1.
Physician
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Both the role of the physician and the meaning of the word itself vary around the world. Degrees and other qualifications vary widely, but there are common elements, such as medical ethics requiring that physicians show consideration, compassion. Around the world the term refers to a specialist in internal medicine or one of its many sub-specialties. This meaning of physician conveys a sense of expertise in treatment by drugs or medications and this term is at least nine hundred years old in English, physicians and surgeons were once members of separate professions, and traditionally were rivals. Henry VIII granted a charter to the London Royal College of Physicians in 1518 and it was not until 1540 that he granted the Company of Barber/Surgeons its separate charter. In the same year, the English monarch established the Regius Professorship of Physic at the University of Cambridge, newer universities would probably describe such an academic as a professor of internal medicine. Hence, in the 16th century, physic meant roughly what internal medicine does now, currently, a specialist physician in the United States may be described as an internist. Another term, hospitalist, was introduced in 1996, to describe US specialists in internal medicine who work largely or exclusively in hospitals, such hospitalists now make up about 19% of all US general internists, who are often called general physicians in Commonwealth countries. In such places, the more general English terms doctor or medical practitioner are prevalent, in Commonwealth countries, specialist pediatricians and geriatricians are also described as specialist physicians who have sub-specialized by age of patient rather than by organ system. Around the world, the term physician and surgeon is used to describe either a general practitioner or any medical practitioner irrespective of specialty. This usage still shows the meaning of physician and preserves the old difference between a physician, as a practitioner of physic, and a surgeon. The term may be used by state medical boards in the United States of America, in modern English, the term physician is used in two main ways, with relatively broad and narrow meanings respectively. This is the result of history and is often confusing and these meanings and variations are explained below. In the United States and Canada, the term physician describes all medical practitioners holding a professional medical degree, the American Medical Association, established in 1847, as well as the American Osteopathic Association, founded in 1897, both currently use the term physician to describe members. However, the American College of Physicians, established in 1915, does not, its title uses physician in its original sense. A physician trained in the United States has either a Doctor of Medicine degree, all boards of certification now require that physicians demonstrate, by examination, continuing mastery of the core knowledge and skills for a chosen specialty. Recertification varies by particular specialty between every seven and every ten years, graduates of osteopathic medical schools in the United States should not be confused with osteopaths, who are trained in the European and Commonwealth nations. Their training is similar to physical therapy and they are not licensed to prescribe medications or perform surgeries, also in the United States, the American Podiatric Medical Association defines podiatrists as physicians and surgeons that fall under the department of surgery in hospitals
2.
Preventive healthcare
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Preventive healthcare consists of measures taken for disease prevention, as opposed to disease treatment. Health, disease, and disability are dynamic processes which begin before individuals realize they are affected, Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention. Each year, millions of people die of preventable deaths, a 2004 study showed that about half of all deaths in the United States in 2000 were due to preventable behaviors and exposures. Leading causes included cardiovascular disease, chronic disease, unintentional injuries, diabetes. This same study estimates that 400,000 people die each year in the United States due to poor diet and this is an increase from the year 2000, during which 60% of deaths were attributed to these diseases. Preventive healthcare is especially important given the rise in prevalence of chronic diseases. There are many methods for prevention of disease, genetic testing can also be performed to screen for mutations that cause genetic disorders or predisposition to certain diseases such as breast or ovarian cancer. However, these measures are not affordable for every individual and the cost effectiveness of healthcare is still a topic of debate. Preventive healthcare strategies are described as taking place at the primal, primary, secondary, in the 1940s, Hugh R. Leavell and E. Gurney Clark coined the term primary prevention. They worked at the Harvard and Columbia University Schools of Public Health, respectively, goldston notes that these levels might be better described as prevention, treatment, and rehabilitation, though the terms primary, secondary, and tertiary prevention are still in use today. A separate category of health promotion has recently been propounded and this new way of promoting health is now commonly called primal prevention. It consists mainly in providing future parents with pertinent, unbiased information on primal health and this includes adequate parental leave - ideally for both parents - with kin caregiving and financial help where needed. Another related concept is primordial prevention which to refers to all measures designed to prevent the development of risk factors in the first place, primary prevention consists of traditional health promotion and specific protection. Health promotion activities are current, non-clinical life choices, for example, eating nutritious meals and exercising daily, that both prevent disease and create a sense of overall well-being. Preventing disease and creating overall well-being, prolongs our life expectancy, health-promotional activities do not target a specific disease or condition but rather promote health and well-being on a very general level. On the other hand, specific protection targets a type or group of diseases, whereas specific protective measures would be using prophylactics during sex and avoiding sexual promiscuity. Food is very much the most basic tool in preventive health care, the 2011 National Health Interview Survey performed by the Centers for Disease Control was the first national survey to include questions about ability to pay for food. Difficulty with paying for food, medicine, or both is a problem facing 1 out of 3 Americans and these are often low-income neighborhoods with the majority of residents lacking transportation
3.
Health education
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Health education is a profession of educating people about health. Areas within this profession encompass environmental health, physical health, social health, emotional health, intellectual health, and spiritual health. Health education can be defined as the principle by which individuals and groups of people, learn to behave in a manner conducive to the promotion, maintenance, however, as there are multiple definitions of health, there are also multiple definitions of health education. From the late nineteenth to the century, the aim of public health was controlling the harm from infectious diseases. By the mid 1970s it was clear that reducing illness, death, in January 1978 the Role Delineation Project was put into place, in order to define the basic roles and responsibilities for the health educator. The result was a Framework for the Development of Competency-Based Curricula for Entry Level Health Educators, a second result was a revised version of A Competency-Based Framework for the Professional Development of Certified Health Education Specialists. These documents outlined the seven areas of responsibilities which are shown below and it hopes to motivate them with whatever interests they may have in improving their living conditions. Its aim come is to develop in them a sense of responsibility for health conditions for themselves as individuals, as members of families, Health education is also an effective tool that helps improve health in developing nations. It not only teaches prevention and basic health knowledge but also ideas that re-shape everyday habits of people with unhealthy lifestyles in developing countries. Accreditation, licensure, or certifications are all forms of credentialing, in 1978, Helen Cleary, the president of the Society for Public Health Education started the process of certification of health educators. Prior to this, there was no certification for individual health educators, the only accreditation available in this field was for school health and public health professional preparation programs. Her initial response was to incorporate experts in the field and to funding for the process. The director if the Division of Associated Health Professions in the Bureau of Health Manpower of the Department of Health, Education, in attendance were interested professionals who covered the possibility of creating credentialing within the profession. Funding for this became available in January 1979, and role delineation became a realistic vision for the future. They presented the framework for the system in 1981 and published entry-level criteria in 1983, Seven areas of responsibility,29 areas of competency and 79 sub-competencies were required of health education professionals for approximately 20 years for entry-level educators. In 1986 a second conference was held in Bethesda, Maryland to further the credentialing process, in June 1988, the National Task Force in the Preparation and Practice of Health Educators became the National Commission for Health Education Credentialing, Inc. Their mission was to development of the field by promoting, preparing and certifying health education specialists. The NCHEC has three division boards that included preparation, professional development and certification of health educator professionals, the third board, which is called the Division Board of Certification of Health Education Specialist, has the responsibility of developing and administering the CHES exam
4.
Holism
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Holism is the idea that systems and their properties should be viewed as wholes, not just as a collection of parts. The term Holism was coined by J C Smuts in Holism and it was Smuts opinion that Holism is a concept that represents all of the wholes in the universe, and these wholes are the real factors in the universe. Further, that Holism also denoted a theory of the universe in the vein as Materialism and Spiritualism. The derived adjective holistic has been applied to a range of fields where they incorporate the concept of holism. The field characterizes a whole as a unified and synthesised event in the system of Relativity, as such, the concept of field entails both activity and structure. Darwins theory of organic descent placed primary emphasis on the role of natural selection, the whole exhibits a discernible regulatory function as it relates to cooperation and coordination of the structure and activity of parts, and to the selection and deselection of variations. The result is a correlation of organs and functions. The activities of the parts are directed to central ends, co-operation and it is the intermingling of fields which is creative or causal in nature. This is seen in matter, where if not for its dynamic structural creative character matter could not have been the mother of the universe, with minds the regulatory function of Holism acquires consciousness and freedom, demonstrating a creative power of the most far-reaching character. Holism is not only creative but self-creative, and its structures are far more holistic than its initial structures. Holism exemplifies this idea while emphasizing the holistic character of the process. The whole completely transforms the concept of Causality, results are not directly a function of causes, the whole absorbs and integrates the cause into its own activity, results appear as the consequence of the activity of the whole. It is the edition of Holism and Evolution that provides the most recent. In philosophy, any doctrine that emphasizes the priority of a whole over its parts is holism, some suggest that such a definition owes its origins to a non-holistic view of language and places it in the reductivist camp. Alternately, a definition of holism denies the necessity of a division between the function of separate parts and the workings of the whole. It suggests that the key characteristic of a concept of holism is a sense of the fundamental truth of any particular experience. This exists in contradistinction to what is perceived as the reductivist reliance on inductive method as the key to verification of its concept of how the function within the whole. In the philosophy of mind, a state may be identified only in terms of its relations with others
5.
Republic of Ireland
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Ireland, also known as the Republic of Ireland, is a sovereign state in north-western Europe occupying about five-sixths of the island of Ireland. The capital and largest city is Dublin, which is located on the part of the island. The state shares its land border with Northern Ireland, a part of the United Kingdom. It is otherwise surrounded by the Atlantic Ocean, with the Celtic Sea to the south, Saint Georges Channel to the south-east, and it is a unitary, parliamentary republic. The head of government is the Taoiseach, who is elected by the Dáil and appointed by the President, the state was created as the Irish Free State in 1922 as a result of the Anglo-Irish Treaty. It was officially declared a republic in 1949, following the Republic of Ireland Act 1948, Ireland became a member of the United Nations in December 1955. It joined the European Economic Community, the predecessor of the European Union, after joining the EEC, Ireland enacted a series of liberal economic policies that resulted in rapid economic growth. The country achieved considerable prosperity between the years of 1995 and 2007, which known as the Celtic Tiger period. This was halted by a financial crisis that began in 2008. However, as the Irish economy was the fastest growing in the EU in 2015, Ireland is again quickly ascending league tables comparing wealth and prosperity internationally. For example, in 2015, Ireland was ranked as the joint sixth most developed country in the world by the United Nations Human Development Index and it also performs well in several national performance metrics, including freedom of the press, economic freedom and civil liberties. Ireland is a member of the European Union and is a member of the Council of Europe. The 1922 state, comprising 26 of the 32 counties of Ireland, was styled, the Constitution of Ireland, adopted in 1937, provides that the name of the State is Éire, or, in the English language, Ireland. Section 2 of the Republic of Ireland Act 1948 states, It is hereby declared that the description of the State shall be the Republic of Ireland. The 1948 Act does not name the state as Republic of Ireland, because to have done so would have put it in conflict with the Constitution. The government of the United Kingdom used the name Eire, and, from 1949, Republic of Ireland, for the state, as well as Ireland, Éire or the Republic of Ireland, the state is also referred to as the Republic, Southern Ireland or the South. In an Irish republican context it is referred to as the Free State or the 26 Counties. From the Act of Union on 1 January 1801, until 6 December 1922, during the Great Famine, from 1845 to 1849, the islands population of over 8 million fell by 30%
6.
United Kingdom
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The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom or Britain, is a sovereign country in western Europe. Lying off the north-western coast of the European mainland, the United Kingdom includes the island of Great Britain, Northern Ireland is the only part of the United Kingdom that shares a land border with another sovereign state—the Republic of Ireland. The Irish Sea lies between Great Britain and Ireland, with an area of 242,500 square kilometres, the United Kingdom is the 78th-largest sovereign state in the world and the 11th-largest in Europe. It is also the 21st-most populous country, with an estimated 65.1 million inhabitants, together, this makes it the fourth-most densely populated country in the European Union. The United Kingdom is a monarchy with a parliamentary system of governance. The monarch is Queen Elizabeth II, who has reigned since 6 February 1952, other major urban areas in the United Kingdom include the regions of Birmingham, Leeds, Glasgow, Liverpool and Manchester. The United Kingdom consists of four countries—England, Scotland, Wales, the last three have devolved administrations, each with varying powers, based in their capitals, Edinburgh, Cardiff and Belfast, respectively. The relationships among the countries of the UK have changed over time, Wales was annexed by the Kingdom of England under the Laws in Wales Acts 1535 and 1542. A treaty between England and Scotland resulted in 1707 in a unified Kingdom of Great Britain, which merged in 1801 with the Kingdom of Ireland to form the United Kingdom of Great Britain and Ireland. Five-sixths of Ireland seceded from the UK in 1922, leaving the present formulation of the United Kingdom of Great Britain, there are fourteen British Overseas Territories. These are the remnants of the British Empire which, at its height in the 1920s, British influence can be observed in the language, culture and legal systems of many of its former colonies. The United Kingdom is a country and has the worlds fifth-largest economy by nominal GDP. The UK is considered to have an economy and is categorised as very high in the Human Development Index. It was the worlds first industrialised country and the worlds foremost power during the 19th, the UK remains a great power with considerable economic, cultural, military, scientific and political influence internationally. It is a nuclear weapons state and its military expenditure ranks fourth or fifth in the world. The UK has been a permanent member of the United Nations Security Council since its first session in 1946 and it has been a leading member state of the EU and its predecessor, the European Economic Community, since 1973. However, on 23 June 2016, a referendum on the UKs membership of the EU resulted in a decision to leave. The Acts of Union 1800 united the Kingdom of Great Britain, Scotland, Wales and Northern Ireland have devolved self-government
7.
Commonwealth of Nations
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The Commonwealth of Nations, also known as simply the Commonwealth, is an intergovernmental organisation of 52 member states that are mostly former territories of the British Empire. The Commonwealth dates back to the century with the decolonisation of the British Empire through increased self-governance of its territories. It was formally constituted by the London Declaration in 1949, which established the states as free. The symbol of free association is Queen Elizabeth II who is the Head of the Commonwealth. The Queen is also the monarch of 16 members of the Commonwealth, the other Commonwealth members have different heads of state,31 members are republics and five are monarchies with a different monarch. Member states have no obligation to one another. Instead, they are united by language, history, culture and their values of democracy, free speech, human rights. These values are enshrined in the Commonwealth Charter and promoted by the quadrennial Commonwealth Games, the Commonwealth covers more than 29,958,050 km2, 20% of the worlds land area, and spans all six inhabited continents. She declared, So, it marks the beginning of that free association of independent states which is now known as the Commonwealth of Nations. As long ago as 1884, however, Lord Rosebery, while visiting Australia, had described the changing British Empire—as some of its colonies became more independent—as a Commonwealth of Nations. Conferences of British and colonial prime ministers occurred periodically from the first one in 1887, the Commonwealth developed from the imperial conferences. Newfoundland never did, as on 16 February 1934, with the consent of its parliament, Newfoundland later joined Canada as its 10th province in 1949. Australia and New Zealand ratified the Statute in 1942 and 1947 respectively, after World War II ended, the British Empire was gradually dismantled. Most of its components have become independent countries, whether Commonwealth realms or republics, there remain the 14 British overseas territories still held by the United Kingdom. In April 1949, following the London Declaration, the word British was dropped from the title of the Commonwealth to reflect its changing nature, burma and Aden are the only states that were British colonies at the time of the war not to have joined the Commonwealth upon independence. Hoped for success was reinforced by such achievements as climbing Mount Everest in 1953, breaking the four minute mile in 1954, however, the humiliation of the Suez Crisis of 1956 badly hurt morale of Britain and the Commonwealth as a whole. More broadly, there was the loss of a role of the British Empire. That role was no longer militarily or financially feasible, as Britains withdrawal from Greece in 1947 painfully demonstrated, Britain itself was now just one part of the NATO military alliance in which the Commonwealth had no role apart from Canada
8.
Primary care physician
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Since recently, the term is primarily used in the United States. In the past in the US and still in the United Kingdom, all physicians first complete medical school. To become primary care physicians, medical school graduates then undertake postgraduate training in primary care programs, such as family medicine, emergency physicians are sometimes counted as primary care physicians. A set of skills and scope of practice may define a primary physician, generally including basic diagnosis and treatment of common illnesses. Diagnostic techniques include interviewing the patient to collect information on the present symptoms, prior history and other health details. Many PCPs are trained in medical testing, such as interpreting results of blood or other patient samples, electrocardiograms. Primary care physicians also counsel and educate patients on safe health behaviors, self-care skills and treatment options, in some countries, for example Norway, residents are registered as patients of a doctor and must contact that doctor for referral to any other. Also, many health maintenance organizations position PCPs as gatekeepers, who regulate access to more costly procedures or specialists, continuous care is particularly important for patients with medical conditions that encompass multiple organ systems and require prolonged treatment and monitoring, such as diabetes and hypertension. Studies that compare the base and quality of care provided by generalists versus specialists usually find that the specialists are more knowledgeable. However, the studies examine the quality of care in the domain of the specialists, in addition, they need to account for clustering of patients and physicians. Studies of the quality of health care find the opposite results. An analysis of elderly patients found that patients seeing generalists, as compared to patients seeing specialists, were likely to receive influenza vaccination. In health promotion counseling, studies of self-reported behavior found that generalists were more likely than internal medicine specialists to counsel patients, exceptions may be diseases that are so common that primary care physicians develop their own expertise. A study of patients with low back pain found the primary care physicians provided equivalent quality of care. Factors associated with quality of care by primary care physicians, The more experience the primary care physician has with a specific disease, physician group affiliation with networks of multiple groups. The dissemination of information to generalists compared to specialists is complicated, two studies found specialists were more likely to adopt COX-2 drugs before the drugs were recalled by the FDA. Similarly, a study found that specialists were less discriminating in their choice of journal reading. In the United States, the number of students entering family practice training dropped by 50% between 1997 and 2005
9.
Pakistan
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Pakistan, officially the Islamic Republic of Pakistan, is a federal parliamentary republic in South Asia on the crossroads of Central Asia and Western Asia. It is the sixth-most populous country with a population exceeding 200 million people, in terms of area, it is the 33rd-largest country in the world with an area covering 881,913 square kilometres. It is separated from Tajikistan by Afghanistans narrow Wakhan Corridor in the north, Pakistan is unique among Muslim countries in that it is the only country to have been created in the name of Islam. As a result of the Pakistan Movement led by Muhammad Ali Jinnah and it is an ethnically and linguistically diverse country, with a similarly diverse geography and wildlife. Initially a dominion, Pakistan adopted a constitution in 1956, becoming an Islamic republic, an ethnic civil war in 1971 resulted in the secession of East Pakistan as the new country of Bangladesh. The new constitution stipulated that all laws were to conform to the injunctions of Islam as laid down in the Quran. Pakistan has an economy with a well-integrated agriculture sector. The Pakistani economy is the 24th-largest in the world in terms of purchasing power and it is ranked among the emerging and growth-leading economies of the world, and is backed by one of the worlds largest and fastest-growing middle classes. The post-independence history of Pakistan has been characterised by periods of military rule, the country continues to face challenging problems such as illiteracy, healthcare, and corruption, but has substantially reduced poverty and terrorism and expanded per capita income. It is also a member of CERN. Pakistan is a signatory to the Kyoto Protocol, the Paris Agreement, the name Pakistan literally means land of the pure in Urdu and Persian. It is a play on the word pāk meaning pure in Persian and Pashto, the letter i was incorporated to ease pronunciation and form the linguistically correct and meaningful name. Some of the earliest ancient human civilisations in South Asia originated from areas encompassing present-day Pakistan, the earliest known inhabitants in the region were Soanian during the Lower Paleolithic, of whom stone tools have been found in the Soan Valley of Punjab. The Vedic Civilization, characterised by Indo-Aryan culture, laid the foundations of Hinduism, Multan was an important Hindu pilgrimage centre. The Vedic civilisation flourished in the ancient Gandhāran city of Takṣaśilā, the Indo-Greek Kingdom founded by Demetrius of Bactria included Gandhara and Punjab and reached its greatest extent under Menander, prospering the Greco-Buddhist culture in the region. Taxila had one of the earliest universities and centres of education in the world. At its zenith, the Rai Dynasty of Sindh ruled this region, the Pala Dynasty was the last Buddhist empire, which, under Dharampala and Devapala, stretched across South Asia from what is now Bangladesh through Northern India to Pakistan. The Arab conqueror Muhammad bin Qasim conquered the Indus valley from Sindh to Multan in southern Punjab in 711 AD, the Pakistan governments official chronology identifies this as the time when the foundation of Pakistan was laid
10.
Pakistan Medical and Dental Council
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Pakistan Medical and Dental Council, established in 1962, is a regulatory authority for practitioners and students of medicine and dentistry in Pakistan. It was established under Pakistan Medical & Dental Council Ordinance 1962 as a body corporate and it is a long-standing member of the International Association of Medical Regulatory Authorities. It is responsible for developing of National Curriculum of MBBS & BDS and its elected President till August 2012 was Prof Syed Sibtul Hasnain and Registrar is Dr. Ahmad Nadeem Akbar. PMDC has its headquarters located in Islamabad and regional offices in Lahore, established by adopting Indian Medical Council Act 1933 on the recommendation of Health Conference in 1947. West Pakistan Medical Council was created on the formation of West Pakistan by merging Sindh & Punjab Medical Councils, the Council was re-constituted under Medical & Dental Council Ordinance 1962, and Provincial Medical Councils were dissolved. The Medical & Dental Council Act, the Medical & Dental Council Ordinance. S. The standards used by PM&DC for accreditation and inspection of medical and dental colleges in Pakistan have been declared comparable to U. S standards, the system of accreditation had also been approved by the General Medical Council U. K. Previously the General Medical Council used to conduct inspection of medical colleges in Pakistan through their own team for the purpose of recognition of medical college. All the colleges recognised under the PM&DC ordinance 1962 were recognised by FAIMER in 2012, list of Medical Colleges Notified in International Directory of Medical Colleges, this is with little seats for public sector only 3200 for 60000 candidates Official website PFMSG
11.
College of Physicians and Surgeons Pakistan
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College of Physicians & Surgeons Pakistan is an autonomous institution offering certification following postgraduate training in specialties of Medicine, Surgery & Dentistry. It is also the examination body in Pakistan awarding degrees of FCPS, DCPS, MCPS. The College of Physicians and Surgeons Pakistan was incorporated through Ordinance of 1962 issued on 19 May 1962, the College of Physicians and Surgeons Pakistan was incorporated in 1962. A Burki was the founding President of CPSP
12.
Aga Khan University
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Founded in 1983 by the Prince Aga Khan IV through the Aga Khan Development Network. The university launched a medical college and a hospital on a 65-acre site in Karachi. The university over the expanded, in 2004 established a teaching hospital in Nairobi. In 2002, the university established a campus in London dedicated to the study of the Near East, in 2015, the university established the Institute for Human Development funded by the CIDA, and in 2016, the university launched the Graduate School of Media and Communications. In 2016, the university launched the East African Institute, the universitys clinical laboratories in Karachi are the only in Pakistan to be accredited by the College of American Pathologists. The universities campus in Karachi is ranked among the top 185 universities in Asia, the Higher Education Commission of Pakistan ranks the university as the top medical school in Pakistan.75 million patients. The Aga Khan University accounts for 75% of all research in Pakistan while the remaining 25 percent is shared by all the other institutions. AKU publishes more research articles in peer-reviewed, indexed internationally recognised journals than any university in Pakistan. Faculty promotions are dependent on publications in indexed journals while most medical students have published by the time they graduate, undergraduate medical students have published up to 50 research papers in indexed health journals. It is the one of the few universities in Pakistan to provide facilities to students at the undergraduate level. The university maintains an office to guide and support research conducted at the university. A University Research Council also funds grants after a review process facilitated by a Grants Review Committee. Particular emphasis is placed on community related health sciences research. AKU organizes international and national research workshops and seminars, a Health Sciences Research Assembly is held annually in which faculty and students present their research. The university is a site for NIH clinical trials, the seal of the Aga Khan University is a visual representation of the principles which underlie the founding of the university. The circular form of the seal has its roots in the rosettes of early Islamic periods and it also symbolizes the world and reflects the internationality of the Aga Khan University. At the centre of the seal is a star or sun representing light – a universal symbol of the enlightenment that education provides, the light is also symbolic of Nur. The star incorporates 49 points to commemorate the founding by Prince Karim Aga Khan
13.
Residency (medicine)
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Residency is a stage of graduate medical training. A resident or house officer is a physician who practices medicine usually in a hospital or clinic under the direct or indirect supervision of an attending physician, successful completion of a residency program is a requirement to obtaining an unrestricted license to practice medicine in many jurisdictions. Residency training may be followed by fellowship or sub-specialty training, a resident physician is more commonly referred to as a resident, senior house officer, or alternatively as a senior resident medical officer or house officer. Residents have graduated from a medical school and hold a medical degree. Residents are, collectively, the staff of a hospital. This term comes from the fact that resident physicians traditionally spend the majority of their training in house, duration of residencies can range from three years to seven years, depending upon the program and specialty. A year in residency begins between late June and early July depending on the program, and ends one calendar year later. Depending on the number of years a specialty requires, the term junior resident may refer to residents that have not completed half their residency, Senior residents are residents in their final year of residency. Some residency programs refer to residents in their year as chief residents. Alternatively, a resident may describe a resident who has been selected to extend his or her residency by one year and organize the activities. If a physician finishes a residency and decides to further his or her education in a fellowship, post-residency physicians are referred to as attending physicians, or consultants. However, the above applies only in educational institutes in which the period of training is specified in advance. In privately owned, non-training hospitals, in countries, the above terminology may reflect the level of responsibility held by a physician rather than their level of education. The first formal residency programs were established by Sir William Osler, residencies elsewhere then became formalized and institutionalized for the principal specialties in the early 20th century. But even mid-century, residency was not seen as necessary for general practice, residencies are traditionally hospital-based, and in the middle of the twentieth century, residents would often live in hospital-supplied housing. Call was sometimes as frequent as every second or third night for up to three years, pay was minimal beyond room, board, and laundry services. It was assumed that most young men and women training as physicians had few obligations outside of training at that stage of their careers. The first year of practical patient-care-oriented training after school has long been termed internship
14.
France
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France, officially the French Republic, is a country with territory in western Europe and several overseas regions and territories. The European, or metropolitan, area of France extends from the Mediterranean Sea to the English Channel and the North Sea, Overseas France include French Guiana on the South American continent and several island territories in the Atlantic, Pacific and Indian oceans. France spans 643,801 square kilometres and had a population of almost 67 million people as of January 2017. It is a unitary republic with the capital in Paris. Other major urban centres include Marseille, Lyon, Lille, Nice, Toulouse, during the Iron Age, what is now metropolitan France was inhabited by the Gauls, a Celtic people. The area was annexed in 51 BC by Rome, which held Gaul until 486, France emerged as a major European power in the Late Middle Ages, with its victory in the Hundred Years War strengthening state-building and political centralisation. During the Renaissance, French culture flourished and a colonial empire was established. The 16th century was dominated by civil wars between Catholics and Protestants. France became Europes dominant cultural, political, and military power under Louis XIV, in the 19th century Napoleon took power and established the First French Empire, whose subsequent Napoleonic Wars shaped the course of continental Europe. Following the collapse of the Empire, France endured a succession of governments culminating with the establishment of the French Third Republic in 1870. Following liberation in 1944, a Fourth Republic was established and later dissolved in the course of the Algerian War, the Fifth Republic, led by Charles de Gaulle, was formed in 1958 and remains to this day. Algeria and nearly all the colonies became independent in the 1960s with minimal controversy and typically retained close economic. France has long been a centre of art, science. It hosts Europes fourth-largest number of cultural UNESCO World Heritage Sites and receives around 83 million foreign tourists annually, France is a developed country with the worlds sixth-largest economy by nominal GDP and ninth-largest by purchasing power parity. In terms of household wealth, it ranks fourth in the world. France performs well in international rankings of education, health care, life expectancy, France remains a great power in the world, being one of the five permanent members of the United Nations Security Council with the power to veto and an official nuclear-weapon state. It is a member state of the European Union and the Eurozone. It is also a member of the Group of 7, North Atlantic Treaty Organization, Organisation for Economic Co-operation and Development, the World Trade Organization, originally applied to the whole Frankish Empire, the name France comes from the Latin Francia, or country of the Franks
15.
Disease
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A disease is a particular abnormal condition, a disorder of a structure or function, that affects part or all of an organism. The study of disease is called pathology which includes the study of cause, Disease is often construed as a medical condition associated with specific symptoms and signs. When caused by pathogens, even in the literature, the term disease is often misleadingly used in the place of its causal agent. This language habitat can cause confusion in the communication of the principle in epidemiology. Diseases can affect not only physically, but also emotionally. Death due to disease is called death by natural causes, there are four main types of disease, infectious diseases, deficiency diseases, genetic diseases, and physiological diseases. Diseases can also be classified as communicable and non-communicable, the deadliest diseases in humans are coronary artery disease, followed by cerebrovascular disease and lower respiratory infections. In many cases, terms such as disease, disorder, morbidity, there are situations, however, when specific terms are considered preferable. Disease The term disease broadly refers to any condition that impairs the normal functioning of the body, for this reason, diseases are associated with dysfunctioning of the bodys normal homeostatic processes. The term disease has both a count sense and a noncount sense, by contrast, an infection that is asymptomatic during its incubation period, but expected to produce symptoms later, is usually considered a disease. Non-infectious diseases are all other diseases, including most forms of cancer, heart disease, acquired disease disease that began at some point during ones lifetime, as opposed to disease that was already present at birth, which is congenital disease. Acquired sounds like it could mean caught via contagion, but it simply means acquired sometime after birth and it also sounds like it could imply secondary disease, but acquired disease can be primary disease. It is often, genetic and can be inherited and it can also be the result of a vertically transmitted infection from the mother such as HIV/AIDS. Genetic disease disease that is caused by genetic mutation and it is often inherited, but some mutations are random and de novo. Hereditary or inherited disease a type of disease caused by mutation that is hereditary Iatrogenic disease A disease condition caused by medical intervention. Idiopathic disease disease whose cause is unknown, as medical science has advanced, many diseases whose causes were formerly complete mysteries have been somewhat explained or even extensively explained. Bacterial infections can be primary or secondary to a viral infection or burn. Terminal disease disease with death as an inevitable result Illness Illness is generally used as a synonym for disease, however, this term is occasionally used to refer specifically to the patients personal experience of his or her disease
16.
Sport
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Usually the contest or game is between two sides, each attempting to exceed the other. Some sports allow a tie game, others provide tie-breaking methods, to one winner. A number of such two-sided contests may be arranged in a tournament producing a champion, many sports leagues make an annual champion by arranging games in a regular sports season, followed in some cases by playoffs. Hundreds of sports exist, from those between single contestants, through to those with hundreds of participants, either in teams or competing as individuals. In certain sports such as racing, many contestants may compete, each against each other, however, a number of competitive, but non-physical, activities claim recognition as mind sports. Sports are usually governed by a set of rules or customs, which serve to ensure fair competition, winning can be determined by physical events such as scoring goals or crossing a line first. It can also be determined by judges who are scoring elements of the sporting performance, records of performance are often kept, and for popular sports, this information may be widely announced or reported in sport news. Sport is also a source of entertainment for non-participants, with spectator sport drawing large crowds to sport venues. Sports betting is in some cases severely regulated, and in some cases is central to the sport, kearney, a consultancy, the global sporting industry is worth up to $620 billion as of 2013. The worlds most accessible and practised sport is running, while football is the most popular spectator sport. The word Sport comes from the Old French desport meaning leisure, other meanings include gambling and events staged for the purpose of gambling, hunting, and games and diversions, including ones that require exercise. Rogets defines the noun sport as an activity engaged in for relaxation, the singular term sport is used in most English dialects to describe the overall concept, with sports used to describe multiple activities. American English uses sports for both terms, the precise definition of what separates a sport from other leisure activities varies between sources. They also recognise that sport can be physical, primarily mind, predominantly motorised, primarily co-ordination. The inclusion of sports within sport definitions has not been universally accepted. Whilst SportAccord recognises a number of mind sports, it is not open to admitting any further mind sports. According to Council of Europe, European Sports Charter, article 2, other bodies advocate widening the definition of sport to include all physical activity. For instance, the Council of Europe include all forms of physical exercise, in competitive events, participants are graded or classified based on their result and often divided into groups of comparable performance
17.
Death
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Death is the cessation of all biological functions that sustain a living organism. Bodies of living organisms begin to decompose shortly after death, other concerns include fear of death, necrophobia, anxiety, sorrow, grief, emotional pain, depression, sympathy, compassion, solitude, or saudade. The potential for an afterlife is of concern for some humans, the word death comes from Old English deað, which in turn comes from Proto-Germanic *dauthuz. This comes from the Proto-Indo-European stem *dheu- meaning the Process, act, when a person has died, it is also said they have passed away, passed on, expired, or are gone, among numerous other socially accepted, religiously specific, slang, and irreverent terms. Bereft of life, the person is then a corpse, cadaver, a body, a set of remains, and when all flesh has rotted away. The terms carrion and carcass can also be used, though more often connote the remains of non-human animals. As a polite reference to a person, it has become common practice to use the participle form of decease, as in the deceased. The ashes left after a cremation are sometimes referred to by the neologism cremains, senescence refers to a scenario when a living being is able to survive all calamities, but eventually dies due to causes relating to old age. Almost all animals who survive external hazards to their biological functioning eventually die from biological aging, some organisms experience negligible senescence, even exhibiting biological immortality. These include the jellyfish Turritopsis dohrnii, the hydra, and the planarian, unnatural causes of death include suicide and homicide. From all causes, roughly 150,000 people die around the world each day, physiological death is now seen as a process, more than an event, conditions once considered indicative of death are now reversible. Where in the process a dividing line is drawn between life and death depends on factors beyond the presence or absence of vital signs, in general, clinical death is neither necessary nor sufficient for a determination of legal death. A patient with working heart and lungs determined to be dead can be pronounced legally dead without clinical death occurring. As scientific knowledge and medicine advance, formulating a precise definition of death becomes more difficult. The concept of death is a key to understanding of the phenomenon. There are many approaches to the concept. For example, brain death, as practiced in medical science, One of the challenges in defining death is in distinguishing it from life. As a point in time, death would seem to refer to the moment at which life ends, determining when death has occurred requires drawing precise conceptual boundaries between life and death
18.
Emergency medicine
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Different models for emergency medicine exist internationally. In developing countries, emergency medicine is still evolving and international emergency medicine programs offer hope of improving basic emergency care where resources are limited and it further encompasses an understanding of the development of pre-hospital and in-hospital emergency medical systems and the skills necessary for this development. The field of emergency medicine encompasses care involving the care of internal medical and surgical conditions. Emergency physicians also provide primary care to patients during off hours. Emergency medicine is distinct from urgent care, which refers to immediate healthcare for less emergent medical issues, however, many emergency physicians work in urgent care settings, since there is obvious overlap. Emergency medicine also includes aspects of acute primary care, and shares with family medicine the uniqueness of seeing all patients regardless of age. The emergency physician workforce also includes many competent physicians who trained in other specialties, the practice of emergency medicine is often quite different in rural areas where there are far fewer consultants and health care resources. In these areas, family physicians with additional skills in emergency medicine often staff emergency departments, rural emergency physicians may be the only health care providers in the community, and require skills that include primary care and obstetrics. Patterns vary by country and region, in the United States, the employment arrangement of emergency physician practices are either private, institutional, corporate, or governmental. In the United Kingdom, all consultants in emergency medicine work in the National Health Service, rural emergency departments may be headed by general practitioners alone, sometimes with non-specialist qualifications in emergency medicine. Dominique Jean Larrey is sometimes called the father of medicine for his strategies during the French wars. Emergency medicine as an independent medical specialty is relatively young, in many smaller emergency departments, nurses would triage patients and physicians would be called in based on the type of injury or illness. Family physicians were often on call for the department. Many of the pioneers of medicine were family physicians and other specialists who saw a need for additional training in emergency care. During this period, groups of physicians began to emerge who had left their respective practices in order to devote their work completely to the ED, in the UK in 1952, Maurice Ellis was appointed as the first casualty consultant at Leeds General Infirmary. In 1967, the Casualty Surgeons Association was established with Maurice Ellis as its first President, many hospitals and care centers feature departments of emergency medicine, where patients can receive acute care without an appointment. While many patients are treated for life-threatening injuries, others utilize the emergency department for non-urgent reasons such as headaches or a cold. As such, EDs can adjust staffing ratios and designate an area of the department for faster patient turnover to accommodate a variety of patient needs and volumes
19.
Emergency medical services
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This is most likely an emergency department at a hospital. In such services, the EMS is not summoned by members of the public, in some jurisdictions, EMS units may handle technical rescue operations such as extrication, water rescue, and search and rescue. Training and qualification levels for members and employees of emergency medical services vary widely throughout the world, in some systems, members may be present who are qualified only to drive ambulances, with no medical training. In contrast, most systems have personnel who retain at least basic first aid certifications, additionally many EMS systems are staffed with Advanced Life Support personnel, including paramedics, nurses, or, less commonly, physicians. Emergency care in the field has been rendered in different forms since the beginning of recorded history, the New Testament contains the parable of the Good Samaritan, where a man who was beaten is cared for by a Samaritan. Luke 10,34 - He went to him and bandaged his wounds, pouring on oil, then he put the man on his own donkey, took him to an inn and took care of him. Also during the Middle Ages, the Knights Hospitaller were known for rendering assistance to wounded soldiers in the battlefield, the first use of the ambulance as a specialized vehicle, in battle came about with the ambulances volantes designed by Dominique Jean Larrey, Napoleon Bonapartes chief surgeon. Larreys projects for flying ambulances were first approved by the Committee of Public Safety in 1794, in civilian ambulances, a major advance was made with the introduction of a transport carriage for cholera patients in London during 1832. This tenet of ambulances providing instant care, allowing hospitals to be spaced further apart, the first known hospital-based ambulance service operated out of Commercial Hospital, Cincinnati, Ohio by 1865. In June 1887 the St John Ambulance Brigade was established to provide first aid and it was modelled on a military-style command and discipline structure. Named the Vienna Voluntary Rescue Society, it served as a model for similar societies worldwide and this was followed in 1900 by New York City, who extolled its virtues of greater speed, more safety for the patient, faster stopping and a smoother ride. These first two ambulances were electrically powered with 2 hp motors on the rear axle. Canadian historians dispute this with the city of Toronto claiming The first formal training for ambulance attendants was conducted in 1892, two-way radios became available shortly after World War I, enabling for more efficient radio dispatch of ambulances in some areas. Prior to World War II, there were areas where a modern ambulance carried advanced medical equipment, was staffed by a physician. In many locations, however, ambulances were hearses - the only vehicle that could carry a recumbent patient - and were thus frequently run by funeral homes. These vehicles, which could serve either purpose, were known as combination cars, prior to World War II, hospitals provided ambulance service in many large cities. With the severe manpower shortages imposed by the war effort, it became difficult for many hospitals to maintain their ambulance operations, City governments in many cases turned ambulance services over to the police or fire department. No laws required minimal training for personnel and no training programs existed beyond basic first aid
20.
Midwifery
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In many countries, midwifery is a medical profession. A professional in midwifery is known as a midwife, however, midwifery-led care was also associated with a longer mean length of labor as measured in hours. A normal pregnancy lasts about 9 months and has 3 trimesters, first trimester screening varies by country. Women are typically offered a Pap smear and urine analysis, and blood tests including a complete blood count, blood typing, syphilis, hepatitis, HIV, and rubella testing. Additionally, women may have chlamydia testing via a urine sample, Women must consent to all tests before they are carried out. The womans blood pressure, height and weight are measured and her past pregnancies and family, social, and medical history are discussed. Women may have an ultrasound scan during the first trimester which may be used to find the estimated due date. Some women may have genetic testing, such as screening for Downs Syndrome, diet, exercise, and discomforts such as morning sickness are discussed. The mother visits the midwife monthly or more often during the second trimester, the mothers partner and/or the labor coach may accompany her. The midwife will discuss pregnancy issues such as fatigue, heartburn, varicose veins, blood pressure and weight are monitored and the midwife measures the mothers abdomen to see if the baby is growing as expected. Lab tests such as a UA, CBC, and glucose tolerance test are done if the midwife feels they are necessary, in the third trimester the midwife will see the mother every two weeks until week 36 and every week after that. Weight, blood pressure, and abdominal measurements will continue to be done, lab tests such as a CDC and UA may be done with additional testing done for at-risk pregnancies. The midwife palpates the abdomen to establish the lie, presentation and position of the fetus and later. A pelvic exam may be done to see if the mothers cervix is dilating, the midwife and the mother discuss birthing options and write a birth care plan. Midwives are qualified to assist with a vaginal delivery while more complicated deliveries are handled by a health care provider who has had further training. Childbirth is divided into four stages, first stage of labor The first stage of labour involves the opening of the cervix. In the early parts of this stage the cervix will become soft, the first stage of labour is complete when the cervix has dilated the full 10cm. During the first stage of labor the mother begins to feel strong and regular contractions that come every 5 to 20 minutes, contractions gradually become stronger, more frequent, and longer lasting
21.
Anatomy
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Anatomy is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is inherently tied to embryology, comparative anatomy, evolutionary biology, Human anatomy is one of the basic essential sciences of medicine. The discipline of anatomy is divided into macroscopic and microscopic anatomy, macroscopic anatomy, or gross anatomy, is the examination of an animals body parts using unaided eyesight. Gross anatomy also includes the branch of superficial anatomy, microscopic anatomy involves the use of optical instruments in the study of the tissues of various structures, known as histology, and also in the study of cells. The history of anatomy is characterized by an understanding of the functions of the organs. Anatomy and physiology, which study the structure and function of organisms and their parts, make a pair of related disciplines. Derived from the Greek ἀνατομή anatomē dissection, anatomy is the study of the structure of organisms including their systems, organs. It includes the appearance and position of the parts, the materials from which they are composed, their locations. Anatomy is quite distinct from physiology and biochemistry, which deal respectively with the functions of those parts, the discipline of anatomy can be subdivided into a number of branches including gross or macroscopic anatomy and microscopic anatomy. Gross anatomy is the study of large enough to be seen with the naked eye, and also includes superficial anatomy or surface anatomy. Microscopic anatomy is the study of structures on a scale, including histology. Anatomy can be studied using both invasive and non-invasive methods with the goal of obtaining information about the structure and organization of organs, angiography using X-rays or magnetic resonance angiography are methods to visualize blood vessels. The term anatomy is commonly taken to refer to human anatomy, however, substantially the same structures and tissues are found throughout the rest of the animal kingdom and the term also includes the anatomy of other animals. The term zootomy is also used to specifically refer to animals. The structure and tissues of plants are of a dissimilar nature, the kingdom Animalia or metazoa, contains multicellular organisms that are heterotrophic and motile. Most animals have bodies differentiated into separate tissues and these animals are known as eumetazoans. They have a digestive chamber, with one or two openings, the gametes are produced in multicellular sex organs, and the zygotes include a blastula stage in their embryonic development. Metazoans do not include the sponges, which have undifferentiated cells, unlike plant cells, animal cells have neither a cell wall nor chloroplasts
22.
Physiology
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Physiology is the scientific study of normal mechanisms, and their interactions, which operate within a living system. A sub-discipline of biology, its focus is in how organisms, organ systems, organs, cells, and biomolecules carry out the chemical or physical functions that exist in a living system. Given the size of the field, it is divided into, among others, animal physiology, plant physiology, cellular physiology, microbial physiology, bacterial physiology, and viral physiology. The Nobel Prize in Physiology or Medicine is awarded to those who make significant achievements in this discipline by the Royal Swedish Academy of Sciences. In medicine, a state is one occurring from normal body function, rather than pathologically. Physiological studies date back to the ancient civilizations of India and Egypt alongside anatomical studies, the study of human physiology as a medical field dates back to at least 420 BC to the time of Hippocrates, also known as the father of medicine. Hippocrates incorporated his belief called the theory of humours, which consisted of four basic substance, earth, water, air. Each substance is known for having a corresponding humour, black bile, phlegm, blood and yellow bile, Hippocrates also noted some emotional connections to the four humours, which Claudis Galenus would later expand on. The critical thinking of Aristotle and his emphasis on the relationship between structure and function marked the beginning of physiology in Ancient Greece. Like Hippocrates, Aristotle took to the theory of disease. Claudius Galenus, known as Galen of Pergamum, was the first to use experiments to probe the functions of the body, unlike Hippocrates though, Galen argued that humoral imbalances can be located in specific organs, including the entire body. His modification of this theory better equipped doctors to more precise diagnoses. Galen was also the founder of experimental physiology, and for the next 1,400 years, Galenic physiology was a powerful and influential tool in medicine. Jean Fernel, a French physician, introduced the term physiology, inspired in the work of Adam Smith, Milne-Edwards wrote that the body of all living beings, whether animal or plant, resembles a factory. Where the organs, comparable to workers, work incessantly to produce the phenomena that constitute the life of the individual, in more differentiated organisms, the functional labor could be apportioned between different instruments or systems. In 1858, Joseph Lister studied the cause of blood coagulation and inflammation that resulted after previous injuries and he later discovered and implemented antiseptics in the operating room, and as a result decreases death rate from surgery by a substantial amount. The Physiological Society was founded in London in 1876 as a dining club, the American Physiological Society is a nonprofit organization that was founded in 1887. The Society is, devoted to fostering education, scientific research, in 1891, Ivan Pavlov performed research on conditional reflexes that involved dogs saliva production in response to a plethora of sounds and visual stimuli
23.
Biochemistry
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Biochemistry, sometimes called biological chemistry, is the study of chemical processes within and relating to living organisms. By controlling information flow through biochemical signaling and the flow of energy through metabolism. Biochemistry is closely related to biology, the study of the molecular mechanisms by which genetic information encoded in DNA is able to result in the processes of life. Depending on the definition of the terms used, molecular biology can be thought of as a branch of biochemistry, or biochemistry as a tool with which to investigate. The chemistry of the cell depends on the reactions of smaller molecules. These can be inorganic, for water and metal ions, or organic, for example the amino acids. The mechanisms by which cells harness energy from their environment via chemical reactions are known as metabolism, the findings of biochemistry are applied primarily in medicine, nutrition, and agriculture. In medicine, biochemists investigate the causes and cures of diseases, in nutrition, they study how to maintain health and study the effects of nutritional deficiencies. In agriculture, biochemists investigate soil and fertilizers, and try to discover ways to improve crop cultivation, crop storage and pest control. However, biochemistry as a scientific discipline has its beginning sometime in the 19th century, or a little earlier. Gowland Hopkins on enzymes and the nature of biochemistry. The term biochemistry itself is derived from a combination of biology, the German chemist Carl Neuberg however is often cited to have coined the word in 1903, while some credited it to Franz Hofmeister. Then, in 1828, Friedrich Wöhler published a paper on the synthesis of urea and these techniques allowed for the discovery and detailed analysis of many molecules and metabolic pathways of the cell, such as glycolysis and the Krebs cycle. Another significant historic event in biochemistry is the discovery of the gene and this part of biochemistry is often called molecular biology. In the 1950s, James D. Watson, Francis Crick, Rosalind Franklin, in 1958, George Beadle and Edward Tatum received the Nobel Prize for work in fungi showing that one gene produces one enzyme. In 1988, Colin Pitchfork was the first person convicted of murder with DNA evidence, mello received the 2006 Nobel Prize for discovering the role of RNA interference, in the silencing of gene expression. Around two dozen of the 92 naturally occurring elements are essential to various kinds of biological life. Most rare elements on Earth are not needed by life, while a few common ones are not used, most organisms share element needs, but there are a few differences between plants and animals
24.
Statistics
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Statistics is a branch of mathematics dealing with the collection, analysis, interpretation, presentation, and organization of data. In applying statistics to, e. g. a scientific, industrial, or social problem, populations can be diverse topics such as all people living in a country or every atom composing a crystal. Statistics deals with all aspects of data including the planning of data collection in terms of the design of surveys, statistician Sir Arthur Lyon Bowley defines statistics as Numerical statements of facts in any department of inquiry placed in relation to each other. When census data cannot be collected, statisticians collect data by developing specific experiment designs, representative sampling assures that inferences and conclusions can safely extend from the sample to the population as a whole. In contrast, an observational study does not involve experimental manipulation, inferences on mathematical statistics are made under the framework of probability theory, which deals with the analysis of random phenomena. A standard statistical procedure involves the test of the relationship between two data sets, or a data set and a synthetic data drawn from idealized model. A hypothesis is proposed for the relationship between the two data sets, and this is compared as an alternative to an idealized null hypothesis of no relationship between two data sets. Rejecting or disproving the hypothesis is done using statistical tests that quantify the sense in which the null can be proven false. Working from a hypothesis, two basic forms of error are recognized, Type I errors and Type II errors. Multiple problems have come to be associated with this framework, ranging from obtaining a sufficient sample size to specifying an adequate null hypothesis, measurement processes that generate statistical data are also subject to error. Many of these errors are classified as random or systematic, the presence of missing data or censoring may result in biased estimates and specific techniques have been developed to address these problems. Statistics continues to be an area of research, for example on the problem of how to analyze Big data. Statistics is a body of science that pertains to the collection, analysis, interpretation or explanation. Some consider statistics to be a mathematical science rather than a branch of mathematics. While many scientific investigations make use of data, statistics is concerned with the use of data in the context of uncertainty, mathematical techniques used for this include mathematical analysis, linear algebra, stochastic analysis, differential equations, and measure-theoretic probability theory. In applying statistics to a problem, it is practice to start with a population or process to be studied. Populations can be diverse topics such as all living in a country or every atom composing a crystal. Ideally, statisticians compile data about the entire population and this may be organized by governmental statistical institutes
25.
Medicine
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Medicine is the science and practice of the diagnosis, treatment, and prevention of disease. The word medicine is derived from Latin medicus, meaning a physician, Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Medicine has existed for thousands of years, during most of which it was an art frequently having connections to the religious and philosophical beliefs of local culture. For example, a man would apply herbs and say prayers for healing, or an ancient philosopher. In recent centuries, since the advent of modern science, most medicine has become a combination of art, while stitching technique for sutures is an art learned through practice, the knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science. Prescientific forms of medicine are now known as medicine and folk medicine. They remain commonly used with or instead of medicine and are thus called alternative medicine. For example, evidence on the effectiveness of acupuncture is variable and inconsistent for any condition, in contrast, treatments outside the bounds of safety and efficacy are termed quackery. Medical availability and clinical practice varies across the world due to differences in culture. In modern clinical practice, physicians personally assess patients in order to diagnose, treat, the doctor-patient relationship typically begins an interaction with an examination of the patients medical history and medical record, followed by a medical interview and a physical examination. Basic diagnostic medical devices are typically used, after examination for signs and interviewing for symptoms, the doctor may order medical tests, take a biopsy, or prescribe pharmaceutical drugs or other therapies. Differential diagnosis methods help to rule out conditions based on the information provided, during the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the record, which is a legal document in many jurisdictions. Follow-ups may be shorter but follow the general procedure. The diagnosis and treatment may take only a few minutes or a few weeks depending upon the complexity of the issue, the components of the medical interview and encounter are, Chief complaint, the reason for the current medical visit. They are in the patients own words and are recorded along with the duration of each one, also called chief concern or presenting complaint. History of present illness, the order of events of symptoms. Distinguishable from history of illness, often called past medical history
26.
Doctorate
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There are a variety of doctoral degrees, with the most common being the Doctor of Philosophy, which is awarded in many different fields, ranging from the humanities to the scientific disciplines. The term doctor derives from the Latin docere meaning to teach, the doctorate appeared in medieval Europe as a license to teach Latin at a university. Its roots can be traced to the church in which the term doctor referred to the Apostles, church fathers. The right to grant a licentia docendi was originally reserved to the Catholic church, the Third Council of the Lateran of 1179 guaranteed the access—at that time largely free of charge—of all able applicants. This right remained a bone of contention between the authorities and universities that were slowly distancing themselves from the Church. The right was granted by the pope to the University of Paris in 1213 where it became a universal license to teach, according to Keith Allan Noble, the first doctoral degree was awarded in medieval Paris around 1150. The so-called professional, vocational, or technical curriculum of the Middle Ages included only theology, law, the doctorate of philosophy developed in Germany in the 17th century. The term philosophy does not refer solely to the field or academic discipline of philosophy, but is used in a sense in accordance with its original Greek meaning. In most of Europe, all fields were traditionally known as philosophy, the doctorate of philosophy adheres to this historic convention, even though the degrees are not always for the study of philosophy. D. University doctoral training was a form of apprenticeship to a guild, the traditional term of study before new teachers were admitted to the guild of Masters of Arts was seven years, matching the apprenticeship term for other occupations. Originally the terms master and doctor were synonymous, but over time the doctorate came to be regarded as a higher qualification than the masters degree, University degrees, including doctorates, were originally restricted to men. The use and meaning of the doctorate has changed over time, for instance, until the early 20th century few academic staff or professors in English-speaking universities held doctorates, except for very senior scholars and those in holy orders. After that time the German practice of requiring lecturers to have completed a research doctorate spread, universities shift to research-oriented education increased the doctorates importance. Today, a doctorate or its equivalent is generally a prerequisite for an academic career. Professional doctorates developed in the United States from the 19th century onward, the first professional doctorate to be offered in the United States was the M. D. The MD became the standard first degree in medicine during the 19th century, the MD, as the standard qualifying degree in medicine, gave that profession the ability to set and raise standards for entry into professional practice. The modern research degree, in the shape of the German-style Ph. D. was first awarded in the U. S. in 1861, in the UK, research doctorates initially took the form of higher doctorates, introduced from 1882 onwards. The PhD spread to the UK from the US via Canada, following the MD, the next professional doctorate, the Juris Doctor, was established by Chicago University in 1902
27.
Netherlands
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The Netherlands, also informally known as Holland is the main constituent country of the Kingdom of the Netherlands. It is a densely populated country located in Western Europe with three territories in the Caribbean. The European part of the Netherlands borders Germany to the east, Belgium to the south, and the North Sea to the northwest, sharing borders with Belgium, the United Kingdom. The three largest cities in the Netherlands are Amsterdam, Rotterdam and The Hague, Amsterdam is the countrys capital, while The Hague holds the Dutch seat of parliament and government. The port of Rotterdam is the worlds largest port outside East-Asia, the name Holland is used informally to refer to the whole of the country of the Netherlands. Netherlands literally means lower countries, influenced by its low land and flat geography, most of the areas below sea level are artificial. Since the late 16th century, large areas have been reclaimed from the sea and lakes, with a population density of 412 people per km2 –507 if water is excluded – the Netherlands is classified as a very densely populated country. Only Bangladesh, South Korea, and Taiwan have both a population and higher population density. Nevertheless, the Netherlands is the worlds second-largest exporter of food and agricultural products and this is partly due to the fertility of the soil and the mild climate. In 2001, it became the worlds first country to legalise same-sex marriage, the Netherlands is a founding member of the EU, Eurozone, G-10, NATO, OECD and WTO, as well as being a part of the Schengen Area and the trilateral Benelux Union. The first four are situated in The Hague, as is the EUs criminal intelligence agency Europol and this has led to the city being dubbed the worlds legal capital. The country also ranks second highest in the worlds 2016 Press Freedom Index, the Netherlands has a market-based mixed economy, ranking 17th of 177 countries according to the Index of Economic Freedom. It had the thirteenth-highest per capita income in the world in 2013 according to the International Monetary Fund, in 2013, the United Nations World Happiness Report ranked the Netherlands as the seventh-happiest country in the world, reflecting its high quality of life. The Netherlands also ranks joint second highest in the Inequality-adjusted Human Development Index, the region called Low Countries and the country of the Netherlands have the same toponymy. Place names with Neder, Nieder, Nether and Nedre and Bas or Inferior are in use in all over Europe. They are sometimes used in a relation to a higher ground that consecutively is indicated as Upper, Boven, Oben. In the case of the Low Countries / the Netherlands the geographical location of the region has been more or less downstream. The geographical location of the region, however, changed over time tremendously
28.
Belgium
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Belgium, officially the Kingdom of Belgium, is a sovereign state in Western Europe bordered by France, the Netherlands, Germany, Luxembourg, and the North Sea. It is a small, densely populated country which covers an area of 30,528 square kilometres and has a population of about 11 million people. Additionally, there is a group of German-speakers who live in the East Cantons located around the High Fens area. Historically, Belgium, the Netherlands and Luxembourg were known as the Low Countries, the region was called Belgica in Latin, after the Roman province of Gallia Belgica. From the end of the Middle Ages until the 17th century, today, Belgium is a federal constitutional monarchy with a parliamentary system of governance. It is divided into three regions and three communities, that exist next to each other and its two largest regions are the Dutch-speaking region of Flanders in the north and the French-speaking southern region of Wallonia. The Brussels-Capital Region is a bilingual enclave within the Flemish Region. A German-speaking Community exists in eastern Wallonia, Belgiums linguistic diversity and related political conflicts are reflected in its political history and complex system of governance, made up of six different governments. Upon its independence, declared in 1830, Belgium participated in the Industrial Revolution and, during the course of the 20th century, possessed a number of colonies in Africa. This continuing antagonism has led to several far-reaching reforms, resulting in a transition from a unitary to a federal arrangement during the period from 1970 to 1993. Belgium is also a member of the Eurozone, NATO, OECD and WTO. Its capital, Brussels, hosts several of the EUs official seats as well as the headquarters of major international organizations such as NATO. Belgium is also a part of the Schengen Area, Belgium is a developed country, with an advanced high-income economy and is categorized as very high in the Human Development Index. A gradual immigration by Germanic Frankish tribes during the 5th century brought the area under the rule of the Merovingian kings, a gradual shift of power during the 8th century led the kingdom of the Franks to evolve into the Carolingian Empire. Many of these fiefdoms were united in the Burgundian Netherlands of the 14th and 15th centuries, the Eighty Years War divided the Low Countries into the northern United Provinces and the Southern Netherlands. The latter were ruled successively by the Spanish and the Austrian Habsburgs and this was the theatre of most Franco-Spanish and Franco-Austrian wars during the 17th and 18th centuries. The reunification of the Low Countries as the United Kingdom of the Netherlands occurred at the dissolution of the First French Empire in 1815, although the franchise was initially restricted, universal suffrage for men was introduced after the general strike of 1893 and for women in 1949. The main political parties of the 19th century were the Catholic Party, French was originally the single official language adopted by the nobility and the bourgeoisie
29.
Soviet Union
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The Soviet Union, officially the Union of Soviet Socialist Republics was a socialist state in Eurasia that existed from 1922 to 1991. It was nominally a union of national republics, but its government. The Soviet Union had its roots in the October Revolution of 1917 and this established the Russian Socialist Federative Soviet Republic and started the Russian Civil War between the revolutionary Reds and the counter-revolutionary Whites. In 1922, the communists were victorious, forming the Soviet Union with the unification of the Russian, Transcaucasian, Ukrainian, following Lenins death in 1924, a collective leadership and a brief power struggle, Joseph Stalin came to power in the mid-1920s. Stalin suppressed all opposition to his rule, committed the state ideology to Marxism–Leninism. As a result, the country underwent a period of rapid industrialization and collectivization which laid the foundation for its victory in World War II and postwar dominance of Eastern Europe. Shortly before World War II, Stalin signed the Molotov–Ribbentrop Pact agreeing to non-aggression with Nazi Germany, in June 1941, the Germans invaded the Soviet Union, opening the largest and bloodiest theater of war in history. Soviet war casualties accounted for the highest proportion of the conflict in the effort of acquiring the upper hand over Axis forces at battles such as Stalingrad. Soviet forces eventually captured Berlin in 1945, the territory overtaken by the Red Army became satellite states of the Eastern Bloc. The Cold War emerged by 1947 as the Soviet bloc confronted the Western states that united in the North Atlantic Treaty Organization in 1949. Following Stalins death in 1953, a period of political and economic liberalization, known as de-Stalinization and Khrushchevs Thaw, the country developed rapidly, as millions of peasants were moved into industrialized cities. The USSR took a lead in the Space Race with Sputnik 1, the first ever satellite, and Vostok 1. In the 1970s, there was a brief détente of relations with the United States, the war drained economic resources and was matched by an escalation of American military aid to Mujahideen fighters. In the mid-1980s, the last Soviet leader, Mikhail Gorbachev, sought to reform and liberalize the economy through his policies of glasnost. The goal was to preserve the Communist Party while reversing the economic stagnation, the Cold War ended during his tenure, and in 1989 Soviet satellite countries in Eastern Europe overthrew their respective communist regimes. This led to the rise of strong nationalist and separatist movements inside the USSR as well, in August 1991, a coup détat was attempted by Communist Party hardliners. It failed, with Russian President Boris Yeltsin playing a role in facing down the coup. On 25 December 1991, Gorbachev resigned and the twelve constituent republics emerged from the dissolution of the Soviet Union as independent post-Soviet states
30.
Russian language
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Russian is an East Slavic language and an official language in Russia, Belarus, Kazakhstan, Kyrgyzstan and many minor or unrecognised territories. Russian belongs to the family of Indo-European languages and is one of the four living members of the East Slavic languages, written examples of Old East Slavonic are attested from the 10th century and beyond. It is the most geographically widespread language of Eurasia and the most widely spoken of the Slavic languages and it is also the largest native language in Europe, with 144 million native speakers in Russia, Ukraine and Belarus. Russian is the eighth most spoken language in the world by number of native speakers, the language is one of the six official languages of the United Nations. Russian is also the second most widespread language on the Internet after English, Russian distinguishes between consonant phonemes with palatal secondary articulation and those without, the so-called soft and hard sounds. This distinction is found between pairs of almost all consonants and is one of the most distinguishing features of the language, another important aspect is the reduction of unstressed vowels. Russian is a Slavic language of the Indo-European family and it is a lineal descendant of the language used in Kievan Rus. From the point of view of the language, its closest relatives are Ukrainian, Belarusian, and Rusyn. An East Slavic Old Novgorod dialect, although vanished during the 15th or 16th century, is considered to have played a significant role in the formation of modern Russian. In the 19th century, the language was often called Great Russian to distinguish it from Belarusian, then called White Russian and Ukrainian, however, the East Slavic forms have tended to be used exclusively in the various dialects that are experiencing a rapid decline. In some cases, both the East Slavic and the Church Slavonic forms are in use, with different meanings. For details, see Russian phonology and History of the Russian language and it is also regarded by the United States Intelligence Community as a hard target language, due to both its difficulty to master for English speakers and its critical role in American world policy. The standard form of Russian is generally regarded as the modern Russian literary language, mikhail Lomonosov first compiled a normalizing grammar book in 1755, in 1783 the Russian Academys first explanatory Russian dictionary appeared. By the mid-20th century, such dialects were forced out with the introduction of the education system that was established by the Soviet government. Despite the formalization of Standard Russian, some nonstandard dialectal features are observed in colloquial speech. Thus, the Russian language is the 6th largest in the world by number of speakers, after English, Mandarin, Hindi/Urdu, Spanish, Russian is one of the six official languages of the United Nations. Education in Russian is still a choice for both Russian as a second language and native speakers in Russia as well as many of the former Soviet republics. Russian is still seen as an important language for children to learn in most of the former Soviet republics, samuel P. Huntington wrote in the Clash of Civilizations, During the heyday of the Soviet Union, Russian was the lingua franca from Prague to Hanoi
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Spain
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By population, Spain is the sixth largest in Europe and the fifth in the European Union. Spains capital and largest city is Madrid, other urban areas include Barcelona, Valencia, Seville, Bilbao. Modern humans first arrived in the Iberian Peninsula around 35,000 years ago, in the Middle Ages, the area was conquered by Germanic tribes and later by the Moors. Spain is a democracy organised in the form of a government under a constitutional monarchy. It is a power and a major developed country with the worlds fourteenth largest economy by nominal GDP. Jesús Luis Cunchillos argues that the root of the span is the Phoenician word spy. Therefore, i-spn-ya would mean the land where metals are forged, two 15th-century Spanish Jewish scholars, Don Isaac Abravanel and Solomon ibn Verga, gave an explanation now considered folkloric. Both men wrote in two different published works that the first Jews to reach Spain were brought by ship by Phiros who was confederate with the king of Babylon when he laid siege to Jerusalem. This man was a Grecian by birth, but who had given a kingdom in Spain. He became related by marriage to Espan, the nephew of king Heracles, Heracles later renounced his throne in preference for his native Greece, leaving his kingdom to his nephew, Espan, from whom the country of España took its name. Based upon their testimonies, this eponym would have already been in use in Spain by c.350 BCE, Iberia enters written records as a land populated largely by the Iberians, Basques and Celts. Early on its coastal areas were settled by Phoenicians who founded Western Europe´s most ancient cities Cadiz, Phoenician influence expanded as much of the Peninsula was eventually incorporated into the Carthaginian Empire, becoming a major theater of the Punic Wars against the expanding Roman Empire. After an arduous conquest, the peninsula came fully under Roman Rule, during the early Middle Ages it came under Germanic rule but later, much of it was conquered by Moorish invaders from North Africa. In a process took centuries, the small Christian kingdoms in the north gradually regained control of the peninsula. The last Moorish kingdom fell in the same year Columbus reached the Americas, a global empire began which saw Spain become the strongest kingdom in Europe, the leading world power for a century and a half, and the largest overseas empire for three centuries. Continued wars and other problems led to a diminished status. The Napoleonic invasions of Spain led to chaos, triggering independence movements that tore apart most of the empire, eventually democracy was peacefully restored in the form of a parliamentary constitutional monarchy. Spain joined the European Union, experiencing a renaissance and steady economic growth
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General practice
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General Medical Services is the term used to describe the range of healthcare that is provided by General Practitioners as part of the National Health Service in the United Kingdom. The NHS specifies what GPs, as independent contractors, are expected to do, today, the GMS contract is a UK-wide arrangement with minor differences negotiated by each of the four UK health departments. A new contract is issued each year, the scheme was administered by Local Insurance Committees covering counties and conurbations which held a panel of doctors prepared to work under the scheme. The panel doctors were subject to “Terms of Service” which were lifted directly into the NHS GP contract. Lloyd Georges nationalisation of club medicine and local insurance in 1912 was the progenitor of the NHS in 1948. Lloyd George, when proposing to increase from 6 to 9 shillings per head the annual payment to panel GPs insisted, If the remuneration is increased. Up to the present the doctor has not been adequately paid, in a vast number of cases he has given his services for nothing or for payment which was utterly inadequate. There is no man here who does not know doctors who have been attending poor people without any fee or reward at all, the meaning of independent contractor in respect of GPs has not always been very clear, but was generally tied to their rejection of salaried status. However their behaviour has rarely been that of self-employed entrepreneurs and they have more often behaved as salaried professionals who defend their right to control what they do and how they do it. GPs contract arrangements were made with Local Executive Councils, and then their successors Family Practitioner Committees, Family Health Service Authorities. In England the contract is now between the GP practice and NHS England, in Scotland GP practices are contracted by the Health boards. It was agreed in August 2014 that GPs in Scotland would have a contract with negotiations taking place which would come into force from 2017/18. It is proposed that they should give up employing practice staff, the Beveridge Report of 1942 gave the impetus for White Paper under the Conservative Health Minister Henry Willink that supported the idea of salaried GP services in health centres. The capitation fees was based on the number of patients the GP had on his list, proposals to make GPs salaried professionals were rejected by the profession in 1948. In 1951 the capitation started to be based on the number of doctors, from 1948 to 2004 the contract was an individual one. Virtually every doctor working in practice had a personal contract with the local NHS and patients were registered with a named doctor. ”In 1953. The Royal College of General Practitioners was founded in November 1952 and it became a driving force in developing postgraduate training for doctors wishing to enter general practice. In 1965 GPs demanded a new contract and threatened mass resignation from the NHS, one of their complaints was that there was no provision for improvement of practices
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Medical school in the United Kingdom
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In the United Kingdom, medical school generally refers to a department within a university which is involved in the education of future medical practitioners. All leading British medical schools are state-funded and their purpose is to train doctors on behalf of the National Health Service. Courses generally last five or six years, two years of training in an academic environment and three years clinical training at a teaching hospital and in community settings. Medical schools and teaching hospitals are closely integrated, the course of study is extended to six years if an intercalated degree is taken in a related subject. In the United Kingdom students generally begin school after secondary education. This contrasts with the US and Canadian systems, where a degree is required for entry to medical school. Entry to British medical schools is very competitive, applications for entry into medical school are made through the Universities and Colleges Admissions Service. UCAS allows four applications per applicant for medicine, as opposed to the usual five, the remaining one can either be left blank, or be used to apply for a non-medical course. Most UK medical schools now also require applicants to sit additional entrance tests such as the United Kingdom Clinical Aptitude Test, the number of available medical school places had risen by 3,500 since 1998. There are national quotas imposed on the number of places for students on medicine, the UCAS personal statement gives applicants the opportunity to write about why they are suitable for medicine. Personal statements are reviewed by university admission boards and applicants scoring highly in tests, interviews for medicine differ between individual universities. The majority of school interview applicants using either a Traditional interview or the Multiple Mini Interview formats. Oxford and Cambridge medical schools have their own way of interviewing with focus on science questions. The traditional medical interview consists of 2–4 interviewers sat across a table from the candidate, interviewers take turns to ask the candidate set questions and rate their responses on a Likert scale. Questions cover a range of criteria that future doctors should possess. Developed at McMaster University Medical School in Canada in 2004, the MMI format assesses candidates as they cycle through a selection of mini interview stations similar to the medical school OSCE. 1-2 interviewers assess candidates at each station and each station is focussed on a particular skill desirable of a doctor, queens University Belfast gives the degree of MB BCh BAO. The course structure - on which a clear divide is one extreme
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Modernising Medical Careers
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Modernising Medical Careers is a programme for postgraduate medical training introduced in the United Kingdom in 2005. The programme replaced the traditional grades of medical career before the level of Consultant, the different stages of the programme contribute towards a Certificate of Completion of Training. It has been dogged by criticism within and outside the profession. MMC refers to both the programme itself, and also to the organization, formed in 2003, responsible for its nationwide implementation. At this point doctors move straight into the F2 year in most, under the previous system, doctors applied for SHO jobs within six to eight months of beginning work as a PRHO. The Foundation Programme consists of two years training split into rotations of three or four months in different specialties, the programme features continuing assessments, and the introduction of a national curriculum intended to nationalise and standardise medical training. As part of junior doctors are required to maintain a learning portfolio. Despite these notional benefits, 69% of doctors surveyed felt F2 was not an improvement on the first-year SHO experience it replaced, the next stage of training is the Specialty Registrar. This is a unification of the previous training grades of SHO and this meant that doctors are required under the new system to choose a specialty midway through F2, after just one-and-a-half years of practice. In keeping with these data, 66% of doctors surveyed felt Foundation Training had not had an effect on clinical service delivery. Another principle of MMC has been that doctors from Foundation level and upwards undergo regular assessment of their skills and this would commence for Foundation level in August 2005, with the new intake of Foundation trainees. A smaller number of deaneries opted to use the NHS eportfolio, MMC was intended to improve patient care by improving medical education with a transparent and efficient career path for doctors. This followed the publication of the NHS Plan 2000, which committed to increase the number of consultants in the NHS and this has led to accusations in the press, from regional medical selection committees, and from Remedy UK that it has been a dumbing-down process. In 2007 appointment to this level of training was facilitated using the Medical Training Application Service, due to several system failures and political pressure, this was abandoned partway during the process. In 2008, following significant pressure from doctors, the MMC Programme Board for England came to an agreement to revert to a local application process determined by deaneries and specialties. Agreement was made no further attempts would be made to introduce new selection methodologies without piloting, academic evaluation. The transition to the new system and the Medical Training Application Service have been particularly criticised. In order to implement MMC, all trainees not appointed to specialist registrar posts for 1 August 2007 were required to apply for posts on the new MMC curriculum, with far fewer posts than applicants
. Archived from the original on 1 May 2018. Retrieved 4 October 2014.
