Capitol Hill forecast: the more things change.
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Biomedical subjects
Publications and source records attributed to L Kaeser.
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Eosinophilia has been encountered from 0.2 to 61.7% in clozapine-treated patients, mostly with a transient course and spontaneous remission. There have been few reports, however, which have investigated a challenge with clozapine in patients previously showing eosinophilia. Two case reports are presented: the first with clozapine challenge after eosinophilia, the second under clozapine treatment and no previous haematological side effects. The challenge case showed eosinophilia with 1.2 10(9)/l (z = 1.79, p = 0.04) being followed by normalization despite clozapine continuation, whereas the maximum value reached 2.1 10(9)/l in the single episode case, with consecutive normalization and uninterrupted treatment. Eosinophilia caused by clozapine was observed in challenge, preceded by a faster neutrophil production and consecutive decrease (z = 2.27, p = 0.01). A challenge with clozapine was feasible and showed no clinical symptoms of eosinophilia.
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INTRODUCTION: The purpose of this article is to review the experiences of family planning clinic providers in making Norplant available to adolescents. We look specifically at the proportions of women receiving the implant from these providers who are teenagers, the policies adopted regarding implant education and whether or not parental consent is required for minors. Pricing policies and the implications of high method cost for teenagers are discussed. Finally, some of the policies adopted by state agencies related to adolescent use of the implant are reviewed. METHODS: The data come from two national surveys conducted by the Alan Guttmacher Institute (AGI). The first, a survey of family planning agencies, collected data from 616 family planning providers of clinic services (response rate 69%). The second surveyed the Medicaid, health and welfare agencies in all 51 jurisdictions about policies related to Norplant. RESULTS: Over one-quarter of all contraceptive implants inserted by family planning agencies were provided to teenagers. Teenagers were routinely informed about the implant in about 85% of those clinics offering implant services. Few state agencies notify women about the implant. Twenty-three percent of all family planning agencies providing implant services report that parental consent must be obtained prior to implant insertion. The Medicaid program has paid for a majority of implant insertions at family planning agencies. CONCLUSIONS: Teenagers who rely on publicly funded family planning clinics for contraceptive services face a variety of barriers in obtaining Norplant. High method cost, parental consent requirements and issues related to Medicaid eligibility are likely to deter some teenagers who might otherwise choose Norplant.
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Despite the need for more safe and effective contraceptive drugs and devices, enormous barriers to contraceptive research and development have been raised in the United States. The designation of contraceptives as orphan drugs, with concomitant incentives, may be warranted to encourage private manufacturers to reenter the field.
The study supports the idea that institutionalized elders' quality of life can be enhanced without increasing the cost of nursing care. By increasing resident choice and control over daily activities, well-being is enhanced despite a declining health status. Staff attitudes toward resident control and choice can be positively affected by implementing the Quality of Life Nursing Care Model.