ABSTRACT
Passage of the Occupational Safety and Health Act in 1971 represented a major milestone for occupational and environmental medicine. Creation of the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) flowed directly from the legislation, and the specialty of occupational medicine entered a new era. As the 25th anniversaries of OSHA and NIOSH are celebrated, consideration of the future of the specialty of occupational and environmental medicine seems timely. In this lecture, an expanded role for the specialty is proposed, based on an analysis of the forces shaping the practice of public health and the opportunities that these forces present. This analysis suggests considering the concept of a "Chief Health Officer" serving the broad health needs of the workplace.
Subject(s)
Environmental Medicine/trends , Occupational Health Services/organization & administration , Occupational Medicine/trends , Cost-Benefit Analysis , Education, Medical, Continuing , Environmental Medicine/education , Environmental Medicine/organization & administration , Humans , Information Systems , Leadership , Occupational Medicine/education , Occupational Medicine/organization & administration , Organizational Innovation , United StatesABSTRACT
This review presents historical and cost-effectiveness perspectives of prevention in health care; discusses the nature, extent, and determinants of health system change, particularly the transition to managed care with large integrated health care corporations; and identifies implications for public health agencies and opportunities for prevention within the reforming health system.
Subject(s)
Health Care Reform/organization & administration , Preventive Health Services/organization & administration , Public Health Administration , Cause of Death , Cost-Benefit Analysis , Female , Humans , Male , Managed Care Programs/organization & administration , Medicaid , Organizational Innovation , United States/epidemiologyABSTRACT
Despite growing numbers of internships and residencies offering training in hypnotherapy, no systematic attempt has been made to assess hypnotherapy beliefs and use among former trainees in these settings. This study investigated posttraining hypnotherapy use and effectiveness beliefs in a sample of 77 former psychiatry residents and psychology interns. Over 50% of the study sample had sought additional hypnotherapy training beyond the standard lectures and seminars, and almost 30% had attended external hypnotherapy workshops or presentations. Beliefs in hypnotherapy effectiveness were high, but use of hypnotherapy in clinical practice was very low. Former residents and interns who had received supervised training with patients, who had attended hypnosis workshops, and who had a colleague using hypnotherapy were more likely to use hypnotherapy following training.
Subject(s)
Attitude of Health Personnel , Hypnosis , Internship and Residency , Internship, Nonmedical , Psychiatry/education , Psychology, Clinical/education , Adult , Curriculum , Female , Humans , MaleABSTRACT
Attitudes toward and actual use of hypnotherapeutic techniques with psychotic patients were assessed. Results are discussed in light of historical and current attitudes toward the use of hypnosis with psychotics. Respondents were selected from the 1980 membership directory of the Society for Clinical and Experimental Hypnosis (SCEH). 80 respondents completed and returned the survey. Results indicate that the perceived usefulness of hypnosis with psychotics is currently quite high and negative attitudes toward its use quite low. The growth of the use of hypnotherapeutic techniques and the need for further research are discussed.
Subject(s)
Attitude of Health Personnel , Hypnosis/methods , Psychotic Disorders/therapy , Adult , Female , Humans , Male , Middle Aged , Psychotic Disorders/psychologyABSTRACT
Five experimental approaches to the resolution of the century-old Bernheim/Janet dispute and the issue of involuntariness or coercion (the classical suggestion effect) are presented. Four experiments are reported that follow one of the approaches: attempts to induce hypnotic subjects to resist suggestions made in trance. The design is one in which a "resistance instructor" proposes a reward for the resisting subject. Tentative inferences from the results are that the classical suggestion effect is found with a small number of subjects; for a larger number of subjects there is no classical suggestion effect, and for many subjects the outcome is equivocal. Relational factors in the hypnotic dyad influence responsiveness in the subject, the effect being least for those whose susceptibility is high.
Subject(s)
Coercion , Hypnosis , Internal-External Control , Volition , Adult , Confounding Factors, Epidemiologic , Female , Humans , Male , Reproducibility of ResultsABSTRACT
The purpose of this investigation was to assess the ability of hypnotic Ss to voluntarily resist a neutral suggestion when a monetary reward is offered for resistance. 19 of 40 Ss (47.5%) successfully resisted after money was offered by the "resistance instructor." The correlation between resistance/compliance and hypnotizability was -.44 (high hypnotizables were more likely to comply). Ss' impressions of the hypnotist tended to be positive; impressions of the resistance instructor tended to be neutral. There was a tendency for nonresistors to have a more positive view of the hypnotist but it is not as marked as was found in an earlier study (Levitt & Baker, 1983).