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Gastroenterology team

“In the past, managing irritable bowel syndrome by controlling the diet has been seen as a wacky idea—one for those who aren’t science driven,” admits Miranda Lomer, senior consultant dietician at Guy’s and St Thomas’ NHS Foundation Trust in London. But many minds have been changed by the success of a dietary regimen originally developed in Australia.  
feeds.bmj.com
over 3 years ago
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Two in five consultant posts were unfilled last year

Jane Dacre, the president of the Royal College of Physicians, asked the health secretary, Jeremy Hunt, how he proposes to provide a safe seven day NHS without adequate numbers of doctors, at the college’s annual conference on 15 March.  
feeds.bmj.com
over 3 years ago
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NHS consultants: Employers 'close to 7-day contract offer' - BBC News

Consultants in England could be offered new NHS contracts within weeks, the BBC understands, after what ministers describe as "constructive" negotiations.  
bbc.co.uk
over 3 years ago
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Psychology History

Harry F. Harlow was an American Psychologist who provided a new understanding of human behavior and development through studies of social behavior of monkeys. His research contributions (in the areas of learning, motivation, and affection) have major relevance for general and child psychology. Harlow obtained both his BA and PhD in Psychology from Stanford University. Upon completion of his PhD, Harlow joined the psychology staff at the University of Wisconsin (Madison). He was a modest, brilliant man who enjoyed spending time with students and took special pride in teaching introductory psychology courses. Nearly forty students obtained their PhD under his direction. Professor Harlow's research developed an abundant supply of primate learning tests and tasks that became standards in the field. In general, Harlow wanted to prove to the psychology community that primate research could contribute to the understanding of important clinical issues without having to be molecular in nature. His theory hinged on the universal need for contact. Harlow's famous wire/cloth "mother" monkey studies demonstrated that the need for affection created a stronger bond between mother and infant than did physical needs (food). Harlow was a member several Science and Psychological Associations, including the American Psychological Association, National Academy of Arts & Sciences, and Sigma Xi. He was a national lecturer and also a consultant to the Army's Scientific Advisory Panel. During his career, he was recognized with several distinctions, including: Howard Crosby Warren Medal (1956), National Medal of Science (1967), and Gold Medal from American Psychological Foundation (1973). Much of his primate research regarding social separation, affection, attachment, love, learning, and early life behaviors was published. Harlow died in 1981, at the age of 75. His life work provided a developmental framework based on data results rather than convoluted theories with limited empirical support. Theory In Harlow's initial experiments, infant monkeys were separated from their mothers [visit this site] at six to twelve hours after birth and were raised instead with substitute or "surrogate" mothers made either of heavy wire mesh or of wood covered with cloth. Both mothers were the same size, but the wire mother had no soft surfaces while the other mother was cuddly – covered with foam rubber and soft terry cloth. Both mothers were also warmed by an electric light placed inside them. In one experiment both types of surrogates were present in the cage, but only one was equipped with a nipple from which the infant could nurse. Some infants received nourishment from the wire mother, and others were fed from the cloth mother. Even when the wire mother was the source of nourishment (and a source of warmth provided by the electric light), the infant monkey spent a greater amount of time clinging to the cloth surrogate. These results led researchers to believe the need for closeness and affection goes deeper than a need for warmth. These monkeys raised by the dummy mothers engaged in strange behavioral patterns later in their adult life. Some sat clutching themselves, rocking constantly back and forth; a stereotypical behavior pattern for excessive and misdirected aggression. Normal sexual behaviors were replaced my misdirected and atypical patterns: isolate females ignored approaching normal males, while isolate males made inaccurate attempts to copulate with normal females. As parents, these isolate female monkeys (the "motherless mothers" as Harlow called them) were either negligent or abusive. Negligent mothers did not nurse, comfort, or protect their young, nor did they harm them. The abusive mothers violently bit or otherwise injured their babies, to the point that many of them died. Deprivation of emotional bonds to live mother monkeys (as infant monkeys) these (now adult) monkeys were unable to create a secure attachment with their own offspring. (Principles of General Psychology, 1980, John Wiley and Sons). Harlow's research suggested the importance of mother/child bonding. Not only does the child look to his/her mother for basic needs such as food, safety, and warmth, but he also needs to feel love, acceptance, and affection from the caregiver. His findings show some long-term psychological physical effects of delinquent or inadequate attentiveness to child needs. Harlow also did learning research with his monkeys. His theory, "Learning to Learn", described the ability of animals to slowly learn a general rule that could then be applied to rapidly solve new problem sets. Harlow presented the monkey with two stimuli (a red block and a thimble, for example); one was predetermined "correct" and reinforced with food (red block) and the other was "incorrect" and not reinforced with food (thimble). After each selection, the objects were replaced and the monkey again chose a stimulus. Each trial reinforced the same stimulus (red block). The monkey had a 50% chance of being "correct" on each trial, however, he could increase his chances by adopting the win-stay, lose-shiftstrategy. For example, if the monkey chose the thimble and was not reinforced, he should shift to the red block for the reinforcer. If, however, he correctly selected the red block and was reinforced, he should stay with the reinforced stimulus and choose the same stimulus next time. The monkey continued throughout a series of six trials with eight pairs of stimuli (learning sets). Harlow found the monkeys to be averaging approximately 75% correct responses by the sixth trial of the eighth set. He then began to look at the animal's behavior during the second trial. He found the monkeys to implement the stay or shift strategy on the second trial of the six-trial set, which means the animals did not relearn the strategy with each new stimuli set, they instead applied the rule they had already learned. After 250-plus trials, the monkeys were about 98% correct on the second through the sixth trials with each new stimuli set. Harlow's learning research demonstrates that animals, like humans, are able to learn to apply strategies or rules to situations to help them solve problems. Time Line Born October 31 in Fairfield, Iowa Son of Lon and Mabel (Rock) Israel 30-44 Staff, University of Wisconsin at Madison; Married Clara Mears 39-40 * Carnegie Fellow of Anthropology at Columbia University 44-74 George Cary Comstock Research Professor of Psychology 46 Divorced Clara Mears; Married Margaret Kuenne 47-48 President, Midwestern Psychological Association 50-51 President of Division of Experimental Psychology, American Psychological Association 50-52 Head of Human Resources Research Branch of Department of Army 53-55 Head of Division of Anthropology and Psychology of National Research Council 56 * Howard Crosby Warren Medal 56-74 Director of Primate Lab, University of Wisconsin 58-59 President, American Psychological Association 59,65 Sigma Xi National Lecturer 1960 * Distinguished Psychologist Award, APA / Messenger Lecturer at Cornell University 61-71 Director of Regional Primate Research Center 64-65 President of Division of Comparative & Physiological Psychology, APA 67 * National Medal of Science 1970 Margaret (wife) died 71 Harris Lecturer at Northwestern University / Remarried Clara Mears, Children: 3 Sons, 1 Daughter 72 Martin Rehfuss Lecturer at Jefferson Medical College / * Gold Medal from American Psychological Foundation / * Annual Award from Society for the Scientific Study of Sex 74 University of Arizona (Tucson) Honorary Research Professor of Psychology 75 * Von Gieson Award from New York State Psychiatric Institute 76 * International Award from Kittay Scientific Foundation Also Member of the following (dates not given): Consultant to Army Scientific Advisory Pannel; American Philosophical Society; National Academy of Sciences; National Academy of Arts and Sciences ; Sigma Xi ; Phi Kappa Phi 1981 Died * Denotes Awards and Honors Bibliography Harlow, H. F.; Zimmermann, Robert. Affectional responses in the infant monkey. Foundations of animal Behavior. (1996), xvi, 843, 376-387. Harlow, H., et al. Social rehabilitation of separation-induced depressive disorders in monkeys. American Journal of Psychiatry. (1976), v. 133(11), 1279-1285. Harlow, H., et al. Effects of maternal and peer separations on young monkeys. Journal of Child Psychology & Psychiatry & Allied Disciplines. (1976), v. 17(2), 101-112. Harlow, H. Lust, latency and love: Simian secrets of successful sex. Journal of Sex Research. (1975), v. 11(2), 79-90. Harlow, H. A variable-temperature surrogate mother for studying attachment in infant monkeys. Behavior Research Methods. (1973), v. 5(3), 269-272. Harlow, H., et al. The sad ones: Studies in depression. Psychology Today. (1971), v. 4(12), 61-63. Harlow, H., et al. Nature of love: Simplified. American Psychologist. (1970), v. 25(2), 161-168. [History Home Page] [Psychology Department Home Page]  
muskingum.edu
over 3 years ago
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Sheffield hospital consultant investigated over scarf row - BBC News

A hospital consultant is under investigation over comments he made about a Muslim surgeon who wore a head scarf in an operating theatre.  
bbc.co.uk
over 3 years ago
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Cardiologist shortage prompts NHS trust to ask GPs to cut referrals

A prestigious teaching hospital has asked GPs in neighbouring clinical commissioning groups (CCGs) to send their cardiology patients elsewhere, as a severe shortage of consultants means that it cannot guarantee the safety of its services.  
feeds.bmj.com
over 3 years ago
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Government could fire and rehire consultants to introduce new contract, says BMA

Delegates at the BMA’s annual UK consultants’ conference in London on 3 March heard that this could be one option considered by the government if consultants rejected its final contract offer.  
feeds.bmj.com
over 3 years ago
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Sixty seconds on . . . the consultant contract

Where have you been? The BMA has been holding road show events across England and Northern Ireland over the past couple of weeks to explain the proposed changes.1 These involve scrapping the current clinical excellence awards system and removing the clause that allows consultants to opt out of non-emergency out-of-hours work.2  
feeds.bmj.com
over 3 years ago
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What I learnt this week: Intentional Leadership is just Management #WILTW

Health Education East Midlands have recently reconfigured their leadership and management programme for trainees and I assist on delivering some of the curriculum. I generally present the Quality Improvement workshop but was assisting with the Transition to Consultant/GP session this week.  
rolobotrambles.com
over 3 years ago
Www.bmj
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Seven day services will need 4000 extra doctors, says leaked report

The internal Department of Health report, leaked to the Guardian, said that 11 000 more staff would be needed, including 4000 more doctors (1600 consultants, 1500 registrars, and 900 junior doctors).1 These numbers were “calculated by increasing the number of staff at the weekend . . . in order to match weekdays.”  
feeds.bmj.com
over 3 years ago
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A Survey on Polypharmacy and Use of Inappropriate Medications

In the past, polypharmacy was referred to the mixing of many drugs in one prescription. Today polypharmacy implies to the prescription of too many medications for an individual patient, with an associated higher risk of adverse drug reactions (ADRs) and interactions. Situations certainly exist where the combination therapy or polytherapy is the used for single disease condition. Polypharmacy is a problem of substantial importance, in terms of both direct medication costs and indirect medication costs resulting from drug-related morbidity. Polypharmacy increases the risk of side effects and interactions. Moreover it is a preventable problem. A retrospective study was carried out at Bhopal district (Capital of Madhya Pradesh, India) in the year of September-November 2009 by collecting prescriptions of consultants at various levels of health care. The tendency of polypharmacy was studied and analyzed under the various heads in the survey. Available data suggests that polypharmacy is a widespread problem, and physician, clinical pharmacists and patients are all responsible. These risks can be minimized through identifying the prevalence of this potential problem in a high-risk population and by increasing awareness among patients and healthcare professionals. Physicians and clinical pharmacists have the potential to combating this problem through a variety of interventions such as reducing the number of medications taken, reducing the number of doses taken, increasing patient adherence, preventing ADRs, improving patient quality of life and decreasing facility and drug costs.  
ncbi.nlm.nih.gov
over 3 years ago
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Trust pays cardiologist £1.22m for unfair dismissal

A whistleblowing consultant cardiologist who fought a 14 year battle against the NHS trust that employed him has won £1.22m for unfair dismissal.  
feeds.bmj.com
over 3 years ago
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Trust pays cardiologist £1.22m for unfair dismissal

A whistleblowing consultant cardiologist who fought a 14 year battle against the NHS trust that employed him has won £1.22m for unfair dismissal.  
feeds.bmj.com
over 3 years ago
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Saved from the skip: doctor’s action sees hospital art get national recognition

A sculptural panel rescued from destruction by a consultant anaesthetist at his hospital went on show in central London this week as an important example of postwar public art in Britain.  
feeds.bmj.com
over 3 years ago
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First case of corporate manslaughter against NHS trust collapses

A landmark manslaughter prosecution against an NHS trust and a consultant anaesthetist has collapsed, after the judge directed the jury on 28 January to return not guilty verdicts part way through the trial.  
feeds.bmj.com
over 3 years ago
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JC: Can alcohol relieve nausea. St.Emlyn's - St.Emlyn's

Whilst I was a medical student, I ran several ‘n of 1’ clinical trials, principally investigating whether alcohol could reduce nausea. My notes from these studies were incomprehensible scrawls, and in all honesty the results seemed to disprove my null hypothesis. My early experience, and my subsequent experience as an emergency physician in Virchester rather suggests that alcohol is definitely associated with nausea and vomiting. But maybe we’ve been doing it wrong. So, I was pretty excited to see what Beadle et al found in their trial investigating whether Isopropyl Alcohol wipes could reduce nausea in the Emergency Department. This idea has apparently been around for years with one of the Virchester consultants telling me that this was first mooted in the early 90’s, before iPhones, EBM or #FOAMed.  
feedproxy.google.com
over 3 years ago
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JC: Can alcohol relieve nausea. St.Emlyn's - St.Emlyn's

Whilst I was a medical student, I ran several ‘n of 1’ clinical trials, principally investigating whether alcohol could reduce nausea. My notes from these studies were incomprehensible scrawls, and in all honesty the results seemed to disprove my null hypothesis. My early experience, and my subsequent experience as an emergency physician in Virchester rather suggests that alcohol is definitely associated with nausea and vomiting. But maybe we’ve been doing it wrong. So, I was pretty excited to see what Beadle et al found in their trial investigating whether Isopropyl Alcohol wipes could reduce nausea in the Emergency Department. This idea has apparently been around for years with one of the Virchester consultants telling me that this was first mooted in the early 90’s, before iPhones, EBM or #FOAMed.  
stemlynsblog.org
over 3 years ago
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Master of Advanced Critical Care Practice - INTENSIVE

This new qualification, the Master of Advanced Critical Care Practice degree, is provided by Monash University in conjunction with The Alfred ICU. It is the ideal post-graduate qualification for practicing critical care physicians (both registrars and consultants) who want to extend their clinical expertise. The course will commence in 2016.  
intensiveblog.com
over 3 years ago
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Pediatric Cardiology- Basic Physics of Echocardiography

Pediatric Cardiology Teaching, Class, Lecture conducted by Dr Swati Garekar, Consultant Pediatric Cardiologist. The topic is - Basic Physics of Echocardiogra...  
youtube.com
almost 4 years ago
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Don’t just soldier on—read this

We recently learnt that health professionals, among others, do work that is the least replaceable by computers and robots (doi:10.1136/bmj.h6250). This is something Jeremy Hunt may be pondering with regret as talks continue on the junior doctors’ and consultant contracts. It may also partly explain why doctors don’t take sick leave when they’re ill.  
feeds.bmj.com
almost 4 years ago