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PubMed1994

Fixation and regression in the psychoanalytic theory of homosexuality--a critical evaluation.

This essay evaluates the notions of fixation and regression in the psychoanalytic theoretical conceptualization of homosexuality. Charles Socarides has had a central role in formulating the most prominent and influential psychoanalytic metapsychological understanding of homosexuality in recent years and for that reason this essay focuses principally on him. The concepts of fixation and regression are central to his understanding and I argue that the evolution of these concepts in contemporary usage renders them irrelevant to formulating the current psychoanalytic understanding of homosexuality and that their continued use by analysts reflects a negative attitude toward homosexual behavior on the part of Socarides and many other analysts that stems from an extremely narrow and idealized conception of human development.

Adult↗
PubMed2003

Ethical considerations in bioengineering research.

Biomedical science and engineering have made rapid advancements in the field of medicine over the past few decades. New ethical problems arising from this technology are influencing biomedical research more and more. It is disturbing that bioengineering professionals have had relatively little contact with moral and legal theory in light of these developments and particularly since they represent the forefront of new medical innovations. The objective of this communication is to introduce the study of bioethics and the use of principlism when examining bioengineering problems and dilemmas. Specific examples derived from actual proceedings, such as the Baltimore case, will alert scientists to the importance of misconduct in academic society. Cases will be used to illustrate how tools learned in this presentation are applied to analyze bioethical issues. New technology has a large social impact and is setting the standard of care for treatment. The health care system continually relies on researchers to produce improvements in patient therapy. Society will increasingly expect scientists to be morally responsible for the research they perform and uphold those virtues that ensure good ethical conduct.

Biomedical Engineering↗
PubMed1985

Ethics and health care: the next 20 years.

Shifts in moral values in society as they pertain to the future of health care for the next 20 years are discussed. Even though people tend to think that moral dilemmas linger on forever, any number of moral issues that were once hotly debated are now resolved. The trends in health care since World War II--greater access to health care, continual development of new therapies, and elimination of disease and illness--have produced several moral dilemmas. Questions about what society can afford, rationing of health care, and the quality of life now abound; these will directly affect progress in health care in the next 20 years. Expensive technologies that benefit only a few will likely be scrapped in favor of emphasis on low-cost therapies with broader applications. Although complicated, a cost-benefit analysis and exercise should be undertaken to decide whether advances are worth the investments. There have been several shifts in moral values of society that will affect health care over the next couple of decades. Among these are the resurgence of emphasis on the common good (rather than the rights of individuals), movement away from emphasis on rules and principles and toward development of character and virtue, greater sobriety about the negative potential of new technologies, increased group medical practices, and changing ideas about the moral implications of chronic diseases and about the relative roles of the individual and society in improving health.(ABSTRACT TRUNCATED AT 250 WORDS)

Behavior↗
PubMedDate not supplied

Guilt in young children: development, determinants, and relations with a broader system of standards.

In this comprehensive study of the early development of guilt, 106 children were observed in laboratory paradigms in which they were led to believe that they had damaged valuable objects, during two separate sessions at each of the assessments at 22, 33, and 45 months. The behavioral and affective components of guilt cohered significantly across the sessions, converged with each other, were stable across all the assessments, and corresponded modestly with maternal reports. Most components decreased with age, except for bodily tension, which increased. At 33 and 45 months, girls displayed more guilt than did boys. Children who were more fearful in typical fear-inducing paradigms also displayed more guilt. Children of mothers who relied on more power-assertive discipline, observed and self-reported, displayed less guilt. Guilt related positively to the development of self at 18 months and to moral self at 56 months. Children who displayed more guilt were less likely to violate rules of conduct at 56 months. A mediational model was supported: Fearful temperament contributed to guilt proneness, which in turn served to inhibit children's tendency to violate rules.

Affect↗
PubMed2002

[Humanism and medicine].

WITH THE PROGRESS MADE IN KNOWLEDGE AND TECHNIQUES: Therapeutic efficacy has advanced. However, interrogations concerning the control of the power that is conferred and the new obligations towards patients that stem from this progress have emerged and, further to the sinister ethical deviations in medical research and testing, and the supreme temptation that is represented by the money involved, questioning has increased. THE NUREMBERG CODE: Promulgated in December 1947, is the founder text of modern biomedical ethics. Subsequently completed by numerous other international conventions, it established the principle of voluntary, informed consent, therefore confirming the autonomy of the patient and the respect that is due from the physicians. However, questions arise not only regarding the foetus and embryo, but also regarding those reaching the end of their lives. CONCERNING EMBRYOS: No contradiction is apparent between the singularity of the human embryo and the use of embryos destined to be destroyed in highly scientific and moral quality research projects. With regard to the development of methods for producing cloned human embryos, it appears to be associated with greater risks than establishing urgent and necessary steps towards fulfilling the promises of regenerating medicine. Last but not least, deviations in reproductive biology and clinical trials conducted in this field, with relentless procreation and "human studies", must be denounced. AT THE OTHER END OF LIFE: It is worrying to note the apparent facility with which our societies consider that old age is an indignity. To call knowledge a 'power' is to consider that such power can be used not only to relieve suffering but also to manipulate others. The humanistic finality of an intention is not sufficient to guarantee neither its benignity nor its morality.

Conflict of Interest↗
PubMed1998

Barrett's Esophagus.

Patients who develop Barrett's esophagus should be entered into an endoscopic surveillance program, including endoscopic biopsy. For patients who do not develop dysplasia, we recommend surveillance every 3 years. Patients with low-grade dysplasia should be surveyed with endoscopy and biopsy every 6 months over the next year, then at 1-year intervals if there has not been progression to a higher grade of dysplasia. The role of endoscopic ablation therapy has yet to be defined. Because of the high risk (30% to 40%) of developing esophageal cancer among patients with high-grade dysplasia, we recommend esophagectomy for those who are medically fit to undergo this surgery. However, it is important that an expert pathologist confirms the diagnosis and that the operation is performed by a surgeon experienced in esophageal resection. For those who are not candidates for surgery or refuse it, we recommend consideration of endoscopic ablative therapy. The other option available is to continue surveillance at 3- to 6-month intervals with reconsideration of surgical or experimental ablative therapy if cancer develops (see Figure 1).

Journal Article↗
PubMed1992

Desensitization of junctional and extrajunctional nicotinic ACh receptors expressed in Xenopus oocytes.

Desensitization of nicotinic acetylcholine receptors (AChRs) was studied using the Xenopus oocyte expression system. Mouse and cat extrajunctional AChRs expressed in oocytes desensitized more slowly than Torpedo AChRs. Substitution of the mouse gamma subunit into the Torpedo AChR reduced the rate of desensitization, making it similar to the mouse AChR. Likewise, substitution of the Torpedo gamma subunit into the mouse extrajunctional AChR increased the rate of desensitization, making it similar to the Torpedo AChR. Furthermore, mouse junctional AChRs in which the gamma subunit was replaced by the epsilon subunit desensitized more rapidly than either mouse or cat extrajunctional AChRs, and resembled Torpedo AChRs. Thus, in addition to other properties, junctional and extrajunctional AChRs differ with respect to desensitization, suggesting a possible role of desensitization in normal development of neuromuscular junction.

Animals↗
PubMed1998

(Pro)insulin and insulin-like growth factor I complementary expression and roles in early development.

Evidence that the insulin-like growth factors play a role in embryonic as well as postnatal growth and central nervous system development has accumulated recently from studies using knock-out mice models. However, no effects of IGF-I and II have been demonstrated prior to organogenesis in these studies. We summarize here results supporting the role of insulin (or its precursor proinsulin) in vertebrate development prior to the expression of IGFs. (Pro)insulin mRNA is expressed in the chick embryo during neurulation and early organogenesis and its inhibition by antisense oligodeoxynucleotides increase apoptosis. In another system, proliferative neuroretina, (pro)insulin expression predominates over IGF-I expression. Modulation of apoptosis by (pro)insulin in retina may be largely responsible for the observed stimulation of DNA synthesis and neuronal differentiation. These effects are elicited as well by IGF-I, expressed later in neuroretina. Thus, these polypeptides have complementary expression in early embryos which suggests coordinated actions during development.

Animals↗
PubMed2000

Basic fibroblast growth factor priming increases the responsiveness of immortalized hypothalamic luteinizing hormone releasing hormone neurones to neurotrophic factors.

The participation of growth factors (GFs) in the regulation of luteinizing hormone releasing hormone (LHRH) neuronal function has recently been proposed, but little is known about the role played by GFs during early LHRH neurone differentiation. In the present study, we have used combined biochemical and morphological approaches to study the ability of a number of GFs normally expressed during brain development, including basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), insulin and insulin-like growth factor I (IGF-I) to induce survival, differentiation, proliferation, and phenotypic expression of immortalized (GT1-1) LHRH neurones in vitro, at early (3-days in vitro, 3-DIV) and late (8-DIV) stages of neuronal differentiation. Comparison of GF-treated vs untreated neurones grown in serum-deprived (SD) medium demonstrated bFGF to be the most potent, and insulin the least active in promoting neuronal differentiation. Thus, at both 3-DIV and 8-DIV, but especially at 8-DIV, bFGF induced the greatest increase in the total length and number of LHRH processes/cell and in growth cone surface area. bFGF was also the most active at 3-DIV, and IGF-I at 8-DIV, in counteracting SD-induced cell death, whereas EGF was the most potent in increasing [3H]thymidine incorporation. All GFs studied decreased the spontaneous release of LHRH from GT1-1 cells when applied at 3-DIV or 8-DIV, except for insulin which was inactive at both time-points and bFGF which was inactive at 8-DIV. Pre-treatment of GT1-1 cells with a suboptimal ('priming') dose of bFGF for 12 h followed by application of the different GFs induced a sharp potentiation of the neurotrophic and proliferative effects of the latter and particularly of those of IGF-I. Moreover, bFGF priming counteracted EGF-induced decrease in LHRH release and significantly stimulated LHRH secretion following IGF-I or insulin application, suggesting that bFGF may sensitize LHRH neurones to differentiating effects of specific GFs during development.

Cell Division↗
PubMed1994

Latest figures on infection rates in Indonesia released.

At least 258 people in Indonesia have been found infected with HIV, the official Antara news agency said. It quoted Health Minister Sujudi as saying 40% of the virus carriers were foreigners. Indonesia, the world's fourth most populous country, has established HIV centers in all of the country's 27 provinces in efforts to check the disease's spread. A report earlier in 1994 by U.S. Representative Jim McDermott's Congressional Task Force on HIV and AIDS estimated that up to three million of Indonesia's 185 million people might be infected with HIV in six years. It put the total cost for treatment and lost earnings at more than 16 billion dollars by the end of the century. Sujudi said the best way to prevent the spread of HIV is through education in schools and a strengthening of religious and moral values.

Asia↗
PubMed1999

Private enterprise and public good: ethical issues in the funding of clinical research.

Health-care centres, universities, and the researchers and clinicians working in them are encouraged to procure research funding through the development of commercial relationships. There are positive, practical, and morally relevant arguments in support of this initiative, but the move also raises ethical issues concerning potential conflicts of interest. These include conflicts between an institution's or researcher's responsibilities to each other, to research subjects, and to the public, and competing financial interests. This article examines developments in research funding and ethical difficulties that may arise in the present administrative context. It provides suggestions for the development of guidelines by institutions that are supportive of investigators in their endeavors to enhance clinical care through crucial external funding and the implementation of research.

Biomedical Research↗
PubMed1996

Exploring approaches to the administration of a long-term care facility: The application of a community planning and development process.

This article outlines the approaches taken to the management of two long-term care facilities by the County of Huron in southwestern Ontario in 1994. Lay-offs, a move to new facilities, loss of local political confidence, changes in key administrative personnel and low staff morale prompted the county to ask an interim administrative team to develop and implement an appropriate response. The article explains how community development and planning principles and techniques were applied to the management of the homes to achieve an overall improvement in communication, staff morale and attitude. These approaches may prove helpful to other administrations facing major change.

Aged↗
PubMedDate not supplied

The morale-productivity relationship: how close?

Is there a direct relationship between morale and productivity? According to Robert H. Garin, professor of secondary and higher education at East Texas State University and John F. Cooper, dean of instruction at Patrick Henry Community College, the traditional view that the individual whose morale is high will be highly productive, or vice versa, is not a necessarily valid one. The authors analyzed the historical development of the major representative research studies and concepts concerning the morale-productivity relationship and found that the relationship evolved from one of simple direct correlation to the present viewpoint that a variety of factors--such as the environment, motivation, job levels, and so on--must be taken into consideration before any positive conclusion can be drawn. Because of the national concern over the decline in American productivity standards, Garin and Cooper believe that the morale-productivity relationship is an area ripe for further experimental research.

Efficiency↗