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PubMed2002

Work and health in the global economy: lessons from developing and industrialized countries on the impact of work on health.

Occupational and environmental health are dependent on the decisions made about the production of goods and services: the quality of our lives in the community and workplace and our well-being as workers, residents, and citizens are profoundly influenced by the technology employed in producing "our way of life." We seek to understand the system of decision making about the use of humans and the natural environment in production; we want to know who is sitting at the table where decisions are taken and what drives their decisions; and we want to know how ordinary people can take their appropriate place at the table, so that they can protect their health and well-being. The global economy is not what it seems: a mythology has been created about globalization in which the marketplace is the only reality and nations and national identity--human agency--play only a minor role.

Journal Article↗
PubMed1990

The multiplicity of dreams: cognitive-affective correlates of lucid, archetypal, and nightmare dreaming.

This preliminary research is the first to compare lucid, nightmare, and archetypal-mythological dreams on dimensions important in previous research on each. A first study of 100 subjects showed all three forms significantly correlated with each other and with estimates of dream recall. In a second study, 41 subjects were selected from the above on the basis of relative specialization in each dream form, with a control group equally high on dream recall. Here, the lucid and archetypal dreamers tended to separate themselves from nightmare sufferers on the basis of high imaginativeness, proclivity to waking mystical experience, spatial/analytic skills, and physical balance. It appears that the intensification of dreaming is expressed positively or negatively, depending on variations in these cognitive dimensions.

Adolescent↗
PubMed1989

The stereotype of the mad psychiatrist.

The stereotype of the mad psychiatrist is examined. There is initial consideration of the "popular" model of madness. It is suggested that there is no firm evidence that psychiatrists suffer more frequently from "popular madness" than other medical practitioners. The paper subsequently explores the stereotype's functions, origins, means of propagation and range of effects. It emerges that members of "the first generation" of psychiatrists were labelled as mad. It is inferred that the stereotype may not be about to change. The paper invokes the conceptually closely-related literatures and attendant terminologies of stereotyping, mythology, labelling, deviance, prejudice and stigma.

Career Choice↗
PubMed1990

A phenomenology of jealousy.

Phenomenology is the study of conscious mental events. That it is conscious events requires emphasis, particularly at this moment in the historical development of psychiatry when we are still emerging from the thrall of psychodynamic causalities, said to lie in unconscious and unknowable realms, and are in danger of descending into another mythology of extra conscious mechanisms compounded from neurobiological speculations.

Emotions↗
PubMed1998

Drugs, violence, and federal funding: a research odyssey.

Two decades of research activity focusing on drugs/violence relationships are described. Initial interest in this area was kindled by field experiences. Literature review revealed a dearth of concepts and data. A tripartite conceptual framework was formulated to define drug-related violence. A series of empirical studies were undertaken to verify and elaborate the conceptual framework. Findings from these studies debunked prevailing mythology about drugs/violence relationships. Findings also demonstrated the usefulness of a public health perspective and the critical importance of collecting qualitative data in order to achieve a deeper understanding of these phenomena.

Crime↗
PubMed2003

The cost and cost-effectiveness of PPIs--GP perspectives and responses to a prescribing dilemma and their implications for the development of patient-centred healthcare.

BACKGROUND: Evidence-based medicine (EBM) has stimulated a proliferation of clinical guidelines and prescribing protocols which aim to increase quality and improve equity of healthcare through the standardisation of treatment and access to resources. The containment of rising prescribing costs is a major concern of European healthcare systems, which has led to a more overt rationing of resources. However, prescribing guidelines and cost-containment strategies reduce the capacity of health professionals to involve patients in discussion and choice of treatment and consequently work against the objectives of patient-centred medicine (PCM), which are a priority of current UK healthcare policy. Little is known about the impact of prescribing guidelines or cost-containment strategies on the practice of medicine in the primary care sector, their effect on relations between doctors and patients, and the ways in which laymen and professionals evaluate and respond to strategies for more 'rational' prescribing. AIM: This paper considers the responses of general practitioners (GPs) in the UK to the conflicting commitments of meeting the clinical needs of individual patients and dealing with the situational constraints of the consultation, while also achieving a reduction in prescribing rates (and costs) of proton pump inhibitors (PPIs) in the treatment of gastric disorders. METHOD: Qualitative interview-based research involving 26 GPs. RESULTS: Most doctors considered that they were making an effort to achieve a reduction in PPI prescribing, and none regarded his current prescribing of PPIs to be inappropriate. However, the raised prescribing thresholds for PPIs, which were a consequence of applying a cost-containment policy, conflicted with the GPs' stated commitment to provide the best and most appropriate treatment for individual patients. In addition, the aim to reduce PPI prescribing was often subverted by the situational constraints of the consultation, and doctors' desire to protect their relationship with patients. CONCLUSION: An outcome of the conflicting pressures to which the doctors were subject in their efforts to meet clinical need while also reducing the cost of PPIs was the reinforcement of widespread assumptions and negative patient stereotypes relating to a 'mythology' of PPI prescribing. The prevalence of such stereotypes inhibits the reflexivity in medical practice, which is required for doctors to perceive and respond more constructively to patient perspectives of illness and treatment. Such typifications also function to justify the rationing of treatment on the basis of inappropriate judgements about the deservingness or moral worth of patients. The study illustrates the adverse impact on medical practice of GPs' responses to the competing pressures of meeting patient needs while complying with prescribing incentives and guidelines. It highlights the incompatibility of different policies relating to cost containment and patient-centred medicine and may help to explain the systematic inertia which appears to have hindered the development of genuinely patient-centred medicine over the last few decades.

Adult↗
PubMed1991

The image of the "brain surgeon" in American culture: the influence of Harvey Cushing.

In contemporary American culture, the term "brain surgeon" conjures up the image of an intensely single-minded professional, who deals with terribly complex matters of life and death. These descriptors find their personification in Harvey Cushing, because they are derived directly from him. This hypothesis was tested by a complete search of the New York Times Index and the Reader's Guide to Periodical Literature for the years 1919 to 1942. All entries for Harvey Cushing were reviewed in the original sources. In the New York Times, Cushing's first significant exposure was in response to his winning a Pulitzer Prize in 1925. Major editorial coverage began in 1934, and was especially prominent with the publication of From a Surgeon's Journal in 1936. The process of lionizing Cushing by creating an overdrawn caricature reached its apotheosis in Time magazine in 1939. The Time article was actually a report of Cushing's 70th birthday party. It expounded all of the descriptors that are now associated with "brain surgeon". Thus, it was Cushing's literary skills that initially brought him recognition from editors who were arbiters of public opinion. This attention seems to have been the conduit to his mythologization by the larger public. Although unnamed, it is really Cushing's image that still persists as the prototypical "brain surgeon" in the collective American consciousness.

History, 20th Century↗
PubMed1997

Myths and facts about Lyme disease.

Lyme disease has taken hold in the imagination of the general public and physicians alike. Although the disease is real, the diagnosis is often false. Patients demanding an explanation for feeling out of sorts, and physicians too willing to oblige them with improper use of serologic tests and useless therapies both foster a mythology that conscientious physicians should try to combat. This article debunks the myths and presents the facts.

Animals↗
PubMed1983

Polyorchidism diagnosed preoperatively by ultrasonography.

Polyorchidism, or multiple testes, is a rare condition that has been referred to in both medical literature and mythological folklore. Curious attributes have been ascribed to men with this condition, including supposed increased sexual prowess and virility. In the medical literature, the examples of supernumerary testicles have demonstrated only one additional testis. The first proven case of an extra testicle was by Lane, in 1895. Boggon reviewed 11 additional cases in 1933, and numerous other cases have been reported since then. To date, there has not been a preoperative ultrasonographic study that adequately describes this phenomenon.

Adolescent↗
PubMed1995

Culture, chaos, and refounding. How leaders can refound the Catholic health ministry.

Culture provides us with what we so desperately need in human life--a set of felt meanings in an orderly pattern. A group creates a culture as a way to cope with life's challenges and teach members the correct way to feel, think, and behave. No group is ever without a culture. If culture has a built-in tendency to resist change, how does change take place at all? The process of change involves separation, chaos, and reentry--the letting go of the old and familiar and the embracing of the uncertain new. The way to use chaos constructively is for people to return to the sacred time of their founding in order to identify, relive, and reown the heart of their creation mythology, liberated from the accidental and historical accretions that hold back creativity. For healthcare workers today, this means reidentifying with Christ's actions such as healing the sick or giving sight to the blind. Through this reidentification, healthcare givers can be fired up to form a new cultural integration adapted to changing needs. The chaos that our healthcare ministry is experiencing today offers us unparalleled opportunities for refounding. By acknowledging the chaos of the healthcare system, we thus lock in on the healing and reconciliatory power of God, and from this comes the energy to journey through the refounding process--the process whereby we struggle to enter collaboratively into the paschal mystery with Christ for his mission of healing; thus energized, we work to challenge systems and to create responses to the most urgent needs confronting the health of the people we serve.

Catholicism↗
PubMed1995

In pursuit of physician/organization linkage.

A friend of mine once said that medical staff/administrative relationships are the Bermuda Triangle of health care management. The Bermuda Triangle, as I recall it, is an area of the Atlantic Ocean into which ships and planes disappear without a trace, for no apparent reason. Sometimes, especially late at night on reruns of "Twilight Zone," these planes reappear years later, crew intact and youthful. Sometimes, salt and sharks get the ships, planes, and voyagers. In a like manner, problems in medical staff/administrative relations draw consultants into a vortex. Sometimes, the consultants and their reports float to the surface a long afterward. Sometimes, they are digested by the organization and become a part of its mythology. Sometimes, they vanish forever. This is the story of three consultations. All were intended to make recommendations concerning the structural relationship of management to the physicians and their groups in our HMO: How to link the physician organization to the corporate structure. Like any narrative, this story is constructed to provide a context for reflection and is not intended to question the value of the contribution of specific individuals or companies.

Consultants↗
PubMedDate not supplied

How venture capital works.

The popular mythology surrounding the U.S. venture-capital industry derives from a previous era. Venture capitalists who nurtured the computer industry in its infancy were legendary both for their risk taking and for their hands-on operating experience. But today things are different, and separating the myths from the realities is crucial to understanding this important piece of the U.S. economy. Today's venture capitalists are more like conservative bankers than the risk takers of days past. They have carved out a specialized niche in the capital markets, filling a void that other institutions cannot serve. They are the linch-pins in an efficient system for meeting the needs of institutional investors looking for high returns, of entrepreneurs seeking funding, and of investment bankers looking for companies to sell. Venture capitalists must earn a consistently superior return on investments in inherently risky businesses. The myth is that they do so by investing in good ideas and good plans. In reality, they invest in good industries--that is, industries that are more competitively forgiving than the market as a whole. And they structure their deals in a way that minimizes their risk and maximizes their returns. Although many entrepreneurs expect venture capitalists to provide them with sage guidance as well as capital, that expectation is unrealistic. Given a typical portfolio of ten companies and a 2,000-hour work year, a venture capital partner spends on average less than two hours per week on any given company. In addition to analyzing the current venture-capital system, the author offers practical advice to entrepreneurs thinking about venture funding.

Capital Financing↗
PubMed1998

Virtual reality in psychotherapy: the MYTHSEEKER software.

This chapter outlines the use in psychotherapy and medical diagnosis of an intelligent software system that helps clients to explore Personal Myth within virtual reality environments. Patented MYTHSEEKER software will allow clients to work with mythic analogues of lifeshapes and aspirations. This can help to focus therapy directions, find ways to participate with the person's world, and allow a kind of personal expression not previously possible. The software phases of assessment, facilitation, and enaction are described by which the client is assisted to explore systems of mythology or spirituality (called Depth Systems) that are traditional, ancient or newly-arising. The client builds a Personal Depth System representing Personal Myth, based on experiencing other Depth Systems, which can itself be experienced in the virtual environment. This paper outlines our methodology and technology to realize these operations. Space limitations prevent further description in the present chapter of MYTHSEEKER software technology or psychotherapy scenarios of involvement.

Artificial Intelligence↗
PubMed2001

Echolalia as a novel manifestation of neuropsychiatric systemic lupus erythematosus.

"That tongue of yours, by which I have been tricked, shall have its power curtailed and enjoy the briefest use of speech." With these words, Hera, of Greek mythology, deprived the nymph Echo of spontaneous speech, constraining her instead to merely repeating the words of others. Echolalia, which derives from the word "echo," is disordered speech in which an individual persistently repeats what is heard. Echolalia has been described in patients with a number of neuropsychiatric illnesses including autism and Tourette's syndrome. Neuropsychiatric systemic lupus erythematosus (NPSLE) is a heterogeneous disease with protean manifestations that may occur in approximately 25% to 50% of patients with systemic lupus erythematosus (SLE). Although the most common manifestations include cognitive dysfunction (50%) and seizures (20%), NPSLE may also present as peripheral neuropathy (15%), psychosis (10%), or other central nervous system abnormalities. We report the case of a 57-year-old woman with SLE and echolalia.

Anti-Inflammatory Agents↗
PubMed2000

Demystifying medical complexities.

Although dentists often fear treating medically complex patients, in many cases this fear may be based not on scientific facts but rather on a "mythology" of the dangers of dentistry. Dentistry is a remarkably safe profession, even for most medically complex patients. The myths of endocarditis, artificial joint infections, local anesthetics and vasoconstrictors, dental surgery in anticoagulated patients and patients on antiplatelet drugs, and antibiotic interference with oral contraceptives are discussed. Although dental treatment is not usually a risk factor for endocarditis, practitioners should consult the 1997 American Heart Association statement for recommendations for endocarditis prevention. Most artificial joint patients should not receive antibiotic prophylaxis. Local anesthetics and vasoconstrictors can be used safely in most medically complex patients. Neither continuous anticoagulation nor antiplatelet medications should be withdrawn for dental surgery. Scientific studies have failed to document an interaction between antibiotics used in dentistry and oral contraceptives.

Anesthesia, Dental↗
PubMed2001

A reading list for Bill Gates--and you. A conversation with literary critic Harold Bloom. Interview by Diane L. Coutu.

In today's technology-driven world, who has time to pick up a 400-page novel? Most executives don't--they have urgent e-mails to answer, training seminars to attend, meetings to lead, and trade publications to scan. But according to Harold Bloom, one of America's most influential scholars, they should make time in their hectic schedules to read great works. In a wide-ranging conversation with HBR senior editor Diane Coutu, Bloom discusses the importance of literature: every individual--regardless of profession--needs to stretch his or her mind and reflect now and again on the human condition. "By reading great imaginative literature, you can prepare yourself for surprise and even get a kind of strength that welcomes and exploits the unexpected," he says. Because there are so many great works and there is so little time, Bloom presents a reading list for busy executives. Shakespeare's King Lear can teach businesspeople about change. Ralph Waldo Emerson's essays capture the ethos of the American spirit--individualism and inventiveness. Bloom says Sigmund Freud's conceptions "form the only Western mythology that contemporary intellectuals have in common." And people will never fully understand some aspects of themselves until they read Miguel de Cervantes's Don Quixote. In short, Bloom believes the humanities have much to offer businesspeople: great books broaden their awareness and their range of sensibility, he says. But reading literature will not make businesspeople more moral, he cautions. Bloom also discusses other topics such as how to read well, the state of popular fiction, the role of irony, and the subject of change.

Administrative Personnel↗
PubMed2000

[Disease in Velázquez' painting].

A short biographical abstract of Painter Velázquez and his artistical and cultural background with relation to this own time is given. His whole work and of the court and official jobs he had has, been analysed. Together with his artistical vocation and great capacity and aptitude for painting, he felt the ambition to seek a position of nobility. A peculiar research of the pathological aspects appearing in his pictures has been made, regardless of the technical characteristics of his painting and style. For this purpose, his paintings have been classified in still lives, religious pictures, mythological pictures, portraits of royal male and female family members, portraits of ordinary people, big peoples such as Las Lanzas, Las Hilanderas and Las Meninas, etc., to conclude with the really singular group of buffoons, dwarfs, jesters and mad people. The pathological issues have been commented. A list of bibliographical references is also added.

Dwarfism↗
PubMedDate not supplied

Common cent$ 1: One-armed economists and the invisible hand.

This article is the first in a series called Common Cent$. There is a need for leaders and managers to have a basic understanding--Common Cent$--of elementary economics. The limited, retrospective view of the accountant must be supplemented by the broader, prospective view of the economist. The limits and scope of economics are defined. The First and Second Fundamental Theorems of Welfare Economics are introduced. The mythology behind the mechanism of action of Adam Smith's Invisible Hand is dissected, and the mechanism of the free market is explained in terms of the effect of marginal cost on net market efficiency. The apparently simple case of the effect of legislating a minimum wage on a free market is discussed. This provides an example of the real-world complexity of economies and of applying economic concepts to the business world.

Accounting↗