The Applicability of Nonlinear Systems Dynamics Chaos Measures to Cardiovascular Physiology Variables

Three measures of nonlinear chaos (fractal dimension, Approximate Entropy (ApEn), and Lyapunov exponents) were studied as potential measures of cardiovascular condition. It is suggested that these measures have potential in the assessment of cardiovascular condition in environments of normal cardiovascular stress (normal gravity on the Earth surface), cardiovascular deconditioning (microgravity of space), and increased cardiovascular stress (lower body negative pressure (LBNP) treatments)

Hygiene

Hygiene is defined in current English dictionaries as “the science of health.” This definition, though formally correct, hides a long history of change in the word’s use, from its holistic classical meaning of “individual regimens to preserve health” to its nineteenth-century connotations of “social medicine” (including lethal eugenics programs), to its current limited construal as “personal cleanliness” or “germ removal.” For more than 2,500 years of use in many different lands, concepts of hygiene have been integral to personal identity, shaping sense of self through boundary maintenance and spirituality

Drawing the Lines: Health scares in the age of SARS

Epidemics of fear, perhaps also of disease: here are some important foci for our present anxieties. By ‘us’ I mean the various academics, experts and professionals, who in the ‘western’ nations of North America, Europe and Australia have ongoing conversations on these subjects. Some health professionals are worried about a vast outbreak of a new or re-emerging infectious disease; others are worried about being deliberately attacked with disease or with deadly gas. But also, many health professionals worry about the enormous impacts that these public fears may have on economies and societies: ‘the problem with SARS,’ I have heard several in Canada say, ‘was not SARS itself, but fear’. They meant that the disruptions of SARS were vastly disproportionate to its body count, a mere 44 deaths, and I know they recall, and would like to prevent, other situations where public worries unjustified by scientific evidence (say, of radiation from powerlines) caused trouble and expense. Yet they seem to make little professional effort to trace the tensions between their fears and their fears of fear. And so we who observe public health from the humanities worry and wonder about their (our) worrying: is ours a ‘risk society’, a ‘culture of fear’? In this chapter I will join these conversations to reflect on current concerns about, and responses to, the threats of infectious disease. First, I will situate these concerns and reactions in a more general context of concerns about ‘health scares’ – social, as opposed to individual, phenomena, wherein we see a strong reaction to a specific event that appears to threaten the health of some significant social group. This is not the problem of disease but of ‘fear itself’, in the terms used above. I then briefly discuss concerns with epidemics of new and re-emerging infectious diseases as a particular category of health scare. Here I remind the reader of the central role that real borders, and conceived boundaries, play in these concerns: nation states remain the basic units for preventing and managing disease events, and they produce instrumental categories (like ‘susceptible’ or ‘infectious’) whose crossings are cause for concern. I argue that this may be understood in terms of the logic of dangerousness outlined by Foucault, and, after him, Castel, and that this logic has been reasserted amid contemporary ideas of information flow and of risk. With all this in mind, I then retell the story of SARS in Canada, to show how containment strategies such as quarantine, policing air travel and hospital boundaries, and hygiene messaging, which had vast, largely negative social and economic impacts, were determined by the tensions between these logics of dangerousness and risk. Whether one quarantined newly adopted Chinese children or the nurse in a hospital with SARS patients, whether one spent money on thermal scanners in airports or on hospital emergency wards, such decisions depended, given these logics, on where one chose to ‘draw the line’

Irresistible forces: reflections on the history of women in Australian science

The women scientists from the pre-World War II era, whose implements, publications and images were displayed as part of the League of Remarkable Women in Science exhibition, arouse in me an honouring of their quiet, dedicated sort of nationalism, in which deep connections with land and environment were intermingled with an ethic of humility and service. I went looking in Australia’s history for women scientists whose lives and careers would refute claims that women’s capacity for spatial and abstract reasoning is less than men’s, due to differences in the development and structure of the brain. If you’re interested in these questions, you may enjoy debates such as this from Harvard University

History and Social Change in Health and Medicine

In general, qualitative research – in health or otherwise – has not paid much attention to history. And why should it? While most qualitative scholars, particularly the more constructivist among us, would naturally acknowledge that the people and societies they study are different to those that preceded them, this mostly has little or no influence in practice on research design or conduct. History is interesting, yes, but in most cases must seem either too arcane, or too removed, to inform health research. There are, however, occasions where history may seem to have some instrumental value for health research: to learn about the efficacy and impacts of interventions in the past; to avoid past mistakes or reinventing the wheel; to be more influential advocates. For example, health researchers may be interested in social histories of Prohibition-era USA in order to think about the feasibility of drug bans. Similarly, studies using oral history interviews with politicians and other stakeholders involved in tobacco control legislation were conducted to delineate the set of social conditions and processes that resulted in legislative change, in order to identify any generalisable features that might allow advocates to achieve further tobacco control more quickly and efficiently in the future, or at least to predict and produce conditions conducive to accomplishing further control (Bryan-Jones & Chapman, 2006; Claire Hooker & Chapman, 2006). These studies have empirically verified the utility of Kingdon’s model of policy change (Claire Hooker & Chapman, 2006; Jacobson, Wasserman, & Anderson, 1997; Studlar, 2002) and underscored the key role of ‘policy entrepreneurs’ and ‘windows of opportunity’ in getting tobacco control onto the policy (and eventually, legislative) agenda. These sorts of studies are certainly compelling and often useful. What they do not do, however, is capture the unique qualities of people’s action and experience in a specific time and place, nor situate or understand these things in relation to wider social influences. There are different, good, reasons for qualitative researchers to be interested in history: for its capacity to enhance sensitivity to social context and its unique critical perspectives on health and medicine. The approaches and perspectives of history – the development of what I refer to as an ‘historian’s nose’ – can lead scholars to ask important new analytic questions, challenging their assumptions and goals, and leading to much deeper or more novel analyses

Understanding empathy: why phenomenology and hermeneutics can help medical education and practice

This article offers a critique and reformulation of the concept of empathy as it is currently used in the context of medicine and medical care. My argument is three pronged. First, that the instrumentalised notion of empathy that has been common within medicine erases the term’s rich epistemological history as a special form of understanding, - even a vehicle of social inquiry, - and has instead substituted an account unsustainably structured according to the polarisations of modernity (subject/object, active/passive, knower/known, mind/body, doctor/patient). I suggest that understanding empathy by examining its origins within the phenomenological tradition, as a mode of intersubjective understanding, offers a different and profitable approach. Secondly, I argue that the appropriation of empathy in medicine means that, ironically, empathy can function as a technique of pastoral power, in which virtue, knowledge and authority remain with the doctor (Mayes, 2009). And thirdly, empathy is in danger of being resourced as a substitute for equity and funding within health systems. I conclude however with hope for the productive possibilities for empathy. Keywords: Empathy, sympathy, phenomenology, understanding, medical humanities, patient experienc

Health scares: professional priorities

Currently, many health scholars are concerned about health scares. But what do they mean by the term ‘health scare’ – are health scares an identifiable phenomenon, and how do we currently understand their causation and consequences? By collecting and analyzing published articles about events considered to be health scares, this paper maps the current views of scholars on their characteristics and causes. Results show that health scares are generally understood as events characterized by fears of catastrophic consequences but little actual mortality. However, the social and economic impacts of these events have often been severe. This survey shows that health scares can be usefully sorted into 6 categories, each with identifiable internal dynamics, suggesting different communications strategies to achieve resolution in each category. Using the social amplification of risk framework, the conditions under which risk signals were amplified were traced in general terms among major stakeholders. Simple causes for health scare events could not be identified, though some triggers did emerge. Importantly, public ignorance of real risk, media scaremongering, and political inaction could be dismissed as primary explanations, though they were sometimes factors in scare events. Implications for risk communication and for future research on risk and public health are discussed. Keywords: Health scare, Social amplification of risk, Expert, Media, Risk controversyfunded by the Sidney Sax Travelling Postdoctoral Research Fellowship in Public Health, National Health and Medical Research Council, Australia

Middlemarch

At the time George Eliot wrote Middlemarch, the boundaries between History and Fiction (like those between Science and Romance, or Medicine and various Arts ) were still blurred. We who are the heirs of that era have liked to insist on distinguishing the soberly factual nature of history from the unhampered fantasies of fiction. Yet there are occasions when we must admit that the multi-faceted emotional and sensuous grasp of an era or a character that a good novelist can evoke may be at least as insightful as scholarly history. Eliot offers us this Gestalt-like experience, for she is unsurpassed in the ability to set her characters, with all their uniqueness of traits and doubts and actions and dreams, within the relentless current of the society that shaped them. And our compassion for them is increased by this broader and many-layered conception of them. When Middlemarch was published to instant acclaim in 1871-2, the William Osler was in the midst of his medical education. Middlemarch was and is famous for its finely-tuned portrayal of Dr Lydgate, one of its two leading protagonists, and thus this ‘history’ of a fictional physician, may tell us something of what was passing in the young Osler’s heart and mind. And Osler was hardly unique in identifying with Lydgate, as his own note on the novel suggests: ‘if [he] was to ask the opinion of a dozen medical men upon the novel in which the doctor is best described … the majority will say, ‘Middlemarch’. How could Osler have helped identifying with Lydgate? Lydgate embodies the loftiest ideals and the happiest balances associated with medicine –working for social good rather than personal profit, combining intellectual activity with emotional and social engagement. Few student physicians then or now would like to admit to lesser ambitions. Additionally, the young Osler and the young Lydgate had many things in common: like Lydgate, Osler was driven by intellectual passion (and one fortuitously stumbled upon, since the education of neither could have evoked it, and both were indifferent students as boys); like Lydgate, Osler similarly harboured hopes of building a ‘reputation’ as a scientific discoverer; like Lydgate, he could not earn a living in research, and had to integrate his intellectual ambitions with his professional life. And, although leaving the bench for the bedside initially depressed him, like Lydgate Osler is known for his care for his patients as unique individuals

How to cut through when talking to anti-vaxxers and anti-fluoriders

Dismissing people’s worries as baseless, whether that’s about the safety of mobile phones or fluoridated drinking water, is one of the least effective ways of communicating public health risks. Yet it is common for people to “reassure” like this, both at home and in professional roles as experts, officials or corporate managers. Another poor but common strategy is to try to debunk “alt-facts” (lies or misleading statements claimed as fact) like those circulating among anti-vaccination or anti-fluoridation groups. If your role is to communicate public health risks, it is particularly hard to resist trying harder to help people understand the evidence. This is especially the case when a risk is low, and hence public fears are not only out of proportion but also costly to redress. If an official’s or doctor’s response to a parent worried about fluoridated drinking water is to show them even more data about how safe and effective it is, they often won’t sound convincing. Instead, they’ll look incapable of unbiased discussion. Indeed, the more information they show, the more it can look like propaganda. This approach can even make the opponent’s argument more memorable. Not only are reassuring people and countering misinformation ineffective, they can end up doing a lot of damage

Peter Robertson: Radio Astronomer: John Bolton and a New Window on the Universe (book review)

The founding and flourishing of an entirely new field, radio astronomy, must rate among the most impressive episodes in the history of Australian science. Radio astronomy was as deeply symbolic of a new sense of national confidence in its early years, as it was a signal of the sweeping social changes to economy and society that transformed the nation after the war. Prior to the war, it was nearly impossible for a graduate to find employment as a physicist. Afterwards - could there be a stronger symbol of Australian aspirations, or of investment in research, than the famous 'Dish' telescope at Parkes? Or, as it turns out, any better exemplification of the archetypal Australian hero—ingenious, laconic, humorous, astonishingly stubbornly dedicated—than its Yorkshire émigré designer and first director, John Bolton? Peter Robertson, who has published a history of the Parkes telescope, has now produced a matching biography of Bolton. Both books have been welcomed for their public memorialising of this too-easily forgotten part of Australia's history. Hitherto, while comprehensively covered by Woody Sullivan's magnum opus Cosmic Noise (2009) and in the now-dated sociology of science classic Astronomy Transformed (Mulkay and Edge 1976), the history of radio astronomy has been the preserve of technical experts only. Written in an easy lucid prose, this book aims to reclaim Bolton for public history as well as to celebrate, for astronomers, all that one of their most important colleagues achieved. One of the charms of the story of radio astronomy lies in its small, string-and-sealing wax beginnings, and how this nonetheless produced discovery after discovery, completely reshaping conceptions of the Universe. Bolton was a key player in this story, and one of the advantages provided by this biography is the capacity to assess Bolton’s contribution coherently—something difficult to pick out of the more comprehensive historical works