Historical evolution and modern implications of concepts of consent to, and refusal of, medical treatment in the law of trespass

Many mischiefs arise on the change of a maxim and rule of the Common Law, which those who altered it could not see when they made the change.

Changing perception of average person's risk does not suffice to change perception of comparative risk

The direct method of assessing “unrealistic optimism” employs a question of the form, “Compared with the average person, what is the chance that event X will occur to you?” It has been proposed that when individuals construct their responses to this question (direct-estimates) they focus much more strongly on estimates of their own risk (self-estimates) than on estimates of the average person's risk (other-estimates). A challenge to this proposal comes from findings that interventions that alter other-estimates also change direct-estimates. Employing a novel intervention technique, we tested the possibility that such interventions may indirectly also change self-estimates and that this is what accounts for their effect on direct-estimates. Study 1 (n = 58) showed that an intervention which was designed to (and did) affect other-estimates also affected self-estimates, while Study 2 (n = 101) showed that it affected direct-estimates. Study 3 (n = 79) confirmed that we could modify the intervention so as to maintain the effect on other-estimates, but eliminate that on self-estimates. Study 4 (n = 112) demonstrated that when this was done, there was no longer any effect on direct-estimates. The findings are consistent with the proposal that direct-estimates are constructed largely just out of self-estimates. Implications for heath education programs are discussed.

Dialogue with Hans-Georg Gadamer : the contribution of hermeneutics to understanding what a person is saying

This thesis reviews the development of philosophy of interpretation since the nineteenth century exemplified in the work of Hans-Georg Gadamer, It recognizes Gadamer as the foremost philosopher of hermeneutics in the twentieth century, who draws together the contributions of his predecessors into a major new development. The theme upon which this thesis engages in dialogue with Gadamer is concentrated on the problem of making experience the sole object of hermeneutics to the exclusion of persons and what they say, considered objectively. The problem with this is to express the role of interpretative practices philosophically if non-objectifying thinking is normative for hermeneutics. A solution is found by following up Gadamer’s insight into the influence of tradition on understanding, I show that tradition and its truth, as well as not being separable from the understanding subject's thinking, are also not detached from an author's intentions and are shared by human beings understanding one another. The transmissive nature of tradition discloses its own method for understanding what a person is saying and the ethical requirements of truth are forwarded by following that method.

Use of the Screening tool of older person's prescriptions (STOPP) in older people admitted to an Australian hospital

Aims: To determine the prevalence of potentially inappropriate medications (PIMs) in older people aged 65years and over who were admitted to hospital, and to examine the medications and medication classes that comprised these PIMs with use of the Screening Tool of Older Person's Prescriptions. Method: Using a retrospective clinical audit design, the medical records of 100 older patients were randomly selected and examined for the prevalence and characteristics of PIMs. The audit was undertaken of patients admitted over a 12-month period to an Australian public teaching hospital. Results: In total, 92 individual occurrences of PIMs were detected, and 54 patients had at least one PIM. The most common type of PIM experienced related to prescribed medications that adversely affected individuals who were prone to falls. Conclusion: Many older patients experienced a PIM during their hospital admission, where the risk of an adverse event could outweigh the clinical benefit.

Expert in my pocket: creating first person POV videos to enhance mobile learning

Worldwide, there has been a rapid increase in both the use of mobile technologies as a conduit for student learning and the use of wearable cameras to record sporting and recreational activities. The Expert in My Pocket project (EiMP) has combined these two technologies to produce a repository of freely available short videos and supporting materials to enhance student development of psychomotor clinical skills. The videos are presented from a first person point of view (1PPOV) with expert health professionals ‘thinking aloud’ as they demonstrate selected skills. Research indicates that students and educators overwhelmingly support the concept of EiMP videos and more importantly value the 1PPOV as an authentic view. This paper demonstrates the techniques and equipment employed to produce these videos, which consisted of a chest or head mounted GoPro camera operated via an iPad. Additionally, the paper explains another innovative feature, Quick Response (QR) Codes, that when linked to the videos placed on equipment assists with “just in time” mobile learning.

Perspective taking and empathy: does having similar past experience to another person make it easier to take their perspective?

This study tested the hypothesis that it is easier to take the perspective of another person when one has similar past experience. Volunteer participants (N = 154) were asked to take the perspective of a protagonistin one of four problematic interpersonal situations and then to rate the ease with which they felt able to perspective take and the extent of their personal past experience of similar situations. Similar past experiencepredicted ease of perspective taking, with the relationship influenced by reflection on past experience. Ease of perspective taking mediated the relationship between similar past experience and participant perceptionsof their accuracy in understanding the other person, but ease was not associated with emotional arousal. The findings have potential therapeutic applications for attempts to increase empathy and understanding in people for whom perspective taking may be difficult.

I want to be my own person: the meaning-making and psychosocial processes of legacy students at Bucknell University

This study examined the meaning-making and psychosocial processes of five female legacy students at Bucknell University, each of whom having had at least one parent graduate from the institution. With a research philosophy, design, and methodology rooted in qualitative inquiry and phenomenology, inductive data analysis led to three primary categories that underscored legacy identity development. The first, Paradox of Influence and Identity, revealed through six themes nuanced experiences of separation-individuation. Second, Teaching and Learning, comprised of five themes, illuminated the impact of family — and of Bucknell parent alumni in particular — on their children’s internal working models. Lastly, Bucknell — the Environmental Contextand the five themes grouped therein highlighted the contributions of University community members, and of the campus culture and climate itself, to the co-construction of psychosocial formation. A tentative outline of grounded theory was offered, which explored categorical relationships; Paradox of Influence and Identity emerged as thedominant phenomenon, informing and being reinforced by the data of Teaching and Learning and Bucknell — the Environmental Context. Provisional intervention strategies for student affairs practice, in the contexts of academics, residential life, and career development, were discussed. Further, triangulated research is needed to substantiate and evolve the findings and theoretical model of this thesis.

Tracking of plasma lipids and lipoproteins, within-person and year-to-year variability in plasma cholesterol levels among participants from age 8 to 18 in Project HeartBeat!

Coronary heart disease remains the leading cause of death in the United States and increased blood cholesterol level has been found to be a major risk factor with roots in childhood. Tracking of cholesterol, i.e., the tendency to maintain a particular cholesterol level relative to the rest of the population, and variability in blood lipid levels with increase in age have implications for cholesterol screening and assessment of lipid levels in children for possible prevention of further rise to prevent adulthood heart disease. In this study the pattern of change in plasma lipids, over time, and their tracking were investigated. Also, within-person variance and retest reliability defined as the square root of within-person variance for plasma total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides and their relation to age, sex and body mass index among participants from age 8 to 18 years were investigated. ^ In Project HeartBeat!, 678 healthy children aged 8, 11 and 14 years at baseline were enrolled and examined at 4-monthly intervals for up to 4 years. We examined the relationship between repeated observations by Pearson's correlations. Age- and sex-specific quintiles were calculated and the probability of participants to remain in the uppermost quintile of their respective distribution was evaluated with life table methods. Plasma total cholesterol, HDL-C and LDL-C at baseline were strongly and significantly correlated with measurements at subsequent visits across the sex and age groups. Plasma triglyceride at baseline was also significantly correlated with subsequent measurements but less strongly than was the case for other plasma lipids. The probability to remain in the upper quintile was also high (60 to 70%) for plasma total cholesterol, HDL-C and LDL-C. ^ We used a mixed longitudinal, or synthetic cohort design with continuous observations from age 8 to 18 years to estimate within person variance of plasma total cholesterol, HDL-C, LDL-C and triglycerides. A total of 5809 measurements were available for both cholesterol and triglycerides. A multilevel linear model was used. Within-person variance among repeated measures over up to four years of follow-up was estimated for total cholesterol, HDL-C, LDL-C and triglycerides separately. The relationship of within-person and inter-individual variance with age, sex, and body mass index was evaluated. Likelihood ratio tests were conducted by calculating the deviation of −2log (likelihood) within the basic model and alternative models. The square root of within-person variance provided the retest reliability (within person standard deviation) for plasma total cholesterol, HDL-C, LDL-C and triglycerides. We found 13.6 percent retest reliability for plasma cholesterol, 6.1 percent for HDL-cholesterol, 11.9 percent for LDL-cholesterol and 32.4 percent for triglycerides. Retest reliability of plasma lipids was significantly related with age and body mass index. It increased with increase in body mass index and age. These findings have implications for screening guidelines, as participants in the uppermost quintile tended to maintain their status in each of the age groups during a four-year follow-up. The magnitude of within-person variability of plasma lipids influences the ability to classify children into risk categories recommended by the National Cholesterol Education Program. ^