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Biomedical subjects

F Randall

Publications and source records attributed to F Randall.

17 recordsLinked to original sources
PubMed2003

The perceived expressed emotion in staff scale.

Recent research has highlighted the role of expressed emotion by ward staff in determining the well-being of psychiatric inpatients. Existing methods of assessing staff expressed emotion involve standardized interviews and are expensive and time-consuming. We report the development of a questionnaire measure of expressed emotion in staff as perceived by patients. In study 1, factor analysis of items administered to patients in a variety of settings led to the development of a questionnaire with three subscales: supportiveness, criticism and intrusiveness. In study 2, the test-retest reliability of the questionnaire was found to be adequate, and some evidence of concurrent validity for the scale was obtained against expressed emotion rated from staff speech samples. In study 3, the scale was shown to have good concurrent validity against the ward atmosphere scale, and scores were found to be independent of insight or experience of admission to hospital. The perceived expressed emotion in staff scale is a convenient measure, which may have utility for both research and clinical purposes.

Adult↗
PubMed1998

The meaning and management of neuroleptic medication: a study of patients with a diagnosis of schizophrenia.

The meaning of medication and the way in which people use medicines has been the focus of a number of studies in recent years. However, there has been little attention directed to the meaning and management of neuroleptic medication by people who have received a diagnosis of schizophrenia. This topic is highly relevant to policy because of the central role given to neuroleptics in contemporary mental health and community care services. Using data from in-depth interviews with people with a diagnosis of schizophrenia we explore patients reasons for taking neuroleptics and the ways in which patients self-regulate their medication. The data suggest that the main utility of taking neuroleptic medication is to control specific symptoms and to gain personal control over managing symptoms. The costs of taking medication were side-effects which at times equalised or outweighed the positive gains of the neuroleptic medication. Patient accounts suggest that everyday medication practices are to a significant degree related to a policy context which stresses the need to survey and control the behaviour of people living in the community and the wider meaning and symbolic significance that schizophrenia has for patients in their everyday lives. For this reason, self regulatory action in this group of patients tends to be less evident and the threat of external social control greater than patients taking medication for other chronic conditions. The findings suggest the need to develop a collaborative patient-centred model of medication management for patients diagnosed with schizophrenia.

Adaptation, Psychological↗
PubMed1997

Parenting and the best interests of minors.

The treatment decisions of competent adults, especially treatment refusals, are generally respected. In the case of minors something turns on their age, and older minors ought increasingly to make their own decisions. On the other hand, parents decide on behalf of infants and young children. Their right to do so can best be justified in terms of the importance of preserving intimate family relationships, rather than in terms of the child's best interests, although the child's best interests will most often follow from this arrangement. Nevertheless, there are and ought to be legal, ethical, and financial constraints on parental decision making.

Adolescent↗
PubMed1996

Anxiety and the use of strategies in the performance of a sentence-picture verification task.

An experiment was conducted to examine processing strategy differences in anxiety. The sentence-picture verification task was modified to incorporate a block of threat-related trials (involving a knife and a rifle) and a block of neutral trials (involving a truck and a chair). It was predicted that the high-trait, relative to low-trait, anxious individuals would prefer to use a linguistic strategy for threat-related as compared to neutral trials. In addition, the idea that an image-based strategy is more important for processing emotional material was examined. There was some support for both of these hypotheses.

Adult↗
PubMed1993

Two lawyers and a technician.

The major arguments used to support the legalization of euthanasia are that such a move would increase autonomy both for individuals and for society as a whole, and would diminish suffering. This paper examines these two points from several angles, and concludes that, from the standpoint of society as a whole, the legalization of euthanasia would be likely to achieve the complete opposite: a reduction in autonomy and an increase in overall suffering. The involvement of doctors in euthanasia is seen as a separate debate. The medical ethic of beneficence and its importance are discussed, together with the consequent dilemmas produced if this ethic is to be retained at the same time as requesting doctors to perform euthanasia. Consequences for the doctor-patient relationship in terms of loss of trust are described. To resolve these dilemmas it is suggested that, if euthanasia were legalized, initial assessment should be by two lawyers, and the act itself performed by a technician, suitably vocationally trained.

Beneficence↗
PubMed1987

Terminal care in haematology.

As doctors, it is clearly our duty to continue to care for our patients if their illness is not curable. Basic skills in symptom control and counselling are needed, and if we have taken the trouble to acquire some knowledge in these respects we will be much better equipped to help the dying patient. Pain control is not complicated if approached logically. The exact cause of the pain should be treated if possible, and regular, adequately potent analgesics used to balance the pain so that analgesia is achieved throughout the 24 hours. There is nothing to be gained by withholding opiates when moderate analgesics are ineffective. The approach to the control of other symptoms is similar. Emotional care is generally more difficult and taxing to the doctor than physical care. Initially it may be difficult to decide what to tell the patient about his illness. Mistakes are less likely if the patient is allowed to indicate how much information he wants, and a vital relationship of trust can be maintained only if we tell the truth. Once this relationship of trust is established we should continue to give the opportunity for discussion of fears and worries, or sometimes simply show that we are willing to share our patient's distress. Those who depend upon us for their care deserve our commitment to them until the moment of death.

Hematologic Diseases↗
PubMed1978

Nitrous oxide pollution levels in oral surgery offices.

Nitrous oxide pollutant levels, surveyed in oral surgery offices in Southern California, were lower than previously reported. These evaluations were related to rebreathed gas samples obtained from the operator and assistants, and appear to correlate well with exposure to nitrous oxide contamination. The lower levels in the hallway were tenfold less than those previously reported. Better air-conditioning in these offices and better airway control could be responsible, in part, for the difference.

Air Pollutants↗
PubMedDate not supplied

Comparative circulating serum levels of mepivacaine with levo-nordefrin and lidocaine with epinephrien.

Expected blood levels of common local anesthetics have been reported for numerous types of injections. Comparative levels of mepivacaine and lidocaine after dental injection have been only partially evaluated. A study was designed to compare the circulating serum level of 36 mgs. of mepivacaine with 1:20,000 levonordefrin (M) and 36 mgs. of lidocaine with 1:100,000 epinephrine (L) in 1.8 cc dental cartridges after standardized's bilateral maxillary infiltrations. Each of five subjects received 1.8 cc of (L) to the left maxillary second bicuspid and 1.8 cc of (M) to the right maxillary second bicuspid at a rate of one cc per minute. The serum was sampled before the injections and at 5, 15, 30, 60, 90, 120 and 240 minute intervals after the injections and analyzed by gas liquid chromatography. The results indicated that the serum level of (M) peaked at 30 minutes, 0.37 μg/ml of serum and (L) had peaks at 15 and 30 minutes, 0.22 μg/ml of serum. This difference was statistically significant, (p <.01) at all times sampled with (M) always resulting in a higher serum level. Serum levels persisted throughout the four hour test period.

Adult↗