Thesis (M.A.P.S.)--Catholic Theological Union at Chicago, 2006. / Vita. Includes bibliographical references (leaves 108-114).

Thesis (doctoral)--Uppsala universitet, 1997. / Includes bibliographical references (p. 223-235).

Thesis (M.A.)--Catholic Theological Union at Chicago, 1996. / Vita. Includes bibliographical references (leaves 80-85).

abstract: Emerging adulthood--a developmental point in the life span (usually between the ages of 18-25) during which children no longer see themselves as adolescents but would not yet consider themselves adults--is marked by identity exploration and discovering new life directions. When emerging adults find themselves serving as caregivers for their parent during a time when they would normally be establishing autonomy and exploring new directions, they may feel conflicted by their desire to both care for their parent and maintain a sense of independence. Thus, using a multiple-method research design that includes both an autoethnography and a qualitative content analysis of young adult caregivers' online posts, this study intends to uncover the dialectical tensions (the interplay of communicative tensions within a relationship) an emerging adult daughter experiences in her relationship with her mother as she serves as her caregiver, experiences her death, and grieves her passing by analyzing the author's personal narrative. To provide a deeper understanding of the dialectical nature of the emerging adult caregiver experience, the study was extended with an examination of other young caregivers' experiences, drawn from online forums, to explore how they encounter tensions within their own relationships with their parents. An analysis of the personal narrative revealed one primary dialectical tension, separation-connection, and three interrelated tensions--predictability-change, openness-closedness, and holding on-letting go--that seemed to influence this primary tension. Results of the qualitative content analysis revealed that other caregivers experienced one primary dialectical tension, sacrifice-reward, and two additional, interrelated tensions: independence-dependence and presence-absence. A comparison of the findings from each methodological approach revealed both similarities and differences in experiences of emerging adult caregivers. / Dissertation/Thesis / M.A. Communication 2010

Made available in DSpace on 2015-12-06T23:44:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2006 / Este trabalho teve por finalidade conhecer a participação da iniciativa privada em projetos de educação continuada e congressos organizados pela Federação Brasileira das Associações de Ginecologia e Obstetrícia, Sociedade Brasileira de Clínica Médica e Sociedade Brasileira de Ortopedia e Traumatologia, com objetivo de aferir se estas sociedades poderiam organizar eventos e demais projetos sem o patrocínio externo e saber se as empresas que apóiam financeiramente tais atividades interferem na sua elaboração. A coleta de dados foi feita através de uma entrevista semi-estruturada aberta com os presidentes das três sociedades médicas. Os achados mostram que as instituições pesquisadas não poderiam arcar com os custos dos projetos de educação continuada sem o patrocínio das empresas farmacêuticas, e que 65% dos projetos desenvolvidos são integralmente financiados pelas mesmas. Outro dado importante é que a iniciativa privada não influencia o conteúdo científico dos projetos que patrocinam ou congressos dos quais participam, cabendo integralmente às entidades médicas pesquisadas a definição dos temas e autores. / This paper intended to study the private-sector involvement in continuing education issues and also in congresses organized by the Brazilian Federation of the Associations of Gynecology and Obstetrics, Brazilian Society of Medical Clinic and Brazilian Society of Orthopedics and Traumatology. The study aimed to verify whether such entities could, without using external sponsorship, organize events and other projects with the purpose of keeping their members updated, and find out whether the companies financially supporting such activities would interfere in the development of those events. Data were collected through an open semistructured enquiry with the presidents of three medical societies. The findings showed that the research institutions would not be able to bear the costs of continuing education without the sponsorship of pharmaceutical companies, since 65% of the projects developed are totally financed by these entities. Another important finding was that the private sector does not influence the scientific contents of the projects sponsored by them or of the congresses they participate in, and the medical entities enquired are fully in charge of defining both the themes and authors. / BV UNIFESP: Teses e dissertações

OBJECTIVE: The vast majority of physicians frequently faces ethical dilemmas and feels overwhelmed as a result. Those at Boston Medical Center are no exception. Various studies show more adept handling of ethical issues can improve the quality of care and patient safety by reducing moral distress of physicians and fostering better patient-physician relationship. The method of Preventive Ethics, which actively identifies recurrent themes and underlying systematic issues among ethics consultations, is more effective than the traditional, case-by-case approach in reducing the number of ethical conflicts. The purpose of this study is to identify common themes prompting ethics consultations and any hotspots among recurrent ethical dilemmas at Boston Medical Center by using the Armstrong Clinical Ethics Coding System. METHODS: A total of 32 ethics consultations handled by the BMC Ethics Committee between October 2010 and April 2013 were reviewed. Each consultation was coded using the Armstrong Clinical Ethics Coding System. The data was analyzed to identify the types of ethical dilemma that are most prevalent at BMC. The consultations involving the most frequently occurring issues were evaluated further to expose common themes among these cases and potential underlying systematic failures. RESULT: "Clinical Candidacy or Risk / Benefit Analysis" (6.25%), "Concern About Decision Maker Choices" (14.6%) and "Futility / Inappropriate or Nonbeneficial Treatment" (13.5%) were the most prevalent types of ethical issues at BMC. Not only are these three frequently occurring, they also have a very high tendency to occur simultaneously. Further analysis of consultations involving these three issues revealed that at BMC, there are frequent instances of conflict, in which family members serving as healthcare proxies disagreed with physicians in deciding the best interest of patients with severe ailments, ultimately precipitating ethics consultations. DISCUSSION: Comparison with similar retrospective studies previously carried out at other institutions suggests that consultation involving the issue of futility may be more frequently occurring at BMC, which might be coming from unique systematic problems. Several interventions such as improved policies or educational training in physician-family communication should be considered. CONCLUSION: According to the principles of Preventive Ethics, the issue of physician-healthcare proxy conflict regarding patient futility should be issue to be addressed at BMC. The Armstrong Clinical Ethics Coding System can serve as a much needed standard documentation format for ethics consultations, which would open up the possibility of more detailed future studies

The diploma thesis is divided into a theoretical and a practical part. The first part describes the current state of the issue of informed consent in a general context and related topics. To obtain the data, I used the qualitative research, the method of questioning, and the data collection technique of a semi-structures interview. The research sample group consisted of 11 patients and two doctors. The objective of the thesis was to identify and describe the differences between the theory and the practice of informed consent in the hospital, and to find out whether there has been any shift in the mistakes and errors associated with informed consent as stated by Haškovcová (2007). The research results have shown that the interviewed patients are not familiar with the concept of informed consent. The knowledge of the informed consent concept was more accurate by doctors as presumed. On the issue of viewed benefits of informed consent, it is clear from respondents? answers that informed consent is viewed primarily as doctors? legal protection against any complaints or lawsuits made by the patients in the performance of their profession by making the patient familiar with any complications that may occur during the performance. This benefit is perceived by both patients and doctors. Doctors see its benefit also as the protection of patients. Another benefit viewed by doctors is the written informed consent form. Six of the interviewed patients stated that informed consent was submitted to them to sign by the nurse/male nurse without proper instructions. Furthermore, doctors? answers show that the timing of instructions depends on the nature of the surgery, whether it is planned or acute. However, some patients said that they were not even instructed with the sufficient time after giving informed consent even when related to a planned procedure. The most stated form was the combination of written and oral instructions, so the patient was first instructed orally and then he was also handed a detailed description of the particular procedure in the written form. There was no uniformity about the question of the amount of submitted information among the interviewed patients as well as doctors ? some of them prefer just basic information, some of them want to know all the information. One of the interviewed doctors favored just the adequate informed consent and saw the detailed informed consent as problematic, another doctor preferred introduction of all the details, although in the written form, mainly because of legal protection. In terms of quality of the provided information, it is clear from the statements of the patients that two most important facts for them are that the performance is in their benefit and the duration of hospitalization. All patients have agreed on the fact that it is very good that they are informed about the procedure which will be performed on them. However, they were not united regarding the issue of participation in the decision ? two patients stated that not even the properly informed patient should participate in the decision about their treatment. Only one doctor expressed his stance to the patient?s participation in the decision stating that he tries to persuade his patients that his proposed solution is the optimal. The standard for the patients is to ask questions when they are concerned about something or interested in it. However, the statements showed that they do not always get the answer they are satisfied with. When the patients stated that they do not ask their doctors about anything, their reasons were enough information, lack of staff and a feeling of unwillingness on the part of doctors. If the patients did not receive enough information from the medical staff, they looked for it in other sources of information. This thesis points to the broader psychosocial context of informed consent, so its results may help during the training of staff in the assisting professions.

Down syndrome, or Trisomy 21, is the most commonly occurring genetic condition, and yet there exists a great deal of misinformation and misconception about the lived experience and value of Down syndrome in society. Its construction as a disability is deeply intertwined with racist rhetoric and, despite changes in language, this construction of Down syndrome as a racialized disability category has immense implications in clinical and prenatal genetic counseling settings. This thesis seeks to examine the past and present of Down syndrome in conversation with reproductive justice, disability justice, and the current norms of practice in genetic counseling. In doing so, this thesis makes recommendations towards a disability-centered and actively counter-eugenic genetic counseling practice.

abstract: According to my 2016 survey of ASU undergraduate students, 33% have used stimulant medications (e.g. Adderall or Ritalin) without a prescription to study. I view this practice as a step towards cognitive enhancement, which is the deliberate application of biotechnology to radically alter the human condition. From a foresight perspective, the ability to actively improve human beings, to take our evolutionary destiny into our own hands, may be a turning point on par with agriculture or the use of fossil fuels. The existential risks, however, may be greater than the benefits—and many of the most radical technologies have made little documented progress. I turn to an actual example where people are trying to make themselves marginally better at academic tasks, as a guide to how future transformative development in human enhancement may be incorporated into everyday practice. This project examines the history and context that led to the widespread use of stimulant medication on college campuses. I describe how Attention Deficit Hyperactivity Disorder (ADHD), for which stimulant medication is prescribed and diverted, governs students, negotiates relationships between parents and school authorities, and manages anxieties resulting from a competitive neoliberal educational system. I extend this archeology of ADHD through the actions and ethical beliefs of college students, and the bioethical arguments for and against human enhancement. Through this work, I open a new space for an expanded role for universities as institutions capable of creating experimental communities supporting ethical cognitive enhancement. / Dissertation/Thesis / Doctoral Dissertation Science and Technology Policy 2016

abstract: Vaccinations are important for preventing influenza infection. Maximizing vaccination uptake rates (80-90%) is crucial in generating herd immunity and preventing infection incidence. Vaccination of healthcare professionals (HCP) against influenza is vital to infection control in healthcare settings, given their consistent exposure to high-risk patients like: those with compromised immune systems, children, and the elderly (Johnson & Talbot, 2011). Though vaccination is vital in disease prevention, influenza vaccination uptake among HCP is low overall (50% on average) (Pearson et al., 2006). Mandatory vaccination policies result in HCP influenza vaccination uptake rates substantially higher than opt-in influenza vaccination campaigns (90% vs. 60%). Therefore, influenza vaccination should be mandatory for HCP in order to best prevent influenza infection in healthcare settings. Many HCP cite individual objections to influenza vaccination rooted in personal doubts and ethical concerns, not best available scientific evidence. Nevertheless, HCP ethical responsibility to their patients and work environments to prevent and lower influenza infection incidence overrules such individual objections. Additionally, mandatory HCP influenza vaccination policies respect HCP autonomy via including medical and religious exemption clauses. While vaccination as a prevention method for influenza is logically sound, individuals’ actions are not always rooted in logic. Therefore, I analyze HCP perceptions and actions toward influenza vaccination in an effort to better explain low HCP uptake rates of the influenza vaccine and individual objections to influenza vaccination. Such analysis can aid in gaining HCP trust when implementing mandatory HCP influenza vaccination policies. In summary, mandatory HCP influenza vaccination policies are ethically justified, effective, scientifically-supported method of maximizing HCP influenza vaccine uptake and minimizing the spread of the influenza virus within healthcare settlings. / Dissertation/Thesis / Masters Thesis Biology 2016