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Biomedical subjects

H Mullan

Publications and source records attributed to H Mullan.

10 recordsLinked to original sources

"Existential" therapists and their group therapy practices.

Existential philosophical thought insists that human behavior is indeterminate and subject only to the individual's will. It is, therefore, skeptical of all dynamic psychologies based as they are on Freudian determinism. Group therapists imbued with this philosophy stop short of its extreme. Their existential position, however, does greatly modify treatment, and yet they preserve both the form and goals of therapy. They place properly selected and prepared patients in a group where their individuality and authenticity are highly valued. Finding most technical procedures irrelevant, the therapists themselves, that is, their evolving personalities are central. The key to patient change is the spontaneous meeting of members and the therapist which the therapist orchestrates. Instead of the usual interpretation, members are encouraged to confront the paradoxes in their lives, their humanness, and especially their finitude. Patients are to be brought up to the threshold of their self-knowledge so they can choose. Choice, therefore, along with action coupled with responsibility are frequent themes. Unless the individual is incompetent, decisions made for him or her by the therapist or by group consensus are thought to be nontherapeutic.

Existentialism

Inherent moral practice in group psychotherapy.

The large amount and variety of group psychotherapy practiced today enjoins us to determine its morality, that is, its rightness or wrongness. In this essay group therapy and morality are briefly defined. Using the writings of both philosophers and psychologists, evidence of morality is sought in the intentions and actions of both the patients and therapist and in the group process itself. Paying attention to "personal valuative acts," which are moral in nature and in outcome, group psychotherapy results in the good of the patient, of the therapist, and of the art or practice of group psychotherapy itself.

Group Processes

Malacoplakia of a cadaveric renal allograft: a case report.

A case of malacoplakia in a cadaveric renal allograft is presented. Infection and immunotherapy are presented as possible etiologic factors. The pathogenesis of malacoplakia is discussed with reference to histologic findings in this specific case. The suggestion is made that an altered macrophage response in this disease is the reason for this granulomatous lesion of the bladder.

Adult

Risk of pulmonary aspiration among patients receiving enteral nutrition support.

We investigated the prevalence, incidence, and risk factors for pulmonary aspiration in all tube-fed adult patients over 6 months. Twelve aspiration events occurred among 276 patients (prevalence, 4.4%; 95% confidence interval, 2.2% to 7.6%). The incidence of aspiration was 2.4 per 1000 tube-feeding days (95% confidence interval, 1.2 to 3.9 per 1000). Despite 17% overall mortality, there was no excess mortality and little morbidity associated with aspiration. The major risk factors for aspiration were patient age (p less than .015) and location in the hospital (p less than .008): the probability of aspiration in the intensive care units (n = 113) was 0.9% compared with 4.9% on medical or surgical wards (n = 142), 16.7% among patients transferred from the intensive care unit to the ward (n = 18), and 33% among patients transferred from the ward to the intensive care unit (n = 3). Pulmonary aspiration is an uncommon and generally benign event among enterally supported patients. More frequent aspiration among ward than intensive care unit patients suggests that aspiration is not an inevitable consequence of severe illness, but can be prevented with adequate nursing care and pulmonary precautions. The fear of aspiration is not a sufficient cause to withhold enteral nutrition support in acutely ill patients.

Adult