Care UK

Care UK is a British company providing health and social care. The company works with councils, Clinical Commissioning Groups and doctors to deliver care and support for older people and those with learning disabilities or mental health problems, as well as a range of healthcare services for NHS patients.
History.
The company was formed as Anglia Secure Homes in 1982, becoming Care UK PLC in 1994.
In 1997, the company acquired Care Solutions Limited, a provider of residential services for people with learning disabilities responsible for 59 homes in Newcastle, Bradford, Staffordshire and Guildford. In 1998, it took on a further seven care homes in Hampshire and the South Coast with the acquisition of The Care Partnership.
Care UK delisted from the stock exchange in 2010 following a management buyout. Since 2010 its major shareholder has been Bridgepoint Capital.
It bought Harmoni in 2012 from ECI Partners for about £50 million.
In January 2014 it was announced that Philippa Slinger, the former chief executive of the troubled Heatherwood and Wexham Park Hospitals NHS Foundation Trust was to join Care UK.
After the Health and Social Care Act 2012 came into force in April 2013, by November 2014 Care UK had won three contracts worth £104m.
Following the death of a vulnerable inmate at HM Prison Chelmsford in January 2017 and criticism by the Prison ombudsman, Care UK announced it would end its healthcare contract there as the level of resource the prison service made available was insufficient.
In 2017/8 its turnover was £684.7 million.
Services.
In 2018 Care UK operated 114 care homes with almost 8,000 beds. 44% of the residents are self-funding. It supports over 17,000 older people and those with disabilities through home care services. , its NHS treatment centres, out of hours primary care and 111 service handle more than 18 million patient interactions a year.
The company runs two clinical assessment and treatment centres (CATS) and nine NHS treatment centres, offering a range of procedures for conditions such as cataract surgery and hip replacements. In 2011, independent research organisation, Dr Foster, named Care UK as the best performing provider for hip operations.
Care UK also operates 12 GP-led health centre facilities providing walk-in services and a range of specialist mental health services including 18 homes and hospitals and residential treatment programmes for young people who have serious eating disorders.
In 2013 a joint venture with Sussex Partnership NHS Trust was created to purchase a 32-bed mental health rehabilitation unit in Gosport, and to create a 24-bed self-contained accommodation unit later in the year.
The company's strategy is to concentrate on the provision of primary and secondary NHS health services. In May 2015 the company sold its mental health assets, consisting of 322 beds, to Partnerships in Care and its learning disability services group to Lifeways Group. In June 2015 the home care service which generated revenue of £72.2 million and looks after approximately 13,000 people across the UK and employs around 6,000 staff members was sold to Mears Group.
It is the largest firm providing out-of-hours services in England services with more than ten million patients.
It retained a £55 million contract to run the North East London Treatment Centre in Redbridge in September 2017, after a bid by Barking, Havering and Redbridge University Hospitals NHS Trust, after complaining about the conduct of Barking and Dagenham, Redbridge and Havering CCGs which ran the tendering process.
Controversies.
Political donations.
In November 2009 John Nash, the chairman of Care UK, made a donation of £21,000 to the private office of Andrew Lansley, who would later become Secretary of State for Health, but was at the time the health spokesman for the opposition. Lansley was later accused of a conflict of interest, as Care UK would be a major beneficiary of proposed changes.
In 2014, Care UK's former chairman Lord Nash became a government minister and Care UK took over services for people with severe learning disabilities in Doncaster, south Yorkshire, where they immediately cut wages of staff who had been on NHS terms by up to 35% while bringing in 100 new workers on £7 an hour. Fifty carers for the disabled began strike action in protest and by August 2014, had been on strike for seven weeks, making it one of the longest strikes in the history of the NHS. Care UK won the supported living contract from the council after telling officials that it could deliver it for £6.7m over three years, yet the wage bill alone for the service was £7m.
Alleged tax avoidance.
A report in "The Guardian" of 17 March 2012 stated that Care UK "has a reduced tax bill by taking out loans through the Channel Islands stock exchange and coming to an agreement with HMRC". Another report by the same newspaper in August 2014 stated that "Care UK has not paid a penny in corporation tax" since it was bought by the private equity firm Bridgepoint Capital in 2010.
Ealing Hospital.
In July 2015, ITV's "Exposure" programme uncovered poor practice in the urgent care centre run by the firm at Ealing Hospital. Failings included:
It is also alleged that staff registered the discharge of patients before they had been treated to avoid breaching the four-hour wait target.
Ealing Clinical Commissioning Group and Healthwatch Ealing both investigated the situation. Ealing Council considered the service at a meeting of its scrutiny committee in September 2015. The CCG agreed to pay for an additional GP and said that the service was still considered safe.


National Health Service Lottery

The National Health Service Lottery was a failed lottery scheme designed to provide funding for the National Health Service in the United Kingdom. The scheme progressed as far as a trial in May 1988, but the draw was cancelled at the last minute on legal grounds, and the 43,000 people who took part had their money refunded.
Background.
The lottery, which was a national equivalent of earlier localised lotteries in support of hospital services, had a jackpot of £200,000, and even progressed as far as the issuing of tickets and a prize draw in May 1988. The scheme was approved by Prime Minister Margaret Thatcher in April 1988, and it was estimated that a single draw could have raised up to £500,000 for the NHS.
Cancellation.
Although the National Health Lottery scheme was based upon earlier localised lotteries designed to generate funds for health services, by becoming national in scope, the scheme contravened the Lotteries and Amusements Act 1976. The scheme was referred to the Director of Public Prosecutions by the Gaming Board of Great Britain on 16 May 1988, halting the lottery before the first winner could be announced.
The Attorney-General, Sir Patrick Mayhew reported in the House of Commons in July 1988 that letters were written on 23 and 24 May to the company responsible for running the lottery indicating that the director would request police inquiries if the lottery draw took place.
The issue later appeared at Prime Minister's Questions on 27 October 1988:
Mr. Janner: "Does the Prime Minister recall recently endorsing a lottery intended to benefit the grossly under-resourced National Health Service and then having to remove her endorsement when the lottery turned out to be illegal? Is she proposing to endorse a further lottery launched today for the same purpose, which appears to be illegal under both current and intended legislation?"
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Margaret Thatcher: If something is illegal, one cannot possibly endorse it...On that particular private sector lottery, the advice was that as far as could be seen it was legal. When the advice came that it was illegal, of course one did not endorse it. I have not the slightest intention of having a national lottery organised by the Government. I disapprove of them.
Repercussions.
Despite the failure of the scheme, the idea for a national lottery in aid of the health service was not dropped and was extensively debated during Parliamentary Questions on 28 July 1988, and on later occasions. It was noted in a 1989 issue of "Health Affairs" that surveys showed the most popular approach to raising funds for the NHS was "not an increase in progressive income taxes, but rather the launching of a new national lottery (65 percent)". The idea of a "national lottery" in aid of good causes eventually materialised in the form of the National Lottery, launched in 1994.


Viktor Mucha

Viktor Mucha (17 April 1877 in Königgrätz – 6 June 1933 in Vienna) was a dermatologist from Austria. He was involved in early syphilis research.
He studied medicine at the universities of Vienna and Strasbourg, receiving his doctorate in 1904. From 1905 he worked as an assistant under Ernst Finger in the department of skin and venereal diseases at Vienna. He was also a physician at the Kaiserin-Elisabethspital (1909–13) and the St. Anna-Kinderspital (1913/14). In 1912 he obtained his habilitation for dermatology and syphilology at the university, becoming an associate professor in 1921.
In 1906, with Karl Landsteiner, he developed the technique of dark-field microscopy to visualize the organisms that cause syphilis.
Pityriasis lichenoides et varioliformis acuta is sometimes referred to as "Mucha-Habermann disease"; a skin disorder named in conjunction with German dermatologist Rudolf Habermann (1884–1941).


John Thomas Wolfe

John (Jack) Thomas Wolfe (May 2, 1955 – February 2, 1995) was a community veterinarian before becoming a Canadian provincial politician. He was the Progressive Conservative member of the Legislative Assembly of Saskatchewan for the constituency of Assiniboia-Gravelbourg, from 1988 until 1991.
Early life.
Wolfe was born in Rockglen, Saskatchewan on May 2, 1955, and was raised on the Wolfe family ranch within the Killdeer, Saskatchewan district west of Rockglen. He attended school at Killdeer before completing high school in Rockglen. He studied biology at the University of Saskatchewan and in 1979 he graduated with distinction from the Western College of Veterinary Medicine.
Professional career.
Wolfe practiced as a veterinarian in Alberta for one year before returning to his home in Rockglen, Saskatchewan, where he ran the Borderland Veterinary Clinic with his wife, Dr. Gail Snyder, whom he had married on January 26, 1980. Wolfe also worked as a veterinarian for the thoroughbred and standardbred racetracks in Regina and Saskatoon during the racing seasons for several years. He was extensively involved in community economic development projects and was chairman of the first Rural Development Corporation in the province.
Political career.
Wolfe was elected in a by-election called to replace Liberal party leader and future federal cabinet minister Ralph Goodale, when Goodale retired from provincial politics to run in the 1988 federal election. He served a single term, and was defeated by Lewis Draper of the NDP in the 1991 general election.
During Wolfe's term as an MLA in the Progressive Conservative Party of Saskatchewan he held several titles, including:
He was also involved with the Saskatchewan Property Management Corporation and the Saskatchewan Housing Corporation from March 16, 1990 to November 1, 1991.
Death.
Wolfe died in the early hours of February 2, 1995 due to a self-inflicted gunshot wound. The father of three—and soon to be four—back in his veterinary practice, was anguished at the prospect of being forced to testify against his old friends and ex-colleagues. When told in 1995 that he also potentially faced arrest (charges were never pressed), he shot himself. A former party worker says Jack was an innocent killed by a corrupt system. Jack's wife Gail says her husband's dream of public service was shattered.
He was cremated and buried at the Killdeer community cemetery, which happens to sit upon the site of the original Wolfe family homestead, from his grandfather's immigration, and also directly beside the former farmyard in which he spent his early years.


Virome

Virome refers to the assemblage of viruses that is often investigated and described by metagenomic sequencing of viral nucleic acids that are found associated with a particular ecosystem, organism or holobiont. The word is frequently used to describe environmental viral shotgun metagenomes. Viruses, including bacteriophages, are found in all environments, and studies of the virome have provided insights into nutrient cycling, development of immunity, and a major source of genes through lysogenic conversion.
History.
The first comprehensive studies of viromes were by shotgun community sequencing, which is frequently referred to as metagenomics. In the 2000s, the Rohwer lab sequenced viromes from seawater, marine sediments, adult human stool, infant human stool, soil, and blood. This group also performed the first RNA virome with collaborators from the Genomic Institute of Singapore. From these early works, it was concluded that most of the genomic diversity is contained in the global virome and that most of this diversity remains uncharacterized. This view was supported by individual genomic sequencing project, particularly the mycobacterium phage.
Methods of study.
In order to study the virome, virus-like particles are separated from cellular components, usually using a combination of filtration, density centrifugation, and enzymatic treatments to get rid of free nucleic acids. The nucleic acids are then sequenced and analyzed using metagenomic methods. Alternatively, there are recent computational methods that use directly metagenomic assembled sequences to discover viruses.
The Global Ocean Viromes (GOV) is a dataset consisting of deep sequencing from over 150 samples collected across the world's oceans in two survey periods by an international team.
Virus hosts.
Viruses are the most abundant biological entities on Earth, but challenges in detecting, isolating, and classifying unknown viruses have prevented exhaustive surveys of the global virome. Over 5 Tb of metagenomic sequence data were used from 3,042 geographically diverse samples to assess the global distribution, phylogenetic diversity, and host specificity of viruses.
In August 2016, over 125,000 partial DNA viral genomes, including the largest phage yet identified, increased the number of known viral genes by 16-fold. A suite of computational methods was used to identify putative host virus connections. The isolate viral host information was projected onto a group, resulting in host assignments for 2.4% of viral groups.
Then the CRISPR–Cas prokaryotic immune system which holds a "library" of genome fragments from phages (proto-spacers) that have previously infected the host. Spacers from isolate microbial genomes with matches to metagenomic viral contigs (mVCs) were identified for 4.4% of the viral groups and 1.7% of singletons. The hypothesis was explored that viral transfer RNA (tRNA) genes originate from their host.
Viral tRNAs identified in 7.6% of the mVCs were matched to isolate genomes from a single species or genus. The specificity of tRNA-based host viral assignment was confirmed by CRISPR–Cas spacer matches showing a 94% agreement at the genus level. These approaches identified 9,992 putative host–virus associations enabling host assignment to 7.7% of mVCs. The majority of these connections were previously unknown, and include hosts from 16 prokaryotic phyla for which no viruses have previously been identified.
Many viruses specialize in infecting related hosts. Viral generalists that infect hosts across taxonomic orders may exist. Most CRISPR spacer matches were from viral sequences to hosts within one species or genus. Some mVCs were linked to multiple hosts from higher taxa. A viral group composed of macs from human oral samples contained three distinct photo-spacers with nearly exact matches to spacers in Actionbacteria and Firmicutes.
In January 2017, the IMG/VR system -the largest interactive public virus database contained 265,000 metagenomic viral sequences and isolate viruses. This number scaled up to over 760,000 in November 2018 (IMG/VR v.2.0). The IMG/VR systems serve as a starting point for the sequence analysis of viral fragments derived from metagenomic samples.


Eugene Burnstein

Eugene Burnstein is an American social psychologist and professor emeritus of psychology at the University of Michigan College of Literature, Science, and the Arts. He is also a senior research scientist emeritus at the University of Michigan Institute for Social Research. He is known for his research on the cognitive bases of social influence and group decision-making.


Airway pressure release ventilation

Airway pressure release ventilation (APRV) is a pressure control mode of mechanical ventilation that utilizes an inverse ratio ventilation strategy. APRV is an applied continuous positive airway pressure (CPAP) that at a set timed interval releases the applied pressure. Depending on the ventilator manufacturer, it may be referred to as BiVent. This is just as appropriate to use, since the only difference is that the term APRV is copyrighted.
History.
Airway pressure release ventilation was described initially by Stock and Downs in 1987 as a continuous positive airway pressure (CPAP) with an intermittent release phase. APRV begins at a pressure higher than the baseline pressure and follows with a deflation to accomplish tidal ventilation. Fundamentally APRV is a time-cycled alternant between two levels of positive airway pressure, with the main time on the high level and a brief expiratory release to facilitate ventilation.
Indications.
Based on clinical and experimental data, airway pressure release ventilation is indicated in patients with acute lung injury, acute respiratory distress syndrome and atelectasis after major surgery
Inverse ratio ventilation.
This is a type of inverse ratio ventilation. The exhalation time (Tlow) is shortened to usually less than one second to maintain alveoli inflation. Fundamentally this is a continuous pressure with a brief release. APRV is currently the most efficient, conventional mode for lung protective ventilation.
Settings and measurements.
Settings are sometimes brand specific and the term for the individual settings may differ, however generally the settings listed here are a fundamental explanation of the purpose of the settings within the APRV mode.
Mean airway pressure.
Mean airway pressure on APRV is calculated by this formula:
Perceptions and receptions.
Different perceptions of this mode may exist around the globe. While 'APRV' is common to users in North America, a very similar mode, biphasic positive airway pressure (BIPAP), was introduced in Europe. The term APRV has also been used in American journals where, from the ventilation characteristics, BIPAP would have been the appropriate terminology. To further confusion, BiPAP is a registered trade-mark for a noninvasive ventilation mode in a specific ventilator (Respironics Inc.). Other names (BILEVEL, DUOPAP, BIVENT) have been created for legal reasons. Although similar in modality, these terms describe how a mode is intended to inflate the lung, rather than defining the characteristics of synchronization or the way spontaneous breathing efforts are supported. Concern has been raised about the amount of mechanical power applied to the lung during APRV and the risk of ergotrauma, especially in pulmonary ARDS.
Other terms.
APRV is used by many brands and models of mechanical ventilators under different names. Most names are copyrighted as trademarks and do not represent nomenclature of mechanical ventilation but may be referred to clinically by the brand name.
Some of these names include:


Methane-producing bacteria


Ethel Dickenson

Ethel Gertrude Dickenson (July 6, 1880 – October 26, 1918) was an educator and nurse born in St. John's, Newfoundland. She is noted as being one of the "Remarkable Women of Newfoundland and Labrador" for her tireless work and death in the care of patients during the outbreak of Spanish influenza at St. John's in 1918.
Biography.
Dickenson was educated at Methodist College, St. John's and MacDonald Institute, Guelph, Ontario, became a volunteer nurse during World War I at the Wandsworth Hospital, London and also the Ascot Hospital. She returned to St. John's for health reasons in 1918. The outbreak of Spanish influenza required that emergency services be set up at the King George the Fifth Institute where Dickenson had once again volunteered her nursing duties to care for the sick.
Dickenson was the only nurse who succumbed to the disease, she died October 26, 1918. A monument to Dickenson stands in Cavendish Square, an octagonal shaft with a Celtic cross at its pinnacle, sculpted from grey Aberdeen granite. The monument was unveiled by Lady and Governor Sir Charles Harris on October 26, 1920. Inscriptions on two opposite sides read as follows: This shaft, surmounted by the world emblem of sacrifice, is set up by a grateful public in memory of Ethel Dickenson volunteer nurse who in the great epidemic of 1918 gave her life while tending patients at the King George the Fifth Institute, St. John's. In honour also of those who nursed with her in the imminent shadow of death.
On the other two sides: Be Thou Faithful Unto Death and I Will Give Thee A Crown of Life.


Washington State Nurses Association

Founded in 1908, the Washington State Nurses Association (WSNA) is the professional organization representing more than 18,000 registered nurses in the U.S. state of Washington. WSNA is a constituent organization of the American Nurses Association (ANA) and is affiliated with ANA, AFT Healthcare and the AFL-CIO.
Sally Watkins, PhD, RN, is the Executive Director of the Association.
Primary mission.
The Washington State Nurses Association provides leadership for the nursing profession and promotes quality health care for consumers through education, advocacy and influencing health care policy in the state of Washington.
Washington State Nurses Foundation.
This foundation was established in 1982 to provide awards, grants, and scholarships to support the advancement of nursing in Washington state.
WSNA Political Action Committee (PAC).
The WSNA-PAC is the nonpartisan political action committee of the WSNA. Established in 1972, WSNA-PAC was one of the first state Nurses-PACs in the country. The PAC's activities include educating and assisting nurses for political action, identifying and supporting nurse candidates for elected state office, raising funds, and interviewing and endorsing candidates for state office who are supportive of nursing issues.


Thames Ambulance Service

Thames Ambulance Service is a private ambulance service with headquarters in Lincoln, and bases across England.
It had a sub-contract for patient transport services in Sussex with Coperforma. In November 2016 it proposed to make the staff redundant, claiming it had not been paid since June 2016.
The Care Quality Commission inspected it in 2017 and ordered it to improve after it found issues with found cleanliness, infection control and hygiene.
It took over patient transport services in North East Lincolnshire in October 2016. Six extra ambulance crews were brought in to temporarily support the local operation.
It started a contract for patient transport services in Hull in April 2017. Staff who were transferred from Yorkshire Ambulance Service were told that they would not be paid overtime and expenses in the first month because of “cash flow problems”. After the clinical commissioning group intervened they were paid. The local branch of the health union UNISON said that workers remained concerned about the problems with payment.
It won a five-year contract worth £28 million in Leicestershire and Rutland from October 2017, taking over from Arriva.


Alfred Baumeister

Alfred A. Baumeister (July 25, 1934 – March 14, 2011) was an American psychologist and professor at Vanderbilt University, known for his research on intellectual disabilities and his advocacy for such research.
Biography.
Baumeister was born in Fairbanks, Alaska, on July 25, 1934. He received his master's degree in 1959 and his Ph.D. in 1961, both from the Peabody College at Vanderbilt University. He joined the faculty at Peabody College in 1961 as an assistant professor of psychology. He taught at Central Michigan University from 1961 to 1965 and at the University of Alabama from 1967 to 1973. In 1973, he rejoined Peabody College as a professor and director of the Institute on Mental Retardation and Intellectual Development. From 1983 to 1990, he was the director of Vanderbilt's John F. Kennedy Center for Research on Education and Human Development. After stepping down as director of the Kennedy Center in 1990, he remained on the Vanderbilt faculty until his retirement in 2000. He died in Tuscaloosa, Alabama on March 14, 2011.


Margaret Cleaves

Margaret Abigail Cleaves (November 25, 1848 – November 7, 1917), M.D., was an American physician and scientific writer. She was a pioneer of electrotherapy and brachytherapy, instructor in Electro-Therapeutics New York Post-Graduate Medical School, President of the Women's Medical Society of New York, a Fellow of the American Electro-Therapeutic Association, a member of the Société Francaise d'Electrothérapie, a Fellow of the New York Academy of Medicine, Editor of Asylum Notes: Journal of Nervous and Mental Disease, 1891-2, a member of the Medical Society of the County of New York, a member of the American Medical Association, and a member of the New York Electrical Society.
She was licensed to practice medicine in Iowa (1873), Illinois (1876), Pennsylvania (1880) and New York (1890). Cleaves lectured and had clinical practice in London, Paris, Leipzig, Berlin and New York. From 1873 to 1876, Cleaves worked as an assistant physician at the State Hospital for the Insane, Mt. Pleasant, Iowa. Cleaves was the first woman physician to regularly treat mental illness at that institution, she subsequently served as a member of the board of trustees. From 1880 to 1883, Cleaves was physician-in-chief of the Women's Department, State Hospital for the Insane, Harrisburg, Pennsylvania. In 1885, Cleaves was appointed to the University of Iowa Medical Department's examining committee, "perhaps the first woman to serve in that capacity in the United States." In 1895, Cleaves founded the New York Electro-Therapeutic Clinic, Laboratory and Dispensary in New York City. Her work there included the treatment of a large number of cases of neurasthenia among both male and female patients.
Cleaves was a prolific author on topics concerning the use of radiation and electricity to treat illnesses. Cleaves also invented a variety of instruments for such treatments. Having an interest in the welfare and advancement of women, She organized the Des Moines Woman's Club and served as its first president.
Early years and education.
Margaret Abigail Cleaves was born in Columbus City, Iowa, November 25, 1848. Her father was of Dutch and English, and her mother of Scotch and Irish ancestry, but by birth, they were both Americans. Her father, Dr. John Trow Cleaves, was born in Yarmouth, Maine, in 1813, and her mother, Elizabeth Stronach, in Baltimore, in 1820. In 1843, they were married in Columbus City, where Dr. Cleaves practiced medicine until his death in October 1863. He was a man who took an interest in public affairs, and he was twice elected to the Iowa State Legislature, first in 1852, and again in 1861. Cleaves was the third of seven children. She inherited her father's taste for medical pursuits and, as a child accompanied him on his visits.
Her education was obtained in the public schools and in the Iowa State University, but because of limited means, she was unable to finish the collegiate course in the latter institution. After she was sixteen, she alternately attended and taught school for some years. In 1868, the family moved to Davenport, Iowa. There, Cleaves resolved to become a doctor instead of continuing a school teacher. Her choice of a profession was not regarded with favor by the various members of her family, who entertained the prevailing ideas concerning the limitations of woman's sphere, but her mind was made up, and in 1870, she began to read medicine and, against their wishes, entered the Medical Department of the Iowa State University. In 1871, she entered the office of her preceptor, Dr. W. F. Peck, who was dean of the faculty and professor of surgery in the university. She was graduated March 5, 1873, standing at the head of the class.
Career.
Physician.
Shortly after graduating, Cleaves was appointed second assistant physician in the State Hospital for the Insane, Mount Pleasant, Iowa. There, she was a veritable pioneer, for up to that time, only one other woman in the world had occupied the position of physician in a public insane asylum. She remained in the asylum for three years and then resigned her position to commence private practice in Davenport, She was subsequently appointed one of the trustees of the asylum.
While practicing medicine in Davenport, she became a member of the Scott County Medical Society, being the second woman to gain admission to that body.
For several years, she was the secretary of the society. She also joined the State Medical Society, where she was again the second woman to gain admission. She was the first woman to become a member of the Iowa and Illinois Central District Medical Association. During her residence in Davenport she was an active member of the Davenport Academy of Sciences.
In 1879, the board of trustees of the State Asylum for the Insane chose her their delegate to the National Conference of Charities, which that year met in Chicago, Illinois. In that conference, she read a paper on "The Medical and Moral Care of Female Patients in Hospitals for the Insane." It attracted widespread attention, and was printed in a volume, "Lunacy in Many Lands", which was published by the Government of New South Wales. In June 1880, she was appointed by the Governor of Iowa a Slate delegate to the National Conference of Charities in Cleveland, Ohio, and thus the distinction was conferred upon her of being the first female delegate from Iowa to that body. She reported for the State to the conference, and her report was subsequently incorporated in the Governor's annual message. That same year she was appointed physician-in-chief in the Female Department of the Pennsylvania State Lunatic Hospital in Harrisburg. After three years of hard work, rendered all the more arduous by her conscientious devotion to the minutest details of her duties, Cleaves was compelled by failing health to resign her position.
She went abroad in 1883, remaining nearly two years, visiting insane hospitals in Scotland, England, France, Italy, Germany, Austria, Switzerland, and Belgium, everywhere receiving courtesies from men of recognized eminence in the treatment of insanity. She witnessed operations in general hospitals in England, France, and Germany, and in Paris, she was for several months a regular attendant at lectures and clinics. After returning to the United States, she opened a private home for the reception of patients in Des Moines, Iowa, conducting also an office practice in connection with her other work. In March 1885, she was appointed one of the examining committee of the Medical Department of the Iowa State University. It was the first honor of that kind bestowed on a woman by any standard medical school in the United States. In July 1886, she was sent as a delegate to the yearly meeting of the National Conference of Charities, which was held in St. Paul, Minnesota. During her residence in Des Moines, she was an active member of the Polk County Medical Society, of the Missouri Valley Medical Association and of the Iowa State Medical Association. Before all those bodies she read papers and she served the last-named body as chairman of obstetrics and gynaecology in the session of 1889. At that time she was the only woman who had received such an appointment.
In the medical fields of radiation oncology and gynaecology, Margaret Cleaves is remembered as the first physician to successfully apply radium in the treatment of cancer of the uterine cervix. In her seminal paper of October 1903, she wrote:
""...an inoperable primary pelvic case of epithelioma, involving the cervix, anterior and posterior vaginal walls, almost to the introitus; rectum, bladder, and both broad ligaments." (page 605)"
The patient was treated first by a combination of x-rays and ultraviolet light, followed by intravaginal insertion of one gram of bromide of radium in a sealed glass tube. On September 15, 1903, the patient had radium brachytherapy for five minutes to the posterior wall of the vagina, followed by five minutes to the anterior surface, because of the vesical involvement. A second application of five minutes was given on September 16, 1903.
""September 21, 1903. Five days subsequent to the use of radium, no bleeding, no odor, no discharge, no ulceration, and vaginal and cervical mucous membrane normal in appearance." (page 605)"
"September 28. Is looking and feeling well. No symptoms; still no bleeding from rectum since radium first used, two weeks since."
Since then, brachytherapy is a pivotal part of the curative treatment for women with inoperable cervical cancer. Cleaves introduced a technique that has saved the lives of millions of women with cancer.
Activist and writer.
Her work was not confined to medicine alone. She took a deep interest in all that pertained to the welfare and advancement of women. She organized the Des Moines Women's Club and was its first president. Some time prior to that, she had become a member of the Association for the Advancement of Women. Becoming interested in the subject of electro-therapeutics, she went to New York in the winter of 1887 and to Paris in the following summer, to prosecute her inquiries and investigation. After her return, she continued to practice for a while in Des Moines, but in 1890, she moved to New York City. She there joined the Medical Society of the County of New York, the American Electro-Therapeutic Association and the New York Women's Press Club. In the Post-Graduate Medical School, New York, she served as clinical assistant to the chair of electro-therapeutics. Since she took up her residence in New York, she read papers before the Medical Society of Kings County, Brooklyn, the New York Medico-Legal Society, the American Electro-Therapeutic Association and the National Conference of Charities. Many of them were published, and all of them were distinguished by painstaking research, clearness of statement, and logical reasoning. She was author of "Light Energy: Its Physics, Physiological Action and Therapeutic Application", and American editor of the "Journal of Physiological Therapeutics", London.
Cleaves died in a hospital in Mobile, Alabama, November 7, 1917.


Michael Fanselow

Michael S. Fanselow is an American psychologist, currently a Distinguished Professor at University of California, Los Angeles, specializing in learning and behavior and behavioral neuroscience, and is also a published author of 4 books, having a total number of 655 library holdings, the highest book is held in 513 libraries worldwide. He co-authored a paper that has a citation number of 2,009.


Vaccine Maitri

Vaccine Maitri ("English:" Vaccine Friendship) is a humanitarian initiative undertaken by the Indian government to provide COVID-19 vaccines to countries around the world. Indian government had started providing vaccines since 20 January 2021. As of 9April 2021, India had delivered around 64.5 million doses of vaccines to 85 countries. Of these, 10.5 million doses were gifted to 45 countries by the Government of India. The remaining 54 million were supplied by the Serum Institute of India under its commercial and COVAX obligations.
While speaking at the UN General Assembly high-level panel on the human rights situation in Syria, India pledged help the United Nations to vaccinate Syria through the "Vaccine Maitri" policy, as Syria is facing a dire situation compounded by COVID-19, winterisation and food insecurity.
200,000 doses of COVID-19 vaccines were gifted by India to the UN peacekeepers on 27 March to be distributed to all peacekeeping missions.
Vaccines.
India has two approved COVID-19 vaccines: Covishield and Covaxin. The Government of India supplied both the vaccines to various countries across the globe.
Covishield.
On 1 January 2021, the Drug Controller General of India, approved the emergency or conditional use of Oxford–AstraZeneca COVID-19 vaccine (marketed as Covishield). Covishield is developed by the University of Oxford and its spin-out company, Vaccitech. It’s a viral vector vaccine based on replication-deficient Adenovirus that causes cold in Chimpanzees. It can be stored, transported and handled at normal refrigerated conditions (two-eight degrees Celsius/ 36-46 degrees Fahrenheit). It has a shelf-life of at least six months.
Covaxin.
On 2 January 2021, BBV152 (marketed as Covaxin), first Indian vaccine, developed by Bharat Biotech in association with the Indian Council of Medical Research and National Institute of Virology received approval from the Drug Controller General of India for its emergency or conditional usage. However, this approval was met with some concern as the vaccine had not then completed phase-3 trials. On 3March 2021, Bharat Biotech announced that interim results of covaxin showed the 81% efficacy. Trial was conducted on the 25,800 people in India.
Vaccine supply.
India kicked off international shipment of the vaccines on 20 January 2021, only four days after starting its own vaccination program. Bhutan and Maldives were the first countries to receive vaccines as a grant by India. This was quickly followed by shipments to Nepal, Bangladesh, Myanmar and Seychelles. By mid-March 2021, India was also supplying vaccines on a commercial basis to countries including Canada, the UK, and Saudi Arabia.
The Serum Institute of India was selected as a key supplier of cost-effective COVID-19 vaccines to the COVAX initiative. Several million doses of AstraZeneca's COVID-19 vaccine AZD1222 were supplied by India to various countries through the COVAX initiative.
However, in late March 2021, Modi's government temporarily froze exports of the AstraZeneca vaccine, citing India's own COVID crisis and the domestic need for these vaccines. In May, when COVAX was already short 140 million doses, the Serum Institute announced that it expected to maintain its suspension of vaccine deliveries to COVAX through the end of 2021.
Vaccines exported.
As of 15 March 2021, India had donated over 8 million doses to 37 countries.
As of 29 March 2021, India had exported 58 million doses to more than 65 nations.


Philibert Borie

Philibert Borie (1759–1832) was a French physician and Mayor of Paris for six days in July 1792.


Radiate sternocostal ligaments

The Radiate sternocostal ligaments are fibrous bands that cross from the sternal end of the costal cartilage to the ventral part of the sternum.


Vista Healthcare

Vista Healthcare runs a low secure private hospital in Winchfield Hampshire for people with learning difficulties and associated problems.
The company, Fairhome Care Group (WL) Ltd., was formed in 1987 and opened the hospital in 2002 with 17 beds. It now has 6 wards with a total of 67 beds and also provides community services.
A Care Quality Commission inspection in November 2014 found 334 incidents of physical abuse or violence in seven months, 272 of which were assaults on staff. They reported "little evidence that the provider had the specialist skills or systems to learn from these incidents and prevent them happening in the first place". In February 2015 NHS England closed one ward and moved patients out after the company failed to meet a deadline for improvements.


Assisted Living Federation of America

The Assisted Living Federation of America (ALFA) is a trade association of senior living providers that manage assisted living communities across the United States. ALFA was formed in 1990. It is headquartered in Alexandria, Virginia, and has 30 affiliates and four chapters representing 34 states. ALFA is the largest national association exclusively dedicated to professionally managed, resident-centered senior living communities and the seniors and families they serve.
Awards programs.
The Best of the Best Awards - is an annual awards program that recognizes senior living providers who demonstrative innovative, unique and evolutionary approaches to improving quality of life for seniors and their families and those who work in senior living communities. ALFA Best of the Best Awards are presented at the annual ALFA Conference.
The ALFA Hero Awards - Annual awards program that recognizes senior living professionals who have shown leadership, initiative and work to improve the quality of life for the residents he/she serves in a senior living community. ALFA Hero Awards are presented at the annual ALFA Conference.
The Horace D'Angelo, Jr. Memorial Awards - recognizes outstanding senior living advocacy efforts. Established in 2010 to honor the late Horace D'Angelo, Jr.


Louis-Anne-Jean Brocq

Louis-Anne-Jean Brocq (1 February 1856 – 18 December 1928) was a French dermatologist born in Laroque-Timbaut, a village in the department of Lot-et-Garonne.
He practiced medicine in Paris at the Hospice la Rochefoucauld, the Hôpital Broca, and from 1906 to 1921, the Hôpital Saint-Louis. As a young physician he studied and worked with Jean Alfred Fournier (1832–1915), Jean Baptiste Emile Vidal (1825–1893) and Ernest Henri Besnier (1831–1909).
Brocq provided early, comprehensive descriptions of numerous skin disorders, including keratosis pilaris, parapsoriasis and a form of dermatitis called "Duhring-Brocq disease" (named with Louis Adolphus Duhring and sometimes referred to as dermatitis herpetiformis). Other eponymous skin diseases named after him are "Brocq's pseudopelade", a condition involving progressive scarring of the scalp, and "Brocq-Pautrier angiolupoid", a specific type of sarcoidosis of the skin named in conjunction with Dr. Lucien-Marie Pautrier (1876–1959). With Pautrier he also described "Brocq-Pautrier syndrome" ("glossitis rhombica mediana"), characterized by rhomboid and shiny lesions on the midline of base of the tongue. Brocq is also credited for developing a tar solution used for the treatment of psoriasis.
Along with Ernest Besnier and Lucien Jacquet, he published a four volume encyclopedia of dermatology, titled "La pratique dermatologigue" (1900–04).


American Board of Physician Specialties

The American Board of Physician Specialties (ABPS), the official certifying body for the American Association of Physician Specialists (AAPS) is a non-profit umbrella organization for sixteen medical specialty boards that certifies and re-certifies physicians in fourteen medical specialties in the United States and Canada. The ABPS is one of three organizations overseeing Doctor of Medicine (M.D.) and Doctor of Osteopathic Medicine (D.O.) certification in the United States. The ABPS assists its Member Boards in developing and implementing educational and professional standards to evaluate and certify physician specialists. It is recognized by the U.S. Department of Labor as well as the Centers for Medicare and Medicaid Services (CMS).
History.
The American Association of Physician Specialists (AAPS) is the smallest of three multi-specialty physician/surgeon certifying entities in the United States, providing board certification to both M.D. and D.O. physicians. The AAPS has grouped its certification activities within a single subdivision called the American Board of Physician Specialties (ABPS). In August 2005, the ABPS name was registered to AAPS. The ABPS implements certification functions under the direction of AAPS.
AAPS (originally known as the American Association of Osteopathic Physicians was founded in 1952 by Dr. E.O. Martin. Since 1984, AAPS has provided a headquarters for medical specialty boards of certification.
Recognition by state medical boards.
Today in the U.S. and its territories, there are seventy (70) state medical boards—some state medical boards are composed of an M.D. board and a D.O. board while others are combined as one, called a "composite board". Of the 70 state boards, the vast majority "do not" differentiate between any of the three nationally recognized multi-specialty boards of certification (ABMS, ABPS, AOABOS). In other words, the majority of the state medical boards are silent (or neutral) as to which board a given physician is certified by.
The remaining boards, approximately twenty (20), have established specific rules for physician advertising by which boards have to petition and receive permission for physicians to be able to advertise themselves as "board certified".
Those twenty (20) boards are:
Physicians certified by ABPS and licensed by the Medical Board of California are prohibited from using the term "board certified" unless they are also certified by an American Board of Medical Specialties board.
It also appears that certification by an ABPS member board is not sufficient to allow use of the term "board certified" by physicians licensed in the State of New York. However, interpreting the law in New York is more complex.
Specialties.
The ABPS, the official certifying body of the American Association of Physician Specialists (AAPS), is the United States' third largest recognized physician multi-specialty certifying body, providing physician board certification re-certification for thousands of physicians in following 20 medical specialties:


Lombe Atthill

Lombe Athill (1827–1910) was a Northern Irish obstetrician and gynaecologist. Hailing from Ardess, Magheraculmoney in County Fermanagh, he studied at the Trinity College, Dublin, and obtained his licence to practice from the Royal College of Surgeons in Ireland in 1847. That year, he became the surgeon to a charitable dispensary in Fleet Street, Dublin, and then dispensary doctor of the district of Geashill in King's County from 1848 to 1850. He began working as an assistant physician at the Rotunda Hospital in 1851. In November 1875 he was elected master of hospital, and one of the leading experts on gynaecology in the country at the time. He was elected president of the Irish College of Physicians in 1888.


Viral transformation

Viral transformation is the change in growth, phenotype, or indefinite reproduction of cells caused by the introduction of inheritable material. Through this process, a virus causes harmful transformations of an in vivo cell or cell culture. The term can also be understood as DNA transfection using a viral vector.
Viral transformation can occur both naturally and medically. Natural transformations can include viral cancers, such as human papillomavirus (HPV) and T-cell Leukemia virus type I. Hepatitis B and C are also the result of natural viral transformation of the host cells. Viral transformation can also be induced for use in medical treatments.
Cells that have been virally transformed can be differentiated from untransformed cells through a variety of growth, surface, and intracellular observations. The growth of transformed cells can be impacted by a loss of growth limitation caused by cell contact, less oriented growth, and high saturation density. Transformed cells can lose their tight junctions, increase their rate of nutrient transfer, and increase their protease secretion. Transformation can also affect the cytoskeleton and change in the quantity of signal molecules.
Type.
There are three types of viral infections that can be considered under the topic of viral transformation. These are cytocidal, persistent, and transforming infections. Cytocidal infections can cause fusion of adjacent cells, disruption of transport pathways including ions and other cell signals, disruption of DNA, RNA and protein synthesis, and nearly always leads to cell death. Persistent infections involve viral material that lays dormant within a cell until activated by some stimulus. This type of infection usually causes few obvious changes within the cell but can lead to long chronic diseases. Transforming infections are also referred to as malignant transformation. This infection causes a host cell to become malignant and can be either cytocidal (usually in the case of RNA viruses) or persistent (usually in the case of DNA viruses). Cells with transforming infections undergo immortalization and inherit the genetic material to produce tumors. Since the term cytocidal, or cytolytic, refers to cell death, these three infections are not mutually exclusive. Many transforming infections by DNA tumor viruses are also cytocidal.
Table 1: Cellular effects of viral infections
Cytocidal infections.
Cytocidal infections are often associated with changes in cell morphology, physiology and are thus important for the complete viral replication and transformation. "Cytopathic Effects", often include a change in cell's morphology such as fusion with adjacent cells to form polykaryocytes as well as the synthesis of nuclear and cytoplasmic inclusion bodies. "Physiological changes" include the insufficient movement of ions, formation of secondary messengers, and activation of cellular cascades to continue cellular activity. "Biochemically", many viruses inhibit the synthesis of host DNA, RNA, proteins directly or even interfere with protein-protein, DNA-protein, RNA-protein interactions at the subcellular level. "Genotoxicity" involves breaking, fragmenting, or rearranging chromosomes of the host. Lastly, "biologic effects" include the viruses' ability to affect the activity of antigens and immunologlobulins in the host cell.
There are two types of cytocidal infections, productive and abortive. In productive infections, additional infectious viruses are produced. Abortive infections do not produce infectious viruses. One example of a productive cytocidal infection is the herpes virus.
Persistent infections.
There are three types of persistent infections, latent, chronic and slow, in which the virus stays inside the host cell for prolonged periods of time. During "latent infections" there is minimal to no expression of infected viral genome. The genome remains within the host cell until the virus is ready for replication. "Chronic infections" have similar cellular effects as acute cytocidal infections but there is a limited number of progeny and viruses involved in transformation. Lastly, "slow infections" have a longer incubation period in which no physiological, morphological or subcellular changes may be involved.
Transforming infections.
Transformation infections is limited to abortive or restrictive infections. This constitutes the broadest category of infections as it can include both cytocidal and persistent infection. Viral transformation is most commonly understood as transforming infections, so the remainder of the article focuses on detailing transforming infections.
Process.
 In order for a cell to be transformed by a virus, the viral DNA must be entered into the host cell. The simplest consideration is viral transformation of a bacterial cell. This process is called lysogeny. As shown in Figure 2, a bacteriophage lands on a cell and pins itself to the cell. The phage can then penetrate the cell membrane and inject the viral DNA into the host cell. The viral DNA can then either lay dormant until stimulated by a source such as UV light or it can be immediately taken up by the host's genome. In either case the viral DNA will replicate along with the original host DNA during cell replication causing two cells to now be infected with the virus. The process will continue to propagate more and more infected cells. This process is in contrast to the lytic cycle where a virus only uses the host cell's replication machinery to replicate itself before destroying the host cell.
 The process is similar in animal cells. In most cases, rather than viral DNA being injected into an animal cell, a section of the membrane encases the virus and the cell then absorbs both the virus and the encasing section of the membrane into the cell. This process, called endocytosis, is shown in Figure 3.
Transformation of the host cell.
Viral transformation disrupts the normal expression of the host cell's genes in favor of expressing a limited number of viral genes. The virus also can disrupt communication between cells and cause cells to divide at an increased rate.
Physiological.
Viral transformation can impose characteristically determinable features upon a cell. Typical phenotypic changes include high saturation density, anchorage-independent growth, loss of contact inhibition, loss of orientated growth, immortalization, disruption of the cell's cytoskeleton.
Biochemical.
Viral genes are expressed through the use of the host cell's replication machinery; therefore, many viral genes have promoters that support binding of many transcription factors found naturally in the host cells. These transcription factors along with the virus' own proteins can repress or activate genes from both the virus and the host cell's genome. Many viruses can also increase the production of the cell's regulatory proteins.
Genetic.
Depending on the virus, a variety of genetic changes can occur in the host cell. In the case of a lytic cycle virus, the cell will only survive long enough to the replication machinery to be used to create additional viral units. In other cases, the viral DNA will persist within the host cell and replicate as the cell replicates. This viral DNA can either be incorporated into the host cell's genetic material or persist as a separate genetic vector. Either case can lead to damage of the host cell's chromosomes. It is possible that the damage can be repaired; however, the most common result is an instability in the original genetic material or suppression or alteration of the gene expression.
Assays.
An assay is an analytic tool often used in a laboratory setting in order to assess or measure some quality of a target entity. In virology, assays can be used to differentiate between transformed and non-transformed cells. Varying the assay used, changes the selective pressure on the cells and therefore can change what properties are selected in the transformed cells.
Three common assays used are the focus forming assay, the Anchorage independent growth assay, and the reduced serum assay.
The focus forming assay (FFA) is used to grow cells containing a transforming oncogene on a monolayer of non-transformed cells. The transformed cells will form raised, dense spots on the sample as they grow without contact inhibition. This assay is highly sensitive compared to other assays used for viral analysis, such as the yield reduction assay.
An example of the Anchorage independent growth assay is the soft agar assay. The assay is assessing the cells' ability to grow in a gel or viscous fluid. Transformed cells can grow in this environment and are considered anchorage independent. Cells that can only grow when attached to a solid surface are anchorage dependent untransformed cells. This assay is considered one of the most stringent for detection of malignant transformation
In a reduced serum assay, cells are assayed by exploiting the changes in cell serum requirements. Non-transformed cells require at least a 5% serum medium in order to grow; however, transformed cells can grow in an environment with significantly less serum.
Examples of Natural Transformation.
Natural transformation is the viral transformation of cells without the interference of medical science. This is the most commonly considered form of viral transformation and includes many cancers and diseases, such as HIV, Hepatitis B, and T-cell Leukemia virus type I.
Viral oncogenesis.
As many as 20% of human tumors are caused by viruses. Some such viruses that are commonly recognized include HPV, T-cell Leukemia virus type I, and hepatitis B.
Viral oncogenesis are most common with DNA and RNA tumor viruses, most frequently the retroviruses. There are two types of oncogenic retroviruses: acute transforming viruses and non-acute transforming viruses. Acute transforming viruses induce a rapid tumor growth since they carry viral oncogenes in their DNA/RNA to induce such growth. An example of an acute transforming virus is the Rous Sarcoma Virus (RSV) that carry the v-src oncogene. v-Src is part of the c-src, which is a cellular proto-oncogene that stimulates rapid cell growth and expansion. A non-acute transforming virus on the other hand induces a slow tumor growth, since it does not carry any viral oncogenes. It induces tumor growth by transcriptionally activating the proto-oncogenes particularly the long terminal repeat (LTR) in the proto-oncogenes.
Viral Oncogenesis through transformation can occur via 2 mechanisms:
One or both of these mechanisms can occur in the same host cell.
Hepatitis B.
The Hepatitis B viral protein X is believed to cause hepatocellular carcinoma through transformation, typically of liver cells. The viral DNA is incorporated into the host cell's genome causing rapid cell replication and tumor growth.
Papillomaviruses.
Papillomaviruses typically target epithelial cells and cause everything from warts to cervical cancer. When human papillomavirus (HPV) transforms a cell, it interferes with the function of cellular proteins while degrading other cellular proteins.
Herpesviruses.
The herpesviruses, Kaposi's sarcoma-associated herpesvirus and Epstein-Barr virus, are believed to cause cancer in humans, such as Kaposi's sarcoma, Burkitt's lymphoma, and nasopharyngeal carcinoma. Although genes have been identified in these viruses that cause transformation, the manner in which the virus transforms and replicates the host cell is not understood.
Retroviruses.
The retroviruses include T-cell Leukemia virus type I, HIV, and Rous Sarcoma Virus (RSV). The viral gene tax is expressed when the T-cell Leukemia virus transforms a cell altering the expression of cellular growth control genes and causing the transformed cells to become cancerous. HIV works differently by not directly causing cells to become cancerous but by instead making those infected more susceptible to lymphoma and Kaposi's sarcoma. Many other retroviruses contain the three genes, gag, pol, and env, which do not directly cause transformation or tumor formation.
HIV.
Human immunodeficiency virus is a viral infection that targets the lymph nodes. HIV binds to the immune CD4 cell and reverse transcriptase alters the host cell genome to allow integration of the viral DNA via integrase. The virus replicates using the host cell's machinery and then leaves the cell to infect additional cells via budding.
Medical Applications.
There are many applications in which viral transformation can be artificially induced in a cell culture in order to treat an illness or other condition. A cell culture is infected with a virus causing the transformation; transformed cells can then be used to either produce treatments or be directly introduced into the body.
Personalized type I interferons.
Type I interferons (IFNs) are used to treat a wide variety of medical conditions including hepatitis C, cancers, viral and inflammatory diseases. IFNs can either be extracted from a natural source, such as cultured human cells or blood leukocytes, or they can be manufactured with recombinant DNA technologies. Most of these IFN treatments have a low response rate.
The use of viral transformation of the Epstein-Barr virus (EBV) has been recommended to create personalized IFNs. In this process, primary B lymphocytes are transformed with EBV. These cells can then be used to produce IFNs specific for the patient from which the B lymphocytes were extracted. This personalization decreases the likelihood of an antibody response and therefore increases the effectiveness of the treatment.
Cancer treatments.
When a virus transforms a cell it often causes cancer by either altering the cells' existing genome or introducing additional genetic material which causes cells to uncontrollably replicate. It is rarely considered that what causes so much harm also has the capability of reversing the process and slowing the cancer growth or even leading to remission. Viruses transform host cells in order to survive and replicate; however, the immune responses of the host cell are typically compromised during transformation making transformed cells more susceptible to other viruses.
The idea of using viruses to treat cancers was first introduced in 1951 when a 4-year-old boy suddenly went into a temporary remission from leukemia while he had chickenpox. This led to research in the 1990s where scientists worked to create a strain of the herpes simplex virus strong enough to infect and transform tumor cells but weak enough to leave healthy cells unharmed. Treating patients with viral transformation has the possibility of treating patients more safely and more effectively than using traditional methods, such as chemotherapy. Viruses used in the treatment of cancer gain strength and increase their effectiveness as the multiply in the body while causing only minor side effects, such as nausea, fatigue, and aches.


Texila American University Zambia

Texila American University Zambia is a private University, established in 2016 that offers quality education with a wide range of career-focused programs. The University is approved by Higher Education Authority – Ministry of Higher Education, Zambia, Health Professional Council of Zambia (HPCZ) and Listed in Zambia Chamber of Commerce and Industry (ZACCI) and International Council for Open and Distance Education. The campus is spread across 25,000 sq. ft of academic space with state-of-the-art infrastructure. Texila American University offers Bachelor of Medicine, Bachelor of Surgery (MBCHB), Bachelors in Nursing, Diploma in Nursing, Bachelors in Pharmacy, Diploma In Pharmacy, Masters in Public Health (MPH), Bachelors in Business Management (BBA), Masters in Business Management (MBA). Texila American University is also ranked as top University in Zambia.
Academics.
Texila American University (TAU) offers a multidisciplinary academic programs in Diploma, Bachelors & Masters levels in the field of Medicine, Allied Health Sciences, Business Management, Information Technology which is approved by Higher Education Authority of Zambia.
Bachelor of Medicine, Bachelor of Surgery (MBCHB)
To study medicine in Zambia with Texila American University, students are selected on the basis of their academic, personal, and extracurricular abilities. Students after O Level can also enroll into foundation program (Health Professional Foundation Program) which is a pathway to medicine and allied health science courses.
Department of Business and Management.
The programs at different levels train the students to acquire business leadership skills.
Department of Information Technology.
Bachelors, Masters and PhD programs in IT are focused to prepare students or professionals in wide ranging IT careers including R&D, Software Development, Teaching, and Industrial Consultancy.
Department of Education.
Education programs are developed to foster new streams of educationists and enhance the professional credentials of enrolled students regardless of their prior degree.
Department of Premedical.
The Premedical foundation programs are aimed to provide the basic medical education to the aspirants for Medicine or Pharmacy program.
Texila American University Consortium (TAU – C).
Texila American University Consortium is a Private Educational Group of Universities and Campuses Strategically Spread Across Countries and Continents. Incepted in 2010, the TAU Consortium has campuses in Guyana, Zambia and Fujairah (United Arab Emirates) and Offices in India, USA, Sharjah, Zambia, Hong-Kong and Philippines.
The Portfolio of the TAU Consortium includes the following:


UCL Eastman Dental Institute

The UCL Eastman Dental Institute is the dental school of University College London (UCL) and an academic department of UCL's Faculty of Medical Sciences. The Institute is based on Gray's Inn Road in the Bloomsbury district of London, United Kingdom, adjacent to the Eastman Dental Hospital, with which it is closely associated.
The Institute is the largest postgraduate dental centre in Europe, and together with the Eastman Dental Hospital forms one of the largest concentrations of oral health care specialists and research in Europe. The Institute runs an extensive CPD programme in dedicated facilities.
History.
In 1926 the American industrialist and philanthropist George Eastman, founder of Eastman Kodak, donated £200,000 to fund the establishment of a dental clinic in London. (He had also founded similar institutions in the United States.) Lord Riddell, Chairman of the Royal Free Hospital, had solicited Eastman after having made his own donation of £50,000, with a matching donation by the Royal Free honorary treasurer. On 20 November 1931, the Eastman Dental Clinic opened as part of the Royal Free Hospital.
In 1948, the Eastman became independent of the Royal Free and became the postgraduate dental institute of the Postgraduate Medical Federation. In 1949 the Eastman opened a department of pathology and microbiology and the first civilian oral hygiene school in the UK.
During the Directorship of Professor Frank Wilson (1950–1959) a full department range was established at the Eastman, including children's, oral surgery, radiography and prosthetics. Under the Directorship of Sir Robert Bradlaw (1959–1970), the Eastman's teaching concept was altered, with MSc courses of the University of London being introduced. Professors Ivor Kramer, Gerry Winter and Crispian Scully CBE followed and brought the Research Assessment and the teaching assessment scores to a high level. In 1988 the Eastman moved to the old Royal Free buildings on Gray's Inn Road; in 1992 the Eastman's name was changed to the Eastman Dental Institute (EDI).
The Institute merged with University College London in 1999, becoming the UCL Eastman Dental Institute. In 2002 it won the Queens Award for Higher Education.
Research.
The Institute is a major research centre offering a range of doctorates. Much of the research is focused upon preventing, diagnosing and treating common oral disorders such as childhood dental decay, gum disease in adults or oral cancer.
Postgraduates and staff are also engaged in research designed to have a wider impact on collective public health, such as antibiotic resistance, bone repair and food poisoning.
Research at the Institute is currently represented by three interdisciplinary departments:
Biomaterials & Tissue Engineering Department.
The Biomaterials & Tissue Engineering Department carries out research to develop materials for hard and soft tissue reconstruction, but also with a need to understand the processes involved with cellular interaction with the materials surface.
Clinical Research Department.
The Clinical Research Department focuses on the full spectrum of disorders of the head and neck region including disease of the oral mucosa, dentition, jawbones, salivary glands, cranial nerves, masticatory muscles and adjacent structures and organs. This Department also includes:
Microbial Diseases Department.
The Microbial Diseases Department examines the aetiology, pathogenesis and control of diseases caused by micro-organisms as well as the ecology of the indigenous microbiota and its contribution to health. The department also oversees the Swab and Send project and the Tn Registry, the latter designating Tn numbers to researchers publishing details of new transposable elements discovered in bacteria and archaea.
The Centre for Oral Health and Performance.
The Centre for Oral Health and Performance promotes oral health in sport to enhance the performance, overall health and wellbeing of athletes. The Centre engages in research with a wide range of clinical and academic disciplines as well as elite athletes, sport and exercise medicine professionals, sport organisations, sport funders, policy makers and industry.
The Centre carried out research at the London 2012 Olympic Games, finding high levels of oral and dental disease and self-reported impact of oral health on performance in a fifth of athletes. The results were published in the British Journal of Sports Medicine.
A subsequent paper published in 2015 reported on a large study within Premier League and Championship football in 2014 of nearly 200 senior squad players from eight clubs. The study, which was highly reported, found that the oral health of players was poor and impacted on well-being and performance. Of players examined 37% had active dental decay, 53% dental erosion and 5% moderate to severe and irreversible gum disease.
The Swab and Send project.
Dr Adam Roberts, Senior Lecturer in Microbial Diseases at UCL Eastman Dental Institute, first launched crowdfunding project Swab and Send in 2012 to search for new antibiotics with the help of the public. For a small fee contributors are sent a swab kit enabling them to take a sample from any place in their environment where different bacteria may be competing for space and food. Once the swab is sent in the Institute team analyses the samples to determine if there are any bacteria present producing potentially new antibiotics.
Dr Roberts received The Society for General Microbiology’s 2015 Outreach Prize in recognition of sustained activities to engage and inspire public interest in microbiology. He was also appointed an advisor to the Longitude Prize, a challenge with a £10 million fund to help solve the problem of global antibiotic resistance.
In December 2015 his team assisted BBC programme Trust Me I'm a Doctor in investigating and debunking the widely held belief that male beards contain a stockpile of dangerous bacteria.
Education.
The Institute offers a range of postgraduate courses including master's degrees, specialty training, certificates, diplomas, research-informed degrees and CPD courses. Educational activities are provided through four departments:
Continuing Professional Development Department.
The Continuing Professional Development Department delivers part-time programmes as well as short courses on a wide range of areas relevant to contemporary oral health care.
Craniofacial Growth and Development Department.
The Craniofacial Growth and Development Department is composed of two units: Orthodontics and Paediatric Dentistry.
Maxillofacial Medicine Department.
The Maxillofacial Medicine Department is composed of two units: Oral & Maxillofacial Surgery and Special Care Dentistry.
Restorative Dentistry Department.
The Restorative Dentistry Department is composed of three units: Endodontics, Periodontology and Prosthodontics.
The Institute offers a range of postgraduate study routes, including master's degrees, specialty training, certificates, diplomas, research-informed degrees and CPD courses. At postgraduate level the Institute currently offers a range of degree programmes:
The Institute also offers a range of CPD short courses.
Library.
The UCL Eastman Dental Library provides a specialist library and information service to students, researchers and professionals in the field of dental and oral health sciences. It serves both the UCL Eastman Dental Institute and Eastman Dental Hospital, including computing facilities for both HE and NHS users.
All full-time UCL staff and students are automatically enrolled as members of the library. Most Eastman Dental Hospital staff and students are also eligible for full membership
The library currently holds over 3,200 books, 70 locally held journal titles, and also has access to many e-journals, e-books and online databases. A small collection of DVDs and CD ROMs are available.
UCL staff and students with UCL computer accounts can access an extensive number of databases. Visitors to the library can use the Explore Access Point computers to use those licensed for walk-in users.
Rankings.
The Institute achieved top scores of 5 in both the 1996 and 2001 Research Assessment Exercises and the Institute's research programme is one of only two oral themes to achieve national funding within an NHS Biomedical Research Centre, as part of the UCLH/UCL Biomedical Research Centre. Both the Institute and the Eastman Dental Hospital are part of UCL Partners, the largest academic health science centre in Europe.
The Institute achieved a good outcome in the 2014 Research Excellence Framework, achieving the highest corrected GPA in Dentistry, and has one of the strongest National Institute for Health Research-funded translational portfolios in Dentistry. A citation analysis conducted by RAND Corporation in 2015 ranked dentistry at UCL (the EDI plus the UCL Department of Epidemiology and Public Health) as second in the UK for world leading publications in Dentistry and first for partner NHS organisation.
In the "QS World University Rankings by Subject 2017" the Institute is ranked 6th in the world for Dentistry. UCL is ranked 7th in the world overall.
Errors with students' results (2005–14).
In June 2016 it was reported in the "Times Higher Education" (THE) that hundreds of students who studied at the UCL Eastman Dental Institute between 2005-6 and 2013-14 had been given the wrong marks for their assessments. These administrative errors led to an unknown number of students being attributed with the wrong qualifications and, in some cases, being failed when they should have passed their degrees.
The report of an internal investigation carried out by UCL's Academic Committee between October and December 2013, noted that the Institute's own internal review had found 220 module marks errors for students having studied on a single degree between 2005 and 2013. According to the report, concerns over the accuracy of marks were raised internally in 2011 and 2012, however the matter was ultimately brought to the Registrar's attention in July 2013. A spokesperson for UCL confirmed that a professional data review of all the Institute's taught programmes, which was recommended by the Academic Committee Review Panel in 2013, was incomplete as of June 2016 and gave assurances that affected students would be contacted.
UCL's Academic Committee Review Panel noted in its report that, according to the Institute's own review findings, senior members of UCL staff had been aware of issues with students results but had not taken action to address them. The Review Panel concluded that there was an apparent lack of ownership of these matters amongst the Institute's senior staff. It concluded that assessment data had been corrupted through human error; as a result of inconsistent processes and poor quality assurance; poor record keeping; and poor oversight.
The Academic Committee Review Panel noted that students might potentially have legitimate claims to damages and compensation; it recommended that the Institute should consider offering students the opportunity to be re-assessed and compensation for inconvenience or, consider termination of students' registration and negotiation of financial settlements.


Naval Medical Research Unit One

Naval Medical Research Unit One was a research laboratory of the US Navy which was founded as Naval Laboratory Research Unit 1, a Naval Reserve Unit at the University of California Berkeley in the life sciences building in 1934 after a campaign by a Berkeley scientist Albert P. Krueger to the Bureau of Medicine and Surgery to have a laboratory to study and prevent influenza and respiratory infections in naval forces. It was mobilized as an active duty naval unit in 1941 to study the epidemiological impact of diseases such as influenza, meningitis, and catarrhal fever, as well as tropical diseases such as malaria on the US Navy during World War II.
In 1943, Naval Laboratory Research Unit-1 was renamed Naval Medical Research Unit No. 1 (NAMRU-1) to reflect is broader mission of field-based and not just lab-based research. In 1950 the lab was moved to the Naval Supply Center, Oakland. Following the start of the Korean War, the Navy became concerned about attacks on its forces by biological weapons and from 1952 to '55, the Navy asked Krueger to resign his position on the faculty of Berkeley and devote all his research to prevention of respiratory infections. Hence the Navy poured more resources into NAMRU-1 facilities, developing them into a preeminent world laboratory on respiratory routes of infection.
NAMRU-1 was disestablished in 1974.


Charles Hercus

Sir Charles Ernest Hercus (13 June 1888 – 26 March 1971) was a New Zealand doctor and professor of public health. He was born in Dunedin, New Zealand, on 13 June 1888. He was for many years dean of the University of Otago Dunedin School of Medicine. The Hercus Building of the Dunedin campus, on the corner of Great King and Hanover Streets, is named for him.
Hercus was appointed a Knight Bachelor in the 1947 New Year Honours.


American College Health Association

The American College Health Association (ACHA) is a Silver Spring, Maryland-based organization of college health professionals throughout the United States. It was founded in 1920 as the American Student Health Association (ASHA), obtaining its current name in 1948. Over 800 higher education institutions are members of the ACHA, as of 2019. The association also has over 2,800 individual health care professionals as members. Since 1958, the association's official journal has been the "Journal of American College Health", which was founded in 1958 as "Student Medicine".


Inferior tympanic canaliculus

The inferior tympanic canaliculus is a small passage of the tympanic branch of the glossopharyngeal nerve and inferior tympanic artery.
In the bony ridge dividing the carotid canal from the jugular fossa is the small inferior tympanic canaliculus. The inferior tympanic canaliculus is near the fossula petrosa which houses inferior ganglion of glossopharyngeal nerve/petrous ganglion from which the tympanic nerve arises.


Pliny Earle (physician)

Pliny Earle II, MD (December 31, 1809 – May 17, 1892) was an American physician, psychiatrist, and poet. He was the son of the inventor Pliny Earle of the Earle family.
Biography.
Pliny Earle was born in Leicester, Massachusetts on December 31, 1809. He graduated from the University of Pennsylvania School of Medicine in 1837, then studied in the hospitals of Paris, and visited institutions for the insane in European countries. In 1840 he became resident physician of the asylum for the insane (now known as Friends Hospital) at Frankford, Pennsylvania (now part of Philadelphia), where he remained two years. From April 1844 till April 1849, he was physician to Bloomingdale asylum, in New York. He immediately afterward visited insane hospitals in Europe. In 1853 he was appointed visiting physician to the New York City lunatic asylum, and in the same year delivered a course of lectures on mental disorders at the College of physicians and surgeons, New York. In 1863 he became professor of materia medica and psychology at Berkshire Medical College Pittsfield, Massachusetts, the first professorship of mental diseases ever established by a medical College in the United States. His lectures there were limited to the one course of 1864, owing to his appointment as superintendent and physician-in-chief of the state hospital for the insane in Northampton, Massachusetts. He held this place until October 1885. He was elected as a member to the American Philosophical Society in 1866.
In 1871 he visited forty-six institutions for the insane in Europe. Dr. Earle was, so far as known, the first person that ever addressed an audience of the insane in any other than a religious discourse. His introduction of lectures on natural philosophy at the Frankford asylum, in the winter of 1840–1841, was the initiative to a system of combined instruction and entertainment, which has been widely adopted, and is now considered essential to the highest perfection of an institution for the insane. In the winter of 1866–1867, at the hospital in Northampton, he delivered a course of lectures on insanity before audiences in which the average number of insane persons was about 250.
He was also a founder of the American Medical Association, the New York Academy of Medicine, the Association of Medical Superintendents of American Institutions for the Insane, and the New England Psychological Society.
He died in Northampton on May 17, 1892.
Publications.
Non-fiction


Henry Buchwald

Henry Buchwald (born June 21, 1932) is an Austrian-American surgeon and academic. He is the Professor of Surgery and Biomedical Engineering and the Owen and Sarah Davidson Wangensteen Chair in Experimental Surgery Emeritus at the University of Minnesota, Minneapolis, Minnesota.
Early life and education.
Buchwald was born in Vienna, Austria, in 1932 to Andor and Renee Buchwald. In 1938, his family fled Austria to survive the Nazis. Henry and his mother came to New York City where Renee supported them. In 1939, Henry's father, who was forced to hide and evade capture by the Nazis in his birthplace of Hungary while he waited for a place on the U.S.'s Hungarian Jewish quota, arrived in New York. Henry attended the Bronx High School of Science, and then Columbia College in New York City, graduating as class valedictorian with Summa Cum Laude honor in 1954. He pursued further studies by attending Columbia University College of Physicians and Surgeons from which he graduated in 1957 with an M.D. degree.
He took his internship at the Columbia Presbyterian Hospital in 1957–58, and served in the U.S. Air Force as chief flight surgeon at Strategic Air Command (SAC) Headquarters in Bellevue, Nebraska, until the fall of 1960. After the service, Buchwald resumed his studying, earning an M.S. degree in biochemistry and Ph.D. in surgery.
Career.
During his more than 50 years at the University of Minnesota, Buchwald has been a surgeon, teacher, mentor, researcher, and inventor. He is Professor of Surgery and Biomedical Engineering, Director of Graduate Surgical Training, Director of Resident Training, and Director of In-Training Examination. He was the first Owen H. and Sarah Davidson Wangensteen Chair in Experimental Surgery from 2001-2004 and holds the post as Emeritus. In 2002, the Minnesota Medical Alumni Society of the University of Minnesota presented him with the Harold S. Diehl Lifetime Achievement Award for Outstanding Professional Contributions.
His long-term research interests include cholesterol and atherosclerosis, obesity surgery, implantable devices, hyperlipidemias, and measurement of blood oxygen transport. Early in his career, he discovered that the part of the small intestine called the ileum is the primary site for the absorption or cholesterol and bile acids (the primary end-products of cholesterol metabolism), and, that performing surgery—Buchwald's partial ileal bypass surgery—a procedure that bypasses part of the ileum, lowers cholesterol levels and dramatically improves the lives of those with familial hypercholesterolemia.
Buchwald trained with Richard Varco who performed the first obesity surgery in 1953. Since 1966, Buchwald has performed more than 4,000 obesity surgeries (also known as bariatric surgeries) and become one of the most influential and innovative surgeons in the field. As fellow bariatric surgeon Walter Pories said in a 2006 interview with "Minnesota Monthly"s Tim Gihring, "If you named maybe 10 international leaders [in bariatric surgery] . . . Henry would fall on any list that people in the field would make."
Throughout his career as a general surgeon, Buchwald has performed many thousands of surgeries, including all open gastrointestinal surgeries, partial ileal bypasses, jejunoileal bypasses, gastric bypasses, Fobi Pouch, vertical banded gastroplasty, roux-en-y bypasses, and duodenal switches.
His writing and influence also go into the realm of biomedical ethics and insurance reform. He has been president of the Central Surgical Association (1997–1998), the American Society of Bariatric Surgery (1998-1999), and the International Federation of Surgery for Obesity (2003-2004). He serves on editorial advisory board of the "Bariatric Times", the editorial board of the "Surgery for Obesity and Related Diseases", and is a co-editor of the journal, "Obesity Surgery". He is a Fellow of the American Surgical Association, American College of Surgeons, Central Surgical Association, Epidemiology Council of the American Heart Association, and International College of Surgeons.
Declining opportunities to enter private practice, Buchwald has continued to devote tremendous energy towards mentoring younger surgeons. In 2002, the 53rd Volume of the Surgical Forum was dedicated to Buchwald. In the dedication to that issue, Marshall Z. Schwartz lists some of Henry Buchwald's many accomplishments, commenting: "The above noted accomplishments and contributions alone warrant this dedication. But it has been Dr. Buchwald's strong commitment to mentoring many young individuals (which he proudly lists in his curriculum vitae), including medical students, residents (both surgical and medical), and graduate students, that has made him a great academic role model. What makes Dr. Buchwald unique is his lifelong commitment to his trainees."
Research.
Buchwald was still in his residency when he was granted his first research laboratory. At the time he was a Helen Hay Whitney Fellow. He studied histamine release, as well as groundbreaking work in lipids and the absorption of cholesterol. In 1973, The National Institute of Health (NIH) awarded Buchwald their largest investigator-initiated grant given to a principal investigator (one of the largest the University of Minnesota has ever received). The grant initiated the Program on the Surgical Control of the Hyperlipidemias (POSCH) trial. In 1990, the results of the first 17 years of this study were presented in the New England Journal of Medicine
and at the annual meeting of the American College of Surgeons. The POSCH study definitely proved the link between cholesterol and heart disease. The POSCH trials demonstrated conclusively that lowering cholesterol can reduce heart disease and resultant heart attacks and, therefore, increase life expectancy. The results from all phases of the POSCH study have contributed significant insights and long-term data related to cholesterol, heart disease, and smoking. Buchwald has received seven additional NIH research grants.
Buchwald, who has a joint appointment at the University of Minnesota in Biomedical Engineering, holds 17 patents for medical devices. These include the world's first infusion port, peritoneovenous shunts, and specialty vascular catheters. He also invented the first implantable infusion pump, a precursor to implantable infusion pumps in use throughout the world today. He was inducted into the Minnesota Inventors Hall of Fame in 1988 for his extensive contributions to bioengineering devices.
In the late 1990s and early 2000s, Buchwald's research has included: Type II diabetes and its reduction through bariatric surgery; oxygen transport and the development of a device to measure it; heart disease in women; and new technological approaches to bariatric surgery. One of his latest projects is the development of a new type of bariatric surgery called micro-orifice surgery, surgery performed open (as opposed to laparoscopically) but with very small incisions (to avoid complications of general anesthesia and make patients' recovery faster and easier). His innovative research and development work continues.
Publications.
Buchwald has authored or co-authored more than 300 peer-reviewed manuscripts. He is the co-editor, with Walford Gillison, of "Pioneers in Surgical Gastroenterology" (2007), as well as the co-author, with George S.M. Cowan and Walter J. Pories, of "Surgical Management of Obesity" (2006). His newest title, "Buchwald Atlas of Metabolic and Bariatric Surgery Techniques and Procedures", was published in fall 2011.
He has been Section Editor of "ASAIO Transactions", editor of "Chirurgia Generale", and of the "Journal of American College of Nutrition". He has been on the editorial board of The "Journal of Clinical Surgery". Infu-Systems International, Diabetes, Nutrition, and Metabolism, Associate Editor, of "Journal of Bariatric Surgery ", "Obesity Surgery " and the "Online Journal of Current Clinical Trials", and a consulting editor for "Hospital Medicine".
Personal life.
In 1954, he married his high school sweetheart, Daisy Emilie Bix. (Publicly known as Emilie Buchwald, she later co-founded the literary press Milkweed Editions and, after retirement, founded The Gryphon Press, a children's picture book publisher dedicated to animal issues). He, his wife, and their first daughter, Jane, moved to Minnesota in 1960 so that Buchwald could enter a residency program at the University of Minnesota Surgery Department, where Dr. Owen Harding Wangensteen was the chair. The Buchwald family settled in Minnesota permanently and raised their four daughters – Jane, Amy, Claire, and Dana – while Buchwald initiated what has been a more-than-50-year career at the University of Minnesota.


American Society of Consultant Pharmacists Foundation


Lilith Sternin

Lilith Sternin (formerly Sternin-Crane) is a fictional character on the American television sitcoms "Cheers" and "Frasier", portrayed by Bebe Neuwirth. The character first appears as a date for Frasier Crane, though mutual hostility and discomfort causes the evening to end badly. Several months later, Lilith meets Frasier again and, with some help from Frasier's ex-fiancée, Diane Chambers (Shelley Long), they start a romantic relationship, eventually living together, marrying, and having a son, Frederick.
In the final season of "Cheers", Lilith has an affair with another man and leaves Frasier. The affair later unravels and Lilith returns, seeking reconciliation with Frasier. Although "Cheers" ended ambiguously with regard to Frasier and Lilith's marriage, at the beginning of the spin-off series "Frasier", their divorce had been finalized, with Lilith gaining custody of Frederick and remaining in Boston while Frasier has moved back to his hometown of Seattle. Lilith occasionally appears in "Frasier", sometimes with Frederick.
Role in "Cheers".
Lilith debuts in the "Cheers" episode, "Second Time Around" (1986), as Frasier Crane's (Kelsey Grammer) date. In the episode, their first date does not go well. Lilith walks out of the date because she disdains the bar as Frasier's location for their date and Frasier's activities at the bar. In "Abnormal Psychology" (1986), they feel mutual attraction again when he becomes accustomed to her makeover done by Diane Chambers (Shelley Long). At first reluctant to start over again, they then decide to go for another date. For years they live together since, as first shown in "Dinner at Eight-ish" (1987). "Our Hourly Bread" (1988) reveals that they wed one month before the episode. (In "Smotherly Love" (1992), they re-enact their wedding to please Lilith's mother Betty (Marilyn Cooper), who was irritated that she had not been present for their marriage.) In "The Stork Brings a Crane" (1989), Lilith gives birth to Frederick during the taxi ride home after false labor in the hospital.
The tenth-season "Cheers" episode "I'm Okay, You're Defective" (1991) features two plots: one subplot about Lilith pressuring Frasier to finalize his will and one main plot about Sam Malone's (Ted Danson) concern that his sperm count may be low. The episode's epilogue is described as "Many years later" with an elderly Lilith and adult Frederick () sitting for the reading of Frasier's will. The lawyer opens the sealed envelope and is surprised to find Sam's sperm count report, which turns out stable. In response to the mix-up, Lilith bitterly remarks, "That damn bar."
In the eleventh and final season (1992–93), in "Teaching with the Enemy" (1992), Lilith admits her affair with another man – Dr. Louis Pascal (Peter Vogt). In "The Girl in the Plastic Bubble" (1992), Lilith leaves Frasier, with him contemplating suicide until she promises to him that the marriage can be saved, to live with Pascal in Pascal's experimental underground eco-pod. In "Is There a Doctor in the Howe?" (1993), a depressed Frasier almost has sex with Rebecca Howe (Kirstie Alley) in their bed until Lilith unexpectedly returns. In the following episode, "The Bar Manager, The Shrink, His Wife and Her Lover" (1993), Lilith storms out of the room to go to Cheers, demanding the others tell her how long Frasier and Rebecca have been having an affair. The other characters have no idea as the affair has barely started that very evening. Lilith reveals that the eco-pod experiment with Pascal was a disaster — Pascal turned out to be claustrophobic, among other mental problems — and she abandons the project to return to Boston. Frasier and Rebecca, and eventually Pascal, converge on Cheers in pursuit of Lilith. Pascal, armed with a pistol, demands Lilith return to him, threatening to shoot Frasier and the others. Lilith demands that he shoot her first, which causes him to back down and surrender to police. Although Frasier initially refuses to take Lilith back, her pathetic sobbing wins him over, suggesting a reconciliation can occur.
Role in "Frasier".
In the spin-off "Frasier", however, Lilith and Frasier turn out to have been divorced. Furthermore, Lilith has custody of Frederick. In the opening scene of the 1993 pilot episode of "Frasier" ("The Good Son"), Frasier is hosting his call-in radio show and relates the following:
Six months ago, I was living in Boston. My wife had left me, which was very painful. Then she came back to me, which was excruciating. ... so I ended the marriage once and for all, packed up my things, and moved back here to my home town of Seattle.
Actress Bebe Neuwirth reprises the role of Lilith in several episodes of "Frasier". In her debut "Frasier" episode, "The Show Where Lilith Comes Back" (1994), Lilith calls Frasier during his radio show, which surprises him, and mocks Frasier's psychiatric advice to his callers, especially one who overeats and whom Lilith attempts to help. Later at his apartment, Lilith reminds him about their times together during marriage. They make love at one point, but end up regretting it, strongly indicating no chance of a lasting reconciliation. Throughout the series, Lilith reappears on occasion, often rekindling hers and Frasier's lingering emotional bond, sometimes over concern about the future of Frederick (Trevor Einhorn), who also makes recurring appearances.
A running gag throughout "Frasier" is that Frasier's father and brother, Martin Crane (John Mahoney) and Niles Crane (David Hyde Pierce), are never pleased to see Lilith. Martin finds her "weird" and usually shouts out in shock when he unexpectedly sees her in his and Frasier's apartment. Niles resents her for mocking the vows at his wedding but forgives her when she apologizes. Lilith's presence frightens Martin's dog Eddie, terrifying the normally defiant dog into obedience. Martin's live-in physical therapist, Daphne Moon (Jane Leeves), who fancies herself as having minor psychic abilities, routinely suffers debilitating headaches when Lilith is in town, citing an evil spiritual presence.
Lilith marries her fiancé Brian (James Morrison), an MIT seismologist who appears in only one episode "Adventures in Paradise, Part Two" (1994). A later episode, "Room Service" (1998), reveals that Lilith is recently divorced from Brian after he came out of the closet.
Her final "Frasier" episode is "Guns 'N Neuroses" (2003), where Lilith's colleague Nancy (Christine Dunford), sets Frasier up on a blind date with Lilith, having no idea of their mutual history. However, the two meet up for a drink while Lilith is in Seattle and, when it overruns, they both end up cancelling on the blind date (never learning they had been set up with each other). When the two are interrupted by a loud argument between a young married couple in the next room, Frasier and Lilith successfully resolve the couple's dispute, then spend the night together watching television and finally falling asleep together on the couch. The next morning, they part ways as loving friends without restarting their romance.
Creation and development.
A stereotypical "intelligent ice queen" Lilith Sternin was supposed to appear in one episode of the fourth season of "Cheers", "Second Time Around" (1986). However, she was brought back in the fifth season and became a recurring character thereafter. Over the years, like Diane Chambers, an educated Lilith is often mocked yet "manages to put people in their place."
"Cheers" and "Frasier" writers Ken Levine and David Isaacs found the chemistry of Frasier and Lilith "special" enough to compare them with Katharine Hepburn and Spencer Tracy mixed with "Prozac" and to comfortably write stories about. Nevertheless, Neuwirth did not want to appear as a regular player, and left the role of Lilith on "Cheers". Neuwirth's career has since been focused on stage work. However, she made several guest appearances as Lilith in the spin-off "Frasier".
The "Frasier" episode "Wheels of Fortune" (2002) reveals that Lilith has a half-brother, Blaine (Michael Keaton), whom Frasier despises due to Blaine's relentless swindling.
Reception.
This role earned Neuwirth two Emmy Awards as an Outstanding Supporting Actress in 1990 and 1991.
According to an April 1–4, 1993, telephone survey of 1,011 people by the Times Mirror Center for the People and the Press (now Pew Research Center), before the "Frasier" premiere and the "Cheers" finale, Sam Malone (Ted Danson) was voted a favorite character by 26 percent, and Frasier Crane and Lilith Sternin were voted favorites by 1 percent each. In response to a question of spinning off a character, 15 percent voted Sam, 12 percent voted Woody Boyd (Woody Harrelson), 10 percent voted Norm Peterson (George Wendt), and 29 percent voted no spin-offs. Frasier Crane, whose own spin-off "Frasier" debuted in September 1993, was voted 2 percent to have his own show.
Bill Simmons, who at the time worked for ESPN, deemed Lilith Sternin one of his least favorite "Cheers" characters. Nevertheless, Martha Nolan from "The New York Times" called Frasier and Lilith "repressed" when married together in "Cheers". Josh Bell from "About.com" called Frasier and his ex-wife Lilith Sternin one of the "best sitcom divorced couples" of all-time.
Steven H. Scheuer from "Sarasota Herald-Tribune" considered Lilith's significance to and marriage with Frasier "fun" to watch, especially when, in "Severe Crane Damage" (1990), she used comparisons between "the duller good boy" Frasier and "the interesting bad boy" Sam Malone as "psychiatric examples of the good boy-bad boy syndrome". Faye Zuckerman and John Martin from "The New York Times" called their marriage in "Cheers" a hilariously "[perfect mismatch]". Television critic Kevin McDonough from New York praised Kelsey Grammer and Bebe Neuwirth's performances as "repressed individuals" and "separate couple on TV" with "acidic and hilarious" chemistry together.