Risky business: proposed reform of the antitrust laws as applied to health care provider networks

The use of powerful methodologies in molecular biology, biochemistry, and physiology in the last 2 decades had led to impressive progress in our understanding of the mechanisms of complement activation and its role as either a protective or a pathogenic factor in human disease. With respect to disease pathogenesis, the complexity of the complement cascade provides opportunities for several different therapeutic targets within the complement pathways. More than a century after complement was first described, we are about to witness in the near future the availability of a variety of complement inhibitors for specific therapies. Progress in the area of xenotransplantation has been substantial, but formidable obstacles remain to selective inhibition of the factors that block successful clinical xenotransplantation. Bispecific antibodies, designed to enhance rather than inhibit existing complement pathways, hold strong promise for the clearance of viral and bacterial pathogens from the circulation.     

Psychology's role in the new health care systems: The importance of psychological interventions in primary health care.

Discusses the new health policies of the World Health Organization. It is suggested that these policies are particularly concerned with prevention and health-enhancing life-styles and, therefore, with the role of psychology in primary health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The pursuit of global health: the relevance of engagement for developed countries

The globalisation of the world economy and the consequent increase in commerce, travel, and communication have brought benefits to virtually every country. But these changes also bring risks that cannot be addressed adequately within traditional national borders. These risks include emerging infectious diseases, resulting in part from increased prevalence of drug-resistant pathogens; exposure to dangerous substances, such as contaminated foodstuffs, and banned and toxic substances; and violence, including chemical and bioterrorist attack. By investing in global health, industrialized countries will not only benefit populations in desperate and immediate need of assistance, but also themselves--through protecting their people, improving their economies, and advancing their international interests. This paper describes the rationale for involvement of industrialised countries in global health, and suggests a means for its coordination.     

Managed mental health care: The client's perspective.

Changes in psychotherapy services have been the focus of controversy between psychologists and the managed-care industry, yet too seldom have client preferences been directly heard in that debate. This study investigated consumer attitudes about the central elements of psychotherapy service delivery by 3 participant groups: self-pay clients, managed-care clients, and adults without therapy experience. Important differences of opinion were found among participant groups, yet results revealed that all 5 elements investigated were considered essential. Autonomy in treatment decision-making was ranked most important, followed by choice of therapist, copayment amount, limits to confidentiality, and ease of access to care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The economics of mental health care.

Attempts to assist psychologists involved in policy discussions regarding the economics of mental health care by summarizing important sources of information on the characteristics and trends of psychological service providers and the cost of such services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of psychology in health care delivery.

There is a wealth of professional opportunities for practicing psychologists, particularly given the recent recognition of psychology as a health care profession. A number of dimensions are discussed that can be used as a heuristic to outline the participation of psychologists in the general health care arena. Dimensions include the breadth of disease categories in which psychology has been involved, the involvement of psychologists at different stages of the progression of illnesses, and the diverse roles that psychologists may play in health care. Examples are provided to exemplify the contributions psychologists have made to health care. Recommendations are made to strengthen psychology's role in the health care system. Recent challenges are also reviewed regarding the association of health care and the delivery of services that demand the participation of psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

In pursuit of wellness: The self-care imperative.

The practice of psychology can be demanding, challenging, and emotionally taxing. Failure to adequately attend to one's own psychological wellness and self-care can place the psychologist at risk for impaired professional functioning. An ongoing focus on self-care is essential for the prevention of burnout and for maintaining one's own psychological wellness. Salient aspects of self-care are discussed, including the ethical imperative of addressing self-care throughout one's career. Three invited expert commentaries provide additional insights and recommendations on positive actions, preventive strategies, and steps to be taken by individual psychologists, by those training the next generation of psychologists, and by professional associations. Realities of the current state of psychology and a clear call for action are highlighted, with the overarching goal being the ethical and effective treatment of clients and the successful management of the challenges and stresses faced by practicing psychologists. Baker, Elman, and Schoener provide commentaries on the initial article by Barnett. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Video games in health care: Closing the gap.

Although a great deal of media attention has been given to the negative effects of playing video games, relatively less attention has been paid to the positive effects of engaging in this activity. Video games in health care provide ample examples of innovative ways to use existing commercial games for health improvement or surgical training. Tailor-made games help patients be more adherent to treatment regimens and train doctors how to manage patients in different clinical situations. In this review, examples in the scientific literature of commercially available and tailor-made games used for education and training with patients and medical students and doctors are summarized. There is a history of using video games with patients from the early days of gaming in the 1980s, and this has evolved into a focus on making tailor-made games for different disease groups, which have been evaluated in scientific trials more recently. Commercial video games have been of interest regarding their impact on surgical skill. More recently, some basic computer games have been developed and evaluated that train doctors in clinical skills. The studies presented in this article represent a body of work outlining positive effects of playing video games in the area of health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology in health care: Future directions.

The nature of health care delivery in the U.S. will change radically in the next 5 years, and the nature of psychological services provided will also change. Psychology is evolving into a primary health care profession, at least in terms of "health psychology" broadly defined. Modern clinical health psychology includes, at the minimum, rehabilitation psychology, neuropsychology, and traditional health psychology. The present article represents the views of 20 experts from this evolving area of practice and research on matters of public policy, training, and the future of psychology in health care settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physician satisfaction in a changing health care environment: the impact of challenges to professional autonomy, authority, and dominance

Despite the widespread use of self-report measures of both job-related stressors and strains, relatively few carefully developed scales for which validity data exist are available. In this article, we discuss 3 job stressor scales (Interpersonal Conflict at Work Scale, Organizational Constraints Scale, and Quantitative Workload Inventory) and 1 job strain scale (Physical Symptoms Inventory). Using meta-analysis, we combined the results of 18 studies to provide estimates of relations between our scales and other variables. Data showed moderate convergent validity for the 3 job stressor scales, suggesting some objectively to these self-reports. Norms for each scale are provided.     

Physician role change in managed care: a frontline report

Dr. Christian, Vice President and Chief Medical Officer of ManagedComp, Inc., describes the company's new managed compensation program in which the physician's role is expanded to include more accountability.     

Mental health care in the USSR.

The author received a scientist exchange grant from the National Institutes of Health and visited the USSR as a health-science representative in 1976. He reports that mental health services in the USSR are provided primarily by the medical profession through state mental hospitals and psychiatric sections in general hospitals and clinics. Drug therapy is the main treatment method, but psychotherapy is beginning to make some inroads. Family therapy settings are the newest additions to preventive mental health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The funding of psychological health care services.

Examines issues related to the funding of psychological services identified by a joint task force of the Canadian Psychological Association and the Council of Provincial Associations of Psychologists. Discussion focuses on the identification and assessment of systems, sources, and methods of payment. The review of delivery and payment systems suggests that the majority of psychologists use a few payment sources and methods and that education about payment alternatives is needed. Implementation of training in psychology practice innovations and implications of the task force findings for professional standards are discussed. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The current state of health care in the former Soviet Union: implications for health care policy and reform

OBJECTIVE: To study planning of movement in Parkinson's disease. METHODS: The spatiotemporal pattern of movement related desynchronisation (MRD) preceding a self paced voluntary wrist flexion was compared between two groups of 10 untreated right and left hemiparkinsonian patients receiving no treatment and 10 control subjects. The MRD was computed in the 9 to 11 Hz frequency band from 11 source derivations covering the frontocentral, central, and parietocentral areas, during two successive left and right experimental conditions. RESULTS: In the two patient groups the desynchronisation appeared over the primary sensorimotor area contralateral to the affected side with a shorter latency (750 ms before movement onset for the right hemiparkinsonian group and 875 ms for the left hemiparkinsonian group) than in the control group (1750 ms), only when the movements were performed with the akinetic hand. For the non-affected hand, the same latency as in the control group was noted (1750 ms). CONCLUSION: The delay of appearance of MRD in Parkinson's disease confirmed that the programming of movement is affected, thus partially explaining akinesia.     

U.S. mental health policy: Proactive evolution in the midst of health care reform.

Argues that it is vital that psychological and behavioral health care perspectives be explicitly recognized during the coming reform of the US health care system. Mental health policy should not be treated as a mere extension of physical health policy; to do so extends all the flaws of the physical health system into the psychological care arena, resulting in a mismatch with the actual health care needs of the nation. Furthermore, organized psychology must remind policymakers that psychologists provide health services in areas of health care beyond mental health. The challenge to psychology is to ensure the continuation of adequate and timely access to appropriate psychological and behavioral health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)