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PubMedDate not supplied

Unconventional style reaps rewards for Ruckdeschel. Physician executive's career carries cancer center to the forefront. Interview by Patty Ryan.

He didn't like math. Loved biology. So he ditched his plans to become an engineer and ended up pursuing a career in medicine and hospital administration. He led a sleepy cancer center to new heights of cutting-edge research and progressive types of treatment. And he did it all on his own terms--a mix of practicality and instinct that serves up some interesting perspectives for fellow physician executives to consider. Meet John Ruckdeschel, MD.

Cancer Care Facilities↗
PubMed2001

Outcomes of posttraumatic stress disorder.

The typical reaction to a life-threatening experience is one of distress, anxiety, and fear. This is characteristic of the basic survival instinct; these emotions enhance the individual's memory of the traumatic experience and thus serve to help in the recognition and avoidance of similarly dangerous situations in the future. In a significant minority of individuals, however, the natural reaction to trauma becomes uncontrollably and disastrously intensified, resulting in the symptoms of posttraumatic stress disorder (PTSD). PTSD varies in severity and duration between individuals, often relating to personal characteristics and the nature of the trauma to which a person is subjected. However, several factors, namely, chronicity, impairment, comorbidity, and somatization, are significantly related to and can influence the course of PTSD and subsequent outcome. This article briefly reviews each of these factors.

Adult↗
PubMed2001

We don't need another hero.

Everybody loves the stories of heroes like Martin Luther King, Jr., Mother Teresa, and Gandhi. But the heroic model of moral leadership usually doesn't work in the corporate world. Modesty and restraint are largely responsible for the achievements of the most effective moral leaders in business. The author, a specialist in business ethics, says the quiet leaders he has studied follow four basic rules in meeting ethical challenges and making decisions. The rules constitute an important resource for executives who want to encourage the development of such leaders among their middle managers. The first rule is "Put things off till tomorrow." The passage of time allows turbulent waters to calm and lets leaders' moral instincts emerge. "Pick your battles" means that quiet leaders don't waste political capital on fights they can't win; they save it for occasions when they really want to fight. "Bend the rules, don't break them" sounds easier than it is--bending the rules in order to resolve a complicated situation requires imagination, discipline, restraint, flexibility, and entrepreneurship. The fourth rule, "Find a compromise," reflects the author's finding that quiet leaders try not to see situations as polarized tests of ethical principles. These individuals work hard to craft compromises that are "good enough"--responsible and workable enough--to satisfy themselves, their companies, and their customers. The vast majority of difficult problems are solved through the consistent striving of people working far from the limelight. Their quiet approach to leadership doesn't inspire, thrill, or provide story lines for uplifting TV shows. But the unglamorous efforts of quiet leaders make a tremendous difference every day in the corporate world.

Administrative Personnel↗
PubMed1989

["Freud and fetichism": previously unpublished minutes of the Vienna Psychoanalytic Society].

On the occasion of this session held by the Viennese Psychoanalytic Society on the 24th of February 1909, Freud made a presentation on fetchism that was the point of departure for a reflection that led him to the theorization of the article of 1927. Being careful to differentiate his position from that of other authors having shown an interest for the subject, he clearly stressed the role of infantile sexuality as an etiological factor, and in particular the link between fetichism and repression. The discussion that followed the presentation shows that Freud and Adler's positions were beginning to diverge, the latter replacing the notion of instincts that Freud held to be involved in the mechanism of repression, by that of "fear of degradation" and of "sensitivity". These Minutes that had been thought to have disappeared are studied within the more general framework of the meetings of the Viennese Psychoanalytic Society.

Austria↗
PubMed1991

The injustice of it all: caring for the chronically ill.

... While Spiegelberg emphasizes these "cosmic" -- perhaps more accurately, ontological -- features of birth and undeserved inequalities, it seems to us not inappropriate to suggest that what Douard terms "outrage" and Annas "instinct" go in the same direction. When impairment occurs without desert, something should be done to help. This is all the more true when, as in cases of chronic affliction that concern Douard or the case of the Siamese twins that fascinates Annas, something helpful can be done. Then, in Spiegelberg's words, what is "undeserved" demands redress. In these terms, each of these authors points to a deeply rooted sense of our common human lot. Or, in Albert Schweitzer's apt phrase, to witness such undeserved misfortune is to awaken "a moral sense that is usually dormant but that on special occasions can be brought to the surface." Chronic illnesses, we suggest -- no less than the "accidents of birth" that concern Spiegelberg -- are just such "special occasions" for awakening that "moral sense" suggested by Douard in his appeal to the "outrage" of doing nothing for, or refusing to help, the chronically ill.

Chronic Disease↗
PubMed2001

[Communication between physician and patient with chronic heart decompensation may help to reach the therapeutic objectives. How to make it efficient].

In the management of chronic heart failure there is increasing evidence that effective communication with the patient is an important tool in health care since it permits the achievement of therapeutic goals and the patient's satisfaction in terms of the quality of health assistance received. In fact, the variations in the communication processes relevantly influence the results in some behaviors and attitudes of the patient, such as adherence to the therapeutic prescriptions, understanding and remembering the information received, satisfaction with the medical examination and less worry. The capacity of the patient of co-administering the illness may result in a reduction in the instability due to avoidable concomitant factors, and thus reduce the heart failure morbidity and rehospitalization rate. Building up an effective doctor-patient relationship becomes an important goal to achieve, and the necessary instruments are not only instinctive or the result of experience, but can also be taught and learnt. The aim of this work was to give a contribution, which, in addition to underlining the theoretic aspects of the communicative process by means of numerous examples taken from everyday practice in patient management, is to induce reflection and to propose ways of intervention for the improvement of the therapeutic relationship between the cardiologist and the patient with heart failure.

Communication↗
PubMedDate not supplied

[Hypochondriasis: mechanisms of a disorder in the light of psychoanalytical concepts].

This paper presents the mechanisms of hypochondria from the perspective of different theoretical orientations in psychoanalysis. The authors analyze the significance of narcissism, the death instinct (mainly from the perspective of Melanie Klein's school) and the masochistic tendencies, in hypochondria. The paper presents the views of various psychoanalytical authors on the links between hypochondria and other mental disorders. The authors also present the theory and empirical data, showing the connection between somatoform disorders and the traumatic experiences in childhood. The authors stress the importance of the contribution of different theoretical schools in psychoanalysis to the understanding of the intra psychic work of hypochondria.

Adult↗
PubMedDate not supplied

[Essence and significance of surgery. Part I -- Birth of surgery: determining factors and contexts].

The author intends to particularly analyse the origin of Surgery as regards its deterministic factors and contexts, resounding the essence and the meaning of Surgery itself. The primary core of the surgical practice dates back to Prehistoric Times, when, driven by his self-preservation instinct, the cave man, when suffering from some trauma, performed on himself a series of more or less immediate "actions" in order to remain healthy. At the same time, a second meaningful nucleus of the surgical experience rises contiguously to the operations the Prehistoric Man performed on another member of his clan. The third stage of this ongoing process, coincident with the origin of surgery in the strict sense of the word, goes back to the tribal context: in fact, in this social organisation only one member of the group was specifically assigned to treat diseases, based on group regulations. For the mediterranean area, the chronological development of this evolution is likely to have started 250,000 years ago in connection with the experience initially of Neanderthal Man and subsequently Cro-Magnon Man in Pleistocene and Holocene of the Quarternary Era respectively, and it could have finished at the beginning of the Neolithic, when the "ancient civilization" of the Mediterranean Basin arose in approximately 10,000 B.C.

General Surgery↗
PubMed2002

Psychotrauma and reconciliation.

Our goal was to analyze the phenomenon of intergenerational transmission of trauma-related feelings and propose a way to alleviate this process through reconciliation of conflicted groups. The genesis of psychotrauma, with respect to the organism's defensive barrier being pierced by too strong external impulses, is discussed in terms of activation of the death instinct or by reactivation of childhood trauma. Genesis of the group trauma is explained in terms of chosen trauma, ie, activation of ancient national or other large group traumas, leading to the creation of malignant prejudices and hyper-activation of the social unconscious. Development of hatred, guilt, shame, and a need for revenge is illustrated with a number of examples from the 1991-1995 war in Croatia and the Holocaust, together with the influence they bear on an individual and a group. Therapy of psychotrauma could be a possible means of prevention of intergenerational transmission of traumatic emotions. Special attention is given to the retraumatization of Croatian war veterans in terms of the influence it exerts on future generations. A therapeutic model developed on the basis of eight years of clinical experience, designed specifically for veterans with posttraumatic stress disorder, is presented. The mechanism of intergenerational transmission of traumatic emotions as understood mainly through clinical experience in work with second-generation Holocaust victims is discussed.

Adaptation, Psychological↗
PubMed2001

Positivism and qualitative nursing research.

Despite the hostility to positivism shown by qualitative methodologists in nursing, as in other disciplines, the epistemological and ontological instincts of qualitative researchers seem to coincide with those of the positivists, especially Bayesian positivists. This article suggests that positivists and qualitative researchers alike are pro-observation, proinduction, pro-plausibility and pro-subjectivity. They are also anti-cause, anti-realist, anti-explanation, anti-correspondence, anti-truth. In only one respect is there a significant difference between positivist and qualitative methodologists: most positivists have believed that, methodologically, the natural sciences and the social sciences are the same; most qualitative researchers are adamant that they are not. However, if positivism fails as a philosophy of the natural sciences (which it probably does), it might well succeed as a philosophy of the social sciences, just because there is a methodological watershed between the two. Reflex antagonism to positivism might therefore be a major obstacle to understanding the real reasons why qualitative research and the natural sciences are methodologically divergent; and less hostility on the part of qualitative nurse researchers might bring certain advantages in its wake.

Humans↗
PubMed2002

From the philosophy auditorium to the neurophysiology laboratory and back: from Bergson to Damasio.

Henri Bergson (1859-1941) was probably the most influential French philosopher at the turn of the twentieth century. In 1927 he was awarded the Nobel Prize for literature. Far beyond the restricted academic philosophical milieu, the impact of his thinking reached personalities as diverse as Claude Debussy, Marcel Proust, George Bemard Shaw, and the impressionists. His essay The Laughter (Le Rire) is one of the most profound and original ever written on the sense of humor. Bergson's opinions, with their emphasis on life, instinct and intuition, represented a deviation from the rationalist mainstream of western philosophical tradition. In some circles he was received with skepticism and irony, as in Bertrand Russel's History of Western Philosophy. Today, unbiased by theoretical "bergsonism," neurophysiologic research--as undertaken mainly by Antonio Damasio's team at Iowa University--confirms many of his hypotheses and elucidates their mechanisms. In this new light, intuition and "recognition by the body" should not be seen as the personal fantasy of an original thinker but as fundamental cognitive tools.

Agnosia↗
PubMed2000

Radiotherapy prostheses.

The orofacial region performs the essential functions of mastication and speech, as well as that of appearance, which for better or worse evokes an instant and instinctive response in other people. In this region, tissue loss caused by surgical resection of a malignant tumor has a tremendous negative impact on the patient's quality of life, with deep mental and psychological repercussions. Therefore, from the standpoint of preserving form and function, radiotherapy has a major role to play in the treatment of malignant tumors in the orofacial region. That said, important organs, such as sensory organs, are present in close proximity to each other in this small region. During the irradiation process, therefore, it is important to ensure that the lesion is sufficiently irradiated while simultaneously protecting the surrounding normal tissue. In certain cases of radiotherapy of malignant tumors of the orofacial region, the use of radiotherapy prostheses can help to satisfy a basic principle of radiotherapy: that of delivering a lethal dose to the tumor while minimizing irradiation to normal tissue. In recent years, medical and dental experts have taken a team approach to creating and employing a variety of radiotherapy prostheses, working towards improving the treatment record for malignant tumors as well as reducing complications in surrounding normal tissue. As a result, patients treated with radiotherapy prostheses are now able to receive post-radiotherapy prosthodontic treatment in a dramatically safer and more rapid manner. It is clear that radiotherapy prostheses contribute significantly to the improvement of these patients' quality of life.

Brachytherapy↗
PubMed1975

[Development of neuroses].

In internal medicine neuroses are emphasized by physical symptomatology. In the contest with the environment the psychic reaction is a regulator for the motor and vegetative conditions of action. However, the vegetative emotional reactions take place autonomously according to the laws of the instinct behaviour, whereas the motor emotional reaction is oppressed and a voluntary motor action regulated by thinking is substituted. The coordination disturbance can reach the value of a disease. Hereby in detail organic dispositions, environmental damages, wrong programmations of the behaviour in form of reflex and primarily psychic faulty developments play a role as well as secondary defective psychic developments by advantage through disease.

Adult↗
PubMed1999

[Possibility in unification of oriental and western medicine education by combination of educational curricula].

The authors attempted a possibility of unification in the educational curricula of both Oriental and Western medical schools for the unification of two medicines. Historically the two medicines were originated from the most primitive state like instinctive method and we can say two medicines were entirely the same. However, after abrupt and current development of science in the 19th century by discovery of microscope and bacteria as well as cells, changed medicine into recent unbelievable current medicine from old ancient style medicine like Chinese Medicine which was just the remnant old medicine. The unification of educational curricula is thought to be possible to combine each other by technical adjustment from mutual understanding and cooperation for the most high quality of peoples lives. There were good equality to partial correspondences between two educational curricula around 90% at two pre-and schools from the study to analyse. The combined medicine is thought to be more efficient to the diagnosis and treatment of patients because of the effectiveness of Oriental medicine in certain disease conditions like chronic illness by acupuncture as a alternative medicine or herbs.

Curriculum↗
PubMed2002

Crucibles of leadership.

What makes a great leader? Why do some people appear to know instinctively how to inspire employees--bringing out their confidence, loyalty, and dedication--while others flounder again and again? No simple formula can explain how great leaders come to be, but Bennis and Thomas believe it has something to do with the ways people handle adversity. The authors' recent research suggests that one of the most reliable indicators and predictors of true leadership is the ability to learn from even the most negative experiences. An extraordinary leader is a kind of phoenix rising from the ashes of adversity stronger and more committed than ever. In interviewing more than 40 leaders in business and the public sector over the past three years, the authors discovered that all of them--young and old alike--had endured intense, often traumatic, experiences that transformed them and became the source of their distinctive leadership abilities. Bennis and Thomas call these shaping experiences "crucibles," after the vessels medieval alchemists used in their attempts to turn base metals into gold. For the interviewees, their crucibles were the points at which they were forced to question who they were and what was important to them. These experiences made them stronger and more confident and changed their sense of purpose in some fundamental way. Through a variety of examples, the authors explore the idea of the crucible in detail. They also reveal that great leaders possess four essential skills, the most critical of which is "adaptive capacity"--an almost magical ability to transcend adversity and emerge stronger than before.

Cultural Diversity↗
PubMed2002

Toward an evolutionary psychology of religiosity.

How can the evolution of religiosity be explained? To answer this question, we attempt to develop an understanding of the psychological domains underlying religious behaviour. We see four evolved domains, the sum and interaction of which constitute religiosity, namely: mysticism, ethics, myths and rituals. Even if the individual content, accents and implementations differ in each specific religion, they nevertheless derive from evolved Darwinian algorithms that are species-specific adaptations of homo sapiens. Mysticism. Intuitive ontologies are the basis for mystical experiences. Usually they serve to classify reality into animate and inanimate objects, animals or plants, for example. For a variety of psychological reasons, supernatural experiences result from a mixture of different ontological categories. Ethics. The basis for ethics lies in the social competency of human beings. Ethics is founded on the concept of social exchange ("social-contract algorithm") with its ideas about reciprocity, fairness, justice, cheater detection, in-group/out-group differentiation, etc. Myths. The basis for myths is the "language instinct". We interpret myths as the verbal expression of the cognitive content of those individual modules that constitute the belief system. Above all, myths document the experience and processing of contingency and thus help social bonding. Rituals. Rituals are based on the handicap principle. By making certain symbols and acts more expensive, they signal commitment for a reliable in-group morale. In conclusion, we argue that human religiosity emerges from a cognitive interaction between these four domains. Religiosity processes contingencies and enhances co-operation through social bonding, norm setting and cheater detection. It fulfils those functions for which the mental modules of its four domains have evolved so that we feel it appears to be justified to attribute to religiosity the evolutionary status of an adaptation.

Algorithms↗
PubMed2000

Advances in capillary chromatography.

Capillary columns are used in both capillary liquid chromatography and capillary electrochromatography. The design for capillary liquid chromatography is discussed in comparison with capillary gas chromatography. The difference of diffusion coefficient in gas and liquid phase is a key role. The study for obtaining a high performance capillary liquid chromatography is discussed. Capillary electrochromatography is recently interesting for its instinct ability to realize a high performance chromatography. Capillary electrochromatography with and without pressurized flow is reviewed briefly. Instrumentation for capillary electrochromatography with pressurized flow is discussed. The port of splitting, and gradient elution of both solution and potential are described. The new findings of both the variation of column resistance and capacity factor according to the value of applied electric voltage are also discussed.

Chromatography, Liquid↗
PubMed1992

[Function, molecular structure and gene expression of stem cell factor (SCF)].

Mice of genotype W/Wv and Sl/Sld have been considered as a model of instinct hemopoietic disorders. W/Wv mice have a defect in hemopoietic stem cells and Sl/Sld mice have a defect in the microenvironment. The W locus in murine chromosome 5 encodes the c-kit proto-oncogene and the Sl locus in chromosome 10 encodes the ligand for c-kit, which has been named stem cell factor (SCF), mast cell growth factor (MGF), kit ligand (KL) and steel factor (SL). The cDNA sequence of SCF suggest that it is synthesized as an integral transmembrane protein and that it has common tertiary structure with M-CSF. SCF enhances the proliferation of hemopoietic stem cells and progenitor cells as well as mast cell in combination with other growth factors. Furthermore, it plays an important role in the proliferation and migration of embryonic stem cell, primordial germ cell and melanocyte.

Amino Acid Sequence↗