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Do elderly patients mind how doctors address them?

A survey was carried out in the Geriatric Unit at Cork Regional Hospital to determine how elderly patients would like to be addressed by their doctor. Two hundred patients over the age of 65 were given a Questionnaire asking them to state their preference. Only a minority (4.5%) expressed a definite preference for the formal mode of address. The remainder either did not mind (38%) or preferred to be addressed by their first name (57.5%). We concluded that most elderly patients do have a preference and this should be established on admission.

Aged↗

Physicians should keep an open mind on complementary health care, Congress says.

Three hundred physicians from Canada and abroad attended the 3rd World Congress of Medical Acupuncture and Natural Medicine held in Edmonton last summer. Speakers emphasized that physicians should view complementary health care services with an open mind and consider therapeutic options that may be used in addition to conventional medical therapy.

Canada↗

A critique of social bonding and control theory of delinquency using the principles of Psychology of Mind.

The present paper first describes the refined principles of Psychology of Mind (POM) and shows how their logical interaction can help explain the comparative amounts of both deviant and conforming behavior engaged in by youthful offenders. The logic of these principles is then used to examine the major assumptions of social bonding and control theory of delinquency focusing predominantly on the formulations of Walter Reckless (1956) and Travis Hirschi (1969).

Adolescent↗

Mind-body medicine and holistic approaches. The scientific evidence.

During the past 15 years there has been a birth of a new science--the science of mind-body and holistic medicine, which is reminding us of the ancient principles upon which good health and medical care have been based. As expensive technological medicine continues to grow and stretch the health budgets of modern society, this new area is providing an important counterbalance and reminder of the value of a caring therapeutic relationship and simple lifestyle and support measures. This article will broadly review the four main areas in which excessive stress can affect health and give an overview of some of the key research that provides evidence for the value of useful adjunctive and in some situations alternative, cost effective treatments to current medical practices.

Holistic Health↗

Body or mind: children's categorizing of pretense.

Researchers studying early social cognition have been particularly interested in pretend play and have obtained evidence indicating that young children do not understand that pretending involves mental representation. The present research investigates whether children think of pretending as a mental state at all, by looking at whether they cluster it with other mental states or with physical processes when making certain judgments. The results from 5 experiments suggest that most children under 6 years of age see pretending as primarily physical. Further, when asked about pretending as a 2-part process entailing planning and execution, even 8-year-olds claim that execution of pretense does not involve the mind, although the planning aspect of pretense does.

Age Factors↗

The analogical mind.

The use of analogy in human thinking is examined from the perspective of a multiconstraint theory, which postulates 3 basic types of constraints: similarity, structure, and purpose. The operation of these constraints is apparent in laboratory experiments on analogy and in naturalistic settings, including politics, psychotherapy, and scientific research. The multiconstraint theory has been implemented in detailed computational simulations of the analogical human mind.

Association Learning↗

A mind of one's own.

The author argues that in the transference the patient unconsciously identifies the analyst with what he has projected into him, creating what Strachey called an external phantasy object. In the intimate rapport of the analytic session, the analyst tends to identify with these projections as well, which brings him into a relationship with the patient that complements the patient's narcissistic object relationship with him. The analyst's identification with the patient's projections is a type of pathology of his receptivity to the patient that is exacerbated by the patient's skill at producing states of mind in the analyst with which the analyst is supposed to identify. The analyst's ability to distance himself from the patient's projections and therefore to interpret them depends on his having links to his internal objects that survive the patient's projections and unconscious manipulations. Interpretations make the patient aware simultaneously that he and the analyst are separate and that the analyst has a link to internal objects that are not under the patient's control. The latter is a rudimentary oedipal situation. The author argues that these two 'awarenesses' are really the same, and that working through the depressive position and working through the oedipal situation are therefore fundamentally the same thing.

Adult↗

Beyond the he and the she: toward the reconciliation of masculinity and femininity in the postoedipal female mind.

This paper concerns a postoedipal psyche organization in the female mind whereby early overinclusive body-ego representations and cross-sex identifications are recuperated symbolically in the context of a differentiated female identity. This reintegration allows the female to symbolize what has been "lost" upon awareness of sex differences, play out masculine aspects without there being a threat to her core, primary feminine identity, and by linking rather than prohibiting cross-gender representations, provide imaginative elaboration and empathic access to another as a subject. This state does not reflect a denial of difference; rather, it reflects a psychic organization that uses symbolization to play with differences. Bisexual conflict can be mastered rather than repressed. Such mastery transcends normative, rigid, polarized sexual positions and gender conformity, perversions, and disturbed gender identity. Within the classical discourse, this mastery is suggested as an expansion of our limited and archaic notions of a genital stage specifically for the female. A new elaboration of a specific female genital stage can deepen our understanding of adult femininity and the development of cross-gender transference.

Adolescent↗

Mental time travel and the evolution of the human mind.

This article contains the argument that the human ability to travel mentally in time constitutes a discontinuity between ourselves and other animals. Mental time travel comprises the mental reconstruction of personal events from the past (episodic memory) and the mental construction of possible events in the future. It is not an isolated module, but depends on the sophistication of other cognitive capacities, including self-awareness, meta-representation, mental attribution, understanding the perception-knowledge relationship, and the ability to dissociate imagined mental states from one's present mental state. These capacities are also important aspects of so-called theory of mind, and they appear to mature in children at around age 4. Furthermore, mental time travel is generative, involving the combination and recombination of familiar elements, and in this respect may have been a precursor to language. Current evidence, although indirect or based on anecdote rather than on systematic study, suggests that nonhuman animals, including the great apes, are confined to a "present" that is limited by their current drive states. In contrast, mental time travel by humans is relatively unconstrained and allows a more rapid and flexible adaptation to complex, changing environments than is afforded by instincts or conventional learning. Past and future events loom large in much of human thinking, giving rise to cultural, religious, and scientific concepts about origins, destiny, and time itself.

Animals↗

The interconnectivity of mind, brain, and behavior in altered states of consciousness: focus on shamanism.

This paper examines possible interconnections between mind, brain, and behavior in the area of shamanism and altered states of consciousness. It offers a neurophysiological theory of shamanic altered states of consciousness that integrates theories by Mandell, Persinger, Prince, Winkelman, and Wright. Topics include the shamanic call and temporal lobe phenomena, possible neurological correlates of shamanic ecstasy, and the neurophysiological roles of endorphins, plant substances, and genetic factors in shamanic altered states of consciousness. The difficulty of developing such a theory because of the complexity of human physiology and psychological experience and because of the paucity of neurophysiological data from the field is acknowledged.

Behavior↗

Book reviewing: keeping the audience in mind.

Writing book reviews is an excellent way to start your publication experience and develop a relationship with a journal editor. Most nursing journals include book reviews, and some even select editorial board members from book reviewers who have demonstrated their ability to write concise, honest reviews and submit them on time. This author includes tips on writing a high-quality review by keeping the audience in mind.

Authorship↗

The unbearable agony of being: interpreting tormented states of mind in the psychoanalysis of sexually traumatized patients.

This article focuses on the clinical importance of the disturbing transference-countertransference matrix in the psychoanalysis of patients whose ego development was decisively influenced by early, traumatic sexual abuse. Dissociative defensive operations and "automatic" identifications are emphasized in accounting for the sadomasochistic and other characteristic features of the "traumatic" transference-countertransference ambiance. Two clinical vignettes depict the analyst's need to take his or her own disturbing experience as an object of analytic examination, while illustrating how "here-and-now" transference cues are used to interpret the patient's efforts to cope with overwhelming, traumatized states of mind.

Adult↗

In search of the mind of the analyst: a progress report.

Certain difficulties arise in the positions of both those who embrace the intersubjective approach in psychoanalysis and those who oppose it. Various factors that have led to misunderstandings on both sides of the question are identified, and several recent studies highlighting the importance of unconscious communication both in development and in clinical work are cited to buttress the argument that efforts to understand the mind of the analyst as it registers and resonates with this kind of communication open a still insufficiently explored pathway to the unconscious of the patient, one that may lead to major advances in analytic technique.

Communication↗

Minding the body.

As we continue to elucidate relationships between neural structures and cognitive functioning in this Decade of the Brain, it is important not to lose sight of the larger context. The brain is but one component of the complex system that is the body. We take in information and interact with the world through our bodies, and our bodies change with--and in some cases change--cognitive and emotional processing. In this introductory paper, we present an overview of a broad range of psychophysiological techniques: electroencephalography, event-related potentials, magnetoencephalography, positron emission tomography, optical imaging, functional magnetic resonance imaging, electromyograms, eye tracking, pupillometry, cardiovascular measures, and electrodermal activity. These techniques not only differ in their temporal and spatial resolutions but also in the physiological and psychological processes to which they are sensitive. With respect to the system as a whole, these techniques are thus complementary. Combining measures--old and new, central and peripheral--ultimately provides the most inferential power for attacking the questions we hope to answer with all psychophysiological measures in our quest to understand the nature of the relationship between the mind and the body.

Animals↗

The primordial mind and the work of the negative.

This paper was given at the celebration of Bion's centennial in 1997. At the request of the organisers of this conference, the work of Bion has been brought into perspective with the author's. The author has chosen to illumine Bion's concept of the primordial mind and considers the transformation of the beta-elements into the alpha ones. He also refers to Bion's distinction of thoughts without thinker and thinking as needing thoughts to be thought by a thinker (thinking apparatus). The main point of the paper is Bion's opposition of 'nothing' and 'no thing'. The author refers to Freud's paper on 'Negation'. He recalls his own model of the double limit. He tries to show how Freud's conception of representation has a much wider field than is usually stated. He emphasises differences between Freud's and Bion's 'basic assumptions'. After having tried to clarify Bion's ideas on 'O', 'K and -K', he recalls Bion's reference to Keats's negative capability. The author then gives a short account of his own concept of the 'work of the negative', finding correspondences with Bion's own concepts. As a conclusion two Indian myths are recalled for their great symbolic value.

Defense Mechanisms↗

[Mind Zone--prevention in the techno-scene].

Many youngsters have been gathering experiences with "party drugs" and more than half a million of them are consuming Ecstasy in Germany. Synthetic drugs are an important connecting link especially in techno culture. What's going on and what is now "in" in techno? Which drugs are update? I will deal with these questions below and will then present the campaign "MIND ZONE" that has been exploring new preventive avenues on the techno scene for the last two years.

Adolescent↗

Persistent tachypnea in children: keep pulmonary embolism in mind.

PURPOSE: Tachypnea in children is associated with respiratory disorders and nonrespiratory disorders such as cardiac disease, metabolic acidosis, fever, pain, and anxiety. Pulmonary embolism is seldom considered by pediatricians as a cause of tachypnea. PATIENTS AND METHODS: Three children of various ages with persistent tachypnea are described: a girl after orthopedic surgery for kyphoscoliosis, a boy with nephrotic syndrome, and a neonate with Hirschsprung disease. Other causes of tachypnea were diagnosed and treated before pulmonary embolism was considered. RESULTS: Ventilation-perfusion scanning appeared to be highly probable for pulmonary embolism in these patients. Anticoagulant therapy was started. CONCLUSION: Pulmonary embolism should be kept in mind in children with tachypnea, especially when other risk factors for venous thromboembolism are present, to avoid delay in anticoagulant treatment and a fatal outcome.

Anticoagulants↗

Innovations in integrative healthcare education: mind-body medicine training.

Content on integrative healthcare and complementary and alternative medicine is now being taught in hundreds of educational programs across the country. Nursing, medical, osteopathic, chiropractic, acupuncture, naturopathic, and other programs are finding creative and innovative ways to include these approaches in new models of education and practice. This column spotlights such innovations in integrative healthcare and CAM education and presents readers with specific educational interventions that they can adapt into new or ongoing educational efforts at their institution or program. We invite readers to submit brief descriptions of efforts in their institu-tions that reflect the creativity, diversity, and interdisciplinary nature of the field. Please submit to Dr. Sierpina at or Dr. Kreitzer at . Submissions should be brief, no more than 300-400 words. Please include any Web site or other resource that is relevant as well as contact information.

Clinical Competence↗