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People who inject drugs, particularly opioids, are a growing population, especially in North Philadelphia. This population is at high risk for medical complications that require hospitalization. While hospitalized, this population poses unique challenges to the healthcare system, including high costs and readmission rates, as well as stress and burnout among providers and staff. These patients are at high risk of discharges against medical advice because of complicated social factors as well as inadequate recognition of pain and withdrawal. As the opioid epidemic evolves, previous strategies for managing these patients, which traditionally relied on referral to psychiatry or social work in addition to symptomatic treatment, need to be re-evaluated. Ethically, the decision-making capacity of these patients is frequently called into question, and there is a difficult-to-strike balance between respecting their autonomy and acting with beneficence to provide the best care. There are also public health concerns that come into play. Better acknowledgment of the issues that this population faces, and better management of pain and withdrawal, may improve their outcomes, as well as reduce provider stress and burnout. / Urban Bioethics

The immune system has been suggested as crucial in brain and psychological functioning. More precisely, immune markers reflecting immune system activity are important for psychological and mental health, as evident by their role in the physiopathology of depression and in the impairment of executive functions. Frontal alpha asymmetry (FAA), an electroencephalographic marker of brain function, has also been linked to such psychopathology and is thought to reflect psychological processes underlying approach- versus withdrawal-related motivation and higher-order inhibitory control. Only a few studies have linked FAA to immune markers but notably found a negative association between IL-6, a pleiotropic proinflammatory cytokine, and FAA. The aim of the present work is thus to study the relationship between various immune markers (including pro-inflammatory cytokines and IL-6) and FAA. 35 healthy young male participants underwent a resting EEG recording and blood sampling from which immune markers were measured. The results did not suggest an association between IL-6 and FAA. No other immune markers were either suggested to be associated to FAA. The complexity of the immune system (e.g., effect of cytokines) is underlined and may explain the results. Despite such results, the implication of true negative correlations between FAA and circulating immune markers, as suggested in previous studies, is discussed in the light of the theoretical models of FAA.

L’objectif de la présente thèse est de mieux expliquer le concept de retrait organisationnel et ses déterminants. À travers l’étude de la littérature plus générale des comportements contreproductifs et celle du retrait organisationnel, nous exposons les différentes facettes du retrait organisationnel tant sur le plan du retrait du travail que sur le plan du retrait de l’emploi. Nous proposons également une nouvelle définition du retrait organisationnel, une typologie du retrait du travail et un modèle théorique intégrateur multi-niveaux du retrait organisationnel. Ce modèle original avancé dans cette thèse, duquel découle un certain nombre de propositions théoriques, mobilise principalement l’approche sociologique multi-niveaux, le modèle de l’adaptation en comportement organisationnel, ainsi que la perspective du contrat psychologique et celle de l’ancrage dans l’emploi. L’approche sociologique multi-niveaux de Marchand et al. (2006) permet de répertorier plusieurs déterminants du comportement et/ ou de l’attitude dans les différentes sphères de la vie de l’individu qui, selon le modèle de l’adaptation de Rosse et Miller (1984), agit en s’adaptant adéquatement aux différentes situations au travail. La présente thèse utilise également la perspective du contrat psychologique de Rousseau (1989, 1990). Il s’agit d’une approche pertinente dans l’explication des réactions comportementales et/ou attitudinales de l’employé dans une optique d’échange social (Blau, 1964), suite à une évaluation du degré de respect de son contrat psychologique par son employeur. Cette évaluation porte sur l’ensemble des conditions de travail dans le cadre de la relation d’emploi. Nous privilégions également la perspective de l’ancrage dans l’emploi de Mitchell et al. (2001) pour démontrer que les liens sociaux tissés entre l’employé et les personnes dans son organisation pourraient atténuer l’intensité ou l’ampleur des réponses comportementales et/ou attitudinales négatives résultant d’une situation de non-respect du contrat psychologique de celui-ci de la part de son employeur. Afin de vérifier l’impact du respect du contrat psychologique ainsi que de l’ancrage dans l’emploi dans l’adoption du retrait organisationnel, nous avons choisi d’étudier plus spécifiquement le cynisme comme attitude de retrait du travail et ce, dans le cadre d’un devis quantitatif transversal ainsi que le départ volontaire comme comportement de retrait de l’emploi dans le cadre d’un devis quantitatif longitudinal. Les résultats de régressions multiples multi-niveaux de ces deux études indiquent la présence de certains facteurs de protection et de certains facteurs de risque associés à l’adoption du cynisme et du départ volontaire. L’utilisation des compétences au travail, le fait de recevoir de la reconnaissance et le fait qu’il existe des possibilités de développement de carrière constituent des facteurs communs de prévention contre le cynisme et le départ volontaire. De plus, le soutien reçu de la part du superviseur permet de prévenir les attitudes cyniques au travail, alors que la présence de demandes psychologiques élevées au travail, le fait d’être exposé à des horaires irréguliers et de vivre une certaine insécurité d’emploi pourraient augmenter le cynisme. Les résultats indiquent également que le soutien social des collègues, ainsi que la présence de possibilités de développement de carrière, jouent un rôle conjoint dans la prévention du départ volontaire. Quant à la prévention du cynisme, à la fois le soutien social du superviseur et celui des collègues jouent un rôle supplémentaire de protection contre l’attitude cynique éventuelle chez l’employé qui perçoit le non-respect de son contrat psychologique en matière d’utilisation des compétences, d’autorité décisionnelle, de reconnaissance, de développement de carrière et d’insécurité d’emploi. Nous avons également réalisé une troisième étude quasi-expérimentale, selon un devis quantitatif transversal, sur les déterminants du départ volontaire. Les résultats de l’ANOVA sur le test de trois conditions expérimentales (cynisme, soutien social et durée du soutien social) sur le départ volontaire indiquent que le fait d’être cynique ou le fait de recevoir un faible soutien social augmentent l’intention de quitter chez l’employé. De plus, ces faits, vécus sur une longue durée augmentent davantage l’intention de quitter son emploi. La présente thèse permet de faire avancer les connaissances théoriques et empiriques en matière de retrait organisationnel, de cynisme et de départ volontaire. Elle se conclut sur des recommandations possibles pour les praticiens vers une intervention intégrée pour prévenir ces deux réponses possibles à des conditions insatisfaisantes au travail. La thèse souligne l’importance pour l’employé d’utiliser pleinement ses compétences au travail, d’être reconnu pour ses efforts et contributions à l’organisation et d’avoir des opportunités suffisantes de développement et d’avancement de carrière dans le cadre de son emploi. / The purpose of this thesis is to better explain the concept of organizational withdrawal and its determinants. Through the study of the more general literature on counterproductive behavior and organizational withdrawal, we expose the different facets of organizational withdrawal in terms of both work withdrawal and job withdrawal, a definition of organizational withdrawal, a typology of work withdrawal and a multilevel integrative theoretical model of organizational withdrawal. This original model advanced in this thesis, from which a certain number of theoretical propositions arise, mainly mobilizes the multilevel sociological approach, the model of adaptation in organizational behavior, as well as the perspective of the psychological contract and that of job embeddedness. The multilevel sociological approach of Marchand et al. (2006) identifies several determinants of behavior and / or attitude in the different spheres of the individual's life which, according to Rosse and Miller's adaptation model (1984), acts by adapting appropriately to different situations at work. The present thesis also uses the perspective of Rousseau's psychological contract (1989, 1990). It is a relevant approach in the explanation of the behavioral and / or attitudinal reactions of the employee, with a view to social exchange (Blau, 1964), following an assessment of the degree of respect of his psychological contract by his employer. This assessment covers several working conditions in the employment relationship. We also favor the job embeddedness perspective of Mitchell et al. (2001) to demonstrate that the social connections that exist between the employee and the persons in organization could reduce the intensity or magnitude of the negative behavioral and / or attitudinal responses resulting from a situation of non-compliance with the psychological contract of the latter by his employer. In order to verify the impact of the respect of the psychological contract as well as the job embeddedness on the adoption of the organizational withdrawal, we chose to study more specifically the cynicism as attitude of work withdrawal in the frame of transversal quantitative estimate as well as voluntary departure as a behavior job withdrawal in the context of a long-term quantitative estimate. The results of multiple multilevel regressions of these two studies indicate the presence of certain protective factors as well as certain risk factors associated with the adoption of cynicism and voluntary leaving. The use of one's skills in the workplace, receiving recognition for the work and the presence career development opportunities are common factors in preventing cynicism and voluntary departure. In addition, the support received from the supervisor helps to prevent cynical attitudes at work, while the presence of high psychological demands at work, being exposed to irregular hours and experiencing job insecurity could increase cynicism. The results also indicate that social support from colleagues and the presence of career development opportunities play a joint role in preventing voluntary departure. As for the prevention of cynicism, both social support from the supervisor and colleagues play an additional role of protection against the cynical attitude possible to develop by the employee who perceives the non-respect of his psychological contract as regards use of skills, decision-making authority, recognition, career development and job insecurity. We also carried out a third quasi-experimental study, according to a cross-sectional quantitative estimate, on the determinants of voluntary leaving. The results of the ANOVA regarding the effects of three experimental conditions (cynicism, social support, and duration of social support) on voluntary leaving indicate that being cynical or receiving weak social support increases the intention to leave. In addition, being cynical, receiving weak social support for a long time is the situation that further increases the intention to quit one's job. This thesis helps to advance the theoretical and empirical knowledge of organizational withdrawal, cynicism and voluntary departure and concludes with possible recommendations for practitioners to an integrated intervention to prevent these two possible responses to unsatisfactory conditions at work. The thesis stresses the importance for the employee to fully utilize his skills at work, to be recognized for his efforts and contributions to the organization and to have sufficient opportunities for career development and advancement within the framework of his job.

The dissertation is a study of the origins, development and contemporary manifestations of Christian retreats. It traces origins from the Biblical record until current retreats. Christian retreat is a period of withdrawal from usual activities to experience encounter with God through Christian prayer. Jesus' pattern of engagement in ministry and withdrawal is a vital basis for retreat. Other Biblical descriptions of retreat are studied. There is an examination of retreat experiences in Church history with a particular focus on monasticism, as a major expression of retreat life, and Ignatius of Loyola, the founder of the modern retreat movement. Varieties of subsequent retreat types in the spiritualities of different traditions from the Protestant Reformation onwards are considered. The spectrum of study includes Protestant, Catholic, Eastern Orthodox and Pentecostal spiritualities. The study culminates in focusing on current Ignatian and other retreats in their many forms. This includes private devotions to lengthy periods of retreat. / Christian Spirituality, Church History & Missiology / M.Th. (Christian Spirituality)

This research deals with personality and biographical factors in absenteeism. The literature review looks at personality traits and absenteeism. The following question must then be asked: Can the construct ”personality” be analysed and described within the context of the work environment, and can the relationship between personality, biographical factors and absenteeism be studied empirically. The empirical study focuses on measuring the relationship between personality and absenteeism. The construct ”personality” is presented within the dimensional or trait perspective. The empirical investigation is presented within the functionalistic paradigm (quantitative approach). The chosen measuring instrument, namely, the Sixteen Personality Factor Questionnaire (16 PF SA 92) was administered by means of a random sample to 72 Aviation Security Officers. The reliability of the Sixteen Personality Factor Questionnaire was determined using the Cronbach Alpha coefficient method. To determine if personality is a predictor of absenteeism, stepwise regression analysis was done. The results indicate that the degree (category) of absenteeism is associated only with marital status and number of dependants. / Industrial and Organisational Psychology / M. Comm. (Industrial Psychology)

Thesis (MSc)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Pregnant women living in South African peri-urban settlements face many challenges for their health and the health of their infants. Current health care services face many constraints and are not able to meet all the needs of pregnant mothers. Home-visiting programmes implemented by community health workers can alleviate these constraints. The current RCT assessed the effectiveness of the Philani Plus Intervention Program that addressed HIV, alcohol, maternal and child nutrition and mental health. The effectiveness of the intervention was assessed by measuring infant social withdrawal behaviour using the modified Alarm Distress Baby Scale (m- ADBB). A total of 681 cases were randomised into control (N=330) and intervention groups (N=351) and assessed using the m-ADBB. A cut-off score of two and above was used to determined significant social withdrawal behaviour. Data was analysed using descriptive statistics and cross-tabulation initially, followed by analysis of variance and multilevel modelling. Results indicated a prevalence of 46.7% of social withdrawal behaviour; however, no significant differences between groups were found. The current prevalence was substantially higher in comparison to the only other published study using the m-ADBB. Furthermore, the prevalence rate was also significantly higher compared to the majority of other studies using the original Alarm distress Baby Scale (ADBB). The high prevalence of social withdrawal behaviour found in this study indicates an increased risk for suboptimal infant development. Further research regarding social withdrawal behaviour and the casual mechanisms associated with the development of such behaviour is needed. Furthermore, validation of the m-ADBB in different settings is needed. / AFRIKAANSE OPSOMMING: Swanger vroue wat in Suid-Afrikaanse buitestedelike nedersettings woon staar baie uitdagings in die gesig met betrekking tot hul gesondheid en die gesondheid van hul babas. Huidige gesondheidsdienste is baie beperk en is nie in staat om in al die behoeftes van swanger moeders te voorsien nie. Huis-besoek programme wat deur gemeenskaplike gesondheidswerkers geïmplementeer word, kan hierdie beperkings verlig. Die huidige RCT het die effektiwiteit van die Philani Plus Intervensie Program wat MIV, alkohol, voeding en geestelike gesondheid aanspreek, geassesseer. Die effektiwiteit van die intervensie is geassesseer deur sosiale onttrekkingsgedrag met behulp van die gewysigde Alarm Nood Baba Skaal (m-ADBB) te meet. ‘n Totaal van 681 gevalle is lukraak in kontrole (N = 330) en intervensie groepe (N = 351) verdeel en geëvalueer volgens die m-ADBB. 'n Afsnypunt van twee en hoër is gebruik om beduidende sosiale onttrekkingsgedrag te bepaal. Data is aanvanklik ontleed met behulp van beskrywende statistiek en kruis-tabulering, gevolg deur analise van variansie en multi-modelle. Resultate toon 'n 46,7%-voorkoms van sosiale onttrekkingsgedrag, maar het egter geen beduidende verskille tussen groepe getoon nie. Die huidige voorkoms was aansienlik hoër in vergelyking met die enigste ander gepubliseerde studie wat gebruik gemaak het van die m- ADBB. Verder was die voorkomssyfer ook aansienlik hoër in vergelyking met die meerderheid van die ander studies wat gebruik gemaak het van die oorspronklike Alarm Nood Baba Skaal (ADBB). Die hoë voorkoms van sosiale onttrekkingsgedrag dui op 'n verhoogde risiko vir suboptimale baba ontwikkeling. Verdere navorsing oor sosiale onttrekkingsgedrag en die meganismes wat verband hou met die ontwikkeling van sulke gedrag, is nodig. Verder word die bekragtiging van die m-ADBB in verskillende instellings benodig.

Σκοπός: Ο προσδιορισμός των επιπέδων συγκέντρωσης καταλοίπων κτηνιατρικών παρασιτοκτόνων ουσιών (ανθελμινθικών), σε νωπό γάλα μηρυκαστικών από περιοχές της Νοτίου Ελλάδος και η εκτίμηση της πρόσληψής τους από τον άνθρωπο. Συγκεκριμένα εξετάσθηκαν οι ουσίες, Albendazole, Febantel, Fenbendazole, Mebendazole και κάποιοι μεταβολίτες τους (Albendazole sulfoxide, Albendazole sulfone, Fenbendazole sulfone) στο νωπό γάλα προβάτων, αιγών και βοοειδών. Μέθοδοι: Χημική ανάλυση δειγμάτων γάλακτος, με τη βοήθεια Υγρής Χρωματογραφίας Υψηλής Απόδοσης και ανιχνευτή Συστοιχίας Διόδων, Υπεριώδους (UV). Χρήση βάσης δεδομένων σχετικά με την εκτίμηση της ημερήσιας κατανάλωσης γάλακτος και Φέτας (λήψη προσωπικών συνεντεύξεων, συμπλήρωση ερωτηματολογίων, συχνοτήτων κατανάλωσης τροφίμων, από δείγμα 723 μαθητών ηλικίας 10-12 ετών, από τη Νότια Ελλάδα). Αποτελέσματα: 34 από τα 123 δείγματα γάλακτος βρέθηκαν να περιέχουν κατάλοιπα των διερευνώμενων ουσιών, εκ των οποίων τα 11 υπερέβαιναν τα θεσπισμένα από την Ε.Ε. ανώτατα επιτρεπτά όρια καταλοίπων. Η Εκτιμώμενη Ημερήσια Πρόσληψη των ουσιών αυτών, από το εξετασθέν δείγμα πληθυσμού, κυμαίνεται από 0,4-15,9% της Αποδεκτής Ημερήσιας Πρόσληψης, ανάλογα με την ουσία και το τρόφιμο (νωπό αγελαδινό γάλα ή τυρί Φέτα). Υπάρχει γεωγραφική διακύμανση στη συχνότητα εμφάνισης των καταλοίπων η οποία είναι ιδιαίτερα αυξημένη σε περιοχές οι οποίες στερούνται επαρκών υπηρεσιών ελέγχου τροφίμων. Συμπεράσματα: Από την παρούσα εργασία προκύπτει ότι 11.4% των δειγμάτων γάλακτος, περιέχει κατάλοιπα ανθελμινθικών ουσιών, σε επίπεδα συγκεντρώσεων που υπερβαίνουν το ανώτατο επιτρεπτό όριο (έως και 7 φορές για τη Febantel). Το εύρημα αυτό, εγείρει ερωτήματα για την πλήρη εφαρμογή της Ο.Κ.Π.. Ωστόσο η κατανάλωση νωπού γάλακτος το οποίο περιέχει κατάλοιπα των υπό διερεύνηση ενώσεων, στα προαναφερθέντα επίπεδα συγκεντρώσεων, δεν οδηγεί σε υπέρβαση της Ανώτερης Ημερήσιας Πρόσληψης. Από την άλλη πλευρά, είναι απαραίτητο να τονιστεί ότι οι ουσίες αυτές είναι δυνατό να ανιχνευθούν και σε άλλα τρόφιμα ζωικής προέλευσης για τα οποία δεν έχουν θεσπιστεί MRLs και συνεπώς δε διεξάγονται οι αντίστοιχοι έλεγχοι. Κατά συνέπεια, είναι απαραίτητη η εκπαίδευση των κτηνοτρόφων σε θέματα Ο.Κ.Π., η εντατικοποίηση των ελέγχων και η στελέχωση των κρατικών υπηρεσιών, έτσι ώστε να αντισταθμίζονται οι ελλείψεις των νόμων και να αποφευγονται πιθανές δυσμενείς συνέπειες για τη δημόσια υγεία. / Aim: The determination of the concentration levels, of veterinary parasiticide drug (anthelmintics) residues, in ruminants’ raw milk, from regions of Southern Greece, and the residues’ intake estimation for humans. In particular, the investigated, residues were Albendazole, Febantel, Fenbendazole, Mebendazole and some of their metabolites (Albendazole sulfoxide, Albendazole sulfone, Fenbendazole sulfone), in sheep, goat and bovine raw milk. Methods: Chemical analysis of raw milk samples with High Performance Liquid Chromatography and UV Diode Array Detector. A databank concerning the daily consumption of milk and feta cheese was utilized (personal interviews and filling in of food frequency questionnaires, from a population sample of 723 pupils aged from 10-12 years old, in Southern Greece). Results: 34 out of the 123 milk samples, were found to contain residues of the investigated compounds and 11 of the contaminated samples, contained residues, exceeding the EU established MRLs. The Estimated Daily Intake for these residues resulting from the interviewed population sample, was ranging from 0,4 to 15,9% of the Acceptable Daily Intake, depending on the substance and the kind of food (raw bovine milk or feta cheese). There is a geographical variation concerning the residue occurrence, which is high in regions where food control agencies are poorly staffed. Conclusions: The present study indicates that 11.4% of milk samples analysed, contains concentration levels of anthelmintic residues above the maximum residue limit (up to 7 times for Febantel). This finding raises questions about the full implementation of Good Veterinary Practice. However, consumption of raw milk containing the aforementioned concentration levels of the compounds under investigation, does not result to exceedance of the Acceptable Daily Intake. On the other hand, it is necessary to emphasize that these substances are possible to be detected in other foods of animal origin for which no MRLs have been established and therefore the respective controls are not carried out. Consequently, training of stock-farmers on GVP, intensification of controls and staffing of government agencies, are needed to counterbalance deficiencies of laws and avoid potential adverse effects on public health.

L’utilisation d’antimicrobiens chez les animaux de consommation est une source de préoccupation importante pour la santé publique à travers le monde en raison de ses impacts potentiels sur l’émergence de micro-organismes résistants aux antimicrobiens et sur la présence de résidus antimicrobiens néfastes dans la viande. Cependant, dans les pays en développement, peu de données sont disponibles sur les pratiques d’utilisation des antimicrobiens à la ferme. Par conséquent, une étude épidémiologique transversale a été menée de juin à août 2011 dans des élevages de poulets de chair situés dans le sud du Vietnam, ayant pour objectifs de décrire la prévalence d’utilisation des antimicrobiens ajoutés à l’eau de boisson ou aux aliments à la ferme, et de tester les associations entre les caractéristiques des fermes et la non-conformité avec les périodes de retrait recommandés sur l’étiquette des produits. Un échantillon d’accommodement de 70 fermes a été sélectionné. Les propriétaires des fermes ont été interrogés en personne afin de compléter un questionnaire sur les caractéristiques des fermes et les pratiques d’utilisation d’antimicrobiens. Au cours des 6 mois précédant les entrevues, il a été rapporté que la colistine, la tylosine, l’ampicilline, l’enrofloxacine, la doxycycline, l’amoxicilline, la diavéridine et la sulfadimidine ont été utilisés au moins une fois dans les fermes échantillonnées, avec une fréquence descendante (de 75.7% à 30.0%). D’après deux scénarios de risque basés sur la comparaison de la période de retrait recommandée sur l’étiquette du produit et celle pratiquée à la ferme, de 14.3% à 44.3% des propriétaires de ferme interrogés n’ont pas respecté la période de retrait recommandée sur l’étiquette au moins une fois au cours des 6 derniers mois, et ce pour au moins un antimicrobien. Les facteurs de risque associés (p<0.05) avec une non-conformité avec la période de retrait recommandée sur l’étiquette pour au moins un des deux scénarios sont les suivants : élever des oiseaux qui n’appartiennent pas tous à des races d’origine asiatique, vacciner contre la bronchite infectieuse, avoir utilisé plus de 6 différents antimicrobiens à la ferme au cours des 6 derniers mois, et utiliser un mélange d’aliments fait maison et commerciaux. Nos résultats soulignent l’importance d’utiliser les antimicrobiens de façon judicieuse et en respectant les temps de retrait officiels, afin de protéger le consommateur contre les risques pour la santé causés par une exposition à des niveaux nocifs de résidus antimicrobiens. / Antimicrobial use in food-animal husbandry is an important public health concern worldwide due to its potential impact on the emergence of drug-resistant microbes and its harmful residues in meat. However, in developing countries, few data are available on farm drug use practices. Therefore a cross-sectional epidemiological study was conducted on broiler chicken farms in Southern Vietnam from June 2011 to August 2011 with the aim of both describing prevalence of antimicrobials added to feed or water at the farm level and ascertaining any associations between farm characteristics and non-compliance of antimicrobial withdrawal times on labels. A convenient sample of 70 broiler farms was surveyed via personal interviews with farm owners using a questionnaire pertaining to farm characteristics and drug use practices. Over the 6-month period prior to the interviews, colistin, tylosin, ampicillin, enrofloxacin, doxycyclin, amoxicillin, diaveridin, and sulfadimidin were used at least once in descending frequency (from 75.7% to 30.0%) by the farms surveyed. Following two risk scenarios based on the comparison of recommended label withdrawal times with actual withdrawal times practiced during this period, between 14.3% and 44.3% of farmers did not comply with on-label withdrawal times for at least one antimicrobial. Risk factors associated (p<0.05) with non-compliance with on-label withdrawal times in at least one risk scenario were: raising birds other than Asian-indigenous bird breeds only, vaccinating against infectious bronchitis, using more than 6 different antimicrobials on a farm during the last 6 months prior to the interview, and mixing home-made and commercial feed. Our results underline the importance of using antimicrobials judiciously and respecting official withdrawal times in order to protect the consumer from the health risks caused by exposure to harmful levels of antimicrobial residues.

Background: Since the 60s and with increasing intensity a discussion have continued about balance between useful and useless/harmful treatment. Different attempts have been done to create sustainable criteria and recommendations to manage the situations of futile treatment near the end of life. Obviously, to be able to withhold (WH) or withdraw (WD) treatment which is no longer appropriate or even harmful and burdensome for the patient, other processes than strict medical (or physiological) assessments are necessary. Aim. To shed light on the arguments regarding to WH or WD futile treatment we performed two studies of physicians’ and the general populations’ choice and prioritized arguments in the treatment of a 72-year-old woman suffering from a large intra-cerebral bleeding with bad prognosis (Papers I and II) and a new born boy with postpartum anoxic brain damage (Papers III and IV). Methods. Postal questionnaires based on two cases presented above involving severely ill patients were used. Arguments for and against to WH or WD treatment, and providing treatment that might hasten death were presented. The respondents evaluated and prioritized arguments for and against withholding neurosurgery, withdrawing life-sustaining treatment and providing drugs to alleviate pain and distress. We also asked what would happen to physicians’ own trust if they took the action described, and what the physician estimated would happen to the general publics’ trust in health services (Paper IV). Results. Approximately 70% of the physicians and 46% of the general public responded in both surveys. The 72-year-old woman: A majority of doctors (82.3%) stated that they would withhold treatment, whereas a minority of the general public (40.2%) would do so; the arguments forwarded and considerations regarding quality of life differed significantly between the two groups. Quality-of-life aspects were stressed as an important argument by the majority of both neurosurgeons and ICU-physicians (76.8% vs. 54.0%); however, significantly more neurosurgeons regarded this argument as the most important. A minority in both groups, although more ICU-physicians, supported a patient’s previously expressed wish of not ending in a persistent vegetative state as the most important argument. As the case clinically progressed, a consensus evolved regarding the arguments for decision making. The new born child: A majority of both physicians [56 % (CI 50–62)] and the general population [53 % (CI 49–58)] supported arguments for withdrawing ventilator treatment. A large majority in both groups supported arguments for alleviating the patient’s symptoms even if the treatment hastened death, but the two groups display significantly different views on whether or not to provide drugs with the additional intention of hastening death, although the difference disappeared when we compared subgroups of those who were for or against euthanasia-like actions. Conclusions. There are indeed considerable differences in how physicians and the general public assess and reason in critical care situations, but the more hopelessly ill the patient became the more the groups' assessments tended to converge, although they prioritized different arguments. In order to avoid unnecessary dispute and miscommunication, it is important that health care providers are aware of the public's views, expectations, and preferences. Our hypothesis—physicians’ estimations of others’ opinions are influenced by their own opinions—was corroborated. This might have implications in research as well as in clinical decision-making.