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Biomedical subjects

M J Johnstone

Publications and source records attributed to M J Johnstone.

At least 19 recordsLinked to original sources
PubMed2001

Stigma, social justice and the rights of the mentally ill: challenging the status quo.

People suffering from mental illness and other mental health problems are among the most stigmatized, discriminated against, marginalized, disadvantaged and vulnerable members of society. Although much has been done in recent years to improve the status quo, it is evident that a great deal more needs to be done to improve the moral standing of and to achieve social justice for the mentally ill. A key contention of this philosophical essay is that unless the stigma of difference that is attached to people with mental illness is overturned, their rights will continue to be marginalized, invalidated, violated and/or ignored.

Australia↗
PubMed1999

Reflective topical autobiography: an under utilised interpretive research method in nursing.

Reflective topical autobiography (an autobiographical method) belongs to the genre of testimonial research and is located within the postpositivist interpretive research paradigm. Despite the (reflective) topical autobiographical method enjoying a 'rebirth' in recent years and being utilised by a range of researchers in the human and literary disciplines, it remains largely unknown and under utilised in nursing research domains. In this article it is proposed that reflective topical autobiography is an important research method in its own right, and one which promises to make a substantive contribution to the overall project of advancing nursing inquiry and knowledge. This is particularly so where nursing research shares in the affirming projects of interpretive research generally and the relatively new sociology of the emotions in particular apropos: (i) increasing understanding of subjectivity and making subjective experiences more visible and intelligible, (ii) the search for meaning and increasing understanding of the commonality of existential human experience, and (iii) decentring the detached observer and his/her privileging the objectivist illusion in the hierarchy of research discourses, paving the way for the admission of multiple realities and interpretations of lived experience. In this article, a coherent reflective topical autobiographical research method is advanced for use in nursing education and research contexts.

Autobiographies as Topic↗
PubMed1996

Treatment of hyperemesis gravidarum with the 5-HT3 antagonist ondansetron (Zofran).

Ondansetron is a 5-hydroxytryptamine receptor antagonist which is known to be a highly effective anti-emetic drug for chemotherapy-associated nausea and vomiting and for postoperative nausea. We report here a case where ondansetron was used in severe hyperemesis gravidarum to avoid parenteral nutrition. The drug was used intermittently in every trimester with no apparent adverse effects on mother or infant.

Adult↗
PubMed1993

Term breech delivery: does X-ray pelvimetry help?

Over a 3-year period a retrospective audit was performed of all uncomplicated singleton breech presentations at term to assess the role of X-ray pelvimetry. The review included 267 term breech presentations. Seventy-seven women (Group A) delivered in a consultant unit where X-ray pelvimetry was not used for decision making regarding the mode of delivery; 125 women (Group B) delivered in 2 consultant units where X-ray pelvimetry was always used, and 65 women (Group C) delivered in a fourth consultant unit where X-ray pelvimetry was used selectively. Obstetric outcome was measured in terms of mode of delivery. Short-term neonatal outcome was assessed by Apgar score at 5 minutes, evidence of birth trauma and admission to the neonatal special care unit for more than 24 hours. Significantly fewer women (12.9%) had an elective Caesarean section in group A compared with the other 2 groups (27.2% in group B and 33.8% in group C; p < 0.05). The vaginal delivery rates following a trial of labour were not significantly different (79.1% for group A, 65.9% for group B and 65.1% for group C) and neonatal outcome was similar in all groups. It is concluded that fewer Caesarean sections were done, without adversely affecting the neonatal outcome, when X-ray pelvimetry was not used to select the mode of delivery of uncomplicated singleton breech presentation at term. Satisfactory progress in labour is the best indicator of pelvic adequacy.

Adult↗
PubMed1992

Re-thinking the law, and challenging its traditional role in nursing's affairs: a strategy for professional reform.

Nurses world wide have regarded the law as a powerful tool of professional reform, and have historically looked to the law (its system and processes) to enhance and advance their professional goals. Nevertheless, the nursing profession still has not achieved its ultimate goals. To this day, nurses lack legitimated status as autonomous professionals, and are still burdened with enormous responsibility without the authority to match it. Given that the law is such a powerful tool of professional reform, the question must be asked at this point of nursing history: Why has the nursing profession not received the legal remedies it has sought in its quest to gain legitimated freedom from the subordinate and oppressed position it has historically occupied? In this paper, an attempt will be made to answer this question.

Australia↗
PubMed1990

Approaching ethical issues in critical care units--whose decision is it anyway?

In upholding the patient's interests it is important for intensive care practitioners (nurses and doctors) to distinguish between judgements of fact and judgments of value when making important clinical decisions, and further, not to overstep their authority as health care providers when caring for seriously ill patients. If moral errors and harm are to be avoided in intensive care units it is imperative that not only nurses and other members of the intensive care team are educationally prepared to deal with the complex moral problems posed by intensive care practices, but that the role of the patient (or her/his self-chosen representative) in decision making is fully expanded. In this respect, it is not merely the patient's so-called 'good' which nurses and other health workers must strive to maximise, but also the patients' preferences. In this paper, brief attention will be given to: [1] examining the nature of ethical decisions and the ways in which these differ significantly from clinical medical/nursing and legal decisions; and [2] exploring ways in which nurses (and other members of the intensive care team) can better ensure the realisation of morally just outcomes for patient's requiring intensive care.

Adult↗
PubMed1989

Professional ethics and patients' rights: past realities, future imperatives.

The nature and application of professional ethics in relation to patients' rights is not always clearly understood by healthcare professionals. As a result, patients' rights are not always respected or upheld in a way that they ought to be. An undersirable consequence of this has been that patients have suffered otherwise avoidable harms. The issue of professional ethics and patients' rights is one of concern to all healthcare professionals. It is of particular concern to nurses since they are the ones who are often caught in situations involving abuses of patients' rights. This paper briefly examines the failure of professional ethics to prevent patients' rights' abuses in healthcare contexts. It also makes recommendations on how the nursing profession could respond to this problem.

Altruism↗
PubMed1988

Law, professional ethics and the problem of conflict with personal values.

There are, on occasions, instances in which a nurse may not agree with a given medical order of prescribed treatment. This is particularly likely in cases involving the use of extraordinary means of life-saving treatments on chronically or terminally ill patients. In such instances, the nurse may either (1) refuse to carry out the given medical order(s) or (2) refuse/decline to care for the patient in question (e.g. the nurse may instead request to be assigned a different patient in an attempt to avoid a personal dilemma). In cases where medical orders stand to violate the law, a nurse's refusal to carry out the medical order(s) in question might be seen to be fully justified; where medical orders violate nothing more than a philosophical or personal sense of right and wrong, however, justification for refusing to carry out such orders may not seem so defensible. This paper will critically examine the questions of when, if ever, a nurse might be justified on other than legal grounds (given the sometimes inappropriate and inadequate nature of law) to either (1) refuse to carry out a doctor's orders or (2) refuse/decline to care for a given patient. These questions will be discussed in relation to a real life scenario.

Australia↗
PubMed1988

Management of a patient with Wilms's tumour extending into the right heart chambers: a case report and a review of other published reports.

Wilms's tumours that extend by direct intravascular spread into the right side of the heart are rare. A case of such a tumour was diagnosed by ultrasound. A one stage resection was performed on cardiopulmonary bypass and with profound hypothermic circulatory arrest. It was followed by adjunctive chemotherapy and radiotherapy. The child was alive and tumour free 18 months later. A review of 17 other similar cases indicated that multimodal treatment is justified in patients with extensive intravascular spread of Wilms's tumours.

Cardiopulmonary Bypass↗
PubMed1987

Ethics in focus.

Explore the source record for details and available documents.

Administrative Personnel↗
PubMed1985

Inguinal herniotomy in children: a five year survey.

This retrospective review covers our experience over 5 years of 436 hernia repairs in 392 children upto the age of 15 years. The number of emergency presentations was 71 (18.1 per cent) and 66.2 per cent of these were under the age of 12 months. Most cases were initially treated conservatively and only 18 children required operation on the day of admission. There were 11 recurrences (7 elective and 4 emergency cases) giving a recurrence rate of 2.5 per cent. In all eleven cases the original operation was performed by a junior surgeon. The complication rate (excluding recurrences) was 2.8 per cent but may be an underestimate because of the limitations of a retrospective study. We suspect our results are typical of those to be found in any large British hospital and that with careful training and supervision of junior staff in the technique of inguinal herniotomy the results could be improved and approach those found in specialist paediatric units in America.

Adolescent↗