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PubMed2002

[Second year nursing students' identity crisis. "Assessment of objectives"].

Nursing students, guided by aspirations, begin training with an idealized representation of the profession, and the experiences they will encounter during their studies will vary progressively. Nursing training is based initially on a pedagogical system alternating between the classroom and the work place, exposing the student to a variety of situations. This process of work experience during the three years of study is marked by a crisis period during the second year. This involves an identity crisis resulting in a change of objectives. The analysis indicates that this is structural. The beginning of the second year is characterised by the student's confrontation with the theoretical and practical applications of the course. It is the result of a year's experience and instruction, which puts into question the student's vision, beliefs, and the orientation towards a new conception of himself/herself and of the world. The realisation of an incongruity, this reality check, is followed by a feeling of deception. This conflict, common in the second year, must be recognised in order to avoid further compromise to the identity's transformation. As soon as the student finds himself/herself committed to a training program that does not contribute to the realisation of his/her objectives, the feeling of being thrown off balance in relation to his/her point of reference increases, and the end result will be absenteeism or opposition. The handling of this identity crisis, as well as the motivational procedure, implies a modification in the quality of the instructor and in our way of thinking and acting. Are we adequately prepared to manage this crisis? Do we have access to the theories needed to resolve this cognitive conflict?

Attitude of Health Personnel↗
PubMed2005

[Nursing, simply complicated].

From a very young age, we played doctors and nurses. Back then, society was positive that a nursing profession existed. Now, is society's vision adequate? Evidently not. But, Why does this distortion exist? Fundamentally this occurs because the professionals themselves do not have a clear identity regarding their profession. And Why is this? Because the education transmitted has important lacks, the sanitary system dampens innovation and creativity, there are no appropriate leaders, lobbies transform into "wolves", and neither do we have a tradition which facilitates association and cooperation amongst professionals. These are some of the factors which the author develops in this deep, brave analysis about the reality of the nursing profession in order to arrive at the conclusion that we must have clear in our minds what nursing power is, a power which interacts with the community, and that this is important not only as a power in itself but rather as a means to increase the intrinsic value of nursing, none other than providing care.

Nursing↗
PubMed1980

The dominance of touch by vision: sometimes incomplete.

It is generally agreed that, when the two senses are in conflict, vision dominates touch. In the series of experiments reported here the discrepancy between the visual and the haptic images was progressively increased. In each experiment half of the observes were adults and half children, and half of each group wore a glove which concealed the distortion produced by the lens. In experiment 1 the visual image of a haptic square was transformed by a week or strong cylindrical lens so that the sides were in the ratio 1:1.5 or 1:1.8. Gloved observers selected a comparison image close to the visual image. Bare-handed observers gave compromise judgements with the strong lens, but judgements similar to those of the gloved observers with the weak lens. In experiment 2 the square had a visual image which was either a diamond or a parallelogram, the parallelogram having angles of 70 degrees and 110 degrees. Observers described and drew their percepts, which were generally in accord with the visual image. There were no significant differences due to age, a finding contrary to that of Page and Locke, nor were there differences in experiment 2 due to the gloved-hand-bare-hand dimension. It is concluded (i) that repeated observations do not destroy the effect, (ii) tht considerable discrepancies between the visual and haptic images do not destroy the effect, but (iii) that feedback from a bare hand can reduce the effect when it is of considerable magnitude.

Adult↗
PubMed1978

The control of rapid limb movement in the cat. I. Response latency.

A versatile tracking task has been developed to assess the competence of feline subjects in using sensory information to initiate and guide limb movement. In the present study we investigated the response latency and the factors which affect it in order to define temporal constraints on the underlying processing of information. The paradigm makes use of an electromechanical display of the difference between the output of transducers in a manipulandum (controlled by the cat) and a target level (controlled by the experimenter). Because of inertia and friction, a step change in target level required 230 msec to fully shift the display. The animals were trained to match the position of the manipulandum (or the force they applied to it isometrically) to the target level for a food reward. Target perturbations elicited rapid position or force adjustments of appropriate direction and magnitude at short latency. Under isometric conditions, the latency of the response was an inverse function of the extent of display motion and of the peak rate of force change attained during the adjustment. Asymptotic values of the response time, measured from the perturbation to the first change in force applied to the lever, were typically between 50 and 70 msec. Since the motor responses were invariably initiated while the display was still moving, the animals must have used information contained in the derivatives of its motion. In the absence of visual cues, deflection of the vibrissae by the sudden motion of the dispaly provided two of the four animals with sufficient information to initiate and guide their movements without changes in response latency. When vision was allowed, section of the vibrissae produced a persistent increase in response times of 15-20 msec. This difference in latency is compatible with the delays due to retinal transmission. The short time interval elapsing between stimulus and response strongly suggests that the topography and the metrics of the underlying transformations are adjusted by gating and/or biasing processes which precede the stimulus. It is concluded that sensory information can generate purposeful movements through pathways which include only a small number of central relays in series, independently of its modality.

Animals↗
PubMed1997

A theory of illusory lightness and transparency in monocular and binocular images: the role of contour junctions.

A theory of illusory transparency and lightness is described for monocular and binocular images containing X-, T- and I-contour junctions. This theory asserts that the geometric and luminance relationships of contour junctions induce illusory transparency and lightness percepts by causing a phenomenal scission of a homogenous luminance into multiple contributions. Specifically, it is argued that a discontinuous change in contrast along aligned contours that preserve contrast polarity induces a scission of the lower contrast region into a near-transparent surface or an illumination change, and a more distant surface that continues behind behind this near layer. This scission is assumed to cause changes in perceived lightness and/or surface opacity. Discontinuous changes in contrast along contours also are assumed to induce end-cut illusory contours that run roughly perpendicular to the inducing orientation of the contour, both monocularly and binocularly. Binocular illusory contours are shown to be caused by the presence of unmatchable contour terminators. It is argued that the presented theory can provide a unified account of a variety of monocular and binocular illusions that induce uniform transformations in perceived lightness, including neon-color spreading, the Munker-White illusion, Benary's illusion, and illusory monocular and binocular transparency.

Contrast Sensitivity↗
PubMed1999

Desperately seeking perfection: Christian discipleship and medical genetics.

The question of what, if anything, Christian theology as theology might contribute to ethical debates about appropriate uses of medical genetics has often been ignored. The answer is complex, and the author argues it is best characterized by an explanation of the analogous aspirations of the two: both have as their goal the perfection of the human being, both assert that the present disposition of the human body is on a fundamental level more often than not other than it ought to be, and both aspire to transform the present state of the body toward a future state in which present imperfections no longer exist. Given these analogous concerns, it would seem that one of the primary moral contributions that Christianity can make to debates about medical genetics is to ask whether and to what extent the Christian vision of embodied human perfection is compatible with the vision of perfection offered by the sciences pertaining to medical genetics. The author pursues a discussion of this analogy and its implications in this essay.

Christianity↗
PubMed1987

Efficiency of a model human image code.

Hypothetical schemes for neural representation of visual information can be expressed as explicit image codes. We may test whether a given code is sufficient, in the sense of retaining all the information that the human perceives, and necessary, in the sense of retaining only that information. The latter is a test of efficiency. Here, we explore a code modeled on the simple cells of the primate striate cortex. The Cortex transform maps a digital image into a set of subimages (layers) that are bandpass in spatial frequency and orientation. The layers are sampled so as to minimize the number of samples and still avoid aliasing. Samples are quantized in a manner that exploits the bandpass contrast-masking properties of human vision. The entropy of the samples is computed to provide a lower bound on the code size. Finally, the image is reconstructed from the code. We devise psychophysical methods for comparing the original and reconstructed images to evaluate the sufficiency of the code. When each resolution is coded at the threshold for detection artifacts, the image-code size is about 1 bit/pixel.

Humans↗
PubMed2004

What does it take to transform mental health knowledge into workplace practice? Towards a theory of action.

The purpose of this discussion paper is to consider the question of a knowledge base that might undergird a systematic approach to transforming mental health knowledge into workplace practice. Drawing on a range of systems-change and related research, the paper begins by contrasting the nature of "workplace" as opposed to "mental health knowledge" systems. On the basis of the Luhmann's concepts, these systems are cast as fundamentally being determined by the types of communication in which they are engaged (business about business matters, and mental health about mental health matters). For information from one to be adopted by the other requires the translation of mental health concepts into language understood by the workplace, by people capable of understanding both. The paper then examines the importance of determining a vision of desired outcome from such knowledge transfer. What is the desired outcome? A workplace free of mental health problems? The role of both values and existing knowledge in determining these is outlined, along with the importance of engaging the most immediately involved actors in developing the vision. Because valid and reliable knowledge is central to the task, a framework is set out in which the most immediately relevant research findings might be considered in relation to each other. Three categories of knowledge are proposed: employer-led preventive measures, employee-focused workplace interventions and community-based resources supportive of workplaces. Knowledge drawn from summative analyses of existing research is matched against these three categories to illustrate the potential for guiding both implementation and research decision making.The final section draws together the key elements of an active approach to promoting and supporting knowledge transformation from mental health research to workplaces.

Health Promotion↗
PubMed2005

Transforming a Master of Public Health program to address public health practice needs.

The future of the constantly changing public health profession is tied to the development of practice skills through competency-based training. In this article, we describe a program change in the Master of Public Health program at East Stroudsburg University in northeastern Pennsylvania. The first goal of the program transition was to ensure that all program elements included the relevant vision, values, mission, goals, and objectives. The second goal was to use continuous data input and evaluation to incorporate opportunities for flexible assessments. The change process helped the university faculty define the program's vision and fostered an environment of community collaboration that guides training for public health professionals.

Accreditation↗
PubMed1983

Pars plana vitrectomy in eyes with malignant melanoma.

Three patients underwent pars plana vitrectomy for vitreous hemorrhage secondary to an intraocular malignant melanoma. In all three cases the tumour was unsuspected and had been missed during pre-operative ultrasound examination. In each case vitreous haemorrhage was caused by invasion and perforation of the sensory retina and tumour growth into the vitreous cavity with bleeding from large vessels near the tumour surface (Knapp-Rønne growth pattern). One 75-year-old patient still has useful vision 3 years after surgery; in two patients the eyes were enucleated. Histology revealed in one case a diffuse spreading of tumour cells covering all intraocular surfaces: the posterior and anterior surface of the iris, the angle structures, the posterior corneal surface, and most of the inner retinal surface--probably due to transformation of growth pattern following vitrectomy.

Adult↗
PubMed1998

Carolyn Murdaugh as a transformational leader.

This article presents the lessons learned from Dr Carolyn Murdaugh, a transformational leader in the field of cardiovascular nursing as well as the larger community of scientists and scholars. Dr Murdaugh has inspired us and empowered us with the love of learning, science, and caring for others and ourselves. We present aspects of Dr Murdaugh's leadership, including her abilities to create a vision, model professional commitment, the value of hard work, and the creation of balance.

Cardiovascular Diseases↗
PubMed2001

A new approach of geodesic reconstruction for drusen segmentation in eye fundus images.

Segmentation of bright blobs in an image is an important problem in computer vision and particularly in biomedical imaging. In retinal angiography, segmentation of drusen, a yellowish deposit located on the retina, is a serious challenge in proper diagnosis and prevention of further complications. Drusen extraction using classic segmentation methods does not lead to good results. We present a new segmentation method based on new transformations we introduced in mathematical morphology. It is based on the search for a new class of regional maxima components of the image. These maxima correspond to the regions inside the drusen. We present experimental results for drusen extraction using images containing examples having different types and shapes of drusen. We also apply our segmentation technique to two important cases of dynamic sequences of drusen images. The first case is for tracking the average gray level of a particular drusen in a sequence of angiographic images during a fluorescein exam. The second case is for registration and matching of two angiographic images from widely spaced exams in order to characterize the evolution of drusen.

Fluorescein Angiography↗
PubMed2005

[Phenomenological and ethical aspects of aging and dementia].

Aging is a difficult stage in human life, due to the limitations it imposes and the nearness to death. Modern society tends to be prejudiced against oldness. When dementia is also present, prejudices can be transformed into rejection. The aim of this author tries to devise a phenomenological description of oldness and points out its potentially positive aspects. Following Scheller's classification of dementias (1965), this author tries to determine the common elements of their different forms, using the phenomenological method, which can be applied either to one or to many cases of aging or dementia, not being the number of observations the fundament of the study, as in the case of empirical sciences. Three essential features characterize the spatiality of aging: distance, reduction of mobility and coexistence of the essential and the tangential; temporality is characterized by slowing, coexistence of essential and trivial elements and predominance of present over future and past. In the case of dementias, all characteristics attributed to senescence are exaggerated and/or deformed, for example, < > is transformed into indifference or < > becomes a paralysis of temporal development. Now, regarding the main forms of dementia, this author sees their common feature in the loss of the Ego's ability to rise above the immediate situation, to be able to reflect on the environment and on him or herself. This wide vision both of aging and of the dementia process enables the author to identify the prejudices weighing over old age that must be overcome, as well as the reasons to respect and take care of the elderly when they are caught in a process of deterioration.

Aging↗
PubMed1995

Circumscribed choroidal hemangioma.

BACKGROUND: Circumscribed or solitary choroidal hemangioma is a relatively rare, benign vascular tumor. Because its appearance may mimic more serious intraocular lesions, eye care practitioners should be familiar with differential diagnosis and treatment options. METHODS: A patient presented with an asymptomatic, elevated, red-orange lesion above the macula in the right eye and a history of longstanding unexplained visual acuity loss in the eye. Intraocular lesions such as amelanotic melanoma, metastatic tumor, choroidal osteoma, disciform scar, serous detachment, and central serous chorioretinopathy can appear similar to circumscribed choroidal hemangioma (CCH) on ophthalmoscopy, but may be differentially diagnosed with fluorescein angiography, ultrasonography, and periodic observation. RESULTS: CCH requires various therapeutic options. Until the patient becomes symptomatic from visual loss secondary to serous macular detachment or subretinal neovascular membrane formation, no treatment is necessary. Laser photocoagulation is the preferred therapeutic intervention, and most patients will require a minimum of two sessions. A small percentage of individuals will progress to complete retinal detachment with profound visual loss regardless of therapy. Most CCHs remain stable in size and do not undergo malignant transformation. CONCLUSIONS: CCHs may be overlooked because of their initial subtle clinical appearance with no associated cutaneous or systemic anomaly. Even though CCH is a benign tumor, it may mimic more serious intraocular lesions and require a combination of ancillary tests for proper diagnosis. Depending on visual symptoms or potential threat to vision, management options include periodic observation, laser photocoagulation, cryotherapy, microwave therapy, and possible enucleation. CCH has little or no growth potential, but visual prognosis remains guarded due to significant secondary retinal changes that can occur over the tumor's surface. CCH must be considered in the differential diagnosis of an elevated intraocular lesion.

Aged↗
PubMed1999

Adaptive filtering in spatial vision: evidence from feature marking in plaids.

Much evidence shows that early vision employs an array of spatial filters tuned for different spatial frequencies and orientations. We suggest that for moderately low spatial frequencies these preliminary filters are not treated independently, but are used to perform grouping and segmentation in the patchwise Fourier domain. For example, consider a stationary plaid made from two superimposed sinusoidal gratings of the same contrast and spatial frequency oriented +/- 45 degrees from vertical. Most of the energy in a wavelet-like (e.g. simple-cell) transform of this stimulus is in the oblique orientations, but typically it looks like a compound structure containing blurred vertical and horizontal edges. This checkerboard structure corresponds with the locations of zero crossings in the output of an isotropic (circular) filter, synthesised from the linear sum of a set of oriented basis-filters (Georgeson, 1992 Proceedings of the Royal Society of London, Series B 249 235-245). However, the addition of a third harmonic in square-wave phase causes almost complete perceptual segmentation of the plaid into two overlapping oblique gratings. Here we confirm this result psychophysically using a feature-marking technique, and argue that this perceptual segmentation cannot be understood in terms of the zero crossings marked in the output of any static linear filter that is sensitive to all of the plaid's components. If it is assumed that zero crossings or similar are an appropriate feature-primitive in human vision, our results require a flexible process that combines and segments early basis-filters according to prevailing image conditions. Thus, we suggest that combination and segmentation of spatial filters in the patchwise Fourier domain underpins the perceptual segmentation observed in our experiments. Under this kind of image-processing scheme, registration across spatial scales occurs at the level of spatial filters, before features are extracted. This contrasts with many previous schemes where feature correspondence is required between spatial edge-maps at different spatial scales.

Adaptation, Psychological↗
PubMed2001

Mastering the value chain. An interview with Mark Levin of Millennium Pharmaceuticals. Interview by David Champion.

As today's business leaders are all too aware, a new scientific or technological break-through can quickly transform an industry's competitive landscape. The upheaval is often traumatic for the companies involved, forcing them to rethink their strategies and redefine their boundaries. But an industry in flux also creates vast opportunities. To seize them, companies must see how the current upheavals will affect the future distribution of profits--and then reinvent themselves to capitalize on the new sources of value. In this interview with HBR senior editor David Champion, Mark Levin, the founder and CEO of Millennium Pharmaceuticals, describes his vision of the future of the pharmaceutical industry in the wake of the genetics revolution and new technologies that have altered the economics of drug development. No company, he argues, will create serious long-term value by staying in just one or two stages of the value of chain. That's why Millennium, which started out doing basis research into genes and proteins and selling its findings to pharmaceutical giants, has moved downstream - toward the patients who actually use and pay for the drugs. He explains why the research end has become less lucrative than the more mechanical tasks of identifying, testing, and manufacturing molecules. Levin talks about the changes Millennium has undergone since its inception in 1993-from 30 workers to more than 1,000, and from one end of the value chain to the other. He discusses the company's cultural transformations as well as the partnerships and acquisitions that have helped millennium become involved in every stage of the chain-from gene to patient. Levin's vigorous approach to balancing long-term strategy with short-term tactics offers important lessons to any executive facing an industry upheaval.

Drug Design↗
PubMed2004

Prospects for total synthesis: a vision for a totally synthetic vaccine targeting epithelial tumors.

Vaccines derived from totally synthetic carbohydrate antigens have been shown to elicit an immune response in both preclinical and clinical settings. The vaccines have been proven safe when administered in human clinical trials and are also competent at inducing antibodies that react with aberrant cells expressing the corresponding carbohydrate antigen. The most well studied vaccines have hitherto focused on single carbohydrate antigens, notwithstanding the known heterogeneity of transformed cells. Advances in synthetic organic chemistry have enabled the preparation and subsequent investigation of vaccines that contain several different tumor-associated carbohydrate antigens in a single molecule. These unimolecular constructs could, in principle, serve as superior mimics of cell surface antigens and hence, as multifaceted cancer vaccines. We report here the synthesis of a pentameric vaccine targeting a specific cancer. The new vaccine contains prostate tumor-associated antigens, Tn, TF, STn, Lewis(y), and Globo-H. To reach our goal, antigen-containing amino acid monomers were assembled in a linear fashion to form a glycopeptide containing the five distinct carbohydrate antigen units. The attachment of a linker to the glycopeptide followed by an extraordinary global deprotection and subsequent conjugation to two different immunogenic carriers, keyhole limpet hemocyanin and N-alpha-palmitoyl-S-[2,3-bis(palmitoyloxy)-(2RS)-propyl]-L-cysteine, resulted in the vaccine constructs. The results described herein indicate that complex unimolecular multivalent vaccines can be efficiently produced in the laboratory. These fully synthetic vaccines have the potential to stimulate a multifaceted immune response against prostate cancer.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1988

Coordinates transformation and learning control for visually-guided voluntary movement with iteration: a Newton-like method in a function space.

In order to control visually-guided voluntary movements, the central nervous system (CNS) must solve the following three computational problems at different levels: (1) determination of a desired trajectory in the visual coordinates, (2) transformation of the coordinates of the desired trajectory to the body coordinates and (3) generation of motor command. In this paper, the second and the third problems are treated at computational, representational and hardware levels of Marr. We first study the problems at the computational level, and then propose an iterative learning scheme as a possible algorithm. This is a trial and error type learning such as repetitive training of golf swing. The amount of motor command needed to coordinate activities of many muscles is not determined at once, but in a step-wise, trial and error fashion in the course of a set of repetitions. Actually, the motor command in the (n + 1)-th iteration is a sum of the motor command in the n-th iteration plus two modification terms which are, respectively, proportional to acceleration and speed errors between the desired trajectory and the realized trajectory in the n-th iteration. We mathematically formulate this iterative learning control as a Newton-like method in functional spaces and prove its convergence under appropriate mathematical conditions with use of dynamical system theory and functional analysis. Computer simulations of this iterative learning control of a robotic manipulator in the body or visual coordinates are shown. Finally, we propose that areas 2, 5, and 7 of the sensory association cortex are possible sites of this learning control. Further we propose neural network model which acquires transformation matrices from acceleration or velocity to motor command, which are used in these schemes.

Central Nervous System↗