School of Historical and Philosophical Studies - Research Publications
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ItemArtistic practices of the Bohol School of Painting: An analytical and archival study of nineteenth-century panel paintings in the Philippines(Archetype Publishing, 2005)In the center of the Philippines on the island of Bohol, a unique panel painting practice evolved linking western artistic methods introduced by the Spanish with Filipino knowledge of materials and techniques. The scientific analysis of five nineteenth century panel paintings belonging to the Baclayon Parish was undertaken and combined with an archival investigation of the Parish Archives to develop a better understanding of their provenance. Results illustrate the western construction methods used in the panel paintings with an oil medium as well as the utilization of local materials such as Kedondong wood for the panel support, cotton and bast fiber paper for a gap filler between the wood panels, and a transparent brown hydrocarbon for the ground layer. Some of the pigments identified correlate with the geological deposits from the region and others correspond with the archival church records. Other identified pigments were not referenced in the archives or found locally. The latter indicate the importation of high quality pigments, not of Filipino origin. Further, the good condition of the panels highlight their sound preparation and an environment suited for these particular works.
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ItemAttainable and Sustainable: Skills Gap in Conservation in Australia. Produced by the Australian Institute for the Conservation of Cultural Material (AICCM) for the Collections Management and Conservation Working Party of the Heritage Collections Council (HCC). 2000(Commonwealth of Australia 2000 on behalf of the Heritage Collections Council, 2000-01-01)The National Conservation and Preservation Strategy for Australia's Heritage Collections recognises skills development as one of the major areas requiring strategic support. Key Strategy SD3 aims to: Facilitate the development of a range of conservation and preservation education opportunities and support the development of professional codes of practice, codes of ethics, accreditation and standards for conservators and collection managers. The action required, which forms the basis for this survey, was: Audit gaps in skills and match of trained conservators in certain fields eg. conservation and preservation of textiles, natural history collections, photography and furniture. In order to better assess this need, and in order to identify individuals who are recognised by the Australian Institute for the Conservation of Cultural Material (AICCM) as being accredited conservators, the Collections Management and Conservation Working Party of the Heritage Collections Council (HCC) commissioned the AICCM to undertake a skills gap audit of specialist conservators in Australia. This document goes some way to identifying the issues relating to the auditing of conservation skills in materials conservation in Australia.
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ItemNo Preview AvailableCluster randomisation or randomised consent as an appropriate methodology for trials in palliative care: a feasibility study [ISRCTN60243484].(Springer Science and Business Media LLC, 2004-04-27)BACKGROUND: Although guidelines for the care of the dying patient exist the evidence base to support the guidelines is poor. Some of the factors contributing to this include failure to recruit to trials, protective healthcare professionals and subsequent attrition from trials due to the death of the patients. Recent studies report favourably on the use of cluster randomisation as an appropriate methodology for use in this patient group. METHODS/DESIGN: A feasibility study, exploring two types of randomisation as appropriate methodology for trials involving dying patients. Cluster randomisation and randomised consent will be utilised following a crossover design at two sites, one oncology ward and one Macmillan unit within the Northwest Wales NHS Trust. All patients commencing on the Integrated Care Pathway (ICP) for the Last Days of Life will be eligible for inclusion in the study. Using the hypothesis that it is not necessary to prescribe an anti-emetic medication when setting up a syringe driver for the dying patient, the study will evaluate different models of research methodology. DISCUSSION: The identification of the most appropriate methodology for use in studies concerning this patient group will inform the development of future clinical studies. Furthermore, the outcomes of this feasibility study will inform the development, of a proposal seeking funding for Wales-wide trials in palliative care. The identification of an appropriate methodology will provide a starting point for the establishment of a robust evidence base for the care of the dying patient.
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ItemNo Preview AvailableAccuracy of prognosis estimates by four palliative care teams: a prospective cohort study.(Springer Science and Business Media LLC, 2002)BACKGROUND: Prognosis estimates are used to access services, but are often inaccurate. This study aimed to determine the accuracy of giving a prognosis range. METHODS AND MEASUREMENTS: A prospective cohort study in four multi-professional palliative care teams in England collected data on 275 consecutive cancer referrals who died. Prognosis estimates (minimum - maximum) at referral, patient characteristics, were recorded by staff, and later compared with actual survival. RESULTS: Minimum survival estimates ranged <1 to 364 days, maximum 7 - 686 days. Mean patient survival was 71 days (range 1 - 734). In 42% the estimate was accurate, in 36% it was over optimistic and in 22% over pessimistic. When the minimum estimate was less than 14 days accuracy increased to 70%. Accuracy was related, in multivariate analysis, to palliative care team and (of borderline significance) patient age. CONCLUSIONS: Offering a prognosis range has higher levels of accuracy (about double) than traditional estimates, but is still very often inaccurate, except very close to death. Where possible clinicians should discuss scenarios with patients, rather than giving a prognosis range.
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ItemNo Preview AvailableHealth biotechnology in China -: reawakening of a giant(NATURE PUBLISHING GROUP, 2004-12)
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ItemNo Preview AvailableConsensus guidelines on analgesia and sedation in dying intensive care unit patients.(Springer Science and Business Media LLC, 2002-08-12)BACKGROUND: Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. METHODS: Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given to dying ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1) Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs (N = 9); 2) Deputy chief provincial coroners (N = 5); 3) Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting (N = 12). RESULTS: After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU. CONCLUSION: Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia.
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ItemNo Preview AvailableConclusions:: promoting biotechnology innovation in developing countries(NATURE PORTFOLIO, 2004-12)
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ItemNo Preview AvailableWaiting lists for radiation therapy: A case study(BIOMED CENTRAL LTD, 2001)BACKGROUND: Why waiting lists arise and how to address them remains unclear, and an improved understanding of these waiting list "dynamics" could lead to better management. The purpose of this study is to understand how the current shortage in radiation therapy in Ontario developed; the implications of prolonged waits; who is held accountable for managing such delays; and short, intermediate, and long-term solutions. METHODS: A case study of the radiation therapy shortage in 1998-99 at Princess Margaret Hospital, Toronto, Ontario, Canada. Relevant documents were collected; semi-structured, face-to-face interviews with ten administrators, health care workers, and patients were conducted, audio-taped and transcribed; and relevant meetings were observed. RESULTS: The radiation therapy shortage arose from a complex interplay of factors including: rising cancer incidence rates; broadening indications for radiation therapy; human resources management issues; government funding decisions; and responsiveness to previous planning recommendations. Implications of delays include poorer cancer control rates; patient suffering; and strained doctor-patient relationships. An incompatible relationship exists between moral responsibility, borne by government, and legal liability, borne by physicians. Short-term solutions include re-referral to centers with available resources; long-term solutions include training and recruiting health care workers, improving workload standards, increasing compensation, and making changes to the funding formula. CONCLUSION: Human resource planning plays a critical role in the causes and solutions of waiting lists. Waiting lists have harsh implications for patients. Accountability relationships require realignment.
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ItemNo Preview AvailablePriority setting for new technologies in medicine: A transdisciplinary study(BMC, 2002-07-18)BACKGROUND: Decision makers in health care organizations struggle with how to set priorities for new technologies in medicine. Traditional approaches to priority setting for new technologies in medicine are insufficient and there is no widely accepted model that can guide decision makers. DISCUSSION: Daniels and Sabin have developed an ethically based account about how priority setting decisions should be made. We have developed an empirically based account of how priority setting decisions are made. In this paper, we integrate these two accounts into a transdisciplinary model of priority setting for new technologies in medicine that is both ethically and empirically based. SUMMARY: We have developed a transdisciplinary model of priority setting that provides guidance to decision makers that they can operationalize to help address priority setting problems in their institution.