Wearing powerful words and objects: healing prosthetics

In Civilization and its Discontents (1930), Freud proposed that in striving to overcome the vulnerability of our bodies in the face of nature we create supplementary tools (including writing) in order to remove the limits to human functioning. He famously envisaged a civilisation trajectory in which man, striving to overcome his limitations, would increasingly resemble a ‘prosthetic God’ [James Strachey (ed), Sigmund Freud: Civilization and its Discontents, trans. Joan Riviere (London: The Hogarth Press, 1963), p. 29]. This essay offers a window of understanding onto pre-modern involvement in the ongoing process of extending the limits of self-hood and making the vulnerable, sick and suffering body comprehensible through the prosthetic use of words, symbols and narrative. Studying the widespread medical use of apotropaic textual amulets, word charms and talismans, this essay asks questions about the imagination, memory and healing, arguing that wearing word prosthetics (attached to the body or inscribed on the skin as tattoos) and performing the rituals they often prescribed (reciting, counting, praying, remembering) constituted a highly affective and valuable form of placebo medicine in earlier periods. Further, it contends that complex textual amulets can be apprehended as narrative prosthesis and thus as precursors to the novel in their ability to extend the limits of self-hood and impose some kind of narrative order on chaotic and painful life experience

Popular medicine

Employing a lexicon of pronounced binaries, Herring’s tract evokes a picture of the early modern medical marketplace in which the services of the professional, university-educated, ‘compleat’ and ‘True Physition’ were continuously passed over in favour of ‘Counterfeit Mountebanks’: a motley line-up of dubious types including criminals, debtors, the unemployed and – according to his tract’s suggestive title – exotic foreigners (hence ‘Orient Colours’). By the early seventeenth century such complaints were familiar: in 1566 the eminent physician John Securis railed in print against the ‘unlearned surgeons, meddling empirics, and “presumptuous” women’ who offended his sense of proper medical order and in 1565 the surgeon John Hall lamented the way ‘true’ practitioners had to compete against ‘smiths, cutlers, carters … and a great rabble of women’.2 Dedicating his tract to the Lord Chief Justice, Sir John Popham, Herring was ostensibly seeking judicial help to save sick people from their own ‘folly and madnesse’ by restricting medical practice to professionals; in reality, as revisionist historiography has compellingly argued, Herring and his colleagues in the College of Physicians and Barber Surgeon’s Hall were waging war against unlicensed practitioners, with the aim of increasing their share of a lucrative commercial sphere.3 It was a tough challenge; recent scholarship has revealed that licensed physicians, surgeons and apothecaries were, indeed, probably vastly outnumbered by a wide range of other health care workers. In an important study of community health work in London between 1560 and 1610, Deborah Harkness has identified just over 1,400 men and women who did medical work ‘including apothecaries, midwives, carers for the sick in hospitals and private settings, surgeons and physicians’. She calculates that 70 per cent of these were unlicensed, and approximately 30 per cent of the unlicensed practitioners were women.

Let Your Life Speak: Exploring the Lived Experience of Graduate Nurses In an Emergency Department Setting

The purpose of this research was to explore the lived experience of graduate nurses (GNs) who made the transition from academic to practice environment in the high-acuity setting of a Level 1 trauma center. These GNs entered clinical practice through a nurse residency program at Truman Medical Center (TMC) emergency department (ED) in Kansas City, Missouri. The researcher interviewed 6 GNs participating in the nurse residency program with IRB approval from the University of Missouri, Kansas City IRB. The method of inquiry was hermeneutic phenomenology. The basic research question for this study was as follows: As a participant in a graduate nurse residency program, what was it like for you to make the transition from advanced beginner to competent, practicing nurse in the ED setting? The transcribed narratives of the interviews served as the primary data for this research. Themes which emerged from the data informed the findings of this thesis

Student Loan Recipients: Who are They, What is Their Total Debt Level, and What do They Know About Loan Repayment

The article presents a study that provides information about student loan recipients at Iowa State University. Loan recipients are described, along with their total debt level and their loan repayment knowledge

Validating measures of theoretical constructs useful in examining college persistence

This study examined persistence in college using the model proposed by Spady (1970) and modified by Tinto (1975) in which students must be adequately regulated by the institution\u27s values and goals in order to achieve goal commitment and must be adequately integrated into the social system of the institution in order to achieve institutional commitment. The purpose of this study was to develop reliable measures of the concepts, goal commitment and institutional commitment, and to validate them in terms of whether or not they are useful in identifying direct-from-high-school students who will or will not satisfactorily persist from the first to the second year in college. The measures developed in this study were derived from available institutional data (ACT Student Profile Report);Two constructs were developed in order to define the concept of academic integration or goal commitment: success orientation and accuracy of self-perception. The concept of institutional commitment was measured by the single construct of student fit with the environment. The constructs were related to two criterion variables, the student\u27s grade point average and enrollment status;The results generally support the idea that the student\u27s pre-enrollment, non-intellective characteristics are useful in identifying students who are likely to integrate successfully into the academic value system and the social system of the university, thus persisting from the first to the second year. The construct of success orientation had high reliability (r = .74) and was valid. The construct of accuracy of self-perception, while having only moderate reliability (r = .52), was valid. The construct of student fit with the environment was only moderately reliable (r = .54) but it was significantly related to enrollment status and grade point average

The construction of an instrument for the evaluation of student teachers.

Thesis (Ed.M.)--Boston Universit

Regulatory bioinformatics for food and drug safety

Abstract "Regulatory Bioinformatics" strives to develop and implement a standardized and transparent bioinformatic framework to support the implementation of existing and emerging technologies in regulatory decision-making. It has great potential to improve public health through the development and use of clinically important medical products and tools to manage the safety of the food supply. However, the application of regulatory bioinformatics also poses new challenges and requires new knowledge and skill sets. In the latest Global Coalition on Regulatory Science Research (GCRSR) governed conference, Global Summit on Regulatory Science (GSRS2015), regulatory bioinformatics principles were presented with respect to global trends, initiatives and case studies. The discussion revealed that datasets, analytical tools, skills and expertise are rapidly developing, in many cases via large international collaborative consortia. It also revealed that significant research is still required to realize the potential applications of regulatory bioinformatics. While there is significant excitement in the possibilities offered by precision medicine to enhance treatments of serious and/or complex diseases, there is a clear need for further development of mechanisms to securely store, curate and share data, integrate databases, and standardized quality control and data analysis procedures. A greater understanding of the biological significance of the data is also required to fully exploit vast datasets that are becoming available. The application of bioinformatics in the microbiological risk analysis paradigm is delivering clear benefits both for the investigation of food borne pathogens and for decision making on clinically important treatments. It is recognized that regulatory bioinformatics will have many beneficial applications by ensuring high quality data, validated tools and standardized processes, which will help inform the regulatory science community of the requirements necessary to ensure the safe introduction and effective use of these applications

Factors That Impact the Success of Interorganizational Health Promotion Collaborations : A Scoping Review

publishedVersionPaid Open Acces

Human MAIT cells endowed with HBV specificity are cytotoxic and migrate towards HBV-HCC while retaining antimicrobial functions

Background & Aims: Virus-specific T cell dysfunction is a common feature of HBV-related hepatocellular carcinoma (HBV-HCC). Conventional T (ConT) cells can be redirected towards viral antigens in HBV-HCC when they express an HBV-specific receptor; however, their efficacy can be impaired by liver-specific physical and metabolic features. Mucosal-associated invariant T (MAIT) cells are the most abundant innate-like T cells in the liver and can elicit potent intrahepatic effector functions. Here, we engineered ConT and MAIT cells to kill HBV expressing hepatoma cells and compared their functional properties. Methods: Donor-matched ConT and MAIT cells were engineered to express an HBV-specific T cell receptor (TCR). Cytotoxicity and hepatocyte homing potential were investigated using flow cytometry, real-time killing assays, and confocal microscopy in 2D and 3D HBV-HCC cell models. Major histocompatibility complex (MHC) class I-related molecule (MR1)-dependent and MR1-independent activation was evaluated in an Escherichia coli THP-1 cell model and by IL-12/IL-18 stimulation, respectively. Results: HBV TCR-MAIT cells demonstrated polyfunctional properties (CD107a, interferon [IFN] γ, tumour necrosis factor [TNF], and IL-17A) with strong HBV target sensitivity and liver-homing chemokine receptor expression when compared with HBV TCR-ConT cells. TCR-mediated lysis of hepatoma cells was comparable between the cell types and augmented in the presence of inflammation. Coculturing with HBV+ target cells in a 3D microdevice mimicking aspects of the liver microenvironment demonstrated that TCR-MAIT cells migrate readily towards hepatoma targets. Expression of an ectopic TCR did not affect the ability of the MAIT cells to be activated via MR1-presented bacterial antigens or IL-12/IL-18 stimulation. Conclusions: HBV TCR-MAIT cells demonstrate anti-HBV functions without losing their endogenous antimicrobial mechanisms or hepatotropic features. Our results support future exploitations of MAIT cells for liver-directed immunotherapies. Lay summary: Chronic HBV infection is a leading cause of liver cancer. T cell receptor (TCR)-engineered T cells are patients’ immune cells that have been modified to recognise virus-infected and/or cancer cells. Herein, we evaluated whether mucosal-associated invariant T cells, a large population of unconventional T cells in the liver, could recognise and kill HBV infected hepatocytes when engineered with an HBV-specific TCR. We show that their effector functions may exceed those of conventional T cells currently used in the clinic, including antimicrobial properties and chemokine receptor profiles better suited for targeting liver tumours