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Jeanne Kisacky, Rise of the Modern Hospital: An Architectural History of Health and Healing, 1870–1940 (Pittsburgh: University of Pittsburgh Press, 2017), pp. 456, $65, hardback, ISBN: 9780822944614.
- Charles E. Rosenberg
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- Medical History / Volume 62 / Issue 3 / July 2018
- Published online by Cambridge University Press:
- 11 June 2018, pp. 383-384
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
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- 05 August 2015
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- 27 April 2015, pp ix-xxx
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- By Agoston T. Agoston, Syed Z. Ali, Mahul B. Amin, Daniel A. Arber, Pedram Argani, Sylvia L. Asa, Rebecca N. Baergen, Zubair W. Baloch, Andrew M. Bellizzi, Kurt Benirschke, Allen Burke, Kenneth B. Calder, Karen L. Chang, Rebecca D. Chernock, Wang Cheung, Thomas V. Colby, Byron P. Croker, Ronald A. DeLellis, Edward F. DiCarlo, Ralph C. Eagle, Hormoz Ehya, Brett M. Elicker, Tarik M. Elsheikh, Robert E. Fechner, Linda D. Ferrell, Melina B. Flanagan, Douglas B. Flieder, Christopher S. Foster, Lillian Gaber, Karuna Garg, Kim R. Geisinger, Ryan M. Gill, Eric F. Glassy, David J. Glembocki, Zachary D. Goodman, Robert O. Greer, David J. Grignon, Gerardo E. Guiter, Kymberly A. Gyure, Ian S. Hagemann, Michael R. Henry, Jason L. Hornick, Ralph H. Hruban, Phyllis C. Huettner, Peter A. Humphrey, Olga B. Ioffe, Edward C. Klatt, Michael J. Klein, Ernest E. Lack, James N. Lampros, Lester J. Layfield, Robin D. LeGallo, Kevin O. Leslie, James S. Lewis, Virginia A. LiVolsi, Alberto M. Marchevsky, Anne Marie McNicol, Mitra Mehrad, Elizabeth Montgomery, Cesar A. Moran, Christopher A. Moskaluk, George J. Netto, G. Petur Nielsen, Robert D. Odze, Arthur S. Patchefsky, James W. Patterson, Elizabeth N. Pavlisko, John D. Pfeifer, Celeste N. Powers, Richard A. Prayson, Anja C. Roden, Victor L. Roggli, Andrew E. Rosenberg, Sherif Said, Margie A. Scott, Raja R. Seethala, Carlie S. Sigel, Jan F. Silverman, Bruce R. Smoller, Edward B. Stelow, Nora C. J. Sun, Mark W. Teague, Satish K. Tickoo, Thomas M. Ulbright, Paul E. Wakely, Jun Wang, Lawrence M. Weiss, Mark R. Wick, Howard H. Wu, Rhonda K. Yantiss, Charles Zaloudek, Yaxia Zhang, Xiaohui Sheila Zhao
- Edited by Mark R. Wick, University of Virginia, Virginia A. LiVolsi, University of Pennsylvania School of Medicine, John D. Pfeifer, Washington University School of Medicine, St Louis, Edward B. Stelow, University of Virginia, Paul E. Wakely, Jr
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- Silverberg's Principles and Practice of Surgical Pathology and Cytopathology
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- 13 March 2015
- Print publication:
- 26 March 2015, pp vii-x
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Evaluating Application of the National Healthcare Safety Network Central Line—Associated Bloodstream Infection Surveillance Definition: A Survey of Pediatric Intensive Care and Hematology/Oncology Units
- Aditya H. Gaur, Marlene R. Miller, Cuilan Gao, Carol Rosenberg, Gloria C. Morrell, Susan E. Coffin, W. Charles Huskins
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 34 / Issue 7 / July 2013
- Published online by Cambridge University Press:
- 02 January 2015, pp. 663-670
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- July 2013
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Objective.
To evaluate the application of the National Healthcare Safety Network (NHSN) central line-associated bloodstream infection (CLABSI) definition in pediatric intensive care units (PICUs) and pediatric hematology/oncology units (PHOUs) participating in a multicenter quality improvement collaborative to reduce CLABSIs; to identify sources of variability in the application of the definition.
Design.Online survey using 18 standardized case scenarios. Each described a positive blood culture in a patient and required a yes-or-no answer to the question “Is this a CLABSI?” NHSN staff responses were the reference standard.
Setting.Sixty-five US PICUs and PHOUs.
Participants.Staff who routinely adjudicate CLABSIs using NHSN definitions.
Results.Sixty responses were received from 58 (89%) of 65 institutions; 78% of respondents were infection preventionists, infection control officers, or infectious disease physicians. Responses matched those of NHSN staff for 78% of questions. The mean (SE) percentage of concurring answers did not differ for scenarios evaluating application of 1 of the 3 criteria (“known pathogen,” 78% [1.7%]; “skin contaminant, >1 year of age,” 76% [SE, 2.5%]; “skin contaminant, ≤1 year of age,” 81% [3.8%]; P = .3 ). The mean percentage of concurring answers was lower for scenarios requiring respondents to determine whether a CLABSI was present or incubating on admission (64% [4.6%]; P = .017) or to distinguish between primary and secondary bacteremia (65% [2.5%]; P = .021).
Conclusions.The accuracy of application of the CLABSI definition was suboptimal. Efforts to reduce variability in identifying CLABSIs that are present or incubating on admission and in distinguishing primary from secondary bloodstream infection are needed.
Contributors
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- By Krista Adamek, Ana Luisa K. Albernaz, J. Marcio Ayres†, Andrew J. Baker, Karen L. Bales, Adrian A. Barnett, Christopher Barton, John M. Bates, Jennie Becker, Bruna M. Bezerra, Júlio César Bicca-Marques, Richard Bodmer, Jean P. Boubli, Mark Bowler, Sarah A. Boyle, Christini Barbosa Caselli, Janice Chism, Elena P. Cunningham, José Maria C. da Silva, Lesa C. Davies, Nayara de Alcântara Cardoso, Manuella A. de Souza, Stella de la Torre, Ana Gabriela de Luna, Thomas R. Defler, Anthony Di Fiore, Eduardo Fernandez-Duque, Stephen F. Ferrari, Wilsea M.B. Figueiredo-Ready, Tracy Frampton, Paul A. Garber, Brian W. Grafton, L. Tremaine Gregory, Maria L. Harada, Amy Harrison-Levine, Walter C. Hartwig, Stefanie Heiduck, Eckhard W. Heymann, André Hirsch, Leandro Jerusalinsky, Gareth Jones, Richard F. Kay, Martin M. Kowalewski, Shawn M. Lehman, Laura Marsh, Jesús Martinez, William A. Mason, Hope Matthews, Wynlyn McBride, Shona McCann-Wood, W. Scott McGraw, D. Jeffrey Meldrum, Sally P. Mendoza, Nohelia Mercado, Russell A. Mittermeier, Mirjam N. Nadjafzadeh, Marilyn A. Norconk, Robert Gary Norman, Marcela Oliveira, Marcelo M. Oliveira, Maria Juliana Ospina Rodríguez, Erwin Palacios, Suzanne Palminteri, Liliam P. Pinto, Marcio Port-Carvalho, Leila Porter, Carlos Portillo-Quintero, George Powell, Ghillean T. Prance, Rodrigo C. Printes, Pablo Puertas, P. Kirsten Pullen, Helder L. Queiroz, Luis Reginaldo R. Rodrigues, Adriana Rodríguez, Alfred L. Rosenberger, Anthony B. Rylands, Ricardo R. Santos, Horacio Schneider, Eleonore Z.F. Setz, Suleima S.B. Silva, José S. Silva Júnior, Andrew T. Smith, Marcelo C. Sousa, Antonio S. Souto, Wilson R. Spironello, Masanaru Takai, Marcelo F. Tejedor, Cynthia L. Thompson, Diego G. Tirira, Raul Tupayachi, Bernardo Urbani, Liza M. Veiga, Marianela Velilla, João Valsecchi, Jean-Christophe Vié, Tatiana M. Vieira, Suzanne E. Walker-Pacheco, Rob Wallace, Patricia C. Wright, Charles E. Zartman
- Edited by Liza M. Veiga, Universidade Federal do Pará, Brazil, Adrian A. Barnett, Roehampton University, London, Stephen F. Ferrari, Universidade Federal de Sergipe, Brazil, Marilyn A. Norconk, Kent State University, Ohio
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- Evolutionary Biology and Conservation of Titis, Sakis and Uacaris
- Published online:
- 05 April 2013
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- 11 April 2013, pp xii-xv
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Cholera in Nineteenth-Century Europe: A Tool for Social and Economic Analysis
- Charles E. Rosenberg
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- Comparative Studies in Society and History / Volume 8 / Issue 4 / July 1966
- Published online by Cambridge University Press:
- 03 June 2009, pp. 452-463
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Economists have, in the past generation, become deeply concerned with the problem of economic growth. Of late years, as traditional economic models have demonstrated inadequacies, economists have become increasingly interested in the social and cultural inputs necessary for growth in economic productivity. Human, value-related factors, particularly education, role definition, and the place of science and technology, have taken a place beside the more traditional categories of the economist and economic historian. But these human factors, important though all admit them to be, are, especially in historical contexts, not usually amenable to quantitative methods of datagathering. It is difficult, on the one hand, to evaluate and sample such elusive factors, and on the other hand to define their precise role in social change.
Contributors
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- By Hideki Azuma, Susan Mary Benbow, Bettina Heike Bewernick, T. K. Birkenhäger, Hal Blumenfeld, Tom G. Bolwig, Stanley N. Caroff, Sidney S. Chang, Pinhas N. Dannon, Renana Eitan, Alan R. Felthous, Felipe Fregni, Gabor Gazdag, Nataliya Giagou, Mustafa M. Husain, Charles H. Kellner, Barry Alan Kramer, Galit Landshut, James Stuart Lawson, Bernard Lerer, Jerry Lewis, Dongchen Li, Colleen Loo, Michelle Magid, Stephan C. Mann, Limore Maron, W. Vaughn McCall, Shawn M. McClintock, Niall McCrae, Andrew McDonald, Nikolaus Michael, Paul S. Mueller, Alexander I. Nelson, Unnati D. Patel, Kathy Peng, Keith G. Rasmussen, William H. Reid, Joseph M. Rey, Barbara M. Rohland, Marina Odebrecht Rosa, Moacyr Alexandro Rosa, Oded Rosenberg, Peter B. Rosenquist, Thomas E. Schläpfer, Edward Shorter, Pascal Sienaert, Conrad M. Swartz, Kenneth Trevino, Gabor S. Ungvari, Walter W. van den Broek, Garry Walter, Julie A. Williams
- Edited by Conrad M. Swartz
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- Book:
- Electroconvulsive and Neuromodulation Therapies
- Published online:
- 15 July 2009
- Print publication:
- 02 March 2009, pp ix-xiv
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16 - Anesthetic Considerations for Orthopedic Trauma
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- By Robert M. Donatiello, Department of Anesthesiology, Hospital for Joint Diseases and Orthopedic Surgery, New York University Medical Center, New York, Andrew D. Rosenberg, Department of Anesthesiology, Hospital for Joint Diseases and Orthopedic Surgery, New York University Medical Center, New York, Charles E. Smith, Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
- Edited by Charles E. Smith, Case Western Reserve University, Ohio
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- Trauma Anesthesia
- Published online:
- 18 January 2010
- Print publication:
- 23 June 2008, pp 245-259
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Summary
Objectives
List the advantages of early fracture fixation.
Discuss risk factors and complications of orthopedic trauma including advanced age, obesity, intoxication, compartmental syndrome, positioning injuries, and fat embolism.
Evaluate anesthetic concerns for patients with hip fracture, pelvic injury, and traumatic spinal cord injuries.
Review the options for postoperative pain control after orthopedic trauma including patient-controlled analgesia (PCA), epidural analgesia, and peripheral nerve blocks.
INTRODUCTION
Almost 60 million people are injured in the United States annually, accounting for roughly one in six hospital admissions. There are as many as 148,000 deaths related to trauma each year in the United States [1]. Unintentional injuries were the fifth leading cause of death in 2004 [2]. The fund of knowledge gained from experiences and research work has given victims of trauma significant potential for survival. This is particularly so when considering orthopedic trauma and the anesthetic management of its victims.
This chapter breaks the surface of the choppy waters of orthopedic trauma anesthesia. By exploring the patients that present, and the scenarios by which they may be married to trauma, as well as concepts related to their care, the anesthesia practitioner may gain a new perspective on the management of patients who have suffered acute orthopedic injuries.
EARLY FRACTURE FIXATION
When assessing a multiple-injury patient, attention to all systems is in high order. Although acute cardiopulmonary, visceral, and neurologic trauma take precedence, it is of extreme importance that orthopedic injuries are fully evaluated (see Chapters 13 and 15).
Explaining Epidemics
- Charles E. Rosenberg
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- Published online:
- 29 March 2010
- Print publication:
- 28 August 1992
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Medicine has always had its historians; but until recently it was a history written by and for practitioners. Charles Rosenberg has been one of the key figures in recent decades in opening up the history of medicine beyond parochial concerns and instead viewing medicine in the rich currents of intellectual and social change of the past two centuries. This book brings together for the first time in one place many of Professor Rosenberg's most important essays. The first two sections of essays, focusing on ideas and institutions, are meant at the same time to underline interactions between these realms. The essays treat such topics as therapeutics and its relationship to social change in the nineteenth century; the practice of medicine in New York a century ago; and the rise and fall of the dispensary. The third section of the book focuses on the attempt to use history as a resource for discussion of a medical world that often seems out of control and in a semi-permanent crisis, economic, organizational, and humane. The essays discuss themes that have become visible to the public – deinstitutionalization of the mentally ill and the status of psychiatry; the hospital as a social and economic problem; and the social negotiations surrounding AIDS.
4 - Body and mind in nineteenth-century medicine: Some clinical origins of the neurosis construct
- Charles E. Rosenberg, University of Pennsylvania
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- Book:
- Explaining Epidemics
- Published online:
- 29 March 2010
- Print publication:
- 28 August 1992, pp 74-89
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Summary
Contemporary physicians often file the study of relations between body and mind under the rubric of psychosomatic medicine, a mid-twentiethcentury movement inspired by a self-conscious desire to counteract what its founders felt to be the profession's dominant mechanistic and reductionist tendencies. Yet interest in the relationship between body and mind is, of course, much older. Physicians have always assumed that emotional factors can induce sickness, undergird health, or – properly manipulated – bring about its restoration. The hypothetical mechanisms used to explain this interdependence have changed during the past few centuries, but the clinical reality they sought to explain has never been in doubt.
This essay was originally delivered as the Benjamin Rush Lecture to the American Psychiatric Association in 1988 – at a moment when the longtime domination of dynamic, intrapsychic models in psychiatry had waned, while somaticism had attained increasing prominence. I tried not only to suggest the antiquity of medical concern with the interaction of body and mind but also to underline a continuing and more general ambiguity. As we concern ourselves increasingly with individual lifestyle as a factor in the pathogenesis of chronic disease – in cancer and circulatory disease, for example, or alcoholism – we underline another aspect of mind: volition and thus responsibility. In that elusive and shadowy terrain between blaming and explaining, the relevance of body-and-mind relationships remains central, especially when we consider choice as well as stress.
5 - Florence Nightingale on contagion: The hospital as moral universe
- Charles E. Rosenberg, University of Pennsylvania
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- Book:
- Explaining Epidemics
- Published online:
- 29 March 2010
- Print publication:
- 28 August 1992, pp 90-108
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Summary
While collecting materials some years ago for a history of the American hospital, I became increasingly interested in Florence Nightingale – one of the few individuals who exerted a peculiar and indispensable influence on that history. At first that influence seemed as difficult to understand as it was undeniable; her ideas were typical of the accepted wisdom of her generation, but were anachronistic by the 1880s and 1890s. An explanation seemed in order. And that explanation, I became convinced, lay in her ability to invoke a language of shared moral and conceptual reference, to articulate a world-view that at once explained the hospital's present evils and demanded their reform. It was in some ways her power as rhetorician as much as her social position and skill in bureaucratic infighting that explained Nightingale's enduring influence in nursing and hospital reform. But her ways of thinking about the world are very different from those we have come to accept in the twentieth century. As in understanding traditional therapeutics, understanding Nightingale's social impact means taking ideas seriously, no matter how alien and even inconsistent they may seem (or in her case how transparently they express a seemingly self-serving and hegemonic vision of social control). It means seeing their ultimate consistency, their ability to function as an explanatory, monitory, and hortatory system. Only then can a historian begin to appreciate her ability to mobilize the sentiments of so many of her contemporaries.
Frontmatter
- Charles E. Rosenberg, University of Pennsylvania
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- Book:
- Explaining Epidemics
- Published online:
- 29 March 2010
- Print publication:
- 28 August 1992, pp i-vi
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1 - The therapeutic revolution: Medicine, meaning, and social change in nineteenth-century America
- Charles E. Rosenberg, University of Pennsylvania
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- Book:
- Explaining Epidemics
- Published online:
- 29 March 2010
- Print publication:
- 28 August 1992, pp 9-31
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Summary
Therapeutics has always been central to medical practice, but not to the practice of the profession's historians. My first teacher, Erwin H. Ackerknecht, once wryly cited by way of explanation the German saying that one should not mention rope in the house of the hanged; little glory was to be harvested from the annals of pre-twentieth-century therapeutics. It was more an occasion of embarrassment than of pride, largely ignored by historians except as a source of anecdote and as counterpoint to the laudable accumulation of effective knowledge in more recent generations.
I too could make little sense of traditional therapeutics when I first began to study medical history. Those of my teachers and contemporaries willing to take the older healing tradition seriously saw the physician's role as essentially consolatory and psychological; past therapeutic practices could then be construed as a mixture of ritual and placebo. Little serious attention was paid to the actual drugs and procedures that made up the content of practice – the cathartics, emetics, diuretics, bleeding, and the like – and to the way in which they were understood by patients, families, and practitioners.
Only gradually did the system begin to seem coherent – to seem in fact to be a system of social relations and shared conceptual frameworks. The ideas of both physician and patient had to be taken seriously, even if they seemed arbitrary and irrational in twentieth-century terms, in terms that is of measurable physiological efficacy.
II - Institutions and medical care
- Charles E. Rosenberg, University of Pennsylvania
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13 - What is an epidemic? AIDS in historical perspective
- Charles E. Rosenberg, University of Pennsylvania
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- Explaining Epidemics
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- 28 August 1992, pp 278-292
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Summary
Like the previous essay, this chapter was a product of the academic world's collective response to AIDS. More generally, however, I was intrigued by the challenge of trying to define and describe an epidemic. We have come to use the term so casually and metaphorically that I felt the logical way to think about the root meaning of epidemic was to see it historically, to create an ideal-typical picture of an epidemic based on repetitive patterns of past events. And in the following pages I have tried to abstract and present the narrative structure of an epidemic as historically experienced.
In some ways our generation's encounter with AIDS fits nicely into the dramaturgic pattern I suggest; in other ways recent events have evolved so rapidly that it does not. Within the space of a decade America's perception of AIDS as an acute, epidemic phenomenon has shifted subtly but inexorably: the social identity of this novel ailment has shifted into that of chronic and intractable illness, more akin to tuberculosis than cholera, leukemia than plague. In either guise, however, experience with AIDS has precisely reflected the varied realities that constitute the world's health care system as well as the social-structural and attitudinal factors that have interacted to create patterns of social response to the disease.
8 - Social class and medical care in nineteenth-century America: The rise and fall of the dispensary
- Charles E. Rosenberg, University of Pennsylvania
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- Explaining Epidemics
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- 28 August 1992, pp 155-177
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Like many of these chapters, this one was conceived in a moment of celebratory inadvertence – as a contribution for a symposium honoring Richard H. Shryock, pioneer historian of American medicine. I used the occasion to explore the rise and fall of the outpatient dispensary, an institution that had been central to the delivery of health care in America's growing cities – but which had been largely ignored by historians of medicine. I had first become aware of the dispensary's centrality – both to the medical profession and to urban working people – when completing research for Chapter 7, on mid-nineteenth-century New York. That essay emphasizes the pivotal interdependence between the internal history of the medical profession and the development of urban social institutions. But my interest remained latent as I worked on a variety of unrelated topics in the late 1960s and early 1970s. The focus of the Shryock symposium on social history provided an ideal incentive – and occasion – to pursue this relationship in another context.
To most mid-twentieth-century physicians, the term dispensary evokes the image of a hectic hospital pharmacy. To their mid-nineteenth-century counterparts, it was both the primary means for providing the urban poor with medical care and a vital link in the prevailing system of medical education. These institutions had an effective life span of roughly a hundred years.
Acknowledgments
- Charles E. Rosenberg, University of Pennsylvania
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12 - Disease and social order in America: Perceptions and expectations
- Charles E. Rosenberg, University of Pennsylvania
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- 28 August 1992, pp 258-277
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Written for a conference on AIDS in the mid-1980s, this essay was intended to place a contemporary crisis in historical context. Although AIDS provided an occasion, the argument reflected a longstanding prior concern. This was my effort to understand differences among the old left of the 1930s, 1940s, and 1950s, the no-longer-so-new left of the late 1960s and 1970s, and the less self-assured critical spirit of the 1980s. The older generation shared a faith in the ultimate and unambiguous benefits of science and technology in a just society; their children accepted a parallel yet opposed certainty. They regarded the presumptive benefits of scientific progress as necessarily illusory and imprisoning – and many of its fundamental conceptions as no more than arbitrary social constructions.
The history of AIDS demonstrates the inadequacy of either species of certainty. There were no one-dimensional answers. AIDS could hardly be dismissed as an exercise in stigmatizing the deviant; it obviously had a strong biological component. It was not simply a construction even if it had been constructed. Yet at the same time nothing marked the epidemic more starkly than its ability to evoke and reproduce preexisting social values and attitudes. The diversity and complexity of reactions to AIDS has underlined the need to look carefully at the elusive process through which society constructs its reponse to disease. And we know that there will be no simple and formulaic answers; in the 1990s they are neither intellectually available nor politically compelling.
2 - Medical text and social context: Explaining William Buchan's Domestic Medicine
- Charles E. Rosenberg, University of Pennsylvania
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- 28 August 1992, pp 32-56
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One can make a strong case for William Buchan's Domestic Medicine being the most widely read – nonreligious – book in English during the half century following its Edinburgh publication in 1769. Certainly it was the most frequently reprinted medical treatise in Britain and the United States. Its pages illustrate with particular clarity the shared knowledge and assumptions that bound professionals and lay people together in a community of ideas and healing practice. Buchan concedes the reality of lay practice and the widespread distribution of medical knowledge, yet seeks to define a special role for the credentialed physician.
I had long felt a bookshop browser's interest in Buchan's treatise; it was the only pre-1850 medical text that one was almost certain to find in the “old medical” section of any used or rare bookshop. But when I began my academic work in the early 1960s, it had not seemed an appropriately dignified subject for research. After writing the previous chapter on traditional therapeutics in the mid-1970s, however, I began to think more systematically about the day-to-day aspects of Anglo-American medical care and Buchan seemed an obvious place to start. A growing interest among professional historians in popular ideas and world-views also made the Edinburgh physician's effort to improve “domestic medicine” a potential tool for use in evaluating the relationships among high, low, and middle orders. Material that had seemed marginal – quaint and anecdotal – when I began graduate school in the late 1950s had gradually become acceptable, even exciting to a growing number of professional historians.
14 - Explaining epidemics
- Charles E. Rosenberg, University of Pennsylvania
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- Explaining Epidemics
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- 28 August 1992, pp 293-304
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This essay is intended to serve as a companion piece to Chapter 13, which sought to describe an archetypical pattern of response constituting the historical phenomenon we have come to call an epidemic. That chapter generalized about events; this generalizes about modes of explanation. It suggests that there are two fundamental styles of explanation that have been conceptually “available” since classical antiquity – materials with which to construct the reassurances demanded by an epidemic's otherwise apparently random incursions. I have chosen to label these alternative styles contamination and configuration.
There is always a danger in creating such general categories; lumpers versus splitters, hedgehogs versus foxes, vitalists versus mechanists – few individuals fall neatly into one ideal type or the other. Yet such categories remain valuable as analytical tools for the historian; and I argue in the following pages for the analytic relevance of the configuration – contamination alternatives. Although rarely articulated in pure form, these styles of explanation have served in a variety of mixtures and dilutions to provide hypothetical etiologies for successive generations of physicians and laypersons. Modern-day descendants of these styles of explanation remain viable – as we have seen in our past decade's experience with AIDS.
An epidemic is almost by definition frightening; numbers of unfortunates are seized with grave illness, one after another exhibiting similarly alarming and alarmingly similar symptoms.