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Thielemann's diagonal law of occlusion revisited.

Thielemann's studies of malocclusal relationships and the frequently observed chain reactions created in distant localities led to the formulation of a philosophical approach to occlusion that is also of practical premeditative clinical relevance for the practitioner. Dr. Thielemann presumed to name it a law, and repeated clinical observations apparently support and reinforce his claim. All disciplines of dentistry inevitably encounter and need to know about this aspect of fission-reactive involvement with the common and seemingly innocuous malocclusions. By incorporating the law into the diagnostic, planning, corrective, and therapeutic stages of treatment, the clinician can readily categorize patients for needs assessments and future goals in treatment.

Adult↗

Medical ethics courses for student technologists.

Little has been written regarding instruction in medical ethics. Since it lies outside the familiar technical aspect of the radiologic sciences, some educators may lack confidence in presenting the subject. This article addresses the importance of adequate instruction and presents a systematic and philosophical approach for teaching medical ethics.

Codes of Ethics↗

Quality of institutional and community human service programs in Canada and the United States.

This methodological and substantive study was based on Wolfensberger and Thomas' (1983) Program Analysis of Service Systems' Implementation of Normalization Goals (PASSING), a program evaluation method used by teams of trained raters to assess the quality of human service programs. PASSING is based on Social Role Valorization, an internationally influential theoretical and philosophical approach to structuring human services, particularly services for persons with handicaps or other potentially devaluing conditions. The data for this study were derived from a sample of 213 programs evaluated with PASSING during 1983-88 in Canada (45%), the United States (51%), and the United Kingdom (4%). The programs served mainly mentally retarded persons (40%), subgroups of clients with "mixed" (different) impairments and conditions (38%), or psychiatrically impaired persons (6%). The results showed that PASSING has adequate internal consistency and interrater reliability and yields data suitable for statistical treatment with interval-level, parametric procedures. The average level of quality of services in the sample on the total PASSING scale and its five subscales (Program Relevance, Intensity, Integrativeness, Image Projection, and Felicity) was only modest, however. Community group residences (n = 77) were of significantly better quality than community vocational programs (n = 56), and both were superior to institutional residences (n = 20). Also, Canadian programs (n = 76) were of significantly better quality than U.S. programs (n = 77). An outstanding vocational program that was not part of the study sample was used to illustrate concrete ways in which the quality of many human service programs could be greatly improved, typically at little cost.

Activities of Daily Living↗

Year 2000 fitness objectives for the nation. The physician's role.

Physicians and other health care professionals can play an integral role in encouraging individuals to exercise. This article presents a general philosophical approach to the exercise prescription as well as the Year 2000 Physical Activity and Fitness Objectives for the Nation, which call for greater physician involvement in this area.

Health Promotion↗

Facial paralysis in children.

Facial paralysis in children is a complex condition. It may involve functional issues and always involves esthetic issues. Significant psychosocial problems may arise and family support systems are often necessary. In this brief article the etiology of facial paralysis in children is discussed and the common types described. The philosophical approach to the child and his or her family is emphasized. The timing of surgical intervention is addressed as well as a brief outline of the surgical techniques of cross-face nerve grafting and muscle transplantation. Although these latter procedures have added enormously to our capabilities to deal with this condition, further progress will be necessary through research and clinical ingenuity if we are to restore these children to normality.

Child↗

Moral theory and neurology.

This article presents an outline of a general moral theory and shows its relationship to the concepts of paternalism and that of valid consent and refusal. The authors then show how this theory and these concepts can be usefully applied to the moral problems that neurologists often face in determining how to act when they have distressing information for their patients. Finally, a procedure is provided for determining when it is morally justified to deceive patients by withholding information about their diagnoses, prognoses, or about their prospective treatments.

Comprehension↗

Future policy directions for quality assurance: lessons from the Health Accounting experience.

More than 25 years ago I proposed a philosophic approach for the ongoing, systematic management of quality assurance in the U.S. health care system. Health Accounting, based on the premise that successful quality assurance must evolve into a professional discipline that integrates the health and the management sciences, called for an analysis of the benefits and "disbenefits" of health care services as rigorous as that used by business and industry to analyze fiscal profits and losses. In this paper, I review the origins and development of Health Accounting, assess what we have learned from our experience of the past 25 years, and discuss the implications of this experience for promoting the growth of quality assurance in the United States.

Accounting↗

Canadian surgery during the French regime, 1608 to 1763.

The history of medicine in Canada, from the establishment of Quebec by Champlain in 1608 to the ceding of Canada to the British by the French at the Treaty of Paris in 1763, represents one of the most colourful periods in the history of Canadian surgery. Physicians were notable by their absence and what medicine was available in La Nouvelle France was provided almost exclusively by surgeons, or apothecaries, or individuals who posed as such. Sketches from the lives of five surgeons (Bonnerme, Giffard, Goupil, Bouchard and Sarrazin), an apothecary (Hébert) and a physician; (Gaultier), are presented to highlight various facets of medical care and the leadership role played by medical practitioners in the development of Canada during that period. In addition the study reveals the conflict between the philosophical approach of the physician and the pragmatic approach of the surgeon in 17th century France.

Canada↗

[Weltanschauung aspects of the problem of man, the biosphere and space].

The paper discusses philosophic approaches to the problem of man-environment interplay. Many important problems humanity faces today are associated with biology. Biomedical and astrophysical studies are being carried out to gain a better insight into the laws governing evolution and further development of the Universe. The emergence of a human society started a qualitatively new stage in the evolution of organic matter. A rapid progress of science and engineering is accompanied by a significant rearrangement of the natural environment and, particularly, of living beings. The biosphere is transforming into the sphere of intelligence, i.e. noosphere. However, natural phenomena are still more powerful than man-made productive forces. Man's excursion into outer space allowed him to look at himself as if from the outside and to evaluate critically his actual role, position and responsibility in the infinite Universe as compared with other forms of life and intelligence. The Universe may be boundlessly great but for human beings there is nothing better than the Earth. Our planet will long remain the base for the existence and development of humanity. Today man ought to take the streering-wheel of evolution and fate of the biosphere into his hands, in order to preserve, through the efforts of many generations, our planet as the gem of the Universe.

Biological Evolution↗

Individualized instruction: educational theory or practical method?

Individualized Instruction is a philosophical approach to instruction based on the concept of fixed content, variable methods, and variable time. Shown to be a viable alternative to the traditional lecture method of instruction, Individualized Instruction also involves the student more directly in the learning process and changes the role of instructors to facilitators of learning. This method of instruction can be used in presenting a wide variety of topics, and practical applications are almost unlimited.

Computer-Assisted Instruction↗

[Education of the diabetic patient: 10-year experience at the Karen Bruni Center].

On the basis of a ten year experience, new behavioural and philosophical approaches to the education of insulin-dependent diabetic patients are proposed by the Karen Bruni Diabetes Center of Turin. Conceptual and methodological revisions of conventional programs should be tried out. Practical difficulties are still restricting an integrated educational treatment of the diabetic persons.

Computer-Assisted Instruction↗