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Hübbert, Laila. "Between the Probe and the Pump : An experimental study on cardiac performance analysis based on Echocardiography, tissue and laser Doppler." Doctoral thesis, Linköpings universitet, Kardiologi, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-61518.
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Echocardiography is an ultrasound-based bedside, non-invasive and easily available cardiac diagnostic technique visualising the heart’s morphology and function. Quantification of cardiac wall motion can be measured with the tissue Doppler Imaging (TDI) modality which provides in humans a high diagnostic capacity to differentiate healthy from diseased myocardium with reduced function. Heart failure, as a consequence of, for example, myocardial or ischaemic heart disease, demands both bedside and intraoperative diagnostic procedures for myocardial functional and perfusion assessment. In the late stages of heart failure cardiac left ventricular assist devices (LVAD) may be the treatment of choice. Such new technologies are commonly evaluated in large animals before application in humans is accepted. With the aim of evaluating TDI´s applicability and feasibility in a large animal model 21 calves (aged 3 months and weight around 70 kg), were studied with colour TDI (Paper I). Analysis was performed either during coronary artery occlusion when the laser Doppler perfusion imaging technique (LDMP) was refined (Paper II), or after implantation of the LVAD, Heart Mate II® (Papers III, IV). All animals were haemodynamically monitored (pressures, flows, heart rate) and ECG was continuously recorded. Transthoracic and epicardial echocardiography (TTE) were performed before and after sternotomy and intraoperatively during experimental progressive heart failure. Heart chamber dimensions, native stroke volume, systolic and diastolic regional basal myocardial peak velocities (cm/s; systolic S´, early diastolic E´, and atrial A´, strain (%), strain rate (s-1) and displacement (mm) were determined. Second harmonic imaging (SHI) was applied in order to better visualise air bubbles (Paper IV). In Paper I compiled baseline values were established before and after sternotomy for central haemodynamic and echocardiographic parameters, including the TDI myocardial motion variables velocity, strain rate, strain and displacement. Blood pressure and heart rate changed significantly after sternotomy, but the TDI derived data did not change significantly. In Paper II we report that movement artifacts of the laser Doppler myocardial perfusion measurements can be reduced, both when myocardium is normally perfused and during coronary occlusion, by using the TDI velocity registrations showing wall motion to be minimal. The optimum interval depends on the application but late systole as well as late diastole is preferred. After LVAD implantation in Paper III the flow characteristics and myocardial motion during variations in afterload TDI show that myocardial velocities decrease concomitantly with myocardial depression and are significantly correlated to native stroke volume, heart rate, systemic arterial resistance and cardiac output, but not with left ventricular size, fractional shortening or pump speed. Echocardiography together with TDI thereby offers additional means for monitoring and quantifying residual myocardial function during LVAD treatment. SHI is superior in the early detection of single air-bubbles in the ascending aorta prior to significant air embolism during manipulation of the LVAD pump speed, as shown in Paper IV. A prompt decrease in size of the left atrium during speed adjustment may be a warning that massive air embolism is imminent whereas the commonly used left atrial pressure not provide the same warning.The title of article II is in the list of publications "Correlation between laser Doppler perfusion monitoring and myocardial tissue Doppler echocardiography in the beating heart" and in the published article the title is "Myocardial tissue motion influence on laser Doppler perfusion monitoring using tissue Doppler imaging".
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Tagesson, Mattias, and Hedvig Olsson. "In Vitro Evaluation of Laser Induced Fluorescence for Aided Caries Excavation (FACE)." Thesis, Malmö universitet, Odontologiska fakulteten (OD), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19807.
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Syfte: att utvärdera tillförlitligheten hos laserinducerad fluorescens som hjälpmedel vid kariesexkavering (FACE), och om FACE kan användas som ett komplement till befintliga kliniska diagnostiska metoder för att bestämma när kariesskadan är färdigexkaverad.Material och metod: två experimentprotokoll utvecklades. Tänder till protokoll I valdes ut från en samling extraherade tänder, och nyextraherade och direkt infrusna tänder ingick i protokoll II. Totalt 43 tänder med dentinkaries exkaverades först efter minimalinvasiv teknik enligt konsensuskriterier för kariesexkavering, och sedan enligt FACE. Ljussonden som användes, D-light Pro, lyste upp kaviteten och vid synlig fluorescens indikerades fortsatt exkavering. Skillnader visualiserades med röntgenologisk subtraktionsanalys vilken möjliggjordes av för studien utvecklad reproducerbar röntgenteknik.Resultat: Inkluderade tänder fluorescerade inte som förväntat, vilket är varför nyextraherade tänder användes i protokoll II. Endast en tand från vardera protokoll fluoroscerade efter initiala exkaveringen. Skillnader syntes i subtraktionsanalysen hos de två tänderna som gick igenom FACE.Slutsats: FACE är inte tillförlitligt för att bestämma slutpunkt för exkavering eftersom missfärgningar markeras, tolkningen av fluorescensen är inte tydligt definierad, samt att FACE missar uppenbara karieslesioner. Dessa tillkortakommanden gör att FACE är potentiellt skadlig och vidare forskning behövs för att FACE ska kunna användas kliniskt.Aim: to evaluate the reliability of fluorescence aided caries excavation (FACE), and if FACE could be used as a supplement to existing clinical diagnostic methods for determination of the caries excavation endpoint.Material and methods: two procedure protocols were developed. Protocol I with teeth that were collected from a pool of extracted teeth and protocol II with freshly extracted and immediately frozen teeth. In total, 43 extracted teeth with dentin caries lesions underwent initial excavation adhering to consensus criteria on caries removal, followed by FACE. A light probe, D-light Pro, was used to illuminate the cavity, and if fluorescence was seen, further removal was indicated. Differences in excavated tooth substance were visualised by radiographic subtraction analysis utilising a developed reproducible radiograph imaging.Results: Tooth samples were not fluorescing as expected which is why freshly extracted teeth were used in protocol II. Only one tooth in each protocol exhibited fluorescence after initial excavation. The two teeth that underwent FACE did show difference in the subtraction analysis. Conclusions: FACE is not reliable in determining the endpoint of excavation since discolourations are highlighted, the interpretation of the fluorescence is not properly defined, and furthermore, FACE does not highlight all clinically apparent carious lesions. These shortcomings make FACE potentially harmful and further research is needed until FACE should be used in the clinical setting.
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Fredriksson, Ingemar. "Quantitative Laser Doppler Flowmetry." Doctoral thesis, Linköpings universitet, Biomedicinsk instrumentteknik, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-19947.
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Laser Doppler flowmetry (LDF) is virtually the only non-invasive technique, except for other laser speckle based techniques, that enables estimation of the microcirculatory blood flow. The technique was introduced into the field of biomedical engineering in the 1970s, and a rapid evolvement followed during the 1980s with fiber based systems and improved signal analysis. The first imaging systems were presented in the beginning of the 1990s. Conventional LDF, although unique in many aspects and elegant as a method, is accompanied by a number of limitations that may have reduced the clinical impact of the technique. The analysis model published by Bonner and Nossal in 1981, which is the basis for conventional LDF, is limited to measurements given in arbitrary and relative units, unknown and non-constant measurement volume, non-linearities at increased blood tissue fractions, and a relative average velocity estimate. In this thesis a new LDF analysis method, quantitative LDF, is presented. The method is based on recent models for light-tissue interaction, comprising the current knowledge of tissue structure and optical properties, making it fundamentally different from the Bonner and Nossal model. Furthermore and most importantly, the method eliminates or highly reduces the limitations mentioned above. Central to quantitative LDF is Monte Carlo (MC) simulations of light transport in tissue models, including multiple Doppler shifts by red blood cells (RBC). MC was used in the first proof-of-concept study where the principles of the quantitative LDF were tested using plastic flow phantoms. An optically and physiologically relevant skin model suitable for MC was then developed. MC simulations of that model as well as of homogeneous tissue relevant models were used to evaluate the measurement depth and volume of conventional LDF systems. Moreover, a variance reduction technique enabling the reduction of simulation times in orders of magnitudes for imaging based MC setups was presented. The principle of the quantitative LDF method is to solve the reverse engineering problem of matching measured and calculated Doppler power spectra at two different source-detector separations. The forward problem of calculating the Doppler power spectra from a model is solved by mixing optical Doppler spectra, based on the scattering phase functions and the velocity distribution of the RBC, from various layers in the model and for various amounts of Doppler shifts. The Doppler shift distribution is calculated based on the scattering coefficient of the RBC:s and the path length distribution of the photons in the model, where the latter is given from a few basal MC simulations. When a proper spectral matching is found, via iterative model parameters updates, the absolute measurement data are given directly from the model. The concentration is given in g RBC/100 g tissue, velocities in mm/s, and perfusion in g RBC/100 g tissue × mm/s. The RBC perfusion is separated into three velocity regions, below 1 mm/s, between 1 and 10 mm/s, and above 10 mm/s. Furthermore, the measures are given for a constant output volume of a 3 mm3 half sphere, i.e. within 1.13 mm from the light emitting fiber of the measurement probe. The quantitative LDF method was used in a study on microcirculatory changes in type 2 diabetes. It was concluded that the perfusion response to a local increase in skin temperature, a response that is reduced in diabetes, is a process involving only intermediate and high flow velocities and thus relatively large vessels in the microcirculation. The increased flow in higher velocities was expected, but could not previously be demonstrated with conventional LDF. The lack of increase in low velocity flow indicates a normal metabolic demand during heating. Furthermore, a correlation between the perfusion at low and intermediate flow velocities and diabetes duration was found. Interestingly, these correlations were opposites (negative for the low velocity region and positive for the mediate velocity region). This finding is well in line with the increased shunt flow and reduced nutritive capillary flow that has previously been observed in diabetes.
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McGill, David J. "Current understanding of cutaneous laser treatment : a need for improved outcome and objective methods of assessing results." Thesis, Available from the University of Aberdeen Library and Historic Collections Digital Resources, 2008. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?application=DIGITOOL-3&owner=resourcediscovery&custom_att_2=simple_viewer&pid=25020.
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Thesis (Ph.D.)--Aberdeen University, 2008.Title from web page (viewed on Mar. 2, 2009). With: The effect of ambient temperature on capillary vascular malformations / D.J. McGill, I.R. Mackay. British journal of dermatology. 2006: 154, 896-903. With: Capillary vascular malformation response to increased ambient temperature is dependent upon anatomical location / David J. McGill, Iain R. Mackay. Annals of plastic surgery. 2007: 58, 2, 193-199. With: A direct comparison of Pulsed dye, Alexandrite, KTP and ND: YAG lasers and IPL in patients with previously treated capillary malformation / Davis J. McGill, William MacLaren, Iain R. Mackay. Lasers in surgery and medicine. 2008: 9999, 1-9. With: A randomized split-face comparison of facial hair removal with Alexandrite Laser and Intense Pulsed Light System / D.J. McGill ... et al. Lasers in Surgery and medicine. 2007: 39, 767-772. With: Laser hair removal in women with polycystic ovary syndrome / D.J. McGill ... et al. Journal of plastic, reconstructive & aesthetic surgery. 2007: 60, 426-431. Assessment of burn depth : a prospective, blinded comparison of laser Doppler imaging and videomicroscopy / D.J. McGill ... et al. Burns. 2007: 33, 833-842. Includes bibliographical references.
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Haridoss, Sujithera. "In vivo assessment of focal adhesion kinase (FAK) activity in breast cancer cells using fluorescence resonance energy transfer (FRET) sensor and confocal laser scanning microscope (CLSM)." Thesis, Högskolan i Skövde, Institutionen för hälsa och lärande, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-15706.
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Focal Adhesion Kinase (FAK) is essential for cell migration and plays an important role in tumor metastasis. However, the complex intermolecular and intramolecular interactions that regulate FAK activity at the focal adhesion remain unresolved. We have engineered a toolbox of Fluorescence Resonance Energy Transfer (FRET) sensors for the assessment of FAK activity in human breast cancer cells (MCF-7). Major activity of cancerous cells is drastically growth of the cell in an uncontrollable manner in such cases our human anatomy system normally consists of cell growth activity. The important protein involved in cell functionality in the human body is FAK, due to FAK activity, cell motility, proliferation, survival has been managed in the human body hence, it is necessary to investigate the performance ofFAK activity on breast cancer becomes important. In our study, the differences in bleed through between zoom = 1 and for zoom >1 for donor and acceptor was evaluated. There were no significant differences in Pearson correlation coefficient and bleed through coefficient for both the zooms. With recent advances influorescent probes, instrumentation and methodologies, FRET is sure to revolutionize scientific research in the near future.
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Subraian, Jaqueline, and Geer Emelie De. "Low-level laser therapy as a method to improve orthodontic treatment – a systematic review." Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19680.
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Långa behandlingstider, recidiv och smärta är fenomen som associeras med ortodontisk behandling. Under senare år har ett flertal studier undersökt terapilaser som en metod för att förbättra ortodontisk behandling i dessa avseenden.Syftena med denna systematiska litteraturstudie var att undersöka evidensen för huruvida low-level laser therapy (LLLT) kan fungera som en effektiv metod för att (I) accelerera tandförflyttning, (II) förhindra ortodontisk recidiv eller (III) minska akut smärta vid ortodontisk behandling.Den här systematiska litteraturstudien utfördes i enlighet med riktlinjer från Statens beredning för medicinsk utvärdering, SBU. Vid litteratursökningen i februari 2013 användes databaserna PubMed/Medline samt Cochrane. En kompletterande sökning i Scitation gjordes i oktober 2013. I mars 2014 gjordes en uppdaterad sökning. Två studier där acceleration av tandförflyttning med hjälp av LLLT samt tolv studier där LLLT använts för att minska akut smärta vid ortodontisk behandling hittades. Ingen studie där LLLT använts som metod för att undvika ortodontisk recidiv matchade de givna inklusionskriterierna.Studierna visade på en trend av goda resultat vid användning av LLLT. En ökad tandförflyttningshastighet på omkring 30 % kunde ses samt att försökspersoner rapporterade en smärtreduktion på en numerisk skala, NRS eller en visuell analog skala, VAS. Stor variation kunde ses mellan studierna gällande laserstrålningens olika parametrar och det är uppenbart att det saknas konsensus gällande olika typer av laser, strålningsfrekvens samt styrka.Denna systematiska litteraturstudie föreslår att LLLT kan underlättar den ortodontiska behandlingen genom att minska både behandlingstid och smärta. Inga studier hittades gällande LLLTs inverkan på att minska recidiv. Fler väldesignade undersökningar krävs för att bestämma om low-level laser therapy är en effektiv metod för att förbättra ortodontisk behandling.Denna systematiska litteraturstudie föreslår att evidensen är låg för LLLT som metod för att accelerera ortodontisk tandförflyttning och väldigt låg för LLLT som metod för att minska akut ortodontisk smärta. Ingen studie som uppfyllde givna inklusionskriterier har gjorts gällande LLLTs förmåga att minska ortodontisk recidiv. Detta understryker behovet av forskning med hög kvalitet och större överensstämmelse i både studiedesign och laserschema för att i framtiden kunna bestämma om LLLT är en effektiv metod för att accelerera tandförflyttning, förhindra ortodontisk recidiv eller minska akut ortodontisk smärta hos barn och unga vuxna.Extensive treatment time, relapse and pain are all phenomena associated with orthodontic treatment. Recently, several studies using laser therapy as a method to improve orthodontic treatment have been carried out to offer a solution to the above presented problems.The objectives of this systematic review were to investigate the level of evidence for low-level laser therapy as an effective method to either (I) accelerate tooth movement, (II) prevent orthodontic relapse or (III) diminish acute pain during orthodontic treatment.The present study was designed according to The Swedish Council on Technology Assessment in Health Care. The literature search was performed using PubMed, Medline electronic databases and Cochrane Controlled Clinical Trials Register up to February 2013. An additional search was carried out in Scitation in October 2013. In March 2014 an update search was done. Two studies were found regarding acceleration of tooth movement when using LLLT and twelve studies used LLLT to diminish acute pain. No study on LLLT as a method to prevent orthodontic relapse was found according to given inclusion criteria.The studies showed a trend of good results when using LLLT. Acceleration of approximately 30 % was seen when using LLLT and the subjects reported a lower pain score on numeric rate scale (NRS) or visual analogue scale (VAS) compared to control. The laser regimen was used with a wide range and it is obvious that no consensus has been reached considering different lasers, frequencies and powers.The present systematic review suggests that the quality level of evidence is low for LLLT to accelerate orthodontic tooth movement and very low for LLLT to diminish acute orthodontic pain. No study according to given inclusion criteria has been done on LLLTs ability to diminish orthodontic relapse. This emphasises the need for high quality research with consistency in study design and laser schedule to further determine if LLLT is an effective method to accelerate tooth movement, prevent orthodontic relapse or diminish acute pain during orthodontic treatment on children and young adults.
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Blackwelder, Reid B. "Medical Jeopardy." Digital Commons @ East Tennessee State University, 2001. https://dc.etsu.edu/etsu-works/6999.
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Harvey, Janet. "Behind the medical mask : medical technology and medical power." Thesis, University of Warwick, 1992. http://wrap.warwick.ac.uk/36139/.
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This thesis explores the role of technology as a resource in the structure of medical domination of birth and death, stressing technology's pivotal position at the intersection of control and uncertainty. Based in Intensive Care and Obstetrics (between which the health status of patients diverges sharply), it notes the convergence of technology used and examines the contest for control within the labour process. This includes using technology to facilitate a 'standardized' birth or death; a more retrospectively defensible event. In general, the 'burden of proof' is concluded to lie with those wishing not to intervene rather than the reverse. Given the (cognitively male) biomedical model, mind-body dualism is an assumption embedded in medical technology: this is especially significant in childbirth, where it fractures the woman's ontological experience of giving birth. Its positivistic and pathological emphasis is associated with a reification of processes and a commodification of their 'solution': which becomes located in technology. It is argued that commodification in health provision will increase with the further application of market principles to the NHS. It is concluded that 'uncertainty', endemic to medicine and a possible challenge to control, is proactively manipulated and pressed into the service of medical domination. Technology is used to mask uncertainty and aid the medical profession's control of patients/relatives, and subordinate work groups. A technological fix may be viewed as the opposite to re-discovering societal dreams and myths, however, more paradoxically, it is concluded that dreams and myths have become attached to technology. Thus, the symbolic role of technology is: to provide hope of continued survival (or cure), the veiling of existential uncertainty and the offer of 'absolution' - should all efforts fail (a freedom from guilt in the assurance that "everything possible was tried"). Its 'heroic' project is viewed as an existentially 'masculine' health provision and 'feminized' health care is posited as an alternative.
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Kleine, Klaus. "Micromachining with single mode fibre lasers for medical device production." Thesis, University of Liverpool, 2009. http://livrepository.liverpool.ac.uk/1295/.
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This Thesis is based on several research and development programs to implement the use of fibre lasers in the manufacturing of medical devices like stents and pacemakers. In general, the medical device manufacturing industry has a high demand for laser micromachining applications. The content of the thesis describes laser micromachining of metallic components with single mode fibre lasers. At the started of the research work for this thesis, most laser machining processes used flash-lamp pumped solid-state lasers for those applications. Reliable laser operation and low maintenance are required to meet the yields and up-time requirements for medical devices, such as stent cutting and pacemaker welding. Many lasers for micromachining applications are configured to operate near the diffraction limited beam performance to achieve very small feature sizes. It is challenging to maintain such a laser system performance in a production environment. The fibre laser provides a number of attractive features that could address the needs to maintain high up-time and high yields: • A single mode fibre laser does not require mirror alignment. • Diode pumped fibre lasers reduce maintenance due to eliminating the lamp change. • The compact air-cooled design helps to save expensive clean room space on the production floor. By 2000 the increases in average laser power extended the use of the fibre lasers into industrial applications such as cutting and welding.. The lasers investigated in this thesis generated 50 W to 200 W of laser power, representing the highest power levels commercially available at that time. For the microcutting of medical implants such as stents and guide wires, kerf width and sidewall surface quality are of special interest. Developing processes capable of achieving these criteria was the primary objective of the research described in this thesis. A secondary concern is the heat affected zone created by the laser machining process. Operation conditions to minimize this effect are also discussed in this thesis. Many microwelding applications in the electronics, telecom and medical device industry require smaller and smaller laser joining areas. The quality of a laser welded joint is very dependant on the temporal and spatial parameters of the laser beam. These parameters must be adjusted to match to the processing speed and the materials being welded. Switching continuous wave fibre lasers can achieve the parameters for processes requiring low average power. However the pulse-to-pulse stability can effect the process and has been investigated. Some welding applications require focus spot diameters in the order of 50 μm and pulse energy levels as low as 10 mJ. The fibre laser’s excellent single mode beam quality provides the desired spot size and laser power density. The research summarized in this thesis was performed to prove that fibre lasers are viable tools for micromachining. This thesis compares fibre laser machining results with those using legacy laser processes and describes ways to improve the quality of the fibre laser machining process.
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Blackwelder, Reid B. "Medical Jeopardy Workshop." Digital Commons @ East Tennessee State University, 1995. https://dc.etsu.edu/etsu-works/6970.
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Lai, Man-lung Stanley. "Adjunctive effects of a low-power laser on the healing of periodontal tissue." Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B37651006.
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VILLENA, PHILIPPE. "Traitement laser des affections prostatiques : etude de faisabilite en imagerie 2d et 3d." Reims, 1993. http://www.theses.fr/1993REIMM050.
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Sinclair, Simon Keith. "The institutional apprenticeship of medical students in a London medical school." Thesis, London School of Economics and Political Science (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.482051.
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The thesis provides an account of the basic medical training in England, largely unchanged for 150 years despite many calls for reform. The three stages (preclinical and clinical period and the pre-registration year) that students pass through are described in terms of acquired professional dispositions, with historical, cultural (including linguistic) and epistemological aspects; the dramatic aspects of dispositions give rise to a series of roles acquired through practice. Acquisition of these professional dispositions is fostered by students' aspirations and the general culture of co-operation, rather than by the simple explicit transmission of professional values, knowledge and skills, or a lowly and autonomous group "making out". The medical school and teaching hospital are therefore seen as acting in many ways like a "total institution", their segmentation being held together by students in practice, as well as cognitively and financially. Teaching and assessment of these roles leads, through their linguistic component (whose precise physical referents reflect the associated positivist epistemological base and its certainty) and dramatic features, to the stable reproduction of medical knowledge and is associated with the internal stability of the profession and of its relation to others. The resulting low status attached to academic disciplines (notably psychology and sociology) and branches of medicine (notably psychiatry) tends to limit awareness within the profession of the discordance within and between dispositions and between roles. The high rates of mental illness within the profession may be seen as related to such internal psychological conflicts; these lead, in effect, to classifying sufferers as individual psychiatric patients and so "blaming the victim". For this reason alone, it is most unlikely that students and junior doctors can effect any change in the system of training; other factors that contribute to the system's stability are discussed
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Blackwelder, Reid B. "Medical Jeopardy. Closing session." Digital Commons @ East Tennessee State University, 1994. https://dc.etsu.edu/etsu-works/6971.
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Viator, John Andrew. "Characterization of photoacoustic sources in tissue using time domain measurements /." Full text open access at:, 2001. http://content.ohsu.edu/u?/etd,210.
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Bergstrand, Sara. "Tissue Blood Flow Responses to External Pressure Using LDF and PPG : Testing a System Developed for Pressure Ulcer Research." Licentiate thesis, Linköping : Department of Medical and Health Sciences, Linköping University, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-51886.
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Loeben, Gregory Scott. "Medical futility and the goals of medicine." Diss., The University of Arizona, 1999. http://hdl.handle.net/10150/288943.
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I begin by exploring the distinction between the physiologic, quantitative, and qualitative conceptions of futility. I argue that if medical futility is going to be a useful and appropriate normative tool in the medical lexicon, it should not duplicate and confuse judgments which we already have the tools to make. Hence, I distinguish qualitative futility from the concepts of distributive justice, rationing, harm, and insufficient benefit. Lastly, I consider the argument that providing qualitative futility violates professional integrity. Next I consider the claim that futility judgments are a form of unjustified paternalism. I also explore the relationship of physician imposition of values and the ideas of individual patient well-being, and self-determination. I consider an argument put forth by Thomlinson and Brody that futility judgments actually support autonomy, concluding that their argument must be restricted to individuals whose choices can be shown to be inconsistent with their values and aims. Lastly, I provide a comparison of futility judgments and the ordinary/extraordinary distinction which shows futility to be normatively vague and clinically dangerous. Because of the potential for misuse and confusion, I compare futility and rationing judgments. I argue that rationing decisions are necessary but should be explicit rather than disguised as futility. The consequences of failing to adequately distinguish these two are unfairness to individual patients, and harm to the doctor-patient relationship and societal trust of medicine. I detail a number of models of the physician patient relationship and attempt to determine two things: (1) whether these allow for physician authority to withhold qualitatively futile care, and (2) how well these models can answer this question in the absence of an account of the goals of medicine. I conclude that various accounts offer little specific guidance about the physician's right to withhold qualitatively futile treatment. Finally, in chapter seven I attempt to ground the debate about medical futility in the larger context of a debate about the appropriate ends and goals of medicine, arguing that such limits require an extended social dialogue.
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Nickell, Debra Faith. "SCREEN DOOR MEDICINE: THE INFORMAL MEDICAL CONSULTATION." UKnowledge, 2010. http://uknowledge.uky.edu/gradschool_diss/6.
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This study explores the phenomenon of the informal medical consultation, a communication event in which an individual asks for medical information, advice, or care from an off-duty health professional with whom the individual has no formal patient-provider relationship. Using surveys and interviews, the study describes these consultations from the perspective of the health care professional and the informal patient. The study explores foundational theories that offer explanations for the phenomenon. The theories considered include social support, decision-making, social exchange, perceived partner responsiveness to needs, and uncertainty management.
This study suggests health care providers perceive informal medical consultations to be more problematic than do the informal patients who consult them. The problematic nature of informal consultations increases as the type of request moves from purely informational to a request for treatment. Informal patients do not perceive this distinction. The informal patient’s motivation to pursue an informal consultation instead of a formal consult is affected by the relationship with, trust in, and access to the informal consultant. The willingness of the informal consultant to engage in an informal consultation is affected by the relationship with the informal patient, the type of request made, and perception of risk/benefit for both the provider and the patient.
The study supports the idea that informal medical consultations are potentially problematic within the current medico-legal-ethical environment. Alternately, these consultations may be viewed as offering positive contributions to the health and well-being of informal patients. The study suggests translational research is needed to guide health professionals in considering requests for informal medical consultations.
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Sing, Troy William. "The physiology of pain : analgesic mechanisms of acupuncture and laser treatment /." Thesis, Hong Kong : University of Hong Kong, 1995. http://sunzi.lib.hku.hk/hkuto/record.jsp?B14039035.
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Bell, Heather. "Medical research and medical practice in the Anglo-Egyptian Sudan, 1899-1940." Thesis, University of Oxford, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.320868.
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Blackwelder, Reid B. "Motivating Medical Students and Residents." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/6978.
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Lai, Man-lung Stanley, and 賴文龍. "Adjunctive effects of a low-power laser on the healing of periodontal tissue." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B37651006.
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Thong, K. Joo. "Prostaglandins, mifepristone and medical abortion." Thesis, University of Newcastle Upon Tyne, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.308749.
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Abou-Aly, Amal Mohamed Abdullah. "The medical writings of Rufus of Ephesus." Thesis, Online version, 1992. http://ethos.bl.uk/OrderDetails.do?did=1&uin=uk.bl.ethos.246073.
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Tso, Simon Ho Yuen. "The graduate-entry medical student : challenges to transition through medical school." Thesis, University of Warwick, 2017. http://wrap.warwick.ac.uk/99890/.
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This study aims to make a sociological contribution to understanding the experience of medical students from graduate-entry medicine degree programmes. In this study, I asked the research question ‘what are the challenges experienced by graduate-entry medicine degree programme students during their transition through medical school training?’ Medical students from the University of Warwick Medical School graduate-entry medicine degree programme were invited to take part in this interview-based study. A volunteer sample of 21 medical students took part in a stage one semi-structured one-to-one interview. Fourteen of 21 medical students took part in a follow-up stage two interview between four to thirteen months later. Their interview transcripts were transcribed verbatim and analysed using thematic analysis. Results showed there were three key transition periods within the University of Warwick Medical School’s graduate-entry medicine degree programme. Medical students encountered a range of challenging issues throughout their medical school journey that could be categorised under three conceptual themes: challenges associated with the curriculum, challenges associated with their social role and generic life challenges. Learning, professional identity development and managing coping strategies were the three key challenging issues dominating their transition experience. These challenging issues were in keeping with my findings from literature review on the medical school experience of undergraduate-entry and graduate-entry students. This study has made one original sociological contribution to understanding the professionalism issue about how medical students manage health advice requests from their family and friends. The findings from this study could be useful to educators and medical schools in enhancing their student support services. It could also be useful to prospective and existing medical students in understanding the realities of undertaking a graduate-entry medicine degree programme.
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Tsai, Hung-Yin. "Cultural Encounters in Medicine: (Re)Constituting Traditional Medicine in Taiwan under Colonization, Modernity, and Exchange." Diss., Virginia Tech, 2021. http://hdl.handle.net/10919/104579.
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Today we have many alternative medicines, not a few of which connect back to aboriginal cultures. Some of these alternative medicines were born under the influence of European imperialism, as they were not "alternative" until modern empires and modern medicine came to these distant regions. The present study begins with a broad question: how did conceptions of the relationship between modern Western medicine and traditional local non-Western medicine come to be? To explore the historical origins of these two conceptions, I focus herein on Japanese colonial Taiwan (1895–1945), where modern medicine became dominant while traditional medicine also flourished. My research finds that the historical realities of colonial Taiwan were not reflected in the progressive narrative of medicine. According to this narrative, modern medicine became dominant around the world while traditional medicines were swept into the ash heap of history because only modern medicine was the true, effective science of preventing, diagnosing, and treating physical ailments. The history of colonial Taiwan teaches us a much different lesson: practitioners of traditional medicine there were a significant part of the public health system during the colonial period. For example, they rallied against the plague in the late 19th century, diagnosing and treating patients when antibiotics had yet to be developed. Even so, the island witnessed an institutional medical shift, in which licensed practitioners of modern medicine deified modern medicine and denigrated traditional medicine, labeling the latter "primitive" and "non-medicine." In response, practitioners of traditional medicine produced new narratives aiming to challenge this colonial boundary between medicine and non-medicine. These practitioners' fundamental argument was that traditional medicine, though epistemologically different from modern medicine, was still legitimate medicine. From this effort, we now have the widely held belief today that both modern medicine and traditional medicine are legitimate, but distinct, medicines. This historical outcome of colonial resistance occurred worldwide. In my study, I identify the social, political, and colonial contexts of medical resistance in Japanese Taiwan, revealing their roots in issues related to inequality, distrust, economic affordability, and conceptions of body and health care.Doctor of Philosophy
In this study, I explore conceptions of modern and traditional medicine through a historical lens, and break down two related myths: the first myth is the progressive narrative of modern medicine, which holds that modern medicine became dominant because of its medical superiority; and the second myth is the narrative held by extremist supporters of traditional medicine, who insist that only millennia-old traditional medicine can resolve human ailments without giving rise to untoward side effects and exorbitant costs. I show that, in the case of Japanese colonial Taiwan (1895–1945), both modern and traditional medicine flourished. The history of colonial Taiwan shows us that modern medicine on the island became dominant for two main reasons: first, the public health system successfully dealt with epidemics, which were the most significant threat to life at that time; and second, the colonial government recognized only modern medicine and labeled traditional medicine a non-medicine despite relying on its practitioners in the pre-antibiotic age. The history of colonial Taiwan also shows us that traditional medicine is not "old wisdom" unchanged for thousands of years. Beginning in the 19th century, practitioners of Taiwanese traditional medicine re-constituted it for colonial consumption, arguing that traditional medicine was also true medicine, though epistemologically distinct from modern medicine. This conception of traditional medicine has since informed many current views of traditional medicine. In 2018, the World Health Organization (WHO) published the eleventh revision of the International Classification of Diseases (ICD-11), which, for the first time, featured a chapter on traditional Chinese medicine covering such topics as diagnostic techniques for Qi, blood, and fluid disorders. This inclusion of traditional medicine into the ICD-11 is a major step forward in this process of medical integration and may help resolve the historical confrontation between modern and traditional medicine. However, the WHO decision limits recognition of traditional medicine to Chinese medicine, excluding all other kinds of traditional medicine. Thus, the historical question of whether or not traditional medicine is a true medicine remains ultimately unanswered.
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Aggarwal, Hans (Hans Suta) Carleton University Dissertation Management Studies. "A Rule-based patient simulation system for teaching medical students." Ottawa, 1992.
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Abdelrahman, Mahmoud Abdelwahab. "Medicine, psychiatry and human rights." Thesis, Cardiff University, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.277686.
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Mann, Abbey. "A Medical Perspective on Firearm Safety." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/6441.
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Kiatpongsan, Sorapop. "Decision Making for Medical Innovations." Thesis, Harvard University, 2014. http://dissertations.umi.com/gsas.harvard:11386.
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Dyer, George Lewis. "An analysis of peacetime medical workload and staffing : should medical readiness be viewed through a peacetime lens?" Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 2003. http://library.nps.navy.mil/uhtbin/hyperion-image/03Mar%5FDyer.pdf.
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Simpson, Janet Mary. "Medical student's attitude towards working in geriatric medicine." Thesis, Royal Holloway, University of London, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.543856.
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In general, medical students are unenthusiastic about working in geriatric medicine (GM). Variables potentially related to this problem were identified and questionnaires designed to measure them: attitudes toward the work-of GM, toward GM patients, to old people, amount of prior contact with old people, discussions with other doctors and respondents' gender. Fishbein and Ajzen's (1975) Theory of-Reasoned Action guided a study of how these variables related to final year students' enthusiasm for working in GM, i. e. their behavioural intention (BI). The model explained 60% of the variance in BI. Aact (attitude toward working in GM) and SN (subjective normative pressure) together explained 50% of the variance in BI. Multiple regression showed'that attitude toward GM work most influenced BI. Correlations between the components of this attitude and BI were examined. A method for identifying primary variables is described. Evaluations rather than beliefs emerged as primary. The more students valued social and caring aspects of medicine'(e. g. dealing with social problems and treating chronic cases), the less unenthusiastic they were about GM. The more they valued its financial rewards and status aspects the more unenthusiastic they were. Attitude toward GM patients related weakly to`BI. Attitude to old people was not convincingly related to BI. Women's mean rating on BI was slightly higher than men's. Women students who had worked with old people had the highest BI scores. Cluster analysis showed that students may be grouped according to their values and also-supported the findings of the correlational analysis. A longitudinal study traced change and stability in students' primary values during medical training. Only the value students attached to dealing with social problems appeared to change. It declined during the clinical period. Students appeared to enter medical school with the value systems relevant to an interest in GM already formed. Ways by which GM's'image may be improved are discussed
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Van, Wyk Gerrit Christian Burggraf. "Medicine and medical process as a learning system." Master's thesis, University of Cape Town, 1996. http://hdl.handle.net/11427/17214.
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Bibliography: pages 150-158.Health care systems all over the world are in crisis. The presenting symptom is a cost spiral that is out of control. Money supply is finite, and if this problem continues the system will eventually collapse. There are a number of causes associated with the problem that are usually analysed by reduction, an approach based upon an assumption of simple linear causal relations. This study shows the problem to be the dialectic opposite, in other words these problems are all interrelated through complex causal interactions. Therefore, the health care system is a complex social system and solutions to its problems may be found in terms of the interactions in such a system. An investigation into the history of the health care system shows that the system started with a simple one on one interaction between patients and physicians. At the time of its initiation, very little empirical knowledge was available about illness. After the renaissance, this changed dramatically with a subsequent increase in the ability to diagnose, but also in the complexity to treat illness. However, modern beliefs about illness and illness processes do not reflect the complexity of this knowledge. Beliefs about both illness and knowledge contribute to the process of diagnosis (medical decision making, or problem solving). Furthermore, the expectations, wants, and needs of patients and physicians, as well as the decision environment, increases the complexity and difficulty of this decision making process. These decisions initiate treatment processes that are ultimately represented in the health care system as cost. Therefore, the patient-physician system as the simplest initial interaction is an event that ultimately affects cost. This system is not functioning efficiently at present and a system of inquiry that can improve it may make a contribution to an improved system, and therefore a saving in cost. Altering the diagnostic system from a linear into a circular process, in other words into a learning system, improves both decision making and the use of knowledge. However, an inquiring system is needed in addition that can enhance the rigour of this process. Charles West Churchman devoted a large part of his work to knowledge and the way we acquire knowledge, in other words inquiring systems. His belief is that problem solving ought to be approached in a comprehensive way in order to minimise the risk for making incorrect decisions. Furthermore, because decisions are made upon incomplete information, the solutions will be the cause of new problems. Therefore, problem solving is a never ending cycle of learning. In order to have as complete information as possible about the problem, we have to: know the history of the problem, take a broad view that includes the environment of the problem (use a systems approach), and consider all the alternative solutions to the problem. Virtually all of our knowledge is based upon underlying assumptions. In order to test the validity of the knowledge we use for inquiry and decision making, it is important to test the assumptions upon which the knowledge is based. This is valid in regard to empirical knowledge as well. Finally, according to Churchman, decision making has to be ethical. Therefore, we have to do all we can to ensure that the implementation of the decision will improve the situation, not only now, but also in the future. The application of Churchman's approach to the patient-physician interaction, assists in the synthesis of a more comprehensive world view of health care and illness. This study shows that this leads to important changes in the negative interactions identified as contributing to the health care crisis. In terms of Churchman's approach, the role of physicians can be seen as managers of illness. Their purpose is therefore to plan for the improvement of illness (the problem) in an ethical way. Such planning should include the values of patients in deciding upon appropriate treatment. It is the submission of this study that only a methodology that is able to address complex human systems, such as a systems approach, and a comprehensive philosophy of inquiry, such as that of C West Churchman is appropriate to address the current problems of the health care system.
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McMichael, Alan James. "Medical judgement and decision making in stratified medicine." Thesis, Queen's University Belfast, 2017. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.727757.
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Background: Stratified medicine aims to use a patient's genotype and other individual characteristics to predict their treatment outcomes. Several treatments have been developed which may potentially offer patients an increased response to treatment. For instance 5% of patients with cystic fibrosis can be prescribed Ivacaftor based on a specific genetic mutation. However, it is unclear about how a patient's genotype may influence particular aspects of medical decision-making, despite the relevance that this may have in routine clinical practice. Methods: Medical decision-making was investigated using a series of discrete-choice experiments (DCEs) in which participants were asked to consider and choose one of the presented scenarios. Regarding profession decision-making, in particular, the PhD research investigated extent to which a patient's genotype influenced the treatment judgements and recommendations of psychiatrists (n=68). Patient decision-making was investigated by using DCEs to assess how people with cystic fibrosis (n=80) 'traded-off the risks and benefits that were associated with each treatment option. In the final study of the thesis, I investigated whether or not members of the public (n=2804) would be willing to incur an increase in tax to help fund stratified medicine treatments. Results: The main findings of these studies suggest that clinicians may be unduly influenced by a patient's genotype when judging a patient's response to treatment and in their treatment recommendations. Cystic fibrosis patients may not be willing to tolerate some of the increased risks associated with their treatment options. Thus clinicians should discuss the risks and benefits associated with treatments with their patients. The PhD research highlighted that members of the public may not be willing to pay an increase in taxation unless the majority of people were eligible for the stratified medicine treatment, a result that poses a challenge for stratified medicine because only few people are eligible for potentially more effective treatments. Conclusions: Clinicians need to be cautious about being unduly influenced by a patient's genotype and should discuss the risks and benefits associated with different treatment options. Further research is needed to understand how a patient's genotype may influence the decisions that are made at the clinician, patient and policy level.
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Johansson, Louise. "Analysis of cartilage surfaces using laser speckle imaging." Thesis, Linköping University, Department of Biomedical Engineering, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-5830.
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An arthroscope is a diagnostic instrument for visualisation of the interior of a joint. By adding a laser to an arthroscope and feeding the images to a computer, one gets an method to measure the structure of the cartilage covering the joint. This gives an added diagnostic value. The laser will create laser speckles and this report covers the basic theories behind this. The anatomy of the joints, the properties of cartilage and the background on the disease arthritis are also covered, as well as the field of surface topography and image processing.
Experiments were performed on three different materials - metals of different definite surface roughness, polymerised collagen and bovine articular cartilage.
The conclusion is that the technique would work, providing that some obstacles could be overcome. The technique itself is very precise and detects nanometric differences in the surface structure, making it extremely interesting for research purposes, such as follow-ups on treatments and studies of arthritis and cartilage repair.
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Price, Suzanne Phillips. "The black student medical school experience /." Access Digital Full Text version, 1992. http://pocketknowledge.tc.columbia.edu/home.php/bybib/1106299x.
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Thesis (Ed.D)--Teachers College, Columbia University, 1992.Typescript; issued also on microfilm. Sponsor: Ellen Condliffe Lagemann. Dissertation Committee: Gary Natriello. Includes bibliographical references (p. 113-117).
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Wagers, William D. (William Delbert). "An Interpretation of Archaic Medical Treatises." Thesis, University of North Texas, 1993. https://digital.library.unt.edu/ark:/67531/metadc500572/.
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Ancient peoples did not distinguish between philosophy, religion, and science. Scientific truth did not exist apart from divine truth. Any new idea, finding, or theory was assimilated into a monolithic mythological structure. This is one of the causes of the underestimation of ancient science: it is always packaged in a myth - the method of preserving information in an oral culture. The mythological medium allowed the preservation and dissemination of hard-won, empirical, scientific knowledge through generations of preliterate peoples. The context for mythological memorization, or simply tradition, needed to be easily and naturally acquired. The ideal context was the anthropomorphic context, the ontogenic context. This is the Grand Allegory - the anthropomorphization of information. Biomyths are essentially biological texts allegorized in esoteric language.
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Pereyra, Elías Reneé, Idrogo Juan José Montenegro, and Percy Mayta-Tristan. "Are medical students able to perform multicenter studies?" Medwave Estudios Limitada, 2015. http://hdl.handle.net/10757/579916.
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Barr, Hugh. "Photodynamic therapy for colorectal cancer." Thesis, University of Liverpool, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.329398.
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Whiting, Paul Jonathan. "Mathematical models of laser-tissue interaction and related problems." Thesis, University of Essex, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.278619.
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Webb, J. R. "An evaluation of Igor Ansoff's theory of Weak Signal Management by means of an investigation and forcast of future developments in the ophthalmic laser environment." Thesis, University of Strathclyde, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.382425.
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Blackwelder, Reid B. "Creating Spiritual Support in the Medical Field." Digital Commons @ East Tennessee State University, 2001. https://dc.etsu.edu/etsu-works/7002.
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Hollis, Brett F. "Medical emergencies on commercial airlines| An Analysis of Onboard Medical Incidents, Treatment versus Prevention." Thesis, Brandman University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10181770.
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The occurrence of inflight medical incidents on commercial airlines is documented in medical and aviation journals to occur at a rate of approximately 1 in 11,000 – 50,000 passengers (Lyznicki, 2013; Prout, 2013; Johanson, 2013; and Peterson, 2013) but these numbers can vary. As there are no requirements to report medical incidents to any governing body worldwide (Ruskin, 2009), (Walters, 2008), (Liao, 2010) it is very difficult to obtain an accurate accounting of inflight incidents. The literature reveals that most of the inflight incidents are occurring among passengers with pre-existing conditions (Grounder, 2011) and that issues were not being properly addressed by their primary care providers. The purpose of this study was to show the depth of discrepancy between the currently reported rate of inflight medical incidents and the actual rate of inflight incidents and to gain a better understanding of the general public knowledge base regarding flying with medical conditions and practice of medical providers addressing their patient’s acute & chronic conditions as it pertains to flying on commercial airlines. This study surveyed the general public and revealed the majority of respondents had no knowledge of medical guidelines for passengers and a lack of discussion with their providers regarding safety of flying as it relates to their medical conditions. This study also conducted a survey of medical providers which revealed a lack of understanding of how aircraft cabin pressurization affects their patients with acute and chronic illness. These findings support the need for improvement in developing and implementing a unified method of calculating and reporting inflight medical incidents, along with patient and provider flight education.
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Waterbrook, Anna, Gail Pritchard, Allison Lane, Lisa Stoneking, Bryna Koch, Robert McAtee, Alice Min, et al. "Development of a novel sports medicine rotation for emergency medicine residents." DOVE MEDICAL PRESS LTD, 2016. http://hdl.handle.net/10150/615113.
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Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational experience when compared to the traditional orthopedics rotation. All SC residents successfully completed their sports medicine rotation, had completed postrotation evaluations by attending physicians, and had no duty hour violations while on sports medicine. In our experience, a sports medicine rotation is an effective alternative to the traditional orthopedics rotation for EM residents.
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Alpay, Laurence Lea. "Modelling medical diagnostic processes." Thesis, Open University, 1990. http://oro.open.ac.uk/56449/.
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The thesis investigates the development of medical reasoning processes and how student modelling of such processes can be achieved in intelligent tutoring systems. The domain of orthopaedics was chosen for the research. Literature has shown that medical reasoning has been modelled mainly from an expert point of view. The research problem addressed is to model explicitly various levels of medical expertise in terms of reasoning strategies. The thesis reports on a system, DEMEREST (DEvelopment of MEdical REasoning STrategies), a developmental user model component which describes successive stages of medical reasoning and which could ultimately be part of a medical tutor. The system diagnoses physicians' reasoning strategies, determines the level of expertise and produces a plan corresponding to the application of these strategies. As a basis of doing so, a set of seven reasoning strategies was identified in the medical problem solving literature. These strategies are based on generalisation, specialisation, confirmation, elimination, problem refinement, hypothesis generation and anatomy. An empirical study was carried out to examine the development of these strategies. Protocols of ten physicians at various levels of expertise were collected and analysed. A number of interactions of strategies at different levels of expertise was identified in half of these protocols and this information was used to construct a model of changes of strategies over time. Planning in· artificial intelligence was used as a means of decomposing medical problem solving into a set of goals; the goals being associated with the reasoning strategies. By taking this approach, medical reasoning is viewed as a planning process. The remaining protocols from the empirical study were used to evaluate DEMEREST. The system was tested for its ability to determine a level of expertise for each protocol, model the reasoning strategies applied and their interactions, and generate a plan for each protocol. The assessment of the overall performance of the system showed that it was successful. This assessment also helped to identify conceptual as well as implementation constraints of the prototype system. The main result of the research undertaken in this thesis is that the design of the system DEMEREST demonstrates the feasibility of modelling the development of medical reasoning strategies and its usefulness for student modelling.
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Henderson, Brian. "An isotropic dosimetry probe for monitoring light in tissue, theoretical and experimental assessment." Thesis, Heriot-Watt University, 1990. http://hdl.handle.net/10399/887.
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This thesis provides a unique method of producing an Isotropic dosimetry probe for monitoring light in highly scattering media, such as tissue. The requirement of such a probe is made apparent through a detailed review of current mathematical methods used to predict light distribution based on Radiative transfer theory and its subsequent solution under slab geometry. Initial methods of probe manufacture are discussed with the eventual technique involving a light cured polymer material providing the final method of construction. The resulting probe Is used to assess response uniformity and shadow effects. Mathematical modelling of the probe under spherical geometry is developed with experimental verification of boundary effects caused by refractive index mismatch presented for both internal and external Illumination. Typical application of the probe Is demonstrated resulting In direct measurement of backscattered reflectance and penetration depth. Indirect methods of measurement involving absorber modified penetration depths, reduced scattering co-efficients and an added absorber experiment are compared with theory. Further examination of the internal illumination of a probe In a scattering medium is related through theory and experiment to the optical properties of the surrounding medium. Continuing work on tissue . classification, fluorescence measurement including photodegradation, and a hyperthermia dosimetry probe is introduced.
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Chan, Kin Foong. "Pulsed infrared laser ablation and clinical applications /." Digital version:, 2000. http://wwwlib.umi.com/cr/utexas/fullcit?p9992765.
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Click, Ivy A., Abbey K. Mann, Morgan Buda, Anahita Rahimi-Saber, Abby Schultz, K. Maureen Shelton, and Leigh Johnson. "Transgender Health Education for Medical Students." Digital Commons @ East Tennessee State University, 2019. https://doi.org/10.1111/tct.13074.
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Background Transgender individuals face numerous health disparities and report negative experiences with health care providers related to their gender identity. Significant gaps in medical education regarding transgender health persist despite calls for increased sexual and gender minority content. The purpose of this student‐led study was to assess the effectiveness of a half‐day educational intervention on first‐ and second‐year medical students’ attitudes and knowledge of transgender health. Methods Students and faculty members collaborated to develop an educational session on transgender health. This content was presented to first‐ and second‐year medical students at Integrated Grand Rounds, a pedagogical method in which basic science and clinical faculty members co‐present didactic content interspersed between live patient interviews and student‐led small group discussions. Student participants (n = 138) completed voluntary 9‐item pre‐ and post‐session surveys assessing comfort with and knowledge of transgender medicine. Results Students’ comfort with and perceived knowledge about transgender patients increased significantly between pre‐ and post‐test. Students’ knowledge of transgender medicine standards of care also improved, though not all items reached significance. Discussion A half‐day educational intervention improved many facets of medical students’ attitudes and knowledge about transgender patients. The significant disparities in physical health, mental health and access to care currently experienced by transgender persons in the United States warrants the continued testing and refinement of educational interventions for future and practising providers.
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Sumian, Christien. "Etude de differentes associations lasers - topiques applicables en dermatologie (doctorat : genie biologique et medical)." Lille 2, 1999. http://www.theses.fr/1999LIL2P012.
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Chan, King-chung. "Institute of Chinese Medical Education." Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/orecord.jsp?B25951762.
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