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Biomedical subjects

F M Hull

Publications and source records attributed to F M Hull.

17 recordsLinked to original sources

Death, dying and the medical student.

The objective of this study was to determine the extent of medical students' experience of death and dying. A questionnaire was given to two groups of Birmingham medical students at the beginning of clinical studies (third year) and in the final year which was designed to estimate their experience of death and of dying people. The questionnaire also explored the students' attitudes to their own future deaths. Questionnaires were returned by 119 third-year and 143 final-year students. Students had little experience of death and what they did have was largely acquired before entry to medical school or in their social rather than medical lives. Where they did have experience of death this was often traumatic and there was little chance for them to have counselling about it. There is need for increased teaching about death and dying particularly before clinical training and at the time of graduation. Another time may be at the beginning of human dissection.

Adaptation, Psychological

The management of vaginal discharge in general practice.

A group of general practitioners in active practice were asked to report how they preferred to manage the symptoms of vaginal discharge presented by a woman in her twenties. Subsequently the same practitioners reported their management of such patients in their practice.A shortfall was found for all practitioners between their declared intention and their actual practice.This method of analysis offers a way of working towards a consensus in clinical care and also of auditing medical performance in general practice.

Adult

Altitude sickness.

Ten climbers were studied trekking from 1,950 to 4,650 m (6,500 ft to 15,500 ft) in the Nanda Devi Sanctuary of the Garwhal Himalaya. All developed altitude sickness, one seriously. Pulse, blood pressure, and peak flow rate were monitored daily in an attempt to predict the onset of altitude sickness. Prediction was uncertain though the one climber who became seriously cyanosed at 4,200 m (14,000 ft) had a consistently higher blood pressure than his colleagues.

Altitude Sickness

Pregnancy in women using intra-uterine contraceptive devices.

Among 1,041 women fitted with intra-uterine contraceptive devices during a period of 21,445 months there were 51 pregnancies: a rate of 2.9 per hundred women years. Pregnancy occurred most commonly in the young and nulliparous. The importance of the patient checking her device is stressed. Pregnancy occurs most commonly soon after fitting, but may occur at any time. In more than half the cases pregnancy occurred with the device in the uterus. Though most pregnancies were uterine there was a high incidence of ectopic pregnancies. Many pregnancies ended in vaginal delivery, but since the Abortion Act 1967 fewer probably now go to term.

Age Factors

Intra-uterine contraception in general practice.

The experience of two general practitioners with 1,041 women attending clinics for intra-uterine contraception is analysed retrospectively. Patients were mainly Health Service patients of the doctors, but some were referred by other general practitioners, by the local authority, and a consultant. Some patients travelled considerable distances. Age varied from 15 to 52 and parity from 0 to 11. The fitting of various devices was usually easy, but patients often complained of symptoms, mostly bleeding, pain, or discharge, the majority of which were amenable to treatment and often were not due to the intra-uterine contraceptive device itself. There was evidence of lowered haemoglobin levels in women using this method for some years.The retrospective analysis shows follow up, always difficult in contraceptive clinics, to be less than desirable. In planning contraceptive programmes more attention should be given to this subject. Pregnancy occurred in 51 cases and there were four cases of cancer of which one died. There was a further unrelated death from subarachnoid haemorrhage.

Adolescent

The team; new roles for nurses in general practice--a lesson from America.

IN NORTH AMERICA ATTEMPTS HAVE BEEN MADE TO COUNTERACT THE SHORTAGE OF DOCTORS BY TRAINING ANCILLARIES: the physician's assistant (P.A.) and the family nurse practitioner (FNP). Though physician assistants may give rise to interpersonal difficulties within practices the concept of the family nurse practitioner has much application in Britain. The possibility of employing family nurse practitioners in British general practice is discussed particularly with regard to the help they might give in diagnosis, in psycho-social counselling and follow-up.

Canada