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WANTED: An alternative to Competency-Based Medical Education

By J. Donald Boudreau

Nicaragua (1984): In a hospital—or at least what was labelled as a hospital—a physician receives an elderly woman in a hypertensive crises. He administers the only anti-hypertensive medication available—Reserpine—a drug that is now rarely used because of its side effects. To his profound dismay the patient suffers a stroke and dies a few hours later. There are no morgues in such rural hospitals. There are no ‘funeral parlours’ in the villages. Families take their departed loved ones home for burial.

What can brain research offer people who stutter?

By Jen Chesters

There’s something compelling about watching a person who stutters find a way to experience fluent speech. British TV viewers witnessed such a moment on Educating Yorkshire, back in 2013. When teenager Musharaf Asghar listened to music through headphones during preparations for a speaking exam, he found that his words began to flow. Singers, like Mark Asari who is currently competing on The Voice UK, also demonstrate how using the voice in song, rather than speech, can result in striking fluency.

We can predict rain but can’t yet predict chronic pain

By Steven George

Accurate weather forecasts allow us to prepare for rain, snow, and temperature changes. We can avoid driving on icy roads, pack an umbrella, or purchase sunblock, depending on what is predicted. Forecasting also generates information trustworthy enough to evacuate a city at risk from a category 4 hurricane. Meteorology has come a long way; today satellite data inform sophisticated computer weather models. Unfortunately, the same can’t be said for forecasting chronic pain. In most cases, health care providers can’t anticipate early or accurately enough which patients might develop long-lasting pain.

What’s the deal with genetically modified (GM) foods?

By Mary M. Landrigan and Philip J. Landrigan

It’s complicated; but here is a quick summary of what the controversy over genetically modified foods is all about. GM engineering involves reconfiguring the genes in crop plants or adding new genes that have been created in the laboratory. Scientific modification of plants is not something new. Since time began, nature has been modifying plants and animals through natural evolution, meaning that the plants and animals that adapt best to the changing environment survive and pass their genes on to their offspring. Those that are least fit do not survive.

Better health care delivery: doing more with existing resources

By Boaz Ronen, Joseph S. Pliskin, and Shimeon Pass

The healthcare sector faces challenges which are constantly escalating. Populations are growing worldwide and so is the share of the elderly in society. There is a constant proliferation of new medications, diagnostic methods, medical procedures and equipment, and know-how. This huge progress greatly improves the quality of medical treatment but at the same time increases its costs. Governments and authorities are allocating ever growing budgets to healthcare systems but the increased budgets do not cover the increased costs of providing quality healthcare to the public.

What causes oral cancer and how can we prevent it?

By Hugh Devlin and Rebecca Craven

We know that excessive consumption of alcohol is detrimental to oral health, but why? We know that tobacco smoking, alcohol, and poor oral hygiene cause increased acetaldehyde levels in saliva. Alcohol itself is not carcinogenic, but it is metabolised to acetaldehyde which has been strongly implicated in the development of oral cancer. The variation between people in how they metabolize alcohol might explain why some are at greater risk of cancer than others.

National Volunteer Month: a reading list

By Deborah Carr

On 20 April 1974, President Richard M. Nixon declared National Volunteer Week, to honor those Americans whose unpaid “efforts most frequently touch the lives of the poor, the young, the aged and the sick, but in the process the lives of all men and women are made richer.” This commemoration has since been extended to a full month to recognize those who offer their time, energy, and skills to their communities.

The four principles of medicine as a human experience

By David Rosen and Uyen B. Hoang

The standard in medicine has historically favoured an illness- and doctor-centered approach. Today, however, we’re seeing a shift from this methodology towards patient-centered care for several reasons. In the edited excerpt below, taken from Patient-Centered Medicine, David H. Rosen and Uyen Hoang explore four core principles that underlie the foundation of this clinical approach.

The return of opiophobia

By Robert C. Macauley

Opiophobia (literally, a fear of opioids or their side effects, especially respiratory suppression) has been around for a long time. Nowadays it’s primarily prompted by the opioid epidemic that has caused a five-fold increase in overdose deaths over the past two decades. With opioids implicated in over 40,000 deaths in the United States each year, interventions such as daily milligram limits, short-term prescribing, and “risk evaluation and mitigation strategies” are important public health measures.

What to do about tinnitus?

By Erin Martz and yahav oron

Tinnitus (i.e., ear or head noises not caused by external sounds) is common among the general population across the world. Tinnitus can be experienced as a “ringing in the ears.” It can also sound like a hissing, sizzling, or roaring noise. It can be rhythmic or pulsating. Tinnitus can be a non-stop, constant sound or an intermittent sound that disappears and returns without a pattern. It can occur in one or both ears.

Modernization of mortuary practice and grief

By Claire White-Kravette

Modern western mortuary practices are characterized by the professionalization of the management and presentation of the corpse. These practices serve as a stark contrast to those in traditional societies across the world and those throughout history. Changes to how we treat and dispose of the dead are such that industrialized societies have become outliers on the spectrum of the world’s cultures.

Artificial intelligence in oncology

By Kiashini Sriharan

There is no denying the presence of computers in our everyday life, whether it’s through phones, personal virtual assistants such as Apple’s Siri and Amazon’s Alexa, or video games. Lately, the interest and development surrounding artificial intelligence (AI) has escalated, and the opportunities to embrace this within the healthcare industry seem to be growing.

Collaboration for a cure: harnessing the power of patient data

By Taz Cheema

I am a classic example of a fitness fanatic who uses a wearable device to count my steps, measure my heart rate, and track my sleep pattern. Every day, I am armed with data gathered about my physical activity, alerting me as to whether I’ve been slacking in the gym or eating too many bags of crisps. There is no doubt that now, more than ever, we live in a world where ‘big data’ is ubiquitous in influencing our daily decisions.

Brain tumour awareness: The end counts too

By Kiashini Sriharan

Here in the United Kingdom, we have the worst survival rates for brain cancer in Europe, with just 14% of patients surviving for ten or more years. Whilst prognosis for most other types of cancer has improved, brain tumour survival rates have remained stagnant, with no game-changing new drugs being developed in the last fifty years. As brain tumours progress, the aggressive nature of the disease becomes apparent.

Misconceptions of vaccines

By Anna Shannon

Vaccines help to provide immunity against diseases. Sadly, there are a number of misconceptions surrounding vaccines, leading to some areas of the community opting not to vaccinate. This has a negative impact as decreasing immunisation rates can lead to an increase in diseases that can be prevented by vaccines, as was seen with the whooping cough in California.

Shaping the legacy of Dame Cicely Saunders [excerpt]

By David Clark

She arrived in 1938, at age twenty-one, for the Michaelmas term. In that year, there were 850 women studying at the University, making up a record 18.5% of the student body. Cicely elected to read Politics, Philosophy, and Economics (P.P.E.). This programme of study had been established at Oxford in the 1920s as an alternative to ‘Greats’ or Classics. It was generally known as ‘Modern Greats’.