ing more compassionate, more effective family physicians;” in fact, only 0.8% believed this would occur. In July 2011, the ACGME’s revised duty hour rules went into effect, in part based on voluminous research into the effects of fatigue and sleep deprivation on performance, but also due to external political pressures that forced the ACGME to take action and try to preserve the vestiges of a p...

This is the case of a twenty-two-year-old active duty male soldier with nonexertional chest pain and worsening performance on his physical fitness test. His history was significant for a diagnosis of dextrocardia upon entry to the military. On acute presentation to the emergency department, he was deemed a candidate for the expedited coronary computed tomographic angiography (CCTA) protocol to ...

In their thoughtful criticism of the conclusion by a joint panel of the Canadian Institutes of Health Research and the Multiple Sclerosis (MS) Society of Canada concerning Dr. Paolo Zamboni’s “liberation procedure” for chronic cerebrospinal venous insufficiency (CCSVI), Dr. Andreas Laupacis and Dr. Arthur Slutsky missed an important public policy point: there is an additional, little-developed ...

The purposes of this study were to determine which seat features/occupational demands contributed to police officer discomfort and whether an automobile seat fitted with an active lumbar system (ALS) could reduce driving discomfort. Fifty-eight officers were given questionnaires to assess driving discomfort. High discomfort levels were associated with computer use, duty belt, sidearm/radio, bod...

There is a professional and legal consensus about the clinical duty to obtain informed consent from patients before treating them. This duty is a reflection of wider cultural values about the moral importance of respect for individual autonomy. Recent research has raised practical problems about obtaining informed consent. Some patients have cognitive and emotional problems with understanding c...

Nurses who attend patients with psychiatric disorders often encounter ethical dilemmas and experience difficulties in making the right decision. The present study aimed to evaluate the decisions of psychiatric nurses regarding their duty to warn third parties about the dangerousness of the patient, the need for compulsory hospitalization, and the competence of patients. In total, 111 nurses wor...

Although a pregnant woman can now refuse any medical treatment needed by the fetus, the Court of Appeal has acknowledged that ethical dilemmas remain, adverting to the inappropriateness of legal compulsion of presumed moral duties in this context. This leaves the impression of an uncomfortable split between the ethics and the law. The notion of a pregnant woman refusing medical treatment needed...

You are the attending physician on duty when a poor, 45-year-old man presents to the emergency department of a general hospital in the Philippines. He has severe chest pain for 2 hours, associated with clammy perspiration. Physical examination reveals a blood pressure of 110/70 mm Hg, a pulse rate of 92 beats per minute, a normal first heart sound, and clear lungs. An electrocardiogram disclose...

Before treatment delivery of respiratory-gated radiation therapy (RT) in patients with implanted fiducials, both the patient position and the gating window thresholds must be set. In linac-based RT, this is currently done manually and setup accuracy will therefore be dependent on the skill of the user. In this study, we present an automatic method for finding the patient position and the gating...