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Biomedical subjects

E Rice

Publications and source records attributed to E Rice.

25 records · Page 2Linked to original sources

A computer system for clinical microbiology.

The Department of Clinical Microbiology at St Thomas' Hospital has been producing bacteriological reports on a computer for more than three years and is now producing some 2300 reports per week. The system is operated entirely by laboratory staff without special training, and involves the use of optical mark reader (OMR) forms as worksheets, automatic validation and release of most reports, the use of local terminals, and scrutiny of reports by pathologists using a visual display unit. The OMR worksheet records not only the final result but also most of the tests and observations made on the samples; it is the only working document used by technicians. One specialist clinic submits its laboratory requests on an OMR form, which is subsequently used to record the results. The reports are printed and also filed in the computer to produce analyses for hospital, laboratory, and clinical management.

Computers↗

Fugue states in sleep and wakefulness: a psychophysiological study.

A patient's refusal to participate in recommended treatment is a problem faced in all branches of medicine. However, psychiatry faces special problems because of its authority to impose hospitalization and treatment on unwilling patients. Nowhere is this more poignant than in the treatment of patients exhibiting suicidal behavior where the potential for imminent self-destruction exists. As part of a prospective study to develop utilization review standards for the hospitalization of suicide attempters, cases were identified where there was independent agreement between both the experts' standards and the treating resident psychiatrists that hospitalization was required. Despite this agreement, the patients were not hospitalized because the patients refused. By most criteria, these patients were a high risk group. They had made repeated suicide attempts, used lethal means which eventuated in serious medical consequences, and were still suicidal when referred for treatment. The emergency room psychiatrists reported feeling confused, anxious, and annoyed in dealing with these patients, and the patients signed out against medical advice. A review of these cases indicates that discussions of social control vs. medical responsibility and clear criteria for hospitalization should be incorporated into residency training programs since the emergency room resident faces these tension-producing issues frequently with several different types of patients. Moreover, utilization review criteria may help to set standards which will assist the psychiatrist in making these difficult decisions.

Dissociative Disorders↗

The role of the oedipal fantasy in masturbatory and suicidal phenomena.

The multifaceted syndrome of suicide is viewed as a symptom with a manifest and a latent content. An attempt is made to demonstrate a dynamic reciprocal relationship, in a continuum, among fantasy, masturbation, and suicide. Sadomasochistic phenomena, beating fantasies, and suicidal thoughts and acts are viewed as translations of underlying positive and negative oedipal fantasies. Attention is also paid to how suicidal phenomena are facilitated by immature concepts of death, that is, its perception as a transient and reversible phenomenon, as well as its erotization. Four cases highlighting aspects of these themes are presented and then discussed in terms of how they illustrate the varying vicissitudes and elaborations of the masturbatory and/or oedipal fantasy and act, along separate or simultaneous pathways. In conclusion, there is an exploration of interpretive differences, with special reference to an object relations approach to phenomena, with its emphasis on preoedipal determinants and its attempts to accommodate both the drive/structure and object-relational/structure theoretical orientations.

Adult↗