Philosophy's loss, neurology's gain:the endeavor of John Hughlings-Jackson

The year 2011 marked the centenary of the death of one of the founders of British neurology, John Hughlings-Jackson (1835-1911). By common consent he was a great clinician. But he was more. He endeavored to use clinical observations to throw light on one of the great problems of the modern world, the problem of mind. Hughlings-Jackson's daily contact with mentalities warped by neurological disease caused him to ponder deeply the nature of the mind-brain relationship, nowadays often known simply as the "hard problem. " In particular, he saw the danger of conflating mind and brain, a danger that has grown greater with the spectacular growth of neuroscientific knowledge during the last century. Although Hughlings-Jackson's neuroscientific thought is long outdated, his philosophic endeavors remain highly instructive. © 2012 by The Johns Hopkins University Press.

Stress, burnout and coping strategies in the emergency and intensive care hospital departments

Doctors and nurses working at the accident and emergency (A&E), and intensive care departments are at risk of burnout. They often spend substantial time in intense interactions with other people, centered on patients? health problems (physical, psychological and social) that may lead to feelings of anger, anxiety and frustration, and eventually to burnout. Burnout is a syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment (Maslach & Jackson, 1981) The purpose of this chapter is to assess work stressors, burnout and stress-coping mechanisms among doctors and nurses at the A&E and intensive care departments. A quantitative design using the survey approach was used to collect data from a sample of 200 participants with a response rate of 71% (n=154) Work stressors were associated with burnout in both doctors and nurses. Workload was the most salient work stressor in the sample. Nurses experienced more stress (M=1.5, SD=0.4) than doctors (M=1.2, SD=0.4) in all the work stressor variables examined. The A&E department was reported as more stressful than the intensive care department. Avoidance-oriented and task-oriented coping were the most and the least frequently reported coping strategies respectively. Additionally, only emotion-oriented coping strategy was significantly different between doctors and nurses, and this strategy was also significantly positively correlated with all the variables in the adapted nursing stress scale, and the three burnout variables. Death and dying was most strongly correlated with emotion-oriented coping. This chapter provides an assessment of stress, burnout and coping experienced by both doctors and nurses within the A&E and intensive care departments. Methods that may mitigate stress in these environments may be adequate staffing, supportive management, stress management programs, as well as improvement in communication strategies between doctors and nurses.