Behaviour change in diabetes: behavioural science advancements to support the use of theory.

Behaviour is central to the management of diabetes, both for people living with diabetes and for healthcare professionals delivering evidence-based care. This review outlines the evolution of behavioural science and the application of theoretical models in diabetes care over the past 25 years. There has been a particular advancement in the development of tools and techniques to support researchers, healthcare professionals and policymakers in taking a theory-based approach, and to enhance the development, reporting and replication of successful interventions. Systematic guidance, theoretical frameworks and lists of behavioural techniques provide the tools to specify target behaviours, identify why ideal behaviours are not implemented, systematically develop theory-based interventions, describe intervention content using shared terminology, and evaluate their effects. Several examples from a range of diabetes-related behaviours (clinic attendance, self-monitoring of blood glucose, retinal screening, setting collaborative goals in diabetes) and populations (people with type 1 and type 2 diabetes, healthcare professionals) illustrate the potential for these approaches to be widely translated into diabetes care. The behavioural science approaches outlined in this review give healthcare professionals, researchers and policymakers the tools to deliver care and design interventions with an evidence-based understanding of behaviour. The challenge for the next 25 years is to refine the tools to increase their use and advocate for the role of theoretical models and behavioural science in the commissioning, funding and delivery of diabetes care.

Building Community and Transforming Knowledge: Histories of Women's Health Practitioners and Community-Based Health Services in 20th-Century Alberta, Canada.

As new government health policy was created and implemented in the late 1910s and the late 1960s, women patients and health practitioners recognized gaps in the new health services and worked together to create better programs. This article brings the histories of the district nursing program (1919-43) and local birth control centres (1970-79) together to recognize women's health provision (as trained nurses or lay practitioners) as community-based and collaborative endeavours in the province of Alberta. The district nursing and birth control centre programs operated under different health policies, were influenced by different feminisms, and were situated in different Indigenous-settler relations. But the two programs, occurring half a century apart, provided space for health workers and their patients to implement change at a community level. Health practitioners in the early and late twentieth century took women's experiential knowledge seriously, and, therefore, these communities formed a new field of women's health expertise.

The Kirkbride buildings in contemporary culture (1850-2015): from 'moral management' to horror films.

The so-called 'Kirkbride Plan' is a type of mental institution designed by the American psychiatrist Thomas Story Kirkbride. The Kirkbride-design asylums were built from 1848 to the end of the nineteenth century. Their structural characteristics were subordinated to a certain approach to moral management: exposure to natural light, beautiful views and good air circulation. These hospitals used several architectural styles, but they all had a similar general plan. The popularity of the model decreased for theoretical and economic reasons, so many were demolished or reused, but at least 25 of the original buildings became protected places. Over the years, surrounded by a legendary aura, these buildings have become a leitmotif of contemporary popular culture: 'the asylum of terror'.

From Nuremberg to Guantanamo Bay: Uses of Physicians in the War on Terror.

Seventy years after the Nuremberg Doctors' Trial, health professionals and lawyers working together after 9/11 played a critical role in designing, justifying, and carrying out the US state-sponsored torture program in the CIA "Black Sites" and US military detention centers, including Abu Ghraib, Bagram, and Guantanamo Bay, Cuba. We analyze the similarities between the Nazi doctors and health professionals in the War on Terror and address the question of how it happened that health professionals, including doctors, psychologists, physician assistants, and nurses, acted as agents of the state to utilize their medical and healing skills to cause harm and sanitize barbarous acts, similar to (though not on the scale of) how Nazi doctors were used by the Third Reich.

The Nazi Physicians as Leaders in Eugenics and "Euthanasia": Lessons for Today.

This article, in commemoration of the 70th anniversary of the Doctors' Trial at Nuremberg, reflects on the Nazi eugenics and "euthanasia" programs and their relevance for today. The Nazi doctors used eugenic ideals to justify sterilizations, child and adult "euthanasia," and, ultimately, genocide. Contemporary euthanasia has experienced a progression from voluntary to nonvoluntary and from passive to active killing. Modern eugenics has included both positive and negative selective activities. The 70th anniversary of the Doctors' Trial at Nuremberg provides an important opportunity to reflect on the implications of the Nazi eugenics and "euthanasia" programs for contemporary health law, bioethics, and human rights. In this article, we will examine the role that health practitioners played in the promotion and implementation of State-sponsored eugenics and "euthanasia" in Nazi Germany, followed by an exploration of contemporary parallels and debates in modern bioethics. 1.

African-American Medical Personnel in the US Army in the First World War.

In WWI, the United States was segregated by custom and law, and the Army obeyed the laws, reducing opportunities for Black medical professionals to serve their country in uniform. This article surveys African-American medical personnel serving in the US Army in World War I. It includes physicians, dentists, veterinarians, and other commissioned officers, as well as medical enlisted men. Overall, despite segregation and associated professional limitations, determined individuals still served with distinction in a variety of roles, opening doors for future advances.

Governing Dementia: A Historical Investigation of the Power of States and Professionals in the Conceptualization of Dementia in China.

This study intends to understand how Chinese states and healthcare professionals interact with each other in adopting biomedical concepts within the context of globalization of mental health. The conceptualization of dementia as a stigmatized mental disorder in China serves as a salient case to examine interactions between states and professionals as well as the interrelationships between different healthcare professionals in producing knowledge. By engaging the biopolitical approach, this project explores the historically-contingent conceptualizations of dementia, namely dementia as a vague and stigmatized condition in imperial China, dementia as biosocial deviance in Republican China, dementia as a product of capitalism during Mao-era China, and dementia as a stigmatized mental illness in contemporary China. These dynamics indicate that Chinese professionals have been largely influenced by state ideologies in assimilating biomedical concepts. Through the historical analysis of state-professional interactions in conceptualizing dementia, this study provides an avenue to understand how biomedical concepts transfer within the global context can be read as a site of power struggle between ethnomedicine and biomedicine, between various competing forms of healthcare professionals, and between indigenous sovereignty and governmentality. Moreover, the study of conceptualizing dementia in China sheds light on the larger sociopolitical processes of governmentality in China.

Massacre of Canadian Army Medical Corps personnel after the sinking of HMHS Llandovery Castle and the evolution of modern war crime jurisprudence.

SUMMARY: Events after the sinking of the hospital ship Llandovery Castle on June 27, 1918, by the German submarine U-86 outraged Canadians. Survivors aboard a single life raft gave evidence that many of the 234 souls lost had made it to lifeboats but were rammed and shot by the submarine. Many of those who died were nurses. Three German officers were charged with war crimes after the war. The submarine's captain evaded capture. The remaining two officers' defence that they were following the captain's orders failed and they were convicted. This ruling was used as a precedent to dismiss similar claims at the war crime trials after the Second World War. It is also the basis of the order given to members of modern militaries, including the Canadian Armed Forces, that it is illegal to carry out an illegal order.

"I Was Doctor": White Settler Women's Amateur Medical Practice in East and South-Central African Communities, 1890-1939.

Professional medicine in colonial British Africa has been extensively examined by historians. Few scholars, however, have adequately considered the role that white settlers without medical training played in the provision of colonial health care in local African communities. This article addresses the gap by exploring amateur medical treatment by white settler women in East and South-Central African communities between 1890 and 1939, primarily in highland areas of Kenya and Southern Rhodesia. It examines the types of conditions treated, what techniques and equipment were used for treatment, and where treatment was carried out. It also explores medical identity in settler women's memoirs. Last, it considers the degree of choice exercised by patients in these amateur medical encounters. Overall, this article situates white settlers' amateur treatment in African communities as an important strand of colonial health care and as an intimate contact zone between white settlers, colonial medicine, and local people.

The Change of the Status of Joseon Medical Bureaucrats in the 15th and 16th Centuries.

In the 15th century, Joseon dynasty's goal for the stabilization of the ruling system, the ideological freedom of the era, and the necessity of medicine due to the introduction of Jin and Yuan dynasty's medicine led to the increased interest in medicine by the nobility along with tolerant practice. The practice of reading medical books is a good example of this institutional demonstration. However, by the end of the 15th century, a noticeable change had taken place. Within the nobility, there was an ideological rigidity regarding technology other than those of Confucianism, as the nobility became concentrated on the principles of Neo-Confucianism. In addition, as the publication of large-scale editions such as Uibangyuch'wi (the Classified Collection of Medical Prescriptions) came to an end, they have become less inclined to nurture talent at the level of the central government as in the previous period. In addition, as the discrimination against illegitimate children became stronger, technical bureaucrats such as medical officials, which were open to illegitimate children, came to be seen in increasingly disdainful and differentiated manners. From the late Sejong period to the early Seongjong period, the entrance of illegitimate sons into the medical bureaucracy solidified the negligence of medicine by the nobility. After then, the medical bureaucracy came to be monopolized by illegitimate sons. As for illegitimate sons, they were not allowed to enter society through Confucian practices, and as such, the only way for them to enter the government was by continuing to gain experience as technical bureaucrats. Technical posts that became dominated by illegitimate sons became an object of contempt by the nobility, and the cycle reproduced itself with the social perception that legitimate sons of the nobility could not become a medical official. Medical officials from the Yi clan of Yangseong had been legitimate sons and passers of the civil service examination in the 15th century. However, in the 16th century, only illegitimate sons became medical officials. The formation of Jungin (middleclass) in technical posts since the middle of the Joseon period is also related to this phenomenon. The Yi clan of Yangseong that produced medical officials for 130years over four generations since Yi Hyoji, a medical book reading official, is an exemplary case of the change in the social perception in the early Joseon period regarding medical bureaucrats.

Beyond Competence: Perspectives From Two Centuries.

A sense of failure and guilt can often be associated with the death of a patient. Using the Serenity Prayer as a framework, we present autobiographical narratives describing encounters that happened in Vellore, India over a hundred years apart. Powerlessness in the face of death, we suggest, is not the same as ignorance or incompetence. It could well be the breakthrough to a deeper wisdom and lasting empowerment.

The officier de santé in 19th-century France: A PA prototype.

In 1803, shortly after the French Revolution, the French healthcare system was reorganized and a new independent medical officer, the officier de santé (health officer) was introduced. Qualifications included 3 years in a medical school (compared with 6 years for a physician) and an apprenticeship with a physician. Although somewhat independent, officiers de santé were limited in their scope of practice to general medicine, prescribing medications, and minor surgical procedures. Many were deployed to medically underserved areas. After almost a century of activity in a role not unlike physician assistants, the officiers de santé were abolished in 1892. Development of a more rigorous medical education and an adequate supply of physicians meant that physicians were better deployed throughout France, and were largely the reasons for abolishing this PA prototype.

A barrier to medical treatment? British medical practitioners, medical appliances and the patent controversy, 1870-1920.

From the late nineteenth century onwards there emerged an increasingly diverse response to escalating patenting activity. Inventors were generally supportive of legislation that made patenting more accessible, while others, especially manufacturers, saw patenting culture as an impediment. The medical profession claimed that patenting represented 'a barrier to medical treatment' and was thus detrimental to the nation's health, yet, as I argue, the profession's development of strict codes of conduct forbidding practitioners from patenting resulted in rebellion from some members, who increasingly sought protection for their inventions. Such polarized opinions within the medical trade continue to affect current medical practice today.

[Personnel work at the S. M. Kirov Military Medical Academy: chapters of history].

Personnel work at the S.M.Kirov Military Medical Academy: chapters of history. Brief historical sketches of the personnel work at the S.M.Kirov Military Medical Academy. Various divisions were in charge of personnel work at the Academy in XIX-XX centuries: the Special Office of the Registrar, the economic committee, the administrative part, the department personnel and others. For the first time the personnel department was introduced 'into the Academy in 1946.

[Peculiarities of training of military medical staff during the Great Patriotic War].

Peculiarities of training of military medical staff during the Great Patriotic War. Extreme conditions of the World War II required as soon as possible rebuilding the work of institutions for higher medical education concerning training of military medical personnel. During the war significantly changed the organization of educational process in the S.M.Kirov Military Medical Academy, the military-medical faculties and civilian medical institutions. During the war from military medical academies and military medical faculties annually graduated up to 1450 military and naval doctors, civil universities of the country prepared and sent to the front more than 65 thousand doctors. It called up from reserve 80 thousand doctors. Basically staffing problems have been resolved.

Historical and Social Evolution of the Healers' Charisma.

This study aims to explore the relation between charisma and healing and how the concept of charisma evolved within medical profession over time. The development of medical profession from shamans to modern medical doctors, the gradual transition from ritual to physical healing, the relation between the physician and common people, and the transition from personal to professional charisma are presented in a medico-historical context. The article concludes that there is an indisputable link between the phenomenon of charisma and healing. Healers have often been considered among the most significant charismatic figures in their societies. With time physicians have lost their personal charisma and replaced it by a stable professional charisma. Today, the growing involvement of patients in healing and demystification of the medical profession is diminishing the charisma of the physicians, although medical profession still retains qualities found in classic charismatics and with it also some authority over patients.

Medicine and abortion law: complicating the reforming profession.

The complicated intra-professional rivalries that have contributed to the current contours of abortion law and service provision have been subject to limited academic engagement. In this article, we address this gap. We examine how the competing interests of different specialisms played out in abortion law reform from the early twentieth-century, through to the enactment of the Abortion Act 1967, and the formation of the structures of abortion provision in the early 1970s. We demonstrate how professional interests significantly shaped the landscape of abortion law in England, Scotland, and Wales. Our analysis addresses two distinct and yet related fields where professional interests were negotiated or asserted in the journey to law reform. Both debates align with earlier analysis that has linked abortion law reform with the market development of the medical profession. We argue that these two axes of debate, both dominated by professional interests, interacted to help shape law's treatment of abortion, and continue to influence the provision of abortion services today.

Historical analysis of professionalism in western societies: implications for interprofessional education and collaborative practice.

Health care systems around the world are under tremendous pressure to change their models of health care delivery - from the current multiprofessional health care delivery into interprofessional collaborative care models with the ultimate goal of improving patient/client outcomes. The growing diversity of the population, the increasing number of vulnerable persons (elderly, homeless, those living with chronic health conditions), the complexity of health problems, and the shortage of health care providers have forced health policymakers to call for sweeping revisions to how health care is provided, impacting how health care program students are educated. However, in professional training emphasis is placed on uniprofessional education. Learners are socialized in isolation from those in other related professions to ensure the development of a shared professional identity. Consequently, by program completion each student will not only master the knowledge, skills and norms of his/her own profession, but will also develop a silo identity, called "uniprofessional identity". This isolationist identity creates a lack of understanding of others. In limiting their exposure to learning about the roles and value of other health care professionals, persistent negative stereotypical attitudes towards other professionals are reinforced. In this paper, we present the historical evolution(s) of the discourse of professionalism to assist us to develop a deeper understanding of socio-historical context within which interprofessional education (IPE) is embedded within, and collaborative person-centered practice (CPCP). With greater insight, we can (re)conceptualize the possibilities, and advance research on, interprofessional education and practice in the present.

The Genesis of Multidisciplinary Health Professionals Teams for Pain Management. A History from the Hellenic Antiquity to Modern Palliative Medicine.

The aim of our article is to highlight the history of pain management. The multidisciplinary team (MDT) concept in confronting pain was first conceptualized by the Hippocratics, and has evolved through time and become a trend in medicine over recent decades. Documentary research was conducted to unveil the story of the evolution of MDTs. From the early 1950's the idea of an MDT approach to deal with various types of pain was sporadically introduced in medicine. Studies encouraged health institutions to support this concept by providing health professionals with training, alongside the necessary facilities and resources. Specialized care programs started with Dame Cicely Mary Strode Saunders as one of the pioneers. CONCLUSIONS: Team work and continuous interdisciplinary treatment of pain have rendered MDTs essential for health systems. Barriers in flexibility, information flow and personal issues give rise to the need for better organization and training. Pain and terminal disease palliation call for MDTs, and educated leaders to run them. Present and future health MDTs are considered necessary in all medical fields.