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The process likely begins with the development of defects in the supply of cholesterol and fats to neurons, progressing to extensive oxidative damage, mitochondrial defects, and a shift of metabolism towards utilizing sources other than glucose and minimizing mito- chondrial involvement. In the end stage, neurons can no longer transmit signals effectively, and apoptosis is the best option to avoid damaging neighboring cells. A crucial role is played by astrocytes, the glial cells that supply cholesterol and fats to neurons. A consequence of excess exposure to glucose and oxidizing agents may lead to an initial damage due to glycation and oxidation of ApoE in astrocytes. The subsequent cascade begins with defects. | Human Resources for Health Professionalism in Medicine K R Sethuraman .nothing is more estimable than a physician who having studied nature from his youth knows the properties of the human body the diseases which assail it the remedies which will benefit it exercises his art with caution and pays equal attention to the rich and the poor. - Voltaire Introduction - What is Professionalism Professionalism has been described by the American Board of Internal Medicine as constituting those attitudes and behaviors that serve to maintain patient interest above physician self-interest. 1 The word profession is derived from profess which means to proclaim something publicly . The act of profession of commitment to an ideal to which the professional should conform is the essence of a profession. Physicians profess two things to be competent to help the patients and to have the patient s best interests in mind. Such commitment invites trust from their patients. Physicians profess in two ways the first is the public act of oath taking during medical graduation ceremonies. This is truly the moment of transition - from being a student to becoming a professional. The oath not the medical degree professes the way the newly-acquired competencies are to be employed. Without the oath the doctor is just a skilled worker. The second way of professing is implicit in the doctor-patient encounters Whenever a physician asks the patient What can I do for you they commit themselves to having adequate technical expertise and to using that in the best interests of the patients. Such tacit commitment occurs every day between a physician and a patient. Otherwise the patient would never willingly consult the physician.2 Profession and Vocation To differentiate between a vocation and a profession recent sociological literature has proposed a checklist method. An occupation is considered to be a profession if Practising it requires formal education Its members enjoy control over their own training
