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Biomedical subjects

D Field

Publications and source records attributed to D Field.

16 recordsLinked to original sources
PubMed1992

The routinization of hospice: charisma and bureaucratization.

In 25 years the number of hospices in Britain has multiplied from under 15 in 1965 to over 430 in 1991. During this period, often working out with the mainstream health system, the hospices actively sought to transform terminal care. More recently a process of diversification and legitimation has meant that hospices have become increasingly subject to mainstream influence. Using Weber's concept of charisma we examine the development of the hospice movement during this period of expansion. We suggest there are a number of factors leading to the routinization of hospice care including the ways in which it was sponsored and developed at the local level, and pressures toward bureaucratization and professionalization. We make links with recent developments in the health services. Finally we consider whether it is possible for the hospice movement to sustain its founding ideals.

Hospices↗
PubMed1992

Communication with dying patients in coronary care units.

There now seems to be a much greater willingness among hospital staff to disclose a terminal prognosis to a patient. The paper starts with a review of the changing attitudes towards disclosure and then considers communication with dying patients in Coronary Care Units. After considering general factors influencing nurse communication with dying patients sources of difficulty in such communication are considered. Characteristics of patients and relatives, of nurses, and features of the work environment may all contribute to communicational difficulties. The paper closes with a brief overview of basic communicative requirements.

Cardiovascular Diseases↗
PubMed1992

Pain: a kaleidoscope of ideas, concepts and approaches.

The following pages contain summaries and short statements on chronic pain providing further material for reflection and debate, namely: a) synopses of recent findings on: the physiology and biochemistry of pain; the contribution of psychoneuroimmunology; b) some views on a sociology of pain; c) analysis of various concepts and approaches which consider pain as: a symptom of disease a form of behaviour a psychosomatic reaction and a social learning process a communication phenomenon a symptom of disintegrated life a disruption in the integrity of the system a signal of broken unity a breach in the wholeness of the individual; d) a holistic approach in pain therapy; e) some unanswered questions.

Chronic Disease↗
PubMed1991

Continuity and change in personality in old age--evidence from five longitudinal studies: introduction to a special issue.

This short essay introduces some of the current problems in developmental personality theory and comments on the five articles that follow, all of which arise from longitudinal studies of aging in Israel, Sweden, and the United States. Although the study of personality has always been of central interest in psychology, personality development in advanced old age is a very new topic. We hope that this Special Issue will stimulate a lively discussion and will provoke further studies of personality in old age, which is indeed a "special issue."

Aged↗
PubMed1991

Personality in advanced old age: continuity or change?

A longitudinal study of elderly persons found evidence of personality development even in advanced old age. Five traits, similar to traits found in younger persons, were identified. Although considerable continuity was found, change also was apparent. An increase in agreeableness was observed for the old-old, bringing their scores up to the level maintained by the oldest-old. Two traits were stable: satisfaction (65% did not change reliably) and intellect (63% did not change reliably). A decline in extraversion occurred in both age groups. Energetic, in which 40% declined, may be more affected than the other traits by external, environmental circumstances. The study confirms the findings of longitudinal studies of children and younger adults and extends them into the final stages of life.

Age Factors↗
PubMed1991

Development of a clinical measure of postural control for assessment of adaptive seating in children with neuromotor disabilities.

The primary purposes of this article are to review the literature on seating assessment and to describe the development of a clinical evaluation scale, the Seated Postural Control Measure (SPCM), for use with children requiring adaptive seating systems. The SPCM is an observational scale of 22 seated postural alignment items and 12 functional movement items, each scored on a four-point, criterion-referenced scale. A secondary purpose of this article is to report the reliability of the seven-point Level of Sitting Scale (LSS). Interrater and test-retest reliability of the SPCM items and the one-item LSS were evaluated on a sample of 40 children with developmental disabilities who sat with and without their seating systems. Kappa values of .75 or higher were considered excellent, .40 to .74 as fair to good, and less than .40 as poor. The interrater reliability tests for the two seated conditions and the two test sessions conducted 3 weeks apart yielded overall item Kappa coefficient means of .45 for the alignment section and .85 for the function section. Test-retest results for the SPCM items were less satisfactory, with item Kappa coefficient means for the two seating conditions and raters of .35 and .29 for alignment and function, respectively. Reliability results did not appear to be consistently better among seating conditions, raters, or test sessions. Kappa coefficients for the LSS were fair to good for both interrater and test-retest reliability. Plans for future development of the SPCM and LSS are discussed.

Adolescent↗
PubMed1991

Fear of death and strategies for coping with patient death among medical trainees.

This paper describes a longitudinal study of fear of death following up fourth-year medical students in their junior house officer year. It confirms previous findings that the fear of death is and remains multidimensional, with fear of being dead having the lowest score on both occasions and fear of someone close dying being consistently the highest. Fear of death reduces on each dimension over time, though not significantly. An analysis of descriptions of strategies used by students to cope with patient death showed that passive acceptance through rationalizing was the most commonly used, especially by men, followed by supporting the patient emotionally or clinically, which was used especially by women. The highest fear and stress scores were associated with avoidance, dismissal and seeking advice, while the lowest were shown by those who rationalized the event. The paper goes on to describe the relationship of fear of death to various individual differences including empathy, gender, parental death, parental anxiety, and stress.

Adaptation, Psychological↗
PubMed1991

Survival and place of treatment after premature delivery.

In a one year prospective study in the Trent region we examined the short term outcome (survival to discharge) of all infants who required admission to a baby care unit. Infants of less than or equal to 28 weeks' gestation who received all their perinatal care in one of five large centres (each providing more than 600 ventilator days/year) showed significantly better survival rates than infants electively treated throughout their entire course at one of the 12 smaller units (34 survivors from 65 infants (52%) compared with eight survivors from 37 infants (22%). These differences occurred despite the elective transfer of many of the sickest infants from the smaller units to the larger. Differences in survival between more mature infants were not significant. These results support the policy that there should be a more centralised neonatal service for those infants at or below 28 weeks' gestation.

Birth Weight↗
PubMed1990

A crying baby.

Explore the source record for details and available documents.

Adult↗
PubMed1990

Human discrimination of fractal images.

In order to transmit information in images efficiently, the visual system should be tuned to the statistical structure of the ensemble of images that it sees. Several authors have suggested that the ensemble of natural images exhibits fractal behavior and, therefore, has a power spectrum that drops off proportionally to 1/f beta (2 less than beta less than 4). In this paper we investigate the question of which value of the exponent beta describes the power spectrum of the ensemble of images to which the visual system is optimally tuned. An experiment in which subjects were asked to discriminate randomly generated noise textures based on their spectral drop-off was used. Whereas the discrimination-threshold function of an ideal observer was flat for different spectral drop-offs, human observers showed a broad peak in sensitivity for 2.8 less than beta less than 3.6. The results are consistent with, but do not provide direct evidence for, the theory that the visual system is tuned to an ensemble of images with Markov statistics.

Computer Simulation↗
PubMed1989

Cerebral haemodynamic effects of changes in positive end expiratory pressure in preterm infants.

The effects of changes in positive end expiratory pressure (PEEP) on cerebral blood flow velocity, arterial blood gases, and mean arterial pressure were studied in newborn infants. In mechanically ventilated premature infants with severe respiratory disease, an increase in PEEP from 2 to 6 cm H2O was associated with an increase in cerebral blood flow velocity. There was no significant change in mean arterial blood pressure. There was a significant increase in PaO2 and PaCO2 for every stepwise rise in PEEP. Multivariate regression analysis showed that 72% of the effect on cerebral blood flow velocity was attributable to PaCO2 alone and that any change in blood pressure was not likely to contribute to these changes. There was no evidence that changes in PEEP within the commonly used range adversely affected the neonatal cardiovascular or cerebral circulations.

Blood Flow Velocity↗
PubMed1978

A possible explanation as to why the newly sighted commonly perform well on pseudoisochromatic colour vision tests.

Patients whose vision has been restored after long periods of blindness commonly experience difficulty in perceiving. Parodoxically, such patients often perform well on pseudoisochromatic colour-vision tests. A well-known example is Gregory and Wallace's subject, S.B. who performance on the Ishihara test was perfect. It is suggested that restoration of vision may be associated with relatively poor visual acuity and that this, by filtering higher spatial frequencies, enhances the legibility of pseudoisochromatic test patterns. Two experiments confirm that the Ishihara plates are more legible when seen as defocused images.

Blindness↗
PubMedDate not supplied

Neonatal extracorporeal membrane oxygenation.

Extracorporeal membrane oxygenation is an effective life support technique that has had most success in the treatment of neonatal cardiopulmonary failure. We review the technique and its potential indications and present the latest UK and worldwide survival data.

Extracorporeal Membrane Oxygenation↗