of the social service departments of Massachusetts General and Beth Israel Hospitals, respectively, they ensured that medical social work developed as a profession. They also formulated standards of patient care and educated health‐care professionals about the social aspects of medicine. This study analyzes the work of Cannon and Cohen within the contexts of progressivism, professionalization, immigration, and ethnic identity. It proposes that Cohen adopted key aspects of Cannon’s model of hospital social service but revised it to further accommodate the particular ethnic needs of Jewish immigrants, who were not well served in Boston’s hospital structure. Cohen’s work provides an early model of culturally competent social work practice.

Medical marvels The 100 greatest advances in medicine

Eugene Straus, professor emeritus of medicine at the State University of New York Health Science Center, has followed up his interesting biography, Rosalyn Yalow, Nobel laureate: her life and work in medicine (1), with Medical marvels: the 100 greatest advances in medicine. Coauthored with journalist Alex Straus, with interesting and stimulating black-and-white illustrations by Bette Korman, the volume examines the science and art of many key medical advances throughout history, selected based on the criteria that they changed the course of medicine, relieved suffering, furthered our understanding of health and disease, and culminated in improvements in disease prevention, diagnosis, or therapeusis. Each of the 100 advances is described concisely within individual 3- to 5-page chapters, thus serving as a launching pad for the reader to acquire additional information on specific topics of interest. Naturally, the breakthroughs that most scientists, physicians, and lay readers will be familiar with appear. These include the discovery of viruses, oncogenes, antibiotics, and stem cells; smallpox vaccination; gene therapy; and, of course Watson, Crick, Wilkins, and Franklin’s identification of the structure of DNA and the elucidation of the human genetic code, regarded as the most important biological experiments in history. The authors also examine the evolution of some of the experimental and diagnostic approaches that researchers and physicians have come to rely on daily, including: history taking and the physical exam, surgical anesthesia, tissue culture, the x-ray, the ECG, and PCR. The authors revisit Antonie van Leeuwenhoek’s construction of the single-lens microscope and William Beaumont’s examination via a perforation in the anterior wall of the stomach of a patient following a shotgun wound, which provided the earliest insights into the digestive process and its regulation in vivo. This led to the work of Ivan Pavlov, whose experiments with dogs provided great insight into the mechanisms of salivation, pancreatic function, hunger, and satiation and identified the phenomenon now known as classical conditioning. As an additional resource, the authors include as part of their discussion of solid organ transplantation contact information for national organizations that assist patients in need of transplants. In the 1940s, as a naval medical corpsman, I had the great fortune to be among the first to administer a new drug — penicillin — to casualties from the Pacific Island invasions. At that time the results obtained from using penicillin were astounding and never before equaled by any therapeutic agent for infections. Alexander Fleming and Howard Florey’s work toward the discovery and commercial production of penicillin rightly appears on Straus’s list, and this drug represents a true medical marvel. Throughout the text each chapter is admixed with others concerned with social and economic problems associated with socialized medicine, medical ethics, health maintenance organizations, patient advocacy, and related subjects. These include the evolution of the doctor-patient relationship into one of a provider and customer, the management of addictive behavior, and the underrepresentation of minorities and women in the pursuit of medicine. As interesting and important as the sections on the social aspects of medicine are, they distract from the flow of scientific information and would have better constituted a separate section of the book. This is not to diminish the importance of these sections, but rather to note that they interrupt the sequence of summaries of medical research–related accomplishments. Based on my own experience in medicine and research since 1953, I would have included several additional advances in the physical sciences, akin to some of those highlighted by John Gribbin in The scientists: a history of science told through the lives of its greatest inventors (2), along with the elucidation of the structure of the psychotropic serum vasoconstrictor serotonin and the research of Erwin Chargaff that actually laid the groundwork for the discovery of the double-helix structure of DNA. I would hope to see these featured if a second edition of this volume is released. Thus, we have an interesting, richly illustrated book for both the layman and scientist who wish to develop broad baseline information on major medical advances. However, more than simply a compendium of breakthroughs in medical technology, Medical marvels intertwines the social and ethical aspects of the practice of medicine with the science, impressing upon the reader the dedication of individuals committed to enhancing the quality of human life. The text is strongly recommended as interesting, informative, and stimulating reading.

Difference and Identity: A Special Issue of Literature and Medicine

In an increasingly diverse society, it is essential that medicine be aware of matters of difference. Medical humanities programs promote awareness of the social aspects of medicine, and the Association of American Medical Colleges has recently instituted cultural competencies for clinical interaction for the training of medical students. Yet these efforts to impart understanding of the cross-cultural aspects of medicine are still hindered by a significant limitation: within a medical system whose currency is diagnosis, difference is primarily defined through disease. This special issue of Literature and Medicine focuses on difference and identity in the context of disease and disability. The articles collected here explore the complex ways in which notions of disease, disability, and difference are related and in which bodies marked by gender, race, disability, sexuality, and ethnic identities experience disease in specific ways. The essays take a humanities-based approach to the subject and emphasize an awareness and sensitivity to difference through forms of symbolic representation such as metaphor and narrative. This volume provides a heuristic lens through which relationships between individual expressions of identity and communal experiences of difference can be considered. Each article speaks to the process whereby individual stories and strategies shape, and are in turn shaped by, the institutions they seek to transform. Literature and Medicine is devoted to exploring interfaces between literary and medical knowledge and understanding. The journal showcases the creative and critical work of renowned physician-writers, leading literary scholars, and medical humanists.

Search Strategies for Population and Social Subjects in a Medical School Curriculum

This case study describes strategies developed for medical students to conduct Specific (as opposed to Sensitive) searches in PubMed so they can quickly locate several relevant references to articles on the population and social aspects of medicine. The Specific search strategy protocol for population and social aspects of medicine involves use of the MeSH Database, certain features of the Detailed Display in the MeSH Database, and applying Limits. By teaching the Specific form of search strategy, busy users can learn a handful of basic techniques that should yield a useful proportion of references, thereby ensuring these users' frequent success.

Medical-themed film and literature course for premedical students

The authors introduced a 'Medicine and Literature'course into the premedical curriculum to help students developclearer expectations regarding their lives as future physicians,and also to gain insight into the humanistic and social aspectsof medicine. The course was developed for the entire class of secondgradepremedical students (n = 126) and consisted of one threehoursession per week over six weeks. The course was composedof two main themes: (1) medicine and film; and (2) medicine andliterature. Students' responses showed that this course helped themto gain perspectives on both a physician's life and medical practice,and also enhanced their understanding of the humanistic andsocial aspects of medicine itself. Students reported that they alsovalued the advantages of collaborative learning, which holds thepotential for improving their skills in presentation, discussion,communication and teamwork. In Korea, introducing arts- andhumanities-related courses into the medical curriculum is a recenttrend, and is still in a very early stage. Although our study hasseveral limitations, we conclude that by studying literature andfilms during the premedical period, students can grasp a sense of themany different issues that physicians are faced with.

Learning Empathy: Medical School and the Care of the Dying Patient

Medical education has traditionally been focused on the understanding of pathophysiology and treatment of disease. While there is an increasing level of attention focused on the doctor- patient relationship and the social aspects of medicine, there remains a relative lack of educational efforts regarding the care of individuals who are dying. This paper addresses the cultural context of medical school with respect to end-of-life care and proposes the role of physicians in caring for dying patients. In addition we report initial efforts at the University of Vermont College of Medicine to construct a preclinical course for medical students about end-of-life issues. As part of these efforts we sought to assess the attitudes of entering medical students towards end-of-life care. Review of the data suggests that the majority (66-98%, depending on measure used) of new medical students possess sophisticated attitudes regarding the care of dying individuals. Our conclusion is that medical education should seek to nurture these sophisticated attitudes and supply the basic tools of palliative care in order to improve the quality of experience for individuals who are dying.

Teaching the mental and social aspects of medicine in eastern Europe: role of the WHO definition of health.

Official definitions of health can be categorized into two types: positive and negative. While the negative definitions identify health as an absence of disease or illness, the World Health Organization (WHO) defines health positively, as a state of complete physical, mental, and social well-being, and not merely as the absence of disease or infirmity (World Health Organization, 1946). This latter definition calls attention to the fact that being healthy involves much more than simply determining illness since it also encompasses well-being. Moreover, the WHO definition of health has important educational implications as it suggests medical educators should pay attention to the mental and social dimensions of health and medicine.

Psychoanalytic sociology and the medical encounter: Parsons and beyond

AbstractWhile sociologists earlier this century often used insights derived from psychoanalytic theory in their writings, contemporary sociology has largely tended to ignore this body of work. This is as true of medical sociologists as it is of others, despite the fact that the ‘founding father’ of medical sociology, Talcott Parsons, used psychoanalytic perspectives extensively in his theorising on the social aspects of medicine and health. In this paper I make a case for a return to a medical sociology that incorporates understandings of subjectivity derived from psychoanalytic writings, with particular reference to the medical encounter and the illness experience. The paper begins with an overview of psychoanalytic sociology. I go on to review the major insights Parsons developed in his writings and the work of other writers who have more recently used psychoanalytic theory productively in theorising the sociocultural dimensions of medicine and health care. The paper concludes with some thoughts about future directions for taking up the psychoanalytic perspective in the sociology of health and illness.

The clinician's role in promoting smoking cessation among clinic patients

Like other chronic conditions, nicotine dependence offers both challenges and rewards to clinicians. The treatment of this condition frequently requires experience in pharmacology, behavioral science, and social aspects of medicine. Physicians are uniquely qualified to assist patients in their efforts to overcome the multifaceted condition of tobacco addiction. In providing this treatment, the clinical challenges are far outweighed by the benefit to patients who stop smoking. For many patients, smoking cessation is, by far, the most important step they can take to improve their health and increase their life span. Physicians who help patients accomplish this difficult goal provide a life-saving service. There is sufficient scientific evidence to guide physicians in their approach to smoking patients. Brief, systematic interventions have been shown to increase patient smoking cessation rates. The intervention can be described in four steps: ask about smoking, advise smokers to stop, assist those who want to stop, and arrange adequate follow-up. These interventions are used consistently when a smoking cessation program is adopted by an entire office practice. The components of this office-based program include defining staff roles, maintaining a smoke-free office, stocking appropriate materials, making use of the medical record to identify smokers and to remind staff to intervene, and monitoring patient progress. The potential public health impact of physician intervention with smoking patients is enormous. Even with very modest expectations of cessation rates, 100,000 physicians using effective intervention can produce over 3 million new ex-smokers in the United States each year. In conjunction with other community-based tobacco control efforts, this physician-lead effort will result in a marked reduction in the morbidity and mortality caused by smoking and, thus, control of "the most important public health issue of our time."

Medical schools: training workshops?

1--The aim of the medical course should be the training of doctors. 2--The advances in the medical sciences that took place over the last thirty years have caused profound changes in the professional, institutional and social aspects of medicine and in the professional profile of present doctors. Teaching of the basic sciences (biological and other) relevant to the medical sciences can not be done inside the medical course. 3--Medical Schools should elaborate an inventory and taxonomy of their educational objectives, after consultation with outside institutions involved in the delivery of medical care, as a first step in the design of their curricula. 4--A first degree in biology should be considered as a minimum requirement for entry in a Medical School. 5--The main aim of the pre-clinical training should be the integration of basic knowledge in biology and other relevant areas, in order to understand how the normal human body works and should involve staff from the clinical sectors of the Medical Schools. 6--An integrated curriculum should be gradually introduced. 7--In the pre-clinical years formal teaching (lectures and demonstrations) should be reduced to a minimum. The main activity of students should be the performance of tasks as individuals or integrated in small groups, with involvement in the clinical activity of the school taking place very early. 8--The student should be required to build a detailed CV throughout the course, which will be a log book of his training, to be used in the final evaluation of his academic achievement. 9--A system of formal supervision of the students should be created.(ABSTRACT TRUNCATED AT 250 WORDS)

Principles of Geriatric Medicine

This new textbook is directed to the medical practitioner who cares for the elderly. It attempts to provide state-of-the-art discussions on knowledge of human aging, those changes of aging that are particularly pertinent to management, and, finally, aspects of management of specific problems. The authors provide brief and general reviews on the biology of human aging. A second section covers the epidemiology of aging, including thoughtful papers on the Sex Differential in Aging, Long Lived Populations, Exercise and Aging, and Preventive Health Services for the Elderly. There are four chapters on behavioral and social aspects of medicine followed by models of physicians' care of elderly patients. These four sections make up less than one fifth of the total pages. Cardinal Manifestations of Aging and Disease of the Organ Systems makes up the majority of the book and is patterned very similarly to many of the current textbooks of medicine. There

Sounding board. The biopsychosocial model and medical education. Who are to be the teachers?

Elsewhere I have discussed the need for medicine to adopt a more inclusive scientific model if physicians in the future are to apply the same scientific rigor to the approach and understanding of patients and their care as they customarily apply to the diagnosis and treatment of disease.1 2 3 In this essay I address the question of who are to be the teachers of such a new scientific model. Because psychiatry has in the past had the main responsibility for education in, broadly speaking, the psychological and social aspects of medicine, it is widely assumed, especially by psychiatrists, that to psychiatry . . .

Developing objectives for a core program on social aspects of medicine.

Developing objectives for a core program on social aspects of medicine.

The Medical School of the Future and Its Role in the Community

The dean of a developing medical school must plan now to train young men and women who will not have completed their residencies until a full decade has elapsed. Anyone who ponders the amazing developments in both biological science and social change during the past five years must share the dismay and humility we face as we accept the challenge of predicting the next ten. The possibility of major breakthroughs in our understanding and ability to cope with problems in cancer, heart disease, stroke, diabetes, to mention but a few, is matched by major changes in automation and computers and the possibility of equally dramatic revolutions in the social aspects of medicine. The last Congress passed five specific measures, namely, Titles XVIIIA, XVIIIB, and XIX of Medicare, the Regional Medical Programs and Comprehensive Health Planning, each of which suggests a specific set of philosophies and goals toward the improvement of

The medical school of the future and its role in the community

The dean of a developing medical school must plan now to train young men and women who will not have completed their residencies until a full decade has elapsed. Anyone who ponders the amazing developments in both biological science and social change during the past five years must share the dismay and humility we face as we accept the challenge of predicting the next ten. The possibility of major breakthroughs in our understanding and ability to cope with problems in cancer, heart disease, stroke, diabetes, to mention but a few, is matched by major changes in automation and computers and the possibility of equally dramatic revolutions in the social aspects of medicine. The last Congress passed five specific measures, namely, Titles XVIIIA, XVIIIB, and XIX of Medicare, the Regional Medical Programs and Comprehensive Health Planning, each of which suggests a specific set of philosophies and goals toward the improvement of