Appetite for change: a multidisciplinary team approach to behavioral modification for weight management in a community health group setting.

Purpose: Obesity is a growing issue in Australia with limited evidence for brief community based intervention. This preliminary study aimed to investigate the long term effects of a 4-week group based multidisciplinary behavior management program for weight loss in the community health setting.

Method: A quasi-experimental study design was employed recruiting patients referred to two Community Health Centers.

Cognitive functioning in children on dialysis and post-transplantation.

We studied 124 children, 62 patient-subjects who had end-stage renal disease (ESRD) and 62 sibling-controls who closely matched the patient-subjects in terms of their ethnicity and their socioeconomic status, to discern whether children with ESRD would perform less well than their siblings on standardized achievement and intelligence quotient (IQ) tests, and to determine whether ethnicity would influence such results. The subjects were recruited from nine pediatric transplant and dialysis centers across the United States. Thirty-one subjects were white (Euro-American), 17 were African-American, and 14 were categorized as 'other'.

Infectious diseases presentations of Munchausen syndrome by proxy: case report and review of the literature.

Munchausen syndrome by proxy is a form of abuse, usually of a child by a parent, in which a factitious illness is reported or produced in the child, resulting in unnecessary medical evaluations and treatments. A dramatic case of a 17-month-old infant with recurrent polymicrobial bacteremia prompted a review of cases diagnosed by the Pediatric Infectious Diseases consultation service at our referral children's hospital and a review of the infectious diseases presentations in the medical literature. The infectious diseases presentations of the syndrome as well as criteria for the diagnosis are reviewed and discussed.

What went wrong: multiple perspectives on an adolescent's decision to refuse blood transfusions.

Persons with religious beliefs that conflict with mainstream medical practice create a tension for clinicians between honoring the different religious perspectives of the individual or carrying out what they believe to be their professional obligation. This is a patient presentation of an adolescent Jehovah's Witness who refuses blood transfusions. The major issue in this patient is the conflict among three values (1) respect for religious beliefs, (2) respect for a competent person's right to refuse treatment, and (3) the ability of an adolescent to make good decisions for himself.