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The Greater Victoria Hospital Society (GVHS) Palliative Care Committee surveyed medical and nursing staff from four hospitals and The Victoria Hospice Society in February, 1993. The purpose of the survey was to identify physicians' and nurses' perceived educational needs related to death and dying. Programs that focus on the dying process; patient pain, symptom, and comfort control; and patient and family support were identified as necessary to meet the educational needs of physicians and nurses in providing quality palliative care. Physicians and nurses identified communication skills as being paramount. Communications concerning ethical issues were highlighted as the most difficult to cope with.
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When long voyages in sailing vessels were commonplace, scurvy was a major health hazard in mariners of all nations. The observations of James Lind (1716-94) and others indicated that citrus fruits had both a preventive and curative role in this disease. In the light of this work, by 1800 the disease had been virtually eliminated from Britain's Royal Navy. However, it continued in the merchant navies of all nations until the latter half of the 19th century. In 1867, the Merchant Shipping Amendment Act was passed by the British Parliament largely as a result of a concerted effort by the Seamen's Hospital Society (SHS), one of whose physicians, Harry Leach (1836-79) was the major proselytiser for improved conditions in the merchant service. Examination of the SHS records before and after this event demonstrate a marked reduction in the prevalence of scurvy in the Port of London. Although other factors-such as the introduction of steam ships, which resulted in faster voyages-were clearly important, the compulsory administration of genuine lime juice under supervision in the merchant service seems to have exerted a significant effect.
1999 marks the centenary of the two major British Schools of Tropical Medicine, founded in London and Liverpool, respectively. The origin(s) of the former clearly lies in the Seamen's Hospital Society, which dates from 1821. It seems likely that the foundation of this school (with Government support) also acted as a catalyst for the school at Liverpool, which in fact opened its doors a few months before that in London.
Sir Andrew Halliday (1781-1839) was domestic physician to HRH the Duke of Clarence (1765-1837) (who was later to become King William IV). He also served in the Napoleonic Wars-in Portugal, Spain and Waterloo-as well as in the West Indies, and became the first physician to the Seamen's Hospital Society. Unlike many of his contemporaries, Halliday was also a prolific author, many of his publications being on lunatic asylums in Great Britain and Ireland.
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BACKGROUND: Since 1993, government agencies in Japan have introduced a series of guidelines for gene therapy clinical trials. Appraisals of these guidelines were obtained from academic societies, institutional review boards (IRBs) of hospitals, and ethics committees (ECs) at medical schools nationwide. MATERIAL/METHODS: Using data from a large-scale national opinion survey, this study evaluates the experts' appraisals of the contents of these official guidelines in Japan and the process of their development. RESULTS: 26.3% of the respondents from academic societies and 39.3% of those from university ECs gave positive appraisals of the speediness of the decision process for the 1994 guidelines. Appraisals of speediness improved for the 2002 guidelines. Concerning the clarity of the 1994 guidelines, the proportion of positive appraisals was slightly smaller than negative appraisals among academic societies and hospital IRBs, though the majority of university ECs gave positive ratings. The 2002 guidelines were appraised significantly more positively than the 1994 guidelines. Information received after the decision was consistently rated better than the information before the decision. All groups reported that the opinions of patients and those of citizens were less adequately considered than were the opinions of experts. A majority of respondents rated information disclosure as important for future agendas. CONCLUSIONS: Clarity of the guidelines could be improved by revision. More information disclosure was considered desirable, especially information available before decisions are made. Incorporation of patients and citizens in policymaking is an important future goal.
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