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Enhancing nursing research with children and families using a developmental science perspective.

Nursing scholarship on children and their families has increased rapidly over the past decades. This research focuses on infants, children, and adolescents and their families facing acute or chronic illness, as well as on promoting health and preventing disease in children. While the amount and scope of research in pediatric nursing has increased, the methods and theories used are diverse and are often not based on the most recent science in the broader fields of developmental research. Developmental science, which evolved over the past two decades into a new interdisciplinary framework for the study of human development, involves an integrated holistic, developmental, and systems-oriented perspective. According to this view, the individual functions and develops through dynamic and complex processes involving the integration of many systems within the individual, including mental, biological, and behavioral systems. In addition, individuals function and develop in a continuously ongoing, reciprocal process of interaction with their environment and, as such, have an influence on that environment. These nonlinear, dynamic processes demand complex conceptualizations and research designs if one is to truly understand human development, including health and illness. Key aspects of developmental science important in conceptualization, design, measurement, and data analysis are identified. By providing a framework for critiquing research and presenting recommendations for future research based on developmental science, we hope to move nursing research with children forward toward more developmentally sound knowledge of nursing practice.

Acute Disease↗

Characteristics of faculty for a successful basic sciences program.

The author defines characteristics of an ideal faculty for a successful basic science program including strong grounding in the specific discipline, ability to teach with clinical relevance, dedication to teaching above all other considerations, and motivation to integrate optometric science. He illustrates an approach to this ideal as developed at the Southeastern University of the Health Sciences by integrating the basic science faculty for three separate health profession schools. Further, the author describes the profitable examples which have come about through this program.

Faculty↗

[Medicine: art or science?].

The question of how science, medicine and medical practice are related also compromises the crucial issue of the character of medicine. At the beginning of the 19th century, medicine tried to overcome the ancient contradiction within the unity of scientific thought and the deduction of guidelines and techniques for medical practice. This aim was partly achieved in medico-theoretical reasoning and practical procedures as well as for nosology, casuistic thinking and diagnostics. But medicine is a discipline directed towards healing. So the intentions of medicine and the reality of clinical healing possibilities, however, showed an increasing divergence since the middle of the 19th century. This divergence triggered considerable reactions not only from "Schulmedizin" and from other disciplines but also from practicing doctors and mainly from (disappointed) patients. Together with the continuous changes in empirical clinical research these internal and especially external reactions to medicine showed fundamental differences between medicine and the sciences. During the decades of this development it has become obvious that medicine will never become a pure science, not even an applied science. As medicine is concerned with patients who need to be considered as individual subjects, medical knowledge and medical practice consequently form a dialectic unity which is directed by the patient as a subject.

Art↗

Tracing our roots: the rocky road toward recognition of clinical laboratory science's professional status (1962-1977).

OBJECTIVE: To discuss the progress clinical laboratory science made between 1962 and 1977 toward developing and acquiring characteristics associated with the traditional professions of medicine and law. DESIGN: A survey of literature on the history of clinical laboratory science was conducted. References consulted included various books and professional journals. CONCLUSION: Between 1962 and 1977, the field of clinical laboratory science experienced many changes. Medical technologists in supervisory positions became more involved in higher management functions, such as organizing and directing laboratory operations. Clinical laboratory science educators developed graduate programs that would prepare faculty for positions in two- and four-year colleges and in hospital-based programs.

Clinical Laboratory Techniques↗

Implications of the Precautionary Principle: is it a threat to science?

Scientific research is of proven value to protecting public health and the environment from current and future problems. We explore the extent to which the Precautionary Principle is a threat to this role for science and technology. Not surprisingly for a relatively simple yet still incompletely defined concept, supporters of the Precautionary Principle come from different viewpoints, including a viewpoint that is at least uneasy with the role of science, and particularly its use in risk assessment. There are also aspects of the Precautionary Principle that inherently restrict obtaining and using science. The Hazardous Air Pollutant (HAP) provisions in the US Clean Air Act Amendments are an example of the Precautionary Principle, which both shifted the burden of proof so that the onus is now on showing a listed compound is harmless, and required maximum available control technology (MACT) instead of a primarily risk-based approach to pollution control. Since its passage in 1990 there has been a decrease in research funding for studies of HAPs. Other potential problems include that once MACT regulations are established, it may be difficult to develop new technological approaches that will further improve air pollution control; that by treating all regulated HAPs similarly, no distinction is made between those that provide a higher or lower risk; and that there is a perverse incentive to use less well studied agents that are not on the existing list. As acting on the Precautionary Principle inherently imposes significant costs for what is a potentially erroneous action, additional scientific study should be required to determine if the precautionary action was successful. If we are to maximize the value of the Precautionary Principle to public health and the environment, it is crucial that its impact not adversely affect the potent preventive role of science and technology.

Air Pollution↗

[The values and institutional practice of science: Robert Merton's and Thomas Kuhn's conceptions].

While Robert Merton approached the issue form the perspective of "scientific ethos" and Thomas Kuhn, from the perspective of "paradigm/normal science," this comparative analysis of these two author's conceptions of the social nature of science suggests that their views merged particularly when they argued that taking values into account was essential to understanding scientific activities. Placing prime importance on the notion of scientific community, these authors both analyze science as a practice which is defined and developed out of a set of beliefs, principles, and norms shared by a given collectivity. While there were some substantive differences between Merton's and Kuhn's outlooks - each had his own unique way of defining 'social' in the context of science - a comparison of their work underlines the importance of seeing institutionalized beliefs and values as essential in guiding the concrete actions of scientists.

History of Medicine↗

Laws, causation, and explanation in the special sciences.

There is the general philosophical question concerning the relationship between physics, which is often taken to be our fundamental and all-encompassing science, on one hand and the special sciences, such as biology and psychology, each of which deals with phenomena in some specially restricted domain, on the other. This paper deals with a narrower question: Are there laws in the special sciences, laws like those we find, or expect to find, in basic physics? Three arguments that are intended to show that there are no such laws are presented and examined. The paper ends with brief remarks concerning the implications of these arguments for explanation and causation in the special sciences.

Biological Science Disciplines↗

The middle schooling process: influences on science and mathematics achievement from the longitudinal study of American youth.

The purpose of this longitudinal study was to develop and test a model of middle school science and mathematics achievement with a national probability sample of 3,116 seventh-grade public school students. Eighth-grade achievement was viewed as a function of readiness attributes on entry into seventh grade and intervening parent, peer, self, and classroom affective and behavioral measures. Data were collected from students and parents over three time periods in seventh and eighth grade. Results of a revised structural model showed that prior achievement in science and math was a strong mediator of effects in the process of schooling. Grades in sixth grade, parental expectations, parent educational attainment, and motivation had moderately strong indirect effects on eighth-grade achievements. Also notable was the positive direct influence of perceptions of classroom context on science and math achievement growth and the negative direct influence of sex (in favor of girls) on science achievement growth. Cross-validation on a split-half sample did not disconfirm the model. It was concluded that while prior achievement had a dominant influence in the schooling process, other variables including parental expectations, motivation, and classroom context do contribute to the schooling process and can be a focal point for improving school success. These and other factors, though helpful, may be most effective well before the middle school years.

Achievement↗

[Integrated teaching of morphological sciences in medical training].

To provide more information to participants in the Second Meeting of the Textbook Committee of PAHO/WHO for the teaching of the Morphological Sciences in the Medical Schools of Latin American, a survey was held of the departments of those sciences, in 150 Latin American schools to acquire updated information on the academic organization, the work schedule of the teachers, the levels of integration of the instruction, use of textbooks by students, and the degree of familiarity with the PAHO/WHO Testbook Program and its coverage. The results of the survey, presented in detail in this document, demonstrate the persistence of most of the problems discussed in the First Meeting of the Committee (1969), which makes it necessary to reconsider the integrated teaching of the morphological sciences and the strategies for attaining it. The document also analyzes the development of the morphological sciences and of integration in them.

Education, Medical↗

[Natural science and historicity in modern times].

The history of science in modern times is the history of the loss of and gain in historicity. In contrast to the increasing historicizing of nature (as the objective dimension), the knowledge of nature (as the subjective dimension) after a time of parallelism between historical studies and scientific research (Enlightenment) and a time of integration (Idealism/Romanticism) was fundamentally dehistoricized during the positivistic 19th century. The history of science and science itself have since that time fallen apart--consciousness of science is restricted to consciousness of the presence.

Germany↗

The contribution of social science research to population policy and family planning program effectiveness.

Social science research has made important contributions to population policy and to the effectiveness of family planning programs. Social science concepts, theories, and methods potentially are relevant to all aspects of reproductive behavior, including actual fertility, proximate variables, and desired family size. Social science research also contributes to the understanding of the social, economic, and political institutions that potentially affect, either directly or indirectly, the whole biosocial reproductive system and family planning programs. At least as important as its specific theories and findings is the role of social science in testing how to adapt such knowledge to distinctive national and local cultural circumstances of family planning programs. A central point is that carefully monitored pilot projects are desirable before launching full-scale national programs, as well as being continuing resources for program development. The research on early programs in Asia has been important, because those programs encountered and overcame some of the presumed obstacles to new programs.

Asia↗

Pediatric behavioral science in family practice.

Behavioral science is a well-accepted component of family practice, but official guidelines and proposed curricula have a predominantly adult focus. This paper describes a pediatric behavioral science curriculum for family practice residents that has been successfully integrated into the three-year family practice residency curriculum at the University of Colorado. Details of development and implementation are presented: the requisite knowledge base, skills, and attitudes; the core pediatric behavioral science topics and diagnoses; the family physician's role in handling each core diagnosis; guidelines for making management decisions; suggested approaches to teaching the curriculum; and a reference list for behavioral science faculty.

Attitude of Health Personnel↗

[Regulatory science forum--its background and goal].

Regulatory science is, broadly speaking, the effort to insure that the products of our advanced technological civilization are developed in harmony with human needs. More specifically, regulatory science can be described as the science of evaluating the safety, efficacy and quality of these products. An unbiased assessment of these aspects is necessary for proper regulation of food, drugs, the environment, agricultural chemicals as well as the countless new materials available to the public every year. Evaluation does not interfere with product development; indeed, it often hastens the appearance of beneficial products in the public sector. Evaluation criteria should be established through consensus between industry, academia, and government and only after a thorough scientific discussion grounded in the basic principle of protecting the welfare of society's citizens. Even more important than broad-ranging knowledge is the need to develop new evaluation strategies and methodologies. Numerous problems confronting the world today can surely benefit from the evaluative techniques of regulatory science. Since research in the academic sphere often fails to address many of these issues, I want to reiterate the need for our National Institute to play a more prominent role in coordinating regulatory policy and pursuing these issues based on my firm belief that such activity is indispensable for human survival.

Consumer Product Safety↗

Teaching of basic sciences in postgraduate surgery.

In this paper, important deficiencies in the teaching of basic sciences to residents undergoing training in the surgical specialties are underlined. Since the Royal College of Physicians and Surgeons of Canada has stipulated that residents must be successful at an examination in basic sciences before being admitted to the final examination in certain surgical specialties, it is important that program directors plan the organization of an adequate program in this area. To achieve this goal, it is suggested that closer cooperation is needed between the basic sciences and clinical departments of our medical schools so that specific objectives may be defined and teaching of basic sciences become more consistent with the prerequisites put forward by the Royal College.

Canada↗

Developing behavioral science for a family practice residency.

The development of behavioral science in a family practice residency has first to be structured around a statement of purpose and adequate goals. These goals can only be implemented when the purely custodial function of the medical profession is rejected and the ethical responsiblity of the physician to society is allowed to direct the role innovations that must be incorporated. It is the person of the physician as a diagnostic and therapeutic tool that must be cultivated. The curriculum presented has included behavioral science conferences, a one-month behavioral science rotation, a two-month orientation program, behavioral science clinical attendings, and a personal counseling program for each resident throughout the three years of training. To be complete, such a program requires the further refinement of behavioral objectives that allow reliable evaluation and redefinition by residents and faculty.

Behavioral Sciences↗

NIEHS/AACR Task Force on the Advancement of Minorities in Science: Vision for a Model Program.

The National Institute of Environmental Health Sciences/National Institutes of Health and the American Association for Cancer Research initiated the "NIEHS/AACR Task Force on the Advancement of Minorities in Science" to address the issues of recruitment, participation, retention, and advancement of historically underrepresented minorities in the biomedical sciences. The goal of the Task Force was to establish a model program, national in scope and significance, to increase the number of historically underrepresented minorities who earn a doctorate and excel professionally in the biomedical sciences. To this end, the model program will: seek to promote systemic change in educational institutions from precollege through graduate school; introduce effective models of diversity training for faculty and students from precollege through university; promote collaborative learning, leadership skills, and team building in science; focus on the professional development of teachers; depend on the commitment and collaboration of financial and philosophical partners for its implementation. This document represents the vision for the model program, developed by an eight-member subcommittee charged with representing and documenting the concerns and opinions of the Task Force as a whole.

Education↗

Preparing tomorrow's health sciences librarians: feasibility and marketing studies.

The University of North Carolina at Chapel Hill is devising and evaluating five curricular models designed to improve education for health sciences librarianship. These models fit into a continual learning process from the initial professional preparation to lifelong learning opportunities. Three of them enhance existing degree and certificate programs in the School of Information and Library Science (SILS) with a health sciences specialization, and two are new programs for working information professionals. The approaches involve partnerships among SILS, the Health Sciences Library, and the program in Medical Informatics. The planning process will study the feasibility of the proposed programs, test the marketability of the models to potential students and employers, and make recommendations about implementation.

Certification↗

[The limits of it all. Critique of holistic concepts in nursing science].

Limits of the Whole. A critique of holistic concepts in nursing science. Nursing theories, almost without exception, are geared towards the so-called holistic paradigm in order to differentiate themselves from the deficits of a modern, functionally orientated medicine. This paper evaluates the holistic paradigm as a sound basis for nursing science. A comparison with developments in other scientific disciplines which have already moved away from holistic approaches shows that nursing science departs from these tendencies in allied disciplines. An empirical investigation of nurses' subjective theories about their patients shows that the holistic approach is also unsatisfactory for practical purposes. It is recommended to give up the holistic paradigm in nursing science.

Attitude of Health Personnel↗