ECG Wave-Maven: An Internet-based Electrocardiography Self-Assessment Program for Students and Clinicians

Purpose: To create a multimedia internet-based ECG teaching tool, with the ability to rapidly incorporate new clinical cases. Method: We created ECG Wave-Maven (http://ecg.bidmc.harvard.edu), a novel teaching tool with a direct link to an institution-wide clinical repository. We analyzed usage data from the web between December, 2000 and May 2002. Results: In 17 months, there have been 4105 distinct uses of the program. A majority of users are physicians or medical students (2605, 63%), and almost half report use as an educational tool. Conclusions: The internet offers an opportunity to provide easily-expandable, open access resources for ECG pedagogy which may be used to complement traditional methods of instructio

Alton Ochsner, MD (1896-1981): surgical pioneer and legacy linking smoking and disease.

Edward William Alton Ochsner kept a plain, metal card file in which he recorded close to 50 years worth of medical experiences, research, and insights. The most populated topics were filed as Cancer, Lung and Cancer, Bronchogenic. These reflected his areas of greatest interest, for which he would go on to produce groundbreaking work. Of his many lifetime accomplishments, he is perhaps best known for being the first to report a link between cigarette smoking and lung cancer. This was just one of the many ways in which Ochsner worked to effect social change. The establishment of the Ochsner Health System in New Orleans was born from this similar passion. Ochsner went on to become one of the giants of his generation as a result of this tireless work as a leader, educator, and mentor

Violent video games and attitudes towards victims of crime: an empirical study among youth

Previous research has indicated that playing violent video games may be associated with an increase in acceptance of violence and positive attitudes towards perpetrators of crime. This study is the first to investigate the relationship between playing violent video games and attitudes towards victims of crime. A total of 206 young people (aged 12-24 years) completed measures of attitudes towards victims and violent video game exposure. The results suggest that exposure to violent video games is associated with less concern being reported for victims of crime. Young people who play more violent video games reported less concern for general victims and for culpable victims, and these effects cannot be explained by gender or age differences. The results are discussed in relation to relevant research in the area, along with recommendations for future research

Christian Albert Theodor Billroth, M.D., founding father of abdominal surgery (1829-1894).

In the 1800s, the field of surgery was in its infancy, somewhat primitive and embryonic. The technical nature of surgery was the basis for the dividing line between the disciplines of surgery and internal medicine. Sterilization was not a common practice. Radical surgical resections and experimentation in medicine were shunned. With his boldness equaled only by his innovation and resourcefulness, Theodor Billroth would become a pioneer not only in the development of modern surgery, but also in the advancement of its cultural and historical significance

Edoardo Bassini (1844-1924): father of modern-day hernia surgery.

According to Roman scripture, it was Celsus who attempted the first inguinal hernia repair in history during the first century A.D. His attempts were unsuccessful and resulted in an early recurrence of the hernia, which eventually led to the patient’s death.1 Over the next two millennia, little understanding was gained regarding the anatomy of the inguinal canal. It was only in the last 100 years that major advancements in herniorrhaphy were established, thanks in large part to the work of Edoardo Bassini, who revolutionized the surgical treatment of the inguinal hernia with a technique which has become the basis of modern-day herniorrhaphy

Samuel D. Gross, M.D. (1805-1884): an innovator, even in death.

Dr. Samuel Gross\u27 contributions to the field of surgery are well known and range from numerous clinical advances to pioneering scholarship and professional activities. Dr. Gross was ceaselessly ambitious and even remarked in his autobiography that his ‘‘conviction has always been that is far better for a man to wear out than to rust out.’’1 It is through this frame of motivation that Dr. Gross lived his life

Collaborative Caring: Stories and Reflections on Teamwork in Health Care

[Excerpt] There are many theoretical and conceptual books and countless articles that have explored issues of teamwork in general and teamwork in health care in particular. The editors, and many of the authors in this book, have read most, and have even written some of them. To tackle the issue of teamwork, we have, however, taken a different approach. Rather than write a theoretical book about what teamwork is, what it is not, where it exists in health care, what barriers prevent its implementation and how they can be removed, we have chosen instead to address these questions through narratives and reflections that vividly describe good teamwork as well as problems in creating, leading, and working on genuine teams. What we believe is too often lacking in the literature is a clear and compelling picture of what teamwork looks like on the ground, in the institutions where health care work is delivered and where teams play well, or don\u27t play well, on a daily basis. The question we ask here is thus: What is the state of play in most health care institutions? To describe the state of play, we have asked clinicians to write what we think of as where the rubber hits the road stories or reflections about the nature of teamwork in their own particular work setting. To gather these stories, we talked to many people in different health care disciplines. In the invitation for submissions we wrote the following: We are seeking short, concise narratives that describe a concrete example in which you personally have been involved. The idea here is not to focus so much on the individual doctor-patient, nurse-patient, therapist-patient communication but the teamwork that was involved in ensuring that the standard of care was met or exceeded. If the patient or family was involved, so much the better. Stories can deal with interprofessional or intraprofessional teamwork. On balance, we would prefer to have more stories about interprofessional or occupational teamwork. Nonetheless, we recognize that interprofessional work depends on the ability to create teamwork within an occupation or profession. Stories involving support staff, such as housekeepers who spoke up about a patient safety issue, are definitely within the purview of this book. We would also welcome personal reflections that would enhance our understanding of either how to produce genuine teamwork or the obstacles that stand in its way

Cyberstalking: a new challenge for criminal law

Cyberstalking has recently emerged as a new and growing problem and is an area that will probably receive a higher profile within criminal law as more cases reach court (see Griffiths, 1999; Griffiths, Rogers and Sparrow, 1998; Bojic and McFarlane, 2002a; 2002b). For the purposes of this article we define cyberstalking as the use of information and communications technology (in particular the Internet) in order to harass individuals. Such harassment may include actions such as the transmission of offensive e-mail messages, identity theft and damage to data or equipment. Whilst a more comprehensive definition has been presented elsewhere (Bocij and McFarlane, 2002), it is hoped that the definition here is sufficient for those unfamiliar with this field. The stereotypical stalker conjures up images of someone harassing a victim who is the object of their affection. However, not all stalking incidents are motivated by unrequited love. Stalking can also be motivated by hate, a need for revenge, a need for power and/or racism. Similarly, cyberstalking can involve acts that begin with the issuing of threats and end in physical assault. We also make distinctions between conventional stalking and cyberstalking. Whilst some may view cyberstalking as an extension of conventional stalking, we believe cyberstalking should be regarded as an entirely new form of deviant behaviour

Defining the Role for ZBP-89 in ATM-mediated DNA Damage Response to Irradiation in the Intestine

ZBP-89 (ZNF148, Zfp148) is a zinc-finger transcription factor that inhibits cellular proliferation when overexpressed in cell lines. ZBP-89 forms a protein-protein interaction with p53 and Ataxia-telangiectasia mutated (ATM). However, it is unclear how the interaction modulates the function of these two proteins in vivo. Double strand DNA breakage induced by -irradiation induces ATM phosphoinositol kinase activity, which initiates a cascade of events culminating in cell cycle arrest, DNA repair or apoptosis. Elevated levels of ZBP-89 induce growth arrest and apoptosis in gastrointestinal cell lines. Therefore, we hypothesize that ZBP-89 facilitates cell growth arrest and activation of the DNA repair pathway after ATM activation. To test this hypothesis, we irradiated 4 groups of mice—1) C57BL/6 mice without any genetic deletion; 2) mice with one or both copies of ATM deleted from the intestinal mucosa; 3) mice with the ATM deletion and one copy of Zfp148 deleted; 4) ATM deletion with both copies of Zfp148 deleted. After the intestines were fixed, paraffin-embedded and sectioned, I performed the de-paraffinization step for immunohistochemistry of ZBP-89, p53 and H2AX. To stain for ZBP-89 protein, I performed an antigen retrieval step using sodium citrate, followed by blocking with 3% hydrogen peroxide and serum. I then added the primary antibody then the secondary antibodies. I used diaminobenzidine (DAB), a chromogenic detection method to visualize the antigen-antibody complex. I then counterstained with hematoxylin. We predict that the mice with a deletion of ZBP-89 will exhibit more tissue damage as a result of the irradiation and DNA damage. Results are pending