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The absolute right to refuse medical treatment, even if the reasons are irrational, is confined to competent adults. Children under 16 years can give legal consent to treatment in the absence of consent from those with parental responsibility. Children under 18 years do not, however, have an absolute right to consent, or refuse to consent, to treatment. The views of children assume increasing importance with age and maturity. Accident and emergency medical and nursing staff may face difficult decisions when children, or those with parental responsibility, refuse to consent to medical treatment. This paper presents guidelines designed to guide the decision making process in immediately or potentially life threatening conditions and in non-life-threatening conditions. 相似文献
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Jennings Jerry L.; Williams Charles; Thompson-Owens Margie 《Canadian Metallurgical Quarterly》1994,31(4):700
Presents a model for conceptualizing 4 basic types of suicidality among substance abusers (avoidance of painful consequences, the depressive experience of "crashing," the threat of personal loss, and environmental strain) and offers practical tips for treating the problem. Four general forms of intervention are discussed: pacing the crisis encounter; desensitizing the patient's sense of desperation; talking frankly about the suicidality; and attending to one's own needs as a counselor. These crisis-intervention tips are intended to aid counselors in handling suicidality as it is manifested in substance-abusing populations. Tips and guidelines for suicidal risk assessment with drug and alcohol abusers are given. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
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PA Conrad K Sverlow M Anderson J Rowe R BonDurant G Tuter R Breitmeyer C Palmer M Thurmond A Ardans 《Canadian Metallurgical Quarterly》1993,5(4):572-578
Parasite-specific antibody responses were detected using an indirect fluorescent antibody (IFA) test in cattle that were naturally or experimentally infected with Neospora parasites. The test was developed using Neospora tachyzoites isolated from an aborted bovine fetus and grown in bovine cell cultures (isolate BPA1). In all cases, infections were confirmed by the identification of Neospora tachyzoites and/or bradyzoite cysts in fetal or calf tissues using an immunoperoxidase test procedure. Fifty-five naturally infected cows that aborted Neospora-infected fetuses had titers of 320-5,120 at the time of abortion. The titer of 6 cows that were serologically monitored over a prolonged period decreased to 160-640 within 150 days after they aborted infected fetuses. Two of the cows showed an increase in their Neospora titers during their subsequent pregnancy, and they gave birth to congenitally infected calves that had precolostral titers of 10,240-20,480. Postcolostral titers of these calves and of 4 other calves with congenital Neospora infections were all > or = 5,120, whereas calves with no detectable parasites had titers < or = 160. Two pregnant heifers that were experimentally infected with the BPA1 isolate at approximately 120 days gestation seroconverted to Neospora antigens within 9 days and developed peak titers of 5,120 and 20,480 within 32 days of infection. The fetus taken by caesarean section 32 days postinfection from 1 heifer and the full-term calf born to the other had Neospora titers of 640 and 10,240, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
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Estep D.J. Verduyn Lunel S.M. Williams R.D. 《Antennas and Propagation Magazine, IEEE》1996,38(2):71-76
Given a capable human being and a computer, it is possible to make an approximation to the solution of a nonlinear differential equation. However, under the (usually correct) assumption that the equation is analytically intractable, the result of the computation is not the exact solution; indeed it may be so far from the exact solution as to be completely useless. We are interested in the relationship between the effort expended by the human and the computer, and the duality of the computed approximation to a partial or ordinary differential equation. To be specific, we would like to think in terms of a cost-benefit analysis. The cost of the computation is a combination of the human effort and computer resources used to obtain the approximation. The benefit includes, of course, the computed approximation, but it also includes an estimate of the quality of the approximation, that is, an error estimate. It is our opinion that in computational science, as with the experimental sciences, results should always be presented with some estimate of their accuracy. In addition, however, there is another facet to error estimation: one cannot even attempt a cost-benefit analysis or efficiency comparison of methods without an error estimate to evaluate the results 相似文献
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BACKGROUND AND PURPOSE: We compared the results of conventional angiography, carotid Doppler, and magnetic resonance angiography volume flow rates to determine the clinical utility of volume flow rate assessment of blood flow to the anterior circulation in patients with carotid occlusive disease. METHODS: From 11 symptomatic patients, a total of 22 extracranial carotid arteries were studied with all three techniques. The studies were independently read, and regression analysis was used to compare the measurements. RESULTS: Carotid Doppler measurements of the distal extracranial carotid arteries were proportional to the inverse of the extracranial carotid volume flow rate (r = .53, R2 = 29%, P < .01), volume flow rates were proportional to the inverse of measured percent stenosis on angiography (r = .84, R2 = 71%, P < .01), and Dopplers were proportional to angiography (r = .94, R2 = 90%, P < .01). Symptomatic Doppler systolic velocity was significantly higher (P < .002), symptomatic measured stenosis was significantly higher (P < .002), and symptomatic volume flow rate was significantly lower (P < .01) than their respective asymptomatic-side values. These preliminary observations, however, may well change once a large data set, especially one in which more patients with high-grade carotid stenosis are included, is studied. CONCLUSIONS: Assessment of carotid volume flow rates by magnetic resonance angiography quantifies flow reduction secondary to atherosclerotic occlusive disease. The easily obtained flow data add both documentation of arterial flow characteristics related to internal carotid stenosis and information regarding the adequacy of collateral pathways. 相似文献