A Study of the Ethical Sensitivity of Physicians in Turkey

2003 ◽  
Vol 10 (5) ◽  
pp. 472-484 ◽  
Author(s):  
Nermin Ersoy ◽  
Ümit N Gündoğmuş
Keyword(s):  
Living Will ◽  
Ethical Sensitivity ◽  
Ethical Aspects ◽  
Truth Telling ◽  
Medical Confidentiality ◽  
First Case ◽  
The Individual ◽  
Low Sensitivity ◽  
Ethics Courses ◽  
Made In

In order to prepare bioethics and clinical ethics courses for clinicians in Turkey, we needed to know the attitudes of physicians when placed in ethically difficult care situations. We presented four cases to 207 physicians who are members of the Physicians’ Association in Kocaeli, Turkey. Depending on the decisions they made in each case, we determined whether they were aware of the ethical aspects of the cases and the principles they chose as a basis for their decisions. We aimed to gain information about their ethical tendencies and moral sensitivity. A small number of physicians stated that they would ‘show respect for a patient’s living will’ in the first case, but more stated that they would ‘let the patient refuse the treatment’ in the second. In the third case, where medical confidentiality was the significant ethical issue, most of the physicians said that they would act in order to maintain confidentiality. For the last case, more than half the physicians chose to ‘tell the truth’ to the patient. The paternalism shown in the doctors’ decisions on the first two cases was no longer observed in those made for the last two cases. We concluded that the physicians who participated in our study have low sensitivity to living wills (or advance directives) and patients refusing treatment. However, when issues of medical confidentiality and truth-telling are concerned, they take care to protect the autonomy of the individual and are relatively more aware of the ethical aspects of these cases.

Impairment Tutorial: Functionally Limiting Upper Extremity Pain: Controversies in Impairment Rating

2003 ◽  
Vol 8 (5) ◽  
pp. 4-12
Author(s):  
Lorne Direnfeld ◽  
James Talmage ◽  
Christopher Brigham
Keyword(s):  
Upper Extremity ◽  
Radicular Pain ◽  
Illness Behavior ◽  
Orthopedic Surgeon ◽  
First Case ◽  
Clinical Presentations ◽  
Whole Person ◽  
Physical Examinations ◽  
Upper Extremity Impairment ◽  
The Individual

Abstract This article was prompted by the submission of two challenging cases that exemplify the decision processes involved in using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). In both cases, the physical examinations were normal with no evidence of illness behavior, but, based on their histories and clinical presentations, the patients reported credible symptoms attributable to specific significant injuries. The dilemma for evaluators was whether to adhere to the AMA Guides, as written, or to attempt to rate impairment in these rare cases. In the first case, the evaluating neurologist used alternative approaches to define impairment based on the presence of thoracic outlet syndrome and upper extremity pain, as if there were a nerve injury. An orthopedic surgeon who evaluated the case did not base impairment on pain and used the upper extremity chapters in the AMA Guides. The impairment ratings determined using either the nervous system or upper extremity chapters of the AMA Guides resulted in almost the same rating (9% vs 8% upper extremity impairment), and either value converted to 5% whole person permanent impairment. In the second case, the neurologist evaluated the individual for neuropathic pain (9% WPI), and the orthopedic surgeon rated the patient as Diagnosis-related estimates Cervical Category II for nonverifiable radicular pain (5% to 8% WPI).

A Handbook to Eddic Poetry: Myths and Legends of Early Scandinavia, ed. Carolyne Larrington, Judy Quinn, and Brittany Schorn. Cambridge: Cambridge University Press, 2016, xii, 413 pp., 12 b/w ill.

Mediaevistik ◽  
2018 ◽  
Vol 31 (1) ◽  
pp. 366-366
Author(s):  
Albrecht Classen
Keyword(s):  
Old Norse ◽  
Entire Volume ◽  
Cambridge University ◽  
Critical Studies ◽  
Individual Contributions ◽  
The Many ◽  
The Individual ◽  
Made In ◽  
Scandinavian Literature

Eddic poetry constitutes one of the most important genres in Old Norse or Scandinavian literature and has been studied since the earliest time of modern-day philology. The progress we have made in that field is impressive, considering the many excellent editions and translations, not to mention the countless critical studies in monographs and articles. Nevertheless, there is always a great need to revisit, to summarize, to review, and to digest the knowledge gained so far. The present handbook intends to address all those goals and does so, to spell it out right away, exceedingly well. But in contrast to traditional concepts, the individual contributions constitute fully developed critical article, each with a specialized topic elucidating it as comprehensively as possible, and concluding with a section of notes. Those are kept very brief, but the volume rounds it all off with an inclusive, comprehensive bibliography. And there is also a very useful index at the end. At the beginning, we find, following the table of contents, a list of the contributors, unfortunately without emails, a list of translations and abbreviations of the titles of Eddic poems in the Codex Regius and then elsewhere, and a very insightful and pleasant introduction by Carolyne Larrington. She briefly introduces the genre and then summarizes the essential points made by the individual authors. The entire volume is based on the Eddic Network established by the three editors in 2012, and on two workshops held at St. John’s College, Oxford in 2013 and 2014.

The Chemical Effect in Medicine Interaction Determining the Form and Speed of Psychical Involution in the Prosthetic Restauration in the Edentulous

2018 ◽  
Vol 69 (8) ◽  
pp. 2306-2310
Author(s):  
Aureliana Caraiane ◽  
Razvan Leata ◽  
Veronica Toba ◽  
Doina Vesa ◽  
Luana Andreea Macovei ◽  
...  
Keyword(s):  
Practical Importance ◽  
Psychosocial Problems ◽  
Well Being ◽  
The Elderly ◽  
Chemical Effect ◽  
Special Importance ◽  
Dramatic Form ◽  
Specific Disorders ◽  
The Individual ◽  
Made In

The progress made in dentistry during the latest decades is due, conceptually, to the new, systemic vision of man, which has also taken place in this field of medicine. In this context, the link between organic and psychic is indestructible. Thus illness is understood as a drama in which the somatic process has a psychic value, and the mental one has a body value. It is known that the morphological and functional integrity of the dental system, health and vigorousness, gives the individual a state of well-being that affects his somatic and psychic health, as any disturbance at this level entails repercussions in psychological and social behavior. Such a disruption is the total edification that seriously alters not only the dental system but the whole organism, putting various biological and psychosocial problems to the practitioner. The total expression represents not only a physical disability but also a psychological one. A special importance in studying psychological changes at total edentulous presents the psychological aspects of senile involution. This is not only a theoretical but also a practical importance due to the increase in the number of elderly people. Through the researches of the present paper we intend to present the reality of the psychological manifestations in the total edentation, which is objectified on different methods of psychodiagnosis in the first part, in order for the second part to be addressed to problems of prosthetic psychotherapy.The study comprises a group of 43 patients, of whom 24 were men and 19 women with total uni or bimaxilar edentation. Total edentation can be and is responsible for somatopsychic alterations, along with other pathogens, general, local, social, which sometimes can take a dramatic form, converting, where the area is also favorable, a pure somatic disease, for those who are not in psychopathy or even psychosis, although these latter cases are extremely rare and especially in youngsters, which would disrupt not only the person�s behavior as an individual, but also their status, function and social integrity. The treatment of dental and psychological complex is mandatory for any patient, but especially for the elderly, where recovery is more difficult, with disease-specific disorders adding to those of senescence.

scholarly journals Comparing the Diagnostic Value of Serum D-Dimer to CRP and IL-6 in the Diagnosis of Chronic Prosthetic Joint Infection

2020 ◽  
Vol 9 (9) ◽  
pp. 2917
Author(s):  
Thomas Ackmann ◽  
Burkhard Möllenbeck ◽  
Georg Gosheger ◽  
Jan Schwarze ◽  
Tom Schmidt-Braekling ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Joint Infection ◽  
Revision Arthroplasty ◽  
Preoperative Assessment ◽  
Diagnostic Value ◽  
Musculoskeletal Infection ◽  
Prosthetic Joint ◽  
The Individual ◽  
Low Sensitivity ◽  
D Dimer

Introduction: D-dimer is a diagnostic criterion for periprosthetic joint infection (PJI) of the Musculoskeletal Infection Society (MSIS) in 2018. The aim of this study was to evaluate the serum D-dimer values in comparison to C-reactive protein (CRP) and interleukin-6 (IL-6) for the diagnosis of PJI. Materials and Methods: We included 119 patients (50 women, 69 men; 71 knees, 48 hips) undergoing revision arthroplasty with preoperative assessment of CRP, IL-6, and serum D-dimer. Cases were classified as infected or aseptic based on the MSIS criteria of 2018. Receiver operating curves and Youden’s index were used to define an ideal cut-off value and sensitivity and specificity for the individual parameters, and respective combinations were calculated using cross-tables. Results: The median D-dimer level (2320 vs. 1105 ng/mL; p < 0.001), the median CRP level (4.0 vs. 0.5 mg/dL; p < 0.001), and the median IL-6 level (21.0 vs. 5.0 pg/mL; p < 0.001) were significantly higher in the group of PJI compared to the group with aseptic failure. The calculated optimal cut-off values were 2750 ng/mL (AUC 0.767) for D-dimer, 1.2 mg/dL (AUC 0.914) for CRP, and 10.0 pg/mL (AUC 0.849) for IL-6. D-dimer showed a sensitivity of 38% and specificity of 94%, whereas the CRP and IL-6 had sensitivities of 88% and 76%, and specificities of 87% and 92%, respectively. Conclusion: In comparison with CRP and IL-6, serum D-dimer showed low sensitivity and specificity in our cohort. While CRP and IL-6 combination had the highest sensitivity, a combination of Il-6 and D-dimer or CRP and IL-6 had the highest specificity.

Computerized Image Enhancement for Visually Impaired Persons: New Technology, New Possibilities

1986 ◽  
Vol 80 (7) ◽  
pp. 849-854
Author(s):  
E. Pell ◽  
L. E. Arend ◽  
G. T. Timberlake
Keyword(s):  
Image Enhancement ◽  
Visually Impaired ◽  
Transfer Functions ◽  
Spatial Scales ◽  
New Technology ◽  
Age Related ◽  
Visual Degradation ◽  
The Individual ◽  
Visually Impaired Persons ◽  
Made In

Patients with age-related visual loss suffer reduced ability to recognize faces and other scenes in photographs and on television. Recently, progress has been made in image enhancement, using controlled distortion of digitally stored images that increases their usefulness in particular applications. Described are two approaches to image enhancement for the visually impaired. In one approach, the visual losses that characterize individual patients and disease classes are described using detailed measurements of visual degradation transfer functions, which are profiles of loss of image information at various spatial scales. The particular distortion used for image enhancement is then adjusted to the impairment of the individual patient or disease class. A second approach takes advantage of the resemblance between the visual losses of many patients and the degradation of picture information in other applications due to external limitations (e.g., fog and haze) on photography. Several enhancement algorithms have been found useful with such images and may also improve picture recognition by the visually impaired.

Febrile Convulsions, by J. Gordon Millichap, M.D., M.R.C.P. New York: The Macmillan Company, 1968, 239 pp., $7.95

PEDIATRICS ◽  
1968 ◽  
Vol 42 (2) ◽  
pp. 381-382
Author(s):  
Randolph K. Byers
Keyword(s):  
New York ◽  
Relevant Literature ◽  
Febrile Seizures ◽  
Cerebral Injury ◽  
Extensive Review ◽  
Cerebral Disease ◽  
Febrile Convulsions ◽  
The Individual ◽  
The Brain ◽  
Made In

This rather modest-looking monograph deals not only with the large experiences of the author in relation to febrile seizures, but also presents an extensive review of the modern relevant literature (266 references in the bibliography). The most useful point made in the book, it seems to me, is that febrile convulsions are just that: i.e., convulsions coinciding with fever, the result of illness not directly involving the brain or its meninges. Such a seizure may be an isolated occurrence in the life of the individual, or it may recur a few times with fever; it may be the first sign of idiopathic chronic epilepsy, or it may be evidence of more or less apparent cerebral injury of a static sort; or, it may be the presenting symptom heralding progressive cerebral disease.

scholarly journals The nature of patient complaints: a resource for healthcare improvements

2018 ◽  
Vol 31 (7) ◽  
pp. 556-562 ◽  
Author(s):  
Anna RÅBERUS ◽  
Inger K HOLMSTRÖM ◽  
Kathleen GALVIN ◽  
Annelie J SUNDLER
Keyword(s):  
Reporting System ◽  
Healthcare Services ◽  
Publicly Funded ◽  
Patient Harm ◽  
Patient Complaints ◽  
Communication Needs ◽  
The Individual ◽  
Systematic Random Sample ◽  
Made In

Abstract Objective The aim of this study was to explore the nature, potential usefulness and meaning of complaints lodged by patients and their relatives. Design A retrospective, descriptive design was used. Setting The study was based on a sample of formal patient complaints made through a patient complaint reporting system for publicly funded healthcare services in Sweden. Participants A systematic random sample of 170 patient complaints was yielded from a total of 5689 patient complaints made in a Swedish county in 2015. Main outcome measure Themes emerging from patient complaints analysed using a qualitative thematic method. Results The patient complaints reported patients’ or their relatives’ experiences of disadvantages and problems faced when seeking healthcare services. The meanings of the complaints reflected six themes regarding access to healthcare services, continuity and follow-up, incidents and patient harm, communication, attitudes and approaches, and healthcare options pursued against the patient’s wishes. Conclusions The patient complaints analysed in this study clearly indicate a number of specific areas that commonly give rise to dissatisfaction; however, the key findings point to the significance of patients’ exposure and vulnerability. The findings suggest that communication needs to be improved overall and that patient vulnerability could be successfully reduced with a strong interpersonal focus. Prerequisites for meeting patients’ needs include accounting for patients’ preferences and views both at the individual and organizational levels.

scholarly journals The Control of Cigarette Weight During the Manufacturing Process/Die Kontrolle des Gewichtes von Cigaretten auf den Produktionsmaschinen

1973 ◽  
Vol 7 (1) ◽  
Author(s):  
G. Moretti
Keyword(s):  
Manufacturing Process ◽  
A Posteriori ◽  
Basic Principles ◽  
First Case ◽  
External Causes ◽  
Made In

AbstractThe check of the cigarette weight can be made “a posteriori”, that is when a certain number of cigarettes has been manufactured, and then it is aimed at verifying the acceptability of the lot. Conversely, it can also be executed during the manufacturing process in order to produce acceptable cigarettes. In the first case the ordinary statistical theories can be applied, whereas in the second case, which is the more interesting from cigarette manufacturers' viewpoint, Wiener's theories must be applied on both checks and servo-mechanisms. Consequently, it is necessary to revise the basic principles of the "check'' and then those of the operation of weight-governors in order to attain the highest possible precision, regardless of the external causes which might affect the result. So, the idea of ''self-optimizing'' governors is assumed, that is regulators adjusting their own action to obtain the best results. Molins, Decoufle and, lately, the Industrial Nucleonic Corp., though not having yet developed an adaptive adjuster, have made in recent times the most significant efforts in this field.

scholarly journals Pengaruh Kecerdasan Emosional Dan Ethical Sensitivity Terhadap Persepsi Etis Mahasiswa Sebagai Calon Akuntan

2020 ◽  
Vol 2 (4) ◽  
pp. 3840-3857
Author(s):  
Ridho Irmas Ferdian ◽  
Mayar Afriyenti
Keyword(s):  
Emotional Intelligence ◽  
Linear Regression Analysis ◽  
Sampling Technique ◽  
Multiple Linear Regression Analysis ◽  
Accounting Students ◽  
Ethical Sensitivity ◽  
Ethical Perceptions ◽  
City College ◽  
The Individual ◽  
Positive Effect

This study wanted to determine the ethical perceptions of students from the individual side of accounting students at FE UNP, namely from the emotional intelligence and ethical sensitivity of students. The author makes students the object of research because an accountant's ethical perceptions can also be influenced by several factors. One of them is external factors, namely the environment. The environment affects the formation of a person's character so that it affects their behavior. This research is classified as a causative research. The population used in this study were accounting students at the Padang City College. Samples were taken using purposive stratified sampling technique. Where is the sampling by taking samples of people selected by the author according to specific characteristics and certain characters. The analysis used in this study is multiple linear regression analysis used in this study is to use the SPSS 21 computer program. . The results of this study are that emotional intelligence has a positive effect on students' ethical perceptions as prospective accountants and ethical sensitivity has a positive effect on students' ethical perceptions as prospective accountants.

scholarly journals External supravesical hernia is a rare type of abdominal wall hernia: A case report

2017 ◽  
Vol 7 (1) ◽  
pp. 40-41 ◽  
Author(s):  
Pankaj Kumar Saha ◽  
Ratna Rani Roy ◽  
Mohammad Emrul Hasan Khan ◽  
Md Mamunur Rahman ◽  
Kazi Shafiqul Alam ◽  
...  
Keyword(s):  
Case Report ◽  
Inguinal Hernia ◽  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Surgical Anatomy ◽  
Rare Type ◽  
First Case ◽  
Made In

The first case of external supravesical hernia was made in 1804; but it is so rare that it is very difficult to find any case reported in Bangladesh. Here a case of external supravesical hernia is described in a male who was presented with a left sided direct incomplete reducible inguinal hernia. This report aims to review and discuss the surgical anatomy of these rare supravesical hernias and calls attention to the confusing presentation and treatment of this conditionJ Shaheed Suhrawardy Med Coll, 2015; 7(1):40-41

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