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Update - December 1999, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- John and Alice Wong establish bioethics endowment
-- Richard Rice receives Templeton Award
-- "Humans" and "Persons" in Christian Bioethics (Commentary)
-- Mechanically Restraining the Ill and Elderly: Ethical Problems and Proposals
-- Clinical Ethics Consultation
-- Learn to minister in the clinical setting

Sterilization In The United States: Prevalence And Controversies, Carey Brown

Masters Theses & Specialist Projects

There have been many breakthroughs in birth control technologies, many of which have been beneficial for women. However, many feminists who advocate reproductive freedom also warn that freedom for some might lead to further oppression for others. The case in point is the practice of tubal ligation in the United States. Conflict theory indicates that the field of medicine is a social structure that is based upon capitalistic ideology and serves to perpetuate inequality. Feminist theory argues that medicine systematically disempowers women and that notions of family are very narrowly defined. This study examined the prevalence of tubal ligation among …

Ethnic Variability In The Treatment Of Pain, Rafael A. Ortega, Benjamin A. Youdelman, Richard C. Havel

Department of Surgery Faculty Papers

Ethnicity has been shown to be an important determinant of behavior during illness, particularly when a painful condition is present. Studies have shown that pain may be undertreated among different ethnic groups of patients. Whereas individual variations in the reaction to pain occur, available data do not support racial and/or ethnic differences in the perception of pain, leaving no justification for this discrepancy in treatment. Regardless of ethnicity, inadequate treatment of pain has been known for some time and has been referred to in recent literature as "oligoanalgesia." Lack of understanding of different ethnic and cultural groups can lead to …

Oncolog, Volume 44, Number 11, November 1999, Beth Notzon, Dawn Chalaire, Rhonda L. Moore Phd

OncoLog MD Anderson's Report to Physicians (All issues)

• Overcoming Side Effects: Department of Internal Medicine Specialties Finds Ways to Continue Critical Treatments
• Partners in Knowledge, News in Cancer: P.I.K.N.I.C. Program Brings Physicians, Patients Together
• House Call: CIS: Answering the Call for Help
• Advances in Control of Nausea, Vomiting Aim to Reduce 'Misery Quotient'
• DiaLog: Finding Meaning in Stories of Pain and Suffering, by Rhonda L. Moore, PhD, Postdoctoral Fellow, Department of Epidemiology
• Protocols: Side Effects of Cancer and Cancer Treatments Are the Subject of Clinical Investigations

Medical Education Digest, Vol. 1 No. 2 (October 15, 1999), Nova Southeastern University

Medical Education Digest

No abstract provided.

The Critically Ill Patient After Hepatobiliary Surgery, Stephen P. Povoski, Robert J. Downey, Paul S. Dudrick, Yuman Fong, William R. Jarnigan, Jeffrey S. Groeger, Leslie H. Blumgart

Faculty Publications and Other Works -- Nursing

Background

We analyzed the causes and results of utilization of critical careservices in the special care unit in patients after surgical proceduresperformed by the hepatobiliary surgical service during a 23-month period.

Results

Thirty-two of 537 patients (6.0%) required postoperative admissionto the special care unit. Twenty-one patients were admitted directly fromoperating room or from recovery room because of inability to wean fromventilator (n = 10), hypovolemic shock (n = 4), myocardialischemia or infarction (n = 2), sepsis (n = 2), uppergastrointestinal bleeding (n = 2), and acute renal failure (n=1). Eleven postoperative patients were …

Oncolog, Volume 44, Number 10, October 1999, Dawn Chalaire, Alison Rufffin, Vickie J. Williams

OncoLog MD Anderson's Report to Physicians (All issues)

• Stereotadic Unit Expands Treatment Options for Patients with Brain Tumors
• New Center Teams With Community Physicians to Treat Patients With Advanced Cancer
• IRS Deduction Gives Smokers One More Reason to Quit
• Accuracy Essential in Stereotactic Radiosurgery
• House Call: Vitamins and Cancer Risk: Why You Should Eat Your (Fruits and) Vegetables
• Protocols: Brain Tumor Protocols Include Stereotactic Treatments, Surgery, and Radiation Therapy

Icu Resource Allocation: Life In The Fast Lane, David Crippen, Leslie Whetstine

Faculty Publications and Other Works -- Nursing

Introduction: what's the speed limit?

In 1973, the then United States President, Jimmy Carter, addressed the issue of declining petroleum resources and increasing automobile traffic by the institution of a rationing plan that mandated decreasing consumption fairly and equitably across the entire population of consumers. The national speed limit (NSL) decreased from 70 to 55 miles per hour, and, according to experts, constituted the perfect rationing plan [1]. It affected only those who used a scarce resource (gasoline) and it applied to all equally. In a perfect world, it should have been an extremely effective conservation method.

However, …

Digest Of The Philadelphia College Of Osteopathic Medicine (Summer 1999), Philadelphia College Of Osteopathic Medicine

Digest

The Summer 1999 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates
• Update on Clinical Education
• Board Profile
• Alumni Board Profile
• Convention Highlights
• Class Notes
• In Memoriam
• Coming Events

Factors Which Affect Post-Hospital Resource Use And Patient Health Outcomes Among Taiwanese Older Adults, Chouh-Jiaun Lin

Health Services Research Dissertations

The purpose of this study was to explore relationships among population characteristics, patient post-hospital resource use and patient health outcomes in terms of the Andersen health behavioral model. An additional purpose of this study was to examine a discharge planning screening instrument used in a large urban hospital in Taiwan to determine if it predicts resource use and patient outcomes. A longitudinal research design was adopted for this study. Data were collected from the general medicine departments of an 800-bed university teaching hospital. Out of 109 patients who were interviewed, 78 participants qualified (participation rate = 71.6%).

The majority of …

Oncolog, Volume 44, Number 07/08, July/August 1999, Dawn Chalaire, Kimberly Jt Herrick, Robert C. Bast, Jr. Md

OncoLog MD Anderson's Report to Physicians (All issues)

• New MRI Techniques Pinpoint Brain Tumors, Reveal Brain Functions in Real Time
• Upcoming Conferences Explore Many Topics
• Protocols: Liver Cancer Clinical Trials
• DiaLog: CA 125: The Past and the Future, by Robert C. Bast Jr., MD, Head, Division of Medicine
• House Call: Hormone Replacement Therapy: End to Hot Flashes or Fuse for New Cancers?
• Aggressive Regional Therapies Offer Some Promising Results for Patients with Liver Tumors

The Relationship Between Acculturation And The Effects Of Caregiving Of The Elderly Among Cuban-Americans, Georgia De Las Pozas

FIU Electronic Theses and Dissertations

The purpose of this study was to establish the perceived caregiving effects among thirty Cuban-born individuals caring for elderly relatives and the relationship of these effects with acculturation.

Most common difficulties were lack of private time, or social life, and decreased emotional and physical health. Satisfactions were mostly derived from fostering the elders' welfare. A strong positive relationship was found between caregivers' difficulties and stability of the caregiving dyad (r= - 0.642, p< .001). Caregivers involved in more unstable caregiver-care receiver dyads had more stress associated with caregiving difficulties. The acculturation factors of language, electronic media, and social relations, and the stability of the caregiving dyad accounted for 54 percent of the variation in caregivers' difficulties (p< .001) but only 21 percent of the variation of caregivers' satisfaction (p<.221).

These findings provided preliminary data of caregiving characteristics among Cuban-Americans and the importance of including acculturation in studies involving minorities.

Oncolog, Volume 44, Number 06, June 1999, Jude Richard, Michael Courtney, Alison Rufffin, Dawn Chalaire

OncoLog MD Anderson's Report to Physicians (All issues)

• After Diagnosis, Another Hurdle: Cancer Screening for the Cancer Patient
• House Call: Reduce Cancer Risk With Regular Cancer Screening
• M. D. Anderson Participates in Multinational Breast Cancer Prevention Trial of Tamoxifen and Raloxifene
• Nerve Grafting Attempts to Restore Erectile Function After Prostatectomy
• M. D. Anderson Researchers Study Children's School Lunch Habits and Choices

Views About Women's Mental Health: Study In A Squatter Settlement Of Karachi., Fauziah Rabbani

Community Health Sciences

OBJECTIVE:

Mental health of women is globally receiving particular attention. This study assessed community's view on certain aspects of women's mental health prior to introducing an intervention.

SETTING:

The study was conducted in an urban squatter settlement located in District West of Karachi in 1997 where the Aga Khan University has set up a Primary Health Care program in partnership with the communities.

METHODS:

Using convenient sampling, door to door household survey was conducted by medical students.

RESULTS:

Two hundred and eighty one residents were interviewed. Respondents were asked to list contributory factors which lead to mental distress in women. …

Physical Violence During Pregnancy: Maternal Complications And Birth Outcomes, Vilma E. Cokkinides, Ann L. Coker, Maureen Sanderson, Cheryl Addy, Lesa Bethea

CRVAW Faculty Journal Articles

Objective: To assess the association between physical violence during the 12 months before delivery and maternal complications and birth outcomes.

Methods: We used population-based data from 6143 women who delivered live-born infants between 1993 and 1995 in South Carolina. Data on women's physical violence during pregnancy were based on self-reports of partner-inflicted physical hurt and being involved in a physical fight. Outcome data included maternal antenatal hospitalizations, labor and delivery complications, low birth weights, and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the associations between physical violence, maternal morbidity, and birth outcomes.

Results: The prevalence …

The Accuracy Of Nitrous Oxide Passive Dosimeters As Compared With An Infra-Red Spectrographic Reference Method, Susan Allen

Community & Environmental Health Theses & Dissertations

Nitrous oxide is a gas often used in dental, surgical and veterinary operations as an anesthetic agent. Employees stationed in proximity of fugitive gas emissions may potentially suffer adverse health effects from chronic exposure to this agent. Passive dosimeters can be worn in the breathing zone of potentially affected personnel during exposure periods, then later analyzed to quantify nitrous oxide exposure. This study sought to establish the accuracy of several commercially available passive monitoring devices for nitrous oxide by comparison against an infra-red spectrophotometric reference method.

Vital Signs, Spring 1999, Boonshoft School Of Medicine

Vital Signs

A twenty four page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Breast Cancer: Research And Treatment, Jessica Goodisman

WWU Honors College Senior Projects

We seek to understand and treat cancer to reduce a major source of human suffering. Cancer is a plague of our generation, one of the last incurable diseases. It is interesting to note that past generations did not generally live long enough to suffer from cancer. Infectious disease drastically limited the human life span. In recent history, western medicine has been able to control infection and life expectancy has risen dramatically. Cancer is the next hurdle. Modem research slowly gains insight with the hope of finding new ways to control cancer.

This paper provides information about the process by which …

Oncolog, Volume 44, Number 03, March 1999, Dawn Chalaire, Beth W. Allen, Alison Rufffin

OncoLog MD Anderson's Report to Physicians (All issues)

• Vaccines, Other New Options Expand Renal Cancer Therapy Program
• Thirteen-story Alkek Hospital Makes Debut
• Training Takes Prevention and Early Detection Worldwide
• Nephrectomy Before or After Systemic Therapy­--That Is the Question
• House Call: Alcohol and Cancer: Making Sense of a Cocktail of Risks and Benefits
• Protocols: Renal Cell Carcinoma Trials Offer Therapies for Treated and Untreated Patients
• Compass: New Quarterly Supplement Offers Perspectives on Clinical Guidelines

Home Observation For Asymptomatic Coin Ingestion: Acceptance And Outcomes. The New York State Poison Control Center Coin Ingestion Study Group., Gregory P. Conners, D J. Cobaugh, R Feinberg, R Lucanie, T Caraccio, C M. Stork

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To obtain preliminary estimates of the acceptance rate and the frequency of adverse outcomes, and to identify issues related to acceptance, associated with management of asymptomatic pediatric coin ingestion by home observation, in preparation for a large-scale prospective study.

METHODS: Scripted telephone follow-up of callers who had reported asymptomatic pediatric coin ingestions to one of five poison control centers six to 36 months previously, which had been managed by home observation.

RESULTS: Of the 67 callers enrolled, 41 (67%) reported contacting a physician regarding the coin ingestion, despite home observation instruction by poison control center personnel. Those who did …

Kennis En Houdings Van Verpleegkundiges Aangaande Die Voedingsprobleme Van Babas Met Gesplete Lip En Verhemelte, Brenda Louw, Hannelie Botha

Brenda Louw

Oncolog, Volume 44, Number 02, February 1999, Nancy Arora, Sunni Hosemann, Kimberly Jt Herrick

OncoLog MD Anderson's Report to Physicians (All issues)

• Laryngeal Mask Airway: A New Frontier in Airway Management
• House Call: Exercise--A Hop, Skip, and a Jump for Reducing Cancer Risk
• Conferences Offer Variety of Topics
• Cervical Cancer Study Results Expected to Change Practice
• May I Take Your Order?

Filling The Geriatric Gap: Is The Health System Prepared For An Aging Population?, Janet Firshein

National Health Policy Forum

This issue brief explores the field of geriatrics, the ways practitioners meet the health care needs of the elderly, training gaps, and the impact of Medicare payment policies on the delivery of health care to older Americans.

Vital Signs, Winter 1999, Boonshoft School Of Medicine

Vital Signs

A twenty four page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 1999), Philadelphia College Of Osteopathic Medicine

Digest

The Winter 1999 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates
• College Bestows Highest Award on Nicholas C. Pedano, DO, '61
• Founders Day 1999
• PCOM Alumni Association Honors
• Leonard H. Finkelstein, DO, '59
• Library
• Profiles
• Improving Students' Clinical Years at PCOM
• Convention Highlights
• Mission Milestones
• Remembering a Gem of the Osteopathic Profession
• Class Notes
• In Memoriam
• Special Supplement: PCOM Centennial (First In A Series Of Four)
• Centennial Calendar 1999
• Coming Events

Ethical Concerns In The Care Of Individuals With Alzheimer’S Disease, Jeanne Sorrell

Case Studies from Age in Action

Educational Objectives

1. Identify important ethical concerns in the care of individuals with Alzheimer's Disease.

2. Describe the use of the Fairhill Guidelines as a frame-work for study of ethical issues related to the care of individuals with Alzheimer's Disease.

3. Discuss interventions to assist individuals with dementia and their family members in exploring ethical concerns.

Merging A Divided System: The Need To Integrate Care For Individuals Participating In Both The Medicare And Medicaid Programs, Regina L. Anderson-Cloud

Case Studies from Age in Action

Educational Objectives

1. Identify the underlying premises of the need to integrate care between the Medicare and Medicaid programs for individuals eligible for both insurances.

2. Discuss innovations aimed at assisting older adults with an improved Medicare/Medicaid system.

3. Describe relevant health care concerns related to the current fragmentation of the health care system for older adults who possess both Medicare and Medicaid.

Geriatric Interdisciplinary Team Training, Rita Jablonski, David A. Cifu, Peter A. Boling, Patricia Slattum, A. Leigh Peyton, F. Ellen Netting, Iris A. Parham, Joan B. Wood

Case Studies from Age in Action

Educational Objectives

1. To demonstrate the importance of training health care professionals in inter-disciplinary teamwork and geriatric health issues.

2. To increase one’s knowledge of the roles and responsibilities of the various disciplines involved in interdisciplinary teamwork.

Trauma Outcome: Review Of Results In Urban Hospital In Southern Pakistan, Hasnain Zafar, Fuad Abid, Asad Jamil Raja, Mushtaq Ahmed, Faheem Nanajani, Yousuf Kamal Mirza

Section of General Surgery

No abstract provided.

Results Of Faculty Evaluation At The Aga Khan University, Karachi, Pakistan, Rashida Ahmed, Mohammad Khurshid, Zoon Naqvi

Section of Haematology/Oncology

Objective: The aim of the retrospective correlational analysis was to identify the attributes valued most by students for assessing the overall effectiveness of a teacher.
Methods: Responses of the students to the two versions of evaluation questionnaires, each attempting to assess 4 and 8 characteristics respectively on a scale of 1-5 were included in the analysis. The third and fourth year students, at the end of each course/module completed a total of 2110 evaluation forms, which were studied.
Results: The over all effectiveness of the teacher showed statistically significant correlation of .914 and .895 with ability to communicate ideas effectively …