Definitive Surgical Trauma Skills

The Definitive Surgical Trauma Skills course (DSTS) is a joint development between The Royal College of Surgeons of England, The Royal Centre for Defence Medicine and The Uniformed Services University of the Health Sciences in Washington DC.
Originally designed for the military, the training structure has now been adapted to accommodate civilian surgical consultants and teaches vascular, cardiothoracic and general surgery techniques which are vital in dealing with trauma injuries.
The programme follows on from the Advanced Trauma Life Support (ATLS) programme.


Ectopic thymus

Ectopic thymus is a condition where thymus tissue is found in an abnormal location. It is thought to be the result of either a failure of descent or a failure of involution of normal thymus tissue.
Signs and Symptoms.
Ectopic thymus most often does not cause symptoms. It is most frequently discovered as a mass or swelling in the neck of infants and children. However, when symptoms do occur they are most commonly due to compression of nearby structures such as the trachea and esophagus. This can lead to hoarseness, stridor, difficulty breathing and/or difficulty swallowing.
Cause.
During embryological development, the thymus is formed from the third and fourth pharyngeal pouches. It descends along a pathway from the mandible to its final resting place of the mediastinum. When the thymus tissue fails to descend appropriately or fails to involute, thymus tissue remains in various locations along this pathway. Locations that solid thymus tissue has been reported include near the thyroid (most common), within the thyroid, the base of the skull, and within the pharynx or trachea.
Diagnosis.
Ultrasound is the recommended diagnostic modality used to diagnose cervical ectopic thymus. The thymus has a unique appearance on ultrasound which allows for specific diagnosis. Upon ultrasound, ectopic thymus appears hypoechoic with characteristic linear echogenic foci. However, MRI can and has been utilized as well to better characterize and identify the location of the ectopic thymus. On MRI, ectopic cervical thymus appears as a homogeneous mass which is isointense to muscle on T1-weighted scans and hyperintense on T2-weighted scans. Biopsy or histological examination upon resection can also be used to make a definitive diagnosis.
An appropriate differential diagnosis depends upon location of the ectopic thymus. For cervical ectopic thymus the differential diagnosis should include additional causes of neck masses. This includes common causes of neck masses in children such as thyroglossal duct cyst, branchial cleft cyst, dermoid cyst, inflammatory lymphadenitis, sternocleidomastoid (SCM) tumor of infancy, a salivary gland infection or benign tumor. Rare causes of neck masses in children include lymphoma, rhabdomyosarcoma, thyroid nodules and thyroid cancer.
Treatment.
If the patient is asymptomatic and the mass is identified based upon radiologic findings, biopsy and/or resection may be avoided. Surgical removal of the mass is the definitive treatment for ectopic thymus tissue that is causing symptoms. It has been reported that the ectopic thymus tissue can transform into cancerous tissue. However, due to most diagnosed ectopic thymus tissue being resected due to this concern, the natural progression is not well explored. The data supporting malignant transformation is limited and ectopic thymus tissue that is not causing problems can likely be left to involute. Given the thymus's role in the body's adaptive immune system, it should be confirmed that the patient has a mediastinal thymus prior to surgery in order to prevent the potential for future immune deficiencies.
Prognosis.
Following surgical removal of the ectopic thymus, there have been no reported recurrences.
Epidemiology.
Ectopic thymus is rarely reported in the literature. The prevalence of ectopic thymus reportedly ranges from 1 to 90%. This variation in prevalence is largely dependent upon the method of investigation used and how extensive the workup is. With most ectopic thymus tissue being asymptomatic, it is likely the prevalence is higher than typically reported.


School of Medicine, University of Phayao

The School of Medicine, University of Phayao () is a medical school in Mueang Phayao District, Phayao Province.
History.
In 2007, a school of medical sciences was established at the Naresuan University Phayao IT Campus and initially admitted students for the Physical Therapy, Medical Technology and Public Health branches. Following changes in the structure of the university and in preparation for the creation of the new University of Phayao, the planned medical course would be taught in a separate medical school. The branches of Physical Therapy, Medical Technology and Public Health then became part of the School of Allied Health Sciences since 1 October 2008. The School of Medicine was formally set up on 1 December 2008.
References.
Article incorporates material from the corresponding article in the Thai Wikipedia.


CorVel Corporation

CorVel Corporation is an American technology company.
History.
In 1987, Gordon Clemons joined with Jim Michael and Jeff Michael, investors from Minnesota, and founded CorVel Corporation (originally named FORTIS). Three small vocational rehabilitation firms were consolidated to form the initial foundation of the new Company, valued at approximately $2 million with over 200 associates.
Within two years, the Company expanded to 51 American locations, and they entered the medical bill review and medical case management business.
In 1991, the Company first issued stock to the public and began trading on the NASDAQ at a market capitalization value of $46 million. The offering raised $3.5 million, net of the repayment of venture funding. The following year, the Fortis name was sold, raising $4 million and the Company changed its name to CorVel Corporation. With the funding from the name sale, CorVel began building a national preferred provider organization (PPO).
During the mid '90s, CorVel doubled its office network again, and expanded its software offerings. PPO services became an important part of most healthcare management sales. Out of network medical review was added to the portfolio of provider programs.
By 2005, CorVel grew to over 2,000 clients and 15% compounded annual stock growth.
In March 2009, the Company continued to expand its workers' compensation claims management solutions. During the March quarter, CorVel completed the acquisition of a third party administrator (TPA) in New York, the Company's third acquisition in its TPA expansion effort. Software development efforts have been focused on the incorporation of artificial intelligence capabilities and workflow management tools in to the claims management systems in order to enable CorVel's unique process.
In August 2010, CorVel introduced a provider look up app that can be accessed in the Apple Store and Google Play. This mobile app provides access to locate network doctors, specialists, hospitals and other facilities near the user.
In August 2011, the company also introduced a claim intake app available from Apple that provides mobile access to report workplace incidents and injuries.
In March 2012, the company announced revenues for the quarter ended March 31, 2012 that were a 4% increase over the previous quarter in 2011.
In September 2014, CorVel released a new app (My Care) that provides online access to view indemnity payments, access pharmacy cards, review treatment guidelines and review details of the workplace injury claim. The newest feature of the app provides Touch ID for iPhones that provides secure fingerprint access on iOS devices.
In August 2015, the company announced Telehealth Services as part of their existing Enterprise Comp claims management model to offer immediate access to medical providers for injured workers.
Operations.
CorVel had revenues of $592 million for fiscal year ending March 31, 2020.
CorVel is licensed to do business in all 50 states, the District of Columbia and Puerto Rico.


Working in Partnership Programme

Working in Partnership Programme (WiPP) was launched in England in 2004 under the new general medical services (nGMS) contract to support doctors in general practice by providing them with innovative ideas on how to improve services for the public.
Initiatives.
The GMS contract provided the funds, while the initiatives are being implemented by a number of different agencies including primary care trusts as well as non-government organisations in England. The WiPP website provides several resources for this program. The programme has several initiatives.


Feinstein Institute for Medical Research

The Feinstein Institutes for Medical Research comprise the research arm of Northwell Health. Feinstein is home to 50 research labs, 2,500 clinical research studies, and 5,000 professional and support staff. Feinstein researchers have made breakthroughs in molecular medicine, genetics, cancer, brain research, mental health, autoimmunity and bioelectronic medicine, among others, and continue work in those and other areas. Feinstein is the laboratory and faculty home of the Elmezzi Graduate School of Molecular Medicine. Additionally, students without an MD degree may earn a PhD in molecular medicine via the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, as part of the medical school's MD/PhD or PhD programs.
The Feinstein Institutes acquired assets from the closing of the Picower Institute for Medical Research, founded in 1991 by Anthony Cerami and funded by Jeffry Picower. In 2001 the institute's funding was withdrawn and it closed; in 2002 it was acquired by The Institute for Medical Research at North Shore-LIJ. In 2005 board member Leonard Feinstein, co-founder of Bed Bath & Beyond, made a $25 million gift that led to its renaming The Feinstein Institute for Medical Research. In 2016, Feinstein and his wife, Susan, committed another $25 million.
In 2019, Feinstein comprised 5 institutes:
Feinstein publishes two open-access, international peer-reviewed medical journals in partnership with "BioMed Central", part of "Springer Nature": "Molecular Medicine" and "Bioelectronic Medicine",
The Feinstein Institutes bestow two major academic awards: the Anthony Cerami Award in Translational Medicine, starting in 2013, and the Ross Prize in Molecular Medicine.
Support services and cores.
Feinstein has the standard support services and scientific cores to support basic research. Support includes:
The cores include:
Society and culture.
In 2016, the Feinstein Institutes for Medical Research agreed to pay the U.S. Department of Health and Human Services, Office for Civil Rights (OCR), $3.9 million to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy and security rules and to undertake a substantial corrective action plan to bring its operations into compliance.


Cross-presentation

Cross-presentation is the ability of certain antigen-presenting cells to take up, process and present extracellular antigens with MHC class I molecules to CD8 T cells (cytotoxic T cells). Cross-priming, the result of this process, describes the stimulation of naive cytotoxic CD8+ T cells into activated cytotoxic CD8+ T cells. This process is necessary for immunity against most tumors and viruses that do not readily infect antigen-presenting cells, but rather tumors and viruses that infect peripheral tissue cells. Cross presentation is also required for the induction of cytotoxic immunity by vaccination with protein antigens, for example, tumour vaccination.
Cross-presentation is of particular importance, because it permits the presentation of exogenous antigens, which are normally presented by MHC II on the surface of dendritic cells, to also be presented through the MHC I pathway. The MHC I pathway is normally used to present endogenous antigens that have infected a particular cell. However, cross presenting cells are able to utilize the MHC I pathway in order to remain uninfected, while still triggering an adaptive immune response of activated cytotoxic CD8+ T cells against infected peripheral tissue cells.
History.
The first evidence of cross-presentation was reported in 1976 by Michael J. Bevan after injection of grafted cells carrying foreign minor histocompatibility (MHC) molecules. This resulted in a CD8+ T cell response induced by antigen-presenting cells of the recipient against the foreign MHC cells. Because of this, Bevan implied that these antigen presenting cells must have engulfed and cross presented these foreign MHC cells to host cytotoxic CD8+ cells, thus triggering an adaptive immune response against the grafted tissue. This observation was termed "cross-priming".
Later, there had been much controversy about cross-presentation, which now is believed to have been due to particularities and limitations of some experimental systems used.
Cross-presenting cells.
The primary and most efficient cross-presenting cells are dendritic cells, though macrophages, B lymphocytes and sinusoidal endothelial cells have also been observed to cross present antigens in vivo and in vitro. However, in vivo dendritic cells have been found to be the most efficient and common antigen presenting cells to cross present antigens in MHC I molecules. There are two dendritic cells subtypes; plasmacytoid (pDC) and myeloid (mDC) dendritic cells. pDCs are found within the blood and are able to cross present antigens directly or from neighboring apoptotic cells, but the main physiological significance of pDCs is the secretion of type I IFN in response to bacterial infections. mDCs are categorized as migratory DCs, resident DCs, Langerhans cells, and inflammatory dendritic cells. All mDCs have specialized functions and secretory factors, but they are all still able to cross present antigens in order to activate cytotoxic CD8+ T cells.
There are many factors that determine cross presentation function such as antigen uptake and processing mechanism, as well as environmental signals and activation of cross presenting dendritic cells. The activation of cross presenting dendritic cells is dependent on stimulation by CD4+ T helper cells. The co-stimulatory molecule CD40/CD40L along with the danger presence of an exogenous antigen are catalysts for dendritic cell licensing, and thus the cross presentation and activation of naive CD8+ cytotoxic T cells.
Vacuolar and cytosolic diversion.
In addition to solid structure uptake, dendritic cell phagocytosis simultaneously modifies the kinetics of endosomal trafficking and maturation. As a consequence, external soluble antigens are targeted into the MHC class I cross-presentation pathway instead of the MHC Class II pathway.[18]However, there is still uncertainty in regard to a mechanistic pathway for cross presentation within an antigen presenting cell. Currently, there are two main pathways proposed, cytosolic and vacuolar.
The vacuolar pathway is initiated through the endocytosis of an extracellular antigen by a dendritic cell. Endocytosis results in the formation of a phagocytic vesicle, where an increasingly acidic environment along with the activation of enzymes such as lysosomal proteases triggers the degradation of antigen into peptides. The peptides can then be loaded onto MHC I binding grooves within the phagosome. It is unclear whether the MHC I molecule is being exported from the endoplasmic reticulum before peptide loading, or is being recycled from the cell membrane prior to peptide loading. Once the exogenous antigen peptide is loaded onto the MHC class I molecule, the complex is exported to the cell surface for antigen cross presentation presentation.
There is also evidence that suggest that cross-presentation requires a separate pathway in a proportion of CD8(+) dendritic cells that are able to cross-present.[20] This pathway is called the cytosolic diversion pathway. Similarly to the vacuolar pathway, antigens are taken into the cell through endocytosis. Antigen proteins are transported out of this compartment into the cytoplasm by unknown mechanisms. Within the cytoplasm, exogenous antigens are processed by the proteasome and degraded into peptides. These processed peptides can either be transported by the TAP transporter into the endoplasmic reticulum,[14][16] or back into the same endosome for loading onto MHC class I complexes,[17]. It is believed that MHC I loading occurs both in the ER as well as phagocytic vesicles such as an endosome in the cytosolic pathway. For MHC class I loading within the Endoplasmic Reticulum, exogenous antigen peptides are loaded onto MHC class I molecules with the help of the peptide loading complex and chaperone proteins such as beta-2 microglobulin, ERAP, tapapsin, and calreticulin. After antigen peptide loading, the MHC molecule is transported out of the ER, through the Golgi complex, and then onto the cell surface for cross presentation.
It appears that both pathways are able to occur within an antigen presenting cell, and may be influenced by environmental factors such as proteasome and phagocytic inhibitors.
Relevance for immunity.
Cross-presentation has been shown to play a role in the immune defense against many viruses (herpesvirus, influenzavirus, CMV, EBV, SIV, papillomavirus, and others), bacteria (listeria, salmonella, "E. coli", "M. tuberculosis", and others) and tumors (brain, pancreas, melanoma, leukemia, and others). Even though many viruses can inhibit and degrade dendritic cell activity, cross-presenting dendritic cells that are unaffected by the virus are able to intake the infected peripheral cell and still cross present the exogenous antigen to cytotoxic T cells. The action of cross priming can bolster immunity against antigens that target intracellular peripheral tissues that are unable to be mediated by antibodies produced through B cells. Also, cross-priming avoids viral immune evasion strategies, such as suppression of antigen processing. Consequently, immune responses against viruses that are able to do so, such as herpes viruses, are largely dependent on cross-presentation for a successful immune response. Overall, cross presentation aids in facilitating an adaptive immune response against intracellular viruses and tumor cells.
Dendritic cell-dependent cross-presentation also has implications for cancer immunotherapy vaccines. The injection of anti-tumor specific vaccines can be targeted to specific dendritic cell subsets within peripheral skin tissues, such a migratory dendritic cells and Langerhans cells. After vaccine induced activation, dendritic cells are able to migrate to lymph nodes and activate CD4+ T helper cells as well as cross prime CD8+ T cytotoxic cells. This mass generation of activated tumor specific CD8+ T cells increases anti-tumor immunity, and is also able to overcome many of the immune suppressive effects of tumor cells.
Relevance for immune tolerance.
Cross-presenting dendritic cells have a significant impact on the promotion of central and peripheral immune tolerance. In central tolerance, dendritic cells are present within the thymus, or the location of T cell development and maturation. Thymic dendritic cells can intake dead medullary thymic epithelial cells, and cross present "self" peptides on MHC class I as a negative selection check on cytotoxic T cells that have a high affinity for self peptides. Presentation of tissue specific antigens is initiated by medullary thymic epithelial cells (mTEC), but is reinforced by thymic dendritic cells after expression of AIRE and engulfment of mTECs. Although the function of dendritic cells in central tolerance is still relatively unknown, it appears that thymic dendritic cells act as a complement to mTECs during negative selection of T cells.
In regard to peripheral tolerance, peripheral tissue resting dendritic cells are able to promote self tolerance against cytotoxic T cells that have an affinity for self peptides. They can present tissue specific antigens within the lymph node in order to regulate T cytotoxic cells from initiating an adaptive immune response, as well as regulate T cytotoxic cells that have a high affinity for self tissues, but were still able to escape central tolerance. Cross-presenting DCs are able to induce anergy, apoptosis, or T regulatory states for high self affinity T cytotoxic cells. This has large implications for defense against auto immune disorders and regulation of self specific cytotoxic T cells.


Josiah Clerk

Josiah Clerk, M.D. (1639–1714) was an English physician, briefly president of the College of Physicians.
Life.
Clerk was matriculated as a pensioner of Peterhouse, Cambridge, in December 1656, and took the two degrees in medicine, M.B. in 1661, M.D. on 3 July 1666. He was admitted a candidate of the College of Physicians on 26 June 1671, a fellow on 29 July 1675, and was appointed censor in 1677 and 1692. On the death of Sir Thomas Witherley he was named elect on 16 April 1694, delivered the Harveian oration in 1708, was consiliarius in 1707, 1709, 1710, 1711, and 1712, and was elected to the presidency, void by the death of Dr. Edward Browne. On 13 September 1708, he was re-elected at the general election of officers on the 30th of the same month.
Clerk, who was old and ill, was unable to act as president. He resigned on 18 December, and Charles Goodall was appointed on 23 December 1708. He had been chosen treasurer on 16 April 1708, and retained that office as long as he lived. Clerk died at his house in Fenchurch Street in the autumn of 1714, in the seventy-fifth year of his age. In the annals of the college cited by William Munk the date of Clerk's death is given as 8 December, which is erroneous. His will was proved on 14 October. He desired 'to be decently, tho' very privately, buried by night in the vault in St. Olave Hart Street Church, where my honoured mother and my children lye, if it may be done with conveniency.' By his wife Abigail, who survived him, he left a daughter Elizabeth, married to Richard Wilshaw. Clerk's portrait is at the college.


Arizona Health Care Cost Containment System

The Arizona Health Care Cost Containment System (AHCCCS, pronounced “access”) is the state agency that administers Arizona’s Medicaid program. Medicaid was created to provide healthcare to individuals who qualify by financial (and, for some programs, medical) need. The $14.6 billion dollar program covers the behavioral and physical health care services for more than 1.9 million Arizonans. In 2019, AHCCCS covers approximately 48% of Arizona’s children and 54% of babies born in the state.
In 2010, the Affordable Care Act (ACA) gave states the option to expand Medicaid eligibility to individuals who earn up to 133% of the Federal Poverty Level (FPL). On January 1, 2014, Arizona expanded Medicaid under the ACA for three population categories: children ages 6 - 18 up to 133%  FPL; childless adults to 100% FPL; and adults up to 133% FPL. See more eligibility requirements.
Medicaid was adopted in 1965 as a joint federal and state program with oversight from the federal Centers for Medicare and Medicaid Services (CMS). In October 1982, Arizona became the last state in the nation to add a Medicaid program under Title XIX, but the first state to implement a mandatory managed care program for the majority of Medicaid members. For most AHCCCS programs, as of 2019,  the federal government funds approximately 74% of AHCCCS expenditures, while the state funds the remaining amount through the General Fund and other funding sources.
Managed Care vs. Fee-for-Service.
In the traditional Medicaid payment model, called Fee-for-Service, states contract directly with health care providers in order to render services. Medicaid directly pays each provider for the services rendered. In Arizona, approximately 16 percent of members use Fee-for-Service health care.
The Mandatory Managed Care model  is a public-private partnership where the state contracts with private and non-profit managed care organizations (MCOs) who are the health insurance providers for Medicaid beneficiaries. The MCOs use their market leverage to negotiate rates with their own network of providers. Instead of paying for each service rendered, as the Fee for Service model dictates, AHCCCS pays a monthly capitated rate to the MCOs. Managed care is proven to be an efficient and cost effective Medicaid delivery system.
Behavioral Health History.
In 1990, AHCCCS phased in mental health services and behavioral health coverage in response to federal requirements. This began with coverage of seriously emotionally disabled children under the age of 18 who require residential care. Over the next five years, behavioral health coverage was extended to all Medicaid eligible persons.
Since 1989, AHCCCS has worked to integrate physical and behavioral health care services across its various programs. From the very beginning of the Arizona Long Term Care System (ALTCS), services have been integrated. Members who are eligible for Children’s Rehabilitative Services have received integrated health care services since 2013, and members with a designation of Serious Mental Illness (SMI) were fully integrated in Maricopa County in April 2014. SMI members residing in remainder of the state's counties, known as Greater Arizona, became fully integrated in October 2015. Services for American Indian members in the American Indian Health Program (AIHP) were integrated in 2016. On October 1, 2018, AHCCCS took the largest step toward eliminating fragmentation in the system by moving 1.5 million members into integrated AHCCCS Complete Care (ACC) health care plans. As of 2019, 98 percent of AHCCCS members are enrolled in integrated health care plans.
Health Care Coverage for Arizona Residents.
AHCCCS Complete Care (ACC) health plans cover approximately 1.5 million AHCCCS members. Members choose from up to seven health plans in their geographic service area. ACC plans offer fully integrated behavioral and physical health services.
The Arizona Long Term Care System (ALTCS) provides long term care for people who are elderly or who have physical or developmental disabilities, and require institutional level of care. Applicants must meet specific medical and financial eligibility requirements.
ALTCS members with additional intellectual and developmental disabilities receive long term care services through the Department of Economic Security Developmental Disabilities Division (DES/DDD), and integrated physical and behavioral health care through DES/DDD contracted health plans.
As of 2019, three Regional Behavioral Health Authorities (RBHAs, pronounced “ree-bahs”) serve Arizona, with one RBHA in each geographical region. RBHAs primarily provide integrated healthcare services to AHCCCS members with Serious Mental Illness (SMI) designation. RBHAs also oversee statewide crisis services and other grant and state funded services. Additionally, AHCCCS contracts with five Tribal Regional Behavioral Health Authorities (TRBHA), which provides behavioral health services to some tribal nations.
Children who are in the state foster care system receive physical health services through the Comprehensive Medical and Dental Program (CMDP), and behavioral health services through RBHAs. Health plan integration is planned to begin on 10/1/2020.
American Indians/Alaska Natives who are eligible for Medicaid have the choice of enrolling in an AHCCCS Complete Care plan (ACC), or enrolling with the American Indian Health Program (AIHP). AIHP is administered by AHCCCS as a fee-for-service model. Federal mandate guarantees that American Indians have the option of fee-for-service or managed care health plans.
Children whose parents do not meet the financial eligibility requirements for AHCCCS may qualify for the federal Children’s Health Insurance Program (CHIP), known as KidsCare in Arizona. KidsCare is comprehensive health insurance for children up to age 19, whose parents earn under 200% FPL. Premiums range in cost, depending on the number of children enrolled per family.
How to Apply.
Apply for AHCCCS health care coverage online at healthearizonaplus.gov. Arizona residents with a need for institutional levels of care may apply for ALTCS coverage, by contacting a local ALTCS office, or calling toll free at 888-621-6880.


James Frederick Brailsford

James Frederick Brailsford MD, FRCP (8 July 1888 – 28 January 1961) was a British radiologist, known as the founder and first president of the British Association of Radiologists and as the co-discoverer of the Morquio (or Morquio-Brailsford) syndrome.
He studied with Sir John Robertson, the Medical Officer of Health of Birmingham. In 1923 Brailsford qualified MB, ChB (Birmingham) and was appointed assistant radiologist to Queen's Hospital, Birmingham. In 1928 he received the higher qualification MD (Birmingham). As a radiologist and a demonstrator in living anatomy, he published in 1934 his famous textbook "The Radiology of Joints and Bones" and thereby was acknowledged as one of the world's authorities on skeletal diseases. He received PhD Birmingham (1936) and became MRCS, LRCP (1923), MRCP (1935), and FRCP (1941).


Alpha Hospital Group

Alpha Hospital Group is a private provider of mental health care in England, launched in 2002 by Patricia Hodgkinson, former chief executive of the Florence Nightingale Hospitals Group.
Khalid Hameed, Baron Hameed is chairman of the company. It has 3 low to medium secure mental health facilities in Bury, Sheffield and Woking with more than 300 beds in total and employs more than 1,000 staff. In August 2015 the company was bought by Cygnet Health Care for £95 million.
It was alleged by "The Daily Telegraph" that Sudhir Choudhrie, one of the biggest donors to the Liberal Democrats was denied a peerage because of concerns about the treatment of patients by the group. Choudhrie owned C&C Alpha Group, which owned both the Alpha Hospital Group and Alpha Care Homes. The Care Quality Commission inspected the hospital in Woking in February 2013 and found it had failed eight of the nine “essential standards”. In 2011 the hospital in Sheffield was said not to have sufficient numbers of the right staff. The company responded by saying "Sudhir Choudhrie does not run or manage Alpha Healthcare or Alpha Hospitals. He retired from being a director of both companies in 2007".
The C&C Alpha Group business had a turnover of £89 million in the year to April 2013 and employed more than 1,300 staff. In July 2014 "the Guardian" published a correction, saying there was no evidence to suggest that his peerage was blocked because concerns about Alpha. The "Morning Star" described the company in January 2014 as representing "some of the worst of NHS privatisation", and pointing out that "all three of Alpha's private mental health hospitals that were inspected by the Care Quality Commission in 2013 failed to meet some standards."
The Care Quality Commission made unannounced visits in November and December 2013 to the hospital in Woking found it was failing to meet five out of the six national standards of quality and safety and issued formal warnings in respect of three of them – care and welfare of people, safeguarding people from abuse, and records as they had already been told that they needed to make a number of improvements during two previous visits.
The company takes NHS patients from across England at a cost of up to £1,150 a day. 21 patients from Yorkshire were placed in the Bury hospital between April 2013 and March 2015.
The Care Quality Commission inspected the hospital in Bury in February 2015. It found that the seclusion rooms, where patients are calmed or restrained, were dirty and not equipped with adequate washing facilities or natural light. Alpha Hospital Group was acquired in 2015 by Cygnet Health Care, owned by Universal Health Services, a Pennsylvania-based hospital management company.


Alain Deloche

Alain Deloche, born 2 September 1940 at Paris, is a French surgeon. Ex member of Médecins Sans Frontières, he cofounded Médecins du Monde and is board member of the "Surgeons of Hope Foundation" since 1988.


Karen A. Matthews

Karen A. Matthews is an American psychiatrist and psychologist, currently the Distinguished Professor of Psychiatry at University of Pittsburgh.


Kurt Schrader

Walter Kurt Schrader (born October 19, 1951) is an American politician serving as the U.S. Representative for since 2009. A member of the Democratic Party, his district covers Salem and Newport. Schrader previously served in both houses of the Oregon Legislative Assembly from 1997 to 2008.
Early life, education, and early career.
Schrader was born in Connecticut and received a Bachelor of Arts degree from Cornell University in 1973. While at Cornell, Schrader met Martha Northam and the two were married in 1975. Schrader earned his Doctor of Veterinary Medicine degree from the University of Illinois in 1977. A year later, the Schraders moved to Oregon, and Kurt opened the Clackamas County Veterinary Clinic in Oregon City, to begin his veterinary practice.
Schrader served for 16 years on the Canby Planning Commission.
Oregon legislature.
Elections.
Schrader served three terms in the Oregon House of Representatives. He first ran for the office in 1994, where he lost to Republican Jerry Grisham in the general election by 38 votes. In 1996, Schrader ran again, defeating Paul Kraxburger. He was subsequently reelected in 1998 and 2000.
In 2002, Schrader ran for the Oregon State Senate seat vacated by the retiring Verne Duncan, representing the 20th district in southwestern Clackamas County, including the cities of Barlow, Canby, Gladstone, Johnson City, Oregon City and portions of Milwaukie. He defeated fellow Oregon House member Kathy Lowe in a contentious Democratic primary, then faced no Republican opposition in the general election. His wife, Martha Schrader, was the Democratic nominee to succeed Schrader for his vacant House seat; she lost in the general election to Wayne Scott. She then served as a Clackamas County commissioner until 2009, when she was appointed by the same commission (recusing herself from voting) to replace her husband in the State Senate.
Committee assignments.
In the Oregon Senate, Schrader served as co-chair of the Joint Ways and Means Committee in the 2003 and 2005 sessions, as well as chair of the Interim Joint Legislative Audit Committee in the 2005 session. To prepare for his U.S. House seat, Schrader resigned effective December 17, 2008.
U.S. House of Representatives.
Elections.
2008.
In May 2008, Schrader won the Democratic nomination for for the seat being vacated by Darlene Hooley. In the general election, Schrader defeated Republican Mike Erickson, winning election to the U.S. House. Schrader won the election with 54 percent of the vote to Erickson's 38 percent. Schrader won all seven of the counties in the 5th congressional district, though he posted a plurality win in Polk County.
Schrader was challenged by Republican nominee and Oregon State Representative Scott Bruun and Pacific Green nominee Chris Lugo. Despite several polls showing Bruun ahead and pollster Nate Silver of FiveThirtyEight predicting Schrader would likely lose his bid for reelection, the final vote tally had Schrader winning by a fairly comfortable five-point margin, picking up 51% of the vote to Bruun's 46%. It was the closest House race in Oregon in 2010, a year in which Republicans picked up at least 63 House seats, but only one on the West Coast.
2012.
Schrader won re-election 54.1% to 42.6%.
2014.
Schrader won 53.9% to 39.4%
2016.
Schrader won 53.6% to 43.1%. He was absent from the Congressional swearing-in on January 3, 2017, because he was on his honeymoon. He was the only member of Congress not to be sworn in that day.
Tenure.
Schrader voted for the Budget Control Act. He voted both in favor of the Patient Protection and Affordable Care Act and for funding SCHIP.
On December 17, 2009, Schrader announced that he would become a member of the Blue Dog Coalition.
Schrader was ranked as the 50th most bipartisan member of the U.S. House of Representatives during the 114th United States Congress (and the most bipartisan member of the U.S. House of Representatives from Oregon) in the Bipartisan Index created by The Lugar Center and the McCourt School of Public Policy that ranks members of the United States Congress by their degree of bipartisanship (by measuring the frequency each member's bills attract co-sponsors from the opposite party and each member's co-sponsorship of bills by members of the opposite party). In December 2016, he severely criticized the election of Nancy Pelosi as House Minority Leader. "I'm very worried we just signed the Democratic Party's death certificate for the next decade and a half," he said.
Abortion.
Schrader is pro-choice and has received a 100 rating from both Planned Parenthood and the National Abortion and Reproductive Rights Action League. In May 2012, Schrader opposed and voted against the Prenatal Nondiscrimination Act of 2012, introduced by Republican Representative Trent Franks of Arizona. The bill proposed imposing criminal penalties for giving abortions in special cases, notably when based on gender, race or color of the child or parent.
Health care.
Schrader received a 100% rating from the Children's Health Fund. In 2016, he received an 86% from American Public Health Association. He supports the Affordable Care Act. Schrader is the co-chair (along with Pennsylvania Representative Allyson Schwartz) of the New Dem Health Care Task Force, which set forth an agenda of "more effectively implementing health care policy in this country that improves payment and delivery systems."
In July 2017, Schrader led a group of ten House Democrats who proposed a plan to improve Obamacare. The plan included a $15 billion "annual reinsurance fund to pay health insurers that enroll higher-cost, sicker individuals."
Agriculture regulation.
In March 2017, Schrader told a district audience that the Trump administration seemed determined to deregulate agriculture. He admitted that agriculture regulations "were a bit of an overreach," causing problems for both dairy and dirt farmers.
Veterinary medicine.
Schrader coauthored the Veterinary Medicine Mobility Act of 2014 (H.R. 1528; 113th Congress), a bill that would amend the Controlled Substances Act to clarify that veterinarians are not required to have separate registrations to dispense controlled substances outside of their principal place of business, such as when treating animals on a farm.
Gun control.
In December 2017, Schrader was one of only six House Democrats to support legislation allowing concealed handgun licensees to carry their weapons in all 50 states.
Minimum wage.
In July 2019, Schrader was one of six Democrats in the House of Representatives to oppose a bill which would incrementally increase the federal minimum wage from $7.25 to $15.00 an hour by 2025. He was one of two Democrats who voted against the American Rescue Plan Act of 2021 because of a provision to raise the minimum wage to $15.00. When this was removed, Schrader voted in favor of the bill for final passage.
Personal life.
Schrader and former Oregon state senator Martha Schrader divorced in 2011. He has five children. On December 31, 2016, Schrader married Pepco executive and former lobbyist Susan Mora. He is an Episcopalian.
Schrader's district residence is the Kraft-Brandes-Culberston Farmstead in Canby, also known as Three Rivers Farm, which is listed on the National Register of Historic Places.


Medical education in South Africa


Kew Siang Tong

Dato' Kew Siang Tong, also rendered as Siang Tong Kew, is a Malaysian Chinese physician, academic administrator and health bureaucrat.
She is currently Professor in Internal Medicine and Dean of the School of Medicine at the International Medical University in Kuala Lumpur. She has formerly been Head of Gastroenterology at Kuala Lumpur Hospital and worked in the Ministry of Health from 1999 to 2002. She has been Master of the Academy of Medicine of Malaysia, President of the College of Physicians and President of the Malaysian Society of Gastroenterology and Hepatology.
She completed her studies in medicine at the University of Singapore in 1969. She became a Fellow of the Royal College of Physicians of Edinburgh in 1996 and of the Royal College of Physicians and Surgeons of Glasgow in the same year. She also became a Fellow of the Academy of Medicine of Malaysia in 1996, an Honorary Fellow of the American College of Physicians in 1997, an Honorary Fellow of the Royal Australasian College of Physicians in 1997, a Fellow of the Academy of Medicine, Singapore in 2004 and a Fellow of the Royal College of Physicians of Ireland in 2004.


Lynn Stucky

Lynn Dale Stucky (born February 20, 1958) is an American veterinarian originally from Kansas, who is a Republican member of the Texas House of Representatives for the 64th District in Denton County in the northern portion of the state. Earlier, Stucky served on the board of the Sanger Independent School District for fifteen years, four as the president.
Stucky was elected to the House in 2016, when the incumbent Republican in the district, Myra Crownover, of Lake Dallas, retired after sixteen years in the position.
In 2017, Stucky joined state Senator Kirk Watson of Austin in filing legislation to refer the issue of feral hog proliferation to a university study to determine what impact that poisoning these animals, as proposed by Texas Agriculture Commissioner Sid Miller, would have on the land, agriculture, and hunters. Stucky and Watson want the research conducted before Miller can proceed with his proposal to exterminate the hogs, which have caused millions of dollars in damage to area landowners.
Electoral history.
In the general election held on November 6, 2018, Stucky won his second term with 36,195 votes (52.8 percent) to Democratic nominee Andrew Morris' 30,465 (44.5 percent). Libertarian Party nominee Nick Dietrich held the remaining 1,384 votes (2.7 percent).


W. E. Anderson

William Edmund Anderson (1871–1938) was a Canadian doctor and antiquarian.
Anderson was born in Orillia, Ontario. He was responsible for a significantly large, possibly the largest, mass donation of aboriginal artifacts to the Hudson's Bay Company in 1933. He also contributed articles to "The Beaver". He died in Lake Alma, Saskatchewan.


Charles Gandy

Charles Gandy (April 21, 1872 in Dijon – July 5, 1943 in Paris) was a French physician remembered for Gandy-Gamna nodules.


Pospiviroid

Pospiviroid is a genus of viroids that most commonly infects tubers. It belongs to the family "Pospiviroidae". The first viroid discovered was a pospiviroid, the PSTVd species (potato spindle tuber viroid).


Felix Victor Birch-Hirschfeld

Felix Victor Birch-Hirschfeld (2 May 1842 – 19 November 1899) was a German pathologist who was a native of Kluvensieck bei Rendsburg.
Biography.
In 1867 he received his medical doctorate from the University of Leipzig, where he studied under Carl Reinhold August Wunderlich (1815–1877) and Ernst Leberecht Wagner (1828–1888). In 1870 he became a prosector at the city hospital in Dresden, and in 1885 returned to Leipzig, where he succeeded Julius Cohnheim (1839–1884) as chair of pathological anatomy. One of his better known assistants was pathologist Christian Georg Schmorl (1861–1932).
Birch-Hirschfeld made important contributions in several facets of pathological medicine. He is known for his work in the field of bacteriology, with tuberculosis being the primary focus in regards to infectious diseases. In 1898 he described the unitary nature of nephroblastoma.


Bangkok School of Tropical Medicine


Sustainability and transformation plan

In England, a sustainability and transformation plan (STP) is a non-statutory requirement which promotes integrated provision of healthcare, including purchasing and commissioning, within each geographical area of the National Health Service. The plans were introduced in 2016 but by 2018 had been overtaken by progress towards integrated care systems.
Establishment.
In March 2016, NHS England divided the geographical areas of England into 44 sustainability and transformation plan areas (or footprints) with populations between 300,000 and 3 million, which would implement the Five Year Forward View. These areas were locally agreed between NHS trusts, local authorities and clinical commissioning groups. A leader was appointed for each area, to be responsible for the implementation of the plans which are to be agreed by the component organisations. They were to "work across organisational boundaries to help build a consensus for transformation and the practical steps to deliver it".
Evolution.
During 2017 the use of the acronym STP shifted, so that it was used to signify sustainability and transformation partnerships. In February 2018 it was announced that these organisations were in future to be called integrated care systems, and that all 44 sustainability and transformation plans would be expected to progress in this direction. The ten pioneer systems were described as nascent and fragile by the Health Select Committee in May 2018.
By December 2020 only 13 sustainability and transformation partnerships still existed, with 29 transformed into integrated care systems.
Areas.
The geographical configuration differs in some respects from previous NHS arrangements – regional hospital boards, regional health authorities and strategic health authorities – because the configurations have been locally agreed, rather than imposed from the centre. When established in 2016, there were 44 STPs which varied considerably in size, the largest having more than ten times greater population than the smallest. By 2019 there were 41, after three STPs in the North East merged.
, the seven NHS England regions have 42 STPs which are at varying stages of progression into integrated care systems.
Staffing.
, three of the leaders are from local government: Sir Howard Bernstein, chief executive of Manchester City Council; David Pearson, director of adult social care at Nottingham City Council; and Mark Rogers, chief executive of Birmingham City Council and president of the Society of Local Authority Chief Executives and Senior Managers. The remainder are NHS managers.
Finance.
The NHS planning guidance for 2016–17 stated: "For many years now, the NHS has emphasised an organisational separation and autonomy that doesn’t make sense to staff or the patients and communities they serve… System leadership is needed." It also suggested that the financial problems of individual organisations are no longer critical: "what is important is the financial situation of the organisations in each area considered together". Each area was required to produce a Sustainability and Transformation Plan by end of June 2016.
In February 2017 the National Audit Office produced a report suggesting that plans to save millions of pounds "may be optimistic", that there was poor oversight of the various initiatives and that progress with integration plans had been slower and less successful than planned. £5.3 billion spent through the Better Care Fund in 2015/16 had not delivered value for money. Furthermore, there was "no compelling evidence" to suggest that integration would lead to financial savings or less use of acute hospitals.
£325 million capital funding for the strongest plans was announced in March 2017 but Sir Robert Naylor concluded that at least £10 billion would be needed to deliver proposed plans and make NHS facilities fit for purpose. His review suggested that £6 billion could be raised by selling NHS land and buildings.
Development.
Simon Stevens described the progress made in December 2016, saying that the most advanced areas were "capable of combining the purchaser and provider, the commissioning and provider function, a la Frimley Health”. In some cases he expected a "governance partnership of the relevant statutory bodies" which in some cases might become integrated organisations. But in some areas there were only proposals, not yet progressed into plans. He proposed to give the most advanced money and authority to progress their plans. NHS England would organise national support programmes, particularly for “primary care provider development”, support urgent and emergency care systems, rather than to individual organisations, and set up clinical standardisation and productivity initiatives under professors Timothy Briggs and Tim Evans.
Plans released in March 2017 propose at that all plans should evolve into accountable care systems with "clear collective responsibility for resources and population health" and some control over devolved funding for mental health, cancer and general practice. Between six and ten STP areas are to be launched as accountable care systems.
A survey by the Chartered Institute of Public Finance and Accountancy in September 2017 found that of 56 organisations who responded to a survey, 55 did not believe that joint working between local government and health organisations would be fully achieved in the next 5 years. They also found that there was no funding for plans to increase preventative work.
Accountability.
Steven Broomhead, the chief executive of Warrington Borough Council, complained to NHS England in July 2016 that decisions were being made "without any local transparency". He said changes to where people receive services and what services they receive needed "local scrutiny and local community involvement".
Care in the community.
It is planned to transfer patients to care in the community. This may lead to improved care in some cases but the King's Fund claims not all community care plans are credible because there are insufficient services outside hospitals and there is insufficient money to provide more. The King's Fund fears reducing hospital beds will increase the strain on hospital services which were overstretched during the 2016–2017 winter. Professor Chris Ham of King's Fund maintains transferring services to the community is a potential improvement in many cases and plans should be considered on their merits. Ham maintains further transfer to the community cannot be done without extra funding and urges the government to invest in community services. The Nuffield Trust reported that some STPs were planning up to 30% reductions in some areas of hospital activity - going against trends which have persisted for the last 30 years. They conclude that out-of-hospital care may be better for patients, but it is not likely to be cheaper for the NHS in the short to medium term.
Reaction to proposals.
According to Dr Brian Fisher, "STPs are driven by the Treasury. They are focused on reducing NHS spend. (...) Unless STPs meet the funding demands of the Treasury, the plans will not be approved and areas will not receive any transformation money." An article by the King's Fund states, "Allocations from the fund for sustainability and transformation must be agreed in advance with HM Treasury and DH’." The same article states that the spending review, "is both ring-fenced and needs HM Treasury agreement to unlock."
The Nuffield Trust think tank claims many suggestions would fail to implement government financial targets and involve a "dauntingly large implementation task". Sally Gainsbury of the Nuffield Trust said many current plans involve shifting or closing services... "Our research finds that, in a lot of these kinds of reconfigurations, you don't save very much money - all that happens is the patient has to go to the next hospital down the road. They're more inconvenienced... but it rarely saves the money that's needed." There will be a shift from inpatient to outpatient care but critics fear cuts that could put lives at risk, that the plans dismantle the health service rather than protecting it, further that untested plans put less mobile, vulnerable people at risk. By contrast, NHS England claims that the plans bring joined-up care closer to home. John Lister of Keep Our NHS Public said there are too many assumptions, and managers desperate to cut deficits were resorting to untried plans. A survey of ninety-nine clinical commissioning group chairs and accountable officers conducted by the Health Service Journal in October 2016 found very little confidence that the plans would deliver.
An article in "The Guardian" suggests possible substantial benefits from the plans. The system as a whole lacks money and an ageing English population has growing complex requirements. Health and social services need to be coordinated, STP's got people working enthusiastically together. The article suggests NHS England 'made up the policy on the hoof' and managers were under pressure to produce plans fast. NHS England gave fragmented guidance, coming in bursts with frequently insufficient time for responding to requests. There are fears secrecy within the NHS is hindering effective public discussion and without public discussion there is a risk of later delays, protests, judicial reviews. The Guardian argues that full-time leaders are needed who will not put the interests of their own department before the needs of the whole and will send money where it is needed. Another "Guardian" article questions whether the plan might be to prepare for greater privatisation after 2020. Transferring services from hospitals to the community will only work if there is spare capacity in the community and GP's are already overstretched. There are too few NHS staff generally to enable the reorganisation.
Critics are concerned that the plan will involve cuts but supporters insist some services will be cut while others will be enhanced. Senior Liberal Democrat MP Norman Lamb accepted that the review made sense in principle but stated: "It would be scandalous if the government simply hoped to use these plans as an excuse to cut services and starve the NHS of the funding it desperately needs. While it is important that the NHS becomes more efficient and sustainable for future generations, redesign of care models will only get us so far – and no experts believe the Conservative doctrine that an extra £8bn funding by 2020 will be anywhere near enough."
Plans were generally kept secret until December 2016. 43 out of 44 were published by December 2016. Oxfordshire, Buckinghamshire and Berkshire was, at that stage, still in dispute. One local manager described keeping plans confidential as 'ludicrous' and another said the 'wrong judgement call' had been made. Another person spoke about being in meetings where, 'real people' like patients and the public were not involved. The King's Fund reported the public and patients were mostly absent from plans potentially involving large scale service closing. Chris Ham of the King's Fund described suggesting out-of-hospital services and GP's could take over work now done by hospitals as a “heroic assumption” since both are under too much pressure. Some councils that disagree with the secrecy have published plans on their websites. Funds that should have gone to easing transition of services after closures instead went to plugging other NHS deficits.
Sir Bruce Keogh defended the process in December 2016 saying "I think in a number of areas, {services} will look very different. But what we have to be really careful about is that they serve the needs of patients and the local community. People are always up for change, but they fear loss, and I think that those who are proposing the change have a duty to explain to the local communities why those changes offer an improvement."
Organisers of a protest march in London where tens of thousands of people took part fear the Sustainability Transformation Plans are a "smokescreen for further cuts". Hospital services could be cut in nearly two thirds of England and some hospitals will be completely closed. During the march Jeremy Corbyn said, “There are those waiting on trolleys and those who are desperate to get into an A&E department waiting hours for treatment. It is not the fault of the staff. It is the fault of a government who have made a political choice.” Corbyn also said, "The Tories and the coalition before them managed to cut taxes on big business. Don't let them tell you there's no money for the NHS. There's no excuse for it... the money is there if you collect the taxes properly to fund it and pay for it." Len McCluskey of Unite stated, hospitals, GPs, mental health, ambulance and community services are on their knees". Dr David Wrigley of the BMA said, "As a doctor I see day to day the serious pressures in the NHS due to the funding cuts from the government."
There is concern that plans are being introduced hastily without evidence that they will be effective. Dr Mark Porter of the BMA said money was "wasted" and changes "rushed through without appropriate evidence". According to the Local Government Association only 21% of councillors they surveyed in 2017 felt sufficiently engaged in their STPs, and less than 25% were confident that their STP would deliver on its objectives or bring benefits to the local community.
The King's Fund in September 2017 described plans to cut hospital beds as ‘undesirable and unachievable’, pointing out that the UK has fewer acute beds relative to its population than almost any other comparable health system.
According to Sir David Sloman the purpose of these plans is to focus on population health – helping people to achieve their maximum potential – rather than treating people when they get sick.
Legal considerations.
STPs are not statutory organisations so any changes resulting from the plans most be implemented by their component bodies, and those bodies may be required to conduct public or staff consultations, or, in the case of foundation trusts, ballot their governors. Local authorities have the power to call decisions in for scrutiny. The Health and Social Care Act 2012 provisions may also require approval of proposals from the Competition and Markets Authority.


Clavicular facet of scapula

Clavicular facet of scapula is small oval facet on the medial border of the acromion for articulation with the acromial facet on the lateral end of the clavicle. Also called Clavicular articular facet of acromion.
The coracoacromial ligament is attached near the clavicular facet.


Brian Goldman

Howard Brian Goldman (born 1956) is a Canadian emergency physician, author, public speaker, and radio personality.
Education and career.
He completed his undergraduate medical education at the University of Toronto in 1980. In July 1980, he began postgraduate medical education in family medicine. On 15 January 1982, Goldman obtained his Independent Practice Certificate from the College of Physicians and Surgeons of Ontario. He received his certification in family medicine from the College of Family Physicians of Canada (CFPC) in July 1984, followed by a certificate of advanced competency in emergency medicine from the CFPC in November 1985.
He practices in the Schwartz Reisman Emergency Centre at Mount Sinai Hospital in Toronto, Ontario, Canada.
Goldman has been a regular medical columnist on CBC Radio One since 1999.
Goldman was also awarded fellowship in the CFPC, thereby entitled to display the "FCPF" special designation, in addition to his current membership certification in both family medicine and emergency medicine domains, "MCFP (EM)".
Broadcasting.
He also hosts an award-winning current affairs radio series, "White Coat, Black Art", on CBC Radio One about the culture of modern medicine and various aspects of the Canadian health care system and is the house Doctor for the "Afternoon Edition" on CBC Radio One in Saskatchewan. In addition to the series' podcast copy of their content, Dr. Goldman has a concurrent original podcast, "The Dose", which has a similar medical theme.
Author.
In 2010, his first book, "The Night Shift: Real Life in the Heart of the ER", was published by HarperCollins Canada. "The Night Shift" is a book on his experiences working the night shift as an emergency physician. His second book, "The Secret Language of Doctors" is about slang or argot terms used by doctors, nurses, and other health professionals to talk about patients, unpleasant clinical situations, as well as colleagues.
His third book is "The Power of Kindness", 2018, at HarperCollins Canada.


Farokh Udwadia

Farokh Udwadia is an Indian physician, author and Padma Bhusan award recipient. He graduated from the University of Bombay (MBBS) with a Distinction in Medicine and several other subjects in 1953. He received his MD from the University of Bombay in 1956 (where he graduated as valedictorian). He completed his advanced training at the Brompton Hospital and Middlesex Hospital, London and was on the house staff of City Hospital and Northern General Hospital, Edinburgh, in Professor John Crofton's Unit. He is an elected fellow of the National Academy of Medical Sciences.


Hesperian Health Guides

Hesperian Health Guides, formerly known as Hesperian Foundation, is a nongovernmental non-profit organization publishing health guides for trained and untrained people to care for themselves and others. The foundation is based in Berkeley, California. Among their best-selling publications is "Where There is No Doctor", first published in 1973 and updated every few years. The book has been translated to more than 80 languages and the World Health Organization estimates that it may be the most widely used public health manual in the world.
Hesperian's publications are known for their simplicity of expression and illustrations, both intended to make them suitable for use by ordinary people in home and community contexts. "Where There is No Doctor" was praised by those who felt it "demystified and politicized health care," communicating that "although some health problems require expert medical attention, there is much that we can do on our own to positively affect our health," a message also communicated in subsequent works. As of 2011, the organization had a rating of four out of four stars from Charity Navigator for the efficient use of donated funds.
Collaborations.
Hesperian often works with other organizations to create new publications and revise older ones. The short work "Water for Life: Community Water Security" was published in conjunction with the United Nations Development Program. In 2006, Hesperian received a US$40,000 grant from the Rockefeller Brothers Fund to develop a book on environmental health, and in 2004 the Firelight Foundation provided a small grant to fund the revision of the 1999 book "HIV, Health, and Your Community".
Complementing its other activities, the organization includes a gratis fund that sends free copies of its publications to those who cannot afford them, a translation fund providing seed grants to cover the costs of local translation and adaptation in international communities, and a grant fund to assist health education programs in developing creative ways to use Hesperian publications by such means as street theater and radio broadcasts. Access to the publications also is fostered through the organization's policy of permitting copying, reproduction or adaptation of any part of a publication to meet local needs "provided the parts reproduced are distributed free or at cost—not for profit," resulting in the availability of online copies of various publications.
Hesperian Health Guides is an official supporting organization of Healthcare Information For All by 2015.
Reviews.
Hesperian Health Guides "is responsible for countless miracles in various parts of the world by providing basic health care books to those who either cannot afford medical treatment or cannot survive the long, arduous journey to the nearest doctor," says the San Francisco Chronicle.
Hesperian's publications are widely praised by a variety of sources, and Hesperian involves organizations from all over the world in the development of its books. "Where There Is No Doctor is an indispensable resource... This book has been, quite literally, a lifesaver for the poor - even where there is a doctor." says Paul Farmer, Professor of Social Medicine, Harvard Medical School.
"Helping Children Who are Deaf" was praised in "The Journal of Deaf Studies and Deaf Education" for its "broad perspective. Parents, teachers, deaf adults, and health care workers from around the world—over 17 countries—advised and reviewed draft materials of the book. A very long and impressive list of individuals and organizations from Bangladesh to Zimbabwe are given credit and thanks for sharing their experiences, stories, and knowledge." Another review criticized the book as not sufficiently overcoming Western cultural assumptions about areas such as privacy.
Selected publications.
Hesperian released "Health Actions for Women" in February 2015; a 352-page print book and online resource that shares proven strategies and activities to help women and men facilitate community discussions and action around such topics as family planning, sexuality, HIV, and gender-based violence — even in challenging settings where education and organizing for women's and girls’ health may be difficult or dangerous.
In May 2015 Hesperian also released "Workers' Guide to Health and Safety" to put occupational safety and health information into a form that can be used by those most affected by workplace hazards—the workers themselves. From low wages to sexual harassment, from ergonomics to fire safety, from chemical exposure at work to pollution outside the plant, this book draws on the experiences of factory workers and their communities around the world to provide actionable tools to help organize for short- and long-term improvements. Developed in collaboration with factory workers and their advocates, workers, educators, and organizers will find a wealth of practical and sustainable information in this one-of-a-kind resource.
Other languages.
Most of the titles listed above are available from Hesperian in Spanish, and a few are available from the Foundation in French, Vietnamese, and Chinese. Publications are distributed by a variety of other organizations in over 100 other languages, including:


Franz Weitlaner

Franz Weitlaner (; 1872–1944) was an Austrian physician who is known for designing the self-retaining retractor bearing his name.
Life.
Weitlaner was born in Welsberg, a German-speaking municipality in Italy's South Tyrol province. His initial higher education was in theology, but at the age of 20 he began medical studies at the University of Innsbruck, where he completed his doctorate in 1898 and his clinical training in 1902. After a stint as a ship's surgeon, he married Leopoldine ("née" Kraubmann), and established a general practice in the remote village of Ottenthal. Lacking adequate surgical assistants there, he developed the retractor which bears his name, publishing an article on its genesis and design in 1905. Weitlaner departed Ottenthal in 1909 to take up similar positions in rural Austria.


Hugo Grau

Hugo Grau (April 15, 1899 - June 27, 1984) was a German veterinarian and animal anatomist.
He was the co-founder of the World Association of Veterinary Anatomists and the European Association of Veterinary Anatomists.
In 1933 Grau signed the "Vow of allegiance of the Professors of the German Universities and High-Schools to Adolf Hitler and the National Socialistic State".


David P. Campbell

David P. Campbell is an American psychologist who co-authored the Strong-Campbell Interest Inventory which is widely used in vocational counseling.
For this accomplishment, he was awarded the E.K. Strong Jr Gold Medal for excellence in psychological testing research, an Honorary Doctorate of Humane Letters from the University of Colorado in 1998, and the 2001 Distinguished Professional Contributions Award from the Society for Industrial and Organizational Psychology.
Campbell received his B.S. and M.S. degrees from Iowa State University, and his Ph.D. in psychology from the University of Minnesota, where he served as Professor of Psychology.
Campbell is also the author of several popular books in psychology.


Francis Giraud

Francis Giraud (4 July 1932 – 23 October 2010) was a French physician.


TRIM5alpha

Tripartite motif-containing protein 5 also known as RING finger protein 88 is a protein that in humans is encoded by the TRIM5 gene. The alpha isoform of this protein, TRIM5α, is a retrovirus restriction factor, which mediates species-specific, early block to retrovirus infection.
TRIM5α is composed of 493 amino acids that is found in the cells of most primates. TRIM5α is an intrinsic immune factor important in the innate immune defense against retroviruses, along with the APOBEC family of proteins, tetherin and TRIM22.
Structure.
TRIM5α belongs to the TRIM protein family (TRIM stands for TRIpartite Motif); this family was first identified by Reddy in 1992 as proteins that contain a RING finger zinc binding domain, a B-box zinc binding domain, followed by a coiled-coil region. TRIM5α bears the C-terminal PRY-SPRY or B30.2 domain in addition to the other domains.
Function.
When a retrovirus enters a host cell's cytoplasm, it undergoes capsid uncoating and reverse transcription inside the host nucleus to produce daughter viruses. TRIM5 is present in the cytoplasm and recognizes motifs within the capsid proteins that interferes with the uncoating process, therefore preventing successful reverse transcription and transport to the nucleus of the viral genome. The exact mechanism of action has not been shown conclusively, but capsid protein from restricted viruses is removed by proteasome-dependent degradation.
The involvement of other cellular proteins in the inhibition mediated by TRIM5α is suspected but as yet not demonstrated. However, Cyclophilin A is important for the inhibition of HIV-1 by TRIM5α in Old World monkey species.
The "specificity" of restriction, that is, whether a given retrovirus can be targeted by TRIM5α, is entirely determined by the amino acid sequence of the C-terminal domain of the protein, called the B30.2/PRY-SPRY domain. Amino acid 332, which occurs within this domain, seems to play a critical role in determining the specificity of retrovirus restriction.
TRIM5α may have played a critical role in the human immune defense system about 4 million years ago, when the retrovirus PtERV1 was infecting the ancestors of modern chimpanzees. While no trace of PtERV1 has yet been found in the human genome, about 130 traces of PtERV1 DNA have been found in the genome of modern chimpanzees. After recreating part of the PtERV1 retrovirus, it was reported that TRIM5α prevents the virus from entering human cells "in vitro". While this cellular defense mechanism may have been very useful 4 million years ago when facing a PtERV1 epidemic, it has the side effect of leaving cells more susceptible to attack by the HIV-1 retrovirus. Recently, doubt has been cast over these conclusions. By using a PtERV1 capsid, which produces higher titer virus-like particles, Perez-Caballero "et al." reported that PtERV1 is not restricted by either human or chimpanzee TRIM5α.
Clinical significance.
Rhesus macaques, a species of Old World monkeys, appeared to be almost completely resistant to HIV-1, the virus that causes AIDS in humans. The Rhesus macaques version of TRIM5α was very quick and had a high enough affinity to the incoming HIV capsule that it could bind and degrade it quickly so that the virus was neutralized.
Humans also have a TRIM5α, but it is not well enough tuned to mediate a sufficient response. However, the human version of TRIM5α can inhibit strains of the murine leukemia virus (MLV) as well as equine infectious anemia virus (EIAV).
Prior to the discovery of TRIM5α as an antiviral protein, the inhibition phenotype had been described and coined Ref1 (in human cells) and Lv1 (in monkey cells). This terminology is now largely abandoned.
A related protein, named TRIMCyp (or TRIM5-CypA), was isolated in the owl monkey, a species of New World monkey, and shown to potently inhibit infection by HIV-1. A similar protein has arisen independently in Old World monkeys and has been identified in several species of macaque.
It was recently described that interferon-α-mediated stimulation of the immunoproteasome enables human TRIM5α for effective capsid-dependent inhibition of HIV-1 DNA synthesis and infection.


John Cogswell (psychologist)

John Cogswell is an American clinical psychologist who practices psychotherapy in Los Angeles. He started his career as chief psychologist at the Brattleboro Retreat in Brattleboro, Vermont.
He was trained by William Snyder who, under Carl Rogers, conducted the first research investigation in psychotherapy. In 1959, at System Development Corporation Cogswell pioneered the first study in computer-assisted counseling. In 1965, caught between the "objective" psychologist and the subjective self, he sought therapy with James Bugental. This therapy produced a transpersonal experience that markedly altered his view of reality. Since 1968 he has pursued meditation, Vajrayana Buddhism, Jungian theory and Bioenergetic therapy. Through 1982-2002 he trained with Tibetan lamas and took his Bodhisattva vows with the Venerable Trungram Gyaltrul Rinpoche.
He is the co-founder with Joseph Culp of the body/mind approach Walking-In-Your-Shoes and the L.A.-based Walking Theatre Group.


Friedrich Jacobsohn

Friedrich Jacobsohn (born 1894) was a German urologist and writer on sex.
Jacobsohn's book "Geschlechtsleben und sexuelle Hygiene" (1932) was written with Abraham Buschke, a dermatologist and expert on venereal disease. Illustrated with some colour plates, it was translated into English, where it went through several editions. Given the different sexual needs of men and women, men were not encouraged to over-extend intercourse after orgasm: they should "enjoy sexual intercourse in normal fashion, without extensive preliminaries, without any attempt at artificial prolongation, but proceeding as quickly as may be to orgasm and ejaculation."


Ernst Schwalbe

Ernst Theodor Karl Schwalbe (26 January 1871 – 16 March 1920) was a German pathologist, who specialized in teratological research.
Schwalbe was born in Berlin. He studied medicine at the universities of Strassburg, Berlin and Heidelberg, and received his habilitation in 1900 with a thesis on blood coagulation. Afterwards, he worked as an assistant under Julius Arnold at Heidelberg, and in 1907/08 served as prosector and head of the pathology-bacteriology clinic at the city hospital in Karlsruhe. From 1908 to 1920 he was a full professor at the University of Rostock. He was killed in Rostock while serving as a volunteer during the Kapp Putsch (1920).


Jacques Coitier

Jacques Coitier (c. 1430 – 22 October 1506) was a French doctor. He was chief physician to Louis XI of France and president of the Chambre des comptes.
Coitier was born at Poligny, Franche-Comté. His name is spelled in several ways, most often Coictier (the spelling used by Victor Hugo in his novel "The Hunchback of Notre-Dame"), but also "Coittier", "Cotier", "Coytier" or "Coctier". An analysis of his signatures by Achille Chereau has allowed "Coitier" to become the standard spelling - this was the name cited most often in medical annals. He died in Paris.


Medical School Admission Requirements (MSAR)

The Medical School Admission Requirements Guide (MSAR) is a suite of guides produced by the Association of American Medical Colleges (AAMC), which helps inform prospective medical students about medical school, the application process, and the undergraduate preparation. The MSAR staff works in collaboration with the admissions offices at each medical school and combined B.S./M.D. program to compile information about each school and program. This data originates from a number of sources including the:
MSAR products are for sale on the AAMC’s web site, but also college book stores, Barnes and Noble.com and Amazon.com
History.
The last edition of the MSAR was printed in 1947, and it was called the, “Handbook for Advisors to Students Planning to Enter Medicine.”
Since then, the MSAR was published annually as a print guidebook for prospective medical students. The book was traditionally divided into two sections: information for entering class and school profiles. Originally, information centered around the application process (interviews, MCAT, letters of reference), but it later grew to include information about admissions decisions, diversity in medical schools, financing a medical education, deciding upon a career in medicine, and how undergraduate students can prepare for medical school.
The school profile section contained information on General Information, the school’s mission, curricular highlights, selection factors, financial aid, information on diversity programs, campus setting, enrollment, special features, Regional and Satellite campuses and the application process. The 2000-2001 edition was the Special 50th Edition of the MSAR.
The 2012-2013 edition of the MSAR was published as a guidebook and web site called MSAR Online. With this change, extensive school profile information was moved into an online format where students could compare information in a more accessible format. A condensed, one page version of the school profile was kept as part of the printed book. The MSAR Online site includes functions for advanced searches, data sorting, school browsing at a glance, saving favorites, comparing schools and a notes feature.
Today, three versions of the MSAR are available: a printed guide book, MSAR Online, and an e-reader. In the first six months after launching the MSAR and Medical School Directory was viewed by users in 162 countries.
MSAR Print Guidebook.
The MSAR guidebook is one of three MSAR products. It includes chapters with information about undergraduate course selection, taking the MCAT, applying to medical school, the AMCAS application, how admission decisions are made, financing a medical education, medical school diversity information, and how to choose the best school for you. This information is collected annually from schools and programs, and a range of data sources including:
MSAR Online.
The MSAR Online allows users to perform advanced searches, sort data, browse schools at a glance, save favorites, compare schools, save notes, and access additional data not printed in the paper version of the guidebook. The MSAR Online provides profiles of each LCME-accredited US medical school, Canadian medical schools, and combined BS/MD programs. Each medical school profile includes over 100 pieces of information and data including:
The MSAR Online recently debuted the “My Notes” feature, which allows users to write, save, edit and print messages regarding specific schools for future reference. Each user can view their own notes and print them to bring to advising sessions, campus tours, or interviews.
A public version of the site, The Medical School Directory, is available to all site visitors. It features a list of medical schools as well as some school and program information.
MSAR e-Reader.
MSAR: Getting Started is an eBook designed for students who are just beginning to research and prepare for medical school. Like the MSAR Guidebook, it contains chapters that help students decide if a career in medicine is right for them, as well as information about how to prepare for medical school.
Student Surveys.
Results from the 2010 Pre-MCAT Questionnaire show medical school aspirants ranked the MSAR highest in value compared to other information sources for help in making crucial application decisions


Paul Roberts Cannon

Paul Roberts Cannon (25 August 1892–7 September 1986) was an American physician and medical professor. He was a pioneer in the study of nutrional effects on immune response.
Education.
Cannon completed his undergraduate education at Millikin University, graduating in 1915. His training was interrupted by World War I, during which he spent two years as a lieutenant with the US Army Sanitary Corps. After the war, he studied bacteriology at the University of Chicago, receiving his doctorate in 1921. He spent two years as a professor of pathology and bacteriology at the University of Mississippi School of Medicine, before returning to Chicago to enroll at Rush Medical College, where he earned his MD in 1926 while holding a professorship at the University of Chicago. He was mentored by the eminent pathologist and immunologist Harry Gideon Wells.
Academic career and research.
Cannon spent the rest of his career at the University of Chicago. He was appointed chair of the Department of Pathology in 1940, and held the position until he retired in 1957. His research centered on the effects of nutrional status on immune response, and had significant practical use in combating famine and its associated diseases in developing countries. He utilized rats (rather than the previously more favored rabbits) for his nutritional studies, due to their omnivorous diet and closer immunological similarity to humans. Cannon was able to clearly demonstrate the importance of adequate protein intake for health, as opposed to simply total caloric intake.
Cannon worked with the Journal of Immunology from 1936 to 1954, either as an associate editor or as part of the editorial board. He was also editor of the Archives of Pathology, a position he held from 1954 to 1963.
Awards and honors.
Cannon's research earned him a number of awards over the course of his career. He was elected to membership in the National Academy of Sciences in 1946. In 1948, he was awarded the American Society for Clinical Pathology's Ward Burdick Award for Distinguished Service to Pathology. He was awarded the Gold-Headed Cane Award in 1965, the highest honor bestowed by the American Society for Investigative Pathology.
Cannon served as president of the American Association of Immunologists for 1941–1942. He also served as president of the American Association of Pathologists and Bacteriologists and the American Society for Experimental Pathology.
Personal life.
Cannon and his wife had a small farm near Aurora, Illinois, where they lived after his retirement. He died on 7 September 1986.