The Institute for Music Physiology and Musicians’ Medicine

The Institute of Music Physiology and Musicians' Medicine of the University of Music and Drama in Hannover, Germany, is a unique Institution in Europe whose scope includes teaching the basics of music physiology and musicians' medicine and research into the physiological and neurobiological principles of professional music performance and music perception. Furthermore, the institute conducts research into the causes of occupational injuries in musicians and provides means for prevention, diagnosis and treatment of such injuries.     

Idiographic outcome analyses of the clinical significance of two interventions for patients with musculoskeletal pain

This study adopted a perspective of the individual to define domains of everyday life for the analysis of clinically meaningful change. The purpose was to compare the clinical significance of two interventions for patients with musculoskeletal pain, applying an idiographic outcome measure, The Patient Goal Priority Questionnaire, in combination with the Jacobson and Truax methodology [(1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 67 (3), 300-307] for determination of clinical significance. The concurrent validity of the outcome variables behavioral performance, satisfaction with behavioral performance, and fulfilled pre-treatment expectations was also studied. Eighty-two patients, randomized to either individually tailored behavioral medicine treatment (experimental group) or physical exercise therapy (control group) were evaluated at baseline and 3 months post-treatment regarding behavioral treatment goals. The experimental intervention had high impact on participants' performance of their highest ranked everyday life activities, and resulted in larger proportions of clinically significant outcomes compared with controls. The concurrent validity of the outcomes was high for those reporting clinically significant changes, but more generally, there was a moderate agreement across outcome categories. The individual should be the unit for analyses of clinical significance to enhance the ecological validity of the construct. Further development of idiographic outcome measures is necessary, as is the inclusion in pain intervention research.     

Disabilities and aging

Both older persons and those who havedisabilities can encounter discrimination whenthey seek medical care. Just as ageism andstereotypes about older persons mayinappropriately limit medical care for theelderly, limits may be placed on medical carefor those who are disabled simply because ofthe presence of a disability. At the sametime death is the natural end of the lifespanfor all individuals and there are situationswhen aggressive medical care is not indicated. It is not right to always insist on ``doingeverything' for a person even if that personmay be at risk otherwise for discrimination. Using the example of the elderly, this paperexamines the risks of discrimination and thedangers of overtreatment in caring for olderpersons and suggests parallels in theappropriate care of those who havedisabilities. This revised version was published online in June 2006 with corrections to the Cover Date.     

What can we learn by looking for the first code of professional ethics?

The first code of professional ethics must: (1)be a code of ethics; (2) apply to members of a profession; (3) apply to allmembers of that profession; and (4) apply only to members of that profession. The value of these criteria depends on how we define “code”, “ethics”, and “profession”, terms the literature on professions has defined in many ways. This paper applies one set of definitions of “code”, “ethics”, and “profession” to a part of what we now know of the history of professions, there by illustrating how the choice of definition can alter substantially both our answer to the question of which came first and (more importantly) our understanding of professional codes (and the professions that adopt them). Because most who write on codes of professional ethics seem to take for granted that physicians produced the first professional code, whether the Hippocratic Oath, Percival’s Medical Ethics, the 1847 Code of Ethicsof the American Medical Association (AMA), or some other document, I focus my discussion on these codes. This revised version was published online in June 2006 with corrections to the Cover Date.     

After Novelty: The Mundane Practices of Ensuring a Safe and Stable Supply of Bone

New medical technologies to a great extent use material from human bodies as therapeutic tools. Social science studies of such ‘tools’ have tended to focus on technologies associated with novelty and drama. This paper, in contrast, concerns an old, well-entrenched and ostensibly undramatic technology, bone transfers, that has only recently gained public attention. The history of bone transplants is intertwined with a desire for a safe and stable supply of bone. This desire has a number of rarely debated social implications of relevance to transplant medicine in general: the gradual industrialization of procurement; the institutional production of the view of the body as a dividable resource; the emergence of a notion of scarcity; of body parts as waste; of death as a productive moment in which body parts acquire potential exchange value; and of tensions between an ethics of respect for donors and an ethics of efficient procurement. Historical analysis combined with a contemporary phenomenological approach suggests that the ‘newness’ typically associated with usage of human biological material is not related to transplant technologies as a medical discipline as such, but rather to changes in its social organization and features of the everyday experience of living with the transplant technologies.     

ISLAM AND BIOETHICS IN THE CONTEXT OF “RELIGION AND SCIENCE”

This paper places “Islam and bioethics” within the framework of “religion and science” discourse. It thus may be seen as a complement to the paper by Henk ten Have ( 2013 ) with which this thematic section in Zygon: Journal of Religion and Science opens, which places “Islam and bioethics” in the context of contemporary bioethics. It turns out that in Zygon there have been more submitted articles on Islam and bioethics than on any other Islam‐related topic. This may be a consequence of the global nature of the bioethical issues, driven by advancement in science and technology, which allows for conversation across cultural and religious boundaries even when the normative references and argumentative methods are tradition‐specific.     

中西医结合治疗儿童过敏性紫癜和预防相关肾损害的临床研究

过敏性紫癜是儿童常见的免疫系统疾病。西医治疗过敏性紫癜已形成常规模式,并有一定疗效,但也有一定局限性。本病易反复,易损伤肾脏,严重时可导致紫癜性肾炎。本文拟研究中西医结合方法治疗过敏性紫癜及预防肾脏损伤的临床效果。研究表明,中西医结合治疗该病存在一定优势,能有效治疗过敏性紫癜,并降低肾脏损害及紫癜性肾炎的发生率。但应看到本研究结论主要是通过临床经验取得,样本量小,未进行远期随访,缺乏系统深层次实验室论证,还有待进一步研究。     

论转化医学发展的机制与平台

转化医学被人们认为是穿越死亡峡谷的重要途径,但需要有相应的机制和平台支撑,在机制方面主要需建立转化医学的教育体系、转化医学的管理体系、转化医学发展的科研业绩评价体系和转化医学的协同创新文化体系,并有转化医学中心、临床研究机构、医学伦理委员会、生物样本库、社区中心、成果转化服务平台等条件的支撑.     

医学人文教育的关怀哲学基点探究

医学人文教育固然以提倡患者的自主存在性突破了医学技术主义形态,但若对患者自主地位的过度强调则会使其陷入二律背反的困境,于此之上的关怀哲学探究则把患者视为处于具体情境中的特殊他人,如此便能建立并维持医学人文情境中的医患和谐.透过耕犁“以患者自主为核心的医学教育限度”、“以关怀为始点的医学哲学诠解”与“关怀哲学在医学人文中的教育张力”三重意涵来突显关怀哲学在医学人文教育中的本位复归,期使医学教育能够透过关怀哲学的融汇从而在医疗临床过程中达成其效力显现的人文基点.     

Cognitive organization of disease concepts in Singapore

Abstract

This research investigates illness cognition and its relationship to the use of different types of medicine in three ethnic groups in Singapore. Four hundred and twenty-nine Chinese, Malay, and Indian Singaporeans rated 24 diseases as to their similarity. Multidimensional scaling (MDS) indicated three dimensions. Regression of these dimensions against 17 disease attributes suggested that these dimensions represented spiritual/psychological causation, disease severity, and viral causation. When the dimensions were related to the use of, preference for and perceived effectiveness of different types of medicine it was found that Indian medicine tended to be used, preferred and perceived to be most effective for diseases low in severity whereas Chinese medicine was viewed most favourably for diseases perceived to be low in spiritual/psychological causation as well as those not seen as virally caused. Malay medicine tended to used, preferred and perceived as most effective for conditions believed to be non-serious and not caused by a virus. Western medicine was most likely to be used, preferred, and seen as most effective for diseases viewed as serious as well as those believed to be virally caused.