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Hospitals which opt out of the National Health Service could well consider making a proportion of their money by using their facilities and patients for drugs trials purchase 500 mg mefenamic free shipping. Spurred on by two deaths in 1984 purchase mefenamic 500mg line, the Royal College of Physicians produced a report entitled Research on Healthy Volunteers in 1986 buy mefenamic 250 mg cheap. Many critics of scientific medicine believe that science and its needs should never take precedence over the rights of the sentient human being. They argue that one of the most fundamental human rights is the right not to be subjected unwittingly to experimentation. Another basic right is that, on turning to a doctor, a sick person should receive the most proven, effective and available treatment. The operation for the removal of a breast is called a mastectomy; one of the surgical alternatives to mastectomy is lumpectomy in which only the tumour and surrounding area is removed from the breast. Shortly after her operation, Evelyn Thomas noticed that the woman in the bed next to her, who had been through a similar operation, was being treated with a different regime. It took Evelyn Thomas four years to find out that she had been included without her consent in a trial, and a little longer to find out the full details of the trial, the treatment she had been given and the treatment she had been denied. The randomised trials of which Evelyn Thomas had been a part were initiated in 1980 by the Cancer Research Campaign, under the auspices of Professor Michael Baum. Translated, this means simply that the trials were looking at supportive treatment following breast cancer surgery. Besides the granting and denial of counselling, two hormonal drug therapies, Tamoxifen and Cyclophosphamide, were given to the different trial groups. The trials involved 2,230 women at thirty hospitals across the country between 1980 and 1985. The progress and condition of one group of women who were given the different treatments singly or in combination with or without the counselling, were compared with the condition and progress of another group who were given no adjunct treatments at all. When Evelyn Thomas read about the results of the trial in 1986, it confirmed her suspicions that she had been part of a randomised trial. I placed absolute trust in those treating me and assumed our relationship was based on openness and frankness. Actually patients at that time had their treatment determined by computer randomisation. My rights to have information and to choose, and my responsibility for 6 my own body were denied. The defence of those who had experimented on Evelyn Thomas without her consent was weak. However, after a nurse counsellor pointed out that some patients became distressed when faced with the uncertainty of having to choose their treatment, informed consent was waived for all trial subjects who passed through the hospital. The trial administrators had been against allowing informed consent but had found themselves compelled to compromise with the Hospital Ethics Committee. The raising of this complex and worrying issue on the eve of an awesome operation, threw most women into a state of immobility and confusion. When the poor results of trial subject selection were brought to the attention of the Hospital Ethics Committee, they withdrew their demand for informed consent. Only six years previously, Baum had entered his patients into the trial without obtaining their informed consent. In the same letter to the Observer, Baum complained that the paper used a photograph of him which made him look like Mussolini. Richmond, who made clear her friendship with Baum, argued in favour of science and randomised clinical trials, while at the same time failing to address the matter of informed consent. When Evelyn Thomas found that she had been used as a guinea pig, she complained to the South East Thames Regional Health Authority. The complaint was dealt with by professional medical and health workers, whose system of complaints investigation makes the Police Complaints Authority look like something from the Magic Roundabout. Her case was reviewed by two assessors, a cancer specialist and a consultant surgeon. The cancer specialist who oversaw the complaint was a close colleague of Baum, and another future member of the Campaign Against Health Fraud, Professor Tim McElwain. Unsurprisingly, the professional review found that Evelyn Thomas had been treated in a correct and professional manner. Despite a number of deaths which have occurred as a consequence of uninformed - - trialing " " throughout the eighties, attempts to change medical research methodology have not been completely successful. It In 1982, an 84 year old widow died after having been involved in a secret randomised trial, in 13 Birmingham. In 1983, another trial patient died; the woman had been reluctant to take part in 14 the trial. Carolyn Faulder accepted the invitation to join the working party, thinking that she could make a real contribution to the debate about informed consent. Besides Professor Baum, the Working Party on Breast Conservation included some of the most influential heavyweights of - the cancer industry. Over the five years that she remained a member of the committee, however, she became increasingly uneasy about the reality of informed consent and her use to the committee. More than anything else, her involvement as a well-known woman writer and adviser appeared to fulfil a useful public relations role for the doctors, who did not appear that interested in changing their own ideas about the scientific method. After 1983, and the article, the feeling in the working party became hostile to her, with disagreements being expressed about her criticisms of doctors, both inside and outside the group. For her part, Carolyn Faulder had become so concerned about information coming to light during her ongoing research into informed consent, that she began work on a book. After just over a year, with only 160 women signed up for the trial, the administrators were forced to close it down. With the trial closed down, the working party also became imperilled because its sole job had been to work out protocols for the trial. As far as Carolyn Faulder was concerned, the working party could not close down a minute too soon. By late 1984, some members of the working party had all but stopped speaking to her. Carolyn Faulder had been recruited to the working party to introduce the subject [informed consent] to the National Press, it would seem that a 17 disproportionate emphasis was now being placed on the issue. It crossed her mind that this may have been the role the group had in fact wanted her to perform. Before the working party was closed down in early 1985, Carolyn Faulder forced an apology and a retraction of the minuted remarks. The atmosphere had become so bad that she felt she was being deliberately ignored. In 1986, Carolyn Faulder was able to redress the balance in the case of Evelyn Thomas, by helping to get her case made public. Even then, it was not until 1988, six years after she was the subject of the trial, that her case was taken up by Adam Raphael and became a real issue of concern. Chapter Thirty One The Campaign Against Health Fraud, Part Three: The Players and the Game, 1989-1991 Quackery is practiced not only by barkers at carnivals, but also by men with doctoral degrees who are members and officers of prestigious medical-scientific organizations and who are shielded from detection and criticism by such organizations, by public officials, and by 1 governmental, corporate and organizational secrecy and public relations. The Players Those who represented the core of the Campaign Against Health Fraud at its formation in 1989 remained involved over the next two years; others pulled in on the fringe soon drifted away. An initial statement from the Campaign about funding suggested that it was largely funded by individual subscriptions which stood at £12 per annum. The claim that individual members were paying for the Campaign was similar to that made by the American Council Against Health Fraud. It might strictly have been true, but as the majority of the early core activists had some financial connection with Wellcome, as well as other companies, or worked in projects funded by the pharmaceutical industry, the exact source of their corporate funds is relatively unimportant. Other granting bodies included medical insurance companies and other pharmaceutical companies. Professor Michael Baum worked at the Royal Marsden Hospital which was joined to the Institute of Cancer Research where Dr Robin Weiss had developed testing kits with Wellcome. In 1990 at the same time as he took up a position at the Institute of Cancer Research, Michael Baum became clinical advisor to Breakthrough, a cancer charity which is raising money for a Breast Cancer Centre at the Royal Marsden Hospital. The Centre will be 2 staffed by, amongst others, a team of eight Wellcome-funded scientists. Professor Harold Baum with two other medical scientists received a large grant from Wellcome in 1985. Dr Iain Chalmers was running the National Perinatal 3 Epidemiology Unit, which was hugely subsidised by Wellcome.
This is the polar opposite of multijoint muscles typically serve a mobilizer domi- naturopathic objectives generic mefenamic 500mg free shipping. Summary Outer unit sling systems In summary cheap 500mg mefenamic fast delivery, as a basic model discount 250 mg mefenamic overnight delivery, the earliest movement Examples of key mobilizer systems (commonly termed patterns based on the known major body plans were ‘sling systems’), which are also critical in providing (particularly dynamic) stability, include: 3To read further around the ontogenetic development mimics phylogenetic development, see Wisdom of the Body Moving by • posterior oblique sling Linda Hartley (1995), Amazing Babies by Beverly Stokes • anterior oblique sling (2002) and related texts. Chapter 9 • Rehabilitation and Re-education (Movement) Approaches 339 that of radial contraction. Radial contraction is also known Willard (1996a–c) explains that once a sensitization as a precursor to movement in the human organism, has occurred at a spinal segment, that facilitation can such as the transversus abdominis feed-forward be maintained by just a very mild afferent input to the mechanism (Richardson et al 1999). Singular radial cord (and can perpetuate for several days after the contraction and expansion may initially have devel- initial stimulus has gone due to plastic changes within oped as a primitive means of phagocytosis. Such sensitization will become more ‘plastic’ the longer the sensitization is maintained. This 2 or 3 months of pain (and cumulative afferent drive to movement pattern eventually combined forward the cord), that person may consult a therapist for movement with digestion, where previously diges- treatment. At this point, even if the therapist were able tion was bidirectional and therefore would have com- to ‘magic’ the tissue trauma away, the patient would promised attempts at forward movement. Equally, contraction clearly requires a nervous system to if that patient were to start to feel better and so use orchestrate it, leading to the advent of chordates. To Hence, the focus should not be on the symptomology, prevent the body from telescoping in on itself, a rigid but on a return to function. This takes the focus away from the dimensions is not optimally controlled across the 4th symptomology and concentrates it on the etiology dimension of time. This is clearly in line with ance or dysfunction in any of the three movement naturopathic principles as outlined in Chapter 1. While this approach may be time- effective and is not un-useful, it does mean that pre- Muscle imbalance physiology scription of treatment – corrective stretching, corrective mobilization, corrective exercises and other nutrition Muscle imbalance physiology was ﬁrst described by and lifestyle advice – may be somewhat non-speciﬁc. Muscle imbalance was mainly embraced progress is difﬁcult to gauge with such subjective by the physiotherapy community, though in recent approaches. Nevertheless, this pain patients, it is critical to provide a focus on return- author considers identiﬁcation and correction of ing function as opposed to getting rid of dysfunction. This means that a patient can make great strides Perhaps one reason for the decline in interest in towards a return of function, yet may still have a muscle imbalance is that, as with nearly all clinical similar symptom proﬁle. This phenomenon may be entities, to ﬁnd a ‘textbook’ case is less common than explained neurophysiologically through the process ﬁnding a partial case. When under stress, the body will migrate to its Fast twitch preponderance Slow twitch preponderance position of greatest strength – which is why Fatigue early Fatigue late dynamically loading the patient can help to identify dysfunctional postural patterns. This subjective assessment approach provides Mobilizer dominance Stabilizer dominance little incentive for the patient to perform prescribed corrective exercises – especially in Superﬁcial Deep the absence of pain. Outer unit Inner unit In Chapter 4 there is some discussion of what con- Global stability Local stability stitutes ‘dysfunction’ of a somatic tissue and the point is made that pain does not have to present for a tissue Multi-articular Mono-articular to be dysfunctional. Hence, it is entirely possible that Lengthen/weaken Shorten/tighten a patient may attend with a muscle imbalance (which represents a biomechanical dysfunction) yet have no pain. Nevertheless, any muscle imbalance disrupts the optimal axis of joint motion (a spatial or three- we may be able to see improvement – even though dimensional dysfunction) which will, over time, result the patient may be able to feel little difference. The fore, the means to assess joint position, joint range of point at which the sufferer feels pain is the point at motion and length–tension relationships objectively is which the rate of damage exceeds the rate of repair critical, in order to manage patients effectively and (see Fig. Interestingly, even among these experts, there load it is useful to have, at the very least, a Swiss ball, was still some confusion regarding muscle classiﬁca- but ideally a cable column and a squat rack with tion. So, under tradi- Cranz 2000, Janda 1978, Williams & Goldspink 1973, tional practice, we are only left with observationally 1978). After stretching the facilitated lumbar erector assessing the condition then treating and making (thereby inhibiting it), it would no longer ﬁre with the exercise recommendations to the client, which, in rectus abdominis during the sit-up maneuver (Janda itself, has some serious shortcomings. This approach depends on a very subjective it can create disrupted function at a range of joints (in assessment – which is wide open to bias. Chapter 9 • Rehabilitation and Re-education (Movement) Approaches 341 c b a d e Figure 9. It is not uncommon to hear that a those over 65 years of age (Chek 2004b); hence a therapist works with a mainly elderly population, naturopathic approach is surely to prevent such falls. Swiss ball training can condition the tilting reﬂex – In fact, the therapeutic truth is that, if a given individual something moving under the body. This is technically is unable to sit on a Swiss ball (with three bases of what happens when the interface between the ice and support) then, theoretically, they should not be able to sole of the shoe meet – the water on the surface of the stand (two bases of support) and certainly should not ice moves and the foot slips over it. Therefore, Swiss be able to walk (one base of support for 80% of the ball conditioning is ideal for training fall prevention in the gait cycle). To walk, therefore, is far more neurologically elderly in a slippery (tilting) environment, whereas a demanding than sitting on a Swiss ball. In fact, clinical experience suggests 342 Naturopathic Physical Medicine that it is extremely rare in the symptomatic popula- ment syndromes and/or capsular instabilities (see tion to ﬁnd any patient that does not exhibit at least Fig. Upper crossed syndrome, like lower crossed syn- Lower crossed syndrome (see Chapter 6, drome, is essentially a gravity pattern. This is also known as Muscles that are commonly considered to be short a pronation pattern. At the • Supra- and infrahyoid group lumbar spine, lordosis is enhanced, meaning that the • Middle and lower ﬁbers of trapezius low back is held in relative extension. Across time, this will lead to increased microtrauma, The classic osteokinematic coupling of an upper instability and pain in the hip joint, predisposing to crossed syndrome is a forward head posture (ventral degenerative change. Interestingly, lower crossed cranial glide), an increased 1st rib angle (dropped syndrome is more frequently observed in women – sternum), protracted shoulder girdle, ﬂexed cer- which may help explain the higher incidence of hip vicothoracic junction and an increased thoracic problems in elderly women (Baechle & Earle 2000). Since lordosis is increased in the lumbar spine, greater Arthrokinematically, this means that the cervical loading is placed through the facet joints (see discus- lordosis tends to ﬂatten with a compensatory hyper- sion below under ‘Neutral spine philosophy’), extension in the upper cervical spine to maintain the meaning that they are more prone to cumulative eyes on the optic plane (horizon). Spinal pathologies, such as spon- rib angle creates a ﬂexion stress onto the 1st thoracic dylolysis, spondylolisthesis, foraminal stenosis and vertebra rotating it forward into sagittal ﬂexion – with spinal stenosis, are more common in the extended the potential end result being a ‘dowager’s hump’. The dropped sternum means that the ribs are held in a ﬂexed or ‘exhalation’ position. This may be prob- lematic for those with athletic requirements or with Layered syndrome breathing disorders. With the rib cage in exhalation, Muscles commonly considered short and tight in the the thoracic spine moves into sagittal ﬂexion and, layered syndrome are as follows: across time, may develop an extension restriction due • Hamstrings to contracture of the anterior longitudinal ligament, • Gluteus maximus among other structures. The protraction of the shoul- ders, with or without thoracic extension restriction, • Thoracolumbar erectors disrupts the optimal instantaneous axis of rotation of • Upper ﬁbers of trapezius the glenohumeral joint, and may result in impinge- • Suboccipitals. From the left: optimal posture, layered syndrome, layered syndrome with a sway, lower-crossed and upper crossed syndromes, lower and upper crossed syndromes with a sway Muscles commonly considered to be long and weak workplace. This may hold very little truth, but also in the layered syndrome are as follows: should be put into the context of evolution. Since chairs are known to have been used since 8000 bc • Hip ﬂexors (rectus femoris and iliopsoas) (Cranz 2000) and it takes somewhere in the region of • Lumbar erectors 100 000 years for the human genome to change by • Thoracic erectors 0. Osteokinematically, the pelvis is posteriorly tilted, How the body does adapt is by changing its length– and the lumbar spine is ﬂat with extension at the tho- tension relationships about the pelvis and trunk, the racolumbar junction leading into a thoracic kyphosis most common clinical adaptation being one towards and forward head posture. As the rib cage approximates the posture of the upper quarter is very similar to – and, in pelvis, so the anterior oblique slings (of anterior inter- some cases, indistinguishable from – an upper crossed nal oblique ﬁbers through the linea alba to the contra- syndrome (see Fig. Reciprocally, the lumbar erector group will held in relative extension (and therefore may feel and be held in a lengthened position. Consequently, this posture is commonly a laying down of sarcomeres in a muscle that is held associated with lumbar disc injury clinically. Another example is the ofﬁce worker who likes to Term Deﬁnition spend her weekends playing hockey. She must train her body to survive the relentless load of gravity on Creep The slow movement of a material that her back and neck during her seated work hours and becomes viscous due to shear stresses still be well conditioned enough to not ‘crash’ her Stiffness A material’s resistance to deformation biomechanics when she suddenly takes on the highly competitive unpredictable environment of the hockey Strain The amount of deformation that occurs pitch at the weekend. In most ball sports this is an early skill to be that does not retrace the force–length taught as a prerequisite to moving the feet quickly in tension curve traced when the force was response to the opposition’s play. It is the energy lost from the and habitual use of this stance, result in quadriceps tissue during this transaction dominance and a whole host of common sports inju- Elasticity The property of a material to return to its ries associated with such a posture – such as anterior original form or shape when a deforming cruciate ligament injury, meniscal tear, Achilles injury force is removed and plantar fasciitis (Wallden 2007). Hence, in condi- Viscosity The measure of shear force that must be tioning to survive his sport, such a sportsman must applied to a ﬂuid to obtain a rate of use movement patterns and loading that help to deformation. In the the context within which the naturopathic triad is past, this potential difﬁculty has be circumnavigated embraced.
Pinching also agreed to look at a protocol for a trial of Ayur-Vedic treatment which Dr Davis was then working on discount mefenamic 500 mg without a prescription. Pinching replied in December and from then on Davis and Pinching exchanged letters for well over a year buy discount mefenamic 500mg on-line. He did cheap 500 mg mefenamic fast delivery, however, suggest that he go to the voluntary sector organisations and obtain their help in drawing patients into the trial. For the links between Professor Robin Weiss and the Wellcome Foundation see Chapter Twenty Three. For the links between Wellcome and the Institute of Cancer Research see Chapter Thirty Six. Davis met with very little direct opposition from the orthodox doctors and research scientists he approached. In fact there appeared, superficially at least, to be a tolerable equanimity about the advice that he was proffered. I became very superficially familiar with Ayur-Vedic medicine when I worked in Kerala in 1961/62. Secondly, he understood that any trial of Ayur-Vedic medicine and its protocols should really dovetail into other trials. Questions about other treatments in the case of opportunist infections and the avoidance of other medications while on the trial were far more likely to be resolved, within the more formal environment of the National Health Service than they would be working with a small voluntary cohort which was drifting between other agencies and treatments. At that time, Frontliners still had a section which dealt with alternative medicines. Despite such wildly optimistic ideas, as 1988 wore on, it was becoming clear to Davis that interest in alternative treatments was quickly waning. An antipathy towards independent non-orthodox practitioners was beginning to seep through the voluntary sector. Having made little progress in his attempts to get practical help within the National Health Service, Davis helped establish the Disease Free Society Trust. One sponsor gave £10,000 to help set up the Trust, and with other money the Trust came to be worth £15,000. From the beginning he had been advised by those he had written to, that the estimated cost of a study involving twenty patients would be in the region of £100,000. He had continued to revise his protocols throughout 1988 and the first month of 1989; he continued as well, to send these to a variety of people, for criticism and support. Dr Weir came closer than any of the other doctors contacted to playing a part in the trial. Having suggested that the Ayur-Vedic treatments should be tested for toxicity, and such tests having been incorporated in the study, Dr Weir agreed to act as an observer and attended a number of consultations. Apart from a lack of money, there was one problem with the protocols and the trials which kept cropping up. It was pointed out by a number of advisors that they might have difficulty in separating out the cause and effect of the different aspects of the study. Some purists also thought that it could be a problem that Davis would not allow a placebo control group because he considered it unethical to refuse treatment to patients. This perception of ethics was quite the opposite of that held by many orthodox medical investigators, who thought that a trial was only ethical if it included a randomised placebo control group the members of whom went untreated. In February 1989, having found some funding and sought as much professional help as was humanly possible, Dr Davis began the trial. It was originally intended that some twenty patients would be treated for a year, free of cost. In the end, however, patients were treated for a varying length of time, all less than the intended period. Some patients continued to be treated free, one made an initial contribution of £100, one paid £160 a month, while two further patients agreed to pay £80 a month, half way through the study. The Trust was buying the made-up treatments from a company in Switzerland at about £180 to £200 a month. There is no doubt that the trials did not go well and because Davis lacked finance he was forced to restrict the number of patients on the trial to six. In fact Pinching had said that when there was a conflict between a trial and treatment, you have to devolve into treatment. If the protocol says that the patient should only have treatment A but at some point in the trial it becomes apparent that they would benefit from treatment B, then you have to give them 39 treatment B. By the beginning of 1989, the reaction against natural medicine was gathering pace. During the course of setting up the Trust, Davis met Dietmar Bolle, one of the early members of Positively Healthy. The gathering antagonism towards alternative treatments did not initially bother Davis. He did not see it as an organised response and after all he was fairly used to scepticism, even ridicule. Dietmar Bolle continued to support him and wrote a favourable article for the Body 42 Positive Newsletter. This therapy is based on Ayur-Veda, the ardent health system of India, a natural and holistic approach. The article centred mainly upon Dr Deepak Chopra, the most prominent theoretician of Ayur-Vedic medicine, who works in America. At the end, however, the article carried an advertisement for the clinical trials being carried out by Dr Davis of the Disease Free Society Trust. Davis was worried about this serious inaccuracy and wrote to the Sunday Times to correct the mistake. Duncan Campbell tried frequently and a Dr Dominik Wujastyk from the Wellcome Institute for the History of Medicine, also called his answering service. By the summer of 1989, Davis was refusing to return phone calls which came from anyone connected with Wellcome. He was convinced that he had been targeted by them and they were spreading misinformation about him. After a flyer was sent out to some 2,000 people on the Body Positive mailing list, advertising the seminar, the Trust received a phone call from Campbell. They were frightened, they said, of an article that a journalist was about to write. Next, Davis heard that the Terrence Higgins Trust would picket the seminar if it was held. Following the seminar, Davis received a letter of complaint ostensibly from the Terrence Higgins Trust but most probably, he thought, written by Duncan Campbell. Hamid also failed to tell Davis the real reason that she had requested herbal preparations from him. In August 1990, Campbell published his first serious attack upon Davis and Chalmers, in 44 the Independent on Sunday. As a qualified doctor, Davis had always been adamant that any such diet should be individually suited to the health status of the patient. There were also dietary guidelines based on the type of imbalance which was presented. This page-long article included a paragraph deriding Dr Davis and Dr Chalmers and their adherence to Ayur-Ved. Appearing before the Professional Conduct Committee of the General Medical Council is perhaps one of the worst things which can happen to a doctor, second only to being found guilty and being struck off. Doctors are on the whole only brought before the Committee on serious and substantial charges and only found guilty when there is irrefutable evidence. Being struck off, signals the end of years of training and experience and shatters a professional career. As was to be expected, the witnesses for the prosecution were men who believed unerringly in orthodox medicine. Even from the lay point of view, it is clear that in the case of Davis and Chalmers, we are not dealing with doctors who have broken the criminal law; they have not sexually assaulted patients nor prescribed poisonous or illegal substances. Only one of the charges related to a specific patient and it might be said that it was this charge which was the most substantial.
These tuitions cover all and graduate portions of their education stu- normal charges generic 250mg mefenamic overnight delivery. Living expens- remaining years will be assessed annually es generic mefenamic 250mg visa, health insurance generic 500 mg mefenamic with amex, a $200 imaging fee for at the M. Alterna- matriculation fee are in addition to the tuition tive schedules for payments at the M. Tuition is prorated to Special schedules for payment of fees can be period of enrollment. There is a $25 annual fee for Student in Students will not be admitted to the regu- Residence status. Offce of the Registrar of the School of Medi- Candidates cine and arranged for payment of their fees for the frst half of the academic year. Regis- Tuition for each 12 month period (September- tration is not required for the second half but August) of enrollment will be at the rate estab- arrangements must be made for the payment lished by the University for Ph. 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The Committee on Student Awards received from the Henry Strong Denison Med- will determine the winner after careful study ical Foundation, Incorporated, an endowment of essays and papers submitted by the stu- fund of $100,000, to be known as The Henry dents. The work must be original and must Strong Denison Fund for Medical Research in have been performed during a period in memory of Henry Strong Denison, M. The Lamport arships to students of the School of Medicine Fund will support the effort of medical stu- considered by the committee to give promise dents interested in research in the basic sci- of achievement in research. Lamport contributed to research in physiol- of the directors of departments and not upon ogy, biophysics and circulation. Straus, former asso- the renal afferent and efferent arteriolar resis- ciate professor of anatomy and Acting Direc- tances in relation to kidney function in health tor of the Department of Anatomy. National Mental Health Association, is to Franklin Paine Mall Prize in Anatomy The encourage research by students in the Johns income from an endowment account estab- Hopkins University School of Medicine and lished by Dr. Wesson, an alumnus of the Johns Hopkins University School of Pub- the School, is used as an award for a deserv- lic Health into any aspect of mental illness ing student particularly interested in anatomy. Selection is made by the First Year composed of the Chairman of the Depart- Committee on Student Promotions. Trimakas Award in Cardiovascular The Chairman of the Department of Men- Research This award was established by tal Hygiene of the Johns Hopkins School of contributions from the Class of 1979 to honor Public Health, or persons they designate, the memory of their classmate who died on and Dr. Tri- dent must submit a letter to the chairman makas’ intentions to pursue a career in aca- of either department stating the amount demic cardiology, for which he had shown requested and the reasons for the request, exceptional ability, this award will be given with a supporting letter from a faculty mem- to a medical student who has demonstrated ber. Requests will be received and reviewed unusual promise in the area of cardiovascular at any time. The award will be made during the or the total multiple grants to any one person, third year for a student planning an extended shall not exceed $500. Leo Kanner Student Research Fund was The recipient of this award will be selected established in 1982 by Mrs. June Kanner to by a committee representing the Cardiovas- encourage medical student research in child cular Division of the Department of Medicine. Kanner, the frst professor of Applications should be admitted to the direc- child psychiatry at Johns Hopkins, was divi- tor of the division. Income Outstanding Profciency in Pediatrics This from the fund is used to provide a student award was established by the Alumni/ae of in the School of Medicine the opportunity to Dr. Harold Harrison’s Residency Program participate in a summer research project with in Pediatrics at the Francis Scott Key Medi- a Child Psychiatry faculty member. Saltzstein Prize for Medical Writing the outstanding contributions made by the This prize was established in 1990 through Harrisons over the many years of their ten- an endowment provided by the family of Dr. Saltzstein was the founder of Sinai dents whose efforts in pediatrics have been Hospital of Detroit as well as its frst Chief of distinguished. He founded the Bulletin, Sinai Hospital Sylvan Shane Prize in Anesthesiology and of Detroit and ultimately became its editor. Sylvan Shane, a He maintained a life long interest in medical member of the Department of Anesthesiology writing. Sidney Saltzstein, and Critical Care Medicine at Johns Hopkins graduated from the Johns Hopkins University from 1980 to 1984, has created an endow- School of Medicine in 1954. This annual prize ment to recognize an outstanding medical will recognize excellence in medical writing student making a career choice in anesthe- by a student of the Johns Hopkins University siology. Thoroughness and Johns Hopkins University School of Medicine originality of research are to be primary con- does not offer stipends for summer research siderations in the selection of awardees.
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