Physician health and wellness Taub, Sara; Morin, Karine; Goldrich, Michael S. ...
Occupational medicine,
03/2006, Volume:
56, Issue:
2
Journal Article
Peer reviewed
Open access
Background Impaired physician health can have a direct impact on patient health care and safety. In the past, problems of alcoholism and substance abuse among physicians have received more attention ...than other conditions—usually in the form of discipline. While patient safety is paramount, the medical profession may be more successful in achieving the required standards by fostering a culture committed to health and wellness as well as supporting impaired physicians. Objective To develop ethical guidelines regarding physician health and wellness. Methods The American Medical Association's (AMA's) Council on Ethical and Judicial Affairs developed recommendations based on the AMA's Code of Medical Ethics, an analysis of relevant Medline-indexed articles, and comments from experts. The report's recommendations were adopted as policy of the Association in December 2003. Results Individually, physicians can promote their personal health and wellness through healthy living habits, including having a personal physician. The medical profession can foster health and wellness if its members are taught to identify colleagues in need of assistance and initiate appropriate methods of intervention, including referrals to physician health programs. Conclusions Physicians whose health or wellness is compromised should seek appropriate help and engage in honest self-assessment of their ability to practice. The medical profession should provide an environment that helps to maintain and restore health and wellness. Physicians need to ensure that impaired colleagues promptly modify or cease practice until they can resume professional patient care. In addition, physicians may be required to report impaired colleagues who continue to practice despite reasonable offers of assistance.
In February 1975, a group of leading scientists, physicians, and
policymakers convened at Asilomar, California, to consider the safety of
proceeding with recombinant DNA research. The excitement ...generated by the
promise of this new technology was counterbalanced by concerns regarding
dangers that might arise from it, including the potential for accidental
release of genetically modified organisms into the environment. Guidelines
developed at the conference to direct future research endeavors had
several consequences. They permitted research to resume, bringing to an
end the voluntary moratorium that the National Academy of Sciences (NAS)
had instituted several months earlier. They also served to illustrate that
the scientific community was capable of self-governance, thereby securing
public trust and persuading Congress not to institute legislative
restrictions. Finally, they underscored the importance of weighing
unforeseen risks inherent in some research against potential benefits that
may arise from these same endeavors.The
Council on Ethical and Judicial Affairs of the American Medical
Association (AMA) formulates ethical policies for the medical profession
through its interpretations of the AMA's Principles of Medical
Ethics. The Council at the time this report was adopted consisted of
Michael S. Goldrich, M.D. (Chair); Priscilla Ray, M.D. (Vice-Chair);
Regina M. Benjamin, M.D., M.B.A.; Daniel Higginson (student member); Mark
A. Levine, M.D.; John M. O'Bannon III, M.D.; Robert M. Sade, M.D.;
Monique A. Spillman, M.D., Ph.D. (resident member); and Dudley M. Stewart,
Jr., M.D. Staff to the Council at the time the report was adopted were Audiey
Kao, M.D., Ph.D. (Vice President, Ethics Standards Group); Karine Morin,
L.L.M. (Secretary); and Sara Taub, M.Be. Shane K. Green, Ph.D., was a
Fellow in the AMA's Institute for Ethics.
FORUM Roberts, Priscilla; Levine, Steven I.; Vámos, Péter ...
Journal of cold war studies,
01/2010, Volume:
12, Issue:
1
Journal Article
Peer reviewed
This forum includes six commentaries on Lorenz M. Lüthi’s book The Sino-Soviet Split: Cold War in the Communist World, published by Princeton University Press in 2008. Drawing on recently ...declassified documents and memoirs from numerous countries, Lüthi explains how and why the close alliance between the Soviet Union and the People’s Republic of China fell apart in a remarkably short time, dissolving into fierce mutual enmity. Amassing a wealth of evidence, Lüthi stresses the role of ideology in the split, lending support to the arguments put forth nearly five decades ago by analysts like Donald Zagoria in his pioneering book on the Sino-Soviet rift. Six leading experts on Chinese foreign policy and Sino-Soviet relations discuss the strengths of Lüthi’s book but also raise questions about some interpretations and omissions. The forum includes Lüthi’s reply to the commentaries.
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The terrorist attacks of 2001 were a reminder that individual and
collective safety cannot be taken for granted. Since then, physicians,
alongside public health professionals and other healthcare ...professionals
as well as nonhealthcare personnel, have been developing plans to enhance
the protection of public health and the provision of medical care in
response to various threats, including acts of terrorism or bioterrorism.
Included in those plans are strategies to attend to large numbers of
victims and help prevent greater harm to even larger populations.The Council on Ethical and Judicial Affairs of
the American Medical Association formulates ethical policies for the
medical profession through its interpretations of the AMA's
Principles of Medical Ethics. The Council at the time this report
was adopted consisted of Michael S. Goldrich, M.D. (Chair); Priscilla Ray,
M.D. (Vice-Chair); Regina M. Benjamin, M.D., M.B.A.; Daniel Higginson
(student member); Mark A. Levine, M.D.; John M. O'Bannon, III, M.D.;
Robert M. Sade, M.D.; Monique A. Spillman, M.D., Ph.D. (resident member);
and Dudley M. Stewart, Jr., M.D. Staff to the Council at the time the report was adopted were Audiey
Kao, M.D., Ph.D. (Vice President, Ethics Standards Group); Karine Morin,
L.L.M. (Secretary); and Sara Taub, M.Be.
Twenty-first century progress against infectious diseases is threatened by urbanization, population growth, war refugees, changing sexual standards, and a host of other factors that open doors to the ...transmission of deadly pathogens.Infectious Diseases in an Age of Change reports on major infectious diseases that are on the rise today because of changing conditions and identifies urgently needed public health measures.This volume looks at the range of factors that shape the epidemiology of infectious diseases--from government policies to economic trends to family practices. Describing clinical characteristics, transmission, and other aspects, the book addresses major infectious threats--sexually transmitted diseases, Lyme disease, human cytomegalovirus, diarrheal diseases, dengue fever, hepatitis viruses, HIV, and malaria.The authors also look at the rising threat of drug-resistant strains of tuberculosis, rapid exhaustion of the weapons to fight bacterial infections, and prospects for vaccinations and eradication of pathogens.Infectious Diseases in an Age of Change will be important to public health policymakers, administrators, and providers as well as epidemiologists and researchers.
This report offers recommendations to physicians who provide information or services through online sites. The recommendations maintain that physicians responsible for health-related information ...should ensure that it is accurate, timely, reliable, and scientifically sound. Also, advice to online users with whom physicians do not have preexisting relationships or the use of decision-support programs that generate personalized information directly transmitted to users should be consistent with general and specialty-specific standards. In particular, these standards should address truthfulness, protection of privacy, informed consent, and disclosures including limitations inherent in the technology. Finally, physicians who establish or are involved in health-related online sites must minimize conflicts of interest and commercial biases and, if patient specific information is transmitted, they must provide high-level security protections, as well as privacy and confidentiality safeguards.
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The S-100 protein was purified from bovine brain by ammonium sulfate precipitation, ion exchange chromatography on DEAE-Sephadex,
and gel filtration through Sephadex G-100. Aggregation by disulfide ...bond formation results in the appearance of more than
one peak of the S-100 protein on DEAE-Sephadex and Sephadex G-100. Aggregation can be reversed by incubation with 0.01 m 2-mercaptoethanol for 1 hour at 60°. At least one sulfhydryl group is exposed to Ellman's reagent by calcium or, less effectively,
by magnesium and strontium.
The protein contains three subunits. One of these can be separated from the other two by ion exchange chromatography on DEAE-Sephadex
in 8 m urea. The separated subunit has the only tryptophan in the S-100 protein and does not contain arginine. The amino acid composition
suggests the other two subunits are different. When the lysines of these two subunits are blocked by maleylation, trypsin
cleaves only at the two arginines in these two subunits. Only two fragments of 2000 and 5000 molecular weight result, suggesting
the two subunits are structurally similar.
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The serological activity of the S-100 protein from bovine brain is reduced if the protein is aggregated by disulfide bond
formation, the sulfhydryl groups are blocked by p -mercuribenzoate, or the ...activity is destroyed by incubation at high temperatures. Chelating agents, which bind metals that
can oxidize sulfhydryl groups, protect the serological activity from heat denaturation. Blocking the sulfhydryl groups with
p -mercuribenzoate stabilizes the reduced serological activity to further inactivation by heat. The serological activity, whether
reduced or destroyed, can be recovered in all cases by incubation with 2-mercaptoethanol at 60°. The serological activity
of S-100 from extracts of different portions of the brain is not the same, but incubation with 2-mercaptoethanol abolishes
the differences.
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