Parental reactions to birth-defective children

100 Breast reconstruction has been made less difficult recently, but complications, both emotional and physical, still ensue. They may arise from errors in timing, unrealistic patient expectations, and limitations imposed by the type of mastectomy performed. Vigorous attempts must be made to prevent complications through accurate patient assessment, patient education, and skilled, up-to-date surgical techniques. METItODS OF SUPPORT 6) Parental reactions to birth-defective children VERNON, M. Dept. Psychol., West. Maryland Coll., Westminster, Md., U.S.A. Postgrad. Meal. 65(2), 183-190, 1979 The birth of a defective child usually has pervasive traumatic effects. Certain psychologic mechanisms, ~ueh as denial and guilt, are normal reactions for 'parents in coping with such a tragedy. An understand!ng of these mechanisms is necessary if the physician is to help the family in its adjustment. 7) The roles of chaplains in community mental health SLAUGHTER, J. T., BENNINK, R. J., CARLSON, R. J., and NISI, W. F. Hosp. Community Psychiatry 29(12), 797-800, 1978 Four chaplains working in various community mental health settings--urban and rural, inpatient and outpatient--describe thcir roles with patients, center staff, and the community. Chaplains have a direct role in patient care, counsel patients about general issues of living, and help center staff understand the role religion plays in a patient's life. They help staff realize that religion is a valid support system for patients, and help them respond to patients' religious behavior or conversations. They also offer formal inservice training or informal training by working with a therapist in helping patients deal with specific problems, such as grief and loss. Because center staff arc often transient or have trained in other geographic areas and are unfamiliar with local customs, the chaplain can inform staff about local mores and can be a bridge between the center and the community. 8) Behaviour modification: Three techniques for decreasing the stress of hospitalization and surgery MARSHALL, M. A. Can. Med. Assoc. J. 119(1), 45-47, 1978 Accurate information and reassurance about what is to happen are necessary, but not sufficient, conditions for optimal coping with stress. The more anxious an individual is to begin with, the lcss likely it is that these tools will be effective without additional help. Hyp-

nosis provides another tool for minimizing subjeeti~ anxiety, but itsuse requires specially trained personn and considerable preparation time. Systematic relax~ tion, on the other hand, has the advantages of bol these approaches. THE ROLE OF THE HEALTII PROFESSIONA 9) Futurism, aging, and health education BURDMAN, G. D. M. Univ. Oregon, Eugene, Ore., U.S.A. Educ. Gerontol. 4(1), 25-31, 1979 Gerontology, the interdisciplinary study of aging, r, quires increasingly more attention to the future. Whi the task of prognosticating is extremely difficult, it nonetheless vital if we are to begin bridgin~ the g~ between the theory, policy statement, and actual praq flee in the field of aging. There is an urgent need~ prepare competent individuals for direct service, ar, there is equally as important a mission in providit increased exposure to gerontology throughout tt curricula. The combined Health Edueation-Geront0 ogy Program at the University of Oregon has begun 1 address these critical areas. EVALUATION 10) Preventive health care in the IIMO: Cost benel issues ROWE, D. S. and BISBEE, G. E., JR. Yale Univ. Health Services, New Havcn, Con~ U.S.A. J. Am. Coll. Health Assoc. 26(6), 298-301, 1978 The Yale Health Plan (YHP) functions as a u• versity-based HMO for Yale University students a~ the faculty, staff, and their dependents. In 1971, wh~ the program began, the health plan elected to offer one of its benefits an annual physical examinatk performed by a physician. During the last seven year there has been increasing evidence that patients, pa ticularly those without complaints, derive little reed cal benefit from these examinations. The patient popl lation, which has been repeatedly informed of t[ efficacy of an annual physical examination throu[ advertisements by national groups and the health pl~ during its early years, continues to cxpect it as cornerstone of high-quality medical practice. T[ study was designed to assess the costs and benefits 1 the annual physical examination for a sample i graduate students at Yale University. The role alternative forms of health education, as well as t[ medical eff• of the annual physical examinatiol are discussed.

D ~ k l q " ~(blIN,SEI.I.ING AND HEALTH EDUCATIC]