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Results for “Moral Development”

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PubMed1982

Immunology in Singapore--past and future.

In the past, immunology in Singapore was mainly confined to serology for the diagnosis of certain infectious diseases. Postgraduate education for immunology was not well developed and its undergraduate training was restricted to a few lectures within bacteriology. With the establishment of the W.H.O. IRTC in 1969, training and research in immunology were further developed and a group of scientists and technicians to conduct research work was subsequently built up. This enabled the Centre to provide some immunological services to the Government and University, and soon extended these to our neighbouring countries as well. Further research and the maintenance of international standards are essential for the future development of immunology in Singapore. And this is only possible with the moral and financial support of the Government, University and private granting bodies.

Allergy and Immunology↗
PubMed1997

Intestinal metaplasia of the gastric cardia.

OBJECTIVE: Although the incidence of gastric adenocarcinoma in the U. S. is declining, the incidence of cancer localized to the gastric cardia has risen dramatically. It is not yet clear whether cancer of the gastric cardia arises from a premalignant lesion such as intestinal metaplasia (IM). The purpose of this study was to determine the prevalence of IM involving the cardia in patients presenting for elective EGD, and evaluate potential associated factors. METHODS: During a 7 month period patients referred for elective EGD at the Tucson VA Medical Center were invited to participate in the study. Prior to EGD each patient was surveyed with regard to GERD symptoms and smoking and alcohol history. During EGD note was made of the presence of esophagitis, hiatus hernia, and Barrett's-appearing mucosa. The esophagogastric junction (EGJ) was defined as the end of the tubular esophagus coinciding with the proximal heads of the gastric folds. Seven biopsies were taken from specific sites in the antrum, angularis, cardia, and EGJ. Biopsy specimens were stained with a combination of H & E and Alcian blue at a pH of 2.5. Histologic evidence of IM was defined as columnar-type epithelium including goblet cells staining with Alcian blue. Patients were also evaluated for H. pylori infection by histologic and serologic examinations. RESULTS: There were 104 patients (99 male, 5 female) with a mean age of 61.6 years. Twenty-four (23%) were found to have IM involving the gastric cardia, although none of these had dysplasia. Eleven patients (11%) had Barrett's esophagus; however, only 2 of these had concomitant IM of the cardia. On the other hand, 9 of the 24 with IM of the cardia had concomitant IM elsewhere in the stomach. Forty-nine patients (47%) were found to be positive for H. pylori infection and there was a significant association between H. pylori infection and IM of the gastric cardia (p = 0.03). CONCLUSIONS: These data show that IM of the gastric cardia is a relatively common finding and is associated with H. pylori infection. Although dysplasia was not identified, long-term follow-up studies will be necessary to determine the incidence of dysplasia or adenocarcinoma developing from IM of the cardia.

Adenocarcinoma↗
PubMed1998

A survey of job satisfaction, sources of stress and psychological symptoms among general practitioners in Leeds.

BACKGROUND: The past seven years have seen rapid changes in general practice in the United Kingdom (UK), commencing with the 1990 contract. During the same period, concern about the health and morale of general practitioners (GPs) has increased and a recruitment crisis has developed. AIM: To determine levels of psychological symptoms, job satisfaction, and subjective ill health in GPs and their relationship to practice characteristics, and to compare levels of job satisfaction since the introduction of the 1990 GP contract with those found before 1990. METHOD: Postal questionnaire survey of all GP principals on the Leeds Health Authority list. The main outcome measures included quantitative measures of practice characteristics, job satisfaction, mental health (General Health Questionnaire), and general physical health. Qualitative statements about work conditions, job satisfaction, and mental health were collected. RESULTS: A total of 285/406 GPs (70%) returned the questionnaires. One hundred and forty-eight (52%) scored 3 or more on the General Health Questionnaire (GHQ-12), which indicates a high level of psychological symptoms. One hundred and sixty GPs (56%) felt that work had affected their recent physical health. Significant associations were found between GHQ-12 scores, total job satisfaction scores, and GPs' perceptions that work had affected their physical health. Problems with physical and mental health were associated with several aspects of workload, including list size, number of sessions worked per week, amount of time spent on call, and use of deputizing services. In the qualitative part of the survey, GPs reported overwork and excessive hours, paperwork and administration, recent National Health Service (NHS) changes, and the 1990 GP contract as the most stressful aspects of their work. CONCLUSIONS: Fifty-two per cent of GPs in Leeds who responded showed high levels of psychological symptoms. Job satisfaction was lower than in a national survey conducted in 1987, and GPs expressed the least satisfaction with their hours, recognition for their work, and rates of pay. Nearly 60% felt that their physical health had been affected by their work. These results point to a need to improve working conditions in primary care and for further research to determine the effect of any such changes.

Adult↗
PubMed1998

Children of Armageddon. Common developmental threats in high-conflict divorcing families.

This article traces how parental vulnerability to the feelings of humiliation and loss (inherent in highly conflicted divorce and custody litigation) distorts parenting capacities and parent-child relationships in distinctive ways, putting children at risk for specific kinds of developmental difficulties. Pre-oedipal children often fail to achieve a complete separation from their primary caretakers. Oedipal children, already struggling with separation issues, manifest sexualized anxiety and discomfort with gender identity. By latency, these children present as fragmented within themselves and in relationships with others. Each stage-specific response is discussed and illustrated. It is argued that mental health and legal professionals can use this in-depth understanding of child responses to help parents reframe their disputing agendas in terms of the child's developmental concerns and preoccupations to produce custody settlements that are more protective of the child's best interests.

Adolescent↗
PubMed2005

The impact of a distance learning death and dying course: an analysis of student self-reported changes.

Educational programmes are under way to improve knowledge, awareness and skills in holistic end-of-life care. Not all people can access education and continued professional development in a conventional face-to-face setting. The UK Open University's distance learning course entitled 'Death and Dying' (K260) attracts a broad spectrum of British and foreign students, including those who undertake the course for work-related purposes, and those who have a personal or academic interest in the area. This study explored students' self-reported satisfaction with the course primarily whether respondents perceived changes in their attitudes or practices. Two questionnaires were posted to students registered on K260, the first at the beginning of the course and the second, to those who returned the first questionnaire, following the final examination. Most respondents reported satisfaction with the quality and content of K260. Irrespective of whether respondents worked with dying or bereaved people, most felt that the course: encouraged reflection on personal beliefs and/or attitudes towards death and dying; furthered their knowledge of palliative care; increased their understanding of relevant ethical, legal and moral issues; raised their awareness of religious and cultural issues; and helped them develop skills to deal more effectively with dying and bereaved people.

Attitude of Health Personnel↗
PubMedDate not supplied

[Nursing care and the invasion of the patient's privacy: an ethical-moral question].

Nurses constantly invade patients' intimacy and privacy when delivering nursing care; however, they rarely discuss the aspects involving such issue. Nursing literature on this theme is scarce, which has motivated the development of this study with the purpose to sensitize nurses as to the relevance of and need for reflection on this matter. Ethical, legal and moral questions that permeate the invasion of privacy are pointed out, thus showing the responsibilities of nursing professionals. The actions of Committees of Ethics in Research as well as those of Nursing Ethics Committees in Organizations are discussed as mechanisms for the control and protection of individuals, mainly approaching the conduct and attitudes of nurses in the care-giving process. This study emphasizes the need for discussions and reevaluations of the roles of such mechanisms and of the quality in nursing care, since protection to patients' privacy is still deficient.

Ethics, Nursing↗
PubMedDate not supplied

[Hospital committees of ethics].

Hospital ethics committees have arisen in response to the serious moral dilemmas that are becoming increasingly prevalent in medical practice. This article outlines the historical development of such committees by reviewing some celebrated cases and also categorizes the committees as ethical-praxeological, legal-scientific, or deontological-technical, according to their functions and structure. In addition, a description is given of the establishment of interdisciplinary committees in several health institutions in Argentina that deal with teaching, research, and consultation related to decision-making involving moral questions; case study and clinical ethics protocols; analysis of the relationship between health professionals and patients; and other related topics. Finally, based on their own experience in this field and knowledge of models employed in other countries, the authors offer theoretical, methodological, and administrative recommendations for the establishment of ethics committees.

Argentina↗
PubMed1993

Moral sensibilities and moral standing: Caplan on xenograft "donors".

[I]nterest in animals as a source of organs and tissues for human beings remains strong. New developments in immunosuppression technology promise to lower the technical barriers to a routine use of nonhumans as organ donors, and the image of colonies of animals kept at the ready for supplying the growing human need for new organs seems a much more plausible scenario now than it did when broached by transplantation specialists in the Sixties. As Arthur Caplan has powerfully argued, the prospects that other sources of organs may resolve the supply problem are grim.... In the face of these "pro-xenograft" pressures, it becomes all the more signficant to assess arguments against the practice that rest on considerations of the moral status of the nonhumans from whom the organs are taken. To be sure, xenograft faces other moral difficulties -- for example, concerns about the quality of informed consent obtained for recipients, worries about the possibility that xenografting will serve as a vector by which new and possibly virulent viruses become established in humans, and problems about whether such spending is equitable in the light of other unresolved human needs. Yet whether we morally wrong animals in taking their organs and their lives remains a decidedly central issue here, one that cannot be finessed away by developing better informed consent procedures, better anti-viral strategies, or by situating transplantation medicine in a just health care system.

Anencephaly↗

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