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Biomedical subjects

C Willard

Publications and source records attributed to C Willard.

11 recordsLinked to original sources
PubMed2005

Supportive care in the cancer setting: rhetoric or reality?

BACKGROUND: Since 1995, UK cancer policy has been directed at organizational changes to secure improvements in treatment outcomes and quality of supportive care for cancer patients. The substantial increase in hospital-based specialist cancer nurses (SCNs) during this time suggests they have a major role to play in the delivery of supportive care. AIM: To explore how SCNs implemented their role in the context of organizational change and newly-formed multidisciplinary teams. METHODS: Twenty-nine SCNs participated in observation and/or interviews, resulting in 135 hours of observation and in-depth semi-structured interviews with 17 SCNs. Data were collected and analysed using a grounded theory approach. RESULTS: The prominence of the treatment agenda--the process of investigating, diagnosing and treating cancer--presented the biggest challenge to the delivery of supportive care. The treatment agenda influenced how support was offered, determined professional boundaries and relegated support to a subordinate position in patient care. CONCLUSIONS: Access to supportive care is a central tenet of current cancer policy and crucial to the philosophy of patient-centred care. While SCNs are essential to the delivery of supportive care, this study highlights the challenges they encounter in organizations which prioritise treatment and improvements to treatment outcomes.

Attitude of Health Personnel↗
PubMed2000

Cardiopulmonary resuscitation for palliative care patients: a discussion of ethical issues.

Medical advances have significantly improved the prognosis and life-expectancy for many patients with life-threatening illness. However, the ability to extend and prolong life increases the complexity of clinical decision-making, and this is particularly true in the context of palliative care. During the course of their illness, many patients with palliative care needs will require hospital admission. It is in this setting that ethical dilemmas are likely to arise regarding the use of life-prolonging measures such as cardiopulmonary resuscitation (CPR). This paper considers some of the ethical issues surrounding the use of CPR for palliative care patients in the hospital setting.

Cardiopulmonary Resuscitation↗
PubMed1997

Killing and caring: is euthanasia incompatible with care?

The issue of euthanasia continues to be surrounded by controversy, particularly in relation to its moral status and more recently, the significance that health professionals should attach to the principle of respect for patient autonomy. Increasing knowledge and expertise in the field of palliative care has also led to claims that the provision of effective palliative care services render discussion about the introduction of euthanasia unnecessary. By reviewing and analysing the arguments put forward in support of the continued ban on voluntary active euthanasia, this paper suggests that these arguments largely fail to address the notion of patient autonomy and concludes that even with provision and access to palliative care service, euthanasia could be considered a moral option which is not necessarily incompatible with care.

Beneficence↗
PubMed1996

The nurse's role as patient advocate: obligation or imposition?

In order to secure professional standing, nursing has sought to discover and prove the value and uniqueness of the nursing contribution to patient well-being. A prominent feature of this quest has been the assertion by nurses and nurse writers that the nurse has a specific and special function as patient advocate. There is a substantial amount of literature to support this view, which is further reinforce by the United Kingdom Central Council (UKCC) for Nursing, Midwifery and Health Visiting which states that advocacy forms an integral part of the nurse's duty to patients. This paper provides a critical analysis of some of the features central to advocacy in order to promote clarification of the concept. These include the patient's rights and interests in health care, the moral status of patient autonomy, the obligations owed to patients by nurses and the work of independent advocacy schemes. It is suggested that the literature tends to confuse advocacy with beneficence which dilutes the significance of advocacy in health care, and that nurses have no special function as patient advocate. Furthermore, due to the rigorous demands of the advocate role, the UKCC neither can nor should impose such an obligation on its members, who would be better served by improved support when they endeavour to discharge the full range of beneficent obligations owed to patients within their care.

Ethics, Nursing↗
PubMed1987

Existence of at least three distinct Alu subfamilies.

Computer-assisted sequence analysis of human Alu family members reveals that Alu repeats belong to one of at least three subfamilies. The insertion of human Alu repeats can be represented by three episodic bursts, each of which was founded by a distinct master sequence.

Animals↗
PubMed1985

Comparison of human and chimpanzee zeta 1 globin genes.

The DNA base sequences of the entire chimpanzee zeta 1 globin gene and an additional 1 kb of DNA flanking both the human and chimpanzee genes have been determined. Whereas the human zeta 1 gene contains a termination codon in the sixth position, the chimpanzee gene appears to be functional. This finding confirms Proudfoot et al.'s suggestion that the human zeta 1 gene was recently inactivated. Like the corresponding human zeta 1 and zeta 2 genes, the first and second introns of the chimpanzee zeta 1 gene are occupied largely by tandem repeats of short oligonucleotides. These tandem repeats have undergone several rearrangements since the divergence of the human and chimpanzee zeta 1 genes.

Amino Acid Sequence↗
PubMed1985

Evolution of Alu family repeats since the divergence of human and chimpanzee.

The DNA sequences of three members of the Alu family of repeated sequences located 5' to the chimpanzee alpha 2 gene have been determined. The base sequences of the three corresponding human Alu family repeats have been previously determined, permitting the comparison of identical Alu family members in human and chimpanzee. Here we compare the sequences of seven pairs of chimpanzee and human Alu repeats. In each case, with the exception of minor sequence differences, the identical Alu repeat is located at identical sites in the human and chimpanzee genomes. The Alu repeats diverge at the rate expected for nonselected sequences. Sequence conversion has not replaced any of these 14 Alu family members since the divergence between chimpanzee and human.

Animals↗