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Introducción: La historia del cuidado de enfermería ha transitado cuatro etapas: doméstica, vocacional, técnica y profesional, que han sido fundamentales en su desarrollo. Sin embargo, los actuales desafíos sociosanitarios ponen de manifiesto la necesidad de proyectar nuevas etapas. Objetivo: Proyectar el futuro del cuidado de enfermería a la luz de la filosofía y teoría de los cuidados transpersonales de Jean Watson. Metodología: Se realizó una revisión sistemática y un análisis crítico-reflexivo sobre las proyecciones disciplinares de la enfermería. La revisión abarcó artículos publicados hasta 2023 en Web of Science, LILACS, SciELO y CINAHL. Se encontraron 366 artículos, de los cuales 8 cumplieron con los criterios de elegibilidad. El análisis crítico-reflexivo se centró en describir la evolución de las etapas y en proponer una etapa futura. Resultados: El cuidado humanizado es un proceso complejo que requiere de habilidades de comunicación específicas, no solo entre profesionales de la salud, sino también con los usuarios y sus familias. A su vez, el cuidado humanizado se integra a un entorno clínico desafiante, debido a la alta carga laboral, la disponibilidad limitada de recursos y la necesidad de mantener un nivel competitivo en la práctica profesional. Se propone como quinta etapa el "cuidado disciplinar de enfermería". Conclusiones: Esta nueva etapa se centraría en la gestión del cuidado y en el cuidado humanizado mediante un perfeccionamiento de la investigación, la formación continua, los modelos y teorías, y la autonomía profesional
Introdução: A história do cuidado na enfermagem passou por quatro etapas: doméstica, vocacional, técnica e profissional, que foram fundamentais para seu desenvolvimento. No entanto, os atuais desafios sociossanitários destacam a necessidade de projetar novas etapas. Objetivo: Projetar o futuro do cuidado de enfermagem à luz da filosofia e da teoria dos cuidados transpessoais de Jean Watson. Metodologia: Foi realizada uma revisão sistemática e uma análise crítico-reflexiva sobre as projeções disciplinares da enfermagem. A revisão abrangeu artigos publicados até 2023 nas bases Web of Science, LILACS, SciELO e CINAHL. Foram encontrados 366 artigos, dos quais 8 atenderam aos critérios de elegibilidade. A análise crítico-reflexiva concentrou-se em descrever a evolução das etapas e propor uma etapa futura. Resultados: O cuidado humanizado é um processo complexo que exige habilidades específicas de comunicação, não apenas entre os profissionais de saúde, mas também com os usuários e seus familiares. Por sua vez, o cuidado humanizado está integrado em um ambiente clínico desafiador, devido à alta carga de trabalho, disponibilidade limitada de recursos e à necessidade de manter um nível competitivo na prática profissional. Propõe-se como quinta etapa o "cuidado disciplinar de enfermagem". Conclusões: Esta nova etapa se concentraria no gerenciamento do cuidado e no cuidado humanizado por meio do aperfeiçoamento da pesquisa, da formação continuada, dos modelos e teorias e da autonomia profissional
Introduction: The history of nursing care has passed through four stages: domestic, vocational, technical and professional, which have been fundamental in its development. However, current socio-sanitary challenges demonstrate the need to plan new steps. Objective: Project the future of nursing care in the light of the philosophy and theory of transpersonal care by Jean Watson. Methodology: A systematic review and critical-reflexive analysis of nursing disciplinary projections was carried out. The review covers articles published until 2023 in Web of Science, LILACS, SciELO and CINAHL. There will be 366 articles, of which 8 met the eligibility criteria. The critical-reflexive analysis focuses on describing the evolution of the stages and proposing a future stage. Results: Humanized care is a complex process that requires specific communication skills, both between healthcare professionals and users and their families. In turn, humanized care is integrated into a challenging clinical environment, due to the high workload, limited availability of resources and the need to maintain a competitive level in professional practice. "Disciplinary nursing care" is proposed as a fifth stage. Conclusions: This new stage will focus on care management and humanized care through perfecting research, continued training, models and theories, and professional autonomy
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RESUMEN El objetivo es proponer un esquema conceptual que sea útil para interpretar las implicaciones económicas y ambientales que tienen las organizaciones sociales basadas en un paradigma individualista o altruista. Tras una revisión de literatura y breve recuento histórico de estos paradigmas, se concluye que son las organizaciones complejas y equilibradas las que tienen mayor propensión a desarrollar intercambios de cooperación altruistas. La implicación para las políticas ambientales contemporáneas es que, además de los mecanismos de mercado, es posible complementarlas con otros esquemas basados en mecanismos comunitarios, siempre y cuando exista un contexto propicio para implementarlo.
ABSTRACT The objective is to propose a practical conceptual scheme to interpret social organizations' economic and ecological implications based on an individualistic or altruistic paradigm. After a literature review and a brief historical analysis of these paradigms, we conclude that complex and balanced organizations have the most remarkable propensity to develop altruistic cooperation exchanges. The implication for contemporary environmental policies is the possibility of complementing market mechanisms with community-based schemes in a favorable context.
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Objetivo: analisar o desenvolvimento da enfermagem traumato-ortopédica a partir da primeira turma de residentes de um hospital especializado. Método: o estudo seguiu a metodologia histórica com abordagem qualitativa. As fontes foram documentos escritos e orais. Resultados: trabalhar em uma instituição especializada foi o ponto de partida para a busca por especialização de enfermeiras atuantes no cuidado traumato-ortopédico, que perceberam o saber/poder adquirido no trabalho assistencial, além da intenção de qualificar a assistência e elevar o hospital a instituto. Estratégias empregadas reúnem a busca por parcerias com instituições universitárias e associativas, além da criação de uma associação própria. Considerações finais: a enfermagem traumato-ortopédica ampliou seu espaço científico ao criar um curso de especialização com uma unidade acadêmica. Foi possível delimitar o poder acadêmico e institucional da enfermagem na instituição de saúde pela formação de enfermeiras especialistas constituindo um grupo de reconhecido pelo saber científico.
Objective: to analyze the development of trauma and orthopedic nursing care from the very first class of residents of a specialized hospital. Method: historical methodology study with a qualitative approach. The sources consisted of written and oral documents. Results: working in a specialized institution was the starting point for nurses who were seeking specialization in the field of trauma and orthopedic care as they noticed the power-knowledge acquired through care work, plus they were willing to improve assistance and take the hospital up to an institute level. Strategies used include the search for partnerships with universities and associative-type institutions, in addition to creating their own association. Final considerations: trauma and orthopedic nursing care expanded its scientific space by creating a specialization course together with an academic unit. It was possible to define the academic and institutional power of the nursing staff in the health institution by considering the training process of its nurse specialists, who consisted of a group recognized for their scientific knowledge.
Objetivo: analizar el desarrollo de la enfermería traumatológica ortopédica a partir del primer grupo de residentes de un hospital especializado. Método: estudio con metodología histórica con un enfoque cualitativo. Las fuentes fueron documentos escritos y orales. Resultados: el trabajo en una institución especializada fue el punto de partida para la búsqueda de la especialización de las enfermeras que trabajaban en la atención traumatológica ortopédica, quienes notaron el saber/poder adquirido en el trabajo asistencial, además de la intención de cualificar la atención y elevar el hospital al nivel de instituto. Las estrategias empleadas incluyen la búsqueda de alianzas con instituciones universitarias y asociaciones, y la creación de una asociación propia. Consideraciones finales: la enfermería traumatológica ortopédica amplió su espacio científico mediante la creación de un curso de especialización con una unidad académica. Se logró delimitar el poder académico e institucional de la enfermería en la institución de salud a través de la formación de enfermeros especialistas, que es un grupo reconocido por el conocimiento científico.
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Increasing genome size (GS) has been associated with slower rates of DNA replication and greater cellular nitrogen (N) and phosphorus demands. Despite most plant species having small genomes, the existence of larger GS species suggests that such costs may be negligible or represent benefits under certain conditions. Focussing on the widespread and diverse grass family (Poaceae), we used data on species' climatic niches and growth rates under different environmental conditions to test for growth costs or benefits associated with GS. The influence of photosynthetic pathway, life history and evolutionary history on grass GS was also explored. We found that evolutionary history, photosynthetic pathway and life history all influence the distribution of grass species' GS. Genomes were smaller in annual and C4 species, the latter allowing for small cells necessary for C4 leaf anatomy. We found larger GS were associated with high N availability and, for perennial species, low growth-season temperature. Our findings reveal that GS is a globally important predictor of grass performance dependent on environmental conditions. The benefits for species with larger GS are likely due to associated larger cell sizes, allowing rapid biomass production where soil fertility meets N demands and/or when growth occurs via temperature-independent cell expansion.
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Maude Abbott was a pioneering female Canadian physician who became a world authority on medical museums and congenital heart disease. Abbott spent almost all her career in highly sexist, discriminatory work environments. This paper reviews Abbott's life and accomplishments, but, more importantly, analyzes her pathway to success in the masculine world of early 20th-century academic pathology. Abbott, though well-trained as a pathologist, never provided clinical service, but instead worked as museum curator at McGill University. She established the International Association of Medical Museums (predecessor to the International Academy of Pathology), edited its journal, and essentially ran the organization. Abbott, surrounded by influential males, dealt differently with each. In general, she recognized that male doctors believed women lacked the gravitas to lead major initiatives but that she could circumnavigate this supposed impediment by co-leading projects with male counterparts, preferably ones too busy to get in her way. She repeatedly used this approach, and by doing most of the work but sharing credit, succeeded in gaining reputation, accomplishment, and advancement. Abbott's pioneering work on congenital heart disease established her as one of the founders of pediatric pathology, and, overall, her career promoted the entry of women physicians into the pathology profession.
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Anterior approaches to the acetabulum can be distinguished into extrapelvic, intrapelvic and combined extrapelvic and intrapelvic approaches. Historically, the extrapelvic ilioinguinal approach was introduced in the French, English and German literature during the late 60s and became gradually the Gold-standard in treating anterior acetabular fractures. In the meantime, the intrapelvic approach, introduced by the Helsinki group, is favored by many surgeons with ongoing interest allowing direct antero-medial access to the true pelvis below the linea terminalis, to the quadrilateral plate and medial side of the posterior column. More recently, more supero-medial approaches, allowing access to the large and true pelvis have been developed, e.g. the Pararectus approach. The historical development, the value and approach-related results of the ilioinguinal approach are analyzed and discussed.
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Animal nests provide a beneficial environment for offspring development and as such contribute to fitness. Gathering and transporting materials to construct nests is energetically costly, but the life history trade-offs associated with the types of nests built are largely unknown. Who contributes to building the nest could also mediate these trade-offs, as building a nest as a couple is expected to be less costly per individual than building alone. Using a comparative analysis on 227 songbird species globally, we found a fecundity cost associated with the type of nest a species builds. Species that build domed nests produce fewer broods per year than species building cups or platforms. Dome nesting species also have larger clutch sizes than open nesting species, but only when the nest is built by a couple and not when females build nests alone. This suggests that building domed nests represents a trade-off with investment in young, especially when females are solely responsible for nest building. More broadly, our results could explain macroevolutionary patterns, such as the recent finding that females, building on their own, more often build open cup rather than domed nests.
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Potential immortality is observed in several species (e.g. prickly pear cactus, hydra and flatworms) and is indicative of their negligible or even negative senescence rates. Unlike in senescent species, which experience reduced individual performance with age due to physiological degradation, species with negligible or negative senescence display mortality rates that remain constant or decline with age, respectively. These rates vary across taxa and are correlated with life history traits. Yet, the extent to which variable resource availability, a key driver of variation in life history traits, impacts species that show negligible or negative senescence is currently unknown. Here, we examine whether and how variation in the quantity, quality and feeding interval of resources impact population structure, population performance and life history trait trade-offs in two long-lived planaria that do not senesce: Schmidtea mediterranea and Dugesia tahitiensis. In a full factorial design, different combinations of resource quantity (reduced intake, standard intake and high intake) and quality (high and low quality) were provided in two different feeding intervals (7-day and 14-day intervals) for 19 weeks. We show that variability in resource availability, via decreases in quantity, quality and frequency of resources, does not diminish population viability in either species but does result in suboptimal conditions of stress in S. mediterranea. The high population viability we report can be attributed to two different mechanisms: increased reproduction or increased investment into maintenance at the expense of reproduction. Moreover, which mechanism was responsible for said high population viability was context-dependent and modulated by the specific life history strategy of the two planaria species. We show that suboptimal conditions can cause stress responses that have significant impacts on non-senescent species. The context-dependent response we observe suggests that species that do not senesce but are subject to suboptimal conditions of stress may ultimately exhibit declines in performance and ultimately die. A clearer understanding of the impact of suboptimal conditions of resource availability on non-senescent species is needed to determine the extent of stress experienced and ultimately whether a species can truly be immortal.
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The fundamental trade-off between current and future reproduction has long been considered to result in a tendency for species that can grow large to begin reproduction at a larger size. Due to the prolonged time required to reach maturity, estimates of tree maturation size remain very rare and we lack a global view on the generality and the shape of this trade-off. Using seed production from five continents, we estimate tree maturation sizes for 486 tree species spanning tropical to boreal climates. Results show that a species' maturation size increases with maximum size, but in a non-proportional way: the largest species begin reproduction at smaller sizes than would be expected if maturation were simply proportional to maximum size. Furthermore, the decrease in relative maturation size is steepest in cold climates. These findings on maturation size drivers are key to accurately represent forests' responses to disturbance and climate change.
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Árboles , Clima Tropical , Árboles/crecimiento & desarrollo , Cambio Climático , Reproducción , BosquesRESUMEN
BACKGROUND: Glaucoma is an irreversible silent and dangerous eye condition that leads to damage of the optic nerve head. This study aimed to determine the outcome of targeted glaucoma outreaches done in the University of Ilorin Teaching Hospital over three years with a view to early detection and timely institution of management. METHODS: The study is a retrospective review of 3 targeted hospital-based glaucoma screenings, World Sight Day of 2019 (140 participants), World Glaucoma Week of 2020 (176 participants), and World Glaucoma Week of 2022 (183 participants). The criteria for diagnosing glaucoma and glaucoma suspects were taken from the national study of prevalence and types of glaucoma from the Nigerian national blindness survey and International Society for Geographical and Epidemiological Ophthalmology criteria. RESULTS: The study population had a mean age of 45.54 years (SD 16.92) with individuals within the age group of 51-60 years comprising the majority of the participants (26.4%). Most participants had normal vision or mild visual impairment in the right eye (411, 86.1%) and left eye (405, 84.9%) while blindness was recorded in the right eye of 37 (7.7%) participants and left eye of 36 (7.5%). The prevalence of glaucoma cases and suspects among study participants was 29.4% and 42.5%, respectively. There was a statistically significant relationship between the diagnosis of glaucoma and older age, family history of glaucoma and elevated intraocular pressure. CONCLUSION: This study showed that targeted screening for glaucoma is an invaluable tool for ensuring early detection of the disease.
CONTEXTE: Le glaucome est une affection oculaire silencieuse et dangereuse qui entraîne des dommages au nerf optique. Cette étude visait à déterminer les résultats des campagnes de dépistage ciblé du glaucome menées à l'Hôpital universitaire d'Ilorin sur trois ans en vue d'un dépistage précoce et d'une institution rapide de la prise en charge. MÉTHODES: Cette étude est une revue rétrospective de trois dépistages hospitaliers ciblés du glaucome : la Journée mondiale de la vue de 2019 (140 participants), la Semaine mondiale du glaucome de 2020 (176 participants) et la Semaine mondiale du glaucome de 2022 (183 participants). Les critères de diagnostic du glaucome et des suspects de glaucome ont été tirés de l'étude nationale sur la prévalence et les types de glaucome de l'enquête nationale nigériane sur la cécité et des critères de la Société internationale de géographie et d'épidémiologie ophtalmologique. RÉSULTATS: La population étudiée avait un âge moyen de 45,54 ans (SD 16,92), les personnes âgées de 51 à 60 ans constituant la majorité des participants (26,4 %). La plupart des participants avaient une vision normale ou une légère déficience visuelle à l'Åil droit (411, 86,1 %) et à l'Åil gauche (405, 84,9 %), tandis que la cécité a été enregistrée à l'Åil droit de 37 participants (7,7 %) et à l'Åil gauche de 36 (7,5 %). La prévalence des cas de glaucome et des suspects de glaucome parmi les participants à l'étude était respectivement de 29,4 % et de 42,5 %. Il existait une relation statistiquement significative entre le diagnostic de glaucome et l'âge avancé, les antécédents familiaux de glaucome et l'élévation de la pression intraoculaire. CONCLUSION: Cette étude a montré que le dépistage ciblé du glaucome est un outil précieux pour assurer la détection précoce de la maladie. MOTS CLÉS: Dépistage du glaucome, Prévalence du glaucome, Cécité due au glaucome, Antécédents familiaux de glaucome.
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Glaucoma , Hospitales de Enseñanza , Tamizaje Masivo , Humanos , Persona de Mediana Edad , Femenino , Masculino , Nigeria/epidemiología , Estudios Retrospectivos , Glaucoma/diagnóstico , Glaucoma/epidemiología , Adulto , Tamizaje Masivo/métodos , Prevalencia , Anciano , Presión Intraocular/fisiología , Adulto JovenRESUMEN
Diffuse large B-cell lymphoma (DLBCL) is a high-grade malignancy. We present a case of a 97-year-old female with gastric cancer and DLBCL in whom remission with rituximab-containing minimum chemotherapy was sustained for 10 years. As she had severe adverse effects, she refused further treatments for both tumors. Ten years after the initial treatment, examinations showed several tumors in the lungs, the right pleura, and the liver, as well as advanced gastric cancer. She eventually passed away, and the autopsy revealed that multiple tumors were not lymphoma, but adenocarcinoma. This case report is a valuable addition to the literature as it analyzes whether rituximab-containing minimum chemotherapy is effective for elderly DLBCL and delineates the natural history of gastric cancer.
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Objectives: Cancer screening aims to detect and treat malignant lesions at an early stage and to prolong patients' lifetime. There is still a lack of effective cancer screening programs in China. We initiated a screening project in 2018 and this study presented the cancer screening status in China. Methods: We conducted a cross-sectional study in one cancer-care medical center of China. The screening program included routine blood tests, plasma tumor markers, gastric endoscopy, colonoscopy, ultrasound, and computed tomography (CT) scans. Screening results were presented as sensitivity, specificity and positive predictive values (PPVs). Results: Twenty-three (1.46%) out of 1,576 participants were eventually diagnosed with malignant tumors or high-grade intraepithelial neoplasia (HGIN). A family history of malignancy (78.26% in diagnosed cancer and HGIN vs. 46.36% in the others) was the only statistically significant parameter associated with cancer detection (p = 0.002). None of the common tumor markers were associated with the cancers screened. Except for colonoscopy (50.00%) and ultrasound for renal cancer (66.67%), the sensitivities of most screening methods were 100%. The specificities of all the screening means were above 96%. Most PPVs ranged from 30-60%. Conclusion: We emphasized risk stratification for early cancer screening, such as a family history of cancer. The survey illustrated that gastric endoscopy, colonoscopy, ultrasound, and lung CT for early cancer screening had high specificity, reasonable sensitivity, and PPV. We anticipated this report would motivate larger-sample studies to estimate the risk-to-benefit ratio of cancer screening and urge the establishment of a native Chinese screening project and even guidelines.
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Detección Precoz del Cáncer , Humanos , Detección Precoz del Cáncer/métodos , China/epidemiología , Estudios Transversales , Masculino , Persona de Mediana Edad , Femenino , Anciano , Adulto , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X , Neoplasias/diagnóstico , Neoplasias/epidemiología , Neoplasias/diagnóstico por imagen , Biomarcadores de Tumor/sangre , Tamizaje Masivo/métodos , Colonoscopía/estadística & datos numéricos , Ultrasonografía/métodosRESUMEN
Tinnitus is a subjective acoustic perception in the absence of any external source. Symptoms associated with tinnitus are insomnia, lack of concentration, depression, anxiety and elevated levels of stress. There were many questionnaires to evaluate the severity of tinnitus, one such questionnaire is the Tinnitus Sample Case History Questionnaire (TSCHQ). TSCHQ focuses on the tinnitus history and descriptive characteristics of tinnitus. As far as we know there have been no translation of TSCHQ in any Indian languages. This study aimed to translate TSCHQ into a Tamil version and validate it for use in clinics for the Tamil population. Rather than a direct translation, cross-cultural adaptation has been carried out. The steps involved in this process were forward translation, Synthesizing common translation, Backward translation, Expert committee review and pre-testing of the final version. Incorporating these procedures, the translated and validated TSCHQ questionnaire was made in Tamil. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04941-z.
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Eufemiusz J. Herman was a pioneering figure in Polish neurology whose contributions spanned clinical practice, research, and education. Born in 1892, his career was marked by a deep understanding of neurological semiology, which he honed under the mentorship of Edward Flatau. Herman was a true scientist and physician, demonstrating his dedication to research even before graduating from medical school. His commitment to scientific inquiry persisted even during the harrowing conditions of the Warsaw Ghetto, where, amidst an epidemic of typhus, he documented and treated the neurological complications of the disease. His extensive body of work, comprising 17 books and over 200 scientific papers, led to the description of several enduring clinical signs, including the eponymous Herman's syndrome (post-traumatic syndrome with livedo racemosa universalis) and the nuchal-toe sign in meningitis. Herman's enduring legacy encompasses not only his scientific discoveries but also his pivotal role in shaping Polish neurology. His work bridged pre- and postwar neurological traditions, laying the foundation for modern neurological practice in Poland and contributing to the international advancement of the field. This paper reviews Herman's most noteworthy scientific achievements and their impact on neurological practice.
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The paper explores the development of psychotherapy in Polish psychiatry in the interwar period from the perspective of Kurt Danziger's historical psychology. Firstly, the organizational and social context of the development of Polish psychiatric care in the interwar period and its impact on the development of psychotherapy is outlined. Then, the most influential in Poland, European psychotherapeutic developments in the interwar period are reconstructed. Finally, the views of psychiatric personnel of three psychiatric facilities proposing psychotherapy as one of the main means of treatment of mentally ill patients are introduced: Dziekanka Psychiatric Hospital, the Jewish Hospital in Warsaw and Psychiatry and Neuropathology Clinic of the Jagiellonian University in Krakow. Psychiatric personnel from Dziekanka Psychiatric Hospital, directed by Aleksander Piotrowski, understood psychotherapy broadly, as the influence of the environment on the patient's psyche. Psychiatrists of the Jewish Hospital in Warsaw, Adam Wizel, Gustaw Bychowski, Wladyslaw Matecki, and Maurycy Bornsztajn developed psychoanalytically influenced psychotherapy of schizophrenia. Bychowski also advocated for the application of psychotherapy in such neglected groups of patients as children and the intellectually disabled. Jan Piltz and Eugeniusz Artwinski pursued psychotherapy in the treatment of war neuroses at the Psychiatry and Neuropathology Clinic of the Jagiellonian University.
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Psiquiatría , Psicoterapia , Polonia , Humanos , Historia del Siglo XX , Psiquiatría/historia , Psicoterapia/historia , Trastornos Mentales/terapia , Trastornos Mentales/historiaRESUMEN
The paper further explores the development of psychotherapy in Polish psychiatry in the interwar period. Jaroszynski attempted to sketch out the idea of "emotional psychotherapy". Stryjenski organized a counseling clinic for the mentally ill, using psychotherapy as one of the means of treatment. Bilikiewicz developed oneiroanalysis - a psychotherapeutic method of dream analysis based on modifications of psychoanalysis. Gottliebowa advocated for the use of psychoanalytically influenced psychotherapy in the gynaecologist practice. Markuszewicz considered psychoanalysis the only psychotherapeutic modality aimed at unearthing the real causes of mental illnesses. Henryk Higier proposed to consider psychoanalysis practically as a method of psychotherapy and saw its heterogeneity as its advantage. Critical views on psychoanalysis as a psychotherapeutic method were delivered by Wirszubski and Mikulski. In general, psychotherapy in Polish psychiatry of the interwar period was highly influenced by psychoanalysis. Moreover, the understanding and practice of psychotherapy in public psychiatric facilities differed from that in private practice. In public psychiatric facilities, it was used mainly to deal with psychoses, so it urged clinicians to modify the classic psychoanalytic approach. In private practice, psychiatrists were dealing mainly with cases of neuroses and therefore could apply standard psychoanalytic procedures. Methods of suggestion, persuasion and hypnosis, characteristic of nineteenth-century psychotherapy, were still in use in Polish psychiatry of the interwar period. The main obstacles to the development of Polish psychotherapy in the interwar period were antisemitic attitudes contributing to hostility towards psychoanalysis, as well as the biological orientation of the majority of the Polish psychiatric society.
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Psiquiatría , Psicoterapia , Humanos , Polonia , Historia del Siglo XX , Psiquiatría/historia , Psicoterapia/historia , Psicoterapia/métodos , Trastornos Mentales/terapia , Psicoanálisis/historia , Terapia PsicoanalíticaRESUMEN
A blind spot in the history of the healthcare professions is the evolution of "technical" professions, particularly after 1970. However, these professions underwent major changes at the end of the 20th century. We propose two case studies, on Quebec's paramedics and respiratory therapists' professional projects. The projects and strategies of the two groups, which had previously differed, tended to converge after 1995. From then, both groups minimize their relationship with machines and technology. Instead, they claim new tasks focused on clinical evaluation and first-line intervention. Public reforms appear to be shaping this evolution in the political strategies, professional projects and even clinical preferences, of these healthcare professions after 1995.
Un angle mort en histoire des professions de santé est l'évolution des professions à caractère « technique ¼, surtout après 1970. Or, ces métiers se transforment beaucoup à la fin du 20e siècle. Nous proposons deux études de cas, sur les techniciens ambulanciers paramédics et sur les inhalothérapeutes au Québec, basées sur l'analyse des projets professionnels défendus par leurs représentants associatifs. Les projets et les stratégies des deux groupes, qui étaient jusque-là différents, tendent à converger après 1995. À partir de ce moment, les deux groupes minimisent leur relation aux machines et à la technologie. Ils revendiquent plutôt de nouvelles tâches axées sur l'évaluation clinique et l'intervention en première ligne. Nous avançons que ce sont les réformes publiques qui façonnent cette évolution des projets professionnels, des stratégies politiques, et même des préférences cliniques, des professions de la santé après 1995.
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Terapia Respiratoria , Quebec , Humanos , Historia del Siglo XX , Historia del Siglo XXI , Técnicos Medios en Salud , Ambulancias , Reforma de la Atención de Salud/organización & administración , Auxiliares de UrgenciaRESUMEN
Brouwer's philosophy of mathematics is usually regarded as an intra-subjective, even solipsistic approach, an approach that also underlies his mathematical intuitionism, as he strived to create a mathematics that develops out of something inner and a-linguistic. Thus, points of connection between Brouwer's mathematical views and his views about and the social world seem improbable and are rarely mentioned in the literature. The current paper aims to challenge and change that. The paper employs a socially oriented prism to examine Brouwer's views on the construction, use, and practice of mathematics. It focuses on Brouwer's views on language, his social interactions, and the importance of group context as they appear in the significs dialogues. It does so by exploring the establishment and dissolution of the significs movement, focusing on Gerrit Mannoury's influence and relationship with Brouwer and analyzing several fragments from the significs dialogues while emphasizing the role Brouwer ascribed to groups in forming and sharing new ideas. The paper concludes by raising two questions that challenge common historical and philosophical readings of intuitionism.