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PubMed1993

Care of the dying: a Catholic perspective. Part IV: Theological, moral, and pastoral response--the transformation of suffering. Catholic Health Association.

People struggle to find meaning in suffering and death. In a culture that cannot depend on religious insights into suffering to address the deeper questions (e.g., Why me?), all kinds of interventions, even euthanasia and assisted suicide, may seem inevitable. Catholic healthcare providers can respond by offering patients, families, and care givers a vision of how suffering can be understood. Based on the power of divine love to transform suffering and death from absolute evils to personal triumphs, the moral principles the Catholic Church upholds can provide a hopeful perspective for healthcare professionals who care for the dying. Three principles support Roman Catholic teaching on conserving health and life: sanctity of life, God's dominion and human stewardship, and the prohibition against killing. These principles by themselves are insufficient as a moral or pastoral response to the care of the suffering and dying. Action is also required. Moral virtues must be reflected in ethical behavior and in pastoral practice so that we may enact our Christian vision in the face of suffering and death. Attention to our character as providers and our ethical practices is of grave importance in these days when euthanasia and assisted suicide are being promoted so aggressively. To carry on Jesus' healing mission by responding to human suffering and death, healing communities must embody virtues that bear convincing witness in both a personal and a corporate manner regarding the care of the dying. Three characteristics of a virtuous community stand out: interdependence, care, and hospitality. By being a virtuous community, we may be able to address many of the concerns that motivate people to consider euthanasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude to Death↗
PubMed2000

Comparing contrast-modulated and luminance-modulated masking: effects of spatial frequency and phase.

The masking of a sinusoidal test grating by contrast-modulated (CM) gratings could, in principle, be attributable to the presence of a distortion product, injected into the stimulus during some nonlinear transformation at an early level of visual processing (e.g. Nachmias, 1989 Vision Research 29 137-142). If so, CM gratings and luminance-modulated (LM) gratings of similar effective contrast and spatial frequency should mask the detection of sinusoids in a similar fashion. We compared the effects of masking by 1 cycle deg-1 CM gratings [both simple beats (8 + 9 cycles deg-1) and amplitude-modulated gratings (8 + 9 + 10 cycles deg-1)], with those of masking by 1 cycle deg-1 LM gratings of low contrast. We found that: (i) CM and low-contrast LM grating masks yielded similar spatial-frequency tuning functions around the modulation frequency of 1 cycle deg-1; (ii) low-contrast LM gratings masked the detection of test sinusoids in a highly phase-dependent fashion, while masking by CM gratings did not vary systematically with relative spatial phase. The results suggest that masking produced by CM gratings cannot simply be explained by the presence of a distortion product at the beat or modulation frequency.

Contrast Sensitivity↗
PubMedDate not supplied

The New Hampshire public health network: creating local public health infrastructure through community-driven partnerships.

In 1997, under the auspices of the Turning Point program, New Hampshire's public health stakeholders convened a strategic planning process to transform the state public health system. What emerged was a fundamental vision that the public health system could only be improved by strengthening the capacity of local communities to address local health issues. A plan was developed to create regional public health structures, in areas with no local health departments, to deliver essential public health services at the local level. Seven years later, that plan has become the New Hampshire Public Health Network. The network now covers 67% of the New Hampshire population and includes 113 (48%) cities and towns. Pre- and postevaluations to assess local public health infrastructure at the inception of the program and following 2 years of funding and technical assistance showed significant improvement in local public health capacity and performance. This article describes the development of local public health structures in New Hampshire where none had previously existed.

Community Health Planning↗
PubMed2000

Jesus, peyote, and the holy people: alcohol abuse and the ethos of power in Navajo healing.

Of the three religious healing traditions that coexist within the contemporary Navajo health care system, the Native American Church (NAC) and Pentecostal Christianity are more actively involved in the treatment of alcohol and substance abuse than is Traditional Navajo healing. This article examines these two more recent healing traditions as religious responses to the contemporary Navajo crisis of alcohol and substance abuse as well as to socioeconomic changes. These traditions offer new kinds of power, social networks, and personal meaning that facilitate a transformation of self, a revitalized sense of community, and a new vision of the possibilities of the future for Navajo people who suffer. Examining the ethos of power that underlies Navajo healing can complement the theoretical emphasis on harmony and beauty in anthropological research on Navajo culture and religion.

Alcoholism↗
PubMedDate not supplied

[Anaplastic oligoastrocytoma of the spinal cord: diagnostic difficulties. Case report].

The authors report a rare case of 49-years old woman with rapidly progressing anaplastic oligoastrocytoma primarily localized in the spinal cord. Increasing spastic paresis of the right lower limb was concomitant with decrease in superficial sensibility in this limb and the right side of the trunk below Th10 level, suggested a lesion within the spinal cord. However, it was the difficult confirming the diagnosis by spinal MR imaging, and the negative result of the first MR examination (performed 5 weeks after manifestation of first clinical symptoms of the disease) delayed surgical treatment. During the next 3 weeks the neurological syndrome increased to spastic paraparesis with sphincters dysfunction and decrease in superficial and vibratory sensibility within the lower limbs and the trunk below the Th10 level. The second MR examination of the spine revealed an intraspinal tumour at Th8-Th10 levels. Surgical (partial excision of the tumour) and radiation treatment was given. Histopathological examination of tumour tissue showed the presence of anaplastic oligoastrocytoma. During the follow-up of our patient we found cerebral foci, probably of metastatic origin ascending with cerebrospinal fluid. More than 5 months after the diagnosis was established the patient died of primary disease. The imaging parameters of both spinal MR examinations were similar, however, on second examination narrower field of vision was used. In both cases Magnevist was administered. Discussing factors which might be responsible for the false-negative result of spinal MR examination--the examination of choice for detection of proliferative transformation--the authors take artefacts connected with respiratory and circulatory function, peristaltic movements, and with field of vision into consideration.

Artifacts↗
PubMed2005

Spatial modulation of tactile temporal-order judgments.

We report a series of three experiments designed to examine the effect of posture on tactile temporal processing. Observers reported which of two tactile stimuli, presented to the left and right index fingers (experiments 1-3; or thumb, experiment 3), was perceived first while adopting one of two postures--hands-close (adjacent, but not touching) or hands-far (1 m apart)--in the dark. Just-noticeable differences were significantly smaller in the hands-far posture across all three experiments. In the first two experiments we compared hand versus foot responses and found equivalent advantages for the hands-far posture. In the final experiment the stimuli were presented to either the same or different digit on each hand (index finger or thumb) and we found that only when the same digit on each hand was stimulated was there an advantage for the hands-far posture. The finding that temporal precision was better with greater distance contradicts predictions based on attention-switching models of temporal-order judgments, and also contrasts with results from similar experimental manipulations in other modalities (eg vision). These results provide support for a rapid and automatic process that transforms the representation of a tactile stimulus from a skin-centred reference frame to a more external (eg body-centred or allocentric) one.

Adult↗
PubMed1994

Stability of YACs containing ribosomal or RCP/GCP locus DNA in wild-type S. cerevisiae and RAD mutant strains.

About 2% of human YAC clones, including tandemly repeated segments color vision pigment DNA, ribosomal DNA and alphoid DNA have been reported to be inherently unstable in yeast hosts, producing more stable deletion products. YACs containing color vision red pigment gene DNA or 1.5 rDNA tandem repeat units were transformed into hosts bearing lesions at the RAD1, RAD6, RAD51, or RAD52 loci. YACs susceptible to deletion during outgrowth of wild-type cells (or in preliminary experiments, in RAD6 transformants) were stable for up to 100 generations or more in the other strains. Thus both the RAD1 and RAD51/RAD52 epistatic pathways are apparently involved in the instability of YACs containing tandem repeat loci, presumably during recombination-based deletion formation; and a yeast host disarmed in these pathways will likely maintain YACs intact that are otherwise unstable.

Animals↗
PubMed1998

Acute anterior uveitis and spondyloarthropathies.

Acute anterior uveitis (AAU) is characterized by sudden-onset, mostly unilateral exacerbations of an inflammation of the iris and ciliary body. The duration of illness is short if the patient is treated with corticosteroids. Half of all patients with any type of anterior uveitis are HLA-B27-positive, and more than half of the B27-positive patients have spondyloarthropathy. Ophthalmologists should therefore refer all patients with AAU who are HLA-B27-positive to a rheumatologist. Because attacks of AAU are extremely painful and frightening, most spondyloarthropathy patients with AAU will seek out an ophthalmologist on their own. The anterior chamber of the eye and the joints are mesenchymal cavities that are cleaned by macrophages. Anterior chamber-associated immune deviation is the mechanism by which specific regulatory T cells normally produce sufficient transforming growth factor-beta to impair inflammatory reactions that might hamper vision. Another mechanism of immune privilege is Fas-ligand induced apoptosis. Because the cells of the anterior eye express Fas-ligand, infiltrating cells are apoptotically killed. Comparable mechanisms may occur at a lower level in joints. The cause of AAU and spondyloarthropathy is unknown. B27 is probably only responsible for one quarter of the pathogenesis, other non-B27 genetic factors for another quarter, and unknown exogenous factors for the remaining half. It is possible that Gram-negative bacteria such as Klebsiella or Yersinia are involved in the pathogenesis in a yet unknown way.

Acute Disease↗
PubMed1998

Developing consultant care on delivery suite.

The need to develop a consultant presence on the delivery suite has never been greater given the emerging quality agenda that is occurring within the speciality. This is identifying a clear impetus for changing consultant practice and also meeting the needs of women more effectively. The article describes these trends, the impetus for change and identifies practically how such a change was achieved within the largest women's hospital in the UK. It defines the basis for building a vision for an improved future and the practical use of management and transformational leadership skills to change consultant behaviour and attitudes with a clear set of outcomes that were achieved.

Delivery Rooms↗
PubMed2004

The challenge of leadership in technology and education.

The leadership qualities necessary today in technology, education, and other modern organizations include the ability to recognize rapid changes in organizational environments and ensure continuous transformation and adaptability to that change. The important skills of such leaders include understanding their own business, articulating vision, creating a positive culture, communicating effectively, and measuring results. Rapidly emerging technology is prone to misunderstanding by those who mistake the surface features of how technology works with the functional opportunities it provides. Organizations that transform processes in parallel by adopting new technologies can expect much larger productivity gains than can those who merely insert technology. The problems of memory, speed, and cost have been addressed; the new challenge of technology is making it universal. Education in America is in danger. The infrastructure is outdated and it is not oriented toward change. Jobs will follow competence. Although the challenges of leadership today, especially in technology and education, are great, so is the opportunity for impact and the excitement of bringing diverse skills to bear.

Administrative Personnel↗
PubMed2003

Variance normalisation: a key mechanism for temporal adaptation in natural vision?

A major problem in natural vision is how neurons in the early visual system encode the widely varying visual input with the limited dynamic range of their activity. Recent experiments suggest that retinal neurons adapt their response not only to the temporal mean but also to the temporal variance of the visual input. Inspired by these results, we propose a simple model in which temporal adaptation can be achieved by a transformation consisting of a linear filtering followed by a variance normalisation. We show that such transformation efficiently adapts to the temporal statistics of natural time series of intensities by removing most of its redundancy, while no linear transformation alone achieves the same goal. Results reproduce important features of temporal adaptation in real vision.

Adaptation, Ocular↗
PubMed1992

Stereotactic localization and guidance using a machine vision technique.

Machine vision techniques (video cameras) can be used to determine the three-dimensional position of objects. This transformation can be accomplished with standard mathematical algorithms. Initial accuracy tests of stereotactic localization with video cameras were performed using a standard Brown-Roberts-Wells (BRW) phantom simulator coupled with the BRW angiographic localizer. Localization accuracy was within 1.5 mm. Potential applications of machine vision techniques include freehand stereotactic localization of the position and orientation of surgical instruments. With sufficient computer speed these techniques can be used for continuous monitoring of the position of instruments within the cranial vault.

Brain↗
PubMed1991

Two-dimensional spatial and spatial-frequency selectivity of motion-sensitive mechanisms in human vision.

Thresholds for detecting the direction of motion of drifting (8-Hz) vertical gratings [of spatial frequencies 0.1, 1.0, and 10.0 cycles per degree (c/deg)] were measured in the presence of masks that varied in both spatial frequency and orientation. Masks with different temporal properties were used. The specificity of masking was also measured for a stationary test grating of spatial frequency 3.0 c/deg. After suitable scaling and transformation, the masking data gave an estimate of the two-dimensional spatial-frequency tuning surface of cortical detector units in human vision. With the assumption of small-signal linearity and zero phase, the tuning surfaces were inverse Fourier transformed to give an indication of the size and structure of the psychophysical receptive fields of detector units. The results obtained with drifting test gratings and jittering (random phase) mask gratings indicate that motion-detector receptive fields increase in size (in cycles) with increasing spatial frequency but, at all spatial scales, have a length-width ratio of 1. These results are in close agreement with the summation results reported in J. Opt. Soc. Am. A 8, 1330 (1991). Using the same jittering mask stimuli and stationary test gratings, we confirm reports by Daugman [Vision Res. 24, 891 (1984)] and Harvey and Doan [J. Opt. Soc. Am. A 7, 116 (1990)] that motion-independent units have elongated receptive fields with a length-width ratio near 1.8. We conclude that the receptive fields of motion-dependent and -independent mechanisms in human vision are fundamentally different. The possibility that the orientation selectivity of a motion unit is sharpened by its selectivity for direction of motion is discussed.

Contrast Sensitivity↗
PubMed2003

Transforming the delivery of rural health care in Georgia: state partnership strategy for developing rural health networks.

Since 1996, 19 networks covering 74 of the 117 rural counties in Georgia have emerged. This grassroots transformation of rural health care occurred through a series of partnerships launched by state government officials. These partnerships brought together national and state organizations to pool resources for investment in an evolving long-term strategy to develop rural health care networks. The strategy leveraged resources from partners, resulting in greater impact. Change was triggered and accelerated using an intensive, flexible technical assistance effort amplified by developmental grants to communities. These grants were made available for structural and organizational change in the community that would eventually lead to improved access and health status. Georgia's strategy for developing rural health networks consisted of 3 elements: a clear state vision and mission; investment partnerships; and proactive, flexible technical assistance. Retrospectively, it seems that the transformation occurred as a result of 5 phases of investment by state government and its partners. The first 2 phases involved data gathering as well as the provision of technical assistance to individual communities. The next 3 phases moved network development to a larger scale by working with multiple counties to create regional networks. The 5 phases represent increasing knowledge about and commitment to the vision of access to care and improved health status for rural populations.

Community Health Planning↗
PubMed2000

Spectral analysis of adult dancers' sways: sex and interaction vision-proprioception.

In subjects of both sexes with or without dance training, dependence on vision and proprioception for postural control was studied by destabilizing these cues on a free seesaw. Fast Fourier transform processing allowed spectral frequency analysis of the platform sways recorded by an accelerometer. Two frequency bands of the total spectral energy were used: the lower (0 - 2 Hz) and the higher (2 - 20 Hz) frequency bands. Dancers were significantly less dependent on vision but use more proprioception than untrained subjects. Professional dance training appears to shift sensorimotor dominance from vision to proprioception, and this evolution seems more marked for males than females. Female and male dancers had similar dynamic performances, but for males, the better neuromuscular coordination may be associated with biomechanical factors.

Adult↗
PubMed1991

Recurrent mixed tumor of the right lacrimal gland causes acute contralateral visual loss.

A 23-year-old woman underwent excisional biopsy of a right palpebral mass: the histopathologic study showed a benign mixed tumor of the lacrimal gland. Thereafter, the tumor recurred repeatedly, and multiple excisions were done. Subsequently, right orbital exenteration was performed, and some orbital and frontal bones were removed. When the patient was 52 years old, the orbital tumor recurred. A histopathologic study revealed malignant transformation. At the age of 54 years, the patient suffered acute loss of vision in her left eye. Computed tomography disclosed invasion of the tumor into the posterior paranasal sinuses and brain.

Adenoma↗
PubMed2006

Not just another multi-professional course! Part 2: nuts and bolts of designing a transformed curriculum for multi-professional learning.

Multi-professional education has traditionally aimed to develop health professionals who are able to collaborate effectively in comprehensive healthcare delivery. The respective professions learn about their differences in order to work together, rather than developing unity in their commitment to a shared vision of professionalism and service. In this, the second of two papers, the 'nuts and bolts' or practicalities of designing a transformed curriculum for a multi-professional course with a difference is described. Guidelines for the curriculum design process, which seeks to be innovative, grounded in theory and relevant to the learning of the students and the ultimately the health of the patients, include: valuing education; gaining buy-in; securing buy-out; defining of roles; seeking consensus; negotiating difference and expediting decisions. The phases of the design process are described, as well as the educational outcomes envisaged during the process. Reflections of the designers, in particular on what it means to be a multi-professional team, and a reconceptualization of multi-professional education are presented as challenges for educators of health professionals.

Cooperative Behavior↗