The apology

This is the second issue featuring a selected piece from the Yale Internal Medicine Residency Program's Writers' Workshop. The annual workshop began in 2003. Abraham Verghese and Richard Selzer, among the best known physician-writers in the United States, have served as workshop leaders, teaching the craft of writing to more than 35 residents. In designing the workshop, Anna B. Reisman, assistant professor in the Department of Internal Medicine at the Yale University School of Medicine and VA Connecticut Health Care System, and Dr. Asghar Rastegar had the goal of making participants better physicians by providing a creative outlet for reflection.The stories and essays written by the Writers' Workshop participants present a range of experiences, real and imagined, and take readers deep into the minds of young doctors trying to make sense of what they do.     

Beyond the white coat ceremony

Note from Anna B. Reisman, Co-Director, Yale Internal Medicine Residency Writers’ Workshop, Assistant Professor, Department of Internal Medicine, Yale University School of Medicine and VA Connecticut Health Care System: This issue inaugurates a new feature: selected writings from the Yale Internal Medicine Residency Program’s Writers’ Workshop. The annual workshop began in 2003. Abraham Verghese and Richard Selzer, among the best known physician-writers in the United States, have served as workshop leaders, teaching the craft of writing to more than 35 residents. In designing the workshop with my co-director, Dr. Asghar Rastegar, our aim was to make participants better physicians by providing a creative outlet for reflection. The tempo of a resident’s day is typically furious — one patient dies, perhaps, another sickens, a third refuses a necessary procedure, a fourth’s wife cries inconsolably at the bedside — with no time in between to ponder what happened, much less what it meant to the patient or to the resident and how it might shape the way the resident practices medicine in the future. Without time to muse about the experience, many residents take the easy road: They emotionally detach. Writing, we believe, can be an antidote to this tendency. The exercise of writing not only makes us empathic; it also sharpens our diagnostic skills. One of the keys to compelling writing is attention to detail: the nervous twitch of an old man’s eye muscles or the decayed front teeth of a young woman, a former crack addict. Such details not only make our writing come alive but also sensitize us to our patients’ plights and sharpen our diagnostic skills. The stories and essays written by the Writers’ Workshop participants present a range of experiences, real and imagined, and take us deep into the minds of young doctors trying to make sense of what they do.     

The Yale Affiliated Hospital Program in Internal Medicine

In July, 1975, the Departments of Internal Medicine at the Yale University School of Medicine and eight community hospitals in southern and western Connecticut formed the Yale Affiliated Hospital Program (YAHP) in Internal Medicine. The YAHP provides a planned and focused program of continuing education for medical staff and housestaff at the affiliated hospitals. Six formats for the over 1,000 rounds, lectures, and conferences given annually are used. The members of the YAHP also cooperate in housestaff and faculty recruiting, evaluation of quality of care and evaluation of the process of continuing medical education itself. This report summarizes the organization, goals and future plans of the YAHP.     

Report on the international workshop on alternative methods for human and veterinary rabies vaccine testing: State of the science and planning the way forward

Potency testing of most human and veterinary rabies vaccines requires vaccination of mice followed by a challenge test using an intracerebral injection of live rabies virus. NICEATM, ICCVAM, and their international partners organized a workshop to review the availability and validation status of alternative methods that might reduce, refine, or replace the use of animals for rabies vaccine potency testing, and to identify research and development efforts to further advance alternative methods. Workshop participants agreed that general anesthesia should be used for intracerebral virus injections and that humane endpoints should be used routinely as the basis for euthanizing animals when conducting the mouse rabies challenge test. Workshop participants recommended as a near-term priority replacement of the mouse challenge with a test validated to ensure potency, such as the mouse antibody serum neutralization test for adjuvanted veterinary rabies vaccines for which an international collaborative study was recently completed. The workshop recommended that an in vitro antigen quantification test should be a high priority for product-specific validation of human and non-adjuvanted veterinary rabies vaccines. Finally, workshop participants recommended greater international cooperation to expedite development, validation, regulatory acceptance, and implementation of alternative test methods for rabies vaccine potency testing.     

ILCD Handbook Public Consultation Workshop

Introduction

The European Commission is supporting the development of the International Reference Life Cycle Data System (ILCD). This consists primarily of the ILCD Handbook and the ILCD Data Network. This paper gives an insight into the scientific positions of business, governments, consultants, academics, and others that were expressed at this public consultation workshop.

Workshop focus

The workshop focused on four of the topics of the main guidance documents of the ILCD Handbook: (1) general guidance on life cycle assessment (LCA); (2) guidance for generic and average life cycle inventory (LCI) data sets; (3) requirements for environmental impact assessment methods, models and indicators for LCA; and (4) review schemes for LCA.

Workshop participation

This consultation workshop was attended by more than 120 participants during the 4 days of the workshop. Representatives came from 23 countries, from both within and outside the European Union.

Workshop structure

Approximately half of the participants were from business associations or individual companies. Another 20% were governmental representatives. Others came predominantly from consultancies and academia.

Results

This public consultation workshop provided valuable inputs into the overall ILCD Handbook developments as well as for further development. This paper focuses on some of the main scientific issues that were raised.     

Summary of final report: Space Life Sciences Planning Workshop (SLSPW). June 5-7, 2000 Mont Tremblant, Quebec

A Space Life Sciences Planning Workshop was sponsored by the Canadian Space Agency to identify key questions in the major research areas supported by the Life Sciences Program, to identify Canadian strengths and capabilities as they relate to these research areas, and to make recommendations for the future directions of the Life Sciences Program. The conclusions reached by the workshop participants have been presented to the Canadian Space Agency. This report is a summary of those conclusions.     

第二届生态系统评估与管理(EAM)国际会议综述

自2005年联合国《千年生态系统评估》发布以来,旱区农业生态系统评估与管理研究越来越受到世界各国的广泛关注和重视。综述了2010年7月19日至25日在兰州大学举行的第二届生态系统评估与管理(Ecosystem assessment and management, EAM)国际会议28场特邀专家报告,围绕"气候变化与旱区农业生态系统管理"主题,分别从生态系统时空格局、全球变化生态学、植物逆境适应机制、植物与土壤关系和生态系统管理五个方面进行总结,旨在探讨全球气候变化条件下如何提高干旱与半干旱脆弱农业生态系统生产力和可持续性发展的创新理论研究。对生态系统评估与管理的未来发展趋势和目标进行了探讨,并对该会议将来的举办和组织形式提出了建议。     

WHO/KFDA joint workshop on implementing WHO guidelines on evaluating similar biotherapeutic products, Seoul, Republic of Korea 24-26 August, 2010

In August 2010, the World Health Organization and the Korea Food & Drug Administration jointly organized the first implementation workshop of WHO guidelines on evaluating similar biotherapeutic products (SBPs) at the global level. The objective of the Workshop was to facilitate implementation of the newly adopted WHO Guidelines into the practice of national regulatory authorities (NRAs). WHO Guidelines were recognized by the workshop participants as a tool for harmonizing regulatory requirements worldwide. By reviewing and practicing several case studies, better understanding and consensus on the principles of clinical trial designs were reached. However, variations in terms of the national requirements for quality, safety and efficacy of these products revealed diversity in the regulatory expectations in different countries and regions. In addition, lack of terminology for the products developed as copy products (so called "me too" products) with a partial comparability to an RBP, led to a great diversity in evaluating as well as naming these products. The workshop participants proposed the following actions: a) NRAs should make efforts to build their capacities for regulation of SBPs; b) WHO should revise WHO Guidelines for assuring the quality of products prepared by recombinant DNA technology (WHO TRS 814) and continue monitoring progress with the implementation of the Guidelines on evaluating SBPs. Publication of the outcome of the Workshop was recognized as another action that WHO should coordinate.     

Progress in complementary and alternative medicine research: Yale Research Symposium on Complementary and Integrative Medicine

Integrative Medicine at Yale and the Yale Center for Continuing Medical Education (CME) sponsored the Yale Research Symposium on Complementary and Integrative Medicine in March 2010 at the university's School of Medicine. Delivering the keynote address, Dr. Josephine P. Briggs, Director of the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH), highlighted recent progress made in the field of complementary and alternative medicine (CAM).     

The 2007 anatomy ceremony: a service of gratitude: I: collected experiences

Yale University medical and PA students, classes of 2010 and 2008 respectively, express their gratitude in a compilation of reflections on learning human anatomy. In coordination with the Section of Anatomy and Experimental Surgery at the School of Medicine, the Yale Journal of Biology and Medicine encourages you to hear the stories of the body as narrated by the student.     

Phytohormones in Plant Biotechnology and Agriculture. Proceedings of the NATO-Russia Workshop held in Moscow, 12-16 May 2002. * Machackova I. and Romanov GA, eds. 2004. * Dordrecht: Kluwer Academic Publishers. {euro}95 (hardback).280 pp

This book contains articles writtenby speakers and selected participants who attended the AdvancedResearch Workshop in 2002. The workshop was dedicated to thecentenary of the birth of the distinguished Russian plant physiologistMikhail Khristoforovich Chailakhyan who is best known for proposingthe existence of a universal flowering hormone that he namedflorigen. The opening article by N.     

Putting together the pieces of polio: how Dorothy Horstmann helped solve the puzzle

Dr. Dorothy Horstmann, epidemiologist, virologist, clinician, and educator, was the first woman appointed as a professor at the Yale School of Medicine. Horstmann made significant contributions to the fields of public health and virology, her most notable being the demonstration that poliovirus reached the central nervous system via the bloodstream, upsetting conventional wisdom and paving the way for polio vaccines. In 1961, she was appointed a professor at Yale School of Medicine, and in 1969, she became the first woman at Yale to receive an endowed chair, which was named in honor of her mentor, Dr. John Rodman Paul. In this review, the major scientific contributions of Dr. Dorothy Horstmann will be highlighted from her more than 50-year tenure at Yale School of Medicine.     

From genotype to phenotype: linking bioinformatics and medical informatics ontologies

A small group of around 40 people came together at the Chancellors Conference Centre in Manchester for the Ontologies Workshop, chaired by Alan Rector and Robert Stevens. The workshop was, rather strangely, spread over 2 half days. In hindsight, this programme worked very well as it gave people the opportunity to chat over a drink on the Saturday evening and share ideas, before launching into the second half on the following day. The participants were from various walks of life, all with a common interest in finding out more about ontologies and promoting collaborations between the medical informatics and bioinformatics ontology communities.     

EMBO workshop report. An eclipse over the cell nucleus functional organization of the cell nucleus Prague, August 9-12, 1999

The EMBO workshop 'Functional Organization of the Cell Nucleus' held in Prague at the Hotel of the Postgraduate School of Medicine was attended by 110 participants (49 invited speakers and 61 selected participants) from 22 countries. Such a full range of topics devoted to the cell biology of the nucleus has not been discussed previously in such an intimate meeting in Europe. The workshop not only offered an opportunity for junior scientists to benefit from having an international meeting within Europe and a chance to discuss their work with internationally recognized experts, but it also offered a unique opportunity for interactions among the more established investigators. The fruits of a number of presentations are gathered together in a Special Issue of the Journal of Structural Biology which appeared in spring 2000. Last but not least, it is worth mentioning that while stepping through a packed scientific program, the participants did find the time to observe the solar eclipse just before the lunch break of August 11.     

INVITOX 2004: 13th Workshop of the European Society of Toxicology In Vitro, organised in cooperation with the Scandinavian Society for Cell Toxicology

INVITOX 2004, the 13th Workshop of the European Society of Toxicology In Vitro, was held on 8-11 September 2004, in Zegrze, Poland, in cooperation with the Scandinavian Society for Cell Toxicology. The workshop was attended by 112 participants from 19 countries. The programme included 11 main sessions and two round table discussions. The lectures of the invited speakers, together with short oral presentations and posters, covered the most important aspects of current research in the field of in vitro toxicology. ECVAM's strategies for the replacement of animal testing for toxic chemicals by alternative test systems were discussed.     

Recommendations for ethical approaches to genotype-driven research recruitment

Recruiting research participants based on genetic information generated about them in a prior study is a potentially powerful way to study the functional significance of human genetic variation. However, it also presents significant ethical challenges that, to date, have received only minimal consideration. We convened a multi-disciplinary workshop to discuss key issues relevant to the conduct and oversight of genotype-driven recruitment and to translate those considerations into practical policy recommendations. Workshop participants were invited from around the US, and included genomic researchers and study coordinators, research participants, clinicians, bioethics scholars, experts in human research protections, and government representatives. Discussion was directed by experienced facilitators and informed by empirical data collected in a national survey of IRB chairs and in-depth interviews with research participants in studies where genotype-driven recontact occurred. A high degree of consensus was attained on the resulting seven recommendations, which cover informed consent disclosures and choices, the process for how and by whom participants are recontacted, the disclosure of individual genetic research results, and the importance of tailoring approaches based on specific contextual factors. These recommendations are intended to represent a balanced approach-protecting research participants, yet avoiding overly restrictive policies that hinder advancement on important scientific questions.     

Biochemical education in Romania: Report on a workshop held in Bucharest, 16–20 September 1991

The Workshop Team from IUBMB consisted of Professor W Rombauts (Leuven, Belgium), Professor F Vella (Saskatoon, Canada), and Dr E J Wood (Leeds, UK), with local arrangements being in the hands of Dr S A Hulea (Secretary of the Romanian Biochemical Society). The Workshop was held at the Institute of Biochemistry, Romanian Academy of Sciences (Head: Professor Dr Cecilia Motas) and there were participants from Bucharest, Constantin, Cluj-Napoca, Galati, Tasi and Sibiu. Support was kindly provided by the Romanian Biochemical Society, World Vision International, The Commission of Biochemistry, Romanian Academy of Sciences, Institute of Biochemistry, University of Medicine and Pharmacy “Carol Davilla”, University of Bucharest, and IUBMB     

Understanding the biology of sex and gender differences: using subgroup analysis and statistical design to detect sex differences in clinical trials

In May 2000, a General Accounting Office (GAO) report revealed that although women are now participating in clinical trials in numbers proportionate to their numbers in the general population, data collected in these trials are not routinely analyzed by sex.[1] Without such sex analysis, clinically relevant information about potentially lifesaving treatments could be lost. In July 2001, the Society for Women's Health Research convened a workshop to address strategies for conducting subgroup analyses to detect sex differences. Workshop participants concluded that understanding sex differences will enable medical researchers to design healthcare interventions for both men and women more effectively and that one can plan for and conduct sex analysis without compromising the quality of the study or making the study prohibitively expensive.     

"C.-E.A. Winslow and the early years of public health at Yale, 1915-1925"

C.-E.A. Winslow was the first chairman of the Department of Public Health at the Yale University School of Medicine. This paper considers the development and changing agenda of his department, the structure of Yale University, and the maturation of public health as a discipline. Winslow's successes and failures are discussed as they relate to Yale and external societal influences.