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Cultural competence is a continual process that is ever expanding. Cultural competence is defined as proficient knowledge, skill development, and the application of that knowledge and skills to demonstrate cultural awareness, understanding, sensitivity, and humility. The objective of a health science-related cultural competence seminar is to provide meaningful and in-depth discourse expounding upon cultural attitudes, expressions, and experiences that shape and direct interactions between patient and health providers, allied health professionals, medical and allied health students, and faculty. The current health care infrastructure is “ill-equipped to provide effective health care to underserved populations in the United States” (Roberts et al., 2015, p. 1408). As such, the Post Baccalaureate Seminar was developed to mitigate the gap between what students know upon entering medical studies versus what they need to know to provide culturally competent care, particularly in medically underserved areas. The Post Baccalaureate Seminar is a 15-week course given during the fall semester of the one-year program in preparation for matriculation into medical school. Students have required readings, small group didactics, and group activities which address professionalism, medical ethics and experimentation, informed consent, cross-cultural communication, Lesbian/Gay/Bisexual/Transgender/Questioning (LGBTQ + ) concerns, and other aspects of cultural diversity. The required texts were selected as a pedagogical strategy to introduce the constructs of valuing diversity in a holistic manner. Upon completion of the seminar, premedical students indicate increased knowledge and skills for displaying cultural awareness and a greater level of sensitivity for their medical studies.

“Support a lawyer. go to med school” The above message on the car bumper stickers of members of the medical profession reflects their reaction to the current escalation of malpractice suits filed by attorneys against doctors and hospitals. The impact of these suits against medical personnel and institutions is not limited to patients, doctors and lawyers; the ripple‐effect reaches the entire community, because the rising incidence of malpractice suits tends to increase the cost of malpractice insurance and ultimately the total cost of health care to all members of society. Malpractice is but a small, though highly visible, part of a broader spectrum of interaction between medicine and law. “The complexities of modern society are causing law and medicine to interface with increasing frequency to the extent that contact with the legal process has become an inescapable aspect of the physician's life.” In recognition of this increasing frequency of contacts between medicine and law, a correspondingly increasing number of medicolegal reference works have been published, as exemplified by the selective list which follows this introduction. These should be of direct interest to doctors and members of allied health professions, to attorneys and paralegals and, indirectly, to all who deal with medical personnel and institutions. Traditionally, attorneys, particularly members of the trial bar, have demonstrated a continuing interest in medical literature. For example, the Merck Manual and Goldstein's Medical Trial Technique are familiar to most trial lawyers. They are expected to be well acquainted with anatomy charts, texts on internal medicine, eye, ear, nose and throat, orthopedics, obstetrics, and pediatrics, to name but a few generic medical works of interest to trial lawyers. It should be noted that the lawyer's interest in medical literature is not necessarily motivated by a desire to harass doctors, nurses and hospitals. Attorneys are bound by their Code of Professional Responsibility to represent their clients competently and zealously. In discharging this ethical obligation, the attorney frequently calls upon a physician to testify as an expert witness concerning the cause of a personal injury or death. Consequently, the attorney should be knowledgeable in medical theory and terminology. Furthermore, in pursuit of interdisciplinary competence, a significant number of individuals in the United States have earned both the medical degree and the law degree and appropriate licenses to practice, e.g., Cyril Wecht, M.D., J.D., Director, Pittsburgh Institute of Legal Medicine, Duquesne Law School, member, Faculty of the Pittsburgh School of Medicine and Dentistry, Coroner, Allegheny County, Pennsylvania.

Research involving prisoners repeatedly went astray during the last century, culminating in the cruel medical experiments inside the Nazi concentration camps that gave rise to the Nuremberg Code. However, prisoners continued to become victims of scientific exploitation by the rapidly evolving biomedical research industry. The common roots of these abuses were the flawed philosophy that the needs of the society outweigh the needs of the individual and the researchers’ view that prisoners are cheap, easy to motivate and stable research subjects. Prisoners are vulnerable to exploitation and abuse by research because their freedom for consent can easily be undermined, and because of learning disabilities, illiteracy and language barriers prevailing within prisoner populations. Therefore, penal laws of some countries supported by a number of internationally agreed documents prohibit research involving prisoners completely. However, prisoners must also be regarded as vulnerable to the specific health problems in prisons, e.g. transmissible diseases, mental disorders and suicide ‐ problems that need to be addressed by research involving prisoners. Additionally, the participation of prisoner patients in research they directly can benefit from should be provided. Hence, it must be a common objective to find the right balance between protection from exploitation and access to research beneficial to prisoners.

Debates regarding patient claims to extant tissue samples are often cited as beginning with the infamous US case of John Moore vs. the Regents of the University of California (1984–1990) – where the plaintiff unsuccessfully tried to claim title in a cell line derived from his excised spleen. Following the 1990 Supreme Court verdict, the issue of patient property in excised tissue was held by certain bioethicists as the ethical problem inhering in biomedical research from the 1980s onward: encompassing debates about a newly-avaricious biotechnology, consent, autonomy and identity. I show here that the concept of patient property was first mooted during the 1970s, some 10 years before Moore, as a response to US-based criticism of the use of foetal and human tissues in research. Rather than representing a struggle between an avaricious science and misled patients, it evolved as a result of debates between philosophers, lawyers, scientists and members of the public, amidst broader debates regarding human experimentation and abortion. Moreover, the first person to assert a patient's right to their own, or their family's tissue, in a legal arena was a scientist. This article attempts to investigate, through the evolution of ownership debates, how bioethicists and scientists themselves construct what counts as ‘public opinion’.

This paper aims to describe a numerical approach to the fragmentation of kidney stones by direct impact.

The numerical approach consists of a Lagrangian finite element formulation with dynamic insertion of cohesive‐free surfaces. Cohesive free surfaces are governed by a damage constitutive model whereas the continuum part of the mesh remains linear elastic. The impact of the metallic probe of the medical device is modeled with a displacement control of the nodes inside the area of impact on the stone.

The results show the relation between the total energy transmitted during the impact with the damage and the fragmentation (number of fragments and number of microcrack clusters) of the kidney stone. The paper establishes the existence of both, an activation and saturation energy level, that delimit a range optimum working energy transmitted during the impact. In particular, the computations show that, for the calcium oxalate monohydrate stone, the maximum energy supplied by the medical device (Lithoclast) coincides with the saturation energy level.

In medical investigations, the experimentation is always restricted to the availability of patients or specimens. In the particular case of the elimination of renal calculi, the literature exhibits an extensive number of works reporting the practical experience of medical doctors. However, there is still a lack of information that might help to understand and to improve the comminution of kidney stones.

This article describes and clarifies the human rights of persons with disabilities in the context of detention in light of the recently adopted and already in force Convention on the Rights of Persons with Disabilities (the Convention). Focusing on the Convention, the article sheds light on the legality of certain forms of detention affecting persons with disabilities, the substantive and procedural requirements for their detention, and on their rights in relation to conditions of detention. This article also provides an account of the different treatments and practices inflicted on persons with disabilities in prisons and other institutions and assesses whether they constitute torture and ill treatment. The authors argue that the Convention on the Rights of Persons with Disabilities represents a paradigm shift that requires States to modify and adopt laws, policies and practices that fully respect the right to liberty of persons with disabilities, and their equal enjoyment of rights while in detention, including the right to be free from torture and ill treatment.

The function for the historically Black college and university (HBCU) has always been a hallmark of resolve educational inclusion and justice to promote the Negro identity, and develop social and economic mobility. Yet despite diversity, equity, and inclusion (DEI) determinations popular today, the authors contend that to cater to subpopulations outside of the Black community creates a marginalization and distraction from their historic purpose and legacy. As a necessary function of relevance, the focus of underserved populations on HBCU campuses should, instead, unwaveringly remain on African-Americans, descendants of slaves (DoS). We empirically examine HBCU academic curricula for African-American consciousness that is forward thinking for community advocacy and social justice. Research findings of HBCU course catalogs (N = 98) describe a very limited scope of course titles and descriptions that appear to cultivate intellectual tools to engage in racial and ethnic self-advocacy as a vital role for continued survival. The authors contend that the relevance of HBCU institutions cannot be fully realized and promoted absent a comprehensive understanding of the educational and socioeconomic status of the African-American population. Discussed are the implications and recommendations of how HBCUs will be able to retain their uniqueness and viability of purpose, including the application of social reconstructive theory in practice, as a theoretical framework.

To examine a local primary health care infrastructure and the reality of primary health care from the perspective of residents of a small, urban community in the southern United States.

Data were derived from 13 semistructured focus groups, plus three semistructured interviews, and were analyzed inductively consistent with a grounded theory approach.

Structural barriers to the local primary health care infrastructure include transportation, clinic and appointment wait time, and co-payments and health insurance. Hidden barriers consist of knowledge about local health care services, nonphysician gatekeepers, and fear of medical care. Community residents have used home remedies and the emergency department at the local academic medical center to manage these structural and hidden barriers.

Findings might not generalize to primary health care infrastructures in other communities, respondent perspectives can be biased, and the data are subject to various interpretations and conceptual and thematic frameworks. Nevertheless, the structural and hidden barriers to the local primary health care infrastructure have considerably diminished the autonomy community residents have been able to exercise over their decisions about primary health care, ultimately suggesting that efforts concerned with increasing the access of medically underserved groups to primary health care in local communities should recognize the centrality and significance of power.

This study addresses a gap in the sociological literature regarding the impact of specific barriers to primary health care among medically underserved groups.