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Biomedical subjects

L A Weaver

Publications and source records attributed to L A Weaver.

At least 19 recordsLinked to original sources
PubMed2000

Attitudes of terminally ill patients toward euthanasia and physician-assisted suicide.

BACKGROUND: In jurisdictions that permit euthanasia or physician-assisted suicide, patients with cancer comprise the largest group to die by these methods. We investigated the personal attitudes toward these practices of patients receiving palliative care for advanced cancer. METHODS: Seventy patients (32 men and 38 women; median survival, 44.5 days) took part in a survey using in-depth semistructured interviews. The interviews were audiotaped for transcription and content analysis of themes. RESULTS: Most participants (73%) believed that euthanasia or physician-assisted suicide should be legalized, citing pain and the individual's right to choose as their major reasons. Participants who were opposed to legalization cited religious and moral objections as their central concerns. Forty (58%) of the 69 participants who completed the entire interview also believed that, if legal, they might personally make a future request for a hastened death, particularly if pain or physical symptoms became intolerable. Eight of these individuals (12%) would have made such a request at the time of the interview. These 8 participants differed from all others on ratings of loss of interest or pleasure in activities, hopelessness, and the desire to die (Ps<.02). They also had a higher prevalence of depressive disorders (P<.05). However, they did not differ on ratings of pain severity. CONCLUSIONS: Many patients with advanced cancer favor policies that would allow them access to both euthanasia and physician-assisted suicide if pain and physical symptoms became intolerable. For patients who would actually make requests for a physician-hastened death, however, psychological considerations may be at least as salient as physical symptoms.

Adult↗
PubMed1985

Tardive dyskinesia: clinical and neuroendocrine response to low dose bromocriptine.

Twelve patients with a long-standing history of moderate to severe symptoms of tardive dyskinesia, which had remained stable for several months, participated in a 6-week trial with bromocriptine. All patients were receiving a concomitant neuroleptic medication and were treated with a low dose of bromocriptine (0.75 to 7.5 mg). Patients showed a modest overall improvement of 16.6%, with a trend for greater improvement in male patients (23.6%). Baseline prolactin levels in the female patients showed a positive correlation with age and duration of tardive dyskinesia symptomatology. Plasma prolactin levels 4 hours following administration of bromocriptine were negatively correlated with the dose of bromocriptine. There appears to be a differential sensitivity for prolactin and growth hormone response to bromocriptine at these low doses in the presence of chronic neuroleptic treatment.

Bromocriptine↗
PubMed1982

Studies in brief-pulse electroconvulsive therapy: the voltage threshold, interpulse interval, and pulse polarity parameters.

Three studies of parameters of short-pulse ECT are reported: (i) voltage threshold, (ii) interpulse interval, an (iii) pulse polarity. Using a defined standard stimulus, voltage thresholds were found to vary from 110-250 V with a mean of 185 V. Some patients also required an increased number of pulses. The interpulse interval study demonstrated that intervals from 30 to 50 msec were successful in over 90% of the group. An interpulse interval of 30 msec was adopted as a standard treatment. The third study demonstrated no difference in efficiency of convulsion production when all positive, all negative, or alternating positive and negative pulse stimuli were applied.

Adult↗
PubMed1981

Physician attitudes toward patients' requests to read their hospital records.

Little has been written about physicians' attitudes toward patient record requests. We had predicted that physicians would not welcome such requests and would respond to them defensively. Of the 280 physicians at a university affiliated medical center included in this study, 67 per cent thought that patients were motivated to ask for their hospital charts because they wanted more information or further treatment. Only 16 per cent of the physicians said that the requests were prompted by litigious motives, and 23 per cent thought that they came from the need to obtain secondary gain. A majority of the physicians, 62 per cent, viewed the requests as an opportunity to treat or educate, but 83 per cent felt that reading the hospital record could be harmful to patients. The financial and interpersonal aspects of patient education through a response to chart requests are discussed in the final section of this article.

Attitude of Health Personnel↗
PubMed1981

The dialysis exercise: a learning simulation for medical students.

The dialysis exercise is a small group decision-making clinical simulation which has been completely successful as an educational technique. The success of the exercise stems from its ability to engage students cognitively and affectively while teaching problem solving skills. This complete learning package is presented, together with comments on our experience, for use in other settings.

Behavior↗
PubMed1980

The effect of visiting on psychiatric patients in a general hospital.

A study of the visiting patterns of a general hospital psychiatric unit was undertaken to determine what difference could be detected between visited and unvisited patients. The physical rehabilitation floor at the same hospital was used as a "control." The results indicate that no significant differences could be found between the two groups of psychiatric patients but that a surprisingly large number, 40%, were not visited at all. A comparison of the visiting rates to both services favors rehabilitation 2:1 with visitors coming from a much greater distance than to psychiatry. A discussion of the data raises questions about the social isolation of psychiatric patients. The dynamics of visiting are assessed in light of their tratment implications for patients in both the hospital and the community.

Adult↗
PubMed1977

Neuropsychological effects of electroconvulsive therapy.

Although ECT as the treatment of choice for psychotic depression has been in use for many years, little is known about the neocortical residual of such treatments inferred from behavioral measures. The major portion of the literature has been concerned with inferred or observed changes in affective state. The present study compared pre- and posttreatment performances on the Halstead-Reitan neuropsychological battery of 20 patients who were receiving ECT from two different machines. Most Ss gave indicators of cerebral impairment prior to treatment when performance of one side of the body was contrasted with performance of the other side. After treatment, there was an increased number of Ss who evidenced signs consistent with damage to the right cerebral hemisphere. Some concern was raised that a large number of patients who eventually are subject ot ECT because of depression behave in this way because of an undiagnosed neocortical dysfunction. There is some suggestion that the effect of the procedure is to either create or intensify a right hemisphere focus as inferred from behavioral measures.

Adult↗
PubMed1977

A comparison of standard alternating current and low-energy brief-pulse electrotherapy.

This study compares a low-energy brief-pulse stimulus (LEBS) with a conventional a-c sine wave stimulus in terms of electrical paramenters, efficiency in producing seizures, and clinical outcome on a variety of standard behavioral measures. The results show the LEBS to require equal voltage, less current, and only one-half the total energy to produce clinically manifest convulsions. There was no apparent difference between methods on any outcome measure. The Halstead-Reitan Neuropsychological Test Battery showed as many patients impaired prior to ECT as following treatment. Implications for ECT practices are discussed.

Depression↗
PubMed1976

Portable electromyograph monitoring of unilateral ECT.

The authors describe a portable electromyograph (EMG) designed for use in monitoring unilateral ECT. Administration of muscle relaxants in conjunction with ECT often makes it difficult to determine that an adequate response has been elicited. The authors feel that this adaptation of the EMG provides a useful and easy means of monitoring the presence, bilateralism, and length of the seizure.

Electroconvulsive Therapy↗