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Eric G. Campbell Vinay Kini Julie Ressalam Bridget S. Mosley Dragana Bolcic-Jankovic Hillary D. Lum Elizabeth R. Kessler Matthew DeCamp 《Journal of general internal medicine》2022,37(13):3310
BackgroundApproximately 20% of the US population live in states where MAiD is a legal, though highly contentious, practice. Little generalizable data exists on the experiences of MAiD providers who comprise a small, and intentionally hidden, population.ObjectiveTo examine the nature, extent, and consequences of physicians’ participation in MAiD.DesignAn anonymous, multi-wave, mailed survey (RR= 55%).ParticipantsAn enriched sample (n=583) of Colorado physicians caring for potential MAiD patients.Main MeasuresPhysician willingness, preparedness, and participation in a continuum of MAiD activities. Other outcomes include the effects of providing MAiD and the barriers physicians face related to MAiD.Key ResultsOverall, 81.1% of respondents were willing to discuss MAiD with a patient, 88.3% to refer for MAiD, 46.3% to be a consultant, and 28.1% to be an attending. Fewer felt prepared to discuss MAiD (54.4%), provide a MAiD referral (62.8%), be a consultant (30.7%), or be an attending (18.0%). More than half of respondents (52.3%) had discussed MAiD with a patient, 27.3% provided a MAiD referral, 12.8% had been a MAiD consultant, and 8.5% had been a MAiD attending. Among MAiD consultants and attendings, 75% reported that their most recent MAiD case was emotionally fulfilling and professionally rewarding, though 75% also reported that it was time consuming and 46.9% reported that it was ethically challenging. Common barriers to physician participation in MAiD include lack of knowledge about MAiD (46.8%), the emotional (45.6%) and time (41.7%) investments, and ethical concerns (41.7%).ConclusionsMany physicians in our sample are both willing and prepared to discuss MAiD with patients and to provide MAiD referrals. Fewer are prepared and willing to serve as an attending or consultant and fewer have provided these services. MAID consultants and attendings largely report the experience to be emotionally fulfilling and professionally rewarding, but all respondents reported multiple barriers to participation.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-021-07300-8.KEY WORDS: physician assisted death, physician assisted suicide, medical aid in the dying 相似文献
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We report a case demonstrating a previously undescribed association between bulimia and repeated spontaneous abortion. It is also the first report of bulimia in a British Sikh woman. Her history reveals features of multiimpulsivity and demonstrates an unusually early onset of bulimia associated with an organic condition, asthma. 相似文献
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Multiple sclerosis(MS)is an inflammatory demyelinating disease of the central nervous system.The disability caused by inflammatory demyelination clinically dominates the early stages of relapsing-remitting MS and is reversible.Once there is considerable loss of axons,MS patients enter a secondary progressive stage.Disease-modifying drugs currently in use for MS suppress the immune system and reduce relapse rates but are not effective in the progressive stage.Various animal models of MS(mostly mouse and rat)have been established and proved useful in studying the disease process and response to therapy.The experimental autoimmune encephalomyelitis animal studies reviewed here showed that a chronic progressive disease can be induced by immunization with appropriate amounts of myelin oligodendrocyte glycoprotein together with mycobacterium tuberculosis and pertussis toxin in Freund's adjuvant.The clinical manifestations of autoimmune encephalomyelitis disease were prevented or reduced by treatment with certain pharmacological agents given prior to,at,or after peak disease,and the agents had protective effects as shown by inhibiting demyelination and damage to neurons,axons and oligodendrocytes.In the cuprizone-induced toxicity animal studies,the pharmacological agents tested were able to promote remyelination and increase the number of oligodendrocytes when administered therapeutically or prophylactically.A monoclonal IgM antibody protected axons in the spinal cord and preserved motor function in animals inoculated with Theiler's murine encephalomyelitis virus.In all these studies the pharmacological agents were administered singly.A combination therapy may be more effective,especially using agents that target neuroinflammation and neurodegeneration,as they may exert synergistic actions. 相似文献
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Samson Chengetanai Jonathan D. Tenley Mads F. Bertelsen Therese Hård Adhil Bhagwandin Mark Haagensen Cheuk Y. Tang Victoria X. Wang Bridget Wicinski Patrick R. Hof Paul R. Manger Muhammad A. Spocter 《The Journal of comparative neurology》2020,528(18):3245-3261
The African wild dog is endemic to sub-Saharan Africa and belongs to the family Canidae which includes domestic dogs and their closest relatives (i.e., wolves, coyotes, jackals, dingoes, and foxes). The African wild dog is known for its highly social behavior, co-ordinated pack predation, and striking vocal repertoire, but little is known about its brain and whether it differs in any significant way from that of other canids. We employed gross anatomical observation, magnetic resonance imaging, and classical neuroanatomical staining to provide a broad overview of the structure of the African wild dog brain. Our results reveal a mean brain mass of 154.08 g, with an encephalization quotient of 1.73, indicating that the African wild dog has a relatively large brain size. Analysis of the various structures that comprise their brains and their topological inter-relationships, as well as the areas and volumes of the corpus callosum, ventricular system, hippocampus, amygdala, cerebellum and the gyrification index, all reveal that the African wild dog brain is, in general, similar to that of other mammals, and very similar to that of other carnivorans. While at this level of analysis we do not find any striking specializations within the brain of the African wild dog, apart from a relatively large brain size, the observations made indicate that more detailed analyses of specific neural systems, particularly those involved in sensorimotor processing, sociality or cognition, may reveal features that are either unique to this species or shared among the Canidae to the exclusion of other Carnivora. 相似文献
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Bridget Dolan Chris Evans J. Hubert Lacey 《The International journal of eating disorders》1992,12(3):241-248
This paper reports a survey of natural history of eating behavior and attitudes to weight and shape in British women attending a family planning clinic. Sixty-two women completed a battery of standardized tests, followed by a second questionnaire 18 months later. This rescreening represents the first report of an adult sample not self-defined as ill. The Eating Attitudes Test (EAT)-26 total score showed stability over time (r =.68) but a/so showed a nonsignificant increase in the number of “cases.” The self-reported weight and desired weight increased slightly but statistically over the whole sample in the follow-up period. Analysis of group variances showed evidence of a heterogeneity of variance which was more marked than evidence of group mean effects between responders and nonresponders. The self-reported heights were stable but self-report of historical weight limits showed impossible inconsistencies such that any data related to these must be interpreted with caution. We recommend that future follow-up studies report analysis of loss to follow-up both by group means and variances, that inconsistent responses be counted and explored, and that both group mean changes over time and correlations be reported since they convey different information. 相似文献
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ABSTRACTTrichotillomania (hair pulling) remains a relatively unknown form of body-focused repetitive behavior (BFRB). Sufferers tend to conceal both the action and its effects from others because of stigmatization, which is strong in both public and domestic spheres. Negative responses from close family members can add significantly to the suffering. Based on fieldwork in the United Kingdom and United States, we explore how hair pulling troubles ties even among close family members. We show why ethnographic methods reveal impacts of hair pulling that structured assessments do not yet capture and argue for a more nuanced study of BFRBs through anthropologies of relatedness. 相似文献
110.