Médecine interne hospitalière: l'année 2009 en revue (1). La perspective des chefs de clinique [Hospital based internal medicine: the year 2009 in review (I). The perspective of chief residents]

Internists must regularly adjust their patients care according to recent relevant publications. The chief residents from the Department of Internal Medicine of a university hospital present some major themes of internal medicine treated during the year 2009. Emphasis will be placed primarily on changes in the daily hospital practice induced by these recent studies. This variety of topics illustrates both the broad spectrum of the current internal medicine, and the many uncertainties associated with modern medical practice based on evidence.

The experience of transplantation for patients and their significant ones: A difficult encounter of two worlds

Objectives This paper reports on a longitudinal qualitative study exploring concerns of 60 patients before and after transplantation. Methods Semi-structured interviews were conducted without time constraints in a protected space out of the hospital. Qualitative analysis was performed. Results Prior to transplantation, all patients talked freely about negative feelings, stigmatisation, being misunderstood by others, loneliness and culpability caused by increasing physical dependency or abandoned roles. They mentioned alternative ways to cope (magic, spirituality), and even expressed their right to let go. In a subset of 13 patients, significant ones allowed themselves in the interview, or were integrated on the request of the patients. In this modified setting, two illness-worlds were confronted. If common themes were mentioned (e.g., modified life plans, restricted space, physical and psychological barriers), they were experienced differently. Fear of transplantation or guilt towards the donors was overtly expressed, often for the first time. Mutual hiding of anxiety in order to protect loved ones or to prevent loss of control was disclosed. The significant ones talked about accumulated stress and exhaustion related to the physical degradation of the patient, fear of the unpredictable evolution of illness and financial problems, and stressed their difficulty to adapt adequately to the fluctuating state of the patient. After transplantation, other themes emerged, where difficulty in disclosure was observed: intensive care and near death experiences, being a transplanted person, debt to the donor and his/her family, fear of rejection. Conclusions With the self-imposed strategy of hiding concerns to protect one another, a discrepancy between two illness-worlds was created. When concerns were confronted during the interviews, a new mutual understanding emerged. Patients and their families stated the need for sharing concerns in the course of illness.

SAFO fragmento 16 V: El Deslumbramiento

E1 fr. 16 V es un breve poema en el que, argumentando con rigurosa lógica y utilizando como ejemplo demostrativo el mito de Helena, Safo formula la más antigua teorización conocida sobre la naturaleza de la belleza. Su modernidad es sorprendente; la belleza no es una cualidad absoluta, sino el producto fantasmático del impulso sexual. Los pormenores de su fenomenalogía se desglosan con el apoyo de la tradición homérica: el deslumbramiento inicial trastorna los sentidos creando apariencias ilusorias, ciega la ruzón, enajena, provoca olvido; pero cuando el deseo se extingue retornan memoria y conciencia, y con ellas el dolor. Se entiende así que la Helena que ya está de vuelta, la de la Odisea, proceda a administrar su seducción como una droga analgésica. El proccso se repite constantemente; sus sujetos somos todos, cualquiera, y su actualización afecta, más alla de la singular experiencia psica-física a las prácticas matrimoniales de la época, donde no se contemplava la elección de pareja y la mujer abandonaba su entorno para inscribirse en el del marido. Así la poesía de Safo, que forma parte de la iniciación a la vida adulta femenina, al poner al descubierto la relatividad de la belleza dentro del mecanismo amoroso, distancia a sus pupilas de sus propias emociones y las protege de la soledad insertándolas en una experiencia religiosa compartida.

Mourning becomes Electra d'Eugene O'Neill: Èsquil i Plató per a crear un drama fosc?

The fundamental debt of E. O'Neill's Mourning Becomes Electra to Aeschylus, and to a lesser degree to Sophocles and Euripides, has been always recognised but, according to the author's hypothesis, O'Neill might have taken advantage of the Platonic image of the cave in order to magnify his both Greek and American drama. It is certainly a risky hypothesis that stricto sensu cannot be proved, but it is also reader's right to evaluate the plausibility and the possible dramatic benefit derived from such a reading. Besides indicating to what degree some of the essential themes of Platonic philosophy concerning darkness, light or the flight from the prison of the material world are not extraneous to O'Neill's work, the author proves he was aware of the Platonic image of the cave thanks to its capital importance in the work of some of his intellectual mentors such as F. Nietzsche or Oscar Wilde. Nevertheless, the most significant aim of the author's article is to emphasize both the dramatic benefits and the logical reflections derived, as said before, from reading little by little O'Neill's drama bearing in mind the above mentioned Platonic parameter.

Mourning becomes Electra de Eugene O'Neill: ¿Esquilo y la caverna de Platón para crear un drama oscuro?

The fundamental debt of E. O'Neill's Mourning Becomes Electra to Aeschylus, and to a lesser degree to Sophocles and Euripides, has been always recognised but, according to the author's hypothesis, O'Neill might have taken advantage of the Platonic image of the cave in order to magnify his both Greek and American drama. It is certainly a risky hypothesis that stricto sensu cannot be proved, but it is also reader's right to evaluate the plausibility and the possible dramatic benefit derived from such a reading. Besides indicating to what degree some of the essential themes of Platonic philosophy concerning darkness, light or the flight from the prison of the material world are not extraneous to O'Neill's work, the author proves he was aware of the Platonic image of the cave thanks to its capital importance in the work of some of his intellectual mentors such as F. Nietzsche or Oscar Wilde. Nevertheless, the most significant aim of the author's article is to emphasize both the dramatic benefits and the logical reflections derived, as said before, from reading little by little O'Neill's drama bearing in mind the above mentioned Platonic parameter.

John Addington Symonds. A Problem in Greek Ethics. Plutarch's Eroticus quoted only in some footnotes? Why?

It is certainly astonishing that an innovating study about the Greek pederasty in England like the one by John Addington Symonds does not quote Plutarch's Eroticus -in fact, it is only cited in some footnotes-, if one bears in mind that this dialogue is an accurate philosophical reflection on Greek eros, in which very often significant ethical themes are approached. The aim of this article is just to reveal the different reasons for such an omission.

Assessing the impact of DRGs on patient care and professional practice in Switzerland (IDoC) : a potential model for monitoring and evaluating healthcare reform.

QUESTIONS UNDER STUDY: The starting point of the interdisciplinary project "Assessing the impact of diagnosis related groups (DRGs) on patient care and professional practice" (IDoC) was the lack of a systematic ethical assessment for the introduction of cost containment measures in healthcare. Our aim was to contribute to the methodological and empirical basis of such an assessment. METHODS: Five sub-groups conducted separate but related research within the fields of biomedical ethics, law, nursing sciences and health services, applying a number of complementary methodological approaches. The individual research projects were framed within an overall ethical matrix. Workshops and bilateral meetings were held to identify and elaborate joint research themes. RESULTS: Four common, ethically relevant themes emerged in the results of the studies across sub-groups: (1.) the quality and safety of patient care, (2.) the state of professional practice of physicians and nurses, (3.) changes in incentives structure, (4.) vulnerable groups and access to healthcare services. Furthermore, much-needed data for future comparative research has been collected and some early insights into the potential impact of DRGs are outlined. CONCLUSIONS: Based on the joint results we developed preliminary recommendations related to conceptual analysis, methodological refinement, monitoring and implementation.

Midwest Transportation Consortium Annual Report, 2004-2005

The Midwest Transportation Consortium (MTC) recently completed its sixth year of operation. The MTC has become an established portion of the research and educational programs at ISU and its partner universities. The MTC continues to emphasize its primary focus of developing human capital. For example, this semester, Fall, 2005, ISU has graduate scholars in its educational program. However, we also recognize that the federal grant is an opportunity to build programs at our respective universities that continue after the U.S. DOT UTCP may end. An example of building a long lasting program is the University of Missouri – St. Louis’ (UMSL) and its development of a transportation Ph.D. program in their business college. Admittedly, this program could have been started regardless, but Dr. Ray Mundy, Director of UMSL’s Transportation Scholars Program, believes that the MTC support of the transportation educational program at UMSL was the essential component in establishing a Ph.D. program. At ISU, the MTC has been instrumental in establishing two research and outreach programs, and both have themes that are related to the MTC’s theme of “Transportation System Management and Operation.” The Center for Weather Impacts on Mobility and Safety (C-WIMS) was recently established, and the Center for Road Infrastructure Management and Operations (RIMO) is in the process of being established. The MTC has a critical role in establishing each of these two programs. As part of the on-going MTC program, we have established an effective network that promotes the education of future transportation professionals and the development of new knowledge on how to manage transportation infrastructure and services in a more sustainable manner. The MTC has a track record of developing outstanding students; these students are now becoming leaders in the private sector, government, and academia. The MTC has also supported the development of an extensive research portfolio related to sustainable transportation asset management. More research projects are in the pipeline. Finally, the MTC has dedicated itself to the dissemination of asset management research results through an ongoing technology transfer program. This document provides a progress for the latest fiscal year of operation of the MTC, which ran from October 2004 through September 2005.

Midwest Transportation Consortium Annual Report, 2005-2006

The Midwest Transportation Consortium (MTC) recently completed its sixth year of operation. The MTC has become an established portion of the research and educational programs at ISU and its partner universities. The MTC continues to emphasize its primary focus of developing human capital. For example, this semester, Fall, 2005, ISU has graduate scholars in its educational program. However, we also recognize that the federal grant is an opportunity to build programs at our respective universities that continue after the U.S. DOT UTCP may end. An example of building a long lasting program is the University of Missouri – St. Louis’ (UMSL) and its development of a transportation Ph.D. program in their business college. Admittedly, this program could have been started regardless, but Dr. Ray Mundy, Director of UMSL’s Transportation Scholars Program, believes that the MTC support of the transportation educational program at UMSL was the essential component in establishing a Ph.D. program. At ISU, the MTC has been instrumental in establishing two research and outreach programs, and both have themes that are related to the MTC’s theme of “Transportation System Management and Operation.” The Center for Weather Impacts on Mobility and Safety (C-WIMS) was recently established, and the Center for Road Infrastructure Management and Operations (RIMO) is in the process of being established. The MTC has a critical role in establishing each of these two programs. As part of the on-going MTC program, we have established an effective network that promotes the education of future transportation professionals and the development of new knowledge on how to manage transportation infrastructure and services in a more sustainable manner. The MTC has a track record of developing outstanding students; these students are now becoming leaders in the private sector, government, and academia. The MTC has also supported the development of an extensive research portfolio related to sustainable transportation asset management. More research projects are in the pipeline. Finally, the MTC has dedicated itself to the dissemination of asset management research results through an ongoing technology transfer program. This document provides a progress for the latest fiscal year of operation of the MTC, which ran from October 2004 through September 2005.

Midwest Transportation Consortium Annual Report, 2006-2007

The Midwest Transportation Consortium (MTC) recently completed its sixth year of operation. The MTC has become an established portion of the research and educational programs at ISU and its partner universities. The MTC continues to emphasize its primary focus of developing human capital. For example, this semester, Fall, 2005, ISU has graduate scholars in its educational program. However, we also recognize that the federal grant is an opportunity to build programs at our respective universities that continue after the U.S. DOT UTCP may end. An example of building a long lasting program is the University of Missouri – St. Louis’ (UMSL) and its development of a transportation Ph.D. program in their business college. Admittedly, this program could have been started regardless, but Dr. Ray Mundy, Director of UMSL’s Transportation Scholars Program, believes that the MTC support of the transportation educational program at UMSL was the essential component in establishing a Ph.D. program. At ISU, the MTC has been instrumental in establishing two research and outreach programs, and both have themes that are related to the MTC’s theme of “Transportation System Management and Operation.” The Center for Weather Impacts on Mobility and Safety (C-WIMS) was recently established, and the Center for Road Infrastructure Management and Operations (RIMO) is in the process of being established. The MTC has a critical role in establishing each of these two programs. As part of the on-going MTC program, we have established an effective network that promotes the education of future transportation professionals and the development of new knowledge on how to manage transportation infrastructure and services in a more sustainable manner. The MTC has a track record of developing outstanding students; these students are now becoming leaders in the private sector, government, and academia. The MTC has also supported the development of an extensive research portfolio related to sustainable transportation asset management. More research projects are in the pipeline. Finally, the MTC has dedicated itself to the dissemination of asset management research results through an ongoing technology transfer program. This document provides a progress for the latest fiscal year of operation of the MTC, which ran from October 2004 through September 2005.

Midwest Transportation Consortium Annual Report, 2007-2008

The Midwest Transportation Consortium (MTC) recently completed its sixth year of operation. The MTC has become an established portion of the research and educational programs at ISU and its partner universities. The MTC continues to emphasize its primary focus of developing human capital. For example, this semester, Fall, 2005, ISU has graduate scholars in its educational program. However, we also recognize that the federal grant is an opportunity to build programs at our respective universities that continue after the U.S. DOT UTCP may end. An example of building a long lasting program is the University of Missouri – St. Louis’ (UMSL) and its development of a transportation Ph.D. program in their business college. Admittedly, this program could have been started regardless, but Dr. Ray Mundy, Director of UMSL’s Transportation Scholars Program, believes that the MTC support of the transportation educational program at UMSL was the essential component in establishing a Ph.D. program. At ISU, the MTC has been instrumental in establishing two research and outreach programs, and both have themes that are related to the MTC’s theme of “Transportation System Management and Operation.” The Center for Weather Impacts on Mobility and Safety (C-WIMS) was recently established, and the Center for Road Infrastructure Management and Operations (RIMO) is in the process of being established. The MTC has a critical role in establishing each of these two programs. As part of the on-going MTC program, we have established an effective network that promotes the education of future transportation professionals and the development of new knowledge on how to manage transportation infrastructure and services in a more sustainable manner. The MTC has a track record of developing outstanding students; these students are now becoming leaders in the private sector, government, and academia. The MTC has also supported the development of an extensive research portfolio related to sustainable transportation asset management. More research projects are in the pipeline. Finally, the MTC has dedicated itself to the dissemination of asset management research results through an ongoing technology transfer program. This document provides a progress for the latest fiscal year of operation of the MTC, which ran from October 2004 through September 2005.

Midwest Transportation Consortium Annual Report, 2009

The Midwest Transportation Consortium (MTC) recently completed its sixth year of operation. The MTC has become an established portion of the research and educational programs at ISU and its partner universities. The MTC continues to emphasize its primary focus of developing human capital. For example, this semester, Fall, 2005, ISU has graduate scholars in its educational program. However, we also recognize that the federal grant is an opportunity to build programs at our respective universities that continue after the U.S. DOT UTCP may end. An example of building a long lasting program is the University of Missouri – St. Louis’ (UMSL) and its development of a transportation Ph.D. program in their business college. Admittedly, this program could have been started regardless, but Dr. Ray Mundy, Director of UMSL’s Transportation Scholars Program, believes that the MTC support of the transportation educational program at UMSL was the essential component in establishing a Ph.D. program. At ISU, the MTC has been instrumental in establishing two research and outreach programs, and both have themes that are related to the MTC’s theme of “Transportation System Management and Operation.” The Center for Weather Impacts on Mobility and Safety (C-WIMS) was recently established, and the Center for Road Infrastructure Management and Operations (RIMO) is in the process of being established. The MTC has a critical role in establishing each of these two programs. As part of the on-going MTC program, we have established an effective network that promotes the education of future transportation professionals and the development of new knowledge on how to manage transportation infrastructure and services in a more sustainable manner. The MTC has a track record of developing outstanding students; these students are now becoming leaders in the private sector, government, and academia. The MTC has also supported the development of an extensive research portfolio related to sustainable transportation asset management. More research projects are in the pipeline. Finally, the MTC has dedicated itself to the dissemination of asset management research results through an ongoing technology transfer program. This document provides a progress for the latest fiscal year of operation of the MTC, which ran from October 2004 through September 2005.

Midwest Transportation Consortium Annual Report, 2010

The Midwest Transportation Consortium (MTC) recently completed its sixth year of operation. The MTC has become an established portion of the research and educational programs at ISU and its partner universities. The MTC continues to emphasize its primary focus of developing human capital. For example, this semester, Fall, 2005, ISU has graduate scholars in its educational program. However, we also recognize that the federal grant is an opportunity to build programs at our respective universities that continue after the U.S. DOT UTCP may end. An example of building a long lasting program is the University of Missouri – St. Louis’ (UMSL) and its development of a transportation Ph.D. program in their business college. Admittedly, this program could have been started regardless, but Dr. Ray Mundy, Director of UMSL’s Transportation Scholars Program, believes that the MTC support of the transportation educational program at UMSL was the essential component in establishing a Ph.D. program. At ISU, the MTC has been instrumental in establishing two research and outreach programs, and both have themes that are related to the MTC’s theme of “Transportation System Management and Operation.” The Center for Weather Impacts on Mobility and Safety (C-WIMS) was recently established, and the Center for Road Infrastructure Management and Operations (RIMO) is in the process of being established. The MTC has a critical role in establishing each of these two programs. As part of the on-going MTC program, we have established an effective network that promotes the education of future transportation professionals and the development of new knowledge on how to manage transportation infrastructure and services in a more sustainable manner. The MTC has a track record of developing outstanding students; these students are now becoming leaders in the private sector, government, and academia. The MTC has also supported the development of an extensive research portfolio related to sustainable transportation asset management. More research projects are in the pipeline. Finally, the MTC has dedicated itself to the dissemination of asset management research results through an ongoing technology transfer program. This document provides a progress for the latest fiscal year of operation of the MTC, which ran from October 2004 through September 2005.

Midwest Transportation Consortium Annual Report, 2011

The Midwest Transportation Consortium (MTC) recently completed its sixth year of operation. The MTC has become an established portion of the research and educational programs at ISU and its partner universities. The MTC continues to emphasize its primary focus of developing human capital. For example, this semester, Fall, 2005, ISU has graduate scholars in its educational program. However, we also recognize that the federal grant is an opportunity to build programs at our respective universities that continue after the U.S. DOT UTCP may end. An example of building a long lasting program is the University of Missouri – St. Louis’ (UMSL) and its development of a transportation Ph.D. program in their business college. Admittedly, this program could have been started regardless, but Dr. Ray Mundy, Director of UMSL’s Transportation Scholars Program, believes that the MTC support of the transportation educational program at UMSL was the essential component in establishing a Ph.D. program. At ISU, the MTC has been instrumental in establishing two research and outreach programs, and both have themes that are related to the MTC’s theme of “Transportation System Management and Operation.” The Center for Weather Impacts on Mobility and Safety (C-WIMS) was recently established, and the Center for Road Infrastructure Management and Operations (RIMO) is in the process of being established. The MTC has a critical role in establishing each of these two programs. As part of the on-going MTC program, we have established an effective network that promotes the education of future transportation professionals and the development of new knowledge on how to manage transportation infrastructure and services in a more sustainable manner. The MTC has a track record of developing outstanding students; these students are now becoming leaders in the private sector, government, and academia. The MTC has also supported the development of an extensive research portfolio related to sustainable transportation asset management. More research projects are in the pipeline. Finally, the MTC has dedicated itself to the dissemination of asset management research results through an ongoing technology transfer program. This document provides a progress for the latest fiscal year of operation of the MTC, which ran from October 2004 through September 2005.