De la casa de Orates al Open Door: el paisaje en el proyecto Asilar Chileno, 1852-1928 / From the Madhouse to the open door: the landscape in the Chilean Asylum Project, 1852-1928

En un contexto de desarrollo de la anatomía patológica y de la irrupción de la mirada científica sobre el cuerpo de los enfermos mentales, los asilos de locos subrayaron la importancia del espacio, real o simulado, como recurso curativo. Las Casas de Orates se armaron a partir de una propuesta que en su diseño, emplazamiento y realización representó los principios del alienismo, ajustados a la realidad chilena. Este proceso impulsó un escenario asilar específico, con paisajes interiores y exteriores, que caracterizaron al alienismo local y a su promesa de tratar la locura. Este artículo estudia los asilos proyectados o levantados en Chile desde la Casa de Locos (1852) hasta el Open Door Nacional (1928), dando cuenta de los procesos de apropiación de un modelo internacional desde las particularidades del paisaje local asilar (AU)

In a period shaped by the development of anatomical pathology and by the entrance of the scientific gaze over the body of the insane, the mental asylum underscored the key importance of the space, real or simulate, as a therapeutic tool. Madhouses were influenced by a proposal that followed in terms of design, location and implementation, the principles of alienism, adjusted to the Chilean setting. This process contributed to develop a specific asylum space, with internal and external landscapes, which characterized local alienism and its promise to treat madness. This article studies the Chilean asylums -planned or built- from the Madhouse (1852) to the National Open Door (1928), in order to show the process of appropriation of an international therapeutic model from the peculiarities of the institutional landscape (AU)

Wolf Hat by Preston Singletary.

Recognizing the contribution art has had in the Mayo Clinic environment since the original Mayo Clinic Building was finished in 1914, Mayo Clinic Proceedings features some of the numerous works of art displayed throughout the buildings and grounds on Mayo Clinic campuses as interpreted by the author.

In the shadow of the asylum: the Stanley Royd Salmonella outbreak of 1984.

In August 1984, an outbreak of Salmonella at Stanley Royd Psychiatric Hospital in Yorkshire led to the deaths of 19 elderly residents. It was an incident that attracted a good deal of comment in both the local and national press, and one that had enduring relevance for ideas about psychiatric care, food handling and catering provisions, hospital management and the official inspection of medical institutions. This article examines the impact that the 1984 outbreak had on official and popular perceptions of these issues. As well as bringing to public attention the fact that large numbers of vulnerable elderly patients were long-term residents in psychiatric hospitals, the Salmonella outbreak highlighted the inadequacies of Victorian hospital buildings in modern healthcare. Throughout the press reports and official investigations examined here, the provenance of Stanley Royd was repeatedly emphasised; its Victorian fabric persistently interfered with cleaning regimes, cold storage facilities and the conveyance of food to patients. Within institutions like Stanley Royd, 'new' and 'old' risks came together--the microscopic bacterium and the crumbling nineteenth-century building--to create a strong critique of existing psychiatric care. The episode also highlighted broader problems within the NHS, such as systems of management and the status of psychogeriatrics as a specialism.

Elements of care: nursing environmental theory in historical context.

The natural elements ether, fire, air, water, and earth foundational to many healing traditions are also present in nursing history. Regulation of these elements can be traced to 19th-century nurses' "sickroom management." Nightingale's Notes on Nursing and Coskery's Advices Concerning the Sick provide examples of holistic application of the elements of care.

Managing nurses through disciplinary power: a Foucauldian analysis of workplace violence.

AIMS: This paper describes discipline as a specific technique of power which constitutes, in our view, a form of institutional violence. BACKGROUND: The need to create and maintain safe and healthy work environments for healthcare professionals is well documented. EVALUATION: Foucault's concept of disciplinary power was used to explore institutional violence from a critical perspective. KEY ISSUE: Violence is identified as an important factor in the recruitment and retention of healthcare professionals. Given the shortage of such professionals, there is an urgent need to take a fresh look at their working environments and working conditions. CONCLUSION: Power, surveillance and disciplinary techniques are used at all levels of hospital management to control and contain both human resources and costs. IMPLICATIONS FOR NURSING MANAGEMENT: By associating common workplace practices with institutional violence, employers who have a policy of zero tolerance toward workplace violence will need to re-examine their current ways of operating.

Internal influences in the making of the English military hospital: the early-eighteenth-century Greenwich.

This chapter uses records at the Royal Greenwich Hospital for ex-sailors to analyse the nature of care, and to uncover how the chronically disabled patients themselves experienced the hospital. Greenwich became a 'reverse' institution, in that the ex-servicemen were closely regulated and treated like unruly visitors, while only officers and medics had free movement and influence. Although initially the inner workings of the Hospital owed much to almshouse and shipboard models, over time medical considerations became paramount. Physicians and surgeons became involved actively in governance and discipline, promoting environmental and dietary changes.

The Asklipieion's healing environment--learning from the past.

Asklipieia were the first hospitals (or, better, health care campuses) in Europe, which flourished in Hellas (Greece) for about 12 centuries, since about the 6th century B.C. A kind of holistic health care was offered in Asklipieia through the conception of illnesses as a result of interaction of physical, psychological, social and environmental factors. The study of Asklipleian health care will help us to complete our knowledge on the history of health care and can teach us a lesson deriving from the Hellenic philosophy and history that could form the prototypical base for a better understanding of the concept of healing environment.

Executive forum: design for therapeutic outcomes.

In summary, the two major characteristics of design for therapeutic outcomes are: 1) that it takes into account the functional requirements of patients as these are influenced by illness or disability and 2) that it supports processes of care and treatment aimed at specific desired outcomes. The challenge is a large one and requires a multi-disciplinary effort. Nurses and physicians should be included on design teams, whether in the planning of new facilities, or the redesign of older ones. Physicians will be able to articulate the treatment goals, as will experienced nurses who, in addition, have a handle on the day-to-day activities that can be more effectively carried out by or for patients with the support of good design. In the endeavor to design for therapeutic outcomes, nurses and physicians must be part of the design team, but we should not expect all of them to have the same understanding of the built environment as a design professional has. Rather, their input is an essential complement to the design professional's skills and of critical importance in articulating the requisities of specific patient groups. Because of cost considerations and because there are many users within the hospital, there will of necessity be some trade-offs, but concentration on what the therapeutic outcomes should be for different groups of patients will go a long way toward achieving truly functional designs.