When pregnant women and their physicians disagree on the need for cesarean section: no simple solution

This article provides an analysis of why women might refuse cesarean sections that are advised by their physicians. It presents a review of court cases, ethical opinions, and recommendations in the literature and lists the legal requirements for informed consent. The author delineates the process of weighing whether or not a court order should be requested.     

Assessing equity in access to health care provision in the UK: does where you live affect your chances of getting a coronary artery bypass graft?

STUDY OBJECTIVES: Equity should be monitored routinely for all health care services, but ideal studies for each service would be prohibitively expensive and time consuming. A simple, quick, and cheap method for the preliminary exploration of equity in health care provision using routine data was devised. This method was illustrated by examining whether coronary artery bypass graft (CABG) operations reflect socioeconomic differences in ischaemic heart disease (IHD) mortality. DESIGN: Ecological comparison of operation rates was undertaken for CABG for 1991 and IHD mortality for 1981-85 by quartiles of Townsend deprivation score. SETTING: North East Thames Regional Health Authority, London, UK. SUBJECTS: All residents of this region aged 35-74 were the denominator population. Numerators were 26,834 IHD deaths and 1041 CABG operations for the defined time periods. MAIN RESULTS: IHD mortality showed a steady, significant increase with increasing area deprivation scores for both men and women. CABG rate ratios increased linearly for women, while for men there was a U shaped pattern, being lowest for the second and third quartiles. This pattern was attenuated, but not abolished, when adjusted for geographical proximity to cardiothoracic surgical units. The ratio of CABG operations to IHD mortality by deprivation was relatively constant in women suggesting equitable provision. In men, this ratio was significantly lower for the third quartile. CONCLUSIONS: Inequities may exist in the provision of CABG operations for men in this region and this finding should be the stimulus for further detailed studies. Other health care systems should also examine equity in provision.     

What you need to know: interpreting hepatitis B viral markers

Nutrition has taken on great importance in the health considerations of the general population. To meet expectations many fields have been called to contribute. With his multi-disciplined training the Pharmacist can and should have an important role to play. Upstream, the agro-food industry has many opportunities to offer. Our knowledge of Genetics, Molecular Biology and Botany can be a great advantage. Nutriceuticals are at the interface of nutrition and medicine. They concerns foods which have preventative or curative properties for certain illnesses. Are we going to be able to integrate into this new concept? Administered in pharmacological doses certain nutriments are indeed drugs. The Pharmacist should have a better training in Nutrition in order to be able to do his job properly. In hospitals the Pharmacist dispenses and sometimes prepares solutions for parenteral nutrition, while the biologist participates in denutrition diagnosis.     

Everything you need to know to understand the controversies you learned from psychological research: A comment on the Rind and Lilienfeld controversies.

Psychological theory and research can help explain some of the aspects of the controversies that arose over articles written by B. Rind et al(see record 1998-04232-002) and by S. O. Lilienfeld (see record 2002-10795-003). In particular, one needs to distinguish between rational and intuitive thinking, to recognize the power of context, to be reflective in one's own thinking, and to realize the costs of defying the crowd. There are steps one can take to be wiser and more balanced in one's own thinking than one may have been in the past. One such step is to resolve conflicts among psychologists by attempting to defuse rather than to exacerbate or avoid them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Elevating the status of psychologists: A simple solution is neither simple nor a solution.

Discusses the article by B. D. Forman and S. A. Shackar (1981) in which they discuss how psychologists can improve their status so as to be viewed as "real doctors." The current authors point out that a major difficulty with achieving this status lies in state legislative processes. An example is used of how state laws regulate who can receive cadavers for experimental use and how the cadavers can be used. Some states refuse to recognize psychologists as permissible recipients of cadavers and prohibit the inclusion of psychological techniques as permissible procedures that can be performed on cadavers. (1 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How the trend to elective dental procedures influences your practice

Malignant mesenchymal tumours of the breast are rare neoplasms. Their incidence varies from 1%-3% of all malignant breast tumours (1). Stromal sarcoma of the breast is an extremely uncommon tumour (2). We present a rare case of advanced stromal sarcoma of the breast successfully managed with radical surgery and radiotherapy.     

Economics and psychology practice: What we need to know and why.

Economic contexts and trends relevant to the practice of psychology in mental health and health settings are presented to help practitioners plan better for the future. Professional skills alone are no longer sufficient to thrive and deliver quality services in the current economic climate. A greater focus on understanding the economic indicators for psychology is necessary too. This includes the cost-driven policies, health and behavioral health financing, demands for accountability, losses, and opportunities inherent in the major systemic health care changes occurring in the United States. Practical questions with economic implications about the direction of psychology practices are raised, and the role of psychology initiatives designed to advance practice, which take both professional and economic factors into account, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relocating your psychotherapy practice: Packing and unpacking.

A growing number of psychotherapists are facing the challenge of elective relocation of their practices. In so doing, psychotherapists are confronted by many questions about how to leave (close a practice) and how to arrive (open a new practice in a different setting). This article focuses on a number of the cognitive and affective experiences of the therapist during this period of time. The authors' own experiences with this process as well as the limited literature on the subject inform the discussion. Practical recommendations for constructive management of this process are presented. The decision and experience of elective practice relocation can have transformative effects on the prepared practitioner. (PsycINFO Database Record (c) 2010 APA, all rights reserved)