Psychology and women’s studies: Epistemological dilemma or opportunity?

Women used to be relegated to the periphery in psychology: most of us were not really heard as primary members of our discipline. Moreover, fundamental concepts and methods were developed by men about men, and applied to women only as an afterthought and without due process. Recently, more women are speaking straightforwardly from their experiences and are beginning to be heard with increasing respect, though change is slow. Concurrently, Women's Studies is coming to its own as an academic discipline. Now it is paradoxical that as women psychologists, many of us find ourselves with one foot in each of two different worlds—one in psychology and the other in women's studies. As I reflect on what it must have been like for women many years ago in psychology and on how that experience has (and has not) changed in my generation, I am coming to appreciate the intellectual challenge which I face. In this essay I discuss several epistemological and methodological issues in Women's Studies which are relevant to psychology in an attempt to bring both of my feet closer together. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Competency or incompetency--the dilemma

RATIONALE AND OBJECTIVES: Simplifying data collection and analysis should promote utilization management in review of examinations of the small bowel in the general practice. METHODS: A case control format with the generation of an odds ratio to answer sets of binary questions derived from annual examination data is shown. The positive examination results applied were compared with the literature as a cross-checking mechanism. The examination identified as most likely to be positive was recommended prospectively in a protocol for the following year. Two of 5 years are illustrated to emphasize the development of the methodology. RESULTS: Application of this model in testing its validity, since 1990 at Madigan Army Medical Center, allows for the generation of a new protocol each year to prospectively improve clinical definition. CONCLUSIONS: A 5-year analysis of small bowel examination protocols, subdivisions, and odds ratios, will be forthcoming. The 2 years illustrated show how strongly our practice was influenced in using enteroclysis or in using the small bowel follow through as the examination of choice in the various clinical categories of small bowel disease: (1) practice was influenced by protocol and (2) outcome was steered toward positive examinations.     

Personal paper: medicine in the 1990s needs a team approach

Health care increasingly emphasises the team approach in which doctors, nurses, and other health workers adapt and develop new skills. Before changes of this kind are widely accepted, however, there must be clarity about the training, status, authority, working relationships, career structure, and remuneration of those who undertake responsibilities well beyond their traditional roles.     

The psychologist’s dilemma: To subject the self to science—or science to the self?

William James, one of the major founders of modern scientific psychology, spoke often about "the psychologist's fallacy." This fallacy resulted (and still results) from the tendency of psychologists to confuse their analyses of subjective experience with the nature of so-called objective reality. A related, though less attended problem revolved (and revolves) around what I shall call "the psychologist's dilemma." Although this latter problem was shared by other psychologists at the turn of this century, I will discuss it with special reference to the thought and work of William James. I have chosen to do so partially because James's own psychological and philosophical works reflect the import and centrality of this dilemma in the history of the human sciences, and partially in recognition and honor of the one hundredth anniversary of James's two-volume masterpiece, The Principles of Psychology, which will be celebrated in 1990. As I hope will be clear, this dilemma continues to be relevant to the concerns of contemporary psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Managed care in a new key: Britain's strategies for the 1990s

The new Labour government in Britain has issued three variations of a White Paper that outline significant changes in how the world's largest managed care health system will be run. All three emphasize systemwide criteria for quality, effectiveness, and health gain, which in turn imply redressing past inequalities in funding and service. One, the Scottish Paper, eliminates Thatcher's internal market and returns to a simple organizational structure centering on the health boards. The other two propose combining primary care practices into purchasing groups, a daunting task that will spawn many new problems and expenses as it recreates the internal market.     

The professions in the 1990s

As they did when they were formed 150 years ago, the professions must again convince the public and a cost-conscious and competition-orientated Government that they should be entrusted with the provision of services their training has made them fit to offer. This article explains why.     

Selective shunts in the 1990s

Venous thrombosis is a well-known complication of permanent cardiac pacemaker implantation, particularly, chronic occlusion of the subclavian vein is reported to occur in 20-33% of the cases where the percutaneous approach is performed. We examined 135 asymptomatic patients with digital venography to asses the frequency of venous thromboses causing stenosis and occlusion of the subclavian or anonymous arteries in pacemaker carriers. We considered both one- (44) and two-chamber (91) pacemakers and investigated a possible statistically significant difference between them: we found 21 venous thromboses (15%), seven of them in one-chamber pacemakers (15.9%) and 14 two-chambers pacemakers (15.3%). None of our 94 male and 41 female patients was on anticoagulants or had any evidence of coagulation disorders. Venography was performed 39.3 months (mean) after pacemaker implantation (range: 3-120 months). We conclude that digital venography is a simple and relatively noninvasive method permitting better depiction of subclavian, anonymous and caval veins than Doppler US and also showing some vascular abnormalities which may complicate pacemaker implantation.     

Hypospadias repair in the 1990s

Hypospadias is a congenital anomaly in which the urethral meatus is abnormally located anywhere from the glans to the perineum. Refinements in pediatric anesthesia, surgical technique and instrumentation, and a greater understanding of the psychologic and emotional issues related to hypospadias repair have led to this procedure being performed at an earlier age. The goal of reconstruction is to bring the urethral meatus to the tip of the penis, to correct associated penile curvature if present, to create a conical-shaped glans, and to achieve cosmetically acceptable penile shaft skin coverage. The surgical technique employed varies with the penile anatomy and surgeon's preference. Complications may occur both immediately and long after the surgical procedure, and thus follow-up is necessary.     

Dynamic cost shifting in hospitals: evidence from the 1980s and 1990s

The purpose of this paper is to determine whether dynamic cost shifting occurred among acute care hospitals during the period from the early 1980s to the early 1990s and, if so, whether market factors affected the ability to shift costs. Evidence from this study of California acute care hospitals during three time intervals shows that the hospital did practice dynamic cost shifting, but that their ability to shift costs decreased over time. Surprisingly, hospital competition and HMO penetration did not influence cost shifting. However, increasing HMO penetration (measured as the HMO percentage of hospital discharges) did decrease both net prices and costs for the early part of the study, but later was associated with increases in both.