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Personal Experience (personal + experience)
Kinds of Personal Experience Selected AbstractsSurgical Management of Stable Vitiligo: A Review with Personal ExperienceDERMATOLOGIC SURGERY, Issue 3 2000Sharad Mutalik MB Background. Various modalities are available for surgical management of stable, localized patches of vitiligo, which are resistant to conventional medical treatment. Cutaneous surgeons often struggle to select among various methods of surgical treatment that include camouflage tattooing, melanocyte transplants, excision, and melanocyte culture. The advantages, disadvantages, and limitations of all the available modalities are reviewed. Objective. The purpose of this review is to find out if any guidelines can be drawn regarding the surgical management of stable vitiligo. Methods. This article is based on a review of the medical literature and the author's personal experience over the last decade. Results. It is difficult to draw any fixed guidelines from this review. Treatment must be individualized depending upon the site and the extent of involvement. Conclusion. Although the retrospective nature of this article limits its validity, discussing the various therapeutic options is of value as continuing medical education. Surgical treatment may be individualized to obtain the best possible cosmetic result. [source] The Scary World in Your Living Room and Neighborhood: Using Local Broadcast News, Neighborhood Crime Rates, and Personal Experience to Test Agenda Setting and CultivationJOURNAL OF COMMUNICATION, Issue 3 2003Kimberly Gross This study tested 2 important theories in the history of mass communication research, agenda setting and cultivation, by comparing the effects of watching local television news with direct experience measures of crime on issue salience and fear of victimization. Direct experience was measured in 2 ways: (a) personal crime victimization or victimization of a close friend or family member, and (b) neighborhood crime rates. Using a random digit dial telephone survey of residents of the Washington, DC, metropolitan area, researchers found that local news exposure accounted for an agenda-setting effect but did not cultivate fear of being a victim of crime. By contrast, direct experience had no agenda-setting effect but did predict fear. [source] The evidence-based supply of non-prescription medicines: barriers and beliefsINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 2 2004Margaret C. Watson MRC fellow ABSTRACT Context The reclassification of prescription only medicines (POMs) to pharmacy only (P) and general sale list (GSL) status is ongoing in the UK. Pharmacy staff need support to ensure the appropriate supply of these non-prescription medicines (NPMs). Objective To investigate the type of evidence used in the decision to supply NPMs and the barriers associated with their supply. Methods A participant observation study was conducted in nine pharmacies in one area of Scotland (Grampian). In-depth interviews were conducted with one pharmacist and one medicine counter assistant (MCA) from each pharmacy to explore and compare their attitudes and beliefs towards evidence-based practice (EBP) and the supply of NPMs. Key findings Most consultations were product requests. Pharmacy staff had little awareness or understanding of the term EBP and no specific evidence was used in the majority of consultations. Pharmacists' attitudes towards EBP varied. Personal experience or feedback from customers were cited as evidence upon which treatment recommendations were based. Many barriers and problems were associated with the supply of NPMs. These included: lack of evidence; MCAs' self-perception of their role; questioning and communication skills; safety; and training needs. There was a gap between pharmacists' and MCAs' perceptions of who should be referred to the pharmacist. Many staff used the WWHAM mnemonic for questioning customers, but this was often used as a matter of rote rather than as a framework to engage the customer in a relevant and constructive consultation. The development of adequate communication skills to allow core information to be obtained to support decision making needs to be addressed. Conclusion An increased awareness of EBP and its role in quality care needs to be promoted to community pharmacists and MCAs. There is currently no formal continuing education provision or requirement for MCAs in the UK. Pharmacy staff, particularly MCAs, require continuing education on the supply of NPMs. [source] Multidimensional Attitudes of Medical Residents and Geriatrics Fellows Toward Older PeopleJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2005Ming Lee PhD Objectives: To examine dimensions of a validated instrument measuring geriatric attitudes of primary care residents and performances on these dimensions between residents and fellows. Design: Cross-sectional and longitudinal studies. Setting: An academic medical center. Participants: Two hundred thirty-eight primary care residents (n=177) and geriatrics fellows (n=61) participated in the study from 1995 to 2000. Measurements: A 14-item, 5-point Likert scale previously validated for measuring primary care residents' attitudes toward older people and geriatric patient care was used. Results: Factor analysis showed four dimensions of the scale, labeled Social Value, Medical Care (MC), Compassion (CP), and Resource Distribution, which demonstrated acceptable reliability. Both groups of subjects showed significantly (P<.001) positive (mean>3) attitudes across the dimensions and times, except for residents, who had near-neutral (mean=3) attitudes on MC. Residents' mean attitude scores on the overall scale and the MC and CP subscales were significantly (P<.001) lower than those of fellows over time. Residents and fellows showed different change patterns in attitudes over time. Residents' attitudes generally improved during the first 2 years of training, whereas fellows' attitudes declined slightly. Personal experience was a strong predictor of residents' attitudes toward older patients. Ethnicity, academic specialty, professional experience, and career interest in geriatrics were also associated with residents' attitude scores. Conclusion: The multidimensional analysis of the scale contributes to better understanding of medical trainees' attitudes and sheds light on educational interventions. [source] 1251: Diagnosis of adult ophthalmic tumours: role of clinical history, symptoms and signsACTA OPHTHALMOLOGICA, Issue 2010T KIVELÄ Purpose To summarise signs and symptoms useful in diagnosing adult ophthalmic tumours. Methods Personal experience of the author as a member of the European Ophthalmic Oncology Group. Results According to studies from the United Kingdom, Finland and United States, 28-42% of adult patients with intraocular tumours may experience delays because the lesion is either misdiagnosed (e.g. as macular degeneration, naevus, rhegmatogenous retinal detachment) or missed at the initial visit. Of these patients, 72-87% have symptoms attributable to the tumour such as blurred vision, photopsia, floaters, metamorphopsia, and visual field loss. These symptoms can also be caused by many benign conditions (e.g. vitreous detachment) but should not be interpreted as innocent without thorough clinical examination. Signs specific for iris and ciliary body tumours include a tumour mass, sentinel vessels, acquired astigmatism, and cataracts. Choroidal tumours may induce serous retinal detachments, subretinal and vitreous bleedings and, sometimes, lipid exudation. Finally, orange subretinal pigment suggests the diagnosis of a uveal melanoma whereas many drusen point to a long-standing naevus. Conclusion Signs and symptoms of ophthalmic tumours are mostly nonspecific, necessitating an appropriately high level of suspicion and a systematic approach to clinical examination to avoid delayed or missed diagnoses. Earlier diagnosis could be achieved especially if dilated fundus examinations were performed without exception and if all suspicious naevi were referred for a second opinion. [source] 1342: Communicating numerical results correctlyACTA OPHTHALMOLOGICA, Issue 2010T KIVELÄ Purpose To highlight some pearls and pitfalls in reporting numerical data related to the eye with special reference to the instructions of the EVER Journal, Acta Ophthalmologica. Methods Personal experience of the author as a writer, reviewer and editorial board member is used to highlight common issues specific for reporting statistics. The rules and the reasoning behind them are explained using abundant real life examples. Results Statistics and mathematical analyses applied should be described in the methods section, but the software used need not be referenced unless it is specific for the test used. The following rules regarding reporting are highly recommended: 1. Report proportions if the number of subjects is smaller than 10; percentages in integers if the number of subjects is less than 100; if the number of subjects is larger, one decimal place can be given but is seldom necessary. 2. Report summary statistics of normally distributed variables as mean with standard deviation; other variables as medium with range. 3. Use parametric and nonparametric statistical tests accordingly. 4. Give exact p-values (e.g. p=0.034); if p-value is less than 0.001, report p<0.001. 5. Give 95% confidence intervals for main findings. 6. Mention the statistical test used with the p-value (e.g. p=0.015, paired t-test) if multiple methods are used. Conclusion Efficient reporting and analysis of data related to the eye is not difficult as long as one is aware of the basic rules. Putting them into action helps to ensure that the conclusions the readers draw from your study are proper. [source] 1344: The author, the reviewer and the associate editor: a literary drama triangleACTA OPHTHALMOLOGICA, Issue 2010T KIVELÄ Purpose To provide an insight into interactions between authors, reviewers and editors. Methods Personal experience of the author as a writer, reviewer and associate editor is used to discuss the scholarly interaction involved in having a manuscript reviewed and eventually published. Results The drama triangle is a psychological model of human interaction first described by Karpman. It proposes three ancestral psychological roles which people often take in a social situation: 1. The person who is treated as, or accepts the role of, a victim, 2. the person who pressures or persecutes the victim, and 3. the rescuer, who intervenes to help the situation or the underdog; this role often is one of a mixed or covert motive. The scenario of most novels, plays and movies is based on the drama triangle. Moreover, most of us are neurologically programmed to play any of the three roles. Depending on the context, we will thus - consciously or unconsciously - choose one of them. The roles can consequently also insinuate into the manuscript review process: the author is liable to become the victim and the reviewer the villain; the editorial staff member may then assume the role of the rescuer. Be as it may, the editors should try to identify reviewers whose comments are - often unconsciously - hostile from those whose advice is constructively critical, and then filter these in their targeted advice, keeping a neutral position. Sometimes he may need to guide an author who declares himself a victim or a reviewer who plays rescuer. Conclusion The best way to avoid being trapped in a drama triangle is by being watchful not take one of the three roles. Ideally, all three players work in unison toward a paper which makes best use of the data and of the talent of the authors and reviewers. [source] 1351: Eyelid splitting and extirpation of hair follicles for treatment of trichiasisACTA OPHTHALMOLOGICA, Issue 2010M ROSNER Purpose To review the background for developing the surgical technique of eyelid splitting and extirpation of hair follicles for treatment of acquired trichiasis, to demonstrate the technique, and to highlight its indications, advantages and complications. Methods Personal experience is used to demonstrate the technique, its indications, advantages and complications. This includes the follow-up data of 12 eyelids of 8 consecutive patients who were treated by splitting the eyelid margin using radiosurgical technique and others where the splitting of the lid margin was performed using CO2 laser or Colorado needle. This was followed by extirpation of the hair follicles of the trichiatic eyelashes using surgical microscope. Results Complete recovery of the trichiatic eyelashes at the site of the treatment occurred in most eyelids. There were no complications during or after healing of the surgical wound during the follow-up period. Conclusion Eyelid splitting and extirpation of hair follicles provides a simple and relatively rapid modification of the surgical treatment for acquired trichiasis, with good functional results. [source] 1352: Glass beads implantation in the scleral cavity during eviscerationACTA OPHTHALMOLOGICA, Issue 2010N ROSEN Purpose To review the background for developing the surgical modification of glass bead implantation in the scleral cavity during evisceration, to demonstrate the technique, and to highlight its indications, advantages and complications. Methods Personal experience is used to demonstrate the technique, its indications, advantages and complications. This includes the follow-up data of 17 patients who underwent evisceration with glass bead implantation during 1993-1996 and our experience from 164 eviscerations performed in our eye institute during the last 14 years. Results All patients achieved good cosmetic results with relatively good motility of the prosthesis. Complications included transient chemosis at the early postoperative period; three patients had local dehiscence of the wound, two patients developed a cyst in the socket and one patient was afflicted with thinning of the conjunctiva over the surgical wound. Conclusion The use of glass beads to fill the scleral cavity during evisceration has the advantage of an excellent fit in accordance with the scleral cavity volume, as well as ease of treatment in case of extrusion. The prosthesis movement is good because of its engagement with the scleral bulges caused by the glass beads. [source] The treatment of uveal melanoma with iodine plaque brachytherapyACTA OPHTHALMOLOGICA, Issue 2009T KIVELÄ Purpose To provide an overview of managing uveal melanoma (UM) with iodine brachytherapy (IBT). Methods Personal experience of the author in using IBT since 1990. Results IBT is an effective option for managing a UM of any size, although it is mostly used for medium-sized tumours, preference being given to ruthenium brachytherapy (RBT) when the tumour is <5-6 mm thick and to transscleral local resection when thickness is >6 mm, especially when vision is good. IBT is also a safe alternative to enucleation of large UM >10 mm in thickness if the patient is keen to preserve the eye and motivated to accept eventual complications. The plaque is positioned over the UM with a 1-2 mm safety margin when using a collimated/rimmed plaque. Because of stray radiation, a safety margin is not mandatory when the plaque is non-collimated/non-rimmed. Otherwise, surgical technique does not differ from RBT. An advantage of IBT is that the radioactive seeds are separate from the plaque, allowing economical use of plaques of many different sizes and shapes and individual positioning of the seeds in a conformal way. A disadvantage is a short half-life; the seeds need to be changed every 6 months. The dose the author uses is 80 Gy to tumour apex, which is reduced on an individual basis to 60-70 Gy when the UM is very thick. Local tumour control rate is 90% and, paradoxically, not worse for large UM as compared to smaller ones. There are no unequivocal safety distances for avoiding radiation cataract, maculopathy and optic neuropathy, which are more or less frequent depending on the size and location of the UM. Conclusion IBT achieves good local tumour control of UM of all sizes, but preservation of vision is decidedly less frequent than after RBT, which is always given preference. [source] Diagnosis of ophthalmic tumoursACTA OPHTHALMOLOGICA, Issue 2009T KIVELÄ Purpose To summarise clinical methods used to diagnose ophthalmic tumours. Methods Personal experience of the author as a member of the European Ophthalmic Oncology Group. Results Conjunctival tumours are excised based on provisional clinical diagnosis or, if they are extensive, atypical or part of systemic disease such as lymphoma, first biopsied to obtain a histopathologic diagnosis. Useful methods to diagnose and stage conjunctival tumours are high frequency ultrasonography (US) or ultrasound biomicroscopy (UBM) to measure their thickness, in vivo confocal microscopy or impression cytology to chart their extent, and exfoliative cytology to get a provisional diagnosis. Ciliary body tumours are visualised by radical biomicroscopy, transillumination and indirect ophthalmoscopy with scleral indentation, supplemented with high frequency US or UBM. Binocular indirect ophthalmoscopy and US form the basis or diagnosing choroidal tumours. In addition to fluorescein and indocyanine green angiography in atypical cases, optical coherence tomography to detect subretinal fluid and autofluorescence to detect orange pigment are useful adjuncts in telling a small melanoma from a naevus. The mnemonic "To Find Small Ocular Melanomas" (from Thickness >2mm, subretinal Fluid, Symptoms, Orange pigment, Margin touching disc) is also useful in this respect. Clinical diagnosis of medium-sized to large melanomas is 99% accurate, whereas a fine needle or vitrectomy biopsy may be necessary to diagnose atypical tumours and is also used for cytogenetic analysis of uveal melanomas. Conclusion Conjunctival tumours are mostly diagnosed histopathologically, whereas diagnosis of uveal tumours is usually based on clinical examination. While clinical diagnosis is usually reliable, biopsy of uveal tumours is increasingly used for prognostic purposes. [source] The cervical (Pap) smear,personal experience on both sides of the AtlanticCYTOPATHOLOGY, Issue 2 2000G. T. McKee What's in a name? That which we call a rose By any other name would smell as sweet. Shakespeare, Romeo and Juliet [source] Surgical Management of Stable Vitiligo: A Review with Personal ExperienceDERMATOLOGIC SURGERY, Issue 3 2000Sharad Mutalik MB Background. Various modalities are available for surgical management of stable, localized patches of vitiligo, which are resistant to conventional medical treatment. Cutaneous surgeons often struggle to select among various methods of surgical treatment that include camouflage tattooing, melanocyte transplants, excision, and melanocyte culture. The advantages, disadvantages, and limitations of all the available modalities are reviewed. Objective. The purpose of this review is to find out if any guidelines can be drawn regarding the surgical management of stable vitiligo. Methods. This article is based on a review of the medical literature and the author's personal experience over the last decade. Results. It is difficult to draw any fixed guidelines from this review. Treatment must be individualized depending upon the site and the extent of involvement. Conclusion. Although the retrospective nature of this article limits its validity, discussing the various therapeutic options is of value as continuing medical education. Surgical treatment may be individualized to obtain the best possible cosmetic result. [source] Adalimumab for treatment of moderate to severe psoriasis and psoriatic arthritisDERMATOLOGIC THERAPY, Issue 2008M. R. Bongiorno ABSTRACT: Psoriasis and psoriatic arthritis are common diseases associated with considerable morbidity and disability. Their pathophysiology comprises similar processes leading to inflammation of skin, entheses, and joints. Although traditional systemic agents can be effective, their use may be limited by lack of efficacy and concerns regarding adverse effects. The objective of this study was to assess the efficacy and safety of adalimumab, a fully human antitumor necrosis factor (anti-TNF) monoclonal antibody, over 16 weeks. The present authors report their personal experience in 15 patients with severe plaque psoriasis and psoriatic arthritis, refractory to other treatments, in which a decisive regression of joint/skin involvement was obtained. Psoriasis and psoriatic arthritis are chronic inflammatory disorders resulting from a combination of genetic and environmental factors. [source] Individual preparedness and mitigation actions for a predicted earthquake in IstanbulDISASTERS, Issue 4 2010ka Tekeli-Ye This study investigated the process of taking action to mitigate damage and prepare for an earthquake at the individual level. Its specific aim was to identify the factors that promote or inhibit individuals in this process. The study was conducted in Istanbul, Turkey,where an earthquake is expected soon,in May and June 2006 using qualitative methods. Within our conceptual framework, three different patterns emerged among the study subjects. Outcome expectancy, helplessness, a low socioeconomic level, a culture of negligence, a lack of trust, onset time/poor predictability, and normalisation bias inhibit individuals in this process, while location, direct personal experience, a higher education level, and social interaction promote them. Drawing on these findings, the paper details key points for better disaster communication, including whom to mobilise to reach target populations, such as individuals with direct earthquake experience and women. [source] Diagnostic criteria and surgical procedure for megaesophagus , a personal experienceDISEASES OF THE ESOPHAGUS, Issue 4 2009A. Lewandowski SUMMARY Megaesophagus is the end-stage of achalasia cardiae. It is the result of peristaltic disorders and slow decompensation of the muscular layer of the esophagus. The aim of this article is to detail the diagnostic criteria and surgical management of megaesophagus. Criteria were acute bending of esophagus axis; lack of esophagus peristalsis, and no response to stimulation in the manometric test; and Los Angeles C/D esophagitis in the endoscopic examination. Between 1991 and 2004 seven patients (5 females, 2 males; age, 51,67 years; average age, 59 ± 8 years) were treated. A bypass made from the pedunculated part of the jejunum connecting the part of esophagus above the narrowing with the praepyloric part of the stomach was made. Access was by an abdominal approach. A jejunum bypass was made in six patients with megaesophagus. A transhiatal esophageal resection was carried out, and in the second stage a supplementary esophagus was made from the right half of the colon on the ileocolic vessels in one patient who had experienced two earlier unsuccessful operations. Symptoms of dysphagia, recurrent inflammation of the respiratory tract, and pain subsided in all patients. Complications were not reported in the postoperative period. All patients survived. Subsequent radiographic and endoscopic examination showed very good outcome. The jejunum bypass gave very good results in the surgical treatment of megaesophagus. [source] Colon interposition in the treatment of esophageal caustic strictures: 40 years of experienceDISEASES OF THE ESOPHAGUS, Issue 6 2007J. Š. Knez SUMMARY., The objective of this article was to analyze 40 years of experience of colon interposition in the surgical treatment of caustic esophageal strictures from the standpoints of our long-term personal experience. Colon interposition has proved to be the most suitable type of reconstruction for esophageal corrosive strictures. The choice of colon graft is based on the pattern of blood supply, while the type of anastomosis is determined by the stricture level and the part of colon used for reconstruction. In the period between 1964 and 2004, colon interposition was performed in 336 patients with a corrosively scared esophagus, using the left colon in 76.78% of the patients. In 87.5% a colon interposition was performed, while in the remaining patients an additional esophagectomy with colon interposition had to be done. Hypopharyngeal strictures were present in 24.10% of the patients. Long-term follow-up results were obtained in the period between 1 to up to 30 years. Early postoperative complications occurred in 26.48% of patients, among which anastomosic leakage was the most common. The operative mortality rate was 4.16% and late postoperative complications were present in 13.99% of the patients. A long-term follow up obtained in 84.82% of the patients found excellent functional results in 75.89% of them. We conclude that a colon graft is an excellent esophageal substitute for patients with esophageal corrosive strictures, and when used by experienced surgical teams it provides a low rate of postoperative morbidity and mortality, and long-term good and functional quality of life. [source] SPECIAL SECTION: EVALUATION OF THE WESTERN AUSTRALIAN CANNABIS INFRINGEMENT NOTICE SCHEME,PHASE 1: Community attitudes towards cannabis law and the proposed Cannabis Infringement Notice scheme in Western AustraliaDRUG AND ALCOHOL REVIEW, Issue 4 2005JAMES FETHERSTON Abstract Western Australia (WA) became the fourth Australian jurisdiction to adopt a prohibition with civil penalties scheme for minor cannabis offences when its Cannabis Infringement Notice (CIN) scheme became law on 22 March 2004. Previous criminological research has demonstrated the importance of public attitudes towards the law in determining the effectiveness of legislation. This survey represents the first phase of a pre-post study that attempted to gauge public attitudes towards the legal status of cannabis, the proposed legislative reforms surrounding the drug and their likely effects. A random telephone survey of 809 members of the WA population was conducted prior to the implementation of the new laws with a view to exploring contemporary views of the existing legal status of cannabis, attitudes to the proposed legislative model and respondent perceptions of its likely effects. Despite cannabis being viewed negatively by large numbers of the sample, criminal penalties for minor cannabis offences were viewed as inappropriate and ineffective. Once explained, the proposed civil penalty scheme was viewed as ,a good idea' by 79% of the sample, despite significant differences due to personal experience of cannabis use, political affiliation, religiosity and age of offspring. Most believed that the legislative change would not result in changes to levels of cannabis use (70%) or ease of obtaining cannabis (59%). These data suggest that prior to its implementation the new legislation was highly acceptable to the majority of the community. These baseline data will be compared with data to be collected at the post-change phase of the study to allow empirical observations of attitudinal and behavioural changes occurring in the community. [source] A Fearsome Trap: The will to know, the obligation to confess, and the Freudian subject of desireEDUCATIONAL PHILOSOPHY AND THEORY, Issue 7 2010John Ambrosio Abstract The author examines the relation between Michel Foucault's corpus and Freudian psychoanalysis. He argues that Foucault had a complex and changing relationship to psychoanalysis for two primary reasons: his own psychopathology, personal experience, and expressed desire, and due to an ineluctable contradiction at the heart of psychoanalysis itself. The author examines the history of Foucault's personal and scholarly interest in psychology and psychiatry, tracing the emergence, development, and shift in his thought and work. He then argues that Foucault's critique of psychoanalysis can be extended to the constitution of the Western educated subject, and that Foucault ultimately resolved his personal dilemma in relation to psychoanalysis by rejecting the ,will to knowledge' and refusing the notion of a stable and fixed identity. [source] Implementing life cycle assessment in product developmentENVIRONMENTAL PROGRESS & SUSTAINABLE ENERGY, Issue 4 2003Gurbakhash Singh Bhander The overall aim of this paper is to provide an understanding of the environmental issues involved in the early stages of product development, and the capacity of Life Cycle Assessment (LCA) techniques to address these issues. The paper aims to outline the problems for the designer in evaluating the environmental benignity of a product from the outset, and to provide a framework for decision support based on the performance evaluation at different stages of the design process. The barriers that prevent product developers from using LCA are presented, as well as opportunities for introducing environmental criteria in the design process by meeting the designer's information requirements at the different life cycle stages. This can lead to an in-depth understanding of the attitudes of product developers towards the subject area, and an understanding of possible future directions for product development. This paper introduces an Environmentally Conscious Design method, and presents trade-offs between design degrees of freedom and environmental solutions. Life cycle design frameworks and strategies are also addressed. The paper collects experiences and ideas around the state-of-the-art in eco-design, from literature and personal experience, and provides eco-design life cycle assessment strategies. The end result of this presentation is to define the requirements for performance measurement techniques, and the environment needed to support life cycle evaluation throughout the evaluation of early stages of a product system. [source] Malagasy and Western Conceptions of Memory: Implications for Postcolonial Politics and the Study of MemoryETHOS, Issue 2 2006Jennifer Cole In this article, I analyze the social dynamics of memory during two electoral crises that took place in Madagascar in 1993 and 2002, respectively. These crises were accompanied by intense surges of memory. For some participants, the surge of remembering was simultaneously discursive, emotional, and embodied; for others it remained primarily discursive, with important consequences for how people related to the political changes taking place. Rather than turn to Western social theories of memory, which tend to separate the discursive, embodied, and emotional dimensions of memory, I suggest that the Malagasy practice of memory,mahatsiaro,offers a better analytic, one that combines the different aspects of memory together. The highly contingent ways in which the political, emotional, and embodied dimensions of memory converge to motivate political action suggests the need to integrate attention to personal experience with wider sociopolitical events and structures of power in particular historical settings. [Madagascar, discursive memory, emotion, embodiment, politics] [source] Conversation with Murray JarvikADDICTION, Issue 9 2001Article first published online: 1 SEP 200 In this occasional series we record the views and personal experience of people who have specially contributed to the evolution of ideas in the Journal's field of interest. Murray Jarvik's long and fruitful career in research and teaching spans the 50-year period beginning before the explosion of interest in psychopharmacology up to the present. His studies on LSD, among the first ever published, were followed by studies on the effects of drugs on memory and memory consolidation, which were then followed by studies on nicotine, smoking and pharmacological interventions in tobacco dependence. His contributions to the field of tobacco dependence have earned him international recognition. [source] Conversation with Jim RankinADDICTION, Issue 5 2000Article first published online: 29 AUG 200 In this occasional series we record the views and personal experience of people who have specially contributed to the evolution of ideas in the Journal 's field of interest. Jim Rankin is an Australian physician. Both in his own country and in Canada he has made outstanding contributions to service development and professional education in the alcohol and drugs field. [source] HUMAN STUDY: Heavy drinking relates to positive valence ratings of alcohol cuesADDICTION BIOLOGY, Issue 1 2009Carmen Pulido ABSTRACT A positive family history of alcohol use disorders (FH) is a robust predictor of personal alcohol abuse and dependence. Exposure to problem-drinking models is one mechanism through which family history influences alcohol-related cognitions and drinking patterns. Similarly, exposure to alcohol advertisements is associated with alcohol involvement and the relationship between affective response to alcohol cues and drinking behavior has not been well established. In addition, the collective contribution that FH, exposure to different types of problem-drinking models (e.g. parents, peers) and personal alcohol use have on appraisal of alcohol-related stimuli has not been evaluated with a large sample. We investigated the independent effects of FH, exposure to problem-drinking models and personal alcohol use on valence ratings of alcohol pictures in a college sample. College students (n = 227) completed measures of personal drinking and substance use, exposure to problem-drinking models, FH and ratings on affective valence of 60 alcohol pictures. Greater exposure to non-familial problem-drinkers predicted greater drinking among college students (, = 0.17, P < 0.01). However, personal drinking was the only predictor of valence ratings of alcohol pictures (, = ,0.53, P < 0.001). Personal drinking level predicted valence ratings of alcohol cues over and above FH, exposure to problem-drinking models and demographic characteristics. This suggests that positive affective responses to alcohol pictures are more a function of personal experience (i.e. repeated heavy alcohol use) than vicarious learning. [source] Masculinity and the Biographical Meanings of Management Theory: Lyndall Urwick and the Making of Scientific Management in Inter-war BritainGENDER, WORK & ORGANISATION, Issue 2 2001Michael Roper This article explores the biographical shaping of management theory. Using the British management theorist Lyndall Urwick (1891,1983) as a case study, it argues that existing understandings of the history of management studies are limited by their lack of attention to the emotional a priori of theory production. For men such as Frederick Taylor or Urwick, the work of composing management theory for a public audience was intimately connected to events and experiences in the private life. Theorizing addressed emotional dilemmas even while it strove to construct a separation between the personal and the organizational. Management theories are not only historically, socially or discursively constructed, but can be read in terms of the evidence they provide about individual subjectivity. Psychoanalytic concepts can help illuminate such relations. Theorizing can be seen as a form of play: as something which, in D.W. Winnicott's terms, takes place in the space between the psychic reality of the ,me' and the external world of the ,not me'. The ,classical' administrative theory represented by Taylor, Fayol and Urwick sought to create organizational structures which could stand apart from, and allow the management of, individual personalities. It simultaneously insisted on the status of theory as the ,not me'; that is, as a product which was not shaped by personal experience, but which constituted objective knowledge. The illusion of theory as a largely external, social product persists in much management and organization studies today. This article challenges that social determinism, first, by showing how Urwick's theories addressed issues of separation and intimacy, and second, by placing Urwick's work in the context of his relations with women. [source] Capturing the power of academic medicine to enhance health and health care of the elderly in the USAGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2004William R Hazzard As in Japan, the US population is aging progressively, a trend that will challenge the health-care system to provide for the chronic, multiple and complex needs of its elderly citizens. and as in Japan, the US academic health enterprise has only belatedly mounted a response to that challenge. Herein is reviewed a quarter of a century of the author's personal experience in developing new programs in gerontology and geriatric medicine from a base in the Department of Internal Medicine at three US academic health centers (AHC): The University of Washington (as Division Head), Johns Hopkins University (as Vice-Chair), and Wake Forest University (as Chair). Rather than to build a program from a new department of geriatrics, this strategy was chosen to capture the power and resources of the department of internal medicine, the largest university department, to ,gerontologize' the institution, beginning with general internal medicine and all of the medical subspecialties (the approach also chosen to date at all but a handful of US AHC). The keystone of success at each institution has been careful faculty development through fellowship training in clinical geriatrics, education and research. Over the same interval major national progress has occurred, including expanded research and training at the National Institute on Aging and the Department of Veterans Affairs, and accreditation of more than 100 fellowship programs for training and certification of geriatricians. However, less than 1% of US medical graduates elect to pursue such training. Hence such geriatricians will remain concentrated at AHC, and most future geriatric care in the USA will be provided by a broad array of specialists, who will be educated and trained in geriatrics by these academic geriatricians. [source] Promoting breast-feeding in a deprived area: the influence of a peer support initiativeHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2003Pamela Raine PhD Abstract The present article describes a qualitative study designed to evaluate the effectiveness of a peer-support intervention to promote breast-feeding in a deprived area. The aims of the study were to: explore stakeholders' experiences of the intervention; explore the development of a ,culture' of breast-feeding; and consider the potential of the initiative for building community capacity. The methods used in the research were in-depth interviews, diaries and direct observation. The findings describe the social and cultural barriers to breast-feeding experienced by women, and the ways in which professional and lay participants in the peer-support project attempt to reduce them. The advantages of partnership working between health professionals and lay volunteers are then explored. These include: sharing the workload; providing an informal tier of support to mothers; and importantly, offering support and advice stemming from personal experience. For lay supporters, the benefits of taking part in the project range from personal satisfaction at being recognised as skilled, to gains in confidence which potentially open up further educational and training opportunities. In conclusion, it is suggested that the ,success' of such interventions is unlikely to be captured solely by monitoring breast-feeding rates, but needs to take into account the wider context of community development. [source] ,Balance' is in the eye of the beholder: providing information to support informed choices in antenatal screening via Antenatal Screening Web ResourceHEALTH EXPECTATIONS, Issue 4 2007Shenaz Ahmed BSc (Hons) PhD Abstract Objectives, The Antenatal Screening Web Resource (AnSWeR) was designed to support informed prenatal testing choices by providing balanced information about disability, based on the testimonies of disabled people and their families. We were commissioned by the developers to independently evaluate the website. This paper focused on how participants evaluated AnSWeR in terms of providing balanced information. Setting, West Yorkshire. Participants, A total of 69 people were drawn from three groups: health professionals, people with personal experience of tested-for conditions (Down's syndrome, cystic fibrosis and spina bifida) and people representing potential users of the resource. Method, Data were collected via focus groups and electronic questionnaires. Results, Participants believed that information about the experience of living with the tested-for conditions and terminating a pregnancy for the conditions were important to support informed antenatal testing and termination decisions. However, there were differences in opinion about whether the information about the tested-for conditions was balanced or not. Some people felt that the inclusion of photographs of people with the tested-for conditions introduced biases (both positive and negative). Many participants were also of the opinion that AnSWeR presented insufficient information on termination of an affected pregnancy to support informed choice. Conclusion, This study highlighted the difficulty of designing ,balanced' information about tested-for conditions and a lack of methodology for doing so. It is suggested that AnSWeR currently provides a counterbalance to other websites that focus on the medical aspects of disability. Its aim to provide ,balanced' information would be aided by increasing the number and range of case studies available on the website. [source] Impairment and Disability: Constructing an Ethics of Care That Promotes Human RightsHYPATIA, Issue 4 2001JENNY MORRIS The social model of disability gives us the tools not only to challenge the discrimination and prejudice we face, but also to articulate the personal experience of impairment. Recognition of difference is therefore a key part of the assertion of our common humanity and of an ethics of care that promotes our human rights. [source] The struggle for methodological orthodoxy in nursing research: The case of mental healthINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2003Edward White ABSTRACT: This paper is not intended as an exhaustive review of contemporary mental health nursing research. Rather, the intention is to explore some of the competing arguments for different methodological approaches in social research, using mental health nursing as a case example. The paper questions the extent to which the artificially dichotomized debate over quantitative versus qualitative research impacts upon the working lives of practitioners, managers and policy makers. In particular, the paper traces the development of survey method, during this its centennial anniversary year. It also traces its subsequent decline, in favour of what will be referred to as the new methodological orthodoxy in nursing research. It is also interwoven with occasional accounts of personal experience, drawn from an international perspective. The paper calls for a rapprochement between different wings of methodological opinion, in deference to a publicly unified position for nursing research in which the achievement of quality becomes the over-arching concern. 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