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[Human abnormalities--their importance in the world view during antiquity and the early Middle Ages].

In consideration of the experience that also in our present day society the development of a handicapped baby is understood by some as the visible result of a morally guilty behaviour of the parents, the present study raises the question, whether the identification of physical appearance and moral attitude has been in a certain historical epoch the preferred approach in science for understanding the origin of human malformations. After the treatment of the teratological theories in greek medicine and aristotelian natural philosophy the question of the origin of human malformation is examined in Pliny's "Historia naturalis" and Augustine's "De civitate dei". A comparison between the theories presented shows that the moral interpretation of human malformation is an inevitable consequence of the augustinian theological thinking.

Congenital Abnormalities↗

Cigarette smoking and khat chewing among university instructors in Ethiopia.

OBJECTIVE: To assess the prevalence and risk factors of cigarette smoking and khat chewing. DESIGN: College based cross sectional. SETTING: Four colleges found in north west Ethiopia namely Gondar College of Medical Sciences, Gondar College of Teachers Education, Bahr Dar University Engineering Faculty, and Bahr Dar University Education Faculty. SUBJECTS: All instructors in these colleges. MAIN OUTCOME MEASURES: Prevalence of cigarette smoking and khat chewing. RESULTS: Seventy six (42.0%) instructors were either lifetime smokers or lifetime khat chewers or both. The current prevalence rates of cigarette smoking and khat chewing were found to be 13.3% and 21.0%, respectively. The majority of the instructors started smoking (56.8%) and khat chewing (40.0%) while they were senior high school or first year college students. Most of the instructors (82.1%) knew that cigarette smoking is a risk factor for lung diseases including lung cancer. Statistically significant difference (p<0.05) was seen between the outcome variable and the independent variables faculty, religion, education status, income and family history of khat chewing. CONCLUSION: The prevalence of cigarette smoking seemed to decrease among university instructors but the prevalence of khat chewing is almost the same as it was some years ago. Instructors knew the common health risks associated with cigarette smoking. The high schools and colleges should inform their students about the health and socioeconomic problems associated with cigarette smoking and khat chewing. Additionally, college students need counseling service on ways of coping with their problems.

Adult↗

Attitudes of osteopathic physicians toward physician-assisted suicide.

The use of physician-assisted suicide (PAS) in the care of terminally ill patients is controversial. While there are published surveys assessing the attitudes and views of physicians in certain specialties, both nationally and in targeted geographic areas, no such data are available specifically pertaining to osteopathic physicians, who deliver 9% of the primary care in the United States. This article describes a study whose purpose was to identify the views and perspectives of osteopathic physicians on PAS through a national survey. Questionnaires were forwarded to all board-certified internists who are members of the American College of Osteopathic Internists and all surgeons and a random sample of family physicians who are members of the American Osteopathic Association. Physicians were surveyed with initial and follow-up mailings. The 49-item questionnaire was a modified version of the Physician Survey, Center for Ethics in Health Care: Oregon Health Sciences University. Of the 2910 questionnaires that were mailed, 1028 were returned in a usable form, for a 35% response rate. Respondents were predominantly (81%) male and from all parts of the country. Most (58%) would not be willing to prescribe a medication for a competent, terminally ill patient to use with the primary intention of ending his or her own life, and most (55%) would oppose the legalization of PAS. Thirty-three percent of osteopathic physicians admit to receiving requests by terminally ill patients for PAS. Most (53%) osteopathic physicians indicate that the osteopathic principle of holistic care has influenced their decision-making on this issue, and a significant minority (44%) responded that the osteopathic oath influenced their view on PAS. Religion and the degree of prayer frequency were important predictors of the decisions to support or oppose PAS. When compared to other physician surveys, this survey of osteopathic physicians demonstrates some similarities in response but also significant differences. These data suggest that osteopathic education and training may result in a perspective on PAS that reflects the distinctiveness of the osteopathic profession.

Adult↗

[The visual process as a theological analog of Roger Bacon's eye anatomy and physiology].

The author presents Roger Bacon's conception of the anatomy and physiology of the human eye. The knowledge of ocular function is a precondition to understand the laws of the "perspectiva", the science of seeing. But Bacon doesn't stress perspective per se. The physical laws of light, which are to be analysed in geometrical forms, are analogous to those of the infusion of divine grace. Optics (in the Middle Ages synonymous with perspective) seemed to be the model by which God spread his grace to the world. To understand the physical laws of optics meant that one might gain insight into the nature of God.

England↗

An attempt to elucidate the concept of "folk dietary tradition".

Nutrition is a complex interdisciplinary science. It is an intersection point of a number of other sciences such as biology, economics, technology, ethnography, medicine, history, linguistics, politics. Folk dietary tradition is a normative nutritional system that is used by an already formed community. As no definition is available we analysed the term and, on the basis of our extensive research, came to the following conclusion: folk dietary tradition is constituted together with the establishment of the community for the purpose of consolidating it as well as for differentiating it from other communities; it reflects the historical development and the destiny of the specific community; it changes, becomes enriched or poorer, or loses its originality; it can be formed using previous, local dietary traditions that precede the formation of a community, or can be borrowed by other peoples which are in the process of introducing a new religion. During its golden age Bulgaria introduced its folk dietary tradition to the peoples converted by Bulgaria to Christianity. In the present study I give a definition of the basic characteristics of the Bulgarian folk dietary tradition. This definition can be used to analyse all folk dietary traditions and make comparison between them.

Bulgaria↗

The drug-use patterns of helping-profession students in Brisbane, Australia.

A survey of 1691 first-and final-year students in the helping professions (medicine, law, nursing, pharmacy, police science, seminary, social work/ psychology, and teaching) as to their use of drugs was carried out during February to April, 1980, in Brisbane, Australia. The results indicated that about 86% drank coffee or tea, 85% drank alcohol, 85% used non-prescription analgesics, 31% used tobacco, 25% antihistamines, 9% marijuana, 9% sedatives, 6% tranquilizers, 2% hallucinogens, 2% stimulants, 1% cocaine and 1% used opiates at least once a year. Of these students, females used analgesics and antihistamines significantly more frequently than males and consumed more caffeine, tobacco and analgesics than males, while males drank significantly more alcohol than females. Final-year students used more alcohol, coffee or tea and tobacco, and used marijuana, coffee and tea and tobacco significantly more frequently than first-year students. Individuals who did not consider religion important used more alcohol and tobacco and used marijuana, tobacco and hallucinogens more frequently compared to individuals who considered religion to be important. There was also a significant difference in drug usage between the different courses of study for most of the substances, with law students using the majority of substances the most frequently and seminarians the least frequently.

Analgesics↗

Suffering: toward a contextual praxis.

Janice M. Morse's article in Advances in Nursing Science (24:1) revised and summarized the major findings of a research program exploring the behavioral-experiential nature of suffering. Using a feminist critical theory stance, this article addresses Morse's conceptualization of a praxis of suffering. First, it identifies the strengths and contributions of Morse's body of research to nursing science. Next, it undertakes a critique situated in feminist critical theory in which the limitations of Morse's work are explored using exemplars from the Western literary tradition. Finally, the article proposes a new conceptualization of an alternative contextual praxis of suffering in which nurses' responses to suffering are situated in an emancipatory paradigm of authentic presence.

Adaptation, Psychological↗

[Problem-posing as a nutritional education strategy with obese teenagers].

Obesity is a public health issue with relevant social determinants in its etiology and where interventions with teenagers encounter complex biopsychological conditions. This study evaluated intervention in nutritional education through a problem-posing approach with 22 obese teenagers, treated collectively and individually for eight months. Speech acts were collected through the use of word cards, observer recording, and tape-recording. The study adopted a qualitative methodology, and the approach involved content analysis. Problem-posing facilitated changes in eating behavior, triggering reflections on nutritional practices, family circumstances, social stigma, interaction with health professionals, and religion. Teenagers under individual care posed problems more effectively in relation to eating, while those under collective care posed problems in relation to family and psychological issues, with effective qualitative eating changes in both groups. The intervention helped teenagers understand their life history and determinants of eating behaviors, spontaneously implementing eating changes and making them aware of possibilities for maintaining the new practices and autonomously exercising their role as protagonists in their own health care.

Adolescent↗

Practitioners and saints: medical men in canonization processes in the thirteenth to fifteenth centuries.

This article shows that recourse to expert medical judgement for authenticating miracles has medieval roots which lead to the thirteenth century. It provides a survey of those cases in the printed versions of canonization processes from c. 1200 to c. 1500 where medical men actively appeared as witnesses. It shows how, from the second half of the thirteenth century, many canonization processes (overwhelmingly in southern Europe) included at least one medical man who witnessed or gave expert testimony as a supplier of medicine. The physicians who appeared as expert witnesses were expected to rule out the possibility that there was a natural explanation for the wonderous cure. To acquire medical confirmation that a certain cure was miraculous seemed highly desirable to those wishing to substantiate claims of sanctity. Physician witnesses were often called upon to evaluate cases of which they had personal knowledge because of the medical know-how they possessed: however, medical science was not considered so universal that any physician could review the case (as is theoretically the case today in the medical council at the Vatican). Thus, to the therapeutic function of physicians and surgeons in southern Europe from the second half of the thirteenth century, a hitherto neglected duty should be added: whenever necessary, the community as well as the local ecclesiastical authorities expected the suppliers of medical services to contribute to the formal recognition of an apparent saint.

Catholicism↗

The temple and the plane tree: rationality and cult at the beginnings of western medicine.

There are multiple interrelationships between science, medicine and visual arts. This article discusses aspects of architecture associated with the Greek healing cult of Asklepios, the case in point being the Asklepios temple on the island of Kos in the Aegean. Further, the cult is contrasted with the beginnings of the observation-based medicine practised by Hippocrates (460-c.370 BC). Finally, it is suggested that including elements of visual arts in medical education is consistent with the aims of the new medical curricula.

Education, Medical↗

The moral of her story: exploring the philosophical and religious commitments in Mary Whiton Calkins' self-psychology.

Over the course of 3 decades, from the turn of the century to the late 1920s, Mary Whiton Calkins articulated and defended a system of self-psychology that held that psychology as a field should be organized as the science of selves. Calkins' system was far from popular at the time, which leads one to question why she persisted in dedicating herself to the cause of defending it. Previous research has sought answers to this question through examination of Calkins' experience as a faculty member at Wellesley College. In this article it is additonally argued that Calkins was not prepared to abandon her system of self-psychology because it was intricately connected to her ideas about ethics and morality.

History, 19th Century↗

A philosophical inquiry to include trance in epistemology.

In a state of voluntary trance or meditation, the perception of reality appears to extend beyond the usual spatial and temporal boundaries that are normally perceived by the sense organs. It is argued that the problems of validity and reliability of trance experiences for scientific discourse are in principle no different than the problems associated with ordinary perception. The shift in early Greek philosophy from myth to an emphasis on logos (reason) has led to a neglect of those subtle qualities of reason that were considered to be gateways for divine revelation. Scientific methodologies cannot account for such revelation, and there are no criteria known to science that would enable people to utilize these phenomena. Shamanic experiences are intersubjectively accessible and provide data that is suitable for the construction of rational theories if appropriate methodologies are developed. However, for a scientist, shamanic experiences are considered at most to be psychological ones, and consequently without any value for empirical research. This article examines the possibility of reevaluating the terms "rational" and "consciousness," in order to expand scientific methodologies in such a way that volitionally altered perceptions of reality can be integrated into scientific research.

Culture↗

[Mythology and the medicinal plants of antiquity].

In any civilization, nature is closely bound to the world of divinities. This is clearly seen in the Mediterranean world of Antiquity in every reference to the medicinal plants. Our aim, in this study, was to demonstrate the link between mythology and medicine. Through several centuries of medicinal practice, appears a therapeutic knowledge close to become a science. In spite of many gaps, errors and illusions thus emerges a first attempt to master the art of healing. Is it possible to speculate on a new type of drug research guided from ancient texts? Ethnopharmacology investigating medicinal traditions of the world has already obtained in this field some spectacular findings. At the moment, it would be difficult to predict the future of archeopharmacology but as Paul Valery said: "Present is nothing else than a future nutriment for the past".

History, Ancient↗

Pastoral care in a time of global market capitalism.

The author defines pastoral theology as "the study of the micro-world of intrapsychic and interpersonal interactions with the tools of theology and the social sciences for the purpose of support and healing. In a typical class or supervisory session, we analyze the words, voice inflection, pace, and gestures of an intimate conversation between two people, looking for clues to the deep structure of personality and intimate relationships. The hope of such study is that we will see the revelation of God is love and power in action to validate and challenge the theological traditions that give us eyes to see and invite us to see more clearly."

Capitalism↗

[Self-starvation over 1500 years: the work of God, the devil or weight-control?].

For centuries self-starvation among young women has been the subject of intensive discussion. First and foremost it has been a question of debate over aetiological models. During the middle ages, the central issue was whether self-starvation was the work of God or the devil. Subsequently the question was whether the explanation was scientific or religious. The aim of medical science was to find a scientific explanation or debunk the phenomenon as fraudulent. The causes of self-starvation remain unclear. During the nineteenth century, the focus switched back and forth between biological and psychosocial models. Current multifactorial aetiological models take into account biological susceptibility, socio-cultural factors and psychological vulnerability.

Adolescent↗

The Discipline: its impact on my theological perspective, pastoral identity and practice.

This article is a personal interpretation of how The Discipline has re-formulated the pastoral identity, practice, and theology of a board certified chaplain providing ministry to patients in the heart sciences. His reflections take into account his history as an ordained priest and as a professionally trained chaplain. The article reflects his struggles and theological transformations, demonstrating how a theological base may emerge from the interpretative reflection on The Discipline. The article describes the uneasy internal and external processes that occurred in and around him during that transformation. His story also attests to growth made "from the inside out" as a chaplain within a generative multi-faith department.

Anecdotes as Topic↗

The autopsy: experience of a regional neonatal intensive care unit.

Autopsy rates have declined steadily throughout the 1970s and 1980s. This trend, if not reversed, could negatively affect information provided to families as well as the training of physicians. In the 1980s, low autopsy rates among neonatal deaths, 50-72%, were attributed to limited parental understanding and to physicians' attitudes. In the early 1990s, alternatives to the routine autopsy, such as limited endoscopic/needle autopsies, were widely popularised, and the physician's education about autopsy vigorously addressed. The effects of these efforts on autopsy rates in the latter part of the 1990s have not been well studied. The study population consisted of 643 infants who died at an Ohio, USA, neonatal intensive care unit (NICU) between 1 January 1986 and 31 December 1998. Neonatologists obtained consent for autopsy. Information obtained from the computer database included birth hospital, gestational age, age at death, birth and death weight, race, sex, death year and maternal age, religion, gravidity and parity. The overall autopsy rate during the 13-year study period was 54% [95% CI 44.1%, 63.1%]. There was a trend towards progressive decrease in autopsy rates, 59% in 1986-89, 52% in 1990-94 and 47% in 1995-98 (P = 0.078). Autopsy was associated with increasing gestational age (P < 0.001) and decreasing parity [OR = 0.53 for >2 compared with <or=2, 95% CI 0.36, 0.99], but not with other variables. Autopsy rates remain suboptimum and may be declining despite efforts at educating the medical and general community about its benefits. Among infants who die in the NICU, autopsy is more likely the more mature the infant at birth and the fewer children the mother has. Physicians need to seek autopsy more conscientiously, with consideration for the emotional well-being of the family, and for its potential diagnostic and research value to science.

Age Distribution↗