Toward a biopsychosocial understanding of the patient-physician relationship: an emerging dialogue

Complexity theory has been used to view the patient-physician relationship as constituted by complex responsive processes of relating. It describes an emergent, psychosocial relational process through which patients and physicians continually and reciprocally influence each other\u27s behavior and experience. As psychosocial responses are necessarily biopsychosocial responses, patients and physicians must likewise be influencing each other\u27s psychobiology. This mutual influence may be subjectively experienced as empathy, and may be skillfully employed by the clinician to directly improve the patient\u27s psychobiology

The history of the present illness as treatment: who\u27s listening, and why does it matter?

BACKGROUND: The history of the present illness (HPI) is examined as a narrative communication that has the potential to be therapeutic. METHODS: The general principles that influence the therapeutic potential of the HPI are induced from participant observation of personal experience and natural observations of conventional social interaction. These principles are corroborated by evidence from cross-cultural healing practices, clinical experience, and experimental psychology. RESULTS: To facilitate a therapeutic HPI, the clinician should convey a sense of safety, sensitivity, affective competence, and cognitive competence. Furthermore, the effective clinician joins the patient in coprocessing the illness experience. CONCLUSIONS: The (HPI) is not simply a diagnostic formulation. When skillfully negotiated, it can be therapeutic because it helps patients make cognitive sense of their illness, and it serves as a vehicle for sharing the affective burden with the physician. There is therapeutic potential in each of the three overlapping operations of the HPI: (1) establishing a physician-patient relationship through the process of gathering a database, (2) transforming the database into an etiologic narrative, and (3) using the narrative to coprocess the experience of illness with the patient. The therapeutic potential can be actualized by specific clinical applications

Relationships between scores on the Jefferson Scale of physician empathy, patient perceptions of physician empathy, and humanistic approaches to patient care: a validity study.

BACKGROUND: Empathy is the backbone of a positive physician-patient relationship. Physician empathy and the patient\u27s awareness of the physician\u27s empathic concern can lead to a more positive clinical outcome. MATERIAL/METHODS: The Jefferson Scale of Physician Empathy (JSPE) was completed by 36 physicians in the Family Medicine residency program at Thomas Jefferson University Hospital, and 90 patients evaluated these physicians by completing the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a survey about physicians\u27 humanistic approaches to patient care. RESULTS: A statistically significant correlation was found between scores of the JSPE and JSPPPE (r=0.48, p CONCLUSIONS: These findings provide further support for the validity of the JSPE. Implications for the assessments of empathy in the physician-patient relationship as related to clinical outcomes are discussed

The doctor-patient relationship revisited. An analysis of the placebo effect.

An overview of prescientific medicine, evolution, and individual human development is presented in an attempt to discover the generic factors operating in all interpersonal therapies. We hypothesize that the placebo effect rests on the universal human need for a group and, by symbolic extension, a system

Elliptic flow in Au+Au collisions at sqrt sNN = 130 GeV

Elliptic flow from nuclear collisions is a hadronic observable sensitive to the early stages of system evolution. We report first results on elliptic flow of charged particles at midrapidity in Au+Au collisions at sqrt[sNN] = 130 GeV using the STAR Time Projection Chamber at the Relativistic Heavy Ion Collider. The elliptic flow signal, v2, averaged over transverse momentum, reaches values of about 6% for relatively peripheral collisions and decreases for the more central collisions. This can be interpreted as the observation of a higher degree of thermalization than at lower collision energies. Pseudorapidity and transverse momentum dependence of elliptic flow are also presented.alle Autoren: K. H. Ackermann19, N. Adams28, C. Adler12, Z. Ahammed27, S. Ahmad28, C. Allgower13, J. Amsbaugh34, M. Anderson6, E. Anderssen17, H. Arnesen3, L. Arnold14, G. S. Averichev10, A. Baldwin16, J. Balewski13, O. Barannikova10,27, L. S. Barnby16, J. Baudot14, M. Beddo1, S. Bekele24, V. V. Belaga10, R. Bellwied35, S. Bennett35, J. Bercovitz17, J. Berger12, W. Betts24, H. Bichsel34, F. Bieser17, L. C. Bland13, M. Bloomer17, C. O. Blyth4, J. Boehm17, B. E. Bonner28, D. Bonnet14, R. Bossingham17, M. Botlo3, A. Boucham30, N. Bouillo30, S. Bouvier30, K. Bradley17, F. P. Brady6, E. S. Braithwaite2, W. Braithwaite2, A. Brandin21, R. L. Brown3, G. Brugalette34, C. Byrd2, H. Caines24, M. Calderón de la Barca Sánchez36, A. Cardenas27, L. Carr34, J. Carroll17, J. Castillo30, B. Caylor17, D. Cebra6, S. Chatopadhyay35, M. L. Chen3, W. Chen3, Y. Chen7, S. P. Chernenko10, M. Cherney9, A. Chikanian36, B. Choi31, J. Chrin9, W. Christie3, J. P. Coffin14, L. Conin30, C. Consiglio3, T. M. Cormier35, J. G. Cramer34, H. J. Crawford5, V. I. Danilov10, D. Dayton3, M. DeMello28, W. S. Deng16, A. A. Derevschikov26, M. Dialinas30, H. Diaz3, P. A. DeYoung8, L. Didenko3, D. Dimassimo3, J. Dioguardi3, W. Dominik32, C. Drancourt30, J. E. Draper6, V. B. Dunin10, J. C. Dunlop36, V. Eckardt19, W. R. Edwards17, L. G. Efimov10, T. Eggert19, V. Emelianov21, J. Engelage5, G. Eppley28, B. Erazmus30, A. Etkin3, P. Fachini29, C. Feliciano3, D. Ferenc6, M. I. Ferguson7, H. Fessler19, E. Finch36, V. Fine3, Y. Fisyak3, D. Flierl12, I. Flores5, K. J. Foley3, D. Fritz17, N. Gagunashvili10, J. Gans36, M. Gazdzicki12, M. Germain14, F. Geurts28, V. Ghazikhanian7, C. Gojak14, J. Grabski33, O. Grachov35, M. Grau3, D. Greiner17, L. Greiner5, V. Grigoriev21, D. Grosnick1, J. Gross9, G. Guilloux30, E. Gushin21, J. Hall35, T. J. Hallman3, D. Hardtke17, G. Harper34, J. W. Harris36, P. He5, M. Heffner6, S. Heppelmann25, T. Herston27, D. Hill1, B. Hippolyte14, A. Hirsch27, E. Hjort27, G. W. Hoffmann31, M. Horsley36, M. Howe34, H. Z. Huang7, T. J. Humanic24, H. Hümmler19, W. Hunt13, J. Hunter17, G. J. Igo7, A. Ishihara31, Yu. I. Ivanshin11, P. Jacobs17, W. W. Jacobs13, S. Jacobson17, R. Jared17, P. Jensen31, I. Johnson17, P. G. Jones4, E. Judd5, M. Kaneta17, M. Kaplan8, D. Keane16, V. P. Kenney23*, A. Khodinov21, J. Klay6, S. R. Klein17, A. Klyachko13, G. Koehler17, A. S. Konstantinov26, V. Kormilitsyne7,26, L. Kotchenda21, I. Kotov24, A. D. Kovalenko10, M. Kramer22, P. Kravtsov21, K. Krueger1, T. Krupien3, P. Kuczewski3, C. Kuhn14, G. J. Kunde36, C. L. Kunz8, R. Kh. Kutuev11, A. A. Kuznetsov10, L. Lakehal-Ayat30, J. Lamas-Valverde28, M. A. C. Lamont4, J. M. Landgraf3, S. Lange12, C. P. Lansdell31, B. Lasiuk36, F. Laue24, A. Lebedev3, T. LeCompte1, W. J. Leonhardt3, V. M. Leontiev26, P. Leszczynski33, M. J. LeVine3, Q. Li35, Q. Li17, Z. Li3, C.-J. Liaw3, J. Lin9, S. J. Lindenbaum22, V. Lindenstruth5, P. J. Lindstrom5, M. A. Lisa24, H. Liu16, T. Ljubicic3, W. J. Llope28, G. LoCurto19, H. Long7, R. S. Longacre3, M. Lopez-Noriega24, D. Lopiano1, W. A. Love3, J. R. Lutz14, D. Lynn3, L. Madansky15§, R. Maier19, R. Majka36, A. Maliszewski33, S. Margetis16, K. Marks17, R. Marstaller19, L. Martin30, J. Marx17, H. S. Matis17, Yu. A. Matulenko26, E. A. Matyushevski10, C. McParland17, T. S. McShane9, J. Meier9, Yu. Melnick26, A. Meschanin26, P. Middlekamp3, N. Mikhalin7,26, B. Miller3, Z. Milosevich8, N. G. Minaev26, B. Minor17, J. Mitchell15, E. Mogavero3, V. A. Moiseenko11, D. Moltz17, C. F. Moore31, V. Morozov17, R. Morse17, M. M. de Moura29, M. G. Munhoz29, G. S. Mutchler28, J. M. Nelson4, P. Nevski3, T. Ngo7, M. Nguyen3, T. Nguyen3, V. A. Nikitin11, L. V. Nogach26, T. Noggle17, B. Norman16, S. B. Nurushev26, T. Nussbaum28, J. Nystrand17, G. Odyniec17, A. Ogawa25, C. A. Ogilvie18, K. Olchanski3, M. Oldenburg19, D. Olson17, G. A. Ososkov10, G. Ott31, D. Padrazo3, G. Paic24, S. U. Pandey35, Y. Panebratsev10, S. Y. Panitkin16, A. I. Pavlinov26, T. Pawlak33, M. Pentia10, V. Perevotchikov3, W. Peryt33, V. A Petrov11, W. Pinganaud30, S. Pirogov7, E. Platner28, J. Pluta33, I. Polk3, N. Porile27, J. Porter3, A. M. Poskanzer17, E. Potrebenikova10, D. Prindle34, C. Pruneau35, J. Puskar-Pasewicz13, G. Rai17, J. Rasson17, O. Ravel30, R. L. Ray31, S. V. Razin10,13, D. Reichhold9, J. Reid34, R. E. Renfordt12, F. Retiere30, A. Ridiger21, J. Riso35, H. G. Ritter17, J. B. Roberts28, D. Roehrich12, O. V. Rogachevski10, J. L. Romero6, C. Roy30, D. Russ8, V. Rykov35, I. Sakrejda17, R. Sanchez7, Z. Sandler7, J. Sandweiss36, P. Sappenfield28, A. C. Saulys3, I. Savin11, J. Schambach31, R. P. Scharenberg27, J. Scheblien3, R. Scheetz3, R. Schlueter17, N. Schmitz19, L. S. Schroeder17, M. Schulz3,19, A. Schüttauf19, J. Sedlmeir3, J. Seger9, D. Seliverstov21, J. Seyboth19, P. Seyboth19, R. Seymour34, E. I. Shakaliev10, K. E. Shestermanov26, Y. Shi7, S. S. Shimanskii10, D. Shuman17, V. S. Shvetcov11, G. Skoro10, N. Smirnov36, L. P. Smykov10, R. Snellings17, K. Solberg13, J. Sowinski13, H. M. Spinka1, B. Srivastava27, E. J. Stephenson13, R. Stock12, A. Stolpovsky35, N. Stone3, R. Stone17, M. Strikhanov21, B. Stringfellow27, H. Stroebele12, C. Struck12, A. A. P. Suaide29, E. Sugarbaker24, C. Suire14, T. J. M. Symons17, J. Takahashi29, A. H. Tang16, A. Tarchini14, J. Tarzian17, J. H. Thomas17, V. Tikhomirov21, A. Szanto de Toledo29, S. Tonse17, T. Trainor34, S. Trentalange7, M. Tokarev10, M. B. Tonjes20, V. Trofimov21, O. Tsai7, K. Turner3, T. Ullrich36, D. G. Underwood1, I. Vakula7, G. Van Buren3, A. M. VanderMolen20, A. Vanyashin17, I. M. Vasilevski11, A. N. Vasiliev26, S. E. Vigdor13, G. Visser5, S. A. Voloshin35, C. Vu17, F. Wang27, H. Ward31, D. Weerasundara34, R. Weidenbach17, R. Wells17, R. Wells24, T. Wenaus3, G. D. Westfall20, J. P. Whitfield8, C. Whitten, Jr.7, H. Wieman17, R. Willson24, K. Wilson35, J. Wirth17, J. Wisdom7, S. W. Wissink13, R. Witt16, J. Wolf17, L. Wood6, N. Xu17, Z. Xu36, A. E. Yakutin26, E. Yamamoto7, J. Yang7, P. Yepes28, A. Yokosawa1, V. I. Yurevich10, Y. V. Zanevski10, J. Zhang17, W. M. Zhang16, J. Zhu34, D. Zimmerman17, R. Zoulkarneev11, and A. N. Zubare

Consistency, Amplitudes and Probabilities in Quantum Theory

Quantum theory is formulated as the only consistent way to manipulate probability amplitudes. The crucial ingredient is a consistency constraint: if there are two different ways to compute an amplitude the two answers must agree. This constraint is expressed in the form of functional equations the solution of which leads to the usual sum and product rules for amplitudes. A consequence is that the Schrodinger equation must be linear: non-linear variants of quantum mechanics are inconsistent. The physical interpretation of the theory is given in terms of a single natural rule. This rule, which does not itself involve probabilities, is used to obtain a proof of Born's statistical postulate. Thus, consistency leads to indeterminism. PACS: 03.65.Bz, 03.65.Ca.Comment: 23 pages, 3 figures (old version did not include the figures

The unexpected resurgence of Weyl geometry in late 20-th century physics

Weyl's original scale geometry of 1918 ("purely infinitesimal geometry") was withdrawn by its author from physical theorizing in the early 1920s. It had a comeback in the last third of the 20th century in different contexts: scalar tensor theories of gravity, foundations of gravity, foundations of quantum mechanics, elementary particle physics, and cosmology. It seems that Weyl geometry continues to offer an open research potential for the foundations of physics even after the turn to the new millennium.Comment: Completely rewritten conference paper 'Beyond Einstein', Mainz Sep 2008. Preprint ELHC (Epistemology of the LHC) 2017-02, 92 pages, 1 figur

Synthetic Biology Open Language (SBOL) Version 1.1.0

In this BioBricks Foundation Request for Comments (BBF RFC), we specify the Synthetic Biology Open Language (SBOL) Version 1.1.0 to enable the electronic exchange of information describing DNA components used in synthetic biology. We define: 1. the vocabulary, a set of preferred terms and 2. the core data model, a common computational representation

Evidence That Ca2+ within the Microdomain of the L-Type Voltage Gated Ca2+ Channel Activates ERK in MIN6 Cells in Response to Glucagon-Like Peptide-1

Glucagon like peptide-1 (GLP-1) is released from intestinal L-cells in response to nutrient ingestion and acts upon pancreatic β-cells potentiating glucose-stimulated insulin secretion and stimulating β-cell proliferation, differentiation, survival and gene transcription. These effects are mediated through the activation of multiple signal transduction pathways including the extracellular regulated kinase (ERK) pathway. We have previously reported that GLP-1 activates ERK through a mechanism dependent upon the influx of extracellular Ca2+ through L-type voltage gated Ca2+ channels (VGCC). However, the mechanism by which L-type VGCCs couple to the ERK signalling pathway in pancreatic β-cells is poorly understood. In this report, we characterise the relationship between L-type VGCC mediated changes in intracellular Ca2+ concentration ([Ca2+]i) and the activation of ERK, and demonstrate that the sustained activation of ERK (up to 30 min) in response to GLP-1 requires the continual activation of the L-type VGCC yet does not require a sustained increase in global [Ca2+]i or Ca2+ efflux from the endoplasmic reticulum. Moreover, sustained elevation of [Ca2+]i induced by ionomycin is insufficient to stimulate the prolonged activation of ERK. Using the cell permeant Ca2+ chelators, EGTA-AM and BAPTA-AM, to determine the spatial dynamics of L-type VGCC-dependent Ca2+ signalling to ERK, we provide evidence that a sustained increase in Ca2+ within the microdomain of the L-type VGCC is sufficient for signalling to ERK and that this plays an important role in GLP-1- stimulated ERK activation