The medical device payment controversy rages on

Who will pay for investigational research? This seemingly endless debate assumes different guises as different aspects of the health care industry come under scrutiny. The latest wrinkle in the debate involves reimbursement for devices that are not FDA approved. My September column discussed the issue of funding investigational cancer therapies, specifically high-dose therapy and bone marrow transplant, as treatments for various malignancies. That controversy was centered on the use of FDA-approved drugs in settings beyond the labeled indications. However, the issue with medical devices is different. It involves implantable devices that the FDA says have not proven to be safe and effective.     

Appraising financial performance for financial institutions

The author is an investment analyst whose area of specialization is financial shares, especially in banking. The prime responsibility of the investment analyst is to the investment institutions. However, the information available to the analyst is no more than that available to shareholders in the institution being monitored. The expertise of the analyst is in seeking out the information and interpreting it for the client. There has been a considerable improvement in investor relations in the U.K. in the past few years. The author suggests that more information could be provided by the U.K. Clearing Banks—information which is readily available within the banks—which would enable the investment analyst to make important comparisons from data which is not at present available to him.     

HIV among people with mental illness: contributing factors, prevention needs, barriers, and strategies

1. Findings suggest that PWMI, including those with serious mental illness, are sexually active although some individuals, including mental health professionals, perceive them to be asexual or not sexually active. 2. PWMI may be particularly susceptible to HIV risk-related behaviors due to poor judgment, limited impulse control, deficits in problem-solving skills, and suicidal intent and self-destructive behavior. 3. Nurses, due to their close interaction with PWMI, are in key positions to document HIV risk-related behaviors and to advocate for integrating HIV risk reduction strategies into the therapeutic milieu.     

No foot in the door: an experimental study of employment discrimination against older workers

Pairs of testers, one aged 57 and one aged 32, applied for 102 entry-level sales or management jobs in the Washington, DC, metropolitan area. Although their credentials described them as equally qualified, the older applicants received less favorable responses from employers 41.2% of the time. Three quarters of these differences occurred before older applicants could fully present their qualifications. The negative employer assumptions about older workers implied by these differences in outcome were seldom explicitly stated.     

Voice and Cure: The Significance of Voice in Repairing Early Patterns of Disregulation

This paper illustrates the value of the analyst’s awareness of the importance of her voice with its various intonations in the telephone treatment of a patient with early infant/mother attachment patterns of disregulation. The authors describe the significance of a particular kind of pervasive verbal intrusion by the patient’s mother and how through the use of voice pattern, tone, and rhythm in an extended period of telephone therapy, the patient was able to solidify a more secure attachment. Finally, the authors demonstrate how the verbal music in the analyst/patient and the mother/child dyads enhances self and interactive regulation.

EMDR用于边缘型人格障碍的治疗

边缘型人格障碍(BPD)患者通常有显著的功能行使能力损害。其特征是冲动、情绪不稳、人际困难和身份认同问题,常常导致自杀行为和自杀姿态。虽然传统上认为BPD是一种慢性持久的障碍,但近期的研究却提示它可能会随着时间流逝而有所缓解,而且心理治疗可以促进缓解。BPD的病因与童年期虐待和不恰当的依恋关系有关。由于童年期虐待和创伤的重要意义,被公认有效的创伤治疗方法——眼动脱敏与再加工(EMDR)可能作为BPD的合理备选治疗方案之一。本文中的个案所获得的良好疗效阐明了EMDR在BPD治疗中的运用,提示有理由进行深入的对照研究。     

Sector Programme Approaches: Will They Work in Agriculture?

This article explores why sector‐wide approaches, in which donor funds support a single sector plan under government leadership, have performed less well in agriculture than in the social sectors. Many problems stem from the more limited, more contested and shrinking role of the state in the agricultural sector. It is also argued that sector programmes have worked best where the key constraints on sector development are the responsibility of a single ministry, whereas agricultural development requires co‐ordinated interventions across sectors. The sector approach may have a limited role in delivering better focused agricultural services, but fundamental policy questions need to be resolved first. This is more likely if support for reforms is channelled through central economic ministries and other bodies outside the agriculture ministry.     

Newborn Infants' Preference for Attractive Faces: The Role of Internal and External Facial Features

Several previous experiments have found that newborn and young infants will spend more time looking at attractive faces when these are shown paired with faces judged by adults to be unattractive. Two experimental conditions are described with the aim of finding whether the “attractiveness effect” results from attention to internal or external facial features, or both. Pairs of attractive and less attractive faces (as judged by adults) were shown to newborn infants (mean age 2 days, 9 hours), where each pair had either identical internal features (and different external features) or identical external features (and different internal features). In the latter, but not the former, condition the infants looked longer at the attractive faces. These findings are clear evidence that newborn infants use information about internal facial features in making preferences based on attractiveness. It is suggested that when newborn (and older) infants are presented with facial stimuli, whether dynamic or static, they are able to attend both to internal and external facial features.