Despite its effectiveness, limited research has examined the provision of telemental health and how practices may vary according to treatment paradigm. We surveyed 276 community mental health providers registered with a commercial telemedicine platform. Most providers reported primarily offering TMH services to adults with anxiety, depression, and trauma-and stressor-related disorders in individual therapy formats. Approximately 82% of TMH providers reported endorsing the use of Cognitive Behavioral Therapy in their remote practice. The most commonly used in-session and between-session exercises included coping (...) and emotion regulation, problem solving, mindfulness, interpersonal skills, relaxation, and modifying and addressing core beliefs. CBT TMH providers had a higher odds of using in-session and homework exercises and assigning them through postal mail, email or fax methods, as compared to non-CBT TMH providers. TMH providers, regardless of treatment paradigm, felt that assigning homework was neither easy nor difficult and they believed their patients were somewhat-to-moderately compliant to their assigned exercises. CBT TMH providers also collected clinical information from their patients more often than non-CBT TMH providers. They reported being less satisfied with their method, which was identified most often as paper-based surveys and forms. Overall, TMH providers employ evidence-based treatments to their patients remotely, with CBT TMH providers most likely to do so. Findings highlight the need for innovative solutions to improve how TMH providers that endorse following the CBT treatment paradigm remotely assign homework and collect clinical data to increase their satisfaction via telemedicine. (shrink)

This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

Review of: R. Steven Turner, In the Eye's Mind: Vision and the Helmholtz-Hering Controversy. xiv + 338 pp., frontis., illus., figs., tables, bibl., index. Princeton, N.J.: Princeton University Press, 1994.

Much speculation on the sources of Duhem's historical interests fails to account for the major shifts in these interests: neither his belief in the continuous development of physics nor his Catholicism, when his Church was encouraging the study of generally Aristotelian scholastic thought, led to any interest in mediaeval science before 1904. Equally, his own claim that he was merely testing his views on the nature of physical theory is easily squared only with earlier work with no trace of mediaeval (...) science. Behind this discontinuity lies a major crisis. Though not a positivist, Duhem had based all his work on assumptions acceptable to positivists. One of these, the sterility of the Middle Ages, was refuted by his chance discovery of evidence of genuine mediaeval science in the autumn of 1903, but that left the doctrine of scholastic sterility intact. (shrink)

Contrary to what might be expected given a religious or other motivation, Pierre Duhem's interest in mediaeval science was the result of his surprise encounter with Jordanus de Nemore while working on Les origines de la statique in the late autumn of 1903. Historical assumptions common among physicists at that time may explain this surprise, which occasioned a frantic search for more mediaeval precursors for Renaissance mechanics. It also raised serious historiographical problems that threatened even his methodological views, until they (...) were resolved in his To save the phenomena of 1908. (shrink)

Sex chromosomes are advantageous to mammals, allowing them to adopt a genetic rather than environmental sex determination system. However, sex chromosome evolution also carries a burden, because it results in an imbalance in gene dosage between females (XX) and males (XY). This imbalance is resolved by X dosage compensation, which comprises both X chromosome inactivation and X chromosome upregulation. X dosage compensation has been well characterized in the soma, but not in the germ line. Germ cells face a special challenge, (...) because genome wide reprogramming erases epigenetic marks responsible for maintaining the X dosage compensated state. Here we explain how evolution has influenced the gene content and germ line specialization of the mammalian sex chromosomes. We discuss new research uncovering unusual X dosage compensation states in germ cells, which we postulate influence sexual dimorphisms in germ line development and cause infertility in individuals with sex chromosome aneuploidy. (shrink)

This article highlights the distinction between the ‘art of nursing’ and ‘fine art’. While something in the nature of nursing can be described as ‘the art of nursing’, it is not to be misunderstood as ‘fine art’ or craft. Therefore, the term ‘aesthetic’ in relation to nursing should not be linked to the aesthetic of modern art, but instead to a broader and more general meaning of the word. The paper's main focus is the aesthetic experience, which is treated in (...) a hermeneutic way and elucidated from classical sources and the philosophy of nursing and from Art. The paper argues that the pioneers used the term ‘art of nursing’ in a metaphorical way to say something more specific on the nature of nursing. The term illustrates the nurse's ability to practise at the highest possible level of excellence. (shrink)

The dominant view of women has changed radically during the last century. These changes have had an important impact on the way of life of women in general and, undoubtedly, on women as patients. So far, gender differences have received little attention when developing healthcare services. Stroke hits a great number of elderly women. Wyller et al. found that women seemed to be harder hit by stroke than men; they achieved lower scores in tests of motor, cognitive and ADL functions, (...) both in the acute phase and 1 year after stroke. It is reasonable to expect that differences in outcome among male and female sufferers may in part be explained by the fact that rehabilitation services are designed primarily to meet the needs of men. de Beauvoir's feminist theory maintains that one's body is fundamental in creating the person, which is a lifelong process. Traditionally, the female body has been exposed to alienation and oppression through life. This has led women to develop a life in immanence. This we feel can be of significance in connection with rehabilitation after a stroke, particularly for elderly women. In this article we will discuss how de Beauvoir's theory can throw new light on the experiences and rehabilitation of elderly women and point to ways of improving the process of rehabilitation. (shrink)

This paper first appeared in Modern Theology, Vol. 6, No. 3, July 1989. Copyright (c) Basil Blackwell Publisher Ltd., Oxford. Reprinted by permission.

Writers on jurisprudence often stress that conflict between positive laws and morality does not invalidate the positive laws. A law which requires me to compensate another for an injury caused by a dangerous object kept on my property is not invalidated by the fact that I have not been negligent and have no moral obligation to compensate the injured person. And although I have a moral obligation to keep my promises, positive laws may validly imply that I need not keep (...) promises not made for a consideration or under seal. Thus positive law may permit acts not permitted by morals and may forbid acts permitted by morals. The lesson drawn from these thoughts is that to establish a positive law as valid we need not consider the relationships it bears to the rules of morals. A valid law is simply a law created in accordance with the constitutional conventions or ‘rules of recognition’ of the society in which it is to be applied. It is the manner of its establishment, not its relationship to morals, which makes a law valid. (shrink)

The aim of the essay is to devise a logic of conditionality which escapes the paradoxes which arise when the general conditional is identified with the universalization of the material conditional. The assumption I adopt is that the logic of one contingent form differs from that of another to the extent that the two forms have different confirmations and disconfirmations. The logic of conditionals is not, But that of their confirmations and disconfirmations is, At bottom truth-Functional; and the logical relations (...) between conditionals, And between conditionals and non-Conditionals, May be traced through the truth-Functional connections between their respective confirmations and disconfirmations. The approach necessitates the re-Definition of the notions of confirmation and entailment. A peculiarity of the system which emerges is that from it can be derived, Without existential assumptions, The twenty-Four valid forms of the syllogism, The relationships of the square of opposition and the other commonly accepted inferences of traditional logic. (shrink)

Is an ethical leader an oxymoron? Society demands and expects greater accountability from organizational leaders. The literature on leadership, especially business leadership, has neglected ethical issues by focusing only on those approaches and strategies that emphasize self-centred, individualistic concerns. How ever, true and effective leadership is one in which the leader's behaviour and the exercise of the leadership influence process are consistent with ethical and moral values. The authors argue that our understanding of leadership is incomplete, if not deformed, if (...) it does not include the three critical dimensions of ethical leadership. (shrink)

The nature of quantum waves, whether they are real physical waves or, on the contrary, mere probability waves, has been a very controversial theme since the beginning of quantum theory. Here we present some possible experiments that may clarify the problem.