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PubMed · 7931610

Toward better balance.

J T Hoff
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Abstract

The AANS was founded in 1931 as an educational and scientific organization whose principal purpose was to foster optimum neurosurgical care. Because socioeconomic and political pressures on medicine generally and neurosurgery specifically have escalated in recent years, the American Association of Neurological Surgeons (AANS) has been required to respond effectively to matters beyond its traditional role. However, the AANS has lacked an effective, focused policymaking process to deal with socioeconomic concerns despite existing expertise within the specialty. The AANS now needs to develop a comprehensive socioeconomic effort that is consistent with its more traditional educational and scientific activities. A Task Force on Governance has been appointed to address how the Association's governance structure can reflect all the needs of our specialty in times of economic uncertainty and health care reform.

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CommunicationHealth Care ReformNeurosurgeryPolicy MakingSocieties, MedicalSocioeconomic FactorsJournal Article

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BibTeXRIS

J T Hoff. 1994. Toward better balance.. https://doi.org/10.3171/jns.1994.81.5.0651

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Information-sharing among couples considering multifetal pregnancy reduction.

OBJECTIVE: To determine the information-sharing strategies of couples considering fetal reduction, and the impact of these strategies on the chances of encountering hostility in their social networks. DESIGN: Cross-sectional design of semistructured qualitative interviews, coded with respect to sharing strategies and level of personally directed hostility encountered. SETTING: Multiple Pregnancy Management Program, Comprehensive Genetics, New York, New York. PATIENT(S) AND INTERVENTION(S): Fifty women and their partners who were making a first visit to our maternal-fetal management facility, in order to consider the possibility of multifetal reduction as a pregnancy-management strategy. MAIN OUTCOME MEASURE(S): Development of information-sharing strategies, and the chances of encountering personally directed hostility regarding multifetal reduction associated with more and less selective strategies. RESULT(S): Four information-sharing strategies emerged from the analysis. Two of these strategies were relatively open (extended network, and both parents). Two other strategies were relatively selective (qualified family and friends, and defended relationship). The selective strategies were significantly less likely to encounter to encounter personally directed hostility (odds ratio, 3.88; 95% confidence intervals, 0.87-17.30). CONCLUSION(S): Selective sharing of information for couples considering multifetal prgnancy reduction is a potentially useful strategy for moderating potentially stressful relationships in their social networks. Clinics should find a way of integrating the discussion of selective sharing into their clinic's cultural repertoire of patient-support services.

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