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Biomedical subjects

A Cushing

Publications and source records attributed to A Cushing.

At least 19 recordsLinked to original sources
PubMed2006

Decisions at the end of life: an empirical study on the involvement, legal understanding and ethical views of preregistration house officers.

OBJECTIVES: To collect information on the involvement, legal understanding and ethical views of preregistration house officers (PRHO) regarding end-of-life decision making in clinical practice. DESIGN: Structured telephone interviews. PARTICIPANTS: 104 PRHO who responded. MAIN OUTCOME MEASURES: Information on the frequency and quality of involvement of PRHO in end-of-life decision making, their legal understanding and ethical views on do-not-resuscitate (DNR) order and withdrawal of treatment. RESULTS: Most PRHO participated in team discussions on the withdrawal of treatment (n = 95, 91.3%) or a DNR order (n = 99, 95.2%). Of them, 46 (44.2%) participants had themselves discussed the DNR order with patients. In all, it was agreed by 84 (80.8%) respondents that it would be unethical to make a DNR order on any patient who is competent without consulting her or him. With one exception, it was indicated by the participants that patients who are competent may refuse tube feeding (n = 103, 99.0%) and 101 (97.1%) participants thought that patients may refuse intravenous nutrition. The withdrawal of artificial ventilation in incompetent patients with serious and permanent brain damage was considered to be morally appropriate by 95 (91.3%) and 97 (93.3%) thought so about the withdrawal of antibiotics. The withdrawal of intravenous hydration was considered by 67 (64.4%) to be morally appropriate in this case. CONCLUSIONS: PRHO are often involved with end-of-life decision making. The results on ethical and legal understanding about the limitations of treatment may be interpreted as a positive outcome of the extensive undergraduate teaching on this subject. Future empirical studies, by a qualitative method, may provide valuable information about the arguments underlying the ethical views of doctors on the limitations of different types of medical treatment.

Adult↗
PubMed2000

Medical students' concerns about communicating with patients.

BACKGROUND: Only limited information is available on students' concerns regarding communication with patients. SAMPLE AND DESIGN: A total of 16 concerns regarding communicating with patients were rated by 179 third-year medical students, before the students had any contact with patients and before communication skills teaching had begun. At the end of the term, the ratings were collected again from 139 of the students. The concerns were derived from the list by Cohen-Cole and from a previous pilot study. RESULTS: All concerns diminished significantly by the end of the term, but their order remained similar. At both time points, concerns about dealing with patients who are in pain or show strong negative emotions received the highest ratings. CONCLUSION: Communication skills courses need to focus on helping students to cope with distressed patients.

Communication↗
PubMed1999

Measurement of calcium flux through ionotropic glutamate receptors using Cytostar-T scintillating microplates.

Human embryonic kidney cells (HEK293), expressing the human GluR4 receptor sub-unit of 2-amino-3-hydroxy-methylisoxazol-4-ylpropionic acid (AMPA) type non-NMDA receptors were used, in combination with Cytostar-T scintillating microplates, to develop an assay system for the screening of novel compounds with potential AMPA antagonistic characteristics. Agonist dose responses were measured using the agonists: AMPA; quisqualic acid; L-glutamic acid and kainic acid (KA), and EC50 values of 40, 10, 100 and 100 microM were estimated for each of the agonists, respectively. The AMPA receptor antagonists LY293558 and GYK152466 were tested and shown to inhibit agonist induced [45Ca] influx into the cells. An IC50 value of 600 microM was estimated for the competitive antagonist LY293558 and a value of 100 microM estimated for the non-competitive antagonist GYK152466. The developed assay system is homogeneous, allowing increased assay precision and speed. This allows the potential for automation of the assay and it may be used for screening large numbers of novel compounds.

Calcium↗
PubMed1999

The HIV patient in general dental practice.

General practitioners, especially those working in areas where there is a high incidence of HIV, will inevitably have to face patients who may or may not know that they are HIV antibody positive. This paper gives some guidelines on how to approach the problem, using two case scenarios.

Adult↗
PubMed1999

Nursing leadership in the US 1950s-1970s: a discourse analysis.

This paper proposes that the development of nursing leadership and the struggle for professionalisation from the time of the early nineteenth century to the late twentieth century may be conceived as a series of products of constituent discourses. However, particular attention is focused on the concept of leadership as it pertains to the nursing profession in the US between the 1950s-1970s. This time-frame is an important period in the discursive formation of the idea of leadership and professionalisation as the US literature on these subjects in the areas of sociology, psychology, education and business administration exercised a strong influence on the microsocial world of professional nursing practice in the US and, indeed elsewhere, for example, Australia and the UK. The sociological complexity of the concept of leadership ultimately meant that it came to be regarded as a dynamic process pervading the existence of all people; their interrelationships, their morale, their confidence and their capacity to achieve. These features are reflected through the perceptions, beliefs and experiences of the American nursing profession as its constituent discourse appeared during the 1950s-1970s. Thus the paper is a discourse analysis on leadership in nursing with particular attention given to the bureaucratic authority of the hospital, the drive for the creation of a profession and the idea of leadership itself.

History, 20th Century↗
PubMed1998

The female factory at Parramatta 1804-1850s.

In the first few decades following the arrival of the First Fleet in 1788 there came to be established three institutions in the young colony referred to as female factories. The first was established at Parramatta in 1804 (Schultz, 1991: 4, 11-13) and the other two in 1827, one in Hobart (Schultz, 1991:32, 69) and the other in Moreton Bay (Schultz, 1991:41). This is a brief account of the salient features in the development of the first female factory which highlights the status of women in that early society. In preparing the account I have drawn heavily on Schultz's 'A Tapestry of Service' and Salt's 'These Outcast Women.'

Australia↗
PubMed1998

An historical perspective on clinical supervision in nursing.

This paper examines the concept of formalized clinical supervision by focusing attention on several aspects. First, the current popularity of the concept and the practice of clinical supervision in the British nursing literature. Second, further discussion takes place about the lack of agreement among scholars on the definitions, models and models of utilization of clinical supervision. Third, the significance of the relationship between clinical supervision and management is analyzed. Fourth, the identification of what is currently presented as formal clinical supervision in both mental health nursing and general nursing is achieved through an examination of the relevant psychoanalytic sources from which the concept originated, and the North American nursing contribution. Finally, from examination of the current and past literature, the conclusion is that nursing has misconceived the intention of formalized clinical supervision.

Burnout, Professional↗
PubMed1998

Illness and health in the ancient world.

This is the first in a series of vignettes about health, disease and care giving practices in the ancient worlds of Greece (1000 BC-100 BC) and Rome (1st AD-500 AD). Attention is directed to what the better known conditions were, what structures existed for the delivery of care, what the commonly held health beliefs were, who the most likely care attendants were and what psych-cultural changes occurred which brought about improvements in health care. Thus the series is about the early origins and development of the Western cultural tradition of health care practices. They demonstrate that there was a recognised community need for health care structures to exist and that the association between healing and religious belief began very early.

Attitude to Health↗
PubMed1996

Method and theory in the practice of nursing history.

This paper examines two main issues connected to the writing of history and ipso facto the history of nursing. In the first section, the issue pertaining to the difficulties involved in writing an account of past events is addressed. Light is shed on how the historian goes about interpreting the past in order to render an accurate and reliable account of the phenomenon under investigation. This issue inevitably incorporates the relevant observations of other historians hence highlighting the diversity of views and the underlying assumptions to the methodological approach. In the second section, the issue relating to the thorny problem of the role of social theory in historical writing and the challenge this presents to the historian receive attention. In this analysis about method and theory in the practice of history attention is only directed to the written word as the documentary sources constitute the bulk of the surviving records about the past.

Historiography↗