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Oldham L, Arnott G, Camerlink I, Doeschl-Wilson A, Farish M, Wemelsfelder F, Turner SP. Once bitten, twice shy: Aggressive and defeated pigs begin agonistic encounters with more negative emotions. Appl Anim Behav Sci 2021; 244:105488. [PMID: 34819712 PMCID: PMC8593554 DOI: 10.1016/j.applanim.2021.105488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 01/30/2023]
Abstract
Aggression between unfamiliar commercial pigs is common and likely invokes strong emotions in contestants. Furthermore, contest outcomes affect subsequent aggressive behaviour, suggesting a potential lasting influence on affective state. Here we used a combination of qualitative and quantitative methods to assess the emotional expression of pigs in agonistic encounters. We investigated how recent victory or defeat influences emotions expressed in a subsequent contest, and the role of aggressiveness as a personality trait in emotional expression. We observed the pre-escalation contest behaviour (second contest; age 13 wks) in animals of different aggressiveness (categorised using two resident intruder tests as Agg+ or Agg-, age 9 wks), which had recently won or lost a contest (first contest; 10 wks). We measured gaze direction and ear position. Observers watched video clips of the initial 30 s of the second contest and evaluated the emotional expression of 57 pigs (25 contest 1 winners, 32 contest 1 losers) using qualitative behavioural assessment (QBA) with a fixed list of 20 descriptive terms. QBA identified three principal components (PCs), accounting for 68% of the variation: PC1 (agitated/tense to relaxed/content), PC2 (fearful/aimless to confident/enjoying) and PC3 (listless/ indifferent). Agg- pigs and males showed a more positive emotionality (PC2). PC1 and PC3 were unaffected by first contest outcome and aggressiveness. Agg+ pigs were more likely to hold their ears back (X2 =7.8, p = 0.005) during the early contest period. Differences in attention were detected in the contest outcome × aggressiveness interaction (χ24.3, p = 0.04), whereby approaching the opponent was influenced by winning and losing in the Agg- pigs only. QBA and gaze behaviour reveal differences in emotional valence between pigs of different aggressiveness: less aggressive pigs may be more susceptible to the emotional impact of victory and defeat but overall, more aggressive pigs express more negative emotionality at the start of agonistic encounters.
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Affiliation(s)
- Lucy Oldham
- Animal Behaviour & Welfare, Animal and Veterinary Sciences Department, Scotland’s Rural College (SRUC), West Mains Rd, Edinburgh EH9 3JG, UK
| | - Gareth Arnott
- Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Belfast BT9 7BL, UK
| | - Irene Camerlink
- Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences, Ul. Postepu 36 A, Jastrzebiec, Magdalenka 05-552, Poland
| | - Andrea Doeschl-Wilson
- The Roslin Institute & R(D)SVS, University of Edinburgh, Easter Bush, Edinburgh EH25 9RG, UK
| | - Marianne Farish
- Animal Behaviour & Welfare, Animal and Veterinary Sciences Department, Scotland’s Rural College (SRUC), West Mains Rd, Edinburgh EH9 3JG, UK
| | - Francoise Wemelsfelder
- Animal Behaviour & Welfare, Animal and Veterinary Sciences Department, Scotland’s Rural College (SRUC), West Mains Rd, Edinburgh EH9 3JG, UK
| | - Simon P. Turner
- Animal Behaviour & Welfare, Animal and Veterinary Sciences Department, Scotland’s Rural College (SRUC), West Mains Rd, Edinburgh EH9 3JG, UK
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Abstract
Emotions encompass cognitive and behavioural responses to reward and punishment. Using contests as a case-study, we propose that short-term emotions underpin animals' assessments, decision-making and behaviour. Equating contest assessments to emotional 'appraisals', we describe how contestants appraise more than resource value and outcome probability. These appraisals elicit the cognition, drive and neurophysiology that governs aggressive behaviour. We discuss how recent contest outcomes induce long-term moods, which impact subsequent contest behaviour. Finally, we distinguish between integral (objectively relevant) and incidental (objectively irrelevant) emotions and moods (affective states). Unlike existing ecological models, our approach predicts that incidental events influence contest dynamics, and that contests become incidental influences themselves, potentially causing maladaptive decision-making. As affective states cross contexts, a more holistic ethology (incorporating emotions and moods) would illuminate animal cognition and behaviour.
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Affiliation(s)
- Andrew Crump
- Centre for Philosophy of Natural and Social Science, London School of Economics and Political Science, UK.,Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, UK
| | - Emily J Bethell
- School of Biological and Environmental Sciences, Liverpool John Moores University, UK
| | - Ryan Earley
- Department of Biological Sciences, University of Alabama, USA
| | - Victoria E Lee
- Animal Behaviour and Welfare, Scotland's Rural College, UK
| | - Michael Mendl
- Bristol Veterinary School, University of Bristol, UK
| | - Lucy Oldham
- Animal Behaviour and Welfare, Scotland's Rural College, UK
| | - Simon P Turner
- Animal Behaviour and Welfare, Scotland's Rural College, UK
| | - Gareth Arnott
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, UK
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Oldham L, Camerlink I, Arnott G, Doeschl-Wilson A, Farish M, Turner SP. Winner-loser effects overrule aggressiveness during the early stages of contests between pigs. Sci Rep 2020; 10:13338. [PMID: 32770010 PMCID: PMC7414859 DOI: 10.1038/s41598-020-69664-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/15/2020] [Indexed: 11/15/2022] Open
Abstract
Contest behaviour, and in particular the propensity to attack an unfamiliar conspecific, is influenced by an individual's aggressiveness, as well as by experience of winning and losing (so called 'winner-loser effects'). Individuals vary in aggressiveness and susceptibility to winner-loser effects but the relationship between these drivers of contest behaviour has been poorly investigated. Here we hypothesise that the winner-loser effect on initiation of agonistic behaviour (display, non-damaging aggression, biting and mutual fighting) is influenced by aggressiveness. Pigs (n = 255) were assayed for aggressiveness (tendency to attack in resident-intruder tests) and then experienced two dyadic contests (age 10 and 13 weeks). Agonistic behaviour, up to reciprocal fighting, in contest 2 was compared between individuals of different aggressiveness in the RI test and experiences of victory or defeat in contest 1. Winner-loser effects were more influential than aggressiveness in determining initiation of agonistic behaviour. After accruing more skin lesions in contest 1, individuals were less likely to engage in escalated aggression in contest 2. The interaction between aggressiveness and winner-loser experience did not influence contest behaviour. The results suggest that aggressiveness does not compromise learning from recent contest experience and that reducing aggressiveness is unlikely to affect how animals experience winning and losing.
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Affiliation(s)
- Lucy Oldham
- Animal Behaviour and Welfare, Animal and Veterinary Sciences Department, Scotland's Rural College (SRUC), West Mains Rd, Edinburgh, EH9 3JG, UK.
| | - Irene Camerlink
- Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences, Ul. Postepu 36A, Jastrzebiec, 05-552, Magdalenka, Poland
| | - Gareth Arnott
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, BT9 7BL, UK
| | - Andrea Doeschl-Wilson
- The Roslin Institute and R(D)SVS, University of Edinburgh, Easter Bush, Edinburgh, EH25 9RG, UK
| | - Marianne Farish
- Animal Behaviour and Welfare, Animal and Veterinary Sciences Department, Scotland's Rural College (SRUC), West Mains Rd, Edinburgh, EH9 3JG, UK
| | - Simon P Turner
- Animal Behaviour and Welfare, Animal and Veterinary Sciences Department, Scotland's Rural College (SRUC), West Mains Rd, Edinburgh, EH9 3JG, UK
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McConigley R, Kristjanson LJ, Aoun SM, Oldham L, Currow DC, O'Connor M, Holloway K. Staying just one step ahead: providing care for patients with motor neurone disease: Table 1. BMJ Support Palliat Care 2013; 4:38-42. [DOI: 10.1136/bmjspcare-2013-000489] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Osmond D, Sharpley A, Bolster C, Cabrera M, Feagley S, Lee B, Mitchell C, Mylavarapu R, Oldham L, Walker F, Zhang H. Comparing phosphorus indices from twelve southern U.S. states against monitored phosphorus loads from six prior southern studies. J Environ Qual 2012; 41:1741-1749. [PMID: 23128731 DOI: 10.2134/jeq2012.0013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Forty-eight states in the United States use phosphorus (P) indices to meet the requirements of their Natural Resources Conservation Service (NRCS) Code 590 Standard, which provides national guidance for nutrient management of agricultural lands. The majority of states developed these indices without consultation or coordination with neighboring states to meet specific local conditions and policy needs. Using water quality and land treatment data from six previously published articles, we compared P loads with P-Index values and ratings using the 12 southern P indices. When total measured P loads were regressed with P-Index rating values, moderate to very strong relationships (0.50 to 0.97) existed for five indices (Arkansas, Florida, Georgia, North Carolina, and South Carolina) and all but one index was directionally correct. Regressions with dissolved P were also moderate to very strong ( of 0.55 to 0.95) for the same five state P indices (Arkansas, Florida, Georgia, North Carolina, and South Carolina); directionality of the Alabama Index was negative. When total measured P loads were transformed to current NRCS 590 Standard ratings (Low [<2.2 kg P ha], Moderate, [2.2-5.5 kg P ha], and High [>5.5 kg P ha]) and these ratings were then compared to the southern-Index ratings, many of the P indices correctly identified Low losses (77%), but most did not correctly identify Moderate or High loss situations (14 and 31%, respectively). This study demonstrates that while many of the P indices were directionally correct relative to the measured water quality data, there is a large variability among southern P indices that may result in different P management strategies being employed under similar conditions.
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Affiliation(s)
- D Osmond
- Soil Science Department, North Carolina State University, Raleigh, NC, USA.
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Abstract
This paper investigates the support needs of people living alone with a terminal illness from a client perspective. In depth, interviews were conducted with 11 clients from Silver Chain Hospice Care in Western Australia to capture their personal experiences of managing at home alone and to assess their physical, social and emotional needs. Findings provided useful insights with respect to many of the motivations, beliefs and wishes of individuals who endeavour to cope on their own with minimal assistance. The needs of these individuals are practical, emotional, physical and existential. At the heart of these concerns is a strong need to be independent and maintain a sense of dignity at end of life.
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Affiliation(s)
- S Aoun
- WA Centre for Cancer and Palliative Care, Curtin University of Technology, Bentley, WA 6028, Australia.
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Aoun S, Kristjanson LJ, Currow D, Skett K, Oldham L, Yates P. Terminally-ill people living alone without a caregiver: an Australian national scoping study of palliative care needs. Palliat Med 2007; 21:29-34. [PMID: 17169957 DOI: 10.1177/0269216306073198] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Home-based palliative care services are facing increasing challenges in servicing the needs of clients who live alone and without a primary caregiver. The findings from the analysis of 721 services' records from three Australian states, and feedback from health professionals in interviews and postal surveys, demonstrated that there were aspects of being on one's own with a terminal illness and living at home that require a specialised approach and support. This study explored the issues of palliative care patients living alone, from a service provider perspective, and provided evidence-based information to assist with service planning. The study made recommendations to the Australian Department of Health and Ageing about services considered important in developing support structures for this growing population.
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Affiliation(s)
- S Aoun
- WA Centre for Cancer and Palliative Care, Edith Cowan University, Churchlands, Australia.
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Bakirci N, Kalaca S, Fletcher AM, Pickering CAC, Tumerdem N, Cali S, Oldham L, Francis H, McL Niven R. Predictors of early leaving from the cotton spinning mill environment in newly hired workers. Occup Environ Med 2006; 63:126-30. [PMID: 16421391 PMCID: PMC2078073 DOI: 10.1136/oem.2005.021352] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This longitudinal study aimed to identify the predictors of leaving during the first year of employment from the cotton spinning mill environment in newly hired workers. METHODS One hundred and ninety eight consecutively appointed new employees were investigated by questionnaire, lung function test, and skin test. They were examined before employment and at the end of the 1st week, and the 1st, 3rd, 6th, and 12th month after starting work and when possible before leaving their job. 572 personal dust sampling and 191 endotoxin measurements were performed to assess the environmental exposure. For the univariate analysis chi2, Student t tests, ANOVA, and Kruskall Wallis tests were used. Cox proportional hazards analysis was used to identify factors associated with leaving the job. RESULTS Fifty three per cent of workers left the mill environment during their first working year. Work related lower respiratory tract symptoms reported at the third month were associated with an increase rate of leaving the industry compared to those remaining in the industry (25% v 4.8%; p<0.005). Having respiratory symptoms at the first month of work predicted those leaving the industry at some point in the next 11 months. According to the Cox model, increasing age and having work related lower respiratory tract symptoms were found to be predictors for leaving job at the first working year. Atopic status, dust and endotoxin levels, and lung function changes were not consistently predictive of workers who left the industry in the follow up period. CONCLUSION This study demonstrated that work related respiratory symptoms can predict workers likely to leave the cotton mill environment during the first year of employment, but atopy or acute lung function changes do not.
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Affiliation(s)
- N Bakirci
- Marmara University, School of Medicine, Department of Public Health, Haydarpasa Istanbul, Turkey.
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Francis H, Fletcher G, Anthony C, Pickering C, Oldham L, Hadley E, Custovic A, Niven R. Clinical effects of air filters in homes of asthmatic adults sensitized and exposed to pet allergens. Clin Exp Allergy 2003; 33:101-5. [PMID: 12534557 DOI: 10.1046/j.1365-2222.2003.01570.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Despite medical advice, many pet-allergic asthma sufferers refuse to remove the pet to which they are sensitized from their home. OBJECTIVE We aimed to assess the clinical effects of air cleaners in the homes of adult asthma patients sensitized and exposed to cats and/or dogs. METHODS We performed a randomized, parallel-group study of 30 asthmatic adults sensitized to and sharing a home with cats or dogs. The effects of placing air cleaners in the living room and bedroom for 12 months and using high efficiency particulate air filter vacuum cleaners (active group) were compared with using these vacuum cleaners alone (control group). Measures of airway responsiveness, treatment requirement, lung function, peak flow, reservoir and airborne allergen were recorded before, during and after the interventions. A beneficial clinical response was assessed in terms of a 'combined asthma outcome'. This was defined as a two or more doubling dose improvement in bronchial hyper-reactivity to histamine and/or a reduction in treatment requirement of at least one step change on the British Thoracic Society guidelines for asthma treatment. RESULTS A beneficial clinical response was observed in 10/15 subjects in the active group compared with 3/15 in the control group after 12 months intervention (P = 0.01). No significant differences between the active and control groups were detected for changes in measures of lung function, reservoir pet allergen and airborne pet allergen during the study. CONCLUSION Whilst the study design has not allowed complete exclusion of a placebo effect, we believe that this pragmatic study of adult asthmatic patients sensitized and exposed to pets resulted in a small, but significant improvement in combined asthma outcome.
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Affiliation(s)
- H Francis
- North West Lung Research Centre, Wythenshawe Hospital, Manchester, UK.
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Abstract
The synthesis of a 93-residue chemokine, lymphotactin, containing eight sites of O-linked glycosylation, was achieved using the technique of native chemical ligation. A single GalNAc residue was incorporated at each glycosylation site using standard Fmoc-chemistry to achieve the first total synthesis of a mucin-type glycoprotein. Using this approach quantities of homogeneous material were obtained for structural and functional analysis.
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Affiliation(s)
- L A Marcaurelle
- Department of Chemistry, Howard Hughes Medical Institute, University of California, Berkeley 94720, USA
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Kristjanson LJ, McPhee I, Pickstock S, Wilson D, Oldham L, Martin K. Palliative care nurses' perceptions of good and bad deaths and care expectations: a qualitative analysis. Int J Palliat Nurs 2001; 7:129-39. [PMID: 12192329 DOI: 10.12968/ijpn.2001.7.3.8911] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Individuals who are involved with the death of a person with a terminal illness will often classify the death as either 'good' or 'bad'. Families and healthcare practitioners assess many factors when determining their 'success' or 'failure' in assisting someone in the terminal phase. Palliative care nurses are particularly vulnerable to self-assessments about care of the dying, because death is a daily occurrence. Feelings of failure, unmet expectations and feeling of regret about not being able to prevent a traumatic death may be a source of stress for palliative care nurse and may affect their abilities to function effectively. This article reports the findings of a study involving interviews with 20 palliative care nurses to determine their perceptions of a good and bad death. The study also examined the expectations they hold of themselves and that they believe others hold of them in helping patients to attain a good death. Clinical implications are discussed based on these findings.
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Affiliation(s)
- L J Kristjanson
- School of Nursing and Public Health, Edith Cowan University, Churchlands Campus, Churchlands, Australia
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Stringer NH, Strassner HT, Lawson L, Oldham L, Estes C, Edwards M, Stringer EA. Pregnancy outcomes after laparoscopic myomectomy with ultrasonic energy and laparoscopic suturing of the endometrial cavity. J Am Assoc Gynecol Laparosc 2001; 8:129-36. [PMID: 11172128 DOI: 10.1016/s1074-3804(05)60562-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
STUDY OBJECTIVE To evaluate pregnancy outcomes in women with laparoscopic removal of myomas that resulted in entry into the endometrial cavity and required laparoscopic repair of the endometrial cavity. DESIGN Retrospective chart review (Canadian Task Force classification II-2). SETTING; Private obstetrics-gynecology practice and departments of obstetrics and gynecology at two university-affiliated hospitals. PATIENTS Seven women with symptomatic uterine leiomyomata treated by laparoscopic myomectomy, who achieved pregnancy. INTERVENTION Laparoscopic dissection of myomas with the ultrasonic scalpel and laparoscopic suturing of the uterus with the Endo Stitch device in three layers. MEASUREMENTS AND MAIN RESULTS Indications for laparoscopic myomectomies were excessive bleeding and significant growth of uterine myomas. The size of myomas in all patients ranged from 12 to 2 cm. Average operating time was 232.8 minutes and average blood loss was 117.8 ml. The largest number of myomas removed from a single patient was nine. All procedures were performed on an outpatient basis and no complications occurred. All women easily achieved pregnancy and four were delivered at or near term by cesarean section. One delivered vaginally at 28 weeks secondary to uncontrolled premature labor, without uterine dehiscence. Two had elective terminations at 8 weeks. CONCLUSION Laparoscopic suturing of the endometrial cavity in three layers does not prevent future pregnancies, and pregnancies can progress to term and in some cases be delivered vaginally without dehiscence. (J Am Assoc Gynecol Laparosc 8(1):129-136, 2001)
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Affiliation(s)
- N H Stringer
- Department of Obstetrics and Gynecology, Rush Medical College, Chicago, Illinois, USA
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Abstract
Uterine artery embolization (UAE) is an effective, safe, nonsurgical treatment for uterine myomas. Although menstrual irregularities and transient amenorrhea have occurred after UAE, these reports did not provide proper hormonal documentation of ovarian failure. Our patient experienced elevated follicle-stimulating hormone (FSH) levels and vasomotor symptoms (hot flushes) within 4 weeks after the procedure. To our knowledge, this is the first report in the literature of ovarian failure after UAE confirmed by comparing preprocedure FSH levels with postprocedure levels over 12 months.
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Affiliation(s)
- N H Stringer
- 55 East Washington Street, Suite 2043, Chicago, IL 60602, USA
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Abstract
Transfer of patients from palliative care services to nursing homes is necessary at present when a patient is relatively stable, but does not have adequate support systems at home. With the ageing of the population and the increasing incidence of cancer, the need for inpatient palliative care beds is growing with corresponding pressure for patients to be transferred to nursing homes. Transfer to a nursing home in the general population has been described extensively in the gerontology literature where a critical early phase of relocation has been identified by a high incidence of morbidity and mortality. The vulnerability of terminally ill patients means that they are at increased risk of suffering from stress associated with a transfer. The prognosis of a patient may be shorter than the time required for adjustment to the patient's new home. The issues surrounding transfer of palliative care patients to nursing homes and possible strategies designed to reduce distress associated with transfers are explored.
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Affiliation(s)
- D Porock
- School of Nursing, Edith Cowan University, Churchlands
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Waddell C, Clarnette RM, Smith M, Oldham L. Advance directives affecting medical treatment choices. J Palliat Care 1997; 13:5-8. [PMID: 9231581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Advance directives theoretically enhance individual autonomy and facilitate treatment decision making at the end of life. There is little empirical evidence to support this, however. Based on a national postal survey of 2172 randomly selected medical practitioners (response rate 73%), this paper examines the effect advance medical directives have on (a) treatment prescribing for terminally ill people and (b) the degree of difficulty practitioners experience in making treatment choices. A hypothetical patient with Alzheimer's disease and an acute life-threatening illness was presented with and without an advance directive. With a directive, respondents were more uniform in their choice of treatment, with 86% choosing as the patient had requested. Difficulty with decision making was also less with the directive, 31% vs 45% with no directive. The data indicate that advance directives do affect practitioners' treatment choices in favor of patient wishes and reduce the difficulty practitioners may experience in making them.
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Affiliation(s)
- C Waddell
- Department of Anthropology, University of Western Australia, Nedlands, Western Australia
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Dean A, Martin K, Yuen K, Oldham L, Ewence K. Morphine and clonazepam combinations in the Springfusor 30 infusion device. Palliat Med 1997; 11:256. [PMID: 9205664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Waddell C, Clarnette RM, Smith M, Oldham L, Kellehear A. Treatment decision-making at the end of life: a survey of Australian doctors' attitudes towards patients' wishes and euthanasia. Med J Aust 1996; 165:540-4. [PMID: 8941238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine factors that influence medical practitioners' treatment decisions for patients with life-threatening or terminal illnesses. DESIGN Postal survey, conducted between September and November 1995, of a self-administered questionnaire, describing four clinical case scenarios, to a random sample of 2172 Australian doctors in all States and Territories. Respondents were asked to prescribe treatment for the patients described in the scenarios. Patients' characteristics varied in terms of mental competence, illness severity, prognosis, the presence of advance directives, request for assisted death, and sociodemographic factors. The respondents' sociodemographic and medical training characteristics were also obtained. SETTING Random national sample of all active medical practitioners. PARTICIPANTS Hospital trainees, general practitioners, physicians, palliative care practitioners and surgeons were surveyed. A response rate of 73% was achieved. MAIN OUTCOME MEASURES Frequency of prescription of supportive, acute or intensive treatment for patients in the four clinical scenarios based on respondents' sex, religion, medical training and country of medical degree. RESULTS Three main findings were: (i) doctors did not make consistent decisions, but their decisions varied systematically by sociodemographic and medical training factors; (ii) doctors generally adhered to patient and family wishes when these were known; (iii) doctors did not generally adhere to a patient's request for assisted death. CONCLUSION Treatment provided is significantly determined by the individual characteristics of the doctor and not solely by the nature of the medical problem. Participation in the informed-consent process and in the preparation of advance health care directives would enable practitioners to be familiar with patient and family wishes and could reduce variations of treatment related to sociodemographic and medical training factors. Stronger empirical data on the way that treatment decisions are made could provide the basis for an informed euthanasia policy.
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Affiliation(s)
- C Waddell
- University of Western Australia, Nedlands.
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18
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Oldham L. Killey's fractures of the mandible dental practitioner handbook no. 5. Br J Oral Maxillofac Surg 1984. [DOI: 10.1016/0266-4356(84)90105-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Oldham L. Reticulum-cell sarcoma of the maxilla. A case report. Dent Pract Dent Rec 1965; 16:13-5. [PMID: 5318183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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