Overriding Mental Health Treatment Refusals: How Much Process is “Due”?

Getting mental health treatment to patients who need it is today a much belegaled enterprise. This is in part because lawmakers have a skewed view of the enterprise, in particular regarding the treatment of patients with antipsychotic medications. The properties and uses of these medications are misunderstood by many in the legal community, with the drugs’ undesirable side effects typically overstated and the remedial effects undersold when not outright ignored. One specific legal effect has been to accord to mental patients a substantively outsized right to refuse treatment that comes with a correspondingly action-stifling dose of procedural safeguards, this despite the patients’ frequent lack of capacity to exercise the right wisely and the bad personal and systemic consequences that flow from that. The purpose of this Article is to provide better balanced and accurate evidence of the properties of antipsychotic drugs so as to convince lawmakers and advocates for the mentally disabled that it is safe to roll back some of the more counterproductive legal strictures on the effort to provide mental health treatment. An analysis of selected cases and statutes is intended to illustrate that such a roll back can and should be applied to a variety of legal and institutional contexts

Chronic thromboembolic pulmonary hypertension

C hronic thromboembolic pulmonary hypertension is defined as mean pulmonary-artery pressure greater than 25 mm Hg that persists 6 months after pulmonary embolism is diagnosed. The 2008 World Symposium on Pulmonary Hypertension 1 emphasized the importance of chronic thromboembolic pulmonary hypertension, which occurs in 2 to 4% of patients after acute pulmonary embolism. 2,3 The frequency of this condition among patients with pulmonary hypertension is unknown. Patients with chronic thromboembolic pulmonary hypertension generally present in their 40s, although this condition has been reported in patients in other age groups. 2 The diagnosis is often overlooked because many patients do not have a history of clinically overt pulmonary embolism. Although symptomatic disease develops in a substantial proportion of patients, the clinical importance of asymptomatic chronic thromboembolic pulmonary hypertension remains controversial. This condition is usually detected when pulmonary hypertension worsens and causes dyspnea, hypoxemia, and right ventricular dysfunction. Death is usually due to progressive pulmonary hypertension culminating in right ventricular failure. The risk of the development of chronic thromboembolic pulmonary hypertension is increased by factors associated with pulmonary embolism, certain chronic medical conditions, thrombophilia, and a genetic predisposition The New England Journal of Medicine Downloaded from nejm.org at HOSPITAL SIRIO LIBANES on February 1, 2011. For personal use only. No other uses without permission

Low-threshold organic laser based on an oligofluorene truxene with low optical losses

A blue-emitting distributed feedback laser based on a star-shaped oligofluorene truxene molecule is presented. The gain, loss, refractive index, and (lack of) anisotropy are measured by amplified spontaneous emission and variable-angle ellipsometry. The waveguide losses are very low for an organic semiconductor gain medium, particularly for a neat film. The results suggest that truxenes are promising for reducing loss, a key parameter in the operation of organic semiconductor lasers. Distributed feedback lasers fabricated from solution by spin-coating show a low lasing threshold of 270 W/cm(2) and broad tunability across 25 nm in the blue part of the spectrum

A preliminary investigation into the relationship between functional movement screen scores and athletic physical performance in female team sport athletes

There is little research investigating relationships between the Functional Movement Screen (FMS) and athletic performance in female athletes. This study analyzed the relationships between FMS (deep squat; hurdle step [HS]; in-line lunge [ILL]; shoulder mobility; active straight-leg raise [ASLR]; trunk stability push-up; rotary stability) scores, and performance tests (bilateral and unilateral sit-and-reach [flexibility]; 20-m sprint [linear speed]; 505 with turns from each leg; modified T-test with movement to left and right [change-of-direction speed]; bilateral and unilateral vertical and standing broad jumps; lateral jumps [leg power]). Nine healthy female recreational team sport athletes (age = 22.67 ± 5.12 years; height = 1.66 ± 0.05 m; body mass = 64.22 ± 4.44 kilograms) were screened in the FMS and completed the afore-mentioned tests. Percentage between-leg differences in unilateral sit-and-reach, 505 turns and the jumps, and difference between the T-test conditions, were also calculated. Spearman\u27s correlations (p = 0.05) examined relationships between the FMS and performance tests. Stepwise multiple regressions (p = 0.05) were conducted for the performance tests to determine FMS predictors. Unilateral sit-and-reach positive correlated with the left-leg ASLR (r = 0.704-0.725). However, higher-scoring HS, ILL, and ASLR related to poorer 505 and T-test performance (r = 0.722-0.829). A higher-scored left-leg ASLR related to a poorer unilateral vertical and standing broad jump, which were the only significant relationships for jump performance. Predictive data tended to confirm the correlations. The results suggest limitations in using the FMS to identify movement deficiencies that could negatively impact athletic performance in female team sport athletes

President\u27s Council of Black Education Correspondence 1970

Correspondence between President of USF, Albert R. Jonsen, Herold L. Perry, Samuel L. Kountz, Terry A. Francois, and Burl A. Toler regarding the creation of the President\u27s Council of Black Education

THE EFFECT OF NICOTINIC ACID ON THE CAFFEINE INDUCED SERUM FREE FATTY ACID INCREASE'

In previous publications we have reported that the infusion of caffeine into dogs (Bellet et at., 1968a) as well as the administration of caffeine or caffeinated beverages to human su