The Outpatient Endovascular & Interventional Society (OEIS)-The Voice of Advocacy for the OBL: Origins, Principles, and Historical Perspective.

The physician office offering imaging guided endovascular and minimally invasive interventional procedures is often referred to as an OBL (office based lab), OIS (office interventional suite), or OES (office endovascular suite). Initially, OBL's depended upon the national societies of interventional radiology (SIR), vascular surgery (SVS) and interventional cardiology (SCAI) to advocate for them. However, the OBL space needed a voice dedicated to advocating for the appropriate reimbursement of procedures in the OBL to allow the OBL to survive as a viable site of service and become integral to healthcare delivery in the US healthcare system. This need led to the formation of the Outpatient Endovascular & Interventional Society (OEIS). The society is multispecialty and ensures safety in outpatient care in all sites of service while maintaining a focus on the OBL. The mission of the OEIS is to advocate for patients to have the ability to choose their provider and be able to receive safe and effective healthcare in a more friendly and far less costly site of service for them.

Jules Stein, MD: Ophthalmologist, Entertainment Magnate, and Advocate for Vision.

PURPOSE: To report the lifetime activities and accomplishments of Jules Stein, MD. DESIGN: Retrospective review. METHODS: Assessment of published and unpublished biographical material. RESULTS: Jules Stein combined his love of music and medicine with organizational skills to achieve successive careers as a musician, an ophthalmologist, an entertainment magnate, and an advocate for vision. To preserve vision, he founded Research to Prevent Blindness, founded the Jules Stein Eye Institute at the University of California, Los Angeles, and led a multiyear campaign to establish the National Eye Institute. CONCLUSIONS: With successive careers and extraordinary achievements, Jules Stein created an enduring legacy of benefits to ophthalmology, vision research, and the prevention of blindness.

Cancer research advocacy: past, present, and future.

In this article, we present a brief history of cancer advocacy and discuss the variety of ways advocates have become involved in cancer research and subsequently present principles that establish a framework for successful research advocacy based on a review of many early initiatives coupled with our knowledge as long-time cancer advocates. Challenges to effective advocacy are described, and recommendations for increasing meaningful contributions by research advocates are proposed. The purpose of this article is to discuss the exciting field of research advocacy and to help shape a more productive future for advocates and their scientific collaborators.

Ill patient, public activist: Rose Kushner's attack on breast cancer chemotherapy.

In 1984 the noted breast cancer activist Rose Kushner published a controversial article, "Is Aggressive Adjuvant Chemotherapy the Halsted Radical of the '80s?" In it, she argued that chemotherapy was being used as indiscriminately as the radical mastectomy had been, before she and others had successfully discredited the disfiguring operation. As with all of Kushner's writings, this article raised valid points in an informed and provocative style, but her attack on chemotherapy was more one-sided than was typical. This may have been due to the highly personal nature of the topic: when she was diagnosed with recurrent breast cancer, she had declined chemotherapy in favor of a hormonal agent, tamoxifen. She also developed a close working and financial relationship with the manufacturers of tamoxifen. Although not seen as a problem at the time, Kushner's dual roles as patient and advocate for a particular treatment foreshadowed conflict-of-interest issues that would take center stage in medicine in subsequent decades.

Science is not sufficient: Irving J. Selikoff and the asbestos tragedy.

Professor Irving J. Selikoff (1915-1992) was America's foremost medical expert on asbestos-related diseases between the 1960s and early 1990s. He was also well known to the public for his media appearances on the burgeoning asbestos problem. Yet his reputation has been strikingly mixed. On the one hand, he has been portrayed as a mischief maker and irresponsible demagogue, who exaggerated the risks of asbestos and so destroyed an industry; on the other, as a pioneer in asbestos epidemiology, whose landmark studies of insulation (and other) workers demonstrated the severity of a modern occupational and public health tragedy. Drawing upon unprecedented access to the Selikoff archive at Mount Sinai Hospital in New York City, this article demonstrates that the most serious criticisms of Selikoff are either ill-founded or simply false. It also shows that Selikoff, in the highly politicized world of asbestos science, was a far more complex and conservative individual than previous studies have suggested.

The history of breast cancer advocacy.

There have been four key steps in the advent of breast cancer advocacy: priming the market, engaging consumers, establishing political advocacy, and taking the advocacy mainstream. Breast cancer was surrounded by secrecy until the 1980s, when brave individuals such as former First Ladies Betty Ford and Nancy Reagan, and founder of the Susan G. Komen Foundation, Nancy Brinker (Susan Komen's sister), began speaking publicly about the personal impact of the disease, which increased awareness of breast cancer and made it more acceptable to talk about it openly. At the same time, statistics about breast cancer were presented in new ways that the public could understand. Public health advocates played a key role in the second step, engaging consumers, when they established guidelines in the 1980s that encouraged women to perform breast self-examinations (BSEs) and have screening mammograms and clinical breast examinations (CBEs). Other events that helped engage consumers were increased media coverage of breast cancer issues, the founding of the Komen Race for the Cure in 1983, and the establishment of other programs that both educated the public and raised funds. Funds from these efforts enabled advocates to hold educational forums and produce educational materials in different media and tailored to different audiences and to become active in the funding of research. The third step, political action, became possible when breast cancer advocates joined together in the 1980s and 1990s to work toward legislative, regulatory, and funding changes, such as passage of the Mammography Quality Standards Act and increased funding for the National Cancer Institute. These efforts contributed to a more than quadrupling of federal funding for breast cancer research in the 1990s. Going mainstream, the final step in the advocacy process, entailed establishing a solid base of support to ensure that the message about breast cancer stays strong and fresh. This has been achieved by engaging the business, government, and scientific communities as partners in advocacy.

Professional organizations and their role in advocacy.

OBJECTIVES: To review the role of professional organizations in advocacy using the ONS as a paradigm. DATA SOURCES: Professional journals, organization publications, personal experiences, and internet websites. CONCLUSIONS: Professional organizations are a crucial component of the legislative process as they seek to develop and implement sound public policy. The ONS and other organizations have realized that the work each group does individually is often more effective when the groups collaborate with others possessing the same agendas and priorities. IMPLICATIONS FOR NURSING PRACTICE: As the professional organization for nurses in cancer care, ONS has an active engagement in the establishment of health policy that will have an impact on nursing and cancer care. To be successful in the public policy arena, ONS must not only be aware of current issues at both the state and national levels but also must teach its members how to advocate effectively for issues that affect cancer care.

From ex-patient alternatives to consumer options: consequences of consumerism for psychiatric consumers and the ex-patient movement.

The psychiatric consumer movement in the United States evolved out of the political activism of a small group of antipsychiatry "ex-patients" (former patients) early in the 1970s. The shift in the movement from radical opposition to the medical model to viewing the latter as a possible choice in treatment occurred gradually under a series of social and political changes (e.g., deinstitutionalization), responses to those changes (e.g., the Community Support Program of the National Institute of Mental Health), and the involvement of new actors on the scene (e.g., the National Alliance for the Mentally Ill, a family consumer movement). This article traces the evolution of the psychiatric consumer movement up to the early 1990s in the light of these larger social, political, and economic developments. The author then considers the consequences of that evolution for both consumers and the ex-patient movement in the context of the unique nature of consumerism in the United States and the more recent restructuring of mental health services under managed care.

Los derechos humanos y su vinculación con los derechos de los pacientes / Human rights and their relationship with patientïs rights

This historical article reviews the most important milestones in the evolution of human and patient's rights. The latter have derived from human rights and have followed a similar historical evolution, but in markedly different times. This has lead to the persistence of monarchic type, paternalistic clinical relationship forms in republican societies. The acceptance of informed consent and patient's rights has been a democratization of clinical relationships. On the other hand the right to body health management is a real cultural revolution. The democratization of clinical relationship is in agreement with our technical, pluralist and secularized times

Ethics in gynecologic surgical innovation.

J. Marion Sims' efforts in surgically curing vesicovaginal fistula are retold. The controversy surrounding his surgical innovation on black slaves is discussed in the context of the ethical principles of autonomy, beneficence, and justice. The relevance of his story to modern surgical innovation in incontinence surgery is emphasized in a discussion of the Pereyra, Gittes, and paravaginal procedures. A call is made to establish a gynecologic ethic to ensure that patients' rights are respected in all future surgical innovation.

Influencia de España en la psiquiatría chilena / Spain influence in chilean psychiatry

En el siglo XV, se crearon en España los primeros hospitales para enfermos mentales. En ellos, los pacientes fueron tratados humanitariamente a diferencia de lo que ocurría en el resto de Europa. Como procedimiento de rehabilitación terapéutica realizaban trabajos manuales y agrícolas. Siglos después, P. Pinel introdujo el modelo español de asistencia en Francia. A través de la influencia de la psiquiatría francesa se extendió por todo el mundo y llegó a Chile. En nuestro país, las comunidades de religiosos, atendieron en la Casa de Orates y otros lugares. Así, las ideas de caridad cristiana y rehabilitación de los enfermos que eran tradicionales en ellos fueron también aplicadas en nuestro medio