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Last month I received a call on the Hep C Helpline from a 36 year old woman with two small children, who wanted to know more about hepatitis C treatment. She phoned the Helpline after picking up a National hepatitis C Treatment Awareness Campaign postcard displaying our details, at her local community health centre. After talking to the woman for a couple of minutes about the specifics of treatment, the conversation turned to her diagnosis experience. As it turned out, the woman had been diagnosed as having hepatitis C through her antenatal screening tests during her first pregnancy, at a hospital in one of our capital cities. Not only were these tests conducted without her knowledge or consent, but no pre or post-test counselling was given. The actual diagnosis was even more upsetting, when a nurse totally disregarded confidentiality and told the woman she had hepatitis C in front of both her husband and her mother-in-law. As a result her partnership was put under immense strain, and the women still has a very tenuous relationship with her mother-in-law. To make matters worse, in the years since the traumatic diagnosis, this woman had not sought any follow-up medical advice, social support or basic information about her hepatitis C - until now. She was both angry and hopeful when told that approximately one in four people can clear the hepatitis C virus in the initial stages of infection. Without having had a PCR test done, there was a chance she might not have the active virus. After such a terrible experience the women was left asking `this could all have been for nothing?' It's really saddening that in this day and age, situations like this are still occurring in our major hospitals. Lack of hepatitis C knowledge coupled with discriminatory attitudes, are still a reality in our health system. Until hospital policies procedures are regulated and enforced to make blanket testing of hepatitis C particularly during the vulnerable antenatal period ; a practice of the past, these injustices will continue.

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Epidemiology and Public Health at Yale University School of Medicine in New Haven, CT, USA Source : Suicide Life Threat Behav. 2004 Winter; 34 4 ; : 350-62. Related Articles, Links Summary: The influence of complicated grief CG ; on suicidality among bereaved adults was examined. The Yale Evaluation of Suicidality scale and the Inventory of Complicated Grief-Revised were administered to 309 bereaved adults in face-to-face interviews conducted at baseline 6.2 months post-loss ; and at follow-up 10.8 months post-loss ; . Cross-sectionally, CG was associated with a 6.58 95% CI: 1.74-18.0 ; times greater likelihood of "high suicidality" at baseline, and an 11.30 95% CI: 3.33-38.10 ; times greater risk of high suicidality at follow-up, after controlling for gender, race, major depressive disorder MDD ; , posttraumatic stress disorder PTSD ; , and social support. Longitudinally, CG at baseline was associated with an 8.21 95% CI: 2.49-27.0 ; times greater likelihood of high suicidality at follow-up, controlling for the above confounders. The study results indicate that CG substantially heightened the risk of suicidality after controlling for important confounders such as MDD and PTSD, suggesting that CG poses an independent psychiatric risk for suicidal thoughts and actions, for example, inderal 40. Inderal is generically prescribed as propranolol and is a member of the family of medications known as beta blockers and levofloxacin.
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Allaste, A. 2004 ; : "Uimastite kasutamine" Eesti elanikkonnauuring 2003 alusel. In: "Valikud ja vimalused. Argielu Eestis 19932003". Allaste, A. 2005 ; : Making Distinctions: New Bohemians and Restricted Drug Use. In: Lalander P. & Salasuo, M. Eds. ; : Drugs and Youth Cultures Global and Local Expressions. NAD Publication No. 46. Helsinki: Nordic Council for Alcohol and Drug Research, 4761. Bossius, T. & Sj, F. 2004 ; : Musikfestivaler och droger [Music festivals and drugs]. Rapport 4. Mobilisering mot Narkotika MoB ; . Sockholm, 32. Bretteville-Jensen, A.-L. & degrd, E. 1999 ; : Injeksjonsmissbrukere i Norge [Injecting drug users in Norway]. SIFA-rapport nr. 4. Bretteville-Jensen, A.-L. & Skretting, A. 2005 ; : Survey among young adults aged 21 30 years. SIRUS: unpublished data. Drogutvecklingen i Sverige [Drug trends in Sweden]. Rapport nr 71. Stockholm: Centralfrbundet fr alkohol och narkotikaupplysning CAN ; 2003. Goncharov 2004 ; : Personal interview June 16, 2004. Gourvitch, Jossif N. 2004 ; : Personal interview. June, 15, 2004. Gourvitch, J. N.; Tsvetkova, L. A. & Shur, N. V. 2004 ; : Narkopoteblenie v studenskoi srede; povedencheskie osobennosti [Drug use among students. Changes in drug use patterns]. The Journal of Sociology and Social Anthropology. Vol. 7 no. 1 25 ; . Granath, S.; Svensson, D. & Lindstrm, P. 2003 ; : Polisens insatser mot narkotikabrottsligheten Omfattning, karaktr och effekter [Police action against drugrelated crime Extent, nature and effects]. Brottsfrebyggande rdet BR ; , Rapport 2003: 12. : bra dynamaster publication pdf archive 03121126068 . Gunnlaugson, H. 1998 ; : Narkotikabruk, attityder och kontrollpolitik i Island. En jmfrelse med det vriga Norden [Drug use, attitudes and control policy in Iceland. A comparison with the other Nordic countries]. Guttormsson, U.; Andersson, B. & Hibell, B. 2004 ; : Ungdomars drogvanor 1994 2003. Intervjuer med 1624 ringar [Young people's drug habits 1994-2003. Interviews with young people aged 16-24]. CAN Rapport 75: Stockholm: Centralfrbundet fr alkohol och narkotikaupplysning CAN ; . Hakkarainen, P.; Hbner, L.; Laursen, L. & degrd, E. 1996 ; : Drug use and public attitudes in the Nordic countries. In: Hakkarainen, P.; Laursen, L. & Tigerstedt, C. Eds. ; : Discussing drugs and control policy. NAD publication No. 31. Helsinki: Nordic Council for Alcohol and Drug Reserach, 125164. Hakkarainen, P. & Metso, L. 2001 ; : Onko huumeidenkytn yleistyminen taittumassa? Vuoden 2000 huumekyselyn tulokset [Is the growth of drug use plateauing? The results of the 2000 drug survey]. Yhteiskuntapolitiikka, 66 3 ; : 277283. Hakkarainen, P. & Metso, L. 2003 ; : Huumeidenkytn uusi sukupolvi [Drug use: the new generation]. Yhteiskuntapolitiikka, 68 3 ; : 244256.

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J-E04001-02 Artery Aneurysms, Cognitive and Behavioral Deficits and Anxiety Disorder Predating. Ms. Downey remained home for a very brief period of time before she was admitted to Delaware State Hospital from May 5, 1994 through July 13, 1994. She was admitted on emergency certificates as a result of drinking, misusing medication, leaving home and threatening to kill herself while drinking. She was diagnosed as suffering from Psychotic Disorder, Not Otherwise Specified, Organic Brain Syndrome and Alcohol Abuse, Episodic. Ms. Downey apparently functioned marginally until she was re-admitted to Delaware State Hospital from September 30, 1994 through March 3, 1995. That record indicated that Ms. Downey had been transferred from Wilmington Medical Center in May, 1994 to Delaware State Hospital. Upon discharge from her first admission, her daughter could not maintain her at home due to Ms. Downey's affective instability, child-like manipulative behavior and lack of judgment and insight concerning her own safety. It was noted that she ate erratically and frequently left home at all hours. Her most destructive behavior was secondary to her poor judgment. While hospitalized, she frequently asked for kisses and made sexual comments to other patients and staff. On sign-outs, she walked away from her mother and daughter and was described as seductive and manipulative of staff. Ms. Downey was diagnosed as suffering from Personality Change Disinhibited ; Due to Bilateral Cerebral Aneurysms; Alcohol Abuse and Neuroleptic-Induced Tardive Dyskinesia. While in the hospital, she was on special precautions which involved fifteen minute checks. She did have passes with her family which were always escorted. She did not demonstrate seizure activity during the hospitalization. She was placed on Tegretol, 200 mg., four times a day; Inderal, 20 mg., four times a day; Visteril, 50 mg., six times a day; and BuSpar, 5 mg., six times a day. She was subsequently discharged to the Brookwood Retirement Home, where she remained from March, 1995 until her next psychiatric hospitalization on October 10, 1995. While at the Brookwood Retirement Home, Ms. Downey received outpatient care from the Family Practice Associates. She was also re-admitted to the Medical Center of Delaware from March 11, 1995 through March 15, 1995. She had been getting out of a bathtub when she fell and sustained a right trimalleolar fracture. She underwent a closed reduction in the 5 and miconazole.

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MENTORS 171. Words of wisdom. Agnew, T. Nursing Standard Vol. 20 No. 6 19.10.05 Pages 24-26 METHADONE 172. Methadone doses of 100mg or greater are more effective than lower doses at suppressing heroin self-administration in opioid-dependent volunteers. Donny, E.C. et al Addiction Vol. 100 No. 10 Oct '05 Pages 1496-1509 MIDWIFERY 173. Midwifery-led care: establishing a postnatal perineal clinic. Dugdale, A.F; Hill, S.R British Journal of Midwifery Vol. 13 No. 10 Oct '05 Pages 648-653 174. Admissions and delivery outcomes at a midwife-led unit: 1995-2005. Andres, M; Rankin, J British Journal of Midwifery Vol. 13 No. 10 Oct '05 Pages 643-647 Telemedicine: supporting normality in midwife-led community units. Warriner, S; Martinez, A British Journal of Midwifery Vol. 13 No. 10 Oct '05 Pages 654-658.

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We are pleased to send you our 2004 Drug Trend Report; Navigating the New Health Economy. This publication examines the factors that influenced prescription drug spending in 2003, and looks beyond the horizon at the next 3 years. The report combines independent and proprietary research with scientific data and analysis in a format that we are confident you will find concise yet complete. We also report on legislative and regulatory changes, advances in technology, and the new approaches to benefit management that are rapidly transforming healthcare in America. These changes pose risks and challenges for prescription benefit plans, but also offer many opportunities for controlling costs and improving care. Charting a clear course Benefit providers confront an emerging and often turbulent new health economy. Still, by collaborating with our customers, we have succeeded in reducing average drug trend for Medco clients to 10.2%, a rate lower than either the 2002 average of 12.9%, or the 2003 national rate of 13.4% as projected by the Centers for Medicare and Medicaid Services. * Additionally, more than half of our largest integrated accounts experienced growth rates below 10% during 2003 the median drug trend for Medco clients was 9.6% ; . Although overall progress is both meaningful and measurable, we all acknowledge that there is much important work ahead. Stemming the tide We encourage our customers to take advantage of the company's many innovative options in plan design and clinical management. By thoughtfully constructing and actively managing the pharmacy benefit, plans maintain member satisfaction, provide high-quality care, and save money. In the pages that follow, you will learn how our collaborative efforts have helped clients control drug trend, including: A large employer-client that added a third tier to an incentive formulary design, increased co-payments for generic and nonpreferred brand-name medications, and changed coverage rules for nonsedating antihistamines . held drug trend below 6% for 2 years in a row. Another employer that adjusted brand-name formulary co-payments for its nonunion employees and also implemented coverage rules for several medications . reduced drug trend to 7.2% from 20.6%. A large government plan that increased mail order use by 50% . reduced drug trend to minus 4.2% from plus 15%. Access to expert guidance As always, our dedicated sales and account professionals stand at the ready to help you navigate the waters ahead. We welcome the chance to talk through the specific issues that you face--and we're interested in your thoughts on this year's report. Sincerely, WE WOULD LIKE TO ACKNOWLEDGE THE FOLLOWING PEOPLE FOR THEIR OUTSTANDING CONTRIBUTION TO THE MEDCO 2004 DRUG TREND REPORT and itraconazole.
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