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1.
Teaching psychiatric ethics 总被引:1,自引:0,他引:1
S Bloch 《Medical education》1988,22(6):550-553
In the last decade, we have witnessed a burgeoning of interest in ethical issues amongst psychiatrists. Teaching of the subject, however, remains at a rudimentary stage. Various approaches to such instruction are available, particularly modelling (students observe their experienced counterpart), the case method (examining specific clinical situations which involve a need for ethical decision-making), and the seminar approach (trainees are exposed to a core body of knowledge, mainly theoretical in nature). Faced with these different teaching models, the University of Oxford Department of Psychiatry has opted for a blend of all three approaches, which incorporates two goals: an increase in the trainees' sensitivity to the many intricate moral dilemmas facing the psychiatric profession; and their familiarity with salient concepts in moral philosophy which constitute a basis for ethical reasoning and which have a bearing on clinical practice. The teaching programme comprises the following: a pair of trainees prepares a presentation on an aspect of psychiatric ethics under the supervision of a senior psychiatrist. A moral philosopher assumes the role of discussant of the ethical problems raised by the trainees; this is followed by a general discussion. Topics have included involuntary hospitalization, dual loyalty, suicide, psychiatric diagnosis, and ethical issues in various spheres of psychiatric practice such as sex therapy, psychotherapy and child psychiatry. The approach has worked effectively and proved rewarding to all participants involved. 相似文献
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Outcomes were compared between consecutive patients who had received either total lymphoid irradiation (TLI) or immunosuppressant treatment for intractable rheumatoid arthritis (RA). There were 33 TLI and 32 immunosuppressive recipients; all patients had failed standard therapy. Average followup from the start of therapy was 2.7 years for TLI and 5.9 years for immunosuppressive recipients. Final disability levels were the same in both groups; mortality was equal in both groups as well. There were more hospitalizations for infections in the TLI group and the infecting organisms tended to be staphylococcus or gram negative organisms. Apart from infections, there were more adverse effects reported in the immunosuppressive therapy group. 相似文献
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Ray Walker M.D. Debra Minor-Schork R.N. M.S.N. Richard Bloch Ph.D. James Esinhart Ph.D. 《The Psychiatric quarterly》1996,67(3):235-243
Objective. 1. To identify risk factors associated with psychiatric rehospitalization within six months, using global clinical assessments and demographic information and; 2. To determine if risk factors for a hospital in a rural region are similar to those reported for urban hospitals. Method. The setting was a psychiatric unit within a general hospital. All adult admissions for one year were assigned scores on the North Carolina Functional Assessment Scale (NCFAS) and the Global Assessment of Functioning (GAF) scale. Patients were interviewed six months after discharge to determine if they had been rehospitalized and to assign new NCFAS and GAF scores. Results. Significant risk of rehospitalization was predicted by: 1. NCFAS score >90; 2. history of prior hospitalization; 3. nursing home residence; 4. referral from a small community hospital and; 5. non-compliance with outpatient appointments. Conclusions. Global assessments and demographic information collected during an index admission can generate factors to identify patients at risk for rehospitalization within six months. History of prior admissions and non-compliance with outpatient treatment, reported as risk factors in urban settings, were found also to be risk factors in a rural region.He was formerly Assistant Professor, Center for Health Sciences Statistics, East Carolina University School of Medicine. 相似文献
5.
We tested the effects of pre-treatment with dexamethasone on topically induced ocular anaphylaxis in the rat. Rats were immunized with dinitrophenylated Ascaris suum extract and challenged with di-DNP-lysine. Dexamethasone was administered topically once (24, 6, or 1 h before challenge) or three times (6, 4, and 2 h before challenge). A single pre-treatment given at 24 or 6 h had no significant effect. A single pre-treatment 1 h before challenge reduced the extent of edema assessed histologically but not clinically, and had no significant effect on the eosinophil count in conjunctival tissue examined 6 h after challenge. Eyes pre-treated with dexamethasone 6, 4, and 2 h before challenge showed a significant reduction in conjunctival edema assessed histologically and clinically 1 h after challenge. In addition, 6 h after challenge the number of eosinophils was significantly reduced. We conclude that repeated pre-treatment with dexamethasone can suppress both the immediate phase and the cellular late phase of topically induced ocular anaphylaxis. 相似文献
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A comparison of the stressors experienced by parents of intubated and non-intubated children 总被引:3,自引:0,他引:3
Caroline Haines BN RGN RSCN Christine Perger BHSc Sue Nagy RN BA FRCNA FCN 《Journal of advanced nursing》1995,21(2):350-355
When children are ill enough to require admission to paediatric intensive care, parents may become distressed about their child's medical condition and this distress may be compounded by the unfamiliar nature of the highly technological environment Parents of children who are sick enough to warrant intubation are particularly likely to be exposed to a frightening array of technological equipment Seventy-one parents of intubated and non-intubated children completed the Parental Stressor Scale Paediatnc Intensive Care Unit (PSS PICU) Overall the findings suggest that parents were most distressed (a) by the painful procedures to which their children were subjected, (b) by the sights and sounds of the intensive care unit and (c) by their children's reactions to intensive care The behaviour of staff towards parents and the way that staff communicated with them caused the least distress When the levels of stress reported by parents of intubated children were compared with those reported by parents of non-intubated children, different patterns of stress were found Painful procedures were a source of greater stress to parents of intubated children whereas the behaviour of staff and the children's reactions to the intensive care experience caused greater stress to the parents of the non-intubated children In general the findings suggest that the needs of parents of non-intubated children are being overlooked, with staff focusing more of their attention on the parents of intubated children 相似文献
10.
A. B. Rao BN Pranesh Rao 《Indian journal of otolaryngology and head and neck surgery》1991,43(4):210-213
The present study was undertaken to evaluate the noise attenuation characteristics of different types of Ear protective Devices
which are commonly used. 20 healthy normal subjects’ open and closed hearing thresholds (with the usage of ear protective
device) were recorded in an anechoic chamber and the attenuation charactaristics at 8 discrete frequencies were analysed and
compared. Though the attenuation given by different types of ear protective devices are variable and not the ideal, still
the present generation of devices have shown satisfactory attenuation characteristics, It is important that proper selection,
fitment and usage of these devices should he carefully thought of prior to its usage. 相似文献