Differential intermittent radiation therapy: A conceptual model

Cell membranes are made up of repeating units and subunits of various chemical moieties. It is proposed that these repeating units give each type of cell membrane a natural resonant frequency characteristic of that particular cell. It is further stipulated that this natural resonance is modified by attached antigens, and that this modification is unique to each different tumor type and patient. A signal that is of the same frequency as the natural resonance of the cell membrane may then be used to excite the cell membrane to its natural or modified resonant frequency and lyse it, as well as any metastases with the same characteristic. This resonant frequency must first be determined by growing tumor cells in culture, and is likely to be unique to each patient. Possible other uses of an excitatory signal may be to break apart chemical moieties. The only requirement is that this excitatory signal be matched to the resonant frequency of the cell wall or moiety to be lysed. The excitatory signal may come from various sources-sonic, electrical, x-ray, radio frequency, laser or nuclear. But the problem which must be solved is devising a method for determining the resonant frequencies of cell membranes.     

Some conceptual difficulties with the term 'schizophrenia': an alternative model

The term 'schizophrenic' is used in two distinct ways: namely to describe a particular type of illness and also as a label for the person suffering from this illness. If we concentrate on the 'illness' conception of schizophrenia it readily becomes apparent that its definition and nature varies somewhat from one proponent to another. Added to this is the problem that the major conceptions of schizophrenia are based on disjunctive concepts. The basic argument of this paper is that while all clinical conceptions of schizophrenia have assumed the existence of a disease-entity syndrome, no attempt has ever been made to test its logical alternative: namely a random-symptom model. Some data will be presented which are at least compatible with this alternative and some of the theoretical implications spelt out.     

A self-discrepancy reduction model of religious coping.

It was proposed that effectiveness of a religious response to personal crisis is related to type and amount of self-discrepancy. Fifty subjects were administered a questionnaire to assess the following two types of self-discrepancies: (1) discrepancy between perceived actual self and perceived ideal self and (2) discrepancy between perceived actual self and perceived ought-to-be self. Subjects also were asked to choose types of religious responses to a personal crisis. Religious responses were behaviorally, cognitively, and affectively loaded. Subjects with an actual/ought discrepancy chose behavioral and affective religious responses more frequently than did those without this discrepancy. No effects were found for the actual/ideal discrepancy. Implications of these results for revision and extension of the model are discussed.     

Abused child to nonabusive parent: resilience and conceptual change

Individuals who were abused as children and have spontaneously, without intervention, been able to change their cognitive and behavioral patterns such that they do not abuse their own children represent a heretofore untapped source of information and understanding about the processes of conceptual change and resilience. This pilot study investigates the nature of this conceptual change as an exemplar of resilience. Birth order, gender, locus of control, and coping behaviors emerged as areas needing further study. Additionally, the belief on the part of the abusing parents that abuse was not wrong needs further investigation as a possible precursor to this particular context for conceptual change.     

A simple conceptual model of primary pulmonary blast injury

Primary pulmonary blast injury arises from direct exposure to blast overpressure, and may lead to severe lung injury and systemic air embolism. The phenomena of spallation and implosion can be explained by a simple conceptual model without invoking complex physical principles.     

Sociocultural issues in pediatric transplantation: a conceptual model

OBJECTIVE: To demonstrate the value of viewing the pediatric transplant experience through a sociocultural lens and to offer an organized framework for identifying influential sociocultural variables in pediatric transplantation. METHODS: A conceptual model is presented which organizes sociocultural factors that may influence the transplant process. A review of the pediatric and adult transplant literature is conducted. RESULTS: The need for a model addressing sociocultural issues and benefits of using the proposed model is evident. Guided by the proposed model, pediatric psychologists will be prepared to more readily attend to sociocultural influences associated with the transplant experience when conducting research or providing clinical services to patients and families. CONCLUSIONS: Further development and evaluation of the proposed model are necessary to investigate its practical utility and validate the influence of the identified variables on assessment and treatment of pediatric transplant patients as well as patient health outcomes.     

A developmental cascade perspective of paediatric obesity: a conceptual model and scoping review

Considering the immense challenge of preventing obesity, the time has come to reconceptualise the way we study the obesity development in childhood. The developmental cascade model offers a longitudinal framework to elucidate the way cumulative consequences and spreading effects of risk and protective factors, across and within biopsychosocial spheres and phases of development, can propel individuals towards obesity. In this article, we use a theory-driven model-building approach and a scoping review that included 310 published studies to propose a developmental cascade model of paediatric obesity. The proposed model provides a basis for testing hypothesised cascades with multiple intervening variables and complex longitudinal processes. Moreover, the model informs future research by resolving seemingly contradictory findings on pathways to obesity previously thought to be distinct (low self-esteem, consuming sugary foods, and poor sleep cause obesity) that are actually processes working together over time (low self-esteem causes consumption of sugary foods which disrupts sleep quality and contributes to obesity). The findings of such inquiries can aid in identifying the timing and specific targets of preventive interventions across and within developmental phases. The implications of such a cascade model of paediatric obesity for health psychology and developmental and prevention sciences are discussed.     

Cognitive-behavior modification: A conceptual review

Conceptual issues regarding cognitive-behavior modification are presented, beginning with an analysis of the basic terms of cognition, behavior modification, and behaviorism. Five controversies in the relevant literature that stimulated increased interest in cognitive factors among behavior therapists are reviewed: (a) symbolic control in classical and operant conditioning; (b) Breger and McGaugh's (1965) critique of behavior therapy; (c) cognitive factors in systematic desensitization; (d) the debate regarding cognition in the first issue of Behavior Therapy (1970); and (e) Ledwidge's (1978) Psychological Bulletin critique of cognitive-behavior modification. An analysis of several conceptual issues emerging from the literature results in the following conclusions: cognitive-behavior modification is a “revolutionary” development only insofar as it extends beyond mediational behaviorism to a truly cognitive view that includes internal cognitive structures; cognitions are not behaviors, but can be studied in their effects on behaviors as is done with drugs and genetics; a unifiedinteractive approach that incorporates cognition, behavior, and affect represents the logical future development in psychotherapy research and practice.     

A conceptual model of compensation/decompensation in lumbar segmental instability

Lumbar spinal instability (LSI) is a common spinal disorder and can be associated with substantial disability. The concept of defining clinically relevant classifications of disease or ‘target condition’ is used in diagnostic research. Applying this concept to LSI we hypothesize that a set of clinical and radiological criteria can be developed to identify patients with this target condition who are at high risk of ‘irreversible’ decompensated LSI for whom surgery becomes the treatment of choice. In LSI, structural deterioration of the lumbar disc initiates a degenerative cascade of segmental instability. Over time, radiographic signs become visible: traction spurs, facet joint degeneration, misalignment, stenosis, olisthesis and de novo scoliosis. Ligaments, joint capsules, local and distant musculature are the functional elements of the lumbar motion segment. Influenced by non-functional factors, these functional elements allow a compensation of degeneration of the motion segment. Compensation may happen on each step of the degenerative cascade but cannot reverse it. However, compensation of LSI may lead to an alleviation or resolution of clinical symptoms. In return, the target condition of decompensation of LSI may cause the new occurrence of symptoms and pain. Functional compensation and decompensation are subject to numerous factors that can change which makes estimation of an individual’s long-term prognosis difficult. Compensation and decompensation may influence radiographic signs of degeneration, e.g. the degree of misalignment and segmental angulation caused by LSI is influenced by the tonus of the local musculature. This conceptual model of compensation/decompensation may help solve the debate on functional and psychosocial factors that influence low back pain and to establish a new definition of non-specific low back pain. Individual differences of identical structural disorders could be explained by compensated or decompensated LSI leading to changes in clinical symptoms and pain. Future spine surgery will have to carefully define and measure functional aspects of LSI, e.g. to identify a point of no return where multidisciplinary interventions do not allow a re-compensation and surgery becomes the treatment of choice.     

Communication skills training: describing a new conceptual model.

Current research in communication in physician-patient consultations is multidisciplinary and multimethodological. As this research has progressed, a considerable body of evidence on the best practices in physician-patient communication has been amassed. This evidence provides a foundation for communication skills training (CST) at all levels of medical education. Although the CST literature has demonstrated that communication skills can be taught, one critique of this literature is that it is not always clear which skills are being taught and whether those skills are matched with those being assessed.The Memorial Sloan-Kettering Cancer Center Comskil Model for CST seeks to answer those critiques by explicitly defining the important components of a consultation, based on Goals, Plans, and Actions theories and sociolinguistic theory. Sequenced guidelines as a mechanism for teaching about particular communication challenges are adapted from these other methods. The authors propose that consultation communication can be guided by an overarching goal, which is achieved through the use of a set of predetermined strategies. Strategies are common in CST; however, strategies often contain embedded communication skills. These skills can exist across strategies, and the Comskil Model seeks to make them explicit in these contexts. Separate from the skills are process tasks and cognitive appraisals that need to be addressed in teaching. The authors also describe how assessment practices foster concordance between skills taught and those assessed through careful coding of trainees' communication encounters and direct feedback.     

A conceptual model for faculty development in academic medicine: the underrepresented minority faculty experience

In May 2010, the Association of American Medical Colleges reported that nonwhite professors have a lower promotion rate than white professors. A cohort of 30 underrepresented minority (URM) junior faculty who participated in a structured faculty development program at a public, research-intensive, academic medical center were followed in a 10-year longitudinal study. This paper reports on the career status of 12 of the 30 URM faculty who were eligible for promotion during this period. Ninety-two percent (11/12) of URM faculty eligible for promotion were promoted to associate professor. When asked what factors contributed to their success, these URM faculty identified access and support of senior faculty mentors, peer networking, professional skill development, and knowledge of institutional culture. A faculty development program that addresses these components can promote the success of URM faculty in academic medicine.     

Families coping with schizophrenia: coping styles, their origins and correlates

An analysis of the coping styles adopted by relatives of schizophrenic patients has been identified by many reviewers as essential to an understanding of the complex interactions between patient and caregiver and to the origins of relatives' expressed emotion (EE). This study reports a taxonomy of coping behaviour derived from interviews with relatives of schizophrenic patients. It was found that relatives adopted broad styles of coping across all areas of patients' behaviour change. Relationships were uncovered between the styles and (a) relatives perceived control, burden and stress, (b) patients' social functioning, severity of behavioural disturbance and progress of the illness. It is suggested that advising relatives of changes in their coping styles in the course of family intervention must be tempered by an understanding of their origins in patients' behaviour. Further research is recommended to identify the coping styles associated with the high EE/low EE research classification.