This thesis is an exploration of professional behaviour in health care settings, using a Model of Treatment Engagement that is developed as a tool for ethics critique. The Model is tested and refined using data on: a psychiatric ???treatment??? carried out on over 1,127 occasions in a 15 - 40 bed non-acute hospital during the period 1961-1979; the problematic withdrawal of all life-support from a 37 year old man who had suffered acute brain trauma some five days previously, in a tertiary hospital in March 2000; and a clinical experiment recently proposed for the emergency setting and intended to encompass five hospitals and the NSW Ambulance Service. In each case, the Model proves useful in identifying the shift from the treatment paradigm and the ethical imperative of ensuring the patient (or his/her agent) appreciates the difference between what is proposed and what would normally be done. It reveals how doctors who dealt with the patient but did not decide on treatment contributed to ethically troublesome practice. It clarifies how having multiple doctor players in the treatment situation gave rise to the need to suppress dissenting views. Doctors who were close enough to the action to comprehend its nature, by not dissenting, reinforced the problematic choice for the actor and validated it in the eyes of observers. The lack of dissent at the level of doctors working under supervision, appeared to be a function of institutional arrangements. At the consultant level, there was evidence of pressure to concur from other consultants and indirect evidence of a fear of ostracism. The public responses in the two modern cases point to there being a strong idea in Sydney???s medical community that dissent should not be publicly displayed once a decision on how to treat has been made. I conclude there are two steps to reviewing ethically problematic treatment situations. The first consists of identifying the shift from the treatment paradigm. The second consists of establishing why the problematic choice is translated into action. The Treatment Engagement Model is put forward as a useful tool for both these analyses.

This study explores the experiences of General Practitioners (GPs) and patients in the management of type 2 diabetes in contemporary Australia. I focus on the way the socioeconomic position of patients is a factor in that experience as my underlying interest is in exploring how health inequalities are understood, approached and handled in general practice. The study is thus a practical and grounded exploration of a widely debated theoretical issue in the study of social life, namely the relationship between the micro day-to-day interactions and events in the lives of individuals and the broad macro structure of society and the position of the individual within that. There is now wide acceptance and evidence that people’s social and economic circumstances impact on their health status and their experiences in the health system. However, there is considerable debate about the role played by primary medical care. Nevertheless, better theoretical understanding of the importance of psychosocial processes in generating social inequalities in health suggests medical care may well be important, as such processes are crucial in the care of chronic illnesses such as diabetes which are now such a large part of general practice work. I approach this study through an exploration of patient centred clinical practice. Patient centredness is a pragmatic, idealised prescriptive framework for clinical practice, particularly general practice. Patient centredness developed in part in response to critiques of biomedicine, and is premised on a notion of a more equal relationship between GP and patient, and one that places importance on the context of patients’ lives. It contains an implicit promise that it will help GP and patient engage with and confront social disadvantage.

Thesis (D. Min.)--Ashland Theological Seminary, 2005. / Abstract. Includes bibliographical references (leaves 201-211).

<p>Over the last few decades, bulk-heterojunction organic photovoltaic devices comprising an intimately mixed donor-acceptor blend have gained serious attention due to their potential for being cheap, light weight, flexible and environmentally friendly. In this thesis, APFO-3/PCBM bulk-heterojunction based organic photovoltaic devices with an inverted layer sequence were investigated systematically. Doctor blade coating is a technique that is roll-to-roll compatible and cost efficient and has been used to fabricate the solar cells.</p><p>Initial studies focused on optimization of the electrodes. A thin film of the conductive polymer PEDOT:PSS was chosen to be the transparent anode. Different PEDOT:PSS films with respect to the film thickness and deposition temperature were characterized in terms of conductivity and transmission. Decent conductance and transmittance were obtained in the films deposited with wet film thickness setting of 35 μm, The cathode was fabricated from a metal bilayer comprising Al and Ti with an area about 1 cm², and the best-working cathodes contained a 70 nm thick Al layer covered by a thin Ti layer of about 10 -15 nm.</p><p>Optimized coating temperature and wet film thickness settings for the active layer and PEDOT:PSS layer were experimentally determined. The highest efficiency of the APFO-3/PCBM based inverted solar cells fabricated by doctor blading was 0.69%, which exceeded the efficiency of spin-coated inverted cells.</p><p>A higher efficiency (0.8 %) was achieved by adding a small amount of high molecular weight polystyrene to the active layer. Morphological changes after adding of the polystyrene were observed by optical microscopy and AFM. A coating temperature dependent phase separation of the APFO-3/PCBM/polystyrene blend was found.</p><p> </p>

<p>Abstract</p><p><strong>Titel: </strong>Diagnosing accountability, a study of accountability of UNT and DN’s medical journalism  ( Diagnos av ansvarstagande, en studie av accountability inom DN och UNT:s medicinjournalistik)</p><p><strong>Number of pages: </strong>45 (59 including enclosures)</p><p><strong>Author:</strong> Alexandra Johansson</p><p><strong>Tutor: </strong>Göran Svensson</p><p><strong>Course: </strong>Media and Communication studies C<strong> </strong></p><p><strong>Period: </strong>Fall 2008<strong> </strong></p><p><strong>University: </strong>Division of Media and Communication, Department of Information Science, Uppsala University</p><p><strong>Purpose/Aim: </strong>To evaluate the quality of medical journalism in DN and UNT according to the theories of accountability and responsibility in the media.</p><p><strong>Material/Methods: </strong>The materials and methods used in this thesis are 14 articles from DN and 14 articles from UNT that have been analyzed according to the criterion set forth by Media Doctors, an Australian media accountability system.</p><p><strong>Main Results: </strong>The results showed that DN scored an average of 57% “satisfactory” and UNT scored an average of 52% “satisfactory” of Media Doctors rating scale. Strengths were an educational tone and an insightful review of the newest findings in the scientific community. Weaknesses were poor transparency and a tendency to neglect full disclosure of the scientific findings and sources. Focus was also show to be on research and not on information for potential patients. Media Doctor was also shown to be a well formatted media accountability system which gave insights to the broad uses of such systems.</p><p><strong>Keywords: </strong>Medical journalism, DN, UNT, Accountability, media accountability systems (MAS), Media Doctor.</p><p> </p><p> </p>

Doctors, academically educated and authorized, assert that there is more to being a real doctor than having fulfilled the formal criteria. It has been said that there is a particular doctor's ethos, which is based not only on thorough medical education but also on traditional know-how, internalized ethics and good character. This paper contains several studies of the efforts of Swedish physicians to define themselves as doctors, individually and collectively, during the period 1890-1960 and to identify the ethos of their profession. The empirical material consists mainly of texts written by doctors for doctors on different social and political questions pertaining to the profession's interests. Studying the identities, interests and ideals that have been expressed by Swedish doctors in society and on the professional and individual level made it possible to distinguish and describe different aspects of their particular ethos. The starting point for these studies was the discussions during the inter-war period – held above all in Germany but also in Sweden – about the crisis of medicine and of the medical profession (chapter 1). Developments in legislation concerning the authorization of doctors show the ambiguity of the Swedish doctor's legal identity (chapter 2). The Swedish medical profession's efforts to hold on to the concept of internalized ethics meant that formal ethical rules were not accepted until 1951 (chapter 3). A study of medical obituaries revealed that the ideal doctor was seen as a man and a good colleague with his ethics rooted in antiquity (chapter 4). The heterogeneous medical profession has not been able to reach a consensus as to a common identity or common interests and ideals. The efforts of leading men amongst Swedish doctors gain charismatic, traditional and legal legitimacy for the profession have been opposed. After 1960, however, doctor's legitimacy in the scientific field has gained ground (chapter 5). Debate concerning the ethos of the doctors served as a strategy to unite the profession and to draw boundaries against those considered to be unqualified actors in the field of the healing arts. This, in itself, is part of this ethos.

<p><font face="Times New Roman"> <p align="left">This study looks at the effect of a cross-cultural instructional approach on the learners&rsquo / conceptions of lightning and attitude towards science. It explored Basotho conceptions of lightning and thunder under the following themes: nature of lightning, protection against lightning, animalistic/humanistic behaviour of lighting and nature of wounds inflicted by lightning.</p> </font></p>

Abstract Titel: Diagnosing accountability, a study of accountability of UNT and DN’s medical journalism  ( Diagnos av ansvarstagande, en studie av accountability inom DN och UNT:s medicinjournalistik) Number of pages: 45 (59 including enclosures) Author: Alexandra Johansson Tutor: Göran Svensson Course: Media and Communication studies C Period: Fall 2008 University: Division of Media and Communication, Department of Information Science, Uppsala University Purpose/Aim: To evaluate the quality of medical journalism in DN and UNT according to the theories of accountability and responsibility in the media. Material/Methods: The materials and methods used in this thesis are 14 articles from DN and 14 articles from UNT that have been analyzed according to the criterion set forth by Media Doctors, an Australian media accountability system. Main Results: The results showed that DN scored an average of 57% “satisfactory” and UNT scored an average of 52% “satisfactory” of Media Doctors rating scale. Strengths were an educational tone and an insightful review of the newest findings in the scientific community. Weaknesses were poor transparency and a tendency to neglect full disclosure of the scientific findings and sources. Focus was also show to be on research and not on information for potential patients. Media Doctor was also shown to be a well formatted media accountability system which gave insights to the broad uses of such systems. Keywords: Medical journalism, DN, UNT, Accountability, media accountability systems (MAS), Media Doctor.

The main aims were to: explore whether there is a relation between doctors’ ability to identify patients’ worry and wish for information and self-efficacy with regard to communicating with patients about difficult matters; describe which cues doctors consider when estimating patients’ worry and wish for information, and investigate whether there is a relation between patients’ satisfaction with doctors’ care and patients’ psychosocial function. Eleven doctors and 69 patients (of which 36 patients participated in the longitudinal study) with carcinoid tumours participated. Doctors’ self-efficacy, and ability to identify patients’ worry/wish for information were investigated at patients’ first admission. Doctors were interviewed about which cues they considered when estimating patients worry/wish for information. Patients’ satisfaction with care (CASC SF 4.0) and psychosocial function (EORTC QLQ-C30, HADS) were measured longitudinally, during the first year after diagnosis. Doctors reported higher self-efficacy when showing good ability to identify patients’ wish for information, than when showing less good ability, overestimated patients’ worry and underestimated patients’ wish for information. Doctors considered patients’ verbal behaviour and body language together with knowledge and experience when estimating patients worry and wish for information. Patients who met doctors showing good ability to identify their wish for information, reported a higher cognitive function than patients who met doctors showing less good ability. At all assessments patients expressed high satisfaction with doctor’ care and patients’ satisfaction did not change over time. Patients’ satisfaction with doctors’ care were related to their psychosocial function shortly after the first three admissions to specialist care. Patients with carcinoid tumours in some respects reported a worse HRQoL than the general Swedish population. Fatigue, diarrhoea, limited possibilities to work/pursue daily activities, and worry that the illness will get worse were among the most prevalent, and worst, aspects of disease- and treatment related distress.

<p>Chronic diseases of lifestyle (CDL) are on a raising trend in the world regardless of age, economic class or geographical location of a population. The mortality rate associated with CDL is alarmingly among the highest globally. Tanzania is not exempted from this development. Literature indicates that physical activity is a health practice that can prevent CDL. It is recommended that medical practitioners should hold the responsibility of counselling patients on physical activity. Some studies outside Africa found an association between doctors&rsquo / physical activity patterns and their counselling practices on the same. This study therefore sought to establish whether physical inactivity among medical&nbsp / doctors in Tanzania significantly influenced their counselling practices on physical activity. A cross sectional quantitative survey at the Muhimbili National Hospital and Muhimbili Orthopedic Institute was conducted to derive the required information. A self administered structured questionnaire was voluntarily answered by 144 medical doctors. The Statistical Package for Social Sciences (SPSS) version 17 was used for data capturing and analysis. Descriptive statistics were employed to summarize data and was expressed as means, standard deviation, frequencies and percentages. The students&rsquo / t-test was used to compare mean physical activity between different groups. Furthermore students&rsquo / t-test and analysis of variance tests were used to examine association between different variables. Chisquare tests were used to test for associations between categorical variables. Alpha level was set at p&lt / 0.05. Most of the participants in this study were sedentary in their leisure time and only active at work. When their quality of&nbsp / physical activity counselling was assessed, the majority of them were found to be poor physical activity counsellors. A significant association was found between physical activity and age, as well as physical activity and counselling practice (p&lt / 0.05). Participants mostly informed their patients about the intensity and duration of exercising more than any other idea of physical activity such as types of exercises, issuing of a written prescription and planning for a follow up. Lack of knowledge and experience about details of physical activity were reasons offered for failure to counsel. Participants also reported the inconvenience of physical activity facility&rsquo / s schedules, fatigue and tiredness to be their&nbsp / barriers to physical activity participation. Doctors in Tanzania lacked personal initiative to participate in physical activity and consequently lacked the motivation to counsel.&nbsp / Measures around enhancing this health practice should be enhanced by all stakeholders including medical doctors, physiotherapists and patients. The need for short term and&nbsp / long term training in matters related to physical activity are therefore necessary among the practicing doctors and those undergoing training in medical schools. Physiotherapists who are trained in movement science can offer valuable advice/information to medical doctors to ensure that medical doctors acquire physical activity prescription and&nbsp / counselling knowledge. Collaboration between stakeholders in campaigning against sedentary lifestyles should be enhanced. Further reasons for failure to counsel, hindrances to physical activity participation and modern approaches to counselling should be explored.<br /> &nbsp / </p>