Science, professionalism and the development of medical education in England : a historical sociology.

Education lies at the very epicentre of professional formation, professional behaviour, and professional values. Far-reaching institutional and curricular changes occurred in the education of doctors in the nineteenth century. These changes were related, I argue, to two long-term historical processes - the 'professionalisation' and the 'scientification' of medicine. England is the main geographical focus, but the thesis also encompasses a brief comparative historical sociology of the emergence of 'hospital' and 'laboratory' medical education in France and Germany respectively. Doctors were the first occupational community to claim that their 'professional' status rested on the sure foundation of 'scientific' knowledge and expertise; but the thesis adopts an attitude of anthropological scepticism towards both the alleged cognitive supremacy of 'scientific' medicine and its assumed role in conferring 'professional' privileges. Nevertheless, the rhetorical appeal of scientific culture proved strategically useful to doctors in their collective pursuit of upward social mobility in three particular contexts: the efforts of rank-and-file practitioners to usurp the professional privileges of elite consultants; regular doctors' attempts to eliminate professionally damaging competition from a variety of alternative and irregular healers conventionally labelled as Oquacks'; and the emergent relationship being forged between the medical profession and the modern state. A finely-textured analysis of intra-professional conflict is necessary to account for the politics of medical reform and for prolonged disputation over the future direction of medical education. There were two principal axes of internal conflict between medical interest-groups: the first between general practitioners and consultants; the second between traditional clinicians, many of whom actively opposed the introduction of experimental procedures into medical education, and those who vigorously promoted progressive scientific reform. The latter conflict, which has often been underestimated, is characterised in terms of a structural opposition between the scientific 'word' and the clinical I ward'. Such an explanatory framework offers the historian a more valuable resource than the simple antithesis between 'empiricism' and 'rationalism'. At the end of the Victorian period, apprenticeship had been eliminated and all aspiring doctors were educated in a university. It was through education that doctors were imbued with a set of professional value-orientations, and forged feelings of common identity and solidarity. The instance of Victorian doctors suggests that the historic role of the professions in English society is far less marginal and peripheral than has often been supposed

The Development of a SPME-GC/MS Method for the Analysis of VOC Emissions from Historic Plastic and Rubber Materials

Analytical methods have been developed for the analysis of VOC emissions from historic plastic and rubber materials using SPME-GC/MS. Parameters such as analysis temperature, sampling time and choice of SPME fibre coating were investigated and sampling preparation strategies explored, including headspace sampling in vials and in gas sampling bags. The repeatability of the method was evaluated. It was found that a 7 d accumulation time at room temperature, followed by sampling using a DVB/CAR/PDMS fibre, with a sampling time of 60 min at room temperature was a suitable strategy for the detection of VOC emissions from a wide range of historic plastic and rubber artefacts. For 20 mL vials, a sample size of 50 mg was found to be appropriate and grinding the samples improved the repeatability of the analysis and yielded higher levels of emissions. A non-destructive adaptation of the method that could be used directly on historic objects in a museum environment is also presented. The detected emissions improve understanding of ongoing degradation processes within historic plastic and rubber materials, in addition to providing information on material composition

FIRST BREEDING RECORDS OF KELP GULLS LARUS DOMINICANUS VETULA AT ROBBEN ISLAND, WESTERN CAPE, SOUTH AFRICA

The first recorded breeding of kelp gulls Larus dominicanus vetula on Robben Island, Western Cape, South Africa, took place in 2000, when five nests were recorded. In 2001, there were 15 nests and 29 fledglings. The initiation of breeding by kelp gulls on Robben Island is likely a response to the reduction of disturbance since the Robben Island Museum took control of the island. Afr. J. mar. Sci. 25: 391–39

Estimating Be Star Disk Radii using H-alpha Emission Equivalent Widths

We present numerical models of the circumstellar disks of Be stars, and we describe the resulting synthetic H-alpha emission lines and maps of the wavelength-integrated emission flux projected onto the sky. We demonstrate that there are monotonic relationships between the emission line equivalent width and the ratio of the angular half-width at half maximum of the projected disk major axis to the radius of the star. These relationships depend mainly upon the temperatures of the disk and star, the inclination of the disk normal to the line of sight, and the adopted outer boundary for the disk radius. We show that the predicted H-alpha disk radii are consistent with those observed directly through long baseline interferometry of nearby Be stars (especially once allowance is made for disk truncation in binaries and for dilution of the observed H-alpha equivalent width by continuum disk flux in the V-band).Comment: 12 pages, 2 figures, ApJL in pres

Automated volumetric grid generation for finite element modeling of human hand joints

We are developing techniques for finite element analysis of human joints. These techniques need to provide high quality results rapidly in order to be useful to a physician. The research presented here increases model quality and decreases user input time by automating the volumetric mesh generation step

Comparison of next-generation portable pollution monitors to measure exposure to PM2.5 from household air pollution in Puno, Peru.

Assessment of personal exposure to PM2.5 is critical for understanding intervention effectiveness and exposure-response relationships in household air pollution studies. In this pilot study, we compared PM2.5 concentrations obtained from two next-generation personal exposure monitors (the Enhanced Children MicroPEM or ECM; and the Ultrasonic Personal Air Sampler or UPAS) to those obtained with a traditional Triplex Cyclone and SKC Air Pump (a gravimetric cyclone/pump sampler). We co-located cyclone/pumps with an ECM and UPAS to obtain 24-hour kitchen concentrations and personal exposure measurements. We measured Spearmen correlations and evaluated agreement using the Bland-Altman method. We obtained 215 filters from 72 ECM and 71 UPAS co-locations. Overall, the ECM and the UPAS had similar correlation (ECM ρ = 0.91 vs UPAS ρ = 0.88) and agreement (ECM mean difference of 121.7 µg/m3 vs UPAS mean difference of 93.9 µg/m3 ) with overlapping confidence intervals when compared against the cyclone/pump. When adjusted for the limit of detection, agreement between the devices and the cyclone/pump was also similar for all samples (ECM mean difference of 68.8 µg/m3 vs UPAS mean difference of 65.4 µg/m3 ) and personal exposure samples (ECM mean difference of -3.8 µg/m3 vs UPAS mean difference of -12.9 µg/m3 ). Both the ECM and UPAS produced comparable measurements when compared against a cyclone/pump setup

A Dark Web of Personality: Network Analyses of Dark Personality Features and Pathological Personality Traits

Network analysis offers an opportunity to gain a more nuanced view of the connections between the darker aspects of personality by examining the interrelationships between the components that make up these constructs. We examined the associations that five dark personality dispositions (i.e., narcissism, Machiavellianism, psychopathy, sadism, and spitefulness) had with pathological personality traits (i.e., antagonism, disinhibition, detachment, negative affectivity, and psychoticism) via network analysis. These dark personality networks were examined in four studies (N = 1,800), wherein the second study attempted to replicate the network from the first study, while the last two studies incorporated more specific and independent measures of dark personality features (e.g., grandiose and vulnerable narcissism). Although there were differences across network structures in these studies, the pathological personality trait of antagonism consistently evinced high expected influence centrality (i.e., it was the most strongly connected and possibly influential trait in each network). Our discussion focuses on the implications of these results for the understanding of the connections between the darker aspects of personality

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex disease that affects children and adolescents as well as adults. The etiology has not been established. While many pediatricians and other health-care providers are aware of ME/CFS, they often lack essential knowledge that is necessary for diagnosis and treatment. Many young patients experience symptoms for years before receiving a diagnosis. This primer, written by the International Writing Group for Pediatric ME/CFS, provides information necessary to understand, diagnose, and manage the symptoms of ME/CFS in children and adolescents. ME/CFS is characterized by overwhelming fatigue with a substantial loss of physical and mental stamina. Cardinal features are malaise and a worsening of symptoms following minimal physical or mental exertion. These post-exertional symptoms can persist for hours, days, or weeks and are not relieved by rest or sleep. Other symptoms include cognitive problems, unrefreshing or disturbed sleep, generalized or localized pain, lightheadedness, and additional symptoms in multiple organ systems. While some young patients can attend school, on a full or part-time basis, many others are wheelchair dependent, housebound, or bedbound. Prevalence estimates for pediatric ME/CFS vary from 0.1 to 0.5%. Because there is no diagnostic test for ME/CFS, diagnosis is purely clinical, based on the history and the exclusion of other fatiguing illnesses by physical examination and medical testing. Co-existing medical conditions including orthostatic intolerance (OI) are common. Successful management is based on determining the optimum balance of rest and activity to help prevent post-exertional symptom worsening. Medications are helpful to treat pain, insomnia, OI and other symptoms. The published literature on ME/CFS and specifically that describing the diagnosis and management of pediatric ME/CFS is very limited. Where published studies are lacking, recommendations are based on the clinical observations and practices of the authors