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Biomedical subjects

John A Schneider

Publications and source records attributed to John A Schneider.

7 recordsLinked to original sources
PubMed2006

Residents' perceptions over time of pharmaceutical industry interactions and gifts and the effect of an educational intervention.

PURPOSE: To describe change in residents' attitudes toward gifts from and interactions with industry and to measure the effects of a formal educational workshop on changes in perceptions. METHOD: At the University of Chicago, 118 internal medicine residents completed an observational survey and took part in a controlled intervention across three years (2001-2004) of residency. Four cohorts of residents completing the program in 2004-2007 participated. The intervention was an interactive educational workshop, including reviews of literature and guidelines, and three videos demonstrating routine resident interactions with pharmaceutical representatives. Residents graduating in 2005 were the intervention group and residents graduating in 2004 the comparison group. Analysis of variance and linear regression models were used to determine the relationship between variables. RESULTS: Residents perceived "lunch sponsored at noon conference" and "pharmaceutical representative brief talk at noon conference" as increasingly appropriate over their training period (p < .02). Residents perceived "pens, notepads, pocket antibiotic guides" as increasingly appropriate and "tickets to sporting events," "round of golf," and "travel/registration for national conference" as increasingly inappropriate (p < .05). The intervention group was more likely to rate only one item, "lunch at noon conference," as less appropriate (p = .042). CONCLUSIONS: Residents' perceptions toward industry gifts and interactions changed modestly during their training to reflect institutional policy. "Appropriate" gifts of minimal value were generally perceived as increasingly appropriate, whereas "inappropriate" gifts were perceived as increasingly inappropriate over time. An educational workshop alone may not significantly alter residents' perceptions toward industry without the implementation of broad and consistent institutional policy.

Advertising↗
PubMed2005

Experiences in K and -K.

In this paper the author explores and expands Bion's concepts of K and -K and delineates the nature of the relationship between the two. While Bion views envy as a principal motivating force for -K, his conception of -K goes considerably beyond this. The author explores manifestations of -K not driven by envy and, consequently, not necessarily pathological or pathogenic. -K is viewed by the author as a psychological process, which may serve many functions, including the communication of the patient's fear that knowing will bring on psychological catastrophe. -K, under circumstances that he describes, may serve to protect the individual's sense of continuity of being. The need to know the truth (K) may be at odds with the need to survive psychically, for example, when a person fears that the truth will kill him, or those he loves and depends upon. This idea is explored in two ways: first, by means of a discussion of the Oedipus myth in which Oedipus attempts to evade knowing for fear of recognizing that a prophesied catastrophe has already occurred; and, second, by means of a clinical exploration of the conflict between the need to know and the need to survive. The author discusses his analytic work with a severely disturbed patient for whom not knowing was felt to be essential to her psychic survival. Her need not to know reached a point where she psychically obliterated the analyst through the use of negative hallucination.

Adult↗
PubMed2004

The role of the chief ethics officer in a physician's office.

The unique role of the chief ethics officer in a sports medicine office is described and guided by the four principles of ethics, as well as the principles and codes of ethics of the American Medical Association, the International Sports Medicine Federation, and the American Academy of Orthopaedic Surgeons. The chief ethics officer should understand and be conversant with these principles and these codes of medical ethics, and transmit this information in order to further patient goals, physician goals, and employee goals.

Ethics, Clinical↗
PubMed2004

Pheochromocytoma storm presenting as cardiovascular collapse at term pregnancy.

Pheochromocytomas are neuroendocrine tumors that typically present with paroxysms of hypertension, but occasionally can lead to marked hemodynamic instability, left ventricular dysfunction, and cardiovascular collapse. Although pheochromocytoma in pregnancy is rare, factors specific to pregnancy can precipitate catecholamine crisis, making diagnosis and treatment challenging. We present a case of acute cardiovascular collapse with transient left ventricular dysfunction due to catecholamine crisis in a healthy young woman at term pregnancy. Further clinical and genetic investigation revealed pheochromocytoma as part of multiple endocrine neoplasia IIa (Sipple syndrome). A discussion of diagnosis and treatment strategies for pheochromocytoma in pregnancy and acute catecholamine crisis accompanies this report.

Acute Disease↗
PubMed2003

Working with pathological and healthy forms of splitting: a case study.

The author illustrates through a case discussion how he understands the concept of splitting and how he makes use of that understanding in tracking, and at times, interpreting movement of the unconscious transference and countertransference. He views splitting not simply as a primitive defense but also as essential to early emotional development and to healthy psychological maturation in the course of analytic work. In the analytic relationship discussed in this article, the author presents both aspects of splitting--as a primitive defense and as a healthy movement toward new and more complex object relatedness. Difficulties arise when one fails to distinguish pathological from healthy but immature forms of splitting. Healthy splitting in its beginnings represents an important developmental step that serves as a transition to ambivalence and mature integration. The author demonstrates the importance of the analyst's capacity to distinguish pathological splitting from healthy splitting during periods of analytic impasse.

Dissociative Disorders↗