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Biomedical subjects

John L Young

Publications and source records attributed to John L Young.

9 recordsLinked to original sources
PubMed2006

Commentary: It's about the fundamentals.

Recent actions by the American Psychiatric Association, the American Medical Association, and the American Psychological Association document a growing consensus that health professionals should not become directly involved in hostile interrogations. Challenging questions remain regarding the permissibility of indirect involvement, such as training directed toward promoting the humanity of interrogation procedures and the reliability of their results. A fundamental challenge comes from those who hold that a physician may relinquish the caring role and proceed to disregard medical ethics altogether. Some experts have even gone so far as to allege that all existing rules of medical ethics are baseless statements and thus cannot bind anyone. Forensic psychiatrists' continuing contributions to this debate are critical.

Coercion↗
PubMed2005

Commentary: refusing to give up on forensic research.

Increasing regulation may soon cost forensic patients the opportunity to benefit from participating in research. A wise preventive strategy is the institutional use of quality assurance and related processes for regulating its internal research. Candilis and colleagues provide abundant useful information for this purpose. Additional models to consider include a centralized Institutional Review Board, study coordinators, and services researchers. Research needs to be done on the regulation of forensic research.

Clinical Protocols↗
PubMed2004

Population-based statistics for women diagnosed with inflammatory breast cancer (United States).

OBJECTIVE: The purpose of this study was to use population-based information to describe the demographic and tumor characteristics of inflammatory breast cancer (IBC) - the most aggressive form of this disease. METHODS: IBC cases diagnosed during 1994 through 1998 were reported to 26 population-based cancer registries covering approximately 40% of the US population. Rates were expressed per 100,000 female population and age-adjusted to the 2000 US population. Ninety-five percent gamma confidence limits were estimated for the rates. RESULTS: Among the 3626 women diagnosed with IBC during 1994-1998, the majority were 40-59 years old. Most tumors were diagnosed at a regional (68.9%) or distant (25.3%) stage and were poorly differentiated (49.4%). The rate of IBC was 1.3 per 100,000 for all races combined. Black women had the highest risk (1.6) and Asian and Pacific Islander women the lowest (0.7). CONCLUSIONS: IBC is an extremely rare form of breast cancer. More precise diagnostic criteria are needed to distinguish it from less aggressive forms of the disease. Future studies should use a population-based design and collect detailed clinical information, including the presence of erythema, edema or peau d'orange appearance of the skin, and other clinical signs of disease.

Adult↗
PubMed2004

The incidence of malignant non-carcinomas of the female breast.

OBJECTIVE: Demographic and tumor characteristics of all malignant non-carcinomas of the breast, including the lymphomas and myelomas, are the focus of this investigation. METHODS: Twenty-six US population-based registries identified 363,801 newly diagnosed malignant breast cancers among women during the time period 1994-1998. Of these, 4625 (1.3%) were reported simply as cancer, NOS; 357,775 (98.3%) were of epithelial origin (carcinomas or adenocarcinomas); and the remaining 1401 (0.4%) were non-epithelial in origin. All but nine of the non-epithelial breast cancers were some form of soft tissue sarcoma. RESULTS: The most common non-epithelial cancer was malignant phyllodes tumor, which accounted for 61% of these diagnoses. In addition to the 363,801 malignant cancers classified to the breast, another 613 tumors arose in the breast but were classified as myelomas or lymphomas; two as solitary myelomas, two as Hodgkin lymphoma and the remaining 609 as non-Hodgkin lymphoma. PRINCIPAL CONCLUSIONS: The median age of females with a non-epithelial cancer (53) was 10 years younger than that of women with an epithelial cancer. The age-adjusted incidence rate per 100,000 females was 0.51 for non-epithelial cancers compared to 127.05 for epithelial cancers. Adding the myelomas and lymphomas, which are traditionally included with the hematopoietic cancers, to the incidence rates for breast cancer would increase the rate by less than 0.2 per 100,000.

Adult↗
PubMed2004

Clergy counselors and confidentiality: a case for scrutiny.

As religious organizations contribute increasingly to community mental health, counseling by clergy acquires greater significance. As a result, clergy confront from time to time ethics challenges resulting from the need to balance a commitment to clients and an obligation to follow the requirements of religious doctrine. The recent New York case of Lightman v. Flaum highlights an example of this dilemma. A woman who asked two rabbis (Flaum and Weinberger) for help in her marriage complained that they had violated the confidentiality she expected of them. The rabbis requested summary judgment based on religious grounds, and the trial court rejected their request. The state's highest court concurred with an appeal court's reversal of the trial court. We discuss the arguments raised in this case about the extent to which clergy may owe a duty of confidentiality to those who consult them for psychological help, and we also consider the religion-based arguments that would fashion an exception to confidentiality in this unique context.

Clergy↗
PubMed2003

A vision for cancer incidence surveillance in the United States.

A comprehensive framework for cancer surveillance should span the entire lifespan and be capable of providing information on risk, burden, disparity, cost, cancer care, survival, and death. Cancer incidence, the point in the continuum when an individual is diagnosed with cancer, has a strong, well-developed system to produce information about newly diagnosed cancer cases. However, in the future, this system must be enhanced and integrated with other cancer surveillance networks and other systems to provide timely information on the burden of newly diagnosed patients with respect to various cross-cutting population characteristics (e.g., social, economic, race/ethnic, urbanicity, or access to care) to define, monitor, and reduce incidence and various disparities noted among population groups. Collaboration in data collection, standard setting, surveillance activities, research, education and training, data use, and advocacy among all registries and national programs will be important to the continued success of the cancer incidence surveillance system. The cancer registry is an integral part of the infrastructure to reduce the burden of cancer, including the numbers of newly diagnosed cases.

Forecasting↗
PubMed2003

The integral role of pastoral counseling by African-American clergy in community mental health.

OBJECTIVE: Little is currently known about the pastoral counseling work of pastors of African-American churches. The authors interviewed the pastors of nearly all African-American churches in a metropolitan area about their pastoral counseling work and related aspects of their ministry. METHODS: Of 121 African-American pastors identified, 99 completed a semistructured interview describing their backgrounds, attitudes, concerns, and work. The interview included detailed queries about how they understood and carried out any pastoral counseling work. RESULTS: The respondents averaged more than six hours of counseling work weekly and often addressed serious problems similar to those seen by secular mental health professionals, with whom they reported readily exchanging referrals. Many of the respondents reported having and maintaining specialized education for their counseling work, which they described as including both spiritual and psychological dimensions. Most of the pastors reported that they observe and address severe mental illness and substance abuse in their congregations and that they also counsel individuals outside their own denominations. CONCLUSIONS: African-American urban ministers functioning as pastoral counselors constitute an engaging and useful group with experiences and skills that can be tapped by interested secular professionals. Their work represents a significant mental health resource for persons who lack sufficient access to needed care.

Adult↗