Gadamer and the Authenticity of Openness

Gadamer is too often charged with subjectivism and relativism. Bearing in mind Hubert Dreyfus’ new interpretation that Heidegger describes two separate types of resoluteness and authenticity, the author rescues Gadamer’s philosophy of openness by identifying its hermeneutic with Heidegger’s Aristotelian side—skirting supposed associations with Kierkegaard or Nietzsche that have confused Gadamer’s project in the past. Following Heidegger, Gadamer’s epistemology identifies both a personal (situated, particular) horizon and historical (given, universal) horizon, and understanding is the fusion of the two. Gadamer’s openness is a condition of our accomplished understanding, where our knowing of our essential finitude promotes on-going attention to the concrete real. By way of analogy, Gadamer’s open person understands most readily, as Heidegger’s social virtuoso responds appropriately to the Situation. But it is important to stress that openness is not so much a trait as it is an ability in a situation-by-situation basis. Gadamer’s purpose is ethical insofar as he pushes for us to be more dialectical

Stop the escalation before it begins by using the pediatric Behavior Response Team protocol

In today's world, clinicians need to be prepared to care for challenging patients and families that are struggling with the stress of illness and hospitalization and have inadequate coping skills. The University of Michigan Health System (UMHS) has developed a protocol identifying a team with representatives from psychiatry, security, and risk management to provide a rapid response in situations that historically have resulted in, at worst, sentinel/adverse events and at best, service disasters. The pediatric BRT protocol formalizes the purpose of the team, how staff should access them, and the expectation for involved staff to debrief about the interventions at identified times. It has proven to be an effective intervention and allows clinicians to provide needed care to the patients.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92390/1/21082_ftp.pd

Tracing sources of natural organic matter, trihalomethanes and metals in groundwater from a karst region

Groundwater offers an important source for drinking water around the world; however, groundwater quality is under increasing pressure and is particularly vulnerable in karst areas. Total organic carbon (TOC) is significantly related to groundwater quality and when not removed by water treatment processes can give rise to the formation of disinfection by-products trihalomethanes (THMs) above the level of compliance. This study investigated the source of organic matter giving rise to the THM exceedances in a groundwater supply in a karst area. Results highlighted that source water for this groundwater supply was prone to surface water infiltration linked to rainfall events; was not accurately captured in the zone of contribution (ZoC); had inadequate treatment of natural organic matter (NOM) and suffered THM exceedances in 45% of sampling events. THMs were mostly represented by chloroform and caused by terrestrial delivered reprocessed organic matter. This work will support water managers tasked with decision-making

Suicide:an existentialist reconceptualization

The phenomenon of suicide is one of the primary concerns for mental health professions. The health-care literature is dominated by discussions that focus variously on local and national suicide prevention policies, on the assessment of those individuals judged to be at risk of committing suicide as well as the appropriateness and efficacy of interventions for those who express suicidal ideation and display suicidal behaviours. What appear less frequently in the literature, however, are critical analyses of the concept of suicide and, in particular, critical reflections on the manner in which the concept of suicide has been, and continues to be, understood or ‘framed’. In an attempt to respond to this apparent omission, this paper will suggest that the work of Albert Camus, and his philosophical work The Myth of Sisyphus in particular, can be understood as providing a significant reconceptualization and reframing of suicide. In doing so, it will be suggested that Camus's work not only challenges how the concept of suicide has traditionally been situated within the context of mental illness, but can also be understood as challenging the efficacy of the interventions that have been associated with an understanding of suicide within that context

Trainees\u27 perceptions of patient safety practices: Recounting failures of supervision

Background: Ensuring that trainees receive appropriate clinical supervision is one proven method for improving patient safety outcomes. Yet, supervision is difficult to monitor, even more so during advanced levels of training. The manner in which trainees\u27 perceived failures of supervision influenced patient safety practices across disciplines and various levels of training was investigated. Methods: A brief, open-ended questionnaire, administered to 334 newly hired interns, residents, and fellows, asked for descriptions of situations in which they witnessed a failure of supervision and their corresponding response. Results: Of the 265 trainees completing the survey, 73 (27.5%) indicated having witnessed a failure of supervision. The analysis of these responses revealed three types of supervision failures-monitoring, guidance, and feedback. The necessity of adequate supervision and its accompanying consequences were also highlighted in the participants\u27 responses. Conclusions: The findings of this study identify two primary sources of failures of supervision: supervisors\u27 failure to respond to trainees\u27 seeking of guidance or clinical support and trainees\u27 failure to seek such support. The findings suggest that the learning environment\u27s influence was sufficient to cause trainees to value their appearance to superiors more than safe patient care, suggesting that trainees\u27 feelings may supersede patients\u27 needs and jeopardize optimal treatment. The literature on the impact of disruptive be havior on patient care may also improve understanding of how intimidating and abusive behavior stifles effective com - munication and trainees\u27 ability to provide optimal patient care. Improved supervision and communication within the medical hierarchy should not only create more productive learning environments but also improve patient safety. Copyright 2011 © The Joint Commission