Although bioethics has become an established part of medical school curricula, relatively little is known about how students apply didactic material to clinical problem-solving situations.

Each of 92 second-year students (54 men and 38 women) at the University of California, Irvine, College of Medicine in 1991-92 wrote a paper identifying and attempting to resolve a clinical ethical dilemma of his or her choice. The papers were then coded for content, use of ethical theories and principles, degree of resolution, and level of personal orientation (i.e., evidence of personal involvement in the dilemmas). Data were analyzed by student sex and age, using chi-square tests of significance and correlational analysis.

The students had no difficulty in identifying a range of ethical dilemma. Most students appeared to have understood and become familiar with the major ethical theories and principles currently in use, and to have employed them correctly. A majority of the students were able to successfully resolve their ethical dilemmas. Differences between the men and the women students were found regarding choice of topic, ethical principles used (p = .03), and level of personal orientation (p < .01).

The women tended to be interested in issues involving broad social perspectives; to favor arguments emphasizing the rights of patients and families; and to incorporate personal responses, as well as abstract theories, in their assays. The men tended to be interested in issues involving personal control, authority, and responsibility; to advocate utilitarian, cost-containment thinking, and to rely exclusively on abstract, logical arguments. Further research should determine whether these differences can be identified in actual clinical decision making, and whether the differences have implications for the nature or quality of clinical decisions.

The copper in the saturation extract of dried Davis sewage sludge was mainly in a complexed form. A Cu2+ specific ion electrode was used to determine the extent of complexation. Absorption experiments showed that the Kd value of 90 cc g-1. Paper electrophoresis was used to define the complexes according to their mobility in an electric field. Six fractions of positive, negative and neutral charge were isolated. The fraction of Cu in the sludge which was water soluble was found to increase significantly upon drying. The low Kd values on soil and the large percentage of complexed Cu suggested that sewage sludge may be a potential source of contamination of water and plant systems.

Background

Methods

Results

Discussion

A 3-year study of the accumulation of soluble salts and boron in a soil profile following trickle irrigation with well water is completed. Irrigation treatments consisted of three levels of water applications based on estimated evapotranspiration (ET)requirements of grape vines. Estimates of ET were obtained from soil data using a neutron (CPN) meter. Soil water potentials obtained by tensiometers at different soil depths provided information about soil water movement. Analysis of soil samples taken in late 1981 showed slow but continued salt and boron accumulation during irrigation periods. Plant samples showed boron accumulation in the grape leaves during the irrigation season. Leaves from the lowest irrigation level (2/3 ET) showed higher boron contents than did the 3/3 ET level which was higher than the 4/3 ET irrigation treatment. Chloride accumulation in the plant leaves increased similar to that of boron, however, sodium did not, although it did accumulate in leaf petioles during the irrigation season in all treatments. In general, plant tissues reflected the sodium, chloride, and boron concentrations found in the soil. Grape yields in 1982 responded to the higher irrigation levels and yields were considerably larger than the local area average.

The willingness of physicians to provide care to HIV-positive patients has been linked to a number of attitudinal factors, but little is known concerning the impact of premedical, medical, and residency training on these factors. The purpose of this study is to elicit responses to the same series of questions concerning HIV and its treatment from respondents at different stages of training, to detect trends in attitudes and to measure the impact of those attitudes on willingness to provide care for HIV/AIDS patients. Study data come from a cross-sectional survey (n = 249) of respondents across the training continuum, from premedical students to faculty physicians, using a self-administered questionnaire at a single medical school. The response rate was 59.6%. The study showed significant decreases in personal fear and misgivings concerning HIV, coupled with a substantial decrease in the perceived need for testing of non-high-risk individuals, as respondents gained additional education and training. Overall, the intent to treat HIV did not change significantly by training level, but multivariate analyses showed that while the initially strong influence of attitudes toward AIDS and its attendant risks diminishes, comfort relative to being around homosexuals per se continues to exert an impact on the intent to treat. Appropriate use of protective measures when providing care becomes far more common once individuals enter their clinical training years. The impact of medical education through its entire continuum therefore shows a positive impact on attitudes toward HIV, despite the absence of a significant trend in respondents' stated intent to treat. However, negative attitudes toward homosexuals continue to exert a negative influence on intent to treat that endures into the clinical training years.

The dielectric properties are reported for nanoporous thin films of poly(methyl silsesquioxane) (MSSQ) for use as an ultralow, dielectric intermetal insulator. Direct experimental conformation is provided that the films have low dielectric constants with low loss up to 10 GHz. Low-frequency measurements are also reported.