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Biomedical subjects

Robert Arnold

Publications and source records attributed to Robert Arnold.

26 records · Page 2Linked to original sources
PubMed2002

Financial incentives for cadaver organ donation: an ethical reappraisal.

A panel of ethicists, organ procurement organization executives, physicians, and surgeons was convened by the sponsorship of the American Society of Transplant Surgeons to determine whether an ethically acceptable pilot trial could be proposed to provide a financial incentive for a family to consent to the donation of organs from a deceased relative. An ethical methodology was developed that could be applied to any proposal for monetary compensation to elucidate its ethical acceptability. An inverse relationship between financial incentives for increasing the families' consent for cadaver donation that clearly would be ethically acceptable (e.g., a contribution to a charity chosen by the family or a reimbursement for funeral expenses) and those approaches that would more likely increase the rate of donation (e.g., direct payment or tax incentive) was evident. The panel was unanimously opposed to the exchange of money for cadaver donor organs because either a direct payment or tax incentive would violate the ideal standard of altruism in organ donation and unacceptably commercialize the value of human life by commodifying donated organs. However, a majority of the panel members supported reimbursement for funeral expenses or a charitable contribution as an ethically permissible approach. The panel concluded that the concept of the organ as a gift could be sustained by a funeral reimbursement or charitable contribution that conveyed the appreciation of society to the family for their donation. Depending on the amount of reimbursement provided for funeral expenses, this approach could be ethically distinguished from a direct payment, by their intrusion into the realm of altruism and voluntariness. We suggest that a pilot project be conducted to determine whether this kind of a financial incentive would be acceptable to the public and successful in increasing organ donation.

Cadaver↗
PubMed2002

Myoclonus secondary to withdrawal from transdermal fentanyl: case report and literature review.

Myoclonus is a common and well-described adverse effect of opioids. Most cases reported in the literature have been associated with opioid administration, rather than with opioid withdrawal. We describe a case of myoclonus secondary to withdrawal from transdermal fentanyl. We review the literature regarding myoclonus related to opioid therapy (opioid-induced myoclonus) and withdrawal (opioid withdrawal myoclonus), and discuss possible mechanisms and therapies for these phenomena.

Administration, Cutaneous↗
PubMed2002

Factors associated with the accuracy of family caregiver estimates of patient pain.

This study identified factors associated with inaccurate family caregiver assessments of patient pain. Participants were 31 caregiver-patient dyads receiving hospice home care. All patients had a primary diagnosis of end-stage cancer. As expected, caregivers overestimated patient pain. The degree of disparity for each dyad was calculated by subtracting the patient's pain rating from the caregiver's rating of patient pain. Caregiver knowledge of cancer pain management was not related to the degree of disparity in pain ratings, but caregivers' experience of patient pain was significantly related to accuracy of caregivers' pain ratings. Those caregivers who 1) perceived their loved one to be in a great deal of distress secondary to pain, 2) associated greater efforts at pain relief (i.e., more medication) with greater levels of pain, and 3) were themselves distressed by the patient's pain had the most inaccurate estimates of patient pain. There was a trend for greater disparity in pain estimates to be related to poorer existential quality of life for patients. Overall, the findings suggest that health care providers need to take into consideration family members' interpretation of patient pain when providing pain management education services.

Adult↗
PubMedDate not supplied

Boron isotopes as an artificial tracer.

A field study was conducted using a combination of intrinsic and artificial tracers to estimate travel times and dilution during transport of infiltrate from a reclaimed water infiltration basin to nearby monitoring wells. A major study objective was to validate boric acid enriched in (10)B as an artificial tracer. Basin 10E at the Rio Hondo Spreading Grounds in Whittier, California, was the site of the test. The basin normally receives a mixture of treated municipal waste water, purchased State Project water, and local runoff from the San Gabriel River. Approximately 3.5 kg of (10)B-enriched boric acid was dispersed among 2.05 x 10(5) m(3) of basin water to initiate the experiment. The resultant median delta(11)B in the infiltration basin was -71 per thousand. Prior to tracer addition, the basin water had an intrinsic delta(11)B of +2 per thousand. Local monitoring wells that were used to assess travel times had delta(11)B values of +5 per thousand and +8 per thousand at the time of tracer addition. Analytic results supported an assumption that boron is conserved during ground water transport and that boron enriched in (10)B is a useful artificial tracer. Several intrinsic tracers were used to reinforce the boric acid tracer findings. These included stable isotopes of oxygen (delta(18)O) and hydrogen (deltaD), sulfate concentration, and the boron to chloride ratio. Xenon isotopes, (136)Xe and (124)Xe, also supported boron isotope results. Xenon isotopes were added to the recharge basin as dissolved gases by investigators from the Lawrence Livermore National Laboratory.

Boron↗