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PubMed1980

On "I": the conceptual foundations of responsibility.

In clinical practice, great emphasis is placed on the patient's being responsible, yet the conceptual bases of this therapeutic posture are obscure. The author examines the conceptual foundations of responsibility by focusing on the subjective "I". Although "I" is widely considered to be an empty term, signifying only an illusory "ghost in the machine," the author argues that our acquaintance with "I" is acceptable at face value. "I" is strictly identified with the tacit, rule-governed, grammatical actions of distinguishing (or meaning) that constitute the experienced personal world. The author discusses the clinically important distinction between "having" and "assuming" responsibility.

Ego↗
PubMed1981

Holistic-medical foundations of American psychiatry: a bicentennial.

American psychiatry has reached its bicentennial. Holistic-medical foundations have been its hallmark, inspiration, and source of preeminence. Incorporated by psychobiology, the American school, they enabled the growth of psychiatry as a medical specialty and scientific discipline and stimulated unparalleled growth of general hospital psychiatry, psychiatric research and teaching, and psychosomatic medicine and liaison psychiatry. Holistic conceptions, a product of a democratic system and the liberal mind, continue to provide the best framework for psychiatry and an antidote to dogma and fanaticism.

Education, Medical↗
PubMed1987

Psychological concepts useful in the building of political foundations between nations: Track II diplomacy.

There are two phases in the process of negotiating for peace with antagonistic national groups. The leader (or leaders) of one such group will not negotiate with his opposite number until political foundations to support such negotiation are laid down, and obstacles to peace identified and dealt with; at least some measure of success is anticipated by both sides. Accordingly, the first phase requires the building of bridges between those representing opposing nations. The activities in this preliminary phase are sometimes called Track II diplomacy; they differ from those of official or Track I diplomacy. I suggest two kinds of concepts that may be useful in Track II diplomacy, and present them in the hope of initiating further discussion, and exploration of metapsychological underpinnings of each concept. As Mitscherlich (1971) suggested, the psychology of international politics may be better understood if psychoanalysts are willing to engage in interdisciplinary work with others engaged in such endeavors.

Ceremonial Behavior↗
PubMed1989

Pitfalls of a one-sided image of science: Adolf Grünbaum's Foundations of Psychoanalysis.

Adolf Grünbaum's (1984) The Foundations of Psychoanalysis has received extensive attention in psychoanalytic and philosophical circles. Aspects of Grünbaum's argument are reviewed and criticized. While his volume is an important contribution to the epistemological assessment of psychoanalysis, it reflects serious shortcomings in at least four areas: its treatment of the role of suggestion in the analytic enterprise, its scrutiny of the psychoanalytic genetic method, its appreciation of analytic methodology as actually practiced, and, above all, its predication on a unidimensional, positivistic vision of science. Alternative approaches to the philosophy of psychoanalysis are suggested.

Adult↗
PubMed1995

The intellectual foundation of pastoral counseling: a perspective on the future of the profession.

Reflects on the intellectual nature of pastoral counseling, compares it with certain aspects of contemporary research in psychiatry and clinical psychology, and offers some observations regarding the uniqueness of pastoral counseling as a profession. Argues that pastoral counseling can offer a truly wholistic view of mental health if (1) its intellectual foundation is developed in theological perspective, (2) continues to integrate its theological dimension with clinical psychology and psychiatry, and (3) evaluates its applied research within the framework of the normative standards of mental health.

Chaplaincy Service, Hospital↗
PubMed2000

Quality improvement in health care. Conceptual and historical foundations.

During the past decade, quality improvement (QI) has become the primary approach for health care organizations to measure performance and implement change. From a historical perspective, QI has multiple origins: in systems engineering, as a way of defining production processes; in quantitative analysis, as a methodological approach for collecting and analyzing data; and in organizational behavior, as a way of understanding how QI fits with an organization's structure and management philosophy. Although QI and evaluation share similar goals, as modes of inquiry, they developed in very distinct and separate settings, to fulfill different needs. However, these differences are now beginning to merge as QI gains acceptance as a desirable and legitimate approach for health care organizations to enhance service delivery and outcomes. This article describes the conceptual foundations on which QI is based and identifies historical events that have influenced the development of QI and its adaptation by health care organizations.

History, 19th Century↗
PubMedDate not supplied

Chemical hormesis: its historical foundations as a biological hypothesis.

Despite the long history of hormesis-related experimental research, no systematic effort to describe its early history has been undertaken. The present paper attempts to reconstruct and assess the early history of such research and to evaluate how advances in related scientific fields affected the course of hormesis-related research. The purpose of this paper is not only to satisfy this gap in current knowledge but also to provide a foundation for the assessment of how the concept of hormetic dose-response relationships may have affected the nature of the bioassay, especially with respect to hazard assessment practices within a modern risk assessment framework.

Animals↗
PubMed1990

[The doctrine of free and informed consent: its ethical and legal foundations and its applications in research and practice of psychiatry].

This article briefly examines the ethical and legal foundations for the doctrine of informed consent in medical research and practice. The doctrine is based upon the importance of respecting the individual's autonomy and his right to self-determination. The article also reviews the development of the doctrine of informed consent based on its recent application. The authors cite the Nuremburg Code and the Helsinki Declarations and particularly the media denunication of several scandals in the United States during the late 1960s, when Henri Beecher's name figured prominently. The effects of informed consent in psychiatry are examined specifically, as well as the consequences for psychiatric research, on subjects who are able to give their consent, as well as those who are unable to do so. As for its effects on clinical practice, the paper discusses the right of the hospitalized patient to refuse treatment, and informed consent and the risks for patients treated with neuroleptics of developing tardive dyskinesia. The authors conclude that in psychotherapy the concept of informed consent cannot be taken for granted.

Antipsychotic Agents↗
PubMed2002

King's theory as foundation for an advance directive decision-making model.

This article discusses the utilization of King's conceptual system, transaction process model, and theory of goal attainment as foundations for an advance directive decision-making model. Research has shown nurses may be educationally unprepared, experience conflicts between beliefs and actions, or resist the responsibility to address advance directives and end-of-life issues. Nurses, especially nurse practitioners providing primary care, are in positions to facilitate the process. By understanding and incorporating this model into practice, both the nurse and the client may achieve mutual goal attainment resulting in both increased client autonomy and Patient Self-Determination Act compliance.

Advance Directive Adherence↗
PubMed1999

Adolescent self-esteem: a foundational disposition.

Based on results of a concept synthesis and concept derivation, an argument is made that self-esteem is a human foundational disposition within the self-care deficit theory of nursing and, as such, is a component of an individual's self-care agency. Guided by research literature, the basic conditioning factors of age, gender, developmental state, family systems, sociocultural orientation, health state, and environmental factors are discussed in regard to their influence on the adolescent's developing self-esteem and emerging self-care agency.

Adolescent↗
PubMed1995

Challenging a reductionistic paradigm as a foundation for nursing.

Historically, nursing practice has been grounded in the objective, analytic philosophy of the natural sciences. Over the past decades, caring--a humanistic concept--has been espoused as the essence of nursing. Paradoxically, practice based on the theme of caring remains aligned with the philosophy of the natural sciences and continues to use tools such as nursing process and nursing diagnosis, products of the natural sciences paradigm. The authors have outlined the foundation for a philosophy of caring. The encounter between caregiver and patient is the central aspect of this philosophy and is elaborated with the related concepts of openness, nonreductionism, immediacy, and meaning. In addition, holistic nursing practice requires attention by caregivers to their own self-awareness and the personal growth that is necessary for the demands of encountering patients. Practice based on such a philosophy maintains the primacy of the caregiver-patient relationship and permits the incorporation of analytic tools without depersonalizing effects.

Empathy↗
PubMed1995

Special report: adjusted lupus prevalence. Results of a marketing study by the Lupus Foundation of America.

There are many estimates of the prevalence of systemic lupus erythematosus. These range from a high of 1:245 to 1:1000 from numerous worldwide epidemiologic studies. In a departure from scientific procedure the Lupus Foundation of America recently completed an inexpensive marketing study which produced three findings. Firstly, that lupus awareness in the USA was about 86%, much higher than many other immunologic illnesses. Secondly, that many people have been told by their physicians that they have the lupus, and considering that data, that over 1.4 million people in the USA have the disease. Lastly, that the prevalence of the disease, by unsubstantiated claim, would be a very high 1 in 177 patients. The overall conclusion is that more people are being told that they have the disease lupus than previously expected. Self-reporting studies are notoriously inaccurate as the criteria for the disease are not verified, indicating that the numbers derived from this study may not be true.

Adolescent↗
PubMed2004

Premises, principles, and practices in qualitative research: revisiting the foundations.

In this keynote address, the author focuses on what we bring to qualitative inquiry and how we conduct our research. What we do, why we do it, and how we do it remain contested issues. She proposes that we look at our methodological premises anew, revisit our principles, and revise our practices. Throughout this address, she draws on Goffman's methodological insights to provide a foundation for reassessing qualitative inquiry. She argues that researchers can build on Goffman's ideas to strengthen their methodological practices and research products. Last, she counters current institutional scrutiny of qualitative inquiry and suggests unacknowledged benefits of this work.

Health Services Research↗
PubMed1999

Behavioral science foundations of the Rorschach test: research and clinical applications.

Never without its critics, the Rorschach Test continues to be widely used in clinical settings. The test continues to be criticized vigorously. Rorschach critics appear to fall into two broad groups: those leveling valid methodological concerns about the test s behavioral science foundations and method critics who appear to deny the validity of the test on strictly a priori or theoretical considerations. Many critics do not appear to be acquainted with the extensive Rorschach research literature. The current paper provides an overview of several domains of applied and laboratory Rorschach behavioral science, including statistical power analysis, interobserver agreement and interrater reliability, Rorschach assessment of thought disorder, and emerging research linking Rorschach variables with diagnostic criteria from the DSM-IV, as a means of educating both adherents and detractors alike concerning the test s scientific track record and applicability to clinical assessment.

Behavioral Sciences↗
PubMed2003

Defining biomedical informatics competency: the foundations of a profession.

Is biomedical informatics a science or a profession? This question has been asked of many members in the biomedical informatics community, yet we still lack a response that galvanizes our community. We debate the issues over lunch. We create long, multi-threaded e-mail discussions, we write papers on the topic, and still we aren't able to convince ourselves-let alone the rest of the scientific community. In this paper, I will describe a curriculum model for biomedical informatics and research that is developing at Columbia University, Department of Biomedical Informatics (DBMI). We believe that a strong educational foundation creates competent professionals who, in turn, comprise a bioinformatics culture. The outcome of DBMI's curriculum design and competency project will be a set of biomedical informatics competencies which we believe will define the core knowledge and skills of the field.

Computational Biology↗
PubMed2005

Research protocol: EB-GIS4HEALTH UK - foundation evidence base and ontology-based framework of modular, reusable models for UK/NHS health and healthcare GIS applications.

EB-GIS4HEALTH UK aims at building a UK-oriented foundation evidence base and modular conceptual models for GIS applications and programmes in health and healthcare to improve the currently poor GIS state of affairs within the NHS; help the NHS understand and harness the importance of spatial information in the health sector in order to better respond to national health plans, priorities, and requirements; and also foster the much-needed NHS-academia GIS collaboration. The project will focus on diabetes and dental care, which together account for about 11% of the annual NHS budget, and are thus important topics where GIS can help optimising resource utilisation and outcomes. Virtual e-focus groups will ensure all UK/NHS health GIS stakeholders are represented. The models will be built using Protege ontology editor http://protege.stanford.edu/ based on the best evidence pooled in the project's evidence base (from critical literature reviews and e-focus groups). We will disseminate our evidence base, GIS models, and documentation through the project's Web server. The models will be human-readable in different ways to inform NHS GIS implementers, and it will be possible to also use them to generate the necessary template databases (and even to develop "intelligent" health GIS solutions using software agents) for running the modelled applications. Our products and experience in this project will be transferable to address other national health topics based on the same principles. Our ultimate goal is to provide the NHS with practical, vendor-neutral, modular workflow models, and ready-to-use, evidence-based frameworks for developing successful GIS business plans and implementing GIS to address various health issues. NHS organisations adopting such frameworks will achieve a common understanding of spatial data and processes, which will enable them to efficiently and effectively share, compare, and integrate their data silos and results for more informed planning and better outcomes.

Journal Article↗
PubMed2000

Chemical hormesis: its historical foundations as a biological hypothesis.

Despite the long history of hormesis-related experimental research no systematic effort to describe its early history has been undertaken. The present paper attempts to reconstruct and assess the early history of such research and to evaluate how advances in related scientific fields affected the course of hormesis-related research. The purpose of this paper is not only to satisfy this gap in current knowledge, but also to provide a foundation for the assessment of how the concept of hormetic dose-response relationships may have affected the nature of the bioassay especially with respect to hazard assessment practices within a modern risk assessment framework.

Adaptation, Physiological↗
PubMed2000

Radiation hormesis: its historical foundations as a biological hypothesis.

This paper represents the first systematic effort to describe the historical foundations of radiation hormesis. Spanning the years from 1898 to the early 1940's the paper constructs and assesses the early history of such research and evaluates how advances in related scientific fields affected the course of hormetic related research. The present effort was designed to not only address this gap in current knowledge, but to offer a toxicological basis for how the concept of hormetic dose-response relationships may affect the nature of the bioassay and its role in the risk assessment process.

Animals↗