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AI Criticisms, Obstacles, and Limitations
Published in Paul Cerrato, John Halamka, Reinventing Clinical Decision Support, 2020
Clinicians are accustomed to using diagnostic and therapeutic tools they understand. They are not only interested in evidence to support the effectiveness and safety of these interventions but also want to know that the mechanism of action behind each of these interventions is plausible and consistent with the laws of nature governing human physiology and biochemistry. Unfortunately, throughout the course of history, this need for plausibility has sometimes meant rejecting treatment options that work but are inconsistent with the theories in vogue at the time. In 1860, for example, the Hungarian physician Ignaz Semmelweis published a seminal work demonstrating that puerperal fever was caused by some sort of “putrid” matter that was being transferred from the hands of medical students who had just finished examining cadavers to pregnant women during their physical examination. Few authorities at the time took his findings seriously because he could not provide a plausible mechanism of action that was consistent with the theories of the day.
Healthcare: A Dysfunctional System
Published in Bill Runciman, Alan Merry, Merrilyn Walton, Safety and Ethics in Healthcare, 2007
Bill Runciman, Alan Merry, Merrilyn Walton
Within the last 150 years, the discovery of modern anesthesia has been disseminated (1846),11 Darwin propounded the theory of evolution (1858),12 Claude Bernard founded modern physiology and described the scientific method (1858),13 and Pasteur demonstrated that fermentation and putrification were due to micro-organisms (1864). Semmelweiss in Vienna identified the role of ‘putrid particles’ in the causation of puerperal fever, and introduced hand disinfection with chlorinated lime in the 1850s.14 Lister introduced carbolic spray and the beginnings of surgical antisepsis in the 1860s, and in 1895 Roentgen published his discovery of a new type of radiation which he called ‘X-rays’. The natural outcome of these advances was the development of medical specialization which occurred alongside the growth of hospitals, and which led to the evolution of the roles of the various healthcare professionals we know today. We will discuss aspects of this ongoing evolution with respect to nurses, doctors and pharmacists. A discussion of this process for the many other healthcare professionals who contribute to modern healthcare (physiotherapists, occupational therapists, dieticians, social workers, biomedical engineers and many others) is beyond the scope of this book.
Infection Control Through Environmental Design
Published in AnnaMarie Bliss, Dak Kopec, Architectural Factors for Infection and Disease Control, 2023
Udomiaye Emmanuel, Eze Desy Osondu, Cheche Kalu
In the outbreak of Tugela Ferry, South Africa, in 2006, the hospital management reported that the health facility was not designed to handle airborne infection; rather, it was designed with blood-borne infections in mind. As a result, it never had an airborne infection control policy at the time extremely drug-resistant TB surfaced in patients (WHO, 2020). Such a report underscores the distinctive part architecture plays in contributing to health care delivery. Previous studies by Rubin, Owens, and Golden (1998), Ulrich et al. (2008), and Jamshidi, Parker, and Hashemi (2020) agree that there are expressive suggestions that features of the designed environment have a significant influence on clinical outcomes for patients. Xiao, Jones, Zhao, and Li (2019) used simulation to examine how methicillin-resistant Staphylococcus aureus (MRSA) is transmitted across various surfaces in a medical ward in a Hong Kong hospital. Using graphics to illustrate the network in which MRSA travels, they found that apart from surfaces of the adjacent and the index patients, the public surfaces were found to have higher MRSA concentrations and these public surfaces are surfaces of toilet door handles, toilet lids, the nurse station desk, and the water dispenser. In another study by Rimi et al. (2014) of a health care facility, high concentrations of airborne bacteria were found in densely populated locations such as the pharmacy, lobby, and other areas with densities of 0.5 to 1 cfu per m− 2 of air-inward areas, and these concentrations increased in proportion to the number of people in the room, resulting in a weightier bioburden. According to Ulrich et al. (2008) and Kramer, Schwebke, and Kampf (2006), health care centers could be a probable reservoir of nosocomial pathogens, and such pathogens could have the ability to survive for a few days to several months. Such contaminated floors, walls in toilets, water taps, door handles, and rallies could be potential spots for settlement of pathogens and transmission through hand contact of diseases such as cholera (Goh, Lam, & Ling, 1987), hepatitis A (Rajaratnam, Patel, Parry, Perry, & Palmer, 1992), vancomycin-resistant enterococci (Noble et al., 1998), and puerperal fever (Teare, Smithson, Efstratiou, Devenish, & Noah, 1989). For ease of understanding the nexus, it is important to appraise the modes of disease transmission in the health care environment.
Bioethics and Environmental Ethics: The Story of the Human Body as a Natural Ecosystem
Published in The New Bioethics, 2020
Zoe-Athena Papalois, Kyriaki-Barbara Papalois
In the Victorian era, Ignaz Semmelweis observed that women during childbirth often died of puerperal fever when medical students and young doctors assisted with the labour. However, this did not occur when the nurses were present at the birth (Ataman et al. 2013). He hypothesised this disparity in death rate was due medical students visiting the cadaver lab prior to hospital ward rounds, which led to a transmission of disease. In turn he postulated that carbolic acid would reduce the incidence of puerperal fever.